Chronic arsenic exposure impairs adaptive thermogenesis in male C57BL/6J mice.

The global prevalence of type 2 diabetes (T2D) has doubled since 1980. Human epidemiological studies support arsenic exposure as a risk factor for T2D, although the precise mechanism is unclear. We hypothesized that chronic arsenic ingestion alters glucose homeostasis by impairing adaptive thermogenesis, i.e., body heat production in cold environments. Arsenic is a pervasive environmental contaminant, with more than 200 million people worldwide currently exposed to arsenic-contaminated drinking water. Male C57BL/6J mice exposed to sodium arsenite in drinking water at 300 µg/L for 9 wk experienced significantly decreased metabolic heat production when acclimated to chronic cold tolerance testing, as evidenced by indirect calorimetry, despite no change in physical activity. Arsenic exposure increased total fat mass and subcutaneous inguinal white adipose tissue (iWAT) mass. RNA sequencing analysis of iWAT indicated that arsenic dysregulated mitochondrial processes, including fatty acid metabolism. Western blotting in WAT confirmed that arsenic significantly decreased TOMM20, a correlate of mitochondrial abundance; PGC1A, a master regulator of mitochondrial biogenesis; and, CPT1B, the rate-limiting step of fatty acid oxidation (FAO). Our findings show that chronic arsenic exposure impacts the mitochondrial proteins of thermogenic tissues involved in energy expenditure and substrate regulation, providing novel mechanistic evidence for arsenic's role in T2D development.

Assessment of the Endocrine-Disrupting Effects of Trichloroethylene and Its Metabolites Using in Vitro and in Silico Approaches.

Trichloroethylene (TCE) is a ubiquitous environmental contaminant, which may have effects on both ecosystem and human health. TCE has been reported to cause several toxic effects, but little effort has been made to assess the ecological risks of TCE or its major metabolites: trichloroethanol (TCOH), trichloroacetic acid, and oxalic acid (OA). In this study, the endocrine-disrupting potential of TCE and its metabolites were investigated using in vitro and in silico approaches. We examined alterations in the steroidogenesis pathway using the NCI-H295R cell line and utilized receptor-mediated luciferase reporter cell lines to identify effects on estrogen and androgen receptors. Molecular docking was also used to explore chemical interactions with these receptors. All test chemicals except OA significantly increased 17ß-estradiol production which can be attributed to an up-regulation of 17ß-hydroxysteroid dehydrogenase. Moreover, TCOH exhibited significant antiestrogenic activity with a RIC20 (20% relative inhibitory concentration) of 3.7 × 10-7 M. Molecular docking simulation supported this finding with lower docking scores for TCOH, indicating that hydrogen bonds may stabilize the interaction between TCOH and the estrogen receptor binding pocket. These findings suggest that TCE contamination poses an endocrine-disrupting threat, which has implications for both ecological and human health.

A meta-analysis of genome-wide association studies of follicular lymphoma.

BACKGROUND: B-cell non-Hodgkin lymphoma represents a diverse group of hematological malignancies, of which follicular lymphoma (FL) is one of the most common subtypes. Family and epidemiological studies suggest an important genetic role in the etiology of FL. In recent genome-wide association studies (GWAS) of FL, several genetic susceptibility loci have been identified on chromosome 6p21.33 (rs6457327) and 6p21.32 (rs10484561, rs2647012) in the human leukocyte antigen class I and class II regions. To identify new genetic variants and further elucidate the genetic basis of FL, a meta-analysis was performed of the top 1000 SNPs associated with FL risk from two GWAS in the US, Denmark and Sweden (592 cases, 1541 controls), with independent validation in 107 cases and 681 controls. RESULTS: rs9275517 and rs3117222 in the HLA class II region were validated and inversely associated with FL risk (rs9275517: OR = 0.63, 95% CI = 0.55-0.73, p = 4.03 × 10(-11); rs3117222: OR = 0.66, 95% CI = 0.57-0.77, p = 1.45 × 10(-7)). rs9275517, which is in high linkage disequilibrium with rs2647012 (r2 = 0.9), was no longer associated with FL after conditioning on rs2647012. The rs3117222 association was independent of established FL SNPs, but not of the HLA-DPB1*0301 allele. Using publicly available gene expression profiles with matching genotype information, we found that rs3117222 also was significantly correlated with increased HLA-DPB1 expression. CONCLUSIONS: By performing a meta-analysis of two GWAS of FL, we further validated the relevance of HLA-DPB1*0301 as a protective allele in the pathogenesis of FL. Moreover, the protective rs3117222 A allele correlated with increased levels of HLA-DPB1, suggesting a possible disease mechanism involving HLA-DPB1 expression regulation. Our results add further support to the major role of HLA genetic variation in the pathogenesis of FL.

Common variants within 6p21.31 locus are associated with chronic lymphocytic leukaemia and, potentially, other non-Hodgkin lymphoma subtypes.

A recent meta-analysis of three genome-wide association studies of chronic lymphocytic leukaemia (CLL) identified two common variants at the 6p21.31 locus that are associated with CLL risk. To verify and further explore the association of these variants with other non-Hodgkin lymphoma (NHL) subtypes, we genotyped 1196 CLL cases, 1699 NHL cases, and 2410 controls. We found significant associations between the 6p21.31 variants and CLL risk (rs210134: P = 0·01; rs210142: P = 6·8 × 10(-3)). These variants also showed a trend towards association with some of the other NHL subtypes. Our results validate the prior work and support specific genetic pathways for risk among NHL subtypes.

Estrogenic Activity and Risk of Invasive Breast Cancer Among Postmenopausal Women in the Nurses' Health Study.

BACKGROUND: Estrogens increase breast cancer risk through estrogen receptor (ER)-mediated pathway activation. It is unclear whether a broader assessment of plasma compounds that lead to ER activation would be more strongly related to risk than measurement of individual estrogens. METHODS: A prospective nested case-control study was conducted among postmenopausal women in the Nurses' Health Study, that included 371 cases with blood samples collected prior to breast cancer diagnosis and 731 matched controls. Total estrogen pathway activity (EA) was assessed via a luciferase reporter assay using plasma-treated T47D-Kbluc (ATCC) human breast cancer cells. We also assessed the contribution of EA to risk, independent of circulating estrone, estradiol, and estrone sulfate concentrations. Multivariable ORs and 95% confidence intervals (CI) were calculated using conditional logistic regression adjusting for breast cancer risk factors. RESULTS: Women in the highest, versus lowest EA quartile had an 86% increased risk of invasive breast cancer (ORQ4vsQ1, 1.86; 95% CI = 1.16-2.97). After accounting for estradiol only, a weaker association was observed (ORQ4vsQ1, 1.27; 95% CI = 0.75-2.17). No association was observed after accounting for all three estrogens (ORQ4vsQ1, 1.01; 95% CI = 0.56-1.84). CONCLUSIONS: A positive association between EA and breast cancer risk was observed. However, the association was substantially attenuated after accounting for levels of other estrogens. IMPACT: Our study provides a first detailed assessment of a breast cancer cell line-based EA assay and postmenopausal breast cancer risk.

Plasma glucocorticogenic activity, race/ethnicity and alcohol intake among San Francisco Bay Area women.

Racial and ethnic minorities are at higher risk for a variety of diseases. While sociodemographic and lifestyle factors contribute to racial/ethnic health disparities, the biological processes underlying these associations remain poorly understood. Stress and its biological consequences through the glucocorticoid receptor (GR) have been hypothesized to mediate adverse disease outcomes. In fasting morning samples of 503 control women from the San Francisco Bay Area Breast Cancer Study, we used a sensitive Chemical-Activated LUciferase gene eXpression (CALUX) assay to examine the association of sociodemographic and lifestyle factors with plasma glucocorticogenic (G) activity in three racial/ethnic groups. The G activity is a sensitive measure that reflects biological activity of total plasma glucocorticoids including cortisol and glucocorticoid-like compounds. Associations between G activity and sociodemographic and lifestyle factors were examined using multivariable linear regression models. Latina and non-Latina Black (NLB) women had 9% (P = 0.053) and 14% (P = 0.008) lower morning G activity than non-Latina White (NLW) women, respectively. Additionally, we replicated a previously reported association between G activity and alcohol intake (women who drank >10gms had 19% higher G activity than non-drinkers, P = 0.004) in Latina and NLB women. Further research should assess the association between G activity and health outcomes in a prospective cohort so as to characterize the relationship between total plasma G activity in pre-disease state and disease outcomes across different racial/ethnic populations.

Estrogenic activity, race/ethnicity, and Indigenous American ancestry among San Francisco Bay Area women.

Estrogens play a significant role in breast cancer development and are not only produced endogenously, but are also mimicked by estrogen-like compounds from environmental exposures. We evaluated associations between estrogenic (E) activity, demographic factors and breast cancer risk factors in Non-Latina Black (NLB), Non-Latina White (NLW), and Latina women. We examined the association between E activity and Indigenous American (IA) ancestry in Latina women. Total E activity was measured with a bioassay in plasma samples of 503 women who served as controls in the San Francisco Bay Area Breast Cancer Study. In the univariate model that included all women with race/ethnicity as the independent predictor, Latinas had 13% lower E activity (p = 0.239) and NLBs had 35% higher activity (p = 0.04) compared to NLWs. In the multivariable model that adjusted for demographic factors, Latinas continued to show lower E activity levels (26%, p = 0.026), but the difference between NLBs and NLWs was no longer statistically significant (p = 0.431). An inverse association was observed between E activity and IA ancestry among Latina women (50% lower in 0% vs. 100% European ancestry, p = 0.027) consistent with our previously reported association between IA ancestry and breast cancer risk. These findings suggest that endogenous estrogens and exogenous estrogen-like compounds that act on the estrogen receptor and modulate E activity may partially explain racial/ethnic differences in breast cancer risk.

Technology in the Determination of People Health Level: Design of a Computational Tool.

The health concept has evolved throughout history. The people health level is determined by the perception that each individual has of it. It is a dynamic process over time, so the variations can be see from one moment to another. In this way, knowing the health of the patients you care for will facilitate decision-making in the treatment of care. To know the level of health of the people, a technological tool is presented that calculates the people health level through the Health Variables and Nursing Outcomes Classification (NOC) labels.

Elevated Levels of Organochlorine Pesticides in South Asian Immigrants Are Associated With an Increased Risk of Diabetes.

OBJECTIVE: Rates of diabetes mellitus are higher in South Asians than in other populations and persist after migration. One unexplored cause may be higher exposure to persistent organic pollutants associated with diabetes in other populations. We compared organochlorine (OC) pesticide concentrations in South Asian immigrants and European whites to determine whether the disease was positively associated with OC pesticides in South Asians. RESEARCH DESIGN AND METHODS: South Asians of Tamil or Telugu descent (n = 120) and European whites (n = 72) were recruited into the London Life Sciences Population Study cohort. Blood samples as well as biometric, clinical, and survey data were collected. Plasma levels of p,p'-dichlorodiphenyldichloroethylene (DDE), p,p'- dichlorodiphenyltrichloroethane, ß-hexachlorohexane (HCH), and polychlorinated biphenyl-118 were analyzed by gas chromatography-mass spectrometry. South Asian cases and controls were categorized by binary exposure (above vs below the 50th percentile) to perform logistic regression. RESULTS: Tamils had approximately threefold to ninefold higher levels of OC pesticides, and Telugus had ninefold to 30-fold higher levels compared with European whites. The odds of exposure to p,p'-DDE above the 50th percentile was significantly greater in South Asian diabetes cases than in controls (OR: 7.00; 95% CI: 2.22, 22.06). The odds of exposure to ß-HCH above the 50th percentile was significantly greater in the Tamil cases than in controls (OR: 9.35; 95% CI: 2.43, 35.97). CONCLUSIONS: South Asian immigrants have a higher body burden of OC pesticides than European whites. Diabetes mellitus is associated with higher p,p'-DDE and ß-HCH concentrations in this population. Additional longitudinal studies of South Asian populations should be performed.

Use of Distraction to Reduce Pain in Venipunture when a Venoclysis Is Placed.

The use of a venoclysis in hospitalized pediatric patients is a necessity, a procedure perceived by children as painful, so that distraction techniques have been suggested to attenuate this suffering. Evaluating the implementation of a distraction method with an uncontrolled trial with pre and post maneuver evaluation without control group.

Predictive Tools in the Care of Blood Donors: Prevention of Vasovagal Syndrome.

Prediction in healthcare is essential in order to promote safe and quality care. Taking adequate care of blood donors, who perform an altruistic act towards society, is paramount. Therefore, the use of tools which allow to predict the risk of Vasovagal Syndrome during the act of blood donation is necessary. The objective of this study is to design a predictive engine of an expert system to determine the risk of Vasovagal Syndrome through the use of deductive methodology. Five clusters of predictors of this syndrome were obtained by applying grouping tables of the variables established by logical formulation in such a way that after combinatorial variables, 5 values were obtained for the determination of risk using a Lickert scale. With these results we could design the predictive engine that will allow the development of a computational tool to improve the quality of care of blood donors.

Elements for an Ontology of Care in the Field of Artificial Intelligence.

An ontology of care is a formal, explicit specification of a shared conceptualization. Constructing an ontology is a process that requires four elements: knowledge object, subject that knows, knowledge operation and result. These elements configure theframework to generate ontologies that can be used in Artificial Intelligence systems for care.

Dx-Care: A Device to Help in the Diagnosis of Care Problems.

The diagnosis of care problems is a complex process that involves many variables and inferences. This competence begins to acquire during the student stage, but matures later. The qualified professional continues to settle and perfect this judgment ability. Expert Systems are technologies that can help in making decisions such as diagnosis. The objective of this study is to build an Expert System in order to help in diagnosis of care problems by means of taxonomic triangulation technique. The deductive method follows three phases that result in the representation of expert knowledge through an associative network, the construction of a verified and validated prototype and, finally, the design of an app through a document of requirements specification in IEEE standard.

The Dimensions of Care: Big Data Analysis in Health Information Systems.

The axioms of care postulate energy and time as underlying entities that allow us to study the dimensions of the person as care: the sorge. Logic allows to formalize the deductive study of sorge knowledge in order to determine what are the dimensions of care. These dimensions will be the guiding framework in the analysis of big data contained in health information systems.

Using lysine adducts of human serum albumin to investigate the disposition of exogenous formaldehyde in human blood.

Formaldehyde is a human carcinogen that readily binds to nucleophiles, including proteins and DNA. To investigate whether exogenous formaldehyde produces adducts in extracellular fluids, we characterized modifications to human serum albumin (HSA) following incubation of whole blood, plasma, and saliva with formaldehyde at concentrations of 1, 10 and 100µM. The only HSA locus that showed the presence of formaldehyde modifications was Lys199. A N(6)-Lys adduct with added mass of 12Da, representing a putative intramolecular crosslink, was detected in biological fluids that had been incubated with formaldehyde but not in control fluids. An adduct representing N(6)-Lys formylation was detected in all fluids, but levels did not increase above control values over the tested range of formaldehyde concentrations. An adduct representing N(6)-Lys199 acetylation was also measured in all samples. We then applied the assay to repeated samples of human plasma from 6 nonsmoking volunteer subjects (from Berkeley, CA), and single samples of serum from 15 workers exposed to airborne formaldehyde at about 1.5ppm in a production facility and 15 control workers from Tianjin, China. Although all human plasma/serum samples contained basal levels of the products of N(6)-Lys formylation and acetylation, the putative crosslink product was not detected. Since the putative crosslink was observed in plasma incubated with formaldehyde at 1µM, this suggests that the endogenous concentration of formaldehyde in serum was much lower than reported in the literature. Furthermore, concentrations of the formyl adduct were not higher in workers exposed to formaldehyde at about 1.5ppm than in controls. Follow-up in vitro experiments with gaseous formaldehyde at 1.4ppm detected the putative crosslink in plasma but not whole blood. This combination of results suggests that N(6) formylation occurs within cells with subsequent release of adducted HSA to the systemic circulation. Comparing across human samples, levels of N(6)-Lys199 formyl adducts were present at similar concentrations in subjects from California and China (about 1mmol/mol HSA), but N(6)-Lys199 acetyl adducts were present at higher concentrations in Chinese subjects (0.34 vs. 0.13mmol/mol HSA).

Resiliencia para adaptarse a la crisis sanitaria / Resilience to adapt to health crisis

Desde que la Organización Mundial de la Salud (OMS) declaró el pasado 11 de marzo al COVID-19 como una pandemia, los trabajadores de la salud han trabajado de manera ininterrumpida por cubrir las necesidades de la población, sobre todo de quienes requieren atención médica especializada en unidades de cuidados intensivos. Para contener este grave problema de salud pública se han aplicado estrategias que incluyen la reconversión hospitalaria, el distanciamiento social, el cierre de escuelas y de actividad comercial. Éstas han implicado un cambio drástico en la vida diaria y han tenido el objetivo de atender y disminuir las alarmantes cifras de contagios y fallecimientos. Sin embargo, a 12 meses de jornadas laborales extenuantes es evidente y previsible el desgaste físico, en especial el emocional; en el personal de salud que ha experimentado el estrés de la pandemia y que su resistencia ante las adversidades, se encuentra disminuida por lo anterior, la resiliencia puede ser un factor protector y de prevención para trastornos psicológicos, además de coadyuvar a enfrentar el estrés; ahora más que nunca es una responsabilidad como sociedad tomar conciencia al respecto y cuidar de quien nos cuida

Since March 11, when the World Health Organization (WHO) declared the pandemic associated to COVID-19, health person- nel have worked uninterruptedly to meet the needs of the population, especially those who require specialized medical care in intensive care units.To contain this serious public health problem, strategies including hospital reconversion, social distancing, closure of schools and commercial activity, have been implemented. Such strategies have implied a drastic change in daily life but have had the objective of attending and reducing the alarming numbers of infections and deaths. However, after twelve months of strenuous working hours, physical and especially emotional exhaustion is evident and expected in health personnel, who have experienced the stress of the pandemic and whose resistance to adversity is diminished.Therefore, resilience can be a protective and preventive factor for psychological disorders, in addition to helping to face stress; now more than ever, it is our responsibility as a society to become aware of this situation and take care of those who take care of us.

Grupos de apoyo en línea, una alternativa frente al cáncer de mama / Online support groups, an alternative to breast cancer

El cáncer de mama es el cáncer más frecuente en las mujeres, con un 25.2%, y se presenta tanto en los países desarrollados como en los países en desarrollo. Su incidencia desafortunadamente continúa en aumento pese a las campañas de concientización en todo el mundo; por ejemplo, durante todo el mes de octubre se promueven la sensibilización y la detección oportuna. Todos los esfuerzos siempre serán bienvenidos a fin de lograr el máximo bienestar de las pacientes, y es por eso que desde la década de 1990 surgieron numerosos grupos de apoyo con la finalidad de proporcionar soporte a las mujeres con diagnóstico de cáncer de mama, en los que se identificó que había múltiples beneficios tanto emocionales como fisiológicos, además de favorecer el afrontamiento de su enfermedad y con efectos positivos en cuanto a la supervivencia. Y son justo los tópicos que se abordan en los grupos de apoyo los que pueden ayudar no solo a las pacientes, sino también a sus familias, a su red de apoyo y en particular a su cuidador primario, quien desempeña un rol fundamental en el proceso que llevará la paciente a lo largo de su tratamiento médico.

Breast cancer is the most frequent cancer in women with 25.2% and occurs in both developed and developing countries, its incidence unfortunately continues to increase despite awareness campaigns worldwide, for example during throughout the month of October awareness and timely detection are promoted. All efforts will always be welcome in order to achieve the maximum well-being of patients, and that is why since the 1990s a large number of support groups emerged worldwide, with the purpose of providing support to women with diagnosis. of breast cancer, where it was identified that there were multiple benefits both emotional and physiological, in addition to favoring the coping of their disease with positive effects in terms of survival. And it is precisely the topics that are addressed in the support groups that can help, not only the patients but also their families, their support network and in particular their primary caregiver. Who plays a fundamental role in the process that the patient will take throughout her medical treatment.

Análisis bibliométrico del Journal of Nursing Scholarship, periodo 1983-2019 / Bibliometric analysis of the Journal of Nursing Scholarship. Period 1983-2019

Introducción: los estudios bibliométricos son instrumentos que permiten evaluar la actuación y el impacto de las revistas científicas. Objetivo: es de nuestro interés realizar este tipo de estudio a una revista de enfermería extranjera para conocer si es una buena opción para realizar publicaciones mexicanas. Metodología: se realizó un estudio bibliométrico descriptivo-retrospectivo de los artículos publicados en el período 1983-2019 en la revista Journal of Nursing Scholarship. Se realizó un análisis estadístico descriptivo mediante el uso de tablas, frecuencia y porcentaje. Se consultó la base de datos de Scopus para obtener las métricas de la revista. Resultados: se analizaron en total 2550 artículos, en promedio se publicaron 68.91 artículos por año. El 100% de los autores con el mayor número de publicaciones son del género femenino y el 90% de origen estadounidense. En el 2018 la revista obtuvo un CiteScore de 2.94; SJR de 1.17; SNIP de 1.63 y un IF de 2.54 colocándose en un Q1. Conclusiones: La revista J. Nurs. Scholarsh es una buena opción para los investigadores mexicanos que desean publicar en revistas extranjeras. Realizar un análisis bibliométrico aporta información relevante al campo de la investigación.

Introduction: Bibliometric studies are instruments that allow evaluating the performance and impact of scientific journals. Objective: We are interested in carrying out this type of study on a foreign nursing journal to find out if it is a good option for Mexican publications. Methodology: A descriptive-retrospective bibliometric study of the articles published in the period 1983-2019 in the Journal of Nursing Scholarship was carried out. A descriptive statistical analysis was performed using tables, frequency and percentage. The Scopus database was consulted to obtain the journal metrics. Results: A total of 2550 articles were analyzed; an average of 68.91 articles were published per year. 100% of the authors with the highest number of publications are of female gender and 90% are of US origin. In 2018 the journal obtained a CiteScore of 2.94; SJR of 1.17; SNIP of 1.63 and an IF of 2.54 placing it in a Q1. The least frequent topic was Pharmacology and Pharmaceutical Sciences. Conclusions: The journal J. Nurs. Scholarsh is a good option for Mexican researchers who wish to publish in foreign journals. Performing a bibliometric analysis provides relevant information to the field of research.

El antiguo enemigo resurge: el sarampión está de vuelta / The oíd enemy resurfaces: measles is back

El sarampión regresa a nuestro país después de 20 años, los afectados no tenían antecedente de vacunación ese es su común denominador. ¿Por qué una enfermedad exantemática, y de fácil diagnóstico hoy en día continúa siendo un grave problema de salud pública? Siendo que la estrategia de solución es eficiente y de bajo costo para una enfermedad prevenible por vacunación, que puede desarrollar graves complicaciones de salud. A nivel mundial el sarampión está de vuelta, dado que existen grupos antivacunas que defienden su postura de no aplicarlas por mitos, creencias religiosas o incluso la falsa asociación con el autismo. Esto ha generado un resultado negativo en la población, y como consecuencia una disminución de las coberturas de vacunación. Considerando el escenario epidemiológico antes descrito y el riesgo de propagación del sarampión lo mejor es fortalecer las medidas de prevención sin dejar de largo la contención de los brotes de la enfermedad manteniendo una estricta vigilancia epidemiológica para la identificación de casos probables de manera oportuna que cumplan con definición operacional de probable Sarampión.

Measles returns to our country after 20 years, those affected had no history of vaccination, that is their common denominator. Why an exanthematous disease, and easy to diagnose today it remains a serious public health problem? Being that the fact that the solution strategy is efficient and inexpensive for a vaccine-preventable disease, which can develop serious health complications. Globally, measles is back, since there are anti-vaccine groups that defend their position of not applying them due to myths, religious beliefs or even the false association with autism. This has generated a negative result in the population, and as a consequence a decrease in vaccination coverage. Considering the epidemiological scenario described above and the risk of the spread of measles, it is best to strengthen prevention measures without neglecting the containment of outbreaks of the disease, maintaining strict epidemiological surveillance to ¡dentify probable cases in a timely manner that comply with operational definition of probable Measles.

Los profesionales de la salud en los tiempos de la pandemia: personal de Enfermería frente al COVID-19 / Health professionals in times of pandemic: Nursing staff facing COVID-19

La pandemia de COVID-19 causada por el coronavirus SARS-CoV-2, ha sacudido fuertemente al mundo entero desde hace algunos meses. Los organismos internacionales de salud se encuentran en una carrera a contrarreloj para identificar el tratamiento más adecuado y la vacuna contra este virus, que hasta el momento ha dejado más de 2 494 915 casos y 171 249 personas fallecidas en el mundo. Mientras la crisis sanitaria se hace cada vez más palpable, nuestro gremio se encuentra en pugna sin tregua, contra un enemigo invisible, altamente contagioso y letal. Se han hecho exhortos para fortalecer los sistemas de salud, con especial énfasis en los recursos humanos, de infraestructura y materiales. La epidemia dejará a su paso consecuencias deplorables en salud y economía, pero también será una importante oportunidad para mejorar la práctica de la Enfermería en el país. Será necesario reevaluar la capacidad instalada y la capacitación en diversas áreas del trabajo cotidiano, especialmente en la bioseguridad y biocustodia. Aprenderemos mediante una dura lección, pero tendremos que reflexionar acerca de nuestra razón de ser, de nuestro crecimiento como profesionales y reivindicar nuestro lugar en la vida pública de México.

The pandemic that we are currently experiencing, the COVID-19, has strongly shaken the entire world ¡n recent months. International health organizations are involved in a race against time to identify the most appropriate treatment and vaccine to defeat this virus, which, so far, has left more than 2 494 915 cases and 171 249 people dead. As the health crisis becomes more palpable, our unión is fighting, relentlessly, against an invisible, highly contagious and lethal enemy. Calis have been made to strengthen health systems, with special emphasis on human resources, infrastructure and materials. Perhaps this event not only leaves catastrophic health and economic results in its wake, but also a great area of opportunity to act, implementing ¡mprovements in the country in terms of the increase in nursing professionals and providing training in areas such as biosecurity. Historically, health professionals have faced the disease, and this pandemic is an excellent opportunity to reflect on our reason for being, our growth as professionals and claim our place in the public life of México.