Introducción: el virus de la Hepatitis E (VHE), transmitido por la ruta fecal-oral, causa enfermedad hepática aguda. En Colombia se han realizado algunos estudios en pacientes con diagnóstico de hepatitis viral, en trabajadores de fincas porcícolas, en población porcina y en muestras ambientales. Objetivo: evaluar la presencia de anticuerpos anti-VHE en muestras de donantes de sangre del municipio de Yarumal, departamento de Antioquia. Metodología: se obtuvieron muestras de suero de donantes de sangre colectadas por la Cruz Roja Colombiana en una campaña de donación voluntaria en el municipio de Yarumal. En las muestras se determinó la presencia de anticuerpos anti-VHE tipo IgM e IgG mediante estuche comercial de ELISA. Resultados: se analizaron 42 muestras de suero, 19 de las cuales (45,2%) fueron positivas para anticuerpos anti-VHE IgG. Ninguna de las muestras fue positiva para anticuerpos anti-VHE tipo IgM. Conclusiones: este es el primer reporte de anticuerpos anti-VHE en donantes de sangre en Colombia. La frecuencia de anti-VHE (45,2%) es mayor a lo reportado previamente en otros estudios realizados en el país y a lo reportado en donantes de sangre en otros países de América Latina. Esta frecuencia podría estar relacionada con el contacto con cerdos infectados, así como con la exposición a agua contaminada con el virus. Sin embargo, estudios adicionales deben ser realizados en otras poblaciones similares en el país para confirmar este hallazgo.

Introduction: The hepatitis E virus (HEV) is transmitted via the fecal-oral route and causes acute liver disease. In Colombia there have been some studies of patients who have been diagnosed with viral hepatitis, of swine farm workers and in environmental samples. Objective: The objective of this study was evaluate samples from blood donors in the municipality of Yarumal in the department of Antioquia for the presence of anti-HEV antibodies. Methods: Serum samples were obtained from blood donated to the Colombian Red Cross by blood donors on a voluntary basis in a campaign in the municipality of Yarumal. Samples in the presence of anti-HEV IgM and IgG ELISA using commercial kit was determined.Results: Forty-two serum samples were analyzed: 19 (45.2%) were positive for anti-HEV IgG. None of the samples were positive for anti-HEV IgM. Conclusions: This is the first report of anti-HEV antibodies in blood donors in Colombia. The frequency of anti-HEV (45.2%) is higher than previously reported in other studies in this country and in blood donors in other Latin American countries. This frequency may be linked to contact with infected pigs and to exposure to water contaminated with the virus. However, additional studies should be conducted in similar populations in the country to confirm this finding

Phylogenetic relationships among Chilean species of Drimys as well asD. granadensis from Central America andD. angustifolia from Brazil were reconstructed using internal transcribed spacers (ITS) of nuclear ribosomal DNA and a parsimony analysis. Our results at the family level were congruent with previous phylogenetic hypotheses. Molecular data indicate that the Juan Fernandez Island endemic D. confertifolia diverged early in the evolution of the genus, and it is not closely related to the continental species D. winteri, as might be expected on the basis of morphology and biogeography. The ITS phytogeny also provides general support for a recent distribution of species on the western side of the Andes Mountains; the only exception is D. andina, which may represent an early divergence that occurred just before the Quaternary. The only species examined from east of the Andes, D. angustifolia, also represents an early divergence in the genus, which is in agreement with the ancient pollen record in Argentinean Patagonia and the lack of Tertiary records in Chile.

Se reconstruyeron relaciones filogenéticas de las especies chilenas de Drimys, que incluyó a D. granadensis de América Central y D. angustifolia de Brasil, donde se uso la región del espaciador transcrito interno (ITS) del ADN ribosomal nuclear y sus eventos de inserción/deleción (indels) a través de un análisis de parsimonia. Nuestros resultados a nivel de familia fueron congruentes con previas hipótesis filogenéticas propuestas. Los datos moleculares indican queD. confertifolia, endémica del Archipiélago de Juan Fernández, divergió temprano en la evolución del género, y que no está cercanamente emparentada a las especies continentales de D. winteri, como se podría esperar sobre la base de la morfología y la biogeografía. Los datos moleculares también apoyan una distribución reciente en el lado oeste de la Cordillera de los Andes, la única excepción es D. andina la cual puede representar una divergencia temprana que ocurrió justo antes del Cuaternario. La única especie estudiada del lado este de la Cordillera de los Andes, D. angustifolia, también representa una divergencia temprana en el género, hipótesis que concuerda con el antiguo registro palinológico del Terciario en la Patagonia argentina y la falta de estos en Chile.

Given that highly active antiretroviral therapy (HAART) has been demonstrated useful to restore immune competence in type-1 human immunodeficiency virus (HIV-1)-infected subjects, we evaluated the specific antibody response to influenza vaccine in a cohort of HIV-1-infected children on HAART so as to analyze the quality of this immune response in patients under antiretroviral therapy. Sixteen HIV-1-infected children and 10 HIV-1 seronegative controls were immunized with a commercially available trivalent inactivated influenza vaccine containing the strains A/H1N1, A/H3N2, and B. Serum hemagglutinin inhibition (HI) antibody titers were determined for the three viral strains at the time of vaccination and 1 month later. Immunization induced a significantly increased humoral response against the three influenza virus strains in controls, and only against A/H3N2 in HIV-1-infected children. The comparison of post-vaccination HI titers between HIV-1+ patients and HIV-1 negative controls showed significantly higher HI titers against the three strains in controls. In addition, post vaccination protective HI titers (defined as equal to or higher than 1:40) against the strains A/H3N2 and B were observed in a lower proportion of HIV-1+ children than in controls, while a similar proportion of individuals from each group achieved protective HI titers against the A/H1N1 strain. The CD4+ T cell count, CD4/CD8 T cells ratio, and serum viral load were not affected by influenza virus vaccination when pre- vs post-vaccination values were compared. These findings suggest that despite the fact that HAART is efficient in controlling HIV-1 replication and in increasing CD4+ T cell count in HIV-1-infected children, restoration of immune competence and response to cognate antigens remain incomplete, indicating that additional therapeutic strategies are required to achieve a full reconstitution of immune functions.

La enfermedad médico-quirúrgica catastrófica (EMQ-C) se define como una enfermedad aguda o prolongada, usualmente considerada como amenazante para la vida o con el riesgo de dejar discapacidad residual importante. La EMQ-C , a menudo, conlleva trastornos psicosociales que afectan de manera importante su evolución, porque alteran el proceso de rehabilitación, los hábitos saludables y la calidad de vida y, además, limitan la adherencia al tratamiento. Por lo tanto, para ofrecer un tratamiento a la persona quien la padece, es necesario desarrollar modelos que permitan identificar y tratar integralmente todos los aspectos médicos, psicológicos y sociales. La legislación colombiana, desde la aprobación de la Ley 100 de 1993, reglamentó la atención integral de la EMQ-C. No obstante, el desarrollo de programas de atención integral que incluyan lo psicosocial ha sido lento. Se presenta un modelo teórico de atención psicosocial integral en EMQ-C, que sigue los lineamientos de la medicina biopsicosocial de Ángel, junto a un modelo denominado medicina cognitiva , desarrollado previamente por uno de los autores (HR). El modelo incluye aspectos y procedimientos necesarios para su funcionamiento ajustado a la ley colombiana.

Medical Surgical Catastrophic Illness (MSIC) is defined as an acute or chronic lifethreatening disease or with risk of important disability. MSI-C is frequently associated with Psychosocial Disorders influencing the outcome due to effects on the rehabilitation process, quality of life and compliance. The development of integrative models of care that cover medical, psychological and social aspects is necessary in order to offer treatment to the person with MSI-C. Since Law 100 of 1993 was passed, Colombia ruled an integrative model of care for catastrophic illness. Noteworthy, implementation of these programs has been slow. In this article a theoretical model of integrative psychosocial care that follows recommendations of Engel's Biopsychosocial Model and the Cognitive Medicine model developed by one of the authors (HR). The model includes necessary aspects and procedures for its implementation according to Colombian Law.