Lipid Profile in Inflammatory Bowel Disease Patients on Anti-TNFα Therapy.

BACKGROUND: Previous studies analyzing lipid profile in small cohorts of patients with rheumatic and inflammatory bowel diseases (IBD) treated with TNFα blockers showed conflicting results. We aim to evaluate the effect of anti-TNFα monoclonal antibodies, infliximab and adalimumab, on lipid profile in IBD patients followed up to 3 years. METHODS: Clinical charts of 128 consecutive IBD patients, who received at least three doses of infliximab or two doses of adalimumab, and with a clinical follow-up of at least 1 year, were retrospectively reviewed. Lipid profiles (total, HDL and LDL cholesterol, and triglycerides) before beginning the treatment and after 1 and 3 years of follow-up were collected. Multiple linear regression analysis was performed considering total cholesterol difference at basal time, 1 and 3 years as a dependent variable. RESULTS: There was not a statistically significant difference between pre- and post-treatment lipid profiles. However, the subgroup with normal-range total cholesterol level before anti-TNFα treatment (n = 82) showed a significant increase in total cholesterol after 1 and 3 years, and a significant increase in LDL cholesterol after 3 years. The subgroup with basal normal-range triglycerides showed a significant increase after 1 and 3 years of follow-up. Atherogenic index resulted significantly increased after 3 years of anti-TNFα treatment. Multivariate analysis showed no influence of age, gender, type of IBD, body mass index, or the presence of two or more cardiovascular risk factors. CONCLUSIONS: No significant changes in lipid profile of IBD patients on anti-TNFα therapy were observed after 1 and 3 years of treatment.

[Truancy in the wave of the epidemic in 2009-2010 influenza season schools of the city of Ceuta, Spain]. / Utilidad de la monitorización del absentismo escolar para la vigilancia de la gripe durante la temporada gripal 2009-2010 en la Ciudad de Ceuta.

BACKGROUND: Knowing Influenza absenteeism in the educational environment. Making health education in the same medium. METHODS: Among other actions carried out in the pandemic plan, the absences were monitored by flu-like symptoms in children from kindergarten, primary and secondary public schools and reached epidemiological week 39/2009 to 4/2010, transmitting the data from the Directorate Provincial Ministry of Education to the Ministry of Health and Consumer weekly. These data were compared with the same weeks of Diseases of Compulsory and Ceuta Sentinel Network. Was conducted health education through lectures and written material in schools. RESULTS: There were a total of 2055 absences, with a peak at week 45. The peak in the States and Red Sentinel was at week 47. CONCLUSIONS: Absenteeism data are complementary to the traditional indicator.

Identification of a Plasma Microrna Signature as Biomarker of Subaneurysmal Aortic Dilation in Patients with High Cardiovascular Risk.

Patients with subaneurysmal aortic dilation (SAD; 25-29 mm diameter) are likely to progress to true abdominal aortic aneurysm (AAA). Despite these patients having a higher risk of all-cause mortality than subjects with aortic size <24 mm, early diagnostic biomarkers are lacking. MicroRNAs (miRs) are well-recognized potential biomarkers due to their differential expression in different tissues and their stability in blood. We have investigated whether a plasma miRs profile could identify the presence of SAD in high cardiovascular risk patients. Using qRT-PCR arrays in plasma samples, we determined miRs differentially expressed between SAD patients and patients with normal aortic diameter. We then selected 12 miRs to be investigated as biomarkers by construction of ROC curves. A total of 82 significantly differentially expressed miRs were found by qPCR array, and 12 were validated by qRT-PCR. ROC curve analyses showed that seven selected miRs (miR-28-3p, miR-29a-3p, miR-93-3p, miR-150-5p, miR-338-3p, miR-339-3p, and miR-378a-3p) could be valuable biomarkers for distinguishing SAD patients. MiR-339-3p showed the best sensitivity and specificity, even after combination with other miRs. Decreased miR-339-3p expression was associated with increased aortic abdominal diameter. MiR-339-3p, alone or in combination with other miRs, could be used for SAD screening in high cardiovascular risk patients, helping to the early diagnosis of asymptomatic AAA.

Survival of selenium-enriched lactic acid bacteria in a fermented drink under storage and simulated gastro-intestinal digestion.

Selenium (Se), which is present as SeCys in seleno-proteins, is involved in cancer prevention, thyroid functioning, and pathogen inhibition. Se is incorporated in the diet through Se-containing foods. Some lactic acid bacteria (LAB) can biotransform selenite (toxic) into Se-nanoparticles (SeNPs) and Se-amino acids. To exert their beneficial properties in the host, bacteria should survive the harsh conditions of the gastrointestinal tract and during food storage. We evaluated whether selenization of LAB influenced bacterial growth and survival during gastrointestinal digestion and after storage when present in a fermented fruit juice-milk (FJM) beverage. Lactobacillus brevis CRL 2051 and Fructobacillus tropaeoli CRL 2034 were grown in MRS with and without selenite, and used to inoculate the FJM matrix. Selenization had no effect on LAB growth (9.54-9.9 log CFU/mL) in the FJM drink. The presence of SeNPs was confirmed for both selenized strains in the FJM beverage; however, the highest Se concentration (100 µg/L) was detected for the fermented beverage with selenized L. brevis. Under storage conditions 1.1 log CFU/ml decrease in cell count of selenized cells of L. brevis was observed, while no effect on cell viability was detected for non-selenized L. brevis or both selenized and control cells of F. tropaeoli. Resistance of L. brevis during digestion of the fermented FJM beverage was not affected by selenization. Contrarily, an increase (1 log CFU/mL) in the resistance of F. tropaeoli was observed when cells were selenized. After digestion, Se was detected in the soluble fraction of the beverage fermented by both strains, being higher for L. brevis (23.6 µg/L). Although selenization did not exert a drastic effect on strains´ survival during storage and digestion, microbial selenization previous to food fermentation could be an interesting tool for Se enrichment avoiding thus the addition of toxic Se salts.

Spectrum of BRCA1/2 variants in 940 patients from Argentina including novel, deleterious and recurrent germline mutations: impact on healthcare and clinical practice.

BRCA1/2 mutations in Latin America are scarcely documented and in serious need of knowledge about the spectrum of BRCA pathogenic variants, information which may alter clinical practice and subsequently improve patient outcome. In addition, the search for data on testing policies in different regions constitutes a fundamental strength for the present study, which analyzes BRCA1/2 gene sequences and large rearrangements in 940 probands with familial and/or personal history of breast/ovary cancer (BOC). In non-mutated DNA samples, Multiplex Ligation-dependent Probe Amplification assays (MLPA) were used for the analysis of large rearrangements. Our studies detected 179 deleterious mutations out of 940 (19.04%) probands, including 5 large rearrangements and 22 novel mutations. The recurrent mutations accounted for 15.08% of the total and only 2.87% of the probands analyzed, very different from a Hispanic panel previously described. IN CONCLUSION: a) this first comprehensive description of the spectrum in BRCA1/2 sheds light on the low frequency of recurrent mutations; b) this information is key in clinical practice to select adequate sequencing studies in our population, subsequently improve patient outcome and prevent damage associated to false normal reports resulting from the use of invalid population panels; c) panels of mutations from other populations should be cautiously validated before imported, even those of apparently similar origin, a concept to be considered beyond significance in Argentina.

Nursing work: nurses and users point of view / Trabalho de enfermagem: visão de enfermeiras/os e usuários / Labor de enfermería: visión de enfermeras/os y usuarios

ABSTRACT Objective: to understand the perception of users and nurses about nursing work. Method: a descriptive exploratory qualitative research in a clinic inpatient unit of a public hospital and in a Family Health Center, in the city of Punta Arenas, Chile. For data collection, we worked with a semi-structured interview, and analysis of the information was carried out guided by thematic content analysis. Thirty-five users and sixteen nurses participated; data collection took place between September and December 2018. Results: the results were organized according to the perception of nurses and users into four thematic categories Nursing as a profession of human care; Nursing and its role in administration/management; Nursing as a profession with educational role; Nursing as a health profession. In the case of users, nursing qualification as heavy and arduous work also emerged. Conclusion: nurses and users consider nursing as a health profession that deals with human care, which involves not only healing, but also dimensions of health education and management of material and human resources, which is based on science and requires academic training for proper development at different levels of care.

RESUMO Objetivo: compreender a percepção de usuários e enfermeiras/os sobre o trabalho de enfermagem. Método: pesquisa qualitativa, exploratório-descritiva, realizada em uma unidade de clínica médica de um hospital público e em um Centro de Saúde da Família, na cidade de Punta Arenas, Chile. Para a coleta de dados utilizou-se entrevista semiestruturada e a análise orientou-se pela análise temática de conteúdo. Participaram 35 usuários e 16 enfermeiros. A coleta de dados ocorreu entre setembro e dezembro de 2018. Resultados: os resultados foram organizados de acordo com a percepção de enfermeiros e usuários em quatro categorias temáticas: 1) enfermagem como profissão de cuidado humano; 2) enfermagem e sua função administrativo- gerencial; 3) enfermagem como profissão educadora; 4) enfermagem como profissão da saúde. No caso dos usuários, também emergiu a qualificação de enfermagem como trabalho pesado e árduo. Conclusão: enfermeiros e usuários consideram a enfermagem uma profissão de saúde que lida com o cuidado humano, envolvendo não apenas a cura, mas também as dimensões da educação em saúde e gestão de recursos materiais e humanos. A profissão está baseada na ciência e requer formação acadêmica para o desenvolvimento adequado do trabalho nos diferentes âmbitos de atenção.

RESUMEN Objetivo: comprender la percepción de los usuarios y de las enfermeras/os respecto a la labor de enfermería. Método: investigación de abordaje cualitativo exploratorio descriptivo en un área médica de un Hospital público y en un Centro de Salud Familiar, de la ciudad de Punta Arenas, Chile. Para la recolección de datos se trabajó con entrevista semi estructurada y el análisis de la información se realizó orientado por el análisis temático de contenido. Participaron 35 usuarios y 16 enfermeras/os, la colecta de datos transcurrió entre septiembre y diciembre de 2018. Resultados: los resultados fueron organizados según la percepción de los enfermeros y de los usuarios en cuatro categorías temáticas 1) Enfermería como profesión de cuidado humano, 2) Enfermería y su función de administración/gestión, 3) Enfermería como profesión educadora, 4) Enfermería como profesión. En el caso de los usuarios, también emergió la calificación de enfermería como trabajo pesado y arduo. Conclusión: enfermeros y usuarios consideran a enfermería como una profesión de la salud que trata de cuidado humano, que envuelve no solo el curar, si no que dimensiones de educación en salud y de gestión de recursos materiales y humanos, que está fundamentada en ciencia y que exige una formación académica para el desarrollo adecuado en los distintos niveles de atención.

[Use of medicinal plants among people attending two reference hospitals in Cuzco, Peru]. / Empleo de plantas medicinales en usuarios de dos hospitales referenciales del Cusco, Perú.

In order to determine the frequency and characteristics of the use of medicinal plants in patients from two third-level hospitals in the city of Cusco, a cross-sectional study was conducted between August and September 2011. For data collection, an instrument was built and validated through experts' judgment. The sample included 250 people selected in a non-probabilistic way. 83.2 and 75.3% informed having had used medicinal plants sometime during their lives and in the last month, respectively; additionally, 85.7 indicated that they wished their doctor would have prescribed them medicinal plants. Their most frequent uses include digestive problems (62.4%) as well as urinary (42.4%) and respiratory problems (40.4%). We conclude that the use of medicinal plants is widely spread among users of two hospitals in the city of Cusco. Utilization patterns show that patients wished the physicians of the health system prescribed medicinal plants in their consults.

Association between asthma and dental caries in the primary dentition of Mexican children.

BACKGROUND: Asthma has been associated with a great number of negative health outcomes. This study was undertaken to detect the association between asthma and dental caries in the primary dentition. METHODS: Data were obtained from a cohort of 1160 Mexican children aged 4-5 years. We used the questionnaire of the International Study of Asthma and Allergies Diseases in Childhood. Asthma was classified according to parents' reports. Caries indexes were measured as the number of decayed (d), missing (m), and filled (f), teeth (t) (dmft) or surfaces (dmfs). Decayed teeth included initial caries in this study. Adjusted odds ratios (adjusted ORs) were determined for asthma using logistic regression model. Gender, sugary products consumption, and oral hygiene habits were utilized as covariates. RESULTS: The prevalence of dental caries was 17.9% in the 1160 children. Approximately 226 (19.5%) children were identified with asthma. Among them, 166 (73.5%) presented with symptoms during the day and 60 (26.5%) during the day and night. The prevalence of caries in children with asthma was 19.9%; it was higher in children with nocturnal asthma symptoms than in those with asthma symptoms only during the day. Logistic regression model showed that asthma (adjusted OR=1.24; 95% confidence interval [95% CI]=0.84-1.81) was not associated with caries. A significant association was found between nocturnal asthma symptoms (adjusted OR=1.85; 95% CI=1.00-3.44) and dental caries. CONCLUSIONS: Asthma is not associated with dental caries. Nocturnal asthma symptoms appear to be associated with dental caries in the primary dentition.

Empleo de plantas medicinales en usuarios de dos hospitales referenciales del Cusco, Perú / Use of medicinal plants among people attending two reference hospitals in Cusco, Peru

Con el fin de determinar la frecuencia de empleo de plantas medicinales y describir las características de su uso en pacientes de dos hospitales referenciales de la ciudad de Cusco, se realizó un estudio transversal entre agosto y septiembre de 2011. Para el recojo de datos se construyó un instrumento, validado por juicio de expertos. El tamaño de la muestra fue de 250 personas seleccionadas no probabilísticamente. El 83,2 y 75,3% informaron haber empleado plantas medicinales alguna vez en su vida y en el último mes, respectivamente; además, el 85,7 señaló que desearía que su médico le recete plantas medicinales. Sus usos más frecuentes son para problemas digestivos (62,4%); urinarios (42,4%), y respiratorios (40,4%). Se concluye que el empleo de plantas medicinales se encuentra bastante difundido entre los usuarios de dos hospitales referenciales de la ciudad de Cusco. Los patrones de empleo revelan que los pacientes desean que los médicos del sistema de salud prescriban plantas medicinales en su acto médico.

In order to determine the frequency and characteristics of the use of medicinal plants in patients from two third-level hospitals in the city of Cusco, a cross-sectional study was conducted between August and September 2011. For data collection, an instrument was built and validated through experts’ judgment. The sample included 250 people selected in a non-probabilistic way. 83.2 and 75.3% informed having had used medicinal plants sometime during their lives and in the last month, respectively; additionally, 85.7 indicated that they wished their doctor would have prescribed them medicinal plants. Their most frequent uses include digestive problems (62.4%) as well as urinary (42.4%) and respiratory problems (40.4%). We conclude that the use of medicinal plants is widely spread among users of two hospitals in the city of Cusco. Utilization patterns show that patients wished the physicians of the health system prescribed medicinal plants in their consults.

Subdiagnóstico de carcinoma quístico adenoide de senos paranasales po sinusitis y pólipos nasales: a propósito de un caso / Under-diagnosis of adenoid cystic carcinoma of the paranasal sinuses for sinusitis and nasal polyps: a case report

La posibilidad de subdiagnosticar el cuadro, al confundirlo con enfermedades más comunes y benignas como: sinusitis y pólipos nasales. El tumor raro en senos paranasales; caracterizado por presentar metástasis tardía, ser persistente y agresivo; tener predilección por invadir y crecer siguiendo el trayecto de fibras nerviosas. Varón de 65 años, mecánico durante 25 años; con cuadro antiguo de sinusitis supurativa y poliposis nasal, a repetición; con extirpación quirúrgica hasta en dos oportunidades, teniendo diagnóstico de papiloma invertido. Doce años después se diagnostica carcinoma quístico adenoide con compromiso de maxilar superior, hueso malar y globo ocular. Efectuándosele maxilectomía ampliada y resección de globo ocular derechos.(AU)

The possibility of under-diagnosis, by frequent and benign diseases such as sinusitis and nasal polyposis. The rare tumor in sinuses, characterized by: late metastasis, being persistent and aggressive, predilection for invading and growing along the nerve fibers. A 65-year-old male, mechanic for 25 years, with repetitive suppurative sinusitis and nasal polyps; underwent surgical removal twice, diagnosis of inverted papilloma. Twelve years later was diagnosed with Cystic Adenoid Carcinoma with compromise of the maxilla, malar bone and eyeball, performing extended maxillectomy and resection of right eyeball.(AU)

Manejo integral de un paciente con secuelas neuropsiquiátricas por consumo crónico de alcohol / Integral Treatment of a Patient with Neuropsychiatric Symptoms in a city in the Central-South Region of Chile

La cronicidad de los síntomas neuropsiquiátricos aun cuando tengan etiología diversa, genera una importante discapacidad para el paciente, mayor carga familiar y altos costos de atención. Objetivos. Describir la evolución clínica y el manejo integral de un paciente con deficiencias vitamínicas asociadas al consumo de alcohol. Hallazgos clínicos. Se trata de un hombre de 55 años, residente en San Carlos, Chile, sin antecedentes psiquiátricos previos excepto por dependencia al alcohol que suspendió luego del inicio de su sintomatología psiquiátrica hace cuatro años, caracterizada por ideas delirantes de tipo paranoide, místico y nihilista, además de alucinaciones complejas de tipo auditivo, olfatorio y táctil y compromiso gradual de su estado de ánimo. Posteriormente, presenta paraparesia de extremidades superiores de predominio proximal y más tarde de las inferiores, además de alteraciones cognitivas. Se descartaron otras patologías médicas y sólo se documentó anemia macrocítica, iniciándose manejo con suplencia vitamínica (B12 y folato) y un plan de intervención integral por psiquiatría y terapia ocupacional, para tratamiento sintomático y de rehabilitación. Conclusiones. A lo largo del seguimiento de las intervenciones interdisciplinarias se observa en el paciente una mejoría progresiva especialmente de las alteraciones neurológicas y de su funcionamiento global...

Chronified neuropsychiatric symptoms even when they have diverse etiology, generate an important impairment for the patient, greater family preoccupation, and high attention cost. Objectives. Describe the clinical evolution and integral management of a patient with vitamins deficit for alcohol abuse. Clinical Signs. Subject is a male patient of 55 years of age, resides in San Carlos, Chile, without psychiatric backgrounds except for alcohol dependency that he suspended after beginning psychiatric symptoms four years ago, characterized by delirious thoughts of the paranoid, mystical and nihilistic nature, also visual, olfactory and tactile complex hallucinations and gradual compromise of mood. Afterwards he presented paralysis of the superior extremities predominately proximal, and later of the inferiors, also, cognitive alterations. Other medical pathologies where discarded and only a megaloblastic anemia was documented, beginning treatment of vitamin supplements (B12 and folate) and an integral treatment plan with psychiatry and occupational therapist, for symptomatic treatment and, rehabilitation. Conclusions. Throughout the follow up of the interdisciplinary interventions it could be observed in the patient a progressive betterment of the neurological alterations, and in his global functions...

Utilidad de la monitorización del absentismo escolar para la vigilancia de la gripe durante la temporada gripal 2009-2010 en la ciudad de Ceuta / Truancy in the wave of the epidemic in 2009-2010 influenza seasons schools of the city of Ceuta, Spain

Fundamentos: Conocer el absentismo por la gripe en el medio educativo. Métodos: Entre otras actuaciones llevadas a cabo en el Plan Pan-démico, se monitorizaron las ausencias por síntomas gripales en niños de educación infantil, primaria y secundaria de colegios públi-cos y concertados desde la semana epidemiológica 39/2009 a la 4/2010, transmitiendo los datos de la Dirección Provincial del Minis-terio de Educación a la Consejería de Sanidad y Consumo semanal-mente. Estos datos se compararon con los de las mismas semanas de Enfermedades de Declaración Obligatoria y Red Centinela de Ceuta. Resultados: Se contabilizaron un total de 2.055 ausencias, con un pico máximo en la semana 45. El pico máximo en Edos y Red Centinela fue en la semana 47. Conclusiones: Los datos de absentismo son un indicador com-plementario de otros tradicionales(AU)

Background: Knowing Influenza absenteeism in the educatio-nal environment. Making health education in the same medium. Methods: Among other actions carried out in the pandemic plan, the absences were monitored by flu-like symptoms in children from kindergarten, primary and secondary public schools and reached epi-demiological week 39/2009 to 4 / 2010, transmitting the data from the Directorate Provincial Ministry of Education to the Ministry of Health and Consumer weekly. These data were compared with the same weeks of Diseases of Compulsory and Ceuta Sentinel Net-work. Was conducted health education through lectures and written material in schools. Results: There were a total of 2055 absences, with a peak at week 45. The peak in the States and Red Sentinel was at week 47. ConclusionsAbsenteeism data are complementary to the tradi-tional indicator(AU)

Niveles de Beta-2 microglobulina en pacientes mexicanos con SIDA: asociación con la gravedad del padecimiento / Levels of Beta-2 microglobulin in mexican patientes with aids: association with the severity of the disease

El objetivo del presente trabajo fue analizar niveles de beta-2 microglobulina (ß2MG) en pacientes mexicanos con SIDA y determinar si éstos tenían asocición con la gravedad del padecimiento. Utilizando radioinmunoanálisis, se midió la ß2MG durante la evaluación inicial de 29 pacientes con SIDA referidos al Instituto Nacional de Cancerología. Dieciocho pacientes tenían sarcoma de Kaposi, siete infección oportunista y cuatro linfoma no-Hodgkin de alto grado. De los 18 sujetos con carcoma de Kaposi, 10 tuvieron enfermedad agresiva que requirió de tratamiento. en todos estos caso el nivel de ß2MG fue de 3.5 a 8.0 mg/l (promedio de 4.54). Los otros ocho pacientes con sarcoma de Kaposi tenían enfermedad indolente, y sus niveles de ß2MG fueron menores a 3.5 mg/l (promedio de 1.97). La diferencia entre las medias fue estadísticamente significativa (p < 0.001). los pacientes con infecciones oportunistas presentaron niveles de 1.42 a 5 mg/l (promedio de 3.41). Los niveles no correlacionaron con las supervivencia, el tipo de infección o las cuentas de linfocitos CD4. En los cuatro pacientes con linfoma, los niveles de ß2MG variaron de 1.66 a 3.24 mg/l (promedio de 2.26) y no correlacionaron con la etapa clínica o la supervivencia. por otra parte, los niveles de ß2MG se encontraron elevados (> 4.9 mg/l) en los tres pacintes con síndrome de desgaste. Nuestros datos sugieren que los pacientes con sarcoma de Kaposi y niveles de ß2MG superiores a 3.5 mg/l tienen enfermedad agresiva que requiere de tratamiento. Asimismo, los niveles más altos de ß2MG se asociaron a síndrome de desgaste grave