Diagnósticos e tratamentos em pacientes no hospital do Juquery na Era Vargas / Diagnósticos e tratamentos em pacientes no hospital do Juquery na Era Vargas / Diagnóstico y tratamiento de pacientes en el hospital Juquery durante la Era Vargas

Objetivo: analisar diagnósticos e tratamentos em pacientes no Hospital do Juquery no período Vargas. Método: estudo quanti-qualitativo, exploratório-descritivo, análise dos dados pelo referencial da análise documental e documentos históricos. Resultados:analisados 2.166 prontuários; épocas de conflitos sociais e guerras com incremento de prisões e internações; múltiplos diagnósticos para paciente; diagnósticos inconclusivos; principais diagnósticos.: esquizofrenia (23,59%), psicose maníaca depressiva (4,20%), psicoses diversas (4,02%), delírio (3,83%), parafrenia (3,60%), depressão (3,19%), confusão mental (2,91%) configuravam 45,34% (982) do total; quadros sem serem estritamente psiquiátricos, mas poderiam ter sintomatologia derivada.: sífilis (10,80%), deficiência intelectual (8,08%), epilepsia (4,06%), alcoolismo (3,81%); 2.023 (93,40%) prontuários sem observação médica; 08 (0,37%) pacientes diagnosticados "sem perturbação mental"; 37 (1,71%) "sem diagnóstico conclusivo"; 920 (42,47%) prontuários sem dados de tratamentos; 213 (9,83%) sem definição de tratamentos. Conclusão: múltiplos diagnósticos para mesmo indivíduo; alguns pacientes não tinham quadros psiquiátricos; tratamentos repetidos, majoritariamente orgânicos, não produziram resultados efetivos

Objective: to analyze diagnoses and treatments in patients at the Juquery Hospital during the Vargas period. Method: a quantitative-qualitative, exploratory-descriptive study, analyzing the data using documentary analysis and historical documents. Results: 2. 166 medical records analyzed; times of social conflict and war with an increase in arrests and hospitalizations; multiple diagnoses for patients; inconclusive diagnoses; main diagnoses: schizophrenia (23.59%), manic depressive psychosis (4.20%), various psychoses (4.02%), delirium (3.83%), paraphrenia (3.60%), depression (3.19%), mental confusion (2.91%) made up 45.34% (982) of the total; conditions that were not strictly psychiatric, but could have derived symptoms: syphilis (10.80%), intellectual disability (8.08%), epilepsy (4.06%), alcoholism (3.81%); 2. 023 (93.40%) medical records without medical observation; 08 (0.37%) patients diagnosed "without mental disorder"; 37 (1.71%) "without conclusive diagnosis"; 920 (42.47%) medical records without treatment data; 213 (9.83%) without treatment definition. Conclusion: multiple diagnoses for the same individual; some patients did not have psychiatric conditions; repeated treatments, mostly organic, did not produce effective results

Objetivos:analizar los diagnósticos y tratamientos de los pacientes del Hospital de Juquery durante el período de Vargas. Método:estudio cuantitativo-cualitativo, exploratorio-descriptivo, analizando los datos mediante análisis documental y documentos históricos. Resultados: 2. 166 historias clínicas analizadas; época de conflicto social y guerra con aumento de detenciones y hospitalizaciones; diagnósticos múltiples para los pacientes; diagnósticos no concluyentes; principales diagnósticos: esquizofrenia (23,59%), psicosis maníaco depresiva (4,20%), psicosis diversas (4,02%), delirio (3,83%), parafrenia (3,60%), depresión (3,19%), confusión mental (2,91%) constituyeron el 45,34% (982) del total; afecciones no estrictamente psiquiátricas, pero que podían tener síntomas derivados: sífilis (10,80%), discapacidad intelectual (8,08%), epilepsia (4,06%), alcoholismo (3,81%); 2. 023 (93,40%) historias clínicas sin observación médica; 08 (0,37%) pacientes diagnosticados "sin trastorno mental"; 37 (1,71%) "sin diagnóstico concluyente"; 920 (42,47%) historias clínicas sin datos de tratamiento; 213 (9,83%) sin definición de tratamiento. Conclusión: múltiples diagnósticos para el mismo individuo; algunos pacientes no tenían afecciones psiquiátricas; los tratamientos repetidos, en su mayoría orgánicos, no produjeron resultados efectivos

Amerindian ancestry proportion as a risk factor for inflammatory bowel diseases: results from a Latin American Andean cohort.

Background and aims: Latin American populations remain underrepresented in genetic studies of inflammatory bowel diseases (IBDs). Most genetic association studies of IBD rely on Caucasian, African, and Asian individuals. These associations have yet to be evaluated in detail in the Andean region of South America. We explored the contribution of IBD-reported genetic risk variants to a Chilean cohort and the ancestry contribution to IBD in this cohort. Methods: A total of 192 Chilean IBD patients were genotyped using Illumina's Global Screening Array. Genotype data were combined with similar information from 3,147 Chilean controls. The proportions of Aymara, African, European, and Mapuche ancestries were estimated using the software ADMIXTURE. We calculated the odds ratios (ORs) and 95% confidence intervals (CIs) for gender, age, and ancestry proportions. We also explored associations with previously reported IBD-risk variants independently and in conjunction with genetic ancestry. Results: The first and third quartiles of the proportion of Mapuche ancestry in IBD patients were 24.7 and 34.2%, respectively, and the corresponding OR was 2.30 (95%CI 1.52-3.48) for the lowest vs. the highest group. Only one variant (rs7210086) of the 180 reported IBD-risk SNPs was associated with IBD risk in the Chilean cohort (adjusted P = 0.01). This variant is related to myeloid cells. Conclusion: The type and proportion of Native American ancestry in Chileans seem to be associated with IBD risk. Variants associated with IBD risk in this Andean region were related to myeloid cells and the innate immune response.

Acute elbow dislocation: a critical appraisal of the literature.

Background: The purpose of this study was to perform a narrative review of acute elbow dislocation (AED). There are certain aspects of the management of AED that are controversial, including type and length of immobilization, indications for surgery, type of surgery, and new evidence available. Material and methods: A literature search was performed using MEDLINE and Embase databases for studies regarding AED. Preference was given to studies according to their level of evidence. Studies regarding the outcome of conservative and surgical treatment, including patient-reported outcomes, complications, and conversion to stabilization or revision surgery were included. Results: We found only 1 level I study and 3 level II randomized clinical trials. The rest consisted of level III-V evidence. Conservative care continues to be the standard of care for stable AEDs. Shorter immobilization periods are favored when possible. A consensus definition of an unstable elbow still needs to be improved. Unstable simple elbow dislocation may benefit from surgical intervention with different techniques showing similar outcomes. Advances in surgical procedures and suture designs, including tapes, and ligament augmentation, need to prove their role in managing acute elbow instability. Conclusion: There is a need for higher quality studies after the reduction of an AED, including discerning the outcome of specific patterns of injury and particular groups of patients like high-level athletes or people with preoperative laxity. Comparison between different surgical techniques is warranted, including arthroscopic techniques and types of ligament augmentation to promote early motion and reduce postoperative stiffness.

Genotype Prevalence of Lactose Deficiency, Vitamin D Deficiency, and the Vitamin D Receptor in a Chilean Inflammatory Bowel Disease Cohort: Insights from an Observational Study.

Lactose intolerance (LI) and vitamin D deficiency (VDD) have been linked to inflammatory bowel disease (IBD). We conducted an observational study in 192 Chilean IBD patients to investigate the prevalence of a specific gene variant (LCT-13910 CC genotype) associated with LI and the prevalence of VDD/Vitamin D Receptor (VDR) gene variants. Blood samples were analyzed using Illumina's Infinium Global Screening Array. The LCT-13910 CC genotype was found in 61% of IBD patients, similar to Chilean Hispanic controls and lower than Chilean Amerindian controls. The frequency of the LCT-13910-C allele in Chilean IBD patients (0.79) was comparable to the general population and higher than Europeans (0.49). Regarding VDR and VDD variants, in our study, the rs12785878-GG variant was associated with an increased risk of IBD (OR = 2.64, CI = 1.61-4.32; p-value = 0.001). Sixty-one percent of the Chilean IBD cohort have a genetic predisposition to lactose malabsorption, and a significant proportion exhibit genetic variants associated with VDD/VDR. Screening for LI and VDD is crucial in this Latin American IBD population.

Tratamentos e desfechos em indivíduos internados no hospital do Juquery: o cotidiano na era Vargas / Treatments and outcomes in people hospitalized at Juquery hospital: daily life in the Vargas era / Tratamientos y resultados en personas hospitalizadas en el hospital Juquery: la vida cotidiana en la era Vargas

Objetivo: analisar os tratamentos e desfechos nos internados no Hospital do Juquery no período de 1930 a 1945. Métodos: estudo quanti-qualitativo, exploratório-descritivo, análise dos dados pelo referencial da análise documental. Coleta dos dados foi realizada no Acervo do Patrimônio Histórico-cultural do Complexo Hospitalar do Juquery, entre março e julho de 2022.Resultados: analisados 2.166 prontuários; 920 prontuários sem dados de tratamentos; 213 sem definição de tratamentos; principais tipos de tratamento 494 monoterapia e 235 politerapia; 2.005 prontuários sem dados dos efeitos dos tratamentos. Quanto ao resultado 106 inalterado/não melhorou, 21 melhorou, 18 piorou, 16 morte súbita. Houve 366 desfechos sem dados, 868 óbitos dos quais 496 não especificados, 263 saídas sem alta, 365 saídas com alta, evadidos 36 e 252 transferidos para outras instituições psiquiátricas. Conclusão: os tratamentos eram majoritariamente orgânicos e não produziram resultados efetivos; desfechos apontam para inadequação e ineficiência da assistência psiquiátrica e da internação.

Objective: to analyze the treatments and outcomes of patients admitted to the Juquery Hospital from 1930 to 1945. Methods: quanti-qualitative, exploratory-descriptive study, data analysis by the reference of documentary analysis. Data collection was carried out in the Historical-Cultural Heritage Collection of the Juquery Hospital Complex, between March and July 2022. Results: 2,166 medical records were analyzed; 920 medical records without treatment data; 213 without definition of treatments; main types of treatment: 494 monotherapy and 235 polytherapy; 2,005 medical records without data on the effects of treatments. Regarding outcome: 106 unchanged/not improved, 21 improved, 18 worsened, 16 sudden death. There were 366 outcomes without data, 868 deaths of which 496 unspecified, 263 discharged, 365 discharged, 36 absconded and 252 transferred to other psychiatric institutions. Conclusion: treatments were mostly organic and did not produce effective results; outcomes point to inadequacy and inefficiency of psychiatric care and hospitalization.

Objetivos:analizar los tratamientos y resultados de los pacientes ingresados en el Hospital de Juquery de 1930 a 1945. Métodos: estudio cuantitativo-cualitativo, exploratorio-descriptivo, análisis de datos por la referencia del análisis documental. La recolección de datos se realizó en la Colección de Patrimonio Histórico-Cultural del Complejo Hospitalario Juquery, entre marzo y julio de 2022. Resultados: se analizaron 2.166 historias clínicas; 920 historias clínicas sin datos de tratamiento; 213 sin definición de tratamientos; principales tipos de tratamiento: 494 monoterapia y 235 politerapia; 2.005 historias clínicas sin datos sobre los efectos de los tratamientos. En cuanto al resultado: 106 sin cambios/no mejoría, 21 mejoría, 18 empeoramiento, 16 muerte súbita. Hubo 366 desenlaces sin datos, 868 fallecimientos de los cuales 496 sin especificar, 263 dados de alta, 365 dados de alta, 36 fugados y 252 trasladados a otras instituciones psiquiátricas. Conclusión: los tratamientos fueron en su mayoría orgánicos y no produjeron resultados eficaces; los resultados apuntan a la inadecuación e ineficacia de la atención psiquiátrica y la hospitalización.

Afrontamiento, apoyo social y resiliencia asociados a la calidad de vida de mujeres con cáncer de mama / Coping, social support and resilience associated with quality of life in women with breast cancer

Objetivo Ante el cáncer de mama (CM) se emplean recursos intra e interpersonales que favorecen el mantenimiento de la calidad de vida. El presente estudio buscó analizar la relación que tiene el afrontamiento, el apoyo social y la resiliencia con la calidad de vida de mujeres mexicanas con CM. Método Es un estudio transversal que contempló 150 participantes con edades comprendidas entre los 25 a 60 años, en población abierta con tal diagnóstico y sin antecedentes psiquiátricos. Se les aplicó la Escala de ajuste mental al cáncer, la Escala de resiliencia, el Cuestionario MOS de apoyo social percibido y la European Organization for Research and Treatment of Cancer. Resultados Las variables estudiadas se relacionaron con la calidad de vida. Las estrategias de afrontamiento, como desesperanza, tuvieron relación con la salud global y funcionamiento (físico, de rol y social); y la evitación cognitiva con el funcionamiento de rol y dolor. Por su parte, el apoyo social y la resiliencia con la salud global, el funcionamiento (de rol, físico y social) y las naúseas. Conclusiones Se presentaron relaciones de las estrategias de afrontamiento (desesperanza y evitación cognitiva), apoyo social (tangible, emocional y social) y resiliencia (factores externos) con la calidad de vida, donde el uso de recursos brindados por los miembros de su entorno facilitan la superación del riesgo a pesar de la condición de enfermedad. Se sugiere analizar el efecto de estas variables sobre la calidad de vida en diferentes etapas y tipos de tratamientos del CM. (AU)

Objective In women with breast cancer (BC), intra- and interpersonal resources are used that help to maintain quality of life. This study aimed to analyse the relationship between coping, social support and resilience with quality of life in Mexican women with BC. Method We conducted a cross-sectional study that included 150 participants aged between 25 and 60 years in an open population with BC and no psychiatric history. The women were assessed with the Mental Adjustment to Cancer Scale (MAC-M), the Resilience Scale, the Medical Outcomes Study (MOS) Perceived Social Support Survey, and the European Organisation for Research and Treatment of Cancer (EORCT-QLQ-C30). Results The variables studied were associated with quality of life. Coping strategies such as hopelessness were related to global health and functioning (physical, role, and social), cognitive avoidance with role functioning and pain. Social support and resilience were associated with global health, functioning (role, physical and social) and nausea. Conclusions This study describes the associations between coping strategies (hopelessness and cognitive avoidance), social support (tangible, emotional and social) and resilience (external factors) and quality of life. Resources provided by people in the environment help to overcome risk of vulnerability, despite the illness. We suggest that the effect of these variables on quality of life be analysed in distinct stages and types of treatment in BC. (AU)

Psycho-sociocultural influences on psychopathological symptoms in the open community: ecosystemic inequalities / Influencias psicosocioculturales sobre los síntomas psicopatológicos en comunidad abierta: desigualdades ecosistémicas

Abstract Mental health problems in the general population tend to be related to social determinants which also influence health inequity. However, these determinants are usually taken into account only for clinical populations and often go unnoticed at the community level. The purpose of the present study was to identify the psycho-socio-cultural factors that influence the presence of psychopathological symptoms in the open population. In this study, 229 women and men, Mexican adults, participated. Two self-report instruments were used: the SCL 90-R to evaluate psychopathological symptoms, and the Questionnaire of Factors Associated with Health. The results show differences between men and women, both in the symptoms and in the factors evaluated, where women are more disadvantaged. Predictive models indicate that in women the factors predicting the symptomatology are: conflicting thoughts, domestic violence, lack of confidence in their abilities and gender discrimination; while in men they were: family violence, poverty and lower well-being. It is concluded that psychosocial and ecosystemic models enable to understand that psycho-socio-cultural factors influence the presence of incipient symptoms in the community population, following different paths for women and men, showing that the context has a differential impact on mental health.

Resumen Los problemas de salud mental en la población general tienden a estar relacionados con determinantes sociales que también influyen en la inequidad sanitaria. Sin embargo, estos determinantes suelen tenerse en cuenta solo en la población clínica y pasan inadvertidos en el ámbito comunitario. Teniendo esto en cuenta, el propósito del presente estudio fue identificar los factores psicosocioculturales que influyen en la presencia de los síntomas psicopatológicos en población abierta. Para esto, participaron 229 mujeres y hombres, adultos, mexicanos, a quienes se les aplicaron dos instrumentos de autorreporte para evaluar sus síntomas psicopatológicos, el SCL 90-R y el Cuestionario de Factores Asociados a la Salud. Los resultados muestran diferencias entre hombres y mujeres tanto en los síntomas como en los factores evaluados, en donde las mujeres resultaron ser las más desfavorecidas. Los modelos predictivos señalan que en las mujeres los factores que predicen la sintomatología son los pensamientos conflictivos, la violencia intrafamiliar, la falta de confianza en sus capacidades y la discriminación de género; mientras que en los hombres fueron la violencia intrafamiliar, la pobreza y un menor bienestar. Se concluye que los modelos psicosociales y ecosistémicos permiten comprender que los factores psicosocioculturales influyen sobre los síntomas incipientes de población comunitaria, con vías diferentes tanto para las mujeres como para los hombres. Con esto se demuestra que el contexto imprime un impacto diferencial en la salud mental.

Proteomic profiling of splenic interstitial fluid of malnourished mice infected with Leishmania infantum reveals defects on cell proliferation and pro-inflammatory response.

Protein malnutrition is a risk factor for developing visceral leishmaniasis. Because we previously demonstrated that protein malnutrition and infection with Leishmania infantum disrupts the splenic microarchitecture in BALB/c mice, alters T cell-subsets and increases splenic parasite load, we hypothesize that splenic microenvironment is precociously compromised in infected animals that suffered a preceding malnutrition. To evaluate this, we characterized the abundance of proteins secreted in the splenic interstitial fluid (IF) using an iTRAQ-based quantitative proteomics approach. In addition, local levels of pro-inflammatory and proliferation molecules were analyzed. Whereas well-nourished infected animals showed increased IL-1ß and IL-2 levels, malnourished-infected mice displayed significant reduction of these cytokines. Remarkably, a two-weeks infection with L. infantum already modified protein abundance in the splenic IF of well-nourished mice, but malnourished animals failed to respond to infection in the same fashion. Malnutrition induced significant reduction of chemotactic and pro-inflammatory molecules as well as of proteins involved in nucleic acid and amino acid metabolism, indicating an impaired proliferative microenvironment. Accordingly, a significant decrease in Ki67 expression was observed, suggesting that splenocyte proliferation is compromised in malnourished animals. Together, our results show that malnutrition compromises the splenic microenvironment and alters the immune response to the parasite in malnourished individuals. SIGNIFICANCE: Protein malnutrition is recognized as an important epidemiological risk factor for developing visceral leishmaniasis (VL). Locally secreted factors present in the interstitial fluid have important roles in initiating immune responses and in regulating fluid volume during inflammation. However, the regulation of secreted factors under pathological conditions such as malnutrition and infection are widely unknown. To analyze how protein malnutrition alters secreted proteins involved in the immune response to L. infantum infection we evaluated the proteomic profile of the interstitial fluid of the spleen in malnourished BALB/c mice infected with L. infantum. Our work revealed new elements that contribute to the understanding of the immunopathological events in the spleen of malnourished animals infected with L. infantum and opens new pathways for consideration of other aspects that could improve VL treatment in malnourished individuals.

Thymic Microenvironment Is Modified by Malnutrition and Leishmania infantum Infection.

Detrimental effects of malnutrition on immune responses to pathogens have long been recognized and it is considered a main risk factor for various infectious diseases, including visceral leishmaniasis (VL). Thymus is a target of both malnutrition and infection, but its role in the immune response to Leishmania infantum in malnourished individuals is barely studied. Because we previously observed thymic atrophy and significant reduction in cellularity and chemokine levels in malnourished mice infected with L. infantum, we postulated that the thymic microenvironment is severely compromised in those animals. To test this, we analyzed the microarchitecture of the organ and measured the protein abundance in its interstitial space in malnourished BALB/c mice infected or not with L. infantum. Malnourished-infected animals exhibited a significant reduction of the thymic cortex:medulla ratio and altered abundance of proteins secreted in the thymic interstitial fluid. Eighty-one percent of identified proteins are secreted by exosomes and malnourished-infected mice showed significant decrease in exosomal proteins, suggesting that exosomal carrier system, and therefore intrathymic communication, is dysregulated in those animals. Malnourished-infected mice also exhibited a significant increase in the abundance of proteins involved in lipid metabolism and tricarboxylic acid cycle, suggestive of a non-proliferative microenvironment. Accordingly, flow cytometry analysis revealed decreased proliferation of single positive and double positive T cells in those animals. Together, the reduced cortical area, decreased proliferation, and altered protein abundance suggest a dysfunctional thymic microenvironment where T cell migration, proliferation, and maturation are compromised, contributing for the thymic atrophy observed in malnourished animals. All these alterations could affect the control of the local and systemic infection, resulting in an impaired response to L. infantum infection.

Relación entre síntomas psicopatológicos y calidad de vida en mujeres y hombres / Relationship between psychopathological symptoms and quality of life in women and men

Los problemas de salud mental afectan el desarrollo biopsicosocial de las personas. Dichos problemas empeoran debido a que se acude tardíamente a los servicios de salud, evidenciando la necesidad de detecciones tempranas en población abierta. Por ello, el objetivo de esta investigación fue evaluar la relación entre síntomas psicopatológicos y calidad de vida en mujeres y hombres. Participaron 465 personas, habitantes del Estado de México, quienes contestaron el SCL-90-R y el WHOQOL-BREF. En los resultados, las mujeres presentan mayores puntuaciones de síntomas psicopatológicos y menor calidad de vida con respecto a los hombres. Los problemas de salud mental afectan la calidad de vida por diferentes vías de influencia de acuerdo al sexo; en las mujeres destaca la depresión y la sintomatología global; y en los hombres, la somatización, la sintomatología global y la depresión. Se discute sobre la necesidad de prevención y detección precoz de los síntomas incipientes a través del trabajo comunitario.

Mental health problems, which affect biopsychosocial development of people, worsen because people take too long to come to health services. This situation shows the need for early detection of these problems in open populations. Considering this, the present research aimed to assess the relationship between psychopathological symptoms and quality of life in women and men. The study population consisted of 465 inhabitants of the State of Mexico, who answered the SCL-90-R and WHOQOLBREF questionnaires. Results: women have higher scores of psychopathological symptoms and lower quality of life than men. Mental health problems affect quality of life in different ways according to gender: in women, depression and global symptoms stand out; and in men, somatization, global symptoms and depression are the most common ones. This paper discusses the need for prevention and early detection of incipient symptoms of mental health problems through community work.

Erratum: Protein malnutrition promotes dysregulation of molecules involved in T cell migration in the thymus of mice infected with Leishmania infantum.

This corrects the article DOI: 10.1038/srep45991.

Protein malnutrition promotes dysregulation of molecules involved in T cell migration in the thymus of mice infected with Leishmania infantum.

Protein malnutrition, the most deleterious cause of malnutrition in developing countries, has been considered a primary risk factor for the development of clinical visceral leishmaniasis (VL). Protein malnutrition and infection with Leishmania infantum leads to lymphoid tissue disorganization, including changes in cellularity and lymphocyte subpopulations in the thymus and spleen. Here we report that protein malnutrition modifies thymic chemotactic factors by diminishing the CCL5, CXCL12, IGF1, CXCL9 and CXCL10 protein levels in infected animals. Nevertheless, T cells preserve their migratory capability, as they were able to migrate ex vivo in response to chemotactic stimuli, indicating that malnutrition may compromise the thymic microenvironment and alter in vivo thymocyte migration. Decrease in chemotactic factors protein levels was accompanied by an early increase in the parasite load of the spleen. These results suggest that the precondition of malnutrition is affecting the cell-mediated immune response to L. infantum by altering T cell migration and interfering with the capacity of protein-deprived animals to control parasite spreading and proliferation. Our data provide evidence for a disturbance of T lymphocyte migration involving both central and peripheral T-cells, which likely contribute to the pathophysiology of VL that occurs in malnourished individuals.

Detection and quantification of Leishmania infantum in naturally and experimentally infected animal samples.

Leishmania infantum is one of the causative agents of visceral leishmaniasis (VL). VL is the most severe form of leishmaniasis and can be fatal if it is not properly treated. Although several PCR works are intended to detect L. infantum, in silico analysis of available primers and/or primer-probes reveals potential cross species amplification. Here, a TaqMan-based quantitative real time PCR (qPCR) assay was developed for specific detection and quantitation of L. infantum in tissue samples from experimentally or naturally infected animals, mice or dogs, respectively. For this assay, primers and probes were designed for the kinetoplast minicircle DNA of L. infantum. The qPCR assay achieved a detection limit of 0.01pg of parasite DNA, and allowed specific amplification of L. infantum in both asymptomatic and symptomatic naturally infected dogs with inter-assay variation coefficients between 0.05-0.11. There was no cross amplification with dog DNA or with L. braziliensis, L. donovani, L. major, L. tropica or Trypanosoma cruzi. In addition, our assay detected a significantly higher parasite load in symptomatic than in the asymptomatic animals (p<0.0001). We believe this approach will be a valuable tool for the specific detection of L. infantum in regions of sympatric transmission of VL-causing parasites.

Construcción y Análisis Estadístico del Inventario Multidimensional de Celos Románticos: estudio Preliminar

Con el objetivo de construir y validar una prueba para medir propiedades de los celos románticos, se desarrolló el Inventario Multidimensional de Celos Románticos (IMCR) desde tres ejes: 1) su conceptualización, 2) circunstancias que lo generan y 3) respuestas cognitivas, afectivas y conductuales involucradas. El IMCR está constituido por cinco escalas tipo Likert con sus respectivas opciones de respuesta. Se acudió a juicio de expertos para la validez de contenido y por análisis factoriales exploratorios para la validez de constructo de cada escala, presentando coeficientes de confiabilidad superiores a (α > .873). Por esto, el IMCR tiene una estructura relativamente clara con dimensiones en parte independientes y que miden con razonable precisión los tres ejes; concluyendo que los celos románticos son un constructo multidimensional con respuestas afectivas, cognitivas y conductuales desencadenadas a partir de una situación que representa la posible pérdida de la pareja.

Aiming to construct and validate a test to measure jealousy, the Multidimensional Inventory of Romantic Jealousy (MIRJ) was developed from three axes: 1) conceptualization, 2) conditions that generate romantic jealousy and 3) cognitive, affective and behavioral responses involved. The MIRJ consists of five Likert scales with five response options each. The inventory was validated by expert judgment on the content validity and exploratory factor analysis to construct the validity of each scale, showing higher reliability coefficients (α> 0.85). MIRJ has a fairly clear structure with independent dimensions that measure with reasonable accuracy the three axes. In Conclusion, romantic jealousy is a multidimensional construct with affective, cognitive and behavioral responses, triggered from a situation that represents the possible loss of a partner.

T-cell populations and cytokine expression are impaired in thymus and spleen of protein malnourished BALB/c mice infected with Leishmania infantum.

Visceral leishmaniasis (VL) is a parasitic infectious disease that causes significant morbidity and mortality in the tropical and subtropical regions of the world. Although infections with visceralizing Leishmania may be asymptomatic, factors such as undernutrition increase the likelihood of progressing to clinical disease. Protein malnutrition, the most deleterious cause of malnutrition in developing countries, has been considered as a primary risk factor for the development of clinical VL. However, data regarding the immunological basis of this association are scarce. With the aim to analyze the effects of protein malnutrition on Leishmania infantum infection, we used BALB/c mice subjected to control or low protein isocaloric diets. Each animal group was divided into two subgroups and one was infected with L. infantum resulting in four study groups: animals fed 14% protein diet (CP), animals fed 4% protein diet (LP), animals fed 14% protein diet and infected (CPi), and animals fed 4% protein diet and infected (LPi).The susceptibility to L. infantum infection and immune responses were assessed in terms of body and lymphoid organ weight, parasite load, lymphocyte subpopulations, and cytokine expression. LPi mice had a significant reduction of body and lymphoid organ weight and exhibited a severe decrease of lymphoid follicles in the spleen. Moreover, LPi animals showed a significant decrease in CD4+CD8+ T cells in the thymus, whereas there was an increase of CD4+ and CD8+ T cells percentages in the spleen. Notably, the cytokine mRNA levels in the thymus and spleen of protein malnourished-infected animals were altered compared to the CP mice. Protein malnutrition results in a drastic dysregulation of T cells and cytokine expression in the thymus and spleen of L. infantum-infected BALB/c mice, which may lead to defective regulation of the thymocyte population and an impaired splenic immune response, accelerating the events of a normal course of infection.

Community study of fixed-combination adapalene 0.1% and benzoyl peroxide 2.5% in acne.

A new fixed-dose combination formulation of adapalene 0.1% and benzoyl peroxide (BPO) 2.5% has shown excellent efficacy and safety in registration studies; however, it can be difficult to judge the real-world performance of a product using only the results from controlled clinical trials. This 12-week, open-label, community-based study evaluated adapalene/BPO in 91 patients with mild to moderate acne (20-50 inflammatory lesions and 30-100 noninflammatory lesions) who were treated at dermatology centers throughout Argentina. The study evaluated efficacy, described the most common side effects, determined tolerability, and assessed the level of patient satisfaction with treatment. By week 12, there were statistically significant reductions in both inflammatory and noninflammatory lesions (80.6% and 69.3% from baseline, respectively; P < .001); there were also significant improvements in the Investigator's Global Assessment scores (median score, 2.9 at baseline and 1.0 at week 12; P < .001). By week 12, 67% of patients were rated clear or almost clear by investigators. Local tolerability was good overall. When cutaneous irritation was present, it typically occurred in the first 2 weeks of treatment and improved or resolved with continuing therapy. Patients were highly satisfied with the results of treatment, and 74% of patients felt that they had marked or total improvement by week 12. Patient survey also revealed that 94% rated the efficacy as good or very good and 87.5% rated tolerability as good or very good. A significant majority (81%) felt that the treatment met expectations, and 62% perceived that improvement had been rapid during adapalene/BPO therapy. These results demonstrate that adapalene/BPO has good efficacy and tolerability in routine practice, resulting in continuous reductions in lesion counts throughout the study. Adapalene/BPO therapy is also associated with high patient satisfaction, which is important for therapeutic adherence and satisfaction with the physician's care.

BiosStep-assisted walking in spinal cord-injured patients: an evaluation report.

BiosStep is a functional neuromuscular stimulation system designed to assist the gait of people with central nervous system injuries. It stimulates the quadriceps during the stance phase and the nerves in the popliteal space to produce the swing phase of the gait cycle. The gait obtained with BiosStep was assessed using kinematic analysis and it was compared with nondisabled gait. Moreover, the evolution of the physiological cost of walking using BiosStep was evaluated and compared with the gait obtained with mechanical orthoses. The kinematic analysis of the three lower limb joints showed that the angular excursion morphologies of BiosStep-assisted gait were similar to those obtained in healthy gait, but with minor amplitudes. The physiological cost indexes for the BiosStep-assisted gait were higher than those computed for the mechanical-orthoses-assisted gait. Results show the necessity to continue improving the strategies to obtain more functional movements and enhance the training of patients.

Distalization of maxillary molars with the bone-supported pendulum: a clinical study.

A modified pendulum appliance with 2 endosseus screws for anchorage in the palatal area was used for maxillary molar distalization in each of 15 patients (average age, 13 +/- 2.1 years). Study models and lateral and panoramic x-rays were taken at the beginning and end of the movement to record the dental and skeletal changes. The mean treatment time was 7.8 +/- 1.7 months, the average distal movement of the maxillary molars was 6 mm, and the inclination was 11.3 degrees +/- 6.2 degrees. The second premolars were distalized an average of 4.85 +/- 1.96 mm with inclinations of 8.6 degrees +/- 5 degrees. The maxillary anterior teeth were retruded 0.5 +/- 1.33 mm and palatally inclined 2.5 degrees +/- 2.98 degrees. The mandibular plane rotated posteriorly 1.27 degrees +/- 1.1 degrees. No loss of dental anchorage was observed during the distal movement.

Induction of CD40 expression and enhancement of monoclonal antibody production on murine B cell hybridomas by cross-linking of IgG receptors.

The 55-6 murine B cell hybridoma line not constitutively expressing CD40 was treated with increasing amounts of intact anti-mouse surface immunoglobulin G antibody (anti-mIgG) either not preincubated or preincubated for 48 h with lipopolysaccharide (LPS). In vitro, cross-linking of surface immunoglobulin G (sIgG) with the whole molecule of anti-IgG antibodies induced the expression of CD69, CD40, and CD19 surface antigens on 55-6 cells. The effect of sIgG ligation was dose-dependent, and preincubation with LPS enhanced their responsiveness to anti-mIgG stimulation. The expression of these surface molecules reached the maximum value during the first part of the cell cycle, corresponding to the position of the G1 peak of the DNA distribution. Stimulation of cells with anti-mIgG did not induce changes either in the number of viable cells or in the fraction of cells undergoing proliferation (mitosis). However, preincubation of 55-6 cells with LPS for 48 h before stimulation with anti-mIgG increased both the maximum specific growth rate (micromax) and the percentage of cells in the G2/M phase, in comparison with non-preincubated cells. Moreover, on cells preincubated with LPS prior to anti-mIgG treatment, specific IgG2a production rate was enhanced significantly compared to that obtained in control cultures. The correlation between the antibody production rate and the amount of IgG that is detectable on the cell surface was analyzed by flow cytometry. A good correlation between secreted and surface IgG was observed, and the results of cell cycle analyses demonstrated that the 55-6 hybridoma cell line has a substantially higher sIgG content in G1 phase.

Pleurodesis using autologous blood: a new concept in the management of persistent air leak in acute respiratory distress syndrome.

OBJECTIVE: Pneumothorax is present as a frequent complication in acute respiratory distress syndrome (ARDS). Persistent air leak (PAL) prolongs pneumothorax in 2% of cases of ARDS, increasing the rate of mortality by 26%. Pleurodesis using autologous blood (PAB) is an effective method in cases of oncological pulmonary surgery. The goal of this study was to compare PAB with the conventional drain and water seal in the management of PAL in patients with ARDS and pneumothorax. DESIGN: The study was a case-control, prospective, nonrandomized one comparing 2 groups subjected to artificial pairing (1:1). SETTING: The study took place at the Torrecardenas Hospital (Andalusian Health Service, Almería, Spain). PATIENTS: Participants were 2 groups of 27 patients, all with ARDS, pneumothorax, and PAL. INTERVENTIONS: One group received conventional treatment whereas the other received PAB. MAIN RESULTS: The severity of the conditions of both groups is homogeneous, shown by sex; age; Murray, Marshall, and Acute Physiology and Chronic Health Evaluation II scores; and etiology of ARDS. The patients in the PAB group had a shorter stay in the ICU, shorter weaning time (WT), and lower death rate. The average differences between the groups were 11 days less WT (adjusted odds ratio [OR] = 0.1) and 9 days less on average time spent in the ICU (adjusted OR = 0.24). The death rates in the PAB group and the control group were 3.7% and 29.6%, respectively (adjusted OR = 0.6). CONCLUSIONS: The use of PAB makes possible a decrease in ventilator WT and a shorter stay in the ICU, with a resulting increase in functional recuperation and decrease in patient mortality.