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Objective To study the effect of zona opening (ZO) and 2 zona thinning (ZT) techniques on the hatching process of mouse embryos using a last-generation laser system and time-lapse microscopy (TLM). Design Prospective randomized study. Setting Private research center. Animals A total of 267 F1 hybrid (B6/CBA) mice embryos were included. Intervention(s) Morulae were randomly selected and the zona pellucida (ZP) manipulated using a laser system according to 4 experimental groups: control (ZP intact, n = 59), ZO (25 μm hole, n = 70), ZT25 (25% perimeter thinned, n = 71), and ZT35 (35% perimeter thinned, n = 67). Embryo development was monitored by TLM until day 6. Main Outcome Measure(s) Time to first breach the ZP, hatching time, time to complete hatching, multiple breaching, multiple hatching, loss of cells, hole size, and embryo quality were analyzed. Result(s) No significant differences in the proportion of completely hatched embryos were found among groups. However, the time (average hours ± SD) to complete hatching was significantly delayed in the control group compared with all laser-treated groups: 118.3 ± 9.5 hours in the ZT25 group, 116.6 ± 8.7 hours in the ZT35 group, and 120.4 ± 9.9 hours in the ZO group. The applied laser techniques did not interfere with the quality of the blastocysts at day 5/6 of culture. Conclusion(s) ZO, ZT25, and ZT35 embryos hatched significantly earlier than the zona intact group without increasing the multiple hatching rates, suggesting an improvement of the hatching process. This study found that the pattern of the hatching process after ZT and ZO differs.

Objectives: To study the change of CD16 + 56 in zona. Materials and Methods: 62 zona patients admitted at Inpatient Department of Dermatology, Venereology Allergy, 108 Military Central Hospital, and 30 healthy volunteers who were matched for age and sex participated in this study. Prospective, cross-sectional study with controls was conducted. We measured the number of CD16 + CD56 by flow cytometry using FACS Callibur. Results: The mean level of CD16 + 56 in zona patients was 253 ± 200 (106 cells/l), which was lower than that of control group but then increased after treatment. The change of CD16 + 56 did not correlate with patients’ age. Patients who were in severe condition or had affected size from 3% or more had a lower number of CD16 + 56 than control group. Conclusion: The number of CD16 + 56 in zona patients were lower than that of healthy people.

Hoy en día, la sostenibilidad y la diversidad juegan un papel clave en las empresas. Cada vez es mayor la concienciación y las exigencias en ambas dimensiones. Por ello, el presente trabajo tiene como objetivo analizar la diversidad de género, su relación con la sostenibilidad y su efecto sobre el desempeño en las empresas europeas. Los resultados del estudio revelan como existen diferencias de diversidad entre las distintas zonas de Europa, como ambas dimensiones analizadas no se retroalimentan de la forma esperada y la imposibilidad de establecer una relación entre mayor rentabilidad y mayores niveles de sostenibilidad y diversidad. Las conclusiones de este trabajo engloban los resultados obtenidos y recogen algunas posibles razones explicativas de los mismos. Today, sustainability and diversity play a key role in business. Awareness and demands in both dimensions are increasing. Therefore, this paper aims to analyse gender diversity, its relationship with sustainability and its effect on performance in European companies. The results of the study reveal how there are differences in diversity between the different areas of Europe, how the two dimensions analysed do not feed back in the expected way and the impossibility of establishing a relationship between greater profitability and higher levels of sustainability and diversity. The conclusions of this work encompass the results obtained and include some possible explanatory reasons for them. Graduado o Graduada en Administración y Dirección de Empresas / Graduado o Graduada en Derecho por la Universidad Pública de Navarra Enpresen Administrazio eta Zuzendaritzan Graduatua / Zuzenbide Gradua Nafarroako Unibertsitate Publikoan

O objetivo foi traçar o perfil sócio-econômico e obstétrico das grávidas atendidas em consultas de enfermagem no distrito de Maniçoba pertencente a Juazeiro-BA. Trabalho tem abordagem quantitativa, natureza exploratória e descritiva a partir de uma análise documental retrospectiva em 61 fichas de pré-natal, no período de junho de 2018 a janeiro de 2019. O perfil demonstrou que grande parte das gestantes são primigestas (49%), trabalhadoras rurais (40,98%), católicas (18%), estão dentro da faixa etária de baixo risco para gestar (47,5%), moram com seus companheiros (46%), não concluíram o ensino médio (56%) e a maioria não declarou da cor da pele (82%). A partir dessa compreensão dos dados foi possível identificar fatores de risco durante o período gravídico-puerperal, promover práticas assistenciais e de educação popular em saúde na perspectiva de atenção as necessidades das gestantes.

[ID] Pembangunan Menara Bank Rakyat Indonesia Pekanbaru didukung dengan core wall yang merupakan struktur beton bertulang vertikal berbentuk dinding dirancang untuk menahan gaya geser, gaya lateral. Keterlambatan penyelesaian pekerjaan core wall akan mempengaruhi siklus floor to floor pembangunan bangunan yang akan berdampak pada biaya proyek, maka dibutuhkan suatu metode bekisting yang dapat memberikan dampak yang signifikan dinilai dalam hal efektif dan efisiennya dalam pekerjaan core wall. Oleh karena itu dilakukan penelitian tentang tingkat efisiensi biaya pekerjaan bekisting core wall. Penelitian ini bertujuan untuk mengetahui biaya yang dibutuhkan pada pekerjaan bekisting core wall dengan menggunakan metode konvensional, semi sistem dan climbing system dan menentukan tingkat efisiensi biaya pada pekerjaan bekisting struktur core wall menggunakan semi sistem dan climbing system dibanding konvensional. Metode pada penelitian ini adalah analisa biaya pekerjaan bekisting struktur core wall menggunakan konvensional, semi sistem dan climbing system, untuk pengerjaan struktur bangunan menggunakan sistem zona untuk waktu penyelesaian pekerjaan struktur setiap lantai selama 5 hari, dengan analisa yang terdiri dari analisa kebutuhan material dan alat bekisting, analisa kebutuhan pekerja, analisa upah harian pekerjaan, analisa upah borongan pekerjaan, analisa parameter pendukung harga satuan, analisa harga satuan bekisting, perhitungan biaya total pekerjaan bekisting. Berdasarkan hasil analisa perhitungan diperolehlah total biaya pekerjaan bekisting core wall untuk metode konvensional dengan upah harian sebesar Rp160.981.400,00 dan dengan upah borongan sebesar Rp91.522.980,00 dan untuk metode semi sistem dengan upah harian sebesar Rp125.592.380,00 dan dengan upah borongan sebesar Rp67.751.640,00 sedangkan untuk metode climbing system dengan upah harian sebesar Rp126.062.350,00 dan dengan upah borongan sebesar Rp90.485.000,00 dan tingkat efisiensi biaya pekerjaan bekisting struktur core wall untuk perbandingan menggunakan konvensional dengan semi sistem sebesar 25,97 % dan untuk perbandingan menggunakan konvensional dengan climbing system sebesar 1,13 %.

The article investigates the structure of the suprarenal (adrenal) glands of male rabbits (Oryctolagus cuniculus), in which, on the basis of electrocardiographic and variational-pulsometric studies, different types of autonomic tone were observed. This allowed the animals to be divided into three groups: 1) sympathicotonic rabbits; 2) normotonic rabbits; 3) parasympathicotonic rabbits. The animals of the first two groups were characterized by almost the same body weight, while weight of the rabbits of the third group was slightly higher. After euthanasia, the suprarenal glands were extracted for histological and histochemical analyses. Morphometric study of histopreparations revealed that in the normotonic rabbits the thickness of the zona glomerulosa and zona fasciculata of the suprarenal glands were of average sizes, and the area of the medulla was the smallest. The parasympathicotonic rabbits had the thickest zona glomerulosa and greatest area of the medulla, but the thinnest zona fasciculata. The sympathicotonic rabbits were observed to have the greatest thickness of the zona fasciculata of the suprarenal glands, the area of the medulla was of average values, and the thickness of the zona glumerulosa was of minimum value. The type of autonomic tone also manifests in the saturation of each of the zones with cells. The normotonic rabbits were observed to have the highest number of cells per area of 1,000 µm² in the zona fasciculata and the medulla, sympathicotonic rabbits – in the zona glomerulosa and zona reticularis, and in parasympathicotonic rabbits this parameter had average or lowest values in all the zones. The sizes of cells and their structural parts were characterized on the basis of nuclear-cytoplasmic ratio. In the zona fasciculata and medulla this parameter was highest among parasympathicotonic rabbits, and lowest in sympathicotonic rabbits. In the zona glomerulosa, almost equal values were observed in the normotonic and parasympathicotonic rabbits, while being reliably lower in sympathicotonic rabbits. By the value of nuclear-cytoplasmic ratio in the zona reticularis, the normotonic rabbits dominated, followed by the sympathicotonic animals, and the parasympathicotonic rabbits had the lowest parameters.

Introdução: Os linfomas são um conjunto de neoplasias linfoides em que há o acúmulo de linfócitos malignos nos linfonodos, causando linfonodomegalia. Os linfomas são responsáveis por 3% a 4% dos cânceres no mundo. Estimativa mundial apontou 390 mil novos casos e 199 mil óbitos por linfoma não Hodgkin e 65 mil novos casos e 25 mil óbitos por Linfoma de Hodgkin no ano de 2012. Sendo a busca por cuidados terapêuticos e a tentativa de solucionar problemas de saúde conduzem indivíduo e familiares por caminhos compreendidos como itinerário terapêutico Objetivo: Conhecer o itinerário terapêutico de pacientes portadores de linfoma atendidos na rede pública por serviço de saúde especializado. Material e Métodos: Estudo prospectivo e descritivo com dados coletados em um hospital de referência em oncologia na Zona da Mata Mineira, no estado de Minas Gerais, Brasil. Resultados: Participaram do estudo 32 pacientes, sendo 18 do sexo masculino (56,3%), com idade entre 7 e 80 anos, caracterizados principalmente por baixos níveis de escolaridade e renda. Prevaleceu o linfoma não Hodgkin representado por 23 sujeitos (71,9%). Um total de 24 pacientes (75%) necessitou passar por três ou mais médicos até a obtenção do diagnóstico definitivo. O tempo médio entre o aparecimento dos sintomas e a realização do diagnóstico foi de 9,77 meses. A baixa renda dos pacientes contribuiu para a demora na busca ou obtenção do primeiro atendimento à saúde (p = 0,05) e consequente diagnóstico do linfoma. Conclusão: A dificuldade de acesso aos serviços de atenção à saúde e a baixa suspeita diagnóstica para a doença por parte dos profissionais possivelmente influenciaram o atraso no estabelecimento do diagnóstico.

Research Question Does complete mechanical removal of the zona pellucida modify the outcome of transfer of vitrified–warmed human blastocysts? Design In a prospective randomized controlled study, 419 couples were allocated to either zona pellucida-free (n = 209) or zona intact (n = 210) vitrified–warmed embryo transfer. Main outcome measures included clinical pregnancy, implantation and ongoing pregnancy rates. Results Transfer of zona pellucida-free blastocysts resulted in clinical pregnancy, implantation and ongoing pregnancy rates (35,9%, 33,9% and 32,1%, respectively), similar to those achieved with zona intact control embryos (39%, 36,4% and 33,1%, respectively). Conclusion Total mechanical removal of the zona pellucida did not affect the tested parameters of clinical outcomes.

Objective. Evaluate the effects of the habitat zone and sex on the serum biochemical and morphometric response of Ichthyoelephas humeralis in lotic ecosystems of Los Ríos province, Ecuador. Materials and methods. One of the native species (I. humeralis) that are most commercialized in the cantons of Quevedo, Mocache and Fumisa of Los Ríos Province was identified, 60 specimens were captured for each area (180 total), the sexed and the live weight, length, thickness of the head, body and tail were determined; condition Factor and blood biochemistry (glucose, cholesterol and triglycerides). Results. For the morphometric indicators there was no zone-sex interaction. There were only significant differences (p, Objetivo. Evaluar los efectos de la zona de habitad y sexo en la respuesta bioquímica sérica y morfométrica de Ichthyoelephas humeralis en ecosistemas loticos de la provincia Los Ríos, Ecuador. Materiales y métodos. Se identificó una de las especies nativas (I. humeralis) que más se comercializan en los cantones de Quevedo, Mocache y Fumisa de la provincia Los Ríos. Se capturaron 60 ejemplares por cada zona (180 total). Se realizó el sexado y se determinó el peso vivo, la longitud, el grosor de la cabeza, cuerpo y cola; factor de condición y bioquímica sanguínea (glucosa, colesterol y triglicéridos). Resultados. Para los indicadores morfométricos no hubo interacción zona-sexo. Solo existieron diferencias significativas (p

Objetivo: Determinar el efecto non-dipper inmediato y posterior a 1 mes en pacientes adultos hipertensos postrasplante renal con monitoreo continuo de la presión arterial de 24 horas, en el Hospital General de Zona No. 50 de San Luis Potosí, México. Método: Estudio de tipo cohorte, longitudinal, prospectivo, con muestreo no probabilístico por conveniencia de casos consecutivos en pacientes receptores de trasplante renal con hipertensión arterial. Se recogieron los siguientes datos: edad, sexo, factores de riesgo cardiovascular, uso de antihipertensivos o inmunosupresores, y monitoreo ambulatorio de la presión arterial de 24 horas. Se aplicaron medidas de tendencia central y de dispersión para análisis descriptivo, y prueba t de Student para análisis inferencial. Resultados: Se incluyeron 11 hombres (57.9%) y 8 mujeres (42.1%), con una edad de 20 a 49 años (media 30.2 ± 7.7), en los que el efecto non-dipper inmediato fue del 89.5% y posterior a 1 mes fue del 84.2%. Conclusiones: Existe una alta frecuencia del patrón non-dipper en pacientes a 1 mes del trasplante renal. La persistencia de la hipertensión puede ser, entre otras causas, por el uso de inmunosupresores. Se describe una nueva categoría para la clasificación non-dipper.

Resumo Objetivos: A nevralgia pós-herpética (NPH) é a principal complicação do herpes zoster (HZ), tendo um impacto significativo na qualidade de vida dos doentes e nos custos em saúde. Com esta revisão pretende-se avaliar a eficácia de diferentes terapêuticas utilizadas no tratamento agudo da zona na prevenção desta complicação. Fontes de dados: MEDLINE/PubMed, National Guide Clearinghouse, Canadian Medical Association Practice Guidelines, Bandolier, Evidence-Based Medicine Online, DARE, TRIP Database e The Cochrane Library. Métodos de revisão: Pesquisa de guidelines, meta-análises, revisões sistemáticas e ensaios clínicos controlados e aleatorizados publicados entre abril de 2010 e março de 2020, redigidos em inglês, português ou espanhol, utilizando os termos MeSH herpes zoster e neuralgia, postherpetic. Resultados: Dos 333 resultados obtidos na pesquisa inicial foram selecionados sete artigos para inclusão nesta revisão, nomeadamente duas meta-análises, uma revisão sistemática e quatro ensaios clínicos controlados e aleatorizados. A evidência encontrada relativamente à utilização de antivíricos, glucocorticoides ou gabapentinoides no tratamento do HZ não demonstrou benefício na prevenção da NPH. Apenas as opções por amitriptilina ou vitamina C endovenosa revelaram resultados positivos, ainda que com evidência escassa e limitada. Conclusão: Esta revisão permite concluir que nenhum dos tratamentos habitualmente utilizados no tratamento agudo do HZ previne a ocorrência de NPH. Apesar dos resultados positivos da amitriptilina e da vitamina C não existe ainda evidência suficientemente robusta que permita recomendar o uso disseminado destes fármacos na fase aguda do HZ com o intuito de prevenir esta complicação. Mais estudos são necessários neste sentido, tendo em conta a morbilidade e custos em saúde associados à NPH.

Introduction Varicella zona infection is a rare condition in immunocompetent adults. It can lead to severe and lethal complications including Varicella pneumonia that can rapidly progress to acute respiratory distress syndrome a rare and life-threatening situation. Clinical case A 63 years old man was admitted to the intensive care unit for pneumonia with generalized papulovesicular lesions. After investigations, the diagnosis of Varicella pneumonia complicated with acute respiratory distress syndrome was maintained and the patient was put on mechanical ventilation, and despite proper management (antiviral treatment; protective ventilation and prone position) the patient died 48 hours after his admission. Conclusion Despite its rarity, Varicella pneumonia can be a life-threatening situation in immunocompetent adults. The diagnosis must be evoked when the patient presented with respiratory manifestations with dermatologic lesions., Highlights • Varicella is a highly contagious disease caused by the initial infection with varicella-zoster virus (VZV). • The clinical symptomatology of Varicella infection is usually mild, however, it can manifest with serious complications including varicella pneumonia in immunocompromised patients. • In this paper we describe a rare clinical case of pnumonia varicella complicated with acute respiratory distress syndrom in immunocompetent adult.

Este proyecto se justifica en la creación de una empresa que contribuye a los procesos de reciclaje , especialmente los plásticos que se encuentran en el grupo del polietileno , los cuales son envases de bebidas, plastos, vasos, cucharas, bolsas, entre otros, para la reutilización y disminución de la contaminación en la zona urbana de santa cruz de lorica ,. Para poder llevar a cabo la creación de la empresa productora y comercializadora de muebles hechos con madera plástico, se necesita el valioso recurso humano, con habilidades, destrezas y competencias necesarias para contribuir a la solución de problemas y al desarrollo sostenible del municipio Introducción................................................................................................................ 7 Resumen ejecutivo..................................................................................................... 8 Referente teórico conceptual ................................................................................... 10 Módulo de mercado.................................................................................................. 21 Producto............................................................................................................................................ 21 Características técnicas................................................................................................................. 22 Usos............................................................................................................................................... 26 Beneficios...................................................................................................................................... 26 Productos sustitutos...................................................................................................................... 27 Productos complementarios......................................................................................................... 27 Consumidor final ............................................................................................................................... 27 Segmentación del mercado........................................................................................................... 28 Características socioculturales...................................................................................................... 28 Delimitación del área geográfica:...................................................................................................... 29 Análisis de demanda.......................................................................................................................... 30 Diseño muestra ............................................................................................................................. 30 Validación del instrumentó ........................................................................................................... 31 Calculo de la demanda actual........................................................................................................ 31 Proyección de la demanda ............................................................................................................ 33 Análisis de la oferta ........................................................................................................................... 34 Proyección de la demanda insatisfecha ........................................................................................ 34 Análisis de precios............................................................................................................................. 35 Canales de comercilizacion ............................................................................................................... 36 Imagen del servicio............................................................................................................................ 36 Estrategia de publicidad.................................................................................................................... 37 Módulo técnico y organizacional .............................................................................. 37 Tamaño del proyecto................................................................................................................. 37 Localización ............................................................................................................................... 43 Macro localización..................................................................................................................... 43 Sociales: lorica tiene buenas tendencias de desarrollo. La comunidad es trabajadora y aporta a las buenas prácticas de carácter social......................................................................... 43 Micro localización...................................................................................................................... 44 Distribución en Planta ................................................................................................................... 44 Proceso del servicio....................................................................................................................... 45 Naturaleza jurídica ........................................................................................................................ 46 Misión............................................................................................................................................ 46 Visión............................................................................................................................................. 46 Organigrama.................................................................................................................................. 47 Manual de funciones..................................................................................................................... 48 Módulo de impacto social, económico y ambiental .................................................. 51 Módulo financiero..................................................................................................... 53 Inversiones .................................................................................................................................... 53 Punto de equilibrio........................................................................................................................ 62 Proyecciones financieras para el periodo de evaluación .............................................................. 64 Proyección capital de trabajo........................................................................................................ 66 R B/C............................................................................................................................... 72 Fuentes de financiación ........................................................................................... 75 Conclusiones............................................................................................................ 76 . Recomendaciones.................................................................................................... 77 Bibliografía ............................................................................................................... 78 Pregrado Administrador(a) en Finanzas y Negocios Internacionales Creación de empresa

American cutaneous leishmaniasis is considered endemic in 18 countries in the Americas, including Brazil, and is part of the group of neglected infectious diseases. In the state of Alagoas, from 2008 to 2018, 676 cases of leishmaniasis were reported in SINAN. Therefore, the objective was to describe the epidemiological and sociodemographic characteristics of cases reported and treated for American cutaneous leishmaniasis, during the years 2008 to 2018. This is a descriptive, ecological, cross-sectional epidemiological study with a quantitative, retrospective approach, based on secondary online data from the Informatics Department of the Unified Health System (DATASUS). All cases of leishmaniasis reported in Alagoas, from 2008 to 2018 were considered. The variables analyzed were: clinical evolution of leishmaniasis; sex; age group; schooling; micro-region of residence / IBGE. The health indicators were detailed: incidence; prevalence; and the proportional mortality rate. It was observed that the disease prevalence rate in this period is 0.21% o, the incidence rate is 0.035% o, and mortality is 0.30%. The most affected age group is that of individuals between 20 and 59 years old (50.60%). As for education, 27.81% are from individuals who attended incomplete elementary school. While male people represent 66.72% of the total number of affected individuals. In addition, 51.20% of cases are from the Zona da Mata region. It was found, then, that leishmaniasis is an endemic disease in Alagoas, predominant in men of working age, who have not completed the 4th grade of elementary school, living in the Zona da Mata region. KEYWORDS: Epidemiology; Neglected Diseases; Public Health situation; American cutaneous leishmaniasis. RESUMO: A leishmaniose tegumentar americana (LTA) é considerada endêmica em 18 países das Américas, incluindo o Brasil, e integra o grupo de doenças infecciosas negligenciadas. Diante disso, objetivou-se descrever as características epidemiológicas e sociodemográficas de casos notificados e atendidos de leishmaniose tegumentar americana, durante os anos de 2008 a 2018. Trata-se de um estudo ecológico, com abordagem quantitativa, desenvolvido por meio de consulta a dados secundários online oriundos do Departamento de Informática do Sistema Único de Saúde (DATASUS). Foram considerados todos os casos de LTA notificados em Alagoas, no período de 2008 a 2018. As variáveis analisadas foram: evolução clínica da LTA; sexo; faixa etária; escolaridade; microrregião de residência/IBGE. Detalhou-se os indicadores de saúde: incidência; prevalência; e a taxa de mortalidade proporcional. Observou-se que a taxa de prevalência da doença nesse período é de 0,21%o, a de incidência é de 0,035%o, e de mortalidade é de 0,30%. A faixa etária mais acometida é a de indivíduos de 20 a 59 anos (50,60%). Quanto a escolaridade, 27,81% são de indivíduos que cursaram ensino fundamental incompleto. Enquanto que pessoas do sexo masculino representam 66,72% do total de indivíduos acometidos. Ademais, 51,20% dos casos são provenientes da região da Zona da Mata. Verificou-se, então, que a LTA é uma doença de caráter endêmico em Alagoas, predominante em homens em idade produtiva, que não concluíram a 4ª série do ensino fundamental, residentes da região da Zona da Mata. PALAVRAS-CHAVE: Epidemiologia; Doenças Negligenciadas; Situação de Saúde Pública; Leishmaniose Tegumentar Americana.

Aim: Vitamin D affects the secretion of antimicrobial peptides associated with toll-like receptor (TLR), which have antiviral effects. It has been suggested that vitamin D may affect the susceptibility of the host to varicella zoster virus (VZV) and the clinical course of zona zoster. Materials and Methods: In this study, 101 patients who were diagnosed with zona zoster at the dermatology outpatient clinic and had a vitamin D result at the time of diagnosis and a control group of 100 people were included. Results were analyzed statistically. Results: The 25-OH vitamin D levels of the patients ranged from 2.37 to 32.98 µg / L and the mean value was 14.25 ± 7.20 µg / L. In the control group, 25-OH vitamin D levels ranged between 10.3 and 44.25 µg / L, and the mean value was 24.9 ± 6.24 µg / L. 25-OH vitamin D levels in the patient group were significantly lower than the levels in the control group. (p

Le zona est une réactivation du Virus Varicelle-Zona (VZV) chez le sujet ayant déjà présenté un épisode de varicelle. Il comporte plusieurs phases : primo-infection, phase de latence, réactivation, immunosénescence, évolution clinique de l’éruption cutanée. La prise en charge thérapeutique du zona a pour but d’une part, de baisser la virémie et de contrôler l’infection virale, et d’autre part de traiter les symptômes et soulager le patient que ce soit pendant la poussée aigüe ou les douleurs chroniques.Il y a la prise en charge de l’infection virale grâce à des traitements antiviraux, de la douleur en phase aiguë grâce aux antalgiques et aux anti-inflammatoires ; et des douleurs chroniques grâce aux antidépresseurs tricycliques, aux antiépileptiques ou la lidocaïne en emplâtre.Afin de prévenir le zona, il existe un vaccin : le ZOSTAVAX® qui est indiqué dans la prévention du zona et des névralgies post-zostériennes chez les plus de 50 ans mais recommandé chez les patients de 65 à 74 ans Les différentes études autour du ZOSTAVAX®, ont permis de montrer qu’il est efficace chez les patients de la tranche d’âge des recommandations. Son efficacité porte sur l’impact de la maladie, l’incidence des névralgies post-zostériennes et sur l’incidence des formes sévères. Des conseils sont proposés aux patients présentant un zona avec différents types de thérapeutiques : phytothérapie, aromathérapie, homéopathie… Ces thérapeutiques peuvent être proposés au patient en traitement unique ou en accompagnement d’un traitement allopathique.

Any patient with a herpes zoster infection of the mandibular branch of the trigeminal nerve should benefit from early oral monitoring, especially in elderly population where traumatic dental prostheses are common, because osteonecrosis can occur., Herpes zoster infection is a rare and little‐known etiology of osteonecrosis of the maxilla. Only a few cases have reported in the international literature. We present a rare case of right mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve.

espanolLa pseudoobstruccion de colon puede diagnosticarse facilmente y con precision mediante tomografia computarizada (TC). Los hallazgos radiologicos consisten en una dilatacion extensa del marco colico sin evidencia de lesion obstructiva mecanica y una zona de transicion de calibre intermedia localizada de forma tipica en la flexura esplenica o adyacente a la misma. El tratamiento mediante descompresion colonoscopica mejora el pronostico de los pacientes que presentan gran dilatacion y mayor riesgo de isquemia y perforacion. EnglishColonic pseudoobstruction can be diagnosed by computed tomography (CT). Radiological findings consist of extensive colonic dilatation without an obstructive lesion at the intermediate transitional zone or adjacent to the splenic flexure. Conservative treatment with colonoscopic descompression improves the prognosis of patients who have large distention and increased risk of ischemia and perforation.

espanolThe varicella zoster virus (VZV) belongs to the family of herpesviruses. Varicella (chickenpox) is the clinical manifestation of the primary infection with VZV and zoster (shingles) that of its reactivation. VZV infection is highly contagious. It requires a high level of vigilance during the perinatal period. Treatment of chickenpox in children is generally straightforward. The immunity acquired after the primary infection is virtually definitive francaisLe virus varicelle-zona (VZV) appartient a la famille des herpes virus. La varicelle est la manifestation clinique de la primo-infection au VZV et le zona celle de sa reactivation. L’infection au VZV est tres contagieuse. Elle doit conduire a une grande vigilance en periode perinatale. La prise en charge de la varicelle de l’enfant se revele en general simple. L’immunite acquise apres la primo-infection est quasi definitive

Introduction Les premières manifestations cutanées possiblement liées à la Coronavirus Disease-19 (COVID-19) ont été rapportées au printemps 2020. Des cas de zona post-COVID-19 ont fait l’objet de plusieurs publications, parfois considérés comme une manifestation cutanée prédictive de COVID-19, mais avec une signification diagnostique et pronostique débattue. La survenue d’un zona est un phénomène rare au cours de certains de type de vaccination (fièvre jaune, etc.) mais peu de données sont disponibles dans le cadre de la vaccination anti-COVID-19. Nous rapportons une série de 10 cas de zona survenus dans les suites d’une vaccination anti-COVID-19. Matériel et méthodes Il s’agit d’un recueil multicentrique prospectif anonyme, sur appel à cas auprès des dermatologues hospitaliers des départements du Nord et du Pas-de-Calais entre janvier et juin 2021, des cas de zona survenus après tout vaccin anti-COVID-19 réalisé au sein de structures accueillant des centres de vaccination. Sur le site du CHU de Lille, en plus du recueil prospectif, les fiches de suivi post-vaccinal ont été recueillies rétrospectivement de janvier à février 2021 afin d’en extraire les zonas n’ayant pas été signalés via l’appel à cas. Résultats Un total de 10 patients ont été inclus dont 6 femmes et 4 hommes. L’âge moyen était de 62 ans. Sept patients ont été examinés par un dermatologue sénior, trois patients ont été recontactés à partir des fiches de suivi post-vaccinal. Le vaccin le plus souvent réalisé était le vaccin Pfizer/BioNtech (n = 8/10, 80 %), suivi par le vaccin AstraZeneca (n = 2/10, 20 %). Un patient avait des ATCD d’infection COVID-19 (10 %). Ces zonas étaient survenus essentiellement après la première injection (n = 9/10, 90 %). Le délai médian de survenue après vaccination était de 3,5 jours (IIQ, 2–9 jours). Le zona était homolatéral à l’injection chez 4 patients (40 %). L’éruption était majoritairement localisée aux membres supérieurs (50 %), puis aux membres inférieurs (30 %), au visage (20 %) et au tronc (20 %). Seul un patient présentait un antécédent d’immunosuppression, et un patient avait un antécédent ancien de zona. La PCR VZV, réalisée sur les lésions de 2 patients, était positive. La prise en charge proposée était identique à celle des zonas en général. Discussion Notre série rapporte 10 cas de zona survenus après injection de vaccin anti-COVID-19, dont aucun cas grave. Les douleurs post-vaccinales ou les réactions au point d’injection sont fréquentes avec les vaccins anti-COVID-19, mais une extension de la localisation de la douleur, une sensation de brûlure, et une éruption vésiculeuse doivent faire suspecter un zona, quel que soit le délai entre l’injection du vaccin et la survenue de ces symptômes. Ces évènements ne contre-indiquent pas la réalisation de la seconde injection en cas de survenue lors de la première injection. Le service médical rendu de la vaccination contre la COVID-19 demeure important.

Objective: To evaluate knowledge related to TB and to investigate the predictive factors of the prisoners' knowledge status in a regional penitentiary in the Zona da Mata Mineira - Brazil. Methods: This is a cross-sectional and institutionally based study that was conducted with 729 individuals deprived of their liberty in a regional penitentiary. A questionnaire was applied and the detainees 'knowledge about tuberculosis was obtained from the participants' answers to questions about tuberculosis prevention, transmission and treatment. For data analysis, multiple logistic regression was used. Results: Approximately 40% of the detainees reported not having knowledge about transmission, prevention and treatment of tuberculosis and the lack of knowledge was associated with the following variables: lower education, lower income, closed regime, being the first prison, not having contact with TB outside and inside the prison, not showing symptoms of cough with secretion, weakness and chest pain and not having an HIV test. Conclusion: The lack of knowledge about tuberculosis was associated with education, income, prison terms, first prison, contact with TB outside and inside the prison, symptoms of tuberculosis and HIV testing. The recognition of these factors can contribute to the development of educational interventions aimed at controlling tuberculosis in this population.

Introduction: Injuries and violence represent a major public health problem worldwide. It is still a leading cause of mortality specially in developing countries. Ubiquitin is a heat shock protein, which is induced by various kinds of traumatic stress. Aim of the work: The aim of this study is to investigate the immunohistochemical expression of ubiquitin in suprarenal and renal tissues in blunt and sharp traumatic deaths. Subjects and methods: Cross sectional post-mortem study was conducted on the traumatic medicoegal autopsy cases and natural cases in Banha medicolegal unit (Ministry of Justice) over six months interval from February 2016 to August 2016. For all medicolegal cases, the data collection sheet included age, sex, date of death, survival time and cause of death. Histological examinations and ubiquitin immunostaining were performed on the suprarenal and renal tissues. Results: Forty-five autopsy cases were included in this study. The majority of victims were males (84.4%) from rural regions (70.5%). Blunt injuries represented the majority of traumatic deaths (57.14%). The greater part of traumatic cases (74.3%) died within 24 hours post injuries. Traumatic cases revealed acute tubular necrosis and vascular degeneration in renal tissue and exhaustion of lipid contents of zona fasiculata in suprarenal tissue specimens. Traumatic deaths showed significant increase in ubiquitin expression in compared to natural deaths in renal distal convoluted tubules and suprarenal cortex. Moreover, there was significant positive correlation between survival period and positive ubiquitin immune expression in each of renal distal convoluted tubules (r=0.461, p=0.005) and suprarenal cortex (r=0.459, p=0.006). Conclusion: Ubiquitin immunoexpression can serve as a stress indicator of traumatic deaths and it may be useful for determination of survival period.

DCRoutes es una aplicación web, destinada a ser integrada en un proyecto colaborativo entre el CRAAX y el Hospital Clínic de Barcelona. Uno de los componentes de ese proyecto se centra en facilitar a los médicos, el hecho de poder evaluar a un conjunto de pacientes con problemas respiratorios, con el objetivo de que puedan mejorar su capacidad pulmonar tras una serie de ejercicios. DCRoutes en concreto, tiene como objetivo, ofrecer la posibilidad de crear rutas en una zona geográfica específica. Una vez se genera una ruta, el sistema automáticamente la analizará en base a un conjunto de aspectos como elevaciones, distancia, duración aproximada, etc.,para de esta manera asignar una dificultad a dicha ruta. Pensando en el esquema general del proyecto, una vez el doctor esté con un paciente para asignarle una ruta, podrá utilizar la solución propuesta en este proyecto para bien analizar las rutas ya creadas por otro doctor o por él mismo y reutilizar alguna ruta para asignarla a su paciente, o bien podrá crear nuevas rutas/zonas para poder adecuarse mejor a las necesidades de este. Así, las rutas podrían acomodar necesidades propias del paciente como por ejemplo, el hecho que al paciente le gustara realizar dichas rutas en su zona de residencia y que además el origen de las mismas fuera el domicilio particular del paciente.. Gracias a una serie de reuniones con el resto del equipo del CRAAX y los médicos del Clínic de Barcelona, hemos ido integrando nuevas ideas y el proyecto ha ido evolucionando con las diferentes versiones. Tras estos meses de trabajo y las reuniones realizadas, se considera el resultado final satisfactorio de acuerdo a los objetivos iniciales planteados. DCRoutes is a web application designed to integrate with a collaborative project between CRAAX and Hospital Clínic de Barcelona. The aim of the project is to facilitate the evaluation of patients with respiratory problems in order to improve their lung capacity by a series of exercises. DCRoutes' specific objective is to make it possible to create routes in certain zones saved in the system. Once a route is generated, the system automatically analyses it, based on a set of values such as elevation, distance, approximate duration and more. The final analysis serves to assign a suitable difficulty to the associated track. Regarding the general scheme of the project, the doctor assigning a route to the patient will use our system to analyse routes already created by himself or another doctor/physiotherapist, and he will subsequently allocate the selected route to the patient. Also, as a second option, the doctor is able to create new tracks or choose new zones so as to adjust the route according to the needs of the person. For instance, if the patient would like to carry out all the routes in his area of residence. In addition, the origin of each route is the house of the patient. Throughout the memory, every stage of the process is presented step by step, along with indicated new features implemented in each new version of the project. In addition, we briefly reflect on what these new features provide, both in terms of the usability of the application and the functionalities to improve the creation of exercises for the patients. Thanks to the series of meetings with the rest of the CRAAX team and the doctors at the Barcelona Clinic, we have integrated new ideas and the project has gradually evolved from implementing new features. After months of work and sessions held, the final result is considered satisfactory and useful for hospitals.