[Effectiveness of a structured educative program in Chilean diabetic patients]. / Eficacia de un programa educativo estructurado en población diabética chilena.

BACKGROUND: Structured educative programs have demonstrated their usefulness as a strategy to improve metabolic control in diabetic patients. AIM: To evaluate the effectiveness of a structured educative program for Chilean diabetic patients. MATERIAL AND METHODS: A randomized clinical trial in diabetic patients with glycosylated hemoglobin over 7.5%. One hundred fifteen patients were studied, 59 patients participated in the structured educative program (experimental group) and 56 patients received no structured education (control group). Patients were followed for 12 months. RESULTS: Between baseline and 12 months of follow-up, glycosylated hemoglobin changed from 10.05 to 9.11% in experimental patients and from 9.86 to 9.25% in controls. No significant differences between experimental and control groups in other clinical and metabolic parameters were observed. In the experimental group, glycosylated hemoglobin reductions differed among the different educators who carried out the program. CONCLUSIONS: A structured educative program resulted in a 35% greater reduction in glycosylated hemoglobin levels, compared with a control group. Metabolic control improvement differed between the educators who carried out the program.

Dynamic control of osmolality and ionic composition of the xylem sap in two mangrove species.

• Premise of the study: Xylem sap osmolality and salinity is a critical unresolved issue in plant function with impacts on transport efficiency, pressure gradients, and living cell turgor pressure, especially for halophytes such as mangrove trees.• Methods: We collected successive xylem vessel sap samples from stems and shoots of Avicennia germinans and Laguncularia racemosa using vacuum and pressure extraction and measured their osmolality. Following a series of extractions with the pressure chamber, we depressurized the shoot and pressurized again after various equilibration periods (minutes to hours) to test for dynamic control of osmolality. Transpiration and final sap osmolality were measured in shoots perfused with deionized water or different seawater dilutions.• Key results: For both species, the sap osmolality values of consecutive samples collected by vacuum extraction were stable and matched those of the initial samples extracted with the pressure chamber. Further extraction of samples with the pressure chamber decreased sap osmolality, suggesting reverse osmosis occurred. However, sap osmolalities increased when longer equilibration periods after sap extraction were allowed. Analysis of expressed sap with HPLC indicated a 1:1 relation between measured osmolality and the osmolality of the inorganic ions in the sap (mainly Na+, K+, and Cl-), suggesting no contamination by organic compounds. In stems perfused with deionized water, the sap osmolality increased to mimic the native sap osmolality.• Conclusions: Xylem sap osmolality and ionic contents are dynamically adjusted by mangroves and may help modulate turgor pressure, hydraulic conductivity, and water potential, thus being important for mangrove physiology, survival, and distribution.

Missed opportunities in the prevention and diagnosis of pediatric tuberculosis: a scoping review.

OBJECTIVES: Identify potential barriers, delays, and missed opportunities in the prevention and diagnosis of childhood TB. METHODS: Scoping review according to the PRISMA extension. The definitions considered for the selection followed the acronym PCC where the population (P) is children under 18 years of age with TB disease, the concept (C) refers to missed opportunities for prevention and diagnosis, and context (C) is defined as a diagnosis of TB disease. The authors searched systematically in the databases; VHL/Lilacs, Medline via PubMed, Cochrane, Scopus, and Web of Science, without date or language limitation. RESULTS: Seven studies were included. In developed countries, with low disease burden, the main shortcoming is the delay in diagnosing bacilliferous adults in contact with young children. This problem is concentrated in the portion of the population with socioeconomic vulnerability. In underdeveloped countries, with a high burden of disease, the biggest challenge is tracking children who come into contact with bacilliferous patients. CONCLUSIONS: There are still many missed opportunities in the prevention and diagnosis of childhood TB. The positive legacy of the COVID-19 pandemic should be taken advantage of and the encouragement of scientific development in the management of infectious diseases should be taken.

Neurological manifestation of Brazilian spotted fever in childhood.

Rocky Mountain Spotted Fever is a rickettsial disease caused by the bacteria Rickettsia rickettsii. In Brazil, the disease is known as Brazilian spotted fever (BSF), being the most significant tick-borne disease in the country. Among the affected patients, only 5% of cases occur in children aged one to nine years. Typical symptoms of the disease are fever, rash, headache and digestive symptoms. Neurological manifestations such as seizures, aphasia and hemiparesis have been described in few patients. This study aimed to describe the case of an infant diagnosed with BSF who presented severe signs of neurological manifestation.

Quantifying Decay Due to Wet Atmospheric Deposition on Basalt.

The study of building materials is important for a better conservation of built heritage. Worldwide, volcanic stones (including basalt, andesite and dacite) are among the least studied building materials. In this research, the decay of a red basalt due to wet atmospheric deposition was studied. Red basalt was exposed to artificial rain solutions, prepared from rain samples collected weekly from 2014-2019. In this research, the decay of stone-built heritage was indirectly studied emulating wet atmospheric accelerated weathering under three different volume weighted mean (VWM) compositions: global, acid and no-acid categories. Lixiviates were analyzed to better understand the deterioration mechanisms taking place inside the material. Decay was quantified as mass difference, water absorption capacity (WAC) and open porosity (OP) changes. Results show that the methodology used is suitable to research the decay of built heritage. The studied basalt is indeed prone to decay by wet atmospheric deposition. The main decay mechanisms are the washing of insoluble compounds, dissolution of minerals, salt crystallization and cation exchange. WAC and OP showed promising results of their appropriateness as monitoring variables of decay in situ. Acid conditions produce the most severe decay, but Ph effect is not as important as precipitation volume. Non-linear equations relating volume of precipitation with mass difference in red basalt are presented.

Sulfur and nitrogen compounds in wet atmospheric deposition on the coast of the Gulf of Mexico from 2003 to 2015.

The Gulf of Mexico region has important sources of acid rain precursors, located in all of the countries; U.S., Mexico and Cuba, and so it is very important to study the chemical composition of the wet atmospheric deposition in all coastal areas. For many years along the U.S. Gulf Coast, acidic precipitation has been measured. Measurements along the Mexican Gulf Coast were begun in 2003. The aim of this study was to evaluate pH, sulfate, nitrate and ammonium concentrations in wet atmospheric deposition, collected daily from 2003 to 2015 at La Mancha (LM), Veracruz and compare the values with the National Atmospheric Deposition Program (NADP) sampling sites located along the U.S. coast of the Gulf of Mexico. The annual Volume Weighted Mean (VWM) pH in wet deposition at La Mancha site ranged from 4.81 to 5.40, which is similar to the U.S. Gulf sites. Additionally, the annual VWM SO42- concentration was from 15 to 31 µeq/L, which is higher than the U.S. sites. Annual VWM NO3- concentrations were from of 3.5 to 15 µeq/L, which is lower than all the U.S. sites. At the Mexican site, the SO42-/NO3- ratio was 4.90 and higher than all of the U.S. sites, which were between 1.03 and 2.38. For LM, the median NH4+/NO3- ratio was 0.77, similar to the Florida sites (0.53-0.91), and below the values measured for Louisiana and Texas (1.07-1.5). The Hybrid Single Particle Lagrangian Integrated Trajectory Model (HYSPLIT) was applied in order to identify the emission sources for the pollutants seen at LM. Trajectories showed an important transport to LM from the East (open water) during the rainy season. The region located East of La Mancha shows offshore petroleum operations as sources of acid rain precursors and deposition of acidifying and nitrogen containing compounds. It is important to consider the sulfur dioxide emission sources in the Mexico Gulf region, and to extend the atmospheric deposition sampling to other sites along the Mexican Gulf coast and Cuba.

Missed opportunities in the prevention and diagnosis of pediatric tuberculosis: a scoping review

Abstract Objectives: Identify potential barriers, delays, and missed opportunities in the prevention and diagnosis of childhood TB. Methods: Scoping review according to the PRISMA extension. The definitions considered for the selection followed the acronym PCC where the population (P) is children under 18years of age with TB disease, the concept (C) refers to missed opportunities for prevention and diagnosis, and context (C) is defined as a diagnosis of TB disease. The authors searched systematically in the databases; VHL/Lilacs, Medline via PubMed, Cochrane, Scopus, and Web of Science, without date or language limitation. Results: Seven studies were included. In developed countries, with low disease burden, the main shortcoming is the delay in diagnosing bacilliferous adults in contact with young children. This problem is concentrated in the portion of the population with socioeconomic vulnerability. In underdeveloped countries, with a high burden of disease, the biggest challenge is tracking children who come into contact with bacilliferous patients. Conclusions: There are still many missed opportunities in the prevention and diagnosis of childhood TB. The positive legacy of the COVID-19 pandemic should be taken advantage of and the encouragement of scientific development in the management of infectious diseases should be taken.

Neurological manifestation of Brazilian spotted fever in childhood

ABSTRACT Rocky Mountain Spotted Fever is a rickettsial disease caused by the bacteria Rickettsia rickettsii. In Brazil, the disease is known as Brazilian spotted fever (BSF), being the most significant tick-borne disease in the country. Among the affected patients, only 5% of cases occur in children aged one to nine years. Typical symptoms of the disease are fever, rash, headache and digestive symptoms. Neurological manifestations such as seizures, aphasia and hemiparesis have been described in few patients. This study aimed to describe the case of an infant diagnosed with BSF who presented severe signs of neurological manifestation.

Gonadoblastoma in Turner syndrome patients with nonmosaic 45,X karyotype and Y chromosome sequences.

Turner syndrome (TS) is a disorder caused by partial or complete X-chromosome monosomy. Studies in TS patients with different karyotypes have demonstrated the presence of Y-chromosome-derived sequences (4-61%). Early detection of Y-chromosome sequences in TS is of great importance because of the high risk of gonadal tumor development. We investigated the presence of Y-chromosome sequences in TS patients with a 45,X karyotype. One hundred seven unrelated 45,X Mexican TS patients recruited between 1992 and 2003 were included. Y-chromosome-derived sequences were found by polymerase chain reaction in 10 (9.3%) patients. Six subjects underwent gonadectomy and in one of them a gonadoblastoma was found; another developed a gonadoblastoma with dysgerminoma. Because of the high proportion (33%) of gonadal tumors in patients with Y-chromosome sequences found among our patients of mestizo origin, adequate counseling regarding a gonadectomy should be given.

Optimization of carbohydrate silylation for gas chromatography.

We developed and optimized a new carbohydrate mono- and disaccharides silylation reaction, replacing pyridine and requiring lower reaction temperature and less time. Our method consists of three basic steps. The first one is oxime formation, the second one silylate derivative and the last one gas chromatography separation and quantification with an internal standard. We evaluated several solvents, including acetonitrile, hydroxylamine and aniline. We found aniline to be the best reaction media for oxime formation with hydroxylamine hydrochloride. Among silylation agents we found N,O-bis(trimethyl)trifluoroacetamide (BSTFA) was the most efficient. Together these reagents favored both a short analysis time and fewer by-products. We evaluated the method with model solutions containing: arabinose and co-eluting xylose, fructose, glucose, sucrose and salicin (internal standard) and found it suitable for processed food analysis.

Eficacia de un programa educativo estructurado en población diabética chilena / Effectiveness of a structured educative program in Chilean diabetic patients

Background: Structured educative programs have demonstrated their usefulness as a strategy to improve metabolic control in diabetic patients. Aim: To evaluate the effectiveness of a structured educative program for Chilean diabetic patients. Material and Methods: A randomized clinical trial in diabetic patients with glycosylated hemoglobin over 7.5%. One hundred fifteen patients were studied, 59 patients participated in the structured educative program (experimental group) and 56 patients received no structured education (control group). Patients were followed for 12 months. Results: Between baseline and 12 months of follow-up, glycosylated hemoglobin changed from 10.05 to 9.11% in experimental patients and from 9.86 to 9.25% in controls. No significant differences between experimental and control groups in other clinical and metabolic parameters were observed. In the experimental group, glycosylated hemoglobin reductions differed among the different educators who carried out the program. Conclusions: A structured educative program resulted in a 35% greater reduction in glycosylated hemoglobin levels, compared with a control group. Metabolic control improvement differed between the educators who carried out the program.

[Estimation of coronary heart disease risk in Chilean subjects based on adapted Framingham equations]. / Estimación de riesgo de enfermedad coronaria mediante la función de Framingham adaptada para la población chilena.

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in Chile and worldwide. Framingham functions were developed to calculate overall coronary heart disease risk. However these functions overestimate the risk in some countries like Chile. AIM: To develop Chilean risk tables to assess the overall 10-year risk of coronary heart disease. MATERIAL AND METHODS: The Framingham function was adapted for a population aged 35 to 74 years, based on an estimate of Chilean incidence of coronary heart disease and the prevalence of coronary heart disease risk factors such as age, sex, total cholesterol, high-density lipoprotein cholesterol, blood pressure, diabetes and smoking. RESULTS: The 10-year incidence of coronary heart disease in Chile (2.7% in men, 1.096 in women) was lower than the incidence in the United States (10.096/3.896) and Spain (4.996/2.296), but higher than China (1.196/0.496). Framingham tables have more than 50% of cells in the risk category of 10% or greater. In contrast, Chilean tables have less than 10% of cells in the same risk category. CONCLUSIONS: Adapted tables use local information to calculate overall coronary heart disease risk. A validation study should be conducted to assess their predictive power.

Estimación de riesgo de enfermedad coronaria mediante la función de Framingham adaptada para la población chilena / Estimation of coronary heart disease risk in Chilean subjects based on adapted Framingham equations

Background: Cardiovascular disease is the leading cause of morbidity and mortality in Chile and worldwide. Framingham functions were developed to calculate overall coronary heart disease risk However these functions overestimate the risk in some countries ¡ike Chile. Aim To develop Chilean risk tables to assess the overall 10-year risk of coronary heart disease. Material and methods: The Framingham function was adapted for a population aged 35 to 74 years, based on an estimate of Chilean incidence of coronary heart disease and the prevalence of coronary heart disease risk factors such as age, sex, total cholesterol, high-density lipoprotein cholesterol, blood pressure, diabetes and smoking. Results: The 10-year incidence of coronary heart disease in Chile (2.7 percent in men, 1.096 in women) was lower than the incidence in the United States (10.096/3.896) and Spain (4.996/2.296), but higher than China (1.196/0.496). Framingham tables have more than 50 percent of cells in the risk category of 10 percent or greater. In contrast, Chilean tables have less than 10 percent of cells in the same risk category. Conclusions: Adapted tables use local information to calculate overall coronary heart disease risk. A validation study should be conducted to assess their predictive power.

Masculinidad y Género / Masculinity and gender

Sexo, género y masculinidad son conceptos que frecuentemente se consideran sinónimos. La masculinidad de un nuevo ser puede comenzar a construirse antes del embarazo y continúa después del nacimiento. Relaciones de género son los patrones de comportamiento en que el poder y la desigualdad favorecen al hombre y postergan a la mujer. La diferencia de poder entre género se observa, por ejemplo, en el deterioro de la salud física y mental de la mujer que resulta del trauma de la violencia doméstica. El precio de la masculinidad se refiere a la ®necesidad¼ de someterse a situaciones violentas que puede resultar en muertes prematuras. Para llegar a la igualdad entre los géneros es necesario terminar con la separación entre los espacios masculinos y femeninos. Hace falta una mayor participación de la mujer en el espacio social y en una inserción más igualitaria del hombre en el espacio privado

Prevençäo de doenças sexualmente transmissíveis em mulheres: associaçäo com variáveis sócio-econômicas e demográficas / Prevention of sexually transmitted diseases among women: association with socioeconomic and demographic variables

As doenças sexualmente transmissíveis (DST) têm sido debatidas no ambiente científico e nos meios de comunicaçäo de massa, em especial, por sua associaçäo a maior risco de infecçäo pelo Vírus da Imunodeficiência Humana (HIV). Estudou-se a adoçäo de comportamentos por mulheres para proteçäo das DST, tal como a associaçäo destes a variáveis sócio-econômicas e demográficas. Trata-se de estudo descritivo, com dados secundários de pesquisa feita em Campinas, Säo Paulo, na qual foram entrevistadas 635 mulheres selecionadas mediante a técnica de amostragem "bola de neve". Foram classificadas em: adolescentes e adultas de status sócio-econômico médio-alto ou baixo. Grande proporçäo delas näo se prevenia das DST, em particular, as de status baixo. Em todos os grupos, o condom masculino foi o método de prevençäo mais referido. Houve associaçäo negativa entre parceiro fixo e uso de condom, e a principal razäo para näo usá-lo foi "só ter um parceiro e confiar nele". Em meio às adolescentes, ocorreu associaçäo positiva entre escolaridade acima da oitava série e uso de condom, bem como negativa entre idade e uso desse método. Entre adultas o uso exclusivo de condom esteve, em geral, positivamente associado a status sócio-econômico.

Reversión secual 46,XX. Análisis clínico y molecular en tres varones y dos hermafroditas verdaderos / 46,XX sex reversal. Clinical and molecular analysis in three XX males and two true hermaphrodites

La revisión sexual 46, XX es un estado patológico poco frecuente, genéticamente heterogéno, que se caracteriza por la presencia de desarrollo testicular en ausencia de cromosoma Y. Clínicamente, los pacientes pueden ser categorizados en tres tipos: varones XX con genitales normales, varones XX con ambigüedad genital y hermafroditas verdaderos con tejido ovárico y testicular y genitales anormales. En este trabajo se estudiaron cinco pacientes con revisión sexual 46,XX. El diagnóstico clínico, endocrinológico y ultrasonográfico en tres individuos correspondió a varones XX y en los dos restantes a hermafroditismo verdadero. El análisis del gen determinante testicular (SRY) en DNA genómico reveló la presencia de éste en dos varones XX, en cambio el tercero y los dos hermafroditas verdaderos fueron SRY-negativos. Los datos moleculares confirman que el desarrollo testicular en la mayoría de los varones 46,XX se debe a la presencia del gen SRY en el genoma de estos sujetos. Los pacientes SRY-negativos, un varón XX y dos hermafroditas verdaderos, sugieren que en estos casos la diferenciación testicular es consecuencia de mutaciones en genes autosómicos o ligados al X que participan en la cascada que conduce a la diferenciación sexual

Prevençäo de doenças sexualmente transmissíveis: associaçäo com variáveis econômicas, sociais e demográficas / Prevention of sexually transmitted diseases: economic social and demographic factors

Objetivo: Investiga, entre as mulheres, a adoçäo de comportamentos para se proteger das doenças sexualmente transmissíveis (DST) e a possível associaçäo destes com variáveis socioeconômicas e demográficas. Método: Estudo descritivo, analisando dados secundários. As mulheres estudadas foram classificadas em quatro grupos: adolescentes e adultas de status socioeconômico médio-alto e de status baixo. Utiliza dados de uma pesquisa desenvolvida na cidade de Campinas, Estado de Säo Paulo, na qual foram entrevistadas 635 mulheres, selecionadas utilizando a técnica "bola de neve". Resultados: Observa que uma grande proporçäo de mulheres näo se preveniu das DST, sendo esta característica mais freqüente nos grupos de status socioeconômico baixo. O condom masculino foi o método de prevençäo mais referido entre as que se preveniram. A razäo mais freqüentemente mencionada para pedir ao parceiro o uso do condom foi a de evitar uma gravidez. Mais da metade das mulheres que fizeram esse pedido referiu que seus parceiros näo reclamaram. Nas adolescentes, a análise estatística por regressäo múltipla indicou uma associaçäo positiva entre o uso do condom masculino e a escolaridade acima de oitava série e uma associaçäo negativa entre o uso e ter parceiro fixo e maior idade. Nas adultas, o uso do condom esteve associado positivamente ao status socioeconômico médio-alto e negativamente a ter parceiro fixo