Hyperspectral imaging benchmark based on machine learning for intraoperative brain tumour detection.

Brain surgery is one of the most common and effective treatments for brain tumour. However, neurosurgeons face the challenge of determining the boundaries of the tumour to achieve maximum resection, while avoiding damage to normal tissue that may cause neurological sequelae to patients. Hyperspectral (HS) imaging (HSI) has shown remarkable results as a diagnostic tool for tumour detection in different medical applications. In this work, we demonstrate, with a robust k-fold cross-validation approach, that HSI combined with the proposed processing framework is a promising intraoperative tool for in-vivo identification and delineation of brain tumours, including both primary (high-grade and low-grade) and secondary tumours. Analysis of the in-vivo brain database, consisting of 61 HS images from 34 different patients, achieve a highest median macro F1-Score result of 70.2 ± 7.9% on the test set using both spectral and spatial information. Here, we provide a benchmark based on machine learning for further developments in the field of in-vivo brain tumour detection and delineation using hyperspectral imaging to be used as a real-time decision support tool during neurosurgical workflows.

VNIR-NIR hyperspectral imaging fusion targeting intraoperative brain cancer detection.

Currently, intraoperative guidance tools used for brain tumor resection assistance during surgery have several limitations. Hyperspectral (HS) imaging is arising as a novel imaging technique that could offer new capabilities to delineate brain tumor tissue in surgical-time. However, the HS acquisition systems have some limitations regarding spatial and spectral resolution depending on the spectral range to be captured. Image fusion techniques combine information from different sensors to obtain an HS cube with improved spatial and spectral resolution. This paper describes the contributions to HS image fusion using two push-broom HS cameras, covering the visual and near-infrared (VNIR) [400-1000 nm] and near-infrared (NIR) [900-1700 nm] spectral ranges, which are integrated into an intraoperative HS acquisition system developed to delineate brain tumor tissue during neurosurgical procedures. Both HS images were registered using intensity-based and feature-based techniques with different geometric transformations to perform the HS image fusion, obtaining an HS cube with wide spectral range [435-1638 nm]. Four HS datasets were captured to verify the image registration and the fusion process. Moreover, segmentation and classification methods were evaluated to compare the performance results between the use of the VNIR and NIR data, independently, with respect to the fused data. The results reveal that the proposed methodology for fusing VNIR-NIR data improves the classification results up to 21% of accuracy with respect to the use of each data modality independently, depending on the targeted classification problem.

Masa en el periné al nacimiento / Perineal mass at birth

No disponible

Crowdsourcing digital health measures to predict Parkinson's disease severity: the Parkinson's Disease Digital Biomarker DREAM Challenge.

Consumer wearables and sensors are a rich source of data about patients' daily disease and symptom burden, particularly in the case of movement disorders like Parkinson's disease (PD). However, interpreting these complex data into so-called digital biomarkers requires complicated analytical approaches, and validating these biomarkers requires sufficient data and unbiased evaluation methods. Here we describe the use of crowdsourcing to specifically evaluate and benchmark features derived from accelerometer and gyroscope data in two different datasets to predict the presence of PD and severity of three PD symptoms: tremor, dyskinesia, and bradykinesia. Forty teams from around the world submitted features, and achieved drastically improved predictive performance for PD status (best AUROC = 0.87), as well as tremor- (best AUPR = 0.75), dyskinesia- (best AUPR = 0.48) and bradykinesia-severity (best AUPR = 0.95).

Most Relevant Spectral Bands Identification for Brain Cancer Detection Using Hyperspectral Imaging.

Hyperspectral imaging (HSI) is a non-ionizing and non-contact imaging technique capable of obtaining more information than conventional RGB (red green blue) imaging. In the medical field, HSI has commonly been investigated due to its great potential for diagnostic and surgical guidance purposes. However, the large amount of information provided by HSI normally contains redundant or non-relevant information, and it is extremely important to identify the most relevant wavelengths for a certain application in order to improve the accuracy of the predictions and reduce the execution time of the classification algorithm. Additionally, some wavelengths can contain noise and removing such bands can improve the classification stage. The work presented in this paper aims to identify such relevant spectral ranges in the visual-and-near-infrared (VNIR) region for an accurate detection of brain cancer using in vivo hyperspectral images. A methodology based on optimization algorithms has been proposed for this task, identifying the relevant wavelengths to achieve the best accuracy in the classification results obtained by a supervised classifier (support vector machines), and employing the lowest possible number of spectral bands. The results demonstrate that the proposed methodology based on the genetic algorithm optimization slightly improves the accuracy of the tumor identification in ~5%, using only 48 bands, with respect to the reference results obtained with 128 bands, offering the possibility of developing customized acquisition sensors that could provide real-time HS imaging. The most relevant spectral ranges found comprise between 440.5-465.96 nm, 498.71-509.62 nm, 556.91-575.1 nm, 593.29-615.12 nm, 636.94-666.05 nm, 698.79-731.53 nm and 884.32-902.51 nm.

Deep Learning-Based Framework for In Vivo Identification of Glioblastoma Tumor using Hyperspectral Images of Human Brain.

The main goal of brain cancer surgery is to perform an accurate resection of the tumor, preserving as much normal brain tissue as possible for the patient. The development of a non-contact and label-free method to provide reliable support for tumor resection in real-time during neurosurgical procedures is a current clinical need. Hyperspectral imaging is a non-contact, non-ionizing, and label-free imaging modality that can assist surgeons during this challenging task without using any contrast agent. In this work, we present a deep learning-based framework for processing hyperspectral images of in vivo human brain tissue. The proposed framework was evaluated by our human image database, which includes 26 in vivo hyperspectral cubes from 16 different patients, among which 258,810 pixels were labeled. The proposed framework is able to generate a thematic map where the parenchymal area of the brain is delineated and the location of the tumor is identified, providing guidance to the operating surgeon for a successful and precise tumor resection. The deep learning pipeline achieves an overall accuracy of 80% for multiclass classification, improving the results obtained with traditional support vector machine (SVM)-based approaches. In addition, an aid visualization system is presented, where the final thematic map can be adjusted by the operating surgeon to find the optimal classification threshold for the current situation during the surgical procedure.

Leptospirosis: vigilancia de casos del programa sindrome febril icterohemorragico . Aragua , Venezuela / Leptospirosis : surveillance of cases in the aragua hemorrhagic jaundice febrile syndrome program

La leptospirosis es una antropozoonosis de distribución mundial, con mayor incidencia en países tropicales. En Venezuela los casos son registrados en el sistema nacional de vigilancia para enfermedades íctero-hemorrágicas, con poca publicación sobre los aspectos clínicos y epidemiológicos de la enfermedad, por lo tanto el objetivo fue establecer las características epidemiológicas, clínicas, y diagnósticas de la leptospirosis en el Estado Aragua. El diseño fue un estudio epidemiológico transversal que describe los casos confirmados y probables de leptospirosis, obtenidos a partir del programa nacional de Síndrome Febril Ictérico Hemorrágico. Como resultados de 533 casos reportados desde enero del 2011 hasta julio del 2013, 233 (43,7%) fueron probables y 68 (12,75%) confirmados de leptospirosis. La tasa cruda de incidencia acumulada de leptospirosis por 100.000 habitantes más elevada en el periodo de estudio ocurrió en el año 2012, con un valor de 2,94 y los municipios con mayor tasa fueron Bolívar (7,9) y Sucre (5,2). Los factores de riesgo más reportados fueron: presencia de roedores en vivienda con 63,2%, marzo y abril, los meses con menor pluviosidad presentaron la menor frecuencia de casos. Los síntomas más frecuentes en los casos confirmados fueron fiebre 75%, cefalea 61,8%, ictericia 55,9%, vómitos 54,4%, dolor abdominal 47,1%, diarrea 35,3%. Cefalea, artralgia, mialgia y dolor retro-ocular predominaron en mayores a 10 años. 12,8% de los casos de leptospirosis se diagnosticaron por PCR en sangre, 28% PCR en orina, 45,2% por MAT.

Leptospirosis is a worldwide distribution anthropozoonosis, with a higher incidence in tropical countries. In Venezuela, the cases are registered in the national surveillance system for the ictero-hemorrhagic diseases, with little documentation upon clinical and epidemiological aspects of the disease; hence, the aim of this study was to establish epidemiologic, clinical and diagnostic characteristics of leptospirosis in Aragua state. It was a Cross sectional epidemiological study where probable and confirmed cases of leptospirosis were described, obtained from the febril icterohemorrhagic national surveillance program. From 533 cases reported since January of 2011 to July of 2013, 233 (43,79%) were probable cases, 68 (12,75%) were confirmed for leptospirosis. The highest cumulative incidence crude rate of leptospirosis per 100.000 inhabitants of the study period occurred in 2012 with 2,94. Bolivar (7,9%) and Sucre (5,2%) were the municipalities with the highest incidence rate. The main risk factors were: the presence of rodents in houses 63,2%, march and april were the months with the lowest rainfall which showed the fewest number of cases. The most frequent symptoms in confirmed cases were fever (75%), headaches (61,8%), jaundice (55,9%), vomiting (54,4%), abdominal pain (47,1%), diarrhea (35,3%), were the most frequent symptoms among confirmed cases. Headache, joint pain, myalgia, and retroocular pain, were significantly more frequent in ages over 10 years. 12,8% of the caseswere diagnosed by PCR based on blood, 28% by PCR based on urine, 45,2% by MAT.

Conocimientos, Actitudes y Prácticas sobre dengue y su relación con hábitats del vector en Aragua-Venezuela / Knowlegde, attitudes and practices regarding dengue and their relationships with vector breeding sites in Aragua-Venezuela

Con el objetivo de determinar los conocimientos, actitudes y prácticas sobre dengue en dos localidades del estado Aragua, Venezuela y su relación con la presencia de hábitats larvales de Aedes aegypti, se realizó un estudio epidemiológico transversal de campo, a través de una encuesta aplicada a los jefes de familia de 500 viviendas y una evaluación entomológica. La mayoría, 80,8%, reportó que la enfermedad se transmite por la picadura del vector. Los síntomas más reconocidos fueron: fiebre 86,8%, cefalea 59,4% y malestar general 51%. Las medidas de prevención más conocidas fueron: mantener tapados los recipientes con agua 89,8%, limpiar alrededor de las viviendas 70,6% y evitar agua estancada 68%. Las prácticas de prevención predominantes fueron: tapar los contenedores de agua 77%, limpiar alrededor de las viviendas 39,4% y usar insecticidas 35,8%. La actitud fue buena: un 95% de los entrevistados reconoce que el dengue puede prevenirse y 85,6% acude al médico cuando enferma. El conocimiento adecuado de la clínica, de las medidas de prevención y la práctica adecuada de prevención fue 9%, 20,6% y 5,4% respectivamente. La televisión fue la mayor fuente de información. Los índices entomológicos más conocidos (Índice de vivienda, Índice de recipiente, Índice de Breteau, entre otros) fueron elevados. Se encontraron asociados significativamente a la presencia de hábitats: almacenamiento de agua (OR= 7,43), conocimiento adecuado de las medidas preventivas (OR= 0,42), realizar actividades colectivas de prevención anti-dengue (OR= 0,51) y revisión de patio y casa por instituciones oficiales (OR= 1,78). Las personas en ambas comunidades tienen poco conocimiento adecuado sobre el dengue y poca práctica adecuada de prevención, lo cual se traduce en presencia de hábitats.

To determine the knowledge, attitudes and practices about dengue in two localities of Aragua state, Venezuela and its relationship to the presence of Aedes aegypti breeding sites. A cross-sectional study was conducted through a survey to the heads of the families of 500 homes. Also an entomological evaluation was performed. The majority 80.8%, reported that the disease is transmitted by vector bite. The most recognizable symptoms were: 86.8% fever, 59.4% headache and 51% malaise. The best known prevention measures were: to keep containers covered with water 89.8%, to clean around the house 70.6% and to avoid standing water 68%. The predominant prevention practices were: to cover water containers 77%, to clean around the house 39.4% and to use insecticides 35.8%. The attitude was good: 95% recognize that dengue can be prevented and 85.6% go to the doctor when they are sick. The adequate knowledge of clinical, prevention measures and good prevention practices was 9%, 20.6% and 5.4% respectively. The television was the main source of information. The best-known entomological indices were high. They were significantly associated with the presence of breeding sites: water storage (OR = 7.43), adequate knowledge of preventive measures (OR = 0.42), fullfilling collective activities of anti-dengue prevention (OR = 0.51) and monitoring the backyard and the house by the official institutions (OR = 1.78).People in both communities have poor adequate knowledge about dengue and poor adequate preventive practices which results in the presence of breeding sites.

Efecto Hipoglicemiante de un Fitofármaco (DIAMET) / Hypogly caemi effect of a phytodrug (DIAM)

This research was conducted to test the effect of a phytomedicine hypoglycemic (DIAMET) containing the following plants: Cundeamor (Momordica charantia), Pata de vaca (Bauhinia forficata Link), Eucalyptus (Eucalyptus globulus Labil) and Achiote (Bixa orellana L.) , in media containing human blood cells and glucose. Assays were performed in vitro with phytodrug content dissolved in 0.9% saline media normoglycemic (5.5 mM glucose), demonstrating the hypoglycemic effect, producing a decrease in glucose levels relative to control to the different amounts of the aqueous solution phytodrug (3, 9, 18, 36 and 72 micrograms) is added to the medium. It was evident that the P value was less than 0.05 allowing the odds suggest that these results are obtained randomly are minimal, showing that the phytodrug produced a statistically significant hypoglycemic effect, and that the higher the concentration and interval time this effect increases.

Esta investigación se realizo para comprobar el efecto hipoglicemiante de un fitofármaco (DIAMET) que contiene las siguientes plantas: Cundeamor (Momórdica charantia), Pata de vaca (Bauhinia forficata Link), Eucalipto (Eucalyptus globulus Labil) y Achiote (Bixa orellana L.), en medios que contienen células sanguíneas humanas y glucosa. Se realizaron los ensayos in vitro con el contenido del fitofármaco disuelto en solución salina al 0.9% en medios normoglicémicos (5,5 mM glucosa), evidenciándose el efecto hipoglicemiante, al producir un descenso en las concentraciones de glucosa con respecto al control a las diferentes cantidades de la solución acuosa del fitofármaco (3, 9, 18, 36 y 72 microgramos) añadidas al medio. Se evidenció que el valor P fue menor de 0,05 lo que permite sugerir que las probabilidades de que estos resultados hayan sido obtenidos al azar son mínimas, demostrando que el fitofármaco produjo un efecto hipoglicemiante estadísticamente significativo, y que a mayor concentración e intervalo de tiempo dicho efecto aumenta.

Sentinel surveillance of influenza-like illness in two hospitals in Maracay, Venezuela: 2006-2010.

BACKGROUND: Limited information exists on the epidemiology of acute febrile respiratory illnesses in tropical South American countries such as Venezuela. The objective of the present study was to examine the epidemiology of influenza-like illness (ILI) in two hospitals in Maracay, Venezuela. METHODOLOGY/PRINCIPAL FINDINGS: We performed a prospective surveillance study of persons with ILI who presented for care at two hospitals in Maracay, Venezuela, from October 2006 to December 2010. A respiratory specimen and clinical information were obtained from each participant. Viral isolation and identification with immunofluorescent antibodies and molecular methods were employed to detect respiratory viruses such as adenovirus, influenza A and B, parainfluenza, and respiratory sincytial virus, among others. There were 916 participants in the study (median age: 17 years; range: 1 month--86 years). Viruses were identified in 143 (15.6%) subjects, and one participant was found to have a co-infection with more than one virus. Influenza viruses, including pandemic H1N1 2009, were the most frequently detected pathogens, accounting for 67.4% (97/144) of the viruses detected. Adenovirus (15/144), parainfluenza virus (13/144), and respiratory syncytial virus (11/144) were also important causes of ILI in this study. Pandemic H1N1 2009 virus became the most commonly isolated influenza virus during its initial appearance in 2009. Two waves of the pandemic were observed: the first which peaked in August 2009 and the second--higher than the preceding - that peaked in October 2009. In 2010, influenza A/H3N2 re-emerged as the most predominant respiratory virus detected. CONCLUSIONS/SIGNIFICANCE: Influenza viruses were the most commonly detected viral organisms among patients with acute febrile respiratory illnesses presenting at two hospitals in Maracay, Venezuela. Pandemic H1N1 2009 influenza virus did not completely replace other circulating influenza viruses during its initial appearance in 2009. Seasonal influenza A/H3N2 was the most common influenza virus in the post-pandemic phase.

Incidencia de infecciones sintomáticas y asintomáticas por virus dengue en Maracay, Venezuela: 2006-2007 / Incidence of symptomatic and asymptomatic dengue virus infections in Maracay, Venezuela: 2006-2007

Con el objetivo de estimar las tasas de incidencia de infecciones sintomáticas y asintomáticas por virus dengue (DENV) durante un año (octubre 2006-septiembre 2007) en cuatro barrios de Maracay (Venezuela) se realizó un estudio prospectivo consistente de visitas domiciliarias, tres veces por semana, para detectar casos de dengue y de encuestas serológicas semestrales para determinar infecciones asintomáticas probables por DENV. Los sujetos de estudio pertenecían a una cohorte de 2663 personas ≥5 años de edad. El diagnóstico confirmatorio de DENV se realizó mediante la reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR). Las pruebas serológicas se realizaron mediante el ensayo inmunoenzimático de captura de IgM anti-dengue (MAC-ELISA). Los resultados determinaron tasas de incidencia de 5,7 y 18,6 por 100 000 personas/día (p/d) para las infecciones sintomáticas y asintomáticas, respectivamente. La tasa de incidencia de las infecciones sintomáticas observada en las personas <15 años de edad fue significativamente mayor que la encontrada en los sujetos ≥15 años (15,8 versus 2,9 por 100 000 p/d). Por otro lado, las tasas de incidencia de las infecciones asintomáticas en ambos grupos de edad fueron similares (17,3 y 18,9 por 100 000 p/d, respectivamente). Se detectaron los cuatro serotipos del DENV en tres de los barrios estudiados. Se observó que la edad y la hiperendemicidad fueron probablemente los factores que más contribuyeron a la incidencia del dengue en los cuatro barrios investigados. Seguramente, las infecciones asintomáticas contribuyeron a incrementar la transmisión viral en el área de estudio.

The incidence rates of symptomatic and asymptomatic dengue virus (DENV) infections in four "barrios" of Maracay, Venezuela, during one-year (October 2006-September 2007) were estimated. A prospective study consisting of house visits three-times a week to detect dengue cases, and semiannual serological surveys to determine probable asymptomatic dengue virus (DENV) infections was conducted. The study subjects belonged to a cohort of 2,663 people ≥5 year-old. Confirmatory diagnosis of DENV infections was carried out by reverse-transcriptase polymerase chain reaction (RT-PCR). Serological surveys were performed by anti-dengue IgM-capture immunoassay (MAC-ELISA). The results showed that the incidence rates for symptomatic and asymptomatic infections were determined to be 5.7 and 18.6 per 100,000 persons/day (p/d), respectively. The incidence rate of symptomatic infections was significantly higher in persons <15 year-old than that found in subjects ≥15 years (15.8 versus 2.9 per 100,000 p/d). On the other hand, the incidence rates of asymptomatic infections in both age groups were similar (17.3 and 18.9 per 100,000 p/d, respectively). All four DENV serotypes were detected in three of the four "barrios" studied. Finally, age and hyperendemicity were probably the contributing factors to the incidence of dengue in the four "barrios" investigated. Surely, the asymptomatic infections contributed to increase the viral transmission in the study area.

Efecto hipoglicemiante de la planta Bauhinia purpúrea L., en ratones euglicémicos / Hipoglicemic effect of Bauhinia purpúrea L., in euglicemic mice

La Diabetes Mellitus (DM) es una enfermedad metabólica que se caracteriza por presentar valores elevados de glicemia debido a la disminución total o parcial de la insulina en el organismo y/o resistencia a la misma por los tejidos periféricos. Las complicaciones de la DM son cada vez más frecuentes, por lo tanto se hace necesario incentivar la búsqueda de nuevos fármacos hipoglicemiantes que complementen el protocolo actual de tratamiento. La Bauhinia purpurea L., es una planta abundante en el estado Aragua, frecuentemente usada en la medicina tradicional para el control de la DM. El objetivo principal de esta investigación fue comprobar el efecto hipoglicemiante de B. purpurea L., para lo cual se realizó un estudio experimental, tipo exploratorio, descriptivo y analítico, donde se utilizaron 12 ratones machos euglicémicos, divididos en dos grupos, experimental y control. Al grupo experimental se le administró extracto acuoso de la planta B. purpurea L., vía intraperitoneal (7 mg/Kg / dosis) y a los del grupo control se administró solución salina al 0,9% en la misma cantidad y por la misma vía. Se encontró una disminución significativa (p<0.03) de la glicemia después de la administración del extracto y en comparación con la glicemia medida en el grupo control después de la administración del placebo. Esto demostró la actividad hipoglicemiante de la planta, por lo que es importante identificar el principio activo responsable de disminuir la glicemia y considerar incorporarlos en la preparación de medicamentos con efectos hipoglicemiantes.

Diabetes Mellitus (DM) is a metabolic disease that is characterized by elevated blood glucose values due to total or partial reduction of insulin in the body and / or resistance to it by the peripheral tissues. Complications of DM are increasingly common, therefore it is necessary to encourage the search for new hypoglycemic drugs to supplement the current treatment protocol. The Bauhinia purpurea L., is an abundant plant in the state of Aragua, frequently used in traditional medicine for the control of DM. The main objective of this research was to test the effect of hypoglycemic B. purpurea L., which conducted a pilot study, exploratory, descriptive and analytical, which used 12 male mice, euglicémic divided into two groups, experimental and control. The experimental group was administered aqueous extract of the plant B. purpurea L., intraperitoneally (7 mg / kg / dose) and control group was administered saline 0.9% in the same amount and in the same way. We found a significant decrease (p <0.093) in blood sugar after administration of the extract and comparing the blood glucose measured in the control group after administration of placebo. This demonstrated the hypoglycemic activity of the plant, so it is important to identify the active ingredient responsible for reducing blood sugar and consider incorporating them in the preparation of drugs with hypoglycemic effects.

Condiciones de exposición ocupacional a agentes químicos en un hospital público de Valencia, Venezuela. Evaluación preliminar / Exploratory study on occupational health exposure to chemical agents, in a public hospital in Valencia, Venezuela. Preliminar assessment

Estudio descriptivo que indagó sobre las condiciones de exposición laboral a agentes químicos (AQ) en trabajadores de un hospital público de Valencia, Venezuela. Participaron 48 trabajadores. Se obtuvo información mediante cuestionario como: datos personales, historia ocupacional, uso de AQ; conocimiento del manejo de riesgos, efectos adversos y disposición de desechos. Se reportaron 16 ocupaciones de 12 áreas de alto riesgo. Emergencia de adultos tuvo 11 trabajadores, seguida por esterilización y laboratorio clínico (7 cada uno), y oncología, 6. Las áreas restantes tenían < 8,3% trabajadores. Anestésicos más usados: halotano, enfluorano e isofluorano 4,17% cada uno. Antineoplásicos más usados: doxorrubicina 16,67% y paclitaxel, 5-fluoracilo y etopsoido, 8,33 % cada uno. AQ varios más reportados: alcohol (70,8%) y cloro (64,6%). Ninguna de las respuestas referidas al conocimiento del manejo y disposición de AQ fue satisfactoria. Asociaciones entre entrenamiento y edad, tiempo en el cargo y ser o no un profesional universitario, no resultaron significativas mientras que entre entrenamiento y conocimiento de AQ fue significativa (p < 0,001). Estos hallazgos evidencian un déficit tanto en conocimiento de los riesgos producidos por las sustancias laborales como de sus desechos, por lo que el entrenamiento debería ser parte de los curricula de pre y post-grado. El estudio provee importantes datos preliminares para el diseño de la fase II, la cual incluiría aspectos clínicos y monitoreo ambiental y biológico.

Descriptive study that identified chemical agents (AQ) use and training on risk management and waste disposal techniques in a public Hospital in Valencia. A questionnaire was answered by 48 workers. Information obtained was: personal data, occupational history, AQ used; knowledge of risk management and waste disposal. There were 16 occupations from 12 “High Risk” areas. “Adult emergency” was the one with more workers (11 individuals), followed by “sterilization” and “clinical laboratory” (7 each) and oncology (5). The remained areas had less than 8.3% workers. The most used anesthetic agents were: Halothane, Enfluorane and Isofluorane 4.17% each and main antineoplastics used were: Doxorubicin 16.67% and Paclitaxel, 5-Fluoracil and Etoposide, 8.33% each. The most mentioned substances were: alcohol (70.8%) and Chlorine (64.6%). None of the answers regarding knowledge of AQ' risk management and waste disposal was satisfactory. Statistical associations between training and several variables such as age, time in their job and being or not a professional, resulted non-significant. The correlation between training and the knowledge of AQ's management was significant (p < 0.001). Participants showed that their knowledge about chemical occupational risk factors they are exposed to is still insufficient. Therefore, this theme should be included in graduate course curricula. These results provide important data and will serve as a pilot research for the follow up Phase II study that will include clinical aspects and environmental and biological monitoring.

Differential proinflammatory and angiogenesis-specific cytokine production in human pulmonary endothelial cells, HPMEC-ST1.6R infected with dengue-2 and dengue-3 virus.

In this study, the ability of dengue virus serotypes 2 (DENV-2) and 3 (DENV-3) to infect and induce increased production of proinflammatory cytokines in a pulmonary endothelial cell line (HPMEC-ST1.6R) was investigated. This cell line exhibits the major constitutive and inducible endothelial cell characteristics, as well as angiogenic response. DENV-2 and DENV-3 infection was confirmed by an observed cytopathic effect (CPE), as well as RT-PCR and immunofluorescence assays. Increases in Th-1 and Th-2 cytokines IL-4, IL-8, IL-6, IL-10, GM-CSF, INF-gamma, and tumor necrosis factor (TNF-alpha) within DENV-2- and DENV-3-infected cells were demonstrated using a microbead-based Bio-plex assay. Proinflammatory cytokine increases and the expression of a potent angiogenic inducer protein, VEGF were confirmed by dot-blot analysis using the TranSignal Human Angiogenesis Antibody Array. Dengue virus-infected HPMEC-ST1.6R cells exhibited an elongated cytoplasmic morphology, possibly representing a response to VEGF and activation of angiogenesis. The increased levels of Th-1 cytokines and VEGF in DENV-2 virus infected-HPMEC-ST1.6R could be distinguished from those infected by DENV-3. This suggests that cytokine patterns associated with DENV infections may be serotype and strain-specific. The experimental approaches described here could be developed further into a useful diagnostic tool for the characterization of dengue hemorrhagic fever cases, leading to enhancement of treatment therapy.

Apendicectomía laparoscópica / Laparoscopic apendectomy

La apendicitis aguda es la causa más frecuente del abdomen agudo quirúrgico. Se describe la técnica para la apendicectomía laparoscópica incluyendo el procedimiento general así como la disección del apéndice, su meso y la ligadura y sección de la arteria acompañante. Finalmente se puntualizan las ventajas de este procedimiento frente a la cirugía convencional como son la disminución del riesgo de infección, reintervenciones y complicaciones (tanto respiratorias como digestivas), el menor gasto, la rápida recuperación y reincorporación al trabajo entre otras.

Sida y trabajo: aspetos ético-legales / AIDS and work: lawful and ethic aspects

Se relaciona el Síndrome de Inmunodeficiencia adquirida (SIDA) al riesgo biológico del trabajador de la salud y los efectos físicos y sicológicos en cualquier otro sitio de trabajo, desde el enfoque de la ética médica y según los aspectos legales nacionales e internacionales. En el ambiente laboral, la toma de decisiones frente a la posible exposición, las personas infectadas y las que sufren SIDA, requieren la integración de conocimientos médico-científicos, legales y sico-sociales. Se propone que la comprensión, prevención y el control de esta enfermedad puede ser posible a través de la educación objetiva en el lugar de trabajo