Study of Essential Oil Isolated from Achiote (Bixa orellana) Leaves: Chemical Composition, Enantiomeric Distribution and Antimicrobial, Antioxidant and Anticholinesterase Activities.

Bixa orellana is a native and cultivated species of Ecuador commonly known as achiote (annatto), this species is very versatile with a wide variety of uses and applications of its leaves, fruits and seeds. In this study, the chemical composition, enantiomeric distribution and biological activity of essential oil isolated from the leaves of Bixa orellana were determined. Hydrodistillation was used to isolate the essential oil. Gas chromatography coupled with mass spectrometry was used to determine the qualitative composition, a gas chromatograph equipped with a flame ionization detector was used to determine quantitative composition and gas chromatography on an enantioselective column was used to determine enantiomeric distribution. Antibacterial activity was determined using the broth microdilution method, for which we used three Gram-positive cocci bacteria, a Gram-positive bacilli bacterium and three Gram-negative bacilli bacteria. 2,2'-azinobis-3-ethylbenzothiazoline-6-sulfonic (ABTS) acid radical cation and 2,2-diphenyl-1-picrylhydryl (DPPH) free radical were used as reagents for determining the antioxidant activity of the essential oil. The spectrophotometric method was used to analyze acetylcholinesterase inhibitory effect of the essential oil. The yield of leaves in essential oil was 0.13 ± 0.01% (v/w). A total of 56 chemical compounds, which represent 99.25% of the total composition, were identified in the essential oil. Sesquiterpene hydrocarbons were the most representative group in number of compounds and relative abundance with 31 compounds and 69.06%, respectively. The principal constituents were found to germacrene D (17.87 ± 1.20%), bicyclogermacrene (14.27 ± 0.97%), caryophyllene < (E)- > (8.56 ± 1.24%) and pinene <α-> (6.34 ± 0.13%). Six pairs of enantiomers were identified in the essential oil of Bixa orellana. The essential oil presented strong activity against the Enterococcus faecium (ATCC 27270) with an MIC of 250 µg/mL and weak activity against Enterococcus faecalis (ATCC 19433) and Staphylococcus aureus (ATCC 25923) with an MIC of 1000 µg/mL. The antioxidant activity of the essential oil was strong according to ABTS methods with a SC50 of 61.49 ± 0.04 µg/mL and was moderate in DPPH with a SC50 of 224.24 ± 6,4 µg/mL. Additionally, the essential oil reported moderate anticholinesterase activity with an IC50 of 39.45 ± 1.06 µg/mL.

Medicamentos potencialmente inapropiados para el adulto mayor en el servicio de medicina interna / Potentially inappropriate medications for older adults in the internal medicine service

Introducción: se consideran prescripciones inapropiadas de medicamentos cuando el riesgo supera el beneficio, o en las que hay un incremento en el potencial de interacciones farmacológicas. Para evitarlo en el adulto mayor se han desarrollado herramientas como los criterios Beers y los PRISCUS. Objetivo: identificar las prescripciones potencialmente inapropiadas en la población adulta mayor que consultó al servicio de medicina interna del Hospital Universitario Hernando Moncaleano Perdomo mediante los listados Beers y PRISCUS. Materiales y métodos: estudio observacional descriptivo de corte transversal en pacientes mayores de 65 años, se calculó el tamaño de la muestra en 357 pacientes. La información recolectada fue almacenada en el programa excel versión 2013 y analizada en EPI INFO versión 7.1.4. Resultados: la mediana de edad fue 75 años, el género masculino 52,66%, el promedio de medicamentos por paciente fue de 8,77 con una DE +/- 5. El diagnóstico más frecuente fue insuficiencia cardiaca con 29 casos (8,12 %). La prescripción inapropiada de medicamentos (PIM) según los criterios Beers, se observó en 4,9%, los más frecuentes fueron metoclopramida 20% y amiodarona 14%. La lista PRISCUS identificó 2.5% de prescripciones inapropiadas siendo prazosin (20%) el más relacionado. Conclusiones: los medicamentos encontrados según los criterios BEERS fueron metoclopramida, amiodarona, prazosina, betametildigoxina y con los PRISCUS, prazosina, haloperidol, betametildigoxina y difenhidramina.

Introduction: inappropriate drug prescribing is defined as the use of medicines whose risks outweigh their benefits, or when there is increased potential of drug-drug interactions. The Beers and PRISCUS criteria were developed as tools to prevent potentially inappropriate medication (PIM) in the elderly. Objective: to identify PIM in the elderly population who attended the internal medicine service of Hospital Universitario Hernando Moncaleano Perdomo, by means of the Beers and PRISCUS criteria. Materials and methods: a descriptive, observational, cross-sectional study in patients over age 65. The sample size was calculated in 357 patients. Excel version 2013 was used for data storage. EPI INFO version 7.1.4 was used for data analysis. Results: mean age 75 years, males 52.66%, average number of drugs per patient 8.77 (SD +/- 5). Heart failure was the most common diagnosis (29 cases - 8.12 %). According to the Beers criteria, PIM was identified in 4.9% of patients; metoclopramide (20%) and amiodarone (14%) being the most prescribed. The PRISCUS list identified PIM in 2.5%; prazosin (20%) being the most prescribed. Conclusions: the drugs identified by the BEERS criteria were metoclopramide, amiodarone, prazosin, and beta-methyl digoxin. Prazosin, haloperidol, beta-methyl digoxin, and diphenhydramine were identified by the PRISCUS criteria.

La esquizofrenia: una mirada desde la ciencia, la tecnología y la sociedad

RESUMEN La esquizofrenia es probablemente el trastorno más enigmático y trágico que tratan los psiquiatras, y quizás, el más devastador. Se manifiesta en la juventud, por lo que los pacientes esquizofrénicos normalmente viven muchos años después del inicio de la enfermedad y continúan padeciendo sus efectos sin poder llevar una vida completamente normal. Se realizó una revisión bibliográfica para la cual se emplearon los recursos disponibles en Infomed, específicamente en las bases de datos EBSCO, SCIELO y libros de textos de autores cubanos y extranjeros. Se aplicó el método analítico-sintético y se revisaron 18 artículos científicos. Se expusieron los elementos que abordan el desarrollo histórico- cultural de la esquizofrenia desde la perspectiva de la ciencia, la tecnología y la sociedad. Se realizó esta revisión con el objetivo de contribuir al conocimiento sobre el desarrollo histórico cultural de la esquizofrenia, teniendo en cuenta las teorías que ha desarrollado el hombre a través de la ciencia para explicar la aparición de la enfermedad y la importancia de los factores sociales en la aparición, evolución y rehabilitación de este padecimiento.

ABSTRACT Schizophrenia is probably the most enigmatic and tragic disorder that psychiatrists treat, and perhaps the most devastating. It manifests itself in youth, so schizophrenic patients usually live many years after the onset of the disease and continue to suffer from its effects without being able to lead a completely normal life. A bibliographic review was carried out using the resources available in Infomed, specifically in the EBSCO and SCIELO databases and textbooks by Cuban and foreign authors. The analytical-synthetic method was applied and 18 scientific articles were reviewed. The elements that address the historical-cultural development of schizophrenia from the perspective of science, technology and society were exposed. This review was carried out with the aim of contributing to the knowledge about the historical cultural development of schizophrenia, taking into account the theories that man has developed through science to explain the appearance of the disease and the importance of social factors in the appearance, evolution and rehabilitation of this condition.

La depresión en pacientes con diagnóstico de diabetes mellitus tipo 2

RESUMEN Fundamento: durante la evolución de la diabetes mellitus pueden aparecer complicaciones crónicas que afectan la esperanza y la calidad de vida relacionadas con la salud por lo que se perjudica la salud física y mental de los pacientes. Objetivo: determinar el comportamiento de la depresión en pacientes con diagnóstico de diabetes mellitus del consultorio médico de la familia #21 del municipio Rodas provincia Cienfuegos. Métodos: se realizó un estudio descriptivo de corte transversal, en el período de mayo de 2020 a mayo de 2021, el universo y la muestra estuvieron en correspondencia con los 36 pacientes diabéticos dispensarizados en el consultorio, a los que se les aplicó una encuesta y el Inventario de Depresión Rasgo-Estado. Se estudiaron las variables: edad, sexo, tipo de tratamiento, síntomas de depresión, complicaciones y nivel de depresión. El análisis y procesamiento de la información se hizo mediante el paquete estadístico SPSS versión 15 para Windows, los resultados se expresaron en números y porcientos. Resultados: predominó el sexo femenino en un 58,3 %, el grupo etáreo más representado fue el de 48-57 (50 %). Predominó el grupo de pacientes que consumen hipoglicemiantes orales (55 %). Hubo prevalencia de los pacientes con depresión (72,2 %), siendo más frecuente los que reciben tratamiento con hipoglicemiantes orales (47,2) y existió una elevada incidencia en el sexo femenino (41,6 %). Predominaron los pacientes con complicaciones renales (19,4 %) y cardiovasculares (16,6 %). El 75 % de los pacientes presentaron depresión baja. Conclusiones: en el estudio predominó el sexo femenino y el grupo etáreo de 48-57 años. Existió una prevalencia elevada de las complicaciones asociadas a la aparición de depresión y el consumo de hipoglicemiantes orales. Más de la mitad de los pacientes estudiados presentaron síntomas manifiestos de depresión. Prevalecieron los pacientes que presentaron depresión baja.

ABSTRACT Background: during the evolution of diabetes mellitus, chronic complications may appear that affect life expectancy and health-related quality of life, thus harming the physical and mental health of patients. Objective: to determine the behavior of depression in patients diagnosed with diabetes mellitus of the Family Medical Office #21 of the Rodas municipality, Cienfuegos province. Methods: a descriptive cross-sectional study was carried out, in the period from May 2020 to May 2021, the universe and the sample were in correspondence with the 36 diabetic patients dispensed in the office, to whom a survey was applied and the Adult Depression Test. The variables were studied: age, sex, type of treatment, symptoms of depression, complications, level of depression. The analysis and processing of the information was done using the statistical package SPSS version 15 for Windows, the results were expressed in numbers and percentages. Results: predominance of the female sex in 58.3 %, the most represented age group is that of 48-57 (50 %). The group of patients consuming oral hypoglycemic drugs (55 %) predominated. There was a prevalence of patients with depression (72.2 %), being more frequent those receiving treatment with oral hypoglycemic agents (47.2) and there was a high incidence in females (41.6 %). Patients with renal (19.4 %) and cardiovascular (16.6 %) complications predominated. 75 % of the patients presented low depression. Conclusions: the female sex and the age group of 48-57 predominated in the study. There was a high prevalence of complications associated with the appearance of depression and the consumption of oral hypoglycemic agents. More than half of the patients studied presented manifest symptoms of depression. Patients who presented low depression prevailed.

Efecto de la fritura sobre los componentes bioactivos de la papa nativa (Solanum tuberosum sp.) Puka Ambrosio

RESUMEN En esta investigación, con el método de superficie de respuesta (33), se determinó la máxima retención de ácido ascórbico en papa Puka Ambrosio sometida a fritura. Se ensayó con 160, 170 y 180 °C; 150, 180 y 210 segundos; 2, 3 y 4 mm de espesor de hojuela. Se retuvo 87,3% de ácido ascórbico en hojuelas de 2 mm de espesor sometidas a 170 °C y 200 segundos de fritura. El espesor y la interacción entre este y el tiempo tuvieron efecto significativo (p<0,05) sobre la retención. La papa y la hojuela frita tuvieron respectivamente en promedio: 21,0±1,6 y 18,4±2,9 mg/100 g de ácido ascórbico; 27,1 ± 2,1 y 21,1 ± 3,3 mg/100 g de vitamina C en base seca desgrasada; 69,0±0,03 y 22,2±0,03% de humedad; 1±0,09 y 21,9±0,03 de grasa cruda en base seca; y 332±97 y 597±22 mg de ácido clorogénico equivalente/100 g de compuestos fenólicos totales; 6424±57 y 8309±80 μg de equivalente Trolox/g de capacidad antioxidante; y 58,1±1,7 y 33,6±5,0 mg de cianidina-3-glucósido equivalente/100 g de antocianinas totales, todas medidas en base seca desgrasada. La operación de fritura generó modificaciones en las características físicas, químicas, concentración de componentes bioactivos y capacidad antioxidante, observándose un incremento en el contenido de carbohidratos, fibra, cenizas, compuestos fenólicos y capacidad antioxidante.

ABSTRACT In this research, the maximum retention of ascorbic acid was determined in the Puka Ambrosio potato subjected to frying using the response surface method (33). Retention was tested at 160, 170 and 180 °C for 150, 180 and 210 seconds and with a flake thickness of 2, 3 and 4 mm. In 2 mm flakes at 170 °C and 200 seconds of frying, 87.3% ascorbic acid was retained. Flake thickness and the interaction between thickness and frying time had a significant effect (p<0.05) on retention. The potato and its fried flakes had on average: 21.0±1.6 and 18.4±2.9 mg/100 g of ascorbic acid, respectively; and 7.1±2.1 and 21.1±3.3 mg/100 g of vitamin C on a defatted dry basis; 69±0.03 and 22.2±0.03 percent moisture; 1±0.09 and 21.9±0.03 of crude fat on dry basis; 332±97; and 597±22 mg of chlorogenic acid equivalent/100 g of total phenolic compounds; 6424±57 and 8309±80 μg of Trolox equivalent/g of antioxidant capacity; and 58.1±1.7 and 33.6±5.0 mg of cyanidin-3-glucoside equivalent /100 g of total anthocyanins on a defatted dry basis. The frying operation generated modifications in the physical-chemical characteristics, of bioactive component concentration and in the antioxidant capacity. We observed an increase in the content of carbohydrates, fiber, ash, phenolic compounds and antioxidant capacity.

Effect of non-alcoholic beer, diet and exercise on endothelial function, nutrition and quality of life in patients with cirrhosis.

BACKGROUND: The implementation of nutritional strategies targeting several variables at once could benefit patients with cirrhosis. Non-alcoholic beer has different compounds that exert antioxidant, anti-inflammatory and nutritional properties. AIM: To evaluate the effect of diet + exercise and non-alcoholic beer on nutritional status, endothelial function and quality of life in patients with cirrhosis. METHODS: In this randomized open clinical trial, patients with cirrhosis were randomized into two groups: The intervention (non-alcoholic beer + diet + exercise) and control (water + diet + exercise) group. Treatment consisted of 330 mL non-alcoholic beer/day or the same amount of water, plus an individualized dietary plan and an exercise program with a pedometer-based bracelet to reach at least 5000 steps/d and > 2500 above the baseline during 8 wk. Endothelial function (flow-mediated dilation, plethysmography), biochemical and nutritional variables and quality of life (CLDQ) were evaluated. RESULTS: Forty-three patients were included in the study, 21 in the control group and 22 in the intervention group. The mean age was 53.5 ± 7.8 years, 60% were women, the median MELD score was 8 (7-10) and most patients were Child-Pugh A (88%). Adherence to the interventions was > 90% in both groups, there were no adverse events and all biochemical parameters remained stable in both groups. Endothelial function improved in both groups. All measured nutritional parameters improved in the intervention group, compared to only 2 in the control group and quality of life improved in both groups; however, more domains improved in the intervention group. CONCLUSION: The intervention consisting of non-alcoholic beer, diet and exercise seems to be safe and well tolerated in patients with cirrhosis, and shows improvement in nutritional status, endothelial function, and quality of life. These results need to be further confirmed.

Rol de Terapia Ocupacional en la Unidad de Cuidado Intensivo en Colombia / Role of Occupational Therapy in Intensive Care Unit in Colombia / Papel da Terapia Ocupacional na Unidade de Cuidado Intensivo na Colômbia

Resumen Introducción: la Terapia Ocupacional impacta positivamente en la salud y el bienestar al realizar, por medio de la ocupación, acciones específicas en la Unidad de Cuidado Intensivo (UCI) en las que se abordan la rehabilitación y recuperación de habilidades. Materiales y métodos: estudio aplicado a terapeutas ocupacionales con mínimo de 2 años de experiencia clínica y 1 año en Unidad de Cuidado Intensivo Adulto en Colombia, en el periodo de diciembre de 2016 a marzo de 2017. Se analizaron categorías específicas encaminadas al conocimiento basado en participación, experiencia, evaluación, intervención y retos. Resultados: participaron 20 terapeutas experimentados en diferentes categorías: (a) Participación: como ejecutores, el 70 %, y el 55 % hace parte de intervención temprana en rehabilitación. (b) Experiencia: se evidencia atención de entidades clínicas más referenciadas, se hace uso de modelos y marcos teórico-prácticos reconocidos y difundidos. (c) Evaluación: se realiza en áreas cognitiva y Actividades de la Vida diaria, usando instrumentos como historia ocupacional y observación. (d) Intervención: énfasis en modalidades y medios de intervención encaminados a las Actividades de la Vida diaria, Cognitivo, Sensorial y Trabajo con Familias. (e) Retos: dividido en fortalezas y dificultades donde se expresaron beneficios, problemáticas y otros. Conclusión: se identifican y analizan acciones del terapeuta ocupacional colombiano en las UCI, correlacionándose con los reportes a nivel internacional. Se resalta la participación en los equipos de intervención temprana, sus acciones con las familias y sus acciones centradas en la ocupación.

Abstract Introduction: Occupational Therapy positively impacts on health and well-being by performing, through occupation, specific actions in the Intensive Care Unit (ICU) in which rehabilitation and recovery of skills are addressed. Materials and methods: study applied to occupational therapists with a minimum of 2 years of clinical experience and 1 year in the Adult Intensive Care Unit in Colombia, from December 2016 to March 2017. Specific categories aimed at knowledge based on participation, experience, evaluation, intervention and challenges. Results: 20 experienced therapists participated in different categories: (a) Participation: as executors, 70 %, and 55 % are part of early intervention in rehabilitation. (b) Experience: evidence of more referenced clinical entities is evidenced, models and recognized theoretical and practical frameworks are used and disseminated. (c) Evaluation is done in cognitive areas and Activities of Daily Life, using instruments such as occupational history and observation. (d) Intervention: emphasis on modalities and means of intervention aimed at Activities of Daily, Cognitive, Sensory and Work with Families. (e) Challenges: divided into strengths and difficulties where benefits, problems and others were expressed. Conclusion: actions of the Colombian occupational therapist are identified and analyzed in the ICU, correlating with the reports at the international level. The participation in the early intervention teams, their actions with the families and their actions focused on the occupation are highlighted.

Resumo Introdução: a terapia Ocupacional impacta positivamente na saúde e o bem-estar através da ocupação realizando ações específicas na Unidade de Cuidado Intensivo abordando a reabilitação e recuperação de habilidades, enquadradas em processos de atenção ainda sem desenvolvimento. Analisar as ações que realiza uma terapeuta ocupacional em uma Unidade de Cuidado Intensivo Adulto na Colômbia. Materiais e métodos: estudo misto aplicado a Terapeutas ocupacionais, com mínimo 2 anos de experiência clínica e 1 ano em Unidade de Cuidado Intensivo adulto na Colômbia; no período dezembro 2016 - março 2017. Analisaram-se categorias específicas encaminhadas ao conhecimento baseado em: participação, experiência, avaliação, intervenção e desafios. Resultados: participaram 20 terapeutas experimentados. Respeito às categorias: (a) Participação: como executores de 70 % e o 55 % faz parte de intervenção precoce de reabilitação. (b) Experiência: tempo mínimo de 1 ano na unidade; se evidencia atenção de entidades clínicas mais referenciadas; se faz uso de modelos e marcos teórico-práticos reconhecidos e difundidos. (c) Avaliação: se realizam em áreas cognitivas e Atividade da vida diária, usando instrumentos como História ocupacional e Observação. (d) Intervenção: ênfase, modalidade e meios de intervenção encaminhados às atividades da vida diária, Cognitivo, Sensorial e Trabalho com famílias. (e) Desafios: dividido em fortalezas e dificuldades onde se expressaram benefícios, problemáticas e outros. Conclusão: se identificam e ratificam ações do terapeuta ocupacional colombiano nas UCI, correlacionando-se com os reportes a nível internacional. Ressalta-se a participação nas equipes de intervenção precoce, suas ações com as famílias e suas ações centradas na ocupação. Esta pesquisa aporta e fortalece o conhecimento nesta área específica e convida à construção de novas propostas na intervenção clínica.

Choosing sampling methods for Chilopoda, Diplopoda and Isopoda (Oniscidea): a case study for ferruginous landscapes in Brazilian Amazonia

The edaphic fauna plays an important role in the organic matter dynamics of the soil. Millipeds (Diplopoda),centipeds (Chilopoda) and isopods (Isopoda) are among the main components of the soil fauna. Vegetationstructure represents one of the main factors influencing composition and diversity of these species that inhabitleaf litter and soil, what is particularly important in the Amazon Forest, where there are several singular ve-getation types. Savannah and forest areas stand out in ferruginous hills, which represents one of the most poorlyknown and highly threatened ecosystems in the Amazon. However, sampling the edaphic fauna in high diversitysites represents a challenging task. Studies have shown that sampling method may influence observed patterns ofdiversity. From this perspective, the present study aimed to (i) investigate whether assemblages of Chilopoda,Diplopoda and Isopoda differ between vegetation types in the Amazon, (ii) indicate how biological parametersbehave in such communities, (iii) identify which method or combination of methods is better suited to samplespecies richness and (iv) quantify the efficiency of each method regarding time of work and cost. Sampling wasconducted by means of hand collection, leaf litter collection, hay-bait traps and soil sampling in four patches,two in the savannah (also called canga) and two in the forest. Richness was higher in forest habitats forChilopoda and Diplopoda, while for Isopoda there was no significant difference. Species composition also dif-fered between vegetation types for Chilopoda and Isopoda, but not for Diplopoda. Beta diversity between ve-getation types was mainly determined by nestedness and balancing, while turnover was the main beta diversitycomponent responsible for differences among methods. Soil sampling and hand collection added more species tothe samples, therefore, this combination was the most efficient to access diversity. Our results support thehypothesis that differences in the soil cover promoted by distinct vegetation types influence the species diversityand composition of edaphic fauna. The differences were mainly determined by nestedness and balancing, in-dicating that the fauna sampled in the canga represents a subset of those present in the surrounding forest. In thissense, even in ecosystems with distinct vegetation types, the combination of soil and surface sampling methods isrecommended. Lastly, the present study proposes a set of decision rules and a key to select the most appropriatemethod to sample the studied taxonomic groups

Caracterización clínica paraclínica y epidemiológica de los pacientes con Lupus Eritematoso Sistémico del Hospital Universitario Hernando Moncaleano Perdomo de Neiva / Clinical, paradinical and epidemiological characterization of patients with Systemic Lupus Erythematosus at Hospital Universitario Hernando Moncaleano Perdomo, from Neiva Huila

Objetivo: Caracterizar clínica paraclínica y epidemiológicamente el Lupus Eritematoso Sistèmico en los pacientes del Hospital Universitario Hernando Moncaleano Perdomo de Neiva Diseño: Descriptivo de corte transversal. Población: Pacientes atendidos en el Hospital Universitario de Neiva Hernando Moncaleano Perdomo con diagnóstico de lupus eritematoso sistèmico. Método: Recolección de datos a través de revisión documental de historias clínicas del Hospital Universitario de Enero 2009 a Enero 2014. Resultados: De un total de 104 pacientes con lupus eritematoso sistèmico encontrados en el periodo de estudio, la relación mujer: hombre fue de 5:1. Las comorbilidades de mayor frecuencia en el género femenino fueron la hipertensión arterial con un 26,7%, la fibromialgia con 12,7% y el síndrome de antifosfolípidos con 12, 7%; en el género masculino la hipertensión arterial, la fibromialgia y la falla cardiaca se presentaron cada una en un 27,7%. El 61,5% de las pacientes femeninas tuvieron manifestaciones en piel, el 51,1% refirieron artralgias y solo un 25,5% presentaron compromiso articular caracterizado por derrame sinovial. En los hombres las manifestaciones en piel estuvieron presentes en un 50%, las artralgias y el compromiso articular caracterizado por derrame sinovial fueron un 50% y 22,2% respectivamente. En los exámenes paraclínicos entre el 12,7% y el 31,4% de los pacientes tenían un lupus activo, determinado por la presencia de leucopenia, proteinuria y C3-C4 consumidos. En la muestra de pacientes femeninas las alteraciones paraclínicas más frecuentes se caracterizaron por hemoglobina <12 g/dl en 53,4% y trombocitopenia en 26,7%. Por su parte, 33,3% de los hombres presentaron trombocitopenia y 6,3% hemoglobina <12 g/dl.

Objective: To characterize clinically, paraclinical, and epidemiologically Systemic Lupus Erythematosus in patients at Hospital Universitario in Neiva Design: Descriptive cross sectional. Place: Hospital Universitario Hernando Moncaleano Perdomo, Neiva-Colombia. Population: Patients at Hospital Universitario Hernando Moncaleano Perdomo with diagnosis of Systemic Lupus Erythematosus. Method: Data collection of medical histories was performed. Results: Of 104 medical histories, the disease occurs five times more often in women than in men (ratio of 5:1). The most frequent comorbidities in females were hypertension with 26.74%, fibromyalgia and anti-phospholipid syndrome both with 12, 79%; In male patients hypertension, fibromyalgia and heart failure were presented each in a 27.78%. 61.53% of female patients had skin manifestations, 51.16% reported arthralgia and only 25.58% had joint involvement characterized by synovial effusion; in men skin manifestations were 50%, 50% arthralgia and articular involvement characterized by synovial effusion was 22.22%. In the laboratory test between 12.79% and 31.40% of patients had active lupus, determined by the presence of leukopenia, proteinuria and C3 and C4 consumed. In the sample of female patients the most frequent paraclinical alterations were characterized by hemoglobin <12 g / dl in 53.48% and 26, 74% of patients present thrombocytopenia. Meanwhile, 33.33% of men had thrombocytopenia and 6.38% had hemoglobin <12 g / dl.

Avaliação do nível de conhecimento de alunos de pós-graduação em radiologia e imaginologia sobre mucosite oral / Knowledge, attitude and profile of post-graduate students about oral mucositis

Objetivo: este estudo observacional transversal objetivou avaliar o nível de conhecimento dos cirurgiões-dentistas, alunos de pósgraduação em Radiologia e Imaginologia da Faculdade São Leopoldo Mandic ­ Campinas sobre diagnóstico, prevenção e tratamento de mucosite oral induzida pelo tratamento do câncer, por meio da aplicação um questionário. Metodologia: participaram da pesquisa 54 voluntários, cirurgiões dentistas, alunos de especialização e mestrado, que responderam um questionário desenvolvido para esta pesquisa, composto de questões para caracterização do entrevistado e questões para avaliar os conhecimentos sobre mucosite. Após a coleta, os dados obtidos foram tabulados no editor de planilhas Microsoft Office Excel e submetidos a uma análise estatística descritiva e analítica das variáveis coletadas. Resultados: revelaram que quanto à autoavaliação do conhecimento específico sobre mucosite oral foi "Regular" (44,6%) a resposta mais prevalente, seguida de "Bom" com 30,4%, "Insuficiente" com 17,9% e "Ótimo", com 7,1%. Questionados sobre o contato com a mucosite oral na prática clínica, 62,5% dos voluntários (n:35) responderam não ter tido contato e 35,7% responderam ter tido contato com a mucosite oral (n:20). O local de conhecimento da condição foi na graduação (75%); e quanto à conduta 12,5% realizaria o tratamento e 64,3% encaminharia para um estomatologista; e 50% dos investigados relataram não ter tido orientação de prevenção e tratamento da mucosite oral durante o curso de Graduação. Conclusão: pode se concluir que os entrevistados têm conhecimento teórico em nível médio (54,97%) sobre os conceitos mais gerais de mucosite oral; e a grande maioria (62,5%) não teve experiência clínica com esta patologia.

Objective: this cross-sectional observational study aimed to evaluate the level of knowledge of dentists, graduate students in Radiology and Imaging of Faculdade São Leopoldo Mandic ­ Campinas on diagnosis, prevention and treatment of oral mucositis induced by cancer treatment, through the application of an questionnaire. Methodology: the participants were 54 volunteers, dentists, specialization and master's students, who answered a questionnaire developed for this study, consisting of questions to characterize the interviewee and questions to assess the knowledge of mucositis. The data were tabulated and submitted to a descriptive and analytical statistical analysis of the collected variables.Results: the results revealed that the self-assessment of specific knowledge about oral mucositis was "Regular" (44.6%) the most prevalent response, followed by "Good" with 30.4%, "Not Enough" with 17.9% and "Great", with 7.1%. When asked about contact with oral mucositis in clinical practice, 62.5% of the volunteers (n = 35) responded have had contact and 35.7% reported having had contact with oral mucositis (n: 20). The knowledge of the condition site was graduation (75%); and how to conduct 12.5% undergo the treatment and 64.3% thereafter forward for Stomatological; and 50% of surveyed reported not having guidance for prevention and treatment of oral mucositis during the course of graduation.Conclusion: It can be concluded that the respondents have theoretical knowledge average level (54.97%) of the more general concepts of oral mucositis; and the vast majority (62.5%) had no clinical experience with this disease.

Orientaciones conceptuales, evaluativas y prácticas desde la terapia ocupacional para la participación de niños con enfermedades crónicas: revisión de la literatura / Conceptual, evaluative and practical guidelines for the inclusion of children with chronic diseases from an occupational therapy perspective: Literature review

Resumen Introducción. Las enfermedades crónicas generan alto impacto psicológico, económico y social, restringen la participación y son un factor de riesgo para procesos incapacitantes que se pueden experimentar a largo plazo. En población pediátrica, se reconoce que el terapeuta ocupacional debe intervenir de forma integral para favorecer la participación del niño y mejorar su calidad de vida. Objetivo. Aportar orientaciones conceptuales, evaluativas y prácticas relacionadas con la intervención de niños con enfermedad crónica en sus actividades cotidianas. Materiales y métodos. Revisión de literatura especializada según categorías analíticas: referentes conceptuales, herramientas evaluativas y orientaciones prácticas para el abordaje del niño con enfermedad crónica incapacitante. Resultados. Los referentes conceptuales mencionan la importancia de un enfoque centrado en el niño y la familia, así como de su empoderamiento en el proceso de manejo de la condición de salud crónica. Las herramientas evaluativas muestran suficiente disponibilidad de instrumentos formales aplicables a esta población y dan cuenta de variadas estrategias y recomendaciones prácticas, aplicables a niños en distintas áreas ocupacionales y escenarios donde se desarrolla su cotidianidad. Conclusiones. Se evidenció la necesidad de integralidad en la intervención profesional, de trascender del escenario clínico al familiar y social (manejo individual de los casos) y de acudir a enfoques centrados en el usuario y su familia. También se identificaron temas que resultan de relevancia para ser incorporados en el actuar cotidiano de los terapeutas ocupacionales y sobre los cuales deben ahondar estudios posteriores: bioética y cuidado paliativo de menores con enfermedad crónica.

Abstract Introduction: Chronic diseases generate a high psychological, economic and social impact, restrict participation, and are a risk factor in disabling processes that can be experienced in the long term. In the pediatric population, occupational therapists should comprehensively intervene to favor inclusion of children and improve their quality of life. Objective: To provide conceptual, evaluative and practical guidelines for the intervention in the daily activities of children with chronic illnesses. Materials and methods: Review of specialized literature according to the following analytical categories: conceptual references, evaluative tools, and practical guidelines to approach children with chronic disabling diseases. Results: The conceptual referents address the importance of an approach focused on the child and his family, and of their empowerment in the chronic health condition management process. The evaluation tools show sufficient availability of formal instruments applicable to this population, and account for various strategies and practical recommendations directed to children in different occupational areas and scenarios where their daily activities develop. Conclusions: The need for integrity in professional intervention was evident during the study. It is necessary to transcend the clinical context and consider the family and social scenario (individual case management), and to focus on user and family-centered approaches. Also, relevant topics were identified, which need to be incorporated in the daily work of occupational therapists and on which the study subject should be based for further studies, namely, bioethics and palliative care of children with chronic diseases.

Malnutrition assessed through phase angle and its relation to prognosis in patients with compensated liver cirrhosis: a prospective cohort study.

BACKGROUND: Malnutrition is a frequent complication of cirrhosis and it has been associated to more severe disease and development of complications. Phase angle is a bedside reliable tool for nutritional assessment based on conductivity properties of body tissues. AIM: To evaluate the association between malnutrition assessed through phase angle and mortality in patients with liver cirrhosis. METHODS: We performed a prospective cohort study in a tertiary care centre; 249 patients were enrolled with 48 months of follow-up. Clinical, nutritional (malnutrition = phase angle ≤ 4.9°) and biochemical evaluations were performed. Student's t-test and χ(2) method were used as appropriate. Kaplan-Meier curves and multivariate Cox regression were used to evaluate mortality. RESULTS: Mean follow-up was 33.5 months. Survival analysis showed higher mortality in the malnourished group compared to the well-nourished group (p = 0.076), Kaplan-Meier curves were further stratified according to compensated and decompensated status showing higher mortality in compensated patients according to Child-Pugh (p = 0.002) and Model for End-Stage Liver Disease score (p = 0.008) when malnutrition was present. Multivariate analysis showed that malnutrition was independently associated with mortality (HR = 2.15, 1.18-3.92). CONCLUSIONS: In our cohort, malnutrition was independently associated with mortality. This is the first study showing higher mortality in malnourished compensated cirrhotic patients.

Chitosan-coated magnetic nanoparticles prepared in one-step by precipitation in a high-aqueous phase content reverse microemulsion.

Chitosan-coated magnetic nanoparticles (CMNP) were prepared in one-step by precipitation in a high-aqueous phase content reverse microemulsion in the presence of chitosan. The high-aqueous phase concentration led to productivities close to 0.49 g CMNP/100 g microemulsion; much higher than those characteristic of precipitation in reverse microemulsions for preparing magnetic nanoparticles. The obtained nanoparticles present a narrow particle size distribution with an average diameter of 4.5 nm; appearing to be formed of a single crystallite; furthermore they present superparamagnetism and high magnetization values; close to 49 emu/g. Characterization of CMNP suggests that chitosan is present as a non-homogeneous very thin layer; which explains the slight reduction in the magnetization value of CMNP in comparison with that of uncoated magnetic nanoparticles. The prepared nanoparticles show high heavy ion removal capability; as demonstrated by their use in the treatment of Pb2+ aqueous solutions; from which lead ions were completely removed within 10 min.

Queilite actínica: estudo epidemiológico entre trabalhadores rurais do município de Piracaia - SP / Actinic cheilitis: epidemiological study in the rural municipality of Piracaia - SP

A queilite actínica é uma lesão de lábio inferior definida como uma condição degenerativa do epitélio de revestimento, causada pela ação da radiação ultravioleta do sol sobre os lábios sendo considerada uma lesão cancerizável que pode evoluir para carcinoma. Em geral, os pacientes são assintomáticos e os sinais clínicos não refletem a gravidade histopatológica da lesão. O objetivo do trabalho foi realizar um levantamento epidemiológico da queilite actínica entre trabalhadores rurais do município de Piracaia, São Paulo, por meio de questionário e observação clínica. Aspectos como gênero, faixa etária, exposição solar, grau de alfabetização, uso de protetores solares, tabagismo, etilismo e características clínicas foram avaliados. Os resultados mostraram que o perfil epidemiológico dos 120 pacientes avaliados era composto de homens (73,3%1, com idade entre 20 e 44 anos (68,3%). Destes, 35,8% apresentavam quadro de queilite actínica e, segundo os parâmetros clínicos utilizados, 30,8% apresentavam grau leve a moderado de alterações teciduais. O uso de protetor solar labial foi relatado por 15,83% da população estudada. Os dados obtidos nesta pesquisa reforçam a necessidade de orientação aos trabalhadores rurais quanto aos malefícios da radiação solar e conscientização do uso de fotoproteção, não só aos que já apresentam as características clínicas da queilite actínica, como também aos pertencentes ao grupos de risco, estando os profissionais de saúde, em especial os cirurgiões-dentistas, responsáveis pelo diagnóstico, prevenção e tratamento.

The actinic cheilitis is a lesion located at lower lip defined as a degenerative condition of the lining epithelium. It is caused by the action of ultraviolet radiation from the sun. It is considered a carcinogenic lesion that can progress to carcinoma. In general, patients are asymptomatic and clinical signs do not reflect the severity of histopathological lesions. The aim of this study was an epidemiological survey of actinic cheilitis among rural workers at Piracaia - São Paulo using questionnaires and clinical observation. Some aspects were assessed as gender, age, sun exposure, degree of literacy, use of sunscreens, smoking, alcohol consumption and clinical characteristics. The results showed that the epidemiological profile of the 120 patients evaluateí was composed of 73.3% by men with ages between 20 and 44 years (68.3%). Of these, 35.801; were diagnosed with actinic cheilitis. According second clinical parameters used, 30.8% patients had mild to moderate tissue changes. The use of sunscreen lip was reported by 15.83% of this sample. The data obtained in this study reinforce the need for guidance the rural workers to the harmful effects of solar radiation. It is important to use the sunscreen, not only people who already have clinical features of actinic cheilitis but ali belonging to risk groups, with the health professionals, especially dentist, responsible for the diagnosis, prevention and treatment.

Differential expression of Toll-like receptors in dendritic cells of patients with dengue during early and late acute phases of the disease.

BACKGROUND: Dengue hemorrhagic fever (DHF) is observed in individuals that have pre-existing heterotypic dengue antibodies and is associated with increased viral load and high levels of pro-inflammatory cytokines early in infection. Interestingly, a recent study showed that dengue virus infection in the presence of antibodies resulted in poor stimulation of Toll-like receptors (TLRs), thereby facilitating virus particle production, and also suggesting that TLRs may contribute to disease pathogenesis. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated the expression levels of TLR2, 3, 4 and 9 and the co-stimulatory molecules CD80 and CD86 by flow cytometry. This was evaluated in monocytes, in myeloid and plasmacytoid dendritic cells (mDCs and pDCs) from 30 dengue patients with different clinical outcomes and in 20 healthy controls. Increased expression of TLR3 and TLR9 in DCs of patients with dengue fever (DF) early in infection was detected. In DCs from patients with severe manifestations, poor stimulation of TLR3 and TLR9 was observed. In addition, we found a lower expression of TLR2 in patients with DF compared to DHF. Expression levels of TLR4 were not affected. Furthermore, the expression of CD80 and CD86 was altered in mDCs and CD86 in pDCs of severe dengue cases. We show that interferon alpha production decreased in the presence of dengue virus after stimulation of PBMCs with the TLR9 agonist (CpG A). This suggests that the virus can affect the interferon response through this signaling pathway. CONCLUSIONS/SIGNIFICANCE: These results show that during dengue disease progression, the expression profile of TLRs changes depending on the severity of the disease. Changes in TLRs expression could play a central role in DC activation, thereby influencing the innate immune response.

[Vertical transmission of HTLV-1 in Peru]. / Transmisión vertical de HTLV-1 en el Perú

Human type 1 T-cell lymphotropic virus (HTLV-1) infection has been described in many areas of the world, including Caribbean countries, Japan, Africa, Oceania and South America. In this review we define the endemicity of HTLV-1 in the country proposing four epidemiological criteria. Then we discuss the core subject of the review, which is the vertical transmission of HTLV-1. This mechanism is one of the main forms of transmission in our country. Within the development of this particular topic, we present an estimated rate of vertical transmission and the risk factors associated to vertical transmission based on an exhaustive review of the national and international literature. This review pretend to provide a first approach to the vertical transmission of HTLV-1, an aspect poorly studied in our country.

Transmisión vertical de HTLV-1 en el Perú / Vertical transmission of HTLV-1 in Peru

La infección por el virus linfotrópico humano de células T tipo 1 (HTLV-1) ha sido descrita en muchas áreas del mundo, como en los países del Caribe, Japón, África, Oceanía y en Sudamérica. En la presente revisión definimos la endemicidad del HTLV-1 en el país, planteando cuatro criterios epidemiológicos. Luego discutimos el tema central de la revisión: la transmisión vertical del HTLV-1, que en nuestro país sería uno de los principales mecanismos de transmisión. Dentro del desarrollo de este aspecto en particular, presentamos una estimación de la tasa de transmisión vertical y los factores de riesgo asociados con la transmisión vertical sobre la base de una revisión exhaustiva de estudios nacionales y extranjeros. Con esta revisión pretendemos dar una primera aproximación al estudio de la trasmisión vertical de HTLV-1, un aspecto poco estudiado en nuestro medio.

Human type 1 T-cell lymphotropic virus (HTLV-1) infection has been described in many areas of the world, including Caribbean countries, Japan, Africa, Oceania and South America. In this review we define the endemicity of HTLV-1 in the country proposing four epidemiological criteria. Then we discuss the core subject of the review, which is the vertical transmission of HTLV-1. This mechanism is one of the main forms of transmission in our country. Within the development of this particular topic, we present an estimated rate of vertical transmission and the risk factors associated to vertical transmission based on an exhaustive review of the national and international literature. This review pretends to provide a first approach to the vertical transmission of HTLV-1, an aspect poorly studied in our country.

Prevalência do prolongamento do processo estilóide e/ou calcificação do ligamento estilo-hióideo em radiografias panorâmicas / Prevalence of elongated styloid process and/or ossified stylohyoid ligament in panoramic radiographs

OBJETIVO: Avaliar a prevalência do prolongamento do processo estilóide e/ou calcificação do ligamento estilo-hióideo em uma amostra de 2.600 radiografias panorâmicas. MÉTODOS: As radiografias foram avaliadas por um único examinador e foram consideradas imagens compatíveis com a alteração aquelas em que o processo estilóide do osso temporal ultrapassasse em mais de 1cm (medido sobre a radiografia panorâmica) a borda mais inferior da cartilagem do lóbulo da orelha, e aquelas em que o ligamento estilo-hióideo se apresentasse radiopaco. RESULTADOS: Cento e quarenta e seis radiografias (5,61 por cento) apresentaram as alterações em estudo. Os resultados mostraram que o alongamento do processo estilóide e/ou calcificação do ligamento estilo-hióideo não foram achados. Houve maior incidência do prolongamento do processo estilóide e/ou calcificação do ligamento estilo-hióideo no sexo feminino (63 por cento), sendo este na maioria dos casos bilateralmente (84 por cento) e apresentando uma maior prevalência na faixa etária de 11 a 40 anos. CONCLUSÃO: Pôde-se concluir que houve maior prevalência da alteração no sexo feminino e a maioria dos casos ocorreu bilateralmente..

OBJECTIVE: Access the prevalence of elongated styloid process and/or ossified stylohyoid ligament in 2.600 panoramic radiographs. METHODS: A total of 2600 radiographs were examined by the same examiner. Images where the styloid process of the temporal bone extended beyond the lower edge of the cartilage of the ear lobe by more than 1 cm (measured on the panoramic radiograph) and those where the stylohyoid ligament was radiopaque were counted. RESULTS: One hundred forty-six (5.61 percent) radiographs presented the abovementioned characteristics. The results showed that elongation of the styloid process and/or stylohyoid ligament ossification were not uncommon events. These changes were more common in females (63 percent) and were usually bilateral (84 percent). They were also more common in the 11-40 years age range. CONCLUSION: Prolongation of the styloid process and/or ossification of the stylohyoid ligament were significantly more common in females. The rates at which the sides were affected were also statistically different.

Recent developments in understanding dengue virus replication.

Dengue is the most important cause of mosquito-borne virus diseases in tropical and subtropical regions in the world. Severe clinical outcomes such as dengue hemorrhagic fever and dengue shock syndrome are potentially fatal. The epidemiology of dengue has undergone profound changes in recent years, due to several factors such as expansion of the geographical distribution of the insect vector, increase in traveling, and demographic pressure. As a consequence, the incidence of dengue has increased dramatically. Since mosquito control has not been successful and since no vaccine or antiviral treatment is available, new approaches to this problem are needed. Consequently, an in-depth understanding of the molecular and cellular biology of the virus should be helpful to design efficient strategies for the control of dengue. Here, we review the recently acquired knowledge on the molecular and cell biology of the dengue virus life cycle based on newly developed molecular biology technologies.