Easy to gain but hard to lose: the evolution of the knee sesamoid bones in Primates-a systematic review and phylogenetic meta-analysis.

Sesamoids are variably present skeletal elements found in tendons and ligaments near joints. Variability in sesamoid size, location and presence/absence is hypothesized to enable skeletal innovation, yet sesamoids are often ignored. Three knee sesamoids-the cyamella, medial fabella and lateral fabella-are present in primates, but we know little about how they evolved, if they are skeletal innovations, or why they are largely missing from Hominoidea. Our phylogenetic comparative analyses suggest that sesamoid presence/absence is highly phylogenetically structured and contains phylogenetic signal. Models suggest that it is easy to gain but difficult/impossible to lose knee sesamoids and that the fabellae may have similar developmental/evolutionary pathways that are distinct from the cyamella. Sesamoid presence/absence is uncorrelated to the mode of locomotion, suggesting that sesamoid biomechanical function may require information beyond sesamoid presence, such as size and location. Ancestral state reconstructions were largely uninformative but highlighted how reconstructions using parsimony can differ from those that are phylogenetically informed. Interestingly, there may be two ways to evolve fabellae, with humans evolving fabellae differently from most other primates. We hypothesize that the 're-emergence' of the lateral fabella in humans may be correlated with the evolution of a unique developmental pathway, potentially correlated with the evolution of straight-legged, bipedal locomotion.

Measurement of stigma and associated characteristics in people with tuberculosis in Medellín, Colombia: a cross-sectional study.

BACKGROUND: Stigma towards tuberculosis (TB) delays diagnosis and compromises adherence to treatment. We measured the degree of stigma and identified the sociodemographic and clinical characteristics that were associated with a higher degree of stigma in patients with pulmonary and extrapulmonary TB in Colombia. METHODS: We conducted a cross-sectional study with 232 participants included in the TB control program in 2017. Sociodemographic and clinical variables were measured. The stigma component was measured through a validated scale and a multiple linear regression was used. RESULTS: The study analysed 232 patients, of which 52.2% were men, 53.5% were between 27 and 59 y of age and 66.8% had a basic-medium education level. Two characteristics were significantly related to a higher stigma score: the basic-medium education level and homeless status. Homeless status increased the stigma score by 0.27. In contrast, the adjusted stigma score decreased by 0.07 if the patient's health status was perceived as 'healthy'. CONCLUSION: Stigma is maximized in homeless patients and patients with a low education level. It is minimized in patients who perceive their state of health as 'healthy'.

Delays in diagnosing pulmonary tuberculosis within a context of medium incidence, Medellín, Colombia, 2017: an operational research.

BACKGROUND: Delay in tuberculosis (TB) diagnosis is one of the first obstacles for controlling the disease. Delays generate greater deterioration of the health of the patients and increase the possibilities of transmission and infection at home and in the community. The aim of the study was to identify profiles and individual variables associated with patient delays and health care system delays in patients with pulmonary tuberculosis (PTB) in Medellín, Colombia, a city that notifies 1400 new cases per year. METHODS: A retrospective cohort study in adults with PTB was conducted from May to September of 2017. Sociodemographic, health care-seeking behaviour, and clinical variables were measured. The outcomes were patient delay and health care system delay. The data were obtained from records of the local TB program, and a questionnaire was applied by the health care team that performs routine field visits. Simple correspondence analysis was used to identify groups (profiles), and their characteristics. Cox's proportional hazards model was carried out to identify the variables associated with the delays. RESULTS: The study included 183 patients. The total delay median was 101 days (IQR: 64-163). Patient delay was of 35 days (IQR: 14-84), the profile with greater delay belonged to consumers of psychoactive substances. The health care system delay was of 27 days (IQR: 7-89), the attributes of the profile with greater delay were being a female, having more than two consultations before the diagnosis, and having prescribed antibiotics. Basic-medium educational level [HRa = 0.69; 95% CI (0.49-0.97)] and having a TB home contact [HRa = 0.68; 95% CI (0.48-0.96)] were associated with greater patient delay. Having negative acid-fast bacilli (AFB) smear [HRa = 0.64; 95% CI (0.45-0.92)] and more than two consultations before the diagnosis [HRa = 0.33; 95% CI (0.22-0.49)] was associated with greater health care system delay. CONCLUSIONS: Data from epidemiological surveillance allowed locating risk groups with delays in TB diagnosis which requires the prioritisation of the local TB control program to promote early detection and prevention of adverse outcomes.

Estudio epidemiológico del cólera en las comunidades de Puerto Arturo. Cunchubamba y Unamuncho / Study epidemiologist of the rage in the communities of Arturo Port. Cunchubamba and Unamuncho

Las internas rotativas de enfermería del año 1992-1993 continuando con el trabajo de investigación sobre el cólera de la comunidad de Quilian Loma realizado por la promoción de internas rotativas del año anterior hemos visto la necesidad de ampliar coberturas a otras comunidades aledañas a la mencionada como son: Cuchibamba en los barrios, El Progreso, La Dolorosa, Rocafuerte, Culapachan, San Isidro, San José, Las Carmelitas, La Merced, San Jacinto, y en Puerto Arturo, San Antonio, Unamuncho, la Primavera, Bellavista, El Conde, El Centro, el Mirador, San Francisco y la Floresta. Para realizar nuestro trabajo de investigación contamos con el tiempo de dos meses comprendido abril y mayo primero comenzamos revisando las historias clínicas de pacientes con cólera del Hospital Docente de Ambato desde febrero del 92 hasta marzo del 93, luego tabulamos los datos, finalmente pasamos al análisis mediante la elaboración de tablas con los respectivos gráficos. Trabajamos en tres subgrupos, luego de realizar un trabajo retrospectivo, una de las primeras actividades fue el recorrido de cada comunidad designada con la elaboración de croquis, delimitando los diferentes barrios existentes, los contactos con los líderes para llegar a la población con la respectiva presentación, indicamos que íbamos a realizar trabajos los fines de semana especialmente porque eran días donde se reúne la gente ya que la mayoría son agricultores, realizando también días laborales para gestiones, como solicitudes dirigidas al destacamento de Policía con el fin de conseguir señalización de tránsito, a farmacias que donan medicamentos con el objetivo de implementar botiquín a las escuelas, el trámite más importante realizado fue a la Jefatura de salud de Ambato para obtener los implementos necesarios de los puestos de U.R.O en cada unidad. Se ha puesto mucho énfasis en la educación mediante programas educativos que iban dirigidos a la población, escuelas, madres con temas como el cólera, planificación familiar, Higuiede, Alimentación todo con el fin de prevenir enfermerdades, uno de los problemas persistentes es el abastecimiento de agua ya que no es potable, demostramos a la gente como desinfectar los tanques donde almacenan el agua para mejor consumo humano. Cabe mencionar que todo lo relacionado ha sido con el apoyo de la gente, de cada comunidad, los líderes, docentes e instituciones que dieron su ayuda para alcanzar con los objetivos propuestos en este trabajo de investigación...

Niveles de mercurio en estudiantes de X semestre de Odontologia de la Fundacion Universitaria San Martin / Mercury levels in the students of X semester of the Fundacion Universitaria San Martin Dentistry School

Esta investigación se baso en la determinacion de niveles de mercurio en estudiante de X semestre de Odontologia de la Fundacion Universitaria San Martin de Bogota. Se realizaron encuestas que dejaron establecer caracteristicas de la poblacion objeto del estudio como: edad, sexo y tiempo de exposicion; se estandarizaron las condiciones para el analisis adoptandose el sistema de espectrofotometria de absorcion atomica sin llama. Las muestras de sangre correspondieron a 40 estudiantes de utlimo semestre; las concentraciones encontradas fueron comparadas con los valores del grupo control, estableciendose que en varios estudiantes hay niveles de mercurio que dejan entrever una absorcion preocupante y niveles altos en la generalidad de ellos. Basandose en informacion obtenida y teniendo en cuenta el riesgo originado por el mercurio como contaminante, se sugirieron medidas contribuyentes a disminuir la intoxicacion causada por el mercurio..