Frecuencia de diagnósticos de enfermería en pacientes hospitalizados con infección Covid-19 / Frequency of nursing diagnoses in hospitalized patients with covid-19 infection

Introducción: las respuestas humanas de la persona ante enfermedades nuevas como infecciones por coronavirus (COVID-19), deben estar plasmados en los diagnósticos de enfermería como parte de la utilización del pensamiento crítico al establecer un plan de cuidados. Objetivo: describir la frecuencia de los diagnósticos de enfermería reportados en expedientes de pacientes con infección por COVID-19.Material y métodos: investigación clínica, con enfoque cuantitativo, retrospectivo; muestra probabilística conformada por 163 expedientes de pacientes hospitalizados por diagnóstico COVID-19 del Hospital General de Tula, entre abril y octubre 2020. La información se recabó en una ficha de recolección de datos diseñada ex profeso, acorde a la hoja de enfermería del hospital, utilizando la taxonomía NANDA-I. Investigación aprobada por el Comité de ética e investigación. Resultados: n=163 expedientes, pacientes con infección COVID-19 edad entre 20 y 92 años, 58.9 % del género masculino; en el tratamiento establecido 97.5 % tuvo oxigenoterapia, el rango de estancia de 0-24 días de hospitalización. Los diagnósticos de enfermería registrados con mayor frecuencia fueron riesgo de aspiración (f=1095), ansiedad (f=1079), disconfort (f=928), fatiga (f=862), riesgo de shock (f=813), patrón respiratorio ineficaz (f=660) y limpieza ineficaz de las vías aéreas (f=606). Conclusiones: los diagnósticos de enfermería de la taxonomía NANDA-I son aplicables en pacientes con infección COVID-19, el más frecuente: riesgo de aspiración.

Introduction: the person's human responses to new diseases such as coronavirus infections (COVID-19), must be reflected in nursing diagnoses as part of the use of critical thinking when establishing a care plan. Objective: To describe the frequency of nursing diagnoses reported in the records of patients with COVID-19 infection. Material and methods: clinical research, with a quantitative, retrospective approach; the probabilistic sample was made up of 163 records of patients hospitalized for a COVID-19 diagnosis at the General Hospital of Tula, in the period April-October 2020. The information was collected in a data collection form designed expressly, according to the data sheet. Hospital nursing, using the NANDA-I taxonomy. Research approved by the Ethics and Research Committee. Results: n=163 records, the patients with COVID-19 infection were between 20-92 years old, 58.9% were male; in the established treatment, 97.5% had oxygen therapy, the range of stay was 0-24 days of hospitalization. The most frequently recorded nursing diagnoses were risk of aspiration (f=1095), anxiety (f=1079), discomfort (f=928), fatigue (f=862), risk of shock (f=813), respiratory pattern ineffective (f=660) and ineffective airway clearance (f=606). Conclusions: the nursing diagnoses of the NANDA-I taxonomy are applicable in patients with COVID-19 infection, the most frequent was: risk of aspiration

Potencia muscular y cinética de lactato en sangre entre genotipos de ACTN3 / Muscle Power and Blood Lactate Kinetics Among ACTN3

En este trabajo se estudiaron las diferencias en la potencia muscular y la cinética de las concentraciones de lactato en sangre ([LA-]b) entre genotipos de ACTN3 durante la prueba anaeróbica de Wingate, (PAnW). Participaron 35 voluntarios (18-35 años) masculinos, sanos y físicamente activos. Se analizaron la potencia muscular, las concentraciones de [LA-]b y la actividad de la Lactato Deshidrogenasa (LDH). El gen ACTN3 se determinó a partir de ADN de glóbulos blancos en sangre periférica. Independientemente del peso y masa muscular de los participantes, los portadores del genotipo RR vs. RX y XX desarrollaron mayor potencia muscular durante la PAnW (p<0.05), lo cual sugiere una mayor capacidad en este genotipo para utilizar el sistema ATP-PC durante un ejercicio supramáximo. La cinética en la potencia muscular y en las concentraciones de [LA-]b fueron semejantes entre genotipos. La PAnW no fue suficiente para causar daño muscular observado por la concentración de LDH. (AU)

In this work, the differences in the muscle power and the kinetics of blood lactate concentrations ([LA-]b) between ACTN3 genotypes were studied during the Wingate anaerobic test (PAnW). Thirty-five healthy and physically active male volunteers (18-35 years old) participated. Muscle power, [LA-] b concentrations, and Lactate Dehydrogenase (LDH) activity were analyzed. The ACTN3 gene was determined from the DNA of white blood cells in peripheral blood. Regardless of the participants' weight and muscle mass, carriers of the RR genotype vs. RX and XX developed greater muscle power during PAnW (p <0.05), suggesting a greater capacity in this genotype to use the ATP-PC system during supramaximal exercise. The kinetics in muscle power and in [LA-]b concentrations were similar between genotypes. PAnW was not enough to cause muscle damage seen by LDH concentration. (AU)

Surveillance of avian influenza and Newcastle disease viruses in backyard poultry raised near migratory bird sites in Mato Grosso state, Brazil.

The Pantanal and Cerrado biomes in the state of Mato Grosso contain migratory bird sites in the municipalities of Cáceres and Araguaiana, respectively. The levels of avian influenza (AI) and Newcastle disease (ND) viral activity in backyard poultry at these sites are unknown owing to a lack of studies. Considering the risk of introduction of AI and ND to Brazil from migratory birds, as well as the importance of active surveillance in the detection and prevention of diseases for official control, monitoring in these poultry populations is faster, more practical and cheaper for official service veterinarians. The objective of this study was to verify the presence of AI and ND viral activity in backyard poultry reared near these migratory bird sites in the years 2016 and 2019. Serum samples and cloacal and tracheal swab samples collected from chickens, turkeys, quails, ducks and geese were evaluated by indirect diagnostic methods including enzyme-linked immunosorbent assay and haemagglutination inhibition tests and direct detection of viral sequences using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). No positive samples were detected by qRT-PCR.The frequencies of birds seropositive for AI and ND were 0.7% and 19.6% in 2016 and 0.5% and 17.2% in 2019, respectively, in Araguaiana and 0.8% and 32.3% in 2016 and 7.0% and 38.1% in 2019, respectively, in Cáceres. Antibodies belonging to AI subtypes H1, H4, H6 and H14 were identified in Cáceres in 2019. Spatial analysis showed an agglomeration of farms with seropositive poultry within the urban area of Cáceres, suggesting AI and ND virus activity in this area. This study showed no circulation of the notifiable AI subtypes H5 and H7 or the ND virus in backyard poultry raised around migratory bird sites in the state of Mato Grosso. The results of the present study support evidence indicating that the circulation of strains with low pathogenicity in urban areas enables backyard poultry to serve as a source of infection for other birds; thus, increased surveillance is necessary in this population.

Les biomes du Pantanal et du Cerrado dans l'état du Mato Grosso contiennent deux sites accueillant des oiseaux migrateurs, situés respectivement dans les comtés de Cáceres et d'Araguaiana. Faute d'études de terrain, le niveau d'activité virale de l'influenza aviaire et de la maladie de Newcastle chez les volailles de basse-cour de ces deux sites était jusqu'à présent inconnu. Compte tenu du risque d'introduction au Brésil de l'influenza aviaire et de la maladie de Newcastle par les oiseaux migrateurs, et de l'importance de la surveillance active pour détecter et prévenir ces maladies dans le cadre des activités de lutte conduites par les Services vétérinaires, il est plus pratique, moins onéreux et plus rapide pour les vétérinaires des services officiels d'axer la surveillance sur les populations de volailles de basse-cour. Les auteurs présentent les résultats d'une étude conduite en 2016 et en 2019 pour déterminer le niveau de circulation des virus de l'influenza aviaire et de la maladie de Newcastle chez les volailles de basse-cour élevées à proximité des sites d'oiseaux migrateurs. Des échantillons sériques et des écouvillons cloacaux et trachéaux prélevés sur des poulets, des dindes, des cailles, des canards et des oies ont été soumis à des méthodes de diagnostic indirectes telles que les épreuves immuno-enzymatique et d'inhibition de l'hémagglutination, et à une méthode de détection directe des séquences virales par amplification en chaîne par polymérase quantitative en temps réel couplée à une transcription inverse (qRT-PCR). Aucun échantillon positif n'a été détecté par qRT-PCR. Les taux de séropositivité respectivement à l'influenza aviaire et à la maladie de Newcastle étaient, chez les volailles prélevées à Araguaiana, de 0,7 % et 19,6 % en 2016, et de 0,5 % et 17,2 % en 2019 ; chez les volailles prélevées à Cáceres, ils étaient de 0,8 % et 32,3 % en 2016, et de 7,0 % et 38,1 % en 2019. Les anticorps détectés à Cáceres en 2019 appartenaient aux sous-types H1, H4, H6 et H14 du virus de l'influenza aviaire. L'analyse spatiale a révélé une concentration importante d'élevages ayant des volailles séropositives dans la zone urbaine de Cáceres, indiquant une activité des virus de l'influenza aviaire et de la maladie de Newcastle dans cette région. Aucune circulation des sous-types H5 et H7 à déclaration obligatoire du virus de l'influenza aviaire ni du virus de la maladie de Newcastle n'a été mise en évidence chez les volailles de basse-cour élevées autour des sites d'oiseaux migrateurs dans l'état du Mato Grosso. Les résultats de cette étude étayent les données d'après lesquelles les volailles de basse-cour des zones urbaines deviennent des sources d'infection pour d'autres espèces d'oiseaux à la faveur d'une circulation de souches faiblement pathogènes ; il est donc nécessaire de renforcer la surveillance dans cette population.

Los biomas de Pantanal y Cerrado, situados en el estado de Mato Grosso, albergan espacios frecuentados por aves migratorias en los municipios de Cáceres y Araguaiana, respectivamente. Debido a la falta de estudios al respecto, se desconocen los niveles de actividad de los virus de la influenza aviar (IA) y de la enfermedad de Newcastle (EN) en las aves de corral caseras de estas zonas. Teniendo en cuenta el riesgo de introducción en el Brasil de la IA y la EN por conducto de aves migratorias, así como la importancia de una vigilancia activa para la detección y prevención de enfermedades con fines de control oficial, para los veterinarios de los servicios públicos resulta más rápido, práctico y barato vigilar esas poblaciones de aves de corral. Los autores describen un estudio encaminado a comprobar, en los años 2016 y 2019, la actividad de los virus de la IA y la EN en bandadas caseras de aves de corral criadas cerca de los antedichos espacios de aves migratorias. Tras obtener muestras séricas e hisopados cloacales y traqueales de pollos, pavos, codornices, patos y gansos, se analizaron las muestras con técnicas de diagnóstico indirecto (ensayo inmunoenzimático y prueba de inhibición de la hemaglutinación) y de detección directa de secuencias víricas (retrotranscripción acoplada a reacción en cadena de la polimerasa cuantitativa en tiempo real: qRT-PCR). No se detectó ninguna muestra positiva por qRT-PCR. En cuanto a las tasas de seropositividad para la IA y la EN, en Araguaiana resultaron positivas el 0,7% y el 19,6%, respectivamente, de las aves analizadas en 2016, por un 0,5% y un 17,2% en 2019, mientras que en Cáceres lo fueron el 0,8% y el 32,3% en 2016 y el 7,0% y el 38,1% en 2019. En 2019 se identificaron en Cáceres anticuerpos correspondientes a los subtipos H1, H4, H6 y H14 del virus de la influenza aviar. El análisis espacial puso de relieve una aglomeración de fincas con aves de corral seropositivas en la zona urbana de Cáceres, hecho indicativo de que en la zona hay actividad de los virus de la IA y la EN. El estudio no evidenció circulación alguna de los subtipos H5 y H7 del virus de la IA, que son de declaración obligatoria, ni del virus de la EN en las aves de corral caseras criadas en los alrededores de los espacios del estado de Mato Grosso que albergan aves migratorias. Los resultados del estudio parecen avalar los datos que indican que la circulación de cepas poco patógenas en zonas urbanas hace de las bandadas caseras una posible fuente de infección para otras aves, razón por cual es tanto más necesario redoblar la vigilancia de estas poblaciones de aves de corral.

Production of Hydronium Ion (H3O)+ and Protonated Water Clusters (H2O)nH+ after Energetic Ion Bombardment of Water Ice in Astrophysical Environments.

Water ice exists on many objects in space. The most abundant icy species, among them water, are present in the icy satellites of the outer Solar System giant planets. The nuclei of comets, which are mainly composed of water ice, give another example of its abundance. In the interstellar medium (ISM), ice mantles, formed by molecular species sticking on dust grains, consist mainly of water ice. All these objects are exposed to ionizing radiation like ions, UV photons, and electrons. Sputtering of atoms, molecules, ions, and radicals from icy surfaces may populate and maintain exospheres of icy objects in the Solar System. In other respects, ionized hydrides such as OH+, H2O+, and H3O+ have been detected in the gas phase in star-forming regions. Interactions with cosmic rays could be an additional explanation to the current models for the formation of those species. In fact, laboratory simulations showed that the main components of the sputtered ionic species from water ice are oxygen hydrides. In this work, water ice targets were irradiated at several temperatures (10-200 K) by 90 keV O6+ ions, yielding an electronic stopping power of about 12 eV/Å, when the nuclear stopping power is comparable to the electronic stopping power. Sputtering of secondary ions after bombardment of the ice target was analyzed by time-of-flight mass spectrometry (TOF-SIMS). Besides hydrogen ions (H+, H2+, H3+), also O+, O2+, OH+, (H2O)+, and clusters of (H2O)nH+ with n = 1-8 are emitted. Our results show a progressive yield decrease with increasing temperature of all of the detected species. This is related to the structure of the ice: the ionic sputtering yield for crystalline ice is much lower than for an amorphous ice. For instance, amorphous ice at 10 K exhibits a yield of the order of 2 × 10-6 secondary (H2O)nH+ hydride ions/projectile (with n = 1-8). As the temperature is increasing toward the phase transition to crystalline ice, the yields decrease by about one order of magnitude.

Lesion endobronquial en mujer fumadora / Endobronchial lesion in a female smoker

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The effects of smokeless cookstoves on peak expiratory flow rates in rural Honduras.

BACKGROUND: The use of biomass fuel for cooking in traditional cookstove designs negatively affects respiratory health of communities in developing countries. Indoor pollution affects particularly women and children, who are participating in food preparation. The effects of smokeless cookstove designs on indoor pollution are well documented, but few studies exist to assess the effects of improved stove designs on the respiratory health of community members. METHODS: This study uses peak expiratory flow rate (PEFR) measurements in a before-and-after format to assess respiratory function of inhabitants of all 30 houses of Buenas Noches in central Honduras. PEFRs are measured before and 6 months after the installation of Justa stoves in people's homes. Health behaviors, respiratory symptoms and fire wood use are evaluated in a door-to-door survey format. RESULTS: A total of 137 eligible women and children between 6 and 14 years participated in the study. PEFR improved by 9.9-18.5% (P < 0.001) depending on the participants' exposure to indoor pollution. Health complaints like cough and behaviors like clinic visits did not change with the introduction of smokeless cookstove technology. CONCLUSIONS: Smokeless stoves improve respiratory health in an environment of high levels of indoor pollution.

Unlimited access to low-energy diet causes acute malnutrition in dams and alters biometric and biochemical parameters in offspring.

Here we analyze the outcomes of unlimited access to a low-energy (LE) diet in dams and their offspring. At 3 weeks' gestation, pregnant Wistar rats were divided into two groups: (1) the control group received a normoenergetic diet; and (2) the experimental group received the LE diet. In dams, lactation outcomes, food intake, body weight, plasma IGF-1, prealbumin, transferrin and retinol-binding protein levels were evaluated; in offspring, biometric and biochemical parameters and food intake were evaluated. No differences were observed during pregnancy. However, after lactation, dams that received the LE diet demonstrated significant reductions in body weight (P<0.05), plasma IGF-1 (P=0.01), prealbumin and visceral fat (P<0.001). Pups born to dams that received the LE diet demonstrated reduced body length and weight at weaning (P<0.001) and were lighter than the control animals at the end of the experimental period. Pups also demonstrated reduced plasma, low-density lipoprotein (P=0.04), triglycerides (P=0.002) and glucose levels (P<0.05), and differences were noted in visceral fat. These results indicate that feeding dams with LE diet during the reproductive period induces acute malnutrition and impairs the growth and development of offspring, as well as certain metabolic parameters.

Rice straw as precursor of activated carbons: activation with ortho-phosphoric acid.

Highly mesoporous activated carbons (ACs) with a mesopore fraction ranging from 42 to 73% were obtained by activation of rice straw (RS) with ortho-phosphoric acid (PA). Due to such a high mesoporosity, these ACs can be successfully used for pollutant removal in aqueous phase. The ACs were prepared at activation temperatures (T) ranging from 350 to 500 degrees C, using PA to RS weight ratios (R) from 0 to 1.6 and activation times from 0 to 2 h. They were characterised by nitrogen adsorption at -196 degrees C, SEM-EDX, and methylene blue adsorption. RS is a very heterogeneous material with a variable content of mineral matter: using the product of activated carbon yield multiplied by surface area (CxS(BET)) as the performance criterion, the best AC was produced at T=450 degrees C and R>or=1. These conditions lead to S(BET) higher than 500 m(2) g(-1) and a CxS(BET) around 270 m(2) g(-1).

Effects of the pollution by petroleum on the tracheids along the stem of Podocarpus lambertii Klotzsch ex Endl., Podocarpaceae.

Podocarpus lambertii Klotzsch ex Endl. (Podocarpaceae) is native and a member of the Pinophyta (Gymnosperm) of southern Brazil, locally known as 'pinheiro-bravo'. The present work aims to investigate the effects of petroleum on the tracheids dimensions. Wood samples from twenty individuals were studied along the stem, ten being exposed to pollution and ten used as a control set. The wood samples were collected from incisions at three levels: at the ground level, and one and two metres above the ground level. From these samples, sub-samples were selected at the border of the growth layers in the vascular cambium-medulla direction. The methodology followed that traditionally recommended for plant anatomy studies, with analyses done by light microscopy (OLYMPUS - BX41) assisted by the software Image Pro-plus for measurements. Comparison of the individuals exposed to petroleum with the control set, showed that the length, diameter and cell wall width of the tracheids of the former were smaller, a trend which was statistically significant according to the Student's t-test. These traits were observed mainly on the tracheids of the last growth layer, corresponding to the year in which the individuals were exposed to petroleum.

Effects of the pollution by petroleum on the tracheids along the stem of Podocarpus lambertii Klotzsch ex Endl., Podocarpaceae / Efeitos da poluição por petróleo nas traqueídes ao longo do caule de Podocarpus lambertii Klotzsch ex Endl., Podocarpaceae

Podocarpus lambertii Klotzsch ex Endl. (Podocarpaceae) is native and a member of the Pinophyta (Gymnosperm) of southern Brazil, locally known as "pinheiro-bravo". The present work aims to investigate the effects of petroleum on the tracheids dimensions. Wood samples from twenty individuals were studied along the stem, ten being exposed to pollution and ten used as a control set. The wood samples were collected from incisions at three levels: at the ground level, and one and two metres above the ground level. From these samples, sub-samples were selected at the border of the growth layers in the vascular cambium-medulla direction. The methodology followed that traditionally recommended for plant anatomy studies, with analyses done by light microscopy (OLYMPUS - BX41) assisted by the software Image Pro-plus for measurements. Comparison of the individuals exposed to petroleum with the control set, showed that the length, diameter and cell wall width of the tracheids of the former were smaller, a trend which was statistically significant according to the Student's t-test. These traits were observed mainly on the tracheids of the last growth layer, corresponding to the year in which the individuals were exposed to petroleum.

Podocarpus lambertii Klotzsch ex Endl. (Podocarpaceae), popularmente conhecida por pinheiro-bravo, é uma espécie que pertence ao pequeno grupo de Pinophyta (Gimnospermas) nativas da região Sul do Brasil. O presente estudo teve como objetivo investigar os efeitos da poluição por petróleo nas dimensões das traqueídes que compõem o lenho dessa espécie. Para tanto, amostras do lenho de vinte indivíduos foram coletadas, dez deles expostos à poluição por petróleo e dez usados como controle (coletados em região livre de contaminação). As amostras foram obtidas por meio de incisões paralelas à superfície do solo em três alturas (nível do solo, 1 metro e 2 metros do nível do solo). As subamostras para o estudo da variação estrutural do lenho foram selecionadas no limite das camadas de crescimento no sentido câmbio-medula. A metodologia utilizada para desenvolver o trabalho foi aquela tradicionalmente recomendada para estudos em anatomia vegetal. As mensurações das traqueídes em material macerado, como comprimento, diâmetro e espessura da parede celular, foram feitas pelo software Image Pro-plus em Fotomicroscópio (OLYMPUS - BX41). Nos indivíduos expostos à poluição, o comprimento, diâmetro e espessura da parede das traqueídes foram menores quando comparados aos indivíduos controle e demonstraram diferenças estatisticamente significativas pelo teste t-student. Essas tendências foram observadas, principalmente, nas traqueídes da última camada de crescimento, correspondente ao ano em que os indivíduos permaneceram expostos ao petróleo.

Arsenic removal by iron-doped activated carbons prepared by ferric chloride forced hydrolysis.

Ferric chloride forced hydrolysis is shown to be a good method for increasing the iron content of activated carbons (ACs). Iron content increased linearly with hydrolysis time, and ACs with iron content as high as 9.4wt.% at 24h hydrolysis time could be prepared. The increase in iron content did not produce any modification in the textural parameters determined by nitrogen adsorption at 77K. Iron-based nanoparticles, homogeneous in size and well-dispersed in the carbon matrix, were obtained. Nanoparticles forming iron (hydr)oxide agglomerates at the outer surface of the carbon grains at hydrolysis times higher than 6h were also produced. The AC obtained after 6h of ferric chloride forced hydrolysis removed 94% of the arsenic present in a groundwater from the State of Chihuahua (Mexico), whereas the commercial AC used as precursor allowed the removal of only 14%. The lower performance in arsenic removal observed for AC prepared using long forced hydrolysis time (24h) is probably due to the existence of iron (hydr)oxides nanoparticles agglomerates, which once hydrated could prevent diffusion of arsenate (HAsO(4)(-)) towards the inner surface of the AC grain.

Synthesis, characterization and performance in arsenic removal of iron-doped activated carbons prepared by impregnation with Fe(III) and Fe(II).

Arsenic removal from natural well water from the state of Chihuahua (Mexico) is investigated by adsorption using a commercial activated carbon (AC). The latter is used as such, or after oxidation by several chemicals in aqueous solution: nitric acid, hydrogen peroxide, and ammonium persulphate. Raw and oxidised activated carbons are fully characterised (elementary analysis, surface chemistry, pore texture parameters, pH(ZC), and TEM observation). Adsorption of As is measured in the aforementioned water, containing ca. 300 ppb of arsenic: removal of As is poor with the raw AC, and only the most oxidised carbons exhibit higher performances. By contrast, iron-doped ACs are much more efficient for that purpose, though their As uptake strongly depends on their preparation conditions: a number of samples were synthesised by impregnation of raw and oxidised ACs with HCl aqueous solutions of either FeCl(3) or FeCl(2) at various concentrations and various pH. It is shown that iron(II) chloride is better for obtaining high iron contents in the resultant ACs (up to 8.34 wt.%), leading to high As uptake, close to 0.036 mg As/g C. In these conditions, 100% of the As initially present in the natural well water is removed, as soon as the Fe content of the adsorbent is higher than 2 wt.%.

[Nutritional status, anthropometrical measurements, socio-economic status, and physical activity in Brazilian university students]. / Estado nutricional, medidas antropométricas, nivel socioeconómico y actividad física en universitarios brasileños.

INTRODUCTION: The physical activity and adequate food plays a key role in improving health and the control of diseases. OBJECTIVE: This paper aims at determining the nutritional state through anthropometric measures, socioeconomic level, the most common illnesses and type of physical activity, beyond food consumption and the place where meals are taken, of under-graduate students of the Nutrition course in UFPE. METHODS: The sample is constituted of 68 female students, of different periods and at ages between 18 and 27 years old. The process of selection of the sample was for convenience. The students voluntarily participated and answered three questionnaires, respectively, on their socioeconomic level (income of the family) and possible illnesses they had, measures of the cutaneous folds and type of practiced physical activity; register of consumed foods and local where the meals were carried. Statistical analysis was performed by absolute frequency, percentage, average and standard deviation. The margin of error used in the testing employees was 5%. RESULTS: In relation to the incomes, they had predominated above three minimum wages (86%), the parents have a predominant role in the expenditure of their study (46%), followed by the father (24%), mother (9%), husband (4%), other responsible ones (10%); 7% did not give information. The most common illnesses were: allergic rhinitis, tonsillitis, sleeplessness and intestinal constipation. The weight, the height, the index of body mass and the relation waist hip of the students were within normal standards. The abdominal circumference varied only in 2.57 cm between the studied age range. In relation to the practice of physical activities, 67% were sedentary, 20% practiced light activity and 13% moderate. In relation to where the meals are had, breakfast, in its majority (76%), was carried at home, followed by supper (56%), while lunch (41%) and snack 1 (34%), at University. Among the pupils who did not inform the place where they had their meals there was a high percentage for the big meals and a small one for the minor ones. The main kinds of consumed meals were breakfast, lunch and supper (98%). For the small meals, the values were: snack 1 (54%), snack 2 (61%), snack 3 (45%). The analysis of food consumption for three days disclosed ingestion of energy with deficit of 21% in relation to the recommended one (p < 0.001); the macro-nutrients showed percentages within the standards; the intake of fiber (11.8 g/day) was less than recommended (p < 0.001). Meat, eggs and cereals were ingested daily (for about 80%); vegetables (40%), legumes, fruits and candies (25% 30%), around four or six days a week. Roots and tubercles, salty, embedded and non alcoholic drinks were consumed from one to three days weekly (70%). Animal guts were not consumed by 50% of the studied population. CONCLUSIONS: Having analyzed all this, the studied students need to modify their food habits, acquiring knowledge on the importance of a balanced diet, as well as the practice of physical activity systematically, to prevent illnesses and attain a better quality of life.

Estado nutricional, medidas antropométricas, nivel socioeconómico y actividad física en universitarios brasileños / Nutritional status, anthropometrical measurements, socio-economic status, and physical activity in brazilian university students

Introducción: La actividad física y una alimentación adecuada ejercen un papel esencial al perfeccionamiento de la salud y al control de enfermedades. Objetivo: El objetivo de este trabajo ha sido determinar el estado nutricional a través de medidas antropométricas, nivel socioeconómico, enfermedades más comunes y tipo de actividad física, además del consumo alimentario y el lugar donde son realizadas las comidas de los estudiantes de Graduación en Nutrición de la UFPE. Material y métodos: La muestra se ha constituido de 68 alumnas del Curso de Nutrición, de distintos períodos escolares y con edades entre 18 y 27 años. El proceso de selección de la muestra ha sido por conveniencia. Las estudiantes han participado voluntariamente y han contestado a tres cuestionarios, respectivamente, sobre el nivel socioeconómico (renta familiar) y posibles enfermedades que padecían, medidas de los pliegues cutáneos y tipo de actividad física practicada; registro de los alimentos consumidos y lugar donde las comidas eran realizadas. El análisis estadístico se ha realizado a través de frecuencias absolutas, porcentuales, promedios y desvío estándar. El margen de error utilizado en los tests empleados ha sido de 5%. Resultados: En cuanto a los rendimientos, han predominado los superiores a tres sueldos mínimos (86%), los padres tienen un papel determinante en el coste del estudio (46%), seguido del padre (24%), madre (9%), marido (4%), otros responsables (10%); el 7% no han dado información. Las enfermedades más comunes eran: rinitis alérgica, amigdalitis, insomnio y constipación intestinal. El peso, estatura, el índice de masa corporal y la relación cintura cadera de las estudiantes seguían los patrones normales. La circunferencia abdominal ha variado en solo 2,57 cm entre los grupos etarios investigados. En cuanto a la práctica de actividades físicas, el 68% eran (...)

Introduction: The physical activity and adequate food plays a key role in improving health and the control of diseases. Objective: This paper aims at determining the nutritional state through antropometric measures, socioeconomic level, the most common illnesses and type of physical activity, beyond food consumption and the place where meals are taken, of under-graduate students of the Nutrition course in UFPE. Methods: The sample is constituted of 68 female students, of different periods and at ages between 18 and 27years old. The process of selection of the sample was for convenience. The students voluntarily participated and answered three questionnaires, respectively, on their socioeconomic level (income of the family) and possible illnesses they had, measures of the cutaneous folds and type of practiced physical activity; register of consumed foods and local where the meals were carried. Statistical analysis was performed by absolute frequency, percentage, average and standard deviation. The margin of error used in the testing employees was 5%.Results: In relation to the incomes, they had predominated above three minimum wages (86%), the parents have a predominant role in the expenditure of their study(46%), followed by the father (24%), mother (9%), husband(4%), other responsible ones (10%); 7% did not give information. The most common illnesses were: allergic rinite, tonsilitis, sleeplessness and intestinal constipation. The weight, the height, the index of body mass and the relation waist hip of the students were within normal standards. The abdominal circumference varied only in 2.57 cm between the studied age range. In relation to the practice of physical activities, 67% were sedentary, 20% practiced light activity and 13% moderate. In relation to where the meals are had, breakfast, in its majority (76%),was carried at home, followed by supper (56%), while lunch (41%) and snack 1 (34%), at University. Among the pupils who did not inform the place where they had their meals there was a high percentage for the big meals and a (...)

[Diagnosis of brain death by multislice CT scan: angioCT scan and brain perfusion]. / Diagnóstico de muerte encefálica mediante tomografía computarizada multicorte: angio-TC y perfusión cerebral.

BD was diagnosed by clinical examination, electroencephalogram (EEG), Transcranial Doppler (TCD) and multislice CT of 64 detectors. Initially, a brain perfusion study was performed. This was followed by supra-aortic trunk and brain artery angiography with acquisition of images using 0.5 mm slices, from the origin of the aortic root to the vertex. In all the patients, BD diagnosis was verified by clinical examination, EEG and TCD. Brain perfusion never detected brain blood flow. The angioCT through internal carotid arteries and vertebral arteries demonstrated complete absence of intracranial circulation, observing circulation of the external carotid artery branches. Sensitivity and specificity of the method compared with clinical examination was 100%. These findings demonstrate that the study of brain perfusion and brain angiography by multislice CT scan is a rapid and minimally invasive technique, that is easily available and that shows the absence of brain blood flow through the four vascular trunks. This technique makes it possible to made the diagnosis of BD with high diagnostic safety. Its use has special interest in patients with clinical diagnostic difficulty due to treatment with sedative drugs and serious metabolic alterations.

Diagnóstico de muerte encefálica mediante tomografía computarizada multicorte: angio-TC y perfusión cerebral / Diagnosis of brain death by multislice CT scan: angioCT scan and brain perfusion

El objetivo del presente estudio fue valorar la perfusión cerebral y la angiografía cerebral mediante tomografía computarizada (TC) multicorte, como método diagnóstico de muerte encefálica (ME). Fueron analizados 6 pacientes ingresados en una Unidad de Cuidados Intensivos, con patología neurológica grave y posterior evolución a ME. El diagnóstico de ME se realizó mediante exploración clínica, electroencefalograma (EEG), doppler transcraneal (DTC) y TC multicorte de 64 detectores. Inicialmente se realizó un estudio de perfusión cerebral, seguido de angiografía de troncos supraaórticos y arterias cerebrales con adquisición de imágenes mediante cortes de 0,5 mm, desde el nacimiento de la raíz de aorta hasta el vértex. En todos los pacientes se confirmó el diagnóstico de ME mediante exploración clínica, EEG y DTC. En ningún caso la perfusión cerebral detectaba flujo sanguíneo cerebral. La angio-TC a través de arterias carótidas internas y arterias vertebrales demostraba una ausencia completa de circulación intracraneal visualizándose circulación en ramas de las arterias carótidas externas. La sensibilidad y especificidad del método comparada con la exploración clínica fue del 100%. Estos hallazgos demuestran que el estudio de perfusión cerebral y la angiografía cerebral mediante TC multicorte es una técnica rápida, mínimamente invasiva, de fácil disponibilidad y que demuestra la ausencia de flujo sanguíneo cerebral a través de los 4 troncos vasculares. Esta técnica permite realizar el diagnóstico de ME con una gran seguridad diagnóstica. Su uso tiene especial interés en pacientes con dificultad diagnóstica clínica por tratamiento con fármacos sedantes y graves alteraciones metabólicas

BD was diagnosed by clinical examination, electroencephalogram (EEG), Transcranial Doppler (TCD) and multislice CT of 64 detectors. Initially, a brain perfusion study was performed. This was followed by supra-aortic trunk and brain artery angiography with acquisition of images using 0.5 mm slices, from the origin of the aortic root to the vertex. In all the patients, BD diagnosis was verified by clinical examination, EEG and TCD. Brain perfusion never detected brain blood flow. The angioCT through internal carotid arteries and vertebral arteries demonstrated complete absence of intracranial circulation, observing circulation of the external carotid artery branches. Sensitivity and specificity of the method compared with clinical examination was 100%. These findings demonstrate that the study of brain perfusion and brain angiography by multislice CT scan is a rapid and minimally invasive technique, that is easily available and that shows the absence of brain blood flow through the four vascular trunks. This technique makes it possible to made the diagnosis of BD with high diagnostic safety. Its use has special interest in patients with clinical diagnostic difficulty due to treatment with sedative drugs and serious metabolic alterations

The role of splenectomy in HIV-infected patients with relapsing visceral leishmaniasis.

The treatment of visceral leishmaniasis (VL) in HIV-infected patients is characterized by having a protracted course and frequent relapses, despite the use of adequate anti-leishmanial drugs and effective anti-retroviral therapy. A small subset of patients with significant splenomegaly develops severe cytopaenias and chronic leishmania infection. The use of elective splenectomy is effective for restoring the haematological parameters and reduces the need for blood transfusions but it does not avoid relapsing visceral leishmaniasis.

The Bispectral Index Scale: its use in the detection of brain death.

OBJECTIVE: To evaluate the Bispectral Index Scale (BIS) monitor as a method of brain death (BD) detection. PATIENTS AND METHODS: We performed an observational prospective study in an intensive care unit (ICU) of a university hospital of 19 patients hospitalized nonconsecutively in the ICU with serious neurologic pathology and evolution toward BD. A BIS monitor, XP model, and the sensor "BIS Quatro" were used to continuously record values: suppression ratio (SR), quality of the signal index, and electromyographic (EMG) activity. RESULTS: The BD diagnosis was made through neurological clinical exploration and electroencephalogram (EEG) in all the cases. Additionally, transcranial Doppler was used in 13 patients. Coincident with clinical worsening, it was observed that there was a gradual decrease of the BIS value, together with a rise in the SR. In all the patients in which the BD diagnosis was confirmed, the BIS showed values of 0 and suppression rates of 100. Only one patient showed interferences, due to EMG activity, the same problem was detected when a conventional EEG was performing. After using a neuromuscular blocker, the values of BIS and SR were 0 and 100, respectively. CONCLUSIONS: The BIS is a noninvasive, simple, and easy to interpret method. All the patients with BD diagnosis except for one had a BIS value of 0 and TS of 100, showing a perfect correlation with the other diagnostic methods. The BIS cannot be used on its own for the confirmation of the BD, but it is a useful tool to detect the beginning of brain herniation.

La esteatosis hepática grave en el donante de órganos: valor diagnóstico de la tomografía computarizada abdominal / Severe hepatic steatosis in organ donors: diagnostic value of abdominal scanning

Fundamento. La esteatosis hepática (EH) grave contraindica el trasplante hepático ante el altísimo riesgo de fracaso del injerto. Los depósitos de grasa en los hepatocitos disminuyen de forma importante la densidad hepática; esta hipodensidad, que no existe en condiciones normales, permite diagnosticar radiológicamente la EH. Nuestro objetivo fue validar la tomografía computarizada (TC) abdominal para el diagnóstico de la EH grave en los donantes de órganos. Métodos. El estudio se realizó en 48 donantes multiorgánicos consecutivos. Para el diagnóstico de la EH grave se comparó la biopsia hepática con la densidad, medida en unidades Hounsfield (UH), del hígado y bazo mediante TC abdominal. Se realizaron cinco mediciones en el hígado y tres en el bazo con el fin de comparar la diferencia de densidades entre ambos órganos, con la densidad esplénica como valor de referencia. Los resultados fueron analizados por dos radiólogos y dos anatomopatólogos de forma independiente, que desconocían la historia clínica del donante. Resultados. A mayor diferencia de densidad entre el hígado y el bazo -por disminución de la densidad hepática-, más esteatosis se demostró en las biopsias. Valores superiores a 20 UH de diferencia de densidad entre el hígado y el bazo presentaron siempre en la biopsia una EH superior al 50 per cent. Los valores entre 10-20 UH se correlacionaron con la presencia de algún grado de esteatosis, aunque no se pudo determinar su grado. Valores inferiores a 9 UH se corresponden con hígados normales. Conclusiones. Nuestros resultados presentan una excelente correlación entre el diagnóstico anatomopatológico y el radiológico en la EH grave. Consideramos necesario incluir la realización de una TC abdominal en el protocolo de selección y mantenimiento del donante de órganos. El estudio radiológico nos permite contraindicar a priori la extracción hepática, evitando de esta forma cargas de trabajo y desplazamientos innecesarios de equipos quirúrgicos, así como gastos técnicos y materiales no justificados (AU)

[Ischemic heart disease risk in the west Valladolid health area]. / Riesgo de enfermedad isquémica del corazón en el área de salud de Valladolid oeste.

INTRODUCTION AND OBJECTIVES: Cardiovascular diseases, especially ischemic heart disease present a high morbidity and mortality rate in our country. The aim of this study is to estimate the average coronary risk of people living in the west Valladolid Health District. METHODS: Cross-sectional study in a random sample of 369 people between 35 and 64 years of age from the general population, of systolic blood pressure, total serum cholesterol and cigarette smoking. With these three factors, plus sex and age, individual coronary risk was calculated through the Dundee Coronary Risk-Disk method. RESULTS: The coronary risk in the studied district, which is to say the individual probability of suffering a coronary event within five years of life, was estimated in 5.22 (95% CL: 4.75-5.69), higher among men, 5.66 (95% CL: 4.95-6.36), than among women, 4.63 (95% CL: 4.15-5.11). A descendent trend in coronary risk as age increases was found. CONCLUSIONS: This method is relatively easy to obtain for community studies and simple to use for individual risk. The coronary risk of a person from the studied population has similar levels to figures found in other studies from our settings. The community levels of isolated coronary risk factors do not permit the establishment the best option in coronary risk control, and only a multicausal approach will allow us to evaluate the most efficient interventions for each age group and sex.