Abstract The constant intensification of aquaculture has considerable increased the stress levels of farmed fish and, consequently, the number and intensity of diseases outbreaks. Thus, studies on fish immune response, especially regarding the interaction of fish leukocytes with potential pathogens and xenobiotics are of great importance in order to develop new prophylactic and curative strategies. We isolated leukocytes from the head kidney of Astyanax lacustris—an important Neotropical fish species for aquaculture and a potential model for Neotropical aquaculture research—using a Percoll centrifugation protocol. The isolated leukocytes were incubated with lipopolysaccharide (LPS), and the expression of genes IL-1β, IL-8, LysC, and LysG were measured. We assessed the phagocytotic activity of leukocytes using Congo red-dyed yeast, a novel and cost-effective protocol that has been developed in this study. The isolated leukocytes responded to LPS induction, exhibiting strong IL-1β and IL-8 upregulation, two of the most important pro-inflammatory interleukins for vertebrates immune reponse. The optimal concentration of yeast for the phagocytic assay was 106 cells mL-1, resulting in acceptable phagocytic capacity (PC) but without excess of yeasts during the counting process, ensuring a high precision and accuracy of the method. To the best of our knowledge, the present study is the first to investigate the in vitro gene expression and phagocytic activity of leukocytes isolated from A. lacustris. Our findings will serve as a reference for future studies on the immunology and toxicology of Neotropical fish.

Resumo A constante intensificação da aquicultura tem aumentado consideravelmente os níveis de estresse dos animais cultivados e, consequentemente, o número e a intensidade dos surtos de doenças. Logo, estudos sobre a resposta imune dos peixes, especialmente relacionados com a interação dos leucócitos de peixes com potenciais patógenos e xenobióticos, são de grande importância para o desenvolvimento de novas estratégias profiláticas e curativas. No presente trabalho, nós obtivemos sucesso ao isolar leucócitos oriundos do rim cranial de Astyanax lacustris - uma importante espécie de peixe Neotropical para a aquicultura e um modelo em potencial para pesquisas em aquicultura Neotropical - usando um protocolo de centrifugação com Percoll. Os leucócitos isolados foram incubados com lipossacarídeo (LPS) e, a expressão dos genes IL-1β, IL-8, LysC, e LysG foi avaliada. Ainda, um novo protocolo para avaliação da atividade fagocítica dos leucócitos utilizando leveduras coradas com Vermelho Congo foi estabelecido. Os leucócitos isolados responderam à indução com LPS, exibindo up regulation dos genes IL-1β e IL-8, duas das interleucinas pró-inflamatórias mais importantes para a resposta imune de vertebrados. Além do mais, a concentração ótima de leveduras para a avaliação da fagocitose foi de 106 células mL-1, resultando em uma capacidade fagocítica (PC) aceitável, mas sem excesso de leveduras durante o processo de contagem, garantindo maior precisão e eficácia do método. Até o presente momento, o presente estudo é o primeiro a investigar a expressão gênica e atividade fagocítica de leucócitos isolados de A. lacustris através da abordagem in vitro. Ainda, nossos resultados servirão de referência para futuros estudos em imunologia e toxicologia de peixes Neotropicais.

A chemical investigation of the stem of Waltheria indica (Malvaceae) yielded twelve 4-quinolone alkaloids, which were primarily waltheriones. These were waltherione A (1), waltherione B (2), waltherione C (3), waltherione G (4), waltherione H (5), waltherione J (6), waltherione L (7), waltherione P (8), chamaedrone (9), 8-deoxy-antidesmone (10), antidesmone (11), and the previously unreported alkaloid N-methoxy-waltherione A (12). These alkaloids belong to an unusual class of 4-quinolones and therefore, have chemosystematic significance for distinguishing the Waltheria and Melochia genera from the rest of the Malvaceae family. The ability of the alkaloid isolates to reverse the phenotypic expression of fluconazole-resistance was tested by using a mutant strain of Saccharomyces cerevisiae that expressed a Candida albicans transporter. Of the isolates tested, waltherione G afforded a positive result. Leishmanicidal activity and bactericidal tests were also performed using the isolated alkaloids, which showed promising results.

Abstract Background: Tolchés are tree strips within agricultural matrix in Yucatan; they provide ecosystem services, including woody material supply. Questions and Hypotheses: Are there differences in the structure of the woody vegetation of the tolchés throughout the distance of the town and intensity of use? We hypothesize that structural attributes of the tolchés are negatively affectedby the intensity of forest use that is decreasing, from the margins of the town to the agricultural area, until reaching the mature vegetation. Data description: The structural attributes of tolchés and mature vegetation (VM) were evaluated, a rarefaction analysis was performed to standardize the sampling effort, and a univariate linear model followed by ex post tests were used. Site and years of study: The study was carried out in tolchés and VM of Yaxcabá, Yucatán, from February to July 2019. Methods: 42 sampling units (MUs) were established: 32 MUs were located in tolchés, from 3 groups differentiated by their distance from the town and 8 MUs were located in VM. All woody individuals > 2.5 cm dbh were recorded and the differences in the structural values both conditions were evaluated. Results: The diversity of the tolchés were significantly higher than that achieved by the VM related to the distance to the town. Conclusions: The influence of a harvesting pattern based on the distance to the town was determined. Intermediate levels of use favor the wealth and diversity of the tolchés.

Resumen Antecedentes: Los tolchés son franjas de árboles dentro del paisaje agrícola yucateco; proporcionan varios servicios ecosistémicos, incluyendo el suministro de material leñoso. Preguntas e hipótesis: ¿Existen diferencias en la estructura de la vegetación leñosa de los tolchés a lo largo de la distancia al pueblo y la intensidad de uso? La hipótesis es que los atributos estructurales de la vegetación de los tolchés son afectados negativamente por la intensidad del uso del bosque, que disminuye de los márgenes del poblado, al área agrícola, hasta llegar a la vegetación madura. Descripción de datos: Se evaluaron los atributos estructurales de tolchés y vegetación madura (VM), se realizó una rarefacción para estandarizar el esfuerzo de muestreo, un modelo lineal univariante seguido de pruebas a posteriori. Sitio y años de estudio: El estudio se realizó en tolchés y VM de Yaxcabá, Yucatán, de febrero a julio de 2019. Métodos: Se establecieron 44 unidades de muestreo (UM): 36 UM se ubicaron en tolchés, de 3 grupos diferenciados por su distancia al poblado y 8 UM se ubicaron en VM. Se registraron los individuos leñosos > 2.5 cm de DAP y se evaluaron las diferencias de los valores estructurales de ambas condiciones. Resultados: La diversidad de los tolchés fueron significativamente superiores a la alcanzada por la VM, relacionada a la distancia al poblado. Conclusiones: Se determinó la influencia de un patrón de aprovechamiento basado en la distancia al poblado. Niveles intermedios de aprovechamiento favorecen la riqueza y diversidad de los tolchés.

Leishmaniasis, a neglected tropical disease with a high worldwide incidence, is considered a public health issue in Minas Gerais and Brazil, with a high degree of morbidity, not to mention the lack of therapeutic arsenal. The cysteine protease (rCPB2.8) and cyclin dependent kinase (CRK3), important enzymes for the parasite’s feasibility, were the targets chosen for investigation of the new drugs. The following study aimed to analyze several oximic derivatives starting from safrol, which can present an affinity profile for selected molecular targets using tools from molecular modeling and bioinformatics, planning and synthesis of brand new substances being tested for leishmanicidal drugs. The study allowed to verify that three oximic derivatives (5a, 5f and 5h) presented high affinity for the CRK3 enzyme, and that the compounds 5c and 5g presented good interaction by the amino acids of the catalytic site of the rCPB2.8 enzyme with atomic distances capable of generating covalent bonds, which are essential for enzyme inhibitory activity.

Abstract Introduction Comorbid major depressive disorder (MDD) is present in up to 25 % of chronic rhinosinusitis (CRS) cases and provides prognostic information for patients undergoing endoscopic sinus surgery (ESS). Clinical visits offer an opportunity to identify at-risk patients. Objective The purpose of the present study is to evaluate practice patterns among members of the American Rhinologic Society (ARS) in screening for/diagnosing MDD. Methods A 21-question survey was distributed to 1,206 members of the ARS from May 26, 2018 to June 12, 2018. The impact of demographic factors, including hospital setting, fellowship status, and experience were assessed through chi-squared analysis. Results A total of 80 members of the ARS completed the survey, yielding a response rate of 7 %. Half of the respondents worked in academic settings and 43 % had completed a rhinology fellowship. Twenty percent of the participants felt comfortable diagnosing or managing MDD, while only 10 % of participants screened for MDD in patients with CRS. Respondents cited a lack of training (76 %) and unfamiliarity with diagnostic criteria (76 %) as barriers to the routine assessment of MDD. Most respondents (95 %) considered comorbid psychiatric illness to negatively impact outcomes following ESS. Fellowship-trained respondents were significantly more likely to implement screening tools in their practice (p = 0.05), and believe in the negative impact of MDD on postoperative outcomes (p = 0.007), cost of care (p = 0.04) and quality of life (p = 0.047). Conclusion Amongst ARS members, 95 % of the respondents consider comorbid MDD to negatively impact patient outcomes following ESS. Regardless, a large proportion of surgeons neither screen nor feel comfortable diagnosing MDD.

Resumo Apesar do potencial apresentado pela tecnologia de propagação mediada para a aquicultura e conservação de peixes Neotropicais, o pobre entendimento do sistema imune do hospedeiro pode resultar na rejeição e destruição do material do doador. Com isso, se fazem necessários o estudo e o desenvolvimento de métodos para análise tanto dos efeitos de drogas imunossupressoras quanto para a avaliação da imunocompatibilidade entre doadores e receptores. Logo, o presente estudo teve como objetivo aperfeiçoar um método para analisar a fagocitose in vivo em Astyanax altiparanae usando Saccharomyces cerevisiae marcado e avaliar seu perfil hematológico resultante da indução inflamatória. Para isso, S. cerevisiae foram marcados com vermelho Congo e injetados na cavidade celomática dos A. altiparanae na concentração de 2,5 x 106 células.mL-1. Peixes injetados com PBS e peixes não injetados foram mantidos como controle. Sangue foi colhido e a capacidade fagocítica e o índice fagocítico foram determinados após 1, 2, 3 e 6 horas após à injeção (hpi). A injeção de levedura estimulou a fagocitose com sucesso, com o melhor resultado atingido após 2 hpi. Ainda, foi observada uma alta rastreabilidade das leveduras fagocitadas e não fagocitadas sob microscopia óptica devido à marcação com vermelho Congo. O perfil hematológico foi similar ao observado usualmente em infecções recém-induzidas, indicando migração de linfócitos ao sítio inflamatório e aumento no número de fagócitos circulantes devido à resposta natural ao estímulo inflamatório. Como conclusão, nosso método foi eficiente para analisar a fagocitose in vivo em A. altiparanae e será uma ferramenta importante para a avaliação de eficácia de drogas imunossopressoras para esta espécie. Em adição, estes resultados podem contribuir para futuros estudos em imunocompetência em peixes, tanto em âmbito laboratorial quanto a campo.

Abstract Although the potential of surrogate propagation technology for aquaculture and conservation of Neotropical fish, the poor understanding of the host immune system may results in rejection and destruction of the donor material. Thus, it is necessary to study and to develop methods to evaluate the effects of immunosuppressive drugs employment and to evaluate the immunocompatibility between donor and receptor. Thus, the present study aimed to optimize a methodology to assess in vivo phagocytosis in Astyanax altiparanae using Saccharomyces cerevisiae and to evaluate their hematological response resultant from the inflammatory induction. To this, S. cerevisiae were labeled with Congo red and injected in the coelomic cavity of A. altiparanae at the concentration of 2.5 x 106 cells mL-1. A PBS solution and a non-injected group were kept as control. Fish blood was sampled and the phagocytic capacity and index were determined at 1, 2, 3 and 6 h post-injection (hpi). The yeast injection successfully stimulated phagocytosis, with the best result for phagocytosis assessment after 2 hpi. Moreover, it was achieved a high traceability of phagocytized and non-phagocytized yeast under optic microscopy analysis due to the Congo red labeling. The hematological profile was similar to usually observed in early infections, indicating lymphocyte migration to inflammatory site and increase in number of circulating phagocytes due to natural response to inflammatory stimulus. In conclusion, our method was efficient to assess in vivo phagocytosis in A. altiparanae and will be an important tool to evaluate the efficacy of immunosuppressive drugs in this species. Additionally, these results may serve as support for further studies in fish immunocompetence, both in laboratory and in field conditions.

Resumen Introducción: La colangitis aguda es una entidad clínica causada por una infección del sistema biliar, más comúnmente secundaria a una obstrucción parcial o completa del conducto biliar o del conducto hepático. En los pacientes con colangitis el cultivo de la bilis es positivo en el 80- 100% de los casos. Los agentes causales de la colangitis se corresponden con la flora presente en el tracto digestivo, siendo Escherichia coli el microorganismo diagnosticado con mayor frecuencia. Objetivo: El objetivo primario es determinar cuáles son los agentes patógenos más frecuentes en el cultivo de líquido biliar obtenido por CPRE en pacientes oncológicos con colangitis aguda y como objetivos secundarios determinar la incidencia de presentación de colangitis aguda debido a E. coli BLEE así como los factores de riesgo para el desarrollo de esta. Material y métodos: Estudio retrospectivo, observacional, y transversal, realizado en pacientes con colangitis aguda con diagnóstico oncológico en el Instituto Nacional de Cancerología, a quienes se les realizo Colangiopancreatografía retrograda endoscópica (CPRE) con toma de cultivo biliar determinando el agente infeccioso causal, durante el periodo comprendido del 01 de octubre de 2018 al 30 de junio de 2020. Resultados: Se analizaron 51 pacientes con diagnóstico de colangitis aguda, 26 mujeres (51%) y 25 hombres (49%), media de edad de 61.37 ± 11.33 años, con base en la severidad del cuadro de colangitis se dividieron en leve 25 (49%), moderado 8 (15.7%), y severo 18 (35.3%), 68.63% de los cultivos la infección fue polimicrobiana y en el 31.37% monomicrobiana, siendo el agente causal más frecuente fue E. coli (70.58%), E. faecalis (21.56%), Klebsiella pneumoniae 15.68% y pseudomona aeruginosa 13.72%. Con base a los antibiogramas se observó frecuencia elevada de resistencia a cefalosporinas de 3ra generación y quinolonas para E. coli BLEE y K. pneumoniae BLEE. Se observó E. coli BLEE en el 52.9% de los cultivos, identificándose como factores de riesgo para infección por E. coli BLEE: CPRE previa (61.9 % vs 38.1 %) con p= 0.008, OR 13 (1.484-113-873 IC 95%), prótesis previa 61% vs 39% con p= 0.033, OR 6.25 (1.175- 33.258 IC 95%) y hospitalización por colangitis 3 meses previos 81.8 % vs 18.2 % con p =0.042, OR 5.50 (1.052- 28.752 IC 95%). Conclusión: Los resultados de nuestro estudio demuestran que el principal agente causal infeccioso en colangitis es E. coli, seguido de E. faecalis, Klebsiella pneumoniae y Pseudomona aeruginosa, la infección por E. coli BLEE está presente hasta en la mitad de los casos de colangitis en nuestra población oncológica, siendo los factores de riesgo para infección por E. coli BLEE antecedente de CPRE previas, antecedente de prótesis previa y hospitalización en los 3 meses previas por colangitis.

Resumen Introducción. La evaluación endoscópica del ámpula de Vater (AV), aunque recomendada como parte de la valoración rutinaria del tracto digestivo superior e incluso propuesta como un dato de certeza de un estudio completo, no siempre es posible debido a su localización y configuración anatómica que pueden ocultarla del campo visual del endoscopio frontal haciendo entonces necesario el uso del duodenoscopio. Dos estudios previos y la más reciente actualización de la Sociedad Europea de Endoscopia Gastrointestinal para la valoración duodenal y periampular en pacientes con síndromes polipósicos proponen como alternativa al duodenoscopio el uso de un cap distal en el endoscopio de visión frontal para facilitar la examinación del AV, reportando una efectividad del 91 al 95%. Objetivo. Determinar la factibilidad y eficacia del uso del endoscopio frontal asistido por cap para la valoración completa del AV. De manera secundaria se valora su morfología, el tiempo para realizar la localización correcta del AV, el tiempo total del estudio y los eventos adversos asociados al uso del cap. Material y métodos. Estudio prospectivo de un solo brazo realizado de agosto del 2019 a febrero del 2020. Se incluyeron de manera consecutiva los pacientes con indicación de endoscopia alta electiva de acuerdo con lo recomendado por las guías nacionales e internacionales vigentes. Se excluyeron a los pacientes con neoplasia avanzada, anatomía modificada por antecedente quirúrgico, diagnóstico establecido o sospecha de estenosis u obstrucción del tracto digestivo alto por clínica, endoscopia o estudios de imagen previos. La exploración endoscópica se realizó en todos los casos por o bajo la supervisión de un endoscopista experto certificado con un gastroscopio de visión frontal en cuya punta se colocó un cap plástico transparente de 4 mm de longitud. Se registraron los datos demográficos, la indicación del procedimiento, el diagnóstico final, el tiempo total intraprocedimiento en segundos (s), el tiempo de búsqueda una vez alcanzada la segunda porción duodenal (s), la visualización completa (bordes y orificio), incompleta/no visualizada del AV y su morfología clasificada en 4 tipos de acuerdo con lo propuesto por Haraldson y cols., en caso de poliposis duodenal se utilizó la clasificación de Spigelman. Se registraron los eventos adversos inmediatos y en las siguientes 72 horas. El análisis estadístico se realizó con el programa SPSS v23. Las variables continuas se describieron con medias, medianas y desviación estándar y las cualitativas con frecuencias relativas. Resultados: Se incluyeron 90 pacientes en el periodo establecido, de los cuales 36 fueron hombres (40%) y 54 mujeres (60%), la edad promedio fue de 52.4 (DE ±16.2) años. Un 15.5% contaba con el antecedente de un síndrome hereditario para cáncer de colon. El AV fue visible por completo en 98.8% (89/90) pacientes, en un paciente no fue posible identificarla a pesar de varios intentos y la evaluación por un segundo endoscopista. Se clasificó el AV como tipo 1 (clásica) en 49.4%, tipo 2 (plana) en 16.8%, tipo 3 (protuberante) 11.2% y tipo 4 (anillada) 22.4%, no se identificaron cambios ampulares neoplásicos en algún paciente, una paciente con síndrome de Lynch se encontró con poliposis duodenal (Spigelman IV). El tiempo promedio de búsqueda fue de 37.7 s (DE ±31.6), con un tiempo total procedimiento de 487.4 s (DE ±206.2). No se reportaron eventos adversos asociados a la técnica. Conclusiones. El uso combinado del endoscopio frontal y cap permitió la visualización completa y caracterización del AV en el 98.8% de los casos, con un tiempo promedio de búsqueda de 37 segundos y un tiempo total de procedimiento de 8 minutos, sin reportarse eventos adversos mayores. Su uso facilita la evaluación rutinaria del AV sin aumentar el tiempo recomendado de procedimiento ni las complicaciones de este. La utilidad de esta práctica puede ser aún mayor en pacientes con un riesgo aumentado de patología a este nivel (p. ej., poliposis adenomatosa familiar).

The thymus is a primary lymphoid organ responsible for the maturation of T cells as well as the immunological central tolerance. It is in the antenatal period and infancy that it plays its major role. In clinical practice, T cell receptor excision circles (TRECs) are considered a direct and reliable measure of the thymic function. TRECs are a by-product of DNA formation in gene rearrangement of T cell receptors. They are stable and they do not duplicate during mitosis, representing the recent emigrant T cells from the thymus. Despite their importance, TRECs have been neglected by physicians and there is a lack of data regarding thymic function during infancy of healthy children. In order to evaluate thymic function in the first years of life, we propose measuring TRECs as a valuable tool. One hundred and three blood samples from children and adolescents between 3 months and 20 years of age were analyzed. The mean TRECs count was 136.77±96.7 copies of TRECs/μL of DNA. The individuals between 0 and 5 years of age had significantly higher TRECs values than those between 10 and 20 years of age. No significant difference was observed in TRECs values among age groups below 5 years of age. An inverse correlation between TRECs and age was found (r=0.3 P=0.003). These data highlight and validate the evidence of decreased thymus function with age, even during infancy. Awareness should be raised with this important albeit ignored organ.

RESUMO O objetivo desde estudo foi avaliar as repostas de estresse em dentão (Lutjanus jocu) durante o procedimento de transporte, através de respostas hematológicas e bioquímicas. Vinte e cinco exemplares selvagens de dentão foram utilizados no experimento (220 ± 68 g e 24.5 ± 2.5 cm de comprimento total). Foram realizadas coletas de sangue previamente ao transporte (controle), e os demais peixes foram acondicionados em duas caixas de transporte, uma com anestésico e outra sem anestésico. Imediatamente após o transporte e após 24 h, houve coleta de sangue para cada tratamento (com anestésico e sem anestésico). Os resultados bioquímicos e hematológicos apontam a ineficiência da benzocaína como mitigador do estresse durante o manuseio e transporte. Os parâmetros bioquímicos foram capazes de detectar o efeito do estresse durante o transporte, e após 24 h os níveis de glicose e alguns parâmetros hematológicos (hemoglobina, eritrócitos, leucócitos, neutrófilos e MCH) demonstraram uma tendência de retorno aos níveis do controle. Este trabalho é o primeiro a informar os níveis de resposta basal e de estresse para indicadores hematológicos e bioquímicos em dentão, representando uma base importante para o planejamento de futuras experiências com transporte e manejo dessa espécie.

ABSTRACT The objective of this study was to evaluate stress responses in dog snapper (Lutjanus jocu) during transport by evaluating their hematological and biochemical responses. Twenty-five wild dog snapper specimens were used in the experiment (220 ± 68 g and 24.5 ± 2.5 cm total length). Blood samples were collected prior to transport (control), and fish were placed in two transport boxes, one with anesthetic and one without anesthetic. Immediately after transport and after 24 h, blood was collected from the fish that underwent each treatment (with anesthetic and without anesthetic). Biochemical and hematological results demonstrated the inefficiency of benzocaine as a stress reliever during handling and transport. Biochemical parameters revealed the effects of stress during transport, and after 24 h, glucose levels and hematological parameters (hemoglobin, erythrocytes, leukocytes, neutrophils and MCH) showed a tendency to return to control levels. This study is the first to report stress response measurements of hematological and biochemical indicators in dog snapper, representing an important basis for the planning of future experiments involving the transport and handling of this fish species.

OBJECTIVES: To determine the possible association of serum 25-hydroxyvitamin D (25OHD) levels with disease activity and respiratory infection in granulomatosis with polyangiitis patients during two different periods: winter/spring and summer/autumn. METHODS: Thirty-two granulomatosis with polyangiitis patients were evaluated in the winter/spring, and the same patients (except 5) were evaluated in summer/autumn (n=27). The 25OHD levels were measured by radioimmunoassay. Disease activity was assessed by the Birmingham Vasculitis Activity Score Modified for Wegener’s Granulomatosis (BVAS/WG) and antineutrophil cytoplasmic antibody (ANCA) positivity. Respiratory infection was defined according the Centers for Disease Control and Prevention criteria. RESULTS: 25OHD levels were lower among patients in winter/spring than in summer/autumn (32.31±13.10 vs. 38.98±10.97 ng/mL, p=0.04). Seven patients met the criteria for respiratory infection: 5 in winter/spring and 2 in summer/autumn. Patients with respiratory infection presented lower 25OHD levels than those without infection (25.15±11.70 vs. 36.73±12.08 ng/mL, p=0.02). A higher frequency of low vitamin D levels (25OHD<20 ng/mL) was observed in patients with respiratory infection (37.5% vs. 7.8, p=0.04). Serum 25OHD levels were comparable between patients with (BVAS/WG≥1 plus positive ANCA) and without disease activity (BVAS/WG=0 plus negative ANCA) (35.40±11.48 vs. 35.34±13.13 ng/mL, p=0.98). CONCLUSIONS: Lower 25OHD levels were associated with respiratory infection but not disease activity in granulomatosis with polyangiitis patients. Our data suggest that hypovitaminosis D could be an important risk factor for respiratory infection in granulomatosis with polyangiitis patients.

ABSTRACT Objective This study identified the personal characteristics that affect Chilean health care providers’ readiness to adopt HIV Oral Rapid Testing (ORT) in Chile as a new clinical evidence-based practice (EBP). Methods Using a cross-sectional research design, the study sampled 150 nurses, midwives, and physicians employed at four clinics within the Pontifícia Universidad Católica de Chile Health Network in Santiago. Participants completed a self-administered survey asking about their demographic background, EBP attitudes and experience, personal beliefs related to HIV, the importance of HIV testing, and perceived self-comfort in performing a rapid HIV test. Results Of the participants, 90% believed that incorporating ORT would make a positive difference in their practice and said that they would be willing to adopt the technology for that reason. Nonetheless, the providers reported a mean “readiness to implement ORT” score of 15.1 out of a possible value of 20, suggesting only moderate self-perceived readiness to adopt the EBP. Education, beliefs about evidence-based practice, perceived comfort in performing ORT, and perceived importance of HIV testing explained 43.6% of the variance in readiness to adopt ORT. Conclusion The findings of this first ORT pre-implementation study in Chile can help guide policy makers and HIV stakeholders to prepare for and increase primary health care providers’ readiness to successfully adopt this evidence-based technology. Successful adoption of ORT could increase Chile’s capacity to reach HIV-vulnerable Chileans for testing and referral to care if infected, thus helping the country to reduce further transmission of the virus and its medical complications.

RESUMEN Objetivo En este estudio se determinaron las características personales que influyen sobre la disposición de los prestadores de atención de salud a adoptar la prueba oral rápida de detección del VIH en Chile como una nueva práctica clínica basada en la evidencia. Métodos Con un diseño de investigación transversal, en el estudio se realizó un muestreo de 150 enfermeros, parteras y médicos que trabajaban en cuatro centros de la Red de Salud de la Pontifícia Universidad Católica de Chile, en Santiago. Los participantes llenaron una encuesta autoadministrada en la que se preguntaba sus características demográficas, actitudes y experiencia en relación con la práctica clínica basada en la evidencia, creencias personales respecto del VIH, importancia de las pruebas de detección del VIH y sensación de comodidad respecto de realizar una prueba oral rápida de detección del VIH. Resultados El 90% de los participantes afirmó que creía que la incorporación de la prueba oral rápida significaría un cambio positivo en su práctica y que estaría dispuesto a adoptar la nueva tecnología por ese motivo. No obstante, de acuerdo con las respuestas, la "disposición a utilizar la prueba oral rápida" obtuvo una media de puntuación de 15,1 de un posible valor de 20, lo que sugiere solo una disposición autopercibida moderada a adoptar esta práctica basada en la evidencia. La educación, las creencias acerca de la práctica basada en la evidencia, la sensación de comodidad al realizar la prueba oral rápida y la percepción de la importancia de las pruebas de detección del VIH explican el 43,6% de la varianza de la disposición a adoptar la prueba oral rápida. Conclusiones Los resultados de este estudio previo a la introducción de la prueba oral rápida de detección del VIH en Chile pueden ser útiles para orientar a los responsables de las políticas y a las partes interesadas en cuanto a la preparación de los prestadores de atención primaria de la salud para que aumente su disposición a adoptar con éxito esta tecnología basada en la evidencia. La adopción satisfactoria de la prueba oral rápida podría aumentar la capacidad de Chile para llegar a los chilenos vulnerables a la infección por el VIH para que se realicen la prueba y sean derivados para recibir atención si tienen un resultado positivo y, de este modo, podría contribuir a detener la transmisión del virus y reducir las complicaciones médicas.

Introdução: A leucemia mieloide aguda (LMA) tem incidência variável nas diferentes regiões do Brasil. Objetivos: Determinar a frequência dos subtipos de LMA em crianças entre 0-17 anos, atendidas em Belém, Pará, no período de agosto de 2005 a maio de 2009. Casuística e métodos: Estudo retrospectivo com 278 pacientes com diagnóstico de leucemias agudas ou crônicas com base nos critérios clínicos, morfológicos (classificação franco-americana-britânica [FAB]/Organização Mundial da Saúde [OMS]) e de perfil imunofenotípico por citometria de fluxo para determinação da frequência de subtipos de LMA. Resultados: Foram encontrados 70 (25,18%) casos de LMA; destes, 37 (52,9%) eram crianças entre 0-17 anos (idade mediana de 7 anos e 8 meses). Não houve diferença estatística em relação ao gênero. Observou-se maior frequência de LMA dos subtipos M2 (18/37 - 48,6%) e M0/M1 (10/37 - 27%), principalmente na primeira década de vida (16/28 [57,1%] LMA M2 e 9/28 [32,1%] LMA M0/M1). Conclusão: Na população pediátrica, os tipos de LMA M2, M0/M1 e M3 foram, respectivamente, as mais frequentes.

Introduction: Acute myeloid leukemia (AML) has variable incidence in different regions of Brazil. Objective: To determine the frequency of AML subtypes in children aged 0-17 years attended at Belém, Pará, from August 2005 to May 2009. Patients and methods: A retrospective study was performed with 278 patients diagnosed with acute or chronic leukemia based on clinical and morphological criteria (French-American-British [FAB]/World Health Organization classification [WHO]) and immunophenotyping profile by flow cytometry, to determine the frequency of the subtypes in AML. Results: We found 70 (25.18%) cases of AML, 37 of these (52.9%) were children aged 0-17 years (median age of 7 years and 8 months). There was no statistical difference in relation to gender. We observed a higher frequency of AML subtype M2 (18/37 - 48.6%) and M0/M1 (10/37 - 27%), especially in the first decade of life (16/28 [57.1%] AML M2 and 9/28 [32.1%] AML M0/M1). Conclusion: In the pediatric population, the types of AML M2, M0/M1 and M3 were respectively the most frequent.