Celecoxib: Antiangiogenic and Antitumoral Action / Celecoxib: Acción Antiangiogénica y Antitumoral

SUMMARY: Angiogenesis, a process by which new blood vessels are generated from pre-existing ones, is significantly compromised in tumor development, given that due to the nutritional need of tumor cells, pro-angiogenic signals will be generated to promote this process and thus receive the oxygen and nutrients necessary for its development, in addition to being a key escape route for tumor spread. Although there is currently an increase in the number of studies of various anti-angiogenic therapies that help reduce tumor progression, it is necessary to conduct a review of existing studies of therapeutic alternatives to demonstrate their importance.

La angiogénesis, proceso por el cual se generan nuevos vasos sanguíneos a partir de otros preexistentes, se encuentra comprometida de forma importante en el desarrollo tumoral, dado que por necesidad nutritiva de las células tumorales se generarán señales pro angiogénicas para promover este proceso y así recibir el oxígeno y los nutrientes necesarios para su desarrollo, además de ser una ruta de escape clave para la diseminación tumoral. Si bien, actualmente existe un aumento en la cantidad de estudios de diversas terapias anti angiogénicas que ayudan a reducir el avance tumoral, es necesario realizar una revisión de los estudios existentes de alternativas terapéuticas para demostrar su importancia.

Scorpion sting envenomation outbreak in Mexico. Strategies for prevention and control.

In Mexico occurs 25% of all worldwide cases of scorpion sting envenomation (SSE). An outbreak of SSE was identified in Villa Unión, Sinaloa, Mexico. The objective of this study is to describe the outbreak, and prevention and control strategies implemented. The design was a cross-sectional study. Eligibility criteria included confirmed cases (n = 425) identified from the date the outbreak was recognized (from November 08, 2023 to July 10, 2023). The cases from Villa Unión (n = 231) were included for the analysis of epidemiological and clinical findings. The research followed the recommendations of the Initiative Reporting of studies Conducted Using Observational Routinely collected Data (RECORD). Of the total cases (n = 425), 398 (93.6%) were from the municipality of Mazatlán, and 231 (58%) were from Villa Unión. The incidence rate was 13.64 per 1000 persons. The average cases per week was 51.5(SD ± 12). The male-to-female ratio was 3:4, the average age was 30.7(SD ± 19) years. Most of cases occurred in the 25-44 age group. The sting occurred mostly inside houses (n = 200, 86.5%). The predominant symptoms were local pain (95.2%), and local paresthesia (75.8%). The Case fatality rate was 0%. Implementation of prevention and control strategies based on field epidemiological research and scientific evidence are necessary to reduce the incidence and prevent fatal complications.

Split cricoideo anterior posterior: una novedosa técnica para evitar la traqueotomía en parálisis cordal bilateral en pacientes pediátricos / Posterior anterior cricoid split: a cutting-edge technique to avoid tracheostomy in bilateral cordal paralysis in pediatric patients

Introducción: La parálisis cordal bilateral en aducción es la segunda causa de estridor congénito y genera una grave obstrucción de la vía aérea, debutando con estridor. La traqueotomía ha sido durante mucho tiempo el gold estándar para el tratamiento de esta afección, no exenta de complicaciones. Existen procedimientos que intentan evitar la traqueotomía, como el split cricoideo anterior posterior endoscópico (SCAPE). Objetivo: Presentar experiencia con SCAPE en pacientes pediátricos como tratamiento alternativo de parálisis cordal bilateral en aducción. Material y Método: Análisis retrospectivo de los resultados quirúrgicos obtenidos en pacientes con parálisis cordal bilateral en aducción tratados con SCAPE entre enero de 2016 y diciembre de 2019 en el Hospital Guillermo Grant Benavente de Concepción, Chile. Resultados: Siete pacientes se sometieron a SCAPE. Todos los pacientes presentaban insuficiencia respiratoria severa, cinco requirieron asistencia ventilatoria mecánica. Seis pacientes tenían el diagnóstico de parálisis cordal bilateral (PCB) congénita y uno PCB secundaria a tumor de tronco cerebral. Cuatro pacientes presentaron comorbilidad de la vía aérea: dos pacientes presentaron estenosis subglótica grado I y dos pacientes presentaron laringomalacia que requirió manejo quirúrgico. Los días promedio de intubación fueron once días. Ningún paciente requirió soporte ventilatorio postoperatorio, sólo un paciente recibió oxigenoterapia nocturna debido a hipoventilación secundaria a lesión de tronco. Ningún paciente ha presentado descompensación respiratoria grave. Un 40% ha recuperado movilidad cordal bilateral. Conclusión: Split cricoideo anteroposterior endoscópico es una alternativa eficaz para tratar el PCB en pacientes pediátricos. Nuestro estudio evidencia que es una alternativa a la traqueotomía, con excelentes resultados y menor morbimortalidad.

Introduction: Bilateral vocal fold paralysis in adduction is the second cause of congenital stridor and generates a serious obstruction of the airway. Tracheostomy has long been the gold standard for the treatment of this condition, but it has inherent complications. There are procedures that try to avoid tracheotomy, such as the endoscopic anterior posterior cricoid split (EAPCS). Aim: Present our experience with EAPCS in pediatric patients as a treatment for bilateral vocal fold paralysis in adduction. Material and Method: Retrospective analysis of the surgical results obtained in patients with bilateral vocal cord paralysis in adduction treated with EAPCS between January 2016 and December 2019 at Guillermo Grant Benavente Hospital in Concepción, Chile. Results: Seven patients underwent EAPCS. All patients had severe respiratory failure, five required mechanical ventilation assistance. Six patients were diagnosed with congenital bilateral cord palsy (BCP) and one BCP secondary to a brainstem tumor. Four patients had airway comorbidity: two patients had grade I subglottic stenosis and two patients had laryngomalacia that required surgical management. The average days of intubation were eleven days. No patient required post op invasive/non-invasive ventilation, only one patient received nocturnal oxygen therapy due to hypoventilation secondary to trunk injury. None of the patients has presented severe respiratory decompensation. Forty percent have recovered bilateral chordal mobility. Conclusion: SCAPE is a cutting-edge and effective alternative to treat PCB in pediatric patients. Our study shows that it is an alternative to tracheotomy, with excellent results and lower morbidity and mortality.

Plasmocitoma extramedular solitario rinosinusal: reporte de caso y revisión de literatura / Solitary extramedullary plasmacytoma of the rhinosinusal cavity: a case report and literature review

Resumen El plasmocitoma extramedular solitario (PES) es una neooplasia maligna infrecuente caracterizada por una proliferación aislada de células plasmáticas monoclonales en tejido extramedular. La localización más frecuente es en cabeza y cuello con predominio en el territorio rinosinusal, sin embargo, estas lesiones malignas representan menos del 1% de los tumores de esta región anatómica. El diagnostico requiere una alta sospecha clínica, análisis histopatológico acucioso, estudios serológicos y exámenes radiológicos sistémicos de acuerdo a los criterios diagnósticos establecidos en la literatura internacional. Se analiza el caso de un paciente masculino con un PES que se presentó como un tumor de fosa nasal derecha y obstrucción nasal de meses de evolución con hallazgos clínicos e imagenológicos inespecíficos. El diagnóstico definitivo se realizó mediante biopsia endoscópica nasal y estudio histopatológico. El tratamiento fue abordado de manera multidisciplinaria entre otorrinolaringología, hematología y radiooncología. De acuerdo a las guías internacionales, se decidió realizar radioterapia localizada con buen resultado clínico precoz. El PES requiere un abordaje multidisciplinario para lograr un diagnóstico y tratamiento oportuno, siendo imprescindible la exclusión del mieloma múltiple debido a las diferencias terapéuticas y en pronóstico clínico. El tratamiento puede realizarse con radioterapia y/o cirugía, siendo la radioterapia el pilar de tratamiento.

Abstract Solitary extramedullary plasmacytoma (SEP) is a rare malignant neoplasm characterized by isolated proliferation of monoclonal plasma cells in extramedullary tissue. The most frequent location is in the head and neck with a predominance in the rhinosinusal territory; however, these malignant lesions represent less than 1% of the tumors in this anatomical region. The diagnosis requires a high clinical suspicion, careful histopathological analysis, serological studies and systemic radiological examinations according to the diagnostic criteria established in the international literature. We analyze the case of a male patient with SEP that presented as a tumor of the right nostril and nasal obstruction of months of evolution with nonspecific clinical and imaging findings. The definitive diagnosis was made by nasal endoscopic biopsy and histopathological study. The treatment was approached by multidisciplinary teamwork. According to international guidelines, it was decided to perform localized radiotherapy with good early clinical results. SEP requires a multidisciplinary approach to achieve a timely diagnosis and treatment, being essential exclusion of multiple myeloma due to the therapeutic differences and prognosis. Treatment can be done with radiation therapy and/or surgery; radiation therapy is the mainstay of treatment.

La enfermedad periodontal, diabetes tipo 2 y el riesgo cardiovascular / Periodontal disease, type 2 diabetes and cardiovascular risk

JUSTIFICACIÓN: recientes estudios promovidos por la Federación Dental Internacional y el Consejo General de Dentistas demuestran que existe una relación bidireccional entre la salud oral y la diabetes tipo 2 (DM2). Tanto en la periodontitis como en la DM2, los procesos inflamatorios están aumentados, lo que produce alteraciones microvasculares que provocan que la presencia de una de las dos afecte y empeore el cuadro de la otra enfermedad, lo que puede llevar a un aumento del 20 % del riesgo cardiovascular en estos pacientes. La labor del farmacéutico comunitario podría ayudar a detectar de manera precoz los problemas gingivales y con ello prevenir futuras complicaciones sistémicas derivadas de una enfermedad periodontal (EP) no controlada.OBJETIVO: diseño de un protocolo de cribado para la detección de EP en pacientes con DM2.MATERIAL Y MÉTODOS: se elaboró un protocolo sistematizado "ad hoc" para el desarrollo de una entrevista demográfica, además de una recogida de variables y síntomas de alarma. Fueron seleccionados tras la consulta de documentos hallados mediante una búsqueda bibliográfica en PUBMED, Biblioteca Cochrane Plus y documentos del grupo de Epidemiología de la Sociedad Española de Diabetes. En el registro se incorporaron variables correspondientes a las características de los pacientes: demográficas (edad y sexo), relacionadas con el hábito tabáquico y clínicas (años de tratamiento de la DM2, grupo de fármaco antidiabético, tratamiento cardiovascular, salud dental y sintomatología asociada). RESULTADOS Población diana: pacientes mayores de 18 años que en su plan de tratamiento presenten al menos un medicamento antidiabético frente a DM2. (AU)

Efectos de la suplementación con vitamina D en el control del asma en pacientes adultos: una revisión sistemática / Effects of vitamin D supplementation on asthma control in adult patients: a systematic review

INTRODUCCIÓN: El asma es una enfermedad crónica inflamatoria de la vía aérea e inmunomediada en su patogénesis. La vitamina D es un inmunomodulador que regula el perfil secretor de citoquinas, entre otras funciones celulares. Una asociación entre la suficiencia de vitamina D y mejoría en la función pulmonar, control de asma y número de exacerbaciones se ha propuesto en adultos, importante dada la elevada prevalencia de insuficiencia de vitamina D globalmente. OBJETIVO: Conocer los efectos de la suplementación con vitamina D en el control del asma en adultos. MÉTODOS: Se realizó una revisión sistemática de la literatura a través de una búsqueda en la base de datos PubMed y EMBASE. Los desenlaces primarios fueron cambios en VEF1, control sintomático, frecuencia de exacerbaciones, además de eventos adversos y FEM como desenlaces secundarios. La calidad de evidencia de los desenlaces fue evaluada a través del modelo GRADE. RESULTADOS: Siete estudios fueron seleccionados después de remover duplicados y aplicar los criterios de inclusión y exclusión, con calidad de evidencia muy baja aplicando sistema GRADE. DISCUSIÓN: No se encontraron diferencias estadísticamente significativas tras la suplementación con vitamina D en los desenlaces evaluados en general, pero dada la calidad de evidencia muy baja y que no se reportaron efectos adversos serios, es necesario tomar cautelosamente estos resultados. Asímismo no se puede descartar la utilidad de esta terapia como tratamiento auxiliar a los pacientes asmáticos con este déficit vitamínico.

BACKGROUND: Asthma is an airway chronic disease, with an important inflammatory component within its pathogenesis, driven by a dysregulated immune response. Vitamin D is an immunomodulator that regulates cell proliferation, differentiation and cytokine secretion profile. An association between vitamin D sufficiency and improvement in pulmonary function, asthma control and a decrease in exacerbations have been proposed in the adult population, which falls into importance given the high prevalence of vitamin D insufficiency globally. OBJECTIVE: To know vitamin D supplementation effects in asthma control in adults. METHODS: Through a PubMed and EMBASE database search, a systematic review of the literature was conducted. Primary outcomes were: changes in FEV1, symptomatic control, exacerbation frequency and PEF and adverse events as secondary outcomes. Outcome evidence quality assessment was made using the GRADE model. Results: Seven studies were selected after taking out duplicates, applying inclusion and exclusion criteria. In all cases, evidence quality assessed by the GRADE system yielded very low quality. CONCLUSIONS: No statistically significant differences were found after vitamin D supplementation in the overall evaluated outcomes. Nonetheless, a cautious interpretation of studies is mandatory, because evidence quality was very low and no serious adverse events were reported. Hence this treatment usefulness as an ancillary therapy for vitamin D deficient asthmatic patients cannot be dismissed.

An international survey in Latin America on the practice of interventional cardiology during the COVID-19 pandemic, with a particular focus on myocardial infarction.

INTRODUCTION: A reduction in the number of interventional cardiology procedures has emerged as a result of the COVID-19 pandemic. A survey was performed to quantify this decrease and the impact on the management of myocardial infarction in Latin America. METHODS: A telematic survey was conducted for all countries in Latin America. Diagnostic catheterisations, coronary and structural interventions, as well as the incidence and delay to reperfusion therapy of myocardial infarction (STEMI), were recorded. Two periods were compared: from 24 February to 8 March 2020 (pre-COVID-19) and another 2­week period that varied according to country (COVID-19). RESULTS: Responses were obtained from 79 centres in 20 countries. There was a significant decrease in the number of diagnostic procedures (-65.2%), coronary interventions (-59.4%), structural therapeutics (-86.1%) and STEMI care (-51.2%). A decrease was noted in the incidence of STEMI, but also a delay in the time to STEMI reperfusion. While there was a variation in activity in interventional cardiology between countries, patient behaviour was rather homogeneous. CONCLUSIONS: A significant reduction in healthcare activity has been noted during the COVID-19 pandemic, including STEMI care, with the risk of increased mortality and/or morbidity following STEMI. Healthcare providers should encourage patients with suspected symptoms of STEMI to call for emergency care to ensure rapid diagnosis and timely reperfusion treatment.

Analysis of previous training with simulated models on the success rate of ultrasound-guided supraclavicular block. Prospective cohort study. / Análisis del entrenamiento previo con modelos simulados en el porcentaje de éxito del bloqueo supraclavicular guiado por ultrasonido. Estudio de cohorte prospectivo.

INTRODUCTION: The teaching based on simulation and acquisition of skills is changing the paradigm of education and restructuring the clinical residences, with the aim of acquiring better skills, increasing procedural success, reducing complications, as well as providing safe, effective, and efficient and focused care of the patient. Peripheral nerve blocks have advanced as techniques for anatomical repairs, use of neurostimulator, and ultrasound. The posgraduate anaesthesiology program implemented a teaching program that included phases of theoretical teaching, training with simulated models, and application in real scenarios. OBJECTIVE: To analyse the success, the management of the ultrasound equipment and the incidence of complications of ultrasound-guided supraclavicular blocks (BSE) in the clinical scenario, performed by residents of anaesthesiology previously trained with a theoretical and simulated model. METHODS: Prospective cohort study among residents of anaesthesiology (R1, R2, R3, R4), who received previous theoretical-practical training on simulated models. The evaluation was performed by expert anaesthesiologists, with video analysis of the ultrasound screen performed at the time of BSE initiation. RESULTS: The evaluation included 16 residents, who performed 156 BSE. None had previous experience in ultrasound-guided blocks. The success of the block was 96.15%. The team management was excellent (from 86% to 95%), with no significant differences among the residents. (P=.61) The incidence of complications was 0.64%, corresponding to arterial puncture. CONCLUSIONS: In BSE, previous training with a theoretical and simulated model could increase the probability of success and reduce complications. With adequate training, first year residents managed to successfully carry out the procedure.

Levels of anti-Müllerian hormone in premenopausal women with the antiphospholipid syndrome and its association with the risk of clinical complications.

OBJECTIVE: The study aims to investigate the ovarian reserve in premenopausal women with antiphospholipid syndrome (APS) and to evaluate whether it is associated with cumulative organ damage or the risk of clinical complications. METHODS: This single-center study was conducted in 23 premenopausal female patients (10 with primary APS and 13 with secondary APS) and 24 healthy volunteers. Serum anti-Müllerian hormone (AMH) levels were measured by enzyme-linked immunoassay. Disease-specific organ damage (DIAPS score) and the risk of clinical complications (aGAPSS score) were additionally evaluated in APS patients. RESULTS: Serum AMH levels were similar in APS patients (median 6.06, interquartile range 4.31-7.54 ng/ml) and in controls (4.87, 2.64-6.40 ng/ml; P = 0.116), and no differences were observed between the primary (6.60, 5.49-8.88 ng/ml) and secondary (6.06, 3.91-7.30 ng/ml; P = 0.532) forms of the syndrome. In individuals with APS, serum AMH levels correlated inversely with the aGAPSS score (rho-0.421, 95% confidence intervals -0.716 to -0.001; P = 0.045), while no associations were observed with the DIAPS score (rho-0.001, -0.423 to 0.422; P = 0.996). CONCLUSIONS: Ovarian reserve is not reduced in premenopausal women with APS. In addition, serum AMH levels may reflect the risk of APS-related clinical complications but not the burden of disease-specific organ damage.

El suicidio de indígenas desde la determinación social en salud / Indigenous suicide based on social health determinations / O suicídio dos indígenas a partir da determinação social em saúde

Resumen El suicidio es causa frecuente de muerte en el mundo, su expresión en los pueblos indígenas es un problema de salud pública dadas las tasas de suicidio más altas en ellos que en población general afectando preferentemente a hombres jóvenes, de bajo nivel socioeconómicos, desempleados, y consumidores de sustancias. Dada la magnitud del problema y el impacto sobre pueblos originarios incluso en peligro de extinción, se buscó ampliar las comprensiones sobre el tema, posibilitando plantear investigaciones e intervenciones apropiadas que ayuden en la solución. Objetivo: Analizar el suicidio consumado por población indígena, desde la determinación social de la salud. Metodología: Se realizó un estado del arte sobre suicidio en pueblos indígenas, período 1993 - 2013; 57 artículos fueron seleccionados por su calidad y pertinencia, y analizados a la luz de la determinación social en salud. Resultados: Se delinearon las matrices de procesos críticos que describen procesos protectores y destructivos alrededor del suicidio en pueblos indígenas. Conclusión: El enfoque empleado permitió identificar condiciones estructurales de violencia que impactan el bienestar de los indígenas y son partícipes principales en el fenómeno del suicidio consumado en estos pueblos.

Abstract Introduction: Suicide is a common cause of death in the world. Its expression in indigenous populations is a public health problem due to the fact that suicide rates are higher among them than in the general population, preferably affecting low income, unemployed young men who are involved in substance abuse. The magnitude of the problem and its impact on the original populations, even in danger of extinction, allowed the study to expand its comprehension regarding the subject matter, and propose research studies and suitable interventions that can lead to possible solutions. Objective: Annalise completed suicide in indigenous populations based on a social health determination. Methodology: The study conducted a review of the state-of-the-art regarding suicide in indigenous populations from 1993 to 2013; 57 articles were selected because of their quality and pertinence, and they were analyzed in the light of social health determinations. Results: Critical process matrixes where outlined which describe protective destructive processes surrounding suicide in indigenous populations. Conclusion: The approach used in this study allowed the identification of structural conditions of violence that affect indigenous people's well-being, who are the main participators in completed suicide in these populations.

Resumo Introdução: O suicídio é uma causa frequente de morte no mundo, sua expressão nos povos indígenas é um problema de saúde pública, porque as taxas de suicídio são mais altas neles do que na população em geral, afetando principalmente os homens jovens de baixo nível. Socioeconômicos, desempregados e utentes de substâncias. A magnitude do problema e o impacto sobre os povos nativos, incluindo aqueles em perigo de extinção, nos permitiu ampliar nossa compreensão sobre o assunto e propor pesquisas e intervenções apropriadas para orientar possíveis soluções. Objetivo: Analisar o suicídio consumado pela população indígena, a partir da determinação social da saúde. Metodologia: Uma revisão do estado da arte sobre o suicídio em povos indígenas foi realizada entre 1993 e 2013; 57 artigos foram selecionados por sua qualidade e relevância, e analisados à luz da determinação social em saúde. Resultados: Matrizes de processos críticos que descrevem processos protetores e destrutivos em torno do suicídio em povos indígenas foram delineados. Conclusão: O enfoque empregado permitiu identificar condições estruturais de violência que impactam o bem-estar dos indígenas, partícipes principais no fenómeno do suicídio consumado nestes povos.

Tuberculosis in recipients of solid-organ transplants during 1995-2015 in Cali, Colombia.

SETTING: Tuberculosis (TB) in solid-organ transplants (SOTs) is an important opportunistic infection associated with mortality and graft loss. SOT recipients carry a higher risk of contracting active TB than the general population. Clinical and radiographic presentations are non-specific, and sputum smear and culture have low yields. TB patients with SOTs require standard anti-tuberculosis treatment. However, rifampicin (RMP) use is associated with a 30% rate of acute graft rejection (AGR) and a 20% rate of transplant loss. OBJECTIVE: To determine treatment outcomes in SOT recipients with active TB. DESIGN: A retrospective study of clinical and microbiological data and TB treatment outcomes. RESULTS: Among the 2349 transplants assessed, active TB was detected in 31 recipients; 55% had pulmonary TB and 40% were sputum smear-positive. In 32% of the patients, TB was diagnosed 30 days after symptom onset, 77% of the patients were cured and 10% died. AGR occurred in 13%. CONCLUSION: TB was diagnosed in <30 days. Anti-tuberculosis treatment without RMP (80% vs. 67%; P = 0.48, OR 0.5, 95%CI 0.07-3.55) and with moxifloxacin yielded higher treatment success rates and a lower risk of AGR.

Cambios percibidos por personas con diversidad funcional motora adquirida en sus vidas cotidianas tras la obtención de perros de servicio / Changes perceived by people with acquired motor functional diversity in their daily lives after obtainment service dogs

El presente estudio surge del interés por analizar los cambios percibidos por personas con diversidad funcional motora adquirida en sus vidas cotidianas tras la adquisición de perros de servicio. La revisión de investigaciones internacionales sobre efectividad de la tenencia de estos animales, así como la revisión de las teorías del vínculo y de la biofilia proporcionan un primer acercamiento para comprender los posibles cambios. A partir de todo ello surge la pregunta: ¿Cómo perciben los cambios en sus vidas cotidianas las personas en estudio tras la obtención de perros de servicio otorgado por la corporación Bocalán Confiar? El estudio se visualiza desde el paradigma interpretativo y contempla la revisión teórica y fuentes directas a través de entrevistas semi-estructuradas, mediante las cuales se obtuvo una perspectiva personal acerca de la situación. Se analizaron los cambios desde nueve categorías: Actividades de la vida diaria, trabajo remunerado, tiempo libre, relaciones interpersonales, familia, accesibilidad, responsabilidad, seguridad y vínculo. Los hallazgos dejan en evidencia que la obtención del perro de servicio no sólo influye en independencia funcional, sino también en el ámbito emocional, social y familiar...

This study arises from the interest in analyzing the changes perceived by people with motor functional diversity acquired in their daily lives following the acquisition of service dogs. The revision of international research on effectiveness of tenure of these animals, as well as the revision of the theories on bonding and biophilia provides insight to understand the possible changes. From all this, the question arises: How do the people under study perceive the changes in their daily lives after obtaining service dogs by Bocalán Confiar Corporation? The study is visualized from the interpretive paradigm and provides the theoretical review and direct sources through semistructured interviews, by means of which a personal perspective on the situation was obtained. Changes were analyzed from nine categories: activities of daily living, paid work, free time, relationships, family, accessibility, accountability, security and link. Findings evidence that the obtainment of the service dog does not only influences functional independence, but also in the emotional, social and family field...

Determinación de la dureza total en agua con EDTA empleando una solución amortiguadora inodora de borato / Total hardness water determination by EDTA using a olorless buffer borate

La determinación de Dureza Total con EDTA en agua usando una solución amortiguadora de amonio pH 10 tiene la desventaja de generar vapores de gas amoníaco que suelen ser molestos o ser potencialmente dañinos para el sistema respiratorio del operario. El objetivo de este estudio fue utilizar una solución amortiguadora inodora de borato pH 10 en sustitución de una solución amortiguadora de amonio a pH 10 para la determinación de la dureza total en agua por la metodología de la norma COVENIN 2408-86 y determinar si existía diferencia estadísticamente significativa entre ambos procedimientos. Se determinó la Dureza Total usando la solución amortiguadora inodora de borato en 13 muestras de agua con diferentes grados de dureza (suave, dura y muy dura); los resultados obtenidos se compararon con los valores del procedimiento de referencia. La solución amortiguadora permitió una visualización rápida y definida del punto final durante la ejecución de la determinación volumétrica, los resultados mostraron que no existe diferencia estadísticamente significativa (p≤0,05) en los valores de dureza al emplear ambas soluciones amortiguadoras. Se concluyó que el empleo de la solución amortiguadora inodora de borato para la cuantificación de dureza total en agua es una alternativa a la solución amortiguadora de amonio.

Total Hardness determination EDTA in water using ammonium buffer solution pH 10 has the disadvantage of generating ammonia gas vapors are usually upset or be potentially harmful to the respiratory system operator. The aim of this study was to use a buffer solution pH 10 borate odorless replacing ammonium buffer solution at pH 10 for the determination of total water hardness in the methodology of COVENIN 2408-86 standard and determine whether there was difference statistically significant between the two procedures. Total Hardness was determined using borate buffer odorless in 13 water samples with different degrees of hardness (soft, hard and very hard); the results obtained were compared with the reference method values. The buffer allowed rapid and sharp display of the end point during the execution of the volumetric determination, the results showed that there was no statistically significant difference (p≤ 0,05) in hardness values by using two buffers. It was concluded that the use of borate buffer odorless for quantification of total hardness water is an alternative to the ammonium buffer.

Efectividad del cross tape y compresión isquémica en puntos gatillo miofasciales latentes en músculos epicondíleos laterales: ensayo clínico aleatorizado / Effectiveness of the cross tape and ischemic compression on latent myofascial trigger points in lateral epicondylar muscles: A randomized clinical trial

Objetivo: Comparar la eficacia entre las terapias de compresión isquémica (CI) y cross tape (CT) en secretarias con puntos gatillo miofasciales latentes (PGML) en músculos epicondíleos laterales. Material y método: Ensayo clínico aleatorizado. Participaron 14 secretarias (47,8 ± 4,1 años; peso 71,28 ± 6 kg; altura 1,57 ± 0,05 m). Se utilizó un algómetro para medir el umbral de presión doloroso (UPD), un dinamómetro para la fuerza de prensión (FP) y un goniómetro para el rango de movimiento (ROM) de flexión pasiva de la muñeca. Ambos grupos fueron evaluados en una sesión preintervención (S0) y 4 sesiones postintervención (S1, S2, S3, S4). El análisis estadístico fue realizado con ANOVA de medidas repetidas (un factor) y la prueba post hoc de Bonferroni, además de la prueba de la t de Student para comparar las terapias en cada sesión. Se consideró un riesgo alfa = 0,05. Resultados: Se observaron diferencias significativas entre terapias para el UPD en S2 (p = 0,034). La terapia CI determinó diferencias significativas entre S0 y S3 para el UPD (p = 0,04) y entre S0 y S4 para las variables; FP (p = 0,011); UPD (p = 0,006), y ROM de flexión pasiva de la muñeca (p = 0,032). Conclusiones: No se ha podido demostrar que el CT es superior a la CI en relación con el UPD, la FP y el ROM de flexión pasiva de la muñeca. La CI demostró ser más efectiva a corto plazo que el CT en relación con el UPD

Objective: To compare efficacy between ischemic compression (IC) and cross tape (CT) therapies in secretaries with latent myofascial trigger points (LMTP) in lateral epicondylar muscles. Material and method: A randomized clinical trial. Fourteen secretaries participated (average age = 47.8 ± 4.1 years; weight = 71.28 ± 6 kg; height = 1.57 ± 0.05 m). A pressure algometer was used to measure the pressure pain threshold (PPT), dynamometer for hand grip strength (GS) and a goniometer for passive range of motion (ROM) of wrist flexion. Both groups were evaluated in one pre-session intervention (S0) and four post-intervention sessions (S1, S2, S3, S4). The statistical analysis was performed with repeated-measures analysis of variance (RM-ANOVA) and post-hoc test Bonferroni as well as a Student's t test to compare the therapies in each session. An alpha risk of 0.05 was considered. Results: Significant differences between therapies were observed for the PPT in S2 (P = 0.034). The IC therapy determined significant differences between S0 - S3 for the PPT variable (p = 0.04) and between S0 - S4 for GS (P = 0.011), PPT (P = 0.006) and ROM variables (P = 0.032). Conclusions: It was not possible to demonstrate that CT is superior to IC in relation to the PPT, GS and passive ROM of wrist flexion. CI proved to be more effective in the short-term than CT in relation the PPT

Correlación entre el control postural y neuromuscular con cuestionarios de percepción funcional en deportistas con inestabilidad de tobillo / Correlation between postural and neuromuscular control with functional perception questionnaires in athletes with ankle instability

Objetivo: Determinar la correlación entre evaluaciones del control postural y neuromuscular con cuestionarios de percepción subjetiva en deportistas con inestabilidad funcional de tobillo. Material y método: Estudio descriptivo con un diseño correlacional. Participaron 10 deportistas de género masculino. El control postural fue medido a partir del desplazamiento del centro de presión (COP) en direcciones medio-lateral (ML) y antero-posterior (AP), obteniendo las siguientes variables: área, variabilidad ML, variabilidad AP, velocidad ML y velocidad AP. Se evaluó en bipodal y unipodal con ojos abiertos (OA) y ojos cerrados (OC). El tiempo de reacción de los músculos peroneus longus (PL), peroneus brevis (PB) y tibialis anterior (TA) se registró durante una prueba de inversión repentina de tobillo. Se aplicaron 2 cuestionarios de percepción funcional de tobillos: AJFAT y CAIS. El análisis estadístico que se realizó fue la prueba de Pearson, con un nivel de significación de 0,05. Resultados: Existe correlación negativa moderada del músculo PL con el cuestionario AJFAT (r = -0,64; p = 0,049) y también con el cuestionario CAIS (r = -0,65; p = 0,044). Se observan correlaciones negativas fuertes existentes entre el cuestionario AJFAT y área del COP en OC y unipodal (r = -0,75; p = 0,013), y entre el cuestionario CAIS y velocidad ML del COP en OC y unipodal (r = -072; p = 0,019). Conclusiones: El uso de los cuestionarios aplicados en este estudio podrían ser útiles para evaluar las imitaciones funcionales de los sujetos que presenten inestabilidad funcional de tobillo, favoreciendo el abordaje fisioterapéutico de estos pacientes

Objective: To determine the correlation between postural and neuromuscular control assessments and questionnaires of subjective perception in athletes with functional ankle instability. Material and methods: A descriptive study with a correlational design was performed. Ten male athletes participated. Postural control was measured from the displacement of the center of pressure (COP) in the medio-lateral (ML) and anteroposterior (AP) directions. The following variables were obtained: area, ML variability, AP variability, ML velocity and AP velocity. Bipodal and unipodal measurements with opened eyes (OE) and closed eyes (CE) were made. Muscle reaction time of peroneus longus (PL), peroneus brevis (PB) and tibialis anterior (TA) was recorded with surface electromyography in sudden ankle inversion test. Functional ankle perception questionnaires were administered: AJFAT and CAIS. The statistical analysis was performed with the Pearson Test. Significance level was established a priori at P < 0.05. Results: There was a moderate negative correlation between AJFAT with PL muscle (r = -0.64, P = 0.049) and with the CAIS and PL muscle (r = -0.65, P = 0.044). Strong negative correlations were observed between the AJFAT questionnaire and COP area in unipodal EC (r = -0.75, P = 0.013) and between the CAIS questionnaire and COP velocity ML in and unipodal EC (r = -072, P = 0.019). Conclusions: The use of questionnaires applied in this study could be useful in assessing the functional limitations of patients with functional ankle instability, favoring the physiotherapy approach to these patients

Pro-inflammatory caspase-1 activation during the immune response in cells from rainbow trout Oncorhynchus mykiss (Walbaum 1792) challenged with pathogen-associated molecular patterns.

In response to pathogens, the higher vertebrate innate immune system activates pro-inflammatory caspase-1 which is responsible for the processing and secretion of several important cytokines involved in the host's defence against infection. To date, caspase-1 has been described in few teleost fish, and its activity has been demonstrated through substrate cleavage and inhibition by pharmacological agents. In this study, the detection of the active form of caspase-1 during the immune response in salmonid fish is described, where two antibodies were produced. These antibodies differentially recognize the structural epitopes of the inactive pro-caspase-1 and the processed active form of the caspase. Firstly, caspase-1 activation was demonstrated in vitro by ELISA, Western blotting and immunocytochemistry in rainbow trout macrophages exposed to different pathogen-associated molecular patterns plus the pathogen Aeromonas hydrophila. This activity was clearly abrogated by a caspase inhibitor and seems to be unrelated to IL-1ß secretion. Caspase-1 activation was then validated in vivo in gill cells from fish challenged with Aeromonas salmonicida. These results represent the first demonstration of caspase-1 activation in salmonids, and the first evidence of the putative regulatory role which this protease plays in inflammatory response in this fish group, as described for some other teleosts and mammals.

Efectos del kinesio tape en la rehabilitación de pacientes con síndrome de dolor patelofemoral: una revisión sistemática / Effects of kinesio tape in rehabilitation of patients with patellofemoral pain syndrome: A systematic review

Objetivo: Evaluar los efectos del kinesio tape en la rehabilitación de pacientes con síndrome de dolor patelofemoral. Estrategia de búsqueda: Se realizó una búsqueda bibliográfica en las bases de datos Cochrane Bone, Joint and Muscle Trauma Group, Cochrane Central Register of Controlled Trials, CINAHL, Biomed Central, Lippincott, Williams & Wilkins, MEDLINE/Pubmed, Pubmed Central, SAGE publications, Springer, Science Direct, Wiley-Blackwell, e IOS Press, desde el 1 de enero de 1995 hasta el 12 de mayo del 2012. Selección de estudios: Se seleccionaron 6 artículos. Los estudios fueron evaluados a través de la escala PEDro. Síntesis de los resultados: El promedio de calidad de los estudios fue 4 (calidad baja) y el número total de participantes fue 111 sujetos (107 mujeres y 4 hombres). Solo un estudio de calidad baja señala que el kinesio tape, en menor tiempo, disminuye la tensión de isquiotibiales y aumenta la longitud del complejo banda iliotibial/tensor de la comparado con un grupo de ejercicios. No se observaron diferencias significativas al comparar el kinesio tape frente a otras intervenciones (ejercicio, electroestimulación más ejercicios, kinesio tape placebo y tape McConnell). El kinesio tape, al ser analizado pre y postratamiento, ejerce diferencias significativas en las variables: dolor, funcionalidad, rango articular, flexibilidad de tejidos blandos, sensación de posición articular, balance, fuerza y activación muscular. Conclusión: El kinesio tape no tiene suficiente evidencia clínica de calidad que respalde sus múltiples aplicaciones en pacientes con síndrome de dolor patelofemoral

Objective: To assess the effects of kinesio tape in rehabilitation of patients with patellofemoral pain syndrome. Search strategy: Bibliographic was searched in the following databases: Cochrane Bone, Joint and Muscle Trauma Group, Cochrane Central Register of Controlled Trials, CINAHL, Biomed Central, Lippincott, Williams & Wilkins, MEDLINE/Pubmed, Pubmed Central, SAGE publications, Springer, Science Direct, Wiley-Blackwell and IOS Press from January 1 1995 to May 12, 2012. Study selection: Six articles that met the inclusion criteria were selected. Validity of the articles were evaluated according to criteria PEDro. Summary of results: Average quality of the studies was 4 (low quality) A total of 111 patients were included in the reviews (107 women and 4 men). Only one low quality study indicated that the kinesio tape, used in less time, decreases hamstring tension and increases length of the complex Iliotibial band/tensor fascia lata compared to the exercise group. No significant differences were observed when comparing the kinesio tape versus other intervention (exercise, electrostimulation more exercises, placebo kinesio tape and tape McConnell). When the kinesio tape was analyzed pre- and post- treatment, significant differences were seen in the variables: pain, functionality, join range, flexibility of soft tissues, joint position sense, balance, strength and muscle activation. Conclusion There is not sufficient evidence of quality regarding Kinesio tape to support its many applications in patients with patellofemoral pain syndrome

Signos de alarma en proctocolitis eosinofílica: reporte de dos casos / Warning Signs for Eosinophilic Proctocolitis: Two Case Reports

Se presentan dos pacientes con un diagnóstico de proctocolitis eosinofílica sin persistencia de la manifestación más típica, la rectorragia, aunque con perseverancia de su compromiso inflamatorio eosinofílico. A propósito de estos casos, se señala la importancia de evaluar otras manifestaciones menos relevantes como parte del seguimiento estricto de los pacientes, con el fin de decidir si necesitan colonoscopia y biopsias, así como de reorientar el manejo mediconutricional.

We present the cases of two patients diagnosed with eosinophilic proctocolitis without persistence of rectal bleeding which is the most typical manifestation but with perseverance of the eosinophilic inflammation. One purpose of presenting these cases is to emphasize the importance of assessing less relevant demonstrations as part of the strict monitoring of patients in order to decide whether they need colonoscopy and biopsies and to allow redirection of medical nutrition management.

Expression, functionality, and localization of apurinic/apyrimidinic endonucleases in replicative and non-replicative forms of Trypanosoma cruzi.

Trypanosoma cruzi is the etiological agent of Chagas disease. The parasite has to overcome oxidative damage by ROS/RNS all along its life cycle to survive and to establish a chronic infection. We propose that T. cruzi is able to survive, among other mechanisms of detoxification, by repair of its damaged DNA through activation of the DNA base excision repair (BER) pathway. BER is highly conserved in eukaryotes with apurinic/apirimidinic endonucleases (APEs) playing a fundamental role. Previous results showed that T. cruzi exposed to hydrogen peroxide and peroxinitrite significantly decreases its viability when co-incubated with methoxyamine, an AP endonuclease inhibitor. In this work the localization, expression and functionality of two T. cruzi APEs (TcAP1, Homo sapiens APE1 orthologous and TcAP2, orthologous to Homo sapiens APE2 and to Schizosaccaromyces pombe Apn2p) were determined. These enzymes are present and active in the two replicative parasite forms (epimastigotes and amastigotes) as well as in the non-replicative, infective trypomastigotes. TcAP1 and TcAP2 are located in the nucleus of epimastigotes and their expression is constitutive. Epimastigote AP endonucleases as well as recombinant TcAP1 and TcAP2 are inhibited by methoxyamine. Overexpression of TcAP1 increases epimastigotes viability when they are exposed to acute ROS/RNS attack. This protective effect is more evident when parasites are submitted to persistent ROS/RNS exposition, mimicking nature conditions. Our results confirm that the BER pathway is involved in T. cruzi resistance to DNA oxidative damage and points to the participation of DNA AP endonucleases in parasite survival.