A dynamically coherent pattern of rhythms that matches between distant species across the evolutionary scale.

We address the temporal organization of circadian and ultradian rhythms, crucial for understanding biological timekeeping in behavior, physiology, metabolism, and alignment with geophysical time. Using a newly developed five-steps wavelet-based approach to analyze high-resolution time series of metabolism in yeast cultures and spontaneous movement, metabolism, and feeding behavior in mice, rats, and quails, we describe a dynamically coherent pattern of rhythms spanning over a broad range of temporal scales (hours to minutes). The dynamic pattern found shares key features among the four, evolutionary distant, species analyzed. Specifically, a branching appearance given by splitting periods from 24 h into 12 h, 8 h and below in mammalian and avian species, or from 14 h down to 0.07 h in yeast. Scale-free fluctuations with long-range correlations prevail below ~ 4 h. Synthetic time series modeling support a scenario of coexisting behavioral rhythms, with circadian and ultradian rhythms at the center of the emergent pattern observed.

[Serum microRNA-21 usefulness in inflammatory pathology of the colon]. / Utilidad de la determinación sérica de microRNA-21 en la enfermedad inflamatoria del colon.

BACKGROUND: MicroRNAs are 20-22 nucleotide molecular structures with post-transcriptional activity that are involved in the immune response, as well as in the inflammatory pathways of different cells and tissues. AIMS: We present herein a prospective study in which serum microRNA-21 expression was determined in patients diagnosed with acute appendicitis as a model of bowel inflammation. MATERIAL AND METHODS: A prospective cohort study of patients diagnosed with acute appendicitis was conducted. Serum microRNA-21 was analyzed through the PCR of blood samples taken from the patients prior to surgery. MicroRNA-21 values were compared with the analytic variables (leukocytes, hemoglobin, hematocrit, platelets, prothrombin activity, glucose, urea, and creatinine) and the anatomopathologic variables (normal appendix, phlegmonous, gangrenous, and perforated acute appendicitis). RESULTS: A total of 60 patients with acute appendicitis diagnosis were consecutively included in the study from June to October 2009. Sixty-six percent of the patients were men (40 men and 20 women), with a mean age of 26.2±14.8 years. The mean absolute level of microRNA-21 was 24.8±0.93, whereas the mean microRNA-21 gene expression was 1.04±0.28. No correlation between the analytic and anatomopathologic parameters evaluated was observed (P=.47). CONCLUSIONS: It is necessary to continue to search for the most appropriate microRNAs, so that their determination in serum can lead to greater precision in establishing the diagnosis and outcome of inflammatory disorders of the bowel.

Geographical Information Systems risk assessment models for zoonotic fascioliasis in the South American Andes region.

The WHO recognises Fasciola hepatica to be an important human health problem. The Andean countries of Peru, Bolivia and Chile are those most severely affected by this distomatosis, though areas of Ecuador, Colombia and Venezuela are also affected. As part of a multidisciplinary project, we present results of use of a Geographical Information Systems (GIS) forecast model to conduct an epidemiological analysis of human and animal fasciolosis in the central part of the Andes mountains. The GIS approach enabled us to develop a spatial and temporal epidemiological model to map the disease in the areas studied and to classify transmission risk into low, moderate and high risk areas so that areas requiring the implementation of control activities can be identified. Current results are available on a local scale for: (1) the northern Bolivian Altiplano, (2) Puno in the Peruvian Altiplano, (3) the Cajamarca and Mantaro Peruvian valleys, and (4) the Ecuadorian provinces of Azuay, Cotopaxi and Imbabura. Analysis of results demonstrated the validity of a forecast model that combines use of climatic data to calculate of forecast indices with remote sensing data, through the classification of Normalized Difference Vegetation Index (NDVI) maps.

Factors constraining adherence to referral advice for severely ill children managed by the Integrated Management of Childhood Illness approach in Imbabura Province, Ecuador.

AIM: Low referral completion rates in developing countries undermine the Integrated Management of Childhood Illness (IMCI) strategy for lowering child mortality. This study sought to identify factors constraining adherence to referral advice in a health system using the IMCI approach. METHODS: Caregivers of 160 children urgently referred to hospital were prospectively interviewed. Caregivers who accessed and did not access hospital were compared for potential referral constraining factors, including demographics, family dynamics, the severity of their child's illness, their interaction with the health system, self-perceived problems, and physical and financial access. RESULTS: 67/160 (42%) referred children did not access hospital. Six factors were associated with non-access, including two health worker actions: not being given a referral slip [adjusted odds ratio (OR)= 15.3, 95% confidence interval (95% CI) 4.4-64.6] and not being told to go to the hospital immediately (adjusted OR = 5.3, 95% CI 1.9-16.3). Receiving both of these interventions reduced the risk of not accessing hospital to 19%, from 96% for those who received neither intervention. Several indicators of illness severity, including caregivers' ranking of their children's illness severity, the presence of severe illness signs and mortality, were investigated and found not to be important explanatory factors. CONCLUSION: Providing a referral slip and counseling the caregivers of severely ill children to go to the hospital immediately appear to be powerful tools for increasing successful referral outcomes.

Manejo de las fracturas de diáfisis femoral en niños / Management of the diaphiseal femoral fractures in children

Para determinar el manejo de las fracturas diafisiarias de fémur en niños, en el Hospital "Pérez de León" de Petare, se analizaron retrospectivamente 57 historias con este diagnóstico entre enero de 1995 y enero del 2000. Fueron evaluados 44 varones y 13 hembras entre 1-12 años con un promedio de edad de 5,8 años. 43 (75 por ciento) se trataron de forma ortopédica, de las cuales 28 (48 por ciento) con tracción cutánea seguida de espica con un promedio de hospitalización de 25,8 días; 10 (18 por ciento) con tracción esquelética seguida de espica con un promedio de hospitalización de 27,9 días; 5 (9 por ciento) con yeso de espica inmediato con promedio de hospitalización de 7,6 días y 14 (24 por ciento) quirúrgicamente con enclavado endomedular todos tipo kuntscher con promedio de hospitalización de 19,9 días. Como mecanismo de lesión se encuentran las caídas de altura 38 por ciento, arrollamiento 24 por ciento; caída de sus pies 18 por ciento; trauma directo 11 por ciento; accidentes de tránsito 7 por ciento y heridas por arma de fuego 2 por ciento 50 por ciento de los pacientes presentaron daños asociados tales como traumatismo craneoencefálicos, excoriaciones múltiples, trauma abdominal cerrado y fracturas adicionales. Con estos resultados podemos concluir que las fracturas de diáfisis de fémur en niños son cada vez más frecuentes en las salas de emergencias, que tanto las caídas de altura, arrollamiento y caída de sus pies revisten gran importancia como factor causal; y que el tratamiento ortopédico es el más utlizado hasta la edad preescolar y el quirúrgico en la edad escolar

[Sensitivity analysis in health investment projects]. / Análisis de sensibilidad en los proyectos de inversión en salud.

This paper discusses some of the concepts and methodologies frequently used in sensitivity analyses in the evaluation of investment programs. In addition, a concrete example is presented: a hospital investment in which four indicators were used to design different scenarios and their impact on investment costs. This paper emphasizes the importance of this type of analysis in the field of management of health services, and more specifically in the formulation of investment programs.

La enfermedad meningococica en cuidados intensivos (I): valor de los factores pronósticos / The meningoccocal illness in looking after intensive (I): courage of the factors presages

Se realiza un estudio de los factores pronosticos en los pacientes con enfermedad meningococica ingresados en la unidad de cuidados intensivos del hospital provincial clinico quirurgico docente "Dr. Gustavo Aldereguia Lima", en el periodo comprendido entre los años 1986- 1990. Se determina que estos factores junto a la experiencia práctica del médico de asistencia pueden ayudar a establecer índices pronóstico y realizar una terapéutica mas eficaz, asi como hacer la prevención de aquellas complicaciones que pueden aparecer una vez identificados estos signos. Se estudian 23 pacientes y se analiza la presencia de estos signos de mal pronóstico, tanto en los pacientes engresados vivos, como en los fallecidos encontrándose que la hipocelularidad del líquido cefalorraquídeo y la acidosis metabólica fueron los factores mas frecuentes en los fallecidos

La enfermedad meningococica en cuidados intensivos (II): algunos aspectos clínicos y complicaciones / The meningoccocal illness in looking after intensive (II): some clinical looks and complications

En el número anterior se publicó la primera parte de este artículo, la cual estuvo dedicada la análisis de los factores pronósticos en los pacientes con enfermedad meningococica, en esta segunda parte se aborda la patogenia de las complicaciones fundamentales de esta entidad, haciendo especial enfasis en el choque septico, dificultad respiratoria del adulto, coagulación intravascular diseminada, insuficiencia suprarrenal aguda y se expone el comportamiento de las mismas en una serie estudiada en la unidad de cuidados intensivos del hospital provincial clinico quirurgico de Cienfuegos