Capitulo 1. Ciencias Médicas y de la Salud

En los últimos años se ha observado un incremento de las enfermedades no transmisibles dentro de ellas se destaca el cáncer por su alta incidencia e impacto en la mortalidad (WHO, 2018). En las enfermedades transmisibles, si bien hay una disminución, las micosis se han incrementado, agravando el panorama la resistencia a los antimicóticos (Pfaller, 2012). Objetivo: Evaluar la actividad antifúngica y citotóxica in vitro de extractos etanólicos de Lantana camara L., Petiveria alliacea L. y Lippia dulcis T. Metodología: Se realiza un estudio experimental con tres componentes. Primero: evaluar las características fitoquímicas de los extractos etanólicos de Lantana camara l., Petiveria alliacea l. y Lippia dulcis t. mediante Cromatografía en Capa Delgada (CCD) y pruebas de coloración y precipitación (Sanabria, 1983). Segundo: evaluación de la actividad antifúngica de los extractos etanólicos frente a Candida albicans ATCC 10231, Candida parasilopsis ATCC 22019 y Saccharomyces cerevisiae ATCC 260 por técnica de difusión con disco (CSL 44-A), y la CMI mediante dilución de acuerdo con García y col 2003. Análisis de datos (ANOVA). Tercero: evaluación de actividad citotóxica de extractos etanólicos en líneas celulares de cáncer de seno MCF-7, y cáncer de cuello uterino SiHa, mediante la prueba de MTT (metil-tiazol-tetrazolio), según Mosmann (1983). Resultados: Las pruebas fitoquímicas realizadas confirmaron la presencia en abundancia de metabolitos tipo esteroides y/o terpenoides en las tres especies y tipo flavonoide incluyendo leucoantocianidinas en presencia moderada a abundante especialmente en P. alliacea y L. dulcis, mientras que en L. cámara se presentaron de forma escasa a moderada. Para La evaluación de actividad antifúngica se ha estandarizado mediante espectofotometría el inoculo de 1x10⁶ - 5x10⁶ UFC/mL (0,5 McFarland) a 550 nm (abs 0,125-0,128) respaldado por recuento en SDA + Cloranfenicol y se estableció el control positivo (Fluconazol 25μg) con prueba de difusión. Se evalúa DMSO como solvente y control negativo para continuar pruebas con extractos. En relación con evaluación de actividad citotóxica, las líneas celulares SiHa y MCF-7 se mantienen en medio DMEM 10% SFB y 1% de antibiótico. Se inició la evaluación de extracto etanólico de P. alliacea, en la línea celular SiHa, incluyendo Doxorrubicina como control de citotoxicidad al 0.14 μg/mL en forma preliminar para evaluar el porcentaje de viabilidad celular

Importancia de la reexpresión financiera en el sector hotelero

Seminario: la reexpresión de los estados financieros y su consolidació

A novel scoring system to measure radiographic abnormalities and related spirometric values in cured pulmonary tuberculosis.

BACKGROUND: Despite chemotherapy, patients with cured pulmonary tuberculosis may result in lung functional impairment. OBJECTIVE: To evaluate a novel scoring system based on the degree of radiographic abnormalities and related spirometric values in patients with cured pulmonary tuberculosis. METHODS: One hundred and twenty seven patients with cured pulmonary tuberculosis were prospectively enrolled in a referral hospital specializing in respiratory diseases. Spirometry was performed and the extent of radiographic abnormalities was evaluated twice by each of two readers to generate a novel quantitative score. Scoring reproducibility was analyzed by the intra-class correlation coefficient (ICC) and the Bland-Altman method. Multiple linear regression models were performed to assess the association of the extent of radiographic abnormalities with spirometric values. RESULTS: The intra-observer agreement for scoring of radiographic abnormalities (SRA) showed an ICC of 0.81 (CI:95%, 0.67-0.95) and 0.78 (CI:95%, 0.65-0.92), for reader 1 and 2, respectively. Inter-observer reproducibility for the first measurement was 0.83 (CI:95%, 0.71-0.95), and for the second measurement was 0.74 (CI:95%, 0.58-0.90). The Bland-Altman analysis of the intra-observer agreement showed a mean bias of 0.87% and -0.55% and an inter-observer agreement of -0.35% and -1.78%, indicating a minor average systematic variability. After adjustment for age, gender, height, smoking status, pack-years of smoking, and degree of dyspnea, the scoring degree of radiographic abnormalities was significantly and negatively associated with absolute and percent predicted values of FVC: -0.07 (CI:95%, -0.01 to -0.04); -2.48 (CI:95%, -3.45 to -1.50); and FEV1 -0.07 (CI:95%, -0.10 to -0.05); -2.92 (CI:95%, -3.87 to -1.97) respectively, in the patients studied. CONCLUSION: The extent of radiographic abnormalities, as evaluated through our novel scoring system, was inversely associated with spirometric values, and exhibited good reliability and reproducibility. As intra-observer and inter-observer agreement of the SRA varied from good to excellent, the use of SRA in this setting appears acceptable

Bland-Altman plot of measurement differences against measurements averages with 95% limits of agreement superimposed for pair-wise comparisons of Scoring of radiographic abnormalities (SRA), for inter-observer agreement: A) between reader 1 vs reader 2 for the first measurement, B) between reader one vs reader two for the second measurement.

<p>Bland-Altman plot of measurement differences against measurements averages with 95% limits of agreement superimposed for pair-wise comparisons of Scoring of radiographic abnormalities (SRA), for inter-observer agreement: A) between reader 1 vs reader 2 for the first measurement, B) between reader one vs reader two for the second measurement.</p

Bland-Altman plot of measurement differences against measurements average with a 95% limit of agreement superimposed for pair-wise comparisons of scoring of radiographic abnormalities (SRA), for intra-observer agreement: A) between reader one for the first and second measurements, B) between reader two for the first and second measurements.

<p>Bland-Altman plot of measurement differences against measurements average with a 95% limit of agreement superimposed for pair-wise comparisons of scoring of radiographic abnormalities (SRA), for intra-observer agreement: A) between reader one for the first and second measurements, B) between reader two for the first and second measurements.</p

Association of absolute values and percentage of predicted of forced vital capacity (FVC) (A, B); for whom forced expiratory volume in 1 s (FEV₁) (C, D) with the score of degree of radiographic abnormalities.

<p>(FEV₁).</p

Representative example of the result of the scoring system for radiographic abnormalities.

<p>Score =6.5, which represents the mean value of two evaluations.</p