Factors affecting utilization of an urban community health center: A cross-sectional study

Background@#The local health center (LHC) is the locus of public health service delivery in the barangays of Makati City. It should be the first-line for consultation and should be able to address most health concerns of the community. Considering the many services offered in the LHC, one must study the reasons why constituents opt to consult in the city hospital or in private institutions rather than the LHC. @*Objective@#This study sought to determine the correlation between community perception of the LHC and utilization of the LHC in Barangay Rizal and Barangay Southside, and the correlation between demographic variables and the utilization of the LHC in Barangay Rizal and Barangay Southside. @*Methods@#This is an observational study that utilized a cross-sectional survey. Utilization of the Local Health Center was operationally defined as any consultation in the local health center in the past year, regardless of occurrence of illness. The survey questionnaire had a 5-point Likert Scale and utilized the Patient Satisfaction Questionnaire-18 and added other possible factors affecting utilization based on related literature. @*Results@#Utilization of the LHC had a weak correlation with barangay (Rizal versus Southside), older age, and having more co-morbid illnesses. Community perception of General Satisfaction, Availability of doctors, and Availability of free medications had a weak correlation with consulting in the LHC and had good community perception ratings.@*Conclusion@#Patient-Doctor Relationship also showed a weak correlation with consulting in the LHC but merits attention because it had a somewhat low community perception rating.

Mieloma múltiplo em cão com apresentação clínica atípica de paralisia facial bilateral: relato de caso / Multiple Myeloma in dog with atypical clinical presentation of bilateral facial paralysis: case report

Objetivou-se com o presente trabalho relatar um caso de mieloma múltiplo (MM) em uma cadela com apresentação clínica atípica de rigidez da musculatura facial. Foram realizados hemogramas seriados, exames bioquímicos, sumário de urina, sorologia para leishmaniose, radiografias de crânio, citologia de medula óssea e eletroforese de proteínas séricas. O infiltrado plasmocitário em medula óssea >20%, a gamopatia monoclonal e as lesões compatíveis com lise óssea, observados no mielograma, eletroforese de proteínas e exame radiográfico, respectivamente, foram determinantes para conclusão diagnóstica de MM. A doença pode ter uma apresentação clínica variável em cães e representar um desafio ao diagnóstico na clínica de animais de companhia, principalmente em áreas endêmicas de doenças infecciosas que se manifestam com apresentações clínicas e laboratoriais semelhantes.(AU)

This paper reports a case of multiple myeloma (MM) in a bitch with atypical clinical presentation of rigidity of the facial muscles. Hemogram, biochemical tests, urinalysis, serology for leishmaniasis, skull radiography, bone marrow cytology and serum protein electrophoresis were performed. The plasma cell infiltration in bone marrow was >20 %, the monoclonal gammopathy and lesions compatible with bone lysis observed in the myelogram, protein electrophoresis and radiographic examination respectively, were decisive for diagnostic conclusion of MM. The disease may have a variable clinical presentation in dogs and pose a challenge for diagnosis in the pet clinic, especially in endemic areas of infectious diseases that present with similar clinical and laboratory presentations.(AU)

Aislación y caracterización de células madre mesenquimales provenientes de pulpa y folículo dentario humano / Isolation and characterization of mesenchymal stem cells from human dental pulp and follicle

Recientemente se ha descubierto que diversos tejidos dentales son fuente importante de Células Madre Mesenquimales (CMM). En la cavidad oral podemos encontrar CMM en la pulpa, en el folículo dental, papila y en la encía entre otros lugares. Varios estudios avalan el extenso potencial terapéutico de las CMM en terapias de regeneración. El objetivo de este estudio es aislar, cultivar células madres mesenquimales de pulpa y folículo dental humano, caracterizar su inmunofenotipo y su potencial de diferenciación a linaje osteogénico, condrogénico y osteogénico. Se cultivaron células de pulpa y folículo dental de terceros molares de dientes permanentes jóvenes humanos. Los cultivos de CMM fueron monitoreados por microscopia óptica, las células se inmunotipificaron por citometría de flujo. Posteriormente se evaluó su capacidad de diferenciaron a los tres linajes mencionados. En estas condiciones experimentales se comprobó que las células aisladas y cultivadas de pulpa y folículo dental correspondían a células madre mesenquimales humanas, siendo éstas últimas más fáciles de obtener y proliferar. Las CMM de folículo dental poseen mayor potencial de crecimiento y capacidad de diferenciación en comparación a las CMM de pulpa dental, probablemente debido a su estado evolutivo más inmaduro.

It was recently discovered that dental tissues are important sources of mesenchymal stem cells (MSCs). In the oral cavity MSCs can be found in the pulp, dental follicle, apical papilla and gingival tissue, among others. Many studies support the therapeutic potential of MSCs in regenerative therapies. The objective of this study was to isolate and culture mesenchymal stem cells from human dental pulp and follicle, and to characterize their immunophenotype and differentiation potential to adipogenic, chondrogenic and osteogenic lineages. Oral cavity stem cells were cultured from pulp and dental follicle of wisdom teeth from young permanent teeth. Immunotypification of MSCs was performed by flow cytometry and cultures were evaluated for their ability to differentiate into the three lineages mentioned. Our results corroborate that cultured oral MSC cells isolated from pulp and dental follicle were mesenchymal in origin, being the latter more easy to obtain. Dental follicle MSCs have greater growth potential and differentiation capacity compared to dental pulp MSCs, probably due to their more immature developmental state.

Functional and morphological effects of resistance exercise on disuse-induced skeletal muscle atrophy

Abstract The reduction of skeletal muscle loss in pathological states, such as muscle disuse, has considerable effects in terms of rehabilitation and quality of life. Since there is no currently effective and safe treatment available for skeletal muscle atrophy, the search for new alternatives is necessary. Resistance exercise (RE) seems to be an important tool in the treatment of disuse-induced skeletal muscle atrophy by promoting positive functional (strength and power) and structural (hypertrophy and phenotypic changes) adaptive responses. Human and animal studies using different types of resistance exercise (flywheel, vascular occlusion, dynamic, isometric, and eccentric) have obtained results of great importance. However, since RE is a complex phenomenon, lack of strict control of its variables (volume, frequency, intensity, muscle action, rest intervals) limits the interpretation of the impact of the manipulation on skeletal muscle remodeling and function under disuse. The aim of this review is to critically describe the functional and morphological role of resistance exercise in disuse-induced skeletal muscle atrophy with emphasis on the principles of training.

Conocimientos y actitudes sobre educación vial: predictores de riesgo en escolares de educación primaria, sus madres y profesores: Ica-Perú / Knowledge and attitudes about road safety education: predictors of risk. In primary school, their mothers and teachers: Ica - Perú

Estudio descriptivo, prospectivo, transversal. Objetivo: Determinar el nivel de conocimientos y actitudes sobre Educación Vial, en escolares de Educación Primaria, madres y profesores, como predictores de riesgo de accidentes de tránsito. Métodos. Se seleccionaron aleatoriamente: 4/14 distritos de la Provincia de lea, 13 colegios y 175 alumnos del segundo al sexto grado, aplicándoseles cuestionario ad-hoc, así como a sus madres (90) y profesores (104). Directores de los colegios, fueron entrevistados sobre actividades de educación vial. La validez y confiabilidad del cuestionario, se realizó en base a juicios de expertos, prueba piloto y prueba alfa de Crombach (.762). Para el análisis estadístico se utilizó SPSS 14, determinándose: frecuencias, porcentajes y análisis factorial (pruebas KMO y de Bartlett). Resultados: El análisis factorial reveló: en escolares, conocimientos y actitudes inadecuadas sobre señales de tránsito (.760), tendencia a cruzar por zona no peatonal (.763) y placer por la velocidad (.600); en madres y profesores, puntuaciones más significativas. Los Directores informaron no existencia de curso específico en el plan de estudio. Conclusiones: Los predictores de riesgo más relevantes se relacionan a: no respetar señales de tránsito, no utilizar zonas peatonales y placer por la velocidad. Recomendándose programas de educación vial a la comunidad en su conjunto.

In this prospective, cross-sectional, descriptive, research. Objective: To determine level ofknowledge and attitudes about road education in primary schoolchildren, mothers and teachers, as predictors of risk of traffic accidents. Methods: There were randomly selected: 4/14 districs ofthe province ofIca, 13 schools and 175 students from second to sixth grade, applying to them ad-hoc questionnaire, and their mothers (90) and teachers (104). Directors of schools, were interviewed about road safety education activities. The validity and reliability ofthe questionnaire were made based on expert opinions, pilot test and Crombach alpha test (.762). The statistical analysis was used SPSS14, determining: frequencies, percentages and factor analysis (KMO and Bartlett test). Results: The factor anlysis showed: in schoolchilds, inadequate knowledge and attitudes about traffic signs (.760), a tendency to cross by no pedestrian zone (.763) and enjoy the speed (.600), in mothers and teachers, scores more significant. Directors reported no existence of specific course in the curriculum. Conclusions: The predictors of risk are related to the most important: do not respect traffic signals, do not use pedestrian gones and enjoy the speed. Recommended driver education programs to the community as a whole.

Impact of moisture on survival of Aedes aegypti eggs and ovicidal activity of Metarhizium anisopliae under laboratory conditions

The effect of relative humidity (43 percent, 75 percent, 86 percent and > 98 percent) on Aedes aegypti eggs treated with Metarhizium anisopliae or water only was tested for up to a six months exposure at 25ºC. Survival of larvae inside eggs was clearly affected by the lowest humidity (43 percent) tested, and eclosion diminished at all humidities after increasing periods of exposure. M. anisopliae showed to have a strong ovicidal activity only at humidity close to saturation. No difference of activity was found between conidia and hyphal bodies tested. This fungus affected larvae inside eggs and has potential as a control agent of this important vector in breeding sites with high moisture.

Male gonadal function, prolactin secretion and lactotroph population in an experimental model of cirrhosis

Liver cirrhosis, a highly prevalent chronic disease, is frequently associated with endocrine dysfunctions, notably in the gonadal axis. We evaluated lactotroph population by immunohistochemistry, gonadotropins and prolactin by immunoradiometric assay and testosterone and estradiol by radioimmunoassay in adult male Wistar rats with cirrhosis induced by carbon tetrachloride. No significant difference in mean ± SEM percentages of lactotrophs was found between cirrhotic animals and controls (N = 12, mean 18.95 ± 1.29 percent). Although there was no significant difference between groups in mean serum levels of prolactin (control: 19.2 ± 4 ng/mL), luteinizing hormone (control: 1.58 ± 0.43 ng/mL), follicle-stimulating hormone (control: 19.11 ± 2.28 ng/mL), estradiol (control: 14.65 ± 3.22 pg/mL), and total testosterone (control: 138.41 ± 20.07 ng/dL), 5 of the cirrhotic animals presented a hormonal profile consistent with hypogonadism, all of them pointing to a central origin of this dysfunction. Four of these animals presented high levels of estradiol and/or prolactin, with a significant correlation between these two hormones in both groups (r = 0.54; P = 0.013). It was possible to detect the presence of central hypogonadism in this model of cirrhotic animals. The hyperestrogenemia and hyperprolactinemia found in some hypogonadal animals suggest a role in the genesis of hypogonadism, and in the present study they were not associated with lactotroph hyperplasia.

Prevalencia del anticuerpo anticitoplasmático de los islotes pancreáticos y del anticuerpo antiinsulina en pacientes diabéticos tipo 2 que asisten a la red de diabetes de la Ciudad Hospitalaria Dr. Enrique Tejera (CHET) / Prevalence of the pancreatic islands´ anticytoplasmic antibody and of the antiinsulin antibody in type 2 diabetic patients attending the diabetes support group of the Hospital City Dr. Enrique Tejera (CHET)

Alrededor del 10 por ciento de los pacientes diagnosticados con diabetes mellitus tipo 2 poseen uno o más tipos de autoanticuerpos circulantes contra los antígenos de las células de los islotes pancreáticos, similares a los que se presentan en la diabetes tipo 1. El objetivo de este trabajo fue determinar la prevalencia y los niveles de los anticuerpos antiinsulina (AAI) y anticitoplasmático de los islotes pancreáticos (ICA) en 90 pacientes diabéticos tipo 2, utilizando los métodos de Radioinmunoensayo e Inmunofluorescencia Indirecta. 48 pacientes (53,3 por ciento) fueron positivos, para el AAI, 15 (16,6 por ciento) para el ICA, 7 (7,7 por ciento) para ambos anticuerpos. Los sujetos con anticuerpos positivos presentaron niveles más elevados de glicemia e insulina (185,7 mg/dL y 19,3 µIU7mL respectivamente) en comparación a las concentraciones de los pacientes negativos (175,7 mg/dL y 16,4 µIU/mL), sin embargo, la diferencia no fue estadísticamente significativa por el método de Mann – Whitney (p<0,05). El rango de concentración para el AAI fue de 7 – 15,9 por ciento con un promedio de 8,7 por ciento; mientras que para el ICA fue de 10,0 – 80,0 unidades JDF con un promedio 25,3 unidades JDF. El anticuerpo detectado con mayor frecuencia fue el AAI y en menor proporción el ICA. La predisposición a presentar estos anticuerpos fue independiente del sexo y su prevalencia fue mayor entre los 45 y 54 años de edad. No se observó correlación entre los niveles de anticuerpos y los niveles de glicemia e insulina

La focalizacion de subsidios para aseguramiento en salud: Percepcion de usuarios, funcionarios y autoridades locales y distritales / Subsidies and insurance: the system for selecting beneficiaries

La presente investigación pretende aportar nuevos elementos de juicio para analizar el Sistema de selección de beneficiarios para subsidios de programas sociales (Sisben). El tema central es el problema de la exclusión-inclusión y sus consecuencias generados por el Sisben. Este problema es percibido por distintos actores claves como un resultado de diferentes elementos lógicos entrelazados como la racionalidad de la política social actual, el enfoque metodológico del instrumento de selección de beneficiarios y del proceso de toma de decisiones en él apoyado, entre otros. La investigación se apoya en grupos focales realizados en cuatro localidades de la ciudad de Bogotá. Distintas propuestas para la solución de los problemas del Sisben son expresados por los participantes en los grupos focales

Zinc and water intake in rats: investigation of adrenergic and opiatergic central mechanisms

We have demonstrated that central administration of zinc in minute amounts induces a significant antidipsogenic action in dehydrated rats as well as in rats under central cholinergic and angiotensinergic stimulation. Here we show that acute third ventricle injections of zinc also block water intake induced by central ß-adrenergic stimulation in Wistar rats (190-250 g). Central inhibition of opioid pathways by naloxone reverses the zinc-induced antidipsogenic effect in dehydrated rats. After 120 min, rats receiving third ventricle injections of isoproterenol (160 nmol/rat) exhibited a significant increase in water intake (5.78 ± 0.54 ml/100 g body weight) compared to saline-treated controls (0.15 ± 0.07 ml/100 g body weight). Pretreatment with zinc (3.0, 30.0 and 300.0 pmol/rat, 45 min before isoproterenol injection) blocked water intake in a dose-dependent way. At the highest dose employed a complete blockade was demonstrable (0.54 ± 0.2 ml/100 g body weight). After 120 min, control (NaAc-treated) dehydrated rats, as expected, exhibited a high water intake (7.36 ± 0.39 ml/100 g body weight). Central administration of zinc blocked this response (2.5 ± 0.77 ml/100 g body weight). Naloxone pretreatment (82.5 nmol/rat, 30 min before zinc administration) reverted the water intake to the high levels observed in zinc-free dehydrated animals (7.04 ± 0.56 ml/100 g body weight). These data indicate that zinc is able to block water intake induced by central ß-adrenergic stimulation and that zinc-induced blockade of water intake in dehydrated rats may be, at least in part, due to stimulation of central opioid peptides

Central lead administration inhibits water intake and sodium appetite in rats

We have demonstrated that acute third ventricle injections of lead acetate (PbAc) exert a powerful antidipsogenic effect and induce a significant increase in renal sodium excretion. In the present study we confirm the antidipsogenic effect of lead and demonstrate that central administration of this metal, in minute amounts, significantly reduces salt intake both during dehydration and after central angiotensinergic stimulation. Adult male Wistar rats had the third ventricle cannulated seven days before the experiments. During this period they had free access to distilled water and hypertonic saline solution (1.5 percent). After a 24-h period of fluid deprivation, experimental animals received third ventricle injections of PbAc (0.3, N = 8 and 3.0 nmol/rat, N = 14) while controls received sodium acetate (NaAc; 3.0 nmol/rat, N = 10). Rats treated with PbAc at the highest dose showed a significant reduction both in water and hypertonic saline intake when compared to controls. When the effect of lead administration on angiotensin II-induced water and salt intake was studied, normohydrated animals received third ventricle injections of angiotensin II (9.6 nmol/rat) after pretreatment with 3.0 nmol/rat of PbAc (experimental group, N = 10) or NaAc (controls, N = 8). The group pretreated with PbAc presented a significant reduction in both water and salt intake compared to controls. Thus, this study confirms the antidipsogenic effect of central lead injections and demonstrates that the presence of lead in the brain exerts a significant inhibition of sodium appetite

Opiatergic participation in the thirst-inhibiting effect of acute third ventricle injections of cadmium (Cd 2+ ) and lead (Pb 2+ )

We have previously demonstrated that acute third ventricle injections of both lead and cadmium prevent the dipsogenic response elicited by dehydration or by central injections of dipsogenic agents such as angiotensin II, carbachol and isoproterenol in rats. We have also shown that the antidipsogenic action of cadmium may be due, at least in part, to activation of thirst-inhibitory central serotonergic pathways. In the present paper we show that in Wistar male rats the antidipsogenic effect of both lead acetate (3.0 nmol/rat) and cadmium chloride (3.0 nmol/rat) may be partially dependent on the activation of brain opiatergic pathways since central injections of naloxone (82.5 nmol/rat), a non-selective opioid antagonist, blunt the thirst-inhibiting effect of these metals. One hundred and twenty minutes after the second third ventricle injections, dehydrated animals (14 h overnight) receiving saline + sodium acetate displayed a high water intake (7.90 ñ 0.47 ml/100 g body weight) whereas animals receiving saline + lead acetate drank 3.24 ñ 0.47 ml/100 g body weight. Animals receiving naloxone + lead acetate drank 6.94 ñ 0.60 ml/100 g body weight. Animals receiving saline + saline drank 8.16 ñ 0.66 ml/100 g body weight whilst animals receiving saline + cadmium chloride drank 1.63 ñ 0.37 ml/100 g body weight. Animals receiving naloxone + cadmium chloride drank 8.01 ñ 0.94 ml/100 g body weight. It is suggested that acute third ventricle injections of both lead and cadmium exert their antidipsogenic effect by activating thirst-inhibiting opioid pathways in the brain

Lead (Pb+) and cadmium (Cd2+) inhibit the dipsogenic action of central beta-adrenergic stimulation by isoproterenol

We have previously demonstrated that acute third ventricle injections of both Pb2+ and Cd2+ impair the dipsogenic response elicited by three different situations: dehydration and central cholinergic or angiotensinergic stimulation. beta-Adrenergic activation is part of the multifactorial integrated systems operating in drinking behavior control in the central nervous system. In the present study acute third ventricle injections of Pb2+ (3,30 and 300 pmol/rat) or Cd2+ (0.3, 3 and 30 pmol/rat) blocked the dipsogenic response induced by third ventricle injections of isoproterenol (ISO; 160 nmol/rat) in a dose-dependent manner. Normohydrated animals receiving ISO + NaAc (sodium acetate) or saline (controls) displayed a high water intake after 120 min (ISO + saline = 5.78 ñ O.54 ml/lOO g; ISO + NaAc = 6.00 ñ O.6 ml/lOO g). After the same period,animals receiving ISO but pretreated with PbAc at the highest dose employed (300 pmol/rat) drank O.78 ñ O.23 ml/lOO g while those receiving ISO and pretreated with the highest dose of CdCl(2)(30 pmol/rat) presented a water intake of O.7 ñ O.30 ml/lOO g. Third ventricle injections of CdCl(2) (3 nmol/rat) or PbAc (3 nmol/rat) did not modify food intake in rats deprived of food for 24 h. Thus, general central nervous system depression explaining the antidipsogenic action of the metals can be safely excluded. It is concluded that both Pb2+ and Cd2+ inhibit water intake induced by central beta-adrenergic stimulation.

Calcium channel blockers inhibit the antidipsogenic effect of central injections of zinc in rats

Previous data from our laboratory have indicated that acute third ventricle injections of Zn2+ elicit a significant antidipsogenic response in rats in three different situations: dehydration, and central angiotensinergic or cholinergic stimulation. In the present study we analyzed whether this response depends on voltage-dependent calcium channels. Dehydrated (l4 h of water deprivation, overnight) animals received 2-mul icv injections of zinc acetate (Zn(AC)2; 300 pmol/rat) after pretreatment with the voltage-dependent calcium channel blockers gadolinium (Gd3+;0.03, 3.0 and 30 pmol/rat) or verapamil (VER; 0.027, 0.05 and 0.11 pmol/rat). Both blockers reversed the antidipsogenic effect of third ventricle injections of Zn2+ in a dose-dependent manner. After 120 min, animals pretreated with saline receiving Zn(AC)2 drank 3.10 ñ 0.57 ml/100 g body weight while those pretreated with GD3+ at the highest dose displayed a water intake of 5.45 ñ O.41 ml/l00 g body weight (P<0.01). Animals pretreated with the vehicle of VER receiving Zn(AC)2 drank 3.15 ñ 0.45 ml/l00 g while animals pretreated with VER at the highest dose receiving Zn(AC)2 drank 6.16 ñ 0.62 ml/l00 g (P<0.01). The antidipsogenic effect of Zn(AC)2 seems to be specific since the metal (same dose and injection procedures) did not modify food intake in rats after 24 h of food deprivation. It is suggested that Zn2+ exerts its antidipsogenic effect by activation of mechanism(s) depending on the functional integrity of voltage-dependent calcium channels.

SDZ 216-525, a selective 5-Ht1A receptor antagonist, reverts zinc-induced inhibition of water intake in dehydrate rats

Zinc is found in many brain regions where it participates in important processes such as neurotransmission and neuromodulation. We previously demonstrated that acute third ventricle injection of zinc inhibits wather intake in dehydrated rats. The present study was undertaken to explore a possible link between zinc-induced inhibition of water intake in dehidrated rats and seotonergic systems in the brain. Adult, male Wistar rats had the third ventricle cannulated a week before the experiments. After an overnight period of water deprivation, the animals (N=12 per group) received acute intracerebroventricular injections (2µl) of Zn(Ac)2 (6.7, 67.1 and 67.6 ng/rat). Control animals (N = 12) receives NaAc (671.6 ng/rat). Zinc-treated animals displayed a significant after 120 min was 7.70 ñ 0.50 ml in control (NaAc-treated) dehydrated rats while animals treated with the highest dose of Zn(AC)2 drank 2.63 ñ 0.73 ml. Third ventricle injections of SDZ 216-525, a selective 5-HT1A receptor antagonist, 45 min before zinc administration, generated a dose-dependent reversal of zinc-induced thirst blockade in water-deprived rats. At the highest dose used (10µg/rat), the water intake of the animal after 120 min was 7.30 ñ 0.23 ml, a value equal to that of control animals. These data suggest that zinc may decrease water intake in dehydrated rats by activation of a 5-HT1A receptor-related mechanism

Localización estereotáctica en microcirugía / Stereotactic localization in microsurgery

En nuestro estudio presentamos una serie de 35 pacientes con diferentes tipos de lesiones en el sistema nervioso central. Todos nuestros pacientes fueron sometidos a estudios neurorradiológicos como tomografía axial computarizada (TAC), resonancia magnética (MRI) y angiografía bajo técnicas estereotácticas, antes de ser sometidos a nuestra técnica combinada de cirugía esterotáctica y microneurocirugía. La selección de pacientes para este tipo de técnica combinada, estuvo basada en la localización de la lesión, teniendo como propósito la disminución del daño neurológico post-operatorio, debido a una exacta localización y aproximación de la lesión por parte del cirujano. Solo uno de nuestros pacientes presentó daño neurológico post-operatorio