Bivalent Omicron BA.1-Adapted BNT162b2 Booster in Adults Older than 55 Years.

BACKGROUND: The emergence of immune-escape variants of severe acute respiratory syndrome coronavirus 2 warrants the use of sequence-adapted vaccines to provide protection against coronavirus disease 2019. METHODS: In an ongoing phase 3 trial, adults older than 55 years who had previously received three 30-µg doses of the BNT162b2 vaccine were randomly assigned to receive 30 µg or 60 µg of BNT162b2, 30 µg or 60 µg of monovalent B.1.1.529 (omicron) BA.1-adapted BNT162b2 (monovalent BA.1), or 30 µg (15 µg of BNT162b2 + 15 µg of monovalent BA.1) or 60 µg (30 µg of BNT162b2 + 30 µg of monovalent BA.1) of BA.1-adapted BNT162b2 (bivalent BA.1). Primary objectives were to determine superiority (with respect to 50% neutralizing titer [NT50] against BA.1) and noninferiority (with respect to seroresponse) of the BA.1-adapted vaccines to BNT162b2 (30 µg). A secondary objective was to determine noninferiority of bivalent BA.1 to BNT162b2 (30 µg) with respect to neutralizing activity against the ancestral strain. Exploratory analyses assessed immune responses against omicron BA.4, BA.5, and BA.2.75 subvariants. RESULTS: A total of 1846 participants underwent randomization. At 1 month after vaccination, bivalent BA.1 (30 µg and 60 µg) and monovalent BA.1 (60 µg) showed neutralizing activity against BA.1 superior to that of BNT162b2 (30 µg), with NT50 geometric mean ratios (GMRs) of 1.56 (95% confidence interval [CI], 1.17 to 2.08), 1.97 (95% CI, 1.45 to 2.68), and 3.15 (95% CI, 2.38 to 4.16), respectively. Bivalent BA.1 (both doses) and monovalent BA.1 (60 µg) were also noninferior to BNT162b2 (30 µg) with respect to seroresponse against BA.1; between-group differences ranged from 10.9 to 29.1 percentage points. Bivalent BA.1 (either dose) was noninferior to BNT162b2 (30 µg) with respect to neutralizing activity against the ancestral strain, with NT50 GMRs of 0.99 (95% CI, 0.82 to 1.20) and 1.30 (95% CI, 1.07 to 1.58), respectively. BA.4-BA.5 and BA.2.75 neutralizing titers were numerically higher with 30-µg bivalent BA.1 than with 30-µg BNT162b2. The safety profile of either dose of monovalent or bivalent BA.1 was similar to that of BNT162b2 (30 µg). Adverse events were more common in the 30-µg monovalent-BA.1 (8.5%) and 60-µg bivalent-BA.1 (10.4%) groups than in the other groups (3.6 to 6.6%). CONCLUSIONS: The candidate monovalent or bivalent omicron BA.1-adapted vaccines had a safety profile similar to that of BNT162b2 (30 µg), induced substantial neutralizing responses against ancestral and omicron BA.1 strains, and, to a lesser extent, neutralized BA.4, BA.5, and BA.2.75 strains. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04955626.).

Temporal Evaluation of the Surface Area of Treated Skin Ulcers Caused by Cutaneous Leishmaniasis and Relation with Optical Parameters in an Animal Model: A Proof of Concept.

Cutaneous leishmaniasis (CL) is a neglected disease caused by an intracellular parasite of the Leishmania genus. CL lacks tools that allow its understanding and treatment follow-up. This article presents the use of metrical and optical tools for the analysis of the temporal evolution of treated skin ulcers caused by CL in an animal model. Leishmania braziliensis and L. panamensis were experimentally inoculated in golden hamsters, which were treated with experimental and commercial drugs. The temporal evolution was monitored by means of ulcers' surface areas, as well as absorption and scattering optical parameters. Ulcers' surface areas were obtained via photogrammetry, which is a procedure that allowed for 3D modeling of the ulcer using specialized software. Optical parameters were obtained from a spectroscopy study, representing the cutaneous tissue's biological components. A one-way ANOVA analysis was conducted to identify relationships between both the ulcers' areas and optical parameters. As a result, ulcers' surface areas were found to be related to the following optical parameters: epidermis thickness, collagen, keratinocytes, volume-fraction of blood, and oxygen saturation. This study is a proof of concept that shows that optical parameters could be associated with metrical ones, giving a more reliable concept during the assessment of a skin ulcer's healing.

Cells of renin lineage are progenitors of podocytes and parietal epithelial cells in experimental glomerular disease.

Glomerular injury leads to podocyte loss, a process directly underlying progressive glomerular scarring and decline of kidney function. The inherent repair process is limited by the inability of podocytes to regenerate. Cells of renin lineage residing alongside glomerular capillaries are reported to have progenitor capacity. We investigated whether cells of renin lineage can repopulate the glomerulus after podocyte injury and serve as glomerular epithelial cell progenitors. Kidney cells expressing renin were genetically fate-mapped in adult Ren1cCreER×Rs-tdTomato-R, Ren1cCre×Rs-ZsGreen-R, and Ren1dCre×Z/EG reporter mice. Podocyte depletion was induced in all three cell-specific reporter mice by cytotoxic anti-podocyte antibodies. After a decrease in podocyte number, a significant increase in the number of labeled cells of renin lineage was observed in glomeruli in a focal distribution along Bowman's capsule, within the glomerular tuft, or in both locations. A subset of cells lining Bowman's capsule activated expression of the glomerular parietal epithelial cell markers paired box protein PAX2 and claudin-1. A subset of labeled cells within the glomerular tuft expressed the podocyte markers Wilms tumor protein 1, nephrin, podocin, and synaptopodin. Neither renin mRNA nor renin protein was detected de novo in diseased glomeruli. These findings provide initial evidence that cells of renin lineage may enhance glomerular regeneration by serving as progenitors for glomerular epithelial cells in glomerular disease characterized by podocyte depletion.

Predictive model of suicide risk in Colombian university students: quantitative analysis of associated factors.

Introduction: The risk of suicide and completed suicides among young university students presents critical challenges to mental and public health in Colombia and worldwide. Employing a quantifiable approach to comprehend the factors associated with these challenges can aid in visualizing the path towards anticipating and controlling this phenomenon. Objective: Develop a predictive model for suicidal behavior in university students, utilizing predictive analytics. Method: We conducted an observational, retrospective, cross-sectional, and analytical research study at the University of Manizales, with a focus on predictive applicability. Data from 2,436 undergraduate students were obtained from the research initiative "Building the Future: World Mental Health Surveys International College Students." Results: The top ten predictor variables that generated the highest scores (ranking coefficients) for the sum of factors were as follows: history of sexual abuse (13.21), family history of suicide (11.68), medication (8.39), type of student (7.4), origin other than Manizales (5.86), exposure to cannabis (4.27), exposure to alcohol (4.42), history of physical abuse (3.53), religiosity (2.9), and having someone in the family who makes you feel important (3.09). Discussion: Suicide involves complex factors within psychiatric, medical, and societal contexts. Integrated detection and intervention systems involving individuals, families, and governments are crucial for addressing these factors. Universities also play a role in promoting coping strategies and raising awareness of risks. The predictive accuracy of over 80% in identifying suicide risk underscores its significance. Conclusion: The risk factors related to suicidal behavior align with the findings in specialized literature and research in the field. Identifying variables with higher predictive value enables us to take appropriate actions for detecting cases and designing and implementing prevention strategies.

COVOX: Providing oxygen during the COVID-19 health emergency.

We introduce an autonomous oxygen concentrator that was designed in Peru to fight the oxygen shortage produced worldwide as a consequence of the COVID-19 pandemic. Oxygen concentrators represent a suitable and favorable option for administering this gas at the patient's bedside in developing countries, especially when cylinders and tubed systems are unavailable or when access to them is restricted by lack of accessories, inadequate power supply, or shortage of qualified personnel. Our system uses a pressure swing adsorption technique to provide oxygen to patients at a flow rate of up to 15 l/min ± 1,5 l/min and a concentration of 93 % ± 3 %, offering robustness, safety and functionality. The quality measurements obtained from the validation process demonstrate repeatability and accuracy. The complete design files are provided in the source file repository to facilitate oxygen concentrator production in low and middle income countries, where access to oxygen is still a major problem even after the pandemic. Oxygen is part of the World Health Organization Model List of Essential Medicines and is perhaps the only medicine that has no substitute. This device can provide a reliable supply of oxygen for critically ill patients and improve their chances of survival.

Performance of emergency mechanical ventilators in response to the covid-19 pandemic: an intercomparison study.

Emergency mechanical ventilators developed during the pandemic were used to meet the high demand in intensive care units to care for COVID-19 patients. An example of such ventilators is Masi, developed in Peru and installed in more than 15 hospitals around the country. This study aimed to compare Masi's performance with other emergency mechanical ventilators manufactured during the covid-19 pandemic such as Neyün, Spiro Wave and a prototype developed by the Faculty of Engineering of the National University of Asuncion (FIUNA). Three configurations of a test lung were used, combining different values of resistance and compliance (C1, C2 and C3). Ventilators were set to volume-controlled ventilation with tidal volume = 400 mL, respiratory rate = 12 breaths/minute, and positive end-expiratory pressure (PEEP) = 8 cm H2O. These parameters were measured in a series of ten two-minute tests which then were evaluated through a two-way analysis of variance, considering the type of ventilator and test lung configuration as the two independent variables. For target values, MASI delivered VT that ranged from 319 to 432 ml (-20 to +8%), respiratory rate of 12 bpm, and PEEP from 8.4 to 9.5 cm H2O (+5 to +20%). In contrast, for instance, Neyün delivered VT that ranged from 199 to 543 ml (-50 to +35%) and PEEP from 7.05 to 9.21 cm H2O (--11 to +15%), with p<0.05. The analysis of variance showed that he differences between preset and delivered parameters were influenced by the type of ventilator and, significantly, by the test lung configuration.Clinical Relevance- This establishes the most advantageous conditions in which three emergency mechanical ventilators work and a quantitative perspective in this topic.

PytuTester: RaspberryPi open-source ventilator tester.

PytuTester is an open-source ventilator tester developed to help bio-engineers in the design and verification of new ventilator prototypes. A ventilator tester allows measuring the flow, pressure, volume, and oxygen concentration provided to the patient. During the global pandemic COVID-19, several open-source ventilators prototypes were developed; however, due to high cost and demand testers, they were not available. In this context, a low-cost tester was developed using a Raspberry Pi and medical-grade sensors for the test ventilators prototypes. This paper presents the design files, software interface, and validations tests. Our results indicate that the tester has good accuracy to evaluate the efficacy and performance of new prototypes. When tested on two ventilator designs developed in Paraguay, PytuTester reported flow profiles that were concordant with the industry-standard VT650 Gas Flow Analyzer. PytuTester was then field deployed to test several DIY ventilator designs in low-resource areas.

Extension of Non-invasive Ventilation Capabilities of MASI for the Care of Patients Affected by COVID-19.

The MASI mechanical ventilator was developed in a state of emergency to meet the demand for ventilators caused by COVID-19. Although it has obtained positive results in its use with patients in intensive care units, not having an optimal quality non-invasive ventilation (NIV) modality prevents it from being used in the early treatment of patients, which has been shown to prevent admission to the ICU and reduce mortality. Therefore, the following study focuses on evaluating MASI's ability to provide NIV using different accessories in order to compare their performance and determine which one would work best with MASI, and under which conditions. To do this, the high-flow nasal cannula, facial mask, and ventilation helmet accessories were tested under different pressure parameter settings. The data was collected using a gas flow analyzer. After that, a statistical analysis of the results was carried out, which showed that the face mask is the best accessory to use for NIV with MASI, and that it performs with optimal accuracy and precision when the peak inspiratory pressure is set at a value lower than 25 cmH20. Clinical Relevance- This study presents an optimization of the non-invasive ventilation (NIV) modality of the MASI me-chanical ventilator by evaluating its performance with different accessories.

Cytotoxicity and Genotoxicity of Azobenzene-Based Polymeric Nanocarriers for Phototriggered Drug Release and Biomedical Applications.

Drug nanoencapsulation increases the availability, pharmacokinetics, and concentration efficiency for therapeutic regimes. Azobenzene light-responsive molecules experience a hydrophobicity change from a polar to an apolar tendency by trans-cis photoisomerization upon UV irradiation. Polymeric photoresponse nanoparticles (PPNPs) based on azobenzene compounds and biopolymers such as chitosan derivatives show prospects of photodelivering drugs into cells with accelerated kinetics, enhancing their therapeutic effect. PPNP biocompatibility studies detect the safe concentrations for their administration and reduce the chance of side effects, improving the effectiveness of a potential treatment. Here, we report on a PPNP biocompatibility evaluation of viability and the first genotoxicity study of azobenzene-based PPNPs. Cell line models from human ventricular cardiomyocytes (RL14), as well as mouse fibroblasts (NIH3T3) as proof of concept, were exposed to different concentrations of azobenzene-based PPNPs and their precursors to evaluate the consequences on mitochondrial metabolism (MTT assay), the number of viable cells (trypan blue exclusion test), and deoxyribonucleic acid (DNA) damage (comet assay). Lethal concentrations of 50 (LC50) of the PPNPs and their precursors were higher than the required drug release and synthesis concentrations. The PPNPs affected the cell membrane at concentrations higher than 2 mg/mL, and lower concentrations exhibited lesser damage to cellular genetic material. An azobenzene derivative functionalized with a biopolymer to assemble PPNPs demonstrated biocompatibility with the evaluated cell lines. The PPNPs encapsulated Nile red and dofetilide separately as model and antiarrhythmic drugs, respectively, and delivered upon UV irradiation, proving the phototriggered drug release concept. Biocompatible PPNPs are a promising technology for fast drug release with high cell interaction opening new opportunities for azobenzene biomedical applications.

Quality characteristics of the Masi Peruvian mechanical ventilator manufacturing process.

Three hundred and ten rapid-manufactured mechanical ventilators, named Masi, were produced and validated in Peru, according to applicable standards. From these, a sample of 30 was taken and two ventilation parameters, tidal volume and peak inspiratory pressure, were statically analyzed using control charts and histograms. Results show that several points were outside estimated limits for Shewhart means and ranges charts, which could possibly be due to the quantity of equipment used for data recollection and the fact that the Masi team had over 20 engineers. Nevertheless, Masi ventilators met the tolerance required by their user´s manual and MHRA standard and Peruvian DIGEMID for every parameter.Clinical Relevance-This article shows the performance in the validation stage of the peruvian mechanical ventilator MASI built as an emergency response for the COVID-19 crisis.

Performance of the Masi Peruvian ventilator at high altitude.

In response to Covid-19 crisis, 310 Masi ventilators were produced and validated in Lima, Peru, according to applicable standards. Four of them, were transported to Puno, in order to strengthen ICU Services there, but this set a major challenge to Masi team as effects of altitude on ventilators were unknown. Once there, ventilators were acclimated and calibrated. Volume tidal, I:E ratio, respiratory frequency and PEEP were tested, all of them presenting errors under 15%, except for tidal volume, for which a 25% negative correction was applied. After the installation of a new version of Masi software, parameters were tested again, all of them presenting results with errors below 15%, which allowed the Masi team to take them to ICU services for use.Clinical Relevance- Masi Peruvian Ventilators are able to perform according to their specifications at extremely high altitude, after the adequate calibration. These devices are an alternative to treat COVID-19 patients in the middle of the crisis.

Maternal immunization with Group B Streptococcus six-valent polysaccharide conjugate vaccine supported by lack of toxicity in rat and rabbit fertility and developmental toxicity studies.

A maternal Group B Streptococcus (GBS) six-valent polysaccharide conjugate vaccine (GBS6) is being developed to protect neonates and infants up to 3 months of age through passive transfer of antibodies from the mother to the infant. Fertility and developmental toxicity studies were conducted in female Sprague Dawley rats and New Zealand White rabbits with GBS6 (20 µg capsular polysaccharide/serotype formulated with or without AlPO4 , the highest clinical dose). Females were administered the full human dose of the GBS6 formulation intramuscularly twice prior to mating and twice during gestation, to ensure that high antibody levels were maintained throughout gestation and lactation. Approximately, half of the rats and rabbits were evaluated at the end of gestation, and the remainder were evaluated at the end of lactation. Maternal blood for GBS6 serology, to measure antibody titers to the GBS6 antigens, was collected prior to the first dose, prior to mating, and at each necropsy. Blood for serology was also collected from offspring at the end of gestation and lactation. In both species, there was no evidence of vaccine-related effects on fertility, embryo-fetal development, or postnatal development of the offspring, supporting regulatory guidance that single-species evaluation would have been sufficient. Functional serum antibodies to all six serotypes in the vaccine were confirmed in maternal animals and functional serum antibodies to one or more of the six serotypes was also confirmed in some rat offspring and most of the rabbit offspring. The results of these studies supported the safety of GBS6 vaccine administration to pregnant women.

Masi: A mechanical ventilator based on a manual resuscitator with telemedicine capabilities for patients with ARDS during the COVID-19 crisis.

In this article, we introduce a portable and low-cost ventilator that could be rapidly manufactured, to meet the increasing demand of ventilators worldwide produced by COVID-19 pandemic. These ventilators should be rapidly deployable and with functional capabilities to manage COVID-19 patients with severe acute respiratory distress syndrome (ARDS). Our implementation offers robustness, safety and functionality absent in existing solutions to the ventilator shortage (i.e., telemonitoring, easy-to-disinfect, modularity) by maintaining simplicity. The design makes use of a manual resuscitator as the core respiration component activated by a compression mechanism which consist of two electronically controlled paddles. The quality measurements obtained after testing on a calibrated artificial lung demonstrate repeatability and accuracy exceeding human capabilities of manual ventilation. The complete design files are provided in the supplementary materials to facilitate ventilator production even in resource-limited settings. The implementation of this mechanical ventilator could eliminate device rationing or splitting to serve multiple patients on ICUs.

Photosensitive nanocarriers for specific delivery of cargo into cells.

Nanoencapsulation is a rapidly expanding technology to enclose cargo into inert material at the nanoscale size, which protects cargo from degradation, improves bioavailability and allows for controlled release. Encapsulation of drugs into functional nanocarriers enhances their specificity, targeting ability, efficiency, and effectiveness. Functionality may come from cell targeting biomolecules that direct nanocarriers to a specific cell or tissue. Delivery is usually mediated by diffusion and erosion mechanisms, but in some cases, this is not sufficient to reach the expected therapeutic effects. This work reports on the development of a new photoresponsive polymeric nanocarrier (PNc)-based nanobioconjugate (NBc) for specific photo-delivery of cargo into target cells. We readily synthesized the PNcs by modification of chitosan with ultraviolet (UV)-photosensitive azobenzene molecules, with Nile red and dofetilide as cargo models to prove the encapsulation/release concept. The PNcs were further functionalized with the cardiac targeting transmembrane peptide and efficiently internalized into cardiomyocytes, as a cell line model. Intracellular cargo-release was dramatically accelerated upon a very short UV-light irradiation time. Delivering cargo in a time-space controlled fashion by means of NBcs is a promising strategy to increase the intracellular cargo concentration, to decrease dose and cargo side effects, thereby improving the effectiveness of a therapeutic regime.

Azopolymer based nanoparticles for phototriggered drug delivery.

Controlled release by stimulus-responsive nanoparticles is oriented to increase the specificity of drug delivery, to improve the therapy effectiveness and minimizing side effects. This work presents the synthesis of photosensitive-polymeric nanoparticles as a potential system for localized drug delivery. First, the photoisomerizable amphiphilic-copolymer poly2-[4-phenylazophenoxy]ethyl acrylate-co-acrylic acid (PPAPE), was synthesized. Then, PPAPE was employed to prepare micellar nanoparticles by the nanoprecipitation method. Characterizations of the polymer were performed by proton nuclear magnetic resonance, X-ray photoelectron spectroscopy and FTIR spectroscopy. The morphology of the nanoparticles was analyzed by dynamic light scattering and transmission electron microscopy. Also, photostimulation response was confirmed by UV-VIS spectroscopy. Results indicate that the obtained photoresponsive nanoparticles have the size and photoisomerization necessary to perform the specific release of drugs.

La formación médica en el ámbito de las capacidades, según las necesidades del entorno / Medical training concerning capacities, based on the setting-related needs

Introducción: El análisis crítico y la modificación de la formación médica en Colombia es un asunto de gran relevancia en el sistema educativo universitario. Los procesos educativos y formativos de los médicos no pueden estar a espaldas de las realidades actuales, de los contextos contemporáneos y de las diferentes necesidades que han determinado las nuevas condiciones de orden legal, político, económico y cultural. Objetivo: Identificar las necesidades en la formación médica en el ámbito de las capacidades, de acuerdo con las necesidades del entorno, en el programa de Medicina de la Facultad de Ciencias de la Salud de la Universidad de Manizales. Métodos: Estudio exploratorio, diagnóstico y descriptivo, con enfoque empírico analítico, a partir de preguntas validadas por expertos y utilizadas en grupos focales. Los datos y la información obtenidos se analizaron estructuralmente a través de Atlas Ti, para obtener categorías emergentes. Estas fueron descritas a través de redes semánticas, las cuales, de manera complementaria, se confrontaron con categorías empíricas. Resultados: Los resultados precisaron que la profesión médica como ocupación atiende fundamentalmente a la definición convencional de competencias, que expresa que estas son un saber hacer en contexto. Se encontraron capacidades como: proactividad, toma de decisiones, empatía, perfil investigado y habilidades comunicativas, como perfiles de mayor importancia. Conclusiones: El estudio mostró la importancia de orientar la formación médica integral con un currículo flexible, donde se puedan dar procesos educativos problematizantes. Asimismo, se evidenció la relevancia de la práctica(AU)

Introduction: Critical analysis and modification of medical training in Colombia is a matter of great relevance in the university educational system. Educational and training processes for physicians cannot be ignored by current realities, in contemporary contexts and considering the different needs that have determined the new legal, political, economic and cultural conditions. Objective: To identify the needs in medical training in the field of skills, according to the needs of the environment, in the Medicine major's program of the School of Health Sciences of the University of Manizales. Methods: An exploratory, diagnostic and descriptive study, with an analytical empirical approach, based on questions validated by experts and used in focus groups. The data and information obtained were structurally analyzed through ATLAS.ti, to obtain emerging categories. These were described through semantic networks, which, in a complementary way, were confronted with empirical categories. Results: The results specified that the medical profession as an occupation fundamentally attends to the conventional definition of competences, which expresses that these are know-how in context. Capabilities such as: proactivity, decision making, empathy, researched profile and communication skills were found as the most important profiles. Conclusions: The study showed the importance of guiding comprehensive medical training with a flexible program of studies, in which problematic educational processes can occur. Likewise, the relevance of the practice was evidenced(AU)

Frecuencia de conductas autolesivas y factores asociados en adolescentes escolarizados de Manizales Colombia / Frequency of self-injurious behaviors and associated factors in school adolescents from Manizales, Colombia

Objetivo: esta investigación pretende determinar la frecuencia de conductas autolesivas en una muestra de estudiantes de un colegio de Manizales (Caldas, Colombia). En las últimas dos décadas las conductas autolesivas han aumentado significativamente en la población adolescente. Materiales y métodos: se empleó una muestra por conveniencia de 58 estudiantes (de una población de 538). Se cuantificaron variables demográficas, la frecuencia de conductas autolesivas, factores de riesgo, y se cuantificaron mediante escalas la satisfacción familiar, ansiedad y depresión y acoso escolar (bullying). Resultados: se encontró que una proporción de 22,4% presentaban conductas autolesivas (auto corte, auto golpearse, auto arañarse, intoxicación, arrancarse el cabello, auto quemarse), 10,3% consumo de sustancias psicoactivas, 36,4% consumo de bebidas alcohólicas, 50% probable ansiedad, 56,9% probable depresión. 66,95% de satisfacción familiar. Como factores asociados a autolesiones se encontraron ansiedad, depresión, orientación sexual, consumo de sustancias psicoactivas, bebidas alcohólicas e intento de suicidio en los últimos dos años. Conclusiones: la prevalencia de conductas autolesivas y los factores asociados a estas conductas en esta población es similar a lo reportado en el país y en el mundo, situación que llama la atención, más si se tiene en cuenta que es un importante predictor de suicidio; por tanto, es urgente que las autoridades competentes de la ciudad desarrollen e implementes intervenciones educativas dirigidas a reducir los factores de riesgo de CA, y así, contribuir a la disminución potencial de las tasas de suicidio en Manizales..(Au)

Objective: this research aims to determine the frequency of self-injurious behaviors in a sample of students from a school in Manizales (Caldas, Colombia). In the last two decades, self-injurious behaviors have increased significantly in the adolescent population. Materials and methods: a convenience sample of 58 students (from a population of 538) was used. Demographic variables, the frequency of self-injurious behavior, risk factors were quantified, and family satisfaction, anxiety and depression, and bullying were quantified using scales. Results: it was found that a proportion of 22.4% had self-injurious behaviors (self-cutting, self-hitting, self-scratching, intoxication, hair pulling, self-burning), 10.3% consumption of psychoactive substances, 36.4% consumption of alcoholic beverages, 50% probable anxiety, 56.9% probable depression. 66.95 family satisfaction. As factors associated with self-harm, anxiety, depression, sexual orientation, consumption of psychoactive substances, alcoholic beverages and attempted suicide in the last two year were found. Conclusions: a frequency of self-harm was determined in this population, and associated factors similar to that found in other student populations nationally and internationally. It was determined that this phenomenon of global importance is also present, to a considerable extent, in young students from Manizales city (Colombia)..(Au)

Factores de riesgo para conducta suicida en adolescentes escolarizados: revisión de tema / Risk factors for suicidal behavior in school adolescents: a review of the topic

Introducción: la conducta suicida es una secuencia de eventos que se da de manera progresiva y, en muchos casos, inicia con pensamientos e ideas que siguen con planes suicidas y culminan en uno o múltiples intentos, hasta el suicidio consumado que puede ser desencadenado por diversos factores de riesgo biológicos, psicológicos o socioculturales. Objetivo: identificar los diferentes factores de riesgo más frecuentes en conductas suicidas en adolescentes escolarizados. Metodología: se realizó una revisión de la literatura en las bases de datos internacionales como PubMed, Proquest, Scopus, Dialnet con los términos deCS: suicidio, factores de riesgo, adolescentes y conductas; después, se filtró la búsqueda por fecha; aquellos que fueron publicados como máximo cinco años en inglés y español. Resultados: se encontraron varios factores de riesgo para el desarrollo de la conducta suicida de adolescentes escolarizados, correspondientes a las esferas biológica, psicológica y social de cada individuo, como el género, la edad, problemas emocionales y trastornos afectivos, consumo de sustancias, relaciones interpersonales y bullying. Conclusiones: la conducta suicida es un fenómeno multifactorial que puede ser prevenido mediante intervenciones de atención primaria en salud..Au

Introduction: suicidal behavior is a sequence of events that occur progressively and, in many cases, begin with thoughts and ideas followed by suicidal plans and culminating in one or more suicide attempts, until the consummated suicide that can be triggered by several risks. Factors, both biological, psychological and sociocultural. Objective:to identify the different risk factors with greater frequency of suicidal behavior in adolescents enrolled in school. Methodology: a review of the literature was made in international databases such as PubMed, Proquest, Scopus, Dialnet with the terms of CS: suicide, risk factors, adolescents and behaviors. Subsequently, the search was filtered by date; Those that were published maximum five years ago and the language; english and spanish. Results: several risk factors were found for the development of suicidal behavior in adolescents of school age, which are part of the biological, psychological and social spheres of each individual, such as sex, age, emotional problems and affective disorders. the use of substances, interpersonal relationships and bullying. Conclusions: suicidal behavior is a multifactorial phenomenon that can be prevented through primary health care interventions..Au

Influence of the implantation site on the sensitivity of patient pancreatic tumor xenografts to Apo2L/TRAIL therapy.

OBJECTIVES: We have previously demonstrated activity of Apo2L/TRAIL against patient pancreatic tumor xenografts. Here, we have examined the influence of the tumor implantation site on therapeutic response of orthotopic tumors and their metastases to Apo2L/TRAIL. METHODS: Sensitivity of 6 patient pancreatic tumor xenografts to Apo2L/TRAIL was determined in a subcutaneous model. To compare the response of orthotopic tumors, cells from subcutaneous xenografts were injected into the pancreas. Tumor growth was confirmed by histological examination of selected mice, and then treatment was started. When all control mice developed externally palpable tumors, the experiment was terminated, and pancreatic weights compared between control and treated groups. Magnetic resonance imaging was used to quantitate the response of orthotopic and metastatic tumors. RESULTS: The sensitivity to Apo2L/TRAIL observed in subcutaneous tumors was maintained in orthotopic tumors. Metastatic spread was observed with orthotopic tumor implantation. In an orthotopic model of a sensitive tumor, primary and metastatic tumor burden was significantly reduced, and median survival significantly extended by Apo2L/TRAIL therapy. CONCLUSIONS: Our data provide evidence that the site of tumor engraftment does not alter the inherent sensitivity of patient xenografts to Apo2L/TRAIL, and these results highlight the potential of Apo2L/TRAIL therapy against primary and metastatic pancreatic cancer.

Experiencias de habitantes de calle que asisten al Programa de Salud Camad Rafael Uribe Uribe en Bogotá / The Experiences of Homeless Persons Attending the Health Program Camad Rafael Uribe Uribe in Bogotá / Experiências de pessoas moradoras de rua que participam do Programa de Saúde Camad Rafael Uribe Uribe em Bogotá

Resumen Introducción: la habitabilidad en la calle crea condiciones para el consumo de sustancias psicoactivas ilegales (SPAI) que afectan la salud y que hacen de estas personas un grupo vulnerable. El programa de Centros de Atención Médica a Drogodependientes (Camad) fue una propuesta novedosa que intentó abordar esta situación con la perspectiva de la prevención y la atención en salud in situ de dicha población. El objetivo fue interpretar las experiencias vividas de un grupo de habitantes de calle de la localidad Rafael Uribe Uribe en Bogotá Colombia, en relación con el consumo de sustancias psicoactivas y la atención en salud en el Camad. Materiales y métodos: se realizaron entrevistas semiestructuradas y un abordaje enmarcado en el paradigma cualitativo desde un enfoque comprensivo-hermenéutico. Resultados: los resultados dan cuenta del programa Camad y su efecto en la vida de los habitantes de calle, quienes por medio de sus experiencias construyen un significado propio sobre la atención en salud; también reflejan que los espacios creados por el programa apuntaron a la prevención y mitigación del riesgo en el consumo de SPAI, sin lograr un cambio notorio por la complejidad del problema. Conclusión: los habitantes de calle tienen experiencias que cuentan la relación con el Camad, en cuanto a la atención de la salud y la promoción del autocuidado, pero relacionan de manera deficiente el éxito en el control del consumo de sustancias psicoactivas.

Abstract Introduction: Street habitability creates conditions for the consumption of illegal psychoactive substances (SPAI) that affect health and make these people a vulnerable group. The Camad program was a novel proposal that attempted to address this situation with the perspective of prevention and on-site care of this population. The objective is to interpret the lived experiences of a group of homeless of the locality Rafael Uribe Uribe in Bogota Colombia, in relation to the consumption of psychoactive substances and the health care in Camad. Materials and methods: Semi-structured interviews and an approach framed in the qualitative paradigm focused on the comprehensive-hermeneutical approach were carried out. Results: The results show the Camad program and its effect on the lives of street people, who through their experiences build their own meaning on health care; they also reflect that the spaces created by the program aimed at preventing and mitigating the risk of SPAI consumption without achieving a noticeable change due to the complexity of the problem. Conclusion: The homeless have experiences that relate to the relationship with Camad in terms of health care and self-care promotion, but poorly relate success in controlling the use of psychoactive substances.

Resumo Introdução: a habitabilidade na rua cria condições para o consumo de substâncias psicoativas ilegais (SPAI) que afetam a saúde e que fazem destas pessoas um grupo vulnerável. O programa Camad foi uma proposta inovadora que tentou abordar esta situação com a perspetiva da prevenção e a atenção em saúde in situ de dita população. O objetivo é interpretar as experiências vividas de um grupo de moradores de rua da localidade Rafael Uribe Uribe em Bogotá, Colômbia, em relação com o consumo de substâncias psicoativas e a atenção em saúde no Camad. Materiais e métodos: realizaram-se entrevistas semiestruturadas e uma abordagem enquadrado no paradigma qualitativo desde um enfoque com-preensivo-hermenêutico. Resultados: os resultados dão conta do programa Camad e o seu efeito na vida dos moradores de rua, os quais através de suas experiências constroem um significado próprio sobre a atenção em saúde; também refletem que os espaços criados pelo programa apontaram à prevenção e mitigação do risco no consumo de SPAI sem conseguir uma mudança notória pela complexidade do problema. Conclusão: os moradores de rua tem experiências que contam a relação com o Camad referente à atenção da saúde e à promoção do autocuidado, mas relacionam de maneira deficiente o sucesso no controlo do consumo de substâncias psicoativas.