Abstract Therapeutics that inhibit enzymes, receptors, ion channels, and cotransporters have long been the mainstay of cardiovascular medicine. Now, oligonucleotide therapeutics offer a modern variation on this paradigm of protein inhibition. Rather than target a protein, however, small interfering ribonucleic acids and antisense oligonucleotides target the messenger RNA (mRNA) from which a protein is translated. Endogenous, cellular mechanisms enable the oligonucleotides to bind a selected sequence on a target mRNA, leading to its degradation. The catalytic nature of the process confers an advantage over the stoichiometric binding of traditional small molecule therapeutics to their respective protein targets. Advances in nucleic acid chemistry and delivery have enabled development of oligonucleotide therapeutics against a wide range of diseases, including hyperlipidemias and hereditary transthyretin-mediated amyloidosis with polyneuropathy. While most of these therapeutics were initially designed for rare diseases, recent clinical trials highlight the potential impact of oligonucleotides on more common forms of cardiovascular disease.

RESUMO Introdução: Entre os fatores de risco que estão associados às complicações no binômio mãe-filho estão: histórico de doenças hipertensivas, gravidez na adolescência, uso de drogas, histórico obstétrico desfavorável com histórico de abortos ou óbitos, doenças sexualmente transmissíveis e infecções do trato urinário trato. Objetivo: Identificar o risco obstétrico em tempos de pandemia de COVID-19 na área de saúde "Bastión Popular", Guayaquil, Equador, no período janeiro-junho de 2021. Método: Foi realizada uma investigação de campo descritiva. com abordagem quantitativa, que levou à análise das categorias de risco obstétrico registradas nos prontuários de 117 gestantes, com consentimento informado assinado para obtenção dos dados na referida localidade por meio de visitas domiciliares. Foi utilizada a escala ou escore de risco obstétrico. Resultados: O principal resultado foi que a faixa etária de risco obstétrico mais frequente correspondeu às idades entre 20 e 24 anos e a principal categoria identificada foi Alto risco. O risco obstétrico aumentou proporcionalmente quando o período intergestacional foi reduzido. Conclusões: As mulheres jovens de 20 a 24 anos são as que apresentam maior risco obstétrico, além do risco obstétrico, que se correlaciona com maior número de gestações, abortos, partos e cesarianas, portanto, é necessário fornecer informações às mulheres sobre a gravidez e suas complicações, para que possam identificar os fatores de risco durante a gravidez, parto e puerpério.

ABSTRACT Introduction: Risk factors associated with complications in the mother-child pair include: history of hypertensive disorders, adolescent pregnancy, drug use, unfavorable obstetric history with a background of miscarriages or abortions, sexually transmitted diseases and urinary tract infections. Objective: To identify the obstetric risk in times of COVID-19 pandemic at the ¨Bastión Popular¨ health area, Guayaquil, Ecuador, from January to June 2021. Method: A descriptive-transversal field research was carried out, with a quantitative approach, which favored the analysis of the obstetric risk categories recorded in the medical history of 117 pregnant women, who signed an informed consent, for the collection of data through home visits, using the obstetric risk scale or score. Results: Outcomes assessment showed, as main result, that the most frequent obstetric risk group was the age group 20 to 24 and the high risk factor was the main category identified. Obstetric risk increased proportionally when the interpregnancy interval was reduce. Conclusions: Young women between 20 and 24 years of age are those who presented the highest obstetric risk, which is correlate with a higher number of gestations, abortions, deliveries and cesarean sections. Therefore, it is necessary to provide women with information about pregnancy and its complications, so that they are able to identify risk factors during pregnancy, delivery and the puerperium.

RESUMEN Introducción: Entre los factores de riesgo que se asocian a complicaciones en el binomio madre-hijo se encuentran: antecedentes de trastornos hipertensivos, embarazo adolescente, consumo de drogas, historia obstétrica desfavorable con antecedentes de abortos u óbitos, enfermedades de transmisión sexual e infecciones del tracto urinario. Objetivo: Identificar el riesgo obstétrico en tiempos de pandemia por COVID-19 en el área de salud ¨Bastión Popular¨, Guayaquil, Ecuador, en el periodo enero-junio de 2021. Método: Se realizó una investigación de campo, de tipo descriptiva-transversal, con un enfoque cuantitativo, que propició el análisis de las categorías del riesgo obstétrico registradas en historias clínicas de 117 gestantes, con firma de consentimiento informado para la obtención de los datos en dicha localidad a través de visitas domiciliarias. Fue empleada la escala o score de riesgo obstétrico. Resultados: Se alcanzó como resultado fundamental que el grupo etario de riesgo obstétrico de mayor frecuencia correspondió a las edades comprendidas entre 20 y 24 años y la principal categoría identificada fue el Alto riesgo. El riesgo obstétrico aumentó de manera proporcional cuando el periodo intergenésico se redujo. Conclusiones: Las mujeres jóvenes de 20 a 24 años son las que presentaron mayor riesgo obstétrico, además que el riesgo obstétrico, el cual se encuentra correlacionado con un mayor número de gestas, abortos, partos y cesáreas, por ello, es necesario proporcionarle información a la mujer sobre la gestación y sus complicaciones, para que sean capaces de identificar los factores de riesgos durante el embarazo, parto y puerperio.

Abstract: Objective: To determine the exposure to aflatoxin B1 (AFB1) in southern Mexico and the presence of the aflatoxin signature mutation in hepatocellular carcinoma (HCC) tissue from patients from a cancer referral center. Materials and methods: We estimated the prevalence and distribution of AFB1 in a representative sample of 100 women and men from Chiapas using the National Health and Nutrition Survey 2018-19. We also examined the presence of the aflatoxin signature mutation in codon 249 (R249S), and other relevant mutations of the TP53 gene in HCC tissue blocks from 24 women and 26 men treated in a national cancer referral center. Results: The prevalence of AFB1 in serum samples was 85.5% (95%CI 72.1-93.1) and the median AFB1 was 0.117 pg/µL (IQR, 0.050-0.350). We detected TP53 R249S in three of the 50 HCCs (6.0%) and observed four other G>T transversions potentially induced by AFB1. Conclusion: Our analysis provides evidence that AFB1 may have a relevant role on HCC etiology in Mexico.

Resumen: Objetivo: Determinar la exposición a aflatoxina_B1 (AFB1) en el sur de México y la presencia de la mutación característica de AFB1 en tejido de carcinoma hepatocelular (CHC) de pacientes de un centro oncológico. Material y métodos: Se estimó la prevalencia y distribución de AFB1 en una muestra representativa de 100 mujeres y hombres de Chiapas a partir de la Encuesta Nacional de Salud y Nutrición 2018-19. También se observó la presencia de la mutación característica de AFB1 en el codón 249 (R249S), y otras mutaciones relevantes del gen TP53 en bloques de tejido de CHC de 24 mujeres y 26 hombres estudiados en un centro de referencia nacional de oncología. Resultados: La prevalencia de AFB1 en las muestras de suero fue de 85.5% (IC95% 72.1-93.1) y la mediana de la concentración 0.117 pg/µL (IQR, 0.050-0.350). Se detectó TP53 R249S en tres de 50 casos de CHC (6.0%) y se observaron cuatro transversiones G>T potencialmente inducidas por AFB1. Conclusión: El presente análisis proporciona evidencia de que la AFB1 puede tener un papel relevante en la etiología del CHC en México.

Resumo As espécies invasoras de vertebrados competem com espécies nativas no uso de recursos e transmitem patógenos. Contudo as consequências da co-introdução de parasitos permanecem pouco estudadas. O pardal (Passer domesticus) foi introduzido há um século no Chile, porém não existem dados sobre seus parasitos. O objetivo do estudo foi investigar a fauna parasitária e avaliar se existem espécies co-introduzidas/co-invasivas compartilhadas com as espécies de aves nativas do Chile. Um total de 108 aves foram coletadas em diferentes localidades da região de Ñuble. Seis espécies de artrópodes parasitos foram coletadas de 23 (21,3%) aves. Quatro aves (3,7%) estavam parasitadas por duas espécies de helmintos. Quatro de um total de oito espécies de parasitos correspondem aos primeiros relatos para o Chile. Três artrópodes parasitos e o helminto Anonchotaenia globata são considerados parasitos co-introduzidos no país. Apenas A. globata possui potencial para ser considerada uma espécie co-invasiva, pois pode parasitar Passeriformes em geral. Pesquisas futuras devem investigar se os demais parasitos identificados neste estudo correspondem a espécies co-introduzidas ou co-invasoras e avaliar as possíveis consequências na saúde das aves nativas do país.

Abstract Invasive species impact native wildlife in several ways, as they compete for resources and may transmit their specific pathogens. However, the potential consequences of co-introduced parasites are not fully understood. While the house sparrow (Passer domesticus) was introduced in Chile about a century ago, no data are available regarding its parasites. Thus, the aim of the present study was to determine the parasitic fauna of this avian invader and to determine whether there are co-introduced/co-invasive parasites shared with native birds. One hundred and eight birds were collected from three different localities in the Ñuble region of Chile, and a complete parasitic necropsy was performed in the laboratory. Twenty-three (21.3%) were parasitized by six arthropod species and four (3.7%) were parasitized by two helminth species. Four out of eight taxa are reported for the first time in Chile; among them, three arthropod parasites and the tapeworm, Anonchotaenia globate, are considered as co-introduced parasites. Only A. globata is a potential co-invasive parasite given its low degree specificity in terms of its definitive hosts. Future research should examine whether additional co-introduced/co-invasive parasites have been brought by the house sparrow, and what their potential consequences might be on the health of native birds in Chile.

BACKGROUND: Mental health disorders, which are interlinked with social issues such as poverty and stigma, present a significant burden in Uganda. AIM: This article explores perceptions about and experiences of mental health disorders in western Uganda, particularly as they pertain to the socio-economic context. SETTING: The research was conducted in the mental health unit at the Fort Portal Regional Referral Hospital, Kabarole District, Uganda. METHOD: This article is based on qualitative anthropological research conducted from January to March 2017, including 49 semi-structured interviews about ideas and determinants of mental health, with health workers, former mental health service users, their relatives and influential community members. RESULTS: Many interviewees felt that mental health disorders are an increasing problem in their community. Economic challenges, such as poverty, unemployment and financial stress, are seen as both a cause and a consequence of mental illness. Mental health challenges can be exacerbated by shortages in mental healthcare, which are shown to be complexly interrelated with stigma. CONCLUSION: This article provides an insight into mental health experiences in Fort Portal based on the perspectives of various interviewees. Further funding and research are recommended to inform contextually appropriate services.

Abstract Eumerus Meigen, 1823 is a very speciose genus of flower flies from the Eastern Hemisphere. Several reports of introduced species of this genus in the Americas have been recorded since early in the twentieth century, with a present list of six species recorded to date from the Americas and the US territory of Hawaii. In this paper we give new geographical records for the African-native species Eumerus obliquus (Fabricius, 1805), which reflect the expansion of this fly through Brazil and Paraguay along the last twenty years. At the same time, we report a second species from Paraguay, Eumerus aurifrons (Wiedemann, 1824), being this the first Western Hemisphere record for this Asian-native species. We finally provide an identification key to all of the species of Eumerus presently known from the Americas and Hawaii.

Abstract Background: Beta-cardiotoxin (β-CTX), the three-finger toxin isolated from king cobra (Ophiophagus hannah) venom, possesses β-blocker activity as indicated by its negative chronotropy and its binding property to both β-1 and β-2 adrenergic receptors and has been proposed as a novel β-blocker candidate. Previously, β-CTX was isolated and purified by FPLC. Here, we present an alternative method to purify this toxin. In addition, we tested its cytotoxicity against different mammalian muscle cell types and determined the impact on cardiac function in isolated cardiac myocyte so as to provide insights into the pharmacological action of this protein. Methods: β-CTX was isolated from the crude venom of the Thai king cobra using reverse-phased and cation exchange HPLC. In vitro cellular viability MTT assays were performed on mouse myoblast (C2C12), rat smooth muscle (A7r5), and rat cardiac myoblast (H9c2) cells. Cell shortening and calcium transient dynamics were recorded on isolated rat cardiac myocytes over a range of β-CTX concentration. Results: Purified β-CTX was recovered from crude venom (0.53% w/w). MTT assays revealed 50% cytotoxicity on A7r5 cells at 9.41 ± 1.14 µM (n = 3), but no cytotoxicity on C2C12 and H9c2 cells up to 114.09 µM. β-CTX suppressed the extend of rat cardiac cell shortening in a dose-dependent manner; the half-maximal inhibition concentration was 95.97 ± 50.10 nM (n = 3). In addition, the rates of cell shortening and re-lengthening were decreased in β-CTX treated myocytes concomitant with a prolongation of the intracellular calcium transient decay, indicating depression of cardiac contractility secondary to altered cardiac calcium homeostasis. Conclusion: We present an alternative purification method for β-CTX from king cobra venom. We reveal cytotoxicity towards smooth muscle and depression of cardiac contractility by this protein. These data are useful to aid future development of pharmacological agents derived from β-CTX.

Irritable bowel syndrome (IBS) is a chronic pathology with disorders of the bowel-brain interaction, characterized by abdominal pain localized anywhere in the abdomen as well as bowel habit alteration (constipation, diarrhea or mixed), in the absence of any disease that can cause these symptoms. With the updated concepts according to the latest meeting of experts in Rome 2016, our goal is to raise awareness about irritable bowel syndrome, by reviewing the literature regarding definition, classification, pathophysiology, clinical aspects, treatment, prognosis and the future. IBS is a chronic pathology, characterized by abdominal pain, at least 1 day per week in the last 3 months, associated with the alteration of the intestinal bowel habits. With a classification based on the alteration of intestinal bowel movements and in addition to constipation induced by opioids or narcotics, the etiology and pathophysiology are not well explained or well-known so far. The clinical aspects are based on the Rome IV criteria. A good doctor-patient relationship is key to reassuring the patient’s doubts about his illness, which increases the chances of adherence to individualized treatment from patient to patient depending on the sing and symptoms that may manifest in those that include: dietary advice, psychological support, in some cases pharmacological prescription, suspension of medications or change medications, minimize the dose of drugs or suspend, according to the needs of the patient as is the case of opioids. The prognosis is still uncertain, and a promising future to illustrate new definitions, classifications, pathophysiologies, clinical aspects and treatments according to the type of clinical manifestation of each patient.

El síndrome del intestino irritable (SII) es una patología crónica con desordenes de la interacción cerebro intestino, caracterizado por dolor abdominal localizado en cualquier parte del abdomen además de alteración del hábito intestinal como (constipación, diarrea o mixto), en ausencia de alguna enfermedad que pueda causar estos síntomas. Con los conceptos actualizados conforme en la última reunión de expertos en Roma 2016, nuestra meta es dar a conocer más sobre el síndrome del intestino irritable, mediante revisión de la literatura en cuanto a definición, clasificación, fisiopatología, aspectos clínicos, tratamiento, pronóstico y el futuro. El SII es una patología crónica, caracterizado por dolor abdominal, por lo menos 1 día por semana en los últimos 3 meses, asociado a la alteración del hábito intestinal. Con una clasificación basada en la alteración de los hábitos intestinales y además de constipación inducida por opioides o narcóticos, la etiología y fisiopatología no están bien explicadas ni se conocen bien hasta el momento. Los aspectos clínicos son basados en los criterios de Roma IV. Una buena relación médico-paciente es clave para tranquilizar las dudas del paciente sobre su enfermedad, lo que aumenta las posibilidades de adherencia al tratamiento individualizado de paciente a paciente dependiendo de las sintomatologías y signos que puedan manifestar en los que incluyen: asesoramiento dietético, apoyo psicológico, en algunos casos cambiar medicación, disminuir al mínimo la dosis del medicamento o suspender, según las necesidades del paciente como son los casos de los opiodes. El pronóstico todavía incierto, y un futuro prometedor para ilustrar nuevas definiciones, clasificaciones, fisiopatologías, aspectos clínicos, tratamientos posiblemente de acuerdo con el tipo de manifestación clínica de cada paciente.

John de Gruchy's The Church Struggle in South Africa was a bold attempt to write the story of the kingdom of God in his native land. While it stood toward the beginning of his written work, the themes laid down in it have followed De Gruchy's writings up to the present. They have also sketched the story of South Africa from the climax of the struggle to end Apartheid to the present travails to realize its promise. This article takes up the final chapter in that work, comparing it to another great theological attempt to write the kingdom of God: H. Richard Niebuhr's The Kingdom of God in America. It follows that chapter through its disappearance in the third edition of The Church Struggle, to its re-emergence in The End is Not Yet. The article is especially interested in De Gruchy's eschatological retrieval of Bonhoeffer's tension between the ultimate and the penultimate, and in the question of God's trinitarian reality shaping the world - and us as community of anticipation.

The concept of "public" (as used in the term "public worship) is interrogated in the light of Paul's understanding of nakedness/clothedness in 2 Corinthians 5:1-11. The conclusion drawn is that Christian liturgy is actually "private", and the resulting dissonance between precept and practice is untenable. A more appropriate approach to public-ness is developed with reference to John Wesley: liturgical events should and could intentionally be convened outside Christian premises - with the liturgists stripped of privilege. This is then illustrated by reference to field notes of an actual instance of such a "naked liturgy" that takes place weekly on the streets of Cape Town.

Resumo Objetivo: investigar a cobertura de equipamentos radiográficos odontológicos disponibilizados pelo Sistema Único de Saúde (SUS) nos municípios da região Sul do Brasil em 2016 e a realização de procedimentos radiográficos nos municípios que dispõem desses equipamentos. Métodos: foi realizado estudo ecológico com dados do Sistema de Informações Ambulatoriais do SUS (unidades básicas de saúde com consultório odontológico, disponibilidade e funcionamento dos equipamentos radiográficos e realização de radiografias) e da Fundação Instituto Brasileiro de Geografia e Estatística (população); foram realizados o teste do qui-quadrado e análise de variância. Resultados: 984 equipamentos radiográficos odontológicos foram identificados em 479 dos 1.191 municípios analisados; 60% dos municípios não apresentaram equipamentos, 68% apresentaram cobertura menor que a recomendada e 52% dos municípios com equipamentos não realizaram nenhum exame radiográfico durante o ano de 2016. Conclusão: menos da metade dos municípios possuíam equipamentos radiográficos odontológicos; entre os que tinham esses equipamentos, metade não realizou nenhum procedimento.

Abstract Objective: to investigate the coverage of dental radiographic equipment provided by the Brazilian National Health System (SUS) in South Brazilian municipalities in 2016 and to investigate radiographic procedures in the municipalities that have this equipment. Methods: this was an ecological study conducted with data from the SUS Outpatient Information System (primary healthcare units with a dental surgery, radiographic equipment available and operational and X-rays being performed) and Brazilian Institute of Geography and Statistics data (population); the chi-square test and variance analysis were performed. Results: 984 items of dental radiographic equipment were identified in 479 out of 1,191 municipalities analyzed; 60% of the municipalities had no equipment, 68% had less than the recommended coverage, and 52% of the municipalities with equipment did not perform any radiography examination during 2016. Conclusion: less than half of the municipalities had radiographic dental equipment; among those that did have this equipment, half did not perform any procedures.

Resumen Objetivo: investigar la cobertura de equipos radiográficos odontológicos puestos a disposición por el Sistema Único de Salud (SUS) en municipios de la región Sur de Brasil en 2016 e investigar la realización de procedimientos radiográficos en municipios que disponen de esos equipos. Métodos: se realizó un estudio ecológico con datos del Sistema de Información Ambulatoria del SUS (unidades básicas de salud con consultorio odontológico, disponibilidad/funcionamiento de los equipos radiográficos y realización de radiografías) y de la Fundación Instituto Brasileño de Geografía y Estadística (población); se realizaron pruebas de Chi-cuadrado y análisis de varianza. Resultados: Se identificaron 984 equipos radiográficos odontológicos en 479 de los 1.191 municipios; 60% no presentaron equipamientos, 68% presentaron cobertura menor a la recomendada y el 52% con equipamiento no realizó ninguna radiografía durante el año de 2016. Conclusión: menos de la mitad de los municipios tenía equipos de rayos X; entre los que tenían esos equipos, la mitad no realizó ningún procedimiento.

Resumo Objetivo: investigar a cobertura de equipamentos radiográficos odontológicos disponibilizados pelo Sistema Único de Saúde (SUS) nos municípios da região Sul do Brasil em 2016 e a realização de procedimentos radiográficos nos municípios que dispõem desses equipamentos. Métodos: foi realizado estudo ecológico com dados do Sistema de Informações Ambulatoriais do SUS (unidades básicas de saúde com consultório odontológico, disponibilidade e funcionamento dos equipamentos radiográficos e realização de radiografias) e da Fundação Instituto Brasileiro de Geografia e Estatística (população); foram realizados o teste do qui-quadrado e análise de variância. Resultados: 984 equipamentos radiográficos odontológicos foram identificados em 479 dos 1.191 municípios analisados; 60% dos municípios não apresentaram equipamentos, 68% apresentaram cobertura menor que a recomendada e 52% dos municípios com equipamentos não realizaram nenhum exame radiográfico durante o ano de 2016. Conclusão: menos da metade dos municípios possuíam equipamentos radiográficos odontológicos; entre os que tinham esses equipamentos, metade não realizou nenhum procedimento.

Abstract Objective: to investigate the coverage of dental radiographic equipment provided by the Brazilian National Health System (SUS) in South Brazilian municipalities in 2016 and to investigate radiographic procedures in the municipalities that have this equipment. Methods: this was an ecological study conducted with data from the SUS Outpatient Information System (primary healthcare units with a dental surgery, radiographic equipment available and operational and X-rays being performed) and Brazilian Institute of Geography and Statistics data (population); the chi-square test and variance analysis were performed. Results: 984 items of dental radiographic equipment were identified in 479 out of 1,191 municipalities analyzed; 60% of the municipalities had no equipment, 68% had less than the recommended coverage, and 52% of the municipalities with equipment did not perform any radiography examination during 2016. Conclusion: less than half of the municipalities had radiographic dental equipment; among those that did have this equipment, half did not perform any procedures.

Resumen Objetivo: investigar la cobertura de equipos radiográficos odontológicos puestos a disposición por el Sistema Único de Salud (SUS) en municipios de la región Sur de Brasil en 2016 e investigar la realización de procedimientos radiográficos en municipios que disponen de esos equipos. Métodos: se realizó un estudio ecológico con datos del Sistema de Información Ambulatoria del SUS (unidades básicas de salud con consultorio odontológico, disponibilidad/funcionamiento de los equipos radiográficos y realización de radiografías) y de la Fundación Instituto Brasileño de Geografía y Estadística (población); se realizaron pruebas de Chi-cuadrado y análisis de varianza. Resultados: Se identificaron 984 equipos radiográficos odontológicos en 479 de los 1.191 municipios; 60% no presentaron equipamientos, 68% presentaron cobertura menor a la recomendada y el 52% con equipamiento no realizó ninguna radiografía durante el año de 2016. Conclusión: menos de la mitad de los municipios tenía equipos de rayos X; entre los que tenían esos equipos, la mitad no realizó ningún procedimiento.

Resumen Objetivo. Conocer el estado serológico de hembras bovinas a IBR, DVB, leucosis, leptospira y Neospora caninum en el departamento de Santander, Colombia. Materiales y métodos. Se realizó un muestreo por conveniencia en 460 fincas ganaderas de 23 municipios de Santander (Colombia), los sueros colectados fueron analizados mediante diferentes kits comerciales de ELISA siguiendo las instrucciones del fabricante. Resultados. En todas las enfermedades estudiadas se encontraron animales seroreactores, correspondiendo la prevalencia general a Leucosis 21.8%, Leptospira 26.1%, DVB 29.7%, IBR 48.2% y Neospora 63%. Conclusiones. En el departamento de Santander las enfermedades analizadas se encuentran en la población bovina con prevalencias que fluctúan entre medio a alto, lo cual requiere medidas de control oficial.

Abstract Objective. To determine the serological status of bovine females for infectious bovine rhinotracheitis (IBR), bovine viral diarrhea (BVD), leucosis, Leptospira and Neospora caninum in the department of Santander, Colombia. Materials and methods. Convenience sampling was conducted on 460 cattle farms in 23 municipalities of Santander (Colombia). The collected sera were analyzed using different commercial ELISA kits following the manufacturer’s instructions. Results. Seroreactive animals were found for all diseases studied, with general prevalence rates of 21.8% for leucosis, 26.1% for Leptospira, 29.7% for BVD, 48.2% for IBR and 63% for Neospora. Conclusions. The prevalence rates of the diseases analyzed in the department of Santander among the bovine population fluctuate from medium to high and thus require official control measures.