Proyecto de salud communitaria en un barrio marginal de Quito : evaluación de las necesidades y planteamiento de una red de prevención y attención primaria : documento para la acción local

Résumé du document de thèse Quito, capitale andine de près de deux millions d'habitants, a vu se développer des quartiers ghettos réunissant une population en constante évolution. Mouvements migratoires mal connus, hétérogénéité ethnique et socioculturelle, accès limité aux services publics et conditions de vie difficiles jouent un rôle essentiel mais complexe dans la planification des services de santé. L'étude ciblée de cette problématique est un sérieux défi à relever car les mégalopoles latino-américaines connaissent une importante urbanisation avec pour corollaire une augmentation de la pauvreté urbaine. Les indicateurs de santé tels que mortalité infantile, espérance de vie ou incidence des maladies infectieuses montrent une amélioration globale qui ne reflète toutefois pas les importantes disparités caractéristiques du continent. La démarche exposée dans ce document est une réponse à la demande d'un appui médical par une communauté urbaine défavorisée, pour laquelle peu de données étaient disponibles. Une évaluation des conditions de vie et des besoins en soins a donc été effectuée par trois étudiants en médecine de Lausanne au moyen d'une enquête et d'ateliers qui ont permis de réunir les opinions des différents acteurs sociaux et sanitaires. Cette étude a pu identifier et mesurer les déterminants de santé, comprendre certaines dynamiques locales pour enfin cibler les principales lignes d'actions d'un centre de santé communautaire. Ce document décrit l'ensemble du processus conduit durant cinq ans et expose les données brutes ainsi que leur analyse ; il propose des recommandations concrètes pour une promotion de la santé adaptée aux besoins d'une communauté urbaine défavorisée d'Amérique du Sud. Son objectif est de fournir des données utilisables par les acteurs de santé locaux et de participer ainsi à la réflexion en cours sur la réforme du système de santé équatorien. Il comporte également une bibliographie, point de départ pour d'autres études sur le sujet. Le dossier, construit de manière chronologique, présente l'information de façon accessible et cohérente. Il se veut un témoignage utile, avec ses forces et ses faiblesses, à l'action locale sous forme d'une publication en espagnol qui sera distribuée aux différents acteurs sociaux et sanitaires concernés.

New species of Proteocephalus (Cestoda - Proteocephalidae) parasitic in fishes from the Paraná River, Paraná, Brazil

Two species of the genus Proteocephalus (Cestoda: Proteocephalidae) were collected in fishes from the Paraná River. Proteocephalus vazzolerae n. sp. from Piaractus mesopotamicus and Proteocephalus chubbi, n. sp. from Gymnotus carapo are new species, and are described and illustrated. Proteocephalus vazzolerae n. sp. is characterized mainly by the number of testes and the development of vitellaria. Proteocephalus chubbi n. sp. can be differentiated from its congeners by a combination of characters which include, number of testes, number of proglottids, strobila length, scolex shape and disposition of vitellaria. This is the first record of proteocephalidean in P. mesopotamicus and G. carapo.

Modelo de red de interconexión basado en enlace

La computación de altas prestaciones es una área de la informática que evoluciona rápidamente, en la que actualmente aparecen nuevos computadores que llegan a los petaflops. Al principio del trabajo, se estudian los distintos tipos de redes de interconexión y los modelos de red que se utilizan para medir su latencia. El objetivo de este trabajo, es el diseño, implementación y simulación de un modelo de red de interconexión basado en enlace, que tiene en cuenta la información de topología y enrutamiento de la red de interconexión. Teniendo en cuenta que los modelos son una abstracción del sistema, en éste trabajo se hace la verificación y validación del modelo, para asegurar que éste se aproxima a lo planteado en el diseño y también que se parece al sistema que se quiere modelar.

Voces del pasado, ecos del presente. la Red de Trabajo Contra la Violencia Sobre las Mujeres en Tiempos de Guerra y su labor en la sociedad japonesa

Gracias al trabajo de las redes transnacionales de defensa los marcos legales internacionales se han adaptado a las nuevas dimensiones que han alcanzado los conflictos armados en los últimos veinte años. Esta investigación estudia el papel de la Violence Against Women in War Network, Japan y del Women's Active Museum on War and Peace, como ejemplos de cómo los actores no gubernamentales pueden sensibilizar y transformar las normas nacionales e internacionales, el comportamiento de los Estados, los organismos supraestatales y a la sociedad en la que desarrollan su labor

La red literaria de París no se acaba nunca de Enrique Vila-Matas: un acto de lectura e interpretación

Este trabajo pretende realizar un acto de lectura e interpretación del texto de Enrique Vila-Matas París no se acaba nunca (2003). La lectura se sitúa desde la perspectiva concreta y delimitada de la red literaria que se teje en el novela. La metáfora de la red, atendiendo a sus tres acepciones: red como tejido, red como ardid y red como conexión, da las directrices del trabajo que intenta responder a estas cuestiones: a) qué hilos forman su tejido narrativo, b) cómo se configura la red, c) qué posibles mecanismos establecen la red como conexión. La lectura se inscribe en el doble marco de la intertextualidad y de la ironía. A través de las citas, alusiones y referencias literarias se destacan algunos procedimientos e intencionalidades en la configuración de la novelística de Enrique Vila-Matas, en su Manifiesto estético

Sandfly Lutzomyia longipalpis in a cutaneous leishmaniasis focus in central Colombia

Lutzomyia longipalpis, 15 other species of the genus Lutzomyia, and one species of Brumptomyia were collected in an endemic focus of cutaneous leishmaniasis in a river canyon 450 m above sea-level, in Rio Claro, Antioquia, Colombia. The presence of Lu. longipalpis is associated with the destruction of the primary forest and the development of new farmland and rural settlement in this region. The composition of species identified a different habitat for Lu. longipalpis in Colombia. Lu. yuilli and Lu. longipalpis were predominant (68.26%) followed by Lu. trapidoi, Lu. hartmani, Lu. triramula, Lu. panamensis, Lu. gomezi.

Structure and diversity of endoparasitic infracommunities and the trophic level of Pseudoplatystoma corruscans and Schizodon borelli (Osteichthyes) of the high Paraná river

One hundred and ten specimens of Pseudoplatystoma corruscans (Pimelodidae) and 582 specimens of Schizodon borelli (Anostomidae) collected in the high Paraná River were analyzed. On necropsy 74% of P. corruscans were found to be parasitized; proteocephalidean cestodes presented the greatest number. With regard to S. borelli, the percentage of parasitism reached 19.42% and the nematode Cucullanus pinnai was the most abundant. The absence of correlation between the endoparasitic diversity and the standard length of the two host species indicates that each one presents homogeneity in alimentary behaviour during all its life time, permiting the uniform recruitment of the same species of endoparasites during all its ontogenetic development. Independence of diversity values in relation to sex of P. corruscans and S. borelli evidences that the ecological relationships are similar between males and females in these species. Both host's infrapopulations presented a typical overdispersed pattern of distribution with isolationist characteristics.

Spasskyellina mandi n. sp. (Proteocephalidea: Monticelliidae), parasite of Pimelodus ornatus Kner, 1857 (Pisces: Pimelodidae) of the Paraná River, Paraná, Brazil

Spasskyellina mandi n. sp. (Proteocephalidea: Monticelliidae) is described from the Siluriform fish Pimelodus ornatus Kner, 1857, caught in the Paraná River, Paraná, Brazil. The new species differs from other species of the same genus mainly by a fewer number of testes and by a larger osmoregulatory canal. This is the second species of proteocephalidean cestode collected in P. ornatus.

Time and temperature dependant changes in red blood cell analytes used for testing recombinant erythropoietin abuse in sports.

There has been a long debate since the introduction of blood analysis prior to major sports events, to find out whether blood samples should be analysed right away on the site of competition or whether they should be transported and analysed in an anti-doping laboratory. Therefore, it was necessary to measure blood samples and compare the results obtained right after the blood withdrawal with those obtained after a few hours delay. Furthermore, it was interesting to determine the effect of temperature on the possible deterioration of red blood cell analytes used for testing recombinant erythropoietin abuse. Healthy volunteers were asked to give two blood samples and one of these was kept at room temperature whereas the second one was put into a refrigerator. On a regular basis, the samples were rolled for homogenisation and temperature stabilisation and were analysed with the same haematological apparatus. The results confirmed that blood controls prior to competition should be performed as soon as possible with standardised pre-analytical conditions to avoid too many variations notably on the haematocrit and the reticulocyte count. These recommendations should ideally also be applied to the all the blood controls compulsory for the medical follow up, otherwise unexplainable values could be misinterpreted and could for instance lead to a period of incapacity.

Humoral Immune Response to the Anti-malaria Vaccine SPf66 in the Colombian Atrato River Region

The immunogenicity of anti-malaria synthetic vaccine SPf66 was tested in a region of the Colombian middle Atrato river. The specific serum antibodies against SPf66 were quantified in vaccinees and placebo injected controls for a two-years period post-immunization. The frequency of individuals showing seroconversion of anti-SPf66 antibodies three months after completion of the immunization schedule was higher in vaccinees than in controls (52.7% and 25.5%, respectively, p<0.01). However, an over than four-fold increase of the specific anti-SPf66 antibody titers was observed only in 1.4% of vaccinees and 0.2% of the controls (p<0.01). The anti-SPf66 antibody titers augmented in vaccinees from first dose application to three months after the third dose, continuously decreasing thereafter to reach below baseline values two years after completion of the immunization schedule. The results show that SPf66 has very low immunogenicity and induces a short term humoral immune response (six months).

Analysis and clinical relevance of microparticles from red blood cells.

PURPOSE OF REVIEW: The mechanisms involved in the formation of red blood cell (RBC) microparticles in vivo as well as during erythrocyte storage are reviewed, and the potential role of microparticles in transfusion medicine is described. RECENT FINDINGS: Microparticles release is an integral part of the erythrocyte ageing process, preventing early removal of RBCs. Proteomics analyses have outlined the key role of band 3-ankyrin anchoring complex and the occurrence of selective RBC membrane remodelling mechanisms in microparticles formation. The presence of several RBC antigens, expressed on microparticles, has been demonstrated. The potential deleterious effects of RBC microparticles in transfused recipients, including hypercoagulability, microcirculation impairment and immunosuppression, are discussed. SUMMARY: Formation and role of RBC microparticles are far from being completely understood. Combining various approaches to elucidate these mechanisms could improve blood product quality and transfusion safety. Implementation of RBC microparticles as biomarkers in the laboratory routine needs to overcome technical barriers involved in their analysis.

Characterization of pupil responses to blue and red light stimuli in autosomal dominant retinitis pigmentosa due to NR2E3 mutation.

PURPOSE: We characterized the pupil responses that reflect rod, cone, and melanopsin function in a genetically homogeneous cohort of patients with autosomal dominant retinitis pigmentosa (adRP). METHODS: Nine patients with Gly56Arg mutation of the NR2E3 gene and 12 control subjects were studied. Pupil and subjective visual responses to red and blue light flashes over a 7 log-unit range of intensities were recorded under dark and light adaptation. The pupil responses were plotted against stimulus intensity to obtain red-light and blue-light response curves. RESULTS: In the dark-adapted blue-light stimulus condition, patients showed significantly higher threshold intensities for visual perception and for a pupil response compared to controls (P = 0.02 and P = 0.006, respectively). The rod-dependent, blue-light pupil responses decreased with disease progression. In contrast, the cone-dependent pupil responses (light-adapted red-light stimulus condition) did not differ between patients and controls. The difference in the retinal sensitivity to blue and red stimuli was the most sensitive parameter to detect photoreceptor dysfunction. Unexpectedly, the melanopsin-mediated pupil response was decreased in patients (P = 0.02). CONCLUSIONS: Pupil responses of patients with NR2E3-associated adRP demonstrated reduced retinal sensitivity to dim blue light under dark adaptation, presumably reflecting decreased rod function. Rod-dependent pupil responses were quantifiable in all patients, including those with non-recordable scotopic electroretinogram, and correlated with the extent of clinical disease. Thus, the chromatic pupil light reflex can be used to monitor photoreceptor degeneration over a larger range of disease progression compared to standard electrophysiology.