La misión del INISAV es Contribuir a la disminución de los riesgos y pérdidas por plagas sin afectar al ambiente sobre una base sostenible. Su gestión se basa en un modelo de ciencia centrado en el entorno, caracterizado por 4 etapas: la planificación de las investigaciones, la ejecución, la validación y su adopción en la práctica agrícola. Se describen 3 resultados principales de investigación, relativos al Programa de Lucha Biológica (PLB), los Programas de Manejo de Plagas (PMP) y la Eliminación del uso del Bromuro de Metilo (EBM). Se diseñó e implementó la red nacional de 251 Laboratorios para la Reproducción de Entomófagos y Entomopatógenos (CREE), 4 plantas para la producción de bioplaguicídas y la generación de 13 productos biológicos y sus tecnologías. Además fueron generalizados Programas de Manejo de Plagas en más de 25 cultivos para sistemas convencionales y agroecológicos y la adopción de PMP destinados a sustituir el bromuro de metilo. Los impactos de los resultados al medio ambiente, la producción agropecuaria, la economía del país, y las comunidades rurales, se demuestran con la reducción de importaciones de plaguicidas químicos, de 40 000 t en 1974, a cerca de 3000 t en el 2014. En 1988 el área cultivable beneficiada con bioproductos era de 300 000 ha y en el 2014 ascendió a 1 354 000 ha. La eliminación de 80 t de bromuro de metilo en tabaco, 35 t en el resto de los sectores, la reducción de aplicaciones de otros agroquímicos, la incorporación del control biológico y otras medidas de manejo, se consideran la base fundamental para la sostenibilidad en los cultivos. En la actualidad en el 72% del área total sembrada se realizan aplicaciones de plaguicidas en PMP, de éstas, el 38% solo con biológicos, en el 34% se combinan biológicos y químicos y en el 28% restante, se aplican otras alternativas fitosanitarias en PMP.

The mission of INISAV is to contribute to the reduction of risks and losses by pests without affecting the environment on a sustainable basis. Its management is based on a science model linked with environment and characterized by 4 phases: the planning of research’s, their implementation, validation and adoption in the agriculture practice. Three main results of research are described: Biological control Program (PBC), Pest Management Programs (PMP) and the Elimination of the use of methyl bromide. A national network of 251 Laboratories for reproduction of entomophagues and entomopathogens (CREE) was designed and implemented, together with 4 biopesticide production plants. Thirteen (13) biological products and technologies were created. Furthermore, pest management programs (PMP) were extended in more than 25 crops for conventional and agro-ecological systems, as well as adoption of PMP to replace methyl bromide. The impacts of the results to the environment, agricultural production, the country's economy, and rural communities, were confirmed by the significant reduction of imports of chemical pesticides, from 40 000 t in 1974 to about 3000 t in 2012. In 1988 the arable area benefited by bioproducts was 300 000 ha while in 2012 amounted to 1 354 000 ha. The elimination of 80 t of methyl bromide in tobacco, 35 t in the other sectors, the reduction of other agrochemicals, the incorporation of biological control applications and some management measures, are considered the main basis for sustainability in crops. At present, 72% of the total area planted is under applications of pesticides in PMP. Of these, 38% with only biological products, 34% the combination of biological and chemical pesticides and in the remaining 28% apply phytosanitary alternatives included in the pest management programs.

OBJETIVO: Investigar a associação entre polimorfismos nos genes que codificam enzimas envolvidas no metabolismo da homocisteína dependente de folato e vitamina B12 e aborto espontâneo recorrente.MÉTODOS: Investigamos os polimorfismos C677T e A1298C no gene methilenotetrahidrofalato redutase (MTHFR); o polimorfismo A2756G no gene metionina sintase (MS) e a inserção 844ins68 no gene da cistationina beta-sintetase (CBS). A técnica de PCR seguido por RFLP foi utilizada para investigar os polimorfismos. Os níveis séricos de homocisteína, vitamina B12 e de folato foram investigados pela técnica de quimioluminescência. O Software Epi Info versão 6.04 foi utilizado para realizar a análise estatística. As variáveis paramétricas foram comparadas pelo teste t de Student e as variáveis não paramétricas pelo teste de Wilcoxon rank sum.RESULTADOS: As frequências dos polimorfismos gênicos em 89 mulheres com história de aborto recorrente idiopático e 150 controles foram de 19,1 e 19,6% para o C677T; 20,8 e 26% para o A1298C; 14,2 e 21,9% para o A2756G e 16,4 e 18% para a inserção 844ins68, respectivamente. Não houve diferenças significantes entre os grupos caso e controle em todos os polimorfismos dos genes investigados. No entanto, a frequência da inserção 844ins68 no gene CBS foi maior entre mulher com histórico de perdas no terceiro trimestre da gravidez p=0.003). Os níveis de homocisteína, vitamina B12 e folato séricos não foram diferentes entre os polimorfismos estudados nos grupos casos e controles. No entanto, a análise de regressão linear mostrou dependência dos níveis séricos de folato na manutenção dos níveis de homocisteína.CONCLUSÃO: Os polimorfismos gênicos investigados, assim como homocisteína, vitamina B12 e os níveis séricos de folato não foram associados com abortos recorrentes idiopático no presente estudo. Novas investigações devem ser realizados a fim de confirmar o papel da inserção 844ins68-CBS nos abortos recorrentes.

PURPOSE: To investigate the association between polymorphisms in genes that encode enzymes involved in folate- and vitamin B12-dependent homocysteine metabolism and recurrent spontaneous abortion (RSA).METHODS: We investigated the C677T and A1298C polymorphisms of the methylenetetrahydrofalate reductase gene (MTHFR), the A2756G polymorphism of the methionine synthase gene (MS) and the 844ins68 insertion of the cystathionine beta synthetase gene (CBS). The PCR technique followed by RFLP was used to assess the polymorphisms; the serum levels of homocysteine, vitamin B12 and folate were investigated by chemiluminescence. The EPI Info Software version 6.04 was used for statistical analysis. Parametric variables were compared by Student's t-test and nonparametric variables by the Wilcoxon rank sum test.RESULTS: The frequencies of gene polymorphisms in 89 women with a history of idiopathic recurrent miscarriage and 150 controls were 19.1 and 19.6% for the C677T, insertion, 20.8 and 26% for the A1298C insertion, 14.2 and 21.9% for the A2756G insertion, and 16.4 and 18% for the 844ins68 insertion, respectively. There were no significant differences between case and control groups in any of the gene polymorphisms investigated. However, the frequency of the 844ins68 insertion in the CBS gene was higher among women with a history of loss during the third trimester of pregnancy (p=0.003). Serum homocysteine, vitamin B12 and folate levels id not differ between the polymorphisms studied in the case and control groups. However, linear regression analysis showed a dependence of serum folate levels on the maintenance of tHcy levels.CONCLUSION: The investigated gene polymorphisms and serum homocysteine, vitamin B12 and folate levels were not associated with idiopathic recurrent miscarriage in the present study. Further investigations are needed in order to confirm the role of the CBS 844ins68 insertion in recurrent miscarriage.

INTRODUÇÃO: Este estudo procura contribuir com uma relação pouco explorada no meio acadêmico: capoeira, cognição e envelhecimento. Relacionando estudos sobre funções executivas e a capoeira, busca-se investigar a interligação desta arte e as funções executivas. Estas se referem a desempenhos de comportamentos complexos (memória de trabalho, flexibilidade mental, tomada de decisão) e a memória léxico-semântica. OBJETIVO: Comparar o desempenho de funções executivas em idosas praticantes de capoeira e idosas não praticantes de exercício físico. MÉTODO: Estudo transversal que coletou as informações de cada participante apenas uma vez. Serão comparados dois grupos: 1) grupo de idosos praticantes de capoeira e 2) idosos que não fazem exercício físico. Para seleção e caracterização dos grupos utilizaram-se: questionário sociodemográfico, aspectos gerais de saúde e escala de hábitos de leitura e escrita, mini-exame de estado mental (MEEM) e escala de depressão de Yesavage (GDS-30). Para avaliar o desempenho das funções executivas foi realizado o teste de trilhas e as tarefas de fluência verbal. Para análise estatística dos dados será utilizado o teste de Shapiro-Wilk para normatização dos dados. O teste de t de Student e o teste U de Mann Whitney serão usados para comparar duas médias de amostras independentes. Utilizou-se a improvisação, a ação, a tomada de decisão, o equilíbrio e as noções de espaço, tempo, ritmo, música, e a compreensão do jogo da capoeira como intervenção devido à possível utilização dos processos executivos nessa arte. RESULTADOS: Verificou-se que não houve diferença significativa nos testes realizados. Porém houve superioridade nos testes de fluência verbal e testes de trilha A e B, sendo maior em B no grupo de capoeira do que no grupo controle. CONCLUSÃO: A prática de capoeira tem uma tendência em contribuir para a melhora das funções executivas, embora os mecanismos desse benefício não estejam claros

INTRODUCTION: This study aims to contribute to an underexplored relationship in academic studies: capoeira, cognition and aging. Relating studies on executive functions and capoeira, we seek to investigate the interconnection of this art, and executive function. These refer to the realization of complex behaviors (working memory, mental flexibility, decision making) and lexical-semantic memory. OBJECTIVE: To compare the performance of executive functions in elderly women doing capoeira and the elderly women who do not exercise. Method: Cross-sectional study that collected information about each participant only one time: 1) group of elderly doing capoeira and 2) group of elderly who do not exercise. For selection and characterization of the groups we used the sociodemographic questionnaire, general health issues and scale of reading and writing habits, mini-mental state examination (MMSE) and Yesavage depression scale (GDS-30). To evaluate the performance of executive functions the trial making test and verbal fluency task were carried out. For statistical analysis the Shapiro-Wilk test for normalization of data will be used. The Student t test and Mann-Whitney U were used to compare two means for independent samples. We used improvisation, action, decision making, balance, and the notions of space, time, rhythm, music, and understanding the capoeira game as an intervention due to possible use of executive processes in the art. RESULTS: It was found that there was no significant difference in the tests. However there was superiority in Verbal Fluency and A and B Trail tests, being higher in B in the capoeira group, than the control group. CONCLUSIONS: The practice of capoeira has a tendency to contribute to the improvement in executive functions, although the mechanisms of this benefit are unclear.

INTRODUCCIÓN: Este estudio procura contribuir con una relación poco explorada en el medio universitario: capoeira, cognición y envejecimiento. Vinculando estudios sobre las funciones ejecutivas y la capoeira, se busca investigar la interconexión de este arte y las funciones ejecutivas. Estas se refieren a desempeños de comportamientos complejos (memoria de trabajo, flexibilidad mental, toma de decisión) y a la memoria léxico-semántica. OBJETIVO: Comparar el desempeño de funciones ejecutivas en ancianas practicantes de capoeira y en ancianas que no practican ejercicio física. MÉTODO: Estudio transversal que recolectó, solo una vez, las informaciones de cada participante. Se compararon dos grupos: 1) grupo de ancianas practicantes de capoeira, y 2) ancianas que no hacen ejercicio físico. Para selección y caracterización de los grupos se utilizaron: cuestionario sociodemográfico, aspectos generales de salud y escala de hábitos de lectura y escritura, miniexamen del estado mental (MEEM) y escala de depresión de Yesavage (GDS-30). Para evaluar el desempeño de las funciones ejecutivas se realizó la prueba de senderos y la de tareas de fluencia verbal. Para el análisis estadístico de los datos se utilizó la Prueba de Shapiro-Wilk para normatización de los datos. La prueba de t de Student y la prueba U de Mann Whitney se usaron para comparar dos promedios de muestras independientes. Se usó la improvisación, la acción, la toma de decisión, el equilibrio y las nociones de espacio, tiempo, ritmo, música y la comprensión del juego de la capoeira como intervención, debido a la posible utilización de los procesos ejecutivos en este arte. RESULTADOS: se verificó que no hubo diferencia significativa en las pruebas realizadas, no obstante, hubo superioridad en las Pruebas de Fluencia Verbal y Pruebas de Sendero A y B, siendo mayor en B en el grupo de capoeira que en el grupo de control. CONCLUSIÓN: La práctica de capoeira tiene una tendencia de contribuir para la mejora de las funciones ejecutivas, aunque los mecanismos de ese beneficio no estén claros.

INTRODUÇÃO: A estimativa da composição corporal é um campo de estudo importante no prognóstico e diagnóstico de enfermidades degenerativas. OBJETIVO: Analisar a aplicabilidade do Índice de adiposidade corporal (IAC) e o método de dobras cutâneas. MÉTODOS: A amostra foi constituída por 19 adultas jovens com média de idade 24,53 ± 2,65 anos, submetidas à avaliação antropométrica (circunferências e dobras cutâneas) e absorsiometria por dupla emissão de raio X (DXA). Os valores estimados foram comparados ao valor de referência por meio do teste t pareado e pela análise do nível de associação entre os métodos pela correlação de Pearson; o nível de significância foi p < 0,05. RESULTADOS: Não apontaram diferenças significativas entre o percentual de gordura estimado pelo IAC e os valores de referência, porém, tiveram nível de associação moderado (r = 0,627). No entanto, o método de dobras cutâneas apresentou diferença estatística significante (p > 0,05) com nível de associação forte (r = 0,879). CONCLUSÃO: Embora o IAC não apresente diferença para os valores estimados, fica evidente a necessidade de mais estudos sobre a aplicabilidade do método na população brasileira.

INTRODUCTION: The estimation of body composition is an important study field in the prognosis and diagnosis of degenerative diseases. OBJECTIVE: To analyze the applicability of the Body Adiposity Index (BAI) and the skinfold thickness method. METHODS: The sample consisted of 19 young adult women with a mean age 24.53 ± 2.65 years, who underwent anthropometric measurements (circumferences and skinfold thickness) and dual energy X-ray absorptiometry (DEXA). The estimated values were compared to the reference value by using the paired t test and by analysis of the level of association between the methods through the Pearson correlation. The level of significance was p<0.05. RESULTS: Showed no significant differences between the fat percentage estimated by the BAI and the reference values, however had moderate level of association (r=0.627). Nevertheless, the skinfold thickness method showed statistically significant difference (p>0.05) with a strong association level (r = 0.879). CONCLUSION: Although the BAI does not show difference to the estimated values, it is clear that further studies on the applicability of the method in the Brazilian population are necessary.

INTRODUCCIÓN: La estimativa de la composición corporal es un campo de estudio importante en el pronóstico y diagnóstico de enfermedades degenerativas. OBJETIVO: Analizar la aplicabilidad del Índice de Adiposidad Corporal (IAC) y el método de pliegues cutáneos. MÉTODOS: La muestra fue constituida por 19 adultas jóvenes con promedio de edad de 24,53 ± 2,65 años, sometidas a evaluación antropométrica (circunferencias y pliegues cutáneos) y absorciometría por doble emisión de rayo X (DXA). Los valores estimados fueron comparados al valor de referencia por medio del test t pareado y por el análisis del nivel de asociación entre los métodos por la correlación de Pearson; el nivel de significancia fue de p < 0,05. RESULTADOS: No apuntaron diferencias significativas entre el porcentual de grasa estimado por el IAC y los valores de referencia, no obstante, tuvieron nivel de asociación moderado (r = 0,627). Por otro lado, el método de pliegues cutáneos presentó diferencia estadística significativa (p > 0,05) con nivel de asociación fuerte (r = 0,879). CONCLUSIÓN: Aunque el IAC no presente diferencia para los valores estimados, queda evidente la necesidad de más estudios sobre la aplicabilidad del método en la población brasileña.

Objectives To evaluate the prevalence, distribution and association of HPV with histological pattern of worse prognosis of penile cancer, in order to evaluate its predictive value of inguinal metastasis, as well as evaluation of other previous reported prognostic factors. Material and Methods Tumor samples of 82 patients with penile carcinoma were tested in order to establish the prevalence and distribution of genotypic HPV using PCR. HPV status was correlated to histopathological factors and the presence of inguinal mestastasis. The influence of several histological characteristics was also correlated to inguinal disease-free survival. Results Follow-up varied from 1 to 71 months (median 22 months). HPV DNA was identified in 60.9% of sample, with higher prevalence of types 11 and 6 (64% and 32%, respectively). There was no significant correlation of the histological characteristics of worse prognosis of penile cancer with HPV status. Inguinal disease-free survival in 5 years did also not show HPV status influence (p = 0.45). The only independent pathologic factors of inguinal metastasis were: stage T ≥ T1b-T4 (p = 0.02), lymphovascular invasion (p = 0.04) and infiltrative invasion (p = 0.03). conclusions HPV status and distribution had shown no correlation with worse prognosis of histological aspects, or predictive value for lymphatic metastasis in penile carcinoma.

La Adenosin deaminasa es una enzima del metabolismo de las purinas cuya función es transformar la adenosina en inosina y la desoxiadenosina en desoxiinosina. La unión de ecto-ADA1 a la superficie celular a través de CD26 contribuye a la regulación de citocinas y estimula la proliferación de células T mediante la activación de CD45. La deficiencia de esta enzima genera el síndrome de inmunodeficiencia combinada severa, caracterizado por la acumulación de metabolitos de adenina y desoxiadenosina, los cuales tienen efectos tóxicos sobre los linfocitos, afectando así la síntesis de ADN y en consecuencia la expansión clonal. Un diagnóstico temprano de esta inmunodeficiencia es esencial ya que reduce notablemente la morbilidad y mortalidad asociada con infecciones recurrentes. Los avances recientes en biología molecular y genética han conducido a la identificación de los defectos genéticos de muchas de las inmunodeficiencias primarias y al desarrollo de herramientas de diagnóstico y tratamiento prometedoras

Adenosine deaminase is an enzyme of the purine metabolism whose function is to convert adenosine to inosine and deoxyadenosine to deoxyinosine. The ecto-ADA1 binding to the cell surface through CD26 contributes to the regulation of cytokines and stimulates the proliferation of T cells by activating CD45. The deficiency of this enzyme generates the severe combined immunodeficiency syndrome, characterized by the accumulation of deoxyadenosine and adenine metabolites, which have toxic effects on lymphocytes, affecting DNA synthesis and consequently, clonal expansion. Early diagnosis of this immunodeficiency is essential, as it significantly reduces morbidity and mortality associated with recurrent infections. Recent advances in molecular biology and genetics have led to the identification of genetic defects of many primary immunodeficiencies and the development of promising diagnostic tools and treatment

El objetivo del presente estudio fue detectar las citocinas IFN-g, IL-4 e IL-10 expresadas por células T CD4+ en tejidos de fetos de ratones con infección chagásica aguda. Para ello, se examinaron fetos de ratones NMRI cuyas madres fueron infectadas con 22×10³ tripomastigotes metacíclicos de la cepa M/HOM/BRA/53/Y de T. cruzi y preñadas durante la fase aguda de la infección. Para la detección y localización de infiltrados inflamatorios, nidos de parásitos, antígenos de T. cruzi y citocinas se emplearon las técnicas de hematoxilina-eosina, peroxidasa-anti-peroxidasa e inmunofluorescencia indirecta. Se detectaron infiltrados inflamatorios y antígenos con nidos de amastigotes en el músculo esquelético fetal. Células T CD4+ productoras de IFN-g así como depósitos de IFN-g e IL-10 fueron detectados en las secciones de placenta, corazón y músculo esquelético de fetos de ratones infectadas, mientras que células CD4+/IL-10+ se encontraron sólo en músculo esquelético, adicionalmente se detectaron depósitos de IL-4 sólo en placentas de ratones sanas. Estos resultados indican que el feto es capaz de generar una respuesta inmune propia frente a antígenos transmitidos por su madre, lo cual induce la secreción de citocinas que actuando en sinergia con los anticuerpos maternos le confieren un estado de protección contra la infección, y que la transmisión del parásito depende de factores específicos de cada madre, la cual puede modificar su capacidad de controlar tal transmisión ya sea a nivel placentario o sistémico

The objective of this study was to detect the cytokines IFN-g, IL-4 and IL-10 expressed by CD4+ T cells in tissues of fetal mice with acute chagasic infection. For this, we examined the fetuses of NMRI mice whose mothers were infected with 22×10³ metacyclic trypomastigotes of the M/HOM/BRA/53/Y strain of T. cruzi and made pregnant during the acute phase of infection. For the detection and localization of inflammatory infiltrates, nest parasites, antigens of T. cruzi and cytokines we used hematoxylin-eosin techniques, peroxidase-anti-peroxidase and immunofluorescence. The immunohistochemical study revealed the presence of inflammatory infiltrates and antigens with amastigote nests in fetal skeletal muscle. CD4 + T cells producing IFN-g, as well as deposits of IFN-g and IL-10, were detected in sections of placenta, heart and skeletal muscle of fetuses of mice infected, while CD4+/IL-10+ was found only in skeletal muscle; in addition, deposits of IL-4 were detected only in placentas of healthy mice. These results indicate that fetuses are capable of generating their own immune response to antigens transmitted by their mother, which induces the secretion of cytokines and that, acting in synergy with the maternal antibodies, confer them a state of protection against infection; and that the transmission of the parasite depends on factors specific to each mother, which may modify its ability to control such transmission at the placental or systemic levels

La adenosin deaminasa (ADA), es una enzima del metabolismo de las purinas que ha sido objeto de mucho interés debido a que el defecto congénito de esta enzima causa el síndrome de inmunodeficiencia combinada severa. Una de las tres isoformas de la enzima (ecto-ADA) es capaz de unirse a la glicoproteína CD26 y a los receptores de adenosina A1 y A2B. La interacción ADA-CD26 produce una señal coestimuladora en los eventos de activación de las células T y en la secreción de IFN-g, TNF-a e IL-6. Durante dicha activación la actividad de la enzima está regulada de manera positiva por IL-2 e IL-12 y negativamente por IL-4, basado en un mecanismo de translocación. Diversos estudios señalan que los niveles séricos y plasmáticos de ADA se elevan en algunas enfermedades causadas por microorganismos que infectan principalmente a los macrófagos; así como en trastornos hipertensivos, lo cual podría representar un mecanismo compensatorio como consecuencia de la elevación de los niveles de adenosina y la liberación de mediadores hormonales e inflamatorios estimulados por la hipoxia

Adenosine deaminase (ADA) is an enzyme of purine metabolism which has been the subject of much interest because the congenital defect of this enzyme causes severe combined immunodeficiency syndrome. One of the three isoforms of the enzyme (ecto-ADA) is capable of binding to the glycoprotein CD26 and adenosine receptors A1 and A2B. ADA-CD26 interaction produces a costimulatory signal in the events of T cell activation and secretion of IFN-g, TNF-a and IL-6. During this activation, the enzyme activity is regulated positively by IL-2 and IL-12 and negatively by IL-4, based on the mechanism of translocation. Diverse studies suggest that seric and plasmatic levels of ADA rise in some diseases caused by microorganisms infecting mainly the macrophages and in hypertensive disorders, which may represent a compensatory mechanism resulting from increased adenosine levels and the release of hormones and inflammatory mediators estimulated by hipoxia

La respuesta inmune mediada por células en neonatos y fetos de madres infectadas por Trypanosoma cruzi ha sido objeto de estudio en modelos murinos, existiendo datos que apoyan la idea de que el sistema inmune fetal puede ser competente. Esta revisión sintetiza los resultados obtenidos en estudios multidisciplinarios sobre casos de enfermedad de Chagas congénito, los cuales señalan que dicha afección depende del equilibrio entre complejos fenómenos, tales como la respuesta inmune adaptativa en la madre de tipo Th2 asociada a altas parasitemias, la invasión de la placenta y el cordón umbilical por los parásitos y la respuesta inmune específica en el feto caracterizada por una activación de células T CD8+ productoras de IFN-γ capaces de limitar la multiplicación del parásito, así como la morbi mortalidad y los linajes de mayor virulencia del parásito que pudieran atravesar con facilidad la placenta y llegar a ser más patógenos para el feto/neonato.

The cell-mediated immune response in infants and fetuses of mothers infected with Trypanosoma cruzi has been studied in mouse models and there are data supporting the idea that the fetal immune system may be competent. This review synthesizes the results obtained from multidisciplinary studies of cases of congenital Chagas disease, which indicate that this condition depends on the equilibrium between complex phenomena, such as a maternal type Th2 adaptative immune response associated with high parasitemia, the invasion of placental and umbilical cord by parasites and a fetal specific immune response characterized by an activation of CD8 T cells producing IFN-gamma able to limit parasite multiplication and morbidity/mortality; and that in lineages of higher virulence the parasite could easily cross the placenta and be more pathogenic to the fetus/neonate.

La hepatitis B es una causa importante de morbilidad y mortalidad en el mundo. Un cúmulo importante de evidencias sugiere que tanto la respuesta humoral como la celular son importantes para la eliminación del virus y que la respuesta celular se ha involucrado en la patogénesis de la enfermedad. La vacunación con el antígeno de superficie (HBsAg) es considerada como la estrategia principal para el control de la infección. Sin embargo, aproximadamente 5 a 10% de los individuos fallan en producir anticuerpos específicos. En este trabajo se han revisado aspectos fundamentales en la inmunopatogenia de la Hepatitis B, así como también fenómenos que explican la ausencia de respuesta a la vacuna. Partiendo de la premisa que los individuos no respondedores a la vacuna contra la Hepatitis B, están en riesgo de infección, se propone un mecanismo común para explicar la ausencia de respuesta frente al virus. En el contexto del modelo planteado se describe una alteración en la activación de los linfocitos tau, tanto en no respondedores como en infectados crónicos. Estas observaciones son consistentes con diferencias potenciales en el eje de presentación MHC/Ag, contribuyendo al entendimiento sobre la alteración de la respuesta T cooperadora como un mecanismo de base para la ausencia de inmunidad protectora contra el virus de la hepatitis B (VHB).

Hepatitis B is an important cause of morbidity and mortality around the world. One-third of the world’s population has been estimated to be infected with hepatitis B virus (HBV). A significant amount of evidence suggests that both humoral and cellular immune responses are important to eliminate the virus and that, cellular immunity is involved in the pathogenesis of the disease. Vaccination with HBsAg is considered as the main strategy for effective control of the infection and viral transmission. However, approximately 5-10% of immunized individuals fail to elicit detectable specific antibodies and remain at risk for hepatitis B infection. In this work we have reviewed the current status in the pathogenesis of the disease and the mechanisms described to explain nonresponsiveness to the vaccine as well. Since nonresponders to the vaccine are at risk for the infection, a common mechanism to explain the absence or inappropriate immune response to virus components is proposed. Within the suggested model an impaired activation of tau lymphocytes against viral antigens, both in nonresponders to vaccination and chronically infected patients, is described. These observations could be consistent with potential differences in the MHC/Ag presentation; therefore contributing to our understanding of the altered tau helper response as an underlying mechanism for the lack of protective immunity against VHB.

La Carbamacepina es una droga anticonvulsivante bien tolerada y que origina la aparición de efectos adversos dermatológicos de manera poco frecuente. En este reporte, se describe el caso de un paciente del sexo femenino, quien acudió al Servicio Farmacocinético Clínico del Laboratorio de Toxicología del Hospital Universitario de los Andes, solicitando la realización de niveles de Carbamacepina, por presentar en sus manos manchas hipercrómicas, concéntricas y pruriginosas, de aparición a los 6 meses de iniciado el tratamiento con dicho medicamento; los niveles terapéuticos reportaron un valor de 8,51 μg.mL-1, ubicados dentro de rango terapéutico 4-12 μg.mL-1. Luego de ser remitida al servicio de Dermatología, le fue diagnosticado: eritema fijo pigmentario medicamentoso, el cual comenzó a desaparece a los 15 días de haber suspendido la carbamazepina y con un tratamiento coadyuvante de ungüento magistral.

Carbamazepine (CBZ) is an oral anticonvulsant drug, structurally similar to tricyclic antidepressants. It is preferred over other drugs because it has fewer adverse effects on behavior and alertness. However, hematologic toxicity is possible during therapy with CBZ. Patients should undergo routine monitoring of hematologic function. CBZ can make the skin more sensitive to the sun or ultraviolet light, therefore, dermatological effects of this drug also can happen such as, skin rash, urticaria, and erythema multiforme. The present study reports the case of a female patient that presented hyperchromic-concentric-pruriginous- spots on the skin of her hands after six months of treatment with CBZ. She came to the physicians of the Clinical Pharmacokinetic Service (Laboratory of Toxicology of IAHULA, Mérida-Venezuela) requesting a drug monitoring. The results showed a level of 8,51 μg.mL-1, which was found within the therapeutic range (4-12 μg.mL-1). Subsequently, the dermatologist diagnosed fixed pigmented erythema related to the ingestion of a specific medication which began disappearing after 15 days of CBZ free-treatment and with the aid of a dermatologic formulation.

La infección por el virus de la inmunodeficiencia humana (VIH) se caracteriza por el deterioro progresivo de la respuesta inmune, asociado a una pérdida gradual de los elementos que la generan, especialmente de los linfocitos T CD4+. Aunque estas células son el principal blanco del virus, en la actualidad existe gran interés por el estudio de otros elementos celulares, que se encuentran alterados y que contribuyen al deterioro del paciente. Dentro de este grupo de células se encuentran los polimorfonucleares (PMN), células fundamentales en la defensa innata contra el VIH y cuya función está alterada en el curso de la enfermedad. Probablemente la causa de este deterioro se debe, en parte, a un incremento en su susceptibilidad para sufrir apoptosis espontánea; sin embargo, no han sido dilucidados los mecanismos involucrados en generar muerte celular programada en los neutrófilos de pacientes VIH positivos. En trabajos previos, hemos explorado algunos eventos asociados con la muerte de los neutrófilos de pacientes infectados. Este artículo tiene como objetivo principal profundizar en los eventos involucrados en la apoptosis espontánea e inducida vía Fas, que pudieran estar implicados en el deterioro de los PMN durante la infección por el VIH.

The hallmark of the immunodeficiency virus infection is a progressive detriment of the immune response which has been associated to a gradual loss of its responsible components, in particularly, CD4 positive T cells. Although this cell population is considered the main target of the virus, there is a recent deal of interest in studying other components that may not be targets of the virus, but are important elements to control infectious microorganisms and that have been demonstrated to be altered during HIV infection. Neutrophils (PMN) are innate immune components that play a fundamental role against HIV infection and these cells have been described as functionally altered during AIDS. It has been suggested that such a dysfunction could be attributed to an increased susceptibility of these cells to accelerated spontaneous apoptosis. However, the underlying mechanisms that induce programmed cell death of neutrophils remain unknown. In previous works we have explored some events involved during cell death of neutrophils from HIV infected patients. It is the purpose of this work to review the current knowledge of apoptosis signals in neutrophils and to discuss our own data about some mechanisms involved in spontaneous and Fas mediated apoptosis, which may contribute to understand neutrophils dysfunction during HIV infection.

OBJECTIVE: To conduct research at the Municipal Blood Bank of Caracas (MBBC) and find out the proportion of blood units discarded for being seropositive for human T-lymphotropic virus (HTLV) types I and II, the prevalence of that infection among their donors, and the probable risk factors for that infection among those HTLV-positive donors. METHODS: ELISA serological testing was done with 23 413 donors seen at the MBBC between July 2000 and April 2001. Samples that were repeat reactive (RR) with the ELISA underwent supplementary Western blot (WB) testing. Donors who had a positive or indeterminate WB result were scheduled for counseling in order to carry out confirmatory testing using nucleic acid amplification (NAA), to collect data on their risk background, and to advise them concerning their HTLV status. RESULTS: Of the 23 413 MBBC donors, 48 of them (0.2%) had a donation that was RR. Of those 48, 25 of them (52.1%) were positive on the WB (23 for HTLV-I and 2 for HTLV-II), 2 of them (4.1%) were indeterminate on the WB, 14 of them (29.2%) were negative, and 7 (14.6%) could not be evaluated. Of the 27 donors scheduled for counseling, 16 of them actually attended (14 WB-positive for HTLV-I, 1 WB-positive for HTLV-II, and 1 indeterminate). All 16 of them were positive with the confirmatory NAA testing. When these 16 seropositive donors were compared with a control group of seronegative donors, no significant differences were found with regard to age, sex, type of donation, number of previous donations, history of transfusions, and sexual behavior. However, significant differences were found in two areas: the seropositive donors were more likely to have used non-intravenous drugs (P < 0.05), and the seropositive donors were much more likely to have had an extended breast-feeding period (more than 2 years) as a child (P < 0.001). To assess the probability of mother-to-child transmission, six of the mothers of seropositive donors who had had an extended breast-feeding period were tested, and all six of those mothers were also found to be seropositive. With the 16 seropositive donors who were counseled, the spouse or partner of 13 of them was also tested; only 1 of those 13 was positive, but the oldest son of that couple was also HTLV-positive. CONCLUSIONS: Of the donated blood, 0.2% of the units were discarded for being positive for HTLV-I or HTLV-II, and the prevalence found among the donors was 0.11%. Sexual transmission between an HTLV-positive donor and a partner or spouse was less frequent than was mother-to-child transmission. At present in Venezuela, blood banks are not required to screen donations for HTLV. Given our results at the MBBC, we believe serious consideration should be given to implementing serological screening for HTLV I/II among blood donors throughout Venezuela.

OBJETIVOS: Conocer la proporción de sangre descartada por seropositividad al virus linfotrópico de células T humanas (HTLV) tipos I y II, la prevalencia de dicha infección y los probables factores de riesgo en donantes del Banco Municipal de Sangre de Caracas (BMSC). MÉTODOS: Se evaluaron serológicamente mediante ensayos de inmunoadsorción enzimática (ELISA) 23 413 donantes atendidos entre julio del año 2000 y abril de 2001 en el BMSC. Las muestras repetidamente reactivas (RR) se estudiaron por inmunoblot de Western (WB), como prueba suplementaria. Los donantes positivos o indeterminados por WB fueron citados a la consejería para realizar la confirmación mediante la amplificación de ácidos nucleicos por reacción en cadena de la polimerasa (PCR), recoger datos sobre sus antecedentes de riesgo y asesorarlos acerca de su estado. RESULTADOS. El 0,2% de las donaciones resultaron RR; de ellas 52,1% resultaron positivas en el WB (23 a HTLV I y 2 a HTLV II); 4,1% indeterminadas por WB; 29,2% negativas; y el 14,6% no pudo ser evaluado. Asistieron a la consejería 16 donantes (14 WB positivos a HTLV I, 1 a HTLV II y 1 indeterminado). Todos resultaron positivos en la RCP. No se encontraron diferencias significativas con el grupo control en cuanto a edad, sexo, tipo de donación, número de donaciones previas, antecedentes de transfusiones y comportamiento sexual. Se observaron diferencias significativas según los antecedentes de consumo de drogas no intravenosas (P < 0,05), y altamente significativas (P < 0,001) según los antecedentes de lactancia materna larga. Las madres estudiadas de seis de los donantes positivos que manifestaron haber tenido una larga lactancia materna resultaron positivas, al igual que el hijo mayor de la única pareja positiva de las 13 evaluadas. CONCLUSIONES. Se descartó el 0,2% de la sangre por resultar positiva al HTLV I/II. La prevalencia entre los donantes fue de 0,11%. En el 37,5% de los casos se pudo determinar la probabilidad de transmisión de madre a hijo. La transmisión sexual resultó menos frecuente. Se debe considerar seriamente la implementación del tamizaje serológico del HTLV I/II en los donantes de sangre de Venezuela.

RESUMEN. El contexto actual, configura una tendencia de formación referida no sólo a los puestos de trabajos, sino también, a las características requeridas para la empleabilidad (las competencias). Los programas de formación deberían fomentar el desarrollo de competencias de análisis, reflexión, capacidad de innovar, resolver imprevistos, atender contingencias, entre otras. En este contexto, la presente investigación enuncia un concepto integrador, la "Competencia Clínica", que armoniza un grupo de atributos propios de los profesionales del área de la salud, respetando las características y campos de acción específicos para cada profesión. Se realizó una revisión bibliográfica del constructo competencia: sus orígenes, sus niveles, cambios sociales, económicos y educativos que le sirvieron de contexto, sus implicaciones curriculares y los procesos involucrados en el establecimiento de las mismas. Esto permitió, utilizando la metodología descrita por Cariola (1998), establecer el concepto y los niveles de la competencia clínica, aplicable en pre y post-grado.

ABSTRACT The actual context have a formation tendency related not only to a laboral position but to caracteristics required to get a job (competences). Programs of formation should be to promote the developmet of competences of analysis, reflection, innovation capability, problems resolutions, treat emergencies, into others. This paper state and integrate concept: clinic competence, wich it armonize a group of own atributes of health professionals, respecting. Caracteristics and own action fields for each profession. It was made a bibliografic revision of competence construct: origins, levels, social, economics and educatives changes wich make its context, curricular implications and process involved in its establishment. This allow, using Cariola (1998) metodology, establish the concept and levels of clinic competence, aplied to pre and postgrade studies.