ABSTRACT Sclerosing Mesenteritis (SM) is a rare diagnosis, particularly in pediatric patients, and is typically non-fatal when appropriately treated. Although molecular and immunohistochemical alterations have been described, no pathognomonic signature has been identified for this entity. This report presents a case of a seven-year-old boy who suffered sudden cardiorespiratory arrest. Upon autopsy, he was found to have multicentric SM on the upper mesentery, which led to bowel wall thinning and abdominal bleeding with bacterial translocation. We performed comprehensive morphological, immunohistochemical, and molecular analyses. SM is an atypical disorder with diverse clinical manifestations, including a rare but potentially fatal course. Early diagnosis is critical, given its potential severity. To our knowledge, this is the first case report of pediatric mortality linked to SM. Our findings emphasize the importance of increased awareness and early detection of SM in pediatric patients.

RESUMEN Objetivo : Elaborar una guía de práctica clínica peruana para el diagnóstico y tratamiento de la Distrofia Muscular de Duchenne y Becker (DMD). Materiales y métodos : Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas en neurología, neuropediatría, genética y metodología. El GEG formuló ocho preguntas para desarrollar las recomendaciones de la Guía de Práctica Clínica (GPC). Se realizó una búsqueda sistemática en Medline, Scopus y CCRT durante el periodo enero-abril 2021 para responder a las preguntas PICO. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Resultados : Las preguntas PICO, se orientaron para explorar el tamizaje, diagnóstico y tratamiento de la DMD. Se formularon 15 recomendaciones (10 fuertes, 5 condicionales) y 11 puntos de buena práctica clínica Conclusión : Se presenta la guía para el diagnóstico y tratamiento de la DMD, elaborada bajo una metodología basada en las evidencias actuales.

ABSTRACT Objective : to provide evidence-based clinical recommendations for the diagnosis and treatment of Duchenne Muscular Dystrophy. Methods : a guideline development group (GEG) was formed that included specialized physicians in the fields of neurology, neuropediatrics, genetics, and methodology. The GEG asked eight clinical questions to be answered by recommendations in this clinical practice guidelines (CPG). We conducted a systematic search and - when deemed relevant - primary studies in Medline, Scopus, and the Cochrane Controlled Register of Trials during 2021 were reviewed. Evidence was selected to answer each of the clinical questions posed. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. In periodic work meetings, the GEG used the GRADE methodology to review the evidence and formulate recommendations, points of good clinical practice, and a diagnosis and treatment flowchart. Results : this CPG addressed eight clinical questions, divided into three topics: screening, diagnosis, and treatment. Based on these questions, fifteen recommendations were formulated (10 strong, 5 conditional) and 11 points for good clinical practice. Conclusion : this paper summarizes the methodology and evidence- based conclusions of the CPG for the diagnosis and treatment of Duchenne muscular dystrophy.

ABSTRACT Introduction: Little is known about the acquired form of factor VII deficiency and few cases are reported in the literature. Objective: To present a case of a patient with an isolated deficit of factor VII, in the context of low gastrointestinal bleeding. Presentation of the case: 82-year-old Peruvian woman who comes to the emergency room for presenting with lower GI bleeding. Prolonged prothrombin time and isolated factor VII deficiency are detected during routine examinations. There were no evidence of pathological mechanisms of vitamin K deficiency or malabsorption, anticoagulant therapy with vitamin K antagonists, hyperfibrinolysis, or disseminated intravascular coagulation. She responded to the treatment with fresh frozen plasma and the normal results of the hematological test carried out on the sister remove the possible hereditary etiology. Conclusion: This Peruvian case of isolated factor VII deficit, in the context of low gastrointestinal bleeding, allows adding information to the limited Latin American evidence.

RESUMEN Introducción: Se conoce poco de la forma adquirida del déficit del factor VII y son pocos los casos reportados en la literatura. Objetivo: Presentar el caso de una paciente con déficit aislado del factor VII, en el contexto de una hemorragia digestiva baja. Presentación del caso: Mujer peruana de 82 años que acude a emergencia por presentar hemorragia digestiva baja. Durante los exámenes de rutina se le detecta tiempo de protrombina prolongado y déficit aislado de factor VII. No se evidencia mecanismos patológicos de deficiencia de vitamina K o malabsorción, terapia anticoagulante con antagonistas de la vitamina K, hiperfibrinolisis o coagulación intravascular diseminada. Respondió al tratamiento con plasma fresco congelado y los resultados normales de la prueba hematológica realizada a la hermana, alejan la posible etiología hereditaria. Conclusión: Este caso peruano de déficit aislado del factor VII, en el contexto de una hemorragia digestiva baja, permite sumar información a la escasa evidencia Latinoamericana.

The Sancti Spiritus settlement was established at some undetermined time between May and August 1527 at the Carcarañá and Coronda rivers confluence, when an expedition commanded by Sebastián Caboto arrived. This archaeological site focus on the beginning of the European presence and the introduction of new plant species in the region. The results obtained from the phytoliths and archaeological charcoals analysis contribute with new data because plants introduced in a Hispano-indigenous context of the early 16th century were identified. Charcoals assigned to gymnosperms had to be introduced by colonizers from Europe because material was identified as wild pine (Pinus sylvestris) and yew (Taxus baccata). The presence of gymnosperms in an Argentine archaeological site represents the oldest material evidence of exotic wood in historical moments. The identified phytolytic associations respond to plants related to local grasses (Maideae and Oryzoideae) and a type of introduced plant, as is the case of the forms related to wheat (Triticeae). The archaeobotanical analyzes contribute information that, with historical records, provide elements for the reconstruction of this event relevant to Hispanic American history.

El asentamiento español de Sancti Spiritus se estableció en algún momento indeterminado entre mayo y agosto de 1527 en la confluencia de los ríos Carcarañá y Coronda, cuando arribó una expedición al mando de Sebastián Caboto. Este sitio arqueológico marca el inicio de la presencia europea en la región y con ello la introducción de nuevas especies vegetales. Los resultados obtenidos a partir del análisis de los fitolitos y los carbones arqueológicos del sitio contribuyen con información novedosa debido a que en ambos casos se identificaron vegetales introducidos en un contexto hispano-indígena de principios del siglo XVI. Los carbones debieron ser introducidos por los colonizadores, dado que fueron asignados a gimnospermas afines a pino silvestre (Pinus sylvestris) y tejo (Taxus baccata). La presencia de gimnospermas en un sitio arqueológico argentino representa la evidencia material más antigua de maderas de origen exótico en  momentos históricos. Las asociaciones fitolíticas identificadas responden a vegetales afines a gramíneas locales (Maideae y Oryzoideae) y un tipo de vegetal introducido, como es el caso de las formas afines a trigo (Triticeae). Los análisis arqueobotánicos aportan información que sumada a los registros históricos, proporcionan elementos para la reconstrucción de este acontecimiento relevante para la historia hispanoamericana.

The aim of this study was to determine the association between contamination with Toxocara sp and the sanitary classification of parks of the Department of Food Hygiene and Zoonosis, Ministry of Health (Peru), in the city of Abancay, Peru. The research was analytical, basic level and cross-sectional. Sampling (n=276) was conducted in all 21 city parks through a systematic random sampling using the double «W» methodology. The classification of parks was carried out using the assessment sheet of the Park Sanitary Surveillance Programme, assessing the infrastructure, environment, and health risks. The results showed that 66.7% of parks were contaminated with Toxocara sp and the frequency of samples contaminated with the parasite was 26.8% (95% CI = 21.4-32.2). None of the parks qualified as friendly, 38.1% were considered less friendly and 61.9% as not friendly. The evaluation form of the Park Sanitary Surveillance Programme was not applicable to estimate the contamination with Toxocara sp.

El objetivo de esta investigación fue determinar la asociación entre la contaminación con Toxocara sp y la clasificación sanitaria de parques de la Dirección de Higiene Alimentaria y Zoonosis, Ministerio de Salud (Perú), en la ciudad de Abancay, Perú. La investigación fue de tipo analítico, nivel básico y corte transversal. La toma de muestras (n=276) se realizó en los 21 parques de la ciudad mediante un muestreo aleatorio sistemático a través de la metodología de la doble «W». La clasificación de los parques se realizó utilizando la ficha de evaluación del Programa de Vigilancia Sanitaria de Parques, valorando la infraestructura adecuada, ambiente y riesgo sanitario. El 66.7% de los parques se encontraron contaminados con Toxocara sp, y la frecuencia de contaminación con el parásito en las muestras fue de 26.8% (IC95% = 21.4-32.2). Ningún parque calificó como amigable, 38.1% fueron poco amigables y 61.9% fueron considerados como no amigables. La ficha de evaluación del Programa de Vigilancia Sanitaria de parques no es aplicable para estimar la contaminación con Toxocara sp.

ABSTRACT In recent years, mesenchymal stem cells (MSC) have become very important due to their high plasticity and their ability to release paracrine factors able to interact with various cell types, tissues and organs. The use of MSC in regenerative medicine became of vital importance, since they do not express histocompatibility MHC molecules class II nor costimulant molecules, and low expression of MHC class I, will not be rejected by individuals of same species, they could be used in an autologous, and eventually, allogeneic manner. However, it is important to scientifically demonstrate many properties, including immunomodulatory ones. Having several sources of obtaining, it should be standardized the best one to ensure the purity and quality of these cells. Finally, it is important when working with these cells, that characteristics of cell culture, immunophenotyping and differentiation capacity are fully demonstrated. MSC have been applied in several clinical uses. Among them, their ability to improve, and even heal chronic ulcers, as diabetic, has attracted attention for its potential therapeutic impact.

RESUMEN En los últimos años, las células troncales mesenquimales (Mesenchymal Stem Cells, MSC) han adquirido mucha importancia debido a su gran plasticidad y su capacidad de liberar factores paracrinos con capacidad de interactuar con diversos tipos celulares, tejidos y órganos. El uso de MSC en medicina regenerativa es importante debido a que, al no expresar las moléculas del complejo mayor de histocompatibilidad (MHC) clase II ni moléculas co-estimuladoras y tener baja expresión del MHC clase I, haría que no sean rechazadas por individuos de la misma especie, es posible utilizarlas no sólo de manera autóloga, sino también, eventualmente, alogénica. Sin embargo, es importante demostrar científicamente muchas de sus propiedades, entre ellas las inmunomoduladoras. Al tener varias fuentes de obtención, se debe estandarizar la que sea la mejor para garantizar la pureza y calidad de las MSC. Finalmente, es importante que cuando se trabaje con estas células se demuestre completamente las características del cultivo celular, la inmunotipificación y su capacidad de diferenciación. Se están ensayando muchas aplicaciones clínicas de las MSC. Dentro de ellas, su capacidad para mejorar la recuperación y potencial curación de úlceras crónicas como las diabéticas, ha atraído la atención por su potencial impacto terapéutico.

In recent years, mesenchymal stem cells (MSC) have become very important due to their high plasticity and their ability to release paracrine factors able to interact with various cell types, tissues and organs. The use of MSC in regenerative medicine became of vital importance, since they do not express histocompatibility MHC molecules class II nor co-stimulant molecules, and low expression of MHC class I, will not be rejected by individuals of same species, they could be used in an autologous, and eventually, allogeneic manner. However, it is important to scientifically demonstrate many properties, including immunomodulatory ones. Having several sources of obtaining, it should be standardized the best one to ensure the purity and quality of these cells. Finally, it is important when working with these cells, that characteristics of cell culture, immunophenotyping and differentiation capacity are fully demonstrated. MSC have been applied in several clinical uses. Among them, their ability to improve, and even heal chronic ulcers, as diabetic, has attracted attention for its potential therapeutic impact.

En los últimos años, las células troncales mesenquimales (Mesenchymal Stem Cells, MSC) han adquirido mucha importancia debido a su gran plasticidad y su capacidad de liberar factores paracrinos con capacidad de interactuar con diversos tipos celulares, tejidos y órganos. El uso de MSC en medicina regenerativa es importante debido a que, al no expresar las moléculas del complejo mayor de histocompatibilidad (MHC) clase II ni moléculas co-estimuladoras y tener baja expresión del MHC clase I, haría que no sean rechazadas por individuos de la misma especie, es posible utilizarlas no sólo de manera autóloga, sino también, eventualmente, alogénica. Sin embargo, es importante demostrar científicamente muchas de sus propiedades, entre ellas las inmunomoduladoras. Al tener varias fuentes de obtención, se debe estandarizar la que sea la mejor para garantizar la pureza y calidad de las MSC. Finalmente, es importante que cuando se trabaje con estas células se demuestre completamente las características del cultivo celular, la inmunotipificación y su capacidad de diferenciación. Se están ensayando muchas aplicaciones clínicas de las MSC. Dentro de ellas, su capacidad para mejorar la recuperación y potencial curación de úlceras crónicas como las diabéticas, ha atraído la atención por su potencial impacto terapéutico.

OBJETIVO: Estudar a distribuição espacial da tuberculose no município do Crato, Ceará, no período de 2002 a 2011, buscando verificar se há um padrão pontual. MÉTODO: Trata-se de um estudo com delineamento híbrido, ecológico, de tendência temporal com abordagem quantitativa. Foram georreferenciados 261 casos e 20 (7,1%) foram considerados perdas, devido à inexistência do endereço. O perfil dos doentes nos 10 anos de estudo obedeceu ao seguinte padrão: indivíduos do sexo masculino, na faixa etária de 20 a 59 anos, de baixa escolaridade, acometidos pela forma pulmonar da tuberculose e que alcançaram a cura da doença. RESULTADOS: A análise da distribuição espacial da tuberculose aponta que no período de estudo os casos novos da doença não estão distribuídos de forma regular, indicando um padrão espacial agrupado, confirmado pela função L. O mapa com a densidade dos casos novos por meio da estimava Kernel revelou que as áreas "quentes" se apresentam mais concentradas nas proximidades da região central da área urbana. CONCLUSÃO: O estudo permitiu apontar áreas de maior e menor concentração de casos de tuberculose, identificando o padrão espacial, como também reconhecer que a doença não atingiu todos os grupos populacionais com a mesma intensidade. Os mais vulneráveis habitavam regiões com maiores densidades populacionais, precárias condições de vida e por onde o fluxo de pessoas é intenso.

OBJECTIVE: to analyze the spatial distribution of tuberculosis in Crato, Ceará, Brazil, from 2002 to 2011, aiming to check for a point pattern. METHODS: This is an ecological, temporal trend and hybrid design study, with a quantitative approach. A total of 261 cases of tuberculosis were geo-referenced and 20 (7.1%) were considered as losses due to the lack of address. The profile of patients in 10 years of study was in accordance with the following pattern: men aged between 20 and 59 years, with low schooling, affected by the pulmonary form of tuberculosis and who were cured from the disease. RESULTS: The analysis of the spatial distribution of tuberculosis points out that in the period of study, new cases of the disease were not distributed on a regular basis, indicating a clustered spatial pattern, confirmed by the L-function. The map with the density of new cases estimated by the Kernel method showed that the "hot" areas are more concentrated in the vicinity of the central urban area. CONCLUSION: The study allowed pointing out areas of higher and lower concentration of tuberculosis, identifying the spatial pattern, but it also recognized that the disease has not reached all of the population groups with the same intensity. Those who were most vulnerable were the ones who lived in regions with higher population densities, precarious living conditions, and with intense flow of people.

<sec><title>OBJETIVO:</title><p> Estudar a distribuição espacial da tuberculose no município do Crato, Ceará, no período de 2002 a 2011, buscando verificar se há um padrão pontual.</p></sec><sec><title>MÉTODO:</title><p> Trata-se de um estudo com delineamento híbrido, ecológico, de tendência temporal com abordagem quantitativa. Foram georreferenciados 261 casos e 20 (7,1%) foram considerados perdas, devido à inexistência do endereço. O perfil dos doentes nos 10 anos de estudo obedeceu ao seguinte padrão: indivíduos do sexo masculino, na faixa etária de 20 a 59 anos, de baixa escolaridade, acometidos pela forma pulmonar da tuberculose e que alcançaram a cura da doença.</p></sec><sec><title>RESULTADOS:</title><p> A análise da distribuição espacial da tuberculose aponta que no período de estudo os casos novos da doença não estão distribuídos de forma regular, indicando um padrão espacial agrupado, confirmado pela função L. O mapa com a densidade dos casos novos por meio da estimava Kernel revelou que as áreas "quentes" se apresentam mais concentradas nas proximidades da região central da área urbana.</p></sec><sec><title>CONCLUSÃO:</title><p> O estudo permitiu apontar áreas de maior e menor concentração de casos de tuberculose, identificando o padrão espacial, como também reconhecer que a doença não atingiu todos os grupos populacionais com a mesma intensidade. Os mais vulneráveis habitavam regiões com maiores densidades populacionais, precárias condições de vida e por onde o fluxo de pessoas é intenso.</p></sec>

<sec><title>OBJECTIVE:</title><p> to analyze the spatial distribution of tuberculosis in Crato, Ceará, Brazil, from 2002 to 2011, aiming to check for a point pattern.</p></sec><sec><title>METHODS:</title><p> This is an ecological, temporal trend and hybrid design study, with a quantitative approach. A total of 261 cases of tuberculosis were geo-referenced and 20 (7.1%) were considered as losses due to the lack of address. The profile of patients in 10 years of study was in accordance with the following pattern: men aged between 20 and 59 years, with low schooling, affected by the pulmonary form of tuberculosis and who were cured from the disease.</p></sec><sec><title>RESULTS:</title><p> The analysis of the spatial distribution of tuberculosis points out that in the period of study, new cases of the disease were not distributed on a regular basis, indicating a clustered spatial pattern, confirmed by the L-function. The map with the density of new cases estimated by the Kernel method showed that the "hot" areas are more concentrated in the vicinity of the central urban area.</p></sec><sec><title>CONCLUSION:</title><p> The study allowed pointing out areas of higher and lower concentration of tuberculosis, identifying the spatial pattern, but it also recognized that the disease has not reached all of the population groups with the same intensity. Those who were most vulnerable were the ones who lived in regions with higher population densities, precarious living conditions, and with intense flow of people.</p></sec>

A 40-year-old woman presented with a four weeks history of weight loss, rapid thyroid enlargement, and generalized bone pain. Her previous medical history was unremarkable. Physical examination showed a painless multinodular goiter with multiple cervical lymph nodes. Laboratory tests showed anemia, elevated levels of transaminases, alkaline phosphatase, and lactic dehydrogenase. Thyroid profile was normal and thyroid autoantibodies were negative. Fine-needle aspiration biopsy showed a malignant carcinoma of thyroid. A total thyroidectomy and extensive neck dissection for lymph nodes were performed. Pathology examination showed an anaplastic thyroid carcinoma. The clinical evolution was torpid, and patient died because of respiratory insufficiency, secondary to pulmonary embolism. Anaplastic thyroid carcinoma is an uncommon and lethal malignancy. Distant metastases are associated with a low survival rate.

Mujer de 40 años, sin antecedente de patología tiroidea, con historia de enfermedad de cuatro semanas caracterizado por baja de peso, aumento rápido del tamaño de la glándula tiroides y dolor óseo generalizado. El examen físico mostró bocio multinodular no doloroso con múltiples ganglios cervicales. Los análisis de laboratorio mostraron anemia y niveles elevados de transaminasas, fosfatasa alcalina y deshidrogenasa láctica. El perfil tiroideo fue normal y los anticuerpos antiperoxidasa tiroidea fueron negativos. La biopsia por aspiración mostró carcinoma de tiroides. Se realizó una tiroidectomía total con disección amplia de los ganglios del cuello y en el estudio de anatomía patológica resultó un carcinoma anaplásico de tiroides. La evolución de la paciente fue desfavorable, falleciendo por insuficiencia respiratoria, secundaria a embolismo pulmonar. El carcinoma anaplásico de tiroides es poco frecuente, pero tiene una alta mortalidad. Las metástasis a distancia están asociadas a mal pronóstico.

Introduction: migraine is a chronic recurrent pain syndrome accompanied by neurological features. Objectives: evaluate the efficacy of sodium valproate in the migraine prophylactic, measuring pain intensity and frequency. Material and Methods: prospective, longitudinal, experiemental and randomized in 30 patients, each patient received in the 1st week 1 table/day of 500 mg orally and 2 table/day of 500 mg for the next 7 weeks Results: 97% reported decreased pain intensity. 97% were in category 3 of frequency of migraine attacks per month 0. during the 1 st month of treatment, it was reduced to 0% and remained during the 2nd month. Conclusions: prophylactic treatment of migraine with sodium valproate causes a decrease in pain intensity and frequency.

Introducción: La migraña es un síndrome doloroso recurrente crónico acompañado de características neurológicas, objetivos: evaluar la eficacia del valproato de sodio en la profilaxis de la migraña a través de cambios en intensidad, dolor y frecuencia. Materiales y Métodos: Estudio prospectivo, longitudinal, experimental y aleatorio en 30 pacientes que recibieron en la 1ra semana 1 tableta/dia de valproato de sodio 500 mg vía oral y 2 tabletas/dia de 500 mg por 7 semanas más. Resultados: 97% refirió disminución de la intensidad del dolor. 97% estuvieron en la categoría 3 de frecuencia de crisis de migraña al mes 0; durante el 1er mes de tratamiento, se redujo al 0% y se mantuvo durante el 2do mes. Conclusiones: El tratamiento profiláctico de la migraña con valproato de sodio produce una disminución de la frecuencia e intensidad del dolor

A 65-year-old man came to Hospital Nacional Cayetano Heredia with severe headache and isolated left-sided ptosis. Physical examination showed isolated third cranial nerve palsy. Laboratory tests showed mild hyponatremia and hypopituitarism. Further work-up included a pituitary magnetic resonance imaging that demonstrated a mass in the pituitary fossa with signs of hemorrhage and invasion of left cavernous sinus. Treatment was started with glucocorticoid replacement and neurosurgical decompression via a transsphenoidal approach. Patient was discharged from hospital with replacement therapy of levothyroxine and prednisone. Left-sided ptosis was partially recovered. Pituitary apoplexy is a clinical syndrome characterized by abrupt onset headache, visual deficit, ophthalmoplegia and altered mental status caused by rapid enlargement of a pituitary adenoma, usually due to hemorrhagic infarction of the tumor. This expansive process can extends laterally into the cavernous sinus and compress the cranial nerves. Isolated third cranial nerve palsy is very rare. In most cases, improvement of cranial neuropathy is possible with rapid diagnosis and adequate and timely management.(Rev Med Hered 2011;22:186-189).

Se describe el caso de un varón de 65 años de edad, sin antecedentes patológicos de importancia, que acudió a emergencia del Hospital Nacional Cayetano Heredia por presentar cefalea intensa y ptosis palpebral izquierda. El examen físico mostró parálisis aislada del III par craneal izquierdo. Los análisis de laboratorio mostraron hiponatremia e hipopituitarismo y la resonancia magnética nuclear un adenoma pituitario con áreas de hemorragia e invasión de los senos cavernosos. El tratamiento incluyó glucocorticoides y descompresión quirúrgica transesfenoidal. La anatomía patológica confirmó el diagnóstico de infarto hemorrágico de un adenoma pituitario. El paciente fue dado de alta con terapia sustitutiva de levotiroxina y prednisona. La ptosis palpebral izquierda se recuperó en forma parcial. La apoplejía pituitaria es un síndrome clínico producido por un proceso expansivo dentro de la silla turca, secundario a hemorragia o infarto de un adenoma pituitario, que se caracteriza por cefalea, déficit visual, oftalmoplejía y alteración del nivel de conciencia. Este proceso expansivo puede comprimir los pares craneales en los senos cavernosos, produciendo diferentes grados de parálisis de los músculos oculomotores. La parálisis aislada del III par craneal es rara.(Rev Med Hered 2011;22:186-189).

Wendtia calycina (Griseb.) Griseb., Vivianiaceae, is a Paraguayan herbaceous plant commonly known as burrito. Our previous study indicated that burrito leaves are a very good source of phenylpropanoid glycosides, principally verbascoside. From W. calycina leaves, a standardized, water-soluble extract rich in phenylpropanoid glycosides (WSE) has been developed on an industrial scale to be used as a food supplement, cosmetic, phytomedicine, and ingredient of different formulations. In this study, we investigated the effect of the WSE on human platelet aggregation in vitro induced by adenosine diphosphate (ADP), epinephrine (EPN), collagen (COL) or arachidonic acid (AA). WSE, concentration-dependently, inhibited ADP and EP-induced human platelet aggregation (IC50 were 0.82±0.15 mg/mL and 0.41±0.02 mg/mL, respectively). It did not inhibit collagen-induced platelet aggregation, thus suggesting a selectivity for the ADP-induced platelet activation pathways.

Los adelantos científicos y biotecnológicos propios de la postmodernidad, han planteado nuevos paradigmas en relación a la ética. Las implicaciones bioéticas del empleo de animales de experimentación en investigación son analizadas en la presente revisión. La investigación con humanos se rige desde el punto de vista ético por el código de Nürenberg, las Declaraciones de Helsinki y normas del Consejo de Organizaciones Internacionales de Ciencias Médicas. Estas normativas aún cuando contemplan algunos aspectos relacionados con el empleo de animales de experimentación, presentan el dilema entre el beneficio para el humano, el daño potencial para el animal y el no obstaculizar la investigación. Por esta razón, es importante la creación de comités institucionales para el cuidado y uso de los animales, en especial en las Facultades de Ciencias de la Salud, que se encarguen de concebir y asesorar en la aplicación de códigos de bioética que contemplen pautas para el uso de animales de laboratorio acordes con la normativa internacional y con las particularidades del ámbito nacional que rodea la investigación.

Postmodern advances in science and biotechnology have raised new paradigms in relation to bioethics. The bioethical implications of the use of animals in research are discussed in this review. Nürnberg Code, Helsinki´s Declarations and Norms of the Council for International Organizations of Medical Sciences supply international ethical guidelines for research involving human subjects. These regulations provide some aspects related to the use of experimental animals but rise some dilemmas such as the benefit to humans, the potential harm to the animal, and not obstructing the research. For this reason, it is important the creation of an Animal Care and Use Committee in each research institution, especially in the faculties of health science, which will be responsible for designing and advising bioethics codes implementations that provide guidelines for the use of laboratory animals in accordance with international standards and the particularities of the research rules of each country.

Estudios han comprobado que concentraciones elevadas de colesterol total a expensas del colesterol LDL y marcadores de inflamación, se relacionan con ateroesclerosis subclínica. El objetivo del estudio fue determinar la asociación de los niveles séricos de la proteína C reactiva ultrasensible (PCRus) con la medida del grosor de la íntima media carotídea (GIMCa) en pacientes hipercolesterolémicos. La investigación fue descriptiva, transversal e incluyó 100 pacientes divididos en grupo control (normocolesterolémico) y grupo estudio (hipercolesterolémico). No se observaron diferencias en edad y distribución por género entre los grupos. El índice de masa corporal, circunferencia abdominal, colesterol total y sus fracciones, GIMCa y PCRus se encontraron significativamente elevados en el grupo estudio. Sólo en el grupo hipercolesterolémico, el GIMCa se asoció significativamente con la PCRus. En el grupo estudio, el GIMCa promedio se elevó a través de los cuartiles de PCRus, adquiriendo su máximo valor en el cuarto cuartil. El análisis de regresión lineal múltiple identificó al colesterol unido a la LDLc y a la PCRus como predictores del GIMCa sólo en el grupo estudio. La evidencia encontrada apoya otros datos que apuntan a que no sólo el colesterol unido a la LDL sino también la PCRus podría ser un importante factor de cambios ateroscleróticos tempranos en la arteria carótida de pacientes con hipercolesterolemia aislada.

Studies have shown that high concentrations of total cholesterol at the expense of LDL cholesterol and markers of inflammation are linked with subclinical atherosclerosis. This study was aimed to associate the carotid intima media thickness (IMT) and high-sensitivity C-reactive protein (hs-CRP) in patients with isolated hypercholesterolemia. The investigation was descriptive, transverse and included 100 patients divided into a control group (normocholesterolemic) and a study group (hypercholesterolemic). There were no significant differences in age and gender distribution among the groups. The body mass index, waist circumference, total cholesterol and its fractions, IMT and hs-CRP were significantly elevated in the study group. Only in the hypercholesterolemic group, the IMT was significantly associated with hsCRP. In the study group, the mean IMT rose by quartiles of hs-CRP, reaching its highest level in the fourth quartile. The multiple linear regression analysis identified LDL cholesterol and hs-CRP as predictors of IMT only in the study group. The findings support other data suggesting that not only the LDL cholesterol but also hs-CRP could be an important factor for early atherosclerotic changes in the carotid artery of patients with isolated hypercholesterolemia.