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The development of custom cellular materials has been driven by recent advances in additive manufacturing and structural topological optimization. These contemporary materials with complex topologies have better structural efficiency than traditional materials. Particularly, truss-like cellular structures exhibit considerable potential for application in lightweight structures owing to their excellent strength-to-mass ratio. Along with being light, these materials can exhibit unprecedented vibration properties, such as the phononic bandgap, which prohibits the propagation of mechanical waves over certain frequency ranges. Consequently, they have been extensively investigated over the last few years, being the cores for sandwich panels among the most important potential applications of lattice-based cellular structures. This study aims to develop a methodology for optimizing the topology of sandwich panels using cellular truss cores for bandgap maximization. In particular, a methodology is developed for designing lightweight composite panels with vibration absorption properties, which would bring significant benefits in applications such as satellites, spacecraft, aircraft, ships, automobiles, etc. The phononic bandgap of a periodic sandwich structure with a square core topology is maximized by varying the material and the geometrical properties of the core under different configurations. The proposed optimization methodology considers smooth approximations of the objective function to avoid non-differentiability problems and implements an optimization approach based on the globally convergent method of moving asymptotes. The results show that it is feasible to design a sandwich panel using a cellular core with large phononic bandgaps.

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INTRODUCTION AND OBJECTIVES: Mental disorders are very prevalent in the general population. Despite this, it is estimated that only about a third of the people affected is able to recognise problems on their own and to access health services. The aim was to determine the factors associated with the lack of self-recognition of mental problems and disorders in the Colombian population. METHODS: The National Mental Health Survey (ENSM-2015) conducted in Colombia identified adults over 18 years that answered 'yes' to the question 'Have you had a mental problem or disorder?', had a positive score in mental disorders measured by the Composite International Diagnostic Interview (CIDI) 3.0, or in mental problems detected by the SRQ-20. A bivariate analysis, as well as a logistic regression, were performed with possible related variables. RESULTS: A sample of 10, 870 adults was obtained, of whom 12.25% (1332) had mental disorders and 30.2% (3282) had mental problems. Of those individuals with disorders and problems, 7.9% recognised themselves as affected. The variables associated with self-recognition of disorders or problems were, among others: being female (OR = 1.8; 95%CI, 1.4-2.3), family dysfunction (OR = 1.5; 95%CI, 1.2-2.0), to have experienced a traumatic event (OR = 1.8; 95%CI, 1.4-2.2), illegal substance consumption (OR = 0.5; 95%CI, 0.4-0.7), not being poor (OR = 1.9; 95%CI, 1.2-3.0), and not having chronic illnesses (OR = 1.6; 95%CI, 1.3-2.1). CONCLUSIONS: Self-recognition is of great relevance to improve access to care by adults. The results provide associated variables that allow planning interventions that can promote the recognition of mental problems or disorders in this population.

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RESUMEN Introducción y objetivos: Los trastornos mentales son muy prevalentes en la población general; a pesar de ello, solo alrededor de un tercio reconoce que los tiene y accede a los servicios de salud. El objetivo es determinar los potenciales factores asociados con la falta de autorreconocimiento de trastornos y problemas mentales entre la población colombiana. Métodos: En la Encuesta Nacional de Salud Mental 2015 (ENSM 2015) realizada en Colombia, se recogieron las respuestas de los adultos mayores de 18 anos a la pregunta sobre si tenían algún problema o trastorno mental que hayan puntuado positivo en trastornos mentales medidos por el CIDI 3.0 o en problemas mentales detectados por el SRQ-20. Se realizó un análisis bivariable con posibles variables relacionadas y otro multivariable de regresión logística. Resultados: Se obtuvo una muestra de 10.870 adultos; el 12,25% (1.332) sufría trastornos y el 30,2% (3.282), problemas. Del total de personas con trastornos y problemas, el 7,9% se autorreconoció con ellos. Las variables asociadas con el autorreconocimiento de trastornos o problemas fueron: ser mujer (OR = 1,8; IC95%, 1,4-2,3), tener disfunción familiar (OR = 1,5; IC95%, 1,2-2,0), haber sufrido un evento traumático (OR = 1,8; IC95%, 1,4-2,2), consumir sustancias psicoactivas (OR = 0,5; IC95%, 0,4-0,7), no ser pobre (OR = 1,9; IC95%, 1,2-3,0) y tener enfermedades crónicas (OR = 1,6; IC95%, 1,3-2,1), entre otras variables asociadas. Conclusiones: El autorreconocimiento de los adultos es de gran relevancia para iniciar el acceso a la atención. Los resultados proveen variables asociadas que permiten planear intervenciones para promover el autorreconocimiento en esta población.

ABSTRACT Introduction and objectives: Mental disorders are very prevalent in the general population. Despite this, it is estimated that only about a third of the people affected is able to recognise problems on their own and to access health services. The aim was to determine the factors associated with the lack of self-recognition of mental problems and disorders in the Colombian population. Methods: The National Mental Health Survey (ENSM-2015) conducted in Colombia identified adults over 18 years that answered "yes' to the question 'Have you had a mental problem or disorder?', had a positive score in mental disorders measured by the Composite International Diagnostic Interview (CIDI) 3.0, or in mental problems detected by the SRQ-20. A bivariate analysis, as well as a logistic regression, were performed with possible related variables. Results: A sample of 10, 870 adults was obtained, of whom 12.25% (1,332) had mental disorders and 30.2% (3282) had mental problems. Of those individuals with disorders and problems, 7.9% recognised themselves as affected. The variables associated with self-recognition of disorders or problems were, among others: being female (OR = 1.8; 95%CI, 1.4-2.3), family dysfunction (OR= 1.5; 95%CI, 1.2-2.0), to have experienced a traumatic event (OR =1.8; 95%CI, 1.4-2.2), illegal substance consumption (OR = 0.5; 95% saCI, 0.4-0.7), not being poor (OR = 1.9; 95%CI, 1.2-3.0), and having chronic illnesses (OR= 1.6; 95%CI, 1.3-2.1). Conclusions: Self-recognition is of great relevance to improve access to care by adults. The results provide associated variables that allow planning interventions that can promote the recognition of mental problems or disorders in this population.

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INTRODUCTION: Mental problems and disorders are prevalent in the adolescent population. It is estimated that around 10% of adolescents have mental disorders that require attention and are generally not recognised as such. The aim was to determine potential factors associated with whether or not mental disorders and problems are recognised in the Colombian population. METHODS: Adolescents aged 12 to 17 who said they had been diagnosed with a mental health problem or disorder by a healthcare professional were identified from the National Mental Health Survey conducted in Colombia in 2015. This group was compared with those who scored positive for mental disorders measured by CIDI 3.0 or mental problems detected by SRQ-20. RESULTS: A sample of 1,754 adolescents was obtained, of whom 7.3% (n=129) had disorders and 22.6% (n=396) had problems. Of the total with disorders and problems, 13.9% (n=18) of people with disorders and 8.3% (n=33) with problems knew they had them. Bivariate analyses were performed with the possible related variables, and with the results we constructed a multivariate regression model that identified factors associated with the recognition of disorders or problems, such as family dysfunction (OR=2.5; 95% CI, 1.3-4.5) or counting on family when having financial problems (OR=2.7; 95% CI, 1.0-7.2). CONCLUSIONS: Recognition is of great importance for initiating access to care by adolescents. The results provide associated variables which can aid planning of interventions to improve the detection of disorders and problems in this population.

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INTRODUCTION AND OBJECTIVES: Mental disorders are very prevalent in the general population. Despite this, it is estimated that only about a third of the people affected is able to recognise problems on their own and to access health services. The aim was to determine the factors associated with the lack of self-recognition of mental problems and disorders in the Colombian population. METHODS: The National Mental Health Survey (ENSM-2015) conducted in Colombia identified adults over 18 years that answered "yes' to the question 'Have you had a mental problem or disorder?', had a positive score in mental disorders measured by the Composite International Diagnostic Interview (CIDI) 3.0, or in mental problems detected by the SRQ-20. A bivariate analysis, as well as a logistic regression, were performed with possible related variables. RESULTS: A sample of 10, 870 adults was obtained, of whom 12.25% (1,332) had mental disorders and 30.2% (3282) had mental problems. Of those individuals with disorders and problems, 7.9% recognised themselves as affected. The variables associated with self-recognition of disorders or problems were, among others: being female (OR=1.8; 95%CI, 1.4-2.3), family dysfunction (OR=1.5; 95%CI, 1.2-2.0), to have experienced a traumatic event (OR=1.8; 95%CI, 1.4-2.2), illegal substance consumption (OR=0.5; 95%CI, 0.4-0.7), not being poor (OR=1.9; 95%CI, 1.2-3.0), and having chronic illnesses (OR=1.6; 95%CI, 1.3-2.1). CONCLUSIONS: Self-recognition is of great relevance to improve access to care by adults. The results provide associated variables that allow planning interventions that can promote the recognition of mental problems or disorders in this population.

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RESUMEN Introducción: Los problemas y los trastornos mentales son prevalentes en la población adolescente. Se calcula que alrededor de un 10% de los adolescentes sufren trastornos mentales que requieren atención y, en general, no se reconocen como tales. El objetivo es determinar potenciales factores asociados con que se reconozcan o no los trastornos y problemas mentales en la población colombiana. Métodos: De la Encuesta Nacional de Salud Mental (ENSM) del 2015 realizada en Colombia, se recogió a los adolescentes de 12-17 arios que respondieron a si algún profesional los había diagnosticado un problema o trastorno de salud mental y se los comparó con los que puntuaron positivo en trastornos mentales medidos por el CIDI 3.0 o en problemas mentales detectados por el SRQ-20. Resultados: Se obtuvo una muestra de 1.754 adolescentes, de los que el 7,3% (n = 129) tenían trastornos y el 22,6% (n = 396) tenían problemas. Del total con trastornos y problemas, reconocen que los tienen el 13,9% (n = 18) de las personas con trastornos y el 8,3% (n = 33) de aquellos con problemas. Se realizaron análisis bivariables con posibles variables relacionadas y, con los resultados, se construyó un modelo multivariable de regresión que evidenció factores asociados con el reconocimiento de trastornos o problemas, como disfunción familiar (OR = 2,5; IC del 95%, 1,3-4,5) y acudir a familiar en caso de problemas económicos (OR = 2,7; IC del 95%, 1,0-7,2). Conclusiones: El reconocimiento es de gran relevancia para que los adolescentes inicien el acceso a la asistencia. Los resultados proveen variables asociadas que permiten planear intervenciones que promuevan la detección de trastornos y problemas en esta población.

ABSTRACT Introduction: Mental problems and disorders are prevalent in the adolescent population. It is estimated that around 10% of adolescents have mental disorders that require attention and are generally not recognised as such. The aim was to determine potential factors associated with whether or not mental disorders and problems are recognised in the Colombian population. Methods: Adolescents aged 12 to 17 who said they had been diagnosed with a mental health problem or disorder by a healthcare professional were identified from the National Mental Health Survey conducted in Colombia in 2015. This group was compared with those who scored positive for mental disorders measured by CIDI 3.0 or mental problems detected by SRQ-20. Results: A sample of 1,754 adolescents was obtained, of whom 7.3% (n = 129) had disorders and 22.6% (n = 396) had problems. Of the total with disorders and problems, 13.9% (n = 18) of people with disorders and 8.3% (n = 33) with problems knew they had them. Bivariate analyses were performed with the possible related variables, and with the results we constructed a multivariate regression model that identified factors associated with the recognition of disorders or problems, such as family dysfunction (OR = 2.5; 95% CI, 1.3-4.5) or counting on family when having financial problems (OR = 2.7; 95% CI, 1.0-7.2). Conclusions: Recognition is of great importance for initiating access to care by adolescents. The results provide associated variables which can aid planning of interventions to improve the detection of disorders and problems in this population.

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An amendment to this paper has been published and can be accessed via a link at the top of the paper.

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The geomagnetic field variations on the continent of Africa are still largely undeciphered for the past two millennia. In spite of archaeological artefacts being reliable recorders of the ancient geomagnetic field strength, only few data have been reported for this continent so far. Here we use the Thellier-Coe and calibrated pseudo-Thellier methods to recover archaeointensity data from Burkina Faso and Ivory Coast (West Africa) from well-dated archaeological artefacts. By combining our 18 new data with previously published data from West Africa, we construct a reference curve for West Africa for the past 2000 years. To obtain a reliable curve of the archaeointensity variation, we evaluate a penalized smoothing spline fit and a stochastic modelling method, both combined with a bootstrap approach. Both intensity curves agree well, supporting the confidence in our proposed intensity variation during this time span, and small differences arise from the different methodologies of treating data and uncertainties. Two prominent peaks at around 740 AD and 1050 AD appear to be common in ours and several reference curves from other locations, indicating a general westward movement from China to Hawaii of a rather stable feature of the geomagnetic field. However, independent smaller peaks that do not correlate in different locations may hint to localized expressions of the geomagnetic field as a result of temporarily varying non-dipole sources.

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Riparian forests are important to aquatic ecosystems and produce large quantities of organic matter that are recycled by the microbial community that includes microscopic fungi. The aim of this study was to unveil and compare the diversity of aquatic hyphomycetes associated to submerged leaf litter of tropical lotic and lentic environments in the Atlantic Forest of Northeast Brazil. Six sampling events were carried out in six points of two study areas: Biological Reserve "Mata da Chuva" (MC) and Environmental Protection Area "Lagoa da Mata" (LM), in Pernambuco, Brazil. Twenty three taxa of hyphomycetes were identified resulting in 87 occurrences. In the lake LM, 13 taxa of hyphomycetes were identified with 34 occurrences and in the MC (stream), 20 taxa with 53 occurrences. Ten species were common to both areas. Diversity indices and fungal biomass (ergosterol) were mostly higher in the lotic system. The fungal community analysis did not show any structure regarding sampling periods or sampling points within an area, however the two areas are different. Although the turbulence of the water is considered important for the development of these aquatic fungi, it is possible to find a diverse community of hyphomycetes and considerable fungal biomass in the lentic environment.

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Introducción: en pacientes con trauma encéfalo-craneano (TEC) la presión arterial en el momento de la admisión por urgencias tiene una relevancia especial por ser la base de la presión de perfusión cerebral. El propósito de esta investigación fue estimar la asociación entre los valores de presión arterial al ingreso a urgencias y la mortalidad hospitalaria en dichos pacientes. Métodos: cohorte retrospectiva en pacientes mayores de 18 años con diagnóstico de TEC admitidos al Hospital Pablo Tobón Uribe entre enero de 2012 y enero de 2014. Se hizo una regresión logística multivariable para estimar el efecto independiente de los valores de presión arterial en la mortalidad. Resultados: en 582 pacientes la mediana de edad fue 36 años (rango intercuartílico = 25-59) y el 77,1 % (n = 449) eran hombres. La mortalidad según los valores de presión arterial sistólica al ingreso en las categorías de <100, 100-150 y >150 mm Hg fue 34,6 % (18/52), 13,3 % (56/421) y 29,4 % (32/109), respectivamente. En el análisis univariable tanto la presión menor de 100 como la mayor de 150 mm Hg se asociaron con mortalidad, pero dicha asociación perdió magnitud y significado estadístico (OR = 1,81; IC95 % = 0,94-3,48 y OR = 1,91; IC95 % = 0,86-4,54, respectivamente) al ajustar por la escala de coma de Glasgow, la saturación de oxígeno y la presencia de edema cerebral. Conclusiones: no se demostró asociación estadísticamente significativa entre los valores de presión arterial al ingreso a urgencias y la mortalidad en los pacientes con TEC.

Introduction: Blood pressure is of special relevance in patients with traumatic brain injury (TBI) at admission to emergency services, since it is the basis of cerebral perfusion pressure. The purpose of this research was to estimate the association between blood pressure values measured on admission and hospital mortality in patients with TBI. Methods: Retrospective cohort study in patients older than 18 years admitted with TBI to Hospital Pablo Tobón Uribe, in Medellín (Colombia) between January 2012 and January 2014. A multivariate logistic regression model was performed to estimate the independent effect of blood pressure values on mortality. Results: 582 patients with a median age of 36 years (IQR = 25-59) 77.1 % of them males (n = 449) were evaluated. Mortality according to categories of systolic blood pressure at admission (<100, 100-150 and >150 mmHg) was as follows: 34.6 % (18/52), 13.3 % (56/421) and 29.4 % (32/109), respectively. Univariate analysis showed that blood pressure less than 100 or greater than 150 mm Hg were associated with hospital mortality, but that association lost magnitude and statistical significance (OR = 1.81; 95 % CI = 0.94-3.48 and OR = 1.91; 95 % CI = 0.86-4.54, respectively) after adjustment by Glasgow coma scale, oxygen saturation and cerebral edema. Conclusions: We did not demonstrate a statistically significant association between blood pressure values at admission to the emergency service and mortality in patients with TBI.

Introdução: em doentes com trauma encéfalo-craneano (TEC) a pressão arterial no momento da admissão por urgências tem uma relevância especial por ser a base da pressão de perfusão cerebral. O propósito desta investigação foi estimar a associação entre os valores de pressão arterial ao ingresso a urgências e a mortalidade hospitalar em ditos doentes. Métodos: coorte retrospectiva em doentes maiores de 18 anos com diagnóstico de TEC admitidos no Hospital Pablo Tobón Uribe entre janeiro de 2012 e janeiro de 2014. Se fez uma regressão logística multi-variável para estimar o efeito independente dos valores de pressão arterial na mortalidade. Resultados: em 582 doentes a média de idade foi 36 anos (RIC = 25-59) e 77,1 % (n = 449) eram homens. A mortalidade segundo os valores de pressão arterial sistólica ao ingresso nas categorias de <100, 100-150 y >150 mm Hg foi 34,6 % (18/52), 13,3 % (56/421) e 29,4 % (32/109), respectivamente. Na análise univariável tanto a pressão menor de 100 como a maior de 150 mm Hg se associaram com mortalidade, mas dita associação perdeu magnitude e significado estatístico (OR = 1,81; IC95 % = 0,94-3,48 e OR = 1,91; IC95 % = 0,86-4,54, respectivamente) ao ajustar pela escala de coma de Glasgow, a saturação de oxigeno e a presença de edema cerebral. Conclusões: não se demostrou associação estatisticamente significativa entre os valores de pressão arterial ao ingresso a urgências e a mortalidade nos doentes com TEC.

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Los hongos conidiales se desarrollan en ambientes muy variados en los que influye la temperatura, la humedad y la profundidad de la hojarasca. En esta investigación se analizó la influencia que tiene la humedad del ambiente, microambiente y hojarasca; la temperatura del ambiente y microambiente y la profundidad de la hojarasca, en el desarrollo de 14 especies de hongos anamórficos encontrados en la Reserva Ecológica Cayalá, un bosque urbano ubicado en la Ciudad de Guatemala. Este análisis se realizó por medio de muestreos durante la época lluviosa de julio a noviembre de 2013 y por estadística multivariada para asociar las distintas variables con las especies fúngicas. Se encontró que la presencia de Bactrodesmium longisporum MB Ellis, Beltrania rhombica Penz, Michelia, Junewangia globulosa (Thoth) WA Baker & Morgan - Jones y Neopodocodis megasperma (Boedijin) Rifai fueron influenciadas por la profundidad de la hojarasca y la temperatura del microambiente mientras que el resto de especies lo fueron por la humedad del ambiente, microambiente y hojarasca. Es importante conocer la forma en que las variables evaluadas afectan la presencia de estos hongos, por su acción en la dinámica de remanentes boscosos urbanos, para contribuir a su conservación

Conidial fungi develop in distinct habitats with several environmental conditions in which influences the temperature, humidity and depth of litter. In this research the influence of the humidity, temperature, microenvironment and litter moisture and temperature and depth of litter, was analyzed in the development of 14 species of anamorphic fungi found in the Reserva Ecológica Cayalá, located in Guatemala City. This analysis was performed by sampling during the rainy season from July to November 2013 and using multivariate statistics for different variables associated with the species. It was found that the presence of Bactrodesmium longisporum MB Ellis, Beltrania rhombica Penz, Michelia, Junewangia globulosa (Thoth) WA Baker & Morgan - Jones, and Neopodocodis megasperma(Boedijin) Rifai, was influenced by the depth of litter and microenvironment temperature while the other species were for the environmental humidity, microenvironment moisture and litter moisture. It is important to know how the evaluated variables affect the presence of these fungi, by the roleits action on the dynamics of urban forest remmants, to contribute to their conservation.

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Los hongos anamorfos constituyen un grupo muy diverso microscópicos cuya forma de reproducción es asexual a través de conidios. Actúan como agentes de degradación de la materia vegetal en el suelo, lo cual es un proceso clave en el reciclaje de nutrientes. Debido a la importancia y al vacío de información que existe sobre estos hongos en Guatemala, en este trabajo se identificaron 12 especies, por medio de características microscópicas; luego de la extracción de las estructuras fúngicas desarrolladas en hojas, ramas y semillas recolectadas en una parcela de la Reserva Ecológica Cayalá de la Ciudad de Guatemala. El material de referencia está depositado en la colección de hongos anamorfos de la Micoteca de Macrohongos de Guatemala "Lic. Rubén Mayorga Peralta" (MICG)

Anamorphic fungi are a diverse group of microscopic fungi that reproduce asexually through conidia. They degrade plant debris on the soil, which is a key process in nutrients recycling. Because of its importance and the lack of information regarding to these fungi in Guatemala, In this article, 12 species were identified through microscopic characteristics, after extraction of fungal structures developed in leaves, twigs and seeds collected at the Cayalá Ecological Reserve in Guatemala City. Reference materials are placed at the anamorphic fungi collection at Micoteca de Macro hongos de Guatemala, "Dr. Ruben Mayorga Peralta" (MICG).

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Resumen Antecedentes: La fístula biliar postraumática es el paso anormal del contenido líquido del tracto biliar hacia un órgano, cavidad o cuando se tiene un drenaje artificial hacia la superficie externa del abdomen. Es una secuela postraumática relativamente rara, ocurre en entre 0.5 y 2.6% de los casos de trauma hepático. El manejo endoscópico disminuye considerablemente la estancia hospitalaria y la morbimortalidad de estos pacientes. El objetivo es presentar un caso con fístula biliar postraumática manejado exitosamente con colocación endoscópica de prótesis Cotton 10 FR. Caso clínico: Varón de 28 años que sufrió contusión abdominal contra el volante. Es manejado conservadoramente durante una semana con mejoría leve. Fue sometido a laparotomía exploradora por abdomen agudo con 3000 mL de líquido biliar, se colocó drenaje. Presentó fuga biliar mayor de 500 mL/24 h; se realizó colangiopancreatografía retrógrada endoscópica y se encontró una fístula biliar tipo II; se le colocó prótesis tipo Cotton 10 FR, y 24 horas después el gasto disminuyó a menos de 50 mL/24 h. A los ocho días se retiró el drenaje y tres meses después la prótesis, el paciente no tuvo complicaciones mediatas ni tardías. Conclusión: El tratamiento con colocación de prótesis endoscópica es seguro y eficaz para el manejo de la fístula biliar postraumática.

Abstract Background: Post traumatic biliary fistula is the abnormal passage of liquid from the biliary tract to another organ, cavity or when an artificial drainage to the external surface of the abdomen exists. It is a relatively rare post traumatic sequel, that occurs between 0.5 and 2.6% of the hepatic traumatic cases. Previously, the treatment required a long hospital stay, nowadays the endoscopic management decreased considerably the hospital stay, as well as the morbidity and mortality in these patients. The objective is to describe a case with postraumatic biliary fistula managed with a Cotton 10 FR prosthesis placed endoscopically. Clinical case: 28-year-old male, suffering from abdominal contusion against the steering wheel causing liver lacerations and biliary fistula, which was treated conservatively for a week. . He underwent an exploratory laparotomy for acute abdomen with 3000 mL of bile fluid, afterwars a drain was placed. A biliary leak continued through the drain (greater than 500mL/24 h), an endoscopic retrograde cholangiopancreatography was performed and a biliary type II fistula was found. A Cotton 10 FR prosthesis was placed and 24 hours later the spending decreased to less than 50mL in 24 h. The drainage was removed on the eighth day and three months later the prosthesis was also removed, no mediate or late complications were presented. Conclusion: The conservative treatment does not offer good results; therefore the endoscopic stent placement is a safe and effective therapeutic alternative.

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Introducción:El síndrome de apnea/hipopnea obstructiva del sueño, es una entidad que ha cobrado importancia en los últimos años, con una prevalencia estimada en adultos de edad media cercana al 4 y al 2% en hombres y mujeres, respectivamente, y que por su frecuencia constituye un problema de salud pública. Objetivo:Exponer, tras un análisis exhaustivo de la literatura disponible, la asociación entre el síndrome de apnea/hipopnea obstructiva del sueño y las enfermedades cardiovasculares. Método: Se hizo una revisión narrativa a partir de la literatura encontrada en las bases de datos más reconocidas. Se incluyeron 59 estudios publicados en los últimos treinta años y se excluyeron reportes y series de casos. Conclusiones: El síndrome de apnea/hipopnea obstructiva del sueño se reconoce hoy en día como un problema de salud pública mundial. En Latinoamérica, más específicamente en Colombia, se requieren estudios prospectivos de cohorte que sirvan de pauta para la población del continente e indiquen posibles diferencias respecto a la comunidad internacional en cuanto a su tratamiento y diagnóstico oportunos, así como acerca del impacto de estos en lo concerniente a los desenlaces cardiovasculares de los pacientes.

Introduction: The Obstructive Sleep Apnea Hypopnea Syndrome has gained importance has gained importance in recent years, with an estimated prevalence in population of middle-aged adults around 4 and 2% in men and women respectively, and that given its frequency constitutes a public health problem. Objective: To show, after a thorough analysis of the available literature, the association between the Obstructive Sleep Apnea Hypopnea Syndrome and cardiovascular diseases. Method: A narrative review was made from the literature found at the most recognized databases. Fifty nine studies published in the last thirty years were included and reports and case series were excluded. Conclusions: The Obstructive Sleep Apnea Hypopnea Syndrome is recognized today as a global public health problem. Latin America, specifically Colombia, requires prospective cohort studies that serve as a guideline for the continent's population and that could indicate possible differences compared to the international community regarding early diagnosis and treatment, and its impact in cardiovascular outcomes of these patients.

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La producción experimental de enzimas coagulante de leche se llevó a cabo en un medio de cultivo de laboratorio durante 190 h de incubación, utilizando tres cepas certificadas de Rhizomucor pusillus, R.miehei y dos especies nativas de Rhizomucor spp. BIOMI-12 y 13. La evaluación se realizó midiendo la concentración de glucosa y proteína durante la incubación, estimación de la productividad, actividad específica, índice fuerza de cuajo/actividad proteolítica en los extractos enzimáticos crudos, determinación de los pesos moleculares y actividad proteolítica en los extractos enzimáticos parcialmente purificado. Todas las cepas mostraron un consumo de glucosa similar, el mismo comportamiento se observó en el contenido de proteína, excepto la cepa BIOMI-13. Los incrementos en el contenido de proteínas después del descenso, coincidieron con la máxima actividad coagulante registrada por cada cepa, siendo el extracto crudo de la cepa BIOMI-13 la de mayor actividad coagulante (148,15 FC), productividad (3,09 FC/h), índice fuerza de cuajo/actividad proteolítica (142,60 FC/U) y actividad específica (1.062,00 FC/mg). Los extractos enzimáticos parcialmente purificados de las cepas R miehei 37, Rhizomucor spp BIOMI-12 y 13, presentaron proteínas con pesos moleculares en aproximadamente 22,6 y 46,52 KDa, mientras el extracto R pusillus 39 presentó una banda adicional de 39,6 KDa. En el zimograma se observó para todas las cepas actividad proteolítica en las bandas comprendidas entre 40-50 KDa y 20-22 KDa, no así para el R pusillus 36, donde fue escasa. Finalmente se determinó que la cepa BIOMI-13, tiene la mayor capacidad para producir enzimas coagulantes de la leche.

Experimental production of milk clotting enzymes was conducted on a laboratory culture medium for 190 h incubation, using three certified strains of Rhizomucor pusillus, miehei and two native Rhizomucor spp. BIOMI-12 and 13. The evaluation was performed by measuring the concentration of glucose and protein during incubation, estimate productivity, specific activity, rennet strength/proteolytic activity index in the crude enzyme extracts, determining the molecular weights and proteolytic activity in the partially purified enzyme extracts. All strains showed consumption rates of glucose, the same behavior observed protein content, except strain BIOMI-13. The increase in protein content after descent coincided with the recorded maximum coagulant activity each strains, being the crude extract of strain BIOMI-13 higher coagulant activity (148,15 FC), productivity (3.09 HR / h), rennet strength/proteolytic activity index (142,60 FC/U) and specific activity (1,062 FC/mg). The partially purified enzyme extracts from strains R miehei 37, Rhizomucor spp BIOMI-12 and 13, presented proteins with molecular weights in approximately 22,6 kDa and 46.52, while the extract R pusillus 39 present an additional band of 39,6 KDa. In the zymogram was observed for all strains, proteolytic activity in the bands between 40-50 KDa and 20-22 KDa, but not for the R pusillus 36, where activity was very dim. Finally it was determined that the strain BIOMI-13, has the greatest capacity to produce milk clotting enzymes.

RESUMO

Hepatic encephalopathy is a frequent complication of cirrhosis, when this event becomes persistent, treatment compliance should be verified and any precipitating factor need to be identified. Also the presence of portosystemic shunts, which are a rare cause of decompensation or persistence hepatic encephalopathy need to be ruled out. In this paper we report the case of a 57 year old man with persistent hepatic encephalopathy secondary to the presence of a porto-onfalo-femoral shunt successfully closed with the placement of an Amplatzer device.

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RESUMO

Partindo de uma experiência de leitura e reflexão do drama de Shakespeare, Macbeth, no Laboratório de Humanidades do Centro de História e Filosofia das Ciências da Saúde da Escola Paulista de Medicina da Universidade Federal de São Paulo, este artigo procura problematizar a questão do poder das palavras. Dialogando com filósofos antigos, modernos e contemporâneos, procuramos, no itinerário delineado por Shakespeare em sua peça, analisar as qualidades, força e efeitos da palavra no âmbito das paixões, dos atos e da ética humana.(AU)

Starting from an experience of reading and reflection of the drama of Shakespeare, Macbeth, in the Laboratory of Humanities of the Center of History and Philosophy of Paulista Medical School of Federal University of São Paulo, this article aims at problematizing the question of the power of words. Dialoguing with ancient, modern and contemporary philosophers, this article seeks, by the itinerary outlined in Shakespeare's play, to analyse the qualities, power and effects of the word in the scope of human passions, acts, and Ethics.(AU)

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During a study of the microfungi on decaying leaves collected in México we encountered a fungus sharing features of the anamorph genera Heliocephala and Holubovaniella. This hyphomycete resembled Hol. elegans in possessing obclavate to fusiform, three-septate, rostrate phragmoconidia, but it can be distinguished by its much shorter, branched, determinate conidiophores. Unlike members of genus Heliocephala, which also possess determinant conidiophores, the phragmoconidia of this taxon are short-rostrate and have not been observed to germinate iteratively. Prompted by the discovery of this hyphomycete, we investigated the phylogenetic relationships among species of Heliocephala and Holubovaniella. Analysis of large subunit rDNA gene sequences positioned species of Heliocephala and Holubovaniella in the Dothideomycetes and identified Stomiopeltis betulae (Micropeltididaceae) as their closest relative. These results also indicated that Heliocephala and Holubovaniella are closely related taxa. Based on these findings and the similarity of the developmental and morphological characters of species of Heliocephala and Holubovaniella, we recognize these genera as synonymous and describe a new species, Heliocephala triseptata. A dichotomous key to the species of Heliocephala is provided.

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Se efectuó una intervención comunitaria durante un trienio (2000-2002) para modificar algunos factores de riesgo de la hipertensión arterial en 135 pacientes mayores de 15 años, dispensarizados en el Consultorio Médico No. 28 del Policlínico Dr Carlos J Finlay de Santiago de Cuba, de los cuales 100 accedieron a participar en el estudio. En la casuística predominaron el sexo femenino, las edades de 60 años y más, así como los antecedentes patológicos familiares de hipertensión arterial. Tanto el exceso de sal en las comidas como la cocción con manteca de cerdo, el estrés por las situaciones de la vida cotidiana y la no realización de ejercicios físicos se modificaron favorablemente, pero no así el hábito de fumar y la ingestión de alcohol. Al inicio, la tercera parte de los pacientes no estaban controlados, pero esa situación había variado significativamente al final de la intervención, cuando la mayoría de los factores de riesgo habían sido erradicados.

A community intervention was conducted during a triennium (2000-2002) to modify some risk factors for hypertension in 135 patients over the age of 15, attended in the No 28 doctor’s office of Dr Carlos J Finlay Polyclinic in Santiago de Cuba. From them 100 gave their consent to participate in the study. Female sex, age of 60 years and over, as well as medical family histories of hypertension prevailed in the case material. Excessive salt in foods, cooking with lard, stress for daily living situations and no taking physical exercises were modified favorably, except smoking habit and alcohol consumption. At first, the third of the patients were not controlled, but that situation varied significantly at the end of the intervention, when most of the risk factors had been eliminated.

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