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Summary: Background. Patch testing (PT) is used to identify substances that cause allergic contact dermatitis (ACD). However, the clinical effects of allergen restrictions following PT have not been thoroughly investigated. This study aims to assess the diagnostic accuracy of PT in patients suspected of having ACD. Methods. Prospective study. PT were performed in patients with clinical diagnosis of ACD. Patients with a positive PT (case group) had a strict restriction of the suspected substance for one month. In patients with negative patch testing (control group), allergen restriction was based in clinical history. Clinical reduction (CR) of at least 50% in disease activity (CR50%) after one month of allergen restriction was considered clinically relevant. Total control was defined as clinical reduction of at least 90% (CR90%). Results. From 400 patients, 66.2% had a positive PT. The sensitivity of PT to identify CR50% was 84%, specificity 47%, PPV 53%, and NPV 81%. Only 10.5% of patients achieved CR90%. Conclusions. The PT had moderate diagnostic accuracy. It could be useful as a screening, but a positive result should be confirmed with controlled allergen restriction. The low number of patients who achieved a 90% CR invites to reconsider the allergens included in PT and the mechanistic processes of the disease.

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BACKGROUND: Chagas disease (CD) is considered by the World Health Organisation (WHO) a neglected disease endemic to the Americas, but it has spread throughout the world due to migrations. The disease is almost 100% curable if detected in time. Still, the lack of rapid diagnostic tests with sufficient sensitivity and specificity leads to a chronic phase with a mortality of about 50,000 people worldwide per year. METHODS: Using the total proteins extracted from serum samples of patients confirmed with chronic phase CD; we performed the Bio-SELEX strategy. The best aptamers were selected using next-generation sequencing (NGS) based on their most abundant sequences (reads and rpm). Then, selected aptamers were used to isolate potential biomarkers directly from serum samples of patients with chronic phase CD using pull-down and mass spectrometry experiments. RESULTS: CH1 aptamer was the aptamer selected after the NGS results analysis. The pull-down and mass spectrometry experiments identified the presence of the ATPase alpha subunit of T. cruzi circulating in serum samples of patients with chronic phase CD. CONCLUSIONS: We report the ATPase alpha subunit of T. cruzi as a potential biomarker for chronic phase CD and CH1 aptamer as a potential tool for diagnosing CD.

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La fibrosis pulmonar idiopática (FPI) se caracteriza por presentar una capacidad funcional reducida, disnea e hipoxia inducida por el ejercicio, lo que disminuye su tolerancia al esfuerzo y limita su capacidad de realizar actividades diarias. Las comorbilidades son frecuentes y su presencia contribuyen al empeoramiento de la calidad de vida y aumento de la mortalidad. Por lo anterior, es que además de las terapias antifibróticas, los pacientes con FPI se benefician de un enfoque integral de la atención que puede incluir: pesquisa, diagnóstico y tratamiento de comorbilidades, ingreso a protocolos de investigación, manejo sintomático, cuidados paliativos, oxígeno suplementario, rehabilitación pulmonar, educación y apoyo por un equipo multidisciplinario.

Idiopathic pulmonary fibrosis (IPF) is characterized by reduced functional capacity, dyspnea and exercise-induced hypoxia, which decreases tolerance to exertion and limits the ability to perform daily activities. Comorbidities are frequent and their presence contribute to worsening quality of life and increased mortality. Therefore, in addition to antifibrotic therapies, patients with IPF benefit of a comprehensive approach to care that may include: screening, diagnosis and treatment of comorbidities, admission to research protocols, symptomatic management, palliative care, supplementary oxygen, pulmonary rehabilitation, education and support by a multidisciplinary team.

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OBJECTIVE: To identify determinants and outcomes associated with infection in paediatric systemic lupus erythematosus (SLE) patients at admission and during hospitalization in intensive care units (ICUs). PATIENTS AND METHODS: A retrospective cohort study of paediatric SLE patients admitted to two ICUs was conducted. Frequency and risk factors of infection as well as mortality were studied. RESULTS: Seventy-three infection episodes amongst 55 patients were analysed. The median age was 14.4 years (IQR 12.5-16). The median SLEDAI was 16 (IQR 12-20). Twenty-nine episodes were documented at admission; the CRP was higher in these patients (6.58 versus 1.04 mg/dl, p<0.001) than in non-infected patients, even after multivariate adjustment (OR 8.6, 95% CI = 2.1-34.8, p = 0.003). Twenty-five (34.7%) episodes occurred during hospitalization. Lupus activity (OR 1.14, 95% CI = 1.01-1.27, p = 0.029), cyclophosphamide (OR 17.9, 95% CI = 2-156, p = 0.009) and mechanical ventilation (OR 16, 95% CI = 2.1-122, p = 0.008) were associated with infection. Ten episodes (14%) led to death. Admission to the ICU due to infection was strongly associated with mortality (90% versus 31.8%, OR 19.4, 95% CI = 2.3-163, p = 0.006). CONCLUSION: In paediatric lupus patients admitted to the ICU, elevated CRP should alert clinicians to possible infection. During hospitalization, SLE activity and cyclophosphamide were associated with infection. Infection at admission to the ICU was strongly associated with mortality.

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Resumen La alopecia areata en una enfermedad autoinmune caracterizada por pérdida no cicatricial de pelo, en forma de parches localizados o generalizados, en la que se pierde el privilegio inmunológico del folículo piloso. Factores ambientales, neuroendocrinos y/o psicológicos en individuos genéticamente predispuestos llevan a la activación inmunológica que conduce a la alopecia. La tercera parte de los pacientes tienen familiares afectados y se ha descrito asociación con antígenos del HLA clase I y II, y de polimorfismos de nucleótido único en genes relacionados con la activación del linfocito T. Neuropéptidos como la sustancia P, el péptido relacionado con el gen de la calcitoninay el péptido intestinal vasoactivo, producidos por los nervios cutáneos, participan en la inmunopatogénesis. Como otras entidades dermatológicas, puede ser subestimada y catalogada como un problema estético, sin tener en cuenta que tiene alto impacto en la calidad de vida y se asocia a comorbilidades psiquiátricas, autoinmunes y endocrinas.

Summary Alopecia areata (AA) is an autoimmune disease characterized by non-cicatricial hair loss, in the form of localized or generalized patches, in which the immunological privilege of the hair follicle is lost. Environmental, neuroendocrine and / or psychological factors in genetically predisposed individuals lead to immune activation and hence, alopecia. One third of the patients has affected relatives, association with HLA class I and II antigens, and single nucleotide polymorphisms in genes related to the activation of the T lymphocyte. Neuropeptides such as substance P, the peptide related to the Calcitonin gene and vasoactive intestinal peptide, produced by cutaneous nerves, participate in the immunopathogenesis of AA. Like other dermatological entities, it can be underestimated and cataloged as an aesthetic problem, without considering its high impact on quality of life and its association with psychiatric, autoimmune and endocrine comorbidities.

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Habitat discontinuities, temperature gradients, upwelling systems, and ocean currents, gyres and fronts, can affect distributions of species with narrow environmental tolerance or motility and influence the dispersal of pelagic larvae, with effects ranging from the isolation of adjacent populations to connections between them. The coast of the Tropical Eastern Pacific (TEP) is a highly dynamic environment, with various large gyres and upwelling systems, alternating currents and large rocky-habitat discontinuities, which may greatly influence the genetic connectivity of populations in different parts of the coast. Elacatinus puncticulatus is a cryptic, shallow-living goby that is distributed along the continental shore of virtually the entire TEP, which makes it a good model for testing the influence of these environmental characteristics in the molecular evolution of widespread species in this region. A multilocus phylogeny was used to evaluate the influence of habitat gaps, and oceanographic processes in the evolutionary history of E. puncticulatus throughout its geographical range in the TEP. Two well-supported allopatric clades (one with two allopatric subclades) were recovered, the geographic distribution of which does not correspond to any previously proposed major biogeographic provinces. These populations show strong genetic structure and substantial genetic distances between clades and sub-clades (cytb 0.8-7.3%), with divergence times between them ranging from 0.53 to 4.88 Mya, and recent population expansions dated at 170-130 Kya. The ancestral area of all populations appears to be the Gulf of Panama, while several isolation events have formed the phylogeographic patterns evident in this species. Local and regional oceanographic processes as well as habitat discontinuities have shaped the distribution patterns of the genetic lineages along the continental TEP. Large genetic distances, high genetic differentiation, and the results of species-tree and phylogenetic analyses indicate that E. puncticulatus comprises a complex of three allopatric species with an unusual geographic arrangement.

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Resumen La infección por Salmonella no Typhi es una de las enfermedades transmitidas por alimentos más común y ampliamente extendida en el mundo. Aunque la mayoría de los casos se limitan al tracto gastrointestinal, el compromiso extraintestinal no es infrecuente. Sin embargo, la adenitis como manifestación aislada, es una forma inusual de presentación de la enfermedad. Comunicamos el caso clínico de una mujer de 67 años de edad con diagnóstico de diabetes mellitus y una linfadenitis cervical por Salmonella no Typhi tratada con ciprofloxacina y y que requirió resección quirúrgica.

No Typhoid Salmonella infection is one of the most common and widely spread foodborne diseases worldwide. Although most cases are limited to the gastrointestinal tract, extraintestinal involvement is not uncommon. However, adenitis as an isolated manifestation, is an unusual form of the disease. We report a case of Salmonella no Typhoid cervical lymphadenitis in a 67-year-old female with a recent diagnosis of diabetes mellitus, who was treated with surgery and ciprofloxacin.

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INTRODUCTION: The distal articular femur fracture is a serious injury that for years has been a problem in traumatology. It is often believed that produced varying degrees of permanent disability in the knee and that the fate of the joint was determined by the injury rather than treatment. OBJECTIVES: Present the results of surgical treatment of articular distal femur fractures type C2 with three treatment modalities: dynamic condylar screw (TDC), condylar buttress plate (PSC) and periarticular plate (PPA). MATERIAL AND METHODS: We conducted a comparative study of three therapeutic series designed to compare the effectiveness of dynamic condylar screw, the condylar buttress plate and periarticular plate in treating complete articular fractures of distal femur type C2. Patients of both genders, aged between 16 and 60 years, treated in the IAHULA, with a minimum follow up of 24 months. RESULTS: We included 42 patients divided into three groups. Males predominated with 73.8%, the most affected age group was 21-30 years with 28.57%. The most common type of fracture was the 33C2.3 with 42.86%. The 71.43% of patients experienced complications, highlighting joint stiffness, angular deviation in recurvatum, chronic pain and post traumatic osteoarthritis. CONCLUSION: TDC and the PPA are valid options for the treatment of distal femur fractures AO 33C2, as offered better functional results than PSC.

INTRODUCCIÓN: La fractura articular de fémur distal es una lesión grave que durante años ha representado un problema en la traumatología que con frecuencia ocasiona distintos grados de incapacidad permanente en la rodilla. El destino de la articulación estaba determinado por la lesión más que por su tratamiento. OBJETIVOS: Presentar los resultados del tratamiento quirúrgico de las fracturas articulares de fémur distal tipo C2 con tres modalidades de tratamiento: tornillo dinámico condíleo (TDC), placa de sostén condíleo (PSC) y placa periarticular (PPA). MATERIAL Y MÉTODOS: Estudio comparativo de tres series terapéuticas, diseñado para comparar la efectividad del TDC, la PSC y la PPA en el tratamiento de fracturas articulares completas de fémur distal tipo C2. Se incluyeron 42 pacientes de ambos géneros, con edades entre 16 y 60 años, tratados en el IAHULA, con un seguimiento mínimo de 24 meses. RESULTADOS: Predominó el sexo masculino con 73.8%, el grupo etario más afectado fue de 21-30 años con 28.57%. El tipo de fractura más frecuente fue la 33C2.3 con 42.86%. La PPA mostró mejores resultados que los otros implantes fundamentalmente en la escala funcional de la Knee Society. Setenta y uno punto cuarenta y tres por ciento de los pacientes presentó alguna complicación, resaltando la rigidez articular, la desviación angular en recurvatum, el dolor crónico y la artrosis postraumática. CONCLUSIÓN: El TDC y la PPA son opciones válidas para el tratamiento de las fracturas de fémur distal AO 33C2, puesto que ofrecieron mejores resultados funcionales que la PSC.

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Introduction or case story: Young female patient (24 years-old), without known morbid precedents. She comes for a ten-days period of symptoms characterized by fever of up to 38.5 °C and a dyspnoea grade III. Physical exam showed decreased vesicular murmur on the right pulmonary base with dullness and positive vocal vibrations. Exams: Thorax X-ray: Atelectasis condensation on the right pulmonary base. CT chest scan without contrast: Nodule located in an intermediate bronchus which generates atelectasis in the basal bronchi. Fibro-bronchoscopy (FOB): A tumour-like injury blocking 100% of the right intermediate bronchus’ duct. Biopsy: Pulmonary tissue with haemorrhagic areas, granular tissue with small cellular clusters of lobular disposal and glandular shape with eccentric central nuclei cells, with homogenous chromatin and without atypical mitosis. Immunohistochemistry: Intensely positive cells to synaptophysin and CD56. Diagnosis: Neuroendocrine Typical Carcinoid Tumor. Comments: The patient evolves without progression of dyspnoea, she is waiting for a surgical resolution of tumour at National Institute of Thorax.

Introducción o historia del caso: Mujer joven de 24 años de edad, sin antecedentes mórbidos, acudió por cuadro de 10 días de evolución, de fiebre de hasta 38,5 °C y disnea grado III. Al examen físico destacó a nivel pulmonar: murmullo pulmonar disminuido en base pulmonar derecha, matidez de la misma zona y vibraciones vocales positivas. Exámenes: Radiografía de Tórax: Condensación atelectásica en base pulmonar derecha. TAC de Tórax sin contraste: Imagen nodular a nivel de bronquio intermedio, que genera atelectasia en bronquios basales. Fibrobroncoscopía (FBC): Lesión tumoral que ocluye el 100% del lumen para bronquio intermedio derecho. Biopsia: Tejido pulmonar con áreas de hemorragia, tejido granulatorio y tumor con acúmulos celulares de disposición lobular y glanduliforme, con núcleos centrales excéntricos, cromatina homogénea, sin atipias. Inmunohistoquímica: Células intensamente positivas para sinaptofisina, y CD-56. Diagnóstico: Tumor Neuroendocrino Carcinoide típico Comentarios: Paciente evoluciona sin progresión de su disnea, esperando resolución quirúrgica del tumor en Instituto Nacional del Tórax.

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Resumen: Introducción: La fractura articular de fémur distal es una lesión grave que durante años ha representado un problema en la traumatología que con frecuencia ocasiona distintos grados de incapacidad permanente en la rodilla. El destino de la articulación estaba determinado por la lesión más que por su tratamiento. Objetivos: Presentar los resultados del tratamiento quirúrgico de las fracturas articulares de fémur distal tipo C2 con tres modalidades de tratamiento: tornillo dinámico condíleo (TDC), placa de sostén condíleo (PSC) y placa periarticular (PPA). Material y métodos: Estudio comparativo de tres series terapéuticas, diseñado para comparar la efectividad del TDC, la PSC y la PPA en el tratamiento de fracturas articulares completas de fémur distal tipo C2. Se incluyeron 42 pacientes de ambos géneros, con edades entre 16 y 60 años, tratados en el IAHULA, con un seguimiento mínimo de 24 meses. Resultados: Predominó el sexo masculino con 73.8%, el grupo etario más afectado fue de 21-30 años con 28.57%. El tipo de fractura más frecuente fue la 33C2.3 con 42.86%. La PPA mostró mejores resultados que los otros implantes fundamentalmente en la escala funcional de la Knee Society. Setenta y uno punto cuarenta y tres por ciento de los pacientes presentó alguna complicación, resaltando la rigidez articular, la desviación angular en recurvatum, el dolor crónico y la artrosis postraumática. Conclusión: El TDC y la PPA son opciones válidas para el tratamiento de las fracturas de fémur distal AO 33C2, puesto que ofrecieron mejores resultados funcionales que la PSC

Abstract: Introduction: The distal articular femur fracture is a serious injury that for years has been a problem in traumatology. It is often believed that produced varying degrees of permanent disability in the knee and that the fate of the joint was determined by the injury rather than treatment. Objectives: Present the results of surgical treatment of articular distal femur fractures type C2 with three treatment modalities: dynamic condylar screw (TDC), condylar buttress plate (PSC) and periarticular plate (PPA). Material and methods: We conducted a comparative study of three therapeutic series designed to compare the effectiveness of dynamic condylar screw, the condylar buttress plate and periarticular plate in treating complete articular fractures of distal femur type C2. Patients of both genders, aged between 16 and 60 years, treated in the IAHULA, with a minimum follow up of 24 months. Results: We included 42 patients divided into three groups. Males predominated with 73.8%, the most affected age group was 21-30 years with 28.57%. The most common type of fracture was the 33C2.3 with 42.86%. The 71.43% of patients experienced complications, highlighting joint stiffness, angular deviation in recurvatum, chronic pain and post traumatic osteoarthritis. Conclusion: TDC and the PPA are valid options for the treatment of distal femur fractures AO 33C2, as offered better functional results than PSC.

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No Typhoid Salmonella infection is one of the most common and widely spread foodborne diseases worldwide. Although most cases are limited to the gastrointestinal tract, extraintestinal involvement is not uncommon. However, adenitis as an isolated manifestation, is an unusual form of the disease. We report a case of Salmonella no Typhoid cervical lymphadenitis in a 67-year-old female with a recent diagnosis of diabetes mellitus, who was treated with surgery and ciprofloxacin.

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COPD patients have dyspnea limiting their exercise capacity due to different mechanisms. The origin of the arterial blood gases anomaly is an alteration of the ventilation/perfusion (V'/Q') ratio causing venous admixture which has not been addressed therapeutically so far. Theoretically an arteriovenous fistula (AVF) could increase venous content of O2 so that blood leaving the left ventricle has a higher than expected PaO2 .This, along with the associated increase in cardiac output leads to an increased delivery of O2 to tissues particularly skeletal muscle thus improving its performance. We present a patient with advanced COPD. Full conventional therapy failed to improve his dyspnea and hypoxemia which limits his exercise capacity. We made a peripheral arteriovenous fistula on him as a therapeutic intent. Spirometry showed an initial FEV1 of 0.74 L, a FVC of 1.97 L, he had hypoxemia (PaO2 :56.8 mmHg, oxyhemoglobin saturation (SaO2 ): 82.9 percent). A 6 min walking test with a distance of300 m corresponding to 61 percent of predetermined value that improved by 108 m providing O2 2 L/min. Echocardiography showed a pulmonary artery systolic pressure of 26 mm Hg and a 60 percent of left ventricle ejection fraction. The patient obtained 73.8 percent in Saint George's Respiratory Questionnaire (SGRQ), 38 points in COPD Assesment Test (CAT) and 6 points in BODE Index. After 4 weeks of AVF neither spirometric nor echocardiographic changes were observed, but there was an improvement in PaO2 to 68 mmHg and in SaO2 to 93 percent. The 6 min walking test showed an increase to 425 m. SGRQ improved to 3.88 points, BODE index improved to 3 points and CAT to 21 points. We conclude that in this patient an AVF determined an improvement in exercise capacity with a better control of disease that resulted in a better quality of life constituting an important non pharmacological aid in an advanced COPD patient who failed to improve with full medical therapy. In patients selection...

El paciente portador de EPOC tiene disnea que limita su capacidad de ejercicio por diferentes mecanismos entre los cuales está la incapacidad de la musculatura respiratoria para responder al aumento de las demandas, que puede ser secundaria a la disminución de la entrega de O2. La anomalía gasométrica propia de la enfermedad tiene como origen una alteración de la relación ventilación/ perfusión (V'/Q') que causa un aumento de la admisión venosa el cual no ha sido enfrentado terapéuticamente hasta el momento. Teóricamente una fístula arteriovenosa (FAV) podría aumentar el contenido venoso de O2 ,de modo que la sangre que sale del ventrículo izquierdo lo haga con una PaO2 mayor que la esperada. Esto, junto con el aumento del gasto cardíaco asociado llevaría a una mayor entrega de O2 a los tejidos mejorando de esa forma el desempeño de la musculatura esquelética. En un paciente con EPOC avanzada que con terapia máxima no logra mejorar la disnea ni la hipoxemia que limitan seriamente su capacidad de ejercicio, confeccionamos una fistula entre la vena safena interna y la arteria femoral superficial con intención terapéutica. La espirometría inicial mostró un VEF1de 0,74 L (26 por ciento del valor predeterminado) con CVF de 1,97 L (57 por ciento). Presentaba hipoxemia (PaO2 :56,8 mmHg y SaO2 :82,9 por ciento), un test de caminata de 6 min (TC6M) con un recorrido de 300 m que corresponde a un 61 por ciento del teórico que mejoraba al aportar O2 2 L/min a 408 m correspondiente a un 80 por ciento del teórico. El ecocardiograma detectó una presión sistólica de arteria pulmonar de 26 mmHg y una fracción de eyección del ventrículo izquierdo de 60 por ciento. En el cuestionario respiratorio de Saint George el paciente obtuvo 73,8 por ciento su CAT (COPD Assessment Test) fue de 38 puntos y su índice BODE (Body mass, Obstruction, Dyspnea, Exercise capacity) de 6 puntos. Al mes de realizada la FAVno hubo cambios espirométricos ni ecocardiográficos, pero la PaO2 mejoró a...

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El presente artículo surge como intención de construir una reflexión conceptual, puntual y profunda en el ejercicio de un pensamiento esclarecedor sobre el ser humano y sustransformaciones, lo que bien considera la psicología Humanista-Existencial como principios para comprender la existencia, se abordan cuatro categorías esenciales que en las discusiones sean convertido en elementos capitales para la investigación en el grupo Transformaciones Contemporáneas.

The current article appears as an intent to build up a conceptual, punctual, and deep reflection in the exercise of an enlightening thought about the human being and his transformations, whatthe Humanistic-Existential psychology considers to be the principles to understand existence; four essential categories are approached being the capital elements for the research in theContemporary Transformations group.

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The aims of this study were to describe the clinical features of patients with systemic lupus erythematosus (SLE) who developed cryptococcal infection and ascertain their outcomes when treated with glucocorticoids and immunosuppressive agents in conjunction with long-term maintenance antifungal therapy. Six cases of cryptococcal infection in SLE were reviewed retrospectively. The mean age at the time of infection was 26.3 (11.7) years. Three patients had active SLE and all were receiving glucocorticoids [median prednisone dose of 40 (21.2-60.0) mg/day] at the time of infection diagnosis. Concomitant cytotoxic agents were used in five patients. Meningitis was the most common clinical manifestation (n = 5) and cryptococcemia was found in three cases. The patient, who developed pulmonary cryptococcosis, died from respiratory distress syndrome. All patients received induction anti-fungal therapy with amphotericin B and the five surviving patients switched to oral fluconazole indefinitely as maintenance therapy and none of them has had relapses of cryptococcal infection to last medical evaluation. As SLE patients have intrinsic abnormalities of cell-mediated immunity and receive immunosuppressive therapy, indefinite maintenance therapy with fluconazole is recommended in SLE patients with cryptococcosis.

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The effects of olanzapine (OLZ) on the viability and functioning of human polymorphonuclearcells (PMNs) are clearly opposite to those previously reported forclozapine (CLZ). In fact, after 4- or 24-h-treatment with 20-50 μM OLZ, a significant inhibition of the respiratory burst in PMNs activated with opsonized zimosanor phorbol myristate acetate (PMA) was observed, whereas the burst provoked byformyl-methionyl-leucyl-phenylalanine (fMLP) was only inhibited at 50 μM OLZ.Under the same conditions, spontaneous apoptosis was accelerated at 20-50 μMOLZ, while the exogenous addition of H2O2 resulted in the PMN apoptosis beingdose-dependently inhibited by OLZ in the entire range of concentrations. However,when H2O2 was intracellularly generated by treatment with PMA, the induced apoptosis was only decreased at 2 μM OLZ. Absorbance scans revealed that OLZis able to react with equimolar quantities of either H2O2 or HOCl. These results suggest that OLZ inhibits both ROS-induced PMN apoptosis and respiratory burst due to extracellular scavenging of released ROS.

Los efectos de olanzapine (olz) sobre la viabilidad y el funcionamiento de células humanas polimorfonucleares (pmn, por sus siglas en inglés) claramente son opuestosa los señalados para la clozapine (clz). En efecto, después de 4-24 h de tratamiento con 20-50 μM olz, se observó una inhibición significativa del estallido respiratorio en pmn activados con zimosan o con forbol acetato miristato, mientras que la inhibición provocada por el formil-metionil-leucil-fenilalanina fue sólo inhibida a 50μM de olz. En las mismas condiciones, la apoptosis espontánea se aceleró con 20-50μM olz, mientras que la adición exógena de H2O2 dio lugar a la apoptosis de pmn en dosis dependiente inhibida por olz en el rango entero de concentraciones. Sin embargo, cuando se generó H2O2 intracelular por tratamiento con pma, la apoptosis inducida se disminuyó solamente con 2 μM olz. Las exploraciones de los espectros de absorbancia revelaron que olz puede reaccionar con cantidades equimolares de H2O2 o de HOCL. Estos resultados sugieren que olz inhibe ambos tipos de apoptosis de pmn (la inducida por especies reactivas oxigenadas y por estallido respiratorio debido a atrapadores extracelulares de estas especies reactivas oxigenadas).

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The WHO defines Category A wastewater as one which does not contain more than 1000 FCU 100 ml(-1) of faecal coliforms (FC) and less than 1 helminth egg (HE) per litre. The objectives of this work were to determine: 1) the disinfectant capacity of different concentrations of silver (Ag), silver-copper (Ag-Cu) and silver-copper-peracetic acid (Ag-Cu-PAA) when added to samples of raw wastewater (RW), with a contact time of 60 minutes; 2) the optimal concentration and contact time required by the better performing disinfectant, determined from the previous stage, to obtain Category A RW; 3) the effect of the selected disinfectant when applied to RW, the effluent of activated sludge (ASE) and the effluent of sand filters (FE) for 10, 30 and 60 min duration. The Ag:Cu:PAA ratio of 0.6:6.0:100.0 mg l(-1), showed the best disinfectant capability to produce Category A wastewater. The ratio of 0.1:1.0:20.0 mg l(-1) of Ag:Cu:PAA and a contact time of 10 minutes are the optimal values to produce Category A wastewater in RW. For RW and ASE, the optimal ratios and times for Ag:Cu:PAA were: 1.2:12.0:90.0 mg l(-1) at 60 min and 0.1:1.0:20.0 for 10 min, respectively. The FE samples showed concentrations of FC and HE below the standards of the WHO; therefore, their disinfection is not necessary.

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This paper evaluates the efficacy of hydrogen peroxide (HP) and peracetic acid (PAA) in the disinfection of an Advanced Primary Treatment (APT) effluent, and how said disinfection capacities can be enhanced by combining the oxidants with copper (Cu2+) and silver (Ag). The treatment sequence consisted of APT (adding chemicals to water to remove suspended solids by coagulation and flocculation), followed by disinfection with various doses of HP, HP+Cu2+, HP+Ag, PAA and PAA+Ag. Microbiological quality was determined by monitoring concentrations of fecal coliforms (FC), pathogenic bacteria (PB) and helminth eggs (HE) throughout the sequence. The results revealed that APT effluent still contains very high levels of bacteria as the treatment only removes 1-2 log of FC and PB, but the reduction in the number of viable helminth eggs was 83%. Subsequent disinfection stages demonstrated that both HP+Cu2+ and HP+Ag have a marked disinfection capacity for bacteria (3.9 and 3.4 log-inactivation, respectively). Peracetic acid on its own was already extremely efficient at disinfecting for bacteria, and the effect was enhanced when combining PAA with silver (PAA+Ag). The best result for HE removal was achieved by combining PAA with silver (PAA+Ag) at doses of 20 + 2.0 mg l(-1), respectively. The study concluded that the PAA+Ag and HP+Ag combinations were good alternatives for APT effluent disinfection, because the disinfected effluents met the standards in NOM-001-SEMARNAT-1996, Mexico's regulation governing the microbiological quality required in treated wastewater destined for unrestricted reuse in agricultural irrigation (< or =1 helminths per litre). Combining either of these disinfection treatments with a primary method such as APT, therefore, offers an effective and practical way of reducing the health risks normally associated with the reuse of wastewaters.

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Las afecciones cromosómicas son responsables de un alto porcentaje de las muertes prenatales y neonatales. El realizar un adecuado y oportuno diagnóstico prenatal es fundamental para que el equipo médico y la familia estén preparados de la mejor forma para recibir y tratar al recién nacido. En esta publicación se describe la experiencia de 18 años (1989-2007) del Laboratorio de Citogenética de Clínica Las Condes en el diagnóstico citogenético prenatal. Durante este período se realizaron 2.526 estudios prenatales: 1.446 en vellosidades caria les, 683 en líquido amniótico, 379 en sangre fetal y 18 en otros fluidos (11 líquidos de hidrotórax y 7 orinas fetales), lo que representa un 26% del total de exámenes realizados por el laboratorio durante el período (n= 9.738). El porcentaje de exámenes alterados fue de 20,3%. Se analizan los resultados de acuerdo al tipo de muestra, edad materna, edad gestacional y tipo de alteración encontrada.

Chromosomal abnormalities are the cause of an important number of prenatal and neonatal deaths. Early and reliable prenatal diagnosis is essential for families and for professional teams in order to be prepared to receive and treat in the best way the newborn. In this report we describe the 18 years experience (19892007) of the Cytogenetics Lab of Clinica Las Condes in cytogenetical prenatal diagnosis. During this period 2526 prenatal cytogenetics analysis were performed (1446 corionic villi sample, 683 amniotic fIuid, 379 fetal blood and 18 in others fIuids (11 fluid from hydrothorax and 7 fetal urine); this represents 26% of the total samples analyzed at the Lab during this period (n= 9738). The percentage of abnormal results was 20,3%. We present and discuss the results according to type of sample, maternal age, gestational age, and type of chromosomal abnormalities detected.

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The purpose of this work was to evaluate the effect that ozone (O(3)) has on the advanced primary treatment (APT) and disinfection of wastewaters for their reuse in agriculture. The enhancement and optimization of APT was done by applying low O(3) doses during coagulation. By applying an ozone dose of 2 mg/L during APT, the required coagulant dose may be reduced by up to 25% to achieve a similar turbidity removal (and up to 50% for total suspended solids removal), when compared to a conventional APT treatment. When the same coagulant dose was applied (60 mg/L), the volume of settleable solids was reduced from 31.0 to 25.5 mL/L, and the settling velocity increased from 0.111 to 0.139 m/min. Disinfection was also improved by the use of ozone, which leads to better plant germination rates than when using chlorination, because of reduced toxicity of the ozonated effluents. Additionally, helminth eggs content was reduced by applying ozone.

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Introducción. La Diabetes Mellitus Tipo 2 (DM2) es una enfermedad crónica degenerativa que afecta a la población de nuestro país; el Sistema Nacional de Salud ha creado estrategias para fomentar el autocuidado de las personas con esta enfermedad. El personal de Enfermería es integrante clave en los equipos multidisciplinarios en el desarrollo de estas estrategias, por ello es importante estudiar los elementos que conforman y promueven el autocuidado, entre los que se consideran como los más importantes el nivel de conocimientos de la enfermedad y el apoyo familiar (en este caso determinado por la Salud-Competencia Familiar) con la que cuenta la persona con DM2. Propósito: Identificar la influencia de la Salud-Competencia Familiar en el autocuidado y el nivel de conocimientos que tenga el paciente con DM2 Metodología: Investigación transversal, descriptiva, con una muestra representativa no probabilística de 30 personas con DM2. El análisis de datos se llevó a cabo con el paquete estadístico SPS. Discusión y Conclusiones: El estudio concuerda con resultados de otras investigaciones realizadas. El Nivel de Salud Competencia Familiar y el nivel de conocimientos de la enfermedad influyen en el auto cuidado, puesto que el Nivel de Salud Competencia Familiar es un muro de contención para que el paciente pueda llevar a cabo su Autocuidado, si la persona con DM2 cuenta con un medio familiar estable entonces la adherencia al tratamiento farmacológico y medico será mejor.

Introduction. The Diabetes Mellitus Tip 2 (DM2) is a degenerative chronic disease that affects the population of our country; the National System of Health has created strategies to foment the self care one of the people with this disease. The infirmary personnel is integral key in the multidisciplinary equipment in the development of these strategies, for that reason it is important to study the elements that conform and promote the self care one, between that consider themselves as the most important level of knowledge of the disease and the familiar support (in this case determined by Familiar HealthCompetition) with which counts the person with DM2. Objective: To identify the influence of Familiar Health-Competition in self care and the level of knowledge that the patient with DM2 has. Methodology: Cross-sectional, descriptive investigation, with nonprobabilística a representative sample of 30 people with DM2. The analysis of data was carried out with statistical package SPS. Discussion and Conclusions: The study agrees with results of other made investigations. The Level of Health Familiar. Competition and the level of knowledge of the disease influence in the taken care of car, since the Level of Health Familiar. Competition is a retaining wall so that the patient can carry out his self care, if the person with DM2 has an average then stable relative the adhesion to the pharmacologic treatment and medical it is better.

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