Supervisión en una Unidad de Clínica de Adultos de un Centro de Salud Mental Universitario: Un Estudio Cualitativo del Proceso

Introducción: Las supervisiones clínicas cumplen un rol esencial dentro de la formación profesional del psicólogo clínico. Se han desarrollado diferentes modelos de supervisión, sin embargo, pocos estudios abordan el cómo se desarrolla el proceso de supervisión propiamente tal. Objetivo: Describir las dinámicas de supervisión clínica grupal en la Unidad de Adultos del Servicio de Psicología Integral de una Clínica Universitaria, que proporciona atención psicológica a la comunidad. Metodología: Estudio cualitativo descriptivo y de alcance transversal, en una muestra de 5 sesiones de supervisión videograbadas, cuya interacción verbal fue sometida a análisis de contenido convencional. Resultados: Se distinguen aspectos de la apertura del proceso de supervisión, en el cual se identifica una dificultad variable de los supervisados para formular preguntas de supervisión, dificultad enmarcada en un contexto de involucramiento afectivo de los supervisados. Se identifican intervenciones de los miembros del equipo de supervisión: una transversal de validación de la experiencia del supervisado; e intervenciones durante el proceso de supervisión, como, por ejemplo, preguntas dirigidas a revisar "la experiencia" del supervisado durante la atención del caso; "construcción de hipótesis comprensivas del caso", y la entrega de "sugerencias para el abordaje terapéutico" del caso en específico, y/o que pueden ser aplicados a otros casos.

Background: Clinical supervision plays an essential role in the professional training of clinical psychologists. Different supervision models have been developed; however, few studies address how the ongoing process of supervision is developed. Objective: To describe the dynamics of clinical group supervision at the Adult Unit of the Clinical Psychology Service of a University Clinic, which provides psychological care to the community. Methodology: A descriptive qualitative study of cross-sectional scope, in a sample of 5 video-recorded supervision sessions, whose verbal interaction was subjected to conventional content analysis. Results: Aspects of the opening of the supervision process are distinguished, in which a different degree of difficulties of the supervisees to formulate supervision questions is identified, a difficulty framed in a context of affective involvement of the supervisees. Interventions by members of the supervision team are identified: a validation of the supervisee's experience which is present each one supervision process; and specific interventions during the supervision process, for example, questions aimed at reviewing «the experience» of the supervisee during the care of the case; «construction of comprehensive hypotheses of the case», and the delivery of «suggestions for the therapeutic approach» of the specific case, and/or that can be applied to other ones.

Historias de violencia y desigualdad de género en mujeres del mercado municipal / Violence and gender inequality in women market vendors stories

Introducción: El problema de la violencia no sólo afecta a quien la padece, pues tiene efectos colaterales en los hijos y otros familiares, lo cual deteriora su salud física, mental y emocional. Objetivo: Analizar la situación de desigualdad y la violencia de género en las mujeres. Metodología: El estudio se realizó bajo un enfoque cualitativo de tipo fenomenológico, aplicando la técnica de la entrevista a profundidad con previo consentimiento informado para su grabación, transcripción, análisis e interpretación. Resultados: Se identificaron formas de violencia física, sexual, psicológica, económica y patrimonial debido a las relaciones asimétricas dentro del hogar, producto del machismo y un sistema patriarcal que afectan la calidad de vida y el desarrollo social de las mujeres. Limitaciones: Las mujeres participantes eran vendedoras del mercado municipal y contaban con poco tiempo disponible para las entrevistas, pues el cierre de sus puestos de trabajo podía generar pérdidas económicas. Valor del estudio: La violencia y desigualdad de género son problemáticas en los países latinoamericanos que se deben abordar desde toda perspectiva para su identificación y prevención oportuna. Conclusiones: La situación de violencia y desigualdad de género ha tenido un impacto negativo no sólo en la vida de las mujeres entrevistadas, sino también de su núcleo familiar, sin embargo, cada una de ellas busca mejorar sus condiciones de vida a pesar de estas adversidades.

Introduction: Gender violence does not only affect the women who suffer it, since it causes collateral effects to children and other family members that deteriorates their physical, mental and emotional health. Objective: To analyze gender inequality and gender-based violence against women. Methodology: We carried out qualitative research of phenomenological type, applying in-depth interviews with previously informed consent for its recording, transcription, analysis and interpretation. Results: Physical, sexual, psychological, economic and patrimonial violence were identified in asymmetrical relationships as a result of sexism and the patriarchal system, which affects women's quality of life and social development. Limitations: Female participants were vendors from a local market and had limited time for the interviews, since the closing of their stands could cause economic losses. Value of the study: Gender-based violence and gender inequality constitute a problem in Latin American countries that should be thoroughly studied for its identification and timely prevention. Conclusions: Gender-based violence and gender inequality produces a negative impact not only on the lives of the women interviewed, but also on their families, however, every one of them tries to improve their life conditions and overcome adversities.

¿Es confiable la clasificación de la hernia de disco lumbar de la Universidad Estatal de Míchigan entre cirujanos de columna? / Is the Michigan State University lumbar disc herniation classification reliable among spine surgeons?

Resumen: Introducción: Existen numerosas clasificaciones para las hernias de disco, dichas clasificaciones orientan a los profesionales acerca de la gravedad de la lesión, del posible cuadro clínico del paciente, del tratamiento más adecuado y constituyen, sin lugar a dudas, una herramienta predictiva para proyectar los posibles resultados de las terapias utilizadas. El propósito principal de este trabajo es validar la confiabilidad interobservador e intraobservador de la clasificación de la Universidad Estatal de Míchigan (MSU) entre los cirujanos de columna de nuestro servicio y además, conocer los factores de riesgo asociados con los pacientes que fueron intervenidos con discectomía lumbar, el nivel de disco más afectado, la presentación clínica y los tratamientos previos realizados en los pacientes tratados por nuestro equipo. Material y métodos: Fueron seleccionadas 50 imágenes de resonancia magnética nuclear (RM) en el corte axial de T2 correspondiente al nivel de «hernia discal máxima¼ de pacientes diagnosticados y sometidos a cirugía de liberación meningo radicular y discectomía lumbar de un solo nivel de manera retrospectiva en los últimos dos años de nuestra base de datos, estas imágenes se distribuyeron entre tres cirujanos especialistas en columna de nuestra institución. Los tres cirujanos de columna dieron una clasificación específica para cada imagen de RM basada en la clasificación de la MSU, luego en un intervalo de siete días uno de los tres cirujanos volvió a clasificar las imágenes. El grado de acuerdo entre los cirujanos se analizó calculando la confiabilidad interobservador e intraobservador mediante el análisis estadístico kappa. Resultados: El análisis del coeficiente de kappa indicó que en la mayoría de las comparaciones por observador dieron una fuerza de concordancia «buena¼, el índice de kappa fue superior a 0.64 en todas las posibles comparaciones de las observaciones. En relación con la cantidad de coincidencias, en 60% de los pacientes hubo una coincidencia total entre los tres cirujanos, con dos coincidencias 24% y en 16% no hubo ninguna coincidencia. Para el análisis intraobservador el índice de kappa fue de 0.953 con una fuerza de concordancia muy buena, el acuerdo observado fue de 96%. Conclusión: Nuestra investigación demuestra una confiabilidad buena en la clasificación de la MSU entre cirujanos de columna de nuestra institución así como muy buena al reclasificar el intraobservador. Creemos que tener un corte sagital de RM para clasificarlas sería de gran utilidad. Se necesitan más investigaciones para dar un valor pronóstico a la ubicación y tamaño de la hernia y su relación con la indicación quirúrgica.

Abstract: Introduction: There are numerous classifications for herniated discs, such classifications guide professionals about the severity of the lesion, the possible clinical picture of the patient, the most appropriate treatment and are undoubtedly a predictive tool to project the possible results of the therapies used. The main purpose of this work is to validate the inter- and intra-observer reliability of the Michigan State University (MSU) classification among the spine surgeons of our service and also to know the risk factors associated with the patients who underwent lumbar discectomy, the most affected disc level, the clinical presentation and the previous treatments performed in the patients treated by our team. Material and methods: 50 nuclear magnetic resonance (MR) images in axial T2 section corresponding to the «maximum disc herniation¼ level were selected from patients diagnosed and submitted to meningo-radicular release surgery and single level lumbar discectomy retrospectively in the last two years from our database; these images were distributed among three spine surgeons of our institution. The three spine surgeons gave a specific classification for each MR image based on the MSU classification, then at an interval of seven days one of the three surgeons reclassified the images. The degree of agreement between surgeons was analyzed by calculating interobserver and intraobserver reliability using kappa statistical analysis. Results: The analysis of the kappa coefficient indicated that most of the comparisons by observer gave a «good¼ concordance strength, the kappa index was higher than 0.64 in all the possible comparisons of the observations. In relation to the number of coincidences, in 60% of the patients there was a total coincidence between the three surgeons, with two coincidences in 24%, and in 16% there was no coincidence at all. For the intraobserver analysis the kappa index was 0.953 with a very good concordance strength, the observed agreement was 96%. Conclusion: Our research shows a good reliability in the MSU classification among spine surgeons of our institution, as well as very good when reclassifying the intraobserver; we believe that having a sagittal MRI slice to classify them would be very useful, more research is needed to give a prognostic value to the location and size of the hernia and its relation with the surgical indication.

Antioxidant capacity, reproductive response and glucose concentration and insulin of ewes supplemented prior to insemination with orange residue / [Capacidade antioxidante, resposta reprodutiva e concentração de glicose e insulina de ovelhas suplementadas antes da inseminação com resíduo de laranja]

The objective was to evaluate the antioxidant capacity, glucose and insulin concentration and reproductive performance of ewes supplemented with orange residue prior to insemination. Fifty-five multiparous ewes were divided into two corrals, and 15 unbred ewes were kept individually to measure feed consumption. Two integral diets were administered; T0: control treatment and T1: with 20% of dry matter of orange residue. Ten days after the start of supplementation, the ewes were synchronized. Supplementation was finalized prior to artificial insemination, then, a blood sample was taken to measure the antioxidant capacity and glucose and insulin concentration. An analysis of variance was made to evaluate the effect of treatment on the antioxidant capacity, glucose and insulin; and to analyze the response to estrus, percentage of gestation and prolificity a ji squared test was performed. Of 9 antioxidant compounds found in the orange residue, hesperidin (7.44%), chlorogenic acid (0.50%) and protocatechuic acid had the highest concentration. Feed intake, estrus response, percentage of gestation, antioxidant capacity, and glucose and insulin concentration were not affected by the treatment. It is concluded that inclusion of 20% of orange residue in the diet prior to insemination in ewes is possible.(AU)

O objetivo deste estudo foi avaliar a capacidade antioxidante, a concentração de glicose e insulina e o comportamento reprodutivo de ovelhas suplementadas com resíduo de laranja antes da inseminação. Cinquenta e cinco ovelhas multíparas foram divididas em dois currais e 15 ovelhas sem raça foram mantidas individualmente para se medir o consumo de ração. Duas dietas integrais foram administradas; T0: tratamento controle e T1: dieta com 20% de resíduo de laranja seco. Dias após o início da suplementação, as ovelhas foram sincronizadas. A suplementação foi finalizada antes da inseminação artificial e, em seguida, foi coletada uma amostra de sangue para medir a capacidade antioxidante e a concentração de glicose e insulina. Uma análise de variância foi feita para avaliar o efeito do tratamento sobre a capacidade antioxidante, a glicose e a insulina, e um teste do ji quadrado foi realizado para analisar a resposta ao estro, a porcentagem de gestação e de prolificidade. Dos nove compostos antioxidantes encontrados no resíduo laranja, a hesperidina (7,44%), o ácido clorogênico (0,50%) e o ácido protocatecuico foram os de maior concentração. O consumo alimentar, a resposta ao estro, a porcentagem de gestação, a capacidade antioxidante, a concentração de glicose e a insulina não foram afetados pelo tratamento. Conclui-se que é possível a inclusão de 20% de resíduos de laranja na dieta antes da inseminação em ovelhas.(AU)

Theoretical Study of the Function of the IP3 Receptor/BK Channel Complex in a Single Neuron / Estudio Teórico de la Función del Complejo Receptor-IP3/Canales BK en Neurona Única

ABSTRACT Large conductance calcium-activated potassium (BK) channels carry out many functions in the central nervous system. These channels open in response to increased cytosolic calcium ([Ca2+]cyt) concentration. The influx of calcium ions to the cytosol can occur through voltage-gated calcium channels (VGCCs) on the plasma membrane and/ or through IP3 receptors (IP3-Rs) and ryanodine receptors (RyRs) on the endoplasmic reticulum membrane. The BK channel/IP3-R/RyR interaction has been widely reported in smooth muscle but scarcely investigated in relation to neurons. The aim of this study was to theoretically explore the function of the BK/IP3-R complex by means of a computational model of a neuron that replicates the interaction between the release of Ca2+ from the endoplasmic reticulum (through IP3-Rs) and the opening of the BK channels. The mathematical models are based on the Hodgkin-Huxley formalism and the Goldbeter model. These models were implemented on Visual Basic® and differential equations were solved numerically. Distinct conditions were contemplated for BK conductance and the efflux of endoplasmic Ca2+ to the cytosol. An abrupt rise in [Ca2+]cyt (≥ 5 μM) and short duration (spark) was found to activate BK channels and either pause or stop the action potential train.

RESUMEN Los canales de potasio activados por calcio de gran conductancia (canales BK) cumplen múltiples funciones en el sistema nervioso central. Estos canales se abren en respuesta al incremento de la concentración de calcio citosólico ([Ca2+]cyt). La entrada de Ca2+ puede ocurrir a través de canales de calcio dependientes de voltaje (VGCCs) localizados en la membrana plasmática y por eflujo de Ca2+ del retículo endoplásmico (ER) causado por 1,4,5-Trifosfato (IP3) o rianodina (RyR). La interacción BK/IP3/RyR ha sido ampliamente estudiada en músculo liso, pero escasamente en neuronas. El objetivo de este estudio fue explorar teóricamente la función del complejo BK/IP3-R mediante un modelo computacional de una neurona que replica la interacción entre la liberación de Ca2+ del retículo endoplásmico (a través de IP3-Rs) y la apertura de los canales BK. Los modelos matemáticos se basan en el formalismo de Hodgkin-Huxley y el modelo de Goldbeter. Estos modelos fueron implementados en Visual Basic® y las ecuaciones diferenciales fueron resueltas por métodos numéricos. Se contemplaron distintas condiciones para la conductancia del canal BK y la salida de Ca2+ endoplásmico al citosol. Los resultados muestran que un incremento abrupto de [Ca2+] cyt (≥ 5 μM) y de corta duración (spark) activa los canales BK y producen una pausa o detiene el tren de potenciales de acción.

Factores Asociados al Autoestigma de la Depresión en Adolescentes en Santiago, Chile / Associated factors with self-stigma of depression in adolescents in Santiago, Chile

Determinar la asociación entre autoestigma de la depresión y factores sociodemográficos, historia personal y parental de depresión, sintomatología ansiosa y depresiva, y calidad de vida en adolescentes. Método: Estudio transversal correlacional, en una muestra de 192 adolescentes (8º básico a 3º medio) de tres colegios particulares subvencionados de Santiago, Chile, se aplicaron cuestionarios de factores sociodemográficos, autoestigma de la depresión, sintomatología ansiosa y depresiva, y calidad de vida. Los datos se analizaron con prueba t de Student, ANOVA, coeficiente de Pearson y Regresión Lineal. Resultados: No hubo diferencias en autoestigma de depresión entre hombres y mujeres. Fue mayor el autoestigma de la depresión en adolescentes que sospechaban que habían tenido o tenían depresión, referían que su madre o padre habían tenido depresión, tenían mayor sintomatología depresiva y/o ansiosa y menor calidad de vida. Conclusión: La presencia de depresión en los progenitores progenitores (madre y/o padre), así como el desconocimiento de los adolescentes respecto a si ellos presentan el cuadro clínico, se relaciona con mayor autoestigma de la depresión en los adolescentes, lo que inhibe la búsqueda de ayuda.

To determine the association between self-stigma of depression and sociodemographic factors, personal and parental history of depression, anxious and depressive symptomatology, and quality of life in adolescents. Methods: Non-experimental cross-sectional and correlational study. A total of 192 adolescents from 8th grade to 11th grade from three private subsidized schools in Santiago, Chile, answered questionnaires on sociodemographic factors, self-stigma of depression, anxious and depressive symptomatology, and quality of life. Data were analyzed with Student's t-test, ANOVA, Pearson's coefficient and linear regression. Results: There were no differences in self-stigma of depression between men and women. Self-stigma of depression was higher in adolescents who suspected that they had had or had depression, who reported that their mother or father had had depression, who had greater depressive and/or anxious symptomatology and lower quality of life. Conclusion: The presence of depression in the parents (mother and / or father) as well as the lack of knowledge of adolescents regarding whether they have depression is related to greater self-stigma of depression which inhibits the help-seeking in adolescents.

Factores psicosociales, estrés psicológico y burnout en enfermería: un modelo de trayectorias / Psychosocial factors, psychological stress, and burnout in nursing: a model of trajectories / Fatores psicossociais, estresse psicológico e burnout em enfermagem: um modelo de trajetórias

Resumen Introducción: El personal de enfermería se enfrenta cotidianamente a diferentes eventos asociados al estrés, factores psicosociales y otros mecanismos que afectan su salud mental. Objetivo: Evaluar la correlación entre la demanda psicológica, el control laboral, el apoyo social, el estrés psicológico, y las dimensiones del Síndrome de Burnout (ilusión por el trabajo, desgaste psíquico, indolencia y culpa), en un modelo de trayectorias en enfermeras mexicanas. Metodología: Estudio transversal, observacional, analítico, conducido en 357 profesionales de enfermería de Morelos, México, seleccionados por conveniencia. Los datos fueron colectados empleando tres cuestionarios, la Escala de Estrés Percibido, el Cuestionario del Contenido del Trabajo y el Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo. Los programas SPSS 19 y LISREL 8.3 fueron empleados para el procesamiento y modelaje de los datos. Resultados: En el modelo de trayectorias, se especificó como variable mediadora de los factores psicosociales y de las dimensiones del Síndrome de Quemarse por el Trabajo (SQT), al estrés psicológico. Los índices de ajuste fueron aceptables. Se encontraron altos niveles de apoyo social, control laboral e ilusión por el trabajo; grados moderados de demanda psicológica y estrés psicológico; y bajos niveles de desgaste psíquico, indolencia y culpa. Conclusión: Implicaciones para la disciplina, se propone implementar estrategias de intervención efectivas para mantener en el personal de enfermería bajos niveles de demandas psicológicas, altos niveles de control laboral, altos niveles de apoyo social, y niveles moderados de estrés, para prevenir, el SQT.

Abstract Introduction: Nurses frequently face different events associated with stress, psychosocial factors, and other issues which have impacts on their mental health. Objective: To assess the correlation between psychological demand, work control, social support, psychological stress, and burnout dimensions (illusion for the activity, psychic wear, indolence, guilt), within a model of trajectories among Mexican nurses. Methodology: This is a transversal, observational, and analytical study conducted on a convenience sample of 357 nursing professionals from the state of Morelos, Mexico. Data were gathered using three questionnaires, the Perceived Stress Scale, the Job Content Questionnaire, y el Maslach Burnout Inventory. SPSS 19 and LISREL 8.3 were used to process and model the data. Results: Psychological Stress was specified as the mediating variable of the psychosocial factors and dimensions of burnout within the model of trajectories. Adjustment indexes were acceptable. High levels of social support, work control, and illusion for the activity were found. Moderate degrees of psychological demand and psychological stress were found. Low levels of psychic wear, indolence, and guilt were found. Conclusion: It is recommended to implement effective intervention strategies to maintain nursing personnel within low levels of psychological demand, high levels of work control, high levels of social support, and moderate levels of stress, all these in order to prevent the Syndrome of Burnout.

Resumo Introdução: O pessoal de enfermagem se enfrenta cotidianamente a diferentes eventos associados ao estresse, fatores psicossociais e outros mecanismos que afetam sua saúde mental. Objetivo: Avaliar a correlação entre a demanda psicológica, o controle laboral, o apoio social, o estresse psicológico, e as dimensões e da Síndrome de Burnout (ilusão pelo trabalho, desgaste psíquico, indolência e culpa), em um modelo de trajetórias em enfermeiras mexicanas. Metodologia: Estudo transversal, observacional, analítico, conduzido em 357 profissionais de enfermagem de Morelos, México, selecionados por conveniência. Os dados foram coletados empregando três questionários, a Escala de Estresse Percebido, o Questionário do Conteúdo do Trabalho e o Questionário para a Avaliação da Síndrome de Burnout no Trabalho. Os programas SPSS 19 e LISREL 8.3 foram empregados para o processamento e modelagem dos dados. Resultados: No modelo de trajetórias, especificou-se como variável mediadora dos fatores psicossociais e das dimensões da Síndrome de Burnout no Trabalho (SQT), ao estresse psicológico. Os índices de ajuste foram aceitáveis. Encontraram-se altos níveis de apoio social, controle laboral e ilusão pelo trabalho; graus moderados de demanda psicológica e estresse psicológico; e baixos níveis de desgaste psíquico, indolência e culpa. Conclusão: Implicações para a disciplina, propõe-se implementar estratégias de intervenção efetivas para manter no pessoal de enfermagem baixos níveis de demandas psicológicas, altos níveis de controle laboral, altos níveis de apoio social, e níveis moderados de estresse, para prevenir, o SQT.

Description of the female of Pintomyia (Pifanomyia) deorsa (Diptera, Psychodidae, Phlebotominae) / Descripción de la hembra de Pintomyia (Pifanomyia) deorsa (Diptera, Psychodidae, Phlebotominae)

Pintomyia (Pifanomyia) deorsa (Pérez, Ogusuku, Monje & Young, 1991) was described on the basis of a single male; the female is being described here from specimens collected in Ollantaytambo, Cusco, Peru. Diagnoses for the Pintomyia genus, Pifanomyia subgenus, Verrucarum series and both sexes of Pi. deorsa are presented, as well as an identification key to distinguish the females of the Verrucarum series.

Pintomyia (Pifanomyia) deorsa (Pérez, Ogusuku, Monje & Young, 1991) fue descrita en base a un solo espécimen macho; la hembra es descrita aquí a partir de especímenes colectados en Ollantaytambo, Cusco, Perú. El diagnóstico para en género Pintomyia, el subgénero Pifanomyia, la série Verrucarum y ambos sexos de Pi. deorsa son presentados, así como claves para la identificación y separación de las hembras de la serie Verrucarum.

Caracterización de la Lámpara Flash-LED: EBNeuro Usada para Adquirir Potenciales Evocados Visuales en Ratas / Characterization of the Flash-LED Lamp: EBNeuro Used to Acquired Visual Evoked Potentials in Rats

Resumen: La señal de la amplitud en análisis de Potenciales Evocados Visuales (PEVs) es una variable que depende del tipo y posición de los electrodos, de la fuente, del estímulo y por consecuente, de la intensidad luminosa por lo que es fundamental reportarla para cada diseño experimental y así, garantizar su reproducibilidad. El objetivo de este trabajo es caracterizar una lámpara con 96 LEDs para la adquisición de PEVs en ratas. Se midió la iluminancia y la intensidad luminosa promedio en un sistema espacial XYZ de 8 cm3 aplicable a un sistema estereotáxico para la fijación de ratas. Se realizaron desplazamientos cada 2 cm en cada plano. Se observó que debido a la distribución geométrica de los LEDs la distribución de la iluminancia no sigue la ley del inverso cuadrado, ya que aumenta conforme la lámpara se aleja. Finalmente, se seleccionó una coordenada para la colocación del ojo de la rata empleando una intensidad luminosa promedio para la adquisición del PEV de 1.043 cd e iluminancia de 128.77 luxes a una distancia ojo-lámpara de 9 cm. Una vez caracterizada la intensidad luminosa y de acuerdo con los PEVs obtenidos, esta lámpara puede utilizarse para estudios PEV en ratas en investigaciones posteriores.

Abstract: Signal amplitude for recordings of Visual Evoked Potentials (VEPs) is a variable dependent on the type and position of the electrodes, the source, the stimulus and consequently the luminous intensity; therefore, it is relevant to report it to assure experimental reproducibility. The objective of this work is to characterize flash lamp with 96 LEDs in order to perform the acquisition of VEPs in rats. We measure the illuminance and mean light intensity on space system XYZ of 8 cm3 corresponding to a stereotaxic frame for rodents. Displacements were performed every 2 cm in each plane. Because of the geometric distribution of the LEDs in the EBNeuro lamp the spatial distribution of illuminance does not follow the law of the inverse square, because the illuminance increases as the lamp goes away. Finally a spatial coordinate was selected for the rat eye positioning were the mean luminous intensity was 1.043 cd and 128.77 luxes of illuminance at an eye-lamp distance of 9 cm. According to the obtained VEPs and spatial characterization this lamp can be used for acquire of recordings PEV in rats for further investigations.

Guía de práctica clínica para la evaluación y el manejo de la hemorragia digestiva alta en el Seguro Social del Perú (EsSalud) / Clinical practice guideline for the evaluation and management of upper gastrointestinal bleeding for the Peruvian Social Security (EsSalud)

Objetivo: Proveer recomendaciones clínicas basadas en evidencia para la evaluación y el manejo de pacientes con hemorragia digestiva alta (HDA) en el seguro social del Perú (EsSalud). Materiales y métodos: Se conformó un grupo elaborador local (GEG-Local) conformado por especialistas en gastroenterología y metodólogos. El GEG-Local formuló 11 preguntas clínicas a ser respondidas por la presente guía de práctica clínica (GPC). Se buscaron y seleccionaron GPC de HDA publicadas a partir del 2012, que respondieran a las preguntas planteadas y obtuvieran un puntaje mayor a 60% en los dominios 1 y 3 del instrumento Appraisal of Guidelines for Research and Evaluation II (AGREE-II). Durante septiembre del 2017 se realizaron búsquedas bibliográficas en Pubmed, para actualizar 9 preguntas clínicas de las GPC preseleccionadas, y para responder 2 preguntas de novo. La calidad de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG-Local revisó la evidencia y formuló las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de evaluación y manejo, usando la metodología GRADE Finalmente, la GPC fue aprobada con Resolución N° 80-IETSI-ESSALUD-2017. Resultados: La presente GPC abordó 11 preguntas clínicas, divididas en cuatro temas: valoración de riesgo, manejo inicial, manejo de HDA no variceal, y manejo de HDA variceal. En base a dichas preguntas se formularon 10 recomendaciones (7 recomendaciones fuertes y 3 recomendaciones débiles), 24 puntos de buena práctica clínica, y 2 flujogramas. Conclusión: Este artículo es el resumen de la GPC de EsSalud, en la cual se valoró la evidencia científica disponible sobre evaluación y manejo de HDA.

Objective: To provide evidence-based clinical recommendations for the evaluation and management of patients with upper gastrointestinal bleeding (UGB) in the Peruvian Social Security (EsSalud). Materials and methods: A local guideline development group (local GDG) was established, including specialists in gastroenterology and methodologists. The local GDG formulated 11 clinical questions to be answered by this clinical practice guide (CPG). We searched and selected CPG of UGB published from 2012, which answered the posed questions and obtained a score higher than 60% in domains 1 and 3 of the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. During September 2017, bibliographic searches were conducted in Pubmed, to update 9 clinical questions of the preselected CPGs, and to answer 2 de novo questions. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG reviewed the evidence and formulated the recommendations, points of good clinical practice and the flowchart of evaluation and management, using the GRADE methodology Lastly, the CPG was approved with Resolución N° 80-IETSI-ESSALUD-2017. Results: This CPG addressed 11 clinical questions, divided into four themes: risk assessment, initial management, management of non-variceal UGB, and management of variceal UGB. Based on these questions, 10 recommendations (7 strong recommendations and 3 weak recommendations), 24 points of good clinical practice, and 2 flow charts were formulated. Conclusion: This article is the summary of the EsSalud' CPG, where the available scientific evidence on evaluation and management of UGB was evaluated.

Aspectos clínicos y microbiológicos de la peritonitis asociada a diálisis peritoneal en pacientes adultos con insuficiencia renal crónica en el Servicio de Urgencias / Clinical and microbiological aspects of peritonitis associated with peritoneal dialysis in adult patients with chronic renal failure in the Emergency Department

Resumen Introducción: La peritonitis es la complicación más importante y frecuente de la diálisis peritoneal (DP), las infecciones bacterianas son las responsables en la mayoría de los casos, con sintomatología característica. Objetivo: Determinar los patógenos más frecuentes en peritonitis asociado con la DP en pacientes con insuficiencia renal crónica (IRC). Metodología: Estudio retrospectivo, descriptivo, transversal y observacional, de pacientes con peritonitis en DP con IRC del servicio de urgencias, entre julio de 2012 y junio de 2013. Se evaluaron de los expedientes datos sociodemográficos, de diagnóstico, clínicos y microbiológicos y celulares de líquido de diálisis. Resultados: De 73 expedientes revisados 52% correspondían a pacientes del género masculino, la causa primaria de la IRC fue la diabetes mellitus tipo 2 (67%). Síntomas presentados: dolor abdominal (86%), vómitos (42%) y náuseas (34%), con anemia, azoemia, hiperglicemia hipoalbuminemia e hiponatremia. Los cultivos microbiológicos positivos fueron 59%; y los patógenos identificados fueron Candida tropicalis (9,6%), Staphylococcus epidermidis (8,2%), y Enterococcus faecalis y Staphylococcus haemolyticus (6,8% cada uno), asociados con elevación de leucocitos, azoemia y celularidad alta en el líquido peritoneal (p < 0,05). Conclusiones: El principal microorganismo determinado fue de origen fúngico asociado a leucocitos, azoemia y celularidad alta.

Background: Peritonitis is the most important and frequent complication of peritoneal dialysis (PD). Bacterial infections are responsible in most cases, with characteristic symptoms. Aim: To determine the most frequent pathogens in peritonitis associated with PD in patients with chronic renal failure (CRF). Methodos: Retrospective, descriptive, cross-sectional and observational study of patients with peritonitis in PD with CRF of the emergency department, between July 2012 and June 2013. Sociodemographic, diagnostic, clinical and microbiological and cellular data were evaluated from the patient's fluid. Dialysis. Results: From 73 reviewed records, 52% were male. The primary cause of CRF was diabetes mellitus type 2 (67%). Symptoms presented: abdominal pain (86%), vomiting (42%) and nausea (34%), with anemia, azotemia, hyperglycemia, hypoalbuminemia and hyponatremia. The positive microbiological cultures were 59%; and the pathogens identified were Candida tropicalis (9.6%), Staphylococcus epidermidis (8.2%), Enterococcus faecalis and Staphylococcus haemolyticus (6.8% each one), associated with elevated leukocytes, azotemia and high cellularity in peritoneal fluid (p <0.05). Conclusions: The main microorganism determined was of fungal origin associated with leukocytes, azotemia and high cellularity.

Propiedades psicométricas del inventario de depresión de Beck IA para la población chilena / Psychometric properties of a spanish version of the Beck depression inventory IA

Background: According to the Chilean National Health Survey (2009-2010), 17% of people aged 15 years or more have depressive symptoms. Thus, freely-available, easily-administered, and highly sensitive screening tests for depression are needed in clinical and research settings. Aim: To evaluate the psychometric properties of a Spanish version of the Beck Depression Inventory (BDI-IA) in adult Chilean population. Material and Methods: The inventory was applied to a sample of 1.105 adults aged between 18 to 73 years (94% women). Ninety nine participants were outpatients receiving treatment for affective disorders, 932 were parents and/or guardians of students enrolled in schools and 73 were university students (sample with no known depressive disorder). To perform data analysis, two groups from the random combination of both samples were generated. Results: The inventory showed an appropriate degree of internal consistency (Cronbach alpha = .92). An exploratory factor analysis suggested a one-factor solution. This solution was reinforced with a confirmatory factor analysis, which displayed an adequate goodness of fit. The cutoff score, based on the Youden Index, was 13/14 points. It was able to discriminate between depressed and non-depressed participants. Conclusions: These results indicate that the BDI-IA is an appropriate instrument to assess depressive symptoms in Chilean adults.

Vocalization-Silence Dynamic Patterns: A system for measuring coordination in psychotherapeutic dyadic conversations / Patrones Dinámicos de Vocalización-Silencio: un sistema para medir coordinación en conversaciones diádicas en psicoterapia

Abstract This paper presents the Vocalization-Silence Dynamic Patterns (VSDP) method for the analysis of coordination in psychotherapeutic conversation. The objectives of its development are to empirically account for vocal coordination patterns in dialogs and to examine the association between interactional coordination and positive relational outcomes. The VSDP method makes it possible to demonstrate that vocal activity is a nonverbal phenomenon entwined with and which influences the linguistic code. The analyses which can be carried out through this method are illustrated with real acoustic signals taken from psychotherapy segments. The VSDP method is discussed, considering its usefulness for psychotherapeutic research as well as the study of dyadic conversation within other scenarios.

Resumen Este trabajo presenta el método de Patrones Dinámicos de Vocalización-Silencio (PDVS) para el análisis de la coordinación en la conversación psicoterapéutica. Los objetivos de su desarrollo son dar cuenta empíricamente de los patrones de coordinación vocales en diálogos y examinar la asociación entre la coordinación interaccional y los resultados relacionales positivos. El método PDVS hace posible demostrar que la actividad vocal es un fenómeno no verbal entrelazado con y que influye en el código lingüístico. Los análisis que se pueden realizar a través de este método se ilustran con señales acústicas reales tomadas de segmentos de psicoterapia. El método PDVS es discutido teniendo en cuenta su utilidad para la investigación en psicoterapia, así como para el estudio de la conversación diádica dentro de otros escenarios.

Productive response of hair ewes crossed with Damara and Dorper and growth of their lambs / Resposta produtiva de ovelhas de cabelo cruzado com Damara e Dorper e crescimento de seus cordeiros

Profitability of sheep production depends on the reproductive response of ewes and growth of their lambs, which can be improved through the ram genotype. The aim of this study was to evaluate the reproductive response of Blackbelly (Bb), Pelibuey (Pb), Katahdin (Kat) and Dorper (Dor) ewes crossed with Damara (Dam) and Dor rams and the growth of their offspring. To measure percentage of single and multiple lambings (MLP), 234 Bb, Pb, Kat and Dor ewes were used. To measure lamb growth, the offspring of 86 Bb x Pb (BbPb) ewes and 73 Kat x Dor (KatDOR) ewes were used. Four Dor x BbPb, six Dam x BbPb and six Dam x KatDor lambs were slaughtered for carcass assessment. MLP was analyzed with the CATMOD procedure considering the factors age and breed. Lamb growth data were analyzed with the MIXED procedure, and those of carcass characteristics with the GLM procedure of SAS, using weight at slaughter as covariable. MLP was higher (P0.05) by effect of ram breed. It is concluded that Bb ewes are more prolific than Dor ewes; male lambs of Dam rams had post-weaning growth response and carcass yield similar to those of Dor rams, although the female lambs of Dor rams were heavier than those of Dam rams.

Rentabilidade da produção de ovinos depende da resposta reprodutiva de ovelhas e do crescimento de seus cordeiros, o que pode ser melhorado por meio do genótipo masculino. O objetivo deste estudo foi avaliar o desempenho reprodutivo de ovinos Blackbelly (Bb), Pelibuey (Pb), Katadin (Kat) e Dorper (Dor) e o crescimento de cordeiros com carneiros Damara (Dam) e Dor. Para medir a porcentagem de partos simples e múltiplas (MLP), foram utilizados 234 ovelhas Bb, PB, Kat e Dor. Para medir o crescimento dos cordeiros, foram utilizadas 86 ovelhas Bb x Pb (BbPb) e 73 Kat x Dor (KatDOR). Quatro cordeiros Dor x BbPb, seis Dam x BbPb e seis Dam x KatDor foram sacrificados para avaliação de carcaça. MLP foi analisada com o procedimento CATMOD, considerando-se fatores como idade e raça. Dados de crescimento do cordeiro foram analisados com o procedimento MIXED, e as de características de carcaça com o procedimento GLM do SAS, utilizando-se peso ao sacrifício como covariável. MLP foi maior (P<0.05) em Bb do que em Dor. Os cordeiros Dor x BbPb foram mais pesados (P<0.05) no nascimento do que Dam x BbPb. Em partos simples e múltiplos, os cordeiros de ovelhas KatDor foram mais pesados (P<0.05) no momento do nascimento de cordeiros BbPb. As cordeiras de carneiros Dor apresentaram maior (P<0.05) ganho de peso após o desmame do que as de carneiros Dam. O rendimento de carcaça, a espessura da gordura subcutânea e o rendimento de corte primal não foram diferentes por efeito da raça de carneiro. Conclui-se que as ovelhas Bb são mais prolíficas do que as ovelhas Dor; cordeiros de carneiros Damara tiveram resposta de crescimento pós-desmame e rendimento de carcaça semelhantes aos dos carneiros Dor, embora Dorper cordeiras fossem mais pesadas do que as de Damara.

Productive response of hair ewes crossed with Damara and Dorper and growth of their lambs / Resposta produtiva de ovelhas de cabelo cruzado com Damara e Dorper e crescimento de seus cordeiros

Profitability of sheep production depends on the reproductive response of ewes and growth of their lambs, which can be improved through the ram genotype. The aim of this study was to evaluate the reproductive response of Blackbelly (Bb), Pelibuey (Pb), Katahdin (Kat) and Dorper (Dor) ewes crossed with Damara (Dam) and Dor rams and the growth of their offspring. To measure percentage of single and multiple lambings (MLP), 234 Bb, Pb, Kat and Dor ewes were used. To measure lamb growth, the offspring of 86 Bb x Pb (BbPb) ewes and 73 Kat x Dor (KatDOR) ewes were used. Four Dor x BbPb, six Dam x BbPb and six Dam x KatDor lambs were slaughtered for carcass assessment. MLP was analyzed with the CATMOD procedure considering the factors age and breed. Lamb growth data were analyzed with the MIXED procedure, and those of carcass characteristics with the GLM procedure of SAS, using weight at slaughter as covariable. MLP was higher (P<0.05) in Bb than in Dor. The Dor x BbPb lambs were heavier (P<0.05) at birth than Dam x BbPb. Of the lambs from single and multiple births, the KatDor lambs were heavier (P<0.05) at birth than BbPb lambs. The female lambs of Dor rams had higher (P<0.05) weight gain after weaning than those of Dam rams. Carcass dressing, subcutaneous fat, and primal cut yield were not different (P>0.05) by effect of ram breed. It is concluded that Bb ewes are more prolific than Dor ewes; male lambs of Dam rams had post-weaning growth response and carcass yield similar to those of Dor rams, although the female lambs of Dor rams were heavier than those of Dam rams.(AU)

Rentabilidade da produção de ovinos depende da resposta reprodutiva de ovelhas e do crescimento de seus cordeiros, o que pode ser melhorado por meio do genótipo masculino. O objetivo deste estudo foi avaliar o desempenho reprodutivo de ovinos Blackbelly (Bb), Pelibuey (Pb), Katadin (Kat) e Dorper (Dor) e o crescimento de cordeiros com carneiros Damara (Dam) e Dor. Para medir a porcentagem de partos simples e múltiplas (MLP), foram utilizados 234 ovelhas Bb, PB, Kat e Dor. Para medir o crescimento dos cordeiros, foram utilizadas 86 ovelhas Bb x Pb (BbPb) e 73 Kat x Dor (KatDOR). Quatro cordeiros Dor x BbPb, seis Dam x BbPb e seis Dam x KatDor foram sacrificados para avaliação de carcaça. MLP foi analisada com o procedimento CATMOD, considerando-se fatores como idade e raça. Dados de crescimento do cordeiro foram analisados com o procedimento MIXED, e as de características de carcaça com o procedimento GLM do SAS, utilizando-se peso ao sacrifício como covariável. MLP foi maior (P<0.05) em Bb do que em Dor. Os cordeiros Dor x BbPb foram mais pesados (P<0.05) no nascimento do que Dam x BbPb. Em partos simples e múltiplos, os cordeiros de ovelhas KatDor foram mais pesados (P<0.05) no momento do nascimento de cordeiros BbPb. As cordeiras de carneiros Dor apresentaram maior (P<0.05) ganho de peso após o desmame do que as de carneiros Dam. O rendimento de carcaça, a espessura da gordura subcutânea e o rendimento de corte primal não foram diferentes por efeito da raça de carneiro. Conclui-se que as ovelhas Bb são mais prolíficas do que as ovelhas Dor; cordeiros de carneiros Damara tiveram resposta de crescimento pós-desmame e rendimento de carcaça semelhantes aos dos carneiros Dor, embora Dorper cordeiras fossem mais pesadas do que as de Damara.(AU)

Comparison of the Allometry Coefficient of the Length-Weight and Length-Length Relationship between Selene brownii, S. vomer and S. setapinnis Caught in the Gulf of Mexico / Comparación del Coeficiente de Alometría de la Relación Talla-Peso y Longitud-Longitud entre Selene brownii, S. vomer y S. setapinnis Capturados en el Golfo de México

This work presents a comparison of the length-weight and length-length allometric relationships between six measurements: length pattern (LP), cephalic length (CL), maximum depth (MA), caudal peduncle depth (CPD) ocular diameter (OD) and weight (W) of three species of the genus Selene (S. brownii, S. vomer and S. setapinnis) caught in the port of Veracruz, Mexico, using a beach seine of 800 m. The results show certain relationships between all measurements of S. brownii (an isometric relationship and four negative allometric relationships); S. vomer showed only four relationships (two isometric and two negative allometric); and S. setapinnis showed three relationships (all negative allometric); the results of S. vomer and S. setapinnis are consistent with those reported by Muto et al. (2010). The comparison of the coefficients of allometry between the three species allowed us to determine that S. brownii and S. vomer differed significantly in two of the four allometric coefficients of length-weight relationships common to them, and in three of the four allometric coefficients of length-length relationships common to them. S. brownii and S. setapinnis differed significantly in two of the three allometric coefficients of length-weight relationships common to them and in the only allometric coefficient of length-length relationships common to them. Finally, S. vomer and S. setapinnis differed significantly in the three common allometric coefficients of length-weight relationships, and in the only common allometric coefficient of length-length relationship.

En este trabajo se presentan las comparaciones de las relaciones alométricas de longitud- peso y longitud-longitud de seis medidas (longitud patrón (LP), longitud cefálica (LC), amplitud máxima (AM), amplitud del pedúnculo (AP), diámetro ocular (DO) y Peso (W) de tres especies del género Selene (S. brownii, S. vomer y S. setapinnis) capturados en el puerto de Veracruz México, mediante el uso de un chinchorro playero de 800 m. Los resultados obtenidos muestran que S. brownii posee relaciones entre todas sus medidas (una isométrica y cuatro alométricas negativas), S. vomer posee solo cuatro relaciones (dos isométricas y dos alométricas negativas) y S. setapinnis posee tres relaciones (todas alométricas negativas), los resultados de S. vomer y S. setapinnis concuerdan con los reportados por Muto et al. (2010). Al comparar los coeficientes de alometría entre las tres especies se pudo determinar que S. brownii y S. vomer difieren significativamente en dos de los cuatro coeficientes alométricos comunes en las relaciones longitud-peso, y tres de los cuatro coeficientes alométricos comunes en las relaciones longitud-longitud; S. brownii y S. setapinnis difieren significativamente en dos de los tres coeficientes alométricos comunes en las relaciones longitud-peso y en el único coeficiente alométricos común en las relaciones longitud-longitud; por último S. vomer y S. setapinnis difieren significativamente en los tres coeficientes alométricos comunes en la relaciones longitud-peso, y en el único coeficiente alométrico común en las relaciones longitud-longitud.

Validación de la Escala Rapid Assessment of Physical Activity (RAPA) en población chilena adulta consultante en Atención Primaria / Validation of the Rapid Assessment of Physical Activity Scale (RAPA) in an Adult Chilean Population Seeking Primary Care / Validação da escala Rapid Assessment of Physical Activity (Rapa) em população chilena idosa consultante em Atenção Primária

Introducción: la práctica de actividad física es esencial para el cuidado de la salud. Se requiere contar con instrumentos que permitan medirla y monitorear los cambios en las personas que la practican. Objetivos: adaptar culturalmente el cuestionario Rapid Assessment of Physical Activity (RAPA), y estimar sus propiedades psicométricas, su validez y confiabilidad, para medir el nivel de actividad física en personas adultas consultantes en centros de atención primaria en Santiago (Chile). Materiales y métodos: el RAPA adaptado fue aplicado a 180 adultos asistentes a 5 centros de salud. Se determinó su índice de masa corporal (IMC) y circunferencia de cintura (CC). Resultados: las puntuaciones en la escala RAPA se relacionaron en forma inversa y significativa con el perímetro de cintura y el IMC. Las personas categorizadas con bajo nivel de actividad física (Poco Activo y Poco Activo Regular Ligero) presentan un IMC promedio más elevado y son más frecuentemente categorizados con CC alterada. La confiabilidad del instrumento fue moderada (r = 0,61; K = 0,34). Conclusiones: el RAPA en su versión en español adaptada para Chile, es un instrumento de fácil aplicación, que pese a su moderada confiabilidad, logra ser sensible al desarrollo de actividad física, que presenta una relación coherente con los parámetros antropométricos de IMC y CC sensibles a dicha actividad.

Introduction: Physical activity is vital to health care and having instruments to measure and monitor changes in people who are physically active is essential. Objectives: Culturally adapt the Rapid Assessment of Physical Activity (RAPA) questionnaire and estimate its psychometric properties, validity and reliability as an instrument to measure the level of physical activity among adults seeking primary care at health centers in Santiago (Chile). Materials and Methods: The adapted RAPA was applied to 180 adults who were being treated at five health centers. Their body mass index (BMI) and waist circumference (WC) was determined. Results: The scores on the RAPA scale were inversely and significantly linked to waist circumference and BMI. Persons categorized as having low levels of physical activity (i.e., little activity and little regular light activity) have a higher BMI, on average, and are more often categorized with altered WC. The reliability of the instrument was moderate (r = 61; K = 0.34). Conclusions: The Spanish language version of the Rapid Assessment of Physical Activity (RAPA) questionnaire adapted for Chile is a user-friendly application. Despite being only moderately reliable, it is sensitive to the development of physical activity, which shows a coherent connection to the anthropometric parameters of BMI and WC that are sensitive to this kind of activity.

Introdução: a prática de atividade física é essencial para o cuidado da saúde. Requer-se contar com instrumentos que permitam medi-la e monitorar as mudanças nas pessoas que a praticam. Objetivos: adaptar culturalmente o questionário Rapid Assessment of Physical Activity (Rapa) e estimar suas propriedades psicométricas, sua validade e confiabilidade para medir o nível de atividade física em pessoas idosas consultantes em centros de atenção primária em Santiago (Chile). Materiais e método: o Rapa adaptado foi aplicado a 180 idosos frequentadores de cinco unidades de saúde. Determinou-se seu índice de massa corporal (IMC) e circunferência de cintura (CC). Resultados: as pontuações na escala Rapa se relacionaram em forma inversa e significativa com o perímetro de cintura e o IMC. As pessoas categorizadas com baixo nível de atividade física (pouco ativo e pouco ativo regular leve) apresentaram um IMC médio mais elevado e são mais frequentemente categorizadas com CC alterada. A confiabilidade do instrumento foi moderada (r = ,61; K = 0,34). Conclusões: o Rapa em sua versão em espanhol adaptada para o Chile é um instrumento de fácil aplicação, que, mesmo com sua moderada confiabilidade, consegue ser sensível ao desenvolvimento da atividade física, que apresenta uma relação coerente com os parâmetros antropométricos de IMC e CC sensíveis a essa atividade.

Experiencia del uso de terapia biológica en pacientes con enfermedad inflamatoria intestinal en un hospital público / Experience in the use of biological therapy in IBD patients in a public hospital

Biological therapy plays an important role in the treatment of inflammatory bowel disease (IBD). However, the use of these drugs is limited due to fears about their side effects. Aim: To report the experience with the use of infliximab/adalimumab in IBD patients in a public hospital. Material and Methods: Descriptive study of a historical cohort of IBD patients treated with infliximab and adalimumab between April 2012 and July 2014. The clinical response was considered favourable when general, intestinal and extra intestinal symptoms subsided after the induction therapy. In addition, endoscopic and/or imaging response was evaluated at three and six months of treatment. Results: Fifteen out of 162 patients, aged 17 to 52 years (7 women) were included. Seven had Crohn´s Disease, 7 had ulcerative colitis and one had non-classifiable IBD. Biological therapy was indicated due to conventional refractory disease in all patients. All patients received combined treatment with immunosuppressive medications. A favorable clinical response was observed in 93 percent after induction therapy and 73 percent showed endoscopic/imagining remission after 3-6 months. Only one patient experienced side effects associated to the biological therapy, which did not result in discontinuation or treatment interruption. Conclusions: In this cohort of IBD patients treated in a public hospital, the use of infliximab/adalimumab was associated with favorable clinical and endoscopic evolution, post induction therapy with no major side effects.

La terapia biológica tiene un papel fundamental en el tratamiento de la enfermedad inflamatoria intestinal (EII). Sin embargo, el uso de estos fármacos es escaso debido a los costos y los temores sobre los efectos secundarios. Objetivo: Dar a conocer la experiencia en el uso de infliximab/adalimumab en pacientes con EII atendidos en un hospital público de nuestro país. Material y Métodos: Estudio descriptivo de una cohorte histórica de pacientes con EII tratados con infliximab y adalimumab entre abril de 2012 y julio de 2014. La respuesta clínica fue considerada favorable cuando los síntomas generales, intestinales y extra-intestinales desaparecieron después de la terapia de inducción. Además se evaluó la respuesta endoscópica/radiológica a los 3 y 6 meses de tratamiento. Resultados: De un total de 162 pacientes con EII, 15 fueron tratados con terapia biológica, con edad entre 17-52 años (7 mujeres). Siete presentaban el diagnóstico de enfermedad de Crohn, siete colitis ulcerosa y uno EII no clasificable. En todos se inició terapia biológica debido a la presencia de refractariedad a la terapia convencional. Todos recibieron terapia combinada con inmunosupresores. Se observó una respuesta clínica favorable en 93 por ciento después de la terapia de inducción y 73 por ciento tuvo una mejoría endoscópica después de 3-6 meses. Sólo un paciente presentó un evento adverso a terapia biológica, el cual no motivó la interrupción del tratamiento. Conclusiones: En esta cohorte de pacientes con EII tratados en un hospital público, el uso de infliximab/adalimumab se asoció con mejoría clínica y endoscópica post terapia de inducción, sin mayores efectos secundarios.

Comparación delpperfil lipídico por sexo y edad en ovinos / Comparson of lippid profile by sex and age in sheeps

Se comparó el perfil lipídico y la correlación entre los componentes lipídicos del suero en cuatro grupos de ovinos. A tal fin, se tomaron muestras de sangre de 98 ovinos en ayuno, diferenciados por género y edad (23 machos y 25 hembras mayores de un año de edad; 22 machos y 28 hembras menores a un año). Se determinaron las concentraciones séricas de: triglicéridos, colesterol total (CT) y colesterol de lipoproteínas de alta densidad (C-HDL) mediante el método enzimítico colorimétrico. El colesterol de lipoproteína de muy baja densidad (C-VLDL) y de baja densidad (C-LDL) se determinó usando la fórmula de Friedewald. Las medias para CT, triglicéridos, C-HDL, C-VLDL y C-LDL (mg/dL) fueron de 86.19, 21.57, 39.32, 4.31 y 42.55, respectivamente. En el grupo de adultos existe diferencia significativa (P <0.05) en los niveles de: CT (P <0.0003), C-HDL (P < 0.0007) y C-LDL (P <0.0133), siendo más alto en hembras; las hembras jóvenes presentaron elevado el C-HDL (49.02 mg/dL). Hay diferencias en los machos en el CT (P <0.0138 ) y C-LDL (P <0.0006) y en hembras sólo en el CT (P <0.015). Los valores de triglicéridos y C-VLDL en hembras (P >0.90 para ambos), machos (P >0.405 para ambos), jóvenes (P >0.487 para ambos) y adultos (P >0.179 para ambos) no mostraron diferencias significativas (P -valor >0.05) con un nivel de confianza del 95.0%. En conclusión, debido a las diferencias estadísticamente significativas en las comparaciones del perfil lipídico entre grupos de ovinos, pueden ser considerados cuatro perfiles lipídicos: machos adultos, hembras adultas, machos jóvenes y hembras jóvenes.

To objective was to compare the lipid profile in sheep and to analyze the relationship between serum lipids levels of four groups. Blood samples from 98 sheep were obtained in fasting state, differentiated by gender and age (23 males and 25 female aged over 12 months; 22 males and 28 females aged under 12 months). Serum concentrations of total cholesterol (TC), triglycerides and high density lipoprotein cholesterol (HDL-C) were measured using enzymatic colorimetric method; levels of very low-density lipoprotein cholesterol (VLDL-C) and low-density lipoprotein cholesterol (LDL-C) were determined using Friedewald equation. Mean for TC, triglycerides, HDL-C, VLDL-C and LDL-C were: 86.19, 21.57, 39.32, 4.31, 42.55 mg/dL respectively. The group of adults was differ (P < 0.05) for TC (P <0.0003), HDL-C (P <0.0007) and LDL-C (P <0.0133), being increased in females. In young females HDL-C was higher (49.02 mg/ dL). In males significant differences were observed in TC (P <0.0138), and LDL-C (P <0.0006) and females in TC (P <0.015). Triglycerides and VLDL-C in females (P >0.90 for both), in males (P <0.405 for both), in young (P >0.487 for both) and adults (P >0.179 for both) showed no significant differences (P-value >0.05) with a confidence level of 95.0%. In Conclusion given the differences in the comparisons between groups for the lipid profile in sheep, can be considered four lipid profiles as follows: adult males, adult females, young males and young females.