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Development of efficient portable sensors for accurately detecting biomarkers is crucial for early disease diagnosis, yet remains a significant challenge. To address this need, we introduce the enhanced luminescence lateral-flow assay, which leverages highly luminescent upconverting nanoparticles (UCNPs) alongside a portable reader and a smartphone app. The sensor's efficiency and versatility were shown for kidney health monitoring as a proof of concept. We engineered Er3+- and Tm3+-doped UCNPs coated with multiple layers, including an undoped inert matrix shell, a mesoporous silica shell, and an outer layer of gold (UCNP@mSiO2@Au). These coatings synergistically enhance emission by over 40-fold and facilitate biomolecule conjugation, rendering UCNP@mSiO2@Au easy to use and suitable for a broad range of bioapplications. Employing these optimized nanoparticles in lateral-flow assays, we successfully detected two acute kidney injury-related biomarkers─kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL)─in urine samples. Using our sensor platform, KIM-1 and NGAL can be accurately detected and quantified within the range of 0.1 to 20 ng/mL, boasting impressively low limits of detection at 0.28 and 0.23 ng/mL, respectively. Validating our approach, we analyzed clinical urine samples, achieving biomarker concentrations that closely correlated with results obtained via ELISA. Importantly, our system enables biomarker quantification in less than 15 min, underscoring the performance of our novel UCNP-based approach and its potential as reliable, rapid, and user-friendly diagnostics.

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INTRODUCTION: Metabolic associated steatohepatitis (MASH) is one of the most frequent causes of chronic liver disease. Liver transaminases are important biomarkers to measure liver injury, however, a proportion of patients with MASH may present with normal levels of transaminases. The levels of serum transaminases may not correlate with the severity of histopathological changes. OBJECTIVE: We aimed to identify the frequency of normal transaminases in obese patients with MASH, as well as to describe the clinical, biochemical and histological characteristics in this specific group of patients. MATERIALS AND METHODS: A retrospective cross-sectional study was conducted in the bariatric surgery service of a private clinic. Obese patients older than 18 years with a body mass index (BMI) >30Kg/m2 and 2 co-morbidities undergoing a gastric sleeve surgery were included. Measurement of biochemical routine laboratory exams was performed. Insulin resistance was calculated using the homeostasis evaluation model (HOMA-IR). All patients underwent liver biopsies prior to surgery and the diagnosis of MASH was based on the Brunt criteria. RESULTS: 159 obese patients with MASH were included, of which 47.2% had normal transaminases and 52.8% elevated transaminases. Factors associated with alteration in transaminases were: being male OR=4.02 (95% CI: 2.03- 7.96; p<0.01), diagnosis of type 2 diabetes mellitus OR=4.86 (95% CI: 1.97- 11.95; p<0.01) and levels of GGT >50 IU/L OR=7.50 (95% CI: 3.40-16.56; p<0.01). The values of HOMA-IR and GGT were significantly higher in the group of high transaminases (p<0.01). Differences in the degree of fibrosis were not associated with transaminases levels. CONCLUSION: In conclusion we found that the frequency of normal transaminases was 47.2% in obese patients with MASH. Factors associated with elevation in liver enzymes were being male, diagnosis of diabetes mellitus and elevation in GGT levels. The degree of fibrosis was not associated with elevations in liver transaminases. These findings suggest that transaminases levels alone are not accurate markers to assess liver injury, as they do not necessarily correlate with histological liver damage.

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Chagas disease is a neglected vector-borne zoonosis caused by the parasite Trypanosoma cruzi that is primarily transmitted by insects of the subfamily Triatominae. Although control efforts targeting domestic infestations of Rhodnius prolixus have been largely successful, with several regions in Boyacá department certified free of T. cruzi transmission by intradomicile R. prolixus, novel native species are emerging, increasing the risk of disease. Triatoma dimidiata is the second most important species in Colombia, and conventional control methods seem to be less effective. In this study we evaluated the efficacy and usefulness of micro-encapsulated insecticide paints in laboratory conditions and its applicability in rural communities to avoid triatomine domiciliation. Laboratory conditions measured mortality at 6 months and 12 months, with an average mortality between 93-100% for T. dimidiata and 100% for R. prolixus. Evaluation of triatomine infestation in rural households was measured after one year, with an overall perception of effectiveness in reducing household domiciliation. Although triatomines were still spotted inside and around the homes, our findings demonstrate the ability of micro-encapsulated insecticide to prevent colonization inside the households when comparing infestation rates from previous years. Current control measures suggest insecticide spraying every six months, which implies great economic cost and logistical effort. Complementary triatomine control measures with insecticide spraying and micro-encapsulated insecticide paint would make public health efforts more efficient and reduce the frequency of treatment.

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Resumen Los avances en la cirugía hepática de los últimos años han permitido resecciones hepáticas más extensa y complejas para el tratamiento de diferentes patologías del hígado sin un aumento excesivo de la morbimortalidad perioperatoria. El desarrollo de diferentes técnicas, tecnologías y herramientas para la evaluación preoperatoria han mejorado la planificación quirúrgica con el uso por ejemplo de las tecnologías audiovisuales e impresión de modelos en 3 dimensiones (3D) de alta fidelidad. Otros avances, han permitido realizar una mejor evaluación funcional del parénquima hepático y una caracterización más precisa de las lesiones con el uso por ejemplo de verde de indocianina, cintigrafía hepática y resonancia magnética con contraste hepatoespecífico. Este artículo describe algunos de los nuevos avances en la evaluación y planificación preoperatoria en cirugía hepática.

Advances in liver surgery in recent years have made it possible to achieve more extensive and complex liver resections for the treatment of different liver diseases without an excessive increase in perioperative morbidity and mortality. The development of different techniques, technologies and tools for preoperative evaluation have improved surgical planning with the use, for example, of audiovisual technologies and printing of high-fidelity 3-dimensional (3D) models. Other advances have allowed a better functional evaluation of the liver parenchyma and a more precise characterization of the lesions with the use, for example of indocyanine green or liver scintigraphy and magnetic resonance with hepatospecific contrast. This article describes some of the new advances in preoperative evaluation and planning in liver surgery.

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Introduction: Metabolic associated steatohepatitis (MASH) is one of the most frequent causes of chronic liver disease. Liver transaminases are important biomarkers to measure liver injury, however, a proportion of patients with MASH may present with normal levels of transaminases. The levels of serum transaminases may not correlate with the severity of histopathological changes. Objective: We aimed to identify the frequency of normal transaminases in obese patients with MASH, as well as to describe the clinical, biochemical and histological characteristics in this specific group of patients. Materials and methods: A retrospective cross-sectional study was conducted in the bariatric surgery service of a private clinic. Obese patients older than 18 years with a body mass index (BMI) >30Kg/m2 and 2 co-morbidities undergoing a gastric sleeve surgery were included. Measurement of biochemical routine laboratory exams was performed. Insulin resistance was calculated using the homeostasis evaluation model (HOMA-IR). All patients underwent liver biopsies prior to surgery and the diagnosis of MASH was based on the Brunt criteria. Results: 159 obese patients with MASH were included, of which 47.2% had normal transaminases and 52.8% elevated transaminases. Factors associated with alteration in transaminases were: being male OR=4.02 (95% CI: 2.037.96; p50 IU/L OR=7.50 (95% CI: 3.40-16.56; p<0.01). The values of HOMA-IR and GGT were significantly higher in the group of high transaminases (p<0.01). Differences in the degree of fibrosis were not associated with transaminases levels. Conclusion: In conclusion we found that the frequency of normal transaminases was 47.2% in obese patients with MASH. Factors associated with elevation in liver enzymes were being male, diagnosis of diabetes mellitus and elevation in GGT levels. The degree of fibrosis was not associated with elevations in liver transaminases. These findings suggest that transaminases levels alone are not accurate markers to assess liver injury, as they do not necessarily correlate with histological liver damage.

Introducción: La esteatohepatitis asociada metabólica (MASH) es una de las causas más frecuentes de enfermedad hepática crónica. Las transaminasas hepáticas son biomarcadores importantes para medir el daño hepático; sin embargo, una proporción de pacientes con MASH pueden presentar niveles normales de transaminasas. Los niveles de transaminasas séricas pueden no estar correlacionados con la gravedad de los cambios histopatológicos. Objetivo: Nuestro objetivo fue identificar la frecuencia de transaminasas normales en pacientes obesos con MASH, así como describir las características clínicas, bioquímicas e histológicas en este grupo específico de pacientes. Materiales y métodos: Se realizó un estudio transversal retrospectivo en el servicio de cirugía bariátrica de una clínica privada. Se incluyeron pacientes obesos mayores de 18 años con índice de masa corporal (IMC) >30Kg/m2 y 2 comorbilidades sometidos a cirugía de manga gástrica. Se realizó la medición de los exámenes bioquímicos de laboratorio de rutina. La resistencia a la insulina se calculó mediante el modelo de evaluación de la homeostasis (HOMA-IR). Todos los pacientes se sometieron a biopsias hepáticas antes de la cirugía y el diagnóstico de MASH se basó en los criterios de Brunt. Resultados: Se incluyeron 159 pacientes obesos con MASH, de los cuales el 47,2% tenían transaminasas normales y el 52,8% transaminasas elevadas. Los factores asociados a la alteración de las transaminasas fueron: ser hombre OR=4,02 (IC 95%: 2,03-7,96; p50 UI/L OR=7,50 (IC 95%: 3,40-16,56; p<0,01). Los valores de HOMA-IR y GGT fueron significativamente mayores en el grupo de transaminasas altas (p<0,01). Las diferencias en el grado de fibrosis no se asociaron con los niveles de transaminasas. Conclusión: Encontramos que la frecuencia de transaminasas normales fue del 47,2% en pacientes obesos con MASH. Los factores asociados con la elevación de las enzimas hepáticas fueron el sexo masculino, el diagnóstico de diabetes mellitus y la elevación de los niveles de GGT. El grado de fibrosis no se asoció con elevaciones de las transaminasas hepáticas. Estos hallazgos sugieren que los niveles de transaminasas por sí solos no son marcadores precisos para evaluar el daño hepático, ya que no necesariamente se correlacionan con el daño hepático histológico.

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Resumen El uso de terapia nasal de alto flujo (TNAFO) en pacientes con insuficiencia respiratoria aguda grave (IRAG) por neumonía COVID-19 (NCOVID-19) es debatido. Ante la falta de camas en Unidades de Cuidados Intensivos en el Sistema de Salud Pública de la Provincia del Neuquén, se implementó su uso en salas generales. Con el objetivo de describir la experiencia de uso de la TNAFO en pacientes con IRAG por NCOVID-19, se llevó a cabo este estudio retrospectivo multicéntrico. El resultado primario fue la frecuencia de destete exitoso de TNAFO y la mortalidad intrahospitalaria (MIH). Se analizaron 299 pacientes, de éstos, 120 (40.1%) fueron retirados con éxito de la TNAFO. Esta fracasó en 59.8% (179), 44.1% (132) requirió ventilación mecánica invasiva (VMI) y 15.7% (47) no eran candidatos a la intubación. Un índice ROX ≥ 5 a las 6 h después del inicio, se asoció con el éxito de la TNAFO (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). La MIH general fue del 48.5% (145/299), 70.4% (93/132) en aquellos con VMI, 4.2% (5/120) falleció post destete exitoso de la TNAFO y 100% (47/47) en el grupo no candidatos a la intubación. Los pacientes con TNAFO tuvieron una disminución estadísticamente significativa en la MIH y en días de internación. El uso de TNAFO en salas generales logró una reducción en la utilización de VMI, con una reducción de la mortalidad y días de estada en los internados por NCOVID-19 con IRAG.

Abstract The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneu monia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquén, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. The primary outcome was the frequency of successful weaning from HFNT and in-hospital mortality (IHM). Two hundred ninety-nine patients were analyzed; 120 (40.1%) were successfully withdrawn from HFNT. This failed in 59.8% (179), 44.1% (132) required invasive mechanical ventilation (IMV), and 15.7% (47) was not candidates for intubation. A ROX index ≥ 5 at 6 h after initiation was associated with the success of HFNT (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.

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The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneumonia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquén, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. The primary outcome was the frequency of successful weaning from HFNT and in-hospital mortality (IHM). Two hundred ninety-nine patients were analyzed; 120 (40.1%) were successfully withdrawn from HFNT. This failed in 59.8% (179), 44.1% (132) required invasive mechanical ventilation (IMV), and 15.7% (47) was not candidates for intubation. A ROX index = 5 at 6 h after initiation was associated with the success of HFNT (OR 0.26 [IC 95% 0.15-0.46] p < 0.0001). The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.

El uso de terapia nasal de alto flujo (TNAFO) en pacientes con insuficiencia respiratoria aguda grave (IRAG) por neumonía COVID-19 (NCOVID-19) es debatido. Ante la falta de camas en Unidades de Cuidados Intensivos en el Sistema de Salud Pública de la Provincia del Neuquén, se implementó su uso en salas generales. Con el objetivo de describir la experiencia de uso de la TNAFO en pacientes con IRAG por NCOVID-19, se llevó a cabo este estudio retrospectivo multicéntrico. El resultado primario fue la frecuencia de destete exitoso de TNAFO y la mortalidad intrahospitalaria (MIH). Se analizaron 299 pacientes, de éstos, 120 (40.1%) fueron retirados con éxito de la TNAFO. Esta fracasó en 59.8% (179), 44.1% (132) requirió ventilación mecánica invasiva (VMI) y 15.7% (47) no eran candidatos a la intubación. Un índice ROX = 5 a las 6 h después del inicio, se asoció con el éxito de la TNAFO (OR 0.26 [IC 95% 0.15-0.46] p < 0.0001). La MIH general fue del 48.5% (145/299), 70.4% (93/132) en aquellos con VMI, 4.2% (5/120) falleció post destete exitoso de la TNAFO y 100% (47/47) en el grupo no candidatos a la intubación. Los pacientes con TNAFO tuvieron una disminución estadísticamente significativa en la MIH y en días de internación. El uso de TNAFO en salas generales logró una reducción en la utilización de VMI, con una reducción de la mortalidad y días de estada en los internados por NCOVID-19 con IRAG.

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BACKGROUND: The physiological stress of critically ill patients can trigger several complications, including digestive bleeding due to stress ulcers (DBSU). The use of acid secretion suppressants to reduce their incidence has become widely used, but with the current understanding of the risks of these drugs, their use, as prophylaxis in critically ill patients, is limited to the patients with established risk factors. AIM: To determine the appropriateness of the use of prophylaxis for stress ulcer bleeding in acutely ill patients admitted to intensive care units and to analyze the association of risk factors with adherence to the prophylaxis guideline. METHODS: Retrospective, analytical study carried out in three general adult intensive care units. Electronic medical records were analyzed for epidemiological data, risk factors for DBSU, use of stress ulcer prophylaxis, occurrence of any digestive bleeding and confirmed DBSU. The daily analysis of risk factors and prophylaxis use were in accordance with criteria based on the Guidelines of the Portuguese Society of Intensive Care for stress ulcer prophylaxis. RESULTS: One hundred and five patients were included. Of the patient days with the opportunity to prescribe prophylaxis, compliance was observed in 95.1%. Of the prescription days, 82.35% were considered to be of appropriate use. Overt digestive bleeding occurred in 3.81% of those included. The occurrence of confirmed DBSU was identified at 0.95%. Multivariate analysis by logistic regression did not identify risk factors independently associated with adherence to the guideline, but identified risk factors with a negative association, which were spinal cord injury (OR 0.02 p <0.01) and shock (OR 0.36 p=0.024). CONCLUSION: The present study showed a high rate of adherence to stress ulcer prophylaxis, but with inappropriate use still significant. In the indication of prophylaxis, attention should be paid to patients with spinal cord injury and in shock.

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Abstract: Chagas disease is a neglected vector-borne zoonosis caused by the parasite Trypanosoma cruzi that is primarily transmitted by insects of the subfamily Triatominae. Although control efforts targeting domestic infestations of Rhodnius prolixus have been largely successful, with several regions in Boyacá department certified free of T. cruzi transmission by intradomicile R. prolixus, novel native species are emerging, increasing the risk of disease. Triatoma dimidiata is the second most important species in Colombia, and conventional control methods seem to be less effective. In this study we evaluated the efficacy and usefulness of micro-encapsulated insecticide paints in laboratory conditions and its applicability in rural communities to avoid triatomine domiciliation. Laboratory conditions measured mortality at 6 months and 12 months, with an average mortality between 93­100% for T. dimidiata and 100% for R. prolixus. Evaluation of triatomine infestation in rural households was measured after one year, with an overall perception of effectiveness in reducing household domiciliation. Although triatomines were still spotted inside and around the homes, our findings demonstrate the ability of micro-encapsulated insecticide to prevent colonization inside the households when comparing infestation rates from previous years. Current control measures suggest insecticide spraying every six months, which implies great economic cost and logistical effort. Complementary triatomine control measures with insecticide spraying and micro-encapsulated insecticide paint would make public health efforts more efficient and reduce the frequency of treatment.

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The study presents a novel veterinary forensic approach to analyse the bruising of horse carcasses, based on the nature of the bruises and how they are grouped in certain anatomical areas. Data on pre-slaughter logistics was obtained for 113 journeys with horses that travelled from Mexico and the USA to a Mexican abattoir. We found that carcass bruising was a highly prevalent problem (79% of carcasses had bruising) and was especially problematic in journeys lasting longer than 12 h, independently of the animal's country of origin, sex, age, lairage time or vehicle type. Multivariable logistic regression showed that the most severe bruises were not dispersed randomly on the carcass and that their distribution was associated with the presence of medium-sized bruises on the abdominal wall, front and rear limb. Cluster analysis suggested four damage patterns based on bruise location: severe and concentrated bruising, as well as non-severe bruises on the rear limb, thoracic-wall or more dispersed throughout the carcass.

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Many flesh flies of the subfamily Sarcophaginae are very competitive carrion visitors and breeders, and several are synanthropic species of medical and forensic importance. The knowledge of these taxa is still limited, which is more noticeable in sub-sampled ecosystems such as the tropical dry forests of Colombia. Four new species, Blaesoxipha (Gigantotheca) wajiira sp. nov., Lepidodexia deborarangoa sp. nov., Oxysarcodexia luriza sp. nov. and Udamopyga iku sp. nov., are described from tropical dry forests in the Colombian departments of Atlántico, Bolívar, Cesar and La Guajira, all collected using Van Someren-Rydon traps baited separately with fermented fruit, decomposing fish and human feces. The species B. (G.) wajiira sp. nov. is probably synanthropic, while the remaining three new species avoid habitats in and around built-up areas. A phylogenetic parsimony analysis based on 222 morphological characters across 121 taxa of flesh flies recovers each new species nested within their respective genus. The subgeneric affiliation of L. deborarangoa sp. nov. within the large and diverse genus Lepidodexia (sensu lato) is inconclusive, and potential issues of relying solely on external morphological characters for generic and subgeneric classifications are highlighted. The species Lepidodexia (Notochaeta) woodi (Lopes), Oxyvinia wicharti (Lopes) and Sarcofahrtiopsis spinetta Mulieri & Dufek are new records for Colombia. COI sequence data are provided for U. iku sp. nov., L. (N.) woodi and O. wicharti.

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ABSTRACT Background: The physiological stress of critically ill patients can trigger several complications, including digestive bleeding due to stress ulcers (DBSU). The use of acid secretion suppressants to reduce their incidence has become widely used, but with the current understanding of the risks of these drugs, their use, as prophylaxis in critically ill patients, is limited to the patients with established risk factors. Aim: To determine the appropriateness of the use of prophylaxis for stress ulcer bleeding in acutely ill patients admitted to intensive care units and to analyze the association of risk factors with adherence to the prophylaxis guideline. Methods: Retrospective, analytical study carried out in three general adult intensive care units. Electronic medical records were analyzed for epidemiological data, risk factors for DBSU, use of stress ulcer prophylaxis, occurrence of any digestive bleeding and confirmed DBSU. The daily analysis of risk factors and prophylaxis use were in accordance with criteria based on the Guidelines of the Portuguese Society of Intensive Care for stress ulcer prophylaxis. Results: One hundred and five patients were included. Of the patient days with the opportunity to prescribe prophylaxis, compliance was observed in 95.1%. Of the prescription days, 82.35% were considered to be of appropriate use. Overt digestive bleeding occurred in 3.81% of those included. The occurrence of confirmed DBSU was identified at 0.95%. Multivariate analysis by logistic regression did not identify risk factors independently associated with adherence to the guideline, but identified risk factors with a negative association, which were spinal cord injury (OR 0.02 p <0.01) and shock (OR 0.36 p=0.024). Conclusion: The present study showed a high rate of adherence to stress ulcer prophylaxis, but with inappropriate use still significant. In the indication of prophylaxis, attention should be paid to patients with spinal cord injury and in shock.

RESUMO Racional: O estresse fisiológico dos pacientes críticos pode desencadear várias complicações, entre elas o sangramento digestivo por úlcera de estresse (SDUE). O uso de supressores da secreção ácida para reduzir sua incidência passou a ser amplamente utilizado, mas com o atual entendimento dos riscos destes medicamentos sua utilização, como profilaxia em doentes críticos, está limitada aos pacientes com fatores de risco estabelecidos. Objetivos: Determinar a adequação do uso de profilaxia para sangramento por úlcera de estresse em pacientes agudamente enfermos internados em unidades de terapia intensiva e analisar a associação dos fatores de risco com a adesão à diretriz de profilaxia. Métodos: Estudo retrospectivo, analítico, realizado em três unidades de terapia intensiva gerais de adultos. Os prontuários eletrônicos foram analisados para dados epidemiológicos, fatores de risco para SDUE, uso de profilaxia para SDUE, ocorrência de qualquer sangramento digestivo e de SDUE confirmado. A análise diária dos fatores de risco e uso de profilaxia foram de acordo com critérios baseados nas Diretrizes da Sociedade Portuguesa de Cuidados Intensivos para profilaxia da úlcera de estresse. Resultados: foram incluídos 105 pacientes. Dos pacientes-dia com oportunidade de prescrição de profilaxia, foi observada adesão em 95,1%. Dos dias de prescrição foram considerados de uso apropriado 82,35%. Sangramento digestivo visível ocorreu em 3,81% dos incluídos. A ocorrência de SDUE confirmado foi identificada em 0,95%. A análise multivariada por regressão logística não identificou fatores de risco independentemente associados com a adesão à diretriz, mas identificou fatores de risco com associação negativa, que foram lesão da medula espinhal (OR 0.02 p<0,01) e choque (OR 0.36 p=0.024). Conclusão: O presente estudo evidenciou alta taxa de adesão à profilaxia para SDUE, mas com uso inapropriado ainda significativo. Na indicação de profilaxia deve-se ter atenção aos pacientes com lesão de medula espinhal e choque.

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PURPOSE: We compared the effects of suspension training (ST) with traditional resistance training (TRT) on muscle mass, strength and functional performance in older adults. METHODS: Forty-two untrained older adults were randomized in TRT, ST (both performed 3 sets of whole body exercises to muscle failure) or control group (CON). Muscle thickness (MT) of biceps brachii (MTBB) and vastus lateralis (MTVL), maximal dynamic strength test (1RM) for biceps curl (1RMBC) and leg extension exercises (1RMLE), and functional performance tests (chair stand [CS], timed up and go [TUG] and maximal gait speed [MGS]) were performed before and after 12 weeks of training. RESULTS: MTBB increased significantly and similarly for all training groups (TRT 23.35%; ST 21.56%). MTVL increased significantly and similarly for all training groups (TRT 13.03%; ST 14.07%). 1RMBC increased significantly and similarly for all training groups (TRT 16.06%; ST 14.33%). 1RMLE increased significantly and similarly for all training groups (TRT 14.89%; ST 18.06%). MGS increased significantly and similarly for all groups (TRT 6.26%; ST 5.99%; CON 2.87%). CS decreased significantly and similarly for all training groups (TRT - 20.80%; ST - 15.73%). TUG decreased significantly and similarly for all training groups (TRT - 8.66%; ST - 9.16%). CONCLUSION: Suspension training (ST) promotes similar muscle mass, strength and functional performance improvements compared to TRT in older adults.

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Every year thousands of horses from Mexico and the United States of America (USA) are transported to slaughter in Mexico, but little is known about their welfare or pre-slaughter logistics. In this study, we recorded the origin, sex, age and condition of horses (121 journeys, 2648 animals) upon arrival to an abattoir in northern Mexico, including transport details. Horse welfare was measured indirectly via individual scores for body condition, coat quality, lameness, ocular and nasal discharge, as well as reactivity to a chute restraint test, all performed shortly after unloading. The average journey duration was 9.69 (±7.6) hours for horses from Mexico and 16.77 (±4.51) hours for horses from the USA (77 % of all journeys). The prevalence of ocular discharge, nasal discharge, skin wounds, lameness and diarrhoea, were 23 %, 12 %, 11 %, 9 %, 1 % (respectively) of all the horses observed, with no significant differences between Mexican and American horses (P ≥ 0.05). During the chute test the American horses were calmer than the Mexican ones (P < 0.001), who were more restless and aggressive (P = 0.001). Likewise, vocalizations in their three variants during the restraint, neigh/whinny (P = 0.018), nicker (P < 0.001), and snort (P = 0.018), were more common in horses from Mexico. In order to help characterize fitness for transport, a two-step cluster analysis was applied using the welfare indicators, suggesting the existence of four clusters (C) evaluated on arrival at the abattoir (from good to very poor fitness): good (profile C4, n = 769, 29.1 %), average (profile C1, n = 799 horses, 30.2 %), poor (profile C3, n = 586, 22.1 %) and very poor (profile C2, n = 494, 18.6 %). In fact, the C4 best welfare group had 0% lame, 0% nasal discharge, 16.4 % ocular discharge, 7.9 % skin wounds. Instead, the C2 poorest welfare group had 45.8 % lame, 61.1 % nasal discharge, 42.8 % ocular discharge, and 19.9 % skin wounds. Results show potential for using nasal discharge, lameness and ocular discharge as key indicators of horse fitness and welfare on abattoir. The study provides detailed scientific data to help establish strategies regarding optimal days of recovery post-transport and fattening for homogenization of weights between animals of different origins, logistic planning, and optimization of logistic resources to minimize the biological cost of long-distance transport.

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We report four cases of female patients diagnosed with autoimmune hepatitis treated in the liver unit of the National Hospital Arzobispo Loayza in the period 2014-2018, these patients became pregnant during treatment. Pregnancy in all cases came to an end without any complications, patients received immunosuppressive treatment during pregnancy. We present the sequence of events with their results and a review of the literature.

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Os métodos de produção que privilegiam a acumulação do capital acarretam crescente degradação ambiental e impactos na saúde humana. Em busca de inserção em novos mercados e aumento da competitividade, as organizações empresariais incorporam o discurso da sustentabilidade, adotam sistemas de gestão voluntários, como certificações ambientais, de saúde do trabalho e de responsabilidade social. Esta tese tem por objetivo verificar se processos de certificação internacional em empresas podem contribuir para a governança global em saúde e para a sustentabilidade universal. A metodologia adotada foi estudo de caso e baseou-se na atuação do autor. Envolveu a análise de relatórios de auditoria e consultoria em sistemas de gestão de meio ambiente, saúde e segurança do trabalho e responsabilidade social. Descrevem-se experiências em organizações empresariais do setor de mineração, nos países: Colômbia, Moçambique, Guiné, Chile, Peru e Argentina. Apresentam-se os resultados das análises realizadas e sugestões para novos estudos sobre os inter-relacionamentos da Saúde Global, com as questões de meio ambiente e de saúde do trabalhador.

Production methods that favor capital accumulation increase environmental degradation and affect human health. In search of insertion in new markets and increase of supply, as incorporated actions or in sustainability speeches, adopted voluntary management systems, such as environmental certifications, occupational health and social responsibility. This aims to verify whether international certification processes in companies can contribute to global health governance and universal sustainability. The methodology adopted was the case study and was based on the author's performance. Involve an analysis of audit reports and advice on environmental, occupational health and safety and social responsibility management systems. Experiences in mining sector organizations in Colombia, Mozambique, Guinea, Chile, Peru and Argentina are described. We present the results of the recorded analyzes and suggestions for further studies on the interests of Global Health, with environmental and occupational health issues.

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BACKGROUND AND PURPOSE: It is important to assess the effectiveness and efficiency of water-based training programs in order to prescribe it as an alternative in cardiac rehabilitation for patients who have coronary artery disease (CAD). In these patients, autonomic dysfunction is an important physiological change strongly associated with adverse outcomes, morbidity, and mortality. Given that the beneficial effects of physical training in CAD patients have been traditionally evidenced with programs involving land-based aerobic exercises, this study aims to evaluate the effects of water aerobic exercise training (WAET) on the autonomic modulation of heart rate (HR) and body composition, in the rehabilitation of CAD patients. METHODS: Twenty-six male subjects with CAD were randomly divided into a training group (n = 14), submitted to the WAET, and a control group (n = 12). The WAET consisted of 3 weekly sessions on alternate days, totalling 48 sessions. The analysis of HR variability was used to evaluate the autonomic modulation of HR, from the recording of R-R intervals for 15 min, at rest in the supine position, and the body composition was evaluated through the bioelectrical impedance analysis. RESULTS: Only the training group participants had improvement in the HR variability indices; patterns without variation decreased (0V, p = .005) and an increase of patterns of two different variations (p < .001), Shannon entropy (p = .02), and normalized conditional entropy (p = .03), whereas the control group had an increase of 0V (p = .04) and a decrease of normalized conditional entropy (p = .01). All body composition variables remained unchanged. CONCLUSIONS: The WAET protocol improved the cardiac autonomic modulation of patients with CAD and can be considered as exercise training strategy in cardiac rehabilitation programs.

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INTRODUCTION: Gallbladder cancer (GBC) is a rare tumor in developed countries. Chile has one of the highest incidences worldwide. For patients affected by resectable T1b or more advanced GBC, radical cholecystectomy (RC) is considered the standard therapy. Our aim is to describe the surgical technique and clinical-pathological results of patients undergoing totally laparoscopic radical resection of GBC. METHODS: Patients undergo laparoscopic radical resection for primary and incidental GBC, between the years 2009 and 2016 in two centers from Chile. Patients in whom suspected bile duct invasion, frozen biopsy did not confirm cancer and para-aortic lymph node sampling was positive were excluded. RESULTS: Eighteen patients were operated, 77.8% were female with median age of 60.5 year, and 16 patients had previous cholecystectomy with incidental cancer finding. The median operative time was 490 min (400-550). No conversion to open surgery occurred. All patients achieved a R0 resection. Postoperative complications occurred in 2 patients (11.1%), and there was not mortality. After a median follow-up of 59 months, the 5-year survival was 80.7%. CONCLUSION: This study shows the technical feasibility of the totally laparoscopic approach for radical resection of GBC with the same principles of classical open surgery. It appears that long-term oncological findings would also be similar at least in less advanced lesions.

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The first step for a successful use of any insect as indicator in forensic sciences is providing a precise taxonomic identification at species level. Due to morphology-based identification of Sarcophaginae flies (Diptera, Sarcophagidae) is often difficult and requires strong taxonomic expertise, their use as forensic indicators has been limited. Consequently, molecular-based approaches have been accepted as alternative means of identification. Thus, we aimed testing the efficiency of the barcode region of the mitochondrial cytochrome oxidase subunit I (COI) gene for identification of synanthropic flesh flies of several species of the genera Peckia, Oxysarcodexia, Ravinia, and Tricharaea collected in Colombia. The 645-bp fragment of COI was amplified and aligned (215 parsimoniously informative variable sites). We calculated Kimura two-parameter genetic distances and reconstruct a Neighbor-Joining phylogenetic tree. Our Neighbor-Joining tree recovered all species as monophyletic, and confirmed a new species of the genus Ravinia as also indicated by the interspecific genetic divergences and morphological observations. We obtained a 100% of identification success. Thus, the COI barcodes showed efficiency as an alternative mean of identification of species of flesh flies collected on decaying organic matter in Colombia.

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