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espanolLas comunidades de practica son modelos que enlazan la ensenanza clinica con el aprendizaje en el sitio de trabajo; esto facilita la construccion de la identidad profesional de los estudiantes, optimiza la atencion al paciente y genera oportunidades de aprendizaje para los miembros de la comunidad hospitalaria; fomentan el cambio de modelos educativos en los que el aprendizaje memoristico es reemplazado por experiencias de aprendizaje basadas en la construccion colectiva de saberes y en la coparticipacion de los miembros de la comunidad hospitalaria, con lo que se puede impulsar una practica profesional mas segura para los pacientes. Se presentan los fundamentos pedagogicos que permiten comprender la participacion que los estudiantes asumen dentro de una comunidad de practica clinica y se plantean reflexiones para que el quehacer docente de los profesores clinicos cambie a modelos innovadores que produzcan mayor impacto en el aprendizaje y que los transforme en verdaderos educadores en las profesiones de la salud. EnglishCommunities of practice are models that link clinical teaching to learning in the workplace; This facilitates the construction of the professional identity of the students, optimizes patient care and generates learning opportunities for members of the hospital community; They promote the change of educational models in which rote learning is replaced by learning experiences based on the collective construction of knowledge and the co-participation of members of the hospital community, thus promoting safer professional practice for patients. patients. The pedagogical foundations that allow understanding the participation that students assume within a community of clinical practice are presented and reflections are made so that the teaching tasks of clinical teachers change to innovative models that have a greater impact on learning and transform them into true educators in the health professions.

Objective To design and validate a scale to evaluate the quality of life in children and adolescents with epilepsy. Methods Scale validation, multicentered, three-phase study. We did a literature review for the construction of the instrument, and a validation of appearance, construct, criterion, and reproducibility. We evaluated the scale among the patients that consulted at the Liga Central contra la Epilepsia and the Fundacion Hospital de La Misericordia (Bogota, Colombia) between 2014 and 2015. Results The resulting questionnaire has 4 domains, with 18–26 items according to age groups (0−3, 4−10 and 11−17 years old) and a Likert scale score from 1 to 5. The comparison with CAVE and QOLIE AD 48 was adequate (Pearson correlation coefficient between 0.713 and 0.837 according to age groups: intraclass correlation coefficient between 0.664 and 0.817.) Internal consistency was adequate (Cronbach’s alpha between 0.791 and 0.809). Test-retest assessment was good, with Spearman’s coefficient between 0.99 and 1.00. The time to fill out the scale ranged between 3.5 and 6.8 min. Significance We designed and validated a quality-of-life scale in Spanish for children and adolescents with epilepsy, which is easy and quick to fill and has excellent reliability and validity parameters.

Introducción: La promoción de estilos de vida saludables por el profesional de salud depende de sus propios hábitos, los cuales se afianzan durante la formación universitaria. Sin embargo, los hábitos alimentarios, niveles de actividad física y sedentarismo pueden variar entre universitarios de distintos programas del área de la salud. Objetivo: identificar las diferencias de los niveles de actividad física y de hábitos alimentarios entre estudiantes de diferentes programas del área de la salud de una universidad privada en Bogotá. Material y métodos: estudio transversal en estudiantes de I-IV semestre de enfermería, instrumentación quirúrgica, medicina, odontología y optometría durante agosto 2017. Se midió actividad física (IPAQ-SF) y hábitos alimentarios (cuestionario de frecuencia de consumo). Se emplearon las pruebas χ2 y Kruskal-Wallis para las comparaciones entre programas. Resultados: participaron 692 estudiantes y 77,8% fueron mujeres. Instrumentación mostró el más bajo porcentaje de consumo de almuerzo (88%; p0,004); en la población se presentó bajo consumo de todos los grupos de alimentos, específicamente odontología tuvo bajo consumo de cereales (29%; p0,021) y enfermería de frutas (35%; p0,04) y carnes-huevos-leguminosas (35%; p0,01). Por otra parte, medicina presentó la mayor prevalencia de nivel alto de actividad física (41%; p0,002) y enfermería el mayor porcentaje de nivel bajo (60%; p0,01). Conclusiones: Se encontraron diferencias en los niveles de actividad física y hábitos alimentarios entre los distintos programas evaluados. Se deberían realizar intervenciones a nivel curricular y de promoción de la salud para mejorar los estilos de vida de los universitarios. Introduction: The promotion of healthy lifestyles by the health professional depends on their own habits, which are consolidated during university education. However, the variation in eating habits and physical activity among university students from different health programs is not known. Objective: Identify the differences in the levels of physical activity, sedentary lifestyle, and eating habits among students from different programs in the health area at a private university in Bogotá. Material and methods: cross-sectional study in undergraduate students of nursing, surgical instrumentation, optometry, medicine, and dentistry. Students were in the I to IV semester during August 2017. Physical activity (IPAQ-SF) and eating habits (questionnaire of frequency of consumption) were measured; The χ2 and Kruskal-Wallis tests were used for comparisons between programs. Results: 692 students participated and 77.8% were women. Surgical instrumentation showed the lowest percentage of lunch consumption (88%; p0.004); in the sample there was low consumption of all food groups, specifically dentistry had low consumption of cereals (29%; p0.021) and nursing had low consumption of fruits (35%; p0.04) and meat-eggs-legumes (35%; p0.01). On the other hand, medicine presented the highest prevalence of high level of physical activity (41%; p0.002) and nursing the highest percentage of low level (60%; p0.01). Conclusions: Differences were found in the levels of physical activity and eating habits among the different programs evaluated. Interventions at the curricular level and health promotion are necessary to improve university lifestyles.

Cadmium, one of the more hazardous environmental contaminants, has been proposed as a metabolic disruptor. Vanadium has emerged as a possible treatment for metabolic diseases. Both metals are important in public health. We aimed to investigate whether vanadium treatment is effective against metabolic disturbances caused by chronic exposure to the lowest-observable adverse effect level of cadmium. Male Wistar rats were exposed to cadmium (32.5 ppm) in drinking water for 3 months. Metabolic complications such as overweight, visceral adipose gain, hyperglycemia, impaired glucose tolerance, and dyslipidemia were detected, and low glycogen levels and steatosis were observed in the tissues. Then, the control and treated animals were subdivided and treated with a solution of 5 μM NaVO3/kg/twice a week for 2 months. The control-NaVO3 group did not show zoometric or metabolic changes. A strong interaction of NaVO3 treatment over cadmium metabolic disruption was observed. The vanadium accumulation diminished cadmium concentration in tissues. Also, vanadium interaction improved glucose homeostasis. The major effect was observed on glycogen synthesis, which was fully recovered in all tissues analyzed. Additionally, vanadium treatment prevented overweight and visceral fat accumulation, improving BMI and the percentage of fat. However, NaVO3 treatment did not have an effect on dyslipidemia or steatosis. In conclusion, this work shows that vanadium administration has a strong effect against metabolic disturbances caused by chronic cadmium exposure, observing powerful interaction on glucose homeostasis.

Metabolic syndrome (MetS) represents a cluster of related metabolic abnormalities, including central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance. These metabolic derangements present significant risk factors for chronic kidney disease that carries to loss of essential micronutrients, which accelerates comorbidity apparition. The work aimed was to evaluate the trace element homeostasis regarding morphological adaptations and renal function in MetS early-onset. Fifty male Wistar rats were divided into two groups: (a) control group and (b) hypercaloric diet group that developed MetS early-onset after 3 months. Classical zoometric parameters do not show changes; however, biochemical modifications were observed such as hyperglycemia, protein glycation, insulin resistance, dyslipidemia, hyperinsulinemia, and hypoadiponectinemia. MetS early-onset group observed renal structural modifications, but no functional changes. The structural modifications observed were minimal glomerular injury, glomerular basement membrane thickening, as well as mesangial and tubular cells that showed growth and proliferation. In serum and kidney (cortex and medulla), the concentrations of Zn, Fe, Cr, Mg, Mn, Cu, Co, and Ni were no differences between the experimental groups, but excretory fractions of these were lower in the hypercaloric diet group. In conclusion, MetS early-onset coexist renal structural modification and a hyperreabsorptive activity of essential trace elements that avoid its loss; thus, the excretory fraction of oligo-elements could be used a biomarker of early renal injury caused by metabolic diseases in the clinical practice.

It is known that continuous abuse of amphetamine (AMPH) results in alterations in neuronal structure and cognitive behaviors related to the reward system. However, the impact of AMPH abuse on the hippocampus remains unknown. The aim of this study was to determine the damage caused by AMPH in the hippocampus in an addiction model. We reproduced the AMPH sensitization model proposed by Robinson et al. in 1997 and performed the novel object recognition test (NORt) to evaluate learning and memory behaviors. After the NORt, we performed Golgi-Cox staining, a stereological cell count, immunohistochemistry to determine the presence of GFAP, CASP3, and MT-III, and evaluated oxidative stress in the hippocampus. We found that AMPH treatment generates impairment in short- and long-term memories and a decrease in neuronal density in the CA1 region of the hippocampus. The morphological test showed an increase in the total dendritic length, but a decrease in the number of mature spines in the CA1 region. GFAP labeling increased in the CA1 region and MT-III increased in the CA1 and CA3 regions. Finally, we found a decrease in Zn concentration in the hippocampus after AMPH treatment. An increase in the dopaminergic tone caused by AMPH sensitization generates oxidative stress, neuronal death, and morphological changes in the hippocampus that affect cognitive behaviors like short- and long-term memories.

Pentraxin-3 has been reported as a promising biomarker of pre-eclampsia and its severity; however, available studies have small sample sizes, and analyses are not always adjusted for confounders. The aim of this study is to establish the strength of the association between maternal Pentraxin-3 level and pre-eclampsia or HELLP syndrome. It was a case-control study. Women with pre-eclampsia or HELLP syndrome were defined as cases, and women with healthy pregnancies at term (>37 weeks) were classified as controls. Plasma concentrations of Pentraxin-3 were determined at the time of delivery by quantitative enzyme immunoassay. Associations between Pentraxin-3 and pre-eclampsia and HELLP syndrome were assessed by multinomial logistic regression. Subsidiary analysis for the time of disease onset was also carried out. Odds ratios and 95% confidence intervals are reported. A total of 1024 pregnant women were included (461 controls, 368 pre-eclampsia, 195 HELLP). A positive log-linear relationship was found between the top pentraxin-3 quintile and HELLP syndrome. After adjustment for confounders (maternal age, ethnicity, socioeconomic position, date and place of recruitment, family history of pre-eclampsia, smoking, body mass index at beginning of pregnancy, gestational age and multiple pregnancy), the strength of the association was higher for HELLP syndrome [OR 1.13 (95% CI 1.08; 1.18)] than for pre-eclampsia [OR 1.03 (95% CI 1.03; 1.10)]. No difference according to time of onset or pentraxin-3 level was found. In summary, pentraxin-3 level was associated with pre-eclampsia, but it was more strongly associated with HELLP syndrome. Longitudinal studies with a lower probability of residual confounding are necessary to improve our knowledge about the role of pentraxin-3 in pre-eclampsia.

Genital hair is one of the secondary sexual traits that marks the beginning of puberty; its removal has been part of human culture since ancient times. This practice may lead to modifications in vaginal microbiome with potential repercussions on skin health and balance. We conducted a narrative review with the purpose of describing normal skin microbiota, its impact under microenvironment changes and genital hair removal. Menses, pathological conditions and pubic hair removal may alter vaginal microbiota, being the latter of special relevance giving the risk of hair microtrauma, irritations and potential spread of infectious agents. MÉD.UIS.2019;32(3):27-33 Resumo O cabelo genital é um dos traços sexuais secundários que marcam o início da puberdade; sua remoção faz parte da cultura humana desde os tempos antigos. Essa prática pode levar a modificações no microbioma vaginal com possíveis repercussões na saúde e equilíbrio da pele. Realizamos uma revisão narrativa com o objetivo de descrever a microbiota normal da pele, seu impacto nas alterações do microambiente e na remoção de pelos genitais. A menstruação, as condições patológicas e a remoção de pelos pubianos podem alterar a microbiota vaginal, sendo esta última de especial relevância dando o risco de microtraumatismo capilar, irritações e potencial disseminação de agentes infecciosos. MÉD.UIS.2019;32(3): 27-33 Resumen El vello genital es uno de los rasgos sexuales secundarios que marca el comienzo de la pubertad; su eliminación ha sido parte de la cultura humana desde la antigüedad. Esta práctica puede conducir a modificaciones en el microbioma vaginal con posibles repercusiones potenciales en la salud y el equilibrio de la piel. Realizamos una revisión narrativa con el propósito de describir la microbiota cutánea normal, su impacto bajo los cambios del microambiente y la depilación genital. La menstruación, las condiciones patológicas y la depilación púbica pueden alterar la microbiota vaginal, siendo esta última de especial relevancia dado el riesgo de microtraumatismos, irritaciones y posible propagación de agentes infecciosos. MÉD.UIS.2019;32(3): 27-33

This study presents a correlation between prenatal ultrasonographic images and neuropathologic findings of postmortem tissue samples from five confirmed cases of perinatal Zika virus (ZIKV) infection belonging to the cohort of the ZEN Initiative in Bucaramanga, Colombia. Deaths occurred between June 2016 and March 2017. Mothers consulted with ZIKV infection clinical manifestations or fetal central nervous system (CNS) abnormalities or both. A detailed ultrasound scan and neurosonographic protocol was performed by maternal fetal specialists. Perinatal autopsies were performed following the Colombian National Health Institute's ZIKV protocol. The autopsies were from two fetal deaths, and three early neonatal deaths. Gestational age was between 262/7 and 382/7 weeks. Two cases were classified as mild microcephaly. Few findings by ultrasound and pathology were found in case 1 because it was a late infection; the other cases presented findings corresponding to congenital Zika syndrome: craniofacial malformations, cerebellar hypoplasia, anomalies of the corpus callosum and ventriculomegaly, all confirmed in autopsy specimens. By ultrasonography, hyperechogenicities were seen in several brain structures, which correspond to cortical and periventricular calcifications, subependymal glial reactivity and perivascular rings. The ultrasound and pathological findings show a wide spectrum of CNS anomalies that confirm the neurotropic effect of the ZIKV, recognizing the neuroimaging findings of this disease (unilateral ventriculomegaly, alterations in the corpus callosum and cerebellum, and calcifications) are highly suggestive of ZIKV infection.

Background. Acute Lymphoblastic Leukemia (ALL) is a hematolymphoid neoplasm with multiple complications and variable prognosis, which depends on several factors, one of them related to chemotherapeutic treatment. Objective. To describe the complications developed in patients diagnosed with ALL and who received chemotherapy treatment in Hospital San Rafael. Materials and methods. A retrospective analysis of clinical, paraclinical and demographic variables taken from clinical records of adult patients diagnosed with ALL admitted to hospital between 2016 and 2017. Results. A hundred and sixteen patients had hematological malignancies, 24 had ALL. Most of them had B-cell precursor ALL (79.2 %), 86.4 % were in the chemotherapy induction phase, 87.5 % developed febrile neutropenia, 37.5 % had tumor lysis syndrome, 58.3 % developed infectious complications, and 45.8 % died. Discussion. This is the first study known to date describing the complications in patients with ALL at Hospital San Rafael in Colombia. One of the major findings was the high frequency of febrile neutropenia episodes and infectious complications mainly associated with unfavorable outcomes, such as multiple organ failure and death. Therefore, clinicians should always have these complications in mind when a patient with hematological malignancies is receiving or is about to start a chemotherapeutic regimen. Conclusions. Bloodborne and respiratory tract infections were the most common sources of infection by Staphylococcus epidermidis and Klebsiella pneumoniae as causative agents. Likewise, the most frequent complication was febrile neutropenia. The first cause of death were infections complicated by sepsis; however, only one-third of the patients had a microbial isolation.

Cadmium (Cd) is a toxic metal and classified as a carcinogen whose exposure could affect the function of the central nervous system. There are studies that suggest that Cd promotes neurodegeneration in different regions of the brain, particularly in the hippocampus. It is proposed that its mechanism of toxicity maybe by an oxidative stress pathway, which modifies neuronal morphology and causes the death of neurons and consequently affecting cognitive tasks. However, this mechanism is not yet clear. The aim of the present work was to study the effect of Cd administration on recognition memory for 2, 3 and 4 months, neuronal morphology and immunoreactivity for caspase-3 and 9 in rat hippocampi. The results show that the administration of Cd decreased recognition memory. Likewise, it caused the dendritic morphology of the CA1, CA3 and dentate gyrus regions of the hippocampus to decrease with respect to the time of administration of this heavy metal. In addition, we observed a reduction in the density of dendritic spines as well as an increase in the immunoreactivity of caspase-3 and 9 in the same hippocampal regions of the animals treated with Cd. These results suggest that Cd affects the structure and function of the neurons of the hippocampus, which contribute to the deterioration of recognition memory. Our results suggest that the exposure to Cd represents a critical health problem, which if not addressed quickly, could cause much more serious problems in the quality of life of the human population, as well as in the environment in which they develop.

Objective To quantify the prevalence and related factors to the risk of anorexia and bulimia nervosa in undergraduate students at a private university in Bogotá, Colombia. Methods A cross-sectional study, which evaluated the frequency of food consumption, physical activity (International Physical Activity Questionnaire, short form), the risk of anorexia and bulimia nervosa (Sick, Control, One, Fat, and Food questionnaire) and demographic variables. The statistical analysis used a multivariate logistic regression model, where the outcome was the yes/no risk of anorexia or bulimia nervosa. Results A total of 1,545 university students participated. The average age was 19.2 years (+/-2.5), 65.7% were women, and 63.9% came from Bogotá. The risk of anorexia and bulimia nervosa was 27.6%. In the logistic regression, the risk was associated with female sex (OR 1.6 CI95% 1.2 to 2.1), daily consumption of cereals (OR 0.7 CI95% 0.6 to 0.9), daily fat consumption (OR 1.5 CI95% 1.1 to 2.1), eat light products (OR 1.8 CI95% 1.1 to 2.9), consume protein supplements (OR 0.4 CI95% 0.2 to 0.8), being in disagreement with physical activity for fun (OR 1.8 CI95% 1.1 to 3.1), and physical activity by appearance (OR 2.2 CI95% 1.6 to 2.9). Conclusions The prevalence of risk to anorexia and bulimia nervosa in the study sample is high. The associated factors were the consumption of cereals, fat, light products, and protein supplements. Physical activity by appearance and disagreement to do exercise by fun were associated with the risk of anorexia and bulimia nervosa. So it is recommended that universities implement awareness and education interventions to address this problem. RESUMO Objetivo Quantificar a prevalência e os fatores relacionados ao risco de anorexia e bulimia nervosa em estudantes de graduação de uma universidade particular de Bogotá, Colômbia. Métodos Estudo transversal, que avaliou a frequência de consumo alimentar, atividade física (ferramenta (Questionário Internacional de Atividade Física, versão curta), risco de anorexia e bulimia nervosa (Questionário de doença, controle, um, gordura e comida) e variáveis demográficas. A análise estatística utilizou um modelo de regressão logística multivariada, em que o resultado foi o risco sim / não de anorexia ou bulimia nervosa. Resultados Participaram 1.545 estudantes universitários. A idade média era de 19,2 anos (+/- 2,5), 65,7% eram mulheres e 63,9% eram de Bogotá. O risco de anorexia e bulimia nervosa foi de 27,6%. Na regressão logística, o risco foi associado ao sexo feminino (OR 1,6 IC95% 1,2 a 2,1), consumo diário de cereais (OR 0,7 IC95% 0,6 a 0,9), consumo diário de gordura (OR 1,5 IC95% 1,1 a 2,1), comer produtos leves (OR 1,8 IC95% 1,1 a 2,9), consomem suplementos proteicos (OR 0,4 IC95% 0,2 a 0,8), discordam de atividade física para se divertir (OR 1,8 IC95% 1,1 a 3,1) e atividade física pela aparência (OR 2,2 CI95% 1,6 a 2,9). Conclusão A prevalência de risco para anorexia e bulimia nervosa na amostra do estudo é alta. Os fatores associados foram o consumo de cereais, gorduras, produtos light e suplementos proteicos. A atividade física pela aparência e a discordância para fazer exercício pela diversão estiveram associadas ao risco de anorexia e bulimia nervosa. Portanto, é recomendado que as universidades implementem intervenções de conscientização e educação para resolver esse problema.

In the aging process, the brain presents biochemical and morphological alterations. The neurons of the limbic system show reduced size dendrites, in addition to the loss of dendritic spines. These disturbances trigger a decrease in motor and cognitive function. Likewise, it is reported that during aging, in the brain, there is a significant decrease in neurotrophic factors, which are essential in promoting the survival and plasticity of neurons. The carboxyl-terminal fragment of the heavy chain of the tetanus toxin (Hc-TeTx) acts similarly to neurotrophic factors, inducing neuroprotection in different models of neuronal damage. The aim here, was to evaluate the effect of Hc-TeTx on the motor processes of elderly mice (18 months old), and its impact on the dendritic morphology and density of dendritic spines of neurons in the limbic system. The morphological analysis in the dendrites was evaluated employing Golgi-Cox staining. Hc-TeTx was administered (0.5 mg/kg) intraperitoneally for three days in 18-month-old mice. Locomotor activity was evaluated in a novel environment 30 days after the last administration of Hc-TeTx. Mice treated with Hc-TeTx showed significant changes in their motor behavior, and an increased dendritic spine density of pyramidal neurons in layers 3 and 5 of the prefrontal cortex in the hippocampus, and medium spiny neurons of the nucleus accumbens (NAcc). In conclusion, the Hc-TeTx improves the plasticity of the brain regions of the limbic system of aged mice. Therefore, it is proposed as a pharmacological alternative to prevent or delay brain damage during aging.

The consumption of foods rich in carbohydrates, saturated fat, and sodium, accompanied by a sedentary routine, are factors that contribute to the progress of metabolic syndrome (MS). In this way, they cause the accumulation of body fat, hypertension, dyslipidemia, and hyperglycemia. Additionally, MS has been shown to cause oxidative stress, inflammation, and death of neurons in the hippocampus. Consequently, spatial and recognition memory is affected. It has recently been proposed that metformin decavanadate (MetfDeca) exerts insulin mimetic effects that enhance metabolism in MS animals; however, what effects it can cause on the hippocampal neurons of rats with MS are unknown. The objective of the work was to evaluate the effect of MetfDeca on hippocampal neurodegeneration and recognition memory in rats with MS. Administration of MetfDeca for 60 days in MS rats improved object recognition memory (NORt). In addition, MetfDeca reduced markers of oxidative stress and hippocampal neuroinflammation. Accompanied by an increase in the density and length of the dendritic spines of the hippocampus of rats with MS. We conclude that MetfDeca represents an important therapeutic agent to treat MS and induce neuronal and cognitive restoration mechanisms.

Metabolic syndrome (MS) results from excessive consumption of high-calorie foods and sedentary lifestyles. Clinically, insulin resistance, abdominal obesity, hyperglycemia, dyslipidemia, and hypertension are observed. MS has been considered a risk factor in the development of dementia. In the brain, a metabolically impaired environment generates oxidative stress and excessive production of pro-inflammatory cytokines that deteriorate the morphology and neuronal function in the hippocampus, leading to cognitive impairment. Therapeutic alternatives suggest that phenolic compounds can be part of the treatment for neuropathies and metabolic diseases. In recent years, the use of Gallic Acid (GA) has demonstrated antioxidant and anti-inflammatory effects that contribute to neuroprotection and memory improvement in animal models. However, the effect of GA on hippocampal neurodegeneration and memory impairment under MS conditions is still unclear. In this work, we administered GA (20 mg/kg) for 60 days to rats with MS. The results show that GA treatment improved zoometric and biochemical parameters, as well as the recognition memory, in animals with MS. Additionally, GA administration increased hippocampal dendritic spines and decreased oxidative stress and inflammation. Our results show that GA treatment improves metabolism: reducing the oxidative and inflammatory environment that facilitates the recovery of the neuronal morphology in the hippocampus of rats with MS. Consequently, the recognition of objects by these animals, suggesting that GA could be used therapeutically in metabolic disorders that cause dementia.

Recent reports on brain aging suggest that oxidative stress and inflammatory processes contribute to aging. Interestingly, sodium phenylbutyrate (PBA) is an inhibitor of histone deacetylase, which has anti-inflammatory properties. Several reports have suggested the effect of PBA on learning and memory processes, however there are no studies of the effect of this inhibitor of histone deacetylase on aging. Consequently, in the present study, the effect of PBA was studied in 18-month-old mice. The animals were administered PBA for 2 months after locomotor activity treatment and Morris water maze tests were performed. The Golgi-Cox staining technique and immunohistochemistry for glial fibrillary acidic protein (GFAP) and synaptophysin were performed for the morphological procedures. The administration of PBA improves learning and memory according to the Morris water maze test compared to vehicle-treated animals, which had unchanged locomotor activity. Using Golgi-Cox staining, dendritic length and the number of dendritic spines were measured in limbic regions, such as the nucleus accumbens (NAcc), prefrontal cortex (PFC) layer 3, and the CA1 of the dorsal hippocampus. In addition, PBA increased the number of dendritic spines in the PFC, NAcc, and CA1 subregions of the hippocampus with an increase in dendritic length only in the CA1 region. Moreover, PBA reduced the levels of the GFAP and increased the levels of synaptophysin in the studied regions. Thus, PBA can be a useful pharmacological tool to prevent or delay synaptic plasticity damage and cognitive impairment caused by age.

Multiple small studies have suggested that women with pre-eclampsia present elevated levels of C-reactive protein (CRP) and interleukin-6 (IL-6). However, little is known regarding the source of this CRP and IL-6 increase. Therefore, the aim of this study was to evaluate the relationship between CRP and IL-6 levels with pre-eclampsia considering different confounding factors. Using data from a large Colombian case-control study (3,590 cases of pre-eclampsia and 4,564 normotensive controls), CRP and IL-6 levels were measured in 914 cases and 1297 controls. The association between maternal serum levels of CRP and IL-6 with pre-eclampsia risk was evaluated using adjusted logistic regression models. Pre-eclampsia was defined as presence of blood pressure ≥140/90 mmHg and proteinuria ≥300mg/24 h (or ≥1 + dipstick). There was no evidence of association between high levels of CRP and IL-6 with pre-eclampsia after adjusting for the following factors: maternal and gestational age, ethnicity, place and year of recruitment, multiple-pregnancy, socio-economic position, smoking, and presence of infections during pregnancy. The adjusted OR for 1SD increase in log-CRP and log-IL-6 was 0.96 (95%CI 0.85, 1.08) and 1.09 (95%CI 0.97, 1.22), respectively. Although previous reports have suggested an association between high CRP and IL-6 levels with pre-eclampsia, sample size may lack the sufficient power to draw robust conclusions, and this association is likely to be explained by unaccounted biases. Our results, the largest case-control study reported up to date, demonstrate that there is not a causal association between elevated levels of CRP and IL-6 and the presence of pre-eclampsia.

Aging is a complex process that can lead to neurodegeneration and, consequently, several pathologies, including dementia. Physiological aging leads to changes in several body organs, including those of the central nervous system (CNS). Morphological changes in the CNS and particularly the brain result in motor and cognitive deficits affecting learning and memory and the circadian cycle. Characterizing neural modifications is critical to designing new therapies to target aging and associated pathologies. In this review, we compared aging to the changes occurring within the brain and particularly the limbic system. Then, we focused on key natural compounds, apamin, cerebrolysin, Curcuma longa, resveratrol, and N-PEP-12, which have shown neurotrophic effects particularly in the limbic system. Finally, we drew our conclusions delineating future perspectives for the development of novel natural therapeutics to ameliorate aging-related processes.

Context: The chronic exposure to Cadmium (Cd) constitute an risk to develop hypertension and cardiovascular diseases associated with the increase of oxidative stress.Objective: In this study, we investigate the role of metabolic changes produced by exposure to Cd on the endothelial dysfunction via oxidative stress.Methods: Male Wistar rats were exposed to Cd (32.5-ppm) for 2-months. The zoometry and blood pressure were evaluated, also glucose and lipids profiles in serum and vascular reactivity evaluated in isolated aorta rings.Results: Rats exposed to Cd showed an increase of blood pressure and biochemical parameters similar to metabolic syndrome. Additionally, rats exposed to Cd showed a reduced relaxation in aortic rings, which was reversed after the addition of SOD and apocynin an inhibitor of NADPH.Conclusion: The Cd-exposition induced hypertension and endothelial injury by that modifying the vascular relaxation and develop oxidative stress via NADPH oxidase, superoxide and loss nitric oxide bioavailability.

Metabolic syndrome (MS) is a health problem that is characterized by body fat accumulation, hypertension, dyslipidemia, and hyperglycemia; recently, it has been demonstrated that MS also damages memory processes. The first-line drug in the treatment of MS and type 2 diabetes mellitus is metformin, which is an antihyperglycemic agent. This drug has been shown to produce neuroprotection and to improve memory processes. However, the mechanism involved in this neuroprotection is unknown. A 90-day administration of metformin improved the cognitive processes of rats with MS as evaluated by the novel object recognition test, and this finding could be explained by an increase in the neuronal spine density and spine length. We also found that metformin increased the immunoreactivity of synaptophysin, sirtuin-1, AMP-activated protein kinase, and brain-derived neuronal factor, which are important plasticity markers. We conclude that metformin is an important therapeutic agent that increases neural plasticity and protects cognitive processes. The use of this drug is important in the minimization of the damage caused by MS.

Vanadium compounds have been primarily investigated as potential therapeutic agents for the treatment of various major health issues, including cancer, atherosclerosis, and diabetes. The translation of vanadium-based compounds into clinical trials and ultimately into disease treatments remains hampered by the absence of a basic pharmacological and metabolic comprehension of such compounds. In this review, we examine the development of vanadium-containing compounds in biological systems regarding the role of the physiological environment, dosage, intracellular interactions, metabolic transformations, modulation of signaling pathways, toxicology, and transport and tissue distribution as well as therapeutic implications. From our point of view, the toxicological and pharmacological aspects in animal models and humans are not understood completely, and thus, we introduced them in a physiological environment and dosage context. Different transport proteins in blood plasma and mechanistic transport determinants are discussed. Furthermore, an overview of different vanadium species and the role of physiological factors (i.e., pH, redox conditions, concentration, and so on) are considered. Mechanistic specifications about different signaling pathways are discussed, particularly the phosphatases and kinases that are modulated dynamically by vanadium compounds because until now, the focus only has been on protein tyrosine phosphatase 1B as a vanadium target. Particular emphasis is laid on the therapeutic ability of vanadium-based compounds and their role for the treatment of diabetes mellitus, specifically on that of vanadate- and polioxovanadate-containing compounds. We aim at shedding light on the prevailing gaps between primary scientific data and information from animal models and human studies.

An important worldwide health problem as the result of current lifestyle is metabolic syndrome (MS). It has been shown that MS induced by a high-calorie diet (HCD) in rats produces cognitive deterioration in the novel object recognition test (NORt) and decreases synaptic connections and dendritic order in the hippocampus and temporal cortex. However, it is unknown whether MS induced by an HCD participates in the cognitive process observed with the injection of Aβ1–42 into the hippocampus of rats as a model of Alzheimer disease (AD). The induction of MS in rats produces a deterioration in NORt; however, rats with MS injected with Aβ1–42 show a major deterioration in the cognitive process. This event could be explained by the increment in the oxidative stress in both cases studied (MS and Aβ1–42): together, the hippocampus and temporal cortex produce an enhancer effect. In the same way, we observed an increment in interleukin-1β, TNF-α, and GFAP, indicative of exacerbated inflammatory processes by the combination of MS and Aβ1–42. We can conclude that MS might play a key role in the apparition and development of cognitive disorders, including AD. We propose that metabolic theory is important to explain the apparition of cognitive diseases.

Aggregation of the amyloid beta (Aβ) peptide and hyperphosphorylation of tau protein, which are markers of Alzheimer's disease (AD), have been reported also in diabetes mellitus (DM). One regulator of tau phosphorylation is O-GlcNAcylation, whereas for hyperphosphorylation it could be GSK3beta, which is activated in hyperglycemic conditions. With this in mind, both O-GlcNAcylation and phosphorylation of tau protein were evaluated in the brain of rats with streptozotocin (STZ)-induced hyperglycemia and hyperinsulinemia and treated with the As25-35 peptide in the hippocampal region CA1. Weight, glycated hemoglobin, glucose, and insulin were determined. Male Wistar rats were divided in groups (N=20): a) control, b) treated only with the Aβ25-35 peptide, c) treated with Aβ25-35 and STZ, and d) treated only with STZ. Results showed statistically significant differences in the mean weight, glucose levels, insulin concentration, and HbA1c percentage, between C- and D-treated groups and not STZ-treated A and B (P

Background: Avoiding primary C-section is the safest and most effective way of decreasing C-section rates. We analyzed circumstances and decisions made among pregnant women without history of C-section and cephalic single fetus (group B), who ended up having a Cesarean birth, to identify opportunities that may optimize the decisions about delivery. Methodology: We evaluated the clinical histories of pregnant women from group B who completed their pregnancies in the Hospital Universitario de Santander (Bucaramanga, Colombia) during 2013. We evaluated the decision moments from admission until birth, including the registry of the reasons for having a C-section, compliance of all the criteria to support the decision and its appropriateness, and how adequate were the procedures done during the induction or augmentation of labor. Results: We evaluated 1320 histories; 666 (55.7%) ended by C-Section. In 59.8% of the histories, we identified at least one decision that could have been addressed differently to optimize the delivery type and, potentially, avoid ending in a Cesarean birth. The most frequent opportunities arise due to a lack of clarity in the record of the reason for performing the C-section (70.1%), and inadequate use of labor induction in the patients that had to end their gestation (38.5%). Conclusion: In the Hospital Universitario de Santander during 2013, despite observing a meaningful subregistry of the indication to perform a C-section, we found that in one out of every two patients there are opportunities of improvement in the registry and attention to reduce the high incidence of C-sections in the institution. This analysis allowed us to create a checklist to fill out before making the final decision of performing a Cesarean birth.

Amphetamines (AMPH) are psychostimulants widely used for therapy as well as for recreational purposes. Previous results of our group showed that AMPH exposure in pregnant rats induces physiological and behavioral changes in the offspring at prepubertal and postpubertal ages. In addition, several reports have shown that AMPH are capable of modifying the morphology of neurons in some regions of the limbic system. These modifications can cause some psychiatric conditions. However, it is still unclear if there are changes to behavioral and morphological levels when low doses of AMPH are administered at a juvenile age. The aim of this study was to assess the effect of AMPH administration (1mg/kg) in Sprague-Dawley rats (postnatal day, PD21-PD35) on locomotor activity in a novel environment and compare the neuronal morphology of limbic system areas at three different ages: prepubertal (PD 36), pubertal (PD50) and postpubertal (PD 62). We found that AMPH altered locomotor activity in the prepubertal group, but did not have an effect on the other two age groups. The Golgi-Cox staining method was used to describe the neural morphology of five limbic regions: (Layers 3 and 5) the medial prefrontal cortex (mPFC), the dorsal and ventral hippocampus, the nucleus accumbens and the amygdala, showing that AMPH induced changes at pubertal ages in arborization and spine density of these neurons, but interestingly these changes did not persist at postpubertal ages. Our findings suggest that even early-life AMPH exposure does not induce long-term behavioral and morphological changes, however it causes alterations at pubertal ages in the limbic system networks, a stage of life strongly associated with the development of substance abuse behaviors.

BACKGROUND Over the years, many materials have been used in orbital reconstruction and cranioplasty. Among the materials in current use, polymethyl methacrylate (PMMA) offers a high degree of compatibility with human tissue. OBJECTIVE This work describes a new, custom-made, 3D printing-aided, prosthetic fabrication process for orbital and/or cranial reconstruction using PMMA. METHODS On the basis of information obtained from computerized tomography scanning processed in Digital Imaging and Communication in Medicine format and exported to treatment planning software, a 3D prosthesis master model was designed and digitally printed. This was then used to create an injection mold from which the prosthesis was cast in PMMA and implanted in the patient. Five patients with cranial and/or orbital defects of tumoral or traumatic etiology were treated by this method. After 5 to 7 years follow-up, no complications occurred to cause the removal of the prostheses. CONCLUSION This novel method makes it possible to produce customized PMMA prostheses to treat orbital and/or cranial defects that are cost-effective and individualized to each case.

The main characteristic of brain aging is an exacerbated inflammatory and oxidative response that affects dendritic morphology and the function of the neurons of the prefrontal cortex (PFC) and the hippocampus. This consequently causes memory loss. Recently, the use of the Goji berry (Lycium barbarum) as an antioxidant extract has provided neuroprotection and neuroplasticity, however, its therapeutic potential has not been demonstrated in aging conditions. The objective of this study was to evaluate the effect of Goji administration on memory recognition, as well as the changes in the dendritic morphology of the PFC and Hippocampus pyramidal neurons in old rats. Goji (3 g/kg) was administrated for 60 days in 18-month-old rats. After the treatment, recognition memory was evaluated using the new object recognition task (NORt). The changes in the neuron morphology of the PFC and hippocampus pyramidal neurons in old rats were evaluated by Golgi-cox stain and immunoreactivity for synaptophysin, glial fibrillary acidic protein (GFAP), caspase-3, 3-nitrotyrosine (3-NT) and nuclear factor erythroid 2-related factor 2 (Nrf2). The rats treated with Goji showed a significant increase in dendritic morphology in the PFC and hippocampus neurons, a greater immunoreactivity to synaptophysin and a decrease in reactive astrogliosis and also in caspase-3, in 3-NT and in Nrf2 in these brain regions was also observed. Goji administration promotes the plasticity processes in the PFC and in the hippocampus of old rats, critical structures in the brain aging process.

Alzheimer's disease (AD) is a neurodegenerative disorder caused by the aggregation of the amyloid-beta peptide (Aβ) in senile plaques and cerebral vasculature. The Aβ25-35 fraction has shown the most toxicity; its neurotoxic mechanisms are associated with the generation of oxidative stress and reactive astrogliosis that induce neuronal death and memory impairment. Studies indicate that pharmacological treatment with flavonoids reduces the rate of AD, in particular, it has been shown that antioxidants are compounds that could interact with this peptide due to their antioxidant proprieties. In this study, experimental and computational tools were used to calculate the molecular electrostatic potential and the Fukui function with the Gaussian 09 computational program, to predict the most reactive parts of these molecules and make the complex between Aβ25-35 and two flavonoids (catechin and epicatechin) in the absolute gas-phase, where a possible interaction between them was observed. This is important for understanding the Aβ25-35-Flavonoid (A-F) interaction as a therapeutic strategy to inhibit the neurotoxic effects that this peptide causes in AD, which currently is still considered an ambiguous process.

Introduction The presence of truncus arteriosus represents just 1.2–3% of all complex congenital heart pathologies and if not corrected, less than 20% survive beyond one year of life. When the disease progresses patients usually develop severe pulmonary hypertension and may even develop into Eisenmenger's syndrome. The paper discusses a case of a schoolboy with a diagnosis of uncorrected truncus arteriosus type I, and severe pulmonary arterial hypertension undergoing non-cardiac surgery. Case discussion This is a 9-year old schoolboy with complex heart disease and similar pulmonary and systemic blood pressures, undergoing elective orthopedic surgery under regional anesthesia, with lumbar plexus block and posterior sciatic block. This anesthetic approach provided adequate anesthesia with hemodynamic stability and no impact on vascular resistance. Conclusion The choice of the anesthetic technique should be a planned decision based on the cardiovascular pathophysiology of the truncus arteriosus, the level of pulmonary hypertension, and the surgical procedure to be performed. Patients with severe pulmonary hypertension are at increased risk of developing suprasystemic pulmonary pressures with considerable hemodynamic involvement. Consequently, the anesthetic technique chosen shall provide adequate anesthesia and ensure the least hemodynamic impact. Whenever possible, it is important to consider the peripheral nerve block as the first line approach for orthopedic surgery.

Resumen Introduccion Los farmacos anticolinergicos reducen la eficacia de los inhibidores de la acetilcolinesterasa (IACE) y se consideran inapropiados en pacientes de edad avanzada. El objetivo fue conocer la prevalencia de prescripcion concomitante de IACE y anticolinergicos en un Area de Salud, identificar pacientes afectados e informar a los medicos responsables para que valorasen la idoneidad de los tratamientos. Material y metodos Estudio descriptivo transversal y observacional de prevalencia. Se selecciono a pacientes en tratamiento con IACE y algun farmaco anticolinergico en el primer trimestre de 2015. Para la identificacion de anticolinergicos, se utilizo como referencia la revision de Duran et al., asignando una puntuacion a cada farmaco en funcion de su potencia anticolinergica. Se proporciono a cada medico una nota informativa sobre la interaccion, relacion de pacientes afectados y recomendaciones. Resultados Se incluyo a 486 pacientes, lo que supone el 59,0% sobre el total de pacientes con enfermedad de Alzheimer del area. El 66,0% eran mujeres, el 86,8% mayores de 75 anos, con una media de 9,2 farmacos/paciente. El numero medio de farmacos anticolinergicos fue 1,6; el 38,3% de los pacientes tenian prescritos varios farmacos anticolinergicos y el 23,9% algun farmaco de alta potencia anticolinergica. Se encontro asociacion estadisticamente significativa entre tomar IACE y anticolinergicos de forma concomitante (p = 0,000; OR: 3,9). Conclusiones La prevalencia de interaccion entre IACE y anticolinergicos es relevante, considerando que ademas afecta a poblacion vulnerable. Proporcionar a los medicos informacion sobre la interaccion podria ayudar a la toma de decisiones clinicas, mejorar la seguridad y los resultados en salud de los pacientes.

ResumenIntroducciónLa presencia de tronco arterioso representa únicamente del 1,2% al 3% de las cardiopatías congénitas complejas, y de no ser corregida, menos del 20% sobreviven después del año de vida. Si la enfermedad progresa usualmente desarrollan hipertensión arterial pulmonar severa y pueden manifestarse incluso como un síndrome de Eisenmenger. Se presenta un caso de un escolar con diagnóstico de tronco arterioso tipo i no corregido e hipertensión arterial pulmonar severa llevado a cirugía no cardiaca.Presentación del casoEscolar de 9 años de edad con cardiopatía compleja y presión arterial pulmonar similar a la presión arterial sistémica, sometido a cirugía ortopédica electiva bajo anestesia regional con bloqueo de plexo lumbar y bloqueo ciático posterior. Esta técnica anestésica nos proporcionó una adecuada anestesia con estabilidad hemodinámica sin repercusión en las resistencias vasculares.ConclusiónLa elección de la técnica anestésica debe ser planeada en función de la fisiopatología cardiovascular del tronco arterioso, del grado de hipertensión pulmonar y del procedimiento quirúrgico a realizarse. Los pacientes con hipertensión pulmonar severa tienen mayor riesgo de manifestar presiones pulmonares suprasistémicas con compromiso hemodinámico importante, por lo que la técnica anestésica elegida será aquella que produzca una adecuada anestesia y menor repercusión hemodinámica. Es importante considerar, de ser posible, el bloqueo de los nervios periféricos como primera elección en cirugía ortopédica.AbstractIntroductionThe presence of truncus arteriosus represents just 1.2 to 3% of all complex congenital heart pathologies and if not corrected, less than 20% survive beyond one year of life. When the disease progresses patients usually develop severe pulmonary hypertension and may even develop into Eisenmenger's syndrome. The paper discusses a case of a schoolboy with a diagnosis of uncorrected truncus arteriosus type I, and severe pulmonary arterial hypertension undergoing non-cardiac surgery.Case discussionThis is a 9-year old schoolboy with complex heart disease and similar pulmonary and systemic blood pressures, undergoing elective orthopedic surgery under regional anesthesia, with lumbar plexus block and posterior sciatic block. This anesthetic approach provided adequate anesthesia with hemodynamic stability and no impact on vascular resistance.ConclusionThe choice of the anesthetic technique should be a planned decision based on the cardiovascular pathophysiology of the truncus arteriosus, the level of pulmonary hypertension, and the surgical procedure to be performed. Patients with severe pulmonary hypertension are at increased risk of developing suprasystemic pulmonary pressures with considerable hemodynamic involvement. Consequently, the anesthetic technique chosen shall provide adequate anesthesia and ensure the least hemodynamic impact. Whenever possible, it is important to consider the peripheral nerve block as the first line approach for orthopedic surgery.

Schizophrenia, a severe and debilitating disorder with a high social burden, affects 1% of the adult world population. Available therapies are unable to treat all the symptoms, and result in strong side effects. For this reason, numerous animal models have been generated to elucidate the pathophysiology of this disorder. All these models present neuronal remodeling and abnormalities in spine stability. It is well known that the complexity in dendritic arborization determines the number of receptive synaptic contacts. Also the loss of dendritic spines and arbor stability are strongly associated with schizophrenia. This review evaluates changes in spine density and dendritic arborization in animal models of schizophrenia. By understanding these changes, pharmacological treatments can be designed to target specific neural systems to attenuate neuronal remodeling and associated behavioral deficits.

Resveratrol may induce its neuroprotective effects by reducing oxidative damage and chronic inflammation apart from improving vascular function and activating longevity genes, it also has the ability to promote the activity of neurotrophic factors. Morphological changes in dendrites of the pyramidal neurons of the prefrontal cortex (PFC) and hippocampus have been reported in the brain of aging humans, or in humans with neurodegenerative diseases such as Alzheimer's disease. These changes are reflected particularly in the decrement of both the dendritic tree and spine density. Here we evaluated the effect of resveratrol on the dendrites of pyramidal neurons of the PFC (Layers 3 and 5), CA1- and CA3-dorsal hippocampus (DH) as well as CA1-ventral hippocampus, dentate gyrus (DG), and medium spiny neurons of the nucleus accumbens of aged rats. 18-month-old rats were administered resveratrol (20 mg/kg, orally) daily for 60 days. Dendritic morphology was studied by the Golgi-Cox stain procedure, followed by Sholl analysis on 20-month-old rats. In all resveratrol-treated rats, a significant increase in dendritic length and spine density in pyramidal neurons of the PFC, CA1, and CA3 of DH was observed. Interestingly, the enhancement in dendritic length was close to the soma in pyramidal neurons of the PFC, whereas in neurons of the DH and DG, the increase in dendritic length was further from the soma. Our results suggest that resveratrol induces modifications of dendritic morphology in the PFC, DH, and DG. These changes may explain the therapeutic effect of resveratrol in aging and in Alzheimer's disease.

Resumen Objetivo Identificar y conocer que rol o papel representa el farmaceutico comunitario en la atencion a los pacientes y familia al final de la vida, dentro de los planes y programas de cuidados paliativos (CP) en el ambito nacional, autonomico e internacional. Material y metodos Revision bibliografica de la literatura cientifica, en ingles o espanol, a traves de los buscadores Pubmed, Google Academico y web del SACYL Biblioteca virtual, plataforma de editoriales de revistas electronicas (Editorial Elsevier y Elsevier Doyma), la web del PORTALFARMA (Revista del farmaceutico, Panorama actual del medicamento y Pliegos de rebotica) y Cochrane. Completando la revision con la lectura de los distintos planes o programas de CP a nivel nacional y autonomico. Resultado En los paises de habla inglesa (Reino Unido, Australia, EE.UU., etc.), se ha comenzado a valorar la intervencion del farmaceutico comunitario como farmaceutico colaborador o dentro de un equipo interdisciplinar de CP, a traves de su inclusion en guias, documentos de consenso o programas piloto. No se ha encontrado ningun estudio que recoja la intervencion del farmaceutico comunitario en la prestacion de CP en nuestro pais. Tan solo los planes de CP de la comunidad de Madrid y de la region de Murcia recogen la intervencion del farmaceutico aunque de forma muy general, poco especifica y sin referencia concreta al farmaceutico de oficina de farmacia o farmacia comunitaria. Conclusiones En Espana existen programas de atencion a pacientes cronicos en los que interviene el farmaceutico comunitario, pero no hay ninguna referencia con relacion al paciente con enfermedad avanzada o terminal. Se podria afirmar que los profesionales farmaceuticos comunitarios, con relacion a la prestacion de servicios asistenciales al paciente terminal y su familia, han quedado fuera del sistema y eso, a pesar de que se ha llegado a afirmar que los CP son «cosa de todos». La integracion del farmaceutico comunitario en la atencion a los pacientes en CP formando parte de un equipo interdisciplinar o como «farmaceutico colaborador» deberia ser un recurso a tener en cuenta y valorar.

Setting: Three pediatric pneumatologist offices in Bucaramanga, Colombia. Objective: To establish the concordance between medical criteria and the Childhood-Asthma Control Test (cACT). Design: Study of the assessment of diagnostic technology using transverse sampling. 127 asthma patients aged between 4 and 11 years and their parents filled before clinical evaluation made by a pediatric pneumologist. Patients were classified as controlled or not controlled. Criteria validity was established comparing this classification using Cohen’s kappa and performance indicators according to ROC analysis. Results: 78% of the patients were controlled; patients who are not controlled have a higher score in cACT (mean difference: 3.25 points). Concordance among cACT subscales is acceptable (ρ = 0.554). cACT’s sensitivity was 53.6%, specificity 78.8%, positive likelihood ratio (LR+) 2.53, and negative likelihood ratio (LR-) 0.59. The best cut-off point is 15, with 98% sensitivity, a specificity of 14.3%, LR+ in 1.14, and LR- in 0.14. Conclusions: cACT is a valid tool to determine asthma control in children without replacing medical criteria or other clinical tests. In populations with difficult access to high complexity services, it is useful to decide whether urgent referral to the specialist is necessary.

The aged brain has biochemical and morphological alterations in the dendrites of the pyramidal neurons of the limbic system, which consequently trigger motor and cognitive deficits. Bexarotene 4-[1-(3,5,5,8,8-pentamethyl-6,7-dihydronaphthalen-2-yl)ethenyl]benzoic acid is a selective agonist of X-retinoid receptors which acts by binding to the intracellular retinoic acid receptors (RAR). It decreases oxidative and inflammatory activity, in addition to the transport of lipids, mechanisms that together could have a neuroprotective effect. Our objective was to evaluate the effect of bexarotene on the motor and cognitive processes, as well as its influence on the dendritic morphology of neurons in the limbic system of elderly mice. Dendritic morphology was evaluated with the Golgi-Cox staining procedure followed by the Sholl analysis. Bexarotene was administered at different doses: 0.0; 0.5; 2.5 and 5.0 mg/kg for 60 days in 18-month-old mice. After the treatment, locomotor activity in a novel environment and spatial memory in the water labyrinth were evaluated. Mice treated with bexarotene did not show significant changes in their behavior. Moreover, bexarotene-treated mice only showed a significant increase in the density of the dendritic spines and the dendritic length in the nucleus accumbens (NAcc) neurons. In conclusion, the administration of bexarotene improves the plasticity of the NAcc of aged mice, and therefore could be a pharmacological alternative to prevent or delay neuroplasticity disruptions in brain aging.

Amyloid-β (Aβ) plays a relevant role in the neurodegenerative process of Alzheimer's disease (AD). The 25-35 peptide of amyloid-β (Aβ25-35) induces the inflammatory response in brain experimental models. Mucin-type O-glycosylation has been associated with inflammation of brain tissues in AD, thus in this work, we aimed at identifying changes in the glycosylation profile generated by the injection of Aβ25-35 into the CA1 of the hippocampus of rats, using histochemistry with lectins. Our results indicate that 100μM Aβ25-35 induce increased recognition of the Amaranthus leucocarpus lectin (ALL) (specific for Galβ1,3-GalNAcα1,0-Ser/Thr); whereas concanavalin A (Con A) (specific for α-Man) showed no differences among treated and control groups of rats. Jacalin and peanut agglutinin (Galβ1,3GalNAcα1,0-Ser/Thr) showed no recognition of brain cells of control or treated rats. After 6-h treatment of the tissue with trypsin or with 200mM GalNAc, the interaction with ALL was inhibited. Immunohistochemistry showed positive anti-NeuN and ALL-recognition of neurons; however, anti-GFAP and anti-CD11b showed no co-localization with ALL. The ALL+ neurons revealed the presence of cytochrome C in the cytosol and active caspase 3 in the cytosol and nucleus. Administration of the interleukin-1 receptor antagonist (IL-1RA) to Aβ25-35-treated rats diminished neuroinflammation and ALL recognition. These results suggest a close relationship among over-expression of mucin-type O-glycosylation, the neuroinflammatory process, and neuronal death.

Apomorphine is a dopamine receptor agonist that activates D1-D5 dopamine receptors and that is used to treat Parkinson's disease (PD). However, the effect of apomorphine on non-motor activity has been poorly studied, and likewise, the effects of dopaminergic activation in brain areas that do not fulfill motor functions are unclear. The aim of this study was to determine how dopamine receptor activation affects behavior, as well as plasticity, morphology, and oxidative stress in the hippocampus. Adult mice were chronically administered apomorphine (1 mg/kg for 15 days), and the effects on memory and learning, synaptic plasticity, dendritic length, inflammatory responses, and oxidative stress were evaluated. Apomorphine impaired learning and long-term memory in mice, as evaluated in the Morris water maze test. In addition, electrophysiological recording of field excitatory postsynaptic potentials (fEPSP) indicated that the long-term potentiation (LTP) of synaptic transmission in the CA1 region of the hippocampus was fully impaired by apomorphine. In addition, a Sholl analysis of Golgi-Cox stained neurons showed that apomorphine reduced the total length of dendrites in the CA1 region of the hippocampus. Finally, there were more reactive astrocytes and oxidative stress biomarkers in mice administered apomorphine, as measured by GFAP immunohistochemistry and markers of redox balance, respectively. Hence, the non-selective activation of dopaminergic receptors in the hippocampus by apomorphine triggers deficiencies in learning and memory, it prevents LTP, reduces dendritic length, and provokes neuronal damage.

ResumenObjetivosEstablecer la utilidad del índice de presión arterial tobillo-tobillo (ITT) en los pacientes con trauma de extremidades inferiores y signos blandos de lesión vascular en términos de sensibilidad, especificidad y valores predictivos según el mejor punto de corte detectado.Material y métodoSe incluyeron 120 pacientes con trauma en extremidades inferiores y signos blandos de lesión vascular que ingresaron al Hospital Universitario de Santander (Bucaramanga, Colombia) durante los años 2012 a 2015, a los cuales se les calculó el índice tobillo-brazo (ITB) e ITT.ResultadosUn total de 21 (17,5%) pacientes tuvieron ITB menor a 0,9 al ingreso, los cuales fueron llevados a intervención quirúrgica inmediata, encontrando lesión vascular; 2 (1,6%) pacientes tuvieron ITB menor a 0,9 en el control realizado a las 6h, los cuales también fueron llevados a intervención quirúrgica, encontrando lesión vascular. Por tanto, se encontraron 23 pacientes con lesión vascular. Las curvas ROC tanto de ITB como de ITT señalan que ambas tienen un muy buen desempeño para diagnosticar las lesiones vasculares en pacientes con signos blandos cuando se emplean una única vez. En ambos casos, el punto de corte propuesto tradicionalmente de 0,90 tiene una capacidad discriminatoria adecuada, con sensibilidad de 91% (IC 95%: 0,71-0,98), especificidad de 100% (IC 95%: 0,96-1,0), valor predictivo positivo de 100% (IC 95%: 0,83-1,0) y valor predictivo negativo de 97% (IC 95%: 0,92-0,99).ConclusiónEl índice tobillo-tobillo (ITT) permite descartar lesión vascular en el paciente con trauma en extremidades inferiores y signos blandos.AbstractObjectivesWe pretend to establish the utility of the ankle-ankle systolic pressure index (AAI) in patients with trauma in the inferior limbs and soft signs of vascular injury describing its sensitivity, specificity and predictive values according to the best cut-off point.Material and methodThe cohort included 120 patients with trauma in the inferior limbs and soft signs of vascular injury who attended the University Hospital of Santander (Bucaramanga, Colombia) over a period of 4 years (2012-2015).Results21 (17.5%) patients had an ankle brachial pressure index (ABI)

The aging brain shows biochemical and morphological changes in the dendrites of pyramidal neurons from the limbic system associated with memory loss. Prolame (N-(3-hydroxy-1,3,5 (10)-estratrien-17β-yl)-3-hydroxypropylamine) is a non-feminizing aminoestrogen with antithrombotic activity that prevents neuronal deterioration, oxidative stress, and neuroinflammation. Our aim was to evaluate the effect of prolame on motor and cognitive processes, as well as its influence on the dendritic morphology of neurons at the CA1, CA3, and granule cells of the dentate gyrus (DG) regions of hippocampus (HP), and medium spiny neurons of the nucleus accumbens (NAcc) of aged mice. Dendritic morphology was assessed with the Golgi-Cox stain procedure followed by Sholl analysis. Prolame (60 µg/kg) was subcutaneously injected daily for 60 days in 18-month-old mice. Immediately after treatment, locomotor activity in a new environment and recognition memory using the Novel Object Recognition Task (NORT) were evaluated. Prolame-treated mice showed a significant increase in the long-term exploration quotient, but locomotor activity was not modified in comparison to control animals. Prolame-treated mice showed a significant increase in dendritic spines density and dendritic length in neurons of the CA1, CA3, and DG regions of the HP, whereas dendrites of neurons in the NAcc remained unmodified. In conclusion, prolame administration promotes hippocampal plasticity processes but not in the NAcc neurons of aged mice, thus improving long-term recognition memory. Prolame could become a pharmacological alternative to prevent or delay the brain aging process, and thus the emergence of neurodegenerative diseases that affect memory.

Background Maternal serum concentrations of folate, homocysteine, and vitamin B12 have been associated with pre-eclampsia. Nevertheless, reported studies involve limited number of cases to reliably assess the nature of these associations. Our aim was to examine the relation of these three biomarkers with pre-eclampsia risk in a large Colombian population. Materials and methods Design: A case-control study. Setting: Cases of pre-eclampsia and healthy pregnant controls were recruited at the time of delivery from eight different Colombian cities between 2000 and 2012. Population or Sample: 2978 cases and 4096 controls were studied. Maternal serum concentrations of folate, homocysteine, and vitamin B12 were determined in 1148 (43.6%) cases and 1300 (31.7%) controls. Also, self-reported folic acid supplementation was recorded for 2563 (84%) cases and 3155 (84%) controls. Analysis: Adjusted odds ratios (OR) for pre-eclampsia were estimated for one standard deviation (1SD) increase in log-transformed biomarkers. Furthermore, we conducted analyses to compare women that reported taking folic acid supplementation for different periods during pregnancy. Main Outcomes Measures: Odds ratio for pre-eclampsia. Results After adjusting for potential confounders in logistic regression models, the OR for pre-eclampsia was 0.80 (95% CI: 0.72, 0.90) for 1SD increase in log-folate, 1.16 (95%CI: 1.05, 1.27) for 1SD increase in log-homocysteine, and 1.10 (95%CI: 0.99, 1.22) for 1SD increase in log-vitamin B12. No interactions among the biomarkers were identified. Women who self-reported consumption of folic acid (1 mg/day) throughout their pregnancy had an adjusted OR for pre-eclampsia of 0.86 (95%CI: 0.67, 1.09) compared to women that reported no consumption of folic acid at any point during pregnancy. Conclusions Maternal serum concentrations of folate were associated as a protective factor for pre-eclampsia while concentrations of homocysteine were associated as a risk factor. No association between maternal vitamin B12 concentrations and preeclampsia was found.

Metabolic syndrome (MS) is a serious public health problem, which can promote neuronal alterations in cognitive regions related to learning and memory processes, such as the hippocampus. However, up to now there has been information of a regional segregation of this damage. In this study, we evaluate the MS effect on the neuronal morphology of the hippocampus. Our results demonstrate that 90days of a high-calorie diet alters the metabolic energy markers causing the MS and causes memory impairments, evaluated by the recognition of novel objects test (NORT). In addition, MS animals showed significant differences in dendritic order, total dendritic length and density of dendritic spines in CA1, CA3 and the dentate gyrus (DG) of the hippocampal area, compared with rats fed with a normocaloric diet (vehicle group). Furthermore, the immunoreactivity to synaptophysin (Syp) decreased in the hippocampus of the MS animals compared to the vehicle group. These results indicate that metabolic alterations induced by the MS affect hippocampal plasticity and hippocampal dependent memory processes.

Seventy percent of adolescent morbidity and mortality is related to six risky behaviors. The Rapid Assessment for Adolescent Preventive Services is a screening questionnaire consisting of 21 questions but there is not a validated Spanish-language version. The obj ective of this study was to validate the Spanish-language version of the Rapid Assessment for Adolescent Preventive Services in two Colombian cities: Bucaramanga and Medellin. The questionnaire was administered to 270 randomly selected adolescent students aged between 11 and 19 years old. Its internal consistency measured using Cronbach's alpha was 0.7207. The factor analysis showed that two factors accounted for 84.5% of variance, but factor loading indicates that only one of these is valid in Colombia: substance use (tobacco, alcohol, narcotics, and psychoactive substances).

Gastrectomy represents the main treatment for gastric adenocarcinoma. This procedure is associated with substantial morbidity and mortality. The aim of this study was to evaluate the postoperative mortality changes across the study period and to identify predictive factors of 30-day mortality after elective gastrectomy for gastric cancer.This was a retrospective cohort study of a prospective database from a single centre. Patients treated with an elective gastrectomy from 1996 to 2014 for gastric adenocarcinoma were included. We compared postoperative mortality between four time periods: 1996-2000, 2001-2005, 2006-2010, and 2011-2014. Univariate and multivariate analyses were applied to identify predictors of 30-day postoperative mortality.We included 1066 patients (median age 65 years; 67% male). The 30-day mortality rate was 4.7%. Mortality decreased across the four time periods; from 6.5% to 1.8% (P = 0.022). In the univariate analysis, age, ASA score, albumin3.5, multivisceral resection, splenectomy, intrathoracic esophagojejunal anastomosis, R status, and T status were significantly associated with postoperative mortality. In the multivariate analysis, ASA class 3 (OR 10.06; CI 1.97-51.3; P = 0.005) and multivisceral resection (OR 1.6; CI 1.09-2.36; P = 0.016) were associated with higher postoperative 30-day mortality; surgery between 2011 and 2014 was associated with lower postoperative 30-day mortality (OR 0.55; CI 0.33-0.15; P = 0.030).There was a decrease in postoperative 30-day mortality during this 18-year period at our institution. We have identified ASA score and multivisceral resection as predictors of 30-day mortality for elective gastrectomy for cancer.

Introduction Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. Objectives To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS). Methodology Burn patients hospitalized in the HUS from January 1 to December 2014 were followed. Medical information regarding infections, laboratory and pathology reports were obtained. Statistical analysis with measures of central tendency, proportions, global and specific incidence density plus overall and specific incidence was obtained. For the microbiological profile proportions were established. Results 402 burn patients were included, 234 (58.2%) men and 168 (41.8%) women, aged between 6 days and 83 years, median 12.5 years. The burn agents include scald (52.5%), fire (10.0%), gasoline (9.2%), electricity (7.5%), among others. Burn area ranged from 1% to 80% TBS. Cumulative mortality was 1.5%. 27.8% of burned patients had one or more infections. Identified infections include folliculitis (27.0%), urinary tract infection (19.0%), infection of the burn wound (10.4%), pneumonia (8.6%), Central venous catheter (7.4%), bloodstream infection (7.4%) and skin grafts infection (4.3%) among others. Bacteria were responsible for 88.5% of the cases and fungi 11.5%. The most frequently isolated germs were P. aeruginosa, A. baumannii, E. coli, S. aureus and K. pneumoniae. Most gram-negative bacteria were sensitive to Amikacin, gram positive bacteria were sensitive to multiple antibiotics. Conclusion Burns is a severe trauma that occurs in adult and pediatric patients, has several causative agents and can compromise the patient's life. The burned patient is at risk for a variety of infections. According to the type of infection it is possible to infer the most common causative organisms and their antibiotic sensitivity/resistance which allow a directed early empiric treatment.

Energy drinks (EDs) are often consumed in combination with alcohol because they reduce the depressant effects of alcohol. However, different researches suggest that chronic use of these psychoactive substances in combination with alcohol can trigger an oxidative and inflammatory response. These processes are regulated by both a reactive astrogliosis and an increase of proinflammatory cytokines such as IL-1β, TNF-α, and iNOS, causing cell death (apoptosis) at the central and peripheral nervous systems. Currently, mechanisms of toxicity caused by mixing alcohol and ED in the brain are not well known. In this study, we evaluated the effect of chronic alcohol consumption in combination with ED on inflammatory response and oxidative stress in the temporal cortex (TCx) and hippocampus (Hp) of adult rats (90 days old). Our results demonstrated that consuming a mixture of alcohol and ED for 60 days induced an increase in reactive gliosis, IL-1β, TNF-α, iNOS, reactive oxygen species, lipid peroxidation, and nitric oxide, in the TCx and Hp. We also found immunoreactivity to caspase-3 and a decrease of synaptophysin in the same brain regions. The results suggested that chronic consumption of alcohol in combination with ED causes an inflammatory response and oxidative stress, which induced cell death via apoptosis in the TCx and Hp of the adult rats.

Previous studies have proposed that cadmium (Cd) is a metabolic disruptor, which is associated with insulin resistance, metabolic syndrome, and diabetes. This metal is not considered by international agencies for the study of metabolic diseases. In this study, we investigate the effect of metformin on Cd-exposed Wistar rats at a lowest-observed-adverse-effect level (LOAEL) dose (32.5 ppm) in drinking water. Metabolic complications in the rats exposed to Cd were dysglycemia, insulin resistance, dyslipidemia, dyslipoproteinemia, and imbalance in triglyceride and glycogen storage in the liver, muscle, heart, kidney, and adipose tissue. Meanwhile, rats treated orally with a No-observable-adverse-effect level (NOAEL) dose of metformin (200 mg/kg/day) showed mild improvement on serum lipids, but not on glucose tolerance, in tissues, glycogen storage was improved, but lipid storage was ineffective. In conclusion, metformin as a first-line pharmacological therapy must take into consideration the origin and duration of metabolic disruption, because in this work the NOAEL dose of metformin (200 mg/kg/day) showed a limited efficiency in the metabolic disruption caused by chronic Cd exposure.

Aging is a stage of life where cognitive and motor functions are impaired. This is because oxidative and inflammatory processes exacerbate neurodegeneration, which affects dendritic morphology and neuronal communication of limbic regions with memory loss. Recently, the use of trophic substances has been proposed to prevent neuronal deterioration. The neuropeptide-12 (N-PEP-12) has been evaluated in elderly patients with dementia, showing improvements in cognitive tasks due to acts as a neurotrophic factor. In the present work, we evaluated the effect of N-PEP-12 on motor activity and recognition memory, as well as its effects on dendritic morphology and the immunoreactivity of GFAP, Synaptophysin (SYP), and BDNF in neurons of the prefrontal cortex (PFC), dorsal hippocampus (DH) and nucleus accumbens (NAcc) of aged rats. The results show that N-PEP-12 improved the recognition memory, but the motor activity was not modified compared to the control animals. N-PEP-12 increases the density of dendritic spines and the total dendritic length in neurons of the PFC (layers 3 and 5) and in DH (CA1 and CA3). Interestingly NAcc neurons showed a reduction in the number of dendritic spines. In the N-PEP-12 animals, when evaluating the immunoreactivity for SYP and BDNF, there was an increase in the three brain regions, while the mark for GFAP decreased significantly. Our results suggest that N-PEP-12 promotes neuronal plasticity in the limbic system of aged animals, which contributes to improving recognition memory. In this sense, N-PEP-12 can be considered as a pharmacological alternative to prevent or delay brain aging and control senile dementias.