Factores relacionados con el éxito en la protetización de amputados de extremidad inferior de etiología vascular / Factors related to success in the prosthetic fitting of lower limb amputees from vascular etiology

Objetivos: Recuperar la capacidad de deambulación con prótesis en los amputados de extremidad inferior es fundamental para mejorar su independencia funcional. El objetivo de este trabajo ha sido conocer qué factores intervienen en conseguir la protetización de pacientes amputados vasculares. Material y método: Estudio longitudinal observacional de los pacientes con amputación mayor de extremidad inferior de etiología vascular realizada desde el 1 de abril de 2017 hasta el 1 de abril de 2020. Se compararon las siguientes variables entre los pacientes que fueron protetizados y los que no: edad, sexo, índice de masa corporal, comorbilidades (escala de Charlson), independencia en las actividades de la vida diaria básicas (índice de Barthel) y capacidad de marcha (FAC) previas y al año de la amputación. La utilización de la prótesis al año se midió con el instrumento de Houghton. Resultados: Fueron amputados 80 pacientes con una edad media de 70,5 años, el 78,8% eran varones. El nivel de amputación fue supracondíleo en 42 pacientes y en 38 infracondíleo; se protetizaron 35. Las variables relacionadas con la posibilidad de protetización fueron la menor edad (p=0,020), presentar menos comorbilidad (p=0,00), la amputación infracondílea (p=0,024) y tener una mayor independencia funcional y de marcha previas a la amputación (p=0,00). Al año habían fallecido 22 pacientes, solo uno de los que fueron protetizados. Conclusión: Aunque no existen unas recomendaciones claras para determinar qué amputado ha de ser protetizado, en nuestros pacientes, tener menos comorbilidades, una buena situación funcional previa, menor edad y un nivel de amputación infracondíleo se relacionaron con un mayor éxito en conseguir dicho objetivo.(AU)

Objective: Restoring the ambulation ability with prostheses in lower limb amputeesis essential to improve their functional independence. The aim of this study was to determine the factors involved in achieving prosthesis fitting in vascular amputees. Material and method: Observational longitudinal study of patients with major lower limb amputation of vascular etiology performed from April 1st 2017 to April 1st 2020. The following variables were compared between the group of patients who were prosthetized and those who were not: age, gender, body-mass index, comorbidity (Charlson index), independence in the activities of daily living (Barthel index) and ambulation ability (FAC test) before and a year after the amputation. The prosthetic use after a year was measured with the Houghton scale. Results: A total of 80 patients were amputated with a mean age of 70.5 years old, 78.8% were male. The amputation level was supracondilealin 42 patients and infracondilealin 38 patients. The number of prosthetized patients was 35. The variables related to the possibility of prosthesis fitting were: younger age (P=0.020), less comorbidity (P=0.000), infracondileal amputation (P=0.024) and greater functional independence and ambulation ability prior to amputation (P=0.000). After a year 22 patients had died, only one of those who had been prosthetized. Conclusions: Although there are no clear recommendations to determine which amputees should be prosthetic fitting, in our patients the presence of fewer comorbidities and a good previous functional situation, younger age and infracondileal amputation, are related to greater success in achieving this objective.(AU)

[Factors related to success in the prosthetic fitting of lower limb amputees from vascular etiology]. / Factores relacionados con el éxito en la protetización de amputados de extremidad inferior de etiología vascular.

OBJECTIVE: Restoring the ambulation ability with prostheses in lower limb amputeesis essential to improve their functional independence. The aim of this study was to determine the factors involved in achieving prosthesis fitting in vascular amputees. MATERIAL AND METHOD: Observational longitudinal study of patients with major lower limb amputation of vascular etiology performed from April 1st 2017 to April 1st 2020. The following variables were compared between the group of patients who were prosthetized and those who were not: age, gender, body-mass index, comorbidity (Charlson index), independence in the activities of daily living (Barthel index) and ambulation ability (FAC test) before and a year after the amputation. The prosthetic use after a year was measured with the Houghton scale. RESULTS: A total of 80 patients were amputated with a mean age of 70.5 years old, 78.8% were male. The amputation level was supracondilealin 42 patients and infracondilealin 38 patients. The number of prosthetized patients was 35. The variables related to the possibility of prosthesis fitting were: younger age (P=0.020), less comorbidity (P=0.000), infracondileal amputation (P=0.024) and greater functional independence and ambulation ability prior to amputation (P=0.000). After a year 22 patients had died, only one of those who had been prosthetized. CONCLUSIONS: Although there are no clear recommendations to determine which amputees should be prosthetic fitting, in our patients the presence of fewer comorbidities and a good previous functional situation, younger age and infracondileal amputation, are related to greater success in achieving this objective.

Frailty and kidney transplant candidates.

Frailty is a concept that has been mainly developed in geriatrics and it came from the need of identifying subjects at risk to develop complications when they faced a stressful event. Frail patients have higher risk of mortality, poor outcomes and disability, and this is independent from their age or comorbidities. Chronic kidney disease patients present with high prevalence of frailty, especially those who are in renal replacement therapy. Frail or pre-frail patients on the kidney transplant waiting list represent 20-30%, and these patients are proven to have poorer results after the transplant, which is a stressful event itself. Tools for frailty assessment, both scales or indexes, may be useful to identify which subjects might be at risk for complications after transplant, and this is necessary to adapt our clinical practice and minimize morbidity. The most used frailty scale in kidney patients is Fried scale, which is based in five phenotypic items. Besides that, knowing frail population allows potential interventions such as prehabilitation while the patient is waiting for the kidney transplant, which the aim of improving their vulnerability prior to transplant and, therefore, optimizing results after transplant. More studies are needed amongst kidney patients to improve and prevent frailty.

[Frailty and kidney transplant candidates]. / La fragilidad en candidatos a trasplante renal.

Frailty is a concept that has been mainly developed in geriatrics and it came from the need of identifying subjects at risk to develop complications when they faced a stressful event. Frail patients have higher risk of mortality, poor outcomes and disability, and this is independent from their age or comorbidities. Chronic kidney disease patients present with high prevalence of frailty, especially those who are in renal replacement therapy. Frail or pre-frail patients on the kidney transplant waiting list represent 20-30%, and these patients are proven to have poorer results after the transplant, which is a stressful event itself. Tools for frailty assessment, both scales or indexes, may be useful to identify which subjects might be at risk for complications after transplant, and this is necessary to adapt our clinical practice and minimize morbidity. The most used frailty scale in kidney patients is Fried scale, which is based in five phenotypic items. Besides that, knowing frail population allows potential interventions such as prehabilitation while the patient is waiting for the kidney transplant, which the aim of improving their vulnerability prior to transplant and, therefore, optimizing results after transplant. More studies are needed amongst kidney patients to improve and prevent frailty.

Mercado de Trabalho no Setor Público: o direito de tomar posse e a preservação do princípio da proteção da confiança

O presente artigo tem por objetivo correlacionar o Direito Subjetivo à Nomeação em Concurso Público ao Princípio da Proteção da Confiança, demonstrando situações que ensejem a quebra da expectativa legítima depositada pela Administração Pública ao candidato regularmente aprovado no concurso público, bem como demonstrar, através de argumentos jurídicos e precedentes jurisprudenciais, as ferramentas jurídicas que o candidato poderá utilizar para a obtenção do reconhecimento legítimo do direito de ser convocado.

Análise crítica do debate presidencial das eleições de 2014 / Critical analysis of presidential debate of 2014 elections

O objetivo do presente estudo foi analisar o debate eleitoral realizado entre sete candidatos à presidência do Brasil em 2014. A amostra composta pelos discursos disponibilizados na mídia foi submetida à análise temática de conteúdo. Destacaram-se entre os temas de análise: Programas Educacionais; Programas Sociais; Desenvolvimento Social e Econômico; Corrupção na Petrobrás; Outros Casos de Corrupção e Compromissos Assumidos. Como conclusão, os resultados enfatizam a importância da mídia na decisão do voto popular. (AU)

The aim of the present study was to analyze the electoral debate among seven candidates of Brazil´s presidency in 2014. A sample consisting of the speeches available in the media was submitted to thematic content analysis. Among the themes of analysis we pointed out: educational programs; social programs; social and economic development; Petrobras corruption; other instances of corruption and commitments. The results emphasize the importance of the media in voting decision. (AU)

Análise crítica do debate presidencial das eleições de 2014 / Critical analysis of presidential debate of 2014 elections

O objetivo do presente estudo foi analisar o debate eleitoral realizado entre sete candidatos à presidência do Brasil em 2014. A amostra composta pelos discursos disponibilizados na mídia foi submetida à análise temática de conteúdo. Destacaram-se entre os temas de análise: Programas Educacionais; Programas Sociais; Desenvolvimento Social e Econômico; Corrupção na Petrobrás; Outros Casos de Corrupção e Compromissos Assumidos. Como conclusão, os resultados enfatizam a importância da mídia na decisão do voto popular...

The aim of the present study was to analyze the electoral debate among seven candidates of Brazil´s presidency in 2014. A sample consisting of the speeches available in the media was submitted to thematic content analysis. Among the themes of analysis we pointed out: educational programs; social programs; social and economic development; Petrobras corruption; other instances of corruption and commitments. The results emphasize the importance of the media in voting decision...

Actividad funcional de anticuerpos inducidos por péptido-miméticos derivados del antígeno MSP-2 del Plasmodium, como potenciales agentes inmunoterapéuticos en malaria causada por Plasmodium yoelii y Plasmodium berghei en ratones BALB/c / Functional activity of antibodies induced by peptido-mimetics derived from the Plasmodium MSP-2 antigen, as potential immuno-therapeutic agents in rodent malaria induced by P. berghei and P. yoelii strains

Teniendo en cuenta el alto grado de conservación genética de los residuos críticos de la estructura primaria del péptido 4044 (21KNESKYSNTFINNAYNMSIR40) identificado como crucial en el antígeno MSP-2 para que el Plasmodium falciparum pueda unirse con alta capacidad específica a glóbulos rojos y causar malaria, se diseñaron y sintetizaron dos secuencias en formas monomérica y polimérica de péptido-miméticos denominados pseudopéptidos amida reducida en las cuales se sustituyó un enlace peptídico normal por su isóstero ψ[CH2-NH] entre los residuos fenilalanina-isoleucina y entre los residuos isoleucina-asparagina, para dar lugar a los pseudopéptidos codificados ψ-128 forma monomérica (ψ-129 forma polimérica) y ψ-130 forma monomérica (ψ-131 forma polimérica). Con estos péptido-miméticos se generaron anticuerpos monoclonales de isotipo IgM. Mediante experimentos controlados de inmunización in vitro se indujo el cambio isotipo de los clones reactivos a las subclases IgG1, IgG2a, IgG2b e IgG3. Estas inmunoglobulinas se ensayaron por su actividad funcional antimalárica in vivo mostrando una alta eficacia en el control de la infección por malaria al ser administradas por transferencia pasiva. El efecto neutralizador del desarrollo biológico del patógeno por parte de estos anticuerpos inducidos de manera sitio-dirigida los hacen potencialmente útiles, como una potencial herramienta para el control de la infección por malaria.

Bearing in mind the high degree of genetical conservation of critical binding residues from the primary structure of the peptide 4044 (21KNESKYSNTFINNAYNMSIR40), which was previously identified as being crucial for the MSP-2 antigen to lead Plasmodium falciparum to bind red blood cells with high specific capacity, and so causing malaria, two peptido-mimetics so-named reduced amide pseudopeptides, in which a nature-made amide bond was replaced with a ψ[CH2-NH] methylene amide isoster bond, one between the Phe-Ile aminoacid pair and the second between Ile-Asn, were designed and synthesized in a site-directed manner as monomer and polymer forms, and were coded as ψ-128 for the monomer (ψ-129 polymer) and ψ-130 for the monomer (ψ-131 for polymer) respectively. These peptido-mimetics were used to produce monoclonal antibodies which displayed in both cases IgM isotype. By controlled in vitro immunization experiments their parent reactive hybridomas were induced to a Ig isotype-switching to IgG1, IgG2a, IgG2b and Ig3 sub-classes. These immunoglobulins were tested for their in vivo functional activity against malaria, showing a high efficacy property for controlling the malaria infection when passively transferred into BALB/c mice. The neutralizing effect of these site-directed designed antibodies on the Plasmodium biological development, make them a potential tool for the control of malaria.

Selección de cepas de Shigella sonnei para el desarrollo de una vacuna efectiva contra la shigellosis / Selection of Shigella sonnei strains to develop an effective shigellosis vaccine

En el Instituto Finlay se desarrolló una metodología de trabajo que contribuyó a la selección de cepas de Shigellasonnei como posibles candidatos vacunales contra la shigellosis. Las cepas investigadas, donadas por el Centro Provincial de Higiene y Epidemiología de Ciudad de La Habana, se caracterizaron según los métodos convencionales. La identificación del serogrupo y serotipo se realizó por aglutinación en láminas portaobjetos con antisueros comerciales; mientras que para el estudio de la susceptibilidad antimicrobiana se utilizó el DIRAMIC 10, un equipo semiautomatizado que proporcionó los resultados 4 horas después de su realización. Se investigó también la presencia de plásmidos de virulencia, por el crecimiento de Shigella spp. en medio de agar Triptona Soya con Rojo Congo al 0,025 por ciento, así como la expresión de las proteínas de la membrana externa en SDS-PAGE; para las pruebas de virulencia y potencia se emplearon los modelos animales (modelo ratón-pulmón y Test de Sereny). Los resultados obtenidos conla metodología utilizada permitieron la selección de la cepa de S sonnei A-04 como la más adecuada para la obtencióndel posible candidato vacunal(AU)

A work methodology was developed at Finlay Institute that contributed to the selection of Shigella sonnei strains as possible vaccinal candidates against shigellosis. Strains under study , were donated by the provincial Centre of Hygiene and Epidemiology in the City of Havana and were characterized using traditional methods. The identification and of the serogroup and serotype was performed by agglutination in slides with commercial antisera. Whereas DIRAMIC 10, a semi automatedequipment was used to study antimicrobial susceptibility. Results were obtained four hours after. The presence of virulence plasmid for the growth of Shigella spp. In Agar Soy Triptone with Congo Red at 0,025 percent, as well as outer membrane protein expression in of SDS-PAGE. In addition, animal models mice-lung and the test of Sereny were used for virulence and potency tests. Results obtained allowed the selection of the strain S sonnei A-04 as the most adequate for the obtainment of a possible vaccinal candidate(AU)

Association of the heart fatty acid-binding protein gene with quality of carcass and meat traits in pigs / Associação entre o gene da proteína de ligação de ácidos graxos - coração com características de carcaça e qualidade da carne em suínos

The heart fatty acid-binding protein (HFABP) gene was sequenced in parental animals of a F2 crossing of boars of the Brazilian native Piau breed with commercial sows (Landrace x Large White Pietrain). Primers used for PCR were designed to amplify four exons of the gene. The PCR products were sequenced and compared with the GenBank sequences. Differences between the generated sequences and the GenBank sequences were observed for both genetic groups. A total of 246 F2 animals were genotyped using the Hinf I restriction enzyme. Two genotypes were identified, 198 being animals HH and 48 Hh. The Hinf I SNP was significantly associated with weights of loin (bone-in) (P<0.05), jowl (P<0.05), sirloin (P<0.10), and kidneys (P<0.01). These results showed the potential of the H-FABP gene in marker-assisted selection programs for carcass traits in pigs.

O gene da proteína de ligação de ácidos graxos - coração foi seqüenciado em animais parentais de um cruzamento F2 entre varrões da raça nativa brasileira Piau e fêmeas comerciais (Landrace x Large White x Pietrain). Os primers utilizados na reação em cadeia da polimerase foram desenhados para amplificarem os quatro éxons do gene. Os fragmentos amplificados foram seqüenciados e comparados com a seqüência do gene depositada no GenBank. Foram observadas divergências entre as seqüências geradas e as do GenBank para ambos os grupos genéticos. Foram genotipados 246 animais F2 utilizando-se a enzima Hinf I. Dois genótipos foram identificados, sendo 198 animais HH e 48 animais Hh. O polimorfismo apresentou efeito sobre o peso total do carré (P<0,05), o peso da papada (P<0,05), o peso do filezinho (P<0,10) e o peso dos rins (P<0,01). Os resultados indicam que o gene da H-FABP apresenta potencial para aplicação em programas de seleção assistida por marcadores moleculares em suínos.

Elementos de diagnóstico, contraindicaciones y factores que influyen en el éxito de rehabilitación quirúrgico - protésica por medio de implantes dentales osteo - Integrados en los tratamientos efectuados en el centro dental de El Salvador en el Período de septiembre a noviembre de 1998 / Diagnostic elements, contraindications and factors that influence the success of surgical-prosthetic rehabilitation by means of osteo dental implants - Integrated in the treatments carried out in the dental center of El Salvador in the period from September to November 1998

La implantología dental ha sido tema de múltiples controversias por lo que se han realizado diversas investigaciones a lo largo de los años, ya que en sus inicios era tratamiento exclusivo para pacientes de la tercera edad, los avances obtenidos han conducido a modificaciones en su uso, por lo que se conocen en el comercio más de 26 sistemas de implantes dentales oseointegrados en los cuales se han elaborado diferentes diseños. En el presente, su utilización a variado por las diferentes edades que presentan los individuos sometidos a éste tipo de tratamiento con lo que se pretende proporcionar función, estética, fonética y comodidad. La presente investigación se fundamenta en la elaboración de un diagnóstico adecuado para proporcionar un acertado pronóstico y tratamiento, del paciente candidato a implantes dentales, al igual que se identifican contraindicaciones y factores a tomar en cuenta en cuenta para éxito del tratamiento. La investigación contiene 4 fases; la primera llamada Determinación de los elementos del diagnóstico la cual comprende justificación del trabajo en donde se establece el propósito de dicha investigación sobre elementos del diagnóstico, contraindicaciones y factores que influyen en el éxito de la rehabilitación quirúrgica-protésica por medio de implantes dentales oseointegrados, seguido por los objetivos de la investigación tanto general como específicos en los cuales se plasma lo que se pretende alcanzar en el transcurso de la investigación y aquellas limitantes que impidieron de una u otra forma el desarrollo de la investigación y definición de términos básicos. La segunda fase llamada Marco de referencia incluye los antecedentes del problema, en el que se describe la historia, además comprende la discusión bibliográfica en donde se fundamenta el tema en estudio. La tercera fase llamada metodología de la investigación en donde se detalla el tipo de investigación clasificada como Diagnóstico descriptiva, posteriormente se describe la población que forman parte del estudio, al igual que técnicas e instrumentos que sirvieron de apoyo, durante la evolución del proceso investigativo. La cuarta fase llamada Resultados de diagnóstico aquí se ilustra los cuadros estadísticos e interpretación de los mismos, análisis general de la problemática estudiada en base de los resultados del diagnóstico de igual forma incluye conclusiones de acuerdo al contexto de la problemática expuesta, y en la parte de recomendaciones el grupo sugiere una propuesta guía para la selección del paciente candidato a implantes dentales. Y finalmente se enumera la literatura empleada en el transcurso de la investigación.

Dental implantology has been the subject of multiple controversies, which is why various investigations have been carried out over the years, since in its beginnings it was an exclusive treatment for elderly patients, the advances obtained have led to modifications in its use, For this reason, more than 26 osseointegrated dental implant systems are known in the trade in which different designs have been developed. At present, its use has varied due to the different ages of individuals subjected to this type of treatment, with the aim of providing function, aesthetics, phonetics and comfort. The present investigation is based on the elaboration of an adequate diagnosis to provide an accurate prognosis and treatment of the patient who is a candidate for dental implants, as well as identifying contraindications and factors to take into account for the success of the treatment. The investigation contains 4 phases; the first one called Determination of the elements of the diagnosis which includes justification of the work where the purpose of said investigation on elements of the diagnosis, contraindications and factors that influence the success of the surgical-prosthetic rehabilitation by means of osseointegrated dental implants is established, followed by the objectives of both general and specific research in which what is intended to be achieved in the course of the research and those limitations that prevented in one way or another the development of the research and definition of basic terms are reflected. The second phase called Frame of reference includes the antecedents of the problem, in which the history is described, it also includes the bibliographic discussion on which the subject under study is based. The third phase called research methodology where the type of research classified as descriptive diagnosis is detailed, later the population that are part of the study is described, as well as techniques and instruments that served as support, during the evolution of the research process. The fourth phase called Diagnosis results here illustrates the statistical tables and their interpretation, general analysis of the problem studied based on the results of the diagnosis in the same way includes conclusions according to the context of the problem exposed, and in the part of recommendations, the group suggests a guide proposal for the selection of the patient candidate for dental implants. And finally the literature used in the course of the investigation is listed.