Influencia de variables del manejo de catéteres venosos tunelizados en hemodiálisis sobre la tasa de bacteriemia: estudio analítico observacional / Influence of management variables of tunneled venous catheters in hemodialysis on the bacteremia rate: observational analytical study

RESUMEN Introducción: La infección relacionada con catéter venoso central (CVC) es la complicación más frecuente y grave en los pacientes en hemodiálisis, asociada a una elevada mortalidad y morbilidad. En España, se ha publicado una incidencia de bacteriemia de 0.9 a 2 episodios por catéter y año. Diversas variables se han relacionado con la tasa de bacteriemia asociada a CVC, tales como disfunciones del catéter, la formación y experiencia del personal de enfermería, el número de sesiones de hemodiálisis y la duración de las mismas. El objetivo del presente estudio es analizar la influencia de las variables citadas en la aparición de bacteriemias, en pacientes portadores de catéteres en una unidad de hemodiálisis de un hospital de tercer nivel en España. Material y métodos: Estudio analítico, observacional y retrospectivo en el que se obtuvieron los datos relativos a la formación recibida y experiencia del personal de enfermería, el número y duración de sesiones de hemodiálisis por paciente y disfunciones de CVC. Se contabilizaron las bacteriemias acontecidas en un año, a través de la base de datos de la unidad, y se analizó la posible relación de tales variables en la tasa de bacteriemia. Resultados: Sobre un total de 41 catéteres tunelizados en 35 pacientes, observados durante 365 días, se obtuvo una tasa de incidencia de 1.45/1000 días de catéter, no habiendo encontrada relación estadísticamente significativa con la formación del personal de enfermería (p=0.330), experiencia (p=0.668), número de disfunciones y manipulaciones de catéter (p=0.718; p=0.118). Se objetivó relación inversa con el número y duración de sesiones (p=0.02). Conclusiones: Es preciso seguir analizando la relación entre las variables mencionadas y la tasa de bacteriemias. Abordarlo desde un punto de vista multicéntrico o aumentar el tiempo de observación de forma prospectiva pueden ser aspectos a tener en cuenta para determinar las variables que parecen tener una relación directa con la infección de CVC, que en otros contextos se ha llegado a evidenciar.

ABSTRACT Introduction: Central venous catheter (CVC)-related infection is the most frequent and serious complication in hemodialysis patients, associated with high mortality and morbidity. In Spain, an incidence of bacteremia of 0.9 to 2 episodes per catheter and year has been published. Variables have been related to the rate of bacteremia associated with CVC, such as catheter malfunctions, the training and experience of the nursing, the number of hemodialysis sessions and their duration. The objective of the present study is to analyze the influence of the aforementioned variables on the appearance of bacteremia in patients with catheters in a hemodialysis unit of a tertiary care hospital in Spain. Methods: Analytical, observational, and retrospective study in which data on the training received and experience of the nursing staff, the number and duration of hemodialysis sessions per patient and CVC dysfunctions were obtained. The bacteremia's that occurred in a year were counted, through the unit's database, and the possible relationship of such variables in the rate of bacteremia was analyzed. Results: On a total of 41 tunneled catheters in 35 patients, observed for 365 days, an incidence rate of 1.45/1000 catheter days was obtained, not having found a statistically significant relationship with the training of nursing staff (p = 0.330), experience (p=0.668), number of dysfunctions and manipulations of catheter (p=0.718; p=0.118). An inverse relationship was observed with the number and duration of sessions (p=0.02). Conclusions: It is necessary to continue analyzing the relationship between the mentioned variables and the rate of bacteremia. Approaching it from a multicenter point of view or increasing the observation time prospectively may be aspects to consider to determine the variables that seem to have a direct relationship with CVC infection, which has been shown in other contexts.

Effect of photoperiod on ovarian maturation in Cheirodon interruptus (Teleostei: Characidae) / Efeito do fotoperíodo na maturação dos ovários em Cheirodon interruptus (Teleostei: Characidae)

Abstract Cheirodon interruptus is a ubiquitous small characid that inhabits the Pampean region and commonly used as bait. Its vast market is supplied from the wild population causing a significant environmental impact. In this study, we assess the effect of photoperiod on ovarian maturation in order to evaluate its potential as a tool to manipulate reproduction under artificial conditions. Four treatments in triplicate (light: dark, L: D) were tested: 24L: 0D, 12L: 12D, 0L: 24D and a progressive photoperiod corresponding to the daily photoperiod increments in wild during winter-spring transition, accelerated three times. The experiment was conducted for 45 days. Gonadosomatic index (GSI), oocyte mean diameter, vitellogenic oocyte proportions, plasma estradiol concentrations (E2), condition factor (Kn) and standard length were estimated. Values of mean GSI, oocyte diameter, vitellogenic oocyte proportions and E2 concentration were maximum in the progressive treatment indicating vitellogenesis stimulation. In turn the same parameters were minimum in the 24L: 0D, revealing the vitellogenesis inhibition. This study showed that photoperiodic regime play an important role in the onset of ovarian maturation in C. interruptus.

Resumo Cheirodon interruptus é um pequeno caracídeo amplamente distribuído na região Pampeana e comumente usado como isca. Seu vasto mercado se abastece de populações silvestres causando um impacto ambiental significativo. Neste estudo, investigamos o efeito do fotoperíodo no amadurecimento do ovário para avaliar o potencial deste fator como ferramenta para manipular a reprodução em condições artificiais. Quatro tratamentos foram testados por triplicado (luz: escuro, L: D): 24L: 0D, 12L: 12D, 0L: 24D e um fotoperíodo progressivo que simula as mudanças das horas luz na natureza e na transição de inverno a primavera, acelerado três vezes. O experimento se realizou durante 45 dias. O índice gonadossomático (GSI), o diâmetro médio dos ovócitos, a proporção de ovócitos vitelogênicos, as concentrações plasmáticas de estradiol (E2), o fator de condição (Kn) e o comprimento padrão foram estimados. Os valores médios de GSI, o diâmetro dos ovócitos, as proporções de ovócitos vitelogênicos e a concentração de E2 foram maximizados no fotoperíodo progressivo, indicando estimulação de vitelogênesis. Por outro lado, esses mesmos parâmetros resultaram mínimos no tratamento 24L: 0D, revelando um efeito inibidor da vitelogênesis. Este estudo mostrou que as variações de fotoperíodo exercem um papel importante no início vitelogênesis reprodutiva em C. interruptus .

Microfiltración apical entre tres cementos utilizados en obturación retrógrada / Apical microfiltration between three cements used in retrograde obturation

Objetivo: Determinar la microfiltración apical de tres cementos utilizados en obturación retrógrada. Métodos: 45 piezas unirradiculares estandarizadas a 16 mm de longitud se instrumentaron con sistema ProTaper ® manual e irrigaron con NaClO al 5,25%. Las muestras fueron obturadas con cono principal ProTaper ® F3 y accesorios Denstply ® #A y #B; se realizó la recesión apical de 3 mm, posteriormente se desobturó 3 mm con ultrasonido (Satelec Acteon) con punta s12/70D; se dividió la muestra en tres grupos para realizar obturación retrógrada con diferentes cementos de obturación cada uno. Las muestras se incubaron a 37 °C por 3 días; se cubrieron con barniz de uñas excepto 2 mm apicales para ser sumergidas en azul de metileno al 1% por 48 horas, se lavaron y reali- zaron un corte longitudinal con disco de diamante #2 para su análisis en el estereomi- croscopio (EduBlue ED 1402S), con la ayuda de un micrómetro (Stainless Hardened) se obtuvieron diferentes valores de cada grupo, mismos que fueron analizados por medio de la comparación de medias y pruebas paramétricas. Resultados: La valoración media de la microfiltración que produce la obturación retrógrada indica que: el MTA ® presentó un valor de 87,33 ± 9,61 µm (14,57%), seguido del Biodentine ® con 136 ± 12,42 µm (22,69%), con respecto al IRM ® con mayor cantidad de microfiltración con un valor de 376 ± 12,98 µm (62,74%). Conclusiones: Al comparar las medias y porcentajes de la microfiltración apical que presentan los cementos IRM ® , Biodentine ® y MTA ® , se evidenció que el MTA ® presentó el menor valor de microfiltración

Objective: To determine the apical microfiltration of three cements used in retrograde obturation. Methods: 45 monoradicular pieces standardized to 16 mm in length were instrumented with manual ProTaper ® system and irrigated with 5.25% NaClO. The samples were sealed with ProTaper ® F3 main cone and Denstply ® accessories #A and #B; an apical recession of 3 mm was performed, subsequently a 3 mm of obturation was removed with ultrasound (Satelec Acteon) using tip s12/70D; the samples were divided into three groups to perform retrograde filling, each with different sealing cements. The samples were incubated at 37°C for 3 days; then covered with nail varnish except 2 mm apical to be immersed in 1% methylene blue for 48 hours, washed and longitudinally cut with #2 diamond disc for analysis in the stereo microscope (EduBlue ED 1402S), with the help of a micrometer (Stainless Hardened); different values of each group were obtained, then analyzed through comparison of means and parametric tests. Results: The average evaluation of the microfiltration produced by the retrograde filling indicates that: the MTA ® presented a value of 87.33 ± 9.61 µm (14.57%), followed by the Bio- dentine ® with 136 ± 12.42 µm ( 22.69%), compared to the IRM ® with the highest amount of microfiltration with a value of 376 ± 12.98 µm (62.74%). Conclusions: When comparing the means and percentages of the apical microfiltration of the IRM ® , Biodentine ® and MTA ® cements; it was evident that the MTA ® showed the lowest microfiltration value.

The polymorphisms of genes associated with the profile of fatty acids of sheep / Os polimorfismos de genes associados ao perfil de ácidos graxos de ovinos

The present study aimed to evaluate the occurrence of polymorphisms in Diacylglycerol acyltransferase (DGTA-1 and 2), Fatty acid synthase (FASN), Stearoyl-CoA desaturase (SCD) genes and the Thioesterase domain of FASN (TE-FASN) gene that may be related to the lipid profile. In the experiment, a total of 84 sheep from different genetic groups were used. For the evaluation of the polymorphism of the genes, PCR-Single Strand Conformation Polymorphism (SSCP) technique and subsequent sequencing were used. In DGAT-2 gene, four genotypes were identified with the presence of 6 polymorphisms, with two (c.229T> C; c.255T> C) that resulted into the exchange of phenylalanine by leucine. In FASN gene, two genotypes were identified. In TE-FASN gene, three genotypes and 17 polymorphisms were identified. DGAT-1 and SCD genes did not reveal the occurrence of polymorphism. There was difference in relation to C14: 0, C18: 0 fatty acids and Δ9-desaturase C18 for DGAT-2 gene and of C18: 2ω6t for TE-FASN. There were differences among the genetic groups for C10: 0, C12: 0, C17: 0, C18: 2ω6t, C18: 3ω3, C20: 2, total of ω3, ω3/ω6 and atherogenicity index. There is occurrence of polymorphism of DGAT-2 and TE-FASN genes and these should be further studied in sheep since they revealed influence of the genotypes on the fatty acid profile.(AU)

O presente estudo teve o objetivo de avaliar a ocorrência de polimorfismos nos genes Diacilglicerol aciltransferase (DGTA1 e 2), Ácido graxo sintase (FASN), Estearoil-CoA dessaturase (SCD) e o Domínio da tioesterase do gene FASN (TE-FASN), que possam estar relacionados ao perfil lipídico. No experimento, foram utilizados um total de 84 ovinos de diferentes grupos genéticos. Para avaliação do polimorfismo dos genes, foi utilizada a técnica de polimorfismo de conformação de cadeia simples (PCR-SSCP) e posterior sequenciamento. No gene DGAT-2, foram identificados quatro genótipos com a presença de seis polimorfismos, com dois (c.229T>C; c.255T>C) que resultaram na troca da fenilalanina por leucina. No gene FASN, foram identificados dois genótipos. No gene TE-FASN, foram identificados três genótipos e 17 polimorfismos. Os genes DGAT-1 e SCD não revelaram a ocorrência de polimorfismo. Houve diferença em relação aos ácidos graxos C14:0, C18:0 e ∆9-desaturaseC18 para o gene DGAT-2 e de C18:2ω6t para TE-FASN. Houve diferença entre os grupos genéticos para C10:0, C12:0, C17:0, C18:2ω6t, C18:3ω3, C20:2, total de ω3, ω3/ω6 e índice de aterogenicidade. Há ocorrência de polimorfismo dos genes DGAT-2 e TE-FASN, e estes devem ser mais estudados em ovinos, pois revelaram influência dos genótipos sobre o perfil de ácidos graxos.(AU)

Effect of photoperiod on ovarian maturation in Cheirodon interruptus (Teleostei: Characidae)

Abstract Cheirodon interruptus is a ubiquitous small characid that inhabits the Pampean region and commonly used as bait. Its vast market is supplied from the wild population causing a significant environmental impact. In this study, we assess the effect of photoperiod on ovarian maturation in order to evaluate its potential as a tool to manipulate reproduction under artificial conditions. Four treatments in triplicate (light: dark, L: D) were tested: 24L: 0D, 12L: 12D, 0L: 24D and a progressive photoperiod corresponding to the daily photoperiod increments in wild during winter-spring transition, accelerated three times. The experiment was conducted for 45 days. Gonadosomatic index (GSI), oocyte mean diameter, vitellogenic oocyte proportions, plasma estradiol concentrations (E2), condition factor (Kn) and standard length were estimated. Values of mean GSI, oocyte diameter, vitellogenic oocyte proportions and E2 concentration were maximum in the progressive treatment indicating vitellogenesis stimulation. In turn the same parameters were minimum in the 24L: 0D, revealing the vitellogenesis inhibition. This study showed that photoperiodic regime play an important role in the onset of ovarian maturation in C. interruptus.

Resumo Cheirodon interruptus é um pequeno caracídeo amplamente distribuído na região Pampeana e comumente usado como isca. Seu vasto mercado se abastece de populações silvestres causando um impacto ambiental significativo. Neste estudo, investigamos o efeito do fotoperíodo no amadurecimento do ovário para avaliar o potencial deste fator como ferramenta para manipular a reprodução em condições artificiais. Quatro tratamentos foram testados por triplicado (luz: escuro, L: D): 24L: 0D, 12L: 12D, 0L: 24D e um fotoperíodo progressivo que simula as mudanças das horas luz na natureza e na transição de inverno a primavera, acelerado três vezes. O experimento se realizou durante 45 dias. O índice gonadossomático (GSI), o diâmetro médio dos ovócitos, a proporção de ovócitos vitelogênicos, as concentrações plasmáticas de estradiol (E2), o fator de condição (Kn) e o comprimento padrão foram estimados. Os valores médios de GSI, o diâmetro dos ovócitos, as proporções de ovócitos vitelogênicos e a concentração de E2 foram maximizados no fotoperíodo progressivo, indicando estimulação de vitelogênesis. Por outro lado, esses mesmos parâmetros resultaram mínimos no tratamento 24L: 0D, revelando um efeito inibidor da vitelogênesis. Este estudo mostrou que as variações de fotoperíodo exercem um papel importante no início vitelogênesis reprodutiva em C. interruptus .

Protocolos de estimulación ovárica en inseminación artificial según el patrón utilizado de glicosilación de la hormona folículo estimulante / The impact of different ovarian stimulating protocols in artificial insemination based on the glycosylation pattern of the follicle stimulating hormone

Resumen ANTECEDENTES: los estudios clínicos que comparan diferentes protocolos de estimulación ovárica no son concluyentes. Nuestro estudio compara tres protocolos según el patrón de glicosilación de la hormona folículo estimulante (FHS) que imita el ciclo natural para inseminación artificial. OBJETIVO: proponer un protocolo de estimulación ovárica secuencial con FSH urinaria (isoforma ácida) seguido de FSH recombinante (isoforma menos ácida) y evaluar su efectividad respecto de los esquemas tradicionales de estimulación con FSH recombinante (FSHr) y FSH urinaria (FSHu). MATERIALES Y MÉTODOS: estudio de cohortes, retrospectivo, efectuado entre mayo de 2012 y mayo 2015 en parejas infértiles en protocolo de inseminación artificial. El grupo de estudio se dividió en tres: 1) FSHr, 2) FSHhp y 3) estimulación sequencial: FSHhp + FSHr. Para el análisis estadístico se utilizaron χ2, ANOVA o test Mann-Whitney. Los resultados se reportan con límite de significación de p < 0.05. RESULTADOS: se estudiaron 178 parejas infértiles en protocolo de inseminación artificial y se efectuaron 299 ciclos de estimulación ovárica con inseminación artificial; grupo 1) 99 con FSHr, 2)100 con FSHhp y 3) 100 con estimulación sequencial: FSHhp + FSHr. Los resultados gestacionales fueron mayores en el grupo FSHu y secuencial. En el análisis costo-efectividad se observó menor tasa con el esquema secuencial en comparación con los otros dos. Al comparar los tres protocolos según los intentos previos de inseminación, en la serie con intentos previos, se encontraron diferencias estadísticamente significativas en βHCG y gestación al comparar FSHr versus secuencial. El protocolo FSHr fue menos efectivo que los otros dos tratamientos. CONCLUSIONES: se planteó la estimulación ovárica controlada con protocolo secuencial en pacientes que recibirían inseminación artificial y, aunque no se encontraron diferencias significativas, sí se observó una tendencia en la que tanto la dosis como los días de estimulación requerida son menores con este protocolo que con los clásicos con FSHr o FSHu.

Abstract BACKGROUND: Earlier trials comparing different ovarian stimulating protocols in assisted reproduction found no significant differences in the results. OBJECTIVE: To evaluate the effect of three different stimulation protocols based on the glycosylation pattern of the follicle stimulating hormone (FSH) in an intrauterine insemination (IUI) program. The stimulating protocols are: human FSH (acidic isoform), recombinant FSH (less acidic isoform) and combined urinary and recombinant FSH. MATERIALS AND METHODS: Cohort study, retrospective, conducted between May 2012 and May 2015 in infertile couples in protocol of artificial insemination. The study group was divided into three: 1) FSHr, 2) FSHhp and 3) sequential pacing: FSHhp + FSHr. For statistical analysis, χ2, ANOVA or Mann-Whitney test were used. The results are reported with a significance limit of p < 0.05. RESULTS: 178 infertile couples were studied in an artificial insemination protocol and 299 cycles of ovarian stimulation were performed with artificial insemination; Group 1) 99 with FSHr, 2) 100 with FSHhp and 3) 100 with sequential stimulation: FSHhp + FSHr. CONCLUSION: In this study, controlled ovarian stimulation with sequential protocol was considered in patients who would receive artificial insemination and, although no significant differences were found, a trend was observed in which both the dose and the days of stimulation required are lower with this protocol than with the classics with FSHr or FSHu.

Factores de riesgo para alteraciones de la densidad mineral ósea en mujeres posmenopáusicas / Risk factors for alterations in bone mineral density in postmenopausal women

OBJETIVO: Determinar los factores de riesgo para presentar alteraciones de la densidad mineral ósea (DMO) en mujeres posmenopáusicas atendidas en la consulta de Menopausia y Climaterio de la Maternidad "Dr. Armando Castillo Plaza", de Maracaibo, Venezuela. MÉTODOS: Investigación descriptiva, con diseño no experimental y transeccional, donde se evaluó la DMO y los factores de riesgo para presentar osteoporosis en 60 mujeres posmenopáusicas. RESULTADOS: La medición de la DMO resultó en promedio de 957,45 ± 149,95 y 905,00 ± 151,25 gramos, con índices T de -0,52 ± 1,66 y -0,55 ± 2,67 en columna vertebral y cuello femoral, respectivamente. Se estableció una prevalencia de osteoporosis del 10% y 5%, y de osteopenia del 43,3% y 50% en columna vertebral y fémur, respectivamente. La menopausia quirúrgica (OR [95% CI] = 4,75 [1,58-14,25]; p=0,004), el consumo excesivo de café (OR [95% CI] = 3,20 [1,40-7,10 1]; p=0,000) o gaseosas (OR [95% CI] = 2,50 [1,18-5,60]; p=0,002), tabaquismo (OR [95% CI] = 1,70 [1,102,80]; p=0,013) y la ausencia de suplementación de calcio más vitamina D (OR [95% CI] = 1,70 [1,00-2,80]; p=0,019) resultaron ser factores significativamente asociados al diagnóstico de osteoporosis u osteopenia (p<0,05). CONCLUSIÓN: Las mujeres posmenopáusicas evaluadas presentan una alta prevalencia de alteraciones en la DMO, principalmente osteopenia, y factores de riesgo para presentar Osteoporosis.

AIM: To determine risk factors for presenting alterations in bone mineral density (BMD) in postmenopausal women attending the consultation of Menopause and Menopause Maternity "Dr. Armando Castillo Plaza", Maracaibo, Venezuela. METHODS: A descriptive research with non-experimental and transactional design where was evaluated BMD and risk factors for developing osteoporosis in 60 postmenopausal women. RESULTS: The BMD measurement was averaged in 957.45 ± 149.95 and 905.00 ± 151.25 grams; with T indexes of -0.52 ± 1.66 and -0.55 ± 2.67 in spine and femoral neck, respectively. The prevalence of osteoporosis was 10% and 5%, while osteopenia was 43.3% and 50% in spine and femur, respectively. Surgical menopause (OR [95% CI] = 4.75 [1.58 to 14.25]; p=0.004); excessive coffee consumption (OR [95% CI] = 3.20 [1,40- 7.10 1]; p=0.000) or gaseous beverages (OR [95% CI] = 2.50 [1.18 to 5.60]; p=0.002); smoking (OR [95% CI] = 1.70 [1.10 to 2.80]; p=0.013) and the absence of supplemental calcium plus vitamin D (OR [95% CI] = 1.70 [1.00 to 2.80]; p=0.019) were be factors significantly associated with the diagnosis of osteoporosis or osteopenia (p<0.05). CONCLUSION: The evaluated postmenopausal women have a high prevalence of abnormal BMD, especially osteopenia, and risk factors for developing osteoporosis.

Anemia materna y peso al nacer en productos de embarazos a término / Maternal anemia and birth weight in term pregnancy products

OBJETIVO: Relacionar la anemia materna con el peso al nacer (PAN) en mujeres con embarazos a término atendidas en la emergencia obstétrica de la Maternidad "Dr. Armando Castillo Plaza", Maracaibo, Venezuela. MÉTODOS: Investigación correlacional con diseño no experimental y transeccional, donde se evaluaron 200 embarazadas en fase activa del trabajo de parto, a quienes se les determinaron los valores de hemoglobina (Hb), hematocrito (Hcto) e índices hematimétricos, para luego correlacionarlas con el PAN. RESULTADOS: Los valores de Hb oscilaban entre 8,4 ± 1,0 g/dl y 11,6 ± 0,64 g/dl, mientras que los de Hcto fueron de 28,8 ± 3,3% y 38,9 ± 2,2%, anémicas y no anémicas, respectivamente. Los índices hematimétricos mostraron valores referenciales normales en ambos grupos. El PAN de los recién nacidos de madres anémicas estaba disminuido en 12,39% (-420 g) al compararse con los pesos de los neonatos de madre sin anemia (2.970 ± 0,43 g vs. 3.390 ± 0,32 g; p<0,0001). El BPN fue más frecuente en el grupo de madres anémicas, las cuales mostraron un mayor riesgo, aunque no significativo (15% vs. 10%; OR IC95% 1,558 [0,676-3,728]; p>0,05). Se demostró una relación directamente proporcional y significativa entre los valores de Hb - PAN (r=0,439; p<0,0001). CONCLUSIÓN: Existe una relación directa, proporcional y significativa entre el PAN y los valores de Hb; sin embargo, aunque las gestantes anémicas presentaron con mayor frecuencia BPN, esta diferencia no fue significativa.

AIM: To link maternal anemia and birth weight (BW) in women with term pregnancies present to emergency obstetric at the Maternity "Dr. Armando Castillo Plaza", in Maracaibo, Venezuela. METHODS: A correlational research, with non-experimental and transactional design, where valued a sample of 200 pregnant women in active phase of labor, who are determined hemoglobin (Hb), hematocrit (Hct), and hematimetric indexes values. RESULTS: The values of Hb and Hct in anemic ranged from 8.4 ± 1 g/dl and 11.6 ± 0.64 g/dl, whereas the Hct was 28.8 ± 3.3% and 38.9 ± 2.2%, in patients with and without anemia, respectively. The hematimetric indexes showed normal reference values in both groups. The BW in newborn of anemic mothers was decreased by 12.39% (-420 g) when compared to the weights of infants of mother without anemia (2.970 ± 0.43 g vs. 3.390 ± 0.32 g; p<0.0001). LBW was more common in the group of anemic mothers, who showed an increased risk, although not significant (15% vs. 10%; OR 95%CI 1.588 [0,676-3,728]; p>0.05). Was demonstrated a directly proportional and significant relationship between Hb values and BW(r=0.439; p<0.0001). CONCLUSION: Exist a direct proportional and significant relationship between the PAN and the Hb; however, while anemic pregnant women presented more frequently LBW, this difference was not significant.

Principales trattornos reproductivos en búfalasy vacas en hatos mixtos y de unna especie en el departamento de caquetá, Colombia / Main reproductiee disorders in uffaloes and cows in mixed herds and of one speecies in the department of caquetá, Cloombia

Con el objetivo de determinar los principales problemas reproductivos en vacas y búfalas, su frecuencia y la relación con variables climáticas, se seleccionaron 296 hembras bovinas (150 de rebaños mixtos y 146 de rebaños bovinos) y 238 hembras bubalinas (126 de mixtos y 112 de rebaños bubalinos). Se registraron la frecuencia de patologías reproductivas, los indicadores reproductivos entre 2010 y 2011, así como el promedio de las variables climáticas de la zona. El número de patologías reproductivas fue mayor en bovinos (n=11) que en los búfalos (n=5) y la repetición de celo fue la alteración más frecuente en ambas especies: 36.8% y 12.6% en bovinos y búfalos, respectivamente, con diferencia significativa (P < 0.05) respecto del resto de patologías, pero no entre tipos de hatos. La frecuencia de patologías disminuyó a medida que aumentó el número de partos en vacas, pero en el caso de las búfalas, las diferencias no fueron significativas. Entre las variables climáticas, sólo se encontró asociación directa entre el brillo solar y los partos de vacas y búfalas, así como entre la amplitud térmica y los partos en el caso de las búfalas (P < 0.05). Se concluye que las búfalas presentaron menor frecuencia y variedad de patologías reproductivas que las vacas y que, tanto la frecuencia de los partos como de las patologías, están asociadas con el brillo solar.

In order to determine the main reproductive problems in cows and buffaloes, their frequency and relationship to climatic variables, 296 bovine females (150 and 146 mixed herds cattle herds) and 238 buffaloes cows (126 and 112 mixed herds) were selected. For which the frequency of reproductive disorders, reproductive indicators between 2010 and 2011, and the average climatic variables were recorded in the area. The number of reproductive disorders was higher in cattle (n=11) than in buffaloes (n=5) and repeat breeding was the most frequent in both species: 36.8% and 12.6% in cattle and buffalo, respectively, with significant difference (P < 0.05) with other diseases but not between types of herds. The frequency of pathologies decreased as parity increased cow, but in buffaloes were not significant differences. Between climatic variables, only association between sun's brightness and calving in cows and buffaloes and thermal amplitude deliveries in the case of buffaloes (P < 0.05) was found. We conclude that the buffaloes had lower frequency and variety of pathologies than cows and that both the frequency of deliveries and pathologies are associated with sun's brightness.

Respuesta clínica de 100 implantes en carga oclusal inmediata para pacientes parcialmente desdentados: reporte luego de 12 meses de funcionamiento con restauraciones finales / Clinical response of 100 implants with immediate occlusal loading in partially edentulous patients: report over 12-month functioning with final restorations

Evaluar el rendimiento clínico de 100 implantes SEVEN MIS en protocolos de carga inmediata en pacientes parcialmente desdentados, analizando los criterios de éxito a lo largo de 12 meses. Materiales y métodos: En todos los casos se llevó a cabo el mismo protocolo clínico (quirúrgico y protético) de carga oclusal inmediata. Se utilizaron 100 implantes SEVEN MIS cuya longitud y diámetro se determinó en cada caso según la calidad y cantidad ósea en el sitio quirúrgico.Resultados: Ninguno de los pacientes abandonó el estudio. Todos los implantes fueron clínicamente estables y se correspondieron con los criterios de éxito. Conclusión: Los 100 implantes tuvieron una tasa de éxito de 100 por ciento...

Deficiencia de oligoelementos durante el primer trimestre del embarazo en maracaibo, venezuela / Deficiencies of trace elements during the first trimester of pregnancy at maracaibo, venezuela

Las deficiencias de oligoelementos es un importante problema de salud pública, que pone en riesgo principalmente a las embarazadas y a sus productos; por tanto se propuso determinar las concentraciones séricas de Hierro (Fe), Zinc (Zn) y Cobre (Cu) durante el primer trimestre del embarazo e identificar las patologías asociadas con su deficiencia durante el primer trimestre del embarazo, en embarazadas que acudían a la consulta prenatal de la Maternidad Dr. Armando Castillo Plaza del Hospital Universitario de Maracaibo, Venezuela durante el año 2012. Investigación fue de tipo descriptiva y aplicada; con un diseño de tipo no experimental y prospectivo, que incluyo una muestra no probabilística e intencionada de 70 mujeres en el primer trimestre del embarazo, a las cuales se les determinaron las concentraciones séricas de Fe, Zn y Cu. Se encontró que la edad promedio fue de 20,5± 6 años; 42,85% eran adolescentes y 57,15% adultas. Se determinó una media de FE, Zn y Cu de 40,04 ± 1,212 μg/dL, 0,566 ± 0,130 μg/mL y 1,326 ± 0,878 μg/mL, respectivamente; siendo las concentraciones de Fe y Zn más bajos en las adolescentes (< 0,001). Asimismo, se demostró que el 67%, 57% y 14% de estas embarazadas presentaban deficiencia de Fe, Zn y Cu, respectivamente; sin diferencias significativas entre adolescentes o adultas (p >0,05). Se concluye que existe una alta prevalencia de deficiencias de oligoelementos (Zn, Cu y Fe) en gestantes sin patologías asociadas y aparentemente sanas al inicio de su embarazo(AU)

Deficiencies of trace elements is an important public health problem that threatens mainly pregnant women and their products; we propose to determine serum iron (Fe), Zinc (Zn) and copper (Cu) during the first trimester of pregnancy and identify the pathologies associated with a deficiency during the first trimester of pregnancy in pregnant women attending antenatal care at Maternity Dr. Armando Castillo Plaza, University Hospital of Maracaibo, Venezuela during 2012. A descriptive and applied type research, with a non-experimental and prospective design, which includes a non-probabilistic intentional sample of 70 women during the first trimester of pregnancy, which were measured in serum Fe, Zn and Cu. We found that the age mean was 20,5± 6 years; in terms of the concentrations of these trace elements was determined an average of Fe, Zn and Cu of 40,04 ± 1,212 μg/dL, 0,566 ± 0,130 μg/mL and 1,326 ± 0,878μg/mL, respectively; with concentrations of Fe and Zn lower in adolescents (<0,001). It also showed that 67%, 57% and 14% of these pregnant women were deficient in Fe, Zn and Cu, respectively; without not significant differences between adolescents and adults patients (p> 0,05). Its concluded that exist a high prevalence of deficiencies of trace elements (Zn, Cu and Fe) in patients without associated diseases and apparently healthy at the beginning of her pregnancy(AU)

Concentraciones séricas de zinc en embarazadas preeclámpticas y normotensas / Serum concentrations of zinc in pregnant preeclamptic and normotensive

Objetivo: Comparar las concentraciones séricas de zinc en embarazadas preeclámpticas y normotensas. Métodos: Investigación de tipo correlacional, comparativa y aplicada, con diseño de casos y controles. La cual incluyó a 40 mujeres en el tercer trimestre del embarazo con diagnóstico de preeclampsia y a 40 embarazas normotensas; tanto a los casos como a los controles se les determinó las concentraciones séricas de zinc, mediante la espectrofotometría de absorción atómica. Ambiente: Hospital Materno Infantil “Dr. Raúl Leoni” de Maracaibo. Resultados: Se encontró que las pacientes preeclámpticas presentaban significativamente concentraciones más bajas de zinc que las normotensas (P<0,05), aunque con medias dentro de rangos normales en ambos grupos (76,42±5,29 vs. 80.37±2,7); presentando diferencias altamente significativas en la presión arterial media entre los casos y los controles (P< 0,001). Asimismo, se constató que no existía relación entre las variables presión arterial media y concentraciones séricas de zinc en las preeclámpticas (P> 0,05); mientras que en las normotensas se evidenció una relación significativa e inversamente proporcional (r = - 0,319; P<0,05). Conclusiones: Las embarazadas con preeclampsia presentaban significativamente menores concentraciones séricas de zinc que las normotensas; sin embargo, no existe relación entre la presión arterial media y el zinc.

Objective: To compare serum concentrations of zinc in preeclamptic and normotensive pregnant. Methods: We performed a correlational, comparative and applied type research, with a not experimental, case-control, contemporary transactional and field design, which included 40 women in the third trimester of pregnancy with diagnosis pre-eclampsia and 40 normotensive pregnant; both cases as controls were analyzed for serum concentrations of zinc by atomic absorption spectrophotometry. Setting: Hospital Materno Infantil “Dr. Raul Leoni” in Maracaibo, Venezuela. Results: We found that preeclamptic patients had significantly lower concentrations of zinc to the normotensive (P <0.05), although average within normal ranges in both groups (76.42 ± 5.29 vs. 80.37 ± 2.7), presenting highly significant differences in mean arterial pressure between cases and controls (P <0.001). Also found no relationship between the variables mean arterial pressure and serum zinc concentrations in preeclamptic (P> 0.05), whereas in the normotensive group showed a significant and inversely proportional relationship (r = - 0.319, P <0.05). Conclusion: Pregnant women with pre-eclampsia had significantly lower serum zinc concentrations than normotensive, but there was no relationship between mean arterial pressure and zinc.

Factores de riesgo de depresión posparto en puérperas venezolanas valoradas por medio de la escala de Edimburgo / Risk factors of postpartum depression in Venezuelan women measured by Edinburgh postnatal depression scale

Antecedentes: La depresión posparto (DPP) es un importante trastorno de la salud mental en la mujer, al cual se le han atribuido variados factores de riesgo para su presentación. Objetivo: Se propuso determinar los factores de riesgos para DPP en puérperas atendidas en la Maternidad "Dr. Armando Castillo Plaza" del Hospital Universitario de Maracaibo, Venezuela. Método: Se realizó una investigación descriptiva con diseño no experimental, mediante una muestra de 100 puérperas, evaluadas por la Escala de Depresión Postparto de Edimburgo (EDPS). Resultados: Hubo una prevalencia del test positivo del 91 por ciento, con una prevalência de DPP confirmada mediante el DSM-IV del 22 por ciento. De las características evaluadas solo los trastornos médicos durante el embarazo, la enfermedad del neonato, no contar con el apoyo de su pareja, presentar antecedentes de depresión o melancolía o tener un nivel educativo primario o inferior, mostraron una asociación significativa con el desarrollo de DPP. El nacimiento mediante cesárea y no contar con el apoyo familiar presentaron una asociación significativa con el riesgo de DPP; mientras que el parto vaginal o haber alcanzado un nivel educativo superior a la primaria mostraron tener un efecto protector. Conclusión: Existe una alta prevalencia de DPP, con diversos factores de riesgo que permitirían tomar acciones para un diagnóstico oportuno de esta enfermedad.

Background: Postpartum depression (PPD) is a major mental health disorder in women, which have been attributed to various risk factors for it presentation. Objective: To determine the PPD's risk factors present in the postpartum patients taken care of Maternity "Dr Armando Castillo Plaza" at the University Hospital of Maracaibo, Venezuela. Method: A descriptive study was conducted with non-experimental design, which included a sample of 100 postpartum women, as measured by the scale of the Edinburgh Postpartum Depression (EDPS). Results: The results demonstrated a prevalence of the positive test in 91 percent of the sample, with a confirmed prevalence of postpartum depression by the DSM-IV of 22 percent, determined that the characteristics assessed only medical disorders during pregnancy, the disease of the newborn, not having the support from your partner, have a history of depression or melancholy, or have a primary or lower education level, showed a significant association with the development of PPD. For its part, the birth by caesarean section and not having family support showed a significant association with the risk of PPD, while vaginal delivery or have reached a level higher than primary education showed a protective effect with this condition. Conclusion: There is a high prevalence of postpartum depression, with several risk factors that would take action for a timely diagnosis of disease.

Prevalencia de depresión posparto en primigestas y multíparas valoradas por la escala de Edimburgo / Prevalence of postpartum depression in nulliparous and multiparous women evaluated by Edinburgh postnatal depression scale

Antecedentes: Los trastornos depresivos representan un importante problema de salud pública, siendo más frecuente en las mujeres y con mayor riesgo durante el embarazo y puerperio. Objetivo: Comparar la prevalencia de depresión posparto en primigestas y multíparas atendidas en la División de Obstetricia y Ginecología del Servicio Autónomo Hospital Universitario de Maracaibo, Venezuela. Método: Se realizó una investigación comparativa con diseño no experimental, que incluyó una muestra de 100 mujeres en puerperio tardío, divididas en dos grupos pares de 50 sujetos según paridad, evaluadas mediante la Escala de Depresión Posparto de Edimburgo. Resultados: Los resultados demostraron una prevalencia del test positivo en el 91 por ciento de la muestra, con una prevalencia de depresión posparto confirmada por medio del DSM-IV del 22 por ciento, presentando mayor frecuencia de ideación suicida las multíparas (p<0,05). No hubo una asociación estadísticamente significativa entre paridad y depresión posparto. Conclusión: La población estudiada presenta una alta prevalencia de depresión postparto, sin diferencias en cuanto a su paridad.

Background: Today the depressive upheavals represent an important public health's problem, being more frequent in the women and with greater risk during the pregnancy and puerperium. Objective: To compare the prevalence of postpartum depression in nulliparous and multiparous women taken care of Maternity "Dr. Armando Castillo Plaza" at the University Hospital of Maracaibo, Venezuela. Method: A comparative investigation with non experimental design was realized, it which included a sample of 100 women in later puerperium, divided in two even groups of 50 subjects according to her parity, evaluated by Edinburgh Postnatal Depression Scale. The results demonstrated a prevalence of the positive test in 91 percent of the sample, with a confirmed prevalence of postpartum depression by the DSM-IV of 22 percent, presenting a highly frequency of suicidal ideas in the multiparous group (p<0.05) also, don't found statistically significant association between parity and postpartum depression. Conclusion: The studied population show a highly prevalence of postpartum depression, without majors differences according to the parity.

Rate of weight gain in very-low birth weight Puerto Rican neonates

BACKGROUND: Small for gestational age neonates have a higher risk of growth delay. The purpose of the study is to determine if there are differences in their early weight gain patterns that persist after adjusting for confounding variables. METHODS: Two-hundred sixteen neonates born between 1999 and 2003 were included. The group for analysis was derived by matching all the SGA infants with AGA infants by sex, year of birth, and birth weight. The period of observation was from birth to date of discharge. Weight gain rate was defined as grams gained per kilogram of birth weight per day. Two sample T-test was used to determine the difference in growth rate between the groups. Simple regression was used to establish the effect of morbidities on weight gain rate. RESULTS: The total mean birth weight was 1105 g (+/- 223 g), the mean gestational age was 30 weeks (+/- 2.7 weeks), and the mean weight gain rate was 13.4 g/kg/d (+/- 6.8 g/kg/d). The mean weight gain rate for the adequate for gestational age group was lower (11.9 g/kg/d +/- 7.6g versus 14.9 g/kg/d +/- 5.5 g) (P < 0.001). When all variables were analyzed using the lineal regression model, only having a low APGAR score (P = 0.02) and being small for gestational age (P = 0.0004) were significant. CONCLUSIONS: We conclude that the growth patterns of very low birth weight neonates are different based on the adequacy of their birth weight, and that the disparity in growth rate is not explained by the differences in the incidence of morbidities that affect growth.

Men's role in HIV/AIDS prevention for women: exploring different views

OBJECTIVE: Explore the role male partners should play in interventions that emerge from an empowerment perspective for the prevention of HIV/AIDS in women. Explore the social and cultural context, rationale and format for interventions if male partners are incorporated. BACKGROUND: Heterosexual women have become the most at risk group for HIV infection. Most of the HIV/AIDS prevention efforts have excluded the participation of male partners. Interventions with women have not been as affective as desired since the negotiation of safer sex method, such as the male condom, is not under their control. METHODS: Thirteen focus groups were conducted in Puerto Rico, Dominican Republic and Mexico. Groups were conducted with HIV/AIDS prevention researchers, service providers, and heterosexual men and women who participated in HIV/AIDS prevention interventions. The taped conversations were transcribed and analyzed using content analysis according to a set of defined categories and subcategories. RESULTS: The majority of participants agreed that men must be incorporated in HIV prevention efforts with women. Many conditioned this participation, while some expressed their opposition. Regarding the ways of participation many favored working with men and women separately at the beginning and integrating at the end. They recommended considering working at a group level. CONCLUSIONS: The HIV/AIDS epidemic has put in the forefront the need to consider non-traditional approaches to promote behavior change. A group-base intervention with couples may be an effective way to prevent the HIV/AIDS epidemic.

Changes in soluble carbohydrates during storage of Caesalpinia echinata LAM. (Brazilwood) seeds, an endangered leguminous tree from the Brazilian Atlantic Forest

Sementes de Caesalpinia echinata (pau-brasil) perdem a viabilidade em um mês quando armazenadas no ambiente de laboratório, enquanto a capacidade germinativa é mantida quando armazenadas sob temperturas baixas. O presente trabalho teve como objetivos analisar o conteúdo e a composição dos carboidratos de sementes de C. echinata armazenadas em câmara fria (CT) e em temperatura ambiente do laboratório (RT), em duas embalagens distintas (permeável e impermeável), visando a avaliar o envolvimento desses compostos com a capacidade germinativa das sementes. Os resultados mostraram que os carboidratos solúveis são constituídos principalmente de sacarose, glicose, frutose, myo-inositol e traços de rafinose e estaquiose, totalizando cerca de 10% da massa seca das sementes. As variações nos carboidratos solúveis foram semelhantes nos dois tipos de embalagem, mas diferentes quanto à temperatura de armazenamento. Em CT, as proporções dos monossacarídeos encontradas nas sementes recém-colhidas foram mantidas por cerca de 18 meses de armazenamento, coincidindo com alta porcentagem de germinação (80%). Nas armazenadas em RT houve redução expressiva nas proporções de glicose e frutose e perda completa da germinabilidade. O conteúdo de sacarose se manteve relativamente estável durante todo o período de análise. Os resultados indicam que a perda da germinabilidade de sementes de C. echinata está associada à diminuição dos níveis de glicose e frutose em relação aos níveis de sacarose.

Changes in soluble carbohydrates during storage of Caesalpinia echinata LAM. (Brazilwood) seeds, an endangered leguminous tree from the Brazilian Atlantic Forest

Caesalpinia echinata seeds stored in laboratory environmental conditions lose their viability in one month whilst under low temperatures germination is maintained for 18 months of storage. These seeds are tolerant to desiccation, keeping their viability up to 0.08 gH2O.gDW-1. Since soluble carbohydrates are believed to be involved with desiccation tolerance and seed storability, the aim of this work is to analyze the content and composition of soluble carbohydrates in C. echinata seeds during storage in paper bags (PB) and glass flasks (GF) at laboratory room (RT) and cool (CT) temperatures. In freshly harvested seeds, total soluble carbohydrates comprised approximately 10% of the dry weight, decreasing to ca. 8% over 18 months of storage at RT. In seeds stored at CT, sugars varied differently decreasing initially and being restored at the end of the analysis period. The main neutral sugars in seeds from all treatments were sucrose, fructose and glucose. Raffinose and stachyose were present as traces. Free myo-inositol and other cyclitols were also detected. The main tendency observed was the variation in levels of both glucose and fructose in relation to sucrose, the highest levels of monosaccharides which were found in seeds stored at CT. The values of glucose and fructose were practically constant in seeds stored in paper bags for 18 months at CT, decreasing consistently in the other treatments, mainly at RT. Sucrose contents remained relatively stable. Changes in soluble sugars during storage suggest that the loss of germinability of seeds of C. echinata could be associated with low levels of glucose and fructose in relation to sucrose.

Sementes de Caesalpinia echinata (pau-brasil) perdem a viabilidade em um mês quando armazenadas no ambiente de laboratório, enquanto a capacidade germinativa é mantida quando armazenadas sob temperturas baixas. O presente trabalho teve como objetivos analisar o conteúdo e a composição dos carboidratos de sementes de C. echinata armazenadas em câmara fria (CT) e em temperatura ambiente do laboratório (RT), em duas embalagens distintas (permeável e impermeável), visando a avaliar o envolvimento desses compostos com a capacidade germinativa das sementes. Os resultados mostraram que os carboidratos solúveis são constituídos principalmente de sacarose, glicose, frutose, myo-inositol e traços de rafinose e estaquiose, totalizando cerca de 10% da massa seca das sementes. As variações nos carboidratos solúveis foram semelhantes nos dois tipos de embalagem, mas diferentes quanto à temperatura de armazenamento. Em CT, as proporções dos monossacarídeos encontradas nas sementes recém-colhidas foram mantidas por cerca de 18 meses de armazenamento, coincidindo com alta porcentagem de germinação (80%). Nas armazenadas em RT houve redução expressiva nas proporções de glicose e frutose e perda completa da germinabilidade. O conteúdo de sacarose se manteve relativamente estável durante todo o período de análise. Os resultados indicam que a perda da germinabilidade de sementes de C. echinata está associada à diminuição dos níveis de glicose e frutose em relação aos níveis de sacarose.

Respiratory syncytial virus-related bronchiolitis in Puerto Rico

BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of respiratory tract disease in infants and young children. Immunoprophylaxis is available for high-risk infants. This study reviews infants with bronchiolitis at three primary care hospitals to describe the epidemiology of RSV infection in Puerto Rico. METHODS: We analyzed data from 2 hospitals by obtaining the number of infants diagnosed with bronchiolitis and estimating the percentage of cases due to RSV. A third hospital included patients with confirmed RSV infection. RESULTS: There were 4,557 patients in the study. RSV infection occurred throughout the year. Data shows a progressive decrease in RSV-positive infections. CONCLUSIONS: Data confirms year-round incidence of RSV in Puerto Rico. A standardized surveillance system in Puerto Rico is imperative to determine RSV epidemiology. The decrease in positive RSV infections may be due to the introduction of immunoprophylaxis to high-risk patients.