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Médico especialista en epidemiología ; b médico cirujano; c médico veterinario; d biólogo

Sr. Editor. el envejecimiento es un proceso inevitable que incluye la disminución del rendimiento físico (1) . Por otro lado, el habitar en zonas de gran altitud influye también en el rendimiento físico. Un estudio previo señala la relación existente entre la altitud, el consumo de oxígeno y el rendimiento físico (2) . Existen, sin embargo, pocas investigaciones que hayan evaluado el rendimiento físico de los adultos mayores que habitan en lugares ubicados a gran altitud.

We present a 23-year-old pregnant woman gravida 3, para 1 27 weeks of gestation complaining of intermittent fever, hyporexia, and vomiting since one week. She had history of malar rash that increased with sun exposure since adolescence. Physical examination revealed fever, pulse of 99 beats per min, blood pressure of 80/50 mmHg, and breathing frequency of 19/min. She was pale, a maculopapular skin rash over both cheeks was observed. There was no lymphadenopathy or joint pain. The liver was palpable 2 cm below the right costal margin and tender; the spleen was not palpable. The uterus was gravid, normal tone, fetal heart rate was 158 beats per min, fetal movement was present, and uterine height was 23 cm. She was awake, oriented, and responsive. Laboratory results showed a hemoglobin of 11.1 g/dL, leukocytes of 6220/mm 3 , a platelet count of 240,000/mm 3 , and C protein reactive of 13.3 mg/L, urinary sediment showed leukocyturia without nitrites.