Impacto del estrés laboral en el bienestar psicológico del personal de un hospital público de medellín, colombia

Objetivo: Determinar si el estrés laboral repercute en la percepción subjetiva de bienestar psicológico del personal asistencial de un hospital de Medellín, Colombia. Material y Método: Estudio con diseño cuantitativo, no experimental, transversal; la unidad de análisis fue el personal asistencial conformado por enfermeras/os, auxiliares de enfermería, médicos generales y especialistas; el muestreo no probabilístico intencional fue de 129 participantes; la modalidad de medición fue híbrida utilizando un cuestionario aplicado por Google Forms que midió 2 variables: Estrés laboral y Bienestar psicológico; el pilotaje se realizó con 10 participantes de diferentes departamentos del centro hospitalario; la recolección finalizó en junio de 2022; para el análisis estadístico descriptivo se aplicaron medidas de tendencia central y las correlaciones se realizaron con el coeficiente Rho de Spearman. Resultados: Los participantes mostraron un agotamiento laboral moderado y un bienestar psicológico bajo; los niveles más bajos de bienestar psicológico se correlacionaron con un mayor estrés laboral; la despersonalización y el agotamiento emocional tuvieron el mayor impacto en la reducción del bienestar psicológico; los hombres reportaron niveles más altos de bienestar psicológico que las mujeres. Conclusiones: Es importante fomentar el bienestar psicológico y la implementación de estrategias de manejo del estrés laboral en entornos laborales de la salud, no sólo desde una perspectiva organizacional, sino también cultural y social.

Objective: To determine whether occupational stress has an impact on the subjective perception of psychological well-being of the nursing staff in a hospital in Medellin, Colombia. Material and Method: Quantitative, non-experimental, cross-sectional study; the unit of analysis was the nursing staff consisting of nursing assistants, general practitioners and specialists; the non-probabilistic intentional sampling included 129 participants; the measurement modality was hybrid using a questionnaire applied through Google Forms that focused on 2 variables: Job stress and Psychological well-being; a pilot study was carried out with 10 participants from different departments of the healthcare institution; data collection ended in June 2022; for the descriptive statistical analysis measures of central tendency were applied and correlations were performed using Spearman's Rho coefficient. Results: Participants showed moderate levels of Job stress and low psychological well-being; lower levels of psychological well-being correlated with higher levels of job stress; depersonalization and emotional exhaustion had the greatest impact on reducing psychological well-being; men reported higher levels of psychological well-being than women. Conclusions: It is important to promote psychological well-being and the implementation of job stress management strategies in healthcare work environments, not only from an organizational perspective, but also from a cultural and social perspective.

Objetivo: Determinar se o estresse no trabalho tem impacto sobre a percepção subjetiva do bem-estar psicológico da equipe de enfermagem de um hospital em Medellín, Colômbia. Material e Método: Estudo quantitativo, não experimental, transversal; a unidade de análise foi a equipe de enfermagem composta por auxiliares de enfermagem, clínicos gerais e especialistas; a amostragem intencional não probabilística incluiu 129 participantes; a medição foi híbrida e utilizou um questionário aplicado por meio do Google Forms que se concentrou em 2 variáveis: estresse no trabalho e bem-estar psicológico; um estudo piloto foi realizado com 10 participantes de diferentes departamentos do hospital; a coleta de dados foi concluida em junho de 2022; para a análise estatística descritiva, foram aplicadas medidas de tendência central e as correlações foram realizadas usando o coeficiente Rho de Spearman. Resultados: Os participantes apresentaram níveis moderados de estresse no trabalho e baixo bem-estar psicológico; níveis mais baixos de bem-estar psicológico se correlacionaram com níveis mais altos de estresse no trabalho; a despersonalização e a exaustão emocional tiveram o maior impacto na redução do bem-estar psicológico; os homens relataram níveis mais altos de bem-estar psicológico do que as mulheres. Conclusões: E importante promover o bem-estar psicológico e implementar estratégias de gerenciamento do estresse em ambientes de trabalho da saúde, não apenas de uma perspectiva organizacional, mas também de uma perspectiva cultural e social.

Previous dengue or Zika virus exposure can drive to infection enhancement or neutralisation of other flaviviruses

BACKGROUND Dengue virus (DENV) has circulated in Brazil for over 30 years. During this time, one serotype has cyclically replaced the other, until recently, when all four distinct serotypes began to circulate together. Persistent circulation of DENV for long time periods makes sequential infections throughout a person's life possible. After primary DENV infection, life-long immunity is developed for the infecting serotype. Since DENV and Zika virus (ZIKV) are antigenically similar, the possibility of cross-reactions has attracted attention and has been demonstrated in vitro. OBJECTIVE The aim of this study was to investigate whether immune-sera from DENV and ZIKV infected patients would cross-react in vitro with other Flaviviridae family members. METHODS Cross-reaction of the studied samples with yellow fever virus (YFV), West Nile virus (WNV), Rocio virus (ROCV), Saint Louis virus (SLEV) and Ilheus virus (ILHV) has been investigated by plaque reduction neutralisation test (PRNT) and the antibody-dependent enhancement (ADE) by flow-cytometry. FINDINGS Antibodies against ZIKV and DENV virus cross-reacted with other flaviviruses either neutralising or enhancing the infection. Thus, viral entrance into FcRFcɣRII-expressing cells were influenced by the cross-reactive antibodies. ZIKV or DENV immune sera enhanced cellular infection by WNV, ILHV, ROCV and SLEV. Finally, DENV immune sera presented higher neutralising activity for YFV and SLEV. While ZIKV immune sera neutralised WNV, ILHV and ROCV with high frequencies of positivity. MAIN CONCLUSIONS The co-circulation of those viruses in the same area represents a risk for the development of severe infections if they spread throughout the country. Successive flavivirus infections may have an impact on disease pathogenesis, as well as on the development of safe vaccine strategies.

Análisis bibliométrico de intervenciones basadas en terapia de tercera generación para niños y adolescentes en Iberoamérica y Europa / Bibliometric analysis of interventions based on third generation therapies in children and adolescents in Iberoamerica and Europe

Resumen El presente estudio es un análisis bibliométrico de las publicaciones en intervenciones basadas en las terapias de tercera generación en niños y adolescentes durante los años 2011-2016. Para esto se realizó un estudio descriptivo dentro del cual se analizaron 60 artículos científicos de diversas bases de datos como Proquest, Redalyc, Sage, ScienceDirect y Springer Science, Dialnet, Ebsco Host. Se evidenció que entre los años 2012 y 2014 se presentó un incremento en las publicaciones de terapias de tercera generación en Iberoamérica y Europa. La revista International Journal of Behavioral Consultation & Therapy presenta la mayor cantidad de publicaciones en este ámbito. En relación con el autor que presenta más publicaciones, se referencia a Swart, J como el principal. La revisión teórica y el estudio cuasi experimental fueron la metodología más reportada y el Mindfulness la terapia más utilizada. En cuanto al país con Mayor número de investigaciones en esta temática es Estados Unidos. Este estudio permite concluir que las terapias de tercera generación han comenzado a tomar fuerza en varios de los problemas comportamentales y emocionales en niños y adolescentes. Sin embargo, es necesario ampliar las investigaciones en este ámbito dado que en la mayoría de los artículos no se cuantifica el grado de eficacia.

Abstract The present study is a bibliometric analysis of publications on interventions based on third generation therapies in children and adolescents during the years 2011-2016. For this, a descriptive study was carried out in which 60 scientific articles from diverse databases were analyzed, such as Proquest, Redalyc, Sage, ScienceDirect and Springer Science, Dialnet, Ebsco Host. It was evidenced that between the years 2012 and 2014 there was an increase in the publications of third generation therapies in Ibero-America and Europe. The International Journal of Behavioral Consultation & Therapy presents the largest number of publications in this field. In relation to the author who presents the most publications, reference is made to Swart, J as the principal. The theoretical review and the quasi-experimental study were the most reported methodology and Mindfulness the most used therapy. As for the country with the largest number of investigations in this area is the United States. This study allows us to conclude that third generation therapies have begun to gain strength in several behavioral and emotional problems in children and adolescents. However, it is necessary to expand the research in this field since in most articles the degree of efficacy is not quantified.

Development and characterization of a packaging cell line for pseudo-infectious yellow fever virus particle generation

Abstract INTRODUCTION: Pseudo-infectious yellow fever viral particles (YFV-PIVs) have been used to study vaccines and viral packaging. Here, we report the development of a packaging cell line, which expresses the YFV prM/E proteins. METHODS: HEK293 cells were transfected with YFV prM/E and C (84 nt) genes to generate HEK293-YFV-PrM/E-opt. The cells were evaluated for their ability to express the heterologous proteins and to package the replicon repYFV-17D-LucIRES, generating YFV-PIVs. RESULTS: The expression of prM/E proteins was confirmed, and the cell line trans-packaged the replicon for recovery of a reporter for the YFV-PIVs. CONCLUSIONS: HEK293-YFV-prM/E-opt trans-packaging capacity demonstrates its possible biotechnology application.

Construction and characterization of a recombinant yellow fever virus stably expressing Gaussia luciferase

ABSTRACT Yellow fever is an arthropod-borne viral disease that still poses high public health concerns, despite the availability of an effective vaccine. The development of recombinant viruses is of utmost importance for several types of studies, such as those aimed to dissect virus-host interactions and to search for novel antiviral strategies. Moreover, recombinant viruses expressing reporter genes may greatly facilitate these studies. Here, we report the construction of a recombinant yellow fever virus (YFV) expressing Gaussia luciferase (GLuc) (YFV-GLuc). We show, through RT-PCR, sequencing and measurement of GLuc activity, that stability of the heterologous gene was maintained after six passages. Furthermore, a direct association between GLuc expression and viral replication was observed (r2=0.9967), indicating that measurement of GLuc activity may be used to assess viral replication in different applications. In addition, we evaluated the use of the recombinant virus in an antiviral assay with recombinant human alfa-2b interferon. A 60% inhibition of GLuc expression was observed in cells infected with YFV-GLuc and incubated with IFN alfa-2b. Previously tested on YFV inhibition by plaque assays indicated a similar fold-decrease in viral replication. These results are valuable as they show the stability of YFV-GLuc and one of several possible applications of this construct.

Use of homologous recombination in yeast to create chimeric bovine viral diarrhea virus cDNA clones

Abstract The open reading frame of a Brazilian bovine viral diarrhea virus (BVDV) strain, IBSP4ncp, was recombined with the untranslated regions of the reference NADL strain by homologous recombination in Saccharomyces cerevisiae, resulting in chimeric full-length cDNA clones of BVDV (chi-NADL/IBSP4ncp#2 and chi-NADL/IBSP4ncp#3). The recombinant clones were successfully recovered, resulting in viable viruses, having the kinetics of replication, focus size, and morphology similar to those of the parental virus, IBSP4ncp. In addition, the chimeric viruses remained stable for at least 10 passages in cell culture, maintaining their replication efficiency unaltered. Nucleotide sequencing revealed a few point mutations; nevertheless, the phenotype of the rescued viruses was nearly identical to that of the parental virus in all experiments. Thus, genetic stability of the chimeric clones and their phenotypic similarity to the parental virus confirm the ability of the yeast-based homologous recombination to maintain characteristics of the parental virus from which the recombinant viruses were derived. The data also support possible use of the yeast system for the manipulation of the BVDV genome.

Primary dengue haemorrhagic fever in patients from northeast of Brazil is associated with high levels of interferon-β during acute phase

Dengue is an acute febrile disease caused by the mosquito-borne dengue virus (DENV) that according to clinical manifestations can be classified as asymptomatic, mild or severe dengue. Severe dengue cases have been associated with an unbalanced immune response characterised by an over secretion of inflammatory cytokines. In the present study we measured type I interferon (IFN-I) transcript and circulating levels in primary and secondary DENV infected patients. We observed that dengue fever (DF) and dengue haemorrhagic fever (DHF) patients express IFN-I differently. While DF and DHF patients express interferon-α similarly (52,71 ± 7,40 and 49,05 ± 7,70, respectively), IFN- β were associated with primary DHF patients. On the other hand, secondary DHF patients were not able to secrete large amounts of IFN- β which in turn may have influenced the high-level of viraemia. Our results suggest that, in patients from our cohort, infection by DENV serotype 3 elicits an innate response characterised by higher levels of IFN- β in the DHF patients with primary infection, which could contribute to control infection evidenced by the low-level of viraemia in these patients. The present findings may contribute to shed light in the role of innate immune response in dengue pathogenesis.

Full-length infectious clone of a low passage dengue virus serotype 2 from Brazil

Full-length dengue virus (DENV) cDNA clones are an invaluable tool for many studies, including those on the development of attenuated or chimeric vaccines and on host-virus interactions. Furthermore, the importance of low passage DENV infectious clones should be highlighted, as these may harbour critical and unique strain-specific viral components from field-circulating isolates. The successful construction of a functional Brazilian low passage DENV serotype 2 full-length clone through homologous recombination reported here supports the use of a strategy that has been shown to be highly useful by our group for the development of flavivirus infectious clones and replicons.

Construction and characterisation of a complete reverse genetics system of dengue virus type 3

Dengue virulence and fitness are important factors that determine disease outcome. However, dengue virus (DENV) molecular biology and pathogenesis are not completely elucidated. New insights on those mechanisms have been facilitated by the development of reverse genetic systems in the past decades. Unfortunately, instability of flavivirus genomes cloned in Escherichia coli has been a major problem in these systems. Here, we describe the development of a complete reverse genetics system, based on the construction of an infectious clone and replicon for a low passage DENV-3 genotype III of a clinical isolate. Both constructs were assembled into a newly designed yeast- E. coli shuttle vector by homologous recombination technique and propagated in yeast to prevent any possible genome instability in E. coli . RNA transcripts derived from the infectious clone are infectious upon transfection into BHK-21 cells even after repeated passages of the plasmid in yeast. Transcript-derived DENV-3 exhibited growth kinetics, focus formation size comparable to original DENV-3 in mosquito C6/36 cell culture. In vitro characterisation of DENV-3 replicon confirmed its identity and ability to replicate transiently in BHK-21 cells. The reverse genetics system reported here is a valuable tool that will facilitate further molecular studies in DENV replication, virus attenuation and pathogenesis.

Leucoencefalitis hemorrágica aguda: manifestaciones clínicas, hallazgos radiológicos y neuropatológicos / Acute hemorrhagic leukoencephalitis: clinical presentation, radiologic and neuropathologic features

La Leucoencefalitis Hemorrágica Aguda o enfermedad de Hurst es una enfermedad rara, caracterizada clínicamente por inicio súbito, curso clínico severo, usualmente fatal que se presenta posterior a una infección viral o vacunación. Patológicamente se caracteriza por desmielinización perivenular y necrosis hemorrágica difusa del sistema nervioso central. Se considera que representa una forma hiperaguda y severa de la Encefalomielitis Aguda Diseminada, la cual es una entidad inflamatoria con una base fisiopatológica autoinmune postinfecciosa. A continuación, se expone el caso de una paciente adulta, que ingresó al servicio de urgencias con cuadro clínico típico de migraña y antecedente de cefaleas previas de similares características. Quien doce horas posterior a su ingreso desarrolló de forma rápidamente progresiva depresión del estado de conciencia, signos neurológicos focales y signos de hipertensión de fosa posterior, que llevaron a desenlace fatal en tan solo 96 horas del inicio del cuadro clínico con hallazgos patológicos postmortem que confirman leucoencefalitis hemorrágica aguda. Se revisan las características clínicas, los hallazgos radiológicos y patológicos de esta entidad clínico-patológica poco común.

Acute hemorrhagic leukoencephalitis or Hurst disease is a rare disorder characterized by its severe neurological involvement, rapid progression and fatal outcome in a few days. The disease is usually a post infectious condition. Under microscope, it is identified by a perivenular demyelination and a diffuse hemorrhagic necrosis. This entity is thought to represent a hyperacute severe form of acute disseminated encephalomyelitis, which is an inflammatory autoimmune post infectious disorder. We describe the case of an adult woman, who visits the emergency room with migraine-like symptoms and a previous clinical history of similar headaches. Twelve hours later she developed focal neurologic findings, stupor and signs of endocraneal hypertension, her clinical status continued to worsen and in 96 hours she succumbed. The autopsy confirm acute hemorrhagic Leukoencephalitis. Reviewed clinical, radiological and pathological characteristics of this uncommon disease.

Potential biomarkers for the clinical prognosis of severe dengue

Currently, several assays can confirm acute dengue infection at the point-of-care. However, none of these assays can predict the severity of the disease symptoms. A prognosis test that predicts the likelihood of a dengue patient to develop a severe form of the disease could permit more efficient patient triage and treatment. We hypothesise that mRNA expression of apoptosis and innate immune response-related genes will be differentially regulated during the early stages of dengue and might predict the clinical outcome. Aiming to identify biomarkers for dengue prognosis, we extracted mRNA from the peripheral blood mononuclear cells of mild and severe dengue patients during the febrile stage of the disease to measure the expression levels of selected genes by quantitative polymerase chain reaction. The selected candidate biomarkers were previously identified by our group as differentially expressed in microarray studies. We verified that the mRNA coding for CFD, MAGED1, PSMB9, PRDX4 and FCGR3B were differentially expressed between patients who developed clinical symptoms associated with the mild type of dengue and patients who showed clinical symptoms associated with severe dengue. We suggest that this gene expression panel could putatively serve as biomarkers for the clinical prognosis of dengue haemorrhagic fever.

Sistema trigémino vascular y cefalea / Trigeminovascular System and Primary Headache

La fisiopatología de las cefaleas primarias es compleja e incluye un sinnúmerode interacciones que regulan el proceso nociceptivo. Dentro de los principalesresponsables de generar el dolor se encuentra el sistema trigémino vascular, que esun conjunto de estructuras que integran vías tanto centrales corticosubcorticales comoperiféricas, que desempeñan un papel activo no solo en la génesis del dolor, sino enlas manifestaciones autonómicas y visuales que acompañan la cefalea. Así mismo, estesistema es el responsable de los mecanismos de sensibilización central característicosdel dolor. En el artículo se desarrollan brevemente las principales estructuras queparticipan en la génesis de las cefaleas primarias y sus interacciones en las diferentespartes del sistema nervioso...

The pathophysiology of primary headache iscomplex and it includes several interactionsthat regulate the nociceptive process. The trigeminal-vascular system is perhaps one of theprincipal structures that generate pain due tothe integration of several pathways both centraland peripheral. In addition to this, the trigeminalvascular system also plays a central role inthe autonomic and visual symptoms that affectindividuals with headache and in the centralsensitization process. In this article we brieflydiscuss the main structures that participate in thepathophysiology of primary headaches and theirinteractions in the different levels of the centralnervous system...

Síndrome de opsoclonus-mioclonus-ataxia (OMA) parainfeccioso secundario a infección por citomegalovirus / Opsoclonus myoclonus ataxia syndrome secondary to a parainfectious process by cytomegalovirus

A continuación, se presenta un paciente de 66 años con alteración en los movimientos oculares, asociado a mioclonías, disartria y ataxia cerebelosa, secundario a un proceso parainfeccioso por citomegalovirus. Posteriormente, se revisa la fisiopatología del síndrome de opsoclonus – mioclonus – ataxia, las etiologías del mismo y las opciones terapéuticas disponibles. Esta es una etiología poco frecuente del síndrome, pues sólo se encontró un caso reportado de opsoclonus mioclonus ataxia asociado a citomegalovirus.

Early molecular markers predictive of dengue hemorrhagic fever

The management of acute dengue patients during outbreaks is a challenging problem. Most of the dengue fever cases are benign, but some cases develop into a severe and possibly lethal vasculopathy, known as dengue hemorrhagic fever. Early symptoms of dengue and hemorrhagic fever are very similar. An early differential diagnosis is needed to predict which of these two clinical presentations is crucial to proper patient care and public health management. This study evaluates the predictive potential of specific mRNA expression markers of dengue hemorrhagic fever using quantitative real-time PCR assays. Six candidate "dengue hemorrhagic fever specific signature genes" were evaluated and all showed good correlation among their transcription levels at early days of infection and the later development of severe vasculopathy. The markers selected were able to indicate, at early stages of infection, the evolution of a dengue-infected patient to the severe form of the illness. Despite the fact that these results grant further validation studies, the panel of candidate prognostic markers obtained demonstrated the potential to be useful for clinical use in the form of a fast assay based in blood samples.

O manejo de pacientes infectados pelo dengue ainda é um problema desafiador. A maioria dos casos de dengue é benigna mas parte desses casos pode evoluir para o desenvolvimento de vasculopatia severa conhecida como dengue hemorrágica, que pode ser letal. Os sintomas iniciais da dengue e sua forma hemorrágica são bastante similares. O desenvolvimento de um teste diagnóstico que seja rápido e capaz de diferenciar as duas formas clínicas da dengue é crucial para o cuidado adequado de pacientes. O presente estudo avalia, através da PCR quantitativa em tempo real, o potencial preditivo dos níveis de expressão de RNAm candidatos a marcadores da dengue hemorrágica, previamente identificados por estudos genômicos funcionais. Um conjunto de seis marcadores moleculares para a dengue hemorrágica foi avaliado e apresentou correlação entre seus níveis de transcrição e o posterior desenvolvimento da vasculopatia severa. Os marcadores selecionados foram capazes de indicar, nos momentos iniciais dos sintomas, a evolução de um paciente infectado pelo dengue para a forma severa da doença. O painel de candidatos a marcadores de prognóstico obtido demonstrou um bom potencial para uso clínico na forma de um ensaios rápido baseado em amostras de sangue.

Atrofia cortical posterior: descripción clínica y neuroimágenes de tres casos / Cortical posterior atrophy: clinical description and neuroimages of thre cases

La atrofia cortical posterior (ACP) es una demencia poco frecuente caracterizada por la degeneración de la corteza occipitoparietal y de las vías dorsal y ventral de procesamiento visual, que se manifiesta inicialmente por una alteración en las funciones visuales complejas y posteriormente por la aparición de elementos del síndrome de Balint y del síndrome de Gerstmann. La afectación visuoperceptual es predominante en el cuadro, respecto a otros síntomas cognitivos como el compromiso de la memoria. Se presentan tres pacientes con este síndrome demencial, que iniciaron el cuadro clínico con alteraciones visuoperceptuales y desorientación visuoespacial sin alteración inicial de la memoria, del comportamiento ni del lenguaje. Todos los casos fueron comprobados con estudios de neuroimágenes, en los que se encontró atrofia focal occipitoparietal bilateral predominante. La atrofia cortical posterior es un tipo de demencia focal, en la cual las manifestaciones visuoperceptuales son los síntomas iniciales y predominantes, mientras que otros dominios cognitivos como la memoria, el lenguaje y el comportamiento están preservados y se conservan hasta fases avanzadas de la enfermedad. Al presentar estos casos similares entre sí y concordantes con lo reportado previamente en la literatura, se hace relevante reconocer la ACP como un tipo de demencia presenil con características clínicas propias que permiten diferenciarla del perfil neuropsicológico de otras demencias.

Políticas de Saúde, Pluralidade Terapêutica e Identidade na Amazônia / Health Policies, Therapeutic Plurality and Identity in Indigenous Amazonia

O propósito deste trabalho é realizar uma comparação entre os campos terapêuticos vivenciados por dois grupos pano: os Yaminawa (Departamento do Ucayali, Peru) e os Yawanawa (Acre, Brasil). Essa comparação levanta questões relevantes, na medida em que ambos os grupos, apesar de sua proximidade cultural, se encontram inseridos em realidades nacionais, sociais e políticas diferentes. As diferenças existentes não se limitam a questões derivadas de duas políticas oficiais de saúde distintas, mas estão diretamente associadas às particularidades dos respectivos contextos sociais regionais. A comparação dessas situações mostra que o tipo de relação que as sociedades envolventes e os Estados estabelecem com as populações indígenas, assim como os aspectos identitários derivados dela, são fatores importantes na constituição do habitus terapêutico desses grupos. Esse aspecto é exemplificado no texto por meio de uma reflexão sobre diferenças existentes entre as práticas, de cada um dos grupos, relativas à alimentação dos recém-nascidos e ao uso dos recursos da biomedicina em relação ao parto e o controle da natalidade.

The purpose of this paper is to make a comparison between the therapeutic fields that form part of the daily experience of two Panoan groups: Yaminawa people (Ucayali, Peruvian Amazon) and Yawanawa people (Acre, Brazilian Amazon). This comparison raises some interesting questions, as both groups, in spite of their cultural and linguistic relatedness, are inserted in different national, social and political contexts. The existing differences observed are not limited to questions stemming from two different state health policies; rather, they are directly associated with the particularities of their respective social and regional contexts. A comparison of these situations demonstrates that the relationship that the State establishes with indigenous societies, as well as the identity aspects deriving from it, are important factors in the constitution of indigenous therapeutic habitus. The present analysis examines how these issues are exemplified in newborns' feeding practices and in the use of biomedical resources in childbirth and birth control in both groups.

Reinicio de la actividad ovárica y nivel de metabolitos de lípidos en vacas lecheras suplementadas con aceite vegetal durante el posparto temprano / Resumption of ovarian activity and lipid metabolites in lactating cows supplemented with vegetal oil during early postpartum

Se evaluaó el reinicio de la actividad ovárica posparto (RAO) y los metabolitos de lípidos en vacas lecheras suplementadas con aceite vegetal durante el posparto temprano. Se emplearon 18 vacas Holstein Friesian de tercer parto, de 597,3 ± 50,2 kg y condición corporal = 3,5 ± 0,6. Los animales fueron distribuidos aleatoriamente en dos grupos, uno experimental suplementado con 500 g de aceite vegetal durante 8 semanas a partir de la segunda semana posparto (CAV; n=9), y uno control sin suplemento (SAV; n=9), RAO se determinó cuando las concentraciones semanales de P4 fueron mayor igual Ing/ml y se mantuvieron por dos semanas consecutivas. P4 fue medida por radioinmunoensayo y los metabolitos de lípidos (colesterol, lipoproteínas de alta y baja densidad, triglicéridos y lípidos totales) por enzimunocolorimetría, en muestras de sangre colectadas semanalmente durante el período de suplementación grasa. RAO se presentó siete días antes en el grupo CAV respecto a SAV (23,3 ± 12,8 vs 29,6 ± 12,4 días, P<0,05). La concentración media de P4 no se vio afectada (1,48 ± 0,31 vs 1,15 ± 0,31ng/ml para CAV y SAV, respectivamente); sin embargo, se observó un efecto significativo entre los días 28 y 56 a favor del grupo CAV. Entre los metabolitos de lípidos, solo colesterol, triglicéridos y lípidos totales, mostraron diferencias (P<0,05): 109,3 ± 9,9 vs 135,7 ± 9,9; 29,3 ± 7,9 vs 41,3 ± 7,9; y 366,2 ± 50,3 vs 434,2 ± 50,3 mg/dl para SAV y CAV, respectivamente. La suplementación grasa acorta el reinicio de la actividad ovárica posparto e incrementa la concentración plasmática de colesterol, triglicéridos y lípidos totales en vacas lecheras

O sistema médico Yawanáwa e seus especialistas: cura, poder e iniciaçäo xamânica / The Yawanáwa medical system and its specialists: healing, power, and shamanic initiation

Uma das particularidades do xamanismo Yawanáwa é a multiplicidade de termos existentes para designar seus especialistas, bem como a associaçäo com diversas técnicas de cura e agressäo característica que lhe dá aparência heterogênea e complexa. Contudo, uma unidade subjaz a esse aspecto, já que todas essas técnicas compartilham concepçöes idênticas a respeito da realidade e baseiam sua eficiência nos mesmos conceitos de poder e de conhecimento. Para pesquisar a forma como o poder e o conhecimento - alicerces das práticas relacionadas com a cura - säo concebidos entre os Yawanáwa, explora-se e analisa-se o processo por meio do qual o especialista os adquire: a iniciaçäo xamânica.