Imaging fibrosis in pediatric kidney transplantation: A pilot study.

BACKGROUND: Noninvasive alternatives to biopsy for assessment of interstitial fibrosis and tubular atrophy (IFTA), the major determinant of kidney transplant failure, remain profoundly limited. Elastography is a noninvasive technique that propagates shear waves across tissues to measure their stiffness. We aimed to test utility of elastography for early detection of IFTA in pediatric kidney allografts. METHODS: We compared ultrasound (USE) and MR elastography (MRE) stiffness measurements, performed on pediatric transplant recipients referred for clinically indicated biopsies, and healthy controls. RESULTS: Ten transplant recipients (median age 16 years) and eight controls (median age 16.5 years) were enrolled. Three transplant recipients had "stable" allografts and seven had Banff Grade 1 IFTA. Median time from transplantation to biopsy was 12 months. Mean estimated glomerular filtration rate was 61.5 mL/min/1.73m2 by creatinine-cystatin-C CKiD equation at time of biopsy. Mean stiffness, calculated through one-way ANOVA, was higher for IFTA allografts (23.4 kPa USE/5.6 kPa MRE) than stable allografts (13.7 kPa USE/4.4 kPa MRE) and controls (9.1 kPa USE/3.6 kPa MRE). Pearson's coefficient between USE and MRE stiffness values was strong (r = .97). AUC for fibrosis prediction in transplanted kidneys was high for both modalities (0.91 USE and 0.89 MRE), although statistically nonsignificant (p > .05). Stiffness cut-off values for USE and MRE were 13.8 kPa and 4.6 kPa, respectively. Both values yielded a sensitivity of 100% but USE specificity (72%) was slightly higher than MRE (67%). CONCLUSION: Elastography shows potential for detection of low-grade IFTA in allografts although a larger sample is imperative for clinical validation.

The gut microbiota of chickens in a commercial farm treated with a Salmonella phage cocktail.

The microbiota in broiler chicken intestines affects the animals' health, metabolism, and immunity both positively and negatively. Accordingly, it has a significant impact on animal productivity. Phages, host-specific parasites of bacterial cells, are a promising antimicrobial alternative that selectively target pathogens without disturbing the microbiota. The purpose of this study is to further characterize the commensal microbial community at production scale in broiler chickens treated with a Salmonella phage treatment. We evaluated the cecal microbiota of broilers reared in a commercial farming system where a phage cocktail against Salmonella, SalmoFree was supplied to animals. To do so, two field trials were conducted, incorporating three doses of phages in the broilers' drinking water. Our results showed that the core microbiome (taxa that were present in more than 50% of samples) contained species that are key to microbiota adaptation in the last stage of the production cycle. Among these, there are some important degraders of complex polysaccharides and producers of short chain fatty acids (SCFA) such as Eisenbergiella and Lachnoclostridium. The phage cocktail did not affect the normal development of the microbiota's structure. The addition of the phage cocktail resulted in a significant reduction in Campylobacter and an increase in Butyricimonas, Helicobacter and Rikenellaceae, which are common inhabitants in chicken gut with known negative and positive effects on their health and metabolism. Altogether, we consider that these results contribute valuable information to the implementation of large-scale phage therapy technologies.

Predictors of Complication Following Cleft Lip and Palate Surgery in a Low-Resource Setting: A Prospective Outcomes Study in Nicaragua.

BACKGROUND: Higher rates of postoperative complication following cleft lip or palate repair have been documented in low resource settings, but their causes remain unclear. This study sought to delineate patient, surgeon, and care environment factors in cleft complications in a low-income country. DESIGN: Prospective outcomes study. SETTING: Comprehensive Cleft Care Center. PATIENTS: Candidate patients presenting for cleft lip or palate repair or revision. INTERVENTIONS: Patient anthropometric, nutritional, environmental and peri- and post-operative care factors were collected. Post-operative evaluation occurred at standard 1-week and 2-month postoperative intervals. MAIN OUTCOME MEASURES: Complication was defined as fistula, dehiscence and/or infection. RESULTS: Among 408 patients enrolled, 380 (93%) underwent surgery, of which 208 (55%) underwent lip repair (124) or revision (84), and 178 (47%) underwent palate repair (96) or revision (82). 322 (85%) were evaluated 1 week and 166 (44%) 2 months postoperatively. 50(16%) complications were identified, including: 25(8%) fistulas, 24(7%) dehiscences, 17(5%) infections. Mid-upper arm circumference (MUAC) ≤12.5 cm was associated with dehiscence after primary lip repair (OR = 28, p = 0.02). Leukocytosis ≥11,500 on pre-operative evaluation was associated with dehiscence (OR = 2.51, p = 0.04) or palate revision fistula (OR = 64, p < 0.001). Surgeons who performed fewer previous-year palate repairs had higher likelihood of palate complications, (OR = 3.03, p = 0.01) although there was no difference in complication rate with years of surgeon experience or duration of surgery. CONCLUSIONS: Multiple patient, surgeon, and perioperative factors are associated with higher rates of complication in a low-resource setting, and are potentially modifiable to reduce complications following cleft surgery.

Estudio retrospectivo del carcinoma de células escamosas en bovinos en el departamento de Nariño, Colombia / Retrospective Study of Squamous Cell Carcinoma in Bovines in Nariño Province, Colombia / Estudo retrospectivo do carcinoma de células escamosas em bovinos no departamento de Nariño, Colômbia

Resumen El carcinoma de células escamosas (CCE) es la neoplasia más frecuente en los bovinos. El trabajo determinó la frecuencia del CCE y factores de riesgo asociados desde el año 2007 hasta el 2019, en el departamento de Nariño. Se analizaron 82 casos de la base de datos de la clínica de animales grandes de la Universidad de Nariño, teniendo en cuenta las variables: raza, edad, número de partos, ubicación del tumor, pigmentación de la piel y la altura sobre el nivel del mar de las fincas. Posteriormente, se formaron tres grupos: < 3 años (jóvenes), entre 4 y 7 años (adultos) y > 8 años (seniles). Las 56 fincas están ubicadas a 2973 ± 197.01 metros sobre el nivel del mar (msnm). Las razas estudiadas fueron: Holstein 81.2 %, Normando 7.2%, Montbeliarde 3.4 %, Simhol 3.4 %, Criollas 2.4 %, Jersey 1.2 % y Cebú 1.2 %. La presentación de CCE comprometía en su mayoría, la región ocular y periorbital 85.3 %, seguida de vulva 11.1 % y entre el dorso, ubre y cuerno en un 3.9 %. La despigmentación de la piel se presentó en 31.7 % de los casos. El promedio de edad fue 7.7 ± 1.58 años; dos novillas, 58 adultos y 22 seniles con un promedio de 4.7 ± 1.35 partos. La frecuencia de presentación fue significativamente mayor en animales adultos (p < 0.001). La ubicación del carcinoma fue mayor en el ojo y en el tejido periorbital (p < 0.005), la presentación fue significativa en animales con áreas de piel no pigmentada y en la raza Holstein (p < 0.005 y p < 0.001 respectivamente). Se determinó como factor de riesgo la edad, la despigmentación y la altitud (msnm) de las fincas. El estudio representa el primer reporte de ocurrencia y factores asociados al CCE en bovinos, en el Departamento de Nariño.

Abstract Squamous Cell Carcinoma (SCC) is the most frequent neoplasia in bovines. This work determined the SCC frequency and the associated risk factors from 2007 to 2019 in Nariño Province. Eighty-two cases from the big animal clinic database at the Universidad de Nariño were analyzed. The variables considered herein include: breed, age, parity, tumor location, skin pigmentation and MASL of the farms. Three groups were created: < 3 years old (younger), from 4 to 7 years old (adults), and > 8 years old (elder). The 56 farms are located at 2973 ± 197.01 meters above sea level. The studied breeds include Holstein 81.2%, Normando 7.2%, Montbeliarde 3.4%, Simhol 3.4%, Criollas 2.4%, Jersey 1.2% and Cebú 1.2%. the SCC compromised the eye and periorbital regions in 85.3% of the cases, followed by the vulva 11.1%, and 3.9% in the back, udder and horns. Skin depigmentation was observed in 31.7% of the cases. The average age was 7.7 ± 1.58 years; 2 heifers, 58 adults and 22 elders with a parity of 4.7 ± 1.35 on average. Appearance frequency was significantly higher in adult animals (p<0,001). The location of the carcinoma was greater in the eye and the periorbital tissue (p<0,005). The appearance was significantly higher in animals with non-pigmented skin areas and in the Holstein breed (p<0.005 and p<0.001, respectively). The risk factors found in this research were age, depigmentation and MASL of the farms. This study is the first report of occurrence and factors associated with the SCC in bovines in the Nariño Province.

Resumo O carcinoma de células escamosas (CEC) é a neoplasia mais comum em bovinos. O trabalho determinou a frequência da CCE e os fatores de risco associados de 2007 a 2019, no departamento de Nariño. Foram analisados ​​82 casos a partir do banco de dados da clínica de grandeis animais da Universidade de Nariño, considerando as variáveis: raça, idade, número de partos, localização do tumor, pigmentação da pele e altura acima do nível de mar das fazendas. Três grupos foram formados : <3 anos (jovens), entre 4 e 7 anos (adultos) e> 8 anos (senis). As 56 fazendas estão localizadas a 2973 ± 197,01 metros sobre o nível do mar (msnm). As raças estudadas foram: Holstein 81,2%, Normando 7,2%, Montbeliarde 3,4%, Simhol 3,4%, Crioulo 2,4%, Jersey 1,2% e Cebu 1,2%. A apresentação da CCE comprometeu principalmente a região ocular e periorbital em 85,3%, seguida pela vulva em 11,1% e entre as costas, úbere e corno em 3,9%. A despigmentação da pele ocorreu em 31,7% dos casos. A idade média foi de 7,7 ± 1,58 anos; duas novilhas, 58 adultos e 22 senis, com média de 4,7 ± 1,35 partos. A frequência de apresentação foi significativamente maior em animais adultos (p <0,001). A localização do carcinoma foi maior no olho e no tecido periorbital (p <0,005), a apresentação foi significativa em animais com áreas de pele não pigmentada e na raça Holstein (p <0,005 e p<0,001, respectivamente). A idade, despigmentação e altitude (msnm) das fazendas foram determinadas como fator de risco. O estudo representa o primeiro relato de ocorrência e fatores associados à CCE em bovinos, no Departamento de Nariño.

Comparación de los niveles de agresión entre hombres que ejercen violencia en la pareja y un grupo control, medidos con la versión chilena de la Escala de Agresión de Buss and Perry / Comparison of aggression levels between a perpetrators of intimate partner violence group and a control group, assessed by the chilean version of the Buss and Perry Aggression Scale

Antecedentes: La violencia hacia la pareja es un grave problema de salud pública, con una prevalencia que llega al 49% para la violencia psicológica y 13% para la violencia física. Objetivo: Comparar los niveles de agresión entre una muestra de hombres derivados a terapia por violencia intrafamiliar (n = 34) y una muestra no clínica (n = 40) mediante la versión chilena de la escala AQ. Método: Estudio observacional comparativo analítico de corte transversal. Resultados: Se encuentran diferencias estadísticamente significativas a favor del grupo de perpetradores en puntajes de AQ total (p = 0,013), en la subescala de agresión física (p = 0,005), en la subescala de ira (p = 0,005) y en la subescala de hostilidad (p = 0,000). No se encontraron diferencias estadísticamente significativas en la subescala agresión verbal (p = 0,705), a pesar de ser los puntajes del grupo clínico superiores al grupo control. Conclusiones: Resultados concuerdan parcialmente con hallazgos de investigaciones anteriores. Se discuten resultados desde una perspectiva empírica y sociológica.

Background: Intimate partner violence is a serious public health problem, with a prevalence reaches 49% for psychological violence and 13% physical violence. Aim: To compare the levels of aggression between a sample of men referred for domestic violence therapy (n = 34) and a nonclinical sample (N = 40), assessed by the Chilean version ofthe AQ scale. Method: Comparative analytical observational cross-sectional study Results: Statistically significant differences in favor of the group of perpetrators was found, in overall AQ scores (p = 0.013), physical aggression subscale (p = 0.005), anger subscale (p = 0.005) and hostility subscale (p = 0.000). No statistically significant differences were found in verbal aggression subscale (p = 0.705), despite being the clinical group scores higher than the control group. Conclusions: Results are partially consistent with findings from previous research. Results are discussed from an empirical and sociological perspective.

Intervención neuropsicológica de la memoria en un caso infantil diagnosticado con VIH / Neuropsychological intervention of memory in a child diagnosed with HIV

J.V. es una paciente de 11 años, diagnosticada con VIH por transmisión vertical, quien presenta alteraciones en su neurodesarrollo y problemas de aprendizaje causados por el virus. En la preevaluación neuropsicológica, tras realizar un análisis sindrómico, se encontró que el proceso psicológico más afectado es la memoria, tanto a nivel de la retención audioverbal como la visual. De manera secundaria se encontró debilitado el mecanismo de regulación y control. Por ello, se diseñó y aplicó un programa neuropsicológico bajo la perspectiva histórico cultural buscando prioritariamente rehabilitar su memoria audioverbal y visual, y de manera secundaria la regulación y el control. La intervención constó de 32 sesiones, realizadas 4 veces por semana, cada una de 45 minutos. La evaluación final mostró cambios en la memoria de J.V., logrando mayor número de palabras e imágenes evocadas espontáneamente, además de mayores niveles de regulación en las actividades. Los resultados obtenidos permiten concluir que es posible intervenir positivamente la memoria en niños diagnosticados con VIH. Este reporte de caso proporciona evidencia de la importancia de establecer una relación coherente entre un modelo teórico (histórico-cultural) y la práctica clínica neuropsicológica.

J.V. is an 11 years old female patient diagnosed with HIV, since she was born, and who shows neurodevelopmental and learning disabilities caused by the virus. The results of her last neuropsychological assessment highlighted that memory was one of the most weakened psychological processes. A program to rehabilitate J.V. audio-verbal and visual memory was designed. The program lasted 32 sessions, 4 times per week, each one of 45 minutes long. The post-intervention assessment showed changes in the memory of J.V., achieving greater number of words and images spontaneously evoked. Also, the girl achieved greater levels of self-regulation in this type of tasks. The results suggest the possibility of improving memory performance of children diagnosed with HIV. This report evidences the relevance of establishing a coherent relationship between the theoretical model (historical-cultural) and the neuropsychological clinical practice.

Consideraciones sobre la sexualidad en estudiantes del programa de formación del nuevo médico latinoamericano / Considerations on sexuality in students from the training program of the new Latin American physician

Objetivos: explorar comportamientos y actitudes de los estudiantes del programa de formación del nuevo médico latinoamericano en algunos aspectos relacionados con la sexualidad. Métodos: se realizó un estudio descriptivo de corte transversal en 235 estudiantes del citado programa, entre los meses de octubre a diciembre del año 2008. La información se recogió mediante la aplicación de un cuestionario estructurado que examina variables del comportamiento sexual: relaciones sexuales, edad de inicio, antecedentes de infecciones de transmisión sexual, métodos de protección y necesidades de información. Resultados: en la mayoría de los estudiantes la conducta sexual no se correspondió con el nivel de conocimientos que tienen sobre temas relacionados con la sexualidad. El 25,9 por ciento mantuvo relaciones sexuales sin protección, el 1,3 por ciento tenía varias parejas sexuales, el 51,9 por ciento refirió que ocasionalmente tenía sus relaciones sexuales sin protección mientras el 44,8 por ciento dijo que siempre se protegían para mantener estas relaciones. Conclusiones: los estudiantes inician las relaciones sexuales en edades precoces con tendencia a que los varones comiencen primero, la mayoría sin protección en la primera relación sexual. Aunque conocen las ventajas del uso del condón para evitar una infección de transmisión sexual, un grupo considerable no lo utiliza. Los estudiantes refieren la necesidad de información sobre temas relacionados con la sexualidad, siendo los más solicitados los que tienen que ver con estas infecciones y la sexualidad con enfoque de género...

Objectives: to explore the behaviors and attitudes of students from the Program of the New Latin American Physician in some features related to sexuality. Methods: a descriptive and cross-sectional study was conducted in 235 students of above mentioned program from October to December, 2008. Information was obtained by application of a structured questionnaire examining the following variables of sexual behavior: sexual intercourses, age at onset, background of sexually transmitted infections, methods of protection and needs of information. Results: in most of students sexual behavior was not in correspondence with the level of knowledges on these subjects related to sexuality. The 25.9 percent had sexual intercourses without protection, the 1.3 percent had some sexual partners, the 51.9 percent mentioned that occasionally had sexual intercourses without protection, whereas the 44.8 percent said that always used condom in its sexual intercourses. Conclusions: student started the sexual intercourse in early ages where the males start first, most without protection in the first sexual intercourse. Although they know the advantages of condom use to avoid sexually transmitted infection a significant number not use it. Student refer the need of information on subjects related to sexuality, where the more requested are related to these infections and sexuality with a gender approach...

Distribution and temporal variation of trace metal enrichment in surface sediments of San Jorge Bay, Chile.

Cu, Pb, and Hg concentrations were determined in surface sediment samples collected at three sites in San Jorge Bay, northern Chile. This study aims to evaluate differences in their spatial distribution and temporal variability. The highest metal concentrations were found at the site "Puerto", where minerals (Cu and Pb) have been loaded for more than 60 years. On the other hand, Hg does not pose a contamination problem in this bay. Cu and Pb concentrations showed significant variations from 1 year to another. These variations seem to be a consequence of the combination of several factors, including changes in the loading and/or storage of minerals in San Jorge Bay, the dredging of bottom sediments (especially at Puerto), and seasonal changes in physical-chemical properties of the water column that modify the exchange of metals at the sediment-water interface. Differences in the contamination factor and geoaccumulation index suggest that pre-industrial concentrations measured in marine sediments of this geographical zone, were better than geological values (average shale, continental crust average) for evaluating the degree of contamination in this coastal system. Based on these last two indexes, San Jorge Bay has a serious problem of Cu and Pb pollution at the three sampling locations. However, only Cu exceeds the national maximum values used to evaluate ecological risk and the health of marine environments. It is suggested that Chilean environmental legislation for marine sediment quality--presently under technical discussion--is not an efficient tool for protecting the marine ecosystem.

Reflexiones en torno a los problemas éticos y bioéticos en el tratamiento del paciente con VIH/SIDA / Reflections around the ethical and bioethical problems related to treatment of HIV-AIDS patient

Se realizó una revisión bibliográfica sobre aspectos éticos y bioéticos en el tratamiento del paciente con VIH/SIDA. Se destacó que hace poco más de 30 años surgieron en el mundo con gran fuerza los problemas de la ética médica, con tal pasión e intensidad, que desbordaron los límites clásicos e interdisciplinarios, lo que consecuentemente dio lugar al surgimiento de la Bioética. Las infecciones de transmisión sexual azotan el mundo con su alta incidencia, y se han convertido en un importante problema de salud, reto para científicos, médicos e investigadores; al comienzo de los 80, el descubrimiento del SIDA, multiplicó el poder devastador de estas enfermedades. Cada año se producen millones de casos de infecciones víricas, incluida la infección por VIH. La aparición de la Bioética como nuevo paradigma del pensamiento médico, con sus principios de beneficencia, no maleficencia, autonomía y justicia, ha conmocionado al mundo de las ciencias médicas. Este trabajo realiza algunas reflexiones que debe tener en cuenta el Equipo Básico de Salud y el resto de los trabajadores de la Atención Primaria de Salud, en el tratamiento en la comunidad del paciente con VIH/SIDA...

A bibliographic review on ethical and bioethical features in treatment of HIV/AIDS patients was carried out. It was emphasized that more or less 30 years ago in world appeared with a great strength the problems of medical ethics, so intense that they exceeded the classic and interdisciplinary limits, which consequently gave rise to appearance of Bioethic. Sexually transmitted diseases devastate the world with its high incidence and have to become in a important health problem, a challenge for scientists, physician and researchers; in the early 1980s, the discovery of AIDS, multiplied the devastating power of these diseases. Each year appear millions of cases of viral infections including HIV infection. Appearance of Bioethics as a new paradigm of medical though, with its benefit principles, the non-maleficence, autonomy and justice has shocked the medical sciences world. This paper made some reflections to be taking account by Health Basic Staff and the remainder workers of Health Primary Care related to treatment in community of HIV/AIDS patient...

El futuro de la salud pública en el contexto político-social actual / The future of the public health in the political and social setting

Organizaciones mundiales de la salud han planteado, desde hace más de 30 años, la necesidad de trabajar para lograr un alto nivel de salud para todos los ciudadanos del planeta. Para alcanzar la meta propuesta de "Salud para todos en el año 2000", se necesita realizar acciones políticas y sociales estrechamente vinculadas, entre ellas pueden citarse: a) el desarrollo social y económico que les permita a los pueblos el derecho al desarrollo sostenible, b) la voluntad política de los gobiernos de priorizar la educación y la salud como uno de los derechos humanos más noble y, c) la transformación revolucionaria de los sistemas de salud, con la intención explícita de colocar a la atención primaria, con los conceptos de promoción y prevención de salud, en la estrategia principal para lograr mejorar los sistemas sanitarios de los pueblos. Sin embargo, a pesar de que el futuro de la salud es una preocupación de prestadores y usuarios de sus servicios, políticos, científicos e intelectuales; puede decirse que en la actualidad tal futuro es incierto, amenazado por las tendencias neoliberales, pero con una realidad alentadora en los países que hoy están optando por el cambio y que se integran al proyecto ALBA. La meta "Salud para todos en el año 2000", está distante aún, todo dependerá de la medida en que el mundo comprenda que la paz, la solidaridad, el respeto a los derechos humanos y la integración de los pueblos, son el único camino para acercarse a esos sueños.

Health organizations worldwide have stated for more than 30 years the need of working hard to attain high health levels for all the citizens in this planet. To fulfill the goal " Health for all in the year 2000", closely linked political and social actions are required, among them the following a) the social and economic development that gives the peoples the right to sustainable development; b) the political willingness of governments to give priority to education and healthcare as two of the noblest human rights and c) the revolutionary transformation of healthcare systems, with the explicit aim of placing the primary healthcare in the forefront of the main strategy for improving the healthcare systems of the countries under the concepts of health promotion and prevention. However, in spite of the fact that the future of healthcare is a permanent concern for health service providers and users, politicians, scientists and intellectuals, it may be said that at present this future is uncertain and threatened by neoliberal tendencies, except for the encouraging realities in those countries opting for change and participating in the ALBA program (Bolivarian Alternative for the Americas). The goal "Health for all in the year 2000" is still far from being accomplished; all this will depend on to what extent the world is able to understand that peace, solidarity, respect to human rights and integration of peoples are the only way to make these dreams come true.