Tipos de carbapenemasas expresadas en Klebsiella spp, y Pseudomonas aeruginosa resistente a carbapenémicos en seis hospitales de alta complejidad de la Ciudad de Bogotá - Colombia / Carbapenemases produced in Klebsiella spp, and Pseudomonas aeruginosa in six hospitals in Bogotá - Colombia

INTRODUCCIÓN: En las últimas décadas, se ha incrementado la prevalencia de infecciones por bacilos gramnegativos resistentes a carbapenémicos. OBJETIVO: Determinar los tipos y la frecuencia de las distintas carbapenemasas en aislados de Klebsiella spp. y Pseudomonas aeruginosa, en seis hospitales de alta complejidad de Bogotá-Colombia. MÉTODOS: Estudio observacional descriptivo en seis hospitales de la ciudad de Bogotá, en el período de enero de 2017 a agosto de 2018. Se realizaron RPC para genes de KPC, GES, VIM, NDM, IMP y OXA-48 en cepas de Klebsiella spp y P aeruginosa resistentes a carbapenémicos. RESULTADOS: 52 aislados de P aeruginosa amplificaron para una carbapenemasa, de los cuales 39 (75%) fueron positivos para KPC, 11 (21%) para VIM y 2 co-producciones de KPC y VIM. En cuanto a Klebsiella spp., 165 cepas amplificaron al menos para una carbapenemasa, 98% expresaron KPC y 4 aislados tuvieron co-producciones de metalo-beta-lactamasas y KPC. DISCUSIÓN: Este estudio aporta información valiosa, como el incremento de producción de KPC en P. aeruginosa y la co-producción de KPC y metalo-beta-lactamasas, locual tiene una implicancia tanto en la selección del tratamiento, las medidas de aislamiento de contacto y el pronóstico de los pacientes.

BACKGROUND: In the last decades, the prevalence of infections by carbapenem resistant gram-negative bacilli has been increased. OBJECTIVE: To determine types and frequency of the different carbapenemases in Klebsiella spp. and Pseudomonas aeruginosa, in six hospitals in Bogotá-Colombia. METHODS: Descriptive and observational study, in six hospitals in the city of Bogotá, in the period ftom January 2017 to August 2018. PCR were performed for KPC, GES, VIM, NDM, IMP and OXA-48 genes, in carbapenem resistant Klebsiella spp. and P aeruginosa. RESULTS: 52 P aeruginosa isolates amplified a carbapenemase gene, of which 39 (75%) were positive for KPC, 11 (21%) for VIM and two co-productions of KPC and VIM. Regarding Klebsiella spp. 165 strains amplified at least one carbapenemase gene, 98% expressed KPC and four isolates had co-productions of metallo-P-lactamases and KPC. DISCUSSION: This study provides valuable information, such as the increased production of KPC in P. aeruginosa información valiosa, como el incremento de producción de KPC en P. aeruginosa and the co-production of KPC plus metallobetalactamases, which has an implication both in treatment selection, isolation precautions and patient prognosisy.

[Carbapenemases produced in Klebsiella spp., and Pseudomonas aeruginosa in six hospitals in Bogotá - Colombia]. / Tipos de carbapenemasas expresadas en Klebsiella spp., y Pseudomonas aeruginosa resistente a carbapenémicos en seis hospitales de alta complejidad de la Ciudad de Bogotá - Colombia.

BACKGROUND: In the last decades, the prevalence of infections by carbapenem resistant gram-negative bacilli has been increased. OBJECTIVE: To determine types and frequency of the different carbapenemases in Klebsiella spp. and Pseudomonas aeruginosa, in six hospitals in Bogotá-Colombia. METHODS: Descriptive and observational study, in six hospitals in the city of Bogotá, in the period ftom January 2017 to August 2018. PCR were performed for KPC, GES, VIM, NDM, IMP and OXA-48 genes, in carbapenem resistant Klebsiella spp. and P aeruginosa. RESULTS: 52 P aeruginosa isolates amplified a carbapenemase gene, of which 39 (75%) were positive for KPC, 11 (21%) for VIM and two co-productions of KPC and VIM. Regarding Klebsiella spp. 165 strains amplified at least one carbapenemase gene, 98% expressed KPC and four isolates had co-productions of metallo-P-lactamases and KPC. DISCUSSION: This study provides valuable information, such as the increased production of KPC in P. aeruginosa información valiosa, como el incremento de producción de KPC en P. aeruginosa and the co-production of KPC plus metallobetalactamases, which has an implication both in treatment selection, isolation precautions and patient prognosisy.

Effects of selective REM sleep deprivation on prefrontal gamma activity and executive functions.

Given that the dorsolateral prefrontal cortex is involved in executive functions and is deactivated and decoupled from posterior associative regions during REM sleep, that Gamma temporal coupling involved in information processing is enhanced during REM sleep, and that adult humans spend about 90 min of every 24h in REM sleep, it might be expected that REM sleep deprivation would modify Gamma temporal coupling and have a deteriorating effect on executive functions. We analyzed EEG Gamma activity and temporal coupling during implementation of a rule-guided task before and after REM sleep deprivation and its effect on verbal fluency, flexible thinking and selective attention. After two nights in the laboratory for adaptation, on the third night subjects (n=18) were randomly assigned to either selective REM sleep deprivation effectuated by awakening them at each REM sleep onset or, the same number of NREM sleep awakenings as a control for unspecific effects of sleep interruptions. Implementation of abstract rules to guide behavior required greater activation and synchronization of Gamma activity in the frontopolar regions after REM sleep reduction from 20.6% at baseline to just 3.93% of total sleep time. However, contrary to our hypothesis, both groups showed an overall improvement in executive task performance and no effect on their capacity to sustain selective attention. These results suggest that after one night of selective REM sleep deprivation executive functions can be compensated by increasing frontal activation and they still require the participation of supervisory control by frontopolar regions.

Evaluación de riesgos quirúrgicos y manejo post cirugía del adulto mayor de 80 años / Evaluation of surgical risk and post-surgical treatment of elderly over 80 year

Chile vive un envejecimiento acelerado, con expectativas de vida en aumento. Por otra parte, la tendencia a operar adultos mayores ha sido mayor que la esperada sólo por el envejecimiento de la población. Sin embargo, las complicaciones perioperatorias son más frecuentes en los ancianos. Entre otras razones destaca su mayor comorbilidad y el fenómeno de “homeoestenosis”. Todo esto determina que el paciente anciano requiera evaluaciones y cuidados especiales en el peri-operatorio. Esta revisión explica y discute el rol del Médico Geriatra y de la Evaluación Geriátrica Integralen reducir la morbi-mortalidad peri-quirúrgica del adulto mayor, especialmente del mayor de 80 años; resaltando los componentes de comorbilidad, medicamentos, funcionalidad y exámenes complementarios. También se discuten las principales medidas a considerar en el postoperatorio.

Chile is experiencing a process of accelerated aging with increasing in life expectancies. On the other hand, the tendency to operate elderly patients has been greater than that just explained by that of the aging population. Nevertheless, peri-operative complications are more common for the elderly than for the younger patient. Among other reasons, they have more comorbidities and the “homeoestenosis” phenomenon. All this explains why the elderly patient needs special care and evaluation in the peri-operative period. This review discuses and explains the importance of the Comprehensive Geriatric Assessment and the Geriatrician in reducing morbidity and mortality in the elderly patient, especialy over 80 years of age; emphasizing comorbidity, medications, functionality and lab testing. We also discuss the principal measures that must be considered on the postoperative period.

Epidemiology of Streptococcus pneumoniae and Staphylococcus aureus colonization in healthy Venezuelan children.

Streptococcus pneumoniae and Staphylococcus aureus cause significant morbidity and mortality worldwide. We investigated both the colonization and co-colonization characteristics for these pathogens among 250 healthy children from 2 to 5 years of age in Merida, Venezuela, in 2007. The prevalence of S. pneumoniae colonization, S. aureus colonization, and S. pneumoniae-S. aureus co-colonization was 28%, 56%, and 16%, respectively. Pneumococcal serotypes 6B (14%), 19F (12%), 23F (12%), 15 (9%), 6A (8%), 11 (8%), 23A (6%), and 34 (6%) were the most prevalent. Non-respiratory atopy was a risk factor for S. aureus colonization (p = 0.017). Vaccine serotypes were negatively associated with preceding respiratory infection (p = 0.02) and with S. aureus colonization (p = 0.03). We observed a high prevalence of pneumococcal resistance against trimethoprim-sulfamethoxazole (40%), erythromycin (38%), and penicillin (14%). Semi-quantitative measurement of pneumococcal colonization density showed that children with young siblings and low socioeconomic status were more densely colonized (p = 0.02 and p = 0.02, respectively). In contrast, trimethoprim-sulfamethoxazole- and multidrug-resistant-pneumococci colonized children sparsely (p = 0.03 and p = 0.01, respectively). Our data form an important basis to monitor the future impact of pneumococcal vaccination on bacterial colonization, as well as to recommend a rationalized and restrictive antimicrobial use in our community.

Asociación de la deficiencia de cinc con factores inmunológicos y clínicos / Association between zinc deficiency and immunological and clinical factors

INTRODUCCIÓN: El cinc es un elemento imprescindible para el buen funcionamiento del organismo en todas las etapas de la vida, tanto para la síntesis celular, la reparación de tejidos y el desarrollo cerebral como para el crecimiento. Es cofactor de numerosas enzimas (lactato deshidrogenasa, fosfatasa alcalina, anhidrasa carbónica, carboxipeptidasa, SOD, etc.), siendo muy importante para el funcionamiento de la próstata, desarrollo de los órganos de reproducción, para buen funcionamientode la retina, y está involucrado en la regeneración de rodopsina. El sistema inmune requiere de Zn y es necesario para el mantenimiento de la integridad estructural del ADN y la síntesis de ácidos nucleicos y proteínas. OBJETIVO: El objetivo es estudiar el estado nutricional del cinc en una población sana y establecer la relación con otros factores como ejercicio físico, consumo de alcohol, y otros parámetros bioquímicos como GOT, FA, CPK, ASLO Inmunoglobulina G, Inmunoglobulina A, Alfa 1 anti tripsina, LDH, factor reumatoide. METODOLOGÍA: El estudio se realizó en un colectivo de personas de 21 a 59 años, 56 hombres y 61mujeres. Los criterios de inclusión se basaron en la aceptación de los sujetos a participar en el estudio y en que dichos sujetos no presentaran ningún tipo de patología que pudiera afectar su situación nutricional. El Zn se analizó mediante Espectrofotometría de Absorción Atómica (AAS) en muestras de eritrocitos y plasma mineralizadas por vía húmeda. Se aplicó un cuestionario de frecuencia de consumo, y mediante programa informático Nutriber® (Mataix, y Garcia Diz, 2006) se obtuvo el % RDA. Se contó con la aceptación del Comité ético y el consentimiento informado. Los parámetros clínicos analizados se determinaron en un equipo autoanalizador Hitachi mediante método colorimétrico(AU)

RESULTADOS: La recomendación de ingesta de Zn en la población adulta es de 7 a 15 mg/d. Nuestros resultados muestran una ingesta de Zn por debajo de los 2/3 de las RDA en un 56% de los individuos estudiados. En plasma, aparece deficiencia de Zn en el 17%, y en eritrocitos en un 35%. Se encontró una correlación significativa positiva entre los niveles de Zn y el consumo de alcohol, los niveles de GOT, FA, CPK, ASLO, IgG, IgA y α-1-Antitripsina, y negativa con la intensidad de ejercicio, LDH y factor reumatoide CONCLUSIÓN: según los resultados obtenidos, se hace necesario controlar tanto la ingesta como los niveles plasmáticos y eritrocitarios de Zn para que la población no sufra carencias en este mineral que derivan en el desarrollo de numerosas enfermedades, tal y como se demuestra con las asociaciones encontradas con los parámetros clínicos inmunológicos y enzimáticos que afectan a la integridad celular(AU)

INTRODUCTION: Zinc is an essential element for the proper functioning of the body at all stages of life, both for cell synthesis, tissue repair and brain development to growth. Cofactor of numerous enzymes (lactate dehydrogenase, alkaline phosphatase, carbonic anhydrase, carboxypeptidase, SOD, etc.), being very important for the functioning of the prostate, development of reproductive organs for proper functioning of the retina, and is involved in the regeneration of rhodopsin. The immune system requires Zn and is necessary for maintaining the structural integrity of DNA and the synthesis of nucleic acids and proteins. OBJECTIVE: The objective is to study the nutritional status of zinc in a healthy population and establish relationship with other factors such as exercise, alcohol consumption, and other biochemical parameters such as GOT, ALP, CPK, ALSO immunoglobulin G, immunoglobulin A, alpha 1antitrypsin, lactate dehydrogenase, rheumatoid factor. METHODS: The study was conducted in a group of people from 21 to 59 years, 56 men and 61women. Inclusion criteria were based on the acceptance of subjects to participate in the study and that these subjects did not display any pathology that could affect their nutritional status. Zn was analyzed by Atomic Absorption Spectrometry (AAS) in blood cells and plasma samples mineralized by wet. We applied a food frequency questionnaire, and through software Nutriben (Mataix, and Garcia Diz, 2006) won the% RDA. It was accepted by the Ethics Committee and informed consent. The clinical parameters analyzed were determined on a computer Hitachi autoanalyzer using a colorimetric method. RESULTS: The recommended intake of Zn in the adult population is 7 to 15 mg/d. Our results show that Zn intake below 2 / 3 of the RDA in 56% of individuals studied. In plasma, Zn deficiency occursin 17%. There was a significant positive correlation between Zn levels and alcohol consumption, levels of GOT, ALP, CPK, ASO, Immunogen, Inmuno A and alpha-1-antitrypsin, and negative with exercise intensity, LDH and rheumatoid factor CONCLUSION: According to the results, it is necessary to control both the intake and plasma and cellular levels of Zn for the population are deficient in this mineral that lead to the development of numerous diseases, as demonstrated by the association found with immunological and clinical parameters that affect enzymatic cell integrity (AU)

Deficiencia de cobre en un colectivo y factores asociados / Copper deficiency in a collective and associated factors

INTRODUCCIÓN: El cobre ejerce un papel esencial como nutriente en el organismo, se necesita un aporte diario mínimo a partir de alimentos o suplementos para el buen funcionamiento de la actividad celular. Está presente en todos los tejidos y participa activamente en la síntesis de la hemoglobina e influye sobre la absorción del hierro. Su deficiencia provoca anemia, diarrea, debilidad generalizada, alteraciones respiratorias y lesión cutánea, teniendo un papel esencial como protector frente el estrés oxidativo, un importante papel en el sistema inmunológico y una gran influencia sobre la expresión de numerosos genes. OBJETIVO: Valorar el estatus de cobre en un grupo de personas adultas sanas procedente de un colectivo de personas sanas adultas, estableciéndose tanto los niveles de ingesta como los niveles plasmáticos y eritrocitarios de este mineral, y estudiando una posible relación con otros parámetros. METODOLOGÍA: El estudio se realizó en una muestra de 90 sujetos de edades comprendidas entre 21 y 59 años (31 hombres y 53 mujeres), todos de la provincia de Granada. El criterio de inclusión se basó en la aceptación de los sujetos a participar en el estudio y no presentar ningún tipo de patología que pudiera afectar su situación clínico-nutricional. El Cu se analizó mediante Espectrofotometría de Absorción Atómica (AAS) en muestras de eritrocito y plasma mineralizadas por vía húmeda. Se aplicó un cuestionario de frecuencia de consumo, y mediante programa informático Nutriber (Mataix, yGarcia Diz 2006)1 se obtuvo el % de RDA. Se contó con la aceptación del Comité ético y el consentimiento informado(AU)

RESULTADOS: La ingesta media recomendada de cobre en la población adulta española es de 1,1mg/día. Los resultados obtenidos muestran ingestas del cobre <2/3 de IR en un 58,2% de la población estudiada, de los cuales el 53,6% son hombres y el 60,8% son mujeres. En plasma, se observaron valores deficientes en cobre en el 25% de la población total, siendo el 29% hombres y el 22,6 % mujeres. En eritrocito, el 21,4% de la población general presentaron deficiencia de cobre, siendo el 28,8% hombres y el 18,9% mujeres. Se encontró una correlación significativa positiva entre la ingesta de macronutrientes y los niveles de cobre en ingesta, así como entre la ingesta de cobre y la de hierro, cinc, magnesio, calcio y selenio. Igualmente, se observa una correlación positiva significativa entre los niveles de cobre en plasma y los niveles de cinc (p<0,02). CONCLUSIÓN: Según los resultados obtenidos, podemos concluir que son necesarios estudios recientes y detallados que aborden la valoración del estatus de cobre de una manera más integral, desde una evaluación pormenorizada de la ingesta hasta la determinación de biomarcadores específicos de cobre, teniendo en cuenta su participación en numerosas reacciones biológicas celulares que pueden alterarse por la deficiencia(AU)

INTRODUCTION: The copper has a crucial role as a nutrient in the body, you need a minimum daily intake from food or supplements for the proper functioning of cellular activity. Is present in all tissues and is actively involved in the synthesis of hemoglobin and influences iron absorption. Deficiency causes anemia, diarrhea, general weakness, respiratory and skin lesion, having an essential role as a protector against oxidative stress, an important role in the immune system and a great influence on the expression of numerous genes. OBJECTIVE: To assess copper status in a group of healthy adults from a group of healthy adults, establishing both the levels of intake and plasma and erythrocyte levels of this mineral, and isexploring a possible relationship with other parameters. METHOD: The study was conducted in a sample of 90 subjects aged between 21 and 59 years (31 men and 53 women), all of the province of Granada. The inclusion criteria was based on the acceptance of individuals to participate in the study and did not show any pathology that could affect clinical and nutritional status. Cu was analyzed by Atomic Absorption Spectrometry (AAS) in erythrocytes and plasma samples mineralized by wet. We applied a food frequency questionnaire, and through software Nutriben (Mataix, and Garcia Diz 2006)1 was obtained by the% of RDA. It was accepted by the Ethics Committee and informed consent(AU)

RESULTS: The average recommended intake of copper in the Spanish adult population is 1.1 mg /day. The results show copper intakes <2 / 3 of IR in 58'2% of the population studied, of which 53'6% are men and women 60'8%. In plasma, were found deficient in copper values in 25% of the total population, being 29% male and 22.6% women. In erythrocytes, 21.4% of the general population showed copper deficiency, with 28.8% men and 18.9% women. There was a significant positive correlation between macronutrient intake and levels of copper intake, as well as between dietary copper and iron, zinc, magnesium, calcium and selenium. Similarly, there is a significant positive correlation between plasma copper levels and zinc levels (p <0.02). CONCLUSION: According to the results, we conclude that studies are needed to address recent detailed assessment of copper status in a more comprehensive, since a thorough assessment of intake to the identification of specific biomarkers of copper, taking into account participation in numerous cellular biological reactions that may be altered by the deficiency(AU)

Motivos de elección de una asignatura por parte de los alumnos / Some reasons which could induce to the students to choose an academic subject

El motivo de elección de una determinada asignatura por parte de los alumnos, ha sidofrecuentemente interpretado bajo diferentes puntos de vista. En esta comunicación nuestro objetivo hasido analizar los motivos de elección en distintos tipos de asignaturas con características peculiarescada una de ellas, concretamente dos de ellas son de libre configuración, siendo una de impartición enel campus andaluz virtual –Fotoprotección- y la otra en el campus virtual de la Universidad deGranada –Aplicación de la Tecnología Farmacéutica en el tratamiento del cáncer y del dolor-. Latercera asignatura seleccionada es una optativa -Farmacia Práctica- que se imparte actualmente en laLicenciatura en Farmacia. Se ha realizado un análisis de los diferentes motivos que impulsan a unalumno a la elección de una disciplina frente a otra, para ello se ha utilizado una de las herramientas demayor uso, la encuesta anónima a todos aquellos que estaban matriculados. Las conclusiones de esteestudio son diversas pero ante todo cabe señalar en el caso de las virtuales la facilidad de acceso yrealización de las asignaturas virtuales, y destacar también que un título atractivo es fundamental en suelección. En el caso de la optativa el motivo fundamental ha sido aprender algo nuevo relacionado consu licenciatura y seguido muy de cerca por la facilidad de horario. Por tanto como conclusióndefinitiva es interesante destacar que tanto en un caso como en otro el alumno desea aprender algoatractivo y que se acomode fácilmente a su horario de estudio(AU)

The reason why a specific subject is chosen by the students has been frequently interpretedfrom several points of view. The aim of this study is to analyze the reasons why different types ofsubjects with particular characteristics are chosen. Specifically, two of these subjects are freeelectives: one of them –Fotoprotección- is imparted through the Andalusian Virtual Campus, and theother one –Aplicación de la Tecnología Farmacéutica en el tratamiento del cáncer y del dolorthroughthe virtual campus of the University of Granada. The third subject chosen is optional -Farmacia Práctica- and it is at present imparted within the Degree in Pharmacy. The different reasonswhy a student chooses one subject against other have been analyzed using one of the most used tools:an anonymous survey to all the students enrolled. The conclusions of this study are diverse, but it ismainly to be remarked in the case of the virtual subjects their accessibility and easy implementation aswell as the importance of an attractive title for the selection of a subject. The main reason in the caseof the optional subject is to learn something new in relation to their Degree, followed very closely byits timetable. Therefore, as final conclusion, it is interesting to remark that the students want in bothcases to learn something attractive that can be easily adapted to their study schedule(AU)

Creación de un espacio virtual para el apoyo de la docencia en Química Física (Farmacia) / Creation of a virtual environment for supporting the teaching in Physical-Chemistry (Pharmacy)

Un aspecto importante de la práctica docente en el EEES es su interés en el trabajo global del alumno a partir del cual se establece el sistema ECTS de créditos curriculares. Este enfoque requiere una revisión de la metodología docente.Es reconocido que la irrupción de las TIC en todos los sectores sociales, ha tenido una repercusión directa en el sistema educativo. En este contexto, Internet ha demostrado no sólo su importancia como canal de transmisión de contenidos sino su potencial como herramienta docente ya que incorpora interactividad, permite la personalización en la utilización de recursos, se adapta a necesidades particulares en el proceso formativo y permite combinar diferentes tipos de recursos.La aplicación de las TIC en la educación superior es cada día más palpable. Con las limitaciones que imponen los grupos numerosos de alumnos, es clara la tendencia hacia la creación de entornos virtuales como apoyo de la docencia presencial con una integración lo más completa posible en la programación didáctica.La presente comunicación analiza estas cuestiones desde la experiencia acumulada en el desarrollo de diversos recursos docentes y la creación de un entorno específico para algunos grupos de alumnos del curso primero adscritos a las enseñanzas impartidas por el Departamento de Química Física en su sección de Farmacia.El entorno virtual se propone como a) un espacio diseñado no como acumulación de páginas HTML, sino como estructurado de una forma flexible de manera que permita ser actualizado por aportaciones múltiples; b) un espacio interactivo que facilite tanto los intercambios más habituales: profesor-alumnos, como los intercambios transversales entre los alumnos; c) una referencia para alojar recursos que complementen la actividad presencial y d) un lugar de integración de diversas herramientas de aplicación docente(AU)

A important issue regarding the educational practice in the EEES, is the interest in the students’ global work from which curricular ECST system has been established. This particular approach requires a revision of the methodology applied in teaching.It is well known that the Information and Communication Technologies (ICT) have been extended to all social sectors and have produced a special impact on the educational system. In this context, Internet has proved to be not only important as a channel for the transmission of contents but also as a potential educational tool since incorporates interactivity, allows a personalized use of multiple resources, is adaptable to particular needs in the formative process and allows to combine different kinds of resources.The application of ICT in the University studies is more extended every day. In spite of the limitations imposed by the existence of groups formed by a high number of students, a clear trend seems to consolidate nowadays: the creation of virtual environments supporting on-site teaching and which are integrated as much as possible in the study schedules.The present communication focuses on these general aspects in relation with the experience accumulated in the development of several educational resources and the creation of a specific virtual environment for students which enrolled in Physical- Chemistry (Pharmacy section) during the past academic years.The virtual environment developed is a) a designed space not for accumulating static HTML pages but structured for allowing to update it with periodical contributions; b) an interactive space where the usual communicative exchange between students and teacher as well as between students is facilitated; c) a reference in which to incorporate complementary resources in order to support 'on site' teaching; and d) a place to integrate different tools with application in educational matters(AU)

Prevenir las adicciones a las tecnologías de la información y la comunicación en la escuela mediante actividades educativas / To prevent the addiction to information and communication technology in the school using educational activities

Objetivo: El desarrollo de las tecnologías de la información y de la comunicación (TIC) ha puesto de relieve casos de adolescentes que ven perjudicados su aprendizaje y su descanso por un uso excesivo. Para incrementar el uso saludable de Internet, móvil y videojuegos es necesario desarrollar programas y actividades en los centros educativos. El objetivo del presente estudio es proporcionar a los educadores un programa para educar a los adolescentes de entre 12 y 16 años en el buen uso de las TIC y evaluar su eficacia. Material y métodos: Para evaluar el uso de Internet, móvil y videojuegos antes y después de la aplicación del programa se aplicaron los cuestionarios de experiencias relacionadas con el uso de Internet (CERI), con el móvil (CERM) y con los videojuegos (CERV). Resultados: El grupo con problemas frecuentes en el uso de Internet descendió del 55 % al 47 % y el grupo con problemas frecuentes en el uso de videojuegos descendió del 50,5 % al 0 % mientras que el grupo con problemas frecuentes en el uso del móvil aumentó del 26,1 al 58 %. Conclusiones: Por tanto, el programa fue eficaz para disminuir la problemática asociada al uso de Internet y de videojuegos pero no de móvil (AU)

Objective: The development of information and communication technologies (ICT) has revealed cases of adolescents with hindered learning and rest due to excessive use, which could exceptionally become addictive. To increase a healthy use of Internet, the mobile phone, and videogames programmes some activities have to be developed in educational centres. The objective of the study was to provide educators with a programme to train adolescents in the good use of ICT, and to assess its effectiveness. Material and method: To assess the use of Internet, the mobile phone, and videogames before and after the application of the programme, the pilot version of the CERI, CERM, and CERV questionnaires was used. Results: The group with common problems in Internet use dropped from 55 % to 47 % and the group with common problems in the use of videogames fell from 50.5 % to 0 % while the group with common problems in using mobile increased from 26.1 to 58 %. Conclusions: Therefore, the program was effective in reducing problems associated with the use of Internet and videogames but not mobile (AU)

Vital function of PRELI and essential requirement of its LEA motif.

Proteins containing the late embryogenesis abundant (LEA) motif comprise a conserved family, postulated to act as cell protectors. However, their function and mechanisms of action remain unclear. Here we show that PRELI, a mammalian LEA-containing homolog of yeast Ups1p, can associate with dynamin-like GTPase Optic Atrophy-1 (OPA1) and contribute to the maintenance of mitochondrial morphology. Accordingly, PRELI can uphold mitochondrial membrane potential (ΔΨ(m)) and enhance respiratory chain (RC) function, shown by its capacity to induce complex-I/NADH dehydrogenase and ATP synthase expression, increase oxygen consumption and reduce reactive oxygen species (ROS) production. PRELI can also inhibit cell death induced by STS, TNF-α or UV irradiation. Moreover, in vitro and in vivo dominant-negative overexpression of mutant PRELI/LEA(-) (lacking the LEA motif) and transient in vitro PRELI-specific knockdown can render lymphocytes vulnerable to apoptosis, cause mouse embryo lethality and revert the resistance of lymphoma cells to induced death. Collectively, these data support the long-presumed notion of LEA protein-dependent mechanisms of cytoprotection and suggest that PRELI interacts with OPA1 to maintain mitochondria structures intact, sustain balanced ion(-)/proton(+) gradients, promote oxidative phosphorylation reactions, regulate pro- and antiapoptotic protein traffic and enable cell responses to induced death. These findings may help to understand how bioenergetics is mechanistically connected with cell survival cues.

Diferencias en los motivos de consulta entre pacientes que acuden derivados y por iniciativa propia a un Servicio de Cuidados Críticos y Urgencias de un hospital general / Differences in the consultation motives between referral and non-referral patients attending a Critical Care and Emergency Service at a general hospital

Objetivos: Analizar las diferencias existentes en los motivos de consulta entre pacientes pediátricos derivados y los que acuden por iniciativa propia (IP) a la sección de urgencias de un Servicio de Cuidados Críticos y Urgencias (SU). Métodos: Estudio observacional descriptivo. Se incluyeron pacientes de ambos sexos, con edades comprendidas entre 0 y 12 años, que no acudían por patología traumática. Se realizaron grupos dependiendo de si el paciente venía o no derivado, y según el nivel de gravedad. Resultados: Se incluyeron 411 pacientes, con una edad media de 3,10 años (IC 95%: 2,81-3,39), de los cuales el 52,6% fueron varones. Los motivos de consulta más frecuentes fueron dificultad respiratoria (30,7%), fiebre (25,3%) y patología gastrointestinal (22,6%). El 75,4% acudieron por IP y el 24,6% fueron derivados. Los motivos más frecuentes de acudir al SU de los pacientes que acudieron por IP, fueron: el 31,3% por no accesibilidad a un pediatra extrahospitalario, el 23,8% porque consideraban que no cabía más demora en la atención y el 14% porque deseaban una segunda opinión. De los pacientes que venían derivados, el 45,5% necesitó pruebas complementarias (PC), el 22,8% observación de urgencias o ingreso hospitalario (OU/IH), y el 31,7% fue alta directa (AD), mientras que si acudieron por IP, el 29,2% necesitó PC, el 3,9% OU/IH y el 66,9% AD (p = 0,0001). El 93,5% de los pacientes IP fueron clasificados como nivel 4 de gravedad frente al 80,2% de los derivados (p= 0,0001). Conclusiones: 1. El principal motivo de acudir al área de pediatría de un SU por IP es la no accesibilidad a un especialista en pediatría extrahospitalario. 2. Los motivos de consulta más frecuentes fueron dificultad respiratoria y fiebre. 3. Los pacientes derivados presentan significativamente una mayor necesidad de realización de PC, OU e IH y un mayor nivel de gravedad (AU)

Objectives: To analyse the differences between the consultation motives among patients attending a Critical Care and Emergency Service at a general hospital by comparing paediatric referral patients and those who were brought directly to the hospital. Methods: Observational descriptive study. Patients of both genders with an age range between 0 and 12 years were included who did not come to the hospital because of traumatisms. Referral and non-referral patients were further stratified according to the severity of their condition. Results: The total study population comprised 411 patients (52.6% males) with an average age of 3.10 years (95% CI 2.82-3.39). Only 24.6% were referral cases, the remaining 75.4% having come or been brought directly to the Service. The most frequent motives for consultation were respiratory problems (30.7%), fever (25.3%) and gastrointestinal conditions (22.6%). Among non-referral patients, the most frequent reasons for coming to the Emergency Service were lack of access to an extrahospitalary paediatrician (31.3%), considering that urgent attention was required (23.8%) and wish for a second opinion (14%). Among the referral patients, 45.5% required further complementary tests, 22.8% were admitted for observation or treatment, and 31.7% were discharged directly; the corresponding data for the non-referral patients were 92%, 3.9% and 66.9%, respectively (p = 0.0001). Among the non-referral patients, 93.5% were classed as “severity level 4”, versus only 80.2% of the referral ones (p = 0.0001). Conclusions: 1. The most frequent reason for seeking consultation at the paediatrics area of a hospitalary Emergency Service was the nonavailability of an extrahospitalary paediatrician. 2. The most frequent motives of consultation were respiratory problems and fever. 3. Referral patients significantly more often require complementary testing and admission, and significantly more often evidence more severe conditions (AU)

Estudio cinético de la fotodegradación del ión p-hidroxibencenodiazonio en medio polar / Kinetic study of the photodegradation of p-hydroxybenzenediazonium ion in polar media

Se ha realizado un estudio sobre la fotodescomposición del ión p-hidroxibencenodiazonio (PDQ) basado en los datos espectrofotométricos y cromatográfi cos obtenidos con disoluciones de PDQ expuestas a irradiación UV (254 nm) en medio de acetonitrilo y agua. Los resultados de HPLC y HPLC-masa (HPLC/MS) indican que el 4-acetamidofenol es el principal producto que se forma tras la irradiación de PDQ en acetonitrilo. Esto se explica como consecuencia de la formación inicial del catión arilo, que posteriormente participa en una reacción de Ritter. El análisis cinético de los datos espectrofotométricos revela que la fotodegradación de PDQ es más rápida en acetonitrilo (constante de velocidad observada, kobs, = 0,1442 s-1) que en acetonitrilo acidifi cado (kobs = 0,009 s-1), lo que indica una mayor fotoestabilidad de la especie protonada derivada de PDQ. La constante de segundo orden (0,062 M s-1) encontrada para la fotodescomposición de PDQ en tampón fosfato (pH 7) se justifi ca por el establecimiento de un equilibrio entre las especies protonada y no protonada procedentes de la disociación ácida de PDQ

A study on the photodecomposition of p-hydroxybenzenediazonium ion (PDQ) has been made using chromatographic and spectrophotometric data obtained from UV-irradiated (254 nm) PDQ solutions in acetonitrile and aqueous media. The HPLC and HPLC-mass results indicate that 4-acetamidophenol is the main product formed after the irradiation of PDQ in acetonitrile. This is explained as a consequence of the initial formation of the aryl cation which is later involved in a Ritter’s reaction. A kinetic analysis of the spectrophotometric data reveals that PDQ photodegradation is faster in acetonitrile (observed rate constant (kobs) = 0.1442 s-1) than in acidifi ed acetonitrile (kobs = 0.009 s-1) indicating a higher photostability of the protonated species derived from PDQ. The second order constant (0.062 M s-1) found for the PDQ photodecomposition in phosphate buffer (pH 7) is explained in term of the equilibrium between protonated and non-protonated species coming from the acid dissociation of PDQ

Oxidative effects induced by dediazoniation of the p-hydroxybenzenediazonium ion in a neutral aqueous medium.

The toxicity of arenediazonium ions is believed to result from the appearance of very reactive compounds during the dediazoniation process. In the case of the p-hydroxybenzenediazonium ion (PDQ), radical species generated during dediazoniation could potentially initiate lipid peroxidation. The data obtained in spectrophotometric experiments suggest that an interaction between PDQ and linoleic acid (LA) gives rise to the characteristic absorption of oxidized products deriving from LA, both in the presence and absence of a mixed micellar medium containing the surfactant Tween 20 (Tw20). Spectroscopic evidence also clearly points to the interference of these processes in the dediazoniation of PDQ. Analysis by reverse-phase, high-pressure liquid chromatography (HPLC) confirms that the decomposition of PDQ in a mixed micellar medium induces the peroxidation of both LA and methyl linoleate (MEL), thus causing the appearance of peaks characteristic of dienic conjugated hydroperoxides. The same products are observed after interaction between LA and the water-soluble 2,2'-azobis (2-amidinopropane), a frequently used initiator of lipid peroxidation. The proportion of isomers produced during the peroxidation process agrees well with that reported for reactions mediated by free radicals. A further chromatographic analysis of the decomposition of PDQ in the presence of 2-methylcyclohexa-2,5-diene-1-carboxylic acid (CHD) shows that phenol and quinone are the main products of the reaction. These results are discussed on the understanding that aryl and peroxyl radicals abstract a hydrogen atom from CHD, in accordance with our general scheme for PDQ dediazoniation described in a previous publication.

Estudio cinético de la desdiazoación en medio acuoso del tetrafluorborato de bencenodiazonio / The kinetic study of dediazoniation in an aqueous medium of benzenediazonium tetraflourborate

Los análisis cinéticos realizados a diferentes temperaturas (20º C - 40º C) indican que el proceso de desdiazoación del ion bencenodiazonio (BZ) es de orden uno respecto a BZ siendo A = 2,3.1015 s-1 y Ea = 112,5 kJ.mol-1 en la ecuación de Arrhenius así como A H = 110,0 kJ.mol-1 y AS = 40,7 J.K-1.mol-1 para la ecuación de Eyring. Los resultados cromatográficos revelan que BZ se descompone por un proceso heterolítico mediado por el catión arilo. La presencia de sales Cu(I) o de Cu(II) y ácido ascórbico produce un cambio del mecanismo de reacción. Los compuestos intermedios originados en estas condiciones son especies estables que pueden ser transportadas en la sangre. El modelo estudiado sugiere una posible explicación para la localización descrita en la literatura para los tumores producidos por la administración de BZ a ratas (AU)

Prevalencia de riesgo de trastornos psiquiátricos en estudiantes de pregrado de la escuela de medicina de la Pontificia Universidad Católica de Chile / Prevalence of risk for mental disorders among medical students

Background: Stress caused by the high physical, intellectual and emotional demands imposed to medical students, renders them specially susceptible to the development of mental disorders. Aim: To assess the prevalence of risk for mental disorders among undergraduate students at the Medical School of the Catholic University of Chile. Material and methods : The Twelve Item General Health Questionnaire (GHQ 12) was voluntarily answered by medical students from the first to the fifth year. Results: Sixty eight percent of the total population (305 students) answered the questionnaire. Forty one percent of students were at risk, defined as scoring five or more points in the GHQ 12. The average score was 3.9ñ2.2. First year students had a higher score than fourth year students (4.6ñ2.2 and 3.4ñ2.1 points respectively, p <0.05). No gender differences were observed. Conclusions : Our results are similar to those of other publications concerning psychiatric risk among medical students

Dediazoniation of p-hydroxybenzenediazonium ion in a neutral aqueous medium.

The dediazoniation of p-hydroxybenzenediazonium ion (PDQ) in a neutral aqueous medium has been studied under controlled experimental conditions to prevent photochemical and/or heterolytic side-reactions. Oxygen increased the dediazoniation rate of PDQ and caused the appearance of quinone and hydroquinone. An accumulation of quinone deriving from the reduction of PDQ by hydroquinone was also observed. In ESR analyses with different spin traps, the most stable signal was identified as belonging to the adduct of the p-hydroxyphenyl radical, even in the presence of dimethylsulfoxide or ethanol. A general scheme is proposed including three pathways for the homolytic dediazoniation of PDQ. Pathway 1 represents dediazoniation induced by a hydroxyl ion, a slow process at neutral pH and an even slower one with deaerated samples; a favored quinoid structure is put forward to explain these results. In pathway 2, the formation of a semiquinone radical via the reaction of an aryl radical with oxygen is put forward to justify the increase in the dediazoniation rate in the presence of oxygen. In pathway 3, hydroquinone, produced by semiquinone dismutation, may act as a reducing agent.

Mecanismos de fotosensibilización inducida por fármacos:Una visión general / Mechanisms of photosensitization induced by drugs: A general survey

En el presente trabajo se hace ofrece una visión general los mecanismos relacionados con la fototoxicidad de sustancias farmacológicamente activas. Además se ha confeccionado una lista de 174 compuestos utilizados en la actualidad en la práctica clínica y de los que se existe pruebas de su actividad fototóxica. Conjuntamente se ofrece otra relación con sustancias cuyos efectos fototóxicos se sospechan. Asimismo, se revisan algunos aspectos relacionados con los mecanismos de fotoxicidad de fluoroquinolonas y antiinflamatorios no esteroídicos. Por último, se discute la posible actividad fotosensibilizadora de los iones arenodiazónicos (AU)

Efecto del entrenamiento muscular inspiratorio en el costo de oxígeno de la ventilación en pacientes con enfermedad pulmonar obstructiva crónica / Effects of inspiratory muscle training on the oxygen cost of breathing in patients with chronic obstructive pulmonary disease

Background: Patients with chronic obstructive pulmonary disease have an increased inspiratory work, since they must overcome high loads due to increased airway resistance. Aim: To determine if the reduction in the metabolic cost of exercise observed in patients with chronic obstructive pulmonary disease (COPD) after inspiratory muscle training, was due to a reduction in the oxygen cost of breathing. Patients and methods: Nine patients with COPD (FEV1 39 ñ 13 percent) subjected to inspiratory muscle training, using a training load of 30 percent of maximal inspiratory pressure, during 10 weeks; 5 patients with COPD (FEV1 44 ñ 18 percent) not subjected to training, and 7 healthy controls (FEV1 110 ñ 10 percent) were studied. The cost of breathing was calculated as the difference in VO2 measured at rest and after breathing a gas mixture containing air and 5 percent CO2. Exercise VO2 was measured at submaximal exercise. Results: Oxygen cost of breathing was increased in patients with COPD and it was inversely correlated with FEV1 (r= -0.86 p<0.001). Inspiratory muscle training increased maximal inspiratory pressure and decreased exercise VO2. Oxygen cost of breathing increased in six and decreased in three trained patients. Changes in this parameter after training did not correlate with the reduction in exercise VO2 or the increment in maximal inspiratory pressure. Conclusions: The reduction in exercise VO2 after inspiratory muscle training is not due to a reduction in the oxygen cost of breathing

Determination of microscopic dissociation constants of 3-hydroxy-alpha-(methylamino)methyl-benzenemethanol by a spectral deconvolution method.

Microscopic dissociation constants of 3-hydroxy-alpha-(methylamino)methyl-benzenemethanol have been calculated from the titration spectrophotomeric data (c = 3.8 x 10(-4) M. Ionic strength = 0.16; buffer system: H3BO3/KOH) by application of a spectral deconvolution method. The results found (pKa = 9.48; pKb = 9.71; pKc = 10.12 and pKd = 9.88) are in good concordance with those obtained from the conventional regression linear method (pKa = 9.45; pKb = 9.77; pKc = 10.14 and pKd = 9.81).