[Risk factors associated with adherence to medical oncology treatment in pediatrics]. / Factores de riesgos asociados a la adherencia al tratamiento médico oncológico en pediatría.

In Chile, between 450 and 500 cases of cancer are diagnosed annually in children and adolescents. Treatment is financed by the state, but there are non-financial elements that could condition adherence to treatment. OBJECTIVE: to explore family, socioeconomic, housing, and support network risk factors that could affect adherence to medical treatment in children and adolescents diagnosed with cancer. PATIENTS AND METHOD: Descriptive observational study in pediatric oncology hospitals of a national cancer program. Through a "Social Care Form" applied to 104 caregivers of children and adolescents, between August 2019 and March 2020, socioeconomic data of children diagnosed with cancer were recorded in four dimensions: i) Individual/family/health; ii) Work/education/socioeconomic; iii) Housing/environment; and iv) Participation/support networks. RESULTS: 99% of the children and adolescents were registered in the public health system; 69% belonged to the lowest income brackets. Care for children and adolescents was mainly provided by the mother (91%). 79% reported living in a house; 48% owned or were paying for their home. Housing quality was described as good (70%), with low levels of overcrowding. 56% of households had access to Wi-Fi internet connection, while 27% reported no access. The main support network reported was the family (84%). CONCLUSIONS: Family, socioeconomic, housing, and support network risk factors were observed in children and adolescents diagnosed with cancer; socioeconomic and gender aspects highlight the social inequalities in these families. Descriptive baseline results were obtained, so it is suggested to re-observe its evolution and thus measure its impact on adherence to treatment.

Effect of protein and lipids levels in a growth diet on adult whitebait Galaxias maculatus (Jenyns 1842) / Efeito dos níveis de proteína e lipídio em uma dieta de crescimento em whitebait Galaxias maculatus adulto (Jenyns 1842)

Abstract Galaxias maculatus aquaculture objectives is to produce millions of eggs. Wild females are small (2 g), have quick sexual maturity and low mean fecundity (500 eggs/female), requiring larger fishes with higher fecundity. This study aim is to evaluate experimentally the effect of the levels of protein, lipid and dietary energy on weight increases in adults. Five independent experiments were performed at different sequential time periods at the UCT hatchery, Chile. Specimens were obtained from a) Crystalline sea return specimen catches in the Tolten estuary (4 -6 cm, 0.3-0.4 g.). b) Hatchery cultured fish. Fish were fed by hand ad libitum. In experiments 1 to 4, pelleted diets were prepared with 3 to 5 levels of protein (treatments 27 up to 57%), crumble size, three 100 L fibre ponds replicates. In experiment 5 the effect of two lipid levels (8 and 21%) was evaluated with commercial extruded Salmon Nutra Starter isoproteic crumble 1 diet at 63%, replicated in 4 ponds. The results show: A tendency to increased weight in all sizes with an increased protein level in the pelleted diet.A maximal adult growth is obtained with a diet containing a minimum of 37% crude protein, with 40% the optimal value. A higher % protein in the diet or growth in weight lower feed conversion ratio. The feed conversion ratio in the extruded diet reaches up to 0.5 and in the pelleted vary from 0.7 to 1.5. Fish 0.6 g fed with 63% protein, extruded commercial diet with two different lipid levels (8 and 21%, 20.40 and 23.84 MJ kg-1, PE/TE 0.62 and 0.71) increased weight the first month 67 and 105% each. It has been established that high-energy diets with optimal levels of protein and lipid are a good short-term solution to obtain G. maculatus of higher weight.

Resumo O objetivo da aquicultura de Galaxias maculatus é produzir milhões de ovos. As fêmeas selvagens são pequenas (2 g) e têm maturidade sexual rápida e fecundidade média baixa (500 ovos/fêmea), necessitando de peixes maiores e com fecundidade superior. O objetivo deste estudo é avaliar experimentalmente o efeito dos níveis de proteínas, lipídios e energia da dieta sobre o aumento de peso em adultos. Cinco experimentos independentes foram realizados em diferentes períodos sequenciais de tempo no incubatório UCT, Chile. Os espécimes foram obtidos a partir de: a) capturas de espécimes de retorno do mar cristalino no estuário de Tolten (4-6 cm, 0,3-0,4 g); b) peixes de cultura em incubatório. Os peixes foram alimentados à mão ad libitum. Nos experimentos de 1 a 4, dietas peletizadas foram preparadas com três a cinco níveis de proteína (tratamentos 27 a 57%), tamanho do crumble, três repetições de tanques de fibra de 100 L. No experimento 5, o efeito de dois níveis de lipídios (8 e 21%) foi avaliado com dieta comercial isoproteica crumble 1 de Salmon Nutra Starter extrusada a 63%, replicada em quatro tanques. Os resultados mostram: uma tendência ao aumento de peso em todos os tamanhos, com um aumento do nível de proteína na dieta peletizada; um crescimento adulto máximo com uma dieta contendo um mínimo de 37% de proteína bruta, com 40% do valor ideal; uma porcentagem maior de proteína na dieta ou crescimento em peso com menor taxa de conversão alimentar. A taxa de conversão alimentar na dieta extrusada chega a 0,5, e na peletizada varia de 0,7 a 1,5. Peixes de 0,6 g alimentados com 63% de proteína e dieta comercial extrusada com dois níveis lipídicos diferentes (8 e 21%; 20,40 e 23,84 MJ kg-1; PE / TE 0,62 e 0,71) aumentaram de peso no primeiro mês em 67 e 105% cada, respectivamente. Foi estabelecido que dietas de alta energia com níveis ótimos de proteínas e lipídios são uma boa solução de curto prazo para obter G. maculatus de peso mais alto.

Effect of protein and lipids levels in a growth diet on adult whitebait Galaxias maculatus (Jenyns 1842) / Efeito dos níveis de proteína e lipídio em uma dieta de crescimento em whitebait Galaxias maculatus adulto (Jenyns 1842)

Galaxias maculatus aquaculture objectives is to produce millions of eggs. Wild females are small (2 g), have quick sexual maturity and low mean fecundity (500 eggs/female), requiring larger fishes with higher fecundity. This study aim is to evaluate experimentally the effect of the levels of protein, lipid and dietary energy on weight increases in adults. Five independent experiments were performed at different sequential time periods at the UCT hatchery, Chile. Specimens were obtained from a) Crystalline sea return specimen catches in the Tolten estuary (4 -6 cm, 0.3-0.4 g.). b) Hatchery cultured fish. Fish were fed by hand ad libitum. In experiments 1 to 4, pelleted diets were prepared with 3 to 5 levels of protein (treatments 27 up to 57%), crumble size, three 100 L fibre ponds replicates. In experiment 5 the effect of two lipid levels (8 and 21%) was evaluated with commercial extruded Salmon Nutra Starter isoproteic crumble 1 diet at 63%, replicated in 4 ponds. The results show: A tendency to increased weight in all sizes with an increased protein level in the pelleted diet.A maximal adult growth is obtained with a diet containing a minimum of 37% crude protein, with 40% the optimal value. A higher % protein in the diet or growth in weight lower feed conversion ratio. The feed conversion ratio in the extruded diet reaches up to 0.5 and in the pelleted vary from 0.7 to 1.5. Fish 0.6 g fed with 63% protein, extruded commercial diet with two different lipid levels (8 and 21%, 20.40 and 23.84 MJ kg-1, PE/TE 0.62 and 0.71) increased weight the first month 67 and 105% each. It has been established that high-energy diets with optimal levels of protein and lipid are a good short-term solution to obtain G. maculatus of higher weight.(AU)

O objetivo da aquicultura de Galaxias maculatus é produzir milhões de ovos. As fêmeas selvagens são pequenas (2 g) e têm maturidade sexual rápida e fecundidade média baixa (500 ovos/fêmea), necessitando de peixes maiores e com fecundidade superior. O objetivo deste estudo é avaliar experimentalmente o efeito dos níveis de proteínas, lipídios e energia da dieta sobre o aumento de peso em adultos. Cinco experimentos independentes foram realizados em diferentes períodos sequenciais de tempo no incubatório UCT, Chile. Os espécimes foram obtidos a partir de: a) capturas de espécimes de retorno do mar cristalino no estuário de Tolten (4-6 cm, 0,3-0,4 g); b) peixes de cultura em incubatório. Os peixes foram alimentados à mão ad libitum. Nos experimentos de 1 a 4, dietas peletizadas foram preparadas com três a cinco níveis de proteína (tratamentos 27 a 57%), tamanho do crumble, três repetições de tanques de fibra de 100 L. No experimento 5, o efeito de dois níveis de lipídios (8 e 21%) foi avaliado com dieta comercial isoproteica crumble 1 de Salmon Nutra Starter extrusada a 63%, replicada em quatro tanques. Os resultados mostram: uma tendência ao aumento de peso em todos os tamanhos, com um aumento do nível de proteína na dieta peletizada; um crescimento adulto máximo com uma dieta contendo um mínimo de 37% de proteína bruta, com 40% do valor ideal; uma porcentagem maior de proteína na dieta ou crescimento em peso com menor taxa de conversão alimentar. A taxa de conversão alimentar na dieta extrusada chega a 0,5, e na peletizada varia de 0,7 a 1,5. Peixes de 0,6 g alimentados com 63% de proteína e dieta comercial extrusada com dois níveis lipídicos diferentes (8 e 21%; 20,40 e 23,84 MJ kg-1; PE / TE 0,62 e 0,71) aumentaram de peso no primeiro mês em 67 e 105% cada, respectivamente. Foi estabelecido que dietas de alta energia com níveis ótimos de proteínas e lipídios são uma boa solução de curto prazo para obter G. maculatus de peso mais alto.(AU)

Effect of protein and lipids levels in a growth diet on adult whitebait Galaxias maculatus (Jenyns 1842) / Efeito dos níveis de proteína e lipídio em uma dieta de crescimento em whitebait Galaxias maculatus adulto (Jenyns 1842)

Galaxias maculatus aquaculture objectives is to produce millions of eggs. Wild females are small (2 g), have quick sexual maturity and low mean fecundity (500 eggs/female), requiring larger fishes with higher fecundity. This study aim is to evaluate experimentally the effect of the levels of protein, lipid and dietary energy on weight increases in adults. Five independent experiments were performed at different sequential time periods at the UCT hatchery, Chile. Specimens were obtained from a) Crystalline sea return specimen catches in the Tolten estuary (4 -6 cm, 0.3-0.4 g.). b) Hatchery cultured fish. Fish were fed by hand ad libitum. In experiments 1 to 4, pelleted diets were prepared with 3 to 5 levels of protein (treatments 27 up to 57%), crumble size, three 100 L fibre ponds replicates. In experiment 5 the effect of two lipid levels (8 and 21%) was evaluated with commercial extruded Salmon Nutra Starter isoproteic crumble 1 diet at 63%, replicated in 4 ponds. The results show: A tendency to increased weight in all sizes with an increased protein level in the pelleted diet.A maximal adult growth is obtained with a diet containing a minimum of 37% crude protein, with 40% the optimal value. A higher % protein in the diet or growth in weight lower feed conversion ratio. The feed conversion ratio in the extruded diet reaches up to 0.5 and in the pelleted vary from 0.7 to 1.5. Fish 0.6 g fed with 63% protein, extruded commercial diet with two different lipid levels (8 and 21%, 20.40 and 23.84 MJ kg-1, PE/TE 0.62 and 0.71) increased weight the first month 67 and 105% each. It has been established that high-energy diets with optimal levels of protein and lipid are a good short-term solution to obtain G. maculatus of higher weight.

O objetivo da aquicultura de Galaxias maculatus é produzir milhões de ovos. As fêmeas selvagens são pequenas (2 g) e têm maturidade sexual rápida e fecundidade média baixa (500 ovos/fêmea), necessitando de peixes maiores e com fecundidade superior. O objetivo deste estudo é avaliar experimentalmente o efeito dos níveis de proteínas, lipídios e energia da dieta sobre o aumento de peso em adultos. Cinco experimentos independentes foram realizados em diferentes períodos sequenciais de tempo no incubatório UCT, Chile. Os espécimes foram obtidos a partir de: a) capturas de espécimes de retorno do mar cristalino no estuário de Tolten (4-6 cm, 0,3-0,4 g); b) peixes de cultura em incubatório. Os peixes foram alimentados à mão ad libitum. Nos experimentos de 1 a 4, dietas peletizadas foram preparadas com três a cinco níveis de proteína (tratamentos 27 a 57%), tamanho do crumble, três repetições de tanques de fibra de 100 L. No experimento 5, o efeito de dois níveis de lipídios (8 e 21%) foi avaliado com dieta comercial isoproteica crumble 1 de Salmon Nutra Starter extrusada a 63%, replicada em quatro tanques. Os resultados mostram: uma tendência ao aumento de peso em todos os tamanhos, com um aumento do nível de proteína na dieta peletizada; um crescimento adulto máximo com uma dieta contendo um mínimo de 37% de proteína bruta, com 40% do valor ideal; uma porcentagem maior de proteína na dieta ou crescimento em peso com menor taxa de conversão alimentar. A taxa de conversão alimentar na dieta extrusada chega a 0,5, e na peletizada varia de 0,7 a 1,5. Peixes de 0,6 g alimentados com 63% de proteína e dieta comercial extrusada com dois níveis lipídicos diferentes (8 e 21%; 20,40 e 23,84 MJ kg-1; PE / TE 0,62 e 0,71) aumentaram de peso no primeiro mês em 67 e 105% cada, respectivamente. Foi estabelecido que dietas de alta energia com níveis ótimos de proteínas e lipídios são uma boa solução de curto prazo para obter G. maculatus de peso mais alto.

Effect of protein and lipids levels in a growth diet on adult whitebait Galaxias maculatus (Jenyns 1842)

Abstract Galaxias maculatus aquaculture objectives is to produce millions of eggs. Wild females are small (2 g), have quick sexual maturity and low mean fecundity (500 eggs/female), requiring larger fishes with higher fecundity. This study aim is to evaluate experimentally the effect of the levels of protein, lipid and dietary energy on weight increases in adults. Five independent experiments were performed at different sequential time periods at the UCT hatchery, Chile. Specimens were obtained from a) Crystalline sea return specimen catches in the Tolten estuary (4 -6 cm, 0.3-0.4 g.). b) Hatchery cultured fish. Fish were fed by hand ad libitum. In experiments 1 to 4, pelleted diets were prepared with 3 to 5 levels of protein (treatments 27 up to 57%), crumble size, three 100 L fibre ponds replicates. In experiment 5 the effect of two lipid levels (8 and 21%) was evaluated with commercial extruded Salmon Nutra Starter isoproteic crumble 1 diet at 63%, replicated in 4 ponds. The results show: A tendency to increased weight in all sizes with an increased protein level in the pelleted diet.A maximal adult growth is obtained with a diet containing a minimum of 37% crude protein, with 40% the optimal value. A higher % protein in the diet or growth in weight lower feed conversion ratio. The feed conversion ratio in the extruded diet reaches up to 0.5 and in the pelleted vary from 0.7 to 1.5. Fish 0.6 g fed with 63% protein, extruded commercial diet with two different lipid levels (8 and 21%, 20.40 and 23.84 MJ kg-1, PE/TE 0.62 and 0.71) increased weight the first month 67 and 105% each. It has been established that high-energy diets with optimal levels of protein and lipid are a good short-term solution to obtain G. maculatus of higher weight.

Resumo O objetivo da aquicultura de Galaxias maculatus é produzir milhões de ovos. As fêmeas selvagens são pequenas (2 g) e têm maturidade sexual rápida e fecundidade média baixa (500 ovos/fêmea), necessitando de peixes maiores e com fecundidade superior. O objetivo deste estudo é avaliar experimentalmente o efeito dos níveis de proteínas, lipídios e energia da dieta sobre o aumento de peso em adultos. Cinco experimentos independentes foram realizados em diferentes períodos sequenciais de tempo no incubatório UCT, Chile. Os espécimes foram obtidos a partir de: a) capturas de espécimes de retorno do mar cristalino no estuário de Tolten (4-6 cm, 0,3-0,4 g); b) peixes de cultura em incubatório. Os peixes foram alimentados à mão ad libitum. Nos experimentos de 1 a 4, dietas peletizadas foram preparadas com três a cinco níveis de proteína (tratamentos 27 a 57%), tamanho do crumble, três repetições de tanques de fibra de 100 L. No experimento 5, o efeito de dois níveis de lipídios (8 e 21%) foi avaliado com dieta comercial isoproteica crumble 1 de Salmon Nutra Starter extrusada a 63%, replicada em quatro tanques. Os resultados mostram: uma tendência ao aumento de peso em todos os tamanhos, com um aumento do nível de proteína na dieta peletizada; um crescimento adulto máximo com uma dieta contendo um mínimo de 37% de proteína bruta, com 40% do valor ideal; uma porcentagem maior de proteína na dieta ou crescimento em peso com menor taxa de conversão alimentar. A taxa de conversão alimentar na dieta extrusada chega a 0,5, e na peletizada varia de 0,7 a 1,5. Peixes de 0,6 g alimentados com 63% de proteína e dieta comercial extrusada com dois níveis lipídicos diferentes (8 e 21%; 20,40 e 23,84 MJ kg-1; PE / TE 0,62 e 0,71) aumentaram de peso no primeiro mês em 67 e 105% cada, respectivamente. Foi estabelecido que dietas de alta energia com níveis ótimos de proteínas e lipídios são uma boa solução de curto prazo para obter G. maculatus de peso mais alto.

Effect of protein and lipids levels in a growth diet on adult whitebait Galaxias maculatus (Jenyns 1842).

Galaxias maculatus aquaculture objectives is to produce millions of eggs. Wild females are small (2 g), have quick sexual maturity and low mean fecundity (500 eggs/female), requiring larger fishes with higher fecundity. This study aim is to evaluate experimentally the effect of the levels of protein, lipid and dietary energy on weight increases in adults. Five independent experiments were performed at different sequential time periods at the UCT hatchery, Chile. Specimens were obtained from a) Crystalline sea return specimen catches in the Tolten estuary (4 -6 cm, 0.3-0.4 g.). b) Hatchery cultured fish. Fish were fed by hand ad libitum. In experiments 1 to 4, pelleted diets were prepared with 3 to 5 levels of protein (treatments 27 up to 57%), crumble size, three 100 L fibre ponds replicates. In experiment 5 the effect of two lipid levels (8 and 21%) was evaluated with commercial extruded Salmon Nutra Starter isoproteic crumble 1 diet at 63%, replicated in 4 ponds. The results show: A tendency to increased weight in all sizes with an increased protein level in the pelleted diet.A maximal adult growth is obtained with a diet containing a minimum of 37% crude protein, with 40% the optimal value. A higher % protein in the diet or growth in weight lower feed conversion ratio. The feed conversion ratio in the extruded diet reaches up to 0.5 and in the pelleted vary from 0.7 to 1.5. Fish 0.6 g fed with 63% protein, extruded commercial diet with two different lipid levels (8 and 21%, 20.40 and 23.84 MJ kg-1, PE/TE 0.62 and 0.71) increased weight the first month 67 and 105% each. It has been established that high-energy diets with optimal levels of protein and lipid are a good short-term solution to obtain G. maculatus of higher weight.

Data supporting the production of dietary fibers from sugarcane bagasse and sugarcane tops using microwave - assisted alkaline treatments.

The treatment of agroindustrial residues is an alternative to waste management and obtain products with added value. In this article, we describe the confocal microscopy images, the microbiological data, policosanol content and color measurement linked to the paper "production of dietary fibers from sugarcane bagasse and sugarcane tops using microwave - assisted alkaline treatments". The data contain photographs after elaboration of noodles-type pasta and chapatti-type fermented bread; the confocal laser scanning micrographs, before and after including sugarcane bagasse and sugarcane tops fibers in foods. Microbiological analyses of total coliforms, molds and yeasts, and aerobic mesophiles were also presented according to Mexican Standard NOM- 247-SSA1-2008 which confirmed that the food is safe for human consumption. The data provided in this article have not been previously published and are available to enable critical or extended analyses.

Ocronosis: descripción de dos casos familiares, reseña histórica y revisión de la literatura / Ochronosis: report of two familial cases, historical overview and review of the literature

La ocronosis es la manifestación de la alcaptonuria en el tejido conjuntivo, se origina por la alteración en el metabolismo del ácido homogentísico, producto de la mutación autosómica recesiva del gen HGO, en el brazo largo del cromosoma 3 (3q21-23). Es una patología infrecuente, que se caracteriza por la presencia de calcificaciones de los discos intervertebrales y depósito de ácido homogentísico en el tejido conjuntivo y los tendones. Se presentan dos casos compatibles con las características clínicas y radiológicas de ocronosis.

Ochronosis is the manifestation of alkaptonuria in the connective tissue. It is originated by the alteration in the metabolism of homogentisic acid, a product of autosomal recessive mutation of HGO, gene in the long arm of chromosome 3 (3q21-23). It is a rare disease, characterized by the presence of calcifications in the intervertebral discs and deposit of homogentisic acid in connective tissue and tendons. We present two compatibles cases with the clinical and radiological features of ochronosis.

Indicaciones y utilidad de la inmunoglobulina por vía intravenosa en el manejo de polimiositis refractaria: reporte de caso y revisión de la literatura / Indications and utility of intravenous immunoglobulin in the treatment of refractory polymyositis: a case report and literature review / Indicações e utilidade da imunoglobulina intravenosa na abordagem de polimiosite refratário: relato de caso e revisão da literatura

Las miopatías inflamatorias corresponden a un grupo heterogéneo de enfermedades adquiridas que comprometen el sistema muscular. Tienen en común la presencia de debilidad como síntoma predominante asociado a inflamación muscular. La polimiositis (PM) es una entidad subaguda que afecta principalmente adultos y compromete estructuras musculares proximales. En este artículo se presenta el caso de un paciente de 19 años de edad con diagnóstico confirmado de PM por clínica (compromiso muscular proximal, disfagia), por los resultados de las pruebas bioquímicas (elevación sérica de la creatina kinasa o CK), por estudio de la ultraestructura por microscopia óptica de alta resolución y por los resultados de la resonancia magnética nuclear (RMN) de músculo, quien fue refractario al manejo inicial con corticoesteroides, azatioprina y ciclofosfamida. Con la administración de inmunoglobulina por vía intravenosa se observa una respuesta clínica favorable con aumento progresivo de la fuerza muscular. A pesar de que los esteroides constituyen el tratamiento de elección, en los casos refractarios se usan los agentes inmunosupresores, y la recomendación para su utilización depende de la experiencia médica o conocimiento empírico y de los resultados de los estudios de análisis de seguridad y eficacia. La inmunoglobulina por vía IV es ampliamente usada en el tratamiento de varias enfermedades autoinmunes y su eficacia radica en el efecto inmunomodulador. Sin embargo, es necesario realizar estudios clínicos controlados adicionales, que evalúen su eficacia y seguridad en pacientes con PM...

Inflammatory myopathies belong to a heterogeneous group of acquired diseases involving the muscular system. The predominant symptom is weakness associated with muscle soreness. Polymyositis (PM) is a disorder that primarily affects adults and involves proximal muscle structures. Here, a case report of a 19-year-old patient diagnosed with PM is presented as confirmed by clinical evidence (involving proximal muscle, dysphagia), biochemical findings (elevated serum CK), high-resolution optical microscopy, and ultra structure and nuclear magnetic resonance of muscle. The patient was refractory to initial treatment with corticosteroids, azathioprine and cyclophosphamide. With the administration of intravenous immunoglobulin a good clinical response was observed with progressive increase in muscle strength. Although steroids constitute the main treatment, in refractory cases the use of immunosuppressive agents is recommended, base on medical experience or empirical knowledge together with the analysis of safety and efficacy. Intravenous immunoglobulin is widely used in the treatment of various autoimmune diseases and its effectiveness relies on immunomodulatory effect. Controlled clinical studies are needed to evaluate further its efficacy and safety in patients with PM...

As miopatias inflamatórias pertencem a um grupo heterogêneo de doenças adquiridas, envolvendo o sistema muscular. Têm em comum a presença de fraqueza como sintoma predominante associada a inflamação musculares. A polimiosite (PM) é uma entidade subaguda que afeta principalmente adultos e envolve estruturas musculares proximais. Este artigo apresenta o caso de um doente de 19 anos com diagnóstico confirmado de PM por clínica (envolvendo a musculatura proximal, disfagia), pelos resultados de testes bioquímicos (níveis séricos elevados de creatinoquinase ou CK), para o estudo da ultra-estrutura por microscopia óptica de alta resolução y por los resultados de la resonancia magnética nuclear (RMN) de músculo, que era refratária ao tratamento inicial com corticóides, azatioprina e ciclofosfamida. Com a administração de imunoglobulina intravenosa há uma resposta clínica favorável com aumento progressivo da força muscular. Embora os esteróides são o tratamento de escolha, em casos refratários, são utilizados os imunossupressores, e a recomendação para o uso depende da experiência médica ou conhecimento empírico e os resultados dos estudos de análise de segurança e eficácia. A imunoglobulina intravenosa é amplamente utilizado no tratamento de várias doenças auto-imunes e sua eficácia está no efeito imunomodulador. No entanto, é necessário realizar mais estudos clínicos controlados que avaliem sua eficácia e segurança em pacientes com PM...

Miopatía por cuerpos de inclusión. Caso clínico y revisión de la literatura / Miopatia por corpos de inclusão. Relato de caso e revisão da literatura / Inclusion body myopathy. Case report and literature review

La miositis por cuerpos de inclusión (MCI) es una patología poco común que se presenta en individuos mayores de 50 años y con mayor frecuencia en hombres; sin embargo, los síntomas pueden empezar 20 años antes de su diagnóstico. Hasta un 30% de los casos de miopatías inflamatorias pueden ser de MCI y su prevalencia varía en los diferentes países y grupos étnicos. Clínicamente se manifiesta como debilidad lentamente progresiva proximal y distal. En este artículo se presenta un caso de una paciente de 78 años con antecedentes previos de diabetes mellitus tipo 2, hipertensión arterial, e hipotiroidismo, con cuadro de 18 meses de evolución consistente en debilidad de miembros inferiores, incapacidad para subir y bajar escaleras, limitación en la marcha, acompañado de disestesias. Se realizó la medición de la creatin quinasa (CK) y su valor inicial fue 7820, la electromiografía y neuroconducciones mostraron polineuropatia axonal motora en las cuatro extremidades y miopatía inflamatoria. Se trató con glucorticoides a dosis de 1 mg/kg y después de seis meses de tratamiento no se observó mejoría. Se decide tomar biopsia muscular que mostró miopatía por cuerpos de inclusión, lo que explicó la falla terapéutica inicial. Este caso es interesante desde el punto de vista clínico, ya que no es frecuente la elevación de la CK en los niveles que presentó la paciente y por las múltiples comorbilidades asociadas...

Inclusion body myositis (IBM) is an infrequent disease in people over 50 years of age, affecting more frequently males; however the symptoms may begin 20 years before its diagnosis. Up to 30% of all inflammatory myopathies can be IBM and its prevalence varies among different countries and ethnical groups. IBM manifest clinically by slowly progressive proximal and distal weakness. In this article a report of case is presented: A female patient 78 years old with previous history of type 2 diabetes mellitus, hypertension and hypothyroidism; with 18 months history of weakness in lower limbs, inability to climb stairs, limited to walk, associated with dysesthesias. The initial CK was 7820 mg/dl, the electromyography and nerve conductions reported a motor axonal polyneuropathy of four limbs and inflammatory myopathy. She was treated with steroids at doses of 1mg/kg without improvement, after 6 months of treatment. It was decided to take a muscle biopsy that showed an inclusion body myopathy, explaining the initial treatment failure. This case is interesting from a clinical point of view, since it is not frequent elevated CK levels as it was presented by the patient and for the numerous associated co-morbidities...

A miosite por corpo de inclusão (MCI) é uma doença rara que apresenta-se em indivíduos acima de 50 anos, atingindo 30% das miopatias inflamatória; orém os sintomas podem começar 20 anos antes. Sua prevalência varia entre países e grupos étnicos. Clínicamente manifesta-se como uma fraqueza lentamente progressiva proximal e distal mais frecuentemente nos homens. Nós relatamos um caso de uma paciente de 78 anos com antecedentes de diabetes mellitus tipo 2, hipertensão e hipotireoidismo. Com quadro clínico de 18 meses de evolução consistindo em fraqueza nos membros inferiores, incapacidade de subir escadas, a limitação para a marcha, acompanhados de disestesias. Foi feito a prova de CK dando um valor inicial de 7820 e com eletromiografia e neurocondução que informaram polineuropatia axonal motora de quatro membros e miopatia inflamatória. Foi tratado com corticóides em doses de 1 mg / kg sem melhora após 6 meses de tratamento, razão pela qual foi decidido fazer uma biópsia do músculo que mostrou miopatía do corpo de inclusão, explicando a falha do tratamento inicial. Este caso é interessante do ponto de vista clínico, uma vez que não é frequente a elevação da CK nos niveis apresentados pela paciente e pelas múltiplas comorbidades associadas...

METABOLITOS SECUNDARIOS AISLADOS DE LA CORTEZA DE Dugandiodendron argyrotrichum Lozano (MAGNOLIACEAE) / SECONDARY METABOLITES ISOLATED FROM THE BARK OF Dugandiodendron argyrotrichum Lozano (MAGNOLIACEAE) / METABOLITOS SECUNDARIOS ISOLADOS DA CASCA DA Dugandiodendron argyrotrichum Lozano (MAGNOLIACEAE)

A partir del extracto etanólico de la corteza del árbol colombiano en peligro de extinción Dugandiodendron argyrotrichum (Magnoliaceae) se aisló por cromatografía en columna un aceite compuesto mayoritariamente por sesquiterpenos, así como dos sesquiterpenoides, torreyol y partenólido, y el alcaloide aporfínico N-acetilanonaina. Los compuestos se identificaron por cromatografía de gases acoplada a espectrometría de masas CG-MS y resonancia magnética nuclear (RMN) de 1H y 13C. Los sustancias aisladas se sometieron al ensayo de letalidad en Artemia salina.Aquellos que resultaron más tóxicos fueron el aceite de sesquiterpenos (CL50 = 4,49 mg/ml) y los lignanos dibencilbutánicos (1) (CL50.~ 50 mg/ml).

From the ethanolic extract of the bark of the colombian endangered tree Dugan- diodendron argyrotrichum (Magnoliaceae) was isolated an oil in which major compounds were sesquiterpenes. Two sesquiterpenoids torreyol and parthenolide and the aporphine alkaloid N-acetylanonaine were isolated by column chromatography (CG-EM) and characterized by 1H and 13C nuclear magnetic resonance (NMR) spectroscopy. The isolated substances were subjected to brine shrimp lethality bioassay. The most toxic compounds were sesquiterpene oil (LC50 = 4,49 mg/ml) and dibenzylbutane lignans (1) (LC50 ~ 50 mg/ml).

A partir do extracto etanólico da casca da árvore colômbiano em perigo de extinção Dugandiodendron argyrotrichum (Magnoliaceae) isolou-se um óleo composte maioritariamente por sesquiterpenos. Duos sesquiterpenoides, torreyol e partenólido e o alcalóide N-acetilanonaina se isolaram por cromatografía de coluna e foram caracterizados por meio de espectroscopía de resonância magnêtica nuclear (RMN) 1H e 13C. Os compostos foram evaluados en el bioensaio letalidade do Artemia salina. Os compostos que resultaron mais tóxicos foram o oléo de sesquiterpenos (CL50=4,49 mg/ml) e os lignanos dibencilbutanicos (CL50 ~ 50 mg/ml).

Utilización de medicamentos en adulto mayor: Hospital General Docente Agostinho Neto, 2006 / Use of drugs in older adult: General Teoching Hospital Agosthino Neto, 2006

La población geriátrica constituye un grupo muy importante de pacientes y más en estos momentos en que el mundo está envejeciendo rápidamente, actualmente 2500 000 de personas tienen mas de 65 años de edad y para el 2008 se espera que sean 69 000 000. En los países desarrollados, más del 20por ciento de la población será de la 3ra edad como consecuencia de un aumento de la esperanza de vida y la disminución de la natalidad. En nuestro país el comportamiento es similar al de países desarrollados por lo que debemos contribuir a mejorar la calidad de vida en este grupo poblacional, más sensible a los efectos adversos a los fármacos y la polimedicación en muchos casos justificada por las patologías crónicas que tienen asociadas. Método: Se realizó un estudio de utilización de medicamentos en el adulto mayor en los servicios de medicina del Hospital General de Docente de Guantánamo en el período Enero a Diciembre 2006 con el objetivo de identificar los grupos de medicamentos más utilizados, las patologías más frecuentemente asociadas y las reacciones adversas e interacciones medicamentosas de aparición más frecuente en el adulto mayor.Resultados: Los adultos mayores tienen asociados varios medicamentos por tener más de una patología asociada y en un importante por ciento de ellos han presentado RAM e Interacciones medicamentosas no siendo recogidas en las historias clínicas. Según distribución por edad y sexo se encontró que el 59por ciento de los adultos mayores tiene entre 70 y 74 años de edad, predominando el sexo femenino, el 100por ciento de los pacientes del estudio presentaron patologías crónicas asociadas, las de más frecuente aparición fue la hipertensión arterial (72,1por ciento), así como se apreció que el grupo farmacológico de mayor utilización fue el de los antihipertensivos (87,2 por ciento), seguido por los AINEs, los antiarrítmicos y los antibióticos de amplio espectro. En ningún caso se empleó la monoterapia, el 100por ciento de los pacientes tenían más de 2 fármacos y el 63,2 por ciento más de 3 fármacos. La reacción adversa que más predominó fue la cefalea (65,2 por ciento). Conclusiones: Se demuestra que el adulto mayor es polimedicado por lo que se recomienda el análisis de las normas de tratamiento para pacientes de la tercera edad que garantice una terapéutica adecuada con un menor número de fármacos.

Utilización de medicamentos en adulto mayor: Hospital General Docente Agostinho Neto, 2006 / Use of drugs in older adult: General Teoching Hospital Agosthino Neto, 2006

La población geriátrica constituye un grupo muy importante de pacientes y más en estos momentos en que el mundo está envejeciendo rápidamente, actualmente 2500 000 de personas tienen mas de 65 años de edad y para el 2008 se espera que sean 69 000 000. En los países desarrollados, más del 20por ciento de la población será de la 3ra edad como consecuencia de un aumento de la esperanza de vida y la disminución de la natalidad. En nuestro país el comportamiento es similar al de países desarrollados por lo que debemos contribuir a mejorar la calidad de vida en este grupo poblacional, más sensible a los efectos adversos a los fármacos y la polimedicación en muchos casos justificada por las patologías crónicas que tienen asociadas. Método: Se realizó un estudio de utilización de medicamentos en el adulto mayor en los servicios de medicina del Hospital General de Docente de Guantánamo en el período Enero a Diciembre 2006 con el objetivo de identificar los grupos de medicamentos más utilizados, las patologías más frecuentemente asociadas y las reacciones adversas e interacciones medicamentosas de aparición más frecuente en el adulto mayor.Resultados: Los adultos mayores tienen asociados varios medicamentos por tener más de una patología asociada y en un importante por ciento de ellos han presentado RAM e Interacciones medicamentosas no siendo recogidas en las historias clínicas. Según distribución por edad y sexo se encontró que el 59por ciento de los adultos mayores tiene entre 70 y 74 años de edad, predominando el sexo femenino, el 100por ciento de los pacientes del estudio presentaron patologías crónicas asociadas, las de más frecuente aparición fue la hipertensión arterial (72,1por ciento), así como se apreció que el grupo farmacológico de mayor utilización fue el de los antihipertensivos (87,2 por ciento), seguido por los AINEs, los antiarrítmicos y los antibióticos de amplio espectro. En ningún caso se empleó la monoterapia, el 100por ciento de los pacientes tenían más de 2 fármacos y el 63,2 por ciento más de 3 fármacos. La reacción adversa que más predominó fue la cefalea (65,2 por ciento). Conclusiones: Se demuestra que el adulto mayor es polimedicado por lo que se recomienda el análisis de las normas de tratamiento para pacientes de la tercera edad que garantice una terapéutica adecuada con un menor número de fármacos(AU)

Characterization of CD28, CTLA4, and ICOS polymorphisms in three Brazilian ethnic groups.

Costimulatory molecules CD28, CTLA-4 (cytotoxic T-lymphocyte-associated antigen-4), and ICOS (inducible costimulator) genes lie within the 300-kb chromosome region 2q33. CD28, CTLA-4, and ICOS have been described to be important regulators of T-cell activation. With the objective to study ethnic variations in allelic frequencies and linkage disequilibrium (LD) patterns, we genotyped CD28 intron 3 (+17 T>C), CTLA4 promoter (-319 C>T), CTLA4 exon 1 (+49 A>G), and ICOS 3' UTR (1564 T>C) polymorphisms in white (n = 103), mulatto (n = 97), and black (n = 79) Brazilian healthy individuals. No significant deviations from Hardy-Weinberg equilibrium were found in any of the population samples. A higher frequency of CD28 +17 C allele was detected in white (27%) in comparison with mulatto (15%) and black (13%) (p = 0.005) populations. LD between CD28 +17 C and CTLA4 -319 T alleles was observed in whites (p < 0.0001), mulattos (p = 0.0001), and blacks (p = 0.0002).

A comparison between IgG antibodies against Eimeria acervulina, E. maxima, and E. tenella and oocyst shedding in broiler-breeders vaccinated with live anticoccidial vaccines.

The aim of this study was to compare the IgG response against Eimeria acervulina, E. maxima, and E. tenella and oocyst shedding in broiler-breeders vaccinated with live (virulent or attenuated) anticoccidial vaccines. Serum and faeces samples were collected from chickens before (4 days of age) and after (25 days of age) vaccination with virulent (group A) or attenuated (group B) vaccines and unvaccinated control birds (group C). Criteria for evaluation included the number of oocysts shed on the litter (McMaster technique), the levels of specific serum IgG (ELISA) and the frequencies of antigenic fractions recognised by IgG antibodies (immunoblotting). The results demonstrated that the virulent vaccine (A) presented an ideal association (low oocyst number and high IgG positive rate) for E. acervulina and E. tenella while the immunised flock with the attenuated vaccine (B) demonstrated this ideal association only for E. maxima. Both vaccinated flocks demonstrated a better association for three Eimeria spp. studied when compared to the control group, which presented a divergent association (high oocyst number and low IgG positive rate), particularly for E. acervulina. Immunoblotting assays revealed different antigenic fractions that may be considered as immunodominant antigens. The present study suggests that E. acervulina is critically present in the region studied and the use of live anticoccidial vaccines (virulent or attenuated) showed to be effective to control the clinical coccidiosis in vaccinated flocks.

Seguridad alimentaria y nutricional en un espacio de riesgo para la malaria / Food and nutritional security in a risk area for malaria

To explore some relationships between alimentary and nutritional security (SAN) and nutritional status in an endemic malaria community, applying qualitative and quantitative methods simultaneously. The study was descriptive and prospective. The population were all farming Afro-American families who live in the basin of the river Valle (Bahía Solano. Chocó, Colombia) that derived the base of their feeding of the agriculture. The SAN was measured from the monthly availability of foods and was classified in adequate and inadequate according to the available monthly caloric balance percentage. We determined the risk of acute malnutrition (indicative P/T), chronic (T/E), global (P/E) and risk of thinness (BMI). We sought for malarian cases. The official data of illness were revised. We applied surveys to know the morbidity and knowledge, attitudes and practices in malaria infections, 29 per cent of homes had alimentary insecurity. There was protein deficit and iron of high availability, calcium and vitamin A in 100 per cent of families. In children under 6 years old, we found 31 per cent and 69 per cent, in same order, with low P/T and T/E, while in the 6-10 year old children had 14 per cent and 41 per cent, respectively. In adolescents (11 to 17 years old) the risk of thinness was 15 per cent and in adults 3 per cent. There was not association between alimentary available and family nutritional status. These results suggest subclinics deficiencies of micronutrients.

Parámetros espectrales de fatiga muscular local en erectores espinales de sujetos chilenos / Spectral parameters in local muscular fatigue in spinal erectors of Chilean subjects

Introducción: una baja resistencia a la fatiga muscular local de los músculos erectores espinales se ha relacionado con el desarrollo de dolor lumbar. La evaluación de esta característica mediante electromiografía de superficie, minimiza la influencia de componentes motivacionales y otorga datos más objetivos respecto de la resistencia muscular. Método: en este estudio se comparó el índice EMG de fatiga muscular local de los músculos multifidus e ilicostalis lumborum y el tiempo de resistencia, entre un grupo de sujetos sanos sedentarios (n=10) y un grupo de deportistas (n=10), durante la prueba de Biering-Sorensen. Resultados: no se encontró diferencia significativa entre los índices de fatiga muscular del múltifidus (P=0,5) y del ilicostalis lumborum (P=0,6), tampoco hubo diferencia en el tiempo de resistencia entre los grupos de sujetos. En ambos grupos se encontró una diferencia significativa entre el índice de fatiga del multifidus, en comparación a los del ilicostalis lumborum (P<0,05). Describiendo así un menor grado de fatiga este último. Conclusión: esta diferencia en el grado de fatiga puede ser atribuida a una diferencia funcional entre ambos múculos, explicada por la biomecánica de la columna lumbar

Epidemiologic panorama of stomach cancer mortality in Mexico.

BACKGROUND: Annually, there are more than 6 million deaths from a type of malignant neoplasia worldwide. In developing countries, the highest rates of incidence of malignant neoplasias are uterine cervical cancer, stomach, lung, esophagus, pharynx, and liver cancers. Recent estimates on the incidence of cancer worldwide show that, in 1990, stomach cancer (SC) was the second most frequent type of cancer (900,000 new cases annually). Rates of incidence have decreased consistently in nearly all areas of the world. In Mexico, however, rates of incidence and mortality have increased gradually between 1980 and 1997; in 1995, 4,685 people died of SC in Mexico. This report presents a descriptive analysis of SC mortality in Mexico. METHODS: A mortality database edited from the electronic files of the National Institute of Informatics, Statistics and Geography (INEGI) in Mexico was used; population denominators were edited by the Mexican National Population Council (Conapo). Adjusted mortality rates, taking as standard of reference the population of Mexico City by sex, year, and 10-year age groups were calculated as well as the sex ratio for the 1980-1997 period. To evaluate the magnitude of risks by state, the standardized mortality ratio (SMR) was calculated; prematurity was evaluated through the potential lost-life years index (PLLYI). The analysis was carried out using the Excel and Stata 5.0 software programs. RESULTS: During the years from 1980 to 1997, in Mexico the total number of deaths from SC was 76,315. The male:female ratio was 1.2:1.0. SMR by state showed that the states of Yucatán, Sonora, Zacatecas, Michoacán, and Chiapas had higher mortality rates. The PLLYI was higher for males in the states of Chiapas, Sonora, Chihuahua, Zacatecas, and Southern Baja California, and higher for females in Chiapas, Oaxaca, Yucatán, Puebla, and Campeche. CONCLUSIONS: World statistics on mortality caused by SC suggest a decreasing trend. Findings for this study show an increase in the adjusted mortality rates by SC during the 1980-1997 period in Mexico. However, when analyzing the different indicators that reveal risks, magnitude, and prematurity of mortality, there is a differential trend in mortality by sex that includes regional patterns probably related to different socioeconomic levels.

Breast cancer in Mexican women: an epidemiological study with cervical cancer control.

INTRODUCTION: In Mexico, breast cancer (BC) is one of the main causes of cancer deaths in women, with increasing incidence and mortality in recent years. Therefore, the aim of the study is identify possible risk factors related to BC. METHODS: An epidemiological study of hospital cases of BC and controls with cervical uterine cancer (CUCA) was carried out at eight third level concentration hospitals in Mexico City. The total of 353 incident cases of BC and 630 controls with CUCA were identified among women younger than 75 years who had been residents of the metropolitan area of Mexico City for at least one year. Diagnosis was confirmed histologically in both groups. Variables were analyzed according to biological and statistical plausibility criteria. Univariate, bivariate and multivariate analyses were carried out. Cases and controls were stratified according to the menopausal hormonal status (pre and post menopause). RESULTS: The factors associated with BC were: higher socioeconomic level (OR= 2.77; 95%CI = 1.77 - 4.35); early menarche (OR= 1.32; 95%CI= 0.88 - 2.00); old age at first pregnancy (>31 years: OR= 5.49; 95%CI= 2.16 - 13.98) and a family history of BC (OR= 4.76; 95% CI= 2.10 - 10.79). In contrast, an increase in the duration of the breastfeeding period was a protective factor (>25 months: OR= 0.38; 95%CI= 0.20 - 0.70). CONCLUSIONS: This study contributes to the identification of risk factors for BC described in the international literature, in the population of Mexican women. Breastfeeding appears to play an important role in protecting women from BC. Because of changes in women's lifestyles, lactation is decreasing in Mexico, and young women tend not to breastfeed or to shorten the duration of lactation.

Prostate cancer mortality trends in Mexico, 1980-1995.

BACKGROUND: In Mexico, prostate cancer (PC) is the second highest cause of mortality by cancer in men. In 1991, there were 2,473 deaths, with a crude rate of 5.66 cases per 100,000 men age 40 or over. For this same year, the ratio of proportional mortality to the total number of malignant tumors was 12.6%. Our objectives were to determine the trends and geographic distribution of mortality for PC in Mexico for 1980-1995. METHODS: Crude and adjusted mortality rates were carried out for 1980-1995. A test for trend was done using the simple lineal regression method. The standardized mortality ratio (SMR) was calculated for 1980-1995 for each Mexican state. RESULTS: The total number of deaths by PC in Mexico for 1980-1995 was 32,349. The crude mortality rate increased during that period from 3.16 to 6.75 cases per 100,000 men over age 40. The statistical trend test with respect to time was significant (P<0.0001). The state of Southern Baja California showed a higher SMR, and a smaller SMR was shown for the state of Quintana Roo. CONCLUSIONS: The mortality trends for PC increased for the period studied. It represents a serious problem for public health. We find that the central and northern states of the country, characterized by a greater industrial and socioeconomic development, are those with a higher SMR.