Partial-accelerated irradiation with stereotactic radiotherapy at a dose of 30 Gy in 5 fractions in early breast cancer.

PURPOSE: To evaluate feasibility of accelerated partial breast irradiation (APBI) using stereotactic radiotherapy (SBRT) Thirty Gy delivered in 5 fractions for patients with early breast cancer. METHODS: Between January 1st, 2018, and December 31s, 2022, we conducted 117 treatments for patients with early-stage breast cancer. All patients underwent conservative surgery followed by APBI using stereotactic external beam radiotherapy. We analyzed local, regional, distant control, overall survival, toxicity, and cosmetic outcomes. RESULTS: The average age was 62 years. 21.3% ductal and 78.7% invasive carcinomas. Regarding the PTV volume, the median was 198.8 cc (38-794 cc). Treatments were completed in all cases. The median follow-up period was of 21 months (1-62 months). Regarding acute toxicity, no Grade 3-4 toxicities were recorded. One patient experienced Grade 2 neuropathic pain. One patient developed subacute fibrosis and two patients developed telangiectasia as subacute and chronic toxicity. Cosmetic results were "good" or "very good" in 96.3% of cases. None of the patients relapsed at any level (local, regional, or distant) and overall survival during follow.up was 100%. CONCLUSION: APBI with SBRT 30 Gy in 5 fractions in early-stage breast cancer is a feasible technique, very-well tolerated and has excellent oncologic and cosmetic outcome during our follow-up period.

High depressive symptomatology reduces emotional reactions to pictures of social interaction.

Individuals with severe depressive symptoms present diminished facial expressions compared to healthy individuals. This reduced facial expression, which occurs in most depressive patients could impair social relationships. The current study sought to investigate whether pictures with social interaction cues could elicit different modulations of facial expressions and mood states in individuals with depressive symptoms compared to healthy individuals. A total of 85 individuals were divided into depressive and non-depressive groups based on their beck depression inventory scores. Participants viewed pictures containing neutral (objects), affiliative (people interacting socially), and control (people not interacting) scenes. Electromyographic signals were collected during the entire period of visualization of the blocks, and emotional questionnaires were evaluated after each block to assess sociability and altruism (prosocial states). In non-depressed individuals, affiliative pictures increased the activity of the zygomatic muscle compared to both neutral and control pictures and reduced fear of rejection compared to neutral pictures. During the visualization of the affiliative block, zygomatic major muscle activation was higher and fear of rejection was lower in the non-depressive individuals than in the depressive. These effects reflected the low expressions of smiling and sociability to affiliative pictures in depressive individuals. These findings highlight the importance of smiling and prosocial states in social interactions, especially in these individuals.

Familiarity Processing through Faces and Names: Insights from Multivoxel Pattern Analysis.

The way our brain processes personal familiarity is still debatable. We used searchlight multivoxel pattern analysis (MVPA) to identify areas where local fMRI patterns could contribute to familiarity detection for both faces and name categories. Significantly, we identified cortical areas in frontal, temporal, cingulate, and insular areas, where it is possible to accurately cross-classify familiar stimuli from one category using a classifier trained with the stimulus from the other (i.e., abstract familiarity) based on local fMRI patterns. We also discovered several areas in the fusiform gyrus, frontal, and temporal regions-primarily lateralized to the right hemisphere-supporting the classification of familiar faces but failing to do so for names. Also, responses to familiar names (compared to unfamiliar names) consistently showed less activation strength than responses to familiar faces (compared to unfamiliar faces). The results evinced a set of abstract familiarity areas (independent of the stimulus type) and regions specifically related only to face familiarity, contributing to recognizing familiar individuals.

Intestinal parasitosis in children from a rural Caribbean area in Colombia / Parasitosis intestinal en niños de una zona rural del Caribe de Colombia

Abstract In Colombia, the prevalence of intestinal parasitosis varies throughout its regions, social classes, and living conditions. We performed a cohort study (2017-2018) on children from 1-10 years old in El Cedro, Ayapel, Colombia. We tested a convenience sampling of those who accepted and signed the consent form. The National Intestinal Parasite Survey was applied; feces and water source sampling were tested for coprological and microbiology analysis, respectively. Education and pharmacologic treatment to the minor and co-inhabitants were performed. After the recruiting, we followed up at 7 and 12 months. Statistical analysis was performed using IBM® SPSS22. Participants 47, 61,7% male, average age 5,7 years. The caretakers had a low educational background. The monthly income of 72,3% of households was < USD 87. The coprological test showed 61,7% with at least one type of parasite; 32,2% with two or more. Trichuris trichiura was the most frequent. Water sources were positive for Escherichia coli. The population tested showed a high frequency of parasitic infection. We did not find a reduction of intestinal parasitosis with educa tion and pharmacologic treatment at the end of the follow-up. It must be necessary to impact social determinants of public health to achieve intestinal parasitosis control.

Resumen En Colombia, la prevalencia de parasitosis intestinal varía por regiones, clases sociales, condiciones de vida. Realizamos estudio de cohorte (2017-2018) en niños de 1-10 años en El Cedro, Ayapel, Colombia. Muestra por conveniencia, se incluyeron aquellos que aceptaron y firmaron el consentimiento. Se aplicó la Encuesta Nacional de Parásitos Intestinales; se analizaron muestras de heces y fuentes de agua para análisis coprológico y microbiológico, respectivamente. Se realizó educación y tratamiento farmacológico al menor y cohabitantes. Después del reclutamiento, seguimiento a los 7 y 12 meses. El análisis estadístico se realizó con IBM® SPSS22. Participantes 47, 61,7% hombres, promedio de edad 5,7 años. Cuidadores con bajo nivel educativo, ingreso mensual del 72,3% de los hogares fue <USD 87. La población analizada mostró una alta frecuencia de infección parasitaria, un 61,7% con al menos un tipo de parásito; 32,2% con dos o más. Trichuris trichiura fue el más frecuente. Las fuentes de agua fueron positivas para Escherichia coli. Al final del seguimiento, no se redujo la frecuencia de la parasitosis intestinal a pesar de educación y tratamiento farmacológico. Se requiere incidir en los determinantes sociales y de salud pública para lograr el control de las parasitosis intestinales.

From Dresden to the world: images of the German Hygiene Museum's relations with Latin America, 1911-1933.

As of the nineteenth century, the number of world fairs and hygiene exhibitions grew significantly. This phenomenon was linked to the experience of modernity and the emergence of bacteriology, when different cities were sanitized with the aim of combating urban diseases and epidemics. For the purpose of sanitary education and hygiene propaganda, many objects and pictures were displayed in hygiene exhibitions and museums, such as the International Hygiene Exhibition of 1911 and the German Hygiene Museum, both in Dresden. The goal of this article is to analyze a chapter of the international history of health through images that portray the connections between the German Hygiene Museum and Latin American countries between 1911 and 1933.

From Dresden to the world: images of the German Hygiene Museum's relations with Latin America, 1911-1933 / De Dresden para o mundo: imagens das relações do Museu Alemão de Higiene com a América Latina, 1911-1933

Abstract As of the nineteenth century, the number of world fairs and hygiene exhibitions grew significantly. This phenomenon was linked to the experience of modernity and the emergence of bacteriology, when different cities were sanitized with the aim of combating urban diseases and epidemics. For the purpose of sanitary education and hygiene propaganda, many objects and pictures were displayed in hygiene exhibitions and museums, such as the International Hygiene Exhibition of 1911 and the German Hygiene Museum, both in Dresden. The goal of this article is to analyze a chapter of the international history of health through images that portray the connections between the German Hygiene Museum and Latin American countries between 1911 and 1933.

Resumo A partir do século XIX, o número de exposições universais e de exposições de higiene cresceu significativamente. Esse fenômeno estava ligado à experiência da modernidade e ao surgimento da bacteriologia, quando diferentes cidades foram higienizadas com o objetivo de combater doenças e epidemias urbanas. Visando à educação sanitária e à propaganda da higiene, inúmeros objetos e imagens foram exibidos em exposições e museus de higiene, como na Exposição Internacional de Higiene de 1911 e no Museu Alemão de Higiene, ambos em Dresden. O objetivo deste artigo é analisar um capítulo da história internacional da saúde por meio de imagens que retratam as conexões entre o Museu Alemão de Higiene e os países latino-americanos de 1911 a 1933.

[Prevalence of anogenital condylomas in patients with HIV infection in a center for sexually transmitted infections in Leon, Guanajuato, Mexico]. / Prevalencia de condilomas ano-genitales en pacientes con infección por VIH en un centro para infecciones de transmisión sexual en León, Guanajuato, México.

BACKGROUND: Condylomas are the most frequent sexually transmitted infection worldwide, and thus, have a close relation to HIV infection. The site and serology vary, and some pose higher risk of malignancy. AIM: To describe the prevalence, characteristics and associated factors to the presence of anogenital condylomas in patients with HIV/AIDS. METHODS: Descriptive cross-sectional study conducted in the period from June to December 2014. Adult HIV/AIDS positive patients from "CAPASITS" in Leon, Mexico, from both sexes were included. A questionnaire was performed that included: identification data, and risk factors related to anogenital condylomas. Anogenital area was examined for condylomas. Descriptive statistics were carried out according to the type and distribution of the variables, and the CD4 lymphocyte medians of patients with and without condylomas were compared using U- Mann-Whitney test. RESULTS: A total of 213 HIV/AIDS patients were included; 181 (85%) were male. The prevalence of anogenital condylomas was 30% (IC95%: 23-36%), predominating in the anal region, observed in 21% of the cases. A significant difference was found between median CD4 cell count of patients with and without condylomas (425 vs 510 CD4/mL, p= 0.034). CONCLUSION: A high prevalence of patients with anogenital condylomas was obtained. The presence of condylomas was higher in patients with lower CD4 count. Considering the high prevalence, the application of the vaccine is recommended in this patient group.

Revisión, diseño y construcción de un instrumento de medición para evaluar las competencias laborales del personal farmacéutico ambulatorio / Review, design, and construction of a measuring instrument to assess the labor competencies of outpatient pharmacy staff

Resumen Introducción: La medición y evaluación de las competencias laborales, en el personal farmacéutico ambulatorio, debe combinar aspectos relacionados con los conocimientos (que sabe), habilidades (como lo hace) y actitudes (de que modo lo hace). Objetivo: Identificar y seleccionar las directrices y recomendaciones sobre las competencias laborales que requiere el personal farmacéutico ambulatorio, y construir un instrumento para su medición. Métodos: Se realizó una revisión estructurada en dos fases: a) se revisaron y seleccionaron las funciones/dominios, los criterios de desempeño (habilidades y actitudes), los conocimientos, los marcos de competencias establecidas a nivel internacional, y los instrumentos de medición reportados en la literatura; y b) se identificaron las competencias laborales necesarias de acuerdo con la normatividad colombiana y con los procesos de los Establecimientos Farmacéuticos ambulatorios (droguerías y farmacias-droguerías). Finalmente, se construyó el instrumento de medición por un panel de expertos. Resultados: Se identificaron las competencias laborales establecidas por las organizaciones de regulación internacional. Se revisaron 993 artículos que reportaban la medición y evaluación de las competencias, seleccionándose y analizándose 9 referencias. Se analizaron los marcos de competencias de diferentes países. Se analizaron las regulaciones en Colombia sobre el tema. El instrumento construido contiene 101 competencias distribuidas en los siguientes componentes: a) suministro de cuidados al paciente; b) personales; c) solución de problemas; y d) gestión y organización. Conclusión: Directrices y recomendaciones internacionales, además, la normatividad colombiana para identificar las competencias laborales que requiere el personal farmacéutico para el correcto funcionamiento de los Establecimientos Farmacéuticos ambulatorios, y partir de esto, se construye un instrumento de medición para evaluarlas.

Abstract Introduction: The measurement and evaluation of labor competencies, in outpatient pharmacy staff, must combine aspects related to knowledge (who knows), skills (as it does) and attitudes (in what way it does). Objective: Identify and select the guidelines and recommendations on labor competencies required by outpatient pharmacy staff and build an instrument for their measurement. Methodology: A structured review was carried out in two phases: a) the functions/ domains, performance criteria (skills and attitudes), knowledge, competency frameworks established internationally, and measurement instruments reported were reviewed and selected in the literature; and b) the necessary labor competencies were identified in accordance with Colombian regulations and with the processes of the outpatient Pharmaceutical Establishments (drugstores and pharmacies-drugstores). Finally, the measuring instrument was built by a panel of experts. Results: Labor competencies established by international regulation organizations. were identified. A total of 993 articles were reviewed that reported the measurement and evaluation of competencies, selecting and analyzing 9 references. Competency frameworks from different countries were analyzed. The regulations in Colombia on the subject were analyzed. The constructed instrument contains 101 competencies distributed in the following components: a) provision of patient care; b) personal; c) troubleshooting; and d) management and organization. Conclusion: The international guidelines and recommendations were reviewed and analyzed, in addition, the Colombian regulations to identify the labor competencies required by the pharmacy staff for the correct functioning of the outpatient Pharmaceutical Establishments, and from this, an instrument was built of measurement to evaluate them.

Prevalencia de condilomas ano-genitales en pacientes con infección por VIH en un centro para infecciones de transmisión sexual en León, Guanajuato, México / Prevalence of anogenital condylomas in patients with HIV infection in a center for sexually transmitted infections in Leon, Guanajuato, Mexico

INTRODUCCIÓN: Los condilomas son la infección de transmisión sexual más frecuente en el mundo y tiene estrecha relación con la infección por VIH. La topografía y la serología son variables, y algunos presentan mayor riesgo de malignización. OBJETIVO: Describir la prevalencia, características clínicas, topográficas y factores asociados a la presencia de condilomas ano-genitales en pacientes con infección por VIH/SIDA en Guanajuato. MATERIAL Y MÉTODOS: Estudio descriptivo y transversal realizado entre junio y diciembre de 2014. Se incluyeron pacientes adultos con infección por VIH/SIDA, de ambos sexos, del CAPASITS León, México. Se aplicó un cuestionario que incluyó: datos de identificación, y factores de riesgo relacionados a los condilomas ano-genitales, y se les revisó dicha región corporal en busca de condilomas. Se realizó estadística descriptiva de acuerdo al tipo y distribución de las variables y se compararon las medianas de linfocitos T CD4 (LTCD4+) de los pacientes, con y sin condilomas, con la prueba U- Mann-Whitney. RESULTADOS: Se incluyeron 213 pacientes con infección por VIH/SIDA, 181 (85%) hombres. La prevalencia de condilomas ano-genitales fue de 30% (IC95%:23-36%), con mayor frecuencia en la región anal, con 21% de los casos. Encontramos una diferencia significativa entre las medianas en el recuento de linfocitos LTCD4+ en los pacientes, con y sin condilomas, (425 vs 510 LTCD4+/mL, p = 0,034). CONCLUSIONES: Se obtuvo una prevalencia alta de pacientes con condilomas ano-genitales. La presencia de condilomas fue mayor en pacientes con menor recuento de linfocitos LTCD4+. Considerando la elevada prevalencia, se recomienda la aplicación de la vacuna en este grupo de pacientes.

BACKGROUND: Condylomas are the most frequent sexually transmitted infection worldwide, and thus, have a close relation to HIV infection. The site and serology vary, and some pose higher risk of malignancy. AIM: To describe the prevalence, characteristics and associated factors to the presence of anogenital condylomas in patients with HIV/AIDS. METHODS: Descriptive cross-sectional study conducted in the period from June to December 2014. Adult HIV/AIDS positive patients from "CAPASITS" in Leon, Mexico, from both sexes were included. A questionnaire was performed that included: identification data, and risk factors related to anogenital condylomas. Anogenital area was examined for condylomas. Descriptive statistics were carried out according to the type and distribution of the variables, and the CD4 lymphocyte medians of patients with and without condylomas were compared using U- Mann-Whitney test. RESULTS: A total of 213 HIV/AIDS patients were included; 181 (85%) were male. The prevalence of anogenital condylomas was 30% (IC95%: 23-36%), predominating in the anal region, observed in 21% of the cases. A significant difference was found between median CD4 cell count of patients with and without condylomas (425 vs 510 CD4/mL, p= 0.034). CONCLUSION: A high prevalence of patients with anogenital condylomas was obtained. The presence of condylomas was higher in patients with lower CD4 count. Considering the high prevalence, the application of the vaccine is recommended in this patient group.

Morbimortalidad asociada a la disfagia en pacientes ingresados en un hospital general universitario

RESUMEN Introducción: La disfagia tiene una morbimortalidad importante en pacientes hospitalizados. Objetivos: principal; describir las características de los pacientes con disfagia hospitalizados y, secundarios; cuantificar y analizar la prevalencia de mortalidad y de reingresos. Metodología: Estudio transversal descriptivo de las hospitalizaciones por disfagia durante el año 2015 en un Hospital General Universitario. Resultados: Se evaluaron 431 historias clínicas. La edad de los pacientes fue de 83,21 (DE 11,4) años, el 52,5% fueron mujeres y el 47,2% varones; la estancia media fue de 11,1 (DE 7,99) días. En el 71,2 % de los casos la disfagia fue por afectación de la fase orofaríngea. En el 80,51% de los casos se diagnosticaron complicaciones respiratorias: 48,12% neumonía aspirativa por líquidos, 40,05 % neumonitis química por aspiración y 11,81% neumonía aspirativa por sólidos. La mortalidad general asociada a las complicaciones respiratorias respecto del total de los casos de disfagia fue del 24,49%. El 50,48% de los pacientes con neumonía aspirativa fallecieron. La principal causa de la disfagia fue las enfermedades neurológicas (un 77,25%). La mortalidad fue significativamente mayor en las mujeres - 42,3% frente al 7,8% - (p < 0,01) y esta diferencia se mantuvo tras ajustar el resultado por edad: OR 9,937, IC95%: 5,446; 18,131. El 13,10% de los pacientes reingresaron al menos en una ocasión. Los pacientes de geriatría presentaron un mayor número de reingresos por número de ingresos. Discusión: las enfermedades neurológicas fueron la principal causa de disfagia. La mortalidad fue significativamente mayor en las mujeres.

ABSTRACT Introduction: Dysphagia is an important associated morbidity and mortality in hospitalized patient. Objectives: Main; to describe the characteristics of patients admitted for dysphagia and secondary; quantify and analyze the prevalence of mortality and readmissions. Methodology: Cross-sectional study descriptive revenues by dysphagia during the year 2015 in a University General Hospital. Results: 431 records were evaluated. The age of the patients was 83,21 (11.4), 52.5% women and 47.2% male; the average stay was 11.1 (7.99) days. In 71,2% of cases the dysphagia was involvement of the oropharyngeal phase. 80.51% of cases were diagnosed respiratory complications. The percentage distribution of these complications were: in 48.12% aspiration pneumonia due to fluids, in 40.05% chemical aspiration pneumonitis and in 11.81% aspiration pneumonia due to solids. The overall mortality associated with respiratory complications compared to the total of cases of dysphagia was 24.49%. 50.48% of patients diagnosed with aspiration pneumonia died. The main cause of dysphagia was neurological diseases (77.25%). Mortality was significantly higher in women - 42.3% of women compared with 7.8% of males - (p < 0.01) and this difference remained after adjusting the result by age: OR 9,937, 95% CI: 5,446; 18,131. 13.10% of patients re-entered at least on one occasion. Patients of geriatric unit that presented in greater number of readmissions by admissions. Discussion: neurological diseases were the main cause of dysphagia. Mortality was significantly higher in women

Errores de medicación en pacientes pediátricos en un hospital universitario en Medellín Colombia, un estudio de corte transversal / Medication errors in pediatric patients in an academic hospital in Medellin Colombia. A cross-sectional study

Resumen Introducción: Una tercera parte de los Errores en la atención en salud se ha relacionado a Errores de medicación; con una incidencia 3 veces mayor en pediatría con respecto a los pacientes adultos. Una estrategia recomendada para mejorar la gestión describe adoptar un sistema de notificación que permita la detección, identificación de causas e implementación de acciones enfocadas a la prevención. Objetivo: Determinar la prevalencia y caracterizar los errores de medicación en el servicio de pediatría reportados en el Sistema de notificación y gestión de riesgo clínico de un hospital universitario entre el 2017 y 2018. Metodología: Estudio de corte transversal. Se cuantificó la proporción de errores de medicación en el servicio de pediatría a partir de un informe del Sistema de notificación de riesgo clínico entre el año 2017 y 2018. Los errores de medicación se clasificaron por proceso de ocurrencia, tipo de error, subgrupo y gravedad. Para el análisis se utilizó estadística descriptiva. Resultados: Se generaron 669 reportes de eventos adversos, 376 (56,20%) estaban relacionados con medicamentos. La tasa calculada de errores fue 7,71 por cada 1000 paciente-días. La mayoría de los errores de medicación se clasificaron como Error sin daño (categoría B y C), 176 ambas subcategorías (352 total) para un 93,62% del total de errores. El proceso de prescripción reportó la mayoría de los errores 59,84%. Conclusiones: La mayoría de los errores de medicación reportados se relacionaron con la prescripción, clasificándose principalmente como errores sin daño. MÉD.UIS.2020;33(2):33-40.

Abstract Introduction: A third of medical errors has been related to medication errors. In the pediatric population, an incidence of medication errors 3 times higher compared to adults has been described. A recommended strategy to improve medication errors risk management describes the adoption of a notification system that allows detection, identification of causes and the implementation of activities focused on prevention. Objective: To determine the prevalence and to characterize medication errors in the pediatric service reported in the clinical risk management and notification system of an academic hospital in 2017 and 2018. Methodology: Cross-sectional study. The proportion of medication errors in the pediatric department was quantified from a report of the Clinical Risk notification System for 2017 and 2018. Medication errors were grouped according to process, type of error, subgroup and gravity. Descriptive statistics were used for the analysis. Outcomes: 669 reports of adverse events were generated in the pediatric service, 376 (56,20%) were related to medications. The error rate was 7,71 per-1000 patient days. Most of the errors were classified as Error without damage (category B and C), 176 both subcategories (total 352), representing 93,62 % of the total of errors. The prescription process was the one that most reported errors 59,84%. Conclusions: Most of the reported medication errors were related to the prescription. The main were classified in the errors without damage category. MÉD.UIS.2020;33(2):33-40.

Combustibles, comportamiento del fuego y emisiones en un pastizal y una sabana artificiales en Chiapas, México / Forest fuels, fire behavior and emissions in artificial grasslands and savannas in Chiapas, Mexico

Introducción: Se utilizan quemas como parte del manejo de pastos introducidos en Chiapas, lo cual puede derivar en incendios forestales. Objetivos: obtener la carga de combustibles, comportamiento del fuego, emisiones de CO2 y derivar aspectos de seguridad durante el combate de incendios en pastizales y sabanas artificiales de pasto jaragua (Hyparrhenia rufa Nees.), debido a la falta de información sobre estos temas. Métodos: Se estudiaron un pastizal y una sabana, ambos de pasto jaragua, en las comunidades California y Flores Magón, respectivamente, en la Reserva de la Biosfera La Sepultura. Se midieron cargas de combustibles previos y posteriores a las quemas. Se condujeron seis quemas prescritas (tres a favor de viento y pendiente y tres en contra), en cada uno de los dos tipos de vegetación analizados, y se midieron variables meteorológicas, así como variables de comportamiento del fuego. Las emisiones se estimaron multiplicando la carga de combustibles consumida por una constante de emisión. Resultados: En el pastizal las medias fueron: carga inicial, 6.214 t/ha; carga residual, 0.107 t/ha, emisión de CO2, 10.449 t/ha. Para la sabana, los valores alcanzaron: 14.119, 2.161 y 20.460 t/ha, respectivamente, sin diferencias para las cargas previas y posteriores a la quema entre las quemas. Para el pastizal, las quemas a favor alcanzaron: 3.92 m, 1.83 m y 22.3 m/min para longitud y profundidad de llama y velocidad de propagación, mientras que tales valores para las quemas en contra, fueron: 1.07 m, 0.23 m y 0.67 m/min, con diferencias entre tipos de quema. Para la sabana, las quemas a favor alcanzaron 5.89 m (longitud de llama), 1.53 m (profundidad de llama) y 45.5 m/min (velocidad de propagación), mientras que para las quemas en contra tales valores fueron: 2.21 m, 0.76 m y 2.8 m/min, respectivamente. En todos los casos se reportan diferencias significativas. Conclusiones: El comportamiento del fuego, en particular en la sabana estudiada, es peligroso, por lo cual una buena prescripción y mucha precaución deben preverse durante quemas controladas o prescritas. Asimismo, un combate directo por el frente del fuego puede resultar muy peligroso, por lo cual debe evitarse y mejor combatir por la cola del incendio y esperar a que el frente avance en contra del viento y pendiente para combatirlo.

Introduction: Burns are part of the management of introduced grasses in Chiapas, Mexico, and this may derive in forest fires. Objectives: To determine fuel load, fire behavior, CO2 emissions, and to get fire-fighting security issues for jaragua (Hyparrhenia rufa Nees.) grasslands and savannas. Methods: An artificial jaragua grassland and an artificial jaragua savanna were studied at the California and Flores Magón communities, respectively, in La Sepultura Biosphere Reserve. Were measured pre and post-fire fuel loads. Six prescribed burns (three heading and three backing fires) were conducted in each, grassland and savanna, and were measured meteorological as well as fire behavior variables. Emissions were estimated multiplying the consumed fuel load by an emission constant. Results: In the grassland, were obtained the following averages: fuel load, 6.214 t/ha; residual load, 0.107 t/ha, and CO2 emission, 10.449 t CO2/ha. For the savanna, were recorded 14.119, 2.161 and 20.460 t CO2/ha, respectively, without differences for the pre and post-fire fuel loads between heading and backing fires. For the grassland, the heading fires reached 3.92 m, 1.83 m and 22.3 m/min for flame length, flame depth and fire propagation rate, while for backing fires such values were, respectively: 1.07, 0.23 and 0.67 m/min, with significant differences. For the savanna, heading fires yielded 5.89 m (flame length), 1.53 m (flame depth) and 45.5 m/min (propagation rate), while for backing fires that values were 2.21, 0.76 and 2.8 m/min, also with significant differences. Conclusions: Under the studied environmental conditions, particularly in the savanna, fire behavior is dangerous so a good prescription and more care must be taken for conducting controlled or prescribed burns. For forest fires, direct firefighting by the head of the fire must be avoided, for is too dangerous; instead it is recommended a firefighting by the back of the fire as well as waiting for a backing fire-advance of it after the fire reaches a ridge.

Influence of tobacco, alcohol consumption, eating habits and physical activity in nursing students.

OBJECTIVE: to determine the consumption of alcohol, tobacco, eating habits, and physical activity among nursing students and to detect whether being a nursing student is a protective factor against these habits. METHOD: a questionnaire was used to collect information on age, academic year, sex, alcohol and tobacco consumption, physical activity, and healthy eating. An information sheet and informed consent form were given. The sample was composed of 264 students aged between 18-30 years from four academic years. RESULTS: of the total sample, 15.5% smoked, 83.7% consumed alcoholic beverages and 97.2% consumed over the weekend. The total of 68.6% did not practice exercises and 70.5% needed changes in their diet. CONCLUSION: nursing students have high levels of alcohol consumption and low levels of smoking compared with other studies. The higher the academic year, the lower the age of onset of tobacco consumption. The number of men who exercised was higher, which is considered a protective factor against alcohol and tobacco consumption and is related to a healthy diet. Smoking has a negative influence on diet. The students needed to change their diet. Finally, being a nursing student is not considered a protective factor against alcohol and tobacco consumption, nor having good eating habits and exercising.

Influence of tobacco, alcohol consumption, eating habits and physical activity in nursing students / Influência do consumo de tabaco e álcool, de hábitos alimentares e atividade física em estudantes de enfermagem / Influencia del consumo de tabaco y alcohol, hábitos alimenticios y actividad física en estudiantes de enfermería

Objective: to determine the consumption of alcohol, tobacco, eating habits, and physical activity among nursing students and to detect whether being a nursing student is a protective factor against these habits. Method: a questionnaire was used to collect information on age, academic year, sex, alcohol and tobacco consumption, physical activity, and healthy eating. An information sheet and informed consent form were given. The sample was composed of 264 students aged between 18-30 years from four academic years. Results: of the total sample, 15.5% smoked, 83.7% consumed alcoholic beverages and 97.2% consumed over the weekend. The total of 68.6% did not practice exercises and 70.5% needed changes in their diet. Conclusion: nursing students have high levels of alcohol consumption and low levels of smoking compared with other studies. The higher the academic year, the lower the age of onset of tobacco consumption. The number of men who exercised was higher, which is considered a protective factor against alcohol and tobacco consumption and is related to a healthy diet. Smoking has a negative influence on diet. The students needed to change their diet. Finally, being a nursing student is not considered a protective factor against alcohol and tobacco consumption, nor having good eating habits and exercising.

Objetivo: determinar o consumo de álcool e tabaco, os hábitos alimentares e a atividade física entre estudantes de enfermagem e verificar se o fato de ser estudante de enfermagem é fator de proteção contra estes hábitos. Método: utilizou-se questionário para coletar informações sobre idade, ano letivo, sexo, consumo de álcool e tabaco, atividade física e alimentação saudável. Foram entregues uma folha com informações e um termo de consentimento livre e esclarecido. A amostra foi composta por 264 estudantes com idades entre 18 e 30 anos, de quatro anos acadêmicos. Resultados: do total da amostra, 15,5% fumavam, 83,7% consumiam bebidas alcoólicas e 97,2% consumiam no final de semana. Um total de 68,6% não praticava exercícios, e 70,5% necessitavam de alterações na dieta. Conclusão: estudantes de enfermagem apresentam altos níveis de consumo de álcool e baixos níveis de tabagismo em comparação com outros estudos. Quanto maior é o ano letivo, menor é a idade em que iniciaram o consumo de tabaco. O número de homens que se exercitavam foi maior, o que é considerado fator de proteção contra o consumo de álcool e tabaco e está relacionado a uma dieta saudável. Fumar tem influência negativa na dieta. Os estudantes precisavam mudar sua dieta. Por fim, ser estudante de enfermagem não é considerado fator de proteção contra o consumo de álcool e tabaco, nem significa ter bons hábitos alimentares e praticar exercícios.

Objetivo: determinar el consumo de alcohol, tabaco, hábitos alimenticios y actividad física entre los estudiantes de enfermería y detectar si ser estudiante de enfermería es un factor protector contra estos hábitos. Método: se utilizó un cuestionario para recopilar información sobre la edad, el año académico, el sexo, el consumo de alcohol y tabaco, la actividad física y la alimentación saludable. Se presentó una hoja de información y un formulario de consentimiento informado. La muestra estaba compuesta por 264 estudiantes que tenían entre 18 y 30 años, a partir de cuatro años académicos. Resultados: del total de la muestra, el 15,5% fumaba, el 83,7% consumía bebidas alcohólicas y el 97,2% consumía alcohol durante el fin de semana. El total del 68,6% no practica ejercicio físico y el 70,5% necesita cambios en su dieta. Conclusión: los estudiantes de enfermería tienen altos niveles de consumo de alcohol y bajos niveles de tabaquismo en comparación con otros estudios. A mayor curso académico, menor será la edad de inicio del consumo de tabaco. El número de hombres que practican actividad física fue mayor, lo que es considerado un factor protector contra el consumo de alcohol y tabaco y está relacionado con una dieta saludable. Fumar influye negativamente en la dieta. Los estudiantes necesitaban cambiar sus dietas. Por último, ser estudiante de enfermería no es considerado un factor protector contra el consumo de alcohol y tabaco, ni para que se tenga buenos hábitos alimenticios ni para que se practique actividad física.

A neuropsiquiatria teuto-brasileira até 1918 / The Teuto-Brazilian neuropsychiatry until 1918

Este capítulo discute a psiquiatria alemã entre a clínica, o laboratório e a higiene racial, a medicina entre a clínica e o microscópio, e se é possível fazer neuropsiquiatria em laboratório. Comenta sobre clínica, laboratório e psicologia na época de Griesinger a Kraepelin, Alois Alzheimer, Franz Nissl e a Escola de Kraepelin, e a psiquiatria genética e higiene racial de Ernst Rüdin entre Forel, kraepelin e Ploetz.

Juliano Moreira e Kreapelin: a neuropsiquiatria teuto-brasileria até a grande guerra / Juliano Moreira and Kreapelin: Teuto-brasileria neuropsychiatry until the great war

Aborda o ensino nas faculdades de medicina do Brasil entre França e Alemanha, as reformas e modernização da psiquiatria alemã na agenda de Juliano Moreira,o nascimento da comunidade psiquiátrica teuto-brasileira, e as relações com a psiquiatria alemã o entre ciência, raça e degeneração no Brasil.

De Hindenburg a Hitler: a medicina mental na kulturpolitik para o Brasil nos anos 1930 / From Hindenburg to Hitler: mental medicine in the kulturpolitik for Brazil in the 1930s

Aborda a medicina mental entre a neuropatologia e a eugenia sob a égide do determinismo biológico, a viagem de Cunha Lopes à Alemanha (1929-1930), a participação de Ulysses Vianna no Instituto Teuto-Brasileiro de Alta Cultura (1930). Também trata sobre as conferências de Spielmeyer (1931) representando a psiquiatria de Munique no Brasil, o regresso de Knipping à Alemanha e as mortes de Moreira e Vianna (1932-1935) e a medicina mental na kulturpolitik nazista para o Brasil (1933-1942)

Caminhos cruzados: a psiquiatria genética, eugenia e higiene racial na era Vargas e no terceiro reich / Cross paths: genetic psychiatry, eugenics and racial hygiene in the Vargas era and the third reich

O capítulo trata de questões referentes à educação universitária. Analisa as universidades e institutos de pesquisa sob a NS-Rassenpolitik, a direção de Rüdin (1931-1945) na DFA entre o Estado nazista e a SS-Ahnenberbe. Aborda a psiquiatria universitária no Brasil e a fundação do Ipub (1938), os diálogos de Cunha Lopes com Rüdin na psiquiatria genética,eugenia e raça, a eugenia e racismo no Estado Novo e no Terceiro Reich.

Diferencias por sexo en la motivación, la dependencia y el ansia por el consumo de cigarrillo en estudiantes universitarios / Differences Between Genders in Motivation, Dependence and Craving for Cigarette Smoking in University Students / Diferencias por sexo na motivação, dependência e ânsia pelo consumo de cigarro em estudantes universitários

Objetivo. Identificar las relaciones y las diferencias por sexo en la motivación al cambio, el nivel de dependencia y el ansia (craving) por el consumo de cigarrillo en una muestra de estudiantes universitarios. Método. Participaron 936 estudiantes, seleccionados en un muestreo aleatorio estratificado por carreras y semestres, a los que se les evaluó la historia de consumo de tabaco, el nivel de dependencia, el ansia por el consumo, la motivación y los procesos de cambio. Resultados. El 25.9% de la muestra que reportó consumir tabaco, presentó bajos niveles de motivación al cambio y de dependencia. Se identificó un mayor uso de procesos cognitivos experienciales en las primeras etapas de cambio (ps < 0.03) y un mayor uso de procesos conductuales en las fases finales del cambio (ps < 0.02). La correlación entre nivel de dependencia y de motivación al cambio fue negativa y significativa (r = -0.321, p < 0.01), y positiva entre nivel de dependencia y de ansia por el consumo (r = 0.417, p < 0.01). No hubo correlaciones significativas entre ansia por el consumo y la etapa motivacional. En ninguna de las variables se encontró diferencia entre sexos. Conclusión. La construcción de la motivación al cambio se caracteriza por el uso de procesos cognitivos y la consolidación de la motivación por el uso de procesos conductuales.

Objective. Identify gender relations and differences in motivation for change, dependency level, and craving for cigarette smoking in a sample of college students. Method. A total of 936 students were selected, randomly stratified by races and semesters, who were evaluated for history of tobacco use, dependency level, craving, motivation and change processes. Results. 25.9% of the sample that reported consuming tobacco, showed low levels of motivation for change and dependence. We identified greater use of experiential cognitive processes in the early stages of change (ps <0.03) and increased use of behavioral processes in the final stages of change (ps <0.02). The correlation between level of dependence and motivation to change was negative and significant (r = -0.321, p <0.01), and positive between dependence level and consumer craving (r = 0.417, p <0.01). There were no significant correlations between craving for consumption and motivational stage. No difference was found between the sexes in any of the variables. Conclusion. The construction of motivation to change is characterized by the use of cognitive processes and the consolidation of motivation by the use of behavioral processes.

Escopo. Identificar as relações e diferencias de sexo na motivação pela mudança, o nível de dependência e ânsia (craving) pelo consumo de cigarro numa amostra de estudantes universitários. Metodologia. Participaram 936 estudantes, selecionados numa amostragem aleatória estratificada por carreiras e semestres os que foram avaliados segundo sua história de consumo de tabaco, nível de dependência, ânsia pelo consumo, motivação e processos de mudança. Resultados. O 25.9% da amostra que reportou consumir tabaco, mostrou baixos níveis de motivação à mudança e de dependência. Foi identificado um maior uso de processos cognitivos experienciais nas primeiras etapas de mudança (ps < 0.03) e um maior uso de processos comportamentais nas fases finais da mudança (ps < 0.02). A correlação entre o nível de dependência e motivação à mudança foi negativa e significativa (r = -0.321, p < 0.01), e positiva entre nível de dependencia e ânsia pelo consumo (r = 0.417, p < 0.01). Não teve correlações significativas entre ânsia pelo consumo e etapa motivacional. Em variável nenhuma foi encontrada diferencia entre sexos. Conclusão. A construção da motivação à mudança é caraterizada pelo uso de processos cognitivos e a consolidação da motivação pelo uso de processos comportamentais.

Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras.

In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae, Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.