Management and attitudes about IPF (Idiopathic Pulmonary Fibrosis) among physicians from Latin America

Background: The aim of our study was to assess current practice patterns and attitudes towards diagnosis and management of idiopathic pulmonary fibrosis (IPF) patients in Latin America. Methods: A Cross-sectional survey was developed and up to 455 physicians were enrolled. We used a rigorous method of validation using the translated version of the AIR Survey. Results: Mean age was 47.5 years (SD 12.6) with 20.4 years (SD 12.3) of practice. In around 30% of physicians were reported access to radiologist, pathologist and multidisciplinary team. Despite almost all physicians reported that (ATS/ERS/JRS/ALAT) guidelines are useful, half of them prescribed corticoids for treatment of disease. Most respondents (69.9%) reported cough as the presenting symptom. Around 80% considered IPF to be an important clinical disorder, and felt that identifying patients at risk for IPF was important or extremely important. However, only 59.7% felt confident in managing patients with IPF, and similar numbers (60.8%) felt confident about their knowledge. Pulmonologist have more confidence and management of IPF that no pulmonologist. Conclusion: The results of this survey of Latin American physicians could help to fill gaps regarding awareness, management and treatment of IPF and improve earlier diagnosis of IPF

Percepción cultural del “embarazo y parto”, en las comunidades campesinas del distrito Ayaviri-Puno

Native and Amazonian communities have this tendency to consider pregnancy and childbirth as a cultural and historical process of self-determination. This section deals with traditional knowledge in relation to pregnancy and childbirth, which is still revalued and put into practice in rural areas, however, this knowledge is being displaced by modernity. The objective of the research is aimed at reassessing the cultural perception of "pregnancy and childbirth", linked to customs, beliefs, cultural tradition, the role of midwives and symbolic representations, as a millenary cultural manifestation; This study is qualitative, using the ethnographic design and inductive method. The results describe the customs and beliefs in relation to pregnancy and childbirth associated with food beliefs and importance of supernatural beings and deities; as well as, the popular tradition expressed in celebrations at the family and collective level; The role of midwives is also developed in the therapeutic treatment with plants, minerals and animals, and ultimately the ritual acts related to pregnancy and childbirth are analyzed, as a product of an ancestral cultural heritage still valued in the district's communities. from Ayaviri-Puno.Las comunidades nativas y amazónicas tienen esa tendencia en considerar el embrazo y parto, como un proceso cultural e histórico de libre determinación. El presente apartado trata sobre los conocimientos tradicionales en relación al embarazo y parto, los cuales aún son revalorados y puestos en práctica en las zonas rurales, sin embargo, estos conocimientos están siendo desplazados por la modernidad. El objetivo de la investigación esta orientado en revalorar la percepción cultural del “embarazo y parto”, vinculados a las costumbres, creencias, tradición cultural, la función de las parteras y representaciones simbólicas, como una manifestación cultural milenaria; es estudio es de corte cualitativo, se utiliza el diseño etnográfico y método inductivo. En los resultados se describe las costumbres y creencias en relación al embarazo y parto asociadas a las creencias alimentarias e importancia seres sobrenaturales y deidades; así como, la tradición popular expresado en celebraciones a nivel familiar y colectivo; se desarrolla tambien la función de las parteras en el tratamiento terapéutico con plantas, minerales y animales, y en última instancia se analiza los actos rituales relacionados al embarazo y parto, como producto de una herencia cultural ancestral aún puesta en valor en las comunidades del distrito de Ayaviri-Puno

Identification of latexin by a proteomic analysis in rat normal articular cartilage

<p>Abstract</p> <p>Background</p> <p>Osteoarthritis (OA) is characterized by degeneration of articular cartilage. Animal models of OA induced are a widely used tool in the study of the pathogenesis of disease. Several proteomic techniques for selective extraction of proteins have provided protein profiles of chondrocytes and secretory patterns in normal and osteoarthritic cartilage, including the discovery of new and promising biomarkers. In this proteomic analysis to study several proteins from rat normal articular cartilage, two-dimensional electrophoresis and mass spectrometry (MS) were used. Interestingly, latexin (LXN) was found. Using an immunohistochemical technique, it was possible to determine its localization within the chondrocytes from normal and osteoarthritic articular cartilage.</p> <p>Results</p> <p>In this study, 147 proteins were visualized, and 47 proteins were identified by MS. A significant proportion of proteins are involved in metabolic processes and energy (32%), as well as participating in different biological functions including structural organization (19%), signal transduction and molecular signaling (11%), redox homeostasis (9%), transcription and protein synthesis (6%), and transport (6%). The identified proteins were assigned to one or more subcellular compartments.</p> <p>Among the identified proteins, we found some proteins already recognized in other studies such as OA-associated proteins. Interestingly, we identified LXN, an inhibitor of mammalian carboxypeptidases, which had not been described in articular cartilage. Immunolabeling assays for LXN showed a granular distribution pattern in the cytoplasm of most chondrocytes of the middle, deep and calcified zones of normal articular cartilage as well as in subchondral bone. In osteoarthritic cartilage, LXN was observed in superficial and deep zones.</p> <p>Conclusions</p> <p>This study provides the first proteomic analysis of normal articular cartilage of rat. We identified LXN, whose location was demonstrated by immunolabeling in the chondrocytes from the middle, deep and calcified zones of normal articular cartilage, and superficial and deep zones of osteoarthritic cartilage.</p

Factores contributivos del programa Pensión 65 y su relación con el bienestar del adulto mayor

Aging leads to the physical and mental deterioration of the person, it is a stage of maximum fragility, so the presence of social assistance programs that promote a decent stay at this stage is dispensable. For this reason, the Pension 65 program emerges, whose purpose is to ensure the well-being of the elderly living in poverty. Therefore, the objective of the research was to determine the contributory factors of the Pension 65 program and its relationship with the well-being of the elderly in the district of Pilcuyo, province of El Collao. The study was framed within the quantitative approach of the correlational type, non-experimental design. The sample consisted of 196 elderly beneficiaries. The results showed that there is a relationship between: household targeting (r=0.903**) and affiliation criteria, non-contributory pension (r=0.875**) and access to basic services, and between social assistance (r=0.890* *) and social satisfaction. In conclusion, the contributory factors of Pension 65 are significantly related (+0.891**, p&lt;0.05) with the well-being of the elderly.El envejecimiento conlleva al deterioro físico y mental de la persona, es una etapa de máxima fragilidad, por lo que se hace prescindible la presencia de programas de asistencia social que fomente una estadía digna en esta etapa. En razón a ello, emerge el programa Pensión 65 cuyo propósito es asegurar el bienestar de las personas de la tercera edad en situación de pobreza. Por ende, el objetivo de la investigación fue determinar los factores contributivos del programa Pensión 65 y su relación con el bienestar del adulto mayor en el distrito de Pilcuyo, provincia de El Collao. El estudio se enmarcó dentro del enfoque cuantitativo del tipo correlacional, diseño no-experimental. La muestra estuvo conformada por 196 adultos mayores beneficiarios. Los resultados evidenciaron que existe relación entre: focalización de hogares (r=0,903**) y criterios de afiliación, pensión no contributiva (r=0,875**) y acceso a los servicios básicos, y entre la asistencia social (r=0,890**) y satisfacción social. En conclusión, los factores contributivos de Pensión 65 se relacionan de forma significativa (+0,891**, p&lt;0,05) con el bienestar del adulto mayor

Obstructive sleep apnea knowledge and attitudes among recent medical graduates training in Ecuador

Background: We aimed to assess recent Latin American medical school graduates’ knowledge and attitudes about OSA and examine whether their knowledge and attitudes about OSA differed from practicing physicians. Methods: Recent medical graduates completed the Spanish translation of the OSA Knowledge and Attitudes (OSAKA) questionnaire at the 2013 national primary-care residency-placement meeting in Ecuador. The OSAKA includes 18 knowledge and five attitudinal items about OSA. We compared recent graduates’ data with data collected in 2010–2011 from practicing physicians using chi-square tests of associations among categorical variables and analysis of variance of differences in mean knowledge and attitude scores. Unadjusted logistic regression models tested the odds that recent graduates (vs. practicing physicians) answered each item correctly. Results: Of 265 recent graduates, 138 (52.1%) were male, and mean age was 25.9 years. Although mean knowledge was low overall, scores were lower for recent graduates than for the 367 practicing physicians (53.5% vs. 60.4%; p &lt; 0.001). Practicing physicians were significantly more likely to answer specific items correctly with one exception—recent graduates were more likely to know that &lt; 5 apneas-hypopneas/h is normal (OR 1.47, 1.03–2.07). Physicians in practice attributed greater importance to OSA as clinical disorder and the need for identifying patients with OSA; but recent graduates reported greater confidence in managing patients with OSA and CPAP. Conclusions: OSA-focused educational interventions during medical school should help to improve recent medical graduates’ abilities to diagnose and treat OSA. We recommend a greater number of hours of medical students’ exposure to sleep education

Recuperando la función endotelial

Atherosclerosis starts early in life. The presence of risk factors like hypertension, smoking, dyslipidemia and diabetes as well as obesity and metabolic syndrome accelerates its progress. These factors generate endothelial dysfunction, oxidative stress and inflammation, with early appearance of foamy cells, fatty streaks and atheromatous plaques. These plaques are vulnerable to erosion and rupture, the so called atherothrombotic phenomenon, leading to acute vascular events like acute coronary or cerebrovascular syndromes. Managing and treating the metabolic syndrome, early markers of cardiovascular risk, could slow down end organ aging and damage, probably without reduction of mortality but focusing on three fundamental aspects of early detection of subclinical atherothrombosis: prevention of cardiovascular events, protection of end organs, and improvement of quality of life.La enfermedad ateroesclerótica comienza a temprana edad. La presencia de factores de riesgo, como la hipertensión arterial, tabaquismo, dislipidemia y diabetes mellitus, a lo que hoy se suman la obesidad y el síndrome metabólico, originan desde el inicio disfunción endotelial, incremento del estrés oxidativo e inflamación, con aparición temprana de células espumosas, estrías grasas y placas de ateroma. Placas que en algunos de los casos son consideradas vulnerables, con un riesgo de sufrir erosión y rotura, el fenómeno aterotrombótico y un evento vascular agudo, como el síndrome coronario agudo y el accidente cerebrovascular. Al manejar y tratar los factores de riesgo cardiovasculares, síndrome metabólico, marcadores precoces del riesgo cardiovascular, se podría enlentecer o retardar el envejecimiento (injuria endotelial) de los órganos blanco, probablemente sin reducción de la mortalidad, pero logrando tres enfoques fundamentales con la detección temprana de la aterotrombosis subclínica: prevenir eventos cardiovasculares, brindar protección de los órganos blanco y mejorar la calidad de vida

Searching for star-forming dwarf galaxies in the Antlia cluster

Context. The formation and evolution of dwarf galaxies in clusters need to be understood, and this requires large aperture telescopes. Aims. In this sense, we selected the Antlia cluster to continue our previous work in the Virgo, Fornax, and Hydra clusters and in the Local Volume (LV). Because of the scarce available literature data, we selected a small sample of five blue compact dwarf (BCD) candidates in Antlia for observation. Methods. Using the Gemini South and GMOS camera, we acquired the Hα imaging needed to detect star-forming regions in this sample. With the long-slit spectroscopic data of the brightest seven knots detected in three BCD candidates, we derived their basic chemical properties. Using archival VISTA VHS survey images, we derived KS magnitudes and surface brightness profile fits for the whole sample to assess basic physical properties. Results. FS90-98, FS90-106, and FS90-147 are confirmed as BCDs and cluster members, based on their morphology, KS surface photometry, oxygen abundance, and velocity redshift. FS90-155 and FS90-319 did not show any Hα emission, and they could not be confirmed as dwarf cluster star-forming galaxies. Based on our data, we studied some fundamental relations to compare star forming dwarfs (BCDs and dIs) in the LV and in the Virgo, Fornax, Hydra, and Antlia clusters. Conclusions. Star-forming dwarfs in nearby clusters appear to follow same fundamental relations in the near infrared with similar objects in the LV, specifically the size-luminosity and the metallicity-luminosity, while other more fundamental relations could not be checked in Antlia due to lack of data.Facultad de Ciencias Astronómicas y GeofísicasInstituto de Astrofísica de La Plat

Evaluación de la política pública de escuela saludable en colombia: fase de formulación (1999-2006)

Objetivo Evaluar la formulación de la política pública de escuela saludable en Colombia en el período de 1999 a 2006.Métodos Investigación cualitativa de análisis del ciclo de política pública. Se utilizaron como estrategias centrales de recolección de información la revisión documental de fuente secundaria y la entrevista semi-estructurada (fuente primaria). Se llevó a cabo el análisis de contenido temático.Resultados Se identificaron dos momentos de formulación de políticas o lineamientos de la Estrategia Escuelas Saludables en Colombia. El primero relacionado con la publicación del documento “Escuela Saludable, la alegría de vivir en paz”, cuyo contenido presenta los lineamientos nacionales para implementar la política y el segundo posterior a la promulgación de la Declaración del Milenio, articulándose a la política los ámbitos de vivienda y salud. Los resultados tuvieron como categorías de integración de la información en normas, observación de actores, relaciones, problemas, objetivos, líneas de acción, tiempos de acción de la política y toma de decisión.Conclusiones La escuela saludable no ha sido objeto prioritario de las políticas pública del Estado Colombiano, pese a ser un compromiso asumido por el Estado con la Organización Panamericana de la Salud/Organización Mundial de la Salud, y de los altos mandatarios en las reuniones internacionales y ser una estrategia crucial para lograr las metas de los Objetivos de Desarrollo de Milenio