Educación dirigida a personas con diabetes: abordajes pedagógicos, teóricos y prácticos en tensión / Education aimed at people with Diabetes Mellitus: pedagogical, theoretical and practical approaches in tension / Educação para pessoas com diabetes: abordagens pedagógicas, teóricas e práticas em tensão

Resumen La educación para personas con Diabetes Mellitus (DM) representa un desafío en el campo de la salud pública. Presentamos una propuesta teórica que orienta el análisis pedagógico de la educación para la salud en personas con DM, a partir de un proceso de investigación documental. Los hallazgos evidenciaron la existencia de diferentes perspectivas teóricas en tensión sobre la educación en personas con DM que luchan por la legitimación, que pueden agruparse en dos tendencias, una tradicional y la otra crítica. Se presenta una propuesta guiada desde la teoría pedagógica y la salud pública para explicar los hallazgos. La teoría construida pretende evidenciar la configuración de corrientes educativas como resultado de los debates y las luchas teóricas, políticas y epistemológicas que se dan en la intersección de los campos de la salud pública y la pedagogía. (AU)

Abstract Education for people with Diabetes Mellitus (DM) represents a challenge in the field of public health. We present a theoretical proposal that guides the pedagogical analysis of health education for people with DM, based on a documentary research process. The findings evidenced the existence of different theoretical perspectives in tension about education in people with DM that struggle for legitimacy, which can be grouped into two tendencies, one traditional and the other critical. A proposal guided by pedagogical theory and public health is presented to explain the findings. The theory constructed intends to evidence the configuration of educational currents as a result of the debates and theoretical, political and epistemological struggles that occur at the intersection of the fields of public health and pedagogy. (AU)

Resumo A educação para pessoas com Diabetes Mellitus (DM) representa um desafio no campo da saúde pública. Apresentamos uma proposta teórica que orienta a análise pedagógica da educação em saúde em pessoas com DM, a partir de um processo de pesquisa documental. Os achados evidenciaram a existência de diferentes perspectivas teóricas em tensão sobre a educação em pessoas com DM que lutam por legitimação, que podem ser agrupadas em duas correntes, uma tradicional e outra crítica. Uma proposta pautada na teoria pedagógica e na saúde pública é apresentada para explicar os achados. A teoria construída visa mostrar a configuração das correntes educacionais como resultado dos debates e lutas teóricas, políticas e epistemológicas que ocorrem na intersecção dos campos da saúde pública e da pedagogia. (AU)

Síndromes hipertensivas da gestação e a prematuridade: dados do estudo "Nascer no Brasil" / Hypertensive syndromes of pregnancy and prematurity: data from the "Birth in Brazil" study

As síndromes hipertensivas da gestação são as complicações mais frequentes das gestação. Os objetivos dessa tese foram avaliar a associação entre as síndromes hipertensivas da gestação e a prematuridade com base em estudos que compuseram uma revisão integrativa, e verificar o efeito causal dessa exposição sobre a prematuridade precoce e tardia com base em dados de âmbito nacional. Por isso, essa tese foi estruturada sob a forma de dois artigos. O primeiro artigo investigou as divergências metodológicas entre os estudos que avaliaram a associação entre as síndromes hipertensivas da gestação e a prematuridade através de uma revisão integrativa da literatura realizada entre setembro de 2020 e janeiro de 2021. A busca dos artigos foi realizada nas bases de dados PubMed, Biblioteca Virtual em Saúde, Embase, Web of Science e Scopus com base na combinação dos descritores "Pregnancy Induced Hypertension", "High Risk", Pregnancy", "Prematurity, "Prematury Birth", "Premature Neonate", "Neonate Prematurity". Foram encontrados 582 artigos, sendo nove selecionados. As principais disparidades metodológicas observadas foram relativas à classificação das síndromes hipertensivas da gestação, da prematuridade e controle de confundidores. Mesmo diante disso, verificou-se associação entre as diferentes categorias das síndromes hipertensivas da gestação e a prematuridade. O segundo artigo utilizou dados do estudo de âmbito nacional e de base hospitalar, intitulado Inquérito Nacional sobre Parto e Nascimento: "Nascer no Brasil", conduzido entre fevereiro de 2011 a outubro de 2012, com entrevista a 23.894 mulheres. Para esse artigo, a amostra foi composta por 20.494 puérperas, sendo que 2.369 mulheres apresentaram síndrome hipertensivas da gestação que compreendeu a síntese das respostas positivas para qualquer uma das questões relativas ao aumento da pressão arterial, presença de pré-eclâmpsia, Síndrome HELLP contidas nos questionários preenchidos com dados do prontuário hospitalar e do cartão de pré-natal. O desfecho foi categorizado em prematuridade precoce (<34 semanas de gestação) e tardia (34-36 semanas de gestação). Para a realização das análises, foi elaborado um gráfico acíclico direcionado para identificar as covariáveis de ajuste necessárias para estimar o efeito causal das síndromes hipertensivas da gestação sobre a prematuridade. As variáveis que constituíram o conjunto mínimo de ajuste foram a idade materna, escolaridade materna, situação conjugal, paridade, índice de massa corporal pré-gestacional, ganho de peso gestacional, doença autoimune, doença renal crônica, diabetes mellitus pré-gestacional, diabetes mellitus gestacional, anemia materna, infecção do trato urinário e adequação do pré-natal. Em seguida, aplicou-se o método de ponderação pelo VIII escore de propensão para lidar com o desbalanceamento entre os grupos expostos e não expostos. Dentre os prematuros (2139), 2,6% foram precoces e 7,8%, tardios. Após a ponderação pelo escore de propensão, as mulheres com síndromes hipertensivas da gestação apresentaram 2,74 vezes a chance de terem prematuros precoces (ORaj: 2,74; IC95%: 2,12- 3,54) e 2,40, de terem prematuros tardios (Oradj: 2,40; IC95%: 1,86-3,08). Verificou-se, em publicações prévias, associação entre as síndromes hipertensivas da gestação e a prematuridade. E com base no uso do método de escore de propensão, foi possível avaliar o efeito causal dessa exposição sobre a prematuridade precoce e tardia. Com base nesses resultados, é importante ressaltar a importância da adequação do pré-natal para diagnosticar precocemente e tratar as mulheres com síndromes hipertensivas visando a redução das complicações decorrentes desta condição clínica, sobretudo à prematuridade.

The hypertensive syndromes of pregnancy are the most frequent complications of pregnancy. The objectives of this thesis were to evaluate the association between hypertensive syndromes of pregnancy and prematurity based on studies that were part of an integrative review and to verify the causal effect of this exposure on early and late prematurity based on national data. Therefore, this thesis was structured in the form of two articles. The first article investigated the methodological differences between the studies that evaluated the association between the hypertensive syndromes of pregnancy and prematurity through an integrative literature review carried out between September 2020 and January 2021. The search for articles was carried out in the databases PubMed, Virtual Health Library, Embase, Web of Science and Scopus based on the combination of the descriptors "Pregnancy Induced Hypertension", "High Risk", Pregnancy", "Prematurity, "Premature Birth", "Premature Neonate", "Neonate Prematurity". A total of 582 articles were found, nine of which were selected. The main methodological differences observed were related to the classification of hypertensive syndromes of pregnancy, prematurity and confounding control. Even in the face of this, there was an association between the different categories of hypertensive syndromes of pregnancy and prematurity. The second article used data from a nationwide, hospital-based study entitled National Survey on Childbirth and Birth: "Born in Brazil", conducted between February 2011 and October 2012, with interviews with 23.894 women. For this article, the sample consisted of 20.494 puerperal women, of which 2.369 women had hypertensive pregnancy syndrome, which comprised the synthesis of positive responses to any of the questions related to increased blood pressure, presence of preeclampsia, HELLP syndrome contained in the questionnaires filled in with data from the hospital chart and prenatal card. The outcome was categorized into early (<34 weeks of gestation) and late (34-36 weeks of gestation) prematurity. To perform the analyses, an acyclic graph was designed to identify the adjustment covariates necessary to estimate the causal effect of the hypertensive syndromes of pregnancy on prematurity. The variables that constituted the minimum adjustment set were maternal age, maternal education, marital status, parity, pre-gestational body mass index, gestational weight gain, autoimmune disease, chronic kidney disease, pre-gestational diabetes mellitus, diabetes mellitus pregnancy, maternal anemia, urinary tract infection and adequacy of prenatal care. Then, the propensity score weighting method was applied to deal with the imbalance between exposed and unexposed groups. Among preterm infants (2.139), 2,6% were early and 7,8% were late. After weighting by the propensity score, women with hypertensive syndromes of X pregnancy were 2,74 times more likely to have early preterm infants (ORaj: 2,74; 95%CI: 2,12-3,54) and 2,40 of having late preterm infants (ORaj: 2,40; 95%CI: 1,86-3,08). In previous publications, an association was found between the hypertensive syndromes of pregnancy and prematurity. And based on the use of the propensity score method, it was possible to assess the causal effect of this exposure on early and late prematurity. Based on these results, it is important to emphasize the importance of adequate prenatal care for early diagnosis and treatment of women with hypertensive syndromes, aiming at reducing complications resulting from this clinical condition, especially prematurity.

A simple guidewire and angiocatheter technique for urinary catheter placement.

OBJECTIVE: To report on a simple technique of inserting any difficult urinary catheter using a hydrophilic guidewire and an angiocatheter. MATERIALS AND METHODS: A total of 764 requests were made to the urology team for assistance with a difficult urinary catheter placement. For all patients, either a regular or bent-tip catheter was attempted first. If the initial placement attempt failed, our technique using an angiocatheter, a hydrophilic guidewire, and a urinary catheter of choice was then employed. RESULTS: We were able to successfully insert 526 regular or bent-tip indwelling urinary catheters on first attempt (68.8%). Two hundred and four (26.7%) placements required the use of our described technique. No complication was encountered from the bedside maneuver. CONCLUSIONS: Our method is safe, easily learned, and performed. The technique saves time, effort, and resources, as it averts the necessity of rare use of expensive equipment, bedside flexible cystoscopy, and cystotomy.

Phenotypic and Genotypic Plasticity of Acaricide Resistance in Populations of Tetranychus urticae (Acari: Tetranychidae) on Peppermint and Silage Corn in the Pacific Northwest.

Tetranychus urticae Koch is a generalist pest of economic crops and is notorious for its rapid development of acaricide resistance. This poses a significant threat to the sustainability of integrated pest management (IPM) in cropping systems plagued by T. urticae. It is critical to evaluate the resistance status of T. urticae populations on crops and identify any underlying resistance mechanisms. This study investigated the efficacy of five major acaricides on T. urticae populations on peppermint and silage corn in the Pacific Northwestern United States and identified the underlying resistance mechanisms. Significant variations in acaricide resistance status of T. urticae populations were identified to abamectin, bifenthrin, fenpyroximate, hexythiazox, and spirodiclofen. In most cases, T. urticae populations from silage corn exhibited greater levels of acaricide resistance relative to peppermint populations. We detected known target-site mutations: F1534S and F1538I (conferring resistance to bifenthrin), G126S (linked with resistance to bifenazate), and I1017 (conferring resistance to hexythiazox and etoxazole) in 10, 90, and 90% of the populations, respectively, from peppermint fields. These four mutations were identified in all the populations collected from silage corn fields. Significantly higher transcript levels of metabolic genes associated with resistance to abamectin, fenpyroximate, and spirodiclofen were observed in some T. urticae populations collected from both peppermint and silage corn fields. This study provides evidence of multiple resistance to diverse active ingredients in field populations of T. urticae and the reliability of known molecular markers for active acaricide resistance monitoring. The observed resistance pattern will help in designing a sustainable IPM program for T. urticae.

EFFECT OF HYPOENERGETIC DIET COMBINED WITH CONSUMPTION OF COCONUT FLOUR IN OVERWEIGHT WOMEN.

INTRODUCTION: the prevalence of obesity has increased, especially among women. AIM: the aim of this study was to assess the effect of a hypoenergetic diet combined with coconut flour on anthropometric and biochemical data and the quality of the diet. METHODS: we carried out a crossover clinical trial involving a step with hypoenergetic diet only and another with the diet associated with coconut flour consumption (26 g) over the course of nine months. The volunteers were recruited from the São Gonçalo city of Rio de Janeiro. Anthropometric, biochemical and dietary data were collected monthly. The diet quality index revised for the Brazilian population (DQI-R) and the consumption of ultra-processed foods and additives were assessed. The Wilcoxon and Mann-Whitney tests were performed, with p < 0.05 considered statistically significant. RESULTS: forty-two women of an average 47.5 ± 9.5 years of age participated. The hypoenergetic diet promoted a decrease in body fat, body mass index, waist circumference, waist-to-height ratio, visceral adiposity index, diastolic blood pressure, triglycerides and VLDL. The consumption of coconut flour promoted a drop in glucose and total cholesterol levels when supplementing the hypoenergetic diet. The improvement to diet quality can be noted in the decrease in consumption of ultra-processed foods like vegetable oil, chocolate and soft drinks. CONCLUSION: the hypoenergetic diet promoted a decrease in the anthropometric parameters, blood pressure and triglycerides. The consumption of coconut flour promoted a decrease in glucose and total cholesterol levels when supplementing the hypoenergetic diet. The improved diet quality can be seen in the decrease in consumption of ultra- processed foods.

Introducción: la prevalencia de la obesidad ha aumentado, sobre todo entre las mujeres. Objetivo: el objetivo de este estudio fue evaluar el efecto de una dieta hipoenergética combinada con harina de coco en los datos antropométricos y bioquímicos y, así como la calidad de la dieta. Métodos: se realizó un ensayo clínico cruzado que incluyó un paso solo con dieta hipoenergética y otro con la dieta asociada con el consumo de harina de coco (26 g) a lo largo de nueve meses. Los voluntarios fueron reclutados de la ciudad de São Gonçalo de Río de Janeiro. Antropométrica, datos bioquímicos y dietéticos fueron recolectados mensualmente. Fueron evaluados el índice de calidad de la dieta revisado para la población brasileña (ICD-R) y el consumo de alimentos y aditivos ultraprocesados. Se realizaron las pruebas de Wilcoxon y Mann-Whitney, con p < 0,05, considerado estadísticamente significativo. Resultados: participaron cuarenta y dos mujeres con un promedio de 47,5 ± 9,5 años de edad. La dieta hipoenergética promovió una disminución de la grasa corporal, el índice de masa corporal, la circunferencia de la cintura, la relación cintura-talla, el índice de adiposidad visceral, la presión arterial diastólica, los triglicéridos y VLDL. El consumo de harina de coco promovió una caída en los niveles de colesterol y glucosa totales al complementar la dieta hipoenergética. La mejora de la calidad de la dieta puede observarse en la disminución del consumo de alimentos ultraprocesados como el aceite vegetal, el chocolate y los refrescos. Conclusión: la dieta hipoenergética promovió una disminución en los parámetros antropométricos, la presión arterial y los triglicéridos. El consumo de harina de coco favoreció una disminución de los niveles de colesterol y de glucosa totales cuando se complementa la dieta hipoenergética. La calidad de la dieta mejorada se puede ver en la disminución del consumo de alimentos ultraprocesados.

Effect of hypoenergetic diet combined with consumption of coconut flour in overweight women / Efecto de la dieta hipoenergética combinada con el consumo de harina de coco en las mujeres con sobrepeso

Introduction: the prevalence of obesity has increased, especially among women. Aim: the aim of this study was to assess the effect of a hypoenergetic diet combined with coconut flour on anthropometric and biochemical data and the quality of the diet. Methods: we carried out a crossover clinical trial involving a step with hypoenergetic diet only and another with the diet associated with coconut flour consumption (26 g) over the course of nine months. The volunteers were recruited from the São Gonçalo city of Rio de Janeiro. Anthropometric, biochemical and dietary data were collected monthly. The diet quality index revised for the Brazilian population (DQI-R) and the consumption of ultra-processed foods and additives were assessed. The Wilcoxon and Mann-Whitney tests were performed, with p < 0.05 considered statistically significant. Results: forty-two women of an average 47.5 ± 9.5 years of age participated. The hypoenergetic diet promoted a decrease in body fat, body mass index, waist circumference, waist-to-height ratio, visceral adiposity index, diastolic blood pressure, triglycerides and VLDL. The consumption of coconut flour promoted a drop in glucose and total cholesterol levels when supplementing the hypoenergetic diet. The improvement to diet quality can be noted in the decrease in consumption of ultra-processed foods like vegetable oil, chocolate and soft drinks. Conclusion: the hypoenergetic diet promoted a decrease in the anthropometric parameters, blood pressure and triglycerides. The consumption of coconut flour promoted a decrease in glucose and total cholesterol levels when supplementing the hypoenergetic diet. The improved diet quality can be seen in the decrease in consumption of ultra-processed foods (AU)

Introducción: la prevalencia de la obesidad ha aumentado, sobre todo entre las mujeres. Objetivo: el objetivo de este estudio fue evaluar el efecto de una dieta hipoenergética combinada con harina de coco en los datos antropométricos y bioquímicos y, así como la calidad de la dieta. Métodos: se realizó un ensayo clínico cruzado que incluyó un paso solo con dieta hipoenergética y otro con la dieta asociada con el consumo de harina de coco (26 g) a lo largo de nueve meses. Los voluntarios fueron reclutados de la ciudad de São Gonçalo de Río de Janeiro. Antropométrica, datos bioquímicos y dietéticos fueron recolectados mensualmente. Fueron evaluados el índice de calidad de la dieta revisado para la población brasileña (ICD-R) y el consumo de alimentos y aditivos ultraprocesados. Se realizaron las pruebas de Wilcoxon y Mann-Whitney, con p < 0,05, considerado estadísticamente significativo. Resultados: participaron cuarenta y dos mujeres con un promedio de 47,5 ± 9,5 años de edad. La dieta hipoenergética promovió una disminución de la grasa corporal, el índice de masa corporal, la circunferencia de la cintura, la relación cintura-talla, el índice de adiposidad visceral, la presión arterial diastólica, los triglicéridos y VLDL. El consumo de harina de coco promovió una caí- da en los niveles de colesterol y glucosa totales al complementar la dieta hipoenergética. La mejora de la calidad de la dieta puede observarse en la disminución del consumo de alimentos ultraprocesados como el aceite vegetal, el chocolate y los refrescos. Conclusión: la dieta hipoenergética promovió una disminución en los parámetros antropométricos, la presión arterial y los triglicéridos. El consumo de harina de coco favoreció una disminución de los niveles de colesterol y de glucosa totales cuando se complementa la dieta hipoenergética. La calidad de la dieta mejorada se puede ver en la disminución del consumo de alimentos ultraprocesados (AU)

A surface membrane protein of Entamoeba histolytica functions as a receptor for human chemokine IL-8: its role in the attraction of trophozoites to inflammation sites.

Entamoeba histolytica trophozoites respond to the presence of IL-8, moving by chemotaxis towards the source of the chemokine. IL-8 binds to the trophozoite membrane and triggers a response that activates signaling pathways that in turn regulate actin/myosin cytoskeleton organisation to initiate migration towards the chemokine, suggesting the presence of a receptor for IL-8 in the parasite. Antibodies directed to the human IL-8 receptor (CXCR1) specifically recognised a 29 kDa protein in trophozoite membrane fractions. The same protein was immunoprecipitated by this antibody from total amebic extracts. Peptide analysis of the immunoprecipitated protein revealed a sequence with high homology to a previously identified amebic outer membrane peroxiredoxin and a motif within the third loop of human CXCR1, which is an important site for IL-8 binding and activation of signaling processes. Immunodetection assays demonstrated that the anti-human CXCR1 antibody binds to the 29 kDa protein in a different but close site to where IL-8 binds to the trophozoite surface membrane, suggesting that human and amebic receptors for this chemokine share common epitopes. In the context of the human intestinal environment, a receptor for IL-8 could be a great advantage for E. histolytica trophozoite survival, as they could reach an inflammatory milieu containing abundant nutrients. In addition, it has been suggested that the high content of accessible thiol groups of the protein and its peroxidase activity could provide protection in the oxygen rich milieu of colonic lesions, allowing trophozoite invasion of other tissues and escape from the host immune response.

Deep vein thrombosis screening and risk factors in a high-risk trauma population.

BACKGROUND: Trauma patients requiring acute inpatient rehabilitation are significantly injured, with increased risk for deep vein thrombosis (DVT). We evaluated routine screening for occult DVT in such patients, and analyzed DVT risk factors. MATERIALS AND METHODS: Data from level I trauma center patients discharged to a single acute rehabilitation center (ARC) from 2007-2011 were retrospectively reviewed. Routine lower extremity duplex was performed on ARC admission. Follow-up data were collected for patients with occult DVT (ARC DVT). DVT predictors were evaluated using logistic regression. RESULTS: Of 622 patients, 534 (86%) had screening duplex; 26 (4.8%) had an ARC DVT. A majority of 442 patients (71%) received enoxaparin prophylaxis in hospital, for a median 64% of hospital days. Of ARC DVT patients, 17 received full anticoagulation and 16 received vena cava filters. Thirty-seven patients had DVT diagnosed in the hospital (hospital DVT) before discharge to ARC. Hospital DVT and ARC DVT groups were comparable except shorter median hospital length of stay and lower head abbreviated injury scale in ARC DVT patients. On multivariate analysis, increased intensive care unit length of stay, age >65 y, a lower percentage of hospital days receiving chemoprophylaxis, and delayed initiation of chemoprophylaxis were significantly predictive of DVT after adjustment for sex, mechanism, injury severity score, and admission systolic blood pressure. Presence of pelvic fractures and ages 50-65 y also posed an increased risk. CONCLUSIONS: The incidence of occult DVT on ARC admission is low in trauma patients. Several risk factors for DVT in the trauma ARC population were identified. Nonselective screening of all trauma patients on admission to ARC is not supported by this analysis.

Avaliação da Qualidade da Dieta Hipoenergética em Mulheres com Excesso de Peso / Assessment of the Quality of Hypoenergetic Diet in Overweight Women

Fundamentos: O número de mortes atribuíveis à dieta não saudável aumentou nas últimas décadas e osinstrumentos para sua avaliação apresentam inúmeras limitações.Objetivo: Avaliar o efeito da dieta hipoenergética nos dados antropométricos e bioquímicos e verificar sua qualidade pelo índice de qualidade da dieta revisado para população brasileira (IQD-R) e consumo de alimentosultraprocessados (AU), em mulheres com excesso de peso. Métodos: Estudadas 44 mulheres, com excesso de peso, submetidas à dieta hipoenergética por 180 dias. Foram coletados, mensalmente: pressão arterial (PA), dados antropométricos, bioquímicos e dietéticos. Para avaliação da qualidade da dieta empregou-se o IQD-R e o consumo de AU e ingredientes de adição. Utilizaram-se os testes de Wilcoxon e Mann-Whitney com significância estatística de p<0,05. Resultados: A média de idade encontrada foi 47,0±11,0 anos e do índice de massa corporal (IMC) foi 36,0±7,3kg/m2.Observou-se redução da massa corporal, IMC, perímetro do pescoço e da cintura, razão cintura/estatura, índice de adiposidade visceral, PA sistólica, concentrações de glicose, de triglicerídeos e lipopoproteínas de muito baixa densidade (VLDL-c). Houve melhora da qualidade da dieta em ambos os grupos com redução significativa do consumo de proteínas, lipídeos totais, ácidos graxos e sódio na dieta classificada como adequada; e redução da energia, glicose, VLDL-c e da PA na inadequada. Houve redução significativa do consumo de AU comorefrigerantes, macarrão instantâneo, sucos industrializados e açúcar de adição.Conclusão: A dieta hipoenergética reduziu parâmetros antropométricos e bioquímicos e essas modificações nãoforam explicadas pelo IQD-R, mas pela avaliação dos AU e ingredientes de adição.

Background: The number of deaths attributable to unhealthy diet has increased in recent decades, and the instruments for their assessment have several limitations. Objective: Evaluate the effect of the hypoenergetic diet in anthropometric and biochemical data, and check its quality based on the diet quality index revised for the Brazilian population (DQI-R), and on the consumption of ultra-processed food products (UPP) in women with overweight. Methods: This study covered 44 women with overweight undergoing a hypoenergetic diet for 180 days. Monthly appraisals: bloodpressure (BP), anthropometric, biochemical and dietary data. The DQI-R and the consumption of UPP and additives were used ascriteria to assess the diet quality. The Wilcoxon and Mann-Whitney tests were employed, with statistical significance of p<0.05. Results: The mean age found was 47.0±11.0 years, and the body mass index (BMI) was 36.0±7.3 kg/m2. It was observed a decrease in body mass, BMI, neck and waist circumferences, waist-to-height ratio, visceral adiposity index, systolic blood pressure, and in the concentrations of glucose, triglycerides and very low-density lipoproteins (VLDL-C). The quality of diet improved in both groupswith significant reduction in the consumption of protein, total lipids, fatty acids and sodium in the adequate diet; and there was a reduction in energy, glucose, VLDL-C and BP in the inadequate diet. There was a significant decrease in the consumption of UPP,such as soft drinks, instant noodles, processed juices, and added sugar foods.Conclusion: The hypoenergetic diet reduced anthropometric and biochemical parameters and these changes were not explained by DQI-R, but by the evaluation of UPP and additives.

Dr Alberto Germán Mora Docampo: ejemplo de integridad y dedicación al servicio de la medicina cubana / Dr Alberto Germán Mora Docampo: example of integrity and dedication to the service of the Cuban medicine

En el presente trabajo se reseñan los aspectos más significativos de la vida y obra del Dr Alberto Germán Mora Docampo y se resaltan los elementos más importantes de su etapa estudiantil, especialmente de la universitaria, donde se destacó por su disciplina, constante estudio, modestia y humanismo, a la vez que descubrió su pasión por la cirugía y decidió luchar desde entonces por la justicia social y la Revolución. Sus cualidades humanas y la destacada participación en las organizaciones políticas y de masas, así como los numerosos reconocimientos, premios, distinciones y condecoraciones que le fueron otorgados, lo conceptúan como paradigma de la medicina cubana(AU)

In this work, the most significant aspects in the life and work of Dr Alberto Germán Mora Docampo are pointed out and the most important elements in his stage as student are highlighted, especially from the university stage, where he was outstanding in discipline, constant study, modesty and humanism, at the same time that he discovered his passion for surgery and since then he decided to fight for the social justice and for the Revolution. His human qualities and the distinguished participation in the political and mass organizations, as well as the numerous recognitions, prizes, distinctions and decorations that were granted to him, make him a paradigm of the Cuban medicine(AU)

NEUROEVAL: software para la autoevaluación de educandos en una escuela de medicina ghanesa / NEUROEVAL: software para la autoevaluación de educandos en una escuela de medicina ghanesa / NEUROEVAL: software for self-evaluation of students in a medical school of Ghana / NEUROEVAL: software for self-evaluation of students in a medical school of Ghana

Se efectuó un estudio de desarrollo tecnológico en la Universidad para Estudios del Desarrollo, en especial la Escuela de Medicina y Ciencias de la Salud de Tamale (Northern Region, Ghana), de enero a marzo del 2010, mediante la confección de un software educativo nombrado NEUROEVAL, que incluía el contenido impartido sobre el sistema nervioso central en las clases prácticas de Anatomía y serviría para la autoevaluación de los estudiantes, previo al examen final de cada sección. La eficacia del software se validó mediante encuestas a usuarios (n=15) y expertos (n=7), los cuales coincidieron al evaluarlo como útil (93,7 y 100,0 por ciento, respectivamente). En cuanto a su diseño, los usuarios lo hallaron funcional y comprensible, mientras que los expertos refirieron que era simple. El contenido fue valorado como importante para ambos grupos. En fin, el aporte de esta herramienta informática al proceso docente fue satisfactorio(AU)

Se efectuó un estudio de desarrollo tecnológico en la Universidad para Estudios del Desarrollo, en especial la Escuela de Medicina y Ciencias de la Salud de Tamale (Northern Region, Ghana), de enero a marzo del 2010, mediante la confección de un software educativo nombrado NEUROEVAL, que incluía el contenido impartido sobre el sistema nervioso central en las clases prácticas de Anatomía y serviría para la autoevaluación de los estudiantes, previo al examen final de cada sección. La eficacia del software se validó mediante encuestas a usuarios (n=15) y expertos (n=7), los cuales coincidieron al evaluarlo como útil (93,7 y 100,0 por ciento, respectivamente). En cuanto a su diseño, los usuarios lo hallaron funcional y comprensible, mientras que los expertos refirieron que era simple. El contenido fue valorado como importante para ambos grupos. En fin, el aporte de esta herramienta informática al proceso docente fue satisfactorio(AU)

A technological development study was conducted at the University for Development Studies, especially School of Medicine and Health Sciences of Tamale (Northern Region, Ghana) from January to March 2010, by means of an educational software named NEUROEVAL, including the content imparted on the central nervous system in Anatomy practical classes and it would serve for the self-evaluation of students before the final examination of each section. The effectiveness of the software was validated through users (n =15) and experts (n=7) surveys, who agreed to evaluate it as useful (93.7 percent and 100.0%, respectively). On terms of design, users found it functional and comprehensible, while experts reported that it was simple. The content was valued as important for both groups. Finally, the contribution of this computer tool to the educational process was satisfactory(AU)

A technological development study was conducted at the University for Development Studies, especially School of Medicine and Health Sciences of Tamale (Northern Region, Ghana) from January to March 2010, by means of an educational software named NEUROEVAL, including the content imparted on the central nervous system in Anatomy practical classes and it would serve for the self-evaluation of students before the final examination of each section. The effectiveness of the software was validated through users (n =15) and experts (n=7) surveys, who agreed to evaluate it as useful (93.7 percent and 100.0%, respectively). On terms of design, users found it functional and comprehensible, while experts reported that it was simple. The content was valued as important for both groups. Finally, the contribution of this computer tool to the educational process was satisfactory(AU)

NEUROEVAL: software para la autoevaluación de educandos en una escuela de medicina ghanesa / NEUROEVAL: software for self-evaluation of students in a medical school of Ghana

Se efectuó un estudio de desarrollo tecnológico en la Universidad para Estudios del Desarrollo, en especial la Escuela de Medicina y Ciencias de la Salud de Tamale (Northern Region, Ghana), de enero a marzo del 2010, mediante la confección de un software educativo nombrado NEUROEVAL, que incluía el contenido impartido sobre el sistema nervioso central en las clases prácticas de Anatomía y serviría para la autoevaluación de los estudiantes, previo al examen final de cada sección. La eficacia del software se validó mediante encuestas a usuarios (n=15) y expertos (n=7), los cuales coincidieron al evaluarlo como útil (93,7 y 100,0 %, respectivamente). En cuanto a su diseño, los usuarios lo hallaron funcional y comprensible, mientras que los expertos refirieron que era simple. El contenido fue valorado como importante para ambos grupos. En fin, el aporte de esta herramienta informática al proceso docente fue satisfactorio.

A technological development study was conducted at the University for Development Studies, especially School of Medicine and Health Sciences of Tamale (Northern Region, Ghana) from January to March 2010, by means of an educational software named NEUROEVAL, including the content imparted on the central nervous system in Anatomy practical classes and it would serve for the self-evaluation of students before the final examination of each section. The effectiveness of the software was validated through users (n =15) and experts (n=7) surveys, who agreed to evaluate it as useful (93.7% and 100.0%, respectively). On terms of design, users found it functional and comprehensible, while experts reported that it was simple. The content was valued as important for both groups. Finally, the contribution of this computer tool to the educational process was satisfactory.

Molecular and functional characterization of an Entamoeba histolytica protein (EhMLCI) with features of a myosin essential light chain.

Entamoeba histolytica, a protozoan parasite of humans, relays on its striking motility to survive and invade host tissues. Characterization of the molecular components involved in motile processes is crucial to understand its pathogenicity. Although protein components of myosin II hexamers have been predicted from E. histolytica genome data, only a heavy chain of myosin, EhmhcA, has been characterized so far. We have cloned an E. histolytica cDNA sequence that best matched Dictyostelium discoideum myosin essential light chain and found that the cloned sequence is transcribed as an mRNA of 0.445 kb which could encode a protein of 16.88 kDa, within the predicted range for a myosin light chain. In silico analyses revealed that the protein sequence, named EhMLCI, shows two consensus domains for binding MHC, but lacks the N-terminal sequence for actin binding, as in A2 type myosin essential light chains. A single EF-hand calcium-binding domain was identified in the C-terminus and several high score predictability sites for serine and tyrosine phosphorylation. Antibodies to recombinant EhMLCI identified two proteins of approximately 17 and 15 kDa in trophozoite extracts, the latter phophorylated in tyrosines. Serine phosphorylation was not detected. Immunomicroscopy revealed EhMLCI cortical and cytoplasmic distribution in trophozoites and true colocalization with EhmhcA determined by PCC. Co-immunoprecipitation corroborated EhMLCI interaction with EhmhcA. EhMLCI was also localized in actomyosin-containing complexes. Differential partition of phospho-tyrosinated EhMLCI into cell fractions containing the soluble form of EhmhcA and its lack of serine phosphorylation suggest its possible participation in a novel down regulatory mechanism of myosin II activity in E. histolytica.

Evaluation of the Perkins handheld applanation tonometer in horses and cattle.

The objective of this study was to evaluate and validate the accuracy of the Perkins handheld applanation tonometer for measuring intraocular pressure (IOP) in horses and cattle. Both eyes of 10 adult horses and cattle were evaluated in a postmortem study. The eyes from 10 clinically normal adult horses and cattle were also examined after bilateral auriculopalpebral nerve block and topical anesthesia for an in vivo study. IOP was measured postmortem using direct manometry (measured with an aneroid manometer) and tonometry (measured with a Perkins handheld applanation tonometer). The correlation coefficients (r(2)) for the data from the postmortem manometry and Perkins tonometer study were 0.866 for horses and 0.864 for cattle. In the in vivo study, IOP in horses was 25.1 ± 2.9 mmHg (range 19.0~30.0 mmHg) as measured by manometry and 23.4 ± 3.2 mmHg (range 18.6~28.4 mmHg) according to tonometry. In cattle, IOP was found to be 19.7 ± 1.2 mmHg (range 18.0~22.0 mmHg) by manometry and 18.8 ± 1.7 mmHg (range 15.9~20.8 mmHg) by tonometry. There was a strong correlation between the IOP values obtained by direct ocular manometry and the tonometer in both horses and cattle. Our results demonstrate that the Perkins handheld tonometer could be an additional tool for accurately measuring IOP in equine and bovine eyes.

Indicadores de estrés oxidativo durante la descompensación metabólica en pacientes con hipertensión arterial de tipo II / Indicators of oxidative stress during the metabolic decompensation in patients with hypertension type II

Se realizó un estudio longitudinal y prospectivo para determinar la influencia del cambio metabólico, según niveles de glucemia, sobre el estrés oxidativo en pacientes con hipertensión arterial de tipo II en el Hospital Hermanos Ameijeiras de Ciudad de La Habana entre los años 1997 y 2005, en colaboración con la Facultad de Medicina No. 2 del Instituto Superior de Ciencias Médicas de Santiago de Cuba y The University of the West Indies de Jamaica. El incremento significativo de los niveles de malonildialdehído (p = 0,0002) en el momento de descompensación de la diabetes, reveló que durante el estado de hiperglucemia hubo una degradación sustancial de ácidos grasos, con su consecuente influencia sobre el estrés oxidativo en la población investigada(AU)

A longitudinal and prospective study was carried out to determine the influence of the metabolic change, according to glycemia levels, on the oxidative stress in patients with hypertension type II in Hermanos Ameijeiras Hospital from Havana city between the years 1997-2005, in collaboration with the Medicine Faculty No. 2 of the Medical University in Santiago de Cuba and the University of the West Indies from Jamaica. The significant increase of malonyldialdehyde levels (p = 0,0002) in the moment of decompensation of diabetes, revealed that during the hyperglycemia there was a substantial degradation of fatty acids, with their consequent influence on the oxidative stress in the examined population(AU)

Indicadores de estrés oxidativo durante la descompensación metabólica en pacientes con hipertensión arterial de tipo II / Indicators of oxidative stress during the metabolic decompensation in patients with hypertension type II

Se realizó un estudio longitudinal y prospectivo para determinar la influencia del cambio metabólico, según niveles de glucemia, sobre el estrés oxidativo en pacientes con hipertensión arterial de tipo II en el Hospital Hermanos Ameijeiras de Ciudad de La Habana entre los años 1997 y 2005, en colaboración con la Facultad de Medicina No. 2 del Instituto Superior de Ciencias Médicas de Santiago de Cuba y The University of the West Indies de Jamaica. El incremento significativo de los niveles de malonildialdehído (p = 0,0002) en el momento de descompensación de la diabetes, reveló que durante el estado de hiperglucemia hubo una degradación sustancial de ácidos grasos, con su consecuente influencia sobre el estrés oxidativo en la población investigada.

A longitudinal and prospective study was carried out to determine the influence of the metabolic change, according to glycemia levels, on the oxidative stress in patients with hypertension type II in Hermanos Ameijeiras Hospital from Havana city between the years 1997-2005, in collaboration with the Medicine Faculty No. 2 of the Medical University in Santiago de Cuba and the University of the West Indies from Jamaica. The significant increase of malonyldialdehyde levels (p = 0,0002) in the moment of decompensation of diabetes, revealed that during the hyperglycemia there was a substantial degradation of fatty acids, with their consequent influence on the oxidative stress in the examined population.

The interplay between Entamoeba and enteropathogenic bacteria modulates epithelial cell damage.

BACKGROUND: Mixed intestinal infections with Entamoeba histolytica, Entamoeba dispar and bacteria with exacerbated manifestations of disease are common in regions where amoebiasis is endemic. However, amoeba-bacteria interactions remain largely unexamined. METHODOLOGY: Trophozoites of E. histolytica and E. dispar were co-cultured with enteropathogenic bacteria strains Escherichia coli (EPEC), Shigella dysenteriae and a commensal Escherichia coli. Amoebae that phagocytosed bacteria were tested for a cytopathic effect on epithelial cell monolayers. Cysteine proteinase activity, adhesion and cell surface concentration of Gal/GalNAc lectin were analyzed in amoebae showing increased virulence. Structural and functional changes and induction of IL-8 expression were determined in epithelial cells before and after exposure to bacteria. Chemotaxis of amoebae and neutrophils to human IL-8 and conditioned culture media from epithelial cells exposed to bacteria was quantified. PRINCIPAL FINDINGS: E. histolytica digested phagocytosed bacteria, although S. dysenteriae retained 70% viability after ingestion. Phagocytosis of pathogenic bacteria augmented the cytopathic effect of E. histolytica and increased expression of Gal/GalNAc lectin on the amoebic surface and increased cysteine proteinase activity. E. dispar remained avirulent. Adhesion of amoebae and damage to cells exposed to bacteria were increased. Additional increases were observed if amoebae had phagocytosed bacteria. Co-culture of epithelial cells with enteropathogenic bacteria disrupted monolayer permeability and induced expression of IL-8. Media from these co-cultures and human recombinant IL-8 were similarly chemotactic for neutrophils and E. histolytica. CONCLUSIONS: Epithelial monolayers exposed to enteropathogenic bacteria become more susceptible to E. histolytica damage. At the same time, phagocytosis of pathogenic bacteria by amoebae further increased epithelial cell damage. SIGNIFICANCE: The in vitro system presented here provides evidence that the Entamoeba/enteropathogenic bacteria interplay modulates epithelial cell responses to the pathogens. In mixed intestinal infections, where such interactions are possible, they could influence the outcome of disease. The results offer insights to continue research on this phenomenon.

Eficacia del tratamiento conservador en las fracturas mandibulares / Effectiveness of the conservative procedure in mandibular fractures

Se realizó un estudio en 30 pacientes con fractura mandibular, que fueron atendidos en el servicio de cirugía máxilofacial del Hospital Universitario Abel Santamaría Cuadrado, en el periodo comprendido desde el 1ro de noviembre del 2002 hasta el 28 de febrero del 2006, con el objetivo de demostrar la eficacia del tratamiento conservador en las fracturas mandibulares según los resultados obtenidos con la reducción de la fractura, fijación y oclusión dentaria. Se plantean y analizan los resultados obtenidos, encontrando una mayor incidencia de estas fracturas de 25 a 34 años de edad, siendo las fracturas con desplazamiento y factor dentario favorable las de mayor incidencia y existiendo en el 100 por ciento de los pacientes, al realizar el tratamiento conservador una reducción anatómica, adecuada fijación y buena oclusión...(AU)

A study of 30 patients suffering from mandibular fracture attended at the Oral Surgery Office was carried out at Abel Santamaría Cuadrado General hospital during November 1, 2002 to February 28, 2006. It was aimed at demonstrating the effectiveness of the findings obtained with the reduction of the fracture, fixation and dental occlusion. Findings were analyzed showing a higher incidence in 25 -34 year-old subjects, having the dislocated fractures and the dental factor a higher incidence. In 100 per cent of cases it was observed an anatomic reduction and a proper fixation as well as a good occlusion when the conservative procedure was done...(AU)

Eficacia del tratamiento conservador en las fracturas mandibulares / Effectiveness of the conservative procedure in mandibular fractures

Se realizó un estudio en 30 pacientes con fractura mandibular, que fueron atendidos en el servicio de cirugía máxilofacial del Hospital Universitario "Abel Santamaría Cuadrado", en el periodo comprendido desde el 1ro de noviembre del 2002 hasta el 28 de febrero del 2006, con el objetivo de demostrar la eficacia del tratamiento conservador en las fracturas mandibulares según los resultados obtenidos con la reducción de la fractura, fijación y oclusión dentaria. Se plantean y analizan los resultados obtenidos, encontrando una mayor incidencia de estas fracturas de 25 a 34 años de edad, siendo las fracturas con desplazamiento y factor dentario favorable las de mayor incidencia y existiendo en el 100 % de los pacientes, al realizar el tratamiento conservador una reducción anatómica, adecuada fijación y buena oclusión.

A study of 30 patients suffering from mandibular fracture attended at the Oral Surgery Office was carried out at "Abel Santamaría Cuadrado" General hospital during November 1, 2002 to February 28, 2006. It was aimed at demonstrating the effectiveness of the findings obtained with the reduction of the fracture, fixation and dental occlusion. Findings were analyzed showing a higher incidence in 25 -34 year-old subjects, having the dislocated fractures and the dental factor a higher incidence. In 100% of cases it was observed an anatomic reduction and a proper fixation as well as a good occlusion when the conservative procedure was done.

Tutorbioc / Tutorbioc

El llamado aprendizaje desarrollador busca la participación activa del estudiante en la que los mismos aprenden a aprender. Con esta premisa y tomando como fundamento la insuficiencia demostrada a través del tiempo por los estudiantes del primer año de Medicina para lograr la adquisición e integración de los contenidos relacionados en el Tema Biocatalizadores insertado en el programa de la asignatura Biología Molecular y Celular (BCM), dada su abstractibilidad y complejidad, características referidas por el 90 por ciento de los 50 estudiantes encuestados al efecto, se diseñó y elaboró un software de tipo Tutorial denominado TUTORBIOC para el estudio de los Biocatalizadores o Enzimas, con el objetivo de lograr una mayor asimilación, sistematización e integración de dichos contenidos, a la vez que se propicia la motivación hacia su estudio y la independencia de los mismos para hacer más eficiente su posterior desempeño como profesionales en la comunidad. Dicho software consta de varias secciones como: Introducción, Objetivos, Contenido, Ayuda, Internet, Comentarios y Evaluación , que permiten a los usuarios el abordaje de los principales tópicos a dominar, la retroalimentación y evaluación de los contenidos abordados, la manipulación del software a través de las instrucciones para su uso y aplicación, la revisión de aspectos novedosos relacionados con el tema, la comunicación con el autor por correo electrónico y la emisión de opiniones y sugerencias acerca de lo tratado. Fue elaborado en forma de páginas Web, con lenguaje HTLM, utilizando como editor el sistema FRONT PAGE 2003 y como visualizador el Internet Explorer 6, lo cual hace muy práctica, accesible y universal su utilización, pues no demanda del usuario grandes conocimientos de Informática y se puede implementar con relativa facilidad en nuestros laboratorios docentes con un mínimo requerimiento tecnológico(AU)