ABSTRACT: Using traditional systematic, phytosociological and multivariate statistical methods, the flora and vegetation of three coastal wetlands of the inland sea were compared: Huildad and Putemum on the big island of Chiloé and Quillaipe in the Gulf of Reloncaví, in Los Lagos Region, Southern Chile. The total flora was composed by 91 plant species, of which 75 of which were native and 16 introduced. From the total also 62 correspond to Dicots, 20 Monocots and 9 Pteridophytes. Woody plants and perennial herbs dominated the biological spectrum. Fifty-six species were terrestrial, 26 marshy, 5 epiphytic, 2 psamophytes and 3 aquatic plants. Seventy species are from non-saline environments, 16 are halophytes and 5 are indifferent. Ferns were found only in Chiloé, with a greater extension of forest vegetation. Native species decrease from South to North and introduced species from North to South, in the same way of woody plants and perennial herbs. Only in Quillaipe helophytes and marsh camephytes were abundant. There was a negative correlation between the number of inhabitants of the nearest city and the number of plant species. The floristic similarity between wetlands was very low. Five plant formations were distinguished: forests, scrubs, prairie, freshwater streams and marshes. In the three wetlands, a total of 16 plant associations were identified, with only 2 common to them, so there was also a low vegetation similarity. Eleven associations were primary, 4 secondary and 1 tertiary (Ulexeuropaeusscrub). In general, the wetlands studied are less diverse in flora and vegetation than those in the open sea and further north, in Chile.

RESUMEN: Con metodologías de sistemática tradicional, fitosociológica y estadística multivariada se comparó la flora y la vegetación de tres humedales costeros de mares interiores: Huildad y Putemum en la isla grande de Chiloé y Quillaipe en el Golfo de Reloncaví, en la Región de Los Lagos, en el Sur de Chile. La flora total de ellos está formada por 91 especies de las cuales, 75 son nativas y 16 introducidas. También a ella pertenecen 62 Dicotiledóneas, 20 Monocotiledóneas y 9 Pteridófitos. En el espectro biológico dominan plantas leñosas y hierbas perennes. Cincuenta y seis especies son terrestres, 26 palustres, 5 epifíticas, 2 psamófitas y 3 plantas acuáticas (hidrófitos). Setenta especies son de ambientes no salinos, 16 son halófilos y 5 indiferentes. Helechos se encontraron sólo en Chiloé, con una mayor extensión de vegetación boscosa. Las especies nativas disminuyen de sur a norte y las introducidas de norte a sur, de la misma manera se comportan las plantas leñosas y las hierbas perennes. Sólo en Quillaipe abundaron los helófitos (plantas palustres) y caméfitos de marismas. Se presentó una correlación negativa entre número de habitantes de la ciudad más cercana con el número de especies presentes. La similitud florística entre humedales es muy baja. Se distinguieron 5 formaciones vegetales: bosques, matorrales, praderas, arroyos dulciacuícolas y marismas. En los tres humedales se presentaron en total 16 asociaciones vegetales de las cuales sólo 2 son comunes a ellos, por lo que también se presentó baja similitud vegetacional. Once asociaciones son primarias, 4 secundarias y 1 terciaria (matorral de Ulex europaeus). En general, los humedales estudiados son menos diversos en flora y vegetación que los del mar abierto y de más al norte, en Chile.

Abstract Cowpea is grown mainly in regions with a hot semi-arid climate, where other pulses do not develop satisfactorily. It is the 4th most produced pulse in the world, thus supplying the domestic and export markets. Following the trends of the food products market, a study was carried out to identify the best condition of the extrusion process, to transform these nutritious grains into quality expanded products and ready for consumption. The grains were decorticated and transformed into cotyledon flour. This flour was conditioned and the Evolum HT25 twin screw extruder feeder was adjusted to a rate of 7 kg h-1. A Box-Behnken 23 design was used, considering the following variables and levels: extrusion temperature from 100 °C to 140 °C (in the 7th to 10th zone), screw speed (300 to 700 rpm) and conditioning moisture from 12% to 16%. The temperature affected linearly and negatively (p ≤ 0.05) the sectional expansion index (2.65 to 7.64). The screw speed interfered linearly and positively (p ≤ 0.05) in the longitudinal (1.12 to 9.32) and volumetric (4.91 to 24.15) expansion index, and negatively with the water absorption index (3.05 to 3.86 g g-1). The screw speed (positive linear and negative quadratic), the moisture content (negative quadratic) and the interaction (positive) between the two interfered (p ≤ 0.05) in the water solubility index (25.89% to 33.85%). The hardness value (1.24 to 2.83 N) was affected (p ≤ 0.05) by screw speed (negative linear and positive quadratic), temperature (negative quadratic), moisture (positive quadratic), and interactions of moisture with temperature and screw speed. To obtain a hardness value close to that of commercial extrudates and high-water solubility, the maximum global desirability obtained was 0.81 for extrusion at 135.6 °C, 700 rpm and 12% moisture.

Resumo O feijão-caupi é cultivado principalmente em regiões de clima semiárido quente, onde outras pulses não se desenvolvem satisfatoriamente. É a quarta pulse mais produzida no mundo, abastecendo o mercado interno e de exportação. Seguindo as tendências do mercado de produtos alimentícios, realizou-se o estudo para identificar a melhor condição do processo de extrusão, para transformar esses grãos nutritivos em produtos expandidos de qualidade e prontos para o consumo. Os grãos foram descorticados e transformados em farinha de cotilédones. Essa farinha foi condicionada e o alimentador da extrusora de dupla rosca Evolum HT25 foi ajustado para uma taxa de 7 kg h-1. Um delineamento Box-Behnken 23 foi utilizado, contemplando as seguintes variáveis e níveis: umidade de condicionamento de 12% a 16%, temperatura de extrusão de 100 °C a 140 °C (da 7ª a 10ª zona) e velocidade das roscas de 300 a 700 rpm. A temperatura afetou linear e negativamente (p ≤ 0,05) o índice de expansão seccional (2,65 a 7,64). A velocidade das roscas interferiu linear e positivamente (p ≤ 0,05) nos índices de expansão longitudinal (1,12 a 9,32) e volumétrica (4,91 a 24,15), e negativamente no índice de absorção de água (3,05 a 3,86 g g-1). A velocidade das roscas (linear positiva e quadrática negativa), o teor de umidade (quadrática negativa) e a interação (positiva) entre essas duas variáveis interferiram (p ≤ 0,05) no índice de solubilidade em água (25,89% a 33,85%). O valor da dureza (1,24 a 2,83 N) foi afetado (p ≤ 0,05) pela velocidade das roscas (linear negativo e quadrático positivo), pela temperatura (quadrático negativo) e pela umidade (quadrático positivo), e pelas interações negativas da umidade com a temperatura e a velocidade das roscas. Para obtenção de valor de dureza próximo aos de extrusados comerciais e alta solubilidade em água, a desejabilidade global máxima obtida foi de 0,81 para extrusão a 135,6 °C, 700 rpm e 12% de umidade.

Abstract The aim of this study was to investigate uterine involution using ultrasonography techniques during postpartum. Postpartum ultrasonography evaluation (B-mode, color Doppler and Acoustic Radiation Force Impulse elastography) of the uterus was performed by transabdominal approach at immediate after birth and sequentially every 48 hours, during 30 days. The uterine echotexture did not present significant variations (P >0.05) being homogeneous in most evaluations; echogenicity of the uterus increased along the evaluation period (P =0.0452). Progressive and remarkable decrease of the total uterine diameter (UD) were observed (P <0.0001), especially during the first days postpartum. The thickness of uterine wall gradually decreased, as well the endometrial, myometrium and lumen diameters (P <0.0001). Uterine blood flow was assessed by Doppler and decreased during postpartum period, being significantly lower (P=0.0225) on the 30th day of postpartum. Uterine parenchyma presented as homogeneous dark areas (not deformable) on qualitative ultrasound elastography and the means shear velocity values of the uterine wall on quantitative elastography did not differ. This is the first study that evaluate the stiffness of uterine wall in healthy ewes, providing baseline data about quantitative and qualitative stiffness of the normal uterus, and it may be a useful tool for early diagnosis of uterine alterations during the postpartum period, using the reference parameter established for the assessment of uterine integrity during postpartum period.

Abstract This article presents the Brazilian private insurance market’s actuarial life tables, BR- EMS 2021. Using Bayesian inference on the parameters of the Heligman- Pollard law of mortality and data from 23 insurance groups over 15 years, totaling 3.5 billion registers, the data were corrected through a two hidden-layer neural network. The resulting tables show that the insured population exhibits lower mortality rates than the general Brazilian population, even lower than the national populations of well-developed countries such as the USA. Moreover, besides the expected gender gap in mortality rates, there is a clear distance between the death and survivorship insurance coverage groups. Likewise, the insured population characteristics mitigate well-known regional structural discrepancies in the Brazilian population, indicating that being part of the selected population of insured individuals is thus associated with a more effective protection against death than other outstanding factors such as geographic region of residence.

Resumen Este artículo presenta las tablas de vida del mercado de seguros privados brasileño, BR-EMS 2021. Los datos, obtenidos de 23 grupos de seguros a lo largo de 15 años, totalizando 3,5 mil millones de registros, fueron corregidos usando una red neuronal con dos capas ocultas. Mediante la inferencia bayesiana para estimar los parámetros bajo la ley de mortalidad de Heligman-Pollard, las tablas obtenidas muestran que la población asegurada tiene tasas de mortalidad más bajas que la población general brasileña e incluso más bajas que las poblaciones nacionales de países desarrollados, como los Estados Unidos de Norteamérica. Además de la diferencia de género esperada en las tasas de mortalidad, hay una clara distinción entre las tablas de grupos de cobertura de riesgo y cobertura de sobrevivientes. Asimismo, se demuestra que las tablas regionales de población asegurada no presentan las conocidas discrepancias estructurales regionales en Brasil, lo que indica que participar de la población de asegurados está asociado con una protección contra la muerte más efectiva que otros factores como la región geográfica de residencia.

Resumo Este artigo apresenta as tábuas de vida do mercado de seguros privados brasileiro, BR-EMS 2021. Os dados obtidos de 23 grupos seguradores ao longo de 15 anos, totalizando 3,5 bilhões de registros, foram corrigidos por meio de rede neural com duas camadas ocultas. Usando a inferência bayesiana para estimar os parâmetros sob a lei de mortalidade Heligman-Pollard, as tábuas obtidas mostram que a população segurada apresenta probabilidades de morte mais baixas do que a população brasileira em geral e até mesmo em relação a populações nacionais de países desenvolvidos, como os EUA. Além da esperada diferença de gênero nas taxas de mortalidade, há uma clara distância entre as probabilidades de morte dos grupos de cobertura de risco e cobertura de sobrevivência. Da mesma forma, é demonstrado que as tábuas regionais da população segurada não apresentam as discrepâncias regionais conhecidas no Brasil, indicando que fazer parte da população selecionada de segurados está associado a um fator de proteção mais eficaz do que outros fatores, como a região geográfica de residência.

Resumen Introducción. El tumor de Wilms es la neoplasia abdominal más común en pacientes pediátricos. En la mayoría de los casos se presenta como una masa unilateral indolora en el abdomen. El objetivo de este artículo fue presentar el caso de una paciente de 4 años con tumor de Wilms unilateral derecho manejado con cirugía mínimamente invasiva en el Hospital Universitario del Valle. Métodos. Revisión de la historia clínica e imágenes de la paciente, descripción de la técnica quirúrgica y revisión de la literatura del manejo de tumor de Wilms unilateral. Caso clínico. Paciente femenina de 4 años quien consultó en abril de 2019 por un cuadro clínico de dolor abdominal y sensación de masa en flanco derecho. Se realizó ecografía abdominal donde se encontró imagen nodular heterogénea de contornos definidos en riñón derecho, con riñón izquierdo normal. Se hizo diagnóstico de tumor de Wilms unilateral y se llevó a cirugía mediante abordaje mínimamente invasivo, con buena evolución postoperatoria. Conclusión. La cirugía es el pilar del manejo, y la nefrectomía mediante abordaje laparoscópico para casos seleccionados, en manos entrenadas, tiene la suficiente eficacia, seguridad y cumplimiento de los principios quirúrgicos y oncológicos que provee la cirugía abierta.

Abstract Introduction. Wilms tumor is the most common abdominal neoplasm in pediatric patients. In most cases it presents as a painless unilateral mass in the abdomen. The objective of this article was to present the case of a 4-year-old patient with right unilateral Wilms tumor managed with minimally invasive surgery at the Hospital Universitario del Valle. Methods. Review of the patient’s clinical history and images, description of the surgical technique and review of the literature on the management of unilateral Wilms tumor. Clinical case. A 4-year-old female patient who consulted on April 4, 2019 with a clinical presentation of abdominal pain and sensation of mass in the right flank. Abdominal ultrasound was performed where a heterogeneous nodular image of defined contours was found in the right kidney, with a normal left kidney. A diagnosis of unilateral Wilms tumor was made and surgery was carried out using a minimally invasive approach, with good postoperative evolution. Conclusion. Wilms tumor is the most common abdominal neoplasm in pediatric patients. The most common presentation is a painless palpable mass. Surgery is the mainstay of management, and nephrectomy using a laparoscopic approach for selected cases, in trained hands, has sufficient efficacy, safety, and compliance with surgical and oncological principles that open surgery provides.

Abstract The objective was to evaluate the blood flow of the uterine artery (UA) and umbilical artery (UMB) in the physiological pregnancy of goats by means of Doppler throughout the gestational period. Twenty-five Saanen goats weighing 55 ± 10 kg and aged between 2 and 5 were evaluated weekly, from the 21st until the 143rd day of gestation, and daily from that period until parturition. Values for peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance (RI) and pulsatility (PI) indices of the uterine and umbilical arteries were determined. The values obtained were correlated with gestational age by Spearman's test, tested for adjustment to regression models and compared with the number of fetuses by ANOVA. The umbilical cord was first visualized at 28 days. Of the variables evaluated, RIUMB and PIUMB correlated with gestational age (p<0.001; and 0.046; respectively) and RIUMB had a low negative correlation with the number of fetuses per pregnancy (p = 0.003; r- Spearman = - 0.218). PSVUMB and EDVUMB values did not correlate with gestational age (p=0.737 and 0.768, respectively), but there was a decrease in the mean values throughout pregnancy (PSVUMB= 0.07; 0.31 and EDVUMB= 0.01; 0.06) as well as the change in the flow pattern of the spectral trace. The mean values of the uterine artery dopplervelocimetric variables PSVUT, EDVUT, PIUT and RIUT did not correlate with gestational age (p= 0.324; 0.372, 0.143; 0.13; respectively). It is expected that the results obtained will contribute to a broader understanding of the hemodynamic changes resulting from pregnancy in goats.

Abstract The aim of this study was to measure the nuchal translucency (NT) of canine fetuses to establish reference values for healthy gestational processes and to verify its effectiveness in the diagnosis of congenital abnormalities. On day 34 of gestation, the NT of three fetuses from each of the 26 English bulldog female dogs was measured. The first fetus was the one located immediately cranial to the bladder, the second was selected from the left side of the abdomen, and the third from the right side. The reference values for healthy animals were offset using descriptive statistics. The diagnostic ability of the test to identify fetal malformations was studied using receiver operating characteristic curve analysis. Of the 26 litters, only 18 had healthy fetuses, 4 had fetuses with anasarca, 3 had fetuses with abdominal wall defects, and 1 had both types of abnormalities. The NT was higher in canine fetuses that presented anasarca in the litter than in normal litters (1.8 ± 0.77 mm vs. 1.4 ± 0.48 mm; P = 0.0249), with a cut-off value of NT > 1.45 mm (sensitivity = 61.54%, specificity = 70.18%). NT greater than 1.45 mm seems to be a diagnostic tool for the identification of anasarca during gestation of bulldogs. Considering the unprecedented use of this parameter in canine species and the limitations found during the study, further studies will be needed in order to use it on clinical practice.

Abstract The aim of this study was to evaluate the blood flow of the uterine artery, fetal aorta and umbilical artery in the physiological pregnancy of sheep by means of pulsed Doppler throughout the gestational period. Thirty Santa Inês ewes weighing between 45.4±4.3 kg and aged 2 to 5 years were selected. The evaluations were carried out weekly from the 3rd to the 21st gestational week. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) were obtained. Analysis of variance was performed, and the minimum significant comparison of means was obtained by the BH test with adjusted P<0.05. The results were expressed as mean ± standard error. For the fetal aorta, there was an increase in the EDV values and a decrease in the PSV and RI throughout pregnancy. For the uterine artery, PSV and EDV did not present significant variation, whereas the RI showed a reduction in the last week. Increased EDV values were found for the umbilical artery throughout pregnancy. For the PSV there was no significant difference, as the RI was reduced at the end of pregnancy. The results obtained are expected to contribute to a more complete understanding of the hemodynamic changes resulting from pregnancy.

Abstract Background: Alopecia areata is an autoimmune disease that produces non-scarring hair loss around the body. Gene variants of the cytotoxic T-lymphocyte antigen 4 (CTLA4) gene, a negative regulator of T-cell response, have been associated with a predisposition to autoimmune diseases in different populations; however, the involvement of these genetic variants in the development of AA is controversial. Objective: The present study evaluated the potential association of two CTLA4 gene variants with alopecia areata in a Mexican population. Methods: We genotyped +49AG (rs231775) and CT60 (rs3087243) variants in 50 AA patients and 100 healthy control participants through PCR-RFLP. Results: No statistical difference was observed for either of the gene variants regarding allele or genotype frequencies between AA patients and the controls when the parameters of family/personal history of autoimmune diseases or gender were considered (p > 0.05). Study limitations: Small sample size of patients and the data were obtained from Northeast Mexico population. Conclusion: The genetic variants rs231775 and rs3087243 of the CTLA4 gene are not a risk factor for the development of alopecia areata in the analyzed Mexican population.

Resumen La medicina nuclear es una especialidad médica que utiliza materiales radioactivos inyectados en el cuerpo para diagnóstico y tratamiento de enfermedades humanas. El uso de diferentes radionúclidos y altas cantidades de materiales radiactivos hace necesario que las instalaciones donde se realicen estos procedimientos evalúen los blindajes correspondientes para cumplir los límites de dosis de diseño de una instalación evitando así accidentes radiológicos recomendados y aceptados en las publicaciones internacionales como el ICRP (International Commision on Radiological Protection) y el NCRP (National Council on Radiation Protection and Measurments). En este trabajo se comparan dos métodos para el cálculo de los blindajes necesarios para garantizar que las zonas del servicio de medicina sean seguras a las radiaciones ionizantes. El primer método consiste en calcular el factor de transmisión B para hallar el espesor del material necesario para proteger la zona de interés, este factor se calcula teniendo en cuenta los factores de ocupación, cargas de trabajo, factor de uso y el límite de dosis objetivo de diseño. Una vez obtenido el factor de transmisión B se usan las tablas de HVL (Half Value Layer) o TVL (Tenth Value Layer) para cada material de construcción obteniéndose el espesor del material. El otro método es el cálculo de las tasas de exposición por medio de la constante de la tasa de Kerma en Aire, luego se usan las bases de datos (XCOM) desarrolladas por NITS (National Institute of Standards and Technology) para obtener el coeficiente de atenuación que son utilizados en la ley exponencial de atenuación; finalmente, se obtiene el espesor de material necesario para alcanzar el objetivo de diseño. Finalmente, se muestran las principales diferencias entre los dos métodos y se hace un análisis de la optimización de los blindajes buscando tener criterios para hacer recomendaciones a los servicios de medicina nuclear sobre blindajes óptimos.

Abstract Nuclear medicine is a medical specialization that uses radioactive materials injected into the body to diagnose and treat human diseases. The use of different radionuclides and high amounts of radioactive materials makes it necessary for the facilities where these procedures are conducted to evaluate the corresponding shielding to comply with the design dose limits of a facility and avoid radiological accidents as recommended and accepted in international publications, like the International Commission on Radiological Protection (ICRP) and the National Council on Radiation Protection and Measurements (NCRP). This work compares two methods to calculate the shielding necessary to guarantee que las medicine service zones be safe from ionizing radiations. The first method consists in calculating the transmission factor B to find the thickness of the material necessary to protect the zone of interest, this factor is calculated by bearing in mind the occupancy factors, workloads, use factor, and the design objective dose limit. Upon obtaining the transmission factor B, half value layer (HVL) or tenth value layer (TVL) tables are used for each construction material, obtaining the thickness of the material. The other method is the calculation of is the calculation of rates of exposure through the air Kerma rate constant, then the XCOM databases are used, which were developed by the National Institute of Standards and Technology (NITS) to obtain the attenuation coefficient, used in the law of exponential attenuation; finally, the necessary thickness of the material is obtained to reach the design objective. Finally, the principal differences between both methods are shown and an analysis is performed of the shielding optimization, seeking to set criteria to make recommendations to nuclear medicine services on optimal shielding..

ABSTRACT Uterine arteriovenous malformation (AVMV) is a rare cause of uterine bleeding, since most cases are asymptomatic. The MAVU are intramyometrial arteriovenous variceal dilatations without capillary involvement. They propouse a diagnostic and therapeutic challenge in the effort for preservation of fertility, constituting the embolization its main treatment. At present, the gold standard for the diagnosis of this pathology is angiography. However, less invasive modalities such as color Doppler ultrasound are increasingly used for diagnosis. We present the case of a 20-year-old woman with a history of molar pregnancy and excessive menstrual bleeding due to MAVU.

RESUMEN La malformación arteriovenosa uterina (MAVU) es una causa poco frecuente de sangrado uterino, dado que en la mayoría de casos cursa de forma asintomática. Las MAVU son dilataciones varicosas arteriovenosas intramiometriales sin afectación capilar. Plantean un reto diagnóstico y terapéutico en el esfuerzo de la preservación de la fertilidad, constituyéndose la embolización como su principal tratamiento. En la actualidad, el estándar de oro para el diagnóstico de esta patología es la angiografía. Sin embargo, las modalidades menos invasivas como la ecografía Doppler color se utilizan cada vez más para el diagnóstico. Se presenta el caso de una mujer de 20 años de edad, con antecedente de embarazo molar y sangrado menstrual excesivo debido a MAVU.

Resumen Este documento fue preparado por un grupo multidisciplinario de expertos seleccionados por la Asociación Colombiana de Infectología (ACIN) para poner al día las recomendaciones previas dadas por nuestro grupo en cuanto a la inmunización del adolescente, de la población adulta y de aquellos mayores de 60 años de edad. Para este último grupo, hemos decidido, como lo han hecho en otros países, el inmunizar a esta edad (y no después), debido a la carga de enfermedad incrementada por afecciones respiratorias y otros factores propios para América Latina y las condiciones socioeconómicas de nuestro país. Esta edición reescribe ciertos párrafos y actualiza en parte las recomendaciones hechas anteriormente y publicadas en Infectio en mayo de 2012. Las guías están orientadas al uso por aquellos que cuidan de estos pacientes y hacemos énfasis en el anciano, el inmunocomprometido y en aquellos que sufren de varias comorbilidades. Aunque en un momento dado el documento pudiera parecer incompleto, la intención deseada fue la de abarcar los recientes cambios en la administración de nuevas vacunas y otros regímenes en dosificación. Se incluye por primera vez el uso de las vacunas de 4 valencias contra la influenza. El uso de la vacuna contra el herpes zóster se discute, y se toma un cuidado especial en cuanto a la redacción del "cuándo y por qué" de la vacunación contra Streptococcus pneumoniae. En la administración de esta vacuna, el tiempo de aplicación y la secuencia asociada con la aplicación de la administración de la vacuna polisacárida de 23 valencias puede variar de acuerdo con la edad del paciente,las comorbilidades y en aquellos previamente vacunados con dicha vacuna. Finalmente, exponemos las nuevas recomendaciones de vacunación contra fiebre amarilla y dengue y le damos la bienvenida a la vacuna nonavalente contra el virus humano del papiloma.

Abstract This document was prepared by a multi-disciplinary panel of experts who have been selected by the Asociación Colombiana de Infectologia (ACIN) to revise and update previous recommendations (by our group) for the immunization of adolescents and adult population and those older than 60 years of age. For the latter group, we have chosen to move forward, like many others, and immunize them at that age because of the particular burden of disease due to respiratory conditions, and other factors strictly related to Latin America and Colombian socio-economic conditions. This edition replaces in part, updates or ads to previous recommendations published in Infectio, May 2012. The guidelines are intended to assist those caring for these patients, and emphasizes on the elderly, the immunocompromissed and on those who suffer from several co-morbidities.The contents of the guidelines could seem in complete at some point; nevertheless, they were purposefully thought as such to embrace on major changes in new vaccines or new dosin gregimens. It is included for the first time the use of cuadri-valent vaccines against influenza. The use of herpes zoster vaccine is discussed and special care is placed in the phrasing for the reader so he (she) understands the "when and why" of vaccine administration against Streptococcus pneumoniae. With pneumococcal vaccines, timing of administration may vary according to age, co-morbidities and in those previously vaccinated with the 23-polyvalent polysaccharide vaccine. There are new recommendations for the vaccination against yellow fever and dengue and we welcome the new nona-valent vaccine against the human papillomavirus.

Teaching models in endoscopy are important tools to minimize risks derived from endoscopic procedures, taking into account that therapeutic endoscopy, also known as surgical endoscopy, has greatly developed during the last decade. This results from the fact that minimally invasive procedures present relevant contributions and promote more comfort to patients. In this context, ex vivo teaching models and virtual simulators are important tools to the safe acquisition of abilities. In this article, the Brazilian Society of Digestive Endoscopy presents and describes its first course of therapeutic ERCP and EUS in models of laboratory teaching.

Los modelos de enseñanza en endoscopía son herramientas importantes para minimizar los riesgos de los procedimentos endoscópicos. En la última década la endoscopía terapéutica o también llamada endoscopía-quirúrgica, tuvo gran desarollo debido a que los procedimentos minimamente invasivos tienen mejores resultados para la calidad de vida del paciente. En este contexto, los modelos experimentales y animales son herramientas muy importantes para los alumnos. En este artículo de revisión y presentación, los miembros de la Sociedad Brasilera de Endoscopía Digestiva presentan el primer Curso Taller en Ecoendoscopía terapéutica y CPRE en el Congreso Nacional del 2015.

RESUMO Objetivo Foi investigado o uso de benzodiazepínicos (BZD) e fatores associados em idosos no município de Dourados, MS. Métodos Delineamento transversal, de base populacional com amostra de conglomerados estratificada e em múltiplos estágios. Os participantes totalizaram 1.022 indivíduos com idade > 60 anos. Foi utilizado questionário padronizado com as variáveis nível econômico, escolaridade, demográficas, situação conjugal, exercícios físicos, internações hospitalares, autopercepção de saúde, uso de bebida alcoólica e fumo. Os medicamentos utilizados foram obtidos por meio da verificação da receita médica ou embalagem e classificados segundo o Anatomical Therapeutic Chemical Index. Para avaliar a associação entre as variáveis foram utilizados os testes do qui-quadrado, de tendência linear, exato de Fisher e regressão de Poisson. Resultados A prevalência do uso de BZD foi de 6,5% (IC95%: 5,1-8,2%). A maior idade (RP: 1,60 para 70-79 anos e RP: 1,79 para > 80 anos), o não uso de bebidas alcoólicas (RP: 4,14) e o uso de antidepressivos (RP: 8,73) foram as características estatisticamente associadas. Conclusões A prevalência do uso de BZD na população estudada foi baixa, semelhante à de outros estudos brasileiros recentes e menor do que as obtidas em estudos internacionais. A prevalência do uso de BZD aumentou com a idade e o uso de antidepressivos.

ABSTRACT Objective The use of benzodiazepines (BZD) and associated factors in the elderly of Dourados, MS, Brazil was investigated. Methods This is a cross-sectional population-based study using a multistage sampling design. Participants were 1,022 individuals aged ≥ 60 years. Measurements socioeconomic status, schooling, demographic aspects, marital status, physical activity, hospitalizations, self-rated health, use of alcohol beverages and smoking were assessed by standard questionnaire. The drugs used were obtained by checking the prescription or package and classified according to the Anatomical Therapeutic Chemical Index. Chi-square test, Chi-square for linear tendency, Fisher's exact test and Poisson regression were used to assess association between variables. Results The prevalence of use of BZD was 6.5% (CI95%: 5.1-8.2%). The oldest group (PR: 1.60 for 70-79 years and PR: 1.79 for ≥ 80 years), non-use of alcohol (PR: 4.14) and use of antidepressants (PR: 8.73) were the statistically associated characteristics. Conclusions The prevalence of use of BZD in the study population was low, similar to findings of more recent Brazilian studies and lower than those obtained in international studies. The prevalence of use of BZD increased with aging and use of antidepressants.