Abstract The objectives of this research were to study (1) the dispersion of MWCNTs in an aqueous system by three commercial admixtures (CAds) for concrete, and (2) the effect of CAds and MWCNTs on indirect tensile strength and electrical conductivity of MWCNTs-high early strength (HE) cement-mortar composites. To achieve the objectives, we dispersed MWCNTs in an aqueous system with (1) hydroxylated polymers-based water reducing plasticizer (HPs), a nonionic compound, (2) Naphthalene based superplasticizer (SNF), an anionic compound, and (3) calcium chloride-based accelerating agent (CC) a neutral amphoteric salt. We prepared a total of 242 samples grouped in three sets: (1) Plain mortar [PM] (water + HE cement + Sand), (2) [PM+CAd], and (3) [PM+CAd+MWCNTs]. The three CAds dispersed MWCNTs in an aqueous solution. The CC and HPs admixtures have a two-time bigger dispersing power than the SNF. They demand half of SNF’s ultrasound energy for optimal dispersion. Although the SNF (anionic) based superplasticizer resulted incompatible with the HE cement, it improved the indirect tensile strength of [PM+SNF+MWCNTs] composite. In contrast, the CC (amphoteric) based accelerating agent was compatible with the HE cement; the CC adsorption on the MWCNTs surface favors an improvement in the electrical conductivity of [PM+CAd+MWCNTs] composite.

Abstract Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most technically demanding and high-risk procedures performed by gastrointestinal endoscopists. Gastroenterology associations have developed guidelines or position statements on various aspects of quality and safety indicators in ERCP. Objective: To know the frequency of adherence to quality indicators in studies of ERCP recommended by the American Gastrointestinal Endoscopy Association in the Gastrointestinal Endoscopy Service, Division of General Surgery of the “Manuel Gea González General Hospital”. Material and methods: CPRE files and reports were reviewed, from January 01, 2018 to December 31, 2018. It is an observational, descriptive, retrospective and cross-sectional study. Descriptive statistics and calculation of proportions were performed. All measurement parameters were taken from the ASGE guidelines. The data were represented by the percentage that was achieved for each indicator and the 95% confidence interval (CI) when necessary. Results: 606 ERCPs were included. There were 395 women (65.5%) and 208 (34.5%) were men. The age range was from 2 to 91 years, average age of 48 years. The quality of the ERCP with the performance objectives established by ASGE for almost all the indicators were carried out. The adverse events reported in our series correlate with what is described in the world literature. Conclusion: The present study can be a useful way to guarantee the performance of ERCPs of a better quality in our hospital, as well as being able to perform them in an appropriate manner in any circumstance and pathology. We also have certified endoscopists who comply with the number of appropriate procedures, so teaching is feasible and necessary.

Resumen Introducción: La colangiopancreatografía retrógrada endoscópica (CPRE) es uno de los procedimientos técnicamente más exigentes y de alto riesgo realizados por endoscopistas gastrointestinales. Las asociaciones de gastroenterología han desarrollado directrices o declaraciones de posición sobre diversos aspectos de los indicadores de calidad y de seguridad en la CPRE. Objetivo: Conocer la frecuencia del apego a los indicadores de calidad en estudios de CPRE recomendados por la Asociación Americana de Endoscopia Gastrointestinal en el Servicio de Endoscopia Gastrointestinal, División de Cirugía General del “Hospital General Manuel Gea González “. Material y métodos: Se revisaron los expedientes y reportes de CPRE, del 01 de Enero de 2018 al 31 de Diciembre de 2018. Es un estudio observacional, descriptivo, retrospectivo y transversal. Se realizó estadística descriptiva y calculo de proporciones. Todos los parámetros de medición se tomaron de las pautas de ASGE. Los datos se representaron por el porcentaje que se logró de cada indicador y los intervalos de confianza (IC) de proporción del 95% cuando fue necesario. Resultados: Se incluyeron 606 CPRE. Fueron 395 mujeres (65.5%) y 208 (34.5%) fueron hombres. El rango de edad fue de 2 a 91 años, edad media de 48 años. La calidad de la CPRE con los objetivos de rendimiento establecidos por ASGE para casi todos los indicadores, fueron llevados acabo. Los eventos adversos informados en nuestra serie correlacionan con lo descrito en la literatura mundial. Conclusión: El presente estudio, puede ser una forma útil para garantizar la realización de las CPRE de una mejor calidad en nuestro hospital, así como poder realizarlos de manera adecuada en cualquier circunstancia y patología. Además contamos con médicos endoscopistas certificados y que cumplen con el numero de procedimientos adecuados, por lo cual la enseñanza es factible y necesaria.

Onychomycosis is an uncommon condition in children. When it appears, it usually affects toenails, mainly the first and fifth toenails, and occasionally it is associated to tinea pedis. We report a case of total dystrophic onychomycosis by Tricophyton rubrum in both feet in a male patient seven years old, with favorable outcome after systemic and topical treatment. The interest of this case report lies in the low prevalence of onychomycosis at this age, as well as in an uncommon (total dystrophic) clinical presentation. Fungal isolation is sometimes challenging, but the culture proved positive in this case.

Las onicomicosis son una patología infrecuente en la edad pediátrica. De presentarse, suelen afectar a las uñas de los pies, principalmente a las uñas del primer y quinto dedo, y ocasionalmente se asocia a una tinea pedis. Presentamos un caso de onicomicosis distrófica total por Tricophyton rubrum en ambos pies en un paciente varón de siete años, con evolución favorable tras tratamiento sistémico y tópico. El interés del caso radica en la baja prevalencia de las onicomicosis en esta franja etaria, así como una presentación clínica (distrófica total) poco frecuente. El aislamiento de las levaduras es, en ocasiones, dificultoso, pero en este caso el cultivo resultó positivo.

Introduction: It is currently recognized the impact of different clinical and sociodemographics variables on the health-related quality of life (HRQL) of patients undergoing peritoneal dialysis (DP), albeit the influence of psychological variable has not been thoroughly studied. The objective of this study is to identify the psychological predictors of HRQL in patients under DP. Method: 53 patients on DP participated in the study (49.54 ± 17.03 years, 54.7% women) in whom HRQL was evaluated by the Kidney Disease Quality of Life Short Form and it was obtained information related with psychological variables (depressive and anxious symptoms , alexithymia, health-related locus of control and coping strategies) besides socio-demographical and clinical variables. Results: Patients on DP presented a worse HRQL than general population, particularly in the physical dimension. The comorbility, the number of visits to urgency department, previous hospital admissions, serum albumin and previous treatment with hemodialysis showed a negative impact on several dimensions of HRQL, but depressive symptoms, alexithymia and particularly anxious symptoms were the main determinants of the variability of HRQL in DP patients. We did not obtain a significant relationship between HRQL and the locus of control or the coping strategies. Conclusions: Among patients undergoing DP, anxiety, depression and alexithymia are important determinants of HRQL and they should be considered both in the evaluation and the treatment of this population of patients.

Introducción: Actualmente se reconoce el efecto de distintas variables clínicas y sociodemográficas en la calidad de vida relacionada con la salud (CVRS) de los pacientes en diálisis peritoneal (DP), pero la influencia de los factores psicológicos no ha sido suficientemente explorada. El objetivo de este estudio es identificar los predictores psicológicos de la CVRS en pacientes en DP. Método: Participaron 53 pacientes en tratamiento en DP (49,54 ± 17,03 años, 54,7% mujeres) en los que se evaluó su CVRS mediante el Kidney Disease Quality of Life Short Form y se recogió información de variables psicológicas (síntomas depresivos y ansiosos, alexitimia, locus de control relacionado con la salud y estrategias de afrontamiento), así como de variables sociodemográficas y clínicas. Resultados: Los pacientes en DP presentaron peor CVRS que la población general, particularmente en las dimensiones físicas. La comorbilidad, el número de visitas a urgencias, las hospitalizaciones previas, la albúmina, y el tratamiento previo en HD mostraron un efecto negativo en algunas dimensiones de la CVRS, pero los síntomas depresivos, la alexitimia y particularmente los síntomas ansiosos fueron los principales determinantes de la variabilidad en la CVRS de los pacientes en DP. No se encontraron relaciones significativas entre la CVRS y el locus de control o las estrategias de afrontamiento. Conclusiones: En los pacientes en DP, la ansiedad, la depresión y la alexitimia son importantes determinantes de la CVRS, por lo que deberían ser consideradas tanto en la evaluación como en el tratamiento de esta población de enfermos.

The purpose of this study was to determine the middle latency response (MLR) characteristics (latency and amplitude) in children with (central) auditory processing disorder [(C)APD], categorized as such by their performance on the central auditory test battery, and the effects of these characteristics after auditory training. Thirty children with (C)APD, 8 to 14 years of age, were tested using the MLR-evoked potential. This group was then enrolled in an 8-week auditory training program and then retested at the completion of the program. A control group of 22 children without (C)APD, composed of relatives and acquaintances of those involved in the research, underwent the same testing at equal time intervals, but were not enrolled in the auditory training program. Before auditory training, MLR results for the (C)APD group exhibited lower C3-A1 and C3-A2 wave amplitudes in comparison to the control group [C3-A1, 0.84 µV (mean), 0.39 (SD - standard deviation) for the (C)APD group and 1.18 µV (mean), 0.65 (SD) for the control group; C3-A2, 0.69 µV (mean), 0.31 (SD) for the (C)APD group and 1.00 µV (mean), 0.46 (SD) for the control group]. After training, the MLR C3-A1 [1.59 µV (mean), 0.82 (SD)] and C3-A2 [1.24 µV (mean), 0.73 (SD)] wave amplitudes of the (C)APD group significantly increased, so that there was no longer a significant difference in MLR amplitude between (C)APD and control groups. These findings suggest progress in the use of electrophysiological measurements for the diagnosis and treatment of (C)APD.

Microdeletion 22q11 in humans causes velocardiofacial and DiGeorge syndromes. Most patients share a common 3Mb deletion, but the clinical manifestations are very heterogeneous. Congenital heart disease is present in 50-80% of patients and is a significant cause of morbidity and mortality. The phenotypic variability suggests the presence of modifiers. Polymorphisms in the VEGFA gene, coding for the vascular endothelial growth factor A, have been associated with non-syndromic congenital heart disease, as well as with the presence of cardiovascular anomalies in patients with microdeletion 22q11. We evaluated the association of VEGFA polymorphisms c.-2578C>A (rs699947), c.-1154G>A (rs1570360) and c.-634C>G (rs2010963) with congenital heart disease in Chilean patients with microdeletion 22q11. The study was performed using case-control and family-based association designs. We evaluated 122 patients with microdeletion 22q11 and known anatomy of the heart and great vessels, and their parents. Half the patients had congenital heart disease. We obtained no evidence of association by either method of analysis. Our results provide further evidence of the incomplete penetrance of the cardiovascular phenotype of microdeletion 22ql 1, but do not support association between VEGFA promoter polymorphisms and the presence of congenital heart disease in Chilean patients with this syndrome.

A research study was carried out with the aim to evaluate in situ the genetic variability of wild chilli from the Frailesca region of Chiapas state. The experimental sample was made up of 10 % of the communities and producers from each municipality. The sampling unit was the site with plants. In situ evaluation was based on quantitative and qualitative characteristics contained in the term Capsicum. Variability was measured through Margalef, Simpson and Sorensen´s diversity indexes. The highest discriminant quantitative characters were: flower number per axil, filament length, diameter, fruit length and weight, placenta length, 1000-seed number and weight. As a result of the discriminant analysis, three groups were formed: group 1, where Capsicum annuum prevails, with six accessions having characteristics from C. frutescens; group 2, integrated by accessions from Capsicum frutescens, and group 3, with C. annuum cultivated. There was an evident existence of high levels of variability in the chilli samples evaluated, which formed three groups with characteristics identifying the species: Capsicum frutescens L., Capsicum annuum L. and 12 cultivated accessions from Capsicum annuum. The highest variability was recorded in La Concordia and Villaflores municipalities, where there are conditions for preserving in situ variability

Se realizó un estudio con el objetivo de hacer la evaluación in situ de la variabilidad genética de los chiles silvestres en la región Frailesca del estado de Chiapas. La muestra experimental se constituyó con el 10 % de las comunidades y productores de cada municipio. La unidad de muestreo fue el sitio donde se encontraron las plantas. La evaluación in situ se basó en las características cuantitativas y cualitativas contenidas en el descriptor de Capsicum. La variabilidad se midió utilizando los índices de diversidad de Margalef, Simpson y Sorensen. Los caracteres cuantitativos con mayor valor discriminante fueron: número de flores por axila, longitud del filamento, diámetro, longitud y peso de los frutos, longitud de la placenta, número y peso de 1000 semillas. Como resultado del análisis discriminante, se formaron tres grupos: el grupo 1, donde predominan los Capsicum annuum, con seis accesiones que poseen características de C. frutescens; el grupo 2, integrado por las accesiones de Capsicum frutescens, y el grupo 3, con los C. annuum cultivados. Se evidenció la existencia de altos niveles de variabilidad en las muestras de chile evaluadas, las cuales integraron tres grupos con características que identifican las especies: Capsicum frutescens L., Capsicum annuum L. y 12 accesiones cultivadas de Capsicum annuum. La mayor variabilidad se encontró en los municipios La Concordia y Villaflores, existiendo condiciones para la conservación de la variabilidad in situ.

Portosystemic collateral formation, particularly at the gastroesophageal junction, is a most serious consequence of portal hypertension. Increased portal pressure is the most significant force underlying gastroesophageal variceal formation, to which end portal pressure (estimated from the hepatic venous pressure gradient) must reach at least 10 mmHg. Subsequently, splanchnic hyperemia also contributes to variceal development. Portoystemic collaterals result from repermeabilization of pre-extant vessels, vascular remodeling, and angiogenesis. The goal of pre-primary prophylaxis is preventing or delaying the formation of gastroesophageal varices. In experimental models of portal hypertension, early administration of splanchnic vasoconstrictors such as beta-blockers, nitric oxide synthesis inhibitors, or antiangiogenic substances inhibits portosystemic collateral formation. However, clinical trials of beta-blockers in patients with cirrhosis and no varices to delay variceal formation have failed to yield expected results.

La formación de colaterales portosistémicas, en especial en la unión esofagogástrica, es una de las consecuencias más graves de la hipertensión portal. El aumento de la presión portal es la fuerza más importante que dirige la formación de varices esofagogástricas, siendo necesario para que esto ocurra que la presión portal (estimada por el gradiente de presión venosa hepática) alcance un valor mínimo de 10 mmHg. Posteriormente, la hiperemia esplácnica también contribuye al desarrollo de las varices. Las colaterales portosistémicas se forman por repermeabilización de vasos preexistentes, remodelado vascular y angiogénesis. El objetivo de la profilaxis preprimaria es evitar o retrasar la formación de varices esofagogástricas. En modelos experimentales de hipertensión portal, la administración precoz de vasoconstrictores esplácnicos como los beta-bloqueantes, de inhibidores de la síntesis de óxido nítrico o de sustancias anti-angiogénicas, inhibe la formación de colaterales portosistémicas. Sin embargo, los ensayos clínicos con beta-bloqueantes realizados en pacientes con cirrosis sin varices con objeto de retrasar su formación no han alcanzado los resultados esperados.

Cystic fibrosis (CF) is caused by mutations in the CFTR gene. More than 1600 mutations have been described, with frequencies that differ worldwide according to the ethnic origin of patients. A small group of mutations are recurrent on several populations. It has been shown that they each tend occur on specific chromosome 7 haplotypes, supporting the notion of a single origin for them. Less than 50% of mutations in Chilean patients have been identified to date. To indirectly assess the possible presence of a predominant founder mutation in the remaining unknown alíeles, we evaluated 2 polymorphic markers, XV-2c and KM.19, tightly linked to the CFTR locus. The study was done in Chilean CF patients with unknown or delt F508 ( F508) CFTR mutations and their haplotypes were compared to affected family-based controls. F508 showed marked linkage disequilibrium with XV-2c/KM.19 haplotype B, with 90% of alíeles on that haplotype. There was no difference in haplotype distribution between unknown mutations and normal controls. These results support a European origin for F508 alíeles in Chilean patients, and make unlikely the presence of a predominant founder mutation in the so-far unknown alíeles