Selaginella P.Beauv. (Selaginellaceae) in the state of Maranhão, northeastern, Brazil: A floristic survey and a new record for the Cerrado domain / Selaginella P.Beauv. (Selaginellaceae) no estado do Maranhão, nordeste, Brasil: Levantamento florístico e novo registro para o domínio Cerrado

Abstract This work is a floristic study of Selaginella in Maranhão. The species survey is based on collections from fieldwork conducted between April 2006 and February 2023 and specimens from Maranhão deposited at the CCAA, HBRA, MG, and SLUI herbaria. Ten species were identified: Selaginella conduplicata, S. convoluta, S. erythropus, S. flagellata, S. gynostachya S. marginata, S. minima, S. radiata, S. simplex, and S. sulcata. We report the first record of S. gynostachya for Maranhão and the Cerrado domain in Brazil. Until now, this species was only known from areas of Amazonia. We provide a map with records, an identification key, and comments about the identification and geographic distribution of Selaginella species in Maranhão state. For the new record, we also provide photos.

Resumo O presente trabalho trata do estudo florístico de Selaginella no Maranhão. O levantamento de espécies foi realizado com base em coletas de campo realizadas entre abril de 2006 e fevereiro de 2023 e em análise de espécimes coletados no Maranhão e depositadas nos herbários CCAA, HBRA, MG e SLUI. Foram identificadas 10 espécies: Selaginella conduplicata, S. convoluta, S. erythropus, S. flagellata, S. gynostachya S. marginata, S. minima, S. radiata, S. simplex e S. sulcata. Relatamos a primeira ocorrência de S. gynostachya para o Maranhão e também para o domínio do Cerrado Brasileiro. Até então essa espécie era registrada somente em áreas amazônicas. Neste artigo apresentamos um mapa com pontos de coleta, uma chave de identificação e comentários sobre a identificação, ecologia e distribuição geográfica para as espécies de Selaginella do Maranhão. Para o novo registro apresentamos também fotos.

Características y desenlaces clínicos de pacientes menores de 18 años tratados con oxigenación con membrana extracorpórea posterior a cirugía para la reparación o paliación de cardiopatías congénitas / Characteristics and clinical outcomes of patients under 18 years of age treated with extracorporeal membrane oxygenation after surgery for the repair or palliation of congenital heart disease

Resumen: Objetivo: determinar las características y desenlaces clínicos de pacientes menores de 18 años tratados con oxigenación con membrana extracorpórea (ECMO) posterior a cirugía para la reparación o paliación de cardiopatías congénitas en un centro de referencia del suroccidente colombiano entre 2015 y 2020. Método: estudio descriptivo longitudinal con recolección retrospectiva de la información. Resultados: entre enero de 2015 y diciembre de 2020, 77 pacientes requirieron ECMO posterior a cirugía cardiaca pediátrica, con una mediana de edad de < 1 mes, mediana de peso de 4 kg, tiempo de circulación extracorpórea de 202 minutos y tiempo de pinzamiento aórtico de 95 minutos. La cardiopatía congénita más ingresada a ECMO fue el síndrome de corazón izquierdo hipoplásico (19.4%) en su posquirúrgico de Norwood (18.1%). La mediana del tiempo de ECMO fue de 111 horas. La indicación más frecuente fue la disfunción ventricular (80.5%). El 80.5% presentó complicaciones y la reintervención por sangrado fue la más frecuente (46.7%). La sobrevida a la ECMO fue del 48% y la sobrevida general al momento del alta fue de 25.97%. La edad < 1 mes (p = 0.030), el ácido láctico preECMO ≥ 5 mmol/l (p = 0.014) y el tiempo de normalización del lactato ≥ 24 horas (0.021), se asociaron a un mayor riesgo de mortalidad al egreso hospitalario. Conclusiones: la ECMO proporciona un soporte adecuado posterior a la cirugía cardiaca pediátrica. La edad < 1 mes, el ácido láctico preECMO ≥ 5 mmol/L y el tiempo de normalización del lactato ≥ 24 horas fueron las variables que se asociaron con un mal resultado y mortalidad hospitalaria.

Abstract: Objective: to determine the characteristics and clinical outcomes of patients under 18 years of age treated with extracorporeal membrane oxygenation (ECMO) after surgery for the repair or palliation of congenital heart disease. Method: longitudinal descriptive study with retrospective data collection. Results: between January 2015 and December 2020, 77 patients required ECMO after pediatric cardiac surgery with a median age of < 1 month, median weight of 4 kg, ECC time 202 minutes (IQR 125-272 minutes), aortic cross-clamp time 95 minutes. 76.6% were supported with ECMO prior to their return to the ICU. The congenital heart disease most frequently admitted to ECMO was hypoplastic left heart syndrome (19.4%) in the Norwood postoperative period (18.1%). The median time of ECMO was 111 hours. The most frequent indication was ventricular dysfunction (80.5%). 80.5% presented complications and reoperation for bleeding was the most frequent of these (46.7%). ECMO survival was 48% and overall survival at discharge was 25.97%. Age < 1 month (p = 0.030), pre-ECMO lactic acid ≥ 5 mmol/l (p = 0.014), OR 0.260 and time of normalization of lactate ≥ 24 hours (0.021), OR 0.24 were associated with a higher risk of mortality at hospital discharge. Conclusions: ECMO provides adequate support after surgery for the repair or palliation of congenital heart disease. Age < 1-month, pre-ECMO lactic acid ≥ 5 mmol/l, and lactate normalization time ≥ 24 hours were the variables that were associated with poor outcome and hospital mortality.

Prevalencia de la osificación heterotópica tras artroplastia de disco cervical a los 5 años / Prevalence of heterotopic ossification after cervical disk arthroplasty at 5 years

INTRODUCCION En los últimos años, la artroplastia de disco cervical (ADC) se ha utilizado ampliamente en pacientes como alternativa a la disectomía y fusión cervical anterior (DFCA). Sin embargo, se han informado osificación heterotópica (OH) y fusion espontánea después de ADCs, y el desarrollo de OH puede dificultar el mantenimiento de movimiento después de la artroplastia. MATERIALES Y METODOS El procedimiento ADC con prótesis Activ C y M6-C se realizó en 127 pacientes. El tiempo medio de seguimiento fue de 58.4 meses, con un rango de 51 a 66 meses. RESULTADOS Las osificaciones de grado 1 estuvieron presentes en 11 niveles (8,6%). Un total de 45 (35,4%) segmentos eran de OH de grado 2. Las OHs que produjeron restricciones del rango de movimiento estuvieron presentes en 13 (10,2%) casos. A los 5 años de seguimiento, sólo había 9 (7,0%) pacientes con osificación de grado 4 en el grupo de prótesis de disco artificial M6-C. En el análisis de la supervivencia tras la ocurrencia de OH, la mediana de los pacientes fue de 28,3 5,6 meses. El grupo de prótesis de disco artificial Activ C tuvo una supervivencia estadísticamente más larga (49,5 7,8 meses) que el grupo de disco M6-C. CONCLUSIONES En este estudio, el 61,4% de los pacientes desarrollaron OH en un período de seguimiento medio de 58,4 meses. En el análisis de la supervivencia tras la ocurrencia de OH, la mediana de los pacientes fue de 28.3 5.6 meses. El grupo de prótesis de disco artificial Activ C tuvo una supervivencia estadísticamente más larga (49.5 7.8 meses) que el grupo de disco M6-C.

INTRODUCTION In recent years, cervical disk arthroplasty (CDA) has become widely used in patients as a substitute to anterior cervical diskectomy and fusion (ACDF). However, heterotopic ossification (HO) and spontaneous fusion after CDA have been reported, and maintenance of motion following arthroplasty can be hindered by the development of HO. MATERIALS AND METHODS The CDA procedure with Activ C and M6-C prostheses was performed on 127 patients. The mean follow-up time was of 58.4 months, ranging from 51 to 66 months. RESULTS Grade-1 ossifications were present in 11 (8.6%) levels. A total of 45 (35.4%) segments showed grade-2 HO. Cases of HO that led to restrictions in the range of motion were present in 13 (10.2%) patients. Fives year postoperatively, there were only 9 (7.0%) patients with grade-4 ossifications in the M6-C artificial disk prosthesis group. In the survival analysis after HO occurrence, the median survival of the patients was of 28.3 5.6 months. The Activ C artificial disk prosthesis group had a statistically longer survival (49.5 7.8 months) than the M6-C disk group. CONCLUSION In the present study, 61.4% of the patients developed HO at a mean follow-up period of 58.4 months. In the survival analysis after HO occurrence, the median survival of the patients was of 28.3 5.6 months. The Activ C artificial disk prosthesis group had a statistically longer survival (49.5 7.8 months) than the M6-C disk group.

Extensión de la afectación pulmonar por tomografía en pacientes con neumonía por SARS-CoV-2 / Extent of lung involvement by tomography in patients with SARS-CoV-2 pneumonia

RESUMEN Objetivo. Determinar la extensión de la afectación pulmonar en pacientes con neumonía por SARS-CoV-2 mediante tomografía. Método. Evaluación retrospectiva en pacientes con evidencia de COVID-19 del Hospital Nacional Guillermo Almenara Irigoyen, Lima - Perú, al inicio de la pandemia COVID-19, entre el 15 de marzo y el 14 de mayo de 2020. La extensión de la neumonía se determinó mediante tomografía con base en la Clasificación de la Sociedad Francesa de Imagen Torácica. Resultados. Se incluyeron en el estudio 485 pacientes. La extensión de la neumonía fue: ausente 1,2%, mínima 4,9%, moderada 20,6%, extensa 27,4%, grave 30,7% y crítica 15,1%. La afectación pulmonar se asoció con edad mayor de 60 años (p=0,014) y saturación de oxígeno ambiental por debajo de 90% (n=372, p=0,000). Conclusiones. Por su extensión, las neumonías por SARS-CoV-2 en los primeros dos meses de la epidemia de COVID-19 en el Hospital Almenara fueron graves, extensas y moderadas en su gran mayoría. La extensión de la neumonía se asoció con edad y saturación de oxígeno ambiental al ingreso.

ABSTRACT Objective. To determine the extent of pulmonary involvement in patients with SARS-CoV-2 pneumonia using tomography. Method. Retrospective evaluation in patients with evidence of COVID-19 at the Guillermo Almenara Irigoyen National Hospital, Lima - Peru, at the beginning of the COVID-19 pandemic, between March 15 and May 14, 2020. The extent of pneumonia was determined by means of tomography based on the Classification of the French Society of Thoracic Imaging. Results. 485 patients were included in the study. The extent of pneumonia was: 1.2% absent, 4.9% minimal, 20.6% moderate, 27.4% extensive, 30.7% severe, and 15.1% critical. Lung involvement was associated with age older than 60 years (p = 0.014) and ambient oxygen saturation below 90% (n = 372, p = 0.000). Conclusions. Due to its extension, the SARS- CoV-2 pneumonia in the first two months of the COVID-19 epidemic at Hospital Almenara were severe, extensive and mostly moderate. The extent of pneumonia was associated with age and ambient oxygen saturation at admission.

Hallazgos ecográficos para la determinación de nódulos tiroideos malignos / Ultrasound findings for the determination of malignant thyroid nodules

Resumen Introducción: Los nódulos tiroideos son un crecimiento localizado en el tejido tiroideo, aproximadamente el 8 % son malignos, y el ultrasonido es el método ideal para detectarlos. Objetivo: Determinar cuáles son los hallazgos ecográficos que pueden sugerir una mayor probabilidad de malignidad del nódulo tiroideo. Metodología: Estudio descriptivo de tipo corte transversal en pacientes con nódulo tiroideo en una institución prestadora de salud de Neiva. Resultados: Se evaluaron 63 pacientes con un promedio de edad de 52 años, 95 % fueron femeninos y el 5 % masculinos. El 71 % presentaron nódulos tiroideos benignos, y el 10 % nódulos malignos. En el 100 % de los nódulos tiroideos malignos se encontró vascularidad aumentada, microcalcificaciones, adenopatías asociadas, bordes irregulares y componente sólido, y los hallazgos con respecto a hipoecogenicidad y diámetro anteroposterior mayor al transverso (más alto que ancho), se encontró en el 83 % siendo estadísticamente significativos. La sensibilidad de los hallazgos ecográficos supera el 80 %, excepto la variable "tamaño del nódulo mayor a 1 centímetro". Conclusiones: Los hallazgos ecográficos como adenopatías y el diámetro anteroposterior mayor al transverso son indicadores potenciales de nódulos tiroideos malignos, el tamaño mayor a un centímetro no siempre es predictor de malignidad, sin embargo debido al tamaño de la muestra en nuestro estudio no es posible generalizarlo como un factor determinante para la realización de biopsia, por ende recomendamos el seguimiento de los nódulos teniendo en cuenta los criterios ecográficos de malignidad y la clasificación TIRADS para tomar decisiones con respecto a las biopsias tiroideas.

Abstract Introduction: Thyroid nodules are a localized growth in the thyroid tissue, approximately 8% are malignant, and an ultrasound is the ideal method to detect them. Objective: Determine which are the ultrasound findings that may suggest an increased probability of thyroid nodule malignancy. Methodology: Descriptive cross-sectional study amongst patients with thyroid nodule in a healthcare institution in Neiva. Results: A total of 63 patients were evaluated with an average age of 52 years, 95% were female and 5% male. Seventy-one percent had benign thyroid nodules, and 10% malignant nodules. In 100% of malignant thyroid nodules, increased vascularity, microcalcifications, associated adenopathies, irregular borders and solid component were found, and the findings regarding hypoechogenicity and anteroposterior diameter greater than the transverse (higher than wide), were found in 83%, being statistically significant. The sensitivity of ultrasound findings exceeds 80%, except for the variable nodule size greater than 1 centimetre. Conclusions: Ultrasound findings such as adenopathies and anteroposterior diameters greater than the transverse one are potential indicators of malignant thyroid nodules, the size greater than one centimetre is not always a predictor of malignancy; however, due to the size of the sample in our study it is not possible to generalize it as a determining factor for biopsy. Therefore, we recommend monitoring the nodules considering the ultrasound criteria for malignancy and the TIRADS classification to make decisions regarding thyroid biopsies.

Age determination in subadults using histological analysis of bones / Determinación de la edad en subadultos usando análisis histológico de los huesos

Abstract Introduction: According to the literature, the amount of osteons has been suggested as a good proxy to determine the age of death in adults. However in subadults research has not been carried out yet. Objective: To determine the accuracy of the histomorphometric technique predicting the age at death in subadults using bone remains. Methodology: The information of static histomorphometric parameters from about 120 iliac bones retrieved from the exhumed remains of subadults whose age at death was known was taken from the Granada collection. In order to predict the age at death we performed a step by step linear regression to estimate the fittest model. Results: The most closely and significantly associated biopsy findings with age were: the osteon count, the internal cortical width, and the trabecular bone volume. Pearson's correlation index indicated a weak linear association among these variables. To assess the accuracy of the model we used a coefficient of determination with a 0.32 value. 32% of the age variation in the subadults was explained by the three variables. Conclusion: This regression model explains a percentage of the total age variation in the subadult population. However this model is not enough to determine the age at death.

Resumen Introducción: La capacidad de predicción de las osteonas para determinar la edad de muerte de los individuos ha sido descrito en la literatura científica. No obstante, no se ha determinado dicha capacidad en individuos subadultos. Objetivo: Determinar la eficacia de lo parámetros histomorfometricos en población subadulta. Metodología: Se realizaron biopsias de hueso ilíaco en los restos de 120 subadultos, de la Colección Osteológica de Granada, con edad conocida en el momento de la muerte. Para establecer la capacidad de predicción se utilizó el R2 obtenido a partir de regresión lineal múltiple. Resultados: Las variables con mayor nivel predictivo y significativo para la estimación de la edad fueron: recuento de osteonas tipo 2 de la cortical interna y externa, y el volumen óseo trabecular; En la evaluación del modelo, se obtuvo un coeficiente de determinación de 0.32, es decir, el 32% de la variación en la edad de los subadultos se explica por el modelo. Sin embargo, se evidenció diferencias en la capacidad de predicción por sexo. Conclusión: Este modelo de regresión explica un porcentaje sustancial de la varianza de la edad de los individuos en la muestra. No obstante, no es suficiente para garantizar una adecuada predicción de la edad al momento de muerte de los individuos subdultos.

Does Knee Arthroscopy for Treatment of Meniscal Damage with Osteoarthritis Delay Knee Replacement Compared to Physical Therapy Alone?

Background@#To determine patient factors that lead to treatment of meniscal tears with osteoarthritis (OA) with knee arthroscopy (KA) or physical therapy only (PT-only); and to assess differences in clinical outcomes including the time to knee arthroplasty. @*Methods@#Patients aged ≥ 45 years with OA at meniscal tear diagnosis were followed up from the date of surgery (KA) or first PT visit (PT-only) until partial/total knee replacement surgery, death, disenrollment, or end of study. Demographic and clinical characteristics were compared and used to derive propensity scores. A Cox proportional hazards model was used to estimate the risk of knee replacement surgery and greater healthcare utilization associated with KA vs. PT-only. @*Results@#Among 7,026 patients (KA, 69%; PT-only, 31%), 27% had partial or total knee replacement surgery during follow-up.PT-only patients were older and more likely to be women and had more comorbidities. After accounting for differences between groups, the cumulative incidence of knee replacement was modestly but significantly higher for those who received KA than those who underwent PT-only (hazard ratio, 1.30; 95% confidence interval, 1.17–1.44; p < 0.001), although there was no significant difference in health service utilization, narcotic medication dispenses, or knee injections after initiating treatment. @*Conclusions@#For patients with meniscal damage complicated by OA, those who underwent KA were 30% more likely to have partial or total knee replacement surgery at any given time than those who had PT alone.

Drivers of change in biodiversity and ecosystem services in the Cantareira System Protected Area: A prospective analysis of the implementation of public policies / Agentes de mudança na biodiversidade e serviços ecossistêmicos na APA Sistema Cantareira: Uma análise prospectiva da implementação de políticas públicas

Abstract: The lack of implementation of well-designed public policies aimed at the conservation of natural ecosystems has resulted, at a global level, in the decline of ecosystem functioning and, consequently, of the contributions they make to people. The poor enforcement of important environmental legislation in Brazil - for instance, the "Atlantic Forest Law" (Law n.11.428/2006) and the "Forest Code" (Law n.12.651/2012) - could compromise the overall maintenance of ecosystems and the services they provide. To explore the implications of different levels of federal laws' enforcement within the Cantareira System Protected Area (PA) - a PA in southeastern Brazil that provides fresh water for 47% of the Sao Paulo Metropolitan Area -, we developed a conceptual framework to identify indirect and direct drives of biodiversity and ecosystem changes. We also projected four land-use scenarios to 2050 to test the effects of deforestation control and forest restoration practices on biodiversity and ecosystem services maintenance: the "business-as-usual" scenario (BAU), which assumes that all trends in land-use cover changes observed in the past will continue in the future, and three alternative exploratory scenarios considering the Atlantic Forest Law implementation, the partial implementation of the Forest Code and the full implementation of the Forest Code. Using the land-use maps generated for each scenario, we assessed the impacts of land-use changes on biodiversity conservation and soil retention. Our results revealed all alternative scenarios could increase biodiversity conservation (by 7%; 12%; and 12%, respectively), reduce soil loss (by 24.70%; 34.70%; and 38.12%, respectively) and sediment exportation to water (by 27.47%; 55.06%; and 59.28%, respectively), when compared to the BAU scenario. Our findings highlight the importance of restoring and conserving native vegetation for the maintenance and improvement of biodiversity conservation and for the provision of ecosystem services.

Resumo: A falta de implementação de políticas públicas voltadas para a conservação ambiental, tem resultado, em nível global, em impactos sobre a biodiversidade e o funcionamento dos ecossistemas e, consequentemente, na contribuição da natureza para as pessoas. A aplicação inadequada de importantes de leis ambientais no Brasil, como por exemplo, a "Lei da Mata Atlântica" (Lei nº 11.428 / 2006) e o "Código Florestal" (Lei nº 12.651 / 2012), podem comprometer a manutenção dos ecossistemas e dos serviços que eles fornecem. Neste estudo, nós desenvolvemos um mapa conceitual que busca identificar causas diretas e indiretas de mudanças - agentes de mudança - na biodiversidade e na provisão de serviços ecossistêmicos relacionados ao solo e à água, na Área de Proteção Ambiental (APA) Sistema Cantareira. A APA Sistema Cantareira, localizada no sudeste do Brasil, fornece água potável para 47% da Região Metropolitana de São Paulo. Além da abordagem conceitual, nós projetamos quatro cenários de mudança no uso da terra para o ano de 2050, a fim de analisar o impacto de diferentes níveis de aplicação de leis federais: o cenário "business-as-usual" (BAU), que pressupõe que as tendências na mudança de uso da terra observadas no passado continuarão no futuro, e três cenários alternativos, considerando a implementação da Lei da Mata Atlântica, a implementação parcial do Código Florestal e a implementação completa do Código Florestal. A partir dos mapas de uso da terra gerados, avaliamos os impactos de cada cenário na conservação da biodiversidade, na retenção de solos e na exportação de sedimentos para os corpos d'água. Nossos resultados mostraram que os três cenários alternativos podem aumentar a conservação da biodiversidade (em 7%; 12%; e 12%, respectivamente), reduzir a perda de solo (em 24,70%; 34,70%; e 38,12%, respectivamente) e reduzir a exportação de sedimentos para a água (em 27,47 %; 55,06%; e 59,28%, respectivamente), quando comparados ao cenário BAU. Este estudo destaca a importância da restauração e conservação da vegetação nativa para a manutenção da biodiversidade e melhoria na provisão de serviços ecossistêmicos relacionados ao solo e à água, em uma região estratégica para o abastecimento de água no Brasil.

The effect of green fertilizers on the ecological structure of soil invertebrate communities in an andisol of Southwestern Colombia

Introduction: Chemical fertilizers for agriculture can negatively affect the communities of soil invertebrates that contribute to nutrient cycling, nutrient availability, soil formation and fertility. As an alternative, previous work has suggested that green fertilizers (fresh tissue from plants) are effective to preserve soil fertility, without affecting the ecological properties of invertebrate communities. Objective: This work aimed to evaluate how green fertilizers affect the ecological structure of an invertebrate community in an andisol from Southwestern Colombia. Methods: Fresh leaves from seven plant species locally sown and grown in March 2018 were used as the fertilizers by incorporating and mixing them with the soil in 24 experimental subplots. After 45 days of incorporation, the abundance, richness, biomass and diversity of soil invertebrates were measured in three replicate soil cores per subplot and at three depths. Results: Comparing against a control treatment with no fertilization, the richness and abundance of soil invertebrates were up to 14-fold higher in treatments with Alnus jorullensis and Brassica napus, and up to 5-fold higher in treatments with Vicia sativa, Lupinus mutabilis, Plantago lanceolata and Medicago sativa. Diversity indices showed a shift from high dominance by one or a few invertebrate families in the control treatment, to a high diversity and greater evenness in the A. jorullensis, P. lanceolata and M. sativa treatments. Biomass was negatively correlated with richness and abundance, suggesting a possible ecological trade-off worth to evaluate in further research. Conclusions: In general, our results demonstrate that the application of green fertilizers in this Andean environment can significantly improve the ecological status of soil invertebrate communities. These communities ultimately provide the ecological functions for soil dynamics; thus, agroecology practices should consider them as a valuable alternative to balance production and conservation.

Introducción: Los fertilizantes químicos para la agricultura afectan negativamente a las comunidades de invertebrados, las cuales contribuyen al ciclaje, disponibilidad de los nutrientes y a la formación y fertilidad del suelo. Como alternativa, investigaciones previas han sugerido que los abonos verdes (tejido fresco de plantas) son efectivos para conservar la fertilidad del suelo, posiblemente sin afectar los invertebrados. Objetivo: Evaluar como la aplicación de abonos verdes al suelo afecta cuantitativamente estas propiedades en una comunidad de macrofauna edáfica de un andisol al suroccidente de Colombia. Métodos: El follaje fresco de siete especies de plantas sembradas y cultivadas localmente durante marzo 2018 fue utilizado como abono verde, el cual fue incorporado y mezclado con el suelo superficial en 24 subparcelas experimentales. Después de 45 días de aplicar los abonos, se midió la abundancia, riqueza, biomasa y diversidad de la comunidad de invertebrados. Resultados: En comparación a un tratamiento testigo la riqueza y abundancia de invertebrados fue 14 veces más alta en tratamientos con A. jorullensis y B. napus, y cinco veces más alta en tratamientos con V. sativa, L. mutabilis, P. lanceolata y M. sativa. Los índices de diversidad mostraron un cambio desde una dominancia por una o pocas familias de invertebrados en el testigo, a una alta diversidad y equitatividad en los tratamientos con A. jorullensis, P. lanceolata y M. sativa. La biomasa estuvo correlacionada negativamente con la riqueza y la abundancia, sugiriendo un posible trade-off, en este sentido se sugiere que sea estudiada en futuras investigaciones. Conclusiones: En general, estos resultados demuestran que la aplicación de abonos verdes en estos suelos andinos puede mejorar significativamente la presencia de macroinvertebrados en el suelo.

In vitro evaluation of combination effects of doxorubicin with methylxanthine fractions isolated from Bancha and Pu-erh teas against breast cancer cells

Background: In the present study we investigated the combination effects of anthracycline antibiotic, doxorubicin, with methylxanthine fractions isolated from Bancha and Pu-erh tea leaves, against MCF-7 and MDA-MB-231 breast cancer cell lines.Methods: Neutral red uptake assay was used for assessment of cytotoxicity effects and fractional effect analysis and combination index for evaluation of the combination effects.Results: Doxorubicin was used in varying concentrations by a double dilution method, whereas the methylxanthine fractions were in fixed concentrations – 100, 200, 400 or 600 ?g/ml. Results have shown that methylxanthine fraction isolated from Bancha has synergic effects with doxorubicin, while methylxanthines from Pu-erh displayed antagonistic effects.Conclusions: ?he obtained results lead us to suspect, that even minor differences in the composition of natural products can lead to significant differences in the biological activity of the product.

Herramientas estratégicas para la propuesta de modelo de cadena productiva forestal para Arauca, Colombia / Strategic tools to formulate a proposal for a forest productive chain model for Arauca, Colombia / Ferramentas estratégicas para o modelo de cadeia produtiva florestal proposta para Arauca, Colômbia

Resumen En el presente artículo se realizó un análisis diagnóstico con miras a identificar acciones para favorecer la consolidación de una cadena productiva forestal en Arauca, Colombia, como estrategia de desarrollo. A partir de una investigación de tipo cualitativo, con consulta a expertos y con una metodología de planeación participativa, se desarrolló un análisis de debilidades, fortalezas, oportunidades y amenazas (DOFA). También se identificaron elementos que dieron soporte para un posterior análisis Mactor® (Matriz de alianzas y conflictos, tácticas, objetivos y recomendaciones) para identificar intereses de los actores de la cadena, y finalmente se propuso un modelo de representación de la cadena productiva forestal del departamento, con sus respectivos eslabones y agentes.

Abstract In the present article, a diagnostic analysis aimed at identifying actions to favor the consolidation of a forest productive chain in Arauca, Colombia, as a development strategy, was carried out. From a qualitative investigation, with consultation to experts and with a methodology of participative planning, an analysis of weaknesses, strengths, opportunities and threats was developed (SWOT). Elements also were identified, to gave support for a subsequent Mactor® analysis (Matrix of alliances and conflicts, tactics, objectives and recommendations) in order to identify interests of the actors in the chain, and finally was proposed a model of representation of the forest productive chain of the department, with its respective links and agents.

Resumo No presente artigo, foi realizada uma análise diagnóstica que objetivou identificar ações para favorecer a consolidação de uma cadeia produtiva florestal em Arauca, Colômbia, como estratégia de desenvolvimento. A partir de uma investigação do tipo qualitativa, com consulta a especialistas e com uma metodologia de planejamento participativo, foi desenvolvida uma análise de Forças, Fraquezas, Oportunidades e Ameaças (SWOT). Elementos que deram suporte para uma análise Mactor® subsequente (Matriz de alianças e conflitos, táticas, objetivos e recomendações) para identificar os interesses dos atores da cadeia também foram identificados e, finalmente, um modelo de representação da cadeia de produção florestal da departamento, com seus respectivos links e agentes.

Características y resultados de la ingestión de cuerpos extraños en niños / Characteristics and outcomes of foreign body ingestion in children

Introducción: La ingestión de un cuerpo extraño (CE) es un accidente frecuente en el hogar en la edad pediátrica; su manejo oportuno por especialistas puede evitar complicaciones a corto y largo plazo. Objetivo: Describir características y complicaciones de los CE en el tubo digestivo en población pediátrica. Material y métodos: Estudio transversal, retrospectivo y prospectivo. Se incluyeron pacientes con diagnóstico de ingestión de un CE desde enero de 1971 a diciembre de 2016. Se recabaron características generales de los pacientes, tipo de objeto, métodos de extracción y complicaciones. Se realizó análisis descriptivo. Resultados: Durante 45 años, se extrajeron 2637 CE localizados en faringe (n= 118), esófago (n= 2410), estómago (n= 103) e intestino (n= 6). Predominaron en el sexo masculino (50,9%); 74% fueron en menores de 5 años. El 57% llegó en las primeras 24 horas; sialorrea, disfagia y vómito fueron los principales síntomas y un 16% estaba asintomático. La radiografía permitió localizar el CE en el 93%; el más ingerido fue la moneda (78%); la localización más común fue el tercio superior del esófago (79%); el 86% se extrajo con endoscopio rígido y las complicaciones se presentaron en el 7,8% de los casos. Conclusiones: La ingestión de un CE predomina en menores de 5 años, y los metales son los más frecuentes. La radiografía simple es el estudio de elección, que permite realizar el diagnóstico y la extracción es por vía endoscópica con endoscopio rígido o flexible según la experiencia del endoscopista.

Introduction: Foreign body (FB) ingestion is a common home accident during childhood; a timely management by the specialists may help prevent complications in the short and long term. Objective: To describe the characteristics and complications of FB ingestion located in the gastrointestinal tract in the pediatric population. Material and methods: Two phases, retrospective, and prospective study. Patients diagnosed with FB ingestion between January 1971 and December 2016 were included. The general characteristics of patients, FB type, removal method, and complications were registered. A descriptive analysis was performed. Results: Over 45 years, 2637 FBs were removed from the pharynx (n= 118), the esophagus (n= 2410), the stomach (n= 103), and the intestines (n= 6). Male patients predominated (50.9%); 74% were younger than 5 years. Besides, 57% arrived within the first 24 hours; ptyalism, dysphagia, and vomiting were the main symptoms; 16% of patients had no symptoms. It was possible to locate the FB using an X-ray in 93% of cases; the most common FBs were coins (78%); the most frequent location was the upper third of the esophagus (79%); 86% of FBs were removed using a rigid endoscope, and complications were observed in 7.8% of patients. Conclusions: FB ingestion predominated among children younger than 5 years; metal objects were the most common ones. A plain X-ray is the test of choice for diagnosis; removal is usually done with a rigid or flexible endoscope, depending on the endoscopist's experience.

Diseño y validación de la encuesta "costo financiero del cuidado de la enfermedad crónica" / Design and validation of the financial cost of the chronic illness care survey

Resumen Objetivo: Diseñar y validar la encuesta "Costo financiero del cuidado de la Enfermedad crónica" para medir el consumo real efectivo (CRE) e impacto familiar de cuidar a una persona con enfermedad crónica (EC) en Colombia. Metodología: Estudio descriptivo de tipo metodológico realizado entre 2012 y 2013 en cuatro fases: 1) Revisión bibliográfica para seleccionar los referentes y construir la propuesta preliminar de la Encuesta. 2) Validación inicial realizada con familiares de personas con EC; 3) Validación con expertos y 4) Afinamiento de la versión definitiva de la Encuesta mediante su aplicación. Resultados: La encuesta "Costo financiero del cuidado de la EC" está compuesta de cuatro dimensiones que incluyen: Los datos de identificación; el CRE atribuible al cuidado de las personas con EC; la percepción de carga asociada con el costo financiero y, por último, las observaciones relacionadas con el costo del cuidado. Conclusiones: Se diseñó y validó la encuesta "Costo financiero del cuidado de la EC", la cual es un aporte original que permite medir el consumo real efectivo e impacto familiar de cuidar a una persona con enfermedad crónica (EC) en Colombia.

Abstract Objective: Design and validate the survey "Financial Cost of Chronic Ilness Care" to measure the actual money consumption and the family impact of caring for a person with chronic illness in Colombia. Methodology: This is a descriptive methodological study that was conducted in 2012 -2013 including four phases: 1) The literature review in order to select the references and build the preliminary proposal of the Survey. 2) Initial validation on the families of people with Chronic illness; 3) Validation with experts and 4) Implementation of a pilot survey. Results: The "Financial Cost of Chronic Illness Care" survey is composed of four dimensions including: Identification data; The actual money consumption attributable to the care of people with chronic illness; The perception of the financial burden associated with cost, and finally, observations related to the cost of care. Conclusions: The Financial Cost of Chronic Illness Care Survey was designed and validated as an original contribution for measuring actual money consumption as well as the family impact of caring for a person with chronic disease in Colombia.

Furuncular myiasis -Eco-epidemiological view of a case report / Miasis furuncular. Visión ecoepidemiológica de un reporte de caso

Myiasis includes several entities recognized in the rural environment. It occurs generally in older adults and may compromise locations from the skin and scalp to mucous membranes. The responsibles are insects of the Diptera class, whose larvae develop in living tissues thus infesting of the host. We report the case of an 82-year-old patient with a furuncular right knee lesion associated with Dermatobia hominis myiasis. Following the extraction, full recovery was achieved after a 3-week follow-up. An eco-epidemiological study of the patient´s environment revealed all factors that favor the development of myiasis.

Las miasis son entidades reconocidas en el ambiente rural, se presentan generalmente en adultos mayores y pueden comprometer desde piel y cuero cabelludo hasta mucosas. Los responsables son insectos de la clase díptera cuyas larvas se desarrollan en los tejidos vivos del hospedero que infestan. Se presenta el caso de una paciente de 82 años con lesión foruncular en rodilla derecha asociada a miasis por Dermatobia hominis . Posteriormente a la extracción hubo recuperación total después de 3 semanas de seguimiento. Se realizó un estudio ecoepidemiológico del entorno de vida de la paciente, encontrando todos los factores ambientales que favorecen el desarrollo de las miasis.

Functional nitric oxide conjugate systems state/restored heart thiols of rats in modeling isadrine-pituitrin’s myocardial infarction using metabolite-tropic cardioprotector “Angiolin.

Background: According to modern researches, endothelial dysfunction (ED) is one of the primary pathogenetic elements of cardiovascular diseases (myocardial infarction [MI], ischemic heart diseases, cerebral ischemic stroke, atherosclerosis, arterial hypertension, pulmonary hypertension, heart failure, and dilated cardiomyopathy) as well as obesity, hyperlipidemia, diabetes and hyperhomocysteinemia. The aim of this work was to study the infl uence of potential metabolitotropic cardioprotector “Angiolin” on the parameters of conjugate systems nitric oxide (NO)/restored thiols in heart under isadrine-pituitrin MI. Methods: This study was performed on Wistar white rats weighing 190-210 g. Biochemical, immune-enzyme analysis and histoimmunechemical study were performed. Results: In histological sections of hearts of the rats receiving Angiolin in parenteral dosing 50 mg/kg 30 mins before each pituitrin injection the density of endothelial NOsynthase (NOS)-positive cells increased by 29% and the density of inducible NOSpositive cells decreased by 23.3%. In cytosolic fraction of myocardium homogenate NOS activity increased by 27%, the concentration of NO stable metabolites increased by 70% and the content of nitrosative stress marker nitrotyrosine decreased by 42% when compared with control group. At the same time in similar samples of heart homogenate the increase of restored thiol groups’ level by 53.3%, methionine - by 35.1%, cysteine - by 170% and activity of glutathione reductase - by 186% was noted. The administration of reference drug mildronate to the animals with MI in dose 100 mg/kg did not result in signifi cant changes of the studied parameters of thiol-disulfi de system and NO system of the heart when compared with control group. Conclusions: Angiolin does not infl uence directly on NOS in MI, but at the same time protects NO from nitrosative stress increasing restored equivalents of thioldisulfi de system.

Caracterización molecular con microsatélites amplificados al azar (RAMs) de Inchi (Caryodendron orinocense K.) / Molecular characterization with random amplified microsatellites (RAMs) of Inchi (Caryodendron orinocense K.)

El Inchi o Cacay (Caryodendron orinocense Karsten) es una de las especies más promisorias de la Amazonía y la Orinoquia colombiana. El principal producto del Cacay son sus almendras, de las que se extrae un aceite con aplicaciones cosméticas, fitoterapéuticas y alimenticias, además presenta un alto contenido de antioxidantes como los Omega 3, 6 y 9 y Vitaminas como la A y E. No existen estudios sobre la caracterización molecular de este recurso fitogenético, por lo cual el objetivo de esta investigación fue caracterizar la diversidad genética usando marcadores Microsatélites Amplificados al Azar (RAMs). El análisis de similitud al 0.50 formó cuatro grupos de acuerdo al sitio geográfico, siendo los materiales procedentes de Putumayo, Cacayal 19, Pauna y Castilla los de menor similitud. Los valores de heterocigosidad estimada fueron de 0.16 y 0.28 para los cebadores CGA y GT, respectivamente. El porcentaje de loci polimórfico varió entre 55% para el cebador CGA y el 90% para el GT. El valor de Fst promedio para los 27 materiales estudiados fue de 0.35, mostrando que la dinámica espacio-temporal de los materiales de Caryodendron tienden hacia una diferenciación genética, propio de sus procesos evolutivos e incidencia de la domesticación.

The Inchi or Cacay (Caryodendron orinocense Karsten) is one of the most promising species of the Amazon and Orinoco Colombian. The main product of Cacay are its almonds, from extracted oil cosmetic, phytotherapeutic and food applications, also has a high content of antioxidants such as Omega 3, 6 and 9 and vitamins like A and E. There are no studies on the molecular characterization of this plant genetic resource; therefore the objective of this research was to characterize the genetic diversity using Random Amplified Microsatellite markers (RAMs). The similarity analysis to 0.50 formed four groups according to geographical location, being materials from Putumayo, Cacayal 19, Pauna and Castilla lowest similarity. Estimated heterozygosity values ​were 0.16 and 0.28 for the primers CGA and GT, respectively. The percentage of polymorphic loci ranged from 55% for the primer CGA and 90% for the GT. The average Fst value for the 27 materials studied was 0.35, showing the space-temporal dynamics of materials Caryodendron tend toward genetic differentiation, due to their own evolutionary processes and domestication incidence.

Resultados del tratamiento kinésico en un caso de doble parálisis facial / Physiotherapy treatment results in a case of double facial paralysis

Paciente de sexo masculino de 33 años que ingresa al Servicio Universitario de Kinesiología, con diagnóstico de parálisisfacial derecha, por lo cual se inició el tratamiento kinésico con corriente de tipo exponencial, (indicada paratratar músculos que tienen afectada la placa neuromuscular ya que son músculos patológicos), ejercicios de reeducación de la mímica y masoterapia.A los veinte días de evolución, se instala otra parálisis facial del lado izquierdo, cuando aún estaba realizando la rehabilitación de la hemicara derecha, por lo cual se efectuó el tratamiento de manera simultánea, pero con diferenciasen la utilización de la corriente exponencial, variando el ancho de pulso y la intensidad. El trofismo, las unciones, la simetría y la mímica comprometidas por la parálisis facial derecha, fueron recuperadas en 19 sesiones y la izquierda en 15 sesiones, lográndose la simetría total de la cara, sin secuelas perceptibles al final del tratamiento...

Male patient, 33 years old, who enters at the University Department of Kinesiology, diagnosed with right facial paralysis. He was initiating treatment with current exponential type, which is indicated to treat muscles that have affected the neuromuscular junction (muscle disease), exercise rehabilitation of mime and massage therapy. After twenty days of evolution, installs another left–sided facial paralysis, while still doing the right hemifacial rehabilitation, so treatment was performed simultaneously, but with differences in the use of the exponential current, varying the pulse width and intensity. The nutrition, functions, symmetry and mime committed by right facial palsy. were recovered in 19 sessions, and the left after fifteen sessions on achieving the overall symmetry of the face, withoutsqueale noticeable at the end of treatment...

Neumonía asociada a la ventilación mecánica en una unidad de cuidados intensivos / Pneumonia associated with mechanical ventilation in the intensive care unit

Se realizó un estudio descriptivo y retrospectivo en la Unidad de Cuidados Intensivos del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero hasta diciembre de 2009, a fin de precisar lo concerniente a la ventilación mecánica asociada a neumonía, para lo cual se analizaron las variables demográficas de interés, así como las afecciones que condicionaron el uso de la ventilación mecánica, los gérmenes aislados, los días con el procedimiento y el estado al egreso. En la casuística predominaron el sexo masculino (73,4 por ciento) y las edades de 56-75 años (73,3 por ciento). La enfermedad cerebrovascular (53,3 por ciento) constituyó la principal causa por la cual los pacientes requirieron ventilación mecánica. Los gérmenes frecuentemente aislados en las secreciones endotraqueales fueron Klebsiella (26,6 por ciento) y Escherichia coli (20,0 por ciento). Del séptimo al décimo días con ventilación mecánica fue el tiempo promedio cuando se presentó con mayor frecuencia la neumonía hospitalaria. Dos terceras partes de los integrantes de la serie fallecieron, para una alta tasa de letalidad en el Servicio. Al igual que en otras casuísticas, quedó por aclarar si el paciente muere por neumonía asociada a la ventilación o con neumonía asociada a esta.

A descriptive and retrospective study was carried out at the Intensive Care Unit from Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba from January to December, 2009 in order to specify the information about mechanical ventilation associated with pneumonia. For this purpose, demographic variables of interest, isolated germens, days during the procedure application, and physical condition when being discharged from the hospital, as well as the affections that suggested using mechanical ventilation, were analyzed. Male sex (73,4 percent) and age between 56 and 57 years (73,3 percent) were predominant in the case material. Cerebrovascular disease (53,3 percent) constituted the primary cause for which patients required mechanical ventilation. Klebsiella (26,6 percent) and Escherichia coli (20,0 percent) were the germens frequently isolated in the endotraqueal secretions. Average period of time receiving mechanical ventilation included from the seventh to the tenth day, when the highest frequency of hospital pneumonia was observed. Two third parts of the subjects in the series died, showing a high rate of mortality. Just like in other case materials, further research is needed to clarify whether the patient dies due to pneumonia associated with ventilation or suffering from pneumonia associated with ventilation.

Estudio de caso: la gestión de la alimentación escolar en Santiago de Cali y Bogotá D.C. / Case study: school meals' management in Santiago de Cali and Bogota

Objetivo La preocupación de esta investigación giró alrededor del papel del Estado frente a la problemática del hambre y la manera como gestiona en aras de combatirla, para ello se evaluó la gestión de una medida en seguridad alimentaria y nutricional en dos ciudades colombianas: la alimentación escolar en Santiago de Cali y Bogotá D.C. Métodos Se partió de un enfoque cualitativo, utilizando como técnicas de recolección de información el análisis documental, la observación participante y entrevistas a profundidad con diversos actores para ambos casos seleccionados. Resultados No todas las medidas en la materia se encuentran bajo unos principios normativos orientados a todas las dimensiones que abarca la seguridad alimentaria y nutricional. En Santiago de Cali hay serias debilidades en la gestión que se asocian con un contexto débil en la lucha contra el hambre. Bogotá presenta una gestión encaminada a la realización del derecho a la alimentación que ha contado con un proceso institucional, donde el tema de reducir el hambre se ha vuelto un propósito. Discusión La gestión de la medida se asocia con las características de su producto, lo cual incide en la intervención y finalmente en el estado alimentario y nutricional de la población. De esta forma, la gestión del Estado se vuelve otra dimensión de la seguridad alimentaria y nutricional.

Objective This research was aimed at ascertaining the state's role regarding hunger and how it manages to combat this matter; a food security program in two Colombian cities was thus assessed (i.e. school meals' provision in Cali and Bogota). Methods A qualitative approach was adopted; documentary analysis, participant observation and in-depth interviews with various actors for both selected cases were used as data collection techniques. Results It was found that several measures taken in this area were not covered by regulatory principles aimed at covering all the dimensions of food security. Serious weaknesses in school meals' management in Cali were associated with a weak environment regarding the fight against hunger. School meals' management in Bogotá was aimed at recognizing the right to food as being supported by an institutional process where the issue of reducing hunger has become a firm purpose. Discussion School meals' program management was associated with the characteristics of its product, thereby affecting the program and the population's food and nutritional status; state management thus becomes another dimension of food security.