Dabigatran and rivaroxaban, new oral anticoagulants. New approaches in Dentistry

Treatment in patients with atrial fibrillation or venous thromboembolism in recent decades has been based almost exclusively on the use of vitamin K antagonists. These drugs have a narrow therapeutic index, so it is precise to repeated adjustments of doses that require analytical monitoring. For many years it has advocated the need to have more convenient new antithrombotic drugs. So is developing a new generation of antithrombotic not related to coumarin. In 2008 and 2009, two of these new anticoagulants have been registered and approved in Europe and Ca- nada-these are dabigatran etexilate (Pradaxa ®) and rivaroxaban (Xarelto ®). Anticoagulant dabigatran is the first direct thrombin inhibitor, orally available. Specifically and reversibly inhibits thrombin, so the duration of action is predictable. The anticoagulant effect correlates well with plasma drug concentrations, which implies an effective anticoagulation with low bleeding risk without major problems of interactions with other drugs. Rivaroxaban is first oral anticoagulant inhibitor of factor Xa (FXa). It produces a predictable and reversible inhibition of FXa activity with ability to inhibit clot-bound FXa. The predictable pharmacokinetics and pharmacodynamics characteristics of dabigatran and rivaroxaban may facilitate dental management of patients who until now have been in treatment with traditional anticoagulants, given that it doesn’t require routine laboratory monitoring in the vast majority of patients treated. They also present a profile of drug interactions very favourable

Detection of Human papillomavirus and co-infection with other sexually transmitted pathogens in northern Peru

[El documento adjunto corresponde al resumen de la conferencia. Se presenta en este apartado el propósito del estudio]: Purpose: The epidemiology of human papillomavirus (HPV) and co-infections with other sexually transmitted infections (STIs) remains poorly characterized in Peru. The aim of this study was to identify HPV infections and the presence of co-infections by other important STIs (Chlamydia trachomatis, Trichomonas vaginalis, and Herpes simplex virus) in women attending the public health system in northern Peru.Campus Lima Centr

Biodiversity recovery of Neotropical secondary forests

Old-growth tropical forests harbor an immense diversity of tree species but are rapidly being cleared, while secondary forests that regrow on abandoned agricultural lands increase in extent. We assess how tree species richness and composition recover during secondary succession across gradients in environmental conditions and anthropogenic disturbance in an unprecedented multisite analysis for the Neotropics. Secondary forests recover remarkably fast in species richness but slowly in species composition. Secondary forests take a median time of five decades to recover the species richness of old-growth forest (80% recovery after 20 years) based on rarefaction analysis. Full recovery of species composition takes centuries (only 34% recovery after 20 years). A dual strategy that maintains both old-growth forests and species-rich secondary forests is therefore crucial for biodiversity conservation in human-modified tropical landscapes. Copyright © 2019 The Authors, some rights reserved

Overload and pain in perceived caregivers of dependent elder

Objetivos: Evaluar la sobrecarga subjetiva y el dolor percibido en cuidadoras de ancianos dependientes y determinar si la intensidad del dolor percibido está asociado a la sobrecarga de la cuidadora. Material y métodos: Estudio observacional, descriptivo transversal. Variables:edad, sexo, parentesco familiar, convivencia con el paciente, nivel educativo, tiempo como cuidador, trabajo remunerado, Índice de Esfuerzo del Cuidador (IEC) e intensidad del dolor (EVA). Análisis estadístico descriptivo e inferencial: Test T de Student, r de Pearson y ANOVA, según los casos. Resultados: IEC 6,58 ± 1,21, EVA 6,60 ± 1,21 ; correlación EVA y IEC r= 0,571, p<0,0001; EVA y tiempo como cuidadora r=0,340, p<0,026. Conclusiones: Las cuidadoras de ancianos dependientes presentan elevados índices de sobrecarga y percepción del dolor provocada por propias características de los cuidados que requieren los ancianos dependientes. Existe una relación directa entre la intensidad del dolor y el grado de sobrecarga de las cuidadoras.Objectives: To assess the subjective stress and perceived pain in carers of dependent elders, and whether the perceived pain intensity is associated with the caregiver overload or not. Material and methods: This is an observational, descriptive, transversal study. Variables: age, sex, family relationship, living together with the patient, educational level, time as a caregiver, paid work, the Caregiver Stress Index (IEC) and pain intensity (VAS). Descriptive and inferential statistical analysis: Student's T test, Pearson r and ANOVA, as appropriate. Results: IEC 6.58 ± 1.21, 6.60 ± 1.21 EVA, EVA and IEC correlation r = 0.571, p <0.0001, EVA and time as caregivers r = 0.340, p <0.026. Conclusions: The caregivers of dependent elders have high overhead rates and perception of pain caused by own characteristics of care required by dependent elders. There is a direct relationship between pain intensity and the degree of overload of the caregivers

An emerging public health threat: Mayaro virus increases its distribution in Peru

Background: The infection caused by Mayaro virus (MAYV), which presents as an acute febrile illness, is considered a neglected tropical disease. The virus is an endemic and emerging pathogen in South America and the Caribbean, responsible for occasional and poorly characterized outbreaks. Currently there is limited information about its expansion and risk areas. Methods: A cross-sectional study was performed in 10 urban primary care health centers in the Cajamarca region of Peru from January to June 2017. A total of 359 patients with suspected febrile illness were assessed. RNA was extracted from serum samples, following which MAYV real-time reverse transcriptase PCR (RT-PCR) for the detection of the nsP1 gene was performed. Results: MAYV was detected in 11.1% (40/359) of samples after RT-PCR amplification and confirmatory DNA sequencing. Most infections were detected in the adult population aged 18–39 years (40%) and 40–59 years (32.5%). Headache was the most frequent symptom in patients with MAYV infection (77.5%), followed by fever (72.5%), myalgia (55.0%), and arthralgia (50.0%). During the study, most of the MAYV cases were seen in May (47.5%) and April (35.0%), corresponding to the dry season (months without rain). Conclusions: This study is novel in describing the presence of MAYV in Cajamarca, an Andean region of Peru. Symptoms are non-specific and can be confused with those of other arbovirus or bacterial infections. Molecular biology methods such as RT-PCR allow the timely and accurate detection of MAYV and could thus be considered as a tool for surveillance in endemic areas.This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (No. 2015M3A9B6073666 ). This study was supported by CONCYTEC Peru , under the contract No 164-2016-FONDECYT, Lima, Peru. Incentive for Research of the Universidad Peruana de Ciencias Aplicadas (No. UPC-C-01-2019), Lima, Peru. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Revisión por pare