Abstract: This research study typifies coffee farms in the Municipality of Buesaco (Nariño, Colombia) to implement adaptation technologies to climate change. The methodology applies a semi-structured survey and a descriptive-correlational statistical analysis. A hierarchical cluster is generated and different adaptation scenarios are assessed with the local community. The results show that the factors that generate the greatest perception of vulnerability due to variability and climate change are those associated with increases in frequency and intensity of rains and increase in temperatures. There is both poor implementation of adaptation technologies and intensive coffee agriculture. Coffee farmers perceive a negative impact on both socio-productive aspects and on the family’s economy. Therefore, an implementation and adoption of technologies is presented in terms of infrastructure, productive diversification, and agroecological practices. It is concluded that it is necessary to implement technologies for adapting to climate change and that the adaptation measures identified here for coffee farmers allow enhancing decision-making in the short, mid, and long terms.

Resumen: Esta investigación tipifica fincas cafeteras del municipio de Buesaco (Nariño, Colombia) para implementar tecnologías de adaptación al cambio climático. En la metodología se aplica una encuesta semiestructurada y un análisis estadístico descriptivo-correlacional. Se genera un clúster jerárquico y se priorizan participativamente alternativas de adaptación adecuadas para la zona. Los resultados muestran que los factores con mayor percepción a vulnerabilidad por variabilidad y cambio climático son aquellos asociados al incremento de frecuencia e intensidad de lluvias y al aumento de temperatura. Se observa baja implementación de tecnologías de adaptación y agricultura intensiva con café. Los productores de café perciben impactos negativos en aspectos socio-productivos y de economía familiar. Se propone una implementación de tecnologías en términos de infraestructura, diversificación productiva y prácticas agroecológicas. Se concluye que es necesario adoptar tecnologías encaminadas a la adaptación al cambio climático y que las medidas de adaptación identificadas para la comunidad caficultora permiten promover la toma de decisiones a corto, mediano y largo plazo.

Resumen Objetivo. Comparar la evolución de los pacientes hospitalizados infectados por SARS-CoV-2 que recibieron tratamiento a base de corticoesteroides frente a los pacientes que recibieron la terapia estándar. Método. Estudio de tipo retrospectivo, observacional y analítico. Se recolectaron los expedientes clínicos de las diferentes unidades de terapia intensiva y se obtuvieron datos de los pacientes confirmados de COVID-19, mayores de 18 años, que estuvieron hospitalizados. Se dividió la población en dos grupos: pacientes que recibieron tratamiento con corticoesteroides y pacientes que recibieron terapia estándar. Resultados. De un total de 1603 pacientes ingresados a hospitalización, 984 (62.9%) fallecieron. El resultado principal fue la identificación mediante razón de momios (odds ratio [OR]: 4.68; intervalo de confianza del 95% [IC95%]: 3.75-5.83; p = 0.001) como riesgo para defunción con uso de esteroides sistémicos, así como con uso de ventilación mecánica invasiva (OR: 2.26; IC95%: 1.80-2.82; p < 0.001). El sexo masculino fue el más afectado, con 1051 (65.6%) pacientes. La media de edad fue de 56 años (± 14). Conclusiones. El uso de corticoesteroides se asoció con mal pronóstico en los pacientes hospitalizados por COVID-19, en comparación con los que recibieron la terapia estándar.

Abstract Objective. To compare the evolution of hospitalized patients infected with SARS-CoV-2 who received corticosteroid-based treatment versus patients who received standard therapy. Method. Retrospective, observational, and analytical study. Clinical records were collected from the different intensive care units, and data were obtained from confirmed COVID-19 patients over 18 years of age who were hospitalized. The population was divided into two groups: patients who received corticosteroid treatment, and those who received standard therapy. Results. A total of 1603 patients were admitted to hospital, and of these 984 (62.9%) were discharged due to death. The main result was the identification by odds ratio (OR: 4.68; 95% confidence interval [95% CI]: 3.75-5.83; p = 0.001) as risk for death to the use of systemic steroids, as well as the use of invasive mechanical ventilation (OR: 2.26; 95% CI: 1.80-2.82; p < 0.001). The male gender was the most affected with 1051 (65.6%) patients. Mean age was 56 years (± 14). Conclusions. Corticosteroid use was associated with poor prognosis in patients hospitalized for COVID-19 compared to those receiving standard therapy.

Resumen Introducción: La lesión del ligamento calcaneonavicular ha sido descrita como una de las causas de la deformidad en el pie plano del adulto. El objetivo de este artículo es describir portales modificados para el diagnóstico y la reparación endoscópica de las lesiones del fascículo superomedial del ligamento calcaneonavicular y evaluar la seguridad de los portales utilizados. Materiales y Métodos: Se llevó a cabo un estudio cadavérico con seis preparados reproduciendo una lesión del fascículo superomedial del ligamento calcaneonavicular con una punta de corte de radiofrecuencia y la posterior reparación endoscópica. Se crearon dos portales modificados para el abordaje. Luego se procedió a la disección anatómica para evaluar la seguridad de los portales en relación con las estructuras anatómicas. El primer portal se realiza inmediatamente proximal a una línea trazada desde la punta del maléolo medial dirigida al centro del talón, el segundo portal se emplaza 0,5 cm proximal a la inserción del tendón tibial posterior en el escafoides por transiluminación. Si es necesario, se coloca un portal accesorio inmediatamente dorsal al tendón tibial posterior a mitad de camino entre los dos portales antes descritos. Resultados: En todos los casos, fue posible la reparación del ligamento con el procedimiento endoscópico. En la disección anatómica de los portales, se observó una distancia promedio a las estructuras vasculonerviosas de 11,83 mm del portal proximal y de 9,66 mm del portal distal. Conclusión: Los portales modificados son seguros y permiten la visualización directa del haz superomedial del ligamento calcaneonavicular y su reparación endoscópica.

Abstract Introduction: Calcaneonavicular ligament injury has been described as a cause of adult flat foot deformity. The objective of this study is to describe modified portals for the diagnosis and treatment of injuries to the superomedial bundle of the calcaneonavicular ligament and to evaluate the safety of the portals used. Materials and Methods: We performed a cadaveric specimen study on 6 feet, where we reproduced a lesion of the superomedial bundle of the calcaneonavicular ligament with a radiofrequency ablation device and repaired it endoscopically. Two modified portals were created for the approach and an anatomical dissection was performed to assess the safety of the portals in relation to the anatomical structures. The first portal was placed immediately proximal to a line drawn from the tip of the medial malleolus toward the center of the heel; the second portal was placed 0.5 cm proximal to the posterior tibial tendon insertion into the navicular bone, guided by transillumination. If needed, an accessory portal was placed halfway between the two previously described portals immediately dorsal to the posterior tibial tendon. Results: In all cases, ligament repair was achieved with the endoscopic procedure. In the anatomical dissection of the portals, we observed an average distance of 11.83 mm from the proximal portal and 9.66 mm from the distal portal to neurovascular structures. Conclusion: Modified portals are safe and allow direct visualization of the superomedial bundle of the calcaneonavicular ligament to perform endoscopic repair.

Abstract The objective of this study was to compare the effect of the patent vs. generic sources of zilpaterol hydrochloride (ZH) on the productive performance, carcass characteristics, primary cut yields, and meat quality of lambs finished in feedlot. Thirty (30) Dorper×Pelibuey male lambs were distributed into 10 blocks, each with three lambs of similar initial live weight which were randomly assigned to the following treatments: 1) without ZH (control), 2) with patent ZH (PZH), and 3) with generic ZH (GZH). Treatment means were compared through two orthogonal contrasts: control vs. ZH (PZH+GZH) and PZH vs. GZH. ZH did not affect (P≥0.15) the productive performance, carcass weight, backfat thickness, or fat percentages (kidney-pelvic-heart, mesenteric or omental), but increased (P≤0.05) Longissimus dorsi muscle area and yields of carcass, shoulder, leg, and plain loin. As for the meat quality, ZH did not affect (P≥0.24) pH and shear force, but reduced (P<0.05) redness, yellowness, and chroma color values at 24 h post mortem, as well as the redness value (P<0.01) at 14 days of aging. With exception of carcass yield which tended (P=0.07) to increase with PZH, all measured variables were similar (P≥0.14) between PZH and GZH. It has been concluded that both types of ZH at a dose of 0.10 mg per kg of live weight promote muscular hypertrophy in finishing lambs; however, this dosage is not sufficient to result in a better productive performance or carcass weight.

Resumen El objetivo del estudio fue comparar el efecto de la fuente del clorhidrato de zilpaterol (CZ; patente vs genérico) sobre el comportamiento productivo, características de la canal, rendimientos de cortes primarios y calidad de la carne de corderos finalizados en corral. Se distribuyeron 30 corderos Dorper ×Pelibuey en 10 bloques donde cada bloque tenía tres corderos de similar peso vivo inicial, los cuales se asignaron aleatoriamente a los siguientes tratamientos: 1) sin CZ (testigo), 2) con CZ de patente (CZP), y 3) con CZ genérico (CZG). Las medias de tratamientos se compararon a través de dos contrastes ortogonales: testigo vs. CZ (CZP+CZG) y CZP vs. CZG. El CZ no afectó (P≥0.15) el comportamiento productivo, peso de la canal, espesor de grasa dorsal, ni los porcentajes de grasa (riñón-corazón-pelvis, mesentérica u omental), pero aumentó (P≤0.05) el área del músculo Longissimus dorsi y los rendimientos de canal, paleta, pierna y lomo plano. En calidad de la carne, el CZ no afectó (P≥0.24) el pH y esfuerzo al corte, pero redujo (P<0.05) los valores de color rojizo, amarillento y chroma a las 24 h post mortem, y también los valores de rojizo (P<0.01) a los 14 días de maduración. Con excepción del rendimiento en canal que tendió (P=0.07) a ser mayor con CZP, todas las variables medidas fueron similares (P≥0.14) entre CZP y CZG. Se concluye que ambos tipos de CZ a una dosis de 0.10 mg/kg de peso vivo promueven hipertrofia muscular en corderos de finalización, pero no es suficiente para reflejarse en mejor comportamiento productivo y peso de la canal.

Resumen El impacto negativo del estrés por calor (EC) en la ganadería lechera repercute en cuantiosas pérdidas económicas a nivel mundial, dado que reduce la producción de leche, la eficiencia reproductiva y la vida productiva de las vacas. Adicionalmente, el mejoramiento genético continuo resulta en vacas muy productivas, pero menos tolerantes al EC debido a que producen mayor calor metabólico. Esto en conjunto con el calentamiento global convertirá al EC en un reto difícil de controlar para la industria lechera. Como respuesta dependiente del grado de EC, el ganado lechero realiza una serie de ajustes fisiológicos, metabólicos y conductuales como mecanismos de termorregulación para disipar el exceso de calor corporal y reducir la producción endógena del mismo, todo dirigido a mantener la normotermia. Sin embargo, la secreción láctea y la fertilidad se reducen por efecto directo de la hipertermia e indirectamente por la reducción en el consumo de nutrientes dietéticos. Los consumos de alimento y de agua están asociados estrechamente con la reducción de la productividad en ganado lechero expuesto a EC. Cabe mencionar que el impacto del EC en la productividad del ganado lechero varía entre razas, siendo las razas Bos taurus menos tolerantes al EC, particularmente la raza Holstein. Actualmente, se investiga en la identificación de genes asociados con la termotolerancia, los cuales son empleados en programas de selección por marcadores genéticos para producir vacas altas productoras de leche en climas cálidos. Por lo tanto, el objetivo de esta revisión es hacer un análisis comprensivo de los efectos del EC sobre la producción de leche, activación de mecanismos de termorregulación y conducta de ingesta en ganado lechero.

Abstract The negative impact of heat stress (HS) in dairy cattle results in considerable economic losses at world level, as it reduces the milk production, reproductive efficiency, and productive life in the cows. In addition, the continuous genetic improvement results in highly productive cows, which are, however, less tolerant to HS because they produce greater metabolic heat. This, together with global warming, will turn HS into a hard-to-control challenge for the daily industry. In response dependent on the degree of HS, the dairy cattle carry out a series of physiological, metabolic and behavioral adjustments as thermoregulatory mechanisms for removing excess body heat and reducing the endogenous production of body heat, in order to maintain the normothermia. However, fertility and milk secretion decrease as a direct effect of hyperthermia and an indirect effect of lower dietary nutrient intake. Food and water intake are closely associated to the reduction of the productivity of dairy cattle exposed to HS. Notably, the impact of HS on productivity of dairy cattle varies among breeds, among which Bos taurus, particularly the Holstein breed, are less tolerant to HS. The identification of genes associated to thermotolerance utilized in selection programs using genetic markers to breed high milk-producing cows in warm climates is currently being studied. Therefore, the purpose of this review is to carry out a comprehensive analysis of the effects of HS on milk production, activation of thermoregulatory mechanisms and feed intake behavior in dairy cattle.

Abstract Banana ‘Prata’ has a significant demand in the Brazilian market, and Minas Gerais is one of the largest banana producers in the country. Scientific studies that evaluate the bananas quality produced in different cultivation regions are still incipient. Thus, this study evaluated the physical, biochemical and sensory attributes of banana ‘Prata’ from south and north of Minas Gerais and Vale do Ribeira (SP). Bananas from south were also cultivated in different production systems, organic and conventional. Data were submitted to multivariate analysis that provided the discrimination of the samples according to the cultivation regions. Bananas from southern presented higher levels of soluble solids and acidity, better taste, higher diameter and overall acceptance, where in the organic bananas were the most preferred by consumers. Fruit from northern stood out in appearance, texture, aroma and color, in addition to greater length. Fruit from Vale do Ribeira had higher levels of total phenolics and antioxidant activity. With these results we can assume that fruit quality is highly related to the specific climatic conditions from each producing region. Bananas from the south of Minas Gerais showed superiority for most of the evaluated traits, reflecting on consumer preference.

Abstract A total of 46 nulliparous Katahdin ewes were distributed under a completely randomized block design in two dietary treatments (n=23) around mating to evaluate the effects of adding of polyunsaturated fatty acid (PUFA) on the reproductive performance and pre-weaning growth in lambs. Treatments were two concentrates formulated isoenergetic and isoproteic that contained or did not contain (control) n-6 PUFA, and both were offered for 42 d (7 d before the breeding period and 35 d of breeding period; exposure to ram). Dietary addition of PUFA shortened (P<0.05) the estrus interval, without affecting (P>0.05) other reproductive variables. Lamb birth weight did not change (P>0.05) with addition of PUFA; however, the dietary addition of PUFA increased (P<0.05) pre-weaning growth rate and weaning weight in male lambs but not female lambs. Dietary addition of PUFA also improved (P<0.05) pre-weaning growth in twin birth lambs but not in single birth lambs. In conclusion, the inclusion of omega-6 PUFA in the diet of nulliparous Katahdin ewes during breeding is a promising dietary strategy since it shortens estrus interval without affecting other reproductive variables, and improves pre-weaning growth in male lambs and twin birth lambs.

Resumen Un total de 46 ovejas nulíparas Katahdin se asignaron bajo un diseño de bloques completamente al azar a dos tratamientos dietarios (n= 23) alrededor del empadre para evaluar el efecto de adicionar ácidos grasos poliinsaturados (AGP) sobre el comportamiento reproductivo y el crecimiento pre-destete de las crías. Los tratamientos consistieron en dos concentrados isoenergéticos e isoproteícos formulados sin (testigo) y con AGP omega 6, los cuales se ofrecieron durante 42 d (7 d antes y 35 d de exposición al semental). La adición dietaria de AGP disminuyó (P<0.05) el intervalo a estro, sin afectar (P>0.05) las demás variables reproductivas. En crías, el peso al nacimiento no varió (P>0.05) con la adición de AGP; sin embargo, la inclusión dietaria de AGP aumentó (P<0.05) la tasa de crecimiento pre-destete y el peso al destete en corderos, pero no en corderas. La inclusión de AGP en la dieta también mejoró (P<0.05) el crecimiento pre-destete en crías de parto gemelar pero no en crías de parto simple. En conclusión, la inclusión de AGP omega 6 en la dieta de ovejas nulíparas Katahdin durante el empadre, redujo el tiempo de aparición del estro sin afectar otras variables reproductivas; asimismo, mejoró el crecimiento pre-destete de sus crías machos y aquellas nacidas en parto gemelar.

Abstract Giant cell tumor of bone (GCT) is uncommon and predictable in terms of behavior, we present a male patient with a diagnosis of GCT of the sacrum treated initially with induction chemotherapy with no response and hematological morbidity with clinical tumor progression and logical image with infiltration to soft tissues of the pelvis, exteriorization of the tumor in various sites of the pelvis. Hemicorporectomy is performed in 2 phases (Bricker-type ileal conduit with Lynch technique and intestinal diversion by colostomy after translumbar amputation) with adequate evolution currently at 4 years of surveillance without recurrence.

Resumen El tumor de células gigantes de hueso (TCG) es poco frecuente y predecible en cuanto a comportamiento, presentamos a un paciente de sexo masculino con diagnóstico de TCG de sacro tratado inicialmente con quimioterapia de inducción con nula respuesta y morbilidad hematológica con progresión del tumor clínica e imagen lógica con infiltración a tejidos blandos de la pelvis, exteriorización del tumor en diversos sitios de la pelvis. Se realiza hemicorporectomía en dos fases, (conducto ileal tipo Bricker con técnica de Lynch y derivación intestinal mediante colostomía, posteriormente amputación translumbar) con adecuada evolución actualmente a cuatro años de vigilancia sin recurrencia.

Resumen Introducción y objetivos: La tormenta eléctrica (TE) se caracteriza por episodios repetidos de taquicardia ventricular o fibrilación ventricular relacionados con mal pronóstico a corto y largo plazos. El objetivo fue evaluar la prevalencia, resultados y supervivencia de los pacientes sometidos a tratamiento intervencionista por TE en un centro de referencia. Métodos: Estudio unicéntrico, observacional y retrospectivo. Se revisaron los procedimientos de ablación por TE y se evaluaron las características basales de los pacientes, tipo de procedimiento, mortalidad total, recurrencia de arritmia, mortalidad cardiovascular y necesidad de trasplante. Resultados: Desde enero de 2009 hasta diciembre de 2016 se realizaron 67 procedimientos (38% de complejos: 19% de ablación endoepicárdica, 7.5% de crioablación epicárdica quirúrgica, 3% de simpatectomía, 3% de inyección coronaria con alcohol; 6% de apoyo con oxigenación con membrana extracorpórea) en 41 pacientes (61% de causa isquémica) por TE. La mortalidad intraprocedimiento fue del 1.5%. La mediana de seguimiento fue de 23.5 meses (RIQ, 14.2-52.7). Tras el primer ingreso por TE (uno o varios procedimientos), la mortalidad a un año fue de 9.8%. La incidencia acumulada de trasplante cardiaco por TE fue de 2.4%. En el análisis multivariado, el riesgo de recurrencias arrítmicas o muerte por cualquier causa fue significativamente mayor en pacientes con arritmias clínicas inducibles (HR, 9.03; p = 0.017). Conclusiones: El tratamiento de pacientes con TE, instituido en un centro de referencia y con experiencia, se relacionó con una tasa baja de recurrencia y supervivencia elevada, con una tasa de trasplante cardiaco por TE muy baja. Ante una recurrencia temprana es recomendable practicar un nuevo procedimiento durante el ingreso.

Abstract Introduction and objective: Electrical storm (ES) is characterized by repeated episodes of ventricular tachycardia or ventricular fibrillation, with poor short and long term prognosis. Our objective was to evaluate the prevalence, results of interventional treatment and survival of patients undergoing interventional treatment for ES in our center. Methods: Retrospective, unicentric and observational study. ES ablation procedures were revised and data regarding baseline characteristics of the patients, type of procedure, total mortality, recurrence of arrhythmia, cardiovascular mortality and the need for transplantation were evaluated. Results: From January 2009 to December 2016, 67 procedures (38% complex procedures: 19% epicardial ablation, 7.5% surgical epicardial crioablation, 3% simpatectomy, 3% coronary alcohol injection, 6% extracorporeal membrane oxygenation support) were performed in 41 patients (61% Ischemic etiology) due to ES. Intraprocedural mortality was 1.5%. The median follow-up was 23.5 months (IQR [14.2-52.7]). After the first admission for ES (one or several procedures), 1-year mortality was 9.8%. The cumulative incidence of cardiac transplantation was 2.4%. The risk of arrhythmic recurrences or death was significantly higher in patients with inducible clinical arrhythmias after ablation (HR: 9.03, p = 0.017). Conclusions: The treatment of patients with ES, performed in a reference center, allows obtaining good rates of recurrence and survival, with very low rates of cardiac transplantation for ES. In the presence of an early recurrence, it is advisable to perform a new procedure during admission.

Abstract Introduction: Mexico has the highest 30-day acute myocardial infarction (AMI) mortality rate: 28% versus 7.5% on average for the OECD countries, and it constitutes one of the main causes of mortality in the country. Objective: To establish critical pathways and essential interinstitutional pharmacological strategies for the care of patients with AMI in Mexico, regardless of their socioeconomic status. Method: A group of experts in AMI diagnosis and treatment, representatives of the main public health institutions in Mexico, as well as the Mexican cardiology societies, the Mexican Red Cross and representatives of the Spanish Society of Cardiology, were brought together in order to optimize strategies based on the best existing evidence. Results: An interinstitutional clinical practice guideline was designed for early diagnosis and timely treatment of AMI with ST elevation, following the clinical horizon of the disease, with the proposal of algorithms that improve the prognosis of patients who attend the emergency services due to an AMI. Conclusion: With these clinical practice guidelines, the group of experts proposes to universalize AMI diagnosis and treatment, regardless of patient socioeconomic status.

Resumen Introducción: México tiene la mortalidad más alta a 30 días por infarto agudo de miocardio (IAM), el cual constituye una de las principales causas de mortalidad en el país: 28 % versus 7.5 % del promedio de los países de la Organización para la Cooperación y el Desarrollo Económicos. Objetivo: Establecer las rutas críticas y las estrategias farmacológicas esenciales interinstitucionales para la atención de los pacientes con IAM en México, independientemente de su condición socioeconómica. Método: Se reunió a un grupo de expertos en diagnóstico y tratamiento de IAM, representantes de las principales instituciones públicas de salud de México, así como las sociedades cardiológicas mexicanas, Cruz Roja Mexicana y representantes de la Sociedad Española de Cardiología, con la finalidad de optimizar las estrategias con base en la mejor evidencia existente. Resultados: Se diseñó una guía de práctica clínica interinstitucional para el diagnóstico temprano y tratamiento oportuno del IAM con elevación del segmento ST, siguiendo el horizonte clínico de la enfermedad, con la propuesta de algoritmos que mejoren el pronóstico de los pacientes que acuden por IAM a los servicios de urgencias. Conclusión: Con la presente guía práctica, el grupo de expertos propone universalizar el diagnóstico y tratamiento en el IAM, independientemente de la condición socioeconómica del paciente.

The emergence of antibiotic resistance among microbial pathogens is a serious public health problem, resulting in a constant need of discovering new antibiotics. For this purpose, we synthetized and determined the antimicrobial activity of copper (Cu), cobalt (Co), and tin (Sn) complexes coordinated with scorpionate ligand in a tridentate mode against microorganisms of clinical importance. New complexes with the sodium hydrotris(2-mercaptothiazolyl)borate ligand were characterized by physicochemical and spectroscopic techniques (UV-vis, IR, 1H and 13C NMR). Moreover, their antimicrobial activity was evaluated using microdilution broth method. Cytotoxicity was determined in Vero cells and the selectivity index (SI) was calculated. The coordination with metals increased the ligand antimicrobial activity, which showed no activity when evaluated alone (MIC>1,080 µM). Cu-complex (1) had activity against Candida albicans and C. krusei, with MICs of 130 and 66 µM, respectively. The compounds had low toxicity on Vero cells and chemo-informatics assays corroborated a low systemic toxic effect. The SI revealed that the compound 1 was 16 times more selective for C. krusei and 8 times more selective for C. albicans in relation to Vero cells. The Cu-complex stands out as a potential prototype for the development of new antifungal agents.

Abstract Amyotrophic lateral sclerosis (ALS) is a late-onset neurodegenerative disorder characterized by rapid deterioration and selective death of motor neurons (MNs) in central nervous system. There is no effective therapy for ALS patients. Riluzole, only slightly delays disease progression. Edaravone was FDA approved as an intravenous therapy, however, this drug is expensive and has been applied in few cases in our country. There is compelling evidence patients who attend an ALS multidisciplinary clinic experience improved survival. An ALS multidisciplinary clinic was launched in our institution and adapted to our healthcare system. It is described the processes involved in the evaluation of patients in an all day long session where ALS patients are evaluated by several professionals from different specialties specially trained in the needs of subjects living with this disorder. We consider that this model of healthcare for patients with ALS may be useful in another healthcare institutions in our country.

Resumen Esclerosis Lateral Amiotrófica (ELA) es una enfermedad neurodegenerativa caracterizada por rápido deterioro y muerte selectiva de neuronas motoras en el sistema nervioso central. No existe tratamiento efectivo para los pacientes con ELA. El Riluzole solo prolonga discretamente la sobrevida. El Edaravone aprobado por la FDA como tratamiento intravenoso, es costoso y solo ha sido utilizado en algunos pacientes en nuestro país. Existe evidencia en los últimos años que el manejo multidisciplinario de los pacientes con ELA mejora la sobrevida. En nuestra institución efectuamos la apertura de la clínica multidisciplinaria para ELA. Describimos los procesos involucrados en la evaluación de los pacientes en una sesión durante todo un día, donde los pacientes son evaluados por médicos de diferentes especialidades y con entrenamiento en la evaluación de pacientes con ELA Consideramos que este modelo de atención para el cuidado de los pacientes que sufren este trastorno neurológico es útil y podría ser aplicado en otras instituciones del sector salud de nuestro país.

Abstract The Chapada das Mesas National Park is a federal reserve located in the State of Maranhão, in an ecotonal region of the Brazilian Northeast Cerrado. Aiming to assess the influence of biogeographic patterns and support restoration actions for regions where information is scarce, we analyzed the floristic composition of savanna and forest Cerrado physiognomies, the floristic relationships with other Brazilian Cerrado areas and investigated the floristic relationships between the Cerrado and the Amazon, and the Caatinga and Atlantic Forest biomes. A total of 242 species in 181 genera and 64 families are recorded in our study. Fabaceae was the most representative family. We report 50 new records of species for Maranhão, four new records for the Cerrado biome and one vulnerable species. The separation of the gallery forest from cerradão and typical cerrado by ordination shows the influence of water availability and soil characteristics on floristic composition. In Cerrado ecotonal regions, such as Mato Grosso and Maranhão, the presence of species shared with the Amazon is expressive. In addition to the Amazon, physiognomies had greater floristic connection with the Caatinga flora. Our data demonstrates that the marginal areas of the Brazilian Cerrado may present high species diversity.

RESUMO | Objetivo: Estimar a prevalência de cegueira e deficiência visual em idosos que vivem na Guatemala. Métodos: Indivíduos com idade ³50 anos foram selecionados por amostragem aleatória por conglomerados, e os participantes do estudo foram avaliados pelo método de Avaliação Rápida da Cegueira Evitável. A acuidade visual foi medida e o cristalino foi examinado. Se a acuidade visual apresentada fosse <20/60, então também foi testada com um buraco estenopeico e a fundoscopia realizada. A cegueira e a deficiência visual foram classificadas como deficiência visual moderada com acuidade visual <20/60-20/200; deficiência visual grave com acuidade visual <20/200-20/400; ou cegueira com acuidade visual <20/400. A principal causa de cegueira ou deficiência visual em cada olho foi determinada, e naqueles com catarata, as barreiras ao tratamento foram avaliadas. Resultados: O estudo incluiu 3.850 pessoas com ³50 anos de idade; 3.760 (97,7%) foram examinadas. A prevalência de cegueira ajustada à idade e ao sexo foi de 2,9% (intervalo de confiança de 95%, 2,0-3,8%), 5,2% (4,0-6,4%) deficiência visual grave e 27,6% (23,3-32,0%) deficiência visual moderada. A catarata foi a principal de cegueira (77,6%), seguida de outras doenças do segmento posterior (6,0%). Catarata causada por 79,4% de deficiência visual grave, enquanto erros refrativos não corrigidos causaram 67,9% de deficiência visual moderada. Após a cirurgia de catarata, 75% dos participantes tiveram uma acuidade de 20/200, ou melhor, e 19,0% a deficiência visual não foi melhor do que 20/200 com a correção. O custo foi a principal barreira à cirurgia de catarata (56.7%). Conclusões: A prevalência de cegueira em idosos é maior na Guatemala do que na maioria dos outros países da América Central. A maioria dos casos de cegueira e deficiência visual era evitável ou tratável. O aumento da disponibilidade de tratamento de catarata a preços acessíveis e de alta qualidade teria um impacto substancial na prevenção da cegueira.

ABSTRACT | Purpose: To estimate the prevalence of blindness and visual impairment in older adults living in Guatemala. Methods: Participants ³50 years of age were selected using random cluster sampling and evaluated using the Rapid Assessment of Avoidable Blindness method. Visual acuity was measured, and the lens was examined. If presenting visual acuity was <20/60, it was also tested with a pinhole and fundoscopy was performed. Blindness and visual impairment were classified as moderate visual impairment (presenting visual acuity <20/60 to 20/200), severe visual impairment (presenting visual acuity <20/200 to 20/400), or blindness (presenting visual acuity <20/400). The primary cause of blindness or visual impairment in each eye was determined, and if the cause was cataracts, the barriers to treatment were assessed. Results: The study included 3,850 people ³50 years of age, of whom 3,760 (97.7%) were examined. The age- and sex-adjusted prevalence of blindness was 2.9% (95% confidence interval, 2.0%-3.8%), while 5.2% (4.0%-6.4%) presented with severe visual impairment, and 27.6% (23.3%-32.0%) presented with moderate visual impairment. Cataracts were the leading cause of blindness (77.6%), followed by other posterior segment diseases (6.0%). Cataracts caused 79.4% of cases of severe visual impairment, while uncorrected refractive errors caused 67.9% of cases of moderate visual impairment. Following cataract surgery, 75% of participants had a presenting visual acuity of 20/200 or better, and in 19.0% of participants, visual acuity was not better than 20/200 with correction. Cost was the main barrier to cataract surgery (56.7%). Conclusions: The prevalence of blindness in older adults is higher in Guatemala than in most Central American countries. Most cases of blindness and visual impairment were either preventable or treatable. Increased availability of affordable, high-quality cataract treatment would have a substantial impact on blindness prevention.

O figo possui problemas quanto à sua conservação no período pós-colheita, visto que é fruta climatérica e de alta perecibilidade. Diante disto, o trabalho teve como objetivo avaliar o uso de cloreto de cálcio em pós-colheita, em frutos do cultivar de figueira ‘Roxo de Valinhos’. Foram utilizados frutos colhidos em pomar experimental da Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), localizada no município de Botucatu, estado de São Paulo, Brasil. Os frutos foram transportados para o departamento de Horticultura, onde receberam tratamento com 0, 1, 2 e 3% de CaCl2, pelo método de imersão. Posteriormente, foram armazenados em câmara fria (5± 1ºC e UR 80± 5%), embalados em bandejas de poliestireno expandido e envoltos por filme PVC. As variáveis avaliadas foram: firmeza, pH, sólidos solúveis, acidez titulável, índice de maturação e teor de açúcares totais, redutores e não redutores após 5, 10, 15 e 20 dias de armazenamento. Avaliou-se ainda a perda percentual de massa, em intervalos de 2 dias, até ao vigésimo dia de armazenamento. O uso de cloreto de cálcio em pós-colheita promoveu poucas alterações na qualidade dos frutos durante o armazenamento. Todas as características de qualidade dos frutos variaram em função do período de armazenamento, com exceção dos teores de açúcares totais e sólidos solúveis.

The fig fruits have problems with their post-harvest shelf-life, due to the fact that the fruit is climacteric and it has high perishability. Faced with this issue, this paper objective was to evaluate the use of calcium chloride in the post-harvest period of ‘Roxo de Valinhos’ fruits. The fruits were harvested from an experimental orchard and sent to the horticulture department, where they were treated with different concentrations of CaCl2 (0, 1, 2, and 3%), using the dipping method. The fruits were stored in cold chamber (5±1ºC and 80± 5% RH), packed with polystyrene trays and covered with PVC film. Evaluations were realized at 5, 10, 15 and 20 days after storage, when were observed the following characteristics: firmness, pH, total soluble solids, titratable acidity, maturation index and sugar content. The weight loss percentage was also evaluated every 2 days until the 20th day of storage. Calcium chloride applications on the post-harvest period of fig fruits promoted few changes in the fruit quality during the storage period. All the quality characteristics vary over the days of storage, except total sugar content and total soluble solids.