Microplastics and plastisphere at surface waters in the Southwestern Caribbean sea.

Pollution generated by plastic waste has brought an environmental problem characterized by the omnipresence of smaller pieces of this material known as microplastics (MP). This issue was addresses by collecting samples with 250 µm pore size nets in two marine-coastal sectors of Southwestern Caribbean Sea during two contrasting seasons. Higher concentrations were found in rainy season than in dry season, reaching respectively 1.72 MP/m3 and 0.22 MP/m3. Within each sector, there were differences caused firstly by localities of higher concentrations of semi-closed water bodies localities during rainy season (Ciénaga Grande de Santa Marta and La Caimanera marsh), and secondly by lower concentrations of localities with less influenced of flow rates during dry season (Salamanca and Isla Fuerte). Moreover, the lowest concentration in dry season corresponding to La Caimanera marsh reflects how the community environmental management might decrease MP pollution. In both sectors and seasons, the particles of 0.3 mm (0.3-1.4 mm) size class dominated over those of 1.4 mm (1.4-5.0 mm) (reaching each respectively 1.33 MP/m3 and 0.39 MP/m3), with a dominance of fibers, except in the rainy season in Magdalena, where they were films. Using the FTIR technique, polypropylene was identified as the most abundant polymer in both sectors. The composition of the assemblage of microorganisms attached to microplastics presented higher richness and differed from that of free-living planktonic microbes. The most abundant members of the plastisphere were proteobacteria whose major representation was the pathogenic genus Vibrio, while the cyanobacteria dominated in seawater samples.

Benthic harmful microalgae and their impacts in South America.

Public awareness about Benthic Harmful Algal Blooms (BHABs) and their negative impacts has increased substantially over the past few decades. Even so, reports of BHABs remain relatively scarce in South America (SA). This paper provides a comprehensive overview of the current state of knowledge on BHABs in the continent, by integrating data from published articles, books, and technical reports. We recorded ∼300 different occurrences of potentially toxic BHAB species over the Caribbean, Atlantic and Pacific coasts, mostly in marine (>95%) but also in estuarine areas located from 12°36' N to 54°53' S. Over 70% of the data was published/released within the past 10 years, and ∼85% were concentrated in Brazil, Venezuela, Ecuador and Colombia. Benthic species were mainly associated with macroalgae, seagrass and sediment. Incidental detection in the plankton was also relevant, mainly in places where studies targeting BHAB species are still rare, like Argentina, Uruguay, Chile and Peru. The study listed 31 infrageneric taxa of potentially toxic benthic dinoflagellates and eight of estuarine cyanobacteria occurring in SA, with the greatest species diversity recorded in the equatorial-tropical zone, mainly in northeastern Brazil (Atlantic), Venezuela and Colombia (Caribbean), and the Galapagos Islands, Ecuador (Pacific). Local strains of Amphidinium, Gambierdiscus, Coolia and Prorocentrum spp. produced toxic compounds of emerging concern. Prorocentrum lima species complex was the most common and widely distributed taxon, followed by Ostreopsis cf. ovata. In fact, these two dinoflagellates were associated with most BHAB events in SA. Whereas the former has caused the contamination of multiple marine organisms and cases of Diarrhetic Shellfish Poisoning in subtropical and temperate areas, the latter has been associated with faunal mortalities and is suspected of causing respiratory illness to beach users in tropical places. Ciguatera Poisoning has been reported in Colombia (∼240 cases; no deaths) and Venezuela (60 cases; two deaths), and may be also a risk in other places where Gambierdiscus spp. and Fukuyoa paulensis have been reported, such as the Galapagos Islands and the tropical Brazilian coast. Despite the recent advances, negative impacts from BHABs in SA are intensified by limited research/training funding, as well as the lack of official HAB monitoring and poor analytical capability for species identification and toxin detection in parts of the continent.

The role of time perspective and acculturative stress on adaptive and maladaptive stress coping strategies of Puerto Ricans living in the island of Puerto Rico and the state of Connecticut in mainland United States.

We assessed the role of Time Perspective (TP) and acculturative stress on adaptive and maladaptive coping strategies, across healthy and treatment-seeking Puerto Ricans living in the island of Puerto Rico (PR), as well as at the state of Connecticut in mainland United States (US). Participants were comprised of 197 adults from the island of PR, as well as 138 adults from Connecticut. TP was measured through five categories assessed by the Zimbardo TP Inventory (Past Positive, Past Negative, Present Fatalistic, Present Hedonistic, and Future), the Deviation from a Balanced Time Perspective-revisited (DBTPr) coefficient, and the Deviation from the Negative Time Perspective (DNTP) coefficient. Acculturative stress was measured with the Acculturative Distress Scale. Adaptive and maladaptive stress-coping were measured through the Brief COPE Inventory. DNTP predicted adaptive coping, whereas acculturative stress, Present Hedonistic, and DBTPr predicted maladaptive coping. Puerto Ricans living in Connecticut engaged more often in maladaptive coping than those in PR. Acculturative stress partially mediated the influence of DBTPr on maladaptive coping. DNTP mediated the influence of state on adaptive coping. DBTPr and acculturative stress totally mediated the influence of state on maladaptive coping. These findings suggest that assessing TP, levels of acculturative stress, and coping strategies could assist in tailoring evidence-based interventions to the specific needs of Puerto Rican populations. Doing so could be effective in promoting a Balanced Time Perspective, reducing acculturative stress, increasing adaptive coping, and improving mental as well as physical health, on Puerto Ricans living in PR or mainland US.

Desplazamiento por iatrogenia de tercer molar a seno maxilar: reporte de caso clínico / Third molar iatrogenic displacement to maxillary sinus: report of a clinical case

La relación de los dientes posteriores superiores respecto al seno maxilar tiene connotaciones clínicas importantes, uno de los principales riesgos es el desgarro o perforación de la membrana sinusal (Schneider) y la proyección del diente involucrado, en procedimientos de extracción dental y extracción quirúrgica de raíces. El rescate de un tercer molar superior dentro del seno maxilar requiere tener un área o acceso sufi ciente, que permita visualizarlo y removerlo con facilidad, para tal fi n la técnica quirúrgica de ventana lateral Caldwell-Luc suele ser la de primera elección. El presente artículo muestra un caso clínico de desplazamiento al seno maxilar por iatrogenia durante el intento de extracción de un tercer molar, y su resolución quirúrgica (AU)

The relationship of the maxillary posterior teeth to the maxillary sinuses has important clinical connotations. One of the main risks is the rupture or perforation of the sinus membrane (Schneider) and the projection of the tooth involved in the dental extraction and procedures of surgical extraction of the roots. Rescue of a third upper molar within the maxillary sinus requires a suffi cient access area, which allows visualization and extraction with ease, for this the surgical technique of the side window Caldwell-Luc is usually the fi rst choice. The present article shows a clinical case of displacement to the maxillary sinus by iatrogeny during the extraction of a third molar, and its surgical resolution (AU)

Assessing health-related resiliency in HIV+ Latin women: Preliminary psychometric findings.

BACKGROUND: HIV-associated vulnerabilities-especially those linked to psychological issues-and limited mental health-treatment resources have the potential to adversely affect the health statuses of individuals. The concept of resilience has been introduced in the literature to shift the emphasis from vulnerability to protective factors. Resilience, however, is an evolving construct and is measured in various ways, though rarely among underserved, minority populations. Herein, we present the preliminary psychometric properties of a sample of HIV-seropositive Puerto Rican women, measured using a newly developed health-related resilience scale. METHODS AND DESIGN: The Resilience Scales for Children and Adolescents, an instrument with solid test construction properties, acted as a model in the development (in both English and Spanish) of the HRRS, providing the same dimensions and most of the same subscales. The present sample was nested within the Hispanic-Latino longitudinal cohort of women (HLLC), that is part of the NeuroAIDS Research Program at the University of Puerto Rico (UPR), Medical Sciences Campus (MSC). Forty-five consecutively recruited, HIV+ women from the HLLC completed a demographic survey, the HRRS, and the Beck Depression Inventory-I, Spanish version. RESULTS: The results demonstrate excellent overall internal consistency for the total HRRS score (α = 0.95). Each of the dimensional scores also evidenced acceptable internal consistency (α ≥ 0.88). All the dimensional and subscale content validity indices were above the 0.42 cut-off. Analysis revealed a significant negative correlation between the HRRS total score and BDI-I-S (r(45) = -0.453, p < 0.003). CONCLUSION: Albeit preliminary in nature, the present study provides support for the HRRS as a measure to assess resilience among individuals living with chronic medical conditions. Minority populations, especially non-English speaking ones, are understudied across the field of medicine, and when efforts are made to include these patient groups, measurement is rarely tailored to their unique cultural and linguistic experiences. The HRRS is a measure that addresses these notable voids in the medical literature.

Chronic pain management group psychotherapy for psychiatric inpatients: A pilot study.

Individuals with serious mental illness (SMI) experience significant comorbid chronic pain (CP). Little is known about CP management in psychiatric inpatient settings. To address this gap in clinical practice, the authors developed CP management group psychotherapy for adult inpatients with SMI. In this report, the authors highlight (1) the theoretical underpinnings of and execution of the psychotherapy group, (2) the characteristics of participants in the pilot phase of the group, and (3) outcomes of group participants. Data were collected from 16 participants in the pain management psychotherapy group. The mean number of groups attended was two (SD = 1.7). Participants endorsed pain across five regions of the body with high pain intensity and severity. Improvements in depression, anxiety, somatic, and emotional regulation symptoms were evidenced during the course of treatment. CP group psychotherapy may be an effective modality to disseminate "best practices" and prevent diagnostic overshadowing for SMI patients.

Historia de la Facultad de Ciencias Médicas de la Universidad de Cuenca

Hemos dividido esta obra en cuatro períodos. El motivo de la división es para facilitar la periodización, que nada tiene de académica: El primer período será el de la gestación como CORPORACIÓN UNIVERSITARIA DEL AZUAY desde su fundación en 1867 hasta 1895, año del advenimiento del Liberalismo Radical, y de la primera reforma universitaria abordada por Jacinto Landívar Heredia y Jaime Abad Vázquez. El segundo período desde la revolución liberal hasta el año de 1944, cuando se da la Reforma Universitaria General, estudiada por Ernesto Cañizares Aguilar. El tercer período que comprende desde el año 1944 hasta 1977 año de la crisis y renuncia masiva de docentes abordada por David Achig Balarezo. El último período desde la crisis del año 1977 hasta la actualidad estudiado por el Dr. Raúl Pino Andrade. Se completará el segundo período con el estudio del Libro de Actas de la Escuela de Medicina entre los años 1915-1923 y con la Historia de la Obstetricia revisados por Jacinto Landívar Heredia. Luego del último período se introducirá un análisis y testimonio como actora del mismo de la Mst. Gladys Eskola Torres. Cocluirá con los estudios de historia de Tecnología y Enfermería y luego con minibiografías de los exdecanos últimos y de los profesores recientemente jubilados

Estudio químico preliminar y evaluación de la actividad antioxidante, antialimentaria y tóxica, de la especie Pernettya prostrata (Ericaceae) / Preliminary chemical study and evaluation of antioxidant, antifeedant and toxic activity of the species Pernettya prostrata (Ericaceae)

Introducción: los estudios fitoquímicos y propiedades biológicas de la especie Pernettya prostrata (Cav.) DC. (Ericaceae) han sido preliminares, y muchos de los resultados publicados no son muy confiables. Por lo anterior, la planta se convierte en objeto de estudio promisorio e interesante. Objetivo: realizar el análisis fitoquímico preliminar y la evaluación de algunas propiedades biológicas de extractos y fracciones de la especie P. prostrata. Métodos: a los extractos etanólicos de parte aérea y frutos se les determinaron los posibles constituyentes mediante un análisis fitoquímico preliminar, y se evaluó la actividad antioxidante mediante la captación del radical libre DPPH, la actividad tóxica frente a Artemia salina y antialimentaria frente a Sitophilus zeamais y Tribolium castaneum. Resultados: las pruebas fitoquímicas preliminares sugieren la presencia de flavonoides, taninos triterpenos y/o esteroides en los extractos etanólicos de frutos y parte aérea, obtenidos de P. prostata. Del estudio fitoquímico realizado sobre el extracto etanólico de frutos se aisló e identificó escualeno y β-1-O-metoxiglucopiranosa. Los compuestos aislados e identificados no arrojaron resultados promisorios frente a los ensayos biológicos realizados. Los extractos etanólico de frutos (72,8 ppm) y parte aérea (60,9 ppm) presentan similar actividad antioxidante. La fracción metanólica es la de mayor actividad antioxidante con CI50 (86,2 ± 8,8 ppm) y PI (89,8 %), mayores a los del ácido ascórbico usado como patrón (CI50 = 49,3 ± 0,2 ppm). No se observó actividad tóxica y antialimentaria de los extractos y fracciones evaluados. Conclusiones: el presente trabajo realiza aportes al conocimiento químico y de las propiedades biológicas de la especie P. prostrata, mediante el aislamiento e identificación de dos sustancias nuevas y la determinación de la actividad antioxidante de algunos extractos y fracciones.

Introduction: studies about the phytochemistry and biological properties of the species Pernettya prostrata (Cav.) DC. (Ericaceae) conducted so far have been preliminary and many of the results published are not totally reliable. Therefore, the plant is an interesting and promising object of study. Objective:carry out the preliminary phytochemical analysis and evaluation of some biological properties of extracts and fractions of P. prostrata. Methods: preliminary phytochemical analysis was conducted of ethanolic extracts from the aerial parts and fruits for determination of possible constituents. Antioxidant activity was evaluated by DPPH free radical capture. Toxic activity against Artemia salina and antifeedant activity against Sitophilus zeamais and Tribolium castaneum were also determined. Results: preliminary phytochemical tests suggest the presence of flavonoids, tannins, triterpenes and/or steroids in ethanolic extracts from fruits and aerial parts of P. prostrata. Squalene and β-1-O-methoxy-glucopyranose were isolated and identified from the phytochemical study of the fruit ethanolic extract. The compounds isolated and identified did not reveal any promising results in the biological assays performed. Ethanolic extracts from fruits (72.8 ppm) and aerial parts (60.9 ppm) exhibited similar antioxidant activity. The methanolic fraction showed the highest antioxidant activity with IC 50 (86.2 ± 8.8 ppm) and IP (89.8 %), greater than those in the ascorbic acid used as a standard (IC50 = 49.3 ± 0.2 ppm). No toxic or antifeedant activity was found in the extracts and fractions evaluated. Conclusions: the present paper makes a contribution to knowledge about the chemical composition and biological properties of the species P. prostrata through isolation and identification of two new substances, and determination of the antioxidant activity of some extracts and fractions.

Conocimientos y prácticas del profesional de enfermería sobre las técnicas de fisioterapia respiratoria post operatoria en la prevención de complicaciones respiratorias en la UCI - Clínica Ricardo Palma 2013 / Knowledge and practice of professional nursing on the techniques of postoperative respiratory physiotherapy in the prevention of respiratory complications in the ICU-Clinic Ricardo Palma 2013

El objetivo fue determinar los conocimientos y prácticas del profesional de Enfermería sobre las técnicas de fisioterapia respiratoria post operatoria en la prevención de complicaciones .respiratorias en la UCI-Clínica Ricardo Palma 2013. Material y Método: El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La población estuvo conformada por 35 enfermeras. Las técnicas fueron la encuesta y la observación, los instrumentos un cuestionario y una lista de chequeo, que se aplicaron previo consentimiento informado. Resultados: Del 100 por ciento (35), 63 por ciento (22) desconoce y 37 por ciento (13) conoce, 57 por ciento (20) tienen practicas inadecuadas y 43 por ciento (15) practicas adecuadas. Conclusiones: El mayor porcentaje de las enfermeras desconoce que el drenaje postural es la técnica que se usa con mayor frecuencia, las diferentes técnicas de fisioterapia respiratoria y las técnicas respiratorias para prevenir las complicaciones post operatorias, mientras un porcentaje significativo conocen la importancia de la capacitación del personal de enfermería en las técnicas de fisioterapia respiratoria y que las complicaciones respiratorias en el post operatorio pueden ser prevenibles. Por otro lado la mayoría tiene practicas inadecuadas, referidos a que la enfermera no realiza la revisión de HC, tipo de cirugía y antecedentes, no realiza el drenaje postural a los pacientes por 15' con vibraciones torácicas en la fase inhalatoria, ni efectiviza la toma de rayos x de control, ni registra el procedimiento en las anotaciones de enfermería seguido de un porcentaje significativo tienen practicas adecuadas ya que la enfermeras aspira secreciones si el paciente está en ventilación o por oro faringe, registra las características de las secreciones, monitoriza signos vitales, facilita al paciente un espirómetro y demuestra los ejercicios espiratorios.

The objective was to determine the knowledge and practice of nursing professionals on chest physiotherapy techniques in preventing postoperative respiratory complications in the ICU-Ricardo Palma Clinic 2013. Material and Method: The study was level application, quantitative, cross-sectional descriptive method. The population consisted of 35 nurses. The techniques were the survey and observation, the instrument a questionnaire and a checklist, which applied prior informed consent. Results: 100 per cent (35), 63 per cent (22) and 37 per cent unknown (13) unknown, 57 per cent (20) have inadequate practices and 43 per cent (15) appropriate practices. Conclusions: The highest percentage of nurses known that postural drainage is the technique used most often, the different techniques of chest physiotherapy and breathing techniques to prevent postoperative complications, while a significant percentage know the importance of staff training nursing respiratory physiotherapy techniques and respiratory complications in the postoperative may be preventable. On the other hand most have inadequate practices, referred to the nurse for reviewing HC, type of surgery and history, do not perform postural drainage in patients for 15’ with thoracic vibration inhaler phase nor effective by making x-ray control, or record the proceedings in the nursing notes followed by a significant percentage have adequate practice nurses since aspires secretions if the patient is ventilated or oropharynx, records secretions characteristics, vital signs monitors, provides the patient with a spirometer and demonstrates the exercises expiratory.

[Effects of marijuana on cognition: a review form the neurobiological perspective]. / Efectos de la marihuana en la cognición: una revisión desde la perspectiva neurobiológica.

Marijuana is one of the most commonly used psychoactive substances in society, mainly among youths. Its use has been consistently associated with several health problems, many of which have in common an impairment in the cognitive processes of behavior, including the memory, attention, emotion and decision making. There is evidence suggesting that cannabinoids, marijuana's primary psychoactive substance, have a negative effect in short-term memory, working memory, and decision making. It has also been found that cannabinoids affect attention and the interaction between cognitive events and emotion. This information can be used as an argument of biological plausibility to assess clinical and epidemiological research findings that show that marijuana`s use is associated to problems such as traffic accidents, psychosis, depression and poor academic records, among others.

Efectos de la marihuana en la cognición: una revisión desde la perspectiva neurobiológica / Effects of marijuana on cognition: a review form the neurobiological perspective

La marihuana es una sustancia psicoactiva ampliamente usada en la sociedad, especialmente entre los más jóvenes. El uso de esta sustancia ha sido asociado consistentemente con diversos problemas de salud, muchos de los cuales tienen en común una alteración en las manifestaciones cognitivas de la conducta, incluyendo la memoria, la atención, la emoción y la toma de decisiones. Se encontró evidencia que los cannabinoides, la sustancia activa de la marihuana, impactan negativamente en la memoria a corto plazo, memoria de trabajo y la toma de decisiones. Asimismo, los cannabinoides afectan la atención y la interacción entre los eventos cognitivos y la emoción. Esta información puede ser usada como argumento de plausibilidad biológica para interpretar una serie de hallazgos clínicos y epidemiológicos en los que el uso de marihuana se ha mostrado relacionado con problemas tales como accidentes de tránsito, psicosis, depresión, pobre trayectoria académica, entre otros.

Marijuana is one of the most commonly used psychoactive substances in society, mainly among youths. Its use has been consistently associated with several health problems, many of which have in common an impairment in the cognitive processes of behavior, including the memory, attention, emotion and decision making. There is evidence suggesting that cannabinoids, marijuana´s primary psychoactive substance, have a negative effect in short-term memory, working memory, and decision making. It has also been found that cannabinoids affect attention and the interaction between cognitive events and emotion. This information can be used as an argument of biological plausibility to assess clinical and epidemiological research findings that show that marijuana`s use is associated to problems such as traffic accidents, psychosis, depression and poor academic records, among others.

Inicio, monitoreo y complicaciones de la nutrición parenteral total / Monitor, initiation and complications of the parenteral nutrition total

El manejo nutricional es un elemento esencial en los cuidados del niño enfermo. Se estima que del 30 al 50 por ciento de los niños hospitalizados tienen evidencias clínicas de malnutrición y existe una relación entre el estado nutricional y la mortalidad hospitalaria. Desde su introducción a finales de los años sesenta la nutrición parenteral total ha reducido la incidencia de malnutrición ligada a enfermedades digestivas y no digestivas. La nutrición parenteral total ha reducido la incidencia de malnutrición ligada a enfermedades digestivas y no digestivas. La nutrición parenteral está indicada en el niño para corregir o provenir la malnutrición cualquiera sea la causa, desde el momento en que un aporte enteral óptimo no puede realizarse durante un período prolongado

Oxígeno toxicidad evidenciada por ciitología de lavado bronquial / Oxigen-toxicity identify by citology of bronchial lavage

Los objetivos del trabajo son: Identificar la presencia de alteraciones celulares en la vías aéreas producidas por oxigenoterapia e intentar determinar en los casos de oxigenotoxicidad la relación con FiO2, presión en las vías aéreas, PEEP y tiempo de exposición. El análisis reporta 14 pacientes con signos de oxigenotoxicidad (78 por ciento) siendo el hallazgo más significativo a nivel microscópico: hipoplasia de células alveolares tipo I, metaplasia escamosa y células reactivas. 43 por ciento de los pacientes evidenciaron signos de oxigenotoxicidad en las primeras 48 horas de oxigenoterapia, no lográndose establecer relación con Fio2, PEEP y PIM. En todos los pacientes en etapa neonatal (22 por ciento) se evidenció toxicidad por oxígeno, llamándose a la reflexión en relación al uso indiscriminado de oxigenoterapia

Nuevos conceptos en el tratamiento de la diarrea aguda

Presentamos los resultados obtenidos en niños con diarrea aguda tratados con Sacharomyces Boulardil, una levadura que actúa regulando la ecología intestinal. Se encontraron los siguientes agentes etiológicos: Parásitos 17.5 por ciento de los casos, bacterias 30 por ciento, virus 12.5 por ciento, Candidiasis 5 por ciento muestras de heces fecales negativas 35 por ciento. El primer grupo de 40 pacientes fue tratado con SRO más S. Boulardii. Los resultado fueron buenos con reducción de 82 por ciento en el número de evacuaciones en la primeras 48 horas. El segundo grupo de 32 pacientes recibió FORMULA UNO, solución hidratante oral de facil uso, promocionando por nosotros y S Boulardii. Los resultados fueron excelentes observando que las heces estaban de apariencia normales despúes de 24 horas, no requiriendo tratamiento superior a 3 días. El tercer grupo de 12 pacientes recibieron hidratación venosa en las primeras 6 horas, continuando el tratamiento con el mismo esquema anterior, los resultados muy buenos, obtubieron el alta hospitalaria en 24 horas, siguiendo después el tratamiento domiciliario. En el grupo control contamos con 20 niños, sometidos al tratamiento con SRO y se tomaron entre 7 o más días para que se autolimiten las diarreas.

Hemoperfusión en intoxicación por paraquat / Hemoperfusion in paraquat poisoning

Presentamos un paciente de 3 años de edad con intoxicación por Paraquat, a quien se le practicaron las medidas de prevención de absorción del tóxico, tres y media horas después de su ingestión accidental. A las 20 horas posteriores se consideró otra alternativa terapéutica, la hemoperfusión con carbón, debido a sus condiciones clínicas estables, sin alteraciones sistémicas aparentes, pero con persistencia de la prueba cualitativa del Paraquat en orina fuertemente positiva, lo que indicaba mal pronóstico. A las 22 horas se inicia la técnica en el Servicio de Nefrología del Hospital "J. M. de los Ríos", utilizando un Hemo-Adsorda 150 C (GAMBRO), durante un período de 3 horas. No se presentaron complicaciones de trombocitopenia, hipotensión, hipoglicemia, o trastornos electrolíticos. Al finalizar, se repitió la prueba cualitativa de orina, apreciándose disminución significativa de la reacción. La evolución fue satisfactoria, sin observarse complicaciones hepáticas, renales, ni respiratorias. Su seguimiento ambulatorio 5 meses después es adecuado. Realizamos revisión de la literatura especializada, y se recomiendan pautas del manejo