Resumen Introducción: Una buena relación médico-paciente es crucial para la práctica médica. Un elemento fundamen tal de la misma es la empatía del médico tratante, y esta puede ser cuantificada mediante una escala validada llamada Escala de Empatía de Jefferson. Métodos: En este estudio buscamos correlacionar los valores de empatía de los médicos del servicio con los resultados de las encuestas de satisfacción del pa ciente ambulatorio, medido mediante una herramienta llamada HCAPS. Resultados: Encontramos que los pacientes percibían un mayor trato respetuoso y que se les explicaba mejor sus opciones de tratamiento por parte de los médicos con mayores niveles de empatía. No hubo diferencias en los niveles de empatía de los médicos según su edad, sexo, o tiempo desde la obtención del título de especialista. Discusión: Los resultados validan a la empatía como una habilidad clave dentro de la relación médico-paciente.

Abstract Introduction: A good doctor-patient relationship is crucial to medical practice. A fundamental element of it is the empathy of the treating physician, and it can be quantified by means of a validated scale called the Jefferson Empathy Scale. Methods: In this study we sought to correlate the empathy values of our physicians with the results of outpatient satisfaction surveys, measured using a tool called HCAPS. Results: We found that patients perceived greater respectful treatment and had their treatment options better explained to them by physicians with higher lev els of empathy. There were no differences in physicians’ empathy levels according to their age, gender, or time since qualifying as a specialist. Discussion: These results validate empathy as a key skill in the doctor-patient relationship.

Resumen Introducción: Existe creciente evidencia que el telemonitoreo (TM) de pacientes con insuficiencia cardíaca (IC) parece mejorar su evolución. No se han diseñado y evaluado plataformas de TM en Argentina. El objetivo fue evaluar la factibilidad, aceptabilidad, usabilidad y eficacia preliminar de una plataforma de TM de IC. Métodos: Se realizó un ensayo piloto apareado abierto, con un modelo de intervención de un solo grupo. Los pacientes con IC fueron incluidos en una consulta ambulatoria en enero de 2021. Se diseñó una pla taforma de TM las 24 h y 7 días de la semana. El punto final primario a 30 días fue la factibilidad, aceptabilidad y usabilidad. Resultados: Se incluyeron 20 pacientes, con una media de edad 62 ± 10 años. Se analizaron 542 cargas de parámetros. La autopercepción relacionada al estado de salud en comparación al inicio fue “levemente” o “marcadamente mejor” en el 60% de los pacientes, y en 75% “de acuerdo” o “totalmente de acuerdo” que el TM mejora el cuidado de la IC. En el 80% la carga diaria de parámetros no interfirió en su vida cotidiana. La media total de adherencia farmacológica previa a la intervención de TM fue de 6.8 ± 1.3 y posterior 7.7 ± 0,4 (p = 0.019), sin encontrar diferencias en las escalas de autocuidado. Conclusión: El TM de pacientes con IC parece ser factible, con un adecuado grado de aceptabilidad. Se observó un aumento significativo en la tasa de total adherencia, plantea una hipótesis de potencial beneficio a evaluar en una muestra mayor.

Abstract Introduction: There is growing evidence that telemonitoring (TM) in heart failure (HF) seems to improve their outcome. TM platforms have not been designed and evaluated in Argentina. The objective was to evaluate the feasibility, acceptability, usability and preliminary efficacy of a HF TM platform. Methods: An open-label, paired pilot trial was conducted with a single-group intervention model. HF patients were included in an outpatient clinic in January 2021. A 24-hour*7-day TM platform was designed. The primary endpoint at 30 days was feasibility, acceptability, and usability. Results: Twenty patients were included, mean age 62 ± 10 years; 542 parameter loads were analyzed. Self-perception related to health status compared to baseline was “slightly” or “markedly better” in 60% of patients, and in 75% “agree” or “totally agree” that TM improves patient care. In 80%, the load ing of parameters did not interfere with their daily activities. The total mean pharmacological adherence prior to the TM intervention was 6.8 ± 1.3 and 7.7 ± 0.4 afterward (p = 0.019), with no differences found in the self-care scales. Conclusion: The TM of patients with HF seems to be feasible, with an adequate degree of acceptability. A significant increase in the total adherence rate was reduced, raising a hypothesis of potential benefit to be evaluated in a larger sample.

Curcumin, a phytochemical, exhibits several biological properties and has been studied for the treatment of psoriasis. To facilitate its transdermal permeation, permeation enhancers such as choline and geranic acid ionic liquid (CAGE-IL) have been studied. From this perspective, the research effort entertained herein aimed at developing and evaluating the stability of an emulsion prepared with curcumin (phytochemical from Curcuma longa L.) and locust bean gum (extracted from the seeds of the carob tree, Ceratonia siliqua), with CAGE-IL as a facilitator of transdermal permeation. Stability studies were carried out for six months, with analyses being performed at time intervals of 0 (24 h), 30, 60, 90, and 180 days. The samples were kept at 40 ± 2 °C, with 75 ± 5% relative humidity (RH). The parameters analyzed were morphological characteristics, pH (5.8-6.0), and spreadability. The samples were shown to be stable during the timeframe studied, maintaining adequate physicochemical characteristics and meeting quality specifications for cutaneous applications. CAGE-IL, in addition to facilitating permeation of the active substance, also favored the formation of a stable emulsion encompassing nanosized particles (134.3 ± 2.6 nm) in a simple fashion and with only a few components.

We addressed some physicochemical and biological differences in commercial turmeric, acquired from both handling pharmacies and stores selling natural products for quality assessment. For this, it was determined the melting point, antioxidant activity by 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH), antimicrobial activity via the agar disk-diffusion assay, metallic contaminants by X-ray fluorescence with energy dispersion (EDXRF), spectral behaviors by Fourier transform infrared (FTIR) and ultraviolet-visible (UV-Vis) and determination of curcumin concentration by UV-Vis. The results obtained of the several commercial turmeric samples were not homogeneous, showing in fact significant differences regarding melting points, UV-Vis spectral scan profiles, and FTIR spectra, presenting toxic metals and quite low curcumin contents. This sheds light on the urge to implement adequate quality control in this type of raw material for human safe use of curcumin. Particularly, contamination with heavy metals, such as mercury, is a serious health problem, due to its high toxicity and accumulative power in the body.

Various beneficial biological activities have been reported for passion fruit (Passiflora edulis), grown in tropical and subtropical regions. However, no study has yet demonstrated its action against the Zika virus (ZIKV) infection. The present study aimed to investigate the anti-ZIKV of the ethanolic passion fruit seed extract (PFSE), from which, liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis allowed to putatively annotate the occurrence of piceatannol, astringin, scirpusin A, scirpusin B, isookanin-7-O-glucoside and naringenin-7-O-glucoside, two quadranguloside derivatives, tyrosine, and phenylalanine. PFSE is well tolerated by cell lines (Vero E6 and HTR-8/SVneo) and tissue explants from the human placenta. With 1- and 24-h treatments, PFSE consistently reduced the viral load and NS1 protein expression of the two strains of ZIKV (MR766 and PE243) in placental explants and cell lines. Thus, PFSE has a promising potential for developing anti-ZIKV treatments, protecting the placenta against infection caused by ZIKV, along with relevant antioxidant potential, represented by ferric reducing antioxidant power (FRAP) of 390.5 Trolox eq per g dry extract and half maximal inhibitory concentration (IC50) for 2,2-diphenyl-1-picrylhydrazyl radical (DPPH•) of 12.1 µg mL-1, and more than 90% protection from lipid peroxidation. Although further studies need to be conducted, PFSE treatment was safe and effective in trophoblast cells and placental explants, thus representing a promising class of all-accessible products based on the reuse of industrial by-products.

Resumen Objetivo: Determinar la circulación de poliovirus en tres municipios considerados como punto transitorio de migrantes en Colombia. Material y método: Se colectaron muestras de aguas residuales (n=36) de municipios fronterizos, seleccionados por mayor tránsito de migrantes regulares como irregulares, en el periodo comprendido entre el 2017-2019. Las muestras fueron concentradas y cultivadas siguiendo el algoritmo de vigilancia ambiental para la circulación de poliovirus de la Organización Mundial de la Salud (OMS). La identificación molecular se realizo mediante reacción en cadena de la polimerasa empleando cebadores específicos de grupo, de serotipo y de cepa vacunal sabin. Resultados y Discusión: Se detectó la presencia de Enterovirus no polio (EVNP) en las muestras ambientales obtenidas y no se hallo circulación de poliovirus deriva dos de la vacuna ni de poliovirus salvaje en los tres municipos evaluados; sin embargo en dos estudios previos publicados por Gonzalez y col con una metodologia similar en el año 2005 y 2015 evaluando las aguas residuales de la ciudad de Armenia-Quindio; se logró identificar la presencia de virus derivado de vacuna, con resultados negativos para la identificación de poliovirus salvaje. Conclusiones: Los hallazgos indican que el sistema de monitoreo de aguas residuales con el fin de determinar la presencia de virus es una herramienta util para realizar vigilancia ambiental.

Abstract Objective: To determine the circulation of poliovirus in three municipalities considered as transitory points for migrants in Colombia. Material and Method: Wastewater samples (n = 36) were collected from border municipalities, selected for greater transit of regular and irregular migrants, in the period between 2017-2019. The samples were concentrated and cultured following the World Health Organization (WHO) environmental surveillance algorithm for poliovirus circulation. Molecular identification was performed by polymerase chain reaction using group-specific, serotype and sabin vaccine strain primers. Results: The presence of non-polio Enterovirus (NPV) was detected in the environmental samples obtained and no circulation of poliovirus derived from the vaccine or wild poliovirus was found in the three evaluated municipalities; However, in two previous studies published by Gonzales et al with a similar methodology in 2005 and 2015 evaluating the wastewater of the city of Armenia-Quindío; It was possible to identify the presence of virus derived from vaccine, with negative results for the identification of wild poliovirus. Conclusions: The findings indicate that the wastewater monitoring system in order to determine the presence of viruses is a useful tool to carry out environmental surveillance.

Production of bacterial nanocellulose was pursued as a matrix system for the stabilization of human insulin. The biomembranes produced by Gluconacetobacter hansenii were washed with 2% aqueous sodium dodecylsulfate solution, rinsed with ultrapure water and immersed in 1 mol L-1 NaOH aqueous solution at 60 °C for 90 min until neutralization. For the insulin adsorption assays, the biomembranes were soaked in a buffered solution of human insulin until no protein could be detected in the supernatant. The membranes with adsorbed insulin were characterized via mechanical resistance (resilience, relaxation, perforation), Differential Scanning Calorimetry (DSC), Thermal Gravimetrical Analysis (TGA), Fourier Transform Infrared Spectrophotometry (FTIR), X-ray diffraction (XRD) and Field Emission Scanning Electron Microscopy (FESEM) analyses. The FESEM photomicrographs of the surface of the biomembranes showed a rugged surface without cracks. The biomembranes exhibited adequate mechanical characteristics. The infrared spectra indicated that the chemical aspect of the protein moiety was preserved during adsorption onto the BNC biomembranes. According to the XRD analyses, the biomembranes showed a generalized amorphous behavior. Thermal analyses indicated an adequate thermal stability for a pharmaceuticals product. Hence, an elastic and malleable biomembrane was produced, suitable for incorporation of human insulin, aiming at transdermal delivery.

Abstract: Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) separate papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.

Resumen: La ingestión de cáusticos representa un grave problema médico-social por las consecuencias devastadoras e irreversibles que puede producir en el tracto digestivo superior. En Iberoamérica no se han publicado datos fidedignos sobre la incidencia o la prevalencia de lesiones inducidas por cáusticos. La información disponible sobre la presentación clínica, diagnóstico, tratamiento y pronóstico se basa en series retrospectivas de casos y, de hecho, su manejo clínico se sustenta en muchos casos fundamentalmente en la opinión de expertos. Recientemente como una iniciativa de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (SLAGHNP) y con la co laboración de colegas de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediá trica (SEGHNP), hemos diseñado una Guía de Práctica Clínica (GPC) la cual incluye una serie de enunciados y recomendaciones dirigidos a optimizar la atención a los pacientes y que se basan en la revisión sistemática de la evidencia. En dos (2) manuscritos sucesivos nos hemos enfocado primero, en los aspectos fisiopatológicos y de diagnóstico clínico-endoscópico de la esofagitis cáustica en niños (1a. Parte) y en segundo lugar, en los aspectos más relevantes del tratamiento (2a. Parte). Esperamos esta guía se convierta en una herramienta útil para el clínico en el difícil proceso de toma de decisio nes a la hora de evaluar un paciente posterior a la ingesta de una sustancia cáustica.

Development and optimization of a bioorigami film with silk sericin was pursued for skin regeneration. Several formulations were produced, with varying integrated sericin contents, viz. 0, 1, 2, 5, 10, 20 and 50 mgsericin mLfilm-1. The physico-chemical characteristics of the bioorigami films produced were evaluated via infrared spectrophotometry, X-ray diffraction, X-ray transmission, X-ray fluorescence, thermogravimetry, differential scanning calorimetry, transdermal protein permeation, kinetics of protein release from the bioorigami films and free radical scavenging activities. The mechanical resistance was also evaluated. The results by 2,2-diphenyl-1-picryl-hydrazil (DPPH) assay suggest that the bioorigami films integrating crude sericin extract had capacity to sequester free radicals, exhibited prolonged release of the bioactive protein, good physico-chemical characteristics and adequate mechanical resistance. Specifically, the bioorigami film with 10 mgsericin mLfilm-1 proved to be able to release all the bioactive protein in a 12 h timeframe. The results suggest potential for use in biopharmaceutical application, specifically, as material for use in hydrogels.

Abstract: Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) successive papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.

Resumen: La ingestión de cáusticos representa un grave problema médico-social por las consecuencias devastadoras e irreversibles que puede producir en el tracto digestivo superior. En Iberoamérica no se han publicado datos fidedignos sobre la incidencia o la prevalencia de lesiones inducidas por cáusticos. La información disponible sobre la presentación clínica, diagnóstico, tratamiento y pronóstico se basa en series retrospectivas de casos y, de hecho, su manejo clínico se sustenta en muchos casos fundamentalmente en la opinión de expertos. Recientemente como una iniciativa de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (SLAGHNP) y con la co laboración de colegas de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediá trica (SEGHNP), hemos diseñado una Guía de Práctica Clínica (GPC) la cual incluye una serie de enunciados y recomendaciones dirigidos a optimizar la atención a los pacientes y que se basan en la revisión sistemática de la evidencia. En dos (2) manuscritos sucesivos nos hemos enfocado primero, en los aspectos fisiopatológicos y de diagnóstico clínico-endoscópico de la esofagitis cáustica en niños (1a. Parte) y en segundo lugar, en los aspectos más relevantes del tratamiento (2a. Parte). Esperamos esta guía se convierta en una herramienta útil para el clínico en el difícil proceso de toma de decisio nes a la hora de evaluar un paciente posterior a la ingesta de una sustancia cáustica.

Abstract Objectives: The physicochemical characteristics of bran of cassava starch flour and bran of cassava flour (viz. organoleptic characteristics, pH value, moisture content, total ashes, lipid, protein, starch and fiber contents) and biopharmacotechnical parameters (viz. granulometry, flow capacity, angle at rest, outflow time and apparent density) were evaluated aiming at assessing their potential use as tablet excipients. Methodos: Three tablet formulations of venlafaxine hydrochloride were proposed, having as excipients bran of cassava flour, bran of cassava starch flour and Starch 1500®. The tablets were produced using two different pressures (98±5 MPa and 32±6 Mpa) and their mechanical (hardness and friability) and dissolubility characteristics were evaluated. Results and Conclusions: The tablets produced with both cassava flours, using higher pressures, presented similar physicochemical characteristics to those obtained with the excipient Starch1500®, thus indicating that cassava flours possess the potential to be used as disintegrating agents in tablets.

Resumen Objetivos: Se evaluaron características físico-químicas del salvado de harina y del salvado de la fécula de mandioca (características organolépticas, pH, humedad, cenizas totales y contenido de lípidos, proteínas, almidones y fibras) y biofarmacotécnicas (granulometría, capacidad de flujo, ángulo en reposo, tiempo de salida y densidad aparente) con el objetivo de evaluar el uso de estos residuos como excipientes para comprimidos. Métodos: Se propusieron tres formulaciones en comprimidos de venlafaxina teniendo como excipientes salvado de harina de mandioca, salvado de fécula de mandioca y Starch 1500 ®. Las pastillas se produjeron utilizando dos presiones diferentes (98 ± 5 MPa y 32 ± 6 Mpa). Las características mecánicas (dureza y friabilidad) y de disolución de los comprimidos se evaluaron. Resultados y Conclusiones: Los comprimidos producidos con ambos salvados de mandioca, utilizando las presiones más elevadas, presentaron características físico-químicas similares a las obtenidas con el excipiente Starch1500®, indicando que las harinas de mandioca poseen potencial para ser utilizadas como agentes desintegrantes en comprimidos.

Chemotherapy treatment of leishmaniasis is based on the use of pentavalent antimonials, but these drugs present low efficacy and high toxicity. In the search for new antileishmanial agents, essential oils (EOs) from four Croton species (C. argyrophylloides, C. jacobinensis, C. nepetifolius and C. sincorensis) were evaluated against Leishmania infantum chagasi, L. amazonensis and L. braziliensis. EOs were analyzed by gas chromatography combined with mass spectrometry. Spathulenol, β-caryophyllene, β-caryophyllene oxide, 1,8-cineole and methyl eugenol were the major constituents. The evaluation of antioxidant activity by the 1,1-diphenyl-2-picryl-hydrazyl (DPPH) method showed that all EOs have moderate antioxidant activity. All oils were similarly active against L. i. chagasi, and C. nepetifolius EO showed the best result against L. amazonensis, with median inhibitory concentrations (IC50) of 9.87 μg mL-1, similar to amphotericin B (IC50 = 7.38 μg mL-1). The oils presented low cytotoxicity in macrophages. The in silico analysis revealed that spathulenol and 1,8-cineole were active against the enzyme Leishmania infantum trypanothione reductase (LiTR), showing excellent interaction energies, making them promising agents for leishmaniasis control.

Over the last few years, researchers have started to explore a particular class of compounds defined as ionic liquids (ILs) in attempts to use their unique characteristics. Since ILs have a very low vapor pressure, these fascinating compounds hold great potential as high performance chemicals for several applications in the (bio)pharmaceutical industry. In general, and unlike common organic solvents with comparable polarities, ILs are quite compatible with enzymes (enhancing their structural and chemical stability) and other proteins, since they can promote higher selectivities, faster reaction rates and greater enzyme stabilities in biocatalytic reactions providing, at the same time, a path for the structural and functional stabilization of protein entities. ILs appear to enhance the delivery of macromolecules, particularly protein entities, and their interactions with ILs will be tackled in detail in this review paper.

In the present research effort, production of a crude anthocyanin extract from the fruits of jussara (Euterpe edulis Martius) was pursued. The physico-chemical characteristics of the crude anthocyanin extracts were evaluated via Fourier transform infrared spectrophotometry, X-ray diffraction, X-ray fluorescence, computed tomography via X-ray transmission, UV-Vis spectrophotometric scannings, differential scanning calorimetry, antimicrobial activity, anthocyanin quantification, total phenolic content, thin layer chromatography for sugars and pigments, free radical 2,2-diphenyl-1-picryl-hydrazil (DPPH) scavenging activity and antioxidant activity via the molybdenum phosphate complex. The results gathered suggest that the crude anthocyanin extracts had both obvious antioxidant activity and radical scavenging effects with the DPPH assay, and light antibacterial activity against Staphylococcus aureus, further suggesting that this crude pigment extract might be a valuable addition for either food or pharmaceutical applications.

Abstract Casearborin c (1), syringic acid (2), ent-3β-hydroxy-(-)-13-epi-manoyl oxide (3), ent-(-)-13-epi-manoyl oxide (4), ent-(-)-kaur-16-en-19-oic acid (5), and γ-sitosterol (6) were isolated from Casearia corymbosa stem bark. Only casearborin c showed cytotoxic activity on HeLa and SiHa cancer cell lines. This work contributes to the description of three compounds (1-3) newly isolated from C. corymbosa and highlights that casearborin c, a clerodane-type diterpene, is responsible for the cytotoxic activity shown in the original methanol extract of this species.

Resumen Casearborina c (1), ácido siríngico (2), óxido de ent-3β-hidroxi-(-)-13-epi-manoilo (3), óxido de ent-(-)-13-epi-manoilo (4), ácido ent-(-)-kaur-16-en-19-oico (5) y γ-sitosterol (6) se aislaron de la corteza del tallo de Casearia corymbosa. Sólo casearborina c mostró actividad citotóxica en las líneas de células cancerígenas HeLa y SiHa. Este trabajo describe tres compuestos (1-3) aislados por primera vez de C. corymbosa y destaca que casearborina c, un diterpeno de tipo clerodano, es responsable de la actividad citotóxica del extracto metanólico de esta especie.