El sistema de remuneración e incentivos en la salud, como un instrumento para la mejora de la calidad de atención / System of compensation and incentives in health as an instrument for improving quality of care / O sistema de compensação e incentivos na saúde como instrumento para a melhoria da qualidade assistencial

Es importante señalar que los sistemas de incentivos y sus contradicciones, requieren ser analizados, con especial atención a los de la práctica en salud a fi n de poder mediar los efectos posibles en el sistema. Objetivo: Analizar las normas de remuneración e incentivos existentes en las instituciones de salud y su relación con la calidad de la prestación de los servicios, en Córdoba, Argentina. Método: Observacional, analítico y correlacional. Universo instituciones polivalentes de salud, público y privado. Muestra bietápico aleatorio. Instrumento, análisis documental, dos encuestas auto administradas, e índices estandarizados de calidad. Fuente primaria y secundaria. Resultados: Mayor proporción de personal de enfermería y medicina con respecto a psicología y trabajo social. Predominan mujeres 2 a 1, población joven entre los 20 y 39 años, la antigüedad 5 a 15 años. La planta permanente en las públicas es mayor que en las privadas (p=0,002), mientras que en los contratados la situación se presenta inversa (p=0,0001), en cambio la proporción se muestran similares en el interior y en capital. En la composición de la remuneración los tres ítems más reconocidos fueron: monto básico, antigüedad y título de grado. El sector público tiene un salario mayor que el privado (p< 0.0001).

It is important to note that incentive systems and its contradictions, need to be analyzed, with particular attention to the practice of health in order to mediate the possible effects on the system. Objective: To analyze existing remuneration standards and incentives in health institutions and their relationship to the quality of service delivery, in Córdoba, Argentina. Method: Observational, analytic and correlationa. Universe multipurpose health institutions, public and private. Two-stage random sample. Instrument, documentary analysis, two self-administered survey, and standardized quality indices. Primary and secondary source. Results: A higher proportion of nursing and medicine with respect to psychology and social work. Women prevail 2-1 , young people between 20 and 39 years , age 5-15 years. The permanent public plant is greater than private (p = 0.002) , whereas the reverse situation is employed the (p = 0.0001 ) arises, however the ratio is similar in the interior and in capital. In the composition of the remuneration the three items were recognize: basic amount, age and title of degree. The public sector has a salary greater than the private (p < 0.0001). The incentives they receive, concentrate on training and awards. A correlation between the IACC , and IMRA Iaçu variables regarding the antiquity (p < 0.01) , the amount of wages ( p < 0.0001 ), economic incentives (p < 0.0001 ) , nature legal (p < 0.05 ) and the status of magazine (p < 0.01).

É importante notar que os sistemas de incentivos e suas contradições, precisam ser analisados, com especial atenção para a prática da saúde, a fi m de ter condições de mediar nos possíveis efeitos sobre o sistema. Objetivo: Analisar normas de compensação existentes e incentivos nas instituições de saúde e sua relação com a qualidade da prestação de serviços, em Córdoba, Argentina. Método: observacional, analítico e correlacional.. Universo: instituições de saúde polivalentes, públicas e privativas. Amostra: bietápicaaleatória. Instrumento: análise documental das enquetes, auto-administradas e índices de qualidade padronizados. Fonte primária e secundária. Resultados: Aumento da proporção do pessoal de enfermagem e medicina em relação com o de psicologia e serviço social. As mulheres predominam 2-a 1, população jovem entre 20 e 39 anos, antiguidade de 5 a 15 anos. A quantidade de cargos permanentes públicos é maior do que a privativa (p = 0,002), enquanto que com os contratados apresenta-se a situação oposta (p = 0,0001) apresenta, no entanto, a proporção é semelhante no interior e na capital. Na composição dos salários, os três itens mais reconhecidos foram: o básico, antiguidade e titulação de grau. O salário do setor público é maior do que o privativo (p <0,01).

Screening de trastornos de estrés postraumático en población afectada por el terremoto chileno de 2010 / Screening for posttraumatic stress disorder in people affected by the 2010 earthquake in Chile / Triagem para transtorno de estresse pós-traumático em pessoas afetadas pelo terremoto chileno de 2010

Se analizó un screening de trastornos de estrés postraumático en habitantes chilenos, como consecuencia del terremoto de febrero de 2010; a partir de una Encuesta Post Terremoto con una muestra multietápica de 24.982 personas mayores de 18 años, a quienes se aplicó la Escala de Trauma de Davidson. La prevalencia de screening positivo para los trastornos de estrés postraumático fue del 11% en el país, pero a menor nivel de desagregación llegaron a observarse prevalencias del 30%. El modelo de regresión logística para la estimación de la variable trastornos de estrés postraumático identificó como factores de riesgo el hecho de pertenecer un hogar pobre, haber sufrido daños en la vivienda, haber tenido algún problema de salud en el último mes y ser mujer (p<0,05). También se encontró que el afrontamiento del sismo en familia resultó como un factor protector, en relación a afrontarlo con otros colectivos sociales (vecinos), la mayor cantidad de años de educación formal también fue identificada como un factor de protección (p<0,05). Se observaron claras desigualdades sociales en las personas que presentaron un screening positivo.

The authors conducted an assessment of post-traumatic stress disorder screening in the Chilean population following the February 2010 earthquake, based on the Post Earthquake Survey with a multistage sample of 24,982 individuals over 18 years of age, applying the Davidson Trauma Scale. Multivariate analysis was performed with significance set at p<0.05. Prevalence of positive screening for post-traumatic stress disorder was 11% for the country as a whole, but reached 30% at lower-level disaggregation. The logistic regression model for post-traumatic stress disorder identified the following risk factors: belonging to a low-income family, having suffered damage to the household, a history of health problems in the previous month, and female gender (p<0.05). Family coping with the earthquake proved to be a protective factor as compared to other social or neighborhood groups, and more years of schooling were also protective (p<0.05). Positive screening for posttraumatic stress disorders revealed clear social inequalities.

Foram analisados dados associados a transtornos de estresse pós-traumáticos apresentados por uma população do Chile, após o terremoto de fevereiro de 2010, a partir de uma pesquisa pós-terremoto (EPT 2010, Chile) com uma amostra multiestágio de 24.982 pessoas de mais de 18 anos, com aplicação da Escala de Trauma Davidson. A prevalência de casos positivos de screening para transtornos avaliados foi de 11% no país, mas em um nível inferior de desagregação, a prevalência observada atingiu 30%. O modelo de regressão logística para estimar a variável transtornos de estresse pós-traumático identificou como fatores de risco o fato de pertencer a uma família pobre, ter sofrido danos em seu domicílio, ter problemas de saúde no último mês e ser do sexo feminino (p<0,05). Também se encontrou que enfrentar o terremoto em família resultou como um fator de proteção em comparação com outros grupos sociais ou vizinhos, o maior número de anos de educação formal também foi identificado como um fator de proteção (p<0,05). Foram observadas claras desigualdades sociais em pessoas que tiveram screening positivo.

Analysis of mortality from suicide in children, adolescents and youth. Argentina, 2005-2007 / Análisis de la mortalidad por suicidio en niños, adolescentes y jóvenes. Argentina, 2005-2007

Objective. To analyze mortality from suicide in children, adolescents and youth aged 5 to 24 years by gender, method used, place where the incident occurred and residence (province) in Argentina over the period 2005-2007. Method. Data of Statistical Death Reports were used. Mortality rates from suicide were estimated per 100 000 inhabitants using ICD-10 (X60- X84). The statistical method included categorical data analysis. Results: Total deaths from suicide in the 5 to 24 year old group were 861 in 2005, 897 in 2006, and 815 in 2007. During the period 2005-2007, 6 deaths occurred in children younger than 10 years old. In the 10 to 24 year old group males had higher rates than females (p < 0.01). Analysis by gender and age group showed an increase of suicide in males in the group aged 20-24 years old (p < 0.01), while females had the highest rates of suicide in the 15 to 19 year old group. Hanging and use of firearms were the most frequent methods (p < 0.01). The home was the most frequent place where the incident occurred (p< 0.01). Santa Cruz, Salta and Jujuy had the highest rates of suicide in Argentina, whereas Santiago del Estero, Capital Federal and Misiones showed the lowest ones. Conclusion. Suicide in Argentinean adolescents and youth is a public health problem, especially among males. The provinces in the North and South of Argentina had the highest rates in the country.

Objetivos. Analizar la mortalidad por suicidio en niños, adolescentes y jóvenes de 5 a 24 años, según sexo, método utilizado, lugar de ocurrencia y jurisdicción en la Argentina, en el período 2005-2007. Método. Se utilizaron las Bases de Datos de los Informes Estadísticos de Defunción del Ministerio de Salud de la Nación. Se calcularon frecuencias y tasas de mortalidad por suicidio específicas por 100 000 habitantes, con empleo de la clasificación CIE-10-(X60-X84). El análisis estadístico se realizó mediante datos categorizados. Resultados. El total absoluto de muertes por suicidio en el grupo de 5 a 24 años fue de 861 en 2005, 897 en 2006 y 815 en 2007. En el período 2005-2007 se produjeron 6 óbitos en menores de 10 años. En el grupo de 10 a 24 años las muertes por suicidio fueron más frecuentes en varones (p < 0,01). El análisis por grupo de edad y sexo mostró que, en varones, la mortalidad incrementa con la edad (p < 0,01) y, en mujeres, el grupo de 15 a 19 años fue el más prevalente (p < 0,05). El método utilizado con mayor frecuencia fue el ahorcamiento (p < 0,01) y el lugar de ocurrencia más prevalente el hogar (p < 0,01). Las tasas de suicidio más elevadas del país fueron en las jurisdicciones de Santa Cruz, Salta y Jujuy, y la tasa más baja en Santiago del Estero. Conclusión. El suicidio en la población de adolescentes y jóvenes de la Argentina constituye un problema de salud más frecuente en los varones. Las jurisdicciones del norte y sur del país muestran las tasas más elevadas.

Relationship between academic performance, psychological well-being, and coping strategies in medical students / Relationship between academic performance, psychological well-being, and coping strategies in medical students.

INTRODUCTION: Academic performance is a product of the complex environment that surrounds the student, shaped by aspects such as intensity of study, motivation and context of relationships, which affect the academic achievement of individuals. There may be other psychological or emotional factors, such as anxiety, level of psychological well-being, and behavior strategies for effective adaptation to concrete environment demands and their associated emotional stress. OBJECTIVES: This research study aims at determining the level of psychological well-being and coping strategies in students of the Basic Common Cycle of studies leading to an MD degree in the School of Medicine of the National University of Córdoba, Argentina. METHODS AND MATERIALS: This is an observational study based on a "Questionnaire on determiners of academic performance", that was answered by 374 students. Data was processed using statistical bivariate analysis (p< 0.05) and multiple correspondence factorial analysis. RESULTS: Students with "VG/G (Very Good/Good) performance" show high levels of satisfaction and well-being use direct coping strategies which lead them to "cope with problematic situations" by means of "problem solving". Students with "R/I (Regular/Insufficient) academic performance" declare "dissatisfaction with most aspects of their personalities", feel unable to give a satisfactory response to environment demands, and assume "avoidance behaviors" as coping strategies. CONCLUSIONS: Student academic performance is associated with psychological well-being, feeling of satisfaction with achievements, and coping with stressful situations.

Consumo de sustancias y escuela: un estudio en adolescentes escolarizados de Córdoba / Substance use and school: a study in adolescent students in Cordoba

En esta investigación se propuso identificar el consumode sustancias psicoactivas según tipo de colegio y describir elconsumo según jornada de estudio, sexo, exigencia académicay disciplina escolar. Es un estudio es observacional y analítico.Se trabajó a partir de la Segunda Encuesta Nacional aEstudiantes de Enseñanza Media. El análisis descriptivo seefectuó a partir de las medidas de resumen, el exploratorioa través del procesamiento estadístico con análisis bivariado(p<0,05) y análisis factorial de correspondencia múltiple.Se identificó que fuman más cigarrillos los estudiantes queasisten a escuelas públicas que a escuelas privadas, quemayor es el riesgo de consumo de marihuana y cocaína en losalumnos que asisten a escuelas públicas que en privadas, quemenor es el consumo de sustancias en el turno matutino y que el consumo de alguna sustancia ilícita se asocia a problemas de comportamiento y repitencia escolar.

The objective of this study was to identify the use of psychoactive substances according to school type and describe consumption in relation to school shift, sex, school discipline and academic demand. Observational and analytical study based on the Second National Survey of High School Students. Descriptive analysis was based on summary measures, exploratory analysis lay on statistics processing with bivariate analysis (p<0,05) and multiple correspondence factor analysis. It was found out that students attending publicschools smoke cigarettes more than those at private schools, that the risk of marijuana and cocaine consumption is greater at public than at private schools, that there is lesssubstance consumption in the morning shift and, that consumption of illegal substances is associated with behavioral problems and school repetition.

Análisis de situaciones familiares relacionadas a la salud mental de niños escolarizados en una comunidad del interior de la Provincia de Córdoba, Argentina / Analysis of family environments related to primary schoolchildren mental health in a community located in the Province of Córdoba, Argentina

OBJETIVO: Con la finalidad de establecer un diagnóstico para detectar situaciones de riesgos familiares en niños escolarizados, el objetivo propuesto fue identificar los factores de riesgo vinculados a situaciones familiares que se relacionan con la salud mental, en niños de escuela primaria, de un sector urbano aledaño a la ciudad de Córdoba, en Argentina. METODOLOGÍA: El instrumento utilizado fue el test 'Cómo es tú-su familia'. Se realizó los análisis exploratorio bivariado y lo factorial. Se entrevistaron a 146 niños escolarizados de quinto y sexto grado del nivel primario. RESULTADOS: La estructura familiar más frecuente fue la biparental y el 45% de los encuestados tenían estructuras familiares a cargo de mujeres. Más de la mitad de los niños escolarizados refirieron que sus padres nunca, o algunas veces, dedican tiempo para hablar con ellos; los integrantes de su familia no pueden expresarse fácilmente si lo desean y la posibilidad de afrontar los problemas en familia es baja. El 30% de los niños refirieron haber experimentado alguna situación de estrés. La relación de riesgo con el padre y la madre se asoció a los antecedentes de fumar, peleas, maltratos y emborracharse. CONCLUSIONES: Los resultados de situaciones adversas en el grupo de niños analizados en este trabajo deberían ser tenidos en cuenta para disminuir la vulnerabilidad familiar y favorecer entornos saludables a los niños.

OBJECTIVE: In order to establish a diagnosis to identify family risk situations for children in school, the proposed objective was to identify risk factors associated with family situations that relate to mental health in primary schoolchildren from an urban area, adjacent to the city of Cordoba, in Argentina. METHODOLOGY: The test 'Cómo es tú-su familia' (What is your family like, in English) was used to interview 146 children attending fifth and sixth grades of primary school. Bivariate exploratory and factorial analyses were performed. RESULTS: The most frequent family structure was the biparental type, with 45% of interviewees reporting family structures in which women are in charge. More than 50% reported that their parents have never or seldom have dedicated time to talk to them, that family members do not find opportunities to express themselves, and that the possibilities of settling problems in family are scarce. In addition, 30% of children reported having gone through some type of stressful situation. Risk relations with mother and/or father were associated with smoking, drinking, battering, and quarreling. CONCLUSIONS: The adverse conditions detected for this group of children should be taken into account in order to lessen family vulnerability and foster healthy environments for children.

Estudio de muertes por causas violentas: un análisis de tendencia en jóvenes, Argentina, 2000-2008 / Study about violent deaths: an analysis of trends for youth in Argentina, 2000-2008

INTRODUCCIÓN: Las muertes de jóvenes por causas violentas son las principales causas de muerte en Latinoamérica. En función de la crisis económico-social producida en Argentina a partir del 2001, el objetivo del presente trabajo fue analizar la tendencia de mortalidad por causas violentas en jóvenes de 10 a 24 años en el período 2000-2008. METODOLOGÍA: Se utilizaron las Bases de Datos de los Informes Estadísticos de Defunción y los Anuarios de Estadísticas Vitales. Fueron calculadas tasas de mortalidad por causas violentas por los 100.000 habitantes, utilizando la clasificación de la Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud (CIE-10). El análisis estadístico se llevó a cabo teniendo en cuenta la naturaleza de la variable. RESULTADOS: La tasa de mortalidad por causas violentas en el 2000 fue de 42,48º/0000 muertes, y en el 2008 fue de 43,09º/0000, con una mayor incidencia de muerte por causas violentas en varones (p=0,0015). Dentro de las causas violentas se observó un incremento en los accidentes de tránsito en ambos sexos y agresiones predominantemente en varones. La mayor tasa de suicidio ocurrió durante el periodo 2000-2005. CONCLUSIONES: Teniendo en cuenta que todas son causas de muertes evitables, es imperiosa la reflexión de políticas públicas de salud.

INTRODUCTION: Violence is the leading cause of death among young people in Latin America. The objective of this study was to analyze the trends of youth (ages 10 to 24) mortality resulting from violence, over the period 2000-2008, in the context of the socioeconomic crisis that started in Argentina, in 2001. METHODOLOGY: Databases of the Statistical Reports of Death and Vital Statistics Yearbooks were used. Violent deaths were defined by the International Statistical Classification of Diseases and Related Health Problems (ICD-10), and violent mortality rates for every 100,000 inhabitants were calculated. Statistical analysis was performed according to the nature of the variable involved. RESULTS: Violent mortality rates were 42.48º/0000 deaths for 2000, and 43.09º/0000 for 2008, with the incidence being higher for males (p=0.0015). For both sexes, there was an increase of violent deaths due to car accidents. There was also an increase of deaths by aggression in males. The highest suicide rate corresponded to the period 2000-2005. CONCLUSIONS: Since these violent deaths are preventable, reflection on public health policies is urgent.

Análisis de la frecuencia de experimentación y consumo de drogas de alumnos de escuelas de nivel medio / Análise da frequência de experimentação e consumo de drogas em alunos de escolas de Ensino Médio / Analysis of the frequency of experimentation with and consumption of drugs in high-school students

En el presente trabajo se analiza la frecuencia de experimentación y consumo de drogas, en alumnos de escuelas de nivel medio de Córdoba, Argentina, en relación a variables sociodemográficas. De carácter analítico, la investigación se basó en los registros de la Secretaría de Programación para la Prevención de la Drogadicción y la Lucha contra el Narcotráfico. El procesamiento estadístico fue análisis bivariado, razón de riesgo e intervalos de confianza para cada variable. El consumo de alcohol fue más frecuente en los hombres, el 12,2 por ciento de los adolescentes probó algún tipo de droga ilícita, y los tranquilizantes son los psicofármacos más utilizados. El valor del consumo de drogas aumenta según aumenta el rango de edad, año de estudio y disponibilidad de dinero. Los hallazgos del presente trabajo identificaron una realidad epidemiológica que permitirá elaborar estrategias de prevención de adicción en los adolescentes.

Este estudo teve como objetivo analisar a frequência de experimentação e consumo de drogas em alunos de escolas médias de Córdoba, Argentina, relacionada às variáveis sociodemográficas. Trata-se de estudo observacional e analítico, baseado no cadastro da Secretaria de Programação para a Prevenção da Drogadição e Luta contra o Narcotráfico. O processamento estatístico foi de análise bivariada, razão de risco e intervalos de confiança para cada variável. O consumo de álcool foi mais frequente entre os rapazes, 12,2 por cento dos adolescentes experimentaram algum tipo de droga ilegal. Os tranquilizantes são os psicofármacos mais empregados. O valor do consumo de drogas cresce conforme o aumento da faixa etária, o nível de estudos e a disponibilidade de dinheiro. As descobertas do presente trabalho identificaram realidade epidemiológica útil para desenvolver estratégias de prevenção da adição em adolescentes.

The aim of this study was to survey the frequency of experimentation and consumption of drugs in high-school students in Cordoba, Argentina, relating it to socio-demographic variables. An observational-analytical method was employed, on the basis of the records of the Secretary for the Planning of Drug-Addiction Prevention and Fighting of Drug-Trafficking. Statistical. Bivariate analysis, odds ratio and confidence interval were applied in the processing of each variable. Alcohol consumption was found to be more frequent among males. Of the subjects 12.2 percent had tried some type of illicit substance. Tranquilizers were the most commonly used psycho-medicine. Drug consumption increased with age, years of schooling and availability of money. Our detection of an epidemiological situation is deemed useful for prevention strategies for drug addiction among teenagers.

Estudio de riesgos ergonomicos y sastifacción laboral en el personal de enfermeria / Study of ergonomics risk and job satisfaction in the nurses

El el presente estudio se planteo identificar los riesgos ergonómicos a los que se expone el personal de enfermeria, y determinar la contribución de estoos factores ergonómicos y de los indices de sastifaccion laboral como factores de riesgo laboral. Se incluyeron en el estudio a los 150 profesionales de enfermeria que realizan atencion directa al paciente internado.Se utilizo una matriz de evaluación de riesgo para registrar los factores ergonómicosy un cuestionario de preguntas para medir el grado de satisfacción laboral. El anßlisis sociodemogrßfico reflejo un predominio de sexo femenino sin capacitación universitaria. En el estudio de los riesgos ergonómicos a lo que este personal esta expuesto se observo una alta prevalencia de los mismos, acompa±ada de valores de riesgo relativo que permitirian explicar el alto indice de patologías encontradas. En cuanto a los niveles de satisfacción laboral, el anßlisis muestra conformidad en el tipo de trabajo que se realiza y la relación de los compa±eros. El salario y posibilidad de ascenso son las que produjeron mayor insatisfacción. se concluye la necesidad de mejorar las condiciones laborales y disminuir el alto indice de patologías de origen profesional incorporando medidas preventivas mediante procedimientos de control, promoción de programas de entrenamiento y capacitación

Studies of membrane fluidity and heart contractile force in Trypanosoma cruzi infected mice

In Chagas disease serious cardiac dysfunction can appear. We specifically studied the cardiac function by evaluating: ventricle contractile force and norepinephrine response, affinity and density of beta-adrenergic receptors, dynamic properties of myocardial membranes, and electrocardiography. Albino swiss mice (n = 250) were infected with 55 trypomastigotes, Tulahuen strain and studied at 35, 75, and 180 days post-infection, that correspond to the acute, indeterminate, and chronic phase respectively. Cardiac beta-adrenergic receptors' affinity, myocardial contractility, and norepinephrine response progressively decreased from the acute to the chronic phase of the disease (p < 0.01). The density (expressed as fmol/mg.prot) of the receptors was similar to non-infected mice (71.96 ± 0.36) in both the acute (78.24 ± 1.67) and indeterminate phases (77.28 ± 0.91), but lower in the chronic disease (53.32 ± 0.71). Electrocardiographic abnormalities began in the acute phase and were found in 65 percent of the infected-mice during the indeterminate and chronic phases. Membrane contents of triglycerides, cholesterol, and anisotropy were similar in all groups. A quadratic correlation between the affinity to beta-adrenergic receptors and cardiac contractile force was obtained. In conclusion the changes in cardiac beta-adrenergic receptors suggests a correlation between the modified beta-adrenergic receptors affinity and the cardiac contractile force.

Influence of Antedorsal Thalamic nuclei on the hypophyseal-adrenal axis and cardiac beta receptors in tars submitted to vatriable chronic stress

The limbic structures play an important role in the control of the neuroendocrine and sympathical adrenal function in basal and stress conditions. This work was undertaken to evaluate plasma ACTH, adrenocortical activity, cardiac adrenoceptors density and affnity response to variable chronic stress (VCS) in anterodorsal thalamic nuclei (ADTN) lesioned rats. Thirty days after lesion, shamlesioned stressed animals increased plasma ACTH and corticosterone as compared to sham-lesioned unstressed animals (p<0.05); lesioned rats increased ACTH levels after VCS (p<0.05) as compared unstressed-lesioned rats. Whereas in sham-lesion plasma corticosterone (C) increased after stress. in lesioned animals (C) remained unchanged as compared to unstressed-lesioned animals. In the stressed groups, adrenal C contents were below those found in unstressed rats. Beta-receptors affinity, in all the experimental groups, was similar, but VCS sham-lesioned animals underwent a significant increase in cardiac D-adrenergic receptors density when compared with basal and lesioned groups (P<0.001). Our findings would demonstrate that the increment in cardiac Beta adrenoceptors density appears as a consequence of the increase in ACTH, plasma corticosterone and sympathetic response provoked by stress situations. ADTN lesion attenuated this hipophisoadrenal system response to chronic stress as well as the above mentioned cardiac beta adrenoceptors density increment.

Experimental Chagas' disease: effects of propranolol upon cardiac beta-receptors

Chagas' disease is an important cause of heart disfunction in Latin America. Previous works from our laboratory reproducing experimental Chagas' disease in mice, demonstrated that the affinity and density of cardiac beta-adrenergic receptors were altered during the acute, indeterminate and chronic phase in Albino Swiss mice inoculated with Trypanosoma cruzi. Keeping in mind that Propranolol is a beta-blocking agent that binds in the same receptors'site, which we have described as altered along T. cruzi infection. The present study was performed to determine if a beta-blocker treatment could prevent cardiac beta-receptors'disorders provoked by T. cruzi infection. Two different doses of Propranolol (9 and 40 mg/Kg/day) were injected in the mice during 3 days; then they were infected with 7 x 10(4) parasites/mouse and propranolol was continued daily for one week. The results showed that the concentrations of propranolol used did not protect the beta-receptors'sites by administration of each doses.

Cardiac beta receptors' density or affinity modified by different Trypanosoma cruzi amount

Chagas'disease presents complex physiopathogenic mechanism, many of them poorly understood, that in our country generally produce cardiac lesions. The acute phase related with the presence of the parasite is usually asymptomatic. This report studies if the amount of T. cruzi that induced acute infection could modify the myocardiopathy evolution. Previous works have shown that Albino Swiss mice inoculated with 45 tripomastigotes (AcL) presented alterations in the cardiac pharmacological response to adrenergic agonist and anatogonist studied at 30 days post-infection (p.i.). Mice inoculated with 7 x 10(4) parasites/animal showed similar behaviour at 7 days p.i. We studied the involvement of the affinity and density of cardiac beta receptors in both acute groups by binding with (3)H/DHA. The AcH group presented less cardiac beta receptors number (p<0.001), but their affinity was conserved. The AcL model presented significantly less affinity (p<0.01) but desinty, was not different from non infected animals. Beta receptors'affinity of both infected groups were similar, but AcH density was significantly diminished when compared with AcL. These studies demonstrates that the amount of T. cruzi received by the host determines and acelerates the evolution of the chagasic myocardiopathy.

Cardiac B-receptors in experimental Chagas`disease

Estudaram-se os receptores beta cardiacos de camundongos infectados pelo Trypanosoma cruzi na fase pos-aguda da doenca de Chagas para estabelecer em que medida os mesmos contribuem a gerar respostas anomalas as catecolaminas observadas nestes miocardios. Utilizara-se 3-H/DHA para a marcacao dos receptores beta cardiacos dos camundongos normais e dos infectados na fase pos-aguda (45 a 90 dias pos-infeccao). O numero dos sitios de fixacao foi similar nos dois grupos, 78.591 ñ 3.125 fmol/mg. Proteina no grupo controle. Em vez disso, a afinidade verificou-se significamente diminuida no grupo chagasico (Kd = 7.299 ñ 0.212 nM) p < 0.001. Os resultados obtidos demonstraram que as modificacoes observadas na estimulacao adrenergica do miocardio chagasico se correlacionam com a menor afinidade dos receptores beta cardiacos e que estas alteracoes exerceriam uma parte determinante para as consequencias funcionais que sao detectadas na fase cronica.