Organophosphate esters in airborne particles from subway stations.

For the first time, the concentrations of 19 organophosphate esters (OPEs) were measured in airborne fine particulate matter (PM2.5) from subway stations in Barcelona (Spain) to investigate their occurrence, contamination profiles and associated health risks. OPEs were detected in all PM2.5 samples with levels ranging between 1.59 and 202 ng/m3 (mean value of 39.9 ng/m3). Seventeen out of 19 tested analytes were detected, with TDClPP, TClPP and TCEP being those presenting the highest concentrations. OPE concentrations are not driven by the same factors that determine the ambient PM2.5 concentrations of other constituents in the subway. Newer stations presented higher OPE levels, probably due to the materials used in the design of the platforms, with greater use of modern plastic materials versus older stations with tiles and stones. Estimated daily intakes via airborne particles inhalation during the time expended in subway stations were calculated, as well as the carcinogenic and non-carcinogenic health risks (CR and non-CR), all being much lower than the threshold risk values. Thus, subway inhalation exposure when standing on the platform to OPE's per se is not considered to be dangerous for commuters.

Diabetes, undernutrition, migration and indigenous communities: tuberculosis in Chiapas, Mexico.

We investigated the distribution of comorbidities among adult tuberculosis (TB) patients in Chiapas, the poorest Mexican state, with a high presence of indigenous population, and a corridor for migrants from Latin America. Secondary analysis on 5508 new adult TB patients diagnosed between 2010 and 2014 revealed that the most prevalent comorbidities were diabetes mellitus (DM; 19.1%) and undernutrition (14.4%). The prevalence of DM in these TB patients was significantly higher among middle aged (41-64 years) compared with older adults (⩾65 years) (38.6% vs. 23.2%; P < 0.0001). The prevalence of undernutrition was lower among those with DM, and higher in communities with high indigenous presence. Immigrants only comprised 2% of all TB cases, but were more likely to have unfavourable TB treatment outcomes (treatment failure, death and default) when compared with those born in Chiapas (29.5% vs. 11.1%; P < 0.05). Unfavourable TB outcomes were also more prevalent among the TB patients with undernutrition, HIV or older age, but not DM (P < 0.05). Our study in Chiapas illustrates the challenges of other regions worldwide where social (e.g. indigenous origin, poverty, migration) and host factors (DM, undernutrition, HIV, older age) are associated with TB. Further understanding of these critical factors will guide local policy makers and health providers to improve TB management.

Predicting treatment failure, death and drug resistance using a computed risk score among newly diagnosed TB patients in Tamaulipas, Mexico.

The purpose of this study was to develop a method for identifying newly diagnosed tuberculosis (TB) patients at risk for TB adverse events in Tamaulipas, Mexico. Surveillance data between 2006 and 2013 (8431 subjects) was used to develop risk scores based on predictive modelling. The final models revealed that TB patients failing their treatment regimen were more likely to have at most a primary school education, multi-drug resistance (MDR)-TB, and few to moderate bacilli on acid-fast bacilli smear. TB patients who died were more likely to be older males with MDR-TB, HIV, malnutrition, and reporting excessive alcohol use. Modified risk scores were developed with strong predictability for treatment failure and death (c-statistic 0·65 and 0·70, respectively), and moderate predictability for drug resistance (c-statistic 0·57). Among TB patients with diabetes, risk scores showed moderate predictability for death (c-statistic 0·68). Our findings suggest that in the clinical setting, the use of our risk scores for TB treatment failure or death will help identify these individuals for tailored management to prevent these adverse events. In contrast, the available variables in the TB surveillance dataset are not robust predictors of drug resistance, indicating the need for prompt testing at time of diagnosis.

Consumo de lácteos en población universitaria de la ciudad de Medellín / Dairy consumption of university students at Medellin city

Intake of dairy products in a population of 420 college students from 4 universities of Medellin city, Colombia, was evaluated to determine consumption preferences and knowledge through a personal interview. Analysis of the data using the multivariate technique MANOVA with canonical orthogonal contrast was performed using the statistical package SAS version 9.0. 80.7% of the students consumed milk, with a highly significant difference in the frequency of consumption among socioeconomic levels, being the highest consumption at the highest level. A significant difference in milk consumption according to gender was found, with a higher consumption by men. Milk ranks fifth as favorite beverage (6.1%), behind juice, water, soft drink and aromatic drinks. Cost (28.3%) and taste (20.9%) were the main reasons for non-consumption of dairy milk.

Se evaluó el consumo de productos lácteos en una población de 420 estudiantes universitarios de 4 instituciones de educación superior de la ciudad de Medellín, Colombia, para determinar las preferencias y conocimientos frente al consumo por medio de una entrevista personal. Se efectuó el análisis de los datos aplicando la técnica multivariada MANOVA con contraste canónico ortogonal empleando el paquete estadístico SAS versión 9.0. Se encontró que un 80,7% de los universitarios consumen leche, con una diferencia altamente significativa en la frecuencia de consumo entre niveles socioeconómicos, siendo el nivel alto el de mayor consumo. Se encontró una diferencia significativa en el consumo de lácteos entre sexos, con un mayor consumo por parte de los hombres. La leche ocupa el quinto lugar como bebida preferida (6,1%), por detrás de jugos, agua, gaseosa y aromáticas. Las razones principales para no consumir lácteos son el costo (28,3%) y el sabor (20,9%).

Conocimiento y factores asociados al consumo de frutas por estudiantes universitarios de la ciudad de Medellín, Colombia / Knowledge and factors associated with fruit consumption by university students of the city of Medellin, Colombia

This study aimed to describe habits, preferences, frequency of consumption and knowledge regarding fruit intake among university students in Medellin, Colombia. The sample consisted of 420 randomly chosen male and female students attending both public and private schools with ages ranging from 18-24 years. The sample was selected using a doubly stratified random sampling, with 95% confidence level and 4% maximum permissible error. A multivariate analysis of variance (MANOVA) with canonical contrast of orthogonal type was applied. A statistically significant difference between genders (P<0.05) regarding the opinion on preference and frequency of fruit consumption was found. No difference between socioeconomic level or between attending public and private school (p>0.05) was found. The main conclusion is that university students from Medellin, Colombia, like to eat fruit.

El objetivo de este estudio fue describir los hábitos, gustos, frecuencia de consumo y conocimientos relacionados con el consumo de frutas por estudiantes universitarios de Medellín, Colombia, para lo cual se aplicó una encuesta a 420 estudiantes de ambos sexos de instituciones públicas y privadas, los cuales fueron seleccionados aleatoriamente. La edad de los participantes osciló entre 18 y 24 años. Se aplicó un análisis multivariado de la varianza (MANOVA) con contraste canónico de tipo ortogonal. La muestra fue elegida por medio de la técnica denominada: muestreo aleatorio de proporciones doblemente estratificado, con base en un nivel de confiabilidad del 95% y un error máximo permisible del 4,0%. No se encontró una diferencia estadística significativa por géneros en la opinión referente al gusto y frecuencia de consumo de frutas. Se detectó diferencia entre estratos y entre las universidades públicas o privadas (p>0,05). La principal conclusión del estudio es que a los estudiantes universitarios de la ciudad de Medellín-Colombia, les gusta consumir frutas.

Conocimientos, gustos y prácticas sobre el consumo de lácteos en una población escolar de la ciudad de Medellín-Colombia / Knowledge, preference and practices on dairy intake in schoolchildren from Medellin-Colombia

Antecedentes: el consumo de lácteos es importante para la salud y el desarrollo de los niños, sin embargo en países en desarrollo no se alcanza la recomendación de la OMS de 180 L/persona/ año. Objetivos: determinar los conocimientos, gustos y prácticas de consumo de productos lácteos comparativamente con el de gaseosas, en población escolar de la ciudad de Medellín. Materiales y métodos: estudio descriptivo exploratorio de tipo transversal, en el que participaron 384 niños, entre 7 y 12 años, de nueve instituciones educativas. Se efectuó el análisis de los datos aplicando la técnica multivariada MANOVA con contraste canónico ortogonal, empleando el paquete estadístico SAS versión 9.0. Resultados: se encontró un consumo de lácteos de 135,5 L/persona/año, sin diferencia estadística entre sexos (p=0,53) ni entre niveles socioeconómicos (p=0,17). Frente a los conocimientos sobre el consumo de lácteos, solo 38,2% de los niños conoce la cantidad diaria recomendada y 42% el aporte nutricional. Para el 60,4% de los niños, la principal motivación al consumo de lácteos es el sabor. Se encontró un consumo de gaseosas y refrescos de 132,7 L/persona/ año. Conclusiones: es necesario mejorar los conocimientos de los niños sobre la importancia del consumo de lácteos para la salud, utilizando campañas educativas para fomentar su consumo.

Introduction: Dairy products intake is important for children's health and development. However, in developing countries, it does not reach WHO recommendation; 180 L/person/y. Objective: To determine the knowledge, preference and practices associated with dairy products intake in school population from Medellin, comparing with soft drinks intake. Methods: personal interviews were obtained from 384 children, 7 and 12 y old, from 9 elementary schools. Differences between dairy and soft drink were evaluated by MANOVA, using SAS version 9.0. Results: Mean dairy products intake was 135.5 L/person/y. Differences between gender (p=0.53), or socio-economical level (p=0.17) were not detected. Only 38.2% of children know daily products intake recommendation and 42% knows its nutritional content. Taste was the main motivation for intake in 60.4% of children. Mean soft drink intake was and 137.7 L/person/y. Conclusions: It is necessary to enhance students' knowledge about the importance of dairy products' for health, and to implement educational campaigns to promote their consumption.

Conocimientos, cctitudes y prácticas frente a l limitación de esfuerzos terapééuticos en personal de salud de un hospital universitaiio / Knowledg, attituudes andpractices regarding the limitation of therapeuttic efforts by health personnel at a university hospiall / Conhecimetos, attitudes e práticas diante da limitação de esforços terapêuticos em pessoal de saúde de um hospital universitáioo

El término limitación de esfuerzos terapéuticos se refiere al hecho de no iniciar o retirar un tratamiento médico a un paciente (con o sin capacidad de decidir) que no se beneficia clínicamente de él. Lo que justifica este tipo de conducta es el sentido de desproporción entre los fines y los medios terapéuticos. Describir las actitudes, los conocimientos y las prácticas de profesionales del área de la salud que laboran en un hospital universitario. Estudio descriptivo, de corte transversal. Se les pidió a diferentes profesionales del área de la salud que realizan labores en dicho hospital que respondieran una encuesta sobre los conocimientos, las actitudes y las prácticas que tienen frente a la limitación de esfuerzos terapéuticos en pacientes hospitalizados. 412 personas respondieron la encuesta. El 50% de los encuestados eran auxiliares de enfermería y 25% médicos. Solo el 14,6% conocía el significado de limitación de esfuerzos terapéuticos y el 62,4% de los médicos admitieron tener dificultad para tomar estas decisiones. No obstante la importancia y la polémica que este asunto plantea desde el punto de vista personal y profesional, es bajo el nivel de conocimiento que poseen los profesionales de la salud frente a este importante tema de la bioética. Se requiere mayor capacitación y sensibilización frente al tema.

Limitation of therapeutic efforts refers to the decision not to initiate or to withdraw medical treatment for a patient (with or without the ability to decide) who will not benefit clinically from it. What justifies this behavior is the sense of disproportion between the end and the therapeutic means. The purpose of this article is to describe the attitudes, knowledge and practices of health professionals working at a university hospital. A descriptive, transversal study was conducted in which a number of health professionals who work at the hospital in question were asked to complete a questionnaire on their knowledge, attitudes and practices concerning the limitation of therapeutic efforts for hospitalized patients. A total of 412 persons responded to the questionnaire, Fifty percent (50%) of those surveyed were nursing aids and 25% were physicians. Only 14.6% knew what "limitation of therapeutic efforts" means, and 62.4% of the physicians admitted having difficulty making such decisions. Despite the importance of this bioethical issue and the controversy it provokes from a personal and professional standpoint, health professionals know little about it. More training and awareness in this respect are needed.

A expressão limitação de esforços terapêuticos se refere ao fato de não iniciar ou retirar um tratamento médico a um paciente (com ou sem capacidade de decidir) que não se beneficia clinicamente dele. O que justifica esse tipo de conduta é o sentido de desproporção entre os fins e os meios terapêuticos. O objetivo do presente artigo é descrever as atitudes, os conhecimentos e as práticas de profissionais da área da saúde que trabalham em um hospital universitário. Consiste de um estudo descritivo, de corte transversal, no qual foi pedido a diferentes profissionais da área de saúde que realizam trabalhos nesse hospital que respondessem a uma pesquisa sobre os conhecimentos, as atitudes e as práticas que eles têm diante da limitação de esforços terapêuticos em pacientes hospitalizados. Um total de 412 pessoas respondeu a pesquisa. 50% dos entrevistados eram auxiliares de enfermagem e 25%, médicos. Somente 14,6% conheciam o significado de limitação de esforços terapêuticos e 62,4% dos médicos admitiram ter dificuldade para tomar essas decisões. Contudo, a importância e a polêmica que esse assunto apresenta, sob o ponto de vista pessoal e profissional, é baixo o nível de conhecimento que os profissionais de saúde possuem ante esse importante tema da bioética. Requer-se maior capacitação e sensibilização sobre o tema.

Efecto del plasma seminal sobre el estado redox del semen equino criopreservado / Effect of seminal plasma on the redox state of cryopreserved stallion semen

Objetivo. Determinar el efecto del plasma seminal sobre la generación de especies reactivas de oxígeno (ERO) y la peroxidación lipídica de semen equino criopreservado y su asociación con parámetros de calidad seminal. Materiales y métodos. El semen de cinco caballos de la raza criollo colombiano (dos eyaculados cada uno), fue criopreservado mediante un protocolo de congelación rápida, empleando un diluyente leche-yema de huevo, suplementado con 0%, 10% y 20% de plasma seminal equino. En muestras de semen fresco y criopreservado se evaluó la generación de ERO y la peroxidación lipídica por espectrofluorimetría, y los parámetros de calidad seminal de movilidad progresiva, vitalidad e integridad de membrana, mediante microscopia de contraste de fase. Para el análisis estadístico se ajustaron modelos mixtos y se realizaron análisis de regresión y correlación. Resultados. Se hallaron promedios post-descongelación de movilidad progresiva, vitalidad e integridad de membrana de 37.8%±20.2, 50.6% ± 14.6 y 37.8% ± 15.5, respectivamente. Para el semen fresco y criopreservado suplementado con 0%, 10% y 20% de plasma seminal, los promedios de producción de ERO (URF) fueron de 13.34±10.7, 16.15 ± 13.5, 17.32 ± 16 y 22.98 ± 19.4, respectivamente; mostrando un incremento estadísticamente significativo (p≤0.05) en la producción de ERO por efecto de la criopreservación y la suplementación con plasma seminal. Los promedios de peroxidación lipídica (nmolMDA/ml) para estos mismos tratamientos, fueron de 0.41 ± 0.25, 0.72±0.37, 0.51 ± 0.29 y 0.47±0.26, respectivamente; mostrando una reducción significativa (p≤0.05) de la peroxidación lipídica del semen suplementado con 10% y 20% de plasma seminal, respecto al semen no suplementado (0%). Conclusiones. El plasma seminal reduce la peroxidación lipídica del semen equino criopreservado.

Objective. Determine the effect of seminal plasma on the generation of reactive oxygen species (ROS) and lipid peroxidation of cryopreserved stallion semen, and its association with semen quality parameters. Materials and methods. The semen of five stallions of Colombian creole breed (two ejaculates each) was cryopreserved by a rapid freezing protocol, using a milk-egg yolk extender supplemented with 0%, 10% and 20% of equine seminal plasma. The samples of fresh and cryopreserved semen were evaluated for ROS generation and lipid peroxidation by spectrofluorimetry, and semen quality parameters of progressive motility, vitality and membrane integrity using phase contrast microscopy. Mixed models were adjusted for statistical, regression, and correlation analysis. Results. Post-thaw averages of progressive motility, vitality and integrity of membrane of 37.8% ± 20.2, 50.6% ± 14.6 and 37.8 ± 15.5%, respectively were found. For fresh and cryopreserved semen supplemented with 0%, 10% and 20% of seminal plasma, the averages of ROS production (RFU) were 13.34 ± 10.7, 16.15 ± 13.5, 17.32 ± 16 and 22.98 ± 19.4, respectively; showing a statistically significant increase (p≤0.05) of ROS production by effect of cryopreservation and seminal plasma supplementation. The averages of lipid peroxidation (nmolMDA / ml) for these same treatments were 0.41 ± 0.25, 0.72 ± 0.37, 0.51 ± 0.29 and 0.47 ± 0.26, respectively; showing a significant decrease (p≤0.05) of lipid peroxidation of semen supplemented with 10% and 20% of seminal plasma compared to unsupplemented semen (0%). Conclusions. Seminal plasma reduces lipid peroxidation of stallion cryopreserved semen.

Consumo de vegetales y factores relacionados en estudiantes universitarios de la ciudad de Medellín, Colombia / Knowledge and vegetable consumption among university students in Medellín city, Colombia

Antecedentes: conocer el consumo de vegetales y factores relacionados es de interés para establecer programas tendientes a incrementar su consumo. Objetivo: caracterizar el consumo de vegetales y factores relacionados en universitarios, según sexo, estrato socioeconómico y tipo de universidad. Materiales y métodos: estudio descriptivo exploratorio de tipo multidimensional de corte transversal, en 420 estudiantes universitarios de ambos sexos, pertenecientes a dos universidades públicas y dos privadas, en quienes se indagó cuales vegetales consumían de una lista posible de 52, para cada vegetal se hizo una frecuencia de consumo cualitativa. También se evaluaron gustos y preparaciones preferidas. Se utilizó un análisis multivariado de la varianza (manova) con contraste canónico de tipo ortogonal. Resultados: las mujeres incluyeron un mayor número de vegetales en su dieta que los hombres (P=0,0142), sin embargo, el consumo total de vegetales fue similar en ambos sexos (P=0,8589). El menor consumo de vegetales se evidenció en el estrato más bajo (P=0,0065), de igual manera se detectó diferencia en el consumo entre estudiantes pertenecientes a las universidades públicas con respecto a las universidades privadas (P=0,0354). Conclusiones:el consumo de vegetales en universitarios es bajo, especialmente en los de universidades públicas y los de menor estrato socioeconómico. Lo cual refleja una distribución inequitativa del consumo de estos alimentos.

Background: To know vegetable intake and its related factors is important, in order to design programs that promote these food intake. Objective: To describe vegetable intake and its related factors in undergraduates by gender, socioeconomic status, and type of university (public vs. private). Materials and methods: 420 undergraduates, male and women, participated in a descriptive, exploratory and multidimensional cross sectional study. A FFQ that included 52 vegetables and a questionary to explore preferred taste and recipes were apply to each participant. A multivariate analysis of variance (MANOVA) with type canonical orthogonal contrast was used to analysis data. Results: Women include a higher number of vegetables in their diets than men (P=0.0142), however the total amount of vegetables ingested was similar between genders P=0.8589). The lowest vegetable intake was found in the lowest socioeconomic stratum (p=0.0065), and in undergraduates from public universities (P=0.0354). Conclusions: vegetable intake in undergraduates from Medellin is low. It is especially low in undergraduates from public universities and from low socioeconomic strata; which reflects inequality in vegetables intake.

Antisperm antibodies and fertility association.

OBJECTIVE: To evaluate the relation between antisperm antibodies (ASA) and human fertility by reviewing the scientific literature of the last 45 years. METHODS: We carried out a review of scientific literature about antisperm antibodies and infertility published in spanish or english in databases as Pubmed, Medline, Scielo, some books and another gray literature include information related to this review and that is published in the last 45 years. SUMMARY OF EVIDENCE: Infertile couples suffer infertility by immunological mechanisms mainly by the presence of antisperm antibodies ASA in blood, semen or cervicovaginal secretions; the formation of ASA in men and women may be associated with disturbance in immunomodulatory mechanisms that result in functional impairment of sperm and thus its inability to fertilize the oocyte. CONCLUSION: Immunological infertility caused by ASA is the result of interference of these antibodies in various stages of fertilization process, inhibiting the ability of interaction between sperm and oocyte.

Esquizofrenia y trasplante hepático: reporte de un caso / Schizophrenia and liver transplantation: case report

Introducción: El trasplante hepático es un tratamiento disponible para numerosos pacientes con cirrosis hepática, que encuentran en este tratamiento una alternativa médica para mejorar la expectativa y la calidad de vida. La esquizofrenia paranoide es un trastorno psiquiátrico que afecta al 1% de la población general, que produce síntomas psicóticos y cuyo curso crónico, en algunos casos, deteriora significativamente todas las áreas de la vida. Objetivo: Discutir el caso clínico de una mujer a quien se le diagnostica esquizofrenia paranoide durante el protocolo de evaluación para trasplante hepático por cirrosis hepática. Métodos: Reporte de caso. Resultados: Se reporta el caso de una mujer de 47 años con cirrosis hepática, cuya única alternativa para mejorar la expectativa y calidad de vida era acceder a un trasplante hepático. Durante las evaluaciones de rutina por el grupo de trasplantes, el psiquiatra de enlace observa síntomas psicóticos de primer orden y documenta una historia de vida que confirma la presencia de una esquizofrenia paranoide. Discusión y conclusiones: La esquizofrenia paranoide es un trastorno psiquiátrico mayor que puede hacer parte de las comorbilidades médicas de los pacientes que requieren trasplante de hígado y que no constituye una contraindicación absoluta para su realización. En Colombia no se conocen casos similares de trasplante de hígado en pacientes con esquizofrenia. Este es un gran paso en el camino de vencer el estigma que la enfermedad mental impone a los pacientes y permitirles el acceso a la atención médica general que requieren…

Introduction: Liver transplantation is a treatment available for many patients with liver cirrhosis who find in this treatment a way to improve life expectancy and quality of life. Paranoid schizophrenia affects 1% of the general population, produces psychotic symptoms, and runs a chronic course in some cases with significant deterioration in all areas of life. Objective: To discuss the case of a patient with liver cirrhosis diagnosed with paranoid schizophrenia during the evaluation protocol for liver transplantation. Method: Case report. Results: We report the case of a 47-year-old woman with liver cirrhosis whose only alternative to improve life expectancy and quality of life was access to liver transplantation. During routine evaluations the liaison psychiatrist observed first-order psychotic symptoms and documented a life story that confirmed the presence of paranoid schizophrenia. Discussion and Conclusions: Paranoid schizophrenia is a psychiatric disorder common in the general population that can be a part of the medical comorbidities of patients requiring liver transplantation and is not an absolute contraindication to its completion. We are unaware of similar cases of liver transplantation in patients with schizophrenia in our country. We believe this is a big step on the road to overcome the stigma that mentalillness imposes on patients…

Del principio de beneficencia al principio de autonomía aproximación a la evaluación de la competencia mental de los pacientes en el hospital general / From the principle of beneficence to the principle of autonomy. assessment of patients’ mental competency in the general hospital

Introducción: Rechazar un acto médico es un ejercicio válido dentro del derecho a la autonomía que tiene todo paciente. Desde el punto de vista legal, la autonomía se fundamenta en el derecho a la intimidad. En los últimos decenios, el derecho legal a la autodeterminación se ha ampliado progresivamente y hoy los pacientes en pleno uso de sus facultades mentales tienen el derecho moral y legal de tomar sus propias decisiones y estas tienen prioridad sobre las decisiones del médico y la familia. Objetivo: Analizar el papel de los psiquiatras de enlace para evaluar la competencia mental de estos pacientes. Discusión y Conclusiones: La evaluación de la capacidad de un paciente para decidir y autodeterminarse es un problema clínico frecuente en los hospitales generales. La evaluación de estos pacientes exige un conocimiento apropiado de los fundamentos filosóficos, éticos y legales que guían el tratamiento apropiado de estos complejos problemas clínicos…

Introduction: Refusing a medical procedure is a valid way of exercising every patient’s right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital. Objective: To determine the psychiatrist’s role in evaluating these patients. Discussion and Conclusions: The assessment of a patient’s ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems…

Comparison of autologous serum with a commercial product as an adjunct in the treatment of uncomplicated corneal ulceration in dogs / Comparación de suero autólogo con un producto comercial como complemento en el tratamiento de úlceras corneales no complicadas en caninos / Comparação de soro autólogo com um produto comercial, como adjuvante no tratamento de úlcera de córnea não complicada em cães

Corneal ulcers are among the most common presentations of ocular ailments in dogs. Objective: this study compares the efficacy of a commercial ointment based on vitamin A, E and hydrolyzed casein, with the use of autologous serum eyedrops in the re-epithealization of uncomplicated corneal ulcers. Methods: forty-one dogs with superficial corneal ulcers, and otherwise healthy, were enrolled in the study and randomly allocated into two groups. They all received standard therapy based on antimicrobial eye drops of ciprofloxaxin and use of an Elizabethan collar. With prior owner consent, blood samples were taken from group A, allowed clotting, and serum separated and stored in sterile containers for use topically on the affected eye. In addition to the standard therapy, patients received either 2 drops of autologous serum (group A) or 1 cc of the re-epitelializing ointment (group B) every hours 6 hours, and 10 minutes following the antimicrobial drops. Healing was monitored by measuring the wound size with calipers on days 3 and 7 of the follow-up, and a Mann-Whithey test was used to compare both groups (SAS, version 9.1). Results: no significant differences were observed between groups in the re-epithelization process. On day 3, the reduction of the disepithelialized area was 1.47 ± 1.42 and 1.26 ± 0.99 mm for groups A and B, respectively. By day 7, the average decrease was 0.94 ± 0.77 and 1.42 ± 1.21 mm for groups A and B, respectively. Conclusion: autologous serum was as effective as a commercial re-epithelializing ointment to treat uncomplicated corneal ulcer in dogs.

Las afecciones del globo ocular son frecuentes en pequeños animales, siendo la úlcera corneal una de las presentaciones más comunes. Objetivo: en este trabajo se comparó la eficacia del suero autólogo frente a un ungüento oftálmico a base de vitaminas A, E y caseína hidrolizada, en el tiempo de reepitelización de ulceras no complicadas en caninos. Métodos: para el estudio se formaron dos grupos aleatorios de 21 pacientes cada uno, que presentaban ulceras superficiales en grado I y II. Previo consentimiento del propietario, al grupo A se extrajo sangre para obtención del suero que posteriormente se aplicaría en forma de gotas tópicas en el ojo afectado. Ambos grupos recibieron terapia estándar antimicrobiana en forma de gotas de ciprofloxaxina y uso de collar isabelino. A los 10 minutos de instalar el antimicrobiano, se hicieron aplicaciones tópicas cada 6 horas, de 2 gotas de suero autólogo (grupo A) o de 1 cc del ungüento reepitelizante (grupo B). La respuesta se evaluó mediante dos mediciones del tamaño de la úlcera a los 3 y 7 días de iniciar el tratamiento. Como método estadístico se empleó el contraste de Mann Whithey con base en un 95% de confiabilidad para las variables de disminución de la úlcera corneal y el tiempo de curación (SAS versión 9.1). Resultados: no hubo diferencias significativas al día 3 con respecto a la disminución del tamaño de la úlcera corneal, que fue del 1.47 ± 1.42 mm y 1.26 ± 0.99 mm para los grupos A y B, respectivamente. Al día 7, la media de disminución fue de 0.94 ± 0.77 mm para el grupo A, y de 1.42 ± 1.21 mm para el B, sin haber diferencias estadísticas. Conclusión: los resultados permiten concluir que el suero autólogo es igual de efectivo que el ungüento comercial epitelizante como complemento en el tratamiento de la úlcera corneal no complicada en caninos.

As afecções dos olhos são comuns na prática de pequenos animais, das quais a úlcera de córnea é uma das apresentações mais comuns. A pesquisa consistiu em comparar um produto comercial com o soro autólogo como coadjuvante no tratamento de úlcera de córnea, e determinar após a pesquisa qual sería o tratamento mais adequado. Além disto, esperava-se determinar qual tratamento permitía reduzir mais o tamanho das úlceras de córnea não complicada em cães. Métodos: formaram-se dois grupos de 21 indivíduos cada um; o grupo A recebeu antibiótico tópico mais soro autólogo, e o B recebeu o mesmo antibiótico mais a preparação comercial (epitelizante). A resposta ao tratamento foi avaliada através de duas medidas do tamanho da úlcera. O método estatístico utilizado foi o teste de Mann-Whitney, com uma confiabilidade de 95% para as variáveis de redução da úlcera de córnea e de tempo. Para a análise dos dados foi empregado o software SAS versão 9.1. Resultados: a media no día 3 do tratamento para reduzir o tamanho médio de uma úlcera de córnea foi de 1.47 ± 1.42 mm para o tratamento A e 1.26 ± 0.99 mm para o B, não se encontrou diferença estatística entre os tratamentos (p>0.05); no dia 7 a redução média no tratamento A foi de 0.94 ± 0.77 mm e 1.42 ± 1.21 mm para o B, neste caso, também não houve diferença estatística entre os tratamentos (p>0.05). Em nenhuma das amostras cultivadas encontrou-se contaminação microbiana. Conclusõe: nós concluímos que o soro autólogo é tão eficaz quanto o produto comercial epitelizante como adjuvante no tratamento de úlcera de córnea não complicada em cães. Também foi observado que a preparação do soro autólogo pode ser utilizada por um período máximo de sete días sob refrigeração sem ter problemas de contaminação microbiológica.

[Schizophrenia and Liver Transplantation: Case Report]. / Esquizofrenia y trasplante hepático: reporte de un caso.

INTRODUCTION: Liver transplantation is a treatment available for many patients with liver cirrhosis who find in this treatment a way to improve life expectancy and quality of life. Paranoid schizophrenia affects 1% of the general population, produces psychotic symptoms, and runs a chronic course in some cases with significant deterioration in all areas of life. OBJECTIVE: To discuss the case of a patient with liver cirrhosis diagnosed with paranoid schizophrenia during the evaluation protocol for liver transplantation. METHOD: Case report. RESULTS: We report the case of a 47-year-old woman with liver cirrhosis whose only alternative to improve life expectancy and quality of life was access to liver transplantation. During routine evaluations the liaison psychiatrist observed first-order psychotic symptoms and documented a life story that confirmed the presence of paranoid schizophrenia. DISCUSSION AND CONCLUSIONS: Paranoid schizophrenia is a psychiatric disorder common in the general population that can be a part of the medical comorbidities of patients requiring liver transplantation and is not an absolute contraindication to its completion. We are unaware of similar cases of liver transplantation in patients with schizophrenia in our country. We believe this is a big step on the road to overcome the stigma that mental illness imposes on patients.

[From the Principle of Beneficence to the Principle of Autonomy. Assessment of Patients' Mental Competency in the General Hospital]. / Del principio de beneficencia al principio de autonomía: aproximación a la evaluación de la competencia mental de los pacientes en el hospital general.

INTRODUCTION: Refusing a medical procedure is a valid way of exercising every patient's right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital. OBJECTIVE: To determine the psychiatrist's role in evaluating these patients. DISCUSSION AND CONCLUSIONS: The assessment of a patient's ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems.

Psicosis y quemaduras autoinfligidas / Psychosis and Self-inflicted Burns

Introducción: La relación entre quemaduras y trastorno mental es compleja. Los trastornos mentales pueden predisponer a las quemaduras, y las quemaduras, facilitar la aparición de trastornos mentales. Método: Reporte de casos y revisión de la literatura. Resultados: Se presentan cuatro casos de mujeres con quemaduras autoinfligidas y síntomas psicóticos. El promedio de edad de estas mujeres fue de 39,2 años. La quemadura fue por llama en el 100% de los casos y el porcentaje de quemadura fue del 27,2% de superficie corporal total. Tres de las pacientes (75%) tenía un trastorno afectivo bipolar con síntomas mixtos y en el 50% de las pacientes la enfermedad mental debutó con la quemadura autoinfligida. Conclusiones: En todo paciente quemado debe explorarse una psicopatología de base que explique la ocurrencia de las lesiones o pueda entorpecer el proceso de recuperación y rehabilitación posterior...

Introduction: The relationship between mental disorder and burns is complex. Mental disorders may predispose to burns and burns can facilitate the development of mental disorders. Method: Case report and literature review. Results: We present four cases of women with self-inflicted burns and psychotic symptoms. The average age of these women was 39.2 years. Burns were caused by flames in 100% of the cases and 27.2% of the total body surface was burned. Three of the patients (75%) had a bipolar disorder with mixed symptoms and in 50%of the patients the mental illness debuted with the self-inflicted burns. Conclusions: Basic psychopathology that may explain the occurrence of the injury and could hamper the process of recovery and rehabilitation Should be explored in all burned patients...

[Incidence of nutritional support complications in critical patients: multicenter study]. / Incidencia de complicaciones del soporte nutricional en pacientes críticos: estudio multicéntrico.

INTRODUCTION: Nutritional support (NS) leads complications that must be detected and prompt treated. OBJECTIVE: To estimate the incidence of some complications of nutritional support in critically ill patients. MATERIALS AND METHODS: A multicenter, descriptive, prospective study in patients with NS in intensive care units. Studied variables included medical diagnosis, nutritional status, length of NS, path, type of formula and ten complications. RESULTS: 419 patients evaluated, 380 received enteral nutrition (EN) and 39 parenteral nutrition (PN). The high gastric residue was the most incident complication in the ENS (24.2%), followed by diarrhea (14%) and withdrawal tube (6.6%). The high gastric residue and diarrhea were associated with the duration of the NS (p < 0.05). For the PNS the complication most incidents were hypophosphatemia (38.5%), followed by catheter sepsis (15.4%). The duration of the NS was associated with cholestasis, sepsis and hypophosphatemia (p < 0.05). CONCLUSIONS: complications of highest incidence were the high gastric residue for EN and hypophosphatemia for the PN; the withdrawal of the tube is a complication that claims further monitoring. The duration of the NS was the variable that showed greater association with the complications studied. Is a must to get consensus on complications definitions for comparisons establishment and best international standards target, furthermore propose protocols in order to decrease complications incidence of NS to fulfill the critical ill patient requirements.

Uso de los biomarcadores en la evaluación de la contaminación / Us of biomarkerss in pollution evaluatonn

Cada día es más difícil evaluar la salud de un ecosistema debido a la gran cantidad y diversidad de xenobióticos que son introducidos en ellos. Es por eso, que en las últimas dos décadas se ha incrementado el uso de biomarcadores para la evaluación y monitoreo de los ecosistemas. Un biomarcador es una respuesta funcional, fisiológica o bioquímica al nivel celular o interacciones moleculares que un organismo, una población o una comunidad refleja frente a un peligro potencial, el cual puede ser químico, físico o biológico. El biomarcador representa una señal integrada del nivel de contaminación de una determinada zona y, por consiguiente, constituye un indicador del nivel de riesgo toxicológico al que puede ser sometida una determinada población natural. No obstante, para que sea efectiva una evaluación ambiental o un programa de biomonitoreo, se deberán utilizar múltiples biomarcadores que describan los síntomas que sugieren la relación causa-efecto para una especie.

Each day is more difficult to evaluate an ecosystem health due to the amount and diversity of xenobiotic substances introduced in them. This is why in the last two decades the use of biomarkers for the evaluation and monitoring of ecosystems as been increasingly used. A biomarker is a functional, physiological or bio-chemical response to the cellular level or molecular interactions that an organism, a population or a community reflects before a potential danger. These responses can be chemical, physical or biological. The biomarker represents an integrated signal of the pollution level of a determined area and, as a consequence, constitutes an indicator of the toxicological risk level a determined natural population can be submitted to. However, for an environmental evaluation or biomonitoring program to be effective, multiple biomarkers describing the symptoms that suggest the cause-effect relationship for a species must be used.

Trastornos de sueño en los pacientes en diálisis / Sleep Disorders in Dialysis Patients

Introducción: Los pacientes en diálisis frecuentemente presentan problemas de sueño que afectan su funcionamiento global. Objetivo: Presentar una revisión actualizada de la literatura médica acerca de los trastornos del sueño en pacientes en diálisis por enfermedad renal crónica. Método: Se revisaron los artículos publicados recientemente sobre el tema, buscando establecer asociaciones, mecanismos fisiopatológicos y recomendaciones de manejo. Resultados y conclusión: Los trastornos del sueño son problemas clínicos frecuentes en los pacientes en diálisis por enfermedad renal crónica que impactan negativamente la calidad de vida y la salud de quienes los padecen y que necesitan ser reconocidos apropiadamente por los equipos médicos que atienden estos pacientes.

Introduction: Sleep disorders are very common in dialysis patients. The most common problems are insomnia, restless legs syndrome, sleep apnea, periodic limb movements, and excessive daytime sleepiness. Objective: To present an updated review of the medical literature on sleep disorders in patients on dialysis for chronic kidney disease. Methods: We reviewed recent articles published on the topic, seeking partnerships, pathophysiologic mechanisms, and treatment recommendations. Results and Conclusion: Sleep disorders are common clinical problems in patients on dialysis for chronic kidney disease that negatively impact the quality of life and health of those who suffer from them. They need to be properly diagnosed by the medical teams treating these patients.

Crecimiento de hembras cruzadas en el trópico colombiano / Crescimento de fêmeas cruzadas no tropico colombiano / Growth of crossbred females in the Colombian tropic

El presente trabajo tuvo como objetivo describir el crecimiento de hembras cruzadas de seis gruposgenéticos por medio del modelo de Brody. Los grupos genéticos evaluados fueron 50% Angus 50% Cebú(AC), 50% BON 50% Cebú (BC), 100% Cebú (C), 50% Romosinuano 50% Cebú (RC), 50% Senepol 25%Angus 25% Cebú (SAC), 50% Senepol 50%Cebú (SC). Se estimó el Porcentaje de madurez a los 12, 18 y24 meses y las edades al 75% y al 95% de madurez. La madurez a los 12 meses varió entre 42% y 48.5%, alos 18 entre 53% y 60% y a los 24 meses entre 61% y 69%; el grupo genético más precoz fue AC y el menosprecoz BC. La edad al 75% de madurez varió entre 1067 y 1468 días; y la edad al 95% de madurez estuvoentre 2396 y 3322 días.

The aim of this study was to describe the growth of crossbred females of six genetic groups using themodel of Brody. Genetic groups evaluated were: 50% Angus 50% Zebu (AZ), 50% BON 50% Zebu (BZ),100% Zebu (Z), 50% Romosinuano 50% Zebu (RZ), 50%Senepol 25% Angus 25% Zebu (SAZ), and 50%Senepol 50%Zebu (SZ). The percent of maturity at 12, 18, and 24 months and ages at 75% and 95% ofmaturity was estimated. The maturity at 12 months varied between 42% and 48.5%, at 18 months between 53% and 60%, and at 24 months between 61% and 69%. The genetic group more precocious was AZ, andless precocious was BZ. The age at 75% of maturity varied between 1067 and 1468 days; and age at 95%of maturity varied between 2396 and 3322 days.

Este estudo teve como objetivo descrever o crescimento de fêmeas cruzadas de seis grupos genéticos,utilizando o modelo de Brody. Os grupos genéticos foram: 50% Angus 50% Zebu (AZ), 50% BON 50% Zebu(BC), 100% Zebu (Z) 50% Romosinuano 50% Zebu (RZ), 50%Angus 25% Senepol e 25 % Zebu (SAZ), 50%Zebu e 50% Senepol (ZC). Foi estimada a percentagem de maturidade aos 12, 18 e 24 meses e a idade ao75% e 95% de maturidade. A madures aos 12 meses oscilou entre 42% e 48.5%, para 18 entre 53% e 60%, e24 meses entre 61% e 69%, o mais antigo grupo genético e da AC foi menos precoce BC. A idade variou de75% vencimento entre 1067 e 1468 dias, e idade de maturidade foi de 95% entre 2396 e 3322 dias.