RESUMO Objetivo Avaliar a confiabilidade inter-examinador e a validade preditiva do Índice de Atividades de Frenchay (FAI) em pacientes após acidente vascular cerebral. Métodos 161 pacientes foram selecionados para aplicação consecutiva da FAI e NIH Stroke Scale (NIHSS). O teste de Spearman foi utilizado para correlação entre as diferentes escalas. A associação FAI e NIHSS foi avaliada por meio de regressão logística ordinal. Adicionalmente, 36 pacientes foram submetidos à aplicação do FAI por dois avaliadores independentes, no mesmo dia. Resultados Foi encontrada uma correlação negativa entre o FAI e o NIHSS (r = -0,22; p = 0,017). Ajustando todas as variáveis com possível associação com NIHSS, a regressão logística ordinal demonstrou que o FAI tem associação significativa com o NIHSS (OR 0,93, 95% CI 0,87-0,99, p: 0,033). A concordância entre avaliadores foi considerada boa, k = 0,66 (0,54-0,78), p < 0,001. Conclusões FAI é um método válido e útil para avaliar atividades instrumentais antes de AVC agudo em uma população brasileira.

ABSTRACT Purpose To evaluate the inter-rater reliability and predictive validity of the Frenchay Activities Index (FAI) in patients after stroke. Methods One hundred sixty-one patients were selected for consecutive application of the FAI and National Institutes of Health Stroke Scale (NIHSS). Spearman’s test was used for correlation between different scales. The FAI and NIHSS association was evaluated using ordinal logistic regression. Additionally, 36 patients underwent FAI rating on the same day by two independent evaluators. Results A negative correlation between the FAI and the NIHSS scores (p = 0.017 r = -0.22) was found. Adjusting all variables with possible association with the NIHSS, ordinal logistic regression showed that the FAI had a significant association with NIHSS scores (OR 0.93, 95% CI 0.87 to 0.99, p: 0.033). The inter-rater agreement was considered good, k = 0.66 (0.54 to 0.78), p < 0.001. Conclusions The FAI is a valid and useful method to assess instrumental activities before acute stroke in a Brazilian population.

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia with extremely high insulin levels and the presence of circulating autoantibodies against insulin, in patients who have never been exposed to exogenous insulin. We report two patients with the syndrome. A 36 years old male presenting with hypoglycemia in the emergency room had an oral glucose tolerance test showed basal and 120 min glucose levels of 88 and 185 mg/dl. The basal and 120 min insulin levels were 2,759 and 5,942 μUI/ml. The presence of an insulin secreting tumor was discarded. Anti-insulin antibodies were positive. He was successfully treated with a diet restricted in carbohydrates and frequent meals in small quantities. A 65 years old female presenting with hypoglycemia in the emergency room had the fasting insulin levels of 1,910 µUI/ml. No insulin secreting tumor was detected by images and anti-insulin antibodies were positive. The polyethylene glycol precipitation test showed a basal and after exposition insulin level 1,483 and 114 µUI/ml, respectively. She responded partially to diet and acarbose and required the use of prednisone with a good clinical response.

La selección genética en aves de corral se ha basado en caracteres para crecimiento rápido y no para la adaptabilidad a condiciones estresantes. En esta investigación, se evaluaron variables ambientales y cardiovasculares de dos estirpes de Gallus gallus domesticus con diferentes niveles de domesticación, sometidas a condiciones de estrés calórico agudo. Para la realización del experimento, se utilizaron pollos de engorde comerciales con alto nivel de selección genética (n=40) y pollos criollos (n=40) con bajo nivel de selección. Todos los pollos se criaron bajo las mismas condiciones hasta el día 36 de edad, día en que se evaluó: temperatura ambiental, humedad relativa, temperatura corporal, frecuencia cardiaca, volumen sistólico y gasto cardiaco. El día 37, ambos grupos de animales fueron expuestos a una simulación de estrés calórico agudo (34°C), midiéndose las variables antes mencionadas. Los datos fueron analizados como medidas repetidas (PROC MIXED de SAS, 2005), bajo un diseño de bloques. El día 37, las temperaturas corporales de los pollos comerciales (46,1±0,2°C) fue significativamente mayor (P £ 0,01) que las de los criollos (43,5±0,9°C). El incremento en la frecuencia cardiaca (38±1 lat/min) de los pollos comerciales fue mayor (P ≤0,01), en contraste con la de los pollos criollos (23±0 lat/min), cuando comparamos con el día anterior. De igual modo, cuando se hace la comparación con respecto al día anterior (día 36), el volumen sistólico (0,33±0,03 mL/lat) y el gasto cardiaco (38,50±3,3 ml/min) y disminuyeron (P>0,05) en los pollos comerciales; en contraste, estas variables (volumen sistólico: 0,09±0,00 mL/lat; gasto cardiaco: 59,10±4,8 mL/ min) aumentaron en los criollos. La relación gasto cardiaco sobre peso vivo fue mayor (P≤0,01) en los pollos criollos (0,81±0,03 mL/min/g) con respecto a los comerciales (0,40±0,07 mL/min/g). Estos hallazgos sugieren que el desempeño cardiaco de la estirpe comercial fue menos eficiente, en relación al desempeño cardiaco de la estirpe criolla, frente al estrés calórico, en comparación con los pollos criollos y que estos últimos se encuentran mejor adaptados para hacer frente a situaciones de estrés calórico ambiental.

Genetic selection in poultry has been based on fast growth characters and not on stress adaptability. This investigation assessed cardiovascular variables in two lineages of Gallus gallus domesticus of different domestication levels, subjected to acute heat stress. To carry out the assay, broiler chickens (n=40) with a high-end level of genetic selection and creole chickens (n=40) with a low-end level of genetic selection were evaluated. All chickens were reared under the same conditions until day 36 of age, at which day, the following variables were measured: environmental temperature, relative humidity, body temperature, heart rate, systolic volumen, and cardiac output. On day 37, both flocks were exposed to an acute environmental heat stress simulation (34 ºC). Data were analyzed with repetitive measures test (PROC MIXED, SAS, 2005), with a two-way arrangement. During the heat stress simulation, body temperature of broilers (46.1±0.2°C) was higher (P≤0,01) than that of creole chickens (43.5±0.9°C); likewise, the increase in broilers heart rate (38±1 beats/min) was higher (P≤0,01), when compared to the increase in creole chickens (23±0 beats/min) from the day before. Similarly, a lower (P>0,05) systolic volume (0.33±0.03 mL/beats) and cardiac output (38.5±3.3 mL/min) was registered in broilers in contrast to an increment of these variables (systolic volume: 0.09±0.00 mL/beats; cardiac output: 59.10±4.8 mL/min) in creoles. Cardiac output to body weight ratio was higher (P≤0,01) in creole chickens (0.81±0.03 mL/min/g) in comparison to broilers (0.40 ± 0.07 mL/min/g). These results suggest that chickens from a commercial lineage (broilers) were less effective in terms of cardiac performance, under environmental heat stress, when compared to creole chickens, suggesting that creole chickens are better adapted to cope with environmental heat stress.

Resumo Comparar a espessura muscular (EM), qualidade muscular (QM), e a funcionalidade entre dois grupos de mulheres idosas. Vinte e sete mulheres idosas (entre 60 e 80 anos) fisicamente ativas foram divididas em dois grupos: Grupo Old (n=15, 60-66 anos) e grupo Older (n=12, 73-80 anos). O pico de torque (PT) isométrico dos extensores de joelho foi obtido por contração isométrica voluntária máxima (CIVM), e seu valor foi normalizado pela EM. A espessura muscular do quadríceps femoral (EMQ) foi definida como o somatório da espessura muscular de todas as porções do quadríceps, e a qualidade muscular foi estimada pela média da Eco Intensidade do quadríceps femoral (EIQ). O grupo Old apresentou maiores valores absolutos de PT (120,3±24,8 N.m) comparado ao grupo Older (99,2±20,9 N.m) (p<0,05), entretanto os valores relativizados por espessura muscular não apresentaram diferenças entre grupos (p≥0,05). A EIQ foi maior no grupo Old (97,1±17,3 u.a.) quando comparado ao grupo Older (80,2±14,9 u.a.) (p<0,05). Não houve diferença significante na EMQ entre os grupos (p≥0,05). O grupo Old realizou um número maior de repetições no teste 30-sit-to-stand (30SS) (14,1±2,3 repetições) comparado ao grupo Older (11,2±1,9 repetições) (p<0,05). O grupo Old realizou um maior número de repetições no teste 30SS quando comparado ao grupo Older, embora ambos os grupos tenham apresentado valores semelhantes de EMQ. A EIQ foi maior no grupo Older, o que sugere que a eco intensidade parece ser uma variável melhor preditora da capacidade funcional do que a massa muscular em mulheres idosas ativa.

Abstract The aim of this study was to compare the muscle thickness (MT), muscle quality (MQ), and functionality of two different age groups of active elderly women. Twenty seven older women (between 60 and 80 years old), physically active was dividing in two age groups: old 60-66 years (Old) and old 73-80 years (Older) volunteered for the present study. Knee extension isometric peak torque (PT) was obtained during a muscle isometric voluntary contraction (MIVC), and the value was normalized by MT. The Quadriceps Echo Intensity (QEI) was defined as the mean Echo Intensity (EI) value founded in all quadriceps muscle portions in ultrasound imaging. Was found MIVC increased (p=0.024) in the O1 (120.26±24.77 N/m) group when compared with the O2 (99.25±20.95 N/m) group, but when the MIVC was normalized the difference did not exist between groups (p≥0.05). The QEI was found increased in the Older group (97.10±17.35 a.u.) when compared with the Old group (80.18±14.95 a.u.) (p<0.05). Contrary to that, the QMT did not differ significantly between the groups (p≥0.05). The Old group presented a significant higher number of repetitions in the 30SS (14.13±2.29 repetitions) when compared to Older group (11.25±1.95 repetitions) (p<0.05). We observed that even without significantly greater muscle size, the Old group presented the results of 30SS significantly greater when compared with the older group. Besides that, the QEI was found increased in the older group and suggests that EI may be the best predictor of functional capacity than muscle quantity in active older woman.

A cultura da mandioquinha-salsa constitui-se em ótima alternativa para pequenos e médios produtores, especialmente dentro dos conceitos de agricultura familiar. O objetivo deste trabalho foi conhecer a produtividade agroeconômica da mandioquinha-salsa cultivada com dois espaçamentos entre plantas (20 e 25 cm) e formas de adição de massa seca de cama de frango ao solo [cobertura (10 t ha-1), incorporada (10 t ha-1), cobertura (5 t ha-1) + incorporada (5 t ha-1) e sem cama de frango (0 t ha-1)], realizando duas colheitas independentes em diferentes estágios de maturação, 50% e 70% de senescência, que ocorreram respectivamente aos 224 e 249 dias após o plantio (DAP). As características avaliadas não foram influenciadas significativamente pela interação espaçamentos entre plantas e formas de adição de cama de frango, mas foram influenciadas pelas formas isoladas. As maiores massas de matérias frescas de folhas, coroas e os rebentos foram obtidos com o espaçamento de 25 cm entre plantas, nas duas colheitas. Aos 50% de senescência os aumentos foram de 27% (folhas), 28% (coroas) e 37% (rebentos) e aos 249 DAP foram de 25% (folhas), 13% (coroas), 18% (rebentos) e 22% (raízes comerciais) em relação a 20 cm entre plantas. Aos 70% de senescência as melhores produções de raízes comerciais foram com a cama de frango incorporada e em cobertura + incorporada, que superaram em 10,27 t ha-1 e 7,29 t ha-1, respectivamente, sem a cama de frango. Para serem obtidas maiores produtividades de raízes comerciais, o cultivo em canteiros da mandioquinha-salsa 'Amarela de Carandaí' deve ser feito com espaçamento de 25 cm entre plantas e com a adição ao solo de cama de frango na forma incorporada, realizando a colheita com 70% de senescência da parte foliar aos 249 DAP.

Peruvian carrots is an excellent alternative for small and medium farmers, especially within the concepts of family farming. Thus the aim of this study was to evaluate the agricultural economic yield of this crop when managed under two plant spacing arrangements (20 and 25 cm between plants) and different application methods of dried broiler manure on the soil [surface-applied (10 t ha-1); incorporated to the soil (10 t ha-1); surface applied (5 t ha-1) + incorporated (5 t ha-1)]. Two harvests were performed in different stages of maturation, when plants presented 50% and 70% senescence, at 224 and 249 days after planting (DAP), respectively. The characteristics evaluated were not significantly influenced by the interaction between the plant spacing arrangements and the methods of broiler manure addition, although they were influenced by isolated studied factors. Greater fresh weights of leaves, crown and shoots were obtained under 25 cm plant spacing arrangement in both harvests: there were increases of 27% (leaves), 28% (crowns) and 37% (shoots) for 50% senescence; and 25% (leaves), 13% (crowns), 18% (shoots) and 22% (commercial roots) for 70% senescence, when compared to those obtained under 20 cm. With 70% senescence, the greatest yields of commercial roots were attained when the addition of broiler manure was incorporated on the soil or surface applied + incorporated, outgrowing 10.27 ton ha-1 and 7.29 ton ha-1, respectively, in comparison with those produced without manure. Thereby, to achieve greatest yield of commercial roots and higher net income, the Peruvian carrot crops should follow spacing of 25 cm between plants, with broiler manure incorporated to the soil, as well harvests performed when plants reach 70% senescence, at 249 DAP.

The aim of the study was to determine the frequency of antibiotic residues in milk from cows that had clinical mastitis and returned to production after completion of the 3- day period of discarded milk post treatment. Milk samples were collected from 60 cows that received treatment for mastitis with betalactamic antibiotics. Samples were analyzed by the inmunoenzimatic test SNAP (Betalactam), which indicates presence of betalactamic antibiotics residues in milk. Results showed that 45.0% (27/60) were positive to betalactamic antibiotics residues. Also, 56.0% (14/25), 26.7% (4/15), and 45% (9/20) of samples from animals treated with penicillin and streptomycin, kanamycin and penicillin, and amoxicillin and clavulanic acid respectively had antibiotic residues. In addition, 50.0% (14/28) of the animals treated by the intramuscular route and 40.6% (13/32) by the intramammary route were positive; whereas 46.7% (7/15), 57.1% (12/21), and 33.3% (8/24) of cows with low, medium, and high production cows, respectively, were positive to the test. However, no statistical association between type of antibiotic used, via of administration and level of production with presence of antibiotic residues was found.

El presente estudio tuvo por objetivo determinar la frecuencia de residuos de antibióticos en leche de vacas luego del periodo de descarte (tres días) de leche por tratamiento contra la mastitis con antibióticos betalactámicos. Muestras de leche de 60 vacas se analizaron mediante la prueba inmunoenzimática SNAP (Betalactam), que indica la presencia de antibióticos betalactámicos en leche. El 45.0% (27/60) resultó positivo a residuos de antibióticos. En relación al tipo de antibiótico utilizado, el 56.0% (14/25), 26.7% (4/15) y 45.0% (9/20) de las muestras de animales tratados con la asociación penicilina y estreptomicina, kanamicina y penicilina, y amoxicilina y ácido clavulónico, respectivamente, fue positiva a la prueba. Asimismo, el 50.0% (14/28) de los animales tratados por vía intramuscular y 40.6% (13/32) por vía intramamaria fueron positivos; y el 46.7%(7/15), 57.1% (12/21) y 33.3% (8/24) de las vacas de baja, media y alta producción, respectivamente, fue positiva a la prueba; aunque sin que hubiera una asociación estadística entre el tipo de antibiótico, vía de administración, y nivel de producción con la presencia de residuos de antibióticos.

O objetivo deste estudo foi comparar a força isométrica máxima (FIM) e a atividade elétrica dos músculos vasto medial (VM), vasto lateral (VL), reto femoral (RF), glúteo máximo (GM) e bíceps femoral (BF) entre contrações isométricas voluntárias máximas (CIVM) executadas em diferentes posições articulares e identificar as mais adequadas para normalizar o sinal de eletromiografia (EMG) de cada um dos músculos referidos, quando estes são ativados em condições dinâmicas. A amostra foi constituída de 10 indivíduos do sexo masculino, com idades entre 20 e 30 anos, familiarizados com treinamento de força. Foram realizadas CIVMs em diferentes ângulos articulares para os grupos extensores e flexores do joelho (0°, 60°, 90°) e extensores (-30°, 0°, 60°) e flexores do quadril (90°, 120°). Sobre a FIM foram encontrados valores significativamente diferentes entre as posições em 60° para flexão de joelhos e para extensão de joelhos em 60° e 90° (p<0,01) e não houve diferenças significativas entre as posições na flexão e extensão do quadril (p>0,05). Em relação ao sinal EMG, foram encontrados valores significativamente diferentes entre os ângulos para a extensão de joelhos somente no RF em 90° (p<0,01). Para a flexão de joelhos, flexão e extensão de quadril não foram encontradas diferenças siginificativas entre os músculos nos diferentes ângulos avaliados (p>0,05). Estes resultados sugerem que a posição de 60° é a mais adequada para avaliação dos flexores e extensores do joelho e que todas posições testadas neste estudo apresentam-se como adequadas para a avaliação da flexão e extensão de quadril.

The aim of this study was to compare maximal isometric force (MIF) and the electrical activity of the vastus medialis, vastus lateralis, rectus femoris, gluteus maximus and biceps femoris long head muscles between maximal voluntary contractions (MVC) performed at different joint angles, and to identify the most suitable positions to normalize the electromyography (EMG) signals from each of these muscles when they are activated under dynamic conditions. Ten men ranging in age from 20 to 30 years, who were familiar with strength training exercise, were studied. MVC at different joint angles of the knee extensors and flexors (0°, 60°, 90°) and hip extensors (-30°, 0°, 60°) and flexors (90°, 120°) were tested. The MIF values differed significantly between the 60° knee flexion and 60° and 90° knee extension positions (p<0.01). The same was not observed for hip flexion or extension (p>0.05). Significantly higher EMG values were only observed for the rectus femoris muscle at 90° knee extension (p<0.01). No differences between muscles were found for knee flexion, hip flexion or hip extension at the joint angles tested (p>0.05). These results suggest that the 60° knee joint flexion position is the most suitable for assessment of knee extension and flexion MIF, and that all positions tested in this study are suitable for the assessment of hip flexion and extension.

The objective of the study was to determine the frequency of bacterial otitis cases in dogs, the bacteria involved in the infection and the bacterial susceptibility to antibiotics in samples processed during 2001-2006 in a bacteriology laboratory specialized in the veterinary field. A total of 429 laboratory records were used. The most frequent isolated bacteria was Staphylococcus intermedius (27.7%), but other important species were also found (Pseudomonas aeruginosa, Streptococcus sp. and Staphylococcus sp). Ear infections were mostly due to a single bacteria species (63.6%). In susceptibility test using the Kirby-Bauer method the quinolones, aminoglycosides, cephalosporins, and penicillins combined with inhibitors of betalactamics showed better antimicrobial effect, while bacteria species showed high resistance to penicillin, sulpha, tetracyclines, macrolides and lincosamides.

El objetivo de este estudio fue determinar la frecuencia de casos de otitis bacteriana en canes, las bacterias involucradas y su susceptibilidad a los antibacterianos, en base a muestras procesadas en un laboratorio de microbiología especializado en el campo veterinario en el periodo 2001-2006. Se emplearon 429 fichas de laboratorio. La bacteria de mayor frecuencia fue el Staphylococcus intermedius (27.7%), pero hubo otros agentes de importancia como Pseudomonas aeruginosa, Streptococcus sp. y Staphylococcus sp. Las infecciones óticas fueron mayormente monomicrobianas (63.6%). En las pruebas de susceptibilidad por el método de Kirby-Bauer se encontró el mayor nivel de susceptibilidad de las bacterias a las quinolonas, aminoglucósidos, cefalosporinas y penicilinas combinadas con inhibidores de las betalactamasas; mientras que las penicilinas, sulfas, tetraciclinas, lincosamidas y macrólidos fueron los antimicrobianos de menor efectividad.

Os objetivos do presente estudo foram: a) observar se há diferença entre os valores de espessura muscular (EM) medidos por ultrassonografia e qualidade muscular (QM) de três diferentes pontos nos músculos flexores de cotovelo e extensores de joelho, b) analisar a correlação das medidas de EM e força isométrica de flexão de cotovelo e extensão de joelho. Sessenta e nove sujeitos homens, fisicamente ativos, participaram do estudo. Os valores de produção de força isométrica de flexão de cotovelo e extensão de joelho foram obtidos nos ângulos de 90° e 60°, respectivamente. A medida de EM foi realizada em três pontos nos flexores de cotovelo (proximal - BB1, médio - BB2, e distal - BB3) e extensores de joelho (proximal - RI1, medial - RI2, e distal - RI3). As diferenças entre as três medidas de EM e QM foram avaliadas por meio da one-way ANOVA para medidas repetidas, e a correlação entre EM e produção de força foi testada utilizando correlação de Pearson. O nível de significância utilizado foi de p<0,05. A EM e a QM diferiram estatisticamente nos três pontos de medidas, tanto nos flexores do cotovelo quanto nos extensores do joelho (p<0,001). As correlações entre as medidas de EM dos flexores de cotovelo nos pontos BB1, BB2 e BB3 e a produção de força isométrica foram r=0,57, r=0,52 e r=0,59 (p<0,05), respectivamente. Já nos extensores de joelho, estas foram de r=0,47, r=0,51 e r=0,53 (p<0,01), nos pontos RI1, RI2, e RI3, respectivamente. Os resultados do presente estudo demonstraram que o ponto de medida exerce influência significativa na EM e QM. Os valores de EM relacionam-se com os de produção de força isométrica dos flexores de cotovelo e extensores de joelho.

The aims of this study were: a) to investigate differences in muscle thickness (MT) measured by ultrasound and muscle quality (MQ) at three sites in the elbow flexors and knee extensors, and b) to correlate MT with isometric force production of the elbow flexors and knee extensors. Sixty-nine young male subjects participated in this study. The isometric force production values of the elbow flexors and knee extensors were obtained at 90° and 60°, respectively. MT was assessed at three sites in the elbow flexors (proximal - BB1, middle - BB2, and distal - BB3) and knee extensors (proximal - RI1, middle - RI2, and distal - RI3). Differences between the three measurements of MT and MQ were evaluated by one-way repeated measures ANOVA. Pearson's correlation test was used to assess the correlation between MT and isometric force. The level of significance was set at p<0.05. The results showed significant differences (p<0.001) between the three MT and MQ sites in the elbow flexors (BB1, BB2, BB3) and in the knee extensors (RI1, RI2, RI3). The correlation between BB1, BB2 and BB3 and force production was r=0.57, r=0.52 and r=0.59, respectively (p<0.05). In the knee extensors, the correlation between RI1, RI2 and RI3 and force production was r=0.47, r=0.51 and r=0.53, respectively (p<0.01). There were significant differences in MQ between elbow flexors (p<0.001) and knee extensors (p<0.001The present results showed that the site of measurement has a significant influence on MT and MQ. Furthermore, MT was positively correlated with isometric force production in the elbow flexors and knee extensors.

Objectives: To socialize and discuss recent investigations on the current status of family planning services and their relationship with maternal mortality figures in order to reach consensus on a guide proposed for use in the public sector. Methods: Three Regional Forums were organized with participation of a group of experts at national level and a group of experts at each of the three regions involved in the intervention (Arequipa, Piura y Ucayali). Consensus on thematic content and event development methodology was obtained. Contents centered on: Sexual and Reproductive Rights review, ENDES 2010 Survey results, maternal mortality figures recently processed by the Epidemiology General Direction of the Ministry of Health, evaluation of maternal mortality, family planning and Compromise Round Table for Fighting Poverty at regional level. Contents were exposed by experts followed by a space for questions, answers, opinions, comments and criticism, contributions and proposals. Results: There was ample participation of representatives of various institutions that led to acknowledging evident advances in sexual and reproductive health, particularly in prenatal care, institutional delivery care and other obstetrical interventions that have permitted Maternal Death Rate reduction in the last 10 years. Nevertheless there are gaps to get over in obstetrical care in vulnerable groups and in family planning activities as fecundity has not decreased according to women’s wish, adolescent girls continue getting pregnant at high figures, there is an important number of unwanted pregnancies and as a result unsafe abortion figures are alarming. Conclusions: By strengthening family planning activities we should fulfill millennium goals referred to sexual and reproductive health services access without discrimination thus reducing even more maternal mortality rates.

Objetivos: Socializar y discutir las investigaciones recientes sobre el estado actual de los servicios de planificación familiar y su relación con las cifras de mortalidad materna a fin de consensuar una propuesta guía para su uso en el sector público. Metodología: Se convocó tres Foros Regionales con la participación de un grupo de expertos a nivel nacional y un grupo de expertos a nivel de cada una de las tres regiones involucradas en la intervención (Arequipa, Piura y Ucayali). Se consensuó el contenido temático y la metodología a seguir en el desarrollo del evento. Los contenidos se centraron en: una revisión de los Derechos Sexuales y Reproductivos, los resultados de la Encuesta ENDES 2010, las cifras de mortalidad materna recientemente procesadas por la Dirección General de Epidemiología del Ministerio de Salud, la evaluación de la mortalidad materna, la planificación familiar y de la Mesa de Concertación para la Lucha Contra la Pobreza a nivel regional. Cada uno de estos contenidos fue expuesto por los expertos y después se abrió un espacio para preguntas, respuestas, opiniones, comentarios y críticas, luego de las cuales se sucedieron aportes y propuestas. Resultados: Hubo una amplia participación de los representantes de muchas instituciones luego de lo cual se pudo obtener que existen evidentes avances en lo referente a salud sexual y reproductiva, particularmente en la atención prenatal, atención institucional del parto y otras intervenciones obstétricas que han permitido reducir la Razón de Muerte Materna en los últimos 10 años; sin embargo existen brechas a superar en la atención obstétrica entre los grupos vulnerables y en las actividades de planificación familiar, dado que la fecundidad no ha bajado según el deseo de las mujeres, las adolescentes se siguen embarazando en cifras altas, hay un número importante de embarazos no deseados y como consecuencia las cifras de aborto inseguro son alarmantes. Conclusión: Si se produce un fortalecimiento de las actividades de planificación familiar podemos cumplir con las metas del milenio en relación al acceso a los servicios de salud sexual y reproductiva, sin discriminación y reducir aún más la razón de mortalidad materna.

Introducción: En Colombia se desconoce la magnitud del impacto económico de la depresión. Objetivo: Determinar los costos directos del tratamiento hospitalario de la depresión en pacientes con trastornos depresivos de ambos géneros entre los 18 y 65 años de edad. Método: Estudio de costos directos de la enfermedad, a partir de datos consignados en 279 historias clínicas de pacientes hospitalizados por depresión en ocho instituciones de seis ciudades colombianas entre 2007-2008. Se obtuvieron medias o medianas para datos continuos y proporciones para datos categóricos, con sus respectivas medidas de dispersión. Resultados: El costo total promedio de la hospitalización por depresión se encontró en 1.680.000 pesos. La estancia representa el 74,1% del costo de la hospitalización. El costo promedio por día es 150.000 pesos. Bajo condiciones de acceso a los servicios de salud mental restringidas, el costo total directo de hospitalización por depresión severa o moderada está alrededor de 54.000 millones, en la seis ciudades, y en el país, 162.000 millones de pesos. Bajo condiciones de acceso observadas en el ámbito internacional, el costo total es de 134.000 millones de pesos en las seis ciudades y 399.000 millones en el país. Conclusiones: El presente estudio se constituye en un punto de partida hacia la cuantificación de la carga económica de la depresión en Colombia, concretamente en términos de los recursos monetarios destinados al manejo de la enfermedad en hospitales. Los hallazgos deben ser complementados con información sobre otros costos directos e indirectos de la depresión en la población adulta de Colombia.

Introduction: The magnitude of the economic burden of depression in Colombia is unknown. Objective: To determine the direct costs of hospitalary management of male and female patients with depressive disorders aged 18 to 65. Methods: Study of the costs of the illness, using data from 279 clinical records of patients hospitalized with a diagnosis of depression, in 2007-2008, in eight institutions of six cities in Colombia. Means or medians were estimated for continuous data and proportions for categorical data, along with dispersion measures. Results: The total average cost of hospitalization was 1,68 million Colombian pesos. Hospital stay represents 74.1% of the total cost of hospitalization. The average daily cost was 150,000 pesos. Under restricted access conditions the total direct cost of hospitalization for moderate to severe depression was estimated to be around 54,000 million pesos in the six cities included in the study, and 162,000 million pesos at the national level. Under the access conditions observed at the international level, the cost is 134,000 million pesos in the six cities and 399.000 million at the national level. Conclusions: This study is a starting point towards the quantification of the economic burden of depression in Colombia. Specifically, it provides information about the monetary resources used for depression management at the hospital level. These findings need to be complemented with information about other direct and indirect costs related to depression in the adult population of Colombia.

The present study evaluated the persistence of passive immunity in piglets from seropositive sows to Actinobacillus pleuropneumoniae from weaning to the end of the growing phase in a commercial farm in Ica, Peru. Blood samples were collected from 30 piglets at 17, 42, and 73 days of age, which corresponded to weaning, and to mid and final period or the growing phase respectively. Serum was analyzed by an indirect ELISA test that detects antibodies against the ApxIV toxin. All piglets were positive to the presence of maternal antibodies at day 17 of age, whereas 56.7 and 46.7% were positive at 42 and 73 days of age respectively. There was statistical difference between levels of antibodies at days 17 and 42, and 17 and 73 (p<0.05), but not between days 42 and 73. The level of antibodies was low at the end of the growing phase.

En el presente estudio se, observó la persistencia de la inmunidad pasiva en porcinos procedentes de madres seropositivas a Actinobacillus pleuropneumoniae desde el destete hasta el final del periodo de recría en una granja tecnificada de Ica. Se colectó una muestra de sangre a 30 lechones a los 17, 42 y 73 días de edad, correspondientes al destete, y mitad y final del periodo de recría, respectivamente. El suero se analizó con una prueba de ELISA indirecta que detecta anticuerpos contra la toxina ApxIV. Todos los lechones fueron positivos a la presencia de anticuerpos maternales en el día 17 de edad, en tanto que el 56.7 y el 46.7% de los lechones resultaron positivos a los 42 y 73 días de edad, respectivamente. Existió diferencia estadística entre las medias de los niveles de anticuerpos para los días 17 y 42, y 17 y 73 (p<0.05), pero no hubo entre los días 42 y 73. El nivel de anticuerpos fue bajo al final de la etapa de recría.

The objective of the study was to determine the frequency of antibodies against the ApxIV toxin of Actinobacillus pleuropneumoniae, causal agent of porcine pleuropneumonia in 10 commercial pig farms of Arequipa, Lima, Ica and La Libertad departments. Blood samples were collected from animals in the growing and finishing stages (30 per farm) and analyzed by the indirect ELISA test using a commercial kit. The results showed that 23.7% (71/300) of the animals presented antibodies against the ApxIV toxin, and the highest frequency was found in the farm located in Ica (60%). The presence of antibodies against the ApxIV toxin indicated the presence of A. pleuropneumoniae infection in pig commercial farms in Peru.

El objetivo del estudio fue determinar la frecuencia de anticuerpos contra la toxina ApxIV de Actinobacillus pleuropneumoniae, causante de pleuroneumonía porcina en 10 granjas porcinas tecnificadas de los departamentos de Arequipa, Lima, Ica y La Libertad. Se colectaron muestras de sangre de porcinos de las etapas de crecimiento y acabado (30 por granja) y se analizaron mediante la prueba de ELISA indirecta con un kit comercial. El 23.7% (71/300) de los animales presentaron anticuerpos contra la toxina ApxIV, correspondiendo la mayor frecuencia a la granja del departamento de Ica (60.0%). La presencia de anticuerpos contra la toxina ApxIV evidencia la presencia de la infección con A. pleuropneumoniae en la industria porcina del Perú.

Las opciones terapéuticas y reconstructivas disponibles hoy para las mujeres con cáncer mamario son numerosas. De los métodos disponibles para la reconstrucción mamaria autóloga el colgajo de recto abdominal ha sido el más popular, se ha calificado como uno de los más ingeniosos en el campo de la cirugía plástica. Es un colgajo que incluye piel, tejido graso y músculo recto-abdominal, este conjunto es llevado con su irrigación: la arteria epigástrica superior hasta el defecto de la mastectomía, en tórax. El propósito de la reconstrucción de la areola y pezón es hacer a la mama reconstruida lo más parecida a una mama natural. Se presenta el caso de una paciente que se le realiza mastectomía total más linfadenectomía axilar bilateral de niveles I y II colocación de catéter venoso implantable, colgajo Tram bilateral pediculado con arterias epigástricas superiores, injerto de complejo areola pezón, previa biopsia per operatoria del bloque galactóforo.

The therapeutic and reconstructive options currently available for women with breast cancer are numerous. Of the existing methods for autologous breast reconstruction the abdominis rectus flap has been the most popular and has been considered one of the most ingenious in the field of plastic surgery. It is a flap that includes skin, subcutaneous fat and the rectus abdominis muscle; these tissues are conducted en-bloc with their irrigation, the superior epigastric artery, to the mastectomy defect in the thorax. The purpose of the areola and nipple reconstruction is to make the reconstructed breast similar to the natural breast. We present the case of a patient that underwent bilateral total mastectomy with bilateral axillaries lymphadenectomy of the levels I and II, placement of a central venous port access catheter, bilateral pedicle TRAM flap with superior epigastric arteries and areola nipple complex graft with previous per operative biopsy of the nipple ground.

Over the last 10 years, Uruguay, Chile and Brazil have been certified as being free from disease transmission by Triatoma infestans, the main domiciliated vector for Chagas disease in the Southern Cone countries. This demonstrates that programmes addressing the vector for the disease's transmission are effective. These programmes have resulted in a dramatic decrease in the incidence of Chagas disease in Latin America. Guatemala was certified a few months ago as being free from disease transmission by Rhodnius prolixus, the main domiciliated vector for Chagas disease in Central American countries. However, the main concern for different countries' current control programmes is the continuity and sustainability of future vector control actions. The prevalence and incidence figures for individuals infected by Trypanosoma cruzi in Mexico and Andean and Central American countries highlights the need for broadened strategies in the struggle against the disease and its vectors. A number of triatomine insects are parasite vectors, each with a different life history. Therefore, it is important that new vector control strategies be proposed, keeping in mind that some species are found in peridomiciliary areas and wild ecotopes. The only viable control strategy is to reduce human interactions with vector insects so that the re-infestation and re-colonisation of human habitats will not take place.