Estrategias de Comunicación Participativa, Saneamiento Básico y la Salud Pública de los Pobladores de Paucartambo-Cusco / Participatory Communication Strategies, Basic Sanitation And Public Health Of The People Of Paucartambo-Cusco

Objetivos: Analizar la influencia que tiene la aplicación de estrategias de comunicación participativa en el uso adecuado de servicios de saneamiento básico y su incidencia en la salud pública de los pobladores de comunidades de Paucartambo. Explorar las dimensiones políticas y culturales inmersas en los procesos de comunicación entre poblaciones y promotores de salud de las comunidades de estudio Analizar los procesos de intervención en el campo de la comunicación en salud. Métodos: El tipo de investigación es cualitativo y observacional, con un diseño de tipo transversal en base a entrevistas no estructuradas y entrevistas en profundidad, Se utilizó los datos de los Censos Nacionales de Población y Vivienda 2017, 2007- Instituto Nacional de Estadística e Informática (INEI) - PERÚ. Resultados: Las entrevistas a profundidad, así como la observación directa, dan como resultado que si bien se han realizado esfuerzos por mejorar la situación del saneamiento básico a través de la instalación de red pública de desagüe, y otras formas como las letrinas y pozos sépticos, además de ser insuficientes, no fueron utilizados adecuadamente, porque no se aplicaron estrategias de comunicación participativa desde la etapa de diagnóstico, hasta la evaluación final, más aun por la falta permanente de actividades de monitoreo y vigilancia, que tienen un rol muy decisivo en la calidad de vida y por tanto en la salud pública Conclusión: Las estrategias de comunicación más utilizadas por las instituciones que tienen el rol de promover el uso adecuado de los servicios de saneamiento básico como las redes públicas de desagüe han sido de carácter vertical como las charlas, la radio, el uso de láminas, precisamente por esta razón no se generaron conocimientos, actitudes y prácticas adecuadas para el uso y la conservación de los mismos, situación que tuvo impactos negativos sobre la salud pública y también ambiental.

Objectives: To analyze the influence that the application of participatory communication strategies has on the adequate use of basic sanitation services and its impact on the public health of the residents of communities in Paucartambo. Explore the political and cultural dimensions immersed in the communication processes between populations and health promoters of the study communities. Analyze the intervention processes in the field of health communication. Methods: The type of research is qualitative and observational, with a cross-sectional design based on unstructured interviews and in-depth interviews. Data from the National Population and Housing Censuses 2017, 2007 - National Institute of Statistics and Informatics were used. (INEI) - PERU. Results: In-depth interviews, as well as direct observation, result in the fact that although efforts have been made to improve the situation of basic sanitation through the installation of a public sewage network, and other forms such as latrines and septic tanks In addition to being insufficient, they were not used properly, because participatory communication strategies were not applied from the diagnostic stage to the final evaluation, even more so due to the permanent lack of monitoring and surveillance activities, which have a very decisive role in the quality of life and therefore in public health Conclusion: The communication strategies most used by institutions that have the role of promoting the adequate use of basic sanitation services such as public sewage networks have been of a vertical nature such as those talks, radio, the use of pictures, precisely for this reason, adequate knowledge, attitudes and practices were not generated s for their use and conservation, a situation that had negative impacts on public and environmental health.

Bioremoval of arsenic (V) from aqueous solutions by chemically modified fungal biomass.

The biosorption of arsenic (V) on nine chemically modified biomasses (with iron oxide coated) of mycelia fungi: Aspergillus flavus III, IV and V, Aspergillus fumigatus I-II, Paecilomyces sp., Cladosporium sp., Mucor sp-1 and 2 was studied in this work. This study provides evidence that the biomasses of the fungi A. flavus, IV, III and V, Paecilomyces sp., and A. fumigatus I were very efficient at removing 1 mg/L of the metal in solution, using atomic absorption spectroscopy (AAS), achieving the following percentage of removals: 97.1, 92.3, 90.3, 89.0, and 83.4%, respectively. The results of adsorption were obtained at pH 6.0, 30 °C after 24 h of incubation, with 1 g/100 mL of fungal biomass. These results suggest the excellent potential of almost all isolated strains for bioremediation and removal of metals from contaminated sites.

Neuronal activity enhances tau propagation and tau pathology in vivo.

Tau protein can transfer between neurons transneuronally and trans-synaptically, which is thought to explain the progressive spread of tauopathy observed in the brain of patients with Alzheimer's disease. Here we show that physiological tau released from donor cells can transfer to recipient cells via the medium, suggesting that at least one mechanism by which tau can transfer is via the extracellular space. Neuronal activity has been shown to regulate tau secretion, but its effect on tau pathology is unknown. Using optogenetic and chemogenetic approaches, we found that increased neuronal activity stimulates the release of tau in vitro and enhances tau pathology in vivo. These data have implications for disease pathogenesis and therapeutic strategies for Alzheimer's disease and other tauopathies.

Síndrome hemolítico urémico en Chile: presentación clínica, evolución y factores pronósticos / Hemolytic-uremic syndrome in Chile: clinical features, evolution and prognostic factors

Background: Hemolytic-uremic syndrome (HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. Aim: To describe the characteñstics ofpatients with the diagnosis ofHUS in Chile, and to identify the most reliable early predictors oímorbidity and moñality. Material and methods: The clinical records ofpatients with HUS aged less than 15 years, attended between January 1990 and December 2003 in 15 hospitals, were reviewed. Demographic, clinical, biochemical, hematological parameters, morbidity and mortality were analyzed. Results: A cohort of 587 patients aged 2 to 8 years, 48 percent males, was analyzed. Ninety two percent had diarrhea. At the moment of diagnosis, anuria was observed in 39 percent of the patients, hypertension in 45 percent and seizures in 17 percent. Forty two percent required renal replacement therapy (RRT) and perítoneal dialysis was used in the majoríty of cases (78 percent). The most frequently isolated etiological agentwas Escherichia coli. Mortality rate was 2.9 percent in the acute phase of the disease and there was a positive correlation between mortality and anuria, seizures, white blood cell count (WCC) >20.000/mm³ and requirements of renal replacement therapy (p <0.05). Twelve percent of patients evolved to chronic renal failure and the risk factors during the acute phase were the need for renal replacement therapy, anuria, WCC >20.000/mm³, seizures and hypertension. Conclusions: The present study emphasizes important clinical and epidemiological aspeets ofHUSin a Chilean pediatricpopulation.

The atherosclerotic plaque.

Atherosclerosis is the most frequent cause of ischemic heart disease and cerebrovascular disorders. The condition is the leading cause of death in Western societies. At the core of this condition is the atherosclerotic plaque. It is within the structure of this lesion that multiple biochemical and cellular processes interact influencing its vulnerability to rupture and as a result acute ischemic events. This article will discuss the pathophysiology behind the atherosclerotic plaque, particularly those elements that lead to its instability and the medical tools currently available to counteract it.

[Hemolytic-uremic syndrome in Chile: clinical features, evolution and prognostic factors]. / Síndrome hemolítico urémico en Chile: presentación clínica, evolución y factores pronósticos.

BACKGROUND: Hemolytic-uremic syndrome (HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. AIM: To describe the characteristics of patients with the diagnosis of HUS in Chile, and to identify the most reliable early predictors of morbidity and mortality. MATERIAL AND METHODS: The clinical records of patients with HUS aged less than 15 years, attended between January 1990 and December 2003 in 15 hospitals, were reviewed. Demographic, clinical, biochemical, hematological parameters, morbidity and mortality were analyzed. RESULTS: A cohort of 587 patients aged 2 to 8 years, 48% males, was analyzed. Ninety two percent had diarrhea. At the moment of diagnosis, anuria was observed in 39% of the patients, hypertension in 45% and seizures in 17%. Forty two percent required renal replacement therapy (RRT) and peritoneal dialysis was used in the majority of cases (78%). The most frequently isolated etiological agent was Escherichia coli. Mortality rate was 2.9% in the acute phase of the disease and there was a positive correlation between mortality and anuria, seizures, white blood cell count (WCC)>20.000/mm3 and requirements of renal replacement therapy (p<0.05). Twelve percent of patients evolved to chronic renal failure and the risk factors during the acute phase were the need for renal replacement therapy, anuria, WCC>20.000/mm3, seizures and hypertension. CONCLUSIONS: The present study emphasizes important clinical and epidemiological aspects of HUS in a Chilean pediatric population.

Teorías de Enfermería: un fundamento disciplinar / Nursing theories: A discipline foundation

La Enfermería ha evolucionado gracias al desarrollo de las teorías que son parte fundamental para el sustento del conocimiento de la disciplina. En este sentido, nacen por la necesidad de delimitar el objeto de estudio, por tener un cuerpo de conocimientos propio, diferenciarse de la práctica médica, y pasar de una ocupación a profesión. Actualmente existe un pluralismo teórico que refleja esa evolución, teniendo como resultado una amplia gama de posibilidades para guiar el cuidado al paciente.

The Nursing has evolved thanks to the development of the theories that are fundamental part for the sustenance of knowledge of the discipline. In this sense, they are born by the necessity to delimit the study object, to have an own body of knowledge, to be different themselves from the medical practice, and to happen of an occupation to profession. At the moment a theoretical pluralism exists that reflects that evolution, having like result an ample range of possibilities to guide the care the patient.

Coronary artery abnormalities in Puerto Rico

A retrospective study was done to determine the frequency of coronary artery anomalies in terms of their origin, course, and structure. The clinical history, catheterization data and surgical reports of patients undergoing coronary angiography at the Cardiovascular Center of Puerto Rico and the Caribbean, from 1999 to 2004, were analyzed. Thirty-eight patients were identified with a coronary artery anomaly in this population. These anomalies were classified according to their clinical consequences and the need for surgical intervention.

Gene microarray analysis reveals a novel hypoxia signal transduction pathway in human hepatocellular carcinoma cells.

The molecular details of hypoxia-induced cellular responses have been difficult to identify since there is as yet no known oxygen receptor. We used cDNA microarray technology to extend our studies pertaining to these molecular details in human hepatocellular carcinoma (Hep3B) cells that produce erythropoietin (Epo) in response to hypoxia. Of approximately 1200 genes in the array, those associated with integrin-linked kinase (ILK), fibronectin precursor and glycogen synthase kinase-3beta (GSK-3beta) were markedly stimulated after exposure of Hep3B cells to low oxygen (1%) for 6 h. Epo, HIF-1, and von Hippel-Lindau cDNAs were measured in parallel as markers of low oxygen responses in Hep3B cells. ILK is a serine, threonine protein kinase that interacts with the cytoplasmic domains of integrin beta1 and beta3. This interaction localizes ILK to focal adhesion plaques. ILK is stimulated by cell-fibronectin interaction as well as insulin. It is regulated in a phosphatidylinositol 3-kinase dependent manner and can phosphorylate protein kinase B (PKB/AKT) and GSK-3beta. As a result of these and other activities ILK has been shown to affect anchorage-independent cell survival, cell cycle progression and tumorigenesis in nude mice. ILK has also been implicated in the Wnt pathway and as a critical target in PTEN-dependent tumor therapies. To our knowledge this is the first report implicating the ILK pathway in low oxygen responses. Other genes identified as a result of the microarray analysis not previously known to change as a result of low oxygen treatment were elongation factor-1alpha, glycyl-tRNA synthetase, and laminin receptor protein-1. These findings were all corroborated by RT-PCR assays and in some instances Western blot analysis.

Cobalt induces heme oxygenase-1 expression by a hypoxia-inducible factor-independent mechanism in Chinese hamster ovary cells: regulation by Nrf2 and MafG transcription factors.

We have shown previously that activation of the heme oxygenase-1 (ho-1) gene by hypoxia in aortic smooth muscle cells is mediated by hypoxia-inducible factor-1 (HIF-1). In mutant (Ka13) Chinese hamster ovary cells lacking HIF activity, accumulation of ho-1 mRNA in response to hypoxia and the hypoxia-mimetic CoCl(2) was similar to that observed in wild type (K1) cells. These results support the existence of HIF-dependent and HIF-independent mechanisms for ho-1 gene activation by hypoxia and CoCl(2). In Ka13 cells, CoCl(2) stimulated expression of a luciferase reporter gene under the control of a 15-kilobase pair mouse ho-1 promoter (pHO15luc). Mutation analyses identified the cobalt-responsive sequences as the stress-response elements (StREs). In electrophoretic mobility shift assays, two specific StRE-protein complexes were observed using extracts from Ka13 cells. In response to cobalt, the level of the slower migrating complex X increased, whereas that of complex Y decreased, in a time-dependent manner. Members of the AP-1 superfamily of basic-leucine zipper factors bind to the StRE. Antibody supershift electrophoretic mobility shift assays did not detect Jun, Fos, or ATF/CREB proteins but identified Nrf2 and the small Maf protein, MafG, as components of complex X. Furthermore, dominant-negative mutants of Nrf2 and small Maf, but not of other bZIP factors, attenuated cobalt-mediated gene activation. Additional experiments demonstrated that induction by cobalt does not result from increased expression of MafG or regulated nuclear translocation of Nrf2 but is dependent on cellular oxidative stress. Unlike cobalt, hypoxia did not stimulate pHO15luc expression and did not increase StRE binding activity, indicating distinct mechanisms for ho-1 gene activation by cobalt and hypoxia in Chinese hamster ovary cells.

Anomalous apical plasma membrane phenotype in CK8-deficient mice indicates a novel role for intermediate filaments in the polarization of simple epithelia.

Previous results from our laboratory have indicated a requirement for CK intermediate filaments (IF) for the organization of the apical domain in polarized epithelial cells in culture. The results seemed to be challenged by the phenotype of cytokeratin (CK) 8-deficient mice, which comprises only colorectal hyperplasia, female sterility and a weaker hepatocyte integrity. In this work localization with anti-CK antibodies indicated that many Ck8-/- epithelia still form IF in CK8-deficient mice, perhaps because of the expression of the promiscuous CK7. In the small intestine, only villus enterocytes lacked IFs. These cells appeared to lose syntaxin 3, and three apical membrane proteins (alkaline phosphatase, sucrase isomaltase and cystic fibrosis transmembrane conductance regulator) as they progressed along the villus. At the distal third of the villi, gamma-tubulin was found scattered within the cytoplasm of enterocytes, in contrast to its normal sub-apical localization, and the microtubules were disorganized. These results could not be attributed to increased numbers of apoptotic or necrotic cells. The only other cell type we found without IFs in CK8 null mice, the hepatocyte, displayed increased basolateral levels of one apical marker (HA4), indicating a correlation between the lack of intermediate filaments and an apical domain phenotype. These data suggest a novel function for intermediate filaments organizing the apical pole of simple polarized epithelial cells.

Combination treatment with clomipramine and selective serotonin reuptake inhibitors for obsessive-compulsive disorder in children and adolescents.

Medication management of obsessive-compulsive disorder (OCD) has consisted of monotherapy with either clomipramine (CMI) or selective serotonin reuptake inhibitors (SSRIs) such as fluvoxamine, paroxetine, or sertraline. Frequently, OCD patients receiving monotherapy experience low treatment response rates and problematic side effects that may result in discontinuation or noncompliance. This open-label case series presents 7 patients (6 male, 1 female) ages 9 to 23 years with OCD who were effectively treated with combination of CMI plus an SSRI. Treatment effects persisted through 5 to 22 months of follow-up from onset of combination therapy. The drug combination was effective in the 2 patients with OCD and no mood/anxiety comorbidity. Side effects appeared in 5 of 7 patients; cardiovascular side effects were the most common adverse effects. Two patients had prolongation of QTc intervals and 2 developed tachycardia while taking CMI and SSRI combinations. Other risks might include serotonin syndrome, manic switch, insomnia, and possibly headaches, EPS, and sexual dysfunction. Recommendations are made to monitor electrocardiograms, CMI blood concentrations, and vital signs in all cases because SSRIs can increase the blood levels of CMI and/or its active metabolite, desmethylclomipramine (DCMI). CMI could also potentially increase SSRI absorption and/or protein binding. The use of CMI and SSRI combination therapy was found to be more effective compared with their monotherapy in all 7 cases.