Post-discharge mortality in adult patients hospitalized for tuberculosis: a prospective cohort study.

Determining outcomes and predictors of mortality following discharge from tuberculosis (TB) hospitalization is crucial to establish health policies. The objective of this study was to analyze outcomes and, secondarily, predictors of mortality following discharge from TB hospitalization. This was a prospective cohort study of patients diagnosed with TB (all forms) discharged from the hospital who began treatment during hospitalization. Out of 169 subjects included, 38 died during the 13-months of follow-up, within a median of 3 months (95%CI: 1.49-4.51). In the multivariate analysis, the variables independently associated with death were age (HR=1.04, 95%CI: 1.01-1.06, P=0.001), presence of sputum production (HR=2.18, 95%CI: 1.09-4.34, P=0.027), and Charlson Comorbidity Index (HR=1.19, 95%CI: 1.04-1.36, P=0.015). In conclusion, post-discharge mortality in subjects hospitalized for TB was 22.5%, with mean survival of 4.6 months. The mortality was higher in older subjects, in those who reported sputum production, and in those with a high comorbidity index.

Post-discharge mortality in adult patients hospitalized for tuberculosis: a prospective cohort study

Determining outcomes and predictors of mortality following discharge from tuberculosis (TB) hospitalization is crucial to establish health policies. The objective of this study was to analyze outcomes and, secondarily, predictors of mortality following discharge from TB hospitalization. This was a prospective cohort study of patients diagnosed with TB (all forms) discharged from the hospital who began treatment during hospitalization. Out of 169 subjects included, 38 died during the 13-months of follow-up, within a median of 3 months (95%CI: 1.49-4.51). In the multivariate analysis, the variables independently associated with death were age (HR=1.04, 95%CI: 1.01-1.06, P=0.001), presence of sputum production (HR=2.18, 95%CI: 1.09-4.34, P=0.027), and Charlson Comorbidity Index (HR=1.19, 95%CI: 1.04-1.36, P=0.015). In conclusion, post-discharge mortality in subjects hospitalized for TB was 22.5%, with mean survival of 4.6 months. The mortality was higher in older subjects, in those who reported sputum production, and in those with a high comorbidity index.

Producción de carotenoides en levaduras nativas aisladas de sistemas acuáticos en Cali, Colombia / Carotenoids production in wild yeasts isolated from aquatic systems in Cali, Colombia

Introducción: Los carotenoides son fuente importante de actividades biológicas funcionales, tales como antioxidantes o antimicrobianas, además de tener gran impacto a nivel industrial, ya sea en cosmética o suplementación animal en acuacultura. Se han reportado varias moléculas novedosas a partir de aislamientos en Latinoamérica, principalmente en la Patagonia, Argentina. Sin embargo, no hay reportes en Colombia que evalúen la producción de carotenoides en levaduras nativas pigmentadas. Objetivo: Se evaluó la capacidad de producción de carotenoides en levaduras nativas aisladas de lagos, ríos y aguas residuales de la ciudad de Cali, Colombia. Materiales y métodos: Se caracterizaron 30 levaduras provenientes de dos colecciones. De estas se obtuvo su biomasa, rendimiento de carotenoides totales y producción de ß-caroteno. Las cepas promisorias fueron identificadas secuenciando la región ITS1-5.8S-ITS2. Resultados: El mayor rendimiento en la extracción de pigmentos se obtuvo para las cepas P11A (84,36 ± 5,24 µg/g) y Rhodotorula paludigena CS13 (56,26 ± 7,08 µg/g), mientras que las concentraciones más altas de ß-caroteno fueron 10,2 µg/mL (R. paludigena CS13) y 9,7 µg/mL (R. mucilaginosa/alborubescens P10A). La cinética de crecimiento y producción de pigmentos durante cinco días fue óptima para la cepa P11A, ya que hubo un aumento en el rendimiento de carotenoides totales 10 veces mayor (48 h: 109,62 µg/g, 120 h: 1403,10 µg/g). Conclusiones: En este estudio se encontró que levaduras aisladas de sistemas acuáticos son promisorias para la producción de pigmentos carotenoides (incluyendo ß-caroteno), siendo su extracción y caracterización viable para futuros estudios biotecnológicos.

Introduction: Carotenoids are an important source of biological activities, such as antioxidant or antimicrobial. Also, carotenoids impact the cosmetic or food supplement industry, mainly in aquaculture. Several reports in Latin America showed novel molecules, mainly in isolated strains in Patagonia, Argentina. However, in Colombia, there are not reports about carotenoid production from pigmented wild yeasts. Objective: We assessed the carotenoid production ability in wild yeasts isolated from lakes, wastewater and rivers located in Cali, Colombia. Materials and methods: 30 yeasts were selected from two collections, each of them was characterized by the biomass, yield of total carotenoids and ß-carotene production. Promisor strains were identified with sequence analysis of ITS1-5.8S-ITS2 region. The highest yield in pigment extraction was obtained by strains P11A (84,36 ± 5,24 µg/g) and Rhodotorula paludigena CS13 (56,26 ± 7,08 µg/g), while higher concentrations of ß-carotene were 10,2 µg/mL (R. paludigena CS13) and 9,7 µg/mL (R. mucilaginosa/alborubescens P10A). The kinetics of growth and pigment production for five days was optimal for the P11A strain, where we found an increasing 10-fold higher (48 h: 109,62 µg/g, 120 h: 1403,10 µg/g). Conclusions: We suggest that yeasts isolated from aquatic systems are promising for the production of carotenoid pigments (including ß-carotene), making their extraction and characterization viable for future biotechnological studies.

Deadbeat-fuzzy controller for the power control of a Doubly Fed Induction Generator based wind power system.

This paper proposes a Fuzzy Logic Controller for improvement of the steady-state response of a Doubly Fed Induction Generator used in a wind energy system, and governed by means of a Deadbeat Power Controller. The generator mathematical model is consistent with the Stator Flux oriented strategy in the synchronous reference frame. Different simulation scenarios were developed in Matlab/Simulink to evaluate the dynamic and the steady-state responses. In order to obtain experimental results, the simulated scenarios were repeated by means of a test bench and a Digital Signal Processor board. These results demonstrate that the response still follows the power references imposed, despite the fact that the generator parameters ( Rr, Ls and Lm) were varied in a 30%. A lower steady-state error is also achieved when compared with a Deadbeat and a classical PI controller. All the aforementioned evidence the proper application of this Fuzzy Controller in a wind power system based on a Doubly Fed Induction Generator.

Características de los profesionales kinesiólogos y carga laboral: encuesta transversal de las Unidades de Cuidados Intensivos adulto en Chile / Characteristics of physiotherapy staffing levels and caseload: a cross-sectional survey of Chilean adult Intensive Care Units

INTRODUCCIÓN: La Sociedad Europea de Medicina de Cuidados Intensivos recomienda la presencia de un Kinesiólogo con formación especializada, disponible cada cinco camas de alta complejidad, los 7 días de la semana en la Unidad de Cuidados Intensivos (UCI). En Chile se desconoce la adherencia de las UCI adulto a esta recomendación. OBJETIVO: Describir las características administrativas y de cobertura kinésica en las UCI adulto chilenas, y de acuerdo con la adherencia a las recomendaciones internacionales, informar a los tomadores de decisión en salud. MÉTODOS: Estudio observacional transversal, basado en encuesta telefónica. Se incluyeron las UCI adultos de establecimientos de mayor complejidad, clínicas privadas y centros asociados a universidades (n = 74). La proporción de instituciones con disponibilidad de kinesiólogos las 24 horas del día, los siete días de la semana (kinesiólogo 24/7), con un número máximo de cinco pacientes por kinesiólogo y presencia de un kinesiólogo especialista fueron reportados. RESULTADOS: La tasa de respuesta fue del 86,5% (n = 64), principalmente públicas (59%) y de nivel III (83%). El 70% (n = 45) de las UCI adulto chilenas cuentan con kinesiólogo 24/7; correspondiendo el 87% al sector público y el 46% al privado. El 41% de los centros posee un máximo de 5 pacientes por kinesiólogo en día hábil diurno, disminuyendo en fines de semana y horarios nocturnos. Un 23% de las UCIs cuenta con kinesiólogo especialista en intensivo, siendo mayor en el sector privado (31%). CONCLUSIONES: En UCI adulto chilenas, la disponibilidad de kinesiólogos 24/7 es alta, y la prevalencia de especialistas es baja. Estrategias de creación de programas de formación de especialidad podrían contribuir a disminuir la brecha de especialistas.

INTRODUCTION: The European Society of Intensive Care Medicine recommends the presence of a specialist physiotherapist, available every five beds, seven days a week in the high complexity Intensive Care Unit. However, in Chile the adherence of adult Intensive Care Units to this recommendation is unknown. OBJECTIVE: To describe the organizational characteristics and the physiotherapist availability in adult Intensive Care Units in Chile, and according to the adherence to international recommendations, inform health decision-makers. METHODS: Observational study based on a telephone survey. All adult Intensive Care Units institutions of high complexity, private hospitals and teaching health centers in Chile were eligible (n = 74). The primary outcome measures were the proportion of institutions with physiotherapist availability 24 hours a day and seven days a week (24/7 physiotherapist), a maximum caseload per physiotherapist of five patients and the presence of a specialist physiotherapist. RESULTS: Response rate was 86.5%, with 59% of responding units being public and 83% offering level III care. 70% of the adult Intensive Care Units in Chile have 24/7 physiotherapist (87% of the public and 46% of the private sector). 41% of the centers had a maximum caseload per physiotherapist of five patients during the day on weekdays. This number decreased on weekends and during night shifts. 23% of the Intensive Care Units had a specialist physiotherapist, being more common in the private sector (31%). CONCLUSIONS: In Chilean adult ICU, 24/7 physiotherapist availability is high, the prevalence of physiotherapists with specialist training is low. Future efforts should focus on promoting the uptake of specialist training.

Interventions to improve adherence to tuberculosis treatment: systematic review and meta-analysis.

SETTING: One of the most serious problems in tuberculosis (TB) control is non-adherence to treatment. Several strategies have been developed to improve adherence and increase the cure rate. OBJECTIVE: To systematically review interventions to improve adherence to anti-tuberculosis treatment. DESIGN: We performed a systematic review and meta-analysis of 22 randomised clinical trials (RCTs) to ascertain whether providing directly observed treatment, short-course (DOTS), financial incentives, food incentives and/or patient education/counselling improved adherence to anti-tuberculosis treatment. The primary outcome was cure rate; secondary outcomes were default and mortality rates. Sources used were Medline (accessed via PubMed), Cochrane Central, LILACS (Literatura Latino Americana em Ciências da Saúde, Latin American and Caribbean Health Sciences Literature) and Embase from inception to October 2015. RESULTS: A significant increase in cure rates, by 18% with DOTS and by 16% with patient education and counselling, was observed. In addition, the default rate decreased by 49% with DOTS, by 26% with financial incentives and by 13% with patient education and counselling. There was no statistically significant reduction in mortality rates with these interventions. CONCLUSION: Use of DOTS and patient education/counselling significantly improved cure rates; DOTS, patient education/counselling and financial incentives led to a reduction in the default rate.

Hepatitis autoinmune y cáncer de colon: una asociación inusual. Caso clínico y revisión de la literatura / A case of an unusual association of autoimmune hepatitis and colon cancer: report and literature review

Resumen Introducción: la hepatitis autoinmune idiopática (HAI) es una enfermedad crónica que predomina en mujeres, con episodios de actividad y remisión, favoreciendo la fibrosis hepática. El 40% de los pacientes presenta historia familiar de enfermedades autoinmunes. Al parecer, es mediada por la interacción antígeno-anticuerpo; sin embargo, su causa es desconocida. Se conoce la asociación frecuente de HAI con cáncer hepatobiliar; menos frecuente con linfomas, cáncer de piel y cáncer de colon; y casi inexistente con síndromes hereditarios de cáncer de colon. Este caso debutó con HAI y sangrado rectal causado por poliposis adenomatosa familiar (PAF) y adenocarcinoma de colon sigmoide. Caso clínico: mujer de 51 años con HAI de 1 año de evolución manejada con prednisolona y azatioprina. Se realizó una colonoscopia total por anemia en la que se encontraron múltiples pólipos entre 5 y 10 mm y 1 de 30 mm sésil, ulcerado, en colon sigmoide. Se realizó una polipectomía endoscópica múltiple que reportó un adenoma tubulovelloso con displasia de alto y bajo grado en varios pólipos y un adenocarcinoma de bajo grado en el pólipo del sigmoide. Los estudios de extensión fueron negativos para metástasis. Se realizó una repleción nutricional prequirúrgica, luego una colectomía subtotal y una procto-ileoanastomosis con ileostomía de protección. La patología de pieza quirúrgica mostró un adenocarcinoma de colon de bajo grado y adenomas tubulares y tubulovellosos con displasias de alto y bajo grado. Discusión y conclusiones: La asociación de HAI con PAF y cáncer colorrectal (CC) es infrecuente. Es conocida la correlación de HAI con cáncer hepatobiliar (asociado con cirrosis), linfomas, cáncer de piel y otros desórdenes autoinmunes. El pronóstico es malo y no puede establecerse una correlación clara con moduladores inmunes.

Abstract Introduction: Idiopathic autoimmune hepatitis (IAH) is a chronic disease that occurs predominately in women, has episodic activity and remission, and favors hepatic fibrosis. Forty percent of patients have family histories of autoimmune diseases. It is apparently mediated by antigen-antibody interaction, but its causes are unknown. IAH is frequently associated with hepatobiliary cancer, less frequently with lymphomas, skin cancer and colon cancer and very rarely with hereditary colon cancer syndrome. This case debuted IAH and rectal bleeding caused by familial adenomatous polyposis (FAP) and adenocarcinoma of the sigmoid colon. Clinical case: The patient was a 51-year-old woman who had had IAH for one year which had been managed with prednisolone and azathioprine. A total colonoscopy, performed because of anemia, found multiple polyps that measured 5 and 10 mm and one ulcerated 30 mm sessile polyp in the sigmoid colon. A multiple endoscopic polypectomy revealed a tubulovillous adenoma with high and low grade dysplasia in several polyps and a low grade adenocarcinoma in the sigmoid polyp. Tests and examinations for metastasis were negative. Following presurgical nutritional repletion, a subtotal colectomy was performed and an ileal pouch-anal anastomosis with protective ileostomy was created. The pathology of the surgical specimen showed low grade adenocarcinoma of the colon and tubular and tubulovillous adenomas with high and low grade dysplasia. Discussion and conclusions: Association of IAH with familial adenomatous polyposis (FAP) and colorectal cancer (CC) occurs infrequently although associations of IAH with hepatobiliary cancer associated with cirrhosis, lymphomas, skin cancer and other autoimmune disorders are well-known. The prognosis is bad and no clear correlation with immune modulators can be established.

Comprehensive Database of Carotenoid Contents in Ibero-American Foods. A Valuable Tool in the Context of Functional Foods and the Establishment of Recommended Intakes of Bioactives.

Foods that are commonly consumed in the diet are considered to provide more than 40 different carotenoids. However, the content in carotenoids varies considerably in both qualitative and quantitative terms as a consequence of different genotypes, climatic conditions of the production area, and agronomic factors, among others. In this paper, analytical data, obtained by HPLC or UHPLC, of carotenoids in fruits and vegetables produced in Ibero-America have been compiled from peer-reviewed journals, organized in food categories, and documented in relation to the sampling and analytical quality system used. In addition to common products of the diet of the Ibero-American countries, other wild or little used fruit and vegetables have been included with the aim of contributing to promote and to value species and local varieties. The importance of the commodities containing carotenoids in food, health, agriculture, and biodiversity, and the need of their preservation, was evidenced in this work namely by the large differences in carotenoid content related to the locals of production and varieties, and the high levels of carotenoids in native fruits and vegetables. The contribution of these compounds to meet the needs of vitamin A as well as the necessity of establishing recommendation for the daily intakes of theses bioactive compounds were also discussed.

A Set of miRNAs, Their Gene and Protein Targets and Stromal Genes Distinguish Early from Late Onset ER Positive Breast Cancer.

UNLABELLED: Breast cancer (BC) in young adult patients (YA) has a more aggressive biological behavior and is associated with a worse prognosis than BC arising in middle aged patients (MA). We proposed that differentially expressed miRNAs could regulate genes and proteins underlying aggressive phenotypes of breast tumors in YA patients when compared to those arising in MA patients. OBJECTIVE: Using integrated expression analyses of miRs, their mRNA and protein targets and stromal gene expression, we aimed to identify differentially expressed profiles between tumors from YA-BC and MA-BC. METHODOLOGY AND RESULTS: Samples of ER+ invasive ductal breast carcinomas, divided into two groups: YA-BC (35 years or less) or MA-BC (50-65 years) were evaluated. Screening for BRCA1/2 status according to the BOADICEA program indicated low risk of patients being carriers of these mutations. Aggressive characteristics were more evident in YA-BC versus MA-BC. Performing qPCR, we identified eight miRs differentially expressed (miR-9, 18b, 33b, 106a, 106b, 210, 518a-3p and miR-372) between YA-BC and MA-BC tumors with high confidence statement, which were associated with aggressive clinicopathological characteristics. The expression profiles by microarray identified 602 predicted target genes associated to proliferation, cell cycle and development biological functions. Performing RPPA, 24 target proteins differed between both groups and 21 were interconnected within a network protein-protein interactions associated with proliferation, development and metabolism pathways over represented in YA-BC. Combination of eight mRNA targets or the combination of eight target proteins defined indicators able to classify individual samples into YA-BC or MA-BC groups. Fibroblast-enriched stroma expression profile analysis resulted in 308 stromal genes differentially expressed between YA-BC and MA-BC. CONCLUSION: We defined a set of differentially expressed miRNAs, their mRNAs and protein targets and stromal genes that distinguish early onset from late onset ER positive breast cancers which may be involved with tumor aggressiveness of YA-BC.

Perillyl alcohol: Dynamic interactions with the lipid bilayer and implications for long-term inhalational chemotherapy for gliomas.

BACKGROUND: Gliomas display a high degree of intratumor heterogeneity, including changes in physiological parameters and lipid composition of the plasma membrane, which may contribute to the development of drug resistance. Biophysical interactions between therapeutic agents and the lipid components at the outer plasma membrane interface are critical for effective drug uptake. Amphipathic molecules such as perillyl alcohol (POH) have a high partition coefficient and generally lead to altered lipid acyl tail dynamics near the lipid-water interface, impacting the lipid bilayer structure and transport dynamics. We therefore hypothesized that glioma cells may display enhanced sensitivity to POH-induced apoptosis due to plasma membrane alterations, while in non-transformed cells, POH may be expelled through thermal agitation. METHODS: Interactions between POH and the plasma membrane was studied using molecular dynamics simulations. In this phase I/II trial, we set up to evaluate the clinical effectiveness of long-term (up to 5 years) daily intranasal administration of POH in a cohort of 19 patients with low-grade glioma (LGG). Importantly, in a series of clinical studies previously published by our group, we have successfully established that intranasal delivery of POH to patients with malignant gliomas is a viable and effective therapeutic strategy. RESULTS: POH altered the plasma membrane potential of the lipid bilayer of gliomas and prolonged intranasal administration of POH in a cohort of patients with LGG halted disease progression with virtually no toxicity. CONCLUSION: Altogether, the results suggest that POH-induced alterations of the plasma membrane might be contributing to its therapeutic efficacy in preventing LGG progression.

Sarcoma pleomórfico gigante de la mama / Giant pleomorphic breast sarcoma

Abstract It is reported the case of a female patient 50 years old who, after failed attempts at diagnosis, arrives at breast surgery service of the E.S.E. Hospital Universitario del Caribe with history of five months consistent inthe excessive growth of a mass in right breast; patient received radical mastectomy plus reconstruction withlatissimus dorsi muscle flap. Following excision of tumor mass of 6,500 g is performed immunohistochemicaldiagnosis of a giant pleomorphic sarcoma.

Resumen introducción: Los tumores derivados del tejido conectivo interlobulillar de la mama son en mayor proporción malignos y, en virtud a su ubicación, en la actualidad reciben el nombre de "sarcomas" de la mama. Caso clínico: Se reporta el caso de una paciente femenina de 50 años de edad quien, posterior a fallidosintentos de diagnóstico, acude al servicio de cirugía de mama de la E.S.E. Hospital Universitario del Caribecon un cuadro de cinco meses de evolución consistente en el crecimiento desmedido de una masa en mamaderecha; la paciente recibió mastectomía radical más reconstrucción con colgajo de músculo dorsal ancho.Posterior a exéresis de masa tumoral de 6.500 g de peso se lleva a cabo diagnóstico inmunohistoquímico deun sarcoma pleomórfico gigante de la mama.

Insights into the virulence-related genes of Edwardsiella tarda isolated from turbot in Europe: genetic homogeneity and evidence for vibrioferrin production.

Edwardsiella tarda has long been known as a pathogen that causes severe economic losses in aquaculture industry. Insights gained on E. tarda pathogenesis may prove useful in the development of new methods for the treatment of infections as well as preventive measures against future outbreaks. In this report, we have established the correlation between the presence of virulence genes, related with three aspects typically involved in bacterial pathogenesis (chondroitinase activity, quorum sensing and siderophore-mediated ferric uptake systems), in the genome of E. tarda strains isolated from turbot in Europe and their phenotypic traits. A total of 8 genes were tested by PCR for their presence in 73 E. tarda isolates. High homogeneity was observed in the presence/absence pattern of all the strains. Positive results in the amplification of virulence-related genes were correlated with the detection of chondroitinase activity in agar plates, in vivo AHL production during fish infection and determination of type of siderophore produced by E. tarda. To the best of our knowledge, this is the first study carried out with European strains on potential virulence factors. Furthermore, we demonstrated for the first time that E. tarda produces the siderophore vibrioferrin.

Prognostic Value of ADAMTS Proteases and Their Substrates in Epithelial Ovarian Cancer

Background: ADAMTS are metalloproteases with disintegrin and thrombospondin motifs. They are secreted proteases playing a role in biological processes such as inflammation, angiogenesis, and urogenital development. ADAMTS have specific substrates, such as the proteoglycans (PG) versican, aggrecan, and brevican. Despite data indicating a role of ADAMTS in tumor invasion and metastases, effects played by these molecules in cancer progression are still controversial. In ovarian cancer, the importance of ADAMTS gene mutations was recently described and related to chemotherapy outcome. Objective: To analyze protein levels of ADAMTS-1, -4, and -5, and TIMP-3 in human ovarian cancer classified as benign, borderline, or malignant. We also assessed the expression of the ADAMTS substrates aggrecan, brevican, and versican in these neoplasms. Correlations between overall survival and protein expression were performed. Methods: Tumors were classified according to the WHO Classification of Tumors of Female Reproductive Organs. Protein and PG expression was studied by immunohistochemistry. Differences in labeling were analyzed by percent measurements of stained areas. Results: ADAMTS-1, ADAMTS-5, and its tissue inhibitor TIMP-3 are increased in borderline and malignant tumors compared to benign neoplasms. Aggrecan and versican levels were increased in malignant subtypes compared to benign ovarian cancer. Higher ADAMTS-1, TIMP-3, and versican expression was associated with a shorter overall survival. Conclusions: Comparison of protease, TIMP-3, and substrate expression showed that in malignant tumors all ADAMTS and TIMP-3 expression levels were significantly raised compared to the substrates studied.

H2 O2 activates matrix metalloproteinases through the nuclear factor kappa B pathway and Ca(2+) signals in human periodontal fibroblasts.

BACKGROUND: The mechanisms involved in reactive oxygen species and matrix metalloproteinase (MMP)-mediated periodontal tissue breakdown are unknown. OBJECTIVE: To determine the effect of H2 O2 in MMP-2 and MMP-9 activity, and the involvement of nuclear factor kappa B (NFκB) and Ca(2+) -mediated signals in human periodontal ligament fibroblasts. MATERIAL AND METHODS: Primary cultures were characterized for their phenotype and exposed for 24 h to sublethal doses (2.5-10 µm) of H2 O2 or control media. NFκB involvement was evaluated through immunofluorescence of p65 subunit, using the NFκB blocking peptide SN50 and catalase. Ca(2+) signals were analyzed by loading the cells with Fluo4-AM and recording the fluorescence changes in a confocal microscope before and after the addition of H2 O2 . 1,2-bis(o-aminophenoxy) ethane-N,N,N',N'-tetraacetic acid-acetoxymethyl was used to chelate intracellular Ca(2+) . The activity and levels of MMP-2 and MMP-9 were analyzed by gelatin zymogram and densitometric scanning, and enzyme-linked immunosorbent assay, respectively. Statistical analysis was performed with stata V11.1 software using the ANOVA test. RESULTS: H2 O2 at concentrations of 2.5-5 µm induced Ca(2+) signaling and NFκB subunit p65 nuclear translocation, whereas catalase, SN50 and BAPTA-AM prevented p65 nuclear translocation. H2 O2 at 2.5-5 µm significantly increased MMP-9 and MMP-2 activity, while SN50 resulted in lower MMP-2 and MMP-9 activity rates compared with controls. CONCLUSION: Sublethal H2 O2 induces Ca(2+) -dependent NFκB signaling with an increase in MMP gelatinolytic activity in human periodontal ligament.

Representaciones sociales de la Educación para la Salud: docentes Facultad de Medicina, Universidad de Antioquia / Social representations of Health Education: School of Medicine, University of Antioquia

OBJETIVO: reconocer las representaciones sociales (rs) sobre Educación para la Salud (EpS) presentes en los docentes de la Facultad de Medicina de la Universidad de Antioquia de la ciudad de Medellín. METODOLOGIA: estudio cualitativo desde el enfoque de las (rs), donde se analizaron 93 respuestas de docentes a la pregunta: ¿Qué es para usted la EpS? RESULTADOS:del análisis de los datos emergieron como rs de la EpS: 1) Educación médica, asociada a su quehacer docente; 2) Educación a individuos y comunidades, asociada al ejercicio profesional como agentes de salud; y 3) Apropiación del conocimiento que hace el sujeto para su autocuidado. DISCUSION:las RS de los docentes sobre EpS permitieron comprender que no hay en la enseñanza una intencionalidad política para la trasformación social; que el modelo de comunicación que subyace en la educación es el informacional, aunque hay presencia del modelo relacional; que existe una concepción instrumental de la EpS. Es necesario concientizar al personal de salud de la importancia que para la educación tiene el modelo de comunicación relacional.

OBJECTIVE:to identify the social representations (sr) of health education (he) of the professors from the School of Medicine of the University of Antioquia in the city of Medellin. METHODOLOGY: a qualitative study was conducted focusing on the (sr), where the answer to the question "How do you define he?" given by 93 professors was analyzed. RESULTS:the analysis of the data produced the following sr of he: 1) Medical Education associated with the educator's job; 2) Education for individuals and communities associated to the professional work done by health professionals; and 3) Appropriation of the knowledge for self-care. DISCUSSION: the sr of the professors about he allowed us to understand: that there is no political intention for social reform in the curriculum; that the model of communication underlying this education is the informational one, although there are instances of the relational model; that an instrumental notion of he exists. Thus, it is necessary to make health practitioners aware of the importance of the relational model of communication.

Systemic changes following carrageenan-induced paw inflammation in rats.

OBJECTIVE AND DESIGN: Carrageenan-induced paw edema has been described as a local and acute inflammatory process. In fact, little is known about the time course and systemic changes following a carrageenan injection. In this study, we examine the systemic changes that follow carrageenan injection in the paw. METHODS: Acute inflammation was produced by subplantar injection of carrageenan in a hind paw of Sprague-Dawley rats. Saline was used in control rats. Paw volume was measured with a plethysmometer. The hot plate latency test was used to quantify antinociception. C-reactive protein (CRP) levels were measured with a sandwich enzyme immunoassay. Fibrinogen concentration was measured using the gravimetric method. Lung morphometric analysis was performed using an image processing package. Lungs and paws were also examined for tissue factor (TF) and proinflammatory cytokines expression by immunohistochemistry. RESULTS: We found diverse systemic changes including increased levels of acute phase proteins, such as CRP and fibrinogen, and a lung inflammatory process characterized by lung edema, fibrin deposition, and leukocyte infiltration. An elevated expression of TF, IL-6, IL-1ß, and TNFα, was observed in paw and lung tissue sections by immunohistochemical methods. CONCLUSION: This study provides new evidence that a local carrageenan injection induces a systemic response.

Total thyroidectomy versus hemithyroidectomy for patients with follicular neoplasm. A cost-utility analysis.

INTRODUCTION: Thyroid nodules are a common condition. Overall, 20% of the nodules assessed with FNAB correspond to the follicular pattern. A partial thyroidectomy is the minimal procedure that should be performed to determine the nature of these nodules. Some authors have suggested performing a total thyroidectomy based on the elimination of reoperation and ultrasound follow-up. The aim of this study was to evaluate the most cost-useful surgical strategy in a patient with an undetermined nodule, assessing complications, reoperation, recurrence and costs. MATERIAL AND METHODS: A cost-utility study was designed to compare hemithyroidectomy and total thyroidectomy. The outcomes were complications (definitive RLN palsy, permanent hypoparathyroidism, reoperation for cancer, and recurrence of the disease), direct costs and utility. We used the payer perspective at 5 years. A deterministic and probabilistic sensitivity analysis was completed. RESULTS: In a deterministic analysis, the cost, utility and cost-utility ratio was COP $12.981.801, 44.5 and COP $291.310 for total thyroidectomy and COP $14.309.889, 42.0 and $340.044 for partial thyroidectomy, respectively. The incremental cost-utility ratio was -$535.302 favoring total thyroidectomy. Partial thyroidectomy was more cost-effective when the risks of RLN injury and definitive hypoparathyroidism were greater than 8% and 9% in total thyroidectomy, respectively. In total, 46.8% of the simulations for partial thyroidectomy were located in the quadrant of more costly and less effective. CONCLUSION: Under a common range of complications, and considering the patient's preference and costs, total thyroidectomy should be selected as the most cost-effective treatment for patients with thyroid nodules and follicular patterns.

Evidence of euryhalinity of the Gulf corvina (Cynoscion othonopterus).

The effects of environmental salinity on physiological responses, growth, and survival of the Gulf corvina, C. othonopterus, were evaluated in a 6-week completely randomized design experiment. Corvina (17.2+/-2.3 g mean initial body weight) were subjected to salinities of 5, 15, 25, and 35 ‰ and fed a commercial feed with protein and lipid contents of 46 and 14 %, respectively. Plasma osmolality increased significantly with salinity, ranging from 335.1+/-5.3 mOsm/kg in fish maintained at 5 ‰, to 354.8+/-6.8 mOsm/kg in fish kept in seawater, while a significant inverse relationship was observed between salinity and moisture content of whole fish, ranging from 73.8+/-0.7 (measured at 5 ‰) to 76.9+/-1.0 % (measured at 35 ‰). In spite of this, growth indices (final weight, weight gain, specific growth rate, condition factor, survival) were not altered, suggesting that, like other members of the family Sciaenidae, the Gulf corvina is a strong osmoregulator. The isosmotic point for this species was estimated to correspond to a salinity of 9.8 ‰. The present study represents the first set of experimental data on salinity tolerance of C. othonopterus and confirms the euryhalinity of this species.

Long-term outcome in patients with recurrent malignant glioma treated with Perillyl alcohol inhalation.

AIM: This retrospective study aimed to evaluate the long-term response and toxicity of recurrent malignant glioma patients to inhalation chemotherapy with perillyl alcohol (POH). PATIENTS AND METHODS: The cohort included 117 men and 81 women with primary glioblastoma multiforme (GBM; n=154), grade III astrocytoma (AA; n=26) and anaplastic oligodendroglioma (AO; n=5). POH inhalation schedule 4-times daily started with 66.7 mg/dose; 266 mg/day and escalated up to 133.4 mg/dose; 533.6 mg/day. Clinical toxicity and overall survival following treatment were compared with tumor size, topography, extent of peritumoral edema and histological classification. RESULTS: Adhesion to the protocol was high (>95%), POH (533.6 mg/daily) occasionally caused nose soreness but rarely nosebleed. Tumor size, peritumoral edema and the oligodendroglial component influenced response to treatment. CONCLUSION: After 4 years under exclusive POH treatment, 19% of patients still remain in clinical remission. Long-term POH inhalation chemotherapy is a safe and non-invasive strategy efficient for recurrent malignant glioma.