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Group B Streptococci (GBS) are important causes of neonatal sepsis and meningitis globally. To elucidate the potential benefits of maternal GBS vaccines, data is needed on the epidemiology of maternal GBS rectovaginal colonization, distribution of serotypes, and resistance to intrapartum antibiotic prophylaxis (IAP). We collected rectal and vaginal samples from 305 pregnant women in León, Nicaragua between 35 and 40 weeks gestation. Samples were cultured for GBS and confirmed using latex agglutination. GBS isolates underwent serotyping by quantitative polymerase chain reaction, and antimicrobial susceptibility testing by disk diffusion and microdilution following Clinical Laboratory Standard Institute guidelines. Sixty-three women (20.7%) were colonized with GBS in either the rectum or the vagina. Of 91 GBS isolates collected from positive cultures, most were serotypes II (28.6%), Ia (27.5%), and III (20.9%). Most GBS isolates (52.9%) were resistant to penicillin, the first-line prophylactic antibiotic. Penicillin resistance was highly correlated with resistance to vancomycin, ceftriaxone, and meropenem. The results of our study suggest that one-fifth of pregnant women in the urban area of León, Nicaragua are colonized with GBS and risk transmitting GBS to their offspring during labor. High resistance to commonly available antibiotics in the region suggests that prophylactic maternal GBS vaccination would be an effective alternative to IAP.
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Introducción. El sangrado de tubo digestivo alto de origen variceal tiene una mortalidad alta. El cociente número de plaquetas/diámetro mayor del bazo puede ser un parámetro no invasivo útil para predecir el sangrado por várices esofágicas en pacientes cirróticos. Objetivo: Determinar la sensibilidad y especificidad del cociente número de plaquetas/diámetro mayor del bazo, para el diagnóstico de várices esofágicas con riesgo de sangrado en pacientes con insuficiencia hepática. Material Y Métodos: Estudio de proceso, realizado en un hospital de segundo nivel de atención médica, en pacientes con insuficiencia hepática a quienes se les realizó ultrasonido, citometría hemática, pruebas de función hepática y endoscopia. Se valoró sensibilidad y especificidad del cociente plaquetas/bazo para el diagnóstico de várices esofágicas con riesgo de sangrado. Resultados: Fueron 70 pacientes: 28 mujeres, 42 hombres; causa principal de insuficiencia hepática en hombres fue etilismo en 31 pacientes, virus de la hepatitis C en 20 mujeres. El cociente bazo-plaquetas tiene una sensibilidad de 90%, especificidad 83%, falsos positivos 16%, falsos negativos 9%, valor predictivo positivo 94%, valor predictivo negativo 75 %, prevalencia del 74% y una certeza diagnóstica del 88% para diagnosticar várices esofágicas con riesgo de sangrado. Conclusión: El cociente plaquetas/bazo es un estudio útil y no invasivo para diagnosticar várices esofágicas con riesgo de sangrado, en hospitales donde no se cuenta con endoscopía.
Introduction: Upper gastrointestinal bleeding of variceal origin has a high mortality. The platelet count/spleen major diameter ratio may be a useful noninvasive parameter to predict esophageal variceal bleeding in cirrhotic patients. Objective: to determine the sensitivity and specificity of the platelet count/spleen diameter ratio for the diagnosis of esophageal varices with risk of bleeding in patients with hepatic insufficiency. Material and Methods: Process study, performed in a Second Level Medical Facility, in patients with liver failure who underwent ultrasound, blood cytometry, liver function tests and endoscopy. Sensitivity and specificity of the platelet/spleen ratio were assessed in patients with esophageal variceal and bleeding risk. Results: There were 70 patients: 28 women, 42 men; main cause of liver failure in men was ethylism in 31 patients and hepatitis C virus in 20 women. The spleen-platelet ratio has a sensitivity of 90%, specificity 83%, false positives 16%, false negatives 9%, positive predictive value 94%, negative predictive value 75%, prevalence of 74% and diagnostic accuracy of 88% to diagnose esophageal varices with risk of bleeding. Conclusion: Platelet/spleen ratio is a useful, non-invasive study to diagnose esophageal varices with bleeding risk, in hospitals where endoscopy is not available.
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The ballasting and de-ballasting of ships are two necessary operations with ballast water that provide stability for safe navigation. Empty ships must ballast tanks with water, which contains living organisms and subsequently carries them away from their original distribution. De-ballasting represents an input of still viable zooplankton, phytoplankton, and microorganisms in the destination port, leading to the introduction of alien species, and consequently, the introduction of organisms will alter the local biodiversity. Ballast water treatment is necessary to comply with the International Maritime Organization (IMO) for the maximum viable organisms permitted. It is known that UVC eliminates microorganisms, but there are few studies on the other taxonomical groups, such as phytoplankton and zooplankton. The advance oxidation processes (AOPs) with UV-C can be a good alternative to manage the problem of ballast water, primarily for microorganisms. However, for larger organisms, there is more resistance, and, a stage with filtration (by physical filtration or hydrocyclone) is usually required. The filter can fail, or certain zooplankton organisms can escape across the filter and go to the AOPs or UVC reactor. According to the taxonomic group, there can be a different sensitivity to the treatment, and one could survive and generate a risk. The AOPs tested were natural solar radiation (RAD), UV/H2O2, UV/TiO2, UV/TiO2/H2O2, and UV/TiO2/H2O2/RAD. Natural sea water was pumped and treated with the AOPs. The vital zooplankton organisms counted were polychaetes, cladocerans, ostracods, nauplii and calanoid, cyclopoid, and harpacticoid copepods. For the phytoplankton, the abundance was estimated, and the photosystem II efficiency was determined. To evaluate the phytoplankton regrowth after the treatments, the treated water was stored and populations counted for 20 days. The most effective treatment for the zooplankton groups was UVC/H2O2. Regarding the sensitivity, the cyclopoid copepods were the most resistant. The nauplii and polychaetes were more likely to be killed by the AOPs, greatly decreasing the risk from nauplii due to their abundance and ease of passing through the filters with their smaller size. Phytoplankton regrowth was observed in all treatments, and it even reached abundance values higher than in the intake water. For instance, additional dark conditions and retreatment on days 3 or 5 are suggested for any treatment.
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Fitoplâncton/fisiologia , Navios , Purificação da Água/métodos , Zooplâncton/fisiologia , Animais , Copépodes , Peróxido de Hidrogênio , Água do Mar , Raios Ultravioleta , ÁguaRESUMO
BACKGROUND: High rates of mental illness and addictions are well documented among youth in Nicaragua. Limited mental health services, poor mental health knowledge and stigma reduce help-seeking. The Mental Health Curriculum (MHC) is a Canadian school-based program that has shown a positive impact on such contributing factors. This pilot project evaluated the impact of the MHC on mental wellness and functioning among youth in Leon, Nicaragua. METHODS: High school and university students (aged 14-25 years) were assigned to intervention (12-week MHC; n = 567) and control (wait-list; n = 346) groups in a non-randomized design. Both groups completed measures of mental health knowledge, stigma and function at baseline and 12 weeks. Multivariate analyses and repeated measures analyses were used to compare group outcomes. RESULTS: At baseline, intervention students showed higher substance use (mean difference [MD] = 0.24) and lower perceived stress (MD = -1.36) than controls (p < 0.05); there were no other group differences in function. At 12 weeks, controlling for baseline differences, intervention students reported significantly higher mental health knowledge (MD = 1.75), lower stigma (MD = 1.78), more adaptive coping (MD = 0.82), better lifestyle choices (MD = 0.06) and lower perceived stress (MD = -1.63) (p < 0.05) than controls. The clinical significance as measured by effect sizes was moderate for mental health knowledge, small to moderate for stigma and modest for the other variables. Substance use also decreased among intervention students to similar levels as controls (MD = 0.03) (p > 0.05). CONCLUSIONS: This pilot investigation demonstrates the benefits of the MHC in a low-and-middle-income youth population. The findings replicate results found in Canadian student populations and support its cross-cultural applicability.
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This study aims to approach the world of young addicts in a Western city of Nicaragua to explore and better understand their reality. This a qualitative, descriptive, cross-sectional study, using a detailed interview technique, anonymous and voluntary directed toward young drug users. It was found that only illegal drugs are considered as drugs and that curiosity and easy access are factors facilitating the use; drug use is something natural in the context of their lives, the drug offers the possibility of transgressing social norms; drug combinations occur for economic reasons and the need to search for new sensations; the user acknowledges the problems that develop in the family and the community as a result of the presence of drugs with emphasis on the violence, personal powerlessness and conventional helplessness were identified as factors present at the idea of quitting.(AU)
Este estudo tem como objetivo uma aproximação ao mundo do jovem dependente de drogas em uma cidade do ocidente da Nicarágua com o intuito de explorar e compreender melhor sua realidade. Estudo qualitativo, descritivo de corte transversal, mediante técnica de entrevista em profundidade, anônima e voluntária, de jovens consumidores de substâncias entorpecentes. Observou-se que somente as drogas ilícitas são consideradas drogas; a curiosidade e o aceso são fatores facilitadores do uso; o uso de drogas é algo natural no seu contexto de vida; a droga representa a possibilidade de transgredir as normas sociais; a mistura de substâncias entorpecentes ocorre por questões econômicas e pela necessidade de descobrir novas sensações; o usuário reconhece os problemas que se desenvolvem na família e na comunidade por causa do uso de drogas, promovendo a violência; a impotência pessoal e a falta de apoio formal foram apontadas como fatores presentes diante da ideia de abandonar o uso.(AU)
Este estudio tiene como objetivo un acercamiento al mundo del joven drogodependiente, en una ciudad del occidente de Nicaragua a fin de explorar y comprender mejor la realidad de ellos. Estudio cualitativo, descriptivo de corte trasversal, mediante técnica de entrevista a profundidad, anónima y voluntaria a jóvenes consumidores de sustancias. Se observó que solamente las drogas ilícitas son consideradas drogas; la curiosidad y el acceso son factores facilitadores del uso; el uso de drogas es algo natural en su contexto de vida; la droga representa la posibilidad de transgredir las normas sociales; las mezcla de sustancias ocurre por cuestiones económicas y por necesidad de avanzar con la descubierta de nuevas sensaciones; el usuario reconoce los problemas que se desarrollan en la familia y en la comunidad debido al uso de drogas, promoviendo la violencia; la impotencia personal y la falta de apoyo formal fueran apuntadas como factores presentes ante la idea de abandonar su uso.(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Transtornos Relacionados ao Uso de Substâncias , Drogas Ilícitas , Pesquisa QualitativaRESUMO
This study aims to approach the world of young addicts in a Western city of Nicaragua to explore and better understand their reality. This a qualitative, descriptive, cross-sectional study, using a detailed interview technique, anonymous and voluntary directed toward young drug users. It was found that only illegal drugs are considered as drugs and that curiosity and easy access are factors facilitating the use; drug use is something natural in the context of their lives, the drug offers the possibility of transgressing social norms; drug combinations occur for economic reasons and the need to search for new sensations; the user acknowledges the problems that develop in the family and the community as a result of the presence of drugs with emphasis on the violence, personal powerlessness and conventional helplessness were identified as factors present at the idea of quitting...
Este estudo tem como objetivo uma aproximação ao mundo do jovem dependente de drogas em uma cidade do ocidente da Nicarágua com o intuito de explorar e compreender melhor sua realidade. Estudo qualitativo, descritivo de corte transversal, mediante técnica de entrevista em profundidade, anônima e voluntária, de jovens consumidores de substâncias entorpecentes. Observou-se que somente as drogas ilícitas são consideradas drogas; a curiosidade e o aceso são fatores facilitadores do uso; o uso de drogas é algo natural no seu contexto de vida; a droga representa a possibilidade de transgredir as normas sociais; a mistura de substâncias entorpecentes ocorre por questões econômicas e pela necessidade de descobrir novas sensações; o usuário reconhece os problemas que se desenvolvem na família e na comunidade por causa do uso de drogas, promovendo a violência; a impotência pessoal e a falta de apoio formal foram apontadas como fatores presentes diante da ideia de abandonar o uso...
Este estudio tiene como objetivo un acercamiento al mundo del joven drogodependiente, en una ciudad del occidente de Nicaragua a fin de explorar y comprender mejor la realidad de ellos. Estudio cualitativo, descriptivo de corte trasversal, mediante técnica de entrevista a profundidad, anónima y voluntaria a jóvenes consumidores de sustancias. Se observó que solamente las drogas ilícitas son consideradas drogas; la curiosidad y el acceso son factores facilitadores del uso; el uso de drogas es algo natural en su contexto de vida; la droga representa la posibilidad de transgredir las normas sociales; las mezcla de sustancias ocurre por cuestiones económicas y por necesidad de avanzar con la descubierta de nuevas sensaciones; el usuario reconoce los problemas que se desarrollan en la familia y en la comunidad debido al uso de drogas, promoviendo la violencia; la impotencia personal y la falta de apoyo formal fueran apuntadas como factores presentes ante la idea de abandonar su uso...
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Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Drogas Ilícitas , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de SubstânciasRESUMO
BACKGROUND: Previous studies have shown that women's education is protective against corporal punishment (CP) of children. However, the effect that women's exposure to intimate partner violence (IPV) has on the association between women's education and children's CP has not been studied. OBJECTIVE: To understand how the interaction between women's exposure to IPV and their education level influences the occurrence of children's CP at the household level. METHODS: We selected 10,156 women who had at least one child less than 16 years old from cross-sectional data from the 2006-2007 Nicaraguan Demographic and Health Survey. Children's CP was defined as the punishment of children by slapping them, hitting them with a fist, or hitting them with a rope, belt, stick, or other object. IPV was measured by using a conflict tactic scale. The WHO Self-Reporting Questionnaire 20 (SRQ-20) was used to assess the women's mental health. We computed adjusted risk ratios (ARR) and 95% confidence intervals (CI) using Poisson regression with a robust variance estimator. RESULTS: Women's exposure to IPV was associated with a 10-17% increase in the risk of children's CP. IPV and children's CP were associated with impaired women's mental health. Women's lifetime exposure to emotional IPV and controlling behavior by a partner significantly decreased the protective effect from women's high education level on children's CP. When women were exposed to emotional IPV, the protective effect from having a college education decreased from ARR=0.61 (95% CI 0.47-0.80) to ARR=0.98 (95% CI 0.80-1.19). A similar pattern was found among women exposed to controlling behavior by a partner, the protective effect decreased from ARR=0.71 (95% CI 0.53-0.90) to ARR=0.86 (95% CI 0.70-1.06). CONCLUSION: This study shows how significant gains in one positive social determinant of children's well-being can be undermined when it interacts with men's violence toward women. Policies that aim to end children's CP must include actions to end women's exposure to IPV.
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Punição , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Escolaridade , Feminino , Humanos , Lactente , Recém-Nascido , Nicarágua , Prevalência , Características de Residência , Fatores de Risco , Fatores Socioeconômicos , Saúde da MulherRESUMO
El psicodrama es una técnica psicoterapéutica de carácter grupal que consiste en elaborar un saber sobre la subjetividad por medio de la representación dramática, si el psicodrama del que se trata tiene una orientación psicoanalítica, como es el caso del psicodrama que en este momento trato de transmitir, el saber del que se trata es aquel que Freud descubre como inconsciente y la clínica que se efectúa se inspira en el método analítico de Freud, nuestro eje orientador.
Psychodrama is a group-based psychotherapeutic technique that consists of developing knowledge about subjectivity through dramatic representation, if the psychodrama in question has a psychoanalytic orientation, as is the case with the psychodrama that I am trying to convey at this time. , the knowledge in question is that which Freud discovers as unconscious and the clinic that takes place is inspired by Freud's analytical method, our guiding axis.
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Humanos , Psicodrama , Psicologia , Psicoterapia de Grupo , Ética ProfissionalRESUMO
BACKGROUND: Mental health is increasingly recognised as integral to good public health, but this area continues to lack sufficient planning, resources, and global strategy. It is a pressing concern in Latin America, where social determinants of health aggravate existing inequities in access to health services. Nicaragua faces serious mental health needs and challenges. One key strategy for addressing gaps in mental health services is building capacity at the primary healthcare and system levels. OBJECTIVE: Using the framework of best practice literature, this article analyses the four-year collaborative process between the National Autonomous University of Nicaragua in León (UNAN-León) and the Centre for Addiction and Mental Health (CAMH) in Canada, which is aimed at improving mental healthcare in Nicaragua. DESIGN: Based on a critical analysis of evaluation reports, key documents, and discussion among partners, the central steps of the collaboration are analysed and main successes and challenges identified. RESULTS: A participatory needs assessment identified local strengths and weaknesses, expected outcomes regarding competencies, and possible methodologies and recommendations for the development of a comprehensive capacity-building programme. The partners delivered two international workshops on mental health and addiction with an emphasis on primary healthcare. More recently, an innovative Diploma and Master programme was launched to foster interprofessional leadership and effective action to address mental health and addiction needs. Collaborative activities have taken place in Nicaragua and Canada. DISCUSSION: To date, international collaboration between Nicaragua and CAMH has been successful in achieving the jointly defined goals. The process has led to mutual knowledge sharing, strong networking, and extensive educational opportunities. Evidence of effective and respectful global health capacity building is provided. Lessons learned and implications for global health action are identified and discussed.
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Fortalecimento Institucional/organização & administração , Serviços de Saúde Mental/organização & administração , Canadá , Fortalecimento Institucional/métodos , Educação , Acessibilidade aos Serviços de Saúde/organização & administração , Humanos , Cooperação Internacional , Saúde Mental/estatística & dados numéricos , Serviços de Saúde Mental/provisão & distribuição , Avaliação das Necessidades , NicaráguaRESUMO
The majority of snakebite envenomations in Central America are caused by the viperid species Bothrops asper, whose venom contains a high proportion of zinc-dependent metalloproteinases that play a relevant role in the pathogenesis of hemorrhage characteristic of these envenomations. Broad metalloproteinase inhibitors, such as the peptidomimetic hydroxamate Batimastat, have been shown to inhibit snake venom metalloproteinases (SVMP). However, the difficulty in having open public access to Batimastat and similar molecules highlights the need to design new inhibitors of SVMPs that could be applied in the treatment of snakebite envenomations. We have chosen the SVMP BaP1 as a model to search for new inhibitors using different strategies, that is, screening of the Prestwick Chemical Library and rational peptide design. Results from these approaches provide clues on the structural requirements for efficient BaP1 inhibition and pave the way for the design of new inhibitors of SVMP.
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The parasitoid wasp family Ichneumonidae currently includes approximately 37 subfamilies worldwide. Banchinae subfamily is a cosmopolitan group with three tribes: Atrophini, Banchini and Glyptini, this last characterized with oblique grooves on tergites II-IV, a dorsal subapical notch on the ovipositor, and a median apical impression in the subgenital plate. From the latter tribe, the genus Sphelodon, with eight species reported, can be recognized for the presence of a prominent basolateral tooth in the first abdominal tergite. Significant previous comprehensive studies for that group have been done in Costa Rica by local and international experts, but it is highly probable that many species remain undescribed in the region; before this survey, only one species (S. annulicornis) was registered from Brazil. The material reviewed in this study was obtained from main entomological collections of Southeast and South Brazil, from localities corresponding to 17 of the 27 States of the country, although most of the specimens (70.3%) were collected in São Paulo State. Approximately 3 000 specimens of the subfamily have been examined, 29 belonging to Sphelodon. The description format in this work broadly follows previous works; the species were illustrated through SEM in low vacuum mode (without uncoated the specimens). Here five new species of the genus Sphelodon are described and illustrated, one of these (S. brunicornis), differs from the rest of the species by lacking a median band in the flagellum. An identification key to the Neotropical species is provided. Rev. Biol. Trop. 59 (4): 1621-1635. Epub 2011 December 01.
La familia de avispas parasitoides Ichneumonidae incluye aproximadamente 37 subfamilias a nivel mundial, una de ellas, Banchinae es un grupo cosmopolita con tres tribos: Atrophini, Banchini y Glyptini: los miembros de esta tribu presentan surcos oblicuos en los tergitos II-IV, una muesca dorsal sub-apical en el ovipositor y una impresión media apical en la placa subgenital; este grupo incluye los géneros Levibasis, Teleutaea, Glypta, Zaglyptomorpha y Sphelodon en la región Neotropical. El género mencionado anteriormente se diferencia de los demás por la presencia de un diente baso-lateral en el primer tergito abdominal, y cuenta con 8 especies descritas, sin embargo como Costa Rica es el único país de la región donde se ha realizado un levantamiento riguroso de este grupo, es muy probable que muchas especies no hayan sido descritas todavía. De este género, sólo existe una especie registrada para Brasil (S. annulicornis). Este trabajo se basó principalmente en material obtenido en calidad de préstamo de las colecciones entomológicas más reconocidas del Sur y del Sudeste de Brasil, provenientes de localidades correspondientes a 17 de los 27 estados que existen en este país, aunque la mayoría de ejemplares (70.3 %) fueron recolectados en el estado de São Paulo. Aproximadamente 3 000 ejemplares de la subfamilia fueron examinados, 29 pertenecientes al género de la tribu Glyptini Sphelodon. El formato de descripción de las especies es básicamente el mismo expuesto por Gauld et al. (2002); las microfotografías que ilustran los detalles de las especies nuevas se realizaron en un microscopio electrónico de barrido (SEM), en el modo de bajo vacío (los ejemplares no fueron recubiertos). Se describen e ilustran cinco especies nuevas del género Sphelodon, una de ellas, S. Brunicornis, se distingue de las otras especies descritas del género porque no presenta un anillo medio en el flagelo. Se propone una clave de identificación para las especies neotropicales.
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Animais , Feminino , Masculino , Vespas/anatomia & histologia , Vespas/classificação , BrasilRESUMO
BACKGROUND: Suicide and suicidal expressions among young people represent a major public health problem worldwide. Most studies are from high-income countries, and it remains unclear whether prevalence and risk factors show a similar pattern in other settings. This study aims to assess the prevalence of suicidal expressions and serious suicidal expressions (ideation, plans and attempts) among adolescents in Nicaragua, in relation to previously reported risk factors, such as exposure to suicide in significant others (parents, siblings, partners or friends) and mental health problems. METHODS: 368 adolescents aged 15-18 years were randomly selected from public secondary schools in León, Nicaragua. Data was collected using Attitude Towards Suicide (ATTS) and Youth Self-Report questionnaires (YSR). Bivariate and multivariate analyses were conducted. RESULTS: Suicide ideation prevalence in the past year was 22.6%, suicide plans 10.3%, and suicide attempts 6.5%. Girls were significantly more likely to report suicidal ideation. Multivariate analyses showed that anxious/depressed, somatic complaints and exposure to suicidal behavior in significant others were significantly associated with own serious suicidal expressions. CONCLUSIONS: The prevalence of serious suicidal expressions among young people in Nicaragua is within the range reported from Western high-income countries. An attempted or completed suicide in someone close, is associated with own suicidal expressions even in the absence of increased mental distress. Furthermore, somatic complaints should alert health care professionals of the possibility of increased suicide risk.
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The parasitoid wasp family Ichneumonidae currently includes approximately 37 subfamilies worldwide. Banchinae subfamily is a cosmopolitan group with three tribes: Atrophini, Banchini and Glyptini, this last characterized with oblique grooves on tergites II-IV, a dorsal subapical notch on the ovipositor, and a median apical impression in the subgenital plate. From the latter tribe, the genus Sphelodon, with eight species reported, can be recognized for the presence of a prominent basolateral tooth in the first abdominal tergite. Significant previous comprehensive studies for that group have been done in Costa Rica by local and international experts, but it is highly probable that many species remain undescribed in the region; before this survey, only one species (S. annulicornis) was registered from Brazil. The material reviewed in this study was obtained from main entomological collections of Southeast and South Brazil, from localities corresponding to 17 of the 27 States of the country, although most of the specimens (70.3%) were collected in São Paulo State. Approximately 3 000 specimens of the subfamily have been examined, 29 belonging to Sphelodon. The description format in this work broadly follows previous works; the species were illustrated through SEM in low vacuum mode (without uncoated the specimens). Here five new species of the genus Sphelodon are described and illustrated, one of these (S. brunicornis), differs from the rest of the species by lacking a median band in the flagellum. An identification key to the Neotropical species is provided.
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Vespas/anatomia & histologia , Vespas/classificação , Animais , Brasil , Feminino , MasculinoRESUMO
BACKGROUND: Cebiche is a common dish in Latin America, prepared using raw fish mixed with vegetables and marinated with lime juice. The acidity of the lime juice is commonly believed to destroy bacteria and render cebiche as safe to eat. Little data exist concerning rates of cebiche-associated gastroenteritis outbreaks, although these may be high given the popularity of the dish. METHODS: We inoculated raw fish with Aeromonas hydrophila, Vibrio parahaemolyticus, and enterotoxigenic Escherichia coli to determine the effect of the cebiche preparation process on bacterial viability. Raw fish were exposed to a suspension of 1.0 × 10(8) colony-forming units (CFUs) of each organism in a 50-mL solution, prior to the addition of cebiche ingredients. A typical Peruvian cebiche recipe was used combining limes, onions, sweet potatoes, cilantro, and hot peppers marinated together for 30 minutes. A homogenized mixture of the dish was then evaluated for pH and bacterial counts at 0, 10, and 30 minutes. As much as 100 µL of inocula were streaked onto tryptic soy agar (TSA) agar plates and incubated for 24 hours. RESULTS: The initial average pH of the fish was 6.4 prior to adding cebiche ingredients and 5.0 immediately afterwards. The pH at 10- and 30-minute periods was 5.4 and 5.2, respectively. Little reduction in bacterial counts was observed at either the 10- or 30-minute time periods, with counts increasing at 30 minutes. CONCLUSIONS: The putative bactericidal role of lime juice in the preparation process is not sufficient to reduce the microbial population present in cebiche. Pathogens may remain viable after exposure to acidic conditions. The increasing popularity of Peruvian cuisine may also lead to cebiche-associated illness outside of Latin America.
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Aeromonas hydrophila/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Manipulação de Alimentos/métodos , Frutas/química , Alimentos Marinhos/microbiologia , Vibrio parahaemolyticus/efeitos dos fármacos , Animais , Antibacterianos/farmacologia , Carga Bacteriana , Bebidas , Concentração de Íons de Hidrogênio , Viabilidade Microbiana , Ciências da Nutrição , Peru , VerdurasRESUMO
En primer lugar deseo introducir ciertos elementos contextuales y teóricos que espero sirvan para ilustrar y esclarecer la estructura conceptual del psicodrama, así como justificar su aplicabilidad a problemáticas actuales de la psicología social.
In the first place I wish to introduce certain contextual and theoretical elements that I hope will serve to illustrate and clarify the conceptual structure of psychodrama, as well as justify its applicability to current problems of social psychology.
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Humanos , Psicodrama , Psicologia , Psicologia Social , Psicoterapia de GrupoRESUMO
This study examines suicide intent among parasuicide patients in a low-income country, Nicaragua, with special reference to gender patterns and future suicidal behavior. Using the Suicide Intent Scale (SIS), suicide intent was assessed in 204 persons presenting to hospital after parasuicide. Repetition was checked after a mean follow-up period of three years. The total SIS scores did not differ between women and men. However, a higher SIS score among women was significantly associated with older age, having children and use of pesticide as the parasuicide method. The overall method of suicide intent was low in Nicaragua compared to other countries, as was the nonfatal repetition rate (4.8% after three years). Subsequent suicides were found only in three men. Factor structures within the SIS disclosed supported the cross-cultural validity of the instrument. The level of suicide intent at the index attempt did not show any association with future suicidal behavior.
Assuntos
Intenção , Vigilância da População/métodos , Testes Psicológicos , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Criança , Análise Fatorial , Feminino , Seguimentos , Humanos , Masculino , Nicarágua/epidemiologia , Modelos de Riscos Proporcionais , Curva ROC , Recidiva , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/prevenção & controle , Fatores Sexuais , Fatores Socioeconômicos , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricosRESUMO
Pensar lo social a partir del psicoanálisis implica un salto cualitativo significativo, ya que así como no todo análisis del psiquismo es un psicoanálisis, no todo análisis de lo social es un psicoanálisis de lo social. Pero entonces, ¿como podríamos pensar una aplicación del psicoanálisis a lo social, sin desvirtuar el psicoanálisis y sin provocar un estrago en lo social? Y más allá, ¿que justificaría dicha aplicación? La primera pregunta demanda una postura ética, ya que el psicoanálisis sostiene una consistencia fundamentada, más que en la técnica (asociación libre), en unos principios rectores de una práctica única. Desde un punto de vista epistemológico también es posible afirmar que hay en el psicoanálisis unos conceptos fundamentales (inconsciente, repetición, transferencia y pulsión), conceptos que al ser puestos en operación, le dan existencia al sujeto, sujeto que en psicoanálisis se representa como barrado, dividido, y que es lo que podríamos considerar - si se nos permite - como la esencia del psicoanálisis, es decir, aquello sin lo cual el psicoanálisis no existe.
Thinking about social from psychoanalysis implies a significant qualitative leap, since just as not every analysis of psyche is a psychoanalysis, not every analysis of the social is a psychoanalysis of the social. But then, how could we think of an application of psychoanalysis to the social, without distorting psychoanalysis and without causing a social havoc? And beyond, what would justify such application? The first question demands an ethical stance, since psychoanalysis maintains a grounded consistency, rather than technique (free association), in guiding principles of a single practice. From an epistemological point of view it is also possible to affirm that there are in the psychoanalysis some fundamental concepts (unconscious, repetition, transfer and drive), concepts that when put into operation, give existence to the subject, subject that in psychoanalysis is represented as barred , divided, and what we might consider - if we are allowed - as the essence of psychoanalysis, that is, that without which psychoanalysis does not exist.
Assuntos
Humanos , Psicologia Social , Psicanálise/métodos , Identificação Social , Inconsciência/psicologiaRESUMO
En la intervención grupal, ya sea que se traten problemáticas de orden terapéutico, de aprendizaje, psicosociales, etc., se presentan dificultades tales como la directividad en la coordinación, directividad que llevada al extremo suele llegar a constituir el acto de coordinar en una instauración de un discurso amo del saber, discurso que, como es sabido, suele tener como efecto la desresponsabilización de los miembros participantes del grupo.
In the group intervention, whether they deal with therapeutic, learning, psychosocial problems, etc., there are difficulties such as directivity in coordination, directivity that leads to the extreme usually constitutes the act of coordinating in an establishment of a master of knowledge discourse, discourse that, as is well known, usually has the effect of de-responsibility of the participating members of the group.
Assuntos
Humanos , Psicoterapia de Grupo , Psicologia Social , Papel (figurativo) , Estrutura de GrupoRESUMO
El propósito de este estudio es reportar un caso muy florido de enfermedad de Vogt-Koyanagi-Harada, y además hacer una revisión del tema, principalmente en cuanto a etiopatogenia, presentación clínica y criterios diagnósticos de la misma. En este caso, una paciente de 34 años de edad fue examinada por un cuadro de 1 semana de evolución de cefalea occipital, hipoacusia bilateral, y pérdida súbita de la agudeza visual en forma simétrica y bilateral, como principal queja. No había otros antecedentes patológicos o familiares de importancia. Dentro del abordaje de la paciente, se descartó causa alguna de hipertensión endocraneana mediante TAC, y los laboratorios generales fueron normales, excepto por una VES aumentada. Dentro de examen ocular, se encontraron hallazgos compatibles con proceso panuveítico bilateral, así como desprendimento de retina importante bilateral. El LCR reveleó pelocitosis de predominio linfocítico con hipoglucorraquia y leve hiperproteinorraquia, sin evidencia de microrganismos. La audiometría demostró un déficit neurosensorial simétrico, mientras la paciente se quejaba de sensación de inestabilidad y acúfeno izquierdo. Todos los hallazgos encontrados, nos orientaron muy fuertemente hacia el diagnóstico de Enfermedad de Vogt-Koyanagi-Harada, siendo éste caso muy florido y útil para una revisión del tema. Con el tratamiento médico correspondiente, la paciente evoluciono satisfactoriamente, egresando con una notable mejoría clínica, con tratamiento, para seguir su control ambulatoriamente.
Assuntos
Adulto , Humanos , Feminino , Corticosteroides , Síndrome Uveomeningoencefálica/diagnóstico , Síndrome Uveomeningoencefálica/etiologia , Síndrome Uveomeningoencefálica/terapia , Costa RicaRESUMO
El propósito de este artículo es reportar dos inusuales casos de leve disminución de la agudeza visual, asociada a edema segmentario del disco óptico, en los que la serología por EBV revelo infección aguda. Un hombre de 60 años de edad fue examinado por visión borrosa a nivel del campo visual inferior izquierdo, y asociaba historia de cefalea con faringitis no exudativa. El examen físico revelo una agudeza visual de 20/100 en su ojo izquierdo, edema del segmento superior del disco óptico, defecto pupilar aferente y defecto en el campo visual correspondiente. El segundo caso se trata de una paciente de 52 años de edad, con antecedente de Diabetes Melliltus con buen control metabólico. La paciente consulto por visión borrosa en su ojo derecho de 2 semanas de evolución, asociada a cefalea y malestar general. Su agudeza visual era 20/20 en ambos ojos, y presento edema superior del disco óptico del ojo derecho asociado a defecto pupilar aferente ipsilateral. Ambos pacientes presentaron linfocitosis relativa, y su evaluación serológica fue indicativa de una infección aguda primaria por EBV. No hubo manifestaciones oculares asociadas y fueron descartadas otras posibilidades diagnosticadas. El edema de disco óptico resolvió espontáneamente en algunas semanas sin lesión del mismo, recuperando su agudeza visual a 20/40 y 20/20 respectivamente. Simultáneamente, los títulos de IgM disminuyeron.