[Ocular syphilis: alert for clinicians and ophthalmologists]. / Sífilis ocular: alerta para clínicos y oftalmólogos.

Syphilis is an infectious disease caused by the spirochete Treponema pallidum. It can cause ocular compromise at any stage, in immunocompetent or immunocompromised patients. Even though the ocular form is not frequent, due to the increase in the incidence of syphilis in recent years, it is mandatory to take it into consideration as a differential diagnosis in visual disorders. The most common clinical presentation is uveitis. Diagnosis is based on the presence of clinical signs and symptoms consistent with ophthalmologic involvement in a patient with syphilis. The CSF study should be performed on a clinical basis, to rule out concomitant neurological involvement. We present 5 cases of ocular syphilis, its clinical manifestations, treatment and evolution.

La sífilis es una enfermedad infecciosa causada por la espiroqueta Treponema pallidum. Puede producir compromiso ocular en cualquier estadio, en pacientes inmunocompetentes o inmunocomprometidos. Si bien la frecuencia de presentación de la forma ocular no es alta, debido al aumento de la incidencia de sífilis en los últimos años, es necesario tenerla en cuenta como diagnóstico diferencial en los trastornos visuales. La presentación clínica más frecuente es la uveítis. Se objetiva ante la presencia de signos y síntomas clínicos consistentes con afectación oftalmológica en un paciente con sífilis. El estudio del LCR debe realizarse ante la sospecha clínica, para descartar compromiso neurológico concomitante. Comunicamos 5 casos de sífilis ocular, sus manifestaciones clínicas, tratamiento y evolución.

"Learning to learn" in the Extended Inverted Classroom: An evaluation of the effects of interactive teaching on knowledge and cognitive regulation in medical students.

INTRODUCTION: The evidence regarding the effects of the Inverted Classroom on students' metacognitive skills is limited. This study evaluates these effects on student perceptions about knowledge and cognitive regulation during a surgical course. METHODS: We measured student perceptions before and after a conventional Inverted Classroom in surgery using the Metacognitive Awareness Inventory. We evaluated the mean differences between the scores of the two measurements using Student's t-test (p < 0.05), and the size of the effect on knowledge and cognitive regulation using Cohen's d test (95%CI). RESULTS: A total of 158 students (pre-intervention) and 155 students (post-intervention) were included in the analysis. Significant differences were found (p < 0.05) in, as well as positive effects on, the students' abilities to know their own learning (declarative knowledge) (d = 0.24; 95%CI, 0.02-0.47), to use learning strategies (procedural knowledge) (d = 0.19; 95%CI, -0.02 to 0.41) and to understand when and why to use these strategies (conditional knowledge) (d = 0.20; 95%CI, -0.01 to 0.42), in addition to the abilities to plan (d = 0.31; 95%CI, 0.09-0.53) and to evaluate their learning (d = 0.31; 95%CI, 0.08-0.53). CONCLUSIONS: The Inverted Classroom has positive effects on metacognitive skills according to students' perceptions. Further studies are required that compare these effects with other methodologies for teaching in the classroom and the workplace.

Abscisic Acid Synthesis and Signaling during the Ripening of Raspberry (Rubus idaeus 'Heritage') Fruit.

The raspberry (Rubus idaeus L.) fruit is characterized by its richness in functional molecules and high nutritional value, but the high rate of fruit softening limits its quality during postharvest. Raspberry drupelets have a particular ripening regulation, depending partially on the effect of ethylene produced from the receptacle. However, the possible role of abscisic acid (ABA) in the modulation of quality parameters during the ripening of raspberry is unclear. This study characterized the fruit quality-associated parameters and hormonal contents during fruit development in two seasons. The quality parameters showed typical changes during ripening: a drastic loss of firmness, increase in soluble solids content, loss of acidity, and turning to a red color from the large green stage to fully ripe fruit in both seasons. A significant increase in the ABA content was observed during the ripening of drupelets and receptacles, with the higher content in the receptacle of ripe and overripe stages compared to the large green stage. Moreover, identification of ABA biosynthesis-(9-cis-epoxycarotenoid dioxygenase/NCED) and ABA receptor-related genes (PYRs-like receptors) showed three genes encoding RiNCEDs and nine genes for RiPYLs. The expression level of these genes increased from the large green stage to the full-ripe stage, specifically characterized by a higher expression of RiNCED1 in the receptacle tissue. This study reports a consistent concomitant increase in the ABA content and the expression of RiNCED1, RiPYL1, and RiPYL8 during the ripening of the raspberry fruit, thus supporting the role for ABA signaling in drupelets.

Effect of 3D-MOT training on the execution of manual dexterity skills in a population of older adults with mild cognitive impairment and mild dementia.

Computerized cognitive training tools are an alternative to preventive treatments related to cognitive impairment and aging. In this study, the transfer of 3D multiple object tracking (3D-MOT) training on manual dexterity concerning fine and gross motor skills in 38 elderly participants, half of them with mild cognitive impairment (MCI) and the other half with mild dementia (MD) was explored. A total of 36 sessions of the 3D-MOT training program were administered to the subjects. The Montreal Cognitive Assessment (MoCA) test was used to assess the baseline cognitive status of the participants. Two batteries of manual motor skills (GPT and MMDT) were applied before and after the 3D-MOT training program. The results showed an interaction effect of training and improvement in manual dexterity tests, from the first training session until the fifteenth session, and after this range of sessions, the interaction effect was lost. However, the training effect continued to the end of the thirty-six-session program. The experimental results show the effect of cognitive training on the improvement of motor skills in older adults. This type of intervention could have a broad impact on the aging population in terms of their attention, executive functions, and therefore, their quality of life.

A Bibliometric Study on the Social Validity of Telepractice in Autism Spectrum Disorder.

The field of telepractice is generating increasing interest in recent years. In recent years, early childhood services have used resources such as support for interventions in families with children with autism spectrum disorder. Due to this situation, the social validity of such resources has emerged in this sector, receiving individual attention from academics and practitioners. However, a further deepening of such analyses is needed. Therefore, the main objective of this work is to analyze papers published in the Web of Science on social validity and telepractice in autism spectrum disorders. Bibliometric analysis allows us to discover the current state of a research field, to identify the main authors, articles, and topics, and to propose future lines of research to develop it further. Articles published between 2000 and 2021 were analyzed quantitatively, and by co-occurrence of words and authors. Subsequently, through bibliographic linking, the articles were grouped into different clusters. Five central themes were found, with social skills and the effectiveness of intervention programs being the most developed areas of research. Furthermore, studies focusing on evidence-based practices are necessary for the development of this research field. Thus, the analysis of social validity in the field of telepractice in children with autism spectrum disorders is a developing field within the early childhood sector.

Peças de comunicação governamentais sobre as profilaxias pré (PrEP) e pós-exposição (PEP) ao HIV (2016-2019): análise de seus conteúdos e circulação entre gays, mulheres trans/travestis e trabalhadoras sexuais / Government communication pieces on HIV pre-exposure (PrEP) and post-exposure (PEP) prophylaxis (2016-2019): analysis of their content and circulation among gay men, trans women/travestis, and sex workers

Resumo Este artigo analisa a divulgação das profilaxias pré (PrEP) e pós-exposição (PEP) ao HIV, considerando o papel histórico das campanhas de prevenção à aids. São utilizadas 24 peças de comunicação sobre PrEP, PEP e PC (Prevenção Combinada), produzidas entre 2016 e 2019 e publicadas no site e mídias sociais do Ministério da Saúde, e o depoimento de 30 usuários(as) das profilaxias - que incluem gays, mulheres trans/travestis e profissionais do sexo - na região metropolitana do Rio de Janeiro. As peças foram classificadas quanto ao tipo, ano, público e informação de acesso, e os resultados foram interpretados a partir de três eixos: sexualidade e risco; gênero, emoções e moralidades; deslocamentos do preservativo. A análise indicou o apagamento das expressões de sexualidade e o predomínio de uma linguagem abstrata e esquemática, pressupondo um público racional e individualista, com o preservativo associado à ideia de "risco sexual". Os relatos dos(as) usuários(as) quanto à divulgação de informações sobre essas profilaxias evidenciaram sua insuficiência. Concluímos que ocorre uma baixa exploração do potencial das campanhas de comunicação, orientadas pela realidade sociocultural dos segmentos sociais, comprometendo o acesso às profilaxias. Assim, a biomedicalização da prevenção e o avanço do conservadorismo prejudicam a resposta brasileira à aids.

Abstract This article analyzes the advertisement of pre-exposure (PrEP) and post-exposure (PEP) prophylaxis treatment for HIV considering the historical role of AIDS prevention campaigns in Brazil. A total of 24 pieces of communication on PrEP, PEP, and CP (Combined Prevention), produced from 2016 to 2019 and published on the website and social media of the Brazilian Ministry of Health were analyzed in addition to the testimony of 30 users of prophylaxis - including gays, trans women/travestis, and sex workers - in the metropolitan region of Rio de Janeiro. The materials were classified according to type, year, audience, and access information, and the results were interpreted from four axes: contextualization of the communication pieces and the experience of the interlocutors with the information; sexuality and risk; gender, emotions, and moralities; and condom displacements. The analysis indicated the erasure of expressions of sexuality and the predominance of an abstract and structured language, presupposing a rational and individualistic public, with condoms associated with "sexual risk." Users' reports regarding the advertisement of information on these prophylaxis reveals its insufficiency. We conclude that the potential of information and communication campaigns, guided by the sociocultural reality of social segments, has been little explored, compromising access to prophylaxis. Thus, the biomedicalization of prevention and the advance of conservatism in Brazil hinder the Brazilian response to AIDS.

Systemic lupus erythematosus, a disease conditioned by the environment / Lupus eritematoso sistémico, una enfermedad condicionada por el medio ambiente

ABSTRACT Systemic lupus erythematosus is an autoimmune disease that involves several systems, affects mainly young adult women, and causes a significant deterioration in quality of life. Different environmental aspects are known to facilitate the development of lupus in predisposed individuals. For several years it has been known that factors such as exposure to UV rays are related to the development of lupus; however, due to factors inherent to globalization, life-style changes, improved knowledge of cell signaling pathways as well as a better understanding of metabolomics, proteomics an genomics, it has been possible to better understand the relationship between cells and their environment. This study based on a narrative review, compiles the existing evidence on different risk factors and the development of lupus, including aspects typical of the Colombian population.

RESUMEN El lupus eritematoso sistémico es una enfermedad autoinmune que compromete diferentes sistemas, afecta principalmente a mujeres adultas jóvenes y genera un deterioro significativo de la calidad de vida. Es bien conocido que diferentes aspectos relacionados con la calidad de vida facilitan el desarrollo del lupus en individuos predispuestos. Desde hace varios años se sabe que factores tales como la exposición a los rayos ultravioleta se relacionan con el desarrollo de lupus; sin embargo, debido a factores inherentes a la globalización, a los cambios en los hábitos, a un mayor conocimiento de las vías de señalización celular, así como a una mayor comprensión de la metabolómica, la proteómica y la genómica, ha sido posible entender mejor la relación entre las células y su medio ambiente. En el presente estudio reunimos, a través de una revisión narrativa, la evidencia actual sobre diferentes factores de riesgo y el desarrollo del lupus, incluyendo aspectos típicos de la población colombiana.

Molecular and structural characterization of expansins modulated by fungal endophytes in the Antarctic Colobanthus quitensis (Kunth) Bartl. Exposed to drought stress.

Expansins are proteins involved in cell wall metabolism that play an important role in plant growth, development, fruit ripening and abiotic stress tolerance. In the present study, we analyzed putative expansins that respond to drought stress. Five expansin genes were identified in cDNA libraries isolated from Colobanthus quitensis gown either with or without endophytic fungi under hydric stress. A differential transcript abundance was observed by qPCR analysis upon drought stress. To compare these expansin genes, and to suggest a possible mechanism of action at the molecular level, the structural model of the deduced proteins was obtained by comparative modeling methodology. The structures showed two domains and an open groove on the surface of the proteins was observed in the five structural models. The proteins were evaluated in terms of their protein-ligand interactions using four different ligands. The results suggested differences in their mode of protein-ligand interaction, in particular concerning the residues involved in the protein-ligand interaction. The presented evidence supports the participation of some members of the expansin multiprotein family in the response to drought stress in C. quitensis and suggest that the response is modulated by endophytic fungi.

Prevalencia de tuberculosis latente determinada mediante la prueba de derivado proteico purificado (PPD) en una población de pacientes adultos con artritis reumatoide llevados a terapia biotecnológica / Prevalence of latent tuberculosis determined using the Purified Protein Derivative (PPD) test in adult patients with rheumatoid arthritis receiving biotechnological therapy

RESUMEN Introducción: Colombia es un país endémico para tuberculosis (TB), con una prevalencia de 26 casos por millón. Sin embargo, no se cuenta con datos recientes y claros respecto a la prevalencia de tuberculosis latente (TBL) en la población con artritis reumatoide (AR) candidata a terapia biotecnológica. Metodología: Estudio de corte transversal con componente analítico para determinar la pre-valencia de TBL en pacientes con AR candidatos a terapia biotecnológica. Resultados: La prevalencia de TBL en pacientes con AR candidatos a terapia biotecnológica es alta, del 18,3% (IC 95% 14,7-21,9), y en los cruces exploratorios se encontró una relación entre TBL y la variable género masculino (p ≤ 0,001), hallazgos anormales en la radiografía de tórax (p = 0,039) y el tabaquismo (p = 0,028). Conclusión: La prevalencia de TBL en pacientes con AR candidatos a terapia biotecnológica es alta. Se requieren estudios prospectivos para evaluar la incidencia de TB en este grupo de pacientes y así corroborar su asociación.

ABSTRACT Introduction: Although tuberculosis (TB) is endemic in Columbia, with a prevalence of 26 cases per million, there are no recent and clear data regarding the prevalence of latent tuberculosis (LBT) in the population with rheumatoid arthritis (RA), candidates for biotechnological therapy. Methodology: A cross-sectional study with an analytical component to determine the prevalence of LBT in patients with RA who are candidates for biotechnological therapy. Results: The prevalence of LTB in RA patients who are candidates for biotechnological therapy is high, 18.3% (95% CI: 14.7-21.9). In the exploratory analysis, a relationship between LBT and male gender was found (P ≤ .001), as well as abnormal findings on chest radiography (P = .039), and smoking (P = .028). Conclusion: The prevalence of LTB in patients with RA who are candidates for biotechnological therapy is high. Prospective studies are needed to evaluate the incidence of TB in this group of patients and corroborate this association.

"Learning to Learn" in the Extended Inverted Classroom: An Evaluation of the Effects of Interactive teaching on Knowledge and Cognitive Regulation in Medical Students. / «Aprendiendo a aprender¼ en el Aula Invertida Extendida: una evaluación sobre los efectos de la enseñanza interactiva en el conocimiento y la regulación cognitiva de estudiantes de Medicina.

INTRODUCTION: The evidence regarding the effects of the Inverted Classroom on students' metacognitive skills is limited. This study evaluates these effects on student perceptions about knowledge and cognitive regulation during a surgical course. METHODS: We measured student perceptions before and after a conventional Inverted Classroom in surgery using the Metacognitive Awareness Inventory. We evaluated the mean differences between the scores of the two measurements using Student's t-test (p<0.05), and the size of the effect on knowledge and cognitive regulation using Cohen's d test (95%CI). RESULTS: A total of 158 students (pre-intervention) and 155 students (post-intervention) were included in the analysis. Significant differences were found (p<0.05)in, as well as positive effects on, the students' abilities to know their own learning (declarative knowledge) (d=0.24; 95%CI, 0.02-0.47), to use learning strategies (procedural knowledge) (d=0.19; 95%CI, -0.02 to 0.41) and to understand when and why to use these strategies (conditional knowledge) (d=0.20; 95%CI, -0.01 to 0.42), in addition to the abilities to plan (d=0.31; 95%CI, 0.09-0.53) and to evaluate their learning (d=0.31; 95%CI, 0.08-0.53). CONCLUSIONS: The Inverted Classroom has positive effects on metacognitive skills according to students' perceptions. Further studies are required that compare these effects with other methodologies for teaching in the classroom and the workplace.

Adherencia a medicamentos orales en pacientes con artritis reumatoide, una experiencia colombiana / Adherence to oral disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis: a Colombian experience

RESUMEN Introducción: El uso de los fármacos modificadores de la enfermedad (FAME) en pacientes con artritis reumatoide (AR) es esencial para alcanzar y mantener un control adecuado de la enfermedad y prevenir un daño funcional irreversible. Sin embargo, la tasa de adherencia a la terapia farmacológica varía entre el 20% y el 107%. Esta variabilidad puede deberse a los métodos de medición utilizados en los diferentes estudios. Objetivo: Evaluar la adherencia global al tratamiento oral con FAME en pacientes con AR mediante el autodiligenciamiento del cuestionario Compliance Questionnaire on Rheumatology (CQR) y la actividad de la enfermedad e identificar los factores potenciales asociados con la baja adherencia. Métodos: Estudio descriptivo transversal que incluyó pacientes mayores de 18 años con AR clasificados por criterios ACR-EULAR 2010, con prescripción de FAME durante al menos 3 meses y control con reumatólogo en el último año. Los participantes llenaron el cuestionario CQR y se les indagó acerca del conocimiento de la enfermedad, la percepción sobre el tratamiento, los efectos adversos, el índice de comorbilidad de Charlson, el índice global de apoyo social, el número de medicamentos y FAME prescritos, el acceso a los servicios de salud y la actividad de la enfermedad por DAS 28 o CDAI. Se definió como buena adherencia un punto de corte de CQR >80 y ausencia de actividad (remisión o actividad baja). Para la búsqueda de factores asociados con adherencia se analizaron los datos por medio de mediana y rango intercuartílico, así como frecuencias y proporciones. La comparación entre los grupos de adherentes y no adherentes se hizo con comparaciones absolutas, por medio de test de Mann-Whitney para las variables continuas y chi-cuadrado (para valores esperados > 5), o Fisher (para valor esperado < 5) para variables categóricas, tomando como nivel de significancia un valor de p<0,05. Se utilizaron OR y sus respectivos intervalos de confianza al 95% (IC95%). Resultados: De los 170 participantes incluidos, el 50% (n = 85) tuvo un valor de CQR mayor de 80 (buena adherencia). La mayoría de los pacientes se encontraba en remisión (60,6%) o baja actividad de la enfermedad (17%). El análisis posterior únicamente encontró asociación estadísticamente significativa entre adherencia medida por CQR y el número de amigos (p = 0,0012) y entre adherencia medida por actividad de la enfermedad y el índice de soporte social global (p = 0,004). Conclusiones: Este estudio muestra un nivel de adherencia similar al reportado en otras poblaciones, lo cual puede deberse a comportamientos propios de nuestra población, aunque los autores percibieron dificultades reportadas por los pacientes para entender los enunciados del instrumento en todos los niveles de escolaridad. Únicamente las variables de soporte social tuvieron una asociación estadísticamente significativa con la adherencia, asociación descrita en la literatura. Se requieren más estudios para evaluar las características operacionales del CQR en nuestra población.

ABSTRACT Introduction: The use of disease modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) is essential in order to achieve and maintain adequate disease control, and thus preventing irreversible functional damage. However, the rate of adherence to drug therapy has been reported to be between 20% and 107%. This variability may be due to the measurement methods used in the different studies. Objective: To test the overall medication adherence to oral treatment with DMARD in patients with RA using the self-report Spanish version Compliance Questionnaire on Rheumatology (CQR) and to identify potential factors associated with non-adherence. Methods: A cross-sectional descriptive study was conducted that included patients older than 18 years with RA diagnosed according to the ACR-EULAR 2010 criteria. They also had to have been prescribed oral DMARD for the previous 3 months, and had been seen by a rheumatologist in the last year. Patients completed the CQR to assess adherence, and were asked about disease knowledge, perception about treatment, side effects, Charlson Comorbidity Index, global index of social support, number of medications and DMARD prescribed, access to health resources, and disease activity measured by DAS 28 or CDAI. Good adherence was defined as a cut-off point of CQR > 80 or non-activity (remission or low activity). In the search for factors associated with adherence, the data were analysed using means of median and interquartile range, as well as frequencies and proportions. The comparison between adherent and non-adherent groups was performed using absolute comparisons, with the Mann-Whitney test for continuous, and chi-squared (for expected values > 5), or Fisher (for expected values < 5) tests for categorical variables, taking as a level of significance a value of P < .05. OR and their respective 95% confidence intervals (95% CI) were used. Results: Of 170 participants included, 50% (n = 85) had a value greater than 80% (good drug adherence). Most patients had remission (60.6%) or low disease activity (17%). The subsequent analysis showed statistically significant association between adherence measured by CQR and the number of friends (P = .0012). An association was also found between disease activity as an indirect indicator of adherence and the global social support index (P = .004). Conclusions: This study found a similar level of adherence to that reported in other populations, which could be due to the behaviour of our population, although the authors perceived difficulties reported by patients in understanding the statements of the questionnaire at all levels of education. Only the social support variables had a statistically significant relationship with adherence, which had also been described in the literature. Further studies are required to evaluate the operational characteristics of the CQR in our population.

["In search of respect": life stories of black women seen at a Specialized Center for Women's Care in the Baixada Fluminense, Rio de Janeiro State, Brazil]. / "Respeito é bom e eu gosto": trajetórias de vida de mulheres negras assistidas por um Centro Especializado de Atendimento à Mulher em Situação de Violência na Baixada Fluminense, Rio de Janeiro, Brasil.

Based on a constructivist inter-sector approach and considering the possible agency and negotiations within violent relationships, the study aimed to understand how black women redefined gender violence according to their affective-sexual relationships. The procedures included participant observation in discussion groups and individual interviews with women seen at a Specialized Center for Women's Care in the Baixada Fluminense, Rio de Janeiro State, Brazil. According to the results, gender violence is present throughout the women's lives. The narratives reveal a feeling of affective-sexual loneliness caused by neglect by their partners or potential partners, as well as experiences with racist and sexist treatment in their own relationships at school and work. Violence, apparently limited to intimate partner relations, spills over into other family relations. Understanding violence as "lack of respect" produced a kind of "collective surveillance" among the women, evidencing the building of a solidarity network. By retelling their life stories, these women remember the past, present, and future with expectations by poor black working women of reinventing themselves. A joint on-going effort is needed by civil society, teaching institutions, and the political sphere to deconstruct culturally instituted models that persistently keep black women in a place of submission, inferiority, and marginalization.

Caracterización de pacientes con lupus y fiebre: actividad, infección o ambas / Characterisation of patients with lupus and fever: Activity, infection or both

RESUMEN Objetivo: Describir las características clínicas y de laboratorio en pacientes mayores de 15 arios con diagnóstico de lupus eritematoso sistémico (LES) hospitalizados por fiebre, cuyo diagnóstico final fue infección, actividad lúpica o ambas (actividad e infección). Métodos: Se realizó un estudio descriptivo retrospectivo en el que se incluyeron pacientes con diagnóstico de LES admitidos por fiebre en el servicio de urgencias del Hospital Universitario Clínica San Rafael; se estudiaron variables clínicas y paraclínicas, dividiéndose en 3 grupos de interés: pacientes con actividad de la enfermedad, de la infección o de ambas, de acuerdo con el diagnóstico definitivo una vez se daba el alta hospitalaria. Se estudiaron variables clínicas y de laboratorio, realizándose una descripción de la población en los 3 estados. Resultados: Se evaluaron en total 115 pacientes, incluyéndose en el análisis final 108 pacientes. La mediana de edad fue de 36 años y el 86% fueron mujeres. La mediana del puntaje del Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) en toda la población fue de 6 (R 1-15), en los pacientes con infección y actividad el puntaje mostró una mediana de 9,5 (R 6-15). No hubo diferencias significativas entre los síntomas clínicos y los hallazgos de laboratorio en los diferentes grupos. El uso de prednisolona en los últimos 3 meses fue mayor en el grupo de infección (p = 0,001), pero sin diferencias significativas entre las otras terapias de inmunosupresión. Conclusión: El uso de esteroides en los últimos 3 meses, el puntaje de la escala SLEDAI y el tiempo transcurrido desde el diagnóstico de LES podrían ser variables que pueden ayudar a discriminar entre infección y actividad en pacientes con historia de LES y fiebre. Los hallazgos clínicos y paraclínicos no discriminan entre estas condiciones de enfermedad.

ABSTRACT Objective: To describe clinical characteristics and laboratory findings of patients older than 15 years of age diagnosed with Systemic Lupus Erythematosus (SLE) that were admitted to hospital with fever and with a final diagnosis of infection, disease flare-up, or both. Methods: A retrospective chart review of medical charts was performed to identify patients with a diagnosis of SLE with a fever, admitted to the Emergency Department of Hospital Universitario Clinica San Rafael. The data collected included demographics, SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) scores, clinical symptoms, laboratory findings, and steroid use. Results analysis was based on three groups (according to final diagnosis at discharge): patients diagnosed with SLE and infection, SLE and disease flare-up, and SLE with both infection and disease flare-up. Results: This study included 108 patients with a mean age of 36, of whom 86% were female. The mean SLEDAI score of all patients analysed was 6 (R 1-15), and for patients with SLE with both infection and disease flare-up was 9.5 (R 6-15). No significant differences were found with clinical symptoms and laboratory findings for any group analysed. SLE patients diagnosed with infections took significantly more prednisolone in the last three months before admission (P = .001). No differences were found with other immunosuppressants. Conclusion: The use of steroids in the last three months, the SLEDAI score, and time since a SLE diagnosis may be variables used to distinguish between infection and disease flare-up in SLE patients presenting with fever. Clinical symptoms and laboratory results are not useful markers to make this distinction.

Advances of native and non-native Antarctic species to in vitro conservation: improvement of disinfection protocols.

Plants that inhabit Antarctica have raised scientific interest due to their resilience to climate change, abiotic tolerance mechanisms and potential biological applications. In vitro propagation is useful for conservation, genetic material availability of these species and avoiding mass collection in their habitat. In vitro culture protocols for the native plants Colobanthus quitensis and Deschampsia antarctica and the non-native Juncus bufonius have been affected by endophytic microorganisms that proliferate when introduced to tissue cultures. This study evaluated the microbicidal and phytotoxic effect of calcium hypochlorite (Ca(ClO)2), silver nitrate (AgNO3) and silver nanoparticles (AgNPs), and their use at different concentrations for different time periods. The Ca(ClO)2 at 100 mg mL-1 showed the best microbial contamination control in D. antarctica (applied for 20 min) and for the three C. quitensis populations (applied for 15 min). In J. bufonius, AgNO3 at 10 mg mL-1 for 10 min reduced the microbial growth, but oxidative damage was generated. AgNPs did not prevent contamination or have adverse effects on tissues. Survival plantlets from each treatment, population or species were effectively introduced to the tissue culture and their propagation was successful. These results constitute a fundamental advance for the introduction, propagation and conservation of Antarctic species and their use in scientific research.

Aids em cartazes: representações sobre sexualidade e prevenção da Aids nas campanhas de 1º de dezembro no Brasil (2013-2017) / El Sida en los carteles: representaciones sobre sexualidad y prevención del Sida en las campañas del 1º de diciembre en Brasil (2013-2017) / AIDS in posters: representations on sexuality and Aids prevention in December 1st campaigns in Brazil (2013-2017)

Buscou-se analisar as representações da sexualidade e prevenção em cartazes produzidos pelo Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis (DCCI) a partir da diretriz da prevenção combinada (PC), adotada em 2013. Realizou-se análise de conteúdo, de caráter descritivo e documental, dos cartazes de campanhas do dia 1º de dezembro (2013-2017). Resultados apontam que aspectos relacionais do uso do preservativo teriam menos relevância, ao passo que a individualização do cuidado vem se acirrando sob a lógica de "testar para se conhecer". Nota-se a oferta de alternativas de prevenção, por meio do símbolo do tripé "preservativo, teste e comprimido", ou de novas tecnologias como a profilaxia pré-exposição (PrEP) e Profilaxia Pós Exposição (PEP). Isso sugere que, desde seu lançamento, a PC passou a orientar as campanhas do DCCI, em oposição a campanhas anteriores que privilegiavam populações-alvo e o preservativo masculino.(AU)

El objetivo fue analizar las representaciones de la sexualidad y prevención en carteles producidos por el Departamento de Enfermedades de Condiciones Crónicas e Infecciones de Transmisión Sexual (DCCI, por sus siglas en portugués), a partir de la directriz de prevención combinada (PC), adoptada en 2013. Se realizó el análisis de contenido, de carácter descriptivo y documental de los carteles de campañas del día 1º de diciembre (2013-2017). Los resultados señalan que aspectos relacionales del uso del preservativo tendrían menos relevancia, mientras que la individualización del cuidado se recrudece bajo la lógica de "hacer test para conocerse". Se observa la oferta de alternativas de prevención a través del símbolo del trípode: "preservativo, test y comprimido" o de nuevas tecnologías como PrEP y PEP. Eso sugiere que, desde su lanzamiento, la PC pasó a orientar las campañas del DCCI, en oposición a campañas anteriores que privilegiaban a poblaciones-objetivo y el preservativo masculino.(AU)

The article sought to analyze representations of sexuality and prevention on posters produced by the Department of Chronic Conditions Diseases and Sexually Transmitted Infections (DCCI) stemming from the combination prevention (CP) guidelines adopted in 2013. A descriptive and documental content analysis of posters relative to the World Aids Day (December 1st) was carried out (2013-2017). Results indicate that relational aspects of condom use appear to be less relevant, and increments of the individualization of care under the logic of "know your status" are becoming stronger. It is also possible to notice preventive alternatives, by way of the tripod symbol: "condom, test and pill", or new technologies such as PrEP and PEP. This suggests that the CP has been guiding the DCCI campaigns since its launch, as opposed to previous campaigns focusing on target populations and male condoms.(AU)

"Respeito é bom e eu gosto": trajetórias de vida de mulheres negras assistidas por um Centro Especializado de Atendimento à Mulher em Situação de Violência na Baixada Fluminense, Rio de Janeiro, Brasil / "In search of respect": life stories of black women seen at a Specialized Center for Women's Care in the Baixada Fluminense, Rio de Janeiro State, Brazil / "El respeto es bueno y me gusta": trayectorias de vida de mujeres negras asistidas por un Centro Especializado de Atención a la Mujer en la Bajada Fluminense, Río de Janeiro, Brasil

Resumo: A partir de uma abordagem interseccional construtivista e levando em consideração os agenciamentos e negociações possíveis dentro de relações violentas, a pesquisa visou a compreender como mulheres negras ressignificam a violência de gênero a partir de seus relacionamentos afetivo-sexuais. Utilizaram-se como procedimentos a observação participante em grupos de reflexão e entrevistas individuais junto a mulheres assistidas por um Centro Especializado de Atendimento à Mulher em Situação de Violência na Baixada Fluminense, Rio de Janeiro, Brasil. Os resultados apontam que a violência de gênero está presente ao longo da trajetória de vida das interlocutoras. Nas narrativas é perceptível um sentimento de solidão afetivo-sexual provocada pela preterição dos parceiros ou potenciais parceiros, bem como experiências racistas e sexistas engendradas nos próprios relacionamentos ou no âmbito escolar e de trabalho. A violência, aparentemente restrita à relação entre parceiros íntimos, se desdobrou para outras relações familiares. A compreensão da violência como "falta de respeito" produziu uma espécie de "central de vigilância" entre as mulheres, evidenciando a construção de uma rede de solidariedade. Ao narrarem suas trajetórias de vida, essas mulheres rememoram o passado, o presente e o futuro e também a expectativa de se reinventarem como mulheres, negras, pobres e trabalhadoras. É preciso um esforço conjunto e contínuo da sociedade civil, das instituições de ensino e da esfera política para desconstruir modelos culturalmente instituídos que persistem em colocar as mulheres negras no lugar de submissão, de inferioridade e de marginalização.

Abstract: Based on a constructivist inter-sector approach and considering the possible agency and negotiations within violent relationships, the study aimed to understand how black women redefined gender violence according to their affective-sexual relationships. The procedures included participant observation in discussion groups and individual interviews with women seen at a Specialized Center for Women's Care in the Baixada Fluminense, Rio de Janeiro State, Brazil. According to the results, gender violence is present throughout the women's lives. The narratives reveal a feeling of affective-sexual loneliness caused by neglect by their partners or potential partners, as well as experiences with racist and sexist treatment in their own relationships at school and work. Violence, apparently limited to intimate partner relations, spills over into other family relations. Understanding violence as "lack of respect" produced a kind of "collective surveillance" among the women, evidencing the building of a solidarity network. By retelling their life stories, these women remember the past, present, and future with expectations by poor black working women of reinventing themselves. A joint on-going effort is needed by civil society, teaching institutions, and the political sphere to deconstruct culturally instituted models that persistently keep black women in a place of submission, inferiority, and marginalization.

Resumen: A partir de un abordaje interseccional constructivista, y considerando las gestiones y negociaciones posibles en el seno de relaciones violentas, la investigación tuvo como objetivo comprender cómo las mujeres negras resignifican la violencia de género a partir de sus relaciones afectivo-sexuales. Se utilizaron como procedimientos la observación participante en grupos de reflexión y entrevistas individuales junto a mujeres asistidas por un Centro Especializado de Atención a la Mujer en la Baixada Fluminense, Río de Janeiro, Brasil. Los resultados apuntan que la violencia de género está presente a lo largo de la trayectoria de vida de las interlocutoras. En las narrativas es perceptible un sentimiento de soledad afectivo-sexual, provocada por el rechazo de las parejas o potenciales parejas, así como experiencias racistas y sexistas engendradas en las propias relaciones o en el ámbito escolar y de trabajo. La violencia, aparentemente restringida a la relación entre miembros de la pareja, se desdobló en otras relaciones familiares. La comprensión de la violencia como "falta de respeto" produjo una especie de "central de vigilancia" entre las mujeres, poniendo en evidencia la construcción de una red de solidaridad. Al narrar sus trayectorias de vida, esas mujeres rememoran el pasado, el presente y el futuro y la expectativa de que se reinventen como mujeres, negras, pobres y trabajadoras. Es necesario un esfuerzo conjunto y continuo de la sociedad civil, de las instituciones de enseñanza y de la esfera política para deconstruir modelos culturalmente instituidos que persisten en situar a las mujeres en un lugar de sumisión, inferioridad y marginalización.

Prevalence of neurolupus in a Colombian cohort / Prevalencia de neurolupus en una cohorte colombiana

ABSTRACT Background: Systemic lupus erythematosus (SLE) can affect the nervous system and present a variety of neurological and psychiatric syndromes but the prevalence of neuropsychiatric manifestations in Colombia is unknown. Methods: Cross-sectional study. Patients were assessed by the department of rheumatology between 2010 and 2013 and included randomly chosen subjects over 18 years of age. Prevalence of neurological manifestations was calculated using a confidence interval of 95%. SLE disease activity index was used as baseline to compare statistically with activity, neurological manifestations and fatality. Mann-Whitney U test was used for quantitative variables, while chi-square test was used for qualitative variables. Results: 306 subjects initially entered into the study, 274 were analyzed, 89.1% were women with a median age of 43 years (interquartile range: 23). Prevalence of neuropsychiatric manifestations was 26.2% (95% CI: 21.2-31%). The most common symptoms were headache (13.1%; 95% CI: 9.1-17.2%), cerebrovascular disease (8%; 95% CI: 5.1-11.3%), acute confusional state (6.6%; 95% CI: 4-9.1%), seizure disorders (4.7%; 95% CI: 2.6-7.3%), and aseptic meningitis (2.2%; 95% CI: 0.7-4%); autonomic neuropathy, polyneuropathy, and myelopathy each occurred at 0.7% (95% CI: 0-1.8%). Patients with neuropsychiatric manifestations had severe disease activity (45.8%) and (31.9%) had moderate disease activity. Conclusions: In hospitalized patients diagnosed with SLE, NPS manifestations can occur in up to 26% of cases, the most frequent being headache, cerebrovascular disease, acute confusional state, seizures, and aseptic meningitis and the most frequent treatment being systemic steroids. Prospective studies are required to determine their prognostic implications in this group of patients.

Resumen Antecedentes: El lupus eritematoso sistémico (LES) puede afectar el sistema nervioso con una amplia variedad de síndromes psiquiátricos y neurológicos. La prevalencia de manifestaciones neuropsiquiátricas en Colombia es desconocida. Métodos: Estudio de cohorte transversal. A partir de la revisión del sistema de información del hospital se obtuvieron datos de los pacientes con diagnóstico de LES, mayores de 18 años, que fueron valorados por reumatología entre 2010 y 2013. Se utilizó un muestreo aleatorio del listado de sujetos con diagnóstico de lupus en el hospital, se calculó la prevalencia de manifestaciones neurológicas con IC 95%, se realizaron cruces exploratorios entre la actividad de la enfermedad por SLEDAI y las manifestaciones neurológicas, y desenlace de fallecimiento. Resultados: De 306 sujetos ingresados al estudio se llevaron al análisis final 274 individuos, de los cuales el 89,1% fueron mujeres; la mediana de edad fue de 43 años (RIQ: 23); la prevalencia de manifestaciones neuropsiquiátricas fue del 26,2% (IC 95%: 21,2-31). Los síntomas neurológicos en orden descendente incluyen cefalea (13,1%; IC 95%: 9,1-17,2), enfermedad cerebrovascular (8%; IC 95%: 5,1-11,3), estado confusional agudo (6,6%; IC 95%: 4-9,1), trastornos convulsivos (4,7%; IC 95%: 2,6-7,3), meningitis aséptica (2,2%; IC 95%: 0,7-4), neuropatía autonómica, polineuropatía y mielopatía (presentes en el 0,7%; IC 95%: 0-1,8). Dentro de la población con manifestaciones neuropsiquiátricas se encontró que el 45,8% tenía actividad severa de la enfermedad y el 31,9% actividad moderada. Conclusiones: En pacientes hospitalizados con diagnóstico de LES las manifestaciones neuropsiquiátricas pueden ocurrir hasta en el 26% de los casos; las más frecuentes son cefalea, enfermedad cerebrovascular, estado confusional agudo, convulsiones y meningitis aséptica, y el tratamiento más frecuente son los esteroides sistémicos. Se requieren estudios prospectivos para determinar sus implicaciones pronósticas en este grupo de pacientes.

Challenges facing HIV treatment as prevention in Brazil: an analysis drawing on literature on testing. / Desafios do tratamento como prevenção do HIV no Brasil: uma análise a partir da literatura sobre testagem.

According to current global AIDS guidelines, HIV testing is key to the success of the 'treatment as prevention' (TasP) strategy and the control of AIDS. In view of Brazil's commitment to these guidelines, this article characterizes the principles and justifications underpinning TasP and discusses implementation challenges. The analysis draws on a systematic review of the literature (2005 to 2015) on recruitment and testing strategies for men who have sex with men. This approach was adopted based on the assumption that current knowledge on HIV testing can offer valuable insights into the foundations of global AIDS policies and their uptake in local contexts. Based on the analysis of the 65 articles selected, we suggest that TasP represents a shift in the AIDS prevention paradigm. There is an overlap between prevention and care and the new approach places major emphasis on biomedical and psychological knowledge. The TasP approach fails to address the factors associated with HIV vulnerability and the stigma surrounding AIDS and undermines the participation of activists and PLWHA as autonomous producers of preventive of preventive practices. We argue that, to ensure the effective implementation of TasP in Brazil, it is necessary to discuss issues such as the protection of human rights and the structural problems facing Brazil's public health system.

Segundo as diretrizes globais atuais, a realização do teste anti-HIV é crucial para o sucesso da estratégia do 'tratamento como prevenção' (TcP) e controle da Aids. Dado o compromisso do Brasil com essa política, este artigo objetiva caracterizar os princípios e justificativas do TcP e discutir os desafios da sua implementação. A reflexão é orientada por uma revisão sistemática da literatura internacional de 2005 a 2015 sobre estratégias de captação e oferta do teste do HIV entre homens que fazem sexo com homens (HSHs). Tal escolha parte do pressuposto de que a produção acadêmica é uma fonte relevante para compreender os fundamentos e apropriações das políticas globais de Aids nos contextos locais. Segundo a análise dos 65 artigos selecionados, a TcP opera uma transformação no paradigma preventivo. Prevalece uma superposição entre prevenção e assistência, sugerindo maior peso aos conhecimentos e práticas biomédicos. Esse enfoque não contempla o enfrentamento de fatores estruturais associados à vulnerabilidade ao HIV e ao estigma da Aids e a participação de ativistas e PVHA como produtores autônomos de praticas preventivas. Argumentamos que a efetividades da TcP no Brasil requer uma discussão sobre a garantia dos direitos humanos e problemas estruturais e programáticos do sistema público de saúde.

Colombian propolis as starting material for the preparation of nanostructured lipid carriers

ABSTRACT The value of propolis is scientifically and commercially measured through the content of biologically active molecules as phenolic compounds and flavonoids; on the other hand, a high percentage of waxes in the propolis composition makes it a substandard beekeeping product. Colombian propolis is characterized by a high content of waxes; however, this drawback turns into an advantage when this material is used for preparing lipid nanocarriers. Accordingly, in this research work, a propolis-extracted material obtained by Randall method is characterized by differential scanning calorimetry, infrared spectroscopy, X-ray diffraction, and 1H-Nuclear Magnetic Resonance. Then, it is used for obtaining nanostructured lipid carriers by the emulsification-diffusion technique, whose recipe and operating work conditions were established by a Plackett-Burman statistical screening design. The obtained particles exhibit sizes less than 300 nm, polydispersity indices around 0.1, zeta potential values less than ±2 mV, good physical stability and they show to be safe in the in vitro irritation test. Thus, Colombian propolis arises as an attractive natural source for obtaining lipid carriers that could be used in pharmaceutical or cosmetic industries for developing innovative products.

Desafios do tratamento como prevenção do HIV no Brasil: uma análise a partir da literatura sobre testagem / Challenges facing HIV treatment as prevention in Brazil: an analysis drawing on literature on testing

Resumo Segundo as diretrizes globais atuais, a realização do teste anti-HIV é crucial para o sucesso da estratégia do 'tratamento como prevenção' (TcP) e controle da Aids. Dado o compromisso do Brasil com essa política, este artigo objetiva caracterizar os princípios e justificativas do TcP e discutir os desafios da sua implementação. A reflexão é orientada por uma revisão sistemática da literatura internacional de 2005 a 2015 sobre estratégias de captação e oferta do teste do HIV entre homens que fazem sexo com homens (HSHs). Tal escolha parte do pressuposto de que a produção acadêmica é uma fonte relevante para compreender os fundamentos e apropriações das políticas globais de Aids nos contextos locais. Segundo a análise dos 65 artigos selecionados, a TcP opera uma transformação no paradigma preventivo. Prevalece uma superposição entre prevenção e assistência, sugerindo maior peso aos conhecimentos e práticas biomédicos. Esse enfoque não contempla o enfrentamento de fatores estruturais associados à vulnerabilidade ao HIV e ao estigma da Aids e a participação de ativistas e PVHA como produtores autônomos de praticas preventivas. Argumentamos que a efetividades da TcP no Brasil requer uma discussão sobre a garantia dos direitos humanos e problemas estruturais e programáticos do sistema público de saúde.

Abstract According to current global AIDS guidelines, HIV testing is key to the success of the 'treatment as prevention' (TasP) strategy and the control of AIDS. In view of Brazil's commitment to these guidelines, this article characterizes the principles and justifications underpinning TasP and discusses implementation challenges. The analysis draws on a systematic review of the literature (2005 to 2015) on recruitment and testing strategies for men who have sex with men. This approach was adopted based on the assumption that current knowledge on HIV testing can offer valuable insights into the foundations of global AIDS policies and their uptake in local contexts. Based on the analysis of the 65 articles selected, we suggest that TasP represents a shift in the AIDS prevention paradigm. There is an overlap between prevention and care and the new approach places major emphasis on biomedical and psychological knowledge. The TasP approach fails to address the factors associated with HIV vulnerability and the stigma surrounding AIDS and undermines the participation of activists and PLWHA as autonomous producers of preventive of preventive practices. We argue that, to ensure the effective implementation of TasP in Brazil, it is necessary to discuss issues such as the protection of human rights and the structural problems facing Brazil's public health system.