Farmacovigilancia y alertas del uso de recursos y productos en la medicina tradicional, alternativa y complementaria en el Perú (1997-2016) / Pharmacovigilance and alerts about use of resources and products in Traditional, Alternative and Complementary Medicine in Perú (1997-1976)

Objetivo: Caracterizar las notificaciones de reacciones adversas (RAM) y alertas DIGEMID, relacionadas a problemas de seguridad de las plantas medicinales y productos usados en la medicina tradicional, alternativa y complementaria (MTAC) correspondiente a los años 1997 al 2016. Materiales y métodos: Se realizó un estudio retrospectivo de las notificaciones de RAM y alertas DIGEMID de las plantas medicinales y productos usados en MTAC, las que fueron caracterizadas de acuerdo al tipo de RAM y seguridad. Resultados: En el periodo 1997 a 2016 la Autoridad Nacional de Productos Farmacéuticos, Dispositivos Médicos y Productos Sanitarios (ANM) recibió 28 notificaciones de RAM relacionados al uso de plantas medicinales y productos en MTAC, las que fueron catalogadas como grave 1 (4%), serias 4 (14%), no serias 22 (78%) y no especificada 1 (4%); las principales RAM fueron dermatitis, urticaria, prurito, erupción cutánea, mareos, convulsiones, acidosis y hepatotoxicidad. La ANM emitió 798 alertas DIGEMID, de las cuales 11 (1%) corresponde a plantas medicinales o productos usados en MTAC; de ellas, las alertas por seguridad representan el (73%), calidad (9%) y productos falsificados o venta ilegal (18%). Los principales problemas de seguridad son concordantes con las RAM mencionadas y las interacciones medicamentosas. Arnica montana, Illicium verum, I. anisatum, Desmodium molliculum, Tiquilia paronychioides, Aloe vera y Uncaria sp, o sus preparados, deben ser usadas bajo vigilancia. Conclusión: Durante los años 1997-2016 solo se notificaron 28 RAM y emitieron 11 alertas DIGEMID relacionados al uso de plantas medicinales y productos en medicina tradicional alternativa y complementaria (MTAC); por lo que, la Autoridad Nacional de Productos Farmacéuticos, Dispositivos Médicos y Productos Sanitarios (ANM) en su rol de conductor del Sistema Peruano de Farmacovigilancia y Tecnovigilancia debe proponer estrategias e instrumentos que permitan incrementar la notificación de RAM y establecer su vigilancia activa.

Mal de Simioto: práticas de saúde às crianças no interior do Brasil / Simioto's disease: health practice for children in the interior of Brazil

The "Simioto'sDisease" is a disease that has popular legitimacy and influences the search for treatment for infant health problems. This study aimed to understand the health practices related to Simioto'sDisease in a city in the interior of Brazil, from the perspective of parents of treated children. This is a qualitative and descriptive study performed by obtaining data using a semi-structured questionnaire with parents of children who were diagnosed and treated for the Simioto'sDisease. The data were subjected to content analysis. The categories discussedwere: The Simioto'sDisease pathology and its cultural aspects: symptoms, diagnosis, treatment and its indications and effectiveness; Relationship between Simioto'sDisease and professionalhealth care; The profile of healers or informal care and religiosity in the care of Simioto'sDisease. It was concluded that diagnosis and treatment are practices based on symptoms that generate a popular diagnosis. By describing the parent perspective, this practice is based on the belief of the treatmentefficacy and is legitimized by the healer reception, guidelines and precautionary measures of the disease that are passed, among other care, in addition to the baths performing frequency.

O "Mal de Simioto" é uma doença que possui legitimidade popular e queinfluencia a busca por tratamento para problemas de saúde infantil. Objetivou-se compreender as práticas de saúde relacionadas ao Mal de Simioto em um município no interior do Brasil, na perspectiva dos pais das crianças tratadas. Estudo qualitativo, descritivo, realizado através da obtenção de dados com o uso de questionário semiestruturado com os pais de crianças que foram diagnosticadas e tratadas com o Mal de Simioto. Os dados foram submetidos à análise de conteúdo.As categorias discutidas foram: A patologia Mal de Simioto e seus aspectos culturais: os sintomas, o diagnóstico, o tratamento e sua indicação e eficácia; Relação entre Mal de Simioto e os cuidados profissionais de saúde;Operfil dos curandeiros ou cuidadores informais e a religiosidade no cuidado ao Mal de Simioto. Concluiu-se queo diagnóstico e o tratamento são práticas baseadas em sintomas que geram um diagnóstico popular. Através da descrição pela perspectiva dos pais, essa práticabaseia-se na crença da eficácia do tratamento e é legitimada pelo acolhimento do curandeiro,das orientações e medidas de precaução da doença que são repassadas, entre outros cuidados, além da periodicidade de realização dos banhos.

Hepatotoxicidad asociada a hierbas y productos nutricionales de origen botánico / Herbals and herbal nutritional products hepatotoxicity

Las hierbas y otros productos de origen botánico, han sido utilizados por siglos en diversas culturas con fines medicinales y dietéticos. Contrario a la creencia de ser productos naturales y seguros, su potencial hepatotóxico es reconocido en diversos estudios a nivel mundial, lo que constituye un problema de salud que amerita mayor atención. La prevalencia reportada de hepatotoxicidad asociada a productos botánicos es variable y depende de diversos factores como población estudiada, período y diseño del estudio. Se han reportado un total de 60 productos a base de hierbas con fines medicinales y dietéticos, que pueden causar lesión hepática; sin embargo, el mecanismo fisiopatológico no está completamente dilucidado. Su cuadro clínico y características histológicas, no difieren de la lesión hepática asociada a medicamentos y la mayoría de los pacientes tienen un patrón de lesión hepatocelular. El diagnóstico se hace por exclusión, representando un desafío clínico importante, por lo que resulta fundamental la sospecha clínica y el diagnóstico diferencial de otras patologías agudas y crónicas. De allí que las investigaciones futuras están orientadas a mejorar los métodos diagnóstico existentes e introducir nuevas tecnologías toxicológicas, genéticas e inmunológicas. El manejo es complejo y representa un reto para el especialista puesto que no existe antídoto; el manejo se basa en suspender el uso del producto y en el tratamiento sintomático que disminuya la progresión a la falla hepática aguda fulminante.

Herbs and other botanicals have been used in different cultures with medicinal and dietary purposes for centuries. Contrary to the belief of being natural and safe products, their hepatotoxic potential is recognized in several studies worldwide, and represent a health problem that deserves greater attention. The reported prevalence of hepatotoxicity associated with botanicals is variable and depends on various factors such as population, period and design of the study. There have been reports of a total of 60 products with herbal medicinal and dietary purposes, which may cause liver damage; however, the pathophysiological mechanisms involved are not fully elucidated. Their clinical and histological features, not unlike liver injury associated with drugs in most patients, have a pattern of hepatocellular injury. Diagnosis is by exclusion, and represents a clinical challenge. It is essential the clinical suspicion and the differential diagnosis with other acute and chronic conditions. Hence, future researches are aimed at improving existing diagnostic methods and introducing new toxicological, genetic and immunological technologies. Treatment is complex and presents a challenge for the specialist, as there are no antidotes. Management based on the discontinued use of the product and in the symptomatic treatment, decreases the progression to an acute fulminant hepatic failure.

Susceptibilidade microbiana de bactérias e fungos frente ao extrato de Psidium guajara L: avaliação in vitro / Microbial susceptibility of bacteria and fungi against extracts of Psidium guajava L: in vitro evaluation

Aim: The present study aimed to evaluate the in vitro antimicrobial activity of hydroalcoholic and aqueous extracts from leaves of P. guajava on four bacterial and two fungal samples to determine the range of minimum inhibitory concentration of the extracts. Material and Methods: The antimicrobial activity of extracts of different polarities was compared using the agar dilution method. Differences in susceptibilityto the active ingredient could be observed. Results: The results showed that the hydroalcoholic extract wasactive against Escherichia coli (1024 ìg/ml) and Bacillus cereus (900 ìg/ml). The aqueous extract showedno antimicrobial activity. Conclusions: Despite demonstrating antimicrobial efficiency, the P. guajava extractmay be insufficient or may require a higher concentration to be fully effective.

Assessment of effects on health due to consumption of bitter bottle gourd (Lagenaria siceraria) juice.

Background & objectives: The bottle gourd (Lagenaria siceraria) is popularly known as lauki, ghia or dudhi in India. Its consumption is advocated by traditional healers for controlling diabetes mellitus, hypertension, liver diseases, weight loss and other associated benefits. However, in last few years there have been reports of suspected toxicity due to consumption of its juice. This led to the constitution of an Expert Committee by Department of Health Research at Indian Council of Medical Research (ICMR), Ministry of Health & Family Welfare, Government of India in October 2010. The committee looked into the issues related to safety of consumption of bottle gourd juice, and this paper presents the findings. Methods: Information on cases of suspected toxicity due to consumption of bottle gourd juice was collected by internet search, advertising on website of ICMR and by writing to State and district health authorities as well as to medical colleges, hospitals and private nursing homes across the country. Results: Three deaths were reported, one from Delhi and two from Uttar Pradesh after consumption of extremely bitter bottle gourd juice. Three persons who died after consumption of freshly prepared bottle gourd juice or juice mixed with bitter gourd (karela) juice were over 59 years of age and had diabetes since last 20 years. This juice was reported to be extremely bitter by all three. Twenty six persons were admitted to various hospitals of the country on complaint of abdominal pain and vomiting following consumption of freshly prepared bottle gourd juice. Diarrhoea and vomiting of blood (haematemesis) was reported in 18 (69.2%) and 19 (73.1%) patients, respectively. Biochemical investigations revealed elevated levels of liver enzymes. More than 50 per cent patients had hypotension. Endoscopic findings showed profusely bleeding stomach with excessive ulceration seen in distal oesophagus, stomach and duodenum in most of the cases. All these patients recovered fully and no sequeale was recorded for any of the cases. Interpretation & conclusions: Cucurbitaceae family, of which bottle gourd is a member contains the toxic tetracyclic triterpenoid compounds called cucurbitacins which are responsible for the bitter taste. There is no known antidote for this toxicity and clinicians treat such cases symptomatically only. The Committee made the following recommendations: (i) The community needs to be educated that bitter tasting bottle gourd juice should not be consumed and in case there is any discomfort, nausea, vomiting, diarrhoea or any feeling of uneasiness after consumption of juice, the person should immediately be taken to a nearby hospital. (ii) Clinicians are suggested that patients coming with symptoms (discomfort, nausea, vomiting, diarrhoea, gastrointestinal bleeding after consumption of juice) should immediately be attended to and general supportive care should be provided, i.e. IV fluids/crystalloids/blood products/ fresh frozen plasma to maintain the haemodynamics and electrolyte balance; Ryle’s tube to be put in for gastric lavage and to assess gastrointestinal (GI) bleed- aspirate to be preserved; Proton pump inhibitors should be given for management of GI bleed and appropriate treatment for other complications should be given. (iii) The possible research areas identified are chemical composition studies on bitter and normal bottle gourd and other members of cucurbitaceae family; animal toxicity studies and studies on interaction between bottle gourd juice and other drugs.

Plantas medicinais cultivadas em quintais de comunidades rurais no domínio do cerrado piauiense (Município de Demerval Lobão, Piauí, Brasil) / Medicinal plants cultivated in homegardens of rural communities in the domain of Cerrado in Piaui (Demerval Lobão Municipality, Piauí State, Brazil)

O conhecimento terapêutico acumulado por populações rurais através de séculos de estreito contato com o meio possibilita a obtenção de informações acerca do uso dos recursos naturais. O objetivo do presente trabalho foi realizar um inventário das plantas medicinais cultivadas em quintais do município de Demerval Lobão, Piauí, bem como, conhecer o emprego e a importância dessas espécies na comunidade. Foram amostrados 21 quintais em nove comunidades da zona rural do município de Demerval Lobão com vegetação de cerrado. O trabalho foi conduzido com os mantenedores dos quintais a partir de entrevistas semi-estruturadas e observação direta, associada à técnica de turnê-guiada. As plantas medicinais coletadas foram catalogadas, identificadas, e depositadas no Herbário Graziela Barroso (TEPB) da Universidade Federal do Piauí (UFPI). Foram referidas 100 espécies botânicas, predominantemente herbáceas e cultivadas, distribuídas em 49 famílias, sendo Leguminosae, Euphorbiaceae e Lamiaceae as mais representativas em número de espécies. Na preparação dos remédios, as folhas foram as mais utilizadas, sendo a decocção a principal forma de preparo. As doenças mais frequentes tratadas por remédios caseiros referem-se ao sistema respiratório e digestivo. Observou-se que não há rigidez quanto à posologia e a duração do tratamento, ficando este a critério do hábito de cada pessoa entrevistada. As plantas que apresentaram índice de importância relativa e concordância de uso (CUP) acima de 60% foram cansansão (Cnidosculus urens), boldo (Plectranthus barbatus Andrews), jurema-preta (Mimosa verrucosa Benth) e cidreira (Lippia alba (Mill.) N.E.Br. ex Britton & P.Wilson). P. barbatus foi a mais citada e também a que apresentou os índices mais altos de CUP (100%), fator de correção - FC (1,00) e concordância de uso corrigido - CUPc (100%) para dores no estômago e problemas no fígado. Observou-se a necessidade de resgatar o conhecimento acerca das plantas medicinais para contribuir na melhoria da qualidade de vida dos moradores da zona rural, como primeiro passo para a valorização e adequação dos recursos da medicina popular para o tratamento de doenças mais frequentes.

Therapeutic knowledge accumulated by rural populations, through centuries of direct contact with the environment, makes possible the gathering of information concerning use of natural resources. The aim of the present study was to carry out an inventory of the medicinal plants cultivated in homegardens of Demerval Lobão Municipality, Piauí State, Brazil, as well as to learn their uses and importance in the community. A total of 21 homegardens in nine communities of the rural area of Demerval Lobão Municipality with Cerrado vegetation were sampled. The study was conducted by means of semi-structured interviews and direct observation, associated with the technique of a tour guided by the keepers of the homegardens. The collected medicinal plants were cataloged, identified and deposited in the Herbarium Graziela Barroso (TEPB) of Federal University of Piauí (UFPI). Of 100 botanical species, predominantly herbaceous and cultivated species distributed in 49 families, were cited, and the most representative families in number of species were Leguminosae, Euphorbiaceae and Lamiaceae. For the preparation of medicines, leaves were most used and decoction was the main form of preparation. The most frequent diseases treated by homemade remedies are associated with the respiratory and digestive systems. There is no rigidity as to dosage and duration of treatment; it depended on the habit of each interviewed person. The plants that presented an index of relative importance and use agreement above 60% were the following: "cansansão" (Cnidosculus urens), "boldo" (Plectranthus barbatus Andrews), black-jurema (Mimosa verrucosa Benth) and "cidreira" (Lippia alba (Mill.) N.E.Br. ex Britton & P.Wilson). P. barbatus was most cited and also the species that presented the highest indices of CUP (100%), FC (1,00) and CUPc (100%) for stomach pains and liver problems. There is the need of rescuing knowledge concerning medicinal plants to contribute to the improvement of the life quality of the inhabitants of the rural area, as a first step for the appreciation and adaptation of resources of folk medicine for the treatment of the most frequent diseases.

Linden flower (Tilia spp.) as potential vehicle of Clostridium botulinum spores in the transmission of infant botulism / El té de tilo como vehículo potencial de esporas de Clostridium botulinum en la transmisión del botulismo infantil

Infant botulism is an intestinal toxemia caused principally by Clostridium botulinum. Since the infection occurs in the intestinal tract, numerous food products have been investigated for the presence of C. botulinum and its neurotoxins. In many countries, people use linden flower (Tilia spp) tea as a household remedy and give it to infants as a sedative. Therefore, to help provide a clear picture of this disease transmission, we investigated the presence of botulinum spores in linden flowers. In this study, we analyzed 100 samples of unwrapped linden flowers and 100 samples of linden flowers in tea bags to determine the prevalence and spore-load of C. botulinum. Results were analyzed by the Fisher test. We detected a prevalence of 3% of botulinum spores in the unwrapped linden flowers analyzed and a spore load of 30 spores per 100 grams. None of the industrialized linden flowers analyzed were contaminated with botulinum spores. C. botulinum type A was identified in two samples and type B in one sample. Linden flowers must be considered a potential vehicle of C. botulinum, and the ingestion of linden flower tea can represent a risk factor for infant botulism.

El botulismo del lactante es una toxiinfección causada, principalmente, por Clostridium botulinum. Debido a que esta infección ocurre en el tracto intestinal, la presencia de esta bacteria y sus neurotoxinas ha sido investigada en numerosos alimentos. En muchos países se utiliza el té de tilo (Tilia spp.) como sedante natural, el que se administra incluso a los lactantes. A fin de contribuir al esclarecimiento de la transmisión de esta enfermedad, se investigó la prevalencia y la carga de esporas botulínicas en esta hierba. Se analizaron 100 muestras de tilo comercializado a granel y 100 muestras de tilo industralizado en “saquitos”. Los resultados de prevalencia fueron analizados por el test de Fisher y la carga de esporas por la técnica del número más probable. Se halló una prevalencia de esporas de C. botulinum del 3% en el tilo comercializado a granel, con una carga de 30 esporas/100 g de hierba. En tanto, ninguna de las muestras en saquitos acusó la presencia del patógeno. Se identificaron tres cepas de C. botulinum, dos tipo A y una tipo B. En virtud de estos resultados, el tilo podría considerarse un potencial vehículo de esporas de C. botulinum y la administración de sus infusiones a menores y lactantes, un riesgo para la transmisión de la enfermedad.

Amputations of the upper limb at El Obeid hospital, western Sudan: role of traditional bone setters

Extremity amputation is common, but repugnant events to the patient and surgeon alike. Upper limb amputation results in incapacitating functional impairment especially in economically poor settings at developing countries. The aim is to study the pattern, indications and outcomes of upper limb amputations and their predictive factors in patients seen at El Obeid Hospital, Western Sudan. The medical records of patients who underwent upper limb amputations during five years at El Obeid Hospital were reviewed. The data were analyzed for gender, age, causes, level of amputations, outcomes and the possible predictive factors. There were 27 children and 19 adults. Trauma was the sole cause of upper limb amputations in children and was responsible together with burns and animal bites for 68.4% of upper limb amputations in adults. Diabetic sepsis resulted in 5 amputations in adults and all were finger amputations. The main level for amputation was above elbow [65.2%] while below elbow was 13.1% and finger amputations were 21 .7% of cases. There was no mortality among the study group. In adults road traffic accidents [RTA]. diabetic sepsis and machinery injuries were the main causes of upper limb amputations. In children, the main injury was factures due to domestic falls treated by traditional hone setters [TBS], the majority of them were potentially avoidable

Efectividad del tratamiento acupuntural en el Asma Bronquial / Effectiveness of the acupuncture treatment in bronchial asthma

OBJETIVO: evaluar la efectividad del tratamiento acupuntural en el asma bronquial. MÉTODOS: se realizó un estudio descriptivo en el área de salud de la localidad de Bayate del municipio El Salvador en abril de 2005 al 2006, en la provincia de Guantánamo. El universo de estudio estuvo conformado por los pacientes asmáticos que acudieron a la sala de MNT, y la muestra por los incluidos en el rango de 15-50 años. RESULTADOS: al tratarlos se evidenció la mayor cantidad de ellos en edades comprendidas entre 39-44 años de edad, el esquema acupuntural con mejor respuesta incluyó los puntos P-7 (pulmón 7), P-5 (pulmón 5), VG-14 (vasogobernador 14), Ig-11 (intestino grueso 11), VC-17 (vaso concepción 17) y Din shwan, el meridiano donde más afluencia de pacientes hubo fue el de 8-11 a.m, el tiempo de recidivas fue de 3 meses, el tratamiento convencional más utilizado fue la aminofilina. CONCLUSIONES: el costo-beneficio-mejoría es favorable, el 79,7 por ciento mejoró y se ahorró $ 20.85 por cada uno de los que consumieron los medicamentos y sobre todo los pacientes estuvieron menos propensos a sufrir reacciones adversas a los medicamentos(AU)

OBJECTIVE: to evaluate the effectiveness of the acupuncture treatment in bronchial asthma. METHODS: a descriptive study was conducted in the health area of Bayate, El Salvador municipality, Guantánamo province, in April 2005-2006. The universe was composed of asthmatic patients that were seen at the Natural and Traditional Medicine ward. The sample included those patients aged 15-50. RESULTS: on treating them, it was observed that most of them were 39-44 years old. The acupuncture scheme with best response comprised the points P-7 (lung-7), P-5 (lung 5), GV-14 (governing vessel 14), Ig-11 (small intestine 11), CV 17 (conception vessel 17) and Din Shawn. The meridian from 8 to 11 a.m. had the greatest number of patients, the time of relapses was 3 months and the most used conventional treatment was aminophiline. CONCLUSIONS: the cost-benefit-improvement was favourable. 79.7 percent improved and $20.85 were saved per each of the patients taking medications and what's more important the patients were less prone to suffer adverse reactions to drugs(AU)

Farmacología en atención estomatológica en menores de 19 años / Presence of Pharmacology in stomatologic care in children aged under 19

Se presenta una revisión bibliográfica actualizada basada en evidencias científicas del uso de antimicrobianos, antiinflamatorios, analgésicos, antisépticos bucales y medicina natural y tradicional en estomatología, realizada por Medline, Doyma y otras fuentes bibliográficas. Se reporta que más de la mitad de la población mundial consume en un momento de su vida algunos de estos fármacos, indicados por diferentes patologías de orígenes infecciosos, inflamatorios, incluso como tratamiento prevenivos y preoperatorios. La edad pediátrica constituye un grupo de difícil manejo terapéutico dada la inmadurez física, fisiológica (sistema pulmonar, cardiovascular, inmunológico y metabólico) y emocional, lo que exige que el uso de estas drogas requieren un conocimiento actualizado por parte del personal médico. En tal sentido, presentamos una revisión con el objetivo de exponer lo más actual sobre el uso de antibióticos, antiinflamatorios, analgésicos y antisépticos bucales en cuanto a farmacología para estomatólogos generales que brindan atención a menores de 19 años con afecciones estomatológicas(AU)

A updated bibliographic review is presented based on scientific evidences on use of antimicrobials, anti-inflammatory, analgesics agents, oral antiseptics and natural and folk medicine in Stomatology, performed by Medline Doyma, and other bibliographic sources. Authors reports that more than half of world population, in any moment of its life, has been a consumer of these drugs, prescribed from different pathologies of infectious, inflammatory nature, even as a preventive preoperative treatment. Pediatric age is a difficult therapeutic management group due to physical, physiological ( pulmonary, cardiovascular, immunologic, and metabolic system) and emotional immaturity, requiring that medical staff must to have a updated knowledge on use of these drugs. In this context, we presented a revision to expose the more updated features on use of antibiotics, anti-inflammatory, and oral antiseptics, as for a Pharmacology for general stomatologists giving care to children ages under 19 presenting with stomatologic affections(AU)

Eficacia de la medicina natural tradicional en el asma bronquial / Efficacy of natural traditional medicine in bronchial asthma

El asma bronquial es una enfermedad respiratoria con significativa prevalencia y una de las principales causas de ingreso hospitalario. Se realizó un estudio descriptivo retrospectivo con el objetivo de mostrar la eficacia de la medicina natural tradicional en los pacientes con asma bronquial; en el Hospital Amalia Simoni Argilagos, en un período comprendido desde enero de 2003 a diciembre de 2004. La muestra estuvo constituida por 130 pacientes tratados en el servicio de Medicina Natural Tradicional. Se confeccionó un formulario que contenía las variables: grupo de edades, sexo, factores determinantes, métodos utilizados y efectividad del tratamiento. Se constató un predomino del grupo de edad entre 35 - 44 años con 56 casos (43,3 por ciento) y los pacientes con sexo femenino fueron los que más asistieron a la consulta con 87 casos (66,9 por ciento). Entre los factores determinantes en la aparición del asma bronquial incidieron los genéticos en 55 casos (42,5 por ciento). La digitopuntura fue el método más utilizado, pues se aplicó en 75 pacientes (57,7 por ciento), siendo esta la de mayor efectividad del tratamiento que se reportó en 65 casos (50 por ciento)(AU)

Bronchial asthma is a respiratory disease with a significant prevalence and one of the main causes of hospital admission. A descriptive retrospective study was conducted to prove the efficacy of natural traditional medicine in patients with bronchial asthma at "Amalia Simoni Argilagos" Hospital from January 2003 to December 2004. The sample consisted of 130 patients treated at the NaturalTraditional Medicine Service. A questionnaire was made that included variables such as age groups, sex, determinants, methods used and the effectiveness of the treatment. The age group 35-44 predominated, with 56 cases (43.3 percent). The highest number of visits corresponded to females, with 87 cases (66.9 percent). Among the determining factors in the appearance of bronchial asthma, the genetic factors influenced on 55 cases (42.5 percent). Pressure acupuncture was the most used method, since it was applied in 75 patients (57.7 percent). Its effectivity proved to be the highest in the treatment, taking into account that it was reported in 65 cases (50 percent)(AU)

Medicina Natural y Tradicional. Conocimientos y aplicaciones de enfermería en MINAS-II / Nursing knowledge and applications in MINAS-II

Los procederes de la medicina natural y tradicional tienen generalmente en común el objetivo de prevenir y tratar enfermedades. Así, la intención de mantener la salud como la misma vida y tan inherentes a los seres vivos para utilizar lo bueno y defenderse de lo malo. Por la importancia que reviste el tema se realizó este estudio. El universo de trabajo estuvo constituido por 21 enfermeras a quienes les fueron aplicadas encuestas, las que una vez concluidas se convirtieron en registros primarios de datos. Los resultados fueron procesados en una microcomputadora IMB compatible, en la que se obtuvieron los siguientes datos: predominio del personal técnico y que labora en la comunidad; entre las técnicas más utilizadas figuran los peloides, que son mayormente empleadas en la cefalea; sin embargo, se comprobó que el 61,9 (por ciento) de los encuestados no han pasado cursos de superación, pero aplican la medicina natural, y obtienen buenos resultados. Así, podemos concluir que predominó el nivel técnico que laboró en la comunidad, que conocieron fundamentalmente la técnica de los peloides y aplicaron la medicina natural y tradicional con buenos resultados(AU)

Natural and traditional medicine procedures have the general common objective of preventing and treating diseases. Thus, the purposes of preserving health as well as life are inherent to these methods and to the live people so as to use "the good thing" and defend from "the bad thing". We undertook this study due to the importance of the topic. The universe of study was made up of 21 nurses who were administered surveys. Later these surveys served as primary data records. The results were processed in an IBM-compatible micro-computer and the following data were obtained: predominance of technical nursing staff that works in the community; one of the most used techniques was peloids mainly for treating headaches, and it was confirmed that 61.9 percent of the surveyed nurses had not taken any graduate courses, but they were able to successfully apply natural medicine. Therefore, we may conclude that the technical level of nurses working in the community prevailed; they fundamentally used peloids and applied natural and traditional medicine with good results(AU)

Candidiasis de la mucosa bucal. Revisión bibliográfica / Oral mucosal candidiasis. A literature review

Se presenta una revisión de la literatura actualizada de una de las enfermedades más frecuentes de la mucosa bucal y la afección micótica más común en esta localización: la candidiasis de la mucosa bucal. Se detallan los factores predisponentes generales y locales que favorecen la aparición de esta alteración patológica como son los tratamientos prolongados con antibióticos, la diabetes, la anemia, la radioterapia y quimioterapia antineoplásicas, las drogas inmunosupresoras y el SIDA, entre otros. Se exponen las diferentes clasificaciones clínicas, según el criterio de distintos autores y el cuadro clínico de la enfermedad. Finalmente se presentan alternativas terapéuticas tanto en el campo de la medicina convencional como en el de la medicina tradicional y natural(AU)

This paper presents an updated literature review of one of the most frequent diseases in the oral mucosa and the most common mycotic affection in this site, i.e, oral mucosal candidiasis. The general and local predisposing factors that favor the occurrence of this pathological disorder such as extended antibiotic treatments, diabetes, anemia, anti-neoplastic radiotherapy and chemotherapy, immunosuppresive drugs, AIDS, among others. Different clinical classifications, according to several authors´ criteria and the clinical picture of the disease, are stated. Finally, therapeutical options in the fields of conventional medicine and traditional and natural medicine are presented(AU)