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La infografía es un elemento clave a la hora de sistematizar datos sobre temas de interés social que son representados visualmente, cuyas estructuras narrativas sufren cambios profundos para adaptarse al nuevo escenario digital. La investigación determinó los factores claves de las narrativas, donde se aplicó la técnica de la observación y se analizaron las infografías usadas y los elementos constitutivos. Se evidencia como resultado la presencia de la interactividad, la multimedialidad y la hipertextualidad entre los elementos básicos para la composición armónica de la información. Se concluye que existe una necesidad de un dominio de las herramientas tecnológicas y la utilización de múltiples aplicaciones digitales para mejorar la narrativa de los diseños y cumplir con el objetivo comunicacional de las infografías.

Se presenta el caso de un paciente masculino de 2 meses de edad, admitido a la emergencia de pediatría, con historia de vómitos de contenido biliar, distensión abdominal y fiebre de 3 días de evolución. Al examen físico, presentó abdomen con irritación peritoneal. Fue llevado a sala de operaciones documentando divertículo de Meckel perforado a 2.6 mt de ángulo de Treitz con brida mesodiverticular que provoca obstrucción a este nivel, por lo que se realizó laparotomía exploradora más resección de divertículo y anastomosis de intestino delgado. Paciente egresa en condiciones satisfactorias.

Introduction: In Rwanda, only 20% of sexually active unmarried youth use contraception as compared to 64% of married women. Adolescence is an important time of growth and development that often includes the initiation of sexual activity. Sexually active adolescents need support in accessing contraceptive services to prevent negative health outcomes. In sub-Saharan Africa, the adolescent population represents a large share of the total population and that proportion is predicted to expand over time. Adolescent contraceptive needs have largely been unmet, and with growing numbers, there is increased potential for more negative health sequelae. Due to the low use of contraception by adolescents in Rwanda, and the growing population of adolescents, this study aims to explore the perspectives of family planning providers and adult contraceptive users on adolescent contraceptive use. Inclusion of adult community members in the study is a unique contribution, as research on adolescent contraceptive use in sub-Saharan Africa relies primarily on perspectives from adolescent and family planning providers.Methods: This qualitative study in 2018 utilized 32 in-depth interviews with experienced users of modern contraceptive methods and eight focus group discussions with family planning providers. Respondents were from Musanze and Nyamasheke Districts, the districts with the highest and lowest modern contraceptive use, respectively. Thematic content analysis was conducted in Atlas.ti. Results: Stigma regarding premarital sex results in barriers to adolescent access to contraceptive services. Family planning providers do provide services to adolescents; however, they often recommend secondary abstinence, offer a limited method selection, and accentuate risks associated with sexual activity and contraceptive use. Providers do support adolescent clients by emphasizing the need for privacy, confidentiality, and expedient services, particularly through youth corners, which are spaces within health facilities designed to meet youth needs specifically. Contraceptive using adult female community members advocate for youth access to contraception, however mothers are mixed in their comfort with discussing sexual health with their own youth. Conclusion: To destigmatize premarital sexual activity, government efforts to initiate communication about this topic must occur at national and community levels with the goal of continued conversation within the family. The government should also train family planning providers and all health personnel interacting with youth on adolescent-friendly health services. Dialogue between community members and family planning providers about adolescent access to contraceptive services could also reduce barriers for adolescents due to community members' generally supportive views on adolescent contraceptive use. Efforts to engage adolescent caregivers in how to talk with youth about sex could also contribute to expanded use.

Background and Aims It is commonly accepted that the leaf of a crassulacean acid metabolism (CAM) plant is thick, with large mesophyll cells and vacuoles that can accommodate the malic acid produced during the night. The link between mesophyll characteristics and CAM mode, whether obligate or C3/CAM, was evaluated. Methods Published values of the carbon isotopic ratio (δ 13C) as an indicator of CAM, leaf thickness, leaf micrographs and other evidence of CAM operation were used to correlate cell density, cell area, the proportion of intercellular space in the mesophyll (IAS) and the length of cell wall facing the intercellular air spaces (Lmes/A) with CAM mode. Key Results Based on 81 species and relatively unrelated families (15) belonging to nine orders, neither leaf thickness nor mesophyll traits helped explain the degree of CAM expression. A strong correlation was found between leaf thickness and δ 13C in some species of Crassulaceae and between leaf thickness and nocturnal acid accumulation in a few obligate CAM species of Bromeliaceae but, when all 81 species were pooled together, no significant changes with δ 13C were observed in cell density, cell area, IAS or Lmes/A. Conclusions An influence of phylogeny on leaf anatomy was evidenced in a few cases but this precluded generalization for widely separate taxa containing CAM species. The possible relationships between leaf anatomy and CAM mode should be interpreted cautiously.

Background Growing evidence underscores the utility of ketamine as an effective and rapid-acting treatment option for major depressive disorder (MDD). However, clinical outcomes vary between patients. Predicting successful response may enable personalized treatment decisions and increase clinical efficacy. Methods We here explored the potential of pregenual anterior cingulate cortex (pgACC) activity to predict antidepressant effects of ketamine in relation to ketamine-induced changes in glutamatergic metabolism. Prior to a single i.v. infusion of ketamine, 24 patients with MDD underwent functional magnetic resonance imaging during an emotional picture-viewing task and magnetic resonance spectroscopy. Changes in depressive symptoms were evaluated using the Beck Depression Inventory measured 24 hours pre- and post-intervention. A subsample of 17 patients underwent a follow-up magnetic resonance spectroscopy scan. Results Antidepressant efficacy of ketamine was predicted by pgACC activity during emotional stimulation. In addition, pgACC activity was associated with glutamate increase 24 hours after the ketamine infusion, which was in turn related to better clinical outcome. Conclusions Our results add to the growing literature implicating a key role of the pgACC in mediating antidepressant effects and highlighting its potential as a multimodal neuroimaging biomarker of early treatment response to ketamine.

Background In Rwanda, nearly a third of contraceptive users discontinue within the first year of use. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users and minimizing discontinuation is imperative for long-term family planning program success. This study explores the efforts providers and contraceptive users in Rwanda employ to prevent one of the greatest challenges to family planning programs: contraceptive discontinuation. Methods This was a qualitative study conducted in Rwanda between February and July 2018. It included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with experienced modern contraceptive users. Data were collected in two districts with the highest (Musanze) and lowest (Nyamasheke) rates of contraceptive use. Data were analyzed using thematic content approach. Results Family planning providers in this study used the following strategies to prevent discontinuation: counseling new users on the potential for side effects and switching, reminding clients about appointments for resupply, as well as supporting dissatisfied users by providing counseling, medicine for side effects, and discussing options for switching methods. Users, on the other hand, employed the following strategies to prevent discontinuation: having an understanding that experiences of side effects vary by individuals, supporting peers to sustain use, persisting with use despite experiences of side effects, and switching methods. Conclusions The strategies used by family planning providers and users in Rwanda to prevent discontinuation suggest the possibility of long-term sustained use of contraception in the country. Harnessing and supporting such strategies could contribute to sustaining or improving further contraceptive use in the country.

This work focuses on the search and development of drugs that may become new alternatives to the commercial drugs currently available for treatment of leishmaniasis. We have designed and synthesized 12 derivatives of bis(spiropyrazolone)cyclopropanes. We then characterized their potential application in therapeutic use. For this, the in vitro biological activities against three eukaryotic models—S. cerevisiae, five cancer cell lines, and the parasite L. mexicana—were evaluated. In addition, cytotoxicity against non-cancerous mammalian cells has been evaluated and other properties of interest have been characterized, such as genotoxicity, antioxidant properties and, in silico predictive adsorption, distribution, metabolism, and excretion (ADME). The results that we present here represent a first screening, indicating two derivatives of bis(spiropyrazolone)cyclopropanes as good candidates for the treatment of leishmaniasis. They have good specificity against parasites with respect to mammalian cells.

Between 2005 and 2020, total contraceptive use among married women in Rwanda increased from 17% to 64%. The aim of this study is to better understand how the Rwandan government’s mobilization and demand generation efforts have impacted community norms and interpersonal discourse surrounding family planning. Eight focus group discussions with family planning providers and 32 in-depth interviews with experienced modern contraceptive users were conducted in 2018 in the two Rwandan districts with the highest and the lowest contraceptive prevalence rates. Results suggest that outspoken government support, mass media, and community meetings were valuable sources of information about family planning. Information received through these channels generated interpersonal dialogue about contraceptives through both conversation and observation; however, rumors and misinformation remained a significant barrier to use. A once taboo subject is now normative among married couples. Continuing to address common fears and misinformation through communication channels such as mass media and community meetings may help to further increase contraceptive uptake in Rwanda.

Supporting Information. Synthesis and evaluation of biological activities of bis(spiropyrazolone)cyclopropanes: a potential application against leishmaniasis

Background Supportive male involvement is strongly correlated with contraceptive use. In Rwanda, where the contraceptive prevalence rate among married women increased from 17 to 52% from 2005 to 2010, and stagnated at 53% in 2015, understanding the role of male partners in collaborative couple contraceptive use can help inform programs designed to further increase the use of contraception in Rwanda. Methods This study utilized qualitative methods in 2018, specifically 32 in-depth interviewers with mostly current users of modern contraceptive methods and eight focus group discussions with family planning providers—both family planning nurses and community health workers (CHWs). Respondents were from Musanze and Nyamasheke Districts, the districts with the highest and lowest modern contraceptive use, respectively, to explore the role of couple collaboration in family planning use in Rwanda. Data were analyzed using the thematic content approach in Atlas.ti (8). Results Findings demonstrate that some men are opposed to use of male methods of contraception, and some are opposed to any contraceptive use, which can lead to covert use. Women and providers prefer collaborative couple contraceptive use—as a result, providers advocate for and encourage male partner participation in contraceptive use. Women are most often burdened with seeking out information, initiating discussions, and sharing information discovered about contraceptive use with partners. Decision-making about contraceptive use, once discussed, can be collaborative and motivated by financial considerations. When couple contraceptive use is collaborative, benefits range from marital harmony to husband’s support of sustained use through reminders about appointments, joint counseling, and support in managing side effects. Conclusion Family planning providers at the community and clinic levels encourage collaborative contraceptive use among couples and some Rwandan couples communicate well about family planning use. Despite the positives, women are expected to source family planning information, share that information with their male partners, seek out family planning services, and use family planning. If more Rwandan male partners accepted use, used male methods of contraception, and participated even more in the work it takes to use family planning, the potential for sustained, and even enhanced, contraceptive use in Rwanda could be realized.

Additional file 1. Clinical characteristics between survivors and non-survivors SARS-CoV-2 pneumonia patients.

Use of modern contraception in Rwanda has risen dramatically over a short time period. To better understand contraceptive users’ motivations for family planning services in Rwanda, 32 in-depth interviews with contraceptive users and eight focus groups with 88 family planning providers were conducted in Rwanda’s Musanze and Nyamasheke districts. Study participants noted how family planning is critical for providing a better life for children. Family planning gives mothers independence from childcare to work in order to provide for their children’s wellbeing. Family planning presented an opportunity for generational upward mobility and was perceived as a way to contribute positively to society.

Background Rwanda has markedly increased the nation’s contraceptive use in a short period of time, tripling contraceptive prevalence in just 5 years between 2005 and 2010. An integral aspect of family planning programs is the interactions between family planning providers and clients. This study aims to understand the client-provider relationship in the Rwandan family planning program and to also examine barriers to those relationships. Methods This qualitative study in Rwanda utilized convenience sampling to include eight focus group discussions with family planning providers, both family planning nurses and community health workers, as well as in-depth interviews with 32 experienced modern contraceptive users. Study participants were drawn from the two districts in Rwanda with the highest and lowest modern contraceptive rates, Musanze and Nyamasheke, respectively Data analysis was guided by the thematic content approach, Atlas.ti 8 was utilized for coding the transcripts and collating the coding results, and Microsoft Excel for analyzing the data within code. Results Data analysis revealed that, despite workplace related challenges – including inadequate staffing, training, and resources, relationships between providers and clients are strong. Family planning providers work hard to understand, learn from, and support clients in their initiation and sustained use of contraceptives. Conclusion Given the existing context of purposeful efforts on the part of family planning providers to build relationships with their clients, if the current level of government support for family planning service provision is enhanced, Rwanda will likely sustain many current users of contraception and engage even more Rwandans in contraceptive services in the future.

Introducción: La sepsis es una entidad clínica frecuente que causan una alta morbimortalidad en la población adulta que acude a los servicios de urgencia, la respuesta inflamatoria desregulada que la caracteriza puede ser modulada por lo niveles de lipoproteína de alta densidad, por lo cual el objetivo de este estudio fue determinar la asociación entre los niveles de lipoproteína de alta densidad y las complicaciones en pacientes con diagnóstico de sepsis. Materiales y Métodos: Se realizó un estudio observacional, prospectivo con un diseño no experimental, cuya población estuvo conformada por 60 sujetos de ambos géneros con diagnóstico de sepsis. Los datos se recogieron mediante un formulario que incluyo: datos de identificación, datos clínicos como: presión arterial, frecuencia cardíaca, frecuencia respiratoria, puntaje en escala de Glasgow y datos de laboratorio, leucocitos, nivel de HDL-C, creatinina, bilirrubina total, plaquetas, diuresis, PaO2/FiO2, y tiempos de coagulación. Resultados: Del total de la muestra, el 58,3% (n=35) presentó complicaciones como shock séptico o fallo multiorgánico, con un mayor porcentaje en aquellos con HDL-C más bajas (HDL-C

Background Contraceptive use in Rwanda tripled since 2005. This study aims to understand the role of coordinated and integrated family planning service delivery in achieving this increase in contraceptive use in Rwanda. Methods This qualitative study in 2018 included eight focus group discussions with family planning providers and 32 in-depth interviews with experienced family planning users. Results Results indicate a well-coordinated family planning service delivery system with community health workers and nurses filling different and complementary roles in meeting family planning client needs at the local level. In addition, integration of family planning into other maternal and child health services is the norm. Conclusions The coordination and integration of family planning across both providers and services may help explain the rapid increase in Rwanda’s contraceptive use and has potential applications for enhancing family planning service delivery in other settings.

BackgroundHigh fertility rates pose health risks to both mothers and children and impede economic growth; therefore, family planning use is vital to achieving sustainable population growth and to help build thriving communities. Contraceptive use in Rwanda has tripled since 2005. This study aims to understand the role of coordinated and integrated family planning service delivery in achieving this unparalleled success in Rwanda. MethodsThis qualitative study in 2018 included eight focus group discussions with family planning providers and 32 in-depth interviews with experienced family planning users.ResultsResults indicate a well-coordinated family planning service delivery system with community health workers and nurses filling different and complementary roles in meeting family planning client needs at the local level. In addition, integration of family planning into other maternal and child health services is the norm. ConclusionsThe coordination and integration of family planning across both providers and services may help explain the extraordinary increase in Rwanda’s contraceptive usage, and has potential applications for enhancing family planning service delivery in other settings as well.

Ecosystem monitoring is central to effective management, where rapid reporting is essential to provide timely advice. While digital imagery has greatly improved the speed of underwater data collection for monitoring benthic communities, image analysis remains a bottleneck in reporting observations. In recent years, a rapid evolution of artificial intelligence in image recognition has been evident in its broad applications in modern society, offering new opportunities for increasing the capabilities of coral reef monitoring. Here, we evaluated the performance of Deep Learning Convolutional Neural Networks for automated image analysis, using a global coral reef monitoring dataset. The study demonstrates the advantages of automated image analysis for coral reef monitoring in terms of error and repeatability of benthic abundance estimations, as well as cost and benefit. We found unbiased and high agreement between expert and automated observations (97%). Repeated surveys and comparisons against existing monitoring programs also show that automated estimation of benthic composition is equally robust in detecting change and ensuring the continuity of existing monitoring data. Using this automated approach, data analysis and reporting can be accelerated by at least 200x and at a fraction of the cost (1%). Combining commonly used underwater imagery in monitoring with automated image annotation can dramatically improve how we measure and monitor coral reefs worldwide, particularly in terms of allocating limited resources, rapid reporting and data integration within and across management areas.

Introducción: El trastorno antisocial de la personalidad está vinculado a la clasificación de trastornos de la personalidad en la salud mental. Este diagnóstico se les otorga a personas que presenten rasgos de personalidad específicos e inflexibles que afectan su funcionalidad y en los que no se encuentra otra causa médica aparente. Existen diversos tratamientos posibles para estos pacientes y cuyo manejo debe ser individualizado según su edad y progresión de los rasgos de personalidad. Este trastorno genera un impacto adicional a la comunidad debido a su relación con conductas delictivas e inapropiadas de los pacientes con este diagnóstico, convirtiéndolo en un asunto de interés para la convivencia social. Objetivo: Reflexionar acerca del rol de la sociedad en la prevención, inclusión y manejo de pacientes con trastorno antisocial de la personalidad. Discusión: Conociendo las variables involucradas en el desarrollo de trastornos de personalidad como el antisocial, además del impacto social que genera la expresión de dichos síntomas en la comunidad, se hace necesario una intervención multidisciplinaria desde la sociedad y sectores públicos como salud y justicia a la hora de abordar estos pacientes, pues medidas como mejorar el ambiente que los rodea y el reconocimiento a temprana edad mejora los resultados en el tratamiento y podría disminuir la expresión de la misma, así como las consecuencias sociales producto de casos graves. Conclusiones: El trastorno antisocial de la personalidad es un diagnóstico psiquiátrico que involucra necesariamente al paciente y la comunidad. La concientización de esta patología en la sociedad podría dar herramientas para mejorar la prevención, diagnóstico y atención integral con resultados a nivel individual y social. [Herrera-Gómez AL. Una reflexión sobre la labor social en pacientes con trastorno antisocial de la personalidad. MedUNAB 2017-2018; 20(3): 368-373]. Introduction: The antisocial personality disorder is linked to the classification of personality disorders in mental health. This diagnosis is given to people who have specific and inflexible personality traits that affect their functionality and in which no other apparent medical cause is found. There are several possible treatments for these patients and their management must be individualized according to their age and the progression of their personality traits. This disorder generates an additional impact on the community due to its relationship with criminal and inappropriate behavior of patients with this diagnosis, making it a matter of interest for social coexistence. Objective: To reflect on the role of society in the prevention, inclusion and management of patients with antisocial personality disorder. Discussion: By knowing the variables involved in the development of personality disorders such as antisocial, besides the social impact generated by the expression of these symptoms in the community, it is necessary a multidisciplinary intervention from society and public sectors such as health and justice when dealing with these patients. Furthermore, if some measures are adopted such as improving the environment that surrounds patients and the recognition at an early age of this disorder, these measures could improve the results in the treatment and reduce the expression of itself, as well as the social consequences of serious cases of this disorder. Conclusions: The antisocial personality disorder is a psychiatric diagnosis that involves the patient and community. The awareness of this pathology in society could provide tools to improve prevention, diagnosis and comprehensive care with individual and social results. [Herrera-Gómez AL. A Reflection on Social Work in Patients with Antisocial Personality Disorder. MedUNAB 2017-2018; 20(3): 368-373].

BACKGROUND AND AIMS: Crassulacean acid metabolism (CAM) can be induced by salinity, thus conferring the plant higher water-use efficiency. Talinum triangulare does not frequently encounter salt in its natural habitat but is cultivated in soils that may become salinized. Here we examined whether plants of T. triangulare can grow in saline soils and show salt-induced CAM. METHODS: Leaf gas exchange, carbon isotopic ratio (δ(13)C), nocturnal acid accumulation (ΔH(+)), water relations, photosynthetic pigment and mineral contents, leaf anatomy and growth were determined in greenhouse in plants irrigated with 0, 150, 300 and 400 mm NaCl. KEY RESULTS: Salinity reduced gas exchange and induced CAM, ΔH(+) reaching 50.2 μmol H(+) g(−1) fresh mass under 300 mm NaCl. No nocturnal CO(2) uptake, but compensation, was observed. Values of δ(13)C were lowest under 0 and 400 mm NaCl, and highest under 150 and 300 mm. The difference in osmotic potential (ψ(s)) between control and treated plants averaged 0.45 MPa for the three [NaCl] values, the decrease in ψ(s) being accounted for by up to 63 % by Na(+) and K(+). Pigment contents were unaffected by treatment, suggesting lack of damage to the photosynthetic machinery. Changes in stomatal index with unchanged stomatal density in newly expanded leaves suggested inhibited differentiation of epidermal cells into stomata. Whole-leaf and parenchymata thickness increased under 150 and 300 mm NaCl. Only plants irrigated with 400 mm NaCl showed reductions in biomass (stems, 41 %; reproductive structures, 78 %). The K/Na molar ratio decreased with [NaCl] from 2.0 to 0.4. CONCLUSIONS: The operation of CAM in the recycling mode was evidenced by increased ΔH(+) with no nocturnal CO(2) uptake. Talinum triangulare can be classified as a halo-tolerant species based on its low K/Na molar ratio under salinity and the relatively small reduction in growth only at the highest [NaCl].

Se presenta el caso de una paciente de 18 años de edad, que es evaluada en la unidad de Hospital de Día, con historia de 8 meses de dificultad para deglutir alimentos sólidos, tolerando únicamente la ingestión de alimentos líquidos, asociado a regurgitaciones nocturnas por lo que consulta a médico particular quien realiza exámenes complementarios y la refiere a esta unidad para tratamiento. Al examen físico no presenta alteraciones, persistiendo con disfagia por lo que se programa para realizar esofagomiotomia de Heller videolaparoscópica.

Background High fertility rates pose health risks to both mothers and children and impede economic growth; therefore, family planning use is vital to achieving sustainable population growth and to help build thriving communities. Contraceptive use in Rwanda has tripled since 2005. This study aims to understand the role of coordinated and integrated family planning service delivery in achieving this unparalleled success in Rwanda. Methods This qualitative study in 2018 included eight focus group discussions with family planning providers and 32 in-depth interviews with experienced family planning users. Results Results indicate a well-coordinated family planning service delivery system with community health workers and nurses filling different and complementary roles in meeting family planning client needs at the local level. In addition, integration of family planning into other maternal and child health services is the norm. Conclusions The coordination and integration of family planning across both providers and services may help explain the extraordinary increase in Rwanda’s contraceptive usage, and has potential applications for enhancing family planning service delivery in other settings as well.

Background Contraceptive discontinuation is a common event. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users is imperative for long-term family planning program success. Methods This qualitative study in Rwanda in 2018 included eight focus group discussions with family planning providers and 32 in-depth interviews with contraceptive users. The data were collected in the two districts with the highest and lowest rates of contraceptive use, Musanze and Nyamasheke, respectively. The aim of this study is to better understand contraceptive use dynamics in Rwanda. Results Family planning providers and current users in Rwanda do not consider method discontinuation an option. Providers give support and medicine for side effects for continuers and counseling for those opting to switch. Current users are willing to try many methods until they find the right one for them – and once they find the right method, they plan to, or use the method, for long durations. Conclusions The Rwandan family planning program is primed to meet the needs of users in their sustained use of contraceptives through empathetic and responsive counseling. Concurrently, family planning users are determined to use family planning to meet their desired family size goals. The matching goals of both providers and clients indicates that contraceptive use will likely continue to increase in the future in Rwanda; however, due to long periods of pregnancy prevention desired – increased use of long acting methods should be encouraged.

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz A Diabetes mellitus é uma doença crónica que compreende um grupo de distúrbios metabólicos, que afetam diferentes órgãos e tecidos. É caracterizada por um aumento nos níveis de glicose no sangue, conhecido como hiperglicemia. Pacientes com um deficiente controle da hiperglicemia apresentam níveis mais severos de Diabetes Mellitus, assim como uma maior destruição dos tecidos, além de resultados insatisfatórios perante o tratamento periodontal convencional. A diabetes mellitus pode ser classificada em diabetes mellitus tipo 1 e diabetes mellitus tipo 2 em função da necessidade ou não de insulina. O tratamento vai dirigido a um controle metabólico apertado e em casos de necessidade, inclui administrações diárias de insulina no caso de diabetes tipo 1. As infeções periodontais são um conjunto de doenças localizadas na gengiva e nas estruturas de suporte do dente, são produzidas por certas bactérias presentes na placa bacteriana as quais são essenciais para o aparecimento da doença mas não são suficientes para que a doença exista, sendo necessária a presença de um hospedeiro suscetível. Neste contexto, pacientes com diabetes mellitus possuem uma elevada probabilidade de adquirir esta doença devido aos distúrbios metabólicos que apresentam. A relação entre diabetes e doença periodontal é considerada bidirecional, posto que uma piora a situação da outra. A prevenção, assim como o diagnóstico precoce e o tratamento adequado da doença periodontal podem influenciar notavelmente o controle da diabetes. Os Médicos Dentistas são os encarregados por um lado, de fornecer aos pacientes um diagnóstico e um tratamento adequado para evitar o avanço da doença periodontal e por outro lado, estão familiarizados com os protocolos necessários em situações de emergência, afinal estamos a lidar com uma doença que se estima vir a afetar 552 milhões de indivíduos em 2030. Diabetes Mellitus is a chronic disease comprising a group of metabolic disorders, affecting different organs and tissues. It is characterized by an increase of glucose levels in blood, known as hyperglycemia. Patients with deficient control of hyperglycemia have more severe levels of Diabetes Mellitus, as well as greater tissue destruction and unsatisfactory results with conventional periodontal treatment. Diabetes Mellitus may be classied as diabetes mellitus type 1 and diabetes mellitus type 2 depending on the necessity of insulin to ensure the person´s survival. The treatment is directed for tight metabolic control and, for a daily insulin’administration in the case of type 1 diabetes are required. Peridontal infections are a combination of diseases located in the gum and the tooth´s support struture, are produced by a certain bacteria present in the bacterial plaque which alone wouldn`t result in the appearance of the disease as the presence of a susceptible host is also required. In this context, patients with diabetes mellitus have a high probability of acquiring this disease due to the metabolic disorders they have. The relationship between diabetes and periodontal disease is considered bidirectional, since one worsens the situation of the other. Prevention, as well as an early diagnosis and an appropriate treatment of periodontal disease, can significantly influence on diabetes control. Dentists are responsible to provide patients with a diagnosis and an appropriate treatment to avoid the progression of periodontal disease, and also have to get used to the protocols needed in emergency situations, after all we are dealing with an illness that is expected to affect 552 million in 2030.

In many plant species that remain leafless part of the year, CO2 fixation occurring in green stems represents an important carbon gain. Traditionally, a distinction has been made between stem photosynthesis and corticular photosynthesis. All stem photosynthesis is, sensu stricto, cortical, since it is carried out largely by the stem cortex. We proposed the following nomenclature: stem net photosynthesis (SNP), which includes net CO2 fixation by stems with stomata in the epidermis and net corticular CO2 fixation in suberized stems, and stem recycling photosynthesis (SRP), which defines CO2 ling in suberized stems. The proposed terms should reflect differences in anatomical and physiological traits. SNP takes place in the chlorenchyma below the epidermis with stomata, where the net CO2 uptake occurs, and it resembles leaf photosynthesis in many characteristics. SRP is found in species where the chlorenchyma is beneath a well-developed stomata-free periderm and where reassimilation of internally respired CO2 occurs. SNP is common in plants from desert ecosystems, rates reaching up to 60% of the leaf photosynthetic rate. SRP has been demonstrated in trees from temperate forests and it offsets partially a carbon loss by respiration of stem nonphotosynthetic tissues. Reassimilation can vary between 7 and 123% of respired CO2, the latter figure implying net CO2 uptake from the atmosphere. Both types of stem photosynthesis contribute positively to the carbon economy of the species, in which they occur; they are advantageous to the plant because they allow the maintenance of physiological activity during stress, an increase of integrated water use efficiency, and they provide the carbon source used in the production of new organs.

El virus del dengue es un virus ARN miembro de la familia Flaviviridae, la cual incluye, además, el de la fiebre amarilla, el del Nilo del Oeste y la encefalitis japonesa. Se realizó un estudio retrospectivo con tres pacientes diagnosticados de encefalitis asociada al dengue, en cuyas muestras de suero y líquido cefalorraquídeo se cuantificaron los niveles de las clases mayores de inmunoglobulinas por inmunodifusión radial y la manosa de unión a lectina, proteína de la vía de las lectinas del sistema del complemento por fluorometría. En el reibergrama se muestra la presencia de síntesis intratecal de las tres clases de inmunoglobulinas y ausencia de síntesis intratecal de lectina de unión a manosa. Existieron diferencias en cuanto al por ciento de síntesis intratecal de inmunoglobulinas, las cuales estuvieron relacionadas con el momento de la infección por el virus y la aparición de las manifestaciones neurológicas compatibles con una encefalitis. Este es el primer reporte de afectaciones neurológicas en pacientes cubanos con dengue. La respuesta inmune intratecal puede ser utilizada para el mejor conocimiento de la enfermedad y contribuir al desarrollo de posibles candidatos vacunales.

OBJETIVO: Analizar la forma como se aplica la política de gestión del riesgo en elámbito territorial en el sur de Atlántico (Caribe colombiano), partiendo de la ópticade actores institucionales y de miembros de las comunidades afectadas pordesastres invernales que integran organismos de protección civil. MÉTODO:Estudio cualitativo basado en la investigación acción, desarrollado en seismunicipios mediante revisión documental, entrevistas y gruposfocales. RESULTADOS: reducido nivel de apropiación de la política comoherramienta de planeación territorial y desarrollo comunitario por parte de lainstitucionalidad, baja participación de organismos municipales y escasaintegración de la comunidad. CONCLUSIONES: Se resalta la relevancia de losprocesos sociales implicados en la aplicación de la política, señalando losdesaciertos que los actores en estudio denuncian en la gestión pública. OBJECTIVE: To analyze how the risk management policy is applied in theterritorial area in the southern part of the department of Atlántico (ColombianCaribbean) starting from the perspective of institutional actors and members of thecommunities affected by winter disasters who integrate civil protectionagencies. METHOD: Qualitative study based on action research, developed in sixmunicipalities through document review, interviews and focusgroups. RESULTS: Reduced level of ownership of the policy as a tool for territorialplanning and community development by the institutions, low participation ofmunicipal agencies and poor integration of the community. CONCLUSIONS: Therelevance of the social processes involved in the implementation of the policy bypointing out the mistakes that the studied actors reported in the carrying out of thisprocess is emphasized.

Nicotiana glauca, a shrub native to southern South America, is widely distributed in the Americas, from Patagonia to the USA, from zero up to 3,700 m; it rapidly invades disturbed environments. In Venezuela, it has been reported from zero up to 2,000 m growing in contrasting conditions of relative humidity, temperature, rainfall, and salinity. In order to gain insight into the extent and mode of resistance to drought and salinity in N. glauca, we studied the effect of these factors on water relations and photosynthesis under both natural and greenhouse conditions. In the field, water potential, photosynthetic rate (A) and stomatal conductance (gs), but not relative water content (RWC) decreased because of drought. Manual removal of epicuticular wax increased excess energy dissipation through non-photochemical quenching without altering the capacity of photochemical quenching. In the greenhouse, water deficit as well as salinity resulted in osmotic adjustment; at the end of the experiment, turgor potential and RWC under water deficit were similar to control and higher under salinity. Water deficit and salinity caused marked decreases in A and gs. There were very few or no changes with natural drought, salinity or experimental water deficit in potential quantum efficiency of PSII, which could be explained partly by an increased non-photochemical quenching. We conclude that the partial tolerance to drought and salinity in plants of N. glauca resides in their ability to achieve water conservation through stomatal closure and osmotic adjustment, reduce absorption of excess radiation through the presence of leaf wax and dissipate it through increased non-photochemical quenching. All these characteristics confer plants of N. glauca advantages to invade disturbed areas, subject to salinity and/or seasonal drought under high irradiance.