Sólo soy un ama de casa / I'm just a housewife

El objetivo de este trabajo fue describir y profundizar la vivencia de las mujeres en su rol como amas de casa (AC). Es un estudio cualitativo, fenomenológico con mirada etnográfica. Se realizaron veinte entrevistas semiestructuradas analizadas en profundidad, familigramas y ecomapas, a AC de 29 y 61 años seleccionadas en forma intencional y por conveniencia en una población rural y otra urbana. Ama de casa y nada más: Las AC están pendientes de aquellos que las rodean, "sos maestra, cocinera, costurera, un montón de cosas…". Aunque su dedicación es de tiempo completo, su relato finaliza con "(…) nada más (…)". Nunca termina: Un día de las AC resulta agotador, "siempre hay cosas para hacer". ¿Atrapadas sin salida?: El tiempo libre es gestionado de diferente manera. Algunas no cuentan con este momento por la dificultad que tienen para delegar tareas, "sin mí no son nada". Quisiera ser…: varias no pudieron proyectarse más allá del día a día, otras expresaron sentimientos de resignación y algunas se vieron esperanzadas en realizar nuevas actividades. "La que no puede enfermarse soy yo": Nadie las sustituye en su trabajo, remarcando tener que estar 100 % disponibles para sus familias. "Se dice de mi": Se sienten valoradas por su familia, no socialmente, haciendo referencia al machismo predominante, "los hombres creen que es muy fácil". Es un trabajo invisible que se valora cuando está ausente. Creemos que, como Médicos de Familia podemos intervenir brindando un refuerzo positivo en cada consulta, empoderándolas, reconociendo que su trabajo es importante y valioso (AU)

The objective of this research was to describe and deepen into the experience of women in their role as housewives (HW). It is a qualitative, phenomenological research with an ethnographic view, based on 20 semi-structured interviews analyzed in depth, with family genograms and ecomaps, from HW between 29 and 61 years old, selected intentionally and for convenience, on a rural and a urban scenary. Housewife and nothing else: The HWs are aware of those around them, "you're a teacher, cooker, seamstress, a lot of things ...". Although their dedication is full time, their story ends with "(...) nothing else (...)". It never ends: A HW's day is exhausting, "there're always things to do." Caught with no way out?: Free time is managed in different ways. Some do not have this moment, because of the difficulty to delegate tasks, "without me they're nothing". I would like to be ...: many of them could not project beyond their rutine, others expressed feelings of resignation and some were hopeful at performing new activities. "The only one who can't get sick is me": No one substitutes them in their work, they have to be a 100% available for their families. "It's said of me": They feel valued by their families, not socially, referring to the predominant machismo, "men believe it's very easy." It's an invisible work that's valued when it's absent. We believe that, as Family Physicians, we can intervene by providing positive reinforcement in each consultation, empowering them, recognizing that their work is important and valuable (AU)

Progesterone and estradiol receptors and Ki-67 in the superficial and deep infiltrating endometriosis / Receptores de progesterona e estradiol e Ki-67 no estroma e no epitélio de endometriose superficial e profunda

ABSTRACT Introduction: Endometriosis is a hormone-dependent disease characterized by ectopic presence of endometrial tissue responsive to ovarian steroids. Estrogen and progesterone are the main regulators of endometrial tissue, and the expression of receptors of these hormones in the ectopic tissue seems to be related to the pathophysiology of the disease. Ki-67 is a marker of tissue proliferation and an important marker of epithelial kinetics. Endometriosis can be classified as superficial, in the peritoneum, and deep, when it extends into ligaments and other organs. Objective: Our objective was to analyze the expression of estrogen and progesterone receptors and Ki-67, through immunohistochemistry, in different sites of endometriosis tissues (superficial peritoneal/ovarian endometriosis and deep infiltrating endometriosis). Casuistic and methods: We studied nine patients; five with superficial and four with deep endometriosis. Statistical correlation was performed with the Shapiro-Wilk test (significance level of 5%) and linear correlation analysis using Spearman's non-parametric test (significance of 1%). There was a correlation of Spearman between the estrogen receptor variable and Ki-67 in patients with superficial endometriosis. There was also a correlation between the variables estrogen receptor and progesterone receptor in patients with deep endometriosis. Results: Contrary to what was found for superficial endometriosis, there is linear increase of the variables, with a strong and positive correlation coefficient. This demonstrates that the variation of estrogen receptors can be explained in 99.1% by the same variation of progesterone receptors in deep endometriosis. Conclusion: It is possible to infer that other factors are involved in the response to hormonal variations for superficial and deep endometriosis.

RESUMEN Introducción: Endometriosis es una enfermedad dependiente de hormonas que se caracteriza por la presencia ectópica de tejido endometrial sensible a los esteroides del ovario. El estrógeno y la progesterona son los principales reguladores del tejido endometrial, y la expresión de receptores de esas hormonas en el tejido ectópico parece tener conexión con la fisiopatología de la enfermedad. El Ki-67 es un marcador de proliferación tisular y de la cinética epitelial. La endometriosis puede ser clasificada en superficial y profunda, alcanzando ligamentos y otros órganos. Objetivo: El objetivo de este estudio fue analizar la expresión de los receptores de estrógeno y progesterona y Ki-67, mediante inmunohistoquímica en endometriosis superficial peritoneal/ ovárica y endometriosis infiltrativa profunda. Casuística y métodos: Estudiamos nueve casos: cinco de endometriosis superficial y cuatro de endometriosis profunda. La correlación estadística fue realizada con el test de Shapiro-Wilk (nivel de significación del 5%), y el análisis de correlación linear, por la prueba no paramétrica de Spearman (nivel de significación del 1%). Hubo correlación de Spearman entre la variable receptor de estrógeno (RE) y Ki-67 en pacientes con endometriosis superficial, y entre las variables RE y receptor de progesterona (RP) en pacientes con endometriosis profunda. Resultados: Al contrario de lo que se ha encontrado para endometriosis superficial, hay aumento lineal de las variables, con coeficiente de correlación fuerte e positivo. Eso demuestra que la variación de los receptores para estrógeno puede ser explicada en el 99,1% por la misma variación de los RP en la endometriosis profunda. Conclusión: Es posible deducir que otros factores estén involucrados en las diferentes respuestas hormonales para endometriosis superficial y profunda.

RESUMO Introdução: Endometriose é doença hormônio-dependente caracterizada pela presença ectópica de tecido endometrial responsivo aos esteroides ovarianos. O estrogênio e a progesterona são os principais reguladores do tecido endometrial, e a expressão de receptores desses hormônios no tecido ectópico parece ter relação com a fisiopatologia da doença. O Ki-67 é um marcador de proliferação tecidual e importante sinalizador da cinética epitelial. A endometriose pode ser classificada em superficial e profunda, atingindo ligamentos e outros órgãos. Objetivo: O objetivo deste estudo foi analisar a expressão dos receptores de estrógeno e progesterona e Ki-67, por meio de imuno-histoquímica em endometriose superficial peritoneal/ovariana e endometriose infiltrativa profunda. Casuística e métodos: Estudamos nove casos, cinco de endometriose superficial e quatro de endometriose profunda. A correlação estatística foi efetuada com os testes de Shapiro-Wilk (nível de significância 5%) e a análise de correlação linear, pelo teste não paramétrico de Spearman (1% de significância). Houve correlação de Spearman entre a variável receptor de estrogênio (RE) e Ki-67 em pacientes com endometriose superficial e entre as variáveis RE e receptor de progesterona (RP) em pacientes com endometriose profunda. Resultados: Ao contrário do que foi encontrado para endometriose superficial, há o aumento linear das variáveis, com coeficiente de correlação forte e positivo. Isso demonstra que a variação dos receptores para estrogênio pode ser explicada em 99,1% pela mesma variação dos RP na endometriose profunda. Conclusão: É possível inferir que estejam envolvidos outros fatores nas diferentes respostas hormonais para endometriose superficial e profunda.

Gene expression analysis identifies hypothetical genes that may be critical during the infection process of Xanthomonas citri subsp. citri

Background: Gene expression analysis via microarray is widely used in phytobacteria to validate differential gene expression associated with virulence or to compare biological profiles of wild type and mutant strains. Here, we employed DNA microarrays to study the early stages of the infection process (24, 72 and 120 h post-inoculation) of Xanthomonas citri subsp. citri (Xac) infecting Citrus sinensis to interrogate the expression profiles of hypothetical genes. Results: Under infective conditions, 446 genes were up- and 306 downregulated. Outstanding among genes upregulated during infection were those involved in synthesizing the Type 3 Secretion System and effectors, xanthan gum and quorum-sensing induction, and flagellum synthesis and regulation. Additionally, 161 hypothetical genes were up- and 100 were downregulated, 49 of which are known to have a significant biological role. To understand hypothetical gene co-regulation or -expression, nine expression profiles including 158 genes were identified during the three infection phases. Of these, 47 hypothetical genes were identified as having expression profiles associated with at least one connected to a gene associated with adaptation and virulence. Conclusions: Expression patterns of six differentially expressed genes were validated by quantitative reverse transcription polymerase chain reaction, thus demonstrating the effectiveness of this tool in global gene expression analysis in Xac.

Mientras haya vida, hay todo: una mirada en la sexualidad del adulto mayor / While there is life, there is everything: a look at the elderly sexuality

Introducción.Desde un punto de vista integral, la sexualidad comprende aspectos de orden biopsicosocial. Los prejuiciosy el desconocimiento llevan a evitar hablar sobre este tema en la consulta con el adulto mayor (AM).Objetivo.Profundizar en la vivencia de la sexualidad del AM.Metodología.Estudio cualitativo, fenomenológico, realizado en dos centros de actividades recreativas para AM en SanMiguel de Tucumán, que incluyó 13 entrevistas semiestructuradas en profundidad a pacientes mayores de 60 años, 11 desexo femenino, seleccionados en forma intencional y por conveniencia en Agosto de 2018.Resultados.Existe una dicotomía entre quienes hablan del tema y quienes no; sin embargo, todos expresan el deseode naturalizarlo tanto en su círculo social como en la consulta médica. Los AM aceptan el proceso de envejecimiento,tienen una autopercepción positiva de su imagen y pese a los prejuicios, experiencias, comorbilidades y adversidades, seadaptan buscando formas para sentirse bien y disfrutar de una sexualidad plena.Conclusión.El envejecimiento y la sexualidad son conceptos dinámicos que confluyen con las experiencias de vida.Creemos que como médicos de familia es importante brindar una atención integral, abordando las diferentes dimensionesdel ser humano, incluyendo su sexualidad. (AU)

Introduction.Sexuality from an integral point of view includes aspects of biopsychosocial order. Prejudice and ignorancelead to avoid talking about this topic in the medical consultation with the Eldery.Objective.To deepen the experience of the sexuality of the Eldery.Methodology.Qualitative, phenomenological study, conducted in two centres of recreational activities for Senior Citizensin San Miguel de Tucumán, which included 13 in-depth semi-structured interviews to patients over 60 years of age, 11female, selected intentionally and for convenience in August 2018.Results.There is a dichotomy between those who talk about the subject and those who do not; however, all of themexpress the desire to naturalize it in both, their social circle and the medical consultation. The eldery patients acceptthe ageing process, have a positive self-perception of their image and despite prejudices, experiences, comorbidities andadversities, they adapt looking for ways to feel good and enjoy a full sexuality.Conclusion.Aging and sexuality are dynamic concepts that converge with life experiences. We believe that, as familydoctors, it is important to provide comprehensive care, addressing the different dimensions of the human being, wheresexuality is included. (AU)

Asociación entre enfermedad periodontal y disfunción endotelial valorada por vasodilatación mediada por flujo en la arteria braquial: Estudio piloto / Association between periodontal disease and endothelial dysfunction assessed by flow-mediated dilation in the brachial artery: Pilot study

Objetivo: evaluar la disfunción endotelial a través de la vasodilatación mediada por flujo (VMF) en la arteria braquial en pacientes fumadores con periodontitis crónica avanzada y compararla con pacientes fumadores sin enfermedad periodontal, para determinar si hay diferencias en cuando a disfunción endotelial entre quienes presentan o no periodontitis crónica avanzada. Métodos: se incluyeron 30 pacientes con hábito de tabaquismo, 15 con periodontitis crónica avanzada y 15 sin periodontitis. Se realizó historia clínica completa, exámenes de laboratorio y prueba de vasodilatación mediada por flujo de la arteria braquial. Resultados: el estudio mostró que había diferencias significativas en los diámetros finales, resultantes de vasodilatación mediada por flujo (p=0,0328), con menores valores finales para quienes tenían enfermedad periodontal. Las diferencias en las respuestas porcentuales y en el número de personas con disfunción determinada dicotómicamente, no alcanzaron significación estadística. Conclusión: se observó que el grupo de pacientes con periodontitis crónica avanzada tuvo diámetros resultantes luego de la prueba que fueron significativamente menores que los del grupo de controles. Aunque al evaluar las diferencias en porcentajes no se alcanzó significación estadística, el estudio mostró una respuesta claramente menor en vasodilatación en el grupo con enfermedad periodontal.

Objective: To evaluate endothelial dysfunction through flow-mediated vasodilation (FMD) in the brachial artery in smokers with advanced chronic periodontitis and compare it with smokers without periodontal disease, to determine whether there are differences in endothelial dysfunction among those with or without advanced chronic periodontitis. Methods: We included 30 patients with smoking habit, 15 with advanced chronic periodontitis and 15 without periodontal disease. We performed a complete medical history, laboratory tests and flow-mediated vasodilation test of the brachial artery. Results: The study showed that there were significant differences in the final diameters, resulting from flow-mediated dilation (p = 0.0328), with lower final values for those with periodontal disease. The differences in the percentage responses and the number of people with specific dysfunction determined dichotomously did not reach statistical significance. Conclusion: We observed that the group of patients with advanced chronic periodontitis had after the test resulting diameters that were significantly lower than those in the control group. Although when evaluating differences in percentages no statistical significance was found, the study showed a clearly lower response in vasodilation in the group with periodontal disease.

Intrusismo en la especialidad de ortodoncia: un problema ético / Intrusion in the specialty of orthodontics: an ethical problem

Inmersos en una sociedad cada vez con más exigencia estéticas, el tratamiento de Ortodoncia es solicitado con mayor frecuencia en las consultas odontológicas. El paciente requiere y confía en el profesional de la salud para devolver tanto estética como función. El dilema se plantea cuando profesionales en el área de la salud e incluso personas ajenas a este medio, sin la debida formación y capacitación realizan este tipo de tratamiento; que indudablemente debe estar en manos de los especialistas.El objetivo del presente artículo es realizar una descripción de las diferentes dimensiones en las que está inmerso el intrusismo, así como realizar un llamado a la reflexión de los diferentes actores involucrados

Expression of SMAD proteins, TGF-beta/activin signaling mediators, in human thyroid tissues / Expressão de proteínas SMAD, mediadores da sinalização de TGF-beta/activina, em tecidos de tiroide humana

OBJECTIVE: To investigate the expression of SMAD proteins in human thyroid tissues since the inactivation of TGF-β/activin signaling components is reported in several types of cancer. Phosphorylated SMAD 2 and SMAD3 (pSMAD2/3) associated with the SMAD4 induce the signal transduction generated by TGF-β and activin, while SMAD7 inhibits this intracellular signaling. Although TGF-β and activin exert antiproliferative roles in thyroid follicular cells, thyroid tumors express high levels of these proteins. MATERIALS AND METHODS: The protein expression of SMADs was evaluated in multinodular goiter, follicular adenoma, papillary and follicular carcinomas by immunohistochemistry. RESULTS: The expression of pSMAD2/3, SMAD4 and SMAD7 was observed in both benign and malignant thyroid tumors. Although pSMAD2/3, SMAD4 and SMAD7 exhibited high cytoplasmic staining in carcinomas, the nuclear staining of pSMAD2/3 was not different between benign and malignant lesions. CONCLUSIONS: The finding of SMADs expression in thyroid cells and the presence of pSMAD2/3 and SMAD4 proteins in the nucleus of tumor cells indicates propagation of TGF-β/activin signaling. However, the high expression of the inhibitory SMAD7, mostly in malignant tumors, could contribute to the attenuation of the SMADs antiproliferative signaling in thyroid carcinomas.

OBJETIVO: Investigar a expressão de proteínas SMAD em tecidos de tiroide humana desde que a inativação dos componentes da sinalização de TGF-β/activina é relatada em diversos tipos de câncer. SMAD 2 e SMAD3 fosforilados (pSMAD2/3) associados com SMAD4 induzem a transmissão do sinal gerado por TGF-β e activina, enquanto SMAD7 inibe essa sinalização intracelular. Embora TGF-β e activina exerçam efeitos antiproliferativos nas células foliculares da tiroide, tumores de tiroide expressam altos níveis dessas proteínas. MATERIAIS E MÉTODOS: A expressão proteica de SMADs foi avaliada em bócio multinodular, adenoma folicular, carcinomas papilífero e folicular por imuno-histoquímica. RESULTADOS: A expressão de pSMAD2/3, SMAD4 e SMAD7 foi observada tanto em tumores benignos como malignos da tiroide. Embora pSMAD2/3, SMAD4 e SMAD7 exibissem alta positividade citoplasmática em carcinomas, a positividade nuclear de pSMAD2/3 não foi diferente entre lesões benignas e malignas da tiroide. CONCLUSÕES: O achado da expressão de SMADs em células tiroidianas e a presença das proteínas pSMAD2/3 e SMAD4 no núcleo de células tumorais indicam propagação da sinalização TGF-β/activina. Contudo, a alta expressão de SMAD7 inibitório, principalmente em tumores malignos, poderia contribuir para atenuação da sinalização antiproliferativa de SMADs em carcinomas de tiroide.

Distribution and biological role of the oligopeptide-binding protein (OppA) in Xanthomonas species

In this study we investigated the prevalence of the oppA gene, encoding the oligopeptide binding protein (OppA) of the major bacterial oligopeptide uptake system (Opp), in different species of the genus Xanthomonas. The oppA gene was detected in two Xanthomonas axonopodis strains among eight tested Xanthomonas species. The generation of an isogenic oppA-knockout derivative of the Xac 306 strain, showed that the OppA protein neither plays a relevant role in oligopeptide uptake nor contributes to the infectivity and multiplication of the bacterial strain in leaves of sweet orange (Citrus sinensis) and Rangpur lime (Citrus limonia). Taken together these results suggest that the oppA gene has a recent evolutionary history in the genus and does not contribute in the physiology or pathogenesis of X. axonopodis.

Los exámenes orales y escritos analizados desde una óptica bioética en el ámbito universitario / The oral and written examinations bioethics analyzed from a perspective within the university

El presente artículo está orientado a analizar la presentación de exámenes orales y escritos dentro del ámbito universitario, haciendo énfasis en los Principios Bioéticos que deben prevalecer durante el desarrollo de los mismos, el papel del Docente al aplicar exámenes orales o escritos, cómo puede variar la actitud del Docente de acuerdo a la Pedagogía Tradicional en Ciencias de la Salud, la tipología de profesores que pueden incidir positiva o negativamente en la presentación de exámenes y en el rendimiento académico, incidentes incorrectos que se han evidenciado durante exámenes orales, así como las consecuencias que la manipulación dentro de la Universidad puede tener en el desempeño del futuro profesional

This article analyzes oral and writing exams in University, emphasizing the Bioethical Principles that must prevail during the exam, teacher´s role when he applies writing or oral exams, teachers´ attitude variation according to Traditional Teaching in Health Sciences, teachers´ typology which could influence negatively or positively in exams presentation and academic scores, wrong incidents that have been evidenced during oral exams, and the consequences that manipulation into the University can have in the performance of the future professional

Análisis bioético de un paciente con un caso clínico periodoncia ortodoncia / Bioethical Analysis of a patient with a clinical periodontology orthodontics

En el ejercicio diario, nos enfrentamos con situaciones en las cuales debemos aplicar no solamente nuestros conocimientos científicos y técnicos que competen a la odontología, sino también nuestra condición humana y vocación de servicio para atender, con responsabilidad y ética profesional, a nuestros pacientes. El propósito de este estudio surgió para concientizar la importancia de conocer los principios bioéticos, así como la actitud integral del odontólogo general y el especialista cuando se presenta un paciente por primera vez o de emergencia a la consulta, y atenderlo no solo por la "emergencia" por la cual asiste, sino como un ser bio-psico-social. En nuestro caso, si el odontólogo general se hubiese limitado a atender al paciente solo por la emergencia que presentó y no hubiese orientado al paciente desde los principios bioéticos de benevolencia, beneficencia, no maleficencia, autonomía, consentimiento informado de tipo verbal y remitido al periodoncista, el paciente hubiese seguido en desconocimiento del estado real de sus condiciones bucales, evitando consecuencias indeseables. Los procedimientos básicos realizados en este artículo fueron la revisión bibliográfica y el estudio clínico del caso.Igualmente hacemos énfasis en realizar todos los estudios diagnósticos necesarios para realizar nuestro protocolo de tratamiento, ya que si no diagnosticamos correctamente, no podremos planificar el tratamiento correctamente y remitirlo al especialista si lo requiere. Concluimos en este estudio la importancia a que, tanto odontólogos generales como especialistas, aprendan a ver al paciente como un ser integral bajo los principios bio-éticos y aplicar el consentimiento informado de manera habitual en nuestra consulta

In exercising daily, we are faced with situations in which we must apply not only our scientific and technical knowledge that fall within dentistry, but also our human condition and vocation of service to meet with responsibility and professional ethics, to our patients.The purpose of this study was to raise awareness of the importance of knowing the bio-ethical principles, as well as the attitude and parcel of clinicians and experts when a patient presents for the first time or emergency consultation, and caring not only for the "Emergency" by which assists, but like a bio-psycho-social. In our case, if the general dentist had been limited to meet the patient only by the emergency and had not submitted oriented to the patient from the bioethical principles of benevolence, charity, not maleficencia, informed consent type of verbal and sent to periodontist The patient had remained in ignorance of the real state of their oral conditions, avoiding undesirable consequences. The basic procedures in this article were the literature review and clinical study of the case. Likewise make all the emphasis on conducting diagnostic studies needed to carry out our treatment protocol, because if not properly diagnose, treat, we can't plan properly and know refer to a specialist if required. We conclude this study in the importance to both general dentists and specialists, learn to see the patient as an integral be under the bio-ethical principles and applying the informed consent on a regular basis in our consultation

La bioetica: salud de la cultura

El propósito de este ensayo es resaltar la importancia que tiene la bioética en el campo de la salud y así poder crear una cultura de salud. En la medida en que todos los deberes y derechos del ser humano se refieren a su persona, y la asistencia como principio fundamental de la bioética, corresponderá definir a esta disciplina por su objeto formal, como ciencia de la salud de la cultura. La bioética, como toda ciencia, profundiza en el estudio de los principios y en su aplicación. Debe conocer los fundamentos teóricos, y los mecanismos por los que los ordenamientos teóricos se articulan con los hechos fenomenológicos, los principios con los criterios, la verdad con su significado. El principio de asistencia actuaría respecto al criterio asistencial de modo similar al que lo hace la moral, respecto a la ética de los actos humanos concretos. La ética, que se refiere a una determinada actividad humana, debe correlacionarse con el criterio asistencial presente en todos los actos humanos. En todos estos actos, tendrán un carácter ético. Se proyectan en un criterio asistencial, práctico y concreto, adecuado a un ordenamiento moral de referencia.

The subject or purpose of this essay is to emphasize the importance of Bioethics in the area of health in order to create a culture of health. To the point that the duties and the rights of all human beings refer to the person, and assistance as a fundamental principle of bioethics, it will mean defining this discipline by its formal object, as a science of the health of the culture. Bioethics as do all sciences, delves deeply into the study of principles and their application. It should know the theoretical foundations and the mechanisms by which the theoretical propositions are compatible with phenomenological facts, the principles with the criteria, and the truth with its meaning. The assistance principle will behave in reference to the assistance criteria as the moral, criteria do concrete human acts. Ethics, which refers to a predetermined human activity, must be related to the assistance criteria present in all human acts. In all of theses acts they will have an ethical character. They project themselves on assistance criteria, practical and concrete, adapted to of a moral order of reference.

La bioetica y sus principios

El propósito de este artículo esta orientado a dar a conocer los principios de la bioética según Beauchamp y Childress (beneficencia, no-maleficencia, autonomía y justicia), con el objeto de proponer elementos para resolver situaciones dilemáticas que se presentan en la práctica odontológica, al permitir un enfoque orientado a la solución del problema y sustentar los argumentos que defiendan ciertas posiciones. Para su elaboración se recurrió a la revisión bibliográfica utilizando posteriormente el método como la reflexión y el análisis. Se concluyó que el reto en la labor del odontólogo consiste en imprimir a su quehacer clínico y profesional un sentido ético, en tanto y en cuanto permita al paciente alcanzar su fin último en la vida, que es la felicidad, no sólo porque alivia el dolor y así se aproxima a ella, sino porque contribuye dándole un sentido que le serena y tranquiliza; en la medida de lo posible el odontólogo virtuoso ha de tratar de ayudar al paciente a ser feliz, a través de un cambio cualitativo del dolor, sujetándose a la benevolencia y demás principios de la bioética.

The intention of this article consisted of presenting the principles the bioethical according to Beauchamp and Childress (charity, not-slander, autonomy and justice), with the intention of trying to solve difficult situations that appear actually odontologycal, when allowing a oriented approach the solution of the problem and sustaining the arguments that defend certain positions. The made procedures were bibliographical revision and the method consists of the reflection and the analysis. One concluded that the challenge in the work of the odontologist consists of turning its clinical and professional task an ethical task, as much and as soon as allows the patient to reach its last aim in the life, that is the happiness, not only because it alleviates the pain and thus it comes near her, but because it contributes giving a sense him that calm him and it tranquilizes; as far as possible the virtuous odontologist has to try to help the patient to be happy, through a qualitative change of the pain to something next with the benevolence and other principles of the bioethical.

Consentimiento informado de interés para el odontólogo

El presente estudio tiene como propósito dar a conocer algunas generalidades sobre la aplicación del consentimiento informado en el campo odontológico. Luego de la revisión bibliográfica, la cual se realizó en primera instancia de los clásicos de bioética y posteriormente desde el año 2000 hasta el año 2007, se concluyó: el consentimiento informado debe ser una consecuencia de una buena relación odontólogo-paciente u odontólogo-representante; el paciente debe decidir en base a sus propios valores y prioridades, en forma libre y exento de manipulación y coacción, el derecho de la autonomía del paciente se reconoce a través del consentimiento informado. Las referencias teóricas sobre el C.I. en el área odontológica son escasas, por lo cual es necesario incluir en el plan de estudios de las instituciones, los aspectos inherentes a los principios éticos y legales en del C.I.

this study aims to raise awareness of some generalities on the application of informed consent in area odontological. Following the literature review which took place in the first instance of the classics of bioethics and then from 2000 until 2007, concluded: C.I. must be the result of a good relationship Dental representative or dentist-patient, the patient must decide based on their own values and priorities, in a free and free of coercion and handling, the right of autonomy of the patient is recognized through the C.I. theoretical references on C.I. odontological in the area are scarce, making it necessary to include in the curriculum of institutions, aspects inherent in the legal and ethical principles of C.I.

Nódulos reumatóides pulmonares precedendo o aparecimento de artrite / Pulmonary rheumatoid nodules preceding arthritis development

A artrite reumatóide é uma doença sistêmica, de causa desconhecida e de natureza auto-imune. A característica clínica principal é a poliartrite crônica, em geral envolvendo pequenas e grandes articulações, com tendência a deformidades e incapacidades. A presença de nódulos subcutâneos pode ser parte da apresentação clínica e tem histopatologia típica. O comprometimento visceral pode incluir os pulmões, vasos, pericárdio etc. O envolvimento pulmonar pode se apresentar com derrame pleural, bronquiolite, vasculite pulmonar e mais raramente nódulos reumatóides. O desenvolvimento clássico é o dos envolvimentos viscerais após o aparecimento da artrite. Os nódulos reumatóides pulmonares têm baixa prevalência. Seu desenvolvimento precedendo a artrite acrescenta interesse ao assunto. Relata-se um caso de paciente do sexo feminino com nodulose reumatóide pulmonar que precedeu o envolvimento articular.

Rheumatoid arthritis is a systemic disease of unknown cause and autoimune disease mechanisms. Its main clinical feature is a chronic polyarthritis involving large and small joints that may cause deformities and disabilities. Subcutaneous nodules can be part of the clinical presentation with a typical pathological appearance. Visceral involvement may include lungs, pericardium, and blood vessels. Pulmonary involvement is characterized by pleural effusions, vasculitis, bronchiolitis and pulmonary rheumatoid nodules. Usually, visceral manifestations appear after arthritis development. Pulmonary rheumatoid nodules are a rare feature. Its development preceding arthritis make this characteristic even more interesting. Our case report refers to a female patient with pulmonary rheumatoid nodules that has preceded the arthritis.

Sudden infant death syndrome in Brazil: fact or fancy?

CONTEXT AND OBJECTIVE: The true incidence of sudden infant death syndrome (SIDS) in Brazil is unknown. The aim here was to identify SIDS cases in the city of Ribeirão Preto, State of São Paulo, between 2000 and 2005, in order to estimate its incidence. DESIGN AND SETTING: Retrospective analysis of data on live births and infant deaths in Ribeirão Preto and from autopsies of infants performed at the Death Verification Service of the Interior (SVOI) between 2000 and 2005. RESULTS: There were 47,356 live births and 537 deaths, with infant mortality rates ranging from 12.9‰ to 10.9‰ of live births. Among the 24 infants who died possibly due to SIDS and who were autopsied at the SVOI, six were from families living in the municipality (0.13‰ of live births): three (50 percent) were diagnosed as SIDS, and one each (16.66 percent) as indeterminate cause, bronchoaspiration and cerebral edema. Two deaths occurred in the first month of life (33.33 percent) and one each (16.66 percent) at two, four, six and eight months. Two deaths each (33.33 percent) occurred in the months of February and December, one each in August and October (16.66 percent). Four cases (66.7 percent) occurred in the summer and one each (16.66 percent) in winter and spring. There was 5:1 predominance of males over females. CONCLUSIONS: The frequency of SIDS was lower than what has been reported worldwide and in the Brazilian literature, thus suggesting underdiagnosis, indicating the lack of any specific postmortem protocol for SIDS identification and showing the need to implement this.

CONTEXTO E OBJETIVO: A real incidência da síndrome da morte súbita na infância (SIDS) no Brasil é desconhecida. O objetivo foi identificar casos de SIDS na cidade de Ribeirão Preto, SP, entre os anos de 2000 e 2005 para estimar a sua incidência. TIPO DE ESTUDO E LOCAL: Análise retrospectiva dos dados relativos aos nascidos vivos e óbitos em Ribeirão Preto, além das necropsias de menores de um ano de idade realizados no Serviço de Verificação de Óbito do Interior (SVOI) entre 2000 e 2005. RESULTADOS: Houve 47.356 nascidos vivos e 537 óbitos de menores de um ano de idade, com mortalidade infantil variando de 12,9‰ a 10,9‰ nascidos vivos e pós-neonatal de 5,0 por cento a 3,8‰. Dos 24 óbitos possivelmente devidos a SIDS autopsiados no SVOI, 6 eram do município (0,13‰ nascidos vivos), 3 (50 por cento) diagnosticados como SIDS, 1 (16,66 por cento) cada como causa indeterminada, broncoaspiração e edema cerebral. Dois óbitos ocorreram no primeiro mês de vida (33,33 por cento) e um óbito (16,66 por cento) com dois, quatro, seis e oito meses. Dois óbitos (33,33 por cento) ocorreram nos meses de fevereiro e dezembro cada, um caso em agosto e outro em outubro (16,66 por cento). Foram quatro casos (66,7 por cento) no verão, um caso (16,66 por cento) cada no inverno e na primavera. Houve predomínio do gênero masculino sobre o feminino numa proporção de 5:1. CONCLUSÕES: A freqüência de síndrome da morte súbita na infância foi inferior à da literatura mundial e brasileira, sugerindo subdiagnóstico, falta de protocolo de investigação post mortem específico e necessidade de sua implantação.

La bioética como proyecto antropológico / Bioethics as an anthropological project

La Bioética como juicio interdisciplinario ha alcanzado un tremendo desarrollo y en Venezuela se han dado grandes paso. El desarrollo de la bioética está involucrado en una gran variedad de temas y diferentes enfoques, donde marca una trascendencia para el futuro de la humanidad, en especial en nuestro país. El desarrollo de la bioética ha hecho que la misma ingrese a la cultura contemporánea y que prácticamente cualquier problema del acontecer social pueda analizarse desde el punto de vista bioético, la cual no sólo es importante, sino además muy sano para la vida en sociedad que adquiere así una nueva forma de reflexión ética, especialmente con relación a las ciencias biológicas y al extraordinarios desarrollo de la biotecnología que la acompaña y que constituye, para la ética contemporánea, un desafío por no contar con un patrón m oral común para solucionar los dilemas que se derivan de este desarrollo. Esta reflexión tiene como finalidad dar un aporte para la reflexión bioética y que el hombre como proyecto antropológico sea un punto de partida para la bioética para los profesionales de salud, ante un paciente, una comunidad por su compromiso social con ella, pero sobre todo ante sí mismo para no traicionar su conciencia; porque esto en las profesiones de salud, suele tener fatales consecuencias en el paciente que confía en los conocimientos de estos profesionales y que espera de ellos honestidad, respeto y amor.

Bioethical like interdisciplinary trial has reached a tremendous development and in Venezuela they have occurred big step. The development of the bioethical is involved in a great variety of topics and different focuses, where it marks a transcendency for the humanity's future, especially in our country. The development of the bioethical has made that the same one enters to the contemporary culture and that practically any problem of happening social it can be analyzed from the point of view bioético, which is not only important, but also very healthy for the life in society that acquires this way a new form of ethical reflection, especially with relationship to the biological sciences and the extraordinary development of the biotechnology that it accompanies her and that it constitutes, for the contemporary ethics, a challenge for not having a common patron oral m to solve the dilemmas that are derived of this development. This reflection has as purpose to give a contribution for the reflection bioethical and that the man like anthropological project is a starting point for the bioethical for the professionals of health, before a patient, a community for its social commitment with her, but mainly before itself for not betraying its conscience; because this in the professions of health, he/she usually has fatal consequences in the patient that trusts the knowledge of these professionals and that he/she expects from them honesty, respect and love.

Incidência de aterosclerose em artérias radiais de cadáveres / Incidence of atherosclerosis in radial arteries of cadavers

OBJETIVO: Determinar a incidência de lesões ateroscleróticas obstrutivas e também lesões ateroscleróticas microscópicas em cadáveres acima de 35 anos, pesquisando toda a extensão da artéria radial. MÉTODO: Foram dissecadas ambas as artérias radiais de 29 cadáveres, em toda sua extensão, como se fossem ser utilizadas para cirurgia de revascularização do miocárdio. Foi realizada uma angiografia com contraste nessas artérias, a fim de detectar lesões ateroscleróticas obstrutivas. Após isso, cada artéria teve três fragmentos preparados em parafina, para se detectar histologicamente lesões ateroscleróticas e pré-ateroscleróticas. Os resultados foram confrontados com os fatores de risco para aterosclerose encontrados nesses cadáveres. RESULTADOS: Não foram encontradas lesões obstrutivas à angiografia. Quatro cadáveres apresentaram lesões ateroscleróticas à microscopia. Dos fatores de risco estudados, a idade mostrou associação significante para o aparecimento de lesões ateroscleróticas microscópicas. As artérias mediram, em média, 19,22 cm, nos homens, 17,45 cm, nas mulheres. Seu diâmetro médio foi 1,87 mm, nos homens e 1,72 mm, nas mulheres. CONCLUSÃO: Não foram encontradas lesões obstrutivas nas artérias radiais dos cadáveres estudados. A idade é fator que aumenta a incidência de lesão ateromatosa microscópica.

OBJECTIVE: To verify the incidence of atherosclerotic obstructions and microscopic atherosclerotic lesions in radial arteries dissected from cadavers of over 34-years-olds. METHODS: Twenty-nine cadavers had both radial arteries dissected as if they were going to be utilized as a coronary artery bypass grafts. An angiogram was performed to determine atherosclerotic obstruction of the radial arteries Subsequently, three fragments of the artery (proximal, medial, distal) were prepared on microscopic slides using hematoxylin-eosin in order to identify microscopic atherosclerotic lesions. Results were compared with risk factor found in patient's records: age, gender, hypertension, diabetes, history of smoking, myocardial infarctation, stroke, peripheral vascular disease, obesity, family history. RESULTS: No obstructive lesions were found in the angiograms. Four cadavers presented with microscopic atherosclerotic and pre-atherosclerotic lesions. Among the risk factors considered, only age was correlated with microscopic lesions. The arteries measured, on average, 19.22 cm in males and 17.45 cm in females. Theirs diameters were 1.87 mm for men and 1.72 for women. CONCLUSIONS: No atherosclerotic obstructions were found in the radial arteries of those cadavers. Age is a risk factor for microscopic atherosclerotic lesions.