Feasibility in the use of the UV-Visible region for the characterization of glucose in deionized water using Arduino 1 / Viabilidad en el uso de la región UV-Visible para la caracterización de glucosa en agua desionizada mediante Arduino 1

ABSTRACT With an estimated approximately 2 million deaths per year, diabetes is one of the top 5 deadliest noncommunicable diseases globally. Although this disease is not fatal, the degradation of the patient's health due to a bad plan to control their glucose levels can have a fatal outcome. In order to lay the foundations for the development of a device that allows estimating glucose levels in some body fluid, we present the results obtained not only for the estimation of glucose in deionized water, but also describe the development and configuration of the created device. After analyzing 50 signals obtained from 5 different glucose concentrations, the feasibility of using the developed device for the analysis is evident, since, considering the K-Nearest Neighbors (KNN) algorithm, all the signals were associated correctly to the glucose group to which they belong.

RESUMEN Con un estimado de aproximadamente 2 millones de muertes por año, la diabetes es una de las 5 enfermedades no transmisibles más mortales a nivel mundial. Aunque esta enfermedad no es mortal, el deterioro de la salud del paciente por un mal plan para controlar sus niveles de glucosa puede tener un desenlace fatal. Con el fin de sentar las bases para el desarrollo de un dispositivo que permita estimar los niveles de glucosa en algún fluido corporal, presentamos los resultados obtenidos no solo para la estimación de glucosa en agua desionizada, sino que también describimos el desarrollo y configuración del dispositivo creado. Luego de analizar 50 señales obtenidos a partir de 5 concentraciones de glucosa diferentes, se evidencia la factibilidad de utilizar el dispositivo desarrollado para el análisis, ya que, considerando el algoritmo K-Nearest Neighbors (KNN), todas las señales se asociaron correctamente al grupo de glucosa al que pertenecen.

Clinical characteristics and variables associated with COVID-19 morbidity and mortality in Luanda, Angola, in the first year of the pandemic

Background: The impact of SARS-CoV-2 infection in Africa is still unclear. In comparison to Europe and North America, morbidity and death rates are lower. Several factors have been proposed, including geographical variation in virus impact, environmental factors, differences in age distribution, and the impact of infectious diseases such as malaria, HIV infection and tuberculosis. Objectives: We investigated the clinical characteristics and putative determinants linked with COVID-19 in Angolan patients. Methods: Cross-sectional study undertaken at Military Hospital, Luanda, from March 2020 to March 2021. The survey collected sociodemographic and clinical information. Results: The sample included 1,683 patients aged ≥18 years, 64% men, with mean age of 46.3 years. SARS-CoV-2 was positive in 39% of the cases with RT-PCR. Patients ≥46 years with a level of education of ≥12 years had a considerably higher likelihood of testing positive. About 58% of positive patients had at least one comorbidity, of which hypertension and Diabetes were associated with SARS-CoV-2 infection. HIV and pulmonary TB were putative protective factors. About 14% of positive patients died. Most deaths occurred in patients ≥46 years, with less education and unemployed. Working as a healthcare practitioner was linked to a protective effect. Malignant diseases were the most common comorbidities associated with death. Conclusions: We identified putative factors related to SARS-CoV-2 infection and mortality. HIV and TB were protective and not associated with mortality. Further study with a broader scope should be conducted to explain the main features related to COVID-19 mortality in Angola

Detection of People Positive to COVID-19 through ATR-FTIR Spectra Analysis of Saliva using Machine Learning / Detección de Personas Positivas a COVID-19 mediante el Análisis de Espectros ATR-FTIR de Muestras de Saliva empleando Machine Learning

ABSTRACT COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. This virus's spread is mainly through droplets released from the nose or mouth of an infected person. Although vaccines have been developed that effectively reduce the effects that this viral infection causes, the most effective method to contain the virus's spread is numerous tests to detect and isolate possible carriers. However, the response time, combined with the cost of actual tests, makes this option impractical. Herein, we compare some machine learning methodologies to propose a reliable strategy to detect people positive to COVID-19, analyzing saliva spectra obtained by Fourier transform infrared (FTIR) spectroscopy. After analyzing 1275 spectra, with 7 strategies commonly used in machine learning, we concluded that a multivariate linear regression model (MLMR) turns out to be the best option to identify possible infected persons. According to our results, the displacement observed in the region of the amide I of the spectrum, is fundamental and reliable to establish a border from the change in slope that causes this displacement that allows us to characterize the carriers of the virus. Being more agile and cheaper than reverse transcriptase polymerase chain reaction (RT-PCR), it could be reliably applied as a preliminary strategy to RT-PCR.

RESUMEN La COVID-19 es una enfermedad infecciosa ocasionada por el virus SARS-CoV-2. La propagación de este virus se produce principalmente a través de gotitas liberadas por la nariz o la boca de una persona infectada. Aunque se han desarrollado vacunas que permiten reducir efectivamente los efectos que esta infección viral provoca, el método más eficaz para contener la propagación del virus son las numerosas pruebas para detectar y aislar los posibles portadores. Sin embargo, el tiempo de respuesta, combinado con el costo de las pruebas reales, hace que esta opción sea poco práctica. Aquí, comparamos algunas metodologías de machine learning para proponer una estrategia confiable para detectar personas positivas a COVID-19 analizando espectros de saliva obtenidos por espectroscopia infrarroja transformada de Fourier (FTIR). Tras analizar 1275 espectros, con 7 estrategias comúnmente empleadas en el área de machine learning, concluimos que un modelo de regresión lineal multivariante (MLMR) resulta ser la mejor opción para identificar posibles infectados. De acuerdo con nuestros resultados, el desplazamiento observado en la región de la amida I del espectro, resulta fundamental y confiable para establecer una frontera a partir del cambio de pendiente que este provoca. Al ser más ágil y económica que la reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR), podría aplicarse confiablemente como estrategia preliminar a RT-PCR.

Caracterización biomolecular mediante microespectroscopía FTIR en la fase de remodelación de la cicatrización en un modelo murino de lesión excisional / Biomolecular characterization by FTIR microspectroscopy in the modeling phase of wound cicatrization in a murine model of excisional injury

La cicatrización de la piel es un proceso complejo y organizado que involucra tres fases: inflamatoria, proliferativa y de remodelación. Es indispensable el análisis de este proceso biomolecularmente para investigar y proponer nuevas estrategias terapéuticas que mejoren la cicatrización o promuevan la regeneración. El objetivo de este proyecto fue analizar histológica y biomolecularmente mediante microespectroscopía infrarroja por transformada de Fourier (MFTIR) y su función de mapeo bioquímico, muestras de lesiones excisionales de piel, comparando los cambios morfológicos y espectroscópicos entre piel sana y piel cicatrizada. Se estandarizó un modelo de lesión excisional de piel en ratones hembra de la cepa NIH de 8 semanas de edad (n=16), provocando una herida excisional de 1 cm2. Se analizó piel sana (día 0) y cicatrizada (día 15 post-lesión) morfométrica, histológica y biomolecularmente mediante análisis fotográfico, técnica histológica y MFTIR con su función de mapeo. El análisis morfométrico demostró una reducción del área de la herida en un 87,6 % al día 15 post-lesión. Histológicamente, en la piel cicatrizada se evidenció un adelgazamiento de la epidermis y menor celularidad en la dermis, observándose la formación de tejido de granulación y fibras de colágena desorganizadas. Espectroscópicamente, se apreciaron cambios entre los dos grupos de estudio, principalmente en las bandas de lípidos y en la región de proteínas. El cálculo de las áreas bajo la curva y el mapeo bioquímico mostraron menor concentración de queratina y colágena en la piel cicatrizada, así como desorganización de las fibras de colágena. Se demostró la capacidad de la MFTIR para caracterizar de forma precisa los cambios biomoleculares en la cicatrización, entre ellos la cantidad de queratina, colágena, y el depósito y ordenamiento de las fibras de colágena asociadas a su maduración.

The skin cicatrization is a complex and organized process that involves three phases: inflammatory, proliferative, and remodeling. It is essential to analyze this process biomolecularly, in order to investigate and propose new therapeutic strategies that improve the healing or promote regeneration. The objective of this project was to analyze histological and biomolecularly through Fourier Transform infrared microspectroscopy (FTIRM) and its biochemical mapping function, samples of an excisional skin wound, comparing the morphological and spectroscopic changes between healthy skin and scarred skin. An excisional skin wound healing model was standardized using female, NIH strain 8-week-old mice (n = 16), provoking an excisional wound of 1 cm2. Healthy skin (day 0) and scarring skin (day 15 post-injury) were morphometrical, histological, and biomolecularly analyzed by digital picture analysis, histological technique, and FTIRM with its mapping function. The morphometric analysis showed a reduction of the wound area of 87.6 % at day 15 after wound. Histologically, in the scarred skin a thinning of the epidermis was evidenced, besides reduced cellularity in the dermis, granulation tissue formation, and disorganized collagen fibers were observed. Spectroscopically, changes between the study groups were appreciated, mainly in the lipid bands and in the protein region. The calculation of the areas under the curve and the biochemical mapping showed a lower concentration of keratin and collagen in the scarred skin, as well as collagen fibers disorganization. The ability of the FTIRM to accurately characterize biomolecular changes in cicatrization process was demonstrated, such as the amount of keratin, collagen, and the deposition and ordering of the collagen fibers associated with their maturation.

Vivenciando a Rede: Caminhos para a Formação do Médico no Contexto do SUS / Experiencing the Network: Paths for Medical Training in the Context of the SUS

RESUMO Os cursos de educação médica têm implementado disciplinas e módulos que aproximem os discentes da realidade da saúde nacional, a fim de se adequarem às crescentes necessidades de reorganização da formação médica. O presente artigo relata uma experiência de acadêmicos de Medicina da Universidade Estadual de Santa Cruz (UESC) com as atividades e ações incluídas no módulo de Gestão e Rede de Atenção à Saúde, parte da Prática de Integração Ensino-Serviço-Comunidade (PIESC), como proposta de reorientação do currículo na aquisição de habilidades de liderança e gerenciamento de recursos físicos e humanos em saúde. A proposta foi inserir os discentes em diferentes níveis de complexidade tecnológica do SUS a fim de contextualizar o estudo da Rede de Atenção à Saúde (RAS) por meio de vivências e pesquisa-ação em serviços de saúde situados nos diferentes níveis de atenção. Para isso, foram realizadas entrevistas semiestruturadas com profissionais e usuários em cada ambiente visitado. Tais vivências ampliaram a visão dos acadêmicos sobre os serviços de saúde, possibilitando um melhor entendimento da estruturação da RAS, bem como um dimensionamento dos entraves encontrados nos diferentes cenários e proporcionando uma experiência in loco das críticas e dificuldades apresentadas e vividas por usuários e profissionais. Percebeu-se que não há resolutividade dos problemas de saúde dos usuários nos serviços, bem como existe uma falta de entendimento destes acerca de seus direitos e da continuidade da atenção à saúde nos diferentes níveis de atenção. Explicitou-se que as instâncias primárias de atenção não funcionam como porta de entrada adequada, o que culmina com a desestruturação da RAS observada. A experiência relatada neste artigo demonstrou um modo dinâmico de abordar a temática da Gestão e Rede de Atenção à Saúde, além de contribuir para a formação do estudante de Medicina, já que possibilitou um melhor entendimento da rede quanto às práticas em saúde e às dimensões do processo saúde-doença implicados na gestão do SUS.

ABSTRACT Medical courses in Brazil have implemented subjects and modules that aim to bring students closer to actual national health concerns, as one way of adapting to the growing needs for medical training reorganization. Thus, this article reports on the experience of medical students at the Universidade Estadual de Santa Cruz (UESC) [State University of Santa Cruz] with activities and actions included in the Health Care Network and Management module, part of the Teaching-Service-Community Intergration Practice (PIESC), as a proposal for the reorientation of the curriculum and acquisition of leadership skills and management of physical and human resources in health. The proposal was to insert the students at different levels of technological complexity of the Unified Health System (SUS) in order to contextualize the study of the Health Care Network (RAS) through experiences and action research in health services located at different care levels. Semi-structured interviews with professionals and users were therefore performed in each visited environment. These experiences served to broaden the students' vision of health care networks, enabling a better understanding of how the services are structured, as well as of the magnitude of the obstacles found in different scenarios, providing an in loco experience of the criticisms and difficulties faced by users and professionals. It was noticed that user health problems are often not resolved within the health care services, and the users lack understanding of their health rights. A lack of continuity of the health care was also observed through the various health care levels. Thus, it is concluded that the instances of primary care fail to offer adequate gateway services, culminating in the breakdown of the observed network. The experiment reported in this article demonstrated a dynamic way to approach the issue of Health Care Network Management, contributing to medical student training, as it enabled a better understanding of the network in terms of the health practices and the dimensions of the health-disease process involved in the management of the SUS.

“Além da Mama”: o Cenário do Outubro Rosa no Aprendizado da Formação Médica / “Beyond the Breast”: the Pink October Scenario among Medical Students

RESUMO O câncer de mama pode ser considerado, atualmente, um problema de saúde pública devido a sua crescente incidência e índices de letalidade. Diante disso, o movimento Outubro Rosa visa chamar a atenção da população a respeito dessas neoplasia em mulheres de todo o mundo, de modo que suas ações têm por objetivo comum realizar o diagnóstico precoce no intuito de diminuir a mortalidade em decorrência dessa neoplasia. Dessa forma, o presente artigo objetiva relatar a experiência de acadêmicos do curso de Medicina da Universidade Estadual de Santa Cruz, no Módulo de Práticas de Integração Ensino, Serviço e Comunidade III (Piesc III), numa ação conjunta com a Equipe de Saúde da Família (ESF) de Iguape, em Ilhéus (BA), no contexto do movimento Outubro Rosa, objetivando também compartilhar considerações sobre a formação médica levantadas pelo grupo acerca da vivência descrita. No período, realizou-se abordagem inicial na sala de espera, anamnese dirigida e foi feito o exame físico das mamas das pacientes que compareceram à Unidade de Saúde da Família. A experiência não consistiu apenas em identificar pacientes com suspeita de câncer de mama e quantificar os dados, mas numa oportunidade de exercício da Educação e Comunicação em Saúde e de desenvolvimento da relação médico-paciente. Ainda permitiu aos acadêmicos reconhecer e entender melhor as dificuldades das usuárias em relação à prevenção e promoção da saúde das mamas, sendo que se observou que diversas mulheres não estavam familiarizadas com os temas abordados. O estudante de Medicina precisa compreender que o conhecimento teórico-prático se reconstrói em cada paciente com contexto histórico específico e com diferentes visões e interpretações dos conceitos de saúde e doença. Além disso, o profissional médico deve exercitar, desde a graduação, habilidades que extrapolam o ortodoxo trabalho médico, assumindo também uma postura de multiplicador de cidadania, um agente propagador de direitos e deveres.

ABSTRACT The breast cancer can now be considered a public health problem due to its increasing incidence and lethality rates. In view of this, the October Rosa mobilization aims at drawing the population’s attention regarding this neoplasm in women from all over the world, so that their common objective is to perform the early diagnosis in order to reduce mortality due to this neoplasm. Thus, the following article describes the experiences of undergraduate medical students at the Universidade Estadual de Santa Cruz (Uesc) regarding the practice module on Integrated Teaching with Community Health and Service, as part of a joint initiative with a Family Health Team in the outskirts of Ilhéus, Bahia, Brazil, within the context of the “Pink October” movement, also aiming to share thoughts on the medical degree raised by the group on the experience described. As part of the Pink October initiative, the students were given the opportunity to take a clinical approach in the waiting room, collecting information and performing physical examinations on patients who appear at the Family Health Unit. This experience was not only intended to identify patients with suspected cancer and measure the data collected, but was also designed to provide the students the opportunity to put their health education and communication skills into practice, developing the doctor-patient relationship. It also allows academics to better recognize and understand users’ difficulties in preventing and promoting breast health. In this context, it was observed that several women were not familiar with the recommended techniques for the breast self-exam (???). Medical students must understand that practical and theoretical knowledge is reconstructed with every single patient according to their specific historical context and varying viewpoints and interpretations of the concepts of health and disease. In addition, the medical professional must exercise, from the undergraduate, skills that extrapolate the orthodox medical work, also assuming a position of multiplier of citizenship, a propagating agent of rights and duties.

Effect of Deworming on Hemoglobin Concentration in Children from 2 to 15 Years from the Bengo Province, Angola.

Objectives: The most common causes of anemia are micronutrient deficiencies, but other factors may influence namely inflammation, parasitic infections and inherited disorders. One strategy to combat micronutrient deficiencies is supplementation, yet, in zones with high prevalence of Schistosomiasis or Soil Transmitted Helminthes (STH), supplementation could be not sufficient. The aim of this study was to evaluate the effects of deworming, on hemoglobin concentration, in children from 2 to 15 years, from Bengo. Methods: A total of 429 children between 2 to 15 years were involved. Nutritional status and anemia were evaluated. Urine and feces samples were collected for diagnosis of Schistosoma haematobium and STH. Praziquantel (40 mg/Kg) and Albendazol (400 mg) were administrated. All parameters were determined at baseline and after 6 months. Results: The prevalence at baseline of S. hematobium was 61,9%, Trichuris trichuria 15,3%, Ascaris lumbricoides 11,8 %, Hymenolepis nana 7,8%, and hookworm 3,8%. Anemia was detected in 71,2% of the children (mild 11,7%, moderate 57,1% and severe 2,3%). Average hemoglobin concentration was 106,8 g/L. 6 months after treatment the prevalence of S. hematobium decreased to 44,5%, Trichuris trichuria to 10,9%, Ascaris lumbricoides to 5,0 %, Hymenolepis nana to 6,7%, and hookworm to 0,8%.The average hemoglobin concentration increased by 7,9 g/L and the prevalence of anemia declined to 49,5% (mild 17,1%, moderate 32,2% and severe 0,2%). Conclusions: These results confirm the benefit of deworming on hemoglobin concentration, even with a single intervention. However it should be clear that integrated intervention aiming nutritional education water treatment, hygiene and sanitation are needed to reduce micronutrient deficiency.

Plan Hospital Eugenio Espejo para desastres / Plan Hospital Eugene Mirror for disasters

El presente trabajo de investigación está dividido en dos componentes: el primer componente hace referencia a la elaboración del Plan Hospitalario para Desastres del Hospital Eugenio Espejo, y el segundo componente consiste en la realización de un Seminario-Taller sobre desastres. Componente I: Elaboración del Plan Hospitalario para Desastres Internos y Externos. Se realizó una evaluación de la vulnerabilidad estructural y no estructural del Hospital lo que le permitió tomar las medidas de prevención y mitigación necesarias. Se evaluó el actual funcionamiento de los servicios básicos con los que cuenta el Hospital (agua potable, luz eléctrica, alcantarillado, comunicaciones) y se tomó los correctivos necesarios; igualmente se estableció formas alternas de funcionamiento que suelen ser esenciales ante las situaciones críticas que suelen presentarse en situaciones de desastres...

Diagnóstico de caridopatía isquémica con talio 201 y ergometría graduada / Diagnosis of isquémica cardiopathy with 201 thallium and graduated ergometría

Durante el período ene.-dic. 1992, se estudian en el Laboratorio de Medicina Nuclear del Hospital Carlos Andrade Marín a 115 pacientes con diagnóstico de caridopatía isquémica, 45 de ellos con infarto antiguo de miocardio; el resto con sospecha clínica y electrocardiográfica de isquemia. Con el objeto de confirmar la isquemia, se les sometió a ergometría graduada con Talio201. La prueba ergométrica se realizó con un protocolo similar al de Bruce, hasta alcanzar la frecuencia cardíaca submáxima, momento en el cual se administró 2.5 mCi de Talio201, manteniéndose el esfuerzo por 2 minutos adicionales. 32 (27.8xciento) pacientes demostraron estudios normales; 83 (72,2xciento) pacientes incluyendo 45 pacientes con infarto antiguo de miocardio, revelaron gammagrafías positivas para isquemia, siendo la localización más frecuente inferior y anteroseptal. El método resulta útil para seleccionar a los pacientes sanos de aquellos que requieren estudio cinecoronariográfico.

Epidemiología de la hipertensión en un servicio de emergencia

El objetivo de este trabajo fue establecer el perfil epidemiológico de los pacientes hipertensos que acuden al servicio de emergencia del HEG durante el lapso de un año. Mediante en estudio retrospectivo, transversal, observacional, se revisó 152 archivos de pacientes hipertensos (3,4 por ciento del total de urgencias clínicas) observandose mayor frecuencia (54.5) para pacientes comprendidos entre 35-65 años de edad; el sexo femenino predominó en relación a las emergencias hipertensivas, y dentro de este grupo, el accidente cerebro vascular y la encefalopatía hipertensiva fueron las mas frecuentes. No se encontró una correlación estadistica con los picos de tensión arterial diastólica y las emergencias hipertensivas. Se concluye que la hipertensión arterial representa una enfermedad con repercusiónes severas en órganos vitales, siendo imprescindible un diagnostico y tratamiento adecuados para reducir la morbi-mortalidad asociada a esta patalogía.

Hipertensión arterial en el servicio de Emergencia del hospital "Dr. Enrique Garces"

Se realizo un estudio retrospectivo y transversal, para conocer las caracteristicas de la hipertensión arterial en pacientes que acudieron al servicio de emergencia del Hospital Dr. Enrique Garcés en el período comprendido entre enero de 1994 y enero de 1995. Se analizaron 2475 historias clínicas, de las cuales 152 correspondieron a pacientes hipertensos. En relación a la edad, 82 (54.0 por ciento) estuvieron comprendidos entre 35 y 65 años, y en cuanto al sexo hubo predominio del femenino al masculino (2.5:1). Las urgencias hipertensivas [n=123 (80.9 por ciento)] tuvieron mayor frecuencia en relacion a las emergencias hipertensivas [n=29 (19.1 por ciento)], y dentro de este grupo, el accidente cerebro-vascular y la encefalopatia hipertensiva fueron las mas frecuentes (62por ciento y 17 por ciento respectivamente). Se concluye que la hipertensión arterial es una enfermedad con repercusiones severas en órganos vitales, siendo imprescindible un diagnostico y tratamiento adecuados para reducir la morbimortalidad asociada a esta patología.

Estudio de la hipertensión arterial en el servicio de emergencias del Hospital "Dr. Enrique Garcés" 1994-1995

Se realizó un estudio retrospectivo y transversal, para conocer las caracteristicas de la hipertensión arterial en pacientes que acudieron al Servicio de Emergencias del Hospital "Dr Enrique Garcés" en el período comprendido entre Enero de 1994 y Enero de 1995. Se analizarón 4475 historias clínicas, de las cuales 152 correspondieron a pacientes hipertensos. En relación a la edad [n=82(54.5 por ciento)] estuvieron comprendidos entre 35 y 65 años, y en cuanto al sexo hubo predominio del femenino al masculino (2:1). Las urgencias hipertensivas [n=123 (80.9 por ciento)] tuvieron mayor frecuencia en relación a las emergencias hipertensivas [n=29 (19.1 por ciento), y dentro de este grupo, el accidente cerebro-vascular y la encefalopatía hipertensiva fueron las mas frecuentes (62 por ciento y 17 por ciento respectivamente). No se encontró una correlación estadística entre los valores más altos de presión arterial diastólica y las emergencias hipertensivas. Se concluye que la hipertensión arterial es una enfermedad con repercusiónes severas en órganos vitales, siendo imprescindible un diagnóstico y tratamiento adecuados para reducir la morbimortalidad asociada a esta patología.

Anestesia peribulbar en la cirugía de desprendimiento de la retina / Peribulbar anesthesia in surgery of retinal detachment

La anestesia peribulbar constituye un procedimiento que ha ganado popularidad en diferentes tipos de cirugía ocular. En el presente trabajo se realizó un estudio en 27 pacientes (27 ojos) portadores de desprendimiento de retina aplicándoles dicho método, utilizando 4 ml de hidrocloruro de bupivacaína al 0,75 por ciento, 4 ml de lidocaína al 5 por ciento hiperbárica, y 150 U de hialuronidasa. Se obtuvo como resultado un grado de anestesia satisfactoria (grado IV de Weiss y Deichmann) en 19 casos, y moderadamente satisfactoria en 8 casos (grado III). Se recomienda el procedimiento en casos seleccionados de pacientes portadores de desprendimiento de retina que serán sometidos a cirugía, por la reducción del tiempo quirúrgico y la disminución de complicaciones postoperatorias relacionadas con el uso de anestesia local

Medicamentos caseros inocuos / Inocuos domestic medicaments

El presente trabajo demostró las diversas colonias de bacterias y hongos encontrados en los medicamentos caseros inocuos preparados en forma empírica y recetados por médicos inclusive oftalmólogos. Se cultivaron bacterias gram (-), un coco gram (+) y hongos, la recomendación final eliminar de la práctica médica cotidina la utilización de estos medicamentos caseros inocuos