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The article summarizes three of the data collection studies that can assist researchers in examining population aging processes in the Latin America and Caribbean region with an emphasis on cross-national comparisons, including the population of Mexican immigrants in the United States. These are the Survey on Health and Wellbeing of Elders conducted in seven urban centers of the region, the national Mexican Health and Aging Study, and the Hispanic Established Populations for Epidemiologic Studies of the Elderly in the United States. The article describes the studies and marks them as informative, comprehensive, and still underanalyzed in particular for the purpose of cross-national analyses of aging among Latin American and Caribbean populations.

It has been stated that small organisms do not have barriers for distribution and will not show biogeographic discreteness. General models for size-mediated biogeographies establish a transition region between ubiquitous dispersal and restricted biogeography at about 1-10 mm. We tested patterns of distribution versus size with water mites, a group of freshwater organisms with sizes between 300 microm and 10 mm. We compiled a list of all known water mite species for Sierra del Guadarrama (a mountain range in the centre of the Iberian Peninsula) from different authors and our own studies in the area. Recorded habitats include lotic, lentic and interstitial environments. Species body size and world distribution were drawn from our work and published specialized taxonomic literature. The null hypothesis was that distribution is size-independent. The relationship between distribution and size was approached via analysis of variance and between size and habitat via logistic regression. Contrary to expectations, there is no special relationship between water mite size and area size distribution. On the other hand, water mite size is differentially distributed among habitats, although this ecological sorting is very weak. Larger water mites are more common in lentic habitats and smaller water mites in lotic habitats. Size-dependent distribution in which small organisms tend to be cosmopolitan breaks down when the particular biology comes into play. Water mites do not fit a previously proposed size-dependent biogeographical distribution, and are in accordance with similar data published on Tardigrada, Rotifera, Gastrotricha and the like.

This document outlines the methodology of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) survey (known as the "SABE survey"), and it also summarizes the challenges that the rapid aging of the population in Latin America and the Caribbean imposes on society in general and especially on health services. The populations of the countries of Latin America and the Caribbean are aging at a rate that has not been seen in the developed world. The evaluation of health problems and disability among older adults in those countries indicates that those persons are aging with more functional limitations and worse health than is true for their counterparts in developed nations. In addition, family networks in Latin America and the Caribbean are changing rapidly and have less capacity to make up for the lack of protections provided by social institutions. The multicenter SABE study was developed with the objective of evaluating the state of health of older adults in seven cities of Latin America and the Caribbean: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The SABE survey has established the starting point for systematic research on aging in urban areas of Latin America and the Caribbean. Comparative studies of these characteristics and with this comparative nature should be extended to other countries, areas, and regions of the world in order to expand the knowledge available on older adults.

Objectives: To evaluate self-reported general health (SRGH) as a health indicator and to analyze its covariates in people 60 years old or older living in private homes in seven cities of Latin America and the Caribbean., Methods: This cross-sectional descriptive study was based on data from the Health, Well-Being, and Aging survey (Salud, Bienestar y Envejecimiento, or "SABE survey"), which was carried out in 1999 and 2000 in Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The survey looked at the demographic and socioeconomic characteristics of the participants, several health indicators (self-reported chronic diseases, depression, and cognitive features), the social and family support network, the use of health services, reported and observed functionality, the respondent's income, and the durable consumer goods in the household. In probit regression models, self-reported fair or poor health was used as the dependent variable. The marginal effect of each categorical explanatory variable was used to indicate the difference between the probability of reporting poor health by persons who did or did not have a given characteristic., Results: In all the cities studied the self-reporting of "excellent" health was very low (6% or less). The results of the multivariate analysis of the relationships between SRGH and covariates showed: (1) the relative importance of several health indicators as covariates of SRGH, (2) the association between sociodemographic characteristics and SRGH, and (3) the differences or similarities found among the seven cities with respect to the relationships studied. The level of self-rated good health was highest in Buenos Aires and Montevideo (60%), followed by Bridgetown and São Paulo (around 50%) and Havana, Santiago, and Mexico City (between 30% and 40%). The respondents' evaluation of their memory was the factor that was most strongly related to SRGH, followed by satisfaction with nutritional status and satisfaction with life., Conclusions: The SRGH captured multiple facets of the health of the older adults, such as suffering from chronic diseases, the degree of satisfaction with the level of nutrition and with life, perception of memory, and any functional problems. More detailed studies should be undertaken to try to determine the role that the emotional health of older adults in Latin America and the Caribbean plays in the demand for health care, and to determine if there is some association between SRGH and the use of health services.

Objective: There are few studies on anthropometry and nutritional status in large and representative samples of elderly populations in Chile and South America. We describe age and sex differences in weight, height, body mass index, knee height, waist circumference, midarm circumference, triceps skinfold thickness, arm muscle area, and calf circumference in Chilean elderly subjects., Methods: This was a population-based, cross-sectional study. A total of 1220 elderly persons (819 women and 411 men; age range, 60-99 y) were recruited in the city of Santiago (Chile) through a probabilistic sampling procedure carried out from October to December 1999., Results: Men were significantly heavier and taller than women in all age groups, whereas body mass index values were significantly higher in women than in men. All anthropometric variables showed a decrease in average values with aging in men and women. The apparent negative slopes for the decline in average values of body weight with aging was of greater magnitude in women than in men (-0.42 kg/y and -0.54 kg/y in male and female subjects, respectively). However, significant age x sex interaction was detected only for triceps skinfold thickness. In women, quadratic terms for age provided a significantly better fit than did the simple linear model for the association between age and weight, body mass index, waist circumference, triceps skinfold thickness, calf circumference, or midarm circumference., Conclusion: These observations indicated that body weight changes associated with aging might be more severe in Chilean women than in men, probably determining a differential pattern of lean and fat mass loss.

For centuries, mouthwashes have been used in order to provide us with oral health or cosmetic benefits. Nowadays, in most countries, there is a variety of formulas available for the general public in the form of products which may require prescription or not. Alcohol is used in mouthwashes as a solvent of other ingredients and as a preservative of the preparation. For years, different formulas of mouthwashes have been used, however, the question about its alcohol content being a threat for health or not has recently appeared. The high quantity of alcohol in some mouthwashes combined with the fact that they keep in contact with the oral mucosa for much more time than alcoholic drinks, can make us think about a harmful effect from a local mechanism. Mouthrinses increase the time of the mucosa being in contact with alcohol and it has been proved that those with a high content of alcohol do cause hyperkerastosic lesions both in human beings and laboratory animals. At the moment and with the data we have, it has not been possible to establish a causal relationship between the use of alcohol-containing mouthwashes and the development of oral cancer. There is neither an evidence of the fact that alcohol increases the effects of antiplaque agents in mouthwashes.

Pectus excavatum, the most common congenital deformity of the chest wall, has esthetic, psychological and social repercussions as well as a slight impact on pulmonary function. Treatment is surgical and is carried out for esthetic purposes in most cases. The most commonly applied surgical technique is based on the one originally described by Ravitch: sub-perichondrial, bilateral chondrectomy and sternal osteotomy. In 1997, however. Nuss described a minimally invasive approach to correction by means of a support bar. Our objective was to perform minimally invasive correction of pectus excavatum using a substernal extrapleural approach guided by video-assisted thoracoscopy. We treated three patients over 15 years of age without surgical complications. In all three cases, the minimally invasive technique corrected the pectus excavatum with excellent esthetic results. Both the path of insertion and duration were shorter with the described approach than with traditional surgery. Video images facilitated extrapleural insertion of the bar and minimized complications.

Nine contiguous genes encoding a potential type IV secretion system have been identified in the chromosome of Actinobacillus actinomycetemcomitans strain VT747 and on a plasmid (pVT745) in strain VT745. Seven of these genes encode predicted proteins that share significant homology with type IV secretion proteins in Bordetella pertussis (ptl operon), Brucella melitensis biovar suis and Agrobacterium tumefaciens (virB operons), where they are involved in protein secretion, pathogen intracellular survival and multiplication, and DNA transport, respectively. Results of previous studies have demonstrated that pVT745 is a conjugative plasmid and that a secondary plasmid, pMMB67, can be mobilized from strain VT745. Given these results, it was hypothesized that (1) the type IV secretion genes on pVT745 are responsible for these two functions and (2) the type IV VT747 chromosomal genes also play a role in the transport of DNA. Wild-type and mutant strains of VT745 were evaluated for their conjugative abilities. Wild-type mating efficiency was 10(-6) transconjugants per donor, while the mutant strain yielded no transconjugants. Wild-type VT745 harbouring a co-resident plasmid, pMMB67, mobilized pMMB67 at a frequency of 10(-6), while VT747 was unable to mobilize this plasmid. These results support the hypothesis that the plasmid-encoded type IV secretion system on pVT745 is involved in DNA transport. However, the chromosomally encoded secretion system may not play a role in DNA transport in strain VT747. While the precise function of these chromosomal genes in strain VT747 has not been determined, Northern blot analyses demonstrated that these genes are expressed in both ACT: actinomycetemcomitans strains VT745 and VT747.

Spontaneous rupture of the pulmonary alveoli after a sudden increase in intra-alveolar pressure is a common cause of pneumomediastinum, which is usually seen in healthy young men. Other common causes are traumatic and iatrogenic rupture of the airway and esophagus; however, pneumomediastinum following cervicofacial emphysema is much rarer and is occasionally found after dental surgical procedures, head and neck surgery, or accidental trauma. We present four cases of subcutaneous emphysema and pneumomediastinum with two secondary pneumothoraces after self-induced punctures in the oral cavity. They constitute an uncommon clinical entity that, to our knowledge, has not been reported in the literature. Its radiologic appearance, clinical presentation, and diagnosis are described.

Pharmacological therapeutics in acute myocardial infarction. The acute myocardial infarct is one of the main causes of death among the adult population of the industrialized countries, and this pattern is starting to be paralleled in many developing countries. The mortality rate due to coronary diseases has decreased 30% in the last decade, thanks to the new therapeutic strategies and the guidelines developed by the American college of Cardiology and the American Heart Association, aimed at physicians, nurses, and health personnel in charge of patients with suspected myocardial infarct or with an established myocardial infarct. These guidelines and strategies explain the fundaments of the administration of thrombolytic agents, coronary angioplasty, surgery, and the use of betablockers, platelet antiaggregating agents and angiotensin-converting enzyme inhibitors. These recommendations are followed at the Coronary Intensive Care Unit of the National Institute of Cardiology "Ignacio Chávez", and therefore it was necessary to perform this bibliographic review to continue with the safety standards established for the follow-up protocols of the ischemic patient, aimed at assessing their efficacy and efficiency.

A case of a 40 year old female patient who began to present alterations in the tongue and who was diagnosed of Progressive Sclerosis of that organ is presented. The manifestation and diagnostic tools used in this case, as well as the treatment use, is given. The rareness of this disease, which is possible in systemic diseases, stands out.

Cerebral venous sinus thrombosis is an uncommon but potentially lethal condition, with mortality between 5.5-30 per cent. It was previously associated with infections of the orbit, mastoid or face, but, after the advent of antibiotics, the most common causes include neoplasms, dehydration, oral contraceptives, coagulopathies, collagen diseases, and pregnancy and the puerperium. We report a case of fatal cerebral venous sinus thrombosis in a 68-year-old patient with a metastatic cervical mass, who developed internal jugular vein thrombosis that progressed cranially to transverse and sagittal sinus thrombosis.

Renal cell carcinoma represents a 2.5-3% of all neoplastic processes, usually seen un patients older than 50 years. 60-75% are resectable at diagnosis, representing local or metastatic advanced disease the rest of them. This tumor tends to spread intravascularly, leading to tumoral thrombosis within the inferior caval vein (ICV) and renal vein 4-10% and 21-35% of cases, respectively. As the only effective treatment is surgical resection, preoperative determining of the thrombus extension is crucial. Thus, an accurate radiological study including ultrasound, doppler sonography, computed tomography and/or Magnetic Resonance, is key for these patients. We present a 49 year-old patient with renal cell carcinoma and associated tumoral thrombosis in inferior caval vein and left renal vein; we provide the most significant figures, explaining its most characteristic radiological findings.

A prospective descriptive observational study was made to determine the incidence of esophageal foreign bodies in adults who had been admitted to the Manual Ascunce Domenech teaching hospital of Camaguey, Cuba in the period from 1 September 1997 to 31 August 1998. The highest frequency of patients with this diagnosis was in 31 to 50 year-old men. Dysphagia and salivary retention in the pyriform sinuses were the prevalent symptoms. The state of the oral cavity was poor in 82.50% of patients. The foreign body was removed in the first 24 hours in 83.33% of patients. The radiological diagnosis was positive in 75% of patients. The upper third was the most common location in radiological and endoscopic studies. Fish bones were the prevalent foreign body. A quarter of the patients had complications and stable esophagoscopy was used to extract the foreign body in 96.67% of cases.

Thoracic wall resections are performed to treat a wide variety of conditions. Reconstruction techniques have varied considerably since the introduction of synthetic prosthesis, the most recent of which are made of polytetrafluoroethylene (PTFE, or Gore-Tex). We describe our department's experience with PTFE prosthesis. PTFE was used in 21 patients treated for various diseases. Thirteen reconstructions were of the thoracic wall, 4 were of the diaphragm and 4 of the pericardium. Three of the 13 thoracic wall reconstructions involved bilateral myoplasty of the pectoralis major, 2 involved omentoplasty and 1 required use of a wide musculocutaneous flap. Complications included pneumonia in 2 cases and 1 seroma with chronic cutaneous fistula that required removal of the prosthesis after 9 months. Two patients died, 1 after 19 days and the other after 9 months, both as a result of causes unrelated to reconstruction. Follow-up of these patients ranged from 3 to 54 months. We recommend the prosthetic use of PTFE for thoracic wall reconstruction, along with plasty or musculocutaneous flaps when necessary.

A 50-year-old man was diagnosed as parotid sarcoidosis. The main features of the disease and the importance of biopsy and histological studies for its diagnosis and treatment are emphasized. The disease, although rare, should be kept in mind if the prognosis of these patients is to be improved.

Osteomyelitis of the sternocosto-clavicular (SCC) articulation is a rare infection usually caused by Staphylococcus aureus and enterobacteria. It usually occurs in individuals with osteoarticular disease or predisposing factors. Prolonged antibiotic treatment and articular puncture are generally accepted. Authors do not agree on an established protocol. We report three cases of SCC septic arthritis in two previously healthy patients with two foci of infection (one perianal abscess and one dental extraction) and in one adult patient with Still's disease. Pain and intense inflammation was referred to the shoulder, with scarce leukocytosis and fever reaching 38 degrees C. The germs responsible were S. aureus, Bacteroides fragilis and B. oralis. Two of the patients had local, regional abscesses. Long-term antibiotic treatment failed in all cases and surgery for SCC resection and myoplasty of the pectoralis major muscle was required. Recovery was good and shoulder and arm mobility was excellent. We propose medical treatment and articular diagnostic-therapeutic puncture as the first line of therapy for this disease. When evolution is poor or when complications appear, such as abscesses or mediastinitis, we conclude that radical debridement and myoplasty of the pectoralis major muscle are indicated.

Here we present a case of a female patient 70 years old stricken with diabetes mellitud 40 years of evolution with manifestations of malignant external otitis accompanied by disfunction of the temporomandibular articulation. Here we will show the clinical characteristics and the diagnosis in our patient likewise its treatment. We will expound the most important aspects of the entity at this present time.

Here we present the case of a patient with lesion on the tongue, during more than 6 months, which in its self required different therapeutic measures and because of a benign evolution is remitted to this center for study, which concluded with an histological diagnosis of sarcoidosis, a granulomatous disease systemic in character which in this patient only affect the tongue which reminds us daily the necessity to remember this entity by internist, gastroenterologists and dentists.

A case of a female patient aged 72, suffering from a parotid gland lymphocytic lymphoma is presented. We have to remark the tumor significance for otorhinolaryngology, maxillo-facial and internal medicine specialists. In spite of being relatively uncommon, nowadays is more frequently reported. In this paper we also expose some of its features.

The hepatic metallothionein was isolated and partially purified from rats treated previously with stable Cl2Cd and Cl2Cd109. The livers were subjected to the extraction of proteins of low relative molecular weight by heat, ammonium sulphate, Sephadex G-25 and Sephadex G-75. The partially purified extracts were subjected to the pharmacological activity test on isolated mouse vas deferens. A specific effect on the norepinephrine synapsis was obtained through an increment of the answer to the electric stimulus. The mechanism of action could be explained by the increase of the calcium permeability through the membrane or by the increment of the norepinephrine presynaptic release.

Complementation tests among Phycomyces auxotrophic strains revealed the existence of four genes with mutants requiring riboflavin, three genes with purine auxotrophs, two with nicotinic acid auxotrophs, and two with lysine auxotrophs. A total of 134 sexual crosses between strains carrying mutations affecting phototropism (madA-madE), carotenoid biosynthesis (carA), auxotrophy (ribA-ribD, purA-purC, lysA and lysB, nicA and nicB, and leuA) and resistance to 5-fluorouracil (furA and furB) were studied; mating type (sex) was also included as a marker. The results from random spore analysis, tetrad analysis, and gene-centromere distances shows that these markers are distributed into 11 linkage groups.