Ligand-free 99mTc-polyurea dendrimer complexes: nanoradiotheranostics targeting ovarian cancer.

A folic acid-targeted polyurea (PURE) dendrimer was easily radiolabelled with Technetium-99m (99mTc-PUREG4-FA2) avoiding the use of additional ligands and bioconjugation chemistry. This straightforward strategy is enabled in PURE dendrimers due to their favourable surface terminal groups configuration, showing coordination capabilities and turning these biodendrimers into attractive platforms for nanoradiotheranostics.

Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis.

PURPOSE: To evaluate the effectiveness of photobiomodulation in the treatment of oral mucositis. METHODS: Systematic review and meta-analysis encompassing in the electronic databases: LILACS, MEDLINE, EMBASE, COCHRANE, SCOPUS, WEB OF SCIENCE, and CINAHL and in http://clinicaltrials.gov . Eligibility criteria were randomized, non-randomized, and observational studies that used photobiomodulation for the treatment of oral mucositis. The endpoints were reduction in the severity of oral mucositis, duration of lesions, and pain reduction. For data analysis, the Review Manager 5.4 program was used. RESULTS: A total of 316 studies were identified, 297 in the electronic databases and 19 in http://clinicaltrials.gov . After removing duplicates, 260 studies were selected for title and abstract reading, of which 223 were excluded. A total of 37 studies were chosen for full reading, of which 6 were included in the review, totaling 299 patients. The treatment used was photobiomodulation. The patients were divided into two groups: the laser group used only photobiomodulation or associated with other therapies, and the control group did not use photobiomodulation. For the endpoint reduction in the severity of oral mucositis (OM), the chance of reduction of the OM was greater in the laser group as compared to the control group. For the endpoints duration of OM lesions and pain reduction, it was not possible to carry out a meta-analysis due to the high heterogeneity between studies. In the interpretation of the meta-analysis, the reduction in the severity of oral mucositis was greater in the group that received photobiomodulation. CONCLUSION: Photobiomodulation was effective in the treatment of oral mucositis.

Differences between leukemic arthritis and juvenile idiopathic arthritis.

OBJECTIVES: To determine the clinical and laboratory differences between leukemic arthritis (LA) and juvenile idiopathic arthritis (JIA) at the onset of the disease. MATERIAL AND METHODS: Patients under 16 years of age, both genders, who presented for the first time to the pediatric rheumatology service with a diagnosis of probable JIA, with arthritis and without peripheral blood blasts, in which the final diagnosis was acute lymphoblastic leukemia (ALL) or JIA. The clinical and laboratory characteristics of the patients were compared, chi-square and relative risk were used for categorical variables, and the Mann-Whitney U and T-test for the comparison of means between groups. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA. RESULTS: A total of 76 patients, 14 with LA and 62 with JIA, were analyzed. The mean age at diagnosis was lower in the leukemic arthritis group, the female gender prevailed in the JIA group, and the time to onset of symptoms was lower in the leukemic arthritis group. Patients with leukemic arthritis showed increased pain intensity, fever, weight loss, nocturnal diaphoresis, lymph node enlargement, hepatosplenomegaly, and pain that did not improve with analgesic administration. Laboratory parameters with statistical significance were the presence of anemia, leukopenia, and neutropenia. The platelet count was significant but in a low normal value, compared to the JIA. A binary logistic regression model was developed to differentiate leukemic arthritis from JIA. The probability associated with the statistic (Chi-square) was 0.000, and the Cox and Snell R2 and Nagelkerke R2 values were 0.615 and 1, respectively. The developed model correctly classified 100% of the cases. CONCLUSIONS: The diagnosis of acute lymphoblastic leukemia should be ruled out in patients who present with arthritis and hematological alterations, mainly leukopenia and neutropenia, with joint pain disproportionate to the degree of arthritis, predominantly at night and that does not improve with the use of analgesics, fever, lymph nodes, and hepatosplenomegaly. Criteria are suggested to differentiate both diseases.

A Glimpse into Dendrimers Integration in Cancer Imaging and Theranostics.

Cancer is a result of abnormal cell proliferation. This pathology is a serious health problem since it is a leading cause of death worldwide. Current anti-cancer therapies rely on surgery, radiation, and chemotherapy. However, these treatments still present major associated problems, namely the absence of specificity. Thus, it is urgent to develop novel therapeutic strategies. Nanoparticles, particularly dendrimers, have been paving their way to the front line of cancer treatment, mostly for drug and gene delivery, diagnosis, and disease monitoring. This is mainly derived from their high versatility, which results from their ability to undergo distinct surface functionalization, leading to improved performance. In recent years, the anticancer and antimetastatic capacities of dendrimers have been discovered, opening new frontiers to dendrimer-based chemotherapeutics. In the present review, we summarize the intrinsic anticancer activity of different dendrimers as well as their use as nanocarriers in cancer diagnostics and treatment.

Producción científica sobre Ortodoncia publicada en revistas biomédicas pertenecientes a universidades médicas cubanas / Scientific production on Orthodontics published in biomedical journals belonging to Cuban medical universities

La necesidad de impulsar la investigación en Ortodoncia y realizar un análisis de los artículos publicados en la web cubana, con la finalidad de conocer sus características bibliométricas, es cada vez mayor. El presente estudio tuvo como objetivo caracterizar la producción científica sobre Ortodoncia, publicada en revistas biomédicas profesionales patrocinadas por las universidades médicas cubanas entre enero del 2015 y agosto del 2021. Se realizó un estudio bibliométrico, observacional, descriptivo, longitudinal de la productividad científica acerca de Ortodoncia publicada en dichas revistas. Se empleó el gestor de referencias Zotero para procesar los metadatos y VOSviewer para analizar las redes de coautoría. Se constataron 158 artículos; el 15,19 por ciento se publicó en Medisan y el año más productivo fue el 2015. Predominaron los artículos originales (67,72 por ciento), con autoría múltiple (cinco autores), el sexo femenino (76,41 por ciento), los autores de nacionalidad cubana (98,38 por ciento) y procedentes de Santiago de Cuba/Cuba (15,19 por ciento). Se emplearon 2665 referencias con un índice de Price de 0,53. El área temática más abordada fue la Ortodoncia interceptiva (33,54 por ciento). Los artículos recibieron un total de 1041 citas en el Google Académico. El análisis de la red de coautoría permitió establecer 13 clústeres, donde fueron visualizados 106 autores, con 282 links y una fuerza de atracción total entre ellos de 97. Se concluye que la producción científica sobre Ortodoncia, por lo general, es baja. Es necesario lograr la indexación de estas revistas en las grandes bases de datos para así aumentar la visibilidad e impacto de los artículos(AU)

The need to promote research in orthodontics and to carry out an analysis of the articles published in the Cuban web, with the purpose of knowing their bibliometric characteristics, is increasing. The present study aimed at characterizing the scientific production on orthodontics, published in professional biomedical journals sponsored by Cuban medical universities between January 2015 and August 2021. A bibliometric, observational, descriptive, longitudinal, descriptive study of the scientific productivity about Orthodontics published in these journals was carried out. The reference manager Zotero was used to process the metadata and VOSviewer to analyze the co-authorship networks. A total of 158 articles were ascertained; 15.19percent ere published in Medisan and the most productive year was 2015. Original articles predominated (67.72percent), with multiple authorship (five authors), female gender (76.41percent), authors of Cuban nationality (98.38percent) and from Santiago de Cuba/Cuba (15.19percent). A total of 2665 references were used with a Price index of 0.53. Interceptive orthodontics (33.54percent) was the most common subject area. The articles received a total of 1041 citations in Google Scholar. The analysis of the co-authorship network made it possible to establish 13 clusters, where 106 authors were visualized, with 282 links and a total strength of attraction among them of 97. It is necessary to achieve the indexing of these journals in large databases in order to increase the visibility and impact of the articles(AU)

Experiencias adquiridas de las enseñanzas de procesos sustantivos en el enfrentamiento a la COVID-19 desde una perspectiva enfermera / Lessons Learned from Substantive Process Teachings in Coping with COVID-19 from a Nursing Perspective

Introducción: El personal de enfermería cumple un papel fundamental en tiempos de pandemia, porque aporta conocimientos, habilidades y experiencias de vida unido al equipo de salud. Objetivo: Comprender las experiencias adquiridas de las enseñanzas de los procesos sustantivos en el enfrentamiento a la COVID-19 en la práctica pediátrica, desde una perspectiva enfermera. Métodos: Estudio cualitativo fenomenológico transcendental, realizado en Hospital Pediátrico "Octavio de la Concepción", Holguín, Cuba, en el período febrero-abril de 2021. Se integraron experiencias de ocho enfermeras, siete médicos, cinco estudiantes de medicina y cinco de enfermería, seleccionados por muestreo no probabilístico. Se obtuvo la información a través de entrevistas semiestructuradas. Se recurrió a tres etapas, descriptiva (elección de técnica, entrevista, elaboración de la descripción), estructural (lectura, determinación del tema central, expresión en lenguaje científico) y discusión (comparación de hallazgos con los de otros investigadores) para entender diferencias y similitudes. Resultados: Del análisis de los datos emergieron tres categorías: a) Experiencias adquiridas en las enseñanzas durante la COVID-19 en los procesos sociales. b) Experiencias adquiridas en las enseñanzas durante la COVID-19 para los profesionales de la salud. c) Experiencias adquiridas en las enseñanzas durante la COVID-19 para el personal en formación. Conclusiones: Se evidenció la implementación de acciones sanitarias y de apoyo social en la accesibilidad a los sistemas de salud. La oportunidad de compartir experiencias con expertos que facilitaron el diseño de protocolos, generación continua de evidencia científica y la formación de estudiantes con métodos alternativos(AU)

Introduction: Nurses play a critical role in times of pandemic because they bring knowledge, skills, and life experiences together with the healthcare team. Objective: To understand the experiences gained from the lessons learned from the substantive processes in dealing with COVID-19 in pediatric practice, from a nursing perspective. Methods: Transcendental phenomenological qualitative study, carried out at the Pediatric Hospital "Octavio de la Concepción", Holguín, Cuba, in the period from February to April 2021. The experiences of eight nurses, seven physicians, five medical students and five nursing students, selected by non-probabilistic sampling, were integrated. Information was obtained through semi-structured interviews. Three stages were used: descriptive (choice of technique, interview, and formulation of the description), structural (reading, determination of the central theme, expression in scientific language) and discussion (comparison of findings with those of other researchers) to understand differences and similarities. Results: Three categories emerged from the data analysis: a) Experiences acquired in the teachings in the COVID-19 in social processes. b) Experiences acquired in the teachings in the COVID-19 for health professionals. c) Experiences acquired in the teachings in the COVID-19 for personnel in training. Conclusions: The implementation of health and social support actions in accessibility to health systems was evidenced. The opportunity to share experiences with experts facilitated the design of protocols, continuous generation of scientific evidence and the training of students with alternative methods(AU)

Representación social sobre gestión de servicios hospitalarios pediátricos para atender sospechosos de COVID-19 desde una perspectiva enfermera / Social Representation about Pediatric Hospital Services for Providing Care to Patients Suspected of COVID-19 from a Nursing Perspective

Introducción: Resulta indispensable la organización de los servicios pediátricos en el actual proceso de enfrentamiento a la pandemia COVID-19. Objetivo: Describir, desde una perspectiva enfermera, la representación social sobre gestión en la organización de los servicios hospitalarios pediátricos para la atención de pacientes sospechosos de COVID-19. Métodos: Estudio cualitativo de orientación metodológica fenomenológica transcendental, realizado en Hospital Pediátrico "Octavio de la Concepción de la Pedraja", Holguín, Cuba, entre enero y abril del 2021. Se integraron los conocimientos adquiridos de la experiencia de enfermeras, cinco supervisoras, tres jefas de áreas y ocho jefas de salas, seleccionadas por muestreo no probabilístico. Se recurrió a las etapas: descriptiva, estructural y discusión. La descriptiva constó de tres etapas: elección de técnica, entrevista semiestructurada y elaboración de la descripción. La etapa estructural: lectura, determinación del tema central, expresión en lenguaje científico y etapa de discusión de los resultados, se relacionaron con las conclusiones y hallazgos de investigadores para entender las posibles diferencias o similitudes para mayor enriquecimiento. Resultados: Del análisis de los datos emergieron cuatro categorías: Categoría I: diseño de los protocolos de atención de enfermería para pacientes sospechosos y positivos a COVID-19. Categoría II: reorganización, reclutamiento y capacitación de personal. Categoría III: organizar grupos de trabajo según cuadro clínico y resultado del test rápido y el PCR. Categoría IV: medidas generales. Conclusiones: La organización de los servicios de atención de enfermería por grupos evitó el colapso del recurso humano enfermero y garantizó la disponibilidad de camas, la seguridad propia y del paciente para minimizar la transmisibilidad intrahospitalaria(AU)

Introduction: The organization of pediatric services is essential in the current process of confronting the COVID-19 pandemic. Objective: To describe, from a nursing perspective, the social representation on management in the organization of pediatric hospital services for the care of patients suspected of COVID-19. Methods: A qualitative study of transcendental phenomenological methodological orientation was carried out at Octavio de la Concepción de la Pedraja Pediatric Hospital from Holguín, Cuba, between January and April 2021. The knowledge acquired from the experience of nurses, five supervisors, three area heads and eight ward chiefs, selected by nonprobabilistic sampling, was integrated. The following phases were used: descriptive, structural and discussion. The descriptive phase consisted of three stages: choice of technique, semistructured interview and elaboration of the description. The structural phase had the following stages: reading, determination of the central topic and expression in scientific language. In the results discussion phase, the results were related to the conclusions and findings of researchers to understand the possible differences or similarities for further enhancement. Results: Four categories emerged from the data analysis: design of nursing care protocols for COVID-19 positive and suspect patients; reorganization, recruitment and training of personnel; organization of working groups according to clinical picture and rapid test or PCR results; and general measures. Conclusions: The organization of nursing care services by groups avoided the collapse of the nursing human resource and guaranteed the availability of beds, as well as staff own safety and patient safety, to minimize in-hospital transmissibility(AU)

Differential Expression of Proteins in an Atypical Presentation of Autoimmune Lymphoproliferative Syndrome.

Autoimmune lymphoproliferative syndrome (ALPS) is a rare disease defined as a defect in the lymphocyte apoptotic pathway. Currently, the diagnosis of ALPS is based on clinical aspects, defective lymphocyte apoptosis and mutations in Fas, FasL and Casp 10 genes. Despite this, ALPS has been misdiagnosed. The aim of this work was to go one step further in the knowledge of the disease, through a molecular and proteomic analysis of peripheral blood mononuclear cells (PBMCs) from two children, a 13-year-old girl and a 6-year-old boy, called patient 1 and patient 2, respectively, with clinical data supporting the diagnosis of ALPS. Fas, FasL and Casp10 genes from both patients were sequenced, and a sample of the total proteins from patient 1 was analyzed by label-free proteomics. Pathway analysis of deregulated proteins from PBMCs was performed on the STRING and PANTHER bioinformatics databases. A mutation resulting in an in-frame premature stop codon and protein truncation was detected in the Fas gene from patient 2. From patient 1, the proteomic analysis showed differences in the level of expression of proteins involved in, among other processes, cell cycle, regulation of cell cycle arrest and immune response. Noticeably, the most down-regulated protein is an important regulator of the cell cycle process. This could be an explanation of the disease in patient 1.

Lipid Droplets in Cancer: From Composition and Role to Imaging and Therapeutics.

Cancer is the second most common cause of death worldwide, having its origin in the abnormal growth of cells. Available chemotherapeutics still present major drawbacks, usually associated with high toxicity and poor distribution, with only a small fraction of drugs reaching the tumour sites. Thus, it is urgent to develop novel therapeutic strategies. Cancer cells can reprogram their lipid metabolism to sustain uncontrolled proliferation, and, therefore, accumulate a higher amount of lipid droplets (LDs). LDs are cytoplasmic organelles that store neutral lipids and are hypothesized to sequester anti-cancer drugs, leading to reduced efficacy. Thus, the increased biogenesis of LDs in neoplastic conditions makes them suitable targets for anticancer therapy and for the development of new dyes for cancer cells imaging. In recent years, cancer nanotherapeutics offered some exciting possibilities, including improvement tumour detection and eradication. In this review we summarize LDs biogenesis, structure and composition, and highlight their role in cancer theranostics.

Recidivism at the puerto rico trauma hospital.

PURPOSE: Although trauma represents a leading cause of morbidity and mortality worldwide, there is limited and heterogeneous evidence regarding trauma recidivism and its outcomes. This analysis determined the rate and independent risk factors of trauma recidivism and compared the first and second injury episode among recidivists. METHODS: An IRB-approved retrospective cohort study was performed with data from the Puerto Rico Trauma Hospital Registry. Bivariate analyses were done using Pearson's Chi squared, Wilcoxon rank-sum, McNemar, Stuart-Maxwell or Wilcoxon signed-rank tests, as appropriate. Independent predictors for recidivism were determined through a logistic regression model. Statistical significance was set at p < 0.05. RESULTS: 24,650 patients were admitted to the hospital during 2000-2017. Recidivism rate was 14 per 1,000 patients discharged alive. Males and individuals aged 15-24 years old were 3.88 (95% CI: 2.21-6.80) and 3.80 (95% CI: 2.24-6.46) times more likely to be recidivists, respectively. Contrariwise, an ISS [Formula: see text] 25 [adjusted odds ratio (AOR) = 0.44; 95% CI: 0.28-0.68] and a GCS [Formula: see text] 8 (AOR = 0.56; 95% CI 0.34-0.92) were protective factors. Furthermore, recidivists exhibited less in-hospital mortality than their non-recidivist counterparts (7.2% vs. 10.7%; p = 0.045). For recidivists, the median (interquartile range) time to reinjury was 42 (59) months; and the second injury episode was more severe than the first one, as the proportion of patients with ISS [Formula: see text] 25 increased (7.9% vs. 14.1%; p = 0.022). CONCLUSION: The independent predictors of trauma recidivism and the median time to reinjury identified in this study provide valuable information to the development of prevention strategies aimed at reducing the burden of injury.

Pulmonary involvement in patients with juvenile systemic sclerosis / Afección pulmonar en pacientes con esclerosis sistémica juvenil

Abstract Background: Pulmonary involvement in juvenile systemic sclerosis (JSSc) is rare in children and contributes to morbimortality. This study aimed to describe the pulmonary function and clinical, radiologic, and tomographic findings in JSSc. Methods: Patients with JSSc between 5-14 years of age were included. Clinical, functional, and imaging characteristics were assessed. Patients were excluded if they showed lung disease not associated with JSSc: mixed connective tissue disease, overlap syndrome, or acute cardiopulmonary failure at the time of the study. All patients underwent physical examination, electrocardiogram, spirometry, chest X-ray, high-resolution computed tomography (HRCT) of the chest, echocardiography, lung function tests, and the 6-minute walk test (6-MWT). Descriptive statistics were employed for data analysis. Results: We studied 15 patients with the following characteristics: median age, 11 years; median since symptoms onset, 6 years; median since JSSc diagnosis and the finding of pulmonary involvement, 2 years. Lung disease was detected in 73%, interstitial lung disease (ILD) the most common affection (67%); pulmonary hypertension was found in 6.6%. 6-MWT was positive in 26.6%, forced vital capacity (FVC) was abnormal in 26.6%. No pulmonary involvement was found in four patients. Conclusions: The most frequent pulmonary affection in JSSc was ILD. Thus, early JSSc detection and periodic lung monitoring are mandatory to avoid further complications once JSSc is diagnosed.

Resumen Introducción: La afección pulmonar en la esclerosis sistémica juvenil (ESJ) es rara en niños y contribuye a la morbimortalidad. El objetivo de este estudio fue describir los hallazgos de función pulmonar, clínicos, radiológicos y tomográficos en la ESJ. Métodos: Se incluyeron pacientes con ESJ de 5-14 años de edad. Se evaluaron las características clínicas, funcionales y de imagen. No se incluyeron pacientes con enfermedades pulmonares no asociadas con ESJ en el momento del estudio: enfermedad mixta del tejido conectivo, síndrome de superposición o insuficiencia cardiopulmonar aguda. Se realizaron exploración física, electrocardiograma, espirometría, radiografía de tórax, tomografía computarizada de alta resolución de tórax, ecocardiografía, pruebas de función pulmonar y prueba de caminata de 6 minutos (PC6M). Se utilizó estadística descriptiva para el análisis de los datos. Resultados: Se estudiaron 15 pacientes con las siguientes características: mediana de edad, 11 años; mediana desde el inicio de los síntomas, 6 años; y mediana desde el diagnóstico de ESJ y hallazgo de afección pulmonar, 2 años. Se detectó enfermedad pulmonar en el 73%. La enfermedad pulmonar intersticial (EPI) fue la afección más común (67%) y se encontró hipertensión pulmonar en el 6.6%. La PC6M fue positiva en el 26.6%, y la capacidad vital forzada resultó anormal en el 26.6%. Cuatro pacientes no presentaron afección pulmonar. Conclusiones: La afección pulmonar más frecuente en la ESJ fue la EPI. La detección temprana de ESJ y la monitorización pulmonar periódica son obligatorias para evitar más complicaciones una vez diagnosticada la ESJ.

Barriers and Facilitators Affecting the HIV Care Cascade for Migrant People Living with HIV in Organization for Economic Co-Operation and Development Countries: A Systematic Mixed Studies Review.

Migrants in countries affiliated with the Organization for Economic Co-operation and Development (OECD) have a higher risk of acquiring HIV, experience delayed HIV diagnosis, and have variable levels of engagement with HIV care and treatment when compared to native-born populations. A systematic mixed studies review was conducted to generate a multilevel understanding of the barriers and facilitators affecting HIV Care Cascade steps for migrant people living with HIV (MLWH) in OECD countries. Medline, Embase, Scopus, CINAHL, and the Cochrane Library were searched on March 25, 2020. Screening, critical appraisal, and analysis were conducted independently by two authors. We used qualitative content analysis and the five-level Socio-Ecological Model (i.e., individual, interpersonal, organizational, community, and policy) to categorize barriers and facilitators. Fifty-nine studies from 17 OECD countries were included. MLWH faced similar barriers and facilitators regardless of their host country, ethnic and geographic origins, or legal status. Most barriers and facilitators were associated with the individual and organizational levels and centered around retention in HIV care and treatment. Adapting clinical environments to better address MLWH's competing needs via multidisciplinary models would address retention issues across OECD countries.

miR-138-5p induces aggressive traits by targeting Trp53 expression in murine melanoma cells, and correlates with poor prognosis of melanoma patients.

Deregulation of miRNAs contributes to the development of distinct cancer types, including melanoma, an aggressive form of skin cancer characterized by high metastatic potential and poor prognosis. The expression of a set of 580 miRNAs was investigated in a model of murine melanoma progression, comprising non-metastatic (4C11-) and metastatic melanoma (4C11+) cells. A significant increase in miR-138-5p expression was found in the metastatic 4C11+ melanoma cells compared to 4C11-, which prompted us to investigate its role in melanoma aggressiveness. Functional assays, including anoikis resistance, colony formation, collective migration, serum-deprived growth capacity, as well as in vivo tumor growth and experimental metastasis were performed in 4C11- cells stably overexpressing miR-138-5p. miR-138-5p induced an aggressive phenotype in mouse melanoma cell lines leading to increased proliferation, migration and cell viability under stress conditions. Moreover, by overexpressing miR-138-5p, low-growing and non-metastatic 4C11- cells became highly proliferative and metastatic in vivo, similar to the metastatic 4C11+ cells. Luciferase reporter analysis identified the tumor suppressor Trp53 as a direct target of miR-138-5p. Using data sets from independent melanoma cohorts, miR-138-5p and P53 expression were also found deregulated in human melanoma samples, with their levels negatively and positively correlated with prognosis, respectively. Our data shows that the overexpression of miR-138-5p contributes to melanoma metastasis through the direct suppression of Trp53.

Barriers and facilitators associated with steps of the HIV care cascade for migrants in OECD countries: a systematic mixed studies review protocol.

INTRODUCTION: In 2019, the United Nations signalled a substantial rise in the number of international migrants, up to 272 million globally, about half of which move to only 10 countries, including 8 member nations of the Organization for Economic Co-operation and Development (OECD). Migrants in OECD countries are often at higher risk for acquiring HIV and have a higher frequency of delayed HIV diagnosis. The barriers and facilitators that migrant people living with HIV (PLWH) in OECD countries face in relation to HIV care are insufficiently understood. The five-step HIV Care Cascade Continuum (HCCC) is an effective model to identify gaps, barriers and facilitators associated with HIV care. The purpose of this study is to generate a comprehensive, multilevel understanding of barriers and facilitators regarding the five steps of the HCCC model in OECD countries by migration status. METHODS AND ANALYSIS: A systematic mixed studies review using a data-based convergent design will be conducted. Medline, Embase, Scopus, CINAHL and the Cochrane Library will be searched on 25 March 2020. Screening and critical appraisal will be conducted independently by the first author. Authors 3-5 will act as second reviewers, each independently conducting 33% of the screening and appraisal. Quantitative data will be transformed to qualitative data and be synthesised using thematic analysis. The Mixed Methods Appraisal Tool will be used for quality assessment. An advisory committee, composed of four migrant PLWH, will be involved in screening and appraising 5% of articles to build knowledge and experience with systematic reviews. They will also be involved in analysis and dissemination. ETHICS AND DISSEMINATION: Ethics approval was obtained from the McGill University Health Centre (15-188-MUHC, 2016-1697, eReviews 4688). Publications arising from this study will be open-access. PROSPERO REGISTRATION NUMBER: CRD42020172122.

Conocimiento sobre trastornos del neurodesarrollo asociado con la aceptación del modelo de educación inclusiva en docentes de educación básica / Knowledge about neurodevelopmental disorders associated with the acceptance of the inclusive education model, in basic education teachers

Resumen Objetivo: Describir la prevalencia del conocimiento sobre trastornos del neurodesarrollo (TdN) y el nivel de aceptación de los modelos de educación inclusiva (MEI) en docentes. Material y métodos: Estudio transversal multicéntrico en México y Centroamérica. Aplicación de un instrumento de autorreporte a docentes de nivel básico sobre conocimiento en TdN y aceptación de los MEI. Resultados: Se obtuvo la respuesta de 511 docentes. La prevalencia de alta aceptación de MEI fue de 28.6%. De los 120 docentes que refirieron tener un amplio conocimiento sobre discapacidad intelectual, 3.8% estuvieron en el percentil más bajo de aceptación de MEI, 19.5% en el percentil de aceptación promedio y 55.5% de ellos se encontraron en el percentil de mayor aceptación (p<0.001). Entre los docentes, un mayor conocimiento sobre los TdN se mostró asociado con la aceptación de MEI: trastornos del aprendizaje RM 3.76 (IC95% 2.13-6.62); trastornos por déficit de atención con hiperactividad RM 2.24 (IC95% 1.31-3.84) y discapacidad intelectual RM 3.84 (IC95% 2.46-5.99). Conclusión: La aceptación docente de MEI puede favorecerse con una mayor y mejor capacitación de los profesionales de la educación sobre los diferentes TdN.

Abstract Objective: To describe the prevalence of knowledge about neurodevelopment disorders (NDDs) and the level of acceptance of models of inclusive education (IEM) in teachers. Materials and methods: A multicenter crosssectional study in Mexico and Central America. A self-report instrument to teachers of basic level on knowledge in NDDs and acceptance of the IEM. Results: The response of 511 teachers was obtained. The prevalence of high acceptance of the IEM was 28.6%. Of the 120 teachers who reported having extensive knowledge about intellectual disability, 3.8% were in the lowest percentile of acceptance of the IEM, 19.5% in the average percentile of acceptance and 55.5% of them were in the highest percentile acceptance (p<0.001). Among teachers, a greater knowledge about NDDs was associated with the acceptance of IEM: learning disorders RM 3.76 (95%CI 2.13-6.62); attention deficit disorders with hyperactivity RM 2.24 (95%CI 1.31-3.84) and intellectual disability RM 3.84 (95%CI 2.46-5.99). Conclusion: The teaching acceptance of IEM can be favored with greater and better training of education professionals on the different NDDs.

Polyurea Dendrimer Folate-Targeted Nanodelivery of l-Buthionine sulfoximine as a Tool to Tackle Ovarian Cancer Chemoresistance.

: Ovarian cancer is a highly lethal disease, mainly due to chemoresistance. Our previous studies on metabolic remodeling in ovarian cancer have supported that the reliance on glutathione (GSH) bioavailability is a main adaptive metabolic mechanism, also accounting for chemoresistance to conventional therapy based on platinum salts. In this study, we tested the effects of the in vitro inhibition of GSH synthesis on the restoration of ovarian cancer cells sensitivity to carboplatin. GSH synthesis was inhibited by exposing cells to l-buthionine sulfoximine (l-BSO), an inhibitor of -glutamylcysteine ligase (GCL). Given the systemic toxicity of l-BSO, we developed a new formulation using polyurea (PURE) dendrimers nanoparticles (l-BSO@PUREG4-FA2), targeting l-BSO delivery in a folate functionalized nanoparticle.

CD3+ Macrophages Deliver Proinflammatory Cytokines by a CD3- and Transmembrane TNF-Dependent Pathway and Are Increased at the BCG-Infection Site.

Macrophages are essential cells of the innate immune response against microbial infections, and they have the ability to adapt under both pro- and anti-inflammatory conditions and develop different functions. A growing body of evidence regarding a novel macrophage subpopulation that expresses CD3 has recently emerged. Here, we explain that human circulating monocytes can be differentiated into CD3+TCRαß+ and CD3+TCRαß- macrophages. Both cell subpopulations express on their cell surface HLA family molecules, but only the CD3+TCRαß+ macrophage subpopulation co-express CD1 family molecules and transmembrane TNF (tmTNF). CD3+TCRαß+ macrophages secrete IL-1ß, IL-6 IP-10, and MCP-1 by both tmTNF- and CD3-dependent pathways, while CD3+TCRαß- macrophages specifically produce IFN-γ, TNF, and MIP-1ß by a CD3-dependent pathway. In this study, we also used a mouse model of BCG-induced pleurisy and demonstrated that CD3+ myeloid cells (TCRαß+ and TCRαß- cells) are increased at the infection sites during the acute phase (2 weeks post-infection). Interestingly, cell increment was mediated by tmTNF, and the soluble form of TNF was dispensable. BCG-infection also induced the expression of TNF receptor 2 on CD3+ myeloid cells, which increased after BCG-infection, suggesting that the tmTNF/TNFRs axis plays an important role in the presence or function of these cells in tuberculosis.

Tjalma syndrome (pseudo-pseudo Meigs') as initial manifestation of juvenile-onset systemic lupus erythematosus. / Síndrome de Tjalma (pseudo-pseudo Meigs) como manifestación inicial de lupus eritematoso sistémico de inicio juvenil.

Tjalma syndrome or pseudo-pseudo Meigs' syndrome is a clinical condition characterized by pleural effusion, ascites and elevated CA-125 with no associated benign or malignant ovarian tumor in a patient with systemic lupus erythematosus (SLE). Tjalma described the first case of a patient with SLE, pleural effusion, ascites and elevated CA-125. We report the first case in a 14-year old patient who presented with ascites and pleural effusion refractory to treatment and elevated CA-125, in the absence of an ovarian tumor, that warranted aggressive management.

Enterobacterias productoras de b-lactamasas de espectro-extendido y plásmido-ampc en aguas de riego, zona maica, cochabamba / Extended-spectrum b-lactamase and plasmid ampc b-lactamase-producing enterobacteriaceae in water sources for irrigation in maica's zone, cochabamba

Introducción: Las enterobacterias han ido adquiriendo mecanismos de resistencia a los antimicrobianos, como la producción de Beta Lactamasas de Espectro Extendido (BLEE) que otorga resistencia a varios beta-lactámicos. Estas bacterias, capaces de causar infecciones intrahospitalarias y comunitarias difíciles de tratar, se están diseminando y habitan reservorios ambientales, como aguas;y es considerado un problema de salud pública. Situación desconocida en nuestro medio. Objetivo: Identificar Enterobacterias productoras de BLEE y AmpC en agua de los ríos Tamborada y Rocha, utilizados para el riego de cultivos en la zona Maica de Cochabamba. Métodos: Estudio descriptivo, transversal y cuantitativo. Se analizaron 70 muestras de agua: 44 del rio Tamborada y 26 del Rocha. Las muestras se cultivaron en Agar MacConkey con Cefotaxima (2 μm/ml). Las bacterias que crecieron se identificaron con agar cromogénico y pruebas bioquímicas. Las cepas productoras de BLEE y tipo AmpC se determinaron por difusión y aproximación de discos: Cefotaxima, ceftazidima, Amoxicilina/Acido clavulánico para BLEE y Cefoxitin para AmpC. Resultados: Se aislaron 23 cepas de Escherichia coli (E. coli) productoras de BLEE (32,8%) de las 70 muestras y 22 muestras (resistentes a cefoxitin) que podrían tener además resistencia tipo AmpC. Conclusión: E. coli productoras de BLEE y probablemente AmpC están circulando en ambientes de nuestro medio como ser agua de Ríos Tamborada y Rocha, esto representa un problema de salud pública, más si consideramos que estas aguas son utilizadas en riego de verduras que abastecen los mercados de Cochabamba y pueden diseminar estas bacterias entre la población.

Introduction: Enterobacteria have been acquiring antimicrobial resistance mechanisms, such as the production of extended spectrum beta lactamases (ESBL) thatgives resistance to several beta-lactams.These bacteria, capable of causing intrahospital and community infections difficult to treat, are spreading and inhabit environmental reservoirs, such as water; and is considered a public health problem. Unknown situation in our environment. Objective: Identify Enterobacteria producing BLEE and AmpC in water from the Tamborada and Rocha rivers, used for irrigation of crops in the Maica area of Cochabamba. Methods: Descriptive, cross-sectional and quantitative study. 70 water samples were analyzed: 44 from the Tamborada river and 26 from Rocha.The samples were grown in MacConkey Agar with Cefotaxime (2 μm/ml). Bacteria that grew were identified with chromogenic agar and biochemical tests.The ESBL and AmpC type producing strains were determined by diffusion and approximation of discs: Cefotaxime, Ceftazidime, Amoxicillin/Clavulanic acid for ESBL; and Cefoxitin for AmpC. Results: 23 strains of ESBL-producing Escherichia coli (32.8%) were isolated from the 70 samples. 22 of these isolates (resistant to cefoxitin) could also have AmpC resistance. Conclusion: E. coli producers of ESBL and probably AmpC are circulating in our environment such as waters of Rocha and Tamborada rivers, which represent a public health problem, more if we consider that these waters are used in irrigation of vegetables that they supply Cochabamba markets and can spread these bacteria among the population.

Diagnóstico de sífilis: al derecho y al revés / diagnosis of syphilis: rigth and wrong

La sífilis es una infección crónica de transmisión sexual, causada por la espiroqueta Treponema pallidum. A pesar de existir un tratamiento eficaz, continúa siendo un importante problema de salud pública. La Organización Mundial de la Salud (OMS) ha estimado que más de 6 millones de personas se infectan cada año en el mun-do (1), y los Centros para el Con-trol y la Prevención de Enferme-dades (CDC) de Estados Unidos reportaron con preocupación, en el 2017, una incidencia de sífilis primaria y secundaria de 9,5 casos por cada 100 000 habitantes, lo que equivale a un incremento del 72,7 % en comparación con el 2013 (2). En Colombia, se estima una preva-lencia de sífilis venérea sustan-cialmente mayor, del 1,25 % (3)

Syphilis is a chronic sexually transmitted infection, caused by the spirochete Treponema pallidum. Despite effective treatment, it remains a major public health problem. The World Health Organization (WHO) has estimated that more than 6 million people infected each year in the world (1), and the Centers for Disease Control and Prevention (CDC) in the United States reported with concern, in 2017, an incidence of primary and secondary syphilis of 9.5 cases per 100,000 inhabitants, equivalent to an increase of 72.7% compared to 2013 (2). In Colombia, a prevalence of substantially greater venereal syphilis is estimated at 1.25% (3