External urology consultation quality at a third-level public hospital in Mexico.

INTRODUCTION: Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. OBJECTIVE: To identify the quality of care in the Urology outpatient department of a third-level hospital. MATERIALS AND METHODS: The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. RESULTS: According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11-20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. CONCLUSIONS: The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.

Plant size, latitude, and phylogeny explain within-population variability in herbivory.

Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.

Validez de contenido de un ECOE en el pregrado de fisioterapia para el razonamiento clínico / Validity of content of a ECOE in the physiotherapy undergraduate for clinical reasoning

Introducción: El Examen Clínico Objetivo Estructurado (ECOE) es una metodología de evaluación que permite medir de manera válida las competencias clínicas en estudiantes de fisioterapia a través de estaciones previamente estandarizadas. Objetivo: Determinar la validez de contenido del instrumento ECOE-LM 2017 para la medición de competencias clínicas en el examen, evaluación, diagnóstico, pronóstico e intervención de una persona con lumbalgia mecánica en fisioterapia. Métodos: Se diseñó un instrumento de seis estaciones evaluado con la técnica de juicio de expertos, para posteriormente calcular la confiabilidad interobservador a través de Fleiss’ Kappa, por medio del ReCal; adicionalmente se identificó el índice de aceptabilidad. Resultados: Se obtiene un índice kappa de 0,82 (casi perfecto) que da cuenta de una buena confiabilidad para el instrumento. Conclusiones: Se cuenta con un instrumento con una buena concordancia para su empleo en los procesos educativos. (AU)

Introduction: The Objective Structured Clinical Examination (ECOE) is an evaluation methodology that allows to validly measure clinical competencies in Physiotherapy students through previously standardized stations. Objective: To determine the content validity of the ECOE-LM 2017 instrument for the measurement of clinical competencies in the examination, evaluation, diagnosis, prognosis and intervention of a person with mechanical low back pain in Physiotherapy. Methods: An instrument of six stations evaluated with the expert judgment technique was designed to subsequently calculate the inter-observer reliability, through Fleiss’ Kappa, by means of the ReCal, additionally the acceptability index was identified. Results: A Kappa index of 0.82 (almost perfect) is obtained, which shows good reliability for the instrument. Conclusions: There is an instrument with good agreement for its use in educational processes. (AU)

Factor 1 inducible por hipoxia y enfermedad pulmonar obstructiva crónica: respuestas epigenéticas al ejercicio físico. Revisión sistemática / Hypoxia-inducible factor 1 and chronic obstructive pulmonary disease: Epigenetic responses to physical exercise. Systematic review

Antecedentes: El ejercicio físico es una de las principales recomendaciones para la mejora de la calidad de vida de las personas con enfermedad pulmonar obstructiva crónica (EPOC). El ejercicio genera múltiples reacciones moleculares que favorecen el ciclo y funcionamiento celular a partir de estímulos que modulan la transcripción y traducción de genes mediados por el factor 1 inducible por hipoxia (HIF-1). Objetivo: Determinar el conocimiento actual sobre las respuestas epigenéticas mediadas por HIF-1 y su comportamiento posterior a la práctica del ejercicio físico en personas con EPOC. Métodos: Búsqueda de artículos en las bases de datos Science Direct, PubMed, Scielo y PEDro. Se emplearon los términos de búsqueda Chronic obstructive pulmonary disease; Hypoxia; Hypoxia-inducible factor 1; Epigenomics; Exercise. Criterios de inclusión: publicaciones que presentaran las respuestas biomoleculares reguladas por HIF-1 en personas con EPOC. Criterios de exclusión: publicaciones de personas con diagnóstico de anemia, enfermedad hepática, enfermedad renal o antecedentes de hemorragia digestiva. Resultados: Se identificaron 75 estudios, de los cuales se seleccionaron 40 con posterioridad al cumplimiento de criterios de inclusión y exclusión. Se encontraron diferencias sobre las modificaciones postranscripcionales para la expresión de genes que favorecen al transporte hematológico de O2, el incremento del metabolismo oxidativo y el favorecimiento de la angiogénesis en el tejido muscular en personas con EPOC posterior a la práctica de ejercicio físico. Conclusiones: Las investigaciones en torno a las respuestas del HIF-1 en personas con EPOC son contradictorias. Se encuentran estudios que estipulan una retroalimentación positiva del HIF-1 para la expresión o silenciamiento de genes susceptibles al O2 y otros que plantean retroalimentación negativa. Es necesario realizar más estudios sobre las respuestas mediadas por HIF-1 en personas con EPOC y que realizan ejercicio físico.

Background: Physical exercise is one of the main recommendations for improving the quality of life of people with chronic obstructive pulmonary disease (COPD). Exercise generates multiple molecular reactions that promote cell cycle and function from stimuli that modulate the transcription and translation of genes mediated by hypoxia-inducible factor 1 (HIF-1). Objective: To determine the current knowledge about the epigenetic responses mediated by HIF-1 and their behavior after the practice of physical exercise in people with COPD. Methods: Search for articles in the Science Direct, PubMed, Scielo and PEDro databases. Se search terms Chronic Obstructive Pulmonary Disease; Hypoxia; Hypoxia-Inducible Factor 1; Epigenomics; Exercise. Inclusion criteria: publications presenting the biomolecular responses regulated by HIF-1 in people with COPD. Exclusion criteria: publications of people with a diagnosis of anemia, liver disease, kidney disease or a history of gastrointestinal bleeding. Results: Seventy-five studies were identified, of which 40 were selected after meeting the inclusion and exclusion criteria. Differences were found on the post-transcriptional modifications for the expression of genes that favor the hematological transport of O2, the increase in oxidative metabolism and the favoring of angiogenesis in muscle tissue in people with COPD after practicing physical exercise. Conclusions: Research on HIF-1 responses in people with COPD is conflicting. There are studies that stipulate a positive feedback of HIF-1 for the expression or silencing of genes susceptible to O2 and others that pose negative feedback. More studies are needed on HIF-1-mediated responses in people with COPD and those who engage in physical exercise.

Hemorragia del tracto digestivo superior, enfoque para el médico general / Upper digestive tract bleeding, approach for the general Practitioner / Hemorragia do trato digestivo superior, enfoque para o médico geral

La hemorragia del tracto digestivo superior (HTDS) es el sangrado originado por encima del ángulo de Treitz. A pesar del aumento en las estrategias de prevención, del incremento en los tratamientos con Inhibidor de bomba de protones (IBP) y de la intervención endoscópica temprana, esta patología sigue siendo una causa frecuente de consulta a urgencias, con una morbimortalidad no despreciable y alta carga para el sistema de salud. Esta revisión se enfoca en la HTDS de causa diferente a las varices. La principal causante de esta entidad es la enfermedad ácido-péptica, que es consecuencia del gran consumo de antiinflamatorios no esteroideos (AINES) y de la infección por Helicobacter Pylori. Otras causas son el síndrome de Mallory Weiss, la esofagitis erosiva, las malformaciones arteriovenosas y la malignidad.

Upper gastrointestinal bleeding (UGIB) refers to any bleeding originating above the angle of Treitz. Despite an increase in prevention strategies, proton pump inhibitor (PPI) therapy and early endoscopic intervention, this pathology continues to be an important cause of admission to the emergency department for gastrointestinal causes, having a pretty high morbidity and mortality in addition to a high burden on the health system. This review focuses on non-variceal UGIB. The main cause of this entity being peptic acid disease, due to great consumption of NSAIDs and Helicobacter Pylori infection. Other causes are Mallory Weiss syndrome, erosive esophagitis, arteriovenous malformations, and malignancy.

A hemorragia do trato digestivo superior (HTDS) é o sangrado originado acima do ângulo de Treitz. Apesar do aumento nas estratégias de prevenção, do incremento nos tratamentos com Inibidor da bomba de prótons (IBP) e da intervenção endoscópica precoce, esta patologia segue sendo uma causa frequente de consulta a urgências, com uma morbimortalidade não depreciável e alta carga para o sistema de saúde. Esta revisão se enfoca na HTDS de causa diferente às varizes. A principal causante desta entidade é a doença ácido-péptica, que é consequência do grande consumo de anti-inflamatórios não esteróideos (AINES) e da infecção por HelicobacterPylori. Outras causas são a síndrome de Mallory Weiss, a esofagites erosiva, as malformações arteriovenosas e a malignidade. Palavras-chave: hemorragia gastrointestinal; úlcera péptica; endoscopia gastrointestinal; inibidores da bomba de prótons; medicina geral.

Moringa oleifera leaves alleviated inflammation through downregulation of IL-2, IL-6, and TNF-α in a colitis-associated colorectal cancer model.

New chemopreventive alternatives are needed due to the rising worldwide incidence of colorectal cancer. The objective was to evaluate the chemopreventive activity of Moringa oleifera leaves (MO) in a colitis-associated colon carcinogenesis model. We hypothesized that MO contain bioactive compounds capable of modulating the expression of genes involved in the inflammatory response and carcinogenesis. Forty-eight male mice (CD-1) were divided into six groups; 1: Healthy control; 2: Positive control induced with azoxymethane (AOM, 10 mg/Kg body weight, intraperitoneal injection) and three cycles of dextran sodium sulfate (DSS, 1.5% in drinking water); groups 3, 4, and 5 were induced with AOM/DSS and supplemented with 5%, 10%, and 20% of MO, respectively; group 6: had no disease induction and supplemented with 20% of MO. Mice were treated for 12 weeks and euthanized. Significant differences (p < 0.05) were found for the moringa-administered groups in morphological and histopathological parameters compared to the AOM/DSS control. A decrease in myeloperoxidase activity (~50%) and lipid peroxidation (1.9-3.1 times) were found in groups with 10% and 20% of MO compared to the AOM/DSS control (p < 0.05). The group supplemented with 10% MO showed a significant increase (~3 times) in butyrate and propionate in fecal and cecal content. Groups supplemented with 10%, and 20% MO showed a reduction in proinflammatory cytokines in serum (MCP-1, IL-6, TNF-α) compared to the AOM/DSS control. Treatment with 10% MO induced differential expression of 65 genes in colon tissue such as IL-2, IL-6, TNF, IL-1ß, and INF-γ. MO downregulated proinflammatory mediators showing chemopreventive properties against inflammatory response and colon carcinogenesis.

Stability analysis of silver nanoparticle suspensions by cyclic voltammetry.

We report the application of cyclic voltammetry and absorption spectroscopy to the characterization and study of the stability of silver colloids in water. The samples are prepared via chemical reduction and the reactions are catalyzed by irradiation with white light. The electrochemical response is related to the characteristic sample surface plasmon resonance (SPR) in the UV-visible absorption spectra. Cyclic voltammetry shows a characteristic reduction peak whose position is specific to each analyzed sample. Optical analysis of a colloid precursor during a 12 h time span, under low-power white-light irradiation, shows that nanoparticles undergo change in size and surface state (absorption bands splitting and inversion) to attain the "stable" colloidal form. While the absorption spectrum bands of the precursor return almost periodically to similar positions, the cyclic voltammogram characteristic reduction peak is displaced as a function of time. Finally, we follow the SPR changes of one "stable" colloid being subjected to electrolysis, heating, and sunlight irradiation, for environmental remediation purposes. Sunlight exposure produces the most significant SPR intensity drop, but the electrochemical technique shows itself promising as well.

[Exposure to second-hand smoke in school adolescents from Tunja (Colombia), 2017]. / Exposición al humo de segunda mano en adolescentes escolarizados de Tunja, Colombia, 2017.

INTRODUCTION: Adolescents exposed to second-hand smoke have a higher risk of morbidity. This is one of the main preventable public health problems in Latin America. OBJECTIVE: To determine the prevalence and sociodemographic factors associated with exposure to second-hand tobacco smoke at home and out-of-home, in school adolescents from Tunja-Colombia. METHODOLOGY: This cross-sectional study included 1100 school students, aged between 11 and 19 years. The information was obtained using a self-administered and totally anonymous questionnaire. For the analysis, the proportions of everyday exposure and the mean number of days of exposure to second-hand smoke during a regular week were estimated. For the associations, ordinal logistic regression and negative binomial regression models were performed. RESULTS: The average age of the participants was 14.5 years, with the majority (59%) being female. As regards second-hand tobacco smoke exposure at home, an everyday prevalence of 4.9% was found, from 1 to 6 days of 14.7%, with a mean exposure of 0.7 days (SD 1.7). Additionally, there was a higher prevalence of exposure to second-hand smoke out-of-home: every day 8%, from 1 to 6 days of 34.1%, with a mean exposure of 1.5 days (SD 2.2). CONCLUSION: The prevalence of exposure to second-hand smoke in adolescents of Tunja was high. Interventions at school and family level are recommended to counteract this problem.

Porosity, bulk density and CaCO3 content of travertines. A new dataset from Rapolano, Canino and Tivoli travertines (Italy).

The dataset presented in this article is used in the Quaternary Science Review research article "Evaluating the geogenic CO2 flux from geothermal areas by analysing Quaternary travertine masses. New data from western Central Italy and review of previous CO2 flux data" [1]. The present data article reports the physical properties and new compositional data of 86 travertine samples from Rapolano, Canino and Tivoli travertine deposits (Italy). The dataset include the following parameters: mass, volume, porosity, bulk density, CaCO3 content and insoluble fraction. The dataset is integrated with the photographic documentation of the sampling areas, the location and the stratigraphic position of each sample.

Histopathological and Ultrastructural Changes after Electroporation in Pig Liver Using Parallel-Plate Electrodes and High-Performance Generator.

Irreversible electroporation (IRE) has gained attention as a new non-thermal therapy for ablation with important benefits in terms of homogeneous treatment and fast recovery. In this study, a new concept of high voltage generator is used, enabling irreversible electroporation treatment in large tissue volume using parallel plates. Unlike currently available generators, the proposed versatile structure enables delivering high-voltage high-current pulses. To obtain homogeneous results, 3-cm parallel-plates electrodes have also been designed and implemented. IRE ablation was performed on six female pigs at 2000 V/cm electric field, and the results were analysed after sacrifice three hours, three days and seven days after ablation. Histopathological and ultrastructural studies, including transmission and scanning electron microscopy, were carried out. The developed high-voltage generator has proved to be effective for homogeneous IRE treatment using parallel plates. The destruction of the membrane of the hepatocytes and the alterations of the membranes of the cellular organelles seem incompatible with cell death by apoptosis. Although endothelial cells also die with electroporation, the maintenance of vascular scaffold allows repairing processes to begin from the third day after IRE as long as the blood flow has not been interrupted. This study has opened new direction for IRE using high performance generators and highlighted the importance of taking into account ultrastructural changes after IRE by using electron microscopy analysis.

Physicochemical and nutraceutical properties of moringa (Moringa oleifera) leaves and their effects in an in vivo AOM/DSS-induced colorectal carcinogenesis model.

Moringa (Moringa oleifera) is a plant that has generated great interest in recent years because of its attributed medicinal properties. The aim of this study was to characterize the bioactive compounds of moringa leaves (MO) and evaluate their effect on a colorectal carcinogenesis model. Twenty-four male CD-1 mice were divided into 4 groups: Group 1 fed with basal diet (negative control/NC); Group 2 received AOM/DSS (positive control); Groups 3 and 4 were fed with basal diet supplemented with moringa leaves (2.5% w/w and 5% w/w, respectively) for 12weeks. Moringa leaves exhibited a high content of dietary fiber (~18.75%) and insoluble dietary fiber (2.29%). There were identified 9 phenolic compounds whereas the chlorogenic and ρ-coumaric acid showed the higher contents (44.23-63.34µg/g and 180.45-707.42µg/g, respectively). Moringa leaves decreased the activity of harmful fecal enzymes (ß-glucosidase, ß-glucuronidase, tryptophanase and urease up to 40%, 43%, 103% and 266%, respectively) as well tumors incidence in male CD1-mice (~50% with 5% w/v of moringa dose). These findings suggest that the bioactive compounds of moringa such as total dietary fiber and phenolic compounds may have chemopreventive capacity. This is the first study of the suppressive effect of moringa leaves in an in vivo model of AOM/DSS-induced colorectal carcinogenesis.

Derivaciones fecales y urinarias en un centro de atención especializado, México 2016 / Fecal and urinary derivations at a specialized attention center, Mexico 2016 / Derivações fecais e urinarias em um centro de atenção especializado, México 2016

Objetivo: Describir las características epidemiológicas de las derivaciones fecales y urinarias, las características demográficas de los pacientes ostomizados y las características de los productos utilizados en un Centro Especializado en Cuidado de Heridas y Ostomías de la Ciudad de México. Metodología: Estudio descriptivo, retrospectivo y transversal en el cual se revisaron los expedientes clínicos de personas ostomizadas atendidas durante el año 2016. Resultados: Se analizaron 143 expedientes. La media de edad fue de 56.3±15.2 años. El diagnóstico más común fue el cáncer de colon (27.8%). Las características presentes en mayor proporción fueron: colostomías descendentes (44.7%), regulares (56.6%), diámetro medio de 30±8 mm; ángulo de drenaje al centro (36.4%), de una boca (69.2%), sin marcaje quirúrgico (55.2%), mucosa viable (100%), planos (49.6%), efluente pastoso (51.0%). El 51.7% de los pacientes presentaron complicaciones estomales y el 54.5% complicaciones de la piel periestomal, las cuales fueron resueltas en el 68.0% de los casos, en un tiempo medio de 16.3± 11.5 días. Conclusión: Los resultados del presente estudio aportan evidencia respecto a la necesidad permanente de desarrollar profesionales de Enfermería especializados en terapia enterostomal e incorporarlos al Sistema Nacional de Salud como miembros indispensables del equipo multidisciplinario.

Objective: To describe the epidemiologic characteristics of fecal and urinary derivations, the demographic characteristics of ostomized patients, and the characteristics of utilized products, in a Specialized Center of Wounds and Ostomy Care in Mexico City. Methodology: This is a descriptive, retrospective, and transversal study in which, clinical registers of ostomized patients in 2016 were reviewed. Results: 143 registers were reviewed. The mean age was 56.3±15.2. The most common underlying diagnosis was colon cancer (27.8%). The most prevailing characteristics were: descending colostomy (44.7%), regular (56.6%), median diameter 30±8mm, angle of drainage at center (36.4%), one mouth (69.2%), without surgical mark (55.2%), viable mucous membrane (100%), planes (49.6%), and thick discharge (51.0%). Fifty one point seven percent of the patients showed stomal complications and 54.7% showed peristomal skin complications, which were further solved in 68.0% of these cases in a mean time of 16.3±11.5 days. Conclusion: The results of this study provided evidence regarding the permanent need to prepare enterostomal therapy specialized nursing professionals and incorporate them into the National Health System as indispensable members of the multidisciplinary teams.

Objetivo: Descrever as características epidemiológicas das derivações fecais e urinarias, características demográficas dos pacientes ostomizados e características dos produtos utilizados em um Centro Especializado em Cuidado de Feridas e Ostomias da Cidade do México. Metodologia: Estudo descritivo, retrospectivo e transversal onde se revisaram os expedientes clínicos de pessoas ostomizadas atendidas durante o ano de 2016. Resultados: Analisaram-se 143 expedientes. A média de idade foi de 56.3±15.2. O diagnóstico mais comum foi o câncer de cólon (27.8%). As características presentes em maior proporção foram: colostomias descendentes (44.7%), regulares (56.6%), diâmetro médio de 30±8 mm; ângulo de drenagem ao centro (36.4%), de uma boca (69.2%), sem marcação cirúrgica (55.2%), mucosa viável (100%), planos (49.6%), efluente pastoso (51.0%). O 51.7% dos pacientes apresentaram complicações estomacais e o 54.5% de complicações da pele periestomal, as quais foram resolvidas no 68.0% dos casos, em um tempo médio de 16.3±11.5 dias. Conclusão: Os resultados do presente estudo aportam evidência respeito à necessidade permanente de desenvolver profissionais de Enfermagem especializados em Terapia Enterostomal e incorporá-los ao Sistema Nacional de Saúde como membros indispensáveis da equipe multidisciplinar.

Class of cooperative stochastic models: Exact and approximate solutions, simulations, and experiments using ionic self-assembly of nanoparticles.

We present exact and approximate results for a class of cooperative sequential adsorption models using matrix theory, mean-field theory, and computer simulations. We validate our models with two customized experiments using ionically self-assembled nanoparticles on glass slides. We also address the limitations of our models and their range of applicability. The exact results obtained using matrix theory can be applied to a variety of two-state systems with cooperative effects.

Cadmium and phosphate variability during algal blooms of the dinoflagellate Lingulodinium polyedrum in Todos Santos Bay, Baja California, Mexico.

Dinoflagellate algal blooms (DABs), with Lingulodinium polyedrum as the dominant species, have increased over the past few years in coastal areas off Baja California, Mexico. Vertical and temporal variability of particulate cadmium (Cdp), dissolved Cd (Cdd), PO4(3-) and Cdd/PO4(3-) were investigated during two intense DABs of L. polyedrum that occurred during the fall of 2011 and 2012 in Todos Santos Bay. Results were then, compared with data gathered in the absence of algal blooms during the autumn of 2013. In both algal blooms, L. polyedrum tended to be concentrated near the surface throughout the duration; however, during DAB 2011 the number of cells was twice as abundant ([10.0 ± 8.0] × 10(5) cells L(-1)) as in DAB 2012 ([5.0 ± 4.4] × 10(5) cells L(-1)). During DAB 2011, Cdp increased significantly (up to 1.02 ± 0.99 nmol kg(-1)) and was positively correlated with the cell abundance of L. polyedrum, suggesting that this dinoflagellate is able to assimilate and concentrate Cdd. Likewise, Cdd (up to 0.71 ± 0.17 nM) increased in the days of highest cell abundance, which could be attributed to uptake and subsequent regeneration of Cdd resulting from the remineralization of organic particulate matter produced during the bloom, as well as with the presence of organic ligands secreted by L. polyedrum that could keep Cdd in solution. During DAB 2011, dissolved Cdd/PO4(3-) ratios exhibited high vertical and temporal variability in the upper 5 m of the water column, but remained virtually constant near the bottom, suggesting a depth-dependent decoupling between these two dissolved components during the bloom development. Given the observed differences in the vertical and temporal variability of Cdd, Cdp, and PO4(3-) between these two intense DABs, we propose the existence of an abundance threshold of approximately 10(6) cells L(-1) of L. polyedrum above which Cd and PO4(3-) significantly increased due to remineralization in coastal waters during the bloom development.

Úlceras por presión en diversos servicios de un hospital de segundo nivel de atención / Pressure ulcers at diverse services in a second level attention hospital / Úlceras por pressão em diversos serviços de um hospital de segundo nível de atenção

Objetivo: Describir las características epidemiológicas de las úlceras por presión, de la población que las desarrolla y estimar los costos directos del cuidado de estas lesiones en diversos servicios de un hospital de segundo nivel de atención. Metodología: Estudio descriptivo y transversal donde se valoró la población mayor de edad de los servicios de cirugía general, cirugía plástica y reconstructiva, medicina interna y unidad de cuidados intensivos de un hospital de segundo nivel de atención. Cada paciente fue valorado diariamente por 30 días consecutivos aplicando un formato de registros clínicos. Resultados Se valoraron 218 pacientes, de los cuales 61 presentaron una o más UPP, se detectaron un total de 378 lesiones. Se reportó una prevalencia cruda del 28.0% y una incidencia del 13.3%. La edad media de los pacientes afectados fue 61.4 ± 20.9. Las enfermedades más frecuentes fueron las cardiovasculares. La mayor proporción de pacientes con UPP presentaron algún tipo de incontinencia y/o sobrepeso. La puntuación media en la Escala de Braden fue 12.5 ± 2.8. La mayor proporción de UPP se localizó en los talones, el sacro y los omóplatos, con categoría I el 81.5%. Los costos directos del cuidado de UPP fueron estimados en 6,457.64 $ MXN per cápita al día. Conclusión: Las UPP continúan siendo un problema para los pacientes hospitalizados en unidades hospitalarias de segundo nivel de atención, que requieren de intervenciones a nivel asistencial, de los gestores del cuidado y autoridades sanitarias, optimizar los recursos materiales y humanos disponibles y formular políticas sanitarias enfocadas en la prevención y atención de las UPP.

Objective: To describe the epidemiologic characteristics of pressure ulcers and of the affected population and estimate the direct costs of care at diverse services in a second level of attention hospital. Methodology: Descriptive and transversal design studying the elder population of the General Surgery, Plastic and Surgery, Internal Medicine, and Intensive Care services in a second level of attention hospital. Each patient was assessed. Methodology: Descriptive and cross-sectional study, in which the entire population over 18 years old of General Surgery, Plastic and Reconstructive Surgery, Internal Medicine and Intensive Care services in second level of attention hospital. Each patient was assessed on a daily basis during 30 consecutive days through clinical registers Results: From 218 patients assessed, 61 showed one or more pressure ulcers. The total number of lesions detected was 378. A raw prevalence of 28% was reported, as well as an incidence of 13.3%. The median age of the patients was 61.4 ± 20.9 years old. The most prevalent pathologies found were cardiovascular illnesses. The majority of patients suffering from pressure ulcer showed some type of incontinence and/or overweight. The median score in the Braden scale turned out to be 12.5 ± 2.8. The majority of pressure sores were localized at the heels, sacrum, and scapula, with 81.5% being category I. The pressure ulcers direct costs were estimated at $6,457.64 MXN per person per day. Conclusion: Pressure ulcers continue being a problem for hospitalized patients in second level of attention hospital units. Therefore, it is necessary that healthcare authorities and providers offer assistance interventions, optimize available human and material resources, and develop sanitary policies focused towards both preventing and attending pressure sores.

Objetivo: Descrever características epidemiológicas das úlceras por pressão, da população que as desenvolve e calcular os custos diretos do cuidado destas lesões em diversos serviços de um hospital de segundo nível de atenção. Metodologia: Estudo descritivo e transversal onde se avaliou a população idosa dos serviços de cirurgia geral, cirurgia plástica e reconstrutiva, medicina interna e unidade de cuidados intensivos de um hospital de segundo nível de atenção. Cada paciente foi avaliado diariamente por 30 dias consecutivos aplicando um formato de registros clínicos. Resultados: Avaliaram-se 218 pacientes, dos quais 61 apresentaram uma ou mais UPP, detectando um total de 378 lesões. Reportou-se uma prevalência crua de 28.0% e uma incidência de 13.3%. A idade meia dos pacientes afetados foi de 61.4 ± 20.9. As patologias mais frequentes foram doenças cardiovasculares. A maior proporção de pacientes com UPP apresentaram algum tipo de incontinência e/ou sobrepeso. A pontuação meia na Escala de Bradem foi 12.5 ± 2.8. A maior proporção de UPP se localizou em calcanhares, sacro e omoplatas, sendo Categoria I, o 81.5%. Os custos diretos do cuidado de UPP foram calculados em 6,457.64 $ MXN per capita ao dia. Conclusão: As UPP continuam sendo um problema para os pacientes hospitalizados em unidades hospitalares do segundo nível de atenção, precisando de intervenções a nível assistencial, dos gestores de cuidado e autoridades sanitárias, melhorar os recursos materiais e humanos disponíveis e formular políticas sanitárias focalizadas na prevenção e atenção das UPP.

Adaptación de una cepa compatible con Acidithiobacillus ferrooxidans sobre concentrados de calcopirita (CuFeS2), esfalerita (ZnS) y galena (PbS) / Adaptation of a strain Acidithiobacillus ferrooxidans compatible on concentrates of chalcopyrite (CuFeS2), sphalerite (ZnS) and galena (PbS)

En este estudio se evaluó la adaptación de una cepa compatible con Acidithiobacillus ferrooxidans a altas densidades de pulpa de calcopirita, esfalerita y galena, con dos distribuciones de tamaño de partícula, -200 y -325 serie Tyler de tamices. Los microorganismos fueron adaptados por la disminución gradual de la fuente principal de energía, sulfato ferroso, y el aumento en el contenido de mineral, para finalmente realizar un subcultivo sin la adición de fuente de energía externa. La realización de subcultivos en serie resultó ser una estrategia eficaz para la adaptación a altas densidades de pulpa de esfalerita, calcopirita y galena indicando que el protocolo empleado es adecuado. Los resultados muestran que la cepa compatible con Acidithiobacillus ferrooxidans es más resistente a altas concentraciones de esfalerita, seguido por calcopirita y finalmente por galena. El tamaño de partícula juega un papel fundamental en la adaptación de los microorganismos al mineral.

In this study the adaptation of Acidithiobacillus ferrooxidans-like to high concentrations of chalcopyrite, sphalerite and galena were evaluated with two mineral-particle sizes: 200 and 325 Tyler mesh. The strain was adapted using two simultaneous processes. The first one consisted in a gradual decreasing of the main energy source, ferrous sulphate. The second one consisted in a gradual increasing of the mineral content. Finally, a test was made without ferrous sulphate. The serial subculturing was found to be an efficient strategy to adapt Acidithiobacillus ferrooxidans-like to higher concentrations of chalcopyrite, sphalerite and galena. This indicates that a suitable protocol was employed. The results showed that Acidithiobacillus ferrooxidans-like is more resistant to high concentration of sphalerite, chalcopyrite and galena in descendant order. The particle size played an important role in the adaption of microorganism to the mineral.

Energy Drinks: An Assessment of Their Market Size, Consumer Demographics, Ingredient Profile, Functionality, and Regulations in the United States.

The consumption of energy drinks is rapidly increasing, as demonstrated by their large market growth. The targeted demographic group is teenagers, young adults, 18 to 34 y old; although expansion into nontraditional markets is also occurring. It is claimed that energy drinks can offer an increased energy boost related to their ingredient profile of caffeine, taurine, herbal extracts, and vitamins. Research suggests that energy drink formulations, in addition to increasing energy utilization, may also improve mood, enhance physical endurance, reduce mental fatigue, and increase reaction time. However, in most cases, the corresponding mechanisms of action are not clear. In addition, concerns have been raised over their safety and with a currently weak regulatory environment, efforts need to be made to ensure consumer safety. The objective of this article is to review the current U.S. energy drink market with emphasis on its market size, target demographic, active ingredients, potential benefits, safety, and regulations.

Mercury and arsenic in muscle and liver of the golden cownose ray, Rhinoptera steindachneri, Evermann and Jenkins, 1891, from the upper Gulf of California, México.

Mercury and arsenic levels in muscle and liver of Rhinoptera steindachneri were determined in organisms collected in 2006. Element concentrations in both tissues were directly related to size. Maxima mean concentrations of Hg and As (0.41 and 59.9 microg g(-1) dry wt, respectively) were found in adults muscle. Mercury concentrations were significantly different between juveniles and adults in muscle and liver. For As concentrations, differences between juveniles and adults were found only in muscle. Mercury concentrations were higher in muscle of juveniles and adults. Arsenic concentrations were higher in liver of juveniles, and in muscle of adults. Maximum Hg concentration in muscle (0.65 microg g(-1) dry wt) was below the safe limit established by Mexican regulations for seafood.

Volumetric and anatomical MRI for hypoxic-ischemic encephalopathy: relationship to hypothermia therapy and neurosensory impairments.

OBJECTIVE: To relate volumetric magnetic resonance imaging (MRI) findings to hypothermia therapy and neurosensory impairments. STUDY DESIGN: Newborns > or =36 weeks' gestation with hypoxic-ischemic encephalopathy who participated in the National Institute of Child Health and Human Development hypothermia randomized trial at our center were eligible. We determined the relationship between hypothermia treatment and usual care (control) to absolute and relative cerebral tissue volumes. Furthermore, we correlated brain volumes with death or neurosensory impairments at 18 to 22 months. RESULT: Both treatment groups were comparable before randomization. Total brain tissue volumes did not differ in relation to treatment assignment. However, relative volumes of subcortical white matter were significantly larger in hypothermia-treated than control infants. Furthermore, relative total brain volumes correlated significantly with death or neurosensory impairments. Relative volumes of the cortical gray and subcortical white matter also correlated significantly with Bayley Scales psychomotor development index. CONCLUSION: Selected volumetric MRI findings correlated with hypothermia therapy and neurosensory impairments. Larger studies using MRI brain volumes as a secondary outcome measure are needed.