Sociodemographic, socioeconomic and motivational profile of brazilian triathletes / Perfil sociodemográfico, socioeconómico y motivacional de los triatletas brasileños / Perfil sociodemográfico, socioeconômico e motivacional de triatletas brasileiros

ABSTRACT Introduction: Triathlon can be considered one of the most successful endurance sports worldwide due to the wide dissemination of information, expansion of the offer of competitions, and greater popularity. Objective: To analyze Brazilian triathletes' sociodemographic, socioeconomic, and motivational profiles. Methods: 411 triathletes participated in the study, 127 women [37.87 ± 9.34 years] and 284 men [36.02 ± 9.23 years]. Three questionnaires were sent electronically to assess sociodemographic, socioeconomic, and motivational data. In addition, descriptive analyses and statistical tests were performed to compare motivation between age, sex, and technical level groups. Results: It was found that there is a prevalence of male triathletes, amateurs, aged between 30-40 years, employed and economically favored. Amateur athletes have running as a base sport for Triathlon, and professionals start their sports career through swimming. Among the most practiced distances are the sprint Triathlon and half Ironman. Regarding motivation, women differ in the dimensions of group activity (p=0.020), emotion (p=0.002), and technical competence (p=0.007). Professional triathletes had higher scores in the dimensions of social recognition (p=0.001) and competition (p=0.001) and lower scores in the physical fitness dimension (p=0.005). Triathletes aged between 35 and 49 years had lower averages in the social recognition dimension (p=0.007), (p=0.012) and (p=0.004) and competition (p=0.028), (p=0.008) and (p=0.044) when compared to athletes aged 20 to 29 years. Conclusion: the profile of Brazilian triathletes is diverse, and differences in sex, age, and technical level impacted the motivation of the evaluated triathletes. Level of Evidence III; Diagnostic studies - Investigation of a diagnosis test; Study of non-consecutive patients, with no uniformly applied "gold standard".

RESUMEN Introducción: El triatlón puede considerarse uno de los deportes de resistencia de mayor éxito a nivel mundial debido a la gran difusión de información, ampliación de la oferta de competiciones y mayor popularidad. Objetivo: Analizar el perfil sociodemográfico, socioeconómico y motivacional de los triatletas brasileños. Métodos: Participaron en el estudio 411 triatletas, 127 mujeres [37,87 ± 9,34 años] y 284 hombres [36,02 ± 9,23 años]. Se enviaron electrónicamente tres cuestionarios para evaluar datos sociodemográficos, socioeconómicos y de motivación. Se realizaron análisis descriptivos y pruebas estadísticas para comparar la motivación entre grupos de edad, sexo y nivel técnico. Resultados: Se encontró que existe un predominio de triatletas masculinos, amateurs, con edades entre 30-40 años, empleados y económicamente favorecidos. Los deportistas aficionados tienen la carrera como deporte base para el Triatlón y los profesionales inician su carrera deportiva a través de la natación. Entre las distancias más practicadas se encuentran el Triatlón sprint y el medio Ironman. Respecto a la motivación, las mujeres difieren en las dimensiones actividad grupal (p=0,020), emoción (p=0,002) y competencia técnica (p=0,007). Los triatletas profesionales obtuvieron puntuaciones más altas en las dimensiones de reconocimiento social (p=0,001) y competición (p=0,001) y puntuaciones más bajas en la dimensión de condición física (p=0,005). Los triatletas con edades comprendidas entre 35 y 49 años tuvieron medias más bajas en la dimensión reconocimiento social (p=0,007), (p=0,012) y (p=0,004) y competición (p=0,028), (p=0,008) y (p=0,044) en comparación con atletas de 20 a 29 años. Conclusión: el perfil de los triatletas brasileños es diverso y las diferencias de sexo, edad y nivel técnico impactaron en la motivación de los triatletas evaluados. Nivel de Evidencia III; Estudios diagnósticos - Investigación de un diagnóstico prueba; Estudio de pacientes no consecutivos, sin un "patrón oro" aplicado uniformemente.

RESUMO Introdução: O Triathlon pode ser considerado um dos esportes endurance de maior sucesso mundialmente devido à grande disseminação de informações, ampliação da oferta de competições e maior popularidade. Objetivo: Analisar o perfil sociodemográfico, socioeconômico e motivacional de triatletas brasileiros. Métodos: Participaram da pesquisa 411 triatletas, sendo 127 mulheres [37,87 ± 9,34 anos] e 284 homens [36,02 ± 9,23 anos]. Foram enviados eletronicamente três questionários que avaliam dados sociodemográficos, socioeconômicos e a motivação. Foram realizadas análises descritivas e testes estatísticos para comparar a motivação entre grupos de idade, sexo e nível técnico. Resultados: Verificou-se que há prevalência de triatletas homens, amadores, com faixa etária entre 30-40 anos, empregados e economicamente favorecidos. Atletas amadores possuem a corrida como esporte de base para o Triathlon e profissionais iniciam sua carreira esportiva pela natação. Entre as distâncias mais praticadas estão o Triathlon sprint e meio Ironman. Sobre a motivação, mulheres diferem nas dimensões de atividade de grupo (p=0,020), emoção (p=0,002) e competência técnica (p=0,007). Triatletas profissionais apresentaram maiores pontuações nas dimensões de reconhecimento social (p=0,001) e competição (p=0,001) e menores pontuações na dimensão aptidão física (p=0,005). Triatletas com idades entre 35 a 49 anos obtiveram menores médias na dimensão reconhecimento social (p=0,007), (p=0,012) e (p=0,004) e competição (p=0,028), (p=0,008) e (p=0,044) quando comparados com atletas de 20 a 29 anos. Conclusão: o perfil de triatletas brasileiros é diverso e as diferenças de sexo, idade e nível técnico impactaram na motivação dos triatletas avaliados. Nível de Evidência III; Estudos diagnósticos - Investigação de um diagnóstico este; Estudo de pacientes não consecutivos, sem "padrão ouro" aplicado de maneira uniforme.

Ética y derechos humanos en el servicio hospitalario por COVID-19 / Ethics and human rights in the hospital service by COVID-19

Resumen Objetivo: Analizar las experiencias de los organismos internacionales y el Gobierno de México en el establecimiento de recomendaciones para proteger los derechos humanos de los usuarios, de los servicios hospitalarios a causa de la COVID-19, tomando en cuenta la ética médica. Materiales y métodos: La presente investigación se centró en un enfoque cualitativo, donde se analizaron las experiencias, perspectivas y enfoques en materia de ética y derechos humanos durante la pandemia COVID-19. Con ello, se estudiaron libros, artículos científicos, informes y documentos oficiales de los organismos y dependencias involucradas. Resultados: En la pandemia por el coronavirus, los sistemas de salud se vieron obligados a buscar apoyo de la sociedad civil para contrarrestar sus efectos negativos en la economía y la protección de los derechos humanos. No obstante, hoy en día, la tarea del sector salud continua, ya que se siguen suscitando casos de COVID-19, además, existen pacientes que aún tienen secuelas y que deben ser atendidos sin exclusión. De modo que se continue privilegiando la accesibilidad oportuna, aceptable y asequible a los servicios de salud con la calidad suficiente. Conclusiones: La pandemia COVID-19 modificó el goce de los derechos humanos, incluyendo el derecho a la salud, por lo que la labor médica se modificó a partir de las recomendaciones de organismos internacionales y los gobiernos de los tres niveles. En la atención de la emergencia sanitaria fue fundamental proteger la integridad humana; actuar con respeto, solidaridad, empatía y reciprocidad; y entendiendo que todos debían ser atendidos sin discriminación, es decir, con inclusión y considerando la existencia de grupos vulnerables, basando la atención en la ética médica y los valores.

Abstract Objective: To analyze the experiences of international organizations and the Government of Mexico in establishing recommendations to protect the human rights of users of hospital services due to COVID-19, taking into account medical ethics. Materials and methods: This research focused on a qualitative approach, where experiences, perspectives, and approaches to ethics and human rights during the COVID-19 pandemic were analyzed. With this, books, scientific articles, reports and official documents of the organizations and dependencies involved were studied. Results: In the coronavirus pandemic, health systems were forced to seek support from civil society to counter its negative effects on the economy and the protection of human rights. However, today, the task of the health sector continues, since cases of COVID-19 continue to arise, in addition, there are patients who still have sequelae and who must be treated without exclusion. So that timely, acceptable and affordable access to health services with sufficient quality continues to be privileged. Conclusions: The COVID-19 pandemic modified the enjoyment of human rights, including the right to health, for which reason medical work was modified based on the recommendations of international organizations and governments of the three levels. In the care of the health emergency, it was essential to protect human integrity; act with respect, solidarity, empathy and reciprocity; and understanding that everyone should be cared for without discrimination, that is, with inclusion and considering the existence of vulnerable groups, basing care on medical ethics and values.

Nada, pedala e corre: análise qualitativa das motivações para a prática esportiva de triatletas amadores e profissionais / Nadar, pedalear y correr: análisis cualitativo de las motivaciones para la práctica deportiva de triatletas aficionados y profesionales / Swim, pedals and run: qualitative analysis of motivations for the practice of sports by amateur and professional triathletes

Resumo O Triathlon, composto por natação, ciclismo e corrida, evidenciou um crescimento da sua prática nos últimos anos. Atualmente enfrentamos uma das maiores pandemias mundiais devido ao novo coronavírus, o que afetou diretamente a rotina de treinos e preparação para competições de triatletas. O objetivo desta investigação, sob uma metodologia qualitativa, é compreender quais são os fatores motivacionais para a prática do Triathlon por atletas brasileiros. Os resultados mostram três categorias emergentes: planilhas de treinos, provas e competições e impactos da pandemia de COVID-19. O artigo conclui que triatletas são motivados por razões distintas e traçam íntima relação à prática do Triathlon com suas respectivas trajetórias esportivas.

Resumen El triatlón, compuesto por natación, ciclismo y carrera a pie, ha mostrado un incremento en su práctica en los últimos años. Actualmente nos enfrentamos a una de las pandemias más grandes del mundo debido al nuevo coronavirus, que afectó directamente a la rutina de entrenamiento y preparación para las competencias de los triatletas. El objetivo de esta investigación, bajo una metodología cualitativa, es comprender cuáles son los factores motivacionales para la práctica del Triatlón por parte de los atletas brasileños. Los resultados muestran tres categorías emergentes: hojas de entrenamiento, pruebas y competencias e impactos de la pandemia de COVID-19. El artículo concluye que los triatletas se motivan por diferentes motivos y trazan una íntima relación entre la práctica del Triatlón y sus respectivas trayectorias deportivas.

Abstract Triathlon, composed of swimming, cycling and running, has shown an increase in its practice in the last few years. We are currently facing one of the biggest pandemics in the world due to the new coronavirus, which directly affected the training routine and preparation for triathlon competitions. The objective of this investigation, under a qualitative methodology, is to understand what are the motivational factors for the practice of Triathlon by Brazilian athletes. The results show three emerging categories: workout schedules, tests and competitions and the impacts of the COVID-19 pandemic. The article concludes that triathletes are motivated by different reasons and trace an intimate relationship between the practice of Triathlon and their respective sports trajectories.

Development of microparticles and microparticulated tablets containing piperine

Abstract Piper nigrum (black pepper) is used in Indian traditional medicine and its main alkaloid, Piperine (PIP), presents antioxidant, antitumor and neuroprotective pharmacological properties. This substance is insoluble in aqueous media and can irritate the gastrointestinal tract. Aiming to avoid these inconvenient characteristics and enable PIP oral administration, this study suggested the PIP microencapsulation through the emulsion-solvent evaporation method and the preparation of microparticulated tablets by direct compression. An UV-spectroscopy method was validated to quantify PIP. Microparticles and microparticulated tablets were successfully obtained and the microparticles exhibited excellent flow. The scanning electron microscopy images showed that PIP microparticles were intact after compression. The in vitro release showed a controlled release of PIP from microparticles and PIP microparticles from tablets in comparison to PIP and PIP tablets. The release profiles of PIP microparticles and the microparticulated tablets were similar. Therefore, tablets containing PIP microparticles are promising multiparticulated dosage forms because a tablet allows microparticles administration and the intact ones promote a controlled release, decreasing its irritating potential on the mucosa.

Locust bean gum hydrogels are bioadhesive and improve indole-3-carbinol cutaneous permeation: influence of the polysaccharide concentration

Abstract The locust bean gum (LBG) is a polysaccharide with thickening, stabilizing and gelling properties and it has been used in the preparation of pharmaceutical formulations. Hydrogels (HGs) are obtained from natural or synthetic materials that present interesting properties for skin application. This study aimed to develop HGs from LBG using indole-3-carbinol (I3C) as an asset model for cutaneous application. HGs were prepared by dispersing LBG (2%, 3% and 4% w/v) directly in cold water. The formulations showed content close to 0.5 mg/g (HPLC) and pH ranging from 7.25 to 7.41 (potentiometry). The spreadability factor (parallel plate method) was inversely proportional to LBG concentration. The rheological evaluation (rotational viscometer) demonstrated a non-Newtonian pseudoplastic flow behavior (Ostwald De Weale model), which is interesting for cutaneous application. The HET-CAM evaluation showed the non-irritating characteristic of the formulations. The bioadhesive potential demonstrated bioadhesion in a concentration-dependent manner. Permeation in human skin using Franz cells showed that the highest LBG concentration improved the skin distribution profile with greater I3C amounts in the viable skin layers. The present study demonstrated the feasibility of preparing HGs with LBG and the formulation with the highest polymer concentration was the most promising to transport active ingredients through the skin.

Visión de las causas de muerte por la COVID-19 con las experiencias de las autopsias / Vision of the causes of death by COVID-19 with the experiences of autopsies

RESUMEN El 30 de enero de 2020, la Organización Mundial de la Salud declaró a la infección por SARS-CoV-2 una emergencia internacional de salud pública. La autopsia, considerada el mejor método de estudio del enfermo y la enfermedad, corrobora que los pacientes pueden morir por la acción directa del virus (fallecidos por la COVID-19), mientras que otros positivos al SARS-CoV-2, no mostraron cambios morfológicos pulmonares atribuidos a la acción del virus. Se propone establecer los criterios diagnósticos morfológicos en el contexto de la epidemia por el SARS-CoV-2 y la COVID-19 en los fallecidos en Cuba, a partir del estudio sistemático de las autopsias. Se han identificado los patrones morfológicos que se establecen en los pulmones de los pacientes fallecidos bajo el efecto de la COVID-19. El edema pulmonar de permeabilidad con el ensanchamiento de tabique pulmonar, el depósito de la membrana hialina desorganizada en el interior de los alveolos, el desprendimiento de células epiteliales (neumocitos y células bronquiales y bronquiolares), seguida de la hiperplasia epitelial con presencia en ocasiones de cambios metaplásicos y atipias, y finalmente, la fibrosis. Cuando se realizan autopsias, es posible ubicar cada enfermedad en su lugar, en el cronopatograma, lo que permite realizar el reparo de los certificados de defunción, para evaluar el lugar que la COVID-19 ha ocupado como causa de muerte en la población estudiada. En criterio del colectivo, identificar en las alteraciones morfológicas, es imprescindible para elaborar el cronopatograma del fallecido y la adecuada evaluación clínico patológica del paciente.

ABSTRACT On January 30, 2020, the World Health Organization (WHO) declared SARS-CoV-2 infection an international public health emergency. The autopsy, considered the best method of studying the patient and the disease, corroborates that patients can die from the direct action of the virus (who died from COVID-19), while others positive for SARS-CoV-2 did not show morphological lung changes attributed to the action of the virus. It is proposed to establish the morphological diagnostic criteria in the context of the SARS-CoV-2 and COVID-19 epidemic in the deceased in Cuba based on the systematic study of autopsies. The morphological patterns that are established in the lungs of patients who died under the effect of COVID-19 have been identified. The pulmonary edema of permeability with the widening of the pulmonary septum, the deposit of the disorganized hyaline membrane inside the alveoli, the detachment of epithelial cells (pneumocytes and bronchial and bronchiolar cells), followed by epithelial hyperplasia with sometimes the presence of metaplastic changes and atypia, and finally, fibrosis. When autopsies are performed, it is possible to locate each disease in its place, in chronopathogram, which allows death certificates repair to be carried out to assess the place that COVID-19 has occupied as a cause of death in the population studied. In the opinion of the group, identifying morphological alterations is essential to prepare the chronopathogram of the deceased and the adequate clinical-pathological evaluation of the patient.

Motivação de atletas amadores e profissionais para a prática do triathlon: uma investigação qualitativa / Motivation of amateur and professional athletes for the practice of triathlon: a qualitative investigation / Motivación de atletas amateurs y profesionales para la práctica del triatlón: una investigación cualitativa

O objetivo dessa investigação foi verificar as motivações para a prática esportiva de triatletas amadores e profissionais. Participaram desse estudo 12 triatletas, sendo 7 atletas profissionais (4 homens e 3 mulheres) e 5 atletas amadores (2 homens e 3 mulheres), com idades entre 19 e 67 anos. Utilizouse como instrumento de pesquisa uma entrevista semiestruturada a partir de um roteiro de questões previamente elaborado pelas pesquisadoras responsáveis, considerando as principais dimensões da motivação. Os dados foram analisados através da análise de conteúdo temática. Como resultado, triatletas são motivados por razões distintas, tanto de forma intrínseca (aptidão física, emoção, competência técnica e diversão), como extrínseca (reconhecimento social, atividades de grupo, competição e afiliação). Concluiu-se que condições como status social, preocupação com a forma física, intensa dedicação a modalidade e presença de motivações ora intrínsecas, ora extrínsecas, parecem ser motivos determinantes para ingresso e permanência de triatletas na modalidade.

The objective of this investigation was to verify the motivations for the sport practice of amateur and professional triathletes. Twelve triathletes participated in this study, 7 professional athletes (4 men and 3 women) and 5 amateur athletes (2 men and 3 women), aged between 19 and 67 years. A semistructured interview was used as a research instrument based on a script of questions previously prepared by the responsible researchers, considering the main dimensions of motivation. Data were analyzed through thematic content analysis. As a result, triathletes are motivated by different reasons, both intrinsically (physical fitness, emotion, technical competence and fun) and extrinsically (social recognition, group activities, competition and affiliation). It was concluded that conditions such as social status, concern with physical shape, intense dedication to the modality and the presence of either intrinsic or extrinsic motivations, seem to be determining reasons for entry and permanence of triathletes in the modality.

El objetivo de esta investigación fue verificar las motivaciones para la práctica deportiva de triatletas aficionados y profesionales. Doce triatletas participaron en este estudio, 7 atletas profesionales (4 hombres y 3 mujeres) y 5 atletas aficionados (2 hombres y 3 mujeres), con edades entre 19 y 67 años. Se utilizó como instrumento de investigación una entrevista semiestructurada a partir de un guión de preguntas previamente elaborado por los investigadores responsables, considerando las principales dimensiones de la motivación. Los datos fueron analizados a través del análisis de contenido temático. Como resultado, los triatletas están motivados por diferentes motivos, tanto intrínsecos (aptitud física, emoción, competencia técnica y diversión) como extrínsecos (reconocimiento social, actividades grupales, competencia y afiliación). Se concluyó que condiciones como el estatus social, la preocupación por la forma física, la intensa dedicación a la modalidad y la presencia de motivaciones intrínsecas o extrínsecas, parecen ser motivos determinantes para el ingreso y permanencia de los triatletas en la modalidad.

Improved antimutagenic effect of Pyrostegia venusta (Ker Gawl. ) Miers nanostructured extract in liposome and polymeric nanoparticle

Abstract Pyrostegia venusta (Ker Gawl.) Miers, popularly known as "Cipó-de São-João", has been used in traditional medicine for its therapeutic properties. Nanotechnology is able to enhance the pharmacological activity of plant extracts. In this context, liposomes and polymeric nanoparticles containing P. venusta ethanolic extract were developed and then physico-chemically characterized to evaluate the mutagenic/antimutagenic effects of P. venusta. In addition, transaminases and serum creatinine were biochemically analyzed for liver and renal damage, respectively. The micronucleus test was performed with male Swiss mice treated orally for 15 consecutive days with free extracts and nanostructured with P. venusta, and then intraperitoneally with N-ethyl-N-nitrosurea (50 mg/kg) on the 15th day of treatment. Micronucleated polychromatic erythrocytes (MNPCE) were evaluated in bone marrow. There was a significant reduction in the frequency of MNPCE (LPEPV = 183% and NPEPV = 114%, p < 0.001), indicating antimutagenic potential of the nanostructured extracts with P. venusta. The groups treated with only nanostructured extract did not show an increase in MNPCE frequency, and biochemical analyzes showed no significant difference between treatments. The liposomes and polymeric nanoparticles containing Pyrostegia venusta ethanolic extract showed biological potential in preventing the first step of carcinogenesis under the experimental conditions

Relación de los niveles séricos de ácido úrico, con la mortalidad y morbilidad en pacientes graves con ventilación mecánica

RESUMEN Introducción: Los procesos oxidativos en el paciente clínico grave con ventilación mecánica, justifican investigar la posible asociación de los niveles del ácido úrico sérico, con la mortalidad y morbilidad. Objetivo: Identificar la posible asociación del ácido úrico sérico al ingreso, con la mortalidad y morbilidad de pacientes clínicos graves, con ventilación mecánica invasiva. Métodos: Se realizó estudio descriptivo longitudinal y prospectivo, en 89 pacientes clínicos graves con ventilación mecánica, ingresados en cuidados intensivos del hospital "Dr. Luís Díaz Soto" de enero del 2000 a agosto del 2007. Al ingreso y por 72 horas se determinó el ácido úrico sérico, cuyo valor medio se contrastó con la mortalidad, la morbilidad y el tiempo de ventilación mecánica. Las variables cuantitativas se expresaron como media con una desviación estándar; las cualitativas, como frecuencias absolutas o porcentajes. La comparación de medias se realizó con la t de Student. La asociación entre variables cualitativas se evaluó con el ji cuadrado. Resultados: Predominó el sexo masculino (58,4 %), edad media de 51,2 años y como mayor diagnóstico al ingreso, la sepsis (47,1 %). Se asociaron los valores elevados del ácido úrico a la mortalidad hospitalaria, la presencia del síndrome de daño múltiple de órganos (316,8 ± 165 mmol/L, p = 0,04) y al mayor tiempo de ventilación mecánica (307,3 ± 157 mmol/L, p = 0,016). Conclusiones: La asociación del ácido úrico sérico con la mortalidad y morbilidad, es evidente, en pacientes con afecciones clínicas graves y ventilación mecánica.

ABSTRACT Introduction: The oxidative process in severe clinically ill patient with mechanical ventilation, base the possible association of serum uric acid with mortality and morbidity. Objectives: To identify the possible association of serum uric acid with the mortality and morbidity of severe clinically ill patients with invasive mechanical ventilation. Methods: A longitudinal and prospective observational study was carried out in 89 patients with invasive mechanical ventilation, admitted to the intensive care unit of the Hospital "Dr. Luís Díaz Soto", from January 2000 to August 2007. On admission and for three consecutive days, the serum uric acid was determined with a Hitachi 902 microprocessor. The mean value was contrasted with mortality, morbidity, and mechanical ventilation time. Quantitative variables were expressed as mean and standard deviation; the comparison of means was made with Student's t test. Qualitative variables were expressed with absolute frequencies and percentages; the association was evaluated with the chi square. Results: Male sex predominated (58,4 %) and mean age of 51,2 ± 14,9 years. The most frequent diagnosis on admission was sepsis (47,1 %). The mortality was 59,6 % and 66,3% in the hospital. The higher value of uric acid was associated to hospital mortality, the multiple organ damage syndrome (316,8 ± 165 mmol/l p=0,04) and the longer mechanical ventilation time (307,3 ± 157 mmol/l p=0,016). Conclusions: The association of mortality and morbidity, with serum uric acid on admission, was evident in severe clinical patients with mechanical ventilation.

El tratamiento con Jusvinza disminuye la hiperinflamación y la hipercoagulación en pacientes críticos con la COVID-19

RESUMEN Introducción: La infección con el SARS-CoV-2 induce un estado protrombótico en los pacientes, atribuible a la combinación de la respuesta hiperinflamatoria y la hipoxia. En Cuba, se usa el fármaco Jusvinza, basado en un péptido inmunomodulador, para el tratamiento de los pacientes con la COVID-19, que presenten signos y síntomas de hiperinflamación. Objetivos: Describir la evolución clínica y las variaciones de biomarcadores asociados con la inflamación y la coagulación, en un grupo de pacientes críticos con la COVID-19, tratados con Jusvinza, en comparación con un grupo de pacientes que no recibieron tratamiento con este péptido. Métodos: Se incluyeron 40 pacientes críticos con la COVID-19; se dividieron en 2 grupos: 20 pacientes tratados con Jusvinza y 20 no fueron tratados con dicho péptido (grupo control). Las características demográficas, comorbilidades, signos vitales, parámetros respiratorios, biomarcadores de la inflamación y de la coagulación se obtuvieron a partir de las historias clínicas de cada paciente. Resultados: El tratamiento con Jusvinza indujo una mejoría clínica en los pacientes, asociada con la disminución de varios biomarcadores de la inflamación y la coagulación. La sobrevida de los pacientes tratados con Jusvinza fue significativamente superior a la sobrevida de los pacientes no tratados con este péptido. Conclusiones: Jusvinza es capaz de controlar la hiperinflamación y la hipercoagulación en pacientes críticos con la COVID-19.

ABSTRACT Introduction: Infection with SARS-CoV-2 induces a prothrombotic state in patients, by the combination of hyperinflammatory response and hypoxia. In Cuba, the drug called Jusvinza, based on an immunomodulatory peptide, is used for the treatment of patients with COVID-19, who present signs and symptoms of hyperinflammation. Objectives: To describe the clinical course and behavior of various biomarkers associated with the inflammation and coagulation, in a group of critically ill patients with COVID-19 treated with Jusvinza, compared to a group of patients who did not receive treatment with this peptide. Methods: 40 critically ill patients with COVID-19 were included. The patients were divided into 2 groups: 20 patients were treated with Jusvinza and 20 were not treated with this peptide (control group). Demographic characteristics, comorbidities, vital signs, respiratory parameters and inflammation and coagulation biomarkers were obtained from the medical records of each patient. Results: Treatment with Jusvinza induced a clinical improvement in the patients, associated with the decrease of several inflammation and coagulation biomarkers. Patients treated with Jusvinza had a significantly higher survival than patients not treated with this peptide. Conclusions: Jusvinza is able to control hyperinflammation and hypercoagulation in critical ill patients with COVID-19.

Evolución del paciente quirúrgico grave con ventilación mecánica en cuidados intensivos, según valor de creatininuria / Evolution of critically ill surgical patient with mechanical ventilation in intensive care, according the urine creatinine value

Introducción: El estado nutricional al ingreso influye en la evolución del paciente quirúrgico grave. La creatininuria, indicador de este estado, podría mostrar su posible asociación con la evolución de estos pacientes. Objetivos: Identificar la evolución de los pacientes quirúrgicos graves, con ventilación mecánica invasiva y su posible asociación con la creatininuria al ingreso. Métodos: Se realizó un estudio observacional descriptivo y longitudinal, en 85 pacientes quirúrgicos con ventilación mecánica invasiva, ingresados en la sala de cuidados intensivos, desde enero del 2000 a agosto del 2007. Se evaluó el índice APACHE II al ingreso y la creatininuria en la orina de 24 horas durante 3 días seguidos, con un equipo microprocesador Hitachi 902. El valor medio se contrastó con la mortalidad, morbilidad, estadía en cuidados intensivos y tiempo de ventilación mecánica. Las variables cuantitativas se expresaron como media, con desviación estándar y las cualitativas, como frecuencias absolutas o porcentajes. La comparación de medias se realizó con la t de Student. La asociación entre variables cualitativas se evaluó con ji cuadrado. Resultados: La edad media fue de 52,3 ± 15,8 años; el 54,1 por ciento correspondió al sexo masculino y el índice de APACHE II fue 20,4 ± 6 puntos. El diagnóstico más frecuente fue la peritonitis secundaria (49,4 por ciento). Los valores inferiores de creatininuria se asociaron a la mortalidad, presencia de complicaciones, mayor estadía en cuidados intensivos y del tiempo de ventilación mecánica. Conclusiones: La creatininuria al ingreso está asociada a la evolución de los pacientes quirúrgicos con ventilación mecánica invasiva(AU)

Introduction: The nutritional status at admission influences the evolution of the severely ill surgical patient. Urine creatinine, an indicator of this state, could show its possible association with the evolution of these patients. Objectives: To identify the evolution of critically ill surgical patients with invasive mechanical ventilation and its possible association with urine creatinine on admission. Methods: A descriptive and longitudinal observational study was carried out in 85 surgical patients with invasive mechanical ventilation, admitted to the Intensive Care Unit, from January 2000 to August 2007. The APACHE II index on admission and urine creatinine in the 24-hour urine for 3 consecutive days, with a Hitachi 902 microprocessor equipment. The mean value was contrasted with mortality, morbidity, stay in intensive care and time on mechanical ventilation. Quantitative variables were expressed as mean, with standard deviation, and qualitative variables, as absolute frequencies or percentages. The comparison of means was carried out with Student's t test. The association between qualitative variables was evaluated with chi square. Results: The mean age was 52,3 ± 15,8 years; 54,1 percent corresponded to the male sex and the APACHE II index was 20,4 ± 6 points. The most frequent diagnosis was secondary peritonitis (49,4 percent). Lower urine creatinine values ​​were associated with mortality, the presence of complications, a longer stay in intensive care and the time on mechanical ventilation. Conclusions: Urine creatinine on admission is associated with the evolution of surgical patients with invasive mechanical ventilation(AU)

Autopsias de pacientes con enfermedad respiratoria aguda / Autopsies of patients with acute respiratory disease

Introducción: La enfermedad respiratoria aguda es la entidad más frecuente en la vida del ser humano y las enfermedades respiratorias agudas se encuentran entre las causas de muerte. La autopsia es el mejor método del estudio del enfermo y su realización es una fortaleza del sistema de salud cubano. Objetivo: Determinar las características demográficas y morfológicas que se encontraron en las autopsias de fallecidos con enfermedad respiratoria aguda. Método: Se realizó un estudio descriptivo y de corte transversal, de los fallecidos a quienes se realizó autopsia, en el periodo de 1986 al 2019. Se estudiaron las variables edad, sexo, comorbilidades, causas de muerte y relación clínico - patológica. Resultados: La población quedó conformada por 390 autopsias que presentaban estas afecciones (2,5 por ciento). El grupo de edades entre 65 a 84 años fue el más afectado en ambos sexos. En las causas directas de muerte predominó la bronconeumonía bacteriana. Se destaca la elevada coincidencia en las causas directas de muerte y las discrepancias en las causas básicas. La línea de tendencia indica el incremento progresivo en el transcurso de los años estudiados. Conclusiones: Las características demográficas muestran que todos los grupos de edades están afectados, con predominio de 65 a 84 años, en ambos sexos. El pulmón fue el órgano más afectado en las causas directas de muerte, con predominio de la bronconeumonía, mientras que la mayoría presenta enfermedad respiratoria aguda como causa básica de muerte, con elevada discrepancia en su relación clínico patológica(AU)

Introduction: Acute respiratory disease is the most frequent entity in human life and acute respiratory diseases are among the causes of death. The autopsy is the best method of studying the patient and it is a strength of the Cuban health system. Objective: To determine the demographic and morphological characteristics found in the autopsies of the deceased with acute respiratory diseases. Method: A descriptive and cross-sectional study was carried out of the deceased who underwent autopsy, in the period from 1986 to 2019. The variables age, sex, comorbidities, causes of death and clinical-pathological relationship were studied. Results: The population was made up of 390 autopsies with these conditions (2.5 percent). The 65 to 84 age group was the most affected in both sexes. In direct causes of death, bacterial bronchopneumonia predominated. The high coincidence in the direct causes of death and the discrepancies in the basic causes stand out. The trend line indicates the progressive increase in the course of the years studied. Conclusions: The demographic characteristics show that all age groups are affected, with a predominance of 65 to 84 years, in both sexes. The lung was the most affected organ in direct causes of death, with a predominance of bronchopneumonia, while the majority had acute respiratory disease as the basic cause of death, with a high discrepancy in its clinical-pathological relationship(AU)

Caracterización de pacientes geriátricos con ventilación mecánica invasiva en cuidados intensivos / Characterization and evolution of the geriatric patient with invasive mechanical ventilation in intensive care unit

Introducción: La ventilación mecánica invasiva en pacientes geriátricos ingresados en las unidades de cuidados intensivos, es frecuente y tiene una letalidad elevada. Objetivos: Caracterizar a los pacientes geriátricos con ventilación mecánica invasiva y su evolución en la unidad de cuidados intensivos. Métodos: Se realizó un estudio descriptivo, en 149 pacientes geriátricos ingresados en la sala de cuidados intensivos. Las variables estudiadas fueron: edad, sexo, antecedentes patológicos personales, índices APACHE II y SOFA, perfil diagnóstico, diagnóstico al ingreso, aplicación de traqueostomía, tiempo de ventilación mecánica, estado al egreso y complicaciones. Se emplearon como medidas las frecuencias porcentajes; se evaluó la posible asociación entre las variables. Resultados: Predominó la edad de 70 a 79 años (44,9 por ciento) y el sexo masculino (53,7 por ciento). La mortalidad fue de 40,9 por ciento y se asoció a: valores elevados de los índices APACHE II y SOFA, pacientes quirúrgicos y tiempo de ventilación mecánica mayor de 7 días. Las complicaciones más frecuentes fueron: el síndrome de disfunción múltiple de órganos (23,4 por ciento), la neumonía asociada a la ventilación (22,8 por ciento) y la insuficiencia renal aguda (22,1 por ciento). Conclusiones: Los pacientes se caracterizan por el predomino del sexo masculino, edad menor de 80 años y presencia de enfermedades crónicas; el diagnóstico al ingreso más relevante, es el posoperatorio de afecciones quirúrgicas urgentes; la mortalidad se asociada al sexo femenino, al perfil quirúrgico, la gravedad de la enfermedad y el tiempo de ventilación mecánica. Las complicaciones se relacionan con la sepsis(AU)

Introduction: Invasive mechanical ventilation in geriatric patients admitted to intensive care units, is frequent and has a high lethality. Objectives: To characterize geriatric patients with invasive mechanical ventilation and their evolution in the intensive care unit. Methods: A descriptive study was carried out in 149 geriatric patients admitted to the intensive care unit. The variables studied were: age, sex, personal pathological history, APACHE II and SOFA indices, diagnostic profile, diagnosis on admission, application of tracheostomy, time of mechanical ventilation, status at discharge and complications. Percentage and frequencies were used as measurements; the possible association between the variables was evaluated. Results: The age of 70 to 79 years (44.9 percent) and the male sex (53,7 percent) predominated. Mortality was 40,9 percent and was associated with: elevated APACHE II and SOFA indices, surgical patients, and mechanical ventilation time greater than 7 days. The most frequent complications were: multiple organ dysfunction syndrome (23,4 percent), ventilator-associated pneumonia (22,8 percent) and acute renal failure (22,1 percent). Conclusions: The characteristics were: age less than 80 years, most were male sex, history of chronic diseases and in the diagnosis at admission, urgent surgical conditions. Mortality was associated with female sex, surgical profile, severity of the disease, and time on mechanical ventilation. Complications were related to sepsis (AU)

Os aspectos emocionais do lesado medular frente ao seu diagnóstico / The emotional aspects of the patients in front of the spinal Cord Injury diagnose

Introdução: A Lesão Medular (LM) é uma condição que afeta homens e mulheres, podendo ser traumática ou não, sendo ela grave e incapacitante. Objetivos: Compreender determinadas alterações emocionais para o indivíduo após receber esse diagnóstico. Participantes: 10 pacientes que passaram pelo Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo (CRER) e que atualmente estão, ou já estiveram, em acompanhamento ambulatorial. Análise de dados: Análise de Conteúdo de Laurence Bardin. Resultados: Revelaram-se as seguintes categorias relacionadas à lesão medular: humor (subcategoria: irritabilidade), autoestima, tristeza, esperança, reação ao diagnóstico, coping (subcategoria: dificuldade de aceitação do diagnóstico, adaptação e espiritualidade) e dependência do outro. Discussão e considerações finais: Dentro da população pesquisada, os participantes conseguiram desenvolver estratégias de enfrentamento funcionais e adaptativas, sendo a sintomatologia, em sua maioria, reativa

Introduction: Spinal cord injury is a condition that affects men and women, and it can be traumatic or not, being severe and disabling. Objectives: To understand certain emotional changes for the individual after receiving this diagnosis. Participants: 10 patients who went through the Dr. Henrique Santillo Rehabilitation and Readaptation post and who are currently or have been under outpatient follow-up. Data analysis: Content Analysis by Laurence Bardin. Results: The following categories related to spinal cord injury were revealed: mood (subcategory: irritability), self-esteem, sadness, hope, reaction to the diagnosis, coping (subcategory: difficulty in accepting the diagnosis, adaptation and spirituality) and dependence on the other. Discussion and conclusion: Within the researched population, the participants were able to develop functional and adaptive coping strategies, the symptoms being mostly reactive

Péptido inmunomodulador CIGB-258 para el tratamiento de pacientes graves y críticos con la COVID-19 / An immunomodulatory peptide CIGB-258 for the treatment of critical and severe COVID-19 patients

Introducción: El CIGB-258 es un péptido inmunomodulador con propiedades antiinflamatorias. Objetivos: Establecer la frecuencia de dosis y el tiempo de tratamiento con el péptido CIGB-258, para pacientes críticos con COVID-19. Además, definir los criterios de uso y el esquema terapéutico del péptido, para pacientes graves con COVID-19. Métodos: Se incluyeron 9 pacientes críticos y 3 pacientes graves. Las evaluaciones clínicas, radiológicas y de laboratorio se registraron de acuerdo al protocolo establecido. Se obtuvieron muestras de suero antes y después del tratamiento con la CIGB-258, para la determinación de los biomarcadores de la inflamación. Resultados: Se estableció el protocolo de actuación con el péptido CIGB-258, el cual consiste en la administración intravenosa de 1 mg del péptido cada 12 horas a los pacientes críticos. La dosis debe aumentarse a 2 mg cada 12 horas, para los pacientes que no muestren mejoría clínica y radiológica en 24 horas. Después de la extubación, los pacientes deben recibir 1 mg de CIGB-258 al día, durante otros tres días. Los pacientes graves deben recibir 1 mg de CIGB-258 cada 12 horas, hasta que resuelvan su condición clínica. Conclusiones: CIGB-258 mostró un buen perfil de seguridad. El protocolo de actuación establecido contribuyó a que todos los pacientes críticos se recuperaran de la dificultad respiratoria y fueran extubados. Los pacientes graves mejoraron considerablemente. Los niveles de los biomarcadores asociados con hiperinflamación y las citocinas disminuyeron significativamente durante el tratamiento(AU)

Introduction: CIGB-258 is an immunomodulatory peptide with anti-inflammatory properties. Objectives: To establish the therapeutic schedule with CIGB-258 peptide for COVID-19 critically ill patients. In addition, to define the criteria for use and schedule of this peptide for COVID-19 seriously ill patients. Methods: 9 critically ill patients and 3 seriously ill patients were included in this study. Clinical, radiological and laboratory evaluations were recorded according to the established protocol. Serum samples were obtained before and after treatment with CIGB-258, for the determination of the inflammation biomarkers. Results: The therapeutic protocol was established with the CIGB-258 peptide, which consists of intravenous administration of 1 mg of peptide every 12 hours for critically ill patients. The dose should be increased to 2 mg every 12 hours, for patients who do not show clinical and radiological improvement in 24 hours. After extubation, patients should receive 1 mg of CIGB-258 daily, for another three days. Seriously ill patients should receive 1 mg of CIGB-258 every 12 hours, until their clinical condition resolves. Conclusions: CIGB-258 showed an excellent safety profile. The established therapeutic protocol contributed to all critically ill patients recovering from respiratory distress and being extubated. Seriously ill patients improved considerably. The levels of the biomarkers associated with hyperinflammation and cytokines decreased significantly during treatment(AU)

Experiencia en autopsias de fallecidos con la COVID-19 en el Hospital Militar Central Dr. Luis Díaz Soto / Experience in autopsies of deceased with COVID-19 in the Central Military Hospital Dr. Luis Díaz Soto

Introducción: La autopsia es una fortaleza del sistema de salud cubano. Su realización con la metodología adecuada a fallecidos confirmados a la COVID-19 en el Hospital Militar Central Dr. Luis Díaz Soto, permitió su estudio más adecuado. Objetivo: Identificar las características demográficas, enfermedades concomitantes y alteraciones morfológicas encontradas en las autopsias de fallecidos confirmados a la COVID-19. Métodos: Se realizó un estudio descriptivo de las 10 autopsias parciales realizadas a fallecidos confirmados de la COVID-19 entre el mes de marzo y junio del 2020, de acuerdo a la metodología en la realización de estas autopsias en el proceso de enfrentamiento a esta enfermedad. Resultados: Al sexo masculino y al grupo de edades de 70 - 79 años correspondió el 60 por ciento de los casos estudiados. En las causas directas de muerte predominó la bronconeumonía bacteriana, como complicación del proceso producido por la COVID-19 y en relación con otras causas básicas. Los fallecidos presentaron entre 3 a 6 comorbilidades asociadas. Conclusiones: Los grupos de edades más afectados estuvieron entre 70 y 79 años con equivalencia en ambos sexos. Las comorbilidades contribuyen a empeorar el pronóstico de estos fallecidos, con predominio de la hipertensión arterial y la diabetes mellitus. Las manifestaciones de la respuesta inflamatoria sistémica se presentan como complicaciones en ellos. La mortalidad por la COVID-19 como causa de muerte afectó a menos de la mitad de los casos estudiados, con expresión respiratoria y cardiaca por la acción del virus(AU)

Introduction: The autopsy is a strength of the Cuban health system. Its implementation with the appropriate methodology to deceased confirmed to COVID-19 at the Central Military Hospital "Dr. Luis Díaz Soto", allowed their more adequate study. Objective: To identify the demographic characteristics, concomitant diseases and morphological alterations found in the autopsies of deceased confirmed to COVID-19. Methods: A descriptive study of the 10 partial autopsies performed on confirmed deaths of COVID-19 between March and June 2020 was carried out, according to the methodology used to carry out these autopsies in the process of coping with this disease. Results: The male sex and the age group 70 - 79 years corresponded to 60 percent of the cases studied. Bacterial bronchopneumonia predominated in direct causes of death, as a complication of the process produced by COVID-19 and in relation to other basic causes. The deceased had between 3 to 6 associated comorbidities. Conclusions: The age groups most affected were between 70 and 79 years old with equivalence in both sexes. Comorbidities contribute to worsening the prognosis of these deceased, with a predominance of arterial hypertension and diabetes mellitus. The manifestations of the systemic inflammatory response present as complications in them. Mortality from COVID-19 as a cause of death affected less than half of the cases studied, with respiratory and cardiac expression due to the action of the virus(AU)

Imagem corporal e sexualidade na infância: uma abordagem qualitativa / Body image and sexuality in children: a qualitative approach / Imagen corporal y sexualidad en la infancia: un enfoque cualitativo

A imagem corporal é conceituada como a representação do indivíduo para si. O cerne familiar, os meios sociais e a mídia podem ser listados como relevantes formadores de opinião e consequentes difusores de estereótipos e padrões de estética que se convertem em requisitos de aceitação e inclusão. O objetivo foi identificar referências de imagem corporal e sexualidade entre meninos e meninas de 6 a 11 anos. Os dados foram coletados através de grupos focais com amostras constituídas de quatro escolas públicas de Juiz de Fora/MG. Foram agrupadas categorias por temas similares de acordo com a técnica de Análise de Conteúdo Temática referente aos aspectos físicos, comportamentais e libidinais. Foi possível identificar falas de cunho sexual relacionadas à imagem corporal das crianças.

The body image is conceited as the individual representation for themselves. The familiar core, the social media and the media vehicles may be listed as the most relevant opinion shapers. They also can be consequent diffusers of stereotypes and beauty patterns that are converted into acceptance and inclusion requirements. The goal of this study was to identify references of body image and sexuality among boys and girls from 6 to 11 years old. The data were collected through focal groups from four municipal public schools of Juiz de Fora/MG. Categories were grouped by similar themes according to the technique of Content and Thematic Analysis, regarding to physical, behavioral and libidinous aspects. In these categories, it was possible identify sexual pronouncements related to the body image of the children.

La imagen corporal es conceptuada como la representación del individuo para sí. El núcleo familiar, los medios sociales y los vehículos mediáticos pueden ser listados como los formadores de opinión y difusores de estereotipos de estética que se convierten en requisitos de aceptación e inclusión. El objetivo fue identificar referencias de imagen corporal y sexualidad entre niños y niñas de 6 a 11 años. Los datos fueron recolectados a través de grupos focales de cuatro escuelas públicas de Juiz de Fora/MG. Se agruparon categorías por temas similares de acuerdo con la técnica de Análisis de Contenido Temático en lo concerniente a los aspectos físicos, comportamentales y libidinales. En estas categorías fue posible identificar los discursos sexuales relacionados con la imagen corporal de los niños.

Diphenyl Diselenide and Clotrimazole Co-loaded into Eudragit® RS 100 Nanocapsules Formulation Has Superior Antioxidant Potential and Promising Anti-candida Activity

Abstract In the current study, nanocapsules (NC) formulations containing a co-load of clotrimazole (C), a highly prescribed antifungal drug, and diphenyl diselenide [(PhSe)2], an organoselenium compound with a promising scope of pharmacological actions, were prepared. Formulations were characterized as well as the potential toxicity, antioxidant action, and antifungal effect were assessed using in vitro techniques. The NCs were prepared employing Eudragit® RS 100 as polymeric wall and medium chain triglycerides or virgin coconut oil (CO) as core. All NC suspensions had pH around acid range, compound content close to theoretical value (1 mg/mL/drug), average diameter in nanometric range, positive values of zeta potential as well as high encapsulation efficacy and mucoadhesive property. Physicochemical stability was performed over a 30-day period and showed no modification in the aforementioned parameters to all samples. Preliminary screening of toxicological potential performed by the hen's egg test chorioallantoic membrane technique classified the formulations as non-irritant. The DPPH radical assay revealed that nanoencapsulated compounds had superior antioxidant action in comparison to their free forms (concentration range tested 1.0-25.0 µg/mL). Importantly, the formulation composed of CO and containing C and (PhSe)2 showed the highest antioxidant potential and was selected for further investigation regarding antifungal effect against some Candida spp strains. Results of in vitro antifungal assay demonstrated that the C and (PhSe)2 co-encapsulation had a minimum inhibitory concentration (MIC) values around 60. Thus, our study supplies additional data about advantages achieved by encapsulating active compounds.

Implication of the fecal egg count reduction test (FECRT) in sheep for better use of available drugs / Implicação do teste de redução da contagem de ovos nas fezes (TRCOF) em ovinos para melhor uso dos anti-helmínticos disponíveis

Abstract The aim here is to present data on the efficacy of anthelmintics in sheep flocks in Rio de Janeiro, Brazil, and to discuss the interpretation of the fecal egg count reduction test (FECRT) for each nematode genus. Fecal eggs counts and pre- and post-treatment coprocultures were performed, the former to evaluate the efficacy of and the latter to determine the overall parasite prevalence. An additional efficacy test was performed at Farm # 1 a year after the initial test. Severe anthelmintic resistance was found for the flocks, with no FECRT sensitivity at any of the 22 farms evaluated. However, an analysis of the infective larvae showed that some drugs were effective against certain parasitic genera; i.e., levamisole was more effective against Haemonchus spp. and moxidectin against Trichostrongylus spp. In the additional FECRT performed at Farm # 1, moxidectin and nitroxynil were ineffective separately, but when applied in combination they were highly effective due to their efficacy against Haemonchus (nitroxynil) and Trichostrongylus (moxidectin), respectively. The use of the FECRT targeting the parasitic nematode species prevalent on farms may make it possible to choose more effective anthelmintics.

Resumo O objetivo deste trabalho foi apresentar dados sobre a eficácia de anti-helmínticos em rebanhos ovinos no Rio de Janeiro, Brasil, e discutir a interpretação do teste de redução da contagem de ovos nas fezes (TRCOF) para cada gênero de nematoide. A contagem de ovos fecais (OPG) e coprocultura pré e pós-tratamento foram realizadas para avaliar a eficácia e a prevalência geral do parasito, respectivamente. Um teste de eficácia adicional foi realizado na Fazenda # 1 após um ano do teste inicial. Resistência anti-helmíntica grave foi encontrada, não havendo sensibilidade no TRCOF em nenhuma das 22 fazendas avaliadas. No entanto, na análise das larvas infectantes observou-se que algumas drogas foram eficazes contra certos gêneros parasitários; por exemplo, o levamisol foi mais eficaz contra Haemonchus spp. e a moxidectina contra Trichostrongylus spp. No TRCOF adicional realizado na Fazenda 1, a moxidectina e o nitroxinil foram ineficazes separadamente, mas quando aplicados em combinação, foram altamente eficazes devido à sua eficácia contra Haemonchus spp. (nitroxinil) e Trichostrongylus spp. (moxidectina), respectivamente. O TRCOF visando às espécies de nematoides parasitas prevalentes nas fazendas pode possibilitar a escolha de anti-helmínticos mais eficazes.