Resumen Objetivos: La metodología “Six Sigma” se basa en el análisis de los flujos de trabajo e identificación de los puntos de mejoras con el fin de lograr una máxima eficiencia en los procesos, tanto industriales como sanitarios. El objetivo de este estudio es comparar la eficiencia entre un sistema “clásico” de elaboración de quimioterapia centralizado en el Servicio de Farmacia frente a un modelo descentralizado. Material y métodos: Estudio observacional en el que se analizó la eficiencia de los modelos de elaboración de preparaciones quimioterápicas: Modelo clásico (MC), a partir del cual se suministran las preparaciones al Hospital de Día de Hematología: las campanas de elaboración de tratamientos y el farmacéutico están presentes en el Servicio de Farmacia. Modelo descentralizado (MD): el farmacéutico y las campanas de preparación de la medicación se encuentran en Hospital de Día de Oncología. La eficiencia de cada sistema se evaluó mediante el tiempo transcurrido desde la recepción de la orden médica hasta la administración de la quimioterapia (TAQ). Resultados: El TAQ siguiendo el MD fue inferior que para el MC: 13,7 [5-28] minutos versus 71,0 [42-96] minutos (p<0,001) con una diferencia media de 57,3 minutos/preparación. El tiempo potencialmente ahorrado con el modelo descentralizado fue de 40,3 horas/día. Conclusiones: Con el presente trabajo hemos querido cuantificar y comparar la eficiencia de los dos modelos de elaboración de mezclas citostáticas, siendo desfavorable para el sistema clásico de centralización para la preparación de la medicación en los Servicios de Farmacia.

Summary Aims: The "Six Sigma" methodology is based on the analysis of workflows and the identification of areas for improvement in order to achieve maximum efficiency in industrial and healthcare processes. The aim of this study is to compare the efficiency of a "classic" chemotherapy preparation system centralised in the Pharmacy Service versus a decentralised model. Material and methods: Observational study in which the efficiency of the models for the preparation of chemotherapy treatments was analysed: Classical model (MC), which has the treatment preparation cabinets and a pharmacist located in the Pharmacy Service, and from which the preparations are supplied to the Haematology Day Hospital. Decentralised model (MD), where both the pharmacist and the medication preparation cabinets are located in the Oncology Day Hospital. For the evaluation of the efficiency of each system, the time elapsed from the receipt of the medical order to the administration of chemotherapy (TAQ) was compared. Results: The TAQ following MD was less than for MC: 13.7 [5-28] minutes versus 71.0 [42-96] minutes (p<0.001) with a mean difference of 57.3 minutes/prescription. The potential time saved with the decentralised model was 40.3 hours/day. Conclusions: The aim of this study was to quantify and compare the efficiency of the two models for the preparation of cytostatic mixtures, showing that the classical centralised system for the preparation of medication in pharmacy services is unfavourable.

Resumen El Manejo Integrado de Plagas (MIP) es un enfoque de control de plagas que considera todas las estrategias disponibles y su posterior integración para el control de plagas. Entre sus estrategias se destacan el Control Biológico (CB) mediante el uso de enemigos naturales. El control biológico por depredadores generalistas ha cobrado relevancia en la última década. Esta estrategia por aumento exige la cría masiva de estos organismos. En la Región Neotropical, Chrysoperla externa (Neuroptera: Chrysopidae) tiene gran importancia por su alta voracidad y su amplia gama de hospederos. El objetivo de este estudio fue describir los cambios externos de los huevos, especialmente en color y forma, asociados al desarrollo intracoriónico de embriones de C. externa, para caracterizarlos morfo-colorimétricamente. Se construyó una clave práctica a partir de la determinación de su desarrollo embrionario como herramienta para la técnica de cría masiva. Esta clave proporciona información valiosa que facilitaría la implementación de CB para programas de MIP en regiones en desarrollo, donde aún es incipiente.

Abstract Integrated Pest Management (IPM) is a pest control approach that considers all available strategies and their subsequent integration for pest control. The Biological Control (BC) of pests through the use of natural enemies is an outstanding strategy. Biological control by generalist predators has had a highlighted relevance in the last decade. This strategy by augmentation demands mass rearing of these organisms. In the Neotropical Region Chrysoperla externa (Neuroptera: Chrysopidae) is of great importance for its high voracity and its wide range of hosts. The aim of this study was to describe the external changes of the eggs, especially in colour and shape, associated with the intrachorionic development of C. externa embryos, to characterize them morpho-colorimetrically. A practical key from its embryonic development determination was constructed as a tool for mass rearing technique, providing valuable information that could facilitate BC implementation for IPM programs in developing regions.

SUMMARY In mountain environments of Córdoba (Argentina), where tourist activity predominates and livestock activity is based on native species, the fires that affect the area compromise the recovery of the natural landscape. The objective of this work was to evaluate the germination capacity of Eustachys retusa and Schizachyrium condensatum, native forages, subjected to pre-germination treatments and fire factors. Three repetitions were performed for each seed treatment: potassium nitrate, cold, smoke and heat shock tests. Germination was assessed for 21 days. A favorable increase in germination was observed in the 90 °C treatments for S. condensatum and a decrease in germination of E. retusa in cold and 120 °C for 10 min treatments. In the rest of the treatments carried out there were no significant differences with the control. In none of the treatments S. condensatum reached 50% germination, while E. retusa was always higher than 70%. We conclude that the seeds of E. retusa and S. condensatum tolerate low or moderate fire temperatures and are capable of germinating at 120°C. E. retusa has advantages for colonizing burned sites in the Cordoba highlands.

RESUMEN En ambientes serranos de Córdoba (Argentina) donde predomina la actividad turística y ganadera basada en especies forrajeras nativas, los incendios que afectan la zona comprometen la recuperación del paisaje natural. El objetivo de este trabajo fue evaluar la capacidad germinativa de Eustachys retusa y Schizachyrium condensatum, forrajeras nativas, sometidas a tratamientos pregerminativos y a factores del fuego. A sus semillas se les aplicaron tres repeticiones de los siguientes tratamientos: nitrato de potasio, frío, humo y choques térmicos. Se evaluó la germinación durante 21 días. Se observó un incremento favorable de la germinación en los tratamientos de 90 °C para S. condensatum y una disminución en la germinación de E. retusa en los tratamientos de frío y 120 °C durante 10 min. En el resto de los tratamientos realizados no hubo diferencias significativas con el testigo. En ninguno de los tratamientos S. condensatum alcanzó el 50 % de germinación, mientras que E. retusa resultó siempre mayor al 70 %. Se concluye que las semillas de E. retusa y S. condensatum toleran temperaturas de incendios rasantes o moderados y son capaces de germinar a 120 °C. E. retusa presenta ventajas para colonizar sitios quemados de las serranías cordobesas.

RESUMEN La aerofagia es la estereotipia clásica más común en los equinos, con una etiología poca entendida; sin embargo, se reconoce por ser de naturaleza multifactorial. Además, se ha asociado con efectos negativos sobre la salud de los equinos portadores. El objetivo de este estudio fue describir los factores de riesgo y la frecuencia de presentación de la aerofagia en una población de caballos criollos colombianos (CCC). Fueron encuesta-dos 42 criaderos, entre los que se presentó un total de 1063 CCC (488 machos y 575 hembras). De esta población, el 5,27% (56 animales) fue plenamente identificado con aerofagia. Esta prevalencia fue superior a la mayoría de otros reportes de Sur América. La aerofagia, posiblemente obedeció tanto a factores inherentes al animal como a factores externos relacionados con el manejo; sin embargo, se requiere el diseño de estudios longitudinales sobre prácticas de manejo y de líneas dentro de la raza para cuantificar y validar la información relacionada con la posible predisposición genética o racial a la aerofagia y a otras estereotipias y comportamientos anormales observados en estos animales.

ABSTRACT Crib-biting is the most common classic stereotype in equines, with a poorly understood etiology; however, it is recognized for being multifactorial in nature. Furthermore, it has been associated with negative effects on the health of horses. The objective of this study was to describe the risk factors and the frequency of presentation of crib-biting in a population of Colombian Creole Horses (CCC by its Spanish acronym). We surveyed Forty-two properties, which meant a total of 1063 CCC (488 males and 575 females). Of this population, 5,27% (56 animals) were fully identified with crib-biting. This prevalence was higher than most other reports in South America. Crib-biting is possibly due to both inherent of the animal and external factors related to management; however, the design of longitudinal studies on management practices and genetic lines within the breed is required to quantify and validate the information related to the possible genetic or racial predisposition for this and other stereotypes and abnormal behaviors observed in horses.

Abstract Background: Cardiorespiratory (aerobic) fitness is strongly and directly related to major health outcomes, including all-cause mortality. Maximum oxygen uptake (VO2max), directly measured by maximal cardiopulmonary exercise test (CPET), represents the subject’s aerobic fitness. However, as CPET is not always available, aerobic fitness estimation tools are necessary. Objectives: a) to propose the CLINIMEX Aerobic Fitness Questionnaire (C-AFQ); b) to validate C-AFQ against measured VO2max; and c) to analyze the influence of some potentially relevant variables on the error of estimate. Methods: We prospectively studied 1,000 healthy and unhealthy subjects (68.6% men) aged from 14 to 96 years that underwent a CPET. The two-step C-AFQ describes physical activities with corresponding values in metabolic equivalents (METs) - ranging from 0.9 to 21 METs. Results: Application of C-AFQ took less than two minutes. Linear regression analysis indicated a very strong association between estimated (C-AFQ) and measured (CPET) maximal METs - r2 = 0.83 (Sy.x = 1.63; p < .001) - with median difference of only 0.2 METs between both values and interquartile range (percentiles 25 and 75) of 2 METs. The difference between estimated and measured METs was not influenced by age, sex, body mass index, clinical condition, ß-blocker use or sitting-rising test scores. Conclusion: C-AFQ is a simple and valid tool for estimating aerobic fitness when CPET is unavailable and it is also useful in planning individual ramp protocols. However, individual error of estimate is quite high, so C-AFQ should not be considered a perfect substitute for CPET’s measured VO2max.

The use of online digital environments at Jorge Tadeo Lozano University has allowed the implementation of a question bank, with feedback, with the purpose of supporting students in their learning process for the subject of Mathematical Thinking; this subject is taught through lectures and workshops that are interrelated and leaded by different professors, one lecture session and two workshop sessions per week. A pedagogical innovation project was developed along two academic periods with the purpose of observing if the use of this online question bank with feedback improved the appropriation of mathematical concepts. The questions that are part of this bank were designed following recommendations for elaborating multiple choice questions with one answer; the selection of distractors for each question was made following conceptual or procedural reasons, which is where most of the difficulties for students are when solving an evaluation on this subject. For each question a detailed description was made, including conceptual aspects and key features such as type of question, question statement, answer choices, reasons for each choice, key information that must be included in feedback (graphics, concepts, solved examples, etc.), cognitive and conceptual domain, level of difficulty, date of elaboration and revision, name of who elaborated the question and name of who reviewed it. Each question was made available on this bank, located at the Virtual Classrooms System at Jorge Tadeo Lozano University (AVATA is the name of this Learning Management System working over Moodle) and corresponding to the Mathematical Thinking course, organized on folders separated by topics and levels of difficulty, according to the available syllabus of the subject. Evaluation models that gathered the topics covered on each of the three segments that form the academic period were used; such formative assessment was made available for students two weeks before each course evaluation. Due to the features of this evaluation, online, with multiple attempts and accessible from multiple devices, students were able to prepare their evaluations with a higher level of autonomy and at the pace, they would establish. Surveys, interviews and focus groups from students and professors that were part of the Mathematical Thinking course were carried out, with the purpose of identifying qualitative features that could eventually lead to adjustments and improvements to the question bank, although not many students participated in these interviews and surveys. Among the qualitative aspects that were highlighted is the fact that students felt comfortable when using this kind of evaluation, as they did not feel the pressure of the results; they also pointed out the role of workshop professors as a motivating element to consult the question bank in order to prepare the evaluations and strengthen mathematical concepts. The data obtained from each evaluation model and the results from students during the academic periods were analyzed statistically, allowing to conclude that there is a significant difference on course grades, both partial and finals, for students who used the evaluation models and students who did not. Results, both qualitative and quantitative, indicated that in general terms there is an improvement in performance for students who access to these online evaluation models compared to students who don't. In order to continue progressing on the work presented here, it is necessary to feed the bank with more questions, considering the aspects indicated from students and professors and also as a way of expanding the possibilities of randomizing the questions as students use the bank. It is also important to carry out statistical analysis to questions, with the purpose of establishing with better precision their levels of difficulty and the levels of difficulty of the evaluation models themselves.

El uso de entornos digitales en línea en la Universidad Jorge Tadeo Lozano ha permitido implementar una base de preguntas con retroalimentación para apoyar al estudiante en el proceso de aprendizaje en la asignatura Pensamiento Matemático. Se desarrolló un proyecto de innovación pedagógica en dos semestres académicos, con el fin de observar si el uso de una base de preguntas con retroalimentación en línea mejora el proceso de apropiación de los conceptos matemáticos de los estudiantes. Las preguntas que conformaron la base se diseñaron siguiendo indicaciones sobre elaboración de preguntas de múltiples opciones con única respuesta; se utilizaron exámenes modelo con los temas vistos en cada uno de los tres momentos en que se divide un periodo académico de la Universidad; dichas evaluaciones formativas fueron puestas a disposición de los estudiantes dos semanas antes de cada evaluación. Debido al carácter del examen -en línea-, con múltiples intentos y accediendo desde cualquier dispositivo, el estudiante podía preparar sus evaluaciones con mayor autonomía y al ritmo que él estableciera. Se realizaron encuestas, entrevistas y grupos focales para identificar algunas características cualitativas que han permitido realizar ajustes y mejoras a la base de preguntas. Los datos obtenidos de cada modelo de examen y los resultados de los estudiantes durante los semestres fueron analizados estadísticamente. Los resultados, tanto cualitativos como cuantitativos, indican que en general, sí hay mejora en el desempeño y apropiación de los conceptos matemáticos en aquellos estudiantes que acceden a los exámenes en línea frente a aquellos que no los usan.

Objective: To analyze the effects of detraining on body composition, vertical jumping and speed abilities. Methods: Twenty two under-�17 soccer players (16.4 ± 0.4 years; 70.0 ± 7.1 kg; 175.9 ± 6.9 cm) were evaluated before and after two weeks of detraining. Anthropometric measurements, countermovement (CMJ) and squat jumps (SJ) and sprint speed tests were performed. Results: There was a significant increase in body fat (p < 0.001) and despite the fact that the decrease in the speed was no significant (p > 0.05), an increase of 2.24% in the 0-�5 m time (ES = 0.78) and 0.97% in the 0-�20 m time (ES = 0.41) were observed. In addition, there was an upward trend in the SJ (p = 0.056). Conclusion: Two weeks of detraining resulted in significant alterations of the body composition and in speed performance (from 0 to 5 m) in young elite soccer players.

Objetivo: Analisar os efeitos do destreinamento na composição corporal e nas capacidades de salto vertical e na velocidade. Método: Vinte e dois jogadores sub17 (16.4 ± 0.4 anos; 70.0 ± 7.1 kg; 175.9 ± 6.9 cm) foram submetidos à avaliação antropométrica, de saltos verticais sem (SVSC) e com contramovimento (SVCC), e de velocidade linear, antes e após 2 semanas de destreinamento. Resultados: Houve aumento significante na gordura corporal (p < 0.001) e, apesar da redução da velocidade não ser significante (p > 0.05), houve 2.24% de aumento no tempo de 0-�5 m (ES = 0.78) e de 0.97% no tempo de 0-�20 m (ES = 0.41). Adicionalmente, houve tendência de aumento para o SVCC (p = 0.056). Conclusão: Duas semanas de destreinamento provocaram alterações significantes na composição corporal e na capacidade da velocidade motora e na distância de 0-�5 m em jovens futebolistas.

Objetivo: Analizar los efectos del desentrenamiento sobre el salto vertical, la velocidad de desplazamiento y la composición corporal en futbolistas jóvenes. Método: Veintidós jugadores (16.4 ± 0.4 años, 70.0 ± 7.1 kg, 175.9 ± 6.9 cm) se sometieron a evaluaciones de composición corporal, saltos verticales y velocidad (carreras de 20 metros), antes y después de 2 semanas de desentrenamiento. Resultados: Se encontraron aumentos significativos en el porcentaje de grasa corporal (p < 0.001) y a pesar de que la disminución de la velocidad no fue significativa (p > 0.05), hubo una reducción del 2.24% (ES = 0.78) y del 0.97% (ES = 0.41) en los tiempos en 5 y 20 m, respectivamente. Igualmente, se observó una tendencia al aumento del salto sin contramovimiento (p = 0.056). Conclusión: Dos semanas de desentrenamiento produjeron alteraciones significativas en la composición corporal y en la velocidad (entre 0-�5 m) de los jóvenes futbolistas.

ResumoFundamento:A condição aeróbica, avaliada pela medida do VO2máx no teste cardiopulmonar de exercício máximo (TCPE) ou estimada por equações no teste de exercício, é preditora de mortalidade. Porém, o erro obtido pela estimativa em um dado indivíduo pode ser alto, afetando decisões clínicas.Objetivo:Determinar o erro de estimativa do VO2máx em cicloergometria em população atendida nos serviços de ergometria e propor equações específicas por sexo para minimizar o erro na estimativa do VO2máx.Métodos:Foram avaliados 1715 adultos (18 a 91 anos) (68% homens) submetidos a TCPE máximo em cicloergômetro de membros inferiores (CMI) com protocolo de rampa. Calculou-se o erro percentual (E%) entre o VO2máx medido e o estimado pela equação ACSM modificada (Lang e col. MSSE, 1992). A seguir, foram desenvolvidas equações de estimativa: 1) para toda a amostra testada (C-GERAL) e 2) separadamente por sexo (C-HOMENS e C-MULHERES).Resultados:O VO2máx medido foi maior em homens do que em mulheres - 29,4 ± 10,5 e 24,2 ± 9,2 mL.(kg.min)-1 (p < 0,01) -. As equações de estimativa do VO2máx foram mL.(kg.min)-1: C-GERAL = [carga final (W)/peso (kg)] x 10,483 + 7; C‑HOMENS = [carga final (W)/peso (kg)] x 10,791 + 7; e C-MULHERES = [carga final (W)/peso (kg)] x 9,820 + 7. Os E% em homens foram -3,4 ± 13,4% (ACSM modificada), 1,2 ± 13,2% (C-GERAL) e -0,9 ± 13,4% (C-HOMENS) (p < 0,01). Em mulheres, obtivemos: -14,7 ± 17,4% (ACSM modificada), -6,3 ± 16,5% (C-GERAL) e -1,7 ± 16,2% (C-MULHERES) (p < 0,01).Conclusão:O erro de estimativa do VO2máx através de equações específicas por sexo foi reduzido, porém não eliminado, nos testes de exercício em CMI.

AbstractBackground:Aerobic fitness, assessed by measuring VO2max in maximum cardiopulmonary exercise testing (CPX) or by estimating VO2max through the use of equations in exercise testing, is a predictor of mortality. However, the error resulting from this estimate in a given individual can be high, affecting clinical decisions.Objective:To determine the error of estimate of VO2max in cycle ergometry in a population attending clinical exercise testing laboratories, and to propose sex-specific equations to minimize that error.Methods:This study assessed 1715 adults (18 to 91 years, 68% men) undertaking maximum CPX in a lower limbs cycle ergometer (LLCE) with ramp protocol. The percentage error (E%) between measured VO2max and that estimated from the modified ACSM equation (Lang et al. MSSE, 1992) was calculated. Then, estimation equations were developed: 1) for all the population tested (C-GENERAL); and 2) separately by sex (C-MEN and C-WOMEN).Results:Measured VO2max was higher in men than in WOMEN: -29.4 ± 10.5 and 24.2 ± 9.2 mL.(kg.min)-1 (p < 0.01). The equations for estimating VO2max [in mL.(kg.min)-1] were: C-GENERAL = [final workload (W)/body weight (kg)] x 10.483 + 7; C-MEN = [final workload (W)/body weight (kg)] x 10.791 + 7; and C-WOMEN = [final workload (W)/body weight (kg)] x 9.820 + 7. The E% for MEN was: -3.4 ± 13.4% (modified ACSM); 1.2 ± 13.2% (C-GENERAL); and -0.9 ± 13.4% (C-MEN) (p < 0.01). For WOMEN: -14.7 ± 17.4% (modified ACSM); -6.3 ± 16.5% (C-GENERAL); and -1.7 ± 16.2% (C-WOMEN) (p < 0.01).Conclusion:The error of estimate of VO2max by use of sex-specific equations was reduced, but not eliminated, in exercise tests on LLCE.

Objective: To develop an updated guide about the stability of thermolabile drugs included in the Pharmacotherapeutic Guide that, according to product information sheet, should be stored under refrigeration or freezing, when are accidentally exposed to temperatures outside the range recommended by the manufacturer. Methods: It was reviewed the information about storage temperatures recommended in the product information sheet and the available stability data at different temperatures of thermolabile drugs included in the Pharmacotherapeutic Guide of a 400-bed hospital that, according to the manufacturer, should be stored under refrigeration or freezing. Drugs of clinical trials were excluded. Stability data were obtained from the product information sheet, the last two guides published in Spain about thermolabile drugs and through consultations to laboratories (via phone or e-mail). Results: It was created a table with the storage temperatures recommended in the product information sheet and currently available stability data at different temperatures of 209 presentations of several drugs. Stability data were requested to laboratories in 172 cases. Conclusions: The stability guide is a tool that facilitates decisions of pharmacists when they are faced with an accidental interruption of the cold chain, when it is necessary to know whether the drug can be used and it is not possible to contact the laboratory.

Objetivo: Elaborar una guía actualizada sobre la estabilidad de los medicamentos termolábiles incluidos en la Guía Farmacoterapéutica que, según ficha técnica, deben conservarse bajo refrigeración o congelación, expuestos accidentalmente a temperaturas de conservación fuera del rango recomendado por el fabricante. Métodos: Se revisó la información sobre las temperaturas de conservación recomendadas en ficha técnica y los datos de estabilidad disponibles a distintas temperaturas de los medicamentos termolábiles incluidos en la Guía Farmacoterapéutica de un hospital de 400 camas que, según el fabricante, deben conservarse bajo refrigeración o congelación. Se excluyeron los medicamentos incluidos en ensayos clínicos. Los datos de estabilidad se obtuvieron a partir de la ficha técnica, la información contenida en las dos últimas guías de conservación de medicamentos termolábiles publicadas en España y a través de las consultas realizadas a los laboratorios (vía telefónica o por e-mail). Resultados: Se confeccionó una tabla con las temperaturas de conservación recomendadas en ficha técnica y los datos de estabilidad disponibles actualmente a distintas temperaturas de 209 presentaciones de distintas especialidades farmacéuticas. Se solicitaron datos de estabilidad actualizados de 172 de ellas a los laboratorios. Conclusiones: La guía elaborada constituye una herramienta que facilita la toma de decisiones del farmacéutico ante una rotura accidental de la cadena de frío, cuando sea necesario conocer si el fármaco puede ser utilizado y no sea posible contactar con el laboratorio fabricante.

Objective: To determine whether pharmacist is able to guarantee cold chain maintenance of thermolabile drugs during transport using the available information in the reception process and to compare these results with those obtained in a subsequent intervention phase, in which the manufacturing laboratories were contacted. Methods: Intervention study, prospective and comparative "before-after". It was analyzed the storage conditions during transport of all thermolabile drugs received in a 400-bed hospital for 3 months, excluding those from clinical trials. Results: The intervention allowed to ensure cold chain maintenance in 76,5% (n = 488) of received drugs, representing an increase of 41,8% (IC 95% 36,7-46,6%; p < 0,001) compared with the percentage obtained before the intervention. Conclusions: The pharmacist isn't able to ensure the cold chain maintenance of received thermolabile drugs without temperature monitoring device (64,6%). Reports requested from laboratories allowed to increase significantly that percentage.

Objetivo: Determinar si el farmacéutico puede garantizar el mantenimiento de la cadena de frío (CF) durante la distribución de los medicamentos termolábiles (MT) utilizando la información disponible durante la recepción y comparar estos resultados con los obtenidos en una fase posterior de intervención, en la que se contactó con los laboratorios. Métodos: Estudio de intervención, prospectivo, comparativo "antes-después". Se analizaron las condiciones de conservación durante el transporte de todos los MT recepcionados en un hospital de 400 camas durante 3 meses, excluyéndose los ensayos clínicos. Resultados: Tras la intervención pudo garantizarse el mantenimiento de la CF en el 76,5% (n = 488) de los pedidos recepcionados, lo que supuso un incremento del 41,8% (IC95% 36,746,6%; p < 0,001) respecto al porcentaje pre-intervención. Conclusiones: El farmacéutico no dispone de medios a su alcance para poder garantizar el mantenimiento de la CF de MT recepcionados sin indicador (64,6%). Los informes solicitados a los laboratorios permitieron incrementar significativamente este porcentaje.

Introduction: The term Primary Empty Sella (PES) makes reference to the herniation of the subarachnoid space within the sella turcica in those patients with no history of pituitary tumor, neither surgery, nor radiotherapy. Though it is usually not associated with endocrine abnormalities, different degrees of hypopituitarism and mild hyperprolactinemia have been reported. Objective: To assess clinical features, radiological findings and biochemical endocrine function retrospectively from the records of 117 patients with diagnosis of PES. Patients and Methods: One hundred seventeen patients, 98 females, were studied. The mean age at diagnosis was 48 ± 14.9 yr. Most diagnoses were made with magnetic resonance imaging (n = 115), and only 2 through sellar computed tomography scan. Only pituitary basal hormones determinations were made, except for the TRH and ACTH tests which were performed for the diagnosis of primary hypothyroidism and secondary adrenal failure respectively. Results: Pituitary images were requested because of different reasons: headaches (35 %), clinical and biochemical suspicion of pituitary deficiency (22 %), visual disturbances (11 %), abnormalities on the simple sella turcica radiography (11 %) hyperprolactinemia (2.6 %), others (18.4 %): dizziness, seizures, rhinorrhea, loss of consciousness, skull trauma, galactorrhea. Multiple pregnancies were observed in 48.9 % of women; headaches, obesity, arterial hypertension and thyroid autoimmunity were found in 60 %, 67 %, 24.5 % and 22.5 % of the studied population respectively. Mild hyperprolactinemia (< 50 ng/ml) was present in 6.1 % of women and 15.8 % of men. Twenty seven percent of our patients had some degree of hypopituitarism. For male population hypopituitarism comprised 72 %, whereas it took up 19 % for the whole female group. Conclusions: PES seems to be more commonly found in middle-aged women (sex ratio 5/1) with history of multiple pregnancies. In most patients it was discovered as an incidental finding at image studies, while in almost a quarter of patients PES was found during the diagnosis stage of anterior pituitary deficiency, which was more frequently seen among men.

Introducción: El término Silla Turca Vacía Primaria (STVP) hace referencia a la invaginación del espacio subaracnoideo hacia el interior de la silla turca en pacientes sin antecedentes de tumor, cirugía o radioterapia de la región selar. Aunque usualmente no está asociado con disfunciones endocrinas, diferentes grados de hipopituitarismo e hiperprolactinemia han sido reportados. Objetivo: Analizar retrospectivamente datos clínicos, hallazgos radiológicos y bioquímicos de 117 pacientes con diagnóstico de STVP. Pacientes y Métodos: Se estudiaron 117 pacientes, 98 mujeres (48 ± 14.9 años). Los diagnósticos fueron realizados por Resonancia Magnética Nuclear (n=115) y Tomografía Computada (n=2). La evaluación de la función adenohipofisaria se realizó a través de determinaciones hormonales basales. Resultados: Los motivos que llevaron al pedido de las imágenes fueron: cefaleas (35 %), sospecha clínica y/o bioquímica de deficiencia pituitaria (22 %), trastornos visuales (11 %), anormalidades de la radiografía simple de la silla turca (11 %), hiperprolactinemia (2,6 %), otros (18.4 %). El 48,9 % de las mujeres eran multíparas. Cefaleas, obesidad, hipertensión arterial y autoinmunidad tiroidea fueron halladas en el 60, 67, 24,5 y 22,5 % de la población evaluada respectivamente. Hiperprolactinemia (< 50 ng/ml) estuvo presente en 6,1 % de las mujeres y 15, 8 % de los hombres. El 27 % de los pacientes estudiados presentó algún grado de hipopituitarismo, que fue más frecuente en la población masculina. Conclusiones: STVP fue más frecuente en mujeres multíparas de mediana edad. En la mayoría de los casos fue descubierta incidentalmente por estudios radiológicos, mientras que en un cuarto de los pacientes, fue encontrada durante la evaluación diagnóstica de deficiencia adenohipofisaria, lo cual fue más frecuente en hombres.

Cytogenetic studies in model groups of insects (Odonata and Heteroptera) and arachnids (Dysderoidea and Buthidae) with holokinetic chromosomes allowed us to identify differences in autosomes and sex chromosomes meiotic behaviour (pre-or post-reductional meiosis, chiasmatic or achiasmatic meiosis, telokinetic or holokinetic activity). Also, we detected differences in the frequency and distribution of chromosomal mutations (fusions, fragmentations and translocations both in homozygosity or heterozygosity) in the karyotype evolution mechanisms.

Los estudios citogenéticos en grupos modelo de insectos (Odonata y Heteroptera) y arácnidos (Dysderoidea y Buthidae) con cromosomas holocinéticos nos han permitido determinar diferencias en el comportamiento meiótico de autosomas y cromosomas sexuales (meiosis pre- o post-reduccional, quiasmática o aquiasmática, actividad telocinética u holocinética) y en la frecuencia y distribución de las mutaciones cromosómicas (fusiones, fragmentaciones y translocaciones en homocigosis o heterocigosis) en la evolución del cariotipo.

FUNDAMENTO: Valores exagerados da pressão arterial sistólica (PAS) durante um teste cardiopulmonar de exercício máximo (TCPE) são classicamente considerados como inapropriados e associados a um maior risco para desenvolvimento de doenças cardiovasculares. Sabe-se que o sistema nervoso autônomo modula a PA no exercício. Contudo, não está claramente estabelecido o comportamento do tônus vagal cardíaco (TVC) em indivíduos saudáveis com uma resposta pressórica exagerada no TCPE. OBJETIVO: Analisar o comportamento do TVC em homens adultos saudáveis que apresentam uma resposta pressórica exagerada no TCPE. MÉTODOS: De 2.505 casos avaliados entre 2002-2009, foram identificados criteriosamente 154 casos de homens, entre 20-50 anos de idade, saudáveis e normotensos. A avaliação incluía exame clínico, medidas antropométricas, testes de exercício de 4 segundos (tônus vagal cardíaco) e TCPE realizado em cicloergômetro, com medidas de pressão arterial a cada minuto pelo método auscultatório. Baseado no valor máximo de PAS obtido no TCPE, a amostra foi dividida em tercis, comparando-se o TVC, a carga máxima e o VO2 máximo. RESULTADOS: Os valores de TVC diferiram entre os indivíduos que se apresentavam nos tercis inferior e superior para a resposta da PAS ao TCPE, respectivamente, 1,57 ± 0,03 e 1,65 ± 0,04 (média ± erro padrão da média) (p = 0,014). Os dois tercis também diferiam quanto ao VO2 máximo (40,7 ± 1,3 vs 46,4 ± 1,3 ml/kg-1.min-1; p = 0,013) e a carga máxima (206 ± 6,3 vs 275 ± 8,7 watts; p < 0,001). CONCLUSÃO: Uma resposta pressórica exagerada durante o TCPE em homens adultos saudáveis é acompanhada de indicadores de bom prognóstico clínico, incluindo níveis mais altos de condição aeróbica e de tônus vagal cardíaco.

BACKGROUND: Exaggerated systolic blood pressure (SBP) levels during a maximal cardiopulmonary exercise test (CPET) are classically considered as inappropriate and associated with a higher risk for the development of cardiovascular diseases. It is known that the autonomic nervous system modulates the BP during exercise. However, the behavior of the cardiac vagal tone (CVT) has not been fully established in healthy individuals with an exaggerated BP response to CPET. OBJECTIVE: To analyze the behavior of the CVT in healthy adult males presenting an exaggerated BP response to CPET. METHODS: Of the 2,505 cases evaluated between 2002-2009, 154 cases were thoroughly identified, consisting of healthy male normotensive subjects aged 20-50 years. The evaluation included clinical assessment, anthropometric measurements, 4-second exercise test (cardiac vagal tone) and cardiopulmonary exercise test (CPET) performed in a cycle-ergometer, with BP measurements being taken every minute through auscultation. Based on the maximum SBP value obtained at the CPET, the sample was divided in tertiles, comparing CVT, maximum workload and VO2 max. RESULTS: The CVT results differed between individuals in the lower tertile and upper tertile for the SBP response to the CPET, respectively: 1.57 ± 0.03 and 1.65 ± 0.04 (mean ± standard error of mean) (p = 0.014). The two tertiles also differed regarding the VO2 max (40.7 ± 1.3 vs 46.4 ± 1.3 ml/kg-1.min-1; p = 0.013) and the maximum workload (206 ± 6.3 vs 275 ± 8.7 watts; p < 0.001). CONCLUSIOn: An increased BP response during the CPET in healthy adult males is accompanied by indicators of good clinical prognosis, including higher levels of aerobic fitness and cardiac vagal tone.

FUNDAMENTO: Valores exagerados de presión arterial sistólica (PAS) durante una test cardiopulmonar de ejercicio máximo (TCPE) son clásicamente considerados como inapropiados y asociados a un mayor riesgo de desarrollo de enfermedades cardiovasculares. Se sabe que el sistema nervioso autónomo modula la PA en el ejercicio. Con todo, no está claramente establecido el comportamiento del tono vagal cardíaco (TVC) en individuos sanos con una respuesta presora exagerada en el TCPE. OBJETIVO: Analizar el comportamiento del TVC en hombres adultos sanos que presentan una respuesta presora exagerada en el TCPE. MÉTODOS: De 2.505 casos evaluados entre 2002-2009, fueron identificados criteriosamente 154 casos de hombres, entre 20-50 años de edad, sanos y normotensos. La evaluación incluía examen clínico, medidas antropométricas, pruebas de ejercicio de 4 segundos (tono vagal cardíaco) y TCPE realizado en cicloergómetro, con medidas de presión arterial a cada minuto por el método auscultatorio. Basado en el valor máximo de PAS obtenido en el TCPE, la muestra fue dividida en terciles, comparándose el TVC, la carga máxima y el VO2 máximo. RESULTADOS: Los valores de TVC difirieron entre los individuos que se presentaban en los terciles inferior y superior para la respuesta de la PAS al TCPE, respectivamente, 1,57 ± 0,03 y 1,65 ± 0,04 (promedio ± error estándar del promedio) (p = 0,014). Los dos terciles también diferían en cuanto al VO2 máximo (40,7 ± 1,3 vs 46,4 ± 1,3 ml/kg-1.min-1; p = 0,013) y la carga máxima (206 ± 6,3 vs 275 ± 8,7 watts; p < 0,001). CONCLUSIÓN: Una respuesta presora exagerada durante el TCPE en hombres adultos sanos es acompañada de indicadores de buen pronóstico clínico, incluyendo niveles más altos de condición aeróbica y de tono vagal cardíaco.

OBJECTIVES: to determine if there are differences in cardiac vagal tone values in non-obese healthy, adult men with and without unfavorable anthropometric characteristics. INTRODUCTION: It is well established that obesity reduces cardiac vagal tone. However, it remains unknown if decreases in cardiac vagal tone can be observed early in non-obese healthy, adult men presenting unfavorable anthropometric characteristics. METHODS: Among 1688 individuals assessed between 2004 and 2008, we selected 118 non-obese (BMI <30 kg/m²), healthy men (no known disease conditions or regular use of relevant medications), aged between 20 and 77 years old (42 ± 12-years-old). Their evaluation included clinical examination, anthropometric assessment (body height and weight, sum of six skinfolds, waist circumference and somatotype), a 4-second exercise test to estimate cardiac vagal tone and a maximal cardiopulmonary exercise test to exclude individuals with myocardial ischemia. The same physician performed all procedures. RESULTS: A lower cardiac vagal tone was found for the individuals in the higher quintiles - unfavorable anthropometric characteristics - of BMI (p=0.005), sum of six skinfolds (p=0.037) and waist circumference (p<0.001). In addition, the more endomorphic individuals also presented a lower cardiac vagal tone (p=0.023), while an ectomorphic build was related to higher cardiac vagal tone values as estimated by the 4-second exercise test (r=0.23; p=0.017). CONCLUSIONS: Non-obese and healthy adult men with unfavorable anthropometric characteristics tend to present lower cardiac vagal tone levels. Early identification of this trend by simple protocols that are non-invasive and risk-free, using select anthropometric characteristics, may be clinically useful in a global strategy to prevent cardiovascular disease.

The aim of our study was to describe the clinical-biochemical and radiologic presentation and the post surgery outcome in a cohort of patients with gonadotrophinomas. Patients were selected from nine Endocrinology Units of the city of Buenos Aires from 1983 at 2003. The inclusion criteria was defined by nonfunctinoning pituitary adenomas with positive innmunohistochemical (IH) for luteinizing hormone (LH), follicle-stimulating hormone (FSH) and/or alpha subunit (ASU). Innmunohistochemically plurihormonal adenomas were excluded. Sixty six patients were analyzed, aged 51,8 ± 12,1 (X +/- DS) years; (39 men). More prevalent symptoms were visual alterations (72,8%), hypogonadism and headaches. Eleven percent was diagnosed as incidentalomas. Ninety eight percent were macroadenomas, 56,9% was Hardy stage (HS) 3 and 29,6% was HS 4. The patients were followed up for 47,8 months (r: 5-168). Hypogonadism was biochemically found in 82,4%. The majority showed low or inappropriately normal levels of gonadotrophins except for 4 women and 3 men that had high and dissociated levels. Hyperprolactinemia was observed in 45,2% and was interpreted as an interference with normal dopamine inhibition of prolactin secretion (X+/-DS: 65.6+/- ng/ml, r: 30-172). Hypopituitarism was found in 25,7% of the patients. Transsphenoidal surgery was carried out in 80% and in 28% a second surgery was needed. The IH was positive for LH, FSH and ASU in this order of frequency or its combinations. Tumor persistency and/or recurrency were found in 84% of the patients. Forty one percent showed improvement of visual defects. Radiotherapy was indicated in 37% and hormonal replacement was needed in 65% of the patients.

Objetivo: Analizar la presentación clínica, radiológica, bioquímica y el comportamiento posquirúrgico de una cohorte de pacientes portadores de gonadotrofinomas. Pacientes y Métodos: Se evaluaron pacientes con gonadotrofinomas estudiados en nueve centros endocrinológicos de la ciudad de Bs.As. durante el período 1983 a 2003. El criterio de inclusión fue la inmunohistoquímica (IH) positiva para hormona luteinizante (LH), folículoestimulante (FSH) y/o alfa subunidad (ASU). Los adenomas plurihormonales fueron excluidos. Resultados: Fueron analizados 66 pacientes de 51,8 ± 12,1 (X +/- DS) años (39 varones). Los síntomas mas frecuentemente observados fueron las alteraciones visuales (72,8%), seguidas por el hipogonadismo y las cefaleas. El 10,6% se diagnosticaron en forma incidental. El 98,5% fueron macroadenomas, 56,9% de los cuales correspondieron a un estadio Hardy (EH) 3 y 29,6% a un EH 4. El tiempo de seguimiento fue de 47,8 meses (r: 5-168). El hipogonadismo definido bioquímicamente se presentó en el 82,4% de los pacientes. En su mayoría presentaban niveles bajos o inapropiadamente normales de gonadotrofinas, pero 4 mujeres y 3 varones presentaron niveles séricos elevados y disociados de FSH y LH. La hiperprolactinemia por desconexión fue observada en 45,2% de la población (X: 65.6 ng/ml r: 30-172). El hipopituitarismo se detectó en 25,7% de los casos. La cirugía fue transeptoesfenoidal (TSE) en 80%; una segunda operación fue realizada en el 28% de la población. La IH fue positiva por orden de frecuencia para LH, FSH y ASU o las 3 combinaciones. La evolución posquirúrgica evidenció mejoría en el campo visual (CV) en el 41%. La presencia de restos tumorales y/o recidiva fue del 84%. Se indicó radioterapia en 37% y la sustitución hormonal fue necesaria en el 65% de los pacientes.