Significado de estar sano, enfermedad y curación para los sobanderos indígenas del departamento de Nariño

Introducción: Estudio que tuvo por objetivo comprender los significados de estar sano, enfermedad y curación de lesiones musculares y esqueléticas para los sobanderos del resguardo indígena Quillasinga “Refugio del Sol”. Se realizó un estudio cualitativo fenomenológico, aplicando un instrumento de recolección de información con entrevista semiestructurada de 14 preguntas, dirigidas a 4 sobanderos de la comunidad Quillasinga. Desarrollo: Para los sobanderos el significado de salud, enfermedad y curación tiene múltiples definiciones, que dependen de diferentes factores que influye en la interpretación de este conocimiento, como la cultura, el entorno y, sobre todo, la cosmovisión que tenga cada población. Conclusiones: Cabe resaltar que, desde la cosmovisión indígena, se entiende por curación: una tradición enfocada al tratamiento de lesiones musculares y esqueléticas, que utilizan diferentes métodos ancestrales, convirtiendo su práctica terapéutica en una manera de curación holística e integral, que beneficia a todo aquel que acuda a ellos; enfermedad: la desconexión del cuerpo con el plano astral, compuesto por diferentes creencias espirituales que conforman el aura de una persona (espíritu), como también el consumo permanente de alimentos cultivados con químicos, que contribuyen a la pérdida de la energía positiva del cuerpo. Finalmente, se puede decir que todas sus prácticas tradicionales se fundamentan en el aprendizaje empírico que hace parte de una cascada generacional

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Inborn errors of OAS–RNase L in SARS-CoV-2–related multisystem inflammatory syndrome in children

International audienceMultisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows benign COVID-19. We report autosomal recessive deficiencies of OAS1 , OAS2 , or RNASEL in five unrelated children with MIS-C. The cytosolic double-stranded RNA (dsRNA)–sensing OAS1 and OAS2 generate 2′-5′-linked oligoadenylates (2-5A) that activate the single-stranded RNA–degrading ribonuclease L (RNase L). Monocytic cell lines and primary myeloid cells with OAS1, OAS2, or RNase L deficiencies produce excessive amounts of inflammatory cytokines upon dsRNA or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulation. Exogenous 2-5A suppresses cytokine production in OAS1-deficient but not RNase L–deficient cells. Cytokine production in RNase L–deficient cells is impaired by MDA5 or RIG-I deficiency and abolished by mitochondrial antiviral-signaling protein (MAVS) deficiency. Recessive OAS–RNase L deficiencies in these patients unleash the production of SARS-CoV-2–triggered, MAVS-mediated inflammatory cytokines by mononuclear phagocytes, thereby underlying MIS-C