Canine preclinical safety evaluation of a multimodal nanoparticle agent (Nanotrast-CF800) for image-guided cancer surgery.

Surgical oncology often requires the use of contrast-enhanced cross-sectional imaging preoperatively to characterize solitary tumours and identify sentinel lymph nodes. Intraoperative optical guidance can effectively aid tissue-sparing tumour excision and locate sentinel lymph nodes. Nanotrast-CF800 (CF800) is a novel dual-modality contrast agent, which co-encapsulates iohexol and indocyanine green (ICG) within a liposomal nanoparticle. It was developed for preoperative and intraoperative imaging of solitary tumours and sentinel lymph node mapping and its efficacy has been demonstrated in preclinical animal models (Zheng et al. 2015). The objective of this study is to evaluate the safety profile of CF800 following intravenous administration in healthy dogs. Six research dogs were randomized into two groups. Group 1 received a low dose (1 mL/kg) and group 2 received a high dose (5 mL/kg). Dogs were placed under general anesthesia and a continuous rate infusion of CF800 was administered based on group allocation. Physiologic parameters including heart rate, respiratory rate, direct arterial blood pressure, cardiac output, and temperature were measured at set time points. Plasma concentrations of iohexol, ICG, and histamine were measured at set time points. Dogs underwent whole body computed tomography scans pre-injection, 2-, and 7-days post-injection (p.i.). Contrast enhancement was measured in select organ systems and great vessels at each time point. There were no significant changes in physiologic parameters following IV infusion of CF800 in all dogs. Plasma iohexol and ICG concentrations peaked at 1 day p.i., while histamine concentrations peaked at 30 minutes p.i. Significant contrast enhancement was noted within the liver, heart, aorta, and caudal vena cava on day 2 p.i., which was significantly different compared to baseline. Prolonged contrast retention within the liver was identified. Intravenous administration of CF800 was safe to use in healthy dogs with no significant systemic adverse effects.

Sex and Gender-related Disparities in Clinical Characteristics and Outcomes in Heart Transplantation.

PURPOSE OF REVIEW: Limited research has been conducted on sex disparities in heart transplant (HT). The aim of this review is to analyse the available evidence on the influence of sex and gender-related determinants in the entire HT process, as well as to identify areas for further investigation. RECENT FINDINGS: Although women make up half of the population affected by heart failure and related mortality, they account for less than a third of HT recipients. Reasons for this inequality include differences in disease course, psychosocial factors, concerns about allosensitisation, and selection or referral bias in female patients. Women are more often listed for HT due to non-ischaemic cardiomyopathy and have a lower burden of cardiovascular risk factors. Although long-term prognosis appears to be similar for both sexes, there are significant disparities in post-HT morbidity and causes of mortality (noting a higher incidence of rejection in women and of malignancy and cardiac allograft vasculopathy in men). Additional research is required to gain a better understanding of the reasons behind gender disparities in eligibility and outcomes following HT. This would enable the fair allocation of resources and enhance patient care.

Increased ER Stress and Unfolded Protein Response Activation in Epithelial and Inflammatory Cells in Hypersensitivity Pneumonitis.

Several types of cytotoxic insults disrupt endoplasmic reticulum (ER) homeostasis, cause ER stress, and activate the unfolded protein response (UPR). The role of ER stress and UPR activation in hypersensitivity pneumonitis (HP) has not been described. HP is an immune-mediated interstitial lung disease that develops following repeated inhalation of various antigens in susceptible and sensitized individuals. The aim of this study was to investigate the lung expression and localization of the key effectors of the UPR, BiP/GRP78, CHOP, and sXBP1 in HP patients compared with control subjects. Furthermore, we developed a mouse model of HP to determine whether ER stress and UPR pathway are induced during this pathogenesis. In human control lungs, we observed weak positive staining for BiP in some epithelial cells and macrophages, while sXBP1 and CHOP were negative. Conversely, strong BiP, sXBP1- and CHOP-positive alveolar and bronchial epithelial, and inflammatory cells were identified in HP lungs. We also found apoptosis and autophagy markers colocalization with UPR proteins in HP lungs. Similar results were obtained in lungs from an HP mouse model. Our findings suggest that the UPR pathway is associated with the pathogenesis of HP.

Thermoplastic polymers as water substitutes.

Background. New applications of 3D printing have recently appeared in the fields of radiotherapy and radiology, but the knowledge of many radiological characteristics of the compounds involved is still limited. Therefore, studies are needed to improve our understanding about the transport and interaction of ionizing radiation in these materials.Purpose. The purpose of this study is to perform an analysis of the most important radiation interaction parameters in thermoplastic materials used in Fused Deposition Modeling 3D printing. Additionally, we propose improvements to bring their characteristics closer to those of water and use them as water substitutes in applications such as radiodiagnosis, external radiotherapy, and brachytherapy.Methods. We have calculated different magnitudes as mass linear attenuation, mass energy absorption coefficients, as well as stopping power and electronic density of several thermoplastic materials along with various compounds that have been used as water substitutes and in a new proposed blend. To perform these computations, we have used the XCOM and ESTAR databases from NIST and the EGSnrc code for Montecarlo simulations.Results. From the representation of the calculated interaction parameters, we have been able to establish relationships between their properties and the proportion of certain chemical elements. In addition, studying these same characteristics in different commercial solutions used as substitutes for water phantoms allows us to extrapolate improvements for these polymers.Conclusion. The radiological characteristics of the analyzed thermoplastic materials can be improved by adding some chemical elements with atomic numbers higher than oxygen and by using polyethylene in new blends.

SuRxgWell: study protocol for a randomized controlled trial of telemedicine-based digital cognitive behavioral intervention for high anxiety and depression among patients undergoing elective hip and knee arthroplasty surgery.

BACKGROUND: Mood disorders (anxiety, depression), sleep disorders, and catastrophizing lead to increased post-operative pain perception, increase in postoperative opioid consumption, decreased engagement with physical activity, and increased resource utilization in surgical patients. Psychosocial disorders significantly affect postoperative outcome. Unfortunately, studies focused on perioperative psychological assessment and treatment are scarce. We propose to test whether digital cognitive behavioral intervention (dCBI) can help surgical patients. dCBI such as RxWell™ is a proven treatment for mood disorders in medical patients such as reducing depression in patients with inflammatory bowel disease. We hypothesize that RxWell™ will also be effective in surgical patients. This study aims to test whether RxWell™ can improve preoperative mood disorders and subsequently reduce postoperative pain and opioid requirement in patients scheduled for primary total hip and knee arthroplasty (THA, TKA). We named the trial as the SuRxgWell trial. METHODS: This is a randomized, controlled trial that will enroll primary and unilateral THA or TKA patients with anxiety and/or depression symptoms before surgery to receive the SuRxgWell dCBI program and investigate its impact on postoperative outcomes including postoperative pain, anxiety, depression, sleep disorder, and catastrophizing. After signing an informed consent, subjects will be screened using the PROMIS questionnaires, and subjects with a T-score of ≥ 60 on the short Patient-Reported Outcomes Measurement Information System (PROMIS) 4a Anxiety and/or short PROMIS 4a Depression questionnaires will be randomized to either usual care (control group) or the cognitive behavioral intervention, RxWell™, plus usual care (intervention group). The control group will receive information on how to locate tools to address anxiety and depression, whereas the intervention group will have access to SuRxgWell 1 month prior to surgery and up to 3 months after surgery. The allocation will be 3:1 (intervention to control). Investigators will be blinded, but research coordinators approaching patients and research subjects will not. The primary outcome will be day of surgery anxiety or depression symptoms measured with the PROMIS Short Form v1.0 -Anxiety 4a/Depression and Generalized Anxiety Disorder Measure (GAD-7) and Patient Health Questionnaire (PHQ-8). Secondary end points include measuring other health-related quality of life outcomes including sleep disturbance, fatigue, ability to participate in social roles, pain interference, cognitive function, pain catastrophizing, and physical function. Other secondary outcomes include collecting data about preoperative and postoperative pain scores, and pain medication usage, and orthopedic functional recovery at baseline, day of surgery, and 1, 2, and 3 months after the surgery with the Pain Catastrophizing Scale, the Knee injury and Osteoarthritis Outcome Score (KOOS), and Hip injury and Osteoarthritis Outcome Score (HOOS). In addition, subjects will be asked to complete a GAD-7 and PHQ-8 questionnaires bi-weekly (via the RxWell™ app for the interventional group or REDCAP for the control group). Data about postsurgical complications, and resource utilization will also be recorded. We will also receive monthly reports measuring the usage and engagement of RxWell use for each participant randomized to that arm. The primary hypotheses will be assessed with intention-to-treat estimates, and differences in primary outcome will be tested using independent two sample t-tests. This trial is registered to the ClinicalTrials.gov database (NCT05658796) and supported by the DAPM, UPMC Health Plan, and the NIH. DISCUSSION: Our trial will evaluate the feasibility of digital cognitive behavioral intervention as a perioperative tool to improve anxiety and depression before and after major orthopedic surgery in comparison to education. If digital cognitive behavioral intervention proves to be effective, this might have important clinical implications, reducing the incidence of chronic postsurgical pain and improving outcomes.

Near-infrared fluorescence cholangiography in dogs: A pilot study.

OBJECTIVE: To determine the effect of indocyanine green (ICG) dose and timing of administration on near-infrared fluorescence (NIRF) imaging of the normal canine biliary tree. STUDY DESIGN: Preclinical prospective study. ANIMALS: Eight purpose-bred beagles. METHODS: The dogs were randomized to receive two of four intravenous ICG dose (low [L]:0.05 mg/kg or high [H]:0.25 mg/kg)/time (0 and 3 h prior to NIRF) combinations. NIRF images were collected every 10 min for 120 min. Target (cystic duct)-to-background (liver) ratios were calculated for all timepoints and compared. RESULTS: ICG cholangiography was successful in all dogs. The contrast ratio was above 1 in the L0 group by 20 min and reached its peak at 100 min. In the H0 group, the ratio was above 1 by 60 min and reached its peak at 90 min. Contrast ratios above 2 (fluorescence twice as bright in the cystic duct compared to the liver) were maintained from 180 to 300 min for L3 and H3 and was achieved after 80 min for L0. CONCLUSION: Low dose ICG provided better ratios early after injection compared to the high dose which remained highly concentrated in the liver tissue after injection. Both doses provided excellent visualization of the biliary tree at 3 h post injection, low dose ICG provided better ratios from 3 to 5 h post injection. Based on these results, 0.05 mg/kg of ICG administered at anesthetic premedication, or as early as 3 h prior to laparoscopic surgery should yield optimal fluorescence images. CLINICAL SIGNIFICANCE: This study provides guidelines for NIRF cholangiography in clinically normal dogs.

Use of enamel matrix- derived proteins combined with bone graft for the treatment of intrabony defects: overview of reviews (FRISBEE review) / Uso de proteínas derivadas de la matriz del esmalte combinado con injerto óseo para el tratamiento de defectos intraóseos: resumen estructurado de revisiones sistemáticas (revisión FRISBEE)

Introduction: The use of enamel matrix-derived proteins (EMD) has increased in recent years due to their tissue-inducing properties that support periodontal regeneration. This study is an overview of systematic reviews with FRISBEE methodology on the use of EMD alone or combined with autologous bone graft materials (BGM) in the treatment of intrabony defects. Materials and Methods: A systematic search in the Epistemonikos database was performed. RevMan 5.3 and GRADEpro were used for data analysis and presentation Results: Four systematic reviews and two clinical trials were identified. All studies analysed change in probing depth, clinical attachment level, gingival margin level and bone defect depth (all changes in favour of EMD+BGM groups: mean difference (MD): 0.37 mm more, MD: 0.7 mm more, MD: 0.3 mm less, MD: 0.75 more, respectively). Conclusions: Adding autologous bone graft to EMD to treat intrabony defects showed better results, but not a relevant clinical difference compared to the use of EMD alone.

Introducción: El uso de proteínas derivadas de la matriz del esmalte (EMD) ha aumentado en los últimos años debido a sus propiedades inductoras de tejidos que apoyan la regeneración periodontal. Este estudio es una revisión sistemática de revisiones sistemáticas utilizando metodología FRISBEE sobre el uso de EMD solo o combinado con materiales injerto óseo autólogo (BGM) en el tratamiento de defectos intraóseos. Materiales y Métodos: Se realizó una búsqueda sistemática en la base de datos Epistemonikos. Se utilizaron RevMan 5.3 y GRADEpro para el análisis y la presentación de los datos. Resultados: Se identificaron cuatro revisiones sistemáticas y dos ensayos clínicos. Todos los estudios analizaron el cambio en la profundidad de sondaje, el nivel de inserción clínica, el nivel del margen gingival y la profundidad del defecto óseo (todos los cambios a favor de los grupos EMD+BGM: MD: 0,37 mm más, media de diferencia (MD): 0,7 mm más, MD: 0,3 mm menos, MD: 0,75 más, respectivamente). Conclusión: La adición de injerto óseo autólogo a la EMD para tratar defectos intraóseos mostró mejores resultados, pero no una diferencia clínica relevante en comparación con el uso de la EMD sola.

Determinants of activity and efficacy of anti-PD1/PD-L1 therapy in patients with advanced solid tumors recruited in a clinical trials unit: a longitudinal prospective biomarker-based study.

Immune-checkpoint inhibitors (ICI) have revolutionized the therapeutic landscape of cancer. However, optimal patient selection is still an unmet need. One-hundred-forty-six patients with metastatic cancer candidates to ICI at the Hospital Clinic of Barcelona Clinical Trials Unit were prospectively recruited in this observational study. Blood samples were collected at different timepoints, baseline LIPI score calculated and pre-ICI archived tissues retrieved to evaluate PD-L1, tumor-infiltrating lymphocytes (TILs) and PD1 mRNA levels. Tumor assessments were centrally reviewed by RECIST 1.1 criteria. Associations with overall response rates (ORR), durable clinical benefit (DCB), progression-free survival (PFS) and overall survival (OS) were performed with univariable/multivariable logistic and Cox regressions, where appropriate. At a median follow-up of 26.9 months, median PFS and OS were 2.7 and 12.9 months. Response rates were 17.8% with duration of response (DOR) of 4.4 months. LIPI score was independently associated with PFS (p = 0.025) and OS (p < 0.001). Immunotherapy-naïve status was independently associated with better PFS (p = 0.005). Time-to-best response (TTBR) and ORR (p < 0.001 both) were associated with better OS at univariate analysis. PFS and DOR were moderately correlated with OS (p < 0.001 both). A PD-L1 10% cut-off detected worse/best responders in terms of ORR (univariate p = 0.011, multivariate p = 0.028) and DCB (univariate p = 0.043). PD1 mRNA levels were strikingly associated to complete responses (p = 0.021). To resume, in our prospective observational pan-cancer study, baseline LIPI score, immunotherapy-naïve status, cancer type and RT before starting ICI were the most relevant clinical factors independently correlated with immunotherapy outcomes. Longer TTBR seemed to associate with better survival, while PD1 mRNA and PD-L1 protein levels might be tumor-agnostic predictive factors of response to ICI and should be furtherly explored.

Some cardiopulmonary effects of capnoperitoneum in anesthetized guinea pigs (Cavia porcellus): spontaneous ventilation versus intubation and mechanical ventilation.

OBJECTIVE: To compare cardiopulmonary variables and blood gas analytes in guinea pigs (Cavia porcellus) during anesthesia with and without abdominal carbon dioxide (CO2) insufflation at intra-abdominal pressures (IAPs) 4 and 6 mmHg, with and without endotracheal intubation. STUDY DESIGN: Prospective experimental trial. ANIMALS: A total of six intact female Hartley guinea pigs. METHODS: A crossover study with sequence randomization for IAP and intubation status was used. The animals were sedated with intramuscular midazolam (1.5 mg kg-1) and buprenorphine (0.2 mg kg-1) and anesthetized with isoflurane, and an abdominal catheter was inserted for CO2 insufflation. Animals with endotracheal intubation were mechanically ventilated and animals maintained using a facemask breathed spontaneously. After 15 minutes of insufflation, the following variables were obtained at each IAP: pulse rate, respiratory rate, rectal temperature, oxygen saturation, end-tidal CO2 (intubated only), peak inspiratory pressure (intubated only), noninvasive blood pressure and blood gas and electrolyte values, with a rest period of 5 minutes between consecutive IAPs. After 4 weeks, the procedure was repeated with the guinea pigs assigned the opposite intubation status. RESULTS: Intubated guinea pigs had significantly higher pH and lower partial pressure of CO2 in cranial vena cava blood (PvCO2) than nonintubated guinea pigs. An IAP of 6 mmHg resulted in a significantly higher PvCO2 (65.9 ± 19.0 mmHg; 8.8 ± 2.5 kPa) than at 0 (53.2 ± 17.2 mmHg; 7.1 ± 2.3 kPa) and 4 mmHg (52.6 ± 10.8 mmHg; 7.01 ± 1.4 kPa), mean ± standard deviation, with intubated and nonintubated animals combined. CONCLUSIONS AND CLINICAL RELEVANCE: Although the oral anatomy of guinea pigs makes endotracheal intubation difficult, capnoperitoneum during anesthesia induces marked hypercapnia in the absence of mechanical ventilation. An IAP of 4 mmHg should be further evaluated for laparoscopic procedures in guinea pigs because hypercapnia may be less severe than with 6 mmHg.

CD20, generalidades básicas-moleculares y su posible relación como marcador de mal pronóstico en leucemia / CD20, basic-molecular generalities, and its possible relationship as a marker of poor prognosis in leukemia

CD20 es una proteína transmembranal expresada en la superficie del linfocito B y desempeña un papel muy importante en su desarrollo y diferenciación. Se expresa en la gran mayoría de neoplasias de células B, como en la leucemia linfoblástica aguda (LLA). Se recopiló información sobre la estructura biológica y molecular del marcador CD20 y su mecanismo de regulación, para mejorar el entendimiento sobre su función dentro de la célula, el efecto que ejerce como marcador de mal pronóstico cuando se encuentra expresado en pacientes adultos diagnosticados con LLA y las ventajas de ser utilizado como blanco terapéutico en esta patología.

CD20 is a transmembrane protein expressed on the surface of the B lymphocyte and plays a significant role in its development and differentiation. It is expressed in most B-cell neoplasms, such as Acute Lymphoblastic Leukemia (ALL). Information was collected on the biological and molecular structure of the CD20 marker and its regulation mechanism to improve the understanding of its function within the cell, the effect it exerts as a marker of poor prognosis when expressed in adult patients diagnosed with ALL, and the advantages of being used as a therapeutic target in this pathology.

Traducción y adaptación transcultural en español de criterios consolidados para reportar investigaciones cualitativas / Spanish Translation and Cross-Cultural Adaptation of Consolidated Criteria for Reporting about Qualitative Research

Introducción: Las listas de verificación para reporte de estudios son un recurso necesario para investigadores y revisores; es indispensable contar con listas para estudios cualitativos disponibles en idioma español. Objetivo: Desarrollar la traducción y adaptación transcultural de la lista de verificación Consolidated Criteria for Reporting Qualitative Research al español. Métodos: Se estructuraron cinco fases metodológicas: traducción, síntesis, retrotraducción, prueba piloto y entrega. Cada una auditada por un comité de expertos, que consolidó las distintas versiones de la lista de verificación y generó consensos. Se calculó concordancia entre evaluadores y fiabilidad. Resultados: La traducción y retrotraducción siguieron los pasos metodológicos relacionados con las equivalencias de la lista de verificación original. En la prueba piloto participaron 10 expertos en investigación cualitativa; cuyas evaluaciones llevaron a la mejora del 50 por ciento (n = 16) de los dominios e ítems de la lista, 43,80 por ciento (n = 7) en redacción y 56,20 por ciento (n = 9) en explicación. Después, con la moderación del comité de expertos se implementaron ajustes finales con una equivalencia semántica alta; la valoración de concordancia fue de 0,69 con Kappa de Fleiss y la fiabilidad de 0,88 con Alfa de Cronbach. Conclusiones: Se obtuvo una versión traducida y con adaptación transcultural al español de la lista de verificación Consolidated Criteria for Reporting Qualitative Research que conservó las equivalencias semánticas, idiomáticas, experimentales y conceptuales de la versión original, útil para el desarrollo de investigaciones cualitativas en salud, pues Consolidated Criteria for Reporting Qualitative Research se ha posicionado como referente de la calidad metodológica, teniendo en cuanta que su aplicación precisa ser contextualizada a la tipología y contenido de cada investigación(AU)

Introduction: Checklists for reporting about studies are a necessary resource for researchers and revisers; it is indispensable to have checklists in Spanish available for qualitative studies. Objective: To carry out the Spanish translation and cross-cultural adaptation of the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Methods: Five methodological phases were structured: translation, synthesis, back translation, pilot testing and delivery. Each was audited by an expert committee, which consolidated the different versions of the checklist and reached consensus. Inter-rater agreement and reliability were calculated. Results: Both translation and back translation followed the methodological steps related to the equivalences of the original checklist. Ten qualitative research experts participated in the pilot test; their evaluations led to the improvement of 50 percent (n = 16) of the domains and items of the checklist: 43.80 percent (n = 7) in writing and 56.20 percent (n = 9) in explanation. Then, with the revision from the expert committee, final adjustments were implemented in view of a high semantic equivalence; the concordance rating was 0.69 with Fleiss' Kappa and reliability was 0.88 with Cronbach's alpha. Conclusions: A Spanish-translated version, together with a transcultural adaptation, was obtained for the (COREQ) checklist, which preserved the semantic, idiomatic, experimental and conceptual equivalences of the original version, useful for the development of qualitative research in health, since the (COREQ) checklist has positioned itself as a reference of methodological quality, taking into account that its application needs to be contextualized according to the typology and content of each research(AU)

Shewanella sp. T2.3D-1.1 a Novel Microorganism Sustaining the Iron Cycle in the Deep Subsurface of the Iberian Pyrite Belt.

The Iberian Pyrite Belt (IPB) is one of the largest deposits of sulphidic minerals on Earth. Río Tinto raises from its core, presenting low a pH and high metal concentration. Several drilling cores were extracted from the IPB's subsurface, and strain T2.3D-1.1 was isolated from a core at 121.8 m depth. We aimed to characterize this subterranean microorganism, revealing its phylogenomic affiliation (Average Nucleotide Identity, digital DNA-DNA Hybridization) and inferring its physiology through genome annotation, backed with physiological experiments to explore its relationship with the Fe biogeochemical cycle. Results determined that the isolate belongs to the Shewanella putrefaciens (with ANI 99.25 with S. putrefaciens CN-32). Its genome harbours the necessary genes, including omcA mtrCAB, to perform the Extracellular Electron Transfer (EET) and reduce acceptors such as Fe3+, napAB to reduce NO3- to NO2-, hydAB to produce H2 and genes sirA, phsABC and ttrABC to reduce SO32-, S2O32- and S4O62-, respectively. A full CRISPR-Cas 1F type system was found as well. S. putrefaciens T2.3D-1.1 can reduce Fe3+ and promote the oxidation of Fe2+ in the presence of NO3- under anaerobic conditions. Production of H2 has been observed under anaerobic conditions with lactate or pyruvate as the electron donor and fumarate as the electron acceptor. Besides Fe3+ and NO3-, the isolate also grows with Dimethyl Sulfoxide and Trimethyl N-oxide, S4O62- and S2O32- as electron acceptors. It tolerates different concentrations of heavy metals such as 7.5 mM of Pb, 5 mM of Cr and Cu and 1 mM of Cd, Co, Ni and Zn. This array of traits suggests that S. putrefaciens T2.3D-1.1 could have an important role within the Iberian Pyrite Belt subsurface participating in the iron cycle, through the dissolution of iron minerals and therefore contributing to generate the extreme conditions detected in the Río Tinto basin.

Diagnostic and public health investigation of Mycobacterium tuberculosis infection in a dog in Ontario, Canada.

A 4-y-old, female mixed-breed dog was presented to the Ontario Veterinary College for further evaluation of multiple pulmonary and hepatic masses, intrathoracic lymphadenitis, and recent development of a pyogranulomatous pleural effusion. Along with other comprehensive tests, a thoracic lymph node biopsy was performed, and Mycobacterium tuberculosis complex infection was confirmed by real-time PCR. The dog's condition declined post-operatively, and euthanasia was elected. Postmortem examination confirmed severe granulomatous pneumonia, hepatitis, intrathoracic and intraabdominal lymphadenitis, omentitis, and nephritis. Line-probe assays performed on samples collected postmortem confirmed the species as M. tuberculosis. 24-loci MIRU-VNTR genotyping, spoligotyping, and whole-genome sequencing revealed relations to known human isolates, but no epidemiologic link to these cases was investigated. Given the concern for potential human exposure during this animal's disease course, a public health investigation was initiated; 45 individuals were tested for M. tuberculosis exposure, and no subsequent human infections related to this animal were identified. Our case highlights the need for more readily available, minimally invasive testing for the diagnosis of canine mycobacteriosis, and highlights the ability of canid species to act as potential contributors to the epidemiology of M. tuberculosis infections.

Calidad de atención y satisfacción del paciente atendido en una cadena de clínicas odontológicas. Lima-Perú, 2019-2020 / Quality of care and satisfaction of patients treated at a dental chain. Lima-Peru, 2019-2020

RESUMEN Objetivo: Evaluar la relación entre la calidad de atención y el grado de satisfacción de los pacientes atendidos en una cadena de clínicas odontológicas en Lima, Perú, en los años 2019 y 2020. Materiales y métodos: Enfoque cuantitativo, diseño descriptivo y transversal. Se aplicaron dos encuestas: SERVPERF (conformada por 5 dimensiones) y la encuesta de satisfacción elaborada por Ramírez (3 dimensiones). Las encuestas fueron dirigidas a los pacientes atendidos durante el periodo 2019-2020. Resultados: De los 150 encuestados se identificó que el 93,30 % de ellos percibieron una alta calidad (Parcialmente de acuerdo y Totalmente de acuerdo); el 3,30 % evidenciaron su desacuerdo con la calidad (Totalmente en desacuerdo y Parcialmente en desacuerdo) y, por tanto, fueron clasificados en un nivel de calidad baja. También se observó que el 96,70 % (145) de los pacientes entrevistados mostraron estar satisfechos con la atención recibida en la cadena de clínicas odontológicas; el 3,30 % (5) estuvieron insatisfechos, y ninguno evidenció estar moderadamente satisfecho. Conclusiones: Se concluye que existe relación directa y significativa entre la calidad de atención y la satisfacción del paciente. En la dimensión fiabilidad, sensibilidad, seguridad, empatía y elementos tangibles, la percepción de calidad también fue alta. Igualmente, en la dimensión humana, técnico-científica y entorno, los pacientes manifestaron estar satisfechos con la atención recibida.

ABSTRACT Objective: To evaluate the relationship between quality of care and degree of satisfaction of patients treated at a dental chain in Lima, Peru, from 2019 to 2020. Materials and methods: A quantitative, descriptive and cross-sectional study. Two surveys were administered: the SERVPERF model (consisting of five dimensions) and the satisfaction survey created by Ramírez (consisting of three dimensions). Both surveys were administered to patients treated during the 2019-2020 period. Results: Out of the 150 respondents, 93.30 % perceived a high quality of care (Partially agree and Totally agree) and 3.30 % disagreed with the quality of care (Totally disagree and Partially disagree). Therefore, the latter were included in the low-quality-of-care group. It was also found that 96.70 % (145) of the surveyed patients were satisfied with their care in the dental chain, 3.30 % (5) were dissatisfied, and none was moderately satisfied. Conclusions: It is concluded that there is a direct and statistically significant relationship between quality of care and patient satisfaction. In the reliability, sensitivity, security, empathy and tangible elements dimensions, patients' perception of quality was high. Likewise, in the human, technical-scientific and environment dimensions, patients stated that they were satisfied with the care received.

El ejercicio ético en disputa: entre la enseñanza, el imperialismo y la reflexividad en el oficio antropológico / The ethical exercise in dispute: between teaching, imperialism, and reflexivity in anthropological practice

RESUMEN Se presenta un ejercicio ético referido a recorridos académicos e institucionales en la investigación antropológica y en la enseñanza, en un contexto político donde la dimensión de lo ético se construye a partir de normativas fiscalizadoras. Se destaca el valor de la práctica docente, articulando la participación de la investigadora en un seminario de ética y derechos humanos, de carácter obligatorio, de la licenciatura en Antropología de la Universidad de la República (Montevideo, Uruguay), con su experiencia en el proceso de evaluación del comité de ética de la Escola Nacional de Saúde Pública Sergio Arouca (Río de Janeiro, Brasil), que tuvo a cargo la revisión y aprobación de un proyecto de investigación doctoral. Este ejercicio ético encuentra expresiones singulares en los diferentes lugares en los que se inscriben nuestros procesos de investigación: en el campo, en contextos políticos propios y en la práctica docente, y retroalimenta todo el proceso de investigación, debate y análisis.

ABSTRACT This article presents an ethical exercise related to academic and institutional trajectories in anthropological research and teaching, in a political context where ethical considerations are centered around supervisory regulations. The value of teaching practice is highlighted through the author's experience articulating participation in a seminar on ethics and human rights, a required course for the degree in Anthropology at the Universidad de la República (Montevideo, Uruguay), with experience participating in the evaluation process of the ethics committee at the Escola Nacional de Saúde Pública Sergio Arouca (Rio de Janeiro, Brazil), which was charged with reviewing and approving a doctoral research project. This ethical exercise is uniquely expressed in different arenas in which our research processes unfold: in fieldwork, in particular political contexts, and in teaching practice, providing feedback throughout the research, debate, and analysis process.