Kikuchi-Fujimoto Disease: The Unexpected Diagnosis of a Cervical Adenopathy.

Many cases of adenopathies, whose differential diagnosis includes a wide spectrum of pathologies (including some malignant conditions like lymphoproliferative diseases, e.g., lymphomas), resort to primary healthcare. Kikuchi-Fujimoto disease is a rare, benign, self-limiting entity characterized by adenopathies, mainly in the cervical region, which may be associated with constitutional symptoms. This specific pathology is very rare in primary care and is often overlooked. That is why it is essential to promote medical literacy and provide support in managing these cases, which we want to emphasize through this case presentation. This case report presents a 24-year-old female patient who sought a consultation at the Family Health Unit due to a painful swelling in the right cervical region that lasted two weeks. She denied a history of recent infections or constitutional symptoms. A painful and hard right submaxillary mass, measuring 2 cm in diameter, was identified upon palpation. An analytical study and ultrasound of the soft tissues of the cervical region were initially required. Analytically, there were no relevant changes; however, the ultrasound revealed "hypoechoic ganglion formations in the right laterocervical chains, from the retroauricular region to the lower region of the neck, the largest measuring 19x7mm". The patient was reassessed one month later, due to an increase in the number of adenopathies, and a new ultrasound was performed that revealed "supraclavicular adenopathy". After that, she was referred to Secondary Healthcare (Central Hospital), where a lymph node biopsy was performed, with histological results of Kikuchi-Fujimoto disease. The patient maintains a follow-up in a hemato-oncology consultation, with painless adenopathies that, according to her, get worse with anxiety symptoms. Currently, the patient is being treated symptomatically, with stabilization of adenopathies and anxious manifestations. These patients need long-term follow-up due to the possibility of disease recurrence or the development of autoimmune processes. Although it is a diagnosis of exclusion, this disease must always be considered, since it can be mistaken with other serious pathologies that require aggressive treatments. Regarding the relationship between anxiety disorder and the worsening of adenopathies, although no conclusive evidence was found in the literature, there are some studies that have established a connection between inflammation and the deterioration of certain depressive symptoms.

Implante coclear, efectos en implante unilateral o bilateral: revisión de la literatura / Cochlear implant, effects on unilateral or bilateral implant: review of the literature

El implante coclear (IC) es un dispositivo que habilita la capacidad de escucha en una persona con sordera neurosensorial profunda o moderada. La mayoría de las sorderas profundas son bilaterales, aunque no suelen ser simétricas, por lo que requerirán una adaptación específica de un aparato auditivo para cada oído. Según el grado de sordera, el individuo experimentará diversos grados de complicaciones en el desarrollo del lenguaje; en la sordera prelocutiva, habría modificaciones neuronales realizadas por la plasticidad cerebral, en las que los núcleos del lenguaje no se desarrollarían hasta no tener algún tipo de input de lenguaje. Idealmente, la edad máxima de implantación sería de 42 meses de edad en sorderas prelocutivas. Se recomienda fuertemente realizar implantación coclear bilateral (ICB) simultánea siempre que sea necesaria y adaptar un audífono de forma contralateral al implante coclear unilateral (ICU), cuando así se amerite, para proporcionar binauralidad y sus beneficios.(AU)

Implante coclear, efectos en implante unilateral o bilateral: revisión de la literatura / Cochlear implant, effects on unilateral or bilateral implant: review of the literature

El implante coclear (IC) es un dispositivo que habilita la capacidad de escucha en una persona con sordera neurosensorial profunda o moderada. La mayoría de las sorderas profundas son bilaterales, aunque no suelen ser simétricas, por lo que requerirán una adaptación específica de un aparato auditivo para cada oído. Según el grado de sordera, el individuo experimentará diversos grados de complicaciones en el desarrollo del lenguaje; en la sordera prelocutiva, habría modificaciones neuronales realizadas por la plasticidad cerebral, en las que los núcleos del lenguaje no se desarrollarían hasta no tener algún tipo de input de lenguaje. Idealmente, la edad máxima de implantación sería de 42 meses de edad en sorderas prelocutivas. Se recomienda fuertemente realizar implantación coclear bilateral (ICB) simultánea siempre que sea necesaria y adaptar un audífono de forma contralateral al implante coclear unilateral (ICU), cuando así se amerite, para proporcionar binauralidad y sus beneficios.(AU)

Molecular identification and phylogenetic characterization of influenza A virus at a wildlife-livestock interface in Mexico.

Influenza A virus (IAV) outbreaks constitute a constant threat to public health and pose a remarkable impact on socio-economic systems worldwide. Interactions between wild and domestic birds, humans and swine can lead to spillover events. Backyard livestock systems in proximity to wetlands represent high-risk areas for viral spread. However, some gaps remain in our knowledge of IAV transmission at the wildlife-livestock interface in Mexico. Hence, the study aimed at molecular identification and phylogenetic characterization of IAV in the wild duck-backyard livestock interface at a wetland of Mexico. A total of 875 animals were tested by real-time RT-PCR (qRT-PCR). We detected IAV in 3.68% of the wild ducks sampled during the winter season 2016-2017. Nonetheless, the samples obtained from backyard poultry and swine tested negative. The highest IAV frequency (11.10%) was found in the Mexican duck (Anas diazi). Subtypes H1N1, H3N2 and H5N2 were detected. Phylogenetic analyses revealed that IAV detected in wild birds from the Lerma wetlands was mostly related to swine and poultry IAV strains previously isolated in the United States and Mexico. Except, the UIFMVZ377/H5N2 related to North American waterbirds. In conclusion, the co-circulation of three IAV subtypes in wild ducks close to backyard farms in Mexico, as well as the local identification of influenza viruses genetically related to Mexican and North American IAV strains, highlights the importance of the Lerma marshes for influenza surveillance given the close interaction among wild birds, poultry, pigs and humans.

Índice de Masa Corporal una medida antropométrica asociada a Índice TG/HDL, un novel factor de riesgo cardio-metabólico / Body Mass Index An Anthropometric Measure Associated With TG / HDL Index, A Novel Cardio-Metabolic Risk Factor

Objetivos: determinar la relación entre obesidad e índice TG/HDL en pacientes atendidos en el servicio de consulta externa de endocrinología del hospital nacional Sergio Bernales en el año 2018. Métodos: el estudio fue observacional, analítico, tipo casos y controles no emparejado a razón de 4:1, con un total 288 sujetos de estudio siendo 230 controles y 58 casos quienes cumplieron con criterios de selección, involucro a los pacientes atendidos en el servicio de consulta externa endocrinología. La muestra fue aleatoria simple, se incluyeron las variables, Sexo, edad, Índice de masa corporal, Colesterol total, Triglicéridos total, HDL-c, LDL-c, Índice TG/HDL. Se empleó un modelo de regresión logística para obtener un Odds Ratio para fuerza de asociación. Resultados: La frecuencia relativa de obesidad fue del 65.52% y 29.13%, para los casos y controles respectivamente, a su vez una significancia estadística con la prueba exacta de Fisher, P-valor 0.000. Se encontró un por regresión logística bivariada una relación entre Obesidad e Índice TG/HDL-c (OR 4.62, p=0.000, IC95% 2.51-8.52). Conclusiones: se encontró una relación entre la Obesidad y el índice TG/HDL-c pudiéndose extrapolar a población adulta atendida en el servicio de endocrinología de Lima Metropolitana, este es el primer artículo publicado al respecto a nivel nacional, se recomiendan estudios prospectivos para determinar causalidad.

Objectives: to determine the relationship between obesity and the TG / HDL index in patients treated at the endocrinology outpatient service of the Sergio Bernales national hospital in 2018. Methods: the study was observational, analytical, case-control type not matched to ratio of 4: 1, with a total of 288 study subjects, 230 controls and 58 cases who met the selection criteria, involved the patients treated in the endocrinology outpatient service. The sample was simple random, the variables were included: Sex, age, Body mass index, Total cholesterol, Total triglycerides, HDL-c, LDL-c, TG / HDL index. A logistic regression model was used to obtain an Odds Ratio for the strength of association. Results: The relative frequency of obesity was 65.52% and 29.13%, for cases and controls respectively, in turn a statistical significance with Fisher's exact test, P-value 0.000. A bivariate logistic regression found a relationship between Obesity and TG / HDL-c Index (OR 4.62, p = 0.000, 95% CI 2.51-8.52). Conclusions: a relationship was found between Obesity and the TG / HDL-c index, which can be extrapolated to the adult population treated in the endocrinology service of Metropolitan Lima, this is the first article published in this regard at the national level, prospective studies are recommended to determine causality.

Phylogenetic characterization of a reassortant H5N2 influenza A virus from a resident Mexican duck (Anas diazi).

Congregation of different migratory and resident bird species on aquatic ecosystems during winter migration increases contact rates and enhances influenza A virus (IAV) transmission. However, scarce research has been focused on the resident bird's contribution to the viral ecology at a local scale. The Mexican duck (Anas diazi) is an endemic endangered anatid from Mexico. This resident species shares aquatic habitats with migratory birds in the wetlands of Central Mexico. Therefore, here we describe the phylogenetic analysis of an IAV (A/Mexican duck/EstadodeMexico; Lerma/UIFMVZ377/2016(H5N2)) isolated in this species, during spatiotemporal concurrence with migratory anatids in the winter season. All eight gene sequences were obtained by nextgeneration sequencing. Maximum Likelihood trees were constructed using MEGA-X, with General Time Reversible + Invariant (GTR+I), Subtree Pruning and Regrafting (SPR) heuristic method, and 1000 bootstrap replicates. Similarities with six different IAV subtypes were observed through a BLAST search: H6N5, H7N7, H5N2, H4N6, H9N2, and H11N9, detected in wild ducks during 2015 in the Pacific, Central and Mississippi flyways stop sites across the United States of America and Canada. The molecular identification of this reassortant H5N2 IAV highlights the importance of resident species as a reservoir host and its potential participation in the maintenance and transmission of IAV in wetlands surrounded by rural areas.

Children from a rural region in The Chiapas Highlands, Mexico, show an increased risk of stunting and intestinal parasitoses when compared with urban children / Alto riesgo de desmedro y parasitosis intestinal en niños de una región rural de los Altos de Chiapas, México, en comparación con niños de una región urbana

Abstract Background: The state of Chiapas has held the first place of extreme poverty in Mexico. The majority of Chiapas' municipalities are inhabited by marginalized, indigenous populations, who usually present diarrhea of unknown etiology. We evaluated the nutritional status, intestinal parasites, and common bacterial pathogens, including DEC (diarrheagenic Escherichia coli) strains, in 178 children under five years of age with a high (rural) and a moderate (urban) degree of marginalization. Methods: Z-scores for anthropometric indexes from the children were obtained, whereas intestinal parasites were investigated by using a direct coproparasitoscopic analysis and a concentration method. DEC strains were detected by polymerase chain reaction (PCR). Results: The stunting prevalence in children from the rural and urban regions was 79.8 and 7.5%, respectively. Only children from rural municipalities were parasitized (72.6%), being Ascaris lumbricoides and Entamoeba histolytica/Entamoeba dispar the most prevalent parasites (57.1 and 38.1%, respectively). More than half of the children presented moderated ascariasis. Besides Giardia intestinalis, these parasites were associated with stunting. The prevalence of DEC strains was similar in both regions. Conclusions: Only children from the Chiapas Highlands (rural zone) exhibited high prevalences of stunting and intestinal parasites. A reevaluation of social development programs should be in place to address stunting and intestinal parasitoses, mainly in rural regions of Chiapas, to avoid adverse functional consequences on these children.

Resumen Introducción: El estado de Chiapas ha ostentado el primer lugar de pobreza extrema en México. La mayor parte de la población de los municipios de Chiapas es indígena, vive en condiciones de marginación y padece de diarrea de etiología desconocida. Este trabajo evaluó el estado nutricional, la presencia de parásitos intestinales y patógenos bacterianos comunes, además de cepas DEC (Escherichia coli diarreogénica) en 178 niños menores de cinco años, provenientes de una localidad con alto grado de marginación (rural) y de una con moderada marginación (urbana). Métodos: Se obtuvieron los puntajes Z de los índices antropométricos de los niños. Los parásitos intestinales se investigaron con el método coproparasitoscópico directo y un método de concentración. Las cepas DEC se detectaron mediante reacción en cadena de la polimerasa. Resultados: La prevalencia de desmedro en niños de la zona rural y urbana fue de 79.8 y 7.5%, respectivamente. Únicamente los niños de la zona rural estuvieron parasitados (72.6%), y los más prevalentes fueron Ascaris lumbricoides y Entamoeba histolytica/Entamoeba dispar (57.1 y 38.1%, respectivamente). Más de la mitad de los infantes exhibieron ascariasis moderada. Estos parásitos, además de Giardia intestinalis, se asociaron con el desmedro. En ambas regiones, la prevalencia de DEC fue similar. Conclusiones: Solo los niños de los Altos de Chiapas (zona rural) exhibieron alta prevalencia de desmedro y parásitos intestinales. Para evitar las consecuencias adversas entre los infantes, es necesario reevaluar los programas de desarrollo social para combatir el desmedro y la parasitosis intestinal, principalmente en las regiones rurales de Chiapas.

Children from a rural region in The Chiapas Highlands, Mexico, show an increased risk of stunting and intestinal parasitoses when compared with urban children.

Background: The state of Chiapas has held the first place of extreme poverty in Mexico. The majority of Chiapas' municipalities are inhabited by marginalized, indigenous populations, who usually present diarrhea of unknown etiology. We evaluated the nutritional status, intestinal parasites, and common bacterial pathogens, including DEC (diarrheagenic Escherichia coli) strains, in 178 children under five years of age with a high (rural) and a moderate (urban) degree of marginalization. Methods: Z-scores for anthropometric indexes from the children were obtained, whereas intestinal parasites were investigated by using a direct coproparasitoscopic analysis and a concentration method. DEC strains were detected by polymerase chain reaction (PCR). Results: The stunting prevalence in children from the rural and urban regions was 79.8 and 7.5%, respectively. Only children from rural municipalities were parasitized (72.6%), being Ascaris lumbricoides and Entamoeba histolytica/Entamoeba dispar the most prevalent parasites (57.1 and 38.1%, respectively). More than half of the children presented moderated ascariasis. Besides Giardia intestinalis, these parasites were associated with stunting. The prevalence of DEC strains was similar in both regions. Conclusions: Only children from the Chiapas Highlands (rural zone) exhibited high prevalences of stunting and intestinal parasites. A reevaluation of social development programs should be in place to address stunting and intestinal parasitoses, mainly in rural regions of Chiapas, to avoid adverse functional consequences on these children.

Introducción: El estado de Chiapas ha ostentado el primer lugar de pobreza extrema en México. La mayor parte de la población de los municipios de Chiapas es indígena, vive en condiciones de marginación y padece de diarrea de etiología desconocida. Este trabajo evaluó el estado nutricional, la presencia de parásitos intestinales y patógenos bacterianos comunes, además de cepas DEC (Escherichia coli diarreogénica) en 178 niños menores de cinco años, provenientes de una localidad con alto grado de marginación (rural) y de una con moderada marginación (urbana). Métodos: Se obtuvieron los puntajes Z de los índices antropométricos de los niños. Los parásitos intestinales se investigaron con el método coproparasitoscópico directo y un método de concentración. Las cepas DEC se detectaron mediante reacción en cadena de la polimerasa. Resultados: La prevalencia de desmedro en niños de la zona rural y urbana fue de 79.8 y 7.5%, respectivamente. Únicamente los niños de la zona rural estuvieron parasitados (72.6%), y los más prevalentes fueron Ascaris lumbricoides y Entamoeba histolytica/Entamoeba dispar (57.1 y 38.1%, respectivamente). Más de la mitad de los infantes exhibieron ascariasis moderada. Estos parásitos, además de Giardia intestinalis, se asociaron con el desmedro. En ambas regiones, la prevalencia de DEC fue similar. Conclusiones: Solo los niños de los Altos de Chiapas (zona rural) exhibieron alta prevalencia de desmedro y parásitos intestinales. Para evitar las consecuencias adversas entre los infantes, es necesario reevaluar los programas de desarrollo social para combatir el desmedro y la parasitosis intestinal, principalmente en las regiones rurales de Chiapas.

New Synthesis, Structure and Analgesic Properties of Methyl 1-R-4-Methyl-2,2-Dioxo-1H-2λ6,1-Benzothiazine-3-Carboxylates.

According to the principles of the methodology of bioisosteric replacements a series of methyl 1-R-4-methyl-2,2-dioxo-1H-2λ6,1-benzothiazine-3-carboxylates has been obtained as potential analgesics. In addition, a fundamentally new strategy for the synthesis of compounds of this chemical class involving the introduction of N-alkyl substituent at the final stage in 2,1-benzothiazine nucleus already formed has been proposed. Using nuclear magnetic resonance (NMR) spectroscopy, mass spectrometry and X-ray diffraction analysis it has been proven that in the DMSO/K2CO3 system the reaction of methyl 4-methyl-2,2-dioxo-1H-2λ6,1-benzothiazine-3-carboxylate and alkyl halides leads to formation of N-substituted derivatives with good yields regardless of the structure of the alkylating agent. The peculiarities of NMR (¹Ð and 13С) spectra of the compounds synthesized, their mass spectrometric behavior and the spatial structure are discussed. In N-benzyl derivative the ability to form a monosolvate with methanol has been found. According to the results of the pharmacological testing conducted on the model of the thermal tail-flick it has been determined that replacement of 4-ОН-group in methyl 1-R-4-hydroxy-2,2-dioxo-1H-2λ6,1-benzothiazine-3-carboxylates for the methyl group is actually bioisosteric since all methyl 1-R-4-methyl-2,2-dioxo-1H-2λ6,1-benzothiazine-3-carboxylates synthesized demonstrated a statistically significant analgesic effect. The majority of the substances can inhibit the thermal pain response much more effective than piroxicam in the same dose. Under the same conditions as an analgesic the N-methyl-substituted analog exceeds not only piroxicam, but more active meloxicam as well. Therefore, it deserves in-depth biological studies on other experimental models.

Crystal structure of methyl 1-allyl-4-methyl-1H-benzo[c][1,2]thia-zine-3-carboxyl-ate 2,2-dioxide.

In the title compound, C14H15NO4S, the di-hydro-thia-zine ring adopts a distorted sofa conformation with the S atom displaced from the mean plane through the N and C ring atoms by 0.767 (1) Å. The allyl substituent (C-C=C) is inclined to this mean plane by 78.5 (7)° and the acetate group [C(=O)-O-C] by 66.5 (3)°. In the crystal, mol-ecules are linked by C-H⋯π inter-actions forming chains propagating along the a-axis direction.

Consenso para las prácticas de alimentación complementaria en lactantes sanos / Guidelines for complementary feeding in healthy infants

Resumen: La nutrición adecuada durante los primeros dos años de vida es fundamental para el desarrollo pleno del potencial de cada ser humano; actualmente se reconoce que este periodo es una ventana crítica para la promoción de un crecimiento y desarrollo óptimos y un buen estado de salud. Por tanto, cumplir con una alimentación adecuada en esta etapa de la vida tiene impacto sobre la salud, estado de nutrición, crecimiento y desarrollo de los niños; no sólo en el corto plazo, sino en el mediano y largo plazo. El presente trabajo ofrece recomendaciones de alimentación complementaria (AC) que se presentan en forma de preguntas o enunciados que consideran temas importantes para quienes atienden niños durante esta etapa de la vida; por ejemplo: inicio de la alimentación complementaria a los 4 o 6 meses de edad; exposición a alimentos potencialmente alergénicos; introducción de bebidas azucaradas; uso de edulcorantes artificiales y productos light; secuencia de introducción de alimentos; modificaciones de consistencia de alimentos de acuerdo a la maduración neurológica; número de días para probar aceptación y tolerancia a los alimentos nuevos; cantidades por cada tiempo de comida; prácticas inadecuadas de alimentación complementaria; mitos y realidades de la alimentación complementaria; hitos del desarrollo; práctica del "Baby Led Weaning" y práctica de vegetarianismo.

Abstract: A proper nutrition during the first two years of life is critical to reach the full potential of every human being; now, this period is recognized as a critical window for promoting optimal growth, development, and good health. Therefore, adequate feeding at this stage of life has an impact on health, nutritional status, growth and development of children; not only in the short term, but in the medium and long term. This paper provides recommendations on complementary feeding (CF) presented as questions or statements that are important for those who take care for children during this stage of life. For example: When to start complementary feedings: 4 or 6 months of age?; Exposure to potentially allergenic foods; Introduction of sweetened beverages; Use of artificial sweeteners and light products; Food introduction sequence; Food consistency changes according to neurological maturation; Number of days to test acceptance and tolerance to new foods; Amounts for each meal; Inadequate complementary feeding practices; Myths and realities of complementary feeding; Developmental milestones; Practice of "Baby Led Weaning" and practice of vegetarianism.

[Guidelines for complementary feeding in healthy infants]. / Consenso para las prácticas de alimentación complementaria en lactantes sanos.

A proper nutrition during the first two years of life is critical to reach the full potential of every human being; now, this period is recognized as a critical window for promoting optimal growth, development, and good health. Therefore, adequate feeding at this stage of life has an impact on health, nutritional status, growth and development of children; not only in the short term, but in the medium and long term. This paper provides recommendations on complementary feeding (CF) presented as questions or statements that are important for those who take care for children during this stage of life. For example: When to start complementary feedings: 4 or 6 months of age?; Exposure to potentially allergenic foods; Introduction of sweetened beverages; Use of artificial sweeteners and light products; Food introduction sequence; Food consistency changes according to neurological maturation; Number of days to test acceptance and tolerance to new foods; Amounts for each meal; Inadequate complementary feeding practices; Myths and realities of complementary feeding; Developmental milestones; Practice of "Baby Led Weaning" and practice of vegetarianism.

Intervenção com a pessoa em início de hemodiálise para a adesão ao regime terapêutico / Intervention with the person starting hemodialysis for adherence to the therapeutic regimen

A pessoa com doença renal em início de Hemodiálise é sujeita a muitas mudanças na sua vida diária e é alvo de regimes terapêuticos complexos e multifacetados, assumindo os enfermeiros uma importância fundamental em todo o processo da doença, nomeadamente na promoção da adesão ao regime terapêutico. Com este estudo procurou-se analisar a intervenção da equipa de enfermagem na promoção do processo de adesão ao regime terapêutico da pessoa com doença renal crónica em início de hemodialise. Realizou-se um estudo descritivo e transversal inserido numa abordagem de natureza qualitativa. A entrevista semiestruturada em grupos focais foi a técnica escolhida para a colheita de dados e foram entrevistados 21 enfermeiros, por amostragem de caso único. A análise de dados foi orientada pelos critérios propostos por Bogdan e Biklen (1994), Carey (2007), Barbour (2009). Na intervenção para o processo de adesão emergiram como temas principais: Adesão conceito(s); Acolhimento; Informação/Educação; Avaliação e Promoção de adesão. Os enfermeiros têm a perceção que são os profissionais com mais competência para acolher a pessoa e estabelecer com ela uma relação de proximidade e confiança determinante para os processos de adesão. Os conceitos de adesão são díspares, contudo unânimes na importância atribuída ao envolvimento da pessoa no processo de adesão. Reconhecem que a educação terapêutica da pessoa é um processo complexo que assenta: no esclarecimento sobre a terapia dialítica e os ganhos em saúde; no esclarecimento das mudanças nutricionais e hídricas; nos cuidados a ter com acessos vasculares; e na elucidação das alterações de vida que vão ocorrer. Identificam como dificuldades no processo educativo: os internamentos de curta duração; escassez de recursos humanos e sobrecarga de trabalho; falta de motivação dos profissionais; falta de articulação na equipa multidisciplinar; e falta de estruturação e sistematização do processo. Destacam o envolvimento da família, a regressão dos sintomas, o empenho, a simpatia e confiança estabelecida com a pessoa como aspetos fundamentais para promover o processo de adesão ao regime terapêutico. São sugestões a elaboração de um plano em que se sistematize uma metodologia de intervenção da equipa de enfermagem, na preparação para o início do tratamento dialítico e nos seus resultados.

Síndrome de agotamiento profesional en trabajadores de tratamiento de dos establecimientos penitenciarios de Lima / No disponible

El Síndrome de Agotamiento Profesional (SAP) ha sido considerado como una respuesta de las personas frente al estrés laboral crónico, presente especialmente en aquellas profesiones donde se busca ofrecer un servicio o ayuda a un tercero. Frente a ello, consideramos que los profesionales que trabajan dentro de un contexto penitenciario pueden ser vulnerables a mostrar síntomas del SAP. Este artículo presenta los resultados de una investigación sobre la prevalencia y manifestación del SAP en los trabajadores del área de tratamiento de dos Establecimientos Penitenciarios de Lima. Para ello, se aplicó el Maslach Burnout Inventory, adaptado al ámbito penitenciario, y se realizaron grupos focales para profundizar en las características de los contextos laborales. Los resultados señalan que 11.9% de los participantes presentó el SAP al momento de la aplicación, 11.9% de los participantes está en tendencia a desarrollarlo, el 42.9% se encuentra en riesgo y el 33.3% no se encuentra en riesgo

Professional Burnout Syndrome is a possible response of individuals to chronic job stress, present especially in those professions which seek to provide service or support to a third party. In that sense, professionals who work in prison settings may be vulnerable to show signs of burnout syndrome. This article presents the results of a research that have the aim to identify the prevalence and manifestation of burnout syndrome in the treatment staff of two prisons in Lima. For this, we used the Maslach Burnout Inventory -adapted to the prison environment-, and focus groups. The results show that 11.9% of participants presented the SAP at the time of application, 11.9% of participants is trending develop, 33.3% are at risk and 33.9% are not at risk

ANCA: Ainda jovem mas atingindo a maioridade / ANCA: Still young but reaching full age

Os anticorpos anticitoplasma de neutrófilos (ANCA) foram inicialmente identificados em pacientes com glomerulonefrite necrotizante. Posteriormente, a pesquisa desses anticorpos passou a ser utilizada como teste para diagnóstico para granulomatose de Wegener, e atualmente os mesmos vêm sendo identificados em diversas situaçöes clínicas, muitas das quais o seu valor ainda necessita ser definido. Os métodos de detecçäo desses anticorpos säo a imunofluorescência indireta, onde säo observados predominantemente dois padröes de fluorescência, o citoplasmático (C-ANCA) e o perinuclear (P-ANCA), e a ELISA, para identificar anticorpos contra antígenos citoplasmáticos específicos como proteinase 3, meiloperoxidase e elastase. Recentes estudos experimentais em animais de laboratório têm trazido evidências convincentes do papel patogênico desses anticorpos no desenvolvimento de vasculites.

Estado de salud bucal de niños preescolares de nivel socioeconómico alto y medio-alto. Medellín, 1997 / Oral health status of pre-school children in upper and upper-middle socio-economic levels in Medellín, Colombia, 1997

El propósito del estudio fue describir y comparar el estado de salud bucal y los conocimientos y practicas de las madres de 241 niños preescolares (1-5 años) de estrato socioeconómico alto y medio-alto, matriculados en 4 jardines infantiles de Medellín. Se realizó un estudio descriptivo con técnicas sugerida de recolección, examen clínico bucal y encuesta autoaplicada a las madres o encargados del cuidado del niño. Se encontró baja prevalencia de caries, 15 por ciento para estrato medio-alto y 12 por ciento para estrato alto. El índice ceo es 0,57 en el medio-alto y 0,33 en el alto. La conservación dentaría es muy buena con solo 2 dientes perdidos por caries del total examinado. El índice gingival de 0,27 (alto) y 0,43 (medio-alto), revela una gingivitis leve en la mayoría de los examinados. Los hábitos de succión digital, chupo y biberón tienen baja prevalencia, lo que ha contribuido con el buen estado de la dentición y evitara problemas esqueléticos posteriores. En cuanto a la higiene oral, el 94,7 por ciento del medio-alto, la inician antes del segundo año y el 63,3 por ciento del alto, después de este año. En el estrato medio-alto el 27,5 por ciento de los niños se dispensan la crema ellos mismos y en el alto lo hacen un 16,7 por ciento. De estos niños según las madres, las 213 partes se tragan la crema dental. El 60 por ciento de los niños ha asistido al odontólogo y un 41,3 por ciento (alto) y 66 por ciento (medio-alto) lo han hecho antes del primer año. Las madres tienen alto nivel de escolaridad, pero pasan más de cuatro horas fuera de casa, dejando los niños al cuidado de la abuela o empleada, por lo cual se sugieren programas educativos no solo a las madres, sino a otras personas que tienen responsabilidad en su cuidado. En general se puede concluir que, para el grupo de preescolares evaluados según los resultados existe un buen estado de salud oral y que el nivel socioeconómico influye notablemente en el...