Background: Intrauterine devices (lUDs) are reversible birth control methods that are widely used throug-hout the world. It is estimated that 120 million women use an IUD in the world as a contraceptive. Aim: To assess the risk factors that may relate to incorrect insertion of the IUD. Methods: The sample included 93 patients of a Family Health Center, Talca, Chile. Using contingency tables, various measures of association were calculated, and the cases of incorrectly positioned IUD were compared with the cases where one or more risk factors were identified. Results: We found an incidence of 15.8% of incorrectly positioned IUD, of which 2.1% presented with uterine perforation, 2.1% with embedment of the IUD and 11.8% with a descended IUD. We identified the following risk factors for incorrectly positioned IUD: cesarean section (RR: 2.31), difficulty on insertion (RR: 3.31) and practitioner's opinión of an uncertain result (RR: 3.64), with a sensitivity of 73.3%. Conclusions: Transvaginal ultrasound is a crucial tool for confirmation of proper insertion of an IUD and should be considered a routine examination when any of the identified risk factors are present.

Introducción: Los dispositivos intrauterinos (DIU) son métodos de anticoncepción reversible, ampliamente usados en el mundo. Se estima que 120 millones de mujeres usan un DIU en el mundo como método anticonceptivo. Objetivo: Evaluar los factores de riesgo que puedan relacionarse con una incorrecta inserción del DIU. Método: 93 pacientes de un Centro de Salud Familiar de la ciudad de Talca, Chile. Utilizando tablas de contingencia se calcularon diferentes medidas de asociación y se compararon los casos de DIU mal posicionado con los casos con uno o más factores de riesgo identificados. Resultados: Se encontró una incidencia de DIU incorrectamente posicionado de un 15,8%, de los cuales hubo un 2,1% de perforación uterina, 2,1% para DIU incrustado y 11,8% para DIU descendido. Se identificaron como factores de riesgo de DIU incorrectamente posicionado la cicatriz de cesárea (RR: 2,31), inserción dificultosa (RR: 3,31) y opinión de un resultado dudoso (RR: 3,64), con una sensibilidad de 73,3%. Conclusiones: La ecotomografía transvaginal es una herramienta crucial para la confirmación de una correcta inserción del DIU y debería ser un examen de rutina ante la presencia de cualquiera de los factores de riesgo identificados.

Objective: To review our results in the correction of stress urinary incontinence (SUI) with a modified TOT technique using polypropylene mesh and local anesthesia, measuring effectiveness, quality of life and degree of satisfaction during 3 years of follow-up. Method: Prospective evaluation of 56 patients operated between 2003 and 2005, with modérate or severe SUI, or mixed urinary incontinence with effort predominance, according to clinical diagnosis and simple cystometry. A follow-up of 87% of the patients over a period of 37.9 months (19-51 months) was achieved. A physical examination was realized and a survey of satisfaction was applied by a team of independent interviewers on home visits. Results: On physical examination, 88% of patients are without SUI. In the survey of satisfaction, the patients manifested feeling better or much better in terms of daytime voiding frequency (79%), voiding dysfunction (69%), groin pain (58%), urge incontinence (84%) and sexual function (53%); 90% manifested feeling better or much better about their SUI than before the operation. De novo urgency or urge incontinence appeared in 6%. Conclusions: The modified TOT technique used by our group obtains results that are comparable to those of the original TOT techniques, with a significant improvement in the quality of life of patients.

Objetivos: Evaluar nuestros resultados en la corrección de la incontinencia de orina de esfuerzo (IOE) con una técnica de cinta suburetral transobturatriz modificada (TOTm) con malla desnuda de polipropileno y anestesia local, midiendo efectividad, calidad de vida y grado de satisfacción por 3 años de seguimiento. Método: Evaluación prospectiva de 56 pacientes operadas entre los años 2003 y 2005, con IOE moderada o severa, según diagnóstico por clínica y cistometría simple. Se logró realizar un seguimiento del 87% de las pacientes, por 37,9 meses (19-51 meses). Se realizó control con examen físico y se aplicó una encuesta de satisfacción en visita domiciliaria por un grupo independiente de encuestadores. Resultados: Un 88% de las pacientes se encuentra sin IOE en el examen físico. A la encuesta de satisfacción, las pacientes manifestaron sentirse mejor o mucho mejor en frecuencia miccional diurna (79%), disfunción del vaciamiento vesical (69%), dolor pelviano (58%), urgeincontinencia (84%) y función sexual (53%). Un 90% manifiesta sentirse mejor o mucho mejor de la IOE que antes de la operación. La urgencia o urgeincontinencia de novo apareció en un 6%. Conclusiones: La técnica TOTm utilizada por nuestro grupo tiene resultados comparables con las técnicas TOT originales, con mejoría significativa en la calidad de vida de las pacientes.

OBJETIVOS: Avaliar os efeitos da respiração freno-labial (RFL), em repouso, sobre o comportamento da frequência cardíaca (FC) e sua variabilidade e variações na pressão arterial (PA), frequência respiratória (FR) e saturação parcial de oxigênio (SpO2) em pacientes com doença pulmonar obstrutiva crônica (DPOC). MÉTODOS: Dezesseis pacientes com DPOC (7: estágio GOLD I, 3: estágio GOLD II e 6: estágio GOLD III; média de idade=64±11; média de VEF1=60±25% do predito) foram avaliados em repouso, na posição sentada, nas seguintes condições: 10 minutos respirando normalmente sem RFL (R1), 8 minutos com RFL (R2) e 10 minutos respirando novamente normalmente (R3). A FC foi registrada, batimento a batimento, por meio do frequencímetro Polar S810, e o índice RMSSD (raiz quadrada da média das diferenças entre intervalos RR sucessivos) foi determinado. PA, FR e SpO2 foram também avaliados durante o protocolo. ANOVA para medidas repetidas, seguida pelo teste de Tukey e teste de Kruskal-Wallis foram usados para análise dos dados, com nível de significância de 5%. RESULTADOS: Ocorreu aumento significante no índice RMSSD durante R2 em comparação com R1. A variação na FC inspiração/expiração foi de 8,98 bpm, e a variação na FC em repouso/RFL foi de 8,25 bpm. Durante R2, FR diminuiu e SpO2 aumentou significativamente em comparação a R1 e R3. Os valores de PA não apresentaram modificações significativas. CONCLUSÕES: Os resultados mostraram que a RFL produziu modificações significativas na FC, FR e SpO2 e não alterou a PA em pacientes com DPOC. Além disso, a análise do índice RMSSD mostrou que a RFL promoveu aumento da atividade parassimpática nesses pacientes, indicando que essa técnica influencia a modulação autonômica cardíaca.

OBJECTIVES: To assess the effects of pursed-lip breathing (PLB) at rest on the behavior of heart rate (HR) and its variability, and on variations in blood pressure (BP), respiratory rate (RR) and pulse oxygen saturation (SpO2) in subjects with chronic obstructive pulmonary disease (COPD). METHODS: Sixteen subjects with COPD (seven in GOLD stage I, three in GOLD stage II and six in GOLD stage III; mean age 64±11 years; mean FEV1 60±25% of predicted value) were assessed at rest, in a seated position, under the following conditions: ten minutes of normal breathing without PLB (R1), eight minutes with PLB (R2) and ten minutes of normal breathing once more (R3). HR was recorded, beat-to-beat, by means of a Polar S810 heart monitor. The RMSSD index (root mean square of the difference between successive R-R intervals) was determined. BP, RR and SpO2 were also assessed during the trials. ANOVA for repeated measures followed by the Tukey test and Kruskal-Wallis test were used for data analysis, with a 5% significance level. RESULTS: There was a significant increase in the RMSSD index during R2, in comparison with R1. The HR variation between inspiration and expiration was 8.98 bpm, and the variation between HR at rest and HR with PLB was 8.25 bpm. During R2, RR decreased and SpO2 increased significantly in comparison with R1 and R3. BP values did not show significant changes. CONCLUSIONS: The results showed that PLB produced significant changes in HR, RR and SpO2, and did not alter BP in subjects with COPD. Furthermore, analysis of the RMSSD index showed that PLB promoted increased parasympathetic activity in these subjects, thus indicating that this technique influenced the autonomic cardiac modulation.

Objective: We planned a prospective and descriptive analysis of the centenarian population in Lugo sanitary area, establishing their social, functional and medical status as well as its relationship with their basic hematological and biochemical parameters. Material and methods: During the study period between january 2001 and september 2003, participants were visited at home by a doctor and a nurse. The following variables were assessed: social status, past medical history, physical examination, functional status (Barthel index), blood analysis. Results: 54 centenarians were interviewed, 16 men and 38 women. 75,9% were widows; 87% lived with their family and 57,4% in urban areas. 79,6% had followed studies. All of them had their own incomes. Regarding past medical history, 64,8% had some visual or auditive disturbances, 81,5% were taking medical drugs, 59,3% had some surgical intervention and 46,3% had been hospitalized for medical reasons. Their vaccination status was poor. Functional status, assessed by Barthel index, showed an average of 59 ± 36,4, higher in men (82,7 ± 28,7) than in women (49,6 ± 35,1) (p<0,003). Blood samples were analyzed in 51 cases, there were not significant differences among them regarding sex or physical disability. Conclusion: The features of the centenarian population of Lugo are similar to other countries. It is an heterogeneous group. There are more women, but their clinical and functional status are significantly worse than in males. We have not founded a relationship between hematological and nutritional parameters and the degree of functional dependence in centenarians.

Objetivo: Estudio prospectivo y descriptivo de la población centenaria del área sanitaria de Lugo, valorando su situación social, médica y funcional y la relación de ésta con los parámetros analíticos básicos. Material y métodos: Entre enero de 2001 y septiembre de 2003 se realizó una visita domiciliaria cumplimentandose un protocolo que incluía situación social, historia clínica, exploración física, estado funcional (Índice de Barthel -IB-) y extracción de muestras de sangre. Resultados: Se entrevistó a 54 centenarios, 16 varones y 38 mujeres. El 75,9% eran viudos; el 87% viven con su familia, en núcleos urbanos (57,4%); el 79,6% cursó estudios. Todos tienen ingresos propios. En sus antecedentes médicos destaca que el 64,8% presenta alteraciones de vision o audición, el 81,5% consume medicamentos, el 59,3% sufrío intervenciones quirúrgicas y el 46,3% ingresó por causas medicas. La cobertura vacunal es baja. La valoración funcional, mediante el IB, obtuvo una puntuación media de 59 ± 36,4, mostrando una diferencia significativa p<0.003 entre varones (82,7 ± 28,7) y mujeres (49,6 ± 35,1). Se extrajeron muestras de sangre a 51 centenarios, no demostrándose diferencias significativas entre sexos ni tampoco según el nivel de dependencia. Conclusión: La población centenaria del área sanitaria de Lugo es similar a la descrita en otros países. Es un grupo heterogéneo, con predominio de mujeres, pero su situación clínica y funcional es significativamente peor que la de los varones. No hemos encontrado relación entre los parámetros hematológicos y nutricionales y el nivel de dependencia funcional de los centenarios.

It was proposed a consistent protocol in sistematic education, diet, exercises and metformin to consulting patients, who were diagnosticated of PCOS. Fifty five women in reproductive age were submited to controls since April 2001 to May 2004. All the patients were submited at least three times, with a follow up of at least nine months. Laboratory exams and antropometric controls were carried out. The patients' average age was twenty nine years old, we found significant changes in the studied variables and we succeeded to prove that the treatment protocol that had been proposed can diminish the metabolic risks of this disease

Se propuso un protocolo consistente en educación continua, dieta, ejercicio y metformina a pacientes con diagnóstico de síndrome de ovario poliquístico. Se controlaron 55 mujeres en edad reproductiva, de abril de 2001 a mayo de 2004. Todas se controlaron al menos 3 veces, por un mínimo de 9 meses de seguimiento. Se realizaron exámenes de laboratorio y controles antropométricos. La edad promedio de las pacientes fue de 29 años. Hubo cambios significativos en las variables estudiadas y logramos demostrar que el protocolo propuesto es capaz de disminuir los riesgos metabólicos de esta enfermedad

Recent advances in techniques to manipulate and study, with high precision, atomic hydrogen, from one hand, and successful trapping schemes for positrons and antiprotons, from the other hand, have encouraged the pursuit of experiments to test CPT violation and the Weak Equivalence Principle (WEP) through the comparison of hydrogen and antihydrogen. A description of the hydrogen trap and laser system being built in Rio, to trap and perform high resolution spectroscopy on cold hydrogen, is presented along with a discussion on the techniques and experimental system being implemented by the ATHENA collaboration at CERN to produce cold antihydrogen. A new technique to make a cold antihydrogen beam is proposed.