PTEN hamartoma tumor syndrome: Clinical and genetic characterization in pediatric patients.

OBJECTIVE: The aim of this study was to provide a full characterization of a cohort of 11 pediatric patients diagnosed with PTEN hamartoma tumor syndrome (PHTS). PATIENTS AND METHODS: Eleven patients with genetic diagnostic of PHTS were recruited between February 2019 and April 2023. Clinical, imaging, demographic, and genetic data were retrospectively collected from their hospital medical history. RESULTS: Regarding clinical manifestations, macrocephaly was the leading sign, present in all patients. Frontal bossing was the most frequent dysmorphism. Neurological issues were present in most patients. Dental malformations were described for the first time, being present in 27% of the patients. Brain MRI showed anomalies in 57% of the patients. No tumoral lesions were present at the time of the study. Regarding genetics, 72% of the alterations were in the tensin-type C2 domain of PTEN protein. We identified four PTEN genetic alterations for the first time. CONCLUSIONS: PTEN mutations appear with a wide variety of clinical signs and symptoms, sometimes associated with phenotypes which do not fit classical clinical diagnostic criteria for PHTS. We recommend carrying out a genetic study to establish an early diagnosis in children with significant macrocephaly. This facilitates personalized monitoring and enables anticipation of potential PHTS-related complications.

LGBTQ Utilization of a Statewide Tobacco Quitline: Engagement and Quitting Behavior, 2010-2022.

INTRODUCTION: Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals use tobacco at disproportionately high rates but are as likely as straight tobacco users to want to quit and to use quitlines. Little is known about the demographics and geographic distribution of LGBTQ quitline participants, their engagement with services, or their long-term outcomes. AIMS AND METHODS: Californians (N = 333 429) who enrolled in a statewide quitline 2010-2022 were asked about their sexual and gender minority (SGM) status and other baseline characteristics. All were offered telephone counseling. A subset (n = 19 431) was followed up at seven months. Data were analyzed in 2023 by SGM status (LGBTQ vs. straight) and county type (rural vs. urban). RESULTS: Overall, 7.0% of participants were LGBTQ, including 7.4% and 5.4% of urban and rural participants, respectively. LGBTQ participants were younger than straight participants but had similar cigarette consumption. Fewer LGBTQ participants reported a physical health condition (42.1% vs. 48.4%) but more reported a behavioral health condition (71.1% vs. 54.5%; both p's < .001). Among both LGBTQ and straight participants, nearly 9 in 10 chose counseling and both groups completed nearly three sessions on average. The groups had equivalent 30-day abstinence rates (24.5% vs. 23.2%; p = .263). Similar patterns were seen in urban and rural subgroups. CONCLUSIONS: LGBTQ tobacco users engaged with and appeared to benefit from a statewide quitline even though it was not LGBTQ community-based. A quitline with staff trained in LGBTQ cultural competence can help address the high prevalence of tobacco use in the LGBTQ community and reach members wherever they live. IMPLICATIONS: This study describes how participants of a statewide tobacco quitline broke down by sexual orientation and gender. It compares participants both by SGM status and by type of county to provide a more complete picture of quitline participation both in urban areas where LGBTQ community-based cessation programs may exist and in rural areas where they generally do not. To our knowledge, it is the first study to compare LGBTQ and straight participants on their use of quitline services and quitting aids, satisfaction with services received, and rates of attempting quitting and achieving prolonged abstinence from smoking.

Influencia correctiva de la actividad física en la inclusión de los educandos con trastornos de la conducta

La Educación Física, el deporte y la recreación constituyen herramientas efectivas en la educación para corregir o compensar los modos de actuación de los educandos con trastornos en la conducta, manifestaciones que muchas veces son motivo de exclusión por parte del grupo de coetáneos, docentes y/o la comunidad donde reside. Ante las exigencias actuales de crear escuelas verdaderamente inclusivas en su funcionamiento, no siempre se encuentran en las aulas los profesionales competentes que garanticen una educación de calidad y equidad, capaz de aprovechar los beneficios de la actividad física y el deporte, tanto en el desarrollo social como en el psicológico; debido a su impacto en la construcción de las identidades individuales y colectivas, los educandos sienten la necesidad de su participación, la satisfacción con la tarea desarrollada y pueden valorar sus resultados, lo que permite la formación de actitudes y valores positivos hacia las diferentes esferas de la vida social. Es por ello que el siguiente artículo tiene como objetivo diseñar un sistema de talleres que contribuyan a la preparación de los docentes para la inclusión de escolares con trastornos de la conducta desde la actividad física y deportes. Para ello se utilizaron métodos como el histórico-lógico, el análisis documental, la entrevista y la observación científica, los que permitieron constatar el estado actual de la preparación de dichos profesionales y plantear desde la vía científica una respuesta de solución que promueva nuevos modos de actuación profesional.

A Educação Física, o esporte e a recreação constituem ferramentas eficazes na educação para corrigir ou compensar o comportamento dos alunos com distúrbios comportamentais, manifestações que muitas vezes são motivo de exclusão por parte do grupo de pares, professores e/ou da comunidade onde reside. Dadas as atuais exigências de criação de escolas verdadeiramente inclusivas no seu funcionamento, nem sempre se encontram profissionais competentes que garantam uma educação de qualidade e equidade, capazes de aproveitar os benefícios da atividade física e do desporto, tanto no desenvolvimento social como nas salas de aula. nas salas de aula, como no psicológico; Pelo seu impacto na construção de identidades individuais e coletivas, os alunos sentem necessidade da sua participação, satisfação com a tarefa realizada e podem valorizar os seus resultados, o que permite a formação de atitudes e valores positivos perante as diferentes esferas da vida social. vida. É por isso que o artigo a seguir tem como objetivo desenhar um sistema de oficinas que contribua para a preparação de professores para a inclusão de escolares com distúrbios comportamentais por meio da atividade física e esportiva. Para isso, foram utilizados métodos como histórico-lógico, análise documental, entrevistas e observação científica, que permitiram verificar o estado atual da preparação destes profissionais e propor, numa perspectiva científica, uma resposta de solução que promova novas formas de atuação profissional.

Physical Education, sports and recreation constitute effective tools in education to correct or compensate for the behavior of students with behavioral disorders, manifestations that are often a reason for exclusion by the group of peers, teachers and/or or the community where you reside. Given the current demands to create schools that are truly inclusive in their operation, competent professionals who guarantee quality and equity education, capable of taking advantage of the benefits of physical activity and sport, both in social development and in the classrooms, are not always found in the classrooms. as in the psychological; Due to its impact on the construction of individual and collective identities, students feel the need for their participation, satisfaction with the task carried out and can value their results, which allows the formation of positive attitudes and values towards the different spheres of social life. That is why the following article aims to design a system of workshops that contribute to the preparation of teachers for the inclusion of schoolchildren with behavioral disorders through physical activity and sports. To do this, methods such as historical-logical, documentary analysis, interviews and scientific observation were used, which made it possible to verify the current state of the preparation of these professionals and propose, from a scientific perspective, a solution response that promotes new ways of professional performance.

Prediction of adverse neonatal outcome at admission for early-onset preeclampsia with severe features.

BACKGROUND: Preeclampsia remains the leading cause of maternal morbidity and mortality. Consequently, research has focused on validating tools to predict maternal outcomes regarding clinical and biochemical features from the maternal compartment. However, preeclampsia also leads to neonatal complications due to placental insufficiency and prematurity, being the early-onset type associated with the poorest outcome. Hence, it is imperative to study whether these existing tools can predict adverse neonatal outcome. OBJECTIVE: To assess the predictive value for adverse neonatal outcome of Doppler ultrasound, angiogenic factors and multi-parametric risk-score models in women with early-onset severe preeclampsia. STUDY DESIGN: This is a prospective cohort study of consecutive singleton pregnancies complicated by early-onset (developed before 34 week's gestation) severe preeclampsia. RESULTS: 63 women with early-onset severe preeclampsia, 18 (28.6%) presented an adverse neonatal outcome. Placental growth factor (PlGF) showed the best discrimination between neonatal outcomes among angiogenic factors. PREP-L score is a multi-parametric risk-score for the prediction of complications in early-onset preeclampsia which includes maternal characteristics and clinical and analytical data obtained at admission. Good predictive values for the prediction of neonatal complications were found with the combination of PREP-L score with advanced Doppler (AUC ROC 0.9 95% CI 0.82-0.98]) and with PlGF levels (AUC ROC 0.91 [95% CI 0.84-0.98]). CONCLUSIONS: The combination of maternal risk scoring (PREP-L score) with angiogenic factors or fetal Doppler ultrasound at the time of diagnosis of early-onset preeclampsia with severe features performs well in predicting adverse neonatal outcome.

Valoración de prácticas sociales que hacen uso de especies animales no humanas

Introducción: Los científicos han explorado las capacidades intelectuales de los animales, su importancia para la salud física y emocional de los humanos, su uso como sujetos en la investigación biomédica y psicológica, pero se ha prestado poca atención a las valoraciones que hacen las personas del común sobre estas prácticas sociales. El objetivo de esta investigación fue presentar los resultados sobre las valoraciones de prácticas de divertimiento, producción industrial, investigación biológica y psicológica, que involucran animales, a partir de las dimensiones: ética, legal, las capacidades intelectuales, los beneficios para la salud física y emocional de las personas y la preocupación por su bienestar. Método: Se construyó un instrumento online a partir una frase mapa compuesto por 28 ítems, que exploran la evaluación de 255 personas, hombres y mujeres sobre estas prácticas, bajo la condición de tener o no mascota. Las respuestas se analizaron mediante un análisis de escalamiento multidimensional. Resultados: Queda en evidencia la preocupación de las personas por las condiciones en que se usan los animales, en particular, de quienes tienen o han tenido mascota. Conclusiones: Los hallazgos se discuten a partir del soporte de las facetas incluidas en la frase mapa y la propuesta para nuevos estudios sobre prácticas sociales que involucre animales en la población general.

Introduction: Scientifics have explored the intellectual capacities of animals, their importance for the physical and emotional health of humans, its use as subjects for biomedical and psychological research. However, little attention has been involved to studying how lay people think about these types of social practices. The objective of this research was to present the results of the evaluations of social practices involving animals in entertainment, industrial production, biological and psychological research. The practices were evaluated on the following dimensions: ethics, legal, intellectual capacities, benefits for the physical and emotional health of people; and concern for their well-being. Method: An instrument based on a mapping sentence and composed of 28 items was responded online by 255 people, men and women with the condition of having a pet or not. Item responses were analyzed using multidimensional scaling analysis. Results: It is evident people's concern for the conditions in which the animals are used particularly in people that have or has have pets. Conclusions: The findings are discussed on the evidence that support the mapping sentence, and on the proposal for new studies on social practices involving lay people.

Factores asociados con el agotamiento psicológico en odontólogos especialistas colombianos / Factors Associated With Burnout Syndrome in Colombian Dental Specialists

RESUMEN Objetivo: Determinar los factores asociados con el agotamiento psicológico (AP) en odontólogos especialistas que laboraban en la ciudad de Bucaramanga y su área metropolitana. Métodos: Se realizó un estudio observacional analítico de corte transversal en el que se aplicó la versión validada del cuestionario Maslach Burnout Inventory-Human Services Survey (MBI-HSS) a 117 especialistas del área de odontología. Se analizaron los puntajes obtenidos en las 3 dimensiones del instrumento, las características sociodemográficas, los aspectos del entorno laboral y profesional y los hábitos. En el análisis bivariado, se utilizó el coeficiente de correlación de Spearman, la prueba de la U de Mann Whitney o Kruskal-Wallis y en el ánalisis multivariado, se realizó una regresión logística. Un valor de p<0,05 se consideró estadísticamente significativo. Cada participante aceptó su inclusión en el estudio tras el proceso de consentimiento informado. Resultados: El promedio de edad fue 44,0 ± 7,8 años y el 57,3% eran mujeres. El 3,4, el 4,3 y el 4,3% de los participantes tenían altos grados de agotamiento emocional, despersonaliza ción y falta de realización personal respectivamente. El consumo de cigarrillo presentó una asociación directa con las dimensiones despersonalización (p = 0,031) y falta de realización personal (p = 0,025). De otra parte, tener 10 años o más de egresado del posgrado evidenció una asociación inversa en estas 2 dimensiones (p = 0,049 y p = 0,045 respectivamente). Conclusiones: Los resultados indican que el AP no es un problema frecuente en los odontó logos especialistas que laboran en Bucaramanga y su área metropolitana; sin embargo, es importante tener en cuenta que se observó relación del AP con el hábito de fumar y los años de egresado de la especialidad.

ABSTRACT Objective: To establish the factors associated with burnout syndrome in dental specialists working in the city of Bucaramanga and its metropolitan area. Methods: A cross-sectional study was conducted in which the validated version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied to 117 dental specialists. The variables analysed were the scores obtained in the three dimensions of the instrument - sociodemographic and job-related characteristics, professional environment, and habits. Spearman's correlation coefficient and the Mann Whitney or Kruskal-Wallis U test were used in the bivariate analysis, and a logistic regression was perfor med in the multivariate analysis. A value of p < 0.05 was considered statistically significant. Each participant accepted their inclusion in the study after the Informed Consent process was done. Results: The average age was 44.0 ± 7.8 years, and 57.3% were women. It was observed that 3.4%, 4.3% and 4.3% of respondents scored highly in emotional exhaustion, depersonalisation and lack of personal achievement, respectively. Cigarette smoking presented a direct association with the dimensions of depersonalisation (p = 0.031) and lack of personal achie vement (p = 0.025). On the other hand, having completed the postgraduate degree 10 years or more ago showed a negative association in these two dimensions (p = 0.049 and p = 0.045, respectively). Conclusions: The results suggest that burnout syndrome is not a frequent problem in dental specialists who work in Bucaramanga and its metropolitan area. However, it is important to keep in mind that a relationship was observed between the syndrome and smoking, and the years after graduating in the specialty.

Factors associated with burnout syndrome in Colombian dental specialists.

OBJECTIVE: To establish the factors associated with burnout syndrome in dental specialists working in the city of Bucaramanga and its metropolitan area. METHODS: A cross-sectional study was conducted in which the validated version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied to 117 dental specialists. The variables analysed were the scores obtained in the three dimensions of the instrument - sociodemographic and job-related characteristics, professional environment, and habits. Spearman's correlation coefficient and the Mann Whitney or Kruskal-Wallis U test were used in the bivariate analysis, and a logistic regression was performed in the multivariate analysis. A value of p < 0.05 was considered statistically significant. Each participant accepted their inclusion in the study after the Informed Consent process was done. RESULTS: The average age was 44.0 ± 7.8 years, and 57.3% were women. It was observed that 3.4%, 4.3% and 4.3% of respondents scored highly in emotional exhaustion, depersonalisation and lack of personal achievement, respectively. Cigarette smoking presented a direct association with the dimensions of depersonalisation (p = 0.031) and lack of personal achievement (p = 0.025). On the other hand, having completed the postgraduate degree 10 years or more ago showed a negative association in these two dimensions (p = 0.049 and p = 0.045, respectively). CONCLUSIONS: The results suggest that burnout syndrome is not a frequent problem in dental specialists who work in Bucaramanga and its metropolitan area. However, it is important to keep in mind that a relationship was observed between the syndrome and smoking, and the years after graduating in the specialty.

Implementación de un programa de alimentación escolar en una institución educativa durante la pandemia, Bogotá, 2021 / Implementation of a school feeding program in an educational institution during the pandemic, Bogotá, 2021

RESUMEN Objetivo El Programa de Alimentación Escolar (PAE) en Colombia brinda un complemento alimentario para niños y adolescentes vinculados al sistema educativo público; sin embargo, debido a la pandemia por COVID-19, este tuvo que modificar su modalidad de entrega. Este estudio tuvo como propósito describir las estrategias del Colegio CEDID Ciudad Bolívar al implementar el PAE durante la pandemia por COVID-19. Métodos Diseño metodológico cualitativo basado en entrevistas semiestructuradas a docentes, estudiantes y padres de familias, pertenecientes a este colegio. La información fue analizada de acuerdo con un conjunto de categorías establecidas previamente. Resultados Los participantes coinciden en que el traslado de los padres por pérdida de empleo y el no tener dispositivos tecnológicos, influye en la deserción escolar. Por otra parte, el colegio se acogió a la modalidad transitoria del PAE, entregando bonos redimibles por mercado; sin embargo, afirman que no todos lograron acceder a este por desconocimiento del trámite. Se resalta por los participantes que es una ayuda alimentaria, económica y que logra beneficiar a toda la familia, pero se evidencia el alto costo de los alimentos, el desabastecimiento y las dificultades a la hora de redimirlos. Conclusiones A pesar de la pandemia, la institución ha hecho esfuerzos para adaptar el PAE a las circunstancias epidemiológicas a fin de enfrentar el riesgo de deserción escolar y garantizar el complemento alimentario para los estudiantes, siendo valorado por ellos y sus familias.

ABSTRACT Objective The School Feeding Program (PAE, by its initials in Spanish) in Colombia provides a food supplement for children and adolescents enrolled in the public educational system; however, due to the COVID-19 pandemic, its delivery modality had to be modified. The purpose of this study was to describe the strategies of the CEDID Ciudad Bolívar School to implement the PAE during the COVID-19 pandemic. Methods Methodological design based on semi-structured interviews with teachers, students and parents of families belonging to this school. The information was analyzed according to a set of previously established categories. Results The participants agree that the transfer of parents due to loss of employment and not having technological devices influences school dropout. On the other hand, the school took advantage of the transitory modality of the PAE, delivering bonds redeemable by market; however, they affirm that not all were able to access it, due to ignorance of the process. It is highlighted by the participants that it is a food aid, it is economic, and that it manages to benefit the whole family, but the high cost of food, the shortage of supplies, and the difficulties when it comes to redeeming it are evident. Conclusions Despite the pandemic, the institution has made efforts to adapt the PAE to epidemiological circumstances, in order to face the risk of school dropout and guarantee the food supplement for students, being valued by them and their families.

Differences between COVID-19-induced acute kidney injury and chronic kidney disease patients / Diferenças entre pacientes com lesão renal aguda induzida por COVID-19 e pacientes com doença renal crônica

Abstract Introduction: This article describes the main differences between COVID-19-induced acute kidney injury (AKI-COVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKI-CKD) treated in a high complexity clinic in Barranquilla (Colombia). Material and Methods: The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARS-CoV-2. Of these patients, 188 developed AKI during their hospital stay. Patients' epidemiological data, serum parameters, and clinical frailty status were recorded. Statistical analysis and comparison among AKI-NRF, AKI-CKD, and non-AKI patients were performed. Results: The incidence of COVID-19-induced AKI was 33%, with the majority classified as AKIN 1, 16% requiring renal replacement therapy, and AKI-COVID19 mortality of 68%. A significantly higher prevalence of hypertension, cardiac disease, and serum reactive C-protein and lower albumin values in AKI-CKD patients was recorded. Mortality rate, invasive ventilation requirement, and D-dimer levels were significantly higher in AKI-NRF patients: Conclusion: Different clinical patterns between AKI-NRF and AKI-CKD were documented.

Resumo Introdução: Este artigo descreve as principais diferenças entre a lesão renal aguda induzida por COVID-19 (LRA-COVID19) em pacientes com função renal normal prévia (LRA-FRN) e aqueles com doença renal crônica (LRA-DRC) atendidos em uma clínica de alta complexidade em Barranquilla (Colômbia). Material e Métodos: Os pacientes incluídos neste estudo (n: 572) foram aqueles com um diagnóstico positivo de COVID-19 confirmado pela detecção de PCR positivo para SARS-CoV-2. Destes pacientes, 188 desenvolveram LRA durante sua internação. Foram registrados os dados epidemiológicos, os parâmetros séricos e o estado de fragilidade clínica dos pacientes. Foram feitas a análise estatística e a comparação entre pacientes com LRA-FRN, LRA-DRC, e pacientes sem LRA. Resultados: A incidência de LRA induzida por COVID-19 foi de 33%, com a maioria classificada como AKIN 1, 16% exigindo terapia renal substitutiva, e a mortalidade por LRA-COVID19 foi de 68%. Foi registrada uma prevalência significativamente mais alta de hipertensão, doença cardíaca e proteína C reativa sérica e valores mais baixos de albumina em pacientes com LRA-DRC. A taxa de mortalidade, a necessidade de ventilação invasiva e os níveis de dímero-D foram significativamente mais altos em pacientes com LRA-FRN. Conclusão: Foram documentados padrões clínicos diferentes entre LRA-FRN e LRA-DRC.

Resistin Modulates Low-Density Lipoprotein Cholesterol Uptake in Human Placental Explants via PCSK9.

Maternal metabolic status influences pregnancy and, consequently, the perinatal outcome. Resistin is a pro-inflammatory adipokine predominantly expressed and secreted by mononuclear cells, adipose tissue, and placental trophoblastic cells during pregnancy. Recently, we reported an inverse association between maternal resistin levels and fetal low-density lipoprotein cholesterol (LDL-C). Then, in this work, we used a human placental explant model and the trophoblast cell line JEG-3 to evaluate whether resistin affects placental LDL-C uptake. Resistin exposure induced the transcription factor SREBP-2, LDLR, and PCSK9 mRNA expression, and changes at the protein level were confirmed by immunohistochemistry and Western blot. However, for LDLR, the changes were not consistent between mRNA and protein levels. Using a labeled LDL-cholesterol (BODIPY FL LDL), uptake assay demonstrated that the LDL-C was significantly decreased in placental explants exposed to a high dose of resistin and a lesser extent in JEG-3 cells. In summary, resistin induces PCSK9 expression in placental explants and JEG-3 cells, which could be related to negative regulation of the LDLR by lysosomal degradation. These findings suggest that resistin may significantly regulate the LDL-C uptake and transport from the maternal circulation to the fetus, affecting its growth and lipid profile.

Apelin-13 facilitates lordosis behavior following infusions to the ventromedial hypothalamus or preoptic area in ovariectomized, estrogen-primed rats.

In normal hormonal conditions, increased neuronal activity in the ventromedial hypothalamus (VMH) induces lordosis whereas activation of the preoptic area (POA) exerts an opposite effect. In the present work, we explored the effect of bilateral infusion of different doses of the apelin-13 (0.37, 0.75, 1.5, and 15 µg) in both brain areas on the expression of lordosis behavior. Lordosis quotient and lordosis reflex score were performed at 30, 120, and 240 min. Weak lordosis was observed following the 0.37 µg dose of apelin-13 at 30 min in the VMH of EB-primed rats; however, the rest of the doses induced significant lordosis relative to the control group. At 120 min, all doses induced lordosis behavior, while at 240 min, the highest dose of 15 µg did not induce significant differences. Interestingly, only the 0.75 µg infusion of apelin in the POA induced significant lordosis at 120 and 240 min. These results indicate that apelin-13 acts preferably in HVM and slightly in POA to initiate lordosis behavior in estrogen-primed rats.

Protective Effect of Curcumin against Doxazosin- and Carvedilol-Induced Oxidative Stress in HepG2 Cells.

Doxazosin and carvedilol have been evaluated as an alternative treatment against chronic liver lesions and for their possible role during the regeneration of damage caused by liver fibrosis in a hamster model. However, these drugs have been reported to induce morphological changes in hepatocytes, affecting the recovery of liver parenchyma. The effects of these α/𝛽 adrenoblockers on the viability of hepatocytes are unknown. Herein, we demonstrate the protective effect of curcumin against the possible side effects of doxazosin and carvedilol, drugs with proven antifibrotic activity. After pretreatment with 1 µM curcumin for 1 h, HepG2 cells were exposed to 0.1-25 µM doxazosin or carvedilol for 24, 48, and 72 h. Cell viability was assessed using the MTT assay and SYTOX green staining. Morphological changes were detected using the hematoxylin and eosin (H&E) staining and scanning electron microscopy (SEM). An expression of apoptotic and oxidative stress markers was analyzed using reverse transcription-quantitative PCR (RT-qPCR). The results indicate that doxazosin decreases cell viability in a time- and dose-dependent manner, whereas carvedilol increases cell proliferation; however, curcumin increases or maintains cell viability. SEM and H&E staining provided evidence that doxazosin and carvedilol induced morphological changes in HepG2 cells, and curcumin protected against these effects, maintaining the morphology in 90% of treated cells. Furthermore, curcumin positively regulated the expression of Nrf2, HO-1, and SOD1 mRNAs in cells treated with 0.1 and 0.5 µM doxazosin. Moreover, the Bcl-2/Bax ratio was higher in cells that were treated with curcumin before doxazosin or carvedilol. The present study demonstrates that curcumin controls doxazosin- and carvedilol-induced cytotoxicity and morphological changes in HepG2 cells possibly by overexpression of Nrf2.

Dens Invaginatus: Clinical Implications and Antimicrobial Endodontic Treatment Considerations.

Dens invaginatus or dens in dente is a developmental dental anomaly resulting from an invagination of the enamel organ into the dental papilla during odontogenesis. Radiographically, it is usually seen as a radiolucent invagination surrounded by a radiopaque area (enamel) limited to the tooth crown or extending into the root. Because the invagination is opened to the oral cavity, it can retain saliva, food remnants, and bacteria. In conditions where the enamel lining of the invagination is naturally absent or lost because of caries, bacterial cells and products can diffuse from the invagination through the dentin tubules to reach the pulp and cause disease. Management of teeth with dens invaginatus includes preventive sealing or filling of the invagination, or if the pulp is affected, therapeutic options include vital pulp therapy, nonsurgical root canal treatment, apexification or regenerative endodontic procedures, periradicular surgery, intentional replantation, or extraction. It is recommended that the invagination be always approached, regardless of the type of dens invaginatus. The root canal should be treated whenever the pulp is irreversibly inflamed or necrotic. Endodontic management of teeth with dens invaginatus is often tricky because of its anatomic complexity, and special and customized strategies should be devised. This review discusses the endodontic implications of this anomaly and the current treatment recommendations based on anatomic, pathological, and technologic considerations.

Estrategias de afrontamiento en familiares de pacientes críticos / Coping strategies for relatives of critically ill patients

Introducción: la estadía en la unidad de cuidados intensivos genera cambios en la dinámica familiar causados por las alteraciones en las actividades diarias que obligan a utilizar estrategias que los mitiguen. Objetivo: describir las estrategias de afrontamiento de los familiares de pacientes críticos. Materiales y métodos: revisión integradora de literatura en las bases de datos y metabuscadores PUBMED, LILACS, EPISTEMONIKOS, CUIDEN, SCIELO, CINAHL y CLINICALKEY, obteniendo 13 artículos: 7 estudios cuantitativos observacionales, 4 cualitativos fenomenológicos y 2 revisiones sistemáticas. Resultados: se determinó que las estrategias más utilizadas por los familiares de pacientes críticos son respuesta emocional, apoyo social, valores y creencias y crisis familiar. La más recurrente en los estudios revisados es la respuesta emocional debido a la implicación afectiva que tiene en los familiares la hospitalización de su ser querido. Conclusión: la respuesta emocional usada por los familiares como estrategia evidencia la necesidad de que los enfermeros garanticen espacios de acercamiento y expresión de sentimientos. Los servicios de salud deben priorizar el trato humanizado y una comunicación acorde con las necesidades de los familiares.

Introduction: the stay in the intensive care unit generates changes in the family dynamics caused by alterations in its daily activities that force the use of strategies that mitigate them. Objective: to describe the coping strategies for the relatives of critically ill patients. Materials and methods: integrative review of the literature in the PUBMED, LILACS, EPISTEMONIKOS, CUIDEN, SCIELO, CINAHL y CLINICALKEY databases, obtaining 13 articles: 7 quantitative observational studies, 4 qualitative phenomenological studies and 2 systematic reviews. Results: it was determined that the most used strategies by relatives of critically ill patients are emotional response, social support, values and beliefs and family crisis. The most recurrent in the studies reviewed is the emotional response due to the emotional involvement of the family members in the hospitalization of their loved ones. Conclusion: the emotional response used by relatives as a strategy shows the need for nurses to guarantee spaces for approaching and expressing feelings. Health services should prioritize humanized treatment and communication according to the need of family members.

Oxytocin induces lordosis behavior in female rats through the prostaglandin E2/GnRH signaling system.

Intracerebroventricular (icv) administration of oxytocin (OT) induces robust lordosis behavior (lordosis quotient and lordosis intensity) in estrogen-primed rats. The present study explored the hypothesis that the OT-Prostaglandin E2-GnRH pathway (a pathway produced in astrocytes) is involved in the facilitation of lordosis behavior by icv infusion of OT (2 µg). In Experiment 1, we tested the involvement of the OT receptor (OTR) by infusion of the OTR antagonist, atosiban (ATO). OT-induced lordosis was significantly reduced at both 30 and 120 min by prior infusion of ATO. In Experiment 2, we studied the effects of aspirin (COX2 inhibitor) and ONO-AE3-208 (ONO; EP4 prostaglandin receptor antagonist) on OT-induced lordosis. Infusions of both compounds diminished OT-induced lordosis at both 120 and 240 min. In Experiment 3, the involvement of the GnRH-1 receptor inhibitor antide on OT-induced lordosis was evaluated. Antide significantly inhibited OT-induced lordosis at all times tested. These data indicate that the OT/PGE2/GnRH pathway is involved in the expression of OT-induced lordosis behavior, an effect that may be occurring directly in hypothalamic astrocytes.

Effects of Endodontic Infections on the Maxillary Sinus: A Case Series of Treatment Outcome.

This article shows the follow-up of several cases of maxillary sinusitis of dental (usually endodontic) origin, with different manifestations, diagnostic challenges, and outcomes.Cases from 14 patients from 3 countries and treated by 7 different endodontists are presented, all of them with inflammatory sinus changes represented by mucositis, osteoperiostitis, and/or partial/full obstruction. All cases showed dental and/or sinus signs/symptoms that resolved after dental management. In 13 cases, the sinus condition had an endodontic origin, 4 of them concurrently with periodontal involvement. In 1 case, sinusitis was caused by trauma to the face. All cases but 1 had a satisfactory response of the periradicular tissues and maxillary sinus to treatment that consisted of root canal therapy, root amputation, extraction, or trauma management.The successful management of most cases reported in this article emphasizes the importance of endodontics as a specialty engaged in saving teeth and promoting health not only in the oral cavity but also in other areas that may be affected by infections of endodontic origin, including the maxillary sinus.

Studied of Prunus serotine oil extracted by cold pressing and antioxidant effect of P. longiflora essential oil.

Prunus serotine oil, was extracted from the seeds without shells, resulting in an oil yield of 23.41 ± 3.62%. Through GC it was shown that 52.38% of the total fatty acids present in the oil were polyunsaturated fatty acids. The fatty acids profile presented in the P. serotine oil were oleic (41.42%), linoleic (26.97%) and α-eleostearic acid (25.33%). It had a high concentration of total phenols (221 ± 15.85 mg as gallic acid equivalents/kg oil) and flavonoids (0.77 ± 0.01 mg catechin equivalents/kg oil). The antiradical activity was 31.52 ± 2.71% and 12.94 ± 0.67% of radical inhibition for colorimetric methods using ABTS [2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulphonic acid)] and DPPH (2,2-diphenyl-1-picrylhydrazyl), respectively. The activity inhibition was 2.3 (ABTS) and 1.8 (DPPH) times higher, respectively, than the ones of Prunus dulcis oil. Lipid oxidation showed that at day nine, P. serotine oil has it maximum hydroperoxide production through two methods (hydroperoxide and MDA). Three oregano fractions were added (code: 642, 655 and A01) as natural antioxidants at four different concentrations (3000, 300, 30 and 3 ppm) each one, to extend its shelf life. Fraction 642 managed to extend its shelf life until day 30 (30 °C ± 2 °C), in both methodologies. The fraction 642 at 3 ppm, controls the production of hydroperoxide formation. Resulting in values of 3.65 µM equivalents of cumene hydroperoxide/kg of oil and 10.29 µM equivalents of 1,1,3,3-Tetraethoxypropane/kg of oil, decreasing by 3.2 times the peroxide formation with respect to P. serotine oil without leaving a Poliomintha longiflora fraction.

Factors Associated With Burnout Syndrome in Colombian Dental Specialists. / Factores asociados con el agotamiento psicológico en odontólogos especialistas colombianos.

OBJECTIVE: To establish the factors associated with burnout syndrome in dental specialists working in the city of Bucaramanga and its metropolitan area. METHODS: A cross-sectional study was conducted in which the validated version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied to 117 dental specialists. The variables analysed were the scores obtained in the three dimensions of the instrument - sociodemographic and job-related characteristics, professional environment, and habits. Spearman's correlation coefficient and the Mann Whitney or Kruskal-Wallis U test were used in the bivariate analysis, and a logistic regression was performed in the multivariate analysis. A value of p<0.05 was considered statistically significant. Each participant accepted their inclusion in the study after the Informed Consent process was done. RESULTS: The average age was 44.0±7.8 years, and 57.3% were women. It was observed that 3.4%, 4.3% and 4.3% of respondents scored highly in emotional exhaustion, depersonalisation and lack of personal achievement, respectively. Cigarette smoking presented a direct association with the dimensions of depersonalisation (p=0.031) and lack of personal achievement (p=0.025). On the other hand, having completed the postgraduate degree 10 years or more ago showed a negative association in these two dimensions (p=0.049 and p=0.045, respectively). CONCLUSIONS: The results suggest that burnout syndrome is not a frequent problem in dental specialists who work in Bucaramanga and its metropolitan area. However, it is important to keep in mind that a relationship was observed between the syndrome and smoking, and the years after graduating in the specialty.

Prenatal blood lead levels and reduced preadolescent glomerular filtration rate: Modification by body mass index.

BACKGROUND: For the developing kidney, the prenatal period may represent a critical window of vulnerability to environmental insults resulting in permanent nephron loss. Given that the majority of nephron formation is complete in the 3rd trimester, we set out to test whether 1) prenatal lead exposure is associated with decreased preadolescent kidney function and 2) whether preadolescent obesity acts synergistically with early life lead exposure to reduce kidney function. METHODS: Our study included 453 mother-child pairs participating in the PROGRESS birth cohort. We assessed prenatal blood lead levels (BLLs) in samples collected in the 2nd and 3rd trimesters and at delivery, as well as tibial and patellar bone lead measures assessed one-month postpartum. Preadolescent estimated glomerular filtration rate (eGFR) was derived from serum levels of creatinine and/or cystatin C measured at age 8-12 years. We applied linear regression to assess the relationship between prenatal bone and BLL with preadolescent eGFR, and adjusted for covariates including age, sex, BMI z-score, indoor tobacco smoke exposure, and socioeconomic status. We also examined sex-specific associations and tested for effect modification by BMI status. RESULTS: We observed null associations between prenatal lead exposure and eGFR. However, in interaction analyses we found that among overweight children, there was an inverse association between BLL (assessed at 2nd and 3rd trimester and at delivery) and preadolescent eGFR. For example, among overweight participants, a one ln-unit increase in 2nd trimester BLL was associated with a 10.5 unit decrease in cystatin C-based eGFR (95% CI: -18.1, -2.8; p = 0.008). Regardless of lead exposure, we also observed null relationships between BMI z-score and eGFR overall, as well as among overweight participants. However, among participants with preadolescent obesity, we observed a significant 5.9-unit decrease in eGFR. We observed no evidence of sex-specific effects. CONCLUSIONS: Our findings, if confirmed in other studies, suggest a complex interplay between the combined adverse effects of adiposity and perinatal lead exposure as they relate to adolescent kidney function. Future studies will assess kidney function and adiposity trajectories through adolescence to better understand environmental risk factors for kidney function decline.

Cuidados de enfermería para la persona adulta, diabética con hipoglucemia: revisión integrativa / Nursing care for the adult diabetic experiencing hypoglycemia: an integrative review

Introducción:La hipoglucemia es la complicación más frecuente del tratamiento con insulina en adultos. Los eventos de hipoglucemia severa se asocian con complicaciones a corto, mediano y largo plazo en pacientes con diabetes mellitus. Una de las estrategias para reducir la frecuencia de hipoglucemia son las intervenciones de enfermería y aunque hay pocos estudios que las enuncian de manera explícita, se ha publicado respecto a las necesidades de dichos pacientes, que permiten determinar diagnósticos de enfermería y a partir de ellos establecer metas e intervenciones para el cuidado de dichos pacientes. Objetivo: identificar los cuidados de enfermería para prevenir y controlar los eventos de hipoglucemia en pacientes adultos diagnosticados con diabetes mellitus. Metodología: revisión integrativa, se realizó en seis fases: planteamiento de la pregunta PICO; búsqueda en bases de datos y metabuscadores; lectura crítica; análisis, clasificación, validación por nivel de evidencia y grado de recomendación, y presentación de la información. Resultados: la revisión reportó cinco categorías: factores de riesgo y protectores, miedo a la hipoglucemia, atención brindada al paciente, disminución de la hipoglucemia y descripcióndel impacto de la hipoglucemia en los pacientes. Conclusiones: a partir de las necesidades reportadas en las 5 categorías de los resultados se determinaron características definitorias y factores relacionados que permitieron formular diagnósticos de enfermería y determinar como principales intervenciones: enseñanza del proceso de enfermedad, medicamentos prescritos, entrenamiento de asertividad, manejo de la hipoglicemia, nutricional y de la medicación, mejorar el afrontamiento, enseñanza individual, facilitar el aprendizaje y potenciación de la disposición de aprendizaje.

ntroduction: hypoglycemia is the most common complication of insulin therapy in adults. Events of severe hypoglycemia are associated with short, medium and long term complications in patients with diabetes mellitus (DM). One of the strategies to reduce the frequency of hypoglycemia are nursing interventions and although there are few studies that explicitly describe them, there are publications on the needs of such patients, allowing the determination of nursing diagnoses and based on them, setting goals and interventions to deliver care for these patients. Objective: to identify nursing care interventions to prevent and control hypoglycemic events in adult patients diagnosed with DM. Methodology: an integrative review was conducted in six phases: posing the PICOT question; search in databases and metasearch engines; critical reading; analysis, classification, validation by level of evidence and degree of recommendation, and data presentation. Results: the review reported five categories: risk and protective factors, fear of hypoglycemia, care provided to the patient, decrease in hypoglycemia and description of the impact of hypoglycemia on patients. Conclusions: Based on the needs reported in the resulting five categories, defining characteristics and related factors were determined allowing the formulation of nursing diagnoses and identifying the following as the main nursing interventions for hypoglycemia management: teaching of the disease process, prescribed medication, assertiveness training, hypoglycemia management, nutritional and medication therapy, improving coping, individual teaching, facilitating learning and empowering the willingness to learn.