Estrategias de retroalimentación inmersas en tecnologías de asistencia para promover la participación social de niños con parálisis cerebral: revisión sistemática / Feedback strategies in assistive technology to promote social participation in children with cerebral palsy: Systematic review

Introducción: Vivir con parálisis cerebral tiene consecuencias en la participación social. Las tecnologías utilizadas para generar independencia se limitan a resultados en variables biológicas y fisiológicas. El objetivo es sintetizar la evidencia en intervenciones con tecnologías de asistencia que incluyan sistemas de retroalimentación, con el fin de conocer los desenlaces en la participación social en niños con parálisis cerebral. Metodología: Se tomaron 5 bases de datos de rehabilitación y se obtuvieron 683 artículos, de los cuales se incluyeron 9. Resultados: Los estudios evaluaron la participación social con diversos instrumentos; la mayoría sugieren efectos positivos en actividades como caminar, escribir y jugar, favoreciendo la interacción social en el entorno, utilizando tecnologías como lápices electrónicos, switches, exoesqueletos, entre otros.Conclusión: Debido a la baja calidad metodológica de los estudios, no se establecen conclusiones sólidas. Sin embargo, la evidencia propone que las tecnologías de asistencia con retroalimentación tienen un impacto positivo en los componentes de la participación social.(AU)

Introduction: Living with cerebral palsy has consequences such as social interaction. Assistive technologies used for improving independence only focuses on biological and physiological variables. The main objective in this review is to synthesize the evidence on interventions with assistive technologies, including feedback systems, with the aim of discovering outcomes of social participation in children with cerebral palsy. Methodology: There were 5 databases from rehabilitation which showed 683 articles in which only 9 were included. Results: The studies assessed social participation with several instruments. The majority suggested positive effects in activities such as: walking, writing, playing, and social interaction. There were tools such as electronic pencils, switches, and exoskeletons present. Conclusion: Due to the poor quality of the methodologies of these studies, the search does not establish solid conclusions. However, the evidence suggests that assistive technologies with feedback have a positive impact on aspects of social participation.(AU)

[Feedback strategies in assistive technology to promote social participation in children with cerebral palsy: Systematic review]. / Estrategias de retroalimentación inmersas en tecnologías de asistencia para promover la participación social de niños con parálisis cerebral: revisión sistemática.

INTRODUCTION: Living with cerebral palsy has consequences such as social interaction. Assistive technologies used for improving independence only focuses on biological and physiological variables. The main objective in this review is to synthesize the evidence on interventions with assistive technologies, including feedback systems, with the aim of discovering outcomes of social participation in children with cerebral palsy. METHODOLOGY: There were 5 databases from rehabilitation which showed 683 articles in which only 9 were included. RESULTS: The studies assessed social participation with several instruments. The majority suggested positive effects in activities such as: walking, writing, playing, and social interaction. There were tools such as electronic pencils, switches, and exoskeletons present. CONCLUSION: Due to the poor quality of the methodologies of these studies, the search does not establish solid conclusions. However, the evidence suggests that assistive technologies with feedback have a positive impact on aspects of social participation.

Root anatomy and canal configuration of maxillary premolars: a cone-beam computed tomography study / Anatomía de la raíz y configuración del conducto de los premolares maxilares: estudio de tomografía computarizada de haz cónico

SUMMARY: The aim of the study was to determine the number and anatomical configuration of roots and root canals of maxillary first and second premolars using cone-beam computed tomography scans. n273 CBCT scans were evaluated, obtaining a sample of 592 maxillary premolars. Root number and root canal anatomy were categorized using Ahmed´s classification. Data was analyzed using Pearson's Chi-squared test. Two roots were present on 157 first premolars, one root in 132 premolars and three roots in 17. Second premolars presented one root in 266 samples and two roots in 20; no second premolars presented three roots. Eight different configurations were found; the most frequent was 2MP B1 P1 in first premolars (51,3 %) and 1MP1 (63.6 %) in second premolars. The most frequent morphology found in maxillary premolars in Chilean population was two and three roots. The analysis of internal anatomy using CBCT revealed a highly variable distribution of root canals, generally of low to medium complexity, similar to what is found in other ethnic groups.

RESUMEN: El objetivo de este estudio fue determinar el número y la configuración de raíces y canales radiculares de primeros y segundos premolares maxilares utilizado tomografía computacional de haz cónico. 273 TCHC fueron evaluados, obtenido una muestra de 592 premolares maxilares. El número de raíces y la anatomía de los canales radiculares fueron categorizados utilizando la clasificación de Ahmed. Los datos fueron analizados con la prueba Chi- Cuadrado de Pearson. Dos raíces fueron observadas en 157 primeros presentaron una raíz en 266 muestras y dos raíces en 20; no se encontraron tres raíces en segundos premolares. Ocho diferentes configuraciones fueron encontradas; siendo la más frecuente 2MP B1 P1 en primeros premolares (51,3 %) y 1MP1 (63,6 %) en segundos premolares. La morfología radicular más frecuentemente encontrada en premolares de población Chilena fue de dos y tres raíces. El análisis de la anatomía interna usando TCHC mostró una gran variabilidad de en la distribución de los canales radiculares. Generalmente de mediana y baja complejidad como los encontrados en otros grupos etnicos.

Ictiosis Lamelar autosómica recesiva: revisión de la literatura y caso clínico / Autosomal recessive lamellar ichthyosis: review of the literature and clinical case

Resumen Las ictiosis congénitas autosómicas recesivas (ICAR) son poco frecuentes a nivel mundial con una incidencia de 1:300,000 nacimientos, se caracterizan por trastornos de la queratinización, entre sus variantes engloban las formas no sindrómicas de ictiosis, como la ictiosis laminar (IL), la eritrodermiaictiosiforme congénita (EIC) y actualmente se incluyen la ictiosis arlequín, el bebé colodión autorresolutivo, el bebé colodión autorresolutivoacral y la ictiosis en traje de baño. Desde el punto de vista genético son heterogéneas, originadas por una mutación en el gen de la transglutaminasa 1 y se las haasociado a TGM1, ALOXE3, ALOX12B, NIPAL4, CYP4F22 y ABCA12. Clínicamente, la ictiosis se caracteriza principalmente por piel gruesa, escamas laminares adherentes con hendiduras profundas. En este trabajo pretende revisar los conocimientos actuales en el campo de las ICAR, incluyendo aspectos clínicos, histológicos, ultraestructurales, genético-moleculares, tratamiento,y también su manejo clínico.

Abstract The autosomal recessive congenital ichthyosis (ARCI) is a rare worldwide condition with an incidence of (1: 300,000 births), characterized by disorders of keratinization, among its variants encompass the non-syndromic forms of ichthyosis, such as laminar ichthyosis (IL) , congenital ichthyosiform erythroderma (EIC) and currently include harlequin ichthyosis, self-healing colodion baby, acral self-healing colodion baby and ichthyosis in swimsuits. From a genetic point of view, they're heterogeneous, originated by a mutation in the gene of transglutaminase 1 and associated with TGM1, ALOXE3, ALOX12B, NIPAL4, CYP4F22 and ABCA12. Clinically, ichthyosis is mainly characterized by thick skin, adherent lamellar scales with deep clefts. The aim of this work is to review the current knowledge in the field of ICAR, including clinical, histological, ultrastructural, genetic-molecular and therapeutic aspects as well as its clinical management.

Dermatitis atópica: Pitiriasis alba. A propósito de un caso / Atopic Dermatitis: Pityriasis Alba. A clinical case

RESUMEN La Pitiriasis alba es una enfermedad cutánea inespecífica de etiología desconocida, caracterizada por máculas hipocrómicas, redondeadas u ovaladas poco delimitadas y cubiertas con escamas finas que ocurren usualmente en la región facial de los niños. Fue descrita por Gilbert en 1860 y Fox en 1923, pero fue O'Farrell en 1956 quien propuso el nombre de Pitiriasis alba. La condición dermatológica con la que suele asociarse es la dermatitis atópica. La presencia de Pitiriasis alba fue definida como uno de los criterios menores para el diagnóstico de Dermatitis atópica, según Hanifin y Rajka en 1980. Sin embargo, también se presenta en 20-40% de los niños atópicos, sin evidencia de Dermatitis atópica, así como en individuos no atópicos. La disfunción de la barrera epitelial causada por mutaciones del gen de la filagrina, proteína estructural epidérmica, que forma parte del factor humectante natural, se considera un factor de riesgo emergente para la Dermatitis atópica severa de comienzo precoz. Se presenta un caso de Pitiriasis albaen el que fue necesaria terapia combinada tópica y vía oral, con evolución satisfactoria en 8 semanas de tratamiento.

SUMMARY Pityriasis Alba is a non-specific skin disease of unknown etiology characterized by hypochromic macules, rounded or oval, poorly defined and covered with fine scales that usually occur in the facial region of children. It was described by Gilbert in 1860 and Fox in 1923, but it was O'Farrell in 1956 who proposed the name Pityriasis alba. The dermatological condition with which it is usually associated is Atopic dermatitis. The presence of Pityriasis alba was defined as one of the minor criteria for the diagnosis of Atopic dermatitis, according to Hanifin and Rajka in 1980. However, it also occurs in 20-40% of atopic children, without evidence of Atopic dermatitis, as well as in non-atopic individuals. Epithelial barrier dysfunction caused by mutations of the filaggrin gene, epidermal structural protein, which is part of the natural humectant factor, is considered an emerging risk factor for severe early onset Atopic dermatitis. We present a case of Pityriasis alba where combined topical and systemic therapy was necessary with satisfactory evolution in 8 weeks of treatment.

Tiña de la cabeza / Tineacapitis

RESUMEN La tiña de la cabeza (tineacapitis) es una dermatofitosis del cuero cabelludo frecuente en niños. Es la más común de todas las micosis cutáneas en este grupo de edad a nivel mundial, y es muy rara en adultos. Se ha considerado unproblema de salud pública importante durante décadas.Algunos de los factores asociados son higiene personal deficiente, hacinamiento y bajo nivel socioeconómico.El agente etiológico frecuentemente aislado fue elMicrosporumcanis con un 82,09 %, seguido por Trichophytontonsurans con 17,91%. Enconclusión,la tineacapitis ocupa un lugar preponderante que merece ser estudiado,siendo necesarios la detección y tratamiento precoz para evitar complicaciones.Se presenta un caso de tineacapitis, en el que se evidencia clínicamente infección micótica por Microsporumcanis.

SUMMARY Ringworm of the head (tinea capitis) is a frequent dermatophytosis of the scalp in children. In fact, it is the most common of all cutaneous mycosis in this age group worldwide, being very rare in adults. It has been considered an important public health problem for decades, of the factors associated are: poor personal hygiene, overcrowding and low socioeconomic level. The most frequently isolated etiologic agent was Microsporumcanis with 82.09% followed by Trichophyton tonsurans with 17.91% In conclusion tinea capitis occupies a preponderant place that deserves to be studied, being necessary the detection and early treatments to avoid complications.A case of tinea capitis is presented, where there is clinically evidence of fungal infection by Microsporumcanis.

Liquen Plano Pigmentado:a propósito de un caso / Flat LichenPigmented:Clinical case

RESUMEN El Liquen Plano Pigmentado es una dermatosis crónica frecuente de etiología aún desconocida, caracterizada clínicamente por la presencia de pápulas purpúreas, poligonales, pruriginosasdistribuidas en forma simétrica. ElLiquen Plano Pigmentado representa una de todas las variantes clínicas, cuya característica histológica distintiva es la incontinencia de pigmento melánico. Su curso es autolimitado pues se resuelve en un período de meses a años, pero puede persistir indefinidamente. Existen múltiples opciones de tratamiento, que incluyen corticoides tópicos, intralesionales y sistémicos, retinoides, fototerapia, inmunomoduladores tópicos y, en casos graves o resistentes al tratamiento, la ciclosporina, metotrexato. La dermatoscopía es una técnica auxiliar de diagnóstico no invasivaque permite incrementar la certeza diagnóstica en diversasenfermedades cutáneas; en el caso del Liquen Plano Pigmentado se observa la lesión clásica que consiste en una pápula poligonal aplanada, de tonalidad eritemato-violácea que suele tener finas escamas adherentes en la superficie,denominadasestrías de Wickham, queconsisten en estructuras polimórficas blanquecinas y que corresponden histológicamente a zonas de ortoqueratosis.Es una herramienta de gran utilidad para el diagnóstico de estas lesiones.

ABSTRACT The Pigmented Flat Lichen is a frequent chronic dermatosis of etiology still unknown, clinically characterized by the presence of purpuric, polygonal, pruritic papules distributed symmetrically. The Pigmented Flat Lichen represents one of all clinical variants, where the distinctive histological feature is melanin pigment incontinence. Its course is self-limited, it resolves over a period of months to years, but it can persist indefinitely. There are multiple treatment options that include topical, intralesional and systemic corticosteroids, retinoids, phototherapy, topical immunomodulators and in severe or resistant cases to treatment, cyclosporine, methotrexate. Dermatoscopy is a non-invasive diagnostic auxiliary technique that allows accelerating diagnostic certainty in various skin diseases; in the case of the Pigmented Flat Lichen, the classic lesion is observed, consisting of a flattened polygonal papule, with an erythematous-violet hue that usually has fine adherent scales on the surface, called Wickham striae, which consists of whitish polymorphic structures and that corresponds histologically to areas of orthokeratosis. It is a very useful tool for the diagnosis of these lesions.

Estudio comparativo de insectos asociados a cadáveres de cobayas en dos formas de muerte en Castilla, Piura (Perú) / Comparative study of insects associated with guinea pig corpses in two forms of death in Castilla, Piura (Peru)

Se determinaron los insectos asociados a cadáveres de cobayas, en las dos formas de muerte con mayor incidencia en Piura: envenenamiento (raticida) y arma blanca (cuchillo); utilizando como testigo una muerte por parada cardiorrespiratoria. Para este fin, se sacrificaron cobayas hembras, de pesos similares y procedentes de la misma granja, en tres repeticiones (una por mes), expuestos en un área de bosque seco en el distrito de Castilla, dentro de jaulas de malla metálica, y separadas 60 metros entre sí. La colecta de dípteros adultos se realizó mediante una red entomológica, y se les sacrificó con cianuro en un frasco mortal. Los coleópteros se colectaron por muestreo manual alrededor del cadáver, y se sacrificaron en un frasco mortal con alcohol al 70%. Todos los individuos fueron determinados y cuantificados con un estereoscopio y claves taxonómicas, siempre procurando llegar al nivel taxonómico más bajo. Se utilizó el programa SPSS Vs.22 para calcular las diferencias en la entomofauna entre las formas de muerte, mediante el análisis de varianzas (ANOVA); encontrándose un total de 24 especies, correspondientes a 22 especies para el testigo, 17 para envenenamiento y 19 para arma blanca, a una temperatura y humedad promedio de 25,94 °C y 63,19%, respectivamente. Estadísticamente, no existían diferencias significativas entre las formas de muerte con un nivel de significancia de 0,05

The insects associated with corpses of guinea pigs were determined, in the two forms of death with the highest incidence in Piura: poisoning (rat poison) and white weapon (knife); using as a witness, a death due to cardiorespiratory arrest. For this purpose, female guinea pigs, of similar weights and from the same farm, were slaughtered in three repetitions (one per month), exposed in an area of dry forest in the district of Castilla, in metal mesh cages, and separated 60 meters between them. The collection of adult diptera was carried out with an entomological network, and the sacrifice of these, in a deadly vial with cyanide. Coleoptera were collected by manual sampling around the body, and sacrificed in a deadly vial with 70% alcohol. All individuals were determined and quantified with a stereoscope and taxonomic keys, always trying to reach the lowest taxonomic level. The SPSS program Vs.22 was used to calculate the differences in the entomofauna between the forms of death, through the analysis of variances (ANOVA). There were a total of 24 species, corresponding to 22 species for the control, 17 for poisoning and 19 for weaponry, at an average temperature and humidity of 25.94 °C and 63.19% respectively, there being no statistically significant differences between the forms of death at a significance level of 0.05

Molecular identification of Nocardia species using the sodA gene: Identificación molecular de especies de Nocardia utilizando el gen sodA.

Currently for bacterial identification and classification the rrs gene encoding 16S rRNA is used as a reference method for the analysis of strains of the genus Nocardia. However, it does not have enough polymorphism to differentiate them at the species level. This fact makes it necessary to search for molecular targets that can provide better identification. The sodA gene (encoding the enzyme superoxide dismutase) has had good results in identifying species of other Actinomycetes. In this study the sodA gene is proposed for the identification and differentiation at the species level of the genus Nocardia. We used 41 type species of various collections; a 386 bp fragment of the sodA gene was amplified and sequenced, and a phylogenetic analysis was performed comparing the genes rrs (1171 bp), hsp65 (401 bp), secA1 (494 bp), gyrB (1195 bp) and rpoB (401 bp). The sequences were aligned using the Clustal X program. Evolutionary trees according to the neighbour-joining method were created with the programs Phylo_win and MEGA 6. The specific variability of the sodA genus of the genus Nocardia was analysed. A high phylogenetic resolution, significant genetic variability, and specificity and reliability were observed for the differentiation of the isolates at the species level. The polymorphism observed in the sodA gene sequence contains variable regions that allow the discrimination of closely related Nocardia species. The clear specificity, despite its small size, proves to be of great advantage for use in taxonomic studies and clinical diagnosis of the genus Nocardia.

Actualmente, para la identificación y clasificación bacteriana se utiliza como método de referencia la secuenciación el gen rrs que codifica al rRNA16S, en el caso del análisis de cepas del género Nocardia, sin embargo, no tiene el suficiente polimorfismo para diferenciarlas a nivel de especie lo que hace necesaria la búsqueda de blancos moleculares que puedan proporcionar una mejor identificación. El gen sodA (que codifica la enzima superóxido dismutasa) ha tenido buenos resultados en la identificación de especies de otros Actinomicetos. En este estudio se propone para la identificación y diferenciación a nivel de especie del género Nocardia. Se utilizaron 41 especies Tipo de diversas colecciones, se amplificó y secuenció un fragmento de 386 pb del gen sodA y se realizó un análisis filogenético comparando los genes rrs (1171 pb) hsp65(401pb) secA1 (494pb), gyrB (1195pb) y rpoB (401pb), las secuencias fueron alineadas utilizando el programa Clustal X, los árboles evolutivos de acuerdo con el método de "Neighbor-Joining"se hicieron con el programa Phylo_win y Mega 6. Se analizó la variabilidad específica del gen sodA del género Nocardia presentando una alta resolución filogenética, una variabilidad genética importante, especificidad y confiabilidad para la diferenciación de los aislados a nivel de especie. El polimorfismo observado en la secuencia del gen sodA contiene regiones variables que posibilitan la discriminación de especies de Nocardia estrechamente relacionadas, y una clara especificidad, a pesar de su pequeño tamaño, demostrando ser de gran ventaja para utilizarse en estudios taxonómicos y en el diagnóstico clínico del género Nocardia.

First case of isolation of Nocardia wallacei reported in Mexico.

Nocardia species are aerobic, Gram-positive bacteria with branched filaments reported as opportunistic microorganisms associated with infectious diseases of the skin. We report the isolation of N. wallacei in Mexico from a 43-year-old man, an HIV-positive construction worker who sought care for difficulty breathing and abundant sputum.

Biocompatibility and degradation of LAE442-based magnesium alloys after implantation of up to 3.5years in a rabbit model.

UNLABELLED: Magnesium as basic implant material has long been the center of orthopedic research. Latest progress is achieved with a European certification and clinical use of a magnesium based compression screw. However, long term studies with implantation duration that exceed one year considerably do not exist. The present examinations analyzed the degradation progress from nine months to 3.5year after implantation of cylindrical pins into the medullary cavity of New Zealand White rabbits. Evaluation included clinical assessment, in vivo µ-computed tomography, analysis of the implants by three-point-bending and examination of the adjacent tissue by means of histology and of inner organs by mass- and optical emission spectrometry using inductively coupled plasma. Clinical acceptance was without objections in all animals. Immoderate reaction of the surrounding bone could be found in neither of the applied techniques. While in vivo µ-computed tomography showed a very slow degradation rate up to 72weeks, three-point-bending revealed a percentage loss of F(max) of 41.1% for implants after 9months implantation and 88.47% for the implant after 3.5years implantation. Although the total amounts of RE detected in the inner organs were very low, the organs of rabbits with LAE442 cylinders showed 10-20-fold increased concentrations of the alloying elements lanthanum, cerium, neodymium and praseodymium compared to animals without any implanted material. STATEMENT OF SIGNIFICANCE: This is the first animal study investigating the degradation process of a magnesium alloy in vivo for up to 3.5years. Currently available data from different other in vivo studies cover only implantation durations up to one year. Therefore, the analysis of these long-time effects in the present study is highly significant and of great interest. Comprehensive outcome achieved by different techniques was assessed. The degradation process was slow and homogenous. Maximum applied force (F(max)) reduced by 41.1% for implants after 9months and by 88.47% for the implant after 3.5years implantation. Total amounts of RE detected in the inner organs were very low; the organs of rabbits with LAE442 cylinders showed 10-20-fold increased concentrations.

Phenotypic and genotypic evaluation of 18 Nocardia isolates from human clinical samples in Mexico.

BACKGROUND: Mexico has the largest number of clinical cases of actinomycetoma in North and South America. Species originally identified by less specific methods have been recently reclassified as other known species or as new species. OBJECTIVE: To assess, by 16S rRNA gene sequencing and phenotypic methods, the species distribution of 18 human clinical isolates originally identified as N. brasiliensis, some of them isolated between 1947 and 1959 in Mexico City. METHODS: Clinical isolates came from the Hospital General, "Dr. Manuel Gea Gonzalez", and Instituto Nacional de Diagnóstico y Referencia Epidemiológica (INDRE) in Mexico, D.F. The strains used in this study included 15 clinical strains isolated between 1947 and 1959 that were originally identified as N. brasiliensis and three more strains obtained in 2007 identified as Nocardia spp. The isolates were identified genotypically by sequencing the 16S rRNA gene, and their phenotypic profiles were obtained with the API Coryne(®) system. Antibiotic susceptibility patterns were tested according to the protocol of the Comité de l'antibiogramme de la Société française de microbiologie[4]. RESULTS: According to 16S rRNA gene, sequencing were identified among 18 human clinical isolates as Nocardia farcinica (n=11) and Nocardia brasiliensis (n=7). A high number of the strains were susceptible to the majority of the antibiotics tested. The phenotypic profiles of the strains were quite uniform for N. farcinica and some variability was observed for N. brasiliensis strains. CONCLUSION: N. farcinica was the most prevalent species identified. Modern methodologies should be applied in clinical laboratories to accurately identify etiological agents.

Evaluación de efecto vasoprotector del consumo de curcumina en ratas macho Sprague-Dawley con dieta hipercolesterolémica / Evaluation of the curcumin vasoprotective effect in Sprague-Dawley male rats with a hypercholesterolemic diet

INTRODUCCIÓN: El hígado graso no alcohólico puede abarcar desde una simple esteatosis hasta una cirrosis hepática. Los mecanismos fisiopatológicos que modulan el estrés oxidativo, la actividad inflamatoria y profibrótica, deberían ser cruciales en su mayor o menor agresividad hepática y vascular. Un compuesto derivado de la Cúrcuma longa L, la curcumina, poseería propiedades vasoprotectoras. OBJETIVO: Comparar en situaciones de dieta hipercolesterolémica los cambios vasculares entre ratas macho Sprague Dawley que consumen curcumina y las que no consumen. MATERIAL Y MÉTODO: Estudio analítico, experimental, longitudinal y prospectivo en ratas macho Sprague-Dawley expuestas a condiciones de hígado graso no alcohólico e hígado graso no alcohólico adicionando curcumina, durante 4 meses. Sacrificadas, se realizó protocolo de función vascular en arteria mesentérica superior aislada (respuesta a acetilcolina, N nitro-L-arginina metil éster y nitroprusiato) y medición de presión portal por punción directa. Los resultados fueron expresados en promedios junto a la desviación estándar de la media. Lasdiferencias entre los grupos fueron probadas mediante t de Studenty test de Mann-Whitney. RESULTADOS: La medición de presión portal no mostró diferencias significativas entre ambos grupos. No hubo diferencias significativas en las pruebas con Nnitro-L-arginina metil éster ni nitroprusiato; diferencia que sí existió con acetilcolina entre la dilatación de la arteria mesentérica superior de hígado graso no alcohólico y las de hígado graso no alcohólico más curcumina. DISCUSIÓN: La curcumina mejoró la respuesta vasodilatadora a acetilcolina, lo que sugiere que el posible efecto antioxidante sería mejorando la función endotelial. Se sugiere su futuro uso terapéutico.

INTRODUCTION: Nonalcoholic fatty liver disease can range from simple steatosis to cirrhosis. The pathophysiological mechanisms that modulate oxidative stress, inflammatory and profibrotic activity should be crucial in the liver injury and vascular aggressiveness. Curcumin, a compound derived from Curcuma longa L, possesses vasoprotectives properties. OBJECTIVE: To compare in hypercholesterolemic diet situations the vascular changes between Sprague-Dawley male rats who consume curcumin and who do not consume. MATERIAL AND METHOD: Analytical, experimental, prospective and longitudinal study in Sprague-Dawley male rats exposed to conditions of Nonalcoholic fatty liver with and without curcumin, for four months. After the sacrifice, a vascular function protocol was performed on an isolated superior mesenteric artery (response to acetylcholine, L-NGNitroarginine Methyl Ester and nitroprusside) and measurement of portal pressure by direct puncture. The results were expressed as average and the standard deviation of the central tendency. The differences between the groups were tested using Student's t-test and Mann-Whitney test. RESULTS: The portal pressure measurement showed no significant differences between groups. There was no significant difference in the nitroprusside test, in the other hand, exist a difference with acetylcholine between arteries of nonalcoholic fatty liver group against nonalcoholic fatty liver plus curcumin group. DISCUSSION: Curcumin improved the vasodilator response in response to acetylcholine, suggesting a possible antioxidant effect which improves endothelial function. It is suggested for future therapeutic use.

Appropriate medication prescribing in elderly patients: how knowledgeable are primary care physicians? A survey study in Parma, Italy.

WHAT IS KNOWN AND OBJECTIVE: Increasing attention is being paid to inappropriate medication prescribing for the elderly. A growing body of studies have detected a prevalence of inappropriate prescribing ranging from 12% to 40% worldwide, including Regione Emilia-Romagna, Italy. To improve quality of prescribing, a multi-phase pilot project in the Local Health Unit (LHU) of Parma, Regione Emilia-Romagna, was established. This phase aimed to assess primary care physicians' knowledge of appropriate prescribing in elderly patients. METHODS: In total, 155 primary care physicians (51% of the total), convened by the LHU of Parma for an educational session, were asked to complete anonymously a 19-item paper survey. Knowledge of inappropriate medication use in the elderly was assessed using seven clinical vignettes based on the 2002 Beers Criteria. Topics tested included hypertension, osteoarthritis, arrhythmias, insomnia and depression. Data regarding physician's perceived barriers to appropriate prescribing for elderly patients were also collected. To evaluate the relationship between physician knowledge scores and physician characteristics, physicians were classified as having a 'low score' (three or below) or a 'high score' (six or more) with respect to their knowledge of prescribing for the elderly. RESULTS AND DISCUSSION: All physicians completed the survey. Most physicians (88%) felt confident in their ability to prescribe appropriate medications for the elderly. Thirty-nine physicians (25%) received a 'high score' compared to 26 (17%) who received a 'low score'. 'Lower score' respondents had been in practice for a longer time (P < 0·05) than 'higher score' respondents. Perceived barriers to appropriate prescribing included potential drug interactions (79% of respondents) and the large number of medications a patient is already taking (75%). WHAT IS NEW AND CONCLUSION: The study results show an unsatisfactory knowledge of appropriate prescribing among primary care physicians in the LHU of Parma, especially among older physicians. Educational strategies tailored to primary care physicians should be establish to enhance knowledge in this area and improve quality of prescribing.

A study of ablation, spatial, and temporal characteristics of laser-induced plasmas generated by multiple collinear pulses.

Multi-pulse laser-induced breakdown spectroscopy (LIBS) in the collinear pulse configuration with time-integrating detection was performed on metallic samples in ambient air in an effort to clarify the contributing processes responsible for the signal enhancement observed in comparison with single-pulse excitation. Complementary experiments were also carried out on another LIBS setup using detection by an imaging spectrograph with high time resolution. The effects of laser bursts consisting of up to seven ns-range pulses from Nd-doped solid-state lasers operating at their fundamental wavelength and separated by 8.5-50 micros time gaps was studied. The ablation and emission characteristics of the generated plasmas were investigated using light profilometry, microscopy, plasma imaging, emission distribution mapping, time-resolved line emission monitoring, and plasma temperature calculations. The experimental data suggest that the two contributing processes mainly responsible for the signal enhancement effect are the plume reheating caused by the sequential laser pulses and, more dominantly, the increased material ablation attributed to the lower breakdown threshold for the preheated (molten) sample surface and/or the reduced background gas pressure behind the shockwave of preceding pulses.