Evaluación de un cuestionario de conocimientos en insuficiencia cardíaca y su utilidad para guiar la intervención educativa / Evaluation of a heart failure knowledge questionnaire and its use in guiding the educational intervention

ntroducción y objetivo: La educación por enfermería es una pieza clave en todo programa de insuficiencia cardíaca (IC), pero existen modelos muy heterogéneos y faltan instrumentos de medida. Nuestro objetivo ha sido evaluar un cuestionario propio y su utilidad como guía de la educación.Métodos: Estudio de cohortes prospectivo de pacientes tras el diagnóstico de IC seguidos en una unidad especializada. El grupo expuesto recibió sesiones educativas guiadas por evaluación del conocimiento mediante el cuestionario, y se comparó con un grupo con educación estándar. Se evaluó la validez y la fiabilidad del cuestionario. La utilidad del modelo educativo se determinó por la variable combinada principal de muerte y/o ingreso hospitalario o atención en urgencias por IC.Resultados: Se incluyeron 152 pacientes, 88 con educación guiada y 64 estándar, con un seguimiento medio de 16±4 meses. En el grupo guiado, la puntuación del cuestionario de evaluación (pc) subió del 59 al 78,5% (p=0,018) y se asoció con un mayor autocuidado (28,5-0,6*pc; p=0,04) y una tendencia a mejor calidad de vida (51,1-1,1*pc; p=0,09) y adherencia (5,02+0,04*pc; p=0,06), con una fiabilidad aceptable (Alfa de Cronbach: 0,75). La variable combinada principal ocurrió en 12 pacientes (13,6%) con educación guiada frente a 19 (29,7%) con la estándar (hazard ratio: 0,46; intervalo de confianza del 95%: 0,24-0,88; p=0,019), aunque en el análisis multivariante, solo fueron predictores: el nivel educativo, la edad, NT-proBNP y la fibrilación auricular.Conclusión: El cuestionario de conocimientos en IC propuesto es una herramienta válida y fiable, y permite cuantificar el aprendizaje. Su utilidad para guiar la educación precisa de cierta habilidad del paciente que determina un grupo con mejor pronóstico. (AU)

Introduction and objective: Patient education by nurses is a cornerstone of any heart failure (HF) program, but the models are widely heterogeneous and few specific instruments exist. Our objective is to evaluate our own questionnaire and its utility as a guide for educational intervention.Methods: This work is a prospective cohort study of patients followed-up on in a specialized unit after diagnosis of HF. The intervention group received educational sessions guided according to their knowledge using the questionnaire and was compared to a group which received standard education. The validity and reliability of the questionnaire was evaluated. The utility of the educational model was determined by the primary composite endpoint of death and/or hospital admission or emergency care for HF.Results: A total of 152 patients were included, 88 which received guided education and 64 which received standard education, with a mean follow-up time of 16±4 months. In the guided education group, the evaluation questionnaire score (qs) rose from 59% to 78.5% (P=0.018), which was associated with greater self-care (28.5-0.6*qs, P=0.04), a tendency toward better quality of life (51.1-1.1*qs, P=0.09), and adherence (5.02+0.04*qs, P=0.06), with acceptable reliability (Cronbach's alpha 0.75). The primary composite endpoint was met in 12 patients (13.6%) in the intervention group compared to 19 (29.7%) in the control group (hazard ratio: 0.46; 95% confidence interval: 0.24-0.88; P=0.019). Only educational level, age, NT-proBNP, and atrial fibrillation were predictors in the multivariate analysis.Conclusion: The HF knowledge questionnaire proposed is a valid, reliable tool and allows for quantifying learning. Its utility in guiding education requires a certain degree of skill from the patient that determines a group with better prognosis. (AU)

Evaluation of a heart failure knowledge questionnaire and its use in guiding the educational intervention.

INTRODUCTION AND OBJECTIVE: Patient education by nurses is a cornerstone of any heart failure (HF) program, but the models are widely heterogeneous and few specific instruments exist. Our objective is to evaluate our own questionnaire and its utility as a guide for educational intervention. METHODS: This work is a prospective cohort study of patients followed-up on in a specialized unit after diagnosis of HF. The intervention group received educational sessions guided according to their knowledge using the questionnaire and was compared to a group which received standard education. The validity and reliability of the questionnaire was evaluated. The utility of the educational model was determined by the primary composite endpoint of death and/or hospital admission or emergency care for HF. RESULTS: A total of 152 patients were included, 88 which received guided education and 64 which received standard education, with a mean follow-up time of 16±4 months. In the guided education group, the evaluation questionnaire score (qs) rose from 59% to 78.5% (p=0.018), which was associated with greater self-care (28.5-0.6*qs, p=0.04), a tendency toward better quality of life (51.1-1.1*qs, p=0.09), and adherence (5.02+0.04*qs, p=0.06), with acceptable reliability (Cronbach's alpha 0.75). The primary composite endpoint was met in 12 patients (13.6%) in the intervention group compared to 19 (29.7%) in the control group (hazard ratio: 0.46; 95% confidence interval: 0.24-0.88; p=0.019). Only educational level, age, NT-proBNP, and atrial fibrillation were predictors in the multivariate analysis. CONCLUSION: The HF knowledge questionnaire proposed is a valid, reliable tool and allows for quantifying learning. Its utility in guiding education requires a certain degree of skill from the patient that determines a group with better prognosis.

Stent for the management of Esophagic Stenosis by caustics in pediatry. / Stent para el manejo de las Estenosis Esofágicas por cáusticos en pediatría.

INTRODUCTION: Esophageal stricture is one of the most serious complications of caustic ingestion in children, and may occasionally recur or be refractory to management with repeated dilations. OBJECTIVE: To pre sent a case of the use of a silicone-coated metallic stent in a child with recurrent esophageal stricture secondary to caustic ingestion. CLINICAL CASE: A 6-year-old boy with accidental caustic ingestion, with evidence of Zargar grade IIIA esophagitis in all three portions of the esophagus and a 3 cm prepyloric gastric ulcer that received initial treatment with antibiotics and corticosteroids. After 21 days, the esophageal lumen diminished in relation to the healing process, which required serial di lations. Later, he developed a punctal stenosis, so it was decided to place two silicon-coated metallic esophageal stents, which were kept for 4 months, without new stenosis episodes. CONCLUSIONS: The silicone-coated metallic stent is an alternative for the treatment of recurrent esophageal stricture due to caustic ingestion in children.

[Treatment with plantar supports in Müller-Weiss disease. Preliminary report]. / Tratamiento con soportes plantares en la enfermedad de Müller-Weiss. Reporte preliminar.

The objective of this work is to assess the efficacy of conservative treatment with orthopedic insoles in Müller-Weiss disease (EMW). The plantar support aims to pronounce the hindfoot and immobilize the talo-navicular, and naviculo-cuneiform joints or both at the same time, as an alternative to the valguizing osteotomy of the calcaneus and arthrodesis. The clinical and radiological characteristics of 10 cases of EMW in 8 patients under study are analyzed and the results obtained are evaluated. The manufacturing process of the plantar supports is commented, as well as the materials used. The sample size is not significant, however, preliminary, conservative treatment is possible in certain cases of EMW to relieve pain, improve gait dynamics and limit disease progression in the short-term.

El objetivo de este trabajo es valorar la eficacia del tratamiento conservador con plantillas ortopédicas en la enfermedad de Müller-Weiss (EMW). El soporte plantar tiene como objetivo pronar el retropié e inmovilizar las articulaciones talonavicular y naviculocuneiforme o ambas a la vez como alternativa a la osteotomía valguizante de calcáneo y las artrodesis. Se analizan las características clínicas y radiológicas de 10 casos de EMW en ocho pacientes objeto del estudio y se valoran los resultados obtenidos. Se comenta el proceso de fabricación de los soportes plantares así como los materiales empleados. El tamaño de la muestra no es significativo; sin embargo, de manera preliminar, el tratamiento conservador es posible en determinados casos de la EMW para aliviar el dolor, mejorar la dinámica de la marcha y limitar la progresión de la enfermedad en el corto plazo.

Tratamiento con soportes plantares en la enfermedad de Müller-Weiss. Reporte preliminar / Treatment with plantar supports in Müller-Weiss disease. Preliminary report

Resumen: El objetivo de este trabajo es valorar la eficacia del tratamiento conservador con plantillas ortopédicas en la enfermedad de Müller-Weiss (EMW). El soporte plantar tiene como objetivo pronar el retropié e inmovilizar las articulaciones talonavicular y naviculocuneiforme o ambas a la vez como alternativa a la osteotomía valguizante de calcáneo y las artrodesis. Se analizan las características clínicas y radiológicas de 10 casos de EMW en ocho pacientes objeto del estudio y se valoran los resultados obtenidos. Se comenta el proceso de fabricación de los soportes plantares así como los materiales empleados. El tamaño de la muestra no es significativo; sin embargo, de manera preliminar, el tratamiento conservador es posible en determinados casos de la EMW para aliviar el dolor, mejorar la dinámica de la marcha y limitar la progresión de la enfermedad en el corto plazo.

Abstract: The objective of this work is to assess the efficacy of conservative treatment with orthopedic insoles in Müller-Weiss disease (EMW). The plantar support aims to pronounce the hindfoot and immobilize the talo-navicular, and naviculo-cuneiform joints or both at the same time, as an alternative to the valguizing osteotomy of the calcaneus and arthrodesis. The clinical and radiological characteristics of 10 cases of EMW in 8 patients under study are analyzed and the results obtained are evaluated. The manufacturing process of the plantar supports is commented, as well as the materials used. The sample size is not significant, however, preliminary, conservative treatment is possible in certain cases of EMW to relieve pain, improve gait dynamics and limit disease progression in the short-term.

Analysis of historical negative control group data from the rat in vivo micronucleus assay.

A database of micronuclei counts for historical negative control data from rat in vivo micronuclei tests performed in 10 different laboratories was established. Data were available from over 4000 negative control rats from 10 laboratories. The mean frequency of micronucleated cells (MN)/1000 cells ranged from 0.44 to 2.22, a 5-fold range. Overall there were no major sex or strain differences in frequency, although there were some small but statistically significant differences within laboratories. There was appreciable variability between experiments compared with variability within experiments in some laboratories. No specific factor was identified which could explain this variability although it was noted that many different vehicles were used in the experiments. It is hoped that these data will help laboratories beginning studies with the rat micronucleus assay and those involved in the assessment of micronucleus assay results.

Letter to the Editor: In the last CTO issue members of SEHOP SEAP and SEFH headed by Pilar Garrido

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Livebirth and utero-placental insufficiency in Papio hamadryas baboons with uterus angiosome perfused by bilateral utero-ovarian microsurgical anastomoses alone.

STUDY QUESTION: Can the baboon uterus support a gestation to livebirth with an angiosome using microsurgically anastomosed utero-ovarian vessels and lacking uterine arteries and veins? SUMMARY ANSWER: Our angiosome model allows healthy livebirth albeit with risk of fetal growth restriction and stillbirth. WHAT IS KNOWN ALREADY: Uterine transplant can provide livebirth in humans, but requires a living donor to undergo a prolonged laparotomy for hysterectomy. In an attempt to avoid the time-consuming dissection of the uterine vein, our group has previously shown maintenance of baboon uterine menstrual function after ligation of the uterine vein and after ligation of both the uterine artery and uterine vein. STUDY DESIGN, SIZE, DURATION: In a 19-month timespan, three baboons underwent laparotomy to surgically alter uterine perfusion, and pregnancy outcomes were monitored after spontaneous mating in a breeding colony. PARTICIPANTS/MATERIALS, SETTING, METHODS: Three nulligravid female Papio hamadryas baboons in a breeding colony underwent laparotomy to ligate uterine arteries and veins along with colpotomy and cervico-vaginal anastomosis. During the same surgery, the utero-ovarian arteries and veins were microsurgically transected and re-anastomosed to themselves. Intraoperative organ perfusion was confirmed with laser angiography. After a recovery period, monitoring of menstrual cycling via menstrual blood flow and sex-skin cycling occurred, as well as uterine viability via sonography and cervical biopsy. Each baboon was released to the breeding colony for spontaneous mating and pregnancies dated by menstrual calendar and compared with early ultrasound. Delivery outcomes were monitored in each including neonate weight and placental pathology. In the event of a stillbirth, the animal was returned to the breeding colony for repeat mating attempts. After achieving a livebirth, the maternal baboon was removed from the study. MAIN RESULTS AND THE ROLE OF CHANCE: Each baboon in the trial underwent successful surgery with all uteri demonstrating viability and return of menstrual function within 10 weeks of surgery. Pregnancies occurred within two menstrual cycles in breeding colony. Baboons one and two initially had vaginal breech stillbirths, both with appearance of placental insufficiency, and one with fetal growth restriction. Baboon three underwent scheduled cesarean delivery resulting in a normally grown livebirth. Baboon one had a subsequent pregnancy resulting in a livebirth via cesarean delivery. LIMITATIONS, REASONS FOR CAUTION: Stillbirth in two of four gestations, and fetal growth restriction in one of four, are the largest concerns in our perfusion model. It remains uncertain whether the stillbirths resulted from placental insufficiency, or birth trauma from breech deliveries. WIDER IMPLICATIONS OF THE FINDINGS: The success of two livebirths warrants further attempts at improving consistency of our proposed uterine angiosome. This may allow living uterine donors to undergo less-invasive and shorter donor hysterectomy procedures. STUDY FUNDING/COMPETING INTEREST(S): The study had no external sponsors, and was supported by the Cleveland Clinic Foundation. Some equipment was loaned without cost to the research team including a laser angiography system courtesy of Novadaq Technologies, Inc. (Missaugua, ON, Canada) and a surgical microscope courtesy of DB Surgical (Coral Springs, FL, USA). B.B., K.A., M.S., K.R., M.M., P.F.E., A.T. and T.F. have no conflicts of interest. M.L.S. and S.Z. report activity as consultants for Medtronic-Covidien, and S.Z. also is a consultant to Applied Medical.

A New Synthetic Peptide with In vitro Antibacterial Potential Against Escherichia coli O157:H7 and Methicillin-Resistant Staphylococcus aureus (MRSA).

In this work, we performed the rational design of a cationic antimicrobial peptide, GIBIMPY4, using the software DEPRAMPs developed at the GIBIM research group. GIBIMPY4 has a length of 17 amino acids, it is amphipathic, its structure is α-helix and it has a net charge of (+5). Solid-phase peptide synthesis was performed using the Fmoc strategy in acid medium. The primary structure was confirmed by MALDI-TOF mass spectrometry. The antimicrobial activity of the peptide was evaluated by broth microdilution method by measuring optical density in 96-well microplates. The minimal inhibitory concentration of GIBIMPY4 to kill 50 % of the bacterial cells (MIC50) was 6.20 ± 0.02 µM for MRSA and 4.55 ± 0.02 µM for E. coli O157:H7, while also reporting a bacteriostatic effect for the later. GIBIMPY4 activity was sensitive to salt concentration in E. coli but insignificant effect in its activity against MRSA. The peptide seems to be a broad-spectrum antimicrobial agent based on the results against Gram-positive and Gram-negative bacteria and was specific for bacterial cells E. coli O157:H7 with index of specificity equal to 9.01 in vitro assays.

Comparison of two negative pressure systems and syringe irrigation for root canal irrigation: an ex vivo study.

AIM: To compare in a laboratory study two negative pressure systems and syringe irrigation, regarding the delivery of a contrast solution (CS) to working length (WL) and into simulated lateral canals and the effective volume of irrigant aspirated during negative pressure irrigation. METHODOLOGY: Twenty single-canaled incisor training models were constructed with six simulated lateral canals each (2, 4 and 6 mm to WL) and a size 40, 0.04 taper apical size canal. Each model underwent all irrigation procedures (EndoVac at WL (EndoVac-0) and WL-2 mm (EndoVac-2), iNP needle with negative pressure (iNPn) and syringe irrigation with the iNP needle (iNPs) and a 30-G side-slot needle placed at WL (SI0) and WL-2 (SI2) mm in a crossover design. CS was delivered at 4 mL min(-1) for 60 s with a peristaltic pump and a recovery device collected the volume (in mL) of irrigant suctioned by the negative pressure groups. The irrigation procedures were digitally recorded, and a still image of the 60-s time-point of irrigation was evaluated for CS distance to WL (in millimetres) after irrigation and penetration into lateral canals (3-point scale). Statistical tests used were Kruskal-Wallis and Dunn's test. RESULTS: EndoVac-0, iNPn and iNPs had median distances of CS to WL of 0 mm, followed by SI0 (0.2 mm), SI2 (0.7 mm) and EndoVac-2 (1.7 mm). There were no significant differences between EndoVac-0, iNPn, iNPs and SI0, but these were significantly different to SI2 and EndoVac-2 (P < 0.05). There were no significant differences between the volume of CS delivered by syringe irrigation and that collected by iNPn (4 mL), but these were significantly greater than EndoVac-0 (2.8 mL, P < 0.001) and EndoVac-2 (2.85 mL, P < 0.001), which were not different to each other (P = 1.0). The irrigation procedures were ineffective at penetration into lateral canals. CONCLUSION: iNPn, EndoVac-0, iNPs and SI0 achieved greater irrigant penetration to WL. iNPn was able to collect a median volume of CS (4 mL) similar to that delivered by syringe irrigation (iNPp, SI0 and SI2). An adequate irrigant penetration into lateral canals could not be achieved by any of the systems.

Estenosis esofágica por Histoplasma: manejo con prótesis metálica autoexpandible / Management of Esophageal Stenosis Due to Histoplasma with Self-expanding Metal Stents

Las estenosis esofágicas benignas son una causa común de consulta en los servicios de endoscopia y gastroenterología. Usualmente, dada su naturaleza no neoplásica, estas se han manejado con dilataciones endoscópicas a repetición, incómodas y costosas para el paciente, dada su constante repetición; además de tener siempre el riesgo de perforación esofágica en cada sesión. El uso de prótesis esofágicas para manejo de las estenosis esofágicas benignas viene en progresivo aumento con resultados prometedores para varias de las etiologías de este tipo de obstrucciones. Presentamos el caso de una estenosis esofágica benigna secundaria a infección por Histoplasma capsulatum, manejada con una prótesis metálica totalmente cubierta con resolución completa de la obstrucción.

Benign esophageal strictures are a common cause of medical consultation and gastroenterological endoscopy. Usually, given their non-neoplastic nature, they have been managed with recurrent endoscopic dilation which is uncomfortable for the patient and which generates high costs due repetition. In addition, there is always the risk of esophageal perforation at every session. The use of esophageal stents for management of benign esophageal strictures is becoming increasingly more common and is promising for various etiologies. We present a case of a benign esophageal stricture secondary to infection with histoplasma capsulatum which was managed entirely with a completely covered metal stent. This led to complete resolution of the obstruction.

Ameboma del recto con absceso hepático asociado: reporte de un caso / Case Report of Rectal Ameboma with Associated Liver Abscess

La infección por Entamoeba histolytica sigue siendo un problema mayor de salud pública en los países en desarrollo como Colombia. Aunque en la gran mayoría de casos se presenta como una disentería o un absceso hepático amebiano, existen casos donde la evolución genera una verdadera masa inflamatoria en el colon llamada ameboma. Estos amebomas son fácilmente confundidos con una lesión neoplásica y, de no tener un gran nivel de sospecha clínica o endoscópica, terminan en una resección de colon con un diagnóstico posoperatorio dado por la presencia de trofozoítos sin malignidad. Sin embargo, cuando el diagnóstico se hace de manera preoperatoria, podría haber resolución del cuadro sin necesidad de cirugía. Exponemos el caso de una rara presentación de ameboma en el recto asociado con un absceso hepático perforado, en el cual se hizo un diagnóstico preoperatorio, pero dada la ruptura de la lesión en el hígado, requirió de una intervención quirúrgica.

Entamoeba histolytica infections continue to be a major public health problem in developing countries such as Colombia. Although it most often presents as dysentery or amebic liver abscess, there are cases in which a true inflammatory mass develops in the colon. This is called an ameboma. These amebomas are easily confused with neoplastic lesions so that in the absence of a high level of clinical and endoscopic suspicion, a colon resection may be performed with the postoperative diagnosis given by the presence of trophozoites without malignancy. However, when the diagnosis is made preoperatively symptoms can be without surgery. We report a rare presentation of ameboma in the rectum associated with a perforated liver abscess. This was diagnosed prior to surgey, but given the liver injury, required surgery.

Evaluación del seguimiento de 29 niños chilenos con la enfermedad de la orina olor a jarabe de arce clásica / Follow up evaluation of 29 chilean children with classical maple syrup urine disease

Introduction: Maple Syrup Urine Disease (MSUD) is caused by a defect of the ketoacid dehydrogenase enzyme complex of the branched amino acids Valine, Isoleucine and Leucine (VIL). The treatment consists of a leucine-restricted diet. Objective: To evaluate the long-term follow-up in children with MSUD. Methodology: 29 records were reviewed of patients with MSUD, of which 24 were clinically identified (> 5th day of life), 4 cases by MSUD family history and one by neonatal screening (< 5th day of life). Leucine (Leu) levels were measured at diagnosis (Biotronic 2000) and during follow-up (mass spectrometry). The number of decompensation events, Total Intellectual Quotient (TIQ, Bayley and Wechsler scale) and nutritional status were also measured. STATA statistical software version 9.2 was applied (p≤0.05). Results: Mean age at diagnosis was 14 days old. In all cases the diagnosis was confirmed by elevated levels of Leu and alloisoleucin. When comparing the TIQ of 19 cases over 3 years old with their age at diagnosis, it was observed that those cases screened by the 5th day of life had a TIQ 84.6 ± 13, while those diagnosed later had a TIQ 73 ± 17 (p≤0.05). In assessing the number of hospitalizations that occurred during follow-up, we determined that the 5 cases screened early never had a metabolic crisis and had a higher TIQ than those who had had one or more decompensation (92 and 74, respectively, p≤0.05). An inverse correlation was observed between the Leu+Isoleucine value and TIQ. Conclusion: The diagnosis before the 5th day of life and a good metabolic control during follow-up, enables children with MSUD to have normal cognitive development.

La enfermedad de la orina olor a jarabe de arce (EOJA) se produce por un defecto del complejo enzimático deshidrogenasa de los cetoácidos de los aminoácidos ramificados: Valina, Isoleucina, Leucina (VIL). El tratamiento es una dieta restringida en leucina (Leu). Objetivo: evaluar el seguimiento a largo plazo en niños con EOJA. Metodología: Se revisaron 29 fichas de pacientes EOJA, 24 fueron pesquisados por clínica (> 5to día de vida) y 4 casos por antecedentes familiares con EOJA y 1 por pesquisa neonatal (< 5to día de vida). Se midió nivel de Leu al diagnóstico (Biotronic 2000) y durante el seguimiento (Espectrometría de masa), número de descompensaciones, Coeficiente Intelectual Total (CIT) (Escalas de Bayley y Wechsler) y estado nutricional. Se aplicó programa estadístico STATA versión 9.2 (p≤0.05). Resultados: La edad de diagnóstico fue a los 14 días de edad. En todos se confirmó el diagnóstico por los niveles elevados de Leu y presencia de alloisoleucina. Al comparar el CIT de los 19 casos mayores de 3 años con la edad de diagnóstico, se observó que aquellos casos pesquisados antes del 5to día tenían un CIT de 84,6±13, a diferencia de los diagnosticados posteriormente que tenían un CIT=73±17 (p≤0.05). Al evaluar el número de descompensaciones ocurridas durante el seguimiento, se determinó que los 5 casos nunca habían tenido una crisis metabólica, tuvieron un CI mayor que aquellos que habían tenido una o más descompensaciones (92 y 74 respectivamente) (p≤0.05). Cuando se correlacionó el valor de Leu+Iso de seguimiento con el CIT, se observó una correlación inversamente proporcional. Conclusión: el diagnóstico antes de los 5to día de vida y un buen control metabólico durante el seguimiento, permite que los niños con EOJA tengan un desarrollo cognitivo normal.

Autocuidado de la salud en jóvenes universitarios, Manizales, 2010-2011 / Self-care in university students. Manizales, 2010-2011

Los jóvenes se consideran un grupo poblacional relativamente sano, de ahí la necesidad de repensar el autocuidado como estrategia para promover su salud. Objetivo: Describir algunas características de las prácticas de autocuidado de la salud, en jóvenes universitarios. Metodología: Investigación descriptiva transversal, realizada en el 2010-2011, en una muestra de 353 estudiantes universitarios. Por medio del Cuestionario de Estilos de Vida en Jóvenes Universitarios, se evaluó la dimensión autocuidado de la salud indagando sobre: prácticas, motivos para realizar o no una práctica, motivación para el cambio y recursos para llevarlas a cabo. Resultados: en las mujeres se presentan más prácticas de autocuidado relacionadas con: baño diario y cepillado de dientes después de las comidas. En cuanto a la exploración del cuerpo para detectar cambios, los hombres son los que menos la realizan, siendo estadísticamente significativo. Las mujeres utilizan menos el bloqueador solar con relación a los hombres. Conclusiones: las prácticas de autocuidado de la salud fueron saludables según la puntuación establecida en la metodología implementada para la dimensión de autocuidado de la salud. Se plantea la necesidad de educar a los jóvenes universitarios para su autocuidado como parte del proceso de la formación integral...

Young people are considered a relatively healthy population, hence the need to rethink self-care as a strategy for promoting their health. Objective: to describe some of the characteristics of the health-related self-care practices among young university students. Methodology: a cross-sectional descriptive study conducted in 2010-2011 using a sample of 353 university students. The health-related self-care dimension was assessed using the Lifestyle Questionnaire for Young University Students. The participants were asked about their practices, reasons for having or not having them, their motivations for changing a practice and the resources required for carrying them out. Results: women have more self-care practices related to taking a daily bath and brushing their teeth after meals. As for checking oneÆs body to detect changes, it was found that men are less likely to do so, which is statistically significant. In addition, women use less sunscreen than men. Conclusions: the health-related self-care practices were healthy according to the score established in the methodology used for the self-care dimension. Likewise, the authors propose that education regarding self-care practices should be provided to young university students as part of their comprehensive training...

Permeación en piel y biodistribución de una nanoemulsión de ftalocianina de aluminio clorada (PcAlCl) aplicada tópicamente en ratas Wistar / Skin permeation and biodistribution of chloroaluminum phthalocyanine (ClAlPc) nanoemulsion applied topically in Wistar rats

Una formulación tópica en leishmaniasis cutánea debe garantizar la permeación y acumulación del compuesto en la dermis, sitio donde se encuentran los macrófagos infectados con Leishmania. Se determinó la difusión y retención de PcAlCl contenida en una nanoemulsión (nano-PcAlCl) y en solución-PcAlCl y su distribución en ratas Wistar, con piel sana o lesionada quirúrgicamente. La nano-PcAlCl se preparó por el método de emulsificación espontánea y la solución-PcAlCl en mezcla DMSO: Tween 80: agua tipoI; la estabilidad se determinó espectrofotométricamente. La difusión se determinó utilizando celdas de Franz y la retención en el estrato córneo (EC) y la epidermis-dermis (E+D) por "tape stripping". Las formulaciones mantuvieron las características espectroscópicas del compuesto. La PcAlCl no difundió al medio receptor. Después de 12 y 24 horas la retención del compuesto en EC con nano-PcAlCl fue 99,73 y 79,40nM y con solución-PcAlCl 66,73 y 57,01nM; en E+D la retención con nano-PcAlCl fue 40,94 y 62,49nM y con solución-PcAlCl 81,92 y 50,28nM. En EC la nano-PcAlCl registró mayor retención y en E+D la solución-PcAlCl, registró mayor retención a las 12 horas y la nano-PcAlCl a las 24 horas. Se observó desprendimiento y disminución en las capas del epitelio. El tratamiento con nano-PcAlCl retuvo el compuesto en EC y E+D de los animales con valores de 6,43nM y 33,18nM con piel sana y 0,99nM y 17,08 con piel lesionada; valores menores de 1,92nM fueron detectados sólo en pulmón. El tratamiento con solución-PcAlCl retuvo el compuesto en EC y E+D de los animales con valores de 31,86 y 202,40nM con piel sana y 5,93 y 63,83nM con piel lesionada; se encontraron valores de 2,36nM y 20,33nM en los pulmones y valores entre 1,58 y 5,80nM en otros órganos. La piel lesionada presentó regeneración del epitelio, desprendimiento de queratina, infiltrado celular y neovascularización. La PcAlCl retenida en EC y E+D indicó la eficacia de las formulaciones para penetrar el EC y retener el compuesto en las capas viables de la piel. El tratamiento con nano-PcAlCl permeó el EC, se retuvo en E+D y no presentó distribución hacia órganos.

A successful formulation contained aluminum phthalocyanine chloride (ClAlPc) able for cutaneous leishmaniasis (CL) ensures the skin permeation and retention of the compound in dermis, a place where macrophages infected with Leishmania are located. The aim of this study was to determine the ClAlPcex vivo permeation and retention in Wistar rat skin and its distribution in animals with healthy skin and surgically damaged skin. Two formulations were prepared: nanoemulsion (ClAlPc-nano) and solution (ClAlPc-solution). The diffusion was determined using Franz diffusion cells with Wistar rat skin as membrane after 12 and 24 hours of testing. Retention in stratum corneum (SC) and epidermis plus dermis (E+D) was determined by the tape stripping method and organic solvent extraction. The distribution was performed after the topical application of formulations analyzing the CLAlPc concentration in the skin layers and organs by fluorometry. The results were expressed as nM/mg of tissue of ClAlPc. Simultaneously, skin biopsies were taken in order to determine their histological characteristics. ClAlPc formulations were effective in maintaining compound solubility and spectroscopic characteristics. ClAlPc was unable to pass completely through the skin; its skin retention was related with the used formulation, time of assays and type of skin layer. After 12 and 24 hours, the SC retention induced by ClAlPc-nano treatment was 99.73 and 79.40nM and by ClAlPc-solution was 66.73 and 57.01nM. In E+D the retention induced by ClAlPc-nano was 40.94 and 62.49nM and by ClAlPc-solution was 81.92 and 50.28nM. In SC, ClAlPc-nano showed greater retention after 12 and 24 hours, while in E+D, ClAlPc-solution was greater retained at 12 hours and ClAlPc-nano at 24 hours. After the permeation assays, detachment and reduction in epithelial layers were observed in skin membranes. In Wistar rats, ClAlPc-nano placed on healthy skin retained the compound in E+D and SC with values of 33.18nM and 6.43nM and placed on damaged skin retained in E+D in SC with values of 17.08nM and 0.99nM respectively; no organs distribution occur, except in lung where values of 0.82nM in animals with healthy skin and 1.92nM in animals with damaged skin were observed. ClAlPc-solution induced retention of 31.86 in SC and 202,40nM in E+D placed on healthy skin and 5.93 in SC and 63.83nM E+D placed on damaged skin; concentrations in lung with values of 2,36nM after application in animals with healthy skin and 20,33nM in animals with damaged skin were observed. In addition, ClAlPc-solution promoted, after application on damaged skin, distribution of ClAlPc to other organs with values between 1.58 and 5.80nM. In animals without skin injury, normal histologic skin anatomy were observed after treatment. In contrast, epithelial regeneration, detachment of keratin, loss of cellular differentiation, cellular infiltration and neovascularization were observed in animals with skin injury. The efficacy of the formulation to penetrate the SC and be retained in the viable skin layers was demonstrated. The in vivo ClAlPc-biodistribution was related on its concentration and skin state. A nanoemulsion contained ClAlPc, represents a good system of drug delivery because induce both the SC penetration and E+D retention, without systemic organ distribution even when presented tissue repair and regeneration. A ClAlPc-nano prepared in this work constitutes a good formulation for the topical application of ClAlPc in LC treatment.

Permeación en piel y biodistribución de una nanoemulsión de ftalocianina de aluminio clorada (PcAlCl) aplicada tópicamente en ratas Wistar / Skin permeation and biodistribution of chloroaluminum phthalocyanine (ClAlPc) nanoemulsion applied topically in Wistar rats

Una formulación tópica en leishmaniasis cutánea debe garantizar la permeación y acumulación del compuesto en la dermis, sitio donde se encuentran los macrófagos infectados con Leishmania. Se determinó la difusión y retención de PcAlCl contenida en una nanoemulsión (nano-PcAlCl) y en solución-PcAlCl y su distribución en ratas Wistar, con piel sana o lesionada quirúrgicamente. La nano-PcAlCl se preparó por el método de emulsificación espontánea y la solución-PcAlCl en mezcla DMSO: Tween 80: agua tipoI; la estabilidad se determinó espectrofotométricamente. La difusión se determinó utilizando celdas de Franz y la retención en el estrato córneo (EC) y la epidermis-dermis (E+D) por "tape stripping". Las formulaciones mantuvieron las características espectroscópicas del compuesto. La PcAlCl no difundió al medio receptor. Después de 12 y 24 horas la retención del compuesto en EC con nano-PcAlCl fue 99,73 y 79,40nM y con solución-PcAlCl 66,73 y 57,01nM; en E+D la retención con nano-PcAlCl fue 40,94 y 62,49nM y con solución-PcAlCl 81,92 y 50,28nM. En EC la nano-PcAlCl registró mayor retención y en E+D la solución-PcAlCl, registró mayor retención a las 12 horas y la nano-PcAlCl a las 24 horas. Se observó desprendimiento y disminución en las capas del epitelio. El tratamiento con nano-PcAlCl retuvo el compuesto en EC y E+D de los animales con valores de 6,43nM y 33,18nM con piel sana y 0,99nM y 17,08 con piel lesionada; valores menores de 1,92nM fueron detectados sólo en pulmón. El tratamiento con solución-PcAlCl retuvo el compuesto en EC y E+D de los animales con valores de 31,86 y 202,40nM con piel sana y 5,93 y 63,83nM con piel lesionada; se encontraron valores de 2,36nM y 20,33nM en los pulmones y valores entre 1,58 y 5,80nM en otros órganos. La piel lesionada presentó regeneración del epitelio, desprendimiento de queratina, infiltrado celular y neovascularización. La PcAlCl retenida en EC y E+D indicó la eficacia de las formulaciones para penetrar el EC y retener el compuesto en las capas viables de la piel. El tratamiento con nano-PcAlCl permeó el EC, se retuvo en E+D y no presentó distribución hacia órganos.(AU)

A successful formulation contained aluminum phthalocyanine chloride (ClAlPc) able for cutaneous leishmaniasis (CL) ensures the skin permeation and retention of the compound in dermis, a place where macrophages infected with Leishmania are located. The aim of this study was to determine the ClAlPcex vivo permeation and retention in Wistar rat skin and its distribution in animals with healthy skin and surgically damaged skin. Two formulations were prepared: nanoemulsion (ClAlPc-nano) and solution (ClAlPc-solution). The diffusion was determined using Franz diffusion cells with Wistar rat skin as membrane after 12 and 24 hours of testing. Retention in stratum corneum (SC) and epidermis plus dermis (E+D) was determined by the tape stripping method and organic solvent extraction. The distribution was performed after the topical application of formulations analyzing the CLAlPc concentration in the skin layers and organs by fluorometry. The results were expressed as nM/mg of tissue of ClAlPc. Simultaneously, skin biopsies were taken in order to determine their histological characteristics. ClAlPc formulations were effective in maintaining compound solubility and spectroscopic characteristics. ClAlPc was unable to pass completely through the skin; its skin retention was related with the used formulation, time of assays and type of skin layer. After 12 and 24 hours, the SC retention induced by ClAlPc-nano treatment was 99.73 and 79.40nM and by ClAlPc-solution was 66.73 and 57.01nM. In E+D the retention induced by ClAlPc-nano was 40.94 and 62.49nM and by ClAlPc-solution was 81.92 and 50.28nM. In SC, ClAlPc-nano showed greater retention after 12 and 24 hours, while in E+D, ClAlPc-solution was greater retained at 12 hours and ClAlPc-nano at 24 hours. After the permeation assays, detachment and reduction in epithelial layers were observed in skin membranes. In Wistar rats, ClAlPc-nano placed on healthy skin retained the compound in E+D and SC with values of 33.18nM and 6.43nM and placed on damaged skin retained in E+D in SC with values of 17.08nM and 0.99nM respectively; no organs distribution occur, except in lung where values of 0.82nM in animals with healthy skin and 1.92nM in animals with damaged skin were observed. ClAlPc-solution induced retention of 31.86 in SC and 202,40nM in E+D placed on healthy skin and 5.93 in SC and 63.83nM E+D placed on damaged skin; concentrations in lung with values of 2,36nM after application in animals with healthy skin and 20,33nM in animals with damaged skin were observed. In addition, ClAlPc-solution promoted, after application on damaged skin, distribution of ClAlPc to other organs with values between 1.58 and 5.80nM. In animals without skin injury, normal histologic skin anatomy were observed after treatment. In contrast, epithelial regeneration, detachment of keratin, loss of cellular differentiation, cellular infiltration and neovascularization were observed in animals with skin injury. The efficacy of the formulation to penetrate the SC and be retained in the viable skin layers was demonstrated. The in vivo ClAlPc-biodistribution was related on its concentration and skin state. A nanoemulsion contained ClAlPc, represents a good system of drug delivery because induce both the SC penetration and E+D retention, without systemic organ distribution even when presented tissue repair and regeneration. A ClAlPc-nano prepared in this work constitutes a good formulation for the topical application of ClAlPc in LC treatment.(AU)