Synthesis, characterization and structural analysis of complexes from 2,2':6',2''-terpyridine derivatives with transition metals.

The synthesis and structural characterization of three families of coordination complexes synthesized from 4'-phenyl-2,2':6',2''-terpyridine (8, Ph-TPY), 4'-(4-chlorophenyl)-2,2':6',2''-terpyridine (9, ClPh-TPY) and 4'-(4-methoxyphenyl)-2,2':6',2''-terpyridine (10, MeOPh-TPY) ligands with the divalent metals Co2+, Fe2+, Mn2+ and Ni2+ are reported. The compounds were synthesized from a 1:2 mixture of the metal and ligand, resulting in a series of complexes with the general formula [M(R-TPY)2](ClO4)2 (where M = Co2+, Fe2+, Mn2+ and Ni2+, and R-TPY = Ph-TPY, ClPh-TPY and MeOPh-TPY). The general formula and structural and supramolecular features were determinated by single-crystal X-ray diffraction for bis(4'-phenyl-2,2':6',2''-terpyridine)nickel(II) bis(perchlorate), [Ni(C21H15N3)2](ClO4)2 or [Ni(Ph-TPY)2](ClO4)2, bis[4'-(4-methoxyphenyl)-2,2':6',2''-terpyridine]manganese(II) bis(perchlorate), [Mn(C22H17N3O)2](ClO4)2 or [Mn(MeOPh-TPY)2](ClO4)2, and bis(4'-phenyl-2,2':6',2''-terpyridine)manganese(II) bis(perchlorate), [Mn(C21H15N3)2](ClO4)2 or [Mn(Ph-TPY)2](ClO4)2. In all three cases, the complexes present distorted octahedral coordination polyhedra and the crystal packing is determined mainly by weak C-H...π interactions. All the compounds (except for the Ni derivatives, for which FT-IR, UV-Vis and thermal analysis are reported) were fully characterized by spectroscopic (FT-IR, UV-Vis and NMR spectroscopy) and thermal (TGA-DSC, thermogravimetric analysis-differential scanning calorimetry) methods.

The Impact of Health Inequities on Population-Based Breast Cancer Survival in a Colombian Population, 2008-2015.

OBJECTIVE: To obtain breast cancer survival estimates in Manizales, Colombia, considering socioeconomic level, health insurance regime and residential area, while adjusting for age, histology and stage at diagnosis. METHODS: Analytical cohort study based on breast cancer incident cases recorded by the Population-based Manizales Cancer Registry between 2008-2015. Patients were followed-up for 60 months. Cause-specific survival was calculated using the Kaplan-Meier method for variables of interest, with the Wilcoxon-Breslow-Gehan test for differences. Cox multivariate regression models were fitted. RESULTS: 856 breast cancer cases were included. The 5-year cause-specific survival for the entire cohort was 78.2%. It was higher in women with special/exception health insurance, high socioeconomic level, <50 years old, ductal carcinoma, and stages I and II. Residential area did not impact survival. In Cox models, the subsidized health insurance regime (HR: 4.87 vs contributory) and low socioeconomic level (HR: 2.45 vs high) were predictors of the hazard of death in women with breast cancer, adjusted for age, histology, stage and interactions age-stage and insurance-stage. A positive interaction (synergistic effect modification) between health insurance regime and stage regarding to survival was observed. CONCLUSION: Socioeconomic factors significantly contribute to the inequities in breast cancer survival, independent of the stage at diagnosis. This suggests the need for comprehensive interventions to remove barriers to accessing the health system. This research provides evidence of survival gaps mediated by certain social determinants of health and generates data on the overall performance of the Colombian health system.

Estenosis traqueal postintubación después de neumonía grave por coronavirus / Postintubation Tracheal Stenosis after Severe Coronavirus Pneumonia

Introducción: La rápida propagación del SARS­CoV­2 ha provocado una pandemia mundial. Si bien puede salvar vidas, la intubación traqueal presenta el riesgo inherente de inducir daño en la mucosa traqueal con estenosis, con una incidencia estimada de 4,9 casos por millón cada año. Objetivo: Caracterizar la presentación de una estenosis traqueal por intubación prolongada en un paciente que sufrió neumonía grave por coronavirus. Presentación del caso: Se asiste a un paciente de 55 años que sufrió neumonía grave por coronavirus y necesitó intubación orotraqueal prolongada. Una vez recuperado comienza con disnea de empeoramiento progresivo. Se diagnostica una estenosis traqueal y se decide tratamiento quirúrgico donde se realiza resección y anastomosis. El paciente no presentó complicaciones y evolucionó satisfactoriamente. Conclusiones: La estenosis traqueal debe reconocerse como una complicación potencial, aun cuando los pacientes se recuperan de una neumonía grave por COVID-19. El diagnóstico definitivo de estenosis traqueal se realiza mediante fibrobroncoscopia. La resección traqueal con anastomosis entre tráquea y tráquea es el procedimiento más comúnmente realizado(AU)

Introduction: The rapid spread of SARS-CoV-2 has resulted in a global pandemic. Although tracheal intubation can save lives, it presents the inherent risk of inducing tracheal mucosal damage with stenosis, with an estimated annual incidence of 4.9 cases per million. Objective: To characterize a case of tracheal stenosis due to prolonged intubation in a patient with severe coronavirus pneumonia. Case presentation: A 55-year-old patient who suffered severe coronavirus pneumonia and required prolonged orotracheal intubation was attended. Once recovered, the patient began with progressively worsening dyspnea. Tracheal stenosis was diagnosed and surgical treatment was decided, in which resection and anastomosis were performed. The patient did not present any complications and evolved satisfactorily. Conclusions: Tracheal stenosis should be recognized as a potential complication, even when patients recover from severe COVID-19 pneumonia. A definitive diagnosis of tracheal stenosis is made by fibrobronchoscopy. Tracheal resection with anastomosis between trachea is the most commonly performed procedure(AU)

Mucocele apendicular benigno / Benign Appendiceal Mucocele

Introducción: El mucocele apendicular se considera una lesión rara del apéndice que se caracteriza por la dilatación de la luz del órgano con acumulación de moco. Este puede ser benigno o maligno. Objetivo: Caracterizar un caso de mucocele apendicular de comportamiento benigno en un paciente adulto masculino. Presentación del caso: Se asiste a un paciente, en estudio de tumor de vías digestivas, que se interviene quirúrgicamente con cuadro peritoneal agudo hallando masa de localización apendicular. Se realiza apendicectomía convencional y se estudia la pieza por anatomía patológica como mucocele apendicular benigno. La evolución del paciente fue satisfactoria. Conclusiones: Se presenta clínicamente de forma inespecífica, lo que posibilita que su diagnóstico sea intraoperatorio con mayor frecuencia. La estrategia quirúrgica depende de los hallazgos intraoperatorios donde la apendicectomía y la hemicolectomía derecha son las técnicas más utilizadas. El pseudomixoma peritoneal es una complicación temida(AU)

Introduction: Appendiceal mucocele is considered a rare lesion of the appendix characterized by dilatation of the organ lumen with mucus accumulation. It can be benign or malignant. Objective: To characterize a case of appendiceal mucocele with benign behavior in an adult male patient. Case presentation: A patient under study of digestive tract tumor is attended. The patient underwent surgery for having acute peritoneal symptoms; a mass of appendicular location was found. Conventional appendicectomy was performed and the piece was studied by pathological anatomy, being a benign appendicular mucocele. The patient's evolution was satisfactory. Conclusions: This condition is presented clinically in a nonspecific manner, which makes for its diagnosis to be more frequently intraoperative. The surgical strategy depends on the intraoperative findings, in which appendectomy and right hemicolectomy are the most used techniques. Pseudomyxoma peritonei is a feared complication(AU)

Acquisition of new function through gene duplication in the metallocarboxypeptidase family.

Gene duplication is a key first step in the process of expanding the functionality of a multigene family. In order to better understand the process of gene duplication and its role in the formation of new enzymes, we investigated recent duplication events in the M14 family of proteolytic enzymes. Within vertebrates, four of 23 M14 genes were frequently found in duplicate form. While AEBP1, CPXM1, and CPZ genes were duplicated once through a large-scale, likely whole-genome duplication event, the CPO gene underwent many duplication events within fish and Xenopus lineages. Bioinformatic analyses of enzyme specificity and conservation suggested a greater amount of neofunctionalization and purifying selection in CPO paralogs compared with other CPA/B enzymes. To examine the functional consequences of evolutionary changes on CPO paralogs, the four CPO paralogs from Xenopus tropicalis were expressed in Sf9 and HEK293T cells. Immunocytochemistry showed subcellular distribution of Xenopus CPO paralogs to be similar to that of human CPO. Upon activation with trypsin, the enzymes demonstrated differential activity against three substrates, suggesting an acquisition of new function following duplication and subsequent mutagenesis. Characteristics such as gene size and enzyme activation mechanisms are possible contributors to the evolutionary capacity of the CPO gene.

Incidence and mortality by cancer in the Pasto municipality, Colombia. 2013-2017.

Introduction: The information permanently produced by population cancer registries is the input used by decision makers of the local and national health systems in order for planning cancer prevention strategies and evaluating the impact of their interventions. Objective: To determine the incidence and mortality from cancer in the municipality of Pasto Colombia, 2013-2017 period. Methods: Descriptive observational study of cancer morbidity and mortality. The collection and processing of information was carried out following the recommendations of the IARC. Rates were calculated by sex, age, and tumor location. Results: The overall incidence of cancer was 3,759 cases; 1,608 in men (AAR= 169.4 cases/100,000 men-year), and 2,151 cases in women (AAR= 176.6 cases/100,000 women-year). The most frequent tumors in men were: prostate (25.9%), stomach (16.5%) and lung (4.8%); and in women: breast (19.7%), thyroid (12.2%) and cervix (10.6%). There were 2,130 cancer deaths, 934 in men (AAR=97.8 deaths/100,000 men-year) and 1,196 deaths in women (AAR=95.1 deaths/100,000 women-year). The main causes of mortality in men were tumors of the stomach (24.8%), prostate (12.8%) and lung (7.5%). In women: breast (12.2%), stomach (11.6%) and cervix (10.0%). Conclusion: The five-year follow-up of cancer burden indicators allows to make comparisons at both national and international levels, in order to provide the basis for planning and evaluating the implementation of public health policies; especially those related to the prevention and care of the most common causes of morbidity and mortality from cancer in Pasto-Colombia.

Introducción: La información producida permanentemente por los registros poblacionales de cáncer es el insumo utilizado por los tomadores de decisiones del sistema de salud local y nacional para planificar las estrategias de prevención del cáncer y evaluar el impacto de sus intervenciones. Objetivo: Determinar la incidencia y mortalidad por cáncer en el municipio de Pasto Colombia periodo 2013-2017. Métodos: Estudio observacional descriptivo de la morbimortalidad por cáncer. La recolección y procesamiento de información se realizaron siguiendo recomendaciones del IARC. Las tasas se calcularon según sexo, edad y ubicación del tumor. Resultados: La incidencia global de cáncer fue de 3.759 casos, 1.608 en hombres (Tasa Estandarizada de Edad TAE= 169.4 casos/100,000 hombres-año) y 2.151 casos en mujeres (TAE= 176.6 casos/100,000 mujeres-año). Los tumores más frecuentes en hombres fueron: próstata (25.9%), estómago (16.5%) y pulmón (4.8%) y en mujeres: mama (19.7%), tiroides (12.2%) y cérvix (10.6%). Se presentaron 2.130 muertes por cáncer, 934 en hombres (TAE=97.8 muertes/100,000 hombres-año) y 1.196 muertes en mujeres (TAE=95.1 muertes/100,000 mujeres-año). Las principales causas de mortalidad en hombres fueron los tumores de estómago (24.8%), próstata (12.8%) y pulmón (7.5%). En mujeres: mama (12.2%), estómago (11.6%) y cérvix (10.0%). Conclusión: El seguimiento quinquenal de los indicadores de carga de cáncer permite realizar comparaciones a nivel nacional e internacional con el fin de ofrecer las bases para planificar y evaluar la implementación de las políticas públicas de salud, relacionadas con la prevención y atención de las causas más comunes de morbimortalidad en Pasto-Colombia.

Sociodemographic and clinical characteristics related to the final condition of patients intoxicated by paraquat in a hospital in southwestern Colombia / Características sociodemográficas y clínicas relacionadas con la condición final de pacientes intoxicados por paraquat en un hospital del suroccidente de Colombia.

Introduction: Paraquat is an agrochemical that constitutes the first cause of death by poisoning in different countries. Objective: To relate sociodemographic and clinical characteristics with the final condition of patients intoxicated by paraquat in a hospital in southwestern Colombia. Materials and methods: This was an observational, descriptive, analytical, crosssectional, and retrospective study. We reviewed the medical records of patients diagnosed with paraquat poisoning at a level III hospital in Pasto, Colombia, from 2013 to 2018. We collected the data regarding their final condition (alive or deceased) and their sociodemographic, clinical, and paraclinical information. We established group comparisons and designed a binary logistic regression model. Results: We reviewed 299 records and, after the exclusion, we analyzed 160 cases. The characteristics related to the final condition of the patients were length of stay (OR = 0.124; 95% CI: 0.03-0.6; p = 0.009), heart rate (OR = 35.65; 95% CI: 1.44-884.78; p = 0.029), and initial creatinine (OR = 1.73; 95% CI: 1.23-2.44; p = 0.002). Conclusion: The proportion of case fatality was higher in patients with short hospital stay times and elevated heart rates and admission creatinine levels. This report may be useful as a rationale for the creation of a severity scale for the early detection of patients with adverse outcomes and their timely treatment.

Introducción. El herbicida paraquat constituye la primera causa de decesos por intoxicaciones en distintos países. Objetivo. Relacionar las características sociodemográficas y clínicas con la condición final de pacientes intoxicados por paraquat atendidos en un hospital del suroccidente de Colombia. Materiales y métodos. En este estudio observacional, descriptivo, analítico, transversal y retrospectivo, se revisaron las historias clínicas de pacientes atendidos por intoxicación con paraquat en una institución de tercer nivel de complejidad en Pasto (Colombia) entre el 2013 y el 2018. Se recolectó la información sobre la condición final (vivo o fallecido) de cada paciente, así como los datos sociodemográficos, clínicos y de los exámenes paraclínicos. Se establecieron comparaciones por grupos y se diseñó un modelo de regresión logística binaria. Resultados. Se filtró la información de 299 registros y se analizaron finalmente 160 casos. Las características relacionadas con la condición final de los pacientes fueron el tiempo de estancia (OR=0,124; IC95% 0,03-0,6; p=0,009), la frecuencia cardiaca (OR=35,65; IC95% 1,44-884,78; p=0,029) y la creatinina inicial (OR=1,73; IC95% 1,23-2,44; p=0,002). Conclusiones. La proporción de la letalidad fue mayor entre los pacientes con estancia hospitalaria corta, taquicardia y elevación de la concentración sérica de creatinina al ingreso. Este reporte puede ser útil como fundamento de una escala de gravedad para detectar a los pacientes con resultados adversos en la fase temprana para que puedan recibir una intervención oportuna.

Características sociodemográficas y clínicas relacionadas con la condición final de pacientes intoxicados por paraquat en un hospital del suroccidente de Colombia / Sociodemographic and clinical characteristics related to the final condition of patients intoxicated by paraquat in a hospital in southwestern Colombia

Introducción. El herbicida paraquat constituye la primera causa de decesos por intoxicaciones en distintos países. Objetivo. Relacionar las características sociodemográficas y clínicas con la condición final de pacientes intoxicados por paraquat atendidos en un hospital del suroccidente de Colombia. Materiales y métodos. En este estudio observacional, descriptivo, analítico, transversal y retrospectivo, se revisaron las historias clínicas de pacientes atendidos por intoxicación con paraquat en una institución de tercer nivel de complejidad en Pasto (Colombia) entre el 2013 y el 2018. Se recolectó la información sobre la condición final (vivo o fallecido) de cada paciente, así como los datos sociodemográficos, clínicos y de los exámenes paraclínicos. Se establecieron comparaciones por grupos y se diseñó un modelo de regresión logística binaria. Resultados. Se filtró la información de 299 registros y se analizaron finalmente 160 casos. Las características relacionadas con la condición final de los pacientes fueron el tiempo de estancia (OR=0,124; IC95% 0,03-0,6; p=0,009), la frecuencia cardiaca (OR=35,65; IC95% 1,44-884,78; p=0,029) y la creatinina inicial (OR=1,73; IC95% 1,23-2,44; p=0,002). Conclusiones. La proporción de la letalidad fue mayor entre los pacientes con estancia hospitalaria corta, taquicardia y elevación de la concentración sérica de creatinina al ingreso. Este reporte puede ser útil como fundamento de una escala de gravedad para detectar a los pacientes con resultados adversos en la fase temprana para que puedan recibir una intervención oportuna.

Introduction: Paraquat is an agrochemical that constitutes the first cause of death by poisoning in different countries. Objective: To relate sociodemographic and clinical characteristics with the final condition of patients intoxicated by paraquat in a hospital in southwestern Colombia. Materials and methods: This was an observational, descriptive, analytical, crosssectional, and retrospective study. We reviewed the medical records of patients diagnosed with paraquat poisoning at a level III hospital in Pasto, Colombia, from 2013 to 2018. We collected the data regarding their final condition (alive or deceased) and their sociodemographic, clinical, and paraclinical information. We established group comparisons and designed a binary logistic regression model. Results: We reviewed 299 records and, after the exclusion, we analyzed 160 cases. The characteristics related to the final condition of the patients were length of stay (OR = 0.124; 95% CI: 0.03-0.6; p = 0.009), heart rate (OR = 35.65; 95% CI: 1.44-884.78; p = 0.029), and initial creatinine (OR = 1.73; 95% CI: 1.23-2.44; p = 0.002). Conclusion: The proportion of case fatality was higher in patients with short hospital stay times and elevated heart rates and admission creatinine levels. This report may be useful as a rationale for the creation of a severity scale for the early detection of patients with adverse outcomes and their timely treatment.

Incidence and mortality by cancer in the Pasto municipality, Colombia. 2013-2017 / Incidencia y mortalidad por cáncer en el municipio de Pasto - Colombia, 2013-2017

Abstract Introduction: The information permanently produced by population cancer registries is the input used by decision makers of the local and national health systems in order for planning cancer prevention strategies and evaluating the impact of their interventions. Objective: To determine the incidence and mortality from cancer in the municipality of Pasto Colombia, 2013-2017 period. Methods: Descriptive observational study of cancer morbidity and mortality. The collection and processing of information was carried out following the recommendations of the IARC. Rates were calculated by sex, age, and tumor location. Results: The overall incidence of cancer was 3,759 cases; 1,608 in men (AAR= 169.4 cases/100,000 men-year), and 2,151 cases in women (AAR= 176.6 cases/100,000 women-year). The most frequent tumors in men were: prostate (25.9%), stomach (16.5%) and lung (4.8%); and in women: breast (19.7%), thyroid (12.2%) and cervix (10.6%). There were 2,130 cancer deaths, 934 in men (AAR=97.8 deaths/100,000 men-year) and 1,196 deaths in women (AAR=95.1 deaths/100,000 women-year). The main causes of mortality in men were tumors of the stomach (24.8%), prostate (12.8%) and lung (7.5%). In women: breast (12.2%), stomach (11.6%) and cervix (10.0%). Conclusion: The five-year follow-up of cancer burden indicators allows to make comparisons at both national and international levels, in order to provide the basis for planning and evaluating the implementation of public health policies; especially those related to the prevention and care of the most common causes of morbidity and mortality from cancer in Pasto-Colombia.

Resumen Introducción: La información producida permanentemente por los registros poblacionales de cáncer es el insumo utilizado por los tomadores de decisiones del sistema de salud local y nacional para planificar las estrategias de prevención del cáncer y evaluar el impacto de sus intervenciones. Objetivo: Determinar la incidencia y mortalidad por cáncer en el municipio de Pasto Colombia periodo 2013-2017. Métodos: Estudio observacional descriptivo de la morbimortalidad por cáncer. La recolección y procesamiento de información se realizaron siguiendo recomendaciones del IARC. Las tasas se calcularon según sexo, edad y ubicación del tumor. Resultados: La incidencia global de cáncer fue de 3.759 casos, 1.608 en hombres (Tasa Estandarizada de Edad TAE= 169.4 casos/100,000 hombres-año) y 2.151 casos en mujeres (TAE= 176.6 casos/100,000 mujeres-año). Los tumores más frecuentes en hombres fueron: próstata (25.9%), estómago (16.5%) y pulmón (4.8%) y en mujeres: mama (19.7%), tiroides (12.2%) y cérvix (10.6%). Se presentaron 2.130 muertes por cáncer, 934 en hombres (TAE=97.8 muertes/100,000 hombres-año) y 1.196 muertes en mujeres (TAE=95.1 muertes/100,000 mujeres-año). Las principales causas de mortalidad en hombres fueron los tumores de estómago (24.8%), próstata (12.8%) y pulmón (7.5%). En mujeres: mama (12.2%), estómago (11.6%) y cérvix (10.0%). Conclusión: El seguimiento quinquenal de los indicadores de carga de cáncer permite realizar comparaciones a nivel nacional e internacional con el fin de ofrecer las bases para planificar y evaluar la implementación de las políticas públicas de salud, relacionadas con la prevención y atención de las causas más comunes de morbimortalidad en Pasto-Colombia.

Hipoglucemia hiperinsulínica en un adulto con nesidioblastosis / Hyperinsulinic Hypoglycemia in an Adult with Nesidioblastosis

RESUMEN Introducción: La Nesidioblastosis es una rara afección pancreática que provoca hipoglucemia por hipersinsulinismo endógeno en la infancia. Es poco habitual en el adulto; solo se han publicado casos aislados desde su descripción. Objetivo: Caracterizar la presentación de una hipoglucemia hiperinsulínica en un paciente adulto con Nesidioblastosis. Caso clínico: Paciente adulto de 35 años, blanco, sexo masculino, sospecha de insulinoma, con episodios de hipoglucemia en ayunas o tras un ejercicio que revertía con la ingesta de alimentos o soluciones glucosadas. Se le realizó pancreatectomía de un 85 por ciento y en el estudio histológico se detectó una Nesidioblastosis. Conclusiones: Es infrecuente en el adulto, realizar su diagnóstico es difícil, se llega a la cirugía con el conocimiento de un estado hiperinsulínico endógeno, sin la certeza de su origen(AU)

ABSTRACT Introduction: Nesidioblastosis is a rare pancreatic condition that causes hypoglycemia due to endogenous hypersinsulinism in childhood. It is unusual in adults; only isolated cases have been published including its description. Objective: To characterize a case of hyperinsulinic hypoglycemia, in an adult patient with nesidioblastosis. Clinical case: A 35-year-old, white, male, adult patient with suspected insulinoma, with episodes of hypoglycemia in the fasting state or after exercise that was reversed with ingestion of food or glucose solutions. 85 percent pancreatectomy was performed and nesidioblastosis was detected in the histological study. Conclusions: It is rare in adults, making its diagnosis is difficult, and surgery is reached with the knowledge of an endogenous hyperinsulinic state, without the certainty of its origin(AU)

Epidemiologic Profile of Erectile Dysfunction in Patients with Systemic Lupus Erythematosus: The Latin American Landscape.

OBJECTIVE: The aim of this study was to describe the prevalence of erectile dysfunction (ED), as well as associated demographic and clinical features, in men with systemic lupus erythematosus (SLE), by means of a systematic, standardized evaluation. METHODS: We performed a transversal study in 8 tertiary care centers in Latin America. We included male patients ≥ 16 years who fulfilled ≥ 4 American College of Rheumatology criteria for SLE and had regular sexual activity, and evaluated them with the International Index of Erectile Function-5 questionnaire. Relevant demographic, clinical, and serological characteristics were recorded. We included 2 control groups: the first was made up of healthy men and the second of men with autoimmune diseases other than SLE (non-SLE group). RESULTS: We included 590 subjects (174 SLE, 55 non-SLE, and 361 healthy controls). The prevalence of ED in the SLE group was 69%. Mean age in that group was 36.3 ± 1.03 years. Among SLE patients with and without ED, these factors were significantly different: the presence of persistent lymphopenia (p = 0.006), prednisone dose (9.3 ± 1.2 vs 5.3 ± 1.3 mg, p = 0.026), and the Systemic Lupus International Collaborating Clinics damage score (1.25 ± 0.14 vs 0.8 ± 0.16 points, p = 0.042). Independent risk factors for ED in patients with SLE were persistent lymphopenia (OR 2.79, 95% CI 1.37-5.70, p = 0.001) and corticosteroid use in the previous year (OR 2.15, 95% CI 1.37-3.37, p = 0.001). CONCLUSION: Regardless of comorbidities, treatment (excluding steroids), and type of disease activity, patients with SLE have a high prevalence of ED, especially considering that most patients are young. Recent corticosteroid use and persistent lymphopenia, which could be related to endothelial dysfunction, are risk factors for this complication in men with SLE.

Mechanisms of action of paraoxon, an organophosphorus pesticide, on in vivo dopamine release in conscious and freely moving rats.

Paraoxon is the active metabolite of parathion, an organophosphorus pesticide which can cause neurotoxic effects in animals and humans. In the present work, we investigated the effects of 5 mM paraoxon on striatal dopamine, DOPAC and HVA levels in conscious and freely moving rats, after treatment with TTX, reserpine, nomifensine, KCl, Ca++-free/EDTA medium, AP-5 or L-NAME. The intrastriatal administration of paraoxon for 60 min, through the microdialysis probe, significantly produced an increase of the dopamine to 1066 ±â€¯120%, relative to basal levels. Administration of paraoxon to 20 µM TTX, 10 mg/kg reserpine or Ca++-free/EDTA medium-pretreated animals decreased the dopamine levels to 73%, 81%, and 70%, respectively, when compared with the effect of 5 mM paraoxon. Infusion of 50 µM nomifensine induced a maximal increase in extracellular dopamine levels to 1435 ±â€¯387%, and when nomifensine was coadministered with paraoxon, striatal dopamine levels increased to 2429 ±â€¯417%, an increase that was ∼230% higher that observed with the administration of the pesticide alone. Coinfusion of KCl and paraoxon produced an increase in extracellular dopamine to 1957 ±â€¯445%, that was significantly higher than that observed with POX or KCl (1104 ±â€¯220%) administered individually. Pretreatment with 650 µM AP-5 or 100 L-NAME reduced the effect of paraoxon on extracellular dopamine levels by 49.1% and 53.7%, respectively. Our results suggest that paraoxon induces dopamine release by a vesicular-, Ca++-, and deporalization-dependent mechanism, being independent of dopamine transporter. In addition, the paraoxon-induced dopamine release is mediated by glutamatergic and nitrergic neurotransmitter systems.

Characterization of acute intrastriatal effects of paraoxon on in vivo dopaminergic neurotransmission using microdialysis in freely moving rats.

Paraoxon (POX) is an extremely neurotoxic organophosphorous compound (OP) which main toxic mechanism is the irreversible inhibition of cholinesterase. Although the cholinergic system has always been linked as responsible for its acute effects, experimental studies have suggested that the dopaminergic system also may be a potential target for OPs. Based on this, in this study, the acute intrastriatal effects of POX on dopaminergic neurotransmission were characterized in vivo using brain microdialysis in freely moving rats. In situ administration of POX (5, 25 and 50 nmol, 60 min) significantly increased the striatal dopamine overflow (to 435 ± 79%, 1066 ± 120%, and 1861 ± 332%, respectively), whereas a lower concentration (0.5 nmol) did not affect dopamine levels. Administration of POX (25 nmol) to atropine (15 nmol) pretreated animals, produced an increase in dopamine overflow that was ∼63% smaller than those observed in animals not pretreated. Administration of POX (25 nmol) to mecamylamine (35 nmol) pretreated animals did not significantly affect the POX-induced dopamine release. Our results suggest that acute administration of POX increases the dopamine release in a concentration-dependent way, being this release dependent on acetylcholinesterase inhibition and mediated predominantly by the activation of striatal muscarinic receptors, once the muscarinic antagonist atropine partially blocks the POX-induced dopamine release.

Calidad percibida de la atención en salud en una red pública del municipio de Pasto, Colombia / Perceived quality of health care in a public network in the municipality of Pasto, Colombia

Resumen Introducción: Las percepciones de los usuarios frente a los servicios de salud son indicadores indispensables de calidad sobre procesos de atención sanitaria. Objetivo: Conocer las percepciones de los usuarios de una red pública del municipio de Pasto, Colombia frente a la calidad de los servicios de salud del primer nivel de atención. Materiales y métodos: Investigación cualitativa con enfoque histórico hermenéutico con 28 participantes, usuarios de centros de atención rurales y urbanos. Las técnicas de recolección de información desarrolladas fueron entrevistas semiestructuradas y un grupo focal. El proceso investigativo abordó las dimensiones: confianza, fiabilidad, responsabilidad, capacidad de respuesta y tangibilidad. Resultados: En las dimensiones se identificaron como limitantes en la calidad, dificultades de acceso por aspectos administrativos y geográficos, problemas en la oportunidad en la atención especializada, fallas en la referencia y contra referencia y la necesidad de generar mejoras en la infraestructura de las IPS. Se reconoció que el buen trato del personal asistencial es un aspecto que incide de manera positiva en la percepción de la calidad. Conclusiones: Mejorar la calidad de los servicios sanitarios, requiere reconocer a los usuarios como el centro de la atención, con miras a la integralidad, continuidad, eficacia, eficiencia y la equidad de los servicios, bajo el imperante fundamental de la garantía y protección del derecho a la salud y a la vida digna de los pacientes.

Abstract Introduction: Perceptions of users from the health services are indispensable indicators for quality on the processes of health care. Objective: To know the perceptions of the users of a public network of the municipality of Pasto, Colombia versus the quality of health services at the first level of attention. Materials and methods: A qualitative research with a hermeneutic historical approach was conducted with 28 participants, who were users of rural and urban centers of care. The techniques developed for collecting the information were semi-structured interviews and a focal group. The research process addressed five dimensions: trust, reliability, responsibility, responsiveness and tangibility. Results: In the dimensions mentioned before, the difficulties of access by administrative and geographical aspects, problems in the opportunity in the specialized attention, faults in the reference and counter-reference and the necessity of infrastructure improvements in the IPS were identified as limitations in the quality. Moreover, it was recognized that the good treatment of the healthcare personnel is an aspect that affects in a positive way in the perception of the quality. Conclusions: Improving the quality of health services, requires recognizing users as the center of attention, with a view to the integrality, continuity, efficiency, efficiency and fairness of services, under the fundamental principle of guarantee and protection of the right to health and life worthy of patients.

Percepciones de un grupo de epidemiólogos en formación acerca de su propia vejez / Perceptions about their own old age from the perspective of a group of epidemiologists in training

RESUMEN Objetivo Explorar desde la mirada de un grupo de epidemiólogos en formación, las percepciones sobre su propia vejez. Material y Métodos Estudio exploratorio, cualitativo - descriptivo, en el cual se hizo aplicación de herramientas etnográficas: observación, diario de campo y entrevista grupal (GF). Resultados El grupo consensuo que programarse para llegar a una vejez funcional y digna es importante, a pesar de las desfavorables y adversas condiciones actuales, reconociendo que no todos lograrán llegar a ella, y que es menos común en los jóvenes pensar y planear su propia vejez, y menos trabajar con y para los viejos. Los significados sobre vejez más frecuentemente referidos por el grupo contienen la palabra "etapa", en cuyo concepto y cuidados se reflejan los altos estándares deseados a nivel individual. Se puso de manifiesto que los hogares para ancianos son necesarios, pero que los servicios prestados son diferenciados pues "la economía determina la atención para el anciano". Conclusión La reflexión acerca de la percepción de la propia vejez, para el grupo de epidemiólogos en formación, ayudó a visualizar sus inquietudes, miedos, expectativas y a reflexionar acerca de su responsabilidad y posibilidades en el aporte de evidencia científica que permita planear y tomar decisiones acertadas para un envejecimiento y vejez dignas de la población nariñense.(AU)

ABSTRACT Objective Exploring, from the perspective of a group of epidemiologists in training, the perceptions about their own old age. Material and Methods Exploratory, qualitative-descriptive study, in which ethnographic tools were applied: observation, field diary and group interview (GF). Resultados Explored from the perspective of a group of epidemiologists in training. The group agreed that to plan to reach a functional and decent old is important, despite the current unfavorable and adverse conditions, recognizing that not all will reach there, and it is less common for young people to think and plan their own old age, and even less work with and for the elderly. The meaning of aging most often mentioned by the group contain the word "phase", in which concept and care reflect the high standards desired individually. It became clear, that nursing homes for old age people are necessary, but the services provided are differentiated since "the economy determines the care for the elderly". Conclusion Reflecting on the perception of old age itself, for the group of epidemiologists in training, helped visualize their concerns, fears, expectations, and to reflect on their responsibilities and possibilities in providing scientific evidence to plan and make sound decisions for a dignified old age and aging of the population from Nariño.(AU)

Determinantes sociodemográficos y clínicos asociados a mortalidad fetal intrauterina en el municipio de Pasto, 2010-2012 / Demographic and clinical determinants associated with intrauterine fetal mortality in the municipality of Pasto, 2010-2012

Resumen Introducción: La mortalidad fetal intrauterina (MFIU) es un problema de salud pública por sus elevadas tasas a nivel mundial y en poblaciones de ingresos medios y bajos. Sin embargo, es un evento poco estudiado y carece de visibilidad en las políticas, planes y programas de salud pública. Objetivo: Analizar los determinantes sociodemográficos y clínicos asociados a la MFIU en Pasto-Colombia. Materiales y métodos: Estudio analítico observacional con 88 muertes fetales como casos y 88 nacidos vivos como controles, ocurridas en hospitales de tercer nivel en el municipio de Pasto-Colombia durante 2010-2012, para determinar la relación entre mortalidad fetal, condiciones clínicas (complicaciones del embarazo, edad gestacional, peso al nacer, controles prenatales, antecedentes obstétricos, tóxicos o aborto) y sociodemográficas (edad, etnia, ocupación, estado civil, estrato, zona de residencia, escolaridad, paridad, condición de desplazamiento, embarazo planeado). Resultados: Se identificó que el riesgo de mortalidad fetal es significativamente menor con el incremento de la edad gestacional (OR ajustado=0,76 IC95% 0,62; 0,93) y el peso al nacer (OR ajustado=0,99 IC95% 0,98; 0,99). Otras variables clínicas y sociodemográficas no se asociaron. Conclusión: Los resultados proveen evidencia para la planificación de planes de intervención que prioricen a mujeres cuyo feto tenga un peso inferior al normal y un riesgo de nacimiento prematuro.

Abstract Introduction: Intrauterine fetal mortality (IUFM) is a public health problem because of its high rates worldwide and in low-and middle-income populations. However, it is a little-studied event and lacks visibility in public health policies, plans and programs. Objective: To analyze the sociodemographic and clinical determinants associated with IUFM in Pasto-Colombia. Materials and methods: A study, that includes 88 fetal deaths as cases and 88 live births as controls occurred in third level hospitals in Pasto-Colombia during 2010 and 2012, was carried out to determine the relationship between fetal mortality, clinical conditions (complications of pregnancy, gestational age, birth weight, prenatal controls, pathological and toxic medical history, or abortion) and sociodemographic conditions (age, ethnicity, occupation, marital status, stratum, area of residence , schooling, parity, displacement condition, planned pregnancy). Results: It was identified that the risk of fetal mortality is significantly lower with the increase in gestational age (OR ajustado = 0.76 IC95% 0.62; 0.93) and birth weight (OR ajustado = 0.99 IC95% 0.98; 0.99). Other clinical and sociodemographic variables were not associated. Conclusion: The results provide evidence for planning intervention plans that prioritize women whose fetus has a lower-than-normal weight and a risk of premature birth.

[Perceptions about their own old age from the perspective of a group of epidemiologists in training]. / Percepciones de un grupo de epidemiólogos en formación acerca de su propia vejez.

OBJECTIVE: Exploring, from the perspective of a group of epidemiologists in training, the perceptions about their own old age. MATERIAL AND METHODS: Exploratory, qualitative-descriptive study, in which ethnographic tools were applied: observation, field diary and group interview (GF). RESULTADOS: Explored from the perspective of a group of epidemiologists in training. The group agreed that to plan to reach a functional and decent old is important, despite the current unfavorable and adverse conditions, recognizing that not all will reach there, and it is less common for young people to think and plan their own old age, and even less work with and for the elderly. The meaning of aging most often mentioned by the group contain the word "phase", in which concept and care reflect the high standards desired individually. It became clear, that nursing homes for old age people are necessary, but the services provided are differentiated since "the economy determines the care for the elderly". CONCLUSION: Reflecting on the perception of old age itself, for the group of epidemiologists in training, helped visualize their concerns, fears, expectations, and to reflect on their responsibilities and possibilities in providing scientific evidence to plan and make sound decisions for a dignified old age and aging of the population from Nariño.

OBJETIVO: Explorar desde la mirada de un grupo de epidemiólogos en formación, las percepciones sobre su propia vejez. MATERIAL Y MÉTODOS: Estudio exploratorio, cualitativo - descriptivo, en el cual se hizo aplicación de herramientas etnográficas: observación, diario de campo y entrevista grupal (GF). RESULTADOS: El grupo consensuo que programarse para llegar a una vejez funcional y digna es importante, a pesar de las desfavorables y adversas condiciones actuales, reconociendo que no todos lograrán llegar a ella, y que es menos común en los jóvenes pensar y planear su propia vejez, y menos trabajar con y para los viejos. Los significados sobre vejez más frecuentemente referidos por el grupo contienen la palabra "etapa", en cuyo concepto y cuidados se reflejan los altos estándares deseados a nivel individual. Se puso de manifiesto que los hogares para ancianos son necesarios, pero que los servicios prestados son diferenciados pues "la economía determina la atención para el anciano". CONCLUSIÓN: La reflexión acerca de la percepción de la propia vejez, para el grupo de epidemiólogos en formación, ayudó a visualizar sus inquietudes, miedos, expectativas y a reflexionar acerca de su responsabilidad y posibilidades en el aporte de evidencia científica que permita planear y tomar decisiones acertadas para un envejecimiento y vejez dignas de la población nariñense.

Fortalecimiento Institucional de Procesos Asociativos Rurales en Uruguay: modelos de desarrollo, grupalidad y organizaciones del trabajo / Institutional Strengthening of Rural Associative Processes in Uruguay: models of development, group and work organizations / Fortalecimento Institucional dos Processos Associativos Rurais no Uruguai: modelos de desenvolvimento, grupalidade e organizações do trabalho / Renforcement Institutionnel de Processus Associatif Rural en Uruguay: des modeles de developpement, groupage et des organisations du travail

El presente artículo busca aportar a la discusión sobre el Fortalecimiento Institucional de procesos asociativos rurales en Uruguay. Desde la década del '90 los gobiernos uruguayos han trabajado en fortalecer este sector de la producción a través de diversas políticas que llegan hasta la actualidad. En este sentido cabe preguntarse ¿De qué forma se busca fortalecer la institucionalidad de los procesos asociativos? Y ¿Como impacta en las organizaciones los efectos de estas políticas públicas? Para buscar dar respuesta a estas problemáticas se realizó un abordaje desde un enfoque territorial de las ruralidades y desde la Psicología de las Organizaciones y el Trabajo (POT). La invitación es, además, a realizar un recorrido por más de dos décadas de políticas de apoyo a los procesos asociativos de productores familiares y asalariados, teniendo en cuenta los aspectos macro-políticos, económicos y sociales que afectan al agro uruguayo.

This article seeks to contribute on the discussion of Institutional Strengthening of rural associative processes in Uruguay. Since the 90s, Uruguayan governments have worked to strengthen this sector of production through various policies that have reached the present day. In this sense, it is necessary to ask: How is it sought to strengthen the institutionality of associative processes? And how do the effects of these public policies impact on organizations? In order to answer these problems, an approach will be taken from a territorial focus of the ruralities and from the Psychology of Organizations and Work (POT). The invitation is also to make a journey through more than two decades of policies to support the associative processes of family producers and wage earners, taking into account the macro-political, economic and social aspects that affect Uruguayan agriculture.

Este artigo busca contribuir para a discussão sobre fortalecimento institucional dos processos associativos rurais no Uruguai. Desde 1990 os governos uruguaios trabalharam para fortalecer este setor de produção através de várias políticas que vão ter continuidade até a atualidade. Neste sentido, é necessário perguntar-se: como se busca fortalecer a institucionalidade dos processos associativos? E como estas políticas públicas afetam as organizações? Para responder a esses questões, realizou-se uma abordagem territorial das ruralidades e da Psicologia das Organizações e o Trabalho (POT). O convite também é fazer um recorrido através de mais de duas décadas de políticas orientadas a apoiar os processos associativos dos produtores familiares e assalariados, levando em consideração os aspectos macro-políticos, econômicos e sociais que afetam o agro uruguaio.

L article présente cherche apporter la discussion sur le renforcement de processus associatifs rural en Uruguay. Depuis les années 90 les gouvernements uruguayens ont travaillé pour ce secteur de la production à travers de divers politiques jusqu'à la actualité. Dans ce cas il faut se demander de De quelle façon on cherche fortifier linstutinnalité des processus associatifs? Et Comment percute dans les organisations les effets de ces politiques publiques? Pour pouvoir répondre ce problème on fera un abordage a partir d'un point de vue territorialité des ruralités et de la Psychologie des Organisations et du Travail (POT)

Adenoma paratiroideo. Presentación de un caso / Parathyroid adenoma. Case presentation

El adenoma paratiroideo es un tumor no canceroso de las glándulas paratiroides, que aumenta los niveles de parathormona. Esta hormona regula los niveles de calcio, fósforo y vitamina D en sangre y huesos. Su triada clásica se caracteriza por aumento de los niveles de parathormona, hipercalcemia e hipofosfatemia. Esta entidad afecta a uno entre 500-1000 habitantes y es la causa principal de hiperparatiroidismo primario en un 80- 85 % de los pacientes. Se presenta el caso de una paciente femenina de 69 años de edad, ingresada por fracturas patológicas de cadera, clavícula y dedos de las manos, causada por hiperparatiroidismo primario originado por adenoma paratiroideo. Por la baja incidencia esta entidad, su publicación se considera de interés para el personal científico.

Parathyroid Adenoma is a non-malignant tumor of the thyroid glands, which increases the levels of parathormone. This hormone regulates blood and bone levels of calcium, phosphorus and Vitamin D. Its classic triad is characterized by the increase of the levels of parathormone, hyperkalimia and Hipophosphatemia. This entity affects between 500-1000 inhabitants and is the main cause of primary Hyperparathyroidism in about 80-85% of the patients. It is presented a case of a 69 year old female patient, admitted due to pathologic fractures of hip, clavicle, and fingers, caused by primary hyperparathyroidism originated by parathyroid adenoma. For the low incidence of this entity, its publication is considered of interest for the scientific staff.