La economía feminista. Camino hacia la construcción de un paradigma alternativo. Ideas para seguir debatiendo / The feminist economy. Path towards the construction of an alternative paradigm. Ideas for further discussion

El abordaje onto epistémico de este ensayo se desarrolla en tres grandes miradas: un desarrollo gnoseológico orientado a precisar diferentes posicionamientos de la economía feminista como un movimiento político, herramienta de lucha y resistencia para enfrentar un modelo económico misógino, patriarcal, excluyente y a espaldas de la vida. Seguidamente, se precisan aspectos relevantes de su historicidad, partiendo de las figuras más resaltantes de la economía neoclásica. El hombre dentro de esta perspectiva (Homus Economicus), es el motor de la producción de riqueza, el agente económico por excelencia. Modelo donde no aparecen las relaciones sociales, las mujeres, la vida… Solo producir y consumir. Finalmente, se destaca toda una serie de avances y desafíos. Dentro de estas nuevas perspectivas, se pone especial atención a las relaciones de cuidado y afecto que se producen en los hogares como trabajo no remunerado. El cuidado de la vida humana toma el escenario, exigiendo nuevas perspectivas de análisis y la ampliación de fronteras a fin de destacar su relevancia social y económica; a partir de la utilización de estrategias para la valoración de la producción doméstica incorporando nuevas propuestas sobre el manejo de las estadísticas con lentes de género. El presupuesto gubernamental, se debe presentar desagregado y analizado el efecto de políticas de gastos e ingresos de manera diferenciada y situada(AU)

The ontologic epistemic approach in this essay is developed in three main perspectives: a gnoseological development aimed at specifying different positions of feminist economics as a political movement, a tool of struggle and resistance to face a misogynistic, patriarchal, exclusionary economic model behind the back of life. Next, relevant aspects of its historicity are specified, starting from the most outstanding figures of neoclassical economics. Man within this perspective (Homus Economicus), is the engine of the production of wealth, the economic agent par excellence. Model where social relationships, women, life do, not appear... Just produce and consume. Finally, a whole series of advances and challenges are highlighted. Within these new perspectives, special attention is paid to the relationships of care and affection that occur in households as unpaid work. The care of human life takes the stage, demanding new perspectives of analysis and the expansion of borders in order to highlight its social and economic relevance; from the use of strategies for the valuation of domestic production, incorporating new proposals on the management of statistics with gender lenses. The government Budget, should be presented disaggregated, and the effect of expenditure and revenue policies should be analyzed in a differentiated and situated manner(AU)

Retiro de elementos de osteosíntesis en trauma maxilofacial / Osteosynthesis elements removal in maxillofacial trauma

Resumen Objetivo: Analizar la prevalencia y los factores en la remoción de elementos de osteosíntesis (OTS) de pacientes tratados quirúrgicamente debido a fracturas maxilofaciales. Materiales y Método: Estudio retrospectivo descriptivo, donde fueron incluidos todos los pacientes con diagnóstico de fractura maxilofacial y tratados mediante reducción abierta y fijación interna rígida en un intervalo de 10 años, en el Servicio de Cirugía Oral y Maxilofacial en el Hospital Clínico Mutual de Seguridad (HCMS). Resultados: En un total de 807 pacientes intervenidos, con un rango etario entre 22-66 años, fueron utilizados 2.421 OTS. Entre ellos, 58 pacientes (7,2%) fueron sometidos a un segundo procedimiento quirúrgico, retirándose un total de 129 OTS (5,3%). La principal causa de retiro fue infección (41,1%), comúnmente de carácter tardío. El tercio inferior facial fue el más afectado, específicamente, la zona parasinfisiaria. El 39% fue retirado antes de los 12 meses de posicionados. Conclusiones: El retiro de OTS, posterior a trauma maxilofacial tiene una baja prevalencia. El sitio más afectado es el hueso mandibular y la mayoría se retira dentro de los primeros 12-24 meses. La etiología es variable, sin embargo, la infección se mantiene como una de las principales. Los hallazgos sugieren que no sería recomendable realizar este procedimiento de forma universal para todos los pacientes.

Aim: To analyse the prevalence and factors regarding to osteosynthesis elements (OTS) removal from patients surgically treated due to maxillofacial fractures. Materials and Method: Retrospective study in which all patients with diagnosis of maxillofacial fractures and treated with open reduction and internal rigid fixation were included, in an interval of 10 years, in the Maxillofacial Surgery Service of HCMS. Results: In 807 surgically treated patients, with an age between 22-66 years, 2.421 OTS were used. Among them, 58 patients (7.2%) underwent a second surgical procedure, with a total of 129 OTS removed (5.3%). The main cause of removal was infection (41.1%), commonly of a chronic nature. The lower third of the face was the most affected, specifically, the parasymphysis region. 39% of OTS were withdrawn before 12 months. Conclusions: OTS removal after maxillofacial trauma has a low prevalence, the most affected site is the mandibular bone, within the first 12-24 months. The aetiology is variable, however, infection remains one of the main. The findings suggest that it would not be advisable to perform this procedure universally for all patients.

COMPLEJO ESCLEROSIS TUBEROSA: a propósito de un caso clínico / TUBEROUS SCLEROSIS COMPLEX: about a clinical case

RESUMEN El Complejo Esclerosis Tuberosa (CET) es un síndrome neurocutáneo multisistémico que pertenece al grupo de las genodermatosis, de transmisión de herencia autosómica dominante con alta penetrancia y muy variable expresividad fenotípica. Es producido por mutaciones en los genes TSC1 y TSC2. Se caracteriza por la triada de epilepsia, retraso madurativo y angiofibromas. El diagnóstico es clínico y consiste en ensamblar los signos clínicos identificados, con los criterios diagnósticos consensuados de criterios principales y secundarios. Presentamos un paciente adulto con antecedentes de retraso madurativo y epilepsia desde la infancia en tratamiento y seguimiento por neurología desde entonces; y antecedentes familiares de síndrome convulsivo en sus hermanos, a quien se le realiza diagnóstico tardío de CET al momento de la consulta, cumpliendo con los criterios para el mismo.

ABSTRACT Tuberous Sclerosis Complex (TSC) is an autosomal dominant multisystem neurocutaneous syndrome with almost complete penetrance but variable expressivity. This genodermatosis occurs upon mutation of TSC1 and TSC2 genes. It is characterized by the classic triad of seizures, mental retardation and cutaneous angiofibromas. The diagnosis of TSC is based by the presence of major and minor criteria. We report the case of an adult male patient with personal history of mental retardation in addition with personal and family history of seizures since childhood.

Reconstrucción con colgajo de músculo temporal en defecto del tercio medio de la región facial. Nuestra experiencia en un hospital de mediana complejidad / TEMPORALIS MUSCLE FLAP RECONSTRUCTION IN FACIAL REGION DEFECTS. OUR EXPERIENCE IN MEDIUM COMPLEXITY HOSPITAL

Introducción: El colgajo pediculado realizado con músculo temporal es una opción terapéutica válida para la reconstrucción de defectos de la región facial posterior a una resección quirúrgica, es una alternativa aceptable a los colgajos libres cuando estos no pueden ser utilizados ya sea por el performance status o patología de base de los pacientes a tratar o por no contar con cirujano microvascular. Objetivo: Describir nuestra experiencia en el uso de este colgajo para la reconstrucción de 7 pacientes con defectos de órbita, paladar y mucosa yugal tras la cirugía ablativa de diversas patologías. Materiales y métodos: Revisión retrospectiva de los pacientes del Servicio de Cirugía General del Hospital José Ramon Vidal, Corrientes-Argentina operados en el periodo comprendido desde enero del 2019 hasta enero del 2021.En este lapso, 7 pacientes fueron sometidos a cirugía reconstructiva inmediata con colgajo de músculo temporal en defectos del tercio medio de la región facial. Resultados: Un total de siete pacientes, (4 masculino- 3 femenino), sometidos a cirugía ablativa por presentar patología maligna (6) y patología benigna (1), con una edad media de 60 años. Dos colgajos se utilizaron para defectos de región orbitaria y partes blandas, seis para defectos en la cavidadoral­ en un paciente se emplearon los 2 músculos temporales-. El colgajo fue exitoso en todos los casos, se presentaron complicaciones menores como: dolor postoperatorio, hematoma, trismus, depresión de la zona dadora. Se obtuvo márgenes libres en el total de los procedimientos. Discusión: La cirugía reconstructiva con colgajo pediculado de musculo temporal es una excelente alternativa de colgajo regional con buenos resultados, posee alta tasa de éxito justificada por su buena vascularización. Además, la proximidad del músculo temporal con la región maxilofacial y su inserción contribuyen a obtener un arco de rotación hasta 180° sin comprometersu vitalidad. Es útil para la reconstrucción en un acto quirúrgico, acortando el tiempo intraoperatorio y sin cambios posicionales. Conclusiones: El colgajo de músculo temporal resulta una opción válida a los colgajos libres osteo-mio-cutáneos para defectos mixtos (óseos y de partes blandas) del tercio medio facial luego de la cirugía ablativa, cuando estos últimos no pueden ser implementados teniendo en cuenta varios aspectos como performance estatus de los pacientes, patología de base y necesidad de contar con un cirujano microvascular

Introduction: temporalis muscle vascularized flaps is a valid therapeutic option for reconstruction of defects in facial region after surgical resections. It is an acceptable alternative to free transfer flaps when these cannot be used because of the patient's performance state and base pathologies. Or because of the lack of a microvascular surgeon. Objectives: To describe on experience applying this kind of flaps for the reconstruction or 7 patients, with defects in palate orbit and yugal mucose after resective surgeries for various pathologies. Materials and methods: retrospective revision of patients in the general department, of Jose R Vidal Hospital (Corrientes - Argentina) into underwent surgery during the period between January 2019 ad January 2021. A total of 7 patients underwent immediate reconstructive surgery using a temporalis muscle flap. Results: 7 patients (4 males y 3 female) underwent resective surgery for different malignant (6) and benign (1) with a median age of 60. Two flaps were used for defects of the orbitary region and soft tissue, six for defects of the oral cavity (in one patient both temporalis muscle were used. Te procedure was successful in all cases, and minor complication were present, (post operatory pain, hematoma, trismus, excavation of the donor region) all procedures resulted un surgical margins of lesion of malignancy. Discussion: reconstructive surgery using a vascularized flap of temporalis muscle is an excellent alternative for regional flaps with good results and a high success justified because of its a good irrigation. Besides the proximity between temporalis muscle and the maxillofacial region, possibilities a flap rotation of up to 180 grades without compromising its vitality it is also useful for reconstruction in a single surgery shortening intra-operatory time while avoiding repositioning of the patients during the procedure. Conclusions: Temporalis muscle flaps are valid option to free osteo- mayo- cutaneal flaps for mixed defects (involving bone and soft tissue) of the medium third of facial region after resective surgeries when the latter cannot be carried and because of various aspects little performance status base pathologies and lack of microvascular margin.

Bacterias aisladas en hemocultivos positivos en lactantes bajo 90 días de edad ingresados por fiebre al Hospital Exequiel González Cortés entre 2014 y 2016 / Positive blood cultured isolated bacteria in children under 90 days old admitted for fever in Hospital Exequiel González Cortés between 2014 and 2016

INTRODUCCIÓN: En neonatos y lactantes bajo 90 días de vida la fiebre constituye un signo clínico relevante ya que puede corresponder a una infección bacteriana grave, por lo que se toman hemocultivos de forma rutinaria y el paciente es hospitalizado. Aún no existe una recomendación respecto al tiempo de observación necesario una vez internado el paciente. OBJETIVO: Describir las bacterias aisladas en hemocultivos de lactantes bajo 90 días de vida hospitalizados por fiebre y el tiempo de detección de crecimiento microbiano en los mismos. ¨MÉTODO: Estudio descriptivo, retrospectivo. Se revisaron hemocultivos positivos tomados entre 2014 y 2016 en neonatos y lactantes < 90 días de edad. Se obtuvieron las identificaciones, tiempo de positividad de las bacterias, así como datos clínicos, de laboratorio y demográficos. RESULTADOS: Se identificaron 172 hemocultivos positivos, 51 cumplían los criterios de inclusión. De éstos, 21 microorganismos fueron patógenos (Escherichia coli: 10, Streptococcus agalactiae: 3, Streptococcus pyogenes: 3, otros: 5) y 30 se consideraron contaminación, principalmente Staphylococcus coagulasa negativa. En relación al total de la muestra, la mediana del tiempo de positividad fue de 10 h. A las 24 h de cultivo se detectó crecimiento bacteriano en 94% de la muestra. CONCLUSIÓN: Las bacterias patógenas aisladas en los hemocultivos de pacientes < 90 días de edad, que ingresaron con fiebre, corresponden principalmente a bacilos gramnegativos y estreptococos. Todos los patógenos aislados fueron detectados antes de 24 h de incubación.

BACKGROUND: Fever in infants younger than 90 days may reflect a serious bacterial infection, so blood cultures (BC) are taken routinely and the patient is hospitalized. The observation time to detect occult bacteremia is not well established. AIM: To describe type and positivity time of isolated bacteria in blood cultures in infants under 90 days admitted for fever. METHODS: Retrospective, descriptive study. Positive blood cultures taken between 2014-2016 in young infants admitted for fever were included. Identification and time of positivity of each bacteria, clinical, laboratory and demographic data were recorded. Demographic variables and the clinical outcome was obtained. RESULTS: There were 172 positive blood cultures, only 51 met inclusion criteria. Of these, 21 microorganisms were pathogenic (Escherichia coli: 10, Streptococcus agalactiae: 3, Streptococcus pyogenes: 3, others: 5) and 30 were considered contamination, mainly coagulase negative Staphylococcus. In relation to the total sample, the median time of positivity was 10 hrs. At 24 hours of culture, bacterial growth was detected in 94% of the sample. CONCLUSION: The pathogenic bacteria isolated in the blood cultures of patients younger than 90 days who were admitted with fever correspond mainly to Gram negative bacilli and streptococci. All isolated pathogens were detected before 24 h of incubation.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo, 1762 (Diptera: Culicidae) / Efeitos tardios de Beauveria bassiana nos estágios larvais de Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Abstract Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

Resumo O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Late effects of Beauveria bassiana on larval stages of Aedes aegypti Linneo , 1762 (Diptera: Culicidae) / Efeitos tardios de Beauveria bassiana nos estágios larvais de Aedes aegypti Linneo, 1762 (Diptera: Culicidae)

Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104 , 1.5× 105 , 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107 , while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

Cobalamin cbiP mutant shows decreased tolerance to low temperature and copper stress in Listeria monocytogenes

BACKGROUND: Listeria monocytogenes is a foodborne pathogen that causes listeriosis in humans. This pathogen activates multiple regulatory mechanisms in response to stress, and cobalamin biosynthesis might have a potential role in bacterial protection. Low temperature is a strategy used in the food industry to control bacteria proliferation; however, L. monocytogenes can grow in cold temperatures and overcome different stress conditions. In this study we selected L. monocytogenes List2-2, a strain with high tolerance to the combination of low temperature +copper, to understand whether the cobalamin biosynthesis pathway is part of the tolerance mechanism to this stress condition. For this, we characterized the transcription level of three cobalamin biosynthesis related genes ( cbiP , cbiB, and cysG ) and the eutV gene, a transcriptional regulator encoding gene involved in ethanolamine metabolism, in L. monocytogenes strain List2-2 growing simultaneously under two environmental stressors: low temperature (8 °C) +copper (0.5 mM of CuSO4 ×5H2O). In addition, the gene cbiP , which encodes an essential cobyric acid synthase required in the cobalamin pathway, was deleted by homologous recombination to evaluate the impact of this gene in L. monocytogenes tolerance to a low temperature (8 °C) +different copper concentrations. RESULTS: By analyzing the KEGG pathway database, twenty-two genes were involved in the cobalamin biosynthesis pathway in L. monocytogenes List2-2. The expression of genes cbiP , cbiB, and cysG, and eutV increased 6 h after the exposure to low temperature +copper. The cobalamin cbiP mutant strain List2-2Δ cbiP showed less tolerance to low temperature +copper (3 mM) than the wild type L. monocytogenes List2-2. The addition of cyanocobalamin (5 nM) to the medium reverted the phenotype observed in List2-2Δ cbiP . CONCLUSION: These results indicate that cobalamin biosynthesis is necessary for L. monocytogenes growth under stress and that the cbiP gene may play a role in the survival and growth of L. monocytogenes List2-2 at low temperature +copper.

Consideraciones radiológicas del cáncer de pulmón y Covid-19: una mirada oncológica / Radiological considerations of lung cancer and Covid-19: a oncology look

Patients with SARS-Cov-2 infection and lung cancer have an unfavorable prognosis, characterized by higher rates of respiratory failure, use of invasive mechanical ventilation and higher mortality rates. Due to similarities in affected organs in Covid-19 and lung cancer, the radiological accurate diagnosis has become a challenge for physicians. Radiologic findings of lung cancer, such as parenchymal consolidation, spiculation and microlobulations are not specific. Imaging findings of Covid-19 in patients with lung cancer consist of multiple patchy multifocal bilateral ground-glass opacities and consolidations, being hardly distinguishable from an underlying lung malignancy. Differential radiological diagnosis in patients with lung cancer and Covid-19 must include pneumonitis and lung toxicity caused by chemotherapy, target therapies and radiotherapy. Follow-up and simulation tomography in radiotherapy have become an unexpected ally in the early detection of Covid-19 in asymptomatic stages in lung cancer patients. Patients with lung cancer should have particular considerations due to their high risk and the adverse effects of systemic therapies and radiotherapy. (AU)

Diagnostico de Chagas Congénito en el Hospital de Niños "Sor María Ludovica" / Diagnosis of Congenital Chagas in the Children's Hospital "Sor María Ludovica"

Introducción:La transmisión congénita de Trypanosoma cruzi constituye, en la actualidad, la vía que genera mayor cantidad de nuevos casos de infección aguda. El diagnóstico y tratamiento temprano aseguran una elevada probabilidad de cura parasitológica. El objetivo del trabajo fue evaluar el seguimiento de potenciales casos de Chagas Congénito, estimar la tasa de transmisión materno-fetal y la capacidad diagnóstica del microhematocrito. Materiales y métodos: Se realizó un estudio descriptivo transversal sobre hijos de mujeres con Chagas, que concurrieron al Laboratorio Central del H.I.A.E.P. Sor María Ludovica durante abril 2013-febrero 2019. Los niños fueron estudiados por microhematocrito y pruebas serológicas. Los resultados se obtuvieron del Sistema Informático de Laboratorio de Wiener®. Resultados: En el período de tiempo evaluado, fueron estudiados por microhematocrito un total de 268 niños (edad promedio= 2,35 meses), obteniéndose 16 resultados positivos. De los 252 niños con microhematocrito negativo, 58 fueron seguidos por pruebas serológicas hasta el año de vida, obteniéndose 3 resultados positivos. Se evidenció una pérdida de seguimiento serológico del 77%. La tasa de transmisión congénita estimada fue del 6,9% y el porcentaje de detección diagnóstica de la técnica directa, del 84,2%. Conclusión: La búsqueda de infección congénita en hijos de mujeres con Chagas, y su seguimiento hasta el año de vida, resulta esencial para lograr la detección y tratamiento temprano de nuevos casos. Sin embargo, la pérdida de seguimiento de potenciales casos de Chagas Congénito resulta alarmante. Esto enfatiza la necesidad de plantear estrategias sólidas para mejorar la aplicación del algoritmo diagnóstico

Introduction:Congenital Trypanosoma cruzi transmission is currently the route that generates the largest number of new cases of acute infection. Early diagnosis and treatment ensure a high probability of parasitological cure. The aim of this article was to evaluate the follow-up of possible cases of Congenital Chagas, to estimate the maternal-fetal transmission rate and the diagnostic capacity of microhematocrit. Materials and methods: A cross-sectional descriptive study was carried out on children born from Chagasic women, who attended the Central Laboratory of the H.I.A.E.P Sor María Ludovica during April 2013-February 2019. The children were studied by microhematocrit and serological tests. The results were obtained from the Wiener® Laboratory Information System. Results: In the evaluated time period, a total of 268 children (mean age = 2.35 months) were studied by microhematocrit, obtaining 16 positive results. Among the 252 children with negative microhematocrit, 58 were followed by serological tests up to one year of life, obtaining 3 positive results. A 77% loss of serological follow-up was evidenced. The estimated congenital transmission rate was 6.9% and the percentage of diagnostic detection of the direct technique was 84.2%. Conclusion: The search for congenital infection in children born from Chagasic women, and its follow-up until one year of life, is essential to achieve the early detection and treatment of new cases. However, the loss of follow-up of potential cases of Congenital Chagas is alarming. This emphasizes the need to propose solid strategies to improve the application of the diagnostic algorithm

Antimicrobianos en neonatología. Parte II: Recomendaciones para la dilución y administración de antimicrobianos utilizados en el recién nacido / Antimicrobials in neonatology. Part II: Recommendations for the dilution and administration of antimicrobials in the newborn

Resumen Los antimicrobianos corresponden al grupo de medicamentos más utilizados en Unidades de Cuidados Intensivos Neonatales; no obstante, su uso ha sido asociado a constantes errores de medicación en la práctica clínica. Paradojalmente, aún no existe consenso en torno a la administración adecuada de estos medicamentos y existen importantes brechas de conocimiento en torno a los procesos de dosificación, administración y manipulación de antimicrobianos en esta población. Con el fin de mejorar el uso de antimicrobianos, disminuir errores y optimizar los resultados clínicos en el recién nacido, la presente revisión tiene por objetivo entregar recomendaciones y servir de guía para la correcta preparación de aquellos antimicrobianos de mayor relevancia en neonatología.

Abstract Antimicrobials are among the most commonly prescribed classes of medications in Neonatal Intensive Care Units; however, its use has been constantly associated with a number of medication errors in clinical practice. In contrast to this situation, there is no common agreement when it comes to determining the right dosing, administration, or handling of antibiotics in this population. In order to help improve the use of antibiotics, decrease the rate of medication errors and optimize clinical results in the newborn, this review aims to provide recommendations to support and guide the correct preparation of some of the most relevant antibiotics used in neonatal wards.

Estado actual del condrosarcoma en un centro de referencia / Current status of chondrosarcoma in a reference center

Resumen: Introducción: El condrosarcoma es el segundo tumor óseo maligno primario más frecuente, se caracteriza por la formación de matriz condroide, es más común en edades avanzadas y su pronóstico guarda relación directa con el subtipo histológico y el grado tumoral. El objetivo de este artículo es presentar el perfil demográfico y de tratamiento en un centro de referencia. Material y métodos: Se realizó un estudio retrospectivo, descriptivo, observacional, analítico de tipo cohorte en un centro de referencia entre el 01 de Enero de 2005 y el 31 de Diciembre de 2019, se analizaron las variables demográficas y se contrastaron con las variables de desenlace que fueron supervivencia global y período libre de enfermedad. Resultados: Se incluyeron 85 pacientes, la media edad de presentación fue 43.3 años, la etapa clínica al momento de la presentación fue mayormente IIa y IIb abarcando 54.1%, 35 pacientes tuvieron metástasis con etapa clínica IV. El principal sitio de metástasis fue el pulmón en 32 pacientes (37.6%). De los pacientes, 36 (42.3%) presentaron mortalidad cáncer específica, 35 (41.2%) fallecieron como consecuencia de la enfermedad metastásica a pulmón u otros órganos y un paciente falleció por extensión directa del tumor en columna cervical. Conclusión: Los factores pronósticos importantes hallados en nuestra serie que influyen en la supervivencia global son: la presencia de metástasis y la localización axial.

Abstract: Introduction: Chondrosarcoma is the second most frequent primary malignant bone tumor, is characterized by the formation of a chondroid matrix, is more frequent in advanced ages and its prognosis is directly related to the histological subtype and tumor grade. The objective of this article is to present the demographic and treatment profile in a reference center. Material and methods: A retrospective, descriptive, observational, analytical cohort-type study was conducted in a reference center between January 1, 2005 and December 31, 2019, the demographic variables were analyzed and contrasted with the outcome variables that were overall survival and disease-free period. Results: 85 patients were included, the mean age of presentation was 43.3 years, the clinical stage at the time of presentation was mostly IIa and IIb covering 54.1%. 35 patients had metastases with clinical stage IV. The main site of metastasis was the lung in 32 patients (37.6%). Thirty-six patients (42.3%) had specific mortality. 35 patients (41.2%) died as a result of metastatic disease to lung or other organs, one patient died from direct extension of the tumor in the cervical spine. Conclusion: The important prognostic factors found in our series that influence global survival are: the presence of metastases and axial localization.

Neurodengue / Neurodengue

RESUMEN La infección por virus del dengue es una entidad común alrededor del mundo, países como Colombia presentan altas tasas de incidencia para esta enfermedad. Si bien el compromiso neurológico no es muy común, se han descrito diversas formas de manifestación a nivel del sistema nervioso, tanto central como periférico, y estas han empezado a constituir formas nosológicas claramente reconocidas, algunas de ellas pudiendo comprometer la supervivencia del paciente, siendo causales de cuadros clínicos más severos, como la encefalitis, la encefalomielitis aguda diseminada y la enfermedad cerebrovascular. Por ello, para el clínico es de vital importancia reconocer sus principales características y las pautas generales sobre su diagnóstico y respectivo tratamiento.

SUMMARY Dengue virus infection is extremely common worldwide, countries like Colombia have high incidence rates for dengue. Although neurological involvement is not very common, various forms of manifestations have been described at the level of the nervous system, both central and peripheral. These have begun to constitute clearly recognized nosological forms, such as encephalitis, acute disseminated encephalomyelitis, and cerebrovascular disease. For this reason, for the clinician it is essential to know them, because some of these conditions require specific and prompt therapeutic interventions.

Covid -19 -Ciencia-Espiritualidad y Salud: el camino de regreso a casa / Covid -19 -Science-Spirituality and Health: the way home

Cuando el planeta amanece con la noticia de la existencia de un virus mortal (Covid-19), se prenden todas las alarmas y con ellas, una gran cantidad de interpretaciones y análisis desde diferentes posturas científicas, filosóficas, ideológicas, socio antropológicas y espirituales. El virus ha puesto sobre el tapete oscuros intereses, perversas maniobras políticas, poderes maléficos, guerra de poderes, contradicciones y falencias en los sistemas de salud, olvidos y abandonos. Ha visibilizado los lados más contradictorios de la ciencia y de las promesas de la modernidad. La mirada desde la espiritualidad no ha faltado en estos momentos de pandemia mundial. Hemos estado saturados de infinidad de mensajes invitándonos a volver sobre nuestros pasos para poder entender con otros ojos y con otra mente; el sentido de este virus que nos puso cara a cara con una muerte a destiempo, dolorosa y en soledad. Muchas reflexiones nos deja esta pandemia, en este ensayo, se ha intentado desagregar en tres grandes temáticas: Transitando por los caminos de la espiritualidad, la salud publica en apuros y finalmente, Covid-19 ciencia, espiritualidad y salud. El propósito que ha orientado esta mirada no ha sido otro que incorporar en el análisis, como el ser humano, ha buscado algo que este más allá y que les brinde respuestas a sus más profundas interrogantes. Esta búsqueda ha sido precisada como su dimensión espiritual. La dimensión espiritual, no es otra cosa que la búsqueda ante el asombro de la finitud para poder comprender el sentido de vivir. Por otra parte, visibilizar las debilidades de la salud pública para hacer frente a la pandemia y la necesidad de consolidar el pensamiento de la salud colectiva. Finalmente mostrar evidencias dentro del campo de la medicina cuántica donde la espiritualidad toma el escenario, para lograr la sanación. La inteligencia espiritual como camino restaurador de la salud.

When the planet dawns with the news of the existence of a deadly virus (Covid-19), all alarms are set on and with them, a lot of interpretations and analysis from different scientific, philosophical, ideological, anthropological and spiritual socio postures. The virus has put on the table dark interests, perverse political maneuvers, evil powers, war of powers, contradictions and fallacy in health systems, forgetfulness and abandonment. He has made visible the most contradictory sidesof science and the promises of modernity. The estilo from spirituality has not been lacking at the moment. We have been saturated with countless messages inviting us to return to our steps so that we can understand with other eyes and with another mind; thesense of this virus that put us face to face with a death of time, painful and loneliness. Many reflections leave us this pandemic, in this essay, we have tried to disaggregate into three great thematic. Transiting the paths of spirituality, health publishes in distress and finally, Covid-19 science, spirituality and health. The purpose that has oriented this essay has been nothing more than to incorporate into the analysis, like the human being, has sought something that is beyond and that gives answers to its deepest questions. This search has been specified as its spiritual dimension. The spiritual dimension is nothing more than the search for the astonishment of finesse in order to understand the meaning of living. On the other hand, to make public health weaknesses visible to address the pandemic and the need to consolidate the thinking of collective health. Finally show evidence within the field of quantum medicine where spirituality takes the stage to achieve healing. Spiritual intelligence as a restorative path of health.

Prevalencia de Incontinencia urinaria en personas mayores chilenas y su impacto en la calidad de vida: Encuesta Nacional / Prevalence of Urinary Incontinence in Chilean older people and impact on quality of life: National Survey

INTRODUCCIÓN Y OBJETIVO: La incontinencia urinaria (IU) es una patología qué por sus características epidemiológicas y fisiopatológicas, afecta en gran medida a los adultos mayores (AM); en particular en Chile, se han reportado prevalencias que van desde el 12,2 al 30% para este grupo. El objetivo de esta investigación fue evaluar la prevalencia de la IU a nivel nacional en personas mayores que viven en comunidad; analizar y describir si aquellos que presentan IU perciben una disminución en su calidad de vida evaluado a través del cuestionario SF-36, en los aspectos físicos y mentales. MÉTODOS: Estudio transversal, analítico, realizado en una muestra de personas chilenas de 60 años y más, residentes en la comunidad; con representatividad nacional, regional y urbano-rural. El análisis se realizó con el software STATA 15.0 RESULTADOS: Este estudio fue realizado en 4186 adultos mayores chilenos, se encontró una prevalencia de IU de un 12,1% siendo más frecuente en mujeres que en hombres (15,2% v/s 7,1 % respectivamente, p<0,0001). Los análisis de asociación mostraron que la IU afecta de manera negativa la autopercepcion de calidad de vida tanto en el aspecto físico como mental. La Calidad de vida, medida por SF-36 reportó una disminución en sus puntajes en personas incontinentes y de los AM que refieren una calidad de vida regular, mala o muy mala, el 50% de ellos presenta IU. CONCLUSIÓN: La IU se asocia a una percepción de disminución en la calidad de vida en las personas mayores chilenas residentes en la comunidad.

INTRODUCTION AND OBJECTIVES: Due to its epidemiological and pathophysiological characteristics, urinary incontinence (UI) is a pathology which greatly affects older adults. The reported prevalence for this group in Chile, specifically, ranges from 12.2 to 30%. The objective of this study was to evaluate, at the national level, the prevalence of UI in older people living in the community; analyze and describe whether those who experience UI perceive diminished quality of life, using the physical and mental subscales of the SF-36 questionnaire to evaluate. METHODS: Cross-sectional, analytical study conducted on a nationally, regionally and urban-rural representative sample of Chilean people aged 60 and over, who residents of the community. The analysis was performed using STATA 15.0 software. RESULTS: This study of 4,186 older Chilean adults found the prevalence of UI to be 12.1%, with higher frequency in women than in men (15.2% v / s 7.1%, respectively, p <0, 0001). Association analysis showed that UI negatively affects perceptions of the subject's own physical and mental quality of life. Quality of life, measured using SF-36, showed lower scores for incontinent people and, of the older adults who report normal, bad or very bad quality of life, 50% present UI. CONCLUSION: UI is associated with a perception of diminished in the quality of life in older Chilean people living in the community.

Estudio de caso de quiste tirogloso lingual: una urgencia en la vía aérea del lactante menor / Lingual thyroglossal cyst case study: an airway emergency in the young infant

El quiste tirogloso es una de las principales causas de tumores congénitos en el cuello, cuyo sitio menos frecuente de presentación es la lengua; no obstante, es importante conocer esta ubicación, principalmente en los lactantes menores, ya que debido a sus características anatómicas presentan disnea ­como síntoma principal­ con diferentes grados de severidad, que puede llegar a comprometer su vía aérea y su vida. Se presentan dos casos de lactantes que ingresan por estridor y signos de falla ventilatoria: en principio, se les realizó una nasofibrolaringosocopia flexible, que evidenció una lesión de aspecto quístico en la base de la lengua; luego, se complementó con un estudio imagenológico, cuya primera opción diagnóstica fue un quiste tirogloso lingual; por último, se les realizó una microlaringoscopia de suspensión más una marsupialización endoscópica con corte frío y radiofrecuencia, lo que dio como resultado una adecuada evolución posoperatoria. Basados en los casos previos, proponemos un algoritmo de tratamiento que hace énfasis en el uso de imágenes diagnósticos y la técnica quirúrgica.

The thyroglossal cyst is one of the main causes of congenital neck tumors, being the tongue infrequent site of presentation. However, it´s relevant to know this location, mainly in young infants, since, due to its anatomical characteristics respiratory distress is a main finding, it could be presented in different degrees of severity, until it completely compromises the airway and the life of the patient. Two cases of infants are admitted due to stridor and signs of ventilatory failure are presented. In both cases, flexible nasofibrolaryngoscopy was performed, showing a cystic appearance lesion on the tongue, and a diagnostic study was subsequently completed with images giving the lingual thyroglossal cyst as the first diagnostic option. Both patients underwent surgical management with suspension microlaryngoscopy plus endoscopic marsupialization with cold cut and radiofrequency with adequate postoperative evolution. Based on the previous cases, we propose a management algorithm emphasizing the use of diagnostic images and surgical technique.

Efecto de la psicoeducación en el afrontamiento y adaptación al rol de cuidador familiar del adulto mayor / Effect of psychoeducation in the support of the older adult family caregiver adaptation and coping role / Efeito da psicoeducação no enfrentamento e adaptação ao papel de cuidador familiar do idoso

Resumen Introducción: La transición demográfica y epidemiológica mundial, aunado a los avances en la ciencia y tecnología aplicados en mejorar la calidad de vida de la población, han influido en la longevidad; los individuos viven más, pero con un bienestar deficiente debido a las limitaciones y comorbilidades inherentes al envejecimiento, con las que a menudo necesitan el cuidado de alguien. Actualmente, uno de cada cuatro adultos mayores requiere de ayuda para realizar sus actividades de la vida diaria. Objetivo: Evaluar el efecto de una intervención de enfermería por medio de la psicoeducación para facilitar el proceso de afrontamiento y adaptación al rol de cuidador familiar del adulto mayor. Material y Métodos: Estudio cuantitativo, cuasi experimental, realizado en una unidad de medicina familiar, con un grupo de 70 cuidadores familiares de adultos mayores, los criterios de inclusión: adultos de 20 a 59 años que supieran leer y escribir. La intervención psicoeducativa consistió en 10 sesiones, los instrumentos aplicados pre y post intervención fueron la escala sobre el proceso de afrontamiento y adaptación, así como la que evalúa habilidad de cuidado. Se utilizó estadística descriptiva e inferencial. Resultados: La edad de los cuidadores familiares tuvo una media de 50.6, femeninos 92.8%. La intervención fue efectiva, pues se obtuvieron diferencias estadísticamente significativas entre el pre y post en afrontamiento y adaptación (X2 Mc nemar p=0.00001), así como para la habilidad de cuidado (X2 p=0.01), lo que sugiere un efecto positivo y sostenido de la intervención. Conclusiones: Los cuidadores familiares de los adultos mayores que participaron en la intervención, mostraron un efecto positivo en la adaptación a su rol de cuidador familiar.

Abstract Introduction: The present demographic transition, influenced by science and technology advances aimed at improving the quality of life, features a greater longevity; however, older adults sometimes suffer from limitations and comorbidities which are related to their aging process and which make them require caring assistance. Currently, around 25% of older adults require some kind of aid in order to perform their daily living activities. Objective: To assess the effect of a nursing intervention using psychoeducation to support the older adult family caregiver adaptation and coping role. Methods and materials: This is a quantitative quasi-experimental study carried out in a unit of family medicine with 70 family caregivers of older adults. The inclusion criteria was: adults aged 20 to 59 who could read and write. The intervention included 10 sessions. The pre and post applied instruments were the Coping Adaptation Processing Scale, and a scale to assess the ability to provide care. Descriptive and inferential statistics were calculated. Results: The mean age of the family caregivers was 50.6 years. 65 were female. The intervention turned out to be effective as statistically significant differences in coping and adaptation measures (X2 Mc Nemar p=0.00001), as well as caregiving abilities (X2 p=0.01) measures, were obtained at the post intervention assessment. Conclusion: The older adult family caregivers who participated in this nursing intervention showed a positive effect in their role.

Resumo Introdução: A transição demográfica e epidemiológica mundial, os avanços na ciência e tecnologia aplicados em melhorar a qualidade de vida da população, influenciam a longevidade; os indivíduos vivem mais, no entanto com um bem-estar deficiente, devido às limitações e comorbilidades inerentes ao envelhecimento, regularmente necessitam o cuidado de alguém. Atualmente, um de cada quatro idosos requerem de ajuda para realizar suas atividades da vida diária. Objetivo: Avaliar o efeito de uma intervenção de enfermagem através da psicoeducação para facilitar o processo de enfrentamento e adaptação no papel de cuidador familiar do idoso. Material e Métodos: Estudo quantitativo, quase experimental, realizado na unidade de medicina familiar, com um grupo de 70 cuidadores familiares de idosos, os critérios de inclusão: adultos de 20 a 59 anos, que soubessem ler e escrever. A intervenção psicoeducativa consistiu em 10 sessões, os instrumentos aplicados pre e post intervenção foram a escala sobre o processo de enfrentamento e adaptação, assim como a que avalia habilidade de cuidado. Utilizou-se estatística descritiva e inferencial. Resultados: A idade dos cuidadores familiares teve una média de 50.6, femininos 92.8%. A intervenção foi efetiva, pois se obtiveram diferenças estatisticamente significativas entre o pre e post em enfrentamento e adaptação (X2 Mc nemar p=0.00001), assim como, para a habilidade de cuidado (X2 p=0.01), o que sugere um efeito positivo e sustenido da intervenção. Conclusões: Os cuidadores familiares dos idosos que participaram na intervenção mostraram um efeito positivo na adaptação do seu papel de cuidador familiar.