Violencia de pareja en adolescentes chilenos: Influencia del abuso infantil en la victimización y perpetración / Association of adolescent dating violence as victim or perpetrator with childhood maltreatment

BACKGROUNDBackground: Childhood maltreatment extends beyond this stage of development, impacting adolescence and adulthood, and even adolescent dating violence. Adolescence is an essential transitional stage, so dating violence puts development at risk. In Chile, studies on adolescent dating violence are just emerging and still show a gap. Aim: To examine the relationship between abuse during childhood with victimization and perpetration experiences for adolescent dating violence. MATERIAL AND METHODS: The sample consisted of 242 adolescents between 14 and 19 years of age (59% females) who completed the Conflict in Adolescent Dating Relationship Inventory (CADRI) and the Childhood Trauma Questionnaire-Short Form (CQT-SF), both in their Spanish version. Multiple regression analysis was used to evaluate the degree of association between sexual, emotional, and physical abuse during childhood with adolescent dating violence. Results: Sexual and emotional abuse were predictors of dating victimization. In addition, sexual and physical abuse were found to be predictors of perpetration. CONCLUSIONS: Our study supports the evidence on differentiated outcomes between adolescent dating victimization and perpetration. Moreover, it highlights the role of childhood sexual abuse as a predictor of both.

Cognitive and clinic profile of volatile substance users / Perfil cognitivo y clínico de usuarios de sustancias volátiles

Abstract Introduction Inhalant use disorder has increased in spite of its adverse medical consequences. Due to the inherent difficulties of working with this population, so far there has been no quantifiable clinical evidence of the cognitive characteristics of inhalants users in early withdrawal and the clinic effect of consumption time. Objective To evaluate the clinical and cognitive performance of inhalant users and the clinic effects of consumption time. Method A cross-sectional study in which 28 adult users of inhalants were included, divided in two groups according to their consumption time: less than or greater than seven years. They were all evaluated in terms of clinical and neuropsychological values. Results Consumers of inhalant showed presence of craving (M = 479.14, SD = 213.51), altered frontal behavior before (M = 119.18, SD = 29.53) and now (M = 130, SD = 33.03), sleeping problems (M = 8.93, SD = 3.4), and cognitive difficulties (inhibitory control, planning, decision-making, working memory, verbal fluency, and cognitive flexibility); all these tasks were statistically significant (p = < .05). Discussion and conclusion Executive functioning is impaired with inhalant use disorder; these alterations increase with withdrawal and craving and changes remain independent from the use time.

Resumen Introducción El trastorno por uso de inhalables ha aumentado a pesar de las consecuencias médicas adversas. Debido a las dificultades que entraña trabajar con estas poblaciones, hasta hace poco no había evidencia clínica cuantificable de las características cognitivas de los usuarios de inhalables en la abstinencia temprana y de los efectos clínicos del tiempo de consumo. Objetivo Se analizó el rendimiento clínico y cognitivo de usuarios de inhalables y los efectos clínicos del tiempo de consumo. Método Estudio transversal en el que se incluyeron 28 adultos usuarios de inhalables, divididos en dos grupos dependiendo del tiempo de consumo, menor o mayor a siete años. Todos fueron evaluados en términos de valores clínicos y neuropsicológicos. Resultados Los consumidores de inhalables mostraron presencia de craving (M = 479.14, SD = 213.51), comportamiento frontal alterado antes (M = 119.18, SD = 29.53) y actualmente (M = 130, SD = 33.03), problemas para dormir (M = 8.93, SD = 3.4) y dificultades cognitivas (control inhibitorio, planificación, toma de decisiones, memoria de trabajo, fluidez verbal y flexibilidad cognitiva); todas estas tareas fueron estadísticamente significativas (p = < .05). Discusión y conclusión El funcionamiento ejecutivo se ve afectado en el trastorno por uso de inhalables. Estas alteraciones aumentan en la abstinencia y en la apetencia, y los cambios se mantienen independientes del tiempo de uso.

Implementación del algoritmo reverso para el cribado de sífilis en un laboratorio clínico / Implementation of the reverse screening syphilis algorithm in a clinical laboratory

Resumen Introducción: La sífilis sigue siendo un problema de salud pública en todo el mundo; la precisión de las pruebas de diagnóstico es fundamental para el éxito de su control. Actualmente, hay dos enfoques para el diagnóstico serológico de la sífilis: el algoritmo tradicional y el algoritmo reverso. Objetivo: Analizar las ventajas y desventajas en la implementación del cribado para sífilis con el algoritmo reverso en un laboratorio clínico de pacientes ambulatorios. Materiales y Métodos: Se realizó un estudio de corte transversal analizando 246 sueros reactivos en el cribado sobre un total de 14.700 solicitudes de serología para sífilis. Se utilizaron los ensayos ARCHITECT SyphilisTP, V.D.R.L. y FTA-Abs. Resultados: De los 246 sueros reactivos por ARCHITECT Syphilis TP, 129 fueron reactivos y 117 no reactivos con V.D.R.L., éstos últimos resultaron 97 reactivos y 20 no reactivos por FTA-Abs, sugiriendo falsos positivos (0,13%). Se detectaron dos casos de infección primaria, no detectados con V.D.R.L y un caso de infección primaria en una gestante con un valor alto S/CO y V.D.R.L. de 1 dils. Conclusiones: Entre las ventajas de utilizar el algoritmo reverso se encontró mayor sensibilidad en la detección de sífilis primaria; automatización, trazabilidad, interpretación objetiva y resultados concluyentes.

Background: Syphilis remains a public health concern worldwide, the accuracy of diagnostic tests is critical for its successful control. Currently, there are two approaches to the diagnosis of syphilis using serological tests: the traditional algorithm and the reverse algorithm. Aim: The goal of this study was to analyse the advantages and disadvantages in the implementation of the syphilis reverse-screening algorithm in an outpatient clinical laboratory. Methods: An observational cross-sectional study was carried out analyzing 246 reactive sera from a total of 14700 requests for syphilis serology. Chemiluminescent assay ARCHITECT Syphilis TP, V.D.R.L. and FTA-Abs were performed. Results: Among 246 reactive sera by ARCHITECT Syphilis TP, 129 were reactive and 117 were non-reactive by V.D.R.L. the last mentioned resulted in 97 reactive and 20 non-reactive by FTA-Abs, suggesting false positives (0.13%). Two patients with primary infection were detected, that were not detected by V.D.R.L. and one pregnant woman with primary infection with a high value S/CO and V.D.R.L.:1 dils. Conclusions: Among the advantages of using a reverse algorithm were greater sensitivity in the detection of patients with primary syphilis; automation, complete traceability of the samples; objective interpretation and conclusive results.

Presentación inusual de una fractura-luxación peritalar / Unusual presentation of a peritalar fracture dislocation

Una luxación peritalar implica la ruptura simultánea de las articulaciones talocalcánea y talonavicular. Es relativamente poco frecuente y representa aproximadamente del 1% al 1,5% de todas las lesiones traumáticas del pie. La luxación medial es la más frecuente (alrededor del 80% de los casos comunicados). Las luxaciones peritalares laterales son menos frecuentes (17%) y las posteriores (2,5%) y anteriores son raras (1%). Aproximadamente el 55% del subtipo medial y el 72% del subtipo lateral se asocian con fracturas. Se presenta el caso de una mujer de 36 años que sufrió un traumatismo indirecto practicando kitesurf al caerse de la tabla tratando de evitar un accidente. Sufrió una luxación peritalar lateral con fracturas de escafoides tarsiano, calcáneo y peroné asociadas. A los tres días, se intentó una reducción cerrada y a los seis días, se realizó la cirugía. Se recomienda un diagnóstico precoz de las luxaciones peritalares y un rápido reconocimiento de las fracturas asociadas e infrecuentes, con el fin de evitar complicaciones frecuentes. Nivel de Evidencia: IV

A peritalar dislocation involves simultaneous disruption of the talocalcaneal and talonavicular joints. It is relatively uncommon and account for approximately 1% to 1.5% of all traumatic foot injuries. Medial dislocation is the most frequent type accounting for approximately 80% of reported cases. Lateral peritalar dislocations are less common (17%), and posterior (2.5%) and anterior dislocations are rare (1%). Approximately 55% of medial and 72% of lateral subtypes are associated with fractures. We report the case of a 36-year-old woman who suffered an indirect traumatism during kitesurf practice, after falling from the kite-board trying to avoid an accident. She presented a lateral peritalar dislocation with associated navicular, calcaneal and fibular fractures. A closed reduction was attempted three days from trauma. Six days after the lesion, surgery was performed. We recommend an early diagnosis of peritalar dislocations and a correct recognition of infrequent fractures to avoid usual complications. Level of Evidence: IV

Tiña capitis por Microsporum gypseum, una especie infrecuente / Tinea capitis by Microsporum gypseum, an infrequent species

La tiña capitis es considerada la infección por dermatofitos más frecuente en los niños. Los agentes etiológicos varían con el tiempo y según la zona geográfica, aunque, normalmente, son dermatofitos de origen zoofílico y, en los últimos años, también dermatofitos antropofílicos. Se presenta un caso de tiña capitis inflamatoria en un niño de 6 años de edad causada por Microsporum gypseum, un hongo geofílico patógeno para humanos y animales. Las fuentes de infección humana son el suelo, los gatos, los perros y pequeños mamíferos. Esta especie es poco frecuente como causa de dermatofitosis en el hombre, descrita, sobre todo, en tiña corporis y, raramente, en tiña capitis. En el diagnóstico de tiña capitis, identificar la especie causal es un factor determinante para el tratamiento.

Tinea capitis is considered the most frequent dermatophyte infection in children. The etiological agents vary from time to time and by geographical area, although they normally are zoophilic dermatophytes and in the last years also anthropophilic species. We report a clinical case of inflammatory tinea capitis in a 6-year-old child caused by Microsporum gypseum, a geophilic fungus pathogenic to humans and animals. The sources of human infection are soil, cats, dogs and small mammals. This species is less frequent as a cause of dermatophytosis in humans, described mainly in tinea corporis and rarely in tinea capitis. In the diagnosis of tinea capitis identifying the causative species is a determinant of the treatment.

Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results

Objective: Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC). Method: Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS). Results: Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups. Conclusions: Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD. Clinical trial registration: NCT02273674.

Calcifilaxis / Calciphylaxis

La calcifilaxis es una vasculopatía caracterizada por isquemia y necrosis cutánea dolorosa debida a calcificación, fibroplastia de la íntima y trombosis de las arteriolas paniculares. Compromete más frecuentemente a pacientes con insuficiencia renal crónica terminal y tiene muy elevada mortalidad. La biopsia de las lesiones cutáneas se utiliza como método diagnóstico. No se han registrado hallazgos específicos de laboratorio. Las lesiones cutáneas generalmente comienzan en las extremidades a modo de moteado violáceo doloroso similar al livedo reticularis. La evolución natural es hacia úlceras y escaras. La primera línea de tratamiento consiste en el cuidado de las lesiones cutáneas y antibioticoterapia. El tiosulfato sódico se utiliza como tratamiento debido a su actividad como antioxidante y quelante. Se presentan dos casos clínicos.

Calciphylaxis is vasculopathy characterized by ischemia and painful skin necrosis due to calcification and intimal fibroplasia of thrombosis of the panicular arterioles. It most frequently compromises patients with terminal chronic renal failure and has a high mortality rate. Biopsy of skin lesions is used as a diagnostic method. No specific laboratory findings have been recorded. Skin lesions usually begin in the extremities like a painful purplish mottling similar to "livedo reticularis". The natural evolution is to ulcers and bedsores. The first line of treatment involves the care of skin lesions and antibiotic therapy. Sodium thiosulfate is used as treatment due to its antioxidant activity and as a chelating. Two clinical cases are here reported.

Pigmented Bowen’s disease: a case report of an unusual variant / Doença de Bowen pigmentada: relato de caso de uma variante rara

ABSTRACTBowen's disease is a squamous cell carcinoma in situ with the potential to turn into invasive carcinoma. Pigmented Bowen's disease is an unusual variant, with few reported in the literature, and becomes a problem in the differential diagnosis with other pigmented tumors. We reported the case of a white female patient, 73-year-old, with a brownish asymmetric plaque, with more than one color, in the right upper limb, with 2-years of follow up.

RESUMOA doença de Bowen é um carcinoma espinocelular in situ com potencial para transformar-se em invasivo. Ela é pigmentada, uma variante rara, possui poucos relatos na literatura e torna-se um problema no diagnóstico diferencial com outros tumores pigmentados. Relatamos o caso de uma paciente de 73 anos, branca, com uma placa acastanhada, assimétrica, com mais de uma cor, em membro superior direito, com evolução de dois anos.

Utilidad del valor de referencia del cambio en la interpretación de resultados seriados en el monitoreo de pacientes oncológicos / Usefulness of the reference value of the change in the interpretation of results serially monitoring cancer patients

El valor de referencia del cambio (VRC) es el valor máximo que es permisible cambie el resultado de un analito entre dos mediciones sucesivas en un mismo paciente, sin que esta diferencia sea de relevancia clínica. Incluye critérios basados en la variabilidad biológica intraindividual (CVI) y la imprecisión analítica (CVA). La principal utilidad de los marcadores tumorales (MT) es el monitoreo de pacientes, resultando más apropiado informar el VRC que evaluar un resultado con su valor de referencia, como lo indica su bajo índice de individualidad. El objetivo fue evaluar la utilidad del VRC para detectar un cambio significativo entre resultados sucesivos en los principales MT. Se analizaron datos de sueros de controles de calidad de MT desde mayo de 2010 a febrero de 2014, se calculó el CVA%, y los datos de CVI % fueron obtenidos de bibliografía. Se calcularon los VRC para cada MT. Para los MT evaluados: AFP, CEA, CA125, CA15-3, CA19-9, PSA y tiroglobulina, los VRC fueron: 29.7, 32.3, 58.0, 16.3, 38.3, 42.7 y 34.2% respectivamente (p<0.05). Estos valores se compararon con datos bibliográficos. El VRC es un dato útil para el médico ya que colabora en la correcta interpretación de resultados seriados durante el seguimiento de pacientes, en la evaluación del tratamiento o en la estimación de recurrencias. Le permite saber si la diferencia encontrada entre dos valores consecutivos representa un cambio em el estado de salud del paciente. Nuestros VRC resultaron comparables con los de literatura

The reference change value (RCV) is the maximum allowable change between two consecutive results with no meaningful clinical relevance. It is analyzed within individual biological variability (CVI ) and analytical imprecision (CVA) criteria. For tumor markers (TM) monitoring is more appropriate to report RCV than reference interval due to their low individuality index. The aim of the study was to evaluate the usefulness of RCV to indicate a significant change between two consecutives TM results. Data from MT quality control serums (QC) were analyzed from May 2010 to February 2014, the imprecision was calculated as CVA% and CVI % data was obtained from literature. The RCV for each MT was calculated. The RCV for AFP, CEA, CA125, CA15-3, CA19-9, PSA and thyroglobulin were 29.7, 32.3, 58.0, 16.3, 38.3, 42.7 and 34.2% respectively (p < 0.05). These values were compared with literature data. The RCV is an appropriate tool for the clinicians and aids for the correct interpretation of results in the monitoring of patients, in treatment evaluation or estimation of recurrence. Physicians can determine whether the differences found between two successive values represent a change in the health status of the patient. The RCV calculated were comparable with those obtained in literature

Incidence of dementia and association with APOE genotype in older Cubans / Incidência de demência e associação com o genótipo APOE em idosos Cubanos

Objective: In an admixed population of older Cubans, the incidence and association of APOE and sociodemographic risk factors with dementia incidence was estimated. Methods: A single-phase survey (baseline) of all over 65-year-olds residing in seven catchment areas in Cuba (n=2944) was conducted between 2003 and 2007. Dementia diagnosis was established according to DSM-IV and 10/66 criteria. APOE genotype was determined in 2520 participants. An incidence wave was conducted 4.5 years after cohort inception in order to estimate incidence and associations with sociodemographic risk factors of the APOE ?4 genotype. Results: The incidence rate of DSM IV dementia was 9.0 per 1000 person-years (95% CI 7.2-11.3) and of 10/66 dementia was 20.5 per 1000 person-years (95% CI, 17.6-23.5). Older age, a family history of dementia and APOE e4 genotype were independent risk factors for incident 10/66 dementia. APOE genotype was associated cross-sectionally with dementiaprevalence, but the effect on the incidence of dementia was attenuated, and only apparent among those in the youngest age group. Conclusion: The incidence of dementia in the older Cuban population is relatively high and similar to levels reported in Europe and North-America. The study showed that the relationship between APOE e4 and incident dementia is stronger in the younger-old than the older-old and that this change must be taken into account in models of dementia.

Objetivo: Em uma população miscigenada de cubanos idosos, estimamos a incidência de demência e a associação entre o genótipo da APOE e os fatores de risco sociodemográficos na incidência de demência. Métodos: Realizamos uma pesquisa de uma fase (linha de base) de todos os idosos com mais de 65 anos residentes em sete áreas de Cuba (n=2944), de 2003 a 2007. O diagnóstico de demência foi estabelecido de acordo com os critérios do DSM-IV e do 10/66. O genótipo APOE foi determinado em 2520 participantes. Avaliação da incidência foi conduzida 4,5 anos após a linha de base, a fim de estimar a incidência e associações com fatores de risco sociodemográficos e o genótipo APOE 4. Resultados: A taxa de incidência de demência foi de 9,0 por 1000 pessoas-ano (IC 95% 7,2-11,3) de acordo com o DSM-IV e de 20,5 por 1000 pessoas-ano (IC95%, 17,6-23,5) de acordo com o 10/66. Idade avançada, história familiar de demência e genótipo APOE 4 foram fatores de risco independentes para a incidência de demência de acordo com os critérios do 10/66. O genótipo APOE foi associado com a prevalência de demência em estudo transversal, mas o efeito sobre a incidência de demência foi atenuado, e apenas aparente entre aqueles na faixa etária mais jovem. Conclusão: A incidência de demência na população cubana mais velha é relativamente alta, semelhante às relatadas na Europa e América do Norte. O estudo mostra que a relação entre APOE 4 incidente e demência é mais forte entre os idosos mais jovens e que esta alteração deve de ser considerada em modelos de demência.

Prospecting Filamentous Fungi for Amylase Production: Standardization of Aspergillus japonicus Culture Conditions.

Aims: Prospecting different filamentous fungi for high production of amylases in standard conditions for future application in biotechnology industries. Methodology: Samples were collected in different field areas in the state of Bahia, Brazil, for isolating filamentous fungi. Fungi were grown in Petri dishes in a culture medium containing 4% Quaker® oatmeal and 2% bacteriological agar. Fungi screening was carried out in liquid medium containing 1% starch at 30°C and pH6.0 under static conditions for 4 days. Proteins and enzyme activities were determined by Bradford and DNS methods, respectively. A submerged fermentation was performed with different liquid media in order to obtain the best growth composition and enzyme production for the selected fungus. Several conditions such as time course of inactivation, pH, temperature, carbon and nitrogen sources were determined in the culture medium with the aim of improving amylase production and fungi growth. Various fibers and food residues were used as enzymatic inducers in a way to assess potential integration of this enzyme, producing microorganisms in the food industry. Results: A. japonicus proved to be the best degrader of fibers and food residues. After 4 days, A. japonicus enzyme production was maximal, with 44.65(±0.49) U/ml under static conditions. The maximal enzyme activity was obtained at pH 6.0, retaining its activity even at a higher pH. The optimum temperature was 25°C. The best carbon source was potato starch and the best food residues were orange bagasse and bark for the enzyme production by A. japonicus. Conclusion: The results suggest that A. japonicus is a good amylase producer for the degradation of fibers and food residues, indicating that it might become important for the food industry, bringing value to what is known as waste these days.

Screening of Filamentous Fungi for Xylanases and Cellulases Not Inhibited by Xylose and Glucose.

Aims: Screening different filamentous fungi for thermostable xylanases and cellulases that would not be inhibited by xylose and glucose, respectively. Methodology: Samples of fungi collected in the Atlantic forest region, Minas Gerais, Brazil, and some fungi from our Culture Collection were used in this screening. All fungi were grown in liquid media containing 1% sugar cane bagasse (SCB). After that, an aliquot of the crude broth was incubated at different temperatures (from 4 to 60 °C) in carboxymethyl cellulose (CMC) or xylan-media plates, for 12 hours. After this period, the plates were stained with Congo Red. Fungi that presented the best results (larger halos) were tested for the effect of adding xylose and glucose in the xylanase and cellulases activities, respectively. Crude extracts obtained from fungi grown in SCB were used for laccase and lichenase assay. Results: The screening on agar plates with CMC/xylan presented halos of different sizes. From all tested fungi, the best cellulase producer was Malbranchea pulchella, which also presented the most thermostable xylanase. Penicillium griseofulvum presented bigger halos at all temperatures tested, but the xylanase lost almost 14% of its stability in higher temperatures. The effect of xylose and glucose on the enzymatic activities recorded dosedependent. It was observed that 20% activation of the enzymes produced by M. pulchella with 30 mM glucose or 20 mM xylose to cellulase and xylanase, respectively. It was observed a loss of less than 20% for P. griseofulvum xylolytic activity using 50 mM xylose. Lichenase was detected in some fungi prospected but laccase was not detected. Conclusion: Malbranchea pulchella was a good producer of xylanase and cellulase tolerant to xylose and glucose, respectively. Other studies must be performed with this fungus so that it can be used in the future for biotechnological purposes.

Análisis de fuentes del EEG en pacientes tratados con estimulación magnética transcraneal a 5 Hz como tratamiento antidepresivo / Electroencephalographic source analysis in patients receiving 5-Hz transcranial magnetic stimulation as antidepressant treatment

Transcranial Magnetic Stimulation (rTMS) is a technique that allows noninvasive electrical stimulation of the cortex with few side effects. An antidepressant effect has been proposed when rTMS is delivered over prefrontal dorsolateral cortex (DLPFC) ≥5Hz. Quantitative EEG studies have shown increases in alpha and theta power bands as well as frontal interhemispheric asymmetries in most recordings from depressed patients. rTMS over left DLPFC at 5Hz involve a safer and more tolerable procedure, and its neurophysiological correlates has not been explored using EEG source analysis. The aim of this research was to study changes in EEG sources using VARTERA method in a group of patients with major depressive disorder (MDD) treated with 5Hz rTMS over left DLPFC as single or combined treatment with escitalopram. Methods 18 patients with DSM-IV MDD diagnosis without treatment for the current episode were included. Subjects were randomly assigned to one of two groups: A) rTMS+escitalopram 10mg, n=9; B) rTMS+placebo, n=9. Subjects received 15 sessions of rTMS on a daily basis. In order to compare changes in EEG sources two recordings were obtained, prior and after treatment. HDRS, BDI and HARD were used for clinical assessments. Results All patients of group A and eight patients of group B showed response to treatment (considered as a reduction of 50% in HDRS score). An increase in absolute power at 9.37Hz and 10.17Hz in temporal and postcentral gyrus on the left hemisphere was found in group B. Absolute power in those frequencies was decreased in the same regions for group A. In addition, an increased power in beta band frequencies was observed in both hemispheres for group A. Conclusion Increases in alpha band could be the hallmark of the 5Hz rTMS, but it could be reduced by escitalopram. Besides, increases observed in beta band for group A could be related to escitalopram effect.

La estimulación magnética transcraneal repetitiva (EMTr) es una técnica que permite estimular eléctricamente la corteza cerebral de manera no invasiva y con pocos efectos secundarios. Se ha propuesto que la EMTr aplicada sobre la corteza prefrontal dorsolateral (CPFDL) izquierda con frecuencias ≥5Hz tiene efectos antidepresivos. Se ha encontrado que en el electroencefalograma cuantitativo (QEEG por sus siglas en inglés) la mayoría de pacientes deprimidos presentan incrementos en las bandas theta y alfa, así como asimetrías interhemisféricas en la actividad alfa en regiones anteriores. La EMTr sobre la CPFDL izquierda a 5Hz ofrece ventajas considerables en seguridad y tolerabilidad; sin embargo, sus correlatos neurofisiológicos no han sido explorados por el análisis de fuentes del EEG. Objetivo Estudiar los cambios en las fuentes del EEG según el método VARETA en un grupo de pacientes con trastorno depresivo mayor que recibieron EMTr a 5Hz sobre la corteza prefrontal dorsolateral izquierda como tratamiento único o en combinación con escitalopram. Material y métodos Se estudiaron 18 pacientes con diagnóstico de trastorno depresivo mayor de acuerdo con los criterios del DSM-IV sin tratamiento para el episodio en curso. Los sujetos habían sido aleatoriamente asignados a uno de los siguientes grupos de tratamiento: A) EMTr+escitalopram 10mg, n=9; B) EMTr+placebo, n=9. Se aplicó EMTr, a 5Hz en una sesión diaria durante 15 días. Se obtuvieron dos registros electroencefalográficos, uno basal y otro final, con el fin de comparar los cambios en las fuentes de actividad eléctrica cerebral, pretratamiento y post-tratamiento. Se realizaron evaluaciones clinimétricas con las escalas de Hamilton para Depresión y Ansiedad y el Inventario de Depresión de Beck. Resultados Todos los pacientes en el grupo A y ocho pacientes en el grupo B respondieron al tratamiento, con una reducción de 50% o más en la escala HDRS. En el análisis de fuentes se encontró un efecto en el grupo B caracterizado por incremento en la PA de 9.37 a 10.17Hz, en regiones temporales y giro poscentral izquierdos, mismo que se encontró disminuido en el grupo A, Además se encontró un incremento en fracuencias correspondientes a la banda beta en regiones frontales de ambos hemisferios en el grupo A. Conclusiones Podría considerarse que el incremento en la banda alfa es característico de la EMTr a 5Hz, mismo que se ve reducido por efecto del escitalopram. Por otro lado, se observó que el grupo A mostró incrementos en fuentes correspondientes a la banda beta como posible efecto relacionado del fármaco antidepresivo.

Seropositividad a Neospora caninum en Perros de Áreas Rurales y Urbanas del estado Yaracuy, Venezuela / Seropositivity to Neospora caninum in Dogs of Rural and Urban Areas of Yaracuy State, Venezuela

Se realizó un estudio de tipo exploratorio para determinar la seropositividad a Neospora caninum y su asociación con la procedencia y el sexo en perros de áreas rurales y urbanas del estado Yaracuy, Venezuela. Se evaluaron en total 232 perros, de los cuales 116 pertenecían a fincas de producción bovina del municipio Bolívar y 116 fueron muestreados al acudir a consultas en tres clínicas veterinarias privadas de la ciudad de San Felipe. La presencia de anticuerpos contra N. caninum fue determinada utilizando la técnica serológica de inmunofluorescencia indirecta, mientras que la asociación de la seropositividad al parásito con la procedencia y el sexo de los animales se determinó mediante la razón de productos cruzados (OR). Se obtuvo una positividad general de 12,93%, siendo de 20,69% para los caninos provenientes del área rural y 5,17% para los provenientes del área urbana. La seropositividad se encontró asociada significativamente (P<0,05) al origen rural de los animales (OR=4,78), mientras que no se encontró asociación significativa (P>0,05) con el sexo. Se encontraron evidencias de la importancia de los perros en la epidemiología de la neosporosis en la región estudiada.

An exploratory study was conducted to determine the Neospora caninum seropositivity and its association with the origin and sex in dogs from rural and urban areas of Yaracuy state, Venezuela. A total of 232 dogs were evaluated, 116 of which belonged to cattle production farms of Bolivar municipality and 116 were sampled to attend consultations in three private veterinary clinics in the city of San Felipe. The presence of antibodies against N. caninum was determined using indirect immunofluorescence serological technique, while the association of parasite seropositivity with origin and sex of the animals was determined by the odds ratio (OR). It was obtained a 12.93% overall positivity, being 20.69% for canines from rural areas and 5.17% for those from urban areas. Seropositivity was found significantly associated (P<0.05) to rural animal origin (OR=4.78), whereas no significant association was found (P>0.05) with sex. Evidences of the importance of dogs in the epidemiology of neosporosis in the study region were found.

Moralidad, empatia, inteligencia emocional y liderazgo transformacional: un modelo de rutas en estudiantes de posgrados gerenciales en una universidad venezolana / Morality, Empathy, Emotional Intelligence and Transformational Leadership: A Path Analysis Model in Post-graduate Management Students at a Venezuelan University

En el artículo se contrasta un modelo de rutas (path analysis) para las relaciones causales entre el nivel de desarrollo moral posconvencional, la preocupación empática, el autoconocimiento emocional y la autorregulación emocional sobre el estilo de liderazgo transformacional. La muestra de estudio la conformaron estudiantes de posgrado en gerencia de una universidad pública venezolana, y estaba compuesta por profesionales de ambos sexos provenientes de distintas profesiones (N = 162; media edad = 31,37; D.T. = 4,67). Se utilizaron diversos instrumentos como el Test de Definición de Criterios Morales (DIT), el índice de Reactividad Interpersonal (IRI), la Subescala de Comprensión Empática, entre otros. Los resultados muestran que el modelo de rutas propuesto resultó parcialmente válido, evidenciando que la comprensión de las relaciones entre las variables del modelo resulta más compleja de lo que se plantea en la literatura; en tal sentido, la empatía es la variable más influyente en el modelo, al hallarse efectos directos altos y significativos sobre el desarrollo moral posconvencional y la capacidad de autoconocimiento y autocontrol emocional.

A path analysis model was contrasted to establish causal relationships between the level of post-conventional moral development, empathic concern as a measure of empathy, emotional selfawareness and emotional self-regulation on transformational leadership style. The study sample was made up of graduate students in management of a public Venezuelan University and was composed of professionals of both sexes from different disciplinary fields (N = 162, mean age = 31,37, SD = 4,67). The instruments used among others, were the Defining Issues Test (DIT), the Interpersonal Reactivity Index (IRI) and the Sub-Scale of Empathic Understanding. Results show that the proposed model was partially valid; this indicates that the understanding of the relationships between the model variables is more complex than what is proposed in the literature; in this regard, empathy is the most influential variable in the model. As a matter of fact, there are high and significant direct effects on post-conventional moral development and the self-knowledge and emotional self-control ability.

Therapeutic dose of Ginkgo biloba extract 761 may alter the urine excretion of Wistar rats

Wistar rats (n=20) were divided in two groups: G1 received 2 mg/kg of GBE (Ginkgo biloba extract 761), whereas G2 received the same volume of a sodium chloride solution (0.9%), both for 10 days. After a 7-day interval, the treatment was repeated for 8 days. Urine volume and food and water intake were measured daily during this protocol. Histological assessments were performed. No significant difference (p>0.05) was observed in food and water intake of animals during treatment with GBE. Animals who received GBE had a smaller urine volume and increase of weight with a significance difference (p<0.05) during the first and second exposure period. No histological alteration was observed in tissues, except for the kidney of the experimental group, which revealed a higher concentration of red cells in the glomerulus with a strong staining for Vascular Endothelial Growth Factor (VEGF). The introduction of GBE (therapeutic dose) in health rats may promote alterations in the physiology of the kidney, but no sufficient to modify the glomerulus architecture, including at ultra structural level (electron microscopy).

Hydrocortisone decreases apoptosis in jejunum of horses subjected to experimental ischemia and reperfusion / Hidrocortisona diminui a apoptose no jejuno de equinos sujeitos a isquemia e reperfusão experimentais

In order to evaluate the effect of hydrocortisone on apoptosis in the jejunum of horses subjected to ischemia and reperfusion, ten horses were paired and grouped into two groups - treated (n=5) and non treated (n=5). Segments of the jejunum were used as controls (C), or as venous ischemia (VIsc), which were subjected to 2h of ischemia followed by 2 or 12h of reperfusion. C samples were collected at time zero (prior to ischemia) and VIsc samples were collected at 2h of ischemia and at 2 and 12h of reperfusion. TUNEL positive apoptotic cells were counted in 10 microscopical fields in deep mucosa from each horse throughout the time course. After 12h of reperfusion, the number of apoptotic cells in treated group were significantly lower than in untreated animals, indicating that hydrocortisone inhibits apoptosis. These results indicate that hydrocortisone has a beneficial effects favoring the maintenance of jejunal integrity in horses with ischemia and reperfusion injuries by preventing apoptotic cell death.

Com o objetivo de avaliar o efeito da hidrocortisona sobre a apoptose no jejuno de equinos submetidos à is-quemia e reperfusão, dez cavalos foram agrupados em dois grupos: tratado (n=5) e não-tratado (n=5). Foi utilizado um segmento do jejuno como controle (C) e outro foi submetido a isquemia venosa (VIsc) por 2h seguida de 2 ou 12 h de re-perfusão. Amostras de C foram coletadas no tempo zero (antes da isquemia) e amostras de VIsc foram coletadas após 2h de isquemia e a 2 e 12h de reperfusão. Células apoptóticas TUNEL positivas foram contadas em 10 campos microscópicos da mucosa na região das criptas de cada animal em cada tempo. Após 12h de reperfusão, o número de células apoptóticas no grupo tratado foram significativamente menores do que no grupo não-tratado, indicando que a hidrocortiso-na inibe a apoptose. Esses resultados mostram que a hidro-cortisona tem efeito benéfico favorecendo a manutenção da integridade do jejuno em cavalos com lesão de isquemia e reperfusão por prevenir a morte celular por apoptose.

Apoyo social dignificante del adulto mayor institucionalizado. Medellín, 2008 / Dignified social support for elderly institutionalised adults in Medellín, 2008

Objetivo Analizar el apoyo social del adulto mayor residente en los Centros de Bienestar del Anciano de Medellín registrados en la Secretaría de Bienestar Social en el año 2008. Materiales Estudio descriptivo transversal, que abordó algunas características relacionadas con el apoyo social recibido por 276 adultos mayores institucionalizados en 39 centros de protección social, con fuente de información primaria. El análisis de la información fue univariado y bivariado. Resultados Los institucionalizados eran en su mayoría mujeres, con edades de 65-84 años, solteras o viudas, con nivel de educación primaria y secundaria; la mayor parte estaban afiliadas al régimen contributivo. Los principales motivos de institucionalización fueron: soledad, problemas de salud y por decisión familiar; ellos son visitados por sus hijos y otros familiares, y este apoyo fue valorado como satisfactorio, pero más de la mitad tenía sentimientos de soledad y la sexta parte manifestó humillaciones de sus seres queridos; es de anotar que una baja proporción reportó maltrato de sus cuidadores. Conclusiones Las redes de apoyo social son fuertes dentro de la institución y perciben un menor maltrato por parte de los cuidadores institucionales que de los familiares. En general, la soledad es un aspecto que lleva a los adultos mayores a institucionalizarse, pero esta permanece en ellos, motivada en parte por el poco contacto con las familias y la mediana satisfacción con amigos y la misma institución, evidenciando su condición de desamparo y de vulnerabilidad social.

Objective Analysing the social support provided for elderly institutionalised adults being cared for in Elderly Welfare Centres (Centros de Bienestar del Anciano de Medellín) in Medellin during 2008. Materials This was a cross-sectional descriptive study (primary information source) which addressed some characteristics related to the social support being received by 273 elderly people institutionalised in 37 social welfare centres. Univariate and bivariate analysis was applied to the data. Results The institutionalised people were mostly single or widowed women aged between 65 and 84 who had received primary and secondary education; most were affiliated to the contributory health regimen. Loneliness, health problems and family decision were the main causes for them having become institutionalised. They were visited by their children and other relatives and such support was rated as being satisfactory; however, more than half of them had feelings of loneliness and one sixth claimed to be humiliated and insulted by their loved ones. It should be noted that a few of them reported being mistreated by their caregivers. Institutionalised elderly adults performed recreational activities, were satisfied with the support received from friends, with cohabitation and the pertinent institution. Conclusions Social support networks were strong within the institution (i.e. Elderly Welfare Centres); the elderly seemed to receive greater abuse from family members and cohabitants than institutional caregivers. Loneliness generally leads elderly adults to become institutionalised; however, once having entered an institution (being partly motivated by little family contact and average satisfaction with friends and the institution itself) their neglect and social vulnerability becomes evident.