ABSTRACT Introduction: The prevalence of diabetes demands the identification of more efficient long-term methods to achieve good patient control. Clinical Case: This paper reports the progress of 4 patients diagnosed with previously poorly controlled type 2 diabetes and prediabetes with comorbidities that were attended in an outpatient clinic, they received orientation regarding lifestyle change and were instructed to increase consumption of dietary fiber and physical activity. Body composition and biochemical markers were followed, and changes were reported. Conclusion: In a 5-month period Patient 1 achieved criterion for controlled diabetes and was able to suspend oral hypoglycemic agents, reducing his body weight by 10%. Within an 8-week period Patient 2 experienced a 50% decrease of HOMA IR and was able to achieve criteria of controlled diabetes. Furthermore a 3 kg increase in lean body mass and a 4 kg body weight decrease were documented. These findings were accompanied by a 23% and 38% decrease in total cholesterol and triglycerides respectively. Patient 3 achieved criteria for type 2 diabetes remission within a 18 month time span (Inicial HBA1C 11.4% Final HBA1C 5.3). Patient 4 progressed to remission of prediabetes and a decrease of 5.9% in total body weight in a 3-month period.

RESUMEN Introducción: Las cifras de prevalencia de la diabetes nos obligan a identificar métodos más eficientes a largo plazo para lograr el buen control de los pacientes. Caso Clínico: En este trabajo se reporta el curso clínico de 4 pacientes con diagnóstico de diabetes mellitus tipo 2 y prediabetes quienes fueron atendidos en la consulta externa y recibieron asistencia no intensiva para cambio de comportamiento en salud, orientada a aumentar consumo de fibra alimentaria y a aumentar sus niveles de actividad física. Se reportan cambios en indicadores bioquímicos y antropométricos. Conclusión: El paciente 1 en 5 meses logró suspender hipoglucemiantes orales, disminuyendo un 10% de su peso corporal y logrando criterios de prediabetes (remisión parcial). El paciente 2 en un período de 8 semanas logró alcanzar criterios de diabetes controlada, disminuyendo en 50% el índice HOMA IR. Además, se documentó pérdida de 4 kg de masa grasa corporal con ganancia de 3 kg de masa magra. Lo anterior se acompañó de una disminución del 23% del colesterol total y 38% de triglicéridos. La paciente 3 alcanzó criterios de remisión de DM2 durante un seguimiento de 18 meses (HBA1C 11.4% inicial y 5.3% final). La paciente 4 evolucionó a remisión de prediabetes y disminución de 5.9% de peso corporal total en un periodo de 3 meses.

Resumen La enfermedad COVID-19 es una enfermedad infecciosa ocasionada por el virus SARS-CoV 2 cuya presentación clínica es muy heterogénea: puede ir desde personas asintomáticas hasta pacientes críticamente enfermos, con tormenta de citoquinas, distrés respiratorio agudo, disfunción de órganos e incluso la muerte. Las terapias actuales para su tratamiento van encaminadas a reducir el impacto de la cascada inflamatoria, y dentro de estas encontramos las tecnologías de hemoadsorción como la membrana CytoSorb. A continuación, presentamos un paciente masculino de 31 años de edad, quien consultó por sintomatología severa de COVID-19 y mostró una evidente mejoría clínica y bioquímica posterior al uso del dispositivo CytoSorb. Este es el único paciente documentado en Colombia al que se le haya realizado terapia de hemoperfusión con este dispositivo en conjunto con terapia de reemplazo renal intermitente prolongada y se hayan registrado desenlaces clínicos favorables.

Abstract The COVID-19 disease is an infectious disease caused by the SARS-CoV 2 virus whose clinical presentation is very heterogeneous: it can range from asymptomatic people to critically ill patients, with cytokine storm, acute respiratory distress, organ dysfunction and even death. Current therapies for its treatment are aimed at reducing the impact of the inflammatory cascade, and within these we find hemoadsorption technologies such as the CytoSorb membrane. Next, we present a 31-year-old male patient, who consulted due to severe symptoms of COVID-19 and showed an evident clinical and biochemical improvement after using the CytoSorb device. This is the only documented patient in Colombia who has undergone haemoperfusion therapy with this device in conjunction with prolonged intermittent renal replacement therapy and favorable clinical outcomes have been recorded.

Abstract: Introduction: The diagnosis of ACL injury is established with the physical examination that includes the Lachman maneuver and the pivot-shift test since it has the highest positive predictive value. Imaging tests such as MRI are still used for confirmation of the same; so the quantification of clinical maneuvers is sought. Material and methods: Prospective clinical study in which the maneuvers of pivot-shift and Lachman are quantified for later classification. Results: Of 36 patients, 64% found a range between 0 and 3 mm when subtracting the value of the affected knee from the value of the healthy knee. It was found that 28% of the patients recorded values of KT-1000 ranging between 4 and 6 mm of displacement. In 8% of the total patients, values of KT-1000 were found that exceeded 7 mm of displacement. The data obtained are normalized and classified into 3 degrees of injury: grade 1 with partial injury; grade 2 with complete anteromedial and partial injury in posterolateral bundle; grade 3 with complete injury of both bundles. Conclusion: A classification is proposed for the degrees of ACL injury with future application to a more personalized reconstruction.

Resumen: Introducción: El diagnóstico de lesión del ligamento cruzado anterior se establece con la exploración física que incluya la maniobra de Lachman y la prueba de pivot-shift, ya que cuenta con el mayor valor predictivo positivo. Aún se recurre a pruebas de gabinete como la RMN para la confirmación del mismo; por lo que se busca la cuantificación de maniobras clínicas. Material y métodos: Estudio clínico prospectivo en el que se cuantifican las maniobras de pivot-Shift y Lachman para su posterior clasificación. Resultados: De 36 pacientes, 64% se encontró un rango entre 0 y 3 mm al restar al valor de la rodilla sana el valor de la rodilla afectada. Se encontró que 28% de los pacientes, registraron valores de KT-1000, que oscilan entre los 4 y 6 mm de desplazamiento. En 8% del total de los pacientes se encontraron valores de KT-1000 que superaron los 7 mm de desplazamiento. Se normalizan los datos obtenidos y se clasifican en 3 grados de lesión: grado 1 con lesión parcial; grado 2 con lesión completa de haz anteromedial y parcial en haz posterolateral; grado 3 con lesión completa de ambos haces. Conclusiones: Se propone una clasificación para los grados de lesión del LCA con futura aplicación a una reconstrucción más personalizada.

ABSTRACT Objective: The intermediate-risk (IR) category includes tumors with different degrees of aggression. We aimed to identify the risk factors associated with unfavorable response to initial treatment and compare the effect of low/high radioactive iodine (RAI) therapy. Subjects and methods: A total of 614 IR patients were selected from a database, during 1972-2015. All patients underwent total thyroidectomy and RAI therapy and were reclassified after 12-18 months into the favorable (complete/indeterminate) response group and the unfavorable (biochemical/incomplete structural) response group. A total of 92 patients were assessed for late response (mean: 9.19 ± 5.73 years). Age, gender, tumor size, histology, multifocality, vascular invasion, extrathyroidal extension, presence and number of lymph node metastasis, and stimulated thyroglobulin at ablation (sTg) were evaluated. Results: Mean age at diagnosis was 41.47 ± 15.81 years, and 83.6% of the patients were female. Within 12-18 months after initial therapy, unfavorable response was detected in 41.2% of the patients and was associated, in multivariate analysis, with lymph node metastasis (p = 0.041; odds ratio [OR] = 1.9), presence of more than five metastatic lymph nodes (p = 0,017; OR = 2.6), and sTg > 10 ng/mL (p = 0.005; OR = 10.0). For patients with a longer follow-up, sTg >10 ng/mL was associated with unfavorable response (p = 0.002; OR = 6.8). A higher RAI dose was not related to better prognosis at the end of the follow-up. Conclusion: A sTg level of >10 ng/mL and lymph node metastasis were associated with an unfavorable response 12-18 months after initial treatment. A RAI dose below 150 mCi was proven sufficient to treat IR patients.

ABSTRACT Objective: To gain insight on the aspects that impact non-adherence to sickle cell disease treatment in a family with several sick members. Method: Single case study of four siblings with sickle cell disease monitored at a Referral Center in the state of Bahia, Brazil. Data was collected with the use of a questionnaire, open interviews and themed story-drawing. Results: The following themes emerged: Prejudice and discrimination promote self-isolation; Transportation problems prevent patients to get to health services; The health unit is a space that amplifies doubts and uncertainty; Hopelessness leads to treatment withdrawal. Conclusion: Social assistance, emotional, instrumental and educational support are essential to reduce the vulnerability of families experiencing sickle cell disease. The contents addressed in health facilities must include perspectives on positive experiences, encouraging hope and the construction of meanings during life in the process of chronic illness, in order to increase treatment adherence.

RESUMEN Objetivo: comprender los aspectos que influyen en la no adhesión al tratamiento de la enfermedad falciforme en una familia con varios miembros enfermos. Método: estudio de caso único que se realizó con cuatro hermanos con enfermedad falciforme asistidos en un Centro de Referencia en el estado de Bahia, Brasil. Se obtuvieron los datos por medio de cuestionario, entrevista abierta y dibujo historia con tema. Resultados: los temas que resultaron del proceso fueron: Prejuicio y discriminación promueven el auto aislamiento; Dificultad para desplazarse imposibilita ir al trabajo; La unidad de salud es un espacio que aumenta dudas e incertidumbres; Desesperanza lleva a desistimiento del tratamiento. Conclusión: ayuda social, apoyo emocional, instrumental y educacional son esenciales para reducir la vulnerabilidad de la familia que vive la enfermedad falciforme. Es necesario añadir perspectivas de experiencias positivas en los contenidos que se abordaron en las unidades de salud, fomentando esperanza y construcción de sentidos para la vida en el proceso crónico de la enfermedad, para aumentar la adhesión al tratamiento.

RESUMO Objetivo: compreender os aspectos que influenciam a não adesão ao tratamento da doença falciforme em uma família com vários membros adoecidos. Método: estudo de caso único realizado com quatro irmãos com doença falciforme acompanhados em um Centro de Referência no estado da Bahia, Brasil. Os dados foram colhidos por questionário, entrevista aberta e desenho-estória com tema. Resultados: os temas emergidos foram: Preconceito e discriminação promovem o autoisolamento; Dificuldade para deslocamento impede as idas ao serviço; A unidade de saúde é um espaço que amplia dúvidas e incertezas; Desesperança leva à desistência do tratamento. Conclusão: amparo social, suporte emocional, instrumental e educacional são essenciais para reduzir a vulnerabilidade da família que vivencia a doença falciforme. Conteúdos abordados nas unidades de saúde necessitam incluir perspectivas de experiências positivas, fomentando esperança e construção de sentidos para a vida no processo de adoecimento crônico, a fim de aumentar a adesão ao tratamento.

ABSTRACT Objective to analyze the relationship between the care received during normal delivery and the immediate postpartum and its effects on breastfeeding, from the experience of primiparous women. Method qualitative and descriptive study, approved by the Ethics Committee, held in a Normal Birth Center in Petrolina-Juazeiro Center, Brazil, in 2018. Seventeen primiparous women participated through semi-structured interviews, treated by thematic content analysis. Results breastfeeding occurred positively, as this locus is appropriate for this practice, favoring it naturally. Supporting and understanding are primordial and should go beyond assistance focused only on quick, technical and generalized information. Conclusion the wishes and particularities of each postpartum woman need to be respected and met, valuing the increment in health policies that emphasize humanized care for each woman. Therefore, health education needs to establish reflection, discussion and learning in this process that transcends the biological.

RESUMEN Objetivo analizar la relación entre la atención recibida durante el parto normal y el posparto inmediato y sus efectos sobre la lactancia materna, a partir de la experiencia de las mujeres primíparas. Método estudio cualitativo y descriptivo, aprobado por el Comité de Ética, realizado en un Centro de Parto Normal en el Centro Petrolina-Juazeiro, Brasil, en 2018. Diecisiete mujeres primíparas participaron a través de entrevistas semiestructuradas, tratadas por análisis de contenido temático. Resultados la lactancia materna ocurrió positivamente, ya que este lugar es apropiado para esta práctica, favoreciéndolo naturalmente. El apoyo y la comprensión son primordiales y deben ir más allá de la asistencia centrada solo en información rápida, técnica y generalizada. Conclusión los deseos y particularidades de cada mujer posparto deben ser respetados y cumplidos, valorando el incremento en las políticas de salud que enfatizan la atención humanizada para cada mujer. Por lo tanto, la educación sanitaria necesita establecer reflexión, discusión y aprendizaje en este proceso que trasciende lo biológico.

RESUMO Objetivo analisar, a partir da experiência de primíparas, a relação entre a assistência recebida durante o parto normal e o pós-parto imediato e seus reflexos na amamentação. Método qualitativo, descritivo, aprovado pelo Comitê de Ética, realizado em um Centro de Parto Normal, do polo Petrolina-Juazeiro, em 2018. Participaram 17 primíparas, através de entrevista semiestruturada, sendo os dados submetidos a análise temática de conteúdo. Resultados a amamentação ocorreu positivamente, pois esse lócus é apropriado para essa prática, favorecendo-a de maneira natural. O apoio e a compreensão são primordiais e devem superar uma assistência focada apenas em informações rápidas, técnicas e generalizadas. Conclusão os anseios e particularidades de cada puérpera precisam ser respeitados e atendidos, valorizando o investimento em políticas de saúde que enfatizem o cuidado humanizado para cada mulher. Logo, a educação em saúde precisa estabelecer reflexão, discussão e aprendizado nesse processo que transcende o biológico.

O estudo teve como objetivo analisar as propriedades psicométricas da escala de satisfação com a assistência hospitalar no parto, a partir dos dados da primeira entrevista de seguimento do estudo Nascer no Brasil. As 11 perguntas da escala foram endereçadas via telefone dentro de seis meses depois da alta hospitalar em uma amostra aleatória estratificada de 16.109 mulheres residentes nas cinco macrorregiões brasileiras. A amostra foi dividida aleatoriamente em duas metades. Na primeira metade, foi realizada análise fatorial exploratória (AFE) para identificar a estrutura fatorial da escala. O gráfico de declividade sugeriu que a escala era unidimensional. A AFE demonstrou bom ajuste do modelo unidimensional. As cargas fatoriais foram maiores de 0,50 para todos os itens, exceto para o tempo médio de viagem da residência da parturiente até a maternidade, que foi excluído da análise subsequente. A análise fatorial confirmatória realizada com os dez itens remanescentes na segunda metade da amostra mostrou bom ajuste, com cargas fatoriais > 0,50 e valores de p < 0,001. As associações entre a satisfação com a assistência hospitalar no parto e as variáveis externas de escolaridade materna (coeficiente padronizado = 0,073; p = 0,035), plano de saúde privado (CP = 0,183; p < 0,001) e ter acompanhante em algum momento durante a internação para o parto (CP = 0,193; p = 0,001) foram na direção esperada. Houve evidências de invariância configural e métrica de acordo com o tipo de hospital (privado vs. público) e tipo de parto (cesáreo vs. vaginal). Os resultados mostram que a escala de satisfação com a assistência hospitalar no parto no Brasil é um instrumento unidimensional constituído de dez itens.

The objective of this study was to analyze the psychometric properties of the hospital birth satisfaction scale with data from the first follow-up interview of the Birth in Brazil survey. The 11 questions of the scale were asked by telephone up to six months after discharge in a stratified random sample of 16,109 women residing in all five regions of the country. The sample was randomly divided into two halves. Exploratory factor analysis (EFA) was applied to the first half in order to identify the scale’s factorial structure. The scree plot suggested the scale to be one-dimensional. The EFA demonstrated a good fit of the one-dimensional model. Factor loadings were greater than 0.5 for all items, except for the mean time transpired between leaving the home and arriving at the maternity hospital, which was excluded from the next analysis. The confirmatory factor analysis applied to the sample’s second half with the remaining ten items had a good fit and the factor loadings were > 0.50 with p-values < 0.001. The associations between birth satisfaction and the external variables, the mother’s education level (standardized coefficient = 0.073; p = 0.035), private insurance (SC = 0.183; p < 0.001) and having a companion at some point during the hospitalization for labor (SC = 0.193; p = 0.001) were all as expected. There was evidence of configural and metric invariance according to type of hospital (private or public) and type of delivery (cesarean or vaginal). These results showed that the hospital birth satisfaction scale in Brazil is a one-dimensional instrument composed of ten items.

El objetivo de este estudio fue analizar las propiedades psicométricas de la escala de satisfacción sobre cuidados hospitalarios durante el parto, con datos procedentes de la primera entrevista de seguimiento, pertenecientes a la encuesta Nacer en Brasil. Se hicieron 11 preguntas de esta escala por teléfono hasta seis meses después del parto, mediante un muestreo aleatorio estratificado a 16.109 mujeres, residentes en las cinco regiones del país. Se dividió el mismo aleatoriamente en dos mitades. En la primera, se realizó un análisis factorial exploratorio (AFE) para identificar la estructura factorial de la escala. El gráfico de sedimentación indicó que la escala era unidimensional. El AFE demostró un buen ajuste al modelo unidimensional. Las cargas factoriales fueron superiores al 0,5 en todos los ítems, excepto en el tiempo empleado en ir de casa al hospital materno-infantil, que se excluyó del siguiente análisis. En la segunda mitad de la muestra se realizó un análisis factorial confirmatorio con los diez ítems restantes que tuvo un buen ajuste y cuyas cargas factoriales fueron > 0,50 con p-valor < 0,001. Las asociaciones entre la satisfacción con los cuidados hospitalarios recibidos para el parto, las variables externas, escolaridad maternal (coeficiente estandarizado = 0,073; p = 0,035), seguro privado (CE = 0,183; p < 0,001) y contar con pareja en algún momento durante la hospitalización para el parto (CE = 0,193; p = 0,001), estuvieron en línea con lo esperado. Hubo evidencia de invarianza métrica y de configuración, según el tipo de hospital (privado o público), y tipo de parto (cesárea o vaginal). Estos resultados mostraron que la escala de satisfacción sobre cuidados hospitalarios durante el parto en Brasil es un instrumento unidimensional compuesto de diez ítems.

O estudo teve como objetivo analisar as propriedades psicométricas da escala de satisfação com a assistência hospitalar no parto, a partir dos dados da primeira entrevista de seguimento do estudo Nascer no Brasil. As 11 perguntas da escala foram endereçadas via telefone dentro de seis meses depois da alta hospitalar em uma amostra aleatória estratificada de 16.109 mulheres residentes nas cinco macrorregiões brasileiras. A amostra foi dividida aleatoriamente em duas metades. Na primeira metade, foi realizada análise fatorial exploratória (AFE) para identificar a estrutura fatorial da escala. O gráfico de declividade sugeriu que a escala era unidimensional. A AFE demonstrou bom ajuste do modelo unidimensional. As cargas fatoriais foram maiores de 0,50 para todos os itens, exceto para o tempo médio de viagem da residência da parturiente até a maternidade, que foi excluído da análise subsequente. A análise fatorial confirmatória realizada com os dez itens remanescentes na segunda metade da amostra mostrou bom ajuste, com cargas fatoriais > 0,50 e valores de p < 0,001. As associações entre a satisfação com a assistência hospitalar no parto e as variáveis externas de escolaridade materna (coeficiente padronizado = 0,073; p = 0,035), plano de saúde privado (CP = 0,183; p < 0,001) e ter acompanhante em algum momento durante a internação para o parto (CP = 0,193; p = 0,001) foram na direção esperada. Houve evidências de invariância configural e métrica de acordo com o tipo de hospital (privado vs. público) e tipo de parto (cesáreo vs. vaginal). Os resultados mostram que a escala de satisfação com a assistência hospitalar no parto no Brasil é um instrumento unidimensional constituído de dez itens.

The objective of this study was to analyze the psychometric properties of the hospital birth satisfaction scale with data from the first follow-up interview of the Birth in Brazil survey. The 11 questions of the scale were asked by telephone up to six months after discharge in a stratified random sample of 16,109 women residing in all five regions of the country. The sample was randomly divided into two halves. Exploratory factor analysis (EFA) was applied to the first half in order to identify the scale’s factorial structure. The scree plot suggested the scale to be one-dimensional. The EFA demonstrated a good fit of the one-dimensional model. Factor loadings were greater than 0.5 for all items, except for the mean time transpired between leaving the home and arriving at the maternity hospital, which was excluded from the next analysis. The confirmatory factor analysis applied to the sample’s second half with the remaining ten items had a good fit and the factor loadings were > 0.50 with p-values < 0.001. The associations between birth satisfaction and the external variables, the mother’s education level (standardized coefficient = 0.073; p = 0.035), private insurance (SC = 0.183; p < 0.001) and having a companion at some point during the hospitalization for labor (SC = 0.193; p = 0.001) were all as expected. There was evidence of configural and metric invariance according to type of hospital (private or public) and type of delivery (cesarean or vaginal). These results showed that the hospital birth satisfaction scale in Brazil is a one-dimensional instrument composed of ten items.

El objetivo de este estudio fue analizar las propiedades psicométricas de la escala de satisfacción sobre cuidados hospitalarios durante el parto, con datos procedentes de la primera entrevista de seguimiento, pertenecientes a la encuesta Nacer en Brasil. Se hicieron 11 preguntas de esta escala por teléfono hasta seis meses después del parto, mediante un muestreo aleatorio estratificado a 16.109 mujeres, residentes en las cinco regiones del país. Se dividió el mismo aleatoriamente en dos mitades. En la primera, se realizó un análisis factorial exploratorio (AFE) para identificar la estructura factorial de la escala. El gráfico de sedimentación indicó que la escala era unidimensional. El AFE demostró un buen ajuste al modelo unidimensional. Las cargas factoriales fueron superiores al 0,5 en todos los ítems, excepto en el tiempo empleado en ir de casa al hospital materno-infantil, que se excluyó del siguiente análisis. En la segunda mitad de la muestra se realizó un análisis factorial confirmatorio con los diez ítems restantes que tuvo un buen ajuste y cuyas cargas factoriales fueron > 0,50 con p-valor < 0,001. Las asociaciones entre la satisfacción con los cuidados hospitalarios recibidos para el parto, las variables externas, escolaridad maternal (coeficiente estandarizado = 0,073; p = 0,035), seguro privado (CE = 0,183; p < 0,001) y contar con pareja en algún momento durante la hospitalización para el parto (CE = 0,193; p = 0,001), estuvieron en línea con lo esperado. Hubo evidencia de invarianza métrica y de configuración, según el tipo de hospital (privado o público), y tipo de parto (cesárea o vaginal). Estos resultados mostraron que la escala de satisfacción sobre cuidados hospitalarios durante el parto en Brasil es un instrumento unidimensional compuesto de diez ítems.

Abstract INTRODUCTION Infrared imaging (IR) is a noninvasive technique that quantifies body surface temperature, producing a digital color image. IR has been used to study diseases in which skin temperature can reflect the presence of inflammation. METHODS This was an observational pilot study of eight patients envenomed by snakes, spiders, and scorpions. All patients were examined using a thermal camera. RESULTS In all cases, we obtained infrared images that corroborated clinical findings indicating localized effects of venom, specifically inflammation. CONCLUSIONS IR has potential for use as a research, diagnostic, and monitoring tool for localized effects of animal venoms.

The perception and evaluation of the landscape by its inhabitants expressed their degrees of territorial identity and community knowledge regarding its fragility and vital need for preservation. Being a natural resource with growing demand, studies on ethical and aesthetic territorial preferences, provide fundamental knowledge for sustainable environmental management planning. Using an ethnomethodologically perspective, this research aims to analyze the perceptions and appreciation of the landscape in Maullín, Chile. The main finding is the desire to keep the landscape in suspended animation, this means slowing down the transformation of the landscape, and preserve its characteristic condition of tranquility. The rurbanization and the imminent transformation of these territories seem to go in an opposite direction and put the territorial identity and aspirations of the community in an effort that requires mediation. In this context, considering the approach of urban-rural continuum where urban and rural territory constitutes a single large system can be crucial to dinamize regional development.

La percepción del paisaje por parte de los habitantes es expresión de identidad territorial, saberes comunitarios y la necesidad vital de preservación relativa a una conciencia de su fragilidad. Al ser un recurso natural con demanda creciente, el estudio de las preferencias territoriales éticas y estéticas, aporta conocimiento fundamental para una gestión ambiental sustentable. Utilizando la perspectiva etnometodológica, esta investigación analiza las percepciones y la valoración del paisaje en Maullín, Chile. El principal hallazgo, es el deseo de mantener el paisaje en animación suspendida, esto significa ralentizar la transformación del paisaje, y preservar su característica condición de tranquilidad. La rururbanización y la inminente transformación de estos territorios parece ir en una dirección opuesta y pone la identidad territorial y las aspiraciones de la comunidad en una tensión que requiere de una mediación. En este contexto, la consideración del enfoque de continuum urbano-rural donde el territorio urbano y rural constituye un solo gran sistema puede ser determinante para dinamizar el desarrollo territorial.

This work aimed to determine and compare the apparent activation energy, involved in thermal decomposition of CTMA+ from the pores of Ti-MCM-41 synthesized by two different source of silica in order to evaluate their influence in the template removal. The molecular sieves Ti-MCM-41 were synthesized using rice husk ash (RHA), as alternative low cost source of silica, and commercial silica gel, obtaining two mesoporous material by hydrothermal synthesis of gel molar composition of: 1.0 CTMABr: 4.0 SiO2: X TiO2: 1.0 Na2O: 200.0 H2O. The samples were characterized to compare its properties by X-ray diffraction, IR spectroscopy, BET method and thermogravimetric analysis (TGA). The kinetic study using the model proposed by Flynn and Wall to determine the apparent activation energy for CTMA+ removal was performed using TGA data. The thermogravimetric analysis results of the material obtained from RHA confirmed intrinsic properties of mesoporous MCM-41 as the synthesized with commercial silica gel, such as high specific area, mesoporous range of pore diameter and hexagonal structure. According to the kinetics results the RHA showed similar chemical interaction to commercial silica gel, which makes it an interesting material, since it is a low cost source of natural silica from agricultural waste.

INTRODUÇÃO: Estudantes de Odontologia podem ser particularmente vulneráveis ao risco de adquirir infecções por acidentes de trabalho.OBJETIVO: Investigar os sentimentos vivenciados entre acadêmicos de Odontologia que sofreram acidentes de trabalho por exposição a material biológico contaminado.MATERIAL E MÉTODO: Entrevistas foram realizadas por meio de um roteiro de perguntas abertas e gravadas. Após a transcrição dos depoimentos, realizou-se a análise qualitativa com auxílio do programa QUALIQUANTISOFT® e obteve-se o Discurso do Sujeito Coletivo (DSC).RESULTADO: Os sentimentos vivenciados pela maioria dos acadêmicos estavam relacionados ao medo de contágio. A maioria dos acidentes ocorreu durante o manuseio do instrumental perfurocortante. Os entrevistados atribuíram a ocorrência dos acidentes principalmente à falta de atenção, descuido durante o manuseio do perfurocortante e à falta de uso de EPIs. Quanto às condutas após a injúria, a primeira medida mais adotada foi "lavar o local da perfuração". Outros entrevistados relataram "continuar o atendimento". A maior queixa foi "medo de ter se contaminado", ou "ter que ir ao hospital para realizar teste rápido para HIV". Como aprendizado, os acidentados afirmaram que passaram a ter mais cuidado ao manusear perfurocortantes. Os acadêmicos relataram que todas as formas de contato com material biológico contaminado devem ser notificadas. Porém foram negligentes ao relatarem sua própria injúria.CONCLUSÃO: As medidas educativas de prevenção e segurança no trabalho precisam ser reestruturadas, uma vez que o conhecimento e o medo de contágio entre os estudantes de odontologia nem sempre foram suficientes para a completa adesão aos protocolos de atendimento e de notificação.

INTRODUCTION: Dental students may be a particularly vulnerable group exposed to the risk of acquiring infections through occupational injuries.OBJECTIVE: To investigate the perceptions with regard to their occupational exposure to potentially infectious biologic materials.MATERIAL AND METHOD: Interviews were conducted by means of a script with open questions. The speeches were recorded, transcribed and qualitative analysis was performed with the aid of QUALIQUANTISOFT® software. The Collective Subject Discourse (CSD) was obtained.RESULT: The feeling most frequently experienced was related to the fear of contagion. Most accidents occurred during the handling of sharp dental instruments. Respondents attributed the occurrence of accidents especially the lack of attention, carelessness while handling sharp instruments, and lack of use of Personal Protective Equipment. As regards the measures taken right after the exposure, they "washed the local area". Other respondents reported they "continued the dental treatment". They complained mostly about the fear of having been infected, and because they had to leave the faculty to take blood exams for HIV screening. As part of the learning experience the injured reported they paid more attention when handling sharp instruments. The students informed that any type of injury due to contact with contaminated material must be notified. However, they were neglectful about reporting their own injury.CONCLUSION: Education strategies for preventive measures related to occupational exposure must be restructured, because the knowledge and the fear of contagion among dental students were not always sufficient for a complete adherence to treatment protocols and notification.

Objetivo: Determinar la interrelación entre el índice triglicéridos/colesterol de la lipoproteína de alta densidad (TG/cHDL) y los índices HOMA homeostasis model assessment (HOMA IR) y QUICKI (Quantitative Insulin Sensitivity Index) y antropometría fetal, en mujeres embarazadas sanas. Métodos: Este estudio transversal evaluó 91 mujeres embarazadas sanas en edad de 18-41 años; de acuerdo a la edad gestacional se categorizaron en 3 grupos: primer trimestre (TI, n= 29); segundo trimestre (TII, n=32) y tercer trimestre (TIII, n =30). Se realizó una prueba de tolerancia a la glucosa oral (75g). Se cuantificaron glucosa, insulina, triglicéridos (TG), colesterol total (CT) y colesterol de alta densidad (cHDL). Se calculó el colesterol no-HDL y los índices TG/cHDL, HOMA IR y QUICKI. Se registró el peso del recién nacido y la altura uterina (AU); por ultrasonido se determinaron la circunferencia abdominal fetal (CAF) y el peso estimado fetal (PEF). Resultados: La concentración plasmática de TG, colesterol, cLDL, colesterol no-HDL, e índices TG/cHDL, HOMA IR y QUICKI fueron significativamente más altos en el segundo y tercer trimestre respecto al primer trimestre. En el total de la muestra, tanto el índice TG/cHDL como el colesterol no-HDL mostraron una correlación positiva con el IMC pre-gestacional (r = 0.30, p<0,01; r = 0,26. P<0,05 respectivamente), CAF (r=0,38, p<0,05; r = 0,50, p<0,01 respectivamente), PEF (r = 0,39, p<0,01; r = 0,50, p<0,01 respectivamente) y AU (r= 0,485, p<0,001). Conclusión: Se confirma la dislipidemia del embarazo y se demuestra que el aumento en el índice TG/cHDL y del colesterol no-HDL está relacionado con el peso pre gestacional y la antropometría fetal.

Objective: to determine the relationship between triglycerides/high density lipoprotein cholesterol (TG/HDLc) index and indexes HOMAIR (Homeostasis Model assessment) y QUICKI (Quantitative Insulin Sensitivity Check Index) and fetal anthropometrics in healthy pregnant women. Methods: This cross-sectional study evaluated 91 healthy pregnant women aged 16-41 yr, categorized by gestational age: first trimester (TI, n = 29); second trimester (TII, n = 32); third trimester (TIII, n = 30). Oral glucose tolerance test (75g) was performed. Plasma concentrations of glucose, insulin, triglyceride (TG), total cholesterol (TC) and HDLc were measured. Low density lipoprotein cholesterol (LDLc), no-HDLc, TG/HDLc index, HOMA IR and QUICKI were calculated. Fetal abdominal circumference (FAC) and estimated fetal body weight (EFBW) were evaluated by abdominal ultrasound; uterine height (UH), blood pressure and birth weight were registered. Results: Mean plasma TG, total cholesterol, LDLc, no-HDLc and TG/HDLc, HOMA IR and QUICKI indexes were significantly higher in TII and TIII compared to TI. In all women analysis, both TG/HDLc and no-HDLc showed a significant correlation with pregestational body mass index (BMI) (r = 0.30, p<0,01; r = 0,26, p<0,05 respectively), FAC (r= 0,38, p<0,05; r = 0,50,, p<0,01 respectively), EFBW (r = 0,39, p<0,01; r = 0,50, p<0,05 respectively) and UH (r= 0,485, p<0,001). Conclusions: our results confirm dislipidemia in pregnancy; the increased values of TG/HDLc and no-HDLc, are related with pre-gestational BMI and fetal anthropometrics.

The search for factors shaping leaf-litter ant communities has received particular attention due to the essential role of these insects in many ecological processes. Here, we aimed to investigate how the number of leaves and leaf morphotypes affect the litter-ant species density at forest edge and interior in an Atlantic Forest remnant in the state of Alagoas, Brazil. This study was developed based on 28 litter plots (1m² each), 14 in the forest interior and 14 in the forest edge. As we early expected, ant species density increased with increasing both the number of leaves and the number of leaf morphotypes, but this result was clearly influenced by plot location. Contrasting with the forest interior, ant species density did not increase as the number of leaves increased in the forest edge. Possibly, factors such as plant species richness, vegetation structure and environmental conditions affect ant species density as well as promote a patchy distribution of species in ant communities along the edge-to-interior gradient. Our findings suggest that edge-affected forests present more simplified ant communities, with different factors shaping its structure. We encourage future studies to include leaf litter heterogeneity as one of the explanatory variables investigated.

Although seed dispersal by ants might reduce seed predation near the parent plants, predation on discarded seeds clustered on nest refuse piles may reduce any initial benefit provided by seed removal. Here we examine the fate of Croton sonderianus seeds that were discarded by Pheidole fallax Mayr ants on their nest refuses in caatinga vegetation of northeast Brazil. We collected all seeds discarded in refuse piles of 20 nests and within a radius of 50 cm from their borders, and examined them for evidence of predation. A total of 3,017 seeds were recorded either located in the P. fallax refuse piles (89.1%) or nest vicinity (10.9%). Predation was three fold higher in nest vicinity as compared to refuse piles. By removing seeds from beneath parent plants and relocating then to refuse piles, P. fallax is possibly providing double protection services for C. sonderianus seeds. Our findings represent the first evidence for predator-avoidance as benefit for plants resulting from ant seed-dispersal in the neotropics.