Multimorbidity in people living with HIV and cancer in Mexico.

BACKGROUND: The proportion of older people living with HIV (PLWH) has increased. Non-communicable diseases occur earlier in PLWH than in the general population. OBJECTIVE: The goal of this study was to estimate the prevalence of comorbidities in PLWH and cancer in a tertiary referral center in Mexico City. MATERIAL AND METHODS: In this retrospective study, we included PLWH > 40 years with a history of cancer, coming to Instituto Nacional de Cancerologia from 2010 through 2019. All patients needed to be on antiretrovirals for at least six months. Data collected included cancer type, comorbidities, frequency of polypharmacy, FRAX score and 10-year cardiovascular risk. Patients were evaluated for depression with the Beck Inventory Depression-II Scale. Variables associated to multimorbidity (2 or more comorbidities) were evaluated. RESULTS: Of 125 patients, 69% had at least one comorbidity; 32% had ≥ 2. Common comorbidities were dyslipidemia (54%), hypertension (19%), obesity (14%) and Diabetes (12%). In patients ≥ 50 years, 29 (62%) already undergone a densitometry and 9 (31%) had osteoporosis; 56 depression questionnaires were used: 30% had mild-to-severe depression. Being ≥ 50 years was associated with multimorbidity (aOR 2.57 (1.18-5.58), p = 0.017). CONCLUSIONS: A high prevalence of multimorbidity and poor screening of bone disease and mental health is reported in patients with PLWH and cancer. A holistic approach to the PLWH in the Infectious Diseases consultation is needed to improve the detection and management of non-communicable diseases, to go beyond viral suppression and towards an improved quality of life.

INTRODUCCIÓN: La proporción de personas mayores que viven con VIH (PVVIH) va en aumento, y las enfermedades no transmisibles ocurren antes en PVVIH comparado con la población general. OBJETIVO: El objetivo de este estudio fue estimar la prevalencia de las comorbilidades en PVVIH con cáncer de un centro de tercer nivel de la Ciudad de México. MÉTODOS: Este estudio retrospectivo incluyó todas las PVVIH > 40 años con cáncer, que acudieron al Instituto Nacional de Cancerología entre 2010 y 2019). Se incluyeron datos sobre el tipo de cáncer, comorbilidades y polifarmacia. Se calcularon la puntuación FRAX, el riesgo cardiovascular a 10 años, y se aplicó un cuestionario para evaluar depresión (Beck Inventory Depression-II Scale). RESULTADOS: De 125 pacientes, 69% tenía al menos una comorbilidad; 32% tenía ≥ 2. Las comorbilidades más comunes fueron dislipidemia (54%), hipertensión (19%), obesidad (14%) y diabetes (12%). En pacientes ≥ 50 años, 29% tenía una densitometría osea; 31% tenía osteoporosis. Se aplicaron 56 cuestionarios: 30% tenía algún grado de depresión. Tener ≥ 50 años se asoció con multimorbilidad (aOR 2.57, 1.18-5.58), p = 0.017. CONCLUSIONES: Se reporta una alta prevalencia de multimorbilidad en PVVIH y cancer, con pobre escrutinio de enfermedad ósea y salud mental. Se requiere un enfoque holístico para las PVVIH en la consulta de infectología, para mejorar el manejo de las enfermedades no transmisibles, yendo más alla de la supresión virológica.

Severe acute respiratory syndrome coronavirus 2 infection in hematopoietic stem cell transplant recipients in Mexico City.

BACKGROUND: Hematopoietic stem cell transplant (HSCT) recipients are among patients with highest risk of adverse coronavirus disease 2019 (COVID-19) outcomes. OBJECTIVE: We compared clinical outcomes in post-HSCT patients with COVID-19 before and during the Omicron period. STUDY DESIGN: This was a retrospective study including patients post-HSCT with severe acute respiratory syndrome coronavirus 2 infection from April 2020 to March 2023 at Instituto Nacional de Cancerología, Mexico City. We describe their clinical characteristics and report the variables associated with severe clinical disease, hospitalization, and death. RESULTS: Fifty-three patients were included; 31 (58.5%) from the pre-Omicron period and 22 (41.5%) from the Omicron period. Median age was 42-years old (interquartile range 26-53), and 31 patients (59%) were men. Only four patients (16%) had received a vaccine prior to COVID-19 diagnosis in the pre-Omicron period versus 20 (91%) in the Omicron period (p < 0.001). COVID-19 severe cases were more common before Omicron: seven patients (23%) versus two patients (9%). Only one patient (3%) received an antiviral in the pre-Omicron period compared to 11 patients (50%) during the Omicron period (p < 0.01). COVID-19-associated mortality was almost double in the pre-Omicron period (16% vs. 9%, p = 0.6). CONCLUSIONS: This study reports patients with a high proportion of severe outcomes during the first 2 years of the pandemic. Outcomes improved during Omicron with better access to vaccines and antivirals and no in-hospital cases. Variables associated with worse outcomes were similar to other reports. Strengthening infection control measures in the hospital and better access to preventive strategies and therapeutic options are mandatory in these high-risk patients.

SARS-CoV-2 infection in health care workers during the first 2-years of the pandemic at a cancer hospital in Mexico.

BACKGROUND: Health care workers (HCWs) are occupationally exposed to severe acute respiratory syndrome coronavirus (SARS-CoV-2). This study aimed to characterize COVID-19 in HCWs at an oncology hospital in Mexico City over 2-years, identify factors associated with severity, and establish transmission dynamics. METHODS: This retrospective study included HCWs with confirmed COVID-19. Socio-demographic, clinical, and outcome data were retrieved from March 2020 to March 2022. We compared the proportion of HCWs affected in each wave. A survey on COVID-19 transmission dynamics was conducted in a subgroup. RESULTS: We included 1,058 workers. The risk of COVID-19 was higher during the Omicron odds ratio (OR 2.10, 95% confidence interval [CI] 1.77-2.50, P < .001). Age ≥41 years old (OR 6.32, 95% CI 2.4-16.62) and being administrative staff (OR 5.51, 95% CI 1.72-17.6) or medical staff (OR 6.82, CI 95% 1.77-26.23), compared to nursing staff, were associated with severity. Vaccination with ≥1 vaccine against SARS-CoV-2 was a protective factor for severe disease (OR 0.04, 95% CI 0.005-0.331). CONCLUSIONS: This study highlights the impact of COVID-19 on HCWs in a cancer hospital in Mexico City and the impact of vaccination as a protective factor against severity.

Nivel de conocimientos y prácticas sobre salud bucodental de estudiantes de posgrado de la Carrera de Enfermería de la Facultad de Ciencias de la Salud de la Universidad Católica de Asunción / Level of knowledge and practices on oral health of graduate students of the Nursing Career of the Faculty of Health Sciences of the Catholic University of Asunción

Los adultos jóvenes constituyen gran parte de la población paraguaya y se considera que los conocimientos y prácticas sobre salud bucodental están muy relacionados al nivel de instrucción, el objetivo de este estudio fue evaluar el nivel de conocimientos y prácticas sobre salud bucodental de estudiantes de posgrado de la Carrera de Enfermería de la Facultad de Ciencias de la Salud de la Universidad Católica de Asunción (CE FCSUCA), en el 2018. Estudio observacional descriptivo de corte transversal con componente analítico en el que se incluyeron a todos los estudiantes de posgrado entre mayo y junio de 2018. La recolección de datos se realizó mediante un cuestionario sobre salud bucodental autoadministrado y de carácter anónimo. Los datos se asentaron en una planilla electrónica, y fueron analizados utilizando el Programa estadístico IBMSSPS 23.0. La muestra estuvo constituida por 166 estudiantes, en su mayoría del sexo femenino (75,3%), de entre 20 y 29 años (54,8%), cursando algún programa de especialización (57,8% y pertenecientes al área de la salud (94%). El 57,83% y el 55,42% de los estudiantes presentaron conocimientos y prácticas de salud bucodental de nivel regular, respectivamente. Se encontró asociación entre nivel de conocimiento y de práctica y entre el nivel de conocimiento y la edad. Se concluye que los niveles de conocimientos y prácticas sobre salud bucodental en los estudiantes de posgrado fueron deficientes por lo que se propone la implementación de estrategias educativas de concienciación en el área(AU)

Young adults constitute a large part of the Paraguayan population and considering that oral health knowledge and practices are closely related to the level of education, the objective of this study was to evaluate the level of knowledge and practices on oral health of postgraduate students of the Nursing Career of the Faculty of Health Sciences of the Catholic University of Asunción (CE FCSUCA), in 2018. The design was descriptive, cross-sectional with an analytical component in which all postgraduate students were included in May and June 2018. Data collection was carried out through a questionnaire on oral health self-administered and anonymous. The data were recorded in an electronic spreadsheet and analyzed using the IBMSSPS 23.0 Statistical Program. The sample consisted of 166 students, mostly female (75.3%), between 20 and 29 years old (54.8%), studying some specialization program (57.8%) and belonging to the area of Health (94%). 57.83% and 55.42% of the students presented knowledge and practices of oral health at the regular level, respectively. An association was found between the level of knowledge and practice and between the level of knowledge. It is concluded that the levels of knowledge and practices on oral health in the postgraduate students were insufficient, so the implementation of educational awareness strategies in the area is proposed(AU)

Digestibilidade e palatabilidade de dietas com extrato de própolis para cães / Digestibility and palatability of diets with propolis extract for dogs

O objetivo do estudo foi avaliar o efeito da inclusão de extrato de própolis na digestibilidade e na palatabilidade de dietas para cães. Foram realizados dois experimentos, sendo o primeiro constituído por um ensaio de digestibilidade, com a inclusão de diferentes extratos de própolis (FT0,55, FT0,59, FT2,59, FT2,11). Com base nos resultados do primeiro ensaio, foi definido o extrato FT0,59 a ser utilizado nos demais experimentos, misturado em crescentes níveis à dieta, resultando em outras concentrações de apiginina. Ambos os ensaios de digestibilidade utilizaram dez cães da raça Beagles, os quais foram alojados em gaiolas metabólicas. A palatabilidade foi avaliada pela preferência alimentar e pela primeira escolha, sendo utilizados 20 cães de quatro diferentes raças. No primeiro ensaio de digestibilidade, somente a inclusão do extrato de própolis FT2,11 diminuiu o valor do coeficiente de digestibilidade aparente (CDA) da matéria seca (MS). Já no segundo ensaio, a inclusão crescente do extrato de própolis FT0,79 melhorou linearmente os CDA da proteína bruta (PB), extrato etéreo em hidrólise ácida (EEA), extrativos não nitrogenados (ENN), MS e energia metabolizável (EM) das dietas. A inclusão de extrato de própolis favoreceu a palatabilidade da dieta. Os flavonoides podem ser adicionados na dieta de cães como nutracêuticos em concentrações menores do que 2,11mg/kg de MS da dieta, sem alterar a digestibilidade.(AU)

The aim of the study was to evaluate the effect of inclusion of propolis extract digestibility and palatability. Two experiments were conducted, the first consisting of a digestibility trial with the inclusion of different propolis extracts (FT0,55, FT0,59, FT2,59, FT2,11). Based on the results of the first test, the extract being used in the other experiments, so the chosen FT0,59 extract was mixed in increasing levels in diets resulting in different apiginin concentrations. the diet was defined. Both digestibility assays beagle dogs 10, which were housed in metabolic cages were used. Palatability was assessed by food preference and first choice, 20 dogs of different breeds being used. In the first digestibility trial, only the inclusion of propolis extract FT2,11 decreased the value of the apparent digestibility coefficient (ADC) of dry matter (DM). In the second trial, increasing inclusion of propolis extract FT0,59 linearly improved the ADC of crude protein (CP), ether extract in acid hydrolysis (EEA), nitrogen free extract (NFE), MS and metabolizable energy (ME) of the diets. The inclusion of propolis extract favored the palatability of the diet. Flavonoids can be added in the diet of dogs as nutraceuticals in concentrations lower than 2.11mg/kg of DM of the diet without altering digestibility.(AU)

Digestibilidade e palatabilidade de dietas com extrato de própolis para cães / Digestibility and palatability of diets with propolis extract for dogs

O objetivo do estudo foi avaliar o efeito da inclusão de extrato de própolis na digestibilidade e na palatabilidade de dietas para cães. Foram realizados dois experimentos, sendo o primeiro constituído por um ensaio de digestibilidade, com a inclusão de diferentes extratos de própolis (FT0,55, FT0,59, FT2,59, FT2,11). Com base nos resultados do primeiro ensaio, foi definido o extrato FT0,59 a ser utilizado nos demais experimentos, misturado em crescentes níveis à dieta, resultando em outras concentrações de apiginina. Ambos os ensaios de digestibilidade utilizaram dez cães da raça Beagles, os quais foram alojados em gaiolas metabólicas. A palatabilidade foi avaliada pela preferência alimentar e pela primeira escolha, sendo utilizados 20 cães de quatro diferentes raças. No primeiro ensaio de digestibilidade, somente a inclusão do extrato de própolis FT2,11 diminuiu o valor do coeficiente de digestibilidade aparente (CDA) da matéria seca (MS). Já no segundo ensaio, a inclusão crescente do extrato de própolis FT0,79 melhorou linearmente os CDA da proteína bruta (PB), extrato etéreo em hidrólise ácida (EEA), extrativos não nitrogenados (ENN), MS e energia metabolizável (EM) das dietas. A inclusão de extrato de própolis favoreceu a palatabilidade da dieta. Os flavonoides podem ser adicionados na dieta de cães como nutracêuticos em concentrações menores do que 2,11mg/kg de MS da dieta, sem alterar a digestibilidade.

The aim of the study was to evaluate the effect of inclusion of propolis extract digestibility and palatability. Two experiments were conducted, the first consisting of a digestibility trial with the inclusion of different propolis extracts (FT0,55, FT0,59, FT2,59, FT2,11). Based on the results of the first test, the extract being used in the other experiments, so the chosen FT0,59 extract was mixed in increasing levels in diets resulting in different apiginin concentrations. the diet was defined. Both digestibility assays beagle dogs 10, which were housed in metabolic cages were used. Palatability was assessed by food preference and first choice, 20 dogs of different breeds being used. In the first digestibility trial, only the inclusion of propolis extract FT2,11 decreased the value of the apparent digestibility coefficient (ADC) of dry matter (DM). In the second trial, increasing inclusion of propolis extract FT0,59 linearly improved the ADC of crude protein (CP), ether extract in acid hydrolysis (EEA), nitrogen free extract (NFE), MS and metabolizable energy (ME) of the diets. The inclusion of propolis extract favored the palatability of the diet. Flavonoids can be added in the diet of dogs as nutraceuticals in concentrations lower than 2.11mg/kg of DM of the diet without altering digestibility.

Revisión del hepatocarcinoma fibrolamelar / Fibrolamellar Hepatocelullar Carcinoma

El carcinoma hepatocelular fibrolamelar (CHC-FL) es una variante poco frecuente de CHC convencional, representa el 0,85 al 16% de todos los carcinomas hepatocelulares. Se presenta en personas jóvenes, sin antecedente de enfermedad hepática crónica subyacente, alrededor del 65-85% de estos tumores ocurren en pacientes menores de 40 años. Para su diagnóstico, las modalidades de imagen cumplen un papel importante tanto el ultrasonido, tomografía y resonancia magnética principalmente ésta última podría aportar sustancialmente al diagnóstico. Se presenta el caso de un joven de 16 años con diagnóstico histopatológico de hepatocarcinoma fibrolamelar y su correlación con las diferentes modalidades de imagen, el cual fue sometido a trasplante hepático, se realiza la revisión del mismo dada la importancia del diagnóstico por imagen y las alternativas terapéuticas en estos casos.

Fibrolamellar hepatocellular carcinoma (CHC-FL) is a rare variant of conventional HCC, representing 0.85 to 16% of all hepatocellular carcinomas. It occurs in young people, without a history of underlying chronic liver disease, about 65-85% of these tumors occur in patients under 40 years. For its diagnosis, imaging modalities play an important role, both ultrasound, tomography and magnetic resonance, mainly the latter could contribute substantially to the diagnosis. We present the case of a 16-year-old boy with a histopathological diagnosis of fibrolamellar hepatocellular carcinoma and its correlation with the different imaging modalities, which underwent hepatic transplantation. He was reviewed, given the importance of imaging diagnosis and alternatives. therapeutic in these cases.

Empoderamiento enfermero en las unidades de cuidados intensivos de adultos en el Hospital Central del Instituto de Previsión Social / Nursing empowerment in the adult intensive care units at the Central Hospital of the Instituto de Previsión Social

El empoderamiento es el proceso por el cual las personas fortalecen sus capacidades, confianza, visión y protagonismo para impulsar cambios positivos de las situaciones que viven, por lo que es un desafío para los profesionales de enfermería en todos los niveles de asistencia. El objetivo de esta investigación es realizar un análisis del empoderamiento de los enfermeros asistenciales de cuidados intensivos de adultos en el Hospital Central del Instituto de Previsión Social en la ciudad de Asunción, Paraguay. Se realizó un estudio cualitativo con enfoque fenomenológico. Los datos se recolectaron a través de entrevistas semi estructuradas grabadas cuyas preguntas se fundamentaron en seis categorías de estudio: sentido de pertenencia, autonomía, liderazgo, trabajo en equipo, participación en asociaciones y percepción de empoderamiento. La muestra se determinó por conveniencia y saturación alcanzando a 17 sujetos. Las respuestas de los participantes se agruparon en ideas comunes para deducir los resultados. En el análisis se tuvo en cuenta las propuestas de Zimmerman y Benner en materia de empoderamiento y desarrollo profesional de enfermería respectivamente. En el grupo estudiado se distinguen atributos como autonomía y trabajo en equipo que favorecen el empoderamiento individual. Sin embargo, estas cualidades contrastan con un débil sentido de pertenencia, una práctica relativa del liderazgo y escasa participación en asociaciones. En consecuencia, el empoderamiento de enfermería en las unidades de cuidados intensivos estudiadas es un proceso incipiente que requiere intervenciones efectivas para consolidarse y fortalecer la identidad profesional(AU)

[Norovirus detection in children with community-acquired or nosocomial diarrhea at Guillermo Grant Benavente Hospital in Concepción, Chile]. / Detección de norovirus en niños con diarrea adquirida en la comunidad o nosocomial en el Hospital Guillermo Grant Benavente de Concepción, Chile.

INTRODUCTION: Norovirus (NoV) are RNA viruses highly contagious, stable in the environment, genetically variable, and the most common cause of viral sporadic acute gastroenteritis worldwide. This is the first study carried out in Concepcion, Chile, to investigate the presence of NoV as an etiologic agent of viral diarrheas in hospitalized children. Objective. To detect the presence and genogroup of NoV in children with diarrhea and to compare it with rotavirus (RV) and adenovirus (AdV). MATERIAL AND METHODS: A one year descriptive, prospective study in children 0-14 years old. A single diarrheic stool sample per patient was analyzed for the presence of NoV, RV and AdV. Clinical data were unknown at the moment of sampling. Real time RT-PCR with Taqman™ probes for NoV and the immunocromatography VIKIA™ kit for RoV /AV detection were used. RESULTS: Infection for NoV (25.5%) was significantly higher than for RV (15.9%) and AdV (6.2%). It was even greater in infants younger than 2yr. old (n: 103): NoV 34%, RV 17.5%, AdV 7.8%. Children 2-4 yr. old had 11.8% infection of NoV and RV. Children older than 4, only had 12% RV and 4% AdV. Children hospitalized for diarrhea (n: 92) had: 21.7% of both NoV and RV, and 7.6% AdV; whereas children hospitalized for other causes (n: 53) had 32.1% NoV,5.7% RV and 3.8% AV. The proportion of infection due to NoV was significantly higher in males (31.5%) than in females (19.4%). The average frequency during the year was higher for NoV (30.3%) than for RV (14.7%) except in summer. CONCLUSION: The presence of NoV was higher than RV in children with diarrhea. NoV infection showed defined characteristics regarding age, gender, seasonal occurrence and nosocomial transmission that are important epidemiological features.

Detección de norovirus en niños con diarrea adquirida en la comunidad o nosocomial en el Hospital Guillermo Grant Benavente de Concepción, Chile / Norovirus detection in children with community-acquired or nosocomial diarrhea at Guillermo Grant Benavente Hospital in Concepción, Chile

Introduction: Norovirus (NoV) are RNA viruses highly contagious, stable in the environment, genetically variable, and the most common cause of viral sporadic acute gastroenteritis worldwide. This is the first study carried out in Concepcion, Chile, to investigate the presence of NoV as an etiologic agent of viral diarrheas in hospitalized children. Objective. To detect the presence and genogroup of NoV in children with diarrhea and to compare it with rotavirus (RV) and adenovirus (AdV). Material and Methods: A one year descriptive, prospective study in children 0-14 years old. A single diarrheic stool sample per patient was analyzed for the presence of NoV, RV and AdV. Clinical data were unknown at the moment of sampling. Real time RT-PCR with Taqman™ probes for NoV and the immunocromatography VIKIA™ kit for RoV /AV detection were used. Results: Infection for NoV (25.5%) was significantly higher than for RV (15.9%) and AdV (6.2%). It was even greater in infants younger than 2yr. old (n: 103): NoV 34%, RV 17.5%, AdV 7.8%. Children 2-4 yr. old had 11.8% infection of NoV and RV. Children older than 4, only had 12% RV and 4% AdV. Children hospitalized for diarrhea (n: 92) had: 21.7% of both NoV and RV, and 7.6% AdV; whereas children hospitalized for other causes (n: 53) had 32.1% NoV,5.7% RV and 3.8% AV. The proportion of infection due to NoV was significantly higher in males (31.5%) than in females (19.4%). The average frequency during the year was higher for NoV (30.3%) than for RV (14.7%) except in summer. Conclusion: The presence of NoV was higher than RV in children with diarrhea. NoV infection showed defined characteristics regarding age, gender, seasonal occurrence and nosocomial transmission that are important epidemiological features.

Introducción: Los norovirus (NoV) son virus ARN altamente contagiosos, resistentes, variables genéticamente y una de las etiologías más frecuente de gastroenteritis viral esporádica mundial. Este es el primer trabajo en Concepción, Chile, de búsqueda de NoV como etiología viral de diarreas en niños hospitalizados. Objetivo: Determinar la presencia y genogrupo de NoV en niños con diarrea y compararla con la frecuencia de rotavirus (RV) y adenovirus (AdV). Material y Método: Estudio descriptivo, prospectivo de un año, en niños de 0-14 años ingresados por diarrea aguda o que la adquirieron dentro del hospital. La muestra de deposiciones diarreica se tomó una sola vez por paciente. Las fichas clínicas se analizaron al finalizar el estudio etiológico. Para la detección de NoV se utilizó RPC-TR a en tiempo real con sondas Taqman® y para detección de RV/AdV, el kit VIKIA® de inmunocromatografia. Resultados: La infección por NoV (25,5%) fue significativamente más frecuente que por RV (15,9%) y AdV (6,2%). La mayor presencia de infección fue en pacientes bajo2 años de edad (n: 103): NoV 34,0%, RV 17,5%, AdV 7,8%. La detección en niños hospitalizados por diarrea fue: NoV y RV 21,7% cada uno; AdV 7,6%. En niños con diarrea nosocomial hospitalizados por otras causas se detectó NoV en 32,1%, RV en 5,7% y AdV en 3,8%. La presencia de NoV fue significativamente mayor en varones (31,5%) que en niñas (19,4%). El promedio de diarreas durante el año fue mayor para NoV (30,3%) que para RV(14,7%), excepto en verano. Discusión y Conclusión: La presencia de NoV fue mayor que la de RoV en niños con diarrea y con una tendencia nosocomial que podría deberse a las características del virus que favorece infecciones de ambiente confinado, como hospitales, asilos y cruceros. La infección por NoV presentó características definidas, en edad, género, ocurrencia estacional y relevancia nosocomial, que aportan datos epidemiológicos importantes.

[Measurement of the index of infection by Demodex spp in patients with chronic blepharitis and in patients without other ocular diseases]. / Determinación de índice de infestación por Demodex spp, en pacientes con blefaritis crónica y en pacientes sin otra patología ocular.

BACKGROUND: Infestation by Demodex spp. in the palpebral edge follicles in humans is common. However, these mites are not routinely diagnosed in patients with or without ocular pathologies in Chile and their relevance is unclear. One of the eye diseases most related to infestation by Demodex spp. is blepharitis, a chronic inflammation of the eyelid margin with intermittent exacerbations, which is very common in ophthalmic practice. Its management is prolonged treatment, which is often ineffective, leading to relapses and frustration of patient and treating physician. Blepharitis can be typed by its etiology into various types, one of them is caused by Demodex folliculorum and another species, D. brevis. OBJECTIVE: The overall objective was to detect the presence and estimate the rate of infestation of Demodex spp. in healthy subjects and in patients with ocular pathology such as blepharitis, bacterial conjunctivitis, chalazion, and stye. PATIENTS AND METHODS: Samples of tabs from both lower eyelids of ophthalmologically healthy patients (23) and patients with ocular pathologies (9) were mounted in immersion oil as described in literature, then visualized with a 10x objective and confirmed with 40x objective. RESULTS: Detection rates of eggs, nymphs or adults of Demodex spp. in patients with and without ophthalmological problems were above and below 0.5 mites per tab, respectively. D.folliculorum was the species most frequently found. DISCUSSION: The results are consistent with the international literature on both the rate of infestation as the predominant species. CONCLUSION: This paper is the first study in Chile on this subject and represents a significant contribution to ophthalmic clinical diagnosis and treatment of patients with this disease.

Determinación de índice de infestación por Demodex spp, en pacientes con blefaritis crónica y en pacientes sin otra patología ocular / Measurement of the index of infection by Demodex spp in patients with chronic blepharitis and in patients without other ocular diseases

Infestation by Demodex spp. in the palpebral edge follicles in humans is common. However, these mites are not routinely diagnosed in patients with or without ocular pathologies in Chile and their relevance is unclear. One of the eye diseases most related to infestation by Demodex spp. is blepharitis, a chronic inflammation of the eyelid margin with intermittent exacerbations, which is very common in ophthalmic practice. Its management is prolonged treatment, which is often ineffective, leading to relapses and frustration of patient and treating physician. Blepharitis can be typed by its etiology into various types, one of them is caused by Demodex folliculorum and another species, D. brevis. Objective: The overall objective was to detect the presence and estimate the rate of infestation of Demodex spp. in healthy subjects and in patients with ocular pathology such as blepharitis, bacterial conjunctivitis, chalazion, and stye. Patients and Methods: Samples of tabs from both lower eyelids of ophthalmologically healthy patients (23) and patients with ocular pathologies (9) were mounted in immersion oil as described in literature, then visualized with a 10x objective and confirmed with 40x objective. Results. Detection rates of eggs, nymphs or adults of Demodex spp. in patients with and without ophthalmological problems were above and below 0.5 mites per tab, respectively. D.folliculorum was the species most frequently found. Discussion: The results are consistent with the international literature on both the rate of infestation as the predominant species. Conclusion: This paper is the first study in Chile on this subject and represents a significant contribution to ophthalmic clinical diagnosis and treatment of patients with this disease.

La infestación por Demodex spp. en los folículos del borde palpebral en humanos es frecuente; no obstante, en Chile no se diagnostica de rutina la presencia de estos ácaros en pacientes sin o con patologías oculares por lo cual no se conocen aspectos de esta parasitosis. Una de las patologías oculares que más se relaciona con infestación por Demodex spp. es la blefaritis, enfermedad muy común en la práctica oftalmológica, que cursa con inflamación crónica del borde palpebral, con exacerbaciones intermitentes de los síntomas. Su manejo suele llevar mucho tiempo frecuentemente ineficaz, con múltiples recaídas que terminan desmoralizando al paciente y, al médico que las trata. De acuerdo a la etiología, se caracterizan varios tipos de blefaritis y una de ellas es asociada a Demodexfolliculorum, existiendo también la especie D. brevis. Objetivo: Detectar la presencia y calcular el índice de infestación de Demodex spp. en pacientes sanos y en pacientes con alguna patología ocular como blefaritis crónica, conjuntivitis bacteriana, chalazión y orzuelo. Pacientes y Métodos: Se tomaron muestras de pestañas desde el párpado inferior de ambos ojos en pacientes oftalmológicamente sanos23 y pacientes con patologías oculares9 las que fueron montadas en aceite de inmersión según técnica descrita en la literatura, visualizadas con objetivo 10x y confirmadas con objetivo 40x. Resultados: Se encontró la presencia de huevos, ninfas y ejemplares adultos de D. folliculorum y D. brevis, tanto en pacientes normales como en pacientes oftalmológicos siendo el índice de infestación menor a 0,5 ácaros por pestaña en los pacientes sanos y mayor o igual a 0,5 en pacientes oftalmológicos. La especie más frecuentemente encontrada fue D. folliculorum. Discusión: Los resultados encontrados coinciden con la literatura internacional tanto en el índice de infestación como en la especie predominante. Conclusión: Este trabajo constituye el primero realizado en Chile en esta temática, de acuerdo a la literatura revisada, lo cual constituye un gran aporte al diagnóstico clínico oftalmológico con implicancias en el tratamiento de estos pacientes.

Body measurements and serum lipid profile of overweight adult dogs fed diet with containing conjugated linoleic acid / Medidas corporais e perfil lipídico plasmático de cães adultos com sobrepeso alimentados com dieta contendo ácido linoléico conjugado

Studies with human beings and animals have shown that dietary conjugated linoleic acid (CLA) promotes changes in body structure, markedly, body fat reduction. This research aimed to assess the effect of CLA (60 percent of conjugated linoleic acid methyl ester, at the proportion of 1:1 of the 9, 11: 10, 12 isomers) on changes in body weight, subcutaneous tissue thickness, body fat mass and concentration of serum lipids (triacylglycerols, total cholesterol, LDL and HDL) in overweight dogs. Dogs of different breeds weighting 16.85±7.13 assigned in a randomized assay. Two types of diets were offered for 120 days: control (-CLA) and test (+CLA, 0.3 percent). There was no difference between control and test groups considering body weight and serum levels of triacylglycerols, total cholesterol and LDL portion. There was a significant difference between the final and initial results for subcutaneous tissue thickness and body fat mass and for serum concentration of HDL in dogs supplemented with CLA. The addition of 0.3 percent of CLA in the diet of overweight dogs decreased the fat deposition on subcutaneous tissue and the development of body fat mass but increased blood levels of HDL.

Estudos em humanos e animais têm demonstrado que o uso do ácido linoléico conjugado (ALC) promove alterações na composição corporal, principalmente reduzindo a deposição de gordura. O objetivo deste trabalho foi avaliar as alterações sobre o peso corporal, tecido adiposo subcutâneo, gordura corporal e concentração sérica de lípideos (triacilglicerol, colesterol total, LDL e HDL) de cães com sobrepeso alimentados com ALC (60 por cento de ácido linoléico conjugado metil ester, na proporção de 1:1 de 9, 11: 10, 12 isômeros) na dieta. Duas dietas foram fornecidas por quatro meses, para 14 cães com sobrepeso (16,85±7,13) de diferentes raças: dietas controle (-ALC) e teste (+ALC, 0,3 por cento). O experimento seguiu delineamento inteiramente casualizado. Não houve diferença entre os grupos para peso corporal e nível sérico de triacilglicerol, colesterol total e LDL. No entanto, foram observadas diferenças significativas entre os períodos final e inicial para tecido adiposo subcutâneo, gordura corporal e nível sérico de HDL nos cães que receberam ALC. A suplementação de 0,3 por cento de ALC na dieta de cães com sobrepeso diminuiu a deposição de lipídios no tecido subcutâneo e a gordura corporal total, mas aumentou os níveis sanguíneos de HDL.

Body measurements and serum lipid profile of overweight adult dogs fed diet with containing conjugated linoleic acid

Studies with human beings and animals have shown that dietary conjugated linoleic acid (CLA) promotes changes in body structure, markedly, body fat reduction. This research aimed to assess the effect of CLA (60% of conjugated linoleic acid methyl ester, at the proportion of 1:1 of the 9, 11: 10, 12 isomers) on changes in body weight, subcutaneous tissue thickness, body fat mass and concentration of serum lipids (triacylglycerols, total cholesterol, LDL and HDL) in overweight dogs. Dogs of different breeds weighting 16.85±7.13 assigned in a randomized assay. Two types of diets were offered for 120 days: control (-CLA) and test (+CLA, 0.3%). There was no difference between control and test groups considering body weight and serum levels of triacylglycerols, total cholesterol and LDL portion. There was a significant difference between the final and initial results for subcutaneous tissue thickness and body fat mass and for serum concentration of HDL in dogs supplemented with CLA. The addition of 0.3% of CLA in the diet of overweight dogs decreased the fat deposition on subcutaneous tissue and the development of body fat mass but increased blood levels of HDL.

Estudos em humanos e animais têm demonstrado que o uso do ácido linoléico conjugado (ALC) promove alterações na composição corporal, principalmente reduzindo a deposição de gordura. O objetivo deste trabalho foi avaliar as alterações sobre o peso corporal, tecido adiposo subcutâneo, gordura corporal e concentração sérica de lípideos (triacilglicerol, colesterol total, LDL e HDL) de cães com sobrepeso alimentados com ALC (60% de ácido linoléico conjugado metil ester, na proporção de 1:1 de 9, 11: 10, 12 isômeros) na dieta. Duas dietas foram fornecidas por quatro meses, para 14 cães com sobrepeso (16,85±7,13) de diferentes raças: dietas controle (-ALC) e teste (+ALC, 0,3%). O experimento seguiu delineamento inteiramente casualizado. Não houve diferença entre os grupos para peso corporal e nível sérico de triacilglicerol, colesterol total e LDL. No entanto, foram observadas diferenças significativas entre os períodos final e inicial para tecido adiposo subcutâneo, gordura corporal e nível sérico de HDL nos cães que receberam ALC. A suplementação de 0,3% de ALC na dieta de cães com sobrepeso diminuiu a deposição de lipídios no tecido subcutâneo e a gordura corporal total, mas aumentou os níveis sanguíneos de HDL.

Body measurements and serum lipid profile of overweight adult dogs fed diet with containing conjugated linoleic acid

Studies with human beings and animals have shown that dietary conjugated linoleic acid (CLA) promotes changes in body structure, markedly, body fat reduction. This research aimed to assess the effect of CLA (60% of conjugated linoleic acid methyl ester, at the proportion of 1:1 of the 9, 11: 10, 12 isomers) on changes in body weight, subcutaneous tissue thickness, body fat mass and concentration of serum lipids (triacylglycerols, total cholesterol, LDL and HDL) in overweight dogs. Dogs of different breeds weighting 16.85±7.13 assigned in a randomized assay. Two types of diets were offered for 120 days: control (-CLA) and test (+CLA, 0.3%). There was no difference between control and test groups considering body weight and serum levels of triacylglycerols, total cholesterol and LDL portion. There was a significant difference between the final and initial results for subcutaneous tissue thickness and body fat mass and for serum concentration of HDL in dogs supplemented with CLA. The addition of 0.3% of CLA in the diet of overweight dogs decreased the fat deposition on subcutaneous tissue and the development of body fat mass but increased blood levels of HDL.

Estudos em humanos e animais têm demonstrado que o uso do ácido linoléico conjugado (ALC) promove alterações na composição corporal, principalmente reduzindo a deposição de gordura. O objetivo deste trabalho foi avaliar as alterações sobre o peso corporal, tecido adiposo subcutâneo, gordura corporal e concentração sérica de lípideos (triacilglicerol, colesterol total, LDL e HDL) de cães com sobrepeso alimentados com ALC (60% de ácido linoléico conjugado metil ester, na proporção de 1:1 de 9, 11: 10, 12 isômeros) na dieta. Duas dietas foram fornecidas por quatro meses, para 14 cães com sobrepeso (16,85±7,13) de diferentes raças: dietas controle (-ALC) e teste (+ALC, 0,3%). O experimento seguiu delineamento inteiramente casualizado. Não houve diferença entre os grupos para peso corporal e nível sérico de triacilglicerol, colesterol total e LDL. No entanto, foram observadas diferenças significativas entre os períodos final e inicial para tecido adiposo subcutâneo, gordura corporal e nível sérico de HDL nos cães que receberam ALC. A suplementação de 0,3% de ALC na dieta de cães com sobrepeso diminuiu a deposição de lipídios no tecido subcutâneo e a gordura corporal total, mas aumentou os níveis sanguíneos de HDL.

Estudio de sobrevida y cultivo de células cocoides en cepas de: Campylobacter jejuni / A survival and culture study of cocoid cells in Campylobacter jejuni strains

Campylobacter jejuni, uno de los principales agentes causales de síndrome diarreico en seres humanos, es una bacteria que a bajas temperaturas y en condiciones de estrés forma células cocoides no cultivables. Para determinar las condiciones en las que cepas de C. jejuni se conserven viables y cultivables independiente de la morfología, se sometió a dos cepas de este a tres diversas condiciones de laboratorio evaluando morfología mediante tinción de Gram, viabilidad celular mediante pruebas bioquímicas y Citometría de Flujo. Ambas cepas lograron mantenerse viables y cultivables en dichas condiciones, tanto en la forma bacilar como en la cocoide, siendo la condición mas desfavorable para ambas cepas la temperatura ambiente (sobrevida de 4 días y 6 días), y mas favorable la bolsa hermética a 4° C (15 Y 22 días de sobrevida). La citometría de flujo resulto ser una buena herramienta para medir viabilidad de las cepas ensayadas, mostrando que las células cocoides presentaban alteraciones en la continuidad de su membrana, indicativo de perdida de viabilidad celular.

Campylobacter jejuni, a major causative agent of diarrhoeal syndrome in humans, is a bacterium that at low temperatures and under conditions of stress, coccoid cells form non-arable. To determine the conditions under which strains of C. jejuni is kept viable and cultivable, independent of the morphology, underwent two strains of C. jejuni three different laboratory conditions, and morphology was assessed by Gram stain, and cell viability by biochemical tests and flow cytometry. Both strains were able to remain viable and culturable in the three laboratory conditions, both in the form of bacilli in the coccoid form, being the most unfavourable condition for both strains, room temperature (survival of 4 days and 6 days), and the most favourable airtight bag 4 0 C (75 and 22 days of survival). The flow cytometry proved to be a good tool for measuring viability of the strains tested, showing that cells coccoid, showed alterations in the continuity of its membrane, indicative of loss of cell viability.

Relación entre las manifestaciones bucales asociadas al VIH-SIDA pediátrico y las categorías clínicas / The relationship between the oral manifestations associated with pediatric AIDS-HIV and clinical inmunological categories

El objetivo es relacionar las manifestaciones bucales asociadas al VIH-SIDA y las categorías clínicas inmunológicas de los pacientes que acuden al Servicio de Odontopediatría del Hospital Universitario de Maracaibo-Estado Zulia. Se estudiaron 32 pacientes en edades comprendidas entre 6 meses y 18 años, positivos para la prueba ELISA y Wester Blot. Se identificaron las manifestaciones bucales a través del examen clínico y se clasificaron de acuerdo con el grupo colaborador de las manifestaciones bucales para la infección por VIH pediátrico y se establecieron las categorías clínicas inmunológicas según el CDC de Atlanta en 1994. El 68,75 por ciento presentó manifestaciones bucales asociadas al VIH-SIDA, la mayoría (71,42 por ciento) se encontraban en el grupo de las más comunes (candidiasis, herpes, parotiditis y ulceras aftosas), siendo la más frecuente la candidiasis (47,61 por ciento) asociada a la categoría clínico inmunológica C de síntomas graves o SIDA y del grupo de las menos frecuentes en niños, sólo se presentó un linfoma de Burkitt correspondiente a la misma categoría. Los niños presentaron alto porcentaje de manifestaciones bucales las cuales estuvieron relacionadas con la categoría clínica inmunológica y depresión del sistema inmunitario.

Substance use among school-based youths in Puerto Rico: differences between gender and grade levels.

The present study examined substance use rates among adolescents in Grades 7-12 in Puerto Rico. Nine hundred eighty-nine students completed the Spanish version of the International Survey of Adolescent Health. More than 50% of middle school youths and 75% of high-school youths reported lifetime alcohol use. Female gender was associated with tobacco use in middle school while male gender was associated with marijuana use in high school. High-school females reported lower rates of tobacco use and marijuana use than middle-school females. High-school males exhibited substantially higher drug-use rates than middle-school males for each substance. These findings may suggest that universal drug prevention interventions may be needed for females in Puerto Rico before they enter middle school, while targeted interventions aimed at high-risk females who continue to smoke tobacco or marijuana may be more effective during high school. In contrast, targeted drug prevention interventions for males probably need to begin in middle school and be maintained if not increased in intensity throughout the high-school years.

Manejo odontológico de pacientes con enfermedades hemorrágicas y terapia anticoagulante / Dental management of patients with hemorrhagic diseases and anticoagulant therapy

La historia clínica es fundamental en el manejo de cualquier tipo de pacinetes, los síntomas y signos que pueden sugerir enfermedad hemorrágica pueden ser de dos tipos: los que se ven más frecuentes en las alteraciones de los factores de coagulación y aquellos que son más comunes en trastornos de la hemostasia primaria, plaquetaria o vasculares y se conocen generalmente como púrpuras o síndrome purpúrico. Las petequias son pequeñas hemorragias capilares, usualmente puntiformes, son típicas en el síndrome purpúrico y suelen ser más intensas y confluentes en los sitios de presión. La equimosis es la infiltración en la piel o mucosas de la sangre extravasada (el típico moretón o cardenal), están usualmente asociadas a petequias en el síndrome purpúrico, pero pueden verse de buen tamaño, en los trastornos de coagulación y síndromes hiperfibrinolíticos. Los hematomas, colección de sangre extravasada en los músculos o tejidos profundos, son más frecuentes en los defectos del sistema de coagulación, como lo es también la hemartrosis, hemorragia intraarticular casi patognomónica de trastorno hereditario severo de la coagulación (hemofilia A y B). El sangramiento purpúrico se caracteriza por hemorragias mucocutáneas (petequia, equimosis, monorragias, hematura o sangramiento digestivo). Usualmente ellas son múltiples, y a veces aparecen después de injurias superficiales, el sangramiento comienza inmediatamente después de la ruptura vascular, todas estas manifestaciones clínicas son importantes que el odontólogo las reconozca con el fin de proporcionar un mejor tratamiento odontológico al paciente con trastornos hemorrágicos y evitar complicaciones no deseadas

Pulpal therapy for primary teeth: formocresol vs electrosurgery: a clinical study.

Post-operative clinical and x-ray findings on 80 primary molars were evaluated. These molars had undergone pulpal therapy by 2 techniques: pulpotomy with formocresol and with electrosurgery. The sample was selected from children between the ages of 4 and 7. A criterion for inclusion was each child must have at least 2 primary molars with pulp exposed by caries. Experimental molars with 1 or more of the following clinical or radiographic signs and symptoms were excluded: mobility, sensitivity to percussion, the presence of fistulae, groove drainage, apical or internal resorption, fetid smell and compromised furcation. Also excluded were patients previously diagnosed with diabetes, cardiopathy and renal alterations. Initially, a dinical and radiographic examination was carried out, followed by another at 1, 3 and 6 months after application of the techniques. No significant differences were found at the end of the period. However, electrosurgery had an advantage: it was faster to apply and dispensed with the use of formocresol. Further research is suggested, using larger samples and shorter evaluation periods.