Distribuição ultraestrutural de colágeno tipo IV em feridas experimentais após tratamento com papaína / Ultrastructural distribution of type IV collagen in experimental wounds after treatment with papaine

RESUMO: Modelo do estudo: Experimental. Objetivo: Investigar a distribuição de fibras colágeno tipo IV, por microscopia eletrônica de transmissão, em feridas experimentais tratadas com soluções de papaína. Metodologia: Ratos Wistar (n=18), machos, adultos, foram submetidos a procedimento cirúrgico para a retirada de seção quadrada de pele da região cervical, e posteriormente separados em dois grupos: Grupo I (n = 9), sem tratamento; e Grupo II (n = 9), tratado com soluções de papaína a 10% (até o 7º dia), 6% (do 8º ao 14º dia) e 4% (do 15º ao 21º dia). Todos os animais foram sacrificados com 7, 14 e 21 dias, e as áreas lesadas retiradas, lavadas em PBS e fixadas em 2,5% de glutaraldeo, 4% de formaldeio recém preparado, em solução tamponada contendo 60 mM Pipes, 20 mM Hepes, 10 mM etilenoglicol-bis- (B-aminoetiléter) - Ácido N, N, N'-tetraacético, KCl 70 mM e MgCl2 5 mM pH 7,2 por 1h; pós-fixadas em solução contendo tetróxido de ósmio a 1%, ferrocianeto a 0,8% e cloreto de cálcio a 5 mM; desidratados em acetona graduada e embebidos em Epon® para confecção de secções finas, coradas com acetato de uranilo e citrato de chumbo, e examinadas em microscópio electrônico de transmissão Zeiss LEO EM 906 (TEM). Resultados: A distribuição das fibras colágeno tipo IV das lesões tratadas com papaína (Grupo II), com 14 e 21 dias, mostraram-se mais organizadas que as fibras do Grupo I. Conclusões: A papaína mostrou-se um importante facilitador para a organização de fibras colágeno tipo IV em feridas experimentais. (AU)

ABSTRACT Study model: Experimental. Objective: Investigate the distribution of type IV collagen fibers by transmission electron microscopy, in experimental wounds treated with papaine solutions. Methodology: Adult male Wistar rats (n = 18) underwent a surgical procedure to remove a square section of skin from the cervical region, and then separated into two groups: Group I (n = 9), without treatment; and Group II (n = 9), treated with papain solutions of 10% (up to the 7th day), 6% (from the 8th to the 14th day) and 4% (from the 15th to the 21st day). All animals were sacrificed at 7, 14 and 21 days, and the injured areas removed, washed in PBS, and fixed in 2.5% glutaraldehyde, 4% freshly prepared formaldehyde in buffered solution containing 60 mM Pipes, 20 mM Hepes, 10 mM ethyleneglycol-bis- (B-aminoethylether) -N, N, N'-tetraacetic acid, 70 mM KCl, and 5 mM MgCl 2 pH 7.2 for 1h; post-fixed in solution containing 1% osmium tethoxide, 0.8% ferrocyanide, and 5 mM calcium chloride; dehy-drated in graduated acetone and soaked in Epon® to make thin sections stained with uranyl acetate and lead citrate and examined under a Zeiss LEO EM 906 (TEM) transmission electron microscope. Results: The distribution of type IV collagen fibers from papaine-treated lesions (Group II) at 14 and 21 days was more organized than Group I fibers. Conclusions: Papaine has proven to be an important facilitator for the organization of type IV collagen fibers in experimental wounds. (AU)

Evaluación del riesgo fetal en las pacientes cesareadas con el diagnóstico de estado fetal intranquilizante con reanimación intraútero efectiva / Evaluating the fetal risk in patients diagnosed with fetal distressing status with intrauterine revival

Fundamento: el término sufrimiento fetal impreciso e inespecífico, tiene bajo valor predictivo, incluso en poblaciones de alto riesgo. Objetivo: evaluar el riesgo fetal en las pacientes cesareadas con el diagnóstico de estado fetal intranquilizante con reanimación intraútero efectiva. Métodos: se realizó un estudio cuasiexperimental para dos grupos en las pacientes cesareadas con el diagnóstico de estado fetal intranquilizante con reanimación intraútero efectiva, en el Hospital Universitario Ana Betancourt de Mora en el período del 1 junio de 2014 al 1 de febrero de 2015. Resultados: se asoció el diagnóstico de estado fetal intranquilizante con reanimación intraútero efectiva y las condiciones del cordón umbilical con odss ratio 1,3. La probabilidad del diagnóstico de estado fetal intranquilizante con reanimación intraútero fue 5,6 veces más para las pacientes con enfermedad hipertensiva en el embarazo. La probabilidad fue 4,3 veces para la diabetes. No se asoció el diagnóstico de estado fetal intranquilizante con reanimación intraútero efectiva y la anestesia neuroaxial. Conclusiones: los factores de riesgo fetal de las pacientes cesareadas con el diagnóstico de estado fetal intranquilizante con reanimación intraútero efectiva fueron: enfermedad hipertensiva en el embarazo, diabetes, alteraciones del cordón umbilical y la anestesia neuroaxial fue independiente del riesgo fetal de las pacientes.

Background: the term fetal imprecise suffering, predictive value has softly, even in populations of tall risk. Objective: to evaluate the fetal risk in patients who underwent Cesarean sections and diagnosed with fetal distressing status with effective intrauterine revival. Methods: a quasi-experimental accomplished study was conducted for two groups in patients diagnosed with fetal distressing status with intrauterine revival at Ana Betancourt de Mora hospital from June 1st, 2014 to February 1st, 2015. Results: the fetal distressing status was associated with effective intrauterine revival and the conditions of the umbilical cord with odss ratio 1.3. The probability of the diagnosis of fetal distressing status with intrauterine revival was 5.6 times more for patients with hypertensive disease in pregnancy. Probability was 4.3 times for diabetes. The diagnosis of fetal distressing status was not associated with effective intrauterine revival and the neuroaxial anesthesia. Conclusions: fetal risk factors of patient cesareans with the diagnosis of fetal distressing status with revival the intrauterine cashes they went: disease hipertensive in pregnancy, diabetes, alterations of the umbilical cord and anesthesia the neuroaxial was independent of fetal risk of patients.

Efectividad del tratamiento con oleozón versus crema de aloe en la estomatitis subprotésica / Effectiveness of the treatment with oleozón versus aloe cream in the subprosthesis stomatitis

Fundamento: la estomatitis subprótesis es una enfermedad inflamatoria que afecta la mucosa oral que se encuentra en contacto con las prótesis dentales. Objetivo: establecer la efectividad terapéutica del oleozón y la crema de aloe al 25 % en el tratamiento de la estomatitis subprótesis. Métodos: se realizó un estudio experimental de evaluación de alternativas terapéuticas, en un universo de 96 pacientes con diagnóstico de estomatitis subprótesis tipo I y II en la Clínica Estomatológica Municipal Manuel Sánchez, Manzanillo, Granma, en el primer semestre del año 2016. Resultados: la estomatitis subprótesis tipo II fue identificada en los pacientes de ambos grupos de tratamiento. Solo se registró un paciente con una reacción adversa leve, consistente con ardor a la aplicación del oleozón. A los 10 días de seguimiento el oleozón resultó en un 100 % de efectividad terapéutica en los tipos IA y IB de estomatitis subprótesis mientras que en el tipo II fue un poco más baja. En este mismo periodo de tiempo la efectividad de la crema de aloe al 25 % fue efectiva en los tipos IA y IB mientras que en el tipo II esta efectividad fue de apenas de un porcentaje más bajo. Conclusiones: la estomatitis subprótesis es más prevalente en el sexo femenino donde el oleozón es una alternativa terapéutica efectiva y con resultados terapéuticos muy superiores, al mismo tiempo, el uso de crema de aloe al 25 %.

Background: the denture stomatitis is an inflammatory pathology that affects the mucous oral that is contact with the dental prosthesis. Objective: to establish the therapeutic effectiveness of the oleozón and the aloe cream to 25 % in the treatment of the denture stomatitis. Methods: a experimental study of evaluation of therapeutic alternatives in an universe of 96 patients with diagnostic of denture stomatitis type I and II in the Manuel Sánchez Municipal Stomatolgical Clinic, Manzanillo, Granma, in the first semester of the year 2016. Results: the denture stomatitis type II were identified in 39,58 % of the patients in both treatment groups. Alone a patient registered with a consistent light adverse reaction with ardor to the application of the oleozón. To the 10 days of pursuit the oleozón was in 100 % of effectiveness therapeutic in the types IA and IB of denture stomatitis while in the type II this it was of 84,21 %. In this same period of time the effectiveness of the aloe cream to 25 % was 94,12 % and 91,67 % in the types IA and IB respectively while in the type II this effectiveness was of hardly 68,42 %. Conclusions: the denture stomatitis continues being more prevalent in the female sex being the oleozón a highly effective therapeutic alternative and with very superior therapeutic results, in the time, to the use of aloe cream to 25 %.

Efectividad de la magnetoterapia en la terapéutica de las alveolitis / Effectiveness of magnet therapy in the treatment of alveolitis

Fundamento: la elevada incidencia de las alveolitis en los servicios estomatológicos precisa emplear técnicas de tratamiento eficaz e inofensivo que logren, en el menor tiempo posible, la curación del paciente. La magnetoterapia constituye una opción terapéutica. Objetivo: demostrar la efectividad de la magnetoterapia en la terapéutica de las alveolitis. Métodos: se realizó un estudio cuasi-experimental en la Clínica Estomatológica Ormani Arenado Llonch, de la provincia Pinar del Río, de septiembre de 2014 a agosto de 2015. El universo coincide con la muestra de estudio, que estuvo constituida por 100 pacientes con diagnóstico de alveolitis que cumplieron con los criterios de inclusión y exclusión. Se establecieron dos grupos de estudio comprendidos por 50 pacientes cada uno. En ellos se evaluaron las variables: grupo etario, sexo biológico, evolución y comparación del tratamiento en ambos grupos. Resultados: predominó el sexo femenino, entre 35 y 54 años de edad en ambos grupos. Prevaleció la variante de tratamiento curado en los grupos I y II con 80 % y 42 %. Se destacó la evolución satisfactoria con 96 % de pacientes curados en el grupo I y 92 % en el grupo II sin diferencias significativas. Conclusiones: se demostró la efectividad de la magnetoterapia en las alveolitis como alternativa de tratamiento seguro, técnico e inofensivo para los pacientes que acuden a consulta estomatológica.

Background: the high impact of alveolitis in the dentistry service requires the use of effective and harmless treatment techniques that achieve in less possible time the recovery of the patient. Magnet therapy constitutes a therapeutic option. Objective: to demonstrate the effectiveness of magnet therapy in the treatment of alveolitis. Methods: a quasi-experimental study was carried out in Ormani Arenado Llonch clinic, Pinar del Río, from September 2014 to August 2015. The universe coincides with the sample of study. The latter was made up of 100 patients with diagnosis of alveolitis. They all met inclusion and exclusion criteria. Two groups of study composed of 50 patients were created. In them the following variables were assessed: age group, sex, evolution and comparison of the treatment followed by both groups. Results: female sex prevailed, between 35 and 54 years of age in both groups. Variant of cured treatment in groups I and II was predominant, with 80 % and 42 %. Satisfactory evolution with 96 % of the cured patients in group I was highlighted as well as in group II, without significant differences. Conclusions: effectiveness of magnet therapy in alveolitis as a high save, technical and harmless alternative treatment for patients who attend the dentist’s.

Porphyromonas gingivalis influye en la eficacia de la terapia periodontal / Porphyromonas gingivalis: influence on the effectiveness of periodontal therapy

Fundamento: los protocolos de tratamiento que incluyen la combinación de terapia mecánica periodontal con antimicrobianos demuestran mayor eficacia clínica y microbiológica comparada con la terapia mecánica tradicional sola. Objetivo: evaluar la influencia basal de porphyromonas gingivalis sobre los parámetros clínicos de pacientes con periodontitis agresiva tratados con moxifloxacina adjunta a la terapia mecánica tradicional. Métodos: se realizó un estudio experimental en los grupos de tratamiento donde se involucraron 40 pacientes distribuidos de igual forma un grupo recibió terapia mecánica más moxifloxacina sitémica de 400 mg una vez al día por siete días, y un grupo control, que recibió terapia mecánica más placebo, una vez por día durante siete días. Los pacientes se asignaron de forma aleatoria a uno de los dos grupos de estudio. Los pacientes se evaluaron de manera clínica y microbiológica, antes y después de la terapia periodontal. Resultados: se observó mayor ganancia en el nivel de inserción clínica y mayor disminución de la profundidad sondeable en el grupo tratado con moxifloxacina, con diferencias estadísticas significativas que favorecieron a los pacientes con presencia de germen porphyromonas gingivalis a nivel basal.La regresión lineal múltiple demostró que la presencia basal de la porphyromonas gingivalis se asoció con mejores parámetros clínicos a los seis meses después de la terapia. La interacción p. gingivalis moxifloxacina también se relacionó con ganancia en el nivel de inserción clínica y disminución de la profundidad sondeable. Conclusiones: la moxifloxacina adjunta a la terapia mecánica tradicional parece que conduce a mejores ventajas clínicas en pacientes con periodontitis agresiva que presentan p. gingivalis.

Background: treatment protocols that include the combination of mechanical periodontal and antimicrobial therapy have shown greater clinical and microbiological efficacy compared to traditional mechanical therapy. Objective: to evaluate the influence of basal porphyromonas gingivalis on clinical parameters of patients treated with moxifloxacin attached to traditional mechanical therapy in aggressive periodontitis. Methods: an experimental study in treatment groups in which 40 patients were distributed in equitable way. One group received mechanical therapy plus moxifloxacin 400 mg systemically administered, once daily for seven days. Also, a control group received mechanical therapy and placebo, also once daily for seven days. Patients were randomly assigned to one of two study groups. Patients were evaluated clinically and microbiologically before periodontal therapy and six months after treatment. Results: a higher increase was observed in clinical attachment level and greater reduction in probing depth in the group treated with moxifloxacin, with statistically significant differences favoring patients with presence of p. gingivalis at baseline. Multiple linear regression analysis showed that the presence of p. gingivalis at baseline was significantly associated with improved clinical parameters six months after therapy. The interaction p. gingivalis moxifloxacin was also significantly associated with a rise in clinical attachment level and probing depth decreased. Conclusions: adjunctive moxifloxacin compared to traditional mechanical therapy leads to improved clinical benefits in patients with aggressive periodontitis harboring p. gingivalis.

Lecciones de parafunciones en lenguaje de señas para pacientes sordos o hipoacúsicos / Lessons about parafunctions in sign language for deaf or hard of hearing patients

Fundamento: las personas con trastornos auditivos severos o moderados no están exentas de presentar alteraciones parafuncionales y no existen propuestas informativas que los acerquen al tema. Objetivo: evaluar la utilidad de lecciones de parafunciones en lenguaje de señas para pacientes de estomatología sordos o hipoacúsicos. Métodos: se desarrolló un estudio cuasi experimental de febrero de 2014 a febrero de 2015. El universo de estudio lo conformaron 1 129 personas sordas o hipoacúsicas de la provincia de Camagüey, la muestra no probabilística quedó integrada por 513 pacientes del municipio de Camagüey, según criterios de inclusión. Se estructuró la investigación en cinco fases. Resultados: en un inicio predominó en el 83, 04 % de los pacientes el nivel de información no satisfactorio. Después de impartidas las lecciones se alcanza un 97, 85 % de estos, nivel de información satisfactorio. El 97, 61 % del personal docente estuvo conforme con la propuesta. El 99, 02 % de los pacientes sordos e hipoacúsicos, consideraron útiles las lecciones de parafunciones en lenguaje de señas. Conclusiones: el nivel de información sobre parafunciones resultó no satisfactorio en las personas sordas o hipoacúsicas antes de aplicar las lecciones en lenguaje de señas; después de estas, fue satisfactorio en la totalidad de los pacientes. La mayoría de los pacientes consideró útil la propuesta.

Background: people with severe or moderate hearing disorders are not exempt from presenting parafunctional alterations. There are no informative proposals that lean toward the topic. Objective: to assess the utility of lessons about parafunctions in sign language for deaf and hard or hearing patients in stomatology. Methods: a quasi-experimental study from February 2014 to February 2015 was conducted. The universe was composed of 1129 deaf or hard of hearing people from Camagüey province. The non-probabilistic sample was made up by 513 patients from Camagüey municipality, according to inclusion criteria. The research was divided in five stages. Results: at the beginning, non-satisfactory level of information was predominant in 83, 04 % of patients. After teaching the lessons, 97, 85 % of patients reached satisfactory level. From the teaching staff, 97, 61 % was satisfied with the proposal. Deaf and hard of hearing patients (99, 02 %) considered the lessons about parafunctions useful in sign language. Conclusions: the level of information about parafunctions was non-satisfactory in deaf or hard of hearing people before applying the lessons in sign language. Once the lessons concluded, the level was satisfactory in the totality of patients. Professors and patients gave consent to the proposal.

Texto de parafunciones en sistema braille para pacientes ciegos y de baja visión / Parafunctions text in Braille system for blind and poor vision patients

Fundamento: las personas con defectos visuales no están exentas de presentar alteraciones parafuncionales y no existen propuestas informativas en sistema braille que les acerque al tema. Objetivo: evaluar la utilidad de un texto de parafunciones en sistema braille para pacientes ciegos y de baja visión. Métodos: se desarrolló un estudio cuasiexperimental desde enero de 2014 hasta enero de 2015, por especialistas vinculadas a la consulta de Oclusión de la clínica estomatológica docente provincial Ismael Clark y Mascaró. El universo lo formaron 1 766 personas ciegas y de baja visión, la muestra no probabilística quedó integrada por 476 pacientes, según criterios de inclusión. Se estructuró la investigación en cinco fases: coordinación, búsqueda-selección, aprobación, intervención y evaluación. Resultados: antes de aplicar el texto en braille a los pacientes ciegos y de baja visión el nivel de información no satisfactorio se encontró en el 83, 19 %, después de aplicado predominó el nivel satisfactorio en el 98, 94 %. El concepto de parafunciones fue el primer aspecto a incluir en el texto por el 100 % de los expertos. El 97, 14 % del personal docente se mostró conforme. La utilidad del texto se manifestó en el 97, 68 % de los pacientes. El texto fue considerado útil por el 97 % de estos. Conclusiones: la conceptualización de las parafunciones fue el primer aspecto conciliado por todos los expertos, se pronunció conforme de aceptación del texto en sistema braille, por la mayoría de los docentes dedicados a la enseñanza de personas ciegas y de baja visión. Gran parte de los pacientes con déficit visual consideró el texto útil.

Background: people who have visual problems are not exempted from presenting parafunctional alterations and there are not informative proposals in Braille system that deal with the topic. Objective: to assess the utility of a parafunction text in Braille system for blind and poor vision patients. Methods: a quasi-experimental review was conducted from January 2014 and January 2015, by specialists from the Occlusion consultation in the provincial dental clinic Ismael Clark y Mascaró. The universe was composed of 1 766 blind and poor vision people. Non probabilistic sample consisted of 476 patients, according to criteria of inclusion. The research was organized into five stages: coordination, search-selection, approval, intervention and evaluation. Results: before showing the Braille text to blind and poor vision patients, the unsatisfactory level of information was 83, 19 %. After being shown satisfactory level prevailed in 98, 94 %. The concept of parafunctions was the first aspect to include in the text according to 100 % of experts. The teaching staff who was satisfied accounted for 97, 14 %. The utility of the text was demonstrated in 97, 68 % of the patients. The text was considered useful according to 97 % of these people. Conclusions: conceptualization of parafunctions was the first aspect reconciled by all experts. It was agreed the acceptance of the text in Braille system by the majority of teachers dedicated to the teaching of blind and poor vision patients. Great part of the patients with visual handicap found the text useful.

Avaliação da frequência fundamental em laringes humanas excisadas com diferentes extensões de sinéquia glótica anterior / Fundamental frequency in excised human larynges after the formation of anterior glottic webs of varying extent

Os resultados do aumento da frequência fundamental após diminuição do comprimento da porção vibratória das pregas vocais pela realização de sinéquia na região anterior da glote são variáveis, e não é estabelecida a extensão ideal de tal sinéquia nas técnicas cirúrgicas para aumentar a frequência vocal. Comparou-se neste estudo a elevação da frequência fundamental do som produzido por laringes humanas excisadas de cadáveres após realização de diferentes extensões de sinéquia glótica anterior, correspondentes a » (25%), 1/3 (33%) e ½ (50%) do comprimento da prega vocal. Além disso, verificou-se a correlação entre as frequências fundamentais anterior e posteriores aos experimentos com tais diferentes extensões de sinéquia glótica anterior para formular modelos matemáticos que estimem a frequência fundamental obtida após o procedimento. Os padrões de vibração das pregas vocais foram avaliados qualitativamente por videolaringoscopia e videoquimografia digital com câmera de alta velocidade. MÉTODOS: Realizou-se estudo experimental com 21 laringes humanas excisadas de cadáveres masculinos adultos. O som glótico foi artificialmente produzido com a colocação de ar comprimido pela traqueia, passando pelas pregas vocais. A frequência fundamental e os parâmetros da videoquimografia digital foram obtidos previamente (controle) e após realização de pontos que mimetizaram uma sinéquia glótica anterior de », 1/3 e ½ do comprimento das pregas vocais em todas as laringes, simulando uma das técnicas cirúrgicas para aumento da frequência vocal, a glotoplastia de Wendler. RESULTADOS: A frequência fundamental média foi distinta entre as diferentes extensões de sinéquia glótica anterior (P < 0,001), e observou-se aumento progressivo, significativo a cada ampliação da extensão da sinéquia na glote (P < 0,05), tanto em hertz quanto em semitons. Os modelos de regressão que estimam a frequência fundamental após os procedimentos mostraram melhor...

After anterior glottic web formation to decrease the length of the vibrating portion of the vocal folds, the degree of increase in fundamental frequency is variable. The ideal extent of such a web in surgical approaches aimed at raising the vocal pitch has not been established. This study compared the increase in the fundamental frequency of sound produced by excised human larynges after the formation of anterior glottic webs of varying extents (25%, 33%, and 50% of the length the vocal fold). In addition, the correlation between the fundamental frequencies before and after the experiments with the various extents of anterior glottic web formation was verified in order to create mathematical models designed to estimate the change in fundamental frequency obtained after the procedure. The vibration patterns of the vocal folds were evaluated qualitatively by laryngoscopy and by kymography with a highspeed digital camera. METHOD: We conducted an experimental study on 21 normal larynges excised from adult male human cadavers. Laryngeal vibration was artificially produced and was recorded by high speed videoendoscopy and digital kymography for analysis. The fundamental frequency and digital videokymography parameters were obtained before (as a control) and after the formation of anterior glottic webs occupying 25%, 33%, and 50% of the vocal folds, simulating a surgical technique to increase the vocal frequency, Wendler glottoplasty. RESULTS: The mean fundamental frequency differed among the various extents of anterior glottic web formation (P < 0.001), and there were significant increases from one extent to the next (P < 0.05), in hertz as well as in semitones. Regression models to estimate post-procedure fundamental frequency showed better coefficients of determination (r2) for smaller web extents. There was no aperiodic vibration in any of the experiments. The changes in glottal closure/phase and amplitude symmetry did not follow any...

High-fat Diet Promotes Cardiac Remodeling in an Experimental Model of Obesity / Dieta Hiperlipídica Promove Remodelação Cardíaca em Modelo Experimental de Obesidade

AbstractBackground:Although nutritional, metabolic and cardiovascular abnormalities are commonly seen in experimental studies of obesity, it is uncertain whether these effects result from the treatment or from body adiposity.Objective:To evaluate the influence of treatment and body composition on metabolic and cardiovascular aspects in rats receiving high saturated fat diet.Methods:Sixteen Wistar rats were used, distributed into two groups, the control (C) group, treated with isocaloric diet (2.93 kcal/g) and an obese (OB) group, treated with high-fat diet (3.64 kcal/g). The study period was 20 weeks. Analyses of nutritional behavior, body composition, glycemia, cholesterolemia, lipemia, systolic arterial pressure, echocardiography, and cardiac histology were performed.Results:High-fat diet associates with manifestations of obesity, accompanied by changes in glycemia, cardiomyocyte hypertrophy, and myocardial interstitial fibrosis. After adjusting for adiposity, the metabolic effects were normalized, whereas differences in morphometric changes between groups were maintained.Conclusion:It was concluded that adiposity body composition has a stronger association with metabolic disturbances in obese rodents, whereas the high-fat dietary intervention is found to be more related to cardiac morphological changes in experimental models of diet-induced obesity.

Fundamento:Embora anormalidades nutricionais, metabólicas e cardiovasculares sejam comuns a diversos experimentos de obesidade, ainda não está esclarecido se tais efeitos são resultantes do tratamento ou da adiposidade corporal.Objetivo:Analisar a influência do tratamento e da composição corporal sobre aspectos metabólicos e cardiovasculares de ratos submetidos a dieta hiperlipídica.Métodos:Foram utilizados 16 ratos Wistar, distribuídos em dois grupos, Controle (C), tratado com dieta normocalórica (2,93 kcal/g), e Obeso (OB), que recebeu dieta hiperlipídica (3,64 kcal/g). O período de estudo foi de 20 semanas. Posteriormente, foram realizadas análises do comportamento nutricional e murinométrico, glicemia, colesterolemia, lipidemia, pressão arterial sistólica, ecocardiograma e aspectos histológicos do coração.Resultados:A dieta hiperlipídica associa-se com manifestações de obesidade, acompanhada de alterações da glicemia, hipertrofia cardiomiocitária e fibrose intersticial do miocárdio. Quando ajustados aos valores de adiposidade, os efeitos metabólicos foram normalizados, enquanto que as alterações morfométricas mantiveram-se diferentes entre os grupos C e OB.Conclusão:Conclui-se que a adiposidade está mais associada com anormalidades metabólicas em obesos. A intervenção hiperlipídica mostra-se mais relacionada com modificações morfológicas do coração em experimentos de obesidade induzida por dieta.

Estrategia educativa sobre dengue en estudiantes de la Universidad de Ciencias Pedagógicas de Pinar del Río / Educational strategy about dengue for students of the University of Pedagogical Sciences, Pinar del Río

Fundamento: el dengue es un reto para la Salud Pública en el mundo. Más de 2 500 millones de personas viven en zonas en riesgo de dengue. Objetivo: elevar el nivel de conocimientos sobre dengue en estudiantes de la Universidad de Ciencias Pedagógicas de Pinar del Río. Métodos: se realizó un estudio cuasi experimental de intervención educativa trietápico, el universo de estudio estuvo constituido por 230 estudiantes del curso regular diurno que forman parte de la matricula de tercer año de la universidad antes mencionada, la muestra de forma no probabilística por criterio de autoridad quedó conformada por 71 alumnos de tercer año de las carrera de Pre escolar, Enseñanza especial y Logopedia. Se aplicó un cuestionario para la recogida la información, para el análisis y procesamiento de los resultados obtenidos, se creó una base de datos utilizando el sistema Epi Info versión 6.0, las diferencias estadísticas de las variables categóricas se analizaron mediante la prueba Exacta de Fisher. Resultados: al inicio existía desconocimiento de todas las variables estudiadas, después de la intervención más del 90 % de la muestra obtuvo evaluación satisfactoria, 94,4 % identificó la causa y vía de transmisión del dengue, el 93 % identificó los factores de riesgo, reconocieron las medidas de prevención el 95,8 %, la conducta a seguir ante un caso de dengue fue aprendida por el 93 %. Conclusiones: la intervención realizada fue satisfactoria ya que se logró que el mayor por ciento de los estudiantes elevara los conocimientos acerca de los temas impartidos.

Background: controlling dengue epidemic is a challenge for the public health system worldwide. More than 2 500 million people live in dengue-risk areas. Objective: to increase the level of knowledge about dengue epidemic in students from the University of Pedagogical Sciences of Pinar del Río. Methods: a quasi-experimental, three-stage study of educational intervention was conducted. The universe was composed of 230 students from the regular-daytime course that are part of the third year roll of the university. The non-probable sample, chosen following the authority criterion, was composed of 71 students who major in Preschool, Special Education and Logopedics. A questionnaire was applied to collect the information; a database was created using the Epi Info system version 6.0 for the analysis and processing of the obtained results; the statistical differences of the categorical variables were analyzed by means of Fisher's exact test. Results: at first, no knowledge of the variables was observed but after the intervention more than the 90 % of the sample got a satisfactory mark. The 94, 4 % identified the cause and way of transmission of dengue; the 93 % identified the risk factors; the 95, 8 % recognized the prevention measures; the conduct to be followed in case of dengue was learned by the 93 %. Conclusions: the intervention designed was satisfactory since the greatest percent of students increased their knowledge about the topics taught.

Impacto económico del uso secuencial de los antimicrobianos en los niños con apendicitis aguda complicada / Economic impact of the sequential use of antimicrobials in children with complicated acute appendicitis

FUNDAMENTO: el presente estudio mostró el resultado económico conseguido con la aplicación secuencial de los antimicrobianos en los niños tratados por apendicitis aguda complicada en el servicio de cirugía pediátrica de Camagüey. MÉTODO: se realizó un estudio cuasi-experimental transversal en todos los casos de niños tratados por apendicitis aguda complicada entre enero de 2010 y diciembre de 2013, en el servicio de cirugía pediátrica del Hospital Pediátrico Universitario Eduardo Agramonte Piña de Camagüey. Los resultados económicos fueron comparados con los enfermos tratados por la misma enfermedad entre enero de 2006 y diciembre de 2009. RESULTADOS: se incluyeron en el estudio 401 enfermos. Entre los años 2006-2009 la estadía hospitalaria fue de 7, 03 días/enfermo, en tanto entre el 2010-2013 fue de 4, 2 días. La media de los costos por pacientes fue $ 578, 8 para los casos y de $ 953, 6 para los controles. El consumo de los antimicrobianos entre el 2006-2009 fue de 3 755 bulbos de ceftriaxona, 2 253 bulbos de amikacina y de 4 506 frascos de metronidazol; entre el 2010-2013 solo fueron utilizados 1 965 bulbos de ceftriaxona, 1 179 bulbos de amikacina y 2 358 frascos de metronidazol. CONCLUSIONES: el estudio demostró una notable reducción en la estancia, los costos hospitalarios y en la utilización de antimicrobianos costosos.

BACKGROUND: the present study demonstrates the economic results achieved with the sequential application of antimicrobials in children treated because of complicated acute appendicitis in the pediatric surgery department of Camagüey. METHOD: a transversal quasi-experimental study was conducted in all the cases of children treated because of complicated acute appendicitis between January, 2010 and December, 2013 in the pediatric surgery department of the Eduardo Agramonte Piña Pediatric Teaching Hospital of Camagüey. The economic results were compared to those obtained from the patients treated because of the same disease between January, 2006 and December, 2009. RESULTS: four hundred and one patients were included in the study. Between the years 2006-2009 the hospital stay was of 7, 03 days/ patient; on the other hand, between the years 2010-2013 it was of 4, 02 days/patient. On average, the cost per patient was $ 578, 8 for the cases and $ 953, 6 for the controls. The consumption of antimicrobials, between 2006 and 2009, was of 3 755 ampoules of ceftriaxone, 2 253 ampoules of amikacin and 4 506 bottles of metronidazole; between 2010 and 2013 only 1 965 ampules of ceftriaxone, 1 179 ampoules of amikacine and 2 358 bottles of metronidazole were used. CONCLUSIONS: the study demonstrated a notable reduction in hospital stay and costs and in the use of expensive antimicrobials.

Multivariate Analysis for Animal Selection in Experimental Research / Análise Multivariada na Seleção de Animais em Pesquisas Experimentais

Background: Several researchers seek methods for the selection of homogeneous groups of animals in experimental studies, a fact justified because homogeneity is an indispensable prerequisite for casualization of treatments. The lack of robust methods that comply with statistical and biological principles is the reason why researchers use empirical or subjective methods, influencing their results. Objective: To develop a multivariate statistical model for the selection of a homogeneous group of animals for experimental research and to elaborate a computational package to use it. Methods: The set of echocardiographic data of 115 male Wistar rats with supravalvular aortic stenosis (AoS) was used as an example of model development. Initially, the data were standardized, and became dimensionless. Then, the variance matrix of the set was submitted to principal components analysis (PCA), aiming at reducing the parametric space and at retaining the relevant variability. That technique established a new Cartesian system into which the animals were allocated, and finally the confidence region (ellipsoid) was built for the profile of the animals’ homogeneous responses. The animals located inside the ellipsoid were considered as belonging to the homogeneous batch; those outside the ellipsoid were considered spurious. Results: The PCA established eight descriptive axes that represented the accumulated variance of the data set in 88.71%. The allocation of the animals in the new system and the construction of the confidence region revealed six spurious animals as compared to the homogeneous batch of 109 animals. Conclusion: The biometric criterion presented proved to be effective, because it considers the animal as a whole, analyzing jointly all parameters measured, in addition to having a small discard rate. .

Fundamento: Muitos pesquisadores buscam métodos para a seleção de grupos homogêneos de animais em pesquisas experimentais, fato que se justifica por ser a homogeneidade pré-requisito indispensável à casualização de tratamentos. A ausência de métodos robustos, que atendam a princípios estatísticos e biológicos, faz com que os pesquisadores utilizem métodos empíricos ou subjetivos, influenciando seus resultados. Objetivo: Desenvolver modelo estatístico multivariado para a seleção de grupo homogêneo de animais para pesquisas experimentais e elaborar pacote computacional que o operacionalize. Métodos: O conjunto de dados ecocardiográficos de 115 ratos Wistar, machos, com estenose aórtica (EAo) supravalvular foi utilizado para exemplificar o desenvolvimento do modelo. Inicialmente, os dados foram padronizados, tornando-se adimensionais. Em sequência, submeteu-se a matriz de variabilidade do conjunto à análise de componentes principais (ACP) buscando-se reduzir o espaço paramétrico e conservar a variabilidade relevante. Essa técnica estabeleceu um novo sistema cartesiano em que os animais foram alocados e, finalmente, construiu-se a região de confiança (elipsoide) para o perfil de respostas homogêneas dos animais. Os que se situaram no interior do elipsoide foram considerados pertencentes ao grupo homogêneo; caso contrário, espúrios ao grupo. Resultados: A ACP estabeleceu oito eixos descritores que representaram a variabilidade acumulada dos dados em 88,71%. A alocação dos animais no novo sistema e a construção da região de confiança revelou a presença de seis espúrios ao lote homogêneo formado por 109 animais. Conclusão: O critério biométrico proposto mostra-se eficiente, pois considera o animal como um todo, analisando conjuntamente todos os parâmetros mensurados, além de apresentar pequena frequência de descartes. .

Densidad superficial nuclear de hepatocitos de hígados sometidos a un factor estimulante humoral en ratones / Superficial nuclear density of hepatocytes of livers subjected to a humoral stimulating factor in mice

FUNDAMENTO: la regeneración hepática es la respuesta fundamental del hígado frente a los diversos estímulos internos y externos. Es multifactorial inducida, que origina cambios secuenciales en la expresión génica, la estructura y organización de las células hepáticas. OBJETIVOS: analizar el comportamiento de la densidad superficial de los núcleos de los hepatocitos según la posición que ocupan en las zonas del lóbulo hepático medio de ratones sometidos a citosol regenerativo. Método: se estudió la densidad superficial de los núcleos de hepatocitos con el uso de la morfometría en 14 lóbulos medios de hígados de ratones, que fueron sometidos a dosis de citosol de hígado regenerativo al inicio del experimento. Las muestras fueron tomadas cada 12 horas durante ocho días. El corte se dividió en zonas proximal, medial y distal al hilio donde se realizaron las determinaciones. RESULTADOS: los valores promedios y su desviación estándar en la zonas fueron: proximal 701,23 ± 135,83 (μm2.103), medial 707,48 ± 46,87 (μm2.103) y distal 682,48 ± 125,21 (μm2.103). Al comparar los resultados mediante el análisis de varianza se aprecia que no existen diferencias en el comportamiento de los promedios en las tres zonas. Al comparar la fase inicial con la fase final del experimento se aprecia diferencias significativas (p ≤ 0,05) en las mismas zonas, con un predominio de la zona proximal y distal. CONCLUSIONES: en las tres zonas del lóbulo el comportamiento de la densidad superficial de núcleos de hepatocitos ocurre de manera similar, con un sentido al incremento al final del experimento, lo que se corroboró con la aplicación de la prueba de la t de Student. Los incrementos más significativos ocurrieron en la zona proximal y distal, aunque en todas las zonas existen diferencias significativas entre los valores obtenidos en la primera mitad de tiempo del experimento respecto a la parte final.

BACKGROUND: hepatic regeneration is the basic answer of the liver to various internal and external stimuli. It is multifactorial and induced and originates sequential changes in the gene expression, the structure and organization of hepatic cells. OBJECTIVE: to analyze the behaviour of the superficial density of the nuclei of the hepatocytes according to the position they have in the areas of the middle hepatic lobes of mice subjected to regenerative cytosol. METHOD: the superficial density of the nuclei of the hepatocytes was studied with the use of morphometry in 14 middle hepatic lobes of mice subjected to a dose of regenerative liver cytosol at the beginning of the experiment. The samples were taken every 12 hours during eight days. The cut was divided into proximal, medial and distal areas to the hilum, where the determinations were made. Results: the average values and their standard deviations in the areas were: proximal 701,23 ± 135,83 (μm2.103), medial 707,48 ± 46,87 (μm2.103) y distal 682,48 ± 125,21 (μm2.103). When comparing the results through the analysis of variance, it could be seen that there are not differences among the averages in the three areas. When comparing the initial stage with the final stage of the experiment major differences (p ≤ 0,05) could be seen in the same areas, predominating the proximal and distal area. CONCLUSIONS: in the three areas of the lobe the behaviour of the superficial density of the nuclei of the hepatocytes is similar, with a tendency to increase at the end of the experiment. This could be corroborated with the application of the Student’s t- test. In spite of the fact that there were major differences between the values obtained in the first part and the final part of the experiment in all the areas, the most significant increases occurred in the proximal and distal areas.

Estabilidad de un suero control para proteínas totales como controlador bioquímico en los laboratorios clínicos / Stability of a control serum for total proteins used as a biochemical controller in clinical laboratories

FUNDAMENTO: una de las vías fundamentales para garantizar la calidad en los laboratorios clínicos es mediante el uso del suero control o controlador. El alto costo de estos productos en el mercado nacional es una problemática hoy en día. OBJETIVO: evaluar la estabilidad de un suero bovino adulto para proteínas totales como controlador bioquímico en los laboratorios clínicos. MÉTODO: se realizó un estudio cuasiexperimental, mediante muestreo probabilístico durante tres años (enero de 2010-diciembre de 2012). Se evaluó la estabilidad a tiempo real del suero enriquecido con proteínas totales durante 12 meses a dos temperaturas (refrigeración y congelación). El estudio quedó diseñado para tres lotes por mes y tres determinaciones por lote, para un número total de muestra del estudio (N=63). RESULTADOS: se obtuvo un suero control líquido para proteínas totales. La concentración de proteínas totales, en el producto obtenido en condiciones de refrigeración y congelación se mantuvieron estables por un tiempo de 12 meses. El producto obtenido al compararse con el suero control de la firma OLYMPUS, mostró fluctuaciones similares con respecto a la concentración de proteínas totales. CONCLUSIONES: se logró un material de referencia como controlador estable por un período de 12 meses.

BACKGROUND: one of the main ways to guarantee the quality in clinical labs is by using a control serum or controller. A problem we face is the lack of these products in the domestic market due to their high cost. OBJECTIVE: to evaluate the stability of an adult bovine serum for total proteins as a biochemical controller in clinical labs. METHOD: a quasiexperiment was conducted during three years (January 2010- December 2012) through a probabilistic sampling. The stability in real time of the serum enriched with total proteins was evaluated during 12 months under two temperatures (refrigeration and freezing). The study was designed for three batches per month and three determinations per batch, for a total number of sample of the study (N=63). RESULTS: a liquid control serum for total proteins was obtained. The concentration of total proteins in the product obtained under refrigeration and freezing conditions kept stable for 12 months. The obtained product, when compared to the control serum from the company OLYMPUS, showed similar fluctuations regarding the concentration of total proteins. CONCLUSIONS: a reference material was obtained as a stable controller for a period of 12 months..

Educación a familiares sobre el manejo del adulto mayor dependiente / Training families for the management of dependent old people

RESUMEN Fundamento: el aumento de la esperanza de vida y la demanda de más y mejores servicios sociales y sanitarios suponen un reto para la sociedad del conocimiento. Objetivo: educar a familiares sobre el manejo del adulto mayor dependiente. Método: se realizó un estudio pre-experimental en un grupo de cuidadores de adultos mayores de la Casa de Abuelos del municipio Pinar del Río, durante enero a diciembre 2012. El universo estuvo formado por 40 adultos mayores y sus cuidadores, la muestra quedó conformada por 38 de ellos que cumplieron nuestros criterios de inclusión. Se aplicó una encuesta inicial y final a los mismos para verificar el impacto de la intervención educativa. Resultados: la mayoría de los pacientes evaluados pertenecen al nivel funcional 2, sexo masculino, al grupo de 65 y más años, la enfermedad más frecuentemente asociada fue hipertensión arterial, las cuidadoras por excelencia fueron mujeres, la totalidad de los cuidadores tenían conocimientos inadecuados antes de la intervención. Conclusiones: es viable e ineludible educar a los familiares sobre la atención a los ancianos.

ABSTRACT Background: the increase of life expectancy and the demand of better social and health services are a challenge for the knowledge society. Objective: to educate families for the management of dependent aged people. Methods: a pre-experimental study was carried out in a group of old people caregivers´ at the Old People´s Home of Pinar del Rio municipality from January to December 2012. The universe was consisted of 40 aged people and their caregivers; the sample was made up of 38 of them who comply with the inclusion criteria. An initial and final survey was applied to them to verify the impact of the educational intervention. Results: the majority of patients assessed belonged to the second (2) functional level, male sex, to the group of 65 years or older patients prevailed, hypertension was the most frequent associated disease, women were the caregivers par excellence, the totality of caregivers had inadequate knowledge before the educational intervention. Conclusions: it is feasible and essential to educate families for the management of dependent aged people.

Estudo Pré-Clínico de Stent com Polímero Biodegradável e Liberação Abluminal de Sirolimus / Preclinical Study of a Biodegradable Polymer-based Stent with Abluminal Sirolimus Release

Fundamento: Stents recobertos com polímeros bioabsorvíveis e fármacos apenas na face abluminal podem ser mais seguros que stents farmacológicos com polímeros permanentes. Objetivo: Relatar os resultados experimentais com o stent Inspiron(r), um stent recoberto com polímero bioabsorvível e com liberação de sirolimus apenas da face abluminal, recentemente aprovado para uso clínico. Métodos: Foram implantados 45 stents nas artérias coronárias de 15 porcos e, no 28° dia pós-implante, foram obtidos os resultados angiográficos, de ultrassonografia intracoronária e de histomorfologia. Cinco grupos foram avaliados: Grupo I (nove stents sem recobrimento); Grupo II (nove stents com polímero bioabsorvível nas faces luminal e abluminal); Grupo III (oito stents com polímero bioabsorvível na face abluminal); Grupo IV (nove stents com polímero bioabsorvível e sirolimus nas faces luminal e abluminal); e Grupo V (dez stents com polímero bioabsorvível e sirolimus na face abluminal exclusivamente). Resultados: Observamos, para os Grupos I, II, III, IV e V respectivamente: porcentual de estenose de 29 ± 20; 36 ± 14; 33 ± 19; 22 ± 13 e 26 ± 15 (p = 0,443); perda luminal tardia (em mm) de 1,02 ± 0,60; 1,24 ± 0,48; 1,11 ± 0,54; 0,72 ± 0,44 e 0,78 ± 0,39 (p = 0,253); área neointimal (em mm2) de 2,60 ± 1,99; 2,74 ± 1,51; 2,74 ± 1,30; 1,30 ± 1,14 e 0,97 ± 0,84 (p = 0,001; Grupos IV e V versus Grupos I, II e III) e porcentual de área neointimal de 35 ± 25; 38 ± 18; 39 ± 19; 19 ± 18 e 15 ± 12 (p = 0,001; Grupo IV e V versus Grupo I, II e III). Os escores de injúria e inflamação foram baixos e sem diferenças entre os grupos. Conclusão: O stent Inspiron(r) foi seguro e inibiu significativamente a hiperplasia ...

Background: Bioabsorbable polymer stents with drug elution only on the abluminal surface may be safer than durable polymer drug-eluting stents. Objective: To report the experimental findings with the Inspiron(tm) stent - a bioabsorbable polymer-coated stent with sirolimus release from the abluminal surface only, recently approved for clinical use. Methods: 45 stents were implanted in the coronary arteries of 15 pigs. On day 28 after implantation, angiographic, intracoronary ultrasonographic and histomorphological data were collected. Five groups were analyzed: Group I (nine bare-metal stents); Group II (nine coated with bioabsorbable polymer on the luminal and abluminal surfaces); Group III (eight stents coated with bioabsorbable polymer on the abluminal surface); Group IV (nine stents with bioabsorbable polymer and sirolimus on the luminal and abluminal surfaces); and Group V (ten stents with bioabsorbable polymer and sirolimus only on the abluminal surface). Results: The following results were observed for Groups I, II, III, IV and V, respectively: percentage stenosis of 29 ± 20; 36 ± 14; 33 ± 19; 22 ± 13 and 26 ± 15 (p = 0.443); late lumen loss (in mm) of 1.02 ± 0.60; 1.24 ± 0.48; 1.11 ± 0.54; 0.72 ± 0.44 and 0.78 ± 0.39 (p = 0.253); neointimal area (in mm2 )) of 2.60 ± 1.99; 2.74 ± 1.51; 2.74 ± 1.30; 1.30 ± 1.14 and 0.97 ± 0.84 (p = 0.001; Groups IV and V versus Groups I, II and III); and percentage neointimal area of 35 ± 25; 38 ± 18; 39 ± 19; 19 ± 18 and 15 ± 12 (p = 0.001; Groups IV and V versus Groups I, II and III). Injury and inflammation scores were low and with no differences between the groups. Conclusion: The Inspiron(tm) stent proved to be safe and was able to significantly inhibit the neointimal hyperplasia observed on day 28 after implantation in porcine coronary arteries. .

Pronóstico de empeoramiento tomográfico significativo en pacientes con traumatismo craneoencefálico / Prognosis of significant tomographic worsening in patients with cranio-encephalic traumatism

Fundamento: la realización del monitoreo imagenológico estructural del encéfalo mediante tomografía computarizada de cráneo secuencial es una práctica establecida, aunque se realiza de forma heterogénea en los diferentes contextos por no existir toda la evidencia necesaria para dictar estándares. Objetivo: determinar los factores predictivos de cambio tomográfico significativo en los pacientes con traumatismo craneoencefálico. Métodos: se practicó un estudio cuasi-experimental con todos los lesionados craneales hospitalizados y que fueron estudiados al menos en dos ocasiones en el mismo ingreso con tomografía computarizada de cráneo. Se realizó la sistematización de las indicaciones de la tomografía secuencial, su aplicación y después la evaluación del comportamiento de variables mediante estadística exploratoria, prueba de la X2, ANOVA y regresión logística. Resultados: se estudiaron 84 pacientes y el 16, 7 % de la muestra mostró cambios tomográficos significativos en los estudios secuenciales. El grupo de enfermos más relacionados con estos cambios fue el que presentó síntomas persistentes con Marshall inicial III o IV. Las principales variables involucradas en el pronóstico fueron los mecanismos de alta velocidad en la producción del traumatismo, los síntomas persistentes y el puntaje de Rotterdam inicial. Conclusiones: en la aplicación del protocolo para la realización de tomografía computarizada secuencial de cráneo en estos lesionados es fundamental tener en cuenta si el mecanismo de producción fue de alta velocidad, la persistencia de los síntomas de los pacientes y la elevación del puntaje de Rotterdam en la tomografía inicial.

Background: the carrying out of the structural imaging study of the brain through a sequential computerized tomography of brain is an established practice although it is conducted in a heterogeneous way in different contexts since there does not exist all the evidence necessary to set the standards. Objective: to determine the predictive factors of significant tomographic change in patients with cranio-encephalic traumatism. Method: a quasi-experimental study was conducted with all the cranial-injured patients who had been studied at least twice during the same hospitalization period through a computerized tomography of brain. The systematization of the orders of the sequential tomography, its application, and afterwards the evaluation of the behavior of the variables through an exploratory statistic, the X2 test, ANOVA, and logistic regression, were made. Results: eighty-four patients were studied and the 16.7 % of the sample showed significant tomographic changes in the sequential studies. The patients group that presented persistent symptoms with initial Marshall III or IV was more related to these changes. The main variables involved in the prognosis were the high-speed mechanisms in the appearance of the traumatism, the persistent symptoms, and the initial Rotterdam score. Conclusions: when applying the protocol for the carrying out of the sequential computerized tomography of brain in these patients it is really important to take into consideration the persistence of the symptoms of the patients, the increase of the Rotterdam score in the initial tomography, and if the mechanism of appearance was a high-speed one or not.

Eficacia de la magnetoterapia en pacientes con queratitis viral / Effectiveness of magnetotherapy in patients with viral keratitis

Fundamento: la aplicación de métodos terapéuticos efectivos en pacientes con afecciones corneales como la queratitis viral, por su alta incidencia y complicaciones, lo ineficiente de la terapia específica que se dispone y su alto costo, constituye un reto para los oftalmólogos en su actuar diario. Objetivo: evaluar la eficacia de la aplicación de la magnetoterapia en pacientes con queratitis viral. Métodos: se realizó un estudio explicativo experimental de intervención antes y después con grupo control, que determinó la eficacia de la magnetoterapia en 50 pacientes con queratitis viral divididos en dos grupos, estudio y control, ambos conformados por 25 pacientes. La investigación se desarrolló en los Servicios Médicos del Ministerio del Interior de Camagüey, desde septiembre 2011 a abril de 2012. Al grupo estudio se le aplicó como tratamiento un total de 15 sesiones de magnetoterapia, al grupo control tratamiento convencional. Resultados: los resultados en el grupo estudio fueron superiores; fue más eficaz el tratamiento realizado a este grupo sobre todo en pacientes entre 33 a 47 años de edad y sin asociación significativa con la variable sexo. El dolor fue el síntoma de mayor y más rápida mejoría en este grupo y predominó la desaparición de las lesiones corneales epiteliales después de la aplicación de la terapia de campo magnético en la serie. El tratamiento con electromagnetoterapia fue considerado favorable y satisfactorio. Conclusiones: con la aplicación de la magnetoterapia en pacientes con queratitis viral se observó una alta eficacia del tratamiento.

Background: the application of inefective therapeutic methods in patient with corneal affections as the viral keratitis, for their high incidence and complications, the inefficient of the specific therapy that prepares, and their high cost constitutes a challenge for the oculists in their dairy acting. Objective: to evaluate the effectiveness of the application of the magnetotherapy in patient with Viral Keratitis. Methods: it was carried out a development project. It was an experimental explanatory study of intervention before and later with group control that determined the effectiveness of the magnetotherapy in 50 patients with viral keratitis divided in two groups, study and control, both conformed by 25 patients. The investigation was developed in the Medical Services of the Ministry of the Interior of Camagüey, in the period: September 2011 to April of the 2012. To the group study it was applied as treatment a total of 15 magnetotherapy sessions, to the group control conventional treatment. Results: the results in the group study were superior; it was more effective the treatment carried out mainly to this group in patients among 33 to 47 years of age and without significant association with the variable sex. The pain was the symptom of more and quicker improvement in the group study and the disappearance of the lesions corneal epitelials after the application of the magnetic field therapy it prevailed in the series. The treatment with magnetotherapy was considered favorable and satisfactory. Conclusions: in the application of the magnetotherapy in patient with viral keratitis a high effectiveness of the treatment was observed.

Quantificação da área de infarto usando-se SPECT de perfusão miocárdica de alta resolução em ratos / Myocardial infarction area quantification using high-resolution SPECT images in rats

FUNDAMENTO: Técnicas de imageamento in vivo permitem avaliar sequencialmente a morfologia e a função dos órgãos em diversos modelos experimentais. Desenvolvemos um dispositivo de adaptação de uma gama-câmara clínica para obter imagens tomográficas por emissão de fótons singulares (SPECT) de alta resolução, baseado em colimador pinhole. OBJETIVO: Determinar a acurácia desse sistema na quantificação da área de infarto miocárdico em ratos. MÉTODOS: Treze ratos Wistar machos (250 g) foram submetidos a infarto do miocárdio por oclusão da artéria coronária esquerda. Após 4 semanas, foram adquiridas imagens tomográficas com o sistema desenvolvido, 1,5 hora após a injeção endovenosa de 555MBq de 99mTc-Sestamibi. Na reconstrução tomográfica, utilizamos software especialmente desenvolvido baseado no algoritmo de Máxima Verossimilhança. Comparamos as médias e analisamos a correlação entre a extensão dos defeitos perfusionais detectados pela cintilografia e a extensão da fibrose miocárdica avaliada pela histologia. RESULTADOS: As imagens apresentaram ótima relação órgão-alvo/fundo, com apropriada visualização das paredes e da cavidade do ventrículo esquerdo. Todos os animais exibindo áreas de infarto foram corretamente identificados pelas imagens de perfusão. Não houve diferença entre a área do infarto medida pelo SPECT (21,1 ± 21,2%) e pela histologia (21,7 ± 22,0%; p = 0,45), obtendo forte correlação entre os valores da área de infarto mensurada pelos dois métodos (r = 0,99; p < 0,0001). CONCLUSÃO: O sistema desenvolvido apresentou resolução espacial adequada e elevada acurácia para detecção e quantificação das áreas de infarto miocárdico, sendo uma opção de baixo custo e grande versatilidade na obtenção de imagens em SPECT de alta resolução de órgãos de pequenos roedores.

BACKGROUND: Imaging techniques enable in vivo sequential assessment of the morphology and function of animal organs in experimental models. We developed a device for high-resolution single photon emission computed tomography (SPECT) imaging based on an adapted pinhole collimator. OBJECTIVE: To determine the accuracy of this system for quantification of myocardial infarct area in rats. METHODS: Thirteen male Wistar rats (250 g) underwent experimental myocardial infarction by occlusion of the left coronary artery. After 4 weeks, SPECT images were acquired 1.5 hours after intravenous injection of 555 MBq o f 99mTc-Sestamibi. The tomographic reconstruction was performed by using specially developed software based on the Maximum Likelihood algorithm. The analysis of the data included the correlation between the area of perfusion defects detected by scintigraphy and extent of myocardial fibrosis assessed by histology. RESULTS: The images showed a high target organ/background ratio with adequate visualization of the left ventricular walls and cavity. All animals presenting infarction areas were correctly identified by the perfusion images. There was no difference of the infarct area as measured by SPECT (21.1 ± 21.2%) and by histology (21.7 ± 22.0%; p=0.45). There was a strong correlation between individual values of the area of infarction measured by these two methods. CONCLUSION: The developed system presented adequate spatial resolution and high accuracy for the detection and quantification of myocardial infarction areas, consisting in a low cost and versatile option for high-resolution SPECT imaging of small rodents.

Seguridad de la práctica de la discectomía lumbar bajo régimen ambulatorio / Safety of the practice of lumbar discectomy under ambulatory procedure

La gran demanda social que acoge la atención de los pacientes con hernia discal lumbar, obliga la aplicación de sistemas que mejoren la reinserción social de los pacientes. Objetivo: valorar la seguridad de la realización de la discectomía lumbar de forma ambulatoria. Método: se practicó un estudio cuasiexperimental, longitudinal y prospectivo con todos los pacientes sometidos a discectomía lumbar de forma ambulatoria en el servicio de Neurocirugía de Camagüey, desde el primero de enero de 2010 hasta el 31 de marzo de 2011. Se utilizó un grupo de control externo obtenido de otras investigaciones realizadas en el servicio. Los indicadores analizados fueron: frecuencia de pacientes operados, técnicas anestésicas y quirúrgicas empleadas, complicaciones, necesidad de ingreso hospitalario y frecuencia de reintervenciones quirúrgicas. Se aplicaron técnicas descriptivas para variables no paramétricas y chi-cuadrado. Resultados: se operaron de forma ambulatoria 73 pacientes, en el 40 por ciento se aplicó anestesia peridural, el 46,56 por ciento de los enfermos se operó mediante fenestración interlaminar o microdiscectomía de Caspar y el 86,3 por ciento no presentó complicaciones, dato con significación estadística respecto al grupo control. Conclusiones: se comprobó en esta serie de pacientes que la realización de la discectomía lumbar de forma ambulatoria, constituye un método seguro y eficiente en el tratamiento quirúrgico

The great social demand for patients'care with lumbar disk hernia requires the use of systems that improve social reintegration of these patients. Objective: to evaluate the safety of ambulatory lumbar discectomy. Method: a quasi-experiment, longitudinal and prospective study was conducted with all patients who underwent ambulatory lumbar discectomy at the Neurosurgical unit in Camagüey, from January 1st, 2010 to March 31st, 2011. An external control group was obtained from previous researches carried out in the unit. The analyzed indicators were: frequency of operated patients, anesthetic and surgical techniques used, complications, and the need of hospital admissions, as well as, the frequency of surgical reinterventions. Descriptive techniques of non parametric variables and chi-squared test were applied. Results: 73 patients were operated on ambulatory procedure, peridural anesthesia was used in 40 percent of patients, the 46, 56 percent of sick people had interlaminar fenestration or Caspar's microdiskectomy and the 86, 3 percent had no complications, value with statistical significance regarding the control group. Conclusion: in this series of patients was demonstrated that ambulatory lumbar discectomy, constitutes a safe and effective method in surgical treatment