Mechanical regulation of the Notch signaling pathway.

The mechanical regulation of Notch signaling is an emerging area of interest in cell biology. Notch is essential in many physiological processes in which mechanical stress plays an important role. This review provides an overview of the mechanoregulation of Notch signaling in multiple steps of the pathway. First, we discuss the current knowledge on the direct mechanoregulation of Notch receptor maturation and localization to the membrane and the effect of mechanical stress on the Notch components. Next, we explore how ligand-receptor interactions and membrane dynamics are possible subjects to mechano-regulation, emphasizing the role of cytoskeletal interactions, membrane stiffness, and endocytic complex formation. We further delve into the necessity of tension generation for negative regulatory region (NRR) domain unfolding, facilitated by ligand endocytosis and other microforces. Additionally, we examine the indirect mechano-regulation of S2 and S3 cleavages. Finally, we discuss the mechanoregulation of the Notch intracellular domain (NICD) trafficking and nuclear entry and the impact of mechanical stress on heterochromatin dynamics and nuclear NICD interactions. This review aims to draw attention to the intricate interplay between mechanical cues and Notch signaling regulation, offering novel insights into the multifaceted nature of cellular mechanobiology.

Real-world effectiveness of omalizumab for severe allergic asthma treatment in Colombia.

BACKGROUND: The allergic phenotype is responsible for more than 50% of severe asthma cases. In a stepwise approach, add-on treatments such as anti-IgE are used for severe allergic asthma (SAA). This study was aimed to describe the real-world effectiveness of omalizumab in adult and pediatric patients with SAA in Colombia. METHODS: This was an observational, non-interventional, retrospective study. Data from patients with SAA that received at least one month of treatment with omalizumab was obtained from medical records at eight sites in Colombia. Time-zero (t - 0) was defined as the date of initiation of omalizumab, and data was gathered for a 12-month period before t - 0 and a 12-month period after t - 0. Clinical outcomes, including exacerbations, were assessed at 6 and 12 months. Effectiveness of omalizumab was evaluated in terms of the reduction of the risk of exacerbations (annualized rate). RESULTS: We included 143 patients with SAA. There was a decrease of 72.4% of the annualized rate of clinically significant asthma exacerbations during the year after omalizumab (from 1.74 before to 0.48 after) with a substantial reduction of the risk of exacerbations by 56.7% (RR [95% CI] 0.43 [0.30-0.63] p < 0,001). CONCLUSION: The use of omalizumab in Colombia as a treatment for SAA notably reduced the risk of clinically significant exacerbations. This study is the first to evaluate omalizumab real-life effectiveness in pediatric and adult patients in the country.

Impact of parental chromosomal polymorphisms on the incidence of congenital anomalies and perinatal complications in a cohort of newborns conceived after ICSI + PGT-A.

BACKGROUND: To assess the association between chromosomal polymorphisms (CPM) with congenital anomalies and perinatal complications in a cohort of newborns from couples undergoing intracytoplasmic sperm injection (ICSI), trophectoderm biopsy, and preimplantation genetic testing for aneuploidy (PGT-A). METHODS: A retrospective cohort of singletons conceived after ICSI, trophectoderm biopsy, and PGT-A cycles performed at IVIRMA clinics in Spain over 4 years was involved in the study. Newborns were classified according to the parental karyotype analysis: Group I: non-carriers, Group II: CPM carriers. Couples with chromosomal anomalies and instances when both partners were CPM carriers were excluded from the study. The groups were compared for several perinatal complications. RESULTS: There was a significant decrease in the number of NB with complications in the carrier group compared to the non-carriers (19.7% vs 31.9%, p = 0.0406). There were no statistical differences among the two groups regarding congenital anomalies, preterm birth, alterations in birth length and weight, cranial perimeter, Apgar test score, or sex ratio (p > 0.05). CONCLUSIONS: Chromosomal polymorphisms appear to have no adverse effects on congenital anomalies or perinatal complications on newborns from ICSI + PGT-A cycles.

Conocimientos y actitudes de voluntarios de la Cruz Roja Colombiana sobre VIH y sus portadores / Knowledge and attitudes of volunteers of the Colombian Red Cross on VIH and its carriers

RESUMEN Objetivo Determinar el conocimiento y las actitudes de un grupo de 53 jóvenes de la Cruz Roja de la Juventud en la Seccional Valle del Cauca sobre el fenómeno social del VIH/SIDA y sus portadores. Método El diseño de la investigación se basó en la línea de desarrollo humano y construcción de ciudadanía, bajo el método cuantitativo de orden descriptivo. Para la recolección de la información, se empleó un formato de encuesta de tipo descriptivo con preguntas cerradas o de alternativa fija, compuesto por un cuestionario de 39 preguntas. Resultados Entre el 69% y 72% de los jóvenes refieren conocimiento sobre sus derechos sexuales y reproductivos; sin embargo, un porcentaje bajo, entre 26% y 39%, afirma haber recibido asesoría sobre la realización de la prueba del VIH, un porcentaje menor se la ha realizado. Conclusiones Es claro el bajo nivel de reconocimiento que tienen las instituciones y los medios de comunicación como difusores de temas relacionados con la salud sexual y reproductiva y el VIH/SIDA. Por otro lado, a pesar del reconocimiento de sus derechos, perviven en los jóvenes mitos sobre la forma de contagio, la actitud de distanciamiento con los portadores y las conductas de riesgo en las prácticas sexuales.

ABSTRACT Objective Determine the knowledge and attitudes of a group of 53 young people of the Red Cross of Youth in the Valle del Cauca Sectional about the social phenomenon of HIV/AIDS and its bearers. Method The design of the research was based on the line of human development and construction of citizenship, under the quantitative method of descriptive order. For the collection of information, a descriptive survey format with closed questions or a fixed alternative was used, consisting of a questionnaire of 39 questions. Results Between 69% and 72% of young people report knowledge about their sexual and reproductive rights, however, a low percentage between 26% and 39% say they have received counseling about the HIV test and a smaller percentage have accomplished. Conclusions It is clear the low levels that institutions and media have in the dissemination of the topic of sexual and reproductive health and HIV/AIDS. Despite the recognition of their rights, myths persist about the form of contagion, the attitude of distancing with carriers and risk behaviors in sexual practices.

Natural Aging of Ethylene-Propylene-Diene Rubber under Actual Operation Conditions of Electrical Submersible Pump Cables.

Ethylene-propylene-diene monomer (EPDM) rubbers used in electric submersible pump (ESP) cables were analyzed after being aged in actual operation conditions in oil wellbores. These rubbers constitute the insulation and jacket layers of the ESP cables. EPDM rubbers from four different cables operating during different time intervals (2 and 4.8 years) at different depths (from 760 to 2170 m) below sea level were studied. To verify the effects of the long exposure on the rubber performance, thermal analysis was performed to determine the thermal stability and activation energy of degradation. In addition, structural analysis, through vibrational spectroscopy and crosslinking fraction assessment, was carried out. The mechanical properties of the aged rubbers were inferred through the measurement of hardness, while the absorption of a service fluid was studied by gravimetry. The results showed only minor changes in the thermal, structural, mechanical and barrier properties of the EPDM-based ESP cable layers. It is suggested that the thermo-oxidation mechanism followed by chain scission does not have a role in the degradation of EPDM within the aged ESP cables, and no sign of variation of crosslink fractions has been encountered. Therefore, it was concluded that EPDM-based layers seem not to be weak links in the configuration of modern ESP systems.

From structural resilience to cell specification - Intermediate filaments as regulators of cell fate.

During the last decades intermediate filaments (IFs) have emerged as important regulators of cellular signaling events, ascribing IFs with functions beyond the structural support they provide. The organ and developmental stage-specific expression of IFs regulate cell differentiation within developing or remodeling tissues. Lack of IFs causes perturbed stem cell differentiation in vasculature, intestine, nervous system, and mammary gland, in transgenic mouse models. The aberrant cell fate decisions are caused by deregulation of different stem cell signaling pathways, such as Notch, Wnt, YAP/TAZ, and TGFß. Mutations in genes coding for IFs cause an array of different diseases, many related to stem cell dysfunction, but the molecular mechanisms remain unresolved. Here, we provide a comprehensive overview of how IFs interact with and regulate the activity, localization and function of different signaling proteins in stem cells, and how the assembly state and PTM profile of IFs may affect these processes. Identifying when, where and how IFs and cell signaling congregate, will expand our understanding of IF-linked stem cell dysfunction during development and disease.

Exploración del contexto y las necesidades de educación en salud en un grupo indígena uitoto en Bogotá / Survey on the context and healthcare education needs of a uitoto indigenous group in Bogota

Introducción: Colombia es un país multiétnico y multilingüe con seis millones (14%) de habitantes que pertenecen a grupos étnicos minoritarios, por lo que la situación actual de las comunidades indígenas ha sido precaria por las limitantes de acceso a los planes de salud. Objetivo: realizar una exploración de la comunidad uitoto ubicada en la ciudad de Bogotá D.C., Colombia, del contexto y las necesidades de educación frente al cáncer del cuello uterino y la salud sexual y reproductiva. Materiales y métodos: estudio cualitativo de enfoque etnográfico (prueba piloto) en la comunidad uitoto con una observación participante, registrado en un diario de campo. Resultados: las personas de la comunidad uitoto manifiestan que muchos de sus integrantes no cuentan con un servicio de salud contributivo, sino subsidiado por condiciones de desplazamiento. Discusión: se reconoce la existencia latente de las barreras de salud en comunidades indígenas en estado de vulnerabilidad en las áreas urbanas. Conclusión: se destaca la importancia de integrar en la medicina occidental y tradicional en los procesos de salud para esta comunidad.

Introduction: Colombia is a multiethnic and multilingual country with six million (14%) of inhabitants belonging to minority ethnic groups. These indigenous communities are currently living in a precarious situation due to their limited access to healthcare plans. Objective: to conduct a survey on a uitoto community living in the city of Bogotá D.C., Colombia, predominantly on their context and their education needs regarding uterine cervix cancer and sexual and reproductive health. Materials and Methods: a qualitative study with a focus on ethnography (pilot study) on a uitoto community, using participant observation recorded in a fieldwork diary. Results: uitoto community members interviewed manifest that many of them do not count with a contributive healthcare service. They only count with a subsidiary service as a result from being displaced people. Discussion: better awareness of the latent existence of barriers to healthcare for vulnerable indigenous communities living in urban areas was achieved. Conclusion: we stress the importance of integrating traditional medicine into Western medicine healthcare processes for this community.

Vimentin regulates Notch signaling strength and arterial remodeling in response to hemodynamic stress.

The intermediate filament (IF) cytoskeleton has been proposed to regulate morphogenic processes by integrating the cell fate signaling machinery with mechanical cues. Signaling between endothelial cells (ECs) and vascular smooth muscle cells (VSMCs) through the Notch pathway regulates arterial remodeling in response to changes in blood flow. Here we show that the IF-protein vimentin regulates Notch signaling strength and arterial remodeling in response to hemodynamic forces. Vimentin is important for Notch transactivation by ECs and vimentin knockout mice (VimKO) display disrupted VSMC differentiation and adverse remodeling in aortic explants and in vivo. Shear stress increases Jagged1 levels and Notch activation in a vimentin-dependent manner. Shear stress induces phosphorylation of vimentin at serine 38 and phosphorylated vimentin interacts with Jagged1 and increases Notch activation potential. Reduced Jagged1-Notch transactivation strength disrupts lateral signal induction through the arterial wall leading to adverse remodeling. Taken together we demonstrate that vimentin forms a central part of a mechanochemical transduction pathway that regulates multilayer communication and structural homeostasis of the arterial wall.

An annotated and illustrated checklist of Microgastrinae wasps (Hymenoptera, Braconidae) from the Canadian Arctic Archipelago and Greenland.

The Microgastrinae (Hymenoptera: Braconidae) from ten islands of the Canadian Arctic Archipelago (CAA) and Greenland were studied based on 2,183 specimens deposited in collections. We report a total of 33 species in six genera, more than doubling the totals previously known. Most of the species (75.7%) have a distribution restricted to the Nearctic, with nine of those (27.3%) confirmed to be High Arctic endemics and another 10 species considered very likely to be High Arctic endemics as well - accounting for all of those, more than half of all species found are endemic to the region. The most diverse genera were Cotesia (10 species), Glyptapanteles (9 species), and Microplitis (7 species), representing 78.8% of the overall species diversity in the region. The six most frequently collected species comprised 84.7% of all examined specimens. The flight period for Microgastrinae in the High Arctic encompasses only two months, with activity peaking during the first half of July, when almost 40% of all available specimens were collected, and then plummeting in the first half to the end of August. Microgastrinae wasps from the High Arctic are currently known to parasitize eight species within four families of Lepidoptera: three species of Noctuidae, two each of Lymantridae and Nymphalidae, and one species of Pterophoridae. However, that information is very preliminary, as only six of the 33 species of microgastrines currently have associated host data. An annotated checklist, including photographs for 24 of the 33 species, is provided, as well as a key to all Microgastrinae genera present in the region.

First uniportal video assisted thoracic surgery masterclass in Ecuador.

Currently video-assisted thoracic surgery (VATS) and the evolution Uniportal VATS have a worldwide acceptance and Ecuador is not exception when we decided invited to Dr. Diego Gonzalez-Rivas pioneer surgeon in the world of single-port video-assisted thoracoscopic procedures, with the aim to provide a faster recovery of the patients compared to those who received a conventional thoracotomy. We thanks the opportunity to present a report to the first Masterclass in Uniportal VATS with live surgery, performed on February 23rd to 24th of 2017 at the Luis Vernaza Hospital in Guayaquil-Ecuador. In addition to demonstrate the efficacy and safety of the uniportal VATS technique we presented a video of uniportal VATS left lower lobectomy performed by Dr. Diego Gonzalez-Rivas during the first uniportal masterclass in Guayaquil, Ecuador.

[Real-time quantification to analyze historical Colombian samples detecting a short fragment of hypervariable region II of mitochondrial DNA].

INTRODUCTION: Unlike other molecular biology studies, the analysis of ancient DNA (aDNA) requires special infrastructure and methodological conditions to guarantee the quality of the results. One of the main authenticity criteria is DNA quantification, where quantitative real-time PCR is often used given its sensitivity and specificity. Nevertheless, the implementation of these conditions and methodologies to fulfill authenticity criteria imply higher costs. Objective: To develop a simple and less costly method for mitochondrial DNA quantification suitable for highly degraded samples. Materials and methods: The proposed method is based on the use of mini-primers for the specific amplification of short fragments of mitochondrial DNA. The subsequent purification of these amplified fragments allows a standard curve to be constructed with concentrations in accordance to the state of degradation of the samples. Results: The proposed method successfully detected DNA from ancient samples including bone remains and mummified tissue. DNA inhibitory substances were also detected. Conclusion: The proposed method represents a simpler and cost-effective way to detect low amounts of aDNA, and a tool to differentiate DNA-free samples from samples with inhibitory substances.

Osmotic fragility of red blood cells, lipid peroxidation and Ca²âº-ATPase activity of placental homogenates and red blood cell ghosts in salt-loaded pregnant rats.

OBJECTIVE: To evaluate the osmotic fragility of red blood cells and the level of lipid peroxidation, the Ca(2+)-ATPase activity of red cell ghosts and placental homogenates from salt-loaded pregnant rats. METHODS: Salt-loaded pregnant rats received 1.8% NaCl solution ad libitum as a beverage for seven days, starting on 15th day of pregnancy. Then, it was evaluated the level of lipid peroxidation and the Ca(2+)-ATPase activity of placental homogenates and red blood cell ghosts from control and experimental rats. Furthermore, the osmotic fragility of the red blood cells was evaluated by measuring the lysis of these cells when incubated with a NaCl solution with different osmolarities. RESULTS: It was found that placental homogenates and red blood cell ghosts from experimental pregnant rats showed an increased level of lipid peroxidation and a lowered Ca(2+)-ATPase activity, as compared to control pregnant rats. They also presented an increased osmotic fragility of their red blood cells. CONCLUSIONS: Salt-loaded pregnant rats showed, similar to preeclamptic women, an increased level of lipid peroxidation and a lowered Ca(2+)-ATPase activity in placental and red blood cells membranes, as well as an increased osmotic fragility of the red blood cells.

[NUTRITIONAL STATUS BY ANTHROPOMETRIC AND BIOCHEMICAL PARAMETERS OF COLLEGE BASKETBALL PLAYERS]. / ESTADO NUTRICIONAL MEDIANTE PARÁMETROS ANTROPOMÉTRICOS Y BIOQUÍMICOS DE BASQUETBOLISTAS UNIVERSITARIAS.

INTRODUCTION: in relation to the student population, their class schedules, hours of study, budget shortages, among others, do not allow them to have good eating habits and sedentary ago. Within this context are the sports teams, which must deal with the above. OBJECTIVE: knowing the nutritional status of a group of college basketball players (BU) by anthropometric and biochemical parameters. METHODS: the research provides a non-experimental, descriptive, transversal, with a quantitative approach The sample was selected on a non-probabilistic approach. which included 12 players design. Anthropometric parameters for body mass index (BMI), somatotype and body composition was assessed. For biochemical glucose, triglycerides and cholesterol. RESULTS: have a BMI of 24.6 (kg/m2), are classified as endomesomorfas (5,5-4,3-1,2) have a fat mass 39.9% and 37.8% of muscle mass, glucose values are 68.7 (mg/dl), triglycerides 128 (mg/dl) and 189 cholesterol (mg/dl). CONCLUSION: the BU have normal values for BMI and biochemical parameters, but dig deeper greater amount of adipose tissue is found as reported by body composition and somatotype, a situation that could be related to poor eating habits, however is required further study to reach a categorical conclusion.

Introducción: en relación a la población universitaria, sus horarios de clases, horas de estudio, escasez de presupuesto, entre otras, no les permiten tener buenos hábitos alimentarios y los hace ser sedentarios. Dentro de este contexto se encuentran las selecciones deportivas, las cuales deben lidiar con lo antes mencionado. Objetivo: conocer el estado nutricional de un grupo de basquetbolistas universitarias (BU) mediante parámetros antropométricos y bioquímicos. Métodos: la investigación contempla un diseño no experimental, descriptivo, transversal, con un enfoque cuantitativo. La muestra fue seleccionada bajo un criterio no probabilístico, que incluyó a 12 jugadoras. Para los parámetros antropométricos se valoró el índice de masa corporal (IMC), el somatotipo y la composición corporal. Para los bioquímicos se valoró la glucosa, los triglicéridos y el colesterol. Resultados: las que presentan un IMC de 24,6 (kg/m2) se clasifican como endomesomorfas (5,5-4,3-1,2) y tienen un 39,9% de masa adiposa y un 37,8% de masa muscular; los valores de glucosa son 68,7 (mg/dl), triglicéridos 128 (mg/dl) y colesterol 189 (mg/dl). Conclusión: las BU poseen valores normales para el IMC y los parámetros bioquímicos, pero al indagar más profundamente se encuentra mayor cantidad de tejido adiposo, según lo reportado por la composición corporal y el somatotipo, situación que podría estar relacionada con malos hábitos alimentarios; no obstante se requiere un mayor estudio para llegar a una conclusión más tajante.

Biofilm inhibition activity of compounds isolated from two Eunicea species collected at the Caribbean Sea

Abstract Biofilm has a primary role in the pathogenesis of diseases and in the attachment of multicellular organisms to a fouled surface. Because of that, the control of bacterial biofilms has been identified as an important target. In the present study, five lipid compounds isolated from soft coral Eunicea sp. and three terpenoids together with a mixture of sterols from Eunicea fusca collected at the Colombian Caribbean Sea showed different effectiveness against biofilm formation by three marine bacteria associated with immersed fouled surfaces, Ochrobactrum pseudogringnonense,Alteromona macleodii and Vibrio harveyi, and against two known biofilm forming bacteria, Pseudomonas aeruginosa ATCC 27853 and Staphylococcus aureus ATCC 25923. The pure compounds were characterized by NMR, HRESI-MS, HRGC-MS and optical rotation. The most effective compounds were batyl alcohol (1) and fuscoside E peracetate (6), acting against four strains without affecting their microbial growth. Compound 1 showed biofilm inhibition greater than 30% against A. macleodii, and up to 60% against O. pseudogringnonense,V. harveyi and S. aureus. Compound 6 inhibited O. pseudogringnonense and V. harveyi between 25 and 50%, and P. aeruginosa or S. aureus up to 60% at 0.5 mg/ml. The results suggest that these compounds exhibit specific biofilm inhibition with lower antimicrobial effect against the bacterial species assayed.

Estado nutricional mediante parámetros antropométricos y bioquímicos de basquetbolistas universitarias / Nutritional status by anthropometric and biochemical parameters of college basketball players

Introducción: en relación a la población universitaria, sus horarios de clases, horas de estudio, escasez de presupuesto, entre otras, no les permiten tener buenos hábitos alimentarios y los hace ser sedentarios. Dentro de este contexto se encuentran las selecciones deportivas, las cuales deben lidiar con lo antes mencionado. Objetivo: conocer el estado nutricional de un grupo de basquetbolistas universitarias (BU) mediante parámetros antropométricos y bioquímicos. Métodos: la investigación contempla un diseño no experimental, descriptivo, transversal, con un enfoque cuantitativo. La muestra fue seleccionada bajo un criterio no probabilístico, que incluyó a 12 jugadoras. Para los parámetros antropométricos se valoró el índice de masa corporal (IMC), el somatotipo y la composición corporal. Para los bioquímicos se valoró la glucosa, los triglicéridos y el colesterol. Resultados: las que presentan un IMC de 24,6 (kg/m2) se clasifican como endomesomorfas (5,5-4,3-1,2) y tienen un 39,9% de masa adiposa y un 37,8% de masa muscular; los valores de glucosa son 68,7 (mg/dl), triglicéridos 128 (mg/dl) y colesterol 189 (mg/dl). Conclusión: las BU poseen valores normales para el IMC y los parámetros bioquímicos, pero al indagar más profundamente se encuentra mayor cantidad de tejido adiposo, según lo reportado por la composición corporal y el somatotipo, situación que podría estar relacionada con malos hábitos alimentarios; no obstante se requiere un mayor estudio para llegar a una conclusión más tajante (AU)

Introduction: in relation to the student population, their class schedules, hours of study, budget shortages, among others, do not allow them to have good eating habits and sedentary ago. Within this context are the sports teams, which must deal with the above. Objective: knowing the nutritional status of a group of college basketball players (BU) by anthropometric and biochemical parameters. Methods: the research provides a non-experimental, descriptive, transversal, with a quantitative approach The sample was selected on a non-probabilistic approach. which included 12 players design. Anthropometric parameters for body mass index (BMI), somatotype and body composition was assessed. For biochemical glucose, triglycerides and cholesterol. Results: have a BMI of 24.6 (kg/m2 ), are classified as endomesomorfas (5,5-4,3-1,2) have a fat mass 39.9% and 37.8% of muscle mass, glucose values are 68.7 (mg/dl), triglycerides 128 (mg/dl) and 189 cholesterol (mg/dl). Conclusion: the BU have normal values for BMI and biochemical parameters, but dig deeper greater amount of adipose tissue is found as reported by body composition and somatotype, a situation that could be related to poor eating habits, however is required further study to reach a categorical conclusion (AU)

Factores causales de complicaciones en el trabajo de parto, de los Centros de Salud del Valle Alto, Cochabamba / Causal factors of complications in the Labor of Health Center of the Upper Valley, Cochabamba

Se denomina trabajo de parto a un conjunto de fenomenos fisiológicos que tienen por objeto de salida del feto viable de los genitales maternos. Con el presente estudio se determina los factores causales de complicaciones en el trabajo de parto y el tipo de costumbre al desarrollo del mismo. Se realizo un estudio de tipo retrospectivo; transversal y cuantitativo comprendiendo a los municipios de Punata, Arani,Villa Rivera, Tiraque, Cliza y Tarata y de Vacas. El método de recolección de datos fue a través de la utilización de un cuestionario dirigido a las mujeres pos-puerperio. La informacion se obtuvo de los cuadernos de control prenatal, parto, y puerperio del Sistema Nacional de Información en Salud (SNIS). Entre los resultados obtenidos se tiene que los factores causales de complicaciones en el trabajo de parto en la mayoría se debe a la realización de actividades costumbristas traumáticas que se caracteriza por el balanceo horizontal de la gestante sobre una sabana (manteo) 63%. Se concluye que los factores de riesgo en el trabajo del parto son: el vivir en un lugar pobre, no realizar un adecuado control prenatal, presentar el antecedente de un parto pretérmino y además que la comunidades tienen costumbres que ponen en peligro el bienestar de la madre en trabajo de parto.

Labor is called a set of physiological phenomena aimed at the output of a viable fetus of maternal genitals. Through this study was to determine the causative factors of complications in labor, what kind of habits are mainly these causal factors. We performed a retrospective study, transversal and quantitative understanding of the municipalities Punata, Arani, Villa Rivera, Tiraque, Cliza and Vacas. El Tarata and data collection method was through the use of a questionnaire addressed to the postmenopausal women postpartum.The information was obtained from the notebooks of prenatal care, childbirth, and puerperium of the National Health Information (NHRS). Among the results has to be the causative factors of complications in labor in the majority is due to the traumatic folkloric activities characterized by horizontal balancing of the pregnant woman on a sheet (Manteo) 63%. It is concluded that the risk factors in the work of labor are: living in a poor place, not making adequate prenatal care, presenting a history of preterm labor and also that the communities have customs that endanger the welfare of the newly born.

Lo andino una realidad que nos interpela

El Instituto Superior Andino de Teologia (ISEAT) ofrece este material de reflexion a distintas personas e instituciones interesadas en contribuir al proceso de reflexion acerca del contexto cultural, social y politico en el cual nos movemos como actores eclesiasticos, teologicos, sociales y politicos. Este Cuaderno de Reflexion sirve de base para fomentar el debate abierto y respetuoso, en el ambito en que se desenvuelve cada lectora o lector

Comporación de dos formulaciones de nimodipina en pacientes de edad avanzada con deterioro cognitivo estudio multicéntrico nacional aleatorizado doble ciego / Comporación two nimodipine formulations in elderly patients with cognitive impairment randomized national multicentre double-blind

Evaluar la seguridad y la efectividad en deterioro cognitivo de pacientes con edades entre 55 a 80 años de dos formulaciones de nimodipina: 120 mg de liberación programada (LP) una toma diaria y nimodipina 30 mg de liberación inmediata (LI), 4 tomas diarias. Estudio doble ciego, doble simulado, aleatorio, con pacientes con MMST entre 15 y 24. Estos recibieron las 4 semanas iniciales placebo, luego 12 semanas doble ciego, nimodipina LI activo cuatro tomas diaria, o nimodipina LP activo en una toma diaria. Fueron evaluados a las 12 semanas de tratamiento mediante MMST, escala de Barthel, impresión clínica de cambio" por el médico y el paciente. Ingresaron 69 pacientes, finalizaron el 95.6 por ciento. Treinta y tres con nimodipina LP y treinta y tres con nimodipina LI. Con nimodipina LI, 79 por ciento mejoraron el score de MMST; 78 por ciento notaron mejoría y en 84 por ciento la mejoría fue observada por el médico. Cinco pacientes presentaron reacciones adversas (lipotimia, dos con erupción cutánea, cefalea y epigastralgia), dos suspendieron el tratamiento. En nimodipina LP, 94 por ciento mejoraron el MMST, 94 por ciento dijeron sentirse mejor y en el 91 por ciento, la mejoría fue observada por el médico. Tres (3) pacientes presentaron reacciones adversas (acidez gástrica, hipotensión y mareos), uno suspendió el tratamiento. La nimodipina 120 mg. LP administrada una vez al día y la nimodipina LI 30 mg. administrada cuatro veces al día mejoran el deterioro cognitivo en la edad avanzada, siendo bien toleradas.

Comparison of the blood pressure-lowering effects and tolerability of Losartan- and Amlodipine-based regimens in patients with isolated systolic hypertension.

BACKGROUND: Elevated systolic blood pressure is a more important risk factor for cardiovascular and renal disease than elevated diastolic blood pressure. Isolated systolic hypertension (ISH) is the predominant form of hypertension in the elderly. Effects of angiotensin II on the vascular wall and endothelium may contribute to development of ISH. OBJECTIVE: The primary objective of this study was to compare the effects on trough sitting systolic blood pressure (SiSBP) of a regimen of losartan, a selective angiotensin II-receptor antagonist, and an amlodipine-based regimen in patients with ISH. METHODS: This multicenter, prospective, randomized, double-blind, parallel-group study consisted of a 4-week placebo phase and an 18-week active-treatment phase. The losartan-based regimen consisted of losartan 50 mg, increased as needed to losartan 50 mg/hydrochlorothiazide (HCTZ) 12.5 mg at week 6 and to losartan 100 mg/HCTZ 25 mg at week 12 to achieve a target SiSBP <140 mm Hg. the amlodipine-based regimen consisted of amlodipine 5 mg, increased as needed to amlodipine 10 mg at week 6 and to amlodipine 10 mg/HCTZ 25 mg at week 12. The primary efficacy measure was change in trough SiSBP from baseline to week 18. Information on the tolerability of study treatments was collected at each visit, including the investigator's and patient's observations of clinical adverse experiences (CAEs), laboratory adverse experiences, and responses to a symptom questionnaire. RESULTS: Eight hundred fifty-seven patients (65.6% female) were randomized to treatment, 432 in the losartan group and 425 in the amlodipine group. Their mean age was 67.6 years, and they had a mean duration of hypertension of 6.7 years at baseline. The losartan and amlodipine groups (intent-to-treat population) had baseline mean SiSBP values of 171.2 and 171.9 mm Hg, respectively. At week 18 (the primary end point), the mean change from baseline in SiSBP was -27.4 mm Hg for 426 patients who received losartan and -28.1 mm Hg for 419 patients who received amlodipine (estimated least-square mean difference, 0.3 mm Hg; 95% CI, -1.4 to 2.0), indicating that losartan's effect on systolic blood pressure was noninferior to that of amlodipine. The proportion of patients who responded (SiSBP <140 mm Hg or a > or =20-mm Hg decrease in SiSBP from baseline) was comparable between groups (73.9% losartan, 75.4% amlodipine). The incidence of CAEs and drug-related CAEs was significantly greater in the amlodipine group (amlodipine, 79.8% and 43.8%, respectively; losartan, 67.8% and 25.5%; P < or = 0.001). In addition, more patients in the amlodipine group discontinued therapy due to a drug-related CAE compared with patients in the losartan group (12.9% vs 4.4%, respectively; P < or = 0.001). Lower-extremity edema was the most common drug-related CAE in the amlodipine group (24.0% amlodipine, 2.5% losartan; P < or = 0.001); dizziness was the most common drug-related CAE in the losartan group (6.0% losartan, 4.0% amlodipine). CONCLUSIONS: In these patients with ISH, losartan and amlodipine produced comparable clinically relevant reductions in SiSBP; however, losartan was better tolerated, as evidenced by fewer CAEs and discontinuations compared with amlodipine. Losartan may be considered for the initial treatment of ISH.