Abstract We present the case of a 54-year-old patient who presented with a history of 2 years with angina. Invasive studies revealed critical coronary artery stenosis coexisting with obstructive hypertrophic miopathy. This is a rare association with only isolated case reports.

Resumen Se presenta el caso de un paciente de 54 años que consulta por angina de esfuerzo de 2 años de evolución en quien se identifica una dilatación ectásica del árbol coronario con lesiones ateroscleróticas críticas y miocardiopatía hipertrófica septal obstructiva. Una revisión bibliográfica revela que es una asociación infrecuente de la cual solo existen reportes de casos aislados.

Resumen: El tiempo de compromiso motor (TCM) tiene implicaciones relevantes en la clase de Educación Física, dado que está relacionado con la actividad física regular que debe realizar un niño o adolescente y las sugerencias de organizaciones internacionales en relación con la mínima cantidad requerida para el mantenimiento de la salud. Este trabajo tiene como objetivo analizar el tiempo de compromiso motor en clases de Educación Física en enseñanza primaria a partir de una revisión sistemática. La búsqueda se hizo en Web of Science, Scopus, ERIC y Dialnet, seleccionando artículos publicados entre 2009 y el primer semestre de 2021. Aplicando criterios de inclusión y exclusión, fueron seleccionados ocho artículos que comprenden una población de estudio de 1262 alumnos. El TCM es bajo en las clases observadas, y la actividad física de moderada a vigorosa presenta datos a la baja. En el estudio de mejor resultado, el TCM alcanza el 46,67 % y, en los restantes, 43,44 %, 42,8 %, 41,45 %, 32 %, 31,5 %, 28,53 % y 18,10 %. Los niños logran mayor TCM que las niñas; niños y niñas en las primeras edades logran mayor participación y tienen más actividad física; el horario matutino y algunas unidades didácticas favorecen un mayor TCM. Se constata que el TCM es bajo en las clases de Educación Física, y que la gestión del tiempo en la clase condiciona la magnitud de la actividad física que realizan niños y niñas. El tiempo de compromiso motor alcanzado en la clase es insuficiente para cubrir las sugerencias mínimas de actividad física en el período escolar.

Abstract: Motor commitment time (MCT) has relevant implications in the Physical Education class, since it is related to the regular physical activity that a child or adolescent should perform and the suggestions of international organizations in relation to the minimum amount required for the maintenance of health. The aim of this work is to analyze the engagement motor time in physical education classes in primary education through a systematic review. The search was made in Web of Science, Scopus, ERIC and Dialnet, selecting articles published between 2009 and the first semester of 2021. Applying inclusion and exclusion criteria, eight articles were selected, comprising a study population of 1262 students. The MCT is low in the classes observed, and moderate to vigorous physical activity presents declining data. In the study with the best result, the MCT reaches 46.67 % and, in the remaining studies, 43.44 %, 42.8 %, 41.45 %, 32 %, 31.5 %, 28.53 % and 18.10 %. Boys achieve higher MCT than girls; boys and girls in the early ages achieve higher participation and have more physical activity; the morning schedule and some didactic units favor a higher MCT. It was found that the MCT is low in Physical Education classes, and that time management in the class conditions the magnitude of the physical activity carried out by boys and girls. The motor engagement time achieved in the class is insufficient to cover the minimum suggestions for physical activity in the school period.

Resumen Introducción: los servicios de urgencias requieren de la toma de medidas eficaces y oportunas en el manejo de los pacientes, esto incluye el uso adecuado de antibióticos. La resistencia antimicrobiana dificulta la instauración de terapias empíricas adecuadas, por lo que su vigilancia toma un papel fundamental en los programas de optimización de uso de antimicrobianos. Objetivo: describir el perfil microbiológico y la resistencia antibiótica de los aislamientos urinarios obtenidos de pacientes adultos de los servicios de urgencias de 7 instituciones de tercer nivel de la ciudad de Manizales, durante el año 2018. Resultados: se recolectaron 1991 aislamientos urinarios, el microorganismo más frecuentemente aislado fue Escherichia coli con un 62%. Se encontraron altas tasas de resistencia a cefazolina, trimetoprim/sulfametoxazol, ciprofloxacina y ampicilina/sulbactam. La resistencia a nitrofurantoína y fosfomicina al igual que a carbapenémicos es baja para Escherichia coli. Los aislamientos urinarios de Pseudomonas aeruginosa muestran niveles de resistencia superiores al promedio nacional. Conclusiones: es importante individualizar el manejo antibiótico empírico, teniendo en cuenta la estratificación por severidad, la presencia de factores de riesgo para bacterias multidrogorresistentes, y la epidemiología local; los análisis de cada institución y los resultados de este trabajo, pueden ser utilizados para establecer conductas terapéuticas más precisas en los casos de infecciones del tracto urinario, mejorando los desenlaces de estos pacientes y los costos derivados de la atención en salud.

Abstract Introduction: patient management in emergency rooms require swift and effective clinical decisions; this includes choosing antibiotics correctly. Antimicrobial resistance impairs the adequate choice of empirical therapy, making the surveillance of utmost importance for antimicrobial stewardship programs. Objective: we aimed to describe the microbiological and antimicrobial resistance profile of urinary isolates obtained from adult patients of the emergency services of seven tertiary institutions in the city of Manizales, during the year 2018. Results: from a total of 1991 urinary tract isolates, 62% corresponded to Escherichia coli, the most common bacteria cultured from the emergency room. Susceptibility analysis revealed high resistance levels to cefazolin, trimethoprim-sulfamethoxazole, and ciprofloxacin. Resistance to nitrofurantoin, fosfomycin, and carbapenems was low for Escherichia coli isolates. Pseudomonas aeruginosa showed antimicrobial resistance levels above national averages. Conclusions: empirical antibiotic therapy must be tailored on a patient by patient basis, taking into account the severity of the disease, risk factors for multi-drug resistance bacteria, the institutional and local epidemiology depicted in this work. By using these results, the adjustment of empirical antimicrobial regimens for urinary tract infections could improve clinical outcomes and reduce health care costs.

Se estudió la capacidad como inoculantes de biosilo de Lactococcus lactis Tw34 y Lactobacillus plantarum Lb7. Los experimentos se llevaron a cabo con una mezcla de subproductos de merluza (Merluccius hubbsi) y harina de cebada, fermentada durante 7 días. Como control se utilizó una muestra acidificada con ácido láctico. En las mezclas biológicas, el pH disminuyó por debajo de 5,0 después de 2 días de fermentación y permaneció estable hasta el final de la experiencia. La población máxima (>109 UFC/g) se alcanzó después de 5 días de incubación a 18°C. La concentración de péptidos solubles en agua aumentó durante los 7 días de incubación y no hubo diferencias significativas (p < 0,05) entre el control y ambos biosilos. Las concentraciones de péptidos solubles en ácido tricloroacético de los biosilos fueron superiores al control (p > 0,05). Después de 7 días, las concentraciones de fósforo alcanzadas fueron 2,26 y 2,42 g /100 g en los biosilos fermentados con Lc. lactis Tw34 y Lb. plantarum Lb7 respectivamente, mientras que en el control los valores permanecieron casi estables (1,61 g/100 g). Al final de la experiencia, la actividad inhibitoria de tripsina fue suprimida en ambos biosilos mientras que, en el control los factores antinutricionales seguían siendo activos. Los resultados indican la factibilidad del uso de la mezcla seleccionada como sustrato para la producción de biosilo y la eficacia de Lc. lactis Tw34 y Lb. plantarum Lb7 como inoculantes.

Suitability of Lactococcus lactis Tw34 and Lactobacillus plantarum Lb7 as bio-silage inoculants was studied. Experiments were carried out with a mixture of hake (Merluccius hubbsi) by-products and barley meal fermented during 7 days. A sample acidified with lactic acid was used as control. In biological mixtures, the pH dropped below 5,0 after 2 days of fermentation and remained stable until the end of the experience. Maximum populations (> 109 CFU/g) were reached after 5 days of incubation at 18°C. Water soluble peptides concentration increased during the 7 days of incubation and no significant differences (p < 0,05) were found between the control and both bio-silage. Trichloroacetic acid soluble peptides concentrations of bio-silages were higher than the control (p > 0,05). After 7 days, phosphorous concentrations reached 2.26 and 2,42 g/100 g in bio-silages fermented with Lc. lactis Tw34 and Lb. plantarum Lb7, respectively, while control values remains almost stable (1,61 g/100 g). At the end of the experience, inhibitory activity of trypsin was abolished in both bio-silage while in control sample antinutritional factors remained active. The results indicated the feasibility of the use of the selected mixture as substrate for bio-silage production and the effectiveness Lc. lactis Tw34 and Lb. plantarum Lb7 as inoculants.

Foi estudada a capacidade de inoculantes em biosilagem de Lactococcus lactis Tw34 y Lactobacillus plantarum Lb7. Os experimentos foram realizados com uma mistura de produtos de merluza (Merluccius hubbsi) e farinha de cevada, fermentada durante 7 dias. Como controle se utilizou uma amostra acidificada com ácido láctico. Nas misturas biológicas, o pH ficou abaixo 5,0 depois de 2 dias de fermentaç ão e permaneceu estável até o final do experimento. A contagem máxima de viáveis (>109 UFC/g) foi alcançada depois de 5 dias de incubaç ão a 18°C. A concentração de peptídeos solúveis em água aumentou durante os 7 dias de incubação e não houve diferença significativa (p < 0,05) entre o controle e a silagem. As concentrações de peptídeos solúveis em ácido tricloroacético da silagem foram superiores ao controle (p >0,05). Depois de 7 dias, as concentrações de fósforo alcançadas foram de 2,26 e 2,42 g/100 g nas silagens fermentadas com Lc. lactis Tw34 e Lb. plantarum Lb7 respectivamente, en quanto que no controle os valores permaneceram quase estáveis (1,61 g/100 g). No final do experimento, a atividade inibitória de tripsina foi suprimida em ambas silagens enquanto que no controle os fatores antinutricionais continuavam ativos. Os resultados indicam a possibilidade do uso de uma mistura selecionada como substrato para a produç ão de silagem e a capacidade de Lc. lactis Tw34 e Lb. plantarum Lb7 como inoculantes.

Objective: Verifying the ability of reproducibility of a scale that assesses the attitude to obesity and develops percentile standard for university students from the region of Maule (Chile). Material and Methods: A survey was conducted on 918 university students (535 men and 383 women) from the region of Maule (Chile). Weight and height were evaluated. Body mass index (BMI) was calculated and attitude scale was applied to obesity. The LMS method was used to develop percentile curves. Results: The scale of attitude to obesity (EAO) showed acceptable values of Cronbach's alpha (0.70 men) and women 0.73). The percentile references were dealers in P15, P50 and P85 by allowing value indicator (Preference/Rejection, Concern/Selflessness and Will/Apathy), age range and gender. Conclusions: The EAO is a reliable reference percentile and proposals are an alternative to diagnose, control and monitor obesity attitude of university students.

Objetivos: Verificar la capacidad de reproducibilidad de una escala que valora la actitud a la obesidad y desarrollar estándares de percentil para jóvenes universitarios de la región del Maule (Chile). Material y Métodos: Se efectuó una encuesta en 918 jóvenes universitarios (535 hombres y 383 mujeres) de la región del Maule (Chile). Se evaluó el peso y la estatura. Se calculó el Índice de Masa Corporal (IMC) y se aplicó una escala de actitud a la obesidad. Se utilizó el método LMS para desarrollar las curvas de percentil. Resultados: La escala de actitud a la obesidad (EAO) mostró valores aceptables de Alfa de Cronbach (hombres 0,70) y mujeres 0,73). Las referencias de percentil fueron distribuidas en P15, P50 y P85 que permiten valorar por indicador (Preferencia/Rechazo, Preocupación/Desinterés y Voluntad/Apatía), rango de edad y sexo. Conclusiones: La escala de actitud a la obesidad es un instrumento confiable y las referencias de percentiles propuestas son una alternativa para diagnosticar, controlar y monitorizar la actitud a la obesidad de jóvenes universitarios.

La contaminación por metales pesados (MP) constituye un problema creciente para la salud pública. La utilización de bioindicadores permite evaluar el impacto de la contaminación antrópica. En este estudio se evaluaron 730 cepas de Enterococcus provenientes de diferentes fuentes de la comarca VIRCh-Valdés (Provincia de Chubut), mediante la prueba de sensibilidad a Pb++ por el método de dilución en placa, a concentraciones comprendidas entre 50 mg/L y 1.200 mg/L. De las cepas evaluadas, 223 exhibieron resistencia a plomo a concentraciones ≥ 50 mg/L. Dentro de este grupo se seleccionaron 22 aislados altamente resistentes a plomo (≥ 800 mg/L) con el objetivo de evaluar su resistencia a otros metales pesados, resistencia a antibióticos y determinar sus factores de virulencia. Todas las cepas seleccionadas mostraron alta sensibilidad a Hg++, un patrón variable de resistencia frente a Cd++ y Cr+6 y resistencia moderada a Ni++. Las cepas resultaron susceptibles a ampicilina y penicilina, y presentaron un patrón variable de resistencia a los restantes antibióticos ensayados. Entre los factores de virulencia, se detectó actividad de gelatinasa en dos cepas y sólo una cepa exhibió actividad hemolítica. Estos resultados sugieren una relación entre la resistencia a metales pesados, resistencia a antibióticos y factores de virulencia en cepas de Enterococcus aisladas del medio ambiente.

Contamination by heavy metals is a growing problem for public health and the use of bio-indicators are means for assessing anthropogenic pollution. In this study 730 Enterococcus strains were isolated from different sources of the region VIRCh - Valdés (Province of Chubut) were tested for sensibility to Pb++ by the plate dilution method at concentrations ranging from 50 mg/L to 1200 mg/L. A total of 223 strains displayed resistance to lead at concentration ≥ 50 mg/L. Among this group, and on the basis of its high resistance to lead (≥ 800 mg/L), 22 strains were selected with the goal to determine antibiotic and heavy metal resistance pattern and also the presence of virulence traits. All isolates showed high sensibility to Hg++, a variable pattern against Cd++ and Cr+6, and moderate resistance to Ni++. The strains were all susceptible to ampicillin and penicillin and displayed a variable pattern of resistance towards the remaining antibiotics assayed. Among the virulence traits determined, gelatinase production was detected in 2 strains and only one isolate showed hemolytic activity. The results obtained in this work suggest a relationship between heavy metal resistance, antibiotic resistance and virulence factors in Enterococcus strains isolated from the environment.

Objetivo: El suicidio se sitúa en España como la primera causa de muerte no natural, y el juego patológico es uno de sus principales factores de riesgo de los trastornos adictivos. El estudio realizado tiene como objetivo describir y comparar las características sociodemográficas, la comorbilidad y las características del intento en pacientes con intentos de suicidio que cumplen criterios de juego patológico frente a pacientes con intento de suicidio sin criterios de juego patológico. Métodos: Para los distintos análisis se empleó una muestra de 345 pacientes con intento de suicidio recogida a partir de las admisiones en el servicio de Urgencias de un Hospital Universitario de la Comunidad Autónoma de Madrid durante el periodo comprendido entre 1999 y 2004. Para describir y comparar las características sociodemográficas, de comorbilidad y las relacionadas con el intento de suicidio, se utilizaron modelos de regresión logística ajustados por sexo y edad. Resultados: Los resultados muestran que los pacientes con intento de suicidio que cumplen criterios de juego patológico son predominantemente varones, con bajo nivel de estudios y con mayor tendencia a tener descendencia. Además presentan mayor prevalencia en determinadas comorbilidades: dependencia global de sustancias, dependencia de nicotina, dependencia de cocaína y dependencia de opiáceos. Conclusiones: En este estudio se muestra cierta evidencia sobre la existencia de un subtipo de suicida (jugador patológico suicida) con ciertas características propias, similares a las encontradas en muestras de jugadores patológicos.

Objective: Suicide is the first cause of non-natural death in Spain. Among addictive disorders, pathological gambling is one the most significant independent risk factors for suicidal behavior. The objective of this study is to describe and compare the sociodemographic traits, comorbidity and attempt characteristics, between suicide attempters who fulfill diagnostic criteria for pathological gambling and those who do not. Methods: A total of 345 patients admitted to the emergency department of a University Hospital in Madrid between 1999 and 2004 were interviewed for this study. To describe and compare the demographic characteristics, comorbidity and those related to attempted suicide, using logistic regression models adjusted for sex and age were used. Results: Suicide attempters who fulfilled diagnostic criteria for pathological gambling were predominantly male, with a low education level, and had more offspring. Furthermore, these patients had more comorbidities, such as: global substance dependence, nicotine, cocaine and opioid dependence. Conclusions: The present study suggests that pathological gamblers represent a distinct subgroup among suicide attempters, with particular characteristics, similar to those found in pathological gamblers in the general population.

The aim of this work was to determine the prevalence and gastrointestinal nematodes (gin) burden in hair sheep for slaughter. The study was carried out in a slaughterhouse in Villahermosa, Tabasco. Gastrointestinal contents from 122 sheep were analyzed. The animals came from different municipalities of Tabasco (Centro, Emiliano Zapata, Centla, Huimanguillo Teapa) and Chiapas (Reforma). The GLM procedure of SAS was used to analyze the adult nematode counts and counts by species respect to the age, sex, physiological status and sampling month. Haemonchus contortus, Trichostrongylus colubriformis and Cooperia curticei were the principal nematodes species found in this study and showed the presence of the cestode Moniezia expansa. 41 % (50/122) of the animals sampled had any of the above parasites. The highest percentage of parasitized sheep occurred in Centro (40 %, 19/47) and Huimanguillo (54 %, 22/ 41). The discarded males (8/64) had the highest number of gin (2190 ± 3263). Of ewes (58/122) the open (40/58) had the highest amount of gin (486 ± 1120). In sheep from 31 to 36 mo of age, parasite burdens (49 ± 143) were lower than in animals of all other ages. It was conclude that in the study population age, sex and physiological status affected the number of adult nematodes prevalent in the host.

El objetivo del trabajo fue determinar la prevalencia y conteo de nematodos gastrointestinales (ngi) de ovinos de pelo destinados al abasto. El estudio se llevó a cabo en un rastro en Villahermosa, Tabasco, donde se analizó el contenido gastrointestinal de 122 ovinos provenientes de diferentes municipios del estado de Tabasco (Centro, Emiliano Zapata, Centla, Huimanguillo y Teapa) y Chiapas (Reforma). Se utilizó el procedimiento GLM del SAS para analizar la influencia de la edad, sexo, estado fisiológico y mes de muestreo en los conteos de nematodos adultos totales y por especie. Las especies de nematodos encontrados fueron Haemonchus contortus, Trichostrongylus colubriformis y Cooperia curticei, además el cestodo Moniezia expansa. El 41 % (50/122) de los animales presentaron alguno de los anteriores parásitos. El mayor porcentaje de ovinos parasitados se encontró en los municipios de Huimanguillo (54 %, 22/41) y Centro (40 %, 19/47). De los ovinos machos sacrificados (64/122), los de desecho (8/64) tuvieron el mayor número de ngi (2190 ± 3263) y de las hembras (58/122), las vacías (40/58) presentaron la mayor cantidad de ngi (486 ± 1120). En los ovinos de 31 a 36 meses de edad, las cargas parasitarias (49 ± 143) fueron menores que en los animales de todas las demás edades. Se concluye que en la población de estudio la edad, sexo y estado fisiológico afectaron la prevalencia de nematodos adultos.

O artigo apresenta os resultados de uma pesquisa sobre a política federal de saúde para a Amazônia Legal de 2003 a 2005, visando fornecer subsídios para o desenvolvimento de políticas regionais na saúde. Tal região é marcada por uma dinâmica peculiar, extensa área de fronteira e indicadores sociais desfavoráveis. A metodologia envolveu: análise documental e financeira, observação participante, entrevistas com dirigentes federais de vários ministérios, secretários estaduais e municipais de saúde da Amazônia; caracterização de situações geográficas na Amazônia e estudos de campo em 15 municípios. Observou-se uma baixa institucionalidade da política de saúde para a Amazônia, no período, por dificuldades estruturais, institucionais e políticas. A identificação de seis situações geográficas foi útil para a sistematização de diferenças nos usos do território que repercutem na saúde e devem ser considerados na condução de políticas públicas. Há certo distanciamento entre as ações federais e a dinâmica territorial, expressa no descolamento entre a política em curso e seu reconhecimento pelos gestores locais. Além da construção de uma política regional para a Amazônia, fica evidente a necessidade de políticas diferenciadas dentro da região.

This article presents the results of a study on Federal health policy in the Brazilian Legal Amazon (BLA) from 2003 to 2005, aimed at backing the development of regional health policies. The region has peculiar dynamics, an extensive border area, and adverse social indicators. The methodology included documental and financial analysis, participatory observation, interviews with heads of various Federal Ministries and State and Municipal health secretaries from the BLA; characterization of geographic situations in the BLA; and field studies in 15 municipalities. Institutional consolidation of health policy proved to be low in the Amazon during the study period, due to structural, institutional, and political difficulties. The identification of six geographic situations was useful for systematizing land use differences with repercussions on health, and which should be considered when implementing public policies. There is a certain gap between Federal actions and territorial dynamics, expressed as a mismatch between the current policy and its recognition by local administrators. In addition to establishing a regional policy for the Amazon, there is an evident need for differentiated policies within the region.

O artigo apresenta os resultados de uma pesquisa sobre a política federal de saúde para a Amazônia Legal de 2003 a 2005, visando fornecer subsídios para o desenvolvimento de políticas regionais na saúde. Tal região é marcada por uma dinâmica peculiar, extensa área de fronteira e indicadores sociais desfavoráveis. A metodologia envolveu: análise documental e financeira, observação participante, entrevistas com dirigentes federais de vários ministérios, secretários estaduais e municipais de saúde da Amazônia; caracterização de situações geográficas na Amazônia e estudos de campo em 15 municípios. Observou-se uma baixa institucionalidade da política de saúde para a Amazônia, no período, por dificuldades estruturais, institucionais e políticas. A identificação de seis situações geográficas foi útil para a sistematização de diferenças nos usos do território que repercutem na saúde e devem ser considerados na condução de políticas públicas. Há certo distanciamento entre as ações federais e a dinâmica territorial, expressa no descolamento entre a política em curso e seu reconhecimento pelos gestores locais. Além da construção de uma política regional para a Amazônia, fica evidente a necessidade de políticas diferenciadas dentro da região.

This article presents the results of a study on Federal health policy in the Brazilian Legal Amazon (BLA) from 2003 to 2005, aimed at backing the development of regional health policies. The region has peculiar dynamics, an extensive border area, and adverse social indicators. The methodology included documental and financial analysis, participatory observation, interviews with heads of various Federal Ministries and State and Municipal health secretaries from the BLA; characterization of geographic situations in the BLA; and field studies in 15 municipalities. Institutional consolidation of health policy proved to be low in the Amazon during the study period, due to structural, institutional, and political difficulties. The identification of six geographic situations was useful for systematizing land use differences with repercussions on health, and which should be considered when implementing public policies. There is a certain gap between Federal actions and territorial dynamics, expressed as a mismatch between the current policy and its recognition by local administrators. In addition to establishing a regional policy for the Amazon, there is an evident need for differentiated policies within the region.

The post-embryonic development of the female gonads in Triatoma infestans (Hemiptera, Heteroptera), insects of importance in health affairs as harbors and vectors of different tripanosomatidea flagellates, is presented in a complete follow-up since insect hatches from the egg up to the last molt in the fifth instar stage. The detailed description of the morphological changes which occur in each instar as well as careful measurements evaluating its size increase have been analyzed by stereomicroscopy, phase contrast, dark field, and oblique illumination, in order to optimize the observations as well the photographic register of gonad morphology and structure. The analysis was performed on gonad specimens obtained from broods no less than twenty (20) nymph bugs, reared at constant temperature and fed-up regularly. According to the results of our study we can assert that gonad differentiation takes place in early phases of the insect development. Such is the case that first instars nymph’s present absolutely and easily recognizably male and female gonads. From the third instar on beside the filament region, the three zones in each ovariole body is distinguished, a differentiation that is more noticeable during the fourth instar where a definite organization is present at the vitelarium. Such a clear cut zone development continues intensively during the fifth instar. Finally at the end of such fifth nymph stage and when the last molt toward adults is prepared, clear signs of ovariole maturation take place since oocytes in early vitelogenesis are found.