Anomalous origin of the left coronary artery with origin in the right coronary artery from a single coronary ostium associated with multivessel coronary artery disease: case report and literature review

The anomalous origin of the coronary arteries is a group of rare congenital heart conditions in which there has been an increase in its diagnosis thanks to more accessible and less invasive imaging techniques such as coronary angiotomography, which allows visualization of the arteries in its entire path in a short exploration interval, with adequate spatial and temporal resolution. The clinical presentation is variable, up to 80% are asymptomatic and the remaining 20% may present arrhythmias, myocardial infarction, heart failure and sudden death. We present the case of a patient with unstable angina in whom an anomalous origin of the left coronary artery (LCA) with origin in the right coronary artery (RCA) from a single coronary ostium associated with multivessel coronary artery disease was diagnosed.

Fuentes de luz de uso clínico en el pre grado: 7 años de seguimento / Light curing units in the undergraduate dental clinics: 7 years of follow-up

RESUMEN Objetivo: Realizar, durante siete años ininterrumpidos, un control y seguimiento de las fuentes de luz disponibles en las clínicas odontológicas de pre graado de una Institución de Enseñanza Superior Pública Brasileña. Material y métodos: Durante el período comprendido entre 2011-2017 se evaluó el control de calidad de las fuentes de luz de la Facultad de Odontología de la Universidad Federal de Goiás a través del análisis de su estado de conservación y de su densidad de potencia (mW/cm2). Los datos obtenidos se sometieron a un análisis estadístico descritpivo y a las pruebas de Levene, Shapiro-Wilk, Kruskal-Wallis, Dunn y Chi-cuadrado (P<0,05). Resultados: No se observaron diferencias estadísticas significativas del estado de conservación de las fuentes de luz entre los años 2012, 2016 y 2017 (p>0,05). Sí se observaron diferencias estadísticas significativas entre los valores de densidad de potência entre dichos años (p<0,0001). En las comparaciones por pares, los valores de densidad de potencia para los años 2011 (p<0,01) y 2012 (p<0,05) fueron estadísticamente diferentes de los años 2015, 2016 y 2017. Conclusiones: Comparativamente se observó una mejora sustancial del estado de conservación de las fuentes de luz en los cuatro años iniciales de evaluaciones, con una disminución en el quinto año y una estabilización en los dos últimos años. Durante los siete años de estudio de la densidad de potencia de las fuentes de luz se observó en un aumento gradual de la misma con una estabilización de los resultados a partir del quinto año de control de calidad.

SUMMARY Objetive: To monitor the light curing units available at undergraduate dental clinics of a Brazilian Public Higher Education Institution for seven uninterrupted years. Materials and methods: In the period between 2011-2017, the quality control of light curing units at the Faculty of Dentistry, Federal University of Goiás, was evaluated by analyzing their state of conservation and power density (mW/cm2). Data obtained were subjected to descriptive statistical analysis and Levene, Shapiro-Wilk, Kruskal-Wallis, Dunn and Chi-square tests (P <0.05). Results: Regarding the conservation status of the light curing units, comparatively, there was no statistically significant difference between the years 2012, 2016 and 2017 (p> 0.05). Statistically significant differences were found for power density values between years (p <0.0001). In pairwise comparisons, the power density values for the years 2011 (p <0.01) and 2012 (p <0.05) were statistically different from the years 2015, 2016 and 2017. Conclusions: A significant improvement in the state of conservation of light curing units was observed in the initial four years of evaluations, with a decline in the fifth year and stabilization in the last two years. Regarding the power density of the light curing units, a gradual increase was observed in the seven years of study, with stabilization of the results after the fifth year of quality control.

Efectos de una terapia basada en estimulación eléctrica funcional de activación bimanual combinada con el entrenamiento de biofeedback electromiográfico en la función motora de la extremidad superior parética en sujetos secuelados de accidente cerebrovascular / Effects of a therapy based on a functional electrical stimulation of bimanual activation combined with the training of electromyographic biofeedback on the motor function of the upper limb in subjects with stroke

Resumen Introducción El accidente cerebrovascular constituye la principal causa de muerte y discapacidad en Chile. Más del 85% de los pacientes sufren hemiplejía y más del 69% discapacidad motora funcional de las extremidades superiores. Esta alteración genera impacto en el uso de la extremidad superior, afectando las diversas actividades de la vida diaria de las personas. No existen estudios que combinen terapia de biofeedback electromiográfico y activación bimanual con estimulación eléctrica funcional en sujetos secuelados de Accidente cerebrovascular (ACV). Por esto, surge el interés de determinar el efecto que tiene un protocolo de entrenamiento basado en Estimulación Eléctrica Funcional (EEF) con activación bimanual y terapia de biofeedback en la función de la extremidad superior. Metodología: 15 sujetos secuelados de ACV entre 40 y 85 años reclutados en el área de neurorrehabilitación ambulatoria de Clínica Dávila, aleatorizados en un grupo experimental y en dos grupos controles de 5 sujetos. En cada sesión el grupo experimental entrenará quince minutos de activación bimanual con electroestimulación funcional y luego un programa de entrenamiento de biofeedback de diez minutos, mientras que el grupo control 1 y control 2 entrenaron en las mismas condiciones pero con EEF placebo y BF-EMG placebo respectivamente Resultados Existieron cambios significativos en el grupo experimental luego de la intervención. Conclusión Este estudio sugiere la estimulación eléctrica funciona y biofeedback como una herramienta para la rehabilitación de la extremidad superior paréticas en sujetos secuelados de ACV.

Introduction: Stroke is the leading cause of death and disability in Chile. More than 85% of patients suffer from hemiplegia and more than 69% functional motor disability of the upper extremities. This alteration generates an impact on the use of the upper limb, affecting the various activities of people's daily lives. There are no studies that combine electromyographic biofeedback therapy and bimanual activation with functional electrical stimulation in subjects with stroke. Therefore, there is interest in determining the effect of a training protocol based on Functional Electrical Stimulation (FES) with bimanual activation and biofeedback therapy on the function of the upper limb. Methodology: 15 subjects with stroke between 40 and 85 years recruited in the outpatients neurorehabilitation program of Clínica Dávila, randomized in an experimental group and in two control groups of 5 subjects. In each session the experimental group will train fifteen minutes of bimanual activation with functional electrostimulation and then a ten-minute biofeedback training program, while the control 1 and control 2 group trained under the same conditions but with placebo FES and placebo BF-EMG respectively. Results There were significant changes in the experimental group after the intervention. Conclusion This study suggests the electrical stimulation works and biofeedback as a tool for the rehabilitation of the upper limb in subjects with stroke.

Evaluación de la posición condilar mediante tomografía computarizada de haz cónico en pacientes Clase III sometidos a cirugía ortognática / Evaluation of the condylar position by conical beam computed tomography in Class III patients undergoing orthognathic surgery

Objetivo . El propósito de este estudio fue comparar los cambios mediante tomografía computarizada de haz cónico en el posicionamiento condilar de pacientes Clase III antes y después de una osteotomía sagital bilateral de rama mandibular indicada para la retro- posición mandibular. Métodos . Se analizaron 30 pacientes, 16 mujeres y 14 hombres con rango de edad de 15 a 40 años y deformidad dentofacial Clase III no tratada que asistieron a consulta de diagnóstico en el periodo del año 2013 al 2016 en el Hospital Regional "General Ignacio Zaragoza" (CDMX, México), realizándoseles mediciones de la posición condilar en tres tiempos: prequirúrgico, intermedio (4 días posquirúrgico) y final (9 meses posquirúrgico), en dos planos: corte sagital y corte coronal. Resultados . No se observó diferencia significativa en los espacios anterior, central y posterior antes (2,56 ± 0,55 mm; 1,78 ± 0,48 mm; 1,92 ± 0,36 mm) y después (2,68 ± 0,51 mm; 1,87 ± 0,43 mm; 2,01 ± 0,37 mm), diferencia de medias -0,120; -0,085; -0,090 p =0,921; 0,948 y 0,778, respectivamente. Del mismo modo, en el corte coronal no se observan cambios significativos en los ángulos condilares derecho antes (68,25 ± 1,56°) y después (68,77 ± 1,63°) p =0,217; e izquierdo antes (68,92 ± 1,63°) y después (69,30 ± 2°) p =0,215. Conclusiones . La osteotomía sagital bilateral de rama mandibular en pacientes Clase III es una técnica quirúrgica que ofrece mínimas alteraciones condilares, pues mantiene una estabilidad condilar en el posoperatorio a 9 meses.

Objective. The purpose of this study was to compare the changes by conical beam com- puted tomography in the condylar positioning of Class III patients before and after a sagittal osteotomy of the bilateral mandibular ramus in Class III indicated for mandibu- lar retroposition. Methods. Thirty patients were analyzed, 16 women and 14 men with an age range of 15 to 40 years and untreated Class III dentofacial deformity who were attended by diagnostic consultation during the period from 2013 to 2016 at the "Gen eral Ignacio Zaragoza" Regional Hospital (CDMX, Mexico), performing measurements of the condylar position in three stages: presurgical, intermediate (4 days after surgery) and final (9 months after surgery), in two planes: sagittal section and coronal section. Re - sults. No significant difference was observed in the anterior, central and posterior spaces before (2.56 ± 0.55 mm; 1.78 ± 0.48 mm; 1.92 ± 0.36 mm) and after (2.68 ± 0.51 mm; 1.87 ± 0.43 mm; 2.01 ± 0.37 mm), mean difference -0.120; -0,085; -0.090 p =0.921; 0.948 and 0.778, respectively. Similarly, in the coronal section there are no significant changes in the right condylar angles before (68.25 ± 1.56 °) and after (68.77 ± 1.63°) p =0.217; and left before (68.92 ± 1.63°) and then (69.30 ± 2°) p =0.215. Conclusions. Sagittal osteotomy of the bilateral mandibular ramus in Class III patients is a surgical technique that offers minimal condylar alterations, since it maintains a condylar stability in the postoperative period at 9 months.

First record of Bulimulus tenuissimus (Mollusca) as potential experimental intermediate host of Angiostrongylus cantonensis (Nematoda) / Primeiro registro de Bulimulus tenuissimus (Mollusca) como hospedeiro intermediário de Angiostrongylus cantonensis (Nematoda)

Abstract Snails are essential to complete the life cycle of the metastrongylid nematode Angiostrongylus cantonensis, the causative agent of infections in domestic and wild animals, mainly rodents, and also of neural angiostrongyliasis or eosinophilic meningitis in humans. There are many reports of mollusks that can act as intermediate hosts of this parasite, especially freshwater snails and the African giant Achatina fulica. The terrestrial gastropod Bulimulus tenuissimus is widely distributed in Brazil and other species of the same genus occur in Brazil and other countries, overlapping regions in which there are reports of the occurrence of A. cantonensis and angiostrongyliasis. In spite of this, there are no records in the literature of this species performing the role of intermediate host to A. cantonensis. The present study analyzed the experimental infection with first-stage larvae of A. cantonensis, under laboratory conditions, of B. tenuissimus, by using histology and electron microscopy techniques. Three weeks after exposure to L1 larvae, it was possible to recover L3 larvae in small numbers from the infected snails. Developing larvae were observed in the cephalopedal mass (foot), ovotestis, and mantle tissues, being located inside a granulomatous structure composed of hemocyte infiltration, but there was no calcium or collagen deposition in these structures in significant amounts. In the third week post exposure, it was possible observe a sheath around the developing larvae. The infected snails presented reduction in the fibrous muscular tissue in the foot region, loss of the acinar organization in the digestive gland, with increase of amorphous material inside the acini and loss of epithelial pattern of nuclear organization in the acinar cells. However, the ovotestis seemed unaffected by the infection, since there was a large number of developing oocytes and spermatozoa in different stages of formation. The digestion of infected snails allows us the third-stage recovery rate of 17.25%, at 14 days post exposure to the L1. These L3 recovered from B. tenuissimus were used to infect rats experimentally, and 43 days post infection first-stage (L1) larvae of A. cantonensis were recovered from fresh feces. The results presented constituted the first report of the role of B. tenuissimus as an experimental intermediate host to A. cantonensis and shed some light on a possible problem, since the overlapping distribution of B. tenuissimus and A. cantonensis in Brazil and other countries where different species of Bulimulus occur enables the establishment and maintenance of the life cycle of this parasite in nature, with wild rodents as reservoirs, acting as a source of infection to humans, causing neural angiostrongyliasis.

Resumo Os moluscos são um requisito essencial para a conclusão do ciclo de vida pelo nematoide metastrogilídeo Angiostrongylus cantonensis, o agente causador de infecções em animais domésticos e selvagens, principalmente roedores, e também de angiostrongilíase neural ou meningite eosinofílica em humanos. Há muitos relatos de moluscos que podem atuar como hospedeiro para este parasito, sendo o foco dado aos moluscos de água doce e no gigante africano Achatina fulica. O gastrópode terrestre Bulimulus tenuissimus é amplamente distribuído no território brasileiro e há outras espécies do mesmo gênero que ocorrem no Brasil e outros países, sobrepondo-se às regiões em que há relatos à ocorrência de A. cantonensis e angiostornigilíase. Apesar disso, não há registro na literatura, acerca desta espécie como hospedeiro intermediário para A. cantonensis. O presente estudo teve como objetivo verificar a possibilidade de infectar experimentalmente, utilizando larvas L1 de A. cantonensis, em condições laboratoriais, o molusco B. tenuissimus, utilizando técnicas de histologia e microscopia eletrônica. Três semanas após a exposição às larvas L1, foi possível recuperar larvas L3 dos moluscos infectados, em pequena quantidade. As larvas em desenvolvimento foram observadas na massa cefalopediosa (pé), ovotestis e nos tecidos do manto, sendo localizadas dentro de uma estrutura granulomatosa constituída por infiltração hemocitária, mas não houve deposição de cálcio ou colágeno nessas estruturas em quantidade significativa. Na terceira semana pós exposição, foi possível observar uma bainha ao redor das larvas em desenvolvimento. Os caracóis infectados apresentaram redução no tecido muscular fibroso na região do pé, perda da organização acinar na glândula digestiva, com aumento de material amorfo dentro dos ácinos e perda do padrão epitelial da organização nuclear nas células acinares. No entanto, o ovotestis, pareceu não ser afetado pela infecção, uma vez que houve um grande número de oócitos em desenvolvimento e espermatozóides em diferentes estágios de formação. A digestão dos moluscos infectados nos permitiu a recuperação de larvas de terceiro estágio (17,25%), aos 14 dias após a exposição à L1 de A. cantonensis . Estas L3 recuperadas de B. tenuissimus foram utilizados para infectar ratos experimentalmente, e 43 dias após a infecção, as larvas do primeiro estágio (L1) foram recuperadas de fezes frescas. Os resultados apresentados representam o primeiro registro do papel de B. tenuissimus como hospedeiro intermediário experimental de A. cantonensis e trazem alguma luz a um problema, até então silencioso, uma vez que a sobreposição da distribuição de B. tenuissimus e A. cantonensis no Brasil, e outros países, onde as diferentes espécies de Bulimulus ocorrem, torna possível o estabelecimento e manutenção do ciclo de vida deste parasito na natureza, com roedores selvagens como reservatório, agindo como fonte de infecção para humanos e causando a angiostrongilíase neural.

Xiphidiocercariae from naturally infected Lymnaea columella (Mollusca, Gastropoda) in urban area: morphology and ultrastructure of the larvae and histological changes in the mollusc host / Xifidiocercárias obtidas em Lymnaea columella (Mollusca, Gastropoda) naturalmente infectadas em área urbana: morfologia e ultraestrutura da larva e alterações histológicas do molusco hospedeiro

Abstract Urban agriculture is very common in the cities, as Rio de Janeiro and adjacencies, being important as economic activity. However, this practice can create appropriate conditions for establishment and maintenance of life cycle of many parasites. Lymneid snails can act as intermediate hosts of many trematodes species, including those that infect humans and wild and domestic. In the present study, the snail Lymnaea columella was collected from an urban watercress plantations and the morphology of cercariae released by them was analyzed by light and scanning electron microscopy. The specimens were identified as xiphidiocercariae, belonging to the Cercariae Ornatae group, of the order Plagiorchiiformes. Histological examination of the digestive gland of the infected snails revealed the presence of developing sporocysts, with hemocitary infiltration and metaplasia in the epithelial tissue.

Resumo Agricultura urbana é muito comum nas cidades, como Rio de Janeiro e adjacências, sendo uma importante atividade econômica de subsistência. No entanto, esta prática pode criar condições adequadas para o estabelecimento e manutenção do ciclo de vida de muitos parasitos. Os moluscos limneídeos podem atuar como hospedeiros intermédios de muitas espécies de trematódeos, incluindo aqueles que infectam humanos e animais selvagens e domésticos. No presente estudo, o molusco Lymnaea columella foi coletado de plantações urbanas de agrião e a morfologia das cercárias liberadas por eles foi analisada por microscopia eletrônica de varredura leve e de varredura. As larvas foram identificadas como xifidiocercárias, pertencentes ao grupo das Cercariae Ornatae, Ordem Plagiorchiiformes. Análises histológicas da glândula digestiva dos moluscos infectados evidenciaram esporocistos, com formação de granuloma e metaplasia do tecido epitelial.

Resíduo de acerola em dietas para codornas / Acerola residue in feed for quails

Objetivou-se avaliar a inclusão do resíduo da acerola em dietas de codornas de corte sobre o desempenho produtivo, rendimento de carcaça, biometria intestinal e viabilidade econômica das aves, aos 42 dias de idade. Foram utilizadas 400 codornas europeias, não sexadas, de um dia de idade, distribuídas em delineamento experimental inteiramente ao acaso, com cinco níveis de inclusão (0,0; 3,0; 6,0; 9,0 e 12,0%) de resíduo da acerola, com oito repetições e 10 aves por unidade experimental. Não foram observadas diferenças significativas (P>0,05) para o ganho de peso, o consumo de ração, a conversão alimentar, os pesos absolutos e os rendimentos de carcaça e os cortes nobres (peito, coxa e sobrecoxa). Houve efeito (P<0,05) linear para os pesos absolutos e relativos de fígado e moela. A biometria intestinal das aves não foi (P>0,05) influenciada pelos níveis de inclusão do resíduo de acerola. O resíduo de acerola pode ser utilizado como ingrediente alternativo nas dietas de codornas europeias, até o nível de 12% de inclusão, sem comprometer o desempenho produtivo, o rendimento de carcaça das aves e a viabilidade econômica.(AU)

The objective of this study was to evaluate the inclusion of the acerola residue in broiler quail diets on productive performance, carcass yield, intestinal biometry, and poultry economic viability at 42 days of age. Four hundred one-day unsexed European quail were distributed in a completely randomized experimental design with five inclusion levels (0.0, 3.0, 6.0, 9.0 and 12.0%) of residue of acerola, with eight replicates and 10 birds per experimental unit.No significant differences (P>0.05) were observed for weight gain, feed intake, feed conversion, absolute weights and carcass yields, and noble cuts (chest, thigh and sobrecoxa). There was a linear effect (P<0.05) for absolute and relative weights of liver and gizzard. The intestinal biometry of the birds were not (P>0.05) influenced by the inclusion levels of the acerola residue. The acerola residue can be used as an alternative ingredient in European quails diets up to a 12% inclusion level, without compromising productive performance, poultry carcass yield and economic viability.(AU)

Prevalencia de Malassezia spp en pacientes con diabetes mellitus tipo 2 de acuerdo con el control glucémico / Prevalence of Malassezia spp in type 2 diabetes mellitus according to glycemic control

Resumen ANTECEDENTES: Malassezia spp es un saprófito de la piel, relacionada con diversas afecciones cutáneas, se ha reportado frecuencia elevada en pacientes con inmunosupresión. OBJETIVO: determinar la prevalencia de Malassezia spp en individuos con diabetes mellitus tipo 2 de acuerdo con el control glucémico. MATERIAL Y MÉTODO: estudio abierto, observacional, descriptivo y transversal, efectuado en pacientes voluntarios que participaron en la 24ª Carrera Nacional del Paciente con Diabetes el 15 de octubre de 2016 en la Ciudad de México, en quienes se realizó toma de glucemia capilar preprandial y hemoglobina glicosilada, así como pesquisa de Malassezia spp mediante frotis de la región malar, teñido con azul de metileno. RESULTADOS: se incluyeron 49 pacientes con diabetes mellitus tipo 2; hubo predominio de 31 pacientes sin buen control glucémico (67%) en comparación con 16 pacientes controlados (33%). Los frotis con levaduras escasas (+) estuvieron presentes en 21 (59%) pacientes sin control y en 7 (41%) pacientes con control; los frotis con cantidad de levaduras moderada (++) se observaron en 7 (74%) pacientes sin control y en 5 (26%) pacientes con control; los frotis con levaduras abundantes estuvieron presentes en 7 (63%) pacientes sin control y en 2 (37%) pacientes con control. CONCLUSIÓN: en nuestro estudio la prevalencia de Malassezia spp en pacientes con diabetes mellitus tipo 2 fue del 100%, con menor número de levaduras en los que tenían control glucémico adecuado, lo que puede indicar que la posibilidad de tener esta levadura aumenta con el descontrol glucémico y probablemente denota el grado de inmunosupresión en estos pacientes.

Abstract BACKGROUND: Malassezia spp is a saprophyte of the skin, related to diverse cutaneous affections, and has been reported a high frequency in patients with immunosuppression. OBJECTIVE: To determine the prevalence of Malassezia spp in individuals with type 2 diabetes mellitus according to glycemic control. MATERIAL AND METHOD: An open, observational, descriptive and cross-sectional study was performed in volunteer patients who participated in the 24th National March of the Patient with Diabetes in Mexico City on October 15, 2016; where preprandial capillary glycemia and glycosylated hemoglobin were taken. We took a scraping of the malar region skin to find Malassezia spp, smears stained with methylene blue. RESULTS: A total of 49 patients with type 2 diabetes mellitus were included; there were a predominance of 31 patients without glycemic control (67%) in comparison with 16 controlled patients (33%). Smears with low yeast (+) were present in 21 (59%) uncontrolled patients and in 7 (41%) controlled patients; smears with a moderate amount of yeast (++) were present in 7 (74%) uncontrolled patients and in 5 (26%) controlled patients; smears with abundant yeasts were present in 7 (63%) uncontrolled patients and in 2 (37%) controlled patients. CONCLUSION: In our study the prevalence of Malassezia spp in patients with type 2 diabetes mellitus was of 100%, with a lower number of yeasts in patients with adequate glycemic control; this can indicate that the possibility of presenting this yeast increases with bad glycemic control and probably denotes the degree of immunosuppression in these patients.

Caracterización óptica del Sistema Nervioso Central de Haementeria officinalis / Optical characterization of the Central Nervous System of Haementeria officinalis

Resumen: La falla en la regeneración de las neuronas del sistema nervioso central (SNC) en vertebrados superiores es un problema que no se ha resuelto completamente, esto limita la rehabilitación de muchas conductas motoras después de una lesión en la médula espinal. En la regeneración neuronal intervienen múltiples factores y de estos, los que inducen el crecimiento neurítico se han estudiado para intentar favorecer la extensión y la reconexión de las neuronas lesionadas con sus blancos. La regeneración del SNC de sanguijuelas se ha estudiado intensamente porque permite abordar el problema a diferentes niveles con distintas técnicas, en este trabajo se obtuvo el espectro de absorción óptico, con espectroscopía fotoacústica (EFA), del SNC y de tejido de la sanguijuela Haementeria officinalis, con el objetivo de conocer las longitudes de onda óptimas para la irradiación posterior de células del SNC y de tejido H. officinalis. Los resultados de este estudio muestran que el SNC de estos organismos absorbe en la region comprendida de 300 nm a 500 nm, y las muestras de tejido tienen un máximo de absorción óptico proximo a 300 nm, además se observaron diferencias evidentes entre los espectros de absorción ópticos del SNC con lesión y el control (sin lesión).

Abstract: The failure in the neuron regeneration in the central nervous system (CNS) in higher vertebrates, is a not completely solved problem, this limits the rehabilitation of many motor conducts after an injury in the spinal cord. In neuronal regeneration multiple factors are involved, between them those that induce the neurite outgrowth which has been studied to try to encourage the extension and reconnection of the injury neurons with their blanks. The regeneration of the CNS of leeches has been intensely studied because allows to approach the problem at different levels with different techniques. In this study the optical absorption spectrum of the CNS and the tissue of the leech H. officinalis was obtained, by using photoacoustic spectroscopy (PAS), in order to investigate the optimal wavelenghts for later irradiation of CNS cells and tissue of H. officinalis. The results of this study show that the CNS of these organisms absorbs in the region of 300 nm to 500 nm, and the tissue samples has a maximun of optical absorption near to 300 nm, besides were observed evident differences between the optical absorption spectra of CNS with injury and the control (without injury).

Nivel de conocimientos en adolescentes sobre el virus del papiloma humano / Level of knowledge in adolescents about human papillomavirus

El virus del papiloma humano es una infección de transmisión sexual con un alto índice de contagio en población joven y adulta y principal factor del cáncer cérvico-uterino ligado al inicio precoz de las relaciones sexuales. Objetivo: Determinar el nivel de conocimientos de adolescentes de una escuela preparatoria, sobre el virus del papiloma humano. Métodos: Estudio transversal, descriptivo realizado en 242 alumnos de ambos sexos. Se aplicó instrumento con 46 ítems agrupados en cuatro secciones: datos sociodemográficos, conocimien-tos sobre el virus, aspectos de salud sexual y fuentes de información; nivel de confiabilidad de 0,7. Resultados: Un 53.7% mujeres, 40.5% con 17 anos˜ y un 97.1% soltero. El 64.6% no identificó qué es el virus del papiloma humano, El 68.6% no supo qué afecciones puede generar el virus, y el 88% no identifica que el fumar puede predisponer, en las mujeres, riesgo para la adquisición del virus; el 78.5% identificó el factor principal de riesgo y el 82.6% la mejor vía de protección contra la infección. El nivel de conocimientos general fue bajo en el 80% de los participantes. Conclusiones: El desconocimiento frente al fenómeno puede contribuir a la mala praxis en salud o a tener actividades riesgosas como el tener múltiples parejas sexuales o no usar el preservativo ante un contacto sexual.(AU)

The human papilloma virus, a sexually transmitted infection with a high likelihood of contagion among young and adult populations, is the main cervical- uterine cancer causing factor linked to early initiation of sexual intercourse. Objective: To determine the level of knowledge on the topic among adolescents in one high school. Methods: This is a transversal and descriptive study with a sample of 242 students of both sexes. An instrument with 42 items grouped in four sections: social-demographic data, knowledge on the human papilloma virus, issues on sexual health, and sources of information was applied. The reliability level was estimated at 0.7. Results: From the sample, 53.7% were women, 40.5% were 17 years old, and 91.1% were single. Sixty four point six percent did not identify the virus, 68.6% did not know about the illnesses the virus can provoke, and 88% did not know that smoking can predispose women towards a greater risk of acquiring the virus. From the sample, 78.5% identified the principal risk factor, and 82.6% were aware of the best protection against infection. The general level of knowledge was low in 80% of the participants. Conclusions: The lack of knowledge on the issue can lead to risky lifestyles such as having multiple sexual partners or nor using the condoms accordingly. (AU)

Xiphidiocercariae from naturally infected Lymnaea columella (Mollusca, Gastropoda) in urban area: morphology and ultrastructure of the larvae and histological changes in the mollusc host

Abstract Urban agriculture is very common in the cities, as Rio de Janeiro and adjacencies, being important as economic activity. However, this practice can create appropriate conditions for establishment and maintenance of life cycle of many parasites. Lymneid snails can act as intermediate hosts of many trematodes species, including those that infect humans and wild and domestic. In the present study, the snail Lymnaea columella was collected from an urban watercress plantations and the morphology of cercariae released by them was analyzed by light and scanning electron microscopy. The specimens were identified as xiphidiocercariae, belonging to the Cercariae Ornatae group, of the order Plagiorchiiformes. Histological examination of the digestive gland of the infected snails revealed the presence of developing sporocysts, with hemocitary infiltration and metaplasia in the epithelial tissue.

Resumo Agricultura urbana é muito comum nas cidades, como Rio de Janeiro e adjacências, sendo uma importante atividade econômica de subsistência. No entanto, esta prática pode criar condições adequadas para o estabelecimento e manutenção do ciclo de vida de muitos parasitos. Os moluscos limneídeos podem atuar como hospedeiros intermédios de muitas espécies de trematódeos, incluindo aqueles que infectam humanos e animais selvagens e domésticos. No presente estudo, o molusco Lymnaea columella foi coletado de plantações urbanas de agrião e a morfologia das cercárias liberadas por eles foi analisada por microscopia eletrônica de varredura leve e de varredura. As larvas foram identificadas como xifidiocercárias, pertencentes ao grupo das Cercariae Ornatae, Ordem Plagiorchiiformes. Análises histológicas da glândula digestiva dos moluscos infectados evidenciaram esporocistos, com formação de granuloma e metaplasia do tecido epitelial.

First record of Bulimulus tenuissimus (Mollusca) as potential experimental intermediate host of Angiostrongylus cantonensis (Nematoda)

Abstract Snails are essential to complete the life cycle of the metastrongylid nematode Angiostrongylus cantonensis, the causative agent of infections in domestic and wild animals, mainly rodents, and also of neural angiostrongyliasis or eosinophilic meningitis in humans. There are many reports of mollusks that can act as intermediate hosts of this parasite, especially freshwater snails and the African giant Achatina fulica. The terrestrial gastropod Bulimulus tenuissimus is widely distributed in Brazil and other species of the same genus occur in Brazil and other countries, overlapping regions in which there are reports of the occurrence of A. cantonensis and angiostrongyliasis. In spite of this, there are no records in the literature of this species performing the role of intermediate host to A. cantonensis. The present study analyzed the experimental infection with first-stage larvae of A. cantonensis, under laboratory conditions, of B. tenuissimus, by using histology and electron microscopy techniques. Three weeks after exposure to L1 larvae, it was possible to recover L3 larvae in small numbers from the infected snails. Developing larvae were observed in the cephalopedal mass (foot), ovotestis, and mantle tissues, being located inside a granulomatous structure composed of hemocyte infiltration, but there was no calcium or collagen deposition in these structures in significant amounts. In the third week post exposure, it was possible observe a sheath around the developing larvae. The infected snails presented reduction in the fibrous muscular tissue in the foot region, loss of the acinar organization in the digestive gland, with increase of amorphous material inside the acini and loss of epithelial pattern of nuclear organization in the acinar cells. However, the ovotestis seemed unaffected by the infection, since there was a large number of developing oocytes and spermatozoa in different stages of formation. The digestion of infected snails allows us the third-stage recovery rate of 17.25%, at 14 days post exposure to the L1. These L3 recovered from B. tenuissimus were used to infect rats experimentally, and 43 days post infection first-stage (L1) larvae of A. cantonensis were recovered from fresh feces. The results presented constituted the first report of the role of B. tenuissimus as an experimental intermediate host to A. cantonensis and shed some light on a possible problem, since the overlapping distribution of B. tenuissimus and A. cantonensis in Brazil and other countries where different species of Bulimulus occur enables the establishment and maintenance of the life cycle of this parasite in nature, with wild rodents as reservoirs, acting as a source of infection to humans, causing neural angiostrongyliasis.

Resumo Os moluscos são um requisito essencial para a conclusão do ciclo de vida pelo nematoide metastrogilídeo Angiostrongylus cantonensis, o agente causador de infecções em animais domésticos e selvagens, principalmente roedores, e também de angiostrongilíase neural ou meningite eosinofílica em humanos. Há muitos relatos de moluscos que podem atuar como hospedeiro para este parasito, sendo o foco dado aos moluscos de água doce e no gigante africano Achatina fulica. O gastrópode terrestre Bulimulus tenuissimus é amplamente distribuído no território brasileiro e há outras espécies do mesmo gênero que ocorrem no Brasil e outros países, sobrepondo-se às regiões em que há relatos à ocorrência de A. cantonensis e angiostornigilíase. Apesar disso, não há registro na literatura, acerca desta espécie como hospedeiro intermediário para A. cantonensis. O presente estudo teve como objetivo verificar a possibilidade de infectar experimentalmente, utilizando larvas L1 de A. cantonensis, em condições laboratoriais, o molusco B. tenuissimus, utilizando técnicas de histologia e microscopia eletrônica. Três semanas após a exposição às larvas L1, foi possível recuperar larvas L3 dos moluscos infectados, em pequena quantidade. As larvas em desenvolvimento foram observadas na massa cefalopediosa (pé), ovotestis e nos tecidos do manto, sendo localizadas dentro de uma estrutura granulomatosa constituída por infiltração hemocitária, mas não houve deposição de cálcio ou colágeno nessas estruturas em quantidade significativa. Na terceira semana pós exposição, foi possível observar uma bainha ao redor das larvas em desenvolvimento. Os caracóis infectados apresentaram redução no tecido muscular fibroso na região do pé, perda da organização acinar na glândula digestiva, com aumento de material amorfo dentro dos ácinos e perda do padrão epitelial da organização nuclear nas células acinares. No entanto, o ovotestis, pareceu não ser afetado pela infecção, uma vez que houve um grande número de oócitos em desenvolvimento e espermatozóides em diferentes estágios de formação. A digestão dos moluscos infectados nos permitiu a recuperação de larvas de terceiro estágio (17,25%), aos 14 dias após a exposição à L1 de A. cantonensis . Estas L3 recuperadas de B. tenuissimus foram utilizados para infectar ratos experimentalmente, e 43 dias após a infecção, as larvas do primeiro estágio (L1) foram recuperadas de fezes frescas. Os resultados apresentados representam o primeiro registro do papel de B. tenuissimus como hospedeiro intermediário experimental de A. cantonensis e trazem alguma luz a um problema, até então silencioso, uma vez que a sobreposição da distribuição de B. tenuissimus e A. cantonensis no Brasil, e outros países, onde as diferentes espécies de Bulimulus ocorrem, torna possível o estabelecimento e manutenção do ciclo de vida deste parasito na natureza, com roedores selvagens como reservatório, agindo como fonte de infecção para humanos e causando a angiostrongilíase neural.

Efficacy of Milk Fluoride Prevention of Dental Caries in Children Under 12 Years Old: A Review / Eficacia de la Leche Fluorada en la Prevención de Caries Dentales en Niños Menores de 12 Años: Una Revisión

Dental caries is the most common infectious-contagious worldwide disease that can be prevented with fluoride. Since milk is an important part of children's diets, it is a good choice as vehicle to deliver fluoride. The objective of the study was to determine the efficacy of fluoridated milk as a systemic prevention to prevent dental caries in children under 12 years old. This is a systematic review with narrative analysis. It develops search strategies in all kinds of studies databases without language restrictions. An overview table was done describing: author, method, statistical type, comparison group, outcome type, sample / universe, patient type, intervention type and adverse effect. The results showed that fluoride milk is effective in preventing dental caries. Since milk already contains elements which prevent dental caries, adding the appropriate amount of fluoride would increase the protective effect against them.

La caries dental es la enfermedad común que se puede prevenir con una correcta higiene y el uso de fluoruro. La leche es una parte importante de la dieta de los niños, por ende, una buena opción como vehículo para entregar fluoruro. El objetivo fue determinar la eficacia de la leche fluorada para la prevención de la caries dental en niños menores de 12 años. Se realizó una revisión sistemática con análisis narrativo. Se desarrolló estrategias de búsqueda en bases de datos sin restricciones de idioma ni de diseño. Se generó una tabla general describiendo: autor, método, tipo estadístico, grupo de comparación, el tipo de resultado, muestra / universo, tipo de paciente, el tipo de intervención y los efectos adversos. Se demostró que la leche fluoruro es eficaz para prevenir la caries dental. La leche poseen elementos que impiden la caries dental, la adición de la cantidad apropiada de flúor aumentaría el efecto protector contra ello.

Reconstrucción perineal inmediata en extensa resección abdominoperineal rectal / Immediate perineal reconstruction after vast rectal abdominoperineal resection

Background: Buschke-Lowenstein tumor is a benign skin lesion secondary to human papilloma virus infection. It usually appears as an exophytic anogenital mass and may progress to a squamous cell carcinoma. It can be treated with chemo, radio or immunotherapy and occasionally it requires radical surgery. Case report: We report a 53 years old male with a perianal lesion lasting 15 years that was treated with chemo-radiotherapy that relapsed with malignant transformation. Since the pathological study showed a squamous cell carcinoma, a rectal abdominoperineal resection was planned. The defect that left the surgical procedure was covered with musculocutaneous flaps from gracilis muscle of the thigh.

Introducción: El tumor de Buschke-Lõwenstein es una lesión cutánea benigna, secundaria a la infección por virus papiloma humano, usualmente se presenta como una gran masa exofítica genitoanal y tiene riesgo de evolucionar a carcinoma espinocelular. Dentro de su tratamiento existen varias alternativas, desde menos agresivas como quimio-radioterapia e inmunoterapia, que suelen tener alta tasa de recidiva, hasta la cirugía radical. Caso clínico: Presentamos el caso de un paciente masculino, con una lesión perianal de 15 años de evolución, inicialmente se sometió a terapias locales conservadoras y quimiorradioterapia y posteriormente recidivó con transformación maligna. Habiéndose confirmado histológicamente la presencia de carcinoma espinocelular, debió abordarse mediante una resección abdominoperineal rectal. Dicha cirugía determinó un gran defecto de cobertura perianal y perineal que fue reparado mediante colgajos músculo-cutáneos de gracilis y fasciocutáneos de muslo. Discusión: Si bien se han descrito algunos métodos de resección local, sólo la cirugía radical permite su eliminación completa disminuyendo el riesgo de recurrencia. Ello genera un defecto perianal de difícil manejo, para el cual existen varias opciones reconstructivas: injertos, colgajos locales y regionales, y, con menor frecuencia, colgajos libres. Se debe considerar que en aquellos defectos de gran tamaño, con gran pérdida de tejido, las opciones de reconstrucción del defecto con volumen y cobertura cutánea adecuada son limitadas. Presentamos nuestra experiencia con algunas de estas técnicas, entre las que destaca el colgajo de músculo gracilis, con los múltiples beneficios que posee.

Tetralogía de Fallot asociada a duplicación distal del brazo largo del cromosoma 11 / Tetralogy of Fallot associated with distal duplication of the long arm of chromosome 11

La tetralogía de Fallot es una cardiopatía frecuente y puede representar hasta el 11 al 13% de todas las cardiopatías congénitas clínicas, se presenta en 1 de cada 8.500 nacidos vivos. En la mayoría de los casos, se asocia a una microdeleción del cromosoma 22 y con menor frecuencia al síndrome de Down. El síndrome de la dup 11q es una anomalía cromosómica causada por la duplicación de la porción distal del extremo del brazo largo del cromosoma 11, ocasionando una trisomía parcial del mismo, producto de un desbalance cromosómico, con disfunción de los genes involucrados en este material genético adicional que ocasiona anormalidades tanto físicas como mentales en un recién nacido. Se presenta el caso de un niño de 3 meses de vida que es derivado a la consulta genética por fenotipo sindromático, Tetralogía de Fallot y retraso del crecimiento. El estudio citogenético se realizó en sangre periférica, los cromosomas fueron procesados con técnicas de tinción convencional, bandas de alta resolución y centroméricas, observándose una duplicación 11q. Cariotipo: 46, XY, dup11 (q23àqter). Se enfatiza la importancia del estudio cromosómico en recién nacidos con malformaciones congénitas mayores para el diagnóstico de certeza y posterior asesoramiento genético a los progenitores.

Tetralogy of Fallot is a common heart disease and may represent up to 11 to 13% of allclinical congenital cardiopathies, it occurs in about 1 out of every 8,500 live births. Inmost cases is associated with a microdeletion of chromosome 22 and less frequently withDown syndrome. Syndrome Dup11q is a chromosomal abnormality caused by duplicationof the distal end of the long arm of chromosome 11 resulting in a partial trisomy, productof a chromosomal imbalance, with dysfunction of the genes involved in this additionalgenetic material causing both physical and mental abnormalities in a newborn. This is thecase of a 3-month boy who was referred to genetic consultation due to syndromicphenotype, Tetralogy of Fallot and growth retardation. The cytogenetic study wasperformed in peripheral blood. Chromosomes were processed with conventional stainingtechniques, centromeric and high-resolution bands, showing 11q duplication. Karyotype:46, XY, dup11 (q23qter). We emphasize the importance of chromosomal studies ininfants with major congenital malformations for a subsequent accurate diagnosis andgenetic counseling to parents.

Huella de agua y carbono de una sesión de kinesiterapia / Carbon and water footprint in a physical therapy session

Un tema emergente en la actualidad es el que rodea al término Cambio Climático. Según los estudios de Stegman y McKibbin existe influencia de las actividades humanas en su gestación y control por lo que es posible asumir que nuestra labor como Kinesiologos también es parte de esta influencia. El propósito de este artículo es introducir una mirada que promueva la revisión de las actividades Profesionales del Kinesiólogo Clínico, desde su formación de pregrado hasta su desempeño laboral, a la luz del conocimiento de la huella de Carbono y Agua que estas dejan en el Planeta. Se hace una revisión de la escasa literatura disponible en Kinesiología abordando una observación diferente de nuestro actuar terapéutico.

A currently emerging, issue is what surrounds the term Climate Change. According to studies by Stegman and McKibbin there is influence of human activities in its gestation and control making it possible to assume that our Physical Therapists labor also work as part of this influence. The purpose of this article is to introduce a look that promotes the review of clinical Physical Therapist professional activities from their undergraduate training to job performance in the light of the knowledge of the carbon and water footprint that they leave on the planet. One presents a review of the limited literature available in Physical Therapy, addressing a different observation of our therapeutic act.

Cisgenesis and Intragenesis: New tools For Improving Crops

Genetically Modified Organisms (GMO) could be the answer for many relevant problems affecting crops. However, improving crops through GMO is also often associated with safety concerns, environmental risks and health issues due to the presence of foreign DNA. These limitations have prompted the development of alternative technologies. Recently, cisgenesis and intragenesis have been developed as new tools aimed to modify crops. While cisgenesis involves genetic modification using a complete copy of natural genes with their regulatory elements that belong exclusively to sexually compatible plants, intragenesis refers to the transference of new combinations of genes and regulatory sequences belonging to that particular species. So far, application of cisgenesis and intragenesis as alternatives to conventional transgenesis are limited to a few species, mainly due to the lack of knowledge of the regulatory sequences required. The grape is one of the most cultivated crops worldwide and is the most economically relevant crop in Chile. Its genomic sequence has been completed, making available new sources of information to improve grape traits by genetic manipulation. This review is focused on the current alternatives to transgenesis in plants, including new approaches to develop marker-free crops, their application to economically relevant crops and future perspectives in the area. Also, the identification of grapevine promoters with a wide range of expression profiles is shown. The expression pattern of these genes was analyzed in different tissues and developmental stages, as well as under several stresses and stimuli, giving a broad range of expression patterns, including genes expressed exclusively during ripening, in response to sugars, senescence and biotic stress, among others. Genes with strong and constitutive expression were also identified. Functional analysis using reporter genes has been conducted in order to confirm the promoter's transcription activity, opening new possibilities for developing cisgenic/intragenic grapevines.

A Escola de Educação Física da Universidade Federal do Rio Grande do Sul e a Internacionalização da Educação Superior / The Faculty of Physical Education of the Federal University of Rio Grande do Sul and the internationalization of higher education / La Faculdad de Educación Física de la Universidad Federal del Rio Grande del Sur y la internacionalización de la educación superior

Neste estudo, descrevemos o caminho seguido pela ESEF-UFRGS na direção da internacionalização da pesquisa e da graduação e destacamos alguns desafios para sua efetivação. A pesquisa tomou como referência depoimentos de docentes, documentos institucionais, registros de atividades de pesquisa e publicações científicas sobre a trajetória institucional. Os resultados indicaram que a ESEFUFRGS vem desenvolvendo iniciativas em direção à internacionalização da pesquisa e da graduação. As principais iniciativas foram mobilidade de estudantes e docentes, publicações em periódicos internacionais e participação em eventos com e sem apresentação de trabalhos. O maior desafio tem sido instalar uma cultura de internacionalização em que a relação com instituições de educação superior de outros países seja vista como qualificadora das atividades de ensino e pesquisa

In this study, we attempted to establish the path of ESEF-UFRGS in direction to the internationalization of higher education and to highlight the main challenges to its realization. The study took as reference staff interviews, institutional documents, research reports and scientific publications. The results pointed out that ESEF-UFRGS has taken action in direction of the internationalization of its research activities and undergraduate program. The main actions were student and academic mobility, international publications and participation in scientific meetings with and without presentations. The major challenge has been to establish a culture of internalization in which the exchange with institutions of other countries i seen by the academic community as way to qualify teaching and research

En este estudio, hemos tratado de establecer la trayectoria de la ESEF-UFRGS en dirección a la internacionalización de la educación superior y destacar los principales desafíos para su realización. El estudio tomó como referencia entrevistas con los docentes, documentos institucionales, informes de investigación y publicaciones científicas. Los resultados señalaron que la ESEF-UFRGS se ha tomado medidas en la dirección de la internacionalización de sus actividades. Las principales acciones fueron la movilidad estudiantil y académica, publicaciones en revistas internacionales y participación en eventos con y sin presentación de trabajos. El mayor desafío ha sido establecer una cultura de internalización en la cual el intercambio con las instituciones de otros países es considerado por la comunidad académica como manera de calificar la enseñanza y la investigación