Trachoma Rapid Assessments in Venezuela, an Example of the Integration of Data Gathering with Service Delivery in Hard-to-reach Populations.

A) PURPOSE: The objective of the study was to assess the presence of trachoma in high priority districts in the Amazon state of Venezuela (the Bolivarian Republic of), and use trachoma data gathering platform to offer integrated primary health care services to underserved hard-to-reach populations living in the border with Colombia. B) METHODS: Trachoma Rapid Assessments (TRA) were conducted in indigenous communities of three municipalities of the Amazonas State of Venezuela from June 2018 to April 2019 using the World Health Organization (WHO) guidelines. Integrated health services were delivered based on the identified needs of the population of the assessed communities. C) RESULTS: 1,185 children aged 1-9 years were examined for trachoma in the three municipalities, of which 6.92% had active trachoma; 994 people 15 years and above were examined for trachomatous trichiasis (TT) finding two cases (0.2%). 1,635 people were examined for other health-related problems and the most common diagnoses were intestinal parasites (54.74%), eye diseases (16.81%), cavities (7.34%), scabies (5.56%), headache (4.40%), and malaria (2.81%); additionally, 2,233 vaccine doses were provided to children and adults to complete vaccination series. D) CONCLUSION: The results of the TRA in the Amazon state of Venezuela suggest that trachoma could be a public health problem and standardized population-based surveys to establish the prevalence and determine the interventions to implement are needed.

El Quigong en la intervención de la depresión, la ansiedad, y el estrés psicológico laboral / The Quigong in the intervention of depression, anxiety, and psychological stress at work

El impacto de los dramáticos cambios multidimensionales ocasionado por la globalización genera un proceso histórico crítico que impacta al tejido social, sometiendo a muchas poblaciones, a un deterioro de su calidad de vida y de sus posibilidades de acceso a la atención sanitaria. Asimismo están expuestos a tensiones crónicas que pueden desbordar las capacidades y mecanismos de adaptación de las personas. La Medicina Tradicional China tiene más de 5.000 años de práctica empírica y abarca cinco componentes: fitoterapia, dietética, masajes, acupuntura y el Quigong. Su rol terapéutico ha sido reconocido por la OMS, quien ha diseñado estrategias para promover su integración al sistema sanitario de todos los países. Se eligió el componente Quigong para revisar trabajos científicos donde se implementaron sus prácticas en el tratamiento de la Depresión, la Ansiedad y el Estrés psicológico laboral. Los resultados de los estudios revisados concluyeron que existen evidencias significativas de que el Quigong puede mejorar la clínica de pacientes con diagnóstico de Depresión, Ansiedad y estrés laboral. Asimismo, los autores de los trabajos realizados coinciden en la necesidad de proseguir la línea de investigación relativa a las aplicaciones del Quigong como terapia preventiva y curativa en estrés psicológico, ansiedad y depresión.

The impact of the dramatic multidimensional changes caused by globalization generates a critical historical process that impacts the social fabric, subjecting many populations to a deterioration in their quality of life and their possibilities of access to health care. They are also exposed to chronic tensions that can overwhelm people's capacities and adaptation mechanisms. Traditional Chinese Medicine has more than 5.000 years of empirical practice and includes five components: phytotherapy, dietetics, massage, acupuncture and Quigong. Its therapeutic role has been recognized by the WHO, which has designed strategies to promote its integration into the health system of all countries. The Quigong component was chosen to review scientific works where its practices were implemented in the treatment of Depression, Anxiety and Occupational Psychological Stress. The results of the studies reviewed concluded that there is significant evidence that Quigong can improve the clinic of patients diagnosed with Depression, Anxiety, and occupational stress. Likewise, the authors of the works carried out agree on the need to continue the line of research regarding the applications of Quigong as preventive and curative therapy in psychological stress, anxiety and depression.

Clinical and epidemiological characterization of patients with psoriasis and the prescription of biological therapy in Venezuela: a cross-sectional study. / Caracterización clínica y epidemiológica de pacientes con psoriasis y prescripción de terapia biológica en Venezuela: estudio transversal.

INTRODUCTION: Psoriasis is a chronic disease that affects the skin. One hundred twenty-five million people around the world suffer from this condition. In specific groups of patients, the joints may also be involved. To control and follow-up patients with psoriasis, psoriasis area severity and dermatological quality of life measurements were established. Both parameters are necessary for the initiation of biological therapy, as specified in the psoriasis management guide (2015) of the national committee of rheumatological, immunological, and bone metabolism diseases of the Venezuelan Institute of Social Security. OBJECTIVE: To characterize the clinical and epidemiological variables and the prescription of biological therapy in patients with psoriasis who access the high-cost dispensing program of the Venezuelan Institute Social Security (IVSS) pharmacy. METHODS: This is a descriptive, cross-sectional study. RESULTS: A total of 374 patient records were assessed. The male gender was more frequent, with 56.1% (p <0.001), mostly from Caracas city. In comparing age groups with sex, a difference among these was observed (p <0.05). 57.5% previously used methotrexate, 6.68% biological, 3.2% topical steroids, and 31% did not report which type of previous therapy they had received. Amongst the clinical presentations, 70% corresponded to plaque psoriasis. 79% of the patients presented moderate activity according to the Psoriasis Area and Severity Index (PASI): Eleven percent were assessed with the Dermatology Life Quality Index (DLQI); 39% of them reported an extremely important effect. The anergic range of the Mantoux test represented 70.9% of the cases, and 0.3% took the booster evaluation. Chest X-ray was reported normal in 95% of the cases. The most demanded biological medicine was etanercept, in 52% of the cases. CONCLUSIONS: Male gender and its association with psoriasis was an important finding. The need to improve the administrative components in completing the medication request formats and strengthen clinical measurements and good medical practice was also found.

INTRODUCCIÓN: La psoriasis es una enfermedad crónica que compromete la piel, padecida por cerca de 125 millones de personas en todo el mundo. En un grupo determinado de pacientes, también puede afectar el sistema articular. Para el control y seguimiento de los pacientes con psoriasis se estableció la aplicación de los índices de severidad del área de psoriasis y de calidad de vida dermatológica. Ambos parámetros son necesarios para el inicio de terapia biológica, según lo establecido en la guía de manejo de psoriasis (2015) del comité nacional de enfermedades reumatológicas, inmunológicas y de metabolismo óseo del Instituto Venezolano de los Seguros Sociales. OBJETIVO: Caracterizar las variables clínicas, epidemiológicas y la prescripción de terapia biológica en los pacientes con psoriasis que acceden al programa de dispensación de alto costo de la farmacia del Instituto Venezolano de los Seguros Sociales. MÉTODO: Es un estudio descriptivo, transversal. RESULTADOS: Se evaluaron 374 expedientes, donde el sexo masculino fue más frecuente con 56,1% (p < 0,001), provenientes en su mayoría de la ciudad de Caracas, en la comparación de los grupos de edad con el sexo, se observó que existía una diferencia entre estos (p < 0,05). El 57,5% usó previamente metotrexato; 6,68% biológicos; 3,2% esteroides tópicos y 31% no reportó qué tipo de terapia previa recibía. Dentro de las presentaciones clínicas, 70% correspondió a la psoriasis en placa. El 79% de los pacientes presentaba actividad moderada según el índice de la severidad del área de psoriasis, y al 11% se les realizó el índice de calidad de vida dermatológica, de los cuales 39% presentaban un efecto extremadamente importante. El rango anérgico de la prueba de Mantoux representó 70,9% de los casos, donde al 0,3% le fue realizado la prueba de Booster, y la radiografía de tórax se reportó normal en 95%. El medicamento biológico más demandado fue el etanercept con 52% de los casos. CONCLUSIONES: El sexo masculino y su relación con la psoriasis fue un hallazgo de importancia, como también se evidenció la necesidad de mejorar los componentes administrativos en la gestión de los formatos de solicitud de medicamentos y fortalecer la aplicación de la clinimetría con elemento de buena práctica médica.

Caracterización clínica y epidemiológica de pacientes con psoriasis y prescripción de terapia biológica en Venezuela: estudio transversal / Clinical and epidemiological characterization of patients with psoriasis and the prescription of biological therapy in Venezuela: a cross-sectional study

Introducción La psoriasis es una enfermedad crónica que compromete la piel, padecida por cerca de 125 millones de personas en todo el mundo. En un grupo determinado de pacientes, también puede afectar el sistema articular. Para el control y seguimiento de los pacientes con psoriasis se estableció la aplicación de los índices de severidad del área de psoriasis y de calidad de vida dermatológica. Ambos parámetros son necesarios para el inicio de terapia biológica, según lo establecido en la guía de manejo de psoriasis (2015) del comité nacional de enfermedades reumatológicas, inmunológicas y de metabolismo óseo del Instituto Venezolano de los Seguros Sociales. Objetivo Caracterizar las variables clínicas, epidemiológicas y la prescripción de terapia biológica en los pacientes con psoriasis que acceden al programa de dispensación de alto costo de la farmacia del Instituto Venezolano de los Seguros Sociales. Método Es un estudio descriptivo, transversal. Resultados Se evaluaron 374 expedientes, donde el sexo masculino fue más frecuente con 56,1% (p < 0,001), provenientes en su mayoría de la ciudad de Caracas, en la comparación de los grupos de edad con el sexo, se observó que existía una diferencia entre estos (p < 0,05). El 57,5% usó previamente metotrexato; 6,68% biológicos; 3,2% esteroides tópicos y 31% no reportó qué tipo de terapia previa recibía. Dentro de las presentaciones clínicas, 70% correspondió a la psoriasis en placa. El 79% de los pacientes presentaba actividad moderada según el índice de la severidad del área de psoriasis, y al 11% se les realizó el índice de calidad de vida dermatológica, de los cuales 39% presentaban un efecto extremadamente importante. El rango anérgico de la prueba de Mantoux representó 70,9% de los casos, donde al 0,3% le fue realizado la prueba de Booster, y la radiografía de tórax se reportó normal en 95%. El medicamento biológico más demandado fue el etanercept con 52% de los casos. Conclusiones El sexo masculino y su relación con la psoriasis fue un hallazgo de importancia, como también se evidenció la necesidad de mejorar los componentes administrativos en la gestión de los formatos de solicitud de medicamentos y fortalecer la aplicación de la clinimetría con elemento de buena práctica médica.

Introduction Psoriasis is a chronic disease that affects the skin. One hundred twenty-five million people around the world suffer from this condition. In specific groups of patients, the joints may also be involved. To control and follow-up patients with psoriasis, psoriasis area severity and dermatological quality of life measurements were established. Both parameters are necessary for the initiation of biological therapy, as specified in the psoriasis management guide (2015) of the national committee of rheumatological, immunological, and bone metabolism diseases of the Venezuelan Institute of Social Security. Objective To characterize the clinical and epidemiological variables and the prescription of biological therapy in patients with psoriasis who access the high-cost dispensing program of the Venezuelan Institute Social Security (IVSS) pharmacy. Methods This is a descriptive, cross-sectional study. Results A total of 374 patient records were assessed. The male gender was more frequent, with 56.1% (p <0.001), mostly from Caracas city. In comparing age groups with sex, a difference among these was observed (p <0.05). 57.5% previously used methotrexate, 6.68% biological, 3.2% topical steroids, and 31% did not report which type of previous therapy they had received. Amongst the clinical presentations, 70% corresponded to plaque psoriasis. 79% of the patients presented moderate activity according to the Psoriasis Area and Severity Index (PASI): Eleven percent were assessed with the Dermatology Life Quality Index (DLQI); 39% of them reported an extremely important effect. The anergic range of the Mantoux test represented 70.9% of the cases, and 0.3% took the booster evaluation. Chest X-ray was reported normal in 95% of the cases. The most demanded biological medicine was etanercept, in 52% of the cases. Conclusions Male gender and its association with psoriasis was an important finding. The need to improve the administrative components in completing the medication request formats and strengthen clinical measurements and good medical practice was also found.

Environmental disaster in the northeast coast of Brazil: Forensic geochemistry in the identification of the source of the oily material.

The characterization of petroleum or its products spilled in the environment in relation to its source rocks is an important tool to assist in the resolution of issues of environmental impact and legal responsibility since it clarifies the possible region or the producing country of that type of petroleum. This article analyzes the application of analytical techniques for petroleum geochemistry to identify the type and origin of oily material collected from beaches in Northeast Brazil in 2019. Samples of the oily material collected on the beaches in the states of Bahia and Sergipe were analyzed and for comparison purposes, samples of crude oils produced in Brazil, Middle East, Nigeria and Venezuela were also analyzed. The analytical results showed that the oily material that reached the beaches has geochemical characteristics compatible with those of the Venezuelan oil, indicating it was severely weathered or a product made with heavy oil produced.

Essential oil composition and cytotoxic activity in twospecies ofthe plant genus Vismia (Hypericaceae) from the Venezuelan Andes / Composición de aceites esenciales y actividad citotóxica en dos especies de plantas del género Vismia (Hypericaceae) de los Andes venezolanos

Introduction: The Vismia genus belongs to the Hypericaceae family and comprises around 57 species of which 17 have been located in Venezuela. Previous investigations have been carried out in extracts as well as pure isolated compounds, revealing antimicrobial, antioxidant and anti-HIV, among other, biological activities. Objective: This investigation aims to determine the cytotoxic activity of essential oils from leaves of Vismia baccifera Triana & Planch (VBJ and VBV) and Vismia macrophylla Kunth (VM) collected in three different locations of the Venezuelan Andean region. Methods: Essential oils obtained by hydrodistillation were analyzed using gas chromatography-mass spectrometry (GC-MS) and their cytotoxic activity was analyzed following the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay. Human tumor cell lines from SKBr3, MCF-7 and PANC-1, two breast carcinomas and one pancreatic adenocarcinoma of ductal type, were tested with the oil samples and human dermis fibroblasts were used as non-tumor cells. Results: β-caryophyllene and trans-caryophyllene were present as major components in VBJ and VBV, respectively, while γ-bisabolene was the main component in the VM sample. Anticancer activity was observed on V. baccifera essential oil against SKBr3, MCF-7 and PANC-1. The selectivity index showed that VBV is highly selective against the SKBr3 cell line and has no activity against non-tumor cells. Conclusions: These results are considered a contribution to natural products research and may provide supportive data for future studies on cancer.

Introducción: El género Vismia pertenece a la familia Hypericaceae y comprende alrededor de 57 especies de las cuales 17 han sido ubicadas en Venezuela. Se han realizado investigaciones previas tanto en extractos como en compuestos puros aislados revelando actividad antimicrobiana, antioxidante y anti-VIH, entre otras actividades biológicas. Objetivo: El propósito de esta investigación es determinar la actividad citotóxica de los aceites esenciales de las hojas de Vismia baccifera Triana & Planch (VBJ y VBV) y Vismia macrophylla Kunth (VM) recolectadas en tres localidades de la región andina venezolana. Métodos: Aceites esenciales obtenidos por hidrodestilación fueron analizados por cromatografía de gases-espectrometría de masas y su actividad citotóxica fue analizada siguiendo el método MTT (bromuro de 3-[4,5-dimetiltiazol-2-il]-2,5-difeniltetrazolio). Los aceites esenciales fueron ensayados frente a células tumorales humanas SKBr3, MCF-7 y PANC-1, dos carcinomas de mama y un adenocarcinoma pancreático del tipo ductal, usando cultivos primarios de fibroblastos de dermis humana como células no tumorales. Resultados: β-cariofileno y trans-cariofileno estuvieron presentes como compuestos mayoritarios en VBJ y VBV, respectivamente, mientras que γ-bisaboleno fue el componente principal en la muestra VM. El aceite esencial de V. baccifera mostró actividad anticancerígena frente a SKBr3, MCF-7 y PANC-1. El índice de selectividad reveló que VBV es altamente selectivo frente a la línea celular SKBr3 y no presenta actividad contra las células no tumorales. Conclusiones: Estos resultados se consideran una contribución a la investigación de los productos naturales y los datos pueden ser de utilidad en futuras investigaciones sobre el cáncer.

The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study.

PURPOSE: To investigate the impact of a 3-month course of intracortical injections of autologous platelet-rich plasma (PRP) upon ovarian reserve markers versus no intervention in women with low ovarian reserve prior to undergoing assisted reproductive technology (ART). METHODS: Prospective controlled, non-randomized comparative study conducted in a private fertility clinic, in Venezuela. Women with abnormal ovarian reserve markers (FSH, AMH and AFC) who declined oocyte donation were allocated to one of the following groups according to patient choice: monthly intracortical ovarian PRP injections for three cycles, or no intervention. Primary outcomes were the change in FSH, AMH and AFC pre- and post-treatment. Secondary outcomes included the number of oocytes collected and fertilized, biochemical/clinical pregnancy rates and miscarriage and live birth rates. RESULTS: Eighty-three women were included, of which 46 received PRP treatment and 37 underwent no intervention. Overall median age was 41 years (IQR 39-44). There were no demographic differences between the study groups. At the 3-month follow-up, women treated with PRP experienced a significant improvement in FSH, AMH and AFC, whereas there was no change in the control group. Furthermore, overall rates of biochemical (26.1% versus 5.4%, P = 0.02) and clinical pregnancy (23.9% versus 5.4%, P = 0.03) were higher in the PRP group, while there was no difference in the rates of first trimester miscarriage and live birth between groups. CONCLUSION: PRP injections are effective and safe to improve markers of low ovarian reserve prior to ART, although further evidence is required to evaluate the impact of PRP on pregnancy outcomes.

Clinical factors affecting the efficacy of melasma treatment using the Q-switched 1064 Nd: YAG laser mode in a group of Venezuelan female patients.

The influence of melasma risk factors on the effectiveness of laser toning treatment in Venezuelan females was investigated. Clinical evaluation was performed (n = 64) including ultrasound and thyroid hormone profile. All patients underwent face exposure with laser toning, eight sessions weekly. VISIA percentiles corresponding to dark brown spots determined before and after treatment were compared by ANOVA. Differences between percentile values before and after treatment for each patient were calculated and expressed as percentages. An improvement of ≥30% was considered as significant. Spearman rank correlations between improvement and clinical parameters were determined. A significant increase (p > .005) of the median of the percentiles in the overall group was observed. However, only 62.5% of the patients exhibited an improvement of ≥30% at the right malar, 73.4% at the frontal and 71.8% at the left malar areas. Hormonal contraception during treatment (right malar: p < .0001 left malar: p = .0035), thyroid disorders (right malar: p < .0001; frontal: p = .011; left malar: p < .0001) and photoaging (right malar: p = .0235; frontal: p = .0237; left malar: p = .0137) were inversely associated to melasma improvement after treatment. Prolonged use of sunscreen improved significantly (right malar: p < .001; frontal: p = .016 and left malar: p = .025) treatment effectiveness.

Ethnopsychopharmacology study of patients' beliefs regarding concerns about and necessity of taking psychiatric medications.

OBJECTIVE: The aim of this study was to examine whether or not cultural differences influence beliefs about the necessity of taking prescribed psychiatric drugs and concern about their adverse effects in psychiatric outpatients in Spain, Argentina, and Venezuela. METHODS: This cross-sectional study included 1,372 adult psychiatric outpatients using 2,438 psychotropic drugs and was designed to assess outpatients' beliefs about their prescribed medication. Patients completed sociodemographic, clinical questionnaires, and the Beliefs about Medicines Questionnaire Specific Scale and registered scores ranging from 1 to 5 on each of two subscales: concern and necessity. A "necessity-concern differential" was obtained by calculating the difference (range -4 to +4). RESULTS: The global score, including all drugs in the total sample, had a mean necessity score of 3.50 ± 0.95, a mean concern score of 2.97 ± 0.99, and a mean differential score of 0.54 ± 1.42. The concern and necessity mean scores varied significantly across these three culturally Hispanic countries, probably across drug classes, and were associated with treatment duration. On the other hand, age and education played a very limited role. CONCLUSIONS: Understanding the diverse effects of culture and society on these attitudes is highly relevant for the development of responsive mental health services in multicultural societies.

Antimicrobial activity of four Valeriana (Caprifoliaceae) species endemic to the Venezuelan Andes / Actividad antimicrobiana de cuatro especies de Valeriana (Caprifoliaceae) endémicas de los Andes venezolanos

Abstract Valeriana L. genus is represented in Venezuela by 16 species, 9 of these are endemic of Venezuelan Andes growing in high mountains at 2 800 masl. In this investigation, four species were analyzed in order to determine the main secondary metabolites and antimicrobial activity of extracts obtained from aerial parts of Valeriana parviflora, V. rosaliana, V. triplinervis and V. phylicoides. Alkaloids, flavonoids, tannins, sterols, triterpenoids and saponins were qualitatively observed in all methanolic extracts tested. The color intensity or a precipitate formation was used as analytical response to these tests. Antimicrobial activity was evaluated against Gram positive, Gram negative bacterial strains and yeast, using disc diffusion method. N-hexane extracts of V. triplinervis and V. rosaliana showed the highest efficiency against Staphylococcus aureus, exhibiting inhibition zones of 16 mm and 15 mm; MIC (Minimal Inhibition Concentration) values were observed at 116 mg/mL and 150 mg/mL, respectively. Dichloromethane and methanolic extracts of V. triplinervis and methanolic extract of V. rosalianashowed a rather moderate activity (MIC between 200 to 316 mg/ml) but a very weak antibacterial activity was observed in V. phylicoides and V. parviflora extracts (MIC > 420 mg/mL). None of the extracts assayed in this investigation showed any activity against Candida albicansand Candida krusei. Statistical analysis showed no significant differences on the different polarity extracts assayed with respect to antimicrobial activity against S. aureus (P > 0.10), however it was observed significant differences between the Valeriana species analyzed (P < 0.10) in relation to the minimal inhibitory concentration (MIC). Rev. Biol. Trop. 66(3): 1282-1289. Epub 2018 September 01.

Resumen El género Valeriana, está representado en Venezuela por 16 especies, 9 de las cuales son endémicas de Los Andes y crecen en las altas montañas a 2 800 msnm. En esta investigación cuatro especies fueron analizadas para determinar los principales metabolitos secundarios y la actividad antimicrobiana de los extractos obtenidos de las partes aéreas de Valeriana parviflora, V. rosaliana, V. triplinervis y V. phylicoides. Compuestos como alcaloides, flavonoides, taninos, estroles, triterpenos y saponinas fueron detectados cualitativamente en todos los extractos metanólicos ensayados. La intensidad del color o la formación de un precipitado se tomaron como respuesta positiva para estos análisis. Actividad antimicrobiana fue evaluada frente a bacterias Gram positivas, Gram negativas y levaduras, usando el método de difusión en discos. Los extractos en n-hexano de V. triplinervis y V. rosaliana mostraron la mayor eficiencia frente a Staphylococcus aureus, mostrando zonas de inhibición de 16 mm y 15 mm con valores de CIM (Concentración Inhibitoria Mínima) observados a 116 mg/mL y 150 mg/mL, respectivamente. Los extractos con diclorometano y metanol de V. triplinervis y metanol de V. rosaliana revelaron moderada actividad (CIM entre 200 y 316 mg/ml), mientras actividad muy leve se observó en los extractos de V. phylicoides y V. parviflora (CIM > 420 mg/mL). Ninguno de los extractos ensayados mostraron actividad frente a Candida albicans y Candida krusei. Los análisis estadísticos mostraron que no hay diferencia significativa entre los solventes de diferentes polaridades con relación a la actividad antimicrobiana frente a S. aureus (P > 0.10), sin embargo, sí se observó diferencia significativa (P < 0.10), entre las especies de Valeriana ensayadas con respecto a la concentración inhibitoria mínima (CIM).

Realidades de la estomatología en comunidades de pobreza extrema y nuevas urbanizaciones del estado Carabobo / Realities of estomatology in extreme poverty communities and in the new urbanizations of Carabobo state

Se realizó un estudio descriptivo, observacional, longitudinal y retrospectivo, de todos los pacientes notificados en los registros estadísticos de las comunidades de pobreza extrema y las nuevas urbanizaciones del estado Carabobo, durante el primer semestre del 2016, con vistas a identificar las actividades desarrolladas en estos, de acuerdo a las siguientes variables: consultas estomatológicas, actividades de promoción de salud, otros procedimientos estomatológicos y las remisiones al segundo nivel de atención. Entre los resultados se obtuvo que el mayor porcentaje de consultas se realizara en el primer trimestre del año, con predominio de las consultas-convenios, así como de las actividades de promoción de la salud. El grupo etario de menores de 18 años fue el más beneficiado con las actividades afectivo-participativas impartidas, en tanto los procedimientos estomatológicos preponderaron también en el primer trimestre, a excepción de la aplicación de laca de flúor, y la enfermedad periodontal fue la causa más frecuente de remisión al segundo nivel de atención

A descriptive, observational, longitudinal and retrospective study, from all the patients notified in the statistical records of extreme poverty communities and from the new urbanizations of the state Carabobo was carried out during the first semester of 2016, with the objective of describing the activities developed in them, according to the following variables: estomatological visits, health promotion activities, other estomatological activities and referral at the second care level. Among the results it was obtained that the highest percentage of visits was carried out in the first trimester of the year, with prevalence of the visits-agreements, as well as of the health promotion activities. The age group younger than 18 years had the greatest benefits with the delivered affective-participative activities, while the estomatological procedures also prevailed in the first trimester, except the use of fluorine, and the periodontal disease was the most frequent cause of referral to the second care level

Integrality in Brazil and Venezuela: similarities and complementarities. / A integralidade no Brasil e na Venezuela: similaridades e complementaridades.

This study aims to compare Primary Health Care (PHC) in Brazil and Venezuela, considering its characteristics as to integrality. It has a qualitative approach, using documental analysis, semi-structured interviews with key informants and field diary notes. We observed the three realms of integrality inherent to the health work process: comprehensive and holistic care, the individual viewed as a complex being with multiple needs, requiring the connection of various health knowledge; continuity of care in institutional micro-policy with interprofessional articulation, in order to consider individual care; continuity of care in macro-policy, when a shift to other levels of care is needed; intersectoriality was also included, when the needs of an individual and community require a cross-sectoral coordination, with action on determinants and conditionants of the health-disease process. It is worth highlighting the natural tendency to include a comprehensive community medical training. We conclude that those countries strengthened by democracy draw their integrality practices closer, as well as the construction of social and health policies for underprivileged populations to achieve equity.

A integralidade no Brasil e na Venezuela: similaridades e complementaridades / Integrality in Brazil and Venezuela: similarities and complementarities

O presente estudo tem como objetivo comparar a Atenção Primária à Saúde (APS) no Brasil e na Venezuela, observando suas características quanto à integralidade. Possui abordagem qualitativa, por meio de análise documental, entrevistas semiestruturadas com informantes-chave e anotações em diário de campo. Observou-se as três dimensões de integralidade inseridas no processo de trabalho em saúde: o cuidado integral e holístico, visão do indivíduo como um ser complexo com múltiplas necessidades, exigindo a conexão de diversos saberes em saúde; a continuidade do cuidado na micropolítica institucional com articulação interprofissional, de forma a contemplar o cuidado singular; a continuidade do cuidado na macropolítica, quando é necessário um deslocamento aos demais níveis de atenção; incluiu-se ainda a intersetorialidade, quando as necessidades de um indivíduo e comunidade exigem uma articulação transetorial, com ação sobre os determinantes e condicionantes do processo saúde-doença. Ressalta-se ainda a tendência singular de inclusão de uma formação médica comunitária integral. Conclui-se que estes países, fortalecidos pela democracia, aproximam-se em suas práticas de integralidade, bem como na construção de políticas sociais e de saúde para as populações menos favorecidas, em favor da equidade.(AU)

This study aims to compare Primary Health Care (PHC) in Brazil and Venezuela, considering its characteristics as to integrality. It has a qualitative approach, using documental analysis, semi-structured interviews with key informants and field diary notes. We observed the three realms of integrality inherent to the health work process: comprehensive and holistic care, the individual viewed as a complex being with multiple needs, requiring the connection of various health knowledge; continuity of care in institutional micro-policy with interprofessional articulation, in order to consider individual care; continuity of care in macro-policy, when a shift to other levels of care is needed; intersectoriality was also included, when the needs of an individual and community require a cross-sectoral coordination, with action on determinants and conditionants of the health-disease process. It is worth highlighting the natural tendency to include a comprehensive community medical training. We conclude that those countries strengthened by democracy draw their integrality practices closer, as well as the construction of social and health policies for underprivileged populations to achieve equity.(AU)

Bioinventario de especies subutilizadas comestibles y medicinales en el norte de Venezuela / Bioinventary of underutilized edible and medicinal species of northern Venezuela

En el mundo, los sistemas agroalimentarios se han desarrollado sobre una base estrecha y de alta vulnerabilidad. En particular, en Venezuela, más de un tercio de la ingesta de calorías diarias es suplida por cereales procesados, y el consumo de frutas y hortalizas es limitado. En este trabajo se documenta la presencia de especies nativas o naturalizadas potenciales para el consumo en el norte del país. Se determinaron la frecuencia de uso, el destino de la producción, el origen y distribución de cada especie. Se registraron 46 especies alternativas con uso potencial para la alimentación. El lairén (Calathea allouia) y la pumalaca (Syzygium malaccense) mostraron las mayores frecuencias de uso. La mayor riqueza de especies alternativas es originaria o de amplia distribución en América tropical. Los resultados obtenidos muestran la relevancia para la producción, propagación y aprovechamiento de esta variedad de plantas que, además, pueden contribuir a la soberanía alimentaria a partir de pequeñas comunidades locales.

In the world, food systems have been developed on a narrow base and a high vulnerability. Particularly in Venezuela, more than a third of daily calories intake is supplemented by processed cereals, and the consume of fruits and green vegetables is restricted. This paper document the presence of native or naturalized species growth for consumption, in communities located in northern Venezuela. The frequency of use of alternative species, production fate, and origin and distribution of each species is presented. Up to 46 species were registered as potential alternative for food. The reported species included the lairén (Calathea allouia) and the pumalaca (Syzygium malaccense) with the highest frequency of use. These results show the relevance for production and consume of these wide variety of potentially useful plants for food, and concurrently strengthening food sovereignty of small communities.

Towards Communicative Justice in Health.

This article approaches care from a different angle by looking ethnographically at how it is shaped by structural differences in the power to control the circulation of knowledge. I focus on an investigation conducted by people classified as "indigenous", of an epidemic that killed 38 children and young adults in a Venezuelan rainforest. I trace how health/communicative inequities structured clinical interactions, documents, epidemiological investigations, news stories, and dialogues with healers, thwarting the identification of the epidemic, clinically identified as rabies. Although the Bolivarian socialist government provided access to care, professionals denigrated parents' contributions to care and communication and reduced complex, unequal relations between languages to practical problems of translation. Pointing to parallels with US social movements, I suggest that responding to demands for communicative justice in health requires seeing how health inequities are entangled with health/communicative inequities. The typographical slash points to importance of challenging the subdisciplinary boundary-work that relegates their study to non-overlapping conversations in medical and linguistic anthropology.

Browplasminin, a condensed tannin with anti-plasmin activity isolated from an aqueous extract of Brownea grandiceps Jacq. flowers.

ETHNOPHARMACOLOGICAL RELEVANCE: Following Venezuelan traditional medicine, females with heavy menstrual blood loss (menorrhagia) drink Brownea grandiceps Jacq. flowers (BG) decoctions to reduce the bleeding. In a previous study, we demonstrated that BG aqueous extract (E) possesses a potent anti-fibrinolytic activity capable of inhibiting plasmin, the main serine-protease that degrades fibrin. It is widely known that plasmin inhibitors are often used as anti-fibrinolytics to reduce bleeding during surgeries with high risk of blood loss such as cardiac, liver, vascular, tooth extraction and large orthopedic procedures, as well as for menorrhagia treatments. The aim of this work was to isolate and characterize from BGE the compound responsible for the reported anti-fibrinolytic activity. MATERIALS AND METHODS: A decoction of BG was prepared; then it was homogenized, centrifuged and lyophilized to obtain BGE. Subsequently the extract was fractionated by gel filtration and reverse phase using HPLC and the active compound was characterized by MALDI-ToF MS. The kinetic parameters of anti-plasmin activity were evaluated by an amidolytic assay using a chromogenic substrate; also the anti-plasmin activity was estimated by fibrin plate method. Data were analyzed by nonparametric statistics. RESULTS: The active compound was a condensed tannin denominated Browplasminin, which is capable of inhibiting the plasmin activity in a dose-dependent manner when measured in fibrin plates or by the amidolytic activity method; it also has a minor effect on the FXa activity. However, it does not affect the activity of other serine-proteases such as trypsin, t-PA or u-PA. Browplasminin consists predominately of heteroflavan-3-ols of catechin with B-type linkages, and extents up to heptadecamers (~ 5000Da), with hexose residues attached to the polymer that presents a high degree of galloylation. Its IC50 for plasmin was 47.80µg/mL and for FXa was 237.08µg/mL, while the Ki were 0.76 and 61.61µg/mL for plasmin and FXa, respectively. CONCLUSIONS: The overall outcome of this study suggests that Browplasminin could be responsible for reducing heavy menstrual bleeding in women because its kinetic parameters showed that is a good plasmin inhibitor.

In vitro antioxidant activity and qualitative phytochemical analysis of two Vismia (Hypericaceae) species collected in Los Andes, Venezuela / Actividad antioxidante in vitro y análisis fitoquímico cualitativo de dos especies de Vismia (Hypericaceae) recolectadas en Los Andes, Venezuela

Abstract:Vismia genus is distributed mainly in tropical and subtropical regions of Central, South America and some areas of Africa. According to previous investigations, antioxidant potential of Vismia species might be related to anthrones, anthraquinones, flavonoids and phenol derivatives biosynthesized by these plants. In this investigation, phytochemical screening of Vismia baccifera (VB) from Mérida-Venezuela and Vismia macrophylla (VM) from Táchira-Venezuela methanolic extracts, carried out using various chemical assays, revealed an abundant presence of anthraquinones in both species analyzed. Glycosides were also present while flavones and dehydroflavones were observed abundantly in VB but moderated in VM. Triterpenes were also detected and steroids showed to be abundant in VM but moderate in VB. On the other hand, antioxidant capacity measured by the DPPH assay showed that VM possesses a stronger antioxidant activity than VB with IC50 5.50 µg mL-1. Phenol and flavonoid assays carried out by Folin-Ciocalteu and colorimetric test also revealed that methanol extracts of both species contain high concentrations of these metabolites. A relationship between the antioxidant activity, total phenol and flavonoids content of the extracts analyzed was demonstrated in this investigation since those samples with higher phenolic concentrations showed likewise higher antioxidant activity. Rev. Biol. Trop. 64 (4): 1431-1439. Epub 2016 December 01.

Resumen:El género Vismia esta distribuido principalmente en las regiones tropicales y subtropicales de Centro, Sur América y algunas zonas de África. De acuerdo a reportes previos, el potencial antioxidante de las especies de Vismia puede estar relacionado con antronas, antraquinonas, flavonoides y derivados fenólicos biosintetizados por estas plantas. En la presente investigación, el tamizaje fitoquímico de los extractos metanólicos de Vismia baccifera (VB) de Mérida-Venezuela y Vismia macrophylla (VM) de Táchira-Venezuela realizado con diferentes ensayos químicos reveló abundante presencia de antraquinonas en ambas especies analizadas. Glucósidos también estuvieron presentes mientras que flavonas y dehidroflavonas fueron observados abundantemente en VB pero con presencia moderada en VM. Triterpenos y esteroides también fueron detectados mostrando ser abundantes en VM y moderados en VB. Por otro lado, la actividad antioxidante determinada por el método DPPH reveló que VM posee actividad antioxidante más fuerte que VB con un IC50 de 5.50 µg mL-1. El ensayo del contenido de fenoles y flavonoides realizado con los métodos de Folin-Ciocalteu y test colorimétrico también demostró que los extractos metanólicos de ambas especies contienen altas concentraciones de estos metabolitos. En este estudio se observó una relación entre la actividad antioxidante, el contenido de fenoles y de flavonoides en los extractos analizados ya que las muestras que presentaron concentraciones más altas de fenoles y flavonoides también mostraron una mayor actividad antioxidante.