The Polemic Diagnostic Role of TP53 Mutations in Liquid Biopsies from Breast, Colon and Lung Cancers.

Being minimally invasive and thus allowing repeated measures over time, liquid biopsies are taking over traditional solid biopsies in certain circumstances such as those for unreachable tumors, very early stages or treatment monitoring. However, regarding TP53 mutation status analysis, liquid biopsies have not yet substituted tissue samples, mainly due to the lack of concordance between the two types of biopsies. This needs to be examined in a study-dependent manner, taking into account the particular type of liquid biopsy analyzed, that is, circulating tumor cells (CTCs) or cell-free DNA (cfDNA), its involvement in the tumor biology and evolution and, finally, the technology used to analyze each biopsy type. Here, we review the main studies analyzing TP53 mutations in either CTCs or cfDNA in the three more prevalent solid tumors: breast, colon and lung cancers. We evaluate the correlation for mutation status between liquid biopsies and tumor tissue, suggesting possible sources of discrepancies, as well as evaluating the clinical utility of using liquid biopsies for the analysis of TP53 mutation status and the future actions that need to be undertaken to make liquid biopsy analysis a reality for the evaluation of TP53 mutations.

Botulinum Toxin A: A Novel Therapeutic Modality for Upper Extremity Chronic Regional Pain Syndrome.

BACKGROUND: Complex regional pain syndromes (CRPS) is a disease that is poorly understood. It is a chronic pain syndrome characterized by sympathetic disruptions as well as CNS sensitization. Botulinum Toxin-A has been shown to have efficacy in Raynaud's as well as other neuropathic pain disorders. Perhaps BTX-A warrants experimentation in the treatment of CRPS. METHODS: Patients with CRPS refractory to 2 or more regional sympathetic nerve blocks in 2007 were included in the study. Patient's were asked to rank their initial pain on a visual analog scale of 0 to 10 (10 being the worst pain). "Tenderness maps" were marked on patient's areas of most pain in 1 by 1 centimeter grids. Each box on the grid was injected with 10 IU of BTX-A after nerve blocks with 1% lidocaine. Treatment sessions occured on a monthly basis with VAS pain scores being re-assessed immediately before the new treatment. t Test, linear regression, and Cohen's D-test were used to analyze the correlation of the data. RESULTS: Study sample was 20 patients. Etiology of CRPS was 6 amputations, 4 crush injuries, 4 penetrating injuries, and 2 lacerations. Average pain reduction on VAS scale achieved was 2.05 points. Average percentage pain reduction was 22.94%. Cohen's D Test also showed a meaningful difference with a score of 1.01. Linear regression R2 = 0.491. Maximum pain reduction, on average, was achieved by treatment 9. CONCLUSION: Despite the esoteric etiology of CRPS, BTX-A has a well-demonstrated mechanism of effect. BTX-A should be further explored as a treatment modality for CRPS.

[Cardiac Hydatid Cyst in a Child: A Case Report]. / Quiste hidatídico intracardíaco en una niña: Reporte de caso.

Echinococcosis is a parasitic infection caused by Echinococcus granulosus, which, in its cystic state, forms the socalled hydatid cyst. It presents important morbidity, with possible sequelae related to the location, and high costs due to surgical and prolonged pharmacological treatment. The liver and the lung are the most common anatomical locations, and much rarer are the kidney, spleen, brain, and heart, where the latter represents 0.5 to 2% of total cases. Peru is an endemic country of this anthropozoonosis and mainly records cases in the central highlands (95%). This paper presents the case of a 10-year-old girl, diagnosed with this disease, CE1 ultrasound classification, clinical group 1 (confirmed by pathological anatomy) with specific surgical and pharmacological treatment (albendazole) afterward. The patient recovered satisfactorily from the surgery and was discharged at 16 days, without complications.

La equinococosis es una infección parasitaria provocada por Echinococcus granulosus, que, en su estado quístico, forma al denominado quiste hidatídico. Presenta morbilidad importante, con posibles secuelas relacionadas con la ubicación, y altos costos debido al tratamiento quirúrgico y farmacológico prolongado. El hígado y el pulmón son las ubicaciones anatómicas más usuales, mucho más raras son el riñón, bazo, cerebro y corazón, este último representa el 0,5 % a 2 % del total de casos. El Perú es un país endémico de esta antropozoonosis y principalmente registra casos procedentes de la sierra central (95 %). Se presenta el caso de una niña de diez años, con diagnóstico de esta entidad, clasificación ecográfica CE 1, grupo clínico 1 (confirmado por anatomía patológica) con posterior tratamiento quirúrgico y farmacológico específico (albendazol). La paciente se recuperó satisfactoriamente de la cirugía practicada, y fue dada de alta a los 16 días, sin complicaciones.

Ultrasonic backscatter difference measurements of cancellous bone from the human femur: Relation to bone mineral density and microstructure.

Ultrasonic backscatter techniques are being developed to detect changes in cancellous bone caused by osteoporosis. One technique, called the backscatter difference technique, measures the power difference between two portions of a backscatter signal. The goal of the present study is to investigate how bone mineral density (BMD) and the microstructure of human cancellous bone influence four backscatter difference parameters: the normalized mean of the backscatter difference (nMBD) spectrum, the normalized slope of the backscatter difference spectrum, the normalized intercept of the backscatter difference spectrum, and the normalized backscatter amplitude ratio (nBAR). Ultrasonic measurements were performed with a 3.5 MHz broadband transducer on 54 specimens of human cancellous bone from the proximal femur. Volumetric BMD and the microstructural characteristics of the specimens were measured using x-ray micro-computed tomography. Of the four ultrasonic parameters studied, nMBD and nBAR demonstrated the strongest univariate correlations with density and microstructure. Multivariate analyses indicated that nMBD and nBAR depended on trabecular separation and possibly other microstructural characteristics of the specimens independently of BMD. These findings suggest that nMBD and nBAR may be sensitive to changes in the density and microstructure of bone caused by osteoporosis.

Quiste hidatídico intracardíaco en una niña: Reporte de caso / Cardiac Hydatid Cyst in a Child: A Case Report

RESUMEN La equinococosis es una infección parasitaria provocada por Echinococcus granulosus, que, en su estado quístico, forma al denominado quiste hidatídico. Presenta morbilidad importante, con posibles secuelas relacionadas con la ubicación, y altos costos debido al tratamiento quirúrgico y farmacológico prolongado. El hígado y el pulmón son las ubicaciones anatómicas más usuales, mucho más raras son el riñón, bazo, cerebro y corazón, este último representa el 0,5 % a 2 % del total de casos. El Perú es un país endémico de esta antropozoonosis y principalmente registra casos procedentes de la sierra central (95 %). Se presenta el caso de una niña de diez años, con diagnóstico de esta entidad, clasificación ecográfica CE 1, grupo clínico 1 (confirmado por anatomía patológica) con posterior tratamiento quirúrgico y farmacológico específico (albendazol). La paciente se recuperó satisfactoriamente de la cirugía practicada, y fue dada de alta a los 16 días, sin complicaciones.

ABSTRACT Echinococcosis is a parasitic infection caused by Echinococcus granulosus, which, in its cystic state, forms the socalled hydatid cyst. It presents important morbidity, with possible sequelae related to the location, and high costs due to surgical and prolonged pharmacological treatment. The liver and the lung are the most common anatomical locations, and much rarer are the kidney, spleen, brain, and heart, where the latter represents 0.5 to 2% of total cases. Peru is an endemic country of this anthropozoonosis and mainly records cases in the central highlands (95%). This paper presents the case of a 10-year-old girl, diagnosed with this disease, CE1 ultrasound classification, clinical group 1 (confirmed by pathological anatomy) with specific surgical and pharmacological treatment (albendazole) afterward. The patient recovered satisfactorily from the surgery and was discharged at 16 days, without complications.

La preparación pedagógica en las diferentes formas de organización de la enseñanza / The pedagogical preparation in the different forms of organization of the teaching

Se realizó una revisión bibliográfica en la Facultad de Ciencias Médicas de Guantánamo sobre las diferentes formas de organización de la enseñanza con el objetivo de caracterizar algunas de las formas antes mencionadas teniendo en cuenta los elementos metodológicos para su impartición, de forma tal que puedan ser utilizadas en los diferentes claustros de profesores y así elevar la calidad del proceso docente - educativo en este centro de altos estudios(AU)

A bibliographic review was made in the Faculty of Medical Sciences about the different forms of organization of teaching with the objective to characterize some of the Forms of Organization of the Teaching taking into account the methodological elements for its delivery, so that they can be used in the different professors' staff and thus raise the quality of the teaching - educational process in the Faculty of Medical Sciences of Guantánamo

La participación sociopolítica de los jóvenes universitarios de la salud en el modelo socialista cubano / The sociopolitical participation of the university youths of the health in the Cuban socialist pattern

El presente trabajo es resultado parcial de la ejecución del Proyecto Investigativo Institucional para la evaluación del impacto de la metodología para el desarrollo del capital intelectual en los servicios de salud en Guantánamo. Se brindan reflexiones sobre los resultados de las observaciones, encuestas y entrevistas así como estudios cualitativos de la problemática participación sociopolítica vistos a partir de los más actuales criterios al respecto, los que constituidos en información primaria, permiten proponer una alternativa de intervención educativa sociopolítica en los jóvenes universitarios de la salud que debidamente implementada favorezca la incorporación consciente de este segmento de la juventud en las tareas de dirección sociopolítica en nuestro modelo de socialismo(AU)

The present work is been partially of the execution of the Institutional Investigative Project for the evaluation of the impact of the methodology for the development of the intellectual capital in the services of health in Guantánamo. Reflections are offered on the results of the observations, surveys and interviews as well as qualitative studies of the problematic sociopolitical participation seen starting from the most current approaches in this respect, those that constituted in primary information, that allows to propose an alternative of sociopolitical educational intervention in the university youths of the health that properly implemented it ,favoring the incorporation aware of the youth's segment in the tasks of sociopolitical address in our model of socialism(AU)

Lesiones cutáneas en el recién nacido: perfil clínico y epidemiológico en el Hospital Nacional Dos de Mayo, 2013 - 2014 / Skin lesions in the newborn: clinical and epidemiological profile in the National Hospital Dos de Mayo, 2013 – 2014

Objetivos: Determinar el perfil clínico y epidemiológico de las lesiones cutáneas en el recién nacido, y presentar una nueva propuesta de clasificación de dichas lesiones. Materiales y métodos: Se realizó un estudio descriptivo, transversal, que incluyó a recién nacidos con una edad gestacional >= a 35 semanas, y con tiempo de vida entre 24 a 168 horas. Se diseñó una ficha de recolección de datos para anotar las lesiones encontradas. Los datos obtenidos fueron analizados con el programa estadístico STATA v.12.0. Resultados: Se recolectó datos de 312 recién nacidos, el género masculino fue predominante (58 por ciento) y casi la totalidad (97.1 por ciento) fueron nacidos a término. El 99.6 por ciento de recién nacidos presentaron alguna lesión; las lesiones transitorias se presentaron en 99 por ciento de casos y las permanentes en 12.8 por ciento. El promedio de lesiones fue de 8, con un máximo 18 lesiones por recién nacido. La lesión transitoria más frecuente fue la mancha mongólica (90.1 por ciento). El área corporal con mayor número de lesiones (11) fue la cara. La lesión permanente más frecuente fue la mancha "Café con leche" (8.3 por ciento). Se encontraron asociaciones entre algunas lesiones y factores sociodemográficos. Conclusiones: Casi todos los recién nacidos presentaron lesiones cutáneas, con mayor frecuencia transitorias, siendo la mancha mongólica el hallazgo más frecuente. Factores como estación del año, raza, edad gestacional al nacer y horas de vida pueden ser asociados a lesiones transitorias. Basados en los resultados y en la revisión bibliográfica se postula una nueva clasificación de lesiones cutáneas del recién nacido.

Objectives: To determine the clinical and epidemiological profile of skin lesions in newborns, and to submit a new classification proposal of these lesions. Materials and methods: A descriptive, cross-sectional study was performed, which included infant born with >= 35 weeks' gestation and assessed between 24 to 168 hours of life. Skin lesions findings were collected in a form designed for this purpose. Data collected was analyzed using STATA v.12.0. Results: Data was obtained from 312 newborns, male gender was predominant (58 per cent) and almost all (97.1 per cent) were full-term newborn. At least one skin lesion was presented in 99.6 per cent of cases. Transient and permanent lesions occurred in 99 per cent and 12.8 per cent of cases respectively. The average of incidents of skin lesion was 8 per newborn, with a maximum of 18 lesions per case. The most common skin lesion was transient Mongolian spot (90.1 per cent). The body area with the highest number of skin lesions (11) was the face. The most common birthmark was "Café au lait" macules (8.3 per cent). Associations were found between several skin lesions and sociodemographic factors. Conclusions: Almost all newborn had skin lesions, most frequently transient, being the Mongolian spot the most frequent finding. Factors such as season, race, gestational age at birth and hours of life can be associated with transient injuries. Based on the results of the study and a thorough literature review, we proposed a new classification of skin lesions in newborn.

[Association between hematopoietic nutrient intake and the origin of nutritional anemia in women of childbearing age in Colombia]. / Asociación entre la ingesta de nutrientes hematopoyéticos y el origen nutricional de la anemia en mujeres en edad fértil en Colombia.

OBJECTIVES: Compare the nutritional origin of anemia by sociodemographic variables and analyze its association with deficient hematopoietic nutrient intake. METHODS: The database of Colombia's 2005 National Survey of Nutritional Status was used. The data were obtained through complex representative sampling of the population and processed using SPSS v.15. Anemic women of childbearing age were selected and divided into two groups according to serum ferritin levels. Their customary hematopoietic nutrient intake and risk of deficiency were determined. The proportions of anemia types were compared by sociodemographic variables using the F-distribution, the Rao-Scott second order correction (P < 0.05). The association between the origin of the anemia and classification of the nutrient was analyzed using the odds ratio (OR). SAMPLE: 595 women. Non-hypoferric anemia (67.2%) predominated, with no statistical difference by sociodemographic variable, except in the Pacific region (hypoferric anemia, 52.1%). The prevalence of deficiency in the customary intake of hematopoietic nutrients was high. There was no significant association between the deficit in consumption and the origin of the anemia. CONCLUSIONS: Non-hypoferric anemia was most common, with no difference by sociodemographic indicators except in the Pacific region. All the women were at high risk of deficiency in their customary hematopoietic nutrient intake, but a statistically significant association between the deficiency and the origin of the nutritional anemia was not observed. Programs to improve nutrient intake and a continued search for causes of nutritional anemia other than iron deficiency are justified.

Asociación entre la ingesta de nutrientes hematopoyéticos y el origen nutricional de la anemia en mujeres en edad fértil en Colombia / Association between hematopoietic nutrient intake and the origin of nutritional anemia in women of childbearing age in Colombia

OBJETIVO: Comparar el origen de la anemia nutricional según las variables sociodemográficas y analizar su asociación con la deficiencia en la ingesta de nutrientes hematopoyéticos. MÉTODOS: Se utilizó la base de datos de la Encuesta Nacional de la Situación Nutricional de Colombia, 2005. Los datos se obtuvieron por muestreo complejo representativo de la población y se procesaron con el programa SPSS, v.15. Se seleccionaron mujeres en edad fértil con anemia y se clasificaron en dos grupos según la ferritina sérica. Se determinó la ingesta usual de nutrientes hematopoyéticos y el riesgo de deficiencia. Se compararon las proporciones de los tipos de anemia según las variables sociodemográficas utilizando la prueba F de Rao-Scott de segundo orden (P < 0,05). Se analizó la asociación entre el origen de la anemia y la clasificación del nutriente mediante la razón de posibilidades (odds ratio, OR). RESULTADOS: Muestra: 595 mujeres. Predominó la anemia no ferropénica (67,2 por ciento), sin diferencia estadística por variables sociodemográficas, excepto en la región Pacífica (anemia ferropénica, 52,1 por ciento). La prevalencia de la deficiencia en la ingesta usual de nutrientes hematopoyéticos fue alta. No se encontró asociación significativa entre el déficit de consumo y el origen de la anemia. CONCLUSIONES: La anemia no ferropénica fue más frecuente, sin diferencia según los indicadores sociodemográficos excepto en la región Pacífica. Todas las mujeres presentaron alto riesgo de deficiencia en la ingesta usual de nutrientes hematopoyéticos, pero no se observó una asociación estadísticamente significativa entre la deficiencia y el origen de la anemia nutricional. Se justifica implementar programas orientados a mejorar el aporte de nutrientes y continuar la búsqueda de otras causas de la anemia nutricional diferentes a la deficiencia de hierro.

OBJECTIVES: Compare the nutritional origin of anemia by sociodemographic variables and analyze its association with deficient hematopoietic nutrient intake. METHODS: The database of Colombia's 2005 National Survey of Nutritional Status was used. The data were obtained through complex representative sampling of the population and processed using SPSS v.15. Anemic women of childbearing age were selected and divided into two groups according to serum ferritin levels. Their customary hematopoietic nutrient intake and risk of deficiency were determined. The proportions of anemia types were compared by sociodemographic variables using the F-distribution, the Rao-Scott second order correction (P < 0.05). The association between the origin of the anemia and classification of the nutrient was analyzed using the odds ratio (OR). RESULTS: Sample: 595 women. Non-hypoferric anemia (67.2 percent) predominated, with no statistical difference by sociodemographic variable, except in the Pacific region (hypoferric anemia, 52.1 percent). The prevalence of deficiency in the customary intake of hematopoietic nutrients was high. There was no significant association between the deficit in consumption and the origin of the anemia. CONCLUSIONS: Non-hypoferric anemia was most common, with no difference by sociodemographic indicators except in the Pacific region. All the women were at high risk of deficiency in their customary hematopoietic nutrient intake, but a statistically significant association between the deficiency and the origin of the nutritional anemia was not observed. Programs to improve nutrient intake and a continued search for causes of nutritional anemia other than iron deficiency are justified.

Comparative study of the efficacy and safety of two polyvalent, caprylic acid fractionated [IgG and F(ab')2] antivenoms, in Bothrops asper bites in Colombia.

The efficacy and safety of two polyvalent horse-derived antivenoms in Bothrops asper envenomings were tested in a randomized, double-blind, clinical trial performed in Colombia. Both antivenoms were manufactured from the same pool of hyperimmune plasma. Antivenom A was made of F(ab')2 fragments, generated by pepsin digestion and caprylic acid precipitation, whereas antivenom B consisted of whole IgG molecules produced by caprylic acid precipitation followed by ion-exchange chromatography. Besides the different nature of the active substance, antivenom B had higher protein concentration, slightly higher turbidity and aggregate content. No significant differences were observed in the efficacy of antivenoms. Both halted local and systemic bleeding (P = 0.40) within 6-12 h of treatment in 100% of the cases, and restored blood coagulation (P = 0.87) within 6-24 h in 84.7% of patients, and within 48 h in all of them, in agreement with restoration of plasma fibrinogen concentration. Venom concentrations in serum dropped significantly (P < 0.001), to very low levels, 1 h after antivenom infusion. Nevertheless, eight patients (11.1%), four for each antivenom, presented recurrence of venom antigenaemia at different times, from 6 to 96 h, with clinical significance (recurrent coagulopathy) only in one group B patient (2.9%). Serum creatine kinase (CK) activity was increased, as a consequence of local myonecrosis. There was no significant difference (P = 0.51) in the incidence of early adverse reactions to antivenom administration (28.9% for patients of group A and 20.6% for patients of group B), most of the reactions being mild, mainly cutaneous. The most frequent complications were cellulitis (16.7%), abscess formation (5.6%), acute renal failure (8.3%), and compartmental syndrome (5.6%). In conclusion, IgG and F(ab')2 antivenoms, prepared by caprylic acid fractionation, presented similar efficacy and safety profiles for the treatment of B. asper envenomings in Colombia.

La bioética en América Latina / Bioethics in Latin America

En el presente artículo la bioética en América Latina, se expone desde una perspectiva filosófica la evolución histórica de este nuevo enfoque del pensamiento ético en la región Latinoamericana, sus principales representantes, corrientes o tendencias que plantean el análisis del tema en Latinoamérica a partir de la situación real que presenta el subcontinente y la necesidad de encontrar soluciones autóctonas que den respuestas a estas necesidades, también se expone la influencia que ejerce el pensamiento bioético-médico anglosajón en la región, a partir de la medicalización de la bioética, concepción que se aleja de la elaborada por su fundador Potter y que trasciende los límites de las fronteras de los Estados Unidos(AU)

The bioethics in Latin America, is exposed from a philosophical perspective the historical evolution of this new approach to ethical thinking in the Latin American region, its main representative, current or tendencies that arise in analyzing the issue from Latin America of the real situation that presents the subcontinent and the need to find indigenous solutions that respond to these needs, the article also describes the influence of the Anglo-medical bioethical thinking in the region, from the medicalization of bioethics, concept that moves away from the Potter made by its founder and has moved beyond the borders of the United States(AU)

Metodología para la organización de un ambiente didáctico de Informática / Methodology for the organization of a study environment for Informatics

Se realiza un estudio de enfoque cualitativo fenomenológico con el objetivo de diseñar un sistema organizativo-metodológico para el análisis de la información recuperada en la red, que beneficie y estimule el desarrollo de las investigaciones estudiantiles, en la Filial de Ciencias Médicas de Guantánamo, en el período 2011 - 2012. Los datos primarios se recogen mediante métodos de la observación participante y entrevistas a profundidad, donde se obtienen resúmenes descriptivos a los cuales se les aplica la técnica de triangulación de métodos hasta lograr reflejar las problemáticas que amparan el presente trabajo. Se concluye que les corresponde al colectivo docente unido a los tutores y masa estudiantil, desarrollar y aplicar estrategias de análisis y filtrado de la información en la red, a nivel institucional, para enfrentar los desafíos actuales de las nuevas Tecnologías de Información Científica (TIC) y la transculturación que imponen los países capitalistas desarrollados a los del llamado tercer mundo(AU)

A study of phenomenological, qualitative approach is done in order to design an organizational-methodological analysis of the recovered information in the network, which benefit and encourage the development of student research at the Medical Sciences filial, Guantanamo, from 2011 to 2012. Primary data are collected using methods of participant observation and depth interviews, which are obtained descriptive summaries which are applied techniques of triangulation of methods to achieve, reflecting issues that protect the present work. As a conclusion ,correspond to the educational group joined mentors and student body, develop and implement strategies of analysis and filtering of information in the network, at the institutional level, to meet the challenges of new technologies for Scientific Information (ICTs) and acculturation imposed by capitalist countries of the Third World(AU)

[Tityus asthenes scorpion stings: epidemiological, clinical and toxicological aspects]. / Picaduras por escorpión Tityus asthenes en Mutatá, Colombia: aspectos epidemiológicos, clínicos y toxinológicos.

INTRODUCTION: Scorpion stings are a public health problem in many countries. However, in Colombia, very few epidemiological, clinical or toxicological studies have been undertaken. OBJECTIVE: Ecological and epidemiological aspects were related to the prevalence of scorpion stings by Tityus asthenes. The clinical features of envenomization were described in patients and in an experimental animal model. MATERIALS AND METHODS: The study was conducted in four localities of Mutatá and Urabá Counties in the province of Antioquia, Colombia. The sample consisted of 1,593 (929 urban, 664 rural) of the 5,305 exposed people, inhabitating 324 households (188 urban (58%); 136 rural (42%) of 1,448 houses total in the study area. An interview survey was performed in every selected family for a more realistic estimate of sting prevalence. Additionally, a prospective study was directed toward patients presenting scorpion stings at care at the local hospital over an 18-month period. RESULTS: The probability was 12.9 times greater of finding T. asthenes inside or around houses in places near to forest and high agrarian plantations (odds ratio = 13). Eighty scorpion stings were reported in the retrospective study (4.1% prevalence [95% CI 3.3-4.8%] ), but only 14 of the patients (17.5%) sought care in the local hospital (an 82.5% underreportage). Seventy percent of the stings occurred in rural places; 50% occurred in the locality of Caucheras, with an attack rate of 10.6%. The overall household infestation rate was 269% (95% CI 22.9-30.8%) and an area dispersion ratio of 100%. Signs of systemic envenomization occurred mainly in children (67%). The 50% lethal dose of T. asthenes venom was 121.6 µg for 18-20 g Swiss Webster rats (95% CI 103.7-139.6). Immunodetection of T. asthenes and Centruroides gracilis/C.margantatus venoms in the experimental animals was possible when were tested by Western blot against Alacramyn (Instituto Bioclón, México) and Soro antiaracnídico (Instituto Butantan, Brasil) antivenoms. Scorpion interspecific differences were noted. CONCLUSIONS: The prevalence of stings by T. asthenes were common and their presence was associated with tropical rainforests. Envenomization at low density can be neutralized efficiently by anti-scorpion antivenoms produced in México and Brazil but with differing specificities for the venom of each scorpion species.

Picaduras por escorpión Tityus asthenes en Mutatá, Colombia: aspectos epidemiológicos, clínicos y toxinológicos / Tityus asthenes scorpion stings: epidemiological, clinical and toxicological aspects

Introducción. El escorpionismo afecta a países tropicales como Colombia.Objetivo. Determinar los indicadores ecológicos y epidemiológicos de las picaduras por Tityus asthenes en cuatro localidades de Mutatá, Colombia, y las características clínicas del envenenamiento y toxinológicas del veneno. Materiales y métodos. Es un estudio prospectivo/retrospectivo descriptivo y experimental; se visitaron aleatoriamente 324 de las 1.448 viviendas del municipio: 188 urbanas (58,0%) y 136 rurales (42,0%), con 1.593 habitantes. En 18 meses se estudiaron prospectivamente los pacientes picados por T. asthenes que ingresaron al hospital local y, retrospectivamente en encuestas domiciliarias, se determinó el subregistro. Se recolectaron escorpiones vivos y se realizaron experimentos con el veneno. Resultados. Hubo 12,9 más probabilidades de hallar ejemplares de T. asthenes en el área rural (OR=6,5; IC95% 3,9-10,8), en el intradomicilio y peridomicilio cercano a bosques y plantaciones agrarias altas (OR=13,0; IC95% 7,5-23,0). Se reportaron 80 picaduras ocurridas en los dos últimos años (prevalencia de 4,1%; IC95% 4,8-3,3); sólo 14 personas (17,5%) consultaron al hospital (subregistro de 82,5%). La prevalencia ponderada de infestación por escorpiones en las viviendas encuestadas fue de 26,9% (112 casas) (IC95% 30,8-22,9). El 50% de los accidentes ocurrió en la localidad de Caucheras: 10,6% de proporción de ataque. El envenenamiento sistémico fue más frecuente en niños (67%). La dosis letal 50 del veneno en ratones de 18 a 20 g, fue 121,6 μg (IC95% 103,7-139,6). Hubo reactividad inmunológica por Western blot de los antivenenos del Instituto Bioclón, México (Alacramyn®) y del Instituto Butantan, Brasil (Soro antiaracnídico®)...

Introduction. Scorpion stings are a public health problem in many countries. However, in Colombia, very few epidemiological, clinical or toxicological studies have been undertaken. Objective. Ecological and epidemiological aspects were related to the prevalence of scorpion stings by Tityus asthenes. The clinical features of envenomization were described in patients and in an experimental animal model. Materials and methods. The study was conducted in four localities of Mutatá and Urabá Counties in the province of Antioquia, Colombia. The sample consisted of 1,593 (929 urban, 664 rural) of the 5,305 exposed people, inhabitating 324 households (188 urban (58%); 136 rural (42%) of 1,448 houses total in the study area. An interview survey was performed in every selected family for a more realistic estimate of sting prevalence. Additionally, a prospective study was directed toward patients presenting scorpion stings at care at the local hospital over an 18-month period. Results. The probability was 12.9 times greater of finding T. asthenes inside or around houses in places near to forest and high agrarian plantations (odds ratio=13). Eighty scorpion stings were reported in the retrospective study (4.1% prevalence [95% CI 3.3-4.8%] ), but only 14 of the patients (17.5%) sought care in the local hospital (an 82.5% underreportage). Seventy percent of the stings occurred in rural places; 50% occurred in the locality of Caucheras, with an attack rate of 10.6%. The overall household infestation rate was 269% (95% CI 22.9-30.8%) and an area dispersion ratio of 100%. Signs of systemic envenomization occurred mainly in children (67%). The 50% lethal dose of T. asthenes venom was 121.6 μg for 18-20 g Swiss Webster rats (95% CI 103.7-139.6). Immunodetection of T. asthenes and Centruroides gracilis/C.margantatus venoms in the experimental animals was possible when were tested by Western blot against Alacramyn® (Instituto Bioclón, México) and Soro antiaracnídico®...

Impact of a sun protection campaign in Medellín (Colombia).

OBJECTIVE: To evaluate the impact of an educational massive sun protection campaign. METHODS: Two telephone surveys were performed to 707 participants, on knowledge about the hours of greater solar intensity, UV protection devices, the ultraviolet index, and the history of skin cancer. Between the first and the second survey, a massive sun protection campaign was carried out. A sun protection brochure was also sent to each participant. RESULTS: In the first survey (S1) a total of 707 individuals were interviewed, while in the second one (S2), the effectiveness of the calls decreased to 374 people. Nevertheless, we found significant differences between the first and the second survey (chi(2) = 12.3, P = 0.006). Overall, a significant increment in sun protection knowledge was acquired, but the use of sun-block remained stable. The knowledge about what the UVI means was increased significantly from S1 to S2. The best communication means to increase the overall knowledge about the sun and its effects were the brochure and TV. DISCUSSION AND CONCLUSIONS: We should encourage massive sun protection. The role of women in the transmission of these messages to their children or family nucleus is essential. Also, we should encourage the elaboration of brochures and an appropriate television use for health messages. Dermatologists must have a role in controlling skin topics presented on television to avoid erroneous messages or inadequate attitudes.