Pesquisa | SciELO

SUMMARY Friedreich Ataxia (FA) is an autosomal recessive neurodegenerative disease with multisystemic involvement. This update of epidemiological, pathophysiological, and clinico-therapeutic aspects of FA, includes a systematic review of cases in Latin America. The estimated FA prevalence in Caucasian populations is between 2 to 5 cases per 100 000. In Latin America, 1481 cases have been published in 35 articles from six different countries. Caused by an abnormally repeated expansion of GAA trinucleotide inside the FXN gene, FA’s etiopathogenesis is associated with reduced levels of the frataxin protein, which disturb the energy metabolism and result in mitochondrial iron accumulation. The classic phenotype usually shows symptoms before the age of 25, although there are others with a later onset. The main symptoms of AF are progressive ataxia, sensory disturbances, areflexia, dysarthria, and oculomotor alterations, in addition to cardiac, endocrine, and musculoskeletal compromise. Diagnostic workup requires a detailed neurological examination, neuroconduction studies, neuroimaging, and biochemical tests. The definitive diagnosis is provided by genetic testing showing biallelic variants within the FXN gene. The management is multidisciplinary, aimed at reducing symptoms, preventing complications, and providing an appropriate genetic counseling. Recently, the first pharmacological treatment for AF has been approved, with several others in clinical assessment trials.

RESUMEN La Ataxia de Friedreich (AF) es una enfermedad neurodegenerativa autosómica recesiva con compromiso multisistémico. En esta revisión, se actualizan aspectos epidemiológicos, fisiopatológicos y clínico-terapéuticos y se conduce una búsqueda sistemática de casos de AF reportados en Latinoamérica. La prevalencia de AF en poblaciones caucásicas es estimada entre 2 y 5 casos por 100 000 habitantes. En Latinoamérica se han publicado 35 estudios que reúnen 1481 casos en 6 países. Causada por la expansión anormal de repeticiones GAA en el gen FXN, la etiopatogenia está asociada a una reducción en los niveles de la proteína frataxina (que altera el metabolismo energético) y el acúmulo de hierro mitocondrial. El fenotipo clásico de AF suele comenzar antes de los 25 años, aunque hay otros de inicio tardío y retención de reflejos. La sintomatología se caracteriza por ataxia progresiva, alteración sensitiva, arreflexia, disartria, y alteraciones oculomotoras, además de compromiso cardiaco, endocrino y musculoesquelético. El diagnóstico requiere evaluación neurológica detallada, estudios neurofisiológicos, neuroimágenes y pruebas bioquímicas pero el enfoque determinante es el estudio genético que demuestre variantes genéticas bialélicas en el gen FXN. El manejo es multidisciplinario, orientado a aminorar los síntomas, prevenir complicaciones y brindar asesoramiento genético apropiado. Recientemente se ha aprobado el primer tratamiento farmacológico para AF con varios más en fases de experimentación.

https://doi.org/10.20453/rnp.v86i1.4466

An Evaluation of the Effects of D-Cycloserine on Operant Learning and Response Recovery
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San Martín, Consuelo

; Alfaro, Felipe

; Bustamante, Javier

; Laborda, Mario A.

; Mallea, Jorge

; Míguez, Gonzalo

Psykhe (Santiago)

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2022, Volume 31 Nº especial Páginas 1 - 15

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: D-cycloserine (DCS) is a drug that has generated great interest for its association with improvements in both learning and memory. Few studies have evaluated the effect of DCS on learning, extinction, and response recovery in operant conditioning. The present study aimed to evaluate, over three experiments with rats, the effect of DCS on the spontaneous recovery of a simple operant, and on the resurgence of operant behavior. DCS was expected to strengthen the extinction, and that a decrease in spontaneous recovery and resurgence would also be observed. The results showed a faster extinction in the groups that received DCS during the extinction; however, no differences were observed in the recovery of the response. Based on the present results, it is not possible to conclude that DCS is a supportive drug for learning processes such as exposure therapy.

Resumen: La D-cicloserina (DCS) es un fármaco que ha producido gran interés por su asociación con mejoras tanto en el aprendizaje como en la memoria. Pocos trabajos han evaluado el efecto de la DCS en el aprendizaje, extinción y recuperación de respuesta en el condicionamiento operante. El presente estudio tuvo como objetivo evaluar, a lo largo de tres experimentos con ratas, el efecto de la DCS en la recuperación espontanea de una operante simple y en la resurgencia de la conducta operante. Se esperaba que la DCS fortaleciera la extinción y que se observara además una disminución de la recuperación espontánea y resurgencia. Los resultados mostraron una extinción más rápida en los grupos que recibieron DCS durante la extinción; sin embargo, no se observaron diferencias en la recuperación de la respuesta. En base a los presentes resultados, no es posible concluir que la DCS sea un fármaco de apoyo para procesos de aprendizaje tales como la terapia de exposición.

https://doi.org/10.7764/psykhe.2021.33531

The Effect of Extinction Cues on Response Recovery: A Meta-Analysis
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Alfaro, Felipe

; San Martín, Consuelo

; Laborda, Mario A.

; Míguez, Gonzalo

Psykhe (Santiago)

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2022, Volume 31 Nº especial Páginas 1 - 12

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: A cue presented during Pavlovian extinction may help the recovery of the extinction memory, for which is called an extinction cue (EC). Pavlovian conditioning has been useful as a model of different behavior disorders and extinction as a model for their treatment. Extinguished responses may be recovered under different circumstances, akin to a relapse. Hence, it is important to strengthen extinction memory retrieval. There is contradictory evidence of the effectiveness of ECs to this end. There is also little information about the magnitude of response recovery prevention when using ECs. The magnitude of the ECs effect on response recovery was analyzed by a meta-analysis that considered possible sources of variance in the EC effect. The included studies were gathered mainly through scientific database search engines. Selection criteria included experiments that used a Pavlovian extinction and recovery procedure with an EC test. Effect size was calculated for each relevant experiment. Thirty-seven studies were included. These analyses showed that there is a robust effect of an extinction cue in reducing response recovery, d = 0.71, 95% CI [0.58, 0.85]. This effect is higher when a spontaneous recovery procedure is used and when the experiment is done with non-human animals. Interestingly, the type of control group did not affect the effect size. These results are robust under different statistical analyses, although a publication bias was detected.

Resumen: Una clave presentada durante la extinción pavloviana puede contribuir luego a la recuperación de la memoria de extinción, por lo que esta se conoce como clave de extinción (CE). El condicionamiento pavloviano ha sido utilizado como modelo para la comprensión etiológica de diversos trastornos; asimismo, la extinción ha sido utilizada con un modelo para el tratamiento de otros. Las conductas extinguidas pueden recuperarse debido a diferentes motivos, similar a una recaída. Por ello, es importante fortalecer la recuperación de la memoria de extinción. Existe evidencia contradictoria respecto a la eficacia y prevención de las recaídas al utilizar claves de extinción. Se llevó a cabo un meta-análisis justamente sobre la magnitud y las posibles fuentes de varianza del efecto de las CE en la recuperación de respuestas. Los estudios incluidos se recopilaron principalmente a través de buscadores en bases de datos científicas. Los criterios de selección incluyeron experimentos que utilizaron un procedimiento de extinción y recuperación pavloviana con una prueba de CE. Se calculó un tamaño del efecto para cada experimento utilizado. Se incluyeron 37 estudios. El análisis de dichos tamaños del efecto mostró que existe un efecto robusto de las claves de extinción en la reducción de la recuperación de respuestas, d = 0,71, IC del 95% [0,58, 0,85]. Este efecto es mayor cuando se utiliza un procedimiento de recuperación espontánea y cuando el experimento se realiza en animales no humanos. Curiosamente, el tipo de control utilizado no afectó el tamaño del efecto. Estos resultados son robustos bajo diferentes análisis estadísticos, aunque se detectó un sesgo de publicación.

https://doi.org/10.7764/psykhe.2021.38063

In vitro screening for growth inhibition activity on cancer cell lines of northern Chile highlands shrubs
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González, Luis Bustos

; Simirgiotis, Mario Juan

; Parra, Claudio

; Alfaro-Lira, Susana

; Soto, Emilio

; Echiburú-Chau, Carlos

Ciência Rural

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2021, Volume 51 Nº 1 elocation e20190757

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO: O câncer ainda é uma das principais causas de morte no mundo. Muitos quimioterápicos de plantas foram testados em câncer, como vinblastina e paclitaxel. O norte do Chile, região de Arica e Parinacota, caracteriza-se por sua biodiversidade vegetal devido às suas condições geográficas e climatológicas únicas, oferecendo uma fonte inexplorada e única de compostos de origem natural. A presente pesquisa considerou uma triagem de 26 ervas das terras altas usando um modelo de inibição de crescimento in vitro em um painel de seis linhas celulares de câncer de diferentes tecidos. Cinco, dos 26 extratos etanólicos estudados, mostram forte atividade pelo menos em uma linhagem celular quando testados a 10 µg mL-1. Apresentamos um grupo de plantas dignas de serem avaliadas como extratos promissórios. Este trabalho faz parte da tentativa sistemática de encontrar novos candidatos para serem usados em terapias contra o câncer.

ABSTRACT: Cancer is still one of the leading causes of death worldwide. Many chemotherapeutics from plants have been tested in cancer, such as vinblastine and paclitaxel. The north of Chile, Arica & Parinacota region, is characterized by its vegetal biodiversity due to its unique geographical and climatological conditions, offering an unexplored and unique source of naturally-derived compounds. The present research has considered a screening of 26 highland herbs using an in vitro growth inhibition model in a panel of six cancer cell lines from different tissues. 5 of the 26 studied ethanolic extracts shows strong activity at least in one cell line when tested at 10 µg mL-1. We present a group of plants worthy to be evaluated as promissory extracts. This work is part of the systematic attempt to find new candidates to be used in cancer therapies.

https://doi.org/10.1590/0103-8478cr20190757 1150 downloads

Resultados clínicos del reemplazo valvular aórtico percutáneo con dispositivo balón expandible MyVal en estenosis aórtica severa de alto riesgo
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Maluenda, Gabriel

; Baeza, Cristián

; Giacaman, Arturo

; Sepúlveda, Edgardo

; Cuevas, Óscar

; Alfaro, Mario

; Moreno, Óscar

; Baza, Rodrigo

Revista chilena de cardiología

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Dez 2020, Volume 39 Nº 3 Páginas 237 - 246

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Background: The recently approved balloon expandable MyVal (Meril Life Sciences, India) transcatheter aortic valve replacement (TAVR) prosthesis is available for commercial use in Chile and the European Union. The aim of this study is to provide early and mid-term data on the safety and efficacy of patients with severe aortic stenosis (AS) at high surgical risk undergoing TAVR using the MyVal device. Methods: All patients with symptomatic severe AS at high surgical risk undergoing intended TAVR with MyVal prosthesis at San Borja-Arriarán Hospital entered to a retrospective registry. Results: Between October 2018 and November 2019, 14 patients entered to the registry. The mean age was 82.5±7.8 years-old with a high-surgical riskprofile (mean STS score of 11.6±5.1% for 30-day mortality). Device and procedural success were achieved in 12 patients (86%) with substantial decrease in the mean aortic gradient, persistent at 6 months follow-up, all with mild or trace aortic regurgitation. Device failure occurred in 2 patients, one due to failed delivery and other due to device embolization into the left ventricle, which resulted in patient death. There were one death attributed aortic dissection/rupture and two major bleeding episodes. Three patients receiving MyVal implant required the implantation of a permanent pacemaker (23%). Conclusion: The present registry rises a question upon the safety of the MyVal TAVR device in high-risk AS. However, once a successfully implant was achieved the MyVal prosthesis showed an adequate performance to mid-term follow-up.

Resumen Introducción: El dispositivo MyVal balón-expandible (Meril Life Sciences, India) fue recientemente aprobado en Chile y la Unión Europea para uso comercial. El objetivo del presente estudio fue proveer datos de eficacia y seguridad temprana y de mediano plazo en pacientes portadores de estenosis aórtica (EA) severa de alto riesgo quirúrgico sometidos a reemplazo valvular aórtico percutáneo (RVAP) con dispositivo MyVal. Material y Métodos: Se enrolaron retrospectivamente todos los pacientes con EA severa sintomática de alto riesgo según criterio del ´heart team´ local, sometidos a RVAP usando prótesis MyVal en Hospital San Borja Arriarán. Resultados: La población quedó compuesta por 14 sujetos tratados entre Octubre 2018 y Noviembre 2019. La población tuvo una edad media de 82,5±7,8 años y elevado perfil de riesgo (puntaje STS promedio 11,6±5,1% de mortalidad a 30 días). Se logró éxito de dispositivo y procedimiento en 12 pacientes (86%) con caída sustancial de la gradiente aórtica media, persistente a 6 meses de seguimiento sin insuficiencia aórtica más que leve. Ocurrió falla de dispositivo en 2 pacientes, una debida a falla de entrega y otra por embolización a ventrículo, esta última con resultado de muerte. En términos de complicaciones, ocurrió una muerte precoz atribuida a disección/ruptura de aorta y 2 hemorragias mayores. La tasa de marcapasos ascendió a 3 pacientes, 23% considerando todos quienes recibieron implante. Conclusión: El presente registro cuestiona la seguridad de MyVal en el tratamiento percutáneo de la EA severa de alto riesgo. Sin embargo, una vez logrado un implante exitoso MyVal muestra adecuados parámetros de funcionamiento, persistentes a un plazo mediano de seguimiento.

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Angioedema hereditario en Costa Rica
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Alfaro-Murillo, Alberto Josué

; Martínez-Alfonso, Mario

; Castro-Cordero, José

; León-Bratti, María Paz

; Ivankovich-Escoto, Gabriela

; Espinoza-Mora, María del Rosario

Revista alergia México

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Jun 2020, Volume 67 Nº 2 Páginas 102 - 111

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Background: Hereditary angioedema is classified as a primary immunodeficiency of the complement system because it is characterized by the absence of C1 esterase inhibitor (C1-INH) and by the periodic edema of any region of the body that involves soft tissue. Objective: To characterize the adult patients with a confirmed diagnosis of hereditary angioedema who have been treated in the Clinical Allergology Department of Hospital México de la Caja Costarricense del Seguro Social. Methods: The study was retrospective and observational. The information was obtained from the clinical records of the patients with a confirmed diagnosis of hereditary angioedema that were being controlled in the Allergology Department of the “Hospital México de la Caja Costarricense del Seguro Social”. Results: A total of 14 patients; seven men and seven women, were identified. The average was of 36.6 years of age. The most frequent clinical manifestations were peripheral edema and abdominal pain. Only three patients presented laryngeal edema at some point in their evolution. 12 cases corresponded to hereditary angioedema type I. Conclusion: The clinical characteristics of all the documented cases corresponded to those described for this pathology, although only a few patients had a history of severe manifestations.

Resumen Antecedentes: El angioedema hereditario se encuentra clasificado como una inmunodeficiencia primaria del sistema de complemento, debido a que se caracteriza por la ausencia de C1 inhibidor esterasa y por edema periódico de cualquier región del cuerpo que involucre tejido blando. Objetivo: Caracterizar a los pacientes adultos con diagnóstico de angioedema hereditario atendidos en el Servicio de Alergología Clínica del Hospital México de la Caja Costarricense del Seguro Social. Métodos: Estudio observacional retrospectivo. Los datos fueron obtenidos de los expedientes clínicos de los pacientes con diagnóstico confirmado de angioedema hereditario que estaban en seguimiento en el Servicio de Alergología del Hospital México, Caja Costarricense del Seguro Social. Resultados: Se identificaron 14 pacientes, siete hombres y siete mujeres. El promedio de edad fue de 36.6 años. Las manifestaciones clínicas más frecuentes fueron edema de extremidades y dolor abdominal. Solo tres pacientes en algún momento durante su evolución presentaron edema laríngeo; 12 casos correspondieron a angioedema hereditario tipo I. Conclusión: Las características clínicas de todos los casos documentados correspondieron con las descritas para angioedema, aunque solo algunos pacientes contaban con historial de manifestaciones graves.

https://doi.org/10.29262/ram.v67i2.722 398 downloads

Recomendaciones para el uso racional de la prueba 25-hidroxivitamina D Resumen de política
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Herrera-Molina, Emilio

; González, Nancy Yomayusa

; Low-Padilla, Eduardo

; Oliveros-Velásquez, Juan David

; Mendivelso-Duarte, Fredy

; Gómez-Gómez, Olga Victoria

; Castillo, Ana María

; Barrero-Garzón, Liliana Isabel

; Álvarez-Moreno, Carlos Arturo

; Moscoso-Martínez, Ernesto Augusto

; Ruíz-Blanco, Pilar Cristin

; Luna-Ríos, Joaquín Gustavo

; Ortiz, Natasha

; Herrera, Emiliano Mauricio

; Guevara-Santamaría, Fabián

; Moreno-Gómez, Jairo Enrique

; Cárdenas-Ramírez, Héctor Mauricio

; González-González, Camilo Alberto

; Jannauth, María José

; Patiño-Pérez, Adulkarin

; Pinto, Diego Alejandro

; Acevedo, Juan Ramon

; Torres, Rodolfo Eduardo

; Montero, Jairo Camilo

; Acevedo, Andrés David

; Caceres, Ximena Adriana

; Acuña-Olmos, Jairo

; Arias, Carlos Andrés

; Medardo-Rozo, José

; Castellanos-Parada, Jeffrey

; López-Miranda, Ángelo Mauricio

; Pinzón-Serrano, Estefanía

; Rincón-Sierra, Oswaldo

; Isaza-Ruget, Mario

; Suárez-Ramos, María del Pilar

; Vargas-Rodríguez, Johanna

; Mejia-Gaviria, Natalia

; Moreno-Marín, Sandra Yadira

; García-Guarín, Bibiana María

; Cárdenas, Martha Lucía

; Chavarro, Luis Fernando

; Ronderos-Bernal, Camila

; Rico-Landazabal, Arturo

; Coronado-Daza, Jorge Antonio

; Alfaro-Tejeda, Mercedes Teresa

; Yama-Mosquera, Erica

; Hernández-Sierra, Astrid Patricia

; Restrepo-Valencia, César Augusto

; Arango-Álvarez, Javier

; Rosero-Olarte, Francisco Oscar Fernando

; Medina-Orjuela, Adriana

; Robayo-García, Adriana

; Carballo-Zarate, Virgil

; Rodríguez-Sánchez, Martha Patricia

; Bernal, Dora P.

; Jaramillo, Laura

; Baquero-Rodríguez, Richard

; Mejía-Gaviria, Natalia

; Aroca, Gustavo

Revista Colombiana de Nefrología

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Dez 2019, Volume 6 Nº 2 Páginas 179 - 192

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract The exponential increase in the request for laboratory tests of 25-Hydroxyvitamin D or [25 (OH) D has ignited the alarms and generated a strong call for attention, since it may reflect deficiencies in the standardization of clinical practice and in the use non-systematic scientific evidence for decision-making in real life, which allows to analyze the indications of the test, its frequency, interpretation and even to assess the impact for health systems, especially when contrasted with the minimum or almost. No effects of the strategy of screening or supplying indiscriminately to the general population, without considering a comprehensive clinical assessment of risks and needs of people. From a purely public health impact point of view, the consequence of massive and unspecified requests is affecting most of the health systems and institutions at the global level. The primary studies that determined average population intake values have been widely used in the formulation of recommendations in Clinical Practice Guidelines, but unfortunately misinterpreted as cut points to diagnose disease and allow the exaggerated prescription of nutritional substitution. The coefficient of variation in routine tests to measure blood levels of 25 (OH) D is high (28%), decreasing the overall accuracy of the test and simultaneously, increasing both the falsely high and falsely low values. The most recent scientific evidence analyzes and seriously questions the usefulness and the real effect of the massive and indiscriminate practice of prescribing vitamin D without an exhaustive risk analysis. The available evidence is insufficient to recommend a general substitution of vitamin D to prevent fractures, falls, changes in bone mineral density, incidence of cardiovascular diseases, cerebrovascular disease, neoplasms and also to modify the growth curve of mothers' children. They received vitamin D as a substitute during pregnancy. The recommendations presented in the document are based on the critical analysis of current evidence and the principles of good clinical practice and invite to consider a rational use of 25 (OH) D tests in the context of a clinical practice focused on people and a comprehensive assessment of needs and risks. The principles of good practice suggest that clinicians may be able to justify that the results of the 25 (OH) D test strongly influence and define clinical practice and modify the outcomes that interest people and impact their health and wellness. Currently there is no clarity on how to interpret the results, and the relationship between symptoms and 25 (OH) D levels, which may not be consistent with the high prevalence of vitamin D deficiency reported. For this reason, it is suggested to review the rationale of the request for tests for systematic monitoring of levels of 25 (OH) D or in all cases where substitution is performed. Consider the use of 25 (OH) D tests within the comprehensive evaluation of people with suspicion or confirmation of the following conditions: rickets, osteomalacia, osteoporosis, hyper or hypoparathyroidism, malabsorption syndromes, sarcopenia, metabolic bone disease.

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Subscapular Osteochondroma as a Differential Diagnosis of Winged Scapula
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Oliveira, Marco Aurélio de

; Alfaro, Yuri

; Kotzias Neto, Anastácio

; Korman, Mário César

Revista Brasileira de Ortopedia

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Jun 2019, Volume 54 Nº 3 Páginas 241 - 246

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Objetivo O objetivo do presente trabalho é relatar as características clínicas de pacientes pediátricos comdiagnóstico de osteocondroma retroescapular submetidos a tratamento cirúrgico, entre os anos de 2003 e 2017. Métodos Série de casos, analítica, descritiva e retrospectiva de sete pacientes com diagnóstico de osteocondroma retroescapular. Resultados A média de idade dos pacientes analisados foi de 9,5 anos, sendo 71% deles do sexomasculino. O tempomédio entre o início dos sintomas e o procedimento cirúrgico foi de 1,2 anos. Aproximadamente 71% dos pacientes apresentaram osteocondroma na escápula direita, e 57,1% dos casos foram classificados como sésseis. Ao exame clínico, observou-se pseudoescápula alada em 85,7%, crepitação em 71,4%, e queixa de dor em 42,9% dos pacientes. Conclusão A escápula alada pode ter diferentes etiologias, dentre elas o osteocondroma retroescapular. O conhecimento sobre anatomia funcional e semiologia ortopédica somado à correta sistematização da abordagem dos tumores ósseos consiste na base para o correto diagnóstico diferencial e tratamento adequado.

Abstract Objective This study aims to report the clinical features of pediatric patients diagnosed with subscapular osteochondroma submitted to surgical treatment at Hospital Infantil Joana de Gusmão (HIJG), in Florianópolis, Santa Catarina, Brazil, between 2003 and 2017. Methods Analytical, descriptive and retrospective case series of seven patients with subscapular osteochondroma diagnosis. Results The average age of the analyzed patients was 9.5 years-old; 71% of the patients were male. The mean time between onset of symptoms and the surgical procedure was 1.2 years. Approximately 71% of the patients presented osteochondroma in the right scapula, and 57.1% of the lesions were classified as sessile. At the clinical examination, winged scapula was observed in 85.7%, crepitus in 71.4%, and 42.9% of the patients complained about pain. Conclusion The winged scapula can have different etiologies, including subscapular osteochondroma. The knowledge about functional anatomy and orthopedic semiology added to the correct systematization approach to bone tumors is the basis for the correct differential diagnosis and adequate treatment.

https://doi.org/10.1055/s-0039-1692432 2504 downloads

Rol de Estímulos Asociados a las Claves de Extinción en la Recuperación de Respuesta
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Alfaro, Felipe

; Navarro, Víctor M

; Laborda, Mario A

; Betancourt, Ronald

; Miguez, Gonzalo

Psykhe (Santiago)

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Mai 2019, Volume 28 Nº 1 Páginas 1 - 15

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT: Two experiments analyzed the role of extinction cues (EC) and stimuli associated to them in the reacquisition of conditioned ethanol tolerance. Ethanol-induced ataxia was measured in 80 rat subjects using a tilting plane, in a 5-phase procedure. The first experiment (which used 4 contexts and 40 rats) showed that the presentation of the extinction context by itself diminished the effectiveness of ECs in reducing response reacquisition. The second experiment (conducted in a single context with 40 rats and using 2 stimulus paired for some subjects or explicitly unpaired for others) showed that a secondary cue can reduce reacquisition, regardless of whether it was paired with the EC or not. The results of mixed and factor analyses of variance suggest that ECs affect response recovery through an association with the extinction context; however, a second-order cue associated to an EC appears to be unable to activate this association.

RESUMEN: En 2 experimentos se investigó el rol de las claves de extinción (CE), y estímulos asociados a estas, en la readquisición de la tolerancia condicionada al etanol. La ataxia causada por el etanol fue medida en 80 ratas, utilizando planos de deslizamiento en un procedimiento de 5 fases. El primer experimento (que utilizó 4 contextos y 40 ratas) mostró que la presentación del contexto de extinción por sí solo disminuyó la efectividad de la CE para reducir la readquisición de respuesta. El segundo experimento (hecho en un solo contexto, con 40 ratas y con la diferencia de que se usaron 2 estímulos que fueron pareados para algunos sujetos o explícitamente no pareados para otros) mostró que una clave secundaria puede reducir la readquisición, independientemente de si fue pareada con la CE o no. Los resultados de análisis de varianza mixtos y factoriales sugieren que la CE afectaría la recuperación de la respuesta a través de una asociación con el contexto de extinción; sin embargo, una clave de segundo orden, asociada a la CE, no lograría activar dicha asociación.

https://doi.org/10.7764/psykhe.28.1.1282 1669 downloads

10.

Efecto de los antimaláricos sobre los diferentes dominios del índice de daño SLICC en pacientes de la cohorte GLADEL
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Pons-Estel, Guillermo J.

; Quintana, Rosana

; Wojdyla, Daniel

; Alarcón, Graciela S.

; Serrano, Rosa María

; Ugarte-Gil, Manuel

; Pimentel-Quiroz, Víctor

; Soriano, Enrique R.

; Catoggio, Luis J.

; Scolnik, Marina

; Sacnun, Mónica

; Saurit, Verónica

; Caeiro, Francisco

; Alvarellos, Alejandro

; Sarano, Judith

; García, Mercedes

; Onetti, Laura

; Drenkard, Cristina

; Berbotto, Guillermo

; Scherbarth, Hugo R.

; Sato, Emilia

; Bonfa, Eloisa

; Ferreira Borba, Eduardo

; Costallat, Lilian

; Xavier, Ricardo

; Tavares Brenol, Joao C.

; Da Silva, Nilzio A.

; Cavalcanti, Fernando

; Massardo, Loreto

; Jacobelli, Sergio

; Neira, Oscar

; Molina, José F

; Vásquez, Gloria

; Gómez-Puerta, José A.

; Alonso Gonzalez, Luis

; Iglesias Gamarra, Antonio

; Guibert-Toledano, Marlene

; Reyes, Gil A.

; Cardiel, Mario H.

; Pascual-Ramos, Virginia

; García de la Torre, Ignacio

; Barile, Leonor

; Silveira, Luis H.

; Amigo, Mary-Carmen

; Sauza del Pozo, María Josefina

; Acevedo-Vásquez, Eduardo M.

; Alfaro-Lozano, José

; Segami, María Inés

; Chacón-Díaz, Rosa

; Abadi, Isaac

; Esteva Spinetti, María H

; Pons-Estel, Bernardo A.

Revista argentina de reumatología

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Set 2018, Volume 29 Nº 3 Páginas 6 - 10

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Objective: To assess the effects of antimalarials (AM) over the items of the SLICC Damage Index (SDI). Methods: Patients with recent (≤2 years) diagnosis of systemic lupus erythematosus (SLE) from the GLADEL cohort were studied. End-point: increase in items SDI since cohort entry. Independent variables (socio-demographic, clinical, laboratory and treatment) were included. The effect of AM as a time dependent variable on most frequent SDI items (adjusting for potential confounders) was examined with a multivariable Cox regression model. Results: Of the 1466 patients included in this analysis, 1049 (72%) received AM with a median exposure time of 30 months (Q1-Q3: 11-57). Damage occurred in 665 (45%) patients during a median follow-up time of 24 months (Q1-Q3: 8-55). There were 301 integument, 208 renal, 149 neuropsychiatric, 98 musculoskeletal, 88 cardiovascular and 230 others less frequently represented damages. After adjusting for potential confounders at any time during follow-up, a lower risk of renal damage (HR 0.652; 95% CI: 0.472-0.901) and borderline for neuropsychiatric damage (HR 0.701, 95% CI: 0.481-1.024) was found. Conclusion: In the GLADEL cohort, after adjustment for possible confounding factors, AM were independently associated with a reduced risk of renal damage accrual.

Objetivos: Estimar el efecto de los antimaláricos (AM) sobre los diferentes dominios del índice de daño SLICC (SDI). Métodos: Se estudiaron pacientes con diagnóstico clínico reciente (≤2 años) de lupus eritematoso sistémico (LES) de la cohorte GLADEL. Variable de estudio: aumento en los dominios del SDI desde el ingreso a la cohorte. Variables independientes: características sociodemográficas, clínicas, laboratorio y tratamientos. El efecto de los AM, como variable dependiente del tiempo, sobre los dominios más frecuentes del SDI (ajustado por factores de confusión) fue examinado con un modelo de regresión de Cox multivariado. Resultados: De 1466 pacientes estudiados, 1049 (72%) recibieron AM con un tiempo medio de exposición de 30 meses (Q1-Q3: 11-57) y 665 pacientes (45%) presentaron daño durante un seguimiento medio de 24 meses (Q1-Q3: 8-55); 301 eventos fueron cutáneos, 208 renales, 149 neuropsiquiátricos, 98 musculoesqueléticos, 88 cardiovasculares y 230 otros. Después de ajustar por factores de confusión, el uso de AM se asoció a un menor riesgo de daño renal (HR 0,652; IC 95%: 0,472-0,901) y en el límite de la significancia estadística (HR 0,701, IC 95%: 0,481-1,024) para el dominio neuropsiquiátrico. Conclusión: En GLADEL, el uso de AM se asoció independientemente a un menor riesgo de daño acumulado renal.

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11.

Minería y encadenamientos productivos en México: un estudio comparativo empleando modelos estatales de insumo producto
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Gaytán Alfaro, Edgar David

; Mendoza Sánchez, Mario Alberto

; Vargas Sánchez, Juan Roberto

Economía Coyuntural

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Abr 2018, Volume 3 Nº 2 Páginas 2 - 32

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen A partir del estudio comparativo de las matrices estatales de Hidalgo, Sonora y Zacatecas, el documento analiza el tejido productivo derivado de la actividad minera en las entidades referidas. La delimitación del objeto de estudio resulta de la consideración de entidades con un perfil productivo minero pertenecientes a diferentes zonas económicas de México: norte, centro-norte y centro. Siguiendo un enfoque de redes con técnicas multivariantes de datos aplicadas sobre las submatrices de flujos intersectoriales de los estados en cuestión, el presente estudio determina si, en efecto, la actividad minera genera encadenamientos en la estructura productiva y, si, eventualmente, por su poder (limitado o extendido) de articulación sectorial, se pueden constituir redes de proveeduría tendientes a la diversificación de la planta productiva. El objetivo de última instancia es crear un marco de referencia que favorezca la aparición de esquemas de proveedurías coadyuvantes o trascendentes a la actividad minera.

Abstract Based on the comparative study of the state matrices of Hidalgo, Sonora and Zacatecas, the document analyzes the productive network derived from the mining activity in the referred entities. The object study delimitation results from the consideration of entities with a productive mining profile belonging to different economic zones of Mexico: north, center-north and center. Following a network approach with multivariate data techniques applied to the intersectoral flows submatrices of the states in question, the present study determines whether, in effect, the mining activity generates linkages in the productive structure and, if, eventually, by its power (limited or extended) of sectoral articulation, supply networks can be established tending to the the productive plant diversification. The last instance objective is creating a reference frame that favors the emergence of transcendental supplies schemes coadjuvant with the mining activity.

197 downloads

12.

Axillary local anesthetic spread after the thoracic interfacial ultrasound block - a cadaveric and radiological evaluation
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Torre, Patricia Alfaro de la

; Jones Jr., Jerry Wayne

; Álvarez, Servando López

; Garcia, Paula Diéguez

; Miguel, Francisco Javier Garcia de

; Rubio, Eva Maria Monzon

; Boeris, Federico Carol

; Sacramento, Monir Kabiri

; Duany, Osmany

; Pérez, Mario Fajardo

; Gordon, Borja de la Quintana

Revista Brasileira de Anestesiologia

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Dez 2017, Volume 67 Nº 6 Páginas 555 - 564

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Justificativa Os analgésicos orais à base de opioides têm sido usados para o manejo da analgesia nos períodos peri e pós-operatório de pacientes submetidos à linfadenectomia axilar. A região axilar é uma zona difícil de bloquear e não há registro de uma técnica de anestesia regional específica que ofereça o seu bloqueio adequado. Métodos Após a aprovação do Conselho de Ética institucional, estudos anatômicos e radiológicos foram feitos para determinar a deposição e disseminação de azul de metileno e anestésico local, respectivamente injetados na axila via plano interfascial torácico. Exames de ressonância magnética foram então feitos em 15 de 34 pacientes programados para cirurgia de mama unilateral que envolveria qualquer um dos seguintes procedimentos: esvaziamento axilar, biópsia de linfonodo sentinela, biópsia de linfonodo axilar ou mamas supranumerárias, para verificar a deposição e o tempo de propagação da solução dentro do plano interfascial torácico in vivo. Resultados Estudos radiológicos e em cadáveres mostraram que a injeção de anestésico local e azul de metileno via plano interfascial torácico com a técnica guiada por ultrassom resulta em deposição confiável na axila. Nos pacientes, a injeção de anestésico local produziu um bloqueio sensitivo axilar confiável. Esse achado foi corroborado por estudos de ressonância magnética que mostraram sinais hiperintensos na região axilar. Conclusões Esses achados definem as características anatômicas do bloqueio da região axilar e destacam o potencial clínico desses novos bloqueios.

Abstract Background Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. Methods After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Results Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter-fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper-intense signals in the axillary region. Conclusions These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block.

https://doi.org/10.1016/j.bjane.2015.04.007 3568 downloads

13.

Living on the Edge: Hawksbill turtle nesting and conservation along the Eastern Pacific Rim
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Gaos, Alexander R

; Liles, Michael J

; Gadea, Velkiss

; Peña de Niz, Alejandro

; Vallejo, Felipe

; Miranda, Cristina

; Darquea, Jodie Jessica

; Henriquez, Ana

; Altamirano, Eduardo

; Rivera, Alejandra

; Chavarría, Sofía

; Melero, David

; Urteaga, José

; Pacheco, Carlos Mario

; Chácon, Didiher

; LeMarie, Carolina

; Alfaro-Shigueto, Joanna

; Mangel, Jeffrey C

; Yañez, Ingrid L

; Seminoff, Jeffrey A

Latin american journal of aquatic research

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2017, Volume 45 Nº 3 Páginas 572 - 584

Resumo: En | Texto: En | PDF: En

Prior to 2007, efforts to monitor and conserve hawksbill turtles (Eretmochelys imbricata) in the eastern Pacific Ocean were opportunistic and records were virtually non-existent. The first abundance estimates were published in 2010, but contained limited data on the species. Ongoing research since that time has led to the identification of several rookeries, including sites containing large proportions of the overall hawksbill nesting currently known to occur in the region. Monitoring projects were established at several sites and have since provided substantial nesting data on the species. Here we summarize data collected between 1983 and March 2016 from all sites (n = 9) confirmed to host >10 nests in any given season to provide an update on hawksbill nesting in the eastern Pacific. We documented a total of 3,508 hawksbill nests, 265,024 hatchlings and 528 individual nesting females in the region. The vast majority of these records (99.4%, 99.9% and 99.6%, respectively) were generated subsequent to 2007, coinciding with the discovery of eight of the nine rookeries included in this study and the organization of monitoring efforts at those sites, which led to the increased documentation conferred here. Our findings should not be misconstrued as increases in actual nesting or signs of recovery, which could diminish the ongoing need for conservation actions, but rather as optimism, that there is still an opportunity to restore the species in the eastern Pacific. The top three sites in terms of average annual number of nests were Estero Padre Ramos (Nicaragua; 213.2 ± 47.6 nests), Bahia de Jiquilisco (El Salvador; 168.5 ± 46.7 nests) and Aserradores (Nicaragua; 100.0 ± 24.0 nests), and all three sites are located in mangrove estuaries in Central America, highlighting the importance of these rookeries/habitats for the survival and recovery of hawksbills in the region. The remaining six sites received between 6.9 ± 7.3 nests (Costa Careyes, Mexico) and 59.3 ± 17.7 nests (Los Cobanos, El Salvador) annually. By integrating data collected on nesting hawksbills with local conservation realities at the most important known hawksbill rookeries in the eastern Pacific, we provide a more holistic view of the conservation status and management needs of the species in this ocean region.

https://doi.org/10.3856/vol45-issue3-fulltext-7 1500 downloads

14.

FECUNDIDAD DEL JUREL ALETA AMARILLA, CARANX HIPPOS (LINNAEUS) EN EL CARIBE COLOMBIANO
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Alfaro-Martínez, Sandra

; Bustos-Montes, Diana

; Salas-Castro, Sarith

; Gómez-León, Javier

; Rueda, Mario

Boletín de Investigaciones Marinas y Costeras - INVEMAR

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Jan 2016, Volume 45 Nº 1 Páginas 123 - 134

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Caranx hippos es uno de los recursos ícticos marinos más importantes en Colombia, especialmente en la pesca artesanal. Con el propósito de profundizar en su conocimiento biológico, se estimó la fecundidad parcial y el diámetro de los ovocitos. Las muestras provenían de faenas artesanales comerciales. A cada individuo se le midió longitud total, el peso total y el peso gonadal. La fecundidad se estimó combinando el método gravimétrico con análisis de imágenes, usando el software de libre acceso Image J®. A partir de la medición de 149523 ovocitos se obtuvo un diámetro promedio de 0.32 ± 1.24E-4 mm, y valores de fecundidad variables con un ámbito entre 291439 y 4380480 ovocitos/gónada. No se evidenció una relación directa entre la cantidad y el diámetro de los huevos con la talla y el peso del pez, lo que sugiere que no siempre las hembras más grandes son las más fecundas. Se describe el desarrollo microestructural de los oocitos maduros, encontrando diámetros promedio en alvéolo cortical y vitelogénesis de 98.6 + 33.1 µm y 207.5+ 59.6 µm, respectivamente. Dada la importancia en el país de C. hippos, este trabajo constituyó un importante aporte al conocimiento de la especie, que puede ser usado en modelos pesqueros con aplicabilidad directa en medidas de manejo.

Caranx hippos is one of the most important fish resources in Colombia, particularly in artisanal fisheries. In order to deepen C. hippos biological knowledge, fecundity (number of eggs in development) and oocyte diameter was estimated. Fish samples were collected from commercial artisanal fishing trips, each fish was measured (total length, Lt) and weighted (total weight, Pt); gonads were removed, weighed and analyzed for determining fecundity using a gravimetric method combined with image analysis performed using the open access software Image J®. From the measurement of 149552 oocytes, an average diameter of 0.32 ± 1.24E-4 mm, was obtained, while fecundity varied between 291439 and 4380480 oocytes per gonad. No direct relationship was evidenced between egg number and diameter, and fish size and weight. Mature oocyte microstructural development is described, average diameters in cortical alveoli and vitellogenesis were 98.6 + 33.1 µm y 207.5+ 59.6 µm, respectively. This result suggests that larger females are not always the more fertile. Given the importance of C. hippos in Colombia, this work is a valuable contribution to the knowledge of the species, which can be used in fishery models with direct applicability to management procedures.

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15.

Costo-Efectividad de Reemplazo Valvular Aórtico Percutáneo vs Terapia Conservadora en la Estenosis Aórtica de muy alto riesgo en un centro terciario chileno
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Maluenda, Gabriel

; Sepúlveda, Edgardo

; Alfaro, Mario

; Arias, Ana María

; Muñoz, Rodrigo

; León, Lucio

; Oyonarte, Miguel

Revista chilena de cardiología

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Abr 2015, Volume 34 Nº 1 Páginas 11 - 17

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Aim: to evaluate cost-effectiveness of Transcatheter Aortic Valve Replacement (TAVR) compared to conservative treatment in patients with very high risk severe aortic stenosis (AS) referred to a tertiary center in Santiago, Chile Methods: Patients with high surgical risk and severe AS referred between January 2013 and September 2014 were included. Cost of resources, readdmissions, life-years gained and incremental cost-effectiveness of TAVI were calculated Results: Thirty-nine patients were finally included. Mean age was 82±7 years old, more commonly women (74%) with a mean STS score of 11.4±5.6 that confirmed their high-risk. Seventeen patients (43.6%) had TAVR and 22 (56.4%) underwent conventional medical therapy. All patients in the TAVR group - treated with Sapien XT® device - survived the procedure and were discharged alive. Mean cost of the procedure was approximately US$ 33,500. After a mean follow-up period of 285±204 days, mean survival rate in the control group was 54.5% (10 deaths) as compared to 94.1% in the TAVR group (1 death, p<0.001). Therefore, a gain of al least one year was obtained with TAVR resulting in an incremental cost effectiveness of US$ 26.470 per year of life gained. Conclusion: TAVR resulted costly-effective compared to conventional therapy in patients with severe AS and high surgical risk in a Chilean referral center.

Introducción: El objetivo fue evaluar la costo-efectividad del reemplazo valvular aórtico percutáneo (RVAP) contra terapia conservadora (TC) en pacientes con estenosis aórtica (EA) severa de muy alto riesgo, en un centro de derivación. Métodos: Los pacientes derivados entre Enero 2013 y Septiembre 2014, considerados de muy alto riesgo y candidatos a RVAP fueron incluidos. El costo de los recursos usados, de las readmisiones y la sobrevida fueron obtenidos para determinar el tiempo de vida ganado y la relación incremental de costo-efectividad (RICE) del RVAP Resultados: El grupo estudiado quedó compuesto por 39 pacientes, con edad promedio 82±7 años, más frecuentemente mujeres (74.4%), con elevado perfil de riesgo (STS score 11.4±5.6). Diecisiete pacientes (43.6%) fueron sometidos a RVAP y 22 (56.4%) a TC. Durante el seguimiento se registraron 25 rehospitalizaciones en el grupo de TC, a un costo promedio de $4.195.073 por paciente (7,027 dólares). Todos los pacientes sometidos a RAVP recibieron con éxito una prótesis Sapien XT y fueron egresados vivos. El costo promedio estimado del RVAP fue $20.000.000 (33,500 dólares). La sobrevida media fue de 54.5% (10 eventos) en grupo TC contra 94.1% (una muerte) en el grupo RVAP [285±204 días/seguimiento] (p<0.001). Así se pudo estimar que RVAP se asoció a un incremento de vida de al menos un año, lo cual resultó en una RICE de 26,470 dólares/año de vida ganado. Conclusión: El RAVP resultó costo-efectivo comparado con la TC en pacientes portadores de EA severa de muy alto riego tratados en la realidad de un centro de derivación nacional.

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