A new set of equations for the simplified calibration of fluorescence Ca2+ transients in skeletal muscle fibers.

The classical approach for calibrating non-ratiometric fluorescent Ca2+ dyes entails the measurement of the fluorescence maximum (Fmax) and minimum (Fmin), as well as the dissociation constant (Kd) of the Ca2+-Dye reaction (model 1). An alternative equation does not need the Fmin but requires the rate constants kon and koff (model 2). However, both approaches are experimentally time consuming and the rate constants for several dyes are unknown. Here, we propose a set of equations (model 3) that simplify the calibration of fluorescent Ca2+ transients obtained with non-ratiometric dyes. This equation allows the calibration of signals without using the Fmin: [Ca2+] = Kd(F - Frest/Fmax - F) + [Ca2+]IR(Fmax - Frest/Fmax - F), where [Ca2+]IR is the resting [Ca2+]. If the classical calibration approach is followed, the Fmin can be estimated from: Fmin = Frest - ([Ca2+]IR(Fmax - Frest)/Kd). We tested the models' performance using signals obtained from enzymatically dissociated flexor digitorum brevis fibers of C57BL/6 mice loaded with Fluo-4, AM. Model 3 performed the same as model 2, and both gave peak [Ca2+] values 15 ± 0.3% (n = 3) lower than model 1, when we used our experimental Fmin (1.24 ± 0.11 A.U., n = 4). However, when we used the mathematically estimated Fmin (6.78 ± 0.2 A.U) for model 1, the peak [Ca2+] were similar for all three models. This suggests that the dye leakage makes a correct determination of the Fmin unlikely and induces errors in the estimation of [Ca2+]. In conclusion, we propose simpler and time-saving equations that help to reliably calibrate cytosolic Ca2+ transients obtained with non-ratiometric fluorescent dyes. The use of the estimated Fmin avoids the uncertainties associated with its experimental measurement.

Coloration mechanisms and phylogeny of Morpho butterflies.

Morpho butterflies are universally admired for their iridescent blue coloration, which is due to nanostructured wing scales. We performed a comparative study on the coloration of 16 Morpho species, investigating the morphological, spectral and spatial scattering properties of the differently organized wing scales. In numerous previous studies, the bright blue Morpho coloration has been fully attributed to the multi-layered ridges of the cover scales' upper laminae, but we found that the lower laminae of the cover and ground scales play an important additional role, by acting as optical thin film reflectors. We conclude that Morpho coloration is a subtle combination of overlapping pigmented and/or unpigmented scales, multilayer systems, optical thin films and sometimes undulated scale surfaces. Based on the scales' architecture and their organization, five main groups can be distinguished within the genus Morpho, largely agreeing with the accepted phylogeny.

Brilliant iridescence of Morpho butterfly wing scales is due to both a thin film lower lamina and a multilayered upper lamina.

Butterflies belonging to the nymphalid subfamily, Morphinae, are famous for their brilliant blue wing coloration and iridescence. These striking optical phenomena are commonly explained as to originate from multilayer reflections by the ridges of the wing scales. Because the lower lamina of the scales of related nymphalid butterflies, the Nymphalinae, plays a dominant role in the wing coloration, by acting as a thin film reflector, we investigated single blue scales of three characteristic Morpho species: M. epistrophus, M. helenor and M. cypris. The experimental data obtained by spectrophotometry, scatterometry and scanning electron microscopy demonstrated that also in the Morpho genus the lower lamina of both the cover and ground scales acts as an optical thin film reflector, contributing importantly to the blue structural coloration of the wings. Melanin pigment has a contrast-enhancing function in a sub-class of ground scales.

Efectividad del Bypass Gástrico sobre Factores De Riesgo Cardiovascular y Obesidad, experiencia Grupo Colombiano de Obesidad / Effectiveness of Gastric Bypass on Cardiovascular Risk Factors and Obesity, experience Colombian Group of Obesity

Objetivo: Determinar los efectos del bypass gástrico sobre factores de riesgo cardiovascular (hipertensión, dislipidemia, diabetes) en pacientes sometidos a cirugía bariátrica en Colsubsidio IPS, Bogotá, Colombia, y la proporción de pacientes con éxito posterior al procedimiento, definida como una pérdida del 50% del exceso de peso corporal al año. Métodos: Estudio de corte transversal. El tamaño de muestra se calculó con un nivel de significación de 5%, potencia del 80%, asumiendo una proporción de pacientes con comorbilidades del 40% y una proporción esperada al cabo de un año posterior a la cirugía bariátrica del 10%, obteniendo como mínimo 70 pacientes. Se incluyeron 127 pacientes, 106 (83,46%) mujeres; se les realizó bypass gástrico a 114 pacientes (89,76%). Resultados: Se encontró reducción significativa de comorbilidades al cabo de 1 año con el Bypass gástrico, tanto en la proporción de pacientes dislipidémicos, diabéticos e hipertensos, con reducciones del 60,25% (p<0,001), 80,65% (p<0,001) y 78,05% (p=0,01) respectivamente. Se obtuvo pérdida del exceso de peso del 75,77% (p<0,001) y reducción significativa de los niveles de hemoglobina glicosilada de 2,8% (p =0,0016). Conclusión: La cirugía bariátrica representa una estrategia segura para el manejo de la diabetes mellitus en obesos mórbidos con mejoría importante de los factores de riesgo cardiovascular.

Objective: to determine the effects of gastric bypass on cardiovascular risk factors such as hypertension, dyslipidemia and diabetes in patients undergoing bariatric surgery in Colsubsidio Health Care Service Provider, Bogotá, Colombia, and the proportion of patients with post-procedure success, defined as a 50% of excess weight loss in 1 year. Methods: Cross-sectional study. The sample size was calculated with a significance level of 5%, 80% power, assuming a proportion of patients with comorbidities of 40% and an expected rate after 1 year bariatric surgery of 10%, obtaining as at least 70 patients. There were 127 patients enrolled, among them, 106 (83,46%) were women; 114 patients (89,76%) underwent gastric bypass. Results: A significant reduction of comorbidities was found 1 year after gastric bypass in the proportion of patients with dyslipidemia, diabetes and hypertension, with a reducction of 60,25% (p<0, 001), 80,65% (p<0,001) and 78,05% (p=0, 01) respectively. Besides, an excess weight loss of 75,77% (p<0, 001) was founded, as well as a significant reduction of 2,8% (p =0,0016) in glycosylated hemoglobin levels. Conclusions: Bariatric surgery is a safe strategy for the management of diabetes mellitus in morbid obese patients with significant improvement in cardiovascular risk factors.

Una expresión infrecuente de una asociación epidémica desbordada: Tuberculosis y diabetes / Tuberculosis and diabetes association low frequency from an outbreak recently

La tuberculosis (TB) es la causa más frecuente de muerte por un microorganismo bacteriano específico, causando 1,3 millones de muertes al año. Las alteraciones inmunológicas juegan un papel importante en su desarrollo (1-2). Actualmente las causas de inmunosupresión que favorecen el desarrollo de la (TB) son la infección por el virus del VIH, la desnutrición y el envejecimiento. La diabetes mellitus tipo 2 (DM) presenta una pérdida de la inmunidad, aumentando el riesgo de infección y el desarrollo de enfermedad tuberculosa o su reactivación endógena (3).Los macrófagos tienen un papel protagónico en este proceso debido aldeterioro en la capacidad de fagocitosis, opsonización, producción anómala de peróxido de hidrógeno (H2O2) y mal funcionamiento de receptores Fc para el complemento C3; todos estos mecanismos contribuyen a la respuesta,control y destrucción del M. tuberculosis. La pérdida de estas funciones en las personas diabéticas favorece una creciente asociación con la TB que ha adquirido carácter de epidemia (4-5)...

Dolor torácico: más allá de un síndrome coronario / Chest pain: beyond the coronary syndrome

El dolor torácico representa para el médico, un reto inmediato. Este síntoma suele ser de etiología benigna, pero algunas veces puede augurar una catástrofe inminente. Los textos de medicina siempre suelen hacer hincapié en la naturaleza de alto riesgo en lo referente a este y su asociación con etiologías que amenazan la vida, las cuales pueden tener un carácter incapacitante o mortal y requieren un enfoque eficaz para el diagnóstico (1-2). La historia clínica se convierte en un elemento de vital importancia para la realización de un diagnóstico correcto a través de la adecuada descripción de (características, intensidad, localización, duración, factores atenuantes y desencadenantes del dolor, síntomas asociados, y en algunos casos los factores de riesgo de algunas enfermedades) que se apoyan en hallazgos físicos específicos. Es importante destacar que la prevalencia de las etiologías del dolor torácico varía en función de la población estudiada (3). En estudios realizados en pacientes atendidos en los servicios de urgencias se presentan datos interesantes como: el 60% de diagnósticos de dolor torácico no son de origen “orgánico” (no se debían a patologías cardíacas, gastrointestinales, o enfermedad pulmonar), el dolor torácico de causa músculo esquelética constituye el 36 porciento de todos los diagnósticos, seguido de la esofagitis por reflujo 13 porciento y finalmente la angina de pecho estable es responsable del 11 porciento de los episodios de dolor de pecho, la angina inestable o infarto agudo de miocardio se presentaron en el 1,5 porciento.Dentro de las causas de dolor torácico también se encuentran las originadas en el mediastino a pesar que son poco frecuentes; estas se asocian con signos y síntomas según la implicación de diferentes estructuras comprometidas o circundantes (4). La mediastinitis se define como la inflamación o la infección del tejido conectivo que rodea a las estructuras mediastínicas.

Chest pain is for the physician, an immediate challenge. This symptom is usually a benign etiology, but sometimes may portend an imminent catastrophe. Medical texts tend always to emphasize the high-risk nature with regard to this and its association with life-threatening etiologies, which can be a disabling or fatal nature and require an effective approach for diagnosis (1-2 ). The clinical history becomes a vital element for making a correct diagnosis through adequate description of (characteristics, intensity, location, duration, and triggers pain mitigating factors, associated symptoms, and in some cases the factors risk of some diseases) that rely on specific physical findings. Importantly, the prevalence of the etiologies of chest pain varies depending on the studied population (3). Studies in patients treated in emergency departments as presented interesting data: 60% of diagnoses of chest pain are not “organic” origin (not due to heart disease, gastrointestinal or pulmonary disease), chest pain cause skeletal muscle constitutes 36% of all diagnoses, followed by reflux esophagitis 13% and finally stable angina pectoris is responsible for 11% of episodes of chest pain, unstable angina or acute myocardial infarction presented at 1.5%. Among the causes of chest pain are also those arising in the mediastinum although they are rare; these are associated with signs and symptoms according to the involvement of different compromised or surrounding structures (4). The mediastinitis is an inflammation or infection of connective tissue surrounding mediastinal structures.

High prevalence and risk factors associated with latent tuberculous infection in two Colombian prisons.

SETTING: Two prisons in Medellín and Itagüí, Colombia. OBJECTIVE: To determine the prevalence of tuberculin skin test (TST) positivity in prisoners and the annual risk of tuberculous infection (ARTI), to identify risk factors associated with a positive result, and to describe progression to active disease. DESIGN: Cross-sectional study. Inmates were included if time of incarceration was ⩾1 year and excluded if subjects had had previous or active tuberculosis (TB), or conditions that could hamper TST administration or interpretation. RESULTS: We screened 1014 inmates. The overall prevalence of TST positivity was 77.6%. The first TST administration resulted in 66% positivity, and the second TST an additional 11.6%. In Prison One, the ARTI was 5.09% in high TB incidence cell blocks and 2.72% in low TB incidence blocks. In Prison Two, the ARTI was 2.77%. Risk factors associated with TST positivity were history of previous incarceration and length of incarceration. Among all those included in the study, four individuals developed active pulmonary TB. CONCLUSION: Prevalence of TST positivity in prisoners and the ARTI were higher than in the general population, but differed between prisons; it is important to apply a second TST to avoid an overestimation of converters during follow-up.

Estrés y factores relacionados en padres con hijos en la unidad / Stress and related factors in parents with children in neonatal intensive care unit

Objetivo: identificar el nivel de estrés y los factores relacionados, en padres con hijos en la Unidad de Cuidado Intensivo neonatal de la Clínica Universitaria Bolivariana. Metodología: estudio cuantitativo, de tipo descriptivo, transversal. Se aplicó la escala de Estrés Parental en la Unidad de Cuidado Intensivo, PSS: NICU, desarrollada y validada por Carter y Miles. En total se estudiaron a 50 padres, escogidos a conveniencia. Resultados: la edad promedio de los padres fue de 30.6 años, el 36.7 por ciento tenían escolaridad universitaria, el 42 por ciento con estrato socioeconómico nivel 3. El 62 por ciento eran empleados, el 76 por ciento de género femenino y para el 42 por ciento era su primer hijo. El principal diagnóstico del neonato fue de enfermedad respiratoria (24 por ciento). El 44 por ciento de los padres señaló que el nivel de estrés frente a lo que vio y escuchó en la unidad fue un poco estresante. El comportamiento, el aspecto y los tratamientos del bebé, fueron un poco estresantes para el 34 por ciento. El 32 por ciento de los padres señaló que era muy estresante su relación y rol de padres, valor que fue significativo estadísticamente. La comunicación con el personal de salud, para el 34 por ciento de los padres, fue poco estresante. Para el nivel de estrés general, el 28 por ciento expresó que la experiencia en general de tener a su hijo en la unidad, fue poco estresante, mientras que el 24 por ciento indicó que fue muy estresante. Conclusión: Los padres presentaron mayor estrés, cuando se desempeñan en su rol de padres, valor con significancia estadística.

Objective: To identify the level of stress and related factors in parents of children in the Neonatal Intensive Care Unit of the Clinica Universitaria Bolivariana. Methodology: study quantitative, descriptive, transversal. We applied the Parental Stress Scale in Intensive Care Unit, PSS: NICU, developed and validated by Carter and Miles. A total of 50 parents was studied, chosen for convenience. Results: The mean age of the fathers was 30.6 years; the 36.7 percent had college education, 42 percent with socioeconomic level 3. 62 percent were employed, 76 percent female and in the 42 percent was their first child. The primary diagnosis was neonatal respiratory disease (24 percent). The 44 percent of parents said that the stress level compared to what they had seen and heard in the unit was a bit stressful. The baby behavior, appearance and treatments were a bit stressful for 34 percent. The 32 percent of parents pointed that their relationship and parenting role was very stressful, value which was statistically significant. Communication with health personnel was rushed for the 34 percent of parents. For the general stress level, 28 percent expressed that the overall experience of having your child in the unit, was little stressful, while 24 percent said that it was very stressful. Conclusion: Parents showed more stress when working in their role as parents, statistically significant value.

Exploración de significados con respectoa la salud bucal de un grupo de gestantes de la ciudad de Medellín, Colombia: ¿hay alfabetización en salud bucal? / Exploration of meanings regarding oral health in a group of pregnant women in Medellín, Colombia: is there oral health literacy?

Introducción: en muchas culturas, la madre es la responsable por excelencia del cuidado del bebé, en muchos casos el adulto más significativo, modelo de referencia imitable y transmisora principal de cultura, incluyendo conocimientos y prácticas de salud. El objetivo fue explorar en un grupo de gestantes de la ciudad de Medellín participantes de un programa de intervención, los significados con respecto a la salud bucal propia y de sus hijos. Métodos: el abordaje metodológico fue la etnometodología; se aplicaron entrevistas semiestructuradasque fueron grabadas, transcritas y analizadas, agrupando las respuestas en recurrencias, divergencias, textos significativos y tendencias. Resultados: las gestantes otorgan un significado importante a la boca, relacionado con la supervivencia y la estética; enfatizan en los dientes como parte integrante de la boca y consideran la salud bucal sinónimo de dientes sanos. El concepto de higiene bucal lo representan comohigiene de los dientes, con cepillo y crema dental. La boca de su futuro hijo no es asunto de preocupación, aunque consideran importante su higiene, pero no en etapas tempranas. Conclusiones: la boca como elemento fundamental de supervivencia, es un asunto reconocidopor las entrevistadas. Los cuidados de la boca del bebé, adquieren importancia en relación con la aparición de los dientes. La seda dental, elemento necesario para la higiene de los dientes, no está incorporado en las prácticas de las gestantes, como tampoco una frecuencia del cepillado. La alfabetización en salud propone construir conocimiento que incida positivamente en el fomento y conservación de la salud.

Introduction: in many cultures, mothers are responsible for taking care of their babies, being the mother frequently the most significant adult, a model to follow, and the principal transmitter of culture, including health knowledge and practices. The objective of this study was to explore a group of pregnant women’s perceptions of their own oral health and that of their children. These women were all from Medellín, Colombia, and they were participating in one of the city’s intervention programs. Methods: An ethno-methodologicalapproach was used; therefore, semi-structured interviews were conducted, recorded, transcribed and analyzed, and the responses were classified according to four criteria: recurrence, divergence, tendencies, and significant meanings. Results: pregnant mothers give significant importance to the mouth due to survival and esthetic reasons. They emphasize teeth over other parts of the mouth and think that oral health is synonymous to healthy teeth. The concept of oral hygiene is represented as cleaning the teeth with toothbrush and toothpaste. The mouth of their future child is not a matter of concern, and they consider oral hygiene important but not in early stages. Conclusions: the interviewed mothers recognize the mouth as an essential survival element. Care of the baby’s mouth gains importance as teeth appear.Dental floss, which is considered necessary as a cleaning element, is not used by pregnant women, not is it frequent tooth brushing. The claim of Oral Health Literacy is to build knowledge in order to promote and preserve health.

Resultados funcionales de carpectomía proximal en estadios avanzados en pacientes con enfermedad de Kienbock / Functional results of proximal carpectomyin advanced Kienbock disease

La carpectomía proximal es una de las técnicas más recomendadas para los pacientes con enfermedad de Kienbock en estadios avanzados (IIIa y IIIb). Se estudiaron 5 pacientes sometidos a carpectomía proximal en un periodo de 17 meses. Los resultados mostraron dorsiflexión de 58,8%, flexión palmar de 43,7% y fuerza de 15 Kg respecto al lado no operado. Un paciente presentó dolor persistente con gran limitación funcional. Los resultados clínicos de estos pacientes no alcanzaron los rangos de movimiento y fuerza reportados en la literatura después de esta intervención, posiblemente por el tiempo tan corto de seguimiento.

Capacidad funcional y salud: orientaciones para cuidar al adulto mayor / Functional capacity and health: guidelines and nursing care of the elderly

Objetivo: valorar la salud y la capacidad funcional de ancianos con dependencia funcional para el autocuidado, como elementos para orientar el cuidado de enfermería y el cuidado familiar en casa. Metodología: estudio descriptivo transversal en 40 personas de 65 y más años con dependencia funcional, cuidados por familiar, en Envigado Colombia; muestreo por conveniencia. Valoración de la capacidad funcional con el índice de Katz y la escala de Lawton y Brody, ajustados según grupo de Neurociencias, Universidad de Antioquia. Hallazgos: población entre 67 y 98 años, edad promedio 84,08 años; 82,5 porciento mujeres. Sistemas orgánicos más afectados: cardiovascular, osteomuscular y neurológico; entre 47,5 porciento y 27,5 porciento de los ancianos los tenían comprometidos. Se identificaron dos comportamientos: los hombres, y las personas de edad más avanzada, con mayores grados de dependencia en las actividades básicas e instrumentales; no se determinó asociación estadística por el pequeño tamaño muestral. Las actividades básicas estaban afectadas así: entre el 67,5 porciento y el 55 porciento de los ancianos requería ayuda; y las actividades instrumentales estuvieron comprometidas: entre el 95 porciento y el 75 porciento de los ancianos son totalmente dependientes en ellas. Conclusiones: Enfermería ha de considerar la valoración de la capacidad funcional articulada al estado de salud integral de los ancianos, para orientar su cuidado y apoyar a los cuidadores familiares. Esto además previene dependencias de cuidado innecesarias que estarían en contra de las aspiraciones del adulto mayor como individuo autónomo e independiente. Es tarea de profesionales en enfermería capacitar a cuidadores familiares sobre valoración de la capacidad funcional

Cytokine gene polymorphisms in Colombian patients with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) patients exhibit alterations in cytokine production that may be relevant to SLE pathogenesis. There is evidence that cytokine gene polymorphisms control cytokine production; thus, these polymorphisms may be associated with SLE or its clinical manifestations. To establish the association of tumor necrosis factor alpha (TNF-alpha), transforming growth factor (TGF) beta1, interleukin (IL)-10, and IL-6 gene polymorphisms in Colombian SLE patients and their clinical manifestations, 120 SLE patients and 102 healthy controls were studied. Single nucleotide polymorphisms were studied by sequence-specific primers polymerase chain reaction (SSP-PCR) at: TNFalpha-308 (G/A), TGFbeta1 codon 10 (C/T) and codon 25 (G/C), IL-10 -1082 (G/A), -819 (C/T) and -592 (C/A), and IL-6 + 174 (G/C). Human leukocyte antigen (HLA)-DRbeta1 was typed by SSP-PCR. SLE patients had increased frequency of allele C at TGFbeta1 codon 25 (P = 0.0001, odds ratio (OR): 4.25, 95% confidence interval (CI): 2.17-8.35) and allele A at TNFalpha-308 (P = 0.0004 OR: 3.9, 95% CI: 1.65-5.80) compared with healthy controls. There was higher frequency of GC genotype at TGFbeta1 codon 25 in SLE patients (P < 0.0001). Extended genotypic analysis showed that SLE patients have decreased frequency of TNFalphaLow/TGFbeta1High (0.50) compared with healthy controls (0.80) (P < 0.0001). No association was found between these polymorphisms and SLE clinical manifestations except for Sm and Ro autoantibodies that were associated with TNFalpha allele A. There is an association between TNFalpha-308A/TGFbeta1 codon 25C with SLE susceptibility in Colombian population. This association may result in a highly inflammatory response with a decrease regulatory function mediated by TNFalpha and TGFbeta1, respectively. The TNFalpha-308A/TGFbeta1 25C genotype may be one component of genetic susceptibility to SLE in Colombian population.

Comparación de anestesia espinal versus bloqueo nervioso ciático-femoral en pacientes ambulatorios sometidos a cirugía artroscópica de rodilla / Comparison of spinal anesthesia versus nervous sciatic - femoral blockade in ambulatory patients submitted to surgery artroscópica of knee

Se ha sugerido que la anestesia regional posee efectos benéficos en cirugía ambulatoria resultando en mejor analgesia, superior satisfacción del paciente y disminución de la utilización de recursos. El objetivo del presente estudio fue comparar dos técnicas anestésicas regionales en relación con la preparación para cirugía y la recuperación de los pacientes, en una población ambulatoria estandarizada. Métodos: Se estudiaron 50 pacientes adultos, ASA I-II, sometidos a cirugía artroscópica de rodilla. Los sujetos se dividieron aleatoriamente en grupo espinal (n = 25) y grupo ciático-femoral (n=25). Pacientes del grupo espinal recibieron anestesia subaracnoidea con 7.5 mg de bupivacaina hiperbárica. Pacientes del grupo ciáticofemoral recibieron bloqueo nervioso ciático-femoral utilizando una mezcla de 20 mL de lidocaina al 2 por cien más 20 mL de bupivacaina al 0.5 por cien. Se registraron los tiempos desde el ingreso a salas de cirugía hasta el comienzo de la misma, duración del procedimiento quirúrgico, tiempos de recuperación, satisfacción del paciente, calidad de la analgesia y ocurrencia de efectos adversos. Resultados: No se encontraron diferencias significativas en las medidas de recuperación entre los dos grupos. Luego de la salida del hospital el dolor difirió significativamente a las 6 horas post-operatorias (P = 0.002). La satisfacción fue alta con ambas técnicas. Conclusiones: En pacientes sometidos ambulatoriamente a cirugía artroscópica de rodilla la utilización de bloqueo nervioso ciático-femoral ofrece anestesia satisfactoria con un perfil clínico similar al obtenido con anestesia espinal a bajas dosis. Sin embargo, el bloqueo ciático-femoral se asocia significativamente con menos dolor durante las primeras 6 horas post-operatorias.

Cuidadores familiares de ancianos: quienes son y como asumen este rol / Relatives as caregivers of the elderly: who they are and how they assume their role

Objetivo: caracterizar el perfil sociodemográfico de cuidadores familiares de ancianos con dependencia funcional y describir cómo asumen su rol. Materiales y métodos: estudio descriptivo de corte transversal; 39 cuidadores familiares de ancianos con dependencia funcional, con seis o más meses como cuidadores, sin retribución económica, que viven en Envigado. Muestreo por conveniencia. Resultados: 100 por ciento mujeres, edad promedio 53,9 años, 64,1 por ciento hijas de quien cuidan; 89,7 por ciento comparten vivienda con el anciano; 38,5 por ciento solteras y 38,5 por ciento casadas, 51,3 por ciento tienen hijos. Baja escolaridad: 28,1 por ciento primaria incompleta. Situación socioeconómica así: ingreso familiar promedio del 89,7 por ciento es menor de dos salarios mínimos legales mensuales. El 79,5 por ciento comparten el papel de cuidadora con otro; 64,1 por ciento sin actividad remunerada previamente. Con referencia al cuidado: 30,8 por ciento lleva entre 3 y 6 años, 12,9 por ciento más de 12 años; 76,9 por ciento dedica más de ocho horas día; 56,3 por ciento reciben apoyo fundamentalmente de familiares y, del sistema formal, el 7,7 por ciento . Conclusiones: en Colombia es incipiente el reconocimiento del cuidado familiar; hay similitud del perfil de cuidadores con otros países; la situación del perfil de las cuidadoras se acentúa por el escaso tiempo para enriquecimiento personal y poco apoyo sistemático; se percibe ausencia de políticas de salud para fortalecer el cuidado familiar y los cuidadores.

Fractionation of membrane components from tachyzoite forms of Toxoplasma gondii: differential recognition by immunoglobulin M (IgM) and IgG present in sera from patients with acute or chronic toxoplasmosis.

Tachyzoite forms of Toxoplasma gondii were subjected to a sequential organic solvent extraction, which allows fractionation of membrane components according to their degrees of hydrophobicity, yielding three fractions named F1 (most hydrophobic) to F3 (least hydrophobic). Fractions F2 (80.85% specificity and 86.95% sensitivity) and F3 (89.36% specificity and 93.61% sensitivity) gave the best results, being preferentially recognized by immunoglobulin M (IgM) and IgG in sera from patients with acute and chronic toxoplasmosis, respectively. Improved scores of specificity (100%) and sensitivity (100%) were achieved when a secondary antibody against human IgG1 instead of total IgG was employed to measure the reactivity of IgG antibodies with the F3 fraction. To purify tachyzoite antigens recognized by human IgM or IgG antibodies, the F2 or F3 fraction was loaded onto an octyl-Sepharose column and eluted with a propan-1-ol gradient. The main antigen(s) recognized by IgM or IgG eluted in a single peak from the octyl-Sepharose resin loaded with either F2 (30 to 50% propan-1-ol) or F3 (15 to 35% propan-1-ol), respectively. These semipurified fractions gave improved scores when used to detect T. gondii-specific IgM (95.7% specificity and 81.8% sensitivity) or IgG (100% specificity and 93. 75% sensitivity) in an enzyme-linked immunosorbent assay. Further biochemical and immunological analyses of antigens partially purified from F2 and F3 indicate that glycoinositolphospholipids are preferentially recognized by IgM, whereas proteins of approximately 30 to 40 kDa are recognized by IgG, elicited during T. gondii infection in humans.

[A system of multidimensional behavior assessment. A scale for parents of children from 6 to 11 years of age. Colombian version]. / Sistema de evaluación multidimensional de la conducta. Escala para padres de niños de 6 a 11 años, versión colombiana.

INTRODUCTION: Behavioral Assessment System for Children (BASC) has demonstrated to be useful in the diagnosis of Attention Deficit Disorder (ADD). PATIENTS AND METHODS: A randomized sample of 120 children, 6 to 11-year-old, participants from the school of the city of Medellín, Colombia, was selected. The sample was stratified by sex and two socioeconomic status (SES). Parents were asked to answer the BASC Parent Rating Scale (PRS) 6-11, authorized Spanish version. RESULTS: Cronbach's alpha coefficient was 0.85 for the clinical scale (9 items). It was 0.75 for the Adaptive Scale (3 items). A scale designed with 4 items to assess ADD (hyperactivity, attention problems, aggression, and conduct problems) showed an alpha coefficient of 0.82. Male children scored significantly higher than female (ANOVA, p < 0.05) in hyperactivity, conduct problems, and atypicality. Children from low SES scored significantly higher than children of high SES on the most of clinical measures (p < 0.05) and lower on the three adaptive measures. Cluster analysis selecting six clusters found a prevalence of 61.6% for normal male children. In the total sample there were a 4% at risk of DDA type II (inattentive) and 14% at risk of DDA type I (combined). CONCLUSIONS: BASC PRS (6-11) showed reliability and validity to assessing the behavior in Spanish speaking Colombian children.

Neurocysticercosis in persons with epilepsy in Medellín, Colombia. The Neuroepidemiological Research Group of Antioquia.

PURPOSE: A prospective series of 643 persons with epilepsy attending a reference neurologic center in Medellín, Colombia, was examined by computed tomography (CT scan) or serology or both with the enzyme-linked immunoelectrotransfer blot assay (EITB) to assess the prevalence of Taenia solium cysticercosis. METHODS: All presenting patients were consecutively enrolled in the study. Five hundred forty-six persons underwent cerebral CT scans; 376 of them also had serum EITB performed. RESULTS: Prevalence of neurocysticercosis by CT scan was 13.92%. Overall prevalence of T. solium antibodies with EITB was 9.82%, but for those with late-onset epilepsy (onset after age 30 years), prevalence increased to 17.5% and 19% for those who originated from outside urban Medellín. Seroprevalence in individuals with mixed lesions (cysts and calcifications) was 88.2% and 64.10% in those with live cysts. Conversely, only 2.72% of persons with CT findings not related to neurocysticercosis had positive EITB tests. CONCLUSIONS: Our study shows that an important proportion of individuals with epilepsy have radiologic or serologic evidence of T. solium infection, suggesting that neurocysticercosis is an important etiology for epilepsy in Colombia.

[Prevalence of neurocysticercosis in individuals affected by epilepsy]. / Prevalencia de neurocisticercosis en individuos afectados de epilepsia.

INTRODUCTION: In this investigations, was carried out a neurocysticercosis (NC) prevalence study during seven months in the Instituto Neurológico de Antioquia with the purpose of known neurocysticercosis frequency as cause of epilepsy in patients older than ten years that we attended in our institute. MATERIAL AND METHODS: Computerized tomographies (CT) were made to 503 patients, with epilepsy, 24.7% of them were CT positive for NC. Cysticercosis enzyme linked immunoelectrotransfer blot (EITB) and enzyme linked immunoabsorbent assay (ELISA) test were made to 178 patients, 19.6% were EITB positive for NC and 5% ELISA positive for NC. Results. From this result it is possible to infer that about 8% of the 503 patients with epilepsy had cysticercosis, according to EITB that is the golden assay for NC. The CT and ELISA test had 94.3% and 27.7% sensitivity, respectively, according to EITB. The specificity of the CT for NC was 49.2% and specificity for ELISA test was 100% as compared to EITB. The multivariate analysis with logistic regression allowed to establish association of positive EITB with factors such as male sex, eating pork, headaches and multiple lesions in CT. CONCLUSIONS: Prevention and education actions are necessary for the interruption of the neurocysticercosis transmission chain in order to diminish the high prevalence of epilepsy in the country and its complication and consequences.

Prion plaques: molecular tumors. A hypothesis on the etiopathogenesis of prion diseases.

In spite of remarkable advances in the etiopathogenesis of spongiform encephalopathies in man and animals and the growing acceptance of the prion hypothesis, there is no explanation for the supposed 'autocatalytic' activity of this protein molecule. Our molecular tumor hypothesis proposes that the prion protein is a genotoxin which interacts directly or indirectly but specifically with its homologous cellular gene introducing mutations which lead to aberrant processing and accumulation of the protein. It is also speculated that this hypothesis would shed some light on other diseases not presently classified as prion diseases and in the process of ageing.