Two-Sided Antibacterial Cellulose Combining Probiotics and Silver Nanoparticles.

The constant increase of antibiotic-resistant bacteria demands the design of novel antibiotic-free materials. The combination of antibacterials in a biocompatible biomaterial is a very promising strategy to treat infections caused by a broader spectrum of resistant pathogens. Here, we combined two antibacterials, silver nanoparticles (AgNPs) and living probiotics (Lactobacillus fermentum, Lf), using bacterial cellulose (BC) as scaffold. By controlling the loading of each antibacterial at opposite BC sides, we obtained a two-sided biomaterial (AgNP-BC-Lf) with a high density of alive and metabolically active probiotics on one surface and AgNPs on the opposite one, being probiotics well preserved from the killer effect of AgNPs. The resulting two-sided biomaterial was characterized by Field-Emission Scanning Electron Microscopy (FESEM) and Confocal Laser Scanning Microscopy (CLSM). The antibacterial capacity against Pseudomonas aeruginosa (PA), an opportunistic pathogen responsible for a broad range of skin infections, was also assessed by agar diffusion tests in pathogen-favorable media. Results showed an enhanced activity against PA when both antibacterials were combined into BC (AgNP-BC-Lf) with respect to BC containing only one of the antibacterials, BC-Lf or AgNP-BC. Therefore, AgNP-BC-Lf is an antibiotic-free biomaterial that can be useful for the therapy of topical bacterial infections.

Efficacy of Topical Treatment with (-)-Epigallocatechin Gallate, A Green Tea Catechin, in Mice with Cutaneous Leishmaniasis.

The treatment of leishmaniasis includes pentavalent antimony drugs but, because of the side effects, toxicity and cases of treatment failure or resistance, the search of new antileishmanial compounds are necessary. The aims of this study were to evaluate and compare the in vitro antileishmanial activity of four green tea catechins, and to assess the efficacy of topical (-)-epigallocatechin gallate in a cutaneous leishmaniasis model. The antileishmanial activity of green tea catechins was evaluated against intracellular amastigotes, and cytotoxicity was performed with human monocytic cell line. BALB/c mice were infected in the ear dermis with Leishmania (Leishmania) amazonensis and treated with topical 15% (-)-epigallocatechin gallate, intraperitoneal Glucantime, and control group. The efficacy of treatments was evaluated by quantifying the parasite burden and by measuring the lesions size. (-)-Epigallocatechin gallate and (-)-epigallocatechin were the most active compounds with IC50 values <59.6 µg/mL and with a selectivity index >1. Topical treatment with (-)-epigallocatechin gallate decreased significantly both lesion size and parasite burden (80.4% inhibition) compared to control group (p < 0.05), and moreover (-)-epigallocatechin gallate showed a similar efficacy to Glucantime (85.1% inhibition), the reference drug for leishmaniasis treatment.

High Prevalence of Intermediate Leptospira spp. DNA in Febrile Humans from Urban and Rural Ecuador.

Leptospira spp., which comprise 3 clusters (pathogenic, saprophytic, and intermediate) that vary in pathogenicity, infect >1 million persons worldwide each year. The disease burden of the intermediate leptospires is unclear. To increase knowledge of this cluster, we used new molecular approaches to characterize Leptospira spp. in 464 samples from febrile patients in rural, semiurban, and urban communities in Ecuador; in 20 samples from nonfebrile persons in the rural community; and in 206 samples from animals in the semiurban community. We observed a higher percentage of leptospiral DNA-positive samples from febrile persons in rural (64%) versus urban (21%) and semiurban (25%) communities; no leptospires were detected in nonfebrile persons. The percentage of intermediate cluster strains in humans (96%) was higher than that of pathogenic cluster strains (4%); strains in animal samples belonged to intermediate (49%) and pathogenic (51%) clusters. Intermediate cluster strains may be causing a substantial amount of fever in coastal Ecuador.

Dehydroleucodine and xanthatin, two natural anti-inflammatory lactones, inhibit mast cell degranulation by affecting the actin cytoskeleton.

Actin remodeling is a critical regulator of mast cell secretion. In previous work, we have shown that dehydroleucodine and xanthatin, two natural α,ß-unsaturated lactones, exhibit anti-inflammatory and mast cell stabilizing properties. Based on this background, this study aimed to determine whether the mast cell stabilizing action of these lactones is associated with changes in the actin cytoskeleton. Rat peritoneal mast cells were preincubated in the presence of dehydroleucodine or xanthatin before incubation with compound 48/80. Comparative studies with sodium cromoglycate and latrunculin B were also made. After treatments, different assays were performed on mast cell samples: ß-hexosaminidase release, cell viability studies, quantification of mast cells and their state of degranulation by light microscopy, transmission electron microscopy, and actin staining for microscopy observation. Results showed that dehydroleucodine and xanthatin inhibited mast cell degranulation, evidenced by the inhibition of ß-hexosaminidase release and decreased degranulated mast cell percentage. At the same time, both lactones altered the F-actin cytoskeleton in mast cells resulting, similarly to Latrunculin B, in a higher concentration of nuclear F-actin when activated by compound 48/80. For the first time, this study describes the biological properties of dehydroleucodine and xanthatin concerning to the rearrangement of actin filaments during stimulated exocytosis in mast cells. These data have important implications for developing new anti-inflammatory and mast cell stabilizing drugs and for designing new small molecules that may interact with the actin cytoskeleton.

Extra virgin olive oil inhibits Helicobacter pylori growth in vitro and the development of mice gastric mucosa lesions in vivo.

Helicobacter pylori infection is widespread worldwide, with more than a half of the world population infected. H. pylori antibiotic-resistant strains and non-compliance to therapy are the major causes of H. pylori eradication failure. The search for new therapies based on plant extracts is a scientific interest field. The present study was conducted to evaluate the effect in vitro of extra virgin olive oil (EVOO), hydroxytyrosol (HT), and oleuropein (Olp) against two H. pylori strains and the effect in vivo of the oral administration of EVOO on the gastric mucosa of BALB/c mice infected with this microorganism. The broth microdilution method assayed the antibacterial in vitro activity of EVOO, HT, and Olp against H. pylori strains. For in vivo studies, male BALB/c mice were infected orally with an H. pylori suspension every 72 h. Four groups were used: (1) Control, (2) H. pylori-infected (HP), (3) EVOO, and (4) HP + EVOO. Mice were sacrificed at 7, 15, and 30 days. The stomachs were removed and observed under a microscope. Scoring of the degree of erosion was determined. Samples were processed by histological techniques for light microscopy. Macroscopic analysis showed that the presence of small erosions increased, both in number and size, in the infected group. Animals infected and treated with EVOO exhibited the presence of fewer erosions, which decreased in number as the treatment progressed. The mucosa of the control and EVOO groups showed normal histological characteristics at the three times studied. The mucosa of animals infected with H. pylori showed disruptions of the lining epithelium, damage to gastric glands, and vasodilation. The mucosa of animals infected with H. pylori and treated with EVOO showed morphological characteristics similar to those of normal and EVOO mucosa. For the first time, the current study showed the effect in vitro and in vivo of EVOO and combined administration of HT and Olp against H. pylori using an animal model. Future studies are needed to establish the mechanism of EVOO's action at the gastric mucosa level to propose this product as a natural antimicrobial agent for the treatment of gastric H. pylori infections.

Trypanocidal activity of South American Vernonieae (Asteraceae) extracts and its sesquiterpene lactones.

Chagas disease is caused by Trypanosoma cruzi and affects the poorest population in the Americas. Fourteen plant extracts and seventeen sesquiterpene lactones from the tribe Vernonieae (Asteraceae), were evaluated for the first time against T. cruzi. Cytotoxicity employing HeLa cells was also assessed. The best results were obtained with leaves and flowers rinse extracts from Vernonanthura nebularum (E-1 and E-3) and Elephantopus mollis (E-11 and E-13), with IC50 values <2 µg/mL, being E-1 the most active (IC50 = 0.8 µg/mL). Additionally, these extracts displayed a good selectivity (SI > 10). The most active sesquiterpene lactones, isolated from the extracts, were 2 (2-methoxy-2,5-epoxy-8-methacryloxygermacra-3Z,11(13)-dien-6,12-olide) and 6 (2-ethoxy-2,5-epoxy-8-angeloxygermacra-3Z,11(13)-dien-6,12-olide) from V. nebularum and 12 (8α-methacryloxyhirsutinolide 13-O-acetate) from V. pinguis, with IC50 of 1.5, 2.1 and 2.0 µM, respectively. These compounds showed SI values >14, better than those of the reference drug nifurtimox. Plants living in South American ecosystems could become a potential source of trypanocidal agents.

Development of a Fluorescent Assay to Search New Drugs Using Stable tdTomato-Leishmania, and the Selection of Galangin as a Candidate With Anti-Leishmanial Activity.

Antimonials continue to be considered the first-line treatment for leishmaniases, but its use entails a wide range of side effects and serious reactions. The search of new drugs requires the development of methods more sensitive and faster than the conventional ones. We developed and validated a fluorescence assay based in the expression of tdTomato protein by Leishmania, and we applied this method to evaluate the activity in vitro of flavonoids and reference drugs. The pIR1SAT/tdTomato was constructed and integrated into the genome of Leishmania (Leishmania) amazonensis. Parasites were selected with nourseothricin (NTC). The relation of L. amaz/tc3 fluorescence and the number of parasites was determined; then the growth in vitro and infectivity in BALB/c mice was characterized. To validate the fluorescence assay, the efficacy of miltefosine and meglumine antimoniate was compared with the conventional methods. After that, the method was used to assess in vitro the activity of flavonoids; and the mechanism of action of the most active compound was evaluated by transmission electron microscopy and ELISA. A linear correlation was observed between the emission of fluorescence of L. amaz/tc3 and the number of parasites (r2 = 0.98), and the fluorescence was stable in the absence of NTC. No differences were observed in terms of infectivity between L. amaz/tc3 and wild strain. The efficacy of miltefosine and meglumine antimoniate determined by the fluorescence assay and the microscopic test showed no differences, however, in vivo the fluorescence assay was more sensitive than limiting dilution assay. Screening assay revealed that the flavonoid galangin (GAL) was the most active compound with IC50 values of 53.09 µM and 20.59 µM in promastigotes and intracellular amastigotes, respectively. Furthermore, GAL induced mitochondrial swelling, lipid inclusion bodies and vacuolization in promastigotes; and up-modulated the production of IL-12 p70 in infected macrophages. The fluorescence assay is a useful tool to assess the anti-leishmanial activity of new compounds. However, the assay has some limitations in the macrophage-amastigote model that might be related with an interfere of flavanol aglycones with the fluorescence readout of tdTomato. Finally, GAL is a promising candidate for the development of new treatment against the leishmaniasis.

High performance of an enzyme linked immunosorbent assay for American tegumentary leishmaniasis diagnosis with Leishmania (Viannia) braziliensis amastigotes membrane crude antigens.

The diagnosis of American tegumentary leishmaniasis (ATL) still requires the design of more effective tools. Leishmania (Viannia) braziliensis is the causal agent of the 90% of Argentinean ATL cases. Considering the current knowledge, an ELISA based crude antigen (CA) for the diagnosis was designed. Ninety-nine subjects diagnosed as ATL, 27 as no-ATL, and 84 donors from non-ATL-endemic areas were included in this study. The current ATL diagnosis was based four techniques, dermal smear microscopic examination (parasitological test), PCR, Leishmanin skin test, and clinical records. We obtained CA extracts from promastigotes and amastigotes from macrophage cultures of different zymodemes of endemic Leishmania species circulating in the study area. Crude antigens from the 'local' main zymodeme of L. (V.) braziliensis showed the highest reactivity against anti-Leishmania antibodies compared to the other included species. The CA of amastigotes of this zymodeme was 3.4 fold more reactive than promastigotes one. Moreover, amastigote-membrane CA (MCA) were 3.6 fold more reactive than the soluble antigens. The MCA-ELISA reached a sensitivity and specificity of 98% (CI = 94.7%-100%) and 63.6% (53.9-73.1), respectively. When anti-Trypanosoma cruzi reactive sera were excluded, the specificity reached 98.4% (94.4-100), while the sensitivity was similar, with a positive predictive value (PV) of 98.6% (94.6-100) and negative PV of 96.3% (91.6-100). The performance of the MCA-ELISA results strongly contribute to the final diagnostic decision, since a non-reactive serological result almost discards the suspected ATL, because of its high negative PV. The developed MCA-ELISA showed a high diagnostic performance, which makes it a good candidate for ATL diagnosis, for seroprevalence studies, or for monitoring treatments efficacy.

The Hidden Wounds of Hurricane Dorian: Why Emergency Response Must Look Beyond Physical Trauma.

Project HOPE, a global health and humanitarian assistance organization, has responded to some of the world's largest natural disasters and humanitarian and health crises for more than 60 years. As natural disasters increase in frequency and intensity, otherwise effective health systems can become compromised, and - although less visible than traumatic injuries - populations with chronic diseases can be significantly impacted. Emergency preparedness and response efforts must adapt to address issues around continuity of care, access to pharmaceuticals, strengthening cold chain mechanisms, restoring supply chains, and educating patients with chronic illnesses on emergency preparedness. Project HOPE designs medical teams and supply donations to work alongside, rather than parallel to, existing health care infrastructure, laying the foundation for the long-term recovery of the health system.

Insecticidal effects of Vernonanthura nebularum against two economically important pest insects.

Vernonanthura nebularum (Cabrera) H. Rob. (Asteraceae), an endemic species from the north of Argentina, is a rich source of elephantopus-type sesquiterpene lactones. These compounds have proved to be promising antiparasitic agents, but there is no report about their action against pest insects. In this work we studied for the first time the antifeedant and toxic effects of V. nebularum natural products against the fall army warm Spodoptera frugiperda Smith and the oviposition deterrent activity against the fruit fly Ceratitis capitata Wiedemann. As a result, we found that extracts, fractions composed of sesquiterpene lactones and pure sesquiterpene lactones altered larval feeding behavior in the food choice test. Nutritional parameters of S. frugiperda larvae were also affected. Fraction II (300 µg/g of diet.), containing compounds 1, 2 and 3, was the most toxic substance with 80% pupal mortality and wing malformations in adults. In oviposition deterrent experiments against Ceratitis capitata, we observed a moderate effect at 30 µg/cm2 of the test compound. The most active substances were the methanolic extract, dichloromethane subextract and lactone 2. According to our results, V. nebularum natural products could be used for maximizing the effectiveness and specificity in future insecticide design with specific or multiple target sites, while ensuring the economic and ecological sustainability, in addition to combat the increasing resistance rates developed by synthetic pesticides.

Three decades of heat stress exposure in Caribbean coral reefs: a new regional delineation to enhance conservation.

Increasing heat stress due to global climate change is causing coral reef decline, and the Caribbean has been one of the most vulnerable regions. Here, we assessed three decades (1985-2017) of heat stress exposure in the wider Caribbean at ecoregional and local scales using remote sensing. We found a high spatial and temporal variability of heat stress, emphasizing an observed increase in heat exposure over time in most ecoregions, especially from 2003 identified as a temporal change point in heat stress. A spatiotemporal analysis classified the Caribbean into eight heat-stress regions offering a new regionalization scheme based on historical heat exposure patterns. The temporal analysis confirmed the years 1998, 2005, 2010-2011, 2015 and 2017 as severe and widespread Caribbean heat-stress events and recognized a change point in 2002-2004, after which heat exposure has been frequent in most subsequent years. Major heat-stress events may be associated with El Niño Southern Oscillation (ENSO), but we highlight the relevance of the long-term increase in heat exposure in most ecoregions and in all ENSO phases. This work produced a new baseline and regionalization of heat stress in the basin that will enhance conservation and planning efforts underway.

Active sesquiterpene lactones against Leishmania amazonensis and Leishmania braziliensis.

Seventeen sesquiterpene lactones (SLs) isolated from five species of the tribe Vernonieae were evaluated for their in vitro activity against promastigotes of Leishmania amazonensis and Leishmania braziliensis. Additionally, a quantitative structure activity relationship has been made, since all these natural compounds were found to have potent to mild antileishmanial properties. The most active compounds against L. braziliensis were 16 and 17 (IC50 values 1.45 and 1.34 µM, respectively), followed by compound 15 with IC50 value of 1.60 µM against L. amazonensis. The three glaucolide-type SLs (4-6) were the least active against both parasites. The computational study allowed us to establish that lipophilicity and polarisability play an important role in the antiparasitic activity. This is the first report of the known germacradiendiolides 16 and 17 from Elephantopus mollis. The activity data of the compounds 1-17 assayed against Leishmania parasites are reported here for the first time.

Características epidemiológicas de los 190 pacientes internados con SARS-CoV2 en el Hospital General de Barrio Obrero periodo junio-diciembre 2020

RESUMEN El Hospital General de Barrio Obrero no es ajeno a la pandemia, teniendo pacientes hospitalizados con COVID-19 desde inicios de junio de 2020 con un impacto alto en los servicios. Se analizaron 190 pacientes internados en los distintos servicios. Se encontró predominio del sexo masculino 52%. En cuanto a la edad, se observó un claro predominio de gerontes con el 51% del total de pacientes170 (89%) fueron internados en el servicio de clínica médica, a pesar de eso, aún un bajo porcentaje se detectó en servicios como gineco-obstetricia y cirugía general. Según la evolución clínica de los pacientes, 138 (73%) fueron dados de alta, 29 (15%) fueron trasladados a un centro de mayor complejidad por complicación de la enfermedad y 23 (12%) fallecieron, 16 (70%) eran de sexo masculino, según el rango etario, los pacientes que obitaron eran gerontes 17 (74%), adultos mayores 4 (17%) y adultos jóvenes 2 (9%). Octubre fue el mes con más muertes en pacientes internados con SARS-CoV-2. .En cuanto a la comorbilidad, 91% presentaba al menos una comorbilidad, entre las que predominó la hipertensión arterial (25%)

ABSTRACT The Barrio Obrero General Hospital is no stranger to the pandemic, having hospitalized patients with COVID-19 since the beginning of June 2020 with a high impact on services. 190 patients admitted to the different services were analyzed. 52% male predominance was found. Regarding age, a clear predominance of elderly was observed with 51% of all patients170 (89%) were admitted to the medical clinic service, despite this, a low percentage was still detected in services such as gynecology. obstetrics and general surgery. According to the clinical evolution of the patients, 138 (73%) were discharged, 29 (15%) were transferred to a more complex center due to complications of the disease and 23 (12%) died, 16 (70%) were of male sex, according to age range, the patients who obtained were elderly 17 (74%), older adults 4 (17%) and young adults 2 (9%). October was the month with the most deaths in patients hospitalized with SARS-CoV-2. Regarding comorbidity, 91% had at least one comorbidity, among which arterial hypertension predominated (25%).

Gastroprotective effects and antimicrobial activity of Lithraea molleoides and isolated compounds against Helicobacter pylori.

ETHNOPHARMACOLOGICAL RELEVANCE: Lithraea molleoides (Vell.) Engl. (Anacardiaceae) is a medicinal plant traditionally used in South America to treat various ailments, including diseases of the digestive system. AIM OF THE STUDY: To evaluate the in vivo antiulcer and antimicrobial activities against Helicobacter pylori of L. molleoides and its isolated compounds. MATERIALS AND METHODS: Methanolic extract 250 and 500 mg/kg, (LmE 250 and LmE 500, respectively) and infusions, 10 g and 20 g en 100mL (LmI 10 and LmI 20, respectively) of L. molleoides was evaluated for antiulcer activity against 0.6N HCl, 0.2N NaOH, 200mg/kg acetilsalicilic acid and absolute ethanol-induced gastric ulcers in rats. The degree of erosion in the glandular part of the stomach was assessed from a scoring system. Acute toxicity in mice was also evaluated. The antiulcer effect of the isolated compounds (catechol, mannitol, rutin, gallic acid, ferulic acid and caffeic acid, 100mg/kg) was evaluated against absolute ethanol-induced gastric ulcers in rats. The anti-Helicobacter pylori activity of L. molleoides and isolated compounds was performed using broth dilution methods. RESULTS: The LmE 250, LmE 500, LmI 10 and LmI 20 produced significant inhibition on the ulcer index in 0.6N HCl, 0.2N NaOH, 200mg/kg acetilsalicilic acid and absolute ethanol- induced gastric ulcers in rats. The isolated compounds, catechol, mannitol, rutin, ferulic acid and caffeic acid were active in absolute ethanol- induced gastric ulcers in rats. L. molleoides and different compounds showed antimicrobial activity in all strains tested. The lowest MIC value (0. 5 µg/mL) was obtained with catechol in six of eleven strains assayed. No signs of toxicity were observed with doses up to 2g/kg in an acute toxicity assay. CONCLUSION: These findings indicate that L. molleoides displays potential antiulcerogenic and antimicrobial activities and the identification of active principles could support the use of this plant for the treatment of digestive affections.

Análisis de la laparoscopía diagnóstica y estudios de imagen en el manejo del dolor en fosa ilíaca derecha de etiología incierta / Analysis of diagnostic laparoscopy and imaging studies for the handling of pain in undetermined etiology right iliac fossa / Análise da laparoscopia diagnóstica e estudos de imagem no manejo da dor na fossa ilíaca direita de etiologia incerta

Introducción: el dolor en la fosa ilíaca derecha (FID) es un motivo de consulta habitual en los servicios de urgencias. El principal desafío es diferenciar si es un cuadro quirúrgico o no. Objetivo: conocer qué rol ocupa la laparoscopía diagnóstica (LD), la ecografía de abdomen y la tomografía computada (TC) en el algoritmo de estudio de los pacientes con dolor en FID con diagnóstico incierto en Uruguay. Método: estudio observacional, descriptivo, prospectivo, multicéntrico, sobre pacientes que consultaron por dolor en FID desde el 1º de junio al 31 de agosto de 2017 en centros asistenciales de Uruguay. Se recolectaron los siguientes datos en una planilla electrónica: sexo, edad, sintomatología, hallazgos físicos, exámenes solicitados, conducta tomada, hallazgos intraoperatorios, complicaciones. Resultados: se completaron 159 planillas. Luego de una valoración primaria se planteó duda diagnóstica en 69 (43,4%) pacientes. La TC se solicitó en 29 (42%) pacientes. Se realizó TC al 78% de los mayores de 50 años versus 18% entre los de 15 y 29 años. Del total, 13 (44,8%) se informaron como normales, confirmando en el intraoperatorio cuatro (30,7%) apendicitis agudas. Se realizaron 29 LD en los casos con duda diagnóstica, dos tercios fueron en pacientes de 15 a 29 años. En 22 (76%) casos se arribó a un diagnóstico. No hubo complicaciones. Conclusiones: la LD permitió realizar diagnóstico y tratamiento en la mayoría de los casos. La sensibilidad de la TC fue baja en comparación con datos internacionales. El algoritmo diagnóstico debe ser individualizado, basado en protocolos adaptados a los recursos de cada institución. (AU)

Introduction: right iliac fossa (RIF) pain is a frequent reason for consultation at the Emergency Units. The main challenge lies in defining whether it is a surgical condition or not. Objective: to learn about the role of diagnostic laparoscopy, abdominal ultrasound and CT scan in the studies algorithm of patients with RIF pain of unknown etiology in Uruguay. Method: observational, descriptive, prospective, multi-center study of patients who consulted for RIF from June 1st to August 31, 2017 in Health Institutions in Uruguay. The following data were gathered in an excel sheet: sex, age, symptoms, physical findings, tests requested, conduct adopted, intraoperative findings and complications. Results: 159 sheets were completed. Upon a primary assessment a diagnostic doubt was arose in 69 patients (43.4%). A CT scan was requested to 29 patients, and a CT was performed to 78% of patients older than 50 years old vs 18% of those between 15 and 29 years. Conclusions: the diagnostic laparoscopy allowed for diagnosis in most cases. Sensitivity of the CT scan was low when compared to international data. The diagnostic algorithm needs to me individualized, based on protocols adapted to the resources of every institution.

Introdução: a dor na fossa ilíaca direita (FID) é um motivo habitual de consulta habitual nos Serviços de Urgências. O principal desafio é diferenciar entre um quadro cirúrgico e um não cirúrgico. Objetivo: conhecer o papel da laparoscopia diagnóstica (LD), do ultrassom de abdômen e da tomografia computada (TC) no algoritmo de estudo dos pacientes com dor na FID com diagnóstico incerto no Uruguai. Método: estudo observacional, descritivo, prospectivo, multicêntrico sobre pacientes que consultaram por dor na FID no período 1º de junho - 31 de agosto del 2017 em Centros Assistenciais no Uruguai. Em una planilha electrónica foram incluídos os seguintes dados: sexo, idade, sintomatologia, achados físicos, exames solicitados, conduta tomada, achados intra-operatórios e complicações. Resultados: foram preenchidas 159 planilhas. Depois de uma avaliação primaria foram definidas dúvidas diagnósticas em 69 (43,4%) pacientes. Foram solicitadas TC a 29 (42%) pacientes; 78% dos pacientes com mais de 50 anos vs 18% dos pacientes com idades entre 15 e 29 anos. 13 (44,8% do total) tiveram laudo "normal", confirmando apendicite aguda em 4 (30,7%) durante cirurgia. Foram realizadas 29 LD nos casos com dúvida diagnóstica sem dos terços em pacientes de 15 a 29 anos. Em 22 (76%) casos foi possível definir um diagnóstico. Não se registraram complicações. Conclusões: a LD permitiu realizar diagnóstico e tratamento na maioria dos casos. A sensibilidade da TC foi baixa em comparação com dados internacionais. O algoritmo diagnóstico deve ser individualizado, baseado em protocolos adaptados aos recursos de cada instituição.

Male preventive health behaviors: perceptions from men, women, and clinical staff along the U.S. Mexico border.

Mexican American males have higher levels of total cholesterol and triglycerides, higher body mass indexes, and a higher prevalence of diabetes than do non-Hispanic White males. They are the least likely Hispanic subgroup to be insured, to have recently visited a physician, or to have preventive exams. To explore factors related to the use of preventive exams among mature men, and specifically among Mexican American men residing along the Arizona, United States/Sonora, Mexico border, information on barriers and motivating factors to male participation in preventive screening exams was collected. Interviews were conducted with mature men and women from a single border community and with clinical staff from three different border communities who deliver services to similar populations. Responses were triangulated. Common themes identified include health education/information/advertisement and female/family support as motivating factors and machismo/denial/fatalism as a barrier to male health-seeking behavior.

Medición de calidad de vida: en pacientes con cáncer de mama avanzado. Servicio de Medicina Paliativa y Oncología Hospital San Roque de Córdoba

Este trabajo se inicia a partir de mi vivencia diaria como oncóloga, en un grupo de pacientes con características tan diversas en cuanto a personalidad, entorno familiar, nivel cultural y socioeconómico; pero con algo en común: su dolencia por un cáncer avanzado y la necesidad de ser atendidos. El objetivo es advertir la importancia de la calidad de vida de pacientes con cáncer de mama metastásico. Se realizó un estudio observacional transversal de pacientes del Hospital San Roque de Córdoba con datos aportados por entrevistas a través de un cuestionario de calidad de vida diseñado ad hoc. Se realizaron observaciones referidas a la consulta del paciente, el control del dolor y el acompañamiento familiar, las cuales son determinantes en el control de los síntomas.La investigación permitió identificar individuos más vulnerables respecto a condiciones de calidad de vida. Estos se asociaron con menor acompañamiento familiar, falta de consulta con profesionales en Salud Mental, no así con su equipo médico con las que todas manifestaron conformidad y seguridad.

This report is based on my daily experience as an oncologist doctor, with a group of patients with many differences, in their personalities, family structures, education and culture, and economic and social characteristics; but, they all have something in common: their pain caused by and advanced cancer and the need for attention. The target is to warm the importance of a life quality in metastatic breast cancer patient´s health. A cross- observational study was accomplished in Cordoba´s Hospital San Roque patients with information collected from interviews based on a life quality questionnaire ad hoc. The patient´s consultations, the control of the pain, and the family accompaniment were observed, as determinant factors in the control of the symptoms. This investigation allowed identifying the most vulnerable individuals in respect of life quality conditions. These were associated with lower family accompaniment, lack of professional consultations in mental health. In opposition, they showed themselves satisfied and safe with the medical team.