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Resumen El cáncer de mama es el cáncer más frecuente en las mujeres y constituye un problema de salud pública debido a sus altas tasas de morbimortalidad. El diagnóstico se hace a través de estudios rutinarios de histopatología que se complementan con estudios de expresión de receptores hormonales (Receptores de Estrógenos y Progesterona), del factor de crecimiento epidérmico humano 2 (HER2) e índice de proliferación celular (Ki67) para su subtipificación en grupos moleculares (Luminal A, Luminal B, Her2 y triple negativo), los cuales tienen implicaciones pronósticas y terapéuticas diferentes. Globalmente, se ha reportado una alta prevalencia del subtipo Luminal A, predominantemente en Norteamérica, Europa y algunos países latinoamericanos, sin embargo, los reportes en la población colombiana son heterogéneos. El objetivo de esta investigación es establecer un perfil de incidencia de dichos subtipos moleculares en una población del eje cafetero en Colombia. Retrospectivamente se analizaron muestras de 377 pacientes con diagnóstico de cáncer de mama infiltrante, entre los años 2015 a 2018. Los diagnósticos histológicos incluyeron: Carcinomas Ductal infiltrante NOS (339 casos; 89.9 %), lobulillar infiltrante (23 casos; 6.1 %), mucinoso infiltrante (6 casos; 1.5 %), papilar infiltrante (1 caso; 0.2 %) y patrones mixtos: ductal-lobulillar (3 casos; 0.7 %) y ductal con componente mucinoso (5 casos; 1.3 %), de los cuales 56.2 % (212 casos) corresponden a luminal B, 22.2 % (84 casos) a Luminal A, 14.8 % (56 casos) a triple negativo y 6.6 % (25 casos) a HER2. Estos hallazgos contrastan con la prevalencia reportada a nivel mundial. Por lo tanto, en la población del eje cafetero colombiano, se debe considerar este predominio del patrón luminal B al momento de establecer pronóstico y tratamiento por parte del personal médico tratante.
Abstract Breast cancer is the most common cancer in women and constitutes a public health problem due to its high rates of morbidity and mortality. Diagnosis is made through routine histopathology studies that are complemented by expression studies of hormone receptors (Estrogen and Progesterone Receptors), human epidermal growth factor 2 (HER2) and cell proliferation index (Ki67) for their subtyping into molecular groups (Luminal A, Luminal B, Her2 and triple negative), which have different prognostic and therapeutic implications. Globally, a high prevalence of the Luminal A subtype has been reported, predominantly in North America, Europe, and some Latin American countries; however, the reports in the Colombian population are heterogeneous. The objective of this research is to establish an incidence profile of these molecular subtypes in a population of the coffee region in Colombia. In retrospect, samples of 377 patients with a diagnosis of infiltrating breast cancer were analyzed, between the years 2015 and 2018. The histological diagnoses included: NOS infiltrating ductal carcinomas (339 cases; 89.9 %), infiltrating lobular (23 cases; 6.1%), infiltrating mucinous (6 cases; 1.5%), infiltrating papillary (1 case; 0.2%) and mixed patterns: ductal - lobular (3 cases; 0.7%) and ductal with mucinous component (5 cases; 1.3%), of which 56.2% (212 cases) correspond to luminal B, 22.2% (84 cases) to Luminal A, 14.8% (56 cases) to triple negative and 6.6% (25 cases) to HER2. These findings contrast with the prevalence reported worldwide. Therefore, in the population of the Colombian coffee region, this predominance of the luminal pattern B should be considered when establishing prognosis and treatment from medical staff.
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RESUMEN En Cuba, la transformación de la realidad por medio de la introducción de resultados científicos -en aras del desarrollo sostenible-, es una alta prioridad por parte de las primeras instancias de dirección desde 1959. La introducción de resultados investigativos ha sido abordada por prestigiosos autores desde diferentes aristas y contextos, pero existen escasas referencias relacionadas con el tema en el ámbito de las ciencias de la educación médica. En consecuencia, este artículo presenta un análisis sobre las tendencias del proceso de introducción de resultados científicos en el ámbito académico, para luego delinear cuáles pudieran ser las bases teórico-metodológicas para la mejora del proceso en el ámbito de la educación médica (AU).
ABSTRACT In Cuba, the transformation of reality through the introduction of scientific results -for the sake of the sustainable development- is a high priority for the first instances of direction since 1959. The introduction of research results has been approached by prestigious authors from different edges and in different contexts, but there are few references related to the theme in the field of the medical education sciences. Consequently, this article presents an analysis on the tendencies of the process of introducing scientific results in the academic sphere, and then outlines the possible theoretic-methodological bases for improving the process in the field of medical education (AU).
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Humanos , Masculino , Femenino , Dominios Científicos , Estudios de Evaluación como Asunto , Enseñanza/educación , Formación de Concepto , Informe de Investigación/historiaRESUMEN
En las últimas décadas, la introducción temprana de alimentos en la dieta de los lactantes se ha descrito como un factor de riesgo para el desarrollo de ciertas patologías, entre las que destacan las alergias alimentarias. Debido a la creciente prevalencia de las alergias alimentarias, tanto en países en vías de desarrollo como en países desarrollados, resulta necesario identificar el momento óptimo de introducción de alimentos para la prevención de alergias en lactantes de alto riesgo. La evidencia más reciente, ha demostrado que las estrategias propuestas hasta el momento de retrasar la exposición a los alimentos alergénicos, no ha reducido el riesgo de desarrollar alergias. Esto ha producido un cambio de paradigma que ha derivado en la publicación de nuevas guías que recomiendan no retrasar la introducción de alimentos sólidos después de los 4-6 meses de edad, tanto en lactantes de bajo como de alto riesgo, para prevenir la alergia alimentaria. En la presente revisión, se describe la evidencia científica actual sobre la relación entre el momento de la introducción de alimentos alergénicos (maní, huevos, leche, cereales y pescado) en la dieta de los lactantes y el desarrollo de alergias alimentarias(AU)
In recent decades, the early introduction of foods in infants' diet has been described as a risk factor for developing specific pathologies, among which food allergies stand out. Due to the increasing prevalence of food allergies, both in developing and developed countries, it is necessary to identify the optimal time to introduce foods to prevent allergies in high-risk infants. The most recent evidence has shown that the strategies proposed to delay exposure to allergenic foods have not reduced the risk of developing allergies. Therefore, a paradigm shift has led to the publication of new guidelines that recommend not delaying the introduction of solid foods after 4-6 months of age, both in low-risk and high-risk infants, to prevent food allergy. In this review, we describe the current scientific evidence on the relationship between the timing of the introduction of allergenic foods (peanuts, eggs, milk, cereals, and fish) into infants' diet and the development of food allergies(AU)
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Humanos , Masculino , Lactante , Lactancia Materna , Hipersensibilidad a los Alimentos , Fenómenos Fisiológicos Nutricionales del Lactante , Factores de Riesgo , Ingestión de Alimentos , LactanteRESUMEN
Resumen El presente artículo tiene como objetivos la valorización del cuidado no remunerado en salud en Uruguay y la caracterización de los/as cuidadores/as (remunerado o no) de personas enfermas. Dichos objetivos son llevados a cabo, principalmente, mediante el análisis cuantitativo de los datos de la primera Encuesta Nacional de Cuidados No Remunerados en Salud (2013) en Uruguay. La encuesta permite conocer y valorizar (método de costo de reemplazo) el tiempo de cuidados no remunerados en salud, así como la caracterización de las/os cuidadoras/es no remunerados en salud. El artículo muestra que el trabajo de cuidados no remunerados en salud realizado por los hogares equivale a un tercio del agregado del sector salud del Producto Interno Bruto y que las mujeres son las principales cuidadoras. En consecuencia, asumen los costos de pérdida de autonomía y limitaciones en el goce de derechos que la realización de este trabajo implica.
Abstract This paper is intended to determine the worth of unpaid health care in Uruguay and to characterize the caregivers (either paid or unpaid) who serve ill people. These objectives are accomplished mainly through the quantitative analysis of the data gathered by the first National Survey of Unpaid Health Care (2013) in Uruguay. This survey enables to become aware and set the worth of the unpaid health care times (replacement cost method) and to characterize the unpaid caregivers. This paper shows how the unpaid health care provided by homes accounts for a third of whole health care aggregate in the Gross Domestic Product. Women are the main caregivers, thus assuming the costs of losing their autonomy and seeing reduced the opportunities to enjoy their rights.
Resumo O presente artigo tem como objetivo a valorização do cuidado não remunerado em saúde em Uruguai e a caracterização dos cuidadores e das cuidadoras (remunerados ou não) de pessoas doentes. Tais objetivos são levados a cabo, principalmente, mediante análise quantitativa dos dados do primeiro Inquérito Nacional de Cuidados Não Remunerados em Saúde (2013) em Uruguai. O inquérito permitiu conhecer e valorizar (método de custo de reposição) o tempo de cuidados não remunerados em saúde, bem como a caracterização das/dos cuidadoras/es não remunerados em saúde. O artigo demonstra que o trabalho de cuidados não remunerados em saúde realizado pelas famílias equivale a um terço do agregado do setor saúde no Produto Interno Bruto e que as mulheres são as principais cuidadoras. Em consequência, assumem os custos de perda de autonomia e limitações no desfrute de direitos que a realização desse trabalho implica.
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Humanos , Uruguay/etnología , Política Pública , Atención a la SaludRESUMEN
Introducción: Las enfermedades peroxisomales son un grupo de trastornos monogénicos que incluyen desórdenes en la biogénesis del peroxisoma o deficiencias enzimáticas. La Condrodisplasia Rizomélica Punctata Tipo 1 (RCDP1) pertenece al primer grupo, es autosómica recesiva originada por mutaciones del gen PEX7, que codifica para el receptor PTS2. El objetivo del presente artículo son describir una enfermedad genética de baja prevalencia, explicando sus principales características y la importancia de la aproximación diagnóstica y asesoría genética. Caso clínico: Lactante masculino de 13 meses, sin antecedentes familiares ni consanguinidad. Al nacimiento presentaba acortamiento de miembros superiores. Fue intervenido a los 7 meses por catarata bilateral. Presentaba severo retardo del crecimiento, retraso del desarrollo psicomotor, anomalías menores craneofaciales, acortamiento rizomélico de miembros superiores y en menor grado de miembros inferiores. En la radiografía se identificaban calcificaciones punteadas del cartílago en rótula. Entre los exámenes de laboratorio destacaba elevación de los ácidos grasos fitánico y pristánico. El paciente falleció a la edad de 3 años. Discusión: Esta es una enfermedad rara, la prevalencia es 1/100.000, se han descrito diferentes mutaciones del gen PEX7 teniendo variación en el fenotipo. El tratamiento es básicamente sintomático y depende de la gravedad de las manifestaciones clínicas, el tipo rizomélico es de mal pronóstico, la mayoría de los pacientes no sobrevive antes de la primera década de vida. La asesoría genética es fundamental ya que se considera un riesgo del 25% de recurrencia.
Introduction: Peroxisomal diseases are a group of monogenic disorders that include defects in peroxisome biogenesis or enzyme dificiencies. Rhizomelic chondrodysplasia punctata type 1 (RCDP1) belongs to the first group, caused by autosomal recessive mutations on PEX7 gene, encoding for PTS2 receptor. The aims of this report are to describe a genetic disease of low prevalence, explaining its main characteristics and the importance of the diagnostic approach and genetic counseling. Case report: 13-month-old male infant with no medical history, family or consanguinity, demonstrate at birth upper limbs shortening. Surgery intervention at seven months old for bilateral cataract. Growth retardation, psychomotor retardation, minor craniofacial anomalies, rhyzomelic shortened upper limbs and lower limbs lesser degree. Punctata calcifications in patella cartilage. Also fatty acid phytanic and pristanic increased levels. Patient dead at age of 3 years. Discussion: RCDP1 is a rare disease, with a prevalence of 1/100,000. Different mutations of PEX7 gene have been described, with variations in phenotype. The treatment is basically symptomatic and depends on the severity of clinical manifestations. The rhizomelic type has poor prognosis, most patients do not survive before the first decade of live. Genetic counseling is essential because it is consider a 25% risk of recurrence.
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Humanos , Masculino , Lactante , Condrodisplasia Punctata Rizomélica/diagnóstico , Resultado Fatal , Condrodisplasia Punctata Rizomélica/genética , Receptor de la Señal 2 de Direccionamiento al Peroxisoma/deficiencia , Asesoramiento GenéticoRESUMEN
El impacto de la diabetes tipo 1 (DM1) en el rendimiento escolar es controversial. Objetivo: Evaluar la relación entre rendimiento escolar y control metabólico en niños con DM1 (N-DM1) y comparar sus resultados con niños de la población general (N-PG). Pacientes y Método: Se revisaron datos clínicos de 66 N-DM1. Se compararon las calificaciones de N-DM1 según Hemoglobina Glicosilada (HbA1c) < 7,5% y ≥ 7,5% con N-PG del mismo nivel, comuna, tipo de colegio (municipal, particular subvencionado y particular pagado) y localidad. Para la comparación de los grupos se utilizó la regresión lineal simple y el test de suma de los rangos de Wilcoxon (Mann y Whitney) previa comprobación de incumplimiento de normalidad con el test de Shapiro-Wilk según el caso. Se consideró un valor de p < 0,05 como estadísticamente significativo con una confiabilidad del 95%. Resultados: La edad fue 13,4 ± 2,9 años, tiempo de evolución DM1 5,3 ± 3,2 años, HbA1c 8,6 ± 1,9% y controles de glicemia capilar 3,2 ± 1,2 veces por día. Las calificaciones no mostraron correlación con HbA1c, duración de DM1, hipotiroidismo, problemas de salud mental, antecedentes de hipoglicemia ni de cetoacidosis. N-DM1 de educación básica mostraron calificaciones inferiores a N-PG del mismo nivel 5,6 ± 0,7 vs 6,0 ± 0,2 (p = 0,0002). Las calificaciones se correlacionaron con el número de controles diarios de glicemia capilar, coeficiente de correlación de Pearson (r) de 0,25, 0,41, 0,52 y 0,58 con el promedio general, matemática, lenguaje e historia respectivamente (p < 0,05). Un 6,1% de N-DM1 y 4,8% de N-PG no fue promovido de curso (p = 0,65). La deserción escolar fue 10,5% en N-DM1 y 7,7% en N-PG (p = 0,47). Conclusión: N-DM1que cursaban educación básica tuvieron calificaciones inferiores a N-PG y los pacientes que controlaban su glicemia capilar con mayor frecuencia mostraron mejores calificaciones. La DM1 puede tener un impacto deletéreo en el rendimiento escolar.
The impact of type 1 diabetes (T1D) on school performance is controversial. Objective: To study the relationship between school performance and metabolic control in children with T1D (Ch-T1D), comparing their school grades to general population children (Ch-GP). Patients and Method: Clinical data for 66 Ch-T1D was reviewed, school grades were compared in Ch-T1D with Glycated Haemoglobin (HbA1c) HbA1c < 7.5% and ≥ 7.5%. School marks were also compared between Ch-T1D and Ch-GP from the same level, community and school type (public, private o chartered). Simple linear regression analysis and Mann Whitney test were used to compare groups. A p < 0.05 was considered significant. Results: Ch-T1D were: 13.4 ± 2.9 years old, T1D duration: 5.3 ± 3.2 years, HbA1c was 8.6 ± 1.9% and capillary blood glucose was measured 3.2 ± 1.2 times per day. Grade averages showed no correlation with HbA1c, diabetes duration, hypothyroidism, mental health issues, neither with hypoglycemia or ketoacidosis records. However, primary education Ch-T1D showed lower grades than Ch-GP 5.6 ± 0.7 and 6.0 ± 0.2 (p = 0,0002). School grades correlated with the number of capillary blood glucose readings per day, Pearson correlation coefficient (r) 0.25, 0.41, 0.52 and 0.58 with general grade point average, math, language, and history average respectively (p < 0.05). School non-pass rate was 6.1% in Ch-T1D and 4.8% in Ch-GP (p = 0.65) and school dropout rate was 10.5% in Ch-T1D and 7.7% in Ch-GP (p = 0.47). Conclusion: Ch-T1D attending primary school showed lower school grades than Ch-GP, and patients who more frequently checked capillary blood glucose showed better school grades. T1D may have a deleterious impact on school performance.
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Humanos , Masculino , Femenino , Niño , Adolescente , Glucemia/metabolismo , Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 1/sangre , Rendimiento Académico/estadística & datos numéricos , Hemoglobina Glucada/metabolismo , Biomarcadores/sangre , Modelos Lineales , Estudios Retrospectivos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Hipoglucemiantes/uso terapéuticoRESUMEN
background: Early management of myocardial infarction in the area of public health requires the integration of specific programs for the coordination of healthcare services. Objective: The aim of this study was to evaluate the impact on delay times and reperfusion rate of a comprehensive program for the reperfusion of myocardial infarction in a hospital network of the Southern Greater Buenos Aires. Methods: The network consists of six low-mid-complexity hospitals and a third-level referral center with 24-hour cath-lab. Stage 1 of the program (2009-2010) evaluated the existing barriers to reperfusion; Stage 2 (2011-2013) implemented the progressive incorpora-tion of improvements and Stage 3 assessed the program (2013-2014) complemented with fellows in each hospital. Program impact was evaluated by the proportion of patients reperfused and time to its implementation. results: A total of 432 patients referred from the network were hospitalized with diagnosis of ST-segment elevation myocardial infarction. Mean age was 56±9 years and 83.3% were men. The proportion of reperfused patients progressively increased: S1 60.7%, S2 69% and S3 78%, p for trend=0.01. Time to reperfusion decreased significantly between S1 and S3, from 120 minutes (IQR 55-240) to 90 minutes (IQR 35-150), p=0.04, with a median reduction of 30 minutes in the door-to-balloon and door-to-needle times. Conclusions: The application of a program for myocardial reperfusion based on the diagnosis of barriers was associated with 28.5% increase in reperfusion, and a significant reduction in the implementation times. This public network model built on algorithms adapted to local barriers may contribute to improve the care of myocardial infarction in our country.
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background: Although various studies refer to the effect of meditation on blood pressure (BP), its impact on other cardiovascular clinical variables is unknown. Objective: The aim of this study was to evaluate the effects of a meditation program on pulse wave velocity (PWV), quality of life and ultrasensitive C-reactive protein (us-CRP) in patients with ischemic heart disease or chronic heart failure. Methods: This was a randomized study with two groups of patients: a meditation group (M) and an active control group (AC) with cardiovascular health education, evaluating the difference between initial and final values at 12 weeks of B P, PWV, quality of life (assessed by the SF-36 questionnaire) and us-CRP. results: Thirty-five patients were included in the M group and 35 in the AC group; mean age was 61 years and 80% were men. Both groups had similar baseline characteristics, except for higher number of smokers and triglyceride levels in the M group. At 12 weeks, no significant differences were found for ∆PWV: +0.51 (±1.40) in AC and +0.19 (±1.53) in M (p=0.37). Conversely, ∆SF-36 was +0.79 (±7.58) in AC vs. +5.40 (±9.69) (p=0.03) in M, and ∆us-PCR was +1.17 (±2.9) in AC vs. -0.69 (±0.89) in M (p=0.02). Conclusions: A meditation program did not significantly modify PWV at 12 weeks. However, patients allocated to this intervention improved their quality of life and us-PCR was significantly reduced. Larger studies are required to confirm these findings and explore the mechanisms involved in this improvement.
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background: Physical examination is essential to detect aortic stenosis but there is scarce information currently available. Objectives: The goal of this study is to evaluate the diagnostic yield of physical examination, the interobserver agreement of clinical signs, and to establish a score to identify severe aortic stenosis. Methods: One-hundred patients were included in the study. Before echocardiographic evaluation, two cardiologists independently evaluated the clinical signs of the physical examination in aortic stenosis. Sensitivity, specificity, and inter-observer agreement were calculated, and the area under the curve was analyzed to develop a score for predicting severe aortic stenosis. results: The decreased intensity of the first heart sound and the crescendo-decrescendo shape of the murmur had sensitivity >90% and specificity <70%. The specificities of an absent second sound, a murmur that peaks later in systole and the presence of a parvus et tardus pulse were >95%, but the sensitivities were <50%. Inter-observer agreement was good for most criteria, except for murmur shape and intensity. The best area under the curve was achieved by the score composed of heart sounds of decreased or absent intensity, duration of the holosystolic murmur, parvus et tardus carotid pulse and a grade 3-4 systolic murmur. Conclusions: Physical examination findings have low sensitivity but good specificity. Inter-observer agreement of clinical signs of severity was moderately good. Correct identification of patients with severe aortic stenosis can be achieved using a simple score.
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background: Percutaneous septal ablation is a therapeutic option for patients with obstructive hypertrophic cardiomyopathy refrac-tory to optimal medical therapy. However, results of initial persistence and long-term safety are still controversial. Objectives: The aim of this study was to report percutaneous alcohol septal ablation technique, clinical and functional outcome, cardiovascular events and its impact on long-term follow-up. Methods: A total of 23 patients were included in the study. Functional class (FC), left ventricular outflow tract gradient before and after the procedure and long-term cardiovascular events were evaluated. results: Median follow-up was 52 months (IR 33-72). All patients were in FC III or IV prior to the procedure, under maximum tolerated medical therapy. The procedure was successful in 91% of cases, with 85% of patients currently in FC I and 15% in FC II. Baseline left ventricular outflow tract gradient decreased from 75 mmHg (95% CI 51-89) to 25 mmHg (95% CI 10-37) (p <0.003) and with Valsalva maneuver from 118 mmHg (95% CI 88-152) to 38 mmHg (95% CI 16-69) (p <0.0002), persisting in the long-term follow-up. During hospitalization, two patients presented with complete atrioventricular block requiring permanent pacemaker implantation. No cardiovascular deaths occurred during follow up. Conclusions: Alcohol septal ablation is a promising option for the treatment of a selected population with hypertrophic obstructive cardiomyopathy, generating sustained clinical and functional improvement with low incidence of events in the long-term follow up.
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background: Smoking is the leading cause of preventable morbidity and death. It is important to know the characteristics of smoking habits among physicians and their attitude toward patients who smoke. Objective: The aim of this study is to investigate the prevalence of smoking among physicians in Argentina, the factors associated with tobacco consumption and their attitude toward their patients who smoke. Methods: An observational cross- sectional study was performed between June and December 2013 in Argentine physicians of dif-ferent specialties. Using a structured survey, the following variables were analyzed: associated cardiovascular risk factors, charac-teristics of tobacco consumption, smoking cessation training and the attitude toward the patient who smokes. results: 3,033 physicians were surveyed, ; 57% were men, and mean age was 41.3±12 years; 19.7% were current smokers and 21.7% were former smokers. The probability of being a smoker was higher among surgeons (OR 1.29) or physicians working at the emergency room (OR 1.41). Undergraduate and postgraduate tobacco cessation training was achieved by 36.6% and 40.8% of physicians, respectively. Young physicians, clinical specialties or private practice were associated with higher level of training. Tobacco cessation counseling was more frequent in physicians with higher level of training than physicians who smoked or surgeons. Former smokers presented higher prevalence of risk factors and cardiovascular events. Family history of smoking habit was more common in former smokers and current smokers. Conclusions: The prevalence of smoking among Argentine physicians is high. Different factors are involved in the probability of smoking, tobacco cessation training or the possibility of medical counseling. Higher level of training in smoking cessation must be provided.
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La introducción de especies de peces ha sido considerada como uno de los problemas más difíciles de conservación de la biodiversidad, ya que la degradación de los ecosistemas naturales que ha venido ocurriendo en todo el mundo ha provocado que las especies no nativas se establezcan y se conviertan en invasoras con mayor facilidad. Objetivo: dada la importancia de la introducción de especies de peces y el papel que desempeñan sobre las especies nativas, realizamos una revisión bibliográfica, donde introducimos al lector a cerca del concepto de introducción de especies, algunos aspectos en la introducción de peces no nativos, describimos el conocimiento actual de las especies de peces introducidos en Colombia, y por último determinamos el estado actual de conocimiento sobre las especies de peces introducidas en los ecosistemas fluviales del departamento de Caldas. Metodología: Se realizo un compendio de información con base en artículos, libros e informes técnicos, acerca de la introducción de peces en el departamento de Caldas. Resultados: se registran 18 especies introducidas en aguas naturales de carácter invasor y 72 introducidas en cuerpos de agua artificiales (acuarios y estaques). Del total de especies no nativas 33 pertenecen al orden Perciformes, seguido de los Cypriniformes (12 especies),Characiformes (8 especies) y Cyprinodontiformes (8 especies). Las familias con mayor número de especies no nativas corresponden en su orden: Cichlidae con 24, Cyprinidae con 12 y Poeciliidae con ocho. Conclusiones: la permanencia de estas especies en el departamento de Caldas puede desencadenar efectos en los ecosistemas fluviales, por lo que hay que aplicar normas preventivas para llevar a cabo introducciones de especies en la región.
The introduction of fish species has been considered as one of the most difficult issues of biodiversity conservation since the degradation of natural ecosystems which has been occurring all around the world has caused that non- native species establish themselves and easily become invaders. Objective: Because of the importance of introducing fish species and their role in native species, a bibliographic review was carried out in which the reader gets introduced to the concept of introduction of species, some aspects of introduction of non- native fish species, describing the current knowledge about the introduced species of fish in Colombia, and finally, the present state of the knowledge of introduced species in the fluvial ecosystems of the department of Caldas is determined. Methodology: A summary of information based on articles, books and technical reports dealing with the introduction of fish in the department of Caldas was carried out. Results: Eighteen species were registered as introduced in natural water as invaders and 72 were registered as introduced in artificial water tanks (aquariums and ponds). From the total of non- native species, 33 belong to the Perciformes order, 12 to Cypriniformes order, 8 species to Characiformes order and 8 species to Cyprinodontiformes order. The families with the greatest number of non-native species are: Cichlidae (24 species), Cyprinidae (12 species) and Poeciliidae (8 species). Conclusions: the permanence of these species in the department of Caldas can trigger effects in the fluvial ecosystems, reason why it is necessary to apply preventive regulations in order to carry out introduction of species in this region.
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Humanos , Peces , Trasplante , Colombia , Especies IntroducidasRESUMEN
A propósito de 2 casos clínicos de pacientes con antecedente de enterocolitis neonatal, se presenta el temade síndrome de enterocolitis inducido por proteínas de la dieta. Este es un tipo de alergia alimentaria no mediada por Ig E, de presentación severa, con incidencia y prevalencia desconocidas y cuya sospecha clínica, diagnóstico y manejo oportuno, se anteponen al desarrollo de complicaciones severas que incluso pueden llevar a la muerte.
Two case reports of patients with neonatal enterocolitis present the topic of Food Protein-Induced EnterocolitisSyndrome (FPIES). FPIES is a type of food allergy which is not mediated by IgE and which has a severe presentation.Its incidence and prevalence are unknown. Clinical suspicion, diagnosis, and timely management are important in light of likely development of severe complications which can even lead to death.
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Humanos , Masculino , Recién Nacido , Lactante , Preescolar , Sustitutos de la Leche Humana , Enterocolitis , Lactancia , ProteínasRESUMEN
Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet infant nutritional requirements and therefore other liquids and feed are needed along with it. The aim of this study was to identify the main characteristics of early complementary feeding in children under 6 months of age. This study compared the data from two cross-sectional population based studies carried out in the municipality of Rio Grande, State of Rio Grande do Sul, Brazil, in 1995 and 2004. There was a significant reduction in the proportion of children drinking water and tea in the first month of life. Besides, there was an increase in the proportion of children that started receiving juices, artificial milk, cow milk, vegetables, meat, fruits and beans after the sixth month of life. Thus, there is still high prevalence of precocious feed introduction to children?s diet in that municipality.
La alimentación complementaria es la introducción de alimentos y líquidos en la dieta de los bebés cuando la lactancia materna no es suficiente para satisfacer sus necesidades nutritivas. El objetivo de este estudio fue identificar las principales características de la alimentación complementaria temprana en niños menores de 6 meses. Se compararon los datos obtenidos en dos estudios transversales de base poblacional realizados en Río Grande, RS, Brasil, en 1995 y 2004. Hubo reducción significativa en la proporción de niños que bebieron agua y tés en el primer mes de vida. Hubo, además, un aumento en la proporción de niños que recibieron jugos, leche artificial, leche de la vaca, verduras, carne, frutas y frijoles después del sexto mes de vida. Todavía se introducen alimentos de manera precoz en la dieta de los niños de esa ciudad.
Alimentação complementar é o processo iniciado quando o leite materno não é suficiente para atingir as necessidades dos bebês, precisando-se introduzir outros alimentos e líquidos à dieta. O objetivo deste estudo foi identificar as principais características da introdução de alimentos precocemente, em crianças com menos de 6 meses de vida. Este estudo foi feito através da comparação dos dados obtidos em dois estudos transversais de base populacional realizados na cidade do Rio Grande/RS, Brasil, em 1995 e 2004. Ocorreram reduções significativas na proporção de crianças que ingeriram água e chás no primeiro mês de vida. Além disso, houve um aumento na proporção de crianças que começaram a receber sucos, leite artificial, leite de vaca, vegetais, carnes, frutas e feijão após o sexto mês de vida. Ainda existem altas prevalências de introdução de alimentos precocemente à dieta das crianças desta cidade.
Asunto(s)
Niño , Nutrición del Niño , Fenómenos Fisiológicos Nutricionales del Lactante/normas , Lactancia Materna , Alimentos InfantilesRESUMEN
Introducción: la universidad cubana ha extendido su presencia a todos los municipios del país, con la apertura de las Sedes Universitarias Municipales (SUM). Objetivo: evaluar la calidad de los resultados académicos en estudiantes de medicina de la SUM de Ciencias Médicas Los Palacios durante el curso 2008- 2009, después de aplicada una intervención sobre las diferencias individuales. Métodos: Investigación-acción, constituyen el universo y muestra 30 estudiantes; se estudiaron variables como: vía de ingreso, orientación vocacional, nivel escolar de los padres, hijos y/o familiares que atender; se utilizaron medidas de resúmenes para datos cualitativos y la ventaja de éxito o razón de productos cruzados (OR). Resultados: la vía de ingreso, Curso de Superación Integral para Jóvenes (CSIPJ), incrementó en 16 veces el riesgo de suspender o no ser evaluado; el no tener padres universitarios lo incrementó en 6,0 veces y no poseer orientación vocacional adecuada hizo que se incrementara el riesgo de suspender o no ser evaluado en 29 veces; con la intervención se logró que no hubieran estudiantes suspensos y no evaluados, pero el CSIPJ continuó siendo la vía que incrementó en 8 veces el ser evaluado de regular. Conclusiones: la calidad de los resultados académicos en estudiantes de medicina, mejoró notablemente después de la intervención sobre las diferencias individuales, las de más influencia fueron la orientación vocacional, la vía de ingreso y el nivel escolar de los padres
The Cuban university has been extended to all the municipalities in the country through the setting up of the municipal university affiliates. Objective: to evaluate the quality of the academic results of medical students in the municipal university affiliate in Los Palacios in the 2008-2009 academic year, after an intervention on individual differences. Methods: research-action; the universe of study and the sample was made up of 30 medical students and the study variables were way of entrance in the university, vocational orientation, educational level of parents, children and/or relatives. Summary measures for qualitative data and odd ratios were used. Results: the way of entrance in the university known as Integrated Upgrading Course for Young People increased the risk of failing a test or the risk of not being evaluated by 16 times; having parents who did not attain university degree rose that risk by 6 times ; and the lack of adequate vocation increased it by 29 times. After the intervention, the number of students failing a test or not being evaluated was reduced to zero; however, the Integrated Upgrading Course for Young People continued being the way of entering the university that increased by 8 times the evaluation of students as Regular. Conclusions: the quality of academic results in medical students improved significantly after the intervention on individual differences, being the vocational orientation, the way of entrance in the university and the educational level of parents the most influential factors
Asunto(s)
Individualidad , Estudiantes , Orientación VocacionalRESUMEN
In Uruguay, as well as in other regions of the world, IAS cause negative impacts on natural and managed ecosystems. The use of databases is a helpful tool to elaborate different strategies for prevention and control, and to develop policies and scientific analyses related to IAS. The database of IAS in Uruguay (InBUy) was developed during two time periods (2006-2007 and 2009-2010). It currently contains information on 33 specialists of different taxonomic groups, 14 research projects, 185 references, 351 species and 4,715 records, with vascular plants having both the highest number of species and records. Among vascular plants, herbaceous life forms are the most strongly represented, followed by trees and shrubs. Within animals, the fishes and mollusks are the most important groups. Analysis of the native distribution areas of IAS showed that most are indigenous from Europe, followed by Asia and Oceania. Data showed that introductions of IAS into Uruguay are mainly intentional (67 percent), so efforts should be focused on policies and rules in order to control the entrance of exotic organisms and prevent new invasions. The geography of the compiled dataset shows the main impact is along the coastline, where the highest exotic species richness and records occurs, and also the most biological invasions. The InBUy database is up-to-date and has successfully contributed to the creation of an official IAS list for Uruguay and both a National and a Coastal Geographic Information System. It has also been used for developing consciousness about this important threat to biodiversity, at both national and regional scales.
En Uruguay, al igual que en otras partes del mundo, las EEI han causado impactos negativos sobre los sistemas naturales y productivos. El uso de bases de datos a nivel mundial es una herramienta útil para elaborar estrategias de prevención y control, y para desarrollar políticas y análisis científicos en relación a las EEI. La base de datos de EEI en Uruguay (InBUy) fue desarrollada durante dos períodos (2006-2007 y 2009-2010). Actualmente contiene información de 33 especialistas de diferentes grupos taxonómicos, 14 proyectos de investigación, 185 referencias bibliográficas, 351 especies y 4715 registros, donde las plantas vasculares presentan el mayor número de especies y registros. Entre las plantas vasculares, las herbáceas son la forma de vida más representada, seguida por árboles y arbustos. Dentro de los animales, los peces y moluscos son los grupos más importantes. El origen geográfico de las EEI muestra que la mayoría son nativas de Europa, seguido por Asia y Oceanía. Los datos recabados muestran que la introducción de EEI a Uruguay es mayormente intencional (67 por ciento), por tanto los esfuerzos deberían ser focalizados en políticas y reglamentaciones para controlar el ingreso de organismos exóticos y prevenir nuevas invasiones biológicas. Por otra parte, los datos muestran un impacto mayor sobre los ambientes costeros, donde fue registrado el mayor número de especies y registros, así como el mayor número de invasiones biológicas. Hasta la fecha, la base de datos InBUy ha contribuido exitosamente en la conformación de una lista oficial de EEI para Uruguay, y en la construcción de un Sistema Geográfico de Información Nacional y Costero. Asimismo, ha contribuido a la concientización a través de políticas de divulgación acerca de esta importante amenaza sobre la conservación de la biodiversidad, tanto a escala nacional como regional.
RESUMEN
La aplicación práctica de los resultados derivados de la investigación-desarrollo al sistema de salud y el avance propio de la Ciencia y la Técnica ha impuesto un reto a los investigadores, trabajadores y ejecutivos de las políticas de salud. Se destaca la importancia del diseño del proyecto de investigación-desarrollo que permite a una organización establecer su estrategia para poder acceder finalmente a la práctica social en términos de productos, tecnologías y servicios para la salud. Cuatro generaciones de investigación-desarrollo se reconocen hasta la era actual, la cuarta generación, llamada Administración del Conocimiento, está insertada en aquellos países con mayor desarrollo económico y social. Los países menos desarrollados no pueden acceder a ella por la carencia de recursos financieros y humanos y al fenómeno de que la mayor parte del conocimiento presente en las tecnologías de salud avanzadas es de propiedad privada, debido a los derechos de propiedad intelectual, fundamentalmente en países con altos niveles de desarrollo como los EE.UU., Japón y Europa Occidental. Sin embargo, existe una posibilidad para estos países menos desarrollados cuando se consideran la segunda y tercera generaciones de investigación-desarrollo, donde el factor clave es el proyecto de investigación-desarrollo. El presente trabajo se enfoca hacia los conceptos y condiciones para el diseño de estos proyectos en salud, que incluye todos los factores necesarios para alcanzar el éxito de la introducción del resultado y, por tanto, el objetivo principal de toda investigación en salud: llegar a los pacientes y elevar la calidad de vida de las poblaciones
The implementation of the results from research and development in the health care system and the inherent advance of Science and Technique have challenged researchers, workers and managers of the health policies. It was underlined that the design of the research and development project is important for the organization to set its own strategy to definitely accede to social practice in terms of health products, technologies and services. Four generations of research and development are acknowledged up to the present where the fourth generation called Knowledge Management is inserted into those countries with higher economic and social development. The less developed countries can not have access to this last generation because of the lack of financial and human resources and of the fact that most of knowledge present in advanced health technologies is private property as a result of copyright, mainly in highly developed countries like Japan, USA and Western Europe. However, there is a chance for these less developed nations when taking the second and third generations of research and development into consideration since the key factor here is the research and development project as such. The present paper focused on the concepts and conditions for the design of health projects including all the necessary factors to be successful in implementing the results, and therefore, in accomplishing the main objective of every health research work, that is, to reach the patients and to increase the quality of life of the populations
Asunto(s)
Evaluación de la Investigación en Salud , Proyectos de Investigación y DesarrolloRESUMEN
INTRODUCCCIÓN: Tagetes lucida Cav. se ha cultivado en Cuba en jardines por la belleza de su follaje, pero para su explotación con fines medicinales se requiere establecer su cultivo. OBJETIVO: determinar preliminarmente los parámetros agrícolas fundamentales que brinden la información necesaria para orientar los experimentos que proporcionen la introducción al cultivo de T. lucida. MÉTODOS: propagación de la especie mediante multiplicación sexual y asexual por estacas, establecimiento de los estaquilleros y porcentaje de estacas enraizadas, así como los relativos al cultivo: determinación del método de plantación en canteros de un 1 m de ancho, colocar 2 y 3 hileras de plantas y distanciamiento entre ellas de 30 y 40 cm; la evaluación de las mejores variantes se realizó mediante los resultados obtenidos en 2 cosechas de follaje. Se llevó paralelamente otro experimento preliminar relacionado con la distancia entre plantas, donde las estacas enraizadas se colocaron en 2 hileras y el distanciamiento fue de 30 y 50 cm entre plantas y se evaluaron 6 recolecciones de follaje. RESULTADOS: las semillas no germinaron, bajo nuestras condiciones, la multiplicación de T. lucida se debe efectuar mediante estacas de yemas terminales obtenidas de ramas jóvenes de plantas madres seleccionadas que han sido podadas con anterioridad, con lo que se logran altos porcentajes de estacas enraizadas y que puedan llevarse a cultivo a pleno sol, en un período de 25 a 30 d. Su cultivo mediante la plantación de 3 hileras de plantas por canteros con distanciamiento entre ellas de 30 cm, resultó la más adecuada, se determinó que en la segunda cosecha se duplican los rendimientos y que continúan incrementándose hasta la sexta recolección, donde los valores comienzan a disminuir y las plantas aparecen con alta proporción de tallos lignificados, lo que sugiere se haga una poda baja buscando obtener nuevos brotes o eliminar la plantación, aspecto que será estudiado ulteriormente...
INTRODUCTION: Tagetes lucida Cav. has been cultured in Cuba in gardens due to the beauty of its foliage, but to exploitation for medicinal aims it is necessary to establish its culture. OBJECTIVE: to determine before the fundamental agricultural parameters together with the necessary information to direct the experiment supplying the introduction to T. lucida culture. METHODS: authors used the species spreading by sexual multiplication and asexual by stakes, the establishing of the stretch with pegs and the percentage of rooted stakes, as well as the processes relative to culture: determination of 1 m wide planting in plots, to place 2 and 3 plant rows and a 30 and 40 cm distance among them; the assessment of the better variants was carrying out by results obtained in two foliage harvests. In parallel we made another preliminary experiment related to the distance among plants, where the rooted stakes were placed in two rows and the distance was of 30 and 50 cm among plants assessing 6 foliage harvests. RESULTS: under our conditions, seeds no germinate; multiplication of T. lucida must be carried out by terminal buds stakes obtained from young branches from the prior pruned selected mother plants achieving high percentages of rooted stakes that my be cultured in broad daylight during 25 to 30 days. Its culture by means of three row plantation by plots separated 30 cm was the better method and authors determined that in the second harvest yields are duplicate and remain increasing until the sixth harvest, where values decrease and the plants have a high ratio of lignified sprouts, suggesting the need of a low pruning looking for new buds or to eliminate the plantation, a feature that will be subsequently studied. CONCLUSIONS: these results are the basis for latter experiments to determine the agro-technology of this species due to its medicinal properties.
Asunto(s)
Producción de Cultivos , Tagetes/crecimiento & desarrolloRESUMEN
INTRODUCCIÓN: Artemisia annua L. es una especie originaria de China y Vietnam de interés medicinal para la producción de drogas antipalúdicas, por lo que resulta necesario establecer las condiciones de cultivo en Cuba. OBJETIVO: establecer algunos parámetros agrícolas fundamentales para el cultivo de A. annua. MÉTODOS: se empleó el método de siembra y la fecha de plantación, para lo que se establecieron semilleros en los meses desde diciembre de 2006 a mayo de 2007; posteriormente, a los 2 meses de la siembra, las posturas se trasplantaron a canteros de 1 m de ancho, a pleno sol, y se emplearon 2 variantes: 2 y 3 hileras de plantas y 60 cm de distanciamiento entre plantas, equivalentes a 6 y 9 plantas/m², respectivamente. Para evaluar las mejores variantes las plantas se cosecharon 4 meses después del trasplante, o sea, a la edad de 6 meses; los parßmetros analizados fueron la altura alcanzada en el momento de la cosecha y el rendimiento de follaje fresco. RESULTADOS: solamente se lograron los semilleros que se hicieron en los meses desde diciembre a febrero, con buena germinación, en un período de 10 d. En cuanto al crecimiento y rendimiento se determinó que los mayores valores se observaron en las plantas cultivadas en diciembre y enero y donde se colocaron 3 hileras de plantas/canteros. CONCLUSIONES: esta línea de A. annua introducida en Cuba, adaptada al ambiente tropical vietnamita, bajo las condiciones donde se realizaron los estudios, proporcionó gran adaptabilidad de los semilleros cuando se establecen entre diciembre y enero, así como un crecimiento vigoroso y rendimiento de biomasa adecuada cuando se trasplantan a canteros al sol, con densidad de población de aproximadamente 9 plantas/m², lo que permite hacer su cosecha durante la etapa vegetativa, a los 6 meses de edad, con altos rendimientos de follaje.
INTRODUCTION: Artemisa annua L. is a Vietnam and China-original species of medicinal interest for the anti-paludism drugs begin necessary to establish the culture conditions in Cuba. OBJECTIVE: to establish some fundamental agricultural parameters for A. annua culture. METHODS: we used the sowing method and the plantation date establishing seedbeds from December, 2006 to May, 2007; subsequently at 2 months of sowing, saplings were transplanted to plots of 1 m wide and 60 cm of distance among the plants, equivalent to 6 and 9 plants/m² respectively. To assess the better variants the plants were harvested 4 months after transplantation, that is, at 6 months old; analyzed parameters included the height achieved at the moment of harvest and the fresh foliage yield. RESULTS: we obtained only those seedbeds processed from December to February with a good germination during a period of 10 days. Regards the growth and the yield, we determined that the great values were observed en plants cultured in December and January and where three rows of plants/plots were placed. CONCLUSIONS: this species of A. annua introduced in Cuba and adapted to Vietnamese tropical environment, under conditions where studies were conducted, supplied a big seedbeds adaptation when they are established between December and January, as well as a strong growth and yield of the biomass suitable when seedbeds are transplanted to plots under sunlight, with a population density of approximately 9 plants/m² allowing its harvest during the vegetative stage at 6 months age with high foliage yields.
Asunto(s)
Producción de Cultivos , Artemisia annua/crecimiento & desarrollo , Malaria/tratamiento farmacológicoRESUMEN
Los paradigmas fundacionales de la biología surgen en Europa al margen de la medicina, pero las comunidades médicas los apropiarán socialmente, generando tensión en ellas. Originalmente las teorías celular y de la regulación fisiológica, no están relacionadas con lo médico, pero serán asimiladas a la nueva medicina y los estudios sobre herencia y microbiología, que desde su surgimiento si tienen vínculos con las prácticas médicas, serán apropiados de inmediato por esta medicina diferente. Esta 'domesticación social' del conocimiento implica operaciones de traducción donde surgirán versiones híbridas, con particularidades distintas a las europeas. Aquí se analiza y discute la introducción de paradigmas de la biología en México (siglos XIX y XX).
The functional paradigms of biology emerged in Europe on the margins of medicine, but medical communities appropriated them into society, thereby generating some friction between them. Originally, cell theory and theories about physiological processes did not concern physicians, but they became assimilated into the new medicine and studies into heredity and microbiology, which since their emergence had been close to medical practice, and were quickly appropriated by this new form of medicine. The 'social domestication' of this knowledge involved a process of translation to the new environment, giving rise to hybrid versions with quite distinct features from their European counterparts. Here, we analyze and discuss the introduction of biology paradigms into Mexico (19th and 20th centuries).