Factors shaping the COVID-19 epidemic curve: a multi-country analysis.

BACKGROUND: Lockdown measures are the backbone of containment measures for the COVID-19 pandemic both in high-income countries (HICs) and low- and middle-income countries (LMICs). However, in view of the inevitably-occurring second and third global covid-19 wave, assessing the success and impact of containment measures on the epidemic curve of COVID-19 and people's compliance with such measures is crucial for more effective policies. To determine the containment measures influencing the COVID-19 epidemic curve in nine targeted countries across high-, middle-, and low-income nations. METHODS: Four HICs (Germany, Sweden, Italy, and South Korea) and five LMICs (Mexico, Colombia, India, Nigeria, and Nepal) were selected to assess the association using interrupted time series analysis of daily case numbers and deaths of COVID-19 considering the following factors: The "stringency index (SI)" indicating how tight the containment measures were implemented in each country; and the level of compliance with the prescribed measures using human mobility data. Additionally, a scoping review was conducted to contextualize the findings. RESULTS: Most countries implemented quite rigorous lockdown measures, particularly the LMICs (India, Nepal, and Colombia) following the model of HICs (Germany and Italy). Exceptions were Sweden and South Korea, which opted for different strategies. The compliance with the restrictions-measured as mobility related to home office, restraining from leisure activities, non-use of local transport and others-was generally good, except in Sweden and South Korea where the restrictions were limited. The endemic curves and time-series analysis showed that the containment measures were successful in HICs but not in LMICs. CONCLUSION: The imposed lockdown measures are alarming, particularly in resource-constrained settings where such measures are independent of the population segment, which drives the virus transmission. Methods for examining people's movements or hardships that are caused by covid- no work, no food situation are inequitable. Novel and context-adapted approach of dealing with the COVID-19 crisis are therefore crucial.

Response of Zea mays to multimetal contaminated soils: a multibiomarker approach.

Heavy metals present in mine tailings pollute agroecosystems, put the integrity of the environment at risk and become a major route of exposure to humans. The present study was carried out in Taxco, Guerrero, Mexico, where millions of tons of mine tailings have been deposited. Soils from this region are used for agricultural activities. Maize (Zea mays) was selected as a test plant, because it is one of the most common and important cereal crops in Mexico and worldwide. Thirteen metals were selected and their bioaccumulation in roots, leaves and fruits were measured in plants cultivated in soils contaminated with mine tailings and those cultivated in non-contaminated soils. The effect of metal bioaccumulation on: macro and micromorphology, size, biomass, coloration leaf patterns and on DNA damage levels in different structures were determined. The bioaccumulation pattern was: root > leaf > fruit, being only Mn and Cr bioaccumulated in all three structures and V in the roots and leaves. A significant effect of metal bioaccumulation on 50% of the size and leaf shape and 55% of the biomass characters in Z. mays exposed plants was detected. Regarding micromorphological characters, a significant effect of metal bioaccumulation on 67% of the leaf characters and on 100% of the color basal leaf characters was noted. The effect of metal bioaccumulation on the induction of DNA damage (leaf > fruit > root) was detected employing single cell gel electrophoresis analysis. An approach, in which multi endpoints are used is necessary to estimate the extent of the detrimental effects of metal pollution on agroecosystem integrity contaminated with mine tailings.

WhatsApp-based intervention in urban Colombia to support the prevention of arboviral diseases: a feasibility study.

Arboviral diseases remain a significant health concern worldwide, with over half the world's population at risk for dengue alone. Without a vaccine or targeted treatment, the most effective strategy of prevention is vector management with community involvement. mHealth interventions, like WhatsApp, offer promising results for engaging communities and promoting healthier behaviors. This study explores the feasibility of integrating WhatsApp in vector control activities to improve arbovirus prevention in Colombia. A mixed-methods approach was employed to assess the WhatsApp-based intervention. WhatsApp messages were sent to 45 community women for 5 weeks to increase their knowledge and practices about dengue, Zika, and chikungunya. Pre-and-post surveys and focus group discussions were conducted in community settings to measure the feasibility and acceptability of this intervention. Chat reviews were done to assess the usability of users. A total of 1566 messages were exchanged in 45 WhatsApp chats. High acceptance and good usability (82% of users used the app for replying) were reported in this study. WhatsApp messages were perceived as short, clear, and enjoyable. Users liked the frequency, and design of messages. Pre- and post-surveys demonstrated improvements in the knowledge and practices of arboviral diseases. The intention to apply this knowledge in practice was reflected in a significant improvement, particularly in cleaning the laundry tank once a week (pre 62.1% to post 89.6%, p < 0.008). This study suggests that using WhatsApp as an additional tool could be a feasible, acceptable, and affordable strategy for improving the adoption of better practices in the prevention of arboviral diseases.

Incidence of inguinal hernia repairs in Olmsted County, MN: a population-based study.

OBJECTIVE: To determine age- and sex-specific incidence rates of inguinal hernia repairs (IHR) in a well-defined US population and examine trends over time. BACKGROUND DATA: IHR represent a substantial burden to the US healthcare system. An up-to-date appraisal will identify future healthcare needs. METHODS: A retrospective review of all IHR performed on adult residents of Olmsted County, MN, from 1989 to 2008 was performed. Cases were ascertained through the Rochester Epidemiology Project, a record linkage system with more than 97% population coverage. Incidence rates were calculated by using incident cases as the numerator and population counts from the census as the denominator. Trends over time were evaluated using Poisson regression. RESULTS: During the study period, a total of 4026 IHR were performed on 3599 unique adults. Incidence rates per 100,000 person-years were greater for men: 368 versus 44 for women, and increased with age: from 194 to 648 in men, and from 28 to 108 in women between 30 and 70 years of age. Initial, unilateral IHR comprised 74% of all IHR types. The lifelong cumulative incidence of an initial, unilateral or a bilateral IHR in adulthood was 42.5% in men and 5.8% in women. Over time (from 1989 to 2008), the incidence of initial, unilateral IHR in men decreased from 474 to 373 (relative reduction, RR = 21%). Bilateral IHR increased from 42 to 71 (relative increase = 70%), contralateral metachronous IHR decreased from 29 to 11 (RR = 62%), and recurrent IHR decreased from 66 to 26 (RR = 61%); for all changes P < 0.001. CONCLUSIONS: IHR are common, their incidence varies greatly by age and sex and has decreased substantially over time in Olmsted County, MN.

Intimate Partner Violence Among Women of Reproductive Age in Nicaragua: Results From a Nationwide Survey.

This article aims to identify the factors associated with intimate partner violence (IPV) using data from the latest available nationwide survey in Nicaragua. A secondary analysis of the 2011-2012 Nicaraguan Demography and Health Survey (ENDESA 2011-2012) was conducted. A total of 12,605 women aged 15-49 years who had reported being married or united were included. IPV (yes/no) was defined as the outcome variable, and it was considered if a woman suffered verbal, psychological, physical, or sexual violence during the previous 12 months. Crude and adjusted odds ratios with 95% CI were calculated using a bivariate and multivariate logistic regression model. A p value <.05 was considered statistically significant and did not correct p values for multiple testing. The overall prevalence of IPV was 17.5%. Women living in urban setting (AOR: 1.51, 95% CI: 1.26-1.80), women who self-identify as native (AOR: 1.34, 95% CI: 1.34-1.61) or women who have a history of abuse as a child (AOR: 1.96, 95% CI: 1.69-2.27) were more likely to suffer IPV compared to their counterparts. Age was found to be a protective factor for IPV. Variables such as educational level and wealth index, do not report any association with IPV. Our findings shows that IPV in Nicaragua continues to be a frequent event. The results provide evidence of drivers for IPV at a national level. These findings are useful for the design of intervention policies and strategies for the prevention of IPV.

Prediction of Neonatal Respiratory Morbidity Assessed by Quantitative Ultrasound Lung Texture Analysis in Twin Pregnancies.

The objective of this study was to evaluate the performance of quantitative ultrasound of fetal lung texture analysis in predicting neonatal respiratory morbidity (NRM) in twin pregnancies. This was an ambispective study involving consecutive cases. Eligible cases included twin pregnancies between 27.0 and 38.6 weeks of gestation, for which an ultrasound image of the fetal thorax was obtained within 48 h of delivery. Images were analyzed using quantusFLM® version 3.0. The primary outcome of this study was neonatal respiratory morbidity, defined as the occurrence of either transient tachypnea of the newborn or respiratory distress syndrome. The performance of quantusFLM® in predicting NRM was analyzed by matching quantitative ultrasound analysis and clinical outcomes. This study included 166 images. Neonatal respiratory morbidity occurred in 12.7% of cases, and it was predicted by quantusFLM® analysis with an overall sensitivity of 42.9%, specificity of 95.9%, positive predictive value of 60%, and negative predictive value of 92.1%. The accuracy was 89.2%, with a positive likelihood ratio of 10.4, and a negative likelihood ratio of 0.6. The results of this study demonstrate the good prediction capability of NRM in twin pregnancies using a non-invasive lung texture analysis software. The test showed an overall good performance with high specificity, negative predictive value, and accuracy.

Concordance of the risk of neonatal respiratory morbidity assessed by quantitative ultrasound lung texture analysis in fetuses of twin pregnancies.

To evaluate the concordance of the risk of neonatal respiratory morbidity (NRM) assessed by quantitative ultrasound lung texture analysis (QuantusFLM) between twin fetuses of the same pregnancy. Prospective study conducted in twin pregnancies. Fetal ultrasound lung images were obtained at 26.0-38.6 weeks of gestation. Categorical (high or low) and continuous results of the risk of NRM were compared between twins. Fetal ultrasound lung images from 131 pairs (262 images) of twins were included. The images were classified into three gestational age ranges: Group 1 (26.0-29.6 weeks, 78 images, 39 pairs [29.8%]); Group 2 (30.0-33.6 weeks, 98 images, 49 pairs [37.4%]) and Group 3 (34.0-38.6 weeks, 86 images, 43 pairs [32.8%]). Concordance was good in Groups 1 and 3 and moderate in Group 2. In Groups 2 and 3 at least one fetus presented high-risk results in 26.5% and 11.6% of twin pairs, respectively. Only gestational age < 32 weeks, gestational diabetes mellitus, and spontaneous conception were associated with a high risk of NRM in Group 2. There was good concordance of the risk of NRM between twins < 30.0 weeks and > 34.0 weeks. From 30.0 to 33.6 weeks 26.5% of the twin pairs had discordant results, with moderate concordance of the risk of NRM.

Early warning systems (EWSs) for chikungunya, dengue, malaria, yellow fever, and Zika outbreaks: What is the evidence? A scoping review.

BACKGROUND: Early warning systems (EWSs) are of increasing importance in the context of outbreak-prone diseases such as chikungunya, dengue, malaria, yellow fever, and Zika. A scoping review has been undertaken for all 5 diseases to summarize existing evidence of EWS tools in terms of their structural and statistical designs, feasibility of integration and implementation into national surveillance programs, and the users' perspective of their applications. METHODS: Data were extracted from Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Latin American and Caribbean Health Sciences Literature (LILACS), PubMed, Web of Science, and WHO Library Database (WHOLIS) databases until August 2019. Included were studies reporting on (a) experiences with existing EWS, including implemented tools; and (b) the development or implementation of EWS in a particular setting. No restrictions were applied regarding year of publication, language or geographical area. FINDINGS: Through the first screening, 11,710 documents for dengue, 2,757 for Zika, 2,706 for chikungunya, 24,611 for malaria, and 4,963 for yellow fever were identified. After applying the selection criteria, a total of 37 studies were included in this review. Key findings were the following: (1) a large number of studies showed the quality performance of their prediction models but except for dengue outbreaks, only few presented statistical prediction validity of EWS; (2) while entomological, epidemiological, and social media alarm indicators are potentially useful for outbreak warning, almost all studies focus primarily or exclusively on meteorological indicators, which tends to limit the prediction capacity; (3) no assessment of the integration of the EWS into a routine surveillance system could be found, and only few studies addressed the users' perspective of the tool; (4) almost all EWS tools require highly skilled users with advanced statistics; and (5) spatial prediction remains a limitation with no tool currently able to map high transmission areas at small spatial level. CONCLUSIONS: In view of the escalating infectious diseases as global threats, gaps and challenges are significantly present within the EWS applications. While some advanced EWS showed high prediction abilities, the scarcity of tool assessments in terms of integration into existing national surveillance systems as well as of the feasibility of transforming model outputs into local vector control or action plans tends to limit in most cases the support of countries in controlling disease outbreaks.

The Covid-19 pandemic in low- and middle-income countries, who carries the burden? Review of mass media and publications from six countries.

During the Covid-19 pandemic, rich countries employed lockdown and physical distancing policies for transmission control. However, the question still remains whether these measures are also suitable in countries with a fragile economy, which rests mainly on the informal sector. The impacts of lockdown measures in disadvantaged population strata in six low- and middle-income countries (LMICs) were reviewed using i) 93 media reports and ii) 17 published scientific papers. This review showed that those who suffered the most from the lockdown were migrants, workers in the large informal sector, small businesses, slum dwellers, women and elderly, revealing the social, cultural and economic inequalities of societies. Financial and food support for the poor was inadequate and sometimes mismanaged. In the better organized societies, the resilience was stronger (South Korea, Kerala/India) but here also the poor had to suffer the most. It is strongly recommended that outbreak response strategies should particularly focus on the poor and vulnerable population.

Soluble ß-(1,3)-glucans enhance LPS-induced response in the monocyte activation test, but inhibit LPS-mediated febrile response in rabbits: Implications for pyrogenicity tests.

In the present study, we aimed to determine the influence of ß-(1,3)-d-glucans on the LPS-induced pro-inflammatory cytokine response in the Monocyte Activation Test (MAT) for pyrogens, and on the LPS-induced febrile response in the Rabbit Pyrogen Test (RPT), thus evaluating the resulting effect in the outcome of each test. It was found that ß-(1,3)-d-glucans elicited the production of pro-inflammatory cytokines IL-1ß, IL-6 and TNF-α, also known as endogenous pyrogens, but not enough to classify them as pyrogenic according to MAT. The same ß-(1,3)-d-glucans samples were non-pyrogenic by RPT. However, ß-(1,3)-d-glucans significantly enhanced the LPS-induced pro-inflammatory cytokines response in MAT, insomuch that samples containing non-pyrogenic concentrations of LPS become pyrogenic. On the other hand, ß-(1,3)-d-glucans had no effect on sub-pyrogenic LPS doses in the RPT, but surprisingly, inhibited the LPS-induced febrile response of pyrogenic LPS concentrations. Thus, while ß-(1,3)-d-glucans could mask the LPS pyrogenic activity in the RPT, they exerted an overstimulation of pro-inflammatory cytokines in the MAT. Hence, MAT provides higher safety since it evidences an unwanted biological response, which is not completely controlled and is overlooked by the RPT.

Unexpected inverse correlation between Native American ancestry and Asian American variants of HPV16 in admixed Colombian cervical cancer cases.

BACKGROUND: European (E) variants of HPV 16 are evenly distributed among world regions, meanwhile Non-European variants such as European-Asian (EAs), Asian American (AA) and African (Af) are mostly confined to Eastern Asia, The Americas and African regions respectively. Several studies have shown that genetic variation of HPV 16 is associated with the risk of cervical cancer, which also seems to be dependent on the population. This relationship between ethnicity and variants have led to the suggestion that there is co-evolution of variants with humankind. Our aim was to evaluate the relationship between the individual ancestry proportion and infection with HPV 16 variants in cervical cancer. METHODS: We examined the association between ancestry and HPV 16 variants in samples of 82 cervical cancer cases from different regions of Colombia. Individual ancestry proportions (European, African and Native American) were estimated by genotyping 106 ancestry informative markers. Variants were identified by PCR amplification of the E6 gene, followed by reverse line blot hybridization (RLB) with variants specific probes. RESULTS: Overall European (E) and Asian American (AA) variants frequency was 66.5% and 33.5% respectively. Similar distribution was observed in cases with higher proportions of European or African ancestry. A higher Native American ancestry was significantly associated with higher frequency of E variants (median ancestry>23.6%, Age and place of birth adjusted OR: 3.55, 95% CI: 1.26-10.03, p=0.01). Even further, an inverse geographic correlation between Native American ancestry and frequency of infections with AA variants was observed (ρ=-0.825, p=0.008). Regions with higher proportion of Native American ancestry had a lower frequency of AA variants of HPV 16. CONCLUSIONS: This study suggests replacement of AA variants by E variants of human papillomavirus 16 in cervical cancer cases with high Native American ancestry.

Trends in the utilization of inguinal hernia repair techniques: a population-based study.

BACKGROUND: The use of inguinal hernia repair techniques in the community setting is poorly understood. METHODS: A retrospective review of all inguinal hernia repairs performed on adult residents of Olmsted County, MN, from 1989 to 2008 was performed through the Rochester Epidemiology Project. RESULTS: A total of 4,433 inguinal hernia repairs among 3,489 individuals were reviewed. Non-mesh-based repairs predominated in the late 1980s (94% in 1989), declined throughout the 1990s (40% in 1996), and are rarely used nowadays (4% in 2008). Open mesh-based repairs comprised 21% in 1990, peaked in 2001 with 72%, and declined to 55% in 2008. The adoption of laparoscopic repairs began in 1992 (6%) and has increased steadily to 41% in 2008 (P < .001). CONCLUSIONS: Although non-mesh-based repairs, once the predominant method, have been supplanted by open mesh-based techniques, nowadays the use of laparoscopic inguinal hernia repair techniques has increased substantially to nearly equal that of open mesh-based techniques.

Embarazo gemelar monocoriónico monoamniótico: Presentación de tres casos y revisión de la literatura / Monochorionic monoamniotic twin pregnancy: Three cases presented and review of the literature

Objetivo: realizar el reporte de casos de embarazo gemelar monocoriónico monoamniótico con entrecruzamiento de cordones y hacer una revisión de la literatura respecto al pronóstico de este tipo de gestación, seguimiento prenatal e intervenciones de manejo hasta su finalización. Materiales y métodos: se presenta el reporte de tres casos que ocurrieron en el Hospital Universitario del Valle, Cali, Colombia, centro de referencia de nivel III del suroccidente colombiano, el cual atiende población embarazada de alto riesgo obstétrico. Se desarrolló una búsqueda de la literatura en la base de datos Medline/Pubmed publicada en español e inglés durante el periodo comprendido entre enero de 1990 a mayo 2013. Se utilizaron los términos: “gemelos”, “gemelos monocigóticos”, “embarazo múltiple”, “embarazo gemelar”. Se incluyeron artículos de revisión, reporte de casos y estudios de corte transversal. Resultados: se revisaron 23 artículos de los cuales 5 correspondieron a artículos de revisión, 7 reportes de casos y 11 estudios de corte trasversal. La información acerca de las tasas de mortalidad, evaluación prenatal, seguimiento, manejo de las complicaciones, momento y modo del nacimiento en gemelos monoamnióticos es controversial. Conclusión: la gestación gemelar monocorial monoamniótica constituye un evento poco frecuente. Esta condición está asociada con múltiples complicaciones obstétricas que incluyen la muerte fetal relacionada con accidentes de los cordones umbilicales (entrecruzamientos). El objetivo del cuidado prenatal constituye la prevención de la mortalidad fetal, por lo que se sugiere la realización continua de pruebas de bienestar fetal. Se ha propuesto la terminación del embarazo en la semana 34 de gestación por operación cesárea, previa administración de esteroides.

Objective: To report cases of monochorionic monoamniotic twin pregnancy with cord entanglement, and conduct a review of the literature regarding the prognosis of this type of gestation, prenatal follow-up and management interventions through to delivery. Materials and methods: We report 3 cases that presented to Hospital Universitario del Valle, Cali, Colombia, a level III referral center in Southwestern Colombia that provides healthcare services to pregnant women with a high obstetric risk. We conducted a search in the literature in the Medline/ Pubmed database published in Spanish and English between January 1990 and May 2013. The terms used were “twins”, “monozygotic twins”, “multiple pregnancy”, “twin pregnancy”. Review articles, case reports and cross-sectional studies were included. Results: Overall, 23 articles were reviewed, including 5 review articles, 7 case reports and 11 cross-sectional studies. Information on mortality rates, pre-natal assessment, follow-up, management of complications, time and mode of birth in monoamniotic twins is controversial. Conclusion: Monochorial monoamniotic twin pregnancy is an infrequent event. This condition is associated with multiple obstetric complications, including fetal demise associated with umbilical cord accidents (entanglement). The goal of prenatal care is to prevent fetal death, hence the suggestion of continuous testing for fetal wellbeing. Termination of pregnancy has been proposed at week 34 of gestation through cesarean section after steroid administration.

Validación del método de valoración biológica de gonadotrofina coriónica humana / Validation of the biological potency test for human chorionic gonadotropin

Introducción: en el Centro de Investigación y Desarrollo de Medicamentos se cuenta con una serie de ensayos biológicos para el control de calidad que deben ser sujetos a validación, entre ellos se encuentra la valoración biológica de gonadotrofina coriónica humana. Objetivo: evaluar el desempeño del método de valoración biológica de gonadotrofina coriónica humana. Métodos: se evaluaron la exactitud, la precisión y la especificidad como parámetros de validación siguiendo la metodología descrita en la Regulación 41-2007 del Centro para el Control Estatal de la Calidad de los Medicamentos (CECMED) para la Validación de métodos de análisis. Resultados: en el estudio de exactitud no se observaron diferencias significativas entre los valores de peso del útero obtenidos al ensayar la muestra y el material de referencia a las tres dosis administradas. En el estudio de la repetibilidad se alcanzaron coeficientes de variación menor del 50 por ciento. No se observaron diferencias significativas entre las precisiones alcanzadas por dos analistas diferentes en días diferentes. El estudio de especificidad mostró que los excipientes o sustancias auxiliares de la formulación no interfieren en la valoración biológica del producto. Conclusiones: el método biológico validado resultó ser específico, exacto y preciso en el rango de concentraciones estudiadas, lo que corrobora su calidad, teniendo un valor agregado

Introduction: a number of biological tests for quality control used in the Center for Drug Research and Development should be validated. Biological potency test of human chorionic gonadotropin is one of them. Objective: to evaluate the performance of the human chorionic gonadotropin biological potency test. Methods: the accuracy, precision and specificity were evaluated as validation parameters according to the 41-2007 Regulation of the Center for the State Control of Drug Quality (CEDMED) for analysis method validation. Results: in the accuracy test, no significant differences were observed between the uterus weight values from tested sample and the reference material at the 3 tested doses. Variation coefficients were less than 50 percent in the repeatability test. There were no significant differences between the precision values of two different analysts at different times. The specificity test showed that excipients or auxiliary substances in the formulation did not interfere with the results of the biologic potency test of the final product. Conclusions: the validated biological method showed good accuracy, precision and specificity in the range of studied concentrations, all of which proved its quality, so it has added value

Validación del método de determinación de efecto anestésico local / Validation of the measuring method of local anesthetic effect

Introducción: la determinación del tiempo de anestesia local de un medicamento o principio activo en investigación se realiza empleando un ensayo biológico. Objetivo: validar el método de determinación del tiempo de anestesia local para disponer de un método de ensayo validado para la evaluación de medicamentos genéricos con esta actividad farmacológica. Métodos: se evaluaron los parámetros de exactitud, precisión, robustez, linealidad, paralelismo y especificidad siguiendo la metodología descrita en la Regulación 41-2007 del Centro para el Control Estatal de la Calidad de los Medicamentos (CECMED) para la Validación de métodos de análisis. Resultados: en el estudio de exactitud no se observaron diferencias significativas entre los resultados al ensayar la muestra y el material de referencia. En el estudio de la repetibilidad se alcanzaron coeficientes de variación menor del 50 . No se observaron diferencias significativas entre las precisiones alcanzadas por dos analistas diferentes, en días diferentes, a tres lotes diferentes. El estudio de especificidad mostró que los excipientes o sustancias auxiliares de la formulación no interfieren en la evaluación del producto. El método resultó ser lineal en el intervalo de concentraciones de 50 a 120 por ciento con exactitud y precisión aceptable para cada dilución y mostró paralelismo. El ensayo de robustez mostró que no existen diferencias en las respuestas obtenidas al variar diferentes parámetros. Conclusiones: el método biológico resultó ser exacto, preciso, específico, lineal y robusto

Introduction: a biological test is used to measure local anesthesia time of a drug or an active principle under research. Objective: to validate the measuring method of local anesthesia time for the evaluation of generic drug with this pharmacological action. Methods: accuracy, precision, robustness, linearity, parallelism and specificity were evaluated according to the methodology described in 41-2007 Regulation of the Center for the State Control of Drug Quality (CEDMED). Results: in the accuracy test, no significant differences were observed between the results of tested sample and the reference material at the 3 tested doses. Variation Coefficients was less than 50 percent in the repeatability test. There were no significant differences between the precision values of two different analysts at different times and in three different batches. The specificity test showed that excipients or auxiliary substances in the formulation did not interfere with the evaluation of the product. The method was linear in a 50-120 percent range of concentrations, with acceptable accuracy and precision, and parallelism. The robustness test yielded no differences in the results obtained after changing various parameters. Conclusions: biological method proved to be accurate, precise, specific, linear and robust

Toxicidad de un extracto tánico de Pinus caribaea Morelet / Toxicity of a tanin extract from Pinus caribea Morelet

Se determinó la toxicidad aguda oral, dérmica y toxicogenética de un polvo de taninos obtenido a partir de un extracto acuoso de la corteza de Pinus caribaea Morelet secado por spray dry. En todos los casos se emplearon ratas Wistar de ambos sexos y peso corporal entre 150 y 200 g. Se empleó el ensayo de dosis límite y aplicación cutánea de parche oclusivo durante 24 h, para determinar la toxicidad aguda oral y dérmica, respectivamente. El polvo fue administrado en dosis de 2 000 mg/kg en ambas ocasiones. Después de 14 días de observación, los animales fueron sacrificados para realizarles autopsia y examen macroscópico de órganos y tejidos. El estudio toxicogenético se realizó en un modelo in vitro: el sistema Salmonella/microsoma (Ames) y otro in vivo: el ensayo de inducción de micronúcleos en médula ósea de ratón. En el ensayo de Ames se testaron las cepas TA 100, TA 98, TA 1535 y TA 1537 de Salmonella typhimurium con y sin activación metabólica en el rango de concentraciones de 50, 150, 500, 1 500 y 5 000 mg/placa. En el ensayo de inducción de micronúcleos se ensayaron dosis de 500, 1 000 y 2 000 mg/kg de peso corporal. Se comprobó que el polvo de taninos, obtenido a partir de un extracto acuoso de corteza de Pinus caribaea secado por spray dry, no es tóxico por administración oral y dérmica en los animales y es genotóxico in vitro e in vivo. Sería útil realizar otros estudios, con otras condiciones, para precisar la genotoxicidad de esta preparación

Acute oral, dermal and toxicogenetic toxicity of a spray dry-dried tanin powder from an aqueous extract of the wood of Pinus caribaea Morelet was determined. For all cases, Wistar rats of both sexes weighing 150-200g were used. Limit dose test and application of an occlusive patch on the skin for 24 hours determined the acute oral and dermal toxicities, respectively. The powder was administered at a dose of 2 000 mg/kg in both occasions. After 14 day-observation, the animals were killed to make autopsy and macroscopic test of organs and tissues. The toxicogenetic study was carried out in in vitro model called Salmonella/microsome system(Ames) and in vivo model, that is, the micronucleus induction test in the mouse bone marrow. In Ames test, strains TA 100, TA 98, TA 1535 and TA 1537 of Salmonella typhiumuriun with and without metabolic activation in the range of 50, 150, 500, 1 500 and 5 000 mg/plate concentrations were analyzed. Doses of 500, 1 000 and 2 000 mg/kg of body weight were tested in the micronuclei induction test. It was proved that the spray dry-dried tanin powder obtained from an aqueous extract of the wood of Pinus caribaea is not toxic by oral and dermal administration in the animals but it is genotoxic in vitro and in vivo. It will be advisable to perform other studies under different conditions so as to exactly determine the genotoxicity of this extract.

Proceso de Enfermería a paciente con Diabetes Mellitus Tipo II Aplicando El Modelo de Betty Neuman / Process of Infirmary to patient with Diabetes Mellitus Type II Applying The Pattern of Betty Neuman

Presenta estudio tipo descriptivo realizado para obtener el título de enfermera especialista en pacientes críticos. El estudio tipo diagnóstico esta basado en una paciente con diabetes mellitus tipo 2 con 16 años de padecerla. Este estudio se baso en los patrones funcionales de salud, el modelo de enfermería de Betty Neuman. Se realiza análisis de datos con los cuales se concluye que los patrones afectados en el paciente fueron los siguientes: El patrón nutricional metabólico; El patrón de actividad y ejercicio. Se formularon diagnósticos de enfermería de acuerdo a necesidades detectadas en la paciente, se ejecutaron planes de cuidados de acuerdo a su enfermedad como charlas educativas tanto a ella como a sus familiares, se planificaron cuidados de enfermería priorizando según escala de Maslow. Al concluir el estudio se pudo evaluar que las acciones de enfermería dieron respuestas a las necesidades de la paciente.