Resilient living materials built by printing bacterial spores.

Materials can be made multifunctional by embedding them with living cells that perform sensing, synthesis, energy production, and physical movement. A challenge is that the conditions needed for living cells are not conducive to materials processing and require continuous water and nutrients. Here, we present a three dimensional (3D) printer that can mix material and cell streams to build 3D objects. Bacillus subtilis spores were printed within the material and germinated on its exterior surface, including spontaneously in new cracks. The material was resilient to extreme stresses, including desiccation, solvents, osmolarity, pH, ultraviolet light, and γ-radiation. Genetic engineering enabled the bacteria to respond to stimuli or produce chemicals on demand. As a demonstration, we printed custom-shaped hydrogels containing bacteria that can sense or kill Staphylococcus aureus, a causative agent of infections. This work demonstrates materials endued with living functions that can be used in applications that require storage or exposure to environmental stresses.

Antibiotics for treating urogenital Chlamydia trachomatis infection in men and non-pregnant women.

BACKGROUND: The genital infection caused by Chlamydia trachomatis (CT) is a common sexually transmitted infection (STI) globally. The infection is mainly asymptomatic in women, thus it can produce infertility and chronic pelvic pain. In men infection is mainly symptomatic, but can evolve to prostatitis. Clinical practice guidelines for CT urogenital infections do not give any specific recommendation about which antibiotic use as first option OBJECTIVES: To assess the efficacy and safety of antibiotic treatment for CT genital infection in men and non-pregnant women. SEARCH METHODS: The Cochrane Sexually Transmitted Infections' (STI) Information Specialist developed the electronic searches in electronic databases (CENTRAL, MEDLINE, Embase and LILACS), and trials registers. We searched studies published from inception to June 2018. SELECTION CRITERIA: We included parallel, randomised controlled trials (RCTs) of men, and sexually-active, non-pregnant women with CT infection (urethritis or uterine cervicitis or asymptomatic), diagnosed by cell culture for CT, nucleic acid amplification tests (NAAT) or antigen-based detection methods, who had been treated with any of the antibiotic regimens recommended by any of the updated to 2013 CT Guidelines. DATA COLLECTION AND ANALYSIS: Four review authors screened evidence according to selection criteria and independently extracted data and assessed risk of bias. Two authors developed the 'Summary of findings' tables. We used a fixed-effect meta-analysis model for combining data where it was reasonable to assume that studies were estimating the same underlying treatment effect. We estimated the pooled risk ratio in order to establish the effects of the comparisons. Our primary outcomes were microbiological failure and adverse events, and our secondary outcomes were clinical failure, antimicrobial resistance and reinfection. MAIN RESULTS: We selected 14 studies ( 2715 participants: 2147 (79.08%) men and 568 (20.92%) women). The studies were conducted mainly at STD clinics. Sample sizes ranged from 71 to 606 participants; follow-up was 29.7 days on average.For the comparison: azithromycin single dose versus doxycycline once or twice daily for 7 days, in men treated for CT, the risk of microbiological failure was higher in the azithromycin group (RR 2.45, 95% CI 1.36 to 4.41; participants = 821; studies = 9; moderate-quality evidence), but regarding clinical failure, the results showed that the effect is uncertain (RR 0.94, 95% CI 0.43 to 2,05; I² = 55%; participants = 525; studies = 3; low-quality evidence). Regarding adverse events (AE) in men there could be little or no difference between the antibiotics (RR 0.83, 95% CI 0.67 to 1.02; participants = 1424; studies = 6; low-quality evidence). About women treated for CT, the effect on microbiological failure was uncertain (RR = 1.71, 95% CI 0.48 to 6.16; participants = 338; studies = 5; very low-quality evidence). There were no studies assessing clinical failure or adverse events in women, however, we found that azithromycin probably has fewer adverse events in both genders (RR 0.83, 95% CI 0.71 to 0.98; I² = 0%; participants = 2261; studies = 9; moderate-quality evidence).For the second comparison: doxycycline compared to ofloxacin, for men treated for CT the effect on microbiological failure was uncertain (RR 8.53, 95% CI 0.43 to 167.38, I² not applicable; participants = 80; studies = 2; very low-quality evidence), as also it was on clinical failure (RR 0.85, 95% CI 0.28 to 2.62; participants = 36; studies = 1; very low-quality evidence). The effect of in women on clinical failure was uncertain (RR 0.94, 95% CI 0.39 to 2.25; I² = 39%; participants = 127; studies = 2; very low-quality evidence).Regarding adverse events, the effect in both men and women was uncertain (RR 1.02 95% CI 0.66 to 1.55; participants = 339 studies = 3; very low-quality evidence). The effect on microbiological failure in women and in men and women together, the effect on microbiological failure was not estimable. The most frequently AE reported were not serious and of gastrointestinal origin.No studies assessed antimicrobial resistance or reinfection in either comparison. AUTHORS' CONCLUSIONS: In men, regimens with azithromycin are probably less effective than doxycycline for microbiological failure, however, there might be little or no difference for clinical failure. For women, we are uncertain whether azithromycin compared to doxycycline increases the risk of microbiological failure. Azithromycin probably slightly reduces adverse events compared to doxycycline in men and women together but may have little difference in men alone. We are uncertain whether doxycycline compared to ofloxacin reduces microbiological failure in men or women alone, or men and women together, nor if it reduces clinical failure or adverse events in men or women.Based on the fact that women suffer mainly asymptomatic infections, and in order to test the effectiveness and safety of the current recommendations (azithromycin, doxycycline and ofloxacin), for CT infection, especially in low and middle income countries, future RCTs should be designed and conducted to include a large enough sample size of women, and with low risk of bias. It is also important that future RCTs include adherence, CT resistance to antibiotic regimens, and risk of reinfection as outcomes to be measured. In addition, it is important to conduct a network meta-analysis in order to evaluate all those studies that included in one arm only the current antibiotic treatments for CT infection that are recommended by the updated clinical practice guidelines.

The Potential of Microalgae-Bacteria Consortia to Restore Degraded Soils.

Soil restoration is one of the biggest challenges of this century. Besides the negative impacts of climate change, the current increase in food demands has put severe pressure on soil resources, resulting in a significant area of degraded land worldwide. However, beneficial microorganisms, such as microalgae and plant growth-promoting bacteria, have an outstanding ability to restore soil health and fertility. In this mini-review, we summarize state-of-the-art knowledge on these microorganisms as amendments that are used to restore degraded and contaminated soils. Furthermore, the potential of microbial consortia to maximize beneficial effects on soil health and boost the production of plant-growth-promoting compounds within a mutualistic interaction is discussed.

Semantic Memory and Lexical Availability in Parkinson's Disease: A Statistical Learning Study.

Parkinson's disease (PD) is a neurodegenerative disorder that causes a progressive impairment in motor and cognitive functions. Although semantic fluency deficits have been described in PD, more specific semantic memory (SM) and lexical availability (LA) domains have not been previously addressed. Here, we aimed to characterize the cognitive performance of PD patients in a set of SM and LA measures and determine the smallest set of neuropsychological (lexical, semantic, or executive) variables that most accurately classify groups. Thirty early-stage non-demented PD patients (age 35-75, 10 females) and thirty healthy controls (age 36-76, 12 females) were assessed via general cognitive, SM [three subtests of the CaGi battery including living (i.e., elephant) and non-living things (i.e., fork)], and LA (eliciting words from 10 semantic categories related to everyday life) measures. Results showed that PD patients performed lower than controls in two SM global scores (picture naming and naming in response to an oral description). This impairment was particularly pronounced in the non-living things subscale. Also, the number of words in the LA measure was inferior in PD patients than controls, in both larger and smaller semantic fields, showing a more inadequate recall strategy. Notably, the classification algorithms indicated that the SM task had high classification accuracy. In particular, the denomination of non-living things had a classification accuracy of ∼80%. These results suggest that frontostriatal deterioration in PD leads to search strategy deficits in SF and the potential disruption in semantic categorization. These findings are consistent with the embodied view of cognition.

Plastic bronchitis: A case report.

Plastic bronchitis is a rare and underdiagnosed disease characterized by the formation and expectoration of bronchial casts of amorphous material, which can be potentially fatal. It is more frequent in pediatric population. Symptoms can range from chronic cough and dyspnea to respiratory failure depending on the area of the compromised airway. Casts are classified as type I when constituted by inflammatory cells and accompany diseases such as asthma and pneumonias; and type II when acellular and are associated with congenital heart diseases following procedures such as Fontan. We report the case of a male schoolchild with a history of complex congenital heart disease, treated with palliative surgery, evaluated in the emergency department for cough and respiratory distress. The mother referred expulsion of gelatinous material after coughing. During clinical evaluation, expulsion of bronchial casts was evidenced, suggesting a plastic bronchitis. He underwent a diagnostic and therapeutic bronchoscopy and received initial treatment with respiratory therapy, nebulized hypertonic saline solution, mucolytics, dornase alpha and nebulized heparin. The hospitalization revealed a stenosis of the right pulmonary artery, which was corrected with stent. The patient progressed satisfactorily with improvement of cough and expectoration. He was discharged with combined treatment, nebulized medications and those concerning his underlying disease.

Progress on lipid extraction from wet algal biomass for biodiesel production.

Lipid recovery and purification from microalgal cells continues to be a significant bottleneck in biodiesel production due to high costs involved and a high energy demand. Therefore, there is a considerable necessity to develop an extraction method which meets the essential requirements of being safe, cost-effective, robust, efficient, selective, environmentally friendly, feasible for large-scale production and free of product contamination. The use of wet concentrated algal biomass as a feedstock for oil extraction is especially desirable as it would avoid the requirement for further concentration and/or drying. This would save considerable costs and circumvent at least two lengthy processes during algae-based oil production. This article provides an overview on recent progress that has been made on the extraction of lipids from wet algal biomass. The biggest contributing factors appear to be the composition of algal cell walls, pre-treatments of biomass and the use of solvents (e.g. a solvent mixture or solvent-free lipid extraction). We compare recently developed wet extraction processes for oleaginous microalgae and make recommendations towards future research to improve lipid extraction from wet algal biomass.

[Colombia 2015 National Mental Health Survey. Study Protocol]. / Encuesta Nacional de Salud Mental Colombia 2015. Protocolo del estudio.

INTRODUCTION: The 2015 National Mental Health Survey (NMHS) is the fourth mental survey conducted in Colombia, and is part of the National System of Surveys and Population Studies for health. METHODS: A narrative description is used to explain the background, references, the preparation, and characteristics of the 2015 NMHS. The 2015 NMHS and its protocol emerge from the requirements that support the national and international policies related to mental health. Together with the Ministry of Health and Social Protection, the objectives, the collection tools, the sample, and the operational plan are defined. The main objective was to obtain updated information about the mental health, mental problems and disorders, accessibility to health services, and an evaluation of health conditions. Participants were inhabitants from both urban and rural areas, over 7 years old, and in whom the comprehension of social determinants and equity were privileged. An observational cross-sectional design with national, regional and age group representativity, was used. The age groups selected were 7-11, 12-17, and over 18 years old. The regions considered were Central, Orient, Atlantic, Pacific, and Bogota. The calculated sample had a minimum of 12,080 and a maximum of 14,496 participants. CONCLUSIONS: A brief summary of the protocol of the 2015 NMHS is presented. The full document with all the collection tools can be consulted on the Health Ministry webpage.

Immunohistochemical expression of RANK, GRalpha and CTR in central giant cell granuloma of the jaws.

The aim was to evaluate the phenotypic expression of various cellular osteotropic factors in central giant cell granuloma (CGCG). Paraffin-embedded tissue from 27 aggressive and 10 non-aggressive cases of CGCG was assessed for the expression of RANK, GRalpha and CTR using immunohistochemistry. In addition, a staining-intensity-distribution (SID) score (proportion of stained cells x staining intensity) was used to assess immunoreactivity of each marker. The results showed that the multinucleated giant cells (MGC), mononuclear stromal cells (MSC) and endothelial cells were intensely positives for GRalpha, moderate for RANK and weak-to-moderate for CTR in all clinical groups, whereas spindle-shaped cells were intensely immunoreactive to GRalpha and unreactive to CTR and RANK. Although neither difference in RANK and GRalpha expression nor the SID score between the clinical forms of CGCG was observed, a statistically significant difference for CTR was evident. Furthermore, the comparison of the marker expression and SID score showed a significant correlation for all three markers within the clinical groups, except for GRalpha in the non-aggressive lesions where a weak and no significant correlation was detected. It was concluded that although the MGC share some similarities with the osteoclasts, they demonstrate phenotypic differences from each other that suggest a distinct precursor. The expression of RANK, GRalpha and CTR also suggest a role for these receptors in the resorptive activity of different cellular groups in CGCG and may lead to a more effective use of therapeutic inhibitors of bone resorption for the treatment of these disorders.

Sudden motility reversal indicates sensing of magnetic field gradients in Magnetospirillum magneticum AMB-1 strain.

Many motile unicellular organisms have evolved specialized behaviors for detecting and responding to environmental cues such as chemical gradients (chemotaxis) and oxygen gradients (aerotaxis). Magnetotaxis is found in magnetotactic bacteria and it is defined as the passive alignment of these cells to the geomagnetic field along with active swimming. Herein we show that Magnetospirillum magneticum (AMB-1) show a unique set of responses that indicates they sense and respond not only to the direction of magnetic fields by aligning and swimming, but also to changes in the magnetic field or magnetic field gradients. We present data showing that AMB-1 cells exhibit sudden motility reversals when we impose them to local magnetic field gradients. Our system employs permalloy (Ni(80)Fe(20)) islands to curve and diverge the magnetic field lines emanating from our custom-designed Helmholtz coils in the vicinity of the islands (creating a drop in the field across the islands). The three distinct movements we have observed as they approach the permalloy islands are: unidirectional, single reverse and double reverse. Our findings indicate that these reverse movements occur in response to magnetic field gradients. In addition, using a permanent magnet we found further evidence that supports this claim. Motile AMB-1 cells swim away from the north and south poles of a permanent magnet when the magnet is positioned less than ∼30 mm from the droplet of cells. All together, these results indicate previously unknown response capabilities arising from the magnetic sensing systems of AMB-1 cells. These responses could enable them to cope with magnetic disturbances that could in turn potentially inhibit their efficient search for nutrients.

Controlling magnetotactic bacteria through an integrated nanofabricated metallic island and optical microscope approach.

Herein, we demonstrate the control of magnetotactic bacteria through the application of magnetic field gradients with real-time visualization. We accomplish this control by integrating a pair of macroscale Helmholtz coils and lithographically fabricated nanoscale islands composed of permalloy (Ni80Fe20). This system enabled us to guide and steer amphitrichous Magnetospirillum magneticum strain AMB-1 to specific location via magnetic islands. The geometries of the islands allowed us to have control over the specific magnetic field gradients on the bacteria. We estimate that magnetotactic bacteria located less than 1 µm from the edge of a diamond shaped island experience a maximum force of approximately 34 pN, which engages the bacteria without trapping them. Our system could be useful for a variety of applications including magnetic fabrication, self-assembly, and probing the sensing apparatus of magnetotactic bacteria.

[The knowledge acquired during and adherence to a postgraduate course concerned with mental health aimed at school counselors]. / Conocimiento adquirido y adherencia en un diplomado sobre la salud mental para docentes orientadores.

OBJECTIVE: To evaluate the academic performance in, and adherence to, a postgraduate course focused on promotion, prevention, identification, and early intervention with regard to the different mental problems and pathologies affecting children and adolescents. MATERIALS AND METHODS: This was a before-and-after intervention study involving a postgraduate course. The population of school counselors from the Colombian regions of Boyacá and Cundinamarca were invited to participate in a postgraduate course that addressed mental health. Their knowledge was evaluated before and after having received it. RESULTS: The school counselors performed well on the academic test, with 48.5 % of the population obtaining a score of 4.0/5.0 before the intervention. After the course, 61.2 % achieved the same score. It was thus considered that the course functioned as a tool for improving knowledge about promotion, prevention, recognition, and early intervention with regard to mental health in educational institutions. There was a 90.6 % adherence to the 120-hour-long postgraduate course. CONCLUSION: The postgraduate course seemed to have a positive impact in terms of the knowledge acquired about mental health, and there was good adherence to the course.

[Leptospiral antibodies in a Colombian zoo's neotropical primates and workers]. / Anticuerpos contra Leptospira sp. en primates neotropicales y trabajadores de un zoológico colombiano.

OBJECTIVE: Detecting antibodies against Leptospira spp. in Neotropical primates and workers in a Colombian Zoo and identifying the risk factors associated with the disease. METHODS: A cross-sectional study was performed regarding 65 Neotropical primates and 20 zookeepers. The samples were processed by microagglutination test (MAT) using a reference strain collection consisting of 21 Leptospira serovars. The people being evaluated were given a structured survey to identify risk factors. RESULTS: There was 25 % (5/20) Leptospira spp. infection seroprevalence in the staff and 23.07 % (15/65) in Neotropical monkeys. The most frequently occurring serovars in workers were bataviae, gryppotyphosa and ranarum; icterohaemorrhagiae, pomona and ranarum were the predominant serovars in non-human primates. The black spider monkey (Ateles fusciceps), white-fronted capuchin (Cebus albifrons) and white-footed tamarin (Saguinus leucopus) showed the highest reactivity. Most of the personnel were using protective clothing. CONCLUSIONS: The contact between primates and zookeepers involving different Leptospira sp. serovars was evident. Zoo personnel using protective clothing and their length of experience were considered to be protective factors for the disease. There may be a risk of Leptospira transmission between zoo animals and staff, and it is therefore important to strengthen active surveillance and implement promotion and prevention programs.

Encuesta Nacional de Salud Mental Colombia 2015. Protocolo del estudio / Colombia 2015 National Mental Health Survey. Study Protocol

Introducción: La Encuesta Nacional de Salud Mental 2015 (ENSM 2015) es la cuarta que se realiza en el país y se enmarca en el Sistema Nacional de Encuestas y estudios poblacionales para salud de Colombia. Métodos: Se presenta una descripción narrativa de los antecedentes, los referentes, el proceso de elaboración y las características del protocolo de la ENSM 2015. La ENSM 2015 y el protocolo parten de unos requisitos que dan soporte a las políticas nacionales en salud e internacionales relacionadas con salud mental. Para su elaboración se trabaja junto con el Ministerio de Salud y Protección Social para definir los objetivos, los instrumentos de recolección, la muestra y el plan operativo. Como objetivo principal se definió brindar información actualizada acerca de la salud mental, los problemas, los trastornos mentales, la accesibilidad de los servicios y la valoración de estados de salud, de la población colombiana rural y urbana mayor de 7 años de edad, en la que privilegió su comprensión desde los determinantes sociales y la equidad. Para ello se decidió realizar un estudio observacional de corte transversal en el ámbito nacional, con representatividad nacional, regional y por franjas de edad: 7-11, 12-17 y ≥ 18 años. Las regiones consideradas fueron: Central, Oriental, Atlántica, Pacífica y Bogotá, con un tamaño de muestra total calculado como mínimo de 12.080 sujetos y máximo de 14.496. Conclusiones: Se presenta un breve resumen del protocolo que puede ser consultado en su totalidad en la página web del MSPS que incluye los instrumentos de recolección.

Introduction: The 2015 National Mental Health Survey (NMHS) is the fourth mental survey conducted in Colombia, and is part of the National System of Surveys and Population Studies for health. Methods: A narrative description is used to explain the background, references, the preparation, and characteristics of the 2015 NMHS. The 2015 NMHS and its protocol emerge from the requirements that support the national and international policies related to mental health. Together with the Ministry of Health and Social Protection, the objectives, the collection tools, the sample, and the operational plan are defined. The main objective was to obtain updated information about the mental health, mental problems and disorders, accessibility to health services, and an evaluation of health conditions. Participants were inhabitants from both urban and rural areas, over 7 years old, and in whom the comprehension of social determinants and equity were privileged. An observational cross-sectional design with national, regional and age group representativity, was used. The age groups selected were 7-11, 12-17, and over 18 years old. The regions considered were Central, Orient, Atlantic, Pacific, and Bogota. The calculated sample had a minimum of 12,080 and a maximum of 14,496 participants. Conclusions: A brief summary of the protocol of the 2015 NMHS is presented. The full document with all the collection tools can be consulted on the Health Ministry webpage.

Anticuerpos contra Leptospira sp. en primates neotropicales y trabajadores de un zoológico colombiano / Leptospiral antibodies in a Colombian zoo's Neotropical primates and workers

Objetivo Detectar anticuerpos contra Leptospira sp. en primates neotropicales y funcionarios de un zoológico colombiano e identificar factores de riesgo de la enfermedad. Métodos Se realizó un estudio transversal analítico en 65 primates y 20 funcionarios del Zoológico. Las muestras fueron procesadas mediante la técnica de Microaglutinación macroscópica (MAT) usando un cepario de referencia conformado por 21 serovares de Leptospira sp. Se aplicó un instrumento estructurado al personal evaluado para identificar factores de riesgo. Resultados La seroprevalencia de la infección por Leptospira sp. fue del 25 % (5/20) en el personal y 23,07 % (15/65) en los monos neotropicales. Los serovares más frecuentes entre los funcionarios fueron bataviae, gryppotyphosa y hurstbridge. En los monos neotropicales predominaron los serovares icterohaemorrhagiae, pomona y ranarum. Las especies mono araña negro (Ateles fusciceps), mono cariblanco (Cebus albifrons) y tití gris (Saguinus leucopus), presentaron mayor reactividad. La mayor proporción del personal usaba dotación de protección. Conclusiones Se evidenció el contacto de los primates neotropicales y del personal con diferentes serovares de Leptospira. El uso de la dotación de protección y el tiempo de experiencia de los funcionarios del zoológico se consideraron como factores protectores de la enfermedad. Se sugiere que existe un riesgo de transmisión de leptospirosis, en los animales del zoológico y el personal, siendo por lo tanto importante fortalecer la vigilancia epidemiológica activa e implementar programas de promoción y prevención.

Objective Detecting antibodies against Leptospira spp. in Neotropical primates and workers in a Colombian Zoo and identifying the risk factors associated with the disease. Methods A cross-sectional study was performed regarding 65 Neotropical primates and 20 zookeepers. The samples were processed by microagglutination test (MAT) using a reference strain collection consisting of 21 Leptospira serovars. The people being evaluated were given a structured survey to identify risk factors. Results There was 25 % (5/20) Leptospira spp. infection seroprevalence in the staff and 23.07 % (15/65) in Neotropical monkeys. The most frequently occurring serovars in workers were bataviae, gryppotyphosa and ranarum; icterohaemorrhagiae, pomona and ranarum were the predominant serovars in non-human primates. The black spider monkey (Ateles fusciceps), white-fronted capuchin (Cebus albifrons) and white-footed tamarin (Saguinus leucopus) showed the highest reactivity. Most of the personnel were using protective clothing. Conclusions The contact between primates and zookeepers involving different Leptospira sp. serovars was evident. Zoo personnel using protective clothing and their length of experience were considered to be protective factors for the disease. There may be a risk of Leptospira transmission between zoo animals and staff, and it is therefore important to strengthen active surveillance and implement promotion and prevention programs.

Caracteristicas clinico-epidemiologicas de 291 pacientes hospitalizados por malaria en Medellin (Colombia) / Clinical and epidemiologic characteristics of 291 hospitalized patients for malaria in Medellin (Colombia)

Objetivo: describir las características clínico-epidemiológicas de los pacientes hospitalizados por malaria en Medellín durante cinco años. Diseño: descriptivo, retrospectivo, transversal. Marco de referencia: siete hospitales de tercer nivel tanto públicos como privados de Medellín. Pacientes: muestra de conveniencia de 291 historias clínicas de pacientes con malaria hospitalizados entre 1992 y 1996. Mediciones principales: variables clínicas, epidemiológicas y de laboratorio. Resultados: el 55 por ciento de los pacientes residían en zonas no endémicas principalmente de Antioquia. Las complicaciones encontradas fueron trombocitopenia 35.7 por ciento (104 casos), anemia leve 44.6 por ciento (130 casos), anemia grave 5.1 por ciento (15 casos), compromiso hepático 12 por ciento (35 casos), encefalopatía 7.9 por ciento (23 casos), nefropatía 3.4 por ciento (diez casos), hipoglicemia 2.7 por ciento (ocho casos) y edema pulmonar 2.1 por ciento (seis casos). Las especies parasitarias fueron Plasmodium vivax 44 por ciento, Plasmodium falciparum 39 por ciento, ambas especies (malaria mixta) 8 por ciento y sin información 8 por ciento. La letalidad fue de 17 por mil. El promedio de parasitemia en los casos por P. falciparum tue de 34.349 parásitos/mm3, estadísticamente igual para todas las clases de diagnóstico clínico. Conclusión: sobresale la gran frecuencia de anemia y trombocitopenia y la baja presencia de los compromisos renal y cerebral. Lo novedoso del trabajo es la propuesta para clasificar los compromisos maláricos, con el fin de unificar criterios que posibiliten en el futuro la comparabilidad de los trabajos, lo cual permitiría conocer la real prevalencia de las complicaciones maláricas en nuestro medio.