Adaptation and validation of the Interprofessional Socialization and Valuing Scale (ISVS) in Spanish university health sciences students.

Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 [95% CI 0.903, 0.923]. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization.

Fears of compassion magnify the harmful effects of threat of COVID-19 on mental health and social safeness across 21 countries.

BACKGROUND: The COVID-19 pandemic is a massive global health crisis with damaging consequences to mental health and social relationships. Exploring factors that may heighten or buffer the risk of mental health problems in this context is thus critical. Whilst compassion may be a protective factor, in contrast fears of compassion increase vulnerability to psychosocial distress and may amplify the impact of the pandemic on mental health. This study explores the magnifying effects of fears of compassion on the impact of perceived threat of COVID-19 on depression, anxiety and stress, and social safeness. METHODS: Adult participants from the general population (N = 4057) were recruited across 21 countries worldwide, and completed self-report measures of perceived threat of COVID-19, fears of compassion (for self, from others, for others), depression, anxiety, stress and social safeness. RESULTS: Perceived threat of COVID-19 predicted increased depression, anxiety and stress. The three flows of fears of compassion predicted higher levels of depression, anxiety and stress and lower social safeness. All fears of compassion moderated (heightened) the impact of perceived threat of COVID-19 on psychological distress. Only fears of compassion from others moderated the effects of likelihood of contracting COVID-19 on social safeness. These effects were consistent across all countries. CONCLUSIONS: Fears of compassion have a universal magnifying effect on the damaging impact of the COVID-19 pandemic on mental health and social safeness. Compassion focused interventions and communications could be implemented to reduce resistances to compassion and promote mental wellbeing during and following the pandemic.

Drug Retention Rate and Causes of Discontinuation of Adalimumab in Uveitis: Real-World Data from the Biotherapies in Uveitis (BioÚvea) Study Group.

PURPOSE: To study the drug retention rate (DRR), causes, and predictors of discontinuation of adalimumab (ADA) in a real-world uveitis setting. DESIGN: Multicentric, nationwide, registry-based, ambispective, observational study. PARTICIPANTS: Patients treated with ADA for noninfectious uveitis (NIU) in the Biotherapies for Uveitis (BioÚvea) Spanish registry from November 2016 to November 2017. METHODS: Demographics, clinical data, timing, and reasons for discontinuation, if occurred, were recorded. The DRR and drug retention time (DRT) were estimated using the Kaplan-Meier method. Median follow-up was analyzed by reverse Kaplan-Meier. Log-rank test was used for comparisons. Cox proportional-hazards model (PHM) and propensity score matching were used to identify predictors for discontinuation due to inefficacy and adverse events. MAIN OUTCOME MEASURES: Drug retention rate and DRT. RESULTS: A total of 392 patients were analyzed, including 218 women. Median age was 39 (interquartile range, 25) years. Nonanterior uveitis was recorded in 242 patients. Median follow-up was 49.07 (0.97-131.67) months, median DRT (survival) was 69.3 months, and 14 patients were lost to follow-up. The DRR at 6, 12, 24, and 60 months was 92.97%, 87.68%, 76.31%, and 54.28%, respectively. Adalimumab was discontinued in 151 patients. Discontinuation was due to lack or loss of efficacy in 74 patients, adverse event in 34 patients, and sustained quiescence in 25 patients. Recorded adverse events included infections in 10 patients and malignant neoplasms in 3 patients. Concurrent classic immunomodulatory therapy (IMT) was given to 251 patients. We did not find DRT differences regarding the use of concurrent IMT. Adalimumab was prescribed as a second or greater biotherapy line in 76 patients who showed shorter DRT (P = 0.038). Starting ADA in nonbiotherapy-naive patients was a predictor for "discontinuation due to inefficacy," whereas undifferentiated uveitis was a predictor for "discontinuation due to adverse event." Drug retention time was significantly shorter when spared or intensified, mainly due to discontinuation after sustained quiescence. CONCLUSIONS: Drug retention rate of ADA in uveitis at 60 months was 54.28%, with a good safety profile. The use of concurrent IMT did not show a significant influence on DRT. The use of ADA as a second or further biotherapy could be predictive for discontinuation due to inefficacy. Undifferentiated uveitis may be prone to premature discontinuation of ADA due to adverse events.

Community-based health care for indigenous women in Mexico: a qualitative evaluation.

INTRODUCTION: Indigenous women in Mexico represent a vulnerable population in which three kinds of discrimination converge (ethnicity, gender and class), having direct repercussions on health status. The discrimination and inequity in health care settings brought this population to the fore as a priority group for institutional action. The objective of this study was to evaluate the processes and performance of the "Casa de la Mujer Indígena", a community based project for culturally and linguistically appropriate service delivery for indigenous women. The evaluation summarizes perspectives from diverse stakeholders involved in the implementation of the model, including users, local authorities, and institutional representatives. METHODS: The study covered five Casas implementation sites located in four Mexican states. A qualitative process evaluation focused on systematically analyzing the Casas project processes and performance was conducted using archival information and semi-structured interviews. Sixty-two interviews were conducted, and grounded theory approach was applied for data analysis. RESULTS: Few similarities were observed between the proposed model of service delivery and its implementation in diverse locations, signaling discordant operating processes. Evidence gathered from Casas personnel highlighted their ability to detect obstetric emergencies and domestic violence cases, as well as contribute to the empowerment of women in the indigenous communities served by the project. These themes directly translated to increases in the reporting of abuse and referrals for obstetric emergencies. CONCLUSIONS: The model's cultural and linguistic competency, and contributions to increased referrals for obstetric emergencies and abuse are notable successes. The flexibility and community-based nature of the model has allowed it to be adapted to the particularities of diverse indigenous contexts. Local, culturally appropriate implementation has been facilitated by the fact that the Casas have been implemented with local leadership and local women have taken ownership. Users express overall satisfaction with service delivery, while providing constructive feedback for the improvement of existing Casas, as well as more cost-effective implementation of the model in new sites. Integration of user's input obtained from this process evaluation into future planning will undoubtedly increase buy-in. The Casas model is pertinent and viable to other contexts where indigenous women experience disparities in care.

Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study.

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

Vogt-Koyanagi-Harada disease in Spain.

PURPOSE: To describe the clinical and epidemiological characteristics of patients with Vogt-Koyanagi-Harada (VKH) disease in Spain. METHODS: This was a retrospective multicenter analysis of data from VKH patients followed for at least 6 months. The data collected were related to demographics, clinical manifestations, treatments, and complications. RESULTS: Participants were 112 patients (224 eyes), from 13 tertiary referral centers, of mean age 37.5 ± 14.7 years; 83.9% were women. Ethnicities were 61.6% Caucasian and 30.4% Hispanic. The disease was classified as complete in 16.1%, incomplete in 55.4%, and probable in 28.6%. When seen for the first time, the clinical course was acute in 69.6%, recurrent chronic in 15.2%, and chronic in 14.3%. The most frequent treatment was corticosteroids (acute stage 42.2%, maintenance stage 55.6%). The most common complications were cataract (41.1%) and ocular hypertension (16.1%). In most eyes, visual acuity was improved (96.7%) or remained stable at the end of follow up. CONCLUSION: VKH in Spain mostly affects women and presents as incomplete acute stage disease. Visual prognosis is good. Cataract and glaucoma are the two most frequent complications.

Compassion Protects Mental Health and Social Safeness During the COVID-19 Pandemic Across 21 Countries.

Objectives: The COVID-19 pandemic is having an unprecedented detrimental impact on mental health in people around the world. It is important therefore to explore factors that may buffer or accentuate the risk of mental health problems in this context. Given that compassion has numerous benefits for mental health, emotion regulation, and social relationships, this study examines the buffering effects of different flows of compassion (for self, for others, from others) against the impact of perceived threat of COVID-19 on depression, anxiety, and stress, and social safeness. Methods: The study was conducted in a sample of 4057 adult participants from the general community population, collected across 21 countries from Europe, Middle East, North America, South America, Asia, and Oceania. Participants completed self-report measures of perceived threat of COVID-19, compassion (for self, for others, from others), depression, anxiety, stress, and social safeness. Results: Perceived threat of COVID-19 was associated with higher scores in depression, anxiety, and stress, and lower scores in social safeness. Self-compassion and compassion from others were associated with lower psychological distress and higher social safeness. Compassion for others was associated with lower depressive symptoms. Self-compassion moderated the relationship between perceived threat of COVID-19 on depression, anxiety, and stress, whereas compassion from others moderated the effects of fears of contracting COVID-19 on social safeness. These effects were consistent across all countries. Conclusions: Our findings highlight the universal protective role of compassion, in particular self-compassion and compassion from others, in promoting resilience by buffering against the harmful effects of the COVID-19 pandemic on mental health and social safeness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-021-01822-2.

Adalimumab in Elderly Patients with Non-Infectious Uveitis. Safety and Efficacy.

Purpose: To assess the efficacy and safety of adalimumab in elderly patients with noninfectious uveitis (NIU).Methods: An observational, retrospective, multicenter study was done. Changes in best-corrected visual acuity (BCVA), inflammatory activity parameters, central retinal thickness (CRT), and the occurrence of adverse events (AE) developed during follow-up were recorded.Results: A total of 82 eyes from 41 patients 60 years of age and older with noninfectious uveitis treated with adalimumab were included. A significant improvement in BCVA (71.5 to 75.4 letters, p = .001) and in CRT (311.1 µm to 265 µm, p = .001) was observed. Moreover, a significant decrease from baseline in the rate of patients with anterior chamber cell (ACC) >0+ (34.6% to 5.7%, p = <0.001) or vitreous haze>0+ (21.3% to 4.3%, p = .002) was determined. AEs were observed in 11 patients (26.8%).Conclusion: Adalimumab can be safe and efficacious for the treatment of NIU in patients 60 years of age and older.

The role of social connection on the experience of COVID-19 related post-traumatic growth and stress.

BACKGROUND: Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress. METHODS: Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress. RESULTS: Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries. CONCLUSIONS: Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.

An exploratory sequential design to validate measures of moral emotions.

BACKGROUND: This paper presents an exploratory and sequential mixed methods approach in validating measures of knowledge of the moral emotions of contempt, anger and disgust. METHOD: The sample comprised 60 participants in the qualitative phase when a measurement instrument was designed. Item stems, response options and correction keys were planned following the results obtained in a descriptive phenomenological analysis of the interviews. In the quantitative phase, the scale was used with a sample of 102 Spanish participants, and the results were analysed with the Rasch model. RESULTS: In the qualitative phase, salient themes included reasons, objects and action tendencies. In the quantitative phase, good psychometric properties were obtained. The model fit was adequate. However, some changes had to be made to the scale in order to improve the proportion of variance explained. CONCLUSIONS: Substantive and methodological im-plications of this mixed-methods study are discussed. Had the study used a single re-search method in isolation, aspects of the global understanding of contempt, anger and disgust would have been lost.

Evaluación de la fermentación del lactosuero ácido (entero y desproteinizado) utilizando Lactobacillus casei / Evaluation of acid whey fermentation (whole and deproteinized) using Lactobacillus casei

El lactosuero acidificado espontáneamente pone en riesgo la salud del consumidor al utilizarlo como acidificante de la leche usada en la elaboración del queso tipo mozzarella, y además reduce la calidad del producto. El objetivo de esta investigación fue evaluar el proceso de fermentación del lactosuero ácido (entero y desproteinizado) con Lactobacillus casei, utilizando diferentes porcentajes de su inóculo. Se caracterizaron fisicoquímicamente los lactosueros, sometiéndolos a fermentación anaeróbica a 37°C y 120 rpm por 96 h. Se evaluó la concentración de biomasa celular, el consumo de lactosa, la producción de ácido láctico (AL) y se estimaron los parámetros cinéticos y estequiométricos. Se aplicó un diseño experimental completamente al azar con arreglo factorial 2x3, empleando la metodología de medidas repetidas. Los datos, se procesaron a través de los paquetes estadísticos SAS® versión 9 y Statgraphics Centurión XVI®. El lactosuero, entero y desproteinizado, se encontró dentro de los intervalos fisicoquímicos aceptables para su acidificación. Los valores de acidez fueron superiores a 120 Grados Dornic (120°D) con la inoculación de L. casei, excepto en lactosuero desproteinizado, inoculado con 15% de cultivo. El lactosuero entero con 15% de inóculo, alcanzo 120°D en el menor tiempo (34h). Altas concentraciones de inóculo (15%) favorecieron la acidificación en el lactosuero entero, mostrando la mayor producción (20.83gAL/l), Y´p/s=0.86, Qp=0.173gAL/l*h; mientras el lactosuero desproteinizado mostró un mayor crecimiento microbiano, menor conversión de lactosa (8.2%) y menor producción media de ácido láctico (8.19g/l).

The spontaneously acidified whey threatens consumer health and reduces quality of mozzarella cheese. The goal of this research was to evaluate the acidification process of acid whey (whole and deproteinized) by fermentation with different inoculum concentrations of Lactobacillus casei. The whey was physicochemically characterized and anaerobically fermented at 37°C and120 rpm during 96h. Cellular biomass was evaluated, as well as lactose consumption, lactic acid production, kinetic and stoichiometric parameters were estimated. A completely randomized design with factorial arrangement (2x3) was applied by using the repeated measures methodology. Data was processed by using SAS® statistical package, version 9 and Statgraphics Centurion XVI®. The acidification for the whole and deproteinized whey was found within the acceptable intervals. Acidification values were above 120 degrees Dornic (120°D) with L. casei inoculation, except in the deproteinized whey inoculated with 15% of inoculum. The whole whey with 15% of inoculum reached 120°D in the shortest time (34 hours). High concentrations of inoculum (15%) aided the acidification in whole whey and showed the highest production (20.83 g LA/l), and p/s=0.86, Qp=0.173 g AL/l*h; on the other hand, the deproteinized whey showed the highest microbial growth, lowest conversion of lactose (8.2%) and lowest lactic acid production (8.19g/l).

Intracategorial Varieties of Contempt in a Heterogeneous Sample / Variedades intracategoriales del desprecio en una muestra heterogénea

Consistent with current emotion theory, we should note that contempt is not a homogeneous category but rather shows intracategorial variability. Previous research on Spanish samples shows a communicative structure in which contempt is felt towards intimate, social or abstract receivers, for reciprocal, altruistic or prejudiced reasons. Our objective was to test, on a large and heterogeneous sample, the previously found structure and variations of the experience of contempt as well as its spontaneous facial expression. Testing the association of contempt varieties with certain subject attributes was a secondary goal. Results from 130 participants from the Spanish general population corroborated the previously found structure and varieties, as well as the associations between contempt receiver and attribution. No relation was found with sex, age or emotion recognition ability. As to spontaneous facial expression, disgust was more often expressed by those who narrated their personal episodes of contempt for reciprocal reasons, and was less often expressed by the people who described prejudiced scenarios. This result indicates that the conventionally considered facial expression of contempt is not the only one, as already stated by Darwin, and should not be considered as such by experimental and psychometric procedures.

De forma consistente con las teorías actuales de la emoción, el desprecio no es una categoría homogénea, sino que presenta variedad intracategorial. La investigación previa en muestras españolas muestra una estructura comunicativa en la que el desprecio se experimenta hacia receptores íntimos, sociales o abstractos por razones recíprocas, altruistas o prejuiciosas. Nuestro objetivo fue poner a prueba, en una muestra grande y heterogénea, la estructura previamente encontrada para la experiencia de desprecio, así como sus variedades y expresión facial espontánea. Un objetivo secundario fue la puesta a prueba de la asociación de las variedades del desprecio con atributos de sujeto. Los resultados de 130 entrevistas procedentes de población general española corroboraron la estructura y variedades previamente halladas, así como la asociación entre el receptor del desprecio y la atribución causal. La relación con el sexo, la edad y la aptitud de reconocimiento emocional no resultó significativa. Con respecto a la expresión facial, la de asco apareció con mayor frecuencia en quienes narraron episodios de desprecio por razones de reciprocidad y con menor frecuencia en quienes describieron escenarios prejuiciosos. Este resultado indica que la expresión convencionalmente considerada como de desprecio no es la única, como ya estableció Darwin, por lo que no debería considerarse como tal en los procedimientos experimentales y psicométricos.

Caracterización cinética de un preparado semipurificado de bromelina para uso antitumoral / Kinetic characterization of a semipurified preparation from bromelain for antitumor use

INTRODUCCIÓN: la mayor parte de la producción mundial de enzimas está destinada a la obtención de proteasas. Las aplicaciones de estas biomoléculas con fines terapéuticos son muy variadas. Algunas se conocen como remedios naturales y otras son fármacos modificadores de la respuesta biológica. Las plantas de piña contienen varias cisteíno-proteasas, el componente mayoritario aislado del tallo es la bromelina de tallo (EC 3.4.22.32). En el campo de la salud se le atribuyen varias acciones entre las que se destaca la de inducir la diferenciación de células tumorales y atenuar el crecimiento del tumor. OBJETIVOS: caracterizar cinéticamente un preparado semipurificado de bromelina obtenida por un procedimiento desarrollado en Cuba para ser evaluado en el campo de la salud. MÉTODOS: el extracto crudo de bromelina, obtenido a partir de tallos de plantas adultas de Ananas comosus (L.) Merr cv Española roja (piña) se purificó por cromatografía de intercambio iónico en carboximetilcelulosa-52 en un sistema semibach. RESULTADOS: la caracterización cinética del extracto purificado permitió comprobar la existencia de un preparado activo y estable con una actividad específica de 0,94 U/mg de proteínas (2,34 veces superior a la del extracto crudo original), con una fracción proteica mayoritaria de masa molar 24 500 Da y un punto isoeléctrico, localizado en la zona de pH básico (9,55). Tiene pH óptimo 6,8 al utilizar hemoglobina 2 por ciento como sustrato a 37 ºC y una estabilidad en función del pH y de la temperatura aceptable. Si se conserva liofilizado a - 20 ºC mantiene 80 por ciento de la actividad durante 1 año. CONCLUSIONES: la cromatografía de intercambio iónico en carboximetilcelulosa-52 posibilitó la obtención de un preparado semipurificado de bromelina, con una actividad específica superior a la del extracto original que puede ser utilizado en la medicina como antitumoral

INTRODUCTION: most of the world production of enzymes is devoted to proteases obtaining. Applications of these biomolecules for therapeutical objectives are very varied. Some are known as natural remedies and other are drugs modifying the biological response. Pineapple plants contain some cysteine-proteases, the majority component isolated from stem is the stem Bromelain (EC 3.4.22.32). In the health field it has attributed some actions including the differentiation induction of tumor cells and attenuation of tumor growth. OBJECTIVES: to characterize kinetically a semipurified preparation from Bromelain obtained by a procedure developed in Cuba to be assessed in the health field. METHODS: the crude extract from Bromelain obtained from the adult plant stems of Ananas comosus (L.) Merr Cv Spanish red (pineapple) was purified by ion-exchange chromatography in carboxylmethylcelulose-52 in semibatch system. RESULTS: kinetic characterization of purified extract allowed us to verify the existence of a stable and active preparation with a specific activity of 0,94 U/mg of proteins (2,34 times superior to that of original crude extract) with a protein fraction in the main of molar mass 24 500 Da and a isoelectric point, located in the basic pH zone (9,55). It has a 6,8optimal pH using the 2 percent hemoglobin as substrate at 37ºC and stability depending on pH and on acceptable temperature. If it is preserved lyophilized at 20 ºC it maintains the 80 percent of activity for a year. CONCLUSIONS: the ion-exchange chromatography in carboxyl methylcellulose-52 allowed the achievement of semipurified preparation from Bromelain with a specific activity higher to that of original extract that may to be used in medicine as antitumor agent

El estrés en el perfil de desgaste de las trabajadoras / The role of stress in exhaustion among female workers

El objetivo es el de comparar perfiles de desgaste en distintos grupos de trabajadoras y mostrar la importancia del estrés como efecto de sus condiciones de género. Para ello se revisaron diversas investigaciones, en las que se analizan sus procesos de trabajo y se estudian sus problemas de salud. Los resultados muestran que, en los perfiles de morbimortalidad y desgaste, la patologia relacionada con el estrés ocupa un lugar relevante. En algumas investigaciones se analiza cómo las exigencias domésticas y laborales llevan a una reposición inadequada de la capacidad de trabajo. Y a una constante ansiedad por no poder cumplir satisfactoriamente con las exigencias de ambas tareas, siendo las repercusiones más inmmediatas la fatiga y la patologia relacionada com el estrés.

Control de Lutzomyia en el área endémica venezolana de leishmaniasis tegumentaria / Lutzomyia youngi in the venezuelan endemic area of tegumentary leishmaniasis

La incidencia relativamente alta de leishmaniasis cutánea en ambientes urbanos y suburbanos de la ciudad de trujillo, en Venezuela, condujo a un ensayo de cinco insecticidas diferentes contra lutzomyia (= L.townsendi), vector en la localidad. Infructuosos fueron los resultados, en condiciones de laboratorio, empleando el estuche de ensayo recomendado por la OMS para cuantificar la susceptibilidad de los flebótomos ya que, por su tamaño escapan a travéz del dispositivo de deslizamiento e intercambio. Desarrollamos nuestro propio equipo que describimos. Los flebótomos fueron altamente susceptibles al DDT y al Lindano para dosis latales (DL 100) de 0,25 g/m2 y ,mostraron moderada resistencia al Dieldrin (DL 100: 2,0 g/m2) y al Propoxur (DL60: 2,5 g/m2). Experimentos de campo en un área de 700 m2 dentro de un cafetal, usando equipo swing-fog con DDT en el gas-oil al 2%redujo drásticamente la población de flebótomos desde 65 hasta manos de 1 por m2, nebulizando 0,75 litros de solución de insecticida

La isotermia de 19 -C como factor limitante de la endemicidad de la leishmaniasis cutánea en Los Andes de Venezuela / Isotherm of 19 -C as a limitanting factor of the cutaneus leishmania in the Venezuela Andes Region

Se producen evidencias experimentales que identifican a la isoterma de 19 -C como un factor ambiental que inhibe el desarrollo de Leishmania braziliensis en Lutzomyia townsendi, en la región de Los Andes Venezolanos

El papel del cafeto en la endemicidad de la leishmaniasis cutánea en Venezuela / The role of coffee-tree in the morbidity of cutaneous leishmaniasis in Venezuela

Se hace énfasis en la superposición de las áreas cafetaleras y las de endemicidad de las leishmaniasis cutáneas en la región de Los Andes de Venezuela. Se presentan evidencias sobre el papel de los frutos maduros de café como fuente de azúcares para los flebótomos y al mismo tiempo se demuestra la persistencia de promastigotos de Leishmania spp. hasta por cuarenta y ocho horas en el parénquima de tales frutos. Se discute la significación de estos hallazgos

Perfil psicosocial de la familia del niño infectado con el virus de la inmunodeficiencia humana / Psychosocial profile of the family of HIV virus infected children

Desde agosto de 1990 a diciembre de 1994 se hizo una encuesta, a través de un equipo multidisciplinario, de los niños infectados por VIH que incluía: situación del niño, situación familiar, actitud de los padres frente a la enfermedad de su hijo y frente a su propia enfermedad. En total se encuestaron 23 familias con 26 niños, encontrándose que 25 habían sido contaminados verticalmente, 5 habían fallecido. Requirieron hospitalizaciones en un número importante de ocasiones. Había problemas con la escolaridad de muchos de ellos. Alto índice de mortalidad familiar (4 madres y 1 padre), delincuencia (4 padres y 2 madres encarcelados) y abandono. El niño infectado con VIH requiere no sólo cuidados médicos, los esfuerzos deben dirigirse además a continentar el núcleo familiar y a la educación de los padres para evitar conductas de riesgo

VIH y Tuberculosis una nueva realidad / HIV and tuberculosis a new reality

Se evaluó la incidencia de TB en una población de niños desde junio de 1990 hasta el 15 de setiembre de 1996: 2 con SIDA por transfusión de sangre contaminada, una adolescente que contrajo el VIH por vía sexual y 172 hijos de madre VIH positiva, de los cuales 61 serorrevertidos, 44 infectados y 70 perinatalmente expuestos. Hubo 6 casos de TB, uno ganglionar, 5 pulmonares, siendo 5 infectados por VIH verticalmente y uno expuesto. Los 5 casos pulmonares ocurrieron en menores de 6 meses, el foco contagiante fue la madre en 4 casos. Los linfocitos CD4 estuvieron alterados en 4 pacientes (todos infectados con VIH) y normales en uno (expuesto). Hubo además 4 pacientes que requirieron quimio profilaxis, 3 de ellos infectados por VIH y uno serorrevertido. De la presente serie, la TB fue la enfermedad por oportunistas más frecuente en los infectados VIH (5 en 44) y que además puede afectar a quienes no están inmunocomprometidos

Evaluación de la quimioprofilaxis con zidovudine a la mujer embarazada VIH(+) y su hijo / Evaluation of zidovudine chemoprophylaxis in VIH (+) pregnant women and their son

En 1994 se publicaron los resultados del protocolo ACTG 076 sobre quimioprofilaxis (QP) con zidovudine (AZT) para reducir la transmisión vertical del VIH. El grupo de madres que recibió QP con AZT tuvo un porcentaje de transmisión de 8,4 por ciento, comparado con el 24,2 por ciento de los que recibían placebo. Material y métodos: Se analizaron en forma retrospectiva los datos de 304 binomios madre - hijo captados en la Policlínica materno-infantil del CHPR desde junio de 1990 al 31 de diciembre de 1998. Se definió QP completa cuando la mujer VIH(+) embarazada recibió AZT vía oral las primeras 6 semanas. Se definió QP incompleta, cuando faltaron una o dos fases del tratamiento. Los niños fueron clasificados como serorevertidos (S), infectados (I), o perinatalmente expuestos (E), según criterios del CDC. Resultados. Hasta el 31 de diciembre de 1994 se estudiaron 116 binomios madre - hijo, y el porcentaje de trasmisión vertical fue de 28,4 por ciento. En 1995, en 31 binomios, el porcentaje de transmisión fue 29,03 por ciento, ningún binomio recibió QP completa y 5 (15,6 por ciento) la recibieron en forma incompleta. En 1996, en 60 binomios, el porcentaje de transmisión fue 31,6 por ciento, 7 (11,66 por ciento) recibieron QP completa y 22 (36 por ciento) incompleta. En 1997, en 50 binomios, el porcentaje de transmisión fue de 12 por ciento, 26 (52,9 por ciento) recibieron QP completa 16 (31,3 por ciento) e incompleta. En 1998, en 47 binomios, el porcentaje de transmisión fue de 8,5 por ciento, recibieron QP completa 31 (65 por ciento) e incompleta 14 (29,78 por ciento). Analizados desde el 1 de enero de 1995, recibieron QP completa 64 binomios, el porcentaje de transmisión fue 31,6 por ciento, 7 (11,66 por ciento) recibieron QP completa y 22 (36 por ciento) incompleta. En 1997, en 50 binomios, el porcentaje de transmisión fue de 12 por ciento, 26 (52,9 por ciento) recibieron QP completa y 16 (31,3 por ciento) incompleta. En 1998, en 47 binomios el porcentaje de transmisión fue de 8,5 por ciento, recibieron QP completa 31 (65 por ciento) e incompleta 14 (29,78 por ciento). Analizados desde el 1 de enero de 1995, recibieron QP completa 64 binomios, el porcentaje de transmisión fue 6,25 por ciento. Recibieron QP incompleta 57 binomios, el porcentaje de transmisión fue 8,7 por ciento. El porcentaje de transmisión en los binomios que no recibieron QP fue de 43,2 por ciento...