Estudo da adesão ao tratamento anti-hipertensivo em funcionários de uma instituição pública de saúde e educação / Study of adherence to antihypertensive treatment in employees of a public health and education institution

Introdução: A hipertensão arterial está relacionada a altos custos para as áreas da saúde e previdência, devido às complicações decorrentes de sua evolução crônica. Faz-se, portanto, necessário o seu controle, por meio da adesão ao tratamento farmacológico e não farmacológico. Objetivo: Analisar a adesão de funcionários da saúde, de serviço público hospitalar ao tratamento anti-hipertensivo medicamentoso e suas possíveis relações. Método: Pesquisa observacional, transversal e descritiva de abordagem quantitativa composta por 57 trabalhadores que se auto-referiram hipertensos. Foram avaliadas características do perfil socioeconômico e laboral dos profissionais e sua adesão ao tratamento anti-hipertensivo. Os resultados foram analisados por meio de estudo de frequência absoluta e relativa e a associação entre as variáveis por meio do teste do Qui-quadrado e Teste Exato de Fisher. Resultados: identificaram-se características do perfil dos participantes que contribuíram para a adesão ao tratamento anti-hipertensivo e outros aspectos que limitavam a adesão terapêutica e demandavam intervenções, como: ampliação das ações de educação em saúde para todos os funcionários, possibilidades de seguimento daqueles já diagnosticados e rastreamento dos demais, com fortalecimento do vínculo e da comunicação entre o profissional de saúde e o funcionário, assim como ações voltadas a atividades físicas e qualidade de vida. No cuidado individual salientou-se o uso de pílula única e medidas para evitar o esquecimento das tomadas da medicação. Conclusões: O estudo foi capaz de caracterizar os funcionários e sua adesão ao tratamento anti-hipertensivo, fatores facilitadores e dificultadores, e de sinalizar estratégias institucionais de intervenção para melhoria da adesão e qualidade de vida (AU).

Introduction: The arterial hypertension is related to high costs to the health and social security systems, due to complications of its chronic evolution. Therefore, its control is necessary through pharmacological and non-pharmacological treatment adherence. Objective: To analyze the health worker's adherence to anti hypertensive treatment in a public hospital and its possible relations. Method: observational, cross-sectional, descriptive with quantitative approach research, consisting of 57 workers who self-report as hypertensive. Characteristics of the socioeconomic and work profile of professionals and their adherence to anti hypertensive treatment were evaluated. The results were analyzed by the study of absolute and relative frequency and the association between the variables using the Chi-square test and Fisher's exact test. Results: characteristics of the participants' profile that contributed to adherence to anti-hypertensive treatment and other aspects that limited therapeutic adherence and demanded interventions were identified, such as: expansion of health education actions for all employees, possibilities of following up those already diagnosed and tracking others, strengthening the bond and communication between the health professional and the employee, as well as actions aimed at physical activities and quality of life. In individual care, the use of a single pill and measures to avoid forgetting of medication taken were highlighted. Conclusion: the study was able to characterize the employees and their adherence to anti-hypertensive treatment, facilitating and hindering factors, and to point out institutional intervention strategies to improve adherence and quality of life (AU).

Extracapsular dissection and minimally invasive procedures of primary benign parotid tumours: Case series

Extracapsular dissection is an old technique use for the removal of benign parotid tumours, which is not generally chosen as the first treatment option due to the association of recurrences in the past but is currently considered again accord to the aesthetic requirements of the patients. The general trend in the last decade is to return to minimally invasive procedures for this type of lesions, which are mainly conditioned by the pleomorphic adenoma and its positive margins in its capsule. By this, the purpose of this case series study is to analyze those patients diagnosed with benign parotid tumors and treated by extracapsular dissection in a tertiary hospital in Chile between 2018-2020.

Insectos asociados a productos alimenticios almacenados en el área urbana de Culiacán, Sinaloa, México / Insects associated with food products stored in the urban area of Culiacán Sinaloa, Mexico

Resumen Los insectos asociados a productos almacenados dañan a una amplia variedad de alimentos en hogares y expendios, provocando baja calidad nutricional e incluso riesgo a la salud de los consumidores. El objetivo de este estudio fue determinar las especies y abundancia de insectos asociados a alimentos secos almacenados en casas y tiendas de abarrotes de la ciudad de Culiacán, Sinaloa. Se obtuvieron productos alimenticios, en casas o tiendas de abarrotes, con indicios de daños por insectos o presencia de los mismos, los cuales fueron trasladados al laboratorio, donde se aislaron los imagos. Los organismos inmaduros y las muestras de alimento seco se depositaron en cámaras de emergencia de adultos debido a que la identificación se llevó a cabo por morfología en la fase de imago. Se recolectaron 181 ejemplares de insectos pertenecientes a 8 especies; de ellas, Oryzaephilus mercator (Fauvel), Necrobia rufipes (De Greer), Plodia interpunctella (Hubner) y Cadra cautella (Walker) son nuevos registros para Sinaloa. En las casas se encontró la mayor cantidad de insectos, principalmente del orden coleoptera (U = 96.000, n = 154, P = 0.004). Las especies N. rufipes, T. castaneum (Herbst) y P. interpunctella fueron las más comunes en los sitios de estudio y en las muestras recolectadas. Por primera vez se caracterizó y se determinó la abundancia de insectos plaga de productos alimenticios almacenados en una zona urbana de Sinaloa, entidad federativa con importancia agraria en México. Ubicar taxonómicamente las especies que infestan productos almacenados ayuda a determinar el riesgo económico y de salud que representan para las zonas donde fueron encontrados. También es útil para desarrollar y aplicar medidas adecuadas de control entomológico, en caso de presentarse una plaga en la zona, lo que mantendrá la calidad e integridad de los productos que se comercializan.

Abstract Insects associated with stored produce damage a wide variety of foods in homes and grocery stores, causing poor nutritional quality and even health risk in consumers. The objective of this study was to determine the species and abundance of insects associated with dry food products stored in homes and grocery stores of the city of Culiacán, Sinaloa. Food products were obtained, in houses or grocery stores, with signs of damage by insectes or their presence, which were transferred to the laboratory, where the imagos were isolated immature and dry food samples were deposited in adult emergency chambers because the identification was carried out by morphology in the imago stage. 181 insects belonging to 8 species were collected, of which Oryzaephilus mercator (Fauvel), Necrobia rufipes (De Greer), Plodia interpunctella (Hubner) and Cadra cautella (Walker) represent new records for the state of Sinaloa. The highest number of insects that belong mainly to the order coleoptera were collected in homes (U = 96.000, n = 154, P = 0.004). N. rufipes, T. castaneum (Herbst) and P. interpunctella were the most common species at the study sites and of the food samples collected, dog food and flour were the most affected. For the first time, the abundance of insect pests of stored food products was characterized and determined in an urban area of Sinaloa, an agriculturally important state in Mexico. Identifying taxonomically the species that infest stored products will allow to determine the economic and health risk that they represent for the areas where they were found. It is also useful in developing and applying the appropriate entomological control that will maintain the quality and integrity of the products.

Relación entre actividad física y calidad de vida en adolescentes durante la pandemia por la COVID-19

RESUMEN Introducción: La pandemia por la COVID-19 ha generado distanciamiento social, lo cual provoca disminución de la práctica de actividad física y menor calidad de vida relacionada con la salud. Objetivo: Relacionar el nivel de actividad física con la calidad de vida relacionada con la salud, en adolescentes, durante el confinamiento por la COVID-19. Métodos: Estudio transversal que evaluó 184 estudiantes (61,4 % mujeres) con una edad media de 13,97 + 1,69 años, residentes en la región del Maule, Chile. Se emplearon dos encuestas de autoaplicación, la versión corta del Cuestionario Internacional de Actividad Física y la versión validada en población chilena, del KIDDO-KINDL. Resultados: Se presentó correlación directa y significativa entre el tiempo total de actividad física leve con la autoestima (p= 0,043) y, entre el tiempo total sentado con el bienestar emocional (p= 0,025), autoestima (p= 0,014), escuela (p= 0,031) y puntaje total de calidad de vida (p= 0,006) para el total de la muestra. Solo las mujeres presentaron correlación (p< 0,05) entre el tiempo total sentado con la familia, escuela y puntaje total de calidad de vida. Además, se encontraron diferencias significativas (p< 0,05) en el tiempo total de actividad física moderada, escuela y puntaje total de calidad de vida a favor de los hombres. Conclusión: Existe relación entre el tiempo total de actividad física con la autoestima y, entre el tiempo total sentado con el bienestar emocional, autoestima, escuela y puntaje total de calidad de vida en adolescentes durante el confinamiento por la COVID-19.

ABSTRACT Introduction: The COVID-19 pandemic has generated social distancing, causing a decrease in the practice of physical activity and a lower health-related quality of life. Objective: To relate the level of physical activity with health-related quality of life in youth, during COVID-19 lockdown. Methods: Cross-sectional study that evaluated 184 students (61,4 % female) with a mean age of 13,97 + 1,69 years, residing in the Maule region, Chile. Two self-application surveys were applied, with the short version of the International Physical Activity Questionnaire and the valid version in the Chilean population of the KIDDO-KINDL. Results: There was a direct and significant correlation between the total time of mild physical activity with self-esteem (p= 0,043) and, between the total sitting time with emotional well-being (p= 0,025), self-esteem (p= 0,014), school (p= 0,031), and total quality of life score (p= 0,006) for the total sample. Only females showed a correlation (p< 0,05) between total time sitting with family, school, and total quality of life score. In addition, significant differences (p< 0,05) were found in the total time of moderate physical activity, school, and total quality of life score in favor of males. Conclusion: There is a relationship between the total time of physical activity with self-esteem and between the total sitting time with emotional well-being, self-esteem, school, and total quality of life score in youth during COVID-19 lockdown.

Determinación niveles de glucosa por medio de espectroscopía como método no invasivo / Determination of glucose levels by means of spectroscopy as a non-invasive method

Introducción: la diabetes mellitus es uno de los problemas más graves de salud pública que enfrenta México. El factor más preocupante es la falta de control de la misma, lo que incide de manera directa, causando daños severos a la salud y la calidad de vida del paciente y familiares, así como una carga económica al país. Por lo tanto, el desarrollo de un método no invasivo para la medición de la glucemia proporcionaría a los pacientes una forma sencilla e indolora de monitoreo y, en consecuencia, un mejor control de la diabetes. Objetivo: investigar, desarrollar y validar un sensor no invasivo por medio de la espectroscopía para la estimación del nivel de glucosa en sangre. Material y métodos: se realizó un análisis de estudio transversal analítico de correlación realizado en las instalaciones del laboratorio de la UMAE No 1, Bajío. Se incluyeron pacientes adultos voluntarios que acudieron al laboratorio de dicha unidad para la toma de niveles de glucosa sérica y de manera simultánea se realizó la medición a través de método no invasivo por espectroscopía y, posteriormente, se compararon ambos resultados para demostrar la validez del dispositivo. Resultados: mediante el análisis de la diferencia de medias de Bland-Altman, se identificó que solamente un paciente tuvo un valor extremo, y que el método para medir la glucosa de manera no invasiva sobreestima hasta un 10.2% del valor de glucosa central. Conclusión: comparando dichos resultados con las normas para glucómetros digitales se concluye que nuestro dispositivo es capaz de proporcionar niveles de glucosa certeros.

Background: Diabetes mellitus is one of the most serious public health problems in Mexico. The most worrying factor is the lack of control of it, which has a direct impact, causing severe damage to the health and quality of life of the patient and its family, as well as an economic burden to the health system. Therefore, the development of a non-invasive method for measuring blood glucose would provide to patients a simple and painless way of monitoring and consequently better control of diabetes. Objective: Research, development and validation of a non-invasive sensor by means of spectroscopy for the estimation of the blood glucose level. Material and methods: An analysis of a cross-sectional analytical correlation study was carried out in the facilities of the laboratory at the UMAE No. 1, Bajío. Voluntary adult patients who attended the laboratory of the UMAE to take serum glucose levels were included, and simultaneously the measurement was carried out through a non-invasive method by spectroscopy and, later, both results were compared to demonstrate the validity of the device. Results: By the Bland-Altman mean difference analysis, it was identified that only one patient had an extreme value, and that the method to measure glucose non-invasively overestimates up to 10.2% of the central glucose value. Conclusion: Comparing these results with the standards for digital glucometers, it is concluded that our device is capable of providing accurate glucose levels.

Could Entrustable Professional Activities mediate community-based teaching in care integration services? / ¿Podrían las actividades profesionales confiables mediar servicios de integración docente asistencial en la comunidad?

Abstract Competency-based medical education (CBME) is currently the most common type of curriculum used worldwide. However, its limitations include fragmented learning and difficulties to use properly the knowledge, skills, and attitudes acquired using this educational model. Having this in mind, Entrustable Professional Activities (EPA) emerge as a tool to mediate the transfer of the competency-based curriculum into physicians' professional practice in graduate medical education. Therefore, based on a narrative review of the existing literature on EPA and the authors' experience in teaching community-based health care integration services, the aim of this paper is to reflect on the possible use of these activities in undergraduate medical education for the development of a CBME model integrated with primary health care and community medicine. The reflections presented here allow suggesting that, although it is a challenging process, incorporating EPA into undergraduate medical education is appropriate to improve the provision of primary health care to individuals, families, and communities in general.

Resumen En la actualidad, la educación médica basada en competencias (EMBC) es el diseño curricular más utilizado en el mundo. Sin embargo, sus limitaciones incluyen la construcción fragmentada del aprendizaje y dificultades para lograr el uso adecuado de los conocimientos, habilidades y actitudes adquiridos mediante este modelo pedagógico. Considerando lo anterior, las actividades profesionales confiables (APROC) emergen como una herramienta para mediar la transposición del currículo basado en competencias a la práctica profesional en educación médica de posgrado. Por lo tanto, con base en una revisión narrativa de la literatura existente sobre APROC y la experiencia docente de los autores en la integración de la educación y los servicios de salud basados en la comunidad, el propósito de este estudio es reflexionar sobre el posible uso de estas actividades en la formación médica de pregrado para el desarrollo de un modelo de EMBC integrado con la atención primaria de salud y la medicina comunitaria. Las reflexiones presentadas aquí permiten sugerir que, aunque se trate de un proceso desafiante, la adopción de las APROC en la formación de pregrado en medicina es apropiada para lograr una mejor prestación de atención primaria en salud a personas, familias y comunidades en general.

Recurrent pterygium resection associated to fibrin membrane graft: report of two cases / Resseção do pterígio recorrente associada ao enxerto de membrana fibrina: relato de dois casos

ABSTRACT We propose a novel surgical technique in cases of aggressive recurrent pterygium non-subsidiary of treatment with conjunctival autografts or antimetabolites. Two presented cases were treated with surgical excision and a sutured plasma rich in growth factors membrane (mPRGF) followed by rich in growth factors (PRGF) eye drops treatment. After surgery, dexamethasone, tobramycin and PRGF eye drops were prescribed for 6 weeks. After a 12-month and 3-year post-surgical follow-up respectively, treated eyes with mPRGF did not present relapse, and visual acuity improved in both cases. No ocular complications, pain, eye discomfort nor other symptoms were observed. The combined use of PRGF eye drops and mPRGF seems an effective and safe therapy for recurrent pterygium.

RESUMO Nós propomos uma nova técnica cirúrgica em casos de pterígio agressivo recorrente não subsidiário de tratamento com autoenxertos conjuntivais ou antimetabólitos. Dois casos foram tratados com excisão cirúrgica e um plasma suturado rico em membrana de fatores de crescimento (mPRGF), seguido de tratamento com colírios ricos em fatores de crescimento (PRGF). Após a cirurgia, foram prescritos colírios de dexametasona, tobramicina e PRGF por 6 semanas. Após 12 meses e 3 anos de acompanhamento pós-cirúrgico respectivamente, os olhos tratados com mPRGF não apresentaram recidiva e a acuidade visual melhorou nos dois casos. Não foram observadas complicações oculares, dor, desconforto ocular ou outros sintomas. O uso combinado de colírios de PRGF e mPRGF parece uma terapia eficaz e segura para o pterígio recorrente.

Ascaridiasis hepatobiliar en una adulta joven / Hepatobiliary ascaridiasis in a young adult woman

Se presenta el caso clínico de una paciente de 27 años de edad, con antecedentes de colecistectomía convencional desde hacía 10 meses por aparente colecistitis, quien acudió al Hospital Luis Vernaza de Guayaquil, Ecuador, por presentar ictericia y dolor abdominal. Teniendo en cuenta los hallazgos clínicos, de laboratorio e imagenológicos se le diagnosticó sepsis de foco abdominal, colangitis y coledocolitiasis. Durante la intervención quirúrgica se observó la presencia de 2 Ascaris lumbricoides y cálculo de colesterol en la vía biliar, por lo que se le realizó una derivación bilioentérica. Después de algunas complicaciones como insuficiencia respiratoria y descompensación hemodinámica, la paciente egresó de la institución a los 25 días de operada, con seguimiento por consulta externa durante 2 meses.

The case report of a 27 years patient is presented, with history of conventional cholecystectomy for 10 months due to apparent cholecystitis who went to Luis Vernaza Hospital in Guayaquil, Ecuador, presenting jaundice and abdominal pain. Taking into account the clinical, laboratory and imaging findings a sepsis of abdominal focus, cholangitis and choledocolithiasis was diagnosed. During the surgical intervention the presence of 2 Ascaris lumbricoides and cholesterol calculi in the bile duct was observed, reason why a bilioenteric bypass was carried out. After some complications such as breathing failure and hemodynamic upset, the patient was discharged from the institution 25 days after the surgery, with follow up in outpatient clinics during 2 months.

Dispersión hídrica de enteroparásitos en una zona agropecuaria de gran altitud, en Los Andes Ecuatorianos / Water dispersion of enteroparasites in a high-altitude agricultural area, in The Ecuadorian Andes

La finalidad de esta investigación fue determinar las especies de enteroparásitos que son vehiculizadas por agua de regadío, entubada y estancada, como factor de riesgo asociado a la transmisión en una comunidad rural de la provincia de Chimborazo-Ecuador. Se realizó una investigación de campo, transversal, con muestreo no probabilístico intencional, en el que se incluyeron 214 muestras de agua: 37 de canales de riego, 147 que surten las viviendas y 30 estancadas. Las muestras se analizaron mediante Sedimentación espontánea, técnica de Bailenger (modificada) y coloración de Ziehl Neelsen (modificada). El agua de regadío y la estancada, obtuvieron el 100% de contaminación parasitaria y en menor grado la entubada, con 57,14%. La mayor proporción fue de protozoarios (70,56%), seguidos de chromistas (40,65%) y helmintos (13,08%). Entre los parásitos transmisibles, se destacan: Blastocystis spp. (40,65%), Amebas de vida libre (5,61%), Entamoeba spp. (8,41%), Giardia duodenalis (6,54%), Balantidium spp. (13,51%), Cryptosporidium spp. (17,76%), Cyclospora spp. (3,74%), Cystoisospora spp. (2,34%), Eimeria spp. (13,55%), Dibothriocephalus spp. (0,47%) y larvas de nemátodos (13,08%). Los resultados evidencian la presencia de parásitos de transmisión hídrica en los tres cuerpos de agua estudiados, lo que constituye un riesgo de infección humana, veterinaria y de contaminación para los productos agrícolas

The purpose of this investigation was to determine the species of enteroparasites that are carried by irrigated, piped and stagnant water, as a risk factor associated with transmission in a rural community in the province of Chimborazo-Ecuador. A cross-sectional field investigation was carried out, with an intentional non-probability sampling, in which 214 water samples were included: 37 from irrigation canals, 147 that supply the houses and 30 stagnant. The samples were analyzed by spontaneous sedimentation, Bailenger technique (modified) and Ziehl Neelsen staining (modified). Irrigation and stagnant water obtained 100% of parasitic contamination and to a lesser extent piped, with 57.14%. The highest proportion was of protozoa (70.56%), followed by chromists (40.65%) and helminths (13.08%). Among the transmissible parasites, the following stand out: Blastocystis spp. (40.65%), Free-living amoebas (5.61%), Entamoeba spp. (8.41%), Giardia duodenalis (6.54%), Balantidium spp. (13.51%), Cryptosporidium spp. (17.76%), Cyclospora spp. (3.74%), Cystoisospora spp. (2.34%), Eimeria spp. (13.55%), Dibothriocephalus spp. (0.47%) and nematode larvae (13.08%). The results show the presence of parasites of water transmission in the three bodies of water studied, which constitutes a risk of human, veterinary infection and contamination for agricultural products

Estudio etnozoológico de los vertebrados silvestresde la comunidad Bonifacio García, Morelos, México / Ethnozoological study of wild vertebrates of the Bonifacio Garcia community, Morelos, Mexico

Resumen El objetivo de la investigación fue analizar el conocimiento etnozoológico que conservan de los vertebrados silvestres los habitantes de la comunidad Bonifacio García en Morelos, México. Se aplicaron entrevistas semiestructuradas a 30 informantes clave, mediante la observación participante y recorridos guiados se buscaron rastros como huellas, excretas, madrigueras, pieles y observación in vivo para la identificación de las especies citadas y se calcularon los siguientes índices: valor de diversidad de uso para cada especie (VDE) y de uso medicinal (VDM), así como el índice de diversidad de las enfermedades tratadas (IVDE). Se reportan 41 especies de vertebrados que los entrevistados reconocen, de los cuales 28 son aprovechados: mamíferos 39.3%, aves 32%, reptiles 18%, peces 7.1% y anfibios 3.6%. Los principales valores de uso fueron alimentario (0.54), medicinal (0.46) y ornamental (0.43). El venado cola blanca, la iguana negra y la víbora de cascabel registraron 0.57 de VDE y un VDM de 0.19. Las principales enfermedades tratadas son: cáncer, afecciones respiratorias, enfermedades de la piel y reumatismo con un IVDE de 0.17. La apropiación de los vertebrados silvestres se lleva a cabo por medio de la cacería de subsistencia en el campo (50%), terrenos de cultivo (43%) y el traspatio (7%) utilizando con mayor frecuencia escopeta como arma de captura. Se concluye que la apropiación de vertebrados permite complementar necesidades básicas de alimentación y salud; por lo que los conocimientos etnozoológicos deben de integrarse a políticas públicas que permitan la conservación y manejo de la fauna silvestre en la comunidad.

Abstract The aim of this study was to analyze the ethnozoological knowledge that the inhabitants of the Bonifacio García community, Morelos, Mexico, conserve about wild vertebrate. Semi-structured interviews were applied to 30 key informants, through participant observation and guided tours, traces such as footprints, excreta, burrows and pelts and in vivo observation were researched for the identification of the mentioned species and the following indexes were calculated: value of diversity of use for each species (VDS) and of medicinal uses (DVM), as well as the diversity index of the treated diseases (DITD). The study recorded a total of 42 wild vertebrate species, of these 28 are used: mammals 39.3%, birds 32%, reptiles 18%, fish 7.1% and amphibia 3.6%. The main use values were alimentary (0.54), medicinal (0.46) and ornamental (0.43). The white-tailed deer, the black iguana and the rattlesnake registered 0.57 of VDS and a DVM of 0.19. The main diseases treated are cancer, respiratory and skin diseases and rheumatism with an DITD of 0.17. The animals are obtained by means of subsistence hunting in the fields (50%), croplands (43%) and backyards (7%), using most frequently shotguns as arms for capture. We conclude that the appropriation of vertebrates complements basic needs for food and health; therefore, ethnozoological knowledge must be integrated into public policies that enable the conservation and management of wild fauna in the community.

Caracterización fisicoquímica y microbiológica de aguas subterráneas de un sector rural a baja altitud en Los Andes venezolanos / Physicochemical and microbiological characterization of groundwater wells of a rural sector located at low altitude in the venezuelan Andes

El crecimiento de la población humana y las actividades antropogénicas ha aumentado la tasa de contaminación del agua subterránea en el mundo, por lo que, la finalidad de este estudio es determinar la potabilidad del agua de cuatro pozos subterráneos de un área rural del estado Mérida, mediante la caracterización fisicoquímica y microbiológica, para comprobar la factibilidad de su uso como agua de consumo. Los resultados indican que los parámetros fisicoquímicos cumplen la normativa venezolana. Las aguas presentan una gran variedad de minerales destacándose Ca, Na y Mg como cationes mayoritarios y una dureza básicamente debía a iones bicarbonato. Los valores de la distribución isotópica, sugieren la existencia de dos acuíferos sin conexiones hidráulicas entre los pozos. El análisis bacteriológico y parasitológico detecta: bacterias heterótrofas, coliformes totales y Pseudomonas, así como, Ascaris spp., Blastocystis sp., Giardia sp., y Eimeria sp., probablemente procedentes del filtrado subterráneo de los pozos sépticos y percolado desde la superficie a través del suelo de textura franco arcilloso arenoso, microorganismos que se han adaptado a las características fisicoquímicas de las aguas. Los resultados demuestran que el agua de tres pozos, no puede ser utilizada para el consumo, sin previo tratamiento convencional como coagulación, filtración y cloración

Growth in human population and anthropogenic activities has increased the rate of groundwater pollution in the world, therefore, the purpose of this study is to determine the potability of water from four underground wells in a rural area of Mérida State, through the physicochemical and microbiological characterization, to check the feasibility of its use as drinking water. The results indicate that the physicochemical parameters comply with venezuelan regulations. The waters have a wide variety of minerals, highlighting Ca, Na and Mg as majority cations and a hardness basically due to bicarbonate ions. The values of the isotopic distribution suggest the existence of two aquifers without hydraulic connections between wells. Bacteriological and parasitological analysis detects: heterotrophic bacteria, total coliforms and Pseudomonas, as well as Ascaris spp., Blastocystis sp., Giardia sp., and Eimeria sp., probably derived from the underground filtration of septic tanks and percolated from the surface through the sandy clay loam soil, microorganisms that have adapted to the physicochemical characteristics of waters. The results show that the water from three wells cannot be used for consumption without some conventional treatment as filtration and coagulation, and disinfection process

Dipylidiasis in children, a generally misdiagnosed cestodiasis. First case reported in Venezuela / Dipylidiasis en niños, una cestodiasis generalmente mal diagnosticada. Primer caso reportado en Venezuela

The first case report of human dipylidiasis in Venezuela is presented, including the diagnosis and treatment of a two-year-old child's infection. The diagnosis was parasitologically confirmed, the child was treated with praziquantel and the animal reservoir and its fleas were identified

Se presenta el primer caso de dipylidiasis humana en Venezuela, incluyendo el diagnóstico y el tratamiento de la infección de un niño de dos años. El diagnóstico fue confirmado parasitológicamente, se trató al niño con praziquantel y fueron identificados el reservorio animal y sus pulgas

Comorbidities among adults living with hiv from two healthcare centers in Colombia / Comorbilidad entre adultos viviendo con VIH en dos centros de atención en Colombia

Objective: To determine the prevalence of comorbidities among adults living with HIV from two healthcare centers in Colombia, and to identify factors associated with comorbidity-free years. Methods: Observational, retrospective medical chart review study. Summary statistics for demographic and clinical characteristics were developed and relationship between comorbidity-free years were analyzed through Kaplan-Meier analysis and Cox regression. Results: 669 clinical charts were included, 71.7% were male and 16.1% were 50 years or older, 69.96% had at least one comorbidity. The most frequent comorbidities were dislipidemia(15.06%), hypertension(5.67%), risk factors were tobacco use(15.33%), alcohol intake(24.36%) and drugs abuse (14.66%). Discussion: These findings are consistent with previous reports showing the underlying processes of patients, producing multiple comorbidities. Conclusions: Significant proportion of patients have comorbidities that may increase risk of other complications or reduced comorbidity-free years. Poly-pharmacy among HIV+ adults need to be addressed to ensure adherence and minimize drug-drug interactions.

Objetivo: Determinar la prevalencia de comorbilidades entre adultos viviendo con VIH en dos centros de atención en Colombia e identificar los factores asociados con años libres de comorbilidad . Metodos: Revisión observacional retrospectiva de historias clínicas. Resumen de estadísticas de características demográficas y clínicas y análisis de correlación entre características clínicas a través de pruebas de Kaplan-Meier y regresión de Cox. Resultados: Se analizaron 669 historias clínicas, 71.7% fueron hombres y 16.1% tuvieron 50 años o más, 69.96% tuvieron al menos una comorbilidad. Las comorbilidades más frecuentes fueron dislipidemia(15.06%), hipertensión (5.67%), los factores de riesgo fueron el uso de tabaco (15.33%), ingesta de alcohol (24.36%) y abuso de drogas (14.66%). Discusión: Estos hallazgos son consistentes con reportes previos que evidencian los procesos subyacentes que llevan a múltiples comorbilidades. Conclusiones: Una proporción significativa de pacientes tiene comorbilidades que pueden aumentar el riesgo de otras condiciones o los años libres de comorbilidad. La polifarmacia en pacientes HIV+ debe hacerse de manera que se asegure la adherencia y se minimicen las interacciones entre medicamentos.

Educación para pacientes / Education for patients

Resumen: Una parte fundamental en todo proyecto de mejora continua es la apropiada información y educación para el paciente y su familia. Las expectativas de una intervención quirúrgica, del curso perioperatorio y de la experiencia del dolor, puede ser distinta, de acuerdo con las creencias y el estado previo de ansiedad provocado por la incertidumbre y el miedo a lo desconocido, lo cual puede provocar un manejo del dolor menos efectivo. Esta variabilidad en la respuesta frente al evento quirúrgico puede ser optimizada en el momento que se proporciona la información de todo el proceso de manera objetiva. Dentro del proyecto de Investigación de PAIN OUT para la optimización del manejo del dolor perioperatorio, coordinado por el departamento de Anestesiología en el INCMNSZ, se planteó la posibilidad de implementar estrategias de educación para la población general. El Departamento de Educación para la Salud del INCMNSZ, tiene como objetivo apoyar y asesorar a las distintas áreas del hospital en materia de educación y promoción de la salud, que contribuyan a generar una cultura de prevención y autocuidado en el paciente y su familia. En un esfuerzo conjunto de estos dos departamentos se planteó la posibilidad de generar material audiovisual que cumpliera con el objetivo primordial de educar en el contexto perioperatorio. Se crearon tres audiovisuales con el apoyo de diseñadores gráficos del Instituto Tecnológico y de Estudios Superiores de Monterrey, Campus Ciudad de México. El primero incluye información acerca del proceso anestésico; el segundo habla del dolor postoperatorio, su evaluación por parte del paciente y las alternativas de manejo durante la hospitalización y el egreso; mientras que el tercero tiene información sobre los mitos y realidades del uso de opioides como parte de una estrategia analgésica. Este material tiene el objetivo de ser difundido entre la población general, a través del sitio web de la Red Mexicana PAIN OUT para la optimización del manejo del dolor perioperatorio http://www.painoutmexico.com y del sitio webhttps://www.epsnutricion.com.mx/quienes.php

Abstract: A fundamental part of any continuous improvement project is the appropriate information and education for the patient and his family. The expectations of a surgical intervention, of the perioperative course and of the experience of pain, can be different, according to the beliefs and previous state of anxiety caused by uncertainty and fear of the unknown, which can favor a less effective management of pain. This variability in the response to the surgical event can be optimized if the information of the entire process is provided objectively beforehand. The PAIN OUT Research project for the optimization of perioperative pain management, coordinated by the Department of Anesthesiology at INCMNSZ, provides the possibility of implementing education strategies for the general population was raised. The Department of Health Education of INCMNSZ aims to support and advise the different areas of the hospital in terms of education and health promotion, which contribute to generate a culture of prevention and self-care in the patient and his family. In a joint effort of these two departments, the possibility of generating audiovisual material that met the primary objective of educating in the perioperative context was done. Three audiovisuals were created with the support of graphic designers from the Tecnológico y Estudios Superiores de Monterrey, Mexico City Campus. The first includes information about the anesthetic process, the second includes information about postoperative pain, its evaluation by the patient and management alternatives during hospitalization and discharge, and the third includes information about the myths and realities of the use of opioids as part of an analgesic strategy. This material is intended to be disseminated to the general population, through the website of the Mexican PAIN OUT Network for the optimization of perioperative pain management http://www.painoutmexico.com and the website https://www.epsnutricion.com.mx/quienes.php

Efectividad bactericida del diamino fluoruro de plata a diferente concentración sobre estreptococos cariogénicos en muestras de saliva y dentina de escolares: un estudio in vitro / Bactericidal effectveness of silver diamine fluoride in different concentrations on cariogenic Streptococcus in salivary and dentinal samples of schoolchildren: an in vitro study

La OMS y la FDI han publicado que entre el 60 y 90% de los escolares padecen caries. En nuestro país, el Sistema de Vigilancia Epidemiológica de Patologías Orales (SIVEPAB) 2012, reporta un 85% de caries a nivel nacional en población pediátrica. Los agentes anticariogénicos como el diamino y el fluoruro de plata son un tratamiento alentador, este agente puede actuar como bactericida o bacteriostático en función de su concentración y su capacidad para inhibir el crecimiento de estreptococos del grupo viridans, y por ende, de la caries. Problema: ¿Cuál es la efectividad bactericida del diamino fluoruro de plata (Saforide®) a diferente concentración sobre la microbiota cariogénica de escolares? Objetivo: Determinar la eficacia bactericida del diamino fluoruro de plata (DFP) a diferentes concentraciones en el crecimiento bacteriano de Streptococcus mitis, S. mutans y S. salivarius en muestras de saliva y dentina en escolares. Material y métodos: Se llevó a cabo un estudio experimental con una variable independiente, el efecto bactericida del diamino fluoruro de plata y se tomó el halo de inhibición como la dependiente. Se utilizaron medidas descriptivas como prueba de comparación y análisis de varianza usando post-hoc Tukey≠ con una confianza del 95%, y análisis de datos exploratorios. Resultados: Se analizaron 100 muestras, de las cuales 48.3% correspondió a S. mutans, 41.4% a S. salivarius y 10.3% a S. mitis, se obtuvo una mayor zona de inhibición para las tres bacterias al 38% mostrando una diferencia estadísticamente significativa 12% (p < 0.05). También se observó un efecto bacteriostático al 12%, no así para el 38%, donde se encontró un efecto bactericida Conclusión: Nuestros resultados sugieren que al 38% de la concentración hay un claro efecto bactericida en el grupo de estreptococos viridans y el 12% no se recomienda para la detención de caries debido al efecto bacteriostático (AU)

WHO and FDI have ruled that 60-90% of schoolchildren are affected by caries. In our country, the System of Epidemiological Surveillance of Oral Pathologies (SIVEPAB) (SIVEPAB) 2012. Report a rate of 85% of caries nationally in pediatric population. Anticariogenic diamino agents such as silver fluoride are an encouraging decrease in treatment for these high rates of tooth decay in our country, this agent can act as bactericidal or bacteriostatic based on their concentration and their ability to inhibit endogenous metalloproteinase (MMP-2, 8, 9). Problem: What will be the bactericidal effectiveness of silver diamine fluoride different concentration on cariogenic Streptococci saliva samples taken from school and dentin? Objective: Determine the bactericidal effectiveness Silver diamine fluoride (SDF) to different concentration on bacterial growth of Streptococcus mitis, S. mutans, and S. salivarius in saliva samples and dentin in school. Material and methods: An experimental study was conducted as an independent variable the bactericidal effect of silver diamine fluoride was taken as dependent inhibition halo. Descriptive measures were used as a comparison test and analysis of variance using Post-hoc Tukey with 95% confidence, and exploratory data analysis. Results: One hundred samples, of which 48.3% corresponded to S. mutans, 41.4% to S. salivarius and 10.3% to S. mitis, were analyzed, we obtained a larger zone of inhibition for all three organisms at 38% showing a statistically significant difference from 12% (p < 0.05). It was also observed that the 12% sample bacteriostatic effect, not to the concentration of 38% was found a bactericidal effect. Conclusion: Our results suggest that 38% concentration has a bactericidal effect on Streptococcus viridans group and 12% showed not recommended for the arrest or detention of dentine caries bacteriostatic effect (AU)

Variability in the virulence of specific Mycobacterium tuberculosis clinical isolates alters the capacity of human dendritic cells to signal for T cells

BACKGROUND Once in the pulmonary alveoli, Mycobacterium tuberculosis (Mtb) enters into contact with alveolar macrophages and dendritic cells (DCs). DCs represent the link between the innate and adaptive immune system owing to their capacity to be both a sentinel and an orchestrator of the antigen-specific immune responses against Mtb. The effect that the virulence of Mtb has on the interaction between the bacilli and human DCs has not been fully explored. OBJECTIVE To evaluate the effect of Mtb virulence on human monocyte-derived DCs. METHODS We exposed human monocyte-derived DCs to Mtb clinical strains (isolated from an epidemiological Mtb diversity study in Mexico) bearing different degrees of virulence and evaluated the capacity of DCs to internalise the bacilli, control intracellular growth, engage cell death pathways, express markers for activation and antigen presentation, and expand to stimulate autologous CD4+ T cells proliferation. FINDINGS In the case of the hypervirulent Mtb strain (Phenotype 1, strain 9005186, lineage 3), we report that DCs internalise and neutralise intracellular growth of the bacilli, undergo low rates of apoptosis, and contribute poorly to T-cell expansion, as compared to the H37Rv reference strain. In the case of the hypovirulent Mtb strain (Phenotype 4, strain 9985449, lineage 4), although DCs internalise and preclude proliferation of the bacilli, the DCs also display a high level of apoptosis, massive levels of apoptosis that prevent them from maintaining autologous CD4+ T cells in a co-culture system, as compared to H37Rv. MAIN CONCLUSIONS Our findings suggest that variability in virulence among Mtb clinical strains affects the capacity of DCs to respond to pathogenic challenge and mount an immune response against it, highlighting important parallels to studies previously done in mouse models.

Evaluation of the transcriptional immune biomarkers in peripheral blood from warao indigenous associate with the infection by mycobacterium tuberculosis

Abstract INTRODUCTION: Biomarkers are critical tools for finding new approaches for controlling the spread of tuberculosis (TB), including for predicting the development of TB therapeutics, vaccines, and diagnostic tools. METHODS: Expression of immune biomarkers was analyzed in peripheral blood cells stimulated and non-stimulated with M. tuberculosis antigens ESAT-6, CFP10 and TB7.7. in Warao indigenous individuals. These biomarkers may be able to differentiate TB states, such as active tuberculosis (ATB) cases and latent tuberculosis infection (LTBI) from non-infected controls (NIC). A real-time reverse transcription polymerase chain reaction (RT-qPCR) assay was performed on 100 blood samples under non-stimulation or direct ex vivo conditions (NS=50) and stimulation conditions (S=50). RESULTS: The findings are shown as the median and interquartile range (IQR) of relative gene expression levels of IFN-γ, CD14, MMP9, CCR5, CCL11, CXCL9/MIG, and uPAR/PLAUR immune biomarkers. MMP9 levels were significantly higher in the LTBI-NS and LTBI-S groups compared with the NIC-NS and NIC-S groups. However, CCR5 levels were significantly lower in the LTBI-S group compared with both NIC-NS and NIC-S groups. CCL11 levels were significantly lower in the LTBI-S group compared with the NIC-NS group. CONCLUSIONS: Preliminary findings showed that MMP9 immune biomarkers separated LTBI indigenous individuals from NIC indigenous individuals, while CCR5, CCL11, CD14, and IFN-γ did not differentiate TB states from NIC. MMP9 may be useful as a potential biomarker for LTBI and new infected case detection among Warao indigenous individuals at high risk of developing the disease. It may also be used to halt the epidemic, which will require further validation in larger studies.

Docencia e Investigación en Odontología Legal en Chile: Situación y Desafíos Actuales / Teaching and Research in Legal Dentistry in Chile: Current Situation and Challenges

RESUMEN: El objetivo de este estudio es describir las características de las instituciones y el equipo de investigación y docencia que imparten Odontología Legal (OL) a nivel pregrado en Chile. Estudio cualitativo realizado durante el 2017. Desde las páginas web institucionales de las universidades que imparten la carrera de odontología en Chile, se obtuvo información sobre el cuerpo docente del ramo de OL a nivel pregrado. Cuando la información no estuvo disponible, se solicitó vía correo electrónico. Se realizó una búsqueda de publicaciones chilenas sobre OL y Forense en las bases de datos Medline, SciELO, Lilacs y Cochrane, y se identificó aquellas realizadas por docentes ejerciendo en Chile. La asignatura de OL se imparte a nivel pregrado en 17 de las 21 universidades que imparten la carrera de Odontología, siendo un curso obligatorio en 16 de ellas, y electivo en una de ellas. De los 29 docentes que imparten el ramo a nivel pregrado en Chile, sólo tres tiene la especialidad de OL. Se encontraron sólo 28 publicaciones científicas en el área en los últimos diez años, cuya autoría corresponde a cinco de los docentes del ramo a nivel pregrado. En Chile, la docencia de OL, a nivel pregrado, es impartida mayoritariamente por cirujano-dentistas no especializados en el área, en concordancia con que la especialidad comenzó a impartirse en el año 2015. Es imperioso aumentar la investigación en OL entre los docentes, de manera de desarrollar el área a nivel universitario, aumentando el conocimiento en la disciplina y consolidándola como ciencia.

ABSTRACT: The aim of this study was to describe the characteristics of the universities and the research and education teams imparting "Forensic Odontology" at undergraduate level in Chile. A qualitative cross-sectional study was conducted during 2017. Information was sought from the institutional websites of universities that impart Dentistry degrees. When the information was not available, it was requested via email to the respective authorities. A search was conducted to identify Chilean publications that deal with the topic of forensic dentistry, in the Medline, SciELO, Lilacs and Cochrane databases. Those authored or co-authored by academic(s) teaching in Chile were identified. "Forensic Odontology" is taught at undergraduate level in 17 of the 21 universities that impart the career of Dentistry in Chile, being mandatory in 16 of schools, and an elective in one of them. Of the 29 academics who teach the subject at undergraduate level in Chile, only three have the specialty of OL. Only 28 scientific publications in the area were found in the last ten years, whose authorships correspond to five academics in the field, teaching at undergraduate level. In Chile, "Forensic Odontology" at the undergraduate level, is mainly imparted by dental surgeons not specialized in the subject, in accordance with the fact that the specialty began to be taught in Chile only in 2015. It is imperative to increase the amount of research in forensic odontology conducted by the academics, in order to develop the area at the university level, to improve knowledge in this discipline and consolidate it as a science.

Factores de riesgo asociados a hipertensión inducida por el embarazo en prenatales del estado Apure / Risk factors associated with pregnancy induced hypertension in pregnant women from the Apure state

Con el objeto de determinar los factores de riesgos asociados a hipertensión inducida por el embarazo en prenatales atendidas en el Hospital Acosta Ortiz de San Fernando de Apure durante el período enero-mayo 2016, se efectuó una investigación retrospectiva de recolección de datos de 25 prenatales hospitalizadas. En relación a los factores de riesgo sociodemográficos, se encontró que la mayoría de las gestantes estaban en edades relativamente jóvenes y que el 80% vivían en pareja. El nivel educativo era bajo; un alto porcentaje (60%) se dedicaban a oficios del hogar y el 72% vivía en hacinamiento. En lo que respecta a los factores biológicos, predominó la hipertensión arterial en los padres de las encuestadas; la mayoría tenía de 29 a 36 semanas de gestación y una gran parte de ellas presentó complicaciones en sus embarazos anteriores. En cuanto a su alimentación, la mayoría mantenía un alto consumo de carbohidratos y grasas saturadas. Con respecto a los hábitos psicosociales, el 60% consumía alcohol y el 88% consumía cafeína. Un 10% de las pacientes realizaba algún tipo de actividad física y un 8% participaba en actividades recreativas. El 91% asistía a consultas prenatales, sin embargo 27% de las pacientes no cumplía con el tratamiento prescrito y el 30% no seguían las recomendaciones dadas por el personal de salud(AU)

In order to determine the risk factors associated with pregnancy induced hypertension of patients attended at the Hospital Acosta Ortiz in San Fernando de Apure during the period January-May 2016, a retrospective descriptive study was performed in 25 pregnant hospitalized patients. The majority of pregnant women were of relatively young age and 80% of them lived with their partners. The educational level was low; most of them only went to primary school. 60% of patients were housewives and 72% lived in overcrowded areas. With regard to biological factors, hypertension predominated in the parents of the patients; the majority had between 29 to 36 weeks of gestation and a large proportion of them had complications in previous pregnancies. Most of them had a high consumption of carbohydrates and saturated fats. Regarding psychosocial habits, 60% drank alcohol and 88% consumed caffeine. 10% performed physical activity and 8% recreational activities. 91% of patients attended prenatal consults of which 27% did not comply with the treatment and 30% did not follow the recommendations given by health personnel(AU)