Guidelines for the management of coagulation disorders in patients with cirrhosis.

Coagulation management in the patient with cirrhosis has undergone a significant transformation since the beginning of this century, with the concept of a rebalancing between procoagulant and anticoagulant factors. The paradigm that patients with cirrhosis have a greater bleeding tendency has changed, as a result of this rebalancing. In addition, it has brought to light the presence of complications related to thrombotic events in this group of patients. These guidelines detail aspects related to pathophysiologic mechanisms that intervene in the maintenance of hemostasis in the patient with cirrhosis, the relevance of portal hypertension, mechanical factors for the development of bleeding, modifications in the hepatic synthesis of coagulation factors, and the changes in the reticuloendothelial system in acute hepatic decompensation and acute-on-chronic liver failure. They address new aspects related to the hemorrhagic complications in patients with cirrhosis, considering the risk for bleeding during diagnostic or therapeutic procedures, as well as the usefulness of different tools for diagnosing coagulation and recommendations on the pharmacologic treatment and blood-product transfusion in the context of hemorrhage. These guidelines also update the knowledge regarding hypercoagulability in the patient with cirrhosis, as well as the efficacy and safety of treatment with the different anticoagulation regimens. Lastly, they provide recommendations on coagulation management in the context of acute-on-chronic liver failure, acute liver decompensation, and specific aspects related to the patient undergoing liver transplantation.

Luminescent and magnetic [TbEu] 2D metal-organic frameworks.

We present the synthesis, through a simple, microwave-assisted method, of lanthanoid-based 2D metal-organic frameworks (MOFs) of general formula [LnxLn'1-x(MeCOO)(PhCOO)2], including homonuclear compounds (x = 1), LnEu, Tb, and heterometallic compounds, [TbEu]. The crystalline material is formed by neutral nanosheets held together by van der Waals interactions, which can be easily exfoliated by sonication. Photoluminescent emission in the visible range was observed for all of the synthesized 2D MOF compounds via excitation of the ligand, showing benzoates are efficient antenna ligands. Efficient energy transfer from Tb → Eu was observed in the heterometallic [TbEu] compounds, which could potentially perform as luminescent thermometers. Inks containing nanosheets of 2D MOFs exfoliated in solution were prepared, and luminescent prints of Tb and Eu 2D MOFs on paper were made to show the possible application for anticounterfeiting. Frequency-dependent ac susceptibility results show the occurrence of slow magnetic relaxation in [TbEu] compounds through direct relaxation mechanisms, affected by bottleneck effect. A slowing down of the relaxation time is observed as the Eu/Tb ratio increases.

Asymptotic stabilization of a transformed quadrotor model using energy-shaping method: Theory and experiments.

This note presents a new passivity-based controller that ensures asymptotic stability for quadrotor position without solving partial differential equations or performing a partial dynamic inversion. After a resourceful change of coordinates, a pre-feedback controller, and a backstepping stage on the yaw angle dynamic, it is possible to identify new quadrotor cyclo passive outputs. Then, a simple proportional-integral controller of these cyclo-passive outputs completes the design. The cyclo-passive outputs allow the construction of an energy-based Lyapunov function that includes five out of six quadrotor degrees of freedom and guarantees asymptotic stability of the desired equilibrium. Moreover, the constant velocity reference tracking problem is solved with a slight modification to the proposed controller. Finally, the approach is validated through simulations and real-time experimental results.

Ensayo clínico aleatorizado. Efecto de dos tipos de ayuno en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local en un servicio de hemodinámica en Medellín, 2019 / Randomized clinical trial. Effect of two types of fasting in patients undergoing percutaneous intervention procedures under local anesthesia in a hemodynamic service in Medellín, 2019 / Ensaio clínico randomizado. Efeito de dois tipos de jejum em pacientes submetidos a procedimentos de intervenção percutânea sob anestesia local em um serviço de hemodinâmica em Medellín, 2019

Objetivo: determinar el efecto de dos tipos de ayuno sobre parámetros de satisfacción, náuseas, vómito, presión arterial y glucometría en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local en un servicio de hemodinámica en Medellín, 2019. Metodología: ensayo clínico aleatorizado abierto de dos brazos en pacientes sometidos a procedimientos de intervencionismo percutáneo bajo anestesia local durante tres meses. Cada brazo con 153 participantes; se asignó un ayuno de seis horas y al grupo de exposición un ayuno de dos horas para alimentos de fácil digestión; no hubo cega­miento, se realizó cálculo de muestra, y se hizo análisis univariado, bivariado y modelo de regresión logística con la variable satisfacción. Resultados: en el grupo de ayuno de seis horas el 2.6% presentó náuseas y en el grupo de exposición el 1.3%; se observó un caso de vómito. La presión arterial y glucometría mostraron diferencias estadísticas sin relevancia clínica. Se encontró significancia esta­dística para mareo, cefalea, hambre, sed y tipo de ayuno respecto con la satisfacción del paciente. Los pacientes con ayuno tuvieron un puntaje de satisfacción entre 60 y 100 y los de dieta ligera entre 82.5 y 100 puntos. Conclusiones: El ayuno de dos horas en dieta ligera mejora la satisfacción de los pa­cientes, disminuye la sensación de hambre, sed, presencia de cefalea y mareo, compa­rado con un ayuno de seis horas. Este estudio no encontró diferencias en las variables hemodinámicas ni en la frecuencia de náuseas y vómito.

Objective: to determine the effect of two types of fasting on parameters of satisfaction, nausea, vomiting, blood pressure and glucose measurement in patients undergoing percutaneous intervention procedures under local anesthesia in a hemodynamic service in Medellín, 2019. Methodology: Two-arm open-label randomized clinical trial in patients undergoing percutaneous interventional procedures under local anesthesia for three months, each arm with 153 participants, who were assigned a six-hour fast and the exposure group a two-hour fast for easily digestible foods. There was no blinding, sample calculation was performed, and univariate and bivariate analysis and logistic regression model were performed with the satisfaction variable. Results: in the six-hour fasting group, 2.6% presented nausea and in the exposure group, 1.3%; one case of vomiting was observed. Blood pressure and blood glucose showed statistical differences without clinical relevance. Statistical significance was found for dizziness, headache, hunger, thirst, and type of fasting with respect to patient satisfaction. Fasting patients had a satisfaction score between 60 and 100 and those on a light diet between 82.5 and 100 points. Conclusions: Fasting for two hours on a light diet improves patient satisfaction, decreases the sensation of hunger, thirst, headache and dizziness, compared to a six-hour fast. This study found no differences in the hemodynamic variables, nor in the frequency of nausea and vomiting.

Objetivo: determinaro efeito de dois tipos de jejum nos parâmetros de satisfação, náuseas, vômitos, pressão arterial e glicemia em pacientes submetidos a procedimentos de intervenção percutânea sob anestesia local em um serviço de hemodinâmica em Medellín, 2019. Metodologia: Ensaio clínico randomizado aberto de dois braços em pacientes submetidos a procedimentos intervencionistas percutâneos sob anestesia local por três meses. Cada braço com 153 participantes; um jejum de seis horas foi designado e o grupo de desafio um jejum de duas horas para alimentos facilmente digeríveis; não houve cegamento, foi realizado cálculo amostral, análise univariada, bivariada e modelo de regressão logística com a variável satisfação. Resultados: no grupo de jejum de seis horas, 2,6% apresentaram náuseas e no grupo de exposição, 1,3%; foi observado um caso de vômito. A pressão arterial e a glicemia apresentaram diferenças estatísticas sem relevância clínica. Foi encontrada significância estatística para tontura, dor de cabeça, fome, sede e tipo de jejum em relação à satisfação do paciente. Os pacientes em jejum tiveram um escore de satisfação entre 60 e 100 e os em dieta light entre 82,5 e 100 pontos. Conclusões: O jejum de duas horas com dieta leve melhora a satisfação do paciente, diminui a sensação de fome, sede, dor de cabeça e tontura, em comparação com o jejum de seis horas. Este estudo não encontrou diferenças nas variáveis hemodinâmicas ou na frequência de náuseas e vômitos.

Analysis of potential risk factors of caprine coccidiosis.

Caprine coccidiosis represents a major concern in goat industry worldwide causing high economic losses, mainly due to poor weight gains, treatment costs and even death of kids. Therefore, analyses on risk factors involved in the establishment and outcome of this disease are important to improve infection status and herd management. In Portugal, approximately 400,000 goats are reared every year. The majority of them are allocated in the southern part of the country. In the current study, a representative number of animals (382 goats) and herds (37 herds) from Alentejo were monitored. Faecal samples from five young and five adult goats of each farm were collected rectally and examined individually by using the modified McMaster technique for oocyst counts (oocyst per gram of faeces - OPG). Additionally, a questionnaire on the husbandry conditions and anti-parasitic treatments was performed. Overall, a prevalence of Eimeria infections of 99% and 100% was detected on animal and herd level, respectively. Eimeria arloingi and E. ninakohlyakimovae as the two most pathogenic caprine species also constituted the most prevalent ones (34.91% and 29.90%, respectively), both in the young and the adult goat groups. As expected, OPG vales were significantly higher (p = 0.031) in young than in adult goats. Furthermore, risk factor analyses revealed young age, higher total number of animals on the farm and outdoor kidding as strongly associated with a higher risk of caprine coccidiosis. Overall, the high prevalence of pathogenic Eimeria species on Portuguese goat farms in combination with the occurrence of related risk factors strengthen the importance of coccidiosis control in caprine industry.

Capacidad de Disolución del Hipoclorito de Sodio con o sin Activación / Dissolution Capacity of Sodium Hypochlorite with or without Activation

Introducción: Una de las propiedades del hipoclorito de sodio (NaOCl) es la disolución de tejido pulpar remanente después de la instrumentación. Los sistemas de activación del irrigante pretenden mejorar esta propiedad. Este trabajo tiene como objetivo determinar la capacidad de disolución de tejido de NaOCl con y sin activación sónica o ultrasónica en diferentes concentraciones. Metodología: 300 muestras de tejido conectivo de paladar de cerdo de 4,5 * 2 mm obtenidos 1 día antes del estudio, congelado a-15°C en 100% de humedad, fueron pesados en una balanza analítica y sometidos a la acción de NaOCl 1%, 3% y 5% con y sin activación durante 45 minutos, cambiando la solución cada 10 minutos. Se secaron en papel filtro y se pesaron nuevamente. Los datos se analizaron mediante tests Kolmogorov-Smirnov; Kruskal-Wallis y Mann-Whitney. Resultados y Discusión: NaOCl 1% tiene menor capacidad de disolución que mejora levemente al activarlo. NaOCl 3% tiene mejor capacidad de disolución que NaOCl 1%, pero la activación no la mejora significativamente. NaOCl 5% tiene mayor capacidad de disolución, que aumenta con la activación, sin significancia entre activación sónica y ultrasónica, lo que se debería a que la mucosa palatina porcina requiere más tiempo para su disolución completa, y a que el volumen de tejido utilizado es mayor que una pulpa dental. Conclusiones: Bajo las condiciones de este estudio, sólo NaOCl 5% mostró mayor capacidad de disolución con la activación. NaOCl 1% y 3% no mejoraron significativamente con la activación

Introduction: One of the properties of sodium hypochlorite (NaOCl) is dissolution of pulp tissue remaining after instrumentation. Irrigant activation systems aim to improve this property. The objective of this work is to determine tissue dissolution capacity of NaOCl with and without sonic or ultrasonic activation in different concentrations. Methodology: 300 pork palate connective tissue samples of 4.5 * 2 mm obtained 1 day before the study, frozen at-15 ° C in 100% humidity, weighed on an analytical balance and subjected to the action of NaOCl 1%, 3% and 5% with and without activation for 45 minutes, changing the solution every 10 minutes. They were dried on filter paper and weighed again. The data were analyzed by Kolmogorov-Smirnov tests; Kruskal-Wallis and Mann-Whitney. Results and Discussion: NaOCl 1% has a lower dissolution capacity that improves slightly when activated. NaOCl 3% has better dissolution capacity than NaOCl 1%, but the activation does not significantly improve it. NaOCl 5% has greater dissolution capacity, which increases with activation, without significance between sonic and ultrasonic activation, which is due to the fact that the porcine palatine mucosa requires more time for its complete dissolution, since the volume of tissue used is greater than a dental Pulp. Conclusions: Under the conditions of this study, only NaOCl 5% showed greater dissolution capacity with activation. NaOCl 1% and 3% did not improve significantly with activation

Estratégias de atendimento à crise psíquica por um serviço de atendimento móvel de urgência / Strategies for dealing with the psychic crisis by an emergency mobile service

Objetivo: conhecer quais estratégias estão sendo adotadas no atendimento à crise psíquica pelos profissionais de um Serviço de Atendimento Móvel de Urgência num município do Recôncavo da Bahia. Métodos: estudo qualitativo, descritivo e exploratório. Foram participantes, 22 profissionais que prestam assistência direta aos usuários do serviço. Coletaram-se os dados por meio de entrevista semiestruturada em abril de 2018, analisou-se os dados por meio da técnica de análise temática. Resultados: evidenciou-se como estratégias de atendimento: a avaliação da cena, ação conjunta com a polícia militar, ações de contenção física e química, orientação à família, encaminhamento do usuário para o serviço hospitalar. Considerações finais: as estratégias de atendimentos a crise psíquica são fundamentadas na psiquiatria clássica, havendo a necessidade de educação permanente das equipes do referido serviço, baseando-se nos cuidados fundamentados no modo de atenção psicossocial.

Objective: to know what strategies are being adopted in the care of the psychic crisis by the professionals of emergency mobile service in a municipality of the Recôncavo of Bahia. Methods: this is a qualitative, descriptive and exploratory study. Twenty-two professionals who provide direct assistance to the users of the service were participants of this study. The data were collected by means of a semistructured interview in April of 2018 and was used the technique of content thematic analysis. Results: the evaluation of the scene, joint action with the military police, actions of physical and chemical containment, orientation to the family, and referral of the user to the hospital service were evidenced. Final considerations: the strategies for attending to the psychic crisis are based on the classic psychiatric way, there is a need for permanent education of the emergency mobile service teams based on the psychosocial care.

Projeto saúde mental brincando em família: caracterizando sociodemograficamente crianças cardiopatas hospitalizadas e familiares / Mental health project toying in family: sociodemographic characterization of hospitalized cardiopathy children and of relatives

Objetivo: caracterizar o perfil sociodemográfico e de morbidade da clientela assistida, bem como os fatores associados com a qualidade do atendimento psicológico realizado entre janeiro e dezembro de 2013. Métodos: trata-se de um estudo exploratório, com 357 crianças e seus familiares, no Hospital Ana Nery em Salvador, Bahia, Brasil. Resultados: a maioria das crianças era do sexo masculino, pardas ou negras e com idade média de cinco anos. Verificou-se que aspectos relativos aos familiares, assim como o local onde ocorreram as sessões, influenciaram na qualidade das interações estabelecidas entre familiares e acolhedores do projeto. Conclusões: essa forma de cuidar demonstra a importância de incluir aspectos psicossociais capazes de ampliar as estratégias de cuidado para além do enfoque clínico, contribuindo para promoção e reabilitação em saúde mental.

Objective: characterize the sociodemographic and morbidity profile of the assisted clientele as wellas the factors associated with the quality of psychological care performed between January and December 2013. Methods: we conducted an exploratory study with 357 children and their families at the Ana Nery Hospital in Salvador, Bahia, Brazil. Results: we observed that them a majority of children were male, mixed race or black, and the average age was five years old. Family related aspects and the location in which these sessions took place influenced the quality of interactions established between family members and Play Therapists. Conclusions: this way of caring demonstrates the importance of incorporating psycho-social aspects to extend care strategies beyondthe clinical focus, contributing to the promotion and rehabilitation in mental health.

Reacción pulpar frente a fuerzas ortodónticas: evaluación de la primera semana de tratamiento / Pulpal response to orthodontic forces: evaluation of the first week of treatment

Objetivos: Evaluar la correlación entre: (I) los niveles de fuerza aplicados a dientes anteriores en las etapas iniciales del tratamiento ortodóntico; (II) la percepción de dolor y (III) la sensibilidad pulpar. Universo y Muestra: Clínica de Especialización en Ortodoncia y Ortopedia MáxiloFacial de la Universidad San Sebastián en Santiago de Chile durante los años 2012 al 2014. Se obtuvo una muestra no probabilística por conveniencia de 136 dientes en 37 pacientes con brackets y Arcos de (TM)Nitinol termoactivados (35ºC) de 0.014 pulgadas. Material y Método: Estudio observacional prospectivo. Los dientes fueron evaluados con un dinamómetro siendo las fuerzas clasificadas en cuatro categorías: leves, óptimas, altas y extremas. El dolor fue medido con la Escala Visual Análoga al primer, segundo y séptimo día, después del comienzo de la aplicación de la fuerza y al séptimo día también se sometieron los dientes a test térmicos. Resultados: Después de unas horas del comienzo de la aplicación de la fuerza, el dolor comenzó a disminuir. Con el aumento de magnitud de las fuerzas, el dolor no varió en intensidad. El 39.1% de los dientes que recibieron fuerzas "óptimas" y el 22.4% de los que recibieron fuerzas "extremas", mostraron una respuesta aumentada al frío. El 1% de los dientes sometidos a fuerzas "extremas" presentó una respuesta aumentada al calor. Conclusiones: En los primeros siete días, no se observó daño pulpar irreversible independiente de la magnitud de la fuerza aplicada

Objectives: To evaluate the correlation between: (I) force levels applied to anterior teeth in the initial stages of orthodontic treatment; (II) pain perception, and (III) pulp sensitivity. Setting and Sample Population: Orthodontics and Maxillofacial Orthopedics Clinic at San Sebastián University in Santiago, Chile from 2012 to 2014. A non-probabilistic convenience sample was obtained of 136 teeth in 37 patients with braces and 0.014-inch heat-activated (35ºC) Nitinol(TM) arch wires. Material and Method: Prospective observational study. Teeth were evaluated with a dynamometer. Forces were classified into four categories: mild, optimal, high, and extreme. Pain was measured with the Visual Analog Scale (VAS) on the first, second, and seventh day after the force application, and thermal tests were applied on the seventh day. Results: A few hours after the beginning of the force application, the pain began to diminish. The pain did not vary in intensity with increasing force magnitude. 39.1% of the teeth which received "optimal" forces and 22.4% of those which received "extreme" forces exhibited an increased response to cold. 1% of the teeth subjected to "extreme" forces exhibited an increased response to heat. Conclusions: In the first seven days, no irreversible pulpal damage was observed regardless of the magnitude of the applied force

A transgeneridade feminina e os processos de mudanças corporais / The feminine transgender phenomenon and the process of bodily changes

Pessoas transgêneras, ou trans, são aquelas que não se identificampsicossocialmente com o sexo biológico que lhes fora atribuído ao nascer,vivenciando certa incongruência de gênero.1 Esse processo de reconhecimentodivergente, pode ocorrer desde a infância até a idade adulta nas mais diversasculturas e sociedades. O caminho de (re)construção do gênero dessas pessoas temimplicações em múltiplas dimensões, sejam elas físicas (cirurgias plásticas ehormonização – processo transexualizador), psicossociais, familiares, jurídico-legais.São necessárias algumas compreensões conceituais preliminares relativas a sexobiológico, identidade de gênero e orientação sexual. Sexo refere-se ao statusbiológico que a pessoa recebe ao nascer com base na aparência genital; a identidadede gênero refere-se à experiência que cada pessoa tem de si mesma, como homemou mulher, uma mistura dos dois, nenhum dos dois, ou ainda para além dos dois; e aorientação sexual diz respeito a quem a pessoa sente-se atraída,independentemente, da identidade de gênero.

Absceso cerebral por Nocardia spp. en pacientes inmunocompetentes: presentación de 2 casos / Cerebral abscess by Nocardia spp. in immunocompetent patients: report of 2 cases

Nocardia corresponde a un género de bacterias gram positivo que puede producir compromiso pulmonar, sistémico y abscesos cerebrales, especialmente en pacientes inmunocomprometidos. La infección cerebral por Nocardia spp es extremadamente infrecuente en pacientes inmunocompetentes, por lo cual se reportan dos casos: caso 1: mujer de 61 años, sana, consulta por cefalea y paresia en hemicuerpo izquierdo. Estudio con TAC y RM de encéfalo demuestran absceso cerebral. Se inició tratamiento con ceftriaxona mas cloxacilina y fue drenado quirúrgicamente. En el cultivo del LCR se aisló Nocardia spp. cambiándose esquema a cotrimoxazol con meropenem por 6 semanas. Caso 2: varón de 72 años, hipertenso y tabáquico crónico. Consultó por cefalea, paresia de extremidad inferior derecha y pérdida de visión de ojo derecho. Estudio con TAC y RM de encéfalo objetiva absceso cerebral parietal izquierdo. Se inició tratamiento con ceftriaxona, metronidazol y vancomicina. Se realizó drenaje quirúrgico. El cultivo de absceso resultó positivo para Nocardia spp, ajustándose esquema a cotrimoxazol y meropenem por 6 semanas. Requirió tratamiento prolongado por presentar lenta regresión clínica e imagenoló- gica.

Nocardia is a gram positive bacterial genus. Is involved in pulmonary, systemic and brain abscess usually in immunocompromised patients. Nocardia spp. brain infection is extremely rare in immunocompetent patients, hereby we report 2 cases: case 1: 61 years old woman, without morbid conditions, consulted for headache and left hemiparesis. Study with CT and MRI of encephalon shows brain abscess. Treatment with ceftriaxone plus cloxacilin and surgical drainage were started. In CSF culture, Nocardia spp. was obtained. Scheme was changed to cotrimoxazole with meropenem to complete 6 weeks. Case 2: male of 72 years old, history of smoking and hypertension. Consulted for headache, paresis of right leg and loss of vision of the right eye. CT and MRI showed left parietal brain abscess. Treatment with ceftriaxone, metronidazole and vancomycin were started. Surgical drainage was performed. Abscess culture was positive for Nocardia spp., adjusting scheme to cotrimoxazole and meropenem for 6 weeks. It required prolonged treatment due to slow imaging and clinical regression.

International dog travelling and risk for zoonotic Onchocerca lupi.

Onchocerca lupi is a recently recognized threat for the health of animals and humans in European, American, African and Middle Eastern countries. We describe a case of imported O. lupi infection in Italy and report the lifespan of this parasite in a non-endemic area, to advocate increased awareness of the veterinary community for this zoonotic parasitosis.

Origin of the myotonic dystrophy type 1 mutation in Mexican population and influence of Amerindian ancestry on CTG repeat allelic distribution.

Myotonic dystrophy type 1 is caused by expansion of a CTG trinucleotide repeat situated in the DMPK gene. Worldwide genetic studies suggest a single or limited number of mutational events cause the disease. However, distribution of CTG alleles and disease incidence varies among ethnicities. Due to the great ethnic diversity of the Mexican population, the present study was aimed at analyzing the impact of different lineages in shaping the CTG-repeat allelic distribution in the contemporary Mexican-Mestizo population as well as to shed light on the DM1 ancestral origin. Distribution of CTG-repeat alleles was similar among Mestizo and Amerindian subpopulations with (CTG)11-13 being the most frequent alleles in both groups, which implies that Mexican-Mestizo allelic distribution has been modeled by Amerindian ancestry. We diagnosed a relatively high number of cases, consistent with the high frequency of large-normal alleles found in Mexican subpopulations. Haplotype analysis using various polymorphic-markers in proximity to DMPK gene indicates that a single founder mutation originates myotonic dystrophy type 1 in Mexico; however, Y-STR haplogroups data and the presence of pre-mutated and large normal alleles in Amerindians support the hypothesis that both European and Amerindian ancestral chromosomes might have introduced the disease to the Mexican population, which was further disseminated through mestizaje.

Reabilitação psicossocial de moradores de um serviço residencialterapêutico / Psychosocial rehabilitation of residents of a residential therapeutic service

Objetivo: analisar o processo de reabilitação psicossocial no cotidiano dos moradores deste serviço. Métodos: trata-se de um estudo de caso, com abordagem qualitativa. O referencial teórico adotado foi a Teoria do Cotidiano e a Reabilitação Psicossocial. Utilizou-se como técnica de coleta de dados a observação participante. Foram sujeitos deste estudo, seis moradores de um serviço residencial terapêutico. Os dados foram analisados pela técnica de análise temática, considerando os aspectos históricos e sociais em que foram coletados. Resultados: evidenciaram a vida cotidiana, a alienação cotidiana e a superação desta alienação. Considerações finais: evidencia-se a reabilitação psicossocial quando os moradores apropriaram-se de seus cotidianos, todavia, em alguns momentos os cotidianos ficaram alienados e utilizou-se mecanismos para superá-los. São necessárias estratégias constantes, para profissionais, a fim de tornar o morar/cotidiano destes moradores possível.

Objective: to assess Psychosocial rehabilitation process and daily life of people residing in a Service.Methods: this is a case study with qualitative approach. Theoretical framework was the Theory ofDaily life and Psychosocial Rehabilitation. Participant observation were used as data gatheringmethod. Six residents of a Service were subjects of this investigation. Data were analyzed throughthe thematic analysis technique, considering the historical and social contexts in which data weregathered. Results: evidenced daily life, daily alienation and overcoming this alienation. Finalconsiderations: psychosocial rehabilitation is evident when the residents have appropriated theirdaily lives, however, at times, the daily life has been alienated and mechanisms have been used toovercome them. Constant strategies are needed for professionals in order to make the living/dailylife of these residents possible.

Experiencias adversas de la infancia en una muestra de pacientes con enfermedad crónica en Cali-Colombia / Adverse childhood experiences in a sample of patients with chronic diseases in Cali, Colombia / Experiências adversas da infância em uma amostra de pacientes com doença crônica em Cali-Colômbia

Objetivo: evaluar la frecuencia de Experiencias Adversas de la Infancia (EAI) y las características sociodemográficas de la población con enfermedad crónica. Metodología: se condujo un estudio tipo corte transversal descriptivo, en el que se entrevistaron 121 pacientes mayores de 18 años de edad con enfermedades crónicas no transmisibles que acudieron a consulta externa de Medicina Interna en la Fundación Valle del Lili entre septiembre de 2015 y diciembre de 2015. A los participantes les aplicaron escalas validadas para evaluar EAI y otras variables clínicas de interés. Se realizó un análisis descriptivo de los datos. Resultados: de los participantes, el 69.4% estaba conformado por mujeres, la mediana de edad de los participantes fue 62 años con un RIQ de 50 a 72 años. Se encontró que el 64% de los encuestados presentó por lo menos un tipo de EAI, y el 23% presentó cuatro o más EAI y el abuso físico y la separación parental son los más frecuentes (32% y 23%, respectivamente). Conclusiones: las Experiencias Adversas de la Infancia son eventos prevalentes en nuestra población; sin embargo, no se les ha prestado la atención debida. Se necesitan más estudios para medir el impacto real a corto y a largo plazo, con las implicaciones respectivas para nuestro sistema de salud.

Objective: To evaluate the frequency of Adverse Childhood Experiences (ACEs) and the sociodemographic characteristics of the population with chronic disease. Methodology: Cross-sectional descriptive study that was conducted with 121 patients over age 18 with non-communicable, chronic diseases that sought internal medicine outpatient services at Fundación Valle del Lili from September to December of 2015. Validated scales to assess ACEs and other clinical variables of interest were applied to patients. Descriptive analysis of the data was conducted. Results: Of the participants, 69.4% was female; the median age was 62 years, with an IQR of 50 to 72 years. It was found that 64% of those surveyed presented at least one type of ACE, and 23% presented four or more ACEs, while physical abuse and parental separation were the most frequent (32% and 23%, respectively). Conclusions: Adverse Childhood Experiences are prevalent events in our population; however, such events have not received the attention needed. Further studies are warranted to measure the short- and long-term actual impact, with the respective implications for our health system.

Objetivo: avaliar a frequência de Experiências Adversas da Infância (EAI) e as características sócio-demográficas da população com doença crônica. Metodologia: se conduz um estudo tipo corte transversal descritivo, no qual se entrevistaram 121 pacientes maiores de 18 anos de idade com doenças crônicas não transmissíveis que procuraram a consulta externa de Medicina Interna na Fundación Valle del Lili entre setembro de 2015 e dezembro de 2015. Aos participantes lhes aplicaram escalas validadas para avaliar EAI e outras variáveis clínicas de interesse. Se realizou uma análise descritivo dos dados. Resultados: dos participantes, 69.4% estava conformado por mulheres, a idade média dos participantes foi de 62 anos com um RIQ de 50 a 72 anos. Se encontrou que 64% dos entrevistados apresentou pelo menos um tipo de EAI, e 23% apresentou quatro ou mais EAI e o abuso físico e a separação parental são os mais frequentes (32% e 23%, respectivamente). Conclusões: as Experiências Adversas da Infância são eventos prevalentes na nossa população; porém, não se há dado a atenção devida. Se necessitam mais estudos para medir o impacto real a curto e a longo prazo, com as implicações respectivas para nosso sistema de saúde.

PRP epidural en el manejo de la enfermedad discal degenerativa y dolor axial. Estudio preliminar / PRP into the epidural space for the management of intervertebral disc degeneration and axial pain. Preliminary report

La enfermedad discal degenerativa es un proceso crónico que produce importante discapacidad y dependencia y que genera un alto coste en la sanidad. Es la causa más común de dolor de espalda, que puede comprometer cualquier segmento del eje axial, siendo la región lumbar el sitio más frecuentemente afectado. Es uno de los motivos de consulta más frecuente en la población general, sólo superado por la cefalea, que afecta al 80-85 % de las personas a lo largo de la vida. El manejo realizado hasta el presente es usualmente de tipo conservador, incluyendo la terapia física y los antinflamatorios. Las técnicas quirúrgicas tienen como objetivo sólo el de estabilizar la columna y/o descomprimir el canal medular o foraminal, buscando el alivio del dolor; sin embargo, para nada corrigen la enfermedad de base asociada al desgaste de los discos intervertebrales, e incluso estas técnicas se han asociado con una aceleración del proceso de desgaste osteocondral. El conocimiento de los fundamentos biológicos del plasma rico en plaquetas (PRP) ha llevado a la investigación de su uso como regenerador del tejido condral en general, y en este caso como regenerador del disco intervertebral, siendo la terapia PRP una estrategia que se presenta hoy como una alternativa muy prometedora de tratamiento (biológico) de la enfermedad discal. Son muy pocos los estudios realizados in vitro, y menos aún los estudios clínicos que relacionan el PRP con el manejo de la enfermedad degenerativa discal. No existe al presente ningún documento que emplee el PRP en inyección en el espacio epidural como vía de regeneración del disco intervertebral en los casos de patología discal. Presentamos nuestro estudio preliminar de manejo del dolor crónico en los pacientes con enfermedad discal degenerativa, mediante el uso de PRP inyectado en el espacio epidural, cervical o lumbar (AU)

Intervertebral disc degeneration is a chronic disease that causes significant disability and dependence and exerts a high cost on society. It is the most common cause of back pain, and may involve any segment of the spine, being the lumbar the most frequently affected area. It is one of the most frequent reasons for consultation in the general population, second only to headache, affecting 80-85 % of people throughout life. Current therapeutic strategies are primary conservative, including physical therapy and anti-inflammatory medication. Surgical techniques are intended only to stabilize the spine and/or decompress the spinal or foraminal canal, searching for relieve of symptoms; however, do not address the cause of the degeneration and even accelerate the degeneration of adjacent segments. Understanding of the biology of platelet-rich plasma (PRP) and its effect on condral repair has led to the use of PRP as a promising biological therapeutic strategy for enhance the regenerative process and healing of the intervertebral disc. Very few studies have been conducted in vitro and there are even fewer clinical studies which link PRP with the management of degenerative disc disease. At present, there is no document linking PRP used in injection into the epidural space as a method of intervertebral disc regeneration in cases of disc disease. This is a preliminary study of pain management in patients with degenerative disc disease and axial pain, by using PRP injected into the epidural space, cervical or lumbar (AU)

The endocrine disruptor nonylphenol induces sublethal toxicity in vascular plant development at environmental concentrations: A risk for riparian plants and irrigated crops?

In recent years, there is a growing concern among the scientific community about the presence of the so-called emergent pollutants in waters of different countries, especially endocrine-disrupting compounds (EDCs) that have the ability to alter the hormonal system. One of the substances found almost ubiquitously and in higher concentrations is the alkylphenol nonylphenol. Albeit this compound is included in priority lists as a probable risk for human health and the environment, little is known about its effects on developing plants. The aim of this work is to assess the acute and sub-chronic toxicity of environmental concentrations of nonylphenol in riparian vascular plant development using spores of the fern Polystichum setiferum and a biomarker-based approach: mitochondrial activity (cell viability), chlorophyll (plant physiology) and DNA content (growth). Mitochondrial activity and DNA content show that nonylphenol induces acute and sub-chronic toxicity at 48 h and after 1 week, respectively. Significant effects are observed in both parameters in fern spores at ng L(-1) but chlorophyll autofluorescence shows little changes. The inhibition of germination by natural allelochemicals has been reported to be related with the active hydroxyl group of phenolic compounds and largely independent of the structural nucleus to which it is attached. Results presented in this study suggest that environmental concentrations of nonylphenol could interfere with higher plant germination development by mimicking natural allelochemicals and/or phytohormones acting as a "phytoendocrine disruptor" likely posing ecophysiological risks.

Environmental concentrations of the cocaine metabolite benzoylecgonine induced sublethal toxicity in the development of plants but not in a zebrafish embryo-larval model.

Several studies have found cocaine and its main active metabolite benzoylecgonine (BE) in the aquatic environment and drinking water, derived from its consumption by humans as well as the inability of water treatment processes to eliminate it. A few studies have already investigated the ecotoxicology of BE to aquatic invertebrates, but none has still addressed the effects of BE on aquatic vertebrates or vascular plants. The goal of this publication is to provide information on the toxicity of environmental concentrations of BE during animal and vascular plant development, in order to contribute to a better understanding of the potential risk of this substance for the environment. BE induced alterations in mitochondrial activity and DNA levels of fern spores at environmental concentrations (1 ng L(-1)), which could disrupt gametophyte germination. However, BE at concentrations ranging from 1 ng L(-1) to 1 mg L(-1) did not disturb morphogenesis, hatching, heartbeat rate or larval motility in a zebrafish embryo-larval model. Adverse effects on ferns agree with the allelophathic role described for alkaloids and their unspecific interference with plant germination. Therefore, the anthropogenic dispersion of alkaloid allelochemicals may pose a risk for biodiversity and irrigated food production that should be further investigated.

Hallazgos radiográficos de connotación endodóntica utilizando tomografía computarizada de haz cónico / Radiographic findings of endodontic connotation using cone beam computed tomography

En la práctica de la odontología, la tomografía computarizada de haz cónico (TCHC) ha sido utilizada en la indicación de implantes y cirugía maxilofacial. En endodoncia, ya ha comenzado su uso, por la posibilidad de conocer las tres dimensiones del diente. Este estudio busca determinar la frecuencia de las diferentes condiciones patológicas más prevalentes en endodoncia, mediante el uso de TCHC, para lo cual se identificaron y cuantificaron hallazgos radiográficos de connotación endodóntica en 128 TCHC en pacientes chilenos entre 7 y 78 años, de ambos sexos, evaluando un total de 1.213 dientes. Las imágenes fueron obtenidas por un equipo SkyView 3D TCHC PanoramicImager(R) 12 bits (MyRay, Imola, Italia), con una exposición de 90 Kvp, 10 mA y observadas mediante el software Skyview viewer manager ver 1.2.0.6 MyRay por 2 observadores previamente calibrados. Se observaron los dientes de manera independiente, en los ejes sagital, coronal y axial con un intervalo de corte de 0,5mm. Los datos se introdujeron en la versión 17.0 del paquete estadístico SPSS(R) para Windows (SPSS Inc., Chicago, IL) para su análisis. Los hallazgos de connotación endodóntica fueron: lesión apical, terapia endodóntica realizada, taurodontismo, canales accesorios, dilaceraciones, ápices abiertos, reabsorción interna, reabsorción externa apical y cervical. Se encontró asociación significativa entre la presencia de lesiones apicales y dientes endodónticamente tratados (p= 0,00) (AU)

In the practice of dentistry, cone beam computed tomography (CBCT) has been used in the indication of implants and maxillofacial surgery. In endodontics its use has already begun, because of the possibility to learn the three dimensions of the tooth. The aim of this study was to determine the frequency of various conditions that are the most prevalent in endodontics, using CBCT, for which they were identified and quantified radiographic findings of endodontic connotation in 128 CBCT in Chilean patients between 7 and 78 years old, of both sexes, evaluating a total of 1213 teeth. The images were obtained by SkyView 3D Panoramic CBCT Imager(R) 12 bits (MyRay, Imola, Italy),with an exposure of 90 Kvp, 10 mA and observed by software Skyview viewer manager ver 1.2.0.6 MyRay by two previously calibrated observers. Teeth were observed in the sagittal, coronal and axial axes with a cutting interval of 0.5 mm. "The data was introduced into" SPSS Statistics package for Windows, version 17.0) (SPSSInc., Chicago, IL) for analysis. The findings of endodontic connotation were: apical lesion, endodontic therapy performed, taurodontism, accessory canals, dilacerations, open apices, internal resorption, cervical and apical external resorption). Significant association between the presence of endodontically treated teeth and apical lesions (p= 0.00) was Found (AU)