Postcranial anomalies of Eocene freshwater pleurodiran and cryptodiran turtles from the Spanish Duero Basin.

Testudines are one of the best-represented taxonomic groups among the Paleogene taxa of the Duero Basin (Castile and Leon Autonomous Community, central Spain). Among them, Neochelys (Podocnemidide) and Allaeochelys (Carettochelyidae) are most abundant, allowing the population to be assessed for osteological anomalies. The abundance of postcranial remains of both taxa allows us to identify several individuals with potential anomalies, mostly in their shells. Some of them have already been described in previous studies, but most of them are still unpublished. The objective of this study is to analyze in detail the anomalous Neochelys and Allaeochelys remains. As a result, different categories of causal agents (such as bacteria, fungi, parasites, or trauma) have been identified as potential producers of the anomalies in these freshwater turtles. Information regarding the pathogenesis and healing stages of some of these anomalies is provided.

Shell characterization of the youngest valid species of the European Eocene genus Neochelys (Pleurodira, Podocnemididae): The Spanish Bartonian Neochelys salmanticensis.

The freshwater pleurodiran turtle Neochelys is the best-represented member of Podocnemididae in the European record, being known by eight Eocene species. The youngest of them is the Bartonian (middle Eocene) Neochelys salmanticensis, from the Duero Basin (Salamanca Province, Central Spain). It corresponds to the largest representative known for this genus, its shell reaching 50 cm in length. Despite this form was defined several decades ago, the information currently available on it is very limited, being restricted to shell remains of less than 10 individuals. In fact, this species lacks a valid diagnosis, considering the current knowledge about the genus. Numerous remains (i.e., more than 1,200) of the shell of this Spanish species are identified. Its detailed study is presented here, so that the anatomy of its shell is characterized in detail. In addition, several aspects related to its intraspecific variability are analyzed, relative to the individual, ontogenetic, and sexual variability. In this way, the shell of N. salmanticensis can be characterized with greater precision than that of any other species of the genus.

Analysis of shell anomalies in the Spanish upper cretaceous basal pan-pleurodire Dortoka vasconica (Dortokidae).

The study of pathological bone modifications of extinct organisms of lineages, which are still living today, in combination with extant representatives, allows to infer data about population dynamics, lifestyle, and diseases they were subject to. Pathological studies in turtles are extensive; however, these contributions are mainly focused on extant representative records of survival rates or on non-skeletonized material, and do not generally include morphological descriptions, illustrations, or data concerning their etiology and pathogenesis. As a consequence, paleopathology in turtles remains relatively poorly understood, especially considering extinct forms. In this context, we herein analyze marks of possible pathological origin recognized in two disarticulated plastral plates of the Spanish freshwater basal pan-pleurodiran turtle Dortoka vasconica (Dortokidae), from its type locality, the Upper Cretaceous (late Campanian-early Maastrichtian) fossil site of Laño 1 (Treviño County, Burgos, Spain). As a result, information regarding the possible etiology, pathogenesis, and stages of healing of the marks studied here are provided. A probable infectious origin is recognized as the etiology in both plates, these marks being considered as pathologies. This study contributes to our understanding of pathologies in extinct turtle taxa, specifically a stem-pleurodiran turtle.

A bidirectional switch in the Shank3 phosphorylation state biases synapses toward up- or downscaling.

Homeostatic synaptic plasticity requires widespread remodeling of synaptic signaling and scaffolding networks, but the role of post-translational modifications in this process has not been systematically studied. Using deep-scale quantitative analysis of the phosphoproteome in mouse neocortical neurons, we found widespread and temporally complex changes during synaptic scaling up and down. We observed 424 bidirectionally modulated phosphosites that were strongly enriched for synapse-associated proteins, including S1539 in the autism spectrum disorder-associated synaptic scaffold protein Shank3. Using a parallel proteomic analysis performed on Shank3 isolated from rat neocortical neurons by immunoaffinity, we identified two sites that were persistently hypophosphorylated during scaling up and transiently hyperphosphorylated during scaling down: one (rat S1615) that corresponded to S1539 in mouse, and a second highly conserved site, rat S1586. The phosphorylation status of these sites modified the synaptic localization of Shank3 during scaling protocols, and dephosphorylation of these sites via PP2A activity was essential for the maintenance of synaptic scaling up. Finally, phosphomimetic mutations at these sites prevented scaling up but not down, while phosphodeficient mutations prevented scaling down but not up. These mutations did not impact baseline synaptic strength, indicating that they gate, rather than drive, the induction of synaptic scaling. Thus, an activity-dependent switch between hypo- and hyperphosphorylation at S1586 and S1615 of Shank3 enables scaling up or down, respectively. Collectively, our data show that activity-dependent phosphoproteome dynamics are important for the functional reconfiguration of synaptic scaffolds and can bias synapses toward upward or downward homeostatic plasticity.

Treatment adherence in patients with diffuse neuropsychiatrie disorders associated with systemic lupus erythematosus / Adherencia al tratamiento en pacientes con trastornos neuropsiquiátricos difusos asociados a lupus eritematoso sistémico

ABSTRACT Introduction: Systemic lupus erythematosus (SLE) is a chronic disease that affects multiple systems and may include neurological and psychiatric events that could compromise treatment adherence and long-term outcomes in SLE. Objective: To evaluate treatment adherence in patients with diffuse neuropsychiatric disorders associated with SLE. Methods: A cross-sectional descriptive study was conducted. Treatment adherence was eval uated with the Morisky Medication Adherence Scale (MMAS-8) in patients with diffuse neuropsychiatric disorders associated with SLE (cognitive impairment, psychosis, mood disorders, and anxiety). Results: A total of 60 patients with neuropsychiatric disorders associated with SLE were included. Thirteen patients (21.6%) had high adherence, 9 (15%) had medium adherence, and 38 patients (63.3%) had low treatment adherence. Conclusion: This study has identified that almost two-thirds of the participants (63.3%) had low treatment adherence.

RESUMEN Introducción: El lupus eritematoso sistémico (LES) es una enfermedad crónica que afecta a múltiples sistemas, entre ellos el sistema nervioso, con eventos neurológicos y psiquiátricos que podrían influir en la adherencia al tratamiento y los resultados a largo plazo de la enfermedad. Objetivo: Evaluar la adherencia al tratamiento de los pacientes con trastornos neuropsiquiátricos difusos asociados con el LES. Metodología: Se llevó a cabo un estudio descriptivo transversal que evaluó el grado de adhe rencia al tratamiento con el test de Morisky en pacientes con trastornos neuropsiquiátricos difusos asociados con LES (alteración cognitiva, psicosis, trastornos del ánimo y ansiedad). Resultados: Se incluyó a 60 pacientes con trastornos neuropsiquiátricos difusos asociados con LES, de los cuales 13 (21,6%) tuvieron adherencia alta, 9 (15%) adherencia media y 38 (63,3%) presentaron baja adherencia al tratamiento. Conclusión: En este estudio se identificó que más de la mitad de los participantes (63,3%) presentaron baja adherencia al tratamiento.

Guia de cáncer de pene de la Sociedad Colombiana de Urología / Colombian Society of Urology Penile Cancer Guideline

El cáncer de pene tiene una incidencia de 1.11 por 100.000 habitantes en Colombia, representado en el 95% por carcinoma de células escamosas el cual representa una alta morbilidad y mortalidad, La Sociedad Colombiana de Urología realizo la adaptación de la guía de cáncer de pene para el año 2021 con revisión de la literatura, esta guía permite realizar una evaluación y tratamiento del cáncer de pene, enmuchas ocasiones con el objetivo de preservación de órgano utilizando la ecografía como determinante para evaluar el compromiso de la lesión a las estructuras del pene, los estudios de extensión dependerán de hallazgos al examen físico como ganglios o compromiso local de la enfermedad, de acuerdo al tipo de lesión y su estadificación puede recibir terapia con agentes tópicos, radioterapia, cirugía láser, cirugía preservadora de órgano o penectomía total; La linfadenectomía inguinal permitirá mejorar la supervivencia en tumores de riesgo intermedio y alto (>pT1G2), posteriormente la quimioterapia adyuvante esta en el grupo de pacientes en el cual la intención sea curativa, aunque en terapia paliativa de segunda línea se encuentran los platinos y texanos como alternativa pero con pobre respuesta (<30%); los esquemas de seguimiento se realiza de acuerdo al estadio y el compromiso ganglionar. Al final se presentan los resultados de actividad sexual después de cirugía preservadora de órgano; Esta guía abarca la literatura actualizada del cáncer de pene, el cual es útil para el manejo por parte de los profesionales de salud del país.

Penile cancer has an incidence of 1.11 per 100,000 inhabitants in Colombia, 95% represented by squamous cell carcinoma which represents a high morbidity and mortality, The Colombian Society of Urology adapted the penile cancer guide to The year 2021 with a review of the literature, this guide allows an evaluation and treatment of penile cancer, in many cases with the objective of organ preservation, using ultrasound as a determinant to evaluate the commitment of the injury to the structures of the penis, Extension studies will depend on findings on physical examination such as lymph nodes or local involvement of the disease, according to the type of lesion and its staging, it can receive therapy with topical agents, radiotherapy, laser surgery, organ-sparing surgery or total penectomy; Inguinal lymphadenectomy will improve survival in intermediate and high risk tumors (> pT1G2), subsequently adjuvant chemotherapy is in the group of patients in which the intention is curative, although platinum and Texans are found in second-line palliative therapy as an alternative but with a poor response (<30%); the follow-up schemes are carried out according to the stage and lymph node involvement. At the end, the results of sexual activity after organ-sparing surgery are presented; This guide covers the updated literature on penile cancer, which is useful for the management of health professionals in the country.

Genetic blockade of lymphangiogenesis does not impair cardiac function after myocardial infarction.

In recent decades, treatments for myocardial infarction (MI), such as stem and progenitor cell therapy, have attracted considerable scientific and clinical attention but failed to improve patient outcomes. These efforts indicate that more rigorous mechanistic and functional testing of potential MI therapies is required. Recent studies have suggested that augmenting post-MI lymphatic growth via VEGF-C administration improves cardiac function. However, the mechanisms underlying this proposed therapeutic approach remain vague and untested. To more rigorously test the role of lymphatic vessel growth after MI, we examined the post-MI cardiac function of mice in which lymphangiogenesis had been blocked genetically by pan-endothelial or lymphatic endothelial loss of the lymphangiogenic receptor VEGFR3 or global loss of the VEGF-C and VEGF-D ligands. The results obtained using all 3 genetic approaches were highly concordant and demonstrated that loss of lymphatic vessel growth did not impair left ventricular ejection fraction 2 weeks after MI in mice. We observed a trend toward excess fluid in the infarcted region of the left ventricle, but immune cell infiltration and clearance were unchanged with loss of expanded lymphatics. These studies refute the hypothesis that lymphangiogenesis contributes significantly to cardiac function after MI, and suggest that any effect of exogenous VEGF-C is likely to be mediated by nonlymphangiogenic mechanisms.

Las cabras como dispersores de semillas: aportes y limitaciones para la regeneración del bosque tropical estacionalmente seco de Ecuador / Goats as seed dispersers: contributions and limitations for the regeneration of the seasonally dry tropical forest in Ecuador

Resumen Introducción: Los bosques tropicales estacionalmente secos están sujetos a procesos de degradación crónica que ponen en riesgo su diversidad. La ganadería intensiva dentro de los remanentes de bosque se plantea como una de las principales causas de estos procesos de degradación. Sin embargo, el ganado también podría estar cumpliendo el rol de dispersor de semillas para algunas especies. Objetivo: Evaluar el rol de las cabras en la dispersión de semillas de especies leñosas y las posibles consecuencias de su comportamiento alimenticio sobre la estructura de la vegetación. Métodos: Entre diciembre 2016 y junio 2017 se recolectaron fecas de corrales (N = 38) y parcelas de vegetación (N = 42) de tres localidades de bosque seco en el Suroccidente de Ecuador. Todas las semillas encontradas en las fecas (N = 13 326) se registraron e identificaron taxonómicamente. Para evaluar el efecto de la ingestión de semillas sobre la germinación, se estableció un experimento de siembra de semillas extraídas de fecas procedentes de corrales y semillas recolectadas directamente de la planta. Resultados: Las cabras dispersaron 10 especies leñosas, de las cuales al menos el 50 % son leguminosas. Las semillas de Acacia macracantha representaron más del 70 % de semillas presentes en fecas de cabra. El paso de semillas por el tracto digestivo de las cabras mejoró significativamente el porcentaje y velocidad de germinación en Albizia multiflora, Piscidia carthagenensis y Ziziphus thyrsiflora, mientras que en Choroleucon mangense y Prosopis juliflora no se obtuvo germinación. No encontramos una correlación entre la riqueza de árboles establecidos y el número de especies encontradas en las fecas (χ2 = -0.23, P = 0.53). La composición de especies de semillas dispersadas en las fecas no mostró una dependencia de la localidad, a pesar de que la composición de la vegetación establecida cambia entre localidades. La abundancia de semillas en las fecas no mostró relación con la abundancia de árboles en la vegetación establecida. Conclusiones: Las cabras pueden suplir en cierta medida el rol de otros ungulados localmente extintos, mejorando la germinación de especies de leguminosas con testa dura. Sin embargo, su comportamiento alimenticio y la alta dominancia en la dispersión de ciertas especies puede tener importantes efectos en la estructura de la comunidad.

Abstract Introduction: Seasonally dry tropical forests are subject to chronic degradation processes, which has reduced the populations of some important animal dispersers. Intensive livestock farming within the forest remnants is considered one of the main causes of these degradation processes. However, domestic ungulates could also be fulfilling the role of seed dispersal for some wild species. Objective: To evaluate the role of goats as seed dispersers of woody species and the possible consequences of their feeding behavior on the vegetation structure. Methods: Between December 2016 and June 2017, we collected goat feces from pens (N = 38) and vegetation plots (N = 42) from three locations of dry forest in the Southwestern Ecuador. All the seeds found in the feces (N = 13 326) were recorded and taxonomically identified. To evaluate the effect of gut passage on seed germination, we sowed the seeds found in the goat feces from the pens and seeds collected directly from parent plants. Results: Goats dispersed seeds from ten species, of which at least 50 % are legumes. Acacia macracantha seeds represented ca. 70 % of seeds present in goat feces. The passage of seeds through the digestive tract of goats significantly improved the percentage and speed of germination in Albizia multiflora, Piscidia carthagenensis and Ziziphus thyrsiflora, while in Choroleucon mangense and Prosopis juliflora no germination was registered. We did not find a correlation between the richness of established trees and the number of species found in the goat feces (χ2 = -0.23, P = 0.53). The composition of dispersed seed species in the feces did not show a dependency on the locality, although the composition of the established vegetation changes between localities. The frequency of seeds in the feces did not show a relationship with the tree abundance in the established vegetation. Conclusions: Goats can play, at least partially, the role of locally extinct wild ungulates, improving the germination of legume species with hard coat. However, this positive effect can be blurred by their feeding behavior and high preference for particular species, which can modify the dominance of some species, and result in changes in the composition and structure of the vegetation.

A multifaceted approach to understanding bat community response to disturbance in a seasonally dry tropical forest.

Given widespread habitat degradation and loss, reliable indicators are needed that provide a comprehensive assessment of community response to anthropogenic disturbance. The family Phyllostomidae (Order Chiroptera) has frequently been the focus of research evaluating bats' response to habitat disturbance in seasonally dry tropical forests (SDTFs). However, few studies compare this family to the larger bat assemblage to assess its efficacy as a bioindicator. We compared community and species-specific attributes of understory phyllostomid and all understory bat species: (1) along a gradient of habitat disturbance within a human-modified SDTF landscape; and (2) between forest and riparian habitats within each disturbance level. We captured 290 individuals belonging to 13 species and 4 families. Phyllostomid species exhibited greater sensitivity to disturbance than the understory bat community as a whole based on richness and beta diversity. Both groups were more sensitive to disturbance in forest than riparian habitat, but phyllostomid species were more likely to be lost from highly disturbed forest habitat. The two dominant species declined in abundance with disturbance but variation in body condition was species-specific. These results suggest that Phyllostomidae are more effective indicators of human disturbance in SDTF than the understory bat community as a whole and evaluation of bats' response to disturbance is best accomplished with a multifaceted approach.

Effectiveness of an intermittent fasting diet versus continuous energy restriction on anthropometric measurements, body composition and lipid profile in overweight and obese adults: a meta-analysis.

The effects of an intermittent fasting (IF) diet in the overweight or obese adult population are still controversial. This study aimed to evaluate the effectiveness of an IF diet to reduce anthropometric parameters (body mass index, body weight, and waist circumference), change body composition (fat mass, lean body mass and muscle mass) and lipid profile (total cholesterol, HDL-c, LDL-c and triglycerides), and to adhere to the diet in comparison to continuous energy restriction (CER) in overweight or obese adults. A research question PICO (patients, intervention, comparison, outcome) was established. PubMed, Scopus, Web of Science, Cochrane, and Scielo databases were searched to identify randomized clinical trials that compared an IF diet with a CER diet or a regular diet. DeCS and MeSH descriptors and Boolean operators (AND and OR) were used. From 859 studies identified through the literature search, 18 articles were finally selected. Overall, IF diets were associated with higher weight loss in four studies and similar reduction in waist circumference in one study, compared with a CER regimen. Fat mass tended to decrease more in the IF groups in five studies. However, the lean and muscle mass loss was similar in both groups. Only three studies observed significant differences in lipid profile variables, mostly in the IF groups. Adherence to the diet was inconclusive. An IF diet may provide a benefit by improving anthropometry, body composition, and lipid profile in overweight or obese adult population, likewise a CER diet.

Clasificación ti-rads para diagnóstico y clasificación de los nódulos tiroideos / Ti-rads classification for diagnosis and classification of thyroid nodules

La prevalencia del nódulo tiroideo (NT) en la población general es de entre el 2 al 7% por palpación y de 19 a 76% por ultrasonido. Su incidencia es más alta con la edad, en personas provenientes de áreas con deficiencia de yodo, en mujeres, y después de exposición a radiación. Objetivo: Estudiar distintas fuentes bibliográficas para así establecer la importancia del uso práctico de la clasificación TI-RADS en el nódulo tiroideo. Metodología: Se constituye en una investigación de carácter documental, tanto bibliográfica como digital. Resultados: La importancia del estudio del nódulo tiroideo radica en la necesidad de excluir cáncer, por lo cual, todo nódulo tiroideo >1cm debe ser evaluado. Los nódulos <1cm serán sospechosos cuando se encuentren asociados a factores de riesgo y en presencia de hallazgos ultrasonográficos sugestivos de malignidad. La clasificación TI-RADS de los NT basada en un sistema de puntuación acorde a los criterios ecográficos más relevantes de malignidad tiene una mejor y más fácil aplicación en la práctica diaria. Conclusión: Según los criterios de malignidad y la puntuación asignada en este estudio, la posibilidad de que un NT con un punto en la escala sea maligno es de aproximadamente un 10%, mientras que la probabilidad para aquellos con dos puntos es casi del 50% y para los valorados con tres o cuatro puntos del 85%. Todos los NT con 5 o más puntos son malignos. El presente artículo resume una comparación de referencias bibliográficas para actualización y aplicación de la clasificación TIRADS(AU)

The prevalence of the thyroid nodule (TN) in the general population is between 2 to 7% by palpation and from 19 to 76% by ultrasound. Its incidence is higher with age, in people from iodine-deficient areas, in women, and after exposure to radiation. Objective: To study different bibliographic sources in order to establish the importance of the practical use of the TI-RADS classification in the thyroid nodule. Methodology: It constitutes a documentary research, both bibliographic and digital. Results: The importance of studying the thyroid nodule lies in the need to exclude cancer, therefore, any thyroid nodule> 1cm should be evaluated. Nodules <1cm will be suspicious when associated with risk factors and in the presence of ultrasonographic findings suggestive of malignancy. The TI-RADS classification of NTs based on a scoring system according to the most relevant ultrasound criteria of malignancy has a better and easier application in daily practice. Conclusion: According to the malignancy criteria and the score assigned in this study, the possibility that a TN with one point on the scale is malignant is approximately 10%, while the probability for those with two points is almost 50% and for those valued with three or four points of 85%. All TNs with 5 or more points are malignant. This article summarizes a comparison of bibliographic references for updating and applying the TIRADS classification(AU)

Cerebral cavernous malformations are driven by ADAMTS5 proteolysis of versican.

Cerebral cavernous malformations (CCMs) form following loss of the CCM protein complex in brain endothelial cells due to increased endothelial MEKK3 signaling and KLF2/4 transcription factor expression, but the downstream events that drive lesion formation remain undefined. Recent studies have revealed that CCM lesions expand by incorporating neighboring wild-type endothelial cells, indicative of a cell nonautonomous mechanism. Here we find that endothelial loss of ADAMTS5 reduced CCM formation in the neonatal mouse model. Conversely, endothelial gain of ADAMTS5 conferred early lesion genesis in the absence of increased KLF2/4 expression and synergized with KRIT1 loss of function to create large malformations. Lowering versican expression reduced CCM burden, indicating that versican is the relevant ADAMTS5 substrate and that lesion formation requires proteolysis but not loss of this extracellular matrix protein. These findings identify endothelial secretion of ADAMTS5 and cleavage of versican as downstream mechanisms of CCM pathogenesis and provide a basis for the participation of wild-type endothelial cells in lesion formation.

Retos de la implementación del aprendizaje basado en equipos en los programas de medicina / The challenges of implementing team-based learning to the medical major programs

Introducción: El aprendizaje basado en equipos es una estrategia de enseñanza y de aprendizaje centrada en el alumno, en la cual el profesor tiene un rol facilitador. Este constituye un método pedagógico de aprendizaje activo que mejora la motivación hacia el aprendizaje y lleva a los alumnos a aplicar sus conocimientos para resolver problemas y combinar la teoría con la práctica. Los avances en educación médica a nivel mundial han llevado a las escuelas de medicina a optar por este tipo de estrategias. Objetivo: Identificar los retos de la implementación del aprendizaje basado en equipos en los programas de medicina. Resultados: Mediante la aplicación del aprendizaje basado en equipos en los programas de medicina, se identificaron los factores de sobrecarga laboral y de estudio con incidencia en los participantes en la estrategia, la necesidad de garantizar entrenamiento previo a los actores del proceso, la importancia de la realización de una adecuada distribución de los grupos de trabajo, y los recursos adicionales que deben garantizarse. Conclusiones: Para obtener beneficios pedagógicos de forma plena, la implementación del aprendizaje basado en equipos debe ser sistemática, lo que requiere procesos de formación y preparación, tanto de los estudiantes como de los profesores. Como cualquier cambio, demandará convicción, tiempo y ajustes a lo largo del proceso(AU)

Introduction: Team-based learning is a student-centered teaching and learning strategy, in which the teacher has the role of a facilitator. It constitutes an active learning pedagogical method that improves motivation towards learning and leads students to apply their knowledge to solve problems and combine theory with practice. Advances in medical education worldwide have led medical schools to opt for such strategies. Objective: To identify the challenges of implementing team-based learning in the medical major programs. Results: Through the application of team-based learning to the medical major programs, such factors as work and study overloads were identified as having an impact on the strategy participants, together with the need to guarantee prior training to the process stakeholders, the importance of adequate distribution of the working groups, and the additional resources that must be guaranteed. Conclusions: In order to obtain full pedagogical benefits, the implementation of team-based learning must be systematic, a process requiring training and preparation processes for both students and teachers. Like any change, it will demand conviction, time and adjustments throughout the process(AU)

Increasing Non-tuberculous Mycobacteria Infections in Veterans With COPD and Association With Increased Risk of Mortality.

Background: There are limited data on the epidemiology of Non-tuberculous mycobacteria (NTM) infections among patients with COPD, particularly in the veteran population. This study examined the prevalence, incidence, and mortality of pulmonary NTM infections among veterans with COPD population in the United States. Methods: We analyzed nationwide data from Veterans Affairs Hospitals from 2001 to 2015. First, we determined the incidence and prevalence rates and geographic distribution of NTM infections among veterans with COPD and then we evaluated the association between NTM infections with mortality among veterans with COPD. Pulmonary NTM and COPD diagnosis were defined based on charting claims for each condition on ≥2 occasions and ≥30 days apart. COPD diagnoses had to precede diagnosis of NTM. Cox Proportional-Hazards Regression was performed to determine the dependency of survival time of COPD patients with NTM. Results: The incidence and prevalence rates of NTM rose over the study period, with a sharp rise in incidence after 2012. The areas with the highest NTM period prevalence were Puerto Rico (370), followed by Florida (351) and District of Columbia (309) in 100,000 COPD population. Mortality registered for those patients with COPD Patients and NTM infection was 1.43 times higher compared to those that were uninfected. Conclusions: NTM rates have been increasing in veterans with COPD since 2012. NTM infection is associated with increased risk of mortality. This highlights the importance of identifying preventable risk factors associated with NTM infections in subjects with COPD.

Age as risk factor for death from pandemic (H1N1) 2009, Chile.

Pandemic (H1N1) 2009 affected Chile during the winter of 2009. The hospitalization rate was 0.56% overall and 3.47% for persons >60 years of age at risk for severe disease and death independent of concurrent conditions. Age >60 years was the major risk factor for death from pandemic (H1N1) 2009.

¿Estamos satisfechos con nuestra previsión de salud y con las atenciones de salud que recibimos?: Estudio Nacional sobre Satisfacción y Gasto en Salud / Are we satisfied with our forecast of health and the health care we receive?: National Survey on Satisfaction and Health Expenditure

Entre las metas del sistema de salud chileno está la satisfacción de las expectativas legítimas de la población con respecto a las atenciones de salud. Este artículo presenta los principales resultados del primer estudio nacional acerca de la satisfacción con la previsión de salud, con las atenciones ambulatorias y hospitalarias, aspectos de la atención valorados por los chilenos, comunicación con el profesional de la salud, entre otras. Los datos provienen del Estudio Nacional sobre Satisfacción y Gasto de Salud, encuesta poblacional representativa de población adulta (> 18 años) con residencia urbana (n=5.037). Resultados para el conjunto del país y estratificados por subgrupos poblacionales (sexo, edad, nivel socioeconómico, años de estudio y previsión de salud), destacando las asociaciones estadísticamente significativas (intervalos de confianza 95 por ciento). La atención hospitalaria alcanza el mayor grado de satisfacción con un 86 por ciento, un 77 por ciento está satisfecha/muy satisfecha con la atención ambulatoria, y un 68 por ciento con su sistema previsional de salud. La proporción de insatisfechos/muy insatisfechos está entre un 10 por ciento y un 16 por ciento. La satisfacción entre afiliados a Isapres y a Fonasa es similar. La percepción de protección es mayor en los de 65 o más años (50 por ciento) y en población con menos años de estudio (49 por ciento). Los conocimientos del profesional y la adecuación de las indicaciones son evaluados positivamente por alrededor del 80% de la población, el trato del personal administrativo tiene la evaluación menos positiva. Las condiciones físicas, la relación con el profesional y el trato son mejor evaluadas por quienes acudieron a prestadores privados y por quienes tienen más años de estudio. La satisfacción es considerablemente alta para aspectos técnicos y más crítica para el trato y la relación profesional-usuario, en general, los prestadores privados son mejor evaluados...

Influence of organic soil on the mycoliactericidal activity of the commercial sodium hypochlorite with 2.5% of active chlorine / Influência da matéria orgânica na atividade micobactericida do hipoclorito de sódio comercial com 2.5% de cloro ativo

It was evaluated the highest working dilution of the sodium hypochlorite solution (available as household and laundry bleach, with 2.5% of active chlorine) still effective in inactivating Mycobacterium fortuitum in the presence of different levels of bovine feces as organic soil. The experiments were conducted "in vitro" using filter paper as carriers. The time of contact was one hour at the temperature range of 4 to 8C. The blocking of the desinfectant activity was achieved by the dilution using a solution of 0.5% sodium thiosulphate with 0.05% twenn-80 (v/v). The remaining microrganisms were cultivated in Lowenstcin-Jensen culture medium and the number of colonies forming unities was statiscally evaluated by the MannWhitneyTest. The results showed that the organic soil affected the desinfectant activity. The working dilutions calculated were 1:64 and 1:16, respectively, with and without organic soil. In working dilutions higher than 1:64 the regularity of the desinfectant action was very poor.

Foi investigada a maior diluição do hipoclorito de sódio comercial com 2,5% de cloro ativo (água de lavadeira) capaz de inativar o Mycobacterium fortuitum em presença de níveis variáveis de fezes de bovino como fonte de matéria orgânica. Os ensaios foram conduzidos de modo que o desinfetante atuasse durante 60 minutos à temperatura de 4 a 8C. A neutralização da ação do desinfetante foi obtida com a solução de tiossulfato de sódio a 0,5% e tween-80 a 0,05% (v/v). Os microrganismos sobreviventes foram recuperados em meio de Lowenstein-Jensen. A quantificação das unidades formadoras de colônias (U.F.C.) foi analisada pelo Teste U" de Mann-Whitney. Os resultados obtidos demonstraram que a presença de fezes bovinas prejudicou a atividade micobactericida do desinfetante ensaiado. Foi possível constatar-se que as diluições de trabalho capazes de determinar a redução de 70% do número de U.F.C. foram de 1:64 e 1: 16, respectivamente, em ausência e presença de matéria orgânica. Em diluições de trabalho superiores ao valor de 1:64 a atividade micobactericida do hipoclorito de sódio foi muito irregular.