Percepción del personal de salud sobre un programa de detección oportuna del cáncer cervical / Health personnel perceptions on a cervical cancer early detection program / Percepção do pessoal de saúde sobre um programa de detecção oportuna do câncer cervical

Objetivo: Conocer la percepción que el personal de salud del primer nivel de atención tiene respecto al programa Detección Oportuna del Cáncer Cervical en México. Método: Estudio cualitativo, se realizaron 15 entrevistas semi-estructuradas a médicos y enfermeras de tres centros de salud rurales del Estado de Morelos, México. La información se analizó siguiendo los planteamientos de la Teoría Fundamentada. Resultados: El personal de salud percibe el programa Detección Oportuna del Cáncer Cervical como un programa de salud con fines preventivos, identifica la prueba de citología cervical como el medio para prevenir el cáncer cervicouterino, considera que el objetivo del programa es la obtención de muestras citológicas. La percepción está definida por el cumplimiento de metas, las barreras que se presentan para su operación, la elevada demanda y la escasez de recursos materiales, así como por los sentimientos del personal y sus condiciones de trabajo. Conclusiones: Es necesario reforzar los planes y programas de estudio de las carreras de enfermería y medicina para que los estudiantes obtengan conocimientos, desarrollen habilidades y adquieran competencias con base en conocimientos científicos, generar el correcto uso de términos médicos, la lectura crítica, la búsqueda de información y el interés por la actualización y crecimiento profesional.

Objective: To identify the perceptions which first level of attention health personnel have on the Cervical Cancer Early Detection National Health Program in Mexico. Method: This is a qualitative study which included 15 semi-structured interviews on medicine and nursing personnel of three rural health centers in the State of Morelos, Mexico. Data were analyzed in line with the Grounded Theory. Results: The health personnel perceives the Cervical Cancer Early Detection Program as a preventive initiative which relies on the cervical cytology as a main procedure to prevent cervical cancer. These perceptions are modulated by issues on the achievement of goals, operation barriers, high demand of the tests, scarcity of resources, and working conditions feelings. Conclusions: It is important to keep strengthening the nursing and medicine study plans so that students keep developing their knowledge, competencies, and skills to support health initiatives such as the Cervical Cancer Early Detection Program while they develop their scientific interest and professional growth.

Objetivo: Conhecer a percepção que o pessoal de saúde do primeiro nível de atenção tem ao respeito do programa Detecção Oportuna do Câncer Cervical no México. Método: Estudo qualitativo, realizaram-se 15 entrevistas semiestruturadas a médicos e enfermeiras de três centros de saúde rurais do Estado de Morelos, México. A informação analisou-se seguindo as abordagens da Teoria Fundamentada. Resultados: O pessoal de saúde percebe o programa Detecção Oportuna do Câncer Cervical como um programa de saúde com fins preventivos, identifica a proba de citologia cervical como o médio para prevenir o câncer de colo do útero, considera que o objetivo do programa é a obtenção de amostras citológicas. A percepção está definida pela realização de metas, as barreiras que se apresentam para sua operação, a elevada demanda e a escassez de recursos materiais, assim como pelos sentimentos do pessoal e suas condições de trabalho. Conclusões: É necessário reforçar os planos e programas de estudo das carreiras de enfermagem e medicina para que os estudantes obtenham conhecimentos, desenvolvam habilidades e adquiram competências com base em conhecimentos científicos, gerar o correto uso de termos médicos, a leitura crítica, a busca de informação e o interesse pela atualização e crescimento profissional.

Is high-intensity interval training more effective on improving cardiometabolic risk and aerobic capacity than other forms of exercise in overweight and obese youth? A meta-analysis.

BACKGROUND: The scientific interest in high-intensity interval training (HIIT) has greatly increased during recent years. OBJECTIVE: The objective of this meta-analysis was to determine the effectiveness of HIIT interventions on cardio-metabolic risk factors and aerobic capacity in overweight and obese youth, in comparison with other forms of exercise. DATA SOURCES: A computerized search was made using seven databases. STUDY ELIGIBILITY CRITERIA: The analysis was restricted to studies that examined the effect of HIIT interventions on cardio-metabolic and/or aerobic capacity in pediatric obesity (6-17 years old). PARTICIPANTS AND INTERVENTIONS: Nine studies using HIIT interventions were selected (n = 274). STUDY APPRAISAL AND SYNTHESIS METHODS: Standarized mean difference (SMD) and 95% confidence intervals were calculated. The DerSimonian-Laird approach was used. RESULTS: HIIT interventions (4-12 week duration) produced larger decreases in systolic blood pressure (SMD = 0.39; -3.63 mmHg) and greater increases in maximum oxygen uptake (SMD = 0.59; 1.92 ml/kg/min) than other forms of exercise. Also, type of comparison exercise group and duration of study were moderators. CONCLUSIONS: HIIT could be considered a more effective and time-efficient intervention for improving blood pressure and aerobic capacity levels in obese youth in comparison to other types of exercise. © 2016 World Obesity.

Reticulocyte count in red-blood-cell units stored in AS-1.

BACKGROUND AND OBJECTIVES: Previous data that showed maintenance of reticulocyte percentage in whole blood stored in CPDA-1 have led to the assumption that reticulocyte maturation becomes arrested during refrigerated storage. However, reticulocyte behaviour in red-blood-cell units stored in additive solutions has not yet been studied. This study was thus aimed at determining reticulocyte count and reticulocyte subtypes in red-blood-cells units stored in AS-1. MATERIALS AND METHODS: Reticulocyte percentage and subtypes were determined by flow cytometry with thiazole orange in six red-blood-cells units stored in AS-1. RESULTS: Reticulocyte count was 26.8 ± 4.6 × 10(9) /l at week 0.5 and 8.2 ± 2.9 × 10(9) /l at week 6. Total haemolysis during storage was 0.19 ± 0.08%. High-fluorescence reticulocytes were 2.0 ± 3.2 × 10(9) /l at week 0.5 and decreased by weeks 2, 4 and 6. Low-fluorescence reticulocytes were 22.1 ± 3.1 × 10(9) /l at week 0.5 and decreased by weeks 4 and 6. CONCLUSION: A significant decrease in reticulocytes occurred during red-blood-cells units' storage in AS-1. Even if it were assumed that all of haemolysed cells during storage were reticulocytes, there are a number of them whose disappearance cannot be explained by this mechanism. Changes observed in reticulocyte subtypes suggest that they mature during storage.

Epidemiology of bovine anaplasmosis in dairy herds from Costa Rica.

Bovine anaplasmosis is endemic and occurs in almost all areas of livestock production of Costa Rica. The aim of this study was to determine the seroprevalence and risk factors of anaplasmosis in dairy farms of Costa Rica by the recombinant truncated MSP-5 (rMSP-5) enzyme-linked immunosorbent assay (ELISA). Serum samples were obtained from 733 cattle from 20 commercial dairy herds of Costa Rica. The overall seroprevalence was 37.2% and herd seroprevalence ranged from 20.0 to 72.0%. The age-specific seroprevalence was 49.3% in young and 33.4% in adult animals. The main risk factors associated with seroprevalence were season of occurrence of clinical cases (rainy season) (OR=22.8), presence of tabanids (OR=9.5) and stable flies (OR=6.2), stable flies control measures (OR=3.2), non-use of ear tattoos (OR=2.8), interval of veterinary visit (≤ 60 days) (OR=2.7), altitude of the farms (<800 masl) (OR=2.6) and age (<2 years) (OR=1.8). The results indicated that exposure of cattle to Anaplasma marginale is common in dairy herds of Costa Rica and endemic instability situation probably is due to inadequate vector control.

First report of Trypanosoma vivax infection in dairy cattle from Costa Rica.

An outbreak of haemoparasitoses occurred from October 2007 to July 2008 in cattle from the district of Rio Cuarto, province of Alajuela, Costa Rica. Fifty animals of various ages out of 450 Brown Swiss were affected. The animals presented fever, severe anemia, jaundice, abortion or premature birth, loss of appetite, decrease milk production and accentuated weight loss in a short period of time. Haemoparasites were observed in the blood smears: Anaplasma marginale was present in 17 animals (60.7%); Trypanosoma vivax in nine (32.1%) and Babesia bovis in two (7.1%). Three of the animals (10.7%) had a mixed infection with T. vivax and A. marginale. After treatment, all the animals were clinically recovered and subsequent blood samplings showed no parasites. Data suggest that the outbreak might be related to a decrease in the availability and quality of the pastures due to very heavy rainfalls during the year 2007, as well as an increase in the abundance of Boophilus microplus and Stomoxys calcitrans. This is the first report of the presence of T. vivax in Costa Rica.

Fistula carótido-cavernosa: importancia de su diagnóstico y tratamiento oportunos para prevenir la ceguera / Carotid cavernous fistula: the importance of its opportune diagnosis and treatment to prevent blindness

A carotid cavernous fistula is an abnormal communication between a branch of the carotid artery and the cavernous sinus generating an arteriovenous fistula that can cause severe ocular damage. We hereby report two cases of carotid cavernous fistulas. A 69-year-old male with a 2-month history of right eyelid swelling and red eye aggrarated by diplopia, exophthalmus, and limitation of ocular movements one week before consulting. On admisson his visual acuity, in the right eye was good (0.5) and biomicroscopy showed arterialization of conjunctival vessels. All orbital CAT scan showed a dilatation of the superior orbital vein characteristic of carotid cavernous fistula. A balloon balloon tramponade of the fistula was performed too late (after 3 weeks) and the eye went blind. A 39-year-old female consulted for an acute proptosis of the right eye and severe visual loss. Biomicroscopy showed arterialization of the conjunctival vessels and the CAT scan disclosed a dilatation of the superior orbital vein. She was immediately subjected to a neuroradiological fistula closure with recovery of visual acuity to 1.0 (20/20). Our main purpose is to emphasize the importance of the opportune diagnosis and treatment of these fistulas to prevent visual loss and eventual blindness, as occurred in our first patient.

Fístula carótido-cavernosa: importancia de su diagnóstico y tratamiento oportuno para prevenir la ceguera / Carotid cavernous fistula: importance of its diagnosis and opportune treatment to prevent the blindness

Objetivo: Enfatizar la importancia del diagnóstico clínico y del tratamiento oportuno de las fístulas del seno cavernoso que se manifiestan anterógradamente en la órbita. Pacientes y Métodos: Se presentan dos pacientes atendidos en el Servicio de Oftalmología del Hospital Salvador, tratados endovascularmente en el Instituto de Neurocirugía, quienes presentaron una evolución visual muy disímil (uno llegó a la ceguera y el otro recuperó en 100 por ciento de visión) debido a las diferencias en el tiempo de diagnóstico e inicio del tratamiento. Discusión: Se discuten las diferencias en la expresión clínica de los adversos tipos de fístulas (de bajo y alto flujo), el diagnóstico diferencial y la importancia del tratamiento oportuno para lograr un resultado anatómico y funcional óptimo del ojo afectado.

Preservación de eritrocitos y cambios físicos ocurridos durante el almacenamiento / Preservation of erythrocytes and happened physical changes during storage

La preservación de sangre y de sus derivados ha sido una constante en el desarrollo de los bancos de sangre modernos. Los dos métodos actualmente utilizados son la fase líquida y la criopreservación. Se revisaron las generalidades de cada uno de ellos, así como los cambios físicos ocurridos a los eritrocitos durante su almacenamiento

Treadmill exercise-induced stress causes a rise of blood histamine in normotensive but not in primary hypertensive humans.

We have previously shown an interaction between noradrenergic and histamine-containing neurons in the rat vas deferens. As a generalized phenomenon, this interaction is involved in a novel peripheral reflex that, in an inhibitory way, modulates sympathetic activity and arterial pressure. Consistent with this, an activation of postganglionic sympathetic neurons causes a rise in rat blood histamine. In the present study, we showed that enhanced sympathetic activity due to treadmill exercise in normotensive humans, is accompanied by a rise in blood histamine, suggesting the presence of a similar neuronal interaction in humans. In contrast, the rise in blood histamine does not occur in primary hypertensive humans during the same degree of physical exercise, suggesting that this interaction is faulty in such hypertensives and could be involved in the pathophysiology of the disease.

Zymodeme and serodeme characterization of Leishmania isolates obtained from Costa Rican patients.

Thirty-four Leishmania isolates obtained from Costa Rican patients, from different geographical areas, were characterized by isoenzyme electrophoresis and indirect immunofluorescense with monoclonal antibodies. Thirty-two were characterized as L. panamensis strains and two were L. braziliensis variants. We confirm the evident predominance of L. panamensis as the main etiological agent of leishmaniasis in Costa Rica and the existence of L. braziliensis in the country.

[Measurement of total serum IgE by enzyme immunoassay with three commercial reagents]. / Medición de IgE total en suero por enzimainmunoanálisis con tres reactivos comerciales.

We measured total serum IgE in 14 patients with allergic diseases and 16 healthy subjects, using three commercial ELISA kits. The correlation of results among the three kits was analyzed using Passing and Bablock regression parameters. Results show that measurements of the different kits do not coincide. One kit shows differences using sera from normal subjects. There is no correlation among kits when using sera from allergic patients. It is concluded that it is not possible to determine exactly the amount of IgE using these kits, specially in subjects with elevated levels.

Análisis de riesgo en la importación de vacunas antiaftosa desde países que posean o manipulen en su fabricación agentes exóticos para Colombia

[Introducción] La internacionalización de la economía que permite mayores facilidades para el comercio internacionalde mercancías de origen animal y el potencial que tienen éstas, en especial los productos biológicos, en el mejoramiento de la salud animal hacen que aumente el riesgo de aparicion de eventos indeseables (humanos, animales o medio ambiente) en los países como consecuencia de su ingreso. Así, el análisis de riesgos adquiere un papel preponderante en la identificación, cuantificación, mitigación y administración de los riesgos que pudieran originarse por el ingreso de estos productos.

[Alpha fetoproteins curve in maternal serum of normal pregnant women with risk antecedents]. / Curva de alfa feto proteínas en suero materno de gestantes normales con antecedentes de riesgo.

Two hundred ninety four samples of A.F.P. in maternal serum, taken in different weeks of gestation are evaluated. The group of patients were over 35 years of age and/or had congenital defects or chromosomic disease in previous pregnancy; although in the current pregnancy, the fetuses were normal. A chilean curve of A.F.P. was determined with this data.

[Bacterial translocation in a model of intestinal obstruction. II. Bacteriological study and role of cellular immunity]. / Translocación bacteriana en un modelo de obstrucción intestinal. II. Estudio bacteriológico y papel de la inmunidad celular.

Bacterial translocation (Bt) from the gastrointestinal (GI) tract to systemic organs creates the possibility of Infection and sepsis in a great number of pathologic entities. In a mouse model of Intestinal Obstruction (IO), we evaluated the type of micro-organisms and the organs that bacteria frequent translocated. At 24 hours post-10, positive cultures where obtained at the MLN, portal, systemic circulation and peritoneal cavity, establishing that the translocation is bi-directional. The more frequent bacteria isolated were the Streptococcus group D, Proteus mirabilis, Escherichia coli, Pseudomonas sp., an clostridium. BT occurs at 24 hour post-OI and was due to increased intestinal permeability, at 48 hrs BT increased and related to the physical disruption of the mucosal barrier in the intestinal mucosa. Cell mediated immunity (CMI) response in this model was not altered, although a progressive decrease was observed at 48 hrs it was not significant, suggesting that the CMI play no role in the pathogenesis of BT. In the Control-Laparotomy group, CMI response was increased significantly at 48 hours, suggesting that a simple laparotomy boost the immune defense response.

A double-blind, parallel, comparative evaluation of amlodipine against captopril in the monotherapeutic treatment of mild and moderate essential hypertension: interim results.

Amlodipine (once daily) and captopril (twice daily) had comparable efficacy and safety in reducing the blood pressure of patients with mild and moderate essential hypertension. Amlodipine administered once daily is an effective and well-tolerated treatment.

A double-blind, parallel, comparative evaluation of amlodipine vs. captopril in the monotherapeutic treatment of mild and moderate essential hypertension.

A double-blind, parallel, comparative study of the antihypertensive efficacy and safety of once-daily oral doses of amlodipine (5-10 mg/day) vs. twice-daily oral doses of captopril (25-50 mg twice daily) in adult patients with mild or moderate essential hypertension (supine diastolic blood pressure of 95-115 mm Hg) was undertaken in two hospital centers. Interim analysis of data from 40 patients shows that amlodipine and captopril both significantly (p < 0.05) reduced blood pressure compared with baseline. Nineteen of 21 (90.5%) amlodipine-treated patients and 15 of 19 (78.9%) captopril-treated patients had their diastolic blood pressure "normalized" (< 90 mm Hg) with mean final doses of 8.2 and 76.7 mg/day, respectively. At the final visit, there were no statistically significant differences between the two treatment groups in either mean supine or standing blood pressure. Minor nonsignificant changes in standing heart rate were observed in both treatment groups. Seven of the 21 amlodipine-treated patients and 3 of the 19 captopril-treated patients reported adverse experiences. No patients in either treatment group discontinued due to adverse events; one patient in the amlodipine group required a dose reduction. These interim data indicate that the overall efficacy and safety profiles of these two drugs are comparable.

Prolapso de valvula mitral: aspectos epidemiológicos, clínicos y terapéuticos / Mitral valve prolapse: epidemiological, clinic and therapeutic aspects

Estudio prospectivo a largo plazo fue realizado en 145 pacientes con prolapso de la válvula mitral idiopática diagnosticados por criterios clínicos y ecocardiográficos. De ellos 118 eran mujeres y 27 hombres con una relación de 4:1. En rango de edades de 13 a 70 años con un promedio de 32 para el sexo femenino y 31 para el masculino. El estudio incluyó todos los pacientes con prolapso de la válvula mitral secundaria atribuidos a enfermedades o desórdenes establecidos o acompañantes. el promedio de seguimiento era de 2.0 años con rango de 3 meses a 14 años. La condición clínica de los 145 pacientes con insuficiencia mitral presentaron 92 pacientes, en el curso de la evolución 6 casos progresaron a moderada y severa, siendo necesario el reemplazo valvular en un paciente con evolución satisfactoria. La arritmia cardiaca más frecuente encontrada fue la extrasístolia ventricular grado 2-3 de Lown, en dos casos se presentó colgajo de taquicardia ventricular la cual ameritó tratamiento antiarritmico para control de ella. Siete pacientes cursaron con síndrome de pre-excitación: 4 con WOLF Parkinson White tipo A y 3 con Long Ganon Levine, presentando taquicardia supraventricular con conducción aberrante en dos casos, registrados en el electrocardiograma de reposo. En el Holter 2 pacientes presentaron trastornos de conducción: bloqueo de primer grado y bloqueo de segundo grado intermitente. Endocarditis infecciosa se presentó en un paciente que evoluciono satisfactoriamente con tratamiento médico

Efecto antianginoso de una nueva preparación transdermica de nitroglicerina (Deponit) en pacientes con cardiopatía isquémica / Antianginal effect of a trasdermal nitroglycerin preparation (deponit) in patients with ischemic cardiopathy

La continua aplicación de nitroglicerina transdérmica produce como resultado la aparición de tolerancia a los efectos antianginosos. En un estudio simple ciego, randomizado, los efectos de la aplicación continua de un nuevo preparado transdérmico de nitroglicerina (Deponit) a dosis de 10 mg/día con intervalo de doce horas, fueron comparados con los efectos de placebo en 10 pacientes con angina pectoris estable. Comparado con los valores de placebo, después de 8 semanas de angor pectoris y el consumo de tabletas de Dinitrato de isosorbide de 4.7 a 1.5 semanales, la frecuencia cardíaca aumentó significativamente durante el ejercicio de 122 a 131 latidos por minuto. La presión sanguínea y el tiempo de ejercicio no se modificó