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Abstract Neocaridina davidi, a small freshwater shrimp native to Asia, specifically China, Japan, Korea, and Vietnam, possesses remarkable resistance to poor water quality and offers various advantages over other invertebrate species to examine crucial issues in neuroscience and other related areas. These advantages include robustness, ease of maintenance, and transparency, making them useful for in vivo studies with optical imaging techniques. Despite its suitability for research purposes, particularly in the fields of imaging and fluorescent techniques, the lack of attention given to this species has resulted in the absence of a robust and replicable sedation protocol for immobilization and safe manipulation. Consequently, researchers face challenges in performing experimental procedures while minimizing harm to this specimen. In this study, we have developed and evaluated a simple sedation protocol specifically designed for Neocaridina davidi, assessing its effectiveness using light microscopy and image processing.

En el siglo XVII, Zacharias Janssen y Hans Martens inventaron el primer microscopio compuesto lo que catalizó el desarrollo de técnicas microscópicas en el tiempo. En este artículo, se ha hecho una revisión de tipo narrativa donde nos enfocamos distintos tópicos sobre la microscopía. Dentro del análisis del mismo se aborda los distintos tipos de microscopía (campo oscuro, confocal, invertido, de barrido, de transmisión y de fluorescencia); las diferentes aplicaciones y el desarrollo que han tenido impacto en varias especialidades médicas. Así mismo, se enfoca en los avances que se han realizado en los últimos años viendo la transición de lo diagnóstico a lo terapéutico in vivo. Finalmente se genera una integración de la microscopía actual y la inteligencia artificial, una herramienta que ha incentivado optimizaciones en técnicas diagnósticas y que efectivamente han permitido innovaciones en estos campos y que tedrán un impacto en la medicina futura.

Introducción. Tramadol es un analgésico opioide usado frecuentemente para el manejo del dolor crónico no oncológico (DCNO). En Chile, es parte del arsenal farmacológico de los centros de atención primaria para el tratamiento de patologías como artrosis de cadera y rodilla. Es considerado seguro y efectivo, sin embargo, existen reportes de efectos adversos serios por polimorfismos hepáticos, interacciones farmacológicas, intoxicaciones, adicción y muerte. La dosis óptima de tramadol es paciente dependiente. Por esto, es necesario contar con orientaciones específicas para prescribir tramadol de manera segura y eficaz según las características de cada paciente. Materiales y Métodos. Se revisaron guías actualizadas, revisiones sistemáticas y guías de sociedades internacionales sobre el uso de opioides en DCNO y el uso de tramadol en patologías de DCNO como artrosis, lumbago crónico, dolor neuropático y fibromialgia. Resultados. Tramadol no está indicado en el tratamiento de cuadros de dolor primario como fibromialgia y en DCNO secundario es un fármaco de segunda línea o no está recomendado. En dolor crónico neuropático (DCN) es segunda línea de tratamiento. En osteoartritis de cadera, rodilla y mano, se reporta efecto analgésico modesto. Sopesar riesgos versus beneficios en estos pacientes. En artritis reumatoide y lumbago crónico se desaconseja su uso. Conclusiones. Tramadol es un medicamento seguro y efectivo si se indica, administra, supervisa y descontinúa adecuadamente. Sin embargo, puede asociarse a interacciones farmacológicas, efectos secundarios serios, conductas de abuso y usos ilícitos, por lo que es necesario conocer y manejar adecuadamente su farmacología e indicaciones.

IntroductionIn the context of collective efforts taken in Japan to control the spread of COVID-19, the state of emergency and social distancing have caused a negative impact on the mental health of all residents, including foreign communities in Japan. This study aimed to evaluate the level of anxiety and its associated factors among non-Japanese residents residing in Japan during the COVID-19 pandemic.MethodsA web-based survey in 13 languages was conducted among non-Japanese residents living in Japan during the COVID-19 situation. The State-Trait Anxiety Inventory assessed the level of anxiety-State (STAI-S) scores prorated from its six-item version. The multivariable logistic regression using the Akaike Information Criterion (AIC) method was performed to identify the associated factors of anxiety among participants.ResultsFrom January to March 2021, we collected 392 responses. A total of 357 valid responses were analyzed. 54.6% of participants suffered from clinically significant anxiety (CSA). In multivariable logistic model analysis, the CSA status or the high level of anxiety was associated with three factors, including having troubles/difficulties in learning or working, decreased sleep duration, and decreased overall physical health (pConclusionOur study suggests several possible risk factors of anxiety among non-Japanese residents living in Japan undergoing the COVID-19 pandemic, including the troubles or difficulties in learning or working, the decrease in sleep duration, and the decrease in overall physical health.

The species Chenopodium quinoa Willd. and Amaranthus hybridus L. are Andean staples, part of the traditional diet and gastronomy of the people of the highlands of Colombia, Ecuador, Peru, Bolivia, northern Argentina and Chile, with several ethnopharmacological uses, among them anticancer applications. This review aims to present updated information on the nutritional composition, phytochemistry, and antimicrobial and anticancer activity of Quinoa and Amaranth. Both species contribute to food security due to their essential amino acid contents, which are higher than those of most staples. It is highlighted that the biological activity, especially the antimicrobial activity in C. quinoa, and the anticancer activity in both species is related to the presence of phytochemicals present mostly in leaves and seeds. The biological activity of both species is consistent with their phytochemical composition, with phenolic acids, flavonoids, carotenoids, alkaloids, terpenoids, saponins and peptides being the main compound families of interest. Extracts of different plant organs of both species and peptide fractions have shown in vitro and, to a lesser degree, in vivo activity against a variety of bacteria and cancer cell lines. These findings confirm the antimicrobial and anticancer activity of both species, C. quinoa having more reported activity than A. hybridus through different compounds and mechanisms.

Abstract To estimate the number of objects in an image, each element needs to be segregated as a single unit. Several principles guide the process of element identification, one of the strongest being symmetry. In the current study, we investigated how symmetry affects the ability to rapidly estimate the number of objects (numerosity). Participants judged the numerosity of asymmetric or symmetric arrays of various numerosities. The results show that the numerosity of symmetrical arrays was significantly underestimated at low numerosities, but the effect was greatly reduced at higher numerosities. Adding an additional axis of symmetry (double symmetry) further reduced perceived numerosity. The magnitude of the symmetry-driven underestimation was inversely correlated with autistic personality traits, consistent with previous work associating autistic traits with perceptual grouping. Overall, these results support the idea that perceived numerosity relies on object segmentation and grouping cues, with symmetry playing a key role.

Resumen: Las cardiopatías congénitas son las malformaciones congénitas mayores más comunes. Generan importantes efectos deletéreos en términos de morbimortalidad neonatal y durante la edad temprana.La transposición de grandes arterias representa el 5-7% de las cardiopatías congénitas. Hasta 1976 la única estrategia terapéutica disponible para tratar la transposición de grandes arterias era la corrección fisiológica, conocida también como switch auricular (cirugía de Mustard o Senning). Posteriormente, el profesor Adib Jatene haría pública su experiencia con la cirugía de corrección anatómica o switch arterial, convirtiéndose en el gold standard en el tratamiento de la mayor parte de los casos de transposición de grandes arterias.A pesar del inmenso esfuerzo de grandes cirujanos, cardiólogos y magníficos equipos sanitarios, el switch arterial no está exento de complicaciones a corto, medio y largo plazo, entre otras, obstrucción al flujo coronario, obstrucción al flujo pulmonar e insuficiencia de la válvula neoaórtica secundaria la mayor parte del tiempo a dilatación de la neorraíz aórtica.Con la intención de compartir nuestra experiencia en el tratamiento de la insuficiencia de la válvula neoaórtica luego de la cirugía de switch arterial, presentamos el siguiente caso clínico. El consentimiento informado fue obtenido de los padres de la paciente para realizar esta publicación. Abstract: Congenital heart defects are the most common major congenital malformations causing a significant effect on neonatal mortality and morbidity.Transposition of the great arteries represents approximately 5-7% of all congenital heart defects. Until 1976, the only therapeutic strategy available to treat transposition of the great arteries was the atrial switch (Mustard or Senning surgery), also known as physiological repair. Later on, Professor Adib Jatene published his experience with anatomical repair known as arterial switch operation, this surgery will become the gold standard of care for patients with transposition of the great arteries.Despite the effort of great surgeons, cardiologists and magnificent health teams, the arterial switch operation is related with some complications during short, medium and long term follow up, among these complications, obstruction to coronary flow, obstruction to pulmonary flow and neo-aortic valve regurgitation due in most cases to dilation of the neo-aortic root.We would like to share our experience treating neo-aortic valve regurgitation after switch operation. Informed consent was obtained from the parents of the patient in order to publish the case.

Muchas veces se desconoce que alimentos o bebidas contendrán alcaloides, anticolinérgicas u de otro tipo lo que provoca intoxicaciones accidentales con productos naturales de consumo diario o tradicional. Se presenta el caso de un paciente que tras la ingesta de un licuado de chochos con su agua inicia con íleo paralítico secundario a un síndrome anticolinérgico por los alcaloides presentes en la semilla. El paciente permaneció hospitalizado por 72 horas con mejoría de tras manejo y tratamiento sintomático. Destacamis la importancia de un caso causado por una intoxicación no muy común y con pocos reportes en literatura médica

Introduction. Currently, neurodegenerative diseases (ND) are the fourth leading cause of death worldwide that pose a great challenge in the development of tools for early diagnosis. Thus, advances in science seek sensitive and selective detection systems and this manuscript will highlight the importance of nanotechnology. Material and methods. A literature review was conducted on the representative findings of NPs technologies in neurodegenerative diseases. Articles written in both English and Spanish were included. References between 2015-2021 were also taken into account. Results. One of the most representative techniques, AuNP was specifically implemented, together with a magnetic center composed of magnetite, which has as a specific ligand with a C-terminal cysteine domain present in the B-amyloid protein, which adhere directly to the surface of the NPs, characterizing the anomalous protein. Subsequently, by means of nanosensors capable of detecting and measuring different concentrations, these pathologies are identified at an early stage. Conclusions. Today, along with the advent of biotechnology, it has been possible to design techniques with NPs that allow the identification of specific mutations and provide diagnosis in individuals. In the investigative models of AuNP, it is possible to infer that the capabilities that make them representative focus on their magnetism and biofunctionality, by specifically binding to amyloid peptides and other ligands present in the protein, which are the major components of amyloid plaques used in these studies.

Abstract In the current global emergency due to SARS-CoV-2 outbreak, passive immunotherapy emerges as a promising treatment for COVID-19. Among animal-derived products, equine formulations are still the cornerstone therapy for treating envenomations due to animal bites and stings. Therefore, drawing upon decades of experience in manufacturing snake antivenom, we developed and preclinically evaluated two anti-SARS-CoV-2 polyclonal equine formulations as potential alternative therapy for COVID-19. We immunized two groups of horses with either S1 (anti-S1) or a mixture of S1, N, and SEM mosaic (anti-Mix) viral recombinant proteins. Horses reached a maximum anti-viral antibody level at 7 weeks following priming, and showed no major adverse acute or chronic clinical alterations. Two whole-IgG formulations were prepared via hyperimmune plasma precipitation with caprylic acid and then formulated for parenteral use. Both preparations had similar physicochemical and microbiological quality and showed ELISA immunoreactivity towards S1 protein and the receptor binding domain (RBD). The anti-Mix formulation also presented immunoreactivity against N protein. Due to high anti-S1 and anti-RBD antibody content, final products exhibited high in vitro neutralizing capacity of SARS-CoV-2 infection, 80 times higher than a pool of human convalescent plasma. Pre-clinical quality profiles were similar among both products, but clinical efficacy and safety must be tested in clinical trials. The technological strategy we describe here can be adapted by other producers, particularly in low- and middle-income countries.

Objetivo: Describir la concentración de los anticuerpos neutralizantes detectados en el suero de profesionales de la salud que recibieron alguna de las vacunas contra el SARS-CoV-2, desarrollada por las empresas Sinopharm, Pfizer, Johnson & Johnson o el candidato vacunal de CureVac. Materiales y métodos: Investigación observacional, descriptiva, retrospectiva, de corte transversal. Se incluyeron en el estudio un total de 217 profesionales de la salud que recibieron el esquema completo de las vacunas de Sinopharm, Pfizer, Johnson & Johnson o del candidato de CureVac. A estos individuos se les había determinado la presencia de anticuerpos neutralizantes contra el SARS-CoV-2 en el suero mediante la técnica de inmunoensayo por electroquimioluminiscencia (eCLIA). Se consideraron las variables edad, sexo, antecedentes de infección con el SARS-CoV-2, concentración de anticuerpos neutralizantes y tipo de vacuna administrada. Resultados: El 16,60 % de los profesionales de la salud manifestó haber tenido COVID-19 antes de haber recibido la vacunación. Ellos se inmunizaron con las vacunas de Sinopharm (74,65 %), Pfizer (12,90 %), Johnson & Johnson (5,07 %) y el candidato de CureVac (7,37 %). Independientemente de la vacuna recibida, el 42,50 % de las personas sin infección previa que recibieron la vacuna no desarrollaron anticuerpos neutralizantes, mientras que el 16,70 % de los que sí tuvieron enfermedad previa no desarrolló estos anticuerpos. La vacuna de Pfizer indujo mayor concentración de anticuerpos neutralizantes (196,27 UA/mL) en pacientes con o sin infección previa. Conclusiones: El estudio confirma que la vacunación refuerza la inmunidad contra el nuevo coronavirus en individuos con diagnóstico previo de COVID-19, y sugiere que la vacuna desarrollada por Pfizer estimula de manera más eficaz la producción de anticuerpos neutralizantes.

Objetivo. Describir las características clínico-epidemiológicas y el perfil de resistencia de los casos de tuberculosis extensivamente resistente (TB-XDR) diagnosticados en Perú entre los años 2013 y 2015. Métodos. Estudio descriptivo que incluyó a los pacientes que cumplían con la definición de TB-XDR y que fueron notificados al sistema nacional de vigilancia epidemiológica del Ministerio de Salud del Perú. Se realizó un análisis descriptivo y se elaboró un mapa de calor basado en la estimación de densidad Kernel para identificar la distribución espacial. Resultados. Se estimó que los casos de TB-XDR diagnosticados como nuevos representaron 7,3% del total de casos de tuberculosis multidrogorresistente (TB-MDR) reportados para el período de estudio, 74% de los casos tenían entre 15 y 44 años y la relación hombre/mujer fue de 1,7. La mitad de los departamentos reportó al menos un caso de TB-XDR, con 42% de casos nuevos sin ningún antecedente de resistencia ni tratamiento previo. En la otra mitad de los departamentos, la mayoría tenían resistencia previa tipo MDR y de tipo pre-XDR. El 57,7% de los casos presentaron resistencia a 5 y 7 drogas y 41,6% presentaba resistencia a 8 y 10 drogas de primera y segunda línea. Conclusiones. Este estudio ofrece detalles importantes del perfil epidemiológico de la TB-XDR en el Perú, donde se muestra un incremento de los casos de TB-XDR primario; es decir, casos sin antecedentes de enfermedad previa. Además, esta forma de tuberculosis se ha extendido a un mayor número de departamentos del país.

El lactato es un metabolito altamente dinámico que, en condiciones anaerobias, es producido por hipoxia o isquemia; y en condiciones aerobias, es sintetizado por un mecanismo impulsado por la estimulación adrenérgica, a través del receptor β2, que potencia la acción de la bomba sodio-potasio, y por un estado de glicólisis aerobia acelerada. Este metabolito es capaz de intercambiarse entre diferentes células productoras y consumidoras, con lo que asegura la materia prima para obtener energía. El sistema nervioso simpático responde a los estímulos de estrés con la liberación de catecolaminas, que actúan como hormonas y como neurotransmisores en varios tejidos del cuerpo y permiten un aumento del metabolismo que eleva los valores de glucosa y el oxígeno disponible. Existe una relación fisiológica de dependencia entre las catecolaminas y la producción de lactato que predispone al organismo para responder de forma efectiva ante una situación de estrés. Sin embargo, en tejidos sensibles, la respuesta adrenérgica exacerbada puede ocasionar efectos exagerados que pueden incrementar la probabilidad de fallo. En base al conocimiento de estos mecanismos, se plantean estrategias terapéuticas enfocadas en regular la actividad simpática.

In Brugada syndrome, even within the same family where all affected individuals share the same mutation, phenotypic variation is prominent, with variable penetrance and expressivity, presenting different degrees of involvement. It is difficult to establish a direct correlation between genotype and phenotype to predict prognosis in complications and risk of sudden death. The factors that modulate this inter- and intra-familial phenotypic variability remain to be determined. With the intention of testing whether other genetic factors, in addition to the causal mutation in SCN5A, may have a modulating effect on the Brugada phenotype and the risk of sudden death, we have studied 8 families with a causal variant in SCN5A with at least two affected individuals, one of whom has suffered cardiac arrest or sudden death. Whole exome sequencing was performed looking for additional variants that modify the phenotype and allow us to predict a better or worse prognosis for the evolution of the disease. The results did not show any clear genetic modifier; nevertheless, highlight the possible implication of the cholesterol and fibrosis pathways, as well as the circadian rhythm, as possible modulators of Brugada syndrome phenotype.

Este artigo tem por objetivo relatar atividades extensionistas desenvolvidas junto a uma Equipe de Consultoria em Cuidados Paliativos (ECCP) entre 2018 e 2019. Destaca-se a organização, dinâmica de avaliação e atenção às pessoas em cuidados paliativos (CP) hospitalizadas e suas famílias pela ECCP e estudantes de graduação em enfermagem em articulação com profissionais diretamente responsáveis pela assistência em unidades de internação de um Hospital de Ensino do Sul do Brasil. Por serem enfermeiros os profissionais mais vinculados ao cuidado, seja por suas atividades ou pelo tempo que permanecem com os indivíduos, é fundamental a educação destes sobre o morrer e a morte desde a graduação. Conclui-se que ECCP em instituições hospitalares pode melhorar a qualidade do cuidado prestado às pessoas com doenças que ameaçam à vida e suas famílias, por meio da educação permanente de profissionais saúde e da aproximação de estudantes com as especificidades deste cenário.

Objectives The COVID-19 pandemic has resulted in widespread morbidity and mortality with the consequences expected to be felt for many years. Significant variation exists in the care even of similar patients with COVID-19, including treatment practices within and between institutions. Outcome measures vary among clinical trials on the same therapies. Understanding which therapies are of most value is not possible unless consensus can be reached on which outcomes are most important to measure. Furthermore, consensus on the most important outcomes may enable patients to monitor and track their care, and may help providers to improve the care they offer through quality improvement. To develop a standardised minimum set of outcomes for clinical care, the International Consortium for Health Outcomes Measurement (ICHOM) assembled a working group (WG) of 28 volunteers, including health professionals, patients and patient representatives.Design A list of outcomes important to patients and professionals was generated from a systematic review of the published literature using the MEDLINE database, from review of outcomes being measured in ongoing clinical trials, from a survey distributed to patients and patient networks, and from previously published ICHOM standard sets in other disease areas. Using an online-modified Delphi process, the WG selected outcomes of greatest importance.Results The outcomes considered by the WG to be most important were selected and categorised into five domains: (1) functional status and quality of life, (2) mental functioning, (3) social functioning, (4) clinical outcomes and (5) symptoms. The WG identified demographic and clinical variables for use as case-mix risk adjusters. These included baseline demographics, clinical factors and treatment-related factors.Conclusion Implementation of these consensus recommendations could help institutions to monitor, compare and improve the quality and delivery of care to patients with COVID-19. Their consistent definition and collection could also broaden the implementation of more patient-centric clinical outcomes research.

Con la disponibilidad y mejora en la resolución de los distintos métodos de imagen, los hallazgos incidentales son frecuentemente reportados. Se presenta el caso de una paciente que acude por cefalea pulsátil de elevada intensidad, con signos neurológicos y distinta a otros episodios por lo que se decide su ingreso. En la tomografía contrastada resaltan dos hallazgos: un aneurisma y quistes xantogranulomatosos en plexos coroideos. Tras manejo con analgesia intravenosa es dada de alta y derivada a subespecialidad. Los quistes xantogranulomatosos son hallazgos benignos que no requieren de un manejo clínico o quirúrgico a menos que produzcan efecto de masa.

Diarrhoea is present in 28-60% of people living with human immunodeficiency virus (HIV). This condition is associated with malabsorption, nutritional risk, and higher incidence of infections and is one of the main causes of morbidity and mortality. Diarrhoea may be classified by duration and aetiology. Acute and chronic diarrhoea causes a reduction in dietary intake and also reduces the ability to absorb nutrients, leading to patient malnutrition and impacting their quality of life. The medical treatment for infectious diarrhoea is the eradication of pathogens; however, there is no specific treatment for non-infectious diarrhoea, which suggests the use of antisecretory medications, antimotility, and adsorbent agents. The use of non-pharmacological strategies such as the dietary modifications and nutrition supplements, specifically zinc, elemental diets, glutamine, fibre, and probiotics may decrease the duration of diarrhoea and may ameliorate the frequency and consistency of stool depositions. The goal of nutritional intervention is to promote the intake of energy and protein amounts needed to maintain or improve the nutritional status and quality of life. Despite promising data in individual strategies, further studies are needed to evaluate the multiple approaches in clinical practice. In this review, we aim to summarise the nutritional management and supplementation strategies for diarrhoea in HIV patients.

Objetivos. Evaluar las propiedades psicométricas de la escala para medir la satisfacción de los usuarios de consulta médica ambulatoria (ESCOMA) en Instituciones Prestadoras de Servicios de Salud (IPRESS) del sistema de salud peruano (SSP). Materiales y Métodos. Llevamos a cabo un estudio de tipo instrumental con los datos del Cuestionario 1 de la Encuesta Nacional de Satisfacción de Usuarios de Salud (ENSUSALUD) del 2016; en la cual se administró una escala inicial de 19 ítems construidos por revisión bibliográfica, juicio de expertos y estudio piloto. Realizamos un análisis factorial exploratorio (AFE) para valorar la estructura interna de la escala y luego un análisis factorial confirmatorio (AFC) mediante el método de estimación de máxima verosimilitud robusta. Finalmente, desarrollamos análisis de invarianza de medición y evaluamos la confiabilidad con el coeficiente omega de McDonald. Resultados. Analizamos 13 814 observaciones en dos submuestras aleatorias para el AFE con lo cual definimos un modelo de tres dimensiones con 18 ítems. En el AFC encontramos índices de bondad de ajuste aceptables (CFI=0,945; TLI=0,937; SRMR=0,036). Las dimensiones resultantes fueron: procesos administrativos, infraestructura y atención médica. Evidenciamos invarianza fuerte para la edad, sexo, nivel educativo y región, e invarianza parcial para el tipo de institución (Ministerio de Salud, Seguro Social, Fuerzas Armadas y Policiales, y Clínicas Privadas). Todos los coeficientes de confiabilidad fueron adecuados (0,86ω0,92). Conclusiones. La ESCOMA presenta evidencia de validez y confiabilidad a nivel estructural y de invarianza de medición a diferentes niveles de atención y a nivel nacional en Perú.

The development of a whole-cell vaccine from bacteria auxotrophic for D-amino acids present in the bacterial cell wall is considered a promising strategy for providing protection against bacterial infections. Here, we constructed a prototype vaccine, consisting of a glutamate racemase-deficient mutant, for preventing Klebsiella pneumoniae infections. The deletion mutant lacks the murI gene and requires exogenous addition of D-glutamate for growth. The results showed that the K. pneumoniae ΔmurI strain is attenuated and includes a favourable combination of antigens for inducing a robust immune response and conferring an adequate level of cross-protection against systemic infections caused by K. pneumoniae strains, including some hypervirulent serotypes with elevated production of capsule polysaccharide as well as multiresistant K. pneumoniae strains. The auxotroph also induced specific production of IL-17A and IFN-γ. The rapid elimination of the strain from the blood of mice without causing disease suggests a high level of safety for administration as a vaccine.

El coronavirus tipo 2 del síndrome respiratorio agudo grave (SARS-CoV-2) es el virus causante de la pandemia actual. En general, los pacientes infectados con SARS-CoV-2 desarrollan enfermedades respiratorias. Los síntomas iniciales son fiebre, tos y disnea que progresan con rapidez a una neumonía; además, se han reportado afectaciones extrapulmonares como las gastrointestinales. Está descrito que el receptor de la enzima convertidora de angiotensina 2 (ACE2) y la serina proteasa TMPRSS2 para cebado de la proteína S facilitan el ingreso del SARS-CoV-2 a las células. Estas proteínas se expresan en células alveolares tipo 2 y también en los enterocitos del íleon y colon, por lo que se ha detectado el virus en el tracto digestivo (1). Presentamos el caso de un paciente con neumonía por COVID-19, que también presentó neumatosis intestinal y colitis isquémica, ambas manifestaciones gastrointestinales.

El objetivo de este trabajo fue conocer la frecuencia y la manera en que las plantas medicinales son empleadas por las gestantes del Centro de Salud Viña Alta del distrito de La Molina. En el estudio participaron veintiuna gestantes, quienes respondieron una encuesta, validada por expertos, sobre el uso de plantas medicinales. Se demostró que el 86,00 % de las gestantes utilizaron plantas medicinales, y que 67,00 % no consultó con un médico sobre su empleo. La manera más frecuente de consumo de las plantas medicinales fue la vía oral, en forma de infusiones. Las plantas medicinales más utilizadas fueron manzanilla, perejil, eucalipto, boldo, aloe, menta y ruda; y algunas de ellas mostraron efecto teratogénico, estimulante uterino, abortivo, entre otros. Es necesario conocer la cantidad real y la manera más frecuente en que las gestantes consumen las plantas medicinales, con la finalidad de clasificar estos productos de acuerdo al nivel de seguridad que ofrecen y promover el uso racional de la medicina tradicional para contribuir en la salud pública.

The way couples regulate their emotions affects the quality of their relationship. Despite this, no evidence-based scales of validity and reliability can measure the intention to regulate emotions in the romantic dyad. In order to address this gap, we developed the Couples Extrinsic Emotion Regulation (CEER) questionnaire. First, we adapted the "Others" subscale from the Emotion Regulation of Others and Self questionnaire (EROS) for any close relationship to measure the intention to regulate emotions in couples; second, the psychometric properties of the CEER questionnaire were studied. For the content validity assessment, 23 experts (47.8% of whom worked in social and health psychology and the psychology of emotions, 17.4% in couples' therapy, and 34.8% in social science methodologies) participated. A total of 528 Chileans completed the online CEER questionnaire, the relationship satisfaction scale (RAS) and dyadic adjustment scale (DAS): 27.8% were male, age M = 38.7, SD = 10.05, and time of the relationships M = 11.27, SD = 9.82. The content-based validity study made it possible to determine which items to include in the final version. Two unrelated first-order factors structure of the original test fit (RMSEA = .052, GFI = .97, AGFI = .95; CFI = .99; NFI = .98; and NNFI = .98). The CEER+ and CEER- factors presented adequate internal consistency (α = .79; ω = .80 and α = .85; ω = .85, respectively). The discrimination index of the factors were excellent (CEER+ = .55 and CEER- = .63). Validity evidence based on the relations to other variables showed a direct positive relation between CEER+, RAS and overall DAS, as well as their factors; and a negative relation between CEER-, RAS overall DAS, as well as their factors. The use of this instrument is recommended for the identification of Chilean couples where at least one of the partners has a less favorable opinion of their relationship, providing relevant data for couple's therapy.

La rabia es una enfermedad vírica infecciosa que es considerada zoonótica ya que es trasmitida a los humanos por mordeduras o arañazos de animales domésticos o salvajes infectados, Para esta investigación se tomó en cuenta la problemática de las mordeduras de perros domésticos que residen en la zona urbana de la ciudad de Cuenca con la finalidad de usarla como un indicador de riesgo a la salud pública, para lo cual se realizó encuestas a los profesionales de la salud, se indagó los datos de casos de mordida y se realizaron entrevistas a las personas que sufrieron mordeduras de perros. Los resultados más relevantes fueron los siguientes: El número total de casos de mordeduras estudiadas fueron 1328 casos en cuatro años. Estos fueron atendidos en los diferentes centros de salud públicos de la ciudad de Cuenca, registrando un incremento del 31% de mordeduras atendidas en el 2015. De preguntas que se realizaron en la encuesta con respecto a la agresividad los profesionales de la salud opinaron que se da por territorialidad en un 59,5%, la mayoría de mordidas se dan en las extremidades inferiores (56,5%). Considerando como el principal factor de riesgo de una mordedura la infección (69%), por la trasmisión de bacterias infecciosas que se pueda dar. Las mordeduras causadas por los animales tienen un alto impacto en la sociedad y en la salud pública, existiendo inclusive secuelas emocionales en la víctima. La rabia es una enfermedad zoonóticas considerada desatendida por la OMS, que según el presente estudio está siendo y que para poder controlarla es necesario la responsabilidad de la sociedad.

N/a.

Counterproductive academic behaviors (CAB) is a problem that has plagued academic institutions for centuries. However, research has mostly been focused on higher learning institutes in North America. For this reason, literature on CAB must be expanded to other geographical areas and academic levels. The present research analyses the prevalence and correlates of CAB in a sample of Spanish high school students. The results indicate that CAB is a common phenomenon, cheating and low effort behaviors being the most prevalent forms. Correlational analyses revealed that conscientiousness (ρ = -.55, p < .01), emotional stability (ρ = .28, p < .01), and agreeableness (ρ = -.26, p < .05) are predictors of CAB. Multiple regression analyses showed that conscientiousness is the dimension exerting the strongest impact on CAB (β = -.64, p < .01), followed by agreeableness, and emotional stability. These three dimensions accounted for 51% of CAB variance. Last, implications for theory and practice are described.

Objetivo: Conocer las experiencias y percepciones de donantes de sangre en un hospital público. Materiales y métodos: Se realizó un estudio cualitativo con orientación fenomenológica en un hospital público de Lima. Se realizaron entrevistas semiestructuradas a profundidad y notas de campo basadas en observaciones a los participantes. Resultados: Se entrevistó a doce donantes, los cuales manifestaron no haber tenido mucha información sobre la donación y el banco de sangre. Sin embargo, luego de su experiencia de donar se identificó aspectos positivos como la atención de calidad, rápida y minuciosa. Los participantes valoran el trato cordial del personal a la hora de brindar información, el reducido tiempo de espera y la compañía durante el proceso de extracción de la sangre. Los aspectos negativos fueron la falta de publicidad y difusión de la donación voluntaria de sangre. A pesar de ello la mayoría de entrevistados manifestaron su intención de retornar debido a la calidad del servicio. En resumen, la percepción de los participantes fue favorable a la donación, al recibir una atención de calidad, con información oportuna en el tiempo adecuado. Conclusiones: Los entrevistados no tenían mayor información sobre la posibilidad de hacer donaciones voluntarias de sangre en el hospital. Posterior a su experiencia, la percepción sobre la donación fue favorable, indicando su intención de participar en futuras donaciones.

Objetivo: Demostrar la presencia de alcaloides y fenoles en la rama florida de Minthostachys mollis (muña) y comparar los resultados con los de cinco muestras de muña de expendio informal obtenidas en Lima – Perú. Materiales y métodos: Minthostachys mollis fue colectada en Junín (ubicado a 321 km de Lima y a 4113 m s.n.m) Perú, siguiendo la metodología de Cerrate E. y Ramagosa, siendo identificada por una especialista en botánica. Otras cinco muestras se obtuvieron bajo venta sin registro sanitario. La marcha fitoquímica fue realizada mediante el método de Olga Lock. Fueron referentes cualitativos empleados: “+++” (abundante), “++” (moderado), “+” (leve) y “-” (ausencia). Resultados: Minthostachys mollis presentó alcaloides “++”, en contraste, M1, no presentó, M3 “+” y M2, M4 y M5 “++”. Para fenoles, M. mollis presentó “+++”, en comparación, M4 “++”, y M1, M2, M3 y M5 “+++”. Conclusiones: Frente a M. mollis, se demostraron diferencias cualitativas en la presencia de los metabolitos estudiados en las muestras de expendio informal.

Atrial fibrillation is the most frequent arrhythmia. Its classification according to pattern and clinical type allows to decide the therapeutic strategy to use, that most include control of symptoms and prevention of cardioembolic events. The election of the treatment depends on the presence of triggering events, risk factors for thromboembolism, risk factors for bleeding, cardiac function, patient funcionality, medication costoefectiveness and health care access. The type of anticoagulant has to be supported on the type of atrial fibrillation and the presence of contraindications, documented ineffective anticoagulation or high risk of failure to warfarin. In case of contraindications for anticoagulation this could still be used in high bleeding risk patients, when risk factors are controllable or corrected; leaving left atrial appendage closure as an option for patients that remain in high risk for bleeding events.

Objectives. To evaluate the relationship between having a medical specialty and the monthly income of Peruvian doctors, and to compare the economic incomes among areas with higher and lower density of medical doctors in Peru. Materials and methods. We analyzed data of the National Satisfaction Survey of Health Users (in Spanish: ENSUSALUD) carried out in Peru in the year 2015. This survey, with a national level of inference, was performed on physicians working at health facilities in Peru. Monthly income was measured considering all paid activities of the physician. Crude and adjusted prevalence ratios (PR and aPR) and their 95% confidence intervals (95% CI) were calculated through Poisson regression models with robust variance, taking into account the complex sampling of the survey. Results. Out of 2 219 Physicians surveyed, 2 154 (97.0%) observations were analyzed. The probability of earning S/5 000 (1 572.3 USD) per month was 29.1% for general practitioners; 65.6% for specialists; 63.0% for clinical specialists; 70.5% for surgeons, and 55.7% for other specialties. Compared to general practitioners, physicians with clinical, surgical, and other specialties were more likely to earn S/5 000 per month (aPR = 1.44, 1.49, and 1.26, respectively). The probability of earning S/5 000 was higher in those working in departments with low medical density. Conclusions. Monthly incomes were higher for specialist physicians than for non-specialists. Economic incomes were higher in departments with lower density of physicians, which may encourage physicians to work in these departments. Objectives. To evaluate the relationship between having a medical specialty and the monthly income of Peruvian doctors, and to compare the economic incomes among areas with higher and lower density of medical doctors in Peru. Materials and methods. We analyzed data of the National Satisfaction Survey of Health Users (in Spanish: ENSUSALUD) carried out in Peru in the year 2015. This survey, with a national level of inference, was performed on physicians working at health facilities in Peru. Monthly income was measured considering all paid activities of the physician. Crude and adjusted prevalence ratios (PR and aPR) and their 95% confidence intervals (95% CI) were calculated through Poisson regression models with robust variance, taking into account the complex sampling of the survey. Results. Out of 2 219 Physicians surveyed, 2 154 (97.0%) observations were analyzed. The probability of earning S/5 000 (1 572.3 USD) per month was 29.1% for general practitioners; 65.6% for specialists; 63.0% for clinical specialists; 70.5% for surgeons, and 55.7% for other specialties. Compared to general practitioners, physicians with clinical, surgical, and other specialties were more likely to earn S/5 000 per month (aPR = 1.44, 1.49, and 1.26, respectively). The probability of earning S/5 000 was higher in those working in departments with low medical density. Conclusions. Monthly incomes were higher for specialist physicians than for non-specialists. Economic incomes were higher in departments with lower density of physicians, which may encourage physicians to work in these departments.

At present some of the diseases with greater concern are diabetes, obesity, insulin resistance, cardiovascular, high glucose; all together as the metabolic syndrome caused by multiple factors including sedentary lifestyle, physical inactivity, this being the fourth risk factor with regard to global mortality. The risks of having the metabolic syndrome have been increasing in the last decade, related to insulin resistance and obesity, so that obtaining a mechanism that can counteract this problem is urgent; of which the intake of pharmaceutical products is the most widely used, but the practice of moderate exercises is neglected, which have highlighted the beneficial impact against this disease.

Objectives. To describe the characteristics of tuberculosis epidemiology in Peruvian health workers. Materials and methods. A descriptive study was performed. It included all health workers with tuberculosis listed in the national epidemiological surveillance system of the Peruvian Ministry of Health, during 2013, 2014, and 2015. Results. A total of 755 cases of tuberculosis in health workers were reported: 60% worked in hospitals, 28% worked in primary-care facilities, and 12% worked in private facilities. In 57% of the cases, they worked in health facilities in Lima Metropolitan area and Callao. The average age of workers was 38 years (ranging from 19 to 89 years), and 63.6% were women. Of the cases, 6.1% were resistant, mainly multidrug-resistant tuberculosis, 67% of the cases had bacteriological confirmation of pulmonary tuberculosis. Health professionals and technicians represented 82.5% of the cases, and 55.2% corresponded to doctor’s offices, hospital admissions, and emergency rooms, the areas where they worked. Conclusions. Tuberculosis poses a significant work risk for health workers of both public and private facilities. It mainly affects health professionals and technicians providing direct care and assistance to patients in large Peruvian hospitals.

Abstract: People with disabilities (PWD) face several challenges accessing medical services. However, the extent to which architectural and transportation barriers impede access to healthcare is unknown. In Peru, despite laws requiring that buildings be accessible for PWD, no report confirms that medical facilities comply with such regulations. Thus, we aim to provide an association between these barriers and access to medical facilities. Data from a Peruvian disability survey were analyzed. Participants were 18 years of age and older people who reported having a physical disability. Accessibility was defined by reported struggles accessing medical facilities (health or rehabilitation centers). Absence of ramps, handrails, elevators, adapted bathrooms, and information counters in medical facilities were reported as architectural barriers. The transportation barriers analyzed included struggles using buses or trains. Poisson regression models with robust variance were used to estimate prevalence ratios (PR) and to control for confounding variables. 20,663 participants were included, their mean age was 66.5 years and 57.5% were females. Architectural and transportation barriers reported were 40% and 61%, respectively. All barriers reported were more prevalent in rural compared to urban areas (p < 0.001). Inadequacy of ramps, handrails, and adapted elevators and bathrooms were associated with limited use of rehabilitation centers (p < 0.001) but not of health centers (p > 0.05). Architectural and transportation barriers represent a hindrance to seeking treatment at rehabilitation centers. Actions to improve this situation are needed.

Introducción: El colangiocarcinoma es un cáncer de baja incidencia, asociado a síntomas inespecíficos, por lo que su diagnóstico generalmente se realiza en estadíos avanzados. El tratamiento quirúrgico es el único asociado a sobrevida, sin embargo, el diagnóstico tardío e irresecabilidad, contribuyen a su mal pronóstico. Caso Clínico : Paciente masculino, 56 años, diabético, colecistectomizado, consulta por alza térmica, coluria, acolia y dolor abdominal a nivel epigástrico con irradiación a hipocondrio derecho. Presenta ictericia, leucocitosis con neutrofilia, PCR >100, hiperbilirrubinemia (4.51) a expensas de la directa (3.16), TGP 210, TGO 86 y GGT 362. La Ecografía abdominal reportó dilatación de la vía biliar intrahepática y coledocolitiasis. Resultados : Tras un diagnóstico de coledocolitiasis más colangitis, se inició antibiótico terapia, se extrajeron varios litos mediante CPRE, dejando litos intra-hepáticos residuales. La colangio-resonancia reportó litos a nivel de conducto biliar intra-hepático izquierdo, por lo cual se realizó la hepatectomía de los segmentos II y III con litos palpables en su interior. El reporte anatomo-patológico correspondió a colangiocarcinoma intrahepático multicéntrico moderadamente diferenciado. Conclusiones : El tratamiento de primera línea, en tumores únicos y con función hepática preservada es la resección, logrando hasta un 79% de supervivencia a 5 años. Sin embargo, la asociación de un diagnóstico tardío más irresecabilidad, habitualmente sitúa al colangiocarcinoma intrahepático como un tumor de mal pronóstico.

Introducción: La litiasis intrahepática es poco frecuente en países occidentales, generalmente debuta con un síndrome colestásico que, asociado a complicaciones necesita resolución quirúrgica urgente. Caso Clínico: Paciente masculino, 56 años, diabético, colecistectomizado, consulta por alza térmica, coluria, acolia y dolor abdominal a nivel epigástrico con irradiación a hipocondrio derecho. Presenta ictericia, leucocitosis con neutrofilia, PCR >100, hiperbilirrubinemia (4.51) a expensas de la directa (3.16), TGP 210, TGO 86 y GGT 362. La Ecografía abdominal reportó dilatación de la vía biliar intrahepática y coledocolitiasis. Resultados: Tras un diagnóstico de coledocolitiasis más colangitis, se inició antibiótico terapia, se extrajeron varios litos mediante CPRE, dejando litos intra-hepáticos residuales. La colangio-resonancia reportó litos a nivel de conducto biliar intra-hepático izquierdo y atrofia de lóbulo hepático izquierdo, por lo cual se realizó la hepatectomía de los segmentos II y III con litos palpables en su interior. El reporte anatomo-patológico correspondió a colangiocarcinoma intrahepático multicéntrico moderadamente diferenciado. Conclusiones: La hepatectomía resuelve definitivamente la hepatolitiasis no complicada, y permite hasta un 79% de sobrevida a 5 años en casos de litiasis intrahepática asociada a colangiocarcinoma; sin embargo, la asociación de un diagnóstico tardío más irresecabilidad, habitualmente sitúa al colangiocarcinoma intrahepático como un tumor de mal pronóstico.

Los estilos de personalidad y los tipos de funcionamiento familiar son esenciales para futuros psicólogos pues a partir de ellos se regula el ejercicio profesional y el vínculo terapéutico con los pacientes. Este estudio buscó 1) determinar los estilos de personalidad y los tipos de funcionamiento familiar con mayor prevalencia y 2) la relación entre los 12 pares de los estilos de personalidad y los constructos “adaptabilidad” y “cohesión” dentro de los tipos de funcionamiento familiar en estudiantes de psicología. Se trata de un estudio correlacional- transversal-prolectivo. Participaron estudiantes de psicología clínica (n=231) de una universidad privada de Cuenca-Ecuador. Se aplicaron el MIPS y FACES20 para las mediciones. Dentro de los 24 estilos de personalidad (12 pares), predominaron: apertura, acomodación, afectividad, intuición, discrepancia, introversión, individualismo, insatisfacción, comunicatividad, sistematización, control y firmeza. Los tipos de funcionamiento familiar predominantes fueron: Aglutinado-Caótico, Aglutinado-flexible y Conectadoflexible; los dos primeros tuvieron correlaciones positivas entre su “adaptabilidad” y los pares “sistematización vs innovación” e “individualismo vs protección” respectivamente. Los estilos de personalidad prevalentes representan rasgos esenciales para el ejercicio de la psicología. Los tipos de funcionamiento familiar predominantes están en su mayoría en extremos disfuncionales sugiriendo que quienes escogen esta carrera buscan ser mediadores de conflictos desde tempranamente en sus hogares. Se evidencia que las familias con adaptabilidad en extremos disfuncionales influyen en los estilos de personalidad relacionados al rol de los sujetos en la modificación de su entorno y a la importancia que dan a los demás en sus acciones y toma de decisiones.

In Argentina, during the decade of the 1990s major changes were introduced into the regulatory framework of the national obras sociales, or union-based health coverage plans. Using data from the Federal Administration of Public Income (AFIP) [Administración Federal de Ingresos Públicos], this study evaluates for the years 2004 and 2011: a) the importance of obras sociales within the healthcare system, b) the degree of concentration of this health social security subsystem, and c) the inequalities in the availability of funds among the obras sociales and their beneficiaries. The results show an increased importance of obras sociales within the Argentine health system. The concentration of funds distributed to the most important institutions within the subsystem showed no change, while the concentration of contributors to these institutions slightly increased and that of beneficiaries decreased. Finally, a reduction of the inequalities in funds per beneficiary received by different institutions was observed. This trend can be explained, among other factors, by the attenuation of wage differentials between branches of economic activity and the actions of the so-called Solidarity Redistribution Fund.

Objectives. To identify factors behind a community’s reluctance to dengue vector control efforts in three districts of the Piura region in Peru. Materials and methods. Fieldwork was conducted in May 2015 in the districts of Mori, Rinconada, Llicuar, and Sullana on the northern coast of Peru. Qualitative research methods were employed to understand varying perspectives of individuals involved in the dengue issue. Techniques such as interviewing and observation were used. Interviews included open-ended, in-depth questions. Individual interviews, focus groups, and home visits of community members were performed. Results. Reluctance was based on four arguments: 1. Fumigation is ineffective; 2. Personnel intervening are untrustworthy; 3. The timing of activities is unsuitable; and 4. The larvicide used affected water quality and taste. There was clear heterogeneity in reluctant groups: community members with high economic status, residents in high-risk or “red zone” areas, families with someone working as a healthcare professional, and houses with an ill or disabled member. Conclusions. The arguments behind reluctance as well as the composition of groups reluctant to vector control during dengue outbreaks in the districts examined were heterogeneous. Control strategies must take this heterogeneity into account.

Antecedentes. La rehabilitación es un proceso de reaprendizaje motor, que mejora el desempeño en términos de adquisición de nuevas habilidades y adaptación o refinamiento de habilidades aprendidas previamente. A pesar de este conocimiento, existen, considerablemente, pocos estudios que describan el aprendizaje motor después de un accidente cerebrovascular (ACV) y la relevancia del mismo en los procesos de rehabilitación y recuperación. Objetivo. Describir la transferencia del aprendizaje motor en pacientes con antecedentes de accidente cerebrovascular después de un tratamiento con procedimientos de reeducación funcional. Materiales y métodos. Se realizó un estudio descriptivo de dos casos con pacientes que recibieron tratamiento fisioterapéutico ambulatorio con los principios de reeducación funcional desarrollados en el Hospital de las Clínicas de la Universidad de São Paulo (Brasil), entre los meses de agosto y octubre de 2013. La transferencia del aprendizaje motor se determinó según los resultados obtenidos en la evaluación de balance funcional (Mini-BESTest). Se evaluó el test antes y después del tratamiento y se compararon los resultados para determinar el porcentaje de mejora. Resultados. En los dos casos se observó mejora clínica en el desempeño de la evaluación de balance funcional Mini- BESTest con un porcentaje de mejora entre el 21% y el 41%. Conclusión. Existen pocos hallazgos literarios que describen el mantenimiento de la capacidad de aprendizaje motor en pacientes con antecedentes de ACV. Este estudio reportó la capacidad para transferir el aprendizaje motor a una habilidad motora no aprendida (balance) en dos casos , con base en la mejoría clínica del desempeño motor en el test aplicado.

Introducción: La densidad de Recursos Humanos en Salud (RHUS) a nivel nacional en Perú, ha superado el umbral establecido por la OMS (25 por 10 000 habitantes) para garantizar la cobertura de servicios de Salud. Sin embargo, este promedio nacional enmascara, a nivel regional, densidades inferiores al umbral estipulado, particularmente en las zonas más pobres del país. De ahí la necesidad de estudiar la posible existencia de inequidades en la distribución de RHUS a nivel regional, entendiendo a la inequidad como la innecesaria, evitable e injustificada carencia de RHUS. Objetivos: Determinar la inequidad en la distribución del personal de salud en los establecimientos de salud del Ministerio de Salud de cuatro regiones pobres del Perú (Cajamarca, Loreto, Apurímac y San Martín). Diseño: Estudio observacional descriptivo, de corte transversal. Institución: Dirección General de Gestión del Desarrollo de Recursos Humanos. Métodos: Se calculó la densidad de RHUS para cada región. Para la evaluación de la inequidad se calcularon los índices Gini, para el nivel departamental, y la T de Theil, para el nivel provincial. Resultados: La densidad de recursos humanos estuvo por debajo de mínimo estipulado por la OMS en 3 de las 4 regiones estudiadas. Los índices de Gini encontrados fueron 0,175 (Cajamarca), 0,157 (Loreto), 0,372 (Apurímac), y 0,146 (San Martín), que indican una tendencia a la equidad. En tanto, en el análisis intrarregional, los índices T de Theil muestran que un número importante de provincias tienen una buena distribución de RHUS. Conclusiones: A pesar de encontrar una baja densidad de RHUS en la mayoría de las regiones estudiadas, la distribución de los RHUS entre cada región muestra una tendencia hacia la equidad.

Reptiles are the first amniotes to develop an intromitent penis, however until now the mechanisms involved in the electrical field stimulation-induced contraction on corpora cavernosa isolated from Crotalus durissus terrificus were not investigated. Crotalus and rabbit corpora cavernosa were mounted in 10 mL organ baths for isometric tension recording. Electrical field stimulation (EFS)-induced contractions were performed in presence/absence of phentolamine (10 μM), guanethidine (30 μM), tetrodotoxin (1 μM and 1mM), A-803467 (10 μM), 3-iodo-L-Tyrosine (1 mM), salsolinol (3 μM) and a modified Krebs solution (equimolar substitution of NaCl by N-methyl-D-glucamine). Immuno-histochemistry for tyrosine hydroxylase was also performed. Electrical field stimulation (EFS; 8 Hz and 16 Hz) caused contractions in both Crotalus and rabbit corpora cavernosa. The contractions were abolished by previous incubation with either phentolamine or guanethidine. Tetrodotoxin (1 μM) also abolished the EFS-induced contractions of rabbit CC, but did not affect EFS-induced contractions of Crotalus CC. Addition of A-803467 (10 μM) did not change the EFS-induced contractions of Crotalus CC but abolished rabbit CC contractions. 3-iodo-L-Tyrosine and salsolinol had no effect on EFS-induced contractions of Crotalus CC and Rabbit CC. Replacement of NaCl by N- Methyl-D-glucamine (NMDG) abolished EFS-induced contractions of rabbit CC, but did not affect Crotalus CC. The presence of tyrosine hydroxylase was identified in endothelial cells only of Crotalus CC. Since the EFS-induced contractions of Crotalus CC is dependent on catecholamine release, insensitive to TTX, insensitive to A803467 and to NaCl replacement, it indicates that the source of cathecolamine is unlikely to be from adrenergic terminals. The finding that tyrosine hydroxylase is present in endothelial cells suggests that these cells can modulate Crotalus CC tone.