Administración pública local y construcción de la central hidroeléctrica en la Amazonia

Exponemos los resultados de una observación exploratoria en la que se analizan los impactos funcionales en el sistema administrativo como consecuencia de la construcción de la Central Hidroeléctrica de Belo Monte (CHB) en el municipio de Altamira (Amazonia oriental brasileña). En la perspectiva teórico-conceptual de la teoría de sistemas sociales de Niklas Luhmann, realizamos una observación del sistema administrativo local sobre sus operaciones y funciones, en base a cuatro códigos preestablecidos: toma de decisiones, contingencia, significación simbólica del proyecto y planificación. Las conclusiones permiten entrever en un aplano conceptual la utilidad de los conceptos sistémicos de Luhmann, y en el empírico, una planificación y administración pública municipal reactivas.

Importance of risk factor management in diabetic patients and reduction in Stage B heart failure

BACKGROUND: A number of studies have demonstrated the presence of a diabetic cardiomyopathy, increasing the risk of heart failure development in this population. Improvements in present-day risk factor control may have modified the risk of diabetes-associated cardiomyopathy.

AIM: We sought to determine the contemporary impact of diabetes mellitus (DM) on the prevalence of cardiomyopathy in at-risk patients with and without adjustment for risk factor control.

DESIGN: A cross-sectional study in a population at risk for heart failure.

METHODS: Those with diabetes were compared to those with other cardiovascular risk factors, unmatched, matched for age and gender and then matched for age, gender, body mass index, systolic blood pressure and low density lipoprotein cholesterol.

RESULTS: In total, 1399 patients enrolled in the St Vincent's Screening to Prevent Heart Failure (STOP-HF) cohort were included. About 543 participants had an established history of DM. In the whole sample, Stage B heart failure (asymptomatic cardiomyopathy) was not found more frequently among the diabetic cohort compared to those without diabetes [113 (20.8%) vs. 154 (18.0%), P = 0.22], even when matched for age and gender. When controlling for these risk factors and risk factor control Stage B was found to be more prevalent in those with diabetes [88 (22.2%)] compared to those without diabetes [65 (16.4%), P = 0.048].

CONCLUSION: In this cohort of patients with established risk factors for Stage B heart failure superior risk factor management among the diabetic population appears to dilute the independent diabetic insult to left ventricular structure and function, underlining the importance and benefit of effective risk factor control in this population on cardiovascular outcomes.

Long-term statin therapy in patients with systolic heart failure and normal cholesterol:effects on elevated serum markers of collagen turnover, inflammation, and B-type natriuretic peptide

BACKGROUND: The role of statin therapy in heart failure (HF) is unclear. The amino-terminal propeptide of procollagen type III (PIIINP) predicts outcome in HF, and yet there are conflicting reports of statin therapy effects on PIIINP.

OBJECTIVES: This study determined whether there was an increase in serum markers of inflammation, fibrosis (including PIIINP), and B-type natriuretic peptide (BNP) in patients with systolic HF and normal total cholesterol and determined the effects of long-term treatment with atorvastatin on these markers.

METHODS: Fifty-six white patients with systolic HF and normal cholesterol levels (age 72 [13] years; 68% male; body mass index 27.0 [7.3] kg/m(2); ejection fraction 35 [13]%; 46% with history of smoking) were randomly allocated to atorvastatin treatment for 6 months, titrated to 40 mg/d (A group) or not (C group). Age- and/or sex-matched subjects without HF (N group) were also recruited. Biomarkers were measured at baseline (all groups) and 6 months (A and C groups).

RESULTS: Serum markers of collagen turnover, inflammation, and BNP were significantly elevated in HF patients compared with normal participants (all P < 0.05). There were correlations between these markers in HF patients but not in normal subjects. Atorvastatin treatment for 6 months caused a significant reduction in the following biomarkers compared with baseline: BNP, from median (interquartile range) 268 (190-441) pg/mL to 185 (144-344) pg/mL; high-sensitivity C-reactive protein (hs-CRP), from 5.26 (1.95 -9.29) mg/L to 3.70 (2.34-6.81) mg/L; and PIIINP, from 4.65 (1.86) to 4.09 (1.25) pg/mL (all P < 0.05 baseline vs 6 months). Between-group differences were significant for PIIINP only (P = 0.027). There was a positive interaction between atorvastatin effects and baseline hs-CRP and PIIINP (P < 0.01).

CONCLUSIONS: Long-term statin therapy reduced PIIINP in this small, selected HF population with elevated baseline levels. Further evaluation of statin therapy in the management of HF patients with elevated PIIINP is warranted.

A comparison of different pre-lysis methods and extraction kits for recovery of Stretococcus agalacticae (Lancefield group B Streptococcus) DNA from whole blood

Sub-optimal recovery of bacterial DNA from whole blood samples can limit the sensitivity of molecular assays to detect pathogenic bacteria. We compared 3 different pre-lysis protocols (none, mechanical pre-lysis and achromopeptidasepre-lysis) and 5 commercially available DNA extraction platforms for direct detection of Group B Streptococcus (GBS) in spiked whole blood samples, without enrichment culture. DNA was extracted using the QIAamp Blood Mini kit (Qiagen), UCP Pathogen Mini kit (Qiagen), QuickGene DNA Whole Blood kit S (Fuji), Speed Xtract Nucleic Acid Kit 200 (Qiagen) and MagNA Pure Compact Nucleic Acid Isolation Kit I (Roche Diagnostics Corp). Mechanical pre-lysis increased yields of bacterial genomic DNA by 51.3 fold (95% confidence interval; 31.6–85.1, p < 0.001) and pre-lysis with achromopeptidase by 6.1 fold (95% CI; 4.2–8.9, p < 0.001), compared with no pre-lysis. Differences in yield dueto pre-lysis were 2–3 fold larger than differences in yield between extraction methods. Including a pre-lysis step can improve the limits of detection of GBS using PCR or other molecular methods without need for culture.

The Burkholderia Cenocepacia OmpA-Like Protein BCAL2958: Identification, Characterization, and Detection of Anti-BCAL2958 Antibodies in Serum from B. Cepacia Complex-Infected Cystic Fibrosis Patients

Respiratory infections by bacteria of the Burkholderia cepacia complex (Bcc) remain an important cause of morbidity and mortality among cystic fibrosis patients, highlighting the need for novel therapeutic strategies. In the present work we have studied the B. cenocepacia protein BCAL2958, a member of the OmpA-like family of proteins, demonstrated as highly immunogenic in other pathogens and capable of eliciting strong host immune responses. The encoding gene was cloned and the protein, produced as a 6× His-tagged derivative, was used to produce polyclonal antibodies. Bioinformatics analyses led to the identification of sequences encoding proteins with a similarity higher than 96 % to BCAL2958 in all the publicly available Bcc genomes. Furthermore, using the antibody it was experimentally demonstrated that this protein is produced by all the 12 analyzed strains from 7 Bcc species. In addition, results are also presented showing the presence of anti-BCAL2958 antibodies in sera from cystic fibrosis patients with a clinical record of respiratory infection by Bcc, and the ability of the purified protein to in vitro stimulate neutrophils. The widespread production of the protein by Bcc members, together with its ability to stimulate the immune system and the detection of circulating antibodies in patients with a documented record of Bcc infection strongly suggest that the protein is a potential candidate for usage in preventive therapies of infections by Bcc.

El carácter compilatorio del ms. 126 del Archivo Capitular de El Burgo de Osma

En este trabajo se aborda el estudio de aquellos aspectos que nos llevan a considerar al ms. 126 del Archivo Capitular de El Burgo de Osma un códice compilatorio: por una parte, la identificación de las fuentes de las que beben dos de sus glosas de contenido mitológico y, por otra, el análisis de la estructura del códice en su conjunto y de la relación entre las obras que lo componen.

Una planta sin clásicos. La berenjena en la farmacología medieval y renacentista

La berenjena (Solanum melongena L.) es una planta solanácea de múltiples variedades, cuyos ancestros salvajes se sitúan en Indochina y el este de África. Su cultivo fue muy temprano en zonas de China e India. Aun así, no se extendió al Occidente antiguo ni apenas se conoció, de ahí su ausencia en los textos clásicos de botánica y farmacología. Fueron los árabes quienes llevaron el cultivo de la planta por el Norte de África y Al-Andalus, de donde pasó ya a Europa. Los primeros testimonios occidentales de la berenjena aparecen en traducciones latinas de textos árabes, para incorporarse luego a la literatura farmacológica medieval y, más tarde ya, a la del Renacimiento, que empezó a tratar de ella por su posible parecido con una especie de mandrágora. Pese a que se le reconocían algunas virtudes medicinales, siempre se la tuvo bajo sospecha por ser de sabor poco agradable, indigesta y causante de algunas afecciones. Solo los botánicos de finales del Renacimiento describirían la planta y sus variedades con criterios más «científicos» y botánicos, ya sin apenas intereses farmacológicos.

Impact of weight reduction program on serum alanine aminotransferase activity and immunologic response in obese hepatitis B patients.

Background: Globally, chronic B viral hepatitis (HBV) is a major health problem. Obesity is a common problem among patients with HBV. Several studies have reported that obesity is an important risk factor that alters immune system response in individuals with no underlying cause of liver disease. However, there is a strong association between BMI and the human immune system among HBV patients. Objective: This study was to examine the correlation between body mass index, serum alanine aminotransferase activity (ALT) and immunologic response in obese hepatitis B patients. Material and methods: One hundred fifty male patients with chronic hepatitis B virus, their age ranged from 30 to 45 (38.64 ± 7.12) years and their BMI ranged from 30-35 kg/m2. All Subjects were included in two groups: The first group received weight reduction program in the form of treadmill aerobic exercises in addition to diet control whereas the second group received no therapeutic intervention. Parameters of serum alanine aminotransferase (ALT), CD3, CD4 and CD8 were quantified; Leukocyte, differential counts and body mass index (BMI) were measured before and after 3 months at the end of the study. Results: There was a 24.7%, 36.8%, 30.8%, 40.7%, 28.6%, 25.9%, 33.3% and 14.3 % reduction in mean values of alanine aminotransferase (ALT), white blood cells, total neutrophil count, monocytes, CD3, CD4 ,CD8 and BMI respectively in group (A) at the end of the study. In addition, there were significant differences between mean levels of the investigated parameters in groups. Conclusion: Based on our findings, weight loss modulates serum alanine aminotransferase and immune system parameters of patients with hepatitis B virus infection.

Regulatory T and B cells in asthmatic women: variations from pregnancy to postpartum Treg and Breg: pregnancy to postpartum

BACKGROUND: Allergic asthma and rhinitis are common in pregnancy. The immune mechanisms underlying the effects of pregnancy in asthma and vice-versa are not completely understood. OBJECTIVES: This work aimed to study the evolution of regulatory T and B cells in asthmatic pregnant women, from late pregnancy till postpartum. METHODS: Four groups of women were enrolled for this study: third trimester pregnant women, asthmatic (n=24) and healthy (n=43), and non-pregnant women, asthmatic (n=33) and healthy (n=35). Pregnant women were also evaluated postpartum (>6 weeks after delivery). Blood samples were taken from each woman and flow cytometry was used to characterize circulating regulatory T and B cells. Foxp3 expression was assessed within CD4DimCD25Hi regulatory T cells. RESULTS: In asthmatic and healthy pregnant women, regulatory T cells did not oscillate significantly from pregnancy to postpartum, but CD24HiCD38Hi regulatory B cells, decreased in pregnancy, rose significantly postpartum. Foxp3 expression in regulatory T cells was also impaired during pregnancy in asthmatic and healthy pregnant women, recovering postpartum. Nevertheless, asthmatic pregnant women presented higher Foxp3 expression than healthy pregnant women (p=0.007), probably due to the use of control medication. CONCLUSIONS: Women with controlled asthma present variations in regulatory cell subsets during pregnancy and postpartum. The similar pattern observed for Foxp3 expression and CD24HiCD38Hi regulatory B cells during this period corroborates the interaction established between regulatory T and B cells in immune responses. Considering the immunomodulatory potential of these immune mediators, more studies are needed to evaluate their relation with asthma and rhinitis complications in pregnancy.

HBsAg seroclearance or seroconversion induced by peg-interferon alpha and lamivudine or adefovir combination therapy in chronic hepatitis B treatment: a meta-analysis and systematic review

Background and aims: Seroclearance or seroconversion of hepatitis B surface antigen (HBsAg) is generally considered as a clinical endpoint. The purpose of the present meta-analysis was to evaluate the effect of combined therapy with pegylated interferon alpha (PEG-IFNα) with or without lamivudine (LAM) or adefovir (ADV) on HBsAg seroclearance or seroconversion in subjects with chronic hepatitis B (CHB). Methods: Randomized controlled trials performed through May 30th 2015 in adults with CHB receiving PEG-IFNα and LAM or ADV combination therapy or monotherapy for 48-52 weeks were included. The Review Manager Software 5.2.0 was used for the meta-analysis. Results: No statistical differences in HBsAg seroclearance (9.9% vs. 7.1%, OR = 1.47, 95% CI: 0.75, 2.90; p = 0.26) or HBsAg seroconversion (4.2% vs. 3.7%, OR = 1.17, 95% CI: 0.57, 2.37; p = 0.67) rates were noticed between PEG-IFNα + LAM and PEG-IFN α + placebo during post-treatment follow-up for 24-26-weeks in subjects with hepatitis Be antigen (HBeAg)-positive CHB. No statistical differences in HBsAg clearance (10.5% vs. 6.4%, OR = 1.68, 95% CI: 0.75, 3.76; p = 0.21) were seen, but statistical differences in HBsAg seroconversion (6.3% vs. 0%, OR = 7.22, 95% CI: 1.23, 42.40; p = 0.03) were observed, between PEG-IFNα + ADV and PEG-IFNα for 48-52 weeks of treatment in subjects with HBeAg-positive CHB. A systematic evaluation showed no differences in HBsAg disappearance and seroconversion rates between PEG-IFNα + placebo and PEG-IFNα + LAM for 48-52 weeks in subjects with HBeAg-positive CHB. A systematic assessment found no differences in HBsAg disappearance and seroconversion rates between PEG-IFNα + placebo and PEG-IFNα + LAM during 24 weeks' to 3 years' follow-up after treatment in subjects with HBeAg-negative CHB. Conclusion: Combined therapy with PEG-IFNα and LAM or ADV was not superior to monotherapy with PEG-IFNα in terms of HBsAg seroclearance or seroconversion.

Ingesta dietética de referencia de las vitaminas A, B y D en niños de 1 a 5 años del Ministerio de Salud Pública en el año 2015

ANTECEDENTES: Las Ingestas Dietéticas de Referencia (IDR) son 4 valores que sirven de guía para la ingesta adecuada de un nutriente específico, de acuerdo con la edad, género y condición fisiológica concreta, con el fin de mantener un buen estado de salud. OBJETIVO: Determinar los valores de IDR para las vitaminas A, B y D en niños de 1 a 5 años de edad los subcentros del Ministerio de Salud Pública, del área urbana, de la ciudad de Cuenca, en el año 2015. MATERIALES Y MÉTODO: Es un estudio descriptivo transversal realizado en todos los niños que acudieron a los subcentros de salud urbanos del Ministerio de Salud Pública de Cuenca, durante el período de 6 meses. Mediante el software en línea de nutrición “Nutrimind” 2012, se aplicó el Recordatorio de 24 horas. En el programa estadístico SPSS 19, se tabularon los datos, se calculó el promedio de la ingesta de las vitaminas A, B y D por grupo etario y por sexo. Se compararon estos resultados con las IDR internacionales. RESULTADOS: De los 580 niños estudiados el 64.7% fueron lactantes y el 35.3% escolares, el 49.8% fueron de sexo masculino y el 50.2% femenino. El promedio de ingesta de las vitaminas A, B1, B2 y B3 sobrepasa las ingestas recomendadas. Para las vitaminas B6, B9 y D está por debajo de las recomendaciones. El promedio de ingesta para la vitamina B12 cubre las necesidades diarias recomendadas

Prevalencia y factores de riesgo de infección por estreptococo grupo b en mujeres embarazadas de 34 a 41 semanas del servicio de obstetricia Hospital Vicente Corral Moscoso 2006

La infección por estreptococo del grupo B (GBS) es la principal causa de infección bacteriana y mortalidad por sepsis en los recién nacidos. La transmisión hacia el producto se da durante el trabajo de parto, a más de la mortalidad neonatal las secuelas neurológicas son importantes consecuencias de la infección por GBS, por lo tanto la detección y tratamiento oportuno debe realizarse en forma rutinaria. El objetivo de la presente investigación, es detectar la prevalencia de infección por GBS en embarazadas entre 34 a 41 semanas, y los factores que podrían estar asociados a la infección. En el presente estudio la prevalencia encontrada de EGB fue del 15,9. Los factores de riesgo mas importantes encontrados fueron: la edad de 19 a 35 años, el estado civil casada, vivir en medio urbano, la ocupación quehaceres domésticos, el inicio de vida sexual temprana, tener mas de 1 compañero sexual, la multiparidad antecedente de infección urinaria en el embarazo. El hecho de mantener relaciones anales u orales no fue causa significativa de infección de EGB

Entrepreneurship: a long way to go

Entrepreneurship education has emerged as one popular research domain in academic fields given its aim at enhancing and developing certain entrepreneurial qualities of undergraduates that change their state of behavior, even their entrepreneurial inclination and finally may result in the formation of new businesses as well as new job opportunities. This study attempts to investigate the Colombian student´s entrepreneurial qualities and the influence of entrepreneurial education during their studies.

Síndrome de Burnout y calidad de vida laboral en el personal asistencial de una institución de salud en Bogotá Colombia

El objetivo de este estudio fue describir el Síndrome de Burnout y la Calidad de Vida Laboral en el personal asistencial en una institución de salud de segundo nivel ubicada en Bogotá, y observar si existe relación entre estos constructos. Se aplicó el Inventario de Burnout de Maslach [MBI] y el Cuestionario de Calidad de Vida Profesional [CVP-35] a 62 participantes, pertenecientes a distintos campos del área de la salud. Los resultados indicaron que el 38,7% de los participantes presentaron severidad alta y moderada del síndrome, no obstante, con un nivel de realización personal alto, que unido a la fuerte motivación intrínseca encontrada, constituye un factor protector ante la alta carga laboral y el escaso apoyo directivo. El cansancio emocional correlacionó directamente con la carga laboral e inversamente con la motivación intrínseca. Se resalta la importancia de una eficiente gestión en las organizaciones de salud y la necesidad de una dirección más centrada en las personas a fin de garantizar su bienestar, lo que redundará en su calidad de vida y en la atención ofrecida.

Normative reference values for the 20-meter shuttlerun test in a population-based sample of schoolchildren in Bogota, Colombia: The FUPRECOL Study

Our aim was to determine the normative reference values of cardiorespiratory fitness (CRF) and to establish the proportion of subjects with low CRF suggestive of future cardio-metabolic risk.