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The ixodicidal activity of the methanolic extracts of Artemisia ludoviciana (Astereceae), Cordia boissieri (Boraginaceae) and Litchi chinensis (Sapindaceae) against two field populations of Rhipicephalus (Boophilus) microplus from the state of Nuevo Leon (NL) and Veracruz (VER) was evaluated. The extract of L. chinensis in the concentration of 150 mg/ml showed efficacies of 100% and 99% against engorged females and mortalities of 98% and 99% against larvae. C. boissieri in the same concentration showed efficacies of 71% and 37% against engorged adults and mortalities of 33.04% and 10.33% against larvae and A. ludoviciana had efficacies of 94% and 83% in adults and mortalities of 89.39% and 89.21% against larvae in both populations respectively. The enzymatic activity of Acetylcholinesterase (AChE), Carboxylesterase (CaE), Glutathione-S-Transferase (GST) and Alkaline Phosphatase (ALP) was measured in both populations of ticks. As a result, a significant difference between both populations was shown, being the VER population the one that exhibited a higher enzymatic activity (p ≤ 0.05). It can be concluded that the methanolic extract of the seed of L. chinensis shows potential ixodicidal activity and can be used as an alternative source of tick control, however, prior characterization, toxicity and formulation studies are necessary.

No presente trabalho, a atividade ixodicida de extratos metanólicos de Artemisia ludoviciana (Astereceae), Cordia boissieri (Boraginaceae) e Litchi chinensis (Sapindaceae) contra Rhipicephalus (Boophilus) microplus foi avaliada em duas populações de campo nos estados de Nuevo León (NL) y Veracruz (VER). O extrato de L. chinensis na concentração de 150 mg/ml, apresentou eficácia de 100% e 99% contra fêmeas ingurgitadas, e taxas de mortalidade de 98% e 99% contra larvas. C. boissieri, na mesma concentração, apresentou eficácia de 71% e 37% contra adultas ingurgitados, e taxas de mortalidade de 33,04% e 10,33% contra larvas e A. ludoviciana apresentou eficácias de 94% e 83% em adultos e mortalidade de 89,39% e 89,21% contra larvas em ambas as populações respectivamente. Por outro lado, a atividade enzimática da Acetilcolinesterase (AChE), Carboxilesterase (CaE), Glutationa-S-Transferase (GST) e Fosfatase Alcalina (ALP) foi medida em ambas as populações de carrapatos. Como resultado, foi apresentada uma diferença significativa entre as populações, sendo a população VER a que apresentou maior atividade enzimática (p ≤ 0,05). Assim, pode-se concluir que o extrato metanólico da semente de L. chinensis apresenta potencial atividade ixodicida e pode ser utilizado como fonte alternativa de controle de carrapatos, porém estudos prévios de caracterização, toxicidade e formulação são necessários.

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The ixodicidal activity of the methanolic extracts of Artemisia ludoviciana (Astereceae), Cordia boissieri (Boraginaceae) and Litchi chinensis (Sapindaceae) against two field populations of Rhipicephalus (Boophilus) microplus from the state of Nuevo Leon (NL) and Veracruz (VER) was evaluated. The extract of L. chinensis in the concentration of 150 mg/ml showed efficacies of 100% and 99% against engorged females and mortalities of 98% and 99% against larvae. C. boissieri in the same concentration showed efficacies of 71% and 37% against engorged adults and mortalities of 33.04% and 10.33% against larvae and A. ludoviciana had efficacies of 94% and 83% in adults and mortalities of 89.39% and 89.21% against larvae in both populations respectively. The enzymatic activity of Acetylcholinesterase (AChE), Carboxylesterase (CaE), Glutathione-S-Transferase (GST) and Alkaline Phosphatase (ALP) was measured in both populations of ticks. As a result, a significant difference between both populations was shown, being the VER population the one that exhibited a higher enzymatic activity (p ≤ 0.05). It can be concluded that the methanolic extract of the seed of L. chinensis shows potential ixodicidal activity and can be used as an alternative source of tick control, however, prior characterization, toxicity and formulation studies are necessary.

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Introducción: El perfil de egreso del Licenciado en Enfermería y Obstetricia plantea que las actividades deben responder a las necesidades poblacionales para la resolución de problemas de salud infecciosas y degenerativas en el primer nivel de atención que son prevenibles. Objetivo: Analizar la relación entre el perfil de egreso de los Licenciados en Enfermería y Obstetricia, y las funciones que realizan en el primer nivel de atención. Metodología: estudio cuantitativo, observacional, transversal y comparativo. Una muestra por conveniencia, 80 pasantes de la LEO en Primer Nivel de Atención, de la generación 2007-2010.El instrumento autoadministrado, consta de 13 preguntas generales y 54ítems; dichas preguntas agrupadas en cuatro dimensiones: asistenciales, administrativas, docentes y de investigación. Resultados: Del total dela población el 76% pertenecen al sexo femenino, la edad promedio es de 24 años. El 66% eligieron realizar el servicio social en el primer nivel de atención. En la realización entre las funciones asistenciales, administrativas, docentes y de investigación realizadas y la congruencia del perfil de egreso del LEO; resulta que se realizan siempre con una media de 4.11, las administrativas con una media de 3.33, seguida de funciones docentes con una mediana de 3.27.La fuerza de correlación entre ambas variables es muy fuerte.804, obtenida a través de la prueba r de Pearson. Para analizar las diferencias en el cumplimiento de funciones asistenciales, administrativas, docentes y de investigación, con respecto la variable condición laboral, se detectaron diferencias estadísticas; donde los egresados que cuentan con un empleo, son los que tienen una mejor opinión de la realización de todas sus actividades, que aquellos que no trabajan. Discusión y conclusiones: de acuerdo a los resultados de investigaciones consultadas y del presente estudio, se encontró que existe relación entre el perfil de egreso de los Licenciados en Enfermería y Obstetricia y las funciones que realiza en el primer nivel de atención; por el apoyo integral hacia el paciente y su familia, que concuerda con las políticas gubernamentales e institucionales en la prevención.

Introduction: The graduate profile of the Bachelor of Nursing and Midwifery states that activities should meet the needs of the population for solving health problems in infectious and degenerative primary care preventable. Objective: To analyze the relationship between the exit profile of Graduates in Nursing and Midwifery, and the functions performed in the primary care level. Methodology: quantitative, observational, transversal and comparative. A convenience sample of 80 interns LEO primary care level, 2007-2010 generation. The self-administered instrument consists of 13 items and 54 general questions, such questions grouped into four dimensions: care, administrative, teaching and research. Results: Of the total population 76% are female; the average age is 24 years. 66% chose to perform social service in the primary care level. In carrying between welfare functions, administrative, teaching and research carried out and the consistency of the graduate profile of LEO, it is always done with an average of 4.11, the administrative half of 3.33, followed by teaching positions with a median of 3.27. The strength of correlation between two variables is very strong .804, obtained through Pearson's r test. To analyze the differences in the performance ofhealth care functions, administrative, educational and research regarding employment status variable, statistical differences were detected, where the graduates who have a job are those who have a better opinion of the performance of all its activities, that those who do not work. Discussion and conclusions: according to results surveyed research and the present study, found that there is relationship between the profile of graduates in nursing and obstetrics and the functions performed at the first level of care; for the integral support to the patient and his family, which is consistent with Government and institutional policies on prevention.

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INTRODUCCIÓN Los estudios antropológicos sobre salud/enfermedad permiten indagar acerca de las articulaciones entre características de políticas públicas, particularidades de micro redes sociales, prácticas y saberes informales/formales. OBJETIVOS Describir y analizar sentidos y prácticas que construyen adultos con hijos adolescentes en una zona rural del noroeste de Tucumán, respecto al mundo actual de los adolescentes, a procesos de salud/enfermedad/atención, y a la relación entre las instituciones que articulan con la institución de infancia: Estado, familia, escuela, salud. MÉTODOS Estudio con enfoque etnometodológico y utilización de técnicas cualitativas, a partir de testimonios orales de adultos con hijos adolescentes y análisis de documentos. RESULTADOS Se logró caracterizar los procesos involucrados y se procedió a documentarlos a través de su mapeo, lo que a su vez llevó a a) identificar los procedimientos en cada etapa del proceso; b) establecer objetivos para cada proceso; c) establecer indicadores para su medición; y d) definir al responsable para asegurar su correcta implementación. DISCUSIÓN La etapa de seguimiento y mantenimiento de la gestión por procesos requiere el compromiso de todas las partes involucradas para tomar decisiones oportunas y pertinentes, con el fin de mejorar los procesos que se están desarrollando en el servicio.

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We studied the effects of adverse conditions such as constant light (LL) on the circadian rhythm of malate (MDH, EC 1.1.1.37) and lactate (LDH, EC 1.1.1.27) dehydrogenase activities of the testes of male Wistar rats on postnatal day 28 (PN28), anxiety-like behavior (elevated plus-maze test) at PN60 and sexual behavior at PN120. The rats were assigned to mother groups on day 10 of pregnancy: control (12-h light/dark), LL (light from day 10 to 21 of pregnancy), and LL+Mel (LL and sc injection to the mothers of a daily dose of melatonin, 1 mg/kg body weight at circadian time 12, from day 17 to 21 of pregnancy). LL offspring did not show circadian rhythms of MDH (N = 62) and LDH (N = 63) activities (cosinor and ANOVA-LSD Fisher). They presented a 44.7 percent decrease in open-arm entries and a 67.9 percent decrease in time (plus-maze test, N = 15, P < 0.001, Mann-Whitney U-test and Kruskal-Wallis test), an increase in mounting (94.4 percent), intromission (94.5 percent) and ejaculation (56.6 percent) latencies (N = 12, P < 0.01, Mann-Whitney U-test and Kruskal-Wallis test) and lower numbers of these events (61, 59 and 73 percent, respectively; P < 0.01, N = 12) compared to controls. The offspring of the LL+Mel group presented MDH and LDH circadian rhythms (P < 0.05, N = 50, cosinor and ANOVA-LSD Fisher), anxiety-like and sexual behaviors similar to control. These findings supported the importance of the melatonin signal and provide evidence for the protective effects of hormones on maternal programming during gestation. This protective action of melatonin is probably related to its entrainment capacity, favoring internal coupling of the fetal multioscillatory system.

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We studied the effects of adverse conditions such as constant light (LL) on the circadian rhythm of malate (MDH, EC 1.1.1.37) and lactate (LDH, EC 1.1.1.27) dehydrogenase activities of the testes of male Wistar rats on postnatal day 28 (PN28), anxiety-like behavior (elevated plus-maze test) at PN60 and sexual behavior at PN120. The rats were assigned to mother groups on day 10 of pregnancy: control (12-h light/dark), LL (light from day 10 to 21 of pregnancy), and LL+Mel (LL and sc injection to the mothers of a daily dose of melatonin, 1 mg/kg body weight at circadian time 12, from day 17 to 21 of pregnancy). LL offspring did not show circadian rhythms of MDH (N = 62) and LDH (N = 63) activities (cosinor and ANOVA-LSD Fisher). They presented a 44.7% decrease in open-arm entries and a 67.9% decrease in time (plus-maze test, N = 15, P < 0.001, Mann-Whitney U-test and Kruskal-Wallis test), an increase in mounting (94.4%), intromission (94.5%) and ejaculation (56.6%) latencies (N = 12, P < 0.01, Mann-Whitney U-test and Kruskal-Wallis test) and lower numbers of these events (61, 59 and 73%, respectively; P < 0.01, N = 12) compared to controls. The offspring of the LL+Mel group presented MDH and LDH circadian rhythms (P < 0.05, N = 50, cosinor and ANOVA-LSD Fisher), anxiety-like and sexual behaviors similar to control. These findings supported the importance of the melatonin signal and provide evidence for the protective effects of hormones on maternal programming during gestation. This protective action of melatonin is probably related to its entrainment capacity, favoring internal coupling of the fetal multioscillatory system.

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Tinea nigra is a superficial mycosis caused by Hortaea werneckii. It is an infrequent asymptomatic infection that affects human palms and soles, and is mostly observed in tropical countries. We evaluate retrospectively twenty-two confirmed cases of tinea nigra from a total of eleven yr (1997-2007) and discuss the epidemiology, clinical features and treatment of this disease. In twelve cases, adults were involved, in 10, children. In nineteen cases the disorder was located on palms of hands and in three on soles of feet. In all cases, the obtained isolates were morphologically identified as Hortaea werneckii and the identification of ten isolates was retrospectively confirmed with the help of sequences of the internal transcribed spacer regions of the ribosomal DNA. The patients received topical treatment with Whitfield ointment, ketoconazole, bifonazole, or terbinafine. Treatment with keratolytic agents and topical antifungals was effective.

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BACKGROUND: Actinomycetoma is a chronic occupational condition that occurs frequently in tropical regions. In Mexico 85% of cases are caused by Nocardia brasiliensis. There are two treatments of choice for these cases: a regimen of dapsone plus trimethoprim-sulfamethoxazole (co-trimoxazole) and, recently, amikacin, either alone or combined. However, not all cases respond properly to these therapies. OBJECTIVES: To report a retrospective, 11-year study of cases of actinomycetomas caused by Nocardia spp., treated with amoxicillin-clavulanate (co-amoxiclav). METHODS: All cases were identified clinically and microbiologically and had previously failed standard therapies. Oral co-amoxiclav 875/125 mg was administered every 12 h. Clinical, microbiological and laboratory follow up was performed every 2 months during the treatment period. RESULTS: Twenty-one cases of actinomycetoma were included, 19 caused by N. brasiliensis and one each by N. asteroides and N. otitidiscaviarum. Clinical and microbiological cure occurred in 15 of 21 cases (71%); two cases improved (10%) and four failed (19%). Mean treatment period was 9.6 months, during which neither side-effects nor laboratory test alterations were reported. CONCLUSIONS: Treatment with co-amoxiclav represents an alternative or rescue treatment for cases that have previously failed standard therapies.

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INTRODUCTION AND AIMS: We question the suitability of the usual methods for taking the pressure of cerebrospinal fluid (CSF). We suspect that the composition of CSF and, in consequence, its density have an important effect on its manometric value. MATERIAL AND METHODS: We obtained 322 CSF samples, with known cytological and biochemical composition, density and manometric values. We corrected the manometric measurements and, for each case, we calculated the exact pressure exerted by the column of CSF from its density, which was already known. The working variable was set as the manometric error (ME) that resulted from: Abs (calculated pressure of the column of CSF from its density manometry) (absolute value of the difference). RESULTS: It was found that protein concentration levels in CSF had an important effect on the ME of the CSF, especially in values above 150 mg/cm3, and this result is extrapolated from our ad hoc mathematical model: corrected manometry (mmH2O) = manometry (mmH2O) + [cerebrospinal fluid protein (mg/cm3) / 50] 2. CONCLUSION: This model proved to be a suitable predictor of ME in our sample, with a= 0.005.

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This article presents a general model for estimating population heterogeneity and "lack of knowledge" uncertainty in methylmercury (MeHg) exposure assessments using two-dimensional Monte Carlo analysis. Using data from fish-consuming populations in Bangladesh, Brazil, Sweden, and the United Kingdom, predictive model estimates of dietary MeHg exposures were compared against those derived from biomarkers (i.e., [Hg]hair and [Hg]blood). By disaggregating parameter uncertainty into components (i.e., population heterogeneity, measurement error, recall error, and sampling error) estimates were obtained of the contribution of each component to the overall uncertainty. Steady-state diet:hair and diet:blood MeHg exposure ratios were estimated for each population and were used to develop distributions useful for conducting biomarker-based probabilistic assessments of MeHg exposure. The 5th and 95th percentile modeled MeHg exposure estimates around mean population exposure from each of the four study populations are presented to demonstrate lack of knowledge uncertainty about a best estimate for a true mean. Results from a U.K. study population showed that a predictive dietary model resulted in a 74% lower lack of knowledge uncertainty around a central mean estimate relative to a hair biomarker model, and also in a 31% lower lack of knowledge uncertainty around central mean estimate relative to a blood biomarker model. Similar results were obtained for the Brazil and Bangladesh populations. Such analyses, used here to evaluate alternative models of dietary MeHg exposure, can be used to refine exposure instruments, improve information used in site management and remediation decision making, and identify sources of uncertainty in risk estimates.

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UNLABELLED: The incidence of adenocarcinoma around the esophagogastric junction is increasing. The significance of intestinal metaplasia found in biopsy taken from normal appearing squamocolumnar junction is not clear. The aim of this study was to define the frequency of intestinal metaplasia at normal-appearing esophagogastric junction and clinical, endoscopic and histological associations. METHODS: 239 patients referred for gastroscopy participated in the study. Of 192 patients, two groups were compared. Group I included 40 patients with metaplasia intestinal at the esophagogastric junction and group II included 152 patients with no metaplasia intestinal at the same location. Biopsy specimens were taken from above and below the squamocolumnar junction, and gastric antrum The biopsy specimens were stained with haematoxylin-eosin. RESULTS: Intestinal metaplasia at the squamocolumnar junction was found in 40 patients (21%). Metaplasia was associated with increasing age (p=0.002) and antral intestinal metaplasia (p<0.001)(OR 14.6). There was no association with gastro-oesophageal reflux disease. CONCLUSION: Intestinal metaplasia at the esophagogastric junction occurs frequently in Peruvian patients. It is associated with increasing age and antral intestinal metaplasia but not gastro-esophageal reflux disease.

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Las lesiones elevadas gástricas representan un importante grupo dentro de la patología gástrica. Para establecer su incidencia en nuestra experiencia, estudiamos los informes endoscópicos de dos hospitales importantes de la Ciudad de La Paz; El Instituto Boliviano Japonés de Gatroenterología y el Hospital Obrero N-. 1. En orden de efectuar buena discriminación endoscópica entre diferentes lesiones elevadas usamos parámetros como: localización, forma, tamaño, diámetro, superficie de la lesión y mucosa circundante y características de las paredes. Fueron revisados 10.472 informes endoscópicos, se encontraron 497 lesiones elevadas gástricas, 475 correspondían a lesiones mucosas (352 lesiones benignas y 123 lesiones malignas), 11 correspondían a lesiones submucosas y 11 lesiones extragástricas

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Las lesiones elevadas gástricas representan un importante grupo dentro de la patología gástrica. Para establecer su incidencia en nuestra experiencia, estudiamos los informes endoscópicos de dos hospitales importantes de la Ciudad de La Paz; El Instituto Boliviano Japonés de Gatroenterología y el Hospital Obrero N-. 1. En orden de efectuar buena discriminación endoscópica entre diferentes lesiones elevadas usamos parámetros como: localización, forma, tamaño, diámetro, superficie de la lesión y mucosa circundante y características de las paredes. Fueron revisados 10.472 informes endoscópicos, se encontraron 497 lesiones elevadas gástricas, 475 correspondían a lesiones mucosas (352 lesiones benignas y 123 lesiones malignas), 11 correspondían a lesiones submucosas y 11 lesiones extragástricas (AU)

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Elevated gastric lesions, represent an important group among gastric pathology. To establish its incidence in our experience, we studied the endoscopic reports of two important hospitals in La Paz city: Instituto de Gastroenterología Boliviano Japonés and Hospital Obrero No. 1. In order to make a good endoscopic diagnosis among different elevated lesions we use some parameters like: location, shape, size, diameter, surface of the lesion and surrounding mucosa and characteristics of the falls. 10.472 endoscopic reports were reviewed, 497 elevated gastric lesions were found, 475 corresponded to mucosal lesions (352 benign lesions and 123 malignant lesions), 11 to submucosal and 11 extragastric lesions.

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Elevated gastric lesions, represent an important group among gastric pathology. To establish its incidence in our experience, we studied the endoscopic reports of two important hospitals in La Paz city: Instituto de Gastroenterología Boliviano Japonés and Hospital Obrero No. 1. In order to make a good endoscopic diagnosis among different elevated lesions we use some parameters like: location, shape, size, diameter, surface of the lesion and surrounding mucosa and characteristics of the falls. 10.472 endoscopic reports were reviewed, 497 elevated gastric lesions were found, 475 corresponded to mucosal lesions (352 benign lesions and 123 malignant lesions), 11 to submucosal and 11 extragastric lesions.

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Megacolon occurs frequently in high altitude areas. This report describes observations made in 60 cases seen in La Paz, Bolivia (3,600 meters above sea level). Motility of both the large and small bowel was found to be increased and the feces had a low pH. No histologic abnormalities were noted in the nervous plexus or smooth muscle. It is assumed that megacolon in these circumstances is acquired and not congenital.

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El megacolon es una alteracion frecuentemente encontrada en las grandes alturas.En esta publicacion describimos y analizamos sesenta casos de megacolon encontrados en el Hospital Obrero en La Paz, Bolivia a 3.600 m de altura sobre el nivel del mar. Se ha encontrado el transito intestinal acelerado tanto en intestino delgado como en colon. El pH de las materias fecales acido. En el estudio histopatologico no se encuentran alteraciones ni en los plexos nerviosos ni en la musculatura lisa. Se propone que el megacolon de las grandes alturas es una alteracion adquirida, producida por una mayor distencion de los gases en colon bajo una presion atmosferica mas baja que al nivel del mar, 490 mm Hg a esta altura comparada con los 760 mm Hg al nivel de mar

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Se presentan 45 casos de litiasis de coledoco en los que se realizo papilotomia endoscopica para la extraccion de calculos coledocianos.Se describen los procedimientos. Se obtuvo exito en el 80% con 6,6% de complicaciones

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Se presenta una serie de 380 colangiografias retrogradas endoscopicas practicadas en el Hospital Obrero de la ciudad de La Paz, entre enero de 1979 y junio de 1983.Se describe la tecnica y los resultados.Se establecieron 5 diagnosticos, la mayoria confirmados posteriormente en el acto quirurgico y/o estudio histopatologico. La mayor frecuencia correspondio a la patologia litasica seguida por la neoplasica de via biliar. Se confirma la importancia del procedimiento en el diagnostico de las enfermedades de la via biliar y la baja incidencia de complicaciones consecutivas a su practica

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