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Introducción: la cefalea rinogénica es secundaria al contacto permanente de la mucosa nasal y puede ser secundario a concha bullosa, si se infecta puede ser mucocele o mucopiocele. Caso clínico: paciente de 34 años con cefalea hemicraneal izquierda, dolor periocular ipsilateral, congestión y rinorrea hialina con cambios en consistencia y coloración del moco. En la tomografía computarizada (TAC) de senos paranasales (SPN) desviación septal derecha por concha bullosa izquierda, ocupación de líquido. Se sospecho mucocele y cefalea rinogénica secundaria, prueba de lidocaína positiva. Se detecto por cultivo, Eikenella corrodens. Manejo con antibiótico y posterior resolución de patología. Conclusiones: debe incluirse en el diagnóstico diferencial de cefalea y concha bullosa, realizarse endoscopia nasal y TAC de SPN. El manejo quirúrgico ha demostrado reducir la intensidad y la frecuencia de la cefalea a corto y largo plazo, y es exitoso si hay test de lidocaína positivo.
Introduction: rhinogenic headache is secondary to permanent contact with the nasal mucosa and may be secondary to concha bullosa, if infected it may be mucocele or mucopiocele. Clinical case: 34-year-old patient with left hemicranial headache, ipsilateral periocular pain, congestion, and hyaline rhinorrhea with changes in consistency and coloration of the mucus. In the computed tomography (CT) of the paranasal sinuses (SPN) right septal deviation due to left concha bullosa, fluid occupation. Mucocele and secondary rhinogenic headache were suspected, lidocaine test positive. Eikenella corrodens was detected by culture. Management with antibiotics and subsequent resolution of pathology. Conclusions: nasal endoscopy and SPN CT should be included in the differential diagnosis of headache and concha bullosa. Surgical management has been shown to reduce headache intensity and frequency in the short and long term, and is successful if there is a positive lidocaine test.
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Humanos , Masculino , Femenino , Cefalea , Mucocele , Cornetes Nasales , Rinorrea , Mucosa NasalRESUMEN
Introducción: el síndrome de apnea-hipoapnea obstructiva del sueño, es una enfermedad caracterizada por la obstrucción o colapso recurrente de la vía aérea superior. La escala de Epworth evalúa la somnolencia diurna subjetiva de los pacientes con un cuestionario siendo esta la más usada en la actualidad. Los microdespertares producidos durante los trastornos del sueño se ha encontrado que pueden generar somnolencia diurna excesiva. Objetivo: describir una correlación entre el índice de microdespertares y la escala de Epworth. Diseño: Corte transversal descriptivo analítico. Metodología: revisión de polisomnografías realizadas y a partir de estas obtenciones de los valores de la escala de Epworth e índice de microdespertares, describir una posible correlación entre ellos. Resultados: se evaluaron 130 pacientes y se estableció que no existía correlación estadísticamente significativa entre los valores de la escala de Epworth y el índice de microdespertares. Discusión: la subjetividad de la escala Epworth nos puede llevar a encontrar cierta variabilidad en los resultados de la prueba. Por otro lado, es importante tener en cuenta que hay otros aspectos que pueden generar un aumento de la somnolencia diurna medida con la escala de Epworth como lo es la hipoxemia nocturna aumentada. También es importante mencionar que existen otros elementos de la microestructura del sueño que pueden generar resultados diferentes al comparar con la definición y parámetros de microdespertares, como es el patrón alternante cíclico y sus subtipos. Conclusiones: no existe correlación entre los valores de la escala de Epworth y el índice de microdespertares.
Introduction: Obstructive sleep apnea is a disease characterized by recurrent obstruction or collapse of the upper airway. Epworth Sleepiness Scale (ESS) assesses the subjective daytime sleepiness of patients with a questionnaire, being this the most used in nowadays. It's been found that the arousals produced during sleep disorders can develop excessive daytime sleepiness. Objective: To describe a correlation between arousal index and ESS. Design: Analytic descriptive cross-sectional study. Methodology: Review of sleep study, obtain values of ESS and arousal index and then describe a possible correlation between them. Results: 130 patients were assessed and it was established that there is no statistically significant correlation between the ESS values and the arousal index. Discussion: The subjectivity of ESS can lead to finding some variation in the tested outcomes; on the other hand, it's important to keep in mind that there are other factors that can improve the daytime sleepiness measured with ESS, such as increased nocturnal hypoxemia. Furthermore, it's convenient to identify that there are other elements of sleep microstructure that can generate different results when comparing its definition and taking arousal parameters into account, such as the cyclic alternative pattern and its subtypes. Conclusion: There is no correlation between ESS and arousal index.
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Humanos , Somnolencia , Trastornos del Sueño-Vigilia , Trastornos de Somnolencia ExcesivaRESUMEN
Abstract Backyard pigs have been associated with poor sanitary conditions and the development of parasitic diseases, often causing public health and food safety problems. Therefore, the aim of this study was to determine the prevalence and risk factors for gastrointestinal parasites in backyard pigs. 279 animals were sampled from thirty-two backyard pig farms located in the Bucaramanga, Floridablanca, Giron and Piedecuesta municipalities, from Bucaramanga Metropolitan Area, Colombia. Fecal samples were taken directly from the rectum and processed by four coprological techniques. The overall prevalence of gastrointestinal parasites was 91%, being the highest values for Balantidium coli and Eimeria sp. Regarding the prevalence by municipalities, there was no statistical association (p ≥ 0.05) indicating that the prevalence was similar in the region under study. Floridablanca municipality, free-ranging pigs, access to latrines, and consumption of spring water showed to be a risk factor for nematodes, while Giron municipality, pigs > 7 months of age and access to latrines, increased infection risk for coccidian. We concluded that there is a high prevalence of gastrointestinal parasites in backyard pigs from the Bucaramanga Metropolitan Area, and that it could be controlled by improving management practices and farm facilities.
Resumo Suínos criados em fundo de quintal têm sido associados às más condições sanitárias e ao desenvolvimento de doenças parasitárias, frequentemente causando problemas de saúde pública e segurança alimentar. Assim, o objetivo deste estudo foi determinar a prevalência e os fatores de risco para parasitos gastrointestinais em suínos criados em fundo de quintal. Foram amostrados 279 animais de 32 fazendas de suínos localizadas nos municípios de Bucaramanga, Floridablanca, Giron e Piedecuesta, da Área Metropolitana de Bucaramanga, Colômbia. As amostras fecais foram coletadas diretamente do reto e processadas por quatro técnicas coprológicas. A prevalência geral de parasitos gastrintestinais foi de 91%, sendo os maiores valores para Balantidium coli e Eimeria sp. Em relação à prevalência por municípios, não houve associação estatística (p≥ 0,05), indicando que a prevalência foi semelhante na região estudada. O município de Floridablanca, porcos caipiras, acesso a latrinas e consumo de água da nascente mostraram ser um fator de risco para os nematoides enquanto no município de Giron, porcos com mais de 7 meses de idade e acesso a latrinas, aumentou o risco de infecção por coccídios. Concluiu-se que há uma alta prevalência de parasitos gastrointestinais em suínos criados em fundo de quintal da Área Metropolitana de Bucaramanga, e que isso poderia ser controlado melhorando as práticas de manejo e as instalações agrícolas.
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Animales , Parásitos , Enfermedades de los Porcinos/epidemiología , Enfermedades Gastrointestinales/parasitología , Parasitosis Intestinales/veterinaria , Parasitosis Intestinales/epidemiología , Porcinos , Prevalencia , Factores de Riesgo , Colombia/epidemiologíaRESUMEN
RESUMEN Introducción: La fasciolosis representa un grave problema para el sector pecuario y la salud humana en muchos países. En Colombia, afecta principalmente al ganado bovino y ovino, con escasos reportes en humanos. Objetivo: Estandarizar un Ensayo de Inmunoadsorción Enzimática para bovinos, ovinos y humanos como herramienta de tamizaje de fasciolosis. Metodología: Se utilizaron 50 muestras de bovinos, 50 de ovinos y 39 de humanos con diagnóstico de fasciolosis confirmado por serología y examen de materia fecal. Se utilizaron cuatro presentaciones del antígeno excretor-secretor de Fasciola hepatica. Se calcularon la sensibilidad, la especificidad y la concordancia. Resultados: La sensibilidad del ELISA en humanos, ovinos y bovinos fue de 100% y la especificidad fue de 97%, 85,2% y 96,2%, respectivamente. El coeficiente Kappa de Cohen fue superior a 0,8 en las tres especies. Conclusiones: La prueba de ELISA estandarizada para el diagnóstico de la fasciolosis humana, ovina y bovina demostró una excelente sensibilidad y buena especificidad. Se propone realizar la validación a mayor escala para su posterior uso como herramienta en el tamizaje de esta parasitosis.
ABSTRACT Introduction: Fascioliasis represents a serious problem for livestock production and human health in the world. In Colombia, it mainly affects bovine and ovine cattle, with few cases reported in humans. Objective: To standardize an Enzyme-Linked ImmunoSorbent test (ELISA) in bovine, ovine, and human individuals as a screening tool of fascioliasis. Methods: 50 bovine, 50 ovine and 39 human samples with fascioliasis confirmed by serology and stool test were used. Sensitivity, specificity and concordance were calculated. Results: Sensitivity of the ELISA in humans, bovine and ovine cattle was 100 % and specificity was 97%, 85.2% and 96.2%, respectively. Cohen´s Kappa coefficient was >0.8 in all groups. Conclusions: Standardized ELISA test for bovine, ovine and human fascioliasis exhibited an excellent sensitivity and good specificity. It is proposed to carry out a large-scale validation for its ulterior use as a screening tool for the diagnosis of this parasitic infection.
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Humanos , Animales , Bovinos , Fascioliasis , Estándares de Referencia , Humanos , Bovinos , Ensayo de Inmunoadsorción Enzimática , Ovinos , Diagnóstico , Fasciola hepaticaRESUMEN
Introducción: La Fasciolosis es una enfermedad causada por el parásito Fasciola hepatica, que afecta primordialmente a bovinos, ovinos, caprinos y en algunas zonas de forma endémica a los humanos. En la investigación clínica y epidemiológica de fasciolosis humana es importante contar con técnicas coprológicas de diagnóstico de alta sensibilidad y especificidad. Objetivo: realizar la comparación de tres técnicas coprológicas para el diagnóstico de infección por Fasciola hepatica en humanos. Metodología: se procesaron 200 gramos de materia fecal de humanos contaminada experimentalmente con huevos de F. hepatica que se obtuvieron de análisis anteriores con muestras de ganado bovino y ovino. La muestra se dividió en 10 partes iguales; a cada una de estas muestras se les realizó la técnicas de Kato-Katz, técnica de sedimentación espontánea en tubo (TSET) y técnica de sedimentación rápida (TSR). Finalmente, la lectura de las muestras se basó en el diseño metodológico del doble ciego. Resultados: se encontró que la técnica de sedimentación rápida fue la más sensible de las tres evaluadas, detectándose positividad en 7,5 muestras de 10 analizadas; seguida por la técnica de Kato-Katz con 4,5 muestras y en último lugar la técnica de sedimentación espontánea en Tubo que mostró solo un resultado positivo. Conclusión: en este trabajo se encontró que la técnica de sedimentación rápida constituye la herramienta de elección para el profesional porque es la más sensible de las tres; además de ser sencilla, económica y de fácil aplicación en laboratorios de niveles uno y dos de complejidad para realizar un diagnóstico satisfactorio de fasciolosis humana. Salud UIS 2012; 44 (3): 7-12.
Introduction: fasciolosis is a disease caused by the parasite Fasciola hepatica wich primarily affects cattle, sheep, and goats. In certain areas, it is endemic for human beings. In clinical and epidemiological research of human fasciolosis is important to get diagnostic techniques with high sensibility and specificity. Objective: perform the comparison between three coprological techniques for the diagnosis of infection by F. hepatica in humans. Methods: 200 grams of human feces were experimentally contaminated with F. hepatica eggs obtained from previous analysis with cattle and sheep faecal samples. The preparation was divided into 10 equal parts, each one was processed by the Kato- Katz technique, the spontaneous tube sedimentation technique (STST) and rapid sedimentation technique (TSR). Finally, all samples reading was based on the double-blind study design. Results: we found out that TSR was the most sensitive of the three techniques tested: 7,5 of 10 samples analyzed were positive, followed by the Kato-Katz technique with 4.5 of 10 samples and TSET with only one of 10 samples. Conclusion: This study concludes that the rapid sedimentation technique is the tool of choice for professionals because it is simple, inexpensive and easily applied in laboratories with levels complexity one and two, for a successful diagnosis of human fasciolosis. Salud UIS 2012; 44 (3): 7-12.
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Nas reflexões acerca do que se pode adjetivar como o "novo imaginário anticapitalista", pode-se encontrar afirmações nas quais as práticas de economia solidária representam parte importante na estrutura da ponte de transição da resistência à alternativa ao capitalismo, sendo, portanto, um mecanismo fundamental na busca de alternativas de relacionamentos entre o Estado, o mercado e a sociedade. Sob essa perspectiva, a economia solidária pode significar novas formas ou modos de produção e distribuição. De seus suportes fundamentais, o cooperativismo popular pode ser considerado um dos principais. Por estar fundamentado em uma teoria própria de produção e distribuição de bens e serviços, quando exercido sob a forma autogestionária, o cooperativismo popular possui como ponto cardeal principal a emancipação em relação às formas liberais do mercado. Pode resgatar, nesse sentido, várias propostas alternativas de distribuição de poder e renda, representando a gênese do que se pode chamar de economia solidária.
In the reflections concerning what might be called the "new anti-capitalist scenario", we can find affirmatives in which the solidarity economy practices represent a very important part in the structure of the transition bridge from resistance to the alternative to capitalism, being, therefore, an essential mechanism in the search for alternatives of relationships among the State, the market, and the society. Under this perspective, the solidarity economy may imply new manners or ways of production and distribution. From its essential supports, popular cooperativism might be considered one of the most important. Due to the fact that it is based on a specific theory of production and distribution of goods and services, when exercised in a self-management way, popular cooperativism has as its main characteristic the emancipation in relation to the liberal forms of market. It may rescue, in this sense, several alternative propositions of distribution of power and income, representing the genesis of what might be called solidarity economy.
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This article analyzes the implementation of two policies for territorial development of the Brazilian countryside in the first decade of the 21st century: the Program for the SustainableDevelopment of Rural Territories (Pronat) and the Program for Territories of Citizenship (PTC). Examining the new institutional arrangements, the programs' socialmanagement and governance structures, and the protagonist role of the various stakeholders, the article concludes that to a certain extent the programs represent a unique strategy for political action and development in the respective geographic areas.However, they still face enormous challenges for effective consolidation of their results.
Dans cet article, on examine lamise en place de deux politiques orientées vers le développement du territoire en milieu rural au Brésil dans les années 2000: le Programme de Développement Durable des Territoires Ruraux (Pronat) et le Programme Territoires de la Citoyenneté (PTC). D'après l'examen des nouvelles pratiques institutionnelles en cours, de la gestion sociale des programmes et de leurs structures de gouvernance, ainsi que du rôle des acteurs engagés, on conclut que ces derniers ont suivi, d'une certaine façon, une stratégie singulière d'action politique pour le développement des régions concernées, malgré les immenses enjeux à venir, afin d'aboutir à des résultats vraiment solides.
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Se muestran los resultados obtenidos en un estudio prospectivo realizado en 9 pacientes con parálisis facial periférica idiopática utilizando fisioterapia no convencional: electrocrioterapia, digitopuntura y electrocriodigitopuntura. Se comprueba el beneficio terapéutico en las tres técnicas utilizadas, sugiriendo mayor eficacia de la electrocriodigitopuntura