Assessment of inflammatory activity in Takayasu's arteritis: performance of clinical scores and common biomarkers versus 18F-FDG PET/CT.

OBJECTIVES: There is no consensus on how to evaluate inflammatory activity in Takayasu's arteritis (TAK). Here we compare biochemical tests and three clinical scores, which evaluate inflammatory activity (IA) in TAK, versus quantitative 18F-FDG PET/CT as the gold standard. METHODS: This prospective study included patients with TA diagnosed according to the American College of Rheumatology (ACR) criteria. IA was assessed through laboratory tests, clinical scores of the National Institute of Health (NIH), Dabague-Reyes (DR) and the Indian Takayasu Clinical Activity Score 2010 (ITAS2010), and the result of these assessments was compared against 18F-FDG PET/CT Standardised Uptake Values (SUVmax). RESULTS: A total of 35 patients were studied, 86% were women. SUVmax had positive correlations with acute phase reactants and DR and NIH. Agreement of 18F-FDG PET/CT was significant with erythrocyte sedimentation rate (ESR) and DR score. Receiver Operating Characteristic (ROC) curve analysis showed diagnostic value for inflammatory activity in ESR, DR and NIH scores, which had higher specificity when they were estimated with new cut-off points for the Mexican population. CONCLUSIONS: ESR and other phase reactants have good sensitivity but low specificity to evaluate IA in TAK when compared against 18F-FDG PET/CT. Among all the clinical scores, DR had the best diagnostic value, with strong potential as a clinical tool to define the inflammatory status in TAK patients when the study image is not available. However, in complex TAK cases with doubtful diagnosis after assessment by clinical scores or laboratory, 18F-FDG PET/CT remains mandatory.

Cecal Ligation and Puncture Alters Glucocorticoid Receptor Expression.

OBJECTIVES: Interventional trials on glucocorticoids in sepsis have yielded capricious results. Recent studies have identified multiple glucocorticoid receptor isoforms. The relative abundance of these isoforms in septic patients and following murine cecal ligation and puncture is unknown. The objective of this study is to determine the effects of cecal ligation and puncture on glucocorticoid receptor isoform abundance. DESIGN: Determination of effects of cecal ligation and puncture on glucocorticoid receptor isoform subtype abundance in C57BL/6 mice. Examination of glucocorticoid receptor isoform abundance in tissues harvested from patients immediately after death from sepsis or nonseptic critical illness. SETTING: Research laboratory. SUBJECTS: C57BL/6 mice and human tissue sections from recently deceased critically ill patients. INTERVENTIONS: C57BL/6 mice were subjected to cecal ligation and puncture or sham operation. Abundance of the activating glucocorticoid receptor α and the inactivating glucocorticoid receptor ß isoforms was determined in mouse and human tissue using immunoblotting. Cardiac output with or without stimulation with dexamethasone was assessed using echocardiography. The expression of the gene encoding the glucocorticoid-dependent enzyme glucose-6-phosphatase was identified using polymerase chain reaction. Statistical significance (p < 0.05) was determined using analysis of variance. MEASUREMENTS AND MAIN RESULTS: Results in baseline and sham operation mice were identical. At baseline, glucocorticoid receptor αA predominated in heart, lung, and skeletal muscle; abundance was decreased post cecal ligation and puncture. All glucocorticoid receptor α subtypes were identified in liver. Cecal ligation and puncture decreased the summed abundance of hepatic glucocorticoid receptor α subtypes and those of glucocorticoid receptors αA, B, and D. However, glucocorticoid receptor αC abundance was unchanged. Cecal ligation and puncture increased glucocorticoid receptor ß protein abundance in the heart and lung. Relative to T0, cecal ligation and puncture decreased cardiac output and attenuated the cardiac output response to dexamethasone. Cecal ligation and puncture also decreased expression of glucose-6-phosphatase. Compared with nonseptic patients, human sepsis decreased the abundance of glucocorticoid receptor α and increased the abundance of glucocorticoid receptor ß in heart and liver biopsies. CONCLUSIONS: Cecal ligation and puncture altered glucocorticoid receptor α and glucocorticoid receptor ß isoform expression in tissues and decreased functional responses in heart and liver. Decreases in glucocorticoid receptor α and increases in glucocorticoid receptor ß might explain the diminished glucocorticoid responsiveness observed in sepsis.

Effects of temperature on the timing of breeding and molt transitions in house finches.

Temperature-correlated shifts in reproductive timing are now well documented in numerous bird species. However, whether temperature directly influences reproductive timing or whether its effects are mediated by an intermediate environmental cue, such as plant phenology, remains poorly understood. In this study, we investigated the direct effects of temperature on reproductive timing in house finches (Haemorhous mexicanus), which have a range and breeding diet not well represented in previous studies of temperature and reproductive timing. We conducted experiments with captive male house finches in which temperature was elevated within realistic ranges and the effects on the timing of preparations for reproduction, as well as on the termination of reproduction and the onset of prebasic feather molt, were examined. We found no adjustments in the timing of reproductive preparations of males in direct response to temperature. However, elevated temperature did advance the breeding-molt transition. Our results suggest that elevated temperatures in the range tested here do not directly impact physiological preparations for reproduction in male house finches, but may constrain the timing of the breeding-molt transition in this species.

Burkholderia bacteria infectiously induce the proto-farming symbiosis of Dictyostelium amoebae and food bacteria.

Symbiotic associations can allow an organism to acquire novel traits by accessing the genetic repertoire of its partner. In the Dictyostelium discoideum farming symbiosis, certain amoebas (termed "farmers") stably associate with bacterial partners. Farmers can suffer a reproductive cost but also gain beneficial capabilities, such as carriage of bacterial food (proto-farming) and defense against competitors. Farming status previously has been attributed to amoeba genotype, but the role of bacterial partners in its induction has not been examined. Here, we explore the role of bacterial associates in the initiation, maintenance, and phenotypic effects of the farming symbiosis. We demonstrate that two clades of farmer-associated Burkholderia isolates colonize D. discoideum nonfarmers and infectiously endow them with farmer-like characteristics, indicating that Burkholderia symbionts are a major driver of the farming phenomenon. Under food-rich conditions, Burkholderia-colonized amoebas produce fewer spores than uncolonized counterparts, with the severity of this reduction being dependent on the Burkholderia colonizer. However, the induction of food carriage by Burkholderia colonization may be considered a conditionally adaptive trait because it can confer an advantage to the amoeba host when grown in food-limiting conditions. We observed Burkholderia inside and outside colonized D. discoideum spores after fruiting body formation; this observation, together with the ability of Burkholderia to colonize new amoebas, suggests a mixed mode of symbiont transmission. These results change our understanding of the D. discoideum farming symbiosis by establishing that the bacterial partner, Burkholderia, is an important causative agent of the farming phenomenon.

Systematic review and meta-analysis of right subclavian artery variants and their correlation with cervical-thoracic clinical conditions.

BACKGROUND: A high incidence of anatomical variations in the origin of the branches of the aortic arch has been reported, Nowadays, this variation is considered the most frequent in the aortic arch, its prevalence being estimated between 0.5% and 2.5% of the population. To understand its origin, knowledge of embryonic development is necessary. METHODS: We searched the MEDLINE, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, and Latin-American literature and caribean of health sciences databases with dates ranging from their inception to June 2023. Study selection, data extraction, and methodological quality were assessed with the guaranteed tool for anatomical studies (Anatomical Quality Assurance). Finally, the pooled prevalence was estimated using a random effects model. RESULTS: Thirty-nine studies were found that met the eligibility criteria. Twenty studies with a total of 41,178 subjects were included in the analysis. The overall prevalence of an ARSA variant was 1% (95% confidence interval = 1%-2%), the clinical findings found are that if ARSA is symptomatic it could produce changes in the hemodynamic function of the thoracocervical region in addition to other associated symptomatic complications in surrounding structures. CONCLUSIONS: ARSA can cause several types of alterations in the cervical or thoracic region, resulting in various clinical complications, such as lusory dysphagia. Hence, knowing this variant is extremely important for surgeons, especially those who treat the cervico-thoracic region. The low prevalence of ARSA means that many professionals are completely unaware of its existence and possible course and origin. Therefore, this study provides detailed knowledge of ARSA so that professionals can make better diagnoses and treatment of ARSA.

Association between types of abdominopelvic cancer in patients with situs inversus total: Systematic review.

BACKGROUND: Situs inversus is a rare congenital anatomical variant that involves a group of anomalies regarding the arrangement of intrathoracic and intraabdominal organs. Being able to find in the abdominal region the liver, gallbladder, inferior vena cava, and head of the pancreas and ascending colon on the left side of the abdomen, while on the right side there is the spleen, the stomach, the body of the pancreas, the ligament of Treitz, descending colon among others. In this same way, the thoracic organs, lungs and heart, are changed in their position in a mirror translocation. METHODS: We systematically searched MEDLINE, Web of Science, Google Scholar, CINAHL, Scopus, and LILACS; the search strategy included a combination of the following terms: "Situs inversus," "Situs inversus totalis," "Cancer," "Neoplasm," "Abdominopelvic regions," and "clinical anatomy." RESULTS: Within the 41 included studies, 46 patients with situs inversus who had cancer, in addition to being found in this organ and in these regions, we also found as a result that the majority of the studies in the research were in stage II; finally, no one study could assert the direct relationship between the situs inversus totalis and the cancer. CONCLUSION: If our hallmarks could make us think that more exhaustive follow-up of the stomach and other organs should be carried out in these patients, there could also be other predisposing factors for cancer, which is why more studies are suggested to give future diagnostic and treatment guidelines treatment.

Position of Correct Option and Distractors Impacts Responses to Multiple-Choice Items: Evidence From a National Test.

Even though the impact of the position of response options on answers to multiple-choice items has been investigated for decades, it remains debated. Research on this topic is inconclusive, perhaps because too few studies have obtained experimental data from large-sized samples in a real-world context and have manipulated the position of both correct response and distractors. Since multiple-choice tests' outcomes can be strikingly consequential and option position effects constitute a potential source of measurement error, these effects should be clarified. In this study, two experiments in which the position of correct response and distractors was carefully manipulated were performed within a Chilean national high-stakes standardized test, responded by 195,715 examinees. Results show small but clear and systematic effects of options position on examinees' responses in both experiments. They consistently indicate that a five-option item is slightly easier when the correct response is in A rather than E and when the most attractive distractor is after and far away from the correct response. They clarify and extend previous findings, showing that the appeal of all options is influenced by position. The existence and nature of a potential interference phenomenon between the options' processing are discussed, and implications for test development are considered.

A systematic review on the association between exposure to air particulate matter during pregnancy and the development of hypertensive disorders of pregnancy and gestational diabetes mellitus.

Particulate matter (PM) is considered an intrauterine toxin that can cross the blood-placental barrier and circulate in fetal blood, affecting fetal development, and implicating placental and intrauterine inflammation, and oxidative damage. However, the relationship between PM exposure and adverse pregnancy outcomes is still unclear and our aim was to systematically review toxicological evidence on the link between PM exposure during pregnancy and the development of gestational diabetes mellitus or hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia. PubMed and Science Direct were searched until January 2022. Of the 204 studies identified, 168 were excluded. The remaining articles were assessed in full-text, and after evaluation, 27 were included in the review. Most of the studies showed an association between PM exposure and gestational hypertension, systolic and diastolic blood pressure, pre-eclampsia, and gestational diabetes mellitus. These results should be interpreted with caution due to the heterogeneity of baseline concentrations, which ranged from 3.3 µg/m3 to 85.9 µg/m3 and from 21.8 µg/m3 to 92.2 µg/m3, respectively for PM2.5 and PM10. Moreover, critical exposure periods were not consistent among studies, with five out of ten observational studies reporting the second trimester as the critical period for hypertensive disorders of pregnancy, and ten out of twelve observational studies reporting the first or second trimester as the critical period for gestational diabetes mellitus. Overall, the findings support an association between PM exposure during pregnancy and adverse pregnancy outcomes, highlighting the need for further research to identify the critical exposure periods and underlying mechanisms.

Novel Chlamydiae and Amoebophilus endosymbionts are prevalent in wild isolates of the model social amoeba Dictyostelium discoideum.

Amoebae interact with bacteria in multifaceted ways. Amoeba predation can serve as a selective pressure for the development of bacterial virulence traits. Bacteria may also adapt to life inside amoebae, resulting in symbiotic relationships. Indeed, particular lineages of obligate bacterial endosymbionts have been found in different amoebae. Here, we screened an extensive collection of Dictyostelium discoideum wild isolates for the presence of these bacterial symbionts using endosymbiont specific PCR primers. We find that these symbionts are surprisingly common, identified in 42% of screened isolates (N = 730). Members of the Chlamydiae phylum are particularly prevalent, occurring in 27% of the amoeba isolated. They are novel and phylogenetically distinct from other Chlamydiae. We also found Amoebophilus symbionts in 8% of screened isolates (N = 730). Antibiotic-cured amoebae behave similarly to their Chlamydiae or Amoebophilus-infected counterparts, suggesting that these endosymbionts do not significantly impact host fitness, at least in the laboratory. We found several natural isolates were co-infected with multiple endosymbionts, with no obvious fitness effect of co-infection under laboratory conditions. The high prevalence and novelty of amoeba endosymbiont clades in the model organism D. discoideum opens the door to future research on the significance and mechanisms of amoeba-symbiont interactions.

Dysmobility syndrome: a case-series study describing a musculoskeletal syndrome in postmenopausal Mexican women.

"Dysmobility Syndrome" (DS) is a term that correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls. The prevalence of DS is of 74% in this study. Further research with bigger sample sizes is needed to describe if prevalence and DS characteristics are similar in other studies. PURPOSE: "Dysmobility Syndrome" (DS) correlates sarcopenia and osteoporosis together with mobility disturbances, obesity, fractures, and falls, all of which are related to adverse outcomes in the health of the elderly; however, there are no studies of DS in Mexican patients. In this study, we aimed to describe the characteristics of DS in Mexican postmenopausal women from a private practice. METHODS: A case-series study was conducted; women of 60 years and older were invited to participate from August to December of 2019, a total of 50 patients were included. Medical history, physical tests, bone densitometry, and body composition analysis were performed; patients who met 3 or more of the following criteria were diagnosed with DS: osteoporosis: T-score ≤ -2.5, falls in a previous year, lean appendicular mass: ≤ 5.45 kg/m2, walking speed: < 1.0 m/s, grip strength: < 20 kg, and body fat percentage: > 40%. RESULTS: Out of the total 50 patients, 37 were diagnosed with DS, with a prevalence of 74% in our study. Sixteen patients had a history of a non-vertebral fragility fracture, of which 14 had a diagnosis of DS (87%). CONCLUSIONS: DS has a high frequency in our study group, and was found to be closely related to the presence of non-vertebral fragility fractures. More research is needed to describe the prevalence and characteristics of DS with a stronger statistical significance within our population, and among others across the country, to get an extensive understanding of its presentation in Mexican women. KEY POINTS: • The frequency of DS in this study is higher than the one that is described in global literature. • DS diagnosis is closely related to the antecedent of non-vertebral fragility fracture.

Examen Práctico Objetivo Estructurado como metodología de evaluación en la asignatura de Anatomía Humana: Experiencia de una Implementación Piloto

Aprendizajes en anatomía humana tradicionalmente han sido evaluados a través del reconocimiento de estructuras anatómicas. A pesar de su popularidad, pueden tener un componente subjetivo y memorístico. El Examen Práctico Objetivo Estructurado (EPOE) se ha presentado como una manera más global de evaluación. El objetivo de este estudio fue evidenciar el efecto en el rendimiento académico tras la implementación del EPOE en pasos prácticos. En el estudio 2312 estudiantes fueron divididos: Metodología Tradicional (n=1155) y Metodología EPOE (n=1157). A su vez, los estudiantes fueron identificados según carrera: Enfermería (n=1182); Fonoaudiología (n=185); Kinesiología (n=514) y Terapia Ocupacional (n=431). Se mantuvieron las condiciones de la asignatura en ambos grupos con tres evaluaciones prácticas. Se analizaron las calificaciones obtenidas. Evaluaciones 1 y 2 no presentaron diferencias entre grupos. Evaluación 3, que evaluó sistema nervioso, mostró disminución significativa de 0,5 puntos en el grupo EPOE. El factor tipo de metodología resultó ser significativo en evaluación 3 (p < 0,001; h2p = 0,029) y promedio de las 3 evaluaciones (p < 0,029; h2p = 0,002). El factor carrera resultó ser significativo para las tres evaluaciones. La interacción de ambos factores no mostró significancia estadística. El análisis post hoc mostró diferencias significativas entre estudiantes de Enfermería con las demás carreras, ya que obtuvieron mejores calificaciones en todas las evaluaciones (p < 0,05). Metodología EPOE no produjo drásticos cambios en el rendimiento académico de los estudiantes y tiene un amplio potencial de desarrollo por su naturaleza de evaluación integral no invasiva ni traumática. Se debe considerar la naturaleza de los contenidos en el diseño de la metodología de enseñanza-aprendizaje y en la metodología de evaluación, alineando a nivel microcurricular estos aspectos fundamentales de la formación de nuevos profesionales de la salud.

SUMMARY: Learning in human anatomy has traditionally been assessed by recognizing anatomical structures. Despite their popularity, they can have a subjective component. The Objective Structured Practical Examination (EPOE) has been presented as a more global way of assessment. The aim of this study was to demonstrate the effect on academic performance after the implementation of the EPOE in practical activities. In this study 2312 students were divided into Traditional Methodology (n=1155) and EPOE Methodology (n=1157). In turn, students were identified according to career: Nursing (n=1182), Speech Therapy (n=185), Physical Therapy (n=514), and Occupational Therapy (n=431). Subject conditions were maintained in both groups with three practical evaluations. The grades obtained were analyzed. Assessments 1 and 2 showed no differences between groups. Evaluation 3, which evaluated the nervous system, showed a significant decrease of 0.5 points in the EPOE group. The type of methodology factor was significant in evaluation 3 (p < 0.001; ?2p = 0.029) and the average of 3 evaluations (p < 0.029; ?2p = 0.002). The career factor was significant for all three evaluations. The interaction of both factors did not show statistical significance. The post hoc analysis showed significant differences between nursing students and the other careers since they obtained better scores in all evaluations (p < 0.05). EPOE methodology did not produce drastic changes in students' academic performance and had a broad potential for development due to its non-invasive and non-traumatic comprehensive assessment nature. The nature of the contents should be considered in the design of the teaching-learning methodology and the evaluation methodology, aligning at the micro-curricular level with these fundamental aspects of training new health professionals.

Thermogenic capacity of human periaortic adipose tissue is transformed by body weight.

The anatomical location of adipose tissue might have direct implications for its functionality and risk of cardiovascular disease. Adipose tissue surrounding blood vessels may be thermogenically more active in specific areas of the body, releasing substances that regulate vascular metabolism. In humans, the phenotypic characteristics of adipose tissue surrounding the aorta and the cardiovascular disease risk that it might entail remain largely unknown. Here, we compared thermogenesis-related molecular features of human periaortic adipose tissue samples with those of subcutaneous adipose tissue, obtained by sternotomy from 42 patients undergoing cardiovascular surgery. To determine the expression of genes related to energy expenditure and the levels of some adipokines, histological examinations, quantitative PCR, and protein expression measurements in adipocyte precursor cells were performed. Periaortic adipocytes were smaller than those from subcutaneous tissue. Moreover, weight gain induced periaortic adipocyte hypertrophy (r = -0.91, p<0.01). Compared to subcutaneous tissue, adiponectin, FABP4, IL-4 and IL-6 was decreased in periaortic adipocytes, whereas FGF21, UCP-1, PGC-1a, CITED1, Omentin and TFAM (Mitochondrial protein) increased. Upon analyzing patients' clinical conditions, it emerged that the levels of PGC-1a both in male (r = -0.48 p<0.04) and female (r = -0.61, p<0.05) and TFAM in male (r = -0.72, p<0.0008) and female (r = -0.86, p<0.002) decreased significantly with progressive weight gain. However, no differences were observed in patients with diabetes mellitus 2 or Hyperlipidemia. Adipocytes surrounding the ascending aorta present markers of major thermogenic activity than those in subcutaneous tissue. Nevertheless, this characteristic might change, due to unfavorable metabolic conditions such as obesity, which is a risk factor for cardiovascular disease.

Caracterización del suicidio en adolescentes del Departamento de Cauca, Colombia, 1998-2017 / Characterization of suicide in teenagers in the Department of Cauca, Colombia, 1998-2017

Introducción: El suicidio en adolescentes es una grave problemática de salud pública a nivel mundial. Objetivo: Caracterizar el suicidio en adolescentes residentes en el Departamento de Cauca entre 1998 y 2017. Material y Métodos: Se realizó un estudio ecológico. La información de los decesos se obtuvo de los certificados de defunción que procesa el Departamento Administrativo Nacional de Estadística -DANE- de Colombia. Las tasas de mortalidad bruta y ajustada por edad y sexo, se calcularon utilizando las estimaciones y proyecciones poblacionales que realizó el DANE. Se calcularon medidas de frecuencia absoluta y relativa en las variables de persona, tiempo, lugar que fueron analizadas. Resultados: En los veinte años estudiados se registraron 496 suicidios en adolescentes residentes del Departamento de Cauca. El 51,0 % fueron cometidos por hombres. Según estado civil 17,3 % tenían algún tipo de unión marital, El 33,1 % residían en la cabecera municipal, y 42,7 % murió en su residencia. La tasa de suicidios se ubicó en 9,5 por cada 100,000 habitantes (9,4 en hombres y 9,5 en mujeres). El quinquenio 2003-2007 registró la más alta tasa con 12,7 suicidios por cada cien mil adolescentes. Por provincias, la zona Oriental registró el riesgo más alto con una tasa de 12,8 suicidios por cada cien mil. Conclusiones: Se concluye que entre 1998-2017 el suicidio en adolescentes de Cauca presenta tasas altas y que el riesgo fue levemente mayor en mujeres que en hombres.

Introduction: Suicide in teenagers is a serious public health problem worldwide. The objective of this research is to characterize suicide in teenagers residing in the department of Cauca between 1998 and 2017, according to variables like person, time and place. Material and Methods: A descriptive quantitative investigation was carried out. Information was obtained from death certificates processed by the National Administrative Department of Statistics -DANE- of Colombia. Mortality rates were calculated using population estimates and projections made by DANE. Absolute and relative frequency measures were calculated in the variables of person, time, and place that were analyzed. Results: In the twenty-year study, a total of 496 suicides were registered in teenagers living in the department of Cauca. In addition, 51.0 % were committed by men, 17.3 % had some type of marital union, 33.1 % resided in the municipal seat, and 42.7 % died at their residence. The suicide rate was 9.5 per 100,000 teenagers (9.4 in men and 9.5 in women). The 2003-2007 five-year period registered the highest rate with 12.7 suicides for every one hundred thousand teenagers. By provinces, the Eastern zone registered the highest risk with a rate of 12.8 suicides per 100,000 inhabitants. Conclusions: It is concluded that suicide in adolescents in Cauca presented high rates between 1998-2017 and that the risk was slightly higher in women than in men.

Gamificación educativa en el laboratorio de biología celular / Educational gamification in the cell biology laboratory

La incorporación de estrategias de gamificación en la docencia se ha descrito como una herramienta para aumentar la motivación y el compromiso de los alumnos con la materia. Bajo esta premisa, se ha desarrollado una experiencia de innovación educativa mediante la plataforma Kahoot! en la primera y última práctica de laboratorio de la asignatura de Biología Celular del Grado en Biología. Los participantes fueron 135 alumnos repartidos en 12 grupos de laboratorio, que se dividieron entre experimentales y controles. Todos los grupos resolvieron un cuestionario en papel acerca de los conceptos explicados en clase, al finalizar ambas prácticas (post-test), pero sólo aquellos grupos experimentales resolvían un cuestionario antes de la clase (pre-test). Antes de la primera práctica, los alumnos de los grupos experimentales respondieron al pre-test mediante el Kahoot! Sin embargo, para la última práctica algunos grupos lo resolvieron jugando al Kahoot! y otros, con papel y bolígrafo. Los resultados mostraron que aquellos alumnos que fueron seleccionados para jugar a Kahoot!, obtuvieron un mayor número de aciertos en el test realizado tras la sesión práctica (post-test) con respecto a aquellos que no resolvieron ningún pre-test o, que lo hicieron de un modo clásico. Por lo tanto, nuestros resultados sugieren que implementar la jugabilidad en la docencia incrementa considerablemente la motivación del alumnado debido, probablemente, a cambios fisiológicos experimentados por el cerebro durante el juego y a la creación de un clima positivo, que facilitan el proceso de aprendizaje.

SUMMARY: The incorporation of gamification strategies in teaching has been described as a tool to increase the motivation and engagement of students with the subject. Under this premise, an educational innovation experience has been developed using the Kahoot! platform in the first and last laboratory practice of the Cell Biology course of the Biology degree. The participants were 135 students divided into 12 laboratory groups, which were divided into experimental and control groups. All groups solved a questionnaire on paper about the concepts explained in class, at the end of both practices (post-test), but only the experimental groups solved a questionnaire before the class (pre-test). Before the first practice, students in the experimental groups answered the pre-test using Kahoot! However, for the last practice, some groups solved it by playing Kahoot! and others with pen and paper. The results showed that those students who were selected to play Kahoot! obtained a higher number of correct answers in the test performed after the practical session (post-test) than those who did not solve any pre- test or who did it in a classical way. Therefore, our results suggest that implementing gamification in teaching considerably increases student motivation, probably due to physiological changes experienced by the brain during the game and the creation of a positive climate, which facilitates the learning process.

Deterioro de la piel asociado con aseguramiento del dispositivo de acceso intravascular / Skin breakdown associated with securing of the intravascular access device / Ruptura da pele associada à fixação do dispositivo de acesso intravascular

El deterioro de la piel asociado con adhesivos de uso médico en dispositivos de acceso intra-vascular es un evento adverso que puede contribuir a la interrupción de la terapia de infusión intravascular. La Sociedad de enfermeras de infusión recomienda usar tecnologías de protec-ción como apósito estéril para aseguramiento del catéter y cinta quirúrgica para aseguramien-to complementario. Objetivo: Analizar las causas y prevalencia del deterioro de la piel aso-ciado con aseguramiento del dispositivo de acceso intravascular. Métodos: Estudio analítico, de corte transversal. Para recolectar datos se empleó un formato digital y observación directa a pacientes hospitalizados (n=813) con algún dispositivo de aseguramiento en acceso intra-vascular central o periférico, y aseguramiento complementario con cinta quirúrgica, dando seguimiento durante 7 días en febrero 2020. Resultados: El deterioro de la piel incluyó de-sprendimiento de epidermis, maceración, dermatitis irritativa por contacto y alérgica, con prevalencia de 2.2%. Se atribuyeron a catéter venoso central (f=8), catéter venoso periférico (f=7) y cinta quirúrgica para aseguramiento complementario del apósito transparente (f=3). Discusión: Las causas de deterioro de la piel se debieron al tipo de dispositivo y material implementado para aseguramiento; en la mayoría de casos las lesiones se encontraron en accesos venosos periféricos, seguida de accesos venosos centrales, siendo el aseguramiento complementario la menor causa de deterioro de la piel. Conclusiones: La técnica correcta de aplicación y retiro de insumos adhesivos de estabilización y aseguramiento del catéter intravascular evitará el desprendimiento de los mismos, lesiones de piel e interrupción de la terapia de infusión intravascular

Deterioration of the skin associated with medical adhesives in intravascular access devices is an adverse event that can contribute to the discontinuation of intravascular infusion ther-apy. The Society of Infusion Nurses recommends the use of protective technologies such as sterile dressing for catheter securing and surgical tape for supplemental securing. Objective: To analyze the causes and prevalence of skin deterioration associated with securing the intravascular access device. Methods: Analytical, cross-sectional study. To collect data, a digital format and direct observation of hospitalized patients (n = 813) were used with some device for securing in central or peripheral intravascular access, and complementary securing with surgical tape, with follow-up for 7 days in February 2020. Results: The Skin deterioration included epidermal detachment, maceration, irritant contact and allergic dermatitis, with a prevalence of 2.2%. They were attributed to central venous catheter (f = 8), peripheral venous catheter (f = 7) and surgical tape for complementary securing of the transparent dressing (f = 3). Discussion: The causes of skin deterioration were due to the type of device and mate-rial implemented for belaying; In the majority of cases, the lesions were found in peripheral venous accesses, followed by central venous accesses, with supplementary insurance being the least cause of skin deterioration. Conclusions: The correct technique for applying and removing adhesive supplies for stabilization and securing of the intravascular catheter will avoid their detachment, skin lesions and interruption of intravascular infusion therapy

A deterioração da pele associada a adesivos médicos em dispositivos de acesso intravascular é um evento adverso que pode contribuir para a descontinuação da terapia de infusão intra-vascular. A Society of Infusion Nurses recomenda o uso de tecnologias de proteção, como curativo estéril para fixação do cateter e esparadrapo para fixação suplementar. Objetivo: Analisar as causas e a prevalência da deterioração da pele associada à fixação do dispositivo de acesso intravascular. Métodos: Estudo analítico, transversal. Para a coleta de dados, uti-lizou-se o formato digital e observação direta dos pacientes internados (n = 813) com algum dispositivo de fixação em acesso intravascular central ou periférico e a fixação complementar com esparadrapo, com seguimento de 7 dias em fevereiro de 2020. Resultados: A deterio-ração da pele incluiu descolamento epidérmico, maceração, contato com irritante e dermatite alérgica, com prevalência de 2,2%. Foram atribuídos a cateter venoso central (f = 8), cateter venoso periférico (f = 7) e esparadrapo para fixação complementar do curativo transparente (f = 3). Discussão: As causas da deterioração da pele foram devido ao tipo de dispositivo e material implementado para amarração; Na maioria dos casos, as lesões foram encontradas em acessos venosos periféricos, seguidos de acessos venosos centrais, sendo a amarração suplementar a menor causa de deterioração da pele. Conclusões: A técnica correta de apli-cação e retirada de suprimentos adesivos para estabilização e fixação do cateter intravascular evitará seu descolamento, lesões cutâneas e interrupção da terapia de infusão intravascular

Manejo de un paciente clase III ósea con cirugía ortognática tardía: reporte de caso clínico / Management of an orthognathic surgery treatment in a skeletal class IIIpatient: case report

Antecedentes: El tratamiento establecido como el estándar de oro para las malformaciones óseas del complejo cráneo facial es el tratamiento de ortodoncia compaginado con cirugía ortognática, para alcanzar estabilidad oclusal, eliminar discrepancia ósea, armonía facial, mejora en la masticación, fonación y respiración. El protocolo de cirugía ortognática tardía consiste en 3 fases: tratamiento de ortodoncia pre-quirúrgica, cirugía ortognática y ortodoncia post-quirúrgica. Objetivo:El objetivo del caso clínico es trasmitir que el enfoque de cirugía tardía puede dar excelentes resultados, ser eficaz y rápido si existe un buen diagnóstico, manejo y una comunicación estrecha entre el ortodoncista y el cirujano maxilofacial. Reporte de caso:Paciente femenino de 18 años de edad clase III ósea. Presenta molestia ocasional, crepitación y luxación de la articulación temporomandibular, laterognasia. El tratamiento establecido fue cirugía ortognática tardía de ambos maxilares con osteotomía sagital unilateral. Resultados:Los objetivos del plan de tratamiento se cumplieron a 1 año 9 meses de haber iniciado el tratamiento ortodóncico. Conclusión:Con un buen diagnóstico y planificación del tratamiento de ortodoncia ­cirugía ortognática asegura excelentes resultados, así como, estabilidad ósea y armonía oclusal post-cirugía.

Introduction: The treatment established as the gold standard for skeletal deformities of the craniofacial complex is orthodontic treatment combined with orthognathic surgery, to achieve occlusal stability, facial harmony, improved mastication, phonation and breathing. The conventional orthognathic surgery protocol consists of 3 phases: pre-surgical orthodontic treatment, orthognathic surgery and post-surgical orthodontics. Case Report: 18-year-old female patient with skeletal class III. She presents occasional pain, crepitation and luxation of the temporomandibular joint, laterognathia. Treatment: Conventional orthognathic surgery of both jaws with unilateral sagittal osteotomy. Results: The objectives of the treatment plan were achieved 1 year and 9 months after starting orthodontic treatment.Conclusion: With a good diagnosis and treatment planning orthodontic -maxillofacial surgery ensures excellent results, as well as bone stability and occlusal harmony post-surgery.

Clinical and experimental knowledge of photobiomodulation in accelerated orthodontics: A review / Conocimiento clínico y experimental de la fotobiomodulación en ortodoncia acelerada: Una revisión

Background: In recentyears, there has been an increasing interest in finding a noninvasive method to induce the accelerationofdentalmovement,methodssuchaslowintensityvibrations,pulsedelectromagneticfields,andlow-level laser therapy (LLLT). There have been multiple studies on the efficacy of LLLT in animal models, in vitro and in patients without conclusiveresults. Objective: Evaluate the state of the art on the use of LLLT to increase the rate of the orthodontic tooth movement to create a concise reference guide of the different laser and protocols available. Materials and Methods: The authors searched electronic databases (MedLine, Scopus and Semantic Scholar) for articles that evaluated the effectsoflow-leverlasertherapyontheorthodontictoothmovement.Screeningwasperformedatthetitle/abstract and full-text level. Data extraction and quality assessment were performed by two reviewers independently. The reference lists of relevant studies were also screened for further relevantliterature. Results: We found conflicting information as to the efficacy of LLLT to accelerate the orthodontic tooth movement (OTM). There is no consensus in the way the irradiation should be performed. Conclusions: The lack of a standardized irradiation protocol makes it hard to compare conflicting results, even in cases where the laser have the same technical specifications.

Antecedentes: En los últimos años, ha habido un interés creciente en encontrar un método no invasivo para inducir la aceleración del movimiento dental, métodos como vibraciones de baja intensidad, campos electromagnéticos pulsados y terapia con láser de bajo nivel(LLLT). Se han realizado múltiples estudios sobre la eficacia de la LLLT en modelos animales, in vitro y en pacientes sin resultados concluyentes. Objetivo: Evaluar el estado del arte en el uso de LLLT para aumentar la velocidad del movimiento dental ortodóncico para crear una guía de referencia concisa de los diferentes láser y protocolos disponibles. Materiales y métodos: Los autores buscaron en bases de datos electrónicas (MedLine, Scopus y Semantic Scholar) artículos que evaluaran los efectos de la terapia con láser de baja intensidad sobre el movimiento dental ortodóncico. La selección se realizó a nivel de título / resumen y texto completo. Dos revisores realizaron de forma independiente la extracción de datos y la evaluación de la calidad. También se examinaron las listas de referencias de estudios relevantes para obtener más literatura significativa. Resultados:EncontramosinformacióncontradictoriaencuantoalaeficaciadelaLLLTparaacelerarel movimiento dental ortodóncico (OTM).No hay consenso sobre la forma en que se debe realizar lairradiación. Conclusiones: La falta de un protocolo de irradiación estandarizado dificulta la comparación de resultados, incluso en los casos en que el láser tiene las mismas especificaciones técnicas.

[Prevalence of insomnia in adults aged 18 to 60 years and exposure to electromagnetic fields in households of Barranquilla, Colombia]. / Prevalencia de insomnio en adultos de 18 a 60 años de edad y exposición a campos electromagnéticos en hogares de Barranquilla, Colombia.

INTRODUCTION: Insomnia, a sleep disorder that affects both individual and public health, has not been studied in Barranquilla. Prior studies about the effects of exposure to electromagnetic fields on sleep disorders are controversial. OBJECTIVE: To estimate the prevalence of insomnia symptoms in adults aged 18 to 60 years and its relation to the presence and intensity of electromagnetic fields in two neighborhoods of Barranquilla, Colombia. MATERIALS AND METHODS: A cross-sectional study was carried out in 220 households located in two neighborhoods of Barranquilla, one with high exposure to radio and cell phone antennas and the other one with low exposure. After informed consent, a survey was applied among adults residing in 220 households to investigate the presence of insomnia symptoms, socio-demographic data and intake of medicines. When it was allowed, electromagnetic fields were measured with teslameters in bedrooms. The database was created in Excel™ and the data analysis was done with SPSS™, version 18. RESULTS: Insomnia, mainly of the mild type, was present in 74.5% of the total study population while 25.5% reported a normal sleep pattern. According to the sleeping test score we found a higher prevalence of insomnia in the neighborhood with greater exposure to radio antennas and cell towers (85.4%) than in the one with lower exposure (63.3%), prevalence ratio 1.34 (CI 95% 1.14-1.57). CONCLUSIONS: This study suggests a higher prevalence of insomnia among persons living in areas with higher exposure to electromagnetic fields where the number of radio antennas and cell towers was greater.