SUMMARY Objective: To characterize adherence to pharmacological treatment in the adult population, and in hypertensive patients treated in two primary care centers of the Social Security in Panama. Methods: A survey on drug adherence was applied to 1,200 study participants in 4 major cities in Panama. The survey for hypertensive patients was applied in primary health care centers. Results: Of 1,200 study participants, 671 were taking medications, 54% were women and 54% university degrees. 91% reported suffering from some type of illness and use of various medications. 55% replied that they had once forgotten to take the medication whereas 80% of the participants said they forget medication intake frequently. There were 176 hypertensive patients survey in primary care centers, 67% women, and 42% with university degree. 97% were hypertensive and 48% diabetic. 80% of patients with hypertension took various medications. When the Morisky-Green test was applied to patients, 40% indicated that they stopped taking the medications; therefore, they did not comply with the ordered pharmacotherapy. According to the Batalla test, patients showed great knowledge about their disease. Conclusions: The majority of the population surveyed suffered from hypertension and had forgotten to take the medications. The patients recognized suffering and knowing the hypertension, however, they were not adherent to the drug treatment. Awareness and participation in the control of your disease is necessary and to promote national campaigns on drug adherence.

RESUMEN Objetivo: Caracterizar la adherencia al tratamiento farmacológico en la población adulta, y en pacientes hipertensos atendidos en dos centros de atención primaria de la Caja de Seguro Social en Panamá. Métodos: Aplicación de encuesta poblacional sobre la adherencia medicamentosa a 1.200 personas en las 4 ciudades de mayor población y crecimiento económico en Panamá y otra encuesta a pacientes hipertensos atendidos en centros de atención primaria de la Seguridad Social, durante los meses de septiembre a octubre del 2016. Resultados: De 1.200 personas que participaron en la encuesta, 671 tomaban medicamentos, 54% eran mujeres y 54% con estudios universitarios. El 91% manifestaron padecer algún tipo de enfermedad y uso de diversos medicamentos. El 55% contestó que alguna vez había olvidado tomar el medicamento. Fueron 176 pacientes encuestados en los centros de atención primaria, 67% mujeres, 42% con grado universitario. El 97% eran hipertensos, 48% diabéticos. El 80% de los hipertensos tomaban diversos medicamentos. Al aplicarse el test de Morisky-Green a los pacientes, el 40% indicó haber dejado de tomar los medicamentos por lo tanto no cumplían con la farmacoterapia ordenada. De acuerdo al test de Batalla, los pacientes mostraron tener un gran conocimiento sobre su enfermedad. Conclusiones: La mayoría de la población encuestada sufría HTA y habían olvidado tomar los medicamentos. Los pacientes reconocieron padecer y conocer la hipertensión, sin embargo, no fueron adherentes al tratamiento medicamentoso. Se hace necesario una toma de conciencia y participación en el control de su enfermedad e impulsar campañas nacionales sobre la adherencia medicamentosa.

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

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

This case study examines seed colour during ripening using an exhaustive colorimetric analysis. The aim was to associate the chemical ripening with the seed colour in order to estimate the ripening stages of Cabernet Sauvignon grapes. Cluster samples, obtained from a vertical shoot-positioned vineyard in central Chile, were monitored for their technological and phenolic maturity, as well as for the colorimetric and chemical characteristics of the seeds. The colours of the scanned seed images were determined by human as well as by computer vision. In the first case, an expert assigned a colour to each seed part. In the second case, a computer program estimated the colours of the scanned seed images. An exhaustive analysis of seed colour was proposed, instead of a general observation of seed browning. The seed colour presented a wide range of colours, from moss green to dark brown, depending on the maturity and the face observed. The ripening stages identified, along with the chemical and colorimetric information gathered, were under ripe seed (brown with green traces), ripe seed (dark brown with green traces) and overripe seed (dark brown without any green traces). A new way to quantify seed colour is shown in this paper.

RESUMEN Objetivo. Evaluar el desempeño de diferentes biofiltros en un sistema de recirculación (SRA) para cultivo de trucha arcoiris. Materiales y métodos. Se utilizó: un tanque de 1m3 para cultivo de alevines, bolsas de lienzo para retención de sólidos, bomba sumergible, caja de nivel constante y distribución de flujo, seis biofiltros en tubo de PVC de 3", arena con D10=0.45mm como medio soporte. Los biofiltros se operaron a temperatura ambiente y con tiempo de retención hidráulica (TRH) de 11 min, se inocularon así: R1-Control: Aguas del SRA; R2-Lodos estación piscícola; R3-Agua Laguna aireada relleno sanitario Antanas (RSA); R4-Sedimentos acuarios; R5-Lodos laguna aireada RSA; R6-Lodos reactor sulfidogénico RSA. Se evaluó la ganancia de peso (GP) y la conversión alimenticia (CA), se monitorearon parámetros físico-químicos y se evaluó la eficiencia de remoción de nitrógeno y sólidos suspendidos. Resultados. La GP de los animales fue de 1.58 g/d y la CA de 1.41. No hubo diferencias para remoción de amonio ni nitritos entre reactores; las eficiencias medias de remoción fueron: amonio 4.78%, nitrito 27.2%, nitrato 32.3%, sólidos suspendidos 37.5%. Los reactores R4 y R5 presentaron mejor remoción de nitratos, con eficiencias medias de 47.4% y 42.8%. El R3 reportó la mejor remoción de SS con promedio del 58.2%. Conclusiones. El sistema de tratamiento del agua en el SRA garantizó condiciones de calidad del líquido, apropiadas para el cultivo de la trucha; el reactor más eficiente para la remoción de las formas de nitrógeno evaluadas fue el inoculado con lodos de la laguna aireada del RSA.

ABSTRACT Objective. To evaluate the performance of different biofilters in a recirculating aquaculture system (RAS) for trout farming. Materials and methods. It was used a 1m3 plastic tank for fries farming; fabric bags to solids retention; a submersible pump; a constant water level and flow distribution box; six up flow biofilters in 3" PVC tube; sand of D10=0.45mm as carrier. The reactors were operated at local temperature and with hydraulic retention time (HRT) of 11 min, the biofilters were inoculated in the next way: R1-Control: RAS water; R2-Fish culture farm sludges; R3- Water from aerated lagoon of Antanas landfill (AL); R4-Aquarium sediments; R5- Aerated lagoon of AL sludges; R6-Sludges from sulfidogenic reactor of AL. The weight gain (WG) and the food conversion (FC) were evaluated, some physic-chemical parameters were monitored and the nitrogen and suspended solids removal efficiency were evaluated. Results. The WG of the cultured animals was 1.58 g/d and the FC was 1.41. There were no differences for ammonium and nitrite removal between the reactors; the average removal efficiencies were: ammonium 4.78%, nitrite 27.2%, nitrate 32.3%, suspended solids 37.5%; R4 and R5 reactors presented the best performance on nitrate removal, with average efficiencies of 47.4% and 42.8%. R3 presented the best SS removal with an average of 58.2%. Conclusions. The RAS water treatment system guaranteed appropriated liquid quality conditions for trout farming; the most efficient reactor for removal of the different forms of nitrogen was the inoculated with the aerated lagoon of AL sludges.

The effect of decreasing levels of organic N-fertilization on fruit production, mineral composition and fruit quality was evaluated in organically cultivated “Granny Smith” apples trees. Treatments included the application of decreasing levels of N fertilization (100 kg N ha-1, 75 kg N ha-1, 50 kg N ha-1 and 0 kg N ha-1 ) applied as fossilized red guano (50% of the total amount of N) and blood meal (50% of the total amount of N) to twelve years old Granny Smith apple trees. Yield was not affected by the treatments (yield ranged from 0.28 to 0.4 kg cm-2 SCSA). Fruit mineral concentration and ratios were not affected by treatments. Fruits showed low Ca concentrations (2.8 to 3.3 mg Ca 100 g-1 FW), high levels of K (118.6 to 130.1 mg K 100 g-1 FW) and high values for K+Mg/Ca (> 12) and K/Ca (> 30) ratios. Mineral concentration on leaves was not affected by treatments (normal concentrations for macro and microelements). Bitter pit was only detected after 60 days of storage (100 kg N ha-1 tree, 1.1 in a scale 1-4). Besides orchard nitrogen management, fruit mineral ratios and Ca foliar applications should be considered for managing fruit production and quality in organic apples.

O texto analisa a obra das direções superiores de educação no Chile, comparando as normas que as regem com as funções realizadas. Trata-se de um estudo exploratório, qualitativo, baseado em entrevistas semiestruturadas aplicadas àqueles que exerceram o cargo de Secretário Regional Ministerial de Educação. Os registros permitem compreender as brechas entre o que foi definido e o realizado, identificando dessa forma nós críticos que devem ser resolvidos em diversos planos. A partir desses registros são formuladas propostas no âmbito de uma nova organização da educação no plano subnacional, para orientar e impulsionar um novo projeto, objetivo político fundamental nas propostas de modernização da gestão do Estado.

The text discusses the training senior managers of education in Chile, comparing their rules with the functions performed. This is an exploratory, qualitative study, based on semi-structured interviews applied to Regional Ministerial Secretaries of Education. The records provide insight into stated and implemented gaps, and thus identify critical points that need to be addressed at various levels. From this background, proposals of a new organization of education at the subnational level are formulated to guide and drive its redesign, which is a key policy objective in the modernization of the state administration.

El texto analiza el hacer de los directivos superiores subnacionales de educación en Chile, contrastando las normas que les rigen con las funciones cumplidas. Se trata de un estudio exploratorio, cualitativo, sustentado en entrevistas semiestructuradas aplicadas a quienes ejercieron el cargo de Secretario Regional Ministerial de Educación. Los antecedentes permiten comprender las brechas entre lo definido y lo realizado, y por tanto, identificar nudos críticos que requieren ser resueltos en diversos planos. A partir de estos antecedentes se formulan propuestas en el marco de una nueva organización de la educación en el plano subnacional que orienten e impulsen su rediseño, objetivo político clave en las propuestas de modernización de la gestión del Estado.

Maple syrup urine disease (MSUD) is an autosomal recessive disease associated with high levels of branched-chain amino acids. Children with MSUD can present severe neurological damage, but liver transplantation (LT) allows the patient to resume a normal diet and avoid further neurological damage. The use of living related donors has been controversial because parents are obligatory heterozygotes. We report a case of a 2-year-old child with MSUD who underwent a living donor LT. The donor was the patient's mother, and his liver was then used as a domino graft. The postoperative course was uneventful in all three subjects. DNA analysis performed after the transplantation (sequencing of the coding regions of BCKDHA, BCKDHB, andDBT genes) showed that the MSUD patient was heterozygous for a pathogenic mutation in the BCKDHB gene. This mutation was not found in his mother, who is an obligatory carrier for MSUD according to the family history and, as expected, presented both normal clinical phenotype and levels of branched-chain amino acids. In conclusion, our data suggest that the use of a related donor in LT for MSUD was effective, and the liver of the MSUD patient was successfully used in domino transplantation. Routine donor genotyping may not be feasible, because the test is not widely available, and, most importantly, the disease is associated with both the presence of allelic and locus heterogeneity. Further studies with this population of patients are required to expand the use of related donors in MSUD.

El parasitoide Prorops nasuta es único parasitoide de la broca del café de origen africano que se estableció en Colombia y es considerado el principal enemigo natural en el control biológico de esta plaga. Es necesario desarrollar metodologías para su cría masiva para aumentar sus poblaciones y contribuir en el manejo integrado de la broca del café. Por esta razón, este trabajo tuvo como objetivo evaluar diferentes temperaturas y edades de dieta artificial (Cenibroca) infestada con Hypothenemus hampei para la cría del parasitoide P. nasuta. Se pudo determinar que las temperaturas evaluadas (22, 25 y 28ºC) no tuvieron efecto en el número de parasitoide obtenidos. Sin embargo, con las dietas de 35 días después de haberlas brocado se obtuvo el mayor número de estados biológicos 2,5 avispas por cada 3 cm³ de dieta, comparado con las dietas de 21 y 28 días de brocado. La temperatura de 28ºC afectó considerablemente el tamaño de la avispa. El parasitoide fue criado a 25ºC y se determinaron los principales parámetros reproductivos de P. nasuta, que pueden ser utilizados en proyecciones poblacionales utilizadas en la cría masiva de este parasitoide.

The parasitoid Prorops nasuta is only parasitoid of the coffee berry borer of African origin that was established in Colombia and is considered the main natural enemy in the biological control of this pest. It is necessary to develop methodologies for its mass rearing to increase its populations and contribute to the integrated management of the coffee berry borer. For this reason, this work had as an objective to evaluate different temperatures and ages of the artificial diet (Cenibroca) infested with Hypothenemus hampei for the rearing of the P. nasuta parasitoid. It was possible to determine that the evaluated temperatures (22, 25 and 28ºC) had no effect on the number of parasitoids obtained. However, with the 35 days diets after having them infested with the borer, the largest number of biological stages 2,5 wasps per each 3 cm³ of diet was obtained, compared with the 21 and 28 days diets after infested with the borer. The 28ºC temperature affected significantly the size of the wasp. The parasitoid was raised at 25ºC and the main P. nasuta reproductive parameters were identified, which can be used in population projections used in the mass rearing of this parasitoid.

El uso de alimentos complementarios en la nutrición de los parasitoides, juega un papel importante en la supervivencia y fertilidad de estos insectos. Por esta razón, fue evaluado el efecto de la alimentación del parasitoide de la broca del café Prorops nasuta, utilizando diferentes soluciones de azucares y proteínas. Los parasitoides fueron alimentados separadamente cada día, con 5 azúcares en dos concentraciones, así: fructosa 1M y 50 %, glucosa 1M y 50 %, sacarosa 1M y 50 %, maltosa 1M y 50 % y miel de abejas 25 % y 50 %, además de un testigo con agua. Las mayores supervivencias, se obtuvieron, al alimentar el parasitoide con: miel de abejas al 25 %, fructosa 1M y maltosa 1M; logrando una supervivencia entre 34 y 60 días en el 75 % de la población de avispas. Con las azúcares, fructosa 1M y maltosa 1M, fue posible obtener 3,15 y 3,04 estados del parasitoide respectivamente, que fueron estadísticamente diferentes al testigo con agua (1,67 estados). También, se evaluó el efecto de la alimentación de P. nasuta, utilizando 10 soluciones de proteínas; levadura torula 25 % y 12,2 %, caseína 25 % y 12,2 %, harina de soya 25 % y 12,2 %, germen de trigo 25 % y 12,25 y polen de abejas 25 % y 12,25. El mayor tiempo de vida de P. nasuta, fue conseguido por la alimentación con harina de soya 12,2 % y germen de trigo 25 %, donde se alcanzaron entre 12 y 17 días de supervivencia, correspondientes al 75 y 50 % de la población, respectivamente. La fertilidad del P. nasuta, no fue influenciada con la alimentación de las soluciones con proteínas, debido a que el número de estados biológicos del parasitoide, fue igual al obtenido, al momento en que este, estuvo alimentado únicamente con agua o estuvo sin alimento. Las soluciones azucaradas pueden utilizarse para aumentar la supervivencia y fertilidad de la avispa en la cría masiva de P. nasuta, cuando exista carencia de estados biológicos de la broca del café o para potenciar la reproducción del parasitoide. La maltosa y fructosa, deben ser tenidas en cuenta, en la escogencia de arvenses que ofrecen nectarios con presencia de estos azucares, en programas de conservación del parasitoide P. nasuta.

The use of complementary diets in parasitoids nutrition plays an important role in these insects' survival and fertility. For this reason, the effect of the diet in the coffee berry borer parasitoid Prorops nasuta, was evaluated using different sugar and protein solutions. The parasitoids were fed separtely in a daily basis with 5 sugars in two concentrations as follows: 1M and 50% fructose, 1M and 50 % glucose, 1M and 50 % maltose, and 25 % and 50 % honey, in addition to a control with water. The highest survival rates were obtained when the parasitoid was fed with: 25 % honey, 1M fructose, and 1M maltose, achieving a survival of 34 to 60 days in 75 % of the wasp population. With sugars 1M fructose and 1M maltose it was possible to obtain 3.15 and 3.04 stages of the parasitoid respectively, which was statistically different from the water control (1.67 stages). The effect of the diet on P. nasuta using 10 different protein solutions was also evaluated; 25 % and 12.2 % torula yeast, 25 % and 12.2 % casein, 25 % and 12.2 % soy flour, 25 % and 12.25 % wheat germ, and 25 % and 12.25 % bee pollen. The longest life span of P. nasuta was obtained when fed 12.2 %, soy flour and 25 % wheat germ, and a survival of 12 to 17 days was observed in 75 % and 50 % of the population, respectively. P. nasuta fertility was not influenced by feeding with protein solutions, because the number of biological stages of the parasitoid was the same as that obtained when it was fed only with water or did not receive any food. The sweetened solutions can be used to increase the wasp survival and fertility in massive reproduction of P. nasuta, when there is a lack of biological stages of the coffee berry borer, or to foster the parasitoid reproduction. Maltose and fructose must be taken into account when choosing weeds that offer nectaries with the presence of these sugars for P. nasuta parasitoid conservation programs.

We propose a new set of reduced equations describing the Perfectly Matched Layer (PML) boundary condition for the Finite Difference Time Domain Method (FDTD) algorithm. These expressions take into account the main properties of the electromagnetic wave propagation in continuos medias: absorbing, free space and conductive, simplifying the solution of electromagnetic problems as such as the FDTD lattice. A two-dimensional (2-D) transversal electric TE mode Gaussian pulse propagating along free-space is presented as a vehicle of study. The efficiency of this model is validated by a new way to compute the power reflection coefficient of the electromagnetic field arriving at the PML interface at several points. Also a detailed description of the rounding up process to obtain integer values for FDTD equations indexes is discussed.

Se propone un conjunto de ecuaciones FDTD reducidas que describen la condición de frontera PML y la región de análisis utilizando el método de diferencias finitas en el dominio del tiempo. Para lograr esto el conjunto de ecuaciones describen las propiedades de los principales medios continuos de propagación electromagnética: medio absorbente, espacio libre y conductor, lo que simplifica la implementación y solución de problemas de propagación mediante FDTD. Como caso de estudio se analiza la propagación bidimensional de un pulso gausiano en un modo TE. La eficiencia del modelo propuesto se valida calculando el coeficiente de reflexión en varios puntos de la interfaz entre la región de interés y la region PML. Se presenta también una descripción detallada del proceso de redondeo de los índices fraccionarios del conjunto de ecuaciones FDTD.

Objective: To evaluate the phenotype and genotype characteristic of patients included in the Andalusian Registry for familial adenomatous polyposis, the genotype/phenotype correlation and the impact of Registry in the frequency of colorectal cancer of registered. Material and methods: A descriptive study of 77 patients with FAP belonging to 33 families, included in a centralized database visited by the physicians of the hospitals taking part in the present study, on prior signing of confidentiality letters. All genetic studies were carried out in the Immunology Service of our institution. Results: We have included in our study 77 patients of 33 families; 31 probands with a mean age of 32 years (13-51) and 46 relatives at risk with a mean age of 21.8 years (6-55). Genetic study informed in 68/77 with positive result in 92.6%. Ten probands showed colorectal cancer (CRC) at the time of diagnosis (32.2%). Only two affected relatives showed CRC at diagnosis (4.3%), a statistically significant difference (p < 0.05). Gastrointestinal involvement was observed in 30/61 (49%), desmoid tumors in 7/77 (9.1%) and congenital hypertrophy of the retinal pigment epithelium in 23/55 (65.7%). 86.7% of patients with this alteration showed mutations between codons 454 and 1019, with a statistically significant correlation ((p< 0.05). Conclusions: The registry has facilitated the genetic diagnosis for all affected families disregard their province of origin. It has also improved the screening of affected relatives and has made it possible to take preventive measures immediately, therefore diminishing the incidence of CRC at diagnosis in registered affected relatives. The correlation between congenital hypertrophy of the retinal pigment epithelium with some mutations is the only phenotypic-genotypic correlation with statistical significance.

Objetivos: Valorar las características fenotípicas y genotípicas de los pacientes incluidos en el Registro Andaluz de la poliposis adenomatosa familiar, la relación genotipo/fenotipo y el impacto del Registro en la frecuencia de cáncer colorrectal de los familiares registrados. Material y métodos: Estudio descriptivo de 77 pacientes con PAF, pertenecientes a 33 familias, incluidos en una base de datos centralizada a la que tienen acceso los responsables de los hospitales participantes, previa firma de cartas de confidencialidad. Todos los estudios genéticos se realizan en el Servicio de Inmunología de nuestro Hospital. Resultados: 77 pacientes registrados (50,6% varones): 31 probandos, edad media: 32 años (13-51) y 46 familiares afectos, edad media 21,8 años (6-55). Estudio genético informado en 68/77 con resultado positivo en 92,6%. Cáncer colorrectal al diagnóstico en diez probandos (32,2%) y 2 familiares afectos (4,3%), diferencia estadísticamente significativa (p < 0,05). Se observó afectación de tramos altos en 30/61 (49%), tumor desmoides en 7/77 (9,1%) e hipertrofia del epitelio pigmentario de la retina en 23/35 (65,7%). El 86,7% de los pacientes con esta alteración mostraron mutaciones entre los codones 454 y 1.019, relación estadísticamente significativa (p < 0,05). Conclusiones: El Registro Andaluz ha permitido ofrecer el diagnóstico genético en todas las familias afectas independientemente de su provincia de origen, mejorar el cribado, iniciar medidas preventivas precozmente y disminuir la frecuencia de cáncer colorrectal al diagnóstico en los familiares afectos registrados. La relación de la hipertrofia congénita del epitelio pigmentario de la retina con determinadas mutaciones es la única relación feno-genotípica con significación estadística

Objective: a) to evaluate the appropriateness of histological criteria as proposed by Morson as indicators for surgery; and b) to compare the adequacy of Morson's criteria with Haggitt's levels as indicators for surgery in the case of malignant sessile lesions. Material and methods: we carried out a prospective, protocolized study of 42 patients with polyps with invasive carcinoma (IC) who underwent colonoscopic polypectomy from 1979 through 2008. We applied the histological criteria proposed by Morson to all the patients included in the series. Results: we treated 24 polyps with IC and favorable histological criteria (FC) and 18 polyps showing unfavorable histological criteria (UC). All polyps with FC were treated by means of colonoscopic polypectomy. None of the patients showed signs of disease after a mean follow-up period o f 9.67 yrs. Patients with polyps with UC were recommended to undergo surgery. The presence of unfavorable histological criteria in the polypectomy sample was clearly associated with an unfavorable patient outcome and showed a 100% sensitivity level, a negative prognostic value (NPV) of 100%, and a false negative (FN) percentage of 0% for the prognosis of the disease. We found 12 sessile polyps (Haggitt's level 4). Colonoscopic polypectomy was the treatment employed in 9 out of 12 cases. All patients are free from disease (mean follow-up 7.3 yrs). If Haggitt's level criteria had been applied, all 12 patients would have undergone surgery. This means 58% more patients than following Morson's criteria. Conclusions: Morson's criteria are considered an adequate diagnostic tool for the indication of surgery in patients with malignant adenomas. Haggitt's invasion levels do not accurately discriminate the necessity for surgery in case of malignant sessile lesions.

The alimentary canal and the reproductive tract of males and females of Hypothenemus hampei Ferrari are described. The alimentary canal of H. hampei showed the crop with several spine-like structures and the midgut with few gastric caeca. We evidenced for the first time that adult females need to feed on coffee in order to produce viable eggs before and during oviposition period. The presence of air bubbles inside the anterior midgut may be due to starvation rather than the response of the environment during flying as previously reported. Two ovaries and the same structures and arrangements common to individuals of the Curculionidae beetles composed the female reproductive system. The male reproductive tract showed a significant difference with respect to other Curculionidae and even other Scolytinae species as it showed a sclerotized aedeagus with several pore-like structures in the terminal portion where sperm is released during mating.

El estudio morfológico del tracto digestivo y el sistema reproductor de machos y hembras de Hypothenemus hampei Ferrari se describe a continuación. El tracto digestivo presenta un arreglo típico descrito para otros insectos. Ahora las diferencias morfológicas se encontraron en el buche del estomodeo, en donde se observaron estructuras espinosas y en el mesenteron se observo un número reducido de ciegos gástricos. Se evidenció por primera vez el comportamiento de la alimentación de las hembras de H. hampei, que requiere aparentemente de la ingesta del endosperma del café para poder producir huevos viables durante la oviposición. La presencia de burbujas de aire al interior del ventrículo anterior se cree que puede ser debido al hambre, más que a la respuesta al medio ambiente durante el vuelo como lo indicaban anteriores observaciones. El sistema reproductor de la hembra presenta dos ovarios y un arreglo estructural común a especímenes de la familia Curculionidae. El sistema reproductor masculino mostró una diferencia significativa con respecto a otros miembros de la familia Curculionidae e incluso a otra especie de la tribu Scolytinae presentando un aedeagus esclerotizado compuesto de varios orificios en la porción terminal, por donde el esperma se expulsa durante el apareamiento.

Objective: the study was to assess changes in the rectal mucosa and pouch in a series of patients with familial adenomatous polyposis (FAP) who underwent either subtotal colectomy and ileorectal anastomosis (IRA) or proctocolectomy and ileal pouch-anal anastomosis (IPAA), and to evaluate the suitability of the follow-up interval and postoperative treatment employed to prevent the development of cancer. Method: this study involved 28 patients with FAP who underwent IRA (n=20) or IPAA (n=8), and were followed endoscopically over a mean period of 7.47 years. The number and both macroscopic and histological features of polyps before and after surgery, the treatment, and complications were all analyzed. The suitability of the follow-up interval was assessed. Results: none of the 26 patients who complied with follow-up developed rectal cancer. Two patients developed rectal cancer at 21 and 36 months after withdrawing from the protocol. Except in two cases in which surgery was indicated, patients who developed adenomas during follow-up were treated by endoscopic polypectomy. Conclusions: in our series, the failure to comply with follow-up examinations was associated with cancer development.

Objetivo: analizar la evolución de la mucosa rectal y del reservorio así como idoneidad de los intervalos de seguimiento y del tratamiento realizado para evitar la aparición del cáncer, en una serie de pacientes con poliposis adenomatosa familiar (PAF), intervenidos. Método: estudio prospectivo de 28 pacientes con PAF intervenidos mediante anastomosis íleo-rectal (20 pacientes) y anastomosis íleo-anal con reservorio (8 pacientes). A todos se les había realizado un control endoscópico dos veces al año y análisis del número y características macroscópicas e histológicas de los pólipos antes y después de la cirugía así como del tratamiento realizado, de sus complicaciones y de la adecuación del intervalo de seguimiento. El seguimiento medio fue de 6,47 años (DE = 4,59; rango = 0,72-16,75 años). Resultados: ninguno de los 26 pacientes que cumplimentaron correctamente el protocolo de seguimiento desarrolló cáncer. Sólo dos pacientes lo desarrollaron al 1,75 y los 3 años, respectivamente del abandono del protocolo. Los pacientes que desarrollaron adenomas durante el seguimiento fueron tratados con éxito mediante polipectomía endoscópica, salvo en dos casos que se indicó cirugía. Conclusiones: en nuestra serie, el incumplimiento de las revisiones ha sido el factor que ha condicionado la aparición de cáncer.

Background: In the year 2003, the Ministry of Health replaced rice from the Complementary Nutritional National Program destined to malnourished and in risk children, for a product with higher nutritional value ("Mi Sopita"). Objective: Evaluate the effect of this intervention in the nutritional evolution of children under 6 years-old, in risk or suffering malnutrition. Method: Retrospective cohort of 1.576 children registered in the program 6 months earlier in 300 Primary Care establishments. Analysis of the evolution of anthropometric indicators for a period of 6 months, in function of the initial diagnosis and age. Logistic regressions of multiple factors to determine the variables associated to a better nutritional evolution. Results: 80% of cases presented nutritional risk and the rest malnutrition. In 6 months, the median value of change in Z score for weight/age was + 0,3 SD (95% IC 0,3-0,3), height/age +0,3 SD (0,3-0,4) and weight/height +0,5 SD (0,3-0,6) in children with initial values < -2 SD. The change was approximately 0,1 SD for the group with nutritional risk. Between 44% and 69% of the children with malnutrition got partially better or normalized their nutritional status according to the different indicators (p < 0,001). The most determinant factor for better evolution was major initial nutritional deficit (OR 4,4 IC 3,2-6,1 p < 0,001 for weight/age). Conclusions: The program has a positive effect in the recovery of malnourished children and it avoids major nutritional deterioration in children at risk

Antecedentes: El 2003 el Ministerio de Salud introdujo un nuevo alimento de mayor valor nutricional (Mi Sopita) en el Programa Nacional de Alimentación Complementaria de refuerzo destinado a niños en riesgo nutricional y desnutridos. Objetivo: Evaluar el efecto de esta intervención en la evolución de los indicadores antropométricos y estado nutricional de menores de 6 años en riesgo y desnutridos. Material y Método: Cohorte retrospectiva de 1 576 niños ingresados al programa 6 meses atrás en 300 establecimientos de atención primaria. Análisis de la evolución de la relación peso-edad, talla-edad y peso-talla entre el ingreso y los 6 meses, en función del diagnóstico inicial y la edad. Regresiones logísticas multivariadas para determinar los factores asociados a una mejor evolución nutricional. Resultados: El 80% de la muestra presentaba riesgo nutricional y el resto desnutrición. En 6 meses la mediana de cambio del puntaje Z en niños que ingresaron con valores < – 2 DE fue de + 0,3 DE (95% IC 0,3-0,3) para peso-edad, + 0,3 DE (0,3-0,4) para talla-edad y +0,5 DE (0,3-0,6) para peso-talla. El cambio fue menor (aproximadamente + 0,1 DE para el grupo en riesgo nutricional. El 44 al 69% de los niños desnutridos mejoró parcialmente o normalizó su estado nutricional según los diferentes indicadores (p < 0,001). El factor más determinante de una mejor evolución fue un mayor déficit nutricional inicial (OR 4,4 IC 3,2-6,1 p < 0,001, para la relación peso-edad). Conclusiones: El programa tiene un efecto positivo en la recuperación de los niños con desnutrición y evita un mayor deterioro nutricional en los niños en riesgo