Alacranismo, aportes de la ciencia y la tecnología a la salud pública en los municipios de Quilmes y La Plata / Alacranism, contributions of science and technology to public health in the municipalities of Quilmes and La Plata

Los escorpiones son arácnidos que pueden causar graves problemas de salud con sus picaduras, especialmente si se trata de especies de la familia Buthidae, como el Tityus trivittatus, que es el más peligroso de Argentina. En la Provincia de Buenos Aires, se ha observado un aumento de la presencia de estos animales en los ámbitos urbanos, lo que implica un mayor riesgo para la población. Sin embargo, no hay un protocolo unificado que permita identificar, registrar y monitorear a los escorpiones de interés sanitario, ni mapas que indiquen su distribución geográfica en cada municipio. Se exponen los resultados del convenio de trabajo realizado entre el municipio de Quilmes y el CEPAVE con el fin de obtener un mapeo de la distribución de escorpiones de interés sanitario y focalizar capacitaciones de promoción de salud y prevención de picaduras. Este trabajo permitió conocer la diversidad, la abundancia y la distribución de las especies de escorpiones en Quilmes, así como también las características de los ambientes donde se los encontró, siendo el puntapié inicial para replicarlo en toda la Provincia.

Comorbidities in Chilean patients with psoriasis: a Global Healthcare Study on Psoriasis.

BACKGROUND: Psoriasis is a chronic inflammatory skin disease associated with several important medical comorbidities. There are scant data available on the comorbidities of patients with psoriasis in South America. AIM: To examine the comorbidity profile of adult patients with psoriasis in Chile and its association with severity of psoriasis. METHODS: This was a multicentre, cross-sectional study involving 16 hospitals and clinics in Chile, which used a 48-item questionnaire to study clinician- and patient-reported outcomes and comorbidities. Inferential analyses were performed by psoriasis severity, using Fisher exact test, Student t-test and multivariable logistic regression. RESULTS: In total, 598 adult patients with psoriasis were included (51.1% male; mean age 49.2 ± 15.1 years); 48.5% mild and 51.4% moderate to severe; Psoriasis Area and Severity Index 11.6 ± 11.5; body surface area 14.7 ± 18.2%. Plaque psoriasis was the most common phenotype (90.2%), followed by guttate (13.4%). Psoriatic arthritis occurred in 27.3% of patients. Comorbidities were reported in 60.2% of all patients with psoriasis. Frequent concomitant diseases were obesity (25.3%), hypertension (24.3%), Type 2 diabetes mellitus (T2DM) (18.7%), dyslipidaemia (17.4%), metabolic syndrome (16.7%) and depression (14.4%). After adjustment, significant associations were found between moderate to severe psoriasis and obesity, T2DM and nonalcoholic fatty liver disease (NAFLD) compared with mild psoriasis. CONCLUSIONS: We report a large study of comorbidities, including depression, dyslipidaemia, T2DM and NAFLD, in people with psoriasis in Chile. The prevalence of comorbidities with psoriasis in Chile appears similar to that found in Western countries, and emphasizes the importance of assessing patients with psoriasis for risk factors for and presence of, comorbid disease in a multidisciplinary setting.

El rol de un centro de aislamiento sanitario extrahospitalario durante la pandemia de COVID-19: la experiencia de Quilmes / The role of an out-of-hospital Sanitary Isolation Center during the COVID-19 pandemic: the experience of Quilmes

INTRODUCCIÓN: Frente al aumento de casos de COVID-19 en el municipio bonaerense de Quilmes, y considerando las características sociodemográficas y habitacionales de su población, se puso en funcionamiento el Centro de Aislamiento Sanitario en la Universidad Nacional de Quilmes (CAS-UNQ) desde el 22 de abril hasta el 15 de noviembre de 2020. El objetivo de este trabajo fue describir el funcionamiento del CAS-UNQ y su contribución al abordaje de la primera ola de COVID 19 en el municipio de Quilmes de la Provincia de Buenos Aires. MÉTODOS: La organización general del CAS-UNQ estuvo a cargo del equipo de salud, que desplegó las estrategias necesarias para la atención de todas las personas alojadas. Las personas ingresadas se encontraban cursando cuadros leves de la enfermedad y no podían realizar el aislamiento en su domicilio. Se establecieron tres líneas de trabajo: atención médica, acompañamiento psicológico y abordaje social con perspectiva de derechos. RESULTADOS: Se aisló a 954 personas (407 mujeres adultas, 362 varones adultos y 185 niños menores de 13 años). El máximo de personas aisladas de forma simultánea fue de 120. La media de edad de internación fue de 27 años. DISCUSIÓN: La puesta en funcionamiento del CASUNQ fue una herramienta efectiva tanto para cortar cadenas de contagios en entornos de rápida propagación del virus como para implementar acompañamientos integrales de salud y acceso a derechos de la población.

The role of an out-of-hospital Sanitary Isolation Center during the COVID-19 pandemic: the experience of Quilmes / El rol de un centro de aislamiento sanitario extrahospitalario durante la pandemia de covid-19: la experiencia de quilmes

RESUMEN INTRODUCCIÓN: Frente al aumento de casos de COVID-19 en el municipio bonaerense de Quilmes, y considerando las características sociodemográficas y habitacionales de su población, se puso en funcionamiento el Centro de Aislamiento Sanitario en la Universidad Nacional de Quilmes (CAS-UNQ) desde el 22 de abril hasta el 15 de noviembre de 2020. El objetivo de este trabajo fue describir el funcionamiento del CAS-UNQ y su contribución al abordaje de la primera ola de COVID 19 en el municipio de Quilmes de la Provincia de Buenos Aires. MÉTODOS: La organización general del CAS-UNQ estuvo a cargo del equipo de salud, que desplegó las estrategias necesarias para la atención de todas las personas alojadas. Las personas ingresadas se encontraban cursando cuadros leves de la enfermedad y no podían realizar el aislamiento en su domicilio. Se establecieron tres líneas de trabajo: atención médica, acompañamiento psicológico y abordaje social con perspectiva de derechos. RESULTADOS: Se aisló a 954 personas (407 mujeres adultas, 362 varones adultos y 185 niños menores de 13 años). El máximo de personas aisladas de forma simultánea fue de 120. La media de edad de internación fue de 27 años. DISCUSIÓN: La puesta en funcionamiento del CASUNQ fue una herramienta efectiva tanto para cortar cadenas de contagios en entornos de rápida propagación del virus como para implementar acompañamientos integrales de salud y acceso a derechos de la población.

INTRODUCTION: In response to the increase of COVID-19 cases in the city of Quilmes (Buenos Aires Province), and considering the sociodemographic and housing characteristics of its population, a Sanitary Isolation Center at the National University of Quilmes (CASUNQ) was put into operation from April 22 to November 15, 2020. The objective of this work was to describe the operation of CAS-UNQ and its contribution to addressing the first wave of COVID 19 in Quilmes. METHODS: The general organization if the CAS-UNQ was conducted by a health team, which deployed the necessary strategies to take care of all the people housed there. Those who came to CAS-UNQ were experiencing mild illness and could not be isolated at home. Three lines of work were established: medical care, psychological support and social approach with a rights perspective. RESULTS: A total of 954 people were isolated (407 women, 362 men, and 185 children under 13 years of age). The maximum number of people isolated simultaneously was 120. The mean age of hospitalization was 27 years. DISCUSSION: The implementation of the CAS-UNQ was an effective tool both to cut chains of infections in environments of rapid spread of the virus and to carry out comprehensive health monitoring and access to rights of the population.

Producción imaginativo-reflexiva infantil en talleres clínico-narrativos / Produção imaginativa-reflexiva infantil em oficinas clínico-narrativas / Children's imaginative-reflective production in clinical-narrative workshops / Production imaginative-réfléchissante pour les enfants dans les ateliers cliniques-narratifs

Resumen El trabajo se centra en la variable subjetiva del aprendizaje: busca identificar las transformaciones psíquicas de seis niños en su tránsito por un dispositivo clínico mediado por cuentos (taller narrativo). El trabajo de campo se desarrolló en una escuela pública, con niños de 6 y 7 años, con pronóstico pedagógico desfavorable. Una herramienta informática organiza el análisis cualitativo y cuantitativo de la producción discursiva infantil. Los resultados ponen de manifiesto un incremento de dicha producción a medida que se fueron desarrollando los talleres y un menor requerimiento de participación del equipo coordinador. Sin embargo, se observa una tendencia decreciente de la producción imaginativo-reflexiva que motiva a focalizar el presente texto en esa dimensión y a dar cuenta de sus posibles causas.

Resumo O trabalho centra-se na variável subjetiva do aprendizado: procura identificar as transformações psíquicas de seis crianças em seu trânsito por um dispositivo clínico mediado por contos (oficina narrativa). O trabalho de campo foi realizado em uma escola pública, com crianças de 6 e 7 anos com prognóstico pedagógico desfavorável. Uma ferramenta informática organiza a análise qualitativa e quantitativa da produção discursiva infantil. Os resultados indicam um incremento dessa produção conforme as oficinas foram se desenvolvendo e uma menor exigência de participação da equipe de coordenação. Contudo, observa-se uma tendência decrescente da produção imaginativa-reflexiva que motiva o presente artigo a focalizar nessa dimensão e a dar conta das suas possíveis causas.

Abstract The work focuses on the subjective variable of learning: it aims at identifying psychic transformations in six children within a story-mediated clinical setting (narrative workshop). Field work was conducted in a public school, with children aged six and seven characterized by an unfavorable pedagogical prognosis. The qualitative and quantitative analysis of children's discursive production was analyzed using a software tool, with results showing an increase in discursive production throughout the narrative workshops and a decreasing need for the coordinating team's participation. Nevertheless, a decreasing trend in imaginative-reflective production was observed, driving the team to focus the analysis on that dimension and to attempt at explaining its possible causes.

Résumé Le travail se concentre sur la variable subjective de l'apprentissage : il cherche à identifier les transformations psychiques de six enfants en transit à travers un dispositif clinique à médiation narrative (atelier narratif). Le travail de terrain a été réalisé dans une école publique, avec des enfants de 6 et 7 ans, avec un pronostic pédagogique défavorable. Un outil informatique organise l'analyse qualitative et quantitative de la production discursive des enfants. Les résultats montrent une augmentation de cette production au fur et à mesure du développement des ateliers et une moindre exigence de participation de l'équipe de coordination. Cependant, il y a une tendance à la baisse dans la production imaginative-réfléchissante qui nous motive à concentrer ce texte sur cette dimension et à rendre compte de ses causes possibles.

TCR Repertoire Characterization for T Cells Expanded in Response to hRSV Infection in Mice Immunized with a Recombinant BCG Vaccine.

T cells play an essential role in the immune response against the human respiratory syncytial virus (hRSV). It has been described that both CD4+ and CD8+ T cells can contribute to the clearance of the virus during an infection. However, for some individuals, such an immune response can lead to an exacerbated and detrimental inflammatory response with high recruitment of neutrophils to the lungs. The receptor of most T cells is a heterodimer consisting of α and ß chains (αßTCR) that upon antigen engagement induces the activation of these cells. The αßTCR molecule displays a broad sequence diversity that defines the T cell repertoire of an individual. In our laboratory, a recombinant Bacille Calmette-Guérin (BCG) vaccine expressing the nucleoprotein (N) of hRSV (rBCG-N-hRSV) was developed. Such a vaccine induces T cells with a Th1 polarized phenotype that promote the clearance of hRSV infection without causing inflammatory lung damage. Importantly, as part of this work, the T cell receptor (TCR) repertoire of T cells expanded after hRSV infection in naïve and rBCG-N-hRSV-immunized mice was characterized. A more diverse TCR repertoire was observed in the lungs from rBCG-N-hRSV-immunized as compared to unimmunized hRSV-infected mice, suggesting that vaccination with the recombinant rBCG-N-hRSV vaccine triggers the expansion of T cell populations that recognize more viral epitopes. Furthermore, differential expansion of certain TCRVß chains was found for hRSV infection (TCRVß+8.3 and TCRVß+5.1,5.2) as compared to rBCG-N-hRSV vaccination (TCRVß+11 and TCRVß+12). Our findings contribute to better understanding the T cell response during hRSV infection, as well as the functioning of a vaccine that induces a protective T cell immunity against this virus.

Guía clínica chilena de urticaria crónica espontánea / Chilean guidelines for chronic urticaria

Chronic urticaria (CU) is characterized by itchy wheals, angioedema or both lasting six weeks or more. It is classified as spontaneous (CSU) and inducible urticaria (CIndU), depending whether there is an identifiable trigger or not. CSU is the predominant form, affecting more than 75% of patients, although overlaps often occur. The prevalence of CSU throughout life is around 1.8% and predominates in women at a ratio of 2:1. The higher incidence of CSU is between 20 and 40 years of age and lasts between one to five years. However, in up to 20% of patients the disease may last longer. CSU not only hampers quality of life, but also affect performance at work and school. The diagnosis of CSU is mainly clinical, and laboratory tests are required depending on the clinical history of the patient. Extensive laboratory tests are usually unnecessary. Second generation anti-histamines are used as first line treatment for CSU treatment. In refractory patients, systemic treatments, such as cyclosporine or omalizumab are suggested. We herein report the first Chilean CSU guidelines.

Prevalencia de síndrome metabólico en pacientes psoriáticos chilenos / Prevalence of metabolic syndrome in Chilean patients with psoriasis

Introducción: Existe poca información de la asociación entre Psoriasis y síndrome metabólico (SM) en Chile. Objetivos: Determinar la prevalencia de SM en psoriáticos chilenos. Material y métodos: Se realizó un estudio caso-control, con 487 pacientes (238 psoriáticos y 239 controles). En ambos grupos se analizó la prevalencia de SM además del exceso de peso, hipertensión arterial, diabetes mellitus 2, hipertrigliceridemia y niveles de HDL bajo. Resultados: Los psoriáticos presentaron mayor probabilidad de padecer SM versus los controles (35,29% vs 23,29%) OR 1,8 (1,20-2,66) p<0,05. Se asoció también con circunferencia abdominal aumentada (57,14% vs 36,94) OR 2,6 (1,79 - 3,78), exceso de peso (85,99% vs 63,45%) OR 2,46 (1,62 ­ 3,73) p<0,05 y diabetes mellitus 2 (13,45% vs 4,42%) OR 3,85 (1,79 - 8,26) p<0,05. Conclusiones: Se encontró una mayor prevalencia de SM, exceso de peso, circunferencia abdominal aumentada y diabetes mellitus 2 en el grupo psoriático en comparación al grupo control.

Background: There is a paucity of information about Psoriasis and metabolic syndrome (MS) association in Chile. Aim: To determine the MS prevalence in Chilean psoriatic patients. Material and Methods: A case-control study was conducted which included 487 patients (238 psoriatic patients and 239 controls). In both groups, MS prevalence, overweight, hypertension, diabetes mellitus type 2, hypertriglyceridemia and low HDL were analyzed. Results: Psoriatic patients were more likely to present MS than controls (35.29% vs 23.29%) OR 1.8 (1.20 to 2.66) p <0.05. In addition, it was associated with increased abdominal circumference (57.14% vs 36.94) OR 2.6 (1.79 to 3.78), overweight (85.99% vs 63.45%) OR 2.46 (1.62 to 3.73) p <0.05 and diabetes mellitus type 2 (13.45% vs. 4.42%) OR 3.85 (1.79 to 8.26) p <0.05. Conclusions: There is a higher prevalence of MS, overweight, increased abdominal circumference and type 2 diabetes mellitus in the psoriatic group compared with the control group.

Eosinophils and mast cells in chronic gastritis: possible implications in carcinogenesis.

Eosinophils and mast cells participate in the immune response against Helicobacter pylori, but their involvement in the gastric precancerous process is unclear. This study aimed to estimate eosinophil and mast cell density in antral mucosa in subjects from 2 Colombian populations with contrasting gastric cancer risks. Gastric mucosa biopsies were collected from 117 adult males (72 from a high-risk area and 45 from a low-risk area). A histopathology score was used to quantify severity of the lesions. Quantitation of eosinophils in hematoxylin-eosin-stained sections and mast cells in immunostained sections for CD117/c-Kit was performed. Helicobacter pylori infection and genotyping were assessed in Steiner stain and polymerase chain reaction, respectively. Logistic regression models and semiparametric cubic smoothing splines were used for analysis of the results. Eosinophil density was significantly higher in subjects from the low-risk area as compared with subjects from the high-risk area. In both populations, eosinophil density increased with the histopathology score in the progression of lesions from normal morphology to multifocal atrophic gastritis. Intestinal metaplasia and dysplasia specimens showed further increase in eosinophil density in the high-risk area but an abrupt decrease in the low-risk area. Mast cell density increased in parallel to the histopathology score in both populations. Our results suggest that eosinophils play a dual role in chronic gastritis. In the low-risk area, elevated eosinophil density represents a T helper 2-biased response that may down-regulate the effects of proinflammatory cytokines preventing cancer development. In contrast, in the high-risk area, eosinophils might promote a T helper 1-type response leading to progression of precancerous lesions.

Histopathology of gastritis in Helicobacter pylori-infected children from populations at high and low gastric cancer risk.

Infection with Helicobacter pylori has been recognized as a cause of gastric carcinoma. Although the neoplasia is always detected in adults, the infection starts in childhood. It has been reported that early age at first infection is a determinant of gastric cancer risk. In this study, we examined the histopathology of the gastric mucosa in infected children from a population at high risk for gastric cancer (Pasto, Colombia) and compared it with that of a lower-risk population (New Orleans, LA). Gastric biopsies obtained from antrum and corpus were stained with hematoxylin and eosin and Steiner's silver method. Immunohistochemical stains were used to identify B lymphocytes (CD20), T lymphocytes (CD3 and CD8), macrophages (CD68), and polymorphonuclear neutrophil myeloperoxidase. Morphometric techniques were used to evaluate the immunohistochemical stains. In both populations, the inflammatory lesions were seen predominantly in the antrum. Compared with children from the lower-risk populations, children from the higher-risk population exhibited more severe polymorphonuclear neutrophil infiltration, stromal and intraepithelial lymphocyte infiltration, mucus depletion, and H. pylori colonization density. Regenerative activity was significantly more marked in the lower-risk population. Morphometric analysis of immunohistochemical stains showed increased representation of T lymphocytes and macrophages in the higher-risk population. Most T lymphocytes stained positive for CD8, a marker of suppressor/cytotoxic cells. B lymphocytes were relatively more abundant in the lower-risk population. The possibility that the aforementioned characteristics of H. pylori infection in children are related to cancer risk in adults is discussed.

Dolor pélvico crónico y laparoscopia. Profamilia Medellín. Julio – Septiembre 1989 / Pelvic chronic pain and laparoscopy. Profamilia, Medellín. July - September 1989

En la Clínica de Profamilia de Medellín (Colombia) durante los meses de Julio a Septiembre de 1989 fueron practicadas 231 laparoscopias diagnósticas, a pacientes con dolor pélvico crónico. Las pacientes tenían una edad promedio de 31 años con historia de cirugía ginecológica en 48 por ciento y de éstas 20 por ciento se les había realizado tubectomía. 48 por ciento de las pacientes eran amas de casa y 60 por ciento tenían unión estable. Los principales hallazgos laparoscópicos fueron: endometriosis en 19 por ciento, adherencias pélvicas en 14 por ciento y sin hallazgos el 39 por ciento. Igual porcentaje de pacientes eran nulíparas y de éstas 59 por ciento tenían endometriosis como hallazgo laparoscópico...