Prevalence of anal high-risk human papillomavirus (HR-HPV) types in people living with HIV and a history of cancer.

This study aimed to describe the prevalence of high-risk human papillomavirus (HR-HPV) types in the anal canal in a cohort of people living with HIV (PLWHIV) with a history of malignancy. SETTING: Referral tertiary care hospital for adult patients with cancer. METHODS: We reviewed data of patients from the AIDS Cancer Clinic on antiretroviral therapy in chronic control who were consecutively referred for high-resolution anoscopy (HRA), where they underwent anal evaluation, collection of specimens for anal cytology and anal human papillomavirus (HPV) followed by HRA with directed biopsy if needed. RESULTS: A total of 155 patients were included; 149 (96.1%) were men, all of them men who have sex with men (MSM); the median age was 39 (IQR 32-47) years; 105 (67.7%) with Kaposi sarcoma, 40 (25.8%) with non-Hodgkin lymphoma and 10 (6.4%) with other neoplasms; only 7 (4.5%) had active cancer. The prevalence of HR-HPV infection was 89% (n=138) (95% CI 83-93) with at least one HR-HPV infection, and 62% (96) had coinfection with at least two types; the median HR-HPV types of coinfection were 3 (IQR 2-4). The number of patients infected with HPV 16 was 64 (41.3%, 95% CI 33.8-49.3), HPV 18 was 74 (47.7%, 95% CI 39.9-55.7) and with both 35 (22.6%). Some 59 patients (38%) had high-grade squamous intraepithelial lesions (HSIL) and 49 (31.6%) had low-grade squamous intraepithelial lesions (LSIL). The prevalence of HR-HPV and HSIL among patients aged ≤35 and >35 years was the same. CONCLUSIONS: In this cohort of PLWHIV with a history of malignancy we found a high prevalence of HR-HPV 16 and 18 and anal HSIL, even in persons aged ≤35 years. These data highlight the importance of anal cancer screening in PLWHIV and history of malignancy.

Structure, ultrastructure and cation accumulation in quinoa epidermal bladder cell complex under high saline stress.

Quinoa is a facultative halophyte with excellent tolerance to salinity. In this study, the epidermal bladder cell complex (EBCc) of quinoa leaves was studied to determine their cellular characteristics and involvement in salt tolerance. We used light microscopy, confocal RAMAN microscopy, confocal fluorescence microscopy, transmission electron microscopy, and environmental scanning electron microscopy complemented by energy dispersive X-ray analysis. Ionic content was quantified with flame atomic absorption spectroscopy and with flame emission photometry. Results show that: (i) the number of EBCcs remains constant but their density and area vary with leaf age; (ii) stalk cells store lipids and exhibit thick walls, bladder cells present carotenes in small vesicles, oxalate crystals in vacuoles and lignin in their walls and both stalk and bladder cells have cuticles that differ in wax and cutin content; (iii) chloroplasts containing starch can be found on both stalk and bladder cells, and the latter also presents grana; (iv) plasmodesmata are observed between the stalk cell and the bladder cell, and between the epidermal cell and the stalk cell, and ectodesmata-like structures are observed on the bladder cell. Under high salinity conditions, (v) there is a clear tendency to accumulate greater amounts of K+ with respect to Na+ in the bladder cell; (vi) stalk cells accumulate similar amounts of K+ and Na+; (vii) Na+ accumulates mainly in the medullary parenchyma of the stem. These results add knowledge about the structure, content, and role of EBCc under salt stress, and surprisingly present the parenchyma of the stem as the main area of Na+ accumulation.

Impacto psicológico de la hiperhidrosis primaria / Psychological impact of primary hyperhidrosis / Impacto psicológico da hiperidrose primária

La hiperhidrosis primaria es una patología frecuente que representa un motivo de consulta dermatológica común, se caracterizada por una sudoración excesiva en regiones axilares, plantares, palmares o craneofaciales que aparece generalmente en la pubertad o en la adolescencia, sus portadores con frecuencia desarrollan discapacidad psicológica como síntomas de depresión, ansiedad y auto aislamiento social. Objetivo. Identificar el impacto la hiperhidrosis primaria produce en la calidad de vida de los pacientes, mediante el análisis de la efectividad de tratamientos disponibles para la mejora de síntomas generados antes su padecimiento. Metodología. En la revisión sistemática se recopiló información científica en Pubmed, Scopus y Taylor & Francis, la información obtenida fue de artículos originales y metaanálisis comprendido entre enero de 2011 a diciembre de 2022, la ecuación de búsqueda "hiperhidrosis", "psicología", "salud mental" y "calidad de vida. Resultados. Se obtuvo 127 fuentes entre PubMed, Scopus, Taylor & Francis, se revisó y eliminó los duplicados y los artículos carentes de información de interés, seleccionando 41 artículos, y posteriormente se aplicó a los artículos restantes los criterios de inclusión y exclusión, obteniéndose finalmente 8 artículos para el análisis. Conclusión. El principal impacto psicológico de la hiperhidrosis primaria es la ansiedad y la depresión, las cuales se pueden evidenciar con mayor prevalencia en pacientes de sexo femenino y la repercusión principal en la vida diaria es el aislamiento social, donde el apoyo de sus familiares juega un papel importante en las recuperaciones del paciente, además se desconoce la causa directa de la enfermedad, siendo su causa multifactorial.

Primary hyperhidrosis is a common pathology that represents a common reason for dermatologic consultation, characterized by excessive sweating in axillary, plantar, palmar or craniofacial regions that usually appears at puberty or adolescence, its carriers often develop psychological disability such as symptoms of depression, anxiety and social self-isolation. Objective. To identify the impact of primary hyperhidrosis on the quality of life of patients, by analyzing the effectiveness of available treatments for the improvement of symptoms generated before the condition. Methodology. In the systematic review, scientific information was collected in Pubmed, Scopus and Taylor & Francis, the information obtained was from original articles and meta-analysis from January 2011 to December 2022, the search equation "hyperhidrosis", "psychology", "mental health" and "quality of life". Results. We obtained 127 sources among PubMed, Scopus, Taylor & Francis, reviewed and eliminated duplicates and articles lacking information of interest, selecting 41 articles, and then applied the inclusion and exclusion criteria to the remaining articles, finally obtaining 8 articles for analysis. Conclusion. The main psychological impact of primary hyperhidrosis is anxiety and depression, which are more prevalent in female patients, and the main repercussion in daily life is social isolation, where the support of family members plays an important role in the patient's recovery, and the direct cause of the disease is unknown, being its cause multifactorial.

A hiperidrose primária é uma patologia comum que representa um motivo frequente de consulta dermatológica, caracterizada por sudorese excessiva nas regiões axilar, plantar, palmar ou craniofacial, que geralmente aparece na puberdade ou na adolescência, e seus portadores frequentemente desenvolvem deficiência psicológica, como sintomas de depressão, ansiedade e autoisolamento social. Objetivo. Identificar o impacto da hiperidrose primária na qualidade de vida dos pacientes, analisando a eficácia dos tratamentos disponíveis para a melhora dos sintomas gerados antes da doença. Metodologia. Na revisão sistemática, foram coletadas informações científicas no Pubmed, Scopus e Taylor & Francis, as informações obtidas foram de artigos originais e meta-análises entre janeiro de 2011 e dezembro de 2022, a equação de busca "hyperhidrosis", "psychology", "mental health" e "quality of life". Resultados. Obtivemos 127 fontes do PubMed, Scopus, Taylor & Francis, revisamos e eliminamos duplicatas e artigos sem informações de interesse, selecionando 41 artigos e, em seguida, aplicamos os critérios de inclusão e exclusão aos artigos restantes, obtendo finalmente 8 artigos para análise. Conclusão. O principal impacto psicológico da hiperidrose primária é a ansiedade e a depressão, que são mais prevalentes em pacientes do sexo feminino, e a principal repercussão na vida diária é o isolamento social, em que o apoio dos familiares desempenha um papel importante na recuperação do paciente. Além disso, a causa direta da doença é desconhecida, pois é multifatorial.

Snapshot of four mature quinoa (Chenopodium quinoa) seeds: a shotgun proteomics analysis with emphasis on seed maturation, reserves and early germination.

Chenopodium quinoa Willd. is a crop species domesticated over 5000 years ago. This species is highly diverse, with a geographical distribution that covers more than 5000 km from Colombia to Chile, going through a variety of edaphoclimatic conditions. Quinoa grains have great nutritional quality, raising interest at a worldwide level. In this work, by using shotgun proteomics and in silico analysis, we present an overview of mature quinoa seed proteins from a physiological context and considering the process of seed maturation and future seed germination. For this purpose, we selected grains from four contrasting quinoa cultivars (Amarilla de Maranganí, Chadmo, Sajama and Nariño) with different edaphoclimatic and geographical origins. The results give insight on the most important metabolic pathways for mature quinoa seeds including: starch synthesis, protein bodies and lipid bodies composition, reserves and their mobilization, redox homeostasis, and stress related proteins like heat-shock proteins (HSPs) and late embryogenesis abundant proteins (LEAs), as well as evidence for capped and uncapped mRNA translation. LEAs present in our analysis show a specific pattern of expression matching that of other species. Overall, this work presents a complete snapshot of quinoa seeds physiological context, providing a reference point for further studies. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-023-01295-8.

Levothyroxine Bioequivalence Study and Its Narrow Therapeutic Index: Comparative Bioavailability Results Between Two Formulations Available in Latin America.

INTRODUCTION: The history of levothyroxine has been linked to advances in the treatment of thyroid disease and to date it is the standard therapy for the treatment of hypothyroidism. Bioequivalence studies are the most widely used method to demonstrate interchangeability, although controversy persists regarding the best design for this molecule declared as a narrow therapeutic index product in many countries. This study aimed to evaluate the pharmacokinetic profile of two formulations of levothyroxine to determine bioequivalence between them. METHODS: This two-period, randomized, crossover, blind study was conducted in 80 healthy volunteers, of both sexes, using a single levothyroxine dose of 600 µg with a washout period of 42 days. Blood sampling was performed at - 30 min, - 15 min, and 0 h pre-dose and 30 min, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12, 16, 24, and 48 h post-dose. RESULTS: A total of 78 subjects successfully completed both periods. There were no serious adverse events during the study and both formulations were well tolerated. Baseline correction of serum levothyroxine concentrations was performed before statistical analysis. The mean maximum plasma concentration of the test product (Levotiroxina MK®) was 57.49 ng/mL while for the reference product it reached 59.32 ng/mL. Importantly, both test and reference formulations reached maximum concentrations in plasma at about the same time. The areas under the pharmacokinetic curves with the test product showed AUC0-t of 1407.1 ng h/mL and the reference product 1394.3 ng h/mL. The bioequivalence statistical analysis showed that the 90% confidence interval (CI90%) of the ratio of test over reference formulation was within the bioequivalence margins of 90-111%. For Cmax, the test/reference ratio was 96.2% with CI90% of 91.6-100.9%, and for AUC0-t the test/reference ratio was 99.9 with CI90% of 93.3-107.0%. CONCLUSIONS: Both formulations have the same pharmacokinetic profile and are bioequivalent in the narrow therapeutic index required by some health authorities.

Genetic Characterization in High-Risk Individuals from a Low-Resource City of Peru.

Background: Genetic testing for hereditary cancers is inconsistently applied within the healthcare systems in Latin America. In Peru, the prevalence and spectrum of cancer-predisposing germline variants is thus poorly characterized. Purpose: To determine the spectrum and prevalence of cancer-predisposing germline variants and variants of uncertain significance (VUS) in high-risk individuals located in a Peruvian low-resource setting city. Methods: Individuals presenting clinical criteria for hereditary cancer syndromes or being unaffected with familial history of cancer were included in the study. Samples from a total of 84 individuals were subjected to a high-throughput DNA sequencing assay that targeted a panel of 94 cancer predisposition genes. The pathogenicity of detected germline variants was classified according to the established American College of Medical Genetics and Genomics (ACMG) criteria. All pathogenic variants were validated by cycling temperature capillary electrophoresis. Results: We identified a total of eight pathogenic variants, found in 19 out of 84 individuals (23%). Pathogenic variants were identified in 24% (10/42) of unaffected individuals with family history of cancer and in 21% (9/42) of individuals with a cancer diagnosis. Pathogenic variants were identified in eight genes: RET (3), BRCA1 (3), SBDS (2), SBDS/MLH1 (4), MLH1 (4), TP53 (1), FANCD2 (1), DDB2/FANCG (1). In cancer cases, all colon cancer cases were affected by pathogenic variants in MLH1 and SBDS genes, while 20% (2/10) of the thyroid cancer cases by RET c.1900T>C variants were affected. One patient with endometrial cancer (1/3) had a double heterozygous pathogenic variant in DDB2 and FANCG genes, while one breast cancer patient (1/14) had a pathogenic variant in TP53 gene. Overall, each individual presented at least 17 VUS, totaling 1926 VUS for the full study population. Conclusion: We describe the first genetic characterization in a low-resource setting population where genetic testing is not yet implemented. We identified multiple pathogenic germline variants in clinically actionable predisposition genes, that have an impact on providing an appropriate genetic counselling and clinical management for individuals and their relatives who carry these variants. We also reported a high number of VUS, which may indicate variants specific for this population and may require a determination of their clinical significance.

Anthropogenic impact on the reproductive health of two wild Patagonian fish species with differing reproductive strategies.

A particularly concerning outcome of environmental pollution is the disturbance of reproductive processes. However, studies on the impacts of pollution on the reproductive health of fish inhabiting South American environments are limited. We studied the impact of anthropogenic pollution on the reproductive health of two sympatric Patagonian marine fish species with different reproductive strategies: the live-bearing rockfish Sebastes oculatus and the egg-laying Brazilian sandperch Pinguipes brasilianus. Our findings reveal that both species presented some degree of reproductive disturbance when inhabiting an affected site, but the specific alterations differed depending on the species, sex, and season. During the reproductive season, 17ß-estradiol levels were elevated in females of both species living in polluted areas, while no differences in androgen levels were observed in either species or season. The gonadosomatic index (GSI) was affected in both sexes of S. oculatus during the non-reproductive season, while the gonadal stages were mainly affected in both sexes of P. brasilianus. No signs of intersex condition were observed. Our results highlight the importance of including diverse reproductive parameters to better understand anthropogenic effects on wild animals. Long-term studies including other fish species and including offspring (to evaluate possible transgenerational effects) will be necessary to determine the consequences of the documented reproductive alterations, particularly whether fish species inhabiting Patagonian marine reef areas will be able to reproductively adapt to increasing marine anthropogenic disturbances.

Epitheliocystis in wild marine fishes and its relation with anthropogenic pollution.

Epitheliocystis is a fish disease with recorded in increasing numbers globally. Here we show that (a) pollution-exposed wild marine fishes have higher infection prevalence than nonexposed individuals from reference sites, suggesting that anthropogenic pollution predisposes individuals to this disease in natural systems, (b) the effect of pollution on infection status did not vary significantly between two sympatric fish species, and (c) infected and noninfected individuals from both species did not differ significantly in selected immune and general-health parameters, a result that deserves further study with increased sample sizes.

Angioedema hereditario tipo III en una embarazada: a propósito de un caso / Hereditary angioedema type III in pregnant women: case report and literature review

Resumen ANTECEDENTES: El angioedema hereditario es una enfermedad rara, caracterizada por episodios recurrentes de edema en cualquier parte del cuerpo, sobre todo en las extremidades, la cara y las vías respiratorias. Existen tres tipos de enfermedad en función de su causa, el menos frecuente es el III con un nivel y función del inhibidor de C1 normales. Su fisiopatología es poco conocida; por lo tanto, su diagnóstico es difícil. Su tratamiento ha avanzado en los últimos años, aunque queda mucho por definir, sobre todo durante el embarazo. OBJETIVO: Evaluar la bibliografía disponible relacionada con el angioedema hereditario y su atención médica en mujeres embarazadas. CASO CLÍNICO: Paciente de 30 años, en curso de su primer embarazo. El único antecedente personal destacable fue haber padecido angioedema hereditario tipo III, diagnosticado 10 años antes después de varios episodios de angioedema orofacial. A lo largo del embarazo sobrevinieron varias crisis de la enfermedad que requirieron tratamiento de los episodios agudos y de mantenimiento en el tercer trimestre. Por último, ocurrió un parto instrumentado mediante vaccum, por riesgo de pérdida de bienestar fetal con buen desenlace materno y fetal en el posparto inmediato. CONCLUSIONES: El angioedema hereditario tipo III es una enfermedad muy rara y poco conocida en la Ginecoobstetricia que requiere establecer un protocolo y estandarización de la atención clínica, sobre todo en las embarazadas, lo que ayudará a proporcionar una información y asistencia de calidad a estas pacientes.

Abstract BACKGROUND: Hereditary angioedema is a rare disease characterized by recurrent episodes of edema anywhere in the body, especially in the extremities, face and airways. There are three types of the disease depending on its cause, the most infrequent being III with normal C1 inhibitor level and function. Its pathophysiology is poorly understood; therefore, its diagnosis is difficult. Its treatment has advanced in recent years, although much remains to be defined, especially during pregnancy. OBJECTIVE: To evaluate the available literature related to hereditary angioedema and its medical care in pregnant women. CLINICAL CASE: 30-year-old female patient, during her first pregnancy. The only personal history of note was hereditary angioedema type III, diagnosed 10 years earlier after several episodes of orofacial angioedema. Throughout the pregnancy, several crises of the disease occurred, requiring treatment in acute episodes and maintenance treatment in the third trimester. Finally, one delivery was instrumented by vaccum, due to risk of loss of fetal well-being with good maternal and fetal outcome in the immediate postpartum period. CONCLUSIONS: Hereditary angioedema type III is a very rare and little-known disease that requires establishing a protocol and standardization of clinical care, especially in pregnant women, which will help to provide quality information and assistance to these patients.

Ateneo de la Residencia de Psicopedagogía: Prácticas psicopedagógicas en pandemia: 2020-2021 / Psychopedagogy Residence Athenaeum: Psychopedagogical practices in pandemic: 2020-2021

La decisión del Gobierno Nacional, frente a la situación de pandemia por el COVID 19, de disponer el Aislamiento Social Preventivo y Obligatorio (ASPO), a fines de limitar la circulación de personas en todo el territorio nacional, afectó la concurrencia y participación de las personas en diversas áreas, y en particular, la asistencia de todos los NNy/A a la escuela, así como también a sus respectivos diagnósticos y tratamientos en nuestro hospital. Es por este motivo que dentro del Equipo surge la necesidad de re-pensar nuevas modalidades de abordaje, formas de acción y acompañamiento de los/as pacientes y la comunidad general, en un contexto de emergencia sanitaria. En el presente escrito, se detallan cada una de las actividades realizadas desde el Equipo de Psicopedagogía del Área Programática del Hospital Gral. de Agudos Dr. Dalmacio Vélez Sarsfield. Las mismas fueron planificadas y llevadas a cabo durante el periodo ASPO, y demuestran la reinvención de su quehacer durante ese tiempo, para poder adaptarse al contexto actual. (AU)

Ateneo 2021: Habitando nuevos espacios: Clínica y virtualidad / Atheneaum 2021: Inhabiting new spaces: Clinical and virtuality

Ateneo del Equipo de Psicopedagogía que se desempeña en el Departamento Área Programática del Hospital Dr. Dalmacio Velez Sarsfield, de la Ciudad de Buenos Aires, El Área Programática tiene por función principal aplicar la Estrategia de Atención Primaria de la Salud (APS), siendo ésta, el eje de articulación entre la comunidad y la institución hospitalaria. Gran parte del trabajo del Equipo se encuadra desde el enfoque prevención-promocional, y se ocupa también de la clínica asistencial, dentro del "Programa de Salud Escolar" Durante el mes de marzo del 2020, el trabajo en el Área Programática y en la institución hospitalaria en general, se vio influenciado por la aparición de la Pandemia (COVID-19), que puso al Sistema de Salud en situación de emergencia sanitaria. Se describe la modalidad de atención del Equipo, dentro de este panorama.

Dá el primer paso y los caminos aparecerán: Percepciones de los/as adolescentes sobre el taller de Orientación Vocacional Ocupacional / Take the first step and the paths will appear: Perceptions of adolescents about the vocational orientation workshop

El Equipo de Psicopedagogía del Área Programática del Hospital Vélez Sarsfield, implementa desde el año 1998 procesos de Orientación Vocacional Ocupacional (OVO) en el marco de la Atención Primaria de la Salud (APS), la cual tiene como objetivo generar la participación, autogestión y responsabilidad en el cuidado de la salud de la población en general. El proceso de OVO busca que los/as estudiantes sean protagonistas de su elección, pudiendo llegar a tomar decisiones autónomas y significativas respecto a su futuro y, de esta manera, optimizar así su calidad de vida. Particularmente en este contexto de pandemia por Covid19, se decidió re-pensar de qué modo continuar con la oferta de esta actividad a pesar del impedimento de llevarlos a cabo de forma presencial; se consideró necesario mantener estos espacios donde se pudiera acompañar a los/as adolescentes ante la incertidumbre de la elección de una carrera o trabajo. Por tal motivo, se pensó en la idea de diseñar y llevar a cabo un Taller de OVO de forma virtual y acotado en cantidad de encuentros. La presente investigación tiene como objetivo analizar las percepciones de los/as adolescentes que iniciaron y culminaron el Taller de Orientación Vocacional Ocupacional, realizado de manera virtual en el periodo de octubre a diciembre de 2020, en relación al dispositivo de Orientación Vocacional Ocupacional. (AU)

An Intervention Delivered by Mobile Phone Instant Messaging to Increase Acceptability and Use of Effective Contraception Among Young Women in Bolivia: Randomized Controlled Trial.

BACKGROUND: Although the most effective methods of contraception are available in Bolivia, unmet need for contraception among women aged 15 to 19 years is estimated to be 38% (2008), and the adolescent fertility rate is 71 per 1000 women (2016). Mobile phones are a popular mode to deliver health behavior support. We developed a contraceptive behavioral intervention for young Bolivian women delivered by mobile phone and guided by behavioral science. The intervention consists of short instant messages sent through an app over 4 months. OBJECTIVE: This trial aimed to evaluate the effect of the intervention on young Bolivian women's use of and attitudes toward the effective contraceptive methods available in Bolivia. METHODS: This was a parallel group, individually randomized superiority trial with a 1:1 allocation ratio. Women were eligible if they were aged 16 to 24 years, owned a personal Android mobile phone, lived in La Paz or El Alto, reported an unmet need for contraception, and could read Spanish. The target sample size was 1310 participants. Participants allocated to the intervention had access to an app with standard family planning information and intervention messages. Participants allocated to the control group had access to the same app and control messages. Coprimary outcomes were use of effective contraception and acceptability of at least one method of effective contraception at 4 months. Secondary outcomes were use of effective contraception during the study, acceptability of the individual methods, service uptake, unintended pregnancy, and abortion. Process outcomes included knowledge, perceived norms, personal agency, and intention. Outcomes were analyzed using logistic and linear regression. We also asked participants about physical violence. RESULTS: A total of 640 participants were enrolled, and 67.0% (429) of them contributed follow-up data for the coprimary outcome, the use of effective contraception. There was no evidence that use differed between the groups (33% control vs 37% intervention; adjusted odds ratio [OR] 1.19, 95% CI 0.80 to 1.77; P=.40). There was a borderline significant effect regarding acceptability (63% control vs 72% intervention; adjusted OR 1.49, 95% CI 0.98 to 2.28; P=.06). There were no statistically significant differences in any of the secondary or process outcomes. The intervention dose received was low. In the control group, 2.8% (6/207) reported experiencing physical violence compared with 1.9% (4/202) in the intervention group (Fisher exact test P=.75). CONCLUSIONS: This trial was unable to provide definitive conclusions regarding the effect of the intervention on use and acceptability of effective contraception because of under recruitment. Although we cannot strongly recommend implementation, the results suggest that it would be safe and may increase the acceptability of effective contraception if the intervention messages were offered alongside the download of the app. TRIAL REGISTRATION: ClinicalTrials.gov NCT02905526; https://clinicaltrials.gov/ct2/show/NCT02905526.

Immunity and health of two wild marine fishes naturally exposed to anthropogenic pollution.

There are increasing global concerns of the alarming pollution impacts on marine life, thus it is becoming essential to generate reliable tools to monitor and understand the effects of these impacts on aquatic organisms. We performed a field study assessing how exposure to anthropogenic pollution impacts immunological and health-state parameters and parasite infection of a wild marine fish, the Brazilian sandperch Pinguipes brasilianus. Then we compared this information to previously published data of a sympatric species, the Patagonian rockfish Sebastes oculatus inhabiting the same polluted and pristine areas. The field study revealed that exposed P. brasilianus showed chronic stress, poor immune condition and higher prevalence and abundance of acanthocephalan parasites. By comparing these former results with already published in S. oculatus, we concluded that, although both species exhibited physiological alterations associate to inhabiting sites exposed to pollution, their specific immunological and health-state responses differed. Our results demonstrate that Patagonian reef-fish assemblages inhabiting sites exposed to pollutant are being affected in their immune and heath condition, which could potentially result in higher susceptibility to disease and in turn population decline. These findings highlight the necessity of more studies incorporating interspecific comparisons to assess variation in fish susceptibility in an ecoimmunotoxicological context and get a more profound understanding of anthropogenic impacts on wildlife.

Epistaxis grave durante el embarazo, resistente al tratamiento: reporte de un caso y revisión bibliográfica / Refractory severe epistaxis during pregnancy: a case report and a literature review

Resumen ANTECEDENTES: La epistaxis durante el embarazo, aparte de ser una urgencia, tiene una prevalencia tres veces superior a la de la población general. Se controla con medidas conservadoras, aunque a veces deben indicarse tratamientos que implican intervenciones quirúrgicas. CASO CLÍNICO: Paciente de 37 años, con embarazo de 37 semanas, que acudió a Urgencias por epistaxis, sin reacción a las técnicas conservadoras (taponamiento nasal de diversa índole), que provocó anemia progresiva y requirió ligadura de la arteria esfenopalatina para detener el sangrado. Enseguida se llevó a cabo la cesárea, indicada por rotura prematura de membranas e imposibilidad de realizar la maniobra de Valsalva; nació un varón con Apgar 9-10-10. La paciente continuó con alteraciones en la anatomía de los senos paranasales debido a la intervención quirúrgica y en seguimiento en consulta de Otorrinolaringología. CONCLUSIONES: La epistaxis, aunque es un evento frecuente durante el embarazo, puede afectar a la madre y su hijo; por tanto, es importante conocer los tratamientos disponibles al respecto, notificar los nuevos casos y el tratamiento para aumentar el conocimiento de esta alteración infrecuente pero grave.

Abstract BACKGROUND: Epistaxis is a frequent emergency, which prevalence during pregnancy is three times higher than the general female population. It is usually managed with conservative measures, but sometimes more aggressive treatments like surgery may be required. Due to the limited bibliography currently available, new cases and their management should be recorded in order to assess outcomes. CASE REPORT: A 37-week-old pregnant woman went to the Emergency Department with an epistaxis that did not stop despite the use of conservative techniques. As a result of progressive anemization a sphenopalatine artery ligation was required to stop the bleeding. A cesarean section was performed for premature rupture of membranes and the impossibility of Valsalva maneuver. A male infant was born with APGAR test results of 9-10-10. During follow up the patient presented changes in the anatomy of her paranasal sinuses caused by the sphenopalatine artery ligation and is being followed up by Ear-Nose-Throat specialist. CONCLUSION: Epistaxis during pregnancy rarely leads to maternal and/or fetal involvement; it is therefore essential to know all treatments available as well to record new cases and their management to increase knowledge about this uncommon but severe pathology.

Úlcera de Lipschütz: reporte de un caso y revisión bibliográfica / Lipschütz Ulcer: a case report and a literature review

Resumen: ANTECEDENTES: Las úlceras de Lipschütz son lesiones vulvovaginales dolorosas, de aparición aguda y desaparición espontánea en 2 a 6 semanas, no dejan secuelas ni son recurrentes a largo plazo. Su etiopatogenia es incierta, alrededor de 70% se consideran idiopáticas. En los estudios más recientes se ha demostrado su asociación con agentes infecciosos, sobre todo con el virus de Epstein-Barr. El diagnóstico se establece por exclusión y su tratamiento se basa en el control sintomático, cicatrizantes, analgésicos y antisépticos. CASO CLÍNICO: Paciente de 15 años, con úlceras vulvares de aparición súbita acompañadas de cuadro catarral. Se indicó tratamiento local con cicatrizante, antiséptico y antiinflamatorio; al cabo de tres semanas se observó la desaparición de las lesiones y la negatividad de las pruebas que descartó el origen infeccioso. Se estableció el diagnóstico de úlcera de Lipschütz. CONCLUSIONES: La úlcera de Lipschütz es infrecuente y los niños son quienes más la padecen. Debido al carácter de desaparición espontánea y a la juventud de las pacientes, es decisivo establecer el correcto diagnóstico diferencial.

Abstract: BACKGROUND: Lipschütz Ulcers are painful, acute onset and self-limiting vulvovaginal lesions that can frequently be associated with prodromal symptoms, disappearing in 2-6 weeks without any sequelae. 70% of cases present idiopathic etiopathogenesis, and are related to Epstein-Barr virus, among others. The diagnosis is made by exclusion and its treatment is based on symptomatic control and the promotion of correct healing, using analgesics, cicatrizers and antiseptics. CASE REPORT: A 15-year-old girl reported the acute apparition of ulcerative vulvar lesions coinciding with systemic catarrhal symptoms. Local treatment with healing, antiseptic and anti-inflammatory lotions was prescribed, and after three weeks, she was reevaluated, observing the disappearance of the lesions and the negativity of the tests to rule out infectious origin, for which she was diagnosed with a Lipschütz ulcer. CONCLUSIONS: Lipschütz ulcer is rare and children are the ones who suffer most from it. Due to the spontaneous disappearance character and the youthfulness of the patients, it is decisive to establish the correct differential diagnosis.

Evaluación del curso virtual de Genética Humana en estudiantes universitarios de ciencias de la salud / Evaluation of the Human Genetics virtual course by university health sciences students

Introducción: Los entornos de aprendizaje en línea ofrecen nuevas formas de comunicación que permiten a docentes y estudiantes intercambiar información, conocimientos e ideas, tanto en espacios asincrónicos como en tiempo real. En esta modalidad se desarrolló un curso electivo de Genética Humana para complementar la formación de estudiantes de pregrado del área de la salud. Objetivo: Evaluar la satisfacción con el uso y la percepción del trabajo en una asignatura virtual de Genética Humana en estudiantes universitarios pertenecientes a carreras del área de la salud de la Universidad de Concepción. Métodos: Estudio de tipo cuantitativo, no experimental y transversal. Mediante una encuesta de preguntas cerradas y abiertas, se determinó el grado de satisfacción de los estudiantes con respecto a los aspectos pedagógicos, tecnológicos y el ambiente virtual de aprendizaje. Resultados: Los estudiantes evaluaron en forma satisfactoria el curso virtual. En cuanto a la percepción del ambiente virtual, las opiniones positivas estuvieron centradas en la autonomía (40 por ciento) y en la experiencia de aprendizaje (38 por ciento). Los aspectos negativos se enfocaron en la responsabilidad hacia el aprendizaje (75 por ciento) y la relación con el docente (25 por ciento). Conclusiones: El curso virtual es útil para el aprendizaje de la Genética Humana, y constituye un espacio que favorece la adquisición de conocimientos y el desarrollo de competencias como la autonomía y el trabajo en equipo(AU)

Introduction: Online learning environments offer new forms of communication allowing teachers and students to exchange information, knowledge and ideas, either asynchronously or in real time. An elective Human Genetics course was taught online to complement the training of undergraduate health sciences students. Objective: Evaluate the satisfaction with and perception of the work done in a virtual Human Genetics course taught to university health sciences students from the University of Concepción. Methods: A quantitative cross-sectional non-experimental study was conducted. A survey containing open-ended and closed-ended questions was used to determine the students' level of satisfaction with pedagogical and technological aspects of the course, and with the virtual learning environment. Results: Students ranked the virtual course as satisfactory. Concerning perception of the virtual environment, positive opinions referred to the students' autonomy (40 percent) and the learning experience itself (38 percent). Negative opinions focused on the students' responsibility towards learning (75 percent) and their relationship to the teacher (25 percent). Conclusions: The virtual course proved to be useful to learn about Human Genetics, as well as an environment fostering the acquisition of knowledge and the development of competences such as autonomy and team work(AU)

Precauciones en el uso de los espirales antimosquitos / Precautions in the use of anti-mosquitoes coils

La emergencia y reemergencia de enfermedades transmitidas por vectores (ETV) es un suceso de gran relevancia en la actualidad, debido al cambio climático, a la urbanización no planificada, y al incremento y variación de la temperatura global.1) El vector Aedes Aegypti, es el mayor responsable de algunas ETV como dengue, chikunguya, y zika.1 A nivel mundial, el virus del dengue provoca 390 millones de infecciones anuales,2 con un número estimado de 20 000 fallecidos.3 Latinoamérica, en los últimos años, viene experimentando un incremento dramático de casos y muerte por dengue.1 Esta situación, provoca que las personas intenten mantener las principales medidas de prevención contra estas enfermedades. La finalidad de los programas de prevención, vigilancia y control vectorial a nivel mundial, es controlar la proliferación del vector que causa el dengue y otras ETV. Las prácticas proporcionadas por la Organización Mundial de la Salud (OMS) incluyen el uso de espirales antimosquitos (EAM), que son ampliamente utilizados por la comunidad. Sin embargo, poco se dice sobre el riesgo para la salud que representan esos productos.1 Los EAM están compuestos por piretroides (pesticidas artificiales, eficaces contra diversos géneros de mosquitos) que, al hacer combustión, produce humo con partículas pequeñas (< 1 µm) que pueden ingresar hasta los alveolos y causar problemas pulmonares, vómitos, diarrea, convulsiones, parálisis, entre otros.4 El International Programme on Chemical Safety, en 1989, afirmó: si el uso de EAM se da bajo las condiciones de uso recomendadas, es poco probable que represente un peligro para la salud; de igual manera, la OMS clasifica a los piretroides como levemente peligrosos.5 Un estudio aplicado en ratas reveló que el uso del EAM está relacionado a un mayor riesgo de producir daño pulmonar severo,6 y otro estudio...(AU)