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La terapia ortodóntica permite la mejora funcional y estética de las piezas dentales que tienen mal posición, sin embargo, da lugar a la formación de nichos para el desarrollo de microorganismos debido a la dificultad de higiene y retención de alimentos, en consecuencia, se ha desarrollado materiales antimicrobianos basados en nanotecnología. Por lo que el presente capítulo tiene como objetivo recopilar información actualizada con respecto a nanopartículas aplicadas en el campo ortodóntico. La metodología tuvo un diseño no experimental con enfoque cuantitativo, documental de corte transversal. Los resultados muestran que en el ámbito ortodóntico las nanopartículas se utilizan como recubrimiento o en combinación con materiales del área, siendo la plata el principal nanoparticulado en uso con efectos antimicrobianos y sin acción adversa en las propiedades físicas y químicas del mismo. A pesar de que son grandes las ventajas de las nanopartículas es necesario ampliar los estudios clínicos para establecer criterios plenos para su ejecución terapeútica.

Genital herpes is one of the most common sexually transmitted infections worldwide. It mainly affects women, as the rate of sexual transmission from male-to-female is higher than from female-to-male. The application of vaginal antivirals drugs could reduce the prevalence of genital herpes and prevent future infections. Layer-by-layer vaginal films were prepared by the solvent evaporation method using iota-carrageenan, hydroxypropyl methylcellulose and the polymethacrylates Eudragit® RS PO and Eudragit® S100, for the controlled release of acyclovir. The films were characterized by texture analysis and Raman spectroscopy. Swelling, mucoadhesion, and drug release studies were conducted in simulated vaginal fluid. The results show that Layer-by-Layer films exhibited adequate mechanical properties. The structuring of the layer-by-layer films allowed the controlled release of acyclovir and produced a prolonged mucoadhesion residence time of up to 192 h. The films formed in layer 2 by the combination of Eudragit® RS PO and S100 showed a controlled release of acyclovir for eight days, and adequate mechanical properties. These promising formulations for the prevention of genital herpes deserve further evaluation., This work was supported by the Spanish Ministry of Economy, Industry and Competitiveness [Grant No MAT2012-34552]; and by the Spanish Research Agency and the European Regional Development Fund (AEI/FEDER, UE) [grant number MAT2016-76416-R

BACKGROUND: Depression and anxiety are two pathologies of great personal, social and economic im-pact; in many cases both have an early onset. Domestic violence can separate children and adolescents from their families; being sent, most of the times, to foster homes. Children and adolescents in foster homes tend to develop anxiety, depression and stress triggering lifelong emotional and mental difficulties. In this context, the aim of this study was to determine the frequency of anxiety and depression in girls and female adolescents from “Miguel León” Shelter, Cuenca, during 2016, creating statistical data that will allow set-ting protection projects and future studies. METHODS: Descriptive, quantitative cross-sectional study. The study population was stablished with 35 girls and adolescents, aged 5 to 18 years, from a foster home. For data collection, the SPENCE Child Anxiety Scale and the CDI Inventory were applied. Data was processed with Microsoft Excel 2010 and SPSS 15.0. Data is presented in charts and graphics using frequencies and percentages. RESULTS: The frequency of anxiety was 22.86% and the frequent of depression was 17.14%. The most pre-valent age range for both pathologies was 10 to 14 years old with 62.5% and 50% respectively. In both groups, diagnosed with anxiety and diagnosed with depression, the length of stay in the foster home was 0 to 6 months for the majority of the population ( 50 and 66.67% respectively). CONCLUSIÓN: The frequency of depression in girls aged 5 to 18 years, was 17.14%. The frequency of anxie-ty in girls aged from 5 to 18 years in the foster home was 22.86%, values lower than those found in other studies. The age range in which both diseases were most prevalent was, 10-14 years old. Both disorders were more prevalent the shorter the time spent in the foster home. KEYWORDS: Adolescent Health, Depression, Separation Anxiety, Child Protective Services, Anxiety, Foster Home Care.

Desde que deixou a gestão da Bolô Chérie, em abril de 2016, e regressou ao mercado de trabalho, Maurício dividia seu tempo trabalhando em uma empresa Farmacêutica e em conversas com as equipes administrativa e de vendas da Bolô Chérie, tentando, de longe, apoiar Raquel na gestão da análise do caixa e no acompanhamento das vendas. Apesar da rotina estressante, o que mais o preocupava eram os resultados. Os esforços de Raquel em gerir a empresa eram grandes, mas as vendas cresciam a um ritmo pequeno e a empresa continuava com prejuízo operacional. A falta de um planejamento estratégico, muito comum em pequenas empresas, pode ser determinante para criar uma lacuna entre o sucesso e o fracasso. Em setores de nicho, como os funcionais de alimentos sem glúten, as oportunidades para as empresas de menor porte estão em explorar parcelas de um setor que ainda possui proporções menos interessantes para as grandes e médias. No entanto, é necessário perceber os diferentes segmentos, fazer escolhas por um determinado perfil de cliente e, então, definir um posicionamento que a torne uma opção diferente quando comparado aos seus concorrentes. Assim é possível oferecer produtos que atendam necessidades de um consumidor exigente, meta de todo e qualquer empreendedor cujo objetivo é conquistar resultados favoráveis. Since leaving the management of Bolô Chérie in April 2016 and returned to the labor market, Maurício has divided his time working in a Pharmaceutical company and in conversation with the administrative and sales teams of Bolô Chérie, trying by far, to support Raquel in managing the analysis of the cash and in monitoring sales. Despite the stressful routine, what worried him the most were the results. Raquel's efforts to run the company were large, but sales grew at a small pace and the company continued to lose operations. The lack of strategic planning, quite common in small businesses, can be decisive in creating a gap between success and failure. In niche sectors such as gluten-free food functionals, opportunities for smaller companies are exploring portions of an industry that still has fewer interesting proportions for large and medium-sized ones. However, it is necessary to perceive the different segments, make choices for a customer profile, and then define a placement that makes it a different option when compared to its competitors. Thus, it is possible to offer products that meet the needs of a demanding consumer, a goal of all entrepreneur whose objective is to achieve favorable results.

Aprender consiste en “descubrir, asimilar e incorporar la verdad en la experiencia hasta el punto de influir significativamente en la conducta” (Rogers). Esto significa que el aprendizaje ocurre cuando se produce un cambio importante en alguna de las dimensiones fundamentales del ser humano, tales como la dimensión cognitiva, la actitudinal, la ecológica, etc. Entenderemos entonces que, si la educación es un fenómeno holístico y sistémico, en el que intervienen muchos factores, entre ellos la salud, significa que, por ejemplo, las enfermedades, los trastornos, los síndromes o problemas tendrán una base anatómica. Por eso, los docentes de este siglo deberá incorporar destrezas tecnológicas para impartir sus cátedras, logrando así transmitir conocimiento a una generación eminentemente virtual, Con lo anteriormente mencionado se comprende la importancia de esta obra para los docentes comprometidos con la superación educativa en todos los niveles. Por todo ello esta obra compendia los saberes magistrales de la anatomía descriptiva, logrando a los lectores ubicarlos en cada plano corte y disección anatómica, empleando como herramienta el dibujo, ya que en este podemos captar en una misma lamina todas las referencias anatómicas deseadas por los autores.

Objetivo: Determinar el índice de automedicación en los estudiantes universitarios de la carrera de Odontología de la Universidad Católica de Cuenca. Materiales y Métodos: Se realizó un estudio descriptivo, retrospectivo, de campo con análisis cuantitativo, se aplicó un encuesta a 452 estudiantes de la carrera de Odontología, en donde se indago datos socioeconómicos, frecuencia de automedicación, razones para automedicarse, tipos de medicamentos, y conocimientos sobre los peligros de esta práctica. Resultados: Un 84.3% de estudiantes se automedican, con respecto al género se encontró un predominio del género femenino en un 86.74%, mientras que el género masculino se encontró en un 81.28%, a su vez se puede señalar que la principal razón que conlleva a los estudiantes universitarios a auto medicarse es el hecho de que creen que no siempre es necesario ir al médico en un 57%. El grupo de medicamentos más utilizados ha sido los analgésicos-antiinflamatorios con un 44%, seguidos de los antigripales y antibióticos con un 39% y13% respectivamente. Un 86% de los encuestados consideran que la automedicación es una práctica peligrosa, conociendo las complicaciones que esta conlleva. Conclusión: La frecuencia de automedicación en la población universitaria estudiada es elevada, los medicamentos usados requieren por lo general prescripción médica, los factores influyentes de esta práctica son los conocimientos en el área de la salud que tiene los estudiantes, pues consideran que no siempre es necesario acudir al médico.

Marine resources are today a renewable source of various compounds, such as polysaccharides, that are used in the pharmaceutical, medical, cosmetic, and food fields. In recent years, considerable attention has been focused on carrageenan-based biomaterials due to their multifunctional qualities, including biodegradability, biocompatibility, and non-toxicity, in addition to bioactive attributes, such as their antiviral, antibacterial, antihyperlipidemic, anticoagulant, antioxidant, antitumor, and immunomodulating properties. They have been applied in pharmaceutical formulations as both their bioactive and physicochemical properties make them suitable biomaterials for drug delivery, and recently for the development of tissue engineering. This article provides a review of recent research on the various types of carrageenan-based biomedical and pharmaceutical applications.

Women are the most affected by genital herpes, which is one of the most common sexually transmitted infections, affecting more than 400 million people worldwide. The application of vaginal microbicides could provide a safe method of protection. Acyclovir is a safe and effective medication for vaginal administration, and numerous benefits have been observed in the treatment of primary or recurrent lesions due to genital herpes. Vaginal tablets based on a combination of the polymers iota-carrageenan and hydroxypropyl methylcellulose were developed for the controlled release of acyclovir. Swelling, mucoadhesion and drug release studies were carried out in simulated vaginal fluid. The tablets, containing a combination of iota-carrageenan and hydroxypropyl methylcellulose, have an adequate uptake of the medium that allows them to develop the precise consistency and volume of gel for the controlled release of acyclovir. Its high mucoadhesive capacity also allows the formulation to remain in the vaginal area long enough to ensure the complete release of acyclovir. These promising formulations for the prevention of genital herpes deserve further evaluation.

Background: The aim of this prospective, randomized, double-blind study was to compare the block induced by ropivacaine 0.5% with levobupivacaine 0.33% at the recommended dose range in upper limb surgery. These concentrations have provided equivalent block after epidural analgesia. We hypothesized that the block induced by both local anesthetics at clinical equipotent dose would be similar in axillary block. Methods: Eighty-six patients received 30 mL of ropivacaine 0.5% (150 mg) or 30 mL of levobupivacaine 0.33% (99 mg) by axillary approach. Sensory and motor blocks were assessed in the 5 main nerve territories of the arm at 2, 5, 10, 15, 20, 25, and 30 mins and every 6 hrs for the first 24 hrs. We used the Student t test and χ2 test for comparison between groups and an analysis of survival. P Results: Onset of motor block was 9.0 mins (SD, 5.3 mins) for ropivacaine and 12.4 mins (SD, 7.8 mins) for levobupivacaine (P = 0.02). Time to be considered ready for surgery was similar in both groups: ropivacaine, 25.2 mins (SD, 5.1 mins); and levobupivacaine, 25.3 mins (SD, 6.4 mins) (t = −0.09, P = 0.93). Sensory block was 9.2 hrs (SD, 3.1 hrs) for ropivacaine and 11.3 hrs (SD, 4.1 hrs) for levobupivacaine (P = 0.01). Conclusions: Onset of motor block was significantly faster for ropivacaine than levobupivacaine (P = 0.02), but the time to be ready for surgery was similar with both drugs. Duration of sensory block was prolonged with levobupivacaine (P = 0.01).

Fundamento y objetivo Conocer y cuantificar el peso de la actividad anestesica no quirurgica en Cataluna (Espana) en el ano 2003. Pacientes y metodo Estudio prospectivo de las anestesias no quirurgicas realizadas en 131 hospitales catalanes en 14 dias del 2003. Se analizaron: caracteristicas de los pacientes, tecnicas anestesicas, procedimientos, duracion, tipo de actividad, tipos de centros y distribucion geografica. Resultados Las anestesias no quirurgicas representaron el 10,4% del total de anestesias. De estos procedimientos, la endoscopia digestive represento un 70,4%, el tratamiento electroconvulsivo el 11,7%, la radiologia un 11,5% y las cardioversiones un 1,5%. El 73,7% de estos procedimientos se realizaron fuera de quirofano. Hubo un predominio de actividad programada realizada ambulatoriamente bajo sedacion o anestesia general. Las endoscopias digestivas mas representativas fueron la colonoscopia y la gastroscopia, realizadas mayoritariamente en centros privados. Conclusiones La anestesia para procedimientos no quirurgicos, especialmente endoscopias digestivas, fue superior al 10% de todas las anestesias. Estas tecnicas tienden a aumentar y es necesario conocer su frecuencia para una correcta planificacion y para adelantar las estrategias formativas y organizativas.

The article “Ethics of Clinical Science in a Public Health Emergency: Drug Discovery at the Bedside” by Sarah J. L. Edwards proposes the use of the precautionary principle (PP) to solve the conflic...

The biorhythm of serum uric acid was evaluated in a large sample of a clinical laboratory database by spectral analysis and the influence of the gender and age on uric acid variability.Serum uric acid values were extracted from a large database of a clinical laboratory from May 2000 to August 2006. Outlier values were excluded from the analysis and the remaining data (n=73,925) were grouped by gender and age ranges. Rhythm components were obtained by the Lomb Scargle method and Cosinor analysis.Serum uric acid was higher in men than in women older than 13 years (p26 years, pSerum uric acid biorhythm is dependent on gender and age and it may have relevant influence on preanalytical variability of clinical laboratory results.

Laboratórios clínicos são instituições sujeitas a mudanças, guiadas por fatores econômicos e tecnológicos, voltados à redução de custos e à oferta de maior efetividade e segurança ao paciente. Assim, processos automatizados aumentam sua participação no setor. A tomada de decisões laboratoriais deve satisfazer rapidamente a diferentes questões e com o mínimo de erros. O volume de dados gerados nestes sistemas é imenso e pode ser otimizado por procedimentos informáticos e estatísticos. O presente estudo tem como objetivo o desenvolvimento de estrutura de dados, colhidos a partir do servidor de interfaceamento com equipamentos analíticos. Esta estrutura tem como característica o uso de tabelas relacionais e processamento em paralelo à estrutura informática de operação. Para validar este sistema e mostrar a sua eficiência, descrevem-se dois exemplos de aplicação: estudo de interferência do tempo de resposta em relação ao resultado de hormônio paratireoideano (PTH) e avaliação de ritmicidade populacional para ácido úrico, em população do sul do Brasil. Em relação ao PTH, percebeu-se que resultados tendem a diminuir com o tempo, especialmente após 48 horas depois da coleta. Em relação à ritmicidade de ácido úrico, percebeu-se que homens e mulheres a partir de 25 anos de idade apresentam comportamento circanual (12 meses para homens e 13 meses para mulheres), com acrofase nos meses de verão. Adicionalmente, em homens com mais de 50 anos e mulheres com mais de 25 anos, ocorre outro ritmo, de 17 meses (transanual). Os dados apresentados permitem concluir que esta estrutura é útil como ferramenta complementar aos procedimentos tradicionais de controle de qualidade internos e externos, situações que estes podem não discriminar. Clinical laboratories are subjected to a changing environment, guided by technological and marketing factors, and must be ever commited to cost reduction, better performance and patient´s safety. This drives sector to use more automated processes. Laboratory decision making must answer different questions in a right and fast way. Volume of data generated in this environment is huge, and can be better managed by using informatic and statistics concepts. This study aims to develop a data structure, using information from interfacing server to analytical equipments. This structure uses relational tables and parallel processing with laboratory information system. In order to validate this system, two examples of analysis are described: a study of interference of turnaround time on parathyroid hormone (PTH) results, and an evaluation of rhythmicity of uric acid results based on a population survey on south of Brazil. There are negative correlation between TAT and PTH, especially after 48 hours from sampling. On other side, population uric acid of men and women with more than 25 years old shows circanuallity (12 months for men and 13 months for women), with acrophase in summer months. Another transyear (17 months) rhythm was found for men with more than 50 years old and women with more than 25 years old. Presented data allow to conclude that this structure is useful and suggests that its popularization may improve use in analysis of processes as a complementary tool to traditional quality control procedures.

This arm of the ANESCAT survey sought to characterize and quantify nonsurgical anesthesia practice in Catalonia, Spain.Information about anesthesia for nonsurgical procedures in 131 Catalan hospitals was gathered prospectively on 14 days in 2003. We analyzed patient characteristics, anesthetic techniques, procedures, duration, interventional context for the anesthetic procedure, type of hospital, and geographic distribution.Nonsurgical anesthesia accounted for 10.4% of all acts. Endoscopy of the digestive tract accounted for 70.4% of all nonsurgical procedures, electroconvulsive treatment for 11.7%, radiology for 11.5%, and electrical cardioversion for 1.5%. Anesthesia was provided outside an operating room in 73.7% of the cases. Most procedures were scheduled to be performed in outpatients under sedation or general anesthesia. The most commonly performed digestive tract endoscopic examinations were colonoscopy and gastroscopy, and most took place in private hospitals.Over 10% of anesthesia practice is for nonsurgical procedures and digestive tract endoscopy accounts for the largest proportion of such practice. As the trend is for such procedures to increase in number, their frequency should be studied so that organization and training can be planned.

Objective: To determine whether two low-dose regimens of aprotinin influence platelet function. Design: Prospective, randomized, single-blinded trial. Setting: University teaching hospital performing 600 cardiac operations per year. Participants: Fifty-nine patients scheduled for cardiac surgery undergoing cardiopulmonary bypass (CPB) of expected duration of 60 minutes or more. Interventions: Patients were randomized into three groups. Group C (control) included 21 patients who did not receive aprotinin. In group A2, 17 patients received 14,286 kallikrein inhibitor units (KIU)/kg (2 mg/kg) of aprotinin before surgery, followed by a continuous infusion of 7,143 KIU/kg/h (1 mg/kg/h) until the end of surgery. In group A4, 19 patients received 28,572 KIU/kg (4 mg/kg) of aprotinin before surgery, followed by the same infusion. Measurements and Main Results: Postoperative bleeding and transfusion requirements were significantly less in group A4. Changes in platelet number and function were similar in the three groups. Platelet aggregation was assessed in four periods: before CPB (T1), post-CPB (T2), and 2 hours (T3) and 4 hours (T4) after CPB. Platelet aggregation induced by adenosine diphosphate, 1 and 2 μmol/L; ristocetin, 1 mg/mL; and arachadonic acid (AA), 1.4 mmol/L, decreased at T2 (p < 0.001) in all groups, and for the ristocetin and AA groups, remained at less than baseline values at T3 and T4. In five patients from each group, platelet receptors for glycoprotein IIb-IIIa (GPIIb-IIIa) and expression of platelet activation markers, guanosine monophosphate 140 (GMP-140) and lysosomal protein, were measured by flow cytometry before and after CPB. Modifications in the expression of GPIIb-IIIa were always modest and without statistical significance. Platelet activation markers, GMP-140 or lysosomal protein, nearly doubled from baseline to post-CPB only in the A4 group, whereas they remained stable in both other groups (statistically not significant). Conclusion: The two regimens of aprotinin, both considered low dosage, did not exert a protective effect on platelet function. Neither dose produced changes in platelet GPIIb-IIIa or platelet activation markers. However, bleeding and transfusion needs were decreased.