RESUMO Objetivo. Descrever as carências enfrentadas pelo grupo acadêmico que realiza pesquisa em doenças não transmissíveis (DNT) na Universidade das Índias Ocidentais, campus de Mona, Jamaica. Métodos. Uma pesquisa transversal online foi desenvolvida com o uso da plataforma de captura eletrônica de dados de pesquisa (RedCap) e distribuída por e-mail a 708 integrantes dos grupos acadêmicos nas Faculdades de Ciências Médicas e de Ciência e Tecnologia entre setembro e novembro de 2018. Foi pedido aos participantes que informassem o grau de acesso a conhecimento especializado, capacitação e equipamentos para a realização de pesquisa. Uma análise descritiva foi realizada com o uso do software STATA versão 14. Resultados. Participaram, na sua maioria, mulheres (74,2%), com o predomínio de pesquisadores científicos (33,1%) ou médicos especialistas (22,6%). Menos de 2/3 informaram publicar os resultados de suas pesquisas em periódicos científicos com avaliação por pares e 25% disseram que não divulgavam seus resultados em nenhum veículo. Afirmaram que, em geral, havia recursos para realizar pesquisa de campo/coleta de dados, métodos e procedimentos básicos epidemiológicos e gerenciamento/análise de dados. Porém, era limitado o acesso a capacitação, conhecimentos especializados e equipamentos para empregar métodos emergentes de pesquisa de DNT como metabolômica, bioinformática/processamento em larga escala de grandes conjuntos de dados e economia da saúde. Outras dificuldades citadas foram limitação de financiamento para pesquisa, inadequação dos locais de trabalho e apoio administrativo deficiente à realização de pesquisas. Conclusões. Faz-se necessário mais financiamento para projetos iniciantes locais, firme apoio administrativo aos pesquisadores e oportunidades para capacitação em métodos de ponta de pesquisa de DNT. A situação dos pesquisadores jamaicanos poderia melhorar se fizessem parte de um centro de excelência regional com recursos e equipamentos essenciais para a realização de pesquisa que lhes permitisse formar redes de pesquisadores e fortalecer a resposta da pesquisa de DNT.

ABSTRACT Objective. To describe the needs of academic staff conducting non-communicable disease (NCD) research at the University of the West Indies, Mona Campus in Jamaica. Methods. Utilizing a cross-sectional design an online survey was created using the research electronic data capture application (REDCap); it was disseminated via email to 708 academic staff members in the Faculties of Medical Sciences and Science & Technology between September and November 2018. Participants were asked to indicate their level of access to expertise, training and equipment for conducting research. Descriptive analysis was conducted using STATA version 14. Results. Most respondents were women (74.2%), predominantly scientists (33.1%) or specialist physicians (22.6%). Less than 2/3 of respondents reported publishing research findings in peer reviewed journals, with a quarter not disseminating their research findings in any medium. Resources for field research/data collection, epidemiological methods and principles, and data management/data analysis were generally available. However, there was limited access to training, expertise and equipment in emerging techniques for NCD research such as metabolomics, bioinformatics/analysis of large-scale data sets and health economics. Additional challenges included limited access to financing for research, inadequate workspace and poor administrative support for conducting research. Conclusions. There is a need for more local research seed funding, stronger administrative support for researchers, and opportunities for training in cutting edge NCD research techniques. Jamaican researchers could benefit from being part of a regional research centre of excellence with critical research skills and equipment that builds research networks and strengthens the NCD research response.

RESUMEN Objetivo. Describir las necesidades del personal académico que investiga las enfermedades no transmisibles (ENT) en el Campus de Mona de la Universidad de las Indias Occidentales, en Jamaica. Métodos. Mediante un diseño transversal, se elaboró una encuesta en línea con RedCap, una aplicación para la captura de datos electrónicos para la investigación, y se divulgó por correo electrónico a los 708 miembros del personal académico de las Facultades de Ciencias Médicas y Ciencia y Tecnología entre septiembre y noviembre del 2018. Se pidió a los participantes que indicaran su nivel de acceso a conocimientos, capacitación y equipo para llevar a cabo investigaciones. El análisis descriptivo se realizó con STATA, versión 14. Resultados. La mayoría de los entrevistados fueron mujeres (74,2%), predominantemente científicas (33,1%) o médicas especialistas (22,6%). Menos de dos terceras partes de los entrevistados informó que publicaban los resultados de sus investigaciones en revistas arbitradas y una cuarta parte declaró que no divulgaba los resultados de sus investigaciones en ningún medio. Por lo general, tenían a su disposición recursos para la investigación de campo o la recopilación de datos, métodos y principios epidemiológicos, así como para la gestión y el análisis de datos. Sin embargo, tenían poco acceso a conocimientos, capacitación y equipo en las técnicas emergentes para la investigación sobre ENT como la metabolómica, la bioinformática o el análisis de conjuntos de datos a gran escala y economía de la salud. Otros retos incluyeron poco acceso al financiamiento para la investigación, espacios de trabajo inadecuados y un apoyo administrativo deficiente para investigar. Conclusiones. Se necesita más capital inicial destinado a la investigación local, un mayor respaldo administrativo a los investigadores y oportunidades de capacitación en las técnicas más recientes de investigación de ENT. Los investigadores jamaiquinos podrían sacar provecho de formar parte de un centro regional de excelencia para la investigación con el equipo y las capacidades de investigación fundamentales para contribuir a la formación de redes de investigación y fortalecer la respuesta investigadora a las ENT.

Resumen La teoría de Ehrhart mide un politopo P discretamente, contando los puntos enteros dentro de sus dilataciones P, 2P, 3P, En este artículo calculamos la teoría de Ehrhart de cuatro familias de politopos de gran importancia en varias áreas de la matemática: los permutaedros de Coxeter de los grupos clásicos de Coxeter A n , B n , C n , D n . Una herramienta central, de interés independiente, es la descripción de la teoría de Ehrhart de una traslación racional de una proyección entera de un cubo.

Abstract Ehrhart theory measures a polytope P discretely by counting the lattice points inside its dilates P, 2P, 3P, We compute the Ehrhart theory of four families of polytopes of great importance in several areas of mathematics: the standard Coxeter permutahedra for the classical Coxeter groups A n , B n , C n , Dn. A central tool, of independent interest, is a description of the Ehrhart theory of a rational translate of an integer projection of a cube.

RESUMO O efeito de ácidos húmicos (AH) na disponibilidade de fósforo (P) ainda é contraditório. Assim, é necessário identificar as principais condições que podem influenciar esse efeito. Com o trabalho, objetivou-se investigar o efeito da aplicação de AH, combinada com doses de P, no teor desse nutriente em Latossolo com e sem correção de acidez. Foram conduzidos dois experimentos, um com AH extraído de turfa e outro com AH extraído de carvão mineral (leonardita). Doses desses ácidos (0; 1,12 e 5,62 mg C g-1 de solo) e de P (26,2 e 104,7 mg P g-1 de solo, 1 e 4 vezes maior que o recomendado, respectivamente) foram testadas, em dois valores de pH do solo (4,5 e 7,0), em esquema trifatorial. O solo foi incubado por 20 dias e os teores de P foram extraídos com os métodos Mehlich-1 e P remanescente. O efeito dos AHs na disponibilidade desse nutriente variou com as doses de P e o pH do solo. A adição desses ácidos aumenta o teor desse nutriente em latossolo somente quando a dose de correção de P for maior que a recomendada e a acidez (pH 4,5) não for corrigida. Por outro lado, os AHs não influenciam o teor desse nutriente quando a dose de correção aplicada corresponder à quantidade recomendada, independentemente do pH do solo.

ABSTRACT The effect of humic acids (HA) on phosphorus (P) availability is still contradictory; thus, it is necessary to identify the conditions that play a crucial role in this effect. The aim of this study was to investigate the effect of HA application, combined with doses of P, on the content of this nutrient in a Latosol with and without acidity correction. Two experiments were carried out, one with HA from peat and another with HA from mineral charcoal (leonardite). Doses of these acids (0; 1.12 and 5.62 mg C g-1 of soil) and P (26.2 and 104.7 mg P g-1 of soil, 1 and 4-fold higher than recommended, respectively) were tested at soil pH 4.5 and 7.0, in a three-factorial design. The soil was incubated for 20 days and the soil-P content was measured by Mehlich-1 and remaining-P tests. The effect of HAs on P availability varied with the P doses and soil acidity. Humic acids application increases P content in Latosol when P dose is higher than recommended and there is no acidity correction (pH 4.5). However, there is no effect of HAs application on soil-P content when applying the recommended amount of this nutrient, irrespective of the pH value.

Point-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient's bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes.

Introduction: the evaluation of the body fat distribution by anthropometry can serve to identify excess visceral fat. This diagnosis will enable implementation of specific measures to both prevent and treat excess visceral fat in postmenopausal women. Objective: the aim of this study was to analyze different anthropometric indicators and identify the best cutoff points to discriminate subjects with high visceral fat area (HVFA) in postmenopausal women. Methods: cross-sectional study with a sample of 255 postmenopausal women. Different Receiver Operating Characteristic (ROC) curves were constructed and the areas under them compared in terms of the conicity index (C-index), body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), weight-to-height ratio (WHtR) and HVFA. Sensitivity and specificity identified the best cutoff points between the different anthropometric indicators in order to discriminate subjects with HVFA. The confidence interval was set at 95%. Results: statistically significant areas under the ROC curve were found for all anthropometric indicators analyzed. The following cutoff points, with their respective sensitivities and specificities to discriminate subjects with HVFA, were suggested: C-index (1.19; 75.00%- 74.77%); BMI (27.3 kg/m2; 81.08%-80.37%); WHR (0.98; 90.54%-83.18%); WC (85 cm; 85.14%-81.31%); and WHtR (0.55; 80.41%-80.37%). Conclusion: these results demonstrate that anthropometric indicators identify HVFA well in postmenopausal women and can be used instead of more sophisticated exams to detect high levels of visceral fat.

Introducción: la evaluación de la distribución de la grasa corporal por antropometría puede servir para identificar el exceso de grasa visceral. Este diagnóstico permitirá la aplicación de medidas específicas para prevenir y tratar el exceso de grasa visceral en mujeres posmenopáusicas. Objetivo: el objetivo de este estudio fue analizar diferentes indicadores antropométricos e identificar los mejores puntos de corte para discriminar sujetos con alta área de grasa visceral (AAGS) en mujeres posmenopáusicas. Métodos: estudio transversal con una muestra de 255 mujeres posmenopáusicas. Se construyeron diferentes curvas Receiver Operating Characteristic (ROC) y las áreas bajo ellas comparadas en términos del índice de conicidad (índice C), el índice de masa corporal (IMC), razón cintura-cadera (RCC), circunferencia de la cintura (CC), relación cintura-estatura (RCEst) y AAGS. La sensibilidad y la especificidad identificaron los mejores puntos de corte entre los diferentes indicadores antropométricos para discriminar sujetos con AAGS. El intervalo de confianza se fijó en 95%. Resultados: las zonas estadísticamente significativas bajo la curva ROC se encontraron para todos los indicadores antropométricos analizados. Fueron sugeridos los siguientes puntos de corte, con sus respectivas sensibilidades y especificidades, para discriminar sujetos con AAGS: índice C (1,19; 75,00%-74,77%); IMC (27,3 kg / m2; 81,08%-80,37%); RCC (0,98; 90,54%-83,18%); CC (85 cm; 85,14%-81,31%); y RCEst (0,55; 80,41%-80,37%). Conclusión: estos resultados demuestran que los indicadores antropométricos identifican bien a las mujeres postmenopáusicas con AAGS y pueden ser utilizados en lugar de los exámenes más sofisticados para detectar altos niveles de grasa visceral.

Abstract Niemann-Pick disease type C (NP-C) is a rare autosomal-recessive neurovisceral lysosomal storage disease. We report on a juvenile onset, now 25-year-old female patient with typical neurologic symptoms, including vertical gaze palsy, of NP-C. The diagnosis was supported by a positive filipin test (“variant biochemical phenotype” of cholesterol accumulation) in cultured fibroblasts, high numbers of “Niemann-Pick cells” in the bone marrow, and 1 positive out of 3 NP-C biomarkers tested, but NP-C was not definitely confirmed genetically. She showed only 1 known NPC1 variant (3 bp deletion in exon 18; p.N916del); this allele, however, being distinctly overexpressed at the messenger RNA level as compared to the wild-type allele, as a not as yet clarified (copathogenic?) phenomenon. The patient’s mother, also carrying the p.N916del allele but without overexpression, has a chronic inflammatory disease of the central nervous system classified as multiple sclerosis. However, her severe clinical phenotype includes some signs also consistent with NP-C. The laboratory diagnosis of NP-C can be challenging in detecting novel disease constellations.

INTRODUCTION: Adolescents with physical disabilities are prone to experience lowered self-esteem which can result in negative consequences for the individual as well as the community. It has been found that dancing may have positive emotional, social and developmental consequences. AIM: The aim of this study was to determine the influence of wheelchair dancing on the self-esteem of adolescents with physical disabilities. METHODS: Twenty-four participants were involved in this quantitative study. A before-and-after experimental study design was used which included a control group. Structured interviews were conducted to obtain information from the participants. The experimental group participated in wheelchair dancing, while the control group did not. RESULTS: A difference between the two groups was observed with 72.7% of the intervention group displaying an increase in self-esteem, compared to 54.6% of the control group. Improved self-esteem manifested in, for example, an improvement in eye contact and sense of responsibility. CONCLUSION: The researchers concluded that wheelchair dancing may have a positive influence on the self-esteem of adolescents with physical disabilities.

CONTEXTUALIZAÇÃO: A literatura demonstra o efeito benéfico da terapia ultra-sônica de baixa intensidade sobre o processo de cicatrização de vários tecidos. OBJETIVO: Avaliar o efeito do ultra-som contínuo (USC) sobre a dinâmica hematológica do processo inflamatório agudo de lesão muscular iatrogênica. MÉTODOS: Foram utilizados 16 ratos da raça Wistar (350 a 400g), divididos em grupo controle (GC=8) e grupo experimental (G1=8), submetidos à incisão cirúrgica na face lateral do membro posterior direito, onde o músculo bíceps femoral foi lesionado transversalmente. O USC (1MHz) foi aplicado sobre o local da lesão a uma intensidade de 0,4W/cm², durante três minutos, na 1ª, 8ª e 24ª hora após a lesão. Nestes períodos, foram realizadas as coletas de sangue por punção venosa do plexo retroorbital para as análises sangüíneas das séries brancas e vermelhas. RESULTADOS: O USC diminui 8% dos eritrócitos na primeira coleta (9,9±0,1 versus 7,8±0,1; x10(5)/mm³, p<0,001); dobrou os neutrófilos segmentados na segunda coleta (3.166,8±161,4 versus 6.426,2±306,0; x10³/mm³ p=0,008) e os eosinófilos na terceira coleta (2.883,6±99,0 versus 4.714,4±275,2; x10³/mm³ p=0,011) em relação ao GC. Não se observaram diferenças entre os grupos no hematócrito, leucócitos totais, neutrófilos bastonetes, monócitos e linfócitos, nos três momentos estudados. CONCLUSÕES: A aplicação do USC no tratamento agudo de lesão muscular é contra-indicada nesta condição, pois promove a redução dos eritrócitos, aumento dos neutrófilos segmentados e dos eosinófilos, favorecendo a hemorragia e o aumento do processo inflamatório.

BACKGROUND: The literature shows the beneficial effects of low-intensity ultrasound therapy on the healing process of several biological tissues. OBJECTIVE: To evaluate the effects of continuous ultrasound (CUS) on the hematological dynamics of an acute inflammatory process in iatrogenic muscle injuries. METHODS: Sixteen Wistar rats (350 to 400g) were divided into a control group (CG=8) and an experimental group (G1=8). The rats were submitted to a surgical incision on the lateral aspect of the right hind limb, in which the biceps femoris muscle was transversally injured. The CUS (1MHz) was applied to the injury site at an intensity of 0.4W/cm², for three minutes, in 1, 8 and 24 hour after the injury. At these times, blood was drawn by venipuncture of the retroorbital plexus, for analysis of red and white blood cells. RESULTS: The CUS reduced erythrocytes in 8% at the first blood collection (9.9±0.1 versus 7.8±0.1; x10(5)/mm³; p<0.001); it doubled the number of segmented neutrophils at the second collection (3,166.8±161.4 versus 6,426.2±306.0; x10³/mm³; p=0.008) and the eosinophils at the third collection (2,883.6±99.0 versus 4,714.4±275.2; x10³/mm³; p=0.011), in relation to the CG. No differences between the groups were seen with regard to hematocrit, total leukocytes, rod neutrophils, monocytes or lymphocytes at the three times studied. CONCLUSIONS: Application of CUS for acute treatment of muscle injuries is contraindicated under this condition, because it promotes reductions in erythrocytes and increases in segmented neutrophils and eosinophils, thus favoring hemorrhage and increasing inflammatory process.

Many types of mechanical prosthesis are used for heart valve replacement, but it is difficult to distinguish between them using transthoracic echocardiography. Cinefluoroscopy (CF) may complement the echocardiographic evaluation of cardiac prosthesis. Objectives 1) To describe the contribution of cinefluoroscopy in identifying different prosthesis. 2) To assess heart valve prosthesis functioning comparing gradients obtained by Doppler echocardiography with the opening angle of the disc got by CF. 3) To recognize the ability of CF in the assessment of normal versus dysfunctional cardiac prosthesis. Material and Methods Ninety four cardiac prosthesis (53 in aortic position and 41 in mitral position) were prospectively assessed by echo-Doppler and cinefluoroscopy. Results Cinefluoroscopy was able to identify 100% of prosthesis. Disc motion assessment could differentiate between normal and dysfunctional prosthesis. Echo-Doppler exam revealed that 22 aortic prosthesis and 21 mitral prosthesis were normal. Fluoroscopic sensitivity and specificity to distinguish between normal and malfunctioning prosthesis were 90% and 81%, respectively. Conclusions 1) Cinefluoroscopy allows identifying each model of singleleaflet prosthesis. 2) Cinefluoroscopy distinguishes between a normal and a dysfunctional prosthesis. 3) Fluoroscopy is superior to echo-Doppler to assess disc motion, while echo- Doppler allows the measurement of gradients and areas, and the semi quantification of regurgitation. Thus, both methods should be considered complementary.

La variedad de modelos de prótesis valvulares mecánicas es amplia y su reconocimiento por ecocardiografía es difícil. La cinefluoroscopia (CF) puede complementar su identificación y su evaluación. Objetivos 1) Describir las características cinefluoroscópicas de cada prótesis para su identificación. 2) Evaluar su función a través de la comparación de los gradientes del eco-Doppler con el ángulo de apertura del disco en la CF. 3) Reconocer la capacidad de la CF para diferenciar prótesis normales de disfuncionantes. Material y métodos Se evaluaron prospectivamente 94 prótesis (53 aórticas y 41 mitrales) con ecocardiograma Doppler y cinefluoroscopia. Resultados Con la CF se logró identificar el 100% de las prótesis. La movilidad de los discos diferenció prótesis normales de disfuncionantes. Según el eco-Doppler, 22 prótesis aórticas y 21 mitrales estudiadas eran normales. La sensibilidad y la especificidad de la fluoroscopia para diferenciar prótesis normales de disfuncionantes fue del 90% y del 81%, respectivamente. Conclusiones 1) Mediante la CF se puede identificar cada modelo de prótesis monodisco. 2) La CF permite distinguir entre una prótesis normal y una disfuncionante. 3) La CF es superior al eco- Doppler para evaluar la movilidad de los discos, mientras que el ecocardiograma Doppler permite medir gradientes y áreas y semicuantificar regurgitaciones, por lo que ambos métodos deben considerarse complementarios.

Many types of mechanical prosthesis are used for heart valve replacement, but it is difficult to distinguish between them using transthoracic echocardiography. Cinefluoroscopy (CF) may complement the echocardiographic evaluation of cardiac prosthesis. Objectives 1) To describe the contribution of cinefluoroscopy in identifying different prosthesis. 2) To assess heart valve prosthesis function comparing gradients obtained by Doppler echocardiography with the opening angle of the tilting discs got by CF. 3) To recognize the ability of CF in the assessment of normal versus dysfunctional cardiac prosthesis. Material and Methods Two hundred and nineteen heart valve prosthesis implanted in 191 patients were prospectively assessed. Fourteen prosthesis were excluded owing to severe systolic left ventricular dysfunction. All calculations were performed on 205 heart valve prosthesis (142 aortic valves and 63 mitral valves). Results Cinefluoroscopy was able to identify 100% of cardiac valve prosthesis models according to ring and discs features. Disc motion assessment could differentiate between normal and dysfunctional prosthesis (opening angle 79.3°±5.4° versus 58.7°±15°, respectively). Cinefluoroscopy could not define disc profile or ring profile in 3.9% of aortic prosthesis and in 19.2% of mitral prosthesis. Among 142 aortic prosthesis, echo-Doppler identified 112 normal and 30 dysfunctional prosthesis, while among 63 mitral prosthesis, 52 normal and 11 dysfunctional cardiac prosthesis were recognized. When both methods were correlated, sensitivity, specificity and positive and negative predictive values of fluoroscopy to distinguish between normal and malfunctioning prosthesis were 83%, 80%, 89%, and 71%, respectively. Conclusions 1) Each model of heart valve prosthesis has its own cinefluoroscopic features which allow its identification. 2) Cinefluoroscopy assesses mechanical prosthesis function, and distinguishes between a normal and a dysfunctional prosthesis. 3) In cases of high gradients and absence of thrombus and pannus by transesophageal echocardiography (TEE), the presence of normal opening angles at CF identifies patient-prosthesis mismatch. 4) Fluoroscopy is superior to echo-Doppler to assess disc motion, while echo-Doppler allows the measurement of gradients and areas, and the semi quantification of regurgitation. Thus, both methods should be considered complementary.

Los diferentes modelos de prótesis valvulares mecánicas son numerosos y su reconocimiento por ecocardiografía es difícil. La cinefluoroscopia (CF) puede complementar su identificación y su evaluación. Objetivos 1) Describir las características cinefluoroscópicas de cada prótesis para su identificación. 2) Evaluar su función mediante la comparación de los gradientes del eco-Doppler con el ángulo de apertura de los discos basculantes en la CF. 3) Reconocer la capacidad de la CF para diferenciar prótesis normales de prótesis disfuncionantes. Material y métodos Se evaluaron prospectivamente 219 prótesis implantadas en 191 pacientes. Se excluyeron 14 prótesis debido a la coexistencia de disfunción sistólica ventricular izquierda grave. El análisis se realizó sobre 205 prótesis (142 aórticas y 63 mitrales). Resultados A través de las características del anillo y de los discos, mediante la CF se logró identificar el modelo de la prótesis en el 100% de las válvulas. La movilidad de los discos permitió diferenciar prótesis normales de disfuncionantes (ángulo de apertura 79,3° ± 5,4° versus 58,7° ± 15°, respectivamente). En la CF no se pudieron perfilar los discos y/o el anillo en el 3,9% de las prótesis aórticas y en el 19,2% de las mitrales. De las 142 prótesis aórticas, el eco-Doppler identificó 112 normales y 30 disfuncionantes y de las 63 prótesis mitrales identificó 52 normales y 11 disfuncionantes. Al correlacionar ambos métodos, la sensibilidad, la especificidad, el valor predictivo positivo y el valor predictivo negativo de la fluoroscopia para diferenciar prótesis normales de disfuncionantes fueron del 71%, 93%, 67% y 94%, respectivamente. Conclusiones 1) Cada modelo de prótesis valvular tiene características cinefluoroscópicas que permiten su identificación. 2) La cinefluoroscopia evalúa el funcionamiento de las prótesis mecánicas y distingue una normal de una disfuncionante. 3) Cuando hay gradientes altos y el eco transesofágico (ETE) descarta trombo y pannus, una cineflouroscopia con ángulos de apertura normal identifica el mismatch prótesis-paciente. 4) La fluoroscopia es superior al eco- Doppler para evaluar la movilidad de los discos, mientras que el eco-Doppler permite medir gradientes y áreas y semicuantificar las regurgitaciones, por lo que ambos métodos deben considerarse complementarios.

Specific IgG and IgM responses to soluble egg antigen (SEA) and keyhole limpet haemocyanin (KLH) were measured by ELISA in patients with acute and chronic schistosomiasis. The tests based upon IgM and IgG antibodies responses to KLH presented the best diagnostic discrimination, and can be used in conjunction with clinical and epidemiological data to the differential diagnosis of acute schistosomiasis.

The abundance of snail hosts and the rates of infection with Schistosoma mansoni were monitored monthly for four years in two representative localities subjected to repeated chemotherapy of infected persons. Snail abundance varied from 1.0 to 4.4 collected per person/minute/station for Biomphalaria straminea and from 0.1 to 7.0 for B. glabrata. Infection rates of snails in nature varied from 0% to 15% for the former and from 0% to 70% for the latter species. Human infection increased from 35.5% to 61.9% in the locality occupied by B. straminea, and decreased from 40.3% to 20.8% in that occupied by B. glabrata. No relationship could be detected between human infection and the snail variables. Despite seasonal variations, natural infection persisted throughout the monitoring period in both snail species. It reached remarkably high levels in B. straminea when compared to those obtained by other authors probably because of differences in methodology. It is recommended that longitudinal studies should be carried out focally and periodically to avoid underestimating the prevalence of schistosome infection in snails.