Successful malaria elimination in the Ecuador-Peru border region: epidemiology and lessons learned.

BACKGROUND: In recent years, malaria (Plasmodium vivax and Plasmodium falciparum) has been successfully controlled in the Ecuador-Peru coastal border region. The aim of this study was to document this control effort and to identify the best practices and lessons learned that are applicable to malaria control and to other vector-borne diseases. A proximal outcome evaluation was conducted of the robust elimination programme in El Oro Province, Ecuador, and the Tumbes Region, Peru. Data collection efforts included a series of workshops with local public health experts who played central roles in the elimination effort, review of epidemiological records from Ministries of Health, and a review of national policy documents. Key programmatic and external factors are identified that determined the success of this eradication effort. CASE DESCRIPTION: From the mid 1980s until the early 2000s, the region experienced a surge in malaria transmission, which experts attributed to a combination of ineffective anti-malarial treatment, social-ecological factors (e.g., El Niño, increasing rice farming, construction of a reservoir), and political factors (e.g., reduction in resources and changes in management). In response to the malaria crisis, local public health practitioners from El Oro and Tumbes joined together in the mid-1990s to forge an unofficial binational collaboration for malaria control. Over the next 20 years, they effectively eradicated malaria in the region, by strengthening surveillance and treatment strategies, sharing of resources, operational research to inform policy, and novel interventions. DISCUSSION AND EVALUATION: The binational collaboration at the operational level was the fundamental component of the successful malaria elimination programme. This unique relationship created a trusting, open environment that allowed for flexibility, rapid response, innovation and resilience in times of crisis, and ultimately a sustainable control programme. Strong community involvement, an extensive microscopy network and ongoing epidemiologic investigations at the local level were also identified as crucial programmatic strategies. CONCLUSION: The results of this study provide key principles of a successful malaria elimination programme that can inform the next generation of public health professionals in the region, and serve as a guide to ongoing and future control efforts of other emerging vector borne diseases globally.

Oil bodies as a potential microencapsulation carrier for astaxanthin stabilisation and safe delivery.

Astaxanthin (AST) is a valued molecule because of its high antioxidant properties. However, AST is extremely sensitive to oxidation, causing the loss of its bioactive properties. The purposes of this study were to define conditions for microencapsulating AST in oil bodies (OB) from Brassica napus to enhance its oxidative stability, and to test the bioactivity of the microencapsulated AST (AST-M) in cells. Conditions for maximising microencapsulation efficiency (ME) were determined using the Response Surface Methodology, obtaining a high ME (>99%). OB loaded with AST showed a strong electrostatic repulsion in a wide range of pH and ionic strengths. It was found that AST-M exposed to air and light was more stable than free AST. In addition, the protective effect of AST against intracellular ROS production was positively influenced by microencapsulation in OB. These results suggest that OB offer a novel option for stabilising and delivering AST.

[Motivation perception measurement of intermediate directors in three complex hospitals of the Region of the Maule, Chile]. / Percepción de la motivación de los directivos intermedios en tres hospitales de la Región del Maule, Chile.

OBJECTIVE: In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. MATERIAL AND METHODS: The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. RESULTS: Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. DISCUSSION: It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.

Testing the biogeographical regionalization of the Mexican Transition Zone based on the distribution of Curculionidae (Insecta: Coleoptera).

A test of the biogeographical regionalization of the Mexican Transition Zone (MTZ) is presented, resulting from a Parsimony Analysis of Endemicity (PAE) based on the distributional patterns of 575 species of the family Curculionidae. The analysis was carried out in three stages. First, a PAE was carried out to define a general regionalization scheme for the MTZ, identifying areas and microareas of endemism for the entire area. Then PAEs were undertaken for each province. Third, a PAE was carried out to determine the relationship between the provinces of the MTZ. The analysis of the entire MTZ resulted in four areas and 57 microareas of endemism, while in the independent analysis of each province, five areas and 67 microareas of endemism were obtained. Both analyses coincide basically in the location of the areas and microareas of endemism, which are subordinated to biogeographic units defined by different authors. In the consensus cladogram of the third stage of the analysis, the Transmexican Volcanic Belt (TVB) is the sister area to the Sierra Madre Occidental (SMOC); then, they are the sister area to the Sierra Madre Oriental (SMOR); and finally the previous provinces are united in a trichotomy with the Sierra Madre del Sur (SMS) and the Chiapas Highlands (CHIS). It is assumed that the differences found when comparing our results with different cladistic biogeographic studies of the MTZ reflect the complexity of the study area. Since the data used to perform the analyses are not uniform, and both geographical units and taxa are different, the comparison between different analyses is difficult.

Interacciones potenciales parásito-hospedero entre el escarabajo Dendroctonus (Coleoptera: Scolytidae) y Pinus (Pinaceae) en México / Potential parasite-host interactions between Dendroctonus (Coleoptera: Scolytidae) beetle and Pinus (Pinaceae) in Mexico

Resumen Introducción: La relación parásito-hospedero entre Dendroctonus y Pinus es reconocida como una amenaza importante para los bosques de coníferas, debido a que puede causar una alta mortalidad de árboles y consecuentemente una pérdida de cobertura forestal. Objetivo: Identificar potenciales interacciones parásito-huésped entre descortezadores y pinos, así como la contribución de las condiciones ambientales para el establecimiento de estas interacciones ecológicas. Métodos: Se realizaron modelos de nicho ecológico y análisis de redes ecológicas con la plataforma web de minería de datos espaciales SPECIES (http://species.conabio.gob.mx/). Se incluyeron siete especies de descortezadores, 52 de pinos y 19 variables bioclimáticas del portal WorldClim. Resultados: Se identificaron 140 interacciones potenciales, de las cuales el 42 % no han sido registradas previamente. El análisis de redes ecológicas nos permitió caracterizar las relaciones parásito-hospedero en generalistas y especialistas. En cuanto al análisis de nicho ecológico, se determinó la distribución potencial de los descortezadores combinando las distribuciones de Pinus y variables climáticas como predictores. Se observó que las variables climáticas contribuyen de forma negativa para la mayoría de las especies de Dendroctonus, es decir, estas variables son restrictivas en casi toda su distribución, por el contrario, las variables bióticas (Pinus) fueron positivas e informativas sobre la mayoría de las distribuciones. Conclusiones: Los patrones de coexistencia de descortezadores y pinos nos proporcionan información sobre las interacciones que se pueden establecer entre estas especies y que hasta hoy pueden ser desconocidas. Además, la integración de factores bióticos (hospederos) y abióticos (clima), permite obtener modelos de distribución geográfica que caracteriza las regiones con condiciones favorables para la presencia de las especies, así como las especies de hospederos con los que podrían estar interactuando en dichas regiones. Considerando el riesgo fitosanitario por descortezadores, nuestros resultados brindan escenarios geográficos y ecológicos de riesgo donde infestaciones por descortezadores podrían darse, así como la posible emergencia de nuevas interacciones parásito-hospedero desconocidas hasta hoy. Estos modelos son una herramienta que en el futuro pueden dirigir esfuerzos de trabajo de campo para validar y complementar nuestros resultados.

Abstract Introduction: The parasite-host relationship between bark beetles of the genus Dendroctonus and species of the genus Pinus has been recognized as important threat to coniferous forests because it can cause high tree mortality and therefore a loss of forests. Objectives: We aimed to identify the potential unknown parasite-host relationships among bark beetles and pine trees species, as well as the contribution of environmental conditions as driver of these ecological interactions. Methods: We carried out ecological niche models and ecological network analysis using the spatial datamining platform SPECIES (http://species.conabio.gob.mx/). Our study included seven species of bark beetles, 52 species of the genus Pinus, and 19 bioclimatic variables from Worldclim dataset. Results: We identified 140 potential interactions between Dendroctonus and Pinus species, of which 42 % have not been previously registered. Complex inference network analysis allowed us to characterize ecological parasite-host interactions in generalists and specialists. Regarding the ecological niche analysis, we determined potential bark beetle distributions by combining Pinus species ranges and climatic variables as predictors. We noted that climatic variables contributed negatively to Dendroctonus distribution for the most species, i.e. these abiotic variables are restrictive in almost the entire distribution of the beetles; conversely, biotic variables (i.e. Pinus species) were positive and informative on the most of species ranges. Conclusions: Coexistence patterns of bark beetles and Pinus provide us information on the interactions that are able to establish among these species and that until now can be unknown. In addition, integrating biotic (hosts) and abiotic (climate) factors, allows us to obtain geographic distribution models that characterize the regions with favorable conditions for the presence of bark beetles, as well as the host species with which they could be interacting in those regions. Considering the phytosanitary risk due to bark beetles, our results provide geographic and ecological scenarios where bark beetles infestations may occur, as well as the possible emergence of new parasite-host interactions. These models can be a tool to address future fieldwork efforts to validate and complement our results.

Seed oil bodies from Gevuina avellana and Madia sativa.

In this study, oil bodies (OBs) from Gevuina avellana (OBs-G) and Madia sativa (OBs-M) were isolated and characterized. Microscopic inspection revealed that the monolayer on OB-G was thinner compared to that on OB-M. Cytometric profiles regarding size, complexity, and staining for the two OB sources were similar. Fatty acid to protein mass ratio in both OBs was near 29, indicating high lipid enrichment. OBs-G and OBs-M showed a strong electrostatic repulsion over wide ranges of pH (5.5-9.5) and NaCl concentration (0-150 mM). Proteins displaying highly conserved sequences (steroleosins and aquaporins) in the plant kingdom were identified. The presence of oleosins was immunologically revealed using antibodies raised against Arabidopsis thaliana oleosins. OBs-G and OBs-M exhibited no significant cytotoxicity against the cells. This is the first report about the isolation and characterization of OBs-G and OBs-M, and this knowledge could be used for novel applications of these raw materials.

Venom of the Chilean Latrodectus mactans alters bovine spermatozoa calcium and function by blocking the TEA-sensitive K(+) current.

The morphology and size of spermatozoa make it difficult to study the functional properties of the plasma membrane, however, some studies have revealed the presence of a number of ion channels in this cell. We measured the calcium (Ca(++)) influx induced by depolarization of the plasma membrane and by venom isolated from the Chilean black widow spider (Latrodectus mactans), and functional changes in the presence of either high potassium or total venom. Our results indicate that the venom increased the Ca(++) influx, with an EC50 of 6.1 microg/mL and triggering the acrosome reaction in 43.26% of the cells. The application of potassium (10 mM K(+)) or total venom (10 microg/mL) did not affect the morphology or DNA stability of the sperm. The effects induced by high K(+) and venom suggest that direct blocking of K(+) currents alters the passive properties of the plasma membrane, leading to the entry of Ca(++). These results show the importance of functional changes induced by depolarizing the spermatozoa and by venom. This venom possesses one or more molecules that may be used as pharmacological tools for studies on spermatozoa and have potential applications in reproductive biotechnology.

Tetraethylammonium-sensitive K(+) current in the bovine spermatozoa and its blocking by the venom of the Chilean Latrodectus mactans.

The morphology and size of spermatozoa hinder the study of the functional properties of the spermatozoa plasma membrane. However, some studies have revealed the presence of a number of ion channels in this cell. We set out to measure the endogenous currents and to study the effect of the venom of the Chilean black widow spider (Latrodectus mactans). By patch-clamping bovine spermatozoa our results indicate the presence of an outwardly rectifying current, sensitive to changes in K(+) concentration (30-140 mM) and to tetraethylammonium (TEA, 10-100 mM). The application of the venom (7.5 microg/ml) blocks these K+ currents and then alters the passive properties of the plasma membrane. This leads to the entry of Ca(++), reflected by a change in basal fluorescent units (5+/-2 at 35+/-10 FAU). The Ca(++) influx follows a reduction in the membrane conductance (control 22+/-2; venom 10+/-1 pS), as calcium channels open in accord with voltage dependence.

Apoptosis related genes expressed in cultured Fallopian tube epithelial cells infected in vitro with Neisseria gonorrhoeae.

BACKGROUND: Infection of the Fallopian tubes (FT) by Neisseria gonorrhoeae (Ngo) can lead to acute salpingitis, an inflammatory condition resulting in damage primarily to the ciliated cells, with loss of ciliary activity and sloughing of the cells from the epithelium. Recently, we have shown that Ngo infection induced apoptosis in FT epithelium cells by a TNF-alpha dependent mechanism that could contribute to the cell and tissue damage observed in gonococcal salpingitis. AIM: To investigate the apoptosis-related genes expressed during apoptosis induction in cultured FT epithelial cells infected in vitro by Ngo. MATERIALS AND METHODS: In the current study, we used cDNA macroarrays and real time PCR to identify and determine the expression levels of apoptosis related genes during the in vitro gonococci infection of FT epithelial cells. RESULTS: Significant apoptosis was induced following infection with Ngo. Macroarray analysis identified the expression of multiple genes of the TNF receptor family (TNFRSF1B, -4, -6, -10A, -10B and -10D) and the Bcl-2 family (BAK1, BAX, BLK, HRK and MCL-1) without differences between controls and infected cells. This lack of difference was confirmed by RT-PCR of BAX, Bcl-2, TNFRS1A (TNFR-I) and TNFRSF1B (TNFR-II). CONCLUSION: Several genes related to apoptosis are expressed in primary cultures of epithelial cells of the human Fallopian tube. Infection with Ngo induces apoptosis without changes in the pattern of gene expression of several apoptosis-related genes. RESULTS strongly suggest that Ngo regulates apoptosis in the FT by post-transcriptional mechanisms that need to be further addressed.

Percepción y disposición a donar órganos en Chile / Perception and disposition to donate organs in Chile

Como orientación a la política pública de salud, el presente documento determina la percepción y la disposición de las personas a la donación de órganos. El instrumento de indagación fue un cuestionario aplicado a una muestra de 204 personas localizadas en 10 ciudades de Chile. La varianza del estudio fue 18,8 por ciento, el error un 2,58 por ciento, la confiabilidad, medida por Alfa de Cronbach, fue de 0,777. Las variables se identificaron mediante el método de grupo foco, se midieron por escalas nominales y ordinales. En general se concluye que tanto quienes están inscritos como donantes como aquellos que no lo están tienen una buena disposición a donar órganos y perciben que la decisión de donación debe ser tomada en forma personal, pero en conocimiento de la familia.

Comparación de ranking del Ministerio de Salud (Minsal) e impacto financiero de las 40 primeras patologías Auge-GES vigentes en Chile / Comparing the Minsal ranking with the financial impact of the first 40 Auge-GES pathologies in Chile

El presente artículo compara el ranking Minsal de 40 patologías Auge-GES con el determinado por impacto financiero. Se elaboró una base de datos homogénea, se estandarizaron datos y se aplicaron correlaciones Pearson y Spearman. Se concluye que el criterio de impacto financiero cambia efectivamente las prioridades y modifica la congruencia social de la política de Estado.

Plan de motivación para el personal de un hospital regional de alta complejidad / Motivational plan for the staff of a regional high-complexity hospital

En este trabajo se elabora un plan de motivación para los directivos intermedios de un hospital regional de alta complejidad. Métodos: Se aplicó el método de análisis de factores de componentes principales con rotación Varimax, sobre la base de un cuestionario que incluyó 57 afirmaciones de medición de actitudes tipo Likert de cinco puntos. La población sujeto de la investigación fue la líneade mando intermedia, constituida por 62 profesionales bajo cuya supervisión se desempeñan 1 317 funcionarios. Resultados: Se propone la realización de talleres de integración entre jefes y subalternos, la creación de instancias de participación informativa, consultiva y de decisión, y que, además, se estudie la carga de trabajo, así como un sistema de comunicación que incorpore elementos de reconocimiento.Discusión: Se confirma el hecho de que los factores higiénicos no producen motivación y que tampoco generan desmotivación. Sin embargo, variables económicas como el salario, pueden llegar a ser consideradas motivacionales o desmotivacionales, de acuerdo con el nivel de satisfacción alcanzado...

Percepción de la motivación de los directivos intermedios en tres hospitales de la Región del Maule, Chile / Motivation perception measurement of intermediate directors in three complex hospitals of the Region of the Maule, Chile

OBJETIVO: En este trabajo se diseña un cuestionario y se cuantifican las percepciones de motivación-desmotivación de los jefes intermedios de tres hospitales de la Región del Maule, Chile. MATERIAL Y MÉTODOS: El trabajo de campo se realizó entre septiembre y octubre de 2006, se aplicó un cuestionario con 57 afirmaciones de medición de actitudes que se calificó de acuerdo con una escala tipo Likert de cinco puntos. La población objeto de la investigación fue de 125 profesionales bajo cuya supervisión se encuentran alrededor de 3 800 funcionarios. RESULTADOS: Se identificaron 10 variables, cinco motivacionales y cinco desmotivacionales. Entre las primeras destacan vocación y espíritu de servicio; entre las segundas falta de reconocimiento y falta de compromiso. DISCUSIÓN: Se confirma que tanto las variables motivacionales como las desmotivacionales son esencialmente cualitativas y que las variables económica y de sueldos son menos relevantes y de inferior jerarquía.

OBJECTIVE: In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. MATERIAL AND METHODS: The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. RESULTS: Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. DISCUSSION: It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.

Apoptosis related genes expressed in cultured Fallopian tube epithelial cells infected in vitro with Neisseria gonorrhoeae

Background: Infection of the Fallopian tubes (FT) by Neisseria gonorrhoeae (Ngo) can lead to acute salpingitis, an inflammatory condition resulting in damage primarily to the ciliated cells, with loss of ciliary activity and sloughing of the cells from the epithelium. Recently, we have shown that Ngo infection induced apoptosis in FT epithelium cells by a TNF-alpha dependent mechanism that could contribute to the cell and tissue damage observed in gonococcal salpingitis. Aim: To investigate the apoptosis-related genes expressed during apoptosis induction in cultured FT epithelial cells infected in vitro by Ngo. Materials and Methods: In the current study, we used cDNA macroarrays and real time PCR to identify and determine the expression levels of apoptosis related genes during the in vitro gonococci infection of FT epithelial cells. Results: Significant apoptosis was induced following infection with Ngo. Macroarray analysis identified the expression of multiple genes of the TNF receptor family (TNFRSF1B, -4, -6, -10A, -10B and -10D) and the Bcl-2 family (BAK1, BAX, BLK, HRK and MCL-1) without differences between controls and infected cells. This lack of difference was confirmed by RT-PCR of BAX, Bcl-2, TNFRS1A (TNFR-I) and TNFRSF1B (TNFR-II). Conclusion: Several genes related to apoptosis are expressed in primary cultures of epithelial cells of the human Fallopian tube. Infection with Ngo induces apoptosis without changes in the pattern of gene expression of several apoptosis-related genes. Results strongly suggest that Ngo regulates apoptosis in the FT by post-transcriptional mechanisms that need to be further addressed.

Factores de riesgo de fallecer en domicilio por neumonía de niños chilenos de estratos socioeconómicos bajos, Santiago de Chile: 1990-1994 / Risk factors for home deaths due to pneumonia among low socioeconomic level Chilean children, Santiago de Chile: 1990-1994

Background: Pneumonia is the main cause of late infant mortality in Chile. Over 60 percent of these deaths occur at home. The lack of hospital beds and the inadequate outpatient management are contributing factors. Aim: To assess risk factors for home deaths due to pneumonia in Chilean children. Patients and methods: The clinical and environmental histories of 53 (39 male) children that died due to pneumonia in their homes were analyzed. The cause of death was confirmed by necropsy with histopathological studies in all cases. These cases were compared with 88 control children of similar age, gender, socioeconomic status and living in the same geographical area of Metropolitan Santiago. Results: Fifty four percent of deceased children were of less than 3 months of age and only 3 cases and their controls were above1 year old. Identified risk factors for death were malnutrition with an odds ratio of 30.6 (CI 3.9-64.8, p< 0.001), low birth weight with an odds ratio of 5 (CI 1.8-14.1, p< 0.001), previous admissions to hospitals with an odds ratio of 5.79 (CI 2-17.1, p< 0.001), congenital malformations (mainly cardiac) with an odds ratio of 8.4 (CI 2-39.9, p= 0.001) and a history of bronchial obstruction with an odds ratio of 5.68 (p< 0.001). Identified maternal risk factors were smoking with an odds ratio of 4.13 (CI 1.6-10.7 p< 0.001) and being a teenager with an odds ratio of 4.3 (CI 1.7-11, p<0.001). Malnutrition, low birth weight, history of previous hospital admissions and having a teenager or smoker mother were considered as independent risk factors using a stepwise analysis. Conclusions: Chilean low income children have identifiable risk factors for death at their homes due to pneumonia, that can be preventively managed

Reacondicionamiento físico para pacientes con EPOC

La rehabilitación pulmonar ha surgido como una alternativa de tratamiento para pacientes con EPOC, considerándose el entrenamiento físico como una parte importante de esta investigación. En esta investigación se diseño y aplicó un programa de reacondicionamiento para evaluar los efectos en la tolerancia al ejercicio y al grado de disnea, medidos con el test de caminata, escala análoga visual y modificada del Medical Research Council respectivamente. Se trataron 28 pacientes, 14 en el grupo experimental y 14 en el control, el grupo experimental recibió 16 sesiones de entrenamiento que incluyeron ejercicios para miembros inferiores, superiores y de músculos respiratorios. Fue una investigación analítica, controlada no aleatorizada. En el grupo experimental la distancia caminada aumentó un 27 por ciento y la disnea dismonuyó. Se concluye que los pacientes de este estudio se beneficiaron con el programa de reacondicionamiento y que otros pacientes se pueden beneficiar de tratamiento similares.

Utilización de la técnica de Papanicolaou en profesionales de la salud / Utilization of the Papanicolaou's technique in health professionals

Se aplicó una encuesta a mujeres profesionales del área de la Salud, con el fin de evaluar la utilización de la técnica de Papanicolaou, PAP, como examen preventivo del cáncer cervico-uterino. La encuesta fue contestada por 234 profesionales. En el resultado resalta que una de cada cuatro profesionales nunca se ha realizado el PAP, y que sólo 34% de las profesionales que se lo han practicado lo repitan periódicamente