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Resumen Introducción: El vértigo posicional paroxístico benigno (VPPB) es la afección periférica más común en las enfermedades otoneurológicas. Con el reposicionamiento de partículas se busca eliminar el vértigo y sus síntomas asociados como lo son el mareo residual y la inestabilidad. Objetivo: Determinar si la maniobra de reposicionamiento de Epley (MRE) produce una modificación significativa del control postural (CP) en aquellos pacientes con VPPB de canal semicircular posterior (VPPB-CSC-P). Material y Método: Se realizó un estudio descriptivo prospectivo en una muestra de 21 pacientes con diagnóstico de VPPB-CSC-P. Comparamos el desplazamiento, la velocidad y el área del centro de presión (CoP) antes y después de la MRE. Resultados: La velocidad y el área de la CoP estudiada por posturografía computarizada muestra una disminución significativa en sus valores después de la MRE, mientras que el desplazamiento de la CoP se mantuvo sin cambios. Conclusión: La MRE ejecutada en pacientes con VPPB-CSC-P produce una modulación en el control de la CoP, demostrada por la disminución de la velocidad y el área de desplazamiento de la CoP. El éxito de la MRE produce modulación del CP.

Abstract Introduction: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral condition in otoneurologic diseases. With the repositioning of particles, the aim is to eliminate vertigo and its associated symptoms, such as residual dizziness and instability. Aim: To determine if the Epley repositioning maneuver (ERM) produces a significant modification of postural control (PC) in those patients with posterior semicircular canal BPPV (BPPV-CSC-P). Material and Method: A prospective descriptive study was carried out in a sample of 21 patients diagnosed with BPPV-CSC-P. We compared the displacement, velocity, and area of the center of pressure (CoP) before and after the Epley repositioning maneuver. Results: The velocity and the area of the CoP studied by computed posturography show a significant decrease in its values after the MRE, while the CoP shift remained unchanged. Conclusion: ERM performed in patients with BPPV-CSC-P produces an improvement in the control of the CoP, demonstrated by the decrease in the speed and the area of movement of the CoP. The success of the MRE produces modulation of the PC.

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Background: An adequate consumption of micro and macro nutrients is essential to maintain an adequate health among older people. Aim: To compare the consumption of micro- and macronutrients in older people from three Chilean cities, according to their nutritional status. Material and Methods: Body mass index (BMI) was assessed and a food consumption tendency survey was applied to 976 non-disabled older people, living in the community. Thinness was defined as a BMI < 23 kg/m². Results: Twenty percent of females and 17% of males had a BMI < 23 kg/m². Participants with a higher BMI had a greater intake of micro- and macronutrients. In females, micronutrient intake was adequate among those with higher BMI, although mean intake of calcium and vitamin B-12 were below recommendations. In males, iron, zinc, calcium, magnesium, vitamin A, vitamin B6, vitamin B12 and pantothenic acid intake were below recommendation. Conclusions: Thin older adults, regardless of sex, had a lower intake of calories and micro- and macronutrients. Additionally, an overall low consumption of zinc, calcium, magnesium and vitamin B12 was detected.

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Extraction of filamentous algae from river pools is highly effective for the control of Anophelespseudopunctipennis in southern Mexico. We determined the magnitude of changes to the aquatic insect community following single annual perturbations performed over two years. In 2001, algae were manually removed from all the pools in a 3 km long section of the River Coatán, Mexico, while an adjacent section was left as an untreated control. In 2002, the treatments of both zones were switched and algal extraction was repeated. The abundance of An. pseudopunctipennis larvae + pupae was dramatically reduced by this treatment and remained depressed for two to three months. A total of 11,922 aquatic insects from ten orders, 40 families, and 95 genera were collected in monthly samples taken over five months of each year. Algal extraction did not reduce the overall abundance of aquatic insects in river pools, but a greater abundance and a greater richness of taxa were observed in 2002 compared to the previous year. This was associated with reduced precipitation and river discharge in 2002 compared to 2001. Shannon diversity index values were significantly depressed following algal extraction for a period of three months, in both years, before returning to values similar to those of the control zone. However, differences between years were greater than differences between treatments within a particular year. When insects were classified by functional feeding group (FFG), no significant differences were detected in FFG densities between extraction and control zones over time in either year of the study. Similarly, percent model affinity index values were classified as "not impacted" by the extraction process. Discriminant function analysis identified two orders of insects (Diptera and Odonata), water temperature, dissolved oxygen and conductivity, and river volume (depth, width, and discharge) as being of significant value in defining control and treatment groups in both years. We conclude that habitat manipulation represents an effective and environmentally benign strategy for control of An. pseduopunctipennis. Variation in precipitation and river discharge between years was much more important in determining aquatic insect community composition than variation generated by the filamentous algal extraction treatment.

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To determine whether Pneumocystis carinii is associated with clinical illness in the competent host, 107 normal, healthy infants were enrolled in a 2-year prospective cohort study in Chile. P. carinii was identified by specific stains and nested--deoxyribonucleic acid (DNA) amplification of the large subunit mitochondrial ribosomal ribonucleic acid gene of P. carinii f. sp. hominis, and seroconversion was assessed by enzyme-linked immunosorbent assay of serum samples drawn every 2 months. P. carinii DNA was identified in nasopharyngeal aspirates obtained during episodes of mild respiratory infection in 24 (32%) of 74 infants from whom specimens were available for testing. Three (12.5%) of those 24 infants versus 0 of 50 infants who tested negative for P. carinii had apnea episodes. Seroconversion developed in 67 (85%) of 79 infants who remained in the study by 20 months of age and occurred in the absence of any symptoms of disease in 14 (20.8%). The study indicates that P. carinii DNA can be frequently detected in healthy infants, and it raises the hypothesis that they may be an infectious reservoir of P. carinii in the community. Further investigation is needed to identify whether P. carinii causes overt respiratory disease in infants.

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To delineate clinical and histological features of the first Pneumocystis carinii infection affecting the immunocompetent host, P. carinii-specific histological stains were performed on autopsy lung specimens from 534 consecutive pediatric patients (those with AIDS and malignancies were excluded) in Santiago, Chile. P. carinii clusters were found in 4 (25%) of 16 infants who died of no apparent cause at arrival to the emergency department, and in 10 (2.9%) of 342 infants who died of multiple conditions at the hospital (P=.002, Fisher's exact test). This prompted us to analyze additional series of infants with sudden infant death syndrome (SIDS). In 161 additional SIDS cases, 47 (35.1%) of 134 infants from Chile and 4 (14.8%) of 27 infants from Oxford, United Kingdom, were found to have P. carinii clusters in the lungs. The quantity of P. carinii cysts was small compared with the numbers seen in immunocompromised hosts with P. carinii pneumonitis. This study provides histological evidence that primary P. carinii infection is associated with SIDS.

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A cystic mass of the umbilical cord was identified by transvaginal sonography in 10 first trimester pregnancies at a mean gestational age of 8 weeks 4 days (range, 8 weeks 1 day to 9 weeks 3 days) and at a mean crown-rump length of 20.5 mm (range, 15 to 25 mm). The cyst was solitary in all cases, the mean diameter was 4.6 mm (range, 3 to 6 mm), and the location was closer to the fetal insertion in two cases, in the middle of the cord in seven cases, and closer to the placental insertion in one case. Gestational sac and yolk sac diameters as well as the fetal heart rate were within normal ranges for gestational age in all cases. Information on detailed second trimester scans was available in nine cases, demonstrating complete resolution of the cyst and normal fetal anatomic survey in each case. These nine pregnancies were followed to delivery, and normal healthy infants were delivered at term in all cases. This series suggests that the incidental detection of umbilical cord cysts in early pregnancy is not associated with an adverse pregnancy outcome.

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Two colonies of Anopheles pseudopunctipennis, Tapachula and Abasolo strains, were established under laboratory conditions with a thermoperiod (29 degrees C during the day; 24 degrees C during the night) and artificial dusk. To stimulate mating, a light beam from a flashlight was shone on the cage shortly after lights off. This procedure was repeated for the first 6 mosquito generations (parental to F6) and thereafter light stimulation was unnecessary for mating. The Tapachula colony has been maintained for 24 generations in 24 months, with insemination rates in females > 80% since the F3, and a monthly production of 30,000 pupae since the F7. Using the same procedure, the Abasolo colony from northeastern Mexico has been maintained for 13 generations in 14 months, with insemination rates of 26-52%.

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The abundance and age structure of Anopheles albimanus populations were estimated by UV updraft light traps and human landing catches within villages and in nearby breeding sites of southern México. Four villages and 5 breeding sites were selected for the study. Light trap and human landing catches were simultaneously carried out in each breeding site and each village. Anopheles albimanus was the most abundant malaria vector caught in breeding sites and in villages. Significant differences in overall An. albimanus abundance among villages and among breeding sites were detected only by human landing catches. In both villages and breeding sites, more mosquitoes were captured by 1 human bait (34.3 +/- 6.3 and 14.6 +/- 2.9, respectively) than by one light trap (15.9 +/- 3.3 and 2.4 +/- 0.3 respectively) collection. After pooling, no significant differences were detected in the abundance estimated by each method in breeding sites and villages. A significant correlation of numbers of specimens between methods was detected. Age structure was different between samples from breeding sites and villages, with more gravid females collected in breeding sites, whereas more nulipars were collected in villages. By collection method, age structure was also different both in breeding sites and in villages. In breeding sites, the percentage of parous females was significantly higher in human landing catches, whereas the percentage of gravid females was significantly higher in light traps. In villages, only the percentage of gravid females was significantly higher in light traps. Our results suggests that UV light traps could be used to measure several entomological parameters of An. albimanus populations because both abundance variations and parity rates were similarly detected by both methods.

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A landscape approach using remote sensing and geographic information system (GIS) technologies was developed to discriminate between villages at high and low risk for malaria transmission, as defined by adult Anopheles albimanus abundance. Satellite data for an area in southern Chiapas, Mexico were digitally processed to generate a map of landscape elements. The GIS processes were used to determine the proportion of mapped landscape elements surrounding 40 villages where An. albimanus abundance data had been collected. The relationships between vector abundance and landscape element proportions were investigated using stepwise discriminant analysis and stepwise linear regression. Both analyses indicated that the most important landscape elements in terms of explaining vector abundance were transitional swamp and unmanaged pasture. Discriminant functions generated for these two elements were able to correctly distinguish between villages with high and low vector abundance, with an overall accuracy of 90%. Regression results found both transitional swamp and unmanaged pasture proportions to be predictive of vector abundance during the mid-to-late wet season. This approach, which integrates remotely sensed data and GIS capabilities to identify villages with high vector-human contact risk, provides a promising tool for malaria surveillance programs that depend on labor-intensive field techniques. This is particularly relevant in areas where the lack of accurate surveillance capabilities may result in no malaria control action when, in fact, directed action is necessary. In general, this landscape approach could be applied to other vector-borne diseases in areas where 1) the landscape elements critical to vector survival are known and 2) these elements can be detected at remote sensing scales.

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An exploratory anthropological study on representations, attitudes, and practices related to Cutaneous Leishmaniasis (CL) among the rural population of Acosta County, Costa Rica, aimed to estimate the applicability of epidemiologically-based control measures. Open interviews with a small sample of individuals from both case and control households provided the basic for a Propositional Discourse Analysis (PDA). Results are that Acosta people consider CL a distinct nosologic entity, but they are mainly interested in its clinical manifestations in children (who are mainly affected), as well as in their own capacity to act on the disease using folk remedies. The idea of control measures on reservoirs, on vectors, or on the spatial and temporal context of contact does not arise spontaneously in people's thinking. Nevertheless, CL is perceived as a disruption in the safe domiciliary and peridomiciliary space, so that control measures intervening there could have a chance for success.

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The experience with 180 high-risk pregnancies evaluated with Doppler velocimetry in Rancagua Regional Hospital, classified according to an original integral resistance evaluation table, is presented. Perinatal outcome is analyzed in relation to this classification, demonstrating a high correlation between progressive increase of resistance and poor perinatal outcome, evidenced as proportion of SGA newborns, non-reactive NST, low five-minute Apgar score, admission to neonatology or perinatal death, with good sensibility, specificity and predictive values.

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Se presenta la experiencia adquirida en el Hospital Regional de Rancagua con 180 pacientes de ARO evaluadas con velocimetría Doppler (VD), clasificadas según una tabla original de valoración integral de resistencias. Se analizan los resultados perinatales de acuerdo a esta clasificación, demostrando una alta correlación entre exámenes alterados y resultados perinatales adversos expresados en frecuencia de RN pequeños para la edad gestacional (PEG), registro basal no estresante (RBNS) no reactivo, Apgar<=6 a los 5 min, ingreso a la unidad de neonatología o muerte perinatal, con buenos valores predictivos, de sensibilidad y especificidad

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