Factors related to mortality in patients with chronic obstructive pulmonary disease in Colombian population / Factores relacionados con la mortalidad en pacientes con enfermedad pulmonar obstructiva crónica en población colombiana

Introduction. Data in low- and middle-income countries on mortality and its related risk factors in patients with chronic obstructive pulmonary disease are limited. Objective. To identify the incidence of death and its relationship with variables in a Colombian population during 12 months of follow-up. Materials and methods. We carried out a retrospective study in subjects diagnosed with chronic obstructive pulmonary disease in a third-level hospital in Colombia. Odds ratios were calculated using multivariable logistic regression analysis with the outcome variable "mortality at 12 months". Results. We included 524 patients, 18.1% (95 / 524) died. The average age was 69.7 (SD = 8.92), and 59.2% (310 / 524) were women. The variables associated with mortality were age (OR = 6.54; 95% CI = 3.65-11.36; p < 0.001), years of exposure to wood smoke (OR = 4.59; 95% CI = 1.64-2.82; p = 0.002), chronic heart failure (OR = 1.81; 95% CI = 1.13-2.91; p = 0.014), cerebrovascular disease (OR = 3.35; 95% CI = 1.04-10.75; p = 0.032), and chronic kidney disease (OR = 6.96; 95% CI = 1.15-41.67; p=0.015). When adjusting the variables in the multivariate analysis, only an association was found for sex (OR = 1.55; 95% CI = 0.95-2.54; p = 0.008) and age (OR = 5.94; 95% CI = 3.3-10.69; p < 0.001). Conclusion. Age, years of exposure to wood smoke, chronic heart failure, and cerebrovascular and chronic kidney disease were the clinical variables associated with a fatal outcome. However, age and sex were the only variables related to mortality when adjusted for confounding factors.

Introducción. En los países de medianos y bajos ingresos, los datos sobre la mortalidad y los factores de riesgo en pacientes con enfermedad pulmonar obstructiva crónica son limitados. Objetivo. Identificar la incidencia de muerte y sus variables relacionadas en una población colombiana durante 12 meses de seguimiento. Materiales y métodos. Se llevó a cabo un estudio retrospectivo de sujetos con diagnóstico de enfermedad pulmonar obstructiva crónica en una clínica de tercer nivel en Colombia. Los cocientes de probabilidades se calcularon mediante un análisis de regresión logística multivariable con la variable de resultado "mortalidad a los 12 meses". Resultados. Ingresaron 524 pacientes, de los cuales el 18,1 % (95 / 524) murió. La edad promedio fue de 69,7 (DE = 8,92) y el 59,2 % (310 / 524) eran mujeres. Las variables asociadas con la mortalidad fueron la edad (OR = 6,54; IC95%: 3,65-11,36; p < 0,001), años de exposición al humo de leña (OR = 4,59; IC95%: 1,64-12,82; p = 0,002), insuficiencia cardiaca crónica (OR = 1,81; IC95%: 1,13-2,91; p = 0,014), enfermedad cerebrovascular (OR = 3,35; IC95%: 1,04-10,75; p = 0,032) y enfermedad renal crónica (OR=6,96; IC 95%:1,15-41,67; p = 0,015). Al ajustar las variables en el análisis multivariado únicamente se mostró asociación entre el sexo (OR = 1,55; IC95%: 0,95-2,54; p = 0,008) y la edad (OR = 5,94; IC95%: 3,3-10,69; p < 0,001). Conclusión. La edad, los años de exposición al humo de leña, la insuficiencia cardiaca crónica, la enfermedad cerebrovascular y la renal crónica fueron variables clínicas asociadas a un desenlace fatal. Sin embargo, la edad y el sexo fueron las únicas relacionadas con la mortalidad al ajustarlas por factores de confusión.

Automated free speech analysis reveals distinct markers of Alzheimer's and frontotemporal dementia.

Dementia can disrupt how people experience and describe events as well as their own role in them. Alzheimer's disease (AD) compromises the processing of entities expressed by nouns, while behavioral variant frontotemporal dementia (bvFTD) entails a depersonalized perspective with increased third-person references. Yet, no study has examined whether these patterns can be captured in connected speech via natural language processing tools. To tackle such gaps, we asked 96 participants (32 AD patients, 32 bvFTD patients, 32 healthy controls) to narrate a typical day of their lives and calculated the proportion of nouns, verbs, and first- or third-person markers (via part-of-speech and morphological tagging). We also extracted objective properties (frequency, phonological neighborhood, length, semantic variability) from each content word. In our main study (with 21 AD patients, 21 bvFTD patients, and 21 healthy controls), we used inferential statistics and machine learning for group-level and subject-level discrimination. The above linguistic features were correlated with patients' scores in tests of general cognitive status and executive functions. We found that, compared with HCs, (i) AD (but not bvFTD) patients produced significantly fewer nouns, (ii) bvFTD (but not AD) patients used significantly more third-person markers, and (iii) both patient groups produced more frequent words. Machine learning analyses showed that these features identified individuals with AD and bvFTD (AUC = 0.71). A generalizability test, with a model trained on the entire main study sample and tested on hold-out samples (11 AD patients, 11 bvFTD patients, 11 healthy controls), showed even better performance, with AUCs of 0.76 and 0.83 for AD and bvFTD, respectively. No linguistic feature was significantly correlated with cognitive test scores in either patient group. These results suggest that specific cognitive traits of each disorder can be captured automatically in connected speech, favoring interpretability for enhanced syndrome characterization, diagnosis, and monitoring.

Detailing the organic matter in suspended sediments as a tool to assess the impact of land occupation in water bodies: a case of Barigui Watershed (Southern Brazil).

Suspended sediments were collected to examine the organic carbon content and n-alkanes in order to assess the impact on water bodies caused by soil and land occupation. For this, samples from distinct areas based on the level of land occupation of the Barigui Watershed and different areas under the influence of human activities were examined. The number of industries increasing along the river was also considered. Twenty-two sediment samples were collected using a time-integrated sediment sampler. Samples were extracted with dichloromethane:methanol (DCM:methanol) (2:1) in an ultrasound bath, treated and injected using gas chromatography coupled with mass spectrometry (GC-MS) for separation and quantification. Twenty-one n-alkanes were identified and were used to track both biogenic and anthropogenic inputs. The concentration of total n-alkanes varied from 38.72 to 222.76 µg g-1, due to the impact of urbanization. Diagnostic indexes indicated high numbers of plants, bacteria and petroleum as n-alkanes sources. The following results were obtained using: carbon preference index (CPI), 1.96-2.22 (rainy season) and 2.12-5.80 (summer season); average chain length (ACL), 30.37-31.17 (rainy season) and 30.05-30.50 (summer season) and terrigenous aquatic ratio (TAR), 0.39-5.47 (rainy season) and 2.98-5.06 (summer season); n-alkanes had two main sources: terrestrial plant and petroleum. It is clear that the source of n-alkanes is different in each season (rainy and dry) demonstrated by n-alkanes occurrence. During the rainy season, there was an increase in organic matter of oil origin which was mainly associated with the increased runoff and rain drainage. Finally, the input of organic matter associated with land occupation and erosion can be distinguished by higher concentration in the most urbanized site (PB).

Contribution of food groups to energy, grams and nutrients-to-limit: the Latin American Study of Nutrition and Health/Estudio Latino Americano de Nutrición y Salud (ELANS).

OBJECTIVE: To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans. DESIGN: Data from the Latin American Study of Nutrition and Health (ELANS). SETTING: ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. PARTICIPANTS: Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15-65 years. 'What We Eat in America' food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount. RESULTS: Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %). CONCLUSION: Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.

Use of fatty acids as tracer of organic matter input associated with level of land urbanization.

Suspended sediments (SSs) were examined regarding the content of fatty acids (FAs) to associate them with sources of soil entry into the river. The source of organic matter was traced through fatty acid distribution, as well as erosion. Also, TOC, TN, and TOC/NT were used to support the results of FAs. For this, a tropical river was chosen to understand the main source of input considering the level of land occupation along the river. The Barigui river, in southern Brazil, was segmented in four distinct areas regarding the soil occupation (P1, P2, P3, and P4). Nine sampling campaigns were conducted from Nov/2014 to Nov/2015 using a time-integrated sampler. Site P1 has the lowest level of urbanization and showed the lowest concentration of FAs (16.35 µg-1). In contrast, site P4, the most urbanized, showed the highest content of fatty acids, including those associated with erosion, 378.53 µg g-1, specifically those with long chains. The mean concentrations of the saturated fatty acids (FAs) was 283.40 µg g-1, monounsaturated fatty acids (MUFAs) was 79.46 µg g-1, and polyunsaturated fatty acids (PUFAs) was 15.66 µg g-1. Twenty-seven fatty acids were examined, nevertheless C15:0, C16:0, C18:0, and C18:1ω9 prevailed in all samples. Generally, those acids indicate sewage inputs. Statics analyses were used to find the relation between the source of organic matter (autochthonous, allochthones, and anthropogenic) and FAs. Finally, the input of organic matter is associated with land occupation, which can be distinguished by FA distribution.

Development of gender cognitions in children. Qualitative systematic review / Desarrollo de las cogniciones de género en la infancia. revisión sistemática cualitativa

RESUMEN A pesar del creciente interés en la promoción de cogniciones afines a la equidad en niñas, niños y jóvenes, poco se conoce sobre el desarrollo de las cogniciones de género (CG) durante la infancia. Con el objetivo de contribuir a identificar, integrar y facilitar la utilización de la evidencia disponible sobre el tema, se realizó una revisión cualitativa sistemática en tres bases de datos electrónicas de amplia trayectoria en psicología. Un total de 30 informes fueron codificados y analizados usando el procedimiento desarrollado por Vargas Trujillo (2004). A partir de los hallazgos, se propone una línea de tiempo del desarrollo de las CG de cero a 19 años, con el fin de facilitar su uso por parte de quienes están interesados en el diseño de intervenciones dirigidas a promover cogniciones afines a la equidad en la infancia basadas en evidencia.

ABSTRACT Despite the growing interest in the promotion of cognitions related to equity in children and young people, little is known about the development of gender cognitions ( CG) throughout childhood. With the aim of contributing to identify, integrate and facilitate the use of the available evidence on the subject, a qualitative systematic review was carried out in three electronic databases with extensive experience in psychology. A total of 30 reports were coded and analyzed using the coding manual of Vargas Trujillo (2004). Based on the findings, a timeline for the development of CG from zero to 19 years is proposed in order to facilitate its use by those interested in the design of interventions aimed at promoting cognitions related to equity in childhood based on evidence.

Use of n-alkanes to trace erosion and main sources of sediments in a watershed in southern Brazil.

Erosive processes can transport sediments containing nutrients, heavy metals and contaminants of organic and inorganic origin into bodies of water, therefore affecting the local ecosystem and the population that benefits from the water sources. In order to better understand the origin of sediment sources and establish mitigation measures, the use of the sediment fingerprinting technique has been highlighted. Thus, the present work had as objective to apply n-alkanes in order to trace and understand the main sources of organic matter in sediments and associate the results with land and soil occupation. The study area is located in the municipality of Rio Negrinho - Brazil, in the Saci river basin. Soil samples were collected and classified according to their use and occupation, as well as and samples of local vegetation to be used as reference. The distribution of n-alkanes in the sediments was compared with the distribution found in the vegetation and soil. Previously, a distribution pattern of n-alkanes had been identified in all major vegetation used to trace the source of organic matter and hence the soil. The concentrations of total organic carbon (TOC), total nitrogen (TN), total phosphorus (TP) and granulometry were also analyzed in the soil and sediment samples. Indexes between n-alkanes were used and applied to assess the source together with statistical analysis (PCA). In sum, the results showed that the sediments are mainly composed of Pinus taeda reforestation soils, as well as soil from the abandoned roads used to transport the cut trees, while the contribution of autochthonous sediments was found to be minimal. In this way, the fingerprint technique served as an auxiliary tool in order to establish measures for the good management of a river basin, bringing important information about the contributing sources of sediment to water bodies.

Severe BCG-osis Misdiagnosed as Multidrug-Resistant Tuberculosis in an IL-12Rß1-Deficient Peruvian Girl.

PURPOSE: Mendelian suceptibility to mycobacterial disease (MSMD) is a rare primary immunodeficiency predisposing to severe disease caused by mycobacteria and other intracellular pathogens. Delay in diagnosis can have an impact on the patient's prognosis. METHODS: We evaluated the IFN-γ circuit by studying IFN-γ production after mycobacterial challenge as well as IL-12Rß1 expression and STAT4 phosphorylation in response to IL-12p70 stimulation in whole blood of a 6-year-old Peruvian girl with disseminated recurrent mycobacterial infection diagnosed as multidrug-resistant tuberculosis. Genetic studies with Sanger sequencing were used to identify the causative mutation. Microbiological studies based on PCR reactions were used to diagnose the specific mycobacterial species. RESULTS: We identified a homozygous mutation in the IL12RB1 gene (p. Arg211*) causing abolished expression of IL-12Rß1 and IL-12 response. MSMD diagnosis led to a microbiological reevaluation of the patient, revealing a BCG vaccine-related infection instead of tuberculosis. Treatment was then adjusted, with good response. CONCLUSIONS: We report the first Peruvian patient with IL-12Rß1 deficiency. Specific mycobacterial species diagnosis within Mycobacterium tuberculosis complex is still challenging in countries with limited access to PCR-based microbiological diagnostic techniques. Awareness of MSMD warning signs and accurate microbiological diagnosis of mycobacterial infections are of the utmost importance for optimal diagnosis and management of affected patients.

Conocimientos y aplicación de principios éticos en estudiantes de enfermería / Knowledge and application of ethical principles in nursing students / Conhecimentos e aplicação de princípios éticos em estudantes de enfermagem

Las instituciones universitarias tienen la responsabilidad de formar enfermeros capaces de reconocer las necesidades del sistema de salud, al cual deben responder con una conducta etica y atención humanizada. Objetivo: Determinar el conocimiento en principios éticos y su aplicación al proceso de atención realizado por los estudiantes de Enfermería de la Universidad del Cauca. Metodología: Estudio de enfoque cuantitativo, tipo descriptivo de corte transversal. La muestra escogida fue 155 estudiantes matriculados en el programa de Enfermería entre tercero y décimo semestres en el primer periodo de 2015. Para determinar los conocimientos relacionados con los principios éticos se adapta y valida un cuestionario de preguntas evaluativas, y para comprobar la aplicación de dichos principios se plantea una pregunta problemática. Resultados: Los principios de fidelidad, beneficencia y lealtad fueron los más conocidos y los de no maleficencia, justicia y veracidad fueron los de menor conocimiento. Los estudiantes de semestres inferiores presentaron menor conocimiento frente al tema, quienes a su vez eran los que menos cursos de etica habían recibido y los estudiantes de semestres superiores fueron los de mayor conocimiento y participación en cursos de etica. Los principios se aplicaron aceptablemente, a pesar de no tener conocimientos sólidos sobre ellos. Conclusión: La enseñanza de ética en enfermería debe ser trasversal, pues crea bases sólidas que permitirán abordar los dilemas éticos que se presenten en la vida profesional y brindar un cuidado humanizado.

The universities have the responsibility to train nurses able to recognize the needs of the health systein, which must respond to ethical conduct and humane care. Objective: To determine the knowledge on ethical principies and their application to the care process by nursing students at the University of Cauca. Mcthodology: Quantitative approach study, descriptive cross-sectional type. Tlic sample 155 students enrollcd in the nursing program between III and X semester I period 2015. This adapts and validares a questionnaire evaluation questions to determine knowledge and a problematic question to measure the application of the principies. Results: the principies of loyalty, charity and loyalty were the best known and the principies of non-malcficence, justice and truth were the least knowledge. Those who had less knowledge were students of lower semesters, which in turn were those who had received fewer courses and more knowledge were students of higher semesters, with greater participation in ethics courses. The principies were applied acccptably despite not having solid knowledge about them. Conclusión: The research allows us to concludc that the teaching of ethics in nursing requires more attention and should be transversal in career development because it creates a solid foundation in ethical principies that will allow the nurse (a) address the ethical dilemmas present throughout his professional life and provide a humanizcd care

As universidades tém a responsabilidadc de treinar os enfermeiros capazes de reconhcccr as necessidades do sistema de saúde, que deve responder a conduta ética e cuidado humano. Objetivo: Determinar o conhecimcnto sobre principios éticos e sua aplicado ao processo de cuidado por estudantes de enfermagem da Universidadc de Cauca. Metodología: Estudo de abordagem quantitativa, descritivo transversal. Amostra 155 alunos inscritos no programa de enfermagem entre III c X semestre período I 2015. Este se adapta e valida questóes de avaliaqáo questionário para determinar o conhecimcnto e urna questáo problemática para medir a aplicaqáo dos principios. Resultados: Os principios de lealdade, caridadc e lcaldade eram os mais conhecidos e os principios da náo-maleficéncia, justi

First Symptoms and Neurocognitive Correlates of Behavioral Variant Frontotemporal Dementia.

BACKGROUND: Previous works highlight the neurocognitive differences between apathetic and disinhibited clinical presentations of the behavioral variant frontotemporal dementia (bvFTD). However, little is known regarding how the early presentation (i.e., first symptom) is associated to the neurocognitive correlates of the disease's clinical presentation at future stages of disease. OBJECTIVES: We analyzed the neurocognitive correlates of patients with bvFTD who debuted with apathy or disinhibition as first symptom of disease. METHODS: We evaluated the neuropsychological, clinical, and neuroanatomical (3T structural images) correlates in a group of healthy controls (n = 30) and two groups of bvFTD patients (presented with apathy [AbvFTD, n = 18] or disinhibition [DbvFTD, n = 16]). To differentiate groups according to first symptoms, we used multivariate analyses. RESULTS: The first symptom in patients described the evolution of the disease. AbvFTD and DbvFTD patients showed increased brain atrophy and increased levels of disinhibition and apathy, respectively. Whole brain analyzes in AbvFTD revealed atrophy in the frontal, insular, and temporal areas. DbvFTD, in turn, presented atrophy in the prefrontal regions, temporoparietal junction, insula, and temporoparietal region. Increased atrophy in DbvFTD patients (compared to AbvFTD) was observed in frontotemporal regions. Multivariate analyses confirmed that a set of brain areas including right orbitofrontal, right dorsolateral prefrontal, and left caudate were enough to distinguish the patients' subgroups.∥Conclusion: First symptom in bvFTD patients described the neurocognitive impairments after around three years of disease, playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments.

Discapacidad visual: Factor agravante de la discapacidad física en pacientes reumáticos. Presentación de un caso

Se realiza la presentación de caso de una Paciente, femenina de 53 años de edad, con antecedentes de artritis reumatoide desde hace 34 años tratada con esteroides en dosis pequeñas y moderadas, así como con los fármacos modificadores de la enfermedad con los que dispone el cuadro básico de medicamentos, solos o en combinación, actualmente con leflunomida. Padece así mismo de diabetes mellitus 3 años tratada con Insulina y de hipertensión arterial que es tratada con lmlodipino. Hace aproximadamente 3 años presenta disminución lenta y progresiva de la agudeza visual, que no resolvía con el uso de cristales correctores lo que asociado a su déficit motor y muscular debido a la artritis reumatoide, le impedía tener una vida con calidad, agravando su dependencia de otra persona para la realización de las actividades básicas de la vida diaria. Clasificada desde la Clinimetria: Capacidad funcional: Steinbrocker grado IV. HAQ-CU: 3. Se precisó el diagnóstico de catarata pre-senil y se decidió su tratamiento quirúrgico en aras de mejorar la calidad de vida de esta paciente

The incidence of visual incapacity in patients with rheumatic disease is a factor that increases the physical incapacity in these persons. We report the case of a 53 year old, female, from a rural area, with Antecedents of suffering from rheumatoid arthritis for 34 years and other diseases such as Hypertension and diabetes mellitus. She was treated with different medications such as anti-inflammatory steroids as well as the disease modifier drugs, insulin and Amlodipino. Around 3 years ago she had been having slow and progressive loss of vision which did not improve with the use of glasses. Then she was evaluated by the ophthalmologist and a surgical treatment for bilateral cataracts was indicated to improve her life quality. After surgery the patient had a good recovery

Uveítis. Un reto para el Reumatólogo

Las uveítis son un grupo heterogéneo de entidades clínicas, de muy diversas causas, que tienen en común la inflamación intraocular. Pueden ser la manifestación de una enfermedad generalizada ya establecida, ser un proceso limitado al globo ocular, o incluso ser el primer signo clínico de una entidad que se desarrollará con el tiempo. Por ello, el reumatólogo, con ayuda del examen oftalmológico, intentará buscar manifestaciones extraoculares específicas, para así solicitar las pruebas complementarias oportunas según su hipótesis diagnóstica.

The uveitis are a heterogeneous group of clinical entities, from very different causes, which have in common the intraocular inflammation. They can be the manifestation of disease widespread as established, be a process limited to the eyeball, or even be the first clinical sign of an entity that will develop over time. Therefore, rheumatologist, with the help of an eye examination, will attempt to search specific extraocular manifestations, for appropriate complementary tests according to their diagnostic hypothesis.

Caracterización de hábitats larvales de anofelinos en el municipio Sifontes del estado Bolívar, Venezuela / Characterization of anophelines larval habitats in the municipality of Sifontes, Bolívar State, Venezuela

El municipio Sifontes, ubicado en el noreste del estado Bolívar, constituye el principal foco de malaria de Venezuela. Durante el quinquenio 2010-2014, se registró en el municipio un aumento considerable de la morbilidad con una fuerte tendencia al incremento, cerrando 2014 con la cifra record de 51.603 casos, 58% de la malaria del país en el año. Con el objeto de estudiar la distribución espacial de las larvas de anofelinos en los hábitats acuáticos y su relación con las variables ambientales, se hicieron colectas mensuales de larvas en hábitats representativos de los diferentes tipos existentes en la zona, entre septiembre 2002 y diciembre 2003. El Análisis de Correspondencia Canónica (CANOCO) indica que a nivel de hábitat (humedal), la presencia de las especies de Anopheles está determinada por el tipo y la dinámica hídrica del hábitat, mientras que a nivel de microhábitat (cucharonazo) las especies se ubican a lo largo de un gradiente dominado por el tipo de vegetación, y en menor grado por la luz solar y el color aparente del agua. Esto permitió establecer grupos de especies a priori, tales como las del subgénero Nyssorhynchus, asociadas a la luz solar y a ciertas plantas acuáticas, o las de los subgéneros Anopheles y Stethomyia, An. (Lophopodomyia) squamifemur y Chagasia bonneae asociadas a ambientes sombreados y carentes de vegetación. Los resultados ayudan a comprender mejor la relación de las especies de anofelinos con el medio ambiente y resaltan la importancia de variables como la dinámica hídrica, luz solar, vegetación y color aparente del agua para determinar su ocurrencia en el hábitat acuático.

The Municipality of Sifontes, located in the northeast of Bolivar State, is the main malaria foci in Venezuela. A considerable increase in malaria morbidity was recorded in the Municipality during the decade 2010-2014, with a record figure of 51.603 cases for 2014, 58% of the malaria for the country. In order to study the spatial distribution of anopheline inmature stages in the larval habitats and its relation to environmental variables, monthly collections were carried out in larval habitats representatives of the different types present in the area between September 2002 and December 2003. The Canonic Correspondance Analysis (CANOCO) showed that at the larval habitat level the Anopheles species is determined by the type and dynamics of the habitat, while at the microhabitat level (dip) the species are located along a gradient dominated by the type of vegetation, and in a lesser degree by the exposure to sun light and apparent water color. These allowed to established group of species a priori, such as those of the subgenus Nyssorhynchus associated to sun light and certain aquatic plants, or the subgenus Anopheles and Sthetomyia, An. squamifemur and Chagasia bonneae associated to shaded environments and lack of vegetation. The results help to understand the relationship of anopheline species with the environment and the importance of variables such s water dynamics, sun light, vegetation and water apparent color to determine its occurrence in the larval habitat.

[Spontaneous speech prosody and discourse analysis in schizophrenia and Fronto Temporal Dementia (FTD) patients]. / Valoración de prosodia espontánea afectiva y análisis de discurso en pacientes con esquizofrenia y demencia frontotemporal (DFT) variante lingüística.

UNLABELLED: Patients with schizophrenia and Frontotemporal Dementia (FTD) in their linguistic variants share some language characteristics such as the lexical access difficulties, disordered speech with disruptions, many pauses, interruptions and reformulations. For the schizophrenia patients it reflects a difficulty of affect expression, while for the FTD patients it reflects a linguistic issue. METHODS: This study, through an analysis of a series of cases assessed Clinic both in memory and on the Mental Health Unit of HUSI-PUJ (Hospital Universitario San Ignacio), with additional language assessment (analysis speech and acoustic analysis), present distinctive features of the DFT in its linguistic variants and schizophrenia that will guide the specialist in finding early markers of a differential diagnosis. RESULTS: In patients with FTD language variants, in 100% of cases there is a difficulty understanding linguistic structure of complex type; and important speech fluency problems. In patients with schizophrenia, there are significant alterations in the expression of the suprasegmental elements of speech, as well as disruptions in discourse. CONCLUSIONS: We present how depth language assessment allows to reassess some of the rules for the speech and prosody analysis of patients with dementia and schizophrenia; we suggest how elements of speech are useful in guiding the diagnosis and correlate functional compromise in everyday psychiatrist's practice.

Fluctuación poblacional y hábitat larval de anofelinos en el municipio Sifontes, estado Bolívar, Venezuela / Population fluctuation and larval habitat of anopheline in the Municipality of Sifontes, Bolivar State, Venezuela

El Municipio Sifontes, ubicado en el noreste del estado Bolívar, Venezuela, constituye uno de los principales focos de malaria del país debido a causas naturales y antrópicas.Durante el decenio 2004-2013, se registró en este municipio un aumento considerable del número de casos, cerrando 2013 con 42.981 casos, 56% de la malaria del país. Con el objeto de describir la dinámica poblacional de las principales especies de anofelinos, en fase pre-adulta, entre septiembre 2002 y diciembre 2003, se hicieron colectas mensuales en cuerpos de agua representativos de los diferentes tipos existentes en el municipio. Anopheles triannulatus Neiva & Pinto sensu lato fue la especie más abundante y ubicua en toda el área de estudio, seguida de An. albitarsis Lynch Arribalzaga s.l., mientras que An. darlingi Root fue encontrada principalmente en lagunas y ríos. La variabilidad estacional en la abundancia larval estuvo condicionada principalmente por la especie de anofelino y el tipo de hábitat que ésta coloniza, de tal forma que el efecto de la lluvia sobre la abundancia de las especies depende de la dinámica hídrica del hábitat larval, si bien en general, la abundancia de larvas tiende a ser mayor durante el periodo de transición lluvia-sequía y sequía. Los resultados de este estudio contribuyen a dilucidar la relación de la dinámica poblacional de los anofelinos con el patrón de lluvias en la región estudiada.

Sifontes Municipality in the north-east of Bolivar State is one of the main malaria foci in Venezuela due to both natural and anthropic factors. Between 2004 and 2013 a significant increase in the number of cases were reported for this region: at the close of 2013, 42.981 cases had been registered representing 56% of the total number of cases reported in the country. Between September 2002 and December 2003 anopheline larvae were collected monthly to study population fluctuations in different habitats representative of the study area. Anopheles triannulatus Neiva & Pinto sensu lato was the most abundant species collected followed by An. albitarsis Lynch Arribalzaga s.l., while An. darlingi Root was mainly found in lagoons and rivers. Seasonal variations in larval abundance were mainly determined by anopheline species and the type of larval habitat exploited by each one. Anopheline species are thus differentially influenced by rainfall according to the water dynamics of their larval habitats, but in general abundance is higher during the transitions between rainfall-drought and the dry season. These results help us to understand the relationships between anopheline population dynamics and rainfall patterns in this region. In addition, they contribute to our basic knowledge of the bio-ecology of anopheline vectors important for the epidemiology, surveillance and control of malaria in Sifontes Municipality.

Inhibidores de dipeptidil dipeptidasa-IV: de la teoría a la práctica / Dipeptidil dipeptidase-IV inhibidors: from the theory to the practice

Esta revisión de los inhibidores de dipeptidil peptidasa-IV busca motivar el uso racional de tal grupo farmacológico en la práctica diaria. Este grupo es una nueva opción terapéutica en monoterapia o terapia combinada para el tratamiento de los pacientes con diabetes mellitus tipo 2. En Colombia, se encuentran disponibles: sitagliptina, vildagliptina, saxagliptina y linagliptina. Si bien todas las gliptinas tienen el mismo mecanismo de acción-aumentan la vida media del péptido similar al glucagón-, esta revisión presenta las diferencias entre sus propiedades farmacológicas, eventos adversos y perfil de seguridad. Estos medicamentos son de segunda o tercera línea para el tratamiento oral de los pacientes con diabetes mellitus tipo 2, o primera línea en los pacientes intolerantes a la metformina. Además, algunas de las ventajas que tienen son que: generan menor riesgo de hipoglucemia, tienen efecto neutro sobre el peso, son seguros en adultos mayores, disminuyen la variabilidad de la glucemia y, adicionalmente, se pueden utilizar en la enfermedad renal crónica avanzada, con o sin terapia de reemplazo renal, y en la insuficiencia hepática.

This review of dipeptidyl peptidase-IV inhibitors seeks to encourage the rational use of these drugs in daily practice; this group is a new therapeutic option in monotherapy or combination therapy for the treatment of patients with diabetes mellitus type 2. Sitagliptin, vildagliptin, saxagliptin and linagliptin are available in Colombia. While all gliptins have the same mechanism of action-they increase the average life of glucagon-like peptide-, this review presents the differences among their pharmacological properties, adverse events and safety profile. These drugs are second or third-line for the oral treatment of patients with diabetes mellitus type 2, or first-line in patients intolerant to metformin. They also have some advantages like lower risk of hypoglycemia, neutral effect on weight, safety for the elderly, reduction of glycaemia variability; additionally, they can be used in advanced chronic kidney disease, with or without renal replacement therapy, and in liver failure.

Valoración de prosodia espontánea afectiva y análisis de discurso en pacientes con esquizofrenia y demencia frontotemporal (DFT) variante lingüística / Spontaneous speech prosody and discourse analysis in schizophrenia and Fronto Temporal Dementia (FTD) patients

La esquizofrenia y la demencia frontotemporal (DFT) variante lingüística comparten características de lenguaje tales como la dificultad para acceder al léxico, la desorganización del discurso con múltiples interrupciones, reformulaciones, pausas y retractaciones. En el caso de los pacientes esquizofrénicos, estas dificultades revelan fallas para expresar el afecto, mientras que en los pacientes con DFT variante lingüística refleja un problema lingüístico. Métodos: El presente estudio, a través de un análisis de una serie de casos valorados tanto en la Clínica de memoria como en la Unidad de Salud Mental del HUSI-PUJ (Hospital Universitario de San Ignacio), con evaluación lingüística adicional (análisis de discurso y análisis acústico), presenta características distintivas de la DFT en sus variantes lingüísticas y la esquizofrenia que permiten guiar al especialista en la búsqueda de marcadores tempranos de un diagnóstico diferencial. Resultados: En el 100%de los pacientes con DFT variante lingüística, hay dificultades para comprender estructuras lingüísticas de tipo complejo e importantes problemas de fluidez del discurso. En los pacientes con esquizofrenia se encuentran importantes alteraciones en la expresión de los elementos suprasegmentales del habla e interrupciones en el discurso. Conclusiones: Se presenta como una evaluación lingüística en profundidad permite revaluar algunas de las modalidades de valoración del discurso y la prosodia de los pacientes con demencia y esquizofrenia; indica que algunos elementos del discurso son útiles para orientar el diagnóstico y correlacionar el deterioro funcional en la cotidianidad de la práctica del psiquiatra.

Patients with schizophrenia and Frontotemporal Dementia (FTD) in their linguistic variants share some language characteristics such as the lexical access difficulties, disordered speech with disruptions, many pauses, interruptions and reformulations. For the schizophrenia patients it reflects a difficulty of affect expression, while for the FTD patients it reflects a linguistic issue. Methods: This study, through an analysis of a series of cases assessed Clinic both in memory and on the Mental Health Unit of HUSI-PUJ (Hospital Universitario San Ignacio), with additional language assessment (analysis speech and acoustic analysis), present distinctive features of the DFT in its linguistic variants and schizophrenia that will guide the specialist in finding early markers of a differential diagnosis. Results: In patients with FTD language variants, in 100% of cases there is a difficulty understanding linguistic structure of complex type; and important speech fluency problems. In patients with schizophrenia, there are significant alterations in the expression of the suprasegmental elements of speech, as well as disruptions in discourse. Conclusions: We present how depth language assessment allows to reassess some of the rules for the speech and prosody analysis of patients with dementia and schizophrenia; we suggest how elements of speech are useful in guiding the diagnosis and correlate functional compromise in everyday psychiatrist's practice.

Evolución espacial y temporal de la malaria en el municipio Sifontes del estado Bolívar, Venezuela. 1980-2013 / Spatial and temporal evolution of malaria in the municipality of Sifontes, Bolívar State, Venezuela. 1980-2013

La malaria es endemo-epidémica en el estado Bolívar, con brotes epidémicos frecuentes debido a causas naturales y antrópicas. En el municipio Sifontes, ubicado en el noreste del estado, durante el último decenio se ha registrado un aumento considerable de los casos, cerrando 2013 con 46.610 casos, 71% % de la malaria del estado y 61% del país. Este es un foco meso-endémico de malaria inestable donde la transmisión ocurre durante todo el año, con brotes epidémicos estrechamente relacionados con la minería aurífera. A partir de 1983, gran parte de la malaria en Venezuela depende de la generada en el estado Bolívar, y esta a su vez de la generada en el municipio Sifontes. La revisión de la data de malaria del estado en el periodo 1980-2013 reveló la existencia de dos niveles epidemiológicos, uno basal y otro adicional, este último ligado a la minería aurífera; sin embargo, no se encontró correlación con la lluvia, para el nivel basal (R = 0,41, P= 0,78) ni para el nivel epidémico (R = 0,41; P = 0,32). Asimismo, la proyección geográfica de los datos reveló la naturaleza focal de la enfermedad en el municipio, el cual reúne todas las condiciones epidemiológicas, ambientales, climáticas y sociales para ser considerado un foco caliente. Las características espaciales y temporales de la malaria en el municipio Sifontes lo configuran como el foco de malaria más importante en Venezuela, el cual debe ser priorizado en los planes de control de la enfermedad.

Malaria is endemo-epidemic in Bolívar state with frequent epidemic outbreaks occurring due to both natural and anthropic factors. The Sifontes municipality, located in the northeastern corner of the state, has reported a considerable increase in the number of cases over the last decade; with 46.610 cases registered during 2013. This represents 71% of the number of malaria cases reported for the state and 61% for the country in this same year. Sifontes municipality is a meso-endemic focus of unstable malaria, and transmission occurs throughout the year with epidemic outbreaks tightly linked to gold mining activities. Since 1988 the increase in the number of cases reported in Venezuela has been determined by the number of cases reported in Bolívar state which, in turn, is correlated with the number of cases reported in Sifontes. A review of malaria data between 1980 and 2013 reveals the existence of two epidemiological categories: a base level and an additional level, the latter associated with gold mining; nevertheless, there was not correlation whit the rainfall for basal (R = 0,41, P= 0,78) or additional level (R = 0,41; P = 0,32). In addition, a geographic plotting of the data revealed the focal nature of malaria in the municipality, which to gather all environmental, climatic, social and epidemiological factors that have produced conditions typical of a hot spot. The spatial and temporal characteristics of malaria in the Sifontes municipality demonstrates that this is the most important malaria focus in Venezuela, and must be prioritized when designing strategies for the control of this disease.

Evaluación preliminar de la eficiencia de Bacillus sphaericus en un área endémica a malaria del estado Bolívar, Venezuela / Preliminary evaluation of the effectiveness of Bacillus sphaericus in an malaria-endemic region in Bolívar state, Venezuela

El municipio Sifontes del estado Bolívar es la principal área endémica a malaria de Venezuela. Durante los cinco años anteriores al estudio se reportaron allí un promedio anual de 14 mil casos, alcanzándose en 2009 la cifra de 19.408, constituyendo una situación de epidemia. En la búsqueda de estrategias alternativas al uso de insecticidas, se evaluó la eficiencia para el control de malaria de una formulación comercial de Bacillus sphaericus Neide (VectoLex® CG 7,5%). Entre mayo 2010 y mayo de 2011 se aplicó biolarvicida con motomochila (Solo®) a dosis de 20-30 kg/ha a frecuencia mensual en todos los criaderos de Anopheles darlingi, An. marajoara y An. nuneztovari ubicados alrededor de las viviendas de cuatro comunidades de la parroquia San Isidro de este municipio, acompañadas de colectas de anofelinos adultos con atrayente humano y trampa de luz CDC y ultravioleta. Después de 48 semanas de aplicación, la reducción de 80% de la malaria en el área, más la reducción de la densidad de larvas en los criaderos, muestran que el biolarvicida es eficiente para controlar malaria. Los resultados también sugieren que la prevalencia de larvas es un buen indicador en un programa de control de vectores basado en la aplicación de biolarvicida, no así la de adultos, cuya abundancia no se corresponde con la de larvas. Es la primera vez que se evalúa la eficiencia de B. sphaericus para controlar malaria en Venezuela, considerándose estos resultados prometedores, si el tratamiento de criaderos con biolarvicida es selectivo y se hace a la cobertura, frecuencia y dosis correctas, e integrado a otras estrategias de control de vectores.

The Sifontes municipality in Bolivar state is the principal malaria-endemic region in Venezuela. During the five years prior to the study an annual average of 14,000 cases was reported reaching an epidemic level of 19,408 cases in 2009. As part of the search for vector control measures that could be used as alternatives to insecticides, a commercial formulation of Bacillus sphaericus Neide (VectoLex® CG 7.5%) was evaluated. Between May 2010 and May 2011 monthly dosages of 20-30 kg/ha of Vectolex were sprayed using a motorized backpack (Solo®) in larval Anopheles darlingi, An. marajoara and An. nuneztovari habitats close to houses in four communities in the parish of San Isidro, Sifontes municipality. In parallel, adult anophelines were captured using human baits, CDC light traps and ultraviolet light traps. After 48 weeks of application there was an 80% reduction in malaria as well as a decrease in larval density demonstrating the effectiveness of B. sphaericus for the control of this disease. Moreover, the results suggest that larval prevalence is good indicator for biolarvicide based malaria control programs whereas the abundance of adults, which does not correlate with larval abundance, is not. This is the first time that the effectiveness of B. sphaericus for malaria control has been evaluated in Venezuela. These results show that spraying larval habitats for malaria control can be effective when integrated with other vector control strategies if the treatment is selective and carried out at the correct frequency and dosage in order to ensure adequate coverage of the larval habitat.

Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population.

INTRODUCTION: This cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal-treated teeth from an urban Colombian population and evaluated the association of several factors with the periradicular status. METHODS: Periapical radiographs were used for analyses, and teeth were classified as healthy or diseased according to the periradicular status. Other factors were also evaluated for their association with the periradicular conditions, including gender, quality of both endodontic treatment and coronal restoration, apical level of filling, and presence of post restoration. RESULTS: Fifty-one percent of the treated teeth were classified as healthy. Only 33% of the teeth had endodontic treatment rated as adequate. The quality of both endodontic treatment and coronal restoration significantly influenced the periradicular conditions (P < .001). Combined data revealed that teeth with both adequate endodontic treatment and adequate restorations showed significantly better periradicular status than the other combinations (P < .01), except for teeth with adequate treatment and inadequate restoration (P = .08). Canals filled up to 0-2 mm short of the apex had a significantly higher number of teeth rated as healthy than overfilled or underfilled cases (P = .02). Regression analysis showed that the quality of endodontic treatment was the most significant factor influencing the periradicular status (P < .001). Gender and presence of post restoration had no association with the periradicular conditions. CONCLUSIONS: Data from this Colombian population showed a relatively high prevalence of apical periodontitis in root canal-treated teeth. This was largely due to an equally high prevalence of treatments performed under substandard technical quality. The quality of the endodontic treatment was the most determinant factor for healthy periradicular status.