The COVID-19 Pandemic Affected Hepatitis C Virus Circulation and Genotypic Frequencies-Implications for Hepatitis C Prevention, Treatment and Research.

Hepatitis C is regarded as a global health issue caused by hepatitis C virus (HCV) infection. HCV is targeted for elimination by 2030 as a global public health goal. However, the COVID-19 pandemic has changed human circulation and prevented access to diagnostics and treatment to many other diseases, including hepatitis C. COVID-19 impacted HCV global elimination efforts with implications not fully comprehended yet. The high genetic variability in HCV makes the development of vaccines and pan-genotypic drug therapies a difficult task. Changes in the dynamics of HCV impose new challenges for public health and opportunities for future research. Meta-analysis, the follow up of new cases and sampling of HCV patients compared with previously available data are options for investigating the possible changes. The determination of HCV genotypes and subtypes is important for understanding viral dynamics and treatment; therefore, the changes in genotype and subtype prevalences can directly affect such processes. Recent results in the literature already suggest changes in HCV dynamics during the COVID-19 pandemic, both considering viral circulation and differential genotypic frequencies in distinct geographic areas. In this context, we propose a further examination of these trends using different approaches to provide support for the hypothesis that the COVID-19 pandemic affected HCV circulation, since these findings would have important implications for hepatitis C prevention, treatment and research.

Tailored Time-Temperature Transformation Diagram for IN718 Alloy Obtained via Powder Bed Fusion Additive Manufacturing: Phase Behavior and Precipitation Dynamic.

Experimental and computational approaches were used to study the microstructure of IN718 produced via powder bed fusion additive manufacturing (PBF-AM). The presence, chemical composition, and distribution of stable and metastable phases (γ'', δ, MC, and Laves) were also analyzed. The information obtained from the microstructural study was used to construct a tailored time-temperature transformation (TTT) diagram customized for additive manufacturing of IN718. Experimental techniques, including differential scanning calorimetry (DSC), scanning electron microscopy, energy dispersive X-ray spectroscopy, and electron backscatter diffraction (EBSD), were employed to establish the morphological, chemical, and structural characteristics of the microstructure. The Thermo-Calc software and a Scheil-Gulliver model were used to analyze the presence and behavior of phase transformations during heating and cooling processes under non-thermodynamic equilibrium conditions, typical of AM processes. Unlike conventional TTT diagrams of this alloy, the diagram presented here reveals that the precipitation of γ'' and δ phases occurs at lower temperatures and shorter times in AM-manufactured parts. Significantly, the superposition of γ'' and δ phase curves in the proposed diagram underscores the interdependence between these phases. This TTT diagram is a valuable insight that can help in the development of heat treatment processes and quality control for IN718 produced via PBF-AM.

HLA-G 3'UTR haplotype analyses in HCV infection and HCV-derived cirrhosis, hepatocellular carcinoma and fibrosis.

Hepatitis C virus (HCV) infection is a major cause of chronic liver disease. Chronic HCV infection is also an important cause of hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC). HCV has the capacity to evade immune surveillance by altering the host immune response. Moreover, variations in immune-related genes can lead to differential susceptibility to HCV infection as well as interfere on the susceptibility to the development of hepatic fibrosis, cirrhosis and HCC. The human leucocyte antigen G (HLA-G) gene codes for an immunomodulatory protein known to be expressed in the maternal-foetal interface and in immune-privileged tissues. The HLA-G 3' untranslated region (3'UTR) is important for mRNA stability, and variants in this region are known to impact gene expression. Studies, mainly focusing in a 14 bp insertion/deletion polymorphism, have correlated HLA-G 3'UTR with susceptibility to viral infections, but other polymorphic variants in the HLA-G 3'UTR might also affect HCV infection as they are inherited as haplotypes. The present study evaluated HLA-G 3'UTR polymorphisms and performed linkage disequilibrium test and haplotype assembly in 286 HCV infected patients who have developed fibrosis, cirrhosis or HCC, as well as in 129 healthy control subjects. Haplotypes UTR-1, UTR-2 and UTR-3 were the most observed in HCV+ patients, in the frequencies of 0.276, 0.255 and 0.121, respectively. No statistically significant difference was observed between HCV+ and control subjects, even when patients were grouped according to outcome (HCC, cirrhosis or fibrosis). Despite that, some trends in the results were observed, and therefore, we cannot rule out the possibility that variants associated to high HLA-G expression can be involved in HCV infection susceptibility.

Monitoring Internal Training Load, Stress-Recovery Responses, and Immune-Endocrine Parameters in Brazilian Jiu-Jitsu Training.

ABSTRACT: Campos, F, Molina Correa, JC, Canevari, VCM, Branco, BHM, Andreato, LV, and de Paula Ramos, S. Monitoring internal training load, stress-recovery responses, and immune-endocrine parameters in Brazilian jiu-jitsu training. J Strength Cond Res 36(3): 723-731, 2022-This study aimed to evaluate the relationship between training loads, stress, and immune-endocrine markers during a precompetitive period in Brazilian jiu-jitsu (BJJ) athletes. For this, 12 athletes were submitted to 1 physical and 1 technical-tactical training session per day, 5 days a week, for 7 weeks. The saliva sampling and physical tests (countermovement jump [CMJ] and squat jump [SJ]) were performed before starting the training period (pre) and at the fourth week (4-week) and eighth week (post). Session rating of perceived exertion (sRPE) and the Recovery-Stress Questionnaire-Sport (RESTQ) were applied, and the training load was calculated weekly. Repeated-measures analysis of variance and the Friedman test were used, with significance levels set at p < 0.05. Increased training loads were recorded by the sRPE method in technical-tactical training sessions (p < 0.05). Higher physical loads were reported by athletes during weeks 1-4, contributing to overall higher training load, monotony, and strain during this period (p < 0.05). Increased perception of stress, by the RESTQ, and cortisol were detected, whereas decreased salivary testosterone and salivary immunoglobulin A were observed at 4 weeks (p < 0.05). No significant differences were detected in CMJ and SJ tests, suggesting that training neither elicited significant fatigue and underperformance nor improved strength performance. However, decreasing physical training loads appeared to reduce symptoms of stress and improved recovery, favoring immune recovery and anabolic balance. Thus, the sRPE seems to be a reliable and simple method to monitor training loads in BJJ athletes because variation in values was related to the RESTQ and physiological responses to training loads.

Ergogenic Effects of Photobiomodulation on Performance in the 30-Second Wingate Test: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study.

ABSTRACT: Molina Correa, JC, Padoin, S, Varoni, PR, Demarchi, MC, Flores, LJ, Nampo, FK, and de Paula Ramos, S. Ergogenic effects of photobiomodulation on performance in the 30-second Wingate test: A randomized, double-blind, placebo-controlled, crossover study. J Strength Cond Res 36(7): 1901-1908, 2022-The purpose of this study was to evaluate the ergogenic effects of red light (630 nm) photobiomodulation on anaerobic capacity in the Wingate test. Sixteen healthy and physically active male volunteers (21.71 ± 2.49 years of age, body mass index between 18.5 and 24.9 kg/m2) participated in this randomized, double-blind, placebo-controlled, crossover study. The subjects performed 3 Wingate test sessions, with a 48-hour interval between tests. In the first session (baseline session, BS), a Wingate test was performed to evaluate the initial performance. Subjects were paired by performance in the BS and allocated through a draw to receive either the phototherapy (630 nm, 4.6 J/cm2, 6 J per point, 16 points, light-emitting diode [LED] session) or placebo intervention (PLA session) in the second test session. In the third test session, a crossover intervention was performed. The repeated-measures analysis of variance test, followed by Bonferroni post hoc test or Friedman test with Dunn's post hoc test (p < 0.05) and Cohen's d statistic were used for comparisons. The LED session with phototherapy promoted an increase in performance in peak power (p < 0.05), relative power (p < 0.05), RPMpeak (p < 0.05), and peak velocity (p < 0.05), as well as total displacement (p < 0.01) compared with PLA. The mean power (p < 0.05), relative power (p < 0.05), RPMmean (p < 0.01), and mean velocity (p < 0.01) were higher in the LED session than those of BS. We concluded that phototherapy improves performance in Wingate anaerobic exercise, possibly due to large effects on the anaerobic alactic metabolism.

Phototherapy Improves Muscle Recovery and Does Not Impair Repeated Bout Effect in Plyometric Exercise.

ABSTRACT: Padoin, S, Zeffa, AC, Molina Corrêa, JC, de Angelis, TR, Moreira, TB, Barazetti, LK, and de Paula Ramos, S. Phototherapy improves muscle recovery and does not impair repeated bout effect in plyometric exercise. J Strength Cond Res 36(12): 3301-3310, 2022-The effects of photobiomodulation with red (630 nm) and near-infrared (940 nm) light wavelengths were investigated on the inhibition of exercise-induced muscle damage (EIMD) and adaptation to the repeated bout effect (RBE). Twenty-eight healthy men were randomized to receive light-emitting diode therapy (LEDT) at 630 nm (4.6 J·cm -2 , 97 J energy), LEDT at 940 nm (4.6 J·cm -2 , 114 J), or placebo. After LEDT or placebo treatment, subjects performed 100 drop-jumps (5 sets of 20 repetitions). Creatine kinase, delayed-onset muscle soreness (DOMS), countermovement jump (CMJ), and squat jump (SJ) were assessed before, immediately after, and 24, 48, and 72 hours after the bout. After 14 days, the subjects were submitted to the same plyometric exercise, without LEDT, and were evaluated again. Creatine kinase levels increased significantly 72 hours after the first bout in the placebo group in relation to the LEDT 940-nm group ( P < 0.01). The LEDT 630-nm group showed a significant increase in SJ at 24 hours ( P < 0.05), whereas, at 48 hours, the LEDT 940 nm showed a significant increase compared with the placebo group ( P < 0.05). The 2-way analysis of variance revealed an effect for treatment in the SJ ( F = 7.12; P = 0.001). No differences were found between groups for DOMS and CMJ after the first bout. After the second bout of exercise, there was no effect of treatment. The results suggest that treatment with LEDT 630 nm and LEDT 940 nm before eccentric exercise attenuates EIMD without impairing RBE.

Colonic lipomas an uncommon cause of intussusception in adult patients: report of three cases and literature review.

Colonic lipomas are infrequent, benign, non-epithelial, fatty neoplasms. Most of the colonic lipomas are asymptomatic, but around 25% of patients may develop symptoms. Nowadays, surgical resection of the involved segment is the treatment of choice. We report three cases of colonic intussusceptions caused by colonic lipomas in adult patients. The patients underwent surgical resection, and the diagnosis was confirmed by histopathological examination of the specimens.

Los lipomas colónicos son neoplasias benignas, adiposas, no epiteliales poco frecuentes. La mayoría de los lipomas de colon son asintomáticos, pero alrededor del 25% de los pacientes pueden desarrollar síntomas. En la actualidad, la resección quirúrgica del segmento afectado es el tratamiento de elección. Presentamos tres casos de intususcepción intestinal secundaria a lipomas colónicos en pacientes adultos. Los pacientes fueron sometidos a resección quirúrgica y el diagnóstico se confirmó mediante examen histopatológico.

Tiroidectomía transoral endoscópica por abordaje vestibular (TOETVA): primer caso en Perú / Transoral endoscopic thyroidectomy via vestibular approach (TOETVA): first case in Peru

RESUMEN La calidad de vida luego de la cirugía de la glándula tiroides es tan importante como el control de la enfermedad. Para mejorar los resultados cosméticos y la satisfacción del paciente se usan abordajes endoscópicos usando incisiones fuera de la región cervical. La tiroidectomía transoral endoscópica no deja ninguna cicatriz visible en la piel y es una técnica quirúrgica segura. Se presenta el caso de una paciente mujer de 29 años con una tumoración benigna de la glándula tiroides con síntomas compresivos y preocupaciones estéticas, sometida a hemitiroidectomia derecha mediante abordaje transoral vestibular endoscópico en un tiempo de 150 minutos y sangrado mínimo. Los resultados son comparables con la técnica quirúrgica abierta, con un mejor resultado estético y mejora en la calidad de vida.

ABSTRACT Quality of life after thyroid gland surgery is as important as disease control. To improve cosmetic results and patient satisfaction, endoscopic approaches are used using incisions outside the cervical region. Endoscopic transoral thyroidectomy does not leave any visible scarring on the skin. We present the case of a 29-year-old female patient with a benign thyroid gland tumor with compressive symptoms and aesthetic concerns, who underwent a right hemithyroidectomy by means of an endoscopic transoral vestibular approach in a time of 150 minutes and minimal bleeding, without complications in the postoperative period. The transoral endoscopic vestibular approach for endoscopic resection of the thyroid gland is safe and the results are comparable with the open surgical technique, with a better cosmetic result and improved quality of life.

Could regular practice of volleyball modulate salivary secretory immunity in children? Cross-sectional and longitudinal studies

INTRODUCTION: The aim of these studies was to evaluate the effects of regular volleyball training on salivary SIgA and alpha-amylase in female children and adolescents. MATERIAL AND METHOD: In the cross-sectional study, 115 female children (12.6 ± 2.2 years) participating in a Volleyball training program were classified as beginners, intermediate, and competitive level. The children were evaluated regarding caries index, body mass index (BMI), cardiorespiratory fitness, and countermovement jump. In the longitudinal study: 54 girls (intermediate and competitive groups) trained for 8 weeks and were re-evaluated at weeks 4 and 8. RESULTS: The SIgA secretion rate and alpha-amylase activity did not present correlations with training category, age, caries index, or training status. A weak positive correlation was detected between IgA secretion rate and BMI (r = 0.20, p < 0.05). After 8 weeks of training, VO2max (p < 0.005) and jump height (p < 0.005) improved in the competitive girls. No differences were observed in salivary secretion rate, SIgA concentration and secretion rate, or alpha-amylase activity at weeks 4 and 8. CONCLUSIÓN: We concluded that despite improving physical fitness, 8-weeks of recreational volleyball training are not able to improve salivary SIgA secretion or alter alpha-amylase activity in female children and adolescents

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Consultas a dermatología en el sector público de salud en Chile en 2019 / Consultations to dermatology in the public sector of health in Chile in 2019

Introducción: Existe una amplia heterogeneidad en la distribución de médicos y especialistas en las distintas regiones de Chile. Dermatología no está exenta de esta realidad. Conocer la población consultante resulta clave para complementar la situación sanitaria que la distribución de médicos y diferencias en el acceso, reflejan a nivel nacional. Objetivo: Analizar descriptivamente las consultas a Dermatología durante el 2019 en el Sector Público de salud en Chile; según región, rango etario y consultas en operativos. Materiales y Métodos: 250.649 consultas realizadas a Dermatología reportadas por el DEIS durante el 2019. Resultados: Del total de las consultas a cualquier especialidad en el sector público de salud, las consultas a Dermatología suponen un 2.7%. De estas, la Región Metropolitana concentra el 45.2% mientras que la Región de Aysén es la que más consulta en función de su población. Se establece un promedio nacional de 14.1 consultas por cada 1000 habitantes. Las Zonas Norte y Centro consultan bajo este promedio, mientras que la Zona Sur consulta por sobre este. En cuanto al rango etario, se establecen peaks de consultas entre los 0-4 años, 15-19 y finalmente 75-79. Discusión: Dermatología presenta un porcentaje no despreciable del total de consultas a especialidad. Destaca la baja consulta en la Zona Norte, dado el antecedente de mayor prevalencia de cáncer de piel no melanoma respecto a la media nacional. Asimismo, la mayor consulta en Aysén se condice con una mayor densidad de médicos en la región, respecto a otras regiones.

Introduction: There is wide heterogeneity in the distribution of physicians in the different regions of Chile. Dermatology is no different from this reality. Studying the consulting population is key to complement the health situation that the distribution of physicians and differences in healthcare access reflect at the national level. Objective: To perform a descriptive analysis of the consultations made to Dermatology during 2019 in the Chilean Public Health Sector; according to region, age-range, and consultations in Health operatives. Materials and Methods: 250,649 consultations to Dermatology reported by the DEIS during 2019. Reslts: Of the total number of consultations to any specialty on the public sector, Dermatology accounts for 2.7%. Of these, the Metropolitan Region concentrates 45.2% of the consultations. Aysén is the region with the most consultations according to its population. There is a national average of 14.1 consultations per 1000 inhabitants. The Northern and Central regions consult below this average, while the Southern regions consult above it. Regarding age range, peaks of consultations are established between 0-4 years, 15-19 and finally 75-79. Discussion: Dermatology accounts for a non-negligible percentage of the total number of consultations to specialty. The low number of consultations in the Northern Zone is remarkable, given the history of high UV radiation in the area. Likewise, the greater number of consultations in Aysén is consistent with a greater density of physicians in the region when compared to other regions.

Total esophageal replacement by transmediastinal transposition of the stomach in a gastrointestinal stromal tumor of the thoracic esophagus: a rare surgical case report.

BACKGROUND: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. A rare site of localization of these tumors is the esophagus. Evidence-based consensus regarding the type of surgery for patients with esophageal GIST remains unclear. CLINICAL CASE: A female without history of diseases experienced dysphagia, weight loss (6 kg) and malaise. Computed tomography revealed thickening of the esophagus. During the endoscopic ultrasonography a localized lesion was observed in the esophagus that depended on the muscularis propria. We opted to treat with an esophagectomy with replacement by transmediastinal transposition of the stomach. Patient recovered well from the surgery and she was discharged home in stable condition in post-operative day seven. At 6 months she has no symptoms. CONCLUSION: This case illustrates the clinical presentation of an esophageal GIST which represents only 1% of all sites where GISTs have been reported; open surgery was successfully performed with minimal morbidity, complete resolution of symptoms and improvement of the patient's quality of life. Esophagectomy with replacement by transmediastinal transposition of the stomach should be performed when the center has experience to do so with minimal morbidity and mortality.

ANTECEDENTES: Los tumores del estroma gastrointestinal (GIST) son las lesiones malignas mesenquimales más comunes del tracto digestivo. Un sitio raro de localización de estos tumores es el esófago. A la fecha actual no hay un consenso claro basado en evidencia científica con respecto al tipo de cirugía a realizar en pacientes con GIST en esta localización inusual. CASO CLÍNICO: Una mujer previamente sana presentó disfagia, pérdida de peso (6 kg) y malestar general. La tomografía computarizada reveló un engrosamiento del esófago y en la ultrasonografía endoscópica se observó una lesión localizada en el esófago dependiente de la muscular propia. Se optó por realizar esofagectomía con reemplazo mediante transposición transmediastinal del estómago. La paciente se recuperó bien de la cirugía y fue dada de alta en condición estable en el séptimo día del posoperatorio. A los 6 meses, se encuentra asintomática. CONCLUSIÓN: Este caso ilustra la presentación clínica de un GIST esofágico que representa solo el 1% de todos los sitios reportados. La cirugía se realizó con éxito, con morbilidad mínima, resolución completa de los síntomas y mejoría de la calidad de vida de la paciente. La esofagectomía con reemplazo mediante transposición transmediastinal del estómago (comúnmente llamado ascenso gástrico) debe realizarse cuando el centro tiene experiencia para hacerlo con morbilidad y mortalidad mínimas.

Salivary levels of Interleukin-6 and Tumor Necrosis Factor-alpha in girls aged 7-17 years practicing volleyball / Niveles salivales de interleucina 6 y factor de necrosis tumoral alfa en niñas de 7 a 17 años que practican voleibol

INTRODUCTION: The purpose of the study was to evaluate the salivary concentrations of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNFalfa) and correlate the findings with the caries index, body mass index (BMI), potency of lower limbs (vertical jump), cardiorespiratory fitness, and risk of developing cardiovascular diseases in girls practicing volleyball. MATERIAL AND METHODS: Two studies were performed: 1) a cross-sectional study (n = 120) on the association of IL-6 and TNFalfa with the caries index, anthropometric measures, physical tests, and experience in volleyball practice; 2) longitudinal study (n = 63) on the effects of 8 weeks of training on salivary IL-6 and TNFalfa in girls with intermediate experience in volleyball and competitive girls. RESULTS: The median levels of IL-6 were 1.98 [1.55-3.11] pg/ml and TNFalfa, 0.46 [0.28-0.59] pg/ml and these did not correlate with the caries index, BMI, training volume, training practice, or cardiovascular risk. A correlation was observed between IL-6 and TNFalfa (r = 0.34; p < 0.001), IL-6 and vertical jump height (r = -0.28, p < 0.005), and TNFα and age (r = 0.33; p < 0.001). After 8 weeks of training, TNFα levels increased in the intermediate and competitive groups (p < 0.05), while IL-6 levels decreased only in the intermediate level group (p < 0.05). CONCLUSION: the median levels of IL-6 and TNFalfa did not correlate with the caries index, BMI, training volume, experience practice, or cardiovascular risk. Salivary levels of IL-6 were downmodulated in the group with intermediate experience and TNFalfa was upmodulated by training

INTRODUCCIÓN: el objetivo del estudio fue evaluar las concentraciones salivales de interleukina-6 (IL-6) y factor de necrosis tumoral alfa (TNFalfa) y correlacionarlas con el índice de caries, el índice de masa corporal (IMC), potencia muscular de miembros inferiores (salto vertical), la aptitud cardiorrespiratoria y riesgo de desarrollar enfermedades cardiovasculares en niñas que practican voleibol. MATERIAL Y MÉTODOS: se realizaron dos estudios: 1) un estudio transversal (n = 120) sobre la asociación de IL-6 y TNFalfa con índice de caries, medidas antropométricas, pruebas físicas y experiencia en la práctica de voleibol; 2) estudio longitudinal (n = 63) sobre el efecto de 8 semanas de entrenamiento em IL-6 y TNFalfa salivales en niñas con experiencia intermedia en voleibol y chicas competitivas. RESULTADOS: los niveles medianos de IL-6 fueron 1.98 [1.55 - 3.11] pg/ml y TNFalfa fue 0.46 [0.28 - 0.59] pg/ml y no se correlacionaron con el índice de caries, el IMC, el volumen de entrenamiento, la práctica de entrenamiento y el riesgo cardiovascular. Se observó una correlación entre IL-6 y TNFalfa (r = 0.34; p < 0.001), IL-6 y altura de salto vertical (r = -0.28, p < 0.005), y TNFalfa y edad (r = 0.33; p < 0.001). Después de 8 semanas de entrenamiento, los niveles de TNFalfa aumentaron en los grupos intermedios y competitivos (p < 0.05), mientras que los niveles de IL-6 disminuyeron solo en el grupo intermedio (p < 0.05). CONCLUSIÓN: los niveles medianos de IL-6 y TNFalfa no se correlacionaron con el índice de caries, el IMC, el volumen de entrenamiento, la experiencia práctica y el riesgo cardiovascular. Los niveles salivales de IL-6 se modificaron a la baja en el grupo con experiencia intermedia y el TNFα se moduló al alza mediante el entrenamiento

Cold water immersion or LED therapy after training sessions: effects on exercise-induced muscle damage and performance in rats.

Cryotherapy and phototherapy have been suggested as recovery methods due to their anti-inflammatory effects. They may also induce mitochondrial biogenesis, thus favoring endurance training adaptation. The aim of this study was to evaluate the anti-inflammatory and ergogenic effects of phototherapy or cold water immersion (CWI) applied daily after exercise in rats. Thirty-five rats were divided into five groups: control (CO), non-exercised (CE), passive recovery (PR), cold water immersion (CWI), and LED therapy (LED). The CO and CE groups were not submitted to training; however, the CE were submitted to an exhaustion test after the training period. Low-intensity swimming training (21 sessions, 45 min) was performed followed by passive recovery (PR), CWI (10 °C, 5 min), or infrared irradiation (940 nm, 4 J/cm2). Forty-eight hours after the final training session, the CE, PR, CWI, and LED animals were submitted to an exhaustion test. The animals were euthanized 24 h later and submitted to hematological, creatine kinase (CK), and C-reactive protein (PCR) analysis. Gastrocnemius and soleus muscles were submitted to histological analysis. No differences in blood cell counts, CK, and PCR were detected between groups. The CE group presented an increased number of areas with necrosis in the gastrocnemius and soleus muscles. The PR group presented the highest frequency of areas with edema and inflammation followed by CWI and LED groups. None of the recovery methods improved the performance in the exhaustion test. Successive applications of recovery methods do not improve exercise performance, but downmodulate the inflammation and prevent muscle necrosis.

Bienestar psicológico de los sobrevivientes del conflicto armado: una arista de la salud mental / Psychological well-being of the survivors of the armed conflict: an edge of mental health

El conflicto armado en Colombia ha causado más de 8.746.541 sobrevivientes y efectos psicosociales e incidencia sobre la salud mental en los afectados. Los avances obtenidos en el mejoramiento del bienestar psicológico de los sobrevivientes por parte del Estado no son claros; sin embargo, la literatura evidencia que las condiciones socio-políticas que rodean a los sobrevivientes son poco favorables. Por lo expuesto, el estudio evaluó el bienestar psicológico de la población víctima del conflicto armado de siete municipios de Colombia, beneficiada por alguna medida de atención, asistencia y reparación de la ley 1448 de 2011. Por lo anterior, se utilizó un estudio descriptivo transversal y la escala de Bienestar psicológico de Ryff traducida al español; se obtuvieron los siguientes resultados: las dimensiones con mejor valoración fueron "propósitos en la vida" y "crecimiento personal"; dimensiones con calificaciones más bajas son "relaciones positivas" y "autonomía". se concluye que el bienestar psicológico es percibido mejor en función de plantearse metas para sí mismo y mostrar una mejora, pero que la autonomía se ve afectada, así como las relaciones positivas (desconfianza, construcción de relaciones nuevas cuando se es desplazado) por asuntos relacionados con el conflicto armado. Los hallazgos permitirán mejorar las acciones de atención.

The armed conflict in Colombia has caused more than 8,746,541 survivors and psychosocial effects and incidence on mental health in those affected. The advances obtained in the improvement of the psychological well-being of the survivors by the State are not clear; however, the literature shows that the socio-political conditions surrounding the survivors are unfavorable. Therefore, the study evaluated the psychological well-being of the population victim of the armed conflict in seven municipalities of Colombia, benefited by some measure of attention, assistance and reparation of law 1448 of 2011. Therefore, a cross-sectional descriptive study was used and Ryff's psychological well-being scale translated into Spanish; The following results were obtained: the dimensions with the best evaluation were "purposes in life" and "personal growth"; dimensions with lower ratings are "positive relationships" and "autonomy". it is concluded that psychological well-being is better perceived in terms of setting goals for oneself and showing improvement, but that autonomy is affected, as well as positive relationships (distrust, building new relationships when one is displaced) due to related issues with the armed conflict. The findings will improve the attention actions.

El apoyo social percibido por las víctimas del conflicto armado en Colombia / Social Support as Perceived by Colombia's Armed Conflict Victims

Resumen El conflicto armado Colombiano ha afectado la salud mental de las víctimas. La evaluación de la salud mental se realiza a partir del bienestar psicológico, la calidad de vida y el apoyo social percibido. Se indican resultados del Apoyo Social en 1139 víctimas de los municipios de Barrancabermeja, Trujillo, Bello, Montería y Santa Marta, mediante el cuestionario MOS de Apoyo Social, el cual se encuentra en un nivel alto influido por la dimensión de apoyo emocional. No se encontró una relación significativa con la calidad de vida y el bienestar psicológico, excepto en uno de los municipios de la muestra.

Abstract The Colombian armed conflict has affected victims' mental health. Mental health assessment is done from the psychological well-being, life quality and the perceived social support. Results of Social support are indicated in 1,139 victims of the municipalities of Barrancabermeja, Trujillo, Bello, Montería, and Santa Marta, by using the MOS questionnaire of social support, which is at a high level, which is influenced by the emotional support dimension. No significant relationship with the life quality and psychological well-being was found, except in one of the municipalities of the sample.

LED therapy or cryotherapy between exercise intervals in Wistar rats: anti-inflammatory and ergogenic effects.

The aim of this study was to test, between two bouts of exercise, the effects of light-emitting diode (LED) therapy and cryotherapy regarding muscle damage, inflammation, and performance. Male Wistar rats were allocated in four groups: control, passive recovery (PR), cryotherapy (Cryo), and LED therapy. The animals were submitted to 45 min of swimming exercise followed by 25 min of recovery and then a second bout of either 45 min of exercise (muscle damage analysis) or time to exhaustion (performance). During the rest intervals, the rats were kept in passive rest (PR), submitted to cold water immersion (10 min, 10 °C) or LED therapy (940 nm, 4 J/cm(2)) of the gastrocnemius muscle. Blood samples were collected to analyze creatine kinase activity (CK), C-reactive protein (CRP), and leukocyte counts. The soleus muscles were evaluated histologically. Time to exhaustion was recorded during the second bout of exercise. After a second bout of 45 min, the results demonstrated leukocytosis in the PR and Cryo groups. Neutrophil counts were increased in all test groups. CK levels were increased in the Cryo group. CRP was increased in PR animals. The PR group presented a high frequency of necrosis, but the LED group had fewer necrotic areas. Edema formation was prevented, and fewer areas of inflammatory cells were observed in the LED group. The time to exhaustion was greater in both the LED and Cryo groups, without differences in CK levels. CRP was decreased in LED animals. We conclude that LED therapy and cryotherapy can improve performance, although LED therapy is more efficient in preventing muscle damage and local and systemic inflammation.

Inverse psoriasis involving genital skin folds: successful therapy with dapsone.

INTRODUCTION: Inverse psoriasis is a rare form of psoriasis that affects between 3% and 7% of the patients with psoriasis. It can comprise genital skin folds as part of genital psoriasis, and it is one of the most commonly seen dermatoses of this area. There are few evidence-based studies about the treatment of intertriginous psoriasis involving genital skin folds. CASE PRESENTATION: The authors present a 42-year-old female patient with erythematous plaques in the vulva, groin, and perianal region. The patient had previously received a broad range of topical and systemic therapies that had to be discontinued due to ineffectiveness or side effects. She was treated with 100 mg dapsone daily for 10 months, showing a significant improvement of her cutaneous and mucous lesions. Complete clearance of psoriatic lesions was observed after 4 weeks of treatment. She has remained in remission for up to 2 years, using only topical therapy with tacrolimus 0.1% and calcipotriol. DISCUSSION: Genital psoriasis is a skin disease that causes great discomfort. It is important to include examination of the genital region and to adopt this conduct in daily clinical practice. Research in this field is still poor, making no discrimination between flexural and genital psoriasis, and is based on case series and expert opinion; therefore, empirical recommendations for the treatment of genital psoriasis remain. Dapsone has been shown to be an effective and convenient alternative for the treatment of inverse psoriasis in genital skin folds, which can provide effective control of the disease. Further studies are required to determine the efficacy and safety of current therapies, and to decide whether dapsone therapy should be considered in the management of this form of psoriasis when topical and other systemic agents are not effective.

Pioderma gangrenoso asociado a colitis ulcerosa y compromiso laringotraqueal / Pioderma gangrenosum associated with ulcerative colitis and airways involvement

Se describe el caso de una mujer de 63 años con lesiones ulcerosas extensas en el abdomen y enfermedad inflamatoria intestinal, que desarrolló mutilanteslesiones laringotraqueales luego de breves entubaciones orotraqueales para limpieza quirúrgica de las heridas bajo anestesia general. La grave ydesproporcionada afectación laringotraqueal de esta paciente fue secundaria al fenómeno de patergia subyacente, por lo cual debemos manejar concuidado las vías aéreas en este tipo de enfermedades

A 63 year-old woman with extensive ulcerative lesions in the abdominal area and inflammatory bowel disease who developed mutilating airwayslesions after short period of orotracheal intubation for surgical cleanliness of wounds under general anesthesia is reported. The extensive and severelaringotracheal involvement in this case was secondary to the pathergy phenomena, for this reason we have to manage carefully the airways in thiscondition