Reconfigured professional purpose in times of crisis: Experiences of frontline healthcare professionals during the COVID-19 pandemic.

How is professional purpose impacted in the context of a crisis? Building on discussions about professional purpose and identity, the paper explores how the understanding that professionals have about the framing, scope of functioning and aims of their profession is impacted during a time of crisis. The paper draws on interviews with 41 kinesiologists working at an accidents & emergencies (A&E) hospital in Chile during the COVID-19 pandemic. The paper shows professional purpose as a fluid, situated notion that gets re-shaped in light of contextual features. In the face of new and changing demands during times of crisis, professionals reconfigure their professional purpose to take advantage of the opportunities available. This reconfiguration takes place in response to the external context of the profession (its positioning in the public domain) and the internal relational context of the profession (its positioning with other professionals). The paper suggests a research agenda to develop a processual, situated approach to the interrogation of professional purpose to embed contextual features in scholarship in this area.

Marine Arthropods as a Source of Antimicrobial Peptides.

Peptide therapeutics play a key role in the development of new medical treatments. The traditional focus on endogenous peptides has shifted from first discovering other natural sources of these molecules, to later synthesizing those with unique bioactivities. This review provides concise information concerning antimicrobial peptides derived from marine crustaceans for the development of new therapeutics. Marine arthropods do not have an adaptive immune system, and therefore, they depend on the innate immune system to eliminate pathogens. In this context, antimicrobial peptides (AMPs) with unique characteristics are a pivotal part of the defense systems of these organisms. This review covers topics such as the diversity and distribution of peptides in marine arthropods (crustacea and chelicerata), with a focus on penaeid shrimps. The following aspects are covered: the defense system; classes of AMPs; molecular characteristics of AMPs; AMP synthesis; the role of penaeidins, anti-lipopolysaccharide factors, crustins, and stylicins against microorganisms; and the use of AMPs as therapeutic drugs. This review seeks to provide a useful compilation of the most recent information regarding AMPs from marine crustaceans, and describes the future potential applications of these molecules.

Microbial community characterization of shrimp survivors to AHPND challenge test treated with an effective shrimp probiotic (Vibrio diabolicus).

BACKGROUND: Acute hepatopancreatic necrosis disease (AHPND) is an important shrimp bacterial disease caused by some Vibrio species. The severity of the impact of this disease on aquaculture worldwide has made it necessary to develop alternatives to prophylactic antibiotics use, such as the application of probiotics. To assess the potential to use probiotics in order to limit the detrimental effects of AHNPD, we evaluated the effect of the ILI strain, a Vibrio sp. bacterium and efficient shrimp probiotic, using metabarcoding (16S rRNA gene) on the gastrointestinal microbiota of shrimp after being challenged with AHPND-causing V. parahaemolyticus. RESULTS: We showed how the gastrointestinal microbiome of shrimp varied between healthy and infected organisms. Nevertheless, a challenge of working with AHPND-causing Vibrio pathogens and Vibrio-related bacteria as probiotics is the potential risk of the probiotic strain becoming pathogenic. Consequently, we evaluated whether ILI strain can acquire the plasmid pV-AHPND via horizontal transfer and further cause the disease in shrimp. Conjugation assays were performed resulting in a high frequency (70%) of colonies harboring the pv-AHPND. However, no shrimp mortality was observed when transconjugant colonies of the ILI strain were used in a challenge test using healthy shrimp. We sequenced the genome of the ILI strain and performed comparative genomics analyses using AHPND and non-AHPND Vibrio isolates. Using available phylogenetic and phylogenomics analyses, we reclassified the ILI strain as Vibrio diabolicus. In summary, this work represents an effort to study the role that probiotics play in the normal gastrointestinal shrimp microbiome and in AHPND-infected shrimp, showing that the ILI probiotic was able to control pathogenic bacterial populations in the host's gastrointestinal tract and stimulate the shrimp's survival. The identification of probiotic bacterial species that are effective in the host's colonization is important to promote animal health and prevent disease. CONCLUSIONS: This study describes probiotic bacteria capable of controlling pathogenic populations of bacteria in the shrimp gastrointestinal tract. Our work provides new insights into the complex dynamics between shrimp and the changes in the microbiota. It also addresses the practical application of probiotics to solve problems with pathogens that cause high mortality-rate in shrimp farming around the world. Video Abstract.

New records of Demospongiae (Porifera) from Reserva Marina El Pelado (Santa Elena, Ecuador), with description of Tedania (Tedania) ecuadoriensis sp. nov.

The first taxonomic descriptions of the sponge diversity at El Pelado Marine Protected Area in the province of Santa Elena, Ecuador is reported. Tedania (Tedania) ecuadoriensis Jaramillo & Hajdu, sp. nov. is described from its shallow waters. In addition, Callyspongia (Callyspongia) aff. californica (sensuCruz-Barraza and Carballo 2008; non sensuDickinson 1945) and Cliona aff. euryphylle are reported for the first time. The former species is likely distributed over 4,000 km along the Tropical Eastern Pacific, whereas the latter might be an example of a trans-isthmian lineage. An amended diagnosis for Callyspongia (Callyspongia) and an updated identification key for the subgenera of Callyspongia are provided.

Halogenated Tyrosine Derivatives from the Tropical Eastern Pacific Zoantharians Antipathozoanthus hickmani and Parazoanthus darwini.

In the search for bioactive marine natural products from zoantharians of the Tropical Eastern Pacific, four new tyrosine dipeptides, named valdiviamides A-D (1-4), were isolated from Antipathozoanthus hickmani, and two new tyramine derivatives, 5 and 6, from Parazoanthus darwini. The phenols of all six tyrosine derivatives are substituted by bromine and/or iodine atoms at the ortho positions of the hydroxyl. The planar structures of these aromatic alkaloids were elucidated from 1D and 2D NMR experiments in combination with HRESIMS data, and the absolute configurations of 1-4 were deduced from comparison between experimental and calculated electronic circular dichroism spectra. As halogenated tyrosine derivatives could represent chemotaxonomic markers of these genera, we decided to undertake the first chemical investigation of another species, Terrazoanthus cf. patagonichus. As expected, no halogenated metabolite was evidenced in the species, but we report herein the identification of two new zoanthoxanthin derivatives, named zoamides E (7) and F (8), from this species. Antimicrobial and cytotoxicity bioassays revealed that valdiviamide B (2) displayed moderate cytotoxicity against the HepG2 cell line with an IC50 value of 7.8 µM.

Evaluación de la calidad de la atención estomatológica de dos servicios de Estomatología General Integral. Sancti Spíritus. 2018 / Evaluation of the quality of dental care of two General Comprehensive Stomatology services. Sancti Spíritus. 2018

RESUMEN Fundamento: La calidad de la atención estomatológica está caracterizada en el proceso y factores que intervienen en la prestación de los servicios, dirigidos a alcanzar buenos resultados en lo que a salud bucal se refiere. Objetivo: Evaluar la calidad de la atención estomatológica de dos servicios de Estomatología General Integral de la provincia Sancti Spíritus. Metodología: Se Realizó una investigación en sistema y servicio de salud en la provincia Sancti Spíritus de enero a noviembre del 2016. De las 21 unidades asistenciales que prestan el servicio de Estomatología General Integral, se eligieron dos, una de la zona urbana y otra de la zona rural. El muestreo aleatorio simple fue el proceder que se empleó para efectuar esta elección en cada zona. El Policlínico Tipo II del municipio Cabaiguán fue la unidad seleccionada en la zona urbana y la Clínica Estomatológica Banao del municipio Sancti Spíritus en la zona rural. La muestra fueron 388 pacientes y 24 estomatólogos. Las variables: calidad del servicio, estructura, proceso y resultado, se utilizaron métodos del nivel teórico, empírico (encuesta) y de la estadística descriptiva. Resultados: En el servicio rural los pacientes estuvieron satisfechos en un 57.8 % y en el urbano en un 51.9 %; los profesionales se mostraron medianamente satisfechos en ambos servicios con 50.0 % y 71.4 % respectivamente. Conclusiones: La calidad de la atención estomatológica en la zona urbana fue evaluada de bien y en la rural de regular. Algunos indicadores de las variables estructura y resultado se identificaron con dificultad.

ABSTRACT Background: The quality of dental care is characterized in the process and factors that interfere in the provision of services, aimed at achieving good results in terms of oral health. Objective: To evaluate the quality of dental care of two General Comprehensive Stomatology services in Sancti Spíritus province. Methodology: An investigation was carried out on the system and health service in Sancti Spíritus province from January to November 2016. From 21 health care units that provide General Comprehensive Stomatology service, two were chosen, one from the urban area and the other from the rural one. The procedure used to make this choice in each zone was the Simple random sample. The Type II Polyclinic in Cabaiguán was the selected unit from the urban area and the Dental Clinic Banao in Sancti Spíritus, from the rural one. The sample consisted of 388 patients and 24 dentists. The variables: quality of service, structure, process and result, methods of theoretical, empirical (survey) and descriptive statistics were used. Results: From the rural service the patient's satisfaction represents 57.8 % and from the urban one 51.9 %; the professional's satisfaction was moderately in both services which represent 50.0 % and 71.4 % respectively. Conclusions: The quality of dental care from the urban area was evaluated as good and from the rural area as regular. Some indicators of the structure and outcome variables were identified with difficulty.

Zoanthamine Alkaloids from the Zoantharian Zoanthus cf. pulchellus and Their Effects in Neuroinflammation.

Two new zoanthamine alkaloids, namely 3-acetoxynorzoanthamine (1) and 3-acetoxyzoanthamine (2), have been isolated from the zoantharian Zoanthus cf. pulchellus collected off the coast of the Santa Elena Peninsula, Ecuador, together with three known derivatives: zoanthamine, norzoanthamine, and 3-hydroxynorzoanthamine. The chemical structures of 1 and 2 were determined by interpretation of their 1D and 2D NMR data and comparison with literature data. This is the first report of zoanthamine-type alkaloids from Zoanthus cf. pulchellus collected in the Tropical Eastern Pacific. The neuroinflammatory activity of all the isolated compounds was evaluated in microglia BV-2 cells and high inhibitory effects were observed in reactive oxygen species (ROS) and nitric oxide (NO) generation.

Assessing the Zoantharian Diversity of the Tropical Eastern Pacific through an Integrative Approach.

Zoantharians represent a group of marine invertebrates widely distributed from shallow waters to the deep sea. Despite a high diversity and abundance in the rocky reefs of the Pacific Ocean, very few studies have been reported on the diversity of this group in the Tropical Eastern Pacific coasts. While molecular techniques recently clarified some taxonomic relationships within the order, the taxonomy of zoantharians is still highly challenging due to a lack of clear morphological characters and confusing use of different data in previous studies. Our first insight into the zoantharian diversity at El Pelado Marine Protected Area - Ecuador led to the identification of six species: Terrazoanthus patagonichus; Terrazoanthus sp.; Antipathozoanthus hickmani; Parazoanthus darwini; Zoanthus cf. pulchellus; and Zoanthus cf. sociatus. A metabolomic approach using UHPLC-HRMS was proven to be very efficient as a complementary tool in the systematics of these species and specialized metabolites of the ecdysteroid and alkaloid families were identified as key biomarkers for interspecific discrimination. These results show good promise for an application of this integrative approach to other zoantharians.

Ecdysonelactones, Ecdysteroids from the Tropical Eastern Pacific Zoantharian Antipathozoanthus hickmani.

Despite a large occurrence, especially over the Pacific Ocean, the chemical diversity of marine invertebrates belonging to the order Zoantharia is largely underexplored. For the two species of the genus Antipathozoanthus no chemical study has been reported so far. The first chemical investigation of Antipathozoanthus hickmani collected at the Marine Protected Area "El Pelado", Santa Elena, Ecuador, led to the isolation of four new ecdysteroid derivatives named ecdysonelactones. The structures of ecdysonelactones A-D (1-4) were determined based on their spectroscopy data, including 1D and 2D NMR and HRMS. The four compounds of this family of ecdysteroids feature an unprecedented γ-lactone fused at the C-2/C-3 position of ring A. These derivatives exhibited neither antimicrobial nor cytotoxic activities.

A simple in vitro method to evaluate the toxicity of functional additives used in shrimp aquaculture.

To mitigate the economic losses provoked by disease outbreaks, shrimp producers employ therapeutic additives. However, important issues such as the toxicity of these products on shrimp are not always considered. In vivo toxicity assays require a lot of time and large economic and physical resources. Here, we describe an in vitro procedure to evaluate the toxicity of functional additives, used in the production of shrimp Penaeus vannamei. This method adapted the cell viability assay based on the reduction of tetrazolium salts (MTT) to primary cell cultures of shrimp hemocytes. •A simple and reliable tool that requires few physical and economic resources to evaluate in short time (6 h) the cytotoxic effect of therapeutic products and additives to be included in shrimp culture•This inexpensive method requires only a modified Hank's balanced salt solution (HBSS) containing Ca2+ and Mg2+ to keep hemocytes metabolically active to successfully carry out the cytotoxicity assay•This toxicity in vitro assay does not require exposure of the shrimp to compounds at toxic concentrations.

Terrazoanthines, 2-Aminoimidazole Alkaloids from the Tropical Eastern Pacific Zoantharian Terrazoanthus onoi.

The first chemical study of the common species Terrazoanthus onoi, present off the coast of Ecuador, led to the identification of a new family of 2-aminoimidazole alkaloids named terrazoanthines A-C (1-3). Homologues 1 and 2 feature an unprecedented 6-(imidazol-5-yl)benzo[d]imidazole. Acyl substitution pattern and complete configurational assignments were deduced from comparison between experimental and theoretical 13C NMR and ECD data, respectively. These compounds may represent key derivatives in the biosynthesis of zoanthoxanthins.

Mejores prácticas para el lavado y manipulación de la bolsa de alimentación enteral Kangaroo / Best practices for washing and handling of the bag Kangaroo enteral feeding / Melhores práticas para a lavagem e manuseio do saco alimentação enteral Kangaroo

ResumenIntroducción: La nutrición enteral es una valiosa herramienta en la terapia de los pacientes hospitalizados, especialmente en las unidades de cuidado intensivo y en pacientes que, por sus patologías, pierden su habilidad de ingerir alimentos.Metodología: se aplicó la metodología que señala la práctica clínica basada en evidencia (PCBE) que trata de localizar hallazgos que respondan a la pregunta clínica planteada mediante el estudio y análisis de investigaciones primarias y originales de alta calidad científica.Resultados: Ningún estudio respondió directamente a la pregunta, sin embargo, varias investigaciones aluden que el lavado de manos y el uso de guantes limpios funcionan como estrategia para la manipulación y lavado de este dispositivo. La calidad de los estudios encontrados es baja ya que provienen de investigaciones basadas en la opinión de expertos y revisión de literatura de poca calidad.Conclusiones:No se encuentra evidencia significativa que respalde el uso de técnica aséptica médica y quirúrgica para el manejo y lavado de la bolsa Kangaroo de alimentación enteral.

AbstractIntroduction. Enteral nutrition is a valuable tool in the therapy of hospitalized, especially in intensive care units, and patients for their diseases lose their ability to ingest food patients.Method. The methodology pointing evidence-based clinical practice (PCBE) dealing with the study and analysis of primary and original research of high scientific quality, locating findings that respond to the clinical question posed was applied.Results. No study directly answer the question, however, several investigations allude to the fact that washing hands and using clean gloves as a strategy for handling and washing of this device. The quality of the studies found is low because they come from research based on expert opinion and literature review of low quality.Conclusion. No significant evidence to support the use of medical and surgical aseptic technique for handling and washing Kangaroo Enteral feed bag was found.

ResumoIntrodução.Enteral nutrition é uma ferramenta valiosa na terapia de hospitalizadas, especialmente em unidades de cuidados intensivos, e os pacientes para suas doenças perdem a sua capacidade de ingerir alimentos pacientes.Método. A metodologia apontando prática clínica baseada em evidências (PCBE) lidar com o estudo e análise de pesquisa primária e original de elevada qualidade científica, localização de resultados que respondam à questão clínica proposta foi aplicada.Resultado. Nenhum estudo responder diretamente a questão, no entanto, várias investigações fazem alusão ao fato de que lavar as mãos e usar luvas limpas como uma estratégia para a manipulação e lavagem deste dispositivo. A qualidade dos estudos encontrados é baixa, porque eles vêm de uma pesquisa com base em opinião de especialistas e revisão da literatura de baixo qualidade.Conclusão.Nenhuma evidência significativa para apoiar o uso da técnica médica e cirúrgica asséptica para manusear e lavar o saco de alimentação Canguru Enteral foi encontrado.

Efecto de un plan educativo en la capacidad de agencia de autocuidado del paciente con hipertensión arterial en una institución de segundo nivel / Effect of an Educational Plan on the Self-care Management Capacity of Hypertensive Patients at a Second-tier Institution / Efeito de um programa educativo na capacidade de agência de autocuidado do paciente com hipertensão arterial em uma instituição segundo nível

Objetivo: el propósito de este estudio fue determinar el efecto de un plan educativo en la capacidad de agencia de autocuidado del paciente hipertenso en una institución de segundo nivel. Materiales y métodos: se realizó un estudio de intervención pre y postest, con la participación de 83 pacientes con diagnóstico de hipertensión arterial, a quienes se les aplicó el instrumento "Evaluación de la capacidad de agencia de autocuidado en el paciente hipertenso" al inicio del estudio y tres meses posteriores a la implementación del plan educativo. Resultados: el plan educativo mejoró tanto la capacidad de agencia de autocuidado global como sus rangos, encontrando significancia estadística con un valor de probabilidad menor de 0,002 y de 0,0001 respectivamente. Conclusiones: las intervenciones educativas estructuradas a partir de la identificación de las necesidades individuales de información, en conjunto con el empoderamiento del individuo y el seguimiento por parte del profesional de enfermería, permiten alcanzar conductas permanentes de autocuidado que facilitan el autoconocimiento, la modificación del comportamiento así como la adquisición de conocimientos y habilidades.

Objective: The purpose of this study was to determine the effect of an educational plan on the capacity of hypertensive patients at a second-tier institution to manage self-care. Materials and methods: A pre -and post-intervention test was conducted with the participation of 83 patients who had been diagnosed with hypertension. An instrument entitled "Assessment of Self-care Management Capacity among Hypertensive Patients" was applied to this group at the beginning of the study and three months after implementation of the educational plan. Results: The educational plan improved self-care management capacity overall and in the different ranges, showing a statistical significance with a probability value under 0.002 and 0.0001, respectively. Conclusions: Structured educational interventions based on identified individual needs, coupled with individual empowerment and monitoring done by nursing professionals, made it possible to achieve permanent behavior with respect to self-care, facilitating self-knowledge and changes in behavior patterns, in addition to the acquisition of skills and know-how.

Objetivo: o propósito deste artigo foi determinar o efeito de um programa educativo na capacidade de agência de autocuidado do paciente hipertenso em uma instituição de segundo nível. Materiais e métodos: realizou-se um estudo de intervenção pré e pós-teste, com a participação de 83 pacientes com diagnóstico de hipertensão arterial, aos quais se aplicou o instrumento "Avaliação da capacidade de agência de autocuidado no paciente hipertenso" ao início do estudo e três meses posteriores à implementação do programa educativo. Resultados: o programa educativo melhorou tanto a capacidade de agência de autocuidado global quanto suas faixas, constatando significância estatística com um valor de probabilidade menor de 0,002 e de 0,0001, respectivamente. Conclusões: as intervenções educativas estruturadas a partir da identificação das necessidades individuais de informação, em conjunto com o empoderamento do indivíduo e o seguimento por parte do profissional de enfermagem, permitem atingir condutas permanentes de autocuidado que facilitam o autoconhe-cimento, a modificação do comportamento, bem como a aquisição de conhecimentos e habilidades.

Depresión y ansiedad estado/rasgo en internosadscritos al Programa de Inducción al Tratamiento Penitenciario en Bucaramanga, Colombia / Depressão e ansiedade estado/traço em presos adscritos ao Programa de Indução para o Tratamento Penitenciário em Bucaramanga, Colômbia / Depression and anxiety, state/feature among inmates assigned to the “Induction to Treatment in Prison Program” in Bucaramanga, Colombia

El artículo describe las características de la depresión y la ansiedad estado/rasgo y su prevalencia en internos adscritos al “Programa de Inducción al Tratamiento Penitenciario” del Instituto Nacional Penitenciario y Carcelario –INPEC– en Bucaramanga, Colombia. La muestra comprendió 112 internos con un promedio de edad de 33 años, a quienes se les aplicó el Inventario de Depresión Estado Rasgo (IDER) y el Inventario de Ansiedad Estado Rasgo (STAI). Los resultados indican que un 43,1% realizó su primera transgresión a la norma entre los 8 y 18 años, y un 74,1% presentó consumo de sustancias psicoactivas, mientras los registros de manifestaciones depresivas revelan que el 16,7% la califi có como estado y un 43,68% como rasgo. Por su parte, la afectación ansiosa se mostró en un 8,03% como estado y en un 85,7% como rasgo.De acuerdo con esto, hubo mayor proporción de personas con experiencias previas que desarrollaron cuadros sintomatológicos, que aquellas en las que la situación de encarcelamiento constituye un causante o detonante.

This article describes the characteristic manifestations of the depression and anxiety state/feature, and their prevalence among inmates assigned to the “Programa de Inducción al Tratamiento Penitenciario” (Induction to the Treatment in Prison Program) of the INPEC, the National Penitentiary and Prison Institute at Bucaramanga, Colombia.The sample included 112 inmates with an average age of 33 years to whom the Depression State/Feature Inventory (known as IDER in Colombia) and the Anxiety State/Feature Inventory (known as STAI in Colombia) were applied. The results show that 43.1% of the inmates committed their first off ense between 8 and 18 years of age, and 74.1% had used psychoactive substances, while the records of depressive manifestations reveal that 16.7% rated them as a state, and 43.68% as a feature. On the other hand, in 8.03% of the cases, anxiety was shown as a state, and in 85.7% as a feature. According to this, the ratio of individuals with previous experiences having developed a symptomatology was higher than those where the imprisonment situation is a cause or a triggering factor.

O artigo descreve as características da depressão e a ansiedade estado/traço e sua prevalência em presos adscritos ao “Programa de Indução para o Tratamento Penitenciário” do Instituto Nacional Penitenciario y Carcelario -INPEC em Bucaramanga, Colômbia. A amostra incluiu 112 presos com idade média de 33 anos, que receberam o Inventário de Depressão Estado Rasgo (IDER) e o Inventário de Ansiedade Estado Rasgo (STAI). Os resultados indicam que 43,1% realizou sua primeira transgressão à norma entre 8 e 18 anos de idade, e um 74,1% apresentou consumo de substâncias psicoativas, enquanto os registros das manifestações depressivas revelam que 16,7% atribuíram como estado e 43,68% como rasgo. Por outro lado, a afetação ansiosa mostrou 8,03% como estado e 85,7% como rasgo. De acordo com isso, houve maior proporção de pessoas com experiências anteriores, que desenvolveram os quadros sintomatológicos, do que aqueles em que a situação de detenção constitui uma causa ou um detonante.

Self-care agency capacity in Patients with diagnostic of high blood pressure in a second level institution / Capacidad de agencia de autocuidadoen el paciente con hipertensión arterial en una institución de segundo nivel / Capacidade de agencia de autocuidado no paciente com hipertensão arterial em uma instituição de segundo nível

El objetivo de este estudio fue determinar la capacidad de agencia de autocuidado en245 pacientes hipertensos que asistieron a una institución de segundo nivel de atenciónen el 2010, mediante el desarrollo de un estudio descriptivo de tipo transversalcon la aplicación del instrumento Evaluación de la capacidad de agencia de autocuidadoen el paciente hipertenso. Se encontró que el 81,22 % (n = 199) y el 8,16 % (n = 20)de los pacientes presentaron una capacidad de agencia de autocuidado media y bajarespectivamente, y tan solo el 10,61 % (n = 26) de los pacientes presentó una capacidadde agencia de autocuidado alta. Ello indicaría que aunque el paciente con hipertensiónarterial posee algunas habilidades que le permiten discernir acerca de los factores quedebe controlar para promover su salud y su cuidado, son insuficientes para lograr unaadecuada adherencia al tratamiento, ya que para alcanzar un compromiso y participaciónen este, es necesario que existan conductas permanentes de autocuidado quefaciliten el autoconocimiento, el empoderamiento del individuo y el desarrollo de lacapacidad de tomar decisiones sobre su salud. La percepción del paciente de su estadode salud es fundamental para el desarrollo de las capacidades de autocuidado; por esoes fundamental que el profesional de enfermería intervenga de acuerdo con las capacidadesdel individuo, para autocuidarse promoviendo apoyo educativo que le permita alpaciente modificar su comportamiento, adquirir conocimiento y habilidad...

The objective of this study was to determine the self-care ability on 245 hypertensivepatients who attended to a secondary level institution in 2010. This was done by developinga descriptive cross-sectional study with the application of the “Assessmentself-care ability instrument in hypertensive patients” (Evaluación de la capacidad deagencia de autocuidado en el paciente hipertenso). We found that 81.22% (n = 199) and8.16% (n = 20) of the patients presented a medium and low Self-care ability respectively,and only the 10.61% (n = 26) of the patients presented a high self-care ability.This would indicate that, although the patient with hypertension has some abilitiesthat let him/her discern about the factors that he/she should control to promote hishealth and health care, they are insufficient to achieve an adequate adherence to thetreatment. In order to have their commitment and participation, it is necessary to havepermanent self care behaviors to facilitate the self-awareness, the empowerment of theindividual and the development of the capacity to make decisions about their health.The patient's perception of his health is critical to the development of the self careabilities, so it is essential that the nurse intervene in accordance with the individual'scapacities to self-care, by promoting educational support to allow the patient to modifyhis behavior, acquiring knowledge and skill...

O objetivo deste estudo foi determinar a capacidade de agencia de autocuidado em245 pacientes hipertensos que compareceram a uma instituição de segundo nível deatenção em 2010, mediante o desenvolvimento de um estudo descritivo de tipo transversalcom a aplicação do instrumento Avaliação da capacidade de agencia de autocuidadono paciente hipertenso. Encontrou-se que 81,22 % (n = 199) e 8,16 % (n = 20)dos pacientes apresentaram uma capacidade de agencia de autocuidado média e baixarespectivamente, e somente 10,61 % (n = 26) dos pacientes apresentou uma capacidadede agencia de autocuidado alta. Isso indicaria que, o paciente com hipertensãoarterial possui algumas habilidades que lhe permitem discernir sobre os fatores quedeve controlar para promover sua saúde e seu cuidado, são insuficientes para conseguiruma adequada aderência ao tratamento, já que para alcançar um compromisso eparticipação neste, é preciso que existam condutas permanentes de autocuidado quefacilitem o autoconhecimento, o empoderamento do indivíduo e o desenvolvimento dacapacidade de tomar decisões sobre sua saúde. A percepção do paciente de seu estadode saúde é fundamental para o desenvolvimento das capacidades de autocuidado; porisso é fundamental que o profissional de enfermagem intervenha de acordo com as capacidadesdo indivíduo, para autocuidar-se promovendo apoio educativo que permitaao paciente modificar seu comportamento, adquirir conhecimento e habilidade...

Immunodetection of hemocytes, peneidins and α2-macroglobulin in the lymphoid organ of white spot syndrome virus infected shrimp.

Viral diseases restrict the development of the world shrimp industry and there are few studies on cell response to the presence of viral infections. We performed immunohistochemistry assays to characterize hemocytes subpopulations involved in the immune process occurring in the LO of Litopenaeus vannamei shrimp. Tissue sections of animals that increased their LO spheroids and hemocytes infiltration after WSSV induced infection, were used. Three MABs namely, 40E10 (recognizing small granule hemocytes), 40E2 (recognizing large granule hemocytes), and 41B12, which recognize α(2)-macroglobulin were used. Additionally one polyclonal antibody was used against the penaeidins antimicrobial peptides, and to detect WSSV a commercial immunohistochemistry kit (DiagXotics) was used. Numerous small granule hemocytes were detected in the stromal matrix of LO tubules, whereas large granule hemocytes were less numerous and located mainly in hemal sinuses. The exocytosis of two molecules, which have been related to the phagocytosis process, i.e. penaeidins, and α(2)-macroglobulin, was detected in the external stromal matrix and the outer tubule walls. α(2) -macroglobulin inhibits phenoloxidase activity and its strong release in LO tissue may explain the absence of melanization in the immune processes occurring in it. The immunolabeling of vesicles within the LO spheroids with MABs 41B12 40E10 and antipenaedin antibody suggests that LOS are formed by phagocytic cells derived from small granule and hyaline hemocytes, with a possible role of peneidins and α(2)-macroglobulin acting as opsonines.

Estrategias de tratamiento del paciente con hipertensión arterial esencial: Perfil neurohormonal y geometría ventricular izquierda

La geometría ventricular izquierda, determinada por ecocardiografía bidimensional, proporciona de manera indirecta información sobre el perfil hemodinámico y neurohormonal del paciente hipertenso. En dos estudios pilotos, llevados a cabo en el Instituto de Investigaciones Cardiovasculares de la Universidad de Los Andes hemos utilizado al patrón geométrico como guía para orientar el tratamiento farmacológico del paciente hipertenso. La correspondencia de la estrategia farmacológica con el mecanismo neurohormonal, responsable de la hipertensión arterial, permite un control de la presión arterial con menor número de medicamentos y reduce la incidencia de efectos colaterales y complicaciones. Más aún, el proceso de remodelación cardiaca puede ser influenciado favorable o desfavorablemente, si la estrategia terapéutica empleada se corresponde o no con el mecanismo neurohormonal subyacente. El proceso de remodelación cardiaca, en la transición hacia los dos fenotipos de insuficiencia cardiaca congestiva, se caracteriza por modificaciones opuestas de la geometría y función ventricular. Los pacientes que evolucionan hacia la insuficiencia cardiaca sistólica experimentan una progresiva dilatación de las cavidades cardiacas izquierdas y disminución de la función sistólica. Por el contrario, en los pacientes que evolucionan hacia la insuficiencia cardiaca diastólica, el tamaño de las cavidades cardiacas se reduce y la relajación ventricular se altera.

The neurohormonal and hemodynamic profiles, of uncomplicated hypertensive patients, can be inferred from the left ventricular geometric pattern. We have used the left ventricular geometric pattern to guide the pharmacological treatment of hypertensive patients. Blood pressure control can be achieved with less medications and complications and adverse effects are reduced with a therapeutic strategy aimed at the underlying neurohormonal and hemodynamic profiles. On the contrary, cardiac remodelling is unfavorably influenced by a therapeutic strategy unmatched to the underlying responsable mechanisms. During transition to the two phenotypes of congestive heart failure, cardiac remodelling evolves in opposite directions. Thus, patients with systolic heart failure undergo progressive ventricular dilatation with thinning of its walls, where as, diastolic heart failure patients are characterized by shrinking of their left ventricular cavities with increasing relative wall thickness.

Frecuencia, evitabilidad y consecuencias de los eventos adversos / Frequency, preventability and consequences of adverse events

El presente estudio pretende determinar la frecuencia, evitabilidad y consecuencias de los Eventos Adversos (EA) ocurridos en los servicios de hospitalización basándose en las fichas epidemiológicas e historias clínicas de pacientes que hayan tenido un evento durante este periodo. Como resultados se encontró con mayor frecuencia los Eventos Adversos (EA) son debidos a algún procedimiento (63%): suspensión quirúrgica (38%), seguido de otras complicaciones R/C intervención quirúrgica o procedimiento (13.3%), viéndose mayormente afectada la población masculina (61%), en edades de 10 a 29 años (37%). El servicio donde se presentan más frecuentemente estos eventos es cirugía (52%). Esta problemática produce deterioro físico en un 100% en el paciente, además de aumentar la estancia hospitalaria de 1-2 días (91.7%), siendo el mayor factor causal el tipo de asistencia sanitaria que recibe el paciente. Estos eventos pudieron haber sido evitados en un 74% de los casos. En conclusión el presente estudio mostró que los eventos adversos ocurridos con mayor frecuencia fueron los relacionados con algún procedimiento y/o cuidados, siendo de estos, los más comunes la cancelación de turnos quirúrgicos y quemaduras, erosiones y contusiones (incluyendo fracturas consecuentes) respectivamente. Lo que produjo una prolongación de los días de estancia, lo cual no ocasionó directamente situaciones de gravedad o repercusiones importantes en el estado de salud del paciente; pero la aparición de estos Eventos Adversos (E.A) son completamente prevenibles, puesto que tiene que ver directamente con las prácticas de cuidado impartidas por el personal de salud, que requieren mayor concentración al momento de realizar cualquier procedimiento, si se toman en cuenta las medidas necesarias para garantizar la seguridad del paciente.

This study aims to determine the frequency, preventability and consequences of adverse events (AEs) occurring in hospital services based on epidemiologic and clinical records of patients who have had an event during this period. As a result of this most frequently encountered adverse events (AE) it was found that they were due to procedure (63%)as surgical suspension (38%), followed by other complications R / C surgery or procedure (13.3%). the most affected population are male (61%), aged 10 to 29 years (37%). The service in which these events occur more frequently is surgery (52%). This problem causes physical damage by 100% in the patient, moreover it will increase the hospital stay of 1-2 days (91.7%), it is the largest causing factor the type of health care to the patient. These events could have been avoided in 74% of cases. In conclusion this study showed that adverse events occurred most frequently were related to any procedure and / or care. They were the most common; surgical termination of turns and burns, abrasions and contusions (including resulting fractures) respectively. It produced prolongation of the days of stay, which not directly causes serious situations or significant impact on patient health status, but the occurrence of these adverse events (AEs) are completely preventable, since they are related to the practices of care given by health personnel, who require more concentration when performing any procedure, if one takes into account the measures necessary to ensure patient safety

Calificación de un sistema de HPLC-IR para la determinación de impurezas en vacunas / Quality of a HPLC-IT system for determination of impurities in vaccines

La calificación de los diferentes componentes del sistema HPLC es un aspecto de vital importancia para el logro de buenos resultados en la validación de un método analítico, pues se necesita demostrar previamente que el sistema se encuentra trabajando de forma satisfactoria. En este caso la evaluación reviste una gran importancia, por tratarse de instrumentos de varios años de uso, con los que el fabricante no se responsabiliza, por lo que se recopiló información de instrumentos similares producidos por otros fabricantes o establecidos para versiones modernas de estos donde se describiera la forma de evaluar los parámetros más importantes en el funcionamiento de cada uno de los componentes del sistema cromatográfico a usar. Para calificar la bomba isocrática (Pharmacia-LKB), se evaluó la función de bombeo, la indicación del cero de presión, el límite mínimo y máximo de presión, así como la prueba de hermeticidad y la exactitud del flujo. Para calificar el detector de índice de refracción (Knauer), se evaluó la señal de ruido, la sensibilidad y la linealidad de la señal. Además se calculó la precisión del inyector. Se determinó que tanto la bomba isocrática como el detector de índice de refracción y el inyector manual cumplen con todos los parámetros estudiados, lo que demuestra que todos los componentes del sistema de HPLC cumplen con las especificaciones establecidas y adecuadas a sus características, además de satisfacer los requerimientos necesarios para la determinación de impurezas mediante esta tecnología

The assessment of different components of HPLC system is a very important feature to achieve good results in validaion of a analytical method since it is necessary to demonstrate previously that this system is working in a satisfactory way. In present case the assessment is very important to be about of instruments of some years of use where the manufacturer not accept responsability for the information collected on similar instruments produced by other manufacturers for current versions of these where is is described the way to assess the more significant parameters in the functioning of each components of chromatographic system to be used. To assess the isocratic pump (Pharmacia-LKB) pumping function, zero-pressure indication, minimal and maximal pressure limit, as well as the sealed test and flow accuracy. To determine the refraction rate detector (Knauer), the noise, sensitivity and linearity signal was assessed. Also, the injector's accuracy was estimated. Authors determined that the isocratic pump as refraction rate detector and the manual injector flufill with all study parameters demonstrating that all components of HPLC system also fulfill with specifications established and suitable to its features, satisfying the requirements necessaries for determination on impurities using this technology