Influencia del tiempo psicológico y el autocontrol en el malestar psicológico en adultos argentinos / Influence of psychological time and self-control on psychological distress in Argentinian adults

Resumen El objetivo de este estudio fue conocer si la temporalidad subjetiva -perspectiva y foco temporales- y la capacidad de autocontrol e impulsividad repercuten en el malestar psicológico, en particular durante la pandemia por COVID-19. La conjetura teórica es que el tiempo psicológico está estrechamente vinculado a la autorregulación, que influye en el desarrollo de la impulsividad y el autocontrol e impacta en el malestar psicológico. Se diseñó un modelo y se realizó un estudio empírico cuantitativo, no experimental y transversal (. = 279; 78 % mujeres; ME = 30.14 años; DE = 11.21). Los resultados del análisis de correlación mostraron relaciones significativas entre las variables de interés. Para determinar las variables predictoras del malestar psicológico se realizó un análisis de regresión lineal múltiple. El 48 % de la varianza del malestar psicológico fue explicado por el pasado negativo, autocontrol e impulsividad, y focos temporales futuro y presente. Finalmente, se probó el modelo teórico diseñado para analizar los efectos directos e indirectos del malestar psicológico a través de un análisis de senderos que presentó un buen ajuste a los datos, ya que explicó el 50 % de la varianza de aquel. La perspectiva y el foco temporal explicaron el 53 % de la variabilidad del autocontrol, y presentaron efectos indirectos sobre el malestar psicológico a través del autocontrol. El autocontrol influyó de manera inversa en el malestar. Los hallazgos indican que el tiempo subjetivo y el autocontrol sirven para explicar estados psicológicos, incluso en pandemia, lo cual confirma estudios previos que muestran la importancia de las variables de personalidad -además de las biológicas y contextuales- en la aparición de malestar psicológico.

Abstract Psychological time is an essential aspect of humans. Two of the most important notions of subjective temporality are time perspective and temporal focus. Time perspective is a process by which the flow of personal and social experiences are framed in five different temporal categories: past negative, past positive, present hedonistic, present fatalistic and future. Temporal focus refers to the attention people devote to thinking about the past, present, and future. Previous research shows there is a strong relation between psychological time and self-regulatory processes, specifically self-control and impulsivity. Self-control is the ability to inhibit impulsive behaviors or reactions that can keep the person from pursuing the proposed goals. On the other hand, impulsivity refers to a short attention span and a tendency to engage in risky behaviors, and to prefer immediate rewards. Both subjective temporality and self-regulatory processes influence behaviors and psychological states such as psychological distress. In particular, the objective of this study was to find out if subjective temporality -time perspective and temporal focus-- and self-control and impulsivity have repercussions on psychological distress, particularly during the COVID-19 pandemic, in an Argentinian sample. The theoretical conjecture is that subjective temporality is closely linked to self-regulation, which influences the development of impulsivity and self-control, and impacts psychological distress. A quantitative, non-experimental, and cross-sectional empirical study was carried out (. = 279; 78 % women; ME = 30.14 years old; SD = 11.21). Firstly, the results of the correlational analysis showed significant relations between the variables. Then, to facilitate further analyses, an index variable of self-control was created, which included the scores of self-control and three dimensions of impulsivity. An optimal parallel analysis was performed. It indicated the existence of a single dimension. Then a semi-confirmatory factor analysis was ran, which showed acceptable results (KMO = .68; X. (6) = 198.8, . < .001; GFI = .99; RMSR = 0.03). Thirdly, to determine the predictive variables of psychological distress, a multiple linear regression analysis was performed. It was found that 48 % of the variance of psychological distress was explained by negative past, self-control index, and future and present temporal focuses (. (4, 266) = 64.66, . < .001, R. = .49, R. adjusted = .48). The best predictor variable was past negative. Afterwards, a theoretical model was tested to explain the direct and indirect causes of psychological distress. It presented a good fit (X./gl = 1.63; GFI = .99; RMSEA = .04). Time perspective and temporal focus explained 53 % of the variability of self-control and presented indirect effects on psychological distress through self-control. Self-control inversely influenced psychological distress; more self-control generates less psychological distress. The model explained half of the variance of psychological distress (R. = .50). The findings indicate that subjective temporality and self-control explain psychological states, even during a pandemic, which confirms previous studies that show the importance of personality variables -in addition to biological and contextual variables- in the manifestation of psychological distress. The results support the theory that psychological time can be considered as a personality trait underlying self-control and psychological distress. A theoretical and practical discussion of the results is presented.

El rol predictivo de la red neuronal por defecto sobre la atención sostenida en edades escolares: una revisión sistemática

El rol de la Red Neuronal por Defecto en la aparición del trastorno de déficit atencional ha recibido evidencia científica creciente en los últimos 20 años. Este artículo tuvo por objetivo sistematizar la evidencia empírica y cuantitativa disponible en investigaciones sobre el rol de la Red Neuronal por Defecto en la atención sostenida y déficits atencionales en niños y adolescentes de etapa escolar; se usó la metodología de revisión sistemática de la literatura científica disponible entre 2010 y 2020. Se seleccionó una muestra de 13 estudios. Los resultados evidenciaron que la atención sostenida es rítmica y fluctúa junto a la memoria de trabajo. En cuanto a los niños con déficit atencional, se reportan anomalías en la disponibilidad de dopamina, adelgazamientos de las aéreas de la corteza cerebral interconectadas con la Red Neuronal por Defecto, así como hipo e híper conectividad de los tractos de materia blanca asociados a esta red. Estos hallazgos interpretados en su conjunto aportan evidencia valiosa acerca del rol emergente de la Red Neuronal por Defecto en los procesos subyacentes de la atención sostenida y la aparición de déficits atencionales. Estos hallazgos sistematizados pueden tener implicancias profundas en la didáctica y el diseño instruccional debido a que se cuenta con evidencia suficiente y validada como para adaptar las tareas de aprendizaje a los ritmos de atención y descanso puesto que estos obedecen a limitaciones biológicas y no a prescripciones administrativas.

The role of the Default Neural Network in the emergence of attention deficit disorder has received increasing scientific evidence in the last 20 years. This article aimed to systematize the empirical and quantitative evidence available in research on the role of the Default Neural Network in sustained attention and attention deficits in school children and adolescents; The methodology of systematic review of the scientific literature available between 2010 and 2020 was used. A sample of 13 studies was selected. The results showed that sustained attention is rhythmic and fluctuates along with working memory. Regarding children with attention deficit, anomalies in the availability of dopamine, thinning of the areas of the cerebral cortex interconnected with the Neural Network by Default, as well as hypo and hyper connectivity of the white matter tracts associated with this network are reported. These findings, interpreted as a whole, provide valuable evidence about the emerging role of the Default Neural Network in the underlying processes of sustained attention and the appearance of attentional deficits. These systematized findings can have profound implications in didactics and instructional design, due to the fact that there is sufficient and validated evidence to adapt the learning tasks to the rhythms of attention and rest since these processes obbey biological limitations and not to administrative requirements.

Tradução, adaptação e evidências de validade da Escala de Foco Regulatório (EFR) / Translation, adaptation and validity evidence of Regulatory Focus Scale (EFR)

O Foco Regulatório diz respeito ao processo pelo qual as pessoas procuram alinhar-se, em termos de comportamentos e concepções, a metas ou padrões adequados de acordo com duas orientações motivacionais para atingir seus objetivos: foco para a promoção e foco para a prevenção. O objetivo deste artigo foi analisar as evidências de validade da Escala de Foco Regulatório (EFR) no contexto brasileiro. Participaram do estudo 310 gestores recrutados por meio de instrumento de coleta de dados online. As evidências de validade foram verificadas por meio de análise fatorial confirmatória, alfa de Cronbach, ômega de McDonald e correlação de Pearson. Os resultados indicaram ajuste dos dados ao modelo teórico, adequada confiabilidade interna e validade convergente com a adição ao trabalho e ao engajamento ao trabalho. Assim, constatou-se que o instrumento é indicado para a avaliação do Foco Regulatório, no entanto, sugere-se a realização de novos estudos com amostras com outras categorias profissionais para verificação da estabilidade do instrumento.

The Regulatory Focus refers to the process by which people seek to align themselves, in terms of behaviors and concepts, to appropriated goals or standards according to two motivational orientations to achieve their goals: promotion focus and prevention focus. The purpose of this article was to analyze the validity pieces of evidence of the Regulatory Focus Scale (EFR) in the Brazilian context. The participants were 310 managers recruited through an online data collection tool. Pieces of evidence of validity were verified through confirmatory factor analysis, Cronbach alpha, McDonald's omega, and Pearson's correlation. Results indicate adjustment of the data to the theoretical model, adequate internal reliability, and convergent validity with the workaholism and engagement to work. Thus, the instrument is indicated for the assessment of Regulatory Focus however, it is suggested to accomplish new studies with samples with other professional categories to test its stability.

Desarrollo de los lentes intraoculares para la cirugía de catarata por facoemulsificación / Development of intraocular lenses for phacoemulsification cataract surgery

RESUMEN La tecnología de los lentes intraoculares se desarrolla constantemente, por las necesidades visuales cada vez mayores de los pacientes después de operados de catarata; de ahí que nos propusimos realizar una búsqueda acerca de los diferentes modelos de lentes, como los monofocales, los bifocales, los trifocales, los trifocales tóricos y los de foco extendido. Esta nueva tecnología exige exámenes preoperatorios cada vez de más calidad y precisión, para que los resultados quirúrgicos respondan al concepto de cirugía refractiva del cristalino, por lo que concluimos que en el futuro la tecnología de las lentes intraoculares debe estar encaminada a recuperar la visión funcional. En este sentido, cada uno tiene puntos fuertes y débiles; por lo tanto, no hay una solución universal. Se debe crear un reporte de las ventajas y desventajas para trabajar en los puntos a mejorar, sobre todo en la estandarización de la curva de desenfoque, el modulation transfer function y la sensibilidad al contraste, así como trabajar conjuntamente entre los pacientes, cirujanos y fabricantes(AU)

ABSTRACT Intraocular lens technology is in a process of permanent development, due to the increasing visual needs of patients undergoing cataract surgery. That is why we set out to do a search about the different lens models of lenses are offered, including the monofocal, bifocal, trifocal, toric trifocal and extended focus types. This new technology requires rigorous and accurate preoperative tests, so that surgical results respond to the concept of refractive crystalline lens surgery. We therefore conclude that future intraocular lens technology should be aimed at recovering functional vision. Each of the lens types has its own strengths and weaknesses, and so a universal solution does not exist. A report should be developed of advantages and disadvantages, so that work can be done on aspects requiring improvement, mainly the standardization of the improper focusing curve, the modulation transfer function and contrast sensitivity, as well as the implementation of actions to be performed jointly by patients, surgeons and manufacturers(AU)

Utilidad de los parámetros clínicos y de laboratorio básicos para predecir infección bacteriana seria en menores de 3 meses que se hospitalizan por síndrome febril sin foco / Utility of basic clinical and laboratory parameters to predict Serious Bacterial Infection in children younger than 3 months old hospitalized for Febrile Syndrome without Source

Resumen: Introducción: Un 20% de los niños con síndrome febril se presenta como síndrome febril sin foco (SFSF). Las es trategias de manejo en este grupo presentan alta sensibilidad, pero baja especificidad. Objetivos: Ca racterizar las infecciones bacterianas serias (IBS) en menores de 3 meses hospitalizados por SFSF, y evaluar utilidad de parámetros clínicos y de laboratorio en la identificación de pacientes con alto riesgo de IBS. Pacientes y Método: Estudio prospectivo en pacientes < 3 meses hospitalizados entre enero 2014 y noviembre 2015 por SFSF en dos hospitales pediátricos de la Región Metropolitana. Criterios de inclusión: edad 4 días - 3 meses, fiebre > 38°C de < 72 h de evolución sin causa demostra ble. Criterios de exclusión: uso de antimicrobianos hasta 7 días previo a su ingreso, prematuros < 34 semanas, peso de nacimiento < 2 kg e inmunocomprometidos. Se registraron datos demográficos, clínicos, y exámenes de laboratorio, hemograma y PCR, diagnóstico de egreso, IBS descartada, IBS probable o confirmada. Resultados: 32% de los pacientes egresó con diagnóstico de IBS, 28% con diagnóstico de infección viral o probablemente viral, 34% con diagnóstico de SFSF no especificado y 6% SFSF por otras causas. No se encontraron diferencias significativas en PCR, leucocitosis, aspecto tóxico ni horas de fiebre al ingreso al comparar los grupos con y sin IBS (p > 0,05). La combinación de parámetros clínicos y de laboratorio mostro sensibilidad de 27%, especificidad de 90%, VPP 60% y VPN 71%. Conclusión: No fue posible establecer que parámetros clínicos y de laboratorio permitan identificar menores de 3 meses con alto riesgo de IBS, manteniendo su utilidad como indicadores de bajo riesgo. Es necesario contar con otros elementos clínicos y de laboratorio que permitan discrimi nar IBS de infecciones virales.

Abstract: Introduction: In 20% of children with febrile syndrome, it appears as fever of unknown origin (FUO) syndrome. Management strategies in this group have high sensitivity but low specificity. Objectives: To cha racterize serious bacterial infections (SBI) in children younger than three months old hospitalized because of FUO syndrome and to evaluate the utility of clinical and laboratory parameters in the identification of patients that are at high risk of SBI. Patients and Method: Prospective study in patients aged < 3 months hospitalized due to FUO syndrome between January 2014 and November 2015 in two pediatric hospitals in the Metropolitan Region. Inclusion criteria: age 4 days - 3 months, fever > 38°C longer than 72 hours after onset without demonstrable cause. Exclusion criteria: anti microbial use up to 7 days before admission, preterm infants < 34 weeks, birth weight < 2 kg, and im munocompromised. Demographic, clinical, and laboratory tests data were recorded as well as blood count and CRP, discharge diagnosis, and ruled out, probable or confirmed SBI. Results: 32% of the patients were discharged with diagnosis of SBI, 28% with diagnosis of viral or probably viral infec tion, 34% with diagnosis of not specified FUO syndrome, and 6% due to other causes. There were no significant differences in the CRP value, altered WBCs count, toxic aspect, or hours of fever at the admission when comparing groups with and without SBI (p < 0.05). The combination of clinical and laboratory parameters showed 27% of sensitivity, 90% of specificity, 60% of PPV, and 71% of NPV. Conclusion: It was not possible to establish clinical and laboratory parameters that allow the identifi cation of children younger than 3 months old at high risk of SBI, however, they maintain their value as low risk indicators. It is necessary further investigation of other clinical and laboratory elements that allow discriminating SBI from viral infections.

Antisepsys and profilatic antimicrobial therapy in prevention of surgical site infection of horses / [Antissepsia e terapia antimicrobiana profilática no controle infeccioso do foco cirúrgico em equinos

The efficacy of an antisepsis protocol comprising chlorhexidine gluconate and ethyl alcohol in combination with prophylactic antimicrobial therapy in controlling surgical site infection in horses was studied. To that purpose, seven mixed breed horses received potassium penicillin and gentamicin at least 30 minutes prior to surgery. The surgical site was scrubbed with chlorhexidine gluconate and rinsed with ethyl alcohol. Samples were collected at four time points: (A) - before and (B) - immediately following shaving of the hair coat, (C) - at the end of antisepsis procedures, and (D) - at the end of the surgical procedure. Duration of surgery was recorded. Samples were cultured in three different culture mediums: Mitis Salivarus (Streptococcus sp.), Staphylococcus 110 (Staphylococcus sp.), and Mac Conkey (Enterobacteria). A high level of bacterial growth was observed in all culture mediums at (A) and (B), with no bacterial growth in (C). Staphylococcus sp. growth was observed in (D) in a single patient whose surgical procedure lasted for 120 minutes. Shaving of the hair coat reduced microbial flora on the surface of the skin. Antisepsis in combination with prophylactic antimicrobial therapy was effective in controlling surgical site infection in elective procedures with an average duration of 90 minutes.(AU)

Objetivou-se averiguar a eficácia do protocolo de antissepsia com clorexidina degermante e álcool etílico hidratado 70%, em associação com terapia antimicrobiana profilática, no controle microbiano do foco cirúrgico de equinos submetidos a procedimentos cirúrgicos. Foram utilizados 07 cavalos adultos de raças variadas, onde ambos receberam o mesmo tratamento (terapia antimicrobiana profilática e antissepsia com clorexidina degermante 2% e álcool etílico hidratado 70%), coletando-se amostras em quatro tempos distintos [(A - antes da tricotomia), (B - imediatamente após tricotomia), (C - ao término da antissepsia), (D - ao término do procedimento cirúrgico)]. O tempo de cada procedimento cirúrgico foi contabilizado. Foram utilizados três meios de cultura diferentes, cada um com especificidade para um tipo de crescimento bacteriano. Constatou-se alta incidência de crescimento bacteriano nos três meios utilizados nos tempos de coleta A e B. Para o tempo C, não foi observado crescimento bacteriano. No tempo D averiguou-se crescimento bacteriano do tipo Staphylococcus sp. em um único paciente, cujo tempo cirúrgico foi de 120 minutos de duração. Desta forma, a tricotomia reduziu a carga microbiana na superfície da pele. A antissepsia associada à terapia antimicrobiana profilática mostrou-se eficaz no controle microbiano do foco cirúrgico em procedimentos eletivos, com duração média de 90 minutos.(AU)

Intervención de foco de brote de rabia animal en el municipio de Anapoima, Cundinamarca, Colombia, 2019 / Animal rabies outbreak intervention in the municipality of Anapoima, Cundinamarca, Colombia, 2019 / Intervenção do foco de surto de raiva animal no município de Anapoima, Cundinamarca, Colômbia, 2019

Objetivo: realizar la investigación y contención de brote de rabia animal en el perímetro del foco del caso índice del municipio de Anapoima. Métodos: estudio de investigación de brote con intervención del foco de índole retrospectivo, a partir de la confirmación del caso por laboratorio el 26 de abril de 2019. El equipo de respuesta inmediata departamental (conformado por tres médicos veterinarios, dos epidemiólogos y una enfermera), fue activado y desarrolló acciones en la zona de foco definido en 5 km alrededor de la vivienda del caso índice (vereda Panamá, sector Gallinazos, finca La Esmeralda del municipio de Anapoima). Tanto la población humana como la de gatos y perros de la zona fueron caracterizadas, se determinan factores de riesgo, se controló la población animal con vacunación y gestión del riesgo. Resultados: fueron visitadas 26 veredas que correspondieron al total del foco con 3.185 viviendas y se censaron 3.489 personas, de las cuales el 47% eran de sexo femenino y el 53% de sexo masculino. La cobertura de vacunación canina para control en el foco fue de 88% y la felina del 83%. Conclusiones: se confirma rabia en su ciclo silvestre en el departamento de Cundinamarca, con transmisión de animal silvestre a animal doméstico, con alto riesgo de transmisión a los humanos.

Objective: conduct the research and containment of the animal rabies outbreak in the focus perimeter of the index case in the municipality of Anapoima. Methods: outbreak investigation study with retrospective focus intervention, starting with laboratory confirmation of the case on April 26, 2019. The departmental immediate response team (made up of three veterinarians, two epidemiologists, and a nurse) was activated and carried out actions in the focus area defined as 5 km surrounding the dwelling of the index case (Panama township, Gallinazos sector, La Esmeralda farm, municipality of Anapoima). Both the human population, cats and dogs in the area were characterized. Risk factors were determined, the animal population was controlled with vaccination and risk management. Results: 26 townships were visited which corresponded to the total of the focus point with 3,185 dwellings. 3,489 people underwent a census, of which 47% were female, and 53% were male. The canine vaccine coverage to exercise control in the focus area was 88% with 83% for feline vaccination. Conclusions: rabies was confirmed in the forest cycle in the department of Cundinamarca, with transmission from forest animals to domestic animals, with a high risk of transmission to humans.

Objetivo: realizar a pesquisa e contenção do surto de raiva animal no perímetro do foco do caso índice no município de Anapoima. Métodos: estudo retrospectivo de pesquisa de surto com intervenção focal, baseado na confirmação laboratorial do caso em 26 de abril de 2019. A equipe departamental de resposta imediata (composta por: três veterinários, dois epidemiologistas e uma enfermeira), foi acionada e realizou ações na zona foco definida em 5 km ao redor da casa do caso índice (aldeia Panamá, setor Gallinazos, fazenda La Esmeralda do município de Anapoima). População humana, gatos e cães da área foram caracterizados, determinaram-se os fatores de risco, a população animal foi controlada com vacinação e gestão de risco. Resultados: foram visitadas 26 aldeias que correspondiam ao total do foco com 3.185 domicílios e 3.489 pessoas cadastradas, sendo 47% do sexo feminino e 53% do sexo masculino. A cobertura da vacinação canina para controle no foco foi de 88% e felina 83%. Conclusão: a raiva no seu ciclo silvestre é confirmada no departamento de Cundinamarca, com transmissão de animais silvestres para animais domésticos, com alto risco de transmissão para humanos.

Fisioterapia con compresión cíclica en la estrategia de reconstrucción funcional en la no-unión infectada de diáfisis de húmero en un paciente pediátrico: reporte de un caso / Physiotherapy With Cyclic Compression In The Strategy Of Functional Reconstruction In The Infected Non-Union Of Diaphysis Of Humerus In A Child: Report Of A Case

Introducción Las fracturas de humero diafisiarias abarcan del 5% de todas las fracturas del cuerpo humano. La infección asociada a la no-unión de humero en niños es una patología extremadamente rara e incapacitante, que de no ser tratada adecuadamente puede comprometer de manera definitiva la función de toda la extremidad. Reporte de Caso Se reporta el caso de un paciente masculino de 9 años de edad quien consulta a nuestra institución con la no-unión infectada de humero izquierdo, asociado a pérdida de sustancia ósea, muscular y cutánea, con lesión del nervio radial y con una nula funcionalidad de la extremidad. Se plantea una estrategia de reconstrucción en 5 fases y se presenta el uso de terapias de compresión cíclica como factor clave para la consolidación de la fractura. Discusión En este caso complejo y poco común, se cumplieron todos los objetivos propuestos en el tratamiento de una no-unión infectada, la erradicación de la infección con la adecuada consolidación ósea, recuperación funcional y estética en un lapso de 10 meses.

Background Diaphysis humerus fractures constitute 5% of all fractures in the human body. The infection associated with the non-union of humerus in children is an extremely rare and incapacitating condition, which, if not treated properly, can definitively compromise the function of the whole limb. Case Report The case is presented of a 9 year-old male patient who visited this hospital with a left humerus infected non-union, associated with loss of bone, muscular and cutaneous substance, with radial nerve injury, and a lack of limb functionality. A 5-stage reconstruction strategy is presented, and the use of cyclic compression therapies is as a key factor for fracture consolidation. Discussion In this complex and uncommon case, all the proposed objectives in the treatment of an infected non-union: the eradication of the infection with adequate bone consolidation, functional recovery, and aesthetics were fulfilled within a period of 10 months.

Structural-dependent effects of dietary fibers in colon cancer: Focus on dietary fiber naturally changed by the papaya ripening / Efeitos estrutura-dependente das fibras alimentares no câncer de cólon: foco na fibra alimentar naturalmente modificada durante o amadurecimento do mamão papaia

ietary fiber (DF) consumption is related with several healthy benefits such as the decreasing risk of colon cancer development. The DF is not digested by the digestive enzymes and reach to colon where is fermented by the colonic microbiota. The fermentation process releases metabolites as short chain fatty acids (SCFA) such as butyrate, propionate and acetate. Besides the fermentation process, the DF can directly interact with intestinal epithelial cells inducing mechanism that can also be related with the associated DF consumption benefits. The lack of information regarding DF and colon cancer are due to the complexity of both the cancer and the DF structure. The papayas DF are derived from the fruit cell wall, and they are probably naturally modified during ripening through a massive polysaccharide hydrolysis, because papayas show a very fast pulp softening. Due to the lack of information about DF and their beneficial effects to human health as well as the possibility of the natural papaya ripening to modifying the DF presented in the fruit pulp, the present thesis had as the primary objectives: 1) to evaluate how the cell-wall degrading enzymes affect the fruit cell wall solubilization and molecular weight; 2) to investigate the direct effects of the papaya pectin derived from unripe to ripe papayas in cancer cell lines, in galectin-3 interaction and in HEK cells expressing pattern recognition receptors (PRR); 3) to evaluate the human colonic in vitro fermentation using DF from unripe and ripe papayas as substrates; 4) to conduct an in vivo experiment using rats with pre-neoplastic colon lesions while receiving a diet with DF from unripe and ripe papayas. The endopolygalacturonases were the main enzymes acting on the solubilizing papaya cell wall pectin affecting both the papaya firmness and pectin structure. Overall, the papayas DF showed a ripening dependent structureeffects. In the cancer cell lines experiments, the ripe papayas pectin showed a more pronounced effects in inducing cancer cell death, inhibiting cancer cells migration and aggregation, activating PRR as toll-like receptors and inhibiting the pro-metastatic protein galectin-3. The DF from papayas also showed different aspects in colonic in vitro fermentation regarding the DF utilization by the bacteria and the bacteria abundance profile. Lastly, the animals receiving the diet with the DF from ripe papayas had less aberrant crypt foci in colon than the animals that received the DF from unripe papayas or cellulose (AIN-93G DF). Therefore, the study of papaya DF was carried out both during papaya ripening and its biological effects in vitro and in vivo, generating unprecedented results relating the endogenous biochemical changes of the fruits during maturation with the possible beneficial effects of their ingestion for health human

O consumo de fibras alimentares (FA) está relacionado com vários benefícios à saúde como a diminuição no risco do desenvolvimento de câncer de cólon. A FA não é digerida pelas enzimas digestivas do trato gastrointestinal sendo fermentada pela microbiota intestinal do cólon. Como subproduto do processo de fermentação há a liberação de ácidos graxos de cadeia curta (SCFA) - como o butirato, o propionato e o acetato. Além do processo de fermentação, a FA pode interagir diretamente com as células epiteliais do intestino, induzindo mecanismos que também podem estar relacionados com os benefícios associados ao consumo de FA. A falta de informação sobre a FA e o câncer de cólon é, em partes, devido à complexidade de ambos, tanto do câncer quanto da estrutura da FA. As FA do mamão papaia são derivadas da parede celular da fruta apresentando diferentes estruturas dependendo do ponto de amadurecimento do fruto. Esse fato ocorre, pois, durante o amadurecimento do mamão papaia, existe uma extensa hidrólise dos polissacarídeos presentes na parede celular, diminuindo rapidamente a firmeza da polpa do fruto. Devido à falta de informações sobre FA e seus efeitos benéficos à saúde humana que são dependentes da sua estrutura, bem como a possibilidade do amadurecimento do mamão papaia naturalmente modificar as FA presentes na polpa dos frutos, a presente tese teve como principais objetivos: 1) avaliar como as enzimas que degradam a parede celular do mamão papaia afetam a solubilização e o peso molecular da parede celular do fruto; 2) investigar os efeitos diretos da pectina derivada de mamões verdes e maduros em linhagens de células de câncer, na interação com a galectina-3, e em células do tipo HEK que expressam receptores de reconhecimento de padrões (RRP); 3) avaliar a fermentação colônica humana in vitro utilizando as FA de mamões verdes e maduros; 4) avaliar em ratos com lesões pré-neoplásicas no cólon o efeito do consumo de ração com ou sem FA de mamões papaias verdes e maduros. As endopoligalacturonases foram relacionadas como as principais enzimas que atuam solubilizando a pectina da parede celular do mamão, afetando tanto a firmeza da polpa do fruto quanto a solubilização da pectina durante o amadurecimento. De modo geral, as FA dos mamões exerceram um efeito estruturadependente de acordo com a maturação do fruto. Nos experimentos utilizando linhagens de células de câncer, a pectina do mamão papaia maduro apresentou efeitos mais pronunciados na indução da morte e na inibição da migração e da agregação das células, bem como ativando os RRP, como por exemplo, os receptores do tipo toll-like, além de inibir a proteína pró-metastática galectina-3. As FA dos mamões também apresentaram diferentes resultados na fermentação colônica in vitro quanto à utilização das FA pelas bactérias do intestino, e também no perfil de crescimento dessas bactérias. Por fim, os animais que receberam a dieta com as FA dos mamões maduros apresentaram menor incidência de focos de criptas aberrantes do que os animais que receberam as FA provenientes de mamões verdes ou de celulose (FA da ração AIN-93G). Portanto, o estudo das FA dos mamões foi efetuado tanto durante o amadurecimento dos mamões quanto dos seus efeitos biológicos in vitro e in vivo, tendo gerado resultados inéditos relacionando as alterações bioquímicas endógenas dos frutos durante o amadurecimento com os possíveis efeitos benéficos da sua ingestão para a saúde humana

Crianza: los miedos y el reaseguro médico / Parenting: fears and medical reinsurance

Es muy frecuente, en la práctica ambulatoria de los médicos de familia, que los pacientes nos consulten por problemas de salud que están directamente relacionados con su contexto y su familia. En este sentido, ocupamos un lugar fundamental para evaluar esos aspectos y orientar a nuestros pacientes en la resolución de los problemas. Para llevar a cabo la tarea es preciso contar con tiempo, estar interesado y recibir cierto entrenamiento. Los médicos de familia del Hospital Italiano de Buenos Aires desarrollamos un dispositivo específico denominado FOCO (familia, orientación y contexto) con el objeto de brindar a nuestros pacientes asesoramiento, contención, orientación y, eventualmente, tratamiento de aspectos psicosociales, contextuales o familiares, y nos resulta de gran utilidad en la práctica clínica para el abordaje de estas consultas. Además, creemos que este dispositivo sirve también para poder plasmar en la historia clínica aspectos habitualmente no transcriptos en ella, relacionados con el encuentro clínico. En esta oportunidad presentaremos el caso de una familia con una madre muy temerosa que solicita, ante cualquier problema de salud, interconsultas a especialistas y estudios complementarios para "cuidar bien" a sus hijos. El abordaje del caso incluye el uso del dispositivo FOCO mencionado. (AU)

It is very frequent in Family Physicians practices, to receive consultations where the context of the patient and his family are directly related to their health problems. We have a fundamental place to evaluate these aspects and guide our patients in the resolution of these problems. To carry out this task is necessary to have time, be interested and receive some training. The family doctors of the Hospital Italiano de Buenos Aires developed a specific device called FOCO (Family, Orientation and COntext) in order to provide our patients with advice, containment, guidance and, eventually, treatment of psychosocial, contextual or family aspects. In addition, we believe that this device also serves to be able to translate in clinical history aspects usually not transcribed in it, related to the clinical encounter. We present the case of a family with a fearful mother who thinks that "more is better" in the care of their children and their approach through the FOCO device. (AU)

Control de foco de un brote de Cólera. Matanzas 2014 / Control of Focus in front of a Bud of Cholera. Matanzas 2014

Se presenta un estudio de control de foco de un brote de cólera, mediante la técnica observacional del tipo serie de casos, en el mes de julio de 2014 en el Municipio Matanzas, donde se describe, según el método epidemiológico, la relación de los casos detectados con el caso índice; se analiza el problema detectado teniendo en cuenta el enfoque de riesgo del cólera. Se realiza una evolución clínico-epidemiológica de los casos detectados y se analizan las medidas de control de foco aplicadas. Se revisan tanto las historias clínicas individuales en el consultorio del médico de la familia, como las encuestas epidemiológicas y el expediente de control de foco en el departamento de Epidemiología (AU).

A study of control of focus of a bud of cholera is presented, by means of the observational technique of the type series of cases, in the month of July of 2014 in the Municipality Matanzas, where it is described, according to the epidemic method, the relationship of the cases detected with the index case; the detected problem is analyzed keeping in mind the focus of risk of the cholera. He/she is carried out a clinical-epidemic evolution of the detected cases and of the applied measures of focus control. They are revised the clinical histories so much in the clinic of the doctor of the family, as the epidemic surveys and the file of focus control in the department of epidemiology (AU).

Construcción de la alianza terapéutica durante la sesión: conceptos e instrumento para la investigación empírica / Construction of the therapeutic alliance during the session: concepts and instruments for empirical research

Con el marco teórico freudiano el trabajo tiene el objetivo de diseñar e implementar un instrumento para categorizar la interacción paciente­terapeuta en una primera sesión. El instrumento es útil para considerar la construcción de la alianza terapéutica e incluye las variables de motivo de consulta explícito, sintonía con los estados afectivos y/o somáticos y foco. (AU)

The aim of this work, set within the Freudian theoretical frame, is to design and implement a tool to categorize patient-therapist interaction in a first session. The instrument is useful to consider the construction of the therapeutic alliance and includes the variables of the explicit motive for consultation, affective and/ or somatic attunement and focus. (AU)

La atención-concentraciónen el deporte de rendimento / A atenção-concentração no desportode rendimento / Attention-concentration in sportperformance

El empleo del proceso atencional y de concentración ha demostrado que mejora el rendimiento deportivo. Igualmente, el empleo del enfoque atencional también influye e impacta en la ejecución y aprendizaje deportivo, lo cual constituye una variable esencial en la preparación psicológica y deportiva de los atletas. No obstante, algunos entrenadores no conocen sobre los postulados teóricos que conciernen al proceso atencional. El objetivo de este manuscrito es ofrecer una visión general de la atención y concentración, al igual que ofrecer pautas teórico-prácticas aplicadas en las disciplinas deportivas. La revisión de literatura científica demuestra efectos potencialmente beneficiosos del foco atencional externo sobre el interno, principalmente en tareas de rendimiento y habilidades deportivas. Los estudios evidencian amplio sustento a la hipótesis de acción restringida, la cual sostiene que un enfoque atencional externo es más efectivo en relación al rendimiento, debido al control automático del movimiento. Por el contrario, una adopción de foco interno induce a que el movimiento sea más consciente y, en consecuencia, a perturbaciones del movimiento. Se describen las principales técnicas del mejoramiento y aprendizaje atencional, en consonancia con lo sugerido por las investigaciones, así como los factores distractores. Se alienta a replicar y desarrollar investigaciones en función al proceso atencional en contextos latinoamericanos ajustados a las condiciones particulares.

O emprego do processo de atenção e de concentração tem demonstrado que melhora o rendimento desportivo. Igualmente, o emprego do enfoque de atenção também influi e impacta na execução e aprendizagem desportiva,o qual constitui uma variável essencial na preparação psicológica e desportiva dos atletas. Não obstante, alguns treinadores não conhecem sobre os postulados teóricos que concernem ao processo de atenção. O objetivo deste manuscrito é oferecer uma visão geral da atenção e concentração,ao igual que oferecer pautas teórico-práticas aplicadas nas disciplinas desportivas.A revisão de literatura científica demonstra efeitos potencial mente benéficos do foco de atenção externos sobre o interno, principalmente em tarefas de rendimento e habilidades desportivas. Os estudos evidenciam amplo sustento à hipótese de ação restringida, a qual sustenta que um enfoque de atenção externo é mais efetivo em relação ao rendimento,devido ao controle automático do movimento. Pelo contrário, uma adopção de foco interno induza a que o movimento seja mais consciente e,em consequência, a perturbações do movimento. Descrevem-se as principais técnicas da melhoria e aprendizagem de atenção, de acordo com o sugerido pelas investigações, bem como os fatores de distrações. Alenta-se a replicar e desenvolver investigações em função ao processo de atenção em contextos latino-americanos ajustados às condições particulares.

The use of attentional and concentration process has been shown to improveathletic performance. Similarly, the use of attentional focus also influencesand impacts the learning performance and sporty, which is an essential variablein the psychological preparation of athletes and sports. However, somecoaches do not know about theoretical postulates concerning the attentionalprocess, therefore, the aim of this manuscript is to provide an overview ofattention and concentration, as well as provide theoretical and practical guidelinesapplied in sports. The review of scientific literature shows potentiallybeneficial effects of external attentional focus on domestic tasks primarily onperformance and sports skills. Studies show broad support for the hypothesisof restricted stock, which argues that an external attentional focus is moreeffective in relation to performance, because of the automatic control of themovement, adopting instead a pro-internal focusing induces the movementis more accordingly conscious movement disturbances. It describes the maintechniques attentional improvement and consistent learning as suggestedby the research, as well as distracting factors are encouraged to replicateand develop research according to the American context attentional processtailored to the particular condition.

Seed rain generated by bats under Cerrados pasture remnant trees in a Neotropical savanna

Abstract In this study we described the seed rain generated by bats under four Cerrados tree species common within pastures, Buchenavia tomentosa, Couepia grandiflora, Licania humilis and Qualea grandiflora. We analyzed the similarity among the four tree species in terms of seed rain composition, and compared the number of seeds and seed species deposited under them. Besides that, we assessed the relationship between seed rain intensity and the density of each tree species. Then, we randomly selected 10 mature trees of each species to sample seed rain. We recorded a total of 4892 bat dispersed seeds from 11 species. Also, we observed that along the year seed deposition varied substantially under all trees. At least two seed sub-communities could be distinguished according to tree species used by bats as feeding roost. One related to Couepia grandiflora and Licania humilis, and the other to Buchenavia tomentosa and Qualea grandiflora trees. The variability of seed rain composition in any particular tree and the range of actual seed fall into a particular species indicate patchiness in seed rain, and the overall results appear to be consistent in terms of a substantial and diverse seed rain generated by bats in a highly anthropized landscape. This is the first study concerning seed dispersal by bats in modified Brazilian Cerrado, one of the most endangered biomes in the world. In this respect, by preserving a dense and diverse collection of remnant trees within today's pastures may, potentially, contribute to a faster Cerrado recovery in extensive areas that can be reclaimed for restoration in the future.

Resumo Neste estudo descrevemos a chuva de sementes gerada por morcegos sob quatro espécies arbóreas comuns em pastagens no Cerrado (Bouchenavia tomentosa, Couepia grandiflora, Licania humilis e Qualea grandiflora). Também, analisamos a similaridade quanto à composição da chuva de sementes depositada sob as quatro espécies arbóreas, além da relação entre a intensidade da chuva de sementes e densidade de cada espécies arbóreas. Para tanto, selecionamos aleatoriamente 10 árvores por espécie que fossem reprodutivamente maduras, para amostrar a chuva de sementes. Registramos um total de 4892 sementes, pertencentes a 11 espécies de plantas, dispersadas por morcegos. Durante o ano a deposição de sementes variou substancialmente sob todas as árvores amostradas. Duas sub-comunidades de sementes emergiram associadas às espécies arbóreas usadas por morcegos como abrigo de alimentação. Uma relacionada à Couepia grandiflora e Licania humilis, e outra relacionada à Buchenavia tomentosa e Qualea grandiflora. A variabilidade da composição da chuva de sementes sob qualquer uma das árvores, bem como a amplitude dessa chuva sob cada espécie de árvore indicou um padrão heterogêneo e intenso de deposição de uma coleção diversa de sementes em uma área altamente antropizada. Neste aspecto, a manutenção de uma rica e densa coleção de árvores remanescentes nas áreas de pastagens pode contribuir, potencialmente, para uma regeneração mais rápida do Cerrado em extensas áreas que podem requerer planos de restauração futuramente.

Seed rain generated by bats under Cerrado’s pasture remnant trees in a Neotropical savanna / Chuva de sementes gerada por morcegos sob árvores remanescentes do Cerrado no Brasil Central

Abstract In this study we described the seed rain generated by bats under four Cerrado’s tree species common within pastures, Buchenavia tomentosa, Couepia grandiflora, Licania humilis and Qualea grandiflora. We analyzed the similarity among the four tree species in terms of seed rain composition, and compared the number of seeds and seed species deposited under them. Besides that, we assessed the relationship between seed rain intensity and the density of each tree species. Then, we randomly selected 10 mature trees of each species to sample seed rain. We recorded a total of 4892 bat dispersed seeds from 11 species. Also, we observed that along the year seed deposition varied substantially under all trees. At least two seed sub-communities could be distinguished according to tree species used by bats as feeding roost. One related to Couepia grandiflora and Licania humilis, and the other to Buchenavia tomentosa and Qualea grandiflora trees. The variability of seed rain composition in any particular tree and the range of actual seed fall into a particular species indicate patchiness in seed rain, and the overall results appear to be consistent in terms of a substantial and diverse seed rain generated by bats in a highly anthropized landscape. This is the first study concerning seed dispersal by bats in modified Brazilian Cerrado, one of the most endangered biomes in the world. In this respect, by preserving a dense and diverse collection of remnant trees within today's pastures may, potentially, contribute to a faster Cerrado recovery in extensive areas that can be reclaimed for restoration in the future.

Resumo Neste estudo descrevemos a chuva de sementes gerada por morcegos sob quatro espécies arbóreas comuns em pastagens no Cerrado (Bouchenavia tomentosa, Couepia grandiflora, Licania humilis e Qualea grandiflora). Também, analisamos a similaridade quanto à composição da chuva de sementes depositada sob as quatro espécies arbóreas, além da relação entre a intensidade da chuva de sementes e densidade de cada espécies arbóreas. Para tanto, selecionamos aleatoriamente 10 árvores por espécie que fossem reprodutivamente maduras, para amostrar a chuva de sementes. Registramos um total de 4892 sementes, pertencentes a 11 espécies de plantas, dispersadas por morcegos. Durante o ano a deposição de sementes variou substancialmente sob todas as árvores amostradas. Duas sub-comunidades de sementes emergiram associadas às espécies arbóreas usadas por morcegos como abrigo de alimentação. Uma relacionada à Couepia grandiflora e Licania humilis, e outra relacionada à Buchenavia tomentosa e Qualea grandiflora. A variabilidade da composição da chuva de sementes sob qualquer uma das árvores, bem como a amplitude dessa chuva sob cada espécie de árvore indicou um padrão heterogêneo e intenso de deposição de uma coleção diversa de sementes em uma área altamente antropizada. Neste aspecto, a manutenção de uma rica e densa coleção de árvores remanescentes nas áreas de pastagens pode contribuir, potencialmente, para uma regeneração mais rápida do Cerrado em extensas áreas que podem requerer planos de restauração futuramente.

Exploración de las propiedades psicométricas de la Batería Montreal de Evaluación de Amusia en una muestra de sujetos con epilepsia de lóbulo temporal / Exploration of the psychometric properties of the Montreal Battery of Evaluation of Amusia in a sample with temporal lobe epilepsy

ANTECEDENTES: La Batería Montreal de Evaluación de Amusia (MBEA) es un instrumento de reciente creación, utilizado para evaluar percepción y memoria musical asociadas al funcionamiento de lóbulos temporales. La epilepsia de lóbulo temporal no sintomática (ELTns) es una condición de alta prevalencia en México; esto proporciona una oportunidad para evaluar la MBEA, considerando que las crisis epilépticas pueden producir alteraciones neuropsicológicas específicas según la localización lobular y la lateralización de foco epileptogénico (LFE). OBJETIVO: Explorar las propiedades psicométricas y diagnósticas de la MBEA. MÉTODO: Dos muestras no probabilística de 31 controles y 22 casos de epilepsia ELTns fueron evaluados con la MBEA. Se utilizaron asimismo los datos estandarizados originales de la MBEA para comparación de controles. RESULTADOS: El análisis con prueba t mostró desempeños significativamente menores de los casos en comparación con los controles y significativamente menores entre controles y la norma. No se encontraron diferencias significativas en los puntajes según LFE. El análisis por Curvas ROC mostró propiedades cuestionables de sensibilidad y especificidad en la MBEA utilizando la ELTns como variable de estado. DISCUSIÓN Y CONCLUSIÓN: Se hallaron alteraciones en funciones de percepción musical en los casos; sin embargo, se detectaron inconsistencias teóricas con respecto a la relación de funciones afectadas. Las diferencias entre el grupo control y la norma apuntan a continuar evaluando la MBEA en población mexicana. La MBEA parece ser una medida poco precisa en términos de sensibilidad y especificidad para las alteraciones amúsicas en la ELTns, y su utilidad como medida de apoyo en la determinación de LFE permanece incierta.

BACKGROUND: The Montreal Battery of Evaluation of Amusia (MBEA) is a newly developed instrument to assess music perception and memory, associated to temporal lobe functioning. The non-symptomatic temporal lobe epilepsy is a prevalent condition in Mexico, and it gives an opportunity to test the MBEA, considering the fact that epileptic seizures can cause neuropsychological impairment according to lobar localization and hemispherical lateralization of the epileptogenic foci. OBJECTIVE: To explore the psychometric and diagnostic properties of the MBEA. METHOD: Two non-probabilistic samples of 31 control subjects and 22 cases with non-symptomatic temporal lobe epilepsy were assessed with the MBEA. Data from the original validation were used to compare with the control group. RESULTS: Analysis with t test showed significantly lower performances in the case group relative to controls, and a general lower performance of controls compared to the norm. There was no significant difference in performance between cases with left epileptogenic foci and cases with right epileptogenic foci. ROC curve analysis showed questionable properties of sensitivity and specificity in the MBEA. DISCUSSION AND CONCLUSION: Impairments in music perception were found in cases, although theoretical inconsistences with respect to relation between impaired functions were also detected. The performance of the control group relative to the norm aims to the continuation of the validation process, considering cultural differences. The MBEA seems to be a poor measure in terms of sensibility and specificity for the detection of amusic impairments in subjects with non-symptomatic temporal lobe epilepsy, and its utility for determining hemispheric lateralization of epileptogenic foci remains uncertain.

Aislamiento y caracterización de cepas de Bacillus spp. con actividad contra Tetranychus urticae Koch en cultivos comerciales de rosas / Isolation and characterization of strains of Bacillus spp. With activity against Tetranychus urticae Koch in commercial crops of roses

Una de las especies de ácaros que producen considerables pérdidas cualitativas y cuantitativas en el cultivo de rosas bajo invernadero en Ecuador es Tetranychus urticae, donde el control con agroquímicos convencionales no es efectivo; por lo cual se busca identificar cepas de Bacillus spp. aisladas a partir de T. urticae y determinar sus escenarios anatómicos patogénicos para un futuro control con bacterias. La fase de campo se realizó en la florícola Naranjo Roses S.A. en Latacunga en un cultivo de rosas bajo condiciones orgánicas, en donde se recolectaron hojas de cada tercio de seis plantas con presencia de T. urticae Koch. Las muestras fueron trasladadas para ser procesadas en Plantsphere Laboratories (PSL) en Quito. Se identificaron y cuantificaron los diferentes estadios de la plaga y se aislaron algunos individuos para determinar la presencia de cepas patogénicas de Bacillus spp., las cuales fueron aisladas, purificadas e identificadas. Los tratamientos de verificación patogénica fueron las cepas, agua destilada (testigo) y Bacillus thuringiensis biovar acari (testigo positivo). Los eventos patogénicos se evaluaron en hembras adultas de T. urticae mediante citohistoquímica, por medio de la cual se reportó ruptura de paredes externas, precipitación de contenido celular y malformaciones cuticulares. Se determinó que el mayor número de individuos plaga se localizan en el tercio bajo (59,4%) con mayor presencia de huevos (63,3%). Mediante análisis de componentes principales (ACP) de los tratamientos, se determinó las cepas más eficientes como Efectores Biocatalíticos (EBc©)siendo estas la PSL 104, 113, 114 y Bacillus thuringiensis biovar acari.

One of the species of mites that cause considerable qualitative and quantitative losses in roses growing under greenhouses in Ecuador is Tetranychus urticae, where conventional agrochemicals control is not effective; therefore seeks to identify strains of Bacillus spp. Isolated from T. urticae and determine their anatomical pathogenic scenarios for future control with bacteria. The field phase took place in Naranjo Roses S.A. in Latacunga in a growing roses under organic conditions, where they were collected sheets of each third of six plants with presence of T. urticae Koch. The samples were taken to be processed in Plantsphere Laboratories (PSL) in Quito. They were identified and quantified the different stages of the pest and some individuals were isolated for the presence of pathogenic strains of Bacillus spp., which were isolated, purified and identified. Check treatments of pathogenic were strains, distilled water (control) and Bacillus thuringiensis biovar acari (positive control). Pathogenic events were evaluated in adult females of T. urticae by citohistochemistry, where breakout of the outer walls, precipitation of cell contents and cuticular malformations were reported. It was determined that the largest numbers of pest individuals are located in the lower third (59.4%) with greater presence of eggs (63.3%). Using principal component analysis (PCA) of the treatments, the PSL 104, 113, 114 and Bacillus thuringiensis biovar acari was determined as the most efficient Biocatalytic Effectors (EBc©).

La Psicoterapia Psicoanalítica de Grupos Paralelos de Padres e Hijos: interrelaciones de la perspectiva clínica con la investigación empírica de proceso terapéutico / The psychodynamic Parent-Child Parallel Group Intervention: Relationships between the clinical perspective and the analysis of the therapeutic process

El presente artículo presenta el abordaje denominado Psicoterapia Psicoanalítica de Grupos Paralelos de Padres e Hijos. Se describen diferentes fases y aspectos de la trayectoria clínica y de investigación (2002-2014), incluyendo las perspectivas epidemiológica, diagnóstica y terapéutica de la consulta. Se describen los estudios centrados en el análisis del proceso terapéutico de un grupo de madres, cuyo objeto de investigación fueron la Interacción Grupal, el Foco Terapéutico, los patrones verbales de emoción-abstracción y los factores terapéuticos comunes en la terapia grupal (basados sobre Yalom, 1985). Estos estudios mostraron que en la fase inicial del grupo dominan las racionalizaciones y la disociación de los afectos respecto de las situaciones traumáticas, y especialmente de la problemática del niño. La experiencia del grupo como base segura (factor terapéutico Cohesión Grupal) posibilita el proceso de crecimiento en el grupo en la fase media. En la fase final del grupo se manifiestan nuevas modalidades de afrontar la frustración o las amenazas de un medio circundante poco propicio.

Evolución espacial y temporal de la malaria en el municipio Sifontes del estado Bolívar, Venezuela. 1980-2013 / Spatial and temporal evolution of malaria in the municipality of Sifontes, Bolívar State, Venezuela. 1980-2013

La malaria es endemo-epidémica en el estado Bolívar, con brotes epidémicos frecuentes debido a causas naturales y antrópicas. En el municipio Sifontes, ubicado en el noreste del estado, durante el último decenio se ha registrado un aumento considerable de los casos, cerrando 2013 con 46.610 casos, 71% % de la malaria del estado y 61% del país. Este es un foco meso-endémico de malaria inestable donde la transmisión ocurre durante todo el año, con brotes epidémicos estrechamente relacionados con la minería aurífera. A partir de 1983, gran parte de la malaria en Venezuela depende de la generada en el estado Bolívar, y esta a su vez de la generada en el municipio Sifontes. La revisión de la data de malaria del estado en el periodo 1980-2013 reveló la existencia de dos niveles epidemiológicos, uno basal y otro adicional, este último ligado a la minería aurífera; sin embargo, no se encontró correlación con la lluvia, para el nivel basal (R = 0,41, P= 0,78) ni para el nivel epidémico (R = 0,41; P = 0,32). Asimismo, la proyección geográfica de los datos reveló la naturaleza focal de la enfermedad en el municipio, el cual reúne todas las condiciones epidemiológicas, ambientales, climáticas y sociales para ser considerado un foco caliente. Las características espaciales y temporales de la malaria en el municipio Sifontes lo configuran como el foco de malaria más importante en Venezuela, el cual debe ser priorizado en los planes de control de la enfermedad.

Malaria is endemo-epidemic in Bolívar state with frequent epidemic outbreaks occurring due to both natural and anthropic factors. The Sifontes municipality, located in the northeastern corner of the state, has reported a considerable increase in the number of cases over the last decade; with 46.610 cases registered during 2013. This represents 71% of the number of malaria cases reported for the state and 61% for the country in this same year. Sifontes municipality is a meso-endemic focus of unstable malaria, and transmission occurs throughout the year with epidemic outbreaks tightly linked to gold mining activities. Since 1988 the increase in the number of cases reported in Venezuela has been determined by the number of cases reported in Bolívar state which, in turn, is correlated with the number of cases reported in Sifontes. A review of malaria data between 1980 and 2013 reveals the existence of two epidemiological categories: a base level and an additional level, the latter associated with gold mining; nevertheless, there was not correlation whit the rainfall for basal (R = 0,41, P= 0,78) or additional level (R = 0,41; P = 0,32). In addition, a geographic plotting of the data revealed the focal nature of malaria in the municipality, which to gather all environmental, climatic, social and epidemiological factors that have produced conditions typical of a hot spot. The spatial and temporal characteristics of malaria in the Sifontes municipality demonstrates that this is the most important malaria focus in Venezuela, and must be prioritized when designing strategies for the control of this disease.

Control de foco de tuberculosis en menores de 15 años / Control of tuberculosis focus in under 15 years-old children

INTRODUCCIÓN: los niños se infectan de tuberculosis a partir del contacto con un adulto enfermo, casi siempre en el hogar. OBJETIVO: evaluar la calidad de las acciones de control de foco en niños expuestos. MÉTODOS: estudio retrospectivo, descriptivo de los controles de focos de tuberculosis realizados a 143 menores de 15 años que estuvieron en contacto con 95 enfermos, en el municipio habanero de "10 de Octubre". Se clasificaron en 3 categorías: 1) expuestos: niños sin elementos clínicos, radiológicos ni microbiológicos de enfermedad activa y anergia tuberculínica; 2) con infección latente: niños reactores a la tuberculina (lecturas de 5 o más mm), pero sin elementos de enfermedad activa; y 3) enfermos: niños con criterios clínicos y/o radiológicos de tuberculosis activa, independientemente del resultado de la prueba de Mantoux y los estudios microbiológicos. RESULTADOS: se estudió una media de 1,5 menores de 15 años por cada caso índice, con una edad media de 6,7 años, con predominio de los prescolares (63= 44,1 %) y el sexo masculino (87= 60,8 %). La mayoría se consideraron expuestos (124= 86,9 %); la cuarta parte de los niños con exposición intradomiciliaria se infectaron o enfermaron (16/62= 25,8 %), resultado muy superior a la extradomiciliaria (3/81= 3,7 %). Se diagnosticaron 3 enfermos: 2 formas pulmonares primarias, y una adenitis (entre 1 y 5 años), que representan el 60 % de los casos infantiles diagnosticados en el municipio en ese quinquenio. Se identificaron errores: no registro de la quimioprofilaxis primaria (55= 38,4 %), inicio tardío del control de foco (39= 27,3 %), y la no realización de la prueba de Mantoux o radiografía torácica al inicio (24= 16,7 %), entre otros. CONCLUSIONES: es necesario fortalecer la capacitación del personal de salud y el cumplimiento de los procedimientos establecidos en el Programa, para garantizar la calidad de los controles de foco, y contribuir a la eliminación de la tuberculosis como problema de salud.

INTRODUCTION: the children become infected with tuberculosis from contact with sick adults, most often at home. OBJECTIVE: to evaluate the quality of tuberculosis foci control actions in exposed children. METHODS: retrospective and descriptive study of tuberculosis foci control actions conducted in 143 children aged less than 15 years, who had been in contact with 95 sick persons in 10 de Octubre municipality in Havana. They were classified into 3 categories: 1) exposed: children with no clinical, radiological or microbiological elements of active disease and tuberculin anergy; 2) latent infective: children reacting to tuberculin (5 mm or more readings), but with no active disease elements, and 3) ill: children with clinical and/or radiological criteria of active tuberculosis regardless of the Mantoux's test results and the microbiological studies. RESULTS: a mean of 1.5 children under 15 years of age per index case, average age of 6.7 years, predominating preschoolers (63= 44.1 %) and males (87= 60.8 %). Most of them were considered exposed (124= 86.9 %); a quarter of the children exposed at home became infected or sick (16 out of 62= 25.8 %), and this result was much higher than the outdoor exposure (3 out of 81= 3.7 %). Three sick children were diagnosed-two had primary pulmonary forms and one had adenitis (one to 5 years-old). They accounted for 60% of the pediatric cases diagnosed in the municipality in this 5-year period. The identified errors were non-registration of primary chemoprophylaxis (55= 38.4%), late starting of focus control (39= 27.3 %) and non-performance of Mantoux's test or thorax X-ray at the very beginning (24= 16.7 %) among others. CONCLUSIONS: it is necessary to strengthen the training of the health staff and the compliance with the procedures set by the National Program, in order to assure the quality of focus controls and to contribute to the eradication of tuberculosis as a health problem.