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RESUMEN El abandono precoz de lactancia materna es una problemática de interés mundial. Con el objetivo de determinar la asociación entre factores maternos y duración de la lactancia materna exclusiva (LME) se realizó un estudio observacional, analítico, de cohorte, en niños de seis meses de edad y sus madres, que habitan en el área del policlínico Jimmy Hirzel, municipio Bayamo, provincia Granma, durante el periodo enero-diciembre del 2018. Integraron la muestra 140 niños y sus madres, seleccionados por criterios de inclusión y exclusión. Se exploraron variables maternas: edad, escolaridad, ocupación, paridad, procedencia, conocimientos sobre lactancia materna y prácticas alimentarias con lactancia materna exclusiva. Se utilizaron métodos teóricos, empíricos y estadísticos. Como resultados relevantes, al caracterizar la muestra destacaron las madres de 20 a 34 años de edad (75,7%), nivel de escolaridad preuniversitario (37,1 %), trabajadoras (40,7%), con un solo hijo (66,4%), de procedencia rural (70,7%), con conocimientos adecuados sobre lactancia materna (63,6%). El 65 % ofreció a sus hijos LME por seis meses, la causa principal del abandono del amamantamiento exclusivo fue la hipogalactia materna (59%). Los factores maternos que se asociaron al abandono de la práctica antes de los seis meses fueron: edad (madres adolescentes o añosas 0,0165), menor nivel de escolaridad (0,0373), primiparidad (p= 0,009) y bajo nivel de conocimiento sobre lactancia materna (0,0001).

ABSTRACT The early abandonment of breastfeeding is a problem of global interest. In order to determine the association between maternal factors and duration of exclusive breastfeeding (SCI), an observational, analytical, cohort study was conducted in six-month-old children and their mothers, who live in the Jimmy Hirzel polyclinic area, Bayamo municipality, Granma province, during the period January-December 2018. The sample comprised 140 children and their mothers, selected by inclusion and exclusion criteria. Maternal variables were explored: age, schooling, occupation, parity, origin, knowledge about breastfeeding and exclusive breastfeeding feeding practices. Theoretical, empirical and statistical methods were used. As relevant results, when characterizing the sample, mothers from 20 to 34 years old (75.7%), pre-university level of education (37.1%), workers (40.7%) stood out. , with a single child (66.4%), of rural origin (70.7%), with adequate knowledge of breastfeeding (63.6%). 65% offered their children SCI for six months, the main cause of abandoning exclusive breastfeeding was maternal hypogalactia (59%). The maternal factors that were associated with abandoning the practice before six months were: age (adolescent or elderly mothers 0.0165), lower level of education (0.0373), primiparity (p = 0.009) and low level of knowledge about breastfeeding maternal (0.0001).

RESUMO O abandono precoce da amamentação é um problema de interesse global. Para determinar a associação entre fatores maternos e duração do aleitamento materno exclusivo (LM), foi realizado um estudo observacional, analítico e de coorte em crianças de seis meses e suas mães, residentes na área policlínica de Jimmy Hirzel. , Município de Bayamo, província de Granma, no período de janeiro a dezembro de 2018. A amostra foi composta por 140 crianças e suas mães, selecionadas por critérios de inclusão e exclusão. As variáveis ​​maternas foram exploradas: idade, escolaridade, ocupação, paridade, procedência, conhecimento sobre aleitamento materno e práticas de aleitamento materno exclusivo. Foram utilizados métodos teóricos, empíricos e estatísticos. Como resultados relevantes, ao caracterizar a amostra, destacaram-se mães entre 20 e 34 anos (75,7%), nível de ensino pré-universitário (37,1%), trabalhadoras (40,7%). , com um filho solteiro (66,4%), de origem rural (70,7%), com conhecimento adequado sobre aleitamento materno (63,6%). 65% ofereceram SCI aos filhos por seis meses, a principal causa do abandono do aleitamento materno exclusivo foi a hipogalactia materna (59%). Os fatores maternos associados ao abandono da prática antes dos seis meses foram: idade (mães adolescentes ou idosas 0,0165), menor escolaridade (0,0373), primiparidade (p = 0,009) e baixo nível de conhecimento sobre aleitamento materno materna (0,0001).

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RESUMEN El único alimento que debe recibir el bebé durante los primeros 6 meses de vida es la leche de su madre. Cualquier sustancia que ella consuma mientras esté lactando tiene repercusiones en su hijo, por lo que la utilización de medicamentos, fitofármacos u otras sustancias debe ser por prescripción facultativa y rigurosamente vigilada. Con el objetivo de caracterizar el uso de medicamentos y fitofármacos en madres durante el periodo de lactancia, se realizó un estudio observacional descriptivo, de corte transversal, en diez consultorios urbanos de Bayamo, provincia Granma, durante el periodo septiembre 2017 a abril 2018. El universo agrupó a las madres lactantes pertenecientes a dichos consultorios, y la muestra la integraron las que aceptaron ser incluidas en la investigación, previo consentimiento informado. Se caracterizaron las madres según las variables siguientes: nivel de escolaridad, medicamentos y fitofármacos consumidos, duración de la lactancia materna exclusiva según consumo de medicamentos y tipo de medicamento que motivó la suspensión de la lactancia materna. Se emplearon métodos teóricos, empíricos y como estadísticos (de la estadística descriptiva, las frecuencias absolutas y relativas). Como resultados relevantes, el 64 % de las madres tenía entre 20 y 34 años y el 54,7 % había vencido el nivel de escolaridad preuniversitario; el 69,3 consumía medicamentos y 41,3 %, fitofármacos, destacando dipirona e ibuprofeno en los primeros y la menta, en los segundos. Se concluyó que los medicamentos más influyentes en la suspensión de la lactancia materna fueron el clorodiazépoxido y la amiodarona.

ABSTRACT The only food that the baby should receive during the first 6 months of life is the milk of his mother. Any substance she consumes while breastfeeding has repercussions on her child, so the use of medications, phytopharmaceuticals or other substances must be by prescription and strictly monitored. In order to characterize the use of medicines and phytopharmaceuticals in mothers during the period of breastfeeding, a descriptive, cross-sectional observational study was conducted in ten urban offices in Bayamo, Granma province, during the period September 2017 to April 2018. The The universe grouped nursing mothers belonging to these offices, and the sample was made up of those who agreed to be included in the research, with prior informed consent. Mothers were characterized according to the following variables: level of schooling, medications and phytodrugs consumed, duration of exclusive breastfeeding according to medication consumption and type of medication that led to the suspension of breastfeeding. Theoretical, empirical and statistical methods were used (from descriptive statistics, absolute and relative frequencies). As relevant results, 64% of the mothers were between 20 and 34 years old and 54.7% had overcome the level of pre-university education; 69.3 consumed medications and 41.3%, phytopharmaceuticals, highlighting dipyrone and ibuprofen in the former and mint, in the latter. It was concluded that the most influential medications in the suspension of breastfeeding were chlorodiazopoxide and amiodarone.

RESUMO O único alimento que o bebê deve receber durante os primeiros 6 meses de vida é o leite de sua mãe. Qualquer substância que ela consuma enquanto amamenta repercute em seu filho, portanto o uso de medicamentos, fitofármacos ou outras substâncias deve ser por prescrição e estritamente monitorado. Com o objetivo de caracterizar o uso de medicamentos e fitoterápicos em mães durante o período de aleitamento materno, foi realizado um estudo observacional descritivo, transversal, em dez consultórios urbanos em Bayamo, província do Granma, no período de setembro de 2017 a abril de 2018. O universo agrupou as nutrizes pertencentes a esses consultórios e a amostra foi composta por aqueles que concordaram em ser incluídos na pesquisa, com consentimento prévio informado. As mães foram caracterizadas de acordo com as seguintes variáveis: nível de escolaridade, medicamentos e fitoterápicos consumidos, tempo de aleitamento materno exclusivo segundo o consumo de medicamentos e tipo de medicamento que levou à suspensão do aleitamento materno. Métodos teóricos, empíricos e estatísticos foram utilizados (da estatística descritiva, frequências absolutas e relativas). Como resultados relevantes, 64% das mães tinham entre 20 e 34 anos e 54,7% haviam superado o nível de ensino pré-universitário; 69,3 consumiram medicamentos e 41,3%, fitofármacos, destacando a dipirona e o ibuprofeno no primeiro e o hortelã no segundo. Concluiu-se que os medicamentos mais influentes na suspensão da amamentação foram clorodiazopóxido e amiodarona.

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RESUMEN El alcoholismo constituye la más relevante toxicomanía de nuestros días. Enseñar a los adolescentes acerca del alcoholismo y sus desfavorables consecuencias, es una manera de favorecer la percepción del riesgo y contribuir a la prevención de esta enfermedad. Con el objetivo de modificar la percepción del riesgo de alcoholismo y sus consecuencias, se realizó un estudio de intervención educativa cuasi experimental en adolescentes del Reparto Jesús Menéndez de Bayamo, Granma, 2015-2017. Se trabajó con una muestra de 180 adolescentes de 15 a 19 años de edad. Variables estudiadas: independiente (intervención educativa) y dependiente (percepción de riesgo de alcoholismo y sus consecuencias para el organismo, el ambiente familiar y social). La investigación se realizó en cuatro etapas: diagnóstico, diseño y validación, aplicación y evaluación. Se emplearon métodos teóricos, empíricos y estadísticos. Como medidas de resumen se utilizaron las frecuencias absolutas y relativas, y la prueba de los rangos con signo de Wilcoxon para determinar la existencia de diferencias estadísticamente significativas antes y después de la Intervención, con un nivel de significación del 5%, calculado con el auxilio del programa estadístico profesional SPSS 22.0 para Windows. Inicialmente, predominó el bajo nivel de conocimiento (55,6%), las creencias inadecuadas sobre consumo nocivo del alcohol (86,7%) y baja percepción de riesgo (55,6%). Después de la intervención, la mayoría de los adolescentes había mejorado los conocimientos, las creencias y la percepción del riesgo, con diferencias estadísticamente significativas que demostraron que los resultados se debieron a la labor educativa y no al azar.

ABSTRACT Alcoholism is the most important drug addiction of our time. Teaching adolescents about alcoholism and its unfavorable consequences, is a way to promote the perception of risk and contribute to the prevention of this disease. With the objective of modifying the perception of the risk of alcoholism and its consequences, a study of quasi-experimental educational intervention was conducted in adolescents of the Jesús Menéndez de Bayamo, Granma, 2015-2017. We worked with a sample of 180 adolescents from 15 to 19 years of age. Variables studied: independent (educational intervention) and dependent (perception of risk of alcoholism and its consequences for the organism, the family and social environment). The research was carried out in four stages: diagnosis, design and validation, application and evaluation. Theoretical, empirical and statistical methods were used. As summary measures, the absolute and relative frequencies were used, and the Wilcoxon signed-rank test was used to determine the existence of statistically significant differences before and after the intervention, with a level of significance of 5%, calculated with the aid of the professional statistical program SPSS 22.0 for Windows. Initially, the low level of knowledge (55.6%), inadequate beliefs about harmful consumption of alcohol (86.7%) and low perception of risk (55.6%) predominated. After the intervention, most adolescents had improved knowledge, beliefs and risk perception, with statistically significant differences that showed that the results were due to educational work and not to chance.

RESUMO O alcoolismo é o mais importante vício em drogas do nosso tempo. Ensinar adolescentes sobre o alcoolismo e suas consequências desfavoráveis, é uma forma de promover a percepção de risco e contribuir para a prevenção desta doença. Com o objetivo de modificar a percepção do risco do alcoolismo e suas conseqüências, realizou-se um estudo de intervenção educativa quase experimental em adolescentes do Jesús Menéndez de Bayamo, Granma, 2015-2017. Trabalhamos com uma amostra de 180 adolescentes de 15 a 19 anos de idade. Variáveis ​​estudadas: independente (intervenção educativa) e dependente (percepção do risco de alcoolismo e suas consequências para o organismo, a família e o meio social). A pesquisa foi realizada em quatro etapas: diagnóstico, desenho e validação, aplicação e avaliação. Métodos teóricos, empíricos e estatísticos foram utilizados. Como medidas de resumo, foram utilizadas as frequências absolutas e relativas, e o teste dos postos sinalizados de Wilcoxon foi utilizado para determinar a existência de diferenças estatisticamente significativas antes e após a intervenção, com um nível de significância de 5%, calculado com o auxílio. do programa estatístico profissional SPSS 22.0 for Windows. Inicialmente, predominou o baixo nível de conhecimento (55,6%), as crenças inadequadas sobre o consumo prejudicial de álcool (86,7%) e a baixa percepção de risco (55,6%). Após a intervenção, a maioria dos adolescentes melhorou o conhecimento, as crenças e a percepção de risco, com diferenças estatisticamente significantes que mostraram que os resultados foram devidos ao trabalho educativo e não ao acaso.

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Etoposide-loaded poly(lactic-co-glycolic acid) implants were developed for intravitreal application. Implants were prepared by a solvent-casting method and characterized in terms of content uniformity, morphology, drug-polymer interaction, stability, and sterility. In vitro drug release was investigated and the implant degradation was monitored by the percent of mass loss. Implants were inserted into the vitreous cavity of rabbits' eye and the in vivo etoposide release profile was determined. Clinical examination and the Hen Egg Test-Chorioallantoic Membrane (HET-CAM) method were performed to evaluate the implant tolerance. The original chemical structure of the etoposide was preserved after incorporation in the polymeric matrix, which the drug was dispersed uniformly. In vitro, implants promoted sustained release of the drug and approximately 57% of the etoposide was released in 50 days. In vivo, devices released approximately 63% of the loaded drug in 42 days. Ophthalmic examination and HET-CAM assay revealed no evidence of toxic effects of implants. These results tend to show that etoposide-loaded implants could be potentially useful as an intraocular etoposide delivery system in the future.

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n los últimos años, se ha evidenciado en Costa Rica un aumento importante en la cantidad de casos de dengue, por lo que se necesitan estudios donde se identifiquen las condiciones que promueven la propagación de la enfermedad, el ciclo de vida del vector, así como fenómenos atmosféricos entre los que sobresale el fenómeno El Niño-Oscilación del Sur (ENOS).Objetivo: Analizar el efecto del Fenómeno ENOS en la propagación del virus del Dengue, en las Regiones Pacífico Central y Huetar Atlántico de Costa Rica en el periodo comprendido de 1990 a 2011.Métodos: se utilizó un estudio ecológico exploratorio, el cual tomó fuentes de información primaria, generadas por el Ministerio de Salud (MINSA), el Instituto Meteorológico Nacional (IMN) y el Instituto Nacional de Estadística y Censos (INEC).Resultados: en los periodos durante los cuales se presentó en el país la fase cálida, las incidencias acumuladas promedio mensuales aumentaron en el Pacífico y disminuyeron en el Caribe, mientras que durante los periodos en que se mantuvo la fase fría, la incidencia acumulada promedio mensual aumentó en el Caribe y disminuyó en el Pacífico.Conclusiones: el fenómeno del ENOS afecta el aumento y disminución de los casos de dengue en los litorales de manera inversa.

ver the last years in Costa Rica, there has been a worrying increase in the number of people infected by Dengue. This situation reveals the necessity of searching for the causes that promote the mosquito's proliferation; especially concerning the relationship with environmental type that affects life cycle of the vector, such as atmospheric phenomena: El Niño/Southern Oscillation (ENSO).Objective: The investigation objective was to analyze the effect that ENOS has in the propagation of the Dengue virus in Pacífico Central and Huetar Atlántico in Costa Rica between 1990 and 2011.Methods: It was used an experimental, ecological study and different sources like Ministerio de Salud (MINSA), the Instituto Meteorológico Nacional (IMN) and the Instituto Nacional de Estadística y Censos (INEC) as primarily information bases.Results: The monthly impact accumulated of Dengue grew up during the Warm Phase at the Pacífico, and it decreased at The Caribe, while during the Cold Phase the monthly impact accumulated expanded at The Caribe and detracted at the Pacífico.Conclusions: Among the numerous findings, it turns out that the ENSO phenomenon alters the percentage of the people infected at the littorals in an inverse way.

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INTRODUCTION: Associated factors with complications of the parenteral nutrition (PN) in the preterm infant have not been well studied and there are some controversies in the literature. OBJECTIVE: To identify associated factors with complications of the use of PN in preterm patients Neonatalogy Service. MATERIAL AND METHODS: We performed a longitudinal, observational, retrospective, comparative study (case-control) from January 2008 to December 2010, of the infants who received PN support covering the inclusion criteria (newborns 28 to 36 weeks gestational age from 0 to 28 days after birth, who received PN for at least 6 days). We excluded patients with cholestasis by anatomic obstruction hepatobiliary tract, metabolic disease or congenital metabolic syndrome (inborn errors of metabolism). Statistical analysis was done using descriptive statistics and inferential. The associated factors were investigated through the OR (odds ratio) and multivariate analysis. Significance levels were set at p < 0.05. RESULTS: The total number of patients studied was 67, which is divided into two groups: group A (n = 35) preterm infants with complications secondary to treatment with PN and group B (n = 32), preterm no complications from the procedure. Of all patients in group A, cases, 13 (37%) had mechanical complications; 14 (40%) patients, infectious related with PN or venous catheter (administration via) and 32 (91.4%) patients with metabolic complications as disorders of glucose homeostasis and hyperglycemia predominated (20 patients in group A which corresponds to 57%). In multivariate analysis revealed as protective factors in the use of average protein < 3 g/kg/ day in the first week, osmolarity of the mixture average < 1,200 mOsm/L and relationship non-nitrogenous calories: protein nitrogen > 140:1. CONCLUSIONS: While there are already installed factors that can not be modified, such as prematurity and low birth weight start nutritional therapy, an adequate proportion of nutrients and osmolality of the mixture can reduce the presence of complications associated with PN.

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Poly(ε-caprolactone) implants containing etoposide, an important chemotherapeutic agent and topoisomerase II inhibitor, were fabricated by a melt method and characterized in terms of content uniformity, morphology, drug physical state, and sterility. In vitro and in vivo drug release from the implants was also evaluated. The cytotoxic activity of implants against HeLa cells was studied. The short-term tolerance of the implants was investigated after subcutaneous implantation in mice. The original chemical structure of etoposide was preserved after incorporation into the polymeric matrix, in which the drug was dispersed uniformly. Etoposide was present in crystalline form in the polymeric implant. In vitro release study showed prolonged and controlled release of etoposide, which showed cytotoxicity activity against HeLa cells. After implantation, good correlation between in vitro and in vivo drug release was found. The implants demonstrated good short-term tolerance in mice. These results tend to show that etoposide-loaded implants could be potentially applied as a local etoposide delivery system.

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OBJECTIVE: To identify the parameters of mechanical ventilation related to barotrauma and to identify associated diseases. MATERIAL AND METHODS: There was a partial retrospective study which included all the files and/or newborns (NB) who were in the Neonatal Intensive Care Unit during March 2003 to April 2008 met the inclusion criteria. Two groups were conformed, the group A, cases (those with barotrauma) and B controls (that did not show it). Area of significance was considered when p < 0.05. RESULTS: In multivariate analysis was only significant relevance in relation to the ventilatory parameters mean airway pressure (MAP) > 10 cm H20 on the eighth day, and as confronted all variables including one different from the ventilator as arterial blood gases in the multivariate analysis also, the oxygenation index (OI) with a value > 10 showed statistical significance as it preceded to the barotrauma. The pathology associated with barotrauma was patent ductus arteriosus (PDA) hemodynamically significant with p < 0.05. CONCLUSIONS: Based on the foregoing its is concluded that when a NB patient with mechanical ventilatory support after the first days, to improve lung compliance should be going down different ventilatory parameters as soon as possible to avoid reaching a MAP > 10 cm H2O above the eighth day of ventilatory management, but OI > 10 at any time would be announcing the possibility of barotrauma and other side to treat the significant hemodynamically PDA either medically or surgically in the shortest time.

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Gramicidin, an antimicrobial peptide active against Gram positive bacteria, is commonly used in pharmaceutical preparations for topical use. Considering that only the turbidimetric method has been described in the literature, the present study sought to develop and validate an agar diffusion method for the dosage of gramicidin. The method was developed and validated using the Kocuria rhizophila ATCC 9341 as a test microorganism. Two designs were used: a 3x3 parallel-line model, and a 5x1 standard curve. The validation demonstrated that the method follows the linear model (r²= 0.994), presenting a significant regression between the zone diameter of growth inhibition and the logarithm of the concentration within the range of 5 to 25.3 µg/mL. The results obtained for both designs were precise, having a relative standard deviation (R.S.D.) for intra-day precision of 0.81 for the 3x3 assay and 1.90 for the 5x1 assay. For the inter-day precision, the R.S.D. was 1.35 for the 3x3 and 2.64 for the 5x1. The accuracy was verified and results confirmed to be accurate, having a tolerance interval of 95 percent, which lay within permitted limits and appropriate trueness. In addition, the method was considered selective, with limit of detection and upper and lower limits of quantification of 2.00, 5.00 and 25.3 µg/mL, respectively. No difference in precision between the designs used in the agar diffusion method was evident (p>0.05). The method proved to be appropriate for the microbiological dosage of the raw material gramicidin.

A gramicidina, um peptídeo antimicrobiano ativo contra bactérias Gram positivo, é utilizada em preparações farmacêuticas de uso tópico. Neste trabalho procurou-se desenvolver e validar outro método para o doseamento de gramicidina tendo em vista que somente o método turbidimétrico é descrito. O método de difusão em ágar foi desenvolvido e validado utilizando como microrganismo teste Kocuria rhizophila ATCC 9341. Foram utilizados dois delineamentos: retas paralelas 3x3 e curva padrão 5x1. A validação demonstrou que o método segue o modelo linear (r²= 0,994) havendo regressão significativa entre o diâmetro dos halos de inibição e o logaritmo da concentração na faixa de 5,00 a 25,3 µg/mL. Os resultados obtidos por ambos os delineamentos foram precisos apresentando desvio padrão relativo (DPR) para precisão intra-dia de 0,81 para ensaio 3x3 e de 1,90 para ensaio 5x1. Para a precisão inter-dias o DPR foi de 1,35 para 3x3 e de 2,64 para 5x1. A exatidão foi verificada e os resultados foram exatos apresentando intervalo de tolerância a 95 por cento dentro dos limites permitidos e veracidade adequada. O método foi seletivo com limites de detecção e quantificação inferior e superior iguais a 2,00, 5,00 e 25,3 µg/mL, respectivamente. Não foi observada diferença entre a precisão dos delineamentos empregados no método de difusão em ágar (p>0.05). O método se mostrou adequado para a dosagem microbiológica de gramicidina matéria-prima.

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Some pharmaceutical industries of phytomedicines are using conservation procedures (drying, autoclaving), in an attempt to avoid medicinal plants degradation, and of their fluid-extracts. Or, by adopting techniques adequate to foods, which not always are appropriate. On this sense, there is less research with Brazilian plants, causing some difficulties for their use as raw material by the domestic industry. Thus, the effects of drying at various temperatures or irradiation with microwaves, as well as autoclaving or lyophilization of the fluid-extract of samples collected in natura of Echinodorus macrophyllus (Kunth) Micheli, Alismataceae, on the pharmacochemical composition were analyzed. At the research for chemical groups, the preponderating presence of flavones and coumarin derivatives was observed. The chromatographic profiles of the flavonic extracts were analyzed by TLC and HPLC and the levels of total flavonoids were determined. According to the results obtained, qualitative and quantitative changes were caused by the various processes employed.

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INTRODUCTION: The bronchopulmonary dysplasia (BPD) is a lung illness chronicle that is developed in preterm newborn (PTNB) mainly, secondary to multiple factors of risk which have not been studied completely. OBJECTIVE: To determine the predictors factors (of risk factors) for the production of BPD in the PTNB of 28 at 36 weeks of gestational age. MATERIAL AND METHODS: Eighty medical records from January 2004 to May 2006 of PTNB that there was received mechanical attendance to the ventilation (MAV) at least 24 hrs were reviewed retrospectively. They were divided in two groups: group A, PTNB that had BPD, composed of 40 patients (cases) and group B, PTNB with MAV but that had not developed BPD due to the procedure of 40 patients too (controls). It was used descriptive and inferential statistic. Odds ratio (OR) and multivariate analysis were used to study predictors factors. Statistical significance was considered with P < 0.05. RESULTS: There was significant difference of the supply of the intravenous (i.v.) fluids the days 2, 3, 4 and 7 of extrauterine life (EUL), of the oxygen inspired fraction (FiO2) of in the day 7 of being had initiate the MAV, of the peak inspiratory pressure (PIP) in the day 1 and 3 of being had initiate the MAV everything to favor of the cases, with P < 0.05. In the multivariate analysis was significative in the intake of i.v. fluids > or = 140 mL x kg of weight x day to the fourth day of EUL, the oxygen arterial pressure (PaO2) > 70 mm Hg for > 4 days, reintubations number (two or more times) and the symptomatic patent ductus arteriosus (PDA), all with P < 0.05. CONCLUSIONS: We concluded that, in critically sick PTNB, they exist one series of well-known risk factors but more specified in this study that they should avoid as much as possible; the handling of the liquids i.v. should be cautious, not to spend of 139 mL x kg x day to the 4th day of EUL, not to be so permissive with the PaO2 maintaining it in values < or = 70 mm of Hg after four days, to avoid as much as possible the reintubations and to treat the but quick the symptomatic PDA still without that it is significant, to diminish this way, the risk of BPD.

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El cáncer gástrico, CG, es el tumor maligno con mayor mortalidad en hombres en Costa Rica. En el caso de las mujeres ocupa el segundo lugar, después del cáncer de mama. Desde el punto de vista histológico, el CG se divide en dos tipos: el primero es el "difuso" y su etiología ha sido relacionada con factores genéticos. El segundo tipo es el "intestinal", vinculado con la exposición a cancerígenos ambientales como sustancias químicas tóxicas, altitud geográfica, edad, etc. En este sentido, algunos investigadores han estudiado las posibles relaciones de factores epidemiológicos y ecológicos, como las características físico-químicas de las aguas para consumo humano, ACH, los suelos, los plaguicidas usados en los cultivos, y la ingesta de cancerígenos en la leche como el Pteridium aquilinum, helecho macho. Con respecto al ACH, a partir de 1974, se ha relacionado la cloración del agua con la formación de subproductos de la desinfección como el cloroformo y el bromoformo, llamados trihalometanos, con potencial cancerígeno para favorecer la incidencia de CG en la población. Estos hechos, aunados al sensacionalismo periodístico han provocado inseguridad e incertidumbre entre la población consumidora de aguas sometidas a cloración...

Gastric cancer (GC) is the leading cause of cancer-related mortality in Costa Rican males. After breast cancer, it is the second highest cause of cancermortality in women in Costa Rica. From a histological point-of-view, GC is divided into two types: the first isthe “diffuse” type and it has been related etiologically to genetic factors; the second type is the “intestinal”type and it has been linked to such environmental carcinogenic factors as: toxic chemical substances, geographic altitude and age. Along these lines, someresearchers have studied possible relationships bettween epidemiological and ecological factors such as, for example, physico-chemical traits of water for human consumption (ACH), soils, pesticide use as well ascarcinogen intake in milk such as Pteridium aquilinum (the so-called male fern). Regarding ACH, since 1974,water chlorination has been causally linked to formation of byproducts of disinfection like chloroform and bromoform, so-called trihalomethanes, which have a propensity for causing a higher incidence of GC in the population. These facts, along with media hype, have provoked uncertainty and doubts regarding the safety of chlorinated water among the public. With this background in mind, an exploratory-ecological epidemiological study was carried out with the explicit purpose of analyzing if there is or if there isn´t a statistically significant link between the incidence of GC and the consumptionof chlorinated water in Costa Rica. The analysis used the GC-mortality results in 458 districts during the years1999 to 2002 and the data obtained from the National Water Laboratory on the type of water (chlorinatedor not), the number of years of disinfection and the source of the water (underground, surface or mixed).For the statistical analysis, a Standardized Mortality Index (IME) and the Pearson correlation coefficient...

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Several pharmacopoeias recommend the membrane filtration method for the sterility test of ophthalmic ointments. Isopropyl myristate, a fatty acid ester that exhibits high toxicity mainly against Gram-negative microorganisms, is indicated as a solvent for ointments. In this study, six fatty acid esters (diethyl adipate, diisopropyl adipate, ethyl laurate, ethyl myristate, methyl caprylate and isopropyl palmitate) were evaluated as solvents to replace isopropyl myristate in the sterility test for ophthalmic ointments. The logarithm of the partition coefficient (logP) of the fatty acid esters was calculated from the sum of the substituent hydrophobicity constants (pi) of the functional groups present in their molecules. The ability of the solvents to dissolve an ophthalmic ointment base was investigated. The D-value method was used to assess the antimicrobial activity of isopropyl palmitate, ethyl myristate, ethyl laurate and isopropyl myristate against Pseudomonas aeruginosa. Isopropyl palmitate was the least toxic solvent to this microorganism, since it had the highest D-value (171.1 min). No significant difference was observed between the D-values of ethyl myristate (89.4 min) and isopropyl myristate (92.5 min). Ethyl laurate exhibited the lowest D-value (27.2 min). Using gas chromatography coupled to mass spectrometry, other fatty acid esters were detected as the predominant impurities in the solvents, as well as acid contaminants in low or insignificant amounts.

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RESUMO

La Organización Mundial de la Salud (OMS) indicó en sus Guías de calidad de agua de bebida en 1995 (volumen 2) lo siguiente:"Los estudios epidemiológicos ecológicos o de correlación geográfica proporcionan datos sugerentes que parecen indicar la existencia de una relación entre la exposición alimentaria de nitratos y el cáncer, en particular el de estómago. Sin embargo, estudios analíticos más definitivos, no han confirmado estos resultados". A pesar que esta correlación no se ha probado estadísticamente, varios medios de comunicación en Costa Rica han vinculado los contenidos de nitratos en las aguas para consumo humano como un factor de riesgo para padecer cáncer gástrico. En razón de esta incertidumbre existente, se realizó un estudio exploratorio ecológico sobre la incidencia de cáncer gástrico y los contenidos de nitratos en aguas para consumo humano, suministradas en 458 distritos ubicados en el territorio nacional. Para cumplir con el mencionado objetivo, se utilizaron las tasas de mortalidad provacadas por este tumor maligno en el trienio 1999-2001 y las concentraciones promedio de nitratos en mg/L en las aguas de bebida en cada distrito. Para efectos estadísticos, se calcularon los índices de mortalidad estandarizados (IME) como método indirecto, y se usó el coeficiente de correlación de Pearson, con el objetivo de analizar si existe o no relación entre ambas variables (cáncer gástrico y nitratos en el agua). Los resultados de este estudio exploratorio ecológico comprobaron la no existencia de asociación entre ambas variables. Es decir, se rechaza la hipótesis de estudio y se acogió la hipótesis alternativa "los contenidos de nitratos en el agua de bebida no son un factor de riesgo para padecer cáncer gástrico en Costa Rica". Por último, se recomienda a las autoridades de salud divulgar los resultados de esta investigación, con el propósito de eliminar la confusión existente en la población costarricense.

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