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Abstract Introduction. Reports regarding the correlation and effect size of change of the full spectrum of quality of life and disease severity measures applied in-person to patients with atopic dermatitis are scarce. Objectives. To assess quality-of-life with 3 different instruments and to evaluate disease severity indices and to determine their correlation and effect size of change between two measurements. Materials and methods. Patient-level data were obtained through two in-person visits. Sociodemographic information and data related to disease distribution, severity (through the BSA, EASI, SCORAD, POEM, and itching scales), and the impact of atopic dermatitis on quality of life using the DLQI and Skindex-29, and EQ-5D, were assessed. The correlation between change in quality-of-life scores and disease severity scores in addition to the standardized effect size were also evaluated. Results. Only 139 out of 212 patients completed the follow-up visit. BSA highly correlated with SCORAD and EASI, and the lowest correlation was found with POEM. The best correlation of pruritus VAS was found with sleep disturbance. The SCORAD score highly correlated with EASI, and the lowest correlation was found with POEM. The magnitude of the effect at initiation of the study vs follow-up was in average moderate to important. Conclusions. Patients with atopic dermatitis experience a substantial burden on quality of life. Disease activity correlates better with quality-of-life measurements when the disease is less severe after starting therapy. POEM and Skindex-29 seem to be optimal to determine disease severity and quality of life in adults with atopic dermatitis.

Resumen Introducción. La información publicada sobre la correlación entre la magnitud del efecto de todo el espectro de la calidad de vida y la gravedad de la enfermedad en pacientes con dermatitis atópica es escasa. Objetivos. Evaluar la calidad de vida con tres instrumentos diferentes y los índices de gravedad de la enfermedad en pacientes con dermatitis atópica para determinar su correlación y el tamaño del efecto del cambio. Materiales y métodos. Los datos de los pacientes se obtuvieron a partir de dos visitas. Se evaluó la información sociodemográfica y los datos relacionados con la distribución y la gravedad de la enfermedad (mediante de las escalas BSA, EASI, SCORAD, POEM, prurito) y el impacto de la dermatitis atópica en la calidad de vida utilizando el Dermatology Life Quality Index, Skindex-29 y EQ-5D. También se evaluó la correlación entre el cambio en las puntuaciones de calidad de vida y las de gravedad de la enfermedad, además del tamaño del efecto estandarizado. Resultados. Solo 139 de los 212 pacientes completaron la visita de seguimiento. El área de superficie corporal se correlacionó fuertemente con el SCORAD y el EASI, y la correlación más débil fue con el POEM. La mejor correlación del prurito medido con la escala visual análoga se halló con la alteración del sueño. El puntaje SCORAD se correlacionó altamente con el EASI mientras que la correlación más baja se encontró con el POEM. La magnitud del efecto al inicio del estudio respecto al seguimiento fue en promedio de moderada a importante. Conclusiones. Los pacientes con dermatitis atópica experimentan una carga sustancial en la calidad de vida. La actividad de la enfermedad se correlaciona mejor con las mediciones de calidad de vida cuando esta es menos grave, después de comenzar la terapia. Los índices POEM y Skindex-29 parecen ser óptimos para determinar la gravedad de la enfermedad y la calidad de vida en adultos con dermatitis atópica.

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INTRODUCTION: Reports regarding the correlation and effect size of change of the full spectrum of quality of life and disease severity measures applied in-person to patients with atopic dermatitis are scarce. OBJECTIVES: To assess quality-of-life with 3 different instruments and to evaluate disease severity indices and to determine their correlation and effect size of change between two measurements. MATERIALS AND METHODS: Patient-level data were obtained through two in-person visits. Sociodemographic information and data related to disease distribution, severity (through the BSA, EASI, SCORAD, POEM, and itching scales), and the impact of atopic dermatitis on quality of life using the DLQI and Skindex-29, and EQ-5D, were assessed. The correlation between change in quality-of-life scores and disease severity scores in addition to the standardized effect size were also evaluated. RESULTS: Only 139 out of 212 patients completed the follow-up visit. BSA highly correlated with SCORAD and EASI, and the lowest correlation was found with POEM. The best correlation of pruritus VAS was found with sleep disturbance. The SCORAD score highly correlated with EASI, and the lowest correlation was found with POEM. The magnitude of the effect at initiation of the study vs follow-up was in average moderate to important. CONCLUSIONS: Patients with atopic dermatitis experience a substantial burden on quality of life. Disease activity correlates better with quality-of-life measurements when the disease is less severe after starting therapy. POEM and Skindex-29 seem to be optimal to determine disease severity and quality of life in adults with atopic dermatitis.

Introducción: La información publicada sobre la correlación entre la magnitud del efecto de todo el espectro de la calidad de vida y la gravedad de la enfermedad en pacientes con dermatitis atópica es escasa. Objetivos: Evaluar la calidad de vida con tres instrumentos diferentes y los índices de gravedad de la enfermedad en pacientes con dermatitis atópica para determinar su correlación y el tamaño del efecto del cambio. Materiales y métodos: Los datos de los pacientes se obtuvieron a partir de dos visitas. Se evaluó la información sociodemográfica y los datos relacionados con la distribución y la gravedad de la enfermedad (mediante de las escalas BSA, EASI, SCORAD, POEM, prurito) y el impacto de la dermatitis atópica en la calidad de vida utilizando el Dermatology Life Quality Index, Skindex-29 y EQ-5D. También se evaluó la correlación entre el cambio en las puntuaciones de calidad de vida y las de gravedad de la enfermedad, además del tamaño del efecto estandarizado. Resultados: Solo 139 de los 212 pacientes completaron la visita de seguimiento. El área de superficie corporal se correlacionó fuertemente con el SCORAD y el EASI, y la correlación más débil fue con el POEM. La mejor correlación del prurito medido con la escala visual análoga se halló con la alteración del sueño. El puntaje SCORAD se correlacionó altamente con el EASI mientras que la correlación más baja se encontró con el POEM. La magnitud del efecto al inicio del estudio respecto al seguimiento fue en promedio de moderada a importante. Conclusiones: Los pacientes con dermatitis atópica experimentan una carga sustancial en la calidad de vida. La actividad de la enfermedad se correlaciona mejor con las mediciones de calidad de vida cuando esta es menos grave, después de comenzar la terapia. Los índices POEM y Skindex-29 parecen ser óptimos para determinar la gravedad de la enfermedad y la calidad de vida en adultos con dermatitis atópica.

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Considering that microplastics (MPs) are classified as ubiquitous pollutants, that air quality affects human health, and that people remain indoors most of the time, the need has arisen to evaluate the exposure to MPs within the suspended dust in indoor environments. With this objective, the present study carried out passive sampling to analyze the precipitation of microparticles in some indoor residential environments (2 apartments) and workplaces (an office, a pastry shop, a gift shop, and a paint shop) in Barranquilla, Colombia. The quantification and physical characterization of microparticles were carried out under a stereomicroscope, and the chemical characterization was carried out by infrared microspectroscopy (µFTIR). The highest average concentration of MPs in the apartments was found in the air-conditioned rooms (1.1 × 104 MP/m2/day), and concerning the workplaces, the gift shop and the paint shop were the spaces with a higher proportion of MPs (6.0-6.1 × 103 MP/m2/day), with polyesters being the main synthetic polymers, but being semi-synthetic particles the predominant among the samples. Regarding its morphology, fibers were the most abundant shape (>90%), grouping mainly in the 1000-5000 µm range, while the few fragments found were mostly grouped below 50 µm. Exposure by inhalation of MPs in adults was estimated between 1.7 × 102-1.6 × 103 MP/kg/day, while by ingestion it ranged between 2.7 × 102-2.4 × 103 MPs/kg/day. On the other hand, within our research, a significant presence of non-plastic microparticles was found, which reached up to 69% in analyzed samples, corresponding mainly to cotton and cellulose, so we suggest that these should also be included in future studies that aim to estimate potential health implications from exposure to suspended micropollutants.

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Visceral Leishmaniasis (VL) has a high death rate, with 500,000 new cases and 50,000 deaths occurring annually. Despite the development of novel strategies and technologies, there is no adequate treatment for the disease. Therefore, the purpose of this study is to find structural analogs of natural products as potential novel drugs to treat VL. We selected structural analogs from natural products that have shown antileishmanial activities, and that may impede the purine salvage pathway using computer-aided drug-design (CADD) approaches. For these, we started with the vastly studied target in the pathway, the adenine phosphoribosyl transferase (APRT) protein, which alone is non-essential for the survival of the parasite. Keeping this in mind, we search for a substance that can bind to multiple targets throughout the pathway. Computational techniques were used to study the purine salvage pathway from Leishmania infantum, and molecular dynamic simulations were used to gather information on the interactions between ligands and proteins. Because of its low homology to human proteins and its essential role in the purine salvage pathway proteins network interaction, the findings further highlight the significance of adenylosuccinate lyase protein (ADL) as a therapeutic target. An analog of the alkaloid Skimmianine, N,N-diethyl-4-methoxy-1-benzofuran-6-carboxamide, demonstrated a good binding affinity to APRT and ADL targets, no expected toxicity, and potential for oral route administration. This study indicates that the compound may have antileishmanial activity, which was granted in vitro and in vivo experiments to settle this finding in the future.

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Since the number of drugs based on natural products (NPs) represents a large source of novel pharmacological entities, NPs have acquired significance in drug discovery. Peru is considered a megadiverse country with many endemic species of plants, terrestrial, and marine animals, and microorganisms. NPs databases have a major impact on drug discovery development. For this reason, several countries such as Mexico, Brazil, India, and China have initiatives to assemble and maintain NPs databases that are representative of their diversity and ethnopharmacological usage. We describe the assembly, curation, and chemoinformatic evaluation of the content and coverage in chemical space, as well as the physicochemical attributes and chemical diversity of the initial version of the Peruvian Natural Products Database (PeruNPDB), which contains 280 natural products. Access to PeruNPDB is available for free ( https://perunpdb.com.pe/ ). The PeruNPDB's collection is intended to be used in a variety of tasks, such as virtual screening campaigns against various disease targets or biological endpoints. This emphasizes the significance of biodiversity protection both directly and indirectly on human health.

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En el mundo se reportan más de 600 millones de personas que experimentan tinnitus. Aproximadamente 20% de las personas con tinnitus subjetivo permanente presentan incomodidad significativa, interviniendo negativamente en su calidad de vida, con inducción de estados depresivos. Existen diferentes estrategias de intervención para el manejo del tinnitus, entre ellas la estimulación acústica. El objetivo de este estudio fue evaluar el impacto de la estimulación acústica pasiva en la severidad del tinnitus y en la calidad de vida de los pacientes con tinnitus subjetivo crónico mediante la Escala Visual Análoga(VAS)y el Inventario de Discapacidad del Tinnitus(THI). Estudio descriptivo de cohorte histórico que incluyó a pacientes >18 años con tinnitus subjetivo crónico que recibieron manejo con estimulación acústica pasiva entre 2017-2018. A los pacientes se les aplicó la VAS y el THI antes, durante y después del tratamiento. Se evidenciaron cambios significativos (p<0,05) entre las medianas en dos de los tres dominios del VAS y en todos los dominios pre y post tratamiento del THI. En las pruebas post hoc se encontraron diferencias (p<0.05) entre las medianas de los puntajes al inicio y a los tres meses y entre los puntajes al inicio y a los seis meses en todos los dominios y en el puntaje total de la escala THI. La estimulación acústica pasiva generó cambios en la discapacidad generada por el tinnitus. Se sugiere complementar los abordajes de tratamiento con estrategias que favorezcan también los mecanismos de memoria, atención y conciencia para aumentar la efectividad de las intervenciones

More than 600 million people worldwide are reported to experience tinnitus. Approximately 20% of people with permanent subjective tinnitus present significant discomfort, interfering negatively in their quality of life, inducing depressive states. There are different intervention strategies for the management of tinnitus, including acoustic stimulation. The aim of this study was to evaluate the impact of passive acoustic stimulation on tinnitus severity and quality of life in patients with chronic subjective tinnitus using the Visual Analogue Scale (VAS) and the Tinnitus Disability Inventory (THI). Descriptive historical cohort study including patients >18 years with chronic subjective tinnitus who received management with passive acoustic stimulation between 2017-2018. Patients were administered VAS and THI before, during and after treatment. Significant changes (p<0.05) between medians were evident in two of the three VAS domains and in all pre ­ and post-treatment domains of THI. In post hoc tests, differences (p<0.05) were found between the medians of scores at baseline and at three months and between scores at baseline and at six months in all of the domains and in the total THI scale score. Passive acoustic stimulation generated changes in tinnitus-generated disability. It is suggested to complement treatment approaches with strategies that also favor memory, attention and awareness mechanisms to increase the effectiveness of the inter ventions

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BACKGROUND: Atopic dermatitis (AD) is considered as one of the most frequent chronic skin conditions. Previous AD epidemiologic studies have been mainly retrospective and/or have been performed through surveys instead of in-person visits. Epidemiological studies concerning AD in Latin American countries are scarce. OBJECTIVE: To describe sociodemographic and clinical features and the economic burden of AD on children and adult patients in Colombia through in-person visits. METHODS: This was a cross-sectional study of 212 patients that included sociodemographic and clinimetric data. The diagnostic criteria of Hanifin and Rajka was used and data relating to disease distribution, disease severity (through the BSA: Body surface area; EASI: Eczema Area and Severity Index; SCORAD: Scoring Atopic Dermatitis), Fitzpatrick's skin phototypes, personal and familiar history of allergic diseases, previous treatments, and personal history of comorbidities, was collected. RESULTS: Patient age range was 12-76, and 52.8% were female. Disease distribution was mainly flexural (19.6%). Early age start, Denni-Morgan fold, and infections tendency were more frequent in adolescents compared to adults. Mean age of diagnosis was 12 years old, AD diagnosis was made mostly by a dermatologist, 48.1% (102 patients) reported alcohol consumption, and 59% of consumers were heavy drinkers. Comorbidities found were: chronic rhinitis (68.9%) food allergy (32.5%), allergic conjunctivitis (29.7%), and asthma (28.8%). Around 81% earned less than $896 US dollars and 59% invested 6-30% of their monthly budget yearly, and 40% had work or school absenteeism. Mean scores of BSA, EASI, and SCORAD involvement were 32.6, 13.7, and 42.4, respectively. CONCLUSIONS: This study adds well-supported data through an in-depth clinical and economical characterization of Colombian adolescents and adult patients with atopic dermatitis and shows its high impact and burden on patients and their families. It also contributes to understand the burden of AD in Latin America.

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INTRODUCTION: Introduction: the migration process involves change, modification, or acquisition of new eating patterns and ways of eating, which do not always positively impact the health of migrants, being frequently associated with a higher risk of metabolic diseases and excess malnutrition when the quality of food is not adequate. Objective: to analyze the global food quality index (GQI) in the Colombian migrant population in Chile, comparing it with the Chilean population and non-migrant Colombians. Methods: the total sample consisted of 834 individuals over 18 years of age - 206 Colombian migrants residing in Chile, 266 Colombians residing in Colombia, and 362 Chileans. A global food quality index survey was applied to categorize the healthiness of the participants' dietary patterns. Results: there were significant differences in all the ICGA scores analyzed regarding healthy foods, unhealthy foods, and mealtimes. It was observed that Colombians residing in Colombia have the highest score in the healthy classification, while Colombian migrants have the highest figures in the unhealthy condition. Regarding meal times, Chileans are the least compliant with meal times. However, other influences related to food groups stand out. Conclusion: it is necessary to delve deeper into variables linked to the sociodemographic context, analyze potential changes over time, and replicate in migrants of other nationalities to have more information on the relationship between food quality and the migration process.

INTRODUCCIÓN: Introducción: el proceso de migración involucra cambio, modificación o adquisición de nuevos patrones y formas de alimentación, los cuales no siempre impactan de manera positiva en la salud de los migrantes, siendo frecuentemente asociadas a un mayor riesgo de enfermedades metabólicas y malnutrición por exceso cuando la calidad de la alimentación no es la adecuada. Objetivo: analizar el índice de calidad global de la alimentación (ICGA) en la población migrante colombiana en Chile, comparándola con la población chilena y la colombiana no migrante. Material y método: el total de la muestra fue de 834 individuos mayores de 18 años: 206 migrantes colombianos residiendo en Chile, 266 colombianos residentes en Colombia y 362 chilenos. Se les aplicó una encuesta de índice de calidad global de la alimentación para categorizar cuán saludable es el patrón alimentario de los participantes. Resultados: existen diferencias significativas en todos los puntajes analizados del ICGA en cuanto a alimentos saludables, no saludables y por tiempos de comidas. Se observó que los colombianos residentes en Colombia cuentan con el mayor puntaje de clasificación saludable mientras que los colombianos migrantes presentan las más altas cifras dentro de la condición poco saludable. En cuanto a los tiempos de comida, los chilenos son los que menos cumplen con los horarios. No obstante, destacan otras influencias relacionadas con los grupos de alimentos. Conclusión: es necesario ahondar en las variables vinculadas al contexto sociodemográfico, analizar los potenciales cambios en el tiempo y replicar la investigación en migrantes de otras nacionalidades para contar con mayores antecedentes sobre la relación entre la calidad de la alimentación y el proceso migratorio.

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Given that the COVID-19 era has changed the behavior of all individuals, and since previous reports about its possible impact on atopic dermatitis (AD) patients remained speculative, in this survey we aimed to explore the real impact of COVID-19 among AD patients. All participants provided verbal consent prior to completing the survey. A 37-question web-based survey with no personal identifiers was sent to 212 previously identified AD patients. Itching, sleep disturbances, SARS-CoV-2, illness cost, economic dependence, monthly income, and monthly investment in AD before and during the pandemic, were all included in the analysis. A response rate of 73.1% was obtained. The mean age of participants was 30 years-old, and 57% were women. Around 75% reported AD worsening, and 59.4% of the patients reported sleep problems. Uncertainty, anxiety, and pessimism were frequent during the pandemic. Only 1.3% tested positive for SARS-CoV-2, and it was only significantly associated with comorbidities (p=0.03; Chi2 Test). A significant difference was found in economic dependence and monthly income when compared between before and during the pandemic. This study provides probably the best possible assessment of the clinical, social, and economic effects of the pandemic on patients with an already proven diagnosis of AD.

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Resumen Introducción: El consumo de sustancias psicoactivas es un problema de salud pública con alta prevalencia en los adolescentes, situación que influye en el desarrollo individual y social en la adultez. Objetivo: Determinar los factores psicosociales relacionados al consumo de sustancias psicoactivas en adolescentes escolarizados de básica secundaria y educación media de una Institución Educativa pública del área urbana de Pereira. Materiales y métodos: Estudio descriptivo correlacional con 235 estudiantes de un colegio público, entre 10 y 19 años de edad, quienes completaron una encuesta anónima que indagaba la prevalencia y los factores psicosociales asociados al consumo. Resultados: Se encontró que la adecuada supervisión de los padres es un factor protector frente al consumo de sustancias psicoactivas (p<0,05) (OR<1), los escolares tienen 6,5 veces más posibilidades de consumir cuando se relacionan con amigos que consumen [OR=6,555 IC95% (3,147-13,653)], los que tienen familiares que consumen, tienen 2,2 veces más posibilidades de consumir estas sustancias [OR=2,231 IC95% (1,292-3,852) ]. Conclusiones: El consumo de sustancias psicoactivas muestra una elevada prevalencia en los escolares encuestados y los principales factores relacionados son cursar grados superiores y tener familiares o amigos que consumen sustancias psicoactivas.

Abstract Introduction: The use of psychoactive substances is a public health problem with a high prevalence in adolescents, which also affects the individual and social development of adults. Objective: To determine the psychosocial factors related to the use of psychoactive substances in children and adolescents of a public school from Pereira (Colombia). Materials and methods: A descriptive correlational study was conducted on 235 students of a public school, aged between 10 and 19 years, who completed an anonymous survey to examine the prevalence and psychosocial factors associated with the use of psychoactive substances. Results: Adequate parental supervision is a protective factor against psychoactive drug use (p<0.05) (OR<1). Schoolchildren are 6.5 times more likely to engage in drug use when they interact with psychoactive-drug user friends [OR=6.555 95%CI (3.147-13.653)]. Those with family members who engage in this drug use have a 2.2 times higher possibility to use psychoactive substances [OR=2.231 95%CI (1.292-3.852)]. Conclusions: The use of psychoactive substances shows a high prevalence in the participating schoolchildren and is mainly related to factors such as being in higher grades in their school and having either a family member or a friend who uses psychoactive substances.

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The genus Paracoccidioides consist of dimorphic fungi geographically limited to the subtropical regions of Latin America, which are responsible for causing deep systemic mycosis in humans. However, the molecular mechanisms by which Paracoccidioides spp. causes the disease remain poorly understood. Paracoccidioides spp. harbor genes that encode proteins involved in host cell interaction and mitochondrial function, which together are required for pathogenicity and mediate virulence. Previously, we identified TufM (previously known as EF-Tu) in Paracoccidioides brasiliensis (PbTufM) and suggested that it may be involved in the pathogenicity of this fungus. In this study, we examined the effects of downregulating PbTUFM using a silenced strain with a 55% reduction in PbTUFM expression obtained by antisense-RNA (aRNA) technology. Silencing PbTUFM yielded phenotypic differences, such as altered translation elongation, respiratory defects, increased sensitivity of yeast cells to reactive oxygen stress, survival after macrophage phagocytosis, and reduced interaction with pneumocytes. These results were associated with reduced virulence in Galleria mellonella and murine infection models, emphasizing the importance of PbTufM in the full virulence of P. brasiliensis and its potential as a target for antifungal agents against paracoccidioidomycosis.

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Resumen Se pudo concluir que los procesos de enseñanza y aprendizaje, se manifiestan como prácticas desarticuladas del modelo pedagógico adoptado, debido a la autonomía que impera en los docentes, con respecto al empleo de sus estrategias de enseñanza. Del mismo modo, no existe una articulación de los intereses de los estudiantes con los propósitos de un modelo pedagógico concreto, lo cual, no garantiza la claridad en su proyección a futuro. Como estrategia pedagógica para articular los intereses de los estudiantes de educación media con los procesos de enseñanza y aprendizaje y el modelo pedagógico, se diseñó una unidad didáctica.

Abstract It could be concluded that the teaching and learning processes are manifested as disarticulated practices of the adopted pedagogical model due to the autonomy, which prevails in teachers, with regard to the use of their teaching strategies. Similarly, there is no articulation of students' interests for the purposes of a specific pedagogical model, which does not guarantee clarity in their forward projection. As a pedagogical strategy to articulate the interests of secondary education students with the teaching and learning processes and the pedagogical model, a didactic unit was designed.

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En los últimos meses se ha creado una alarma internacional en torno a la creciente expansión del virus del Zika en las Américas. La transmisión del Zika en Venezuela está asociada amosquitos del géneroAedes al igual que el Dengue y el Chikungunya provocando que las 3 enfermedades coexistan en los mismos espacios geográficos. La posible asociación de la infección por zika y el incremento de casos del Sindrome de Guillain Barré han encendido las alertas sanitarias al igual que los casos de microcefalia en recién nacidos de madres infectadas. Por tratarse de una reciente infección viral, existen características de la infección que aún desconocemos, pero se están estudiando formas de transmisión adicionales a la vectorial. Este flavivirus puede ser detectado por biología molecular, a través de la reacción en cadena de la polimerasa posterior a transcripción inversa en muestras de suero sanguíneo, y las pruebas confirmatorias en nuestro país se realizan únicamente en el Instituto Nacio nal de Higiene "Rafael Rangel", ubicado en la Ciudad universitaria en Caracas. Lamentablemente, en tiempos de una profunda crisis económica y política en un contexto socio sanitario deficiente; el Ministerio del Poder Popular para la Salud en Venezuela no ha publicado el boletín epidemiológico desde el año 2014, y como consecuencia enla poblacióndesconocemos oficialmente cuántos casos existen en el país hasta la fecha. La forma más efectiva de prevención actualmentees la educación sanitaria y el control vectorial, con la necesaria contribución de cada ciudadana/o.

In recent months an international alarm has been createdabouttheincreasingexpansion of theZika virus in theAmericas. Zika transmission in Venezuela is associated with Aedes mosquitoes as well as Dengue and Chikungunya causing 3 diseases coexisting in thesamegeographicalareas. Thepossibleassociation of infectionzika and increased cases of Guillain Barré syndrome have turnedon healthalerts as cases of microcephaly in newborns of infected mothers. Being a recent viral infection, there are features of infection stillunknown, butthey are exploringways of further transmission vector. This flavivirus can be detected by molecular biology, through the chain reaction of subsequentpolymerase reverse transcription in blood serum samples, and confirmatory tests in our country are madeonly at the National Institute of Hygiene "Rafael Rangel", located in the University City in Caracas. Unfortunately, in times of a deep economic and political crisis in poor health social context; the Ministry of Popular Power for Health in Venezuela has notreleased the epidemiological bulletinsince 2014, and as a result the population official lyunknownhow many cases exist in the country to date. Themost effective form of prevention is currently the health education and vector control, witht he necessary contribution of each citizen.

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The ability of Paracoccidioides to defend itself against reactive oxygen species (ROS) produced by host effector cells is a prerequisite to survive. To counteract these radicals, Paracoccidioides expresses, among different antioxidant enzymes, superoxide dismutases (SODs). In this study, we identified six SODs isoforms encoded by the Paracoccidioides genome. We determined gene expression levels of representative isolates of the phylogenetic lineages of Paracoccidioides spp. (S1, PS2, PS3 and Pb01-like) using quantitative RT-PCR. Assays were carried out to analyze SOD gene expression of yeast cells, mycelia cells, the mycelia-to-yeast transition and the yeast-to-mycelia germination, as well as under treatment with oxidative agents and during interaction with phagocytic cells. We observed an increased expression of PbSOD1 and PbSOD3 during the transition process, exposure to oxidative agents and interaction with phagocytic cells, suggesting that these proteins could assist in combating the superoxide radicals generated during the host-pathogen interaction. Using PbSOD1 and PbSOD3 knockdown strains we showed these genes are involved in the response of the fungus against host effector cells, particularly the oxidative stress response, and in a mouse model of infection. Protein sequence analysis together with functional analysis of knockdown strains seem to suggest that PbSOD3 expression is linked with a pronounced extracellular activity while PbSOD1 seems more related to intracellular requirements of the fungus. Altogether, our data suggests that P. brasiliensis actively responds to the radicals generated endogenously during metabolism and counteracts the oxidative burst of immune cells by inducing the expression of SOD isoforms.

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The interaction between the fungal pathogen Paracoccidioides brasiliensis and host cells is usually mediated by specific binding events between adhesins on the fungal surface and receptors on the host extracellular matrix or cell surface. One molecule implicated in the P. brasiliensis-host interaction is the 14-3-3 protein. The 14-3-3 protein belongs to a family of conserved regulatory molecules that are expressed in all eukaryotic cells and are involved in diverse cellular functions. Here, we investigated the relevance of the 14-3-3 protein to the virulence of P. brasiliensis. Using antisense RNA technology and Agrobacterium tumefaciens-mediated transformation, we generated a 14-3-3-silenced strain (expression reduced by ˜55%). This strain allowed us to investigate the interaction between 14-3-3 and the host and to correlate the functions of P. brasiliensis 14-3-3 with cellular features, such as morphological characteristics and virulence, that are important for pathogenesis.

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Introducción. La hernia inguinal es uno de lospadecimientos más comunes que ameritan manejo quirúrgico y puede ser reparada utilizando anestesia local. El bloqueo ilioinguinal-iliohipogástrico es una técnica novedosa y poco evaluada para practicar la hernioplastia inguinal. Objetivos. Evaluar la seguridad y la efectividad de esta técnica en nuestro medio hospitalario. Material y métodos. Se llevó a cabo un estudio observacional y prospectivo que incluyó a todos los pacientes operados con anestesia local por la técnica del bloqueo ilioinguinal-iliohipogástrico, desde el 2009 hasta el 2014. Se estudiaron las variables demográficas, el tipo de hernia según la clasificación de Nyhus, las técnicas quirúrgicas empleadas, el tiempo quirúrgico,las complicaciones posoperatorias inmediatas (menos de 30 días) y el dolor posoperatorio evaluado mediante la escala visual análoga a las 24 y 72 horas, y a los 10 y 30 días. Resultados. La hernia inguinal indirecta se presentó en 409 pacientes (88,3 %). Los defectos de la pared posterior representaron el 11,6 %. El 63,9 % de los casos fueron tratados a base de prótesis y el 8,2 % tuvieron algún tipo de complicación sin relación con la técnica anestésica, en los primeros 30 días del posoperatorio. Los valores medios de la escala visual análoga fueron bajos para las primeras 24 horas y 30 días. El nivel de aceptación del método anestésico fue de 95,5 %. Conclusiones. La hernioplastia inguinal con anestesia local mediante bloqueo ilioinguinal-iliohipogástrico es una técnica factible, segura y efectiva para este tipo de operación, lo que la hace ideal para su aplicación en centros quirúrgicos de cualquier nivel y en lugares con recursos limitados.

Introduction: Repair of inguinal hernia is one of the most common surgical procedures, and it can be performed under local anesthesia. The ilioinguinal-iliohypogastric blockade is a novel and poorly evaluated technique for inguinal hernia repair. Objectives: To evaluate safety and effectiveness of this technique in our hospital environment. Material and methods: Prospective observational study involving all patients operated under local anesthesia with ilioinguinal-iliohypogastric blockade in the period 2009 to 2014. Demographic variables, type of hernia according to the Nyhus classification, surgical techniques employed, operating time, immediate postoperative complications (<30 days) and postoperative pain assessed by visual analog scale (VAS) at 24 hours, 72 hours, 10 days and 30 days were studied. Results: Indirect inguinal hernia occurred in 409 patients (88.3%). Direct hernias represented 11.6 %, and 63.9 % of cases were treated with mesh. 8.2% of our patients had complications in the first 30 postoperative days unrelated to the anesthetic technique. EVA mean values were low for the first 24 hours and 30 days. The level of acceptance of the anesthetic method was 95.5 % Conclusions: Inguinal hernia repair under local anesthesia with ilioinguinal-iliohypogastric blockade is feasible, safe and effective for this type of operation, which makes it ideal for use in surgical centers at any level of care and in places with limited resources

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Los miRNAs son pequeños RNAs que participan en diversos procesos de regulación génica, mediante ribointerferencia y juegan un papel clave en diversos procesos biológicos, tales como proliferación celular, diferenciación y apoptosis. En consecuencia, la expresión alterada de miRNAs contribuye a la enfermedad humana, incluyendo cáncer. En esta revisión, nos centraremos en los recientes hallazgos de miRNAs que inciden en el desarrollo de cáncer y particularmente en cáncer de seno, simultáneamente evaluaremos sus mecanismos de regulación, su clasificación, su uso como marcadores de invasión tumoral, de sensibilidad a fármacos y adicionalmente exploraremos la utilidad de los miRNAs en el diagnóstico, seguimiento y tratamiento individualizo. Finalmente encontramos que los miRNAs representan una gran alternativa para entender las bases moleculares de los procesos tumorales implícitos en cáncer de seno y una vez se conozcan todas sus dianas, será posible dilucidar al menos en parte este proceso complejo y multigénico, ayudado mediante herramientas como la generación de bases de datos, para reportan la expresión diferencial de miRNAs, elementos que nos permitirá realizar medicina preventiva y mejorar la calidad de vida de los pacientes y sus familias.

MiRNAs are small RNAs that are involved in various processes of gene regulation by RNAi and play a key role in various biological, such as cell proliferation, differentiation and apoptosis processes. Consequently, the altered expression of miRNAs contribute to human disease, including cancer. In this review, we will focus on the recent findings of miRNAs that affect the development of cancer, particularly breast cancer, simultaneously evaluate their regulatory mechanisms , their classification , their use as markers of tumor invasion, drug susceptibility and further explore the utility of miRNAs in the diagnosis, monitoring and individualize treatment. Finally found that miRNAs represent a great alternative for understanding the molecular basis of implicit tumor processes in breast cancer and once all targets are known, it will be possible to elucidate at least in part this complex and multigenic process, aided by tools such as generation of databases, to report the differential expression of miRNAs, elements that allow us to preventive medicine and improve the quality of life of patients and their families.

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En este artículo analizamos empíricamente los factores que inciden en la decisión del uso de atención materna en Colombia para el 2010. Estimamos un modelo logístico-binomial para explicar la asistencia de las mujeres a controles prenatales y la atención médica en el parto, utilizando una submuestra de la Encuesta Nacional de Demografía y Salud de 2010. Entre las variables consideradas están la edad de la mujer, el número de hijos o hijas, el índice de riqueza del hogar, el nivel educativo de la mujer y su cónyuge, algunas dimensiones de autonomía femenina, entre otros. Los resultados indican que el nivel educativo, la región de residencia y la participación de la mujer en las decisiones sobre su salud y el uso de anticonceptivos, son las variables que más influenciaron en la probabilidad de emplear servicios maternos.

In this article, we analyze empirically the factors that make an impact on the decision of using maternity health assistance in Colombia for the year 2010. We estimate a logistic-binomial model to explain to the women the importance of their attendance to prenatal control and of medical assistance during labor using a sub-sample of the 2010 National Survey on Demography and Health. Among the variables considered are the woman's age, the number of children, the household's purchasing power, the educational level of the woman and her spouse, some dimensions of feminine autonomy and others. The results indicate that the educational level, the region where they live and the woman's participation in the decisions regarding her health and the use of contraceptives, are the variables that had the strongest impact on the probability of them using maternity services.

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Describir y cuantificar alteraciones morfológicas en vellosidades placentarias de embarazadas cuyo feto desarrolló malformaciones esqueléticas múltiples. MÉTODOS: se analizaron cuatro placentas de abortos terapéuticos a las 13, 16, 20 y 38 semanas de gestación. Estas se compararon con placentas normales a la misma edad de gestación de abortos electivos por indicación médico legal. Tinción de hematoxilinaeosina se aplicó a 10 láminas de 5 regiones de cada placenta utilizando un protocolo con 4 variables cuantitativas: madurez, cambios fibrinoides, edema y fibrosis estromal y una variable cualitativa: trombosis. Los resultados cuantitativos se analizaron utilizando el análisis de varianza (ANAVAR) según arreglo completamente aleatorizado y el test de Tukey. Para la variable cualitativa se aplicó la prueba de tendencia para datos correlacionados. Se empleó el software statistix 8.0 y SAS 9.0 para Windows. RESULTADOS: existen diferencias significativas (p<0,05) entre las placentas asociadas a malformaciones múltiples del sistema esquelético y las placentas control en relación a las variables cuantitativas. No se encontraron diferencias significativas (p>0,05) en relación a la variable cualitativa. CONCLUSIONES: la población de vellosidades placentarias asociadas a malformaciones múltiples del sistema esquelético presentó un alto porcentaje de alteraciones indicando que la barrera placentaria está dañada afectando el intercambio de gases, nutrientes y metabolitos durante el desarrollo del feto...

To describe and quantify morphological changes in placental villi in pregnancies with multiple fetal malformations of the skeletal system. METHODS: four placentas from fetuses of gestational ages 13, 16, 20 and 38 weeks, aborted for therapeutic reasons were examined. Normal placentas of the same gestational age, from cases where legal elective abortion had been recommended on medical grounds, were taken as the control. The hematoxilineosin stain was applied to ten slides in five regions of each placenta using a protocol with four quantitative variables: maturity of villi, fibrinoid changes, edema and stromal fibrosis and one qualitative variable: thrombosis. The quantitative results were analyzed using ANOVA in a randomized manner and the Tukey test was applied; for the qualitative variable the trend test for correlated data was used. The software used was Statistix 8.0 and SAS 9.0 for Windows. RESULTS: there were significant differences (p<0.05) between the placentas associated with multiple malformations of the skeletal system and control placentas in terms of the quantitative variables. No significant differences were found (p>0.05) in relation to the qualitative variable. CONCLUSIONS: the population of placental villi associated with multiple malformations of the skeletal system exhibited a high percentage of changes which is an indication that the placenta is damaged, thereby affecting the exchange of gases, nutrients and metabolites during the development of the fetus...

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INTRODUCTION: Obesity is held as the 21(st) Century epidemics. Multidisciplinary medical management has been insufficient and surgical techniques are more frequently used. Gastric bypass is considered the gold standard in bariatric surgery; however, some patients report low rates of weight loss, which leads to thinking about other conditioning factors. OBJECTIVE: To establish the factors associated to weight loss in a cohort of obese patients submitted to gastric bypass. METHODS: Analytical retrospective study. The study variable was weight loss, expressed as the percentage of excess body mass index lost (%EBMIL). A linear regression model of mixed effects was performed as well as a COX model of proportional risks. RESULTS: 166 patients aged 19-69 years, most of them women (74.7%), were studied. The average baseline body mass index (BMI) was 46.9 ± 6.8 kg/m(2) and 46.3 ± 7.7 kg/m(2) for males and females, respectively. The multivariate analysis showed that for each 10.0 kg/m(2) in excess at the time of surgery, the PBMIEL decreased by 9.8% and that inadequate daily caloric intake decreased the PBMIEL by 4.0%. For each 10.0 kg/m(2) of baseline BMI, there was a 57.8% decrease in the likelihood of achieving a 50% weight loss. CONCLUSIONS: The patients with lower weight excess according to their BMI have a better response to bariatric surgery in terms of PBMIEL.

Introducción: La obesidad es catalogada como la epidemia del siglo XXI. El tratamiento médico multidisciplinario no ha sido suficiente y las técnicas quirúrgicas son empleadas con mayor frecuencia. El bypass gástrico es considerado el gold standard de la cirugía bariátrica, sin embargo, algunos pacientes reportan bajas tasas de pérdida de peso, lo que hace pensar en otros factores condicionantes. Objetivo: Establecer los factores asociados con la pérdida de peso, en una cohorte de pacientes obesos sometidos a bypass gástrico. Métodos: Estudio analítico retrospectivo. La variable respuesta fue la pérdida de peso, expresada en porcentaje del exceso de índice de masa corporal perdido (PEIMCP). Se realizó un modelo de regresión lineal de efectos mixtos y un modelo de riesgos proporcionales de COX. Resultados: Se estudiaron 166 pacientes entre 19 y 69 años, la mayoría mujeres (74,7%). Los hombres presentaron un índice de masa corporal (IMC) inicial promedio de 46,9 ± 6,8 kg/m2 y las mujeres de 46,3 ± 7,7 kg/m2. El análisis multivariado mostró que por cada 10,0 kg/m2 de mas al momento de la cirugía, disminuyó el PEIMCP en un 9,8% y un inadecuado consumo calórico diario disminuyó en un 4,0% el PEIMCP. Por cada 10,0 kg/m2 de IMC inicial, hubo una disminución del 57,8% en la probabilidad de lograr una pérdida de peso del 50%. Conclusiones: Los pacientes con menor exceso de peso según su índice IMC responden mejor a la cirugía bariátrica en términos del PEIMCP.

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