Conhecimento e experiências vividas por cirurgiões-dentistas quanto à importunação sexual e perseguição em Pernambuco, Brasil / Knowledge and experiences lived by dentists regarding sexual harassment and persecution in Pernambuco, Brazil

Importunação Sexual e Perseguição são práticas configuradas como crime pelo Código Penal Brasileiro - CPB. Sendo o tema pouco explorado na área da saúde, este trabalho teve como objetivo verificar o nível de conhecimento do cirurgião-dentista atuante no estado de Pernambuco (Brasil), sobre estes dois tipos penais, suas experiências no exercício profissional e atitudes tomadas para resolutividade da questão. Para isto foi realizado estudo descritivo de corte transversal, com aplicação de um questionário online semiestruturado, através da plataforma Google Forms®, utilizando a metodologia "bola de neve", sendo coletados dados sociodemográficos, questões relacionadas ao conhecimento de Importunação Sexual e Perseguição, e por fim, questões relacionadas a experiências sofridas no exercício de sua profissão. Foram incluídos neste estudo 69 questionários, 22% respondidos por homens e 78% por mulheres. A maioria dos participantes respondeu que já ouviu falar sobre Importunação Sexual e sobre Perseguição, no entanto, grande parte demonstrou dificuldade em reconhecer a definição de Importunação, estabelecida pelo CPB. Os que informaram ter tido vivência com algum destes tipos penais, relataram que contaram o fato a um amigo, a algum familiar ou não fizeram nada a respeito. Conclui-se sobre existência de situações dentro da prática profissional odontológica que podem configurar, sobretudo, o crime de Importunação sexual. E, contar a um amigo, a um familiar ou mesmo não fazer nada a respeito foram as atitudes mais comumente realizadas por estes profissionais

Sexual Harassment and persecution are acts configured as a crime by the Brazilian Penal Code - CPB. As the subject is little explored in the health area, this work aimed to verify the level of knowledge of the dentists working in the state of Pernambuco (Brazil), about these two criminal types, their experiences in professional practice and attitudes taken to resolve the issue. For this, a descriptive cross-sectional study was carried out, with the application of a semi-structured online questionnaire, through the google forms platform, using the "snowball" methodology, collecting sociodemographic data, questions related to the knowledge of sexual harassment and persecution, and by finally, questions related to the experiences suffered in the exercise of their profession. 69 questionnaires were included in this study, 22% answered by men and 78% by women. Most participants answered that they had already heard about sexual harassment and persecution, however, most of them showed difficulty in recognizing the definition of harassment, established by the CPB. Those who reported having had experience with one of these criminal types, reported that they told the fact to a friend, to a family member or did nothing about it. It concludes on the existence of situations within professional dental practice that can configure, above all, the crime of sexual harassment. And telling a friend, a family member or even doing nothing about it were the attitudes most commonly performed by these professionals

Dodonaea viscosa Jacq. induces cytotoxicity, antiproliferative activity, and cell death in colorectal cancer cells via regulation of caspase 3 and p53.

Colorectal cancer (CRC) is the third most common cancer diagnosed worldwide and is the second leading cause of cancer-related death due to an insufficiency prognosis and is generally diagnosed in the last step of development. The Peruvian flora has a wide variety of medicinal plants with therapeutic potential in several diseases. Dodonaea viscosa Jacq. is a plant used to treat inflammatory process as well as gastrointestinal diseases. The aim of this study was to examine the cytotoxic, antiproliferative, and cell death-inducing effects of D. viscosa on colorectal cancer cells (SW480 and SW620). The hydroethanolic extract was obtained by maceration at 70% ethanol, the phytochemical constituents were identified by LC-ESI-MS. D. viscosa revealed 57 compounds some of them are: isorhamnetin, kaempferol, quercetin, methyl dodovisate B, hardwickiic acid, viscosol, and dodonic acid. Regarding the antitumoral activity, D. viscosa induced cytotoxic and antiproliferative activity in both SW480 and SW620 cancer cells, accompanied with, important changes in mitochondrial membrane potential, formation of the Sub G0/G1 population and increasing levels of apoptotic biomarkers (caspase 3 and the tumor suppressor protein p53) in the metastatic derivative cell line (SW620), suggesting an intrinsic apoptotic process after the treatment with the hydroethanolic extract of D. viscosa.

The Essential Oil of Petroselinum crispum (Mill) Fuss Seeds from Peru: Phytotoxic Activity and In Silico Evaluation on the Target Enzyme of the Glyphosate Herbicide.

Petroselinum crispum (Mill) Fuss is an aromatic plant belonging to the Apiaceae family and used in gastronomy as a spice. Several studies have been developed in leaves but studies are limited in seeds, especially the essential oils obtained from seeds. The aim of this study was to determine the phytochemical profile of the volatile compounds of this essential oil by gas-chromatography-mass spectrometry (GC-MS) in order to evaluate its phytotoxic activity on Lactuca sativa seeds and to carry out an in silico analysis on the target enzyme of the herbicide glyphosate 5-enolpyruvylshikimate 3-phosphate synthase (EPSP). The essential oil was obtained by steam distillation for two hours and then was injected into a GC-MS, the phytotoxic assay was carried out on Lactuca seeds and the in silico evaluation on the EPSP synthase focused on the volatile compounds similar to glyphosate, docking analysis, and molecular dynamics to establish the protein-ligand stability of the most active molecule. The chromatographic analysis revealed 47 compounds, predominated by three compounds with the most abundant percentage in the total content (1,3,8-ρ-menthatriene (22.59%); apiole (22.41%); and ß-phellandrene (15.02%)). The phytotoxic activity demonstrated that the essential oil had a high activity at 5% against L. sativa seed germination, inhibition of root length, and hypocotyl length, which is comparable to 2% glyphosate. The molecular docking on EPSP synthase revealed that trans-p-menth-6-en-2,8-diol had a high affinity with the enzyme EPSP synthase and a better stability during the molecular dynamic. According to the results, the essential oil of P. crispum seeds presented a phytotoxic activity and might be useful as a bioherbicide agent against weeds.

Volatile Components, Antioxidant and Phytotoxic Activity of the Essential Oil of Piper acutifolium Ruiz & Pav. from Peru.

Piper acutifolium Ruiz & Pav is known as "matico" and belongs to the Piperaceae family, and in Peru it is traditionally used as an infusion or decoction to ameliorate wound healings or ulcers. In this study, the aim was to investigate the volatile components, the antioxidant profile, and the phytotoxic activity of the essential oil (EO) of P. acutifolium from Peru. To identify the phytoconstituents, the EO was injected into a Gas Chromatography-Mass Spectrometry (GC-MS) to obtain the chemical profile of the volatile components, followed by the antioxidant activity carried out by the reaction with three organic radicals (2,2-diphenyl-1-picrylhydrazyl (DPPH); 2,2'-azinobis-(3-ethylbenzothiazoline)-6- sulfonic acid (ABTS); ferric reducing/antioxidant power (FRAP)). Finally, the phytotoxic capabilities of the EO were tested on two model plants, Lactuca sativa seeds and Allium cepa bulbs. As a result, the analysis identified α-phellandrene as its main volatile chemical at 38.18%, followed by ß-myrcene (29.48%) and ß-phellandrene (21.88%). Regarding the antioxidant profile, the half inhibitory concentration (IC50) in DPPH was 160.12 ± 0.30 µg/mL, for ABTS it was 138.10 ± 0.06 µg/mL and finally in FRAP it was 450.10 ± 0.05 µg/mL. The phytotoxic activity demonstrated that the EO had high activity at 5% and 10% against L. sativa seed germination, the inhibition of root length, and hypocotyl length. Additionally, in A. cepa bulbs, the inhibition root length was obtained at 10%, both comparable to glyphosate, which was used as a positive control. The molecular docking on 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) revealed that α-phellandrene had -5.8 kcal/mol, being near to glyphosate at -6.3 kcal/mol. The conclusion shows that the EO of P. acutifolium presented antioxidant and phytotoxic activity and might be useful as a bioherbicide in the future.

Acute arterial thrombosis in SARS-CoV-2 infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, whose main expression is an acute respiratory syndrome, is also associated with concurrent multisystemic involvement, coagulation disorders and thrombotic complications, both in patients with prior diseases and those without. We present the case of a patient admitted to our hospital with no prior medical problems who had documented SARS-CoV-2 infection. During hospitalization, the patient developed acute left lower limb pain and absent pedal and posterior tibial pulses, with acute arterial ischemia due to thrombosis confirmed with imaging tests. Other causes of thrombosis such as atheromatosis, embolism and coagulation disorders, among others, were ruled out. He was anticoagulated with low-molecular-weight heparin and cilostazol throughout hospitalization and was discharged on warfarin and cilostazol. SARS-CoV-2-related acute arterial thrombosis should also be considered in our region. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2372).

La infección por síndrome respiratorio agudo severo-coronavirus-2 (SARS-CoV-2), cuya expre sión principal es el síndrome respiratorio agudo también se asocia a compromiso multisistémico y se han detectado coagulopatías y complicaciones trombóticas asociadas durante la infección, tanto en pacientes con patologías previas como sin ellas. Presentamos el caso de un paciente que ingresó a nuestro hospital sin antecedentes patológicos, con infección documentada por SARS-CoV-2. Durante la hospitalización presentó dolor agudo de miembro inferior izquierdo con ausencia de pulsos pedio y tibial posterior, confirmándose por estudios imagenológicos isquemia arterial aguda por trombosis. Se descartaron otras causas de trombosis como ateromatosis, embolia, coagulopatía, entre otros. Recibió anticoagulación con heparinas de bajo peso molecular y cilostazol durante el periodo de hospitalización y egresó con warfarina y cilostazol. La trombosis arterial aguda relacionada con infección por SARS-CoV-2 debe considerarse también en nuestra región. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2372).

Ocio familiar en tiempos de confinamiento: construcción y validación de un instrumento / Family leisure during lockdowns: Construction and validation of an instrument / Lazer em família em tempos de confinamento: Construção e validação de um instrumento

Resumen (analítico) La revalorización experimentada por el ocio en los contextos familiares, debido a las restricciones sociales que han conllevado un incremento del tiempo en casa, ha contribuido a que esta emerja con fuerza como línea de investigación educativa, pues hasta ahora se encontraba desatendida en el panorama español. En el presente estudio se diseña y valida el Cuestionario sobre ocio familiar durante el confinamiento. Para dotar de validez de contenido y consistencia al constructo, se contó con el juicio de 10 expertos sobre la claridad, pertinencia y adecuación del instrumento, mediante una escala de validación. Los resultados denotan que el cuestionario resultante (61 ítems) posee propiedades psicométricas adecuadas que lo convierten en una herramienta apropiada para evaluar el ocio familiar, quedando confirmado su rigor y valía como correcto instrumento de análisis.

Abstract (analytical) The revaluation of leisure in family contexts, caused by lockdowns imposed during the COVID-19 pandemic that led to an increase in time spent at home, has contributed to this area emerging as a focus of educational research, which until now had been neglected in Spanish-speaking countries. In the present study, the authors present the process of designing and validating a "Questionnaire on family leisure during lockdowns". In order to provide content validity and consistency to the design of the instrument, feedback from 10 experts assessed the clarity, relevance and suitability of the instrument using a validation scale. The results show that the questionnaire, with 61 questions, has sufficient psychometric properties that make it an appropriate tool to evaluate family leisure. During this process the authors confirmed its rigor and value as an analytical instrument for research.

Resumo (analítico) A revalorização vivenciada pelo lazer em contextos familiares, devido às restrições sociais que têm levado ao aumento do tempo em casa, tem contribuído para o seu surgimento fortemente como uma linha de pesquisa educacional, já que até então era negligenciada no cenário espanhol. No presente estudo, o "Questionário sobre lazer familiar durante o confinamento" é elaborado e validado. Para conferir validade de conteúdo e consistência ao construto, o julgamento de 10 especialistas contou com a clareza, pertinência e adequação do instrumento, por meio de uma escala de validação. Os resultados mostram que o questionário resultante (61 itens) possui propriedades psicométricas adequadas que o tornam um instrumento adequado para avaliar o lazer familiar, confirmando seu rigor e valor como um correto instrumento de análise.

Competitividad de los gobiernos subnacionales y su relación con la mortalidad por COVID-19 en Perú / Competitiveness of subnational governments and their relationship with COVID-19 mortality in Peru

Introducción: La pandemia por COVID-19 ha puesto de manifiesto las grandes desigualdades en la población mundial. Objetivo: Describir la correlación entre la competitividad y la mortalidad por COVID-19 en el Perú, teniendo como elemento de estudio a los gobiernos subnacionales. Material y Métodos: Estudio observacional basado en el análisis secundario de las muertes por COVID-19 en el 2020 y el índice de competitividad regional de los gobiernos subnacionales 2019. Se calcularon: tasas bruta y estandarizada, índice de efecto y de desigualdad de la pendiente, diferencia y razón de tasas brutas y estandarizadas, riesgo atribuible poblacional, gradiente social, así como brechas relativas y absolutas de mortalidad por COVID-19. Resultados: En el año 2020, la tasa estandarizada de mortalidad por COVID-19 (TEM-COVID-19) fue 267,61 muertes x 105 habitantes. El 21,53 por ciento de la varianza de la TEM-COVID-19 es explicada por el índice de competitividad regional del año 2019 (p= 0,019); el índice de desigualdad de la pendiente fue 29,68 y, por cada punto en el INCORE 2019, la TEM-COVID-19 aumentó 100,78 puntos (R2a= 0,181). En el quintil 1 de competitividad regional, esta fue 151,83, mientras que en el quintil 5 llegó a 449,15. La brecha de desigualdad absoluta entre ambos quintiles fue 297,32 y alcanzó 2,95 en la brecha de desigualdad relativa. La curva de concentración evidenció la desigualdad socio geográfica de las muertes por COVID-19 en el año 2020. Conclusiones: La mortalidad por COVID-19 se incrementó a medida que aumentaba la competitividad de los gobiernos subnacionales evidenciando la desigualdad socio-geográfica del impacto de la pandemia(AU)

Introduction: The COVID-19 pandemic has revealed high disparities in the world population. Objective: To describe the correlation between competitiveness and mortality from COVID-19 in Peru, with subnational governments as an element of study. Material and Methods: Observational study based on the secondary analysis of deaths from COVID-19 that occurred in 2020 and the regional competitiveness index of subnational governments in 2019. The crude and standardized rates, the effect index, the difference and ratio of crude and standardized rates, the population attributable risk, the inequality gradient, and the relative and absolute gaps in mortality from COVID-19 were calculated. Results: In 2020, the standardized mortality rate for COVID-19 (COVID-19-SMR) was 267,61 deaths per 105 inhabitants. Additionally, 21,53 percent of the variance from the COVID-19-SMR is explained by the regional competitiveness index 2019 (p= 0,019); the slope inequality index was 29,68 and, for each point in the INCORE 2019, the COVID-19-SMR increased 100,78 points (R2a= 0,181). In quintile 1 of regional competitiveness, it was 151,83, while in quintile 5 it reached 449,15. The absolute inequality gap between both quintiles was 297,32 and it reached 2,95 in the relative inequality gap. The concentration curve evidenced the socio-geographic inequality of deaths from COVID-19 in 2020. Conclusions: Mortality increased as subnational governments became more competitive, evidencing the socio-geographical inequality of the impact of the COVID-19 pandemic(AU)

Cirurgiões-dentistas diante de situações de assédio e importunação sexual: revisão integrativa / Dentists facing situations of sexual harassment: integrative review

Assédio e importunação sexual são tipos de violência configurados como crime pelo Código Penal Brasileiro. Situações como estas são frequentemente vivenciadas pela população, sendo as mulheres as principais vítimas. Na Odontologia, tais comportamentos tem trazido bastante preocupação, e promovido experiências negativas seja aos Cirurgiões-dentistas, Auxiliares de Saúde Bucal ou Técnicos de Saúde Bucal. Assim, por meio de uma revisão integrativa da literatura, este estudo objetivou analisar se o Cirurgião-dentista se sente preparado em lidar com este problema, as atitudes tomadas pelos Cirurgiões-Dentistas quando diante de situações em que se sinta assediado ou importunado sexualmente durante sua atividade profissional, bem como os sentimentos gerados pela experiência vivida. Para seleção dos artigos utilizou-se as bases de dados PubMed, Biblioteca Virtual de Saúde (BVS) e periódicos CAPES, e a amostra desta revisão constituiu-se em sete artigos. Após análise destas publicações, os resultados dos estudos apontaram prejuízos aos profissionais que vão desde o trabalho à vida pessoal. Foram relatados sentimentos de ansiedade, medo, perda de ânimo para realização das atividades profissionais, além de pesadelos e recordações angustiantes do momento vivido. Constatou-se que os Cirurgiões-dentistas de ambos os sexos não se sentem preparados profissionalmente para lidar com situações de assédio e importunação sexual, e que estes consideram de extrema relevância a inclusão da temática nos currículos dos cursos de graduação em Odontologia

Sexual harassment is a type of violence configured as a crime under the Brazilian Penal Code. Situations like these are frequently experienced by the population, with women being the main victims. In Dentistry, such behaviors have brought a lot of concern, and promoted negative experiences either for Dentist, Oral Dental Assistant or Dental Hygienists. Then, through an integrative literature review, this study aimed to analyze whether the dentist feels prepared to deal with this problem, the attitudes taken by dentists when faced with situations in which they feel sexually harassed during their professional activity, as well as the feelings generated by the lived experience. For selection of articles, the databases PubMed, Virtual Health Library (VHL) and CAPES periodicals were used, and the sample of this review consisted of seven articles. After evaluating these studies, the results pointed to several harms for professionals that happen from work to personal life. Feelings of anxiety, fear, and discouragement to do their job were reported, as well as nightmares and distressing memories of the lived moment. It was also found that Dentists do not feel professionally prepared to deal with situations of sexual harassment, and that they consider the inclusion of the subject in undergraduate dentistry curricula extremely relevant

Implementation of endoscopic submucosal dissection in a country with a low incidence of gastric cancer: Results from a prospective national registry.

INTRODUCTION: Endoscopic submucosal dissection (ESD) has become the treatment of choice for early gastric malignancies. In recent years, the ESD technique has been implemented in Western countries with increasing use. OBJECTIVES: To describe the results of gastric ESD in a Western country with a low incidence of gastric cancer. PATIENTS AND METHODS: The prospective national registry was conducted over 4 years in 23 hospitals, including 30 endoscopists. Epithelial and subepithelial lesions (SEL) qualified to complete removal with ESD were assessed. The technique, instruments, and solution for submucosal injection varied at the endoscopist's discretion. ESD was defined as difficult when: en-bloc resection was not achieved, had to be converted to a hybrid resection, lasted more than 2 h or an intraprocedural perforation occurred. Additionally, independent risk factors for difficult ESD were analyzed. RESULTS: Two hundred and thirty gastric ESD in 225 patients were performed from January 2016 to December 2019 (196 epithelial and 34 SEL). Most lesions were located in the lower stomach (111; 48.3%). One hundred and twenty-eight (55.6%) ESD were considered difficult. The median procedure time was 105 min (interquartile range [IQR]: 60-150). The procedure time for SEL was shorter than for epithelial lesions (90 min [45-121] vs. 110 min [62-160]; p = 0.038). En-bloc, R0, and curative resection rates were 91.3%, 75.2%, and 70.9%, respectively. Difficult ESD had lower R0 resection rates than ESD that did not meet the difficulty criteria (64.8% and 87.6%; p = 0.000, respectively). Fibrosis and poor maneuverability were independent factors associated with difficult ESD (OR 3.6, 95%CI 1.1-11.74 and OR 5.07, 95%CI 1.6-16.08; respectively). CONCLUSIONS: Although the number of cases is limited, the results of this analysis show acceptable en-bloc and R0 rates in gastric ESD considering the wide variability in experience among the operators. Fibrosis and poor maneuverability were associated with more difficulty in completing ESD.

Factores asociados con la automedicación no responsable en el Perú / Factors associated with non-responsible self-medication in Peru

Introducción:La automedicación no responsable conduce a una baja efectividad e inseguridad en los tratamientos, daños a la salud e insatisfacción del paciente. Objetivo: Identificar los factores asociados con la automedicación no responsable en la población peruana. Se realizó un estudio analítico Material y Métodos:transversal basado en el análisis secundario de la Encuesta Nacional de Satisfacción de Usuarios en Salud 2016 realizada en Perú. Incluyó 3849 usuarios de establecimientos farmacéuticos. Se calcularon: chi-cuadrado con valor p, odds ratio crudo (ORc) y odds ratio ajustado (ORa) con su intervalos de confianza del 95% (IC 95%). El Resultados:riesgo de automedicación no responsable fue muy alto cuando el dispensador del medicamento no solicitó la receta del usuario (ORa = 29,057). Además, acudir al establecimiento farmacéutico para pedir consejo (ORa= 1,884), el consumo eventual del medicamento comprado (ORa= 1,925), menos de cinco minutos de demora en la compra del medicamento (ORa= 1,587) y ser hombre (ORa= 1,321) también fueron factoresderiesgo.Laproximidaddelestablecimientofarmacéuticoalos establecimientos de salud del primer y segundo nivel de atención también actuó como un factor de riesgo (ORa= 1,340 y 1,652, respectivamente). La falta de Conclusión:solicitud de prescripción en el establecimiento farmacéutico fue el principal factor de riesgo para la automedicación no responsable

Introduction:Non-responsible self-medication leads to low effectiveness and insecurity in treatments, damage of health and patient dissatisfaction.To Objective:identify factors associated with non-responsible self-medication in the Peruvian population.:Ananalyticalcross-sectionalstudywas MaterialandMethodsconducted based on the secondary analysis of the National Survey of Users Satisfaction in Health performed in Peru in 2016. It included 3849 users of pharmaceutical establishments. Chi-square statistic with p-value, crude odds ratio (cOR) and adjusted odds ratio (aOR) with its 95% confidence interval (95% CI) were calculated. Results:When the dispenser of the medicine did not request the prescription from the user, the risk of non-responsible self-medication was very high (aOR=29.057). Additionally, going to the pharmaceutical establishment to ask for advice (aOR=1.884), eventual consumption of the purchased medicine (aOR=1.925), less than five minutes delay in purchasing medicine (aOR=1.587) and being male (aOR=1.321) were also risk factors. The proximity of the pharmaceutical store to health services from the first and second level of health care also acted as a risk factor (cOR=1.340 and 1.652, respectively). Conclusion:The lack of request for prescription in the pharmaceutical establishment was the main risk factor for non-responsible self-medication

Factores asociados con la automedicación no responsable en el Perú / Factors associated with non-responsible self-medication in Peru

RESUMEN Introducción: La automedicación no responsable conduce a una baja efectividad e inseguridad en los tratamientos, daños a la salud e insatisfacción del paciente. Objetivo: Identificar los factores asociados con la automedicación no responsable en la población peruana. Material y Métodos: Se realizó un estudio analítico transversal basado en el análisis secundario de la Encuesta Nacional de Satisfacción de Usuarios en Salud 2016 realizada en Perú. Incluyó 3849 usuarios de establecimientos farmacéuticos. Se calcularon: chi-cuadrado con valor p, odds ratio crudo (ORc) y odds ratio ajustado (ORa) con su intervalos de confianza del 95% (IC 95%). Resultados: El riesgo de automedicación no responsable fue muy alto cuando el dispensador del medicamento no solicitó la receta del usuario (ORa = 29,057). Además, acudir al establecimiento farmacéutico para pedir consejo (ORa= 1,884), el consumo eventual del medicamento comprado (ORa= 1,925), menos de cinco minutos de demora en la compra del medicamento (ORa= 1,587) y ser hombre (ORa= 1,321) también fueron factores de riesgo. La proximidad del establecimiento farmacéutico a los establecimientos de salud del primer y segundo nivel de atención también actuó como un factor de riesgo (ORa= 1,340 y 1,652, respectivamente). Conclusión: La falta de solicitud de prescripción en el establecimiento farmacéutico fue el principal factor de riesgo para la automedicación no responsable.

ABSTRACT Introduction: Non-responsible self-medication leads to low effectiveness and insecurity in treatments, damage of health and patient dissatisfaction. Objective: To identify factors associated with non-responsible self-medication in the Peruvian population. Material and Methods: An analytical cross-sectional study was conducted based on the secondary analysis of the National Survey of Users Satisfaction in Health performed in Peru in 2016. It included 3849 users of pharmaceutical establishments. Chi-square statistic with p-value, crude odds ratio (cOR) and adjusted odds ratio (aOR) with its 95% confidence interval (95% CI) were calculated. Results: When the dispenser of the medicine did not request the prescription from the user, the risk of non-responsible self-medication was very high (aOR=29.057). Additionally, going to the pharmaceutical establishment to ask for advice (aOR=1.884), eventual consumption of the purchased medicine (aOR=1.925), less than five minutes delay in purchasing medicine (aOR=1.587) and being male (aOR=1.321) were also risk factors. The proximity of the pharmaceutical store to health services from the first and second level of health care also acted as a risk factor (cOR=1.340 and 1.652, respectively). Conclusion: The lack of request for prescription in the pharmaceutical establishment was the main risk factor for non-responsible self-medication.

Moving toward Smart Cities: Evaluation of the Self-Cleaning Properties of Si-Based Consolidants Containing Nanocrystalline TiO2 Activated by either UV-A or UV-B Radiation.

This study evaluated the self-cleaning ability and durability of Si-based consolidants (an ethyl silicate consolidant and a consolidant based on nanosized silica) spiked with nanocrystalline TiO2 activated by either UV-A radiation (spectral region between 340 and 400 nm, and main peak at 365 nm) or UV-B radiation (spectral region between 270 and 420 nm, and main peak at 310 nm). Granite samples were coated with consolidant, to which nanocrystalline TiO2 was added at different concentrations (0.5, 1, and 3%, by wt.). Diesel soot was then applied to the coated surfaces, and the samples were exposed to UV-A or UV-B radiation for 1650 h. The surface color changes, relative to the color of untreated granite, were determined every 330 h by color spectrophotometry. Slight color changes indicated a recovery of the reference color due to the degradation of the soot. The final surfaces of both the untreated and treated surfaces were compared by stereomicroscopy and scanning electron microscopy. The main findings were that: (1) In general, the consolidant containing nanosized silica induced the most intense photocatalytic activity. In the more compact xerogel coating formed by the nanosized silica, more TiO2 nanoparticles were available to interact with the radiation. (2) For all consolidant mixtures, soot degradation remained constant or decreased over time, except with ethyl silicate with 0.5 wt % TiO2 (no self-cleaning capacity). (3) Soot degradation increased with the concentration of TiO2. (4) The UV-B radiation was the most effective in terms of soot degradation, except for the surface coated with the ethyl silicate and 3% wt. TiO2.

Acute depletion of telomerase components DKC1 and NOP10 induces oxidative stress and disrupts ribosomal biogenesis via NPM1 and activation of the P53 pathway.

Mutations in DKC1, NOP10, and TINF2 genes, coding for proteins in telomerase and shelterin complexes, are responsible for diverse diseases known as telomeropathies and ribosomopathies, including dyskeratosis congenita (DC, ORPHA 1775). These genes contribute to the DC phenotype through mechanisms that are not completely understood. We previously demonstrated in models of DC that oxidative stress is an early and independent event that occurs prior to telomere shortening. To clarify the mechanisms that induce oxidative stress, we silenced genes DKC1, NOP10, and TINF2 with siRNA technology. With RNA array hybridisation, we found several altered pathways for each siRNA model. Afterwards, we identified common related genes. The silenced cell line with the most deregulated genes and pathways was siNOP10, followed by siDKC1, and then by siTINF2 to a lesser extent. The siDKC1 and siNOP10 models shared altered expression of genes in the p53 pathway, while siNOP10 and siTINF2 had the adherens junction pathway in common. We also observed that depletion of DKC1 and NOP10 H/ACA ribonucleoprotein produced ribosomal biogenesis impairment which, in turn, promoted p53 pathway activation. Finally, we found that those enzymes responsible for GSH synthesis were down-regulated in models of siDKC1 and siNOP10. In contrast, the silenced cells for TINF2 showed no disruption of ribosomal biogenesis or oxidative stress and did not produce p53 pathway activation. These results indicate that depletion of DKC1 and NOP10 promotes oxidative stress and disrupts ribosomal biogenesis which, in turn, activates the p53 pathway.

Laryngeal paralysis detected in preoperative laryngoscopy in malignant and benign thyroid disease. Systematic review and meta-analysis. / Parálisis laríngea detectada en la laringoscopia preoperatoria en enfermedad de tiroides maligna y benigna. Revisión sistemática y metaanálisis.

There is controversy regarding the performance of preoperative laryngoscopy (LP) in thyroid surgery, with different recommendations being made, based on observational studies, in various publications. The aim of the study was to know the prevalence of laryngeal paralysis found in the LPs of patients who underwent thyroidectomy in benign and malignant pathology. A systematic review was carried out with 29 articles included for the qualitative study and a meta-analysis of 13 articles in which the data could be obtained to evaluate the same effect (in all patients in which an LP was carried out, those with preoperative laryngeal paralysis were included, and assigned to malignant or benign postoperative histology groups). The pooled prevalence of preoperative paralysis in benign pathology was 1.1% (95% CI 0.7 to 1.7%, 71% I2) and in 6.3% malignant pathology (95% CI 3.8 to 9.4%; I2 85%). The prevalence was significantly higher among patients with malignant pathology with an estimated effect RR 5.66, 95% CI, 2.48, 12.88. The studies analyzed present biases that will need to be corrected in future research, eliminating blinding biases in the selection and allocation of patients or in the laryngoscopy technique used. The LP in thyroid surgery evaluates possible disorders of laryngeal motility. The prevalence of laryngeal paralysis in thyroid pathology found in LPs in patients with a postoperative diagnosis of malignant pathology was higher than in the benign pathology group. This information is necessary for interpreting the intraoperative neuromonitoring signal and for making informed decisions.

Changes in Corneal Expression of MUC5AC after Autologous Serum Eyedrop Treatment in Patients with Limbal Stem Cell Deficiency.

Purpose: To evaluate the effect of autologous serum eyedrops treatment on corneal expression of the MUC5AC in patients with limbal deficiency. Methods: A prospective and comparative interventional case series study of 42 eyes of 21 patients was performed before and 8 weeks after treatment with autologous serum. All patients underwent a complete ophthalmic assessment of the tear film and ocular surface, corneal impression cytology (IC) and MUC5AC detection by Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Results: Forty-one of the 42 eyes studied were available for both conventional cytology and MUC5AC analysis prior to and after treatment. Differences between outcomes obtained by impression cytology and MUC5AC detection were found in 9 of 82 samples (11%). We found changes in the corneal expression of MUC5AC after treatment in 19 of 41 eyes (46.3%): 18 of them (94.7%) changed from positive to negative expression, and 1 eye (5.3%) changed from negative to positive MUC5AC expression after autologous serum eyedrops. These changes were related with the corneal involvement prior to treatment (15 of them (78.9%) occurred in patients with slight corneal involvement), and with the improvement in the degree of squamous metaplasia after treatment (P = .001 and P = .003, respectively). Conclusions: The treatment significantly improved tear stability, squamous metaplasia, and subjective patient perception. Autologous serum eyedrops treatment diminished the corneal expression of MUC5AC mainly in patients with slight corneal involvement before treatment.

Extracellular histones activate autophagy and apoptosis via mTOR signaling in human endothelial cells.

Circulating histones have been proposed as targets for therapy in sepsis and hyperinflammatory symptoms. However, the proposed strategies have failed in clinical trials. Although different mechanisms for histone-related cytotoxicity are being explored, those mediated by circulating histones are not fully understood. Extracellular histones induce endothelial cell death, thereby contributing to the pathogenesis of complex diseases such as sepsis and septic shock. Therefore, the comprehension of cellular responses triggered by histones is capital to design effective therapeutic strategies. Here we report how extracellular histones induce autophagy and apoptosis in a dose-dependent manner in cultured human endothelial cells. In addition, we describe how histones regulate these pathways via Sestrin2/AMPK/ULK1-mTOR and AKT/mTOR. Furthermore, we evaluate the effect of Toll-like receptors in mediating autophagy and apoptosis demonstrating how TLR inhibitors do not prevent apoptosis and/or autophagy induced by histones. Our results confirm that histones and autophagic pathways can be considered as novel targets to design therapeutic strategies in endothelial damage.

Lymphocytoma cutis on the inguinal region: report of a rare case of benign lymphoproliferative disorder.

Lymphocytoma cutis, or benign reactive lymphoid hyperplasia, is an inflammatory skin lesion that mimics clinically and histologically malignant lymphoma. Most cases are idiopathic, but they may also be triggered by multiple factors, such as insect bites, tattoos, injections and herpes zoster. Clinically, the lesions are erythematous, soft papules, plaques or nodules, usually located on the upper limbs and face. The diagnosis is mainly based on histopathology and immunohistochemistry. Corticosteroid injections, cryosurgery, PUVA therapy, radiotherapy and surgery can be therapeutic options in cases requiring immediate treatment. To demonstrate an atypical presentation of this tumor, a case lymphocytoma skin on the groin will be reported, describing its diagnosis and treatment.

Role of p16INK4a and BMI-1 in oxidative stress-induced premature senescence in human dental pulp stem cells.

Human dental pulp stem cells (hDPSCs) are a source for cell therapy. Before implantation, an in vitro expansion step is necessary, with the inconvenience that hDPSCs undergo senescence following a certain number of passages, loosing their stemness properties. Long-term in vitro culture of hDPSCs at 21% (ambient oxygen tension) compared with 3-6% oxygen tension (physiological oxygen tension) caused an oxidative stress-related premature senescence, as evidenced by increased ß-galactosidase activity and increased lysil oxidase expression, which is mediated by p16INK4a pathway. Furthermore, hDPSCs cultured at 21% oxygen tension underwent a downregulation of OCT4, SOX2, KLF4 and c-MYC factors, which was recued by BMI-1 silencing. Thus, p16INK4a and BMI-1 might play a role in the oxidative stress-associated premature senescence. We show that it is important for clinical applications to culture cells at physiological pO2 to retain their stemness characteristics and to delay senescence.