Multicenter retrospective study on benign testicular tumors in children: save as much as you can please.

BACKGROUND: Testicular tumors (TT) are infrequent in pediatric patients, representing 1% of pediatric solid tumors; benign testicular tumors (BTT) are the most common. We present a multicenter study aiming to describe the incidence, histology and surgical technique of BTT, with special emphasis on which approach could present better outcomes. METHODS: The records of pediatric patients diagnosed with BTT between 2005 and 2020 from 8 centers in 5 different countries in Latin-America, were reviewed. RESULTS: Sixty two BTTs were identified. 73% tumors presented as a testicular mass, and 97% underwent testicular ultrasound as the initial imaging study, all of them had findings suggestive of a benign tumor. 87% had preoperative tumor markers (AFP and BHCG). In 66%, an intraoperative biopsy was done and 98% of the intraoperative biopsies were concordant with the final pathology report. Tumorectomy was performed in 81% of patients and total orchiectomy in the remaining 19%. Six percentage of patients underwent a subsequent orchiectomy. Mean follow-up was 39 months (1-278 months) where no cases of atrophy were observed clinically or on ultrasound. Fertility was not evaluated in this series. CONCLUSIONS: Proper management of BTTs is essential to avoid unnecessary orchiectomies. Preoperative ultrasound associated with intraoperative biopsy seems accurate in identifying benign pathology, thus enabling conservative testicular surgery with safety margins. Based on this multicenter series, we suggest performing an intraoperative biopsy with subsequent tumorectomy preserving healthy testicular tissue in BTT.

On the Causes of Rapid Diversification in the Páramos: Isolation by Ecology and Genomic Divergence in Espeletia.

How diversity arises and what is the relative role of allopatric and ecological divergence are among the most persistent questions in evolution and ecology. Here, we assessed whether ecological divergence has enhanced the diversification of the Neotropical alpine plant complex Espeletia, also known as frailejones. This genus has one of the highest diversification rates ever reported and is distributed in the world's fastest evolving biodiversity hotspot, the Páramo (Neotropical alpine grasslands at elevations of c. 2800-4700 m). Our goal was to determine whether ecology plays a role in divergence within the Espeletia complex by quantifying genome-wide patterns of ecological divergence. We characterized 162 samples of the three most common and contrasting ecotypes (distinct morphotypes occupying particular habitats) co-occurring in six localities in the northern Andes using Genotyping by Sequencing. Contrasting ecotypes were caulescent cloud forest populations, caulescent populations from wind-sheltered and well-irrigated depressions and acaulescent populations from wind-exposed drier slopes. We found high polymorphism with a total of 1,273 single nucleotide polymorphisms (SNPs) that defined the relationships among nine genetic clusters. We quantified allelic associations of these markers with localities and habitats using 18 different general and mixed-effects statistical models that accounted for phylogenetic distance. Despite that these models always yielded more SNPs associated with the localities, markers associated with the habitat types were recovered too. We found strong evidence for isolation-by-distance (IBD) across populations despite rampant gene flow, as expected for plant groups with limited seed dispersal. Contrasts between populations of different habitat types showed that an isolation-by-environment (IBE) trend emerged and masked the IBD signal. Maximum likelihood estimation of the number of migrants per generation (Nem) among ecotypes confirmed the IBE pattern. This result illustrates the importance of mountains' environmental variation at a local scale in generating rapid morphological radiations and maintaining multiple adaptations in a fast-evolving ecosystem like the Páramo.

Electrocardiographic alterations associated with heart transplantation. Triggers, mechanisms and meaning / Alteraciones electrocardiográficas en el paciente con trasplante cardíaco. Desencadenantes, mecanismos y su significado

Abstract Introduction: Heart rhythm disorders are associated with increased morbidity and mortality. However, triggers and implications in patients with heart transplantation are not clear. Objectives: The purpose of this research paper is to identify and explain the determinants for the onset of electrical conductivity alterations in patients with a heart transplant, as well as to describe the most common arrhythmias and their pathological implications. Materials and methods: A literature review was made in the PubMed online database for a total of 411 results. In addition, clinical practice guidelines on cardiac transplantation, cardiovascular electrophysiology and infective endocarditis were searched. Sixty articles related to the objectives of this study were chosen. Results: Surgical technique, heart denervation, sinus node trauma, graft rejection, endomyocardial biopsies and infections are the main factors that compromise organ viability and the life of transplanted patients. These factors can be observed as sinus rhythm disturbances. Conclusions: When a cardiac arrhythmia is detected, the medical team must provide a treatment that is not limited to symptomatic and sinus rhythm control. An active search of the etiology must be initiated since it may indicate an underlying pathological process.

Resumen Introducción. Las alteraciones del ritmo cardíaco están asociadas con un aumento en la morbimortalidad; sin embargo, en pacientes con trasplante cardíaco no son claros sus desencadenantes ni implicaciones. Objetivos. Realizar una búsqueda en la literatura para identificar y explicar los determinantes en la generación de alteraciones de la conducción eléctrica en pacientes con trasplante cardíaco, así como describir las principales arritmias que pueden presentarse, explicando sus implicaciones patológicas. Materiales y métodos. Se realizó una búsqueda en la base de datos PubMed que arrojó un total de 411 resultados. Además, se buscaron las guías de práctica clínica sobre trasplante cardíaco, electrofisiología cardiovascular y endocarditis infecciosa. Se eligieron 60 artículos que lograban responder a los objetivos de este estudio. Resultados. La técnica quirúrgica, la denervación cardíaca, las lesiones del nodo sinusal, el rechazo del injerto, las biopsias endomiocárdicas y las infecciones son los principales factores que comprometen la viabilidad del órgano y la vida del paciente trasplantado, manifestándose como alteraciones del ritmo sinusal. Conclusiones. Ante la detección de alguna arritmia cardíaca, el equipo médico debe proporcionar un manejo que no se limite al control sintomático y del ritmo sinusal, sino que se debe iniciar una búsqueda activa de su etiología, ya que esta puede ser la manifestación de un proceso patológico subyacente.

Percepción de la calidad de vida de cuidadores de pacientes asistentes a un programa de crónicos, Villavicencio, Colombia / Perception of the Quality of Life of Caregivers of Patients Attending a Program for the Chronically, Villavicencio, Colombia / Percepção da qualidade de vida de cuidadores de pacientes participantes de um programa de crónicos, Villavicencio (Colômbia)

Objetivo: determinar la percepción de la calidad de vida de cuidadores informales de adultos que padecen enfermedad crónica, que asisten al Programa de Crónicos de la Empresa Social del Estado de Villavicencio, Colombia. Materiales y métodos: estudio descriptivo, de abordaje cuantitativo y de corte transversal en cuidadores informales (n = 180) de adultos crónico usuarios del Programa de Promoción y Prevención de Crónicos. Con los cuidadores se utilizó el instrumento Calidad de Vida (QOL) versión familiar de Ferrell y Grant, y para valorar la funcionalidad de los pacientes crónicos, se usó el perfil Pulses adaptado por Granger. Se determinan rangos de puntaje, medidas de tendencia central y dispersión para los dominios de bienestar y calidad de vida. Resultados: en la mayoría de los cuidadores se evidenció que los dominios de bienestar físico y social no se encuentran afectados, y las dimensiones de bienestar psicológico y espiritual están en nivel medio, al igual que la calidad de vida. Conclusiones: para la enfermería, los resultados pueden orientar procesos de capacitación a fin de fortalecer habilidades de cuidado en cuidadores que permitan promover la salud y el bienestar, evitar el deterioro de la calidad de vida y cuidar oportunamente y en mejores condiciones al familiar que padece enfermedad crónica.

Objective: Identify perceptions about the quality of life of informal caregivers of chronically ill adults who are attending a program for the chronically ill sponsored by a state-run social welfare agency in Villavicencio, Colombia. Materials and Methods: This is a descriptive, cross-sectional study with a qualitative approach. The focus is on informal caregivers (n = 180) of chronically ill adults who are involved in the Chronic Illness Awareness and Prevention Program. The Quality of Life (QOL) Instrument - Family Version developed by Ferrell and Grant was used with the caregivers, and the Granger adapted version of the Pluses profile was used to assess the functionality of chronically ill patients. The score ranges and measures of central tendency and dispersion for the domains of well-being and quality of life are determined. Results: In most of the caregivers, there was evidence that the domains of physical and social well-being are not affected. The dimensions of psychological and spiritual well-being are at the middle level, as is quality of life. Conclusions: The results can be used by nursing to guide training processes aimed at strengthening the skills caregivers have to promote health and wellbeing, prevent quality of life from deteriorating, and provide timely care and in better conditions for a family member who is suffering from a chronic illness.

Objetivo: determinar a percepção da qualidade de vida de cuidadores informais de idosos que padecem doença crónica, que participam do Programa de Crônicos da Empresa Social do Estado de Villavicencio (Colômbia). Materiais e métodos: estudo descritivo, de abordagem quantitativa e de corte transversal em cuidadores informais (n = 180) de idosos crônicos usuários do Programa de Promoção e Prevenção de Crônicos. Com os cuidadores, utilizou-se o instrumento Qualidade de Vida (QoL, por sua sigla em inglês) versão familiar de Ferrell e Grant, e para avaliar funcionalidade dos pacientes crônicos, usou-se o perfil Pulses, adaptado por Granger. Determinaram-se faixas de pontuação, medidas de tendência central e dispersão para os domínios de bem-estar e qualidade de vida. Resultados: na maioria dos cuidadores, evidenciou-se que os domínios de bem-estar físico e social estão em nível médio, assim como a qualidade de vida. Conclusões: para a enfermagem, os resultados podem orientar processos de capacitação a fim de fortalecer habilidades de cuidado em cuidadores que permitam promover a saúde e o bem-estar, evitar a deterioração da qualidade de vida e cuidar oportunamente e em melhores condições do familiar que padece doença crônica.

Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America.

This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S), an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S) (Elaprase(®), Shire) enzyme replacement therapy (ERT), designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses.

Isolation and characterization of nucleotide-binding site resistance gene homologues in common bean (Phaseolus vulgaris).

Common bean production is constrained by many fungal, viral, and bacterial pathogens. Thus, the identification of resistance (R) genes is an important focal point of common bean research. The main goal of our study was to identify resistance gene homologues (RGH) in the crop, using degenerate primers designed from conserved sequences in the nucleotide-binding site (NBS) domains of R-genes from the model legume Medicago truncatula. Total DNA of the Andean common bean genotype G19833 was used for amplification of over 500 primer combinations. Sequencing of amplicons showed that 403 cloned fragments had uninterrupted open reading frames and were considered representative of functional RGH genes. The sequences were grouped at two levels of nucleotide identity (90 and 80%) and representative sequences of each group were used for phylogenetic analyses. The RGH sequence diversity of common bean was divided into TIR and non-TIR families, each with different clusters. The TIR sequences grouped into 14 clades while non-TIR sequences grouped into seven clades. Pairwise comparisons showed purifying selection, although some sequences may have been the result of diversifying selection. Knowledge about RGH genes in common bean can allow the design of molecular markers for pyramiding of resistance genes against various pathogens.

Características de liderazgo de los estilos transformacional /transaccional en los profesionales de enfermería de una IPS de Bogotá 2011 / Characteristics of leadership of the transformational/transactional styles in the nursing professionals of an IPS in Bogotá 2011

El liderazgo un fenómeno de estudio y de interés desde diferentes áreas y disciplinas, se define como el proceso de dirigir en las actividades laborales de los miembros de un grupo y se reconoce como componente fundamental que influye en la efectividad general de una organización. La Enfermería como disciplina, es un proceso que promueve y contribuye a la mejora de las condiciones de salud y vida de la población, el logro de objetivos de cuidado propios de la profesión, y el alcance de las metas propuestas en los servicios de salud, por ello favorece el desarrollo social, profesional y organizacional. El objetivo de este estudio fue identificar las características de liderazgo de los estilos Transaccional y Transformacional en los profesionales de Enfermería, a partir de la aplicación del cuestionario MLQ 5x en una IPS de Bogotá en el año 2012, con el fin de contribuir en el mejoramiento de la calidad en la prestación de servicios de la institución. El estudio fue de tipo cuantitativo, descriptivo y transversal. Se aplicó el instrumento MLQ-5X versión corta, basado en la teoría de Bass y Avolio sobre el Liderazgo Transformacional y Transaccional y sus características, a 77 profesionales de enfermería. Como resultado se encontró que los profesionales de Enfermería de la institución identificaron sus características de liderazgo pertenecientes al liderazgo transformacional como son: Influencia Idealizada Conductual en un 65%, Motivación Inspiracional en un 80%, Estimulación Intelectual en un 70%, Consideración Individualizada en un 70%, Esfuerzo Extra en un 80%, Efectividad en un 80% y Satisfacción en un 85%. Se concluyó que en lo concerniente al estudio realizado, se indica que éste permitió identificar las características del liderazgo transformacional y transaccional a través del cuestionario MLQ 5x en la versión líder, con relación a las características del liderazgo transformacional se identificaron las siguientes características de liderazgo Influencia Idealizada Conductual 62%, Motivación Inspiracional 80%, Estimulación Intelectual 70%, Consideración Individualizada 70%, Esfuerzo Extra 80%, Efectividad 80%, Satisfacción 85%. Se encuentra un liderazgo transformacional con tendencia a la categoría alta y un liderazgo transaccional con tendencia a la categoría baja. Por otra parte, respondiendo al objetivo de identificar las características del liderazgo transaccional en los profesionales de Enfermería de la IPS se encontró que los profesionales de Enfermería poco se identifican con estas características teniendo así unos porcentajes como en Recompensa contingente un 58.3%, Excepción Activa 36.2% y excepción pasiva 8.28%. Se identificó que el liderazgo transformacional es el estilo predominante en los profesionales en esta IPS, se encuentra un liderazgo transformacional con tendencia a la categoría alta y un liderazgo transaccional con tendencia a la categoría baja. Es importante incluir en el área de Educación de Enfermería de la institución el tema del liderazgo implementando programas y estrategias que ayuden en el desarrollo de líderes, así como proyectos de educación permanente, exponiéndolo en seminarios, talleres, congresos o simposios, utilizando como base este estudio, donde se establezcan estrategias que fomenten y fortalezcan las características de este Modelo de Liderazgo de Rango Total en el profesional de enfermería.

Leadership, a study and interest phenomenon observed from different areas and disciplines, defined as the process of leading members of a group in their work activities, is recognized as a fundamental component which influences the general effectiveness of an organization. Nursing, as a discipline, is a process that promotes and contributes to the improvement of health and life conditions of the population, achieving health care objectives inherent to the profession, and fulfilling the proposed goals in health services, favoring social, professional and organizational development. This study's objective was to identify the leadership characteristics of the Transactional and Transformational styles in the nursing profession, by applying the MLQ 5x questionnaire at an IPS in Bogota during 2012, in order to contribute in improving the quality of the services rendered by the institution. This was a quantitative, descriptive, and transversal study. The short version of the MLQ-5X instrument based on the Bass and Avolio theory on Transformational and Transactional Leadership and its characteristics was applied to 77 nursing professionals. The result showed that nursing professionals of the institution identified their leadership characteristics pertaining to transformational leadership such as: Idealized Influence Behavior 65%, Inspirational Motivation 80%, Intellectual Stimulation 70%, Individualized Consideration 70%, Extra effort 80%, Effectiveness 80%, and Satisfaction 85%. Regarding the performed study it was concluded that, it allowed the identification of the transformational and transactional leadership characteristics by means of the MLQ 5x questionnaire in leader version. In relation to transformational leadership characteristics the following were identified: Idealized Influenced Behavior 62%, Inspirational Motivation 80%, Intellectual Stimulation 70%, Individualized Consideration 70%, Extra effort 80%, Effectiveness 80% and Satisfaction 85%. As a result there is a transformational leadership with tendency towards a high category and a transactional leadership with tendency towards a low category. On the other hand in response to the objective of identifying transactional leadership characteristics in nursing professionals of the IPS, it was found that nursing professionals are less identified with these characteristics, having percentages such as Contingent Reward 58.3%, Active Exception 36.2% and Passive Exception 8.28%. Regarding the third and last objective, transformational leadership was identified as the predominating style in the professionals of this IPS, a transformational leadership with tendency towards a high category and a transactional leadership with tendency towards a low category were found. It is important to include within the Nursing Education area of the institution the topic of leadership, implementing programs and strategies which help develop leaders, as well as permanent educational projects, by means of seminars, workshops, congresses or symposium, using this study as the base, where strategies are established to promote and strengthen the characteristics of this Total Range Leadership Model in nursing professionals.

Alteraciones de patrones funcionales en personas con tuberculosis pulmonar, Villavicencio, Colombia / Functional patterns alteration in people with pulmonary tuberculosis, Villavicencio, Colombia

Objetivo: determinar las alteraciones de patrones funcionales de salud que más frecuentemente se presentan en personas con tuberculosis pulmonar en tratamiento. Metodología: estudio cualitativo, descriptivo, basado en la técnica de análisis de contenido. Durante el segundo semestre de 2009 se valoraron los patrones funcionales de salud de pacientes inscritos en el Programa de Prevención y Control de Tuberculosis de tres instituciones prestadoras de salud de carácter público de Villavicencio, Meta. Resultados y discusión: los patrones más alterados son el patrón de actividad y ejercicio, patrón de nutrición y metabolismo, patrón cognoscitivo perceptual y patrón de autopercepción y autoconcepto. La fatiga y la disnea comprometen los desplazamientos a la institución de salud, la disminución de la energía dificulta mantener un empleo, lo que afecta los ingresos familiares. Hay desconocimiento acerca de aspectos relevantes para el control de la enfermedad. Se presentan manifestaciones de tristeza y aislamiento asociadas a la percepción social negativa de la enfermedad. Conclusiones: el servicio del equipo de salud debe responder a las situaciones complejas de los enfermos, que van más allá de la administración del tratamiento. Enfermería tiene un rol protagónico en la creación de escenarios de cuidado apropiados y en el fomento de la interdisciplinariedad para la atención integral de los enfermos. Se recomienda desarrollar intervenciones individualizadas con guías de cuidado de enfermería y de manera particular mejorar la información suministrada a las personas acerca de la enfermedad, el tratamiento y las estrategias de prevención y de control de la transmisión.

Purpose: To determine functional patterns alterations in people with pulmonary tuberculosis undergoing treatment.Methods: Qualitative, descriptive study, based on the content analysis technique. During the second half of 2009, functional health patterns of patients registered in the Tuberculosis Prevention and Control Program were evaluated in three public health care providers in Villavicencio, Meta. Results and Discussion: patterns showing more alterations were activity and exercise, nutrition and metabolism and self-perception and self-concept. Fatigue and dysnea compromise trips to health institution; decrease in energy makes it difficult for patients to maintain jobs, which affects family income. There is ignorance regarding relevant aspects of disease control. Sadness and isolation associated to social negative perception of the disease are present. Conclusions: the health service team should respond to complex situations of patients, which go beyond the administration of treatments. Nursing has a core role in the creation of appropriate care scenarios and in the promotion of inter-disciplinary characters for the integral care of patients. Developing customized interventions is encouraged, with nursing care guidelines and, particularly, improving information provided to people about the disease, treatment and transmission prevention and control strategies.

Objetivo: Determinar as alterações dos padrões funcionais da saúde mais freqüentes em pessoas em tratamento contra a tuberculose pulmonar.Metodologia: Estudo qualitativo, descritivo, baseado na técnica de análise de conteúdo. Durante o segundo trimestre do ano 2009, avaliaram-se os padrões funcionais de saúde dos pacientes enrolados no Programa de Prevenção e Controle de Pacientes com Tuberculose de três instituições de saúde pública de Villavicencio, Meta, Colômbia.Resultados e discussão: Os padrões mais modificados foram os padrões de atividade e malhação; nutrição e metabolismo; cognoscitivo-perceptual; e de auto-percepção e auto- conceito. O cansaço e a dispnéia impedem o deslocamento para a instituição de saúde, a diminuição da energia dificulta o fato de manter um emprego, o que afeta a renda familiar. Existe um desconhecimento dos aspetos relevantes ao controle da doença. Além disso, a percepção social negativa da doença produz tristeza e isolamento.Conclusões: o serviço da equipe de saúde tem que responder às situações complexas dos doentes, que não dependem somente da aplicação dos tratamentos. A enfermagem desempenha um papel central na criação de possibilidades de cuidado apropriadas, e o fomento da interdisciplinaridade para a atenção integral dos doentes. O desenvolvimento de intervenções individualizadas é recomendado, utilizando guias de cuidado da enfermagem; bem como melhorar a informação que é fornecida às pessoas em relação à doença, tratamento e estratégias de prevenção e controle de transmissões.

Análisis histológico de implantes de apatita carbonatada porosa de síntesis seca y células de médula ósea de porcino / Análise histológica de implantes de apatita carbonatada porosa de síntese seca e células da medula óssea de suínos / Histological analysis of implanted porus carbonated apatite of dry synthesis embedded with porcine bone marrow cells

La apatita carbonatada (CAp) constituye uno de los principales componentes del tejido óseo. Después de sintetizar CAp por precipitación de soluciones acuosas y por reacción del estado sólido, se tomó material poroso de CAp de síntesis seca previamente embebido con células de medula ósea, y se implantó subcutáneamente y en defectos óseos creados en porcinos. En este artículo se muestra la descripción y el análisis de los cortes histológicos de muestras del material implantado. Los resultados obtenidos indicaron que el material no genera rechazo, es reabsorbido por actividad de los osteoclastos del individuo receptor y es reemplazado por tejido óseo neoformado. El tipo de osificación con el que se regenera el tejido óseo en las perforaciones creadas y reemplazadas y no reemplazadas con CAp, es la osificación membranosa la cual se describe. Las diferencias cuantitativas observadas en los controles y tratamientos respecto del área total del material indican su alta biodegradación, aparentemente explicable por una mayor actividad osteoclástica y/o una respuesta de asimilación mejorada por la presencia de células potencialmente osteogénicas del propio individuo. Esta hipótesis se refuerza por el mayor número de vasos sanguíneos encontrados en los implantes subcutáneos previamente embebidos con células madre de la médula ósea. Según los criterios evaluados, CAp poroso de síntesis seca presenta excelente biocompatibilidad, osteoinducción y osteoconducción, características que se potencian cuando el material es pre-embebido con células de médula ósea...

Carbonated apatite (CAp) constitutes one of the principal inorganic components of the osseous tissue. After synthetising of CAp by reaction of the solid state, the ceramic was treated with porcine bone marrow progenitors and then implanted subcutaneously and in created osseous defects. This article shows the description and analysis of histological samples. Results indicated that the material does not generate rejection; it is re-absorbed by the recipient's osteoclasts activity and then is replaced by biologically synthesised bone. Membranous ossification is described to be responsible for the regeneration of osseous tissue in artificially created defects, with or without being filled with CAp. The quantitative differences between controls and treatments in respect of the total area covered by the material indicate its high biodegradability, probably due to a major osteoclastic activity and/or an improved assimilative response, given the presence of potentially osteogenic cells of the own individual. This hypothesis is reinforced by the observation of more blood vessels in subcutaneous implants previously treated with bone marrow cells. According to the evaluated criteria, porous CAp of dry synthesis shows excellent biocompatibility, osteoinductivity and osteoconductivity, characteristics that are promoted when the material is pre-treated with osteoprogenitors from the bone marrow...

A apatita carbonatada (CAP) é um componente importante do tecido ósseo. Depois de sintetizar CAP por precipitação a partir de soluções aquosas e reação em estado sólido, foi colhido material poroso de CAP de síntese seca previamente embebidas com células da medula óssea, e foi introduzida no tecido subcutâneo e em defeitos ósseos criados em suínos. Este artígo mostra a descrição e a análise dos cortes histológicos de amostras do material implantado. Os resultados obtidos indicaram que este não gera rejeiçao, é reabsorvido pela atividade dos osteoclastos do receptor individual e é substituído por tecido ósseo neoformado. O tipo de ossificação com que é regenerada o tecido óssea nas perfurações criados e substituído e não substituído com CAP, é a ossificação membranosa que se descreve. As diferenças quantitativas observadas nos controles e tratamentos ao respeito da área total do material indicam sua alta biodegradação, aparentemente explicável por uma maior atividade osteoclástica e/o uma resposta de assimilação melhorada pela presença de células potencialmente osteogénicas do própio individuo. Esta hipótese é reforçada pelo maior número de vasos sanguíneos encontrados nos implantes subcutáneos previamente embebidas com células madre da medula óssea. Segundo os criterios de avaliação, CAP poroso de síntese seca mostra excelente biocompatibilidade, osteoindução e osteocondução, características que aumentam quando o material é pré-embebida com células da médula óssea...

Seroprevalencia de infección por Leptospira spp. en auxiliares y veterinarios de consultorios de pequeños animales de Villavicencio (Colombia) / Leptospira spp. infection seroprevalence in assistants and veterinarians working in small animal consulting rooms in Villavicencio (Colombia)

Objetivo: Determinar seroprevalencia por la prueba de MAT a seis serovares de Leptospira spp. en el grupo de riesgo: auxiliares y veterinarios de consultorios de pequeños animales de Villavicencio, Meta, Colombia, que previamente había sido serorreactor por Elisa-Pambio. Materiales y métodos: Se tomaron 72 muestras de sueros de individuos pertenecientes al subgrupo de auxiliares y veterinarios, de una población mayor que incluía otros 7 grupos humanos a riesgo a Leptospira spp. y que había presentado reactividad serológica considerada como “positiva” (17 %) a la prueba de Elisa para Leptospira spp. con un kit de Pambio. Los sueros, que se habían conservado a -70°C en el Laboratorio de Reproducción y Genética Animal de la Universidad de los Llanos, fueron evaluados para reactividad serológica a la prueba de microaglutinaciónlisis (MAT) con los serovares L. hardjopra- jitno, L. copenhageni, L. canícola, L. icterohaemorrhagiae, L. autumnalis, L. bratislava, L. australis y L. pomona. Se utilizó el protocolo de laboratorio del Programa Nacional de Investigación en Salud Animal de corpoica-ceisa. Resultados: La seropositidad a MAT fue 26.4%. En los auxiliares 21% y los veterina- rios 29%. La seropositidad por serovar fue L. bratislava 24%, L. australis 8%, L. copenhageni 6%, L. canícola 3%, L. autumnalis y L. hardjoprajitno 1%. No se encontraron reactores a icterohaemorrhagiae y pomona. Los títulos serológicos estuvieron en un rango entre 1:25 y 1:400. La copositividad entre MAT y ELISA IgM fue 42% y la conegatividad 77%. Conclusiones: La seropositidad en el grupo estudiado es alta y preocupante, por lo tanto, exige extremar las medidas de bioseguridad durante la práctica médico veterinaria...

Objective: Determining to six serovares Leptospira spp. seroprevalence in assistants and veterinarians working in small animal consulting rooms in Villavicencio, Meta Colombia that previously had been seroreactor for Elisa-Pambio. Materials and Methods: 72 sera samples were taken from a subgroup of individuals consisting of assistants and veterinarians, in turn forming part of a larger population which included another 7 human groups at risk of becoming infected by Leptospira spp.; a cross-sectional epidemiological model was used and subjects were chosen by convenience. The sera had remained frozen (-70°C) in the Universidad de los Llanos Animal Reproduction and Genetics laboratory since being obtained. A commercial indirect ELISA kit (Pambio) was used for determining IgM antibodies. hardjoprajitno, copenhageni, canícola, icterohaemorrhagiae, autumnalis, bratislava, australis and pomona serovars were used in the microscopic agglutination test (MAT). The protocol of laboratory of the national program of investigation in animal health of CORPOICA-CEISA was used. Results: MAT seropositivity was 26.4% (21% in assistants and 29% in veterinarians) Seropositivity by serovar was: 24% bratislava, 8% australis, 6% copenhageni, 3% canícola, 1% autumnalis and hardjoprajitno. No reactors to icterohaemorrhagiae and pomona were found. Serological titres ranged from 1:25 to 1:400. Conclusions: It was thus concluded that seropositivity in the group being studied was high and worrying, meaning that biosafety measures must be maximized for all people working in veterinary practice...

Neurodesarrollo y epilepsia / Neurodevelopment and epilepsy

El neurodesarrollo humano es un proceso organizado en periodos críticos espaciales y temporales, que puede ser alterado por múltiples factores como la epilepsia, en una complicada interacción cuyo resultado final es individual en cada etapa de la vida. Este artículo presenta los factores de riesgo que afectan al neurodesarrollo relacionados con epilepsia.

The development of the central nervous system in humans is an organized process, occurring through critical periods of the life, this process can be altered by multiple factors such as epilepsy, which exerts some complicate interaction, whose end result is individual at each stage of life. This article explains the risk factors related to developmental disorders and epilepsy.

Congestive heart failure in Latin America: the next epidemic.

Coronary artery disease is the main cause of congestive heart failure (CHF) in all populations. Latin American countries (LAC) are undergoing the first phase of an epidemic of coronary artery disease that probably will lead to an increased incidence of CHF. The progressive implementation of successful interventions, such as early reperfusion and rehabilitation programs, should increase the survival of patients with acute myocardial infarction and the population at high risk of CHF. The increasing prevalence of risk factors, such as diabetes, hypertension, and obesity, and the ageing of the population may also contribute to a rising incidence of CHF in LAC. Moreover, infectious diseases such as Chagas disease and rheumatic heart disease, known causes of CHF, are still frequent in this population and additionally contribute to the incidence of CHF. If timely preventive interventions are not implemented, CHF could become one of the main contributors to the burden of morbidity, mortality, and health costs in LAC. Properly conducted clinical and epidemiologic studies are needed to identify, implement, and evaluate preventive strategies that are likely to succeed within the specific context of LAC.

Using waist circumference as a screening tool to identify Colombian subjects at cardiovascular risk.

OBJECTIVE: A cut-off value for waist circumference (WC) of 94 cm associated with cardiovascular risk factors (CVRF) has been recommended in Caucasian populations. However, it is unclear if recommendations derived from Western studies should be extrapolated to populations from developing countries. The present study evaluated a group of Colombian subjects to determine and evaluate the level of WC capable of identifying subjects with CVRF. RESEARCH DESIGN AND METHODS: (Study 1) A cross-sectional study in 145 healthy men, to determine the level of WC associated with the following lipid profile (triglycerides 2.25 mmol/L and total-cholesterol/HDL-cholesterol ratio >5) was performed. (Study 2) Two hundred and thirty-eight unrelated male adults were recruited to test whether the new WC cut-off point would identify subjects with CVRF. RESULTS: (Study 1) A WC cut-off point of 88 cm identified subjects with the pre-established lipid profile with a sensitivity of 80.6% and specificity of 80.1%, while the WC of 94 cm had a low sensitivity (48.3%) and a high specificity (93.3%). Additionally, the values of C-reactive protein, fasting glucose and insulin levels in subjects with a WC 88 cm were significantly higher compared to subjects with WC <88 cm. (Study 2) The diagnostic accuracy of the new WC cut-off point (88 cm) to identify subjects with two or more CVRF remained acceptable in the new sample studied (sensitivity: 83.7% and specificity: 84.8%); while the WC value of 94 cm suggested in Caucasians showed a very low sensitivity (43.2%) and a high specificity (93.9%). CONCLUSIONS: This study demonstrates a higher prevalence of CVRF in our population at lower levels of WC than those suggested previously in Caucasians, suggesting that ethnic background should be taken into account when using WC as a screener for CVRF.

Situación de salud en la localidad 13, Teusaquillo, 1998 / Health situation in locality 13, Teusaquillo, 1998

Estudio cuyo objetivo fue establecer el estado de salud y sus condicionantes en los habitantes de la localidad de Teusaquillo. Se realizó una encuesta de salud de Teusaquillo a través de una encuesta de hogares por muestreo para medir la morbilidad sentida, los conocimientos, actitudes y prácticas en enfermedades degenerativas, enfermedades de la infancia, accidentes, violencia y variables asociadas, demanda y utilización de servicios y afiliación a la seguridad social. Se describe cada uno de los tópicos contemplados en esta encuesta, los cuales fueron de gran importancia para la comprensión de los problemas de la localidad en materia de salud, la complementación del diagnóstico local y la orientación de las políticas propias para esta comunidad.

The objective of this study was to establish the state of health and its determinants in the inhabitants of Teusaquillo. A health survey of Teusaquillo was conducted through a sample household survey to measure felt morbidity, knowledge, attitudes and practices in degenerative diseases, childhood diseases, accidents, violence and associated variables, demand and use of services and affiliation to social security. Each of the topics contemplated in this survey is described, which were of great importance for the understanding of the local health problems, the complementation of the local diagnosis and the orientation of the policies for this community.

Frecuencia entre la asociación de dermatitis atópica con infección de vías urinarias en pacientes de edad pediátrica / Frequency between association of atopic dermatitis and urinary tract infection in pediatric subjects

Objetivo. Existen en la literatura reportes clínicos que apoyan la asociación entre enfermedad alérgica e infección de vías urinarias, tanto por sintomatología, como por cambios anatomopatológicos e inmunológicos. Este estudio se realizó para evaluar la frecuencia de asociación de dermatitis atópica alérgica e infección de vías urinarias en sujetos pediátricos de nuestro medio. Metodología. Se incluyeron 86 sujetos preescolares, mayores de un mes y menores de cinco años 11 meses, con diagnóstico de dermatitis atópica; tomándoseles a todos examen general de orina, urocultivo, pruebas cutáneas, IgE total e IgE específica, para confirmar etiología alérgica de la dermatitis. Resultados. De los 86 sujetos estudiados, 55.8 por ciento fueron el sexo femenino. Se encontró atopia familiar en primer grado en el 52.3 por ciento y antecedentes personales de atopia en el 65.1 por ciento del grupo problemas. En cuanto a criterios diagnósticos de dermatitis atópica, se detectó morfología típica en el 84.9 por ciento; prurito en el 82.6 por ciento; exacerbación crónica en 65.1 por ciento; ojeras en el 78.9 por ciento y pliegues de Dennie-Morgan en el 62.8 por ciento. Las pruebas cutáneas resultaron positivas en el 13.95 por ciento; con PRIST de 17.45 por ciento y RAST de 5.8 por ciento. Entre los síntomas urinarios encontramos: disuria, nicturia, poliaquiuria, tenesmo vesical, enuresis, fiebre, dolor abdominal y vómito, obteniéndose sólo un urocultivo positivo para E. Coli. Conclusiones: En este estudio no se observó la asociación de dermatitis atópica alérgica e infección de vías urinaria. Se cuantificó la prevalencia de criterios menores y mayores en la población estudiada