Removal of ibuprofen, naproxen and 17-ß-estradiol in water using L. octovalvis constructed wetlands.

This study was developed to evaluate the removal potential of ibuprofen, naproxen and 17-ß-estradiol in artificial wetlands constructed on a laboratory scale, using eight experimental devices planted with L. octovalvis species, tested with gravel substrate and without gravel substrate, which were fortified with synthetic mixtures at concentrations of 1, 2 and 5 mg/L of the three compounds, during a batch exposure time of nine days. The removal efficiency for 17-ß-estradiol was 94.5 ± 2.47%, followed by ibuprofen 94.03 ± 1.96% and naproxen 81.57 ± 8.74%, respectively. The treatment with the highest removal was the one performed without the presence of gravel substrate. The highest removal efficiency occurred from the third day of exposure for the three compounds, so it was established as the optimum residence time. The model that best explained the adsorption process of the three compounds studied, was the Langmuir isotherm. The observed results demonstrate that L. octovalvis can be used as a native species in artificial wetlands for the efficient removal of pharmaceutical compounds.

Through the use of a macrophyte plant native to the state of Morelos, an artificial wetland was built, which was capable of removing several drugs with tolerance to changes in concentration, which constitutes an economic and sustainable alternative that can be coupled to the treatment of wastewater contaminated with this type of compounds.

Clast shape-fabric analysis: A comprehensive and efficient methodology to measure particle-orientation data in solid and loose volcaniclastic deposits.

Fabric analysis is essential for understanding the evolution of volcaniclastic deposits. Here we present a comprehensive and efficient methodology, called "Clast shape-fabric analysis," which is part of the Quantitative Textural Analysis (QTA). This methodology combines high-resolution image analysis techniques with geospatial data processing tools. The fabric of a deposit refers to the three-dimensional orientation of the particles with respect to space, where the degree of iso-orientation of the major axes of the particles is taken into account. The process begins with the collection of oriented samples in the field. Then, in the laboratory, the samples are processed to obtain high-resolution images. The final stage involves the analysis of these images using the FabricS program, which combines image processing techniques and circular statistics. An application of the method was made at the Joya Honda Maar in Mexico, where shape-fabric analysis was used to identify the emission centers of pyroclastic materials. In summary, the "Clast shape-fabric analysis" is a reliable, low-cost and high-potential methodology that can be applied in several geoscientific disciplines and other areas of scientific research.•New Methodology for shape-fabric analysis is presented.•The methodology involves field work, laboratory work and image analysis.•Identification of particle orientations in volcaniclastic deposits.

Detection of Trypanosoma cruzi infection by PCR in Canis lupus familiaris and their ectoparasites in Chile.

Chronic Chagas disease affects humans and animals, involving rural and urban inhabitants. Dogs participate in the maintenance and transmission of Trypanosoma cruzi. The objective of this study was to evaluate the presence of T. cruzi in dogs and their ticks and fleas, in a rural area of Central Chile. Trypanosoma cruzi was detected by PCR both in dogs and ectoparasites. From the blood samples obtained, 57% were infected by T. cruzi, 5.4% of the ticks detected were positive, and all fleas were negative. Additionally, we performed electrocardiograms and found supraventricular arrhythmia in 44% of T. cruzi-positive dogs. Nevertheless, their risk for supraventricular arrhythmias was not higher in infected versus noninfected dogs. Considering the detected infection levels, dogs act as T. cruzi hosts in Central Chile, and ticks could be used as an indicator of infection when blood samples are not available. However, at this point, there is no indication that these ticks could pass on the parasite to another host. Periodic ectoparasitic treatment of pets should reduce the chance of vectorial transmission of T. cruzi and improve canine health; however, this is an uncommon practice among rural communities, so governmental programs are encouraged to tackle this problem.

The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies.

BACKGROUND: Scabies is a common parasitic skin condition that causes considerable morbidity globally. Clinical and epidemiological research for scabies has been limited by a lack of standardization of diagnostic methods. OBJECTIVES: To develop consensus criteria for the diagnosis of common scabies that could be implemented in a variety of settings. METHODS: Consensus diagnostic criteria were developed through a Delphi study with international experts. Detailed recommendations were collected from the expert panel to define the criteria features and guide their implementation. These comments were then combined with a comprehensive review of the available literature and the opinion of an expanded group of international experts to develop detailed, evidence-based definitions and diagnostic methods. RESULTS: The 2020 International Alliance for the Control of Scabies (IACS) Consensus Criteria for the Diagnosis of Scabies include three levels of diagnostic certainty and eight subcategories. Confirmed scabies (level A) requires direct visualization of the mite or its products. Clinical scabies (level B) and suspected scabies (level C) rely on clinical assessment of signs and symptoms. Evidence-based, consensus methods for microscopy, visualization and clinical symptoms and signs were developed, along with a media library. CONCLUSIONS: The 2020 IACS Criteria represent a pragmatic yet robust set of diagnostic features and methods. The criteria may be implemented in a range of research, public health and clinical settings by selecting the appropriate diagnostic levels and subcategories. These criteria may provide greater consistency and standardization for scabies diagnosis. Validation studies, development of training materials and development of survey methods are now required. What is already known about this topic? The diagnosis of scabies is limited by the lack of accurate, objective tests. Microscopy of skin scrapings can confirm the diagnosis, but it is insensitive, invasive and often impractical. Diagnosis usually relies on clinical assessment, although visualization using dermoscopy is becoming increasingly common. These diagnostic methods have not been standardized, hampering the interpretation of findings from clinical research and epidemiological surveys, and the development of scabies control strategies. What does this study add? International consensus diagnostic criteria for common scabies were developed through a Delphi study with global experts. The 2020 International Alliance for the Control of Scabies (IACS) Criteria categorize diagnosis at three levels of diagnostic certainty (confirmed, clinical and suspected scabies) and eight subcategories, and can be adapted to a range of research and public health settings. Detailed definitions and figures are included to aid training and implementation. The 2020 IACS Criteria may facilitate the standardization of scabies diagnosis.

Equipo Médico para Clínicas de Mama una Mirada Desde la Práctica de la Ingeniería Clínica / Medical Equipment for Breast Clinics a View of Clinical Engineering from Practice

Resumen El presente trabajo describe la experiencia que involucro la gestión tecnológica de equipo de médico para el establecimiento de la primera y tercera clínica de mama en la delegación CDMX, Sur, del Instituto Mexicano del Seguro Social (IMSS) como una estrategia para el desarrollo de un programa nacional de detección temprana, diagnóstico oportuno y tratamiento con calidad óptima, trato cordial y respeto a los derechos de las pacientes. En este sentido se exponen los principales argumentos referentes a los lineamientos utilizados para la evaluación de la tecnología medica en el desempeño de los mastógrafos digitales por ser este el equipo más representativo del proyecto, para lo cual se elaboró una cedula de descripción que fue aplicada en seis equipos de mastografía en la cual se vierten los conceptos que intervienen en el análisis de especificaciones técnicas, destacando la respuesta de los detectores, dosimetría, contraste y calidad de la imagen entre los principales aspectos. Teniendo como premisa el compartir las experiencias obtenidas en la creación de dichas clínicas, y el rol del ingeniero biomédico como parte del equipo multidisciplinario, considerado como un gestor del conocimiento respecto a la optimización de los equipos de imagenologia en cada una de las unidades médicas.

Abstract The present work describes the experience which involved the medical management of medical equipment for the establishment of the first and third breast cancer clinic in the Mexican Social Security Institute (IMSS) Delegation CDMX South to development a national program for detection, diagnosis and treatment of breast cancer with optimal quality, friendliness and respect for patients' rights. In this sense it expose the main arguments referring to the guidelines used to validate the performance of digital masthographs, are exposed for being this equipment for the most representative in the project, for which a technical information templates was developed, that applied in six mammography's equipment which are the concepts that intervene in technical specifications analysis, emphasizing the detectors response, dosimetry, contrast and image quality among the main aspects. With the premise of sharing the experiences obtained in the creation of these clinics, and the roll of the biomedical engineer as part of a multidisciplinary team, and considered optimization of knowledge manager as regarding imaging equipment in each of the medical units.

Cytotoxicity and biological capacity of sulfur-free lignins obtained in novel biorefining process.

Lignin is one of the most promising and versatile products obtained in biorefineries due to its diverse therapeutic properties such as antimicrobial, antioxidant and anti-inflammatory activity. However, these properties depend on the source of lignin and the way it was isolated from the biomass. In this study, four different lignins are compared (extracted with Aquasolv (ASL1, ASL2), Organosolv (OSL) and Alkali (ALK) processes) for their cellular antioxidant capacity, anti-diabetic activity, free radical scavenging and cytotoxicity. Alkali and Organosolv lignins showed the highest antioxidant capacity 1159.815 µmol TE g-1 and 1463.415 µmol TE g-1, respectively, in agreement with their highest amount of free -OH groups. Additionally, OSL showed the highest inhibition in the antidiabetic assay followed by ASL1 with values for α-amylase of 3.6 mg/ml and 4.3 mg/ml respectively, and α-glucosidase 1.6 mg/ml and 2.5 mg/ml correspondingly. Nevertheless, cell-based assays revealed that ASL has the lowest cytotoxic effect in Caco-2 cells and, thus, is 10 times less cytotoxic than Alkali and OSL. This work suggests the applicability of ASL for high value applications such as cosmetics or pharmaceuticals. INDUSTRIAL RELEVANCE: Industrially, Liquid Hot Water (LHW) and Organosolv processes may appear as promising biorefining technologies in the following years. Lignin produced is free of sulfur, can be labelled as clean and environmentally-friendly and in this study, was proven that LHW lignin is non cytotoxic. The findings in this paper showed that different sources of lignin can be used in product formulation for life science purposes, thus opening a broad spectrum of possibilities for lignin valorisation in biorefineries.

Determination of the welfare status of freeroaming dogs in two urban centres in Chile. / Determinación del estado de bienestar en perros callejeros de dos centros urbanos de Chile.

Free-roaming dogs are not only a public health and ethical problem, they are also an environmental and economic one. Although the general belief is that freeroaming dogs are not in good condition, there have been insufficient studies in Chile to address and analyse the issue. The objective of this research was to assess the welfare of free-roaming dogs in the centre of the cities of Santiago and Valparaíso. The evaluation was carried out using an observational method and assessed a total of 554 dogs. The following variables were analysed: body condition, motor impairment, skin condition, respiratory disease, reaction to humans and other variables. In addition, spatial distribution was considered, and age, sex and social behaviour were estimated. When the results were analysed in terms of frequency, it was found that, in Valparaíso (n = 204), 37% of the dogs assessed had compromised welfare (poor or fair), while 63% had positive welfare (good or optimal). In contrast, in Santiago (n = 350), only 21.7% had compromised welfare, while 78.3% had positive welfare. With respect to social behaviour, 55% of the dogs assessed in Valparaíso and 68% of those assessed in Santiago led a solitary lifestyle. Although most of the individuals were in good condition, a high percentage were unable to meet the requirements for them to live in harmony with their environment.

Les chiens de rue ou errants posent des problèmes non seulement de santé publique et d'éthique, mais aussi environnementaux et économiques. La condition générale de ces chiens est intuitivement perçue comme n'étant pas bonne mais au Chili le sujet n'a guère fait l'objet d'analyses approfondies. Les auteurs présentent les résultats d'une étude visant à évaluer le bien-être animal des chiens errants du centre-ville de Santiago et de Valparaíso. Cette évaluation a reposé sur l'observation de 554 chiens au total et sur l'analyse d'un certain nombre de variables dont la condition physique, les difficultés motrices, l'état de la peau et du pelage, la présence de maladies respiratoires et les réactions face à l'être humain. La distribution spatiale des chiens examinés a été consignée, ainsi que l'âge estimé, le sexe et le comportement social de chaque animal. Les résultats ont été analysés en termes de fréquence. À Valparaíso, les observations ont fait état d'un niveau de bien-être compromis (allant de mauvais à médiocre) chez 37 % des chiens (n = 204) et d'un pourcentage de 63 % de chiens présentant un niveau de bien-être satisfaisant (bon à optimal). En revanche, à Santiago (n = 350), 21 % seulement des chiens observés présentaient un état de bien-être compromis tandis que 78,3 % présentaient un état de bien-être satisfaisant. En ce qui concerne le comportement social, 55 % des chiens observés à Valparaíso et 68 % de ceux observés à Santiago avaient un mode de vie solitaire. Si la majorité des chiens se trouvaient en bon état physique, un pourcentage élevé d'entre eux ne parvenaient pas à satisfaire les besoins leur permettant de vivre en équilibre avec leur environnement.

Los perros callejeros constituyen no solo un problema de salud pública y ético, sino también, medioambiental y económico. Si bien se cree que estos perros no se encuentran en buenas condiciones, en Chile los estudios que abordan y analizan este tema son insuficientes. El objetivo de esta investigación fue evaluar el bienestar en perros callejeros en el centro de las ciudades de Santiago y Valparaíso. La evaluación se realizó a través de un método observacional en un total de 554 perros, y se analizaron las siguientes variables: condición corporal, dificultad motora, estado de la piel, enfermedad respiratoria, reacción hacia el humano y otras variables. Además, se consideró la distribución espacial y se estimó la edad, el sexo y la conducta social. Los resultados fueron analizados en términos de frecuencia, y se observó que en Valparaíso (n = 204), el 37% de los perros presentaba un bienestar comprometido (malo - escaso) mientras que el 63% presentaba un bienestar favorable (bueno u óptimo). En cambio, en Santiago (n = 350), sólo un 21,7% presentaba un estado de bienestar comprometido mientras que el 78,3% presentaba un estado de bienestar favorable. Asimismo, respecto a la conducta social, un 55% de los perros evaluados en Valparaíso y un 68% de los evaluados en Santiago mostraron un estilo de vida solitario. Si bien los individuos en su mayoría se encontraban en buenas condiciones, un alto porcentaje no lograba satisfacer las necesidades para estar en equilibrio con su entorno.

The brain-derived neurotrophic factor VAL68MET polymorphism modulates how developmental ethanol exposure impacts the hippocampus.

Prenatal exposure to alcohol causes a wide range of deficits known as fetal alcohol spectrum disorders (FASDs). Many factors determine vulnerability to developmental alcohol exposure including timing and pattern of exposure, nutrition and genetics. Here, we characterized how a prevalent single nucleotide polymorphism in the human brain-derived neurotrophic factor (BDNF) gene (val66met) modulates FASDs severity. This polymorphism disrupts BDNF's intracellular trafficking and activity-dependent secretion, and has been linked to increased incidence of neuropsychiatric disorders such as depression and anxiety. We hypothesized that developmental ethanol (EtOH) exposure more severely affects mice carrying this polymorphism. We used transgenic mice homozygous for either valine (BDNFval/val ) or methionine (BDNFmet/met ) in residue 68, equivalent to residue 66 in humans. To model EtOH exposure during the second and third trimesters of human pregnancy, we exposed mice to EtOH in vapor chambers during gestational days 12 to 19 and postnatal days 2 to 9. We found that EtOH exposure reduces cell layer volume in the dentate gyrus and the CA1 hippocampal regions of BDNFmet/met but not BDNFval/val mice during the juvenile period (postnatal day 15). During adulthood, EtOH exposure reduced anxiety-like behavior and disrupted trace fear conditioning in BDNFmet/met mice, with most effects observed in males. EtOH exposure reduced adult neurogenesis only in the ventral hippocampus of BDNFval/val male mice. These studies show that the BDNF val66met polymorphism modulates, in a complex manner, the effects of developmental EtOH exposure, and identify a novel genetic risk factor that may regulate FASDs severity in humans.

Síndrome miasténico congénito por deficiencia de rapsina: reporte de caso con nueva mutación y heterocigosidad compuesta / Congenital myasthenic syndrome due to rapsyn deficiency: A case report with a new mutation and compound heterozygosity

INTRODUCCIÓN Los síndromes miasténicos congénitos son un grupo heterogéneo de desórdenes genéticos, caracterizados por una transmisión sináptica anormal en la placa neuromuscular. REPORTE Presentamos el caso de un paciente de dos años, varón, con hipotonía, ptosis palpebral y debilidad simétrica y de predominio proximal, características que aparecieron desde el nacimiento y que motivaron varias hospitalizaciones por neumonía e insuficiencia ventilatoria. Desde el inicio de la deambulación a los dos años, los padres notaron que la debilidad empeoraba por las tardes y con la actividad física repetida o prolongada. El examen físico a los dos años mostró ptosis palpebral, debilidad de predominio proximal y fatigabilidad con el esfuerzo sostenido. La electro-miografía evidenció decremento del 27% en el potencial de acción muscular compuesto. El análisis de tríos mostró heterocigosis compuesta por transmisión de dos mutaciones diferentes en el gen de rapsina, una ya conocida procedente del padre y la otra no reportada previa-mente, procedente de la madre. El paciente recibió piridostigmina obteniendo mejoría inmediata y logrando un desempeño óptimo en actividades escolares, deportivas y de la vida cotidiana. A la fecha, no ha presentado nuevos episodios de insuficiencia ventilatoria. CONCLUSIONES La debilidad de inicio neonatal y la fatigabilidad o agotamiento con el esfuerzo sostenido, con afección principalmente de los músculos con inervación troncal y con un decremento mayor al 10% en el potencial de acción muscular compuesto en la electromiografía, deben hacer sospechar en un síndrome miasténico congénito. Se revisan los puntos clínicos clave que permiten establecer el diagnóstico oportuno y las opciones de tratamiento efectivo para algunos de estos síndromes.

INTRODUCTION The congenital myasthenic syndromes are a heterogeneous group of genetic disorders characterized by an abnormal synaptic transmission in the neuromuscular plate. REPORT We present a two-year-old patient, male, with hypotonia, palpebral ptosis, and proximal symmetric weakness with a neonatal onset that motivated several and prolonged hospitalizations for pneumonia and respiratory failure. From two years of age, the parents noticed that the facial and general weakness worsened in the afternoons and with repeated or prolonged physical activity. The physical examination showed palpebral ptosis, predominantly proximal weakness, and fatigability with sustained muscular effort. The electromyography showed a 27% decrement in the Compound Muscular Action Potential and the case-parents genetic study showed compound heterozygosity with the transmission of two different mutations in the rapsyn gene from both parents. The patient received pyridostigmine with great improvement, achieving optimal performance in school, sports, and daily life activities. CONCLUSIONS Weakness and fatigability with neonatal onset, mainly affecting the muscles with brain stem innervation and the decrement greater than 10 percent in the Compound Muscular Action Potential in the electromyographic studies, should make us suspect in a congenital myasthenic syndrome. We review the literature and key clinical points to establish a timely diagnosis and effective treatment in some of these syndromes.

Long-term Reductions in the Population of GABAergic Interneurons in the Mouse Hippocampus following Developmental Ethanol Exposure.

Developmental exposure to ethanol leads to a constellation of cognitive and behavioral abnormalities known as Fetal Alcohol Spectrum Disorders (FASDs). Many cell types throughout the central nervous system are negatively impacted by gestational alcohol exposure, including inhibitory, GABAergic interneurons. Little evidence exists, however, describing the long-term impact of fetal alcohol exposure on survival of interneurons within the hippocampal formation, which is critical for learning and memory processes that are impaired in individuals with FASDs. Mice expressing Venus yellow fluorescent protein in inhibitory interneurons were exposed to vaporized ethanol during the third trimester equivalent of human gestation (postnatal days 2-9), and the long-term effects on interneuron numbers were measured using unbiased stereology at P90. In adulthood, interneuron populations were reduced in every hippocampal region examined. Moreover, we found that a single exposure to ethanol at P7 caused robust activation of apoptotic neurodegeneration of interneurons in the hilus, granule cell layer, CA1 and CA3 regions of the hippocampus. These studies demonstrate that developmental ethanol exposure has a long-term impact on hippocampal interneuron survivability, and may provide a mechanism partially explaining deficits in hippocampal function and hippocampus-dependent behaviors in those afflicted with FASDs.

Experiencia en la Elaboración de un Inventario Funcional de Equipo de Imagenología / Experience in the Development of a Functional Inventory of Imaging Medical Equipment

RESUMEN: En nuestro México las Instituciones de salud han ganado experiencia en la administración de sus procesos; para muchos la clave del éxito está en la gestión de los recursos existentes, a medida que estos sean los adecuados, su eficacia será mayor. El presente documento pretende brindar un procedimiento que apoye las funciones de planeación y toma de decisiones de equipos de imagenología, bajo el criterio de contar con un inventario funcional de equipo de Rayos X en las unidades de atención médica de la Delegación Sur del Instituto Mexicano del Seguro Social (IMSS) de la Ciudad de México. Los resultados obtenidos permiten conocer las necesidades de modernización de la infraestructura tecnológica instalada y su distribución; así como planear su renovación y conservación para contribuir en el proceso de mejora de la calidad de los servicios de salud. Se analiza su distribución geográfica, edad media de funcionamiento y su productividad. En el inventario se detectaron 198 equipos relevantes, de los cuales los equipos de Rayos X de 500 y 300 mA son los más abundantes (43.94%) seguidos de los de Ultrasonógrafia (29.80%) y las unidades de radiología y fluoroscopia (21.21%). Los datos presentados deben ayudar a una mejor planeación en la adquisición de los equipos médicos dentro de la Delegación.

ABSTRACT: Healthcare institutions in Mexico have gained experience in the administration of their processes. The key to success lies in the management of existing resources, as long as these are adequate, their effectiveness will be greater. This document is aims to provide a procedure that supports the planning and decision-making functions of imaging equipments, under the criterion of having a functional inventory of X Ray equipment in medical care units of South Delegation of the Mexican Institute of Social Security (IMSS) of Mexico City. In this report it is described the type of equipment used in radiology and other imaging services. Its geographical distribution, average functional age and its productivity are analyzed. The Inventory reported 198 pieces of radiology equipment, equipments of 300 mA or 500 mA the most common type (43.94%) followed by ultrasound (29.80%) and fluoroscopy units (21.21%). Follow-up in the inventory should help in planning the acquisition and maintenance of medical equipment within the Delegation.

Resonancia magnética renal en un paciente con hemoglobinuria paroxística nocturna / Renal magnetic resonance in a patient with paroxysmal nocturnal hemoglobinuria

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal disease causing hematopoietic cell alteration, caused by a mutation in the PIG-A gene; which does not allow certain important proteins to bind to the cells. A 58-year-old patient presented with headache, a history of malaria, and occasionally dark urine. Magnetic resonance imaging proved to be an effective diagnostic method for detecting renal cortical hemosiderosis, thanks to its high spatial resolution capacity.

La hemoglobinuria paroxística nocturna (HPN) es una enfermedad clonal adquirida ocasionando la alteración de células hematopoyética, causada por una mutación en el gen GPI-A; lo cual no permite que ciertas proteínas importantes se fijen a las células. Se presenta un paciente de 58 años que acude con cefalea, antecedente de malaria y en ocasiones orinas oscuras. La resonancia magnética demostró ser un método diagnóstico eficaz para detectar la hemosiderosis renal cortical, gracias a su elevada capacidad de resolución espacial.

The prothrombotic state associated with obesity-induced hypertension is reduced by cocoa and its main flavanols.

BACKGROUND: Little is known about the effects of cocoa and its main flavanols on the prothrombotic state associated with the development of hypertension in diet-induced obesity models. PURPOSE: To evaluate the effects of cocoa powder, cocoa extract and their main flavanols on plasma biomarkers related to impaired coagulation and fibrinolysis and its association with hypertension and obesity-related metabolic disorders in rats fed a hypercaloric diet. METHODS: Male Wistar rats were randomly assigned to 7 treatment groups (n = 7): normal diet (ND); hypercaloric diet control group (HCD); HCD + cocoa powder (CO); HCD + cocoa extract (CO-EX); HCD + (-)-epicatechin (EPI); HCD + (+)-catechin (CAT); and HCD + procyanidin B2 (PB2). Blood pressure was measured using the tail-cuff method (week 7). At the end of the experimental period (week 8), rats were sacrificed and blood samples were collected immediately for coagulation and biochemical analyses. RESULTS: Oral administration of CO, CO-EX and their main flavanols significantly decreased plasma biomarkers related to impaired coagulation and fibrinolysis (vWF, FVIII, fibrinogen and PAI-1) in rats fed a hypercaloric diet. These effects were associated with decreased systolic and diastolic blood pressure, aortic oxidative stress (MDA levels) and improvement of dyslipidemia, insulin resistance and circulating markers of inflammation (TNF-α, IL-6 and CRP) compared to the HCD group. CONCLUSION: Our results showed that cocoa and its main flavanols may improve endothelial dysfunction and exert their antihypertensive effects by decreasing the prothrombotic state in rats fed a hypercaloric diet. Moreover, improvement of obesity-related metabolic disorders may also contribute to their BP-lowering effect.

Transmission Capacity of Trypanosoma cruzi (Trypanosomatida: Trypanosomatidae) by Three Subspecies of Meccus phyllosomus (Heteroptera: Reduviidae) and Their Hybrids.

Three behaviors of epidemiological importance: the time lapse for the onset of feeding, actual feeding, and defecation time for Meccus phyllosomus pallidipennis (Stål), Meccus phyllosomus longipennis (Usinger), Meccus phyllosomus picturatus (Usinger), and their laboratory hybrids were evaluated in this study. The mean time lapse for the beginning of feeding was between 0.5 and 8.3 min considering all instars in each cohort, with highly significant differences only among fifth-instar nymphs, females, and males of M. p. pallidipennis and M. p. longipennis relative to the hybrid cohorts. Four hybrid (LoPa [M. p. longipennis and M. p. pallidipennis] and LoPi [M. p. longipennis and M. p. picturatus] and their reciprocal experimental crosses) cohorts had similar mean feeding times to one of the parental subspecies, but longer than the other one. The remaining hybrid cohort (PaPi [M. p. pallidipennis and M. p. picturatus]) had longer feeding times than both of its parental subspecies. The specimens of the LoPa and LoPi hybrid cohorts defecated faster than the respective instars of the three parental cohorts. With exception of first- and fifth-instar nymphs, PaPi cohorts defecated faster than the remaining seven cohorts. More than 60% of defecation events occurred during feeding in the six hybrid cohorts. Our results indicate that hybrid cohorts have more potential to acquire infection and transmit Trypanosoma cruzi Chagas than their parental cohorts.

Complicaciones maternas en adolescentes y adultas afiliadas al régimen subsidiado, 2012 / Maternal complications in adolescents and adults affiliated to the subsidized regime, 2012 / Complicações maternas em adolescentes e adultas inscritas no regime subsidiado de saúde, 2012

La intervención de las complicaciones maternas y la minimización de sus efectos en la salud materno-infantil es prioridad para el cuidado en salud de esta población. La identificación de factores asociados a la complicación materna es de vital importancia para definir políticas y estrategias de intervención de esta problemática. OBJETIVO: Determinar los factores asociados a complicaciones durante el tercer trimestre del embarazo, parto y puerperio de las maternas pertenecientes al régimen subsidiado atendidas en una institución de segundo nivel de complejidad de Medellín. METODOLOGIA: investigación de cohorte ambiespectivo, que tiene como factor de exposición la edad (expuesto: adolescentes entre 14 y 19 años, no expuesto: entre 20 y 34 años de edad) y la complicación materna. Se calcularon frecuencias absolutas y relativas para las variables cualitativas y media, mediana y rango intercuartílico para las variables cuantitativas, se calculó proporción de incidencia de las complicaciones y el riesgo relativo crudo y ajustado por variables de confusión. RESULTADOS : el principal factor de riesgo asociado a complicación materna fue la atención prenatal inadecuada (criterio de Kessner). Se encontró como factor protector la asistencia al curso psicoprofiláctico CONCLUSION: no se encontraron grandes diferencias entre la población adolescente y adulta, pero sí se identificaron aspectos sociales (relaciones familiares), educacionales y de atención en salud que pueden afectar la salud materna de la población del régimen subsidiado atendida por una institución de segundo nivel de complejidad.

The intervention of maternal complications and the minimization of its impact on mother and child health is a priority for this population's health care. Identifying factors associated with maternal complications is critical to devising policies and intervention strategies against this problem. OBJECTIVE: to determine the factors associated with complications during the third trimester of pregnancy, delivery and puerperium of the mothers belonging to the subsidized health regime who receive care in a second level health care providing institution in Medellin. METHODOLOGY: an ambispective study whose exposure factors are age (exposed: adolescents aged 14 to 19, non-exposed:individuals aged 20 to 34) and maternal complications. Absolute and relative frequencies were calculated for the qualitative variables. Likewise, the mean, median and interquartile range were calculated for the quantitative variables. Moreover, the ratio of incidence was calculated for the complications along with the crude relative risk and the risk adjusted for confounding variables. RESULTS: the main risk factor associated with maternal complications was inadequate prenatal care (Kessner criterion). In addition, attendance to the psychoprophilactic course was found to be a protecting factor. CONCLUSION:No significant differences were found between adolescents and adults. However, social (family relations), educational and health care aspects were found which may affect the health of the mothers belonging to the subsidized regime who receive health care in a second level institution in Medellin.

A intervenção das complicações maternas e a minimização de seus efeitos na saúde materno-infantil é prioridade para o cuidado em saúde desta população.A identificação de fatores associados à complicação materna é de importância fundamental para definir políticas e estratégias de intervenção desta problemática. OBJETIVO: Determinar os fatores associados com complicações durante o terceiro trimestre da gravidez, parto e puerpério das mães pertencentes ao regime subsidiado de saúde atendidas em uma instituição de segundo nível de complexidade de Medellín. METODOLOGÍA: Progresso na consecução dos Objetivos de Desenvolvimento do Milênio:adolescentes entre 14 e 19 anos, não exposto: entre 20 e 34 anos de idade) e a complicação materna. Foram calculadas frequências absolutas e relativas para as variáveis qualitativas e média, mediana e rango interquartílico para as variáveis quantitativas, foi calculada proporção de incidência das complicações e o risco relativo cru e ajustado por variáveis de confusão. RESULTADOS: O principal fator de risco associado à complicação materna foi a atenção pré-natal inapropriada (critério de Kessner). E encontrou-se como fator protetor a assistência ao curso psico-profilático. CONCLUSÃO: Não foram encontradas diferenças grandes entre a população adolescente e adulta, mas sim foram identificados aspectos sociais (relacionamentos familiares), educacionais e de atendimento em saúde que podem afetar a saúde materna da população com regime subsidiado de saúde atendido por uma instituição de segundo nível de complexidade.

Endocarditis Bacteriana en paciente con sospecha de padecer Colagenopatía. Reporte de Caso / Bacterial endocarditis in patients with suspected collagen disease. Case Report

La endocarditis es la inflamación del endotelio valvular o parietal. La fisiopatología de la endocarditis se basa en la lesión del endotelio cardíaco que predispone a la formación de la vegetación, la cual consiste en una masa de plaquetas, fibrina y escasas células inflamatorias. En países industrializados la incidencia anual de la endocarditis infecciosa es de 3 a 9 casos por cada 100.000 personas. Las colagenopatías pueden lesionar el endotelio cardíaco predisponiendo así a una endocarditis infecciosa, aun siendo el paciente seronegativo para las pruebas reumatológicas. Se presenta el caso de una paciente de 38 años que consulta por dolores articulares y sensación febril de larga data en quien se diagnostica endocarditis bacteriana, sospechándose una enfermedad autoinmune de base por la cronicidad de la sintomatología y el grado de lesión de las válvulas nativas que terminan siendo reemplazadas por válvulas mecánicas; no se ha llegado a confirmar el origen autoinmune de la afectación valvular. Palabras clave: endocarditis, seronegativo, afectación valvular, colagenopatías.

Endocarditis is inflammation of the parietal or valvular endothelium. The pathophysiology of endocarditis is based on cardiac endothelium lesions predisposing to the formation of vegetation, which consists of a mass of platelets, fibrin and inflammatory cells. In industrialized countries, the annual incidence of infective endocarditis is 3-9 cases per 100,000 individuals. Collagen vascular disease can damage the heart and predispose an individual to infectious endocarditis, even if a patient is seronegative for rheumatologic serum markers of disease. We report the case of a 38-year female patient who presented with longstanding joint pain and fevers, who was diagnosed with endocarditis and in whom an autoimmune disease was suspected based on the chronicity of her symptoms and the degree of injury to her native heart valve that required replacement with a mechanical valve. The underlying autoimmune etiology of the damage to her heart valve has not been determined. Keywords: endocarditis, seronegative, valvular disease, collagen

Análisis de la gestión territorial: Encuesta Nacional de Salud 2007, Colombia 2011 / Analysis of the local authorities: National Health Survey 2007, Colombia 2011

OBJETIVO: en este artículo se presentan los resultados de la Encuesta Nacional de Salud de 2007 (ENS), del módulo I sobre las administraciones territoriales de salud, en cuanto a la capacidad de gestionar la salud en los municipios y caracterizar la infraestructura sanitaria y la vigilancia en la salud pública. METODOLOGIA: se realizó un estudio descriptivo retrospectivo, en una muestra representativa de 238 municipios del país de todas las categorías, de los cuales respondieron 223. La fuente de información fue la ENS/2007, aplicada a los secretarios de salud de los municipios de la muestra. RESULTADOS: la oferta de instituciones públicas y privadas de salud y aseguradoras, tiene mayor presencia en los municipios de categoría 1 y especial. La infraestructura sanitaria es insuficiente pero es mayor en los municipios de categoría especial y principalmente en la zona urbana. La vigilancia en salud pública para la mortalidad materna, perinatal, Enfermedad Diarréica Aguda (EDA) e Infección Respiratoria Aguda (IRA) es mayor en los municipios de categorías 1 y especial. CONCLUSIONES: a pesar de los esfuerzos realizados por los actores municipales para mejorar la salud, los resultados muestran desigualdades importantes entre la zona urbana y rural, así como entre los municipios de categorías 1 y especial, al igual que en las otras categorías, situación que demanda inversiones mayores en infraestructura sanitaria, en el sistema de vigilancia de la salud pública y en los programas de los municipios de menor desarrollo, para que las desigualdades no sean progresivas y se obtengan mejores beneficios en salud para la población.

OBJECTIVE: this paper presents the results of the 2007 National Health Survey's (ENS) module I, which deals with territorial management of health regarding the capacity to manage health in the municipalities and to characterize their sanitary infrastructure and public health surveillance. METHODOLOGY: a descriptive retrospective study was conducted with a representative sample of 238 Colombian municipalities from all the categories, 223 of which answered the call. The source of information was the ENS/2007, which was applied to the health secretaries of the sample's municipalities. RESULTS: more public and private health providers and health insurance companies are available in the municipalities belonging to the special category and to category 1. The sanitary infrastructure is insufficient but larger in the municipalities from the special category, particularly in the urban area. Public health surveillance for maternal and perinatal mortality, and for add and ari is higher in the municipalities from the special category and from category 1. CONCLUSIONS: in spite of the efforts of the municipalities to improve health, the results show important inequalities between the rural and urban areas, and between the municipalities from the special category and the municipalities from other categories. This situation calls for larger investments for the sanitary infrastructure, the public health surveillance systems, and the programs of the less developed municipalities in order to prevent inequalities from becoming progressive and to obtain better profits in terms of the people's health.

Desempeño de las funciones esenciales de salud pública en tres municipios, Antioquia-Colombia, 2011 / Performance measurement of essential public health functions in three municipalities, Antioquia-Colombia, 2011

OBJETIVO: medir el desempeño de las Funciones Esenciales en Salud Pública (FESP) en tres municipios que corresponden a la zona Penderisco del suroeste antioqueño (Concordia, Betulia y Salgar) en 2011. METODOLOGIA: se realizó un estudio descriptivo transversal en los tres municipios. Se adaptó el instrumento de medición de las FESP en el ámbito nacional, elaborado por la OPS para aplicarlo localmente, se ajustó a las competencias y campos de acción de las autoridades municipales, se suprimieron preguntas no pertinentes para el nivel y se recalcularon las fórmulas que generaban el puntaje y los indicadores. El instrumento se aplicó a un grupo de expertos en cada municipio. RESULTADOS:en la zona Penderisco, se encontraron tres funciones FESP1, FESP2 y FESP4 con desempeño óptimo. Las FESP3, FESP5, FESP6, FESP7, FESP8, FESP9 y FESP11 con desempeño medio superior y la FESP10 un desempeño mínimo. Dos indicadores de desarrollo de capacidades e infraestructura para la salud pública, fueron clasificados como debilidades, coincidente en los tres municipios: conocimientos, habilidades y mecanismos para revisar, perfeccionar y hacer cumplir el marco regulatorio y el desarrollo de la capacidad institucional de investigación. CONCLUSIONES: a pesar de los esfuerzos realizados por los países para mejorar el desempeño de las FESP, el desarrollo es incipiente con algunas excepciones, este mismo esquema se refleja en los municipios estudiados. Pocas funciones están clasificadas en desempeño óptimo y como fortalezas. El desarrollo de capacidades e infraestructura para soportar el desarrollo de las FESP es débil.

OBJETIVE: to measure the performance of the Essential Public Health Functions (EPHF) in three municipalities from the Penderisco area of Southwestern Antioquia (a zone encompassing three municipalities: Betulia, Concordia, and Salgar) in 2011. METHODOLOGY: we conducted a cross-sectional descriptive study in three municipalities. To this end, we adapted the instrument for measuring EPHF for use in Colombia. The instrument was developed by the paho, and we implemented its adapted version locally. The instrument was adjusted to the skills and fields of action of the municipal authorities, the questions that were not relevant for the local context were removed, and the formulas for generating scores and indicators were re-calculated. The instrument was applied to a group of experts in each municipality. RESULTS: in the Penderisco zone, three functions had optimal performance: EPHF1, EPHF4, EPHF2. Additionally, the functions labeled EPHF3, EPHF5, EPHF6, EPHF7, EPHF8, EPHF9, and EPHF11 had above average performance. EPHF10, in turn, showed minimum performance. Two indicators of development of capacity and infrastructure for public health were classified as weaknesses, namely: knowledge, skills, and mechanisms to review, refine and enforce the regulatory framework and development of institutional research capacity. This is consistent in the three municipalities. CONCLUSIONS: In spite of the efforts made by countries to improve the performance of the essential public health functions, development is still budding; the same scenario is seen in the studied municipalities. Few functions had optimal performance and were considered strengths and capacity development and the infrastructure for supporting the development of essential public health functions are weak.

Biological and genetic aspects of crosses between phylogenetically close species of Mexican triatomines (Hemiptera: Reduviidae).

Reproductive isolation between Triatoma mexicana (Herrich-Scaeffer) and the six species of the Phyllosoma complex, belonging to the genus Meccus, was examined by analyzing the fertility of experimental hybrids. The percentage of couples with offspring was highest in the set of crosses between Meccus phyllosomus (Burmeister) and T. mexicana, and lowest in those between Meccus pallidipennis (Stål) and Meccus bassolsae (Alejandre-Aguilar, Nogueda-Torres, Cortés-Jiménez, Jurberg, Galvão, and Carcavallo) with respect to T. mexicana. Crosses between Meccus mazzottii (Usinger), Meccus picturatus (Usinger), and Meccus longipennis (Usinger) and T. mexicana had scarce offspring, whereas offspring from crosses between M. phyllosomus and T. mexicana were abundant. However, all F1 nymphs died in different instars before reaching sexual maturity. The biological evidence in this study suggests that different degrees of reproductive isolation exist between T mexicana and the different species of Meccus. Our data also support the current status of T. mexicana as a separate species.