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Resumen La lipodistrofia es una condicion patologica asociada a una redistribucion anomala del tejido adiposo en el cuerpo. La lipoatrofia facial puede ser consecuencia de defectos congenitos, adquiridos o involutivos. El lipoinjerto es el trasplante de grasa autogena y constituye una opcion de tratamiento que aporta volumen, regeneracion tisular y ventajas en relacion con otros materiales de relleno en enfermedades autoinmunes. Se busca resaltar la accion de relleno y el efecto metabolico de la lipotransferencia facial, por la supervivencia de los adipocitos injertados y la actividad regenerativa de las celulas madre provenientes del tejido adiposo obtenidas por nanofat en pacientes con lipoatrofia facial. La lipoinyeccion mejora la arquitectura de la nueva dermis y aumenta su capacidad funcional, es un tratamiento con tejido autogeno (injerto graso) con gran eficacia en relacion con otros materiales de relleno aloplasticos capaces de exacerbar una respuesta inflamatoria mediada por la produccion de anticuerpos.

Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormone therapy (MHT) was its low rate of prescription by doctors.To determine the use of MHT and perceived related risks among gynecologists.A self-administered and anonymous questionnaire was delivered to certified gynecologists in 11 Latin American countries.A total of 2154 gynecologists were contacted, of whom 85.3% responded to the survey (n = 1837). Mean age was 48.1 ± 11.4 years; 55.5% were male, 20.3% were faculty members and 85% had a partner. Overall, 85.4% of gynecologists responded that they would use MHT if they had menopausal symptoms (81.8% in the case of female gynecologists) or prescribe it to their partner (88.2% in the case of male gynecologists; p0.001). Perceived risk related to MHT use (on a scale from 0 to 10) was higher among female than among male gynecologists (4.06 ± 2.09 vs. 3.83 ± 2.11, p0.02). The top two perceived reported risks were thromboembolism (women 33.6% vs. men 41.4%, p0.009) and breast cancer (women 38.5% vs. men 33.9%, p0.03). Overall, gynecologists reported prescribing MHT to 48.9% of their symptomatic patients (women 47.3% vs. men 50.2%, p0.03) and 86.8% currently prescribed non-hormonal remedies and 83.8% alternative therapies for the management of the menopause. Gynecologists who were older and academic professionals prescribed MHT more often.Although this Latin American survey showed that gynecologists are mostly supporters of MHT use (for themselves or their partners), this is not necessarily reflected in their clinical practice.

Background The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking. Objective To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors. Methods A total of 6079 women aged 40–59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30 kg/m 2 . Results Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depressive symptoms was 46.5% and anxiety 59.7%. Our logistic regression model found that significant factors associated to obesity included: arterial hypertension (OR: 1.87), depressive symptoms (OR: 1.57), sedentary lifestyle (OR: 1.50) diabetes mellitus (OR: 1.34), higher number of individuals living at home (OR: 1.31), sleep problems (OR:1.22), anxiety (OR: 1.21), having a stable partner (OR: 1.20), parity (OR: 1.16) and vasomotor symptoms (OR:1.14). A lower risk for obesity was found among women using hormonal contraceptives (OR: 0.69). Conclusion Obesity in middle-aged women is the consequence of the interaction of multiple factors. It was associated to hypertension, depressive symptoms, sedentary lifestyle, climacteric symptoms and other factors.

Although sleep disturbances are common during female mid-life, few studies have described in detail the prevalence of this problem and related risk factors.To determine the prevalence of sleep disturbances in mid-aged women using validated tools. Assessment of determinants capable of influencing the prevalence of insomnia and poor sleep quality was also performed.A total of 6079 women aged 40-59 of 11 Latin American countries were invited to fill out the Athens Insomnia Scale (AIS), the Pittsburgh Sleep Quality Index (PSQI), the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale (MRS), the Brief Scale of Abnormal Drinking and a general socio-demographic questionnaire.Overall, 56.6% of surveyed women suffered of either insomnia, poor sleep quality, or both. Specifically, 43.6% and 46.2% presented insomnia and poor sleep quality in accordance to the AIS and the PSQI respectively. The prevalence of insomnia increased with female age (from 39.7% in those aged 40-44 to 45.2% in those aged 55-59, p0.0001) and menopausal stage (from 39.5% in premenopausal aged 40-44 to 46.3% in late postmenopausal ones, p0.0001). "Awakening during the night" (AIS: Item 2) was the most highly rated of all items and contributing in a higher degree (mean 16%) to the total score of the scale in all menopausal phases. Sleep quality also worsened with age and menopausal status, impairment particularly affecting sleep efficiency and latency and the increased use of hypnotics. Vasomotor symptoms (VMS), depressive mood and anxiety were associated to sleep disturbances. Women presenting sleep disturbances displayed a 2-fold increase in the severity of menopausal symptoms (higher total MRS scores) which was translated into a 6-8 times higher risk of impaired quality of life. Logistic regression analysis determined that female age, the presence of chronic disease, troublesome drinking, anxiety, depression, VMS, drug use (hypnotics and hormone therapy) were significant risk factors related to the presence of sleep disturbances. Higher educational level related to less insomnia and better sleep quality.Insomnia and poor sleep quality were highly prevalent in this mid-aged female sample in which the influence of age and the menopause was only modest and rather linked to menopausal symptoms already occurring since the premenopause.

Resumen Si bien la neumonitis por hipersensibilidad es la complicacion pulmonar mas frecuentemente descrita durante el tratamiento con metotrexato, existen otras complicaciones de tipo linfoproliferativo e infeccioso que hay que tener en cuenta dentro del diagnostico diferencial ante una neumopatia en el contexto de dicho tratamiento. La existencia de un riesgo incrementado de desarrollar procesos infecciosos o reactivaciones de microorganismos latentes puede ser similar al observado a lo largo del tratamiento con antagonistas del factor de necrosis tumoral y corticoides. Dentro de ellas, la neumonia por citomegalovirus es una complicacion muy severa a tener en cuenta, ya que el diagnostico acertado y el tratamiento oportuno evitaran un desenlace potencialmente mortal.

Background Several studies indicate that quality of life (QoL) is impaired in middle aged women. Assessment of QoL using a single validated tool in Latin American climacteric women has not been reported to date at large scale. Objective The Menopause Rating Scale (MRS) was used to assess QoL among middle aged Latin American women and determine factors associated with severe menopausal symptoms (QoL impairment). Methods In this cross-sectional study, 8373 healthy women aged 40–59 years, accompanying patients to healthcare centres in 18 cities of 12 Latin American countries, were asked to fill out the MRS and a questionnaire containing socio-demographic, female and partner data. Results Mean age of the entire sample was 49.1 ± 5.7 years (median 49), a 62.5% had 12 or less years of schooling, 48.8% were postmenopausal and 14.7% were on hormonal therapy (HT). Mean total MRS score (n = 8373) was 11.3 ± 8.5 (median 10); for the somatic subscale, 4.1 ± 3.4; the psychological subscale, 4.6 ± 3.8 and the urogenital subscale, 2.5 ± 2.7. The prevalence of women presenting moderate to severe total MRS scorings was high (>50%) in all countries, Chile and Uruguay being the ones with the highest percentages (80.8% and 67.4%, respectively). Logistic regression determined that impaired QoL (severe total MRS score ≥17) was associated with the use of alternatives therapies for menopause (OR: 1.47, 95% CI [1.22–1.76], p = 0.0001), the use of psychiatric drugs (OR: 1.57, 95% CI [1.29–1.90], p = 0.0001), attending a psychiatrist (OR: 1.66, 95% CI [1.41–1.96], p = 0.0001), being postmenopausal (OR: 1.48, 95% CI [1.29–1.69, p = 0.0001]), having 49 years or more (OR: 1.24, 95% CI [1.08–1.42], p = 0.001), living at high altitude (OR: 1.43, 95% CI [1.25–1.62, p = 0.0001]) and having a partner with erectile dysfunction (OR: 1.69, 95% CI [1.47–1.94, p = 0.0001]) or premature ejaculation (OR: 1.34, 95% CI [1.16–1.55, p = 0.0001]). Lower risk for impaired QoL was related to living in a country with a lower income (OR: 0.77, 95% CI [0.68–0.88], p = 0.0002), using HT (OR: 0.65, 95% CI [0.56–0.76], p = 0.0001) and engaging in healthy habits (OR: 0.59, 95% CI [0.50–0.69], p = 0.0001). Conclusion To the best of our knowledge this is the first and largest study assessing QoL in a Latin American climacteric series with a high prevalence of impairment related to individual female and male characteristics and the demography of the studied population.

Resumen La succion es un reflejo natural de los bebes; la succion no nutritiva proporciona apoyo emocional y ayuda a que el bebe se calme por si mismo. Al educar a los padres sobre el uso adecuado de los chupetes, las enfermeras pueden promover la seguridad y el bienestar del nino, sentando las bases para la futura salud oral del nino.

Resumen Se presenta un caso de un nino de 2 anos con un quiste hidatidico cerebeloso que se rompio durante la extirpacion quirurgica, diseminandose el liquido hidatidico por el campo quirurgico. En el postoperatorio inmediato se inicio tratamiento con Albendazol (15 mg/Kg/dia en 3 ciclos de 28 dias) sin presentar recidivas en 14 meses de seguimiento. Se revisan los resultados del tratamiento con AIbendazol en la hidatidosis cerebral y se resalta la importancia de un diagnostico preoperatorio a fin de iniciar el tratamiento medico antes de la cirugia. Los datos actualmente disponibles sugieren que el Albendazol complementa el tratamiento quirurgico de la hidatidosis cerebral, previniendo las siembras en caso de ruptura accidental del quiste durante la cirugia y permite plantearse alternativa de la puncion aspiracion del quiste, en los casos en que la extirpacion en bloque no sea posible.

The assessment of the reciprocal impacts of infrastructure investments and their socio-economic environment requires that a number of such aspects be simultaneously considered. Some of those aspects, however, have not been traditionally incorporated in such assessments due (in part) to the limitations inherent in the techniques utilized in current practice. This paper presents a conceptual framework for the use of dynamic simulation in the assessment of packages of infrastructure investments. The concepts are then applied to case studies involving the evaluation of coordinated sets of infrastructure projects in rural areas.

We have studied 450 cases of human breast carcinoma at the histochemical and ultrastructural level. The breast biopsies were obtained from Canada, Mexico and Dominican Republic. This study was undertaken to evaluate the prognostic significance of classification of breast tumors, proposed in 1971 by Murad, based on their cell of origin. Under this classification, ATPase positive tumors represent those of myoepithelial origin, while the remainder are designated ductal or ductular based upon defined ultrastructural characteristics. We observed a distribution of tumor types essentially similar to that reported by Murad, and no significant differences were observed between the contributing centers. No correlation was observed between this classification and the histological classification described by Stewart. We found no evidence that ATPase positive tumors were myoepithelial in origin. They showed histochemical similarities to ductal and ductular tumors, and had features indicating their secretory nature. Estrogen receptor levels were measured in 20 cases, and did not reveal any correlation with tumor type. An interesting feature requiring further investigation was the high incidence of endocrine-like secretory granules in all histological types of tumors studied.

Precedents in the literature point out that vanadylporphyrins, one of the main contaminants in heavy crude oils, can be demetalated in solution under reducing conditions. Based on this observation, the potential demetalating activity of three homogeneous reductive catalysts for vanadylporphyrins was studied. The reactions were carried out in 125 ml Parr minireactors, in CH 2 Cl 2 solutions, under H 2 /CO atmospheres, at different temperatures, pressures and reaction times. It was found that, RhCl(PPh 3 ) and Co 2 (CO) 8 partially reduced vanadylporphyrins to vanadylchlorins, while RuHCl(CO)(PPh 3 ) 3 completely demetalated the vanadyl complexes of tetraphenylporphyrin and octaethylporphyrin in 24 h, at 150°C and 70 atm of H 2 in the presence of diethylamine and acetone. This homogeneous system represents an alternate method to the conventional hydrodemetalation process, which so far involves heterogeneous systems.

The electrochemical behaviour of the binary cofacial dicobalt porphyrin Co 2 FTF 4 was investigated in benzonitrile under a pure nitrogen atmosphere. The two cobalt(II) centres of the molecule are oxidized or reduced separately in two different monoelectronic steps giving rise, for the first oxidation and reduction reactions, to mixed-valence compounds: [Co III Co II ] and [Co II Co I ] respectively; further oxidation or reduction leads to the [Co III Co III ] and [Co I Co I ] derivatives. All the redox systems are nearly reversible and diffusion-controlled, even the Co(III)/Co(II) ones. Except for the [Co I Co I ] species, all the redox states of the dicobalt bisporphyrin were generated by electrolysis and characterized by spectrophotometry and/or ESR spectroscopy. Whereas the [Co II Co II ] compound displays metal—metal interaction, the [Co III Co II ] is a valence-localized mixed-valence compound i.e., the odd electron is localized on one cobalt. Such multistep charge transfers for the two nearly equivalent cobalt nuclei of the molecule are explained by the existence of interactions between the two cobalt(II) centres. The results of this study clearly demonstrate that the proximity of the two(II) atoms induces different properties of the CO 2 FTF 4 porphyrin with regard to cobalt monoporphyrins.

The extracellular components of small grayish-yellow atherosclerotic dots and streaks removed at necropsy from 17 human aortae not later than 3 hours postmortem, were examined with the electron microscope. The broadened intercellular spaces which separated widely the intimal cells contained in more superficial layers moderately to intensely electron dense, fibrillar and granular fibrin material and other blood proteins. Small osmiophilic bodies of different sizes and configuration were present in the deeper portions of earlier lesions and were more numerous in more advanced lesions. The latter contained less fibrin. In addition, myelin-like figures were often seen either “free” in the extracellular space or associated with degenerating elastic elements, remnants of fibrin, and with cellular membranes of intimal smooth muscle cells. These myelinated bodies possessed often a core of variable electron density and texture, but it was possible to identify the cores at times as shreds of elastic tissue, basement membrane-like substance, or remnants of fibrin. It is believed on the basis of the present studies that degeneration of elastica, insuded fibrin and detached basement membrane of smooth muschle cells as well as the many osmiophilic bodies interpreted as precipitated lipoproteins derived from blood, contribute to the presence of the extracellular fat.

A twenty-one year old woman with severe and prolonged renal failure associated with the acute onset of jaundice following delivery is described. The clinical, pathological and biochemical findings were consistent with fatty liver of pregnancy complicated by renal failure. The ultrastructural morphology of the renal lesion is described in detail and the changes in the glomeruli are interpreted as compatible with a lesion produced by intraglomerular fibrin formation. Such an event may have been the cause of the renal failure in this case.

Using silver methenamine technique, which selectively distinguishes between the epinephrine- or norepinephrine-containing granules of the rat adrenal medullary cells, it was found that the specific atrial granules were completely silver negative. In contrast, lysosomal granules appeared intensely impregnated with silver. It is concluded that if catecholamines are present in the atrial granules they are in a form different from that present in the cells of the adrenal medulla. It was found also that the atrial Z-lines reacted to the various staining procedures similarly to specific granules. The results of the work provide important information for further studies of differentiation of atrial granules in senescence and myopathies, since lysosomal granules increase in these conditions.

Electron microscopic studies of the salivary gland chromosomes of C. plumosus and C. cingulatus have shown that the chromosome region associated with the nucleolus proper is characterized by coils of 100 A chromosome fibers, pars amorpha, and nucleolonema. These three components form a disklike structure extending through the chromosome. Coils of 100 A chromosome fibers also extend into the nucleolus proper. The intrachromosomal pars amorpha and nucleolonema resemble those of the nucleolus proper. It is suggested that only the coils of 100 A chromosome fibers represent the nucleolar organizer.

Summary Biopsies from 18 human cervices were studied by the light and electron microscope techniques in order to determine the nature of the “P.A.S.-positive basement membrane of light microscopy.” Under the electron microscope, the light microscope basement membrane was shown to be composed of connective tissue fibers (particularly reticulum fibers) in the 0.4 to 0.5 µ area of the stroma immediately subjacent to the electron microscope basement membrane. Incubation of the sections with collagenase resulted in failure of the tissue to show the “P.A.S.-positive basement membrane of light microscopy.”

The reported methods for porphyrin vanadization were reviewed with the aim of optimizing a synthetic procedure. It was found that 100% metallation was obtained in 2 h with vanadylacetylacetonate in quinoline. The experiments were carried for m - tetraphenylporphyrin and octaethylporphyrin, the latter being easier to metallate.