Transcription elongation mechanisms of RNA polymerases I, II, and III and their therapeutic implications.

Transcription is a tightly regulated, complex, and essential cellular process in all living organisms. Transcription is comprised of three steps, transcription initiation, elongation, and termination. The distinct transcription initiation and termination mechanisms of eukaryotic RNA polymerases I, II, and III (Pols I, II, and III) have long been appreciated. Recent methodological advances have empowered high-resolution investigations of the Pols' transcription elongation mechanisms. Here, we review the kinetic similarities and differences in the individual steps of Pol I-, II-, and III-catalyzed transcription elongation, including NTP binding, bond formation, pyrophosphate release, and translocation. This review serves as an important summation of Saccharomyces cerevisiae (yeast) Pol I, II, and III kinetic investigations which reveal that transcription elongation by the Pols is governed by distinct mechanisms. Further, these studies illustrate how basic, biochemical investigations of the Pols can empower the development of chemotherapeutic compounds.

Obstacles in combating multidrug resistant tuberculosis in pediatric patients: a scope review / Obstáculos no combate à tuberculose multidroga resistente em pacientes pediátricos: uma revisão de escopo

Abstract Objectives: to identify the scientific evidence on excessively resistant and multidrug resistant tuberculosis in pediatric patients. Methods: this is a scope review of the literature, with a guiding question: "What is the scientific evidence on multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis in pediatric patients?". The research used the descriptors: "extensively drug-resistant tuberculosis" OR "multidrug-resistant tuberculosis" AND "pediatrics". The research was carried out in a double-blind manner in the following databases of the Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific's Institutional Repository for Information Sharing, Embase/Elsevier and International Clinical Trials Registry Platform, with a temporal cut-off from 2011 to 2021, sending a final synthesized sample of 18 articles, which evaluated the methodological content through the level of evidence. Results: the results show the lack of research with a high level of evidence related to MDR-TB in children, the lack of adequate dosage of second-line drugs for the pediatric population and the importance of drug sensitivity testing for the cases of treatment Conclusions: it was identified that the obstacles to MDR-TB treatment were concentrated in the lack of detailed protocols, safe drug dosages with a low side effect, and mainly in the social health determinants and disease process involving MDR-TB.

Resumo Objetivos: identificar as evidências científicas sobre tuberculose excessivamente resistente e multidroga resistente em pacientes pediátricos. Métodos: trata-se de uma revisão de escopo da literatura, tendo como questão norteadora: "Quais as evidências científicas sobre tuberculose multidroga-resistente (TB-MDR) e tuberculose extensivamente resistente em pacientes pediátricos?" A pesquisa usou os descritores: "tuberculose extensivamente resistente a medicamentos" OR "tuberculose resistente a múltiplos medicamentos" AND "pediatria". A pesquisa foi realizada de modo duplo-cego nas bases de dados Medical Literature Analysis and Retrieval System Online, Regional Office for the Western Pacific's Institutional Repository for Information Sharing, Embase/Elsevier e International Clinical Trials Registry Platform, com um corte temporal de 2011 a 2021, sendo a amostra final sintetizada de 18 artigos, nos quais avaliou-se o conteúdo metodológico por meio do nível de evidência. Resultados: os resultados mostraram a escassez de pesquisas de alto nível de evidência relacionadas à TB-MDR em crianças, ausência de posologia adequada das drogas de segunda linha para o público pediátrico e a importância do teste de sensibilidade a drogas para o tratamento dos casos. Conclusões: identificou-se que os obstáculos do tratamento TB-MDR se concentraram na ausência de protocolos detalhados, de dosagens medicamentosas seguras e com menor efeito colateral, e, principalmente, nos determinantes sociais do processo saúde e doença que envolvem a TB-MDR.

Uso seguro de medicações: necessidades de aprendizagem e potencialidades para ensino mediado por tecnologias virtuais / Safe use of medications: learning needs and strengths for teaching mediated by virtual technologies

Objetivo: Identificar as necessidades de aprendizagem de graduandos de enfermagem sobre segurança do paciente e segurança medicamentosa. Métodos: Estudo descritivo, transversal, desenvolvido no período de março de 2019 a dezembro de 2020, com amostra não probabilística e intencional constituída por 45 graduandos de enfermagem. Os dados foram analisados por meio de estatística descritiva. Resultados: Houve predomínio de estudantes do sexo feminino (73,3%) com renda familiar entre 1 e 2 salários mínimos. Todos confirmaram ter acesso à internet, com frequência diária de uso de participantes (93,3%). O smartfone foi o aparelho mais utilizado para acesso à internet (77,8%), tendo o domicílio como local predominante de acesso (80,0%). Sobre as necessidades de aprendizagem acerca da segurança do paciente e da segurança medicamentosa, destacou-se a classificação "essencial" dentre as questões avaliadas. Conclusão: Identificaram-se como as principais necessidades de aprendizagem dos participantes: atuar em equipe de forma eficaz, compreender os sistemas e o efeito da complexidade dos cuidados ao paciente e definição dos conceitos-chaves. Junto a isso, verificaram-se fragilidades de diferenciação entre os termos comuns no processo de administração de medicamentos. Descritores: Educação em Enfermagem; Segurança do Paciente; Tratamento Farmacológico; Tecnologia.

Objective: To identify the learning needs of undergraduate nursing students about patient safety and medication safety.Methods: Descriptive and cross-sectional study, developed from March 2019 to December 2020, with a non-probabilistic and intentional sample consisting of 45 undergraduate nursing students. Data were analyzed using descriptive statistics.Results: There was a predominance of female students (73.3%) with family income between 1 and 2 minimum wages. All confirmed having access to the internet, with a daily frequency of use by participants (93.3%). The smartphone was the most used device to access the internet (77.8%), with the home being the predominant place of access (80.0%). Regarding the learning needs about patient safety and medication safety, the classification "essential" stood out among the evaluated questions.Conclusion:The main identified learning needs of the participants were: working effectively as part of a team, understanding the systems and the effect of the complexity of patient care and defining the key concepts. In addition to that, there were weaknesses in differentiating between common terms in the medication administration process. Descriptors: Education, Nursing; Patient Safety; Drug Therapy; Technology.

Abordaje paliativo en enfermedades respiratorias avanzadas / Palliative Approach in Advanced Respiratory Diseases

Las enfermedades respiratorias crónicas avanzadas son prevalentes y producen deterioro de la calidad de vida, en particular la enfermedad pulmonar obstructiva crónica (EPOC), las enfermedades pulmonares intersticiales difusas (EPID) y las enfermedades neuromusculares progresivas con compromiso diafragmático (ENM). Quienes las padecen presentan síntomas persistentes que no son siempre adecuada-mente controlados por los tratamientos recomendados por las guías clínicas de mane-jo. El tratamiento paliativo de los síntomas persistentes es un punto relevante y suelen presentarse barreras para su implementación.Este artículo ofrece una revisión narrativa sobre una perspectiva latinoamericana acerca del rol de los cuidados paliativos en enfermedades respiratorias avanzadas.

Advanced chronic respiratory diseases are prevalent and cause deterioration in qual-ity of life, particularly chronic obstructive pulmonary disease (COPD), diffuse intersti-tial lung diseases (ILD) and progressive neuromuscular diseases with diaphragmatic involvement (NMD). Those who suffer from them usually present persistent symptoms that are not always adequately controlled by the treatments recommended by the clinical management guidelines. Palliative treatment of persistent symptoms is a relevant point, but the pal-liative approach usually presents barriers to its implementation.This article offers a narrative review over Latin American perspective on the role of pal-liative care in advanced respiratory diseases.

[Pharmacokinetic and Safety Evaluation During Pregnancy and Lactation].

Drug therapy during pregnancy and lactation is determined by a balance of risks and benefits. Successful control of disease during pregnancy is necessary for a favorable pregnancy outcome. This lecture will focus on basic concepts.

Real-world practice of acute leukemia intrathecal chemotherapy administration: A Mexican nationwide survey

ABSTRACT Introduction: Intrathecal chemotherapy is a mainstay component of acute lymphoblastic leukemia treatment. In Mexico, there is a considerable practice variability in aspects, such as the manner of preparation and the administration technique. Objective: Our objective was to describe the different techniques used for the application of ITC and review the existing recommendations in the literature. Method: A cross-sectional, nationwide survey study was conducted by an electronic questionnaire sent to hematologists and oncologists in Mexico. We collected demographic data, personal experience, intrathecal chemotherapy techniques, drug preparation and postprocedural conduct. Results: We received 173 responses. Twenty percent had an anesthesiologist administering sedation and pain management. The platelet count considered safe was 50 × 109/L in 48% of the participants. In 77% (n = 133) of the cases, the conventional needle with stylet used was, 49% did not receive any added diluent in the intrathecal chemotherapy and only 42% were recommended to rest in a horizontal position for more than 30 min. Conclusion: We identified a considerable variation in the administration of intrathecal chemotherapy across the hematologists in Mexico. We discuss the implications and opportunities in reducing the variation in our setting, highlighting the unmet need to establish guidelines that should be evaluated by the Mexican professional society to produce a position paper regarding practice standardization.

Outcomes and survival predictors of Latin American older adults with acute myeloid leukemia: Data from a single center

ABSTRACT Introduction: Acute myeloid leukemia (AML) is most commonly presented in older adults; however, it appears 10 years earlier in Latin American countries. Clinical evolution in older adults from this populations has not been characterized. We analyzed outcomes and survival predictors. Methods: Patients ≥ 55 years old diagnosed with AML at a hematology referral center from 2005 to 2020 receiving intensive chemotherapy (IC), low-dose cytarabine (LDAC) and best supportive care (BSC) were included. Survival analysis included the Kaplan-Meier and Cox models and the cumulative incidence of relapse (CIR). Results: Seventy-five adults were included and the overall survival (OS) was 4.87, 1.67 and 1.16 months, using IC, LDAC and BSC, respectively. The IC led to a higher OS (p < 0.001) and was a protective factor for early death, at a cost of more days spent hospitalized and more non-fatal treatment complications; non-significant differences were found between the LDAC and BSC. Eight (10.7%) patients underwent hematopoietic cell transplantation, with a higher OS (p = 0.013). Twenty (26.7%) patients achieved complete remission; 12 (60%) relapsed with a 6-month CIR of 57.9% in those < 70 years old vs. 86.5% in those ≥ 70 years old, p = 0.034. Multivariate analysis showed the white blood cell count (WBC) and IC had a significant impact on the patient survival, whereas chronological age and the Charlson comorbidity index (CCI) did not. Conclusion: AML in low-middle income countries demands a different approach; the IC improves survival, even with a high incidence of relapse, and should be offered as first-line treatment. Eligibility criteria should include WBC and a multidimensional evaluation. The age per se and the CCI should not be exclusion criteria to consider IC.

Manejo de reações adversas dermatológicas em pacientes submetidos à terapia quimioterápica antineoplásica / Management of dermatological adverse reactions in patients undergoing antineoplastic chemotherapy

Objetivo: o presente estudo tem como objetivo reunir recomendações de cuidados considerando a prevenção e tratamento de lesões de pele induzidas pelo tratamento com quimioterápicos antineoplásicos, de acordo com os estudos e consensos atuais. Metodologia: realizou-se um estudo bibliográfico para levantamento das relações entre os principais fármacos antineoplásicos e suas intercorrências dermatológicas, bem como seus respectivos manejos, para subsidiar a orientação e aconselhamento aos profissionais de saúde que acompanham o paciente oncológico. Resultado: os principais problemas dermatológicos decorrentes do uso de antineoplásicos correspondem às lesões de pele, tais como a descoloração, hiperpigmentação, fotossensibilidade, eritemas, descamação e prurido. Também são recorrentes os efeitos adversos que acometem os pelos e cabelos, resultando em alopecia, e a modificação do crescimento e lesões nas unhas. Tratamentos específicos para cada caso são capazes de amenizar ou reverter os problemas. Conclusão: as reações adversas aos medicamentos envolvendo quimioterapia são frequentes na prática oncológica, e variam em termos de frequência e gravidade, atingindo diversos anexos cutâneos. O adequado manejo destes efeitos melhora a integridade da pele e demais estruturas, proporcionando a esses pacientes a melhoria da autoestima e da qualidade de vida.

Objective: the present study aims to gather care recommendations considering the prevention and treatment of skin lesions induced by treatment with antineoplastic chemotherapy, according to current studies and consensus. Methodology: a bibliographical study was carried out to survey the relationships between the main antineoplastic drugs and their dermatological intercurrences, as well as their respective management, to subsidize the guidance and counselling of health professionals who treat cancer patients. Result: the main dermatological problems arising from the use of antineoplastic agents correspond to skin lesions, such as discoloration, hyperpigmentation, photosensitivity, erythema, scaling and pruritus. Adverse effects that affect hair and body hair are also recurrent, resulting in alopecia, and the modification of growth and lesions on the nails. Specific treatments for each case can alleviate or reverse the problems. Conclusion: adverse drug reactions involving chemotherapy are frequent in oncology practice, and vary in terms of frequency and severity, affecting various skin appendages. Proper management of these effects improves the integrity of the skin and other structures, providing these patients with improved self-esteem and quality of life.

Predicting Chemotherapy Distribution into Breast Milk for Breastfeeding Women Using a Population Pharmacokinetic Approach.

BACKGROUND AND OBJECTIVE: Information on the distribution of chemotherapeutic drugs to breast milk is scarce, and reports are limited to small sample sizes. Anecdotal pharmacokinetic data have typically been acquired from lactating but non-breastfeeding patients who collect breast milk by means of an expression pump, which might not necessarily be representative for a breastfeeding population due to differences in milk production. Consequently, little is known about the variability of chemotherapy distribution to breast milk and the effect of milk production on the distribution of chemotherapy to breast milk. Our aim was to predict chemotherapy distribution to breast milk in a more realistic breastfeeding population and evaluate the effect of discarding breast milk on the potential chemotherapy exposure in infants. METHODS: We developed a population pharmacokinetic model that described the breast milk production and the chemotherapy distribution to breast milk of a non-breastfeeding population, linked it to plasma pharmacokinetics, and extrapolated this to a breastfeeding population. RESULTS: We found that cumulative relative infant doses (RID) were higher than 10% for cyclophosphamide and doxorubicin and approximately 1% for paclitaxel. Simulations allowed us to predict the cumulative RID and its variability in the population for patients with different milk productions and the amount of breast milk that has to be discarded to reach cumulative RIDs below 1%, 0.1%, and 0.01%. Discarding 1-2, 3-6, and 0-1 days of breast milk (depending on the milk production of the patient) resulted in cumulative RID below 1% for cyclophosphamide, doxorubicin, and paclitaxel, respectively. CONCLUSION: Our results may help clinicians to derive the optimal breast milk discarding strategy for an individual patient that wants to breastfeed during chemotherapy and minimize chemotherapy exposure in their infants.

Qualidade de vida dos doentes com cancro colorretal submetidos a quimioterapia no ambulatório / Quality of life of colorectal cancer patients undergoing outpatient chemotherapy

Introdução: Nos últimos anos, tem se verificado um aumento das doenças crónicas não transmissíveis, entre elas destacamos o cancro colorretal por ser um problema de saúde pública mundial. A avaliação da qualidade de vida (QV), constitui um importante indicador para a monitorização dos sintomas e efeitos das terapêuticas oncológicas. Deste modo, foi realizado a seguinte questão de investigação ?Qual a qualidade de vida dos doentes do foro colorretal submetidos a quimioterapia, no ambulatório? Objetivos: Analisar a QV dos doentes do foro colorretal submetidos a quimioterapia; descrever e analisar quais os fatores que influenciaram a QV; analisar a relação entre QV e as caraterísticas sociodemográficas, fatores de risco e efeitos secundários dos doentes submetidos a quimioterapia. Metodologia: Estudo quantitativo, descritivo, transversal e correlacional. A colheita de dados realizada com dois questionários: questionário de dados individuais e o instrumento de qualidade de vida Whoqol- bref (Serra et al., 2006), no período de abril a dezembro de 2022. A amostra de 50 doentes que realizaram quimioterapia num ambulatório de um hospital do centro. Foram realizados todos os procedimentos formais e éticos. Resultados: A qualidade de vida no domínio psicológico é de 76,92%, seguido de 75% no domínio social, verificando-se o valor mais baixo no domínio físico com 70,43%. No domínio físico, os doentes profissionalmente ativos percecionam uma melhor qualidade de vida (p=0,020). Nos fatores de riscos, o consumo de café é autopercecionado como indicador de melhor qualidade de vida no domínio psicológico (p=0,048). Nos efeitos secundários, os doentes sem náuseas (p=0,021), percecionam uma melhor QV no domínio físico, na ausência de alopecia, no domínio psicológico (p=0,037) e no meio ambiente (p=0,042), e na ausência de parestesias, no domínio físico (p=0,029), psicológico (p=0,004) e meio ambiente (p=0,007). A presença de anorexia é percecionada como indicador de pior QV no domínio social (p=0,030). Conclusão: Os doentes apresentam uma pior QV no domínio físico e melhor no domínio psicológico. A ausência de efeitos secundários tais como: náuseas, alopecia e parestesias indicam melhor qualidade de vida. A presença de anorexia piora a qualidade de vida no domínio social.

Quality Care in Outpatient Chemotherapy. Design and Validation of the Novel Care Quality Ambulatory Instrument / Cuidado con calidad en quimioterapia ambulatoria. Diseño y validación del nuevo instrumento Care Quality Ambulatory / Cuidado com qualidade em quimioterapia ambulatória. Desenho e validação do novo instrumento Care Quality Ambulatory

Introduction: Neither validated scales nor scales translated into Spanish currently exist to evaluate the perception of quality care in people receiving outpatient chemotherapy, despite their usefulness in evaluating the care provided by nurses and in promoting changes in the delivery of these services. Objective: To design and validate the novel Care Quality Ambulatory-I (CQAMB-I) instrument in outpatient chemotherapy services. Materials and methods: This is an instrument validation study carried out in three stages: literature review, design, and validation of the instrument. Content validation was performed with 14 specialists with at least a master's degree and experience in chemotherapy or quality services; face validation was carried out through a pilot test with 31 participants diagnosed with cancer who received curative chemotherapy, and construct validation was carried out through an exploratory factor analysis with 436 users who received outpatient chemotherapy with curative intent. Results: A total of 15 items were removed in the content validation stage; none were removed in face validation. In construct validation, participants had a median age of 56 years, a median treatment time of 5 months, and breast cancer was the most commonly diagnosed form of cancer. Eighteen models were run, 30 items were removed, 6 factors emerged, and a KMO of 0.80 and a Cronbach's alpha of 0.82 were obtained. Conclusion: The CQAMB-I proved to be valid and reliable for the evaluation of quality care in outpatient chemotherapy services. Additionally, it enabled expanding the conception of such care beyond the attributes of structure, process, and outcome.

Introducción: no existen escalas validadas, ni traducidas al español para evaluar la percepción del cuidado con calidad en personas que reciben quimioterapia ambulatoria, a pesar de su utilidad para evaluar la prestación de servicios enfermeros y generar cambios en la entrega de estos. Objetivo: diseñar y validar el nuevo instrumento Care Quality Ambulatory-I (CQAMB-I) en servicios de quimioterapia ambulatoria. Materiales y métodos: estudio de validación de instrumentos en tres fases: revisión de la literatura, diseño y validación del instrumento. Se realizó validación de contenido con 14 expertos con formación mínima de maestría y experiencia en servicios de quimioterapia o calidad; validación facial a través de prueba piloto con 31 participantes con diagnóstico de cáncer que recibían quimioterapia curativa; y validación de constructo por medio de un análisis factorial exploratorio con 436 usuarios que recibían quimioterapia ambulatoria con intención curativa. Resultados: en la validación de contenido se eliminaron 15 ítems; en la validación facial no se eliminó ninguno; y en la validación de constructo los participantes tuvieron una mediana de edad de 56 años, mediana de tiempo de tratamiento de 5 meses y cáncer de mama como el más diagnosticado. Se ejecutaron 18 modelos, se eliminaron 30 ítems, emergieron 6 factores y se obtuvo un KMO de 0.80 y un alpha de Cronbach de 0.82. Conclusión: el instrumento CQAMB-I demostró ser válido y confiable para evaluar el cuidado con calidad en servicios de quimioterapia ambulatoria y, adicionalmente, permitió ampliar la concepción de este más allá de los atributos de estructura, proceso y resultado.

Introdução: não existem escalas validadas nem traduzidas ao espanhol para avaliar a percepção do cuidado com qualidade em pessoas que recebem quimioterapia ambulatória, apesar de sua utilidade para avaliar a prestação de serviços de enfermagem e gerar mudanças na entrega destes. Objetivo: desenhar e validar o novo instrumento Care Quality Ambulatory-I (CQAMB-I) em serviços de quimioterapia ambulatória. Materiais e método: estudo de validação de instrumentos em três fases: revisão da literatura, desenho e validação do instrumento. Foi realizada validação de conteúdo com 14 especialistas com formação mínima de mestrado e experiência em serviços de quimioterapia ou qualidade; validação facial por meio de teste-piloto com 31 participantes com diagnóstico de câncer que recebiam quimioterapia curativa e validação de constructo por meio de uma análise fatorial exploratória com 436 usuários que recebiam quimioterapia ambulatória com intenção curativa. Resultados: na validação de conteúdo, foram eliminados 15 itens; na validação facial, não foi eliminado nenhum; na validação de constructo, os participantes tiveram uma média de idade de 56 anos, média de tempo de tratamento de 5 meses e câncer de mama como o mais diagnosticado. Foram executados 18 modelos, foram eliminados 30 itens, emergidos 6 fatores e obtido um KMO de 0,80 e um alpha de Cronbach de 0,82. Conclusões: o instrumento CQAMB-I demonstrou ser válido e confiável para avaliar o cuidado com qualidade em serviços de quimioterapia ambulatória e, além disso, permitiu ampliar a concepção deste mais além dos atributos de estrutura, processo e resultado.

[Translated article] Design and validation of two instruments to analyze and evaluate the formal quality in the informed consent process of clinical trials with medicinal products.

OBJECTIVE: The activity of sponsors and Ethics Committees for Research with medicines has increased in recent years. The objective was to design and validate 2 instruments to analyze and evaluate the formal quality of the patient information sheet and the informed consent form of clinical trials with drugs, in accordance with the legislation. METHODS: Design (Guideline for good clinical practice and European and Spanish regulations); validation (Delphi method and expert consensus: concordance ≥ 80%); reliability (inter-observer method, Kappa index). 40 patient information sheets/informed consent forms were evaluated. RESULTS: Very good concordance was obtained in both checklists (k ≥ 0.81, p b 0.001). The final versions consisted of checklist-patient information sheet: 5 sections, 16 items and 46 sub-items; and checklist-informed consent form: 11 items. CONCLUSION: The instruments developed are valid, reliable and facilitate the analysis, evaluation, and decision-making on the patient information sheets/informed consent forms of clinical trials with drugs.

Late effects and frontline treatment selection for children with non-Hodgkin lymphoma.

Approximately 1 in 640 adults between 20 and 40 years of age is a survivor of childhood cancer. However, survival has often come at the expense of increased risk of long-term complications, including chronic health conditions and higher mortality rates. Similarly, long-term survivors of childhood non-Hodgkin lymphoma (NHL) experience significant morbidity and mortality related to prior cancer treatments, highlighting the importance of primary and secondary prevention strategies to mitigate late toxicity. As a result, effective treatment regimens for pediatric NHL have evolved to reduce both short- and long-term toxicity through cumulative dose reductions and elimination of radiation. The establishment of effective regimens facilitates shared decision-making opportunities for frontline treatment selection that considers efficacy, acute toxicity, convenience, and late effects of treatments. The current review seeks to merge current frontline treatment regimens with survivorship guidelines to enhance understanding of potential long-term health risks to facilitate best treatment practices.

Ozonoterapia y cáncer: mito o realidad / Ozone Therapy and Cancer: Myth or Reality

Introducción: El uso clínico de la ozonoterapia se incrementa cada día. Abarca disímiles especialidades médicas como la oncología. En Cuba las investigaciones que evalúan el empleo de la ozonoterapia en pacientes con cáncer son escasas, se precisan estudios científicos que demuestren su eficacia clínica. Objetivo: Explicar los mecanismos farmacológicos y bioquímicos de la ozonoterapia y su uso en el cáncer como terapia complementaria. Métodos: Se consultaron bases de datos disponibles a través de la red de Infomed. Se utilizaron como palabras clave: cáncer, ozonoterapia y estrés oxidativo. Se seleccionaron artículos originales y de revisión sistemáticos de los últimos diez años que evaluaron la utilización de la ozonoterapia en el tratamiento del cáncer. Resultados: El cáncer es per se una enfermedad inductora de estrés oxidativo. La ozonoterapia respalda su utilización como una terapia adyuvante mediante el preacondicionamiento oxidativo que estimula los sistemas antioxidantes de la célula contra la acción de los radicales libres. Así, se logra neutralizar la acción nociva del estrés oxidativo. El ozono incrementa la eficacia de la radio - quimioterapia y ayuda a reducir los efectos secundarios de estos tratamientos al activar los sistemas antioxidantes de la célula. La ozonoterapia se caracteriza por la simplicidad de su aplicación, bajos costos, alta efectividad y prácticamente ausencia de efectos colaterales en comparación con otros tratamientos adyuvantes. Conclusiones: El uso de la ozonoterapia en oncología como una terapia adyuvante representó un recurso terapéutico de gran valor dado por su perfil de efectividad y seguridad. Su uso podría extenderse para disminuir los efectos secundarios y mejorar la calidad de vida de los pacientes(AU)

Introduction: The clinical use of ozone therapy is increasing every day worldwide and it covers different medical specialties, including oncology. However, in Cuba, the investigations that evaluate the use of ozone therapy in cancer patients are scarce, so scientific studies are needed to demonstrate its clinical efficacy. Objective: To explain the pharmacological and biochemical mechanisms of ozone therapy and its use in cancer as a complementary therapy. Methods: Databases available through Infomed Network were consulted. Key words used were cancer, ozone therapy and oxidative stress. Original and systematic review articles from the last ten years that evaluated the use of ozone therapy in the treatment of cancer were selected. Results: Cancer is, as such, a disease that induces oxidative stress. Ozone therapy supports its use as an adjuvant therapy through oxidative pre-conditioning that stimulates the cell's antioxidant systems against the action of free radicals. Thus, it is possible to neutralize the harmful action of oxidative stress. Ozone increases the efficacy of radio-chemotherapy and helps reducing the side effects of these treatments by activating the cell's antioxidant systems. Ozone therapy is characterized by the simplicity of its application, low costs, high effectiveness and with practically no side effects, compared to other adjuvant treatments. Conclusions: The use of ozone therapy in oncology as an adjuvant therapy represented a therapeutic resource of great value given its effectiveness and safety profile. Its use could be extended to improve tissue oxygenation and thus enhance the efficacy of radiochemotherapy, reducing side effects and improving the patients's quality of life(AU)

Epidemiology and healthcare resource utilization in atopic dermatitis in Colombia: A retrospective analysis of data from the National Health Registry from 2015 to 2020 / Epidemiología y uso de recursos de salud en dermatitis atópica en Colombia: análisis retrospectivo de datos del Registro Nacional de Salud de 2015 a 2020

Introduction: Atopic dermatitis, also known as eczema or atopic eczema, is a chronic inflammatory skin disorder characterized by the presence of pruritus accompanied by itching. In Colombia, epidemiological and healthcare resource utilization information regarding this pathology is limited. Objective: To describe atopic dermatitis epidemiological characteristics and healthcare resource utilization patterns in Colombia. Materials and methods: A retrospective database study using real-world data obtained from the national claims database SISPRO (Sistema de Información para la Protección Social) for the 2015-2020 period was carried out. Sociodemographic (age, and health services delivery), epidemiological (incidence, prevalence, and comorbidities), and healthcare resource utilization data were extracted from the SISPRO database. Results: The epidemiological results showed increased incidence and prevalence of atopic dermatitis in Colombia in the 2018-2019 period compared to 2015-2017. Accordingly, the number of medical consultations (particularly with specialists), the number of procedures, and the number of hospitalizations of patients with atopic dermatitis increased. Topic and systemic corticoids were the most frequently prescribed drugs. Conclusions: Diagnoses of atopic dermatitis in Colombia increased with a concomitant increase in healthcare resource utilization during 2015-2020, which was possibly slowed down by the arrival of the Covid-19. This study may help physicians gaining a better understanding of the disease, improving atopic dermatitis patient management.

Introducción. La dermatitis atópica, también conocida como eczema o eczema atópico, es un trastorno inflamatorio crónico de la piel caracterizado por la presencia de prurito acompañado de picor. En Colombia, la información epidemiológica y de utilización de recursos sanitarios sobre esta enfermedad es limitada. Objetivo. Describir las características epidemiológicas y los patrones de utilización de recursos sanitarios para la dermatitis atópica en Colombia. Materiales y métodos. Se trata de un estudio retrospectivo en el cual se utilizan datos de la práctica clínica real obtenidos del registro nacional SISPRO (Sistema de Información para la Protección Social) en el período 2015-2020. Se extrajeron datos sociodemográficos (incluida la edad y la prestación de servicios de salud), epidemiológicos (incluidos la incidencia, la prevalencia y las comorbilidades) y los correspondientes a la utilización de los recursos sanitarios. Resultados. Los resultados epidemiológicos han demostrado un aumento de la incidencia y prevalencia de la dermatitis atópica en Colombia en el periodo 20182019, en comparación con el periodo 2015-2017. Aumentó el número de consultas médicas (particularmente, con especialistas) de pacientes con dermatitis atópica, el de procedimientos y el de hospitalizaciones. Los corticoides tópicos y sistémicos fueron los medicamentos más prescritos. Conclusiones. Los diagnósticos de dermatitis atópica en Colombia aumentaron con un incremento concomitante en la utilización de recursos sanitarios durante 2015-2020, que posiblemente se vio atenuado por la llegada del Covid-19. Este estudio puede ayudar a los médicos a tener un mejor conocimiento de la enfermedad y, por lo tanto, mejorar el tratamiento de los pacientes con dermatitis atópica.