Una mirada transcultural de las prácticas de cuidado de la cultura Embera Chamí / A cross-cultural look at the human practices of the Embera Chamí culture

ResumenObjetivo: Conocer las prácticas de cuidado utilizadas por las madres Embera Chamí de niños menores de 5 años con infecciones respiratorias agudas que asisten al Hospital Universitario San Jorge.MetodologíaEl abordaje de esta investigación es cualitativo, se fundamenta en un proceso inductivo. El método de investigación es la Etnoenfermería, diseñado por la antropóloga enfermera Lenninger en 1985, derivado de la etnografía y fundamentado en la teoría de la diversidad y universalidad del cuidado cultural.Resultados: Después de realizar el análisis de la entrevista a 6 informantes claves, se obtuvieron 2 temas centrales: Tema uno. Prácticas de medicina convencional de los Embera, de donde surgieron dos patrones los cuales se denominaron Jaibaná, fuente de cuidado específico y apropiación cultural de las madres. Para ellas es primordial acudir al Jaibaná cuando sus hijos están enfermos debido a que ocupan un alto rango en la comunidad y confían en lo que él determine para la salud del niño. El segundo tema central Cuidado cultural de las madres embera chamí, con sus respectivos patrones: Identificación de la madre como cuidadora principal y Familia y factor social para el cuidado. La madre Embera Chamí se preocupa por el bienestar de su hijo enfermo, sigue las instrucciones por el Jaibaná, este fenómeno es considerado por Leininger como un "cuidado protector.Conclusiones: La cultura es el aspecto más amplio, comprehensivo, holístico y universal, de los seres humanos. Es por esta razón que el cuidado de los Embera está determinado por el jaibaná como forma de cuidado cultural.Palabras claves: Cuidado del niño, Características Culturales, Pueblos Indígenas, Infección respiratoria, Hospitales.

Sudden death related to small coronary artery disease.

Two cases of sudden death of young people in apparently good health are reported. The only pathologic change found was a fibromuscular dysplasia of the artery supplying the conduction system of the heart with an important narrowing of the lumen and strong thickening of the arterial wall. The first case was of a 12-year-old girl who died suddenly while skiing; the second was of a 32-year-old man who died while talking to his wife. No other pathologic changes were found at autopsy, and the results of toxicologic analysis were negative. There was no individual or family history of cardiac diseases. These cases illustrate the importance of an analysis of the conduction system, including examination of the intramural coronary arteries supplying the conduction system.

Use of von Willebrand diseased kidney as donor in a pig-to-primate model of xenotransplantation.

BACKGROUND: The coagulation process in hyperacute and delayed xenograft rejection is essential and depends upon platelet adhesion and aggregation. The initial binding of platelets to the damaged endothelium is due to the interaction of the platelet receptor glycoprotein Ib with von Willebrand factor (vWF), which is present on activated endothelial cells and bound to the subendothelial matrix. We hypothesized that the use of organs from animals with homozygous von Willebrand disease (vWD), severely deficient in vWF, might prevent the thrombosis encountered in delayed xenograft rejection. METHODS: Ten baboons were treated by extracorporeal immunoadsorption of xenoreactive natural antibodies (XNA) through the donor pig liver to inhibit hyperacute rejection and received heterotopic vWD or control pig kidney xenografts. XNA levels, coagulation, and platelet activation markers were studied, and specimens of rejected kidneys were analyzed histologically. RESULTS: Although XNA depletion was comparable in both groups, neither kidney function nor survival times of control (n=5) or vWD (n=5) porcine kidneys showed any difference. Platelet and coagulation activation was evidenced in both groups after surgery and at rejection time. Immunohistochemical analysis revealed a weak endothelial vWF immunostaining in the rejected vWD kidneys, whereas it was undetectable in the nongrafted vWD kidneys, suggesting the deposition of baboon plasma vWF on the porcine vessels. CONCLUSIONS: The use of vWD organs did not improve the survival time of grafted kidneys in this xenotransplantation model. Further studies on the use of vWD organs, in association with other therapeutic approaches, such as complement inhibition, are nevertheless necessary to evaluate the usefulness of vWF deficiency as an adjunctive therapy to decrease the coagulation process during xenograft rejection.

Effect of methotrexate on the intestinal mucosa of PGE2-treated rats.

In the present study, we aimed to protect the intestinal mucosa from small bowel damage in methotrexate (MTX)-treated rats. The protective effect of prostaglandin E2 (PGE2) was investigated. Ileal integrity was evaluated making use of different biochemical parameters: content of sucrase and maltase activities, contents of DNA, proteins, AMPc, PGE2, putrescine (Put), spermine (Spm) and spermidine (Spd). Rats were orally administered 0.5 ml of NaCl solution (0.9%) containing or not containing 400 micrograms.ml-1 of PGE2 twice daily, during three or ten days. Half an hour after the 18th ingestion of PGE2, 0.5 ml of NaCl solution (0.9%) containing MTX (16 mg.ml-1) was injected intravenously. Rats were killed exactly 48 hours after this injection. MTX had no effect on the Put content, increased the AMPc content and decreased the contents of DNA, proteins, Spm, Spd, PGE2 and sucrase or maltase activity. PGE2 had no effect on the biochemical parameters we studied, except on the contents of DNA (10-day treatment) and of PGE2 (3- and 10-day treatment). When MTX was injected after PGE2 treatment, as compared with what was observed when MTX was used as reported above, we observed--an increase in spermine content after 3-day PGE2 treatment and- an increase in the contents of DNA, Spm, Spd and disaccharidase activity after 10-day PGE2 treatment. No other significant variation in the other biochemical parameters was recorded, whatever the duration of the PGE2 treatment. These results indicate that PGE2 could partially protect the intestinal mucosa against the biochemical effects of MTX. Other experimental conditions may need to be chosen in order to obtain a better cytoprotective effect of PGE.