In Vivo Efficacy of Purified Quillaja Saponin Extracts in Protecting against Piscirickettsia salmonis Infections in Atlantic Salmon (Salmo salar).

Piscirickettsiosis, the main infectious disease affecting salmon farming in Chile, still has no efficient control measures. Piscirickettsia salmonis is a facultative intracellular bacterium that can survive and replicate within the host macrophages, evading the immune response. Triterpenic saponins obtained from the Quillaja saponaria tree have been widely studied, and have been shown to be immunomodulatory agents, suitable for feed and vaccine applications for veterinary and human uses. The impact of the oral administration of two extracts of Quillaja saponins on the infection of P. salmonis in Salmo salar and the corresponding gene expressions of immunomarkers were studied under three in vivo models. In the intraperitoneal challenge model, the group fed with Quillaja extracts showed lower mortality (29.1% treated vs. 37.5% control). Similar results were obtained in the cohabitation model trial (36.3% vs. 60.0%). In the commercial pilot trial, the results showed a significant reduction of 71.3% in mortality caused by P. salmonis (0.51% vs. 1.78%) and antibiotic use (reduction of 66.6% compared to untreated control). Also, Quillaja extracts significantly modulated the expression of IFN-II and CD8. These results represent evidence supporting the future use of purified Quillaja extracts as a natural non-pharmacological strategy for the prevention and control of P. salmonis infections in salmon.

Razonamiento clínico en carreras de la salud: percepción de estudiantes y docentes / The perception of teachers and students about clinical reasoning in health care careers

BACKGROUND: Clinical reasoning (CR) is a training mainstay in health care careers. AIM: To describe the perception of students and teachers about the development of clinical CR in Kinesiology and Dentistry careers. MATERIAL AND METHODS: Exploratory descriptive qualitative study, with 12 informants (six teachers and six students), applying a script of questions through a semi-structured interview. A thematic inductive data analysis was carried out. RESULTS: Two hundred thirty-five meaning units, 38 codes, seven subcategories and three categories were collected. CR was reported as a basic analysis process in health care training. Its necessary elements are knowledge, a learning environment and a facilitator teacher, among others. Motivation, analysis models, variability and exposure are reported as facilitating factors for the development of CR. Teacher paternalism, resistance to change and few learning opportunities are presented as obstacles. Active strategies such as clinical cases, simulation and clinical practice are perceived as facilitators for the development of CR. Those situations where the student does not assume a leading role such as lectures and activities in large groups, are considered as obstacles. CONCLUSIONS: Both students and teachers point to CR as an analysis process that is indispensable in both careers. Exposure to variable educational experiences through active educational strategies in small groups encourages CR.

Gestión, estrategias y adecuaciones educativas implementadas para una estudiante con discapacidad visual completa en la carrera de Kinesiología de la Universidad Austral de Chile: análisis de un caso / Management, strategies and educational adequations implemented for an undergraduate Kinesiology student with total visual disability of the Universidad Austral de Chile: analysis of a case

Introducción: La inclusión educativa es un desafío en la gestión del currículo de las instituciones de educación superior.Material y métodos.Informe de caso de una estudiante de Kinesiología con discapacidad visual que describe la gestión, las estrategias y las adecuaciones educativas implementadas.Resultados.Existió una variedad de adecuaciones educativas impulsadas por la gestión institucional. Deben implementarse actividades extraacadémicas y el quehacer autónomo.Conclusión.La gestión y las adecuaciones educativas permitieron, en gran medida, la participación de la estudiante en el proceso formativo universitario. (AU)

Introduction: Educational inclusion is a challenge in the management of the curriculum of higher education institution.Material and methods.Case report of a Kinesiology student with visual impairment that describes management, strategies and educational adjustments.Results.There was a variety of educational adjustments driven by institutional management. Extracurricular activities and autonomous work must be implemented.Conclusion.The management and educational adjustments greatly allowed the participation of the student in the university training process. (AU)

[The perception of teachers and students about clinical reasoning in health care careers]. / Razonamiento clínico en carreras de la salud: percepción de estudiantes y docentes.

BACKGROUND: Clinical reasoning (CR) is a training mainstay in health care careers. AIM: To describe the perception of students and teachers about the development of clinical CR in Kinesiology and Dentistry careers. MATERIAL AND METHODS: Exploratory descriptive qualitative study, with 12 informants (six teachers and six students), applying a script of questions through a semi-structured interview. A thematic inductive data analysis was carried out. RESULTS: Two hundred thirty-five meaning units, 38 codes, seven subcategories and three categories were collected. CR was reported as a basic analysis process in health care training. Its necessary elements are knowledge, a learning environment and a facilitator teacher, among others. Motivation, analysis models, variability and exposure are reported as facilitating factors for the development of CR. Teacher paternalism, resistance to change and few learning opportunities are presented as obstacles. Active strategies such as clinical cases, simulation and clinical practice are perceived as facilitators for the development of CR. Those situations where the student does not assume a leading role such as lectures and activities in large groups, are considered as obstacles. CONCLUSIONS: Both students and teachers point to CR as an analysis process that is indispensable in both careers. Exposure to variable educational experiences through active educational strategies in small groups encourages CR.

Antibacterial Activity of Photocatalytic Metal Oxide Thin Films Deposited by Layer-by-Layer Self-Assembly.

This paper reports the use of the Layer-by-Layer self-assembly (LbL) as an efficient technique for the fabrication of thin-films with antibacterial activity. The LbL coatings are composed of a positive polyelectrolyte such as Poly(allylamine hydrochloride) (PAH) and an anionic polyelectrolyte such as Poly(sodium 4-styrene sulfonate) solution (PSS). In addition, these polyelectrolytes can be also used as an adequate encapsulating agent of specific metal oxide precursors such as titanium dioxide (TiO2) and iron oxide (Fe2O3) nanoparticles, making possible the fabrication of hybrid thin films composed of organic polymeric chains related to the polyelectrolytes and inorganic structure associated to the metal oxide nanoparticles. Four different LbL coatings have been fabricated and a comparative study about the resultant topographical, optical and wettability properties is presented by using light interferometry, atomic force microscopy (AFM), UV-Vis spectroscopy and water contact angle (WCA) measurements. In addition, X-ray fluorescence (XRF) has been also employed in order to corroborate the presence of metal oxide precursors inside the polymeric chains of the polyelectrolytes. Finally, the antibacterial tests have demonstrated that LbL coatings composed of metal oxide nanoparticles produce an enhancement in the efficacy and antibacterial activity.

Quillaja saponaria (Molina) Extracts Inhibits In Vitro Piscirickettsia salmonis Infections.

P. salmonis infections are the cause of major bacterial disease in salmonids in Chile, and the reason for using more antibiotics compared to other salmon-producing countries. Vaccination and antibiotics have not been efficient and new approaches are needed. The safety of Quillaja saponaria extracts was measured by cytotoxicity using flow cytometry of cytopathic and death of fish cell cultures and efficacy was assessed using in vitro infection models with pathogenic P. salmonis. Cytotoxicity was low and control of in vitro infections was achieved with all products, with protection of over 90%. Minimum inhibitory concentrations were much higher than those in the infection using cell cultures. These results suggest a dual mechanism of action where less purified extracts with a combination of saponin and non-saponin components simultaneously decrease P. salmonis infection while protecting cell lines, rather than exerting a direct antimicrobial effect. Quillaja saponins controlled in vitro infections with P. salmonis and could be considered good candidates for a new, safe and sustainable method of controlling fish bacterial infectious diseases.

Angiomixoma pélvico asociado a endometriosis infiltrativa profunda: reporte de un caso / Pelvic angiomyxoma associated to deep infiltrative endometriosis: case report

El angiomixoma de la pelvis es un tumor mesenquimal inusual; que dado su alto potencial de recidiva es relevante que la exéresis quirúrgica sea lo más radical posible. Por su parte, la endometriosis infiltrativa profunda, es otra entidad poco frecuente que requiere de tratamientos complejos. La co-existencia de ambas patologías representa una situación absolutamente infrecuente; de los que hay muy pocos casos reportado en la literatura occidental. Se presenta el caso de una mujer de 41 años de edad que desarrolló ambas entidades nosológicas de forma concomitante y que fue tratada quirúrgicamente con buenos resultados.

Angiomyxoma of the pelvis is an unusual mesenchymal tumor; that given its high potential for recurrence, it is relevant that the surgical resection be as radical as possible. For its part, to deep infiltrative endometriosis is another rare entity that requires complex treatments. The co-existence of both pathologies represents an absolutely infrequent situation; of which there are very few cases reported in western literature. We present the case of a 41-year-old woman who developed both clinical entities concomitantly and who was treated surgically with good results.

[Effects of a six weeks exercise training program for type 2 diabetes mellitus and hypertensive patients]. / Ejercicio físico en pacientes con diabetes e hipertensión: prevalencia de respondedores y no respondedores para mejorar factores de riesgo cardiometabólicos.

BACKGROUND: There is a wide interindividual variability in the response to a period of exercise training. The science have reported that a minimum of participants could be non-responders for improving different health-related outcomes after training. AIM: To compare the effects of a 6-weeks exercise program on body composition, cardiovascular and metabolic outcomes patients with type 2 diabetes and hypertension. MATERIAL AND METHODS: Data from 23 trained subjects were used in a secondary analysis of the response to exercise. Of these, 14 were considered adherent to training and nine as non-adherent. Body mass, height, waist circumference, four skinfolds and their sum, blood pressure and plasma triglyceride levels were assessed before and after the training period. RESULTS: Among adherent participants, significant reductions were observed in the sum of four skinfolds (30 ± 7 to 27 ± 6 mm, p ≤ 0.05), systolic blood pressure (133 ± 18 to 127 ± 20 mmHg; p ≤ 0.05) and plasma triglycerides (125 ± 58 to 102 ± 34 mg/dL; p ≤ 0.05). No changes were observed in weight or diastolic blood pressure. Among non-adherent participants, no changes of measured parameters were observed. Among adherent participants, 57% were considered as non-responders for waist circumference, 7% for the sum of skinfold thickness, 50% for systolic blood pressure, 64% for diastolic blood pressure and 57% for plasma triglycerides. CONCLUSIONS: Participants with a good adherence to a 6-weeks exercise training program experienced overall improvement in body composition, blood pressure and plasma triglycerides. The prevalence of non-responders varied considerably among measured outcomes.

Ejercicio físico en pacientes con diabetes e hipertensión: prevalencia de respondedores y no respondedores para mejorar factores de riesgo cardiometabólicos / Effects of a six weeks exercise training program for type 2 diabetes mellitus and hypertensive patients

Background: There is a wide interindividual variability in the response to a period of exercise training. The science have reported that a minimum of participants could be non-responders for improving different health-related outcomes after training. Aim: To compare the effects of a 6-weeks exercise program on body composition, cardiovascular and metabolic outcomes patients with type 2 diabetes and hypertension. Material and Methods: Data from 23 trained subjects were used in a secondary analysis of the response to exercise. Of these, 14 were considered adherent to training and nine as non-adherent. Body mass, height, waist circumference, four skinfolds and their sum, blood pressure and plasma triglyceride levels were assessed before and after the training period. Results: Among adherent participants, significant reductions were observed in the sum of four skinfolds (30 ± 7 to 27 ± 6 mm, p ≤ 0.05), systolic blood pressure (133 ± 18 to 127 ± 20 mmHg; p ≤ 0.05) and plasma triglycerides (125 ± 58 to 102 ± 34 mg/dL; p ≤ 0.05). No changes were observed in weight or diastolic blood pressure. Among non-adherent participants, no changes of measured parameters were observed. Among adherent participants, 57% were considered as non-responders for waist circumference, 7% for the sum of skinfold thickness, 50% for systolic blood pressure, 64% for diastolic blood pressure and 57% for plasma triglycerides. Conclusions: Participants with a good adherence to a 6-weeks exercise training program experienced overall improvement in body composition, blood pressure and plasma triglycerides. The prevalence of non-responders varied considerably among measured outcomes.

A comparison of the effectiveness and time efficiency of traditional and photographic environmental monitoring techniques.

Photographic methods of environmental monitoring have grown in popularity and now represent one of the main ways in which habitat and biodiversity are monitored for change through time. However, efficacy and efficiency of this technique compared with traditional approaches to environmental monitoring (direct count or observation) are lacking. This study compares the results and time-efficiency of manual versus photographic monitoring of floral abundance in low-growing flowering plants in a relatively open herbfield. Specifically, we compared 1) manual flower counting of individual plants for four species, followed by data entry in the laboratory, with 2) taking photographic images of each plant and quantifying flower counts in the laboratory. Photographic monitoring underestimated flower counts by an average of 7.5%. Manual counting was more time consuming in the field, but less time consuming in post-processing than photographic monitoring. Overall, photographic monitoring took almost twice as long as manual counting (81.5% longer in duration), which was attributed to the much longer post-processing associated with photographic monitoring. This suggests that perhaps the main benefit of photographic monitoring is a permanent record of the sampling frame rather than any cost savings or enhanced data accuracy, at least in the systems investigated in this study.

High genetic diversity of species A rotaviruses detected in swine farms in Chile.

Rotavirus A is one of the main causative agents of diarrhoea in lactating and weaned pigs worldwide. Its impact in the swine industry is well documented. However, in Chile, the current epidemiological status of rotavirus on porcine farms is unknown. This study evaluated the current epidemiologic status of rotavirus A infection in Chile using on-farm detection techniques, electrophoretic confirmation, genotyping and phylogenetic clustering by analysis of partial sequences of VP4 and VP7 genes. Rotavirus A was detected in four out of five farms with an overall prevalence of 17.7 % in diarrhoeic pigs. The average age of diarrhoea onset was at 32±6.2 days, corresponding to weaning pigs, and rotavirus was not detected in lactating piglets. Molecular characterization indicated that genotypes G5, G3, P[7] and P[13] are currently the most widely represented on these pigs farms. The phylogenetic analysis showed that farms shared similar G types (VP7), which might denote a common origin. Meanwhile, [P] types (VP4) showed considerable genetic diversity, and this might represent a high rate of reassortment of this genetic segment in rotavirus circulating in the researched area. These findings demonstrate the importance of considering both the geographical and production factors to accurately determine rotavirus prevalence status at the national level, and have relevant implications in determining effective strategies for rotavirus infection control on porcine farms.

Impulse source versus dodecahedral loudspeaker for measuring parameters derived from the impulse response in room acoustics.

This study investigates the performance of dodecahedral and impulse sources when measuring acoustic parameters in enclosures according to ISO 3382-1 [Acoustics-Measurement of room acoustic parameters. Part 1: Performance spaces (International Organization for Standardization, Geneva, Switzerland, 2009)]. In general, methods using speakers as a sound source are limited by their frequency response and directivity. On the other hand, getting impulse responses from impulse sources typically involves a lack of repeatability, and it is usually necessary to average several measurements for each position. Through experiments in different auditoriums that recreate typical situations in which the measurement standard is applied, it is found that using impulse sources leads to greater variation in the results, especially at low frequencies. However, this prevents subsequent dispersions due to variables that this technique does not require, such as the orientation of the emitting source. These dispersions may be relevant at high frequencies exceeding the established tolerance criteria for certain parameters. Finally, a new descriptor for dodecahedral sources reflecting the influence their lack of omnidirectionality produces on measuring acoustic parameters is proposed.

Kinetics of the bio-oxidation of volatile reduced sulphur compounds in a biotrickling filter.

Mixtures of volatile reduced sulphur compounds (VRSCs) like hydrogen sulphide (H(2)S), methylmercaptan (MM), dimethyl sulphide (DMS) and dimethyl disulphide (DMDS) are found in gaseous emissions of several industrial activities creating nuisance in the surroundings. Hydrogen sulphide (H(2)S) decreases the removal efficiency of volatile reduced sulphur compounds (VRSCs) in biofilters but the kinetics of this effect is still unknown. Kinetic expressions that represent the rate of bio-oxidation of H(2)S, MM, DMS and DMDS are proposed. In order to observe and quantify this effect, equimolar mixtures of MM, DMS and DMDS were fed into a biotrickling filter inoculated with Thiobacillus thioparus at different H(2)S loads. Experimental results shown a good agreement with the simulations generated by the model considering the kinetic equations proposed. The estimated kinetic constants show that H(2)S and MM have a significant inhibitory effect on the bio-oxidation of DMS and DMDS, having the H(2)S the higher effect.

Oxidation of volatile reduced sulphur compounds in biotrickling filter inoculated with Thiobacillus thioparus

Reduced volatile sulphur compounds generate an impact on the environment, because of the bad smell and its low odour threshold. Compared with the existing physicochemical technologies for their elimination, biotrickling filters are an economically and environmentally sustainable alternative. Usually mixed cultures of microorganisms are used for inoculating biotrickling filters, in this case a pure culture of Thiobacillus thioparus is used for generating a biofilm, allowing to measure its capacity for the oxidation of four volatile reduced sulphur compounds: hydrogen sulphide, dimethyl sulphide, methyl mercaptan and dimethyl disulphide, using a residence time of 0.033 hrs. The viable cells of the biofilm were quantified by epifluorescence microscopy, staining the cells with ethidium bromide and acridine orange, polymerase chain reaction analysis in real time was used for testing the predominance of T. thiopharus in the biofilm. The microorganism was able to adhere and grow on the surface of rings made of polyethylene, with a viable population of 7•10(7) cell•ring-1, a 74 percent of total cells. The real time PCR showed a persistence of the population of T. thioparus for more than 300 days of operation, without being displaced by other microbial species. The maximum elimination capacities for each compound were 34.4; 21.8; 30.8 and 25.6 gS•m-3•h-1 for H2S, dimethylsulphide, dimethyldisulphide and methyl mercaptan, respectively. We conclude that it is possible to implement a biotrickling filter with the bacteria T. thioparus, which can oxidize volatile reduced sulphur compounds efficiently.

Uncertainties caused by source directivity in room-acoustic investigations.

Although deviations in the measurement of acoustic parameters should be lower than the subjectively perceivable change in the corresponding parameter measured, this study reflects that directionality of sound sources could cause wide audience areas to break away from this criterion at high frequencies, even when using dodecahedron loudspeakers which meet the requirements of the ISO 3382 standard. The directivity of four different acoustic sources was measured and the influence of its accurate orientation spatially quantified in five enclosures for speech and music. By means of simulation software, the number of receivers affected by uncertainties greater than difference limens was established.

Cáncer temprano de la vesícula biliar / Early gallbladder cancer

El objetivo de este trabajo es analizar las características clínicas y el pronóstico de una serie de pacientes portadores de un cáncer temprano de la vesícula biliar. El cáncer temprano de la vesícula se define como aquél en que la invasión en la pared de la vesícula no invade más allá de la túnica muscular. Desde 1989 hasta 1996, 52 pacientes portadores de un cáncer temprano de la vesícula fueron atendidos en nuestro hospital. 28 tenían invasión neoplásica restringida a la mucosa o in situ y en 24 pacientes la invasión alcanzaba la túnica muscular. La totalidad de los pacientes fueron sometidos a una colecistectomía como primera intervención. De estos, en sólo 2 el diagnóstico fue sospechado previo a la colecistectomía mientras que durante el post operatorio el diagnóstico fue sospechado sólo en 3 casos. En los restantes pacientes el diagnóstico sólo fue posible posterior al examen de la pieza de colecistectomía. El análisis del tipo macroscópico de estos pacientes mostró que la mayoría de ellos eran de tipo plano e inaparentes. De los pacientes portadores de un tumor muscular, 10 fueron sometidos a una reintervención con el fín de practicar cirugía oncológica (cuña hepática + linfadenectomía locorregional). Tumor residual fue observado en sólo uno de estos pacientes. El seguimiento de los pacientes fluctúa entre 1 y 100 meses con un mediana de 43. Del total de pacientes, 2 con un tumor con invasión de la túnica muscular fallecieron luego de 11 y 19 meses de seguimiento respectivamente. No hubo pacientes fallecidos entre aquellos con invasión in situ o de la túnica mucosa. Como conclusión de este trabajo podemos decir que el cáncer temprano de la vesícula constituye un tipo de tumor asociado a buen pronóstico, generalmente detectado como consecuencia del estudio anatomopatológico de la pieza de colecistectomía. En relación a su tratramiento, la colecistectomía constituye un método terapéutico adecuado para el manejo de este tipo de tumores

Trasplante renal de donante vivo: reporte de 10 casos / Renal transplantation of alive donor: report of 10 cases

Se reportan los diez primeros Trasplantes Renales de Donante Vivo relacionado realizados en el Hospital Regional del IESS. Los resultados en general han sido alentadores porque hay una sobrevida del injerto excelente con muy pocas complicaciones, de las cuales la que más se ha visto en la necrosis tubular aguda, que ha obligado a reconsiderar las ténicas de preservación con lo que se ha mejorado en forma evidente el inicio de la diuresis y por lo tanto al función renal. El trasplante renal ha pasado su largo período experimental para convertirse en un procedimiento terapéutico aceptado en todo el mundo, como la vía más lógica para resolver el problema de la Insuficiencia Renal Crónica, porque no solamente se le ofrece al paciente una mejor espectación de vida, sino que la calidad de la misma es notablemente de la sociedad. Por otra parte las dificultades para los procedimientos de Diálisis por alto costo, y porque en países como el nuestro en el que no se fabrican los materiales y hay dificultade para las importaciones, hace que el trasplante renal sea el procedimiento de elección. Una consideración que reafirma su importancia es el hecho que en 1965 el promedio de vida del trasplnatado a un año era cero%, y ahora se obtienen promdeios de vida con riñones de donante vivo de 95% y los provenientes de cadáveres con sobrevida de 90% al año. (1)(2)(3). El trasplante es factible gracias a los trabajos pioneros de Alexis Carrel, Voranoy de Ucrania, David Hume fallecidos prematuramente en 1973, Jean Dausset quien descubrió el primer antígeno de histocompatibilidad, a Hamburger en París, Merril de Boston y recientemente a Salbatierra, Najarian y Starzl en U.S.A.; y en Brasil a E. Sabbaga. En nuestro medio ha tenido importante retraso en su masificación, a pesar de que el primero que se realizó en el Hospital de Solca se lo hizo el año 1963, sin embargo al año 1988 no se realizan más de 12 trasplantes por año en los ocho Centros que hai en el país. Nosotros en esta oportunidad presentamos los 10 primeros casos realizados en el personal de médicos que trabajan en este Hospital y que además pertenecen a la Facultad de Ciencias Médicas de la Universidad de Guayaquil