RESUMO

OBJECTIVE: To develop a simple, robust, safe and efficient invasive mechanical ventilator that can be used in remote areas of the world or war zones where the practical utility of more sophisticated equipment is limited by considerations of maintainability, availability of parts, transportation and/or cost. METHODS: The device implements the pressure-controlled continuous mandatory ventilation mode, complemented by a simple assist-control mode. Continuous positive airway pressure is also possible. The consumption of compressed gases is minimized by avoiding a continuous flow of oxygen or air. Respiratory rates and inspiration/expiration time ratios are electronically determined, and an apnea/power loss alarm is provided. RESULTS: The pressure profiles were measured for a range of conditions and found to be adjustable within a ± 2.5cmH2O error margin and stable well within this range over a 41-hour period. Respiratory cycle timing parameters were precise within a few percentage points over the same period. The device was tested for durability for an equivalent period of four months. Chemical and biological tests failed to identify any contamination of the gas by volatile organic compounds or microorganisms. A ventilation test on a large animal, in comparison with a well established ventilator, showed that the animal could be adequately ventilated over a period of 60 minutes, without any noticeable negative aftereffects during the subsequent 24-hour period. CONCLUSION: This ventilator design may be viable, after further animal tests and formal approval by the competent authorities, for clinical application in the abovementioned atypical circumstances.

OBJETIVO: Desenvolver um ventilador mecânico invasivo simples, resistente, seguro e eficiente que possa ser utilizado em áreas remotas do mundo ou zonas de guerra, em que a utilidade prática de equipamentos mais sofisticados é limitada por questões de manutenção, disponibilidade de peças, transporte e/ou custo. MÉTODOS: O dispositivo implementa o modo de ventilação mandatória contínua com pressão controlada, complementado por um simples modo assisto-controlado. Pode-se também utilizar a pressão positiva contínua nas vias aéreas. Ao se evitar o fluxo contínuo de oxigênio ou ar, minimiza-se o consumo de gases comprimidos. As taxas respiratórias e as relações de tempo de inspiração e expiração são determinadas eletronicamente. Além disso, conta com um alarme de apneia/falta de energia. RESULTADOS: Os perfis de pressão foram medidos para uma série de condições, sendo considerados ajustáveis dentro de uma margem de erro de ± 2,5cmH2O, e foram considerados bem estáveis dentro dessa variação durante um período de 41 horas. Os parâmetros de tempo do ciclo respiratório foram precisos dentro de alguns pontos percentuais durante o mesmo período. O dispositivo foi testado quanto à durabilidade por um período equivalente a 4 meses. Os testes químicos e biológicos não conseguiram identificar qualquer contaminação do gás por compostos orgânicos voláteis ou micro-organismos. Em comparação com um ventilador bem estabelecido, o teste de ventilação em um animal de grande porte mostrou que este poderia ser ventilado adequadamente durante um período de 60 minutos, sem quaisquer efeitos negativos perceptíveis durante o período subsequente de 24 horas. CONCLUSÃO: Este projeto de ventilador pode ser viável após novos testes em animais e aprovação formal pelas autoridades competentes, para aplicação clínica nas circunstâncias atípicas anteriormente mencionadas.

Assuntos

RESUMO

RESUMO Objetivo: Desenvolver um ventilador mecânico invasivo simples, resistente, seguro e eficiente que possa ser utilizado em áreas remotas do mundo ou zonas de guerra, em que a utilidade prática de equipamentos mais sofisticados é limitada por questões de manutenção, disponibilidade de peças, transporte e/ou custo. Métodos: O dispositivo implementa o modo de ventilação mandatória contínua com pressão controlada, complementado por um simples modo assisto-controlado. Pode-se também utilizar a pressão positiva contínua nas vias aéreas. Ao se evitar o fluxo contínuo de oxigênio ou ar, minimiza-se o consumo de gases comprimidos. As taxas respiratórias e as relações de tempo de inspiração e expiração são determinadas eletronicamente. Além disso, conta com um alarme de apneia/falta de energia. Resultados: Os perfis de pressão foram medidos para uma série de condições, sendo considerados ajustáveis dentro de uma margem de erro de ± 2,5cmH2O, e foram considerados bem estáveis dentro dessa variação durante um período de 41 horas. Os parâmetros de tempo do ciclo respiratório foram precisos dentro de alguns pontos percentuais durante o mesmo período. O dispositivo foi testado quanto à durabilidade por um período equivalente a 4 meses. Os testes químicos e biológicos não conseguiram identificar qualquer contaminação do gás por compostos orgânicos voláteis ou micro-organismos. Em comparação com um ventilador bem estabelecido, o teste de ventilação em um animal de grande porte mostrou que este poderia ser ventilado adequadamente durante um período de 60 minutos, sem quaisquer efeitos negativos perceptíveis durante o período subsequente de 24 horas. Conclusão: Este projeto de ventilador pode ser viável após novos testes em animais e aprovação formal pelas autoridades competentes, para aplicação clínica nas circunstâncias atípicas anteriormente mencionadas.

ABSTRACT Objective: To develop a simple, robust, safe and efficient invasive mechanical ventilator that can be used in remote areas of the world or war zones where the practical utility of more sophisticated equipment is limited by considerations of maintainability, availability of parts, transportation and/or cost. Methods: The device implements the pressure-controlled continuous mandatory ventilation mode, complemented by a simple assist-control mode. Continuous positive airway pressure is also possible. The consumption of compressed gases is minimized by avoiding a continuous flow of oxygen or air. Respiratory rates and inspiration/expiration time ratios are electronically determined, and an apnea/power loss alarm is provided. Results: The pressure profiles were measured for a range of conditions and found to be adjustable within a ± 2.5cmH2O error margin and stable well within this range over a 41-hour period. Respiratory cycle timing parameters were precise within a few percentage points over the same period. The device was tested for durability for an equivalent period of four months. Chemical and biological tests failed to identify any contamination of the gas by volatile organic compounds or microorganisms. A ventilation test on a large animal, in comparison with a well established ventilator, showed that the animal could be adequately ventilated over a period of 60 minutes, without any noticeable negative aftereffects during the subsequent 24-hour period. Conclusion: This ventilator design may be viable, after further animal tests and formal approval by the competent authorities, for clinical application in the abovementioned atypical circumstances.

RESUMO

Resumen Introducción: Si bien actualmente la 8a edición de la clasificación del AJCC para cáncer biliar, recomienda una linfadenectomía con 6 o más GL, su aplicación es escasa. Objetivo: Analizar la aplicabilidad y los resultados de la linfadenectomía en pacientes resecados con fines curativos por cáncer biliar. Materiales y Método: Análisis retrospectivo de pacientes operados por cáncer biliar de 2001 a 2018. Se analizaron variables perioperatorias referidas a la linfadenectomía (número de GL, GL+, morbilidad), comparando supervivencia en pacientes con < 6 y ≥ 6 GL resecados. Resultados: en 72 pacientes resecados por cáncer biliar (46 CaV, 26 CC), se realizaron 66 (91.7%) linfadenectomías N1. En 62.1% (n = 41) se obtuvieron < 6 GL y en el 37.9% (n = 25) ≥ 6 GL. El promedio de GL resecados fue de 5. En 16 (24,2%) linfadenectomías se hallaron GL+ sin diferencias entre ambos grupos. La morbimortalidad global fue de 30,3%, con una mortalidad del 4.5% sin diferencias. Con un seguimiento de 36.9 meses, la supervivencia a 5 años fue 43,7% (n = 17), 7 pacientes con ≥ 6 GL, y 10 pacientes con < 6 GL (p = NS). La supervivencia media en pacientes con GL+ fue 15 meses (6-34 meses). Conclusión: la linfadenectomía ocupa un rol primordial en la cirugía curativa del cáncer biliar, tanto para definir una estadificación y un pronóstico adecuados como para optimizar los resultados de la resección curativa en esta entidad. Su indicación debe ser sistemática con la obtención de un número adecuado de GL acorde a las recomendaciones actuales.

Introduction: Currently the 8th edition of the AJCC classification recommends the resection of 6 or more lymph nodes (LN) in gallbladder cancer and cholangiocarcinoma. However, its implementation is universally scarce. Aim: The goal is to analyze the applicability and results of lymphadenectomy in patients resected with curative purposes in biliary cancer. Materials and Method: a retrospective analysis of patients with biliary cancer (gallbladder carcinoma, intrahepatic and hilar cholangiocarcinoma) treated by curative resection from 2001 to 2018 was performed. Perioperative variables related to lymphadenectomy (LN number, LN positive, related morbidity) were analyzed, comparing survival in patients with < 6 and ≥ 6 resected LN. Results: 72 patients resected for biliary cancer (46 gallbladder cancer, 26 cholangiocarcinoma) were included with 66 (91.7%) N1 lymphadenectomies corresponding to the hepatoduodenal ligament nodes performed. In 62.1% (n = 41) < 6 LN and in 37.9% (n = 25) ≥ 6 LN were resected. Average LN count was 5. In 16 (24.2%) patients positive LN were found, 7 in the group with ≥ 6 LN (28%) vs. 9 in the group with < 6 LN (22%) (p = NS). Overall morbimortality was 30.3% (n = 20). Average follow-up was 36.9 months. Survival at 5 years was 43.7% (n = 17), 7 patients with lymphadenectomy ≥ 6 LN, and 10 patients with < 6 LN (p = NS). Survival mean in patients who had positive LN was 15 months. Conclusión: Lymphadenectomy has a primary role in the radical resection with curative intention for biliary cancer. Systematic indication of lymphadenectomy should be prioritized, with the achievement of an adequately number of LN according to the actual recommendations. Lymphadenectomy is crucial for an adequate staging and prognosis, as well as to optimize the results of curative resection in this entity.

Assuntos

RESUMO

Rambutan (Nephelium lappaceum L.) is a tropical fruit from Asia which has become the main target of many studies involving polyphenolic analysis. Mexico produces over 8 million tons per year of rambutan, generating a huge amount of agro-industrial waste since only the pulp is used and the peel, which comprises around 45% of the fruit's weight, is left behind. This waste can later be used in the recovery of polyphenolic fractions. In this work, emerging technologies such as microwave, ultrasound, and the hybridization of both were tested in the extraction of phenolic compounds from Mexican rambutan peel. The results show that the hybrid technology extraction yielded the highest polyphenolic content (176.38 mg GAE/g of dry rambutan peel). The HPLC/MS/ESI analysis revealed three majoritarian compounds: geraniin, corilagin, and ellagic acid. These compounds explain the excellent results for the biological assays, namely antioxidant activity evaluated by the DPPH, ABTS, and LOI (Lipid oxidation inhibition) assays that exhibited great antioxidant capacity with IC50 values of 0.098, 0.335, and 0.034 mg/mL respectively, as well as prebiotic activity demonstrated by a µMax (maximum growth) of 0.203 for Lactobacillus paracasei. Lastly, these compounds have shown no hemolytic activity, opening the door for the elaboration of different products in the food, cosmetic, and pharmaceutical industries.

Assuntos

RESUMO

Resumen La anisakidosis es una zoonosis parasitaria accidental y cosmopolita de los seres humanos, siendo su hospedero definitivo los mamíferos marinos como lobos de mar, focas y delfines, entre otros. El ser humano se infecta por el consumo en estado larvario del nemátodo de la familia Anisakidae presentes en pescados y mariscos crudos como la merluza o el congrio. Los helmintos se ubican preferentemente en el tubo digestivo alto, observándose la regurgitación del parásito a la boca o evidenciándose durante la realización de una endoscopía digestiva alta. En forma infrecuente las larvas pueden migrar al peritoneo o seguir su paso por el intestino delgado y colon, siendo inhabitual la expulsión por las deposiciones. Presentamos el caso de una expulsión dos larvas L3 de la familia Anisakidae en deposiciones.

Abstract Anisakidosis is an accidental and cosmopolitan parasitic zoonosis of human beings, its definitive host being marine mammals such as sea lions, seals and dolphins, among others. Humans are infested by consumption in the larval stage of the nematode of Anisakis present in raw fish and shellfish such as hake or conger eel. The infestation is preferably located in the upper digestive tract, observing the regurgitation of the parasite to the mouth or becoming evident during an upper gastrointestinal endoscopy. In rare cases, the larvae can migrate to the peritoneum or continue their passage through the small intestine and colon, with expulsion in stools being unusual. We present a case of expulsion of two larvae of the Anisakidae family in feces.

Assuntos

RESUMO

Anisakidosis is an accidental and cosmopolitan parasitic zoonosis of human beings, its definitive host being marine mammals such as sea lions, seals and dolphins, among others. Humans are infested by consumption in the larval stage of the nematode of Anisakis present in raw fish and shellfish such as hake or conger eel. The infestation is preferably located in the upper digestive tract, observing the regurgitation of the parasite to the mouth or becoming evident during an upper gastrointestinal endoscopy. In rare cases, the larvae can migrate to the peritoneum or continue their passage through the small intestine and colon, with expulsion in stools being unusual. We present a case of expulsion of two larvae of the Anisakidae family in feces.

Assuntos

RESUMO

RESUMEN Gluconacetobacter diazotrophicus es una bacteria endófita promotora del crecimiento vegetal utilizada como inoculante microbiano en diferentes cultivos agrícolas. El objetivo del presente trabajo fue aplicar diferentes modelos matemáticos para representar su crecimiento en un cultivo sumergido por lotes empleando un biorreactor de 3 L y usando melazas de caña y sacarosa como fuente de energía. Se obtuvo el perfil temporal de pH, biomasa celular y azúcares totales. Se compararon los modelos estudiados por calidad de ajuste y complejidad y se realizó un análisis de sensibilidad paramétrica. Se consideraron modelos de cuatro y cinco parámetros con expresiones que incluyen efectos de inhibición por sustrato y por biomasa. El modelo con mayor calidad de ajuste fue el de Herbert-Pirt-Contois con coeficientes de determinación para biomasa y sustrato de 0,888 y 0,425 respectivamente. Estos valores indican una mayor correspondencia de los datos experimentales de biomasa con los datos calculados por el modelo, en comparación con los resultados obtenidos para azúcares totales para los que esta correspondencia fue menor. Este modelo generó la mejor combinación de calidad de ajuste y complejidad según el criterio de información de Akaike. El estudio cinético desarrollado permitió observar un comportamiento bifásico en la etapa de crecimiento de la bacteria cuando se cultiva en melaza y un efecto de limitación de su crecimiento por la biomasa. Los resultados obtenidos proporcionan una descripción matemática útil para el diseño, escalamiento y operación de un futuro proceso de producción de un inoculante microbiano a base de la bacteria G. diazotrophicus.

ABSTRACT Gluconacetobacter diazotrophicus is a plant-growth promoting endophytic bacterium used as a microbial inoculant for different crops. The objective of this work was to apply different mathematical models to represent its growth in a batch submerged culture employing a 3-L bioreactor and using sugarcane molasses and sucrose as energy sources. The time profile of pH, cell biomass, and total sugars was obtained. Models studied were compared considering their fit quality and complexity, and a parametric sensitivity analysis was performed. Four- and five-parameter models with expressions involving substrate and biomass inhibition effects were considered. The Herbert-Pirt-Contois model achieved the highest fit quality with determination coefficients of 0.888 and 0.425 for biomass and substrate, respectively. These values indicate a higher correspondence between the experimental data of biomass concentration and the data calculated by the model, compared to results obtained for total sugars for which this correspondence was lower. This model reached the best combination considering the fit quality and complexity according to the Akaike's information criterion. The kinetic study performed enabled to observe a bi-phasic behavior in the growth stage of the bacterium when grown on molasses, and a growth limitation effect due to biomass concentration. The outcomes obtained provide a mathematical description useful for design, scale-up, and operation of a future process for the production of a microbial inoculant based on G. diazotrophicus.

RESUMO

BACKGROUND: Residual disease (RD) has been described as one of the most relevant prognostic factors after radical surgical resection for incidental gallbladder cancer (IGC). The purpose of the present study was to analyze patterns of RD and determinant prognostic factors in patients undergoing re-resection for IGC. METHODS: Patients undergoing re-exploration due to IGC between 1990 and 2014 were identified in two referral centers from different South-American countries. Patients submitted to a radical definitive operation were included in the study. Demographics and tumor-treated related variables were analyzed in correlation with RD and survival. The site of RD, local (gallbladder bed) or regional (lymph nodes and bile duct) was correlated with disease-specific survival (DSS). RESULTS: Of 265 patients with IGC submitted to surgery, 168 underwent a radical re-resection and RD was found in 58 (34.5%). Demographic, clinical and surgical variables were compared between both centers showing differences in type of resection, laparoscopic approach, T stages and disease stage. Location of RD was regional in 34 (20.2%) and local in 24 (14.3%), and no residual disease was found in 110 (65.5%) patients. T stage (T1b = 20%, T2 = 23.8%, T3 = 71.7%, p < 0.001) and disease stage (p < 0.001) were independent predictors of RD. Finding RD at any location reduced the DSS in comparison with non-RD patients (19.6 months vs. 62.7 months p < 0.001). No differences in DSS according to the location of RD were found, and all anatomic sites were equally poor (p = 0.27). RD at any site predicted DSS (p < 0.001), independently of all other IGC variables. CONCLUSIONS: IGC presented similar clinical parameters in two different countries of South America. RD was demonstrated as the most critical prognostic variable in patients with IGC treated by a radical resection. The presence of RD was associated with poor outcome, independently of any anatomic location. Future studies incorporating neoadjuvant chemotherapy in the treatment of patients with prognostic factors for RD are required to improve survival in this entity.

Assuntos

RESUMO

El transhumanismo convive con la humanidad. La presente reflexión analiza el Biopunk, movimiento contracultural que rompe los esquemas tradicionales de investigar del Big Science. Aquel enmarca su gestión investigativa en la ética DIYBio ­Do It Yourself, hágalo usted mismo­, enriqueciendo los canales tecnocientíficos desde la Small Science. Realizando un rastreo desde el movimiento del punk rock de los años setenta, pasando por el Cyber y Cypherpunk, llegando al Biopunk y el accionar de los biohackers, se contrastan sus bases éticas con la autonomía, vulnerabilidad y justicia propias de la bioética. Se identifica un campo, el cual la bioética no ha ocupado; su encuentro con el Biopunk y la manera como podría aquella realizar su aproximación al mencionado movimiento contracultural.

Transhumanism coexists with humanity. The present reflection analyzes the Biopunk, a countercultural movement that breaks with the traditional ways of investigating Big Science. That frames his investigative management in the DIYBio ethic ­Do It Yourself, do it yourself­, enriching the technoscientific channels from the Small Science. Performing a tracking from the punk rock movement of the seventies, going through the Cyber and Cypherpunk, coming to Biopunk and the actions of biohackers, their ethical bases are contrasted with the autonomy, vulnerability and justice of bioethics. A field is identified which bioethics has not occupied; his encounter with Biopunk and the way he could make his approach to the mentioned countercultural movement.

O transumanismo coexiste com a humanidade. A presente reflexão analisa o Biopunk, um movimento contracultural que rompe com as formas tradicionais de investigar a Big Science. Isso enquadra sua gestão investigativa na ética DIYBio ­Do It Yourself, faça você mesmo­, enriquecendo os canais tecnocientíficos da Small Science. Realizando um rastreamento do movimento punk rock dos anos setenta, passando pelo Cyber e Cypherpunk, chegando ao Biopunk e as ações dos biohackers, suas bases éticas são contrastadas com a autonomia, vulnerabilidade e justiça da bioética. Um campo é identificado que a bioética não ocupou; seu encontro com Biopunk e a maneira como ele poderia fazer sua abordagem ao mencionado movimento contracultural.

Assuntos

RESUMO

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignant tumor and its incidence is increasing over the world. At present times, radical liver resection is still the most effective treatment for ICC patients to achieve long term survival. Pathological lymph node metastases (LMN), found in 15% to 45% of the patients, have been recognized as an extremely poor prognostic risk factor, even if curative resection is performed. So, considering this issue, it acquires relevance to determine the validity of surgical resection for LNM cases that are diagnosed in the preoperative setting, or whether a routine lymphadenectomy should be performed systematically in all hepatectomies for ICC. The role of routine lymphadenectomy in the surgical treatment of ICC remains controversial, with some centers considering it standard whereas other surgeons perform lymphadenectomy only as a selective indication. Recently, a growing widespread adoption of lymphadenectomy was demonstrated that nearly doubled its commonly reported execution rate. The newly updated eight edition of the American Joint Committee on Cancer (AJCC) staging system now recommends that six nodes need to be analyzed to stage patients with ICC. In this review, we analyzed and summarized some anatomic considerations of the lymphatic anatomy of the liver and the current knowledge and potential advantages of performing a routine lymphadenectomy in patients with ICC, especially looking at pathological staging, prognosis, prevention of local recurrence and outcome. New areas like lymphadenectomy in cirrhotic patients and laparoscopic lymphadenectomy are also discussed.

Assuntos

RESUMO

Introduction/ProblemFor more than 60 years, Colombia experienced an armed conflict involving government forces, guerrillas, and other illegal armed groups. Violence, including torture and massacres, has caused displacement of entire rural communities to urban areas. Lack of information on the problems displaced communities face and on their perceptions on potential solutions to these problems may prevent programs from delivering appropriate services to these communities. This study explores the problems of Afro-Colombian survivors from two major cities in Colombia; the activities they do to take care of themselves, their families, and their community; and possible solutions to these problems. METHODS: This was a qualitative, interview-based study conducted in Quibdó and Buenaventura (Colombia). Free-list interviews and focus groups explored the problems of survivors and the activities they do to take care of themselves, their families, and their community. Key-informant interviews explored details of the identified mental health problems and possible solutions. RESULTS: In Buenaventura, 24 free-list interviews, one focus group, and 17 key-informant interviews were completed. In Quibdó, 29 free-list interviews, one focus group, and 15 key-informant interviews were completed. Mental health problems identified included: (1) problems related to exposure to torture/violent events; (2) problems with adaptation to the new social context; and (3) problems related to current poverty, lack of employment, and ongoing violence. These problems were similar to trauma symptoms and features of depression and anxiety, as described in other populations. Solutions included psychological help, talking to friends/family, relying on God's help, and getting trained in different task or jobs. CONCLUSION: Afro-Colombian survivors of torture and violence described mental health problems similar to those of other trauma-affected populations. These results suggest that existing interventions that address trauma-related symptoms and current ongoing stressors may be appropriate for improving the mental health of survivors in this population. Santaella-TenorioJ, Bonilla-EscobarFJ, Nieto-GilL, Fandiño-LosadaA, Gutiérrez-MartínezMI, BassJ, BoltonP. Mental health and psychosocial problems and needs of violence survivors in the Colombian Pacific Coast: a qualitative study in Buenaventura and Quibdó. Prehosp Disaster Med. 2018;33(6):567-574.

Assuntos

RESUMO

Plant surfaces have a considerable degree of chemical and physical variability also in relation to different environmental conditions, organs and state of development. The potential changes on plant surface properties in association with environmental variations have been little explored so far. Using two model tree species (i.e., Quercus petraea, sessile oak and Fagus sylvatica, beech) growing in 'Montejo de la Sierra Forest,' we examined various traits of the abaxial and adaxial surface of leaves of both species collected at a height of approximately 15 m (top canopy), versus 3.5-5.5 m for beech and sessile oak, lower canopy leaves. Leaf surface ultra-structure was analyzed by scanning and transmission electron microscopy, and the surface free energy and related parameter were estimated after measuring drops of 3 liquids with different degrees of polarity and apolarity. The permeability of the adaxial and abaxial surface of top and bottom canopy leaves to CaCl2 was estimated by depositing 2 drops of 3-4 µl per cm2 and comparing the concentration of Ca in leaf tissues 24 h after treatment, and also Ca and Cl concentrations in the washing liquid. Higher Ca concentrations were recorded after the application of CaCl2 drops onto the veins and adaxial blade of top canopy beech leaves, while no significant evidence for foliar Ca absorption was gained with sessile oak leaves. Surprisingly, high amounts of Cl were recovered after washing untreated, top canopy beach and sessile oak leaves with deionised water, a phenomenon which was not traced to occur on lower canopy leaves of both species. It is concluded that the surface of the two species analyzed is heterogeneous in nature and may have areas favoring the absorption of water and solutes as observed for the veins of beech leaves.

RESUMO

One approach to protect the human skin against harmful effects of solar ultraviolet (UV) radiation was to use natural products as photoprotectors. In this work, the extract from specie Phyllanthus orbicularis K was evaluated as a protective agent against the photodamage by UVB, UVA artificial lamps, and environmental sunlight exposure. The plasmid DNA solutions were exposed to radiations using the DNA dosimeter system in the presence of plant extract. The DNA repair enzymes, Escherichia coli Formamidopyrimidine-DNA glycosylase (Fpg) and T4 bacteriophage endonuclease V (T4-endo V), were employed to discriminate oxidized DNA damage and cyclobutane pyrimidine dimers (CPD), respectively. The supercoiled and relaxed forms of DNA were separated through electrophoretic migration in agarose gels. These DNA forms were quantified to determine strand break, representing the types of lesion levels. The results showed that, in the presence of P. orbicularis extract, the CPD and oxidative damage were reduced in irradiated DNA samples. The photoprotective effect of extract was more evident for UVB and sunlight radiation than for UVA. This work documented the UV absorbing properties of P. orbicularis aqueous extract and opened up new vistas in its characterization as protective agent against DNA damage induced by environmental sunlight radiation.

Assuntos

RESUMO

Illusory parasitosis, better known as delusional parasitosis, is a neuropsychiatric syndrome in which patients have the belief of suffering a parasitic disease, that can not be demonstrated after an exhaustive medical study. These patients are characterized by being polyconsultants in different medical specialties and, many of them, have antecedents of psychiatric disorders, some of them undiagnosed. Knowing the existence of the clinical picture, diagnosing early and empathizing with the patient, could give to clinician some clues for a timely and assertive psychiatric referral, and improve patient adherence to the proposed treatment.

Assuntos

RESUMO

Illusory parasitosis, better known as delusional parasitosis, is a neuropsychiatric syndrome in which patients have the belief of suffering a parasitic disease, that can not be demonstrated after an exhaustive medical study. These patients are characterized by being polyconsultants in different medical specialties and, many of them, have antecedents of psychiatric disorders, some of them undiagnosed. Knowing the existence of the clinical picture, diagnosing early and empathizing with the patient, could give to clinician some clues for a timely and assertive psychiatric referral, and improve patient adherence to the proposed treatment.

La parasitosis ilusoria, más conocida como delusión parasitaria, es un síndrome neuropsiquiátrico donde los pacientes tienen el convencimiento de padecer una infestación parasitaria, que no puede ser demostrada tras un exhaustivo estudio médico. Estos pacientes se caracterizan por ser policonsultantes en distintas especialidades médicas y, muchos de ellos, poseen antecedentes de trastornos psiquiátricos, algunos de ellos no diagnosticados. Conocer la existencia del cuadro, diagnosticar precozmente y empatizar con el paciente, pueden dar al médico clínico algunas claves para una derivación psiquiátrica oportuna y asertiva, y mejorar la adherencia del paciente al tratamiento propuesto. Se presentan cuatro casos clínicos que consultaron por esta extraña condición.

Assuntos

RESUMO

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS.

Assuntos

RESUMO

Resumen El uso de los sitios web denominados redes sociales es cada vez más frecuente en la práctica médica. El objetivo de este artículo es proporcionar a los médicos y estudiantes de medicina algunas recomendaciones éticas para tomar en cuenta antes de publicar contenido en la internet. Para ello, ofrece un panorama histórico de la evolución de las redes sociales y presenta diversos ejemplos de los beneficios de usarlas como medios de actualización, de comunicación entre colegas, con pacientes, como medios de promoción de los servicios profesionales y de difusión de eventos. Al final provee de recomendaciones puntuales a tomar en cuenta para hacer un uso efectivo, profesional y ético de ellas.

Abstract The use of Social Networking sites has become very frequent in medicine. This article aims to provide physicians and medical students with ethical recommendations to consider before publishing Web content. For that purpose, we provide a historical overview of the evolution of social networks, and we present several examples of the benefits acquired by using them for knowledge updating, promoting professional services and events, and as communication tools among colleagues and patients. Finally, specific recommendations for an effective, professional and ethical use of these media are given.

RESUMO

El síndrome de intestino irritable (SII) es un trastorno funcional digestivo de etiología multifactorial. En su fisiopatología se describen diversos factores, tanto biológicos, como psicológicos y ambientales, que afectan el estado de activación de células inmunes en la mucosa intestinal. Entre los factores ambientales se incluye la presencia de alguna parasitosis intestinal. El síndrome de intestino irritable post-infeccioso (SII-PI) es reconocido como un subgrupo de estos trastornos, cuya aparición de los síntomas es posterior a una infección intestinal provocada por agentes microbianos. A pesar de que en Chile hay pocos estudios respecto a la relación entre SII y parasitosis intestinal, se ha descrito la existencia de una asociación positiva entre SII e infecciones por Blastocistis hominis, uno de los parásitos prevalentes en Chile. En otros países, se ha descrito además una relación entre SII, amebiasis y giardiasis. Por la alta prevalencia de parasitosis en nuestro país, existe la necesidad de ampliar los estudios para clarificar la fuerza de la asociación entre parasitosis y SII.

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS.

Assuntos

RESUMO

El niño con desnutrición grave tiene una disfunción de la respuesta inmune que puede aumentar de manera significativa la morbilidad y la mortalidad por infecciones. El objetivo de la presente investigación fue evaluar el efecto de la recuperación nutricional en las concentraciones séricas de citocinas inflamatorias; tales como: interleucina 12 (IL-12), interleucina 17 (IL-17), interferón gamma (IFN-γ) y factor de necrosis tumoral alfa (TNF-α). En un estudio de tipo prospectivo y longitudinal, se seleccionó la población con base a criterios clínicos y antropométricos, constituida por 24 niños desnutridos graves en edades comprendidas entre 1 y 2 años, quienes formaban parte de un programa de recuperación nutricional. La concentración sérica de las citocinas investigadas se determinó antes y después del tratamiento nutricional, empleando la técnica de Inmunoanálisis Enzimático (ELISA) de doble anticuerpo. Para establecer comparaciones se utilizó la t de Student, y se consideró una p<0,05 como estadísticamente significante. Se observó una diferencia en las concentraciones de IL-12, IL-17, IFN-γ y TNF-α antes y después del tratamiento (p<0,05), lo cual parece indicar que la desnutrición per se provoca un estado inflamatorio y que 2 meses de apoyo nutricional intensivo, favorecen no solo la recuperación clínica del niño desnutrido grave, sino también la recuperación de su respuesta inmunitaria en cuanto a la producción de mediadores solubles como son las citocinas.

Children with severe malnutrition have a dysfunction of the immune response that can significantly increase morbidity and mortality from infections. The aim of this investigation was to evaluate the effect of nutritional recovery in serum measurements of inflammatory cytokines; such as interleukin 12 (IL-12), interleukin 17 (IL-17), interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α). In a prospective and longitudinal study, 24 severe malnourished children aged between 1 and 2 years-old, who were part of a program of nutritional recovery, were selected based on clinical and anthropometric criteria. Serum measurements of cytokines were determined before and after dietary treatment, using the technique of sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA). For comparisons, Student’s t test was used, considered p <0.05 as statistically significant. A difference was observed in the concentrations of IL-12, IL-17, IFN-γ and TNF-α before and after treatment (p <0.05), which suggests that malnutrition provokes an inflammatory state and two months of intensive nutritional support, not only promotes the clinical recovery of severe malnourished children, but also the recovery of the immune response with regard to the production of soluble mediators, such as cytokines.

Assuntos

RESUMO

Children with severe malnutrition have a dysfunction of the immune response that can significantly increase morbidity and mortality from infections. The aim of this investigation was to evaluate the effect of nutritional recovery in serum measurements of inflammatory cytokines; such as interleukin 12 (IL-12), interleukin 17 (IL-17), interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α). In a prospective and longitudinal study, 24 severe malnourished children aged between 1 and 2 years-old, who were part of a program of nutritional recovery, were selected based on clinical and anthropometric criteria. Serum measurements of cytokines were determined before and after dietary treatment, using the technique of sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA). For comparisons, Student's t test was used, considered p <0.05 as statistically significant. A difference was observed in the concentrations of IL-12, IL-17, IFN-γ and TNF-α before and after treatment (p <0.05), which suggests that malnutrition provokes an inflammatory state and two months of intensive nutritional support, not only promotes the clinical recovery of severe malnourished children, but also the recovery of the immune response with regard to the production of soluble mediators, such as cytokines.

Assuntos