Molecular detection of Histoplasma capsulatum in organ samples from bats randomly captured in urban areas of Araraquara, São Paulo state, Brazil.

The mycosis histoplasmosis is also considered a zoonosis that affects humans and other mammalian species worldwide. Among the wild mammals predisposed to be infected with the etiologic agent of histoplasmosis, bats are relevant because they are reservoir of Histoplasma species, and they play a fundamental role in maintaining and spreading fungal propagules in the environments since the infective mycelial phase of Histoplasma grows in their accumulated guano. In this study, we detected the fungal presence in organ samples of bats randomly captured in urban areas of Araraquara City, São Paulo, Brazil. Fungal detection was performed using a nested polymerase chain reaction to amplify a molecular marker (Hcp100) unique to H. capsulatum, which revealed the pathogen presence in organ samples from 15 out of 37 captured bats, indicating 40.5% of infection. Out of 22 Hcp100-amplicons generated, 41% corresponded to lung and trachea samples and 59% to spleen, liver, and kidney samples. Data from these last three organs suggest that bats develop disseminated infections. Considering that infected bats create environments with a high risk of infection, it is important to register the percentage of infected bats living in urban areas to avoid risks of infection to humans, domestic animals, and wildlife.

LIFT procedure: postoperative outcomes, risk factors for fistula recurrence and continence impairment.

Ligation of the intersphincteric fistula tract has been recently employed as definitive treatment of anal fistulas. However, it carries a potential risk of continence impairment, fistula recurrence, and repeated operations. This study aimed to assess postoperative outcomes related to this procedure and evaluate the potential influence of preoperative and intraoperative features. Patients who underwent LIFT procedure between June 2012 and September 2021 were retrospectively analyzed. Patients were divided according to whether they developed fistula recurrence and on the history of a surgery prior to the LIFT. Preoperative features, postoperative outcomes, and risk factors adverse outcomes were analyzed. Forty-eight patients were included, of which 25 received primary LIFT, being the high transsphincteric fistula pattern the most frequent (62.5%). The median follow-up was 13.3 months, with a recurrence rate of 20.8%, of which the majority presented an intersphincteric fistula pattern (50%); and continence impairment rate of 16.7%. A higher prevalence of diabetes (p = 0.026) and a trend towards a higher prevalence of patients with a history of high transsphincteric fistula (0.052) were observed in the group with fistula recurrence. The history of diabetes and the operation time with a cut-off value ≥ 69 min showed a trend as a risk factors for developing fistula recurrence (0.06) and postoperative continence impairment (0.07), respectively. The LIFT procedure seems to be safe in terms of morbidity, with a reasonable incidence of recurrences, showing better results when it is primarily performed. Preoperative characteristics should be considered as they may impact outcomes.

Pelvic diameter is not associated with positive circumferential resection margin in rectal cancer: retrospective analysis of 78 cases

Objective: To identify if there is an association between pelvic entry and pelvic outlet diameters with increased positive circumferential resection margin (CRM) in rectal cancer. Introduction: Positive CRMin rectalcancerisa majorpredictor forlocal anddistant recurrence. Pelvic diameters may be related to the difficulty of dissection, as well as intrinsic tumor characteristics such as tumor size, location, distance from the anal margin, and T stage, which may compromise the integrity of the mesorectum and circumferential margin involvement. Methods: A retrospective review of the patient's medical records who underwent surgical resection of rectal adenocarcinoma from January 2012 to June 2022 was performed. The patient's preoperative staging, operative characteristics, and histopathologic outcomes were gathered from the medical records. Preoperative MRI scanning was done in all patients. MRI pelvimetry was done by two observers. CRM involvement was recorded as stated in the pathology report. Pelvimetry variables were dichotomized according to their mean values for correlation analysis. The odds ratio (OR) was calculated from a binary logistics regression model to assess the relation between the positive CRM and the independent variables. Results: A total of 78 patients were included in this study. A positive CRM was reported in 10 patients (12.8%). BMI >27.4 + 6.6 (p = 0.02), positive extramural vascular invasion (p = 0.027), positive CRM by MRI scanning (p = 0.004), and anal sphincter involvement (p = 0.03) were associated with positive CRM. Pelvimetry values were not associated with a positive CRM. Conclusion: No association was found between the pelvic diameters measured by MRI pelvimetry with a positive CRM. (AU)

Whipple's Disease: A Systematic Review of the Literature

Introduction: Whipple's disease is a chronic systemic disease with a predilection for the digestive system, especially the small intestine. It was first described in 1907 by George H. Whipple, who named it intestinal lipodystrophy. It is caused by a gram-positive bacterium belonging to the Actinomycetaceae family called Tropheryma whipplei. Objective: To characterize patients with Whipple's disease. Materials and methods: A systematic literature review was carried out using the DeCS terms enfermedad de Whipple (Whipple's disease) or (Tropheryma whipplei) in the Pubmed/Medline, Scopus, Scielo, Science Direct, Embase, Cochrane Library, BIREME, Proquest, and Redalyc databases; 123 articles were analyzed. Results: 123 published articles corresponding to case reports and series were examined, noting a higher prevalence in males (70.6%). The most frequent manifestations were joint symptoms (61%), followed by weight loss (47.1%) and diarrhea (43.4%). The most used diagnostic method was polymerase chain reaction (PCR) (63.2%), followed by biopsy (50.7%) and pathological examination with PAS (periodic acid Schiff) granules (47.8%). The management most used was antibiotic therapy with a predominance of trimethoprim/sulfamethoxazole and ceftriaxone. Conclusions: Whipple's disease has a low prevalence, occurs more frequently in white people, mainly affects the elderly, has a predilection for the male sex, and is characterized as a chronic systemic disease with a predilection for the digestive system, especially the small intestine.

Introducción: la enfermedad de Whipple es una enfermedad crónica sistémica con predilección por el aparato digestivo, especialmente el intestino delgado. Fue descrita por vez primera en 1907 por George H. Whipple, quien la denominó lipodistrofia intestinal. Es causada por una bacteria grampositiva perteneciente a la familia de los Actinomycetaceae denominada Tropheryma whipplei. Objetivo: caracterizar a los pacientes con enfermedad de Whipple. Materiales y métodos: se realizó una revisión sistemática de la literatura, de los términos DeCS enfermedad de Whipple (whipple Disease) o (Tropheryma whipplei) en las bases de datos Pubmed/Medline, Scopus, Scielo y Science Direct, Embase, Cochrane Library, BIREME, Proquest y Redalyc; se analizaron 123 artículos. Resultados: se analizaron 123 artículos publicados que correspondían a reportes y series de casos en los cuales se evidenció una mayor prevalencia en varones (70,6%). Las manifestaciones más frecuentes fueron los síntomas articulares (61%), seguidos de pérdida de peso (47,1%) y diarrea (43,4%). El método diagnóstico más usado fue la reacción en cadena de la polimerasa (PCR) (63,2%), seguido por la biopsia (50,7%) y, por último, examen anatomopatológico con gránulos PAS (ácido peryódico de Schiff) (47,8%). El manejo más empleado fue la antibioticoterapia con predominio de trimetoprima/sulfametoxazol y ceftriaxona. Conclusiones: la enfermedad de Whipple tiene una baja prevalencia, se presenta con mayor frecuencia en personas de raza blanca, afecta principalmente a los adultos mayores, tiene predilección por el sexo masculino y se caracteriza por ser una enfermedad crónica sistémica con predilección por el aparato digestivo, especialmente el intestino delgado.

Lesiones por picadura de raya en pacientes atendidos en un hospital de segundo nivel en Colombia: serie de casos / Stingray injuries in patients treated at a secondary care level hospital in Colombia: a case series

Introducción. Las lesiones por raya son la afectación más común de picaduras de peces y pueden ser causadas por rayas marinas y de agua dulce.Objetivo. Caracterizar a los pacientes atendidos en un hospital de segundo nivel en Colombia entre 2019 y 2021 por lesiones por picadura de raya de agua dulce.Metodología. Serie de casos retrospectiva en la que se incluyeron 10 pacientes. Los datos fueron obtenidos de las historias clínicas del hospital y se describen utilizando frecuencias absolutas y porcentajes para las variables cualitativas, y medias y desviaciones estándar para las cuantitativas. Se tuvieron en cuenta variables sociodemográficas y clínicas.Resultados. Todos los participantes eran hombres, el promedio de edad fue 43,5 años (desviación estándar: ±20,74) y el 50% provenía de zonas rurales. Los pies (50%) fueron la región anatómica más afectada por estas lesiones, seguidos por el cuello del pie (25%) y la pierna (25%). El 70% de los pacientes presentó complicaciones (síndrome compartimental [1 caso], celulitis [4 casos] y absceso [2 casos]). Todos los participantes recibieron antibioticoterapia y desbridamiento quirúrgico, el promedio de duración de la estancia hospitalaria fue 16,2 días y no se reportaron muertes

Introduction: Stingray injuries are the most common cause of fish stings and can be caused by marine and freshwater stingrays. Objective: To characterize patients treated at a secondary care level hospital in Colombia between 2019 and 2021 due to freshwater stingray injuries. Methodology: Retrospective case series in which 10 patients were included. Data were obtained from hospital medical records and are described using absolute frequencies and percentages for qualitative variables and means and standard deviations for quantitative variables. Sociodemographic and clinical variables were taken into account.Results: All participants were male, with a mean age of 43.5 years (standard deviation: ±20.74), and 50% were from rural areas. Feet (50%) were the anatomical region most affected by these injuries, followed by the hindfoot (25%), and the leg (25%). 70% of the patients presented complications (compartment syndrome [1 case], cellulitis [4 cases] and abscess [2 cases]). All participants received antibiotic therapy and surgical debridement, the average length of hospital stay was 16.2 days, and no deaths were reported. Conclusion: Stingray sting is an injury of interest to the health area that requires an adequate and timely therapeutic approach to avoid complications and sequelae

Sindrome de Sjögren: una revisión de la literatura / Sjögren's syndrome: A review of the literature

El síndrome de Sjögren es un trastorno crónico autoinmune que afecta a las glándulas secretoras, principalmente salivales y lagrimales; además, puede presentar manifestaciones sistémicas extraglandulares. El objetivo de esta revisión fue revisar la literatura sobre los aspectos generales del síndrome de Sjögren, para lo cual se realizó una búsqueda en bases de datos entre el 15 de enero y el 15 de marzo del 2020, en donde se obtuvieron 29 artículos sobre los cuales se hizo la revisión. El síndrome de Sjögren tiene una importante prevalencia entre las enfermedades autoinmunes más comunes, caracterizada por presentar xerostomía y xeroftalmia. Los criterios diagnósticos tienen alta sensibilidad y especificidad y su tratamiento es sintomático.

Sjögren's syndrome is a chronic autoimmune disorder that affects the secretory glands, mainly salivary and lacrimal glands; and also can present extraglandular systemic manifestations. The objective of this review was to check the literature about the general aspects of Sjorgen's syndrome, for which a search of the literature was carried out between January 15 to March 15, 2020, 29 articles were obtained on which did the review. Sjögren's syndrome is highly prevalent among the most common autoimmune diseases, characterized by xerostomia and xerophthalmia. The diagnostic criteria have high sensitivity and specificity, and their treatment is symptomatic.

Fully Three-Dimensional Hemodynamic Characterization of Altered Blood Flow in Bicuspid Aortic Valve Patients With Respect to Aortic Dilatation: A Finite Element Approach.

Background and Purpose: Prognostic models based on cardiovascular hemodynamic parameters may bring new information for an early assessment of patients with bicuspid aortic valve (BAV), playing a key role in reducing the long-term risk of cardiovascular events. This work quantifies several three-dimensional hemodynamic parameters in different patients with BAV and ranks their relationships with aortic diameter. Materials and Methods: Using 4D-flow CMR data of 74 patients with BAV (49 right-left and 25 right-non-coronary) and 48 healthy volunteers, aortic 3D maps of seventeen 17 different hemodynamic parameters were quantified along the thoracic aorta. Patients with BAV were divided into two morphotype categories, BAV-Non-AAoD (where we include 18 non-dilated patients and 7 root-dilated patients) and BAV-AAoD (where we include the 49 patients with dilatation of the ascending aorta). Differences between volunteers and patients were evaluated using MANOVA with Pillai's trace statistic, Mann-Whitney U test, ROC curves, and minimum redundancy maximum relevance algorithm. Spearman's correlation was used to correlate the dilation with each hemodynamic parameter. Results: The flow eccentricity, backward velocity, velocity angle, regurgitation fraction, circumferential wall shear stress, axial vorticity, and axial circulation allowed to discriminate between volunteers and patients with BAV, even in the absence of dilation. In patients with BAV, the diameter presented a strong correlation (> |+/-0.7|) with the forward velocity and velocity angle, and a good correlation (> |+/-0.5|) with regurgitation fraction, wall shear stress, wall shear stress axial, and vorticity, also for morphotypes and phenotypes, some of them are correlated with the diameter. The velocity angle proved to be an excellent biomarker in the differentiation between volunteers and patients with BAV, BAV morphotypes, and BAV phenotypes, with an area under the curve bigger than 0.90, and higher predictor important scores. Conclusions: Through the application of a novel 3D quantification method, hemodynamic parameters related to flow direction, such as flow eccentricity, velocity angle, and regurgitation fraction, presented the best relationships with a local diameter and effectively differentiated patients with BAV from healthy volunteers.

Síndrome hepatorrenal: revisión de la literatura

Contexto: el síndrome hepatorrenal es una disfunción renal que ocurre en pacientes con enfermedad hepática crónica como cirrosis hepática o enfermedad hepática aguda, caracterizada por la activación de mecanismos reguladores que conducen a la disminución de la tasa de filtrado glomerular. Clínicamente, el síndrome hepatorrenal se divide en dos tipos: el tipo 1 se caracteriza por una pérdida rápida y progresiva de la función renal, mientras que el tipo 2 se caracteriza por ser de progresión lenta y de mejor pronóstico. Objetivo: analizar la historia natural de la enfermedad que presentan los pacientes que desarrollan síndrome hepatorrenal. Metodología: se realizó una revisión de la literatura científica de manuscritos publicados sobre síndrome hepatorrenal, para evaluar la historia natural de esta patología. Resultados: no existen hallazgos clínicos específicos, sin embargo, sus manifestaciones clínicas reflejan la enfermedad hepática avanzada subyacente, la insuficiencia renal y las anomalías circulatorias presentes. Conclusiones: la opción terapéutica más adecuada es el trasplante hepático, pero no todos los pacientes pueden recibirlo, mientras se accede a dicho manejo una opción es el tratamiento medicamentoso con vasoconstrictores y albúmina.

Background: Hepatorenal syndrome is a renal dysfunction that occurs in patients with chronic liver disease such as liver cirrhosis or acute liver disease, characterized by the activation of regulatory mechanisms that lead to a decrease in the glomerular filtration rate. Clinically, hepatorenal syndrome is divided into two types, type 1 and type 2. Type 1 is characterized by a rapid and progressive loss of kidney function while type 2 is characterized by slow progression and a better prognosis. Purpose: To analyze the natural history of the disease presented by patients who develop hepatorenal syndrome. Methodology: A review of the scientific literature of published manuscripts on hepatorenal syndrome was carried out to evaluate the natural history of this pathology. Results: There are no specific clinical findings, however, its clinical manifestations reflect the underlying advanced liver disease, kidney failure, and circulatory abnormalities present. Conclusions: The most appropriate therapeutic option is liver transplantation, but not all patients can receive it, while accessing said management an option is drug treatment with vasoconstrictors and albumin.

Neumatosis quística intestinal y peritoneal, causa de neumoperitoneo. Revisión de la literatura a propósito de un caso / Intestinal and peritoneal cystic pneumatosis as a cause of pneumoperitoneum. Review of the literature about a case

Introducción. La neumatosis intestinal es una condición rara que se caracteriza por la infiltración submucosa o subserosa de gas en el tubo digestivo. Se encuentra más frecuentemente en el intestino delgado y, pocas veces, en localización extraintestinal. Su prevalencia estimada es de 0,03 %.Métodos. Se hizo una búsqueda bibliográfica en las bases de datos biomédicas Medline Pubmed, Science Direct, Tripdatabase y Uptodate, usando como palabras clave 'neumoperitoneo' y 'neumatosis cistoide intestinal' Para la presentación del caso clínico, se tomaron datos de la historia clínica y, además, imágenes de radiografía, tomografías y material fotográfico del procedimiento quirúrgico.Presentación del caso. Se trata de una mujer de 63 años de edad con antecedentes de colagenopatía, que consultó por dolor y distensión abdominal. Aunque no tenía signos de irritación peritoneal, las imágenes diagnósticas revelaron neumoperitoneo y líquido libre en la cavidad peritoneal, por lo que se sospechó una perforación intestinal y se practicó una laparotomía exploratoria, en la cual se encontró neumatosis quística intestinal y peritoneal.Conclusiones. No todos los casos de neumoperitoneo requieren cirugía. Existen casos espontáneos y sin irritación peritoneal, secundarios a neumatosis quística intestinal. En los casos de neumoperitoneo en pacientes estables con un diagnostico etiológico no muy claro, y en quienes se desee descartar perforación intestinal o isquemia mediante exploración quirúrgica, la laparoscopia diagnóstica es una buena opción y menos agresiva que la laparotomía

Introduction: Intestinal pneumatosis is a rare condition that is characterized by submucosal or subserosal gas infiltration in the digestive tract. It is found more frequently in the small intestine, and rarely in an extraintestinal location. Its estimated prevalence is 0.03%.Methods: A literature search was performed in the Medline Pubmed, Sciencedirect, Trip database and Up to date databases, using as keywords Pneumoperitoneum and Intestinal Cystoid Neumatosis. For the presentation of the clinical case, medical history data were collected, in addition to radiography images, tomography and photographic material of the surgical procedure.Clinical case: This is a 63-year-old woman with a history of collagenopathy, who consulted for abdominal pain and distension. Although she had no signs of peritoneal irritation, diagnostic images revealed pneumoperitoneum and free fluid in the peritoneal cavity. Intestinal perforation was suspected, and an exploratory laparotomy was performed, in which intestinal and peritoneal cystic pneumatosis in was found.Conclusions: Not all cases of pneumoperitoneum require surgery. There are spontaneous cases without peritoneal irritation, secondary to intestinal cystic pneumatosis. In cases of pneumoperitoneum in stable patients, with a not very clear etiological diagnosis, and in those who wish to rule out intestinal perforation or ischemia by surgical exploration, diagnostic laparoscopy is a good option and less aggressive than laparotomy

The Psychosocial Factors of Academic Achievement: Three Different Theoretical Models / Factores Psicosociales del Logro Académico: Tres Modelos Teóricos Diferentes

Abstract Within individual factors that affect academic achievement, personality traits have been the least explored even though there is evidence that suggest conscientiousness, neuroticism and self-efficacy are direct contributors of academic achievement. We used a sample of 725 Mexican public high school students (M age =18, SD age =1.09, 59% female) to test three Path Analysis models based on those proposed by Stajkovic, Bandura, Locke, Lee and Sergent, (2018). Although the models present very similar fit statistics and explanatory power, the intrapersonal model is more parsimonious, presents better fit indices and was therefore chosen as our final model. The model identifies middle school GPA, self-efficacy, neuroticism and conscientiousness as direct predictors of high school academic achievement, and both extraversion and academic self-concept as indirect predictors when mediated by self-efficacy. Students can use the power of their own self-efficacy beliefs as support for staying in school, boosting their aptitudes and enhancing previously acquired knowledge. We would suggest the addition of stronger correlates to high school academic achievement such as self-control as well as experimental data on how easy cognitions and capabilities can change in the sample.

Resumen Dentro de los factores académicos que afectan el logro académico, los rasgos de personalidad son de los factores menos explorados, aunque hay gran cantidad de evidencia que sugiere que la escrupulosidad, el neuroticismo y la autoeficacia contribuyen directamente al logro académico. Se utilizó una muestra de 725 estudiantes de escuelas preparatorias públicas (M edad =18, DE edad =1.09, 59% mujer) para poner a prueba tres modelos de trayectorias basados en los propuestos por Stajkovic, Bandura, Locke, Lee y Sergent, (2018). Aunque los modelos muestran índices de ajuste muy similares y poder explicativo, el modelo intrapersonal es más parsimonioso, presenta mejores índices de ajuste y por ende fue elegido como el modelo final. El modelo identifica el promedio de secundaria, la autoeficacia, el neuroticismo y la escrupulosidad como predictores directos del logro académico en preparatoria, y tanto la extroversión como el autoconcepto académico son predictores indirectos cuando son mediados por la autoeficacia. Los estudiantes pueden utilizar el poder de las creencias de su propia autoeficacia como apoyo para permanecer en la escuela, potenciando sus aptitudes y promoviendo el conocimiento adquirido previamente. Se sugiere la adición de correlatos más sólidos para el logro académico de preparatoria, tales como el autocontrol, así como datos experimentales para ver qué tan fácilmente pueden cambiar en la muestra, las cogniciones y capacidades.

Riesgos laborales en las empresas de residuos sólidos en Andalucía: una perspectiva de género / Labour risks in solid waste companies in Andalusia: a gender perspective

Resumen El sector de Residuos Sólidos Urbanos tiene amplia trayectoria en la implementación de planes de prevención en riesgos laborales. Analizamos dos aspectos: cuáles son los factores de riesgos laborales a los que se encuentran expuestos los empleados y que pueden afectar fundamentalmente a su salud dentro del sector analizado; y diferencias en la prevención de riesgos laborales por las empresas del sector que presentaron enfermedades profesionales en función del género de los trabajadores. El procedimiento metodológico consistió en el análisis descriptivo transversal en ocho provincias de Andalucía (España). Como herramienta de estudio se ha utilizado el cuestionario de 75 preguntas para la elaboración del informe sobre "condiciones de trabajo y gestión preventiva en las empresas de gestión de residuos sólidos urbanos en Andalucía" realizado por el Instituto Andaluz de Prevención de Riesgos Laborales. Como técnica estadística se ha usado el análisis de correspondencias múltiple y el test Chi-Cuadrado de independencia. En los resultados se han encontrado dos percepciones bien diferenciadas sobre los riesgos laborales en las organizaciones que vienen fijadas por la jerarquía en la organización. Se puede establecer relación directa entre los puestos de mando de la empresa y la preocupación por los riesgos laborales. A mayor distancia a puestos de dirección mayor es la preocupación de los empleados respecto a los riesgos laborales a los que están expuestos. En cuanto a los riesgos psicosociales se identifica que las mujeres se ven más afectadas que los hombres.

Abstract The Urban Solid Waste sector has a great trajectory in the implementation of preventive plans in workplace risks. We analyzed two aspects: which are the factors of workplace risks to what the employees are exposed and can essentially affect their health inside of the analyzed sector; and the differences in preventive management performed in companies that had informed their workers about occupational diseases, and analyzed these differences according to workers' gender. The method used was cross-sectional analysis in eight provinces of Andalusia (Spain). As research tool, a 75-question questionnaire was used to prepare the report on "Working conditions and safety management in enterprises specialized in management of urban solid wastes in Andalusia" by the Andalusian Institute of Occupational Health and Safety. As statistical technique, it has been used multiple correspondence analysis and the Chi-Squared test of independence. In the results there are two different perceptions of workplace risks in organizations that are fixed by the hierarchy in the company. It is possible to establish a direct relationship between the Team Management of the company and the concerning about workplace risks. The greater the distance between leadership's positions, the greater concern of employees exposed to the workplace risks. Regarding psychosocial risks, we concluded that women are more affected than men.

Uso de Medicinas Complementarias por Estudiantes Universitarios Asociado a Teoría de Autocuidado / Uso de Medicinas Complementarias por Estudiantes Universitarios Asociado a Teoría de Autocuidado

El autocuidado, su relevancia y aprendizaje constituyen temas de constante trabajo para el profesional de enfermería. En este sentido, las medicinas complementarias se presentan como una opción válida para promocionar acciones de bienestar en la población, sobretodo en un grupo tan receptivo, y a la vez, tan susceptible a la presión como los estudiantes universitarios. El objetivo general de este estudio de tipo cuantitativo, no experimental, transeccional, descriptivo y correlacional es determinar en qué medida los estudiantes universitarios consideran las medicinas complementarias como una alternativa para su autocuidado. Para ello, esta investigación se basa en la recolección de datos mediante el instrumento de tipo cuestionario autoadministrado, el cual se ha aplicado a estudiantes universitarios de las carreras de periodismo, enfermería e ingeniería civil industrial, matriculados en tercer semestre o superior de la Pontificia Universidad Católica, Universidad de Chile, Universidad de Santiago de Chile y Universidad de las Américas. La muestra incluyó un total de 338 estudiantes universitarios que cumplieron los criterios de inclusión. Los resultados indican que el uso de las medicinas complementarias es aún bajo entre los estudiantes universitarios, en comparación con el universo encuestado, pero la disposición a utilizarlas resulta amplia siempre que se establezcan las circunstancias apropiadas para acceder a su uso. Así mismo se ha detectado que "el entorno del estudiante" es un factor influyente al uso de estas terapias, por encima de otros factores como el ingreso socioeconómico. Además, la mayoría de los consultados refiere que al momento de padecer alguna enfermedad, no concurren a una atención médica o incluso, se automedican, lo cual evidencia, según los criterios de Dorothea Orem, un déficit en su autocuidado. Dentro de los problemas de salud más frecuentes señalados por los estudiantes, se encuentran: los dolores de cabeza, estrés y los trastornos del sueño. El profesional de enfermería cuenta con un amplio campo de trabajo en la acción de acercar a la población las medicinas complementarias, pero más aún, de alentar a las personas a hacerse cargo de su propio estado de salud.

An adaptation of Pfam profiles to predict protein sub-cellular localization in Gram positive bacteria.

Predicting the sub-cellular localization of a protein can provide useful information to uncover its molecular functions. In this sense, numerous prediction techniques have been developed, which usually have been focused on global information of the protein or sequence alignments. However, several studies have shown that the functional nature of proteins is ruled by conserved sub-sequence patterns known as domains. In this paper, an alternative methodology (PfamFeat) for gram-positive bacterial sub-cellular localization was developed. PfamFeat is based on information provided by Pfam database, which stores a series of HMM-profiles describing common protein domains. The likelihood of a sequence, to be generated by a given HMM-profile, can be used to characterize sequences in order to use pattern recognition techniques. Success rates obtained with a simple one-nearest neighbor classifier demonstrate that this method is competitive with popular sub-cellular prediction algorithms and it constitutes a promising research trend.

Criptococosis en un paciente inmunocompetente. Informe de un caso / Cryptococcosis in an immunocompetent female patient. One case report

Se realizó la presentación de un caso con criptococosis con localización en el sistema nervioso central en un paciente inmunocompetente, atendida en el Hospital General de Medellín. La paciente presentó un cuadro de meningoencefalitis aguda. Se demostró la causa micótica del proceso mediante estudio microbiológico del líquido cefalorraquídeo. No se comprobaron otras localizaciones del hongo en el paciente...