Exploration of photoprotective and antibiotic activity of wild Polypodiaceae ferns from Costa Rica.

Skin disorders affect millions of people all over the world. There are limited options to treat dermal illnesses such as vitiligo, psoriasis, and atopic dermatitis (eczema). Central American ferns are a potential source of bioactive metabolites against those diseases. Currently, Polypodium leucotomos Poir. is the only one being commercially utilized for this purpose. In this work, we evaluated the concentration of the skin bioactive compounds: quinic and chlorogenic acid, in the extract of 20 wild ferns from Costa Rica. We also evaluated the antimicrobial capabilities of the crude extracts of wild ferns and the sun protection factor (SPF) of the extracts. We found 19 out of 20 have either an important concentration of the compounds mentioned above or antimicrobial properties. Also, most samples result in higher SPF than P. aureum's rhizome. We also have studied the fern acclimatization, at different shading conditions, finding a significant influence of the culturing conditions on metabolite production. After acclimatization. So far, we demonstrate that various ferns included in this study are a potential source of treatments for skin conditions.

Ecotoxicity of pesticide formulations and their mixtures: the case of potato crops in Costa Rica.

Despite their environmental implications, ecotoxicological information regarding pesticide mixtures is relatively scarce. This study aimed to determine the ecotoxicity of individual pesticide formulations and their mixtures (insecticides and fungicides), which are applied during the production cycle of potato, according to agricultural practices from a Latin American region in Costa Rica. Two benchmark organisms were employed: Daphnia magna and Lactuca sativa. First, the evaluation of individual formulations (chlorothalonil, propineb, deltamethrin+imidacloprid, ziram, thiocyclam and chlorpyrifos) revealed differences between available EC50 for active ingredients (a.i.) and their respective formulations toward D. magna; on the contrary, no information could be retrieved from scientific literature for comparison in the case of L. sativa. In general, acute toxicity was higher toward D. magna than L. sativa. Moreover, interactions could not be determined on L. sativa, as the chlorothalonil formulation was not toxic at high levels and the concentration-response to propineb could not be fitted to obtain an IC50 value. The commercial formulation composed of deltamethrin+imidacloprid followed the concentration addition model (when compared with parameters retrieved from individual a.i.) and the other three mixtures evaluated (I: chlorothalonil-propineb-deltamethrin+imidacloprid; II: chlorothalonil-propineb-ziram-thiocyclam; III: chlorothalonil-propineb-chlorpyrifos) produced an antagonistic effect on D. magna, thus suggesting less acute toxicity than their individual components. Subsequent chronic studies showed that one of the most toxic mixtures (II) negatively affected D. magna reproduction at sublethal concentrations indicating that this mixture poses a risk to this species if these pesticides co-exist in freshwater systems. These findings provide useful data to better estimate the impact of real agricultural practices related to the use of agrochemicals.

Atención integral por cuidados paliativos para pacientes con ventilación mecánica asistida SARS-CoV-2 severos y sus beneficios / Comprehensive care for palliative care for patients with severe SARS-CoV-2 assisted mechanical ventilation and its benefits

Resumen Objetivo. Esta investigación tiene como objetivo describir la población atendida y los beneficios del programa "Lineamiento de atención integral por Cuidados Paliativos en el Área de Salud de Palmares, para pacientes con SARS-CoV-2 severo" con ventilación mecánica asistida, hospitalizados en unidades de cuidados intensivos de la Caja Costarricense del Seguro Social durante la pandemia en Costa Rica, del 10 de junio al 31 de octubre del 2021. Métodos. Estudio descriptivo mixto de la población y los beneficios del programa por medio de indicadores cuantitativos obtenidos del informe de aplicación y cualitativos a través de la realización de una encuesta de satisfacción a usuarios en el período de estudio. Resultados. El programa atendió a 13 pacientes, brindó apoyo en manejo del duelo a los familiares de cinco pacientes que ya habían fallecido y a los cuidadores de ocho pacientes hospitalizados, también ofreció 70 consultas médicas en un período promedio de 62 días. La edad promedio de los pacientes fue de 55 años; doce pacientes presentaban algún factor de riesgo, siendo la obesidad y la falta de esquema de vacunación completo (dos dosis) los más frecuentes. Durante la implementación del programa fallecieron cinco pacientes más, obteniendo una tasa de mortalidad del 78%. A los pacientes que sobrevivieron se les atendió en promedio por 135 días. Con el apoyo del equipo, los pacientes lograron la recuperación clínica de las complicaciones respiratorias y funcionales. Lograron independencia total de actividades básicas de la vida diaria y reinserción social en menos de tres meses después del alta hospitalaria. En general, se documentó una percepción positiva del programa en el 100% de los usuarios, con cambios en el nivel de sufrimiento manifestado por las familias y el apoyo en el manejo del duelo. Conclusión. Con la optimización de uso de los recursos ya existentes en la Caja Costarricense del Seguro Social y la participación social, este programa abordó aspectos no atendidos previamente para los pacientes que sufrieron COVID 19 severo, como el manejo del sufrimiento y/o duelo durante la hospitalización y al egreso. Además, el programa colaboró en la recuperación clínica y funcional de los usuarios sobrevivientes y documentó múltiples beneficios percibidos por el paciente, sus familias, la institución y la sociedad, como el abordaje del sufrimiento, la adecuada atención al duelo, la organización de los recursos asistenciales y la pronta recuperación física, emocional y social del paciente sobreviviente.

Abstract Aim. This research aims to describe the population served and the benefits of the program "Guidelines for integral care for patients with severe SARS-CoV-2 by Palliative Care at the Area de Salud de Palmares " to patients with assisted mechanical ventilation, hospitalized in intensive care units of the Caja Costarricense del Seguro Social during the pandemic in Costa Rica, from June 10 to October 31, 2021. Methods. This study is a mixed descriptive investigation that analyzes quantitative indicators from the report on the program's application and qualitative indicators from a satisfaction survey for the users in the study period. Results. The program treated 13 patients, provided grief management support to the relatives of five patients who had already died and to the caregivers of eight hospitalized patients, and offered 70 medical consultations in an average period of 62 days. The average age of the patients was 55 years; twelve patients had some risk factors, and obesity and lack of a complete vaccination schedule (two doses) were the most frequent. During the program implementation, five more patients died, obtaining a mortality rate of 78%. The average treatment day for surviving patients was 135 days. Through the team's support, patients accomplished clinical recovery from respiratory and functional complications. They got independent basics activities of daily living and social reintegration in less tan three months after discharge. A positive perception of the program was documented in 100% of the program's users, with changes in the level of suffering manifested by the families and the support in grief management. Conclusion. With the optimization of the use of existing resources in the the Caja Costarricense del Seguro Social and the social participation, this program addressed aspects not previously attended to patients who suffered severe COVID 19, such as the management of suffering and/or grief during hospitalization and upon discharge. In addition, the program helped in the clinical and functional recovery of the surviving users, and documented multiple benefits perceived by the patient, their families, the institution, and society, such as the approach to suffering, adequate bereavement care, organization of care resources, and early physical, emotional and social recovery of the survivor patient.

Integrated surveillance strategy to support the prevention of neural tube defects through food fortification with folic acid: the experience of Costa Rica.

PURPOSE: (1) To describe how Costa Rica implemented an integrated surveillance strategy of folate deficiency, neural tube defects (NTDs) prevalence, NTDs-associated infant mortality rate (NTDs-IMR), and folic acid food fortification (FAFF), to support with evidence NTDs prevention policies; (2) to disseminate updated data from monitoring programs. METHODS: We performed a cross-sectional analysis, using the databases of national surveillance systems for NTDs outcomes to compare NTDs-prevalence and NTDs-IMR observed in the pre-fortification (1987-1998) and post-fortification (2010-2020) periods. In addition, using data from FAFF monitoring program (2010-2020), means of folic acid concentration (mg/kg) and folic acid daily intake (µg/day) were calculated for each fortified food (corn and wheat flour, rice and milk), as well as its contribution to folic acid estimated average requirement (EAR). RESULTS: After FAFF Costa Rica showed a decrease of 84% in folic acid deficiency in women of childbearing age, as well as a 53% decrease in the prevalence of NTDs, falling from 11.82/10,000 to 5.52/10,000 livebirths. In addition, there was a 76% reduction in the NTDs-IMR from 77.01/100,000 to 18.66/100,000 livebirths. Between 2010 and 2020, all fortified foods provided an average contribution of 119% of the EAR of folic acid in the population. CONCLUSION: To reduce NTD risk, an integrated surveillance strategy is essential not only to base prevention strategies on evidence, but also to demonstrate their impact and improve interventions over time. The experience in Costa Rica provides evidence that this type of surveillance is feasible to be implemented in developing countries.

QTOF-ESI MS Characterization and Antioxidant Activity of Physalis peruviana L. (Cape Gooseberry) Husks and Fruits from Costa Rica.

There is increasing interest in research of secondary metabolites from Physalis peruviana (Cape gooseberry) because of their potential bioactivities. In this study, the profile of compounds found in fruits and husks from Costa Rica was determined through ultra-performance liquid chromatography coupled with high-resolution mass spectrometry using a quadrupole time-of-flight analyzer (UPLC-ESI-QTOF MS) on extracts (n = 10) obtained through pressurized liquid extraction (PLE) conditions. In total, 66 different compounds were identified, comprising 34 withanolides, 23 sucrose ester derivatives and 9 flavonoids. UPLC-DAD analysis was performed to determine the ß-carotene in fruits and to quantify the flavonoids in all 10 samples, with the results showing higher contents in samples from the Dota region (58.6−60.1 µg/g of dry material versus 1.6−2.8 mg/g of dry material). The Folin−Ciocalteau total polyphenolic content (FC) and antioxidant activity using the DPPH method showed better results for the husk extracts, with the ones from the Dota region holding the best values (4.3−5.1 mg GAE/g of dry material versus IC50 = 1.6−2.3 mg of dry material/mL). In addition, a significant negative correlation was found between the RU, FC and DPPH values (r = −0.902, p < 0.05), aligning with previous reports on the role of polyphenols in antioxidant activity. Principal correlation analysis (PCoA) and hierarchical clustering (HC) analysis were performed on HRMS results, and they indicated that the D1 and D2 fruit samples from the Dota region were clustered with husks related to a higher presence of the analyzed metabolites. In turn, principal component analysis (PCA) performed on the flavonoid content and antioxidant activity yielded results indicating that the D1 and D2 husks and fruit samples from the Dota region stood out significantly, showing the highest antioxidant activity. In summation, our findings suggest that P. peruviana husks and fruits from Costa Rica constitute a substrate of interest for further studies on their potential health benefits.

Vitamin E and carotenoid profiles in leaves, stems, petioles and flowers of stinging nettle (Urtica leptophylla Kunth) from Costa Rica.

BACKGROUND: Local leafy vegetables are gaining attention as affordable sources of micronutrients, including vitamins, pro-vitamin carotenoids and other bioactive compounds. Stinging nettles (Urtica spp.) are used as source of fibers, herbal medicine and food. However, despite the relatively wide geographical spread of Urtica leptophylla on the American continent, little is known about its content of vitamin E congeners and carotenoids. We therefore investigated the particular nutritional potential of different plant structures of wild Costa Rican U. leptophylla by focusing on their vitamin E and carotenoid profiles. RESULTS: Young, mature and herbivore-damaged leaves, flowers, stems and petioles were collected and freeze-dried. Vitamin E and carotenoids were determined by high-performance liquid chromatography after liquid/liquid extraction with hexane. α-Tocopherol was the major vitamin E congener in all structures. Flowers had a high content of γ-tocopherol. Herbivore-damaged leaves had higher contents of vitamin E than undamaged leaves. Lutein was the major and ß-carotene the second most abundant carotenoid in U. leptophylla. No differences in carotenoid profiles were observed between damaged and undamaged leaves. CONCLUSION: The leaves of U. leptophylla had the highest nutritional value of all analyzed structures; therefore, they might represent a potential source of α-tocopherol, lutein and ß-carotene. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Medicinal plants cultivated in urban home gardens in Heredia, Costa Rica.

BACKGROUND: Urban ethnobotanical research in Costa Rica is rather rare and home gardens are poorly studied so far. Investigating their biodiversity is crucial in gathering knowledge on the uses of this particular flora, especially related to the owners' health. This study therefore explores the diversity and knowledge of medicinal plants of private garden owners from three different urban neighborhoods in Heredia, Costa Rica, an thus far understudied area. METHODS: Semi-structured interviews (n = 61) were conducted with garden owners in three socioeconomically different urban neighborhoods (Central Heredia, Maria Auxiliadora and Bernardo Benavides). Information was collected about medicinal plants cultivated in the garden, treatments, plant part used and mode of administration. All species were identified and their geographical origin was determined. This information was then compared with the available regional and local (ethno)pharmacopoeias to detect possible newly documented uses. RESULTS: The majority or 90% of garden owners who also held knowledge on medicinal plants species were women (n = 30) of all ages (between 26 and 85 years old). A list of 27 species of medicinal plants was obtained from the participants of three urban neighborhoods. In Central Heredia, 74% (n = 20) of the total species were present, in Maria Auxiliadora 33% (n = 9) and in Bernardo Benavides 56% (n = 15). Most plant species were used by the participants to treat respiratory problems (11 spp.), hair and skin problems (9 spp.) and digestive disorders (8 spp.). Some plants were used to treat multiple ailments (10 spp.). About a third of all species (n = 8) were used by the participants to treat disorders that were not indicated in the regional and local pharmacopoeias. More specifically, Aloe saponaria, Blechum pyramidatum, Costus scaber, Impatiens walleriana, Lippia alba, Tradescantia zebrina, Psidium friedrichsthalianum and Solenostemon scutellarioides used for medicinal purposes by the participants were not found in the above-mentioned resources. CONCLUSIONS: The present study provides new information about the use of medicinal plants in a thus far understudied urban area in Costa Rica. We documented new medicinal uses for several plants listed in the regional and local pharmacopoeias as well as for plants not previously reported in an urban environment. In general, there is little information about the types of plants used for medicinal purposes in urban ecosystems in Costa Rica. Although the country has a high endemic diversity of plants, many exotic medicinal plant species were introduced by the Spaniards during the colonization and by Afro-Costa Rican descendants. The present results thus show how the diversity of the medicinal plants used by these garden owners' confirms a socioeconomic gradient and reflects both Costa Rica's colonial history as well as the current epidemiological profile of the country. These findings underline the need for more ethnobotanical research in urban areas in Costa Rica.

HRMS Characterization, Antioxidant and Cytotoxic Activities of Polyphenols in Malus domestica Cultivars from Costa Rica.

There is increasing interest in research into fruits as sources of secondary metabolites because of their potential bioactivities. In this study, the phenolic profiles of Malus domestica Anna and Jonagold cultivars from Costa Rica were determined by Ultra Performance Liquid Chromatography coupled with High Resolution Mass Spectrometry (HRMS) using a quadrupole-time-of-flight analyzer (UPLC-QTOF-ESI MS), on enriched-phenolic extracts from skins and flesh, obtained through Pressurized Liquid Extraction (PLE). In total, 48 different phenolic compounds were identified in the skin and flesh extracts, comprising 17 flavan-3-ols, 12 flavonoids, 4 chalcones, 1 glycosylated isoprenoid and 14 hydroxycinnamic acids and derivatives. Among extracts, the flesh of Jonagold exhibits a larger number of polyphenols and is especially rich in procyanidin trimers, tetramers and pentamers. Evaluating total phenolic content (TPC) and antioxidant activities using ORAC and DPPH procedures yields higher values for this extract (608.8 mg GAE/g extract; 14.80 mmol TE/g extract and IC50 = 3.96 µg/mL, respectively). In addition, cytotoxicity evaluated against SW620 colon cancer cell lines and AGS gastric cancer cell lines also delivered better effects for Jonagold flesh (IC50 = 62.4 and 60.0 µg/mL, respectively). In addition, a significant negative correlation (p < 0.05) was found between TPC and cytotoxicity values against SW620 and AGS adenocarcinoma (r = -0.908, and -0.902, respectively). Furthermore, a significant negative correlation (p < 0.05) was also found between the number of procyanidins and both antioxidant activities and cytotoxicity towards SW620 (r = -0.978) and AGS (r = -0.894) cell lines. These results align with Jonagold flesh exhibiting the highest abundance in procyanidin oligomers and yielding better cytotoxic and antioxidant results. In sum, our findings suggest the need for further studies on these Costa Rican apple extracts-and particularly on the extracts from Jonagold flesh-to increase the knowledge on their potential benefits for health.

Polyphenolic QTOF-ESI MS Characterization and the Antioxidant and Cytotoxic Activities of Prunus domestica Commercial Cultivars from Costa Rica.

There is an increased interest in plum research because of their metabolites' potential bioactivities. In this study, the phenolic profiles of Prunus domestica commercial cultivars (Methley, Pisardii and Satsuma) in Costa Rica were determined by Ultra Performance Liquid Chromatography coupled with High Resolution Mass Spectrometry using a quadrupole-time-of-flight analyzer (UPLC-ESI-QTOF MS) on enriched phenolic extracts obtained through Pressurized Liquid Extraction (PLE) under acidic and neutral extraction conditions. In total, 41 different phenolic compounds were identified in the skin and flesh extracts, comprising 11 flavan-3-ols, 14 flavonoids and 16 hydroxycinnamic acids and derivatives. Neutral extractions for the skins and flesh from all of the cultivars yielded a larger number of compounds, and were particularly rich in the number of procyanidin trimers and tetramers when compared to the acid extractions. The total phenolic content (TPC) and antioxidant potential using the DPPH and ORAC methods exhibited better results for neutral extracts with Satsuma skins and Methley flesh, which showed the best values (685.0 and 801.6 mg GAE/g extract; IC50 = 4.85 and 4.39 µg/mL; and 12.55 and 12.22 mmol TE/g extract, respectively). A Two-Way ANOVA for cytotoxicity towards AGS gastric adenocarcinoma and SW620 colon adenocarcinoma indicated a significant difference (p < 0.05) for PLE conditions, with better results for neutral extractions, with Satsuma skin delivering the best results (IC50 = 60.7 and 46.7 µg/mL respectively) along with Methley flesh (IC50 = 76.3 and 60.9 µg/mL, respectively). In addition, a significant positive correlation was found between TPC and ORAC (r = 0.929, p < 0.05), as well as a significant negative correlation (p < 0.05) between TPC and cytotoxicity towards AGS and SW620 cell lines (r = -0.776, and -0.751, respectively). A particularly high, significant, negative correlation (p < 0.05) was found between the number of procyanidins and cytotoxicity against the AGS (r = -0.868) and SW620 (r = -0.855) cell lines. Finally, the PCA clearly corroborated that neutral extracts are a more homogenous group exhibiting higher antioxidant and cytotoxic results regardless of the part or cultivar; therefore, our findings suggest that PLE extracts under neutral conditions would be of interest for further studies on their potential health benefits.

Starchy Vegetables and Metabolic Syndrome in Costa Rica.

Only a few studies primarily examined the associations between starchy vegetables (other than potatoes) and metabolic syndrome (MetS). We aimed to evaluate the association between starchy vegetables consumption and MetS in a population-based sample of Costa Rican adults. We hypothesized that a higher overall intake of starchy vegetables would not be associated with higher MetS prevalence. In this cross-sectional study, log-binomial regression models were used to estimate prevalence ratios (PRs) of MetS across quintiles of total, unhealthy, healthy starchy vegetables, and individual starchy vegetables (potatoes, purple sweet potatoes, etc.), among 1881 Costa Rican adults. Least square means and 95% confidence intervals (CIs) from linear regression models were estimated for each MetS component by categories of starchy vegetable variables. Higher intakes of starchy vegetables were associated with a higher prevalence of MetS in crude models, but no significant trends were observed after adjusting for confounders. A significant inverse association was observed between total starchy and healthy starchy vegetables consumption and fasting blood glucose. In this population, starchy vegetables might be part of a healthy dietary pattern.

Prevalencia de la deficiencia de vitamina D en niños de Costa Rica / Prevalence of vitamin D deficiency in Costa Rican children

Abstract Objective: To determine the prevalence of vitamin D deficiency in children in the South- Central Region of Costa Rica. Methods: A cross-sectional study was performed with Costa Rican children aged 1-7 years from the South-Central Region of the country belonging to the Nutrition and Education Centers and Children's Nutrition and Comprehensive Care Centers. Serum samples were collected from all participants between August 2014 and May 2016 and stored at -80 ° C. Vitamin D status was assessed by immunoassay on an ARCHITECT Plus i1000 instrument. Descriptive statistics were performed with the SPSS statistical software package (V20, IBM Corp). A value of p˂0.05 was considered significant. Spearman and Pearson correlation were also performed to study the association between vitamin D status, anthropometric and hematological variables. Results: Atotal of 428 sampleswere analyzed.According to the cut-off points establishedby the Endocrine Society, 4.9% of the children tested presented deficiency, 50.2% had insufficiency and 44.9% had vitamin D sufficiency. The mean concentration of 25-hydroxyvitamin D in the studied population was 29.7 ng/mL (SD 6.5) in boys and 29.8 ng/mL (SD 7.0) in girls. A high prevalence of hypovitaminosis D (55.1 %) was found, but only 7.9 % of the children presented 25-hydroxyvitamin D ≤ 20 ng/mL. No correlation was found between vitamin D status and any of the evaluated anthropometric or hematological variables. Conclusions: More than half of the young population presented hypovitaminosis-D. Therefore, in order to overcome this situation, the recommendation is to supplement the population with vitamin D and improve its fortification in widespread accessible food in Costa Rica.

Resumen Objetivo: Determinar la prevalencia de la deficiencia de vitamina D en niños de la Región Central Sur de Costa Rica. Métodos: Se realizó un estudio transversal con niños de 1-7 años de la Región Central Sur de Costa Rica pertenecientes a los Centros de Educación y Nutrición y Centros de Atención Integral y Nutrición Infantil. Se recolectaron muestras de suero de todos los participantes entre agosto de 2014 y mayo de 2016 y se almacenaron a -80 ° C hasta su uso. Se evaluó las concentraciones de vitamina D mediante un inmunoensayo con el instrumento ARCHITECT Plus i1000. Los análisis estadísticos descriptivos se realizaron con el paquete de software estadístico SPSS (V20, IBM Corp). Se consideró significativo un valor de p <0,05. También se realizó la correlación de Spearman y Pearson para estudiar la asociación entre el estatus de vitamina D con variables antropométricas y hematológicas. Resultados: Se analizaron un total de 428 muestras. Un 4,9% de los niños presentaban deficiencia, 50,2% insuficiencia y el 44,9% suficiencia de vitamina D, según los puntos de corte establecidos por Endocrine Society. La concentración media de 25-hidroxi vitamina D en la población estudiada fue de 29,7 ng/mL (DE 6,5) en niños y de 29,8 ng/ mL (DE 7,0) en niñas. Se encontró una alta prevalencia de hipovitaminosis D (55,1%), pero solo el 7,9% de los niños presentó 25- hidroxi vitamina D ≤ 20 ng/mL. No se encontró correlación del estatus de vitamina D con ninguna de las variables antropométricas o hematológicas evaluadas. Conclusiones: Más de lamitad de la población infantil evaluada presentó hipovitaminosis D. Por lo tanto, se recomienda suplementar y mejorar la fortificación con vitamina D en alimentos ampliamente accesibles en la población costarricense.

La escucha psicoanalítica y los recursos psicodramáticos en un grupo de hombres que experimentaron violencia infantil en Costa Rica / The Psychoanalytic Listening and the Psychodramatic Techniques in a Group of Men Who Experienced Childhood Violence in Costa Rica

Resumen Objetivo. Sistematizar los aportes de la escucha analítica con elementos psicodramáticos y corporales en un grupo de hombres que experimentaron violencia durante su infancia. Método. Sistematización y análisis por categorías temáticas, a partir de observación participante, registros escritos y de audio, del discurso verbal y corporal de 9 hombres en un grupo de terapia psicoanalítica con técnicas psicodramáticas. Resultados. Se concluye que la violencia promueve una relación de maltrato con el propio sujeto y la experiencia de dolor es inscrita en el cuerpo como posibilidad de expresión. El abordaje grupal facilitó la reelaboración del sufrimiento psíquico mediante el uso del cuerpo para reconocer y verbalizar emociones de la escena traumática en un encuentro de subjetividades.

Abstract Objective. Systematize the contributions of the psychoanalytic clinic with psychodramatic and body techniques in a group of men who experienced violence in their childhood. Method. Systematization and analysis by theme categories, based on participant observation, written and audio recording, from the verbal and body speech of nine men in psychoanalytic group therapy by using psychodramatic techniques. Results. In conclusion, violence promotes an abusive relationship with the person himself, and the experience of pain is inscribed in the body as a possibility of expression. The group approach facilitated the reworking of psychic suffering through the body to recognize and verbalize emotions from the traumatic scene in an encounter of subjectivities.

The inguinal hernia management in Costa Rica according to a survey between surgeons: result comparison with 2018 International Groin Hernia Guidelines.

BACKGROUND: Inguinal hernia surgery is a frequent procedure among general surgeons in Costa Rica, but the management and technique are not uniform. The International Guideline for Groin Hernia management was published in 2018 to standardize the inguinal hernia surgery, but the diffusion of the guidelines and its adherence have been extremely varied. PURPOSE: Collect and analyze the current reality regarding groin hernia management in Costa Rica. Secondly evaluate the diffusion and development comparing it to the guideline's recommendations. METHOD: Questionnaire of 42 single and multiple answer questions according to the topics of the International Guideline directed to general surgeons. Diffusion of the inquiry through surgical and hernia association chats and email. Timeframe June-December 2019. RESULTS: 64 surveys were collected, which is a representative number of the general surgeons national college. The most frequent procedure between these was the abdominal wall surgery. Every surgeon did more than 52 groin hernia surgeries in one year, most of them outpatients. The epidural anesthesia was used the most and Lichtenstein's technique was the most frequently used (64%). 68% of the surgeons know how to perform a minimally invasive inguinal hernia surgery but with variable volumes. 38% of participants considered themselves experts in groin hernia management and 52% did not know the 2018 International Guideline. The recommendations of such guideline are followed only partially. CONCLUSIONS: The 2018 Hernia Surge International Guidelines have low diffusion among Costa Rican surgeons. The laparoscopic approach is widely accepted but there are no studies to assess the results and the quality. There should be protocols and studies adapted to Costa Rica's national situation.

Anti-platelet activity and chemical characterization by UPLC-DAD-ESI-QTOF-MS of the main polyphenols in extracts from Psidium leaves and fruits.

In Costa Rica, two species of Psidium fruits, P. guajava and P. friedrichsthalianum, are widely consumed as food and used in folk medicine. Although studies have revealed the health effects of these fruits, there has been little research showing the antiplatelet activity of these species. This work evaluated the antiplatelet potential of aqueous extracts made from leaves and fruits of pink guava and Costa Rican guava. Platelet aggregation was induced by the platelet agonists ADP, TRAP-6, collagen and PMA. Platelet activation and secretion were studied using flow cytometry. The chemical profiles of the four extracts were characterized using UPLC-DAD-ESI-QTOF-MS. The studies revealed that the aqueous extracts of leaves and fruits of P. guajava and P. friedrichsthalianum inhibited platelet aggregation induced by ADP (4 µM), TRAP-6 (5 µM), collagen (1 µg mL-1) and PMA (100 nM), and the effect was dependent on the extract concentration. Extracts of leaves and fruits of pink guava and Costa Rican guava reduced secretion of P-selectin and activation of GP IIb/IIIa. The extracts of leaves and fruits of pink guava and Costa Rican guava proved to be a rich source of phenolic compounds, mainly quercetin aglycones and proanthocyanidins derived from (epi) catechin units. Other compounds such as ellagitannins, and benzophenones were also putatively identified. This research showed that P. guajava and P. friedrichsthalianum could potentially be used for the prevention of thrombotic events.

Testing a Proactive Model of Successful Aging Among Older Adults in Costa Rica and Spain.

The purpose of this study is to examine successful aging among Spanish-speaking older adults in Costa Rica and in Spain using the proactive framework proposed by Kahana et al. (2014). More specifically, we hypothesized that older adults' life satisfaction would be positively associated with the frequency and perceived level of social support, spirituality/having purpose in life, and the use of proactive physical, cognitive, and social self-care behaviors. Our results confirmed these hypotheses, not only for the overall group of participants, but also separately for older adults in Costa Rica and in Spain. The present study contributes to the literature of successful aging among older adults, by examining the protective factors associated with life satisfaction among Spanish speaking older adults in Costa Rica and in Spain. It identifies specific protective factors (spirituality/purpose in life, social support, and self-care) associated with the values and preferences held by participants in the study.

Conceptos y prácticas culturales de la medicina ancestral bribri y cabecar en Costa Rica / Concepts and Cultural Practices of Bribri and Cabecar Ancestral Medicine in Costa Rica

Este artículo reflexiona, en el contexto de la pandemia de COVID-19, sobre las prácticas sociales y culturales de la medicina tradicional de los pueblos originarios bribri ­ cabecar de Costa Rica para enfrentar las enfermedades contagiosas. Para lograr este objetivo, revisamos fuentes bibliográficas en antropología, lingüística e historia, pero sobre todo, volvimos a revisar las entrevistas que habíamos realizado durante muchos años a varios a médicos de los pueblos originarios, bribris y cabécares. Todo ello nos ha permitido descubrir que, muchas prácticas sociales y culturales, que prevalecen aún en estos dos pueblos originarios, esconden un complejo sistema de conceptos y protocolos médicos, que garantizan un saber hacer y un saber actuar ante enfermedades contagiosas. Conceptos como cuarentena, aislamiento, familiar o comunal, el tener cuidado de no tocar ciertos objetos, aparecen con total nitidez, en una concepción de mundo que privilegia la reflexión sobre la salud y la enfermedad.

This article reflects, in the context of the COVID-19 pandemic, on the social and cultural practices of the traditional medicine of the Bribri and Cabecar native peoples of Costa Rica in dealing with contagious diseases. In order to accomplish this objective, we reviewed bibliographic sources in Anthropology, Linguistics and History, but above all, we reviewed again the interviews we had done for many years, to various the people dedicated to medicine in the indigenous Bribri and Cabecar towns. All this has allowed us to discover that many social and cultural practices, which still prevail in the Bribri and Cabecar native peoples, hide a complex system of medical concepts and protocols, which guarantee a know-how and a knowledge of how to act in the face of contagious diseases. Concepts such as quarantine, isolation, family or communal, being careful not to touch certain objects, appear with total clarity, in a conception of the world that privileges reflection on health and illness.

Pitiriasis rubra pilaris tratada con lámpara excímero / Pityriasis rubra pilaris treated with excimer lamp

Resumen La pitiriasis rubra pilaris, es una dermatosis inflamatoria papuloescamosa e hiperqueratósica de origen desconocido y de progresión crónica, la cual puede evolucionar incluso a eritrodermia. El presente caso trata de un paciente de 27 años portador del virus de inmunodeficiencia humana, diagnosticado con pitiriasis rubra pilaris tipo IV, inicialmente tratado con corticosteroide tópico y fototerapia, por cuatro meses. Sin embargo, presentó reactivación de las lesiones, por lo que se recurrió a la aplicación de lámpara excímero, utilizada en otras patologías dermatológicas, mas no de uso habitual en la pitiriasis rubra pilaris.

Abstract Pityriasis Rubra Pilaris is an inflammatory papulosquamous and hyperkeratic dermatosis of unknown cause and chronic progression which can envolve even into erythroderma. This case deals with a 27-year old male patient carrier of VIH who was diagnosed with PRP type IV. Initially, it was treated with topical corticosteroid and phototherapy for four months. However, it showed reactivation of the injuries; therefore, excimer lamp was employed, which is used in other dermatologic pathologies but it is not a regular treatment for PRP type IV.

Taxonomic shifts in arbuscular mycorrhizal fungal communities with shade and soil nitrogen across conventionally managed and organic coffee agroecosystems.

The composition of arbuscular mycorrhizal fungal (AMF) communities should reflect not only responses to host and soil environments, but also differences in functional roles and costs vs. benefits among arbuscular mycorrhizal fungi. The coffee agroecosystem allows exploration of the effects of both light and soil fertility on AMF communities, because of the variation in shade and soil nutrients farmers generate through field management. We used high-throughput ITS2 sequencing to characterize the AMF communities of coffee roots in 25 fields in Costa Rica that ranged from organic management with high shade and no chemical fertilizers to conventionally managed fields with minimal shade and high N fertilization, and examined relationships between AMF communities and soil and shade parameters with partial correlations, NMDS, PERMANOVA, and partial least squares analysis. Gigasporaceae and Acaulosporaceae dominated coffee AMF communities in terms of relative abundance and richness, respectively. Gigasporaceae richness was greatest in conventionally managed fields, while Glomeraceae richness was greatest in organic fields. While total AMF richness and root colonization did not differ between organic and conventionally managed fields, AMF community composition did; these differences were correlated with soil nitrate and shade. OTUs differing in relative abundance between conventionally managed and organic fields segregated into four groups: Gigasporaceae associated with high light and nitrate availability, Acaulosporaceae with high light and low nitrate availability, Acaulosporaceae and a single relative of Rhizophagus fasciculatus with shade and low nitrate availability, and Claroideoglomus/Glomus with conventionally managed fields but uncorrelated with shade and soil variables. The association of closely related taxa with similar shade and light availabilities is consistent with phylogenetic trait conservatism in AM fungi.

Isolation and characterization of microsatellites for the neotropical dioecious palm Chamaedorea tepejilote (Arecaceae) and cross-amplification in other Chamaedorea species.

Palms are important components of tropical and subtropical ecosystems and have even been considered keystone plant resources that can support a large array of pollinators and frugivores. Palms are also economically important. Chamaedorea tepejilote Liebm. is a widely distributed palm with important bioeconomic potential for food, traditional medicine and ornamental purposes. Eighteen microsatellite primers were developed for C. tepejilote. Polymorphism and genetic diversity were evaluated in 71 individuals from four populations in Costa Rica. Thirteen loci were polymorphic and the number of alleles in the pooled sample ranged between 5 and 20, the average number of alleles was 10.61. Average observed heterozygosity was Ho = 0.607 ± 0.04 (SD) and the average expected heterozygosity was He = 0.600 ± 0.03. The exclusion probability of the combined 13 loci, was PE = 0.998. We tested transferability of the markers in the congeneric C. costaricana, C. pinnantifrons and C. macrospadix. Dioecious species are common in tropical forests; however, few studies have analyzed gene flow patterns in these species. The markers developed for C. tepejilote are an important tool to quantify gene flow patterns and the distribution of genetic diversity within populations. This information will be useful for the development of conservation and management practices of this dioecious tropical palm species.

Las Bibliotecas públicas como promotoras del envejecimiento activo saludable / Public libraries as promoters of healthy and active elderliness

Resumen Las bibliotecas públicas son por excelencia, las organizaciones que reciben y trabajan con la población adulta mayor. Se presenta un proyecto desarrollado en la Escuela de Bibliotecología y Ciencias de la Información, de la Universidad de Costa Rica, cuyo objetivo general fue desarrollar estrategias lúdico-creativas, para promover la alfabetización informacional en salud en la población adulta y adulta mayor, desde las bibliotecas públicas. Es una investigación cualitativa, en que se aplicó la investigación acción. Los resultados alcanzados muestran que después de la aplicación de talleres lúdico-creativos, las personas adultas mayores aumentaron su conocimiento, interés y destreza en ellos. Así mismo se logró fomentar las relaciones intergeneracionales, pues los talleres fueron desarrollados por estudiantes de Trabajo Comunal Universitario.

Abstract Public libraries are par excellence, the organizations that receive and work with the elderly population. The following is a project developed by the School of Library and Information Sciences of the University of Costa Rica whose general objective was to develop ludic and creative-based strategies to promote informational alphabetization and health in adults and the elderly population from the public libraries. It was a qualitative action-research investigation. Results evince an increase in interest, knowledge, and skills amongst the elderly after the implementation of the ludic and creative workshops. At the same time, it was feasible to promote intergenerational relations since the workshops were implemented by students as part of their Communal University Work.