Understanding and Mitigating Atomic Oxygen-Induced Degradation of Perovskite Solar Cells for Near-Earth Space Applications.

Combining high efficiency with good radiation tolerance, perovskite solar cells (PSCs) are promising candidates to upend expanding space photovoltaic (PV) technologies. Successful employment in a Near-Earth space environment, however, requires high resistance against atomic oxygen (AtOx). This work unravels AtOx-induced degradation mechanisms of PSCs with and without phenethylammonium iodide (PEAI) based 2D-passivation and investigates the applicability of ultrathin silicon oxide (SiO) encapsulation as AtOx barrier. AtOx exposure for 2 h degraded the average power conversion efficiency (PCE) of devices without barrier encapsulation by 40% and 43% (w/o and with 2D-PEAI-passivation) of their initial PCE. In contrast, devices with a SiO-barrier retained over 97% of initial PCE. To understand why 2D-PEAI passivated devices degrade faster than less efficient non-passivated devices, various opto-electrical and structural characterications are conducted. Together, these allowed to decouple different damage mechanisms. Notably, pseudo-J-V curves reveal unchanged high implied fill factors (pFF) of 86.4% and 86.2% in non-passivated and passivated devices, suggesting that degradation of the perovskite absorber itself is not dominating. Instead, inefficient charge extraction and mobile ions, due to a swiftly degrading PEAI interlayer are the primary causes of AtOx-induced device performance degradation in passivated devices, whereas a large ionic FF loss limits non-passivated devices.

Determination of Mobile Ion Densities in Halide Perovskites via Low-Frequency Capacitance and Charge Extraction Techniques.

Mobile ions in perovskite photovoltaic devices can hinder performance and cause degradation by impeding charge extraction and screening the internal field. Accurately quantifying mobile ion densities remains a challenge and is a highly debated topic. We assess the suitability of several experimental methodologies for determining mobile ion densities by using drift-diffusion simulations. We found that charge extraction by linearly increasing voltage (CELIV) underestimates ion density, but bias-assisted charge extraction (BACE) can accurately reproduce ionic lower than the electrode charge. A modified Mott-Schottky (MS) analysis at low frequencies can provide ion density values for high excess ionic densities, typical for perovskites. The most significant contribution to capacitance originates from the ionic depletion layer rather than the accumulation layer. Using low-frequency MS analysis, we also demonstrate light-induced generation of mobile ions. These methods enable accurate tracking of ionic densities during device aging and a deeper understanding of ionic losses.

Effects on venous flow of transcutaneous electrical stimulation, neuromuscular stimulation, and sham stimulation on soleus muscle: A randomized crossover study in healthy subjects.

BACKGROUND: Activation of venous flow has been shown with different types of electrical stimulation. The aim of this study is to compare the hemodynamic effects of transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), and sham stimulation on healthy young people. METHODS: This randomized crossover study was conducted during June 2018 in the Faculty of Physical Therapy of A Coruña (Spain). Twenty-four university students (50% male) received in a randomized order 5 Hz-TENS, NMES, and sham stimulation on soleus muscle. Flow volume (FV) and peak velocity (PV) from popliteal vein were recorded via Doppler ultrasound, and relative changes from baseline were determined. Discomfort among the 3 stimulations was also compared. RESULTS: The differences among the 3 stimulations were assessed using the ANOVA for repeated measured, the Friedman test and the Kendall tau test, according to the type of measurement to be compared. FV (mL/min) and PV (cm/s) increased significantly after NMES (percentual increase 37.2 ± 62.0%, P = .002; 264.4 ± 152.2%, P < .001, respectively) and TENS (226.2 ± 190.3%, P < .001; 202.7 ± 144.6%, P < .001, respectively). These percentual changes from basal level in hemodynamics were statistically different to those after placebo, which was ineffective enhancing hemodynamics. The improvements in FV were statistically higher with TENS than with NMES (P < .001), but there was no statistical difference in PV (P = .531). Despite NMES was applied at a significantly lower amplitude than TENS (P < .001), NMES protocol was the worst tolerated, though the differences in discomfort were not statistically significant. CONCLUSION: Both active electrical protocols but not sham stimulation increased hemodynamics in healthy people. TENS obtained higher flow volume increase from baseline than NMES, considered globally at not only in its on-time.

Static Disorder in Lead Halide Perovskites.

In crystalline and amorphous semiconductors, the temperature-dependent Urbach energy can be determined from the inverse slope of the logarithm of the absorption spectrum and reflects the static and dynamic energetic disorder. Using recent advances in the sensitivity of photocurrent spectroscopy methods, we elucidate the temperature-dependent Urbach energy in lead halide perovskites containing different numbers of cation components. We find Urbach energies at room temperature to be 13.0 ± 1.0, 13.2 ± 1.0, and 13.5 ± 1.0 meV for single, double, and triple cation perovskite. Static, temperature-independent contributions to the Urbach energy are found to be as low as 5.1 ± 0.5, 4.7 ± 0.3, and 3.3 ± 0.9 meV for the same systems. Our results suggest that, at a low temperature, the dominant static disorder in perovskites is derived from zero-point phonon energy rather than structural disorder. This is unusual for solution-processed semiconductors but broadens the potential application of perovskites further to quantum electronics and devices.

How To Quantify the Efficiency Potential of Neat Perovskite Films: Perovskite Semiconductors with an Implied Efficiency Exceeding 28.

Perovskite photovoltaic (PV) cells have demonstrated power conversion efficiencies (PCE) that are close to those of monocrystalline silicon cells; however, in contrast to silicon PV, perovskites are not limited by Auger recombination under 1-sun illumination. Nevertheless, compared to GaAs and monocrystalline silicon PV, perovskite cells have significantly lower fill factors due to a combination of resistive and non-radiative recombination losses. This necessitates a deeper understanding of the underlying loss mechanisms and in particular the ideality factor of the cell. By measuring the intensity dependence of the external open-circuit voltage and the internal quasi-Fermi level splitting (QFLS), the transport resistance-free efficiency of the complete cell as well as the efficiency potential of any neat perovskite film with or without attached transport layers are quantified. Moreover, intensity-dependent QFLS measurements on different perovskite compositions allows for disentangling of the impact of the interfaces and the perovskite surface on the non-radiative fill factor and open-circuit voltage loss. It is found that potassium-passivated triple cation perovskite films stand out by their exceptionally high implied PCEs > 28%, which could be achieved with ideal transport layers. Finally, strategies are presented to reduce both the ideality factor and transport losses to push the efficiency to the thermodynamic limit.

Inter-and Intra-Examiner Reliability of Supraspinatus Muscle Tendon Palpation: A Cross-Sectional Study by Ultrasonography.

BACKGROUND AND OBJECTIVES: Palpation is an inherent and basic skill of health professionals-particularly manual therapists who base their diagnosis and treatment in a clinical environment. Many authors have previously described multiple palpation positions for supraspinatus muscle tendon (SMT); however, there are no current studies that evaluate palpation concordance reliability for the SMT in this particular position. This study aimed to investigate the intra- and inter-rater reliabilities of supraspinatus muscle tendon (SMT) palpation. MATERIALS AND METHODS: Thirty-six healthy participants (14 females; aged 22-35 years) were recruited. Musculoskeletal ultrasound was used to measure the SMT localization after two physiotherapists performed the SMT palpation at two different times. The distance between the two marked points was used to analyze the analysis of true agreement between examiners. Finally, we analyzed if the demographic variables influenced the palpation procedure. RESULTS: The intra-examiner reliability showed a high percentage of concordance for examiner 1 (E.1) (first palpation procedure (P.1) = 91.7%: second palpation procedure (P.2) = 95.8%) and examiner 2 (E.2) (P.1 = 91.6%; P.2 = 97.2%) and high percentage of inter-palpation agreement for E.1 (87.5%) and E.2 (88.9%). The inter-examiner reliability showed a high total concordance for the right shoulder (E.1 = 94.4%; E.2 = 95.8%) and left shoulder (E.1 = 93.05%; E.2 = 95.05%). The agreement (%) according to both examiners was 93.05% for the right shoulder and 94.4% for the left shoulder. The agreement between both examiners and the ultrasound (% of true agreement) was 92.9% for the right shoulder and 92.8% for the left shoulder. A statistically significant association (p = 0.02) was found for weight regarding concordance reliability; this was not seen for dominant arm, age, gender, body mass index, height, and tendon depth (p > 0.05). CONCLUSIONS: The SMT palpation technique showed a high level of concordance and reproducibility.

Effects of transcutaneous electrical nerve stimulation via peroneal nerve or soleus muscle on venous flow: A randomized cross-over study in healthy subjects.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is used to prevent venous stasis and thromboembolism. However, best electrostimulation parameters have yet to be established. The aim of the study was to compare the hemodynamic effects and the participants' relative discomfort of 3 TENS sequences at the maximum tolerated intensity stimulus. METHODS: Twenty-four healthy university students (50% male) participated in a cross-over, randomized study. Each participant received 2 TENS sequences on peroneal nerve at 1 and 5 Hz, and the third one on soleus muscle at 5 Hz. Popliteal flow volume (FV) and peak velocity (PV) were measured using Doppler ultrasound and the relative change from basal values was recorded. Discomfort questionnaires -visual analogue scale (VAS) and verbal rating scale (VRS)- were also administered to compare sensations among the three applications. RESULTS: All interventions produced significant hemodynamic responses compared to baseline. Both 5 Hz applications obtained higher FV increments than 1 Hz TENS (P < .001). The muscle application resulted in the lowest PV increment (P < .001). TENS at 5 Hz on nerve location was the worst tolerated, with higher values in VRS (P = .056) and VAS (P = .11), although not significant. CONCLUSION: TENS at 5 Hz on soleus site may be the most appropriate protocol for enhancing venous return.

Traqueobronquitis y neumonía asociadas a ventilación mecánica en unidades de cuidado intensivo de Latinoamérica: epidemiología, curso clínico y desenlaces (Estudio LATINAVE) / Epidemiology, clinical evolution and outcomes of tracheobronchitis and pneumonia associated with mechanical ventilation in intensive care units of Latin America (LATINAVE study)

Introducción: Las infecciones asociadas a ventilación mecánica son causa importante de morbimortalidad en el paciente crítico. La diferenciación entre traqueobronquitis y neumonía no es siempre fácil, y es controvertida. Algunos trabajos describen aumento de mortalidad, mayor estancia en Unidades de Cuidado Intensivo (UCI), mayor requerimiento de ventilación mecánica e incremento de costos en pacientes con traqueobronquitis asociada a ventilador (TAV), sin diferencias significativas en pacientes con neumonía asociada a ventilador (NAV). Estos estudios no describen el comportamiento clínico y epidemiológico de la TAV y la NAV como 2 entidades independientes, por lo que es necesario describirlo. Métodos: Estudio multicéntrico de cohorte prospectiva, de pacientes adultos que desarrollaron TAV o NAV durante su estancia en UCI, entre noviembre de 2013 y octubre de 2014. A cada una de las variables demográficas, clínicas, de laboratorio y de desenlace, como tiempo de ventilación mecánica, estancia hospitalaria y muerte, se le realizó análisis descriptivo; para evaluar las diferencias entre los grupos se utilizó test de chi cuadrado, t de Student o U de Mann Whitney. Resultados: Se incluyó a 143 pacientes, con edad promedio de 55 años, 57% eran hombres, de 6 países en Latinoamérica; 63% con NAV y 37% con TAV. Las comorbilidades más frecuentes fueron cardiovascular (44%) y neurológica (30%); esta última fue más frecuente en TAV (41,5 vs. 23%; p = 0,02). No se encontró diferencia en APACHE II de ingreso. El índice SOFA fue mayor en NAV (8 vs. 5; p = 0,02). No hubo diferencias en el aislamiento microbiológico, ni en los patrones de resistencia bacteriana entre las 2 entidades. Se observó mayor número de complicaciones cardiovasculares y SDRA en pacientes con NAV. No se encontró diferencia entre los 2 grupos en estancia en UCI, los días de ventilación mecánica ni en mortalidad. Conclusiones: La prevalencia de TAV fue mayor a lo descrito hasta ahora en la literatura. No se encontraron diferencias significativas en el aislamiento microbiológico, la resistencia bacteriana ni el esquema antibiótico utilizado en los 2 grupos. Aunque la NAV cursó con mayor proporción de complicaciones médicas asociadas, el hallazgo de una estancia hospitalaria, tiempo de ventilación mecánica y mortalidad similares sustenta la importancia clínica de la TAV.

Introduction: The infections associated with mechanical ventilation are a major cause of morbidity and mortality in critically ill patients. Limited studies report increased mortality and intensive care units (ICU) stays, requirements for mechanical ventilation and higher costs in ventilator-associated tracheobronchitis (TAV) in comparison to patients with ventilator-associated pneumonia (NAV). These studies do not describe the clinical and epidemiological behavior in the same population as independent entities, so it is necessary to describe the epidemiology of patients with TAV and NAV. Methods: Multicenter cross-sectional study of adult patients who developed TAV and/or NAV during their stay in the ICU in 2013 to 2014. A descriptive analysis was performed on each of the variables. For qualitative variables we assessed differences between groups using the Chi-squared test; for continuous variables, we used Student's t test or the Mann Whitney U test. Results: A total of 147 patients from 6 countries in Latin America were included; 63% with NAV and 37% with TAV. The average age was 55 years; 57% male. The most frequent comorbidity was cardiovascular (44%) and neurological (30%), the latter was more frequent in those with TAV (41.5 vs. 23%, P = .02). No differences were found in APACHE II on entry, but the difference appears in the SOFA index (8 vs. 5, P = .02). There were no differences in microbiological isolation, or bacterial resistance patterns between the 2 entities. A greater number of cardiovascular complications and ARDS were observed in patients with NAV. The ICU stay, days on mechanical ventilation and mortality were not different between the 2 groups. Conclusions: The TAV prevalence was higher than heretofore described in the literature. No significant differences were found in the microbiological isolation, bacterial resistance and antibiotic therapy used in the 2 groups, which might suggest that therapeutic approach be similar to that recommended for NAV. No differences were observed in clinical outcomes such as hospital stay, duration of mechanical ventilation and mortality, although NAV was associated with a greater proportion of medical complications.

Epidemiological surveillance of herpes viral encephalitis in Cordoba, Colombia / Vigilancia epidemiológica de encefalitis por herpes virus en Córdoba, Colombia

Objective To establish an epidemiological surveillance of viral herpes encephalitis in major hospitals of Monteria, Cordoba. Methods From September 2009 to December 2011, a descriptive study of cases of viral encephalitis was made in three hospitals in the city of Monteria. Cerebrospinal fluid (CSF) samples from 118 patients were included in the study. Clinical aspects, as well as cytochemical and microbiological analysis (Gram stain and culture) of CSF, were used for selecting the patients. Virus detection was performed by using multiplex nested PCR for Herpes simplex virus 1 and 2, Epstein Barr virus, Cytomegalovirus and Varicella zoster virus. Results Viral DNA of herpesvirus was detected in the CSFs of 30 (25.4 %) participants, as follows: 22 (18.6 %) Herpes simplex 1 and 2 viruses, 4 (3.3 %) Cytomegalovirus and 1 (0.8 %) Varicella zoster virus. Co-infections were observed in 3 patients (2.5 %), 1 case by HSV-VZV and 2 cases by CMV/HSV. The clinical manifestations of the patients included: headache (18.6 %), fever (14.4 %), asthenia (10.1 %), seizures (9.3 %), vomiting (8.4 %), and stiff neck (5.9 %). Thirty percent of the patients also had HIV-AIDS. A case fatality rate of 20 % was observed for the patients. Conclusions This paper shows that herpesvirus is a cause of infection of the CNS in patients from Cordoba. This study contributes to the epidemiology of encephalitis, as well as to patient management.(AU)

Objetivo Establecer una vigilancia epidemiológica de la encefalitis viral herpética en los principales hospitales de Montería, Córdoba. Materiales y Métodos Se realizó un estudio descriptivo de los casos de encefalitis viral entre septiembre de 2009 diciembre de 2011 en tres hospitales en la ciudad de Montería. Las muestras líquido cefalorraquídeo (LCR) de 118 pacientes fueron incluidos en el estudio. Los aspectos clínicos como el análisis citoquímico y microbiológico (tinción de Gram y cultivo) de LCR fueron utilizados para la selección de los pacientes. La detección de virus se realizó por PCR anidada multiplex para Herpes simplex virus 1 y 2, virus de Epstein Barr, virus zoster de la varicela y el citomegalovirus. Resultados Se detectó ADN viral del virus del herpes en 30 (25,4 %) muestras de LCR en los pacientes de la siguiente manera: 22 (18,6 %) Herpes simplex virus 1 y 2, 4 (3,3 %) Citomegalovirus y 1 (0,8 %) del virus de la varicela zóster. Se observaron Co-infecciones en 3 pacientes (2,5 %), 1 caso por el VHS-VZV y 2 casos por CMV / HSV. Las manifestaciones clínicas de los pacientes fueron: cefalea (18,6 %), fiebre (14,4 %), astenia (10,1 %), convulsiones (9,3 %), vómitos (8,4 %), y rigidez de nuca (5,9 %). El treinta por ciento de los pacientes también tenía VIH-SIDA. Se observó una tasa de letalidad del 20 % de los pacientes. Conclusiones Se demuestra que el herpesvirus es causa de infección del SNC en pacientes en Córdoba. Este estudio contribuye a la caracterización serológica viral epidemiológica de la encefalitis viral, así como en el manejo del paciente ya que se describen hallazgos clínicos importante en la población adulta estudiada.(AU)

Validación del uso tradicional de especies de asclepias contra el veneno de bothrops diporus (yarará chica) en el nordeste de Argentina / Validation of the traditional use of asclepias species against bothrops diporus (yarará chica) venom in northeast of Argentina

La familia Asclepiadaceae posee tradición en etnomedicina. En el nordeste argentino, A.mellodora y A. curassavica se utilizan como cataplasmas en accidentes de ofidios. En este trabajo, los extractos acuosos, etanólicos y hexánicos de A. mellodora y A. curassavica se evaluaron por SDS-PAGE para determinar su actividad alexitérica. El estudio in vitro de la capacidad inhibitoria de las actividades proteolítica, hemolítica indirecta y coagulante permitieron determinar que ambas especies manifiestan actividad, siendo A. mellodora más activa. Estadísticamente los extractos de A. mellodora fueron igualmente activos contra el veneno de Bothrops diporus y no mostraron diferencias significativas respecto del órgano utilizado en la inhibición de la actividad coagulante. Este resultado está en consonancia con la forma tradicional de su uso como cataplasma. Sobre el extracto etanólico de las raíces de A. mellodora se realizó un fraccionamiento bioguiado que permitió identificar fracciones de compuestos responsables de la actividad.

The Aclepiadaceae family has been reported by its use in ethnomedicine. In the northeast of Argentina, A. mellodora and A. curassavica are traditionally used in ofidic accidents as poultices. In this work, aqueous, alcoholic and hexanoic extracts were analyzed by SDS-PAGE to determine their anti-snake activity. The in vitro study of the inhibitory ability of the following activities: proteolytic, indirect hemolytic activity and inhibition of the coagulant activity, allowed demonstrating that both species were active against venom, being A. mellodora the most active. Statistically, all extracts of A. mellodora were active against venom in the inhibition of the coagulant activity, without significant differences with respect to the organ used; which is consistent with the traditional use as external poultice. The alcoholic extract of A. mellodora roots was subjected to a bio-guided separation. The fractions obtained were enriched in compounds which could probably be responsible for the activity against venom.

Epidemiological surveillance of herpes viral encephalitis in Cordoba, Colombia.

Objective To establish an epidemiological surveillance of viral herpes encephalitis in major hospitals of Monteria, Cordoba. Methods From September 2009 to December 2011, a descriptive study of cases of viral encephalitis was made in three hospitals in the city of Monteria. Cerebrospinal fluid (CSF) samples from 118 patients were included in the study. Clinical aspects, as well as cytochemical and microbiological analysis (Gram stain and culture) of CSF, were used for selecting the patients. Virus detection was performed by using multiplex nested PCR for Herpes simplex virus 1 and 2, Epstein Barr virus, Cytomegalovirus and Varicella zoster virus. Results Viral DNA of herpesvirus was detected in the CSFs of 30 (25.4 %) participants, as follows: 22 (18.6 %) Herpes simplex 1 and 2 viruses, 4 (3.3 %) Cytomegalovirus and 1 (0.8 %) Varicella zoster virus. Co-infections were observed in 3 patients (2.5 %), 1 case by HSV-VZV and 2 cases by CMV/HSV. The clinical manifestations of the patients included: headache (18.6 %), fever (14.4 %), asthenia (10.1 %), seizures (9.3 %), vomiting (8.4 %), and stiff neck (5.9 %). Thirty percent of the patients also had HIV-AIDS. A case fatality rate of 20 % was observed for the patients. Conclusions This paper shows that herpesvirus is a cause of infection of the CNS in patients from Cordoba. This study contributes to the epidemiology of encephalitis, as well as to patient management.

Essential oils and major compounds of Hedychium coronarium Koenig (Zingiberaceae) against pathogenic yeast of Candida and Cryptococcus genus / Óleos essenciais e compostos majoritários de Hedychium coronarium Koenig (Zingiberaceae) contra leveduras patogênicas dos gêneros Candida e Cryptococcus

Among the major causative agents of invasive fungal infections stands out the opportunistic yeasts of Candida and Cryptococcus. Regarding the problem of the high incidence of infections by these agents and the difculty of treating the low stockpile of antifungal drugs and the high toxicity of most therapies, the search for new antifungal compounds has been highlighted in recent decades. Hedychium coronarium, popularly known as "lírio-do-brejo" or "gengibre-branco" features several previously reported biological activities, including antimicrobial activity. Compound 1.8-cineole is the major compound in essential oil extracted from roots of H. coronarium, while caryophyllene oxide presents itself as the major in essential oil extracted from leaves of this plant. Our data show strong antifungal activity of compounds, against species of Candida albicans, Candida parapsilosis, Candida krusei, Cryptococcus neoformans and Cryptococcus gattii, with minimal inhibitory concentration and minimal fungicidal concentration equal to 0.2 % (v/v) for essential oil extracted from roots, while the essential oil extracted from leaves showed no activity against yeasts. The caryophyllene oxide showed higher antifungal activity for Cryptococcus spp. Thus, our results showed that the essential oil of rhizome is a promising antifungal agent against pathogenic yeasts.(AU)

Candida spp e Cryptococcus spp estão classifcadas entre os maiores causadores de infecções fúngicas invasivas em pacientes imunocomprometidos. Diante a alta incidência destas infecções por estes agentes e a difculdade do sucesso no tratamento, decorrente do baixo arsenal de fármacos antifúngicos e da alta toxicidade presente na maioria dos esquemas terapêuticos, a busca por novos compostos antifúngicos tem sido alvo de diversos estudos nas últimas décadas. Hedychium coronarium, popularmente conhecido como "lírio-do-brejo" ou "gengibre-branco", apresenta diversas atividades biológicas já descritas, entre elas a atividade antimicrobiana. O composto 1.8-Cineol é o composto majoritário presente no óleo essencial extraído de raízes de H. coronarium e o composto óxido de cariofleno é o composto majoritário extraído das folhas desta planta. Nossos resultados mostram que os compostos extraídos de H. coronarium apresentam forte atividade contra Candida albicans, Candida parapsilosis, Candida krusei, Cryptococcus neoformans e Cryptococcus gattii, com valores de concentração inibitória minima e concentração fungicida minima igual a 0,2 % (v/v) para o óleo essencial extraído das raízes, enquanto que o óleo essencial extraído das folhas, não mostrou atividade contras as leveduras. O composto óxido de cariofleno mostrou maior atividade antifúngica para Crytopcoccus spp. Assim, nossos dados mostraram que o óleo essencial extraído das raízes de H. coronarium, é um agente antifúngico promissor contra leveduras patogênicas.(AU)

Coxiella burnetii infection in a patient from a rural area of Monteria, Colombia.

Q fever is a zoonosis caused by Coxiella burnetii. In Colombia, there have been very few human cases reported to date. This report describes the case of a 56-year-old patient with a background in agriculture and livestock handling. An indirect immunofluorescence assay (IFA) showed high titers of IgG for C. burnetii anti-phase I (1: 256) and anti-phase II (1:1024). For the next six months the patient's IgG antibody titers remained high, and after treatment with doxycycline, the IgG antibody titers decreased to 50% (anti-phase I 1:128 and anti-phase II 1:512); this profile suggests an infection of C. burnetii.

Análisis del control del paciente diabético en el área de atención primaria Mancha-Centro de Castilla-La Mancha. Barómetro de la diabetes / Analysis of diabetic patient control in the Primary Care Area of La Mancha-Centro, in the Castile-La Mancha region. Diabetes barometer

OBJETIVOS: Evaluar el control del paciente con diabetes mellitus (DM) en atención primaria(AP), analizando el sistema de registro informático del Sevicio de Salud de Castilla-La Mancha(SESCAM). MATERIAL Y MÉTODOS: Muestra de 938 pacientes con diagnóstico de DM sobre 14.733 individuos incluidos en el año 2009 en el registro informático del SESCAM del área Mancha Centro (Turriano), que comprende 25 centros de AP. Se analizaron distintos parámetros clínicos y analíticos: hemoglobina glicosilada (HbA1c), colesterol total (CT), presión arterial (PA) e índice de masa corporal(IMC), así como el número de procesos por paciente/año: análisis de HbA1c y lípidos, controles de PA, monitorizaciones de pie diabético y revisiones oculares. RESULTADOS: La prevalencia de diabetes conocida fue del 6,36% en la población general. El 54%de los pacientes presentaron una HbA1c < 7%, y el 24,1%, > 8%. El 79% asociaban sobrepeso u obesidad. El 38% eran hipertensos. No se realizó control de CT en el 16% de los individuos, obteniendo valores por debajo de 200 mg/dl en el 45%. Se registró menos de una revisión de pie al año, ninguna revisión ocular, ni control de microalbuminuria. CONCLUSIONES: El sistema «Turriano» es eficaz en el registro de pacientes con diabetes. La mayoría de los pacientes de nuestro estudio presentan un buen control metabólico y de los factores de riesgo cardiovascular

AIMS: To determine the clinical control of patients with diabetes in Primary Care in the a Mancha Centro area (Castile-La Mancha region).MATERIAL AND METHODS: The computerised records system of the Regional Health Service in Castile-La Mancha (Turriano) included 14,733 patients in 2009, in which 938 patients with diabetes were identified in the 25 centres belonging to La Mancha Centro area. Several parameters were collected: HbA1c, total cholesterol, blood pressure, and body mass index (BMI). The number of process per patient/year also were also collected, including number of: HbA1c, total cholesterol, blood pressure controls, feet controls, and eyes controls. RESULTS: Diabetes prevalence was 6.36% of the general population. The HbA1c was measured on average once a year. An HbA1c under 7 mg/dL was found in 54% of patients, and greater than 8 mg/dL in 24.1% of them. The large majority (79%) of patients with diabetes were overweight or obese. Hypertension was found in 40% of the patients. Total cholesterol was not controlled in 16% of patients; 45% had a total cholesterol under 200 mg/dL. Less than one check-up of the feet was done, and no eye control nor microalbuminuria were registered. CONCLUSIONS: The Turriano system is effective for recording the diabetic population. Most patients in our study showed good metabolic control as well as of cardiovascular risk factors

Neutralización heteróloga e interacción de amanitinas con venenos de Bothropsy Crotalus y de abeja / Heterologous neutralization and interaction of toxic amanitins with Bothrops and Crotalus venoms, and honey bee venom / Neutralização heteróloga e interação das amanitinas tóxicas com veneno de Bothrops e Crotalus e veneno de abelha

En el presente trabajo se examinó la interacción de las amanitinas de Amanita phalloides (Basidiomycetes) con los venenos de las serpientes Bothrops neuwiedi diporus ("yarará pequeña"), B. alternatus ("yarará grande"), Crotalus durissus terrificus ("serpiente de cascabel") y de la abeja mielera Apis mellifera. Se aplicaron las técnicas de Ouchterlony, inmunotransferencia, electroforesis rocket y electroforesis en gel de poliacrilamida a los anti-venenos y anti-toxinas obtenidos por inmunización en caballos y/o en conejos. Los anti­sueros de serpientes y las amanitinas reaccionaron en forma cruzada, así como el veneno de abeja y las amanitinas. Cuando los venenos de Bothrops neuwiedii diporus y Crotalus durissus terrificus se preincubaron con las amanitinas y se analizaron por electroforesis en gel de poliacrilamida-dodecilsulfato de sodio (dodecylsulfate-polyacrylamide gel electrophoresis: SDS-PAGE), algunas bandas de proteínas desaparecieron y otras se redujeron notablemente. Estos resultados revelan por primera vez la interacción y la degradación de las proteínas de los venenos de serpientes por las amanitinas. Por otra parte, la modificación del tiempo de coagulación de la sangre humana, debida a los venenos, se corrigió con los ciclopéptidos de Amanita. Estos resultados también se informan por primera vez en este trabajo. La presencia de polipéptidos tóxicos en los venenos de serpientes y abejas, así como en A. phalloides y la reactividad cruzada demostradas en este trabajo, sugieren la existencia de epítopos comunes a todos ellos. Teniendo en cuenta estas reacciones, el uso de anti-venenos heterólogos parece ser de utilidad en el tratamiento del envenenamiento.

In the present work, the interaction of the amanitins of Amanita phalloides (Basidiomycetes) with the venoms of Bothrops neuwiedi diporus ("small yarará snake"), B. alternatus ("big yarará"), Crotalus durissus terrificus ("rattlesnake"), and honey bee Apis mellifera was examined. Ouchterlony, immunotransfer, rocket-electrophoresis, and polyacrylamide gel electrophoresis techniques were applied to anti-venoms and anti-toxins obtained by immunization in horses and/or in rabbits. Snake antisera and amanitins cross-reacted as well as bee venom and amanitins. When venoms of Bothrops neuwiedii diporus and Crotalus durissus terrificus were preincubated with amanitins and analysed by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE), some protein bands disappeared and others were significantly reduced. These results reveal for the first time the interaction and degradation of proteins in snake venoms by amanitins. Moreover, the modification of the human blood clotting time due to snake venoms was corrected by the Amanita cyclopeptides. These results are also reported for the first time in this work. The occurrence of toxic polypeptides in the snake and bee venoms as well as in A. phalloides, and the cross-reactivity demostrated herein, suggest the occurrence of epitopes common to all of them. Taking into account these reactions,the use of heterologous anti-venoms seems to be of value in envenomation treatment.

No presente trabalho foi examinada a interação das amanitinas de Amanita phalloides (Basidiomy­cetes) com os venenos das serpentes Bothrops neuwiedi diporus ("jararaca-cruzeira"), B. alternatus ("urutu"), Crotalus durissus terrificus ("serpente cascavel") e da abelha-europeia Apis mellifera. Foram aplicadas as técnicas de Ouchterlony, imunotransferência, eletroforese rocket e eletroforese em gel de poliacrilamida aos anti-venenos e anti-toxinas obtidos por imunização em cavalos e/ou em coelhos. Os anti-soros de serpentes e as amanitinas reagiram em forma cruzada, bem como o veneno de abelha e as amanitinas. Quando os venenos de Bothrops neuwiedii diporus e Crotalus durissus terrificus foram incubados previamente com as amanitinas e foram analisados por eletroforese em gel de poliacrilamida-dodecilsulfato de sódio (dodecylsulfate-polyacrylamide gel electrophoresis: SDS-PAGE), algumas faixas de proteínas desapareceram e outras se reduziram notavelmente. Estes resultados revelam por primeira vez a interação e a degradação das proteínas dos venenos de serpentes pelas amanitinas. Por outra parte, a modificação do tempo de coagulação do sangue humano, devido aos venenos, se corrigiu com os ciclopeptídeos de Amanita. Estes resultados também se informam por primeira vez neste trabalho. A presença de polipeptídeos tóxicos nos venenos de serpentes e abelhas, bem como em A. phalloides e a reatividade cruzada demonstradas neste trabalho, sugerem a existência de epítopos comuns a todos eles. Levando em consideração estas reações, o uso de anti-venenos heterólogos parece ser de utilidade no tratamento do envenenamento.

Neutralización heteróloga e interacción de amanitinas con venenos de Bothropsy Crotalus y de abeja / Heterologous neutralization and interaction of toxic amanitins with Bothrops and Crotalus venoms, and honey bee venom / NeutralizaþÒo heteróloga e interaþÒo das amanitinas tóxicas com veneno de Bothrops e Crotalus e veneno de abelha

En el presente trabajo se examinó la interacción de las amanitinas de Amanita phalloides (Basidiomycetes) con los venenos de las serpientes Bothrops neuwiedi diporus ("yarará pequeña"), B. alternatus ("yarará grande"), Crotalus durissus terrificus ("serpiente de cascabel") y de la abeja mielera Apis mellifera. Se aplicaron las técnicas de Ouchterlony, inmunotransferencia, electroforesis rocket y electroforesis en gel de poliacrilamida a los anti-venenos y anti-toxinas obtenidos por inmunización en caballos y/o en conejos. Los anti¡sueros de serpientes y las amanitinas reaccionaron en forma cruzada, así como el veneno de abeja y las amanitinas. Cuando los venenos de Bothrops neuwiedii diporus y Crotalus durissus terrificus se preincubaron con las amanitinas y se analizaron por electroforesis en gel de poliacrilamida-dodecilsulfato de sodio (dodecylsulfate-polyacrylamide gel electrophoresis: SDS-PAGE), algunas bandas de proteínas desaparecieron y otras se redujeron notablemente. Estos resultados revelan por primera vez la interacción y la degradación de las proteínas de los venenos de serpientes por las amanitinas. Por otra parte, la modificación del tiempo de coagulación de la sangre humana, debida a los venenos, se corrigió con los ciclopéptidos de Amanita. Estos resultados también se informan por primera vez en este trabajo. La presencia de polipéptidos tóxicos en los venenos de serpientes y abejas, así como en A. phalloides y la reactividad cruzada demostradas en este trabajo, sugieren la existencia de epítopos comunes a todos ellos. Teniendo en cuenta estas reacciones, el uso de anti-venenos heterólogos parece ser de utilidad en el tratamiento del envenenamiento.(AU)

In the present work, the interaction of the amanitins of Amanita phalloides (Basidiomycetes) with the venoms of Bothrops neuwiedi diporus ("small yarará snake"), B. alternatus ("big yarará"), Crotalus durissus terrificus ("rattlesnake"), and honey bee Apis mellifera was examined. Ouchterlony, immunotransfer, rocket-electrophoresis, and polyacrylamide gel electrophoresis techniques were applied to anti-venoms and anti-toxins obtained by immunization in horses and/or in rabbits. Snake antisera and amanitins cross-reacted as well as bee venom and amanitins. When venoms of Bothrops neuwiedii diporus and Crotalus durissus terrificus were preincubated with amanitins and analysed by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE), some protein bands disappeared and others were significantly reduced. These results reveal for the first time the interaction and degradation of proteins in snake venoms by amanitins. Moreover, the modification of the human blood clotting time due to snake venoms was corrected by the Amanita cyclopeptides. These results are also reported for the first time in this work. The occurrence of toxic polypeptides in the snake and bee venoms as well as in A. phalloides, and the cross-reactivity demostrated herein, suggest the occurrence of epitopes common to all of them. Taking into account these reactions,the use of heterologous anti-venoms seems to be of value in envenomation treatment.(AU)

No presente trabalho foi examinada a interaþÒo das amanitinas de Amanita phalloides (Basidiomy¡cetes) com os venenos das serpentes Bothrops neuwiedi diporus ("jararaca-cruzeira"), B. alternatus ("urutu"), Crotalus durissus terrificus ("serpente cascavel") e da abelha-europeia Apis mellifera. Foram aplicadas as técnicas de Ouchterlony, imunotransferÛncia, eletroforese rocket e eletroforese em gel de poliacrilamida aos anti-venenos e anti-toxinas obtidos por imunizaþÒo em cavalos e/ou em coelhos. Os anti-soros de serpentes e as amanitinas reagiram em forma cruzada, bem como o veneno de abelha e as amanitinas. Quando os venenos de Bothrops neuwiedii diporus e Crotalus durissus terrificus foram incubados previamente com as amanitinas e foram analisados por eletroforese em gel de poliacrilamida-dodecilsulfato de sódio (dodecylsulfate-polyacrylamide gel electrophoresis: SDS-PAGE), algumas faixas de proteínas desapareceram e outras se reduziram notavelmente. Estes resultados revelam por primeira vez a interaþÒo e a degradaþÒo das proteínas dos venenos de serpentes pelas amanitinas. Por outra parte, a modificaþÒo do tempo de coagulaþÒo do sangue humano, devido aos venenos, se corrigiu com os ciclopeptídeos de Amanita. Estes resultados também se informam por primeira vez neste trabalho. A presenþa de polipeptídeos tóxicos nos venenos de serpentes e abelhas, bem como em A. phalloides e a reatividade cruzada demonstradas neste trabalho, sugerem a existÛncia de epítopos comuns a todos eles. Levando em consideraþÒo estas reaþ§es, o uso de anti-venenos heterólogos parece ser de utilidade no tratamento do envenenamento.(AU)

Neutralizing effects of Nectandra angustifolia extracts against Bothrops neuwiedi snake venom.

Leaves extracts and essential oil of Nectandra angustifolia were explored for the first time for neutralization of Bothrops neuwiedi diporus snake venom. The ethanol extract was the most active and inhibited both venom activities (hemolytic and coagulant), while the oil was only active on the coagulant activity. These observations confirmed that certain medicinal plants from Corrientes and Chaco Provinces possess significant snake venom neutralizing capacity and need further examination for their active constituents. Analysis by GC and GC-MS of the essential oil and the enantiomeric excess found for alpha-pinene, beta-pinene and limonene allowed a better characterization of this species.

SDS-PAGE: una herramienta útil en la evaluación preliminar de la actividad alexítera de extractos vegetales / SDS PAGE: a useful tool for preliminary screening of antisnake activity of plant extracts

Some results obtained during our research work in the search of anti-snake compounds from plant origin, allow us to propose sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) as a valuable method for a fast and reliable screening in order to evaluate plant extracts activity on snake proteins from Bothrops diporus (yarará chica). Such approach will allow to process a larger number of plant extracts and to select the active ones. Venoms used in this study came from B. diporus which was previously vacuum dried. Extracts (aqueous, alcoholic and hexanic) were from native plants: Aristolochia elegans, Aristolochia gibertii, Asclepia curassavica, Cissampelos pareira, Dorstenia brasiliensis, Eclipta prostrata, Iresine diffusa, Mikania micrantha, M. periplocifolia, M. coridifolia, Nectandra angustifolia, N. megapotamica, Sapium haematospermum and Trixis divaricata. The results obtained by SDS-PAGE were compared with those obtained from in vitro assays (coagulation and hemolysis inhibition). The correlation between results obtained from electroforetic and in vitro assays allowed to suggest SDS-PAGE as a suitable technique to assist in preliminary plant screenings for anti-snake activity by snake venom protein interaction with plant compounds.

El desarrollo de nuestro trabajo de investigación en la búsqueda de compuestos alexíteros de origen vegetal nos permite proponer la electroforesis en geles de poliacrilamida en condiciones desnaturalizantes, como método de screening rápido y confiable, para evaluar la actividad de extractos vegetales sobre proteínas del veneno de yarará, de manera de procesar mayor número de muestras vegetales y seleccionar aquellas que son activas. Para el desarrollo de la metodología, se utilizó un pool de veneno de Bothrops diporus desecado al vacío y extractos acuosos, alcohólicos y hexánicos de plantas autóctonas Aristolochia elegans, A. gibertii, Asclepia curassavica, Cissampelos pareira, Dorstenia brasiliensis, Eclipta prostrata, Iresine diffusa, Mikania micrantha, M. periplocifolia, M. coridifolia, Nectandra angustifolia, N. megapotamica, Sapium haematospermum y Trixis divaricata. Se realizaron pruebas in vitro (inhibición de la coagulación y hemólisis) para contrastar con los resultados obtenidos por SDS-PAGE. La correlación de los resultados obtenidos con técnicas in vitro validadas, permite sugerir el empleo de la técnica de SDS-PAGE como una herramienta útil en la evaluación preliminar de la actividad alexítera de extractos vegetales, propiedad evidenciada por la modificación en el perfil de bandas proteicas cuando se compara el veneno puro con el producto de la interacción extracto vegetal-veneno.

Tramadol for osteoarthritis: a systematic review and metaanalysis.

OBJECTIVE: Tramadol is increasingly used for the treatment of osteoarthritis (OA) because it does not produce gastrointestinal bleeding or renal problems and does not affect articular cartilage. We sought to determine the analgesic effectiveness, the effect on physical function, the duration of benefit, and the safety of oral tramadol in people with OA. METHODS: We searched the Cochrane Central Register of Controlled Trials (Central), Medline, Embase, and Lilacs databases up to August 2005. We included randomized controlled trials (RCT) that evaluated the effect of tramadol or tramadol plus paracetamol on pain levels and/or physical function. No language restriction was applied. RESULTS: We included 11 RCT with a total of 1019 participants who received tramadol or tramadol/paracetamol and 920 participants who received placebo or active control. Participants who received tramadol reported (1) less pain [-8.5 units on a 0-100 scale; (95% CI -12.0 to -5.0)], a 12% relative decrease in pain intensity; (2) higher degree of global improvement: one of every 6 individuals taking tramadol or tramadol/paracetamol exhibited at least moderate global improvement (95% CI 4 to 9); and (3) improvement in stiffness and function, an 8.5% relative improvement in Western Ontario and McMaster University Osteoarthritis Index score, than patients who received placebo. In terms of adverse events, one of every 5 participants who received tramadol or tramadol/paracetamol experienced minor adverse events and one of every eight stopped taking the medication because of adverse events (95% CI 7 to 12) compared to participants who received placebo. CONCLUSION: Tramadol or tramadol/paracetamol decreases pain intensity, produces symptom relief, and improves function in patients with OA, but these benefits are small.

Avaliação ultra-estrutural da polpa de dentes decíduos - Parte I / Ultra-structural evaluation of human deciduos teeth pulp - Part I

A ultra-estrutura da polpa de dentes decíduos humanos sem cárie e sem rizólise foi estudada por meio de microscopia eletrônica de transmissão. Observou-se, como característica comum em todas as polpas, a presença de uma substância macromolecular não fibrilar. Pode-se dizer que por ter reagido com corante catiônico - tetróxido de ósmio - trata-se de glicosaminoglicanas (GAG), proteoglicanas (PG) e glicoproteínas (Gp). Evidenciam-se dois tipos de distribuição dessas macromoléculas. Na área extrafeixe de fibrilas colágenas, em forma de rede de finíssima trama esparsa por todos os campos examinados com arranjo bastante uniforme e regular. Na área intra-feixe, com aspecto de substância cimentante. Nesse particular conferem a cada fibrila um aspecto anelar, evidenciando-lhes os contornos. Constatou-se ainda que a presença dessas macromoléculas está relacionada com a concentração das fibrilas agrupadas em feixes. Pelo presente estudo podemos concluir que o quadro acima, decorrente do inter-relaciomento das fibrilas colágenas com as macromoléculas não fibrilares, é um referencial de normalidades da polpa de dentes decíduos sem cáries e sem rizólise