Case report: Ibogaine reduced severe neuropathic pain associated with a case of brachial plexus nerve root avulsion.

Brachial plexus nerve root avulsion results from complete separation of the nerve root from the spinal cord and is one of the most challenging types of neuropathic pain, coinciding with motor, sensory and autonomic deficits. The severe pain and typical impossibility of root reattachment often leads to requests for amputation. Ibogaine is an indole alkaloid producing psychoactive effects through reported actions upon multiple neurotransmitter systems, including NMDA, κ- and µ-opioid receptors and σ2 receptor sites, along with stimulation of neurotrophic factors GDNF and BDNF. In this case report we describe a 53-year-old male with two decades of severe intractable pain due to brachial plexus nerve root avulsion from vehicular trauma who was successfully treated with both high dose inpatient and low dose outpatient administrations of ibogaine. Though promising for future study, the adverse effects of high dose ibogaine administrations may limit tolerability of this saturation protocol to the most refractory cases.

Correlación entre el estado nutricional y nivel de actividad física en escolares del sur de Sonora, México / Correlation between nutritional status and level of physical activity in School children from southern sonora, México

Resumen Rojo Villa, J.A., Rojo Villa, L.G., y Martínez Félix, J. (2021). Correlación entre el estado nutricional y nivel de actividad física en escolares del sur de Sonora, México. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-14. La falta de actividad física y presencia de malnutrición son factores importantes que comprometen la salud de toda la población. El estudio tuvo como propósito determinar el grado de asociación entre el estado nutricional y el nivel de actividad física en escolares del sur del estado de Sonora, México. El estudio es de tipo cuantitativo, descriptivo y transversal. La muestra está conformada por 156 estudiantes de nivel primaria ambos sexos (mujeres 48.71% y hombres 51.28%), con rango de edad de 10 a 12 años (10.86 ± 1.56). Las variables evaluadas fueron: nivel de actividad física con el cuestionario PAQ-C, estado nutricional utilizando los percentiles e IMC/E con referencias de la OMS en el año 2007. Los principales resultados indican que el 3.20% de los escolares cuenta con bajo peso; por otra parte, el sobrepeso y obesidad en conjunto suman 19.86% y predomina el sexo masculino con mayor número de casos: el 23.76% cuenta con niveles moderados de actividad física; el sexo femenino cuenta con mayor presencia en los niveles bajos y muy bajos. Se encontró una correlación inversa significativa entre el estado nutricional y nivel de actividad física, tanto en el sexo femenino (r = -0.19; p = .003) como en el masculino (r = -0.55; p < .0001). En conclusión, la asociación entre malnutrición y bajos niveles de actividad física podrían ser considerados para establecer estrategias preventivas y de intervención.

Abstract Rojo Villa, J.A., Rojo Villa, L.G., & Martínez Félix, J. (2021). Correlation between nutritional status and level of physical activity in school children from southern Sonora, México. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-14. The lack of physical activity and malnutrition are important factors that compromise the health of the entire population. The purpose of the study is to determine the degree of association between the nutritional status and the level of physical activity in school children in southern Sonora, Mexico. The study is quantitative, descriptive, and cross-sectional. The sample is comprised of elementary students of both sexes (female 48.71% and male 51.28%) with ages ranging between 10 and 12 years (10.86 ± 1.56). The evaluated variables included level of physical activity with the PAQ-C questionnaire and nutritional status using BMI/Age percentiles from WHO in 2007. Main results indicate that 3.20% of school children are underweight, while overweight and obesity combined add up to 19.86%, with males having the highest number of cases (23.76% with moderate levels of physical activity) and females having a greater presence at low and very low levels. A significant inverse correlation was found between nutritional status and level of physical activity in both females (r = -0.19; p = .003) and males (r = -0.55; p < .0001). In conclusion, the association between malnutrition and low levels of physical activity could be considered to establish preventive and intervention strategies.

Resumo Rojo Villa, J.A., Rojo Villa, L.G., & Martínez Félix, J. (2021). Correlação entre estado nutricional e nível de atividade física em estudantes do sul de Sonora, México. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-14. A falta de atividade física e a presença de desnutrição são fatores importantes que comprometem a saúde de toda a população. O objetivo do estudo foi determinar o grau de associação entre o estado nutricional e o nível de atividade física em estudantes do estado de Sonora, no sul do México. O estudo é quantitativo, descritivo e transversal. A amostra é composta por 156 estudantes do ensino fundamental de ambos os sexos (mulheres 48,71% e homens 51,28%), com faixa etária de 10 a 12 anos (10,86 ± 1,56). As variáveis avaliadas foram: nível de atividade física com o questionário PAQ-C, estado nutricional por meio de percentis e IMC/E com referências da OMS em 2007. Os principais resultados indicam que 3,20% dos alunos estão abaixo do peso; por outro lado, o sobrepeso e a obesidade juntos somam 19,86% e o sexo masculino predomina com o maior número de casos: 23,76% apresentam níveis moderados de atividade física; o sexo feminino tem maior presença nos níveis: baixo e muito baixo. Foi encontrada uma correlação inversa significativa entre o estado nutricional e o nível de atividade física, tanto no sexo feminino (r = -0,19; p = 0,003) quanto no masculino (r = -0,55; p <0,0001). Em conclusão, a associação entre desnutrição e os baixos níveis de atividade física pode ser considerada para o estabelecimento de estratégias preventivas e de intervenção.

[Analysis of mortality caused by tuberculosis in Medellín, Colombia, 2012]. / Análisis de la mortalidad por tuberculosis en Medellín, 2012.

INTRODUCTION: Tuberculosis is a relevant global public health problem. Although reports of the World Health Organization show decrease in overall mortality rates, Colombia and Medellin show no significant decline. OBJECTIVE: To describe the sociodemographic, clinical, diagnosis, and treatment characteristics of patients who died due to tuberculosis in Medellin, Colombia, during 2012. MATERIALS AND METHODS: A descriptive study of tuberculosis deaths reported in the city. RESULTS: 93 deaths were identified, of which 32 were confirmed as directly caused by tuberculosis (34.4%); in 23 deaths (24.7%) tuberculosis was an associated cause. Co-morbidities were found in 34 patients (61.7%), HIV being the most common with 18 cases important(32.7%). Social risk factors such as being homeless, drug addiction or having no fixed address were found in 32 cases (58.1%); and there were deficiencies in the healthcare system in 26 cases (47.2%). No meaningful delay in the onset of anti-tuberculosis treatment was found after the microbiological diagnosis; however, 64% of patients did not adhere to treatment. CONCLUSION: Mortality caused by tuberculosis in Medellin is a relevant problem associated with delays in diagnosis of the disease and lack of adherence to treatment.

Análisis de la mortalidad por tuberculosis en Medellín, 2012 / Analysis of mortality caused by tuberculosis in Medellín, Colombia, 2012

Introducción. La tuberculosis es uno de los principales problemas globales de salud pública. Aunque los reportes de la Organización Mundial de la Salud muestran un descenso en las tasas de mortalidad global, Colombia y la ciudad de Medellín no muestran reducciones significativas. Objetivo. Describir las características sociodemográficas, clínicas y de diagnóstico y tratamiento, de los pacientes fallecidos por tuberculosis en Medellín en el 2012. Materiales y métodos. Es un estudio descriptivo de las muertes por tuberculosis reportadas en Medellín durante el 2012. Resultados. El número de muertes fue de 93, de las cuales, 32 (34,4 %) se confirmaron como muertes directas por tuberculosis y 23 (24,7 %) como asociadas a esta enfermedad. En 34 (61,7 %) de los pacientes hubo alguna enfermedad concomitante, siendo el sida la más importante (18, 32,7 %). Se detectaron factores de riesgo social como ser habitante de la calle, farmacodependencia o carencia de domicilio fijo, en 32 casos (58,1 %), y aspectos que afectaron el proceso de atención de los servicios de salud, en 26 (47,2 %). Hubo un retraso de 40 días (rango intercuartílico: 19 a 84) entre el inicio de los síntomas y el diagnóstico. No se encontró retraso significativo en el inicio del tratamiento antituberculoso después del diagnóstico microbiológico; sin embargo, el porcentaje de incumplimiento del tratamiento fue de 64%. Conclusión. La mortalidad por tuberculosis en Medellín es un problema relevante que está relacionado con retrasos en el diagnóstico de los casos y con el cumplimiento del tratamiento.

Introduction: Tuberculosis is a relevant global public health problem. Although reports of the World Health Organization show decrease in overall mortality rates, Colombia and Medellin show no significant decline. Objective: To describe the sociodemographic, clinical, diagnosis, and treatment characteristics of patients who died due to tuberculosis in Medellin, Colombia, during 2012. Materials and methods: A descriptive study of tuberculosis deaths reported in the city. Results: 93 deaths were identified, of which 32 were confirmed as directly caused by tuberculosis (34.4%); in 23 deaths (24.7%) tuberculosis was an associated cause. Co-morbidities were found in 34 patients (61.7%), HIV being the most common with 18 cases important(32.7%). Social risk factors such as being homeless, drug addiction or having no fixed address were found in 32 cases (58.1%); and there were deficiencies in the healthcare system in 26 cases (47.2%). No meaningful delay in the onset of anti-tuberculosis treatment was found after the microbiological diagnosis; however, 64% of patients did not adhere to treatment. Conclusion: Mortality caused by tuberculosis in Medellin is a relevant problem associated with delays in diagnosis of the disease and lack of adherence to treatment.

IFNgamma response to Mycobacterium tuberculosis, risk of infection and disease in household contacts of tuberculosis patients in Colombia.

OBJECTIVES: Household contacts (HHCs) of pulmonary tuberculosis patients are at high risk of Mycobacterium tuberculosis infection and early disease development. Identification of individuals at risk of tuberculosis disease is a desirable goal for tuberculosis control. Interferon-gamma release assays (IGRAs) using specific M. tuberculosis antigens provide an alternative to tuberculin skin testing (TST) for infection detection. Additionally, the levels of IFNgamma produced in response to these antigens may have prognostic value. We estimated the prevalence of M. tuberculosis infection by IGRA and TST in HHCs and their source population (SP), and assessed whether IFNgamma levels in HHCs correlate with tuberculosis development. METHODS: A cohort of 2060 HHCs was followed for 2-3 years after exposure to a tuberculosis case. Besides TST, IFNgamma responses to mycobacterial antigens: CFP, CFP-10, HspX and Ag85A were assessed in 7-days whole blood cultures and compared to 766 individuals from the SP in Medellín, Colombia. Isoniazid prophylaxis was not offered to child contacts because Colombian tuberculosis regulations consider it only in children under 5 years, TST positive without BCG vaccination. RESULTS: Using TST 65.9% of HHCs and 42.7% subjects from the SP were positive (OR 2.60, p<0.0001). IFNgamma response to CFP-10, a biomarker of M. tuberculosis infection, tested positive in 66.3% HHCs and 24.3% from the SP (OR = 6.07, p<0.0001). Tuberculosis incidence rate was 7.0/1000 person years. Children <5 years accounted for 21.6% of incident cases. No significant difference was found between positive and negative IFNgamma responders to CFP-10 (HR 1.82 95% CI 0.79-4.20 p = 0.16). However, a significant trend for tuberculosis development amongst high HHC IFNgamma producers was observed (trend Log rank p = 0.007). DISCUSSION: CFP-10-induced IFNgamma production is useful to establish tuberculosis infection prevalence amongst HHC and identify those at highest risk of disease. The high tuberculosis incidence amongst children supports administration of chemoprophylaxis to child contacts regardless of BCG vaccination.

Eficacia del colgajo uvulopalatal extendio en el manejo del ronquido simple / Efficacy of extended uvulopalatal flap for the treatment of simple snoring

El ronquido hace parte del espectro de los desórdenes respiratorios del sueño, es una entidad común,que afecta 30 porciento de los adultos; a pesar del múltiple desarrollo de terapias para su manejo, no se ha encontrado el tratamiento idealObjetivo: Determinar si hay mejoría significativa en el ronquido luego de realizar el colgajo uvulopalatal extendido.Materiales y métodos: Estudio prospectivo, donde se evaluaron 24 pacientes con diagnóstico de roncopatía, a los cuales se les realizó el colgajo uvulopalatal extendido y 6 meses posquirúrgicos, se evaluó la escala visual análoga (EVA) para ronquido, la escala de epworth y el índice de masa corporal (IMC).Resultados: Se encontró mejoría significativa del ronquido en 16/24 pacientes (67 porciento), si excluimos los pacientes con hipertrofia de base de lengua, la mejoría es en 14/19 pacientes (74 porciento), asociado a esto se encontró una mejoría en la escala de epworth en 20/24 pacientes (83 porciento). Estas diferencias fueron estadísticamente significativas (p< 0,05)Conclusiones: El colgajo uvulopalatal extendido es una buena alternativa para el manejo del ronquido.