Abstract Linked to extractive practices, territorial dispossession can be traced back to the colonisation of Abya Yala. From a decolonial commitment, this article complicates notions of dispossession and extractivism as merely emerging from war in Colombia and focuses on their presence in Campesinas territories. Based on the conceptualisations of the coloniality of power and coloniality of gender, I narrate how territorial dispossession and extractivism are felt in women’s ‘body-lands’ through foreign tourism/conservation development and new export crops in two rural veredas in the Colombian Andes and in the Sierra Nevada de Santa Marta where I conducted participatory visual projects in 2016. From a relational understanding of place, I also demonstrate the ways that the rural population is resisting and negotiating within these processes. Ultimately, I make a call for feminist scholars to politically commit to the dismantling of the coloniality of gender, and to the resistances to territorial dispossession and extractivism (epistemic and economic) that rural women are leading in place in the Global South.

Resumen El despojo territorial vinculado a las prácticas extractivas puede rastrearse a la colonización de Abya Yala. Partiendo de un compromiso decolonial, en este artículo problematizo las nociones de despojo y extractivismo como una consecuencia meramente de la guerra en Colombia y narro su presencia en los territorios de las mujeres campesinas. Con base en los conceptos de la colonialidad del poder y la colonialidad de género, en este artículo relato cómo se siente el despojo territorial y el extractivismo en el «cuerpo-tierra» de las mujeres a través de emprendimientos turísticos y conservacionistas extranjeros y de nuevos cultivos de exportación en dos veredas rurales en los Andes colombianos y en la Sierra Nevada de Santa Marta, en donde en el 2016 realicé proyectos participativos con métodos visuales. Desde una noción relacional del lugar, también demuestro las formas cómo la población rural resiste y negocia estos procesos. Para terminar, hago un llamado dentro de los feminismos académicos, hacía un compromiso político con desmantelar la colonialidad del género y con las resistencias frente al despojo territorial y el extractivismo (epistémico y económico) lideradas por las mujeres rurales en el Sur global.

Resumo O despojamento territorial associado às práticas extrativas pode-se rastrear na colonização de Abya Yala. Partindo de um compromisso decolonial, neste artigo problematizo as noções de despojamento e extrativismo como uma consequência puramente da guerra na Colômbia e narro sua presença nos territórios das mulheres camponesas. Com base nos conceitos da colonialidade do poder e da colonialidade de gênero, neste artigo relato como se sente o despojamento territorial e o extractivismo no “corpo-terra” das mulheres por meio de empreendimentos turísticos e conservacionistas estrangeiros e de novos cultivos de exportação em duas freguesias rurais nos Andes colombianos e na Serra Nevada de Santa Marta, onde realizei em 2016 projetos participativos com métodos visuais. Desde uma noção relacional do lugar, demonstro também as formas em que a população rural resiste e negocia esses processos. Para terminar, faço um apelo dentro dos feminismos acadêmicos para um compromisso político encaminhado ao desmantelamento da colonialidade do gênero e às resistências frente ao despojamento territorial e o extrativismo (epistêmico e econômico) lideradas pelas mulheres rurais no Sul global.

Abstract Background: Aerobic metabolism generates reactive oxygen species that may cause critical harm to the cell. The aim of this study is the characterization of the stress responses in the model aromatic degrading bacterium Paraburkholderia xenovorans LB400 to the oxidizing agents paraquat and H 2 O2. Methods: Antioxidant genes were identified by bioinformatic methods in the genome of P. xenovorans LB400, and the phylogeny of its OxyR and SoxR transcriptional regulators were studied. Functionality of the transcriptional regulators from strain LB400 was assessed by complementation with LB400 SoxR of null mutant P. aeruginosa ΔsoxR, and the construction of P. xenovorans pIZ oxyR that overexpresses OxyR. The effects of oxidizing agents on P. xenovorans were studied measuring bacterial susceptibility, survival and ROS formation after exposure to paraquat and H 2 O2. The effects of these oxidants on gene expression (qRT PCR) and the proteome (LC–MS/MS) were quantified. Results: P. xenovorans LB400 possesses a wide repertoire of genes for the antioxidant defense including the oxyR , ahpC , ahpF , kat , trxB , dpsA and gorA genes, whose orthologous genes are regulated by the transcriptional regulator OxyR in E. coli . The LB400 genome also harbors the soxR, fumC , acnA , sodB , fpr and fldX genes, whose orthologous genes are regulated by the transcriptional regulator SoxR in E. coli . The functionality of the LB400 soxR gene was confirmed by complementation of null mutant P. aeruginosa Δ soxR . Growth, susceptibility, and ROS formation assays revealed that LB400 cells were more susceptible to paraquat than H2O2. Transcriptional analyses indicated the upregulation of the oxyR , ahpC1 , katE and ohrB genes in LB400 cells after exposure to H2O2, whereas the oxyR , fumC , ahpC1 , sodB1 and ohrB genes were induced in presence of paraquat. Proteome analysis revealed that paraquat induced the oxidative stress response proteins AhpCF and DpsA, the universal stress protein UspA and the RNA chaperone CspA. Both oxidizing agents induced the Ohr protein, which is involved in organic peroxide resistance. Notably, the overexpression of the LB400 oxyR gene in P. xenovorans significantly decreased the ROS formation and the susceptibility to paraquat, suggesting a broad OxyR regulated antioxidant response. Conclusions: This study showed that P. xenovorans LB400 possess a broad range oxidative stress response, which explain the high resistance of this strain to the oxidizing compounds paraquat and H2O2.

ABSTRACT Tramadol is a synthetic opioid whose mechanism of action is twofold: it stimulates the μ, δ and κ receptors; and it also reduces the reuptake of norepinephrine and serotonin. Its adverse effects include nausea, vomiting, sweating, dizziness, sedation, and hypertension. During its historical use it has been contraindicated in children due to the harmful effects it can have on them; Accidental poisoning by this type of opioid is very common in emergency services and in pediatric patients it can even lead to death, which is why the objective of this work is to analyze tramadol poisoning presented in a 4-month-old patient of age, at the Alfredo Noboa Montenegro Hospital, to establish timely diagnostic and therapeutic measures. As a result, the case of a 4-month-old patient who had been accidentally administered tramadol was presented; she was admitted with a clinical picture of drowsiness, accompanied by apparent respiratory distress, hypotension, miosis, tachycardia, and low-grade fever. The tests performed showed leukopenia, elevated Aspartate Transaminase, and respiratory acidosis. The patient presented all the characteristic signs of the opioid syndrome, the treatment consisted of gastric lavage, oxygen therapy and administration of Naloxone.

RESUMEN El tramadol es un opioide sintético cuyo mecanismo de acción es doble: estimula los receptores μ, δ y κ; y también reduce la recaptación de noradrenalina y serotonina. Entre sus efectos adversos se encuentran náuseas, vómitos, sudoración, mareos, sedación, e hipotensión. Durante su uso histórico ha sido contraindicado en niños debido a los efectos nocivos que puede tener sobre éstos; las intoxicaciones accidentales por este tipo de opiáceos son muy frecuente en servicios de urgencias y en pacientes pediátricos ésta puede llegar incluso a la muerte, es por eso que el objetivo de este trabajo es analizar la intoxicación por tramadol presentada en un paciente de 4 meses de edad, en el Hospital Alfredo Noboa Montenegro, para establecer medidas diagnósticas y terapéuticas oportunas. Como resultados se presentó el caso de una paciente de 4 meses de edad a la cual se le había administrado tramadol accidentalmente; ingresó con un cuadro clínico de somnolencia, acompañado por aparente dificultad respiratoria, hipotensión, miosis, taquicardia, y febrícula. En los exámenes realizados se evidenció leucopenia, elevación de la Aspartato Transaminasa, y acidosis respiratoria. La paciente presentó todos los signos característicos del síndrome opiáceo, el tratamiento consistió en lavado gástrico, oxigenoterapia y administración de Naloxona.

ABSTRACT Tramadol is a synthetic opioid whose mechanism of action is twofold: it stimulates the μ, δ and κ receptors; and it also reduces the reuptake of norepinephrine and serotonin. Its adverse effects include nausea, vomiting, sweating, dizziness, sedation, and hypertension. During its historical use it has been contraindicated in children due to the harmful effects it can have on them; Accidental poisoning by this type of opioid is very common in emergency services and in pediatric patients it can even lead to death, which is why the objective of this work is to analyze tramadol poisoning presented in a 4-month-old patient of age, at the Alfredo Noboa Montenegro Hospital, to establish timely diagnostic and therapeutic measures. As a result, the case of a 4-month-old patient who had been accidentally administered tramadol was presented; she was admitted with a clinical picture of drowsiness, accompanied by apparent respiratory distress, hypotension, miosis, tachycardia, and low-grade fever. The tests performed showed leukopenia, elevated Aspartate Transaminase, and respiratory acidosis. The patient presented all the characteristic signs of the opioid syndrome, the treatment consisted of gastric lavage, oxygen therapy and administration of Naloxone. Another purpose of the work is to bring students closer to real situations of daily medical practice.

RESUMEN El tramadol es un opioide sintético cuyo mecanismo de acción es doble: estimula los receptores μ, δ y κ; y también reduce la recaptación de noradrenalina y serotonina. Entre sus efectos adversos se encuentran náuseas, vómitos, sudoración, mareos, sedación, e hipertensión. Durante su uso histórico ha sido contraindicado en niños debido a los efectos nocivos que puede tener sobre éstos; las intoxicaciones accidentales por este tipo de opiáceos son muy frecuente en los servicios de urgencias y en pacientes pediátricos ésta puede llegar incluso a la muerte, es por eso que el objetivo de este trabajo es analizar la intoxicación por tramadol presentada en un paciente de 4 meses de edad, en el Hospital Alfredo Noboa Montenegro, para establecer medidas diagnósticas y terapéuticas oportunas. Como resultados se presentó el caso de una paciente de 4 meses de edad a la cual se le había administrado tramadol accidentalmente; ingresó con un cuadro clínico de somnolencia, acompañado por aparente dificultad respiratoria, hipotensión, miosis, taquicardia, y febrícula. En los exámenes realizados se evidenció leucopenia, elevación de la Aspartato Transaminasa, y acidosis respiratoria. La paciente presentó todos los signos característicos del síndrome opiáceo, el tratamiento consistió en lavado gástrico, oxigenoterapia y administración de Naloxona. Otro de los propósitos del trabajo es lograr acercar a los estudiantes a las situaciones reales de la práctica médica cotidiana.

Resumen La enfermedad renal crónica es una condición con alta morbilidad, mortalidad y costos elevados para los sistemas de salud que afecta todos los grupos de población con impacto significativo en su calidad de vida. Su clasificación ha sido modificada con el tiempo y aún no existe un consenso universal para diferenciar un cambio fisiológico del aclaramiento renal versus patológico. A continuación, se expone la importancia de replantear la definición y clasificación en la población general de acuerdo a la edad, incluyendo a niños y adultos. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.2080).

Abstract Chronic kidney disease is a condition with high morbidity, mortality and healthcare costs which affects all population groups, having a significant impact on their quality of life. Its classification has been modified over time and there is still no universal consensus to differentiate a physiological change in kidney clearance from a pathological change. Below, we will discuss the importance of reconsidering the definition and classification in the general population according to age, including children and adults. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.2080).

Resumo Fundamentos: Os escores GRACE, TIMI e HEART foram validados para avaliar desfechos clínicos desfavoráveis no contexto da suspeita de síndrome coronária aguda sem elevação do segmento ST (SCASSST). No entanto, a associação entre os escores clínicos e a complexidade angiográfica ainda não está bem estabelecida. Objetivos: Descrever as características clínicas de pacientes com SCASSST admitidos em internação hospitalar para estratificação invasiva, a fim de avaliar a associação entre os escores clínicos (TIMI, GRACE e HEART) e a complexidade angiográfica, através do escore SYNTAX. Métodos: Estudo observacional incluindo pacientes com diagnóstico de SCA e admitidos no Instituto Dante Pazzanese de Cardiologia entre os meses de julho de 2018 e fevereiro de 2019. A associação entre os escores foi avaliada por correlações bivariadas e a sua acurácia pela área sob a curva (ASC) ROC. A significância estatística foi estabelecida em 5% (p < 0,05). Resultados: Um total de 138 pacientes foram diagnosticados com SCASSST. As medianas do GRACE, TIMI e HEART foram de 97, 3 e 5, respectivamente. A mediana do SYNTAX foi de 8. Foram observadas correlações positivas do SYNTAX com o HEART (ρ = 0,29; p < 0,01) e o GRACE (ρ = 0,18; p < 0,03). Em contrapartida, a correlação com o TIMI não atingiu significância estatística (ρ = 0,15; p = 0,08). O HEART foi o escore com a maior ASC para predizer SYNTAX > 32 [HEART = 0,81] (IC 95% 0,7-0,91). HEART > 4 apresentou sensibilidade de 100%, com especificidade de 50%, e GRACE > 139 sensibilidade de 55% e especificidade de 97% para SYNTAX alto. Conclusão: Os escores clínicos de risco apresentam associação modesta ao escore SYNTAX. O uso combinado do HEART e do GRACE, entretanto, oferece acurácia favorável para a detecção de complexidade angiográfica.

Abstract Background: GRACE, TIMI and HEART scores have been previously validated to predict serious untoward events among patients with non-ST elevation acute coronary syndrome (Non-ST ACS). However, the ability of these scores to discriminate the angiographic complexity of coronary artery disease has not been clearly established. Objectives: We sought to evaluate the correlation between clinical scores (TIMI, GRACE and HEART) and the anatomical complexity assessed by SYNTAX score, among non-ST ACS patients undergoing cinecoronariography. Methods: Transversal cohort encompassing patients with diagnosis of Non-ST ACS referred to invasive stratification in our single center, between July 2018 and February 2019. Association between the scores was established by the Pearson's linear correlation test while the accuracy of the clinical scores versus SYNTAX score was determined with the ROC curve. Results: A total of 138 patients were enrolled. Median GRACE, TIMI and HEART scores were 97, 3 and 5, respectively, whereas the median SYNTAX was 8. There was a positive correlation between the SYNTAX and the HEART (ρ =0.29; p<0.01) and GRACE (ρ =0.18; p<0.01) scores, but the correlation with TIMI reached no statistical significance (ρ =0.15; p=0.08). The HEART score was also the one with the highest area under the curve to predict a SYNTAX ≥32 [HEART = 0.81 (IC95% 0.7-0.91). HEART> 4 presented 100% sensitivity, with 50% specificity; and GRACE> 139 showed 55% sensitivity and 97% specificity for high SYNTAX. Conclusion: The clinical scores presented a positive, although modest, association with the SYNTAX score. The combined use of HEART and GRACE offers good accuracy for detecting angiographic complexity.

Abstract This study characterized the dermatoglyphic profile and somatotype of 12 university athletes, belonging to the athletics team of the Santo Tomás University, Bogotá Campus. The dermatoglyphic characteristics were identified, according to the Cummins & Midlo (1942) protocol, to obtain the types of designs of digital impressions (A = 0.3; ± 0.7; L = 6.9 ± 2.6 and W = 2.8 ± 2.9) and, in turn, the sum of the total number of lines (SCTL = 170.6 ± 95.1), and finally, the delta index (D10 = 12.4 ± 3.3). For the somatotype, the Heath & Carter protocol (1990) was taken into account. Endomorphy in (2.5 ± 0.9); Mesomorphy (5.3 ± 0.9) and Ectomorphy (3.1 ± 1). The dermatoglyphic profile of each of the athletes evidenced the presence of the ectomorphic somatotype over the others. This determined the importance of this technique as a genetic tool in the optimization of sports strategies and orientations. The need to continue with these reseach processes are fundamental for the academy, sports processes, athletes, and Colombian university professional sport.

Resumen El presente estudio caracterizó el perfil dermatoglífico y somatotipo de 12 atletas universitarios, pertenecientes a la selección de atletismo de la universidad Santo Tomás, sede Bogotá. Se identificaron las características dermatoglíficas, acorde al protocolo de Cummins & Midlo (1942) para obtener los tipos de diseños de las impresiones digitales (A= 0,3; ± 0,7; L= 6,9 ± 2,6 y W= 2,8 ± 2,9) y a su vez la suma de la cantidad total de líneas ( SCTL= 170,6 ± 95,1) y por último, el índice delta (D10= 12,4 ± 3,3). Para el somatotipo, se tuvo en cuenta el protocolo de Heath & Carter (1990). Endomorfia en (2,5 ± 0,9); Mesomorfia (5,3 ± 0,9) y Ectomorfia (3,1 ± 1). El perfil dermatoglífico de cada uno de los deportistas, evidenció la presencia del somatotipo ectomorfo sobre los otros. Esto determinó la importancia de esta técnica como herramienta genética en la optimización de estrategias y orientaciones deportivas. La necesidad de seguir con estos procesos investigativos es fundamental para la academia, los procesos deportivos, los deportistas y al deporte Colombiano, universitario y profesional.

Resumen El objetivo primario de este estudio fue analizar el poder explicativo de las variables identidad social, escolaridad y edad, directamente sobre la autoestima y los efectos indirectos de las tres primeras, a través de la autoestima, sobre la esperanza. Se realizó el estudio en una muestra no probabilística de 657 hombres y mujeres, con edad promedio de 39.75 años (DE = 16.96). Se usó modelamiento de ecuaciones estructurales para analizar los efectos, tanto directos como indirectos, de las variables independientes sobre las dependientes. Se encuentra que el modelo tiene una varianza explicada del 37 % (R2 ≥ 26 % tamaño del efecto grande) en esperanza, con buenos indicadores de bondad de ajuste: χ2/gl = 2.618, GFI = .997, AFGI = .978, CFI = .995, NFI = .992, NNFI = .995, RMSEA = .048 (IC 90 %, .001, .100) y SRMR = .017. Se concluye que la identidad social, junto con algunas variables contextuales de naturaleza personal (e.g., edad y escolaridad) son importantes para explicar los niveles de autoestima y esperanza.

Abstract Social identity theory implies knowledge, affect, and the value given to the individual as a consequence of his/her membership in a given social group. The primary objective of this study was to analyze the direct explanatory power of social identity, schooling, and age on self-esteem, as well as the indirect effects of those variables (through the mediating variable self-esteem) on hope. A non-probabilistic sample composed of 657 persons from southern Nuevo Leon was recruited (mean age = 39.75 years; SD = 16.96). The sample comprised 483 women (73.5 %) and 174 men (26.5 %), with a mean age of 39.54 years (SD = 15.97) and 40.35 years (SD = 19.5), respectively. After comparing the mean age, no statistically significant differences were found between men and women, t(655) = -.540, p = .589, d = .03, 95 % CI (-3.75, 2.13). The age of the participants composing the total sample ranged from 14 to 90 years. The sample’s number of years of schooling ranged from 0 to 15 (M = 6.87 years, SD = 2.91). To measure independent and dependent variables, in this study were used the following instruments: (a) Trait Hope Scale (Snyder et al., 1991), (b) Rosenberg Self-Esteem Scale (Rosenberg, 1965), and (c) Social Identity Scale (García & Corral-Verdugo, 2010). The proposed theoretical model was tested through structural equation modeling, and its parameters were estimated through Maximum Likelihood estimation method. Eight goodness-of-fit indices were used to validate the model: relative chi-square (χ2/df), Jöreskog and Sörbom’s Goodness-of-Fit Index (GFI) and Adjusted Goodness-of-Fit Index (AGFI), Bentler’s Comparative Fit Index (CFI), Bentler and Bonett's Normed Fit Index (NFI), Non-Normed Fit Index (NNFI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR). The criteria to establish that the proposed model showed an excellent goodness of fit were: χ2/df ≤ 2; GFI, CFI, NFI, and NNFI ≥ .95, AGFI ≥ .90; RMSEA and SRMR ≤ .05 (Byrne, 2016). Before performing structural equation modeling, multivariate normality was tested. Since the value of Mardia’s coefficient was lower than 70 (Mardia’s coefficient = 9.76), the assumption of multivariate normality was held. After performing descriptive statistics, the Pearson’s product-moment correlation coefficients between the diverse variables included in this study were calculated. It is worth noting that almost all the variables showed statistically significant correlations at a p-value < .01. The highest correlation coefficients were found between self-esteem and hope (r = .558, p < .01, 95 % CI .494, .618), and between social identity and hope (r = .440, p < .01, 95 % CI .368, .511), whereas the lowest correlation coefficients were found between social identity and schooling (r = -.110, p < .01, 95 % CI -.188, .032), and between self-esteem and age (r = -.123, p < .01, 95 %, CI-203, -.033). The only non-statistically significant correlation was found between hope and age (r = -.015, p > .01, 95% CI -.087, .058). Since none of the correlations was higher than .80, the assumption of no multicollinearity was held and, consequently, the goodness-of-fit indices can be considered as reliable (Kline, 2015). Structural equation modeling was used to analyze the effects, both direct and indirect, of the independent variables upon the dependent variables. With regard to hope, the model yields an explained variance of 37 % (d ≥ 26 % = large effect size) and shows well goodness-of-fit indices: χ2 / df = 2.618, GFI = .997, AFGI = .978, CFI = .995, NNFI = .995, NFI = .992, RMSEA = .048 (90 % CI, .001, .100), and SRMR = .017. It is concluded that social identity, together with some contextual variables of a personal nature (for instance, age and schooling) is probably very important to explain the levels of self-esteem and hope.

Objective: To evaluate the safety and efficacy of a 5 mg sublingual dose of zolpidem, compared to a 10 mg oral dose, at bedtime and “as needed” following middle-of-the-night awakenings. Methods: Participants were randomized into an oral group (oral zolpidem 10 mg and sublingual placebo at bedtime and “as-needed”) and a sublingual group (oral placebo and sublingual zolpidem 5 mg at bedtime and “as-needed”). Participants underwent medical evaluation, polysomnography, the psychomotor vigilance test, and completed questionnaires. Results: Of 85 patients, 67 met the criteria for insomnia (48±10 years; 79% women) and were randomized. Of these, 46 completed 92±5 days of treatment. Mild-to-moderate adverse events were reported by 25% of the participants, including headache, sleepiness, and dizziness. Both treatments decreased middle-of-the-night awakenings by an average of -3.1±2.3 days/week and increased total sleep time by 1.5 hours. Changes in sleep quality and insomnia severity scores were also favorable and comparable between groups: variation depended on continuation of treatment. Regarding PSG findings, sleep latency decreased more in the sublingual group than the oral group (-14±42 vs. 10±29 min; p = 0.03). The psychomotor vigilance test showed minor residual effects 30 minutes after awakening, which reversed after 2 hours. Conclusions: The safety and efficacy of both zolpidem formulations are comparable. The sublingual 5 mg dose induced sleep more rapidly. Clinical trial registration: NCT01896336

Abstract Background: Adults with atopic dermatitis have had a persistent form in childhood or with an onset after the age of eighteen years. Late-onset atopic dermatitis may present with clinical heterogeneity and it often lacks the classic pattern of flexural dermatitis. Clinical case: A 26-year-old man with allergic rhinitis, with late-onset eczema, and an atypical nummular pattern on his trunk and limbs. The skin biopsy showed eczema-like lesions which, together with the patient’s personal history and laboratory abnormalities, allowed the diagnosis of the adult’s late-onset atopic dermatitis. Treatment with methotrexate was started and there was no response, which is why phototherapy was prescribed due to the dependence on systemic corticosteroids. Conclusion: Atypical presentations of atopic dermatitis in adults represent a clinical challenge. A personal history of atopy, sensitivity to aeroallergens, eosinophilia, and a cutaneous biopsy are essential to establish the diagnosis.

Resumen Antecedentes: Los adultos con dermatitis atópica tienen una forma persistente en la infancia o con inicio después de los 18 años. La dermatitis atópica de inicio tardío puede cursar con heterogeneidad clínica y muchas veces sin el patrón clásico de dermatitis flexural. Caso clínico: Hombre de 26 años, portador de rinitis alérgica, con eccema de inicio tardío y patrón numular atípico en tronco y miembros. Con la biopsia cutánea se observaron lesiones tipo eccema, lo que asociado con la historia personal y alteraciones en los exámenes de laboratorio, permitió el diagnóstico de dermatitis atópica del adulto de inicio tardío. Se prescribió metotrexato, sin respuesta, por lo que se inició fototerapia debido a la dependencia de corticoides sistémicos. Conclusión: Las presentaciones atípicas de la dermatitis atópica en el adulto representan un desafío clínico. La historia personal de atopia, la sensibilidad a aeroalérgenos, la eosinofilia y la biopsia cutánea son esenciales para establecer el diagnóstico.

Objective: To estimate the functional relationships between burnout and job satisfaction in health professionals of two hospitals in Peru. Materials and methods: A quantitative, observational, correlational and cross-sectional research was carried out. Out of a study population of 620 health professionals, 177 (physicians, odontologists, pharmacists, psychologists, nurses, obstetricians, medical technologists, nutritionists and social workers) were interviewed. The Maslach Burnout Inventory (MBI) and the Job Satisfaction Scale (SL-SPC) were used as measuring instruments, showing adequate psychometric properties. Results: The high-burnout prevalence rate (TP) was 33.3 %. Using a structural equation analysis, a significant (AGFI = 0.946) and negative (structural coefficient = -0.62) relationship was found between burnout and job satisfaction in health professionals. The predominant dimension of burnout was depersonalization (37 % = 0.72 / (0.56 + 0.72 + 0.65)) and the predominant factor of job satisfaction was profits (35 % = 0.99 / (0.67 + 0.99 + 0.48 + 0.66)). Conclusions: There is a significant and negative functional relationship between burnout syndrome and job satisfaction. Burnout is a predictor of job satisfaction. No significant differences were found when comparing the high-burnout prevalence rate regarding the sociodemographic and work-related variables

Objetivo: Determinar las relaciones funcionales entre el burnout y la satisfacción laboral de los profesionales de la salud de dos hospitales del Perú. Materiales y métodos: Estudio cuantitativo, observacional, correlacional de corte transversal. De una población de 620 profesionales de la salud se encuestaron a 177 profesionales (médicos, odontólogos, químicos farmacéuticos, psicólogos, enfermeros, obstetras, tecnólogos médicos, nutricionistas y trabajadores sociales). Los instrumentos de medición utilizados fueron el inventario de burnout de Maslach (MBI) y la escala de satisfacción laboral (SL-SPC), cuyas propiedades psicométricas fueron adecuadas. Resultados: La tasa de prevalencia (TP) para el burnout alto fue 33,3 %. Mediante el análisis de ecuaciones estructurales, se encontró que existe relación significativa (AGFI = 0,946) y negativa (coeficiente estructural = -0,62) entre el burnout y la satisfacción laboral en los profesionales de la salud. La dimensión predominante del burnout fue la despersonalización (37 %=0,72/ (0,56+0,72+0,65); y el factor predominante de la satisfacción laboral fueron los beneficios económicos (35 %=0,99/ (0,67+0,99+0,48+0,66). Conclusiones: Existe relación funcional significativa y negativa entre el síndrome de burnout y la satisfacción laboral; el burnout es predictor de la satisfacción laboral. No se han encontrado diferencias significativas al comparar la tasa de prevalencia del burnout alto, según las variables sociodemográficas y laborales

Resumen El aislamiento y selección de linfocitos T puros de cultivo primario de bazo de ratón puede obtenerse de manera rápida y fácil utilizando kits comerciales con microesferas magnéticas para capturar y purificar las células. A pesar de estas ventajas, la carga financiera que puede representar para el presupuesto de un laboratorio, la adquisición constante de estos kits justifica la evaluación de otras opciones de menor costo. Por ello, se comparó el porcentaje de recuperación celular, viabilidad y pureza de tres métodos de aislamiento y purificación de linfocitos T; dos de bajo costo y fácil implementación (aislamiento con amortiguador de amonio-cloruro-potasio (ACK)-adhesión celular y aislamiento con Ficoll), y un kit comercial de selección negativa con microesferas magnéticas. Con el método de amortiguador ACK-adhesión celular se obtuvo un porcentaje de recuperación y purificación de linfocitos T viables comparable al obtenido con el kit. Aunque este método requiere más tiempo, dado que las células deben ser incubadas durante toda la noche, es de fácil implementación y tiene una eficiencia comparable al kit, así como un menor costo. Este método puede ser tomado en cuenta para utilizar en experimentos que puedan trabajar con linfocitos activados.

Abstract The isolation and selection of pure T lymphocytes from spleen primary culture can be obtained easily and quickly using commercial kits that use magnetics microbeads to capture and purify the cells. Despite these advantages, the financial burden that the constant acquisition of these kits can impose to a laboratory budget makes it important to evaluate other options. We compared the cell recovery, viability and purity percentage of three isolation and purification methods; two of them of low cost and easy implementation (cell adhesion of cultures treated with Ammonium-Chloride-Potassium (ACK) buffer, and Ficoll), and a commercial with kit of negative selection with magnetics microbeads. With the ACK-cell adhesion method, we found a recovery and purity percentage of lymphocytes T comparable to the one obtained with the kit. Although this method requires more time, as cells must be incubated overnight, it is easily implemented and has a comparable efficiency to the kit, as well as a lower cost. This method can be taken into account for experiments that can use activated cells.

RESUMEN En la población militar, el consumo de tabaco está asociado con la edad, el estrés, la separación familiar y la presión de grupo. Aplicamos una encuesta a 29 cadetes colombianos cuya edad promedio era de 22 años. Asocian fumar con autoconfianza, insomnio, mejor digestión y placer; así como con cáncer, tos, irritación de garganta, enfermedades pulmonares y daño cerebral. Sin embargo, el 42% ha fumado y consume de 1 a 5 cigarrillos al día.

ABSTRACT “Beliefs in health in a young military population, in relation to smoking”. In the military population, tobacco consumption is associated with age, stress, family separation and team pressure. We applied a survey to 29 Colombian cadets whose average age was 22 years. They associate smoking with self-confidence, insomnia, better digestion and pleasure; as well as with cancer, coughing, throat irritation, lung diseases and brain damage. Nevertheles, 42% have smoked, and consume 1 to 5 cigarettes daily.

RESUMO Objetivou-se com este estudo avaliar as características produtivas e nutricionais da pastagem de Brachiaria brizantha cv. BRS Piatã em sistemas integrados com diferentes densidades de árvores. Considerando como trama os sistemas: planta integrada-pecuária com fileiras de árvores (eucalipto) espaçadas a 14 m e 357 árvores ha-1 (ICLF-14m), ICLF com fileiras de árvores espaçadas a 22 m e 227 árvores ha-1 (ICLF-22m) e o cultivo-pecuária integrado (ICL) com cinco árvores nativas restantes ha-1; período do ano como subparcelas e pontos de amostragem como sub-sub-parcelas (A, B C, D e E) dispostas perpendicularmente às vielas das árvores. Foi avaliada a produção de massa seca de lâmina e folha, relação folha: caule, cobertura do solo, intercepção fotossintética de radiação, altura do dossel, proteína bruta (PB), fibra de detergente neutro (FDN), digestibilidade in vitro de matéria orgânica (DIVMO) da lâmina da folha e haste associado com a bainha da folha. Houve uma diferença significativa (P <0,05) para todas as variáveis devido ao mês dentro dos sistemas integrados. Principalmente em janeiro e março, mostrando a redução da massa seca da forragem e das folhas devido a uma maior densidade de árvores. O sistema com maior densidade de árvores mostrou a menor cobertura de solo e a altura do dossel. Os pontos de amostragem A e E em ICLF-22m apresentaram menor produção de massa seca e lâmina foliar e cobertura do solo. O sistema com maior densidade de árvores apresentou menor valor de FDN da lâmina da folha e maior índice de PB. A DIVMO da lâmina da folha foi maior nos sistemas ICLF. Dos parâmetros avaliados os melhores resultados foram para o sistema ICLF-22m.

SUMMARY This study aimed to evaluate the pasture productive and nutritional characteristics of Brachiaria brizantha cv. BRS Piatã in integrated systems with different densities of trees. Considering as plot the systems: integrated crop-livestock-forest with rows of trees (eucalyptus) spaced at 14 m and 357 trees ha-1 (ICLF-14m), ICLF with rows of trees spaced at 22 m and 227 trees ha-1 (ICLF-22m) and the integrated crop-livestock (ICL) with five remaining native trees ha-1; period of the year as subplots, and sampling points as subsubplots (A, B C, D, and E) arranged perpendicular to trees alleys. It was evaluated the production of forage and leaf blade dry mass, leaf:stem ratio, soil coverage, radiation photosynthetically active interception, canopy height, crude protein (CP), neutral detergent fiber (NDF), in vitro digestibility of organic matter (IVDOM) of the leaf blade, and stem associated with the leaf sheath. There was a significant difference (P<0.05) for all variables due to the month within the integrated systems. Mainly in January and March, showing the forage and leaf blade dry mass reduction due to a higher trees density. System with higher trees density showed the lowest soil coverage and canopy height sampling points A and E in ICLF-22m showed lower forage and leaf blade dry mass production and soil coverage. The system with higher trees density showed lower value of NDF of the leaf blade, and higher CP contents. The IVDOM of the leaf blade was higher in ICLF systems. For the evaluated parameters the best results were for the ICLF-22m.

Pituitary stalk interruption syndrome (PSIS) is characterised by the combination of an interrupted or thin pituitary stalk, absent or ectopic posterior pituitary, and anterior pituitary hypoplasia. It is manifested as isolated (IGHD) or combined pituitary hormone deficiencies (CPHD) of variable degrees and timing of onset, with a wide spectrum of clinical phenotypes. PSIS may be an isolated morphological abnormality or be part of a syndrome. A retrospective evaluation is presented of clinical signs and symptoms present at early life stages, as well as an analysis of their relationship with hormone laboratory tests and diagnostic imaging in children with congenital hypopituitarism (CHP), and PSIS. This study was performed in a single centre on a sample of 42 children out of a total of 80 CHP patients, with a chronological age range between 5 days and 9.5 years from a database analysed over a period of 26 years. The study included 26/42 (62%) with CPHD and 16/42 (38%) with IGHD. The analysis of perinatal variables showed a natural delivery in 52% (11/21) of CPHD vs 13% (2/15) of IGHD. Four patients, two with CPHD and two IGHD had breech and transverse presentation respectively. All of them were resolved by caesarean section. The perinatal histories showed hypoglycaemia (61% CPHD vs 19% IGHD, P=.0105), jaundice (38% CPHDvs25% IGHD), micropenis (75%CPHD), hypoglycaemic seizures (75% CPHD), and cholestasis (19% CPHD). The mean CA of consulting for CPHD patients was 2.1 years, 30% in neonatal period and 70% before 2 years. The mean chronical age (CA) was 3.6 years in IGHD patients, with 44% of them less than 2 years. MRI showed that 81% of CPHD patients had absence of pituitary stalk vs 19% with thin pituitary stalk (P=.0001); Patients with IGHD presented 56% absence of pituitary stalk vs 44% with thin pituitary stalk (P=.5067). All (100%) of the patients diagnosed in the neonatal stage had absent pituitary stalk. The characterisation of GH deficient patients by presence and type of hypothalamic-pituitary imaging abnormality provides valuable information as a predictor of phenotypic severity, treatment response, and the potential to develop additional hormonal deficiencies. We conclude that demonstrating PSIS in children with HPC provides valuable information as a predictor of phenotypic severity, presence of MPHD, and response to treatment. The low frequency of potentially dysfunctional positional obstetric history, as part of the pathophysiological mechanisms responsible for PSIS, would indicate the need to analyse the importance of possible genetic and epigenetic factors involved. Early diagnosis of HPC should be suspected in the presence of clinical signs and symptoms, such as hypoglycaemia, cholestasis, micropenis, and associated facial midline defects. MRI should be part of complementary studies in patients with this diagnostic suspicion, especially at an early age. Late recognition of this entity may increase morbidity and mortality with potential permanent deleterious effects.

El síndrome de interrupción del tallo pituitario (PSIS) se caracteriza por la demostración neurorradiológica de un tallo pituitario ausente, interrumpido o hipoplásico, adenohipófisis aplásica/hipoplásica o neurohipófisis ectópica. Este síndrome se ha relacionado con formas severas de hipopituitarismo congénito (HPC), asociado a múltiples deficiencias de hormonas pituitarias (MPHD). Evaluamos a pacientes con HPC y PSIS, analizando los signos y los síntomas neonatales al diagnóstico, relacionándolos con las deficiencias hormonales pituitarias y signos neurorradiológicos presentes. Estudiamos retrospectivamente a 80 pacientes asistidos en el Hospital de Niños de Córdoba, con diagnóstico de HPC, de los cuales 42 (52%) presentaron PSIS; 22 mujeres y 20 varones, EC: 5 días-9,5 años. El 62% presentó MPHD y el 38% insuficiencia somatotrófica aislada (IGHD). El análisis de las variables perinatales demostró antecedentes de parto natural en el 52% (11/21) de las MPHD vs. 13% (2/15) de las IGHD. Cuatro pacientes, 2 con MPHD y 2 con IGHD presentaban antecedentes obstétricos consistentes en presentación podálica y transversa respectivamente, todos ellos resueltos mediante operación cesárea. Los signos y los síntomas perinatales fueron hipo- glucemia: 61% en MPHD vs. 19% en IGHD, p: 0,0105; ictericia: 38% en MPHD vs. 25% en IGHD; micropene: 77% en MPHD y colestasis: 19% en MPHD. Convulsiones neonatales se presentaron en el 75% de los niños con MPHD e hipoglucemia. EC media de consulta: 2,1 años en MPHD (30% en el período neonatal, 70% antes de 2 años) y 3,6 años en IGHD (44% en menores de 2 años). Los pacientes con MPHD presentaban: tallo no visible 81% (n: 21/26) vs. tallo hipoplásico: 19% (n: 5/26), p: 0,0001; en IGHD 56% (n: 9/16) vs. 44% (n: 7/16), p: 0,5067, respectivamente. El 100% de los neonatos con HPC tenían tallo pituitario ausente. Concluimos que la demostración de PSIS en niños con HPC proporciona información valiosa como predictor de la severidad fenotípica, la presencia de MPHD y de la respuesta al tratamiento. La baja frecuencia de antecedentes obstétricos posicionales potencialmente distócicos, como parte de los mecanismos fisiopatogénicos responsables de PSIS, indicaría la necesidad de analizar la importancia de posibles factores genéticos y epigenéticos involucrados. El diagnóstico precoz de HPC debe sospecharse en presencia de signos y síntomas clínicos, tales como hipoglucemia, colestasis, micropene y defectos asociados en la línea media facial. La resonancia magnética cerebral debe formar parte de los estudios complementarios en pacientes con esta presunción diagnóstica, especialmente a edades tempranas. El reconocimiento tardío de esta entidad puede aumentar la morbilidad y la mortalidad con efectos potenciales deletéreos y permanentes.