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Introducción: En los últimos años, los cambios demográficos ocurridos en Puerto Rico demuestran un impresionante crecimiento de la población de mayor edad. Históricamente, este grupo poblacional tiene una tradición profundamente religiosa, y actualmente, enfrentan un sin número de retos y demandas de servicios de salud. Este estudio pretende describir las desigualdades de salud entre católicos y no católicos. Además, se prestará atención en cómo la religión influye en su salud, información imprescindible para educación y el diseño cursos que promuevan entornos saludables. Material y método: Esta investigación será una de carácter descriptivo. Se utilizaron datos secundarios de la base de datos titulada: “Condiciones de Salud de los Adultos de Edad Mayor en Puerto Rico: 2002-2003” (conocido por sus siglas en inglés, PREHCO I). La muestra es representativa de la población de 60 años o más en Puerto Rico, y contiene 4,291 personas de 60 años o más. Para este trabajo se considerarán 3,379 adultos de 60 años o más que no necesitaron informante sustituto. La edad, el sexo, la educación, la salud y la incapacidad se encuentran entre las variables consideradas. Resultados: La diabetes, la hipertensión, la artritis y la depresión parecen afectar más a los no católicos. Estas enfermedades afectan más a las mujeres que a los hombres. Las católicas tienen en promedio 2.77 enfermedades versus 3.0 las no católicas. El promedio para los católicos es de 1.97 comparado con 2.27 para los no católicos. Los no católicos y las no católicas muestran también mayor incapacidad que los católicos y las católicas. Conclusiones: El estudio de las desigualdades por razón de religión deben considerase en los currículos universitarios de forma tal que los egresados adquieran los conocimientos necesarios para proveer planes de acción para fomentar la educación y las políticas públicas que atiendan a esta población vulnerable.

Resumen: Introducción: el volumen urinario bajo (< 1 ml/kg/h) es el factor etiológico más frecuente en la litiasis renal. Frecuentemente, se asume que los niños que refieren beber mucho tienen una diuresis protectora. En este estudio analizamos el hábito de consumo de líquidos en niños sanos y su relación con el volumen urinario. Metodología: se estudiaron 84 niños, de 5 a 17 años. Se registró la percepción de consumo habitual de líquidos como: "poco", "normal" o "mucho" y los tipos de bebida habitual. Se cuantificó el volumen en orina de 24 h y se relacionó con la percepción de la ingesta de líquidos. Resultados: la ingesta habitual de líquidos fue calificada como "poca" en el 23% de los casos, "normal" en un 56% y "mucha" en un 21%. El 39% de los niños (33/84) presentó una diuresis > 1 ml/kg/h que, por grupos, supone el 38,9% de los que refirieron una ingesta escasa, el 63% de los de consumo "normal" y el 73,7% de los que refirieron ingesta elevada. El 56% de los niños de los grupos de ingesta "normal" y "elevada" mostraron una diuresis < 1 ml/kg/h. Conclusiones: la mayoría de niños mostraron una diuresis por debajo del límite recomendado, incluso entre los que refieren una ingesta "normal" o "elevada" de líquidos. Estos hallazgos hacen visible la necesidad de promover estrategias encaminadas a aumentar el consumo de agua en la población.

Patients with prosthetic heart valves have a higher risk of developing valve thrombosis and arterial thromboembolism. Antithrombotic therapy during the early postoperative period after biologic mitral valve replacement (MVR) is controversial. Hence, a retrospective study was conducted to investigate the efficacy of different antithrombotic therapies in patients after MVR with bioprostheses.Between January 2000 and January 2006, a total of 99 patients presenting with preoperative sinus rhythm underwent isolated bioprosthetic MVR. Of these patients, 59 (58%) received a bovine pericardial xenograft, and 40 (42%) a porcine bioprosthesis. The postoperative antithrombotic therapy was prescribed according to the surgeon's preference.Fifty-one (51%) patients received acetylsalicylic acid (ASA group, 100 mg/day), 12 (13%) did not receive any specific antithrombotic therapy (NT group), and 36 (36%) received a vitamin K antagonist (VKA group, INR 2-3). The primary endpoints were the rate of cerebral ischemic events, bleeding events, and survival. The mean follow up was 23 months (range: 3-68 months). There were five early deaths (5%), and eight late deaths (8%). There were five episodes of cerebral ischemic events; these included three patients (8.3%) in the VKA group, one patient (2.0%) in ASA group, and one patient (8.3%) in the NT group (p = 0.351). Of these episodes, two occurred between 24 h and three months after surgery. Only one (2.8%) episode of major bleeding occurred (in the VKA group), due to poor anticoagulation management.Each of the antithrombotic therapies evaluated appeared to be safe. There was no evidence to suggest that any specific antithrombotic therapy would be superior in preventing valve thrombosis in patients undergoing bioprosthetic MVR.

A abordagem cirúrgica da pancreatite aguda grave está fundamentalmente centrada na complicação séptica da necrose. No doente com pancreatite aguda necrosante em sepsis severa ou shock séptico com síndrome de disfunção multiorgânica/falência multiorgânica (MODS/MOF) o objectivo principal é o controlo de foco séptico. Se possível deve proceder-se a drenagem percutânea com controlo imagiológico por Tomografia Computorizada ou ultrasonografia (TC/US) das colecções fluidas infectadas. No caso de sequestro sólido infectado, tem que se proceder a sequestrectomia, que quase invariavelmente tem de ser repetida. Não há uma técnica ideal, mas parece haver evidências que uma abordagem mini-invasiva repetida, está associada a menor morbilidade e menos complicações, limitando porventura a resposta inflamatória à agressão cirúrgica.

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With the recent development of local (optical and thermal) probe microscopy and the advent of nanotechnology, it seems necessary to revisit the old subject of coherence properies of thermal sources of light. Concerning temporal coherence, we show that thermal sources may produce quasi-monochromatic near fields. In light of this result, the possibility of perfoming near-field solid-state spectroscopy and of designing near-field infrared sources is discussed. The problem of radiative transfer between two thermal sources held at subwavelength distance is studied. The radiative flux may be enhanced by several orders of magnitude due to the excitation of resonant surface waves, and this may occur at particular frequencies. Finally, we study the spatial coherence of thermal sources and the substantial influence of the near field. Surface waves may induce long-range spatial correlation, on a scale much larger than the wavelength. Conversely, quasi-static contributions, as well as skin-layer currents, induce arbitary small correlations. With the recent development of local (optical and thermal) probe microscopy and the advent of nanotechnology, it seems necessary to revisit the old subject of coherence of thermal fields.

Several adverse effects of vancomycin have been reported. The aim of this study was to assess the incidence of adverse responses to antibiotic prophylaxis with vancomycin in cardiac surgical patients. Prospectively, 116 consecutive patients (106 adults and 10 children) undergoing cardiac surgical procedures in this institution from January to June 1990 were studied. After the anesthetic induction, vancomycin, 1 g in adults and 10 mg/kg in children, was intravenously administered over 30 minutes. The infusion rate was slowed if any adverse effect was observed. As a control group, 10 similar patients were evaluated during the same period of 30 minutes after anesthetic induction but prior to vancomycin administration and surgical stimulation. Thirty-one patients (26.72%) developed an adverse effect, mainly hypotension (29 patients, 25%), which was considered severe in 15 patients (12.93%). Seven patients (6.03%) developed a maculopapular erythema that was associated with hypotension (Red-Man's syndrome) in 5 patients and with bronchospasm in 1 patient. The incidence of adverse reactions in children (20%) was similar to the overall incidence. Only 1 patient in the control group (10%) developed hypotension during the period studied. The incidence of adverse reactions was not related to age, body weight, vancomycin dose administered per kilogram body weight, type of surgical procedure, or associated disease. Mean duration of the infusion was similar in patients with and without adverse responses (34.60 +/- 12.41 minutes and 37.38 +/- 14.55 minutes, respectively). It is concluded that perioperative prophylaxis with vancomycin in cardiac surgery produces a high and unpredictable risk of significant hypotension.

A single-mode distributed-feedback (DBF) laser with a large side-mode suppression ratio was investigated to fulfill the single-mode assumption of the Lang-Kobayashi (LK) model. A single-mode 1.55-μm DFB semiconductor laser was subjected to delayed optical feedback from an external cavity. The spectra were recorded with a grating spectrometer with a resolution of 0.1 nm. The significant linewidth broadening toward longer wavelength corresponded to predictions of the LK model., This research was supported by the Deutscher Akademischer Ausfausddienst, Accion Integrada HA98-29, the Ministerio de Educacion yCultura of Spain, and the Deutsche Forschungsgemeinschaft Sonderforschungsbereich 185.