Mother's smoking habits affects IL10 methylation but not asthma in Ecuadorian children.

There is no evidence evaluating the IL10 epigenetic upregulation among mestizo children in a high-altitude Andean city in Latin America. OBJECTIVE: To identify polymorphisms and methylation profiles in the IL10 gene associated with asthma in children aged 5 to 11. METHODS: A case-control study was conducted with asthmatic and non-asthmatic children aged 5 to 11 years in Cuenca-Ecuador. Data on allergic diseases and risk factors were collected through a questionnaire for parents. Atopy was measured by skin prick test (SPT) to relevant aeroallergens. Three IL10 single nucleotide polymorphisms were evaluated in all participants, and methylation analysis was performed in 54 participants. Association between risk factors, allergic diseases and genetic factors were estimated using multivariate logistic regression. RESULTS: The results of polymorphisms showed no differences between cases and controls when comparing the SNPs rs3024495, rs3024496, rs1800896 allelic and genotypic frequencies. In the methylation analysis, no differences in the IL10 methylation profile were found between cases and controls; however, the multivariate analysis showed an association between the mother's smoking habits and the IL10 methylation profile. CONCLUSION: Smoking habit could be essential as an environmental exposure factor in regulating gene expression in children with asthma.

Immunomodulation with AM3 and antioxidants creates an adequate framework for skin repair and decreases the monocyte proinflammatory stage in smoker women.

Smoking has been considering a crucial factor in promoting skin and systemic aging that is associated with the development of a low-level, systemic, chronic inflammation known as "inflammaging" in which monocytes play a pivotal role. Our aim was to investigate the effects of AM3 plus antioxidants vs placebo in the activation status, function of monocytes and cutaneous aging parameters in healthy smoker middle-aged women. A total of 32 women were 1:1 randomly assigned to AM3 plus antioxidants or placebo for three months. Peripheral mononuclear blood cells and cutaneous biopsy were obtained and flow cytometry and immunohistological studies, respectively, were performed before and after the treatment. AM3 plus antioxidants treatment compared with placebo significantly reduced the monocyte production of the proinflammatory interleukin 1 (IL-1), tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) cytokines as well as increased the regulatory IL-10 in middle-aged smoker women. Furthermore, AM3 and antioxidants did not modify ROS production by monocytes and granulocytes but increased their phagocytic activity. The active combination also stimulated a significative increase in reticular dermis depth as well as an increase in the expression of CD117 and CD31. Thus, AM3 and antioxidants treatment reduces the systemic proinflammatory monocyte disturbance of heathy smoker middle-aged women and encourage skin repair mechanisms.

The Intramolecular Povarov Tool in the Construction of Fused Nitrogen-Containing Heterocycles.

Nitrogen heterocycles are part of the structure of natural products and agents with important biological activity, such as antiviral, antibiotic, and antitumor drugs. For this reason, heterocyclic compounds are one of today's most desirable synthetic targets and the Povarov reaction is a powerful synthetic tool for the construction of highly functionalized heterocyclic systems. This process involves an aromatic amine, a carbonyl compound, and an olefin or acetylene to give rise to the formation of a nitrogen-containing heterocycle. This review illustrates advances in the synthetic aspects of the intramolecular Povarov reaction for the construction of intricate nitrogen-containing polyheterocyclic compounds. This original review presents research done in this field, with references to important works by internationally relevant research groups on this current topic, covering the literature from 1992 to 2022. The intramolecular Povarov reactions are described here according to the key processes involved, using different combinations of aromatic or heteroaromatic amines, and aliphatic, aromatic, or heteroaromatic aldehydes. Some catalytic reactions promoted by transition metals are detailed, as well as the oxidative Povarov reaction and some asymmetric intramolecular Povarov processes.

Median raphe cysts: A clinico-pathologic and immunohistochemical study of 52 cases.

BACKGROUND: Median raphe cysts (MRC) are epithelial-lined cystic lesions of the genital area that do not communicate with the urethra or the overlying epidermis. Immunohistochemically, MRC show positivity for cytokeratin (CK) 5-6, CK 7, carcinoembryonic antigen, p63 and uroplakin III (URO III). GATA3 and human milk fat globulin 1 (HMFG1) are immunohistochemical markers that have been not previously studied in MRC. METHODS: We conducted a study of 52 patients diagnosed with MRC in the Pathology Departments of eight hospitals between 1990 and 2016. The monoclonal antibodies used were CK5-6, CK7, CK20, URO III, p63, GATA3, and HMFG1. HMFG1 was studied in five cases of apocrine hidrocystomas and compared with five cases of MRC from our series. RESULTS: CK 5-6, CK7, and p63 expression showed strong positivity in the urothelial epithelium of 48 cases. CK20 was focally positive in areas of mucinous differentiation in three cases. GATA3 showed intense nuclear staining in 30 cases. HMFG1 was positive in three cases of MRC and in three cases of apocrine hidrocystoma. CONCLUSION: Positivity of GATA3 and CK7 in MRC supports the urothelial origin of these cysts. We found no differences in HMFG1 expression between MRC and apocrine hidrocystomas.

Multicomponent Synthesis of Unsaturated γ-Lactam Derivatives. Applications as Antiproliferative Agents through the Bioisosterism Approach: Carbonyl vs. Phosphoryl Group.

We report efficient synthetic methodologies for the preparation of 3-amino and 3-hydroxy 3-pyrrolin-2-ones (unsaturated γ-lactams) through a multicomponent reaction of amines, aldehydes and acetylene or pyruvate derivatives. The densely substituted γ-lactam substrates show in vitro cytotoxicity, inhibiting the growth of the carcinoma human tumor cell lines RKO (human colon epithelial carcinoma), SKOV3 (human ovarian carcinoma) and A549 (carcinomic human alveolar basal epithelial cell). In view of the possibilities for the diversity of the substituents that offer a multicomponent, synthetic methodology, an extensive structure-activity profile is presented. In addition, the bioisosteric replacement of the flat ester group by a tetrahedral phosphonate or phosphine oxide moiety in γ-lactam substrates leads to increased growth inhibition activity. Cell morphology analysis and flow cytometry assays indicate that the main pathway by which our compounds induce cytotoxicity is based on the activation of the intracellular apoptotic mechanism.

Triple-negative breast cancer treatment in xenograft models by bifunctional nanoprobes combined to photodynamic therapy.

Triple-negative breast cancer (TNBC) overexpresses the Epidermal Growth Factor Receptor (EGFR), a characteristic of different types of tumors, linked to worse disease prognosis and risk of recurrence. Conventional treatments are also aggressive and can be morbid.. Therefore, t improvement and development of new methods are notorious. Photodynamic Therapy (PDT) is an effective method for treating different types of cancer by using light radiation to activate a photosensitizing agent (drug) in molecular oxygen presence, promoting cell death., Improving drug uptake in target cells could contribute to PDT efficiency. Accordingly, we developed a bifunctional nanoprobe (BN), used in PDT as a a treatment method in vivo against breast cancer. The BN uses gold nanoparticles with active targeting through the Epidermal Growth Factor (EGF) protein and Chlorine e6 (Ce6) carriers. We evaluated the therapeutic efficacy of in vivo xenograft in 4 groups: Saline, BN, Ce6+PDT, and BN+PDT. As a result, we observed that the BN+PDT group exhibited an excellent effect with greater selectivity to tumor tissue and tissue damage when compared to the Saline, BN, and Ce6+PDT groups. The results indicate a potential impact on breast cancer treatment in vivo.. In conclusion, our data propose that the BN developed heightened PDT efficacy through cellular DNA repair effects and tumor microenvironment.

Synthesis and Antiproliferative Activity of Phosphorus Substituted 4-Cyanooxazolines, 2-Aminocyanooxazolines, 2-Iminocyanooxazolidines and 2-Aminocyanothiazolines by Rearrangement of Cyanoaziridines.

Several phosphorus-substituted N-acylated cyanoaziridines 2 and N-carbamoylated cyanoziridines 5 were prepared in good to high yields. N-Acylated cyanoaziridines 2 were used, after ring expansion, in an efficient synthesis of oxazoline derivative 3a and in a completely regio-controlled reaction in the presence of NaI. Conversely, N-carbamoyl cyanoaziridines 5 reacted with NaI to obtain a regioisomeric mixture of 2-aminocyanooxazolines 7. Mild acidic conditions can be used for the isomerization of N-thiocarbamoyl cyanoaziridine 6a into a 2-aminocyanothiazoline derivative 8a by using BF3·OEt2 as a Lewis acid. Likewise, a one pot reaction of NH-cyanoaziridines 1 with isocyanates obtained 2-iminocyanooxazolidines 9 regioselectively. This synthetic methodology involves the addition of isocyanates to starting cyanoaziridines to obtain N-carbamoyl cyanoaziridines 5, which after the ring opening, reacts with a second equivalent of isocyanate to give the final 2-imino cyanooxazolidines 9. In addition, the cytotoxic effect on the cell lines derived from human lung adenocarcinoma (A549) was also screened. 2-Iminooxazolidines 9 exhibited moderate activity against the A549 cell line in vitro. Furthermore, a selectivity towards cancer cells (A549) over non-malignant cells (MCR-5) was detected.

A Pandemic within Other Pandemics. When a Multiple Infection of a Host Occurs: SARS-CoV-2, HIV and Mycobacterium tuberculosis.

By the middle of 2021, we are still immersed in the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The concurrence of this new pandemic in regions where human immunodeficiency virus (HIV) and tuberculosis (TB) infections possess the same epidemiological consideration, has arisen concerns about the prognosis, clinical management, symptomatology, and treatment of patients with triple infection. At the same time, healthcare services previously devoted to diagnosis and treatment of TB and HIV are being jeopardized by the urgent need of resources and attention for COVID-19 patients. The aim of this review was to collect any article considering the three conditions (HIV, TB, and SARS-CoV-2), included in PubMed/Medline and published in the English language since the beginning of the COVID-19 pandemic. We focused on detailed descriptions of the unusual cases describing the three co-infections. Eighty-four out of 184 publications retrieved met our inclusion criteria, but only three of them reported cases (five in total) with the three concomitant infections. The clinical evolution, management, and therapy of all of them were not different from mild/severe cases with exclusive COVID-19; the outcome was not worse either, with recovery for the five patients. Cases of patients with COVID-19 besides HIV and TB infections are scarce in literature, but studies deliberately embracing the triple infection as a priori inclusion criterion should be carried out in order to provide a complete understanding of joint influence.

Synthesis of α-Aminophosphonic Acid Derivatives Through the Addition of O- and S-Nucleophiles to 2H-Azirines and Their Antiproliferative Effect on A549 Human Lung Adenocarcinoma Cells.

This work reports a straightforward regioselective synthetic methodology to prepare α-aminophosphine oxides and phosphonates through the addition of oxygen and sulfur nucleophiles to the C-N double bond of 2H-azirine derivatives. Determined by the nature of the nucleophile, different α-aminophosphorus compounds may be obtained. For instance, aliphatic alcohols such as methanol or ethanol afford α-aminophosphine oxide and phosphonate acetals after N-C3 ring opening of the intermediate aziridine. However, addition of 2,2,2-trifluoroethanol, phenols, substituted benzenthiols or ethanethiol to 2H-azirine phosphine oxides or phosphonates yields allylic α-aminophosphine oxides and phosphonates in good to high general yields. In some cases, the intermediate aziridine attained by the nucleophilic addition of O- or S-nucleophiles to the starting 2H-azirine may be isolated and characterized before ring opening. Additionally, the cytotoxic effect on cell lines derived from human lung adenocarcinoma (A549) and non-malignant cells (MCR-5) was also screened. Some α-aminophosphorus derivatives exhibited very good activity against the A549 cell line in vitro. Furthermore, selectivity towards cancer cell (A549) over non-malignant cells (MCR-5) has been detected in almost all compounds tested.

First synthesis of merged hybrids phosphorylated azirino[2,1-b]benzo[e][1,3]oxazine derivatives as anticancer agents.

This work describes a straightforward diastereoselective synthetic access to azirino[2,1-b]benzo[e][1,3]oxazines containing phosphorus substituents such as phosphonate or phosphine oxide, by means of nucleophilic addition of functionalized phenols to the C-N double bond of 2H-azirine derivatives. In addition, the cytotoxic effect on cell lines derived from human lung adenocarcinoma (A549) and human embryonic kidney (HEK293) was also screened. Some azirino[2,1-b]benzo[e][1,3]oxazines 4 and 6 exhibited very good activity against the A549 cell line in vitro. Furthermore, selectivity towards cancer cell (A549) over (HEK293), and non-malignant cells (MCR-5) has been detected.

Effect of first aid training on teams from special education schools / Efecto de la capacitación sobre primeros auxilios en accidentes para los equipos de escuelas de enseñanza especializada / Efeito de capacitação sobre primeiros socorros em acidentes para equipes de escolas de ensino especializado

ABSTRACT Objectives: Analyze the effect of first aid training on the knowledge of multidisciplinary teams from special education schools, in school accidents. Methods: A quasi-experimental, before-and-after study with a single comparison group. Descriptive statistics and McNemar's test were used to evaluate the effect of the intervention. Results: This study had the participation of 162 higher education professionals, predominantly teachers (82.1%), female (97.5%), aged over 40 (69.2%). An increase in correct answers was observed, with statistical significance (≤0.05), especially in proper handling in case of fall with traumatic brain injury, electric shock, and burn due to hot liquid (98.1%, 98.1% and 96.9% of proper response, respectively). Conclusions: First aid training for child accidents, through content exhibition, in a dialogical and practical way, proved to be efficient for multidisciplinary teams from special education schools for people with disabilities.

RESUMEN Objetivos: Evaluar el efecto de la capacitación sobre los primeros auxilios ante accidentes escolares en el conocimiento del equipo multidisciplinario de escuelas de enseñanza especializada. Métodos: Estudio cuasiexperimental con análisis antes y después de un único grupo de comparación. Se realizaron la estadística descriptiva y la prueba de McNemar para evaluar el efecto de la intervención. Resultados: Participaron 162 profesionales de nivel superior, principalmente profesores (82,1%). El sexo y el grupo de edad predominantes fueron el femenino (97,5%) y la edad superior a 40 años (69,2%). Se observó un incremento de aciertos con significancia estadística en todas las cuestiones abordadas (≤ 0,05). Se destacan el manejo correcto ante la caída con traumatismo craneal encefálico, el choque eléctrico y la quemadura por líquido caliente (con un 98,1%, un 98,1% y un 96,9% de aciertos, respectivamente). Conclusiones: La capacitación sobre primeros auxilios ante accidentes, por medio de exposición de contenido de forma dialogada y práctica, fue eficaz para el equipo multidisciplinario de escuelas de enseñanza especializada para personas con discapacidad.

RESUMO Objetivos: Analisar o efeito de uma capacitação no conhecimento da equipe multidisciplinar de escolas de ensino especializado sobre primeiros socorros diante de acidentes escolares. Métodos: Estudo quase experimental do tipo antes e depois com grupo único de comparação. Realizou-se estatística descritiva e teste de McNemar para avaliar o efeito da intervenção. Resultados: Participaram 162 profissionais de nível superior, predominantemente professores (82,1%). Sexo e faixa etária preponderante foram, respectivamente, feminino (97,5%) e idade acima de 40 anos (69,2%). Houve aumento de acerto em todas as questões abordadas com significância estatística (≤ 0,05). Destacam-se o correto manejo diante de queda com traumatismo craniano encefálico, choque elétrico e queimadura por líquido quente (respectivamente: 98,1%, 98,1% e 96,9% de acertos). Conclusões: A capacitação sobre primeiros socorros diante de acidentes, por meio de exposição de conteúdo de forma dialogada e prática, se mostrou eficiente para a equipe multidisciplinar de escolas de ensino especializado para pessoas com deficiência.

Effect of first aid training on teams from special education schools / Efecto de la capacitación sobre primeros auxilios en accidentes para los equipos de escuelas de enseñanza especializada / Efeito de capacitação sobre primeiros socorros em acidentes para equipes de escolas de ensino especializado

ABSTRACT Objectives: Analyze the effect of first aid training on the knowledge of multidisciplinary teams from special education schools, in school accidents. Methods: A quasi-experimental, before-and-after study with a single comparison group. Descriptive statistics and McNemar's test were used to evaluate the effect of the intervention. Results: This study had the participation of 162 higher education professionals, predominantly teachers (82.1%), female (97.5%), aged over 40 (69.2%). An increase in correct answers was observed, with statistical significance (≤0.05), especially in proper handling in case of fall with traumatic brain injury, electric shock, and burn due to hot liquid (98.1%, 98.1% and 96.9% of proper response, respectively). Conclusions: First aid training for child accidents, through content exhibition, in a dialogical and practical way, proved to be efficient for multidisciplinary teams from special education schools for people with disabilities.

RESUMEN Objetivos: Evaluar el efecto de la capacitación sobre los primeros auxilios ante accidentes escolares en el conocimiento del equipo multidisciplinario de escuelas de enseñanza especializada. Métodos: Estudio cuasiexperimental con análisis antes y después de un único grupo de comparación. Se realizaron la estadística descriptiva y la prueba de McNemar para evaluar el efecto de la intervención. Resultados: Participaron 162 profesionales de nivel superior, principalmente profesores (82,1%). El sexo y el grupo de edad predominantes fueron el femenino (97,5%) y la edad superior a 40 años (69,2%). Se observó un incremento de aciertos con significancia estadística en todas las cuestiones abordadas (≤ 0,05). Se destacan el manejo correcto ante la caída con traumatismo craneal encefálico, el choque eléctrico y la quemadura por líquido caliente (con un 98,1%, un 98,1% y un 96,9% de aciertos, respectivamente). Conclusiones: La capacitación sobre primeros auxilios ante accidentes, por medio de exposición de contenido de forma dialogada y práctica, fue eficaz para el equipo multidisciplinario de escuelas de enseñanza especializada para personas con discapacidad.

RESUMO Objetivos: Analisar o efeito de uma capacitação no conhecimento da equipe multidisciplinar de escolas de ensino especializado sobre primeiros socorros diante de acidentes escolares. Métodos: Estudo quase experimental do tipo antes e depois com grupo único de comparação. Realizou-se estatística descritiva e teste de McNemar para avaliar o efeito da intervenção. Resultados: Participaram 162 profissionais de nível superior, predominantemente professores (82,1%). Sexo e faixa etária preponderante foram, respectivamente, feminino (97,5%) e idade acima de 40 anos (69,2%). Houve aumento de acerto em todas as questões abordadas com significância estatística (≤ 0,05). Destacam-se o correto manejo diante de queda com traumatismo craniano encefálico, choque elétrico e queimadura por líquido quente (respectivamente: 98,1%, 98,1% e 96,9% de acertos). Conclusões: A capacitação sobre primeiros socorros diante de acidentes, por meio de exposição de conteúdo de forma dialogada e prática, se mostrou eficiente para a equipe multidisciplinar de escolas de ensino especializado para pessoas com deficiência.

[Hepatic epithelioid angiomyolipoma/PEComa and focal nodular hyperplasia in a patient with a previous history of cutaneous melanoma]. / Angiomiolipoma epitelioide/PEComa hepático e hiperplasia nodular focal en una paciente con antecedentes de melanoma cutáneo.

Hepatic perivascular epithelioid cell tumors (PEComas) are uncommon mesenchymal neoplasms. PEComas concurrent with other hepatic lesions is a very rare occurrence, with only two previously reported cases. We report a primary hepatic PEComa associated with focal nodular hyperplasia in a patient with a previous history of cutaneous melanoma. Diagnostic imaging studies suggested a hepatic adenoma and the patient underwent a segmentectomy. The tumor was mainly composed of epithelioid cells, adipose tissue and smooth muscle fibers intermixed with blood vessels. The neoplastic cells were diffusely immunoreactive for HMB-45, Melan-A and smooth muscle actin, but not for Hepatocyte, S100, MITF or BRAF. Molecular studies were negative for BRAFV600 mutation. The final diagnosis was hepatic epithelioid angiomyolipoma/PEComa. The differential diagnosis of hepatic PEComa is discussed.

Polyphasic identification of Penicillium spp. isolated from Spanish semi-hard ripened cheeses.

Fifteen samples of semi-hard ripened cheeses, both spoiled (10) and unspoiled (5), and obtained from cheese factories located in Northwest of Spain, were analysed by a dilution plating technique and direct sampling. A total of 32 isolates were identified at species level by a polyphasic approach (phenotypic characterization, partial extrolite analysis and molecular identification). Most isolates (65.6%) belonged to the species P. commune; other species found were P. solitum, P. chrysogenum, P. nordicum, P. expansum and P. cvjetkovicii. All of the P. commune isolates were able to produce cyclopiazonic acid, while the P. nordicum and the P. expansum isolates were producers of ochratoxin A and patulin respectively. Despite this, the role of P. commune as beneficial fungi in cheese ripening should be investigated. Molecular identification based on BenA sequence analysis was able to identify the majority of isolates. The three mycotoxins investigated can be considered key for identification. The polyphasic approach seems to be a very valuable tool for identification of isolates of this complex genus.

Synthesis and biological evaluation of cyanoaziridine phosphine oxides and phosphonates with antiproliferative activity.

This work reports an efficient diastereoselective synthetic methodology for the preparation of phosphorus substituted cyanoaziridines through the nucleophilic addition of TMSCN, as cyanide source, to the C-N double bond of 2H-azirine derivatives. The aziridine ring, in these novel cyanoaziridines, can be activated by simple N-tosylation or N-acylation. In addition, the cytotoxic effect on cell lines derived from human lung adenocarcinoma (A549) and human embryonic kidney (HEK293) was also screened. N-H and N-Substituted cyanoaziridines showed excellent activity against the A549 cell line in vitro. Moreover, selectivity towards cancer cell (A549) over (HEK293), and non-malignant cells (MCR-5) has been observed.

Avaliação de treinamento sobre primeiros socorros para equipe técnica de escolas de ensino especializado / Evaluación de entrenamiento sobre primeros auxilios para el equipo técnico de escuelas de enseñanza especializada / Evaluation of first aid training for the technical staff of special education schools

RESUMO Objetivo: analisar o efeito de atividade educativa sobre primeiros socorros em acidentes escolares. Metodologia: estudo quase experimental do tipo antes e depois, realizado com a equipe técnica de escolas de ensino especializado para pessoas com deficiência, no estado do Mato Grosso, entre fevereiro e agosto de 2017. Foi realizado o teste não paramétrico de McNemar para analisar o efeito da atividade educativa. Resultados: participaram 76 profissionais de nível médio, 62 (81,6%) eram do sexo feminino, 66 (86,8%) eram Auxiliares de Desenvolvimento Infantil. Dos profissionais, 35 (46,1%) nunca participaram de treinamento ou atividade educativa sobre primeiros socorros. Houve significância para o aumento de acerto em todas as questões após o treinamento (p<0,05). Conclusão: os profissionais da equipe técnica apresentaram conhecimento prévio insuficiente sobre primeiros socorros e o treinamento melhora a segurança dos alunos e contribui para a sociedade em que estão inseridos. Evidencia-se a importância da inserção do enfermeiro no ambiente escolar.

RESUMEN Objetivo: analizar el efecto de actividad educativa sobre primeros auxilios en accidentes escolares. Metodología: estudio casi experimental del tipo antes y después, realizado con el equipo técnico de escuelas de enseñanza especializada para personas con deficiencia, en el estado de Mato Grosso, Brasil, entre febrero y agosto de 2017. Fue realizado el test no paramétrico de McNemar para analizar el efecto de la actividad educativa. Resultados: participaron 76 profesionales de nivel medio; 62 (81,6%) eran del sexo femenino y 66 (86,8%) eran Auxiliares de Desarrollo Infantil. De los profesionales, 35 (46,1%) nunca participaron de entrenamientos o actividades educativa sobre primeros auxilios. Hubo significación estadística para el aumento de aciertos en todas las preguntas después del entrenamiento (p<0,05). Conclusión: los profesionales del equipo técnico presentaron conocimiento previo insuficiente sobre primeros auxilios y el entrenamiento mejoró la seguridad de los alumnos y contribuyó para la sociedad en que se encuentran inseridos. Se evidenció la importancia de la inserción del enfermero en el ambiente escolar.

ABSTRACT Objective: to analyze the effect of an educational activity on first aid in school accidents. Methodology: a quasi-experimental, before-and-after type study, carried out with the technical staff of special schools for children with disabilities, in the state of Mato Grosso, between February and August 2017. McNemar's non-parametric test was performed to analyze the effect of the educational activity. Results: 76 mid-level professionals participated, 62 (81.6%) of whom were female and 66 (86.8%) Child Development Assistants. Of the professionals, 35 (46.1%) had never participated in training or an educational activity related to first aid. There was a significant increase in correct response to all the questions after the training (p <.05). Conclusion: the professionals of the technical staff presented insufficient prior knowledge regarding first aid and the training improved the safety of the students and contributed to the society in which they are included. The importance of the integration of nurses in the school environment was evidenced.

Paraffin-embedded micrographic surgery for the treatment of dermatofibrosarcoma protuberans: Analysis of 33 patients.

BACKGROUND: Dermatofibrosarcoma protuberans is a rare malignant tumor with a high rate of recurrence after surgery. Moh's micrographic surgery allows examination of all surgical margins to ensure complete removal. OBJECTIVE: To evaluate the use of Moh's micrographic surgery using paraffin-embedded sections for the treatment of dermatofibrosarcoma protuberans. METHODS: We performed a retrospective analysis of 33 patients with dermatofibrosarcoma protuberans treated in our department with paraffin-embedded micrographic surgery between January 2002 and June 2015. Our cases included patients with primary untreated disease and also those with persistent disease previously treated surgically elsewhere, with histologically positive margins. RESULTS: Tumors were most commonly located on the trunk. After the first stage of micrographic surgery, including an initial lateral margin, 20 (60.6%) tumors were completely excised, 11 (33.3%) tumors required two stages and one tumor each (3.0%) required 4 and 6 stages respectively. Patients were monitored for recurrence for a mean duration of 6.5 years. There was no recurrence in any of our 33 patients. CONCLUSIONS: Our results indicate that Moh's micrographic surgery with paraffin-embedded sections may be the method of choice to treat dermatofibrosarcoma protuberans with a low recurrence rate, while preserving surrounding normal healthy tissue.

Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection.

We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates.In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality.Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality.