Search

Since the start of the COVID-19 pandemic, the top priority was to hinder the spread of the virus and prevent the collapse of the health systems. To achieve this, it was mandatory to ensure adequate supplies of personal protective equipment (PPE), which may not have been available in the short-term during the first months of the crisis. While leading manufacturing companies all over the world were retooling their factories to produce medical equipment, 3D printing offered a transition solution to quickly supply PPEs in the case of emergency. In this context, the University of Castilla-La Mancha started a new solidarity project to produce PPEs via 3D printing, especially for healthcare staff. This project was characterized by the commitment of several geographically distributed volunteers, with limitations due to confinement. The group of volunteers required an organizational model supported by ad-hoc technology to make their collaboration efficient. This article demonstrates how a centralized production model is not efficient in such a situation, and proposes a novel web system supported by an intelligent recommender, which facilitates a distributed organizational model that optimizes manufacturing and delivery times of PPEs. The results show how our proposal drastically improves the efficiency of the group of collaborators, and adequately address the high social demand concentrated in a short period. This was a crucial change for the production and distribution of over 23,500 PPEs during the first 40 days of the crisis, in one of the regions with a higher rate of COVID-19 cases in Europe.

El presente estudio que tiene como objetivo analizar los niveles de conducta violenta, autoestima y práctica de Actividad Física en adolescentes que se encuentran en acogimiento residencial donde se dictaminan posibles relaciones entre todas las variables con tres hipótesis. Participaron 203 adolescentes evaluados mediante la Escala de Conducta Violenta en la Escuela, Test de Autoestima General de Rosenberg y Hoja de Autoregistro para valorar la Actividad Física. Los resultados mostraron que los adolescentes no residentes en el hogar familiar son asiduos practicantes de deportes colectivos de contacto, que los niveles de agresividad son similares y que un tercio de ellos tienen autoestima baja, cumpliendo dos de las tres hipótesis, y denotando falta de correspondencia entre agresividad, autoestima y modalidad deportiva.

La presente investigación tiene por objetivo analizar el grado de coordinación pedagógica existente entre el profesorado de educación física, a partir de la promoción de un estilo de vida saludable entre el alumnado. En concreto, se trató de determinar si existía o no una tendencia a trabajar colaborativamente en aras a conseguir unos objetivos específicos en el área de Educación Física. Para ello, se realizó un cuestionario elaborado para esta investigación, que estaba compuesto por 25 ítems, dirigido a maestros con la especialidad de educación física en ejercicio. A partir de un muestreo aleatorio simple, se consiguieron 300 respuestas de maestros de la provincia de Granada. Entre los resultados, destaca la importancia de la motivación en la conjugación del desempeño profesional docente del especialista del área de educación física. De este modo, se aprecia una fuerte correlación existente entre motivación e inclusión social y vida saludable, así como entre motivacióne innovación curricular.

Debido a la relación existente entre las variables psicológicas y el rendimiento deportivo, la psicología del deporte ha cobrado una especial relevancia en las últimas décadas, por lo que la presente investigación tiene como objetivo analizar los niveles de ansiedad en futbolistas de categorías inferiores, utilizando un diseño descriptivo de corte transversal sobre una muestra de 156 futbolistas adolescentes. Para la recogida de datos se ha utilizado un cuestionario ad-hoc para el registro de las variables sociodemográficas y el Stai-Rasgo para medir los niveles de ansiedad. Los resultados de la presente investigación indican que seis de cada diez futbolistas muestran niveles medios de ansiedad-estado y tres de cada diez alta, en cuanto a la ansiedad-rasgo, la mitad tienen una ansiedad alta y la otra mitad media. Como principal conclusión de esta investigación se extrae que el nivel de estudios de los futbolistas se relaciona con los niveles de ansiedad.

Introducción: El triatlón es un deporte que se compone de la combinación de tres fases de competición. La modalidad de triatlón más extendida es la olímpica, y es utilizada en los Juegos Olímpicos (JJOO), se compone de nado 1,5 km, bicicleta 40 km y carrera 10 km. Objetivos: Determinar la influencia de la duración y orden de las fases con el resultado final de la prueba en el triatlón masculino en los JJOO Pekín 2008. Método: Se analizaron los datos de 50 deportistas que finalizaron. Resultados y conclusiones: El resultado final no viene determinado ni por el orden de las fases, ni por la duración de estas, la fase menos influyente ha sido Bike con rs= 0,039; p =0,351; siendo la que más tiempo ha ocupado con un 52,55%; la fase más influyente ha sido la fase Run con rs=0,991; y p=0,000; y R2=0,982 y con duración 30,21%.

El fenómeno del dopaje no solo está instaurado en el mundo del deporte profesional, sino que está causando cada vez más daño dentro del deporte amateur y recreacional. Ya que la edad de las personas que lo utilizan va disminuyendo con el tiempo, la presente investigación plantea como objetivo analizar y establecer relaciones entre las actitudes de jóvenes escolarizados hacia el dopaje, en función del tipo de centro (público o concertado/privado) en donde estudian los jóvenes. En esta investigación, participaron 839 estudiantes de edades comprendidas entre los 15 y 18 años (M=16.22 años, DT=.77), que permitió el registro y evaluación de las variables tipo de centro escolar y actitudes hacia el dopaje, para la recogida de datos se utilizó la escala de actitudes hacia el dopaje (PEAS) de Petróczi (2002). Los resultados revelaron que la mayoría de los participantes tienen actitudes que rechazan el dopaje (64,2%; n=539); los alumnos que estaban escolarizados en centros públicos tienen actitudes más vulnerables hacia el dopaje (p=.014).

A major task of the newly established "Southern African Science Service Centre for Climate Change and Adaptive Land Management" (SASSCAL; www.sasscal.org) and its partners is to provide science-based environmental information and knowledge which includes the provision of consistent and reliable climate data for Southern Africa. Hence, SASSCAL, in close cooperation with the national weather authorities of Angola, Botswana, Germany and Zambia as well as partner institutions in Namibia and South Africa, supports the extension of the regional meteorological observation network and the improvement of the climate archives at national level. With the ongoing rehabilitation of existing weather stations and the new installation of fully automated weather stations (AWS), altogether 105 AWS currently provide a set of climate variables at 15, 30 and 60 min intervals respectively. These records are made available through the SASSCAL WeatherNet, an online platform providing near-real time data as well as various statistics and graphics, all in open access. This effort is complemented by the harmonization and improvement of climate data management concepts at the national weather authorities, capacity building activities and an extension of the data bases with historical climate data which are still available from different sources. These activities are performed through cooperation between regional and German institutions and will provide important information for climate service related activities.

Los hábitos alimentarios se encuentran en decadencia y los problemas de peso van en aumento en Educación Primaria. Este estudio persigue establecer los niveles de índices de masa corporal, el grado de adherencia a la dieta mediterránea y el autoconcepto en una muestra de escolares, determinando las posibles diferencias físico-saludables y psicosociales tras la realización del programa de intervención “SportFruits”. El diseño esdescriptivo, preexperimental con pretest y posttest, de corte longitudinal, para una muestra de 79 escolares con edades de 6 a 8 años (M=7,1 y D.T.=0.638). Se utilizaron instrumentos como la báscula de bioimpedancia, el test KIDMED y el test de Autoconcepto Forma 5 (AF5). Los resultados no mostraron asociaciones estadísticamente significativas, aunque si evidencian la necesidad de mejorar la dieta, reeducando los hábitos alimentarios y promover la actividad física para mejoras psicosociales y reducir los problemas de obesidad y sobrepeso, a través de programas de intervención.

El Salvador is the smallest and most densely populated country in Central America; its coast has an approximate length of 320 km, 29 municipalities and more than 700 000 inhabitants. In El Salvador there were 15 recorded tsunamis between 1859 and 2012, 3 of them causing damages and resulting in hundreds of victims. Hazard assessment is commonly based on propagation numerical models for earthquake-generated tsunamis and can be approached through both probabilistic and deterministic methods. A deterministic approximation has been applied in this study as it provides essential information for coastal planning and management. The objective of the research was twofold: on the one hand the characterization of the threat over the entire coast of El Salvador, and on the other the computation of flooding maps for the three main localities of the Salvadorian coast. For the latter we developed high-resolution flooding models. For the former, due to the extension of the coastal area, we computed maximum elevation maps, and from the elevation in the near shore we computed an estimation of the run-up and the flooded area using empirical relations. We have considered local sources located in the Middle America Trench, characterized seismotectonically, and distant sources in the rest of Pacific Basin, using historical and recent earthquakes and tsunamis. We used a hybrid finite differences–finite volumes numerical model in this work, based on the linear and non-linear shallow water equations, to simulate a total of 24 earthquake-generated tsunami scenarios. Our results show that at the western Salvadorian coast, run-up values higher than 5 m are common, while in the eastern area, approximately from La Libertad to the Gulf of Fonseca, the run-up values are lower. The more exposed areas to flooding are the lowlands in the Lempa River delta and the Barra de Santiago Western Plains. The results of the empirical approximation used for the whole country are similar to the results obtained with the high-resolution numerical modelling, being a good and fast approximation to obtain preliminary tsunami hazard estimations. In Acajutla and La Libertad, both important tourism centres being actively developed, flooding depths between 2 and 4 m are frequent, accompanied with high and very high person instability hazard. Inside the Gulf of Fonseca the impact of the waves is almost negligible.

La presencia de una lesión de riesgo en la mama aumenta la probabilidad de desarrollar un carcinoma o puede indicar la existencia de malignidad concomitante. El manejo adecuado posterior al diagnóstico percutáneo es muchas veces controvertido, por lo que es importante que el radiólogo conozca las implicancias diagnósticas y terapéuticas de las lesiones mamarias de alto riesgo para su detección y seguimiento. Este trabajo tiene como objetivo revisar la literatura y presentar la evidencia actual sobre el manejo de las hiperplasias atípicas ductal y lobulillar, el carcinoma lobulillar in situ, la cicatriz radiada y las lesiones columnares, papilares y de tipo mucocele, luego del diagnóstico con técnicas de intervencionismo percutáneo.

Speciated atmospheric mercury observations collected over the period from 2008 to 2010 at the Environmental Protection Agency and National Atmospheric Deposition Program Atmospheric Mercury Network sites (AMNet) were analyzed for its spatial, seasonal, and diurnal characteristics across the US. Median values of gaseous elemental mercury (GEM), gaseous oxidized mercury (GOM) and particulate bound mercury (PBM) at 11 different AMNet sites ranged from 148–226 ppqv (1.32–2.02 ng m−3), 0.05–1.4 ppqv (0.47–12.4 pg m−3) and 0.18–1.5 ppqv (1.61–13.7 pg m−3), respectively. Common characteristics of these sites were the similar median levels of GEM as well as its seasonality, with the highest mixing ratios occurring in winter and spring and the lowest in fall. However, discernible differences in monthly average GEM were as large as 30 ppqv, which may be caused by sporadic influence from local emission sources. The largest diurnal variation amplitude of GEM occurred in the summer. Seven rural sites displayed similar GEM summer diurnal patterns, in that the lowest levels appeared in the early morning, and then the GEM mixing ratio increased after sunrise and reached its maxima at noon or in the early afternoon. Unlike GEM, GOM exhibited higher mixing ratios in spring and summer. The largest diurnal variation amplitude of GOM occurred in spring for most AMNet sites. The GOM diurnal minima appeared before sunrise and maxima appeared in the afternoon. The increased GOM mixing ratio in the afternoon indicated a photochemically driven oxidation of GEM resulting in GOM formation. PBM exhibited diurnal fluctuations in summertime. The summertime PBM diurnal pattern displayed daily maxima in the early afternoon and lower mixing ratios at night, implying photochemical production of PBM in summer.

Purpose: We present the case of an 18-year-old Caucasian male with a unilateral macular star and retinal vascular anomalies compatible with adult onset Coats’ disease. Methods: Diagnosis was based on fundoscopic, fluorescein angiography and optical coherence tomography findings. Results: The patient presented to our emergency department with complaints of low vision in his left eye (LE) detected 10 days before. The best-corrected visual acuity in the LE was 20/50. Fundoscopy of the LE evidenced a complete macular star. Optical coherence tomography showed increased retinal thickness, infiltration of the retinal wall, and detachment of the neuroepithelium. Angiography revealed no appreciable diffusion in the macula. Above the superior temporal (ST) arcade, anomalies in the retinal vasculature were found, with interruption of the peripheral vessels and vessels which were ‘sausage’-like. After 1 month, the LE vision evolved to hand movements. Laser photocoagulation was performed in the ST quadrant. Intravitreal injection of bevacizumab 1.25 mg/0.05 ml and photodynamic therapy were performed without any significant changes, progression of ST serous detachment of the neuroepithelium, and finally progression to macular fibrosis. Discussion: Coats’ disease is usually diagnosed in childhood, but rare cases may occur in adults. Those cases usually have a more indolent course which was not observed in our patient. When there is macular involvement, prognosis is more guarded, despite treatment.

En este artículo exponemos algunas mejoras y aportaciones en dos aspectos de los sistemas de gestión de aprendizaje (LMS). El primer aspecto es la seguridad y la autenticación, donde presentamos una modalidad de combinar la autenticación tradicional de contraseña y nombre de usuario con la autenticación por la técnica biométrica de comparación de huellas dactilares. El segundo aspecto es una arquitectura middleware capaz de dar acceso desde los LMS a distintos laboratorios remotos y virtuales (online) de forma que, se evita la duplicación de los servicios proporcionados por ambas y se reutilizan los servicios proporcionados por los LMS en las sesiones prácticas.

Las fases α de estructura cristalina cúbica y hexagonal, formadas durante los ensayos de análisis térmico y tratamientos isotérmicos específicos, han sido analizadas para una serie de aleaciones Al-Mn-Si con diferente contenido de hierro. En estas aleaciones, la relación en peso Fe/Mn se varió de 0,1 a 8,4. Este estudio muestra que las aleaciones Al-13,4Si-1,1 Mn-Fe con relación en peso Fe/Mn menor o igual a 4, la fase a presenta estructura cristalina cúbica, mientras que en aleaciones con una relación Fe/Mn igual o mayor a 5,3, la fase a presenta estructura cristalina hexagonal. Por lo tanto, la relación crítica Fe/Mn para la transición de estructura cristalina de cúbica a hexagonal se encuentra entre 4 y 5,3 para las aleaciones estudiadas.

Estradiol participates in the control of energy homeostasis, as demonstrated by an increase in food intake and in body weight gain after ovariectomy in rats. In the present study, female Wistar rats (200-230 g, N = 5-15 per group), with free access to chow, were individually housed in metabolic cages. We investigated food intake, body weight, plasma leptin levels, measured by specific radioimmunoassay, and the hypothalamic mRNA expression of orexigenic and anorexigenic neuropeptides, determined by real-time PCR, in ovariectomized rats with (OVX+E) and without (OVX) estradiol cypionate treatment (10 µg/kg body weight, sc, for 8 days). Hormonal and mRNA expression were determined at pre-feeding and 4 h after food intake. OVX+E rats showed lower food intake, less body weight gain and lower plasma leptin levels. In the OVX+E group, we also observed a reduction of neuropeptide Y (NPY), agouti-related protein (AgRP) and cocaine- and amphetamine-regulated transcript (CART) mRNA expression in the arcuate nucleus and a decrease in orexin A in the lateral hypothalamic area (LHA). There was an increase in leptin receptor (LepRb), melanocortin-4 receptor (MC4-R), CART, and mainly corticotropin-releasing hormone (CRH) mRNA in the paraventricular nucleus and LepRb and CART mRNA in the LHA. These data show that hypophagia induced by estradiol treatment is associated with reduced hypothalamic expression of orexigenic peptides such as NPY, AgRP and orexin A, and increased expression of the anorexigenic mediators MC4-R, LepRb and CRH. In conclusion, estradiol decreases food intake, and this effect seems to be mediated by peripheral factors such as leptin and the differential mRNA expression of neuropeptides in the hypothalamus.

This paper presents the work carried out on recovering, manipulating, unificating, labeling and processing of documents developed within the congresses of TAEE (Technologies Applied to the Teaching of Electronics). The process developed consists of the creation of digital objects and documents arising from the extraction of metadata which define each digital object as a learning object. With the joint between a learning object and its metadata some information extrapolation is possible in multiple environments. Thus, these units of information permit the implementation of web environments, the study and analysis of their contents and the creation of file structures for their incorporation in repositories in a massive way.

The institutional repository created at UNED (Universidad Nacional de Educación a Distancia, Spain) is a project, originating, from the UNED Library computer services, that aims to provide coverage to members and academic staff at the University. The project, currently in full operation, offers a set of services for the management, preservation and access over the Internet of digital materials created by its members. Derived from these services, the purpose of the repository is the spread of the documentary funds as a tool of consultation and divulgation to researchers, scientists and educators in general. This document describes the functional and technical features of the repository, whose implementation keeps Fedora as backend application as well as Fez as Web interface. Both are freeware distributed under GPL license, making it suitable for academic environments, due to reduced costs for computer equipment and constant upgrading resulting in a permanent immunity to obsolescence. Among the features presented in this paper, there are: the visualization of multiple presentations, the dynamic transformation of the contents with subsequent adaptation to environments outside the repository and the definition of relationships between objects.

Background: triple therapy including a proton pump inhibitor, clarithromycin, and amoxicillin (PPI-CA) is the first-choice treatment used for H. pylori eradication. The efficacy of this treatment is declining of late, and alternative therapies are currently under evaluation. Objectives: to evaluate the efficacy, safety and compliance of a triple therapy with a PPI, amoxicillin and levofloxacin (PPI-LA) - replacing clarithromycin - for the eradication of H. pylori. Methods: the study included 135 patients (65% women), mean age 53 years, with dyspeptic symptoms and H. pylori infection proven by a positive urease rapid test, histological analysis, or C13-urea breath test. Diagnosis: non-investigated dyspepsia 48.9%, functional dyspepsia 36.3%, and ulcerative dyspepsia 14.8%. Treatment was indicated with a proton pump inhibitor at usual doses, amoxicillin 1 g, and levofloxacin 500 mg, administered jointly during breakfast and dinner for 10 days. We studied the performance of this triple therapy and its effects using a questionnaire, and effectiveness by the negativity of the C13-urea breath test after 6-8 weeks after treatment discontinuation. Per protocol, we compared the effectiveness of PPI-LA with a control group of 270 patients treated with PPI-CA for 10 days. Results: 130 patients (96.2%) could complete the treatment and follow-up protocol. Effectiveness (intention to treat) was 71.8% (97/135) and 74.6% (per protocol) (97/130). Sixteen patients (11.8%) had well-tolerated adverse effects, except for 5 subjects (3.7%) who dropped out. PPI-CA was effective (per protocol) in 204 patients out of 270 (75.5%) in the control group. Conclusions: triple therapy with a PPI, amoxicillin and levofloxacin for 10 days is a well-tolerated treatment that is easy to comply with; however it has low efficiency - less than 80% - and is not recommended as a first-choice treatment for H. pylori eradication. Similar results were obtained with the classic triple therapy using a PPI, clarithromycin and amoxicillin.Introducción: la triple terapia con un inhibidor de la bomba de protones, claritromicina y amoxicilina (IBP-CA) es el tratamiento de primera elección más utilizado en la erradicación de H. pylori. La eficacia de este tratamiento está disminuyendo en los últimos años y se están valorando otras alternativas terapéuticas. Objetivos:valorar la eficacia, cumplimiento y seguridad de una triple terapia con un IBP, amoxicilina y levofloxacino, sustituyendo a la claritromicina, en la erradicación de H. pylori. Métodos: periodo de estudio: 2007-2008. Se incluyen 135 pacientes (65% mujeres), edad media de 53 años, con síntomas dispépticos e infección por H. pylori, constatada por positividad del test rápido de la ureasa, histología o prueba del aliento con urea-C13. Diagnósticos: dispepsia no investigada: 48,9%, dispepsia funcional: 36,3% y dispepsia ulcerosa: 14,8%. Se indica tratamiento con un inhibidor de la bomba de protones, a dosis habitual, amoxicilina 1 g y levofloxacino 500 mg (IBP-LA), administrados de forma conjunta en desayuno y cena, durante 10 días. Se valora el cumplimiento de la triple terapia y sus efectos adversos mediante interrogatorio y su eficacia mediante la negatividad de la prueba del aliento con urea-C13 practicada a las 6-8 semanas del término del tratamiento. Se compara la eficacia, por protocolo, del tratamiento con IBP-LA con la observada en un grupo control de 270 pacientes tratados con IBP-CA durante 10 días en los años 2006-2007. Resultados: 130/135 pacientes (96,2) del grupo de estudio completaron el tratamiento y el protocolo del seguimiento. La eficacia por intención de tratar fue del 71,8% (97/135) y por protocolo del 74,6% (97/130). Dieciséis pacientes (11,8%) presentaron efectos adversos bien tolerados, excepto en 5 pacientes (3.7%) que motivan el abandono del tratamiento. El tratamiento con IBP-CA resultó eficaz, por protocolo, en 204/270 (75,5%) pacientes del grupo control. Conclusiones: la triple terapia con un IBP, amoxicilina y levofloxacino durante 10 días es un tratamiento bien tolerado, con fácil cumplimiento, pero con una baja eficacia, inferior al 80%, similar a la obtenida con la triple terapia clásica con un IBP, claritromicina y amoxicilina, no siendo un tratamiento de primera elección recomendable, en nuestra área sanitaria, en la erradicación de H. pylori.

A nutrição enteral consiste em uma opção terapêutica que visa a manutenção ou recuperação do estado nutricional. Formulações para nutrição enteral não-industrializadas são preparações à base de alimentos in natura ou de mesclas de produtos não-industrializados com módulos de nutrientes. Entretanto, as informações existentes sobre suas características físico-químicas são escassas. O objetivo do presente estudo foi determinar osmolalidade, viscosidade, fluidez e pH de dietas enterais artesanais com hidrolisado protéico de carne. As dietas tiveram como fonte protéica os hidrolisados de carne bovina, de frango e de peru. A osmolalidade foi determinada em osmômetro por método crioscópico, a viscosidade por fluxo através de tubo capilar em viscosímetro digital programável Brookfield modelo DV-II e o pH em potenciômetro DMPH-2. Os valores de osmolalidade e viscosidade das dietas elaboradas com os hidrolisados de carne bovina, frango e peru foram respectivamente: 411 ± 0,0 mosm/ Kg e 43,9cP; 438,5 ± 0,7 mosm/Kg e 65,3cP; 415 ± 0,0 mosm/ Kg e 57,1cP. As dietas elaboradas com os três hidrolisados apresentaram pH de 6,1, valor considerado não interferente na motilidade gástrica. As fórmulas desenvolvidas foram classificadas como levemente hipertônicas, com viscosidade, fluidez e pH dentro do preconizado, o que é indicativo de sua administração sem intercorrências significativas.

El trauma psíquico es una transversalidad en la historia de la humanidad, pero de diagnóstico tardío, especialmente en lo que refiere a su incorporación a los sistemas de clasificación en psicopatología como Trastorno por Estrés Postraumático (TEPT). Desde ese momento hasta nuestros días han ido en aumento los estudios sobre TEPT, avanzando primero en las formas de evaluación específica y posteriormente en las propuestas de intervención, con énfasis en población adulta. Otros trabajos han evidenciado que, la semiológica del TEPT en niños y adolescentes, no puede ser analizada y bordada de igual manera que en población adulta. En este artículo se presentan los resultados generales de estudios sobre el TEPT en la infancia y adolescencia y los trabajos sobre un Listado de apoyo a los Clínicos para la evaluación del TEPT y del TEPTC o DESNOS, con algunos de los resultados preliminares de los estudios realizados con población de menores en situación de abuso y maltrato.

Introduction: proton pump inhibitors (PPIs) are the most effective drugs to cure peptic esophagitis and control the symptoms of gastroesophageal reflux disease (GERD). In most patients with GERD esophagitis is not detected by endoscopy, which represents GERD with a negative endoscopy or non-erosive reflux disease (NERD). The influence of infection by H. pylori in the evolution of GERD is controversial since a protective action is identified by some studies, but not all. We conducted a clinical trial to assess the efficacy of lansoprazole 15 mg/day in the initial control of NERD symptoms, and as a secondary endpoint the impact of H. pylori infection on response to treatment. Patients and methods: a pilot, single-center clinical trial was conducted -single-blind regarding the experimental medication (unknown to patients), and double-blind regarding the information concerning H. pylori infection. Sixty (60) patients with NERD were initially included, who had suffered from daytime or nocturnal heartburn for 1-2 days in each of the last two weeks. Nine patients were excluded for failing to comply with the study protocol. The 51 remaining patients, 35 women and 16 men, with a mean age of 49 years, comprised the per protocol analysis population. Patients received treatment for two weeks with a capsule of the study medication (15 mg/day of lansoprazole), with daily controls on the presence and severity of daytime and nocturnal heartburn. Treatment was considered effective when, upon completion, patients referred a maximum of one episode of mild heartburn as defined in the protocol, or answered the following question in the affirmative: "Does the medication you are receiving satisfactorily control the symptoms of your disease?". During diagnostic endoscopy we obtained biopsies of the gastric body and antrum to investigate infection by H. pylori by means of a urease test. Treatment efficacy was assessed with no patients or doctors responsible for the study being aware of urease test results. Results: 41 patients (80.3%) reported that treatment had satisfactorily controlled their symptoms, and 34 patients (66.6%) had a maximum of one episode of mild heartburn in the last week. Forty-two (42) patients (82.3%) had infection by H. pylori. No significant differences were observed in the response to treatment between patients with or without H. pylori infection. Conclusions: with the limitations of a pilot study, these results suggest that lansoprazole 15 mg/day is an effective treatment in the control of NERD symptoms, that it may be a good initial therapeutic strategy, and that, according to data available, H. pylori infection has no significant effect on the response to treatment.Introducción: los inhibidores de la bomba de protones (IBP) son los fármacos más eficaces en la curación de la esofagítis péptica y en el control de los síntomas de la enfermedad por reflujo gastroesofágico (ERGE). En la mayoría de los pacientes con ERGE no se detecta esofagitis al practicarse endoscopia presentando una ERGE con endoscopia negativa o no erosiva (ERNE). La influencia de la infección H. pylori en la evolución de la ERGE es controvertida, ya que mientras que unos estudios le asignan una acción protectora, otros se la niegan. Hemos realizado un ensayo clínico para valorar la eficacia de lansoprazol 15 mg/día en el control inicial de los síntomas de la ERNE y, como objetivo secundario, la influencia de la infección H. pylori en la respuesta al tratamiento. Pacientes y métodos: se realiza un ensayo clínico piloto, unicéntrico, simple ciego en cuanto a la medicación experimental, no conocida por los pacientes, y doble ciego en cuanto a la información de la infección por H. pylori. Se incluyeron inicialmente 60 pacientes con ERNE que presentaban al menos dos días con pirosis diurna o nocturna en cada una de las dos últimas semanas. Se excluyeron 9 pacientes por incumplimiento del protocolo del estudio. Los 51 pacientes restantes, 35 mujeres y 16 hombres, con edad media de 49 años, constituyeron la población de análisis por protocolo. Los pacientes recibieron tratamiento durante dos semanas con una cápsula de la medicación de estudio (15 mg/día de lansoprazol), realizándose en este tiempo un seguimiento diario de la presencia e intensidad de la pirosis diurna y nocturna. Se consideró que el tratamiento era eficaz cuando a su finalización los pacientes referían haber presentado como máximo un episodio de pirosis de intensidad leve, según definición del protocolo, o bien respondían afirmativamente a la siguiente pregunta: "¿la medicación que recibe le controla de forma satisfactoria los síntomas de su enfermedad?". Durante la endoscopia diagnóstica se obtuvieron biopsias de cuerpo y antro gástrico para investigar, mediante test de la ureasa, la infección por H. pylori. Se valoró la eficacia del tratamiento sin conocerse por los pacientes y médicos responsables del estudio los resultados de los test de ureasa. Resultados: cuarenta y un pacientes (80,3%) referían que el tratamiento les controlaba de forma satisfactoria la sintomatología y 34 pacientes (66,6%) habían presentado como máximo un episodio de pirosis de intensidad leve en la última semana. Cuarenta y dos pacientes (82,3%) presentaban infección por H. pylori. No se observaron diferencias significativas en la respuesta al tratamiento en los pacientes con o sin infección por H. pylori. Conclusiones: con las limitaciones propias de un estudio piloto, estos resultados, orientan a que lansoprazol 15 mg/día es un tratamiento eficaz en el control de la sintomatología de la ERNE, pudiendo ser una buena estrategia terapéutica inicial y que, con los datos disponibles, la infección por H. pylori no influye de forma significativa en la respuesta al tratamiento.

Introduction: the sensitivity of invasive diagnostic methods for Helicobacter pylori (H. pylori) infection, particularly of urease rapid test, is decreased in cases of gastroduodenal ulcer and upper gastrointestinal bleeding. Objectives: to assess the influence of blood in the stomach or recent bleeding endoscopic signs in the diagnostic sensitivity of urease rapid test among patients with bleeding duodenal ulcer, as well as the influence of simultaneously collected corporal and antral biopsy samples. Patients and methods: 120 patients, 85 male and 35 female, with an average age of 62 (18-88) years, who were admitted to our Hospital due to bleeding duodenal ulcer and who received an endoscopic diagnosis within 24 hours of admission were included. None of the patients had been under treatment with non-steroideal antiinflammatory drugs, proton-pump inhibitors or antimicrobial drugs in the two weeks prior to the bleeding event, and none had received eradicating therapy for H. pylori. In this group of selected patients an H. pylori infection rate nearing 100% was assumed. H. pylori infection was ruled out using antral biopsy (69 cases) or both antral and fundic biopsies (51 cases) for urease rapid testing (Jatrox®-H.p.-Test). Patients were classified in three groups according to their endoscopic bleeding signs: a) presence of blood in the stomach or recent bleeding ulcer (21 cases); b) ulcer showing non-recent bleeding signs (38 cases); and c) ulcer without bleeding signs (61 cases). The sensitivity of the urease rapid test was compared between patient groups. Similarly, urease test results with an antral biopsy sample were compared in 100 patients with non-bleeding duodenal ulcer. Results: urease test was positive in 93% of patients with non-bleeding duodenal ulcer, and in 83% of patients with upper gastrointestinal bleeding, which reached statistical significance (p = 0.019). This test was positive in 82.6% of patients with an antral biopsy, and in 82.3% of patients with combined antral and fundic biopsies. In group A, urease test was positive in 90.5% of patients; in group B, it was positive in 89.5% of patients, and in group C, the test turned positive in 75.4% of patients. Statistical differences were only reached when patients in group C were compared to patients in groups A and B together (p = 0.037). Conclusions: 1. The presence of either blood in the stomach or recent bleeding endoscopic signs appeared not to be the conditioning factor for the decreased sensitivity of urease test among patients with bleeding duodenal ulcer. 2. The decreased sensitivity of this test in patients with upper gastrointestinal bleeding is more evident during the resolution stage, and it does not seem to occur because of H. pylori migration from the antrum to the corporal gastric region.Introducción: la sensibilidad de los métodos diagnósticos invasivos de infección por H. pylori, especialmente el test rápido de la ureasa, disminuye en los casos de úlcera gastro-duodenal y hemorragia digestiva. Objetivos: valorar la influencia de la presencia de sangre en estómago o de signos endoscópicos de sangrado en la sensibilidad del test rápido de la ureasa en pacientes con hemorragia por úlcera duodenal, así como la influencia de la obtención de biopsias de cuerpo y antro gástrico. Pacientes y métodos: incluimos 120 pacientes, 85 varones y 35 mujeres, con edad media de 62 (18-88) años, con hemorragia por úlcera duodenal y diagnóstico endoscópico en las primeras 24 horas del ingreso. Ningún paciente había consumido antiinflamatorios no esteroideos, inhibidores de la bomba de protones o antibióticos en las dos semanas previas a la hemorragia digestiva, ni había recibido tratamiento frente a H. pylori. En este grupo seleccionado de pacientes admitimos una tasa de infección de prácticamente el 100%. Investigamos la infección por H. pylori mediante biopsias de antro (69 casos) o de cuerpo y antro (51 casos) gástricos para test de ureasa. Los pacientes se clasificaron en tres grupos según los signos de sangrado: a) sangre en estómago o úlcera con signos recientes de sangrado (21 casos); b) úlcera con signos no recientes de sangrado (38 casos); y c) úlcera sin signos de sangrado (61 casos). Comparamos la sensibilidad del test rápido de ureasa en los distintos grupos de pacientes. Estudiamos asimismo los resultados del test de la ureasa, mediante biopsia antral, en 100 pacientes con úlcera duodenal sin hemorragia digestiva. Resultados: el test de la ureasa resultó positivo en el 93% (93/100) de los pacientes con úlcera duodenal sin hemorragia digestiva y en el 83% (99/120) de los pacientes con hemorragia digestiva, siendo la diferencia estadísticamente significativa (p=0,019). Mediante biopsia antral resultó positivo en el 82,6% (57/69) y mediante biopsias de antro y cuerpo gástrico en el 82,3% (42/51) de los casos. En el grupo A el test de ureasa fue positivo en el 90,5% (19/21); en el grupo B en el 89,5% (34/38) y en el grupo C en el 75,4% (46/61) de los casos, detectándose únicamente diferencias con significado estadístico al comparar el grupo C (nº 61) con los grupos A y B asociados (nº 59) (p=0,037). Conclusiones: 1. La presencia de sangre en estómago o de signos recientes de sangrado, en el momento de la endoscopia, no parecen ser el factor condicionante de la disminución de sensibilidad del test de ureasa en pacientes con hemorragia digestiva por úlcera duodenal. 2. La disminución de la sensibilidad del test rápido de la ureasa, en el contexto de la hemorragia digestiva, no sería un suceso inmediato o precoz, siendo más evidente en el estadio de resolución de la hemorragia digestiva y no parece ocasionado por la emigración de H. pylori del antro al cuerpo gástrico.

Introduction: the endoscopic diagnosis of Helicobacter pylori infection in patients with bleeding peptic ulcer is limited by a decreased sensitivity in standard invasive tests, rapid urease test and histology. There is controversy about the convenience of using one, neither, or both diagnostic tests. Aims: to evaluate the results of simultaneously performed rapid urease test and histology in the diagnosis of Helicobacter pylori infection (H. pylori) in patients with bleeding peptic ulcer. Patients and methods: we included 173 patients, 98 male and 75 female, with an average age of 62 years (18-88), with upper gastrointestinal bleeding secondary to duodenal ulcer (115) or gastric ulcer (58), diagnosed within 24 hours after hospital admission. None of the patients had received treatment for H. pylori, proton pump inhibitors or antibiotics in the two weeks prior to the upper gastrointestinal bleeding episode. H. pylori infection was investigated in all patients by two antral biopsy samples for histological study (hematoxilin-eosin) and one or two antral biopsies for rapid urease test (Jatrox®-H.p.-test). In cases with a negative urease test and histology, a 13C urea breath test was performed. Infection was considered present when at least one invasive test or the breath test was positive, whereas both invasive tests and the breath test had to be negative to establish an absent infection. Results: 152 patients (88%) showed H. pylori infection, 104 patients (90%) with duodenal ulcer and 48 patients (83%) with gastric ulcer. In all 119 cases (78%) were diagnosed by the urease test and 112 cases (74%) by histology. Both methods were used to diagnose 134 of 152 cases (88%) (p < 0.05), these being positive in 97 cases and negative in 39 cases. In 18 of these 39 cases, the breath test was positive. Conclusions: histology and urease test have similar diagnostic values for the identification of H. pylori in patients with bleeding peptic ulcer. Due to its rapid results, the urease test should be the method of choice. However, additional biopsies should be performed, and, when negative, a histological study should be carried out, since a combination of both methods allows a more precise diagnosis.Introducción: el diagnóstico de la infección por Helicobacter pylori, mediante endoscopia, en pacientes con úlcera gastroduodenal y hemorragia digestiva está limitado por la disminución de la sensibilidad de los métodos invasivos habituales, test de la ureasa e histología. Existen controversias sobre el valor diagnóstico de practicar, en estos pacientes, alguna, ninguna o ambas pruebas diagnósticas. Objetivos: valorar los resultados del test rápido de ureasa y la histología, practicados simultáneamente, en el diagnóstico de infección por Helicobacter pylori (H. pylori) en pacientes con úlcera gastroduodenal y hemorragia digestiva. Pacientes y métodos: incluimos 173 pacientes, 98 varones y 75 mujeres, edad media de 62 años (18-88), con hemorragia digestiva por úlcera duodenal (115) o gástrica (58), diagnosticados por endoscopia en las primeras 24 horas del ingreso. Ningún paciente había recibido tratamiento erradicador frente a H. pylori ni consumido inhibidores de la bomba de protones o antibióticos en al menos las dos semanas previas al ingreso. Investigamos la presencia de H. pylori mediante la obtención de dos biopsias antrales, para estudio histológico (hematoxilina-eosina) y una o dos biopsias, también antrales, para el test rápido de ureasa. En los casos con test de ureasa e histología negativos se practicó test del aliento con urea marcada con 13C. Consideramos presencia de infección cuando al menos una de las pruebas invasivas o el test del aliento eran positivos y ausencia de infección cuando las dos pruebas invasivas y el test del aliento eran negativos. Resultados: ciento cincuenta y dos pacientes (88%) presentaban infección por H. pylori, 104 (90%) en el grupo con úlcera duodenal y 48 (83%) en el grupo con úlcera gástrica. El test de ureasa resultó positivo en 119 casos (78%) y la histología en 112 casos (74%). Con ambos métodos diagnosticamos 134 de los 152 casos (88%) (p < 0,05). Ambos métodos fueron positivos en 97 casos y negativos en 39 casos. En 18 de estos 39 casos el test del aliento resultó positivo. Conclusiones: la histología y el test de ureasa tienen un valor diagnóstico similar en la detección de H. pylori en pacientes con úlcera gastroduodenal y hemorragia digestiva. El test de la ureasa, por la rapidez del resultado, debe ser el método de elección, pero puede ser conveniente obtener biopsias adicionales y, ante un resultado negativo, realizar estudio histológico, obteniéndose con ambos métodos una mayor precisión diagnóstica. La negatividad del test de la ureasa y/o de la histología no descarta la infección por H. pylori.

VLDL overproduction by enhanced hepatic FFA flux is a major characteristic of familial combined hyperlipidemia (FCHL). The postprandial complement component 3 (C3) response has been associated with impaired postprandial FFA metabolism in FCHL. We investigated the effects of 16 weeks of treatment with atorvastatin on postprandial C3 and lipid changes in 12 FCHL patients. Atorvastatin significantly lowered fasting plasma C3 and triglyceride (TG) in FCHL. Fasting TG and insulin sensitivity were the best predictors of fasting and postprandial C3. Postprandial triglyceridemia and C3 response, estimated as area under the curve (AUC), were significantly lowered by atorvastatin by 19% and 12%, respectively, albeit still elevated, compared with 10 matched controls. Postprandial FFA-AUC and postheparin plasma lipolytic activities remained unchanged after atorvastatin, suggesting no major effect on lipolysis. After atorvastatin, postprandial hydroxybutyric acid-AUC, which was elevated in untreated FCHL patients, was decreased, reaching values similar to those in controls.The present data show reduction of postprandial hepatic FFA flux in FCHL by atorvastatin, providing an additional mechanistic explanation for the reduction of VLDL secretion reported previously for atorvastatin. This was accompanied by a decrease in fasting plasma C3 concentrations and a blunted postprandial C3 response to an acute oral fat load.

Deficiency of 21-hydroxylase is the most common form of congenital adrenal hyperplasia (CAH-21OH). We determined by allele-specific PCR the frequency of microconversion in the CYP21A2 gene in 50 Brazilian patients with the classical (salt wasting: SW and simple virilizing: SV) forms and nonclassical (NC) form of CAH-21OH and correlated genotype with phenotype. Genotypes were classified into three mutation groups (A, B, and C) based on the amount of enzymatic activity in in vitro studies using adrenal cells. In 94 unrelated alleles, we diagnosed 76% of the affected alleles after screening for 7 microconversions. The most frequent point mutations observed in this series were I172N (19%), V281L (18%), and IVS2,A/C>G,-12 (15%). In the SW form, the most frequent mutation was IVS2,A/C>G,-12 (38%), in the SV form it was I172N (53%), and in the NC form it was V281L (57.7%). We observed a good correlation between genotype and phenotype. Discordance between genotype and phenotype was found in one SV patient with a mild mutation in one of the alleles (R356W/V281L). However, we cannot rule out the presence of an additional mutation in these alleles. We also observed a good correlation of genotype with 17alpha-hydroxyprogesterone, testosterone, and androstenedione levels. The severity of external genitalia virilization correlated with the severity of mutation. In conclusion, the frequencies described in the present study did not differ from worldwide studies, including the Brazilian population. The few differences observed may reflect individual sample variations. This new Brazilian cohort study suggests the presence of new mutations in Brazilian patients with different forms of CAH-21OH.

Atherosclerosis is a low-grade inflammatory disease involving leukocytes, lipids, and glucose leading to endothelial dysfunction. Since activation of neutrophils by triglycerides and glucose has been described in vitro, we hypothesized that the postprandial phase is an inflammatory state affecting leukocytes, possibly contributing to endothelial dysfunction. We measured postprandial blood leukocyte counts, cytokines, hydroperoxides (HPOs), and flow-mediated vasodilation (FMD) in eight healthy males (age 23 ± 2 years) after a FAT (50 g/m2) and GLUCOSE challenge (37.5 g/m2), a combination of both (MIXED test), and after WATER. All tests, except WATER, resulted in significantly impaired FMD (10% reduction) between t = 1 h and t = 3 h, accompanied by a significant increase of neutrophils (59% after FAT and 28% after GLUCOSE and MIXED), total plasma HPOs (15 to 31% increase), and plasma interleukin-8 (IL-8) (50–130% increase). WATER did not affect FMD, neutrophils, HPOs, or IL-8. Lymphocytes increased gradually in all tests (40–70% increase at t = 10 h compared with t = 0; P < 0.005), paralleling a gradual 3- to 5-fold interleukin-6 increase. Monocyte and erythrocyte counts did not change in any test.In conclusion, the neutrophil increment during postprandial lipemia and glycemia with concomitant IL-8 and HPO increases may contribute to endothelial dysfunction. Lymphocyte increment is a nonspecific diurnal process. Postprandial intravascular inflammatory changes may be relevant for the pathogenesis of atherosclerosis.

Aims: Glucocorticoids (GCs) exert some of their anti-inflammatory actions by preventing the activation of the transcription factor nuclear factor (NF)-κB. The GC-dependent inhibition of NF-κB may occur at different levels, but the mechanisms involved are still incompletely understood. In this work, we investigated whether the synthetic GC, dexamethasone (Dex), modulates the activity of NF-κB in the lymphoblastic CCRF-CEM cell line. We also evaluated the ability of Dex to prevent the activation of NF-κB in response to the potent proinflammatory cytokine, interleukin (IL)-1β.

Aims: Annexin 1 (ANXA1), a member of the annexin family of calcium-binding and phospholipid-binding proteins, is a key mediator of the anti-inflammatory actions of steroid hormones. We have previously demonstrated that, in the human lymphoblastic CCRF-CEM cell line, both the synthetic glucocorticoid hormone, dexamethasone (Dex), and the estrogen hormone, 17β-estradiol (E2β), induce the synthesis of ANXA1, by a mechanism independent of the activation of their nuclear receptors. Recently, it was reported that the gene coding for ANXA1 contains a cAMP-responsive element (CRE). In this work, we investigated whether Dex and E2β were able to induce the activation of CRE binding proteins (CREB) in the CCRF-CEM cells. Moreover, we studied the intracellular signalling pathways involved in CREB activation and ANXA1 synthesis in response to Dex and E2β; namely, the role of cAMP and the p38 mitogen-activated protein kinase (MAPK).

The central nervous system plays an important role in the control of renal sodium excretion. We present here a brief review of physiologic regulation of hydromineral balance and discuss recent results from our laboratory that focus on the participation of nitrergic, vasopressinergic, and oxytocinergic systems in the regulation of water and sodium excretion under different salt intake and hypertonic blood volume expansion (BVE) conditions. High sodium intake induced a significant increase in nitric oxide synthase (NOS) activity in the medial basal hypothalamus and neural lobe, while a low sodium diet decreased NOS activity in the neural lobe, suggesting that central NOS is involved in the control of sodium balance. An increase in plasma concentrations in vasopressin (AVP), oxytocin (OT), atrial natriuretic peptide (ANP), and nitrate after hypertonic BVE was also demonstrated. The central inhibition of NOS by L-NAME caused a decrease in plasma AVP and no change in plasma OT or ANP levels after BVE. These data indicate that the increase in AVP release after hypertonic BVE depends on nitric oxide production. In contrast, the pattern of OT secretion was similar to that of ANP secretion, supporting the view that OT is a neuromodulator of ANP secretion during hypertonic BVE. Thus, neurohypophyseal hormones and ANP are secreted under hypertonic BVE in order to correct the changes induced in blood volume and osmolality, and the secretion of AVP in this particular situation depends on NOS activity.

Impaired chylomicron (chylo) remnant clearance and small VLDL overproduction are major metabolic abnormalities in familial combined hyperlipidemia (FCHL). Quantitative data on postprandial apolipoprotein B-48 (apoB-48) and apolipoprotein B-100 (apoB-100) in TG rich lipoproteins (TRL) in FCHL have not been reported before. Eight untreated FCHL patients and 10 matched controls underwent a 24 h oral fat load. Fasting apoB-48 and apoB-100 were significantly higher in all TRL in FCHL. Maximal concentrations of chylo-[Svedberg's flotation rate (Sf) >400] apoB-48 and apoB-100 were reached later in FCHL (at t = 6 h), in contrast to controls (t = 4 h). Maximal VLDL1-(Sf60–400)-apoB-48 occurred at the same time point (t = 2 h) in both, whereas VLDL1-apoB-100 was maximal at t = 4 h in both, most likely representing delayed VLDL clearance by preferential clearance of chylo and their remnants by competition for the same clearance mechanisms. VLDL2-(Sf20–60)-apoB-48 and VLDL2-apoB-100 decreased in FCHL, in contrast to an increase of apoB-48, and no change of apoB-100 in controls, suggesting impaired conversion of VLDL1-apoB-48 into VLDL2-apoB-48 in FCHL, and partly also of VLDL1-apoB-100. In conclusion, in FCHL clearance of large postprandial Sf >400 apoB-48 and apoB-100 TRL is delayed. ApoB-100 accumulates in the VLDL1 range postprandially in both FCHL and controls, reaching higher levels in FCHL and thereby conferring a higher atherogenic burden in the postprandial situation in FCHL.—Verseyden, C., S. Meijssen, and M. Castro Cabezas. Postprandial changes of apoB-100 and apoB-48 in TG rich lipoproteins in familial combined hyperlipidemia.

Se presenta un aspecto de la moralidad juvenil, medido por la aceptación de conductas morales cuestionables (Escala de Harding y Phillips, 1986), y sus relaciones con variables familiares, en una muestra aleatoria de 296 estudiantes de enseñanza media, de la provincia de Concepción, Chile. El funcionamiento psicométrico de la escala de Harding y Phillips fue adecuado. En general, la permisividad moral fue baja, con una más alta permisividad sexual y una más baja legal y personal. Hubo correlación entre las variables funcionamiento familiar y los niveles de permisividad. A mayor familismo e interacción familiar, menor permisividad moral y a mayor insatisfacción con el funcionamiento familiar, mayor permisividad moral.

In order to assess the relative influence of age, resting heart rate (HR) and sedentary life style, heart rate variability (HRV) was studied in two different groups. The young group (YG) consisted of 9 sedentary subjects aged 15 to 20 years (YG-S) and of 9 nonsedentary volunteers (YG-NS) also aged 15 to 20. The elderly sedentary group (ESG) consisted of 16 sedentary subjects aged 39 to 82 years. HRV was assessed using a short-term procedure (5 min). R-R variability was calculated in the time-domain by means of the root mean square successive differences. Frequency-domain HRV was evaluated by power spectrum analysis considering high frequency and low frequency bands. In the YG the effort tolerance was ranked in a bicycle stress test. HR was similar for both groups while ESG showed a reduced HRV compared with YG. Within each group, HRV displayed a negative correlation with HR. Although YG-NS had better effort tolerance than YG-S, their HR and HRV were not significantly different. We conclude that HRV is reduced with increasing HR or age, regardless of life style. The results obtained in our short-term study agree with others of longer duration by showing that age and HR are the main determinants of HRV. Our results do not support the idea that changes in HRV are related to regular physical activity.

Overproduction of very low density lipoprotein (VLDL) is the major characteristic of subjects with familial combined hyperlipidemia (FCHL). As enhanced free fatty acid (FFA) flux to the liver may be one of the determinants of VLDL overproduction, we studied FFA changes and products of hepatic FFA metabolism in response to a 24-h oral fat loading test (50 g/m2) in 7 FCHL subjects and 7 matched control subjects. The response to the meal was subdivided into a postprandial (up to 8 h after ingestion of the meal) and postabsorptive period (from 8 to 24 h). Although postheparin plasma lipolytic activities were not different between both groups, the postprandial FFA area under the curve (FFA-AUC) and FFA incremental area under the curve (FFA-dAUC) were higher in FCHL subjects than in control subjects (6.05 ± 0.45 vs. 3.43 ± 0.46 and 2.60 ± 0.49 vs. 0.96 ± 0.31 mmol·h/L, respectively; P < 0.01 for each). The postprandial increase in ketone bodies was almost four times higher in FCHL patients. As ketogenesis occurs predominantly in hepatocytes, these findings suggest that during the postprandial period in FCHL an increased flux of FFA to the liver occurs, possibly because of inadequate incorporation of FFA into triglycerides (TGs) in adipocytes. In the postabsorptive period, FFA and ketone bodies significantly decreased in FCHL subjects, in contrast to control subjects, in whom both increased. These results may represent a diminished release of FFA from adipocytes by hormone-sensitive lipase (HSL) in FCHL patients. The decrease in postabsorptive FFA and ketone bodies in FCHL patients could not be explained by insulin-mediated inhibition of HSL, as both FCHL subjects and control subjects had similar postabsorptive insulin concentrations, which were below fasting concentrations.This study provides in vivo evidence of impaired metabolism of postprandial FFA in FCHL, which may explain in part the hepatic VLDL overproduction characteristic of FCHL subjects.

The comparison among specimens of Rhodnius prolixus, at different stages of development, exposed to infections by Trypanosoma rangeli and Trypanosoma cruzi, revealed that the bugs exposed to T. cruzi showed a significant higher susceptibility to infection than that observed in the groups exposed to T. rangeli or to the mixture of both parasites. The similar mortality rate recorded in uninfected and T. cruzi infected bugs confirms that this parasite is harmless to R. prolixus. On the other hand. T. rangeli produces its pathological effect although the bugs ingest a relatively low number of flagellates. suggesting the existen ce of a direct relation between the amount of ingested parasites and the mortality produced. In mixed infection, T. cruzi does not inhibit the harmful effect ofT. rangeli on R. prolixus. The life cyc1e of R. prolixus is not affected by high infection of T. cruzi or low infection by T. range~. However, when bugs ingested a high amount of flagellates ofT. rangeli in mixed infections, the time to reach the adult stage in relation to controls, was significantIy longer. The epidemiological significance of the present results is discussed.

Resumen: Este artículo presenta el análisis realizado en modelo físico, escala 1:50, de la presa Toachi y sus obras anexas, para obtener experimentalmente la ubicación, forma, tamaño y profundidad máxima de los fosos de socavación que se conforman en el cuenco de disipación de energía al pie de la presa, como resultado del impacto de los chorros lanzados desde los saltos en esquí que se ubican al final de la rápida de descarga de los vertederos de excesos. La investigación experimental se realiza para tres tamaños representativos de material pétreo que conforman el cuenco amortiguador. El modelo de la presa Toachi reproduce la descarga de los dos vertederos de excesos que se ubican en su tramo central. Los saltos en esquí disponen de dos deflectores que proyectan los chorros hacia la zona central del cuenco, en donde la inestabilidad de las márgenes obliga a centrar las fosas de socavación alejadas de los contornos laterales. En conclusión en el presente estudio se determinan experimentalmente las máximas profundidades de socavación para cada tamaño de material y se los compara con valores calculados con once ecuaciones empíricas que la literatura técnica especializada reporta como las más exitosas. Finalmente se obtienen curvas adimensionales extrapoladas para el diseñó de cuencos de socavación en presas, siendo este el mayor aporte de esta investigación. Abstract: This article shows an analysis of the physical model, at 1:50 scale, of Toachi dam and its related works, to obtain experimentally the positioning, form, size and maximum depth of the scour pits that make up the energy stilling pool at the base of the dam, as a result of the impact of the ski-jump jets situated at the end of the outlet spillways. The experimental investigation is for three representative sizes of rocky materials that make up the stilling basin. The Toachi Dam model reproduces the discharge from two outlet spillways situated on its middle section. The ski jump is made up of two flip buckets that deflect the stream flows towards the center of the stilling basin, where the instability of the banks forces to position the scour pits in the center, removed from the lateral edges. This study determines experimentally the maximum depth of the scour pits for each material size and compares them with the calculated values of eleven empirical equations that specialized technical literature reports as being the most successful.