El valor de la acupuntura en la práctica de la medicina tradicional complementaria en el sector salud de México / The value of acupuncture in the practice of complementary traditional medicine in Mexico's health sector

Introduction: Complementary traditional medicine acquires an essential value from the diversity and pluralism of care and therapy. In this logic, it is up to people to search for alternatives when it comes to caring for and improving their own health. Specifically, acupuncture has had rapid growth, largely due to processes derived from globalization, migration and cultural exchange, which in some way force countries to modify their health system towards one that takes into account the transculturality of its population and treatment preferences. Development: With the establishment of a comprehensive health model, physicians can assess the person as a homeodynamic process (information exchange process between environment and man, to keep an internal and external homeostasis to the individual) and pandimensional (spiritual and energetic care) that allows to identify the health problem's origin and thus determine an intervention more in line with the person's needs during the health-disease, life-death processes, with the corresponding conventional or non-conventional therapy. Conclusions: The value and interest of acupuncture in the population derives from the degree of development of a country, its origin and the incorporation of the West as part of the diagnostic and therapeutic arsenal, in order to respond to the population needs by incorporating low-cost complementary treatments with proven effectiveness, without ceasing to consider its unquestionable cultural heritage.

Introducción: la medicina tradicional complementaria adquiere un valor imprescindible desde la diversidad y el pluralismo de la asistencia y la terapéutica. En esa lógica, corresponde a las personas la búsqueda social de alternativas cuando se trata de atender y mejorar la propia salud. En específico la acupuntura ha tenido un rápido crecimiento, en gran parte debido a la globalización, la migración y el intercambio cultural, que de alguna forma obligan a los países a modificar su sistema de salud hacia uno que tome en cuenta la transculturalidad de su población y las preferencias de tratamiento. Desarrollo: con el establecimiento de un modelo de salud integral, los médicos pueden valorar a la persona como un proceso homeodinámico (intercambio de información entre el ambiente y el hombre para mantener una homeostasis interna y externa del individuo) y pandimensional (cuidado espiritual y energético) que permita identificar el origen real del problema de salud y determinar una intervención más acorde a las necesidades de la persona durante los procesos de salud-enfermedad, de vida-muerte, con la terapia convencional o no convencional que corresponda. Conclusiones: el valor e interés de la acupuntura en la población se deriva del grado de desarrollo de un país, de su origen y de la incorporación de occidente como parte del arsenal diagnóstico y terapéutico, para responder a las necesidades de la población al incorporar tratamientos complementarios de bajo costo y con efectividad demostrada, y sin dejar de considerar su herencia cultural incuestionable.

Caracterización de los sistemas productores de conejos en el municipio Ciego de Ávila, Cuba / Characterization of rabbit production systems in the Ciego de Ávila municipality, Cuba

Resumen La crianza de conejos contribuye a la obtención de proteína animal, así como de ingresos por la venta de dicha especie. La descripción y caracterización de los sistemas de producción de estos animales arrojan información valiosa para el diseño de planes de intervención y mejoras. El objetivo del presente trabajo fue determinar las principales variables que influyen en la heterogeneidad de los sistemas productores de conejos en el municipio Ciego de Ávila, Cuba. La muestra estuvo formada por 49 fincas. Se obtuvo la información cuantitativa de indicadores productivos, reproductivos y sociales, a través de un análisis de factores, usando componentes principales (CP). Se calcularon las puntuaciones factoriales de cada caso, en cada CP, y los estadísticos descriptivos de los indicadores medidos. En las condiciones del territorio estudiado, la eficiencia estuvo determinada por 6 CP que explicaron el 77.6 % de la varianza: 1) tamaño del rebaño y áreas de forrajes; 2) comportamiento reproductivo; 3) edad del productor y manejo reproductivo; 4) mortalidad; 5) edad al destete y sacrificio y 6) número de montas para gestar las conejas. La caracterización a partir del uso de CP, y el índice factorial de cada caso de estudio en cada CP, sirve de base para interpretar la gran heterogeneidad existente en los indicadores estudiados, así como su similitud, y contribuye a definir relaciones y comportamientos en la caracterización de fincas cunícolas en esta región, lo que permitirá implementar planes de mejora productiva.

Abstract The breeding of rabbits contributes to obtaining animal protein and generating income from the sale of this species. The description and characterization of the production systems of these animals provide valuable information for the design of intervention and improvement plans. The aim of this study was to determine the main variables that influence the heterogeneity of the rabbit production systems in the Ciego de Ávila municipality, Cuba. The sample consisted of 49 farms. Quantitative data on productive, reproductive and social indicators were obtained through factor analysis using principal components (PC). The factor scores of each case were calculated, in each PC, and descriptive statistics of the indicators measured. In the conditions of the studied territory, the efficiency was determined by 6 PC that explained 77.6 % of the variance: 1) size of the herd and forage areas; 2) reproductive behavior; 3) age of the producer and reproductive management; 4) mortality; 5) age at weaning and age at slaughter and 6) number of mounts to gestate the breeders. The characterization from the use of PC, and the factor index for each case study in each PC, serve as the basis for interpreting the great existing heterogeneity in the indicators studied, as well as their similarity. It also contributes to defining relationships and behaviors in the characterization of rabbit farms in this region, which will allow the implementation of productive improvement plans.

Caracterización de un Consorcio Microbiano Metanogénico de una Mina de Carbón en la Cuenca de Bogotá / Characterization of a Methanogenic Microbial Consortium from a Coal Mine in Bogotá Basin

RESUMEN En el trabajo se estudió un consorcio microbiano metanogénico de una mina de carbón de la cuenca de Bogotá en Colombia. Se establecieron cultivos de enriquecimiento de carbón ex situ para el crecimiento y la producción de gas de novo. El gas biogénico producido por los cultivos se analizó mediante cromatografía de gases con detectores de ionización de llama y conductividad térmica. Los cultivos se utilizaron para aislar estirpes microbianas y para generar bibliotecas del gene 16S rARN empleando de cebadores de bacteria y de arquea. El análisis de cromatografía de gases mostró producción de metano a 37 oC, pero no a 60 oC, donde el CO2 fue el componente principal del gas biogénico. El análisis de la secuencia del gen 16S rARN de estirpes microbianos y de las bibliotecas de clones, estableció que el consorcio microbiano metanogénico estuvo formado por especies de bacterias de los géneros Bacillus y Gracilibacter más la arquea del género Methanothermobacter. El consorcio microbiano metanogénico identificado es potencialmente responsable de la generación de gas biogénico en la mina de carbón La Ciscuda. Los resultados sugirieron que los metanógenos de este consorcio producían metano por vía hidrogenotrófica o de reducción de CO2.

ABSTRACT The work studied the methanogenic microbial consortium in a coal mine from the Bogotá basin in Colombia. Ex situ coal-enrichment cultures were established for in vitro growth and de novo gas production. Biogenic gas produced by cultures was analyzed by gas chromatography using thermal conductivity and flame ionization detectors. Cultures were used to isolate microbial specimens and to generate 16S rRNA gene libraries employing bacterial and archaeal primer sets. The gas chromatographic analysis showed methane production at 37 oC, but not at 60 oC, where CO2 was the major component of the biogenic gas. 16S rRNA gene sequence analysis of microbial isolates and clone libraries established that the methanogenic microbial consortium was formed by bacteria species from Bacillus and Gracilibacter genera plus archaea from the Methanothermobacter genus. This meth-anogenic microbial consortium was potentially responsible for biogenic gas generation in La Ciscuda coal mine. The results suggested that these methanogens produced methane by hydrogenotrophic or CO2 reduction pathways.

Ablación de taquicardia ventricular asistida con ECMO. Primera experiencia en nuestra institución / Ablation of ventricular tachycardia assisted with ECMO. First experience in our institution

Resumen La ablación con catéter de taquicardia ventricular ha demostrado mejorar la supervivencia y algunas veces es el único tratamiento efectivo, sobre todo en tormenta arrítmica; sin embargo la presencia de inestabilidad hemodinámica dificulta el procedimiento. El soporte con oxigenación por membrana extracorpórea (ECMO) es una alternativa para lograr el mapeo y ablación de taquicardia ventricular durante largos periodos de tiempo. Se presenta el caso de un paciente con cardiopatía isquémica y taquicardia ventricular con inestabilidad hemodinámica, en quien se realiza la ablación exitosa del sustrato mediante soporte con ECMO veno-arterial, sin episodios de taquicardia ventricular durante dos años de seguimiento.

Abstract Catheter ablation is useful for reducing drug refractory ventricular tachycardia (VT) episodes and can be life-saving when VT is incessant or arrhythmic storm. Left ventricular hemodynamic support may be required in patients with VT and hemodynamic instability. Extracorporeal membrane oxygenation (ECMO) support is an alternative to achieve ventricular tachycardia mapping and ablation over long periods of time. We present a case of successful catheter ablation of substrate in a patient with ischemic heart disease and ventricular tachycardia with hemodynamic instability performed using venous- arterial ECMO support. There were not episodes of ventricular tachycardia after 2 years of follow-up.

Caracterización de la apnea del sueño en pacientes cardiópatas e internación por enfermedad grave por COVID-19 / Characterization of sleep apnea and hospitalization for severe illness due to COVID-19

La COVID-19 ha generado mundialmente una morbi-mortalidad considerable, particularmente entre aquellos con comorbilidades crónicas: hipertensión, diabetes y enfermedad cardiovascular. Investigaciones han demostrado que la apnea del sueño puede agravar el pronóstico vital, al causar o agudizar la disfunción endotelial, inflamación, estrés oxidativo, microaspiración y lesiones pulmonares, lo que amplifica el riesgo de hospitalización e incluso de sufrir de insuficiencia respiratoria. Se realizó un estudio descriptivo retrospectivo y transversal, se evaluaron 187 pacientes cardiópatas con clínica sugestiva a apnea obstructiva del sueño con resultaron positivo para SARS-CoV-2, entre 2020-2021.Se aplicaron la metodología de Castro et al., 2021 y cuestionario de STOP-BANG para valorar la disnea y caracterizar la AOS respectivamente. Se corroboró la fuerte asociación entre la enfermedad cardíaca y la presencia de AOS; más de la mitad de los pacientes estudiados presentaron, enfermedad grave por COVID-19, con disnea moderada-grave, que amerito hospitalización con cuidados intensivos, observándose mayor frecuencia en el sexo masculino, con más de 50 años y con IMC >30. Sin embargo, las féminas presentaron valores significativos de STOP-BANG, lo que sugiere a la HTA y obesidad como factores de riesgo para AOS, independiente al sexo. Se recomienda realizar el descarte de AOS como rutina médica, que permita establecer la epidemiología y estrategias para abordaje adecuado de estos pacientes(AU)

COVID-19 has generated considerable morbidity and mortality worldwide, particularly among those with chronic comorbidities: hypertension, diabetes, and cardiovascular disease. Research has shown that sleep apnea can worsen the vital prognosis, by causing or exacerbating endothelial dysfunction, inflammation, oxidative stress, microaspiration and lung damage, which amplifies the risk of hospitalization and even respiratory failure. A retrospective and cross-sectional descriptive study was carried out, 187 heart patients with clinical signs suggestive of obstructive sleep apnea were evaluated and were positive for SARS-CoV-2, between 2020-2021. The methodology of Castro et al., 2021 and questionnaire were applied. STOP-BANG to assess dyspnea and characterize OSA, respectively. The strong association between heart disease and the presence of OSA was confirmed; More than half of the patients studied presented severe disease due to COVID-19, with moderate-severe dyspnea, which required hospitalization with intensive care, with a higher frequency observed in males, over 50 years of age and with BMI >30. However, females presented significant STOP-BANG values, which suggests hypertension and obesity as risk factors for OSA, regardless of gender. It is recommended to rule out OSA as a medical routine, which allows establishing the epidemiology and strategies for an adequate approach to these patients(AU)

PREDATION OF Brevicoryne brassicae AND Aphis craccivora BY Eriopis connexa DEPENDING ON AVAILABILITY / Depredación de Brevicoryne brassicae y Aphis craccivora por Eriopis connexa, según disponibilidad

ABSTRACT Predator species under field conditions can face different and variable densities of prey species. This work evaluated the functional response of the neotropical lady beetle Eriopis connexa (Coleoptera: Coccinellidae) subjected to different densities of the aphids Brevicoryne brassicae and Aphis craccivora (Hemiptera: Aphididae). Thus, predation rates were analyzed of fourth-instar larvae and one-day old adults of the lady beetle preying upon the aphids at constant densities of 20, 40, 50, 60, and 70 aphids with 15 repetitions per density. The aphids were offered on 5 cm leaf discs of each plant host. The handling times and attack rates were 0.03 h-1 and 0.27 h-1 for larvae and 0.03 h-1 and 0.15 h-1 for adults fed B. brassicae and 0.59 h-1 and 0.35 h-1 for larvae and 0.70 h-1 and 0.95 h-1 for adults fed A. craccivora, respectively. Both larva and adult lady beetles increased predation rate as a function of prey density offered, with an estimated maximum number of prey consumed of 30.3 and 31.6 B. brassicae and 36.3 and 34.6 of A. craccivora by larva and adult lady beetles at the highest prey density, respectively. In conclusion, larvae and adults of E. connexa exhibited a type II functional response.

RESUMEN Las especies de depredadores en condiciones de campo pueden enfrentar densidades diferentes y variables de sus presas. Este trabajo evaluó la respuesta funcional de la mariquita neotropical Eriopis connexa (Coleoptera: Coccinellidae) sometida a diferentes densidades de los pulgones Brevicoryne brassicae y Aphis craccivora (Hemiptera: Aphididae). Se analizaron las tasas de depredación de larvas de cuarto estadio y adultos de un día de vida en las densidades constantes de 20, 40, 50, 60 y 70 pulgones con 15 repeticiones por densidad. Los pulgones se ofrecieron en discos de 5 cm de hojas de la planta huésped. Los tiempos de manejo y las tasas de ataque fueron 0.03 h-1 y 0.27 h-1 para larvas y 0.03 h-1 y 0.15 h-1 para adultos alimentados con B. brassicae y 0.59 h-1 y 0.35 h-1 para larvas y 0.70 h-1 y 0.95 h-1 para adultos alimentados con A. craccivora, respectivamente. Las larvas y las mariquitas adultas aumentaron la tasa de depredación en función de la densidad de presas ofrecidas, con un número máximo estimado de presas consumidas de 30.3 y 31.6 de B. brassicae y 36.3 y 34.6 de A. craccivora para larvas y mariquitas adultas a la mayor densidad de presas, respectivamente. En conclusión, las larvas y los adultos de E. connexa exhibieron una respuesta funcional del tipo II.

Factores de riesgo materno asociados con macrosomía fetal en el Hospital de Clínicas / Maternal risk factors associated with fetal macrosomia in Hospital de Clínicas

Introducción: La incidencia de macrosomía está entre 4,7 a 16,4%. La Organización Mundial de la Salud (OMS) en el 2012 refiere que el 6.7% de los recién nacidos en el mundo presentaron sobrepeso u obesidad. En el 2014 reportó que en las regiones de Sudamérica el 7,6% de los recién nacidos nacieron con sobrepeso. Materiales y métodos: Estudio observacional, analítico de casos y controles. El método de muestreo no probabilístico de casos consecutivos. La población accesible son pacientes que dieron a luz a recién nacidos macrosómicos en la Cátedra y Servicio de Ginecología y Obstetricia del Hospital de Clínicas. Los casos son pacientes con ecografía obstétrica del tercer trimestre que dieron a luz a recién nacido único, vivo o muerto, mayor a 37 semanas por Capurro, con peso al nacer mayor o igual a 4000 gramos en la Cátedra y Servicio de Ginecología y Obstetricia del Hospital de Clínicas - San Lorenzo, del 1 de enero a 31 de diciembre de 2017. Resultados: Con diferencia significativa (p<0,05) el estudio manifiesta oportunidad a las cesáreas con 64 (84,21%) como vía de terminación del embarazo, siendo 5,77 veces mayor en las gestaciones con feto macrosómico. Las lesiones del canal del parto se reportaron 8 (10,53%) en los partos de recién nacidos macrosómico y 46 (30,26%) en los controles, representando diferencia significativa. Conclusión: los factores de riesgo materno asociados con macrosomía fetal son: la macrosomía anterior, la obesidad materna pregestacional, la hipertensión inducida por el embarazo, un aumento de ponderal > 15 kg durante la gestación. La mayoría de las mujeres estudiadas fueron de procedencia urbana, en unión libre, amas de casas y con escolaridad secundaria, pero no resultaron ser factores de riesgos de recién nacidos macrosómicos. No se encontró asociación entre macrosomía fetal y diabetes gestacional.

Introduction: The incidence of macrosomia is between 4.7 to 16.4%. The World Health Organization (WHO) in 2012 refers that 6.7% of newborns in the world were overweight or obese.9 In 2014 it reported that in the regions of South America 7.6% of newborns were born with overweight. Materials and methods: Observational, analytical study of cases and controls. The non-probability sampling method of consecutive cases. The accessible population are patients who gave birth to macrosomic newborns in the Department and Service of Gynecology and Obstetrics of the Hospital de Clínicas. The cases are patients with obstetric ultrasound of the third trimester who gave birth to a single newborn, alive or dead, greater than 37 weeks per Capurro, with a birth weight greater than or equal to 4000 grams in the Department and Service of Gynecology and Obstetrics of the Hospital de Clínicas - San Lorenzo, from January 1 to December 31, 2017. Results: With a significant difference (p <0.05), the study shows an opportunity for cesarean sections with 64 (84.21%) as the means of termination of pregnancy, being 5.77 times higher in pregnancies with a macrosomic fetus. Injuries to the birth canal were reported in 8 (10.53%) in macrosomic newborn deliveries and 46 (30.26%) in controls, representing a significant difference. Conclusion: maternal risk factors associated with fetal macrosomia are: anterior macrosomia, pre-pregnancy maternal obesity, pregnancy-induced hypertension, and a weight gain> 15 kg during pregnancy. Most of the women studied were of urban origin, in common union, housewives and with secondary schooling, but they did not turn out to be risk factors for macrosomic newborns. No association was found between fetal macrosomia and gestational diabetes.

Una evaluación de las propiedades fisicoquímicas de suelo en sistema productivo de maíz - algodón y arroz en el Valle del Sinú en Colombia / An evaluation of soil physicochemical properties in corn - cotton, and rice production systems at the Sinu Valley in Colombia

RESUMEN Los sistemas de producción agrícolas en la subregión Valle del Sinú, en Colombia, en los últimos 50 años, se han basado en la siembra de cultivos en rotación o alternancia de maíz - algodón y arroz, y se caracterizan por el uso intensivo de implementos de mecanización e insumos agrícolas. El objetivo de este estudio fue evaluar las características fisicoquímicas de los suelos, bajo los sistemas productivos de maíz - algodón y arroz e identificar las principales limitantes de suelo, que afectan el desarrollo y la productividad de los cultivos, en la subregión Valle del Sinú. Para lo anterior, se realizaron muestreos de suelo en 64 sitios, distribuidos en cinco municipios del Valle del Sinú, evaluando propiedades físicas y químicas del suelo. El suelo en estudio pertenece al orden Inceptisol, moderadamente profundo, compuesto por arcillas expansivas y horizonte argílico. El suelo, se caracterizó por una reacción acida (5,82±0,87 a 6,78±0,34), contenido medio de MO. La media de la CIC varió en rango, de 18,45±2,94 a 22,85±4,36cmol(+) kg-1, la CE estuvo no salinos, variando de 0,29±0,09 a 0,91±1,70dS cm-1. Los contenidos de P, S, Ca, Mg y K fueron altos. La densidad aparente mostró valores promedios restrictivos para el desarrollo de raíces en cuatro de los cinco municipios, variando de 1,42±0,10 a 1,49±0,08g cm-3, excepto en San Carlos (1,33±0,14g cm-3). Los resultados obtenidos evidencian indicios de procesos de degradación de suelo, relacionados con el manejo de los suelos.

ABSTRACT The agricultural production systems in the Valle del Sinú subregion in Colombia, in the last 50 years, have been based on the sowing of crops in rotation and / or alternation of corn - cotton and rice, and are characterized by the intensive use of implements mechanization and agricultural inputs. The aim of this study was to evaluate the physicochemical characteristics of the soils under the corn - cotton and rice production systems and identifying the main soil limitations, which affect crop development and productivity, in the Sinú Valley Subregion. For the above, soil sampling was carried out at 64 sites distributed in five municipalities of the Sinú Valley, evaluating the physical and chemical properties of the soil. The soil under study belongs to the order Inceptisol, moderately deep, composed of expansive clays and argillic horizons. The soil was characterized by an acid reaction (5.82 ± 0.87 to 6.78 ± 0.34), average MO content. The mean of the CIC varied in the range of 18.45 ± 2.94 to 22.85 ± 4.36cmol(+) kg-1, the EC was not saline, varying from 0.29 ± 0.09 to 0.91 ± 1.70dS cm-1. The contents of P, S, Ca, Mg and K were high. The apparent density showed restrictive average values for root development in four of the five municipalities, ranging from 1.42 ± 0.10 to 1.49 ± 0.08g cm-3, except in San Carlos (1.33 ± 0.14g cm-3). The results obtained show evidence of soil degradation processes related to soil management.

Profesionalización de la acupuntura y sus implicaciones en la salud de los pacientes / Acupuncture professionalisation and patients health implications

Introducción: la acupuntura humana es una terapia complementaria en la atención para la salud. Derivado de su alta demanda en gran parte del mundo la OMS fijo su postura a favor de la Medicina Tradicional y Complementaria (MTC) con la publicación "Estrategia sobre medicina tradicional 2014-2023", ésta se centra en dos objetivos: brindar apoyo a los Estados Miembros en la contribución de la MTC en la salud, bienestar y atención centrada en las personas y promover su utilización de forma segura y eficaz; mediante la reglamentación de productos, prácticas y profesionales capacitados. Desarrollo: la estrategia plantea la necesidad de que toda práctica de MTC sea realizada con formación universitaria, sin embargo, solo el 30% de los países miembros (39) cuentan con ella universitaria y 56% (72) tienen reglamentos para su práctica en acupuntura. En México se imparten diversos cursos y diplomados de MTC, a nivel técnico, licenciatura, especialidad y posgrado, con diferentes horas curriculares. Asimismo, cuenta con políticas de regulación sobre acupuntura y sus técnicas. Conclusión: la acupuntura tiene sustento científico en la anatomía y neurofisiología. Debe ser aplicada por profesionales del área de salud y con formación certificada por una institución de reconocido prestigio.

Patrón electrocardiográfico Brugada tipo I asociado a un cuadro febril por Influenza B. A propósito de la pandemia de COVID-19. Caso clínico

We report a 44-year-old male who was admitted for Influenza B and fever, presenting a type I Brugada pattern on the electrocardiogram. He evolved without cardiovascular symptoms. The pharmacological test with intravenous Procainamide reproduced type I Brugada pattern and the programmed electrical stimulation was negative for ventricular arrhythmias. He was discharged without incidents. Clinical aspects of Brugada syndrome and the importance of fever are discussed in the current context of the COVID-19 pandemic.

Resection of the atrial appendages and its impact in the natriuretic homeostasis: development and validation of an animal model in an academic medical center

ABSTRACT Background: The left atrial appendage (LAAp) resection is an effective treatment approach to reduce the risk of thromboembolism in patients with atrial fibrillation. Objective: To study was to study the impact of removing atrial appendages in the production of natriuretic peptides (NPs) in conditions of volume overload and to develop an experimental model of LAAp resection. Materials and Methods: In a swine model of ischemic heart failure (HF), serum NP levels were measured before (Basal-1A) and after (Basal-1B) a fluid overload. Animals were grouped as follows: (0) preserved appendages, (1) resected LAAp, and (2) both atrial appendages resected. Levels of NP were measured before (2A) and after a fluid overload (2B). Results: Furin levels were higher in Group 0-2A than in Group 2-2A, and a significant increase was found in Group 0-2B compared to Groups 1-2B and 2-2B. Corin levels increased in Basal-1B versus Basal-1A. Atrial NP (ANP) decreased in Basal-1B compared to Basal-1A. After HF induction, ANP increased in Groups 2-2A and 2-2B. Conclusions: Resection of atrial appendages drastically modifies the natriuretic mechanisms of cardiac homeostasis, especially after a fluid overload challenge. Herein, we describe the face and predictive validation of an animal model of atrial appendage resection useful to investigations in translational medicine.

Lupus eritematoso sistémico en actividad y cociente albúmina/globulina invertido, ¿hallazgo propio de la enfermedad? / Systemic Erythematosus Lupus and Albumin-Globulin Index, a specific finding in lupus flares?

Introducción: El lupus eritematoso sistémico es el modelo clásico de enfermedad autoinmune. En el desarrollo de la enfermedad intervienen varios tipos de inmunoglobulinas, con predominio de la IgG, IgM e IgA. Objetivo: Describir la utilidad del cociente albúmina/globulina como un indicador de actividad en el lupus eritematoso sistémico. Desarrollo: Se estima que el 50 por ciento de los pacientes con lupus eritematoso sistémico muestran una hipoalbuminemia con una hipergammaglobulinemia. La hipoalbuminemia en mayor medida está relacionada con la presencia de nefritis lúpica. La mitad de los pacientes con nefritis lúpica presentan proteinuria en el orden del síndrome nefrótico. Esta proteinuria iguala o invierte parcialmente el valor del cociente albúmina/globulina. El cociente albúmina/globulina invertido por sí solo es insuficiente para afirmar la presencia de actividad en el lupus eritematoso sistémico. Se deben excluir otras entidades clínicas causantes de hipergammaglobulinemia policlonal. Los criterios de actividad del lupus eritematoso sistémico incrementan la sensibilidad del cociente albúmina/globulina invertido. Conclusiones: La interpretación del cociente albúmina/globulina debe ir aparejada a la estimación de actividad por los criterios clínicos de mayor uso (SLICC, SLEDAI, BILAG). No en todos los pacientes con lupus eritematoso sistémico puede interpretarse como criterio de actividad, por lo que es necesario excluir otras entidades clínicas(AU)

Introduction: Systemic lupus erythematosus is the model of autoimmune disease. Several types of immunoglobulins are involved in the development of the disease, mainly IgG, IgM and IgA. Objective: To describe the potential use of the albumin/globulin ratio as an indicator of activity in systemic lupus erythematosus. Development: fifty percent of patients with systemic lupus erythematosus exhibit hypoalbuminemia with hypergammaglobulinemia. Hypoalbuminemia is mainly related to the presence of lupus nephritis. The half of patients with lupus nephritis develops proteinuria with values of nephrotic syndrome. The proteinuria equals or partially reverses the albumin/globulin ratio. The inverted albumin/globulin ratio is insufficient to establish the presence of lupus activity. Other clinical entities producing polyclonal hypergammaglobulinaemia should be excluded. The systemic lupus erythematosus activity criteria increase the sensitivity of the inverted albumin/globulin ratio. Conclusions: The interpretation of the albumin/globulin ratio requires the activity estimation by different clinical criteria (SLICC, SLEDAI, BILAG). The inverted albumin/globulin ratio cannot be interpreted as a stand-alone indicator of disease activity in every systemic lupus erythematosus patients(AU)

Adaptación y validación de cuestionario para medir hábitos alimentarios en educación superior / Adaptation and validation of a questionnaire to measure food habits in higher education

RESUMEN Validar instrumentos de medición de datos es fundamental para constituir conocimiento certero y objetivo respecto a los hábitos en ingesta alimentaria. El artículo pretende adaptar y validar para el contexto de educación superior un cuestionario que originalmente es de atención primaria, y que se transforme en un insumo válido para medir hábitos alimentarios en estudiantes universitarios. Basados en un cuestionario validado por Pino, Díaz y López en el 2011, se ajustaron las preguntas para un contexto de educación terciaria. El instrumento se aplicó a una muestra estratificada de 405 estudiantes de pregrado de una universidad perteneciente al Consejo de Rectores de Chile (CRUCH) de la región del Maule. Los datos fueron procesados mediante el paquete estadístico SPSS 20, y contó con los respectivos resguardos éticos mediante consentimiento informado firmado. Siguiendo los pertinentes análisis estadísticos para la validación del instrumento, podemos dar cuenta de un cuestionario confiable y aceptable (α= 0,815), estableciéndose 10 dimensiones con 35 preguntas. Se concluye un instrumento válido y adaptado para ser aplicado en estudiantes con el fin de identificar sus hábitos alimentarios en educación superior.

ABSTRACT Validating data measurement instruments is essential to establish accurate and objective knowledge regarding dietary habits. This article aims to adapt and validate a questionnaire to measure dietary habits originally designed for the primary care setting for use in the context of higher education. Based on a questionnaire validated by Pino, Díaz and López in 2011, the questions were adjusted for a tertiary education context. The instrument was applied to a sample of 405 undergraduate students of a university belonging to the Council of Rectors of Chile (CRUCH) of the Maule region, stratified by college year. Data were analysed using SPSS 20; signed informed consent was obtained. Following the relevant statistical analysis for the validation of an instrument, 10 dimensions with 35 questions were established. Results indicated that the instrument is trustworthy and acceptable (α= 0.815). We conclude that the instrument is a valid adaptation and can be applied to higher education students in order to identify their eating habits.

In vitro predatory activity of nematophagous fungi isolated from water buffalo feces and from soil in the Mexican southeastern / Atividade predatória in vitro de fungos nematófagos isolados de fezes de búfalos e do solo no sudeste mexicano

Abstract Nematophagous fungi from the feces of water buffalo and soil from southeastern Mexico were isolated, and their in vitro predatory activity against Haemonchus contortus infective larvae (L3) (HcL3) was assessed. The fungi were isolated by sprinkling soil or feces on water agar plates. Six series of 10 Petri dishes containing a 7-day-old culture of each fungus and a series without fungi as the control were prepared. Five hundred HcL3 were added to each plate. The plates were incubated at room temperature. The average of recovered HcL3 was considered to estimate the larval reduction rate. Four nematophagous fungi isolates corresponding to Arthrobotrys oligospora, var microspora (strains 4-276, 269 and 50-80) and one identified as A. oligospora,var. oligospora (isolates 48-80) were obtained from water buffalo feces. From the soil, five isolates were isolated; three corresponded to A. musiformis (Bajío, Yumca and Macuspana isolates), and two isolates were identified as A. oligospora (Comalcalco and Jalapa de Méndez isolates). The predatory activity of isolates from water buffalo feces ranged between 85.9 and 100%. Meanwhile, the fungi from the soil ranged between 55.5 and 100% (p≤0.05). The nematophagous fungi obtained could have important implications in the control of parasites of importance in the livestock industry.

Resumo Fungos nematófagos das fezes de búfalo de água e do solo no sudeste do México foram isolados, e a atividade predatória in vitro contra larvas infectantes de Haemonchus contortus (L3) (HcL3) foi avaliada.Os fungos foram isolados por aspersão de solo e de fezes em placas de agar água. Foram preparadas seis séries de 10 placas de Petri contendo uma cultura de 7 dias de idade de cada fungo e uma série sem fungos como controle. Quinhentos HcL3 foram adicionadas a cada placa. As placas foram incubadas à temperatura ambiente. O número médio de HcL3 recuperadas foi considerado para estimar a taxa de redução larval. Quatro isolados de fungos nematófagos corresponderam a Arthrobotrys oligospora, var microspora (estirpes 4-276, 269 e 50-80) e um isolado identificado como A. oligospora, var. oligospora (isolados 48-80 de fezes de búfalo de água. Do solo, dos cinco isolados três corresponderam a A. musiformis (Bajío, Yumca e Macuspana isolados), e dois isolados foram identificados como A. oligospora (isolados de Comalcalco e Jalapa de Méndez). A atividade predatória de isolados de fezes de búfalo de água variou entre 85,9 e 100%. Enquanto isso, os fungos do solo variaram entre 55,5 e 100% (p≤0,05). Os fungos nematófagos obtidos podem ter importantes implicações nesse controle de parasitos de importância na indústria pecuária.

Susceptibility of boll weevil to ready-to-use insecticide mixtures / Suscetibilidade do bicudo-do-algodoeiro a misturas de inseticidas prontas para uso

Boll weevil is the major cotton pest in Brazil, and insecticides are widely recommended against it. We determined the susceptibility of boll weevil to insecticides either in single or in mixture ready-to-use formulations, which are registered to spray cotton fields under the hypothesis that mixtures are more toxic to the target pest. Concentration-mortality curves were determined to adult species, simultaneously through dried residues and ingestion. Ten insecticide formulations were studied with five in mixture (lambda-cyhalothrin + thiamethoxam, lambda-cyhalothrin + chlorantraniliprole, thiamethoxam + chlorantraniliprole, and fenitrothion + esfenvalerate) and their five respective single formulations. Cotton leaf discs and cotyledons were dipped into insecticide dilutions prepared by diluting the commercial products into distilled water. Adult mortality was assessed 48 hours after caging adults on treated and untreated materials. The LC50s-concentrations varied from 0.004 to 0.114 g a.i./L, with a relative potency between single and mixture ones, varying from 1.37- to 29.59-fold. Furthermore, lambda-cyhalothrin and thiamethoxam in single formulation were the most toxic insecticides to boll weevil. Among insecticide mixtures, only lambda-cyhalothrin + chlorantraniliprole resulted in a synergic effect; whereas the remaining mixtures showed an antagonistic effect. Therefore, except for the mixture of lambda-cyhalothrin + chlorantraniliprole, the remaining mixtures did not enhance toxicity against the boll weevil and should be recommended only when aimed at different purposes.(AU)

Bicudo-do-algodoeiro é a principal praga do algodoeiro no Brasil, sendo o uso de inseticidas amplamente recomendado para o seu controle. A suscetibilidade do bicudo-do-algodoeiro foi determinada a inseticidas em formulação simples ou em misturas prontas para uso, as quais têm sido recomendadas para pulverizar campos de algodão sob a hipótese de serem mais tóxicas à praga alvo. Assim, curvas de concentração-mortalidade foram determinadas para adultos do bicudo contaminados, simultaneamente, via resíduo seco e ingestão dos inseticidas. Dez formulações foram estudadas, sendo cinco misturas (lambda-cialotrina + tiametoxam, lambda-cialotrina + clorantraniliprole, tiametoxam + clorantraniliprole e fenitrotiona + esfenvalerato) e suas respectivas cinco formulações simples. Folhas e cotilédones do algodoeiro foram mergulhados em diluições do inseticida preparadas com os produtos comerciais e água destilada. A mortalidade adulta foi avaliada 48 horas após o acondicionamento dos adultos em materiais tratados e não tratados. As concentrações de CL50s variaram de 0,004 a 0,114 g i.a./L, com potência relativa entre formulação simples e misturas, variando de 1,37 a 29,59 vezes. A lambda-cialotrina e o tiametoxam em formulações simples foram os inseticidas mais tóxicos para o bicudo. Entre as misturas, aquela preparada com lambda - cialotrina + clorantraniliprole resultou em um efeito sinérgico, enquanto as demais misturas mostraram um efeito antagonista. Portanto, exceto pela mistura de lambda-cialotrina + clorantraniliprole, as demais misturas não demonstraram maior toxicidade para o bicudo-do-algodoeiro e devem ser recomendadas somente quando objetivam finalidades diferentes.(AU)

Burden of rheumatoid arthritis on patients' work productivity and quality of life

Abstract Background: To determine the burden of Rheumatoid Arthritis (RA) on patients' work productivity and health related quality of life (HRQoL), and examine the influence of several exposure variables; to analyze the progression of RA over 1 year and its impact on work productivity and HRQoL. Methods: International multicenter prospective survey including patients in 18 centers in Argentina, Brazil, Colombia and Mexico with diagnosis of RA and aged between 21-55 years. The following standard questionnaires were completed at baseline and throughout a 1-year follow-up: WPAI:RA, WALS, WLQ-25, EQ-5D-3 L and SF-36. Clinical and demographic variables were also collected through interview. Results: The study enrolled 290 patients on baseline visit. Overall mean scores at baseline visit were: WPAI:RA (presenteeism) = 29.5% (SD = 28.8%); WPAI:RA (absenteeism) = 9.0% (SD = 23.2%); WPAI:RA (absenteeism and presenteeism) = 8.6% (SD = 22.6%); WALS = 9.0 (SD = 6.1); WLQ-25 = 7.0% (SD = 5.1%); SF-36 Physical Scale = 39.1 (SD = 10.3) and Mental Scale = 45.4 (SD = 11.3); EQ-5D-3 L VAS = 69.8 (SD = 20.4) and EQ-5D-3 L index = 0.67 (SD = 0.23). Higher educational levels were associated with better results in WLQ-25, while previous orthopedic surgeries reduced absenteeism results of WPAI:RA and work limitations in WLQ-25. Higher disease duration was associated with decreased HRQoL. Intensification of disease activity was associated with decreased work productivity and HRQoL, except in WLQ-25. In the longitudinal analysis, worsening in disease activity was associated with a decrease in both work productivity and HRQoL. Conclusions: RA patients are dealing with workplace disabilities and limitations and loss in HRQoL, and multiple factors seems to be associated with this. Worsening of disease activity further decreased work productivity and HRQoL, stressing the importance of disease tight control.

Age and density of eggs of Helicoverpa armigera influence on Trichogramma pretiosum parasitism / Influência da idade e densidade de ovos de Helicoverpa armigera no parasitismo de Trichogramma pretiosum

This study evaluated the parasitism of Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) on eggs of Helicoverpa armigera Hübner (Lepidoptera: Noctuidae) at different ages and densities. The rates of parasitism and emergence, the number of parasitoids emerged per egg and sex ratio of offspring were evaluated in both experiments. Eggs of H. armigera up to 36 hours provided greater parasitism and emergence of adults compared to eggs up to 60 hours old. The number of parasitoids, which emerged per host egg, was greater than one and the sex ratio remained around 80% of females, regardless of the egg development stage. Females of T. pretiosum responded with superior rates of parasitism, emergence and number of parasitoids per egg at the densities of 20 and 25 eggs of H. armigera . These results indicate that T. pretiosum parasite with superior performance in eggs of up to 36h of age and densities of 20 eggs per female day- 1 in laboratory conditions. These results will help to establish the intervals between releases of parasitoids, aiming to control this pest, when adjusted with knowledge of the survival of the parasitoids in the field and in pest infestation.

Este trabalho avaliou o parasitismo de Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) em ovos de Helicoverpa armigera Hübner (Lepidoptera: Noctuidae) em diferentes idades e densidades. As taxas de parasitismo e emergência, número de parasitoides emergidos por ovo e razão sexual dos descendentes foram avaliados em ambos os experimentos. Ovos de H. armigera de até 36 horas proporcionaram maior parasitismo e emergência dos adultos em comparação com ovos com até 60 horas de idade. O número de parasitoides, que emergiram por ovo hospedeiro, foi superior a 1 e a razão sexual permaneceu em torno de 80% de fêmeas, independentemente do estágio de desenvolvimento do ovo. Fêmeas de T. pretiosum responderam com taxas superiores de parasitismo, emergência e número de parasitoides por ovo nas densidades de 20 e 25 ovos de H. armigera. Estes resultados indicam que T. pretiosum parasita com desempenho superior em ovos de até 36h de idade e densidades de 20 ovos por fêmea dia-1 em condições laboratoriais. Estes resultados ajudarão a estabelecer os intervalos entre as liberações de parasitoides, visando o controle desta praga, quando ajustado com o conhecimento da sobrevivência dos parasitoides no campo e na infestação de pragas.

La autopsia de Santander: el primer caso autóctono de hepatocolecistocoledocolitiasis / Santander's autopsy: first autochthonous case of hepatolithiasis / Autópsia de Santander: primeiro caso autóctone de hepatolithiasis

RESUMEN El informe de la autopsia de Santander, efectuada en 1840, ha sido publicado sin corregir los errores de imprenta originando interpretaciones discutibles. Se corrige y se proponen diagnósticos anatómicos macroscópicos que se comentan a la luz de la fisiopatología.

SUMMARY Santander's autopsy report, dated in 1840, has been published without any regard for the list of errata and controversial interpretations have been made. The necessary corrections are made and gross anatomic diagnoses are proposed along with a comment.

RESUMO Relatório da autópsia do Santander, datada em 1840, tem-se publicado sem qualquer consideração para a lista de errata, e interpretações controversas foram feitas. As correções necessárias são feitas e diagnósticos anatômicas brutas são, juntamente com um comentário proposto.