14-3-3ε protein-immobilized PCL-HA electrospun scaffolds with enhanced osteogenicity.

Adipose-derived mesenchymal stem cells (ASCs) accelerate the osteointegration of bone grafts and improve the efficiency in the formation of uniform bone tissue, providing a practical and clinically attractive approach in bone tissue regeneration. In this work, the effect of nanofibrous biomimetic matrices composed of poly(ε-caprolactone) (PCL), nanometric hydroxyapatite (nHA) particles and 14-3-3 protein isoform epsilon on the initial stages of human ASCs (hASCs) osteogenic differentiation was investigated. The cells were characterized by flow cytometry and induction to differentiation to adipogenic and osteogenic lineages. The isolated hASCs were induced to differentiate to osteoblasts over all scaffolds, and adhesion and viability of the hASCs were found to be similar. However, the activity of alkaline phosphatase (ALP) as early osteogenic marker in the PCL-nHA/protein scaffold was four times higher than in PCL-nHA and more than five times than the measured in neat PCL.

Exercise prescription in patients with cirrhosis: Recommendations for clinical practice. / Prescripción de ejercicio en pacientes con cirrosis: recomendaciones para la atención clínica.

Exercise in cirrhosis of the liver is an emerging topic in hepatology. Despite the known benefits of exercise in the general population, there are currently few studies addressing that issue in relation to cirrhosis and more evidence is still needed. Even though some studies have reported an acute, exercise-induced increase in the hepatic venous pressure gradient (HVPG), the opposite (a decrease in the HVPG) has been shown by recent data after an exercise program carried out for>14 weeks. In addition to that benefit, improvement has been described in the metabolic profile, quality of life, muscle mass, cardiopulmonary function, and nutritional status. Together, those features make exercise in cirrhosis a very attractive intervention. However, certain aspects must be taken into account before prescribing exercise in that population and they include cardiovascular risk, musculoskeletal disorders, and complications related to cirrhosis. After considering those factors, an individually tailored exercise program should be developed for each patient, according to the points stated above and the desired goal. Information about exercise-limiting factors, type of exercise prescribed, monitoring methods, and concomitant nutritional therapy is provided in the present review.

The role of emulsion parameters in tramadol sustained-release from electrospun mats.

Tramadol is an analgesic usually prescribed for the management of pain, with a certain risk of addiction in chronic patients. The incorporation of tramadol in sustained-release systems results particularly attractive for the administration of accurate doses. In this work, emulsion electrospinning was used for the preparation of tramadol-loaded nanofibrous membranes based on poly(ε-caprolactone). Compositional and processing parameters were screened and evaluated in terms of the morphology of the resulting nanofibers, encapsulation efficiency and drug release in time. The polymer concentration, surfactant type and amount, and the homogenization rate used for the emulsions preparation were found to greatly affect the fluid stability and the resulting materials structure and functionality. The intrinsic features of the starting fluid studied in this work played a significant role for the modulation of tramadol release from nanofibrous matrices. The use of sodium dodecyl sulfate as surfactant with an optimal homogenization rate allowed the preparation of electrospun fibrous membranes with good encapsulation efficiency, a minimal burst release and a sustained delivery of tramadol in time.

Dietary management and supplementation with branched-chain amino acids in cirrhosis of the liver. / Manejo dietético y suplementación con aminoácidos de cadena ramificada en cirrosis hepática.

One of the most important characteristics of malnutrition is the loss of muscle mass and the severe depletion of the protein reserve, secondarily affecting energy metabolism. That impacts nutritional status and the progression of disease-related complications. Nutritional treatment is one of the main factors in the comprehensive management of those patients. Achieving adequate energy intake that provides the macronutrients and micronutrients necessary to prevent or correct malnutrition is attempted through dietary measures. ESPEN, the European Society for Clinical Nutrition and Metabolism, recommends a caloric intake of 30-40kcal/kg/day, in which carbohydrates provide 45-60% of the daily energy intake and proteins supply 1.0-1.5g/kg/day. The remaining portion of the total energy expenditure should be covered by lipids. The administration of branched-chain amino acids has been shown to be beneficial not only in counteracting malnutrition, but also as a coadjuvant treatment in specific complications, thus playing a favorable role in outcome and quality of life. Therefore, branched-chain amino acids should be considered part of nutritional treatment in patients with advanced stages of cirrhosis of the liver, particularly in the presence of complications.

Hiperplasia epitelial nodular no cólon de felinos associada à estrongiloidose na região amazônica, pará, brasil / colonic epithelial nodular hyperplasia associated with strongyloidosis in cats in the amazon region, pará, brazil

Strongyloides spp. é um parasito intestinal que afeta diversas espécies animais. Quatro espécies desse gênero têm sido descritas em felinos domésticos: S. felis, S. planiceps, S. stercoralis e S. tumefaciens . Nas três primeiras espécies o adulto é encontrado no intestino delgado. Já os adultos de S. tumefaciens são encontrados em nódulos no intestino grosso. Contudo não foram encontrados relatos dessa espécie no Brasil. Há apenas relatos de infecção por S. stercoralis em gatos domésticos nesse país. O objetivo desse trabalho é descrever os aspectos patológicos do parasitismo por Strongyloides spp. em dois gatos da região amazônica, no estado do Pará. Os dois felinos foram encaminhados para necropsia, onde foram observados numerosos nódulos esbranquiçados no intestino grosso, medindo cerca de 0,2 cm de diâmetro. Os nódulos eram salientes na mucosa do cólon e continham um orifício puntiforme central voltado para o lúmen. Na microscopia os nódulos eram constituídos por projeções do epitélio da mu

HIPERPLASIA EPITELIAL NODULAR NO CÓLON DE FELINOS ASSOCIADA À ESTRONGILOIDOSE NA REGIÃO AMAZÔNICA, PARÁ, BRASIL / COLONIC EPITHELIAL NODULAR HYPERPLASIA ASSOCIATED WITH STRONGYLOIDOSIS IN CATS IN THE AMAZON REGION, PARÁ, BRAZIL

Strongyloides spp. é um parasito intestinal que afeta diversas espécies animais. Quatro espécies desse gênero têm sido descritas em felinos domésticos: S. felis, S. planiceps, S. stercoralis e S. tumefaciens . Nas três primeiras espécies o adulto é encontrado no intestino delgado. Já os adultos de S. tumefaciens são encontrados em nódulos no intestino grosso. Contudo não foram encontrados relatos dessa espécie no Brasil. Há apenas relatos de infecção por S. stercoralis em gatos domésticos nesse país. O objetivo desse trabalho é descrever os aspectos patológicos do parasitismo por Strongyloides spp. em dois gatos da região amazônica, no estado do Pará. Os dois felinos foram encaminhados para necropsia, onde foram observados numerosos nódulos esbranquiçados no intestino grosso, medindo cerca de 0,2 cm de diâmetro. Os nódulos eram salientes na mucosa do cólon e continham um orifício puntiforme central voltado para o lúmen. Na microscopia os nódulos eram constituídos por projeções do epitélio da mu

Maltrato juvenil en discapacitados intelectuales, su relación con la comorbilidad psiquiátrica / Juvenile abuse in intellectual disability, its relationship with psychiatric co-morbidities

Children and teenagers with intellectual disability are a complex issue within the society and for the medical practice. Determining the more frequent forms of abuse, it's behaving in this particular population, and to evaluate the possible relationship between juvenile abuse and psychiatric co-morbidities were the main objectives in this investigation. 99 people with intellectual disability between 5 and 17 year old from three different communities (Felicia, Cocosol and Belen) located at Marianao municipality were selected by monoetapic conglomerate and studied firstly trough an analytic study with transversal cut seconded by a differentiated intervention according with the results. Taking into account the sociopsychiatric history, the psychiatric examination, using strictest observational techniques of the patient at home and the school, and applying the tools for diagnosis of infant abuse in this people, we concluded that juvenile abuse was a serious health problem in the studied population: negligence and carelessness the main types. The relationship between infant abuse and psychiatric co-morbities was demonstrated.

La condición de discapacidad intelectual convierte a niños y adolescentes en población de alta complejidad en la medicina. Determinar comportamiento y formas más frecuentes del maltrato en esta población, así como evaluar la relación entre maltrato infantil y comorbilidad psiquíatrica, fueron los objetivos fundamentales de esta investigación. Para ello se estudió una muestra de 99 pacientes discapacitados intelectuales en edades comprendidas entre 5 y 17 años de tres consejos populares (Felicia, Cocosol y Belén) del municipio Marianao, seleccionados por conglomerado monoetápico. Se realizó un estudio analítico de corte transversal en un primer momento, con intervención diferenciada según los resultados en un segundo momento. Mediante la historia socialpsiquíatrica, examen psiquiátrico, empleo de técnicas observacionales rigurosas del paciente en la casa y escuela y aplicación de instrumento para el diagnóstico de maltrato infantil en este tipo de población. Concluimos que el maltrato infantil fue un problema de salud en la muestra estudiada; el maltrato por negligencia o descuido fueron los más frecuentes. Se comprobó estrecha relación entre la existencia de maltrato infantil y comorbilidad psiquiátrica en los pacientes estudiados.

[Late splenic rupture: a risk of conservative treatment]. / Rotura tardía del bazo: un riesgo del tratamiento conservador.

We report a 33 year old male admitted after a traffic accident with a painful abdomen and an open ankle fracture. An abdominal CAT scan showed a splenic laceration and free ascites. A conservative treatment was decided considering that the patient was hemodynamically stabilized. Seven days later, the patient appeared hypotense and with severe pain and was operated. During surgical intervention, a massive hemoperitoneum due to splenic bleeding from the spleen was found and a splenectomy was performed. Postoperative outcome was uneventful. The therapeutic approach to splenic traumatism ranges from splenectomy to medical treatment. The report case is an example of a complication of this later approach.

Cerebro e cognicao

Com base nos principios da neuropsicologia, os autores discutem alguns vinculos que marcam a interface entre a atividade neuronal e a atividade mental. Para essa area do conhecimento, a atividade mental representa o grau mais elevado de refinamento dos circuitos neuronais do cerebro. Cabe lembrar que ambos, cerebro e mente, constituem sistemas autonomos e abertos e, ao mesmo tempo, interdependentes; eles nao subsistiriam senao mediante a reciprocidade dos seus processos. A natureza dessa interacao foi estabelecendo-se ao longo da evolucao biologica, social e psiquica do homem e revela-se particularmente atraves da producao cognitiva.

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

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

Establecimiento en Cuba de la técnica de fertilización in vitro (FIV) y transferencia embrionaria (TE): informe preliminar / Establishment in Cuba of fertilization in vitro technique (FIV) and embryo transference (ET): preliminary report

La infertilidad constituye un serio problema de salud al nivel mundial con repercusiones psicosociales de extrema importancia. La fertilización in vitro y transferrencia embrionaria es considerada actualmente el tratamiento de elección en gran parte de las causas de infertilidad masculina y femenina. Se estableció en nuestro país el primer Programa de este tipo y se logró el primer éxito a los 10 meses de comenzado el trabajo. Hasta el presente se han obtenido 8 embarazos, de los cuales hay 3 nacimientos, 1 embarazo en curso, 1 ectópico y 3 abortos espontáneos tempranos. La tasa de embarazo es de 12,3

Análisis evaluación del mantenimiento hospitalario en el área de equipamiento. Hospitales San Juan de Dios(Oruro) Clinicas de Niños(La Paz) e Institucional del Torax (La Paz) / Analysis evaluation of the hospital maintenance in the defendant of equipment. Hospitals san Juan of DIos (ORURO Clinics of Niños (La Paz) and Institutional of the Thorax (La Paz)

El objetivo general es contar con uan información veridica sobre la situación de los servicios de mantenimiento en cada establecimiento de Salud; así como establecer las condiciones en la que se halla el equipamiento en sus diferentes servicios.

Funcionamiento de un sistema de información epidemiológica a nivel distrital / Functioning of an epidemiologic information system at district level

Siendo el sistema de información epidemiológica el que se encarga de recolectar y procesar todos aquellos hechos que de una u otra forma tienen influencia en el estudio del fenómeno salud-enfermedad, se dan las pautas para que la recolección de información se haga en forma óptima