Effects of the habitat on anuran blood parasites in the Eastern Brazilian Amazon.

Biological interactions play an important role in regulating and maintaining natural populations. Like most interactions, parasitism may be influenced by environmental conditions. Therefore, changes caused by human activity may drastically affect the equilibrium of the assemblages of parasitized organisms (hosts). Herein, we described the composition of hemoparasites of anurans from two distinct environments: forest and oil palm plantations. We identified the most frequent groups of blood parasites, and whether infections differ between habitats (forest and plantation) and between microhabitats (arboreal or terrestrial). We collected 128 anurans, of which 46 (36%) were parasitized by hemoparasites. The genus Trypanosoma spp. was found in 30% (n = 37/128) of the infected anurans in both habitats, recorded mostly in terrestrial anurans in oil palm plantations. Apicomplexa hemoprotozoans were also found in 13% (n=17/128) of the anurans, which mainly were terrestrial species collected in oil palm plantations. There was no difference in parasitism between the two assemblies and between the studied microhabitats. This is the first study that has analyzed the ecological relationship between anurans as hosts and their blood parasites, in a region under intense anthropic pressure, in the Brazilian Amazon.

Índice de redondez corporal como indicador antropométrico para identificar riesgo de síndrome metabólico en médicos del hospital San Francisco del IESS, en la ciudad de Quito / Body roundness index as an anthropometric indicator to identify risk of metabolic syndrome in physicians of the San Francisco hospital of the IESS, in the city of Quito

Contexto: las enfermedades crónicas no transmisibles revisten interés para la salud pública; algunas de ellas pueden detectarse y predecirse mediante estudios básicos como es la antropometría. El índice de masa corporal (IMC) valora, estratifica y clasifica el nivel de sobrepeso del individuo como factor de riesgo de síndrome metabólico (SM), sin discriminar entre masa muscular y adiposidad que puede dilucidarse mediante el índice de redondez corporal (IRC) y predecir tanto el porcentaje de grasa corporal y el estado de salud. Barazzoni y colaboradores relacionaron tanto al IRC e IMC con el síndrome metabólico; sobre esta relación existen contados estudios, algunos controversiales. Objetivo: demostrar la utilidad del IRC para identificar factores de riesgo de síndrome metabólico y correlacionarlo con el Índice de masa corporal para establecer la utilidad clínica como indicador de riesgo metabólico. Sujetos y métodos: estudio epidemiológico observacional descriptivo transversal de con- junto, en una muestra de 90 médicos del Hospital San Francisco de Quito. Perteneciente al Instituto Ecuatoriano de Seguridad Social. Mediciones principales: estado nutricional según peso, talla, circunferencia abdominal; diagnóstico de síndrome metabólico según «guía para el tratamiento de dislipidemias en adultos¼ (Adult Treatment Panel III). Resultados: el 16,67% (IC95% 10,37­25,69%) de sujetos fueron diagnosticados con SM de- mostrándose similar resultado usando IMC e IRC para establecer la condición de SM según criterios diagnósticos del ATPIII (p<0,05). La exactitud del IMC como predictor de riesgo de SM fue 62% y 30% de precisión; para IRC, la exactitud fue 42%, sensibilidad del 23% y 100% de valor predictivo negativo. Conclusión: la prevalencia de síndrome metabólico en médicos es alta. El IRC es útil para el diagnóstico de SM, sin embargo, su mayor aplicación es para descartar su diagnóstico, comparado con el IMC. Se recomienda nuevos estudios.

Contex: Chronic non-communicable diseases are of interest to public health; some of them can be detected and predicted through basic studies such as anthropometry. The body mass index (BMI) assesses, stratifies and classifies the individual's level of overweight as a risk factor for metabolic syndrome (MS), without discriminating between muscle mass and adiposi- ty that can be elucidated by means of the body roundness index (BRI) and predict both body fat percentage and health status. Barazzoni and collaborators related both IRC and BRI with metabolic syndrome; about this relationship there are few studies, some controversial. Objective: to demonstrate the usefulness of the BRI to identify risk factors for metabolic syndrome and correlate it with the body mass index to establish clinical utility as an indica tor of metabolic risk. Subjects and methods: Cross-sectional descriptive observational epidemiological study, in a sample of 90 doctors from the San Francisco Hostpital of Quito (Ecuadorian Social Security Institute). Main measurements: nutritional status according to weight, height, abdominal circumference; diagnosis of metabolic syndrome according to "guide for the treatment of dyslipidemias in adults" (Adult Treatment Panel III). Results: 16.67% (95% CI 10.37­25.69%) of subjects were diagnosed with MS demonstrating a similar result using BMI and BRI to establish the condition of MS according to diagnostic criteria of ATPIII (p <0.05). The accuracy of the BMI as a predictor of MS risk was 62% and 30% accuracy; for IRC, the accuracy was 42%, sensitivity 23% and 100% negative predictive value. Conclusions: The prevalence of metabolic syndrome in doctors is high. The BRI is useful for the diagnosis of MS, however, its greatest application is to rule out its diagnosis, compared to the BMI. New studies are recommended.

Perfil epidemiológico dos exames de eletroencefalograma realizados no Hospital Universitário Prof. Polydoro Ernani de São Thiago (Florianópolis, SC) no ano de 2013 / Epidemiological profile of electroencephalographic exams in Hospital Universitário Prof. Polydoro Ernani de São Thiago (Florianópolis, SC) in the year of 2013

O presente estudo realizou um levantamento epidemiológico das requisições de eletroencefalograma (EEG) enviadas ao Hospital Universitário Professor Polydoro Ernani de São Thiago (HU-UFSC) (Florianópolis, SC) ao longo do ano de 2013, comparando os achados à literatura. Este é um estudo observacional de desenho transversal em que as requisições enviadas ao HU-UFSC de EEGs realizados no ano de 2013 foram selecionadas e avaliadas quanto às variáveis demográficas dos pacientes, ao perfil dos médicos e serviços de saúde solicitantes e à observância aos seus critérios de utilização. Nos 642 exames realizados em 2013, a média de idade dos pacientes foi de 35,83 [± desvio-padrão (DP) = 19,79] anos, com 55,1% de mulheres e 44,9% homens, sendo 33,0% procedentes de Florianópolis. Os neurologistas solicitaram a maior proporção de EEGs, com 38,2% da amostra e o principal serviço de saúde requerente foi o próprio HU-UFSC, respondendo por 40,8% da mesma. 63,1% dos exames foram considerados bem indicados, havendo diferença estatisticamente significante no comparativo entre o HU-UFSC e os demais serviços de saúde, mas não entre neurologistas e demais médicos. Os resultados encontrados são, em sua maioria, condizentes com a literatura, fazendo-se ressalva para as dificuldades que a escassez de informações oferecidas por parte dos médicos pode impactar negativamente na interpretação adequada destes exames, o que torna evidente a necessidade do correto e completo preenchimento destes pedidos.

Electroencephalography (EEG) exams carried out at the Hospital Universitário Professor Polydoro Ernani de São Thiago (HU-UFSC) (Florianópolis, SC) over the year 2013 were analysed. It was an observational, cross-sectional study in which the EEG requests were evaluated with regards to the demographic variables, the profile of medical and health services requesters and the adequate indication of this exam. Among the 642 exams performed in 2013, the average age of patients was 35.83 [± standard deviation (SD) = 19.79] years, 55.1% were women; 33.0 % coming from Florianópolis. Neurologists asked the largest proportion of EEGs (38.2%), and most exams were requested in HU/UFSC (40.8%). 63.1% of EEGs were considered well-indicated, with statistically significant difference in the comparison between the HU-UFSC and other health services, but not between neurologists and other physicians. The results are mostly consistent with the literature. It is noteworthy the lack of information in most of the requests, which makes clear the need for correct and complete filling of the EEG requisitions.

Fratura toracolombar explosão: confiabilidade do método de guerra na análise tomográfica / Thoracolumbar burst fracture: reliability of the guerra's method on tomographic analysis

OBJETIVOS: Avaliar as características do fragmento retropulsado nas fraturas explosão da coluna toracolombar, de acordo com dois examinadores independentes no plano sagital da TAC e correlacionar estes achados com a presença de déficit neurológico. MATERIAL E MÉTODOS: Coleta retrospectiva de dados de prontuário e TC em 138 pacientes com fratura toracolombar do tipo explosão internados no nosso serviço entre 1983 e 2004. RESULTADOS: Observamos correlação significante entre dois examinadores independentes (p<0,05) na aferição da rotação e migração do fragmento. Este, caracteristicamente, é triangular, tem uma média de rotação de 20º e se desloca na maioria das vezes no sentido cranial, até oito milímetros. Não foi possível a associação entre a rotação do fragmento e o déficit neurológico neste estudo. CONCLUSÃO: Houve correlação positiva entre os achados de dois pesquisadores independentes, usando o mesmo método de mensuração na casuística estudada. Considerando os grupos de rotação, não foi possível relacionar o grau de rotação do fragmento retropulsado com o déficit neurológico.

OBJECTIVES: The objective of the current study was to evaluate the correlation between neurological deficits and the characteristics of retropulsed fragment into the spinal canal in patients with thoracolumbar burst fractures. MATERIAL AND METHODS: From 1983 to 2004, 135 patients with thoracolumbar burst fractures according to Denis' criteria were evaluated at a tertiary teaching institution by two different observers. CT-Scans of the fractured spine were analyzed in order to assess the narrowing of the spinal canal. Neurological deficit was evaluated by using the Franke's classification. RESULTS: A significant correlation was found between two independent observers (P<0.05). The observed characteristics of the retropulsed fragment into the spinal canal were: triangular form, rotation dislocation with average of 20 degrees and cranial dislocation with average of eight millimeters. There was no statistical correlation between neurological deficits and the characteristics of retropulsed fragment of the spinal canal. CONCLUSION: There was no statistical correlation between neurological deficits and the characteristics of retropulsed fragment of the spinal canal.

Síndrome de ativação macrofágica secundária à infecção aguda pelo vírus Epstein-Barr: [relato de caso] / Macrophage activation syndrome triggered by Epstein-Barr virus: [case report]

A síndrome de ativação macrofágica (SAM) ou síndrome hemofagocítica secundária (reativa) consiste de uma rara, grave e potencialmente fatal complicação das doenças reumáticas crônicas, particularmente da artrite idiopática juvenil de início sistêmico, doença de Still do adulto e lúpus eritematoso sistêmico. É caracterizada pela excessiva ativação dos macrófagos, resultando febre, hepatoesplenomegalia, linfadenomegalia, envolvimento neurológico, graus variáveis de citopenias, hiperferritinemia, distúrbio hepático, coagulação intravascular e freqüente falência de múltiplos órgãos. Também ocorre em associação com neoplasias, imunodeficiências e variedade de agentes infecciosos virais (sobretudo do grupo do herpes), bacterianos e fúngicos. Relatamos um caso de SAM decorrente de infecção viral aguda pelo vírus Epstein-Barr tratado com corticóide oral

The macrophage activation syndrome (MAS) or secondary haemophagocytic syndrome (reactive) is an uncommon, severe and life-threatening complication of chronic rheumatic diseases, especially systemic onset juvenile idiopathic arthritis, adult-onset Still disease and systemic lupus eritematosus. It is characterized by the excessive activation of macrophages, resulting in fever, hepatoesplenomegaly, lymphadenopathy, neurological involvement, variable cytopenias, hyperferritinemia, liver disease, intravascular coagulation, often resulting in fatal multiple organ failure. Besides chronic rheumatic diseases, it is also seen in a heterogeneous group of diseases like neoplasms, imunodeficiencies and viruses (especially the herpes group), bacteria and fungi infections. We describe a case report of one patient with MAS triggered by Epstein-Barr virus infection treated with oral corticosteroid.

Plan general de desarrollo provincial de Pichincha, 2002-2022 / General Plan of Provincial Development of Pichincha, 2002-2022

Diagnóstico provincial.- Hitos históricos.- Pichincha en cifras.- Diagnóstico sectorial. Mesas de concertación.- Pichincha solidaria: Salud, cultura, educación, cultura física, gobernabilidad, transparencia, gestión de riesgos y prevención de desastres, seguridad ciudadana, medios de comunicación, niño y familia, género, personas con discapacidades, adultos mayores, niñez, jóvenes.- Pichincha competitiva: Agropecuaria, turismo, energía, industria y comercio, ciencia y tecnología, artesanía, pequeña industria y microempresa.- Pichincha de la integración: Ambiente, transporte y comunicaciones, ordenamiento territorial, vivienda e infraestructura