Participatory ethnobotany: comparison between two quilombos in the Atlantic Forest, Ubatuba, São Paulo, Brazil.

Ethnobotanical studies that use the participatory research approach seek to involve the residents of a community in different stages of the study, promoting the registration, dissemination and strengthening of local knowledge, as well as the empowerment of decisions related to the sustainable use and management of resources. Using the participatory methodology, this study recorded and made a comparative analysis on the use of plants in two quilombola communities (Quilombo do Cambury-QC and Quilombo da Fazenda-QF) in the State of São Paulo. After a training on anthropological and botanical methods, local researchers selected and interviewed the local experts, recording their knowledge on plant uses and collecting the indicated plants, to be identified and deposited in herbariums. In addition, participant observation and field diaries were used by the academic researchers, helping to analyze the data. To test the differences in the composition of species known to local community, a Jaccard dissimilarity matrix was created, and a Permanova test was employed. During the 178 days of fieldwork, three local researchers from the QC and two from the QF, selected nine and eight experts on the uses of the plants in each quilombo, respectively, corresponding to 214 plant species, indicated for eight ethnobotanical categories. Our hypothesis has been confirmed, since the traditional knowledge found in both quilombos, regarding plant uses and the number of plant species by category, are distinct, since each community occupies particular plant areas and different phytophysiognomies. Most of the indicated species are native to the Atlantic forest, and no significant differences were observed in the proportion of native species vs. introduced among quilombos for any of the categories of use studied. Furthermore, the innovative methodology used, participatory ethnobotany, contributed to the empowerment of community members with regard to the use of their available resources in the environment in which they live, while retaining the intellectual property rights over their own knowledge.

(-)-Epicatechin Ameliorates Cardiac Fibrosis in a Female Rat Model of Pre-Heart Failure with Preserved Ejection Fraction.

One of the most abundant flavonoids present in cacao is (-)-epicatechin (Epi) and this flavanol has been linked to the cardiovascular health promoting actions of cocoa products. We previously demonstrated that Epi reduces infarct size in rodent models of ischemia/reperfusion and permanent coronary occlusion. Reduced infarct size was associated with decreased left ventricular (LV) oxidative stress (OS) and indicators of inflammation factors, which foster myocardial fibrosis. In this study, we examine the antifibrotic actions of Epi in an aging female rat model of pre-heart failure with preserved ejection fraction (pre-HFpEF) as well as its potential to mitigate plasma levels of OS, proinflammatory/profibrotic cytokines, and improve passive and active LV function. Epi treatment [1 mg/(kg·d)] was provided daily by gavage from 21 to 22 months of age, whereas controls received water. A Millar catheter was used to assess hemodynamic function. Subsequently, hearts were arrested in diastole, a balloon inserted into the LV and passive pressure-volume curves generated. Fixed LV sections were processed for collagen area fraction quantification using Sirius Red staining. Treatment with Epi did not lead to detectable changes in LV contractile function. However, passive LV pressure volume curves were significantly right shifted with Epi. Collagen area fraction values indicated that Epi treatment significantly reduces LV fibrosis. Epi also significantly reduced plasma OS markers and levels of profibrotic and proinflammatory cytokines. In conclusion, Epi reduces cardiac fibrosis in an aged, female rat model of pre-HFpEF, which correlates with significant reductions in OS and cytokine levels in the absence of changes in LV contractile function.

An expanding role for interventional radiology: Medicare trends in fluoroscopic, endoscopic, and surgical enteric tube placement and maintenance from 2010 to 2018.

BACKGROUND: The purpose of this study is to provide an update on trends in physician volume and payments for enteric tube placement and maintenance procedures by method, provider specialty, and practice setting amongst Medicare beneficiaries from 2010 to 2018. MATERIALS AND METHODS: Claims from the Medicare Part B Physician/Supplier Procedure Summary Master File (PSPSMF) for the years 2010 to 2018 were extracted using current procedural terminology (CPT) codes for gastrostomy and jejunostomy placement, as well as conversion of gastrostomy to gastrojejunostomy, fluoroscopy guided and non-image guided replacement. Total volumes and provider reimbursement were analyzed by provider specialty and practice setting. RESULTS: Volume of de novo placement of all enteric tubes decreased from 157,123 to 106,549 (-32.2%). While endoscopic placement decreased from 133,658 to 81,171 (-39.3%), the volume of fluoroscopic placement increased from 17,999 to 21,277 (18.2%). Fluoroscopic placement was largely performed by interventional radiology (IR) (91.7% in 2018). Surgical placement decreased from 5466 to 4101 (-25.0%). Volume of fluoroscopic replacement increased from 24,799 to 38,470 (55.1%), while non-image guided replacements decreased from 61,377 to 55,116 (-10.2%). Share of both fluoroscopic and non-image guided replacements by advanced practice providers (APPs) more than doubled over this time period. CONCLUSION: De novo placement of enteric tubes decreased from 2010 to 2018, likely related to increased awareness of the complications and limited benefits in scenarios such as end of life care. In contrast to the diminishing volume for gastroenterologists, there was increased participation by IR in both placement and maintenance procedures under fluoroscopic guidance. SUMMARY STATEMENT: Decreasing placement of enteric tubes suggests shifting attitudes and recommendations around end-of-life care. Increase in role by IR/APPs highlights the need for comprehensive care in these patients.

Correlation between baropodometric variables, disability, and intensity of low back pain in pregnant women in the third trimester.

BACKGROUND: Growth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change. OBJECTIVE: Correlate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy. METHODS: This is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation. RESULTS: Twenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = -0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot. CONCLUSION: There is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.

Participatory methods on the recording of traditional knowledge about medicinal plants in Atlantic forest, Ubatuba, São Paulo, Brazil.

INTRODUCTION: Ethnobotanical studies that include participatory methods aim to engage residents in different steps to promote the strengthening and perpetuation of local culture, and empowerment in making decisions about the use of available environmental resources. Thus, the aim of this project was to perform an ethnobotanical survey based on traditional knowledge of medicinal plants with the active participation of residents living in Bairro do Cambury, Ubatuba, São Paulo State, Brazil. MATERIALS AND METHODS: During meetings held between the researchers and community members, locally used plants were regarded as an important means for preserving local knowledge for future generations. Some residents showed interest in participating as local partners, and training courses for collecting ethnobotanical data were offered. Local partners and researchers from São Paulo Federal University (Universidade Federal de São Paulo) utilized ethnobotanical methods to select and interview the specialists in medicinal plants for 80 days between 2016 and 2018. Data on plant use were recorded, and plants were collected and deposited in two herbaria. Furthermore, participant observation and fieldwork diaries were used by the researchers, aiding the data analysis. RESULTS: Three local partners participated in objective definitions, data collection, analysis and publication. Nine local specialists were interviewed by the local partners and indicated the use of 82 plant species in 90 recipes for 55 therapeutic uses. These uses were grouped into 12 categories. In addition, a video and booklet were created. CONCLUSIONS: Data obtained during participatory research show that training local communities in the registration of their own knowledge is feasible and necessary since they register knowledge based on local perceptions, as well as valuing knowledge and approaching the current discussion about intellectual property is a global concern.

Discovery of BMS-986235/LAR-1219: A Potent Formyl Peptide Receptor 2 (FPR2) Selective Agonist for the Prevention of Heart Failure.

Formyl peptide receptor 2 (FPR2) agonists can stimulate resolution of inflammation and may have utility for treatment of diseases caused by chronic inflammation, including heart failure. We report the discovery of a potent and selective FPR2 agonist and its evaluation in a mouse heart failure model. A simple linear urea with moderate agonist activity served as the starting point for optimization. Introduction of a pyrrolidinone core accessed a rigid conformation that produced potent FPR2 and FPR1 agonists. Optimization of lactam substituents led to the discovery of the FPR2 selective agonist 13c, BMS-986235/LAR-1219. In cellular assays 13c inhibited neutrophil chemotaxis and stimulated macrophage phagocytosis, key end points to promote resolution of inflammation. Cardiac structure and functional improvements were observed in a mouse heart failure model following treatment with BMS-986235/LAR-1219.

Participatory ethnobotany and conservation: a methodological case study conducted with quilombola communities in Brazil's Atlantic Forest.

BACKGROUND: Although multiple studies advocate the advantages of participatory research approaches for ethnoscience, few provide solid contributions from case studies that involve residents in all of the project phases. We present a case study of a participatory approach whose aim is to register ethnobotanical knowledge on the use of plants in two quilombola communities (maroon communities), an important biodiversity hotspot in the Atlantic Forest, Southeast Brazil. Our aim is to provide tools that will empower decision-making related to sustainable use and management among residents. METHODS: In phase I, the objectives and activities were defined in meetings with residents to carry out ethnobotanical surveys between two quilombola communities-the Quilombo da Fazenda (QF) and Quilombo do Cambury (QC). In phase II, we offered community partners training courses on how to collect plants and ethnobotanical data. In coordination with the university team and using ethnobotanical methods, community partners interviewed specialists on plants and their uses. In phase III, using the participatory mapping method, residents indicated plot locations and collected plants to calculate the Conservation Priority Index for native species recorded in phase II. RESULTS: In 178 days of fieldwork, two community partners from the QF and three from the QC selected 8 and 11 respondents who reported 175 and 195 plant species, respectively, corresponding to 9 ethnobotanical categories. Based on requests from the local community, booklets and videos with these data were collaboratively produced. A large percentage of species were found to be of great conservation priority-82.1% in the QC and 62.5% in the QF. Virola bicuhyba, Cedrela fissilis, Plinia edulis, and Tabebuia cassinoides are the species most at risk and will be the focus of phase IV, when a participatory management plan will be carried out. Additionally, we present both challenges and opportunities with the hope that others can learn from our successes and failures. CONCLUSIONS: Our experience shows that it is possible to train community members who wish to document their knowledge to support the process of ensuring that local knowledge is highly regarded, further ensuring its perpetuation. In this context, the project may be of great interest to development programs in promoting community-based management strategies for useful plants.

Tratamiento quirúrgico ambulatorio del cáncer de mama. Experiencia en el Hospital General de Ciudad Real / Breast cancer ambulatory surgery. Experience at General Hospital in Ciudad Real

Objetivo. Describir la casuística de pacientes con diagnóstico de cáncer de mama intervenidas en el Hospital General Universitario de Ciudad Real mediante un programa de cirugía mayor ambulatoria (CMA). Pacientes y método. Estudio descriptivo retrospectivo donde se presenta la serie de pacientes del Hospital General de Ciudad Real con diagnóstico de cáncer de mama e intervenidas quirúrgicamente en el periodo comprendido entre el 1 de enero de 2010 y el 1 de febrero de 2011. Resultados. Se intervinieron un total de 130 pacientes; de ellas, un 20% se consideraron larga estancia, un 32,3% corta estancia y un 47,7%, CMA. En el 69,4% de los casos, las técnicas quirúrgicas más asociadas a CMA fueron cirugías conservadoras. Conclusiones. La cirugía del cáncer de mama es factible en programas de cirugía mayor ambulatoria, con criterios establecidos de selección de pacientes. Las técnicas conservadoras fueron las más empleadas en nuestro programa (AU)

Objective. To describe the series of patients diagnosed with breast cancer that went to the operation room in the Ambulatory Surgery Program in the University General Hospital of Ciudad Real. Patients and methods. Retrospective descriptive study of patients diagnosed of breast cancer in University General Hospital of Ciudad Real and had been operated between 01-01-2010 to 01-02-2011. Results. 130 patients were analyzed. 20% were considered long stay more than 72 hours, 32,3% were short stay and 47,7% were ambulatory surgery. Conservative surgery were performed in 69,4% of all the cases included. Conclusion. Breast cancer surgery is feasible in ambulatory surgery programs with patients selection criteria. Conservative techniques were the most common surgery in our program (AU)

Chocolate, café, té y otros estimulantes: bebidas energéticas avant la lettre (II) / No disponible

Las bebidas estimulantes naturales con metilxantinas (chocolate, café y té entre otras) vienen usándose desde la más remota antigüedad por sus propiedades para eliminar la fatiga, aumentar la alerta y combatir el sueño. En el presente artículo se revisan las principales características botánicas, historia, composición, procesamiento, formas de uso y efectos sobre la salud de estas bebidas, así como los principales aspectos farmacodinámicos, farmacocinéticos y toxicológicos del principio activo responsable de sus efectos estimulantes, la cafeína. Dado que los polifenoles juegan también un papel importante en los efectos sobre la salud de estas bebidas, se hace también hincapié en su relevancia en la prevención de enfermedades crónicas

Natural stimulating beverages with methylxanthines (chocolate, coffee and tea, among others) have been used since ancient times because of their properties for avoiding fatigue, enhancing alertness and fighting sleepiness. In this paper we review the main botanical characteristics, the history, composition, processing, use and health effects of these natural beverages, as well as the main pharmacodynamic, pharmacokinetic and toxicological aspects of caffeine, the active ingredient responsible for their stimulant effects. Polyphenols play an important role in the effects of these beverages on health, so we also place stress on their relevance in the prevention of chronic diseases

Adaptive responses of mitochondria to mild copper deprivation involve changes in morphology, OXPHOS remodeling and bioenergetics.

Copper is an essential cofactor of complex IV of the electron transfer chain, and it is directly involved in the generation of mitochondrial membrane potential. Its deficiency induces the formation of ROS, large mitochondria and anemia. Thus, there is a connection between copper metabolism and bioenergetics, mitochondrial dynamics and erythropoiesis. Copper depletion might end in cellular apoptosis or necrosis. However, before entering into those irreversible processes, mitochondria may execute a series of adaptive responses. Mitochondrial adaptive responses (MAR) may involve multiple and diverse mechanisms for preserving cell life, such as mitochondrial dynamics, OXPHOS remodeling and bioenergetics output. In this study, a mild copper deficiency was produced in an animal model through intraperitoneal injections of bathocuproine disulfonate in order to study the MAR. Under these conditions, a new type of mitochondrial morphology was discovered in the liver. Termed the "butternut squash" mitochondria, it coexisted with normal and swollen mitochondria. Western blot analyses of mitochondrial dynamics proteins showed an up-regulation of MFN-2 and OPA1 fusion proteins. Furthermore, isolated liver mitochondria displayed OXPHOS remodeling through a decrease in supercomplex activity with a concomitant increase at an individual level of complexes I and IV, higher respiratory rates at complex I and II levels, higher oligomycin-insensitive respiration, and lower respiratory control ratio values when compared to the control group. As expected, total ATP and ATP/ADP values were not significantly different, since animal's health was not compromised. As a whole, these results describe a compensatory and adaptive response of metabolism and bioenergetics under copper deprivation.

Chocolate, café, té y otros estimulantes: bebidas energéticas avant la lettre (I) / No disponible

Las bebidas estimulantes naturales con metilxantinas (chocolate, café y té entre otras) vienen usándose desde la más remota antigüedad por sus propiedades para eliminar la fatiga, aumentar la alerta y combatir el sueño. En el presente artículo se revisan las principales características botánicas, historia, composición, procesamiento, formas de uso y efectos sobre la salud de estas bebidas, así como los principales aspectos farmacodinámicos, farmacocinéticos y toxicológicos del principio activo responsable de sus efectos estimulantes, la cafeína. Dado que los polifenoles juegan también un papel importante en los efectos sobre la salud de estas bebidas, se hace también hincapié en su relevancia en la prevención de enfermedades crónicas (AU)

Natural stimulant beverages containing methylxanthines (chocolate, coffee and tea, among others) have been used since earliest times because of their properties for avoiding fatigue, enhancing alertness and fi ghting sleepiness. In this paper we review the main botanical characteristics, the history, composition, processing, use and health effects of these natural beverages as well as the main pharmacodynamic, pharmacokinetic and toxicological aspects of caffeine, the active ingredient responsible for their stimulant effects. Polyphenols play an important role in the health effects of these beverages, attention is also paid to their relevance in chronic disease prevention (AU)

Electrical characteristics of silicon nanowire transistors fabricated by scanning probe and electron beam lithographies.

Silicon nanowire (SiNW) field-effect transistors have been fabricated by oxidation scanning probes and electron beam lithographies. The analysis and comparison of the electron mobility and subthreshold swing shows that the device performance is not affected by the top-down fabrication method. The two methods produce silicon nanowire transistors with similar electrical features, although oxidation scanning probe lithography generates nanowires with smaller channel widths. The values of the electron mobility and the subthreshold swing, 200 cm(2) V(-1) s(-1) and 500 mV dec(-1), respectively, are similar to those obtained from bottom-up methods. The compatibility of top-down methods with CMOS (complementary metal-oxide-semiconductor) procedures, the good electrical properties of the nanowire devices and the potential for making sub-10 nanowires, in particular by using oxidation scanning probe lithography, make those methods attractive for device fabrication.

Kratom (Mitragyna speciosa): ¿Droga emergente o bala mágica? / No disponible

En los últimos años, un número indeterminado y creciente de sustancias con actividad psicotrópica están siendo introducidas en contextos recreativos a través del mercado tecnológico que suponen internet y las nuevas tecnologías, tratando de franquear las barreras legislativas existentes en materia sanitaria. Son productos que bien proceden directamente de especies naturales o son modifi caciones de estas a partir de síntesis química. El kratom, procedente de la planta de origen asiático Mytragina speciosa Korth, es una de estas sustancias cuya popularidad y uso han crecido inusitadamente en los países occidentales durante los últimos dos años. La marcada y peculiar actividad farmacológica de los principios activos del kratom podría ofrecer una rentable estrategia terapéutica para intervenir en distintas patologías adictivas, como la dependencia a opiáceos o alcohol. Sin embargo, su potencial como droga de abuso limita esta utilidad. Por tanto, se hacen necesarios estudios clínicos adecuadamente diseñados que permitan posicionar adecuadamente el kratom dentro de los recursos terapéuticos utilizados en el tratamiento de la adicción a ciertas drogas al tiempo que se vigilan estrechamente los efectos para la salud de su introducción en nuestro medio (AU)

In recent years, a growing and indeterminate number of psychotropic substances have been introduced in recreational contexts through the Internet and new technologies market, in an attempt to get across the legislative barriers for health care. These are products that come directly from natural sources or that are modifi cations of these by chemical synthesis. Kratom, from the southeast Asian plant Mitragyna speciosa Korth, is one of these substances whose popularity and usage have grown enormously in the U.S.A., Europe and Australia over the last two years. The marked and peculiar pharmacological activity of the active ingredients of kratom could offer a therapeutic strategy for intervention in various addictive pathologies, such as opioid or alcohol dependence. Its potential as an abused drug may however limit this utility. Appropriately designed clinical trials are thus mandatory in order to establish kratom’s position and its potential role in treatment of alcohol or opiate addiction, at the same time as experts carefully assess the effects on health of introducing this in our environment (AU)

El gel de yodopovidona intrarectal en la incidencia de complicaciones infecciosas tras biopsia prostática transrectal / Effect of intrarectal povidone-iodine in the incidence of infectious complications after transrectal prostatic biopsy

OBJETIVO: Evaluar la incidencia de infecciones genitourinarias asociadas a las biopsias prostáticas transrectales ecoguiadas (BPTRE) utilizando el gel de yodopovidona endorectal como agente bactericida. MÉTODOS: Se evaluaron prospectivamente un total de 530 pacientes a los que se aplicó 30 gr de yodopovidona intrarectal al 10% antes de la realización de BPTRE. En todos los pacientes se realizó profilaxis antibiótica con ciprofloxacino, iniciada el día anterior (1 gr/día/ 3/días) y enema de limpieza. RESULTADOS: Un paciente (0,2%) presentó una orquiepididimitis bacteriana aguda por E. coli después de la biopsia. CONCLUSIONES: En nuestro estudio, el uso intrarectal del gel de yodopovidona al 10% en las BPTRE se asocia a una tasa de complicaciones infecciosas muy inferior a las descritas en las series más recientes de la literatura(AU)

OBJECTIVES: To assess the incidence of genitourinary infections associated with transrectal ultrasound-guided prostate biopsy (TRUS-BX) using endorectal povidone-iodine gel as a bactericidal agent. METHODS: We prospectively studied a total of 530 patients who were given 30g of 10% povidone-iodine intrarectally before TRUS-BX. Each patient received antibiotic prophylaxis with ciprofloxacin, starteing the previous day (1g/day x 3 days), as well as cleansing enemas. RESULTS: One patient (0.20%) presented with an E. coli acute bacterial epididymitis after biopsy. CONCLUSIONS: In our study, the intarrectal use of 10% povidone-iodine gel in TRUS-BX is associated with a much lower rate of infectious complications compared to those described in recent literature(AU)

Implant surface analysis and microbiologic evaluation of failed implants retrieved from smokers.

The aim of this study was to evaluate the microbiota and surface of failed titanium dental implants from 4 manufacturers. Twelve mobile dental implants were retrieved from 10 smokers after 3 to 10 years of functional loading. Before implant removal, microbial samples were taken and evaluated using polymerase chain reaction. After implant removal, analyses of the failed implant surfaces were performed using scanning electron microscopy and energy-dispersive spectrometer x-ray. Periodontal pathogens such as Aggregactibacter actinomycetemcomitans, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola were detected in all implants in different proportions. Surface analysis showed varying degrees of surface roughness between the samples and the presence of proteinaceous material, appearing mainly as dark stains. Foreign carbon, oxygen, sodium, calcium, aluminum, and silicon elements were also found. Although no material-related causes of implant failure were detected, several periodontal pathogens were identified independently of the surface topography or manufacturer.

Alvaradoins E-N, antitumor and cytotoxic anthracenone C-glycosides from the leaves of Alvaradoa haitiensis.

Bioactivity-directed fractionation of an extract of the leaves of Alvaradoa haitiensis, using the KB (human oral epidermoid carcinoma) cell line, led to the isolation and identification of 10 new anthracenone C-glycosides, alvaradoins E-N (1-10), along with the known compound chrysophanol (11). The cytotoxicity of all compounds was evaluated, and preliminary structure-activity relationships are suggested. The most potent compounds in the in vitro assays (1 and 2) were evaluated in vivo versus the P388 (murine lymphocytic leukemia) model, and alvaradoin E (1) showed antileukemic activity (125% T/C) at a dose of 0.2 mg kg-1 per injection when administered intraperitoneally.

Static magnetic therapy does not decrease pain or opioid requirements: a randomized double-blind trial.

A growing multibillion dollar industry markets magnetic necklaces, bracelets, bands, insoles, back braces, mattresses, etc., for pain relief, although there is little evidence for their efficacy. We sought to evaluate the effect of magnetic therapy on pain intensity and opioid requirements in patients with postoperative pain. We designed a randomized, double-blind, controlled trial. One-hundred-sixty-five patients older than 12 yr of age were randomized to magnetic (n = 81) or sham therapy (n = 84) upon reporting moderate-to-severe pain in the postanesthesia care unit. Devices were placed over the surgical incision and left in place for 2 h. Patients rated their pain intensity on a 0-10 scale every 10 min and received incremental doses of morphine until pain intensity was < or =4 of 10. Pain intensity levels were similar in both groups. The magnet group had on average 0.04 U more pain intensity (95% confidence interval, -0.4 to 0.5) than the sham group. Opioid requirements also were similar in both groups. The active magnet group required 1.5 mg more morphine (95% confidence interval, -1.8 to 4.0) than the sham magnet group. Magnetic therapy lacks efficacy in controlling acute postoperative pain intensity levels or opioid requirements and should not be recommended for pain relief in this setting.

Oxigenoterapia hiperbárica para infecciones necrotizantes de partes blandas / Hyperbaric oxygenotherapy for necrotizing infections of soft parts

Introducción: La Oxigenoterapia Hiperbárica (OHB) se ha convertido en el tratamiento de elección de numerosas patologías. Sin embargo, su rol en el tratamiento de las Infecciones Necrotizantes de partes blandas (INPB) es aún controvertido.Objetivo: Evaluar el beneficio de la Oxigenoterapia Hiperbárica (OHB) en el tratamiento de las Infecciones Necrotizantes de partes blandas (INPB).Método: Retrospectivo, revisión de historias clínicas y seguimiento de los casos. Durante el período de Enero 1996 a Diciembre2002, una población de 42 pacientes con INPB, se categorizó las lesiones de acuerdo a profundidad según la clasificación de Ámsterdam y se los dividió en 2 grupos: el grupo I (n = 18) que completó el protocolo de 10 sesione de OHB de 60 minutos cada una a 2.5 atmósferas absolutas (ATA), iniciando el 1º día del postoperatorio y el grupo II (n = 24) que no lo completó. En todos los casos se realizó desbridamiento quirúrgico precoz y antibioticoterapia.Resultado: En el grupo I hubo 12 (66.6%) recuperaciones completas, 5 (27.7%) secuelas leves y 1 (5.7%) grave, en el grupo II hubo 5 (20.8%) recuperaciones completas, 8 (33.4%) secuelas leves y 5 (20.8%) graves. La flora patógena fue en el 85.7% de los casos polimicrobiana. La mortalidad global fue del 25%, todos del grupo II.Conclusión: Se observó una relación inversamente proporcional entre el número de sesiones de OHB y la morbimortalidad. La OHB fue beneficiosa en esta serie como tratamiento complementario a la cirugía y los antibióticos.

[Reduction of HIV mother-to-child transmission in Colombia, two years of experience, 2003-2005]. / Reducción de la transmisión madre hijo del VIH en Colombia: dos años de experiencia nacional, 2003-2005.

INTRODUCTION: A national initiative on reduction of HIV mother-to-child-transmission is being implemented since 2003 in Colombia, including HIV counseled and voluntary testing as part of the routine antenatal care, comprehensive care with ARV treatment to HIV-positive pregnant women and their infected children, caesarian delivery, and replacement of breast milk. OBJECTIVE: To describe the achievements in the implementation of the prevention strategy of mother-to-child HIV transmission, 2003-2005. MATERIALS AND METHODS: The implementation procedures of the Project are described, as well as the coverage percentages achieved, the prevention of vertical transmission and its associated factors, and the six-month prevalence by geographical departments. The probability of transmission adjusted to the ARV treatment offered and the differences by regions are also analyzed. RESULTS: The Project was implemented in 757 municipalities (68%); diagnostic tests were performed to 200,853 pregnant women, 377 of whom were diagnosed as HIV positive (0.19%), with higher prevalences in the Caribbean region, and in the Departments of Quindio and Santander. Complete six-month follow-up after delivery was provided to 285 women and their neonates (12 of whom were HIV-positive). The probability of transmission with the use of ARV schemes during pregnancy (n=170) was 1.78% (IC 95%: 0.37-5.13%). Factors related to probability of transmission were: initial viral load > 10,000/mm3, absence of antenatal care, and late recruitment of pregnant women. No statistical differences were found between the ARV schemes used. In the Caribbean region, antenatal care was lower, and late recruitment of pregnant women was higher. CONCLUSIONS: Reduction of HIV mother-to-child-transmission is an effective preventive intervention, which also strengthens the quality of antenatal care services. Sustainability of this initiative, with nationwide coverage, must be a target for national and regional public health authorities, and for health care providers.

AChE-rich magnopyramidal neurons have a left-right size asymmetry in Broca's area.

Acetylcholinesterase-rich neurons (AChERN) are a particular group of pyramidal neurons, displaying a specific laminar and ontogenetic pattern in the cerebral cortex of human and nonhuman primates. Using histochemistry and morphometrical methods, we have found a layer 3 magnopyramidal AChERN left-right size asymmetry restricted to Brodmann's area 45, a component of Broca's language area. This structural feature could be related to functional lateralization associated to syntactic processing and phonological working memory, and is consistent with a non-cholinergic role of AChE possibly linked to neuroplastic processes in the human neocortex.