RURAL TOURISM, ENVIRONMENTAL IMPACT AND RESILIENCE IN PIEDRA HERRADA, MEXICO

Se analizó el impacto que genera el turismo rural en el ejido Piedra Herrada, ubicado en el municipio de Temascaltepec, Estado de México (México), que se caracteriza por el aprovechamiento turístico del proceso de hibernación de la mariposa monarca (Danausplexippus L.), a partir de la valoración de la resiliencia. Para ello se retoman las aportaciones de Martín-López et al. (2009) para determinar el sistema socio ecológico (SSE) del lugar de estudio, así como Strickland-Munro et al. (2010) y Santos (2012) para el análisis de los impactos del turismo en áreas naturales protegidas (ANP), a partir de la resiliencia y los criterios de valoración: perturbaciones, vulnerabilidad, conectividad y potencial de cambio. Se identificó que el turismo está generando beneficios económicos para la población local, que a su vez incide en la conservación del entorno forestal y el hábitat de la mariposa monarca; no obstante, el SSE es sensible a la dinámica e intensificación de la actividad turística, con alcance sobre la conservación del suelo y la biodiversidad, por lo que es necesario delinear estrategias que favorezcan la conservación ambiental y el adecuado desarrollo del turismo rural

PÉNFIGO FOLIÁCEO REPORTE DE UN CASO CLÍNICO

El pénfigo foliáceo es una enfermedad vesículo-ampollar poco frecuente,autoinmune y crónica. Se caracteriza por presentar desprendimiento intraepidérmico en los estratos más superficiales de la epidermis por acantólisis con ulterior formación de flictenas flácidas y erosiones en la piel.Lo anterior es causado por autoanticuerpos directamente patógenos detipo IgG dirigidos en contra de la desmogleína 1; una proteína estructural de unión en los desmosomas, en la superficie de queratinocitos de la epidermis. Este tipo no afecta, generalmente, las membranas mucosas. Y las ampollas no son dolorosas. Esta enfermedad puede afectar cualquier piel, pero la mayoría de las ampollas aparece en el pecho, la espalda y los hombros.Las flictenas provocan que la piel se vuelva escamosa y pruriginosa.A continuacion se presenta el caso de un paciente de 7 años de edad,shuar, masculino, con el diagnóstico de Pénfigo Foliáceo. El diagnósticose realizó por el examen físico general y ocular mediante la oftalmoscopia oblicua y la biomicroscopia, el examen histopatológico y la inmunifluorescencia directa de piel perilesional. Se realizó una investigación de dicho tema por lo poco frecuente que resulta esta variante de la enfermedad con manifestaciones oculares asociadas y por no existir antecedentes epidemiológicos publicados en el Ecuador sobre la misma

A construção de instrumentos de pesquisa para a documentação do SPI e a busca de novas formas de acesso e diálogo

Este texto apresenta uma análise do Inventário Analítico relativo aos Documentos textuais do SPI - Posto Indígena Caramuru-Paraguaçu. Neste sentido, apresenta subsídios para uma reavaliação do processo histórico que engendrou as relações entre as sociedades indígenas e as políticas indigenistas, propiciando repensar a história dos índios a partir da documentação textual, o que significa, em muitas situações, reescrever, como registra John Monteiro, capítulos inteiros da história do Brasil “para que este novo conhecimento do passado possa lançar uma luz menos pessimista e mais justa sobre o futuro dos povos indígenas”. (Monteiro,1994).&nbsp

Effects of different doses of Salix babylonica extract on growth performance and diet in vitro gas production in Pelibuey growing lambs

Twenty Pelibuey 3-4 month old and 23.7±3.3 kg body weight male lambs were used in a randomised design to study the effects of daily oral administration of Salix babylonica (SB) extract on dry matter (DM), water intake, average daily gain (ADG), and feed efficiency for 72 days. Animals were divided into four groups fed the same total mixed ration with different doses of SB: 0 (Control), 20 (SB20), 40 (SB40) and 60 (SB60) mL/lamb/d. In vitro gas production (GP) of the same diet fed to lambs as a substrate was measured with different doses of SB (0, 0.3, 0.7, 1.0 mL/g DM). Daily administration of SB to lambs had no effects (P=0.05) on growth performance and DMI (linear effect, P=0.2805; quadratic effect, P=0.3747). Both low and moderate doses of SB (SB40>SB20) tended to increase (linear effect, P=0.4010; quadratic effect, P=0.9166) ADG. The asymptotic GP quadratically increased (PSB20) tended to increase (linear effect, P=0.4010; quadratic effect, P=0.9166) ADG. The asymptotic GP quadratically increased (PSB20) tended to increase (linear effect, P=0.4010; quadratic effect, P=0.9166) ADG. The asymptotic GP quadratically increased (P<0.001) with decreased GP rate and with increasing SB extract doses. In vitro GP increased (P<0.05) with advancing of incubation time in all SB doses. During the first 24 h of incubation, 0.3 mL SB/g DM had the highest GP, whereas 1.0 mL SB/g DM quadratically increased (P<0.001) GP. The low dose of SB extract increased ME (linear effect, P=0.024) and short chain fatty acids (SCFA) (linear effect, P=0.023). However, the highest dose quadratically decreased (P=0.02) DM degradability. In conclusion, administration of SB extract at 40 mL/lamb/d tended to increase DM intake, improve daily weight gain in growing lambs with increasing asymptotic in vitro ruminal GP and SB dose

Potential relation of cardiovascular risk factors to disease activity in patients with axial spondyloarthritis

Background: Axial spondyloarthritis (axSpA) patients are known to have a higher prevalence of several comorbidities, including, among others, an increased risk of atherosclerosis, hypertension, dyslipidemia, and diabetes. The purpose of the present study was to determine whether the sum of traditional cardiovascular (CV) risk factors is related to disease characteristics, such as disease activity, in patients with axSpA. Methods: A cross-sectional study that encompassed 804 patients with axSpA was conducted. Patients were assessed for the presence of five traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking status), and disease activity measurements. A multivariable regression analysis was performed to evaluate whether the number of classic CV risk factors was independently associated with specific features of the disease, to include disease activity. Results: A multivariable analysis showed that Ankylosing Spondylitis Disease Activity Score-C reactive protein (ASDAS-CRP) activity score was significantly higher in patients with 1 [beta coefficient 0.3 (95% confidence interval (CI) 0.1-0.5), p = 0.001] and ?2 [beta coefficient 0.5 (95% CI 0.3-0.7), p = 0.000] CV risk factors compared with those without CV risk factors. Similarly, patients with 1 [OR 2.00 (95%CI 0.99-4.02), p = 0.053] and ?2 [OR 3.39 (95%CI 1.82-6.31), p = 0.000] CV risk factors had a higher odds ratio for the presence of high disease activity compared with the zero CV category. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) activity score was significantly associated with the number of CV risk factors, being higher in patients with more CV risk factors. These relationships showed a CV risk factor-dependent effect being beta coefficients and ORs higher for the effect of ?2 over 1 CV risk factor. Conclusion: Among patients with axSpA, as the number of traditional CV risk factors increased, disease activity similarly increases in an independent manner.Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/ or publication of this article: This research was funded by a grant to MAG-G from the Instituto de Salud Carlos III (ISCIII) (Fondo de Investigación Sanitaria grants PI06/0024, PI09/00748, PI12/00060, PI15/00525, PI18/00043) and the ISCIII RETICS programs (RD12/0009 and RD16/0012)

Long-Term Treatment and Effect of Discontinuation of Calcifediol in Postmenopausal Women with Vitamin D Deficiency: A Randomized Trial

Vitamin D plays a major role in bone health and probably also in multiple extraskeletal acute and chronic diseases. Although supplementation with calcifediol, a vitamin D metabolite, has demonstrated efficacy and safety in short-term clinical trials, its effects after long-term monthly administration have been studied less extensively. This report describes the results of a 1-year, phase III-IV, double-blind, randomized, controlled, parallel, multicenter superiority clinical trial to assess the efficacy and safety of monthly calcifediol 0.266 mg versus cholecalciferol 25,000 IU (0.625 mg) in postmenopausal women with vitamin D deficiency (25(OH)D < 20 ng/mL). A total of 303 women were randomized and 298 evaluated. Patients were randomized 1:1:1 to calcifediol 0.266 mg/month for 12 months (Group A1), calcifediol 0.266 mg/month for 4 months followed by placebo for 8 months (Group A2), and cholecalciferol 25,000 IU/month (0.625 mg/month) for 12 months (Group B). By month 4, stable 25(OH)D levels were documented with both calcifediol and cholecalciferol (intention-to-treat population): 26.8 ± 8.5 ng/mL (Group A1) and 23.1 ± 5.4 ng/mL (Group B). By month 12, 25(OH)D levels were 23.9 ± 8.0 ng/mL (Group A1) and 22.4 ± 5.5 ng/mL (Group B). When calcifediol treatment was withdrawn in Group A2, 25(OH)D levels decreased to baseline levels (28.5 ± 8.7 ng/mL at month 4 versus 14.4 ± 6.0 ng/mL at month 12). No relevant treatment-related safety issues were reported in any of the groups. The results confirm that long-term treatment with monthly calcifediol in vitamin D-deficient patients is effective and safe. The withdrawal of treatment leads to a pronounced decrease of 25(OH)D levels. Calcifediol presented a faster onset of action compared to monthly cholecalciferol. Long-term treatment produces stable and sustained 25(OH)D concentrations with no associated safety concerns.This study was funded by Faes Farma, S.A. and Bruno Farmaceutici S.p.A. The authors wish to thank the study participants, research staff, the secondary investigators of the Osteoferol study group, the home nursing staff (Emibet), and Faes Farma clinical research team: Paula Arranz Gutiérrez, Lorena Elgezabal González, Mariana Frau Usoz, and Iñigo Saez Riesco. Medical writing support was provided by Francisco López de Saro (Trialance SCCL), funded by Faes Farma, S.A

La enseñanza del metabolismo: retos y oportunidades

En el marco del Proyecto de Innovación Educativa de la Universidad de Málaga PIE15-163, cuya descripción y resultados incluimos, decidimos que esta era una excelente oportunidad para reflexionar acerca de la enseñanza del metabolismo y de poner por escrito dichas reflexiones en un libro. Quisimos y pudimos contar con la colaboración de buena parte de los compañeros del Departamento de Biología Molecular y Bioquímica que apoyaron con su firma el proyecto PIE15-163 y extendimos nuestra invitaciones a otros compañeros de dentro y fuera de la Universidad de Málaga. Del Departamento de Biología Molecular y Bioquímica de la Universidad de Málaga hemos recibido aportaciones de los catedráticos Victoriano Valpuesta Fernández, Ana Rodríguez Quesada y Antonio Heredia Bayona, los profesores titulares María Josefa Pérez Rodríguez, José Luis Urdiales Ruiz e Ignacio Fajardo Paredes y la investigadora postdoctoral y profesora sustituta interina Beatriz Martínez Poveda. De otros departamentos de la Universidad de Málaga hemos contado con las aportaciones de la catedrática del Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología Pilar Morata Losa, del catedrático del Departamento de Lenguajes y Ciencias de la Computación José Francisco Aldana Montes y los componentes de su grupo de investigación Khaos Ismael Navas Delgado, María Jesús García Godoy, Esteban López Camacho y Maciej Rybinski, del catedrático Ángel Blanco López, del Área de Conocimiento de Didáctica de las Ciencias Experimentales y del Doctor en Ciencias Químicas y actual doctorando del Programa de Doctorado "Educación y Comunicación Social" Ángel Luis García Ponce. De fuera de la Universidad de Málaga, hemos contado con las aportaciones del catedrático de la Universidad de La Laguna Néstor V. Torres Darias, de la catedrática de la Universitat de les Illes Balears Pilar Roca Salom y de sus compañeros los profesores Jorge Sastre Serra y Jordi Oliver, de los catedráticos de la Universidad de Granada Rafael Salto González y María Dolores Girón González y su colaborador el Dr. José Dámaso Vílchez Rienda, del profesor titular de la Universidad de Alcalá Ángel Herráez, del investigador postdoctoral de la Universidad de Erlangen (Alemania) Guido Santos y del investigador postdoctoral de la empresa Brain Dynamics Carlos Rodríguez Caso.Hemos estructurado los contenidos del libro en diversas secciones. La primera presenta el Proyecto en cuyo marco se ha gestado la iniciativa que ha conducido a la edición del presente libro. La segunda sección la hemos titulado "¿Qué metabolismo?" e incluye diversas aportaciones personales que reflexionan acerca de qué metabolismo debe conocer un graduado en Bioquímica, en Biología, en Química, en Farmacia o en Medicina, así como una aportación acerca de qué bioquímica estructural y enzimología son útiles y necesarias para un estudiante que vaya a afrontar el estudio del metabolismo. La tercera sección, "Bases conceptuales", analiza las aportaciones del aprendizaje colaborativo, el contrato de aprendizaje y el aprendizaje basado en la resolución de casos prácticos a la mejora del proceso enseñanza-aprendizaje dentro del campo de la Bioquímica y Biología Molecular, más concretamente en el estudio del metabolismo. La cuarta sección se titula "Herramientas", es la más extensa e incluye las diversas aportaciones centradas en propuestas concretas de aplicación relevantes y útiles para la mejora de la docencia-aprendizaje del metabolismo. Sigue una sección dedicada a presentar de forma resumida los "Resultados" del proyecto PIE15-163. El libro concluye con una "coda final" en la que se reflexiona acerca del aprendizaje de la Química a la luz de la investigación didáctica.Patrocinado por el Proyecto de Innovación Educativa de la Universidad de Málaga PIE15-16

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London