Onyx®, A New Tool for Intraoperative Localization of Liver Lesions.

BACKGROUND: Precise preoperative localization of liver tumors facilitates successful surgical procedures, Intraoperative ultrasonography is a sensitive imaging modality. However, the presence of small non-palpable isoechoic intraparenchymal lesions may be challenging intraoperatively. METHODOLOGY AND MATERIAL DESCRIPTION: Onyx® is a non-adhesive liquid agent comprised of ethylene-vinyl alcohol usually used dissolved in dimethyl-sulfoxide and suspended micronized tantalum powder to provide contrast for visualization under fluoroscopy and ultrasonography and a macroscopic black shape. This embolization material has been increasingly used for the embolization of intracranial arteriovenous malformations. We present the novel application of Onyx® on liver surgery. CURRENT STATUS: We present the case of a female, 55 years-old, whose medical history revealed an elective sigmoidectomy (pT3N1a). After 17 months of follow up, by PET-CT scan, the patient was diagnosed of a small intraparenchymal hypo-attenuated 13 mm tumor located at segment V consistent with metachronous colorectal liver metastasis. Open metastasectomy was performed, ultrasonography-guided Onyx® infusion was delivered the day after, intraoperative ultrasonography showed a palpable hyperechoic material with a posterior acoustic shadowing artifact around the lesion. Onyx® is a promising new tool, without any previous application on liver surgery, feasible with advantages in small not palpable intraparenchymal liver lesions.

Effect of 0.2% carbomer ophthalmic ointment on eye discomfort after general anesthesia: A non-randomized cohort study.

BACKGROUND AND OBJECTIVE: Eye lesions during surgery are rare. Its common causes include direct trauma, chemical damage, and corneal exposure. Eye discomfort may present after surgery in the absence of structural damage. In our hospital, every patient under general anesthesia receives eye protection with eye occlusion associated in most cases with ophthalmic ointment application. We aim to analyze the incidence of eye discomfort with 0.2% carbomer application. METHODS: A cohort study was conducted. Patients who underwent surgery under general anesthesia lasting less than 4h between February and November 2017 were enrolled. We excluded patients with previous ophthalmologic pathology, those undergoing eye, otolaryngology, face or head surgery, and patients in which eye occlusion was not possible. For analysis, patients were divided into two groups: simple eyelid occlusion (Group 1) and eyelid occlusion plus ophthalmic ointment (Group 2). Primary outcome was the incidence of eye discomfort and secondary outcomes were to stablish associated risk factors. RESULTS: 400 patients were analyzed, 50% were exposed to 0.2% carbomer. There was no difference in patients' demographics. During the first 24h post-surgery 7.25% of patients showed visual symptoms, and at one-week postoperative no patient referred symptoms. Most frequent symptoms were blurry vision, pruritus, epiphora and red-eye. On multivariate analysis, the main risk factor associated with eye discomfort was 0.2% carbomer application (RR 13.5 CI 3.27-56.2). Emergent surgery and age were also found to be risk factors. CONCLUSION: 0.2% carbomer does not prevent ophthalmologic symptoms after surgery and it may even increase them in short procedures.

Visualizing physiological parameters in cells and tissues using genetically encoded indicators for metabolites.

The study of metabolism is undergoing a renaissance. Since the year 2002, over 50 genetically-encoded fluorescent indicators (GEFIs) have been introduced, capable of monitoring metabolites with high spatial/temporal resolution using fluorescence microscopy. Indicators are fusion proteins that change their fluorescence upon binding a specific metabolite. There are indicators for sugars, monocarboxylates, Krebs cycle intermediates, amino acids, cofactors, and energy nucleotides. They permit monitoring relative levels, concentrations, and fluxes in living systems. At a minimum they report relative levels and, in some cases, absolute concentrations may be obtained by performing ad hoc calibration protocols. Proper data collection, processing, and interpretation are critical to take full advantage of these new tools. This review offers a survey of the metabolic indicators that have been validated in mammalian systems. Minimally invasive, these indicators have been instrumental for the purposes of confirmation, rebuttal and discovery. We envision that this powerful technology will foster metabolic physiology.

Preferencias alimentarias de Phylloicus sp. (Trichoptera: Calamoceratidae) en un río Neotropical de la Sierra Nevada de Santa Marta, Colombia

Introducción: En los sistemas fluviales colombianos ha sido poco estudiada la fragmentación del material alóctono por parte de los insectos acuáticos. Uno de los organismos trituradores más abundantes en las corrientes tropicales de América es el tricóptero del género Phylloicus (Calamoceratidae). Objetivo: El presente estudio tuvo como objetivo evaluar el efecto de los atributos químicos (nitrógeno, fósforo y lignina) y físicos (dureza) de las hojas de tres especies ribereñas (Ficus tonduzii, Zygia longifolia y Clusia multiflora) dominantes en la parte media del río Gaira, sobre la preferencia de hojas y el crecimiento de larvas de Phylloicus sp. Métodos: Se realizaron experimentos de multiselección de alimento en campo, en los que se ubicaron cámaras experimentales dentro del río por 21 días. Para la valoración de la calidad foliar se recolectaron hojas del río, las cuales se secaron y se pulverizaron para realizar los análisis químicos. Resultados: No se presentaron diferencias significativas en los porcentajes de lignina y fósforo entre las hojas de las tres especies de árboles, pero si en su dureza y en el contenido de nitrógeno. Las hojas de C. multiflora fueron más suaves (180.1± 53.9 g) que las de F. tonduzii (285.3 ± 88.4 g) y Z. longifolia (232.3 ± 60.8 g), pero sin diferencias entre las dos últimas especies. Las hojas de Z. longifolia también tuvieron más nitrógeno (1.9 ± 0.0%) que las de hojas de las otras especies (1 ± 0.0 %). En cuanto a la preferencia de hojas, las larvas de Phylloicus sp. utilizaron en mayor proporción las hojas de C. multiflora. Aunque las hojas de C. multiflora no tuvieron diferencias significativas en el contenido de lignina y fósforo, presentaron valores menores de dureza, lo que podría hacerlas más palatables para Phylloicus sp. Por otra parte, el crecimiento específico diario de las larvas fue mayor cuando usaron hojas de F. tonduzii. Conclusiones: Nuestros resultados parecen indicar que las hojas más preferidas no son necesariamente las de mejor calidad nutricional y sugieren que la dureza de las hojas es la variable más importante en la selección de la hojarasca por parte de las larvas de Phylloicus sp.

Introduction: Fragmentation of allochthonous material by aquatic insects is a functional process that has been little studied in Colombian rivers. One of the most abundant shredder genus in American tropical stream ecosystems is the caddisfly genus Phylloicus (Calamoceratidae). Objective: In this study we evaluate the effect of chemical (nitrogen, phosphorus and lignin) and physical (toughness) attributes of leaves of three dominant tree species (Ficus tonduzii, Zygia longifolia and Clusia multiflora) in the riverine area of the middle section of the Gaira river, on leaf preferences and larval growth of a species of Phylloicus. Methods: Multiple food selection field experiments were performed, in which experimental chambers were located in the river for twenty-one days. For the assessment of leaf quality, leaves were collected in the river, dried and pulverized to perform chemical analyzes. Results: There were no significant differences in lignin and phosphorous percentages between the leaves of the three species, but nitrogen content and leaf toughness differed among them. The leaves of C. multiflora were softer (180.1± 53.9 g) than those of F. tonduzii (285.3 ± 88.4 g) and Z. longifolia (232.3 ± 60.8 g), but without differences between the last two species. The Z. longifolia leaves also had more nitrogen (1.9 ± 0.0 %) than those of the other species (1 ± 0.0 %). Regarding leaf selection, Phylloicus sp. larvae used in greater proportion the leaves of C. multiflora. Although lignin and phosphorous differences were not significant, the leaves of C. multiflora had lower toughness, which could make them more palatable for Phylloicus sp. On the other hand, the daily specific growth of the larvae was higher when they used leaves of F. tonduzii. Conclusions: Our findings seem to indicate that the most preferred leaves were not necessarily those of better nutritional quality and suggest that leaf toughness was the most important variable in the selection of leaf litter by the larvae of Phylloicus sp.

Detection of Entamoeba histolytica by Recombinase Polymerase Amplification.

Amebiasis is an important cause of diarrheal disease worldwide and has been associated with childhood malnutrition. Traditional microscopy approaches are neither sensitive nor specific for Entamoeba histolytica. Antigen assays are more specific, but many cases are missed unless tested by molecular methods. Although polymerase chain reaction (PCR) is effective, the need for sophisticated, expensive equipment, infrastructure, and trained personnel limits its usefulness, especially in the resource-limited, endemic areas. Here, we report development of a recombinase polymerase amplification (RPA) method to detect E. histolytica specifically. Using visual detection by lateral flow (LF), the test was highly sensitive and specific and could be performed without additional equipment. The availability of this inexpensive, sensitive, and field-applicable diagnostic test could facilitate rapid diagnosis and treatment of amebiasis in endemic regions.

Thiafatty acids as tracers to investigate biosynthetic pathways of lepidopteran sex pheromones.

In order to investigate the potential utility of thiafatty acids as tracers for biosynthetic studies of moth sex pheromones, a series of thiatetradecanoic acids, namely 8-, 9-, 10-, 11-, 12- and 13-thiatetradecanoic, were prepared and their metabolism was investigated in pheromone glands of Spodoptera littoralis. Analysis by gas chromatography coupled to mass spectrometry of extracts from pheromone glands treated with the above acids showed that only 8-thiatetradecanoic acid and 13-thiatetradecanoic acid were metabolized by desaturation and were incorporated into the sex pheromone biosynthetic pathway. 13-Thiatetradecanoic acid was converted into (E)- and (Z)-13-thiatetradec-11-enoic acids, (Z,E)-13-thiatetradeca-9,11-dienoic acid, 11-thiadodecanoic acid, (E)- and (Z)-11-thiadodec-9-enoic acids and 15-thiahexadecanoic acid. 8-Thiatetradecanoic acid gave rise to two monoenoic thiafatty acids and two dienoic thiafatty acids, which were assigned to (Z)- and (E)-8-thiatetradec-11-enoic acids, (Z,E)-8-thiatetradeca-9,11-dienoic acid and (E,E)-8-thiatetradeca-10,12-dienoic acid. The other thiafatty acids tested, 9-, 10-, 11- and 12-thiatetradecanoic acids, were not metabolized by desaturation, although the corresponding products of beta-oxidation and chain elongation were detected. The occurrence of sulfoxides was not detected in this case, in disagreement with results on the metabolism of some thiaacids previously reported by other authors in yeast, Saccharomyces cerevisiae.

Liver abscess caused by Ascaris lumbricoides: case report.

A case is reported of a woman who lived in a rural area with a chronic illness that consisted of weight loss and abdominal pain in the epigastrium and upper right quadrant. The initial diagnosis was a mass in the liver, which was later, demonstrated, both by direct and histological examination, to be an abscess caused by Ascaris lumbricoides. Eggs of Ascaris lumbricoides and abundant Charcot-Leyden Crystals were found.

[A comparison of lymphocyte populations of the blood and bronchoalveolar lavage in AIDS patients]. / Comparación de poblaciones linfocitarias de sangre y lavado broncoalveolar en pacientes con SIDA.

Changes in cell immunity made manifest by decreases in blood levels of CD4 T cells is the main indicator of progressing HIV infection. The decrease in these lymphocytes, as well as in the CD4/CD8 index and increases in suppressant or cytotoxic CD8 cells can be detected in bronchoalveolar (BAL) lung samples. It is not clear whether the high incidence of respiratory system diseases in HIV patients stems from local or systemic immune changes. The aim of this study was to compare changes in the systemic cell immunity studied in samples of peripheral blood with changes detected in BAL samples from HIV patients with acute respiratory disease. We studied 42 patients in the advanced stages of AIDS (C3 by Centers for Disease Control classification) who were hospitalized for acute respiratory disease and who underwent diagnostic fiberoptic bronchoscopy and BAL. Cell counts and lymphocyte populations were analyzed by flow cytometry in samples of peripheral blood and BAL. The percentage of CD4 lymphocytes and the CD4/CD8 index were lower in BAL, particularly in patients with blood CD4 levels below 12% of the total T cell population, or at a level of 20 CD4 cells/microliters. Changes in cell immunity in patients with advanced HIV infection (C3 classification) and acute respiratory disease are more manifest locally in the lung than peripherally in blood. Lung depletion of CD4 T cells in the lung can be predicted based on blood levels.

La experiencia farmacoterapéutica: Punto de partida para la Gestión Integral de la Farmacoterapia. Pharmacotherapeutic experience: Starting point for the Comprehensive Medication Management / The pharmacotherapeutical experience: the starting point to the comprehensive management of the pharmacotherapy

Acude a nuestra Unidad de Optimización de la Farmacoterapia (UOF) una persona de 75 años porque tiene algunas dudas sobre algunos medicamentos que utiliza. Es una persona con Diabetes tipo 2 con buen control de la enfermedad. Cumple rigurosamente con su dieta y camina entre 8 y 12 km diarios. Para resolver las dudas que nos expone aplicamos la Gestión Integral de la Farmacoterapia para detectar, prevenir y resolver problemas de la medicación. Esta persona esta preocupara porque considera que utiliza muchos medicamentos

A 75-year-old person comes to our Medication Therapy Optimization Unit (UOF for its acronym in Spanish) with doubts about some of the medication used. This person has Type 2 Diabetes with good disease management. He/she follows strictly his/her diet and walks from 8 to 12 kilometers a day. In order to clarify the doubts raised, we apply the Comprehensive edication Therapy Management (GIF) in order to detect, prevent and solve medication issues. This person is worried because he/she considers that he/she is taking too many drugs

Dermatosis neglecta. a propósito de un caso / Dermatosis neglecta. about a case

RESUMEN La dermatosis neglecta es una entidad benigna poco frecuente, con predominio en pacientes adultos, secundario a una hiperalgesia. Presentamos una paciente de 78 años con antecedente de herpes zoster en rostro, con lesiones características de esta enfermedad.

SUMMARY Dermatosis neglecta is a rare benign entity with predominance in adult patients, secondary to a hyperalgesia. We present a 78-year-old patient with a history of herpes zoster on the face, with characteristic lesions of this disease.

Trophic network of aquatic macroinvertebrates along an altitudinal gradient in a Neotropical mountain river

ABSTRACT Studies of trophic networks and the evaluation of processes that occur along altitudinal gradients in river systems are of great importance because they allow an understanding of energy flow dynamics and provide scientific tools for the planning and management of river ecosystems. This research describes the trophic network of aquatic macroinvertebrates along an altitudinal gradient of the Gaira River, a mountain Neotropical watercourse located in the Sierra Nevada de Santa Marta in northern Colombia. The organisms were collected in the upper, middle and lower reaches of the river during the rainy and dry seasons (between 2010 and 2013). Trophic relationships were evaluated through gut content analysis. The contents were determined and quantified using photographs and expert review, and a binary consumption matrix was used to determine the characteristics of the trophic network. We characterized the diet composition at each site for each season using discriminant analysis. Trophic networks during the dry seasons showed higher trophic species richness and linkage density, and the predominance of coarse particulate organic matter (CPOM) and fine particulate organic matter (FPOM) in the high and medium sections of the river. During the dry seasons the diets had a lower number of basal species, but in the low river section there was a high percentage of fungi and microalgae. During the rainy seasons, no patterns were observed for the percentage of resources. Results indicated a direct relation between periods of hydrologic stability and an increase of CPOM during dry seasons and an increase of resource diversity consumed by macroinvertebrates at all sites during the rainy season, showing that changes in trophic networks of the Gaira River were more important during seasonal periods than along the altitudinal gradient.

Efecto del ungüento oftálmico de carbómero al 02% sobre molestias oculares en pacientes sometidos a anestesia general: Estudio de cohorte no aleatorizado / Effect of 0.2% carbomer ophthalmic ointment on eye discomfort after general anesthesia: A non-randomized cohort study

Introducción y objetivo: Las lesiones oculares durante cirugía son raras. Las causas comunes incluyen trauma directo, lesión química y exposición corneal. Las molestias oculares se pueden presentar después de la cirugía en ausencia de daño estructural del ojo. En nuestro hospital todos los pacientes sometidos a anestesia general reciben protección con oclusión ocular asociado en la mayoría de los casos con la aplicación de gel oftálmico. En este estudio buscamos analizar la incidencia de molestias oculares con la aplicación de gel oftálmico de carbómero 0,2%. Métodos: Se llevó a cabo un estudio tipo cohorte. Se incluyeron los pacientes sometidos a cirugía bajo anestesia general con duración menor a cuatro horas entre febrero y noviembre de 2017. Se excluyeron a los pacientes con patologías oculares previas, los llevados a cirugía oftálmica, facial o de cabeza, y aquellos en los que la oclusión ocular no fue posible. Para el análisis, los pacientes se dividieron en dos grupos: oclusión ocular simple (Grupo 1) y oclusión ocular más gel oftálmico de carbómero al 0,2% (Grupo 2). Nuestro desenlace primario fue la incidencia de molestias oculares y el desenlace secundario fue determinar los factores de riesgo. Resultados: Se analizaron 400 pacientes, de los cuales la mitad (50%) recibieron el gel oftálmico de carbómero 0,2%. No se encontraron diferencias en las características demográficas entre grupos. Durante las primeras 24 horas postoperatorias, el 7,25% de los pacientes presentaron síntomas visuales, y a los siete días postoperatorios ningún paciente refirió síntomas. Los síntomas más frecuentes fueron visión borrosa, prurito, epífora y ojo rojo. En el análisis multivariado el principal factor de riesgo asociado con la aparición de molestias oculares fue la aplicación de gel oftálmico de carbómero 0,2% (RR 13,5; IC 95% 3,27–56,2). Otros factores asociados a molestias oculares fueron cirugía de urgencia y la edad.(AU)

Background and objective: Eye lesions during surgery are rare. Its common causes include direct trauma, chemical damage, and corneal exposure. Eye discomfort may present after surgery in the absence of structural damage. In our hospital, every patient under general anesthesia receives eye protection with eye occlusion associated in most cases with ophthalmic ointment application. We aim to analyze the incidence of eye discomfort with 0.2% carbomer application. Methods: A cohort study was conducted. Patients who underwent surgery under general anesthesia lasting less than 4hours between February and November 2017 were enrolled. We excluded patients with previous ophthalmologic pathology, those undergoing eye, otolaryngology, face or head surgery, and patients in which eye occlusion was not possible. For analysis, patients were divided into two groups: simple eyelid occlusion (Group 1) and eyelid occlusion plus ophthalmic ointment (Group 2). Primary outcome was the incidence of eye discomfort and secondary outcomes were to stablish associated risk factors. Results: 400 patients were analyzed, 50% were exposed to 0.2% carbomer. There was no difference in patients’ demographics. During the first 24hours post-surgery 7.25% of patients showed visual symptoms, and at one-week postoperative no patient referred symptoms. Most frequent symptoms were blurry vision, pruritus, epiphora and red-eye. On multivariate analysis, the main risk factor associated with eye discomfort was 0.2% carbomer application (RR 13.5 CI 3.27 – 56.2). Emergent surgery and age were also found to be risk factors. Conclusion: 0.2% carbomer does not prevent ophthalmologic symptoms after surgery and it may even increase them in short procedures.(AU)

Hábitos alimentrrios, morfometría y estados gondales de cinco especies de pecees en diferentes períodos climáticos en el río sogamoso (santander, Cooombia) / Trophic Habits, Morphometry and Gonadal Status of Five Fish Species in Different Climatic Periods at the Río Sogamoso (Santander, Colombia)

Esta investigación determinó algunos aspectos bioecológicos de cinco especies de peces del río Sogamoso, la cual es información básica que puede permitir analizar los impactos generados por la construcción y operación de la represa Hidrosogamoso. Para cada ejemplar colectado se registraron la longitud estándar y el peso total, se calculó la relación entre el peso y la longitud (P= aLb), se determinó el estado gonadal y el coeficiente de vacuidad, y se definió la importancia de cada categoría de alimento. El bocachico (Prochilodus magdalenae) alcanzó mayor abundancia en el río en la época seca y el inicio del desove se registró en diciembre. El coeficiente de vacuidad fue alto y su dieta se basó en materia orgánica. Pimelodus blochii y P. grosskopfii registraron mayores capturas en diciembre; su dieta estuvo basada en insectos y peces. Los loricáridos Chaetostoma cf. thomsoni y Sturisoma aureum solo se capturaron en los tramos medios y altos del río. Su dieta se basó en materia orgánica. Se requiere un estudio continúo más detallado para establecer el ciclo reproductivo de Pimelodus spp. y de los loricáridos. Dada la condición de especie amenazada y su dinámica migratoria, el bocachico es una de las especies más sensibles a la construcción, el llenado y la operación de la hidroeléctrica en el río Sogamoso. Para los loricaridos la reducción de caudal del río Sogamoso puede disminuir sus hábitats y limitar la conexión con los afluentes a través de los cuales migra.

The objective of this research was to determine some bioecological aspects for five fish species of the Río Sogamoso, to generate baseline information that will permit analyze the impacts generated for the construction and operation of the Hidrosogamoso dam. For each specimen collected the standard length and total weight were recorded, the correlation between weight and length (W= aLb) was calculated, the gonadal status and the coefficient of vacuity were determined, and the importance of each food category was defined. The "bocachico" (Prochilodus magdalenae) reached greatest abundance in the river during the dry season and the beginning of spawning was recorded in December. Its vacuity coefficient was high and its diet was based on organic matter. Pimelodus blochii and P. grosskopfii reported the greatest catches in December; their diet was based on insects and fish. The Loricariids Chaetostoma cf. thomsoni and Sturisoma aureum were captured only in the middle and upper reaches of river. Their diet was based on organic matter. It is required a more detailed and continue study to set the reproductive cycle of Pimelodus spp. and Loricariids. Given the status of threatened species and its migration dynamics, the "bocachico" is one of the most sensitive species to the construction, filling and operation of the hydroelectric dam on the Río Sogamoso. For Loricariids, the reduction of Río Sogamoso flow may decrease their habitats and limit the connection to the tributaries through which they migrate.

Neoliberalismo en salud: La tortura de trabajadoras y trabajadores del Instituto Materno Infantil de Bogotá / Neoliberalism in health: the torture of the health care workers of the Bogota s Instituto Materno Infantil (child and maternity hospital)

Objetivos Relacionar históricamente las transformaciones más significativas del Instituto Materno Infantil (IMI) en su proceso de crisis, cierre y liquidación con las experiencias de sus trabajadores/as. Encontrar elementos vivenciales y teóricos que interconecten el proceso de privatización de la salud con las experiencias de resistencia y dolor/sufrimiento de trabajadores/as. Métodos Etnografía inscrita en corrientes críticas y apoyada en trabajo de campo constante y colectivo, investigación histórica (fuentes primarias y secundarias) y entrevistas semiestructuradas con cinco mujeres que trabajaron por más de quince años en el IMI. Resultados Una línea del tiempo con cuatro periodos principales: Los años de gloria (hasta 1990), Llega el neoliberalismo (1990-2000), La crisis y las resistencias (2001-2005) y Liquidación (2006-). La narrativa de las mujeres entrevistadas devela múltiples agresiones que se intensificaron desde el 2006 generando dolor/ sufrimiento, relatos que ilustran violaciones a sus derechos humanos y laborales. Discusión Proponemos analizar las conexiones entre los diferentes tipos de violencia y el dolor/sufrimiento bajo la categoría tortura, entendida como acciones violentas que causan dolor físico-emocional, las cuales son ejecutadas por actores de poder sobre otros que desafían alterarlo. Enfatizamos en las burocracias, el confinamiento, los agentes torturadores y los resquebrajamientos a la unidad mente/cuerpo para argumentar que esta relación neoliberalismo y tortura pretende eliminar los últimos trabajadores/as de la salud del país con garantías laborales para avanzar en la acumulación de capital que genera la creciente sobreexplotación del trabajo y la mercantilización de la salud.

Objectives To link, from a historical point of view, the most significant transformations of the Instituto Materno Infantil (IMI) [the oldest child and maternity hospital of the country] during its process of crisis, closure and liquidation with the experiences of the hospital workers. To find experience-based and theoretical elements that can interconnect the process of health care privatization of the country with the workers' experiences of resistance and pain/suffering. Methods Critically-oriented ethnography based on continuous collective field work, historical research (primary and secondary sources) and semi-structured interviews with 5 women who worked at the IMI for more than 15 years.Results: A time line of 4 main periods: Los años de gloria [The golden years] (up to 1990); Llega el neoliberalismo [Neoliberalism arrives] (1990-2000); La crisis y las resistencias [Crisis and resistances] (2001-2005); and Liquidación [Liquidation (2006-20??)]. The narratives of the interviewed women unveil multiple aggressions that have intensified since 2006, have caused pain and suffering and are examples of violations of human and labour rights. Discussion We suggest to analyze the links between the different kinds of violence and pain and suffering as torture. This category is defined as the set of violent actions that cause physical and emotional pain, which are performed by actors in positions of power over other people who challenge that power and are part of modern States' ideological principles around a defined moral social order. For the IMI workers' case, the ideological principle that is being challenged is health care neoliberalism. From the analyses of bureaucracy, confinement, torturing agents, and the breaking-off of the body-mind unit we conclude that this relationship between neoliberalism and torture aims to eliminate the last health care workers of the country who had job stability and full-benefits through public labour contracts. Their elimination furthers the accumulation of capital generated by increasing over-exploitation of labour and commodification of health care.

índice de estad limnológico (iel)para evaluar as condiciones ecológicas de laas ciénagas del canal del dique, Colomiia / Limnological State Index (LSI) to Evaluate Ecological Conditions of the Canal del Dique Wetlands, Colombia.

Determinar el estado o salud ecológica de un ecosistema brinda herramientas útiles para su gestión y conservación. En Colombia no existen registros de índices que combinen en un solo parámetro las variables físicas, químicas y biológicas de los sistemas acuáticos, de manera que la evaluación de su estado ecológico ha sido fragmentaria o incompleta. En este trabajo se presenta un Índice de Estado Limnológico (IEL) para las ciénagas del Canal del Dique, ecosistemas sometidos a constante presión por parte de las comunidades humanas. Para la construcción de este índice multimétrico se elaboraron gráficas de calidad de las variables seleccionadas y se les asignaron valores de importancia. Para construir el IEL se empleó la teoría de los multiatributos considerando 12 variables. También se realizó un análisis de componentes principales de las variables seleccionadas. Se diseñó una versión simplificada (IEL parcial -IELP) en la que se excluyeron cuatro de las variables biológicas. Finalmente, se construyó una escala de interpretación de los valores obtenidos con estos índices. El IEL y el IELP se aplicaron a las ciénagas del Canal del Dique para establecer su condición ecológica actual. Los datos muestran que el estado limnológico de la mayoría de ciénagas de esta región es aceptable, lo que sugiere que estos ecosistemas lénticos se encuentran dentro de los límites admisibles de funcionamiento, aunque no están excentos de procesos de deterioro.

Determining the ecological state or health of an ecosystem offers useful tools for its management and conservation. In Colombia, indexes of aquatic systems that combine in a single parameter the physical, chemical and biological variables have not been published, and the evaluation of water bodies’ ecological state has been fragmentary or incomplete. In this work a Limnological State Index (LSI) for wetlands of the Canal del Dique, ecosystems under constant pressure by the human communities, is presented. For the construction of this multi-metric index, graphs of quality of the selected variables were constructed and values of importance were assigned to them. The theory of the multi-attributes was used to construct the LSI, which considers 12 variables. A Principal Components Analysis was realized with these chosen parameters. A simplified version was designed (partial LSI -PLSI) in which four of the biological variables were excluded. Finally, an interpretation scale of the values obtained with these indices was built. The LSI and the PLSI were applied to wetlands of the Canal del Dique to establish their current ecological condition. Data show that the limnological state of most wetlands is acceptable, which suggests that these lentic ecosystems are within tolerable limits of function, although they are not exempt from deterioration processes.

Cryptoregiochemistry of the delta11-myristoyl-CoA desaturase involved in the biosynthesis of Spodoptera littoralis sex pheromone.

Many moth species biosynthesize their sex pheromones by the action of unique desaturases. These membrane-bound family of enzymes are especially interesting, since some of them produce (E)-unsaturated fatty acids either exclusively or along with the (Z)-isomer. In this article we present the first mechanistic study on one of these enzymes, namely, the Delta11-myristoyl-CoA desaturase of the moth Spodoptera littoralis. Intermolecular primary isotope effect determinations were performed in competition experiments. The unusual use of odd-number fatty acids, tridecanoic acid and deuterium-labeled tridecanoic acid, in these experiments showed the existence of a large isotope effect for the carbon-hydrogen bond cleavage at C11, but no isotope discrimination occurred in the removal of C12-H. The results of the competitive experiments are consistent with the hypothesis that this Delta11-desaturase involves a first slow, isotope-sensitive C11-H bond cleavage, with probable formation of an unstable intermediate, followed by a second fast C12-H bond removal. We suggest that a single enzyme may be responsible for the formation of both (Z)- and (E)-11-tetradecenoic acids by accommodating both gauche and anti conformers of the substrate, respectively. It is also possible that two mechanistically identical discrete enzymes are involved in each desaturation. In this case, the geometry of the resulting double bond would result from the different conformation adopted by the acyl substrate at each enzyme active site.

[Immaturity of syncytial trophoblast in maternal malnutrition. Ultrastructural analysis]. / Inmadurez del sinciciotrofoblasto en desnutrición materna. Análisis ultraestructural.

We studied the placental membrane at term in normal females and females with malnutrition not related to associated pathologic processes of pregnancy. Both groups belonged in the low socioeconomic stratum. The fetal aspect of placenta from malnourished females showed signs of immaturity in relation to gestational age, as evidenced by transitional cytotrophoblastic cells in different stages of maturation. The latter appear as a third intermediata layer between cytothropoblast and syncitiotrophoblast.

[Prophylaxis of bacterial endocarditis in children with congenital heart disease: current status of parents' knowledge]. / Profilaxis de endocarditis bacteriana en niños con cardiopatía congénita: Estado actual de conocimientos por parte de los padres.

OBJECTIVE: The purpose of this study was to assess the knowledge that parents of children with congenital cardiac disease have about bacterial endocarditis (EB) and its prophylaxis (PEB). PATIENTS AND METHODS: To this end, an elusive questionnaire was prepared and offered to one hundred parents of children who needed PEB. The group was classified according to the age of the children, the cultural level of the parents an the event of a dental or if another septic focus was known in the past. Likewise, the parents' knowledge of their child's disease was analyzed. RESULTS: Of the results obtained, it stood-out that the parents appeared well informed about their child's illness, but their information was insufficient in relationship to EB and PEB. Of those tested, 85% defined the child's heart disease, while only 14% did so for EB. Likewise, only 67.7% of the children who underwent an intervention for a septic focus performed PEB correctly. The knowledge of this theme are in relationship to the family's cultural formation. CONCLUSIONS: We emphasize the need to reinforce the information about PEB that the cardiologists, pediatricians and general physicians give to the families in order to prevent the morbidity and mortality caused by EB.