The role of trophic, mutualistic, and competitive interactions in an industrial symbiosis process implementation: an ecological network perspective.

For both government and private institutions, the development of collaboration networks becomes an element of great importance for the implementation of related policies such as the circular economy and sustainable practices in manufacturing. Despite the above, such initiatives have not received as much attention in literature but have been decisive as both public and private initiatives. Initiatives in Latin America do not escape this scenario, especially in the creation of conditions that allow the promotion of approaches such as industrial symbiosis. In this way, the present research is aimed at identifying the role of trophic, mutualistic, and competitive interactions in an industrial symbiosis process implementation. A network analysis model is used to achieve this purpose. This technique allows us to know the degree of importance of the different actors that are part of a network, as well as the factors that determine the implementation of initiatives such as industrial symbiosis. Among the results are that empirical findings confirm the presence of trophic interactions that enhance resource efficiency, mutualistic interactions fostering collaboration and synergy, and competitive interactions promoting efficiency and dynamism. Additionally, a green culture, business size, and innovation activities are revealed as influential factors amplifying network dynamics.

Finishing Analysis of Dental Outcome (FADO) as a New Guide in Orthodontic Treatment.

OBJECTIVES: Orthodontic treatment has both functional and esthetic goals. The finishing phase is one of the most important and seeks to solve occlusal, dental, functional, and esthetic problems, offering the possibility of obtaining the best possible outcome. This paper aims to describe the Finishing Analysis of Dental Outcome (FADO) guide as a tool to improve orthodontic treatment results. METHODS: A literature review of finishing procedures and orthodontic treatment outcomes was made. Moreover, current parameters of the esthetics of the smile were considered. The information was systematized to produce a protocol applicable to practice. This guide includes the assessment of mini-esthetic, micro-esthetic, and occlusal results using the Cast Radiographic Evaluation of the American Board of Orthodontics. Treatment options for each item were also suggested. Clinical cases were used to illustrate the application of the guide. RESULTS: The FADO Guide is presented and explained to give the clinician a systematic and orderly guide to achieve the best possible results in orthodontic treatment. To fulfill the FADO Guide, cast models, a panoramic radiograph, smile photographs (frontal and lateral), and an intraoral frontal photo are needed. The FADO Guide includes four sections: mini-esthetic evaluation (the evaluation of the smile), micro-esthetic evaluation, occlusal analysis, and radiographic analysis. CONCLUSION: The FADO guide presents a systematic approach to the application of a finishing protocol in orthodontics. Furthermore, this guideline can improve clinical practice and be used as a checklist to optimize clinical outcomes.

The effects of cultural dimensions on export performance: Vietnam and Colombia cases.

This research focuses on the moderation effects of Hofstede's cultural dimension that influence the relation between ambidextrous leadership and export performance in Born Global Firms in two countries with different cultural characteristics, Vietnam and Colombia. We collected the data from 800 exporting firms in two countries, Colombia and Vietnam, that are characterised by their having begun international operations in the first three years of being Born Global. The results demonstrate that ambidextrous leadership has a positive impact on export performance. Additionally, the dimensions of uncertainty avoidance and indulgence moderate the relation between ambidextrous leadership and export performance, while long-term orientation does not affect the relationship.

[Clinical and electromyographic findings in patients with diabetic polyneuropathy]. / Manifestaciones clínicas y alteraciones electroneuromiográficas en pacientes con diabetes tipo 2 y polineuropatía.

BACKGROUND: Diabetic neuropathy represents a polyneuropathy with electrophiosiological alterations. Electroneuromyography (NMD) plays an important role in the evaluation of patient with diabetes mellitus type 2 (DM2) and doubtful neuropathy. OBJECTIVE: To determine clinical manifestations in patients with distal symmetrical sensory polyneuropathy (DSSP) and to correlate them with electromyographic alterations. MATERIAL AND METHODS: Transversal, analytical study. 138 patients over 18 years old, with DM2 and PSSD were selected. They underwent physical examination, laboratory studies and electromyography (EM) with 4-channel Nicolet electromyograph. Measures of central tendency and their dispersion were analyzed; data normality with Kolmogorov-Smirnov; Student's t test and Spearman's correlation. RESULTS: Thalar hyperkeratosis was the most frequent clinical finding in 103 (74%) patients. The most frequent symptoms were paresthesia in 132 (95.7%) patients and tingling in 93 (67.4%) patients. Exploration of superficial sensitivity determined neuropathy in 42 (30.4%) patients finding greater insensitivity in the medial plantar nerve territory. In the EM, the nerve with the greatest absent response was the left lateral plantar nerve in 51 (59%) patients. A significant correlation (p < 0.05) was found between the variables of EM with age, years of evolution and levels of glycated hemoglobin A1c. CONCLUSIONS: The higher the lack of glycemic control, the chronobiology of the patient and the time of illness, the greater the electromyographic affection.

INTRODUCCIÓN: la neuropatía diabética representa una polineuropatía con alteración electrofiosiológica. La electroneuromiografía (ENM) desempeña un papel importante en la evaluación del paciente con diabetes mellitus tipo 2 (DM2) y neuropatía dudosa. OBJETIVO: determinar las manifestaciones clínicas en pacientes con polineuropatía sensitiva simétrica distal (PSSD) y correlacionarlas con alteraciones electroneuromiográficas. MATERIAL Y MÉTODOS: estudio transversal, analítico. Se seleccionaron 138 pacientes mayores de 18 años, con DM2 y PSSD. Se les realizó exploración física, estudios de laboratorio y ENM con electromiógrafo Nicolet de 4 canales. Se analizaron las medidas de tendencia central y su dispersión; normalidad de datos con Kolmogorov-Smirnov; t de Student y correlación de Spearman. RESULTADOS: la hiperqueratosis talar fue el hallazgo clínico más frecuente en 74% de los pacientes. Los síntomas más frecuentes fueron parestesias en 95.7% y hormigueo en 67.4%. La exploración de sensibilidad superficial determinó neuropatía en 30.4%, encontrando mayor insensibilidad en el territorio del nervio plantar medial. En la ENM, el nervio con mayor respuesta ausente fue el plantar lateral izquierdo en 59%. Se encontró correlación significativa (p < 0.05) entre las variables electroneuromiograficas con la edad, años de evolución y niveles de hemoglobina glucosilada A1c (HbA1c). CONCLUSIONES: a mayor descontrol glucémico, cronobiología del paciente y tiempo del padecimiento, mayor es la afección electroneuromiográfica.

Factors Affecting Voluntary Self-Isolation Behavior to Cope with a Pandemic: Empirical Evidence from Colombia vs. Spain in Times of COVID-19.

Global pandemics are not a new phenomenon. They have occurred at different points in time and can be of different scales. COVID-19 appeared in 2020 and its spread has reached more than 60 countries worldwide. This research aims to analyze voluntary self-isolation behavior used to cope with the COVID-19 pandemic. As part of this study, we carried out sampling in Colombia and Spain, which share similar cultural characteristics but which have substantial social and economic differences. A multi-group model was used to test the application of the theory of planned behavior and the theory of reasoned action in order to analyze self-isolation behavior. The results show that there are differences in self-isolation behavior between both countries, especially with regard to attitudes towards self-isolation and volitional behavior.

Recomendaciones de diagnóstico y tratamiento del ataque cerebrovascular isquémico agudo durante la contingencia por covid-19 / Recommendations for diagnosis and treatment of the acute ischemic stroke during COVID-19 contingency

RESUMEN INTRODUCCIÓN. El tiempo es un factor importante en el tratamiento del ACV agudo, con la pandemia de covid-19 se puede ver afectada la adherencia a las guías. Se han reportado tasas de ACV en presencia de covid-19 alrededor del 5%, además un aumento en el tiempo de consulta de los pacientes en otras regiones del mundo y una mayor ocupación de camas de UCI para patologías respiratorias que usualmente se destinan a pacientes con ACV. Este documento recoge las recomendaciones del comité de Enfermedad Cerebrovascular de la Asociación Colombiana de Neurología basados en la literatura y votadas por consenso. OBJETIVOS. Proporcionar una guía rápida adaptada a los diferentes escenarios de atención de ACV en Colombia, divididos en centro listo, primario y avanzado incluyendo una ruta de atención para paciente con sospecha de covid-19 denominada Código ACV protegido, que incluye el uso de elementos de protección personal para pacientes y personal de salud. PUNTOS PRINCIPALES. Dentro de las recomendaciones principales está el cuestionario de tamizaje al ingreso a urgencias, uso de tapabocas para el paciente, considerar todo Código ACV sospechoso de covid-19, toma de PCR para covid-19 en todos los ACV y llevar a zona buffer. En sospecha de oclusión proximal incluir tomo-grafía de tórax a la evaluación de imágenes. CONCLUSIONES. Establecer pautas de atención durante la pandemia covid-19 permite optimizar protección para pacientes y personal de salud, disminuir retrasos y tratar de evitar que pacientes no reciban el tratamiento adecuado en los diferentes niveles de atención del sistema de salud.

SUMMARY INTRODUCTION. Time is an important factor in the treatment of acute stroke, with the COVID-19 pandemic adherence to guidelines can be affected. Stroke rates in the presence of COVID-19 have been reported around 5%, in addition to an increase in the consultation time of patients in other regions of the world and a greater occupation of ICU beds for respiratory pathologies that are usually intended for patients with stroke. This document contains the recommendations of the Cerebrovascular Disease Committee of the Colombian Neurology Association based on the literature and voted by consensus. OBJECTIVES. Provide a quick guide adapted to the different stroke care scenarios in Colombia, divided into ready, primary and advanced centers, including a care route for a patient with suspected COVID-19 called the protected stroke code, which includes the use of protection elements for the patient and the healthcare team. MAIN FACTS. Among the main recommendations are the screening questionnaire on admission to the emergency department, the use of face masks for the patient, considering all suspected stroke code as COVID-19, taking the PCR for COVID-19 in all strokes and taking them to the buffer zone. In suspected large vessel occlusion, include chest tomography to image evaluation. CONCLUSIONS. Establishing guidelines of care during the COVID-19 pandemic allows optimizing protection for patients and health care personnel, reducing delays and trying to avoid patients not receiving adequate treatment at different levels of attention in the health system.

Born global: the influence of international orientation on export performance.

New international enterprises that are referred to as Born Globals have become the subject of research due to the success of their global operations, despite their early internationalization and limited resources. Given the importance of analyzing the characteristics that contribute to the success of Born Globals, our study examines the influence of international orientation on export performance. Additionally, we consider internal and external drivers for early and accelerated internationalization such as the Born Global's innovative capacity, the dynamism of the market and the favorability of the environment. By estimating a structural equation model, the results show that international orientation is a strong driver of the export performance of Born Globals. However, this relationship is moderated by innovative capacity and the dynamism and favorability of the environment, thus achieving a greater effect on export performance when international orientation is complemented by these variables.

Evaluating the spatial distribution of Leishmania parasites in Colombia from clinical samples and human isolates (1999 to 2016).

In Colombia, nine species of parasites of the genus Leishmania circulate in more than 20 sand fly species, putting at risk of contracting the disease approximately 60% of the population. The Federico Lleras Acosta Dermatological Center, a reference center in Colombia, has been treating patients with cutaneous and mucosal leishmaniasis for more than 15 years, identifying the infecting Leishmania species from different clinical samples, and recording systematically all the epidemiological and geographic information related to each diagnosed patient. With this valuable information, the objective of this work was to perform a long term and large-scale study, aiming to identify the Leishmania species circulating in Colombia from clinical samples from 1999 to 2016, and to assess their current and potential spatial distribution. In all, four Leishmania species were identified in 688 samples from 183 municipalities distributed in 28 of the 32 departments of the country, and 387 records were georeferenced, from 20 departments. The most widespread species was L. (V.) braziliensis, showing new collection records, and the species related to areas with highest leishmaniasis transmission was L. (V.) panamensis. Ecological niche models were built for the three species that had more than 20 georeferenced records, showing a potential distribution for L. (V.) braziliensis on 42% of the national territory mainly in the interandean valleys, and the Orinoquia and Amazon regions. Leishmania (V.) guyanensis potential distribution covers 36% of Colombia continental territory with a spatial distribution similar to that of L. (V.) braziliensis. There was a marked tendency of L. (V.) panamensis to be distributed in the northwest of the country occupying 35% of the national area and mainly in areas of transformed ecosystems. Species were identified in patients from areas where the occurrence of cases was unprecedented, which suggests that the distribution of Leishmania may be greater than currently known. To improve the predictive capacity of the models, we suggest incorporating, in future studies, Leishmania samples from vectors and reservoirs that have a greater dependence on environmental variables. Our results are an important tool for health systems because they allow potential areas of transmission and information gaps to be identified.

Avaliação dos fatores associados ao trauma mamilar / Assessment of factors associated to nipple trauma

Objetivo: Avaliar os fatores associados ao trauma mamilar. Método: Estudo seccional realizado em alojamento conjunto com todas as puérperas e os recém-nascidos internados no período de julho a agosto de 2014. Resultados: Foram avaliadas 73 puérperas e 76 recém-nascidos (três gemelares). Verificou-se associação significativa entre trauma mamilar e dor ou ardência pós-mamada (0.000), orientação no pré-natal (0.016) e número de consultas no pré-natal (0.018), sendo que mesmo as puérperas que tiveram sete ou mais consultas de pré-natal apresentaram trauma mamilar. Conclusão: Esse estudo reforça a importância das orientações e do preparo para amamentação iniciarem no período da gestação, para que a mulher conheça as possíveis complicações e suas formas de prevenção e tratamento. Dessa forma, a gestante poderá sentir-se preparada para amamentar o seu filho, evitando o aparecimento de traumas e lesões

Objective: To evaluate the factors associated with nipple trauma. Method: Cross-sectional study with all mothers and newborns in rooming-in, admitted from July to August 2014. Results: A total of 73 mothers and 76 newborns (3 twins). There was a significant association between nipple trauma and pain or post-feeding burning (0.000), guidance on prenatal care (0.016) and number of visits in prenatal care (0.018), and even though, mothers who had seven or more visits prenatal showed nipple trauma. Conclusion: This study increase the importance of guidance and preparation for breastfeeding start in gestation period, so that women know the possible complications and ways of prevention and treatment. Thus, the pregnant woman may feel prepared to breastfeed her child, avoiding the appearance of traumas and injuries

Objetivo: Evaluar los factores asociados con el trauma del pezón. Método: Estudio transversal en el alojamiento conjunto con todas las madres y los recién nacidos ingresados entre julio y agosto de 2014. Resultados: Un total de 73 madres y 76 recién nacidos (3 gemelos). Se observó una asociación significativa entre el trauma del pezón y dolor o ardor después de la lactancia materna (0.000), orientación sobre el cuidado prenatal (0,016) y el número de consultas en el prenatal (0018), e incluso las madres que tenían siete o más visitas prenatal mostró lesiones del pezón. Conclusión: Este estudio refuerza la importancia de la orientación y preparación para la lactancia materna se inicia en el período de gestación, para que las mujeres conozcan las posibles complicaciones y formas de prevención y tratamiento. Así, la mujer embarazada puede sentir preparada para amamantar a su hijo, evitando la aparición de traumas y lesiones

The Impact of the Content of the Label on the Buying Intention of a Wine Consumer.

This paper aims to analyze the influence of the content of the label of wine bottles on the purchase intention of wine. The sample was 114 individuals (51, 32% women and 48, 67% men) inside simulated Supermarket at Javeriana University of the city of Cali (Colombia). They were viewed for 2 min in front of a grocery shelving with 100 wines. The study uses eye tracking to estimate the behavior related to wine attributes included on the label of wine bottles, specifically the denomination of origin, nutritional information, and health warnings. The authors use the hierarchical model methodology, which generates a pattern of relationships among variables. Among the results, it is possible to determine a consistent model for purchase intention, where the mentioned components of the label that are related to wine attributes and their interactions constitute important factors in the possibility of influencing a purchase intention. However, when executing a group division of the audience attending to the experience in wine consumption, it is evident that based on their experience, consumers read the labels' information differently, causing certain effects in their buying intention.

Compreensão das mulheres sobre o câncer de colo do útero e suas formas de prevenção em um município do interior da Bahia, Brasil / Understanding by women on the cervical cancer and its prevention forms in a municipal-ity in the interior of Bahia, Brazil

O Câncer de Colo do Útero (CCU) é considerado um grave problema de saúde pública, tendo em vista as elevadas e permanentes taxas de incidência. Há uma grande probabilidade de cura, quando diagnosticado precocemente, porém permanece um desafio ampliar a cobertura do exame de rastreamento, o Papanicolaou. O objetivo deste estudo foi avaliar a compreensão das mulheres, na faixa etária de 25 a 59 anos, sobre o CCU e suas formas de prevenção. Tratou-se de estudo descritivo exploratório de abordagem qualitativa. A análise de dados se deu por meio da análise de conteúdo. Foram realizadas vinte entrevistas semiestruturadas com mulheres que frequentavam Unidades de Saúde da Família. As mulheres demonstraram desconhecimento e compreensão superficial sobre o CCU. Também se depreendeu que o CCU e o exame de Papanicolaou desencadeiam sentimentos como o medo, o constrangimento e a vergonha. Alguns fatores foram percebidos como barreiras ao exame de rastreamento: a limitação dos horários de funcionamento dos serviços de saúde, a demora na marcação do exame e o excesso de burocracia. Concluiu-se que há a necessidade de reorganização dos serviços de saúde com ênfase em ações de promoção da saúde e de melhoria do acesso, como estratégia para aumentar a cobertura do exame Papanicolaou e, consequentemente, reduzir a incidência do CCU.

Cervical Cancer (CC) is considered a serious public health problem in view of the high and permanent incidence rates. There is a high cure probability when it is early diagnosed, but it is still a challenge to extend the coverage of the screening examination, the Pap one. The aim of this study was to evaluate the understanding that women have, aged 25 to 59 years old, on the CC and its prevention forms. This was an exploratory descriptive study of qualitative approach. Data analysis was by means of content analysis. Twenty semi-structured interviews with women attending Family Healthcare Units were carried out. These women demonstrated unawareness and superficial understanding on the CC. In addition, it was inferred that the CC and the Pap examination trigger feelings such as fear, embarrassment and shame. Some factors were observed as barriers to the screening test such as the limitation of working hours of health services, the delay in the examination scheduling and excessive bureaucracy. It was concluded that there is a need for the reorganization of the health services with an emphasis on health promotion actions and improving the access, as a strategy to increase the coverage of the Pap examination and, consequently, to reduce the CC incidence.

Influence of Facial and Occlusal Characteristics on Gummy Smile in Children: A Case-Control Study

Objective: To determine the association between occlusal and soft tissue characteristics with the presence of gingival smile (GS) in a pediatric population with inter-transitional mixed dentition. Material and Methods: Case-control study was performed with a probabilistic sample of 163 children in inter-transitional mixed dentition (age:8.8 years ±0.8). Cases were 37 children with GS, and controls were 126 children without GS. Occlusal variables were assessed through clinical examination, and soft tissue variables were assessed through photograms. Kappa test and intraclass correlation coefficient were done (0.87-0.96). The association between malocclusion, gender, and types of smile was assessed using a Chi square test. Comparison of quantitative variables in smile groups was made by Student t test. A multivariate binary logistic regression was performed. Results: Class II malocclusion, short upper lip at smile and short incisor clinical crown, were risk factors for gummy smile (OR= 10.4, 95%CI 3.07- 34.95, OR= 2.1, 95%CI 1.44- 3.13 and OR= 2.5 95%CI 1.34- 4.54 respectively). Lower facial height was a protective factor against GS (OR= 0.76; 95%CI 0.69- 0.85). The logistic regression model explains 48% of GS variability. Conclusion: Class II malocclusion is considered a risk factor for gummy smile. Other variables associated to gummy smile were short upper lip and short incisor clinical crown. Clinicians should considered these aspects in clinical examination of each patient to provide an adequate diagnostic and plan of treatment to control and/or correct a GS.

Functional evaluation of gene silencing on macrophages derived from U937 cells using interference RNA (shRNA) in a model of macrophages infected with Leishmania (Viannia) braziliensis.

Leishmaniasis development is multifactorial; nonetheless, the establishment of the infection, which occurs by the survival and replication of the parasite inside its main host cell, the macrophage, is mandatory. Thus, the importance of studying the molecular mechanisms involved in the Leishmania-macrophage interaction is highlighted. The aim of this study was to characterize a cellular model of macrophages derived from U937 cells that would allow for the identification of infection phenotypes induced by genetic silencing with interference RNA in the context of macrophages infected with Leishmania (Viannia) braziliensis. The model was standardized by silencing an exogenous gene (gfp), an endogenous gene (lmna) and a differentially expressed gene between infected and non-infected macrophages (gro-ß). The silencing process was successful for the three genes studied, obtaining reductions of 88·9% in the GFP levels, 87·5% in LMNA levels and 74·4% for Gro-ß with respect to the corresponding control cell lines. The cell model revealed changes in the infection phenotype of the macrophages in terms of number of amastigotes per infected macrophage, number of amastigotes per sampled macrophage and percentage of infected macrophages as a result of gene silencing. Thus, this cell model constitutes a research platform for the study of parasite-host interactions and for the identification of potentially therapeutic targets.

Changes in Macrophage Gene Expression Associated with Leishmania (Viannia) braziliensis Infection.

Different Leishmania species cause distinct clinical manifestations of the infectious disease leishmaniasis. It is fundamentally important to understand the mechanisms governing the interaction between Leishmania and its host cell. Little is known about this interaction between Leishmania (Viannia) braziliensis and human macrophages. In this study, we aimed to identify differential gene expression between non-infected and L. (V) braziliensis-infected U937-derived macrophages. We deployed a whole human transcriptome microarray analysis using 72 hours post-infection samples and compared those samples with their non-infected counterparts. We found that 218 genes were differentially expressed between infected and non-infected macrophages. A total of 71.6% of these genes were down-regulated in the infected macrophages. Functional enrichment analyses identified the steroid and sterol/cholesterol biosynthetic processes between regulatory networks down-regulated in infected macrophages. RT-qPCR further confirmed this down-regulation in genes belonging to these pathways. These findings contrast with those from studies involving other Leishmania species at earlier infection stages, where gene up-regulation for this metabolic pathway has been reported. Sterol biosynthesis could be an important biological process associated with the expression profile of macrophages infected by L. (V.) braziliensis. Differential transcriptional results suggest a negative regulation of the genetic regulatory network involved in cholesterol biosynthesis.

Social behavior, chemical communication, and adult neurogenesis: studies of scent mark function in Podarcis wall lizards.

Lacertid lizards have been hailed as a model system for the study of reptilian chemical communication. However, results obtained with the genus Podarcis, a diverse group of wall lizards with complex systematics, challenge emerging paradigms and caution against hasty generalizations. Here we review the available evidence on the role of chemical stimuli in male-female and male-male interactions in Iberian Podarcis. Males of several species can discriminate between chemicals left on substrates by females of their own or a different species, suggesting that differences in female chemical cues may underlie species recognition in this group. Females, on the other hand, do not respond differentially to conspecific and congeneric male scent marks. Males of Podarcis liolepis use scent marks to recognize rivals individually, evaluate their competitive ability (i.e., body size), and assess the threat posed by each individual rival neighbor. In contrast, females do not exhibit a preference for territories scent marked by larger (i.e., more competitive) males, which suggests a limited role for male scent marks in pre-copulatory mate choice. This behavioral sex difference is consistent with detailed neuro-ethological evidence showing that chemosensory brain areas in P. liolepis are sexually dimorphic. The accessory olfactory bulbs are larger (both in absolute and relative terms) in males than in females, probably as a result of sex-specific rates of adult neurogenesis. In both sexes, cell proliferation undergoes seasonal cycles that may have evolved to satisfy increased chemosensory demands at particular times of the year. Overall, and against recent generalizations, these results suggest that male scent marks have been shaped mainly by strong intrasexual selection.

Mujeres en tratamiento de cáncer, acogidas por un albergue de apoyo: circunstancias y perspectivas de cuidado de enfermería / Women receiving cancer treatment supported by a housing support: circumstances and perspectives in nursing care

Se realizó un estudio de tipo cualitativo basado en 13 entrevistas a profundidad a mujeres con cáncer entre los 33 y los 70 años, con diferentes diagnósticos, provenientes de varias regiones de Colombia, vinculadas al régimen subsidiado, y que son acogidas por un albergue durante su estadía en Bogotá con motivo de su tratamiento en el Instituto Nacional de Cancerología (INC) con el fin de conocer sus circunstancias y sus necesidades de cuidado de enfermería. De las mujeres, 8 tienen un cáncer de tipo ginecológico y de este grupo 5 viven con cáncer de mama. En 4 de los 13 casos el diagnóstico fue tardío. Para todas las mujeres ha sido difícil asimilar su diagnóstico, asociándolo a la posibilidad de morir; luego ha sobrevenido una etapa de aceptación de su realidad de salud y de afrontamiento. Para este grupo, el INC y el Albergue constituyen redes sociales significativas; la lejanía de sus allegados es una dificultad que destacan del hecho de tener que desplazarse a la capital. La mayoría de las participantes buscan sentirse activas; los aspectos psicosociales son prioritarios entre sus necesidades; desean profundizar en su conocimiento de la enfermedad; es importante para ellas desarrollar mayores habilidades de auto cuidado para minimizar efectos adversos y síntomas. Fortalecer las redes de acompañamiento e interacción generadas entre ellas así como apoyarlas para fortalecer sus perspectivas de afrontamiento de su enfermedad y de autocuidado hacen parte de las estrategias que se proponen para otorgar mayor sentido a la cotidianidad y para favorecer su salud mental y su calidad de vida durante el tiempo que duran sus tratamientos en la capital.

Correlación entre los niveles séricos de dehidroepiandrosterona sulfato con los estadios de maduración esquelética: informe final / Correlation between the seric levels of dehidroepiandrosterone sulphate with the skeletal maturation stages: final paper

Con el fin de detectar un indicador del inicio del brote puberal se correlacionaron los niveles séricos de DHEAS con la edad, el peso, la talla, el estadio de desarrollo esquelético (Hãgg y Taranger) y el de la maduración sexual (Tanner y orquidiometría de Prader). Se estudiaron 33 pacientes, 18 de sexo masculino y 15 de sexo femenino, entre los 8 y los 11 años de edad; el criterio de inclusión fue el de niños sanos con un estadio de maduración sexual de Tanner I. La toma de muestras se realizó cada seis meses durante tres años (2000-2002). El comportamiento de las variables antropométricas de la población general se publicó en el artículo de IGF-1 previo. En el grupo de niños no se observó ninguna correlación significativa entre el nivel de DHEAS con ninguna variable, excepto para el peso al inicio del estudio. En el grupo de niñas, la correlación se dio con el sesamoideo, aunque no fue a largo plazo y con el peso en la mitad del estudio. Sin embargo, ninguna de estas asociaciones y correlaciones confirma nuestra hipótesis inicial, ya que todas estas asociaciones fueron aisladas.

In order to detect an indicator of the onset of pubertal spurt, the DHEAS serie levels were correlated with age, weight, height, skeletal maturity stage (Hägg and Taranger) and sexual maturity (Tanner and, Prader). 33 patients; 18 males and 15 females, between 8 and 12 years old were studied. Healthy children in Tanner I sexual maturity stage was the research criteria for inclusion. The data were taken every six months during three years (2000-2002). The behavior of the anthropometric variables of the general population was published in a previous paper. In the group of males, we did not found any significant correlation between the seric levels of DHEAS with the studied variables, except for the weight at the beginning of the study. In the female group, a correlation was found with the ulnar sesamoid although not in the long term, and with the weight in the middle of the study. However, none of these associations and correlations confirmed our initial hypothesis because the correlations found were considerate such as isolated facts.

Relación entre tres métodos de evaluación de maduración esquelética con la maduración sexual / Relationship between three methods for the evaluation of skeletal maturation with sexual maturation

Con el fin de determinar cuál de los métodos con los que se establece la maduración esquelética se relaciona mejor con la madurez del paciente y por tanto, es más práctico y aplicable en la clínica, se buscó la relación entre tres diferentes métodos de evaluación de la maduración esquelética mediante el carpograma (Taranger y Hãgg, Greulich y Pyle, y Fishman), con la maduración sexual (Tanner, orquidiometría de Prader). Se estudiaron 33 pacientes, 18 de sexo masculino y 15 de sexo femenino, entre los 8 y los 13 años de edad; el criterio de inclusión fue el de niños sanos con un estadio de maduración sexual de Tanner I. El 100 por ciento de la muestra tanto femenina como masculina se ubicó en el estadio F del desarrollo esquelético. La toma de registros se realizó cada seis meses durante tres años (2000-2002). En la población masculina no se encontraron asociaciones entre la maduración esquelética evaluada de acuerdo con los métodos de Greulich y Pyle, y de Fishman con la maduración sexual; sin embargo sí se encontró relación entre algunos parámetros que integran el método de Taranger y Hãgg y la maduración sexual (sesamoideo-Tanner general durante la cuarta muestra y falange media del tercer dedo-volumen testicular derecho durante la misma, al igual que falange media con ambos volúmenes testiculares durante la quinta muestra). En la población femenina se presentaron asociaciones estadísticamente significativas entre el método de Fishman y la maduración sexual durante la segunda y sexta muestras; también, entre la evaluación según Greulich y Pyle y la maduración sexual durante la sexta muestra y entre el método de Taranger y Hãgg en la segunda, tercera y sexta muestras (sesamoideo-Tanner, falange media-Tanner y sesamoideo-Tanner respectivamente).

Prevalência e caracterização da anemia em idosos do Programa de Saúde da Família / Prevalence and characteristics of anemia in an elderly population attending a Health Family Program

A anemia é considerada um problema de saúde pública em escala mundial e é o distúrbio hematológico de maior prevalência que acomete a população idosa. O objetivo deste trabalho foi estimar a prevalência e características da anemia em idosos do Programa de Saúde da Família de Camaragibe, PE. O delineamento foi transversal, com amostra aleatória sistemática de 284 idosos > 60 anos, de ambos os sexos, realizado em novembro/dezembro-2003. A anemia foi avaliada pela hemoglobina (Hb), concentração de hemoglobina corpuscular média (CHCM), volume corpuscular médio (VCM) e amplitude de distribuição eritrocitária (RDW). A prevalência de anemia foi, em média, de 11,0 por cento. A morfologia eritrocitária não mostrou associação com as concentrações de Hb. A grande maioria dos idosos apresentou anemia normocrômica, normocítica, sem anisocitose, sugestivo de anemia por doença crônica. A ínfima prevalência de microcitose e macrocitose com anisocitoseminimiza a gênese da deficiência de ferro, bem como da deficiência de vitamina B12 e ácido fólico na etiologia da anemia em idosos. Concluímos que o uso de indicadores que reflitam o grau de anisocitose eritrocitária associados àqueles que avaliam o estado nutricional do ferro é extremamente recomendado para o diagnóstico das anemias em idosos.

Anemia is a serious public health problem worldwide that mainly affects children and women of childbearing age. However, data about anemia in elderly individuals are still scarce in developing countries. This study aimed at assessing the prevalence and characteristics of anemia among an elderly population attending the Health Family Program in Camaragibe, northeast Brazil. Following a systematic sampling procedure, a cross-sectional study was carried out in November and December 2003 involving 284 subjects of both genders with ages grater than or equal to 60 years old. Anemia was estimated by the measurement of hemoglobin, mean cell hemoglobin concentration, mean cell volume and red cell distribution width. The prevalence of anemia was around 11.0 percent. Red cell distribution width and mean cell volume were not correlated to hemoglobin count. The major characteristics of anemia were normochromia with normocytosis without anisocytosis suggesting anemia due to chronic diseases. The very low prevalence of microcytosis, macrocytosis and anisocytosis seems to be more likely due to causes other than iron, vitamin B12 or folic acid deficiencies. The use of indicators that reflect the degree of anisocytosis, as well as parameters to assess iron status should be strongly recommended in the screening of anemia in the elderly population.