MicroRNA-1307-3p contributes to breast cancer progression through PRM2.

BACKGROUND: Despite advances in screening and therapy, breast cancer (BC) remains the predominant cancer in women globally. Dysregulation of microRNAs (miRNAs) is pivotal in carcinogenesis across various cancers, including BC. Evidence indicates that miR-1307-3p is upregulated in BC tumors, yet its target genes are not fully elucidated. This study aimed to explore how miR-1307-3p regulates BC proliferation, migration, invasion, and angiogenesis and to identify potential target genes. METHODS: Basal miR-1307-3p levels were quantified in BC cell lines MDA-MB-231 and MCF-7, as well as MCF-10A using quantitative real-time reverse transcription-PCR (RT-qPCR). The impact of miR-1307-3p inhibition on BC cell proliferation, migration, invasion, and angiogenesis was assessed. Nine miRNA-target prediction databases identified potential miR-1307-3p targets. Target expression was validated using RT-qPCR, Western blot, and dual-luciferase reporter assays. MiR-1307-3p was overexpressed in MDA-MB-231 and MCF-7 compared to MCF-10A. RESULTS: Inhibiting miR-1307-3p significantly reduced BC cell proliferation, migration, invasion, and angiogenesis. Bioinformatics analysis identified 17 potential miR-1307-3p targets, with protamine 2 (PRM2) overexpression confirmed via Western blot and dual-luciferase assays. CONCLUSION: MiR-1307-3p overexpression in BC promotes proliferation, migration, invasion, and angiogenesis. PRM2 emerges as a novel miR-1307-3p target in BC.

T-FINDER: A highly sensitive, pan-HLA platform for functional T cell receptor and ligand discovery.

Effective, unbiased, high-throughput methods to functionally identify both class II and class I HLA-presented T cell epitopes and their cognate T cell receptors (TCRs) are essential for and prerequisite to diagnostic and therapeutic applications, yet remain underdeveloped. Here, we present T-FINDER [T cell Functional Identification and (Neo)-antigen Discovery of Epitopes and Receptors], a system to rapidly deconvolute CD4 and CD8 TCRs and targets physiologically processed and presented by an individual's unmanipulated, complete human leukocyte antigen (HLA) haplotype. Combining a highly sensitive TCR signaling reporter with an antigen processing system to overcome previously undescribed limitations to target expression, T-FINDER both robustly identifies unknown peptide:HLA ligands from antigen libraries and rapidly screens and functionally validates the specificity of large TCR libraries against known or predicted targets. To demonstrate its capabilities, we apply the platform to multiple TCR-based applications, including diffuse midline glioma, celiac disease, and rheumatoid arthritis, providing unique biological insights and showcasing T-FINDER's potency and versatility.

Decisiones por sustitución en personas mayores con deterioro cognitivo y su delegación de autonomía ¿representada? / Surrogate decision-making in older people with cognitive impairment and the delegation of their autonomy: is it represented? / As decisões de substituição em idosos com deficiência cognitiva e sua delegação de autonomia ¿representada?

Objetivo: Analizar las consideraciones éticas que surgen en situaciones donde las personas mayores con deterioro cognitivo delegan sus decisiones a terceros. Desarrollo: Trabajo de reflexión basado en una revisión narrativa desde diferentes fuentes de información. El envejecimiento de la población es un fenómeno donde se evidencian múltiples desafíos a atender. Chile se encuentra en una etapa de envejecimiento avanzado estimando una esperanza de vida sobre los 85 años para el 2050. La Organización Mundial de la Salud promueve el envejecimiento saludable mediante el fortalecimiento de la capacidad funcional como indicador de bienestar. Existen ocasiones donde las personas mayores delegan a un tercero su capacidad de decidir. Las decisiones por sustitución, que abordan dimensiones éticas y legales deben proteger la dignidad de la persona en todo momento, independientemente de su condición de salud y representar plenamente el derecho de autonomía cedido. Conclusiones. La discusión sobre las decisiones por sustitución y la protección de la autonomía, incluso en situaciones de limitaciones cognitivas, subraya la necesidad de tratar a las personas mayores con respeto y ética, desafiando los estereotipos negativos y evitando conductas discriminatorias y estigmatizantes. La importancia de promover la igualdad, inclusión, información y el respeto de los derechos de las personas mayores tiene un impacto directo en el bienestar y calidad de vida, elemento fundamental que la salud pública promueve bajo el contexto del envejecimiento activo, saludable y digno.

Objective: To analyze the ethical considerations in situations where older people with cognitive impairment delegate their decisions to third parties. Development: Reflective practice based on a narrative review of different sources of information. Population aging is a phenomenon where multiple challenges need to be addressed. Chile is at an advanced stage of population aging, with an estimated life expectancy of over 85 years to be reached by 2050. The World Health Organization (WHO) promotes healthy aging by strengthening functional capacity as an indicator of well-being. There are circumstances in which older people delegate their decision-making capacity to a third party. Surrogate decision-making, with its ethical and legal dimensions, should protect the person's dignity at all times, regardless of the state of their health, and fully represent their ceded right of autonomy. Conclusions: The discussion on surrogate decision-making and the protection of autonomy, even in the context of cognitive impairment, highlights the need to treat older people ethically and respectfully, challenging negative stereotypes and avoiding discriminatory and stigmatizing behaviors. Promoting equality, inclusion, information, and respect for the rights of older adults has a direct impact on their well-being and quality of life, which are fundamental elements that public health promotes in the context of active, healthy, and dignified aging.

Objetivo: Analisar as considerações éticas que surgem em situações em que pessoas idosas com deficiência cognitiva delegam as suas decisões a terceiros. Desenvolvimento: Trabalho de reflexão baseado numa revisão narrativa a partir de diferentes fontes de informação. O envelhecimento da população é um fenómeno onde existem múltiplos desafios a enfrentar. O Chile encontra-se numa fase avançada de envelhecimento, estimando uma esperança de vida superior a 85 anos até 2050. A Organização Mundial de Saúde promove o envelhecimento saudável através do fortalecimento da capacidade funcional como indicador de bem-estar. Há ocasiões em que os idosos delegam a sua capacidade de decisão a terceiros. As decisões de substituição, que abordam as dimensões éticas e legais, devem proteger a dignidade da pessoa em todos os momentos, independentemente do seu estado de saúde, e representar plenamente o direito concedido à autonomia. Conclusões: A discussão sobre as decisões de substituição e a proteção da autonomia, mesmo em situações de limitações cognitivas, sublinha a necessidade de tratar os idosos com respeito e ética, desafiando estereótipos negativos e evitando comportamentos discriminatórios e estigmatizantes. A importância da promoção da igualdade, da inclusão, da informação e do respeito pelos direitos dos idosos tem impacto direto no bem-estar e na qualidade de vida, elemento fundamental que a saúde pública promove no contexto do envelhecimento ativo, saudável e digno.

The E3/E4 ubiquitin ligase UFD-2 suppresses normal and oncogenic signaling mediated by a Raf ortholog in Caenorhabditis elegans.

Signaling by the kinase cascade composed of Raf, MEK, and ERK is critical for animal development and is often inappropriately activated in human malignancies. We sought to identify factors that control signaling mediated by the Caenorhabditis elegans Raf ortholog LIN-45. A genetic screen showed that the degradation of LIN-45 required the E3/E4 ubiquitin ligase UFD-2. Both UFD-2 and its partner, the ATP-dependent segregase CDC-48, were required for the developmental regulation of LIN-45 protein abundance. We showed that UFD-2 acted in the same pathway as the E3 ubiquitin ligase SCFSEL-10 to decrease LIN-45 abundance in cells in which Raf-MEK-ERK signaling was most highly active. UFD-2 also reduced the protein abundance of activated LIN-45 carrying a mutation equivalent to the cancer-associated BRAF(V600E) variant. Our structure-function studies showed that the disruption of LIN-45 domains that mediate protein-protein interactions, including the conserved cysteine-rich domain and 14-3-3 binding motifs, were required for UFD-2-independent degradation of LIN-45. We propose a model in which UFD-2 and CDC-48 act downstream of SCFSEL-10 to remove LIN-45 from its protein interaction partners and facilitate proteasomal targeting and degradation. These findings imply that UFD-2 and CDC-48 may be important for Raf degradation during normal and oncogenic Ras and MAPK signaling in mammalian cells.

Cytotoxicity Induced by Newly Synthesized Palladium (II) Complexes Lead to the Death of MCF-7 and MDA-MB-435 Cancer Cell Lines.

Purpose: Breast cancer is the most common female malignancy and melanoma is the most lethal type of skin cancer. Traditional therapy for cancer treatment is far from satisfactory due to drug resistance and side effects, thus a search for new medicines is being emphasized. Palladium(II) complexes have been reported as anticancer potential agents. In this work, the anticancer activities and cell death induction of a new series of square-planar Pd(II) complexes were evaluated against MCF-7 and MDA-MB-435 cancer cells. Methods: MCF-7 (breast carcinoma) and MDA-MB-435 (melanoma) cells were cultivated, and treated with ligand and Pd(II) complexes. Cell growth, migration and adhesion inhibition, morphological alterations, cell death induction and, DNA interaction upon treatment were studied. Results: Pd(II) complexes exhibited both short and long-term antiproliferative effects on both cell lines, reducing by 80% cell growth in the SRB assay and abolishing longterm proliferation, estimated by the clonogenic assay. Complexes reduced significantly (P<0.05) cell migration and adhesion when compared to the control group. Complexes induced morphological alterations in cell lines and significant (P<0.05) cellular shrinkage. Cell death was induced and the complexes were able to interact with DNA, inducing cleavage of double-stranded DNA, which may account for the complexes cytotoxic effects, observed against both MCF-7 and MDA-MB-435 cells. Conclusion: Overall, the complexes exhibited cytotoxic activities and induced cell death. These observations emphasize an anticancer role with a potential therapeutic value for Pd(II) complexes to improve the outcome of patients with breast cancer and melanoma.

Úlceras de pie diabético y plasma rico en plaquetas / Healing of diabetic foot ulcers with platelet-rich plasma

Introducción: El plasma rico en plaquetas (PRP) se encuentra en desarrollo desde los años 80, asociado con aplicaciones en medicina cardíaca, traumatológica y dermatológica. El PRP es una preparación autóloga, con una concentración de plaquetas por sobre el valor normal en sangre periférica, que se obtiene a partir de su centrifugación siguiendo diferentes protocolos que fueron valorados en distintas revisiones sistemáticas. El plasma luego se activa con trombina o cloruro cálcico, o por lisis física (ultrasonido o frizado). El PRP contiene factores de crecimiento, citoquinas y proteínas de adhesión que, al aplicarse en la lesión, favorecen la hemostasia, la síntesis de tejido conectivo y la revascularización. El producto se aplica en solución o gel. Se intentaron diferentes clasificaciones del PRP para estandarizarlo, sin éxito. Se conceptualizó la receta del PRP para aplicación clínica, que presentó las siguientes características: valores altos de plaquetas, disminución de la contaminación de glóbulos rojos, presencia de neutrófilos y leucocitos para el éxito terapéutico. Protocolo y casos: Se presenta el protocolo de preparación de PRP de centrifugación única de 7 minutos a 1400 rpm, con activación por medio de gluconato de calcio según la siguiente proporción: 3 ml plasma/0.4 ml gluconato cálcico. Además, se informan tres casos de úlceras de pie diabético de nuestra institución. Conclusión: El PRP no presenta complejidad en su preparación y aplicación, por lo que es factible de realizar en el primer nivel de atención que cuente con los recursos materiales y profesionales con conocimiento en el abordaje de heridas crónicas.

Introduction: Platelet-rich plasma (PRP) has been under development since the 1980s, associated with applications in cardiac, traumatological, and dermatological medicine. PRP is an autologous preparation with a platelet concentration above the normal value in peripheral blood that is obtained from its centrifugation following different protocols that were evaluated in different systematic reviews. The plasma is then activated with thrombin or calcium chloride, or by physical lysis (ultrasound or friz). PRP contains growth factors, cytokines, and adhesion proteins that, when applied to the lesion, favor hemostasis, connective tissue synthesis, and revascularization. The product is applied in solution or gel. Different classifications of the PRP were used with the intention of standardizing the procedure without success. The PRP recipe for clinical application was conceptualized. It presented the following characteristics: high platelet values, decreased red blood cell contamination, presence of neutrophils and leukocytes for therapeutic success. Protocol and cases: The PRP preparation protocol for single centrifugation for 7 minutes at 1400 rpm with activation through calcium gluconate is presented according to the following ratio: 3 ml plasma/0.4 ml of calcium gluconate. Three cases of diabetic foot ulcers from our institution are reported. Conclusion: The PRP does not present complexity in its preparation and application, so it is feasible to perform it in the first level of care that has the material and professional resources with knowledge in the approach to chronic wounds.

Transcranial electric stimulation motor evoked potentials for cervical spine intraoperative monitoring complications: systematic review and illustrative case of cardiac arrest.

PURPOSE: We show a systematic review of known complications during intraoperative neuromonitoring (IONM) using transcranial electric stimulation motor evoked potentials (TES-MEP) on cervical spine surgery, which provides a summary of the main findings. A rare complication during this procedure, cardiac arrest by cardioinhibitory reflex, is also described. METHODS: Findings of 523 scientific papers published from 1995 onwards were reviewed in the following databases: CENTRAL, Cochrane Library, Embase, Google Scholar, Ovid, LILACS, PubMed, and Web of Science. This study evaluated only complications on cervical spine surgery undergoing TES-MEP IONM. RESULTS: The review of the literature yielded 13 studies on the complications of TES-MEP IONM, from which three were excluded. Five studies are case series; the rest are case reports. Overall, 169 complications on 167 patients were reported in a total of 38,915 patients, a global prevalence of 0.43%. The most common complication was tongue-bite in 129 cases, (76.3% of all complication events). Tongue-bite had a prevalence of 0.33% (CI 95%, 0.28-0.39%) in all patients on TES-MEP IONM. A relatively low prevalence of severe complications was found: cardiac-arrhythmia, bradycardia and seizure, the prevalence of this complications represents only one case in all the sample. Alongside, we report the occurrence of cardiac arrest attributable to TES-MEP IONM. CONCLUSIONS: This systematic review shows that TES-MEP is a safe procedure with a very low prevalence of complications. To our best knowledge, asystole is reported for the first time as a complication during TES-MEP IONM.

Acute Disseminated Toxoplasmosis in Two Specimens of Macropus rufogriseus Caused by a Genotype so far Exclusive to South America.

Macropods are included among the species considered highly susceptible to Toxoplasma gondii infection. Clinically, it is difficult to distinguish between acute toxoplasmosis due to primary infection and reactivation of chronic latent infection in susceptible species until pathologic studies are performed. Here, we described the clinical cases and lesions found in two deceased Bennett's wallabies (Macropus rufogriseus) with a presumptive diagnosis of toxoplasmosis, as well as the genetic characterization of the T. gondii isolates obtained from these specimens. Both animals presented acute infection lesions in the lungs, liver, spleen and lymph nodes associated to T. gondii infection. Histopathology and immunohistochemistry also demonstrated tissue cysts of different sizes, indicating that the wallabies were previously infected with this parasite. Two isolates were obtained, one from each specimen and the molecular characterization was done; both isolates were the ToxoDB #116 genotype. This is the first study that reports the isolation of this particular genotype outside South America, and given the histopathological findings, it could be considered virulent for this species. The dynamics of infection that T. gondii is causing in definitive and intermediate hosts in a region allows us to know the risks to which the animals and humans that live in the area are exposed, and in the future to implement a preventive medicine plan against this parasite.

Induction Chemotherapy and Chemoradiotherapy Combined to ASA vs. Placebo for High-Risk Rectal Cancer: Results of a Randomized Trial.

INDUCTION: chemotherapy (IC) followed by chemoradiation (CRT) is an attractive approach in high-risk locally advanced rectal cancer. Additionally, ASA has shown potential to improve outcomes alongside CRT in rectal cancer. The ICAR trial aimed to evaluate the safety and efficacy of IC followed by CRT with or without ASA on MRI tumor response. METHODS: Single-center, double-blind, randomized phase II trial to evaluate induction treatment with CAPOX, followed by capecitabine-based chemoradiotherapy with ASA (arm 1) or placebo (arm 2) in high-risk stage II-III rectal adenocarcinoma staged by MRI. The primary endpoint was MRI tumor regression grade (mrTRG). Secondary endpoints were pathological response, surgical outcomes, postoperative complications, treatment tolerance, DFS, and OS. RESULTS: Between January 2018 and August 2019, 27 patients were eligible, 25 (92.5%) completed IC, and 23 patients were randomly assigned (12 to ASA group; 11 to placebo group). In the ASA arm, 3 pts (25%) presented distant disease progression at restaging. Seven patients (30.4%) had cCR after neoadjuvant treatment. All 13 patients submitted to surgery after neoadjuvant treatment underwent R0 resections except for 1 patient with positive CRM, and 12 patients (92.3%) had sphincter preservation. After a median follow-up of 34.9 months, the 2-year DFS was 83.1% and 3-year OS was 81.5%. CONCLUSION: There was good compliance in both treatment arms and encouraging cCR rate. ASA during CRT was safe but failed to improve on MRI tumor response. The study was closed due to the absence of benefits.

Estudio piloto: contacto padre-hijo(a) y oxitocina en varones preparados especialmente para el nacimiento / Pilot study: father-child contact and oxytocin in males with a special education for childbirth

INTRODUCCÍON: Los padres se han involucrado cada vez más en el embarazo y el nacimiento de sus hijos, pero aún se requieren intervenciones paternas que permitan reubicar al padre en su rol de corresponsabilidad en la crianza. OBJETIVO: Observar el comportamiento-actitud paterna hacia el/la hijo(a) y la cantidad de oxitocina (OT) secretada en el nacimiento, en padres preparados de un modo especial para el parto. Método: Estudio piloto de 8 meses, parte de una investigación mayor cuali-cuantitativa de dos fases. La fase cualitativa inicial desarrolló una intervención preparatoria de padres para el nacimiento, con énfasis en la vinculación padre-hijo(a). La fase cuantitativa correspondió al piloto de la intervención paterna antenatal. RESULTADOS: Los padres presenciaron activamente el momento del expulsivo y el encuentro madre-hijo(a). Posteriormente, todos optaron por el contacto físico piel-piel con su hijo(a). La OT paterna experimentó un aumento (no significativo) durante el contacto padre-hijo(a) en comparación con la OT basal (momento inmediato al nacimiento). CONCLUSIONES: Padres preparados, sensibilizados y vinculados con su hijo(a) desde el embarazo experimentarían variaciones de la cantidad de OT cuando realizan contacto piel-piel con su hijo(a) en el nacimiento. Se requiere investigación experimental con una muestra mayor de participantes para concluir de manera categórica.

INTRODUCTION: Fathers have been increasingly involved in the pregnancy and birth of their children, but paternal interventions are still required to relocate the father in his role of co-responsibility in parenting. OBJECTIVE: To observe the paternal behavior-attitude towards the child and the amount of oxytocin (OT) secreted at birth in parents prepared (in a special way) for childbirth. METHOD: Pilot study of 8 months, part of a larger qualitative-quantitative research of two phases. The initial qualitative phase developed a male preparatory intervention for the birth, with emphasis on the father-child bonding. The quantitative phase corresponded to the pilot of the antenatal paternal intervention. RESULTS: Fathers actively witnessed the moment of delivery and the mother-child attachment. Subsequently, all of them opted for physical skin-to-skin contact with their child. Paternal OT experienced a (non-significant) increase during father-child contact, compared to baseline OT (immediately after birth). CONCLUSIONS: Males prepared, sensitized and involved with their child since pregnancy would experience variations in the amount of OT when they make father-child skin-to-skin contact at childbirth. Experimental research with a larger sample of participants is required to categorically reach a conclusion.

Successful Neonatal, Intraoperative Neuromonitoring in the Surgical Correction of a Thoracic Dermal Sinus Tract: Technical Note.

INTRODUCTION: Intraoperative neuromonitoring (IONM) is commonly used during surgery of the spine and spinal cord for early surveillance of iatrogenic injury to the central and peripheral nervous system. However, for infants and young children under 3 years of age, the use of IONM is challenging due to incomplete central and peripheral myelination. CASE PRESENTATION: We report a case of a T4-T6 dermal sinus tract (DST) that was resected on day of life 23, with the successful use of IONM. CONCLUSION: To our knowledge, this is the youngest reported case of the use of IONM in the surgical correction of a DST in a neonatal patient. This case demonstrates the potential efficacy of IONM in neonatal spine surgery and the techniques used to adapt the technology to an immature nervous system.

Quality of life in a randomized trial comparing two neoadjuvant regimens for locally advanced rectal cancer-INCAGI004.

BACKGROUND: Neoadjuvant chemoradiotherapy (neoCRT) followed by surgery is the standard of care for locally advanced rectal cancer (LARC), but the emergence of different drug regimens may result in different response rates. Good clinical response translates into greater sphincter preservation, but quality of life (QOL) may be impaired after treatment due to chemoradiotherapy and surgical side effects. OBJECTIVE: To prospectively evaluate the impact of clinical response and surgical resection on QOL in a randomized trial comparing two different neoCRT regimens. METHODS: Stage II and III rectal cancer patients were randomized to receive neoCRT with either capecitabine (group 1) or 5-Fu and leucovorin (group 2) concomitant to long-course radiotherapy. Clinical downstaging was accessed using MRI 6-8 weeks after treatment. EORTCs QLQ-C30 and CR38 were applied before treatment (T0), after neoCRT (T1), after rectal resection (T2), early after adjuvant chemotherapy (T3), and 1 year after the end of treatment or stoma closure (T4). The Wexner scale was used for fecal incontinence evaluation at T4. A C30SummaryScore (Geisinger and cols.) was calculated to compare QOL results. RESULTS: Thirty-two patients were assigned to group 1 and 31 to group 2. Clinical downstaging occurred in 70.0% of group 1 and 53.3% of group 2 (p = 0.288), and sphincter preservation was 83.3% in group 1 and 80.0% in group 2 (p = 0.111). No significant difference in QOL was detected when comparing the two treatment groups after neoCRT using QLQ-C30. However, the CR38 module detected differences in micturition problems (15.3 points), gastrointestinal problems (15.3 points), defecation problems (11.8 points), and sexual satisfaction (13.3 points) favoring the capecitabine group. C30SummaryScore detected significant improvement comparing T0 to T1 and deterioration comparing T1 to T2 (p = 0.025). The mean Wexner scale score was 9.2, and a high score correlated with symptoms of diarrhea and defecation problems at T4. CONCLUSIONS: QOL was equivalent between groups after neoCRT except for micturition problems, gastrointestinal problems, defecation problems, and sexual satisfaction favoring the capecitabine arm after. The overall QOL using the C30SummaryScore was improved after neoCRT, but decreased following rectal resection, returning to basal levels at late evaluation. Fecal incontinence was high after sphincter preservation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03428529.

Manejo conservador e intervención mínima en pacientes con dientes natales y neonatales: reporte de cuatro casos / Manejo conservador e intervenção mínima em pacientes com dentes natais e neonatais: Relato de quatro casos / Conservative management and minimal intervention in patients with natal and neonatal teeth: Report of four cases

Los dientes natales y neonatales están presentes al momento del nacimiento o en el primer mes de vida respectivamente. Son observados más frecuentemente en los incisivos centrales inferiores, y la mayoría de los casos estos dientes representan los dientes primarios. Las características clínicas, posibles complicaciones y el curso clínico son parámetros a considerar para un adecuado manejo. Sin embargo diferentes reportes afirman que pueden ocurrir complicaciones después de realizar la extracción en recién nacidos. A la fecha, no se han documentado reportes de casos en la literatura describiendo complicaciones en los dientes que se conservan como lo es la aspiración de los dientes. El objetivo del presente estudio es presentar cuatro casos, tres de los cuales fueron tratados con un manejo conservador. Considerando que la prevalencia ha incrementado progresivamente en los últimos años, neonatologos y odontopediatras deben hacer un diagnóstico temprano y ofrecer un adecuado tratamiento, brindando un bienestar general y oral en cada paciente. El éxito del tratamiento depende de un seguimiento periódico.

Os dentes natais e neonatais estão presentes no nascimento ou no primeiro mês de vida, respectivamente. Eles são vistos com mais frequência nos incisivos centrais inferiores e, na maioria dos casos, esses dentes representam os dentes decíduos. As características clínicas, as possíveis complicações e o curso clínico são parâmetros a serem considerados para um manejo adequado. Porém, diferentes relatos afirmam que complicações podem ocorrer após a realização da extração em recém-nascidos. Até o momento, não há relatos de casos documentados na literatura descrevendo complicações em dentes preservados, como aspiração dentária. O objetivo deste estudo é apresentar quatro casos, três dos quais foram tratados com conduta conservadora. Considerando que a prevalência tem aumentado progressivamente nos últimos anos, os neonatologistas e odontopediatras devem fazer o diagnóstico precoce e oferecer tratamento adequado, proporcionando bem-estar geral e bucal a cada paciente. O sucesso do tratamento depende de monitoramento regular.

Natal and neonatal teeth are present at birth or in the first month of life. They are observed more frequently in the mandibular central incisors, and in most cases, these teeth represent the true primary teeth. Clinical characteristics, possible complications and the clinical course are parameters to consider for proper management. Nevertheless, different reports argue that complications may occur after extraction in newborns. To date, there are no documented cases reported in the literature describing complications in retained teeth, such as aspiration of a tooth. The objective of the present study is to introduce four cases, three of which were treated with conservative management. Considering that the prevalence has increased progressively in recent years, neonatologists and pediatric dentists must make an early diagnosis and offer adequate treatment, providing general and oral wellness for each patient. The success of the treatment depends on periodic follow-up.

Análisis temporal del delito en el estado de Tabasco, México (1997-2018) / Temporal analysis of crime in the state of Tabasco, Mexico (1997-2018)

Es innegable que el crimen en México aumenta y sin duda alguna, para frenarlo son necesarias políticas públicas empíricamente argumentadas. La investigación busca dar respuesta a tres interrogantes fundamentales sobre el crimen en el estado de Tabasco: ¿Existen patrones en la conducta delictiva? ¿Cuál es su tendencia? ¿Cómo caracterizarla durante las últimas décadas? Para responderlos se recurre a la estadística descriptiva, la georreferenciación y al análisis de series de tiempo (1997-2018) para identificar los patrones subyacentes. Villahermosa o El Centro, la ciudad capital del estado, ha sido, es y seguirá siendo una de las ciudades más inseguras del país, de no tomarse decisiones radicales para inhibir las tasas delictivas. En la actualidad, el secuestro y el abigeato son las modalidades delincuenciales que afectan, de gran modo, las actividades económicas de la región e i

Abordaje de la vía aérea en el paciente neuroquirúrgico / Airway approach in the neurosurgical patient

Resumen: El abordaje de la vía aérea en el paciente neuroquirúrgico presenta grandes retos debido al escenario tan complejo al cual nos enfrentamos; debemos considerar las características propias del paciente, las comorbilidades presentes y la patología neurológica por la que va a ser intervenido. Conocer la patología neurológica y las implicaciones o repercusiones que ésta puede llegar a tener en el manejo de la vía aérea ayudarán a la toma de decisiones y conocer los retos y escenarios que se pudieran presentar durante el evento anestésico-quirúrgico.

Abstract: The approach to the airway in the neurosurgical patient presents great challenges due to the complex scenario we face; we must consider the patient's own characteristics, the co-morbidities present and the neurological pathology for which it is going to be intervened. Knowing the neurological pathology and the implications or repercussions that this may have over the management of the airway will help decision making and manage the challenges and scenarios that could arise during the anesthetic surgical event.

Factors associated with nursing workload in three intensive care units.

OBJECTIVE: To determine the nursing workload in intensive care units (ICUs) and the factors associated with the Nursing Activities Score (NAS). METHOD: An analytical cross-sectional study was carried out in three ICUs in Bucaramanga, Colombia, between February 2018 and February 2020. The nursing workload was estimated based on the NAS. A descriptive and bivariate analysis stratified by ICU was performed using a robust multiple linear regression model, and the factors associated with the nursing workload (p < 0.05) were estimated. RESULTS: In this study, 362 records were included. The median NAS was 68.1 points (Q1:47.2-Q3:116.7). APACHE II (ß = 3.13, CI: 95% 2.28; 3.98), days of stay in ICU ≥3 (ß = 16.78, CI: 95% 6.15; 27.41), surgery provenance service (ß = 22.31, CI: 95% 9.76; 34.86), and traumatology and emergencies diagnostic category (ß = 33.72, CI 95%: 9.90; 57.53) were associated with high NAS scores. CONCLUSION: The nursing staff spend approximately 70% of their time on a single patient, and administrative work takes up most of their time. Hospital stays of longer than 3 days, high APACHE II score, coming from the surgery department, and having a diagnosis of trauma and emergency were associated with a high workload.

Factors associated with nursing workload in three intensive care units / Fatores associados à carga de trabalho de enfermagem em três Unidades de Terapia Intensiva / Factores asociados a la carga de trabajo de enfermería en tres Unidades de Cuidado Intensivo

ABSTRACT Objective: To determine the nursing workload in intensive care units (ICUs) and the factors associated with the Nursing Activities Score (NAS). Method: An analytical cross-sectional study was carried out in three ICUs in Bucaramanga, Colombia, between February 2018 and February 2020. The nursing workload was estimated based on the NAS. A descriptive and bivariate analysis stratified by ICU was performed using a robust multiple linear regression model, and the factors associated with the nursing workload (p < 0.05) were estimated. Results: In this study, 362 records were included. The median NAS was 68.1 points (Q1:47.2-Q3:116.7). APACHE II (β = 3.13, CI: 95% 2.28; 3.98), days of stay in ICU ≥3 (β = 16.78, CI: 95% 6.15; 27.41), surgery provenance service (β = 22.31, CI: 95% 9.76; 34.86), and traumatology and emergencies diagnostic category (β = 33.72, CI 95%: 9.90; 57.53) were associated with high NAS scores. Conclusion: The nursing staff spend approximately 70% of their time on a single patient, and administrative work takes up most of their time. Hospital stays of longer than 3 days, high APACHE II score, coming from the surgery department, and having a diagnosis of trauma and emergency were associated with a high workload.

RESUMO Objetivo: Determinar a carga de trabalho de enfermagem em Unidade de Terapia Intensiva e os fatores associados ao escore NAS. Métodos: Estudo analítico transversal realizado em três UTIs de Bucaramanga, Colômbia, entre fevereiro de 2018 e fevereiro de 2020. A sobrecarga de enfermagem foi estimada com o Nursing Activities Score (NAS). Foi realizada análise descritiva e bivariada estratificada por UTI por meio de modelo de regressão linear múltipla robusto e estimados os fatores associados à sobrecarga de enfermagem (p <0,05). Resultados: Foram incluídos 362 registros. O NAS mediano foi de 68,1 pontos (Q1: 47,2-Q3: 116,7) APACHE II (β = 3,13, IC 95%: 2,28; 3,98), dias de permanência na UTI ≥ 3 (β = 16,78, IC 95%: 6,15; 27,41), serviço de origem da cirurgia (β = 22,31, IC 95%: 9,76; 34,86), categoria de diagnóstico de trauma e emergências (β = 33,72, IC 95%: 9,90; 57,53) estiveram associados a maior pontuação NAS. Conclusões: a equipe de enfermagem da UTI despende aproximadamente 70% do tempo com um único paciente e as tarefas administrativas ocupam a maior parte do tempo. A permanência hospitalar superior a três dias, maior pontuação do APACHE II, proveniente do serviço de cirurgia, com diagnóstico de trauma e urgências estiveram associados à elevada carga de trabalho.

RESUMEN Objetivo: Determinar la carga la laboral de enfermería en Unidades de Cuidado Intensivo y los factores asociados al puntaje del Nursing Activities Score. Método: Estudio analítico, de corte transversal realizado en tres Unidades de Cuidados Intensivos de Bucaramanga, Colombia entre febrero del 2018 y febrero del 2020. La carga de enfermería fue estimada con el Nursing Activities Score. Se realizó un análisis descriptivo y bivariado estratificado por UCI a través de un modelo de regresión lineal múltiple robusta se estimaron los factores asociados a la carga de enfermería (p < 0,05). Resultados: 362 registros fueron incluidos. La mediana del NAS fue 68.1 puntos (Q1:47.2-Q3:116.7) El APACHE II (β = 3.13, IC 95%: 2.28; 3.98), días de estancia en UCI ≥ 3 (β = 16.78, IC 95%: 6.15; 27.41), servicio de procedencia cirugía (β = 22.31, IC 95%: 9.76; 34.86), categoría diagnostica traumatología y urgencias (β = 33.72, IC 95 %: 9.90; 57.53) se asociaron a mayor puntaje del NAS. Conclusión: El personal de enfermería emplea aproximadamente el 70% de un tiempo en un solo paciente y las labores administrativas ocupan la mayor parte de su tiempo. La estancia hospitalaria mayor de tres días, el mayor puntaje del APACHE II, proceder del servicio de cirugía, el tener un diagnóstico de traumatología y urgencias se asociaron a una alta carga laboral.

La humanización como parte de la atención integral al paciente: revisión narrativa / Humanização como parte do cuidado integral ao paciente: revisão narrativa / Humanization as a part of comprehensive patient health care: a narrative review

Objetivo: identificar los principales criterios, características, enfoques, normas y lineamientos que orientan el desarrollo de atenciones en salud humanizadas, las características y enfoques de la humanización de la atención, así como las políticas, planes e incluso de programas desarrollados actualmente en algunos países. Métodos: se realizó una búsqueda de artículos entre el 2012 y 2020 en los idiomas portugués, español e inglés, en las bases de datos Scielo, Pubmed, Medline, Lilacs, así como también en Epistemonikos, a través de palabras clave seleccionadas con base en los objetivos a investigar y que respondieran la siguiente pregunta de investigación: ¿cuáles son las percepciones sobre el trato no humanizado de los sujetos de atención a partir del análisis de las quejas del sistema distrital de peticiones, quejas y reclamos y los principales criterios, normas y pautas de la atención humanizada? Resultados: se encontraron 62 artículos que se organizaron en las siguientes categorías: trato irrespetuoso; mal servicio y no garantía de derechos; negligencia en la atención; comportamiento abusivo y falta de ética; mala comunicación e información; discriminación y no enfoque diferencial. Conclusiones: 1) la estructura para evidenciar la humanización en las instituciones de salud se basa tanto en el diseño como en la aplicación de políticas y programas de humanización en Colombia y diferentes lugares del mundo. Dentro de esta perspectiva de la humanización de los servicios de salud es una constante la necesidad de comprender el rol que juega el personal de la salud como actor determinante en la garantía del derecho a la salud y la calidad en la prestación de los servicios. 2) Existe una relación directa en lo que determinan los Estados a través de la normatividad para el cumplimiento de atenciones más humanas y unas realidades diferentes en lo que se vive durante el proceso de atención. De allí la importancia que toman las prácticas de estos Estados y organizaciones en salud en torno a la humanización que permita la replicabilidad de estas, y mejorar así las condiciones de salud de los ciudadanos y la prestación de los servicios. 3) La apuesta está en reconocernos más humanos. La revisión sistemática de la bibliografía hace énfasis en los criterios que se deben cumplir frente a los procesos de atención en salud; sin embargo, es necesario generar espacios de formación que no se centren exclusivamente en los conocimientos técnicos, sino que a través de estos le permitan al personal de la salud fortalecer las diferentes habilidades que demanda el proceso de atención en salud, de allí la importancia de comunicarse asertivamente, manejar adecuadamente los conflictos, empatizar frente a las situaciones que puedan estar presentando los usuarios y sus familias, y la respuesta efectiva a las necesidades y expectativas que presentan, permitiendo realizar una simbiosis entre el ser, el hacer y el deber ser en la atención en salud.

Objective: To identify the main criteria, characteristics, approaches, regulations and guidelines that guide the development of humanized health care, the characteristics and approaches of the humanization of health care, and the policies, plans and even programs currently developed in some countries. Methodology: A search was performed for articles between 2012 and 2020 in Portuguese, Spanish and English in the Scielo, Pubmed, Medline, Lilacs and Epistemonikos databases, using keywords selected based on the objectives to be researched. The articles had to be able to answer the following research question: What are the perceptions of health care subjects regarding non-humanized treatment, based on an analysis of complaints in the district petition, complaint and claims system and the main criteria, regulations and guidelines for humanized health care? Results: 62 articles were found, which were organized into the following categories - disrespectful treatment, bad service and a failure to ensure rights; negligence in health care, abusive behavior and a lack of ethics; bad communication and information; discrimination and a lack of a differential approach. Conclusions: 1) The structure for demonstrating humanization in health care institutions is based on both designing and applying humanization policies and programs in Colombia and different parts of the world. There is a constant need to understand the role health care staff play as determining actors in ensuring the right to health and quality in the provision of services, within this perspective of the humanization of health care services. 2) There is a direct relationship between what States determine through regulations in terms of providing more humane health care and the different realities patients experience during the health care process. Therefrom comes the importance of the practices of States and health care organizations when it comes to humanization that facilitates replicating those practices, improving the health conditions of citizens and the provision of services in this way. 3) The challenge is to recognize ourselves as more human. The systematic review of the bibliography emphasizes the criteria to be met in health care processes. However, it is necessary to create training spaces that do not exclusively focus on technical knowledge, but which, through that technical knowledge, help health care staff strengthen the different skills required for the health care process. This explains the importance of communicating assertively, adequately managing conflicts, empathizing with the situations of users and their families, and responding effectively to their needs and expectations, allowing for a symbiosis between being, doing and what should be in health care.

Objetivo: identificar os principais critérios, características, abordagens, normas e diretrizes que orientam o desenvolvimento de cuidados da saúde humanizados, as características e abordagens da humanização da atenção, bem como as políticas, planos e até programas desenvolvidos atualmente em alguns países. Metodologia: foi realizada uma busca de artigos entre 2012 e 2020 nos idiomas português, espanhol e inglês, nas bases de dados Scielo, Pubmed, Medline, Lilacs, bem como na Epistemonikos, por meio de palavras-chave selecionadas com base nos objetivos de investigação e respondendo à seguinte questão de pesquisa: quais as percepções sobre o tratamento não humanizado dos sujeitos do atendimento a partir da análise das denúncias do sistema distrital de petições, denúncias e reclamações e os principais critérios, normas e diretrizes do atendimento humanizado? Resultados: foram encontrados 62 artigos, organizados nas seguintes categorias: tratamento desrespeitoso; atendimento precário e sem garantia de direitos; negligência de cuidados; comportamento abusivo e falta de ética; má comunicação e informação; discriminação e nenhuma abordagem diferencial. Conclusões: 1) a estrutura para evidenciar a humanização nas instituições de saúde se baseia tanto na formulação quanto na aplicação de políticas e programas de humanização na Colômbia e em diferentes partes do mundo. Dentro dessa perspectiva de humanização dos serviços de saúde, há uma necessidade constante de compreender o papel desempenhado pelo pessoal de saúde como ator determinante na garantia do direito à saúde e a qualidade na prestação dos serviços. 2) Existe uma relação direta entre o que os Estados determinam por meio de regulamentações para o cumprimento de um cuidado mais humanizado e as diferentes realidades do que é vivenciado durante o processo de cuidar. Daí a importância das práticas destes Estados e das organizações de saúde em torno da humanização que permita a sua replicabilidade, e assim melhorar as condições de saúde dos cidadãos e a prestação de serviços. 3) A aposta consiste em nos reconhecermos mais humanos. A revisão sistemática da bibliografia enfatiza os critérios que devem ser atendidos diante dos processos de atenção à saúde; no entanto, é preciso criar espaços de formação que não se concentrem exclusivamente no conhecimento técnico, mas que por meio deles permitam que os profissionais de saúde fortaleçam as diferentes habilidades que o processo de cuidar em saúde exige, daí a importância de se comunicar de forma assertiva, lidar adequadamente com os conflitos, ter empatia com as situações que os usuários e seus familiares possam estar apresentando e a resposta efetiva às necessidades e expectativas que apresentam, permitindo uma simbiose entre o ser, o fazer e o que deveria ser no cuidado à saúde.

Father Committed to Early Parenting from the First Father-child Contact Experienced at Birth / Padre comprometido con la crianza temprana desde el primer contacto padre-hijo/a vivido en el nacimiento / Pai comprometido em criar seu filho/a desde o primeiro contato pai-filho/a vivenciado com o parto

ABSTRACT Objective: To know how the phenomenon of active paternal upbringing is shown from the father-child contact experience during birth. Method: Analysis of secondary information from a qualitative study of a phenomenological nature. Transcripts of interviews and focus groups of all the fathers who participated in a father-child contact protocol for a doctoral thesis. Results: The study revealed the global structure of the phenomenon, whose central axis corresponds to "father who advances towards the integral connection with his child and is committed with parenting", and its three comprehensive categories: expectations of being a father and actor in parenting; the experience of being a father at birth time; and the everyday of the upbringing. Conclusion: Prenatal preparation and skin-to-skin contact during birth mobilize the father towards commitment and involvement with the upbringing of his child from the beginning.

RESUMEN Objetivo: conocer cómo se muestra el fenómeno de la crianza paterna activa a partir de la experiencia de contacto padre-hijo/a, vivida durante el nacimiento. Método: análisis de información secundaria de un estudio cualitativo de naturaleza fenomenológica. Transcripciones de entrevistas y grupos focales de todos los padres que participaron de un protocolo de contacto padre-hijo/a para una tesis doctoral. Resultados: el estudio reveló la estructura global del fenómeno, cuyo eje central corresponde a "padre que transita hacia la conexión integral con su hijo/a y se compromete con la crianza", y sus tres categorías comprensivas: expectativas de ser padre y actor en la crianza; la vivencia de ser padre en el momento del nacimiento; el día a día de la crianza. Conclusión: la preparación antenatal y el contacto piel con piel durante el nacimiento movilizan al padre hacia el compromiso e involucramiento con la crianza de su hijo/a desde el comienzo.

RESUMO Objetivo: conhecer como o fenômeno da educação paterna ativa é demonstrado a partir da experiência de contato pai-filho/a vivida durante o nascimento. Método: análise de informações secundárias a partir de um estudo qualitativo de natureza fenomenológica. Transcrições de entrevistas e grupos focais de todos os pais que participaram de um protocolo de contato pai-filho para uma tese de doutorado. Resultados: o estudo revelou a estrutura global do fenômeno, cujo eixo central corresponde ao "pai que transita em direção à conexão integral com o filho / a e está comprometido em criar", e suas três categorias abrangentes: expectativas de ser pai e ator na criação; a experiência de ser pai ao nascer; o dia a dia no processo de criação. Conclusão: o preparo pré-natal e o contato pele a pele durante o parto mobilizam o pai para o comprometimento e o envolvimento com a criação do filho desde o início.