Using Household Dietary Diversity Score and Spatial Analysis to Inform Food Governance in Chile.

This study explores how the Household Dietary Diversity Score (HDDS) and spatial visualization can inform food governance in Chile, focusing on socio-demographic and geographical determinants affecting food consumption patterns. A national household database (n = 4047), including households from 2019 (n = 3967; 98.02%) and 2020 (n = 80; 1.98%), provided by the "Family Support Program of Food Self-Sufficiency" (FSPFS) of the Ministry of Social Development and Family, was analyzed. The findings revealed that Chilean vulnerable households were led mostly by women (86.6%), with an age average of 55.9 ± 15.6 years old, versus 68.9 ± 12.9 years in the case of men. The intake frequency analysis showed that dairy, fruits, and vegetables were below the recommended values in at least half of the households, and that fats and sugars were above recommended levels. Regarding the HDDS (0-189), the national average was 91.4 ± 20.6 and was significantly influenced by the number of minors in the households, water access, food access issues, and residing in the Zona Sur. Finally, the spatial visualization showed that the Zona Central had higher consumption of fruits and vegetables, while the extreme zones Norte Grande and Zona Austral showed higher intakes of fats and sugars. These findings emphasize the importance of leveraging data insights like the HDDS and spatial visualization to enhance food security and inform food governance strategies.

Manejo del trauma pre-hospitalario. ¿Qué hacer?

El manejo pre-hospitalario del trauma corresponde a la fase cero del control de daños, tiene por objetivo evitar y prevenir el desarrollo del rombo mortal. A pesar de que la mortalidad causada por una hemorragia aguda traumática es prevenible, solo el 50% de los pacientes son manejados a tiempo. En la actualidad, existen múltiples métodos mecánicos y químicos para el control hemorrágico en un ambiente austero. La campaña Stop the Bleed de la American College of Surgeons (ACS), ha promovido el uso de los dispositivos mecánicos por la población general a través de la capacitación. En el enfrentamiento prehospitalario del trauma, se utiliza el clásico A-B-C-D-E, agregando la letra X al inicio, para indicar que el primer manejo debe ser el control de las hemorragias externas compresibles. En conclusión: El manejo prehospitalario rápido y ordenado, determina mejores resultados en la evolución clínica y sobrevida del paciente politraumatizado.

The pre-hospital management of trauma is zero phase of damage control, its objective is to avoid and prevent the development of the fatal rhombus. Although mortality caused by acute traumatic hemorrhage is preventable, only 50% of patients are managed on time. Currently there are multiple mechanical and chemical methods for hemorrhagic control in an austere environment. The Stop the Bleed program of the American College of Surgeons (ACS) has promoted the use of mechanical devices by the general population through training. In prehospital trauma, the classic A-B-C-D-E is used, adding the letter X at the beginning to indicate that the first management should be of compressible external hemorrhages. The rapid and orderly prehospital management determines better results in the clinical evolution and survival of the polytraumatized patient.

Nanostructured Conducting Polymers and Their Applications in Energy Storage Devices.

Due to the energy requirements for various human activities, and the need for a substantial change in the energy matrix, it is important to research and design new materials that allow the availability of appropriate technologies. In this sense, together with proposals that advocate a reduction in the conversion, storage, and feeding of clean energies, such as fuel cells and electrochemical capacitors energy consumption, there is an approach that is based on the development of better applications for and batteries. An alternative to commonly used inorganic materials is conducting polymers (CP). Strategies based on the formation of composite materials and nanostructures allow outstanding performances in electrochemical energy storage devices such as those mentioned. Particularly, the nanostructuring of CP stands out because, in the last two decades, there has been an important evolution in the design of various types of nanostructures, with a strong focus on their synergistic combination with other types of materials. This bibliographic compilation reviews state of the art in this area, with a special focus on how nanostructured CP would contribute to the search for new materials for the development of energy storage devices, based mainly on the morphology they present and on their versatility to be combined with other materials, which allows notable improvements in aspects such as reduction in ionic diffusion trajectories and electronic transport, optimization of spaces for ion penetration, a greater number of electrochemically active sites and better stability in charge/discharge cycles.

Capacitors Based on Polypyrrole Nanowire Electrodeposits.

The electrochemical polymerization of polypyrrole nanowires is carried out using potentiodynamic and galvanostatic methods in order to enhance the performance of the modified electrodes as capacitor devices. The electrochemical, spectroscopic, and morphological properties are determined through cyclic voltammetry, Raman spectroscopy and scanning electron microscopy, respectively, corroborating the presence of PPy-nw in dimensions of 30 nm in diameter. Characterization as a capacitor revealed that the nanowire structure enhances key parameters such as specific capacitance with 60 times greater value than bulk polymer modification, in addition to a significant increase in stability. In this way, it is verified that electrodes modified with polypyrrole nanowires obtained in situ by electrochemical methods constitute an excellent candidate for the development of capacitors.

Fístula de gerbode adquirida após cirurgia de correção valvar / Gerbod fistula acquired after valve repair surgery

INTRODUÇÃO: Fístula de Gerbode é uma comunicação entre o ventrículo esquerdo e o átrio direito (VE-AD). O defeito é raro, pode ser congênito ou adquirido. A forma adquirida é mais frequentemente observada após cirurgia valvar, endocardite ou infarto. Relataremos 2 casos de pacientes com fístula de Gerbode adquirida pós-intervenção valvar. Caso 1: Mulher, 56 anos, com diagnóstico pré-operatório de insuficiência mitral (IM) importante, fibrilação atrial, hipertensão pulmonar (HP) e insuficiência tricúspide (IT) discreta. Foi submetida à plastia mitral, tricúspide e exclusão de ambas as auriculetas. Um ano após a cirurgia, paciente assintomática, sem sinais de insuficiência cardíaca (IC), porém foi auscultado um sopro sistólico rude em borda esternal esquerda (BEE). O ecocardiograma transesofágico (ETE) demonstrou presença da fístula com 3,5mm do VE para o AD com gradiente de VE-AD de 95 mmHg, redução da HP (de 50 para 36 mmHg) e função do VD normal. A paciente foi mantido em observação. Caso 2: Homem, 61 anos, diagnóstico pré-operatório de IM importante primária, HP importante (PSAP 116mmHg) e IT moderada. Foi submetido a implante de bioprótese mitral e plastia tricúspide. Evoluiu com melhora sintomática e redução da HP. Foi observado sopro sistólico rude em BEE. O ETE demonstrou uma fístula VE-AD, com gradiente de 92 mmHg. Paciente assintomático, sem repercussão hemodinâmica, mantido em tratamento conservador. DISCUSSÃO: Na literatura, a evolução de casos com a fístula varia desde assintomáticos até desfechos desfavoráveis como insuficiência cardíaca, endocardite e necessidade de oclusão da fístula. Apesar de ser relatado como defeito raro, a incidência está aumentando devido ao maior número de intervenção cirúrgica. O diagnóstico é difícil e muitas vezes necessário complementação com ETE para melhor definição do tamanho e localização do defeito e para melhor programação da correção quando houver indicação. A intervenção pode ser cirúrgica ou percutânea. Em paciente assintomáticos, defeitos pequenos e sem sobrecarga de VD podem ser mantidos em conduta conservadora desde que com acompanhamento frequente. CONCLUSÃO: Foram relatados dois casos de fístula de Gerbode (comunicação entre o VE e o AD) adquiridas após cirurgia de correção valvar. Ambos os pacientes relatados foram tratados clinicamente, estão em CF I, sem alterações das câmaras cardíacas.

Medical education from the point of view of medical students: Results from four participatory Delphi panels in Quito, Ecuador.

BACKGROUND: Medical curricula have historically been designed in a top-down approach, usually excluding students. While Delphi panels have been used as a tool for medical education curricula design, none have been conducted in Ecuador. In addition, no such approach has ever included students both as panelists and researchers. MATERIAL AND METHODS: Four Delphi panels were developed and conducted using a participatory approach that allowed medical students to take part both as expert panelists and researchers: specifically, students developed the questionnaire and conducted a qualitative synthesis. Questionnaire responses were anonymized and dispatched online to panelists. The information was organized and collected to develop the qualitative syntheses and prepare the final statements. RESULTS: Thirty-two medical students participated between February and May 2018. A total of 32 questions were developed, corresponding to five different categories. For some questions, consensus was reached; for other questions, general statements were obtained.Discussion and conclusion: Developing the questionnaire, responding to it and analyzing the answers allowed students to raise significant concerns regarding medical education topics proposing relevant policy and curricula change. Participatory Delphi panels can be an efficient tool to obtain organized feedback, improve student class involvement, and promote research skills.

The influence of hospital antimicrobial use on carbapenem-non-susceptible Enterobacterales incidence rates according to their mechanism of resistance: a time-series analysis.

BACKGROUND: Carbapenem non-susceptible Enterobacterales (CNSE) can be broadly divided into those that produce carbapenemases (carbapenemase-producing Enterobacterales (CPE)), and those that harbour other mechanisms of resistance (non-carbapenemase-producing CNSE (NCP-CNSE)). AIM: To determine the predictors of CNSE nosocomial incidence rates according to their mechanism of resistance. METHODS: A time-series analysis was conducted (July 2013 to December 2018) to evaluate the relationship in time between hospital antibiotic use and the percentage of adherence to hand hygiene with the CNSE rates. FINDINGS: In all, 20,641 non-duplicated Enterobacterales isolates were identified; 2.2% were CNSE. Of these, 48.1% and 51.9% were CPE and NCP-CNSE, respectively. Of the CPE, 78.3% possessed a blaOXA-232 gene. A transfer function model was identified for CNSE, CPE, and OXA-232 CPE that explained 20.8%, 19.3%, and 24.2% of their variation, respectively. According to the CNSE and CPE models, an increase in piperacillin-tazobactam (TZP) use of 1 defined daily dose (DDD) per 100 hospital patient-days (HPD) would lead to an increase of 0.69 and 0.49 CNSE and CPE cases per 10,000 HPD, respectively. The OXA-232 CPE model estimates that an increase of 1 DDD per 100 HPD of TZP use would lead to an increase of 0.43 OXA-232 CPE cases per 10,000 HPD. A transfer function model was not identified for NCP-CNSE, nor was there an association between the adherence to handhygiene and the CNSE rates. CONCLUSION: The use of TZP is related in time with the CPE nosocomial rates, mostly explained by its effect on OXA-232 CPE.

Disintegrins extracted from totonacan rattlesnake (Crotalus totonacus) venom and their anti-adhesive and anti-migration effects on MDA-MB-231 and HMEC-1 cells.

Disintegrins are low molecular weight cysteine-rich proteins (4-14 kDa) that are isolated mainly from viperid snake venom. Due to their potential as lead compounds for binding and blocking integrin receptors, snake venom disintegrins have become one of the most studied venom protein families. The aim of this study was to obtain disintegrins from C. totonacus venom and evaluate their capability to bind and block integrin receptors. The C. totonacus disintegrin fraction (totonacin) represents two disintegrin isoforms obtained from C. totonacus venom. These disintegrins showed extracellular-matrix (ECM) protein adhesion and migration inhibitory effects on MDA-MB-231 and HMEC-1 cells. Totonacin (3 µM) inhibited MDA-MB-231 cell adhesion to the ECM proteins, fibronectin, vitronectin, and laminin by 31.2, 44.0, and 32.1, respectively. Adhesion inhibition to fibronectin, vitronectin, and laminin observed on HMEC-1 cells was 42.8, 60.8, and 51%, respectively. In addition, totonacin (3 µM) significantly inhibited MDA-MB-231 and HMEC-1 cell migration (41.4 and 48.3%, respectively). Totonacin showed more potent cell adhesion inhibitory activity toward vitronectin in both cell lines. These results suggest a major affinity of totonacin toward αVß3, α8ß1, αVß5, αVß1, and αIIbß3 integrins. In addition, the inhibitory effect observed on MDA-MB-231 and HMEC-1 cell migration reinforces the evidence of an interaction between these disintegrins and αVß3 integrin, which plays a key role in migration and angiogenesis.

Local Knowledge for Addressing Food Insecurity: The Use of a Goat Meat Drying Technique in a Rural Famine Context in Southern Africa.

Only 30% of households in Bairro Boroma (Boroma neighborhood) have a regular protein intake, mainly due to the lack of a proper cold chain. We analyzed the level of knowledge about a local dried meat called chinkui, examining the relationship between this knowledge and its value for strengthening local food security. Through surveys of Bairro Boroma goat herders (n = 23) about "chinkui awareness" and passive observation of chinkui preparation (n = 5) from local biotype goats, we found that chinkui was known to most goat herders (91.3%), but was used only irregularly, mainly because knowledge transmission has decreased over time. From passive observation, we found that the amount of dried meat obtained from an animal rarely exceeded a yield of 10% and its performance and safety depended on weather conditions and the absence of other animals in the area of preparation. It is, therefore, recommended to strengthen initiatives to increase the amount of chinkui, based on local knowledge, so as to enhance its frequency of consumption and the possibility of using it as a sustainable alternative source of protein.

Dataset on share issuance, abnormal returns and market timing in the Brazilian stock market.

This article presents a dataset to investigate the determinants of firms' decision for primary share issuance and the effects of market timing on primary share issues in the Brazilian stock market. The data refer to Brazilian nonfinancial firms that issued primary shares (IPOs and SEOs) in the 2004-2015 period. The data were gathered from the online bases of Economatica® and the São Paulo Securities, Commodities and Futures Exchange (BM&FBovespa). The final sample was composed of 123 firms and 165 primary share issues: 97 initial public offerings and 68 follow-on offerings. The dataset was developed to support a model that captures market timing behavior through cumulative abnormal returns and shows the effects of this behavior on the amount of proceeds raised. The dataset contains subsamples and different analysis time windows, processed and unprocessed data. Researchers can use the dataset for future research and comparisons with other markets and models. The related research article using part of the current dataset was published under the following title: "Effects of market timing on primary share issues in the Brazilian capital market" (Gomes et al.).

Fermentative capabilities of native yeast strains grown on juices from different Agave species used for tequila and mezcal production.

The Asparagaceae family is endemic from America, being the Agave genus the most important. The Agave species possess economic relevance and are use as raw material to produce several distilled alcoholic beverages, as bacanora, tequila, and mezcal. The fermentation process has been carry out either spontaneously or by adding a selected yeast strain. The latter is generally responsible for the production of ethanol and volatile compounds. This study comprised five Agave species (A. angustifolia, A. cupreata, A. durangensis, A. salmiana, and A. tequilana) and eight endogenous yeast strains: five of them were non-Saccharomyces (Torulaspora delbrueckii, Zygosaccharomyces bisporus, Candida ethanolica, and two Kluyveromyces marxianus) and three Saccharomyces cerevisiae strains. The results showed that the S. cerevisiae strains were not able to grow on A. durangensis and A. salmiana juices. The Kluyveromyces marxianus strains grew and fermented all the agave juices and displayed high ethanol production (48-52 g L-1) and volatile compounds. The ethanol production was higher on A. angustifolia juice (1.1-2.8-fold), whereas the volatile compound was dependent on both yeast strain and the Agave species. The use of endogenous non-Saccharomyces yeast strains is feasible, as they may outperform S. cerevisiae regarding the production of fermented beverages from agave plants with a high content of ethanol and aromatic compounds. Graphical abstract.

Evaluation of the impact of live pig trade network, vaccination coverage and socio-economic factors in the classical swine fever eradication program in Peru.

Classical swine fever (CSF) is a viral infectious disease of swine with significant economic impact in the affected countries due to the limitation of trade, culling of infected animals and production losses. In Latin America, CSF is endemic in several countries including Ecuador, Bolivia, Brazil and Peru. Since 2010, the National Veterinary Services of Peru have been working to better control and eradicate the disease with an intensive vaccination program. The aim of this study was to evaluate the effectiveness of the vaccination program and determine which factors are still contributing to the persistence of the disease in certain regions of Peru. We integrated the data from the vaccination campaign, the live pig movement network and other socioeconomic indicators into a multilevel logistic regression model to evaluate their association with CSF occurrence at district level. The results revealed that high vaccination coverage significantly reduces the risk of CSF occurrence (OR = 0.07), supporting the effectiveness of the vaccination program. Districts belonging to large and medium pig trade network communities (as identified with walktrap algorithm) had higher probability to CSF occurrence (OR = 2.83 and OR = 5.83, respectively). The human development index (HDI) and the presence of a slaughterhouse in the district was also significantly associated with an increased likelihood of CSF occurrence (OR = 1.52 and OR = 3.25, respectively). Districts receiving a high proportion of the movements from districts that were infected in the previous year were also at higher risk of CSF occurrence (OR = 3.30). These results should be useful to guide the prioritization of vaccination strategies and may help to design other intervention strategies (e.g., target education, movement restrictions, etc.) in high-risk areas to more rapidly advance in the eradication of CSF in Peru.

Phylodynamics of classical swine fever virus with emphasis on Ecuadorian strains.

Classic swine fever virus (CSFV) is a Pestivirus from the Flaviviridae family that affects pigs worldwide and is endemic in several Latin American countries. However, there are still some countries in the region, including Ecuador, for which CSFV molecular information is lacking. To better understand the epidemiology of CSFV in the Americas, sequences from CSFVs from Ecuador were generated and a phylodynamic analysis of the virus was performed. Sequences for the full-length glycoprotein E2 gene of twenty field isolates were obtained and, along with sequences from strains previously described in the Americas and from the most representative strains worldwide, were used to analyse the phylodynamics of the virus. Bayesian methods were used to test several molecular clock and demographic models. A calibrated ultrametric tree and a Bayesian skyline were constructed, and codons associated with positive selection involving immune scape were detected. The best model according to Bayes factors was the strict molecular clock and Bayesian skyline model, which shows that CSFV has an evolution rate of 3.2 × 10-4 substitutions per site per year. The model estimates the origin of CSFV in the mid-1500s. There is a strong spatial structure for CSFV in the Americas, indicating that the virus is moving mainly through neighbouring countries. The genetic diversity of CSFV has increased constantly since its appearance, with a slight decrease in mid-twentieth century, which coincides, with eradication campaigns in North America. Even though there is no evidence of strong directional evolution of the E2 gene in CSFV, codons 713, 761, 762 and 975 appear to be selected positively and could be related to virulence or pathogenesis. These results reveal how CSFV has spread and evolved since it first appeared in the Americas and provide important information for attaining the goal of eradication of this virus in Latin America.

Does freeze-all policy affect IVF outcome in poor ovarian responders?

OBJECTIVE: To evaluate whether the freeze-all strategy affects in-vitro fertilization (IVF) outcome in poor ovarian responders (POR) defined according to the Bologna criteria. METHOD: This was a retrospective cohort study of patients undergoing IVF treatment between January 2012 and December 2016 at a single center. A total of 433 POR (as defined by the Bologna criteria) fulfilled criteria and were included in the study; of these, 277 patients underwent fresh embryo transfer (ET) and 156 followed the freeze-all policy. All patients underwent controlled ovarian stimulation (COS) following a gonadotropin-releasing hormone antagonist protocol, and cleavage-stage ET. Main outcome measure was ongoing pregnancy rate. Secondary outcomes included implantation and clinical pregnancy rates. The freeze-all strategy was implemented when the progesterone serum level was > 1.5 ng/mL or the endometrium was < 7 mm on the trigger day, or as per patient preference. Patients with previous failed fresh ET also underwent fresh ET or freeze-all strategy considering the indications mentioned above. RESULTS: Mean maternal age in the freeze-all group was 39.5 ± 3.6 years and in the fresh ET group was 39.7 ± 3.8 years (P = 0.54). Mean number of embryos transferred (nET) was 1.53 ± 0.6 and 1.60 ± 0.6 (P = 0.12) in the freeze-all and fresh ET groups, respectively. Ongoing pregnancy rate did not differ significantly between the freeze-all and fresh ET groups (9.6% vs 10.1%, respectively; relative risk (RR), 0.95; 95% CI, 0.52-1.73), nor did the clinical pregnancy rate (14.1% vs 13.7%, respectively; RR, 1.03; 95% CI, 0.63-1.67). Implantation rate was 9.6% and 9.8% (P = 0.82) in the freeze-all and fresh ET groups, respectively. Logistic regression analysis (including maternal age, antral follicle count, number of retrieved and mature oocytes, nET, and fresh ET vs freeze-all strategy) indicated that maternal age (P < 0.001) and nET (P = 0.039) were the only independent variables associated with ongoing pregnancy rate. CONCLUSIONS: The freeze-all strategy, compared with fresh ET, had no impact on IVF outcomes in POR patients as defined according to the Bologna criteria. Multicenter studies including large numbers of patients should be carried out to confirm the results of this study and reach conclusions about the potential benefits of the freeze-all policy for poor responders. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Energy drinks and their component modulate attention, memory, and antioxidant defences in rats.

PURPOSE: This study aimed to evaluate the effects of the subchronic consumption of energy drinks and their constituents (caffeine and taurine) in male Wistar rats using behavioural and oxidative measures. METHODS: Energy drinks (ED 5, 7.5, and 10 mL/kg) or their constituents, caffeine (3.2 mg/kg) and taurine (40 mg/kg), either separately or in combination, were administered orally to animals for 28 days. Attention was measured though the ox-maze apparatus and the object recognition memory test. Following behavioural analyses, markers of oxidative stress, including SOD, CAT, GPx, thiol content, and free radicals, were measured in the prefrontal cortex, hippocampus, and striatum. RESULTS: The latency time to find the first reward was lower in animals that received caffeine, taurine, or a combination of both (P = 0.003; ANOVA/Bonferroni). In addition, these animals took less time to complete the ox-maze task (P = 0.0001; ANOVA/Bonferroni), and had better short-term memory (P < 0.01, Kruskal-Wallis). The ED 10 group showed improvement in the attention task, but did not differ on other measures. In addition, there was an imbalance in enzymatic markers of oxidative stress in the prefrontal cortex, the hippocampus, and the striatum. In the group that received both caffeine and taurine, there was a significant increase in the production of free radicals in the prefrontal cortex and in the hippocampus (P < 0.0001; ANOVA/Bonferroni). CONCLUSIONS: Exposure to a combination of caffeine and taurine improved memory and attention, and led to an imbalance in the antioxidant defence system. These results differed from those of the group that was exposed to the energy drink. This might be related to other components contained in the energy drink, such as vitamins and minerals, which may have altered the ability of caffeine and taurine to modulate memory and attention.

Soyamilk fermented with riboflavin-producing Lactobacillus plantarum CRL 2130 reverts and prevents ariboflavinosis in murine models.

It has been previously shown that Lactobacillus plantarum CRL 2130 is able to produce riboflavin in soyamilk. The aim of the present study was to evaluate the efficiency of this riboflavin-bio-enriched soyamilk to revert and/or prevent the nutritional deficiency of riboflavin using different animal models. When used to supplement the diets of previously depleted animals, it was shown that the growth, riboflavin status and morphology of the small intestines reverted to normal parameters and were similar to animals supplemented with commercial riboflavin. In the prevention model, the same tendency was observed, where animals that received soyamilk fermented with L. plantarum CRL 2130 did not show signs of riboflavin deficiency. This new bio-fortified soya-based product could be used as part of normal diets to provide a more natural alternative to mandatory fortification with riboflavin for the prevention of its deficiency.

Intracytoplasmic sperm injection outcomes with cryopreserved testicular sperm aspiration samples.

Intracytoplasmic sperm injection (ICSI) may be performed with testicular frozen-thawed spermatozoa in patients with nonobstructive azoospermia (NOA). Sperm retrieval can be performed in advance of oocyte aspiration, as it may avoid the possibility of no recovery of spermatozoa on the day of oocyte pickup. There are few studies available in the literature concerning the use of frozen-thawed spermatozoa obtained from testicular sperm aspiration (TESA). To evaluate the effects and the outcomes of ICSI with frozen-thawed spermatozoa obtained by TESA, we performed a retrospective analysis of 43 ICSI cycles using frozen-thawed TESA. We obtained acceptable results with a fertilisation rate of 67.9%, an implantation rate (IR) of 17.1%, and clinical and ongoing pregnancy rates of 41.9% and 37.2% respectively. The results of this study suggest that performing ICSI using cryopreserved frozen-thawed testicular spermatozoa with TESA as a first option is a viable, safe, economic and effective method for patients with NOA.

Muerte digna en pediatría: análisis de los dictámenes emitidos por un comité de bioética de un hospital pediátrico en 2008-2012 / Dignified death in pediatrics: analysis of bioethics committee's recommendations in a pediatric hospital between 2008-2012

INTRODUCCIÓN La limitación del esfuerzo terapéutico (LET) podría ser un indicador concreto de tutela de una muerte vivida lo más humanamente posible. El Comité de Bioética (CB) ayuda al equipo tratante a discernir este tipo de situaciones, buscando el mayor bien concretamente realizable. La evolución de la conducta posdictamen encierra claves significativas para la reflexión y práctica bioética en una comunidad hospitalaria. OBJETIVOS Indagar qué porcentaje de dictámenes emitidos por el CB de un hospital pediátrico referían la recomendación de LET en alguna de sus formas y en qué medida fueron llevados a cabo posteriormente por el equipo tratante responsable de la consulta. Escudriñar la labor de discernimiento que aporta un CB en el ámbito hospitalario. Objetivos Indagar qué porcentaje de dictámenes emitidos por el CB de un hospital pediátrico referían la recomendación de LET en alguna de sus formas y en qué medida fueron llevados a cabo posteriormente por el equipo tratante responsable de la consulta. Escudriñar la labor de discernimiento que aporta un CB en el ámbito hospitalario. MÉTODOS Se realizó un estudio descriptivo, cualitativo y retrospectivo. Sobre el total de consultas registradas de un CB en un hospital pediátrico de alta complejidad (2008-2012), se seleccionaron aquellas que recomendaban alguna forma de LET, y se constató la concordancia o no entre la recomendación de LET y las conductas adoptadas posteriormente. RESULTADOS Se estudió a un total de 40 pacientes. Los servicios que más consultaron al CB fueron los de clínica médica (25%) y las terapias intensivas (22%). Las patologías de base predominantes fueron neurológicas (42%) y genéticas (12%). El 60% de los dictámenes del CB aconsejaron LET, que se cumplieron en el 83% de los casos. El resto de los pacientes sobrevivió al estado crítico, aunque altamente secuelados. DISCUSIÓN Por los datos aportados en esta investigación, se respetó la decisión de evitar sufrimientos innecesarios e indebidos en el paciente, a fin de ofrecer una muerte vivida lo más humanamente posible. La comunidad hospitalaria recibe las recomendaciones del CB y las lleva a la práctica. Con el seguimiento de las consultas en el período posdictamen, el CB podrá valorar su aporte y perfeccionarlo desde elementos que emergen del análisis de su misma práctica.

Therapeutic Effects of Policosanol and Atorvastatin against Global Brain Ischaemia-Reperfusion Injury in Gerbils.

Stroke is the third cause of death and the first of permanent adult disability. Pretreatment with policosanol and atorvastatin has been effective in experimental models of cerebral ischaemia in rodents. The objective was to compare the therapeutic effects of policosanol and atorvastatin in a model of global cerebral ischaemia in gerbils. Gerbils were distributed into seven groups, a negative control and six with ischaemia-reperfusion-induced global cerebral ischemia (one vehicle positive control, two policosanol (100 and 200 mg/kg), two atorvastatin (10 and 20 mg/kg) and one aspirin (60 mg/kg) group). Treatments were given 4 h after ischaemia induction. Effects on ischemia-reperfusion-induced symptoms, hyperlocomotion, damage of pyramidal hipoccampal neurons and increased plasma oxidative markers were investigated. Positive, not negative controls, exhibited clinical symptoms, hyperlocomotion, neuronal damage and increased plasma oxidative markers. Policosanol (100 and 200 mg/kg) reduced significantly ischemia-reperfusion-induced symptoms, the frequency of symptomatic animals, histological scores of neuronal damage and plasma oxidative markers as compared with the positive control group. Atorvastatin (10 and 20 mg/kg) decreased significantly the symptoms and histological scores, but unchanged the frequency of symptomatic gerbils and oxidative variables. Only the highest dose of policosanol (200 mg/kg) and atorvastatin (20 mg/kg) reduced significantly ischemia reperfusion-induced hyperlocomotion, policosanol being the most effective. Aspirin 60 mg/kg lowered significantly symptom score, the rate of symptomatic gerbils and hyperlocomotion versus the positive controls, but failed to modify oxidative parameters. In conclusion, postreperfusion treatment with policosanol and atorvastatin was effective for ameliorating symptoms, hyperlocomotion and neurological damage of hippocampal CA1 neurons in gerbils with ischemia-reperfusion-induced global cerebral ischemia, but only policosanol reduced increased plasma oxidative variables.