Abstract Objective To verify the influence of low birth weight and rapid postnatal weight gain and associated factors on blood pressure in adolescence in a population of low socioeconomic status, considering that injuries occur in the perinatal period can be predictors of future metabolic changes and are still poorly explored. Methods A cohort study was carried out with 208 adolescents, 78 born with low weight and 130 born with appropriate weight. The infants were followed up during the first six postnatal months and reassessed at 8 and 18 years of age. The independent variables were birthweight and postnatal weight gain. Rapid postnatal weight gain was defined when above 0.67 z score. The co-variables were sex, maternal height and family income at birth, nutritional status at eight years old, socioeconomic conditions, nutritional status, fat mass index, and physical activity level at 18 years. The outcome variable was blood pressure at 18 years old. The bivariate and multivariable logistic regression analysis were realized and p < 0,05 was considered significant. Results The proportion of adolescents with elevated blood pressure was 37.5%. The multivariable logistic regression analysis showed the variables independently associated with a higher chance of elevated blood pressure in adolescence were rapid postnatal weight gain (OR = 2.74; 95% CI 1.22-6.14; p= 0.014), male sex (OR = 4.15; 95% CI 1.66-10.38; p= 0.002) and being physically active (OR = 2.70; 95% CI 1.08-6.74; p= 0.034). Conclusions The rapid postnatal weight gain was a predictor for elevated blood pressure in adolescence, independently of other factors.

Resumen Un nivel de satisfacción laboral adecuado de los miembros del equipo de salud es esencial para garantizar una buena prestación de servicios, generar compromiso personal, estimular el deseo de actualización y fomentar la retención dentro del sistema. No hemos encontrado ninguna publicación que aborde específicamente este tema en el ámbito de la Ortopedia y Traumatología en nuestro medio. El objetivo de este estudio es conocer cómo perciben los especialistas que pertenecen a la Asociación Argentina de Cirugía de Hombro y Codo sus condiciones de trabajo, cuál es su remuneración y su grado de satisfacción y compararlos con equivalentes de otros países iberoamericanos. Los resultados de la encuesta mostraron niveles promedio de satisfacción bajos en los profesionales argentinos encuestados. Existen diferencias estadísticamente significativas con profesionales de otros países de Iberoamérica tanto en lo relativo a la remuneración como en los índices de bienestar. Si no se producen profundos cambios en el sistema de atención, la remuneración y las condiciones de trabajo, tarde o temprano aparecerán consecuencias que afectarán no solo a los profesionales, sino también a los pacientes y al sistema en general.

Abstract An adequate level of job satisfaction of the members of a health team is essential to guarantee the quality of the services provided, generate personal commitment, stimulate the desire to update, and promote retention within the system. We have not found any publication that specifically addresses this issue in the field of Orthopedics and Traumatology in our setting. The objective of this study is to know how the specialists who belong to the Argentine Association of Shoulder and Elbow Surgery perceive their working conditions, what their remuneration is and their degree of satisfaction, and to compare them with equivalents from other Ibero-American countries. The results of the survey showed low average levels of satisfaction in the Argentine professionals surveyed. There are statistically significant differences with professionals from other Ibero-American countries both in terms of remuneration and wellbeing indices. If there are no profound changes in the healthcare system, the remuneration and the working conditions, sooner or later consequences will appear that will affect not only professionals but also patients and the system in general.

Surgical site infections complicating orthopedic implant surgeries prolong hospital stay and increase risk of readmission, hospitalization costs and mortality. These recommendations are aimed at: (i) optimizing compliance and incorporating habits in all surgery phases by detecting risk factors for surgical site infections which are potentially correctable or modifiable; and (ii) optimizing preoperative antibiotic prophylaxis as well as intraoperative and postoperative care.

Las infecciones del sitio quirúrgico que complican las cirugías ortopédicas con implante prolongan la estadía hospitalaria y aumentan tanto el riesgo de readmisión como el costo de la internación y la mortalidad. Las presentes recomendaciones están dirigidas a: (i) optimizar el cumplimiento de normas y la incorporación de hábitos en cada una de las fases de la cirugía, detectando factores de riesgo para infecciones del sitio quirúrgico potencialmente corregibles o modificables; y (ii) adecuar la profilaxis antibiótica preoperatoria y el cuidado intra y postoperatorio.

Resumo Objetivo: Verificar o efeito agudo do exercício aeróbio vigoroso sobre o controle inibitório em adolescentes. Métodos: Estudo controlado e randomizado com delineamento cruzado. Vinte púberes foram submetidos a duas sessões de 30 minutos: 1) sessão exercício aeróbio feito entre 65-75% da frequência cardíaca de reserva, com cinco minutos para aquecimento, 20 minutos na intensidade alvo e cinco minutos de volta à calma; e 2) sessão controle assistindo a desenho animado. Previamente e após as sessões, o teste de Stroop computadorizado (Testinpacs®) foi aplicado para avaliar o controle inibitório. O tempo de reação (ms) e os erros cometidos (n) foram registrados. Resultados: O tempo de reação da sessão controle não apresentou diferença significativa. Por outro lado, o tempo de reação da sessão exercício diminuiu após a intervenção (p<0,001). Os erros cometidos na sessão exercício foram menores do que na sessão controle (p=0,011). Adicionalmente, houve associação positiva do tempo de reação (Δ) da sessão exercício com a idade (r2=0,404; p=0,003). Conclusões: O exercício aeróbio vigoroso parece promover melhoria aguda no controle inibitório em adolescentes. O efeito do exercício sobre o desempenho do controle inibitório foi associado à idade e demonstrou ser reduzido em faixas etárias mais altas.

Abstract Objective: To assess the acute effect of vigorous aerobic exercise on the inhibitory control in adolescents. Methods: Controlled, randomized study with crossover design. Twenty pubertal individuals underwent two 30-minute sessions: (1) aerobic exercise session performed between 65% and 75% of heart rate reserve, divided into 5 min of warm-up, 20 min at the target intensity and 5 min of cool down; and (2) control session watching a cartoon. Before and after the sessions, the computerized Stroop test-Testinpacs™ was applied to evaluate the inhibitory control. Reaction time (ms) and errors (n) were recorded. Results: The control session reaction time showed no significant difference. On the other hand, the reaction time of the exercise session decreased after the intervention (p<0.001). The number of errors made at the exercise session were lower than in the control session (p=0.011). Additionally, there was a positive association between reaction time (Δ) of the exercise session and age (r2=0.404, p=0.003). Conclusions: Vigorous aerobic exercise seems to promote acute improvement in the inhibitory control in adolescents. The effect of exercise on the inhibitory control performance was associated with age, showing that it was reduced at older age ranges.

Resumo Introdução: Indivíduos com sequelas de acidente vascular encefálico (AVE) apresentam alterações no alinhamento postural e força muscular associada a uma hemiplegia ou hemiparesia. A terapia de espelho é uma técnica que visa melhorar a função motora do membro parético. Objetivo: O objetivo deste estudo foi avaliar o efeito da terapia do espelho, associada à fisioterapia convencional, na amplitude de movimento (ADM), grau de espasticidade do membro superior acometido e no nível de independência das Atividades de Vida Diária (AVD) de paciente pós Acidente Vascular Cerebral (AVC). Métodos: Trata-se de um estudo quase experimental do tipo antes e depois. Participaram do estudo 10 pacientes pós AVC, os quais se encontrassem em atendimento fisioterapêutico e apresentassem paresia em membro superior. Para a avaliação utilizou-se goniometria, escala de Ashworth modificada, Fugl-Meyer e Índice de Barthel. Foram realizadas 15 sessões com duração de 30 minutos, compostas de alongamento dos músculos flexores e extensores de punho e cotovelo, pronadores e supinadores, seguidos da terapia do espelho com exercícios funcionais gradativos. Resultados: Observou-se melhora em todos os aspectos estudados, porém com diferenças estatisticamente significantes para ADM de extensão de punho (p = 0,04) e supinação de antebraço (p = 0,03). Conclusão: Pode-se concluir que a terapia do espelho contribuiu para que os participantes desta pesquisa obtivessem boa evolução nos aspectos estudados, principalmente em relação à ADM do membro superior acometido.

Abstract Introduction: Individuals with stroke sequelae present changes in the postural alignment and muscle strength associated with hemiplegia or hemiparesis. Mirror therapy is a technique that aims to improve the motor function of the paretic limb. Objective: The aim of this study was to evaluate the effect of mirror therapy, associated with conventional physiotherapy, for range of motion (ROM), degree of spasticity of the affected upper limb, and the level of independence in the activities of daily living (ADL) of chronic patients after stroke. Methods: This was a quasi-experimental (before and after) study. The study included ten stroke survivors undertaking physiotherapy and presenting with upper limb paresis. The following gauges were used for the present study: goniometry, the Modified Ashworth Scale, Fugl-Meyer and Barthel Index. Fifteen sessions were performed, each lasting 30 minutes, consisting of stretching of the flexor and extensor muscles of the wrist and elbow, pronators and supinators, followed by mirror therapy with gradual functional exercises. Results: Improvement was observed in all aspects studied, however with significant differences for ROM wrist extension (p = 0.04) and forearm supination (p = 0.03) Conclusion: It can be concluded that mirror therapy contributed to the participants' good performance in the aspects studied, mainly in relation to ROM of the affected upper limb.

Resumo A obesidade é considerada doença com múltipla etiologia. Avanços recentes na tecnologia têm apontado genes candidatos que estão relacionados ao ganho de massa corporal em diversas populações. Entretanto, em países com miscigenação étnica, como o Brasil, estudos dessa natureza com escolares ainda são escassos. Objetivou-se comparar variáveis antropométricas em estudantes brasileiros do sexo masculino de acordo com os genótipos do rs9939609 do gene FTO. Para tanto, 205 participantes tiveram sua massa corporal, estatura, circunferência da cintura e dobras cutâneas medidos. Índice de massa corporal (IMC), relação cintura-estatura e percentual de gordura foram calculados. Os voluntários foram classificados como com excesso de peso de acordo com o escore-z de IMC por idade. Ademais, os participantes foram genotipados conforme o polimorfismo de nucleotídeo único rs9939609 do gene FTO (AA, AT e TT). ANOVA de uma entrada com post hoc de Bonferroni foi realizada para comparar as variáveis antropométricas entre os genótipos. Odds ratio foi calculada no intuito de revelar chances aumentadas de apresentar maior escore-z de IMC por idade, razão cintura-estatura e percentual de gordura. Os indivíduos homozigotos para o alelo A apresentaram valores significativamente mais altos para escore-z de IMC por idade (0,38±1,01 vs. -0,29±1,15), circunferência da cintura (77,15±6,51 vs. 72,85±7,36 cm) e relação cintura-estatura (0,44±0,04 vs. 0,42±0,04) quando comparados aos indivíduos com genótipo TT. O alelo A do rs9939609 do gene FTO parece influenciar a adiposidade de estudantes do sexo masculino.

Abstract Obesity is considered a disease with multiple etiologies. Recent advances in technology have pointed candidate genes that are related to weight gain in several populations. However, in countries with ethnic miscegenation, such as Brazil, studies of this nature with students are still scarce. The aim of the present study was to compare anthropometric variables of Brazilian male students according to the genotypes of the rs9939609 of the FTO gene. In order to do so, 205 participants underwent body mass, height, waist circumference and skinfold thickness measurements. Body mass index (BMI), waist-to-height ratio and body fat percentage were calculated. Volunteers were characterized as overweight according to the BMI-for-age z-score. Participants were genotyped according to the single nucleotide polymorphism rs9939609 of the FTO gene (AA, AT and TT). ANOVA one-way with Bonferroni’s post hoc was performed to compare genotypes and anthropometric variables. Odds Ratio was calculated to reveal increased chances of presenting higher body mass index z-score, waist-to-height ratio and body fat percentage. Participants homozygous for the A allele presented significantly higher values of BMI-for-age z-score (0.38±1.01 vs. -0.29±1.15), waist circumference (77.15±6.51 vs. 72.85±7.36 cm) and waist-to-height ratio (0.44±0.04 vs. 0.42±0.04) when compared to individuals with the TT genotype. The A allele of the rs9939609 of the FTO gene seems to influence in the adiposity of male students.

"Velocidade crítica estima velocidade de lactato mínimo em corredores adolescentes." Com o objetivo de investigar a validade da velocidade crítica (VC) como método não invasivo de estimar a velocidade de lactato mínimo (VLM), 25 corredores adolescentes foram submetidos aos seguintes testes de corrida: 1) 3000m; 2) 1600m; 3) teste de VLM. A intensidade de lactato mínimo foi definida pela velocidade correspondente à menor concentração de lactato sanguíneo durante o teste de VLM. A VC foi determinada utilizando-se o modelo linear, sendo definida pela inclinação da reta de regressão distância-tempo nos testes de corrida de 1600 e 3000m. Não houve diferença significativa (p=0,3055) entre VLM e VC. Além disso, ambos os protocolos apresentaram uma boa concordância, baseado na pequena diferença entre as médias e nos estreitos limites de concordância, bem como um erro padrão de estimativa classificada como ideal. Em conclusão, a VC, como identificada no presente estudo, pode ser uma alternativa para identificação não invasiva da VLM.

In order to investigate the validity of critical velocity (CV) as a noninvasive method to estimate the lactate minimum velocity (LMV), 25 youth runners underwent the following tests: 1) 3,000m running; 2) 1,600m running; 3) LMV test. The intensity of lactate minimum was defined as the velocity corresponding to the lowest blood lactate concentration during the LMV test. The CV was determined using the linear model, defined by the inclination of the regression line between distance and duration in the running tests of 1,600 and 3,000m. There was no significant difference (p=0.3055) between LMV and CV. In addition, both protocols presented a good agreement based on the small difference between means and the narrow levels of agreement, as well as a standard error of estimation classified as ideal. In conclusion, CV, as identified in this study, may be an alternative for noninvasive identification of LMV.

"Velocidad crítica estima velocidad de lactato mínimo en corredores jóvenes." Con el objetivo de investigar la validez de la velocidad crítica (VC) como un método no invasivo de estimar la velocidad de lactato mínimo (VLM), 25 corredores jóvenes realizaron las siguientes pruebas de carrera: 1) 3.000m; 2) 1.600m; 3) prueba de VLM. La intensidad de lactato mínimo fue definida como la velocidad correspondiente a la menor concentración de lactato sanguíneo durante la prueba de VLM. La VC fue determinada utilizando el modelo lineal, definido por la inclinación de la recta de regresión distancia-tiempo en las pruebas de carrera de 1.600 y 3.000m. No hubo diferencia significativa (p=0,3055) entre VLM y VC. Además, ambos protocolos tuvieron una buena concordancia, basado en la pequeña diferencia entre las medias y los estrechos límites de concordancia, así como un error padrón de la estimación clasificado como ideal. En conclusión, la VC, como identificado en este estudio, puede ser una alternativa no invasiva para la identificación de VLM.

Objetivo: Avaliar o nível de radiação no ambiente de um serviço de PET/CT. Materiais e Métodos: Para a determinação dos níveis de radiação no ambiente foram utilizados dosímetros termoluminescentes TLD-100H previamente selecionados e calibrados. Estes detectores foram expostos durante 32 dias em diversos pontos estrategicamente escolhidos nas dependências do serviço e nos prédios adjacentes. Após o período de exposição, os dosímetros foram recolhidos e processados. Resultados: Em nenhum dos pontos avaliados os valores medidos ultrapassaram os limites de restrição de dose para área controlada (5 mSv/ano) ou para área livre (0,5 mSv/ano) recomendados pelas normas brasileiras. Conclusão: Com este trabalho foi possível demonstrar que todas as blindagens do serviço estão adequadas e que, consequentemente, os trabalhadores, desde que seguindo as normas de radioproteção, receberão doses abaixo da dose de restrição indicada no Brasil.

Objective: To evaluate the level of ambient radiation in a PET/CT center. Materials and Methods: Previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results: In none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/year) or free area (0.5 mSv/year) as recommended by the Brazilian regulations. Conclusion: In the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed.

Os objetivos do presente estudo foram analisar e comparar os efeitos do exercício realizado em diferentes intensidades, acima e abaixo do limiar de lactato (LL), sobre a resposta da pressão arterial (PA) e óxido nítrico (NO) em indivíduos com diabetes tipo 2 (DM2). Para tanto, 11 DM2 foram submetidos às seguintes sessões: 1) sessão controle; 2) 20 min de exercício em cicloergômetro em intensidade moderada (80%LL); e 3) 20 min de exercício em cicloergômetro em alta intensidade (120%LL). O NO plasmático e as medidas de PA foram realizadas no repouso, bem como aos 15 e 45 min do período de recuperação de todas as sessões. Quando comparado ao período de repouso, somente a sessão de exercício realizado a 120%LL promoveu aumento do NO (de 7,2 para 9,5 µM, p<0,05) e, por conseguinte, uma diminuição na pressão arterial sistólica (de 126,6±7,9 para 118,7±3,9 mmHg, p<0,05) durante o período de recuperação pós-exercício. Em conclusão, os resultados sugerem que a liberação de NO e a diminuição da PA parecem ser intensidade-dependente para indivíduos com DM2.

The purposes of this study were to analyze and compare the effects of exercise performed in different intensities, above and below lactate threshold (LT) on post-exercise blood pressure (BP) and nitric oxide (NO) responses in individuals with type 2 diabetes (T2D). For this, 11 T2D underwent the following sessions: 1) control session; 2) 20-min of moderate cycling (80% LT); and 3) 20-min of high intensity cycling (120%LT) on a cycle ergometer. Plasma NO and BP measurements were carried out at rest and at 15 and 45 min of post-sessions. When compared to rest, only the exercise session performed at 120%LT elicited an increase of NO (from 7.2 to 9.5 µM, p<0.05), as well as a decrease in systolic BP (from 126.6±7.9 to 118.7±3.9 mmHg, p<0.05) during the post-exercise period. In conclusion, the results suggest that NO release and post-exercise BP decrease are intensity-dependent for individuals with T2D.

Los objetivos del presente estudio fueron examinar y comparar los efectos del ejercicio realizado en diferentes intensidades, arriba y abajo del umbral de lactato (UL), sobre la respuesta de la presión arterial (PA) y el óxido nítrico (NO) en individuos con diabetes tipo 2 (DM2). Por lo tanto, 11 DM2 se sometieron las siguientes sesiones: 1) sesión control; 2) 20 min de ejercicio en cicloergómetro a una intensidad moderada (80%UL); y 3) 20 min de ejercicio en cicloergómetro a una intensidad alta (120%UL). El NO plasmático y las mediciones de la PA fueron realizados en reposo y en 15 y 45 min del período de recuperación para todas las sesiones. En comparación con el período de reposo, sólo la sesión de ejercicio realizado a 120%UL promovió aumento de NO (7,2 para 9,5 µM, p<0,05) y, por lo tanto, una disminución de la presión arterial sistólica (de 126,6±7,9 para 118,7±3,9 mmHg, p<0,05) durante el período de recuperación después del ejercicio. En conclusión, los resultados sugieren que la liberación de NO y la disminución de PA parece ser intensidad-dependiente para individuos con DM2.

This paper develops the methodological principles of pooled analysis design, using it to study situations of vulnerability among drug users at a regional level. Data from thirteen cross-sectional studies carried out in Argentina, Brazil and Uruguay between 1998 and 2004 were integrated. A critical review of the concept of data matrix which identifies four structural components, allowed us to: define the units of analysis spanning the different original populations; identify a core of common variables (social and demographic characteristics, drug use, sexual practices, serology of blood-borne and sexually transmitted diseases) with their respective values; examine the indicators, dimensions and procedures used to measure the variables; and establish their compatibility with a thematic and comparative analysis of data collection tools. The main result was a new data matrix with 3,534 cases. Multidisciplinary collaboration between teams and institutions from the three countries made it possible to maximize the available sources in order to analyze characteristics of the local contexts and of the overall regional.

Este artículo desarrolla los fundamentos metodológicos del diseño de análisis integrado a partir de su empleo para el estudio de situaciones de vulnerabilidad entre usuarios de drogas a nivel regional. Se integraron datos de trece estudios transversales realizados en Argentina, Brasil y Uruguay entre 1998 y 2004. Una revisión crítica del concepto de matriz de datos, que distingue cuatro componentes estructurales, permitió: definir las unidades de análisis abarcando las distintas poblaciones originales; identificar un núcleo común de variables (características sociodemográficas, uso de drogas, prácticas sexuales, serologías de infecciones de transmisión sexual y sanguínea) con sus respectivos valores; examinar los indicadores, las dimensiones y procedimientos empleados para la medición de las variables; y establecer su compatibilidad mediante un análisis comparativo y temático de los instrumentos. Se obtuvo una nueva matriz de 3.534 casos. La colaboración multidisciplinaria entre equipos e instituciones de los tres países hizo posible maximizar las fuentes disponibles para el análisis de características locales y de la región en su conjunto.

This paper develops the methodological principles of pooled analysis design, using it to study situations of vulnerability among drug users at a regional level. Data from thirteen cross-sectional studies carried out in Argentina, Brazil and Uruguay between 1998 and 2004 were integrated. A critical review of the concept of data matrix which identifies four structural components, allowed us to: define the units of analysis spanning the different original populations; identify a core of common variables (social and demographic characteristics, drug use, sexual practices, serology of blood-borne and sexually transmitted diseases) with their respective values; examine the indicators, dimensions and procedures used to measure the variables; and establish their compatibility with a thematic and comparative analysis of data collection tools. The main result was a new data matrix with 3,534 cases. Multidisciplinary collaboration between teams and institutions from the three countries made it possible to maximize the available sources in order to analyze characteristics of the local contexts and of the overall regional.

Este artículo desarrolla los fundamentos metodológicos del diseño de análisis integrado a partir de su empleo para el estudio de situaciones de vulnerabilidad entre usuarios de drogas a nivel regional. Se integraron datos de trece estudios transversales realizados en Argentina, Brasil y Uruguay entre 1998 y 2004. Una revisión crítica del concepto de matriz de datos, que distingue cuatro componentes estructurales, permitió: definir las unidades de análisis abarcando las distintas poblaciones originales; identificar un núcleo común de variables (características sociodemográficas, uso de drogas, prácticas sexuales, serologías de infecciones de transmisión sexual y sanguínea) con sus respectivos valores; examinar los indicadores, las dimensiones y procedimientos empleados para la medición de las variables; y establecer su compatibilidad mediante un análisis comparativo y temático de los instrumentos. Se obtuvo una nueva matriz de 3.534 casos. La colaboración multidisciplinaria entre equipos e instituciones de los tres países hizo posible maximizar las fuentes disponibles para el análisis de características locales y de la región en su conjunto.

Tissue fibrosis is a leading cause of morbidity and mortality. Current treatments for conditions such as hepatic fibrosis have been unsuccessful. The growth hormone relasing peptide 6 (GHRP6) is endowed with cardioprotective actions but its antifibrotic effect had not been anticipated. We examined the GHRP6 ability to prevent and revert liver cirrhosis after induction in Wistar rats by a subcutaneous administration of CCl4. GHRP6 effects were examined after concomitant and delayed administration to toxic respectively. The percentages of hepatic fat, fibrosis, nodularity and septae thickness were histologically and morphometrically determined. Ascitis and portal dilation were judged by ultrasound and serum biochemical profile and oxidative stress parameters determined. Mechanistic involvement of selective gene/proteins was assessed by RT-PCR and immunohistochemistry. Microarrays showed gene expression profiles of GHRP6-treated liver samples on CapitalBio Rat Genome Oligo Array. GHRP6 concomitant intervention prevented in more than 85% parenchymal fibrotic induration (p < 0.0001) and therapeutic administration for only 15 days allowed for 37% fibrotic clearance (p = 0.0004) with more than 30% reduction of septae thickness (p = 0.0011). The 60 days GHRP6 administration scheme produced a 75% reduction of the fibrotic area with more than 60% reduction of nodularity. GHRP6 reduced oxidative damage enhancing the activity of antioxidant enzymes. Vimentin and alpha smooth muscle actin immunodetection profile indicated GHRP6 reduced the number of activated stellate cells. GHRP6 administration reduced fibrogenic factors as TGF-ß and CTGF on Kupffer cells. Differentially expressed genes in the microarray experiment indicated GHRP6 modulate the redox balance and parenchymal cells response to injury. These evidences suggest GHRP6 may control the liver's fibroplastic response.

La fibrosis es causa fundamental de morbilidad y mortalidad. Los tratamientos actuales han fracasado. El péptido liberador de la hormona de crecimiento-6 (GHRP6) ejerce efectos cardioprotectores, pero no se ha descrito su acción antifibrótica. Se examinó la propiedad del GHRP6 para prevenir y revertir la cirrosis hepática, luego de su inducción en ratas mediante la administración de CCl4. Se evaluó el porcentaje de grasa hepática, fibrosis, nodularidad y grosor septal mediante estudios histomorfométricos y la ascitis o dilatación portal por ultrasonido. Se determinó el perfil bioquímico y los parámetros de estrés oxidativo en suero, así como la participación de genes y proteínas, mediante reacción en cadena de la polimerasa con transcripción inversa e inmunohistoquímica. Se utilizó un microarreglo de oligonucleótidos del genoma de rata para estudiar el perfil de expresión de los genes inducidos por el GHRP6. La intervención concomitante con GHRP6 previno la induración fibrótica en más del 85% (p < 0.0001). La administración terapéutica durante 15 días permitió la remoción fibrótica del 37% (p = 0.0004), la reducción del grosor septal superó el 30% (p = 0.0011). La administración durante 60 días redujo las áreas fibróticas en 75%, y la reducción de la nodularidad fue de más del 60%. El GHRP6 redujo el daño oxidativo porque aumentó la actividad de las enzimas antioxidantes y las células estrelladas activadas positivas a vimentina y actina alfa de músculo liso. También redujo la expresión de factores fibrogénicos sobre las células Kupffer. El perfil de expresión de genes indicó que el GHRP6 modula el balance redox y la respuesta al daño tisular en las células parenquimales. Estas evidencias sugieren que el GHRP6 pudiera controlar la respuesta fibroplásica del hígado.

By the end of 2010, Latin America and the Caribbean (LAC) achieved 63% antiretroviral treatment (ART) coverage. Measures to control HIV drug resistance (HIVDR) at the country level are recommended to maximize the efficacy and sustainability of ART programs. Since 2006, the Pan American Health Organization has supported implementation of the World Health Organization (WHO) strategy for HIVDR prevention and assessment through regional capacity-building activities and direct technical cooperation in 30 LAC countries. By 2010, 85 sites in 19 countries reported early warning indicators, providing information about the extent of potential drivers of drug resistance at the ART site. In 2009, 41.9% of sites did not achieve the WHO target of 100% appropriate first-line prescriptions; 6.3% still experienced high rates (> 20%) of loss to follow-up, and 16.2% had low retention of patients (< 70%) on first-line prescriptions in the first year of treatment. Stock-outs of antiretroviral drugs occurred at 22.7% of sites. Haiti, Guyana, and the Mesoamerican region are planning and implementing WHO HIVDR monitoring surveys or threshold surveys. New HIVDR surveillance tools for concentrated epidemics would promote further scale-up. Extending the WHO HIVDR lab network in Latin America is key to strengthening regional lab capacity to support quality assured HIVDR surveillance. The WHO HIVDR control strategy is feasible and can be rolled out in LAC. Integrating HIVDR activities in national HIV care and treatment plans is key to ensuring the sustainability of this strategy.

Hacia fines del 2010, América Latina y el Caribe lograron una cobertura de tratamiento antirretroviral de 63%. Se recomienda la ejecución de medidas para controlar la farmacorresistencia del VIH a nivel de país para potenciar al máximo la eficacia y la sostenibilidad de los programas de tratamiento antirretroviral. Desde el 2006, la Organización Panamericana de la Salud ha apoyado la aplicación de la estrategia de la Organización Mundial de la Salud (OMS) para la prevención y la evaluación de la farmacorresistencia del VIH mediante actividades regionales de formación de capacidad y de cooperación técnica directa en 30 países de América Latina y el Caribe. En 2010, 85 centros en 19 países notificaron indicadores de alerta temprana y suministraron información acerca del alcance de los posibles impulsores de la farmacorresistencia en los centros de tratamiento antirretroviral. En el 2009, 41,9% de los centros no lograron la meta de la OMS de 100% de prescripción de medicamentos de primera línea apropiados; 6,3% todavía tenían tasas elevadas (> 20%) de pérdida de seguimiento y 16,2% tenían una baja retención de pacientes (< 70%) en tratamiento con antirretrovirales de primera línea en el primer año de tratamiento. Se registraron desabastecimientos de medicamentos antirretrovirales en 22,7% de los centros. Haiti, Guyana y la zona mesoamericana están planificando y ejecutando estudios de vigilancia de la farmacorre-sistencia del VIH o estudios del umbral de la OMS. Las nuevas herramientas para la vigilancia de la farmacorresistencia del VIH en las epidemias concentradas permitirán una mejor vigilancia. La ampliación de la red de laboratorios de farmacorresistencia del VIH acreditados por la OMS en América Latina es fundamental para el fortalecimiento de la capacidad de los laboratorios regionales, a fin de de efectuar una vigilancia de la farmacorresistencia del VIH de calidad garantizada. La estrategia para el control de la farmacorresistencia del VIH de la OMS es factible y puede implantarse en América Latina y el Caribe. La integración de las actividades de vigilancia de la farmacorresistencia del VIH con los planes nacionales de atención y tratamiento del VIH es fundamental para garantizar la sostenibilidad de esta estrategia.

Seis extractos crudos de plantas de la amazonia Boliviana se sometieron a pruebas de afinidad de ADN, para identificar potencial actividad anti tumoral y anti malaria, el ensayo utiliza un método en HPLC, el cual se basa en la habilidad de los agentes anti tumorales para reducir el tamaño del pico de ADN. Tres extractos mostraron reducción positiva del pico, dos fueron negativos e inconclusos, Otras observaciones indicaron que la presencia del ADN en la mezcla también reduce o elimina los picos de las sustancias del extracto en el cromatograma, posiblemente indicando afinidad especifica

Six crude extracts of plants from the Bolivian Amazonas rainforest were subject of DNA affinity screening, to identify potential antitumor and antimalarial activity, the assay uses a HPLC method, based on the ability of antitumor agents to reduce DNA peak size. Three extracts showed positive peak reduction, two were negative and resulted inconclusive, further observations indicate that the presence of the DNA in the mixture also reduces or eliminates substances peaks in the Chromatogram, possibly indicating specific affinity

The creation of this park is presented as a landscape operation in Buenos Aires, in a recently rehabilitated zone. Its scale and location transform the park that links and ties the city with the river, generating massive meeting spaces and massive retaining zones.

Se plantea la creación de este parque como una operación paisajística sobre Buenos Aires, en una zona de reciente rehabilitación. Por su escala y localización se transforma en el parque que vincula y amarra la ciudad con el río, generando espacios de encuentro masivo y zonas de contención.