mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial.

BACKGROUND: Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. OBJECTIVES: The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. METHOD: A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). CONCLUSIONS: It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04659746.

3-Nitrooxypropanol substantially decreased enteric methane emissions of dairy cows fed true protein- or urea-containing diets.

Methane is a potent but short-lived greenhouse gas targeted for short-term amelioration of climate change, with enteric methane emitted by ruminants being the most important anthropogenic source of methane. Ruminant production also releases nitrogen to the environment, resulting in groundwater pollution and emissions of greenhouse gas nitrous oxide. We hypothesized that inhibiting rumen methanogenesis in dairy cows with chemical inhibitor 3-nitrooxypropanol (3-NOP) would redirect metabolic hydrogen towards synthesis of microbial amino acids. Our objective was to investigate the effects of 3-NOP on methane emissions, rumen fermentation and nitrogen metabolism of dairy cows fed true protein or urea as nitrogen sources. Eight ruminally-cannulated cows were fed a plant protein or a urea-containing diet during a Control experimental period followed by a methanogenesis inhibition period with 3-NOP supplementation. All diets were unintentionally deficient in nitrogen, and diets supplemented with 3-NOP had higher fiber than diets fed in the Control period. Higher dietary fiber content in the 3-NOP period would be expected to cause higher methane emissions; however, methane emissions adjusted by dry matter and digested organic matter intake were 54% lower with 3-NOP supplementation. Also, despite of the more fibrous diet, 3-NOP shifted rumen fermentation from acetate to propionate. The post-feeding rumen ammonium peak was substantially lower in the 3-NOP period, although that did not translate into greater rumen microbial protein production nor lesser nitrogen excretion in urine. Presumably, because all diets resulted in low rumen ammonium, and intake of digestible organic matter was lower in the 3-NOP period compared to the Control period, the synthesis of microbial amino acids was limited by nitrogen and energy, precluding the evaluation of our hypothesis. Supplementation with 3-NOP was highly effective at decreasing methane emissions with a lower quality diet, both with true protein and urea as nitrogen sources.

MQL Strategies Applied in Ti-6Al-4V Alloy Milling-Comparative Analysis between Experimental Design and Artificial Neural Networks.

This paper presents a study of the Ti-6Al-4V alloy milling under different lubrication conditions, using the minimum quantity lubrication approach. The chosen material is widely used in the industry due to its properties, although they present difficulties in terms of their machinability. A minimum quantity lubrication (MQL) prototype valve was built for this purpose, and machining followed a previously defined experimental design with three lubrication strategies. Speed, feed rate, and the depth of cut were considered as independent variables. As design-dependent variables, cutting forces, torque, and roughness were considered. The desirability optimization function was used in order to obtain the best input data indications, in order to minimize cutting and roughness efforts. Supervised artificial neural networks of the multilayer perceptron type were created and tested, and their responses were compared statistically to the results of the factorial design. It was noted that the variables that most influenced the machining-dependent variables were the feed rate and the depth of cut. A lower roughness value was achieved with MQL only with the use of cutting fluid with graphite. Statistical analysis demonstrated that artificial neural network and the experimental design predict similar results.

The Reduction of Methane Production in the In Vitro Ruminal Fermentation of Different Substrates is Linked with the Chemical Composition of the Essential Oil.

There is interest in identifying natural products capable of manipulating rumen microbial activity to develop new feed additives for ruminant nutrition as a strategy to reduce methane. Two trials were performed using the in vitro gas production technique to evaluate the interaction of substrate (n = 5) and additive (n = 6, increasing doses: 0, 0.3, 3, 30, and 300 µL/L of essential oils-EO-of Lippia turbinata or Tagetes minuta, and monensin at 1.87 mg/L). The two EO utilized were selected because they differ markedly in their chemical composition, especially in the proportion of oxygenated compounds. For both EO, the interaction between the substrate and additive was significant for all variables; however, the interaction behaved differently for the two EO. Within each substrate, the response was dose-dependent, without effects at a low level of EO and a negative outcome at the highest dose. The intermediate dose (30 µL/L) inhibited methane with a slight reduction on substrate digestibility, with L. turbinata being more effective than T. minuta. It is concluded that the effectiveness of the EO to reduce methane production depends on interactions between the substrate that is fermented and the additive dose that generates different characteristics within the incubation medium (e.g., pH); and thus, the chemical nature of the compounds of the EO modulates the magnitude of this response.

Monitorización automática de estados de sedación en señales electroencefalográficas / Automatic monitoring of sedation states in electroencephalographic signals

La anestesia general proporciona al paciente estados de inconciencia, amnesia y analgesia, sin embargo, se reportan casos de despertar intraoperatorio. Debido a la incidencia de este fenómeno y sus efectos psicosomáticos, el Centro de Estudios de Neurociencias, Procesamiento de Imágenes y Señales en la Universidad de Oriente, y el Hospital General Juan Bruno Zayas Alfonso ambos en Santiago de Cuba, Cuba, implementan una metodología que permita detectar automáticamente estados de sedación anestésica aplicando Inteligencia Artificial. Para esto se emplearon las señales registradas por el canal electroencefalográfico F4, nueve parámetros espectrales, las Máquinas de Soporte Vectorial y los Sistemas Neuro-Difusos. En el reconocimiento automático de los estados de Sedación Profunda, Moderada y Ligera se logró una Exactitud de 96.12 por ciento, 90.06 por ciento y 90.24 por ciento respectivamente con las Máquinas de Soporte Vectorial, por lo que se propone el uso del canal electroencefalográfico F4 en la detección de estados anestésicos(AU)

General anesthesia provide the patient states of unconsciousness, amnesia and analgesia, however, cases of intraoperative awareness are reported. Due to the incidence of this phenomenon and the psychosomatic effects it causes, the Neuroscience Studies Center, Images and Signals Processing at the University of Oriente, and the General Hospital Juan Bruno Zayas Alfonso both in Santiago de Cuba, Cuba, implement a methodology that allows the automatic detection of anesthetic sedation states applying Artificial Intelligence. For this, the signals recorded by the electroencephalographic channel F4, nine spectral parameters, the Support Vector Machines and the Neuro-Fuzzy Systems were used. In the automatic recognition of the Sedation States: Profound, Moderate and Mild an Accuracy of 96.12 percent, 90.06 percent and 90.24 percent respectively was achieved with the Support Vector Machines, so the use of the electroencephalographic channel F4 is proposed in the detection of anesthetic states(AU)

Síndrome. Empleo inadecuado del término en la Discusión Diagnóstica. Semejanzas y divergencias en el criterio de expertos / Inappropriate use of the term Syndrome in the Diagnostic Discussion. Similarities and divergences in the criterion of experts

Introducción: hay casos de uso inadecuado del término síndrome en la discusión diagnóstica, en el Hospital Universitario V.I. Lenin de Holguín, lo que puede deberse a diversos factores. Objetivo: identificar, según el criterio de expertos, si existen en otras provincias de Cuba casos de uso inadecuado del término síndrome en la discusión diagnóstica, su repercusión negativa en el diagnóstico médico, principales manifestaciones del uso inadecuado, probables causas, necesidad de consenso y de reemplazo conceptual. Métodos: estudio observacional descriptivo con triangulación metodológica. Muestra intencionada de 15 expertos de diferentes provincias, profesores auxiliar o titular, máster, doctor en ciencias o ambos y especialistas de primer o segundo grado en medicina interna, quienes contestaron, por vía electrónica, una encuesta con diversos ítems y preguntas, tipo Escala Likert. La encuesta fue validada estadísticamente, los datos fueron procesados con uso de la mediana y de cuartiles mediante: test de Anova, coeficiente de correlación de Kendall y análisis clúster. Resultados: la mayoría de expertos concordaron en que existen casos de uso inadecuado del término síndrome en las discusiones diagnósticas, su negativa repercusión en el diagnóstico médico, posibles causas, necesidad de consenso con algunas divergencias, entre tres grupos de expertos, respecto a formas de manifestarse, otros factores influyentes y en especial sobre la ampliación del concepto síndrome, mediante la inclusión de signos propios de los exámenes complementarios, y su posible consecuencia en el algoritmo del método clínico. Conclusiones: aunque la mayoría de expertos concordaron sobre la existencia de uso inadecuado del término síndrome y otros aspectos relacionados, la existencia de divergencias, en especial sobre el reemplazo conceptual del término y su repercusión en el proceso diagnóstico hace plantear la existencia de una escuela heterodoxa (minoría), una escuela ortodoxa o tradicional (mayoría) y una escuela ecléctica, intermedia en número de expertos.

Introduction: there have been cases of misuse of the term syndrome in diagnostic discussion at the University Hospital of Holguin V.I. Lenin, which may be due to several factors. Objective: to identify, according to expert criteria, if there are cases of inappropriate use of the term syndrome in the diagnostic discussion in other provinces of Cuba, its negative repercussion in the medical diagnosis, main manifestations of the inadequate use, probable causes, need of consensus and of conceptual replacement. Method: descriptive observational study with methodological triangulation. Intentional sample of 15 experts from different provinces, assistant or master professors, master, doctor of science or both and specialists of first or second degree on internal medicine, who answered, electronically, a survey with various items and questions, Likert Scale. The survey was statistically validated; the data were processed using the median and quartiles using: anova test, Kendall correlation coefficient and cluster analysis. Results: the majority of experts agreed that there are cases of inadequate use of the term syndrome in diagnostic discussions, its negative repercussion in the medical diagnosis, possible causes, need for consensus with some divergences, among three groups of experts, regarding forms of manifestation, other influential factors and especially on the extension of the syndrome concept, through the inclusion of signs of complementary examinations and their possible consequence in the algorithm of the clinical method. Conclusions: although most experts agreed on the existence of inappropriate use of the term syndrome and other related aspects, the existence of divergences, especially on the conceptual replacement of the term and its repercussion in the diagnostic process, suggests the existence of a heterodox school (minority), an orthodox or traditional school (majority) and an eclectic school, intermediate in number of experts.

Síndrome. Empleo inadecuado del término en la Discusión Diagnóstica. Semejanzas y divergencias en el criterio de expertos / Inappropriate use of the term Syndrome in the Diagnostic Discussion. Similarities and divergences in the criterion of experts

Introducción: hay casos de uso inadecuado del término síndrome en la discusión diagnóstica, en el Hospital Universitario V.I. Lenin de Holguín, lo que puede deberse a diversos factores.Objetivo: identificar, según el criterio de expertos, si existen en otras provincias de Cuba casos de uso inadecuado del término síndrome en la discusión diagnóstica, su repercusión negativa en el diagnóstico médico, principales manifestaciones del uso inadecuado, probables causas, necesidad de consenso y de reemplazo conceptual.Métodos: estudio observacional descriptivo con triangulación metodológica. Muestra intencionada de 15 expertos de diferentes provincias, profesores auxiliar o titular, máster, doctor en ciencias o ambos y especialistas de primer o segundo grado en medicina interna, quienes contestaron, por vía electrónica, una encuesta con diversos ítems y preguntas, tipo Escala Likert. La encuesta fue validada estadísticamente, los datos fueron procesados con uso de la mediana y de cuartiles mediante: test de Anova, coeficiente de correlación de Kendall y análisis clúster.Resultados: la mayoría de expertos concordaron en que existen casos de uso inadecuado del término síndrome en las discusiones diagnósticas, su negativa repercusión en el diagnóstico médico, posibles causas, necesidad de consenso con algunas divergencias, entre tres grupos de expertos, respecto a formas de manifestarse, otros factores influyentes y en especial sobre la ampliación del concepto síndrome, mediante la inclusión de signos propios de los exámenes complementarios, y su posible consecuencia en el algoritmo del método clínico.(AU)

Introduction: there have been cases of misuse of the term syndrome in diagnostic discussion at the University Hospital of Holguin V.I. Lenin, which may be due to several factors.Objective: to identify, according to expert criteria, if there are cases of inappropriate use of the term syndrome in the diagnostic discussion in other provinces of Cuba, its negative repercussion in the medical diagnosis, main manifestations of the inadequate use, probable causes, need of consensus and of conceptual replacement.Method: descriptive observational study with methodological triangulation. Intentional sample of 15 experts from different provinces, assistant or master professors, master, doctor of science or both and specialists of first or second degree on internal medicine, who answered, electronically, a survey with various items and questions, Likert Scale. The survey was statistically validated; the data were processed using the median and quartiles using: anova test, Kendall correlation coefficient and cluster analysis.Results: the majority of experts agreed that there are cases of inadequate use of the term syndrome in diagnostic discussions, its negative repercussion in the medical diagnosis, possible causes, need for consensus with some divergences, among three groups of experts, regarding forms of manifestation, other influential factors and especially on the extension of the syndrome concept, through the inclusion of signs of complementary examinations and their possible consequence in the algorithm of the clinical method.(AU)

UV irradiance and albedo at Union Glacier Camp (Antarctica): a case study.

We report on the first spectral measurements of ultraviolet (UV) irradiance and the albedo at a Camp located in the southern Ellsworth Mountains on the broad expanse of Union Glacier (700 m altitude, 79° 46' S; 82° 52'W); about 1,000 km from the South Pole. The measurements were carried out by using a double monochromator-based spectroradiometer during a campaign (in December 2012) meant to weight up the effect of the local albedo on the UV irradiance. We found that the albedo measured at noon was about 0.95 in the UV and the visible part of the spectrum. This high surface reflectivity led to enhancements in the UV index under cloudless conditions of about 50% in comparison with snow free surfaces. Spectral measurements carried out elsewhere as well as estimates retrieved from the Ozone Monitoring Instrument (OMI) were used for further comparisons.

Factores de riesgo en la infección vaginal / Risk Factors in Vaginal Infection

Se aplicó el análisis clúster para clasificar factores de riesgo de infección vaginal en 576 mujeres, atendidas durante el periodo de junio a septiembre de 2007 en la Policlínica Pe dro del Toro Saad de Holguín, Cuba. Las pacientes presentaban síntomas de infección vaginal, como leucorrea, prurito y ardor e indicaciones de exudados vaginales. Se excluyeron las mujeres menores de 15 y mayores de 45 años, embarazadas, con tratamiento de antibióticos y antecedentes de enfermedad inflamatoria pélvica. Se comprobó la elevada frecuencia de vaginosis bacteriana, candidiasis vulvovaginal y trichomoniasis. Se determinaron tres grupos de variables asociadas: condón-dispositivo intrauterino, edad de inicio de las relaciones sexuales-número de parejas y cambio de pareja sexual-infecciones vaginales. Se demostró una mayor probabilidad de infección vaginal en las mujeres con comportamientos sexuales de riesgo y se recomendó realizar campañas de promoción y prevención de estas infecciones por sus implicaciones para la salud materno-infantil...(AU)

A cluster analysis on vaginal infection risk factors was carried out in 576 women, who were assisted from June to September 2007. The patients had vaginal infection symptoms such as leucorrhea, itching, and burning, with vaginal exudates. Women under 15 years old, or being pregnant or under antibiotics treatments, or having a past history of pelvic inflammatory disease were excluded. A high rate of bacterial vaginosis, vulvovaginal candidiasis and trichomoniasis was observed. Three associated variable groups were found: condom - intrauterine device, sexual intercourse starting age - number of couples, couple change vaginal infections. A higher rate of probability to suffer from vaginal infections in women with risk sexual behavior was showed. The authors of this work recommended to promote a health program in order to prevent these infections, due to their impacts upon the maternal-infant health...(AU)

[Bioethical principles: planning and advance directives in Puerto Rico]. / Principios bioéticos: la planificación y las directrices adelantadas puertorriqueñas.

The libertarian principles of Personal Autonomy and Personalized Justice which grew mightily in the rapidly spreading young American democracy in the 18th and 19th centuries led to the development of Bioethics in the United States. The bioethical principles of Respect for Autonomy, Beneficence, non-Maleficence and Justice support the elaboration of advance directives (living will and the designation of a proxy to attend health matters) for when the patient is no longer capable to make health decisions. Advance directives can be drafted and signed in Puerto Rico with the help of a lawyer. They can also be legally prepared in a doctor's office or in a hospital if witnessed by a doctor and two persons who will not benefit from the patient's demise or are directly involved in his/her care). We present a model for advance directives which may be executed in a doctor's office or a hospital. The model fulfills the legal requirements of Puerto Rico Law 160 which became effective November 2001. It also fulfills requirements of the Patients Self-Determination Act that became effective in 1991.The document also contains standard options for organ donations. We discuss the fundamental bioethical principles which have given root to the development of the advance directives. We suggest that it may be economically advantageous to health insurance carriers to compensate physicians who help their patients in the execution of a valid document. The existence of this document may help prevent the large expenses associated with inappropriate admissions to intensive care of patients at the end-of-life.

The complete genomic sequence of an in vivo low replicating BLV strain.

DNA was extracted from lamb lymphocytes that were infected in vivo with a BLV strain after inoculation with the peripheral blood mononuclear cells from a persistently sero-indeterminate, low viral load, BLV-infected Holstein cow (No. 41) from Argentina. The DNA was PCR amplified with a series of overlapping primers encompassing the entire BLV proviral DNA. The amplified BLV ARG 41 DNA was cloned, sequenced, and compared phylogenetically to other BLV sequences including an in vivo high replicating strain (BLV ARG 38) from the same herd in Argentina. Characterization of BLV ARG 41's deduced proteins and its relationship to other members of the PTLV/BLV genus of retroviruses are discussed.

Host soluble factors that regulate the synthesis of the major core protein of the bovine leukemia virus (BLV) in a naturally infected neoplastic B-cell line.

Bovine leukemia virus (BLV) is a B-cell tropic Deltaretrovirus that induces a lifelong infection and causes a fatal lymphosarcoma in less than 10% of the infected cattle. BLV is usually present in its host in a transcriptional repressed state but becomes de-repressed a few hours after the infected lymphocytes are cultured in vitro. In the present study we have examined the effect of soluble host factors and various substances on the synthesis of the major BLV protein (p24) in a permanent culture (cell line NBC-10) of neoplastic B-lymphocytes derived from BLV-infected cattle. Certain batches of fetal calf serum (FCS) and bovine platelet lysates (PLy) induced a rapid and drastic increase of the synthesis of BLVp24 in the NBC-10 cells. Neutralization experiments with specific antibodies demonstrated that the transforming growth factor-beta (TGF-beta) was responsible for the stimulatory activity of FCS and PLy on the synthesis of BLVp24 in the NBC-10 cells. Recombinant TGF-beta also stimulated the synthesis of BLVp24 in cultures of peripheral blood mononuclear cells (PBMCs) obtained from BLV-infected cattle. Mitogens, phorbol-myristate-acetate and prostaglandin E(2), previously shown to stimulate the expression of BLV in cultures of PBMC, did not induce the synthesis of BLVp24 in cultures of NBC-10 cells. Plasma, serum and milk from BLV-negative cattle inhibited the synthesis of BLVp24 induced by FCS, PLy or TGF-beta in the NBC-10 cells. The blocking activity was found in the whey and the beta-casein fractions of bovine milk. The relevance of these findings with regard to the previously reported plasma factor (PBB) with blocking activity on the expression of BLV in short-term PBMC cultures is discussed. Based on the information obtained in the present study we have standardized a reproducible and rapid assay system for the identification of factors that regulate the synthesis of BLVp24 in naturally infected neoplastic B cells.

LA BIOETICA COMO QUEHACER FILOSOFICO.

This article examines the epistemological statute of bioethics as an academic discipline. The author claims that the epistemological statute of a dialogue determines the fundamental question that is raised and the answer that is sought, essential points of discourse. In the case of bioethics, the fundamental question is of a moral nature. Therefore, bioethics is an ethical discipline that has its epistemological roots in philosophy. The author also defends the concept of applied ethics. Finally, he suggests that bioethical methods, above all especially what is realized in our latitudes, should adopt the Hermeneutic Circle as the methodology for its philosophizing.

La bioética como quehacer filosófico / Bioethics as a philosophical task / A bioética como um quefazer filosófico

El artículo examina el estatuto epistemológico de la bioética como disciplina académica. El autor sostiene que el estatuto epistemológico de un discurso lo determina la pregunta fundamental que se plantea y la respuesta que se busca, focos integradores del discurso. En el caso de la bioética, la pregunta fundamental es de índole moral. La bioética es pues una disciplina ética que tiene su hogar epistemológico en la filosofía. El autor también defiende el concepto de "éticas aplicadas". Sugiere finalmente que el método de la bioética, sobre todo la que se hace desde nuestras latitudes, debería adoptar el círculo hermenéutico como metodología para su filosofar.

This article examines the epistemological statute of bioethics as an academic discipline. The author claims that the epistemological statute of a dialogue determines the fundamental question that is raised and the answer that is sought, essential points of discourse. In the case of bioethics, the fundamental question is of a moral nature. Therefore, bioethics is an ethical discipline that has its epistemological roots in philosophy. The author also defends the concept of applied ethics. Finally, he suggests that bioethical methods, above all especially what is realized in our latitudes, should adopt the Hermeneutic Circle as the methodology for its philosophizing.

O artigo examina o estatuto espistemológico da bioética como disciplina acadëmica. O autor defende que o estatuto espistemológico de um discurso é determinado pela pergunta fundamental que se faz e a resposta que se busca, focos integradores do discurso. No caso da bioética, a pergunta fundamental é de índole moral. A bioética é uma disciplina ética que encontra seu lugar epistemológico na filosofia. O autor também defende o conceito de "éticas aplicadas". O autor sugere finalmente que o método da bioética, sobretudo a que se faz a partir de nossas terras, deveria adotar o círculo hermenëutico como metodologia para seu filosofar.

Percepción popular y profesional del significado del vocablo empacho / Popular and professional perception of the meaning of the word

Con el objetivo de establecer los criterios populares y profesionales sobre el significado del vocablo empacho, sus semejanzas y divergencias, se realizaron dos investigaciones exploratorias paralelas en el período comprendido entre agosto de 2005 y diciembre de 2006. En la dimensión popular se definió como universo la totalidad de habitantes del municipio de Holguín y se obtuvo una muestra intencional de 158 personas mayores de 18 años de edad y dispuestas a cooperar. El universo profesional, por su parte, comprendió el total de pediatras, así como de cirujanos y gastroenterólogos que atienden pacientes adultos en los tres hospitales provinciales del territorio. Ambas muestras, intencionadas, incluyeron 17 pediatras y 10 gastroenterólogos, respectivamente, quienes laboran con adultos, todos con 10 años o más de experiencia profesional y en la atención a pacientes que refirieron padecer un empacho. La definición más frecuente en el criterio popular fue ®parálisis de la digestión¼, seguida por la de ®indigestión¼. La mayoría de los pedíatras identificaron el empacho con la indigestión. Los gastroenterólogos también seleccionaron la indigestión y, junto a ella, "un trastorno con marcada disminución de la motilidad gástrica". En este último caso se aprecia una mayor semejanza con los criterios populares que asocian el término empacho con una parálisis de la digestión(AU)

In oder to establish the popular and professional criteria of the meaning of the word empacho, their similarities and divergences, two exploratory and parallel investigations were carried out from August, 2005, to December 2006. In the popular dimension, all the inhabitants of Holguín municipality were considered as the universe, and an intentional sample of 158 people over 18, ready to cooperate, was selected. On the other hand, the professional universe was composed of all the pediatricians, surgeons and gastroenterologists who give attention to adult patients in the three provincial hospitals of the territory. Both intended samples included 17 pediatricians and 10 gastroenterologists, respectively. All of them had more than 10 years of professional experience, and had seen patients suffering from empacho. The most frequent definition in the popular criterion was "paralysis of the digestion", followed by "indigestion". Most the pediatricians identified the empacho with the word indigestion. The gastroenterologists also selected indigestion and, together with it, "a disorder with marked reduction of the gastric motility". In this case, it is observed a greater similarity with the popular criteria that associates the term empacho with a paralysis of digestion(AU)

Percepción popular y profesional del significado del vocablo empacho / Popular and professional perception of the meaning of the word

Con el objetivo de establecer los criterios populares y profesionales sobre el significado del vocablo empacho, sus semejanzas y divergencias, se realizaron dos investigaciones exploratorias paralelas en el período comprendido entre agosto de 2005 y diciembre de 2006. En la dimensión popular se definió como universo la totalidad de habitantes del municipio de Holguín y se obtuvo una muestra intencional de 158 personas mayores de 18 años de edad y dispuestas a cooperar. El universo profesional, por su parte, comprendió el total de pediatras, así como de cirujanos y gastroenterólogos que atienden pacientes adultos en los tres hospitales provinciales del territorio. Ambas muestras, intencionadas, incluyeron 17 pediatras y 10 gastroenterólogos, respectivamente, quienes laboran con adultos, todos con 10 años o más de experiencia profesional y en la atención a pacientes que refirieron padecer un empacho. La definición más frecuente en el criterio popular fue ®parálisis de la digestión¼, seguida por la de ®indigestión¼. La mayoría de los pedíatras identificaron el empacho con la indigestión. Los gastroenterólogos también seleccionaron la indigestión y, junto a ella, "un trastorno con marcada disminución de la motilidad gástrica". En este último caso se aprecia una mayor semejanza con los criterios populares que asocian el término empacho con una parálisis de la digestión.

In oder to establish the popular and professional criteria of the meaning of the word empacho, their similarities and divergences, two exploratory and parallel investigations were carried out from August, 2005, to December 2006. In the popular dimension, all the inhabitants of Holguín municipality were considered as the universe, and an intentional sample of 158 people over 18, ready to cooperate, was selected. On the other hand, the professional universe was composed of all the pediatricians, surgeons and gastroenterologists who give attention to adult patients in the three provincial hospitals of the territory. Both intended samples included 17 pediatricians and 10 gastroenterologists, respectively. All of them had more than 10 years of professional experience, and had seen patients suffering from empacho. The most frequent definition in the popular criterion was "paralysis of the digestion", followed by "indigestion". Most the pediatricians identified the empacho with the word indigestion. The gastroenterologists also selected indigestion and, together with it, "a disorder with marked reduction of the gastric motility". In this case, it is observed a greater similarity with the popular criteria that associates the term empacho with a paralysis of digestion.

Nutritional and eating quality of Argentinean beef: A review.

This review deals with distinctive aspects of quality of Argentinean beef in terms of tenderness, flavour, colour, juiciness, taste, acceptability, lipid content and composition and its resultant nutraceutical characteristics. Differences are due to beef production systems based on temperate or tropical grasslands aimed at shortening the fattening phase as far as possible, with limited or null use of concentrates. However, the effect of limited supplemental feeding is also discussed as well as the responses arising from the use of beef cattle genotypes, including British, Continental, Dairy, Zebu breeds and their crosses, adapted to the various environments and systems found in the country.

Pulmonary alveolar microlithiasis and pregnancy.

The following is the case of a 36-year old pregnant woman reaching term, suffering from advanced pulmonary alveolar microlithiasis. To our knowledge, this is the first record of such a case.

Association and epidemiologic features of Trypanosoma cruzi and human T cell lymphotropic a virus type II in inhabitants of the Paraguayan Gran Chaco.

Serologic evidence of Trypanosoma cruzi infection was demonstrated in 43.5% of 519 Paleoamerindians and in only 2.5% of 161 non-Indians (Mennonites of German descent and Paraguayans of Spanish descent) inhabiting an area of western Paraguay that belongs to the Gran Chaco territory. These people ranged in age between two and 80 years. All were also tested for infection with the human T cell lymphotropic virus type II (HTLV-II). The prevalence of HTLV-II infection was 22.1% in Indians and 3.7% in non-Indians. As determined by a multivariate logistic regression analysis that controlled for relevant confounders, an HTLV-II-infected individual was 2.28 times more likely to be seropositive for T. cruzi than an HTLV-II negative. Possible explanations for this finding are discussed. The difference in T. cruzi prevalence between Indians and non-Indians was associated with differences between these groups in exposure to known risk factors for infection with the parasite. There were significant differences in the seroprevalence of T. cruzi among the two predominant Indian groups, even when they inhabited communities that were close to each other. These differences were associated with differences in the prevalence of HTLV-II infection but not with differences in exposure to known risk factors for T. cruzi infection. Infection with T. cruzi increased with age, was greater in males than in females, and clustered in families.