Evaluation of the efficacy of a live Escherichia coli biotherapeutic product (asymptomatic bacteriuria E. coli 212).

BACKGROUND: Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed. HYPOTHESIS/OBJECTIVE: Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs. ANIMALS: Thirty-four dogs with >1 UTI in the 12 months before presentation. METHODS: All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture. RESULTS: Clinical cure rates for ASB E. coli 212-treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non-inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline. CONCLUSIONS AND CLINICAL IMPORTANCE: These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.

Convergence of SARS-CoV-2 spike antibody levels to a population immune setpoint.

BACKGROUND: Individual immune responses to SARS-CoV-2 are well-studied, while the combined effect of these responses on population-level immune dynamics remains poorly understood. Given the key role of population immunity on pathogen transmission, delineation of the factors that drive population immune evolution has critical public health implications. METHODS: We enrolled individuals 5 years and older selected using a multistage cluster survey approach in the Northwest and Southeast of the Dominican Republic. Paired blood samples were collected mid-pandemic (Aug 2021) and late pandemic (Nov 2022). We measured serum pan-immunoglobulin antibodies against the SARS-CoV-2 spike protein. Generalized Additive Models (GAMs) and random forest models were used to analyze the relationship between changes in antibody levels and various predictor variables. Principal component analysis and partial dependence plots further explored the relationships between predictors and antibody changes. FINDINGS: We found a transformation in the distribution of antibody levels from an irregular to a normalized single peak Gaussian distribution that was driven by titre-dependent boosting. This led to the convergence of antibody levels around a common immune setpoint, irrespective of baseline titres and vaccination profile. INTERPRETATION: Our results suggest that titre-dependent kinetics driven by widespread transmission direct the evolution of population immunity in a consistent manner. These findings have implications for targeted vaccination strategies and improved modeling of future transmission, providing a preliminary blueprint for understanding population immune dynamics that could guide public health and vaccine policy for SARS-CoV-2 and potentially other pathogens. FUNDING: The study was primarily funded by the Centers for Disease Control and Prevention grant U01GH002238 (EN). Salary support was provided by Wellcome Trust grant 206250/Z/17/Z (AK) and the Australian National Health and Medical Research Council Investigator grant APP1158469 (CLL).

KRAS Exon 2 Mutations in Patients with Sporadic Colorectal Cancer: Prevalence Variations in Mexican and Latin American Populations.

We searched for the prevalence of actionable somatic mutations in exon 2 of the KRAS gene in western Mexican patients with CRC. Tumor tissue DNA samples from 150 patients with sporadic CRC recruited at the Civil Hospital of Guadalajara were analyzed. Mutations in exon 2 of the KRAS gene were identified using Sanger sequencing, and the data were analyzed considering clinical-pathological characteristics. Variants in codon 12 (rs121913529 G>A, G>C, and G>T) and codon 13 (rs112445441 G>A) were detected in 26 patients (with a prevalence of 17%). No significant associations were found between these variants and clinical-pathological characteristics (p > 0.05). Furthermore, a comprehensive search was carried out in PubMed/NCBI and Google for the prevalence of KRAS exon 2 mutations in Latin American populations. The 17 studies included 12,604 CRC patients, with an overall prevalence of 30% (95% CI = 0.26-0.35), although the prevalence ranged from 13 to 43% across the different data sources. Determining the variation and frequency of KRAS alleles in CRC patients will enhance their potential to receive targeted treatments and contribute to the understanding of the genomic profile of CRC.

Enfermedad del legionario en Argentina: evolución de la estrategia diagnóstica en el laboratorio / Legionnaires' disease in Argentina: Evolution of the laboratory diagnostic strategy

Resumen La enfermedad del legionario (EL) es una neumonía aguda grave, que ocurre espo-rádicamente o como epidemias, y que, generalmente, requiere hospitalización. El objetivo deeste trabajo fue describir la experiencia en el abordaje diagnóstico de laboratorio de la ELen Argentina durante el período 2016-2021. Se analizaron 168 especímenes clínicos correspondientes a 93 casos de neumonía con sospecha de EL. Las pruebas de laboratorio incluyeron ladeterminación del antígeno soluble de Legionella pneumophila serogrupo 1 en orina, la detec-ción de ADN de Legionella spp. en secreciones respiratorias bajas, por métodos moleculares convencionales y comerciales de tipo sindrómico, y el cultivo en medio selectivo. Se confirmó EL en 12 pacientes. El antígeno urinario confirmó el diagnóstico de 8 de ellos. Se recuperó L. pneumophila mediante el cultivo del material respiratorio de 6 pacientes que correspondieron a casos de neumonía asociada a cuidados de la salud y que fueron previamente diagnosticados por el método molecular comercial. La mitad de ellos no presentó antigenuria detectable. En un único paciente no hubo antigenuria detectable ni recuperación de Legionella en cultivo, y la confirmación de EL se basó en la detección de ADN de Legionella spp. por PCR en secreción respiratoria y el vínculo epidemiológico con otro caso de EL confirmado por cultivo. La detección del antígeno urinario es la prueba diagnóstica de primera línea. Sin embargo, la incorporación de métodos moleculares complementarios ha demostrado evitar falsos negativos y contribuir a un mejor conocimiento de la verdadera incidencia de la enfermedad.

Abstract Legionnaires' disease (LD) is severe acute pneumonia that occurs in sporadic or epidemic form, and generally requires hospitalizaron. The objective of this work was to describe the experience in the LD laboratory diagnostic approach in Argentina during the period 2016-2021. The laboratory analyzed 168 clinical specimens from 93 cases of suspected LD pneu-monia. Laboratory tests included the detection of the soluble antigen of Legionella pneumophila serogroup 1 in urine sample, detection of DNA of Legionella spp. in lower respiratory secre-tions by conventional and commercial molecular methods and isolation in selective medium. LD was confirmed in 12 patients. The urinary antigen allowed the diagnosis for 8 patients. L. pneumophila was isolated from the respiratory material of 6 patients suffering from health care-associated pneumonia, who had been previously diagnosed using the commercial molecular method. Fifty percent of these cases did not show detectable urinary antigen. A single patient did not shows neither detectable antigenuria nor isolation of Legionella from the respiratory sample and was diagnosed as a confirmed case of LD by the detection of DNA of Legionella spp. by PCR directly from the respiratory secretion and the epidemiological link with another case of confirmed LD by culture. Urinary antigen detection is the first-line diagnostic test. However, the incorporation of complementary molecular methods has proved to avoid false negatives and contributed to a better understanding of the true incidence of the disease.

The Role of Magnetic Transcranial Stimulation in the Diagnosis and Post-Surgical Follow-Up of Cervical Spondylotic Myelopathy.

Degenerative cervical myelopathy (DCM) consists of spinal cord damage due to its compression through the cervical spine. The leading cause is degenerative. The diagnosis is clinical, and the therapeutic approach is usually surgical. Confirmation of the diagnostic suspicion is done by magnetic resonance imaging (MRI); however, this test lacks functional information of the spinal cord, the abnormality of which may precede involvement in neuroimaging. Neurophysiological examination using somatosensory evoked potentials (SSEPs) and transcranial magnetic stimulation (TMS) allows for an evaluation of spinal cord function, and provides information in the diagnostic process. Its role in the post-surgical follow-up of patients undergoing decompressive surgery is being studied. We present a retrospective study of 24 patients with DCM and surgical decompression who underwent neurophysiological tests (TMS and SSEP) before, 6, and 12 months after surgery. The result of the TMS and the SSEP in the post-operative follow-up did not correlate with the clinical outcome, either subjective or measured by clinical scales at six months. We only found post-surgical improvement of central conduction times (CMCTs) in patients with severe pre-surgical motor impairment on TMS. In patients with normal pre-surgical CMCT, we found a transient worsening with return to baseline at the one-year follow-up. Most patients presented pre-surgical increased P40 latency at diagnosis. CMCT and SSEP were more related to clinical outcomes one year after the surgical procedure and were very useful in diagnosing.

Salud mental colectiva: una revisión del concepto en la literatura académica de Brasil, Colombia y España / Collective mental health: a review of the concept in the academic literature of Brazil, Colombia, and Spain

Resumen La noción de salud mental colectiva hace referencia a una propuesta alternativa a la perspectiva biomédica y conductual que ha ido adquiriendo centralidad en las publicaciones académicas de Brasil, España y Colombia, especialmente en las dos últimas décadas. Con el fin de comprender el sentido que adquiere dicha noción, se realizó un análisis del concepto desde una revisión narrativa que empleó criterios intencionados para la selección del material. Se identificaron matices particulares en cada país y/o sus problemáticas asociadas, en estrecha conexión con las particularidades históricas y socioculturales de cada escenario. Las violencias relacionadas con las lógicas manicomiales (Brasil, España) y aquellas derivadas del conflicto armado y la violencia política (Colombia) son las problemáticas en las que la salud mental colectiva aporta orientaciones epistemológicas y modelos de prácticas para el acompañamiento en contextos de sufrimiento social. El deslinde entre lo colectivo y lo comunitario es el principal reto conceptual que emerge de la intersección entre la salud mental y la salud colectiva.

Abstract INTRODUCTION: The notion of collective mental health refers to an alternative proposal to the biomedical and behavioral perspective that has been gaining centrality in academic publications in Brazil, Spain, and Colombia, especially in the last two decades. METHOD: In order to understand the meaning acquired by this notion, an analysis of the concept was carried out through a narrative review that used intentional criteria for the selection of the material. RESULTS: nuances were identified in each country and/or its associated problems, in close connection with the historical and socio-cultural particularities of each scenario. Violence related to asylum logic (Brazil, Spain), and those derived from armed conflict and political violence (Colombia) are the problems where collective mental health provides epistemological and practical guidelines for accompaniment in contexts of social suffering. CONCLUSION: the delimitation between the collective and the community is the main conceptual challenge that emerges from the intersection between mental health and collective health.

SARS-CoV-2 seroprevalence, cumulative infections, and immunity to symptomatic infection - A multistage national household survey and modelling study, Dominican Republic, June-October 2021.

Background: Population-level SARS-CoV-2 immunological protection is poorly understood but can guide vaccination and non-pharmaceutical intervention priorities. Our objective was to characterise cumulative infections and immunological protection in the Dominican Republic. Methods: Household members ≥5 years were enrolled in a three-stage national household cluster serosurvey in the Dominican Republic. We measured pan-immunoglobulin antibodies against the SARS-CoV-2 spike (anti-S) and nucleocapsid glycoproteins, and pseudovirus neutralising activity against the ancestral and B.1.617.2 (Delta) strains. Seroprevalence and cumulative prior infections were weighted and adjusted for assay performance and seroreversion. Binary classification machine learning methods and pseudovirus neutralising correlates of protection were used to estimate 50% and 80% protection against symptomatic infection. Findings: Between 30 Jun and 12 Oct 2021 we enrolled 6683 individuals from 3832 households. We estimate that 85.0% (CI 82.1-88.0) of the ≥5 years population had been immunologically exposed and 77.5% (CI 71.3-83) had been previously infected. Protective immunity sufficient to provide at least 50% protection against symptomatic SARS-CoV-2 infection was estimated in 78.1% (CI 74.3-82) and 66.3% (CI 62.8-70) of the population for the ancestral and Delta strains respectively. Younger (5-14 years, OR 0.47 [CI 0.36-0.61]) and older (≥75-years, 0.40 [CI 0.28-0.56]) age, working outdoors (0.53 [0.39-0.73]), smoking (0.66 [0.52-0.84]), urban setting (1.30 [1.14-1.49]), and three vs no vaccine doses (18.41 [10.69-35.04]) were associated with 50% protection against the ancestral strain. Interpretation: Cumulative infections substantially exceeded prior estimates and overall immunological exposure was high. After controlling for confounders, markedly lower immunological protection was observed to the ancestral and Delta strains across certain subgroups, findings that can guide public health interventions and may be generalisable to other settings and viral strains. Funding: This study was funded by the US CDC.

Application of Bayesian Regression for the Identification of a Catchment Area for Cancer Cases in Dogs and Cats.

Research on cancer in dogs and cats, among other diseases, finds an important source of information in registry data collected from hospitals. These sources have proved to be decisive in establishing incidences and identifying temporal patterns and risk factors. However, the attendance of patients is not random, so the correct delimitation of the hospital catchment area (CA) as well as the identification of the factors influencing its shape is relevant to prevent possible biases in posterior inferences. Despite this, there is a lack of data-driven approaches in veterinary epidemiology to establish CA. Therefore, our aim here was to apply a Bayesian method to estimate the CA of a hospital. We obtained cancer (n = 27,390) and visit (n = 232,014) registries of dogs and cats attending the Veterinary Medical Teaching Hospital of the University of California, Davis from 2000 to 2019 with 2,707 census tracts (CTs) of 40 neighboring counties. We ran hierarchical Bayesian models with different likelihood distributions to define CA for cancer cases and visits based on the exceedance probabilities for CT random effects, adjusting for species and period (2000-2004, 2005-2009, 2010-2014, and 2015-2019). The identified CAs of cancer cases and visits represented 75.4 and 83.1% of the records, respectively, including only 34.6 and 39.3% of the CT in the study area. The models detected variation by species (higher number of records in dogs) and period. We also found that distance to hospital and average household income were important predictors of the inclusion of a CT in the CA. Our results show that the application of this methodology is useful for obtaining data-driven CA and evaluating the factors that influence and predict data collection. Therefore, this could be useful to improve the accuracy of analysis and inferences based on registry data.

Molecular Profiling of Tumor Tissue in Mexican Patients with Colorectal Cancer.

Colorectal cancer is a heterogeneous disease with multiple genomic changes that influence the clinical management of patients; thus, the search for new molecular targets remains necessary. The aim of this study was to identify genetic variants in tumor tissues from Mexican patients with colorectal cancer, using massive parallel sequencing. A total of 4813 genes were analyzed in tumoral DNA from colorectal cancer patients, using the TruSight One Sequencing panel. From these, 192 variants with clinical associations were found distributed in 168 different genes, of which 46 variants had not been previous reported in the literature or databases, although genes harboring those variants had already been described in colorectal cancer. Enrichment analysis of the affected genes was performed using Reactome software; pathway over-representation showed significance for disease, signal transduction, and immune system subsets in all patients, while exclusive subsets such as DNA repair, autophagy, and RNA metabolism were also found. Those characteristics, whether individual or shared, could give tumors specific capabilities for survival, aggressiveness, or response to treatment. Our results can be useful for future investigations targeting specific characteristics of tumors in colorectal cancer patients. The identification of exclusive or common pathways in colorectal cancer patients could be important for better diagnosis and personalized cancer treatment.

Interaction of CCND2, CDKN1A, and POLD3 Variants in Mexican Patients with Colorectal Cancer.

BACKGROUND: Colorectal cancer is the second cause of death by cancer around the world. Sporadic colorectal cancer is the most frequent (75%), and it is produced by the interaction of environmental, epigenetic, and genetic factors. The accumulation of single-nucleotide variants in genes associated with cell proliferation, DNA repair, and/or apoptosis could confer a risk to cancer. The aim of this study was to analyze the gene-gene interactions among CCND2 (rs3217901), CDKN1A (rs1059234 and rs1801270), and POLD3 (rs3824999) variants in Mexican patients with colorectal cancer. METHODS: We collected peripheral blood samples from 185 patients with sporadic colorectal cancer before treatment and from 185 unrelated blood donors as the reference group; all participants signed an informed consent form. DNA extraction was performed by Miller and Cetyltrimethylammonium bromide (CTAB)/ Dodecyltrimethylammonium bromide (DTAB) methods. Polymerase chain reaction- restriction fragment length polymorphism followed by polyacrylamide gel electrophoresis stained with AgNO3 methods were used to identify the variants rs3217901, rs1059234, rs1801270, and rs3824999. Odds ratio and single-nucleotide variant interaction were determined by single-locus analysis and Multifactorial Dimensionality Reduction software, respectively. RESULTS: No association was found for CCND2 and CDKN1A variants; yet, a significant association for the GG genotype, G allele, and recessive and additive models for the POLD3 variant was observed (P < .05). The single-nucleotide variant-single-nucleotide variant interaction revealed the combination rs1059234, rs3217901, and rs3824999 as the best model and the comparison showed an increased risk (P < .05). CONCLUSION: Single-locus and gene-gene interaction analyses disclosed that both the rs3824999 (POLD3) variant and the combination of rs3217901 (CCND2), rs1059234 (CDKN1A), and rs3824999 (POLD3) genotypes increase the risk for colorectal cancer in Mexican population.

Apuntes históricos sobre del proceso de formación del médico general integral en Cuba / Historical notes on the training process of the comprehensive general doctor in Cuba

La salud pública cubana se sustenta en la Atención Primaria de Salud y, con ello, la instauración de la especialidad de medicina general integral en 1985, con cambios sustanciales hasta la actualidad, ha dado un importante paso de avance en la accesibilidad y calidad en los servicios médicos; transformación necesaria en el Sistema Nacional de Salud. Teniendo en cuenta lo anterior se realizó el presente estudio con vistas a profundizar en las tendencias históricas por las que ha transitado el proceso de formación del médico general integral en Cuba. Se concluye que dicho proceso ha tenido transformaciones que obedecen a las necesidades nacionales e internacionales, donde todas las versiones del programa consideran la educación en el trabajo como protagonista en los servicios de salud.

The Cuban public health is sustained in the Primary Health Care which improvement has been favored with the establishment of the comprehensive general medicine specialty in 1985, with substantial changes until the present time that have propitiated a step of important advance in the accessibility and quality in the medical services. Taking into account the above-mentioned the present study was carried out aimed at deepening in the historical tendencies that the training process of the comprehensive general doctor in Cuba has gone through. It was concluded that this process has had transformations that obey the national and international necessities, where all the versions of the program consider the education at work as main character in health services.

Historia de la Cirugía General en Cuba y el mundo

RESUMEN Introducción: La cirugía es tan antigua como la historia de la humanidad, se remonta a los tiempos más lejanos cuando el hombre hace su aparición en el teatro de la historia, a raíz de la individualidad física, psíquica y social. Objetivo: Abordar aspectos importantes de la historia de la Cirugía General desde la antigüedad hasta la actualidad y su desarrollo en Cuba. Método: Se realizó una revisión bibliográfica en la base de datos de la National Library of Medicine, PubMed, Google Académico, Web of Science, ClinicalKey, Elsevier, ResearchGate y páginas web de distintas especialidades que recomendaron artículos de interés en relación al tópico para la reconstrucción del surgimiento de la cirugía desde la antigüedad hasta la actualidad. Resultados: Se recopilaron apuntes cronológicos divididos en: La cirugía en la antigüedad, América precolombina, La Edad Media y el Renacimiento, Desarrollo de la cirugía general en Cuba (breve recorrido 1354 hasta la actualidad). Consideraciones finales: El desarrollo de la cirugía comienza desde la antigüedad como necesidad, la especialización de los cirujanos generales en Cuba comienza a partir del siglo XVIII, cuando se separa de la cátedra de Anatomía para hacer la disciplina quirúrgica, lo cual ha tenido un progreso mantenido a lo largo de la historia, cuya magnitud es consecuente con el grado de desarrollo de la sociedad y de las limitaciones externas e internas, lo que se considera como un hito en el desarrollo de esta especialidad hasta la actualidad, con avances científicos, técnicos y anestésicos quirúrgicos de lo cual Cuba hoy exhibe a nivel mundial.

ABSTRACT Introduction: Surgery is as old as the history of humanity. It goes back to the most distant times when man made his appearance, as a result of physical, mental and social individuality. Objective: To approach important aspects of the history of General Surgery from ancient times to the present and its development in Cuba. Method: A bibliographic review was carried out in the database of the National Library of Medicine, PubMed, Google Scholar, Web of Science, ClinicalKey, Elsevier, ResearchGate and web pages of different specialties that recommended articles of interest in relation to the topic for research, to reconstruct the emergence of surgery from antiquity to the present day. Results: Chronological notes were compiled, divided into the next categories: Surgery in antiquity, pre-Columbian Americas, The Middle Ages and the Renaissance, Development of general surgery in Cuba (brief journey from 1354 to the present). Final considerations: The development of surgery begins from antiquity as a necessity; the specialization of general surgeons in Cuba begins in the eighteenth century, when it is separated from the Anatomy chair to perform as the surgical discipline, which has had a sustained progress throughout history. Its magnitude is consistent with the degree of development of society and society´s external and internal limitations. The development of this specialty in Cuba is considered a milestone, exhibiting high standards of scientific, technical and surgical-anesthetic advances today.

RESUMO Introdução: A cirurgia é tão antiga quanto a história da humanidade, remonta aos tempos mais distantes em que o homem faz sua aparição no teatro da história, fruto da individualidade física, mental e social. Objetivo: Tratar aspectos importantes da história da Cirurgia Geral desde a antiguidade até o presente e seu desenvolvimento em Cuba. Método: Foi realizada revisão bibliográfica na base de dados da National Library of Medicine, PubMed, Google Scholar, Web of Science, ClinicalKey, Elsevier, ResearchGate e páginas da web de diferentes especialidades que recomendavam artigos de interesse em relação ao tema para pesquisa reconstrução do surgimento da cirurgia desde a antiguidade até o presente. Resultados: Foram compiladas notas cronológicas divididas em: Cirurgia na antiguidade, América pré-colombiana, Idade Média e Renascimento, Desenvolvimento da cirurgia geral em Cuba (breve viagem de 1354 até o presente). Considerações finais: O desenvolvimento da cirurgia começa desde a antiguidade como uma necessidade, a especialização dos cirurgiões gerais em Cuba começa no século XVIII, quando se separa da cadeira de Anatomia para fazer a disciplina cirúrgica, que teve um progresso mantido ao longo da história , cuja magnitude é compatível com o grau de desenvolvimento da sociedade e limitações externas e internas, que é considerado um marco no desenvolvimento desta especialidade até hoje, com anestésicos científicos, técnicos e cirúrgicos que Cuba hoje exibe em todo o mundo.

The value of metabolic parameters and textural analysis in predicting prognosis in locally advanced cervical cancer treated with chemoradiotherapy.

OBJECTIVE: The aim of the study was to assess the impact of clinical and metabolic parameters derived from 18F-FDG PET/CT (positron emission tomography-computed tomography) in patients with locally advanced cervical cancer (LACC) on prognosis. METHODS: Patients with LACC of stage IB2-IVA treated by primary radiochemotherapy followed by brachytherapy were enrolled in this retrospective study. Indexes derived from standardized uptake value (SUV), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and textural features of the primary tumor were measured for each patient. Overall survival (OS) and recurrence-free survival (RFS) rates were calculated according to Kaplan-Meier and survival curves were compared using the log-rank test. Uni- and multivariate analyses were performed using the Cox regression model. RESULTS: A total of 116 patients were included. Median follow-up was 58 months (range: 1-129). A total of 36 (31%) patients died. Five-year OS and RFS rates were 69 and 60%, respectively. Univariate analyses indicated that FIGO stage, the presence of hydronephrosis, high CYFRA 21.1 levels, and textural features had a significant impact on OS and RFS. MTV as well as SCC-Ag concentration were also significantly associated with OS. On multivariate analysis, the presence of hydronephrosis, CYFRA 21.1, and sphericity were independent prognostics factors for OS and RFS. Also, SCC-Ag level, MTV, and GLZLM (gray-level zone length matrix) ZLNU (zone length non-uniformity) were significantly associated with OS. CONCLUSION: Classical prognostic factors and tumor heterogeneity on pretreatment PET/CT were significantly associated with prognosis in patients with LACC.

¿Qué se preguntan las enfermeras/os sobre el aborto? Una revisión panorámica / O que as enfermeiras se perguntam sobre o aborto? Uma revisão panorâmica / What are nurses asking about abortion? An overview review

Objetivo: Analizar las preguntas, metodologías y tendencias en investigaciones realizadas por enfermeras/os, con el fin de identificar los intereses disciplinares y posibles derivaciones en el desarrollo del conocimiento y las prácticas de cuidado. Metodología: Revisión panorámica en las bases de datos: Scielo, BVS, PubMed y Redalyc, con una ventana de búsqueda de 2008 a 2020, en idiomas español, inglés y portugués. Se incluyeron 33 artículos, produc-to de la búsqueda con términos de: MeSH, Nursing Care, Abortion, Abortion Applicants. Además, se emplearon expresiones en español sobre: cuidado de enfermería; enfermería; el aborto; el aborto y cuidado de enfermería en la salud pública; aborto inducido y cuidado de enfermería sobre salud mental; aborto criminal y salud mental; y, cuidado de enfermería frente a solicitantes de aborto. Análisis: Se observó una relación entre el tipo de estudios y el contexto jurídico de los países en que se realizaron. Son relevantes los estudios respecto de las actitudes, creencias y prácticas de enfermería en torno al aborto, poniendo el foco en la subjetividad de los profesionales de la disciplina. Resaltan los estudios cualitativos, haciendo acopio de teorías y conceptos de procedencia multidisciplinar y solo marginalmente de aquel-la producida por la disciplina de enfermería. Conclusiones: Las preguntas más frecuentes que se hacen las enfermeras/os sobre el aborto se dirigen especialmente a examinar las formas en que se provee el cuidado de enfermería a las mujeres que pasan por esta experiencia; del mismo modo se evidencia el correlato en las experiencias emocionales y dilemas éticos para el personal de enfermería, constituyéndose en un fenómeno controversial. Lo expuesto anteriormente implica para la disciplina de enfermería ampliar el repertorio para el abordaje epistemológico de este fenómeno, con miradas críticas transdisciplinares, que consideren el contexto social, cultural y normativo, con el fin de enriquecer la investigación disciplinar, que tenga efectos sobre la práctica profesional y los procesos de formación

Objective: Analyze the questions, methodologies and tendencies made in nursing research, with the purpose of identifying the disciplinary interests and possible derivations in the de-velopment of knowledge and care practices. Methodology: Scoping review in the databases: Scielo, BVS, Pubmed and Redalyc, with a search window from 2008 to 2020, in Spanish, English and Portuguese. Thirty-three articles were included, resulting from the search of the terms: MeSH, Nursing Care, Abortion, Abortion Applicants. Furthermore, the following Spanish expressions were used: nursing care; nursing; abortion; abortion and nursing care in public health; induced abortion and mental health nursing care; criminal abortion and men-tal health; and, nursing care for abortion applicants. Analysis: A relationship was observed between the type of studies and the legal context of the countries in which these were con-ducted. The studies about the attitudes, beliefs and nursing practices regarding abortion are relevant, focusing on the subjectivity of the professionals of this discipline. The qualitative studies stand out, gathering theories and concepts from multidisciplinary sources, and only marginally those from the nursing discipline. Conclusions: The most frequently asked ques-tions that nurses have about abortion are specially directed to examine the ways in which nursing care is provided to women who undergo this experience; similarly, the correlation between the emotional experiences and the ethical dilemmas for the nursing personnel is evi-denced, constituting a controversial phenomenon. The forementioned implies for the nursing discipline to broaden the repertoire for the epistemological approach of this phenomenon, with transdisciplinary critical views, that consider the social, cultural and regulatory context, in order to enrich the disciplinary research, having effects on the professional practice and the training processes

Objetivo: Analisar as questões, metodologias e tendências nas pesquisas realizadas pelos enfermeiros, a fim de identificar interesses disciplinares e possíveis derivações no desen-volvimento de práticas de conhecimento e cuidado. Metodologia: Revisão panorâmica nas bases de dados: Scielo, VHL, PubMed e Redalyc, com uma janela de pesquisa entre 2008 e 2020, em espanhol, inglês e português. Foram incluídos 33 artigos, produto da pesquisa com termos: MeSH, Nursing Care, Abortion, Abortion Applicants. Além disso, foram utilizadas expressões em espanhol: cuidado de enfermería, enfermería, aborto, aborto e cuidado de enfermería e salud pública; aborto inducido e cuidado de enfermería e salud mental; aborto criminal e salud mental e cuidado de enfermería, solicitantes de aborto. Análise: Observou-se relação entre o tipo de estudo e o contexto jurídico dos países em que foram realizados. Estu-dos sobre atitudes, crenças e práticas de enfermagem em torno do aborto são relevantes, com foco na subjetividade dos profissionais da disciplina. Destacam-se estudos qualitativos, cole-cionando teorias e conceitos de origem multidisciplinar e apenas marginalmente produzidas pela disciplina de enfermagem. Conclusões: As perguntas mais frequentes das enfermeiras sobre o aborto visam especialmente examinar as formas como a assistência de enfermagem é prestada às mulheres que passam por essa experiência; da mesma forma, evidencia-se a correlação entre experiências emocionais e dilemas éticos para o pessoal de enfermagem, tornando-se um fenômeno controverso. Os achados implicam à disciplina de enfermagem ampliar o repertório para a abordagem epistemológica desse fenômeno, com perspectivas críticas transdisciplinares, que considerem o contexto social, cultural e normativo, a fim de enriquecer a pesquisa disciplinar, com efeitos na prática profissional e nos processos formativos

Reconciliación y salud mental colectiva. La reincorporación de los excombatientes de las FARC-EP en Colombia, 2020 / Reconciliation and Collective Mental Health. The Reincorporation of FARC-EP Ex-combatants in Colombia, 2020

Resumen Un desafío en Colombia, a partir de la firma del Acuerdo de Paz con las FARC-EP, es retejer los vínculos rotos entre excombatientes y sociedad, aspiración presente en propuestas de desarme, desmovilización y reincorporación; reconciliación y salud mental. Desde una investigación cualitativa con excombatientes, familiares y vecinos, se presentan aspectos relacionados con el ingreso, permanencia y reincorporación y las contradicciones del retorno a la vida civil. Incumplimientos, incertidumbre, ausencia de un relato de corresponsabilidad, estigma y reaprendizaje de los códigos de la vida social, entre otros, son examinados desde los encuentros cotidianos con comunidades receptoras en contextos rurales.

Abstract A challenge in Colombia, since the signing of the Peace Agreement with the FARCEP, is to reweave the broken links between ex-combatants and society, an aspiration present in proposals for disarmament, demobilization, and reincorporation; reconciliation and mental health. From qualitative research with ex-combatants, family members, and neighbors, aspects related to the entry, permanence, and reincorporation, and the contradictions of the return to civilian life are presented. Non-compliance, uncertainty, absence of a narrative of co-responsibility, stigma, and re-learning of the codes of social life, among others, are examined from daily encounters with receiving communities in rural contexts.

Efficacy and Safety Results from a Phase 2, Randomized, Double-Blind Study of Enzalutamide Versus Placebo in Advanced Hepatocellular Carcinoma.

BACKGROUND AND OBJECTIVE: Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related mortality worldwide. Despite recent advances, more effective therapeutic options for patients with advanced HCC are still required. The aim of this Phase 2, multicenter, multinational, randomized, double-blind, placebo-controlled study (NCT02528643) was to investigate the potential benefit of enzalutamide in the treatment of patients with advanced HCC. METHODS: Patients aged ≥ 18 years diagnosed with advanced HCC (Barcelona Clinic Liver Cancer stage B or C and Child-Pugh class A at screening who had progressed on, or were intolerant to, sorafenib or other anti-vascular endothelial growth factor therapies) were randomized 2:1 to receive either enzalutamide 160 mg daily or placebo. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS) and safety. RESULTS: In total, 165 patients were randomized to enzalutamide (n = 110) or placebo (n = 55). The hazard ratio (HR) (95% confidence interval [CI]) for OS was 1.15 (0.774-1.696) and median OS was 7.8 months and 7.7 months for enzalutamide and placebo, respectively. The HR (95% CI) for PFS was 1.04 (0.732-1.474) and median PFS was 2.2 months and 1.9 months for enzalutamide and placebo, respectively. The overall frequency of treatment-emergent adverse events (TEAEs) was broadly similar between the groups: 105 (98.1%) enzalutamide patients experienced ≥1 TEAEs compared with 49 (89.1%) placebo patients. CONCLUSIONS: The results of this study indicate that enzalutamide does not provide a benefit in patients with advanced HCC. No unexpected safety findings were observed in the trial. CLINICALTRIALS. GOV IDENTIFIER: NCT02528643.

Contradicción anestesiológica en una gestante con adenoma pleomórfico y alergia a los anestésicos locales / Anesthesiological contradiction in a pregnant woman with pleomorphic adenoma and allergy to local anesthetics

Introducción: El adenoma del paladar blando es frecuente en mujeres, aunado a los cambios fisiológicos que suceden durante el embarazo, es de presumir que la gestante puede presentar una vía aérea difícil. Objetivo: Describir el abordaje de la vía aérea en una gestante con adenoma del paladar blando. Presentación del caso: Se trata de una gestante de 20 años de edad con antecedentes patológicos personales de asma bronquial, alergia a los anestésicos locales, que presenta un adenoma en el paladar blando que impide ver la estructura de la orofaringe, Mallampatti IV, anunciada para procedimiento quirúrgico de urgencia para realizarle cesárea segmentaria anterior. Conclusiones: La embarazada presenta mayor incidencia de vía aérea difícil comparado con la población general, debido a los cambios fisiológicos que presenta en este periodo, si a ello se le adiciona la presencia de un tumor oro faríngeo que imposibilita la manipulación de la vía aérea, la evaluación preoperatoria y trazar una estrategia multidisciplinaria, constituyen los pilares para evitar complicaciones potencialmente fatales(AU)

Introduction: Adenoma of soft palate is frequent in women, together with the physiological changes that occur during pregnancy. The pregnant woman is to be presumed to have a difficult airway. Objective: To describe the airway managment in a pregnant woman with adenoma of soft palate. Case presentation: This is a 20-year-old pregnant woman (Mallampati IV) with a personal pathological history of bronchial asthma and allergy to local anesthetics, who presents an adenoma of soft palate that avoids seeing the oropharynx structure, announced for emergency surgical procedure for an anterior segmental cesarean section. Conclusions: The pregnant woman has a higher incidence of difficult airway compared to the general population, due to the physiological changes that she presents in this period. If, apart from this situation, the presence is considered of an oropharyngeal tumor that makes it impossible to manipulate the airway, preoperative assessment and tracing a multidisciplinary strategy are the pillars to avoid potentially fatal complications(AU)

Risk Assessment of Human Consumption of Meat From Fenbendazole-Treated Pheasants.

Fenbendazole is a benzimidazole-class anthelmintic that is used for the control of immature and adult stages of internal parasites, such as nematodes and trematodes, in domestic food-animal species. It is not approved by the United States Food and Drug Administration for treating pheasants despite Syngamus trachea being one of the most prevalent nematodes that parasitize pheasants. Because it is a highly effective treatment, e.g., 90% effectiveness against S. trachea, and there are very few alternative therapeutic options, this anthelminthic is used in an extra-label manner in the pheasant industry, but few studies have been conducted assessing risks to humans. Therefore, we conducted a risk assessment to evaluate the potential repeat-dose and reproductive, teratogenic, and carcinogenic human risks that may be associated with the consumption of tissues from pheasants that were previously treated with fenbendazole. We conducted a quantitative risk assessment applying both deterministic and stochastic approaches using different fenbendazole sulfone residue limits (tolerance, maximum residue limits, and analytical limit of detection) established in different poultry species by the Food and Drug Administration, the European Medicines Agency, and other regulatory agencies in Japan, Turkey, and New Zealand. Our results show that fenbendazole poses minimal risk to humans when administered to pheasants in an extra-label manner, and a comparison of different fenbendazole sulfone residue limits can help assess how conservative the withdrawal interval should be after extra-label drug use.

Long-Term V-EEG in Epilepsy: Chronological Distribution of Recorded Events Focused on the Differential Diagnosis of Epileptic Seizures and Psychogenic Non-Epileptic Seizures.

Differential diagnosis in epilepsy is sometimes challenging. Video-electroencephalography (V-EEG) is an essential tool in the diagnosis and management of epilepsy. The prolonged duration of V-EEG recording increases the diagnostic yield of a conventional V-EEG. The right length of monitoring for different indications is still to be established. We present a retrospective descriptive study with a sample of 50 patients with long-term V-EEG monitoring, with a mean age of 36.1 years, monitored from 2013 to 2019 at the Burgos University Hospital. The mean monitoring time was 3.6 days. Events were obtained in 76% of the patients, corresponding to epileptic seizures (ES) in 57.9% of them, with psychogenic non-epileptic seizures (PNES) in 39.5%, and with episodes of both pathologies in 2.6% of the patients. We found that the first event was highly representative, and it correlated with the rest of the events that would be recorded. Moreover, 92% of the first PNES had been captured at the end of the second day, and 89% of the first ES by the end of the third day. V-EEG for differential diagnosis between ES and PNES can be performed in hospitals without specialized epilepsy surgery units. For this indication, the duration of long-term V-EEG can be adjusted individually depending on the nature of the first event.