Resumo Este artigo reporta as atividades in vitro antiproliferativa, atiprotozoárica, anti-herpética e antimicrobiana de 32 extratos orgânicos provenientes de 14 esponjas marinhas e 14 corais coletados no litoral nordestino brasileiro. Os extratos etanólicos das esponjas Amphimedon compressa e Tedania ignis, e o extrato acetônico de Dysidea sp. demonstraram resultados promissores em relação aos efeitos antiproliferativos frente as linhagens celulares A549, HCT-8, PC-3 pelo método da sulforrodamina B, mas sem especificidade. Em relação à atividade antiprotozárica, os extratos etanólico de Amphimedon compressa e acetônico e etanólico de Dysidea sp. apresentaram atividade contra Leishmania amazonensis e Trypanosoma cruzi através do método de expressão de β-galactosidase em células THP-1. Na investigação preliminar de atividade antiviral frente ao vírus Herpes simplex tipo 1 (cepa KOS), os extratos etanólicos das esponjas Amphimedon compressa, Haliclona sp. e Chondrosia collectrix inibiram mais de 50% da replicação viral. O extrato etanólico da esponja Haliclona sp. demonstrou resultados promissores para atividade anti-herpética com altos índices de seletividade para as cepas KOS (IS >50) e 29R (IS>79) frente ao VHS-1 e cepa 333 (IS>108) frente ao VHS-2. O extrato etanólico da esponja Amphimedon compressa exibiu uma pequena atividade contra Enterococcus faecalis, Pseudomonas aeruginosa and Escherichia coli pelo método de difusão em disco. De acordo com os resultados apresentados, os extratos das esponjas Amphimedon compressa, Tedania ignis e Dysidea sp. serão selecionados para futuros estudos de isolamento e identificação dos compostos bioativos para as atividades antiproliferativa e antiprozoárica. O extrato etanólico de Haliclona sp. será investigado por possuir atividade relevante anti-herpética.

Abstract This paper reports the in vitro antiproliferative effects, antiprotozoal, anti-herpes and antimicrobial activities of 32 organic extracts of 14 marine sponges and 14 corals collected in northeast Brazilian coast. The ethanolic extracts of the sponges Amphimedon compressa and Tedania ignis, and the acetone extract of Dysidea sp. showed relevant results concerning the antiproliferative effects against A549, HCT-8, and PC-3 cell lines by sulforhodamine B assay, but also low specificity. Concerning the antiprotozoal screening, the ethanolic extract of Amphimedon compressa and the acetone and ethanolic extracts of Dysidea sp. were the most active against Leishmania amazonensis and Trypanosoma cruzi expressing β-galactosidase in THP-1 cells. In the preliminary anti-HSV-1 (KOS strain) screening, the ethanolic extracts of the sponges Amphimedon compressa, Haliclona sp. and Chondrosia collectrix inhibited viral replication by more than 50%. The most promising anti-herpes results were observed for the ethanolic extract of Haliclona sp. showing high selective indices against HSV-1, KOS and 29R strains (SI> 50 and >79, respectively), and HSV-2, 333 strain (IS>108). The results of the antibacterial screening indicated that only the ethanolic extract of Amphimedon compressa exhibited a weak activity against Enterococcus faecalis, Pseudomonas aeruginosa and Escherichia coli by the disk diffusion method. In view of these results, the extracts of Amphimedon compressa, Tedania ignis and Dysidea sp. were selected for further studies aiming the isolation and identification of the bioactive compounds with antiproliferative and/or antiprotozoal activities. The relevant anti-herpes activity of the ethanolic extract of Haliclona sp. also deserves special attention, and will be further investigated.

Abstract Objective To describe the development of weCope, a Portuguese mobile app for people with schizophrenia. Methods The development of weCope followed 4 stages: I-102 people with psychotic disorders completed an online questionnaire; II-a multidisciplinary focus group was conducted among five mental health professionals; III-we developed the app; IV-9 participants used weCope during 8 weeks to assess its efficiency. Results weCope targets coping with voices, problem solving, goals setting and stress management, and results indicated that: weCope improved symptoms, sense of recovery and personal and social functioning; 59% of the participants were willing to download an application for illness self-management; professionals revealed some concerns about mHealth but enhanced the high importance to develop these apps; usability testing revealed that 89% considered weCope useful for illness self-management. However, the more years with mental illness, the less importance is given to a mobile application for this purpose. Discussion weCope was developed through a comprehensive development process and may contribute to a subjective perception of the patient’s better well-being and health condition.

A systematic study was performed on patients aged 60 years and older, who were operated on in elective way by minimum access surgery from June 2003 to May, 2004 at the Laparoscopic Surgery Department of “Dr Luis Díaz Soto” Higher Institute of Military Medicine, with the objective of determining the clinical and surgical characteristics of these patients. One hundred and three patients aged 60-70 years were studied, 71.8 % of which were Caucasian women. Among the most frequent associated diseases were blood hypertension (56 patients, 53,3 %); asthma and heart diseases (19 patients, 18.4 % respectively). Most of patients (75, 72,8 %) had a clinical picture of pain and dyspeptic disorders. Development of symptoms took several years in 81 patients (78,6 %). The ultrasound scanning was the most efficient diagnostic means since it showed that gall-bladder lithiasis affected 101 patients (98 %). Gallbladder plastron and subacute cholecystitis were found in 6 and 10 patients respectively. Surgical length of time was lees than 30 minutes; no post-operative complications occurred, and length of stay at hospital was 24 hours as an average. It was proved that the elderly patients might enjoy the benefits of minimum access surgery.

Se aplicó una sistemática de estudio a los pacientes mayores de 60 años de edad operados de forma electiva por cirugía de mínimo acceso en el período comprendido entre junio de 2003 a mayo de 2004 en el Departamento de Cirugía Laparoscópica del Instituto Superior de Medicina Militar “Dr. Luis Díaz Soto”, con el propósito de determinar las características clinicoquirúrgicas de estos pacientes. Se estudiaron 103 pacientes con edades entre 60 y 70 años; el 71,8 % de ellos correspondió a mujeres de la raza blanca. Entre las enfermedades asociadas más frecuentes estuvo la hipertensión arterial (56 pacientes; 53,3 %), el asma y las cardiopatías (19 pacientes; 18,4 % respectivamente). La mayoría de los enfermos (75 pacientes; 72,8 %) presentó un cuadro clínico caracterizado por dolor y trastornos dispépticos. El tiempo de evolución de los síntomas fue de varios años en 81 pacientes (78,6 %). El examen de ultrasonido resultó el medio diagnóstico más eficaz, pues demostró la litiasis vesicular en 101 pacientes (98 %). Se encontró un plastrón vesicular en 6 pacientes y en 10 colecistitis subaguda. El tiempo quirúrgico fue menor de 30 min, no aparecieron complicaciones posoperatorias y la estadía fue de 24 h promedio. Quedó demostrado que los pacientes de edad avanzada pueden disfrutar de los beneficios de la cirugía de mínimo acceso.

Twenty-four medical histories of multitrauma patients diagnosed with flail chest from January 1989 to December 1994 at "Dr. Carlos J. Finlay" and "Dr. Luis Díaz Soto" hospitals were reviewed to comparatively analyze various therapeutical methods. A predictive index called TRISS was used to obtain the survival probabilities of each injured person. None of the methods was predominantly used but a higher efficiency was found in the stabilization of chest wall with Kirsimmer wires, the internal fixation and the combination of both methods. No one died in spite of a survival probability of 83.4; 81.7 and 87.8 % respectively in the different groups under treatment. In this type of trauma, the mortality rate and complications not only depend on the type of therapy used but also on the level of pulmonary contusion and the associated injury severity.

Se revisaron 24 historias clínicas de pacientes politraumatizados con diagnóstico de tórax batiente en los hospitales "Dr. Carlos J. Finlay" y "Dr. Luis Díaz Soto", correspondientes al período entre enero de 1989 y diciembre de 1994, con el objetivo de analizar de forma comparativa distintos métodos de tratamiento. Se aplicó el índice predictivo TRISS para obtener la probabilidad de sobrevida de cada lesionado. No hubo predominio en el empleo de uno u otro métodos de tratamiento, y mostraron mayor eficiencia la estabilización de la pared torácica con alambres de Kirscnner, la estabilización neumática interna y la combinación de ambos métodos de tratamientos. No se encontraron fallecidos a pesar de existir una probabilidad de supervivencia del 83,4, 81,7 y 87,8 % respectivamente en los diferentes grupos de tratamiento. En esta entidad traumática la mortalidad y las complicaciones dependen del grado de contusión pulmonar y de la severidad de las lesiones asociadas y no solamente del método de tratamiento empleado.

Traumatisms are a severe and disabling affection that caused 5 450 deaths in Cuba, in 1997. Most of them resulted from generalized sepsis and multiple systems organ failure, the commonest cause of death in these patients, despite the progress attained in antibiotic therapy and in the anesthetic and reanimation techniques. A review of the physiological alterations they produce was made, making emphasis on their inmunodepressive effect and differentiating the inflamatory response to trauma known among the most severe patients as incontrolled and hypertensive immunohumoral response or malignant inflamatory response. The role played by the mediators of inflamation in itself, as well as the ways to fight immunodepression are approached. It was concluded tha the decrease of the post traumatic immune response may be measured, prevented and corrected, or at least modified with drugs and supplementary nutritional support.

Los traumatismos constituyen una afección grave e invalidante que en Cuba cobraron 5 450 fallecidos en 1997, la mayoría en sepsis generalizada y fallo orgánico multisistémico, la causa más común de muerte en estos pacientes, a pesar de los progresos en la antibioticoterapia y en las técnicas anestésicas y de reanimación. Motivado por esto se realizó una revisión de las alteraciones fisiológicas que estos producen, haciendo énfasis en su efecto inmunodepresor, diferenciando la respuesta inflamatoria al trauma de que se ha dado a llamar, en los pacientes más severos respuesta inmunohumoral hiperintensa y descontrolada o respuesta inflamatoria maligna. Se expuso el papel que desempeñan los mediadores de la inflamación en la misma, así como las formas de combatir la inmunodepresión. Se concluyó que la disminución de la respuesta inmune depués de traumatismo puede ser medida, prevenida y corregida o al menos modificada con medicamentos y apoyo nutricional suplementario.

A prospective study was perfomed on 52 traumatized patients, and the correlation between tha values of the predictive index used and the results obtained with the protein fractions studied at admission and on the 3rd and 7th days was established. The following statistical tests were applied: median, standard deviation, minimum, maximum, and the correlation-regresion test, and hypothesis with a confidence interval of 95 % (alpha = 0.05). 38.5 % of the injured patients were within the rank of 21 to 30 years of age and males were found to be predominant (88.5 %). Traffic accidents accounted for the most frequent cause of lesions (38.5 %); orthopaedic lesions were found to have the greatest incidence (26.4 %), and complications were found in 38.4 % of the sample. Total proteins, albumins, and gamma globulins were found to be significantly reduced 72 hours after <a name=QuickMark></a>the lesions; this reduction was more intense in subjects who died. A correlation between the variables studied and the predictive indices was evidenced.

Se realizó un estudio prospectivo en 52 lesionados, y se estableció la correlación existente entre los valores de los índices predictivos utilizados y los resultados obtenidos en las fracciones protéicas estudiadas al ingreso, 3 y 7 días. Fueron aplicadas las siguientes pruebas estadísticas: medias, desviación estándar, mínimo, máximo y prueba de correlación-regresión e hipótesis con una confiabilidad de 95 % (alfa = 0,05). El 38,5 % de los lesionados correspondieron al rango entre 21 y 30 años de edad y predominó el sexo masculino (88,5 %). Los accidentes del tránsito constituyeron la causa más frecuente de lesiones (38,5 %); las lesiones ortopédicas fueron las de mayor incidencia (26,4 %) y se encontraron complicaciones en el 38,4 % de la muestra. Las proteínas totales, las albúminas y las globulinas gamma sufrieron disminución significativa a las 72 horas de ocurridas las lesiones, esta depresión se hizo más intensa en los fallecidos y se constató que existe correlación entre las variables estudiadas y los índices predictivos.