Bilateral Uveal Melanoma: An Insight into Genetic Predisposition in Four New Unrelated Patients and Review of Published Cases.

Background: Primary bilateral uveal melanoma (BUM) is an exceptionally rare form of uveal melanoma (UM). This study aimed to explore the potential existence of a genetic predisposition towards the development of BUM. Methods: We employed an exome sequencing approach on germline DNA from four unrelated patients diagnosed with BUM, seeking pathogenic or likely pathogenic variants indicative of a genetic predisposition to UM. Results: None of the patients exhibited pathogenic variants in the BAP1 gene. However, loss-of-function (LoF) variants in the TERF2IP and BAX genes were identified in two of the BUM patients. For patients BUM1 and BUM2, no pathogenic/likely pathogenic variants of significant clinical relevance to BUM were found to warrant inclusion in this report. Conclusions: Our findings suggest the presence of yet-to-be-discovered genes that may contribute to UM predisposition, as evidenced by the absence of pathogenic variants in known UM predisposition genes among the four BUM patients studied. The TERF2IP and BAX genes emerge as noteworthy candidates for further investigation regarding their role in genetic predisposition to UM. Specifically, the potential role of UM as a candidate cancer within the spectrum of cancers linked to pathogenic variants in the TERF2IP gene and other genes associated with the shelterin complex warrants further examination. Additional functional studies are necessary to support or challenge this hypothesis.

Isolation and Characterization of Milk Exosomes for Use in Advanced Therapies.

Exosomes are cell-derived extracellular vesicles (EVs) with diameters between 30 and 120 nm. In recent years, several studies have evaluated the therapeutic potential of exosomes derived from different fluids due to their low immunogenicity and high biocompatibility. However, producing exosomes on a large scale is still challenging. One of the fluids from which they could be isolated in large quantities is milk. Moreover, regeneration is a well-known property of milk. The present work seeks to optimize a method for isolating exosomes from bovine and human milk, comparing different storage conditions and different extraction protocols. We found differences in the yield extraction associated with pre-storage milk conditions and observed some differences according to the processing agent. When we removed milk fat globules and added rennet before freezing, we obtained a cleaner final fraction. In summary, we attempted to optimize a rennet-based new milk-exosome isolation method and concluded that pre-treatment, followed by freezing of samples, yielded the best exosome population.

Impact of Driver Mutations on Metastasis-Free Survival in Uveal Melanoma: A Meta-Analysis.

The prognosis of uveal melanoma is significantly influenced by the risk of metastasis, which varies according to clinical and genetic features. Driver mutations can predict the likelihood of disease progression and survival, although the data in the literature are inconsistent. This meta-analysis aimed to evaluate the prognostic significance of driver mutations, including GNAQ, GNA11, BAP1, and SF3B1, in the advancement of uveal melanoma. A comprehensive search of databases yielded relevant studies, and data from 13 studies (848 eyes) were synthesized to assess the impact of these mutations on metastasis-free survival. The BAP1 mutation and negative immunohistochemistry were associated with a higher risk of metastasis (logHR = 1.44, 95% CI 1.05-1.83). GNAQ, GNA11, and SF3B1 mutations did not show a significant increase in risk. In summary, BAP1 has proven to reliably predict the likelihood of disease progression in uveal melanoma, while further studies are needed to establish the significance of other driver mutations.

Urine beyond electrolytes: diagnosis through extracellular vesicles.

BACKGROUND AND OBJECTIVE: Extracellular vesicles (EV) reflect the pathophysiological state of their cells of origin and are a reservoir of renal information accessible in urine. When biopsy is not an option, EV present themselves as sentinels of function and damage, providing a non-invasive approach. However, the analysis of EV in urine requires prior isolation, which slows down and hinders transition into clinical practice. The aim of this study is to show the applicability of the "single particle interferometric reflectance imaging sensor" (SP-IRIS) technology through the ExoView® platform for the direct analysis of urine EV and proteins involved in renal function. MATERIALS AND METHODS: The ExoView® technology enables the quantification and phenotyping of EV present in urine and the quantification of their membrane and internal proteins. We have applied this technology to the quantification of urinary EV and their proteins with renal tubular expression, amnionless (AMN) and secreted frizzled-related protein 1 (SFRP1), using only 5 µl of urine. Tubular expression was confirmed by immunohistochemistry. RESULTS: The mean size of the EV analysed was 59 ± 16 nm for those captured by tetraspanin CD63, 61 ± 16 nm for those captured by tetraspanin CD81, and 59 ± 10 for tetraspanin CD9, with CD63 being the majority EV subpopulation in urine (48.92%). The distribution of AMN and SFRP1 in the three capture tetraspanins turned out to be similar for both proteins, being expressed mainly in CD63 (48.23% for AMN and 52.1% for SFRP1). CONCLUSIONS: This work demonstrates the applicability and advantages of the ExoView® technique for the direct analysis of urine EV and their protein content in relation to the renal tubule. The use of minimum volumes, 5 µl, and the total analysis time not exceeding three hours facilitate the transition of EV into daily clinical practice as sources of diagnostic information.

Routine Physical Therapy with and without Neural Mobilization in Chronic Musculoskeletal Neck Disorders with Nerve-Related Symptoms: Systematic Review and Meta-Analysis.

No previous study has evaluated the effectiveness of routine physical therapy with and without neural mobilization for patients with chronic musculoskeletal neck disorders and cervical radiculopathy. The objective is to evaluate the effectiveness of routine physical therapy with and without neural mobilization on pain and mobility in patients with chronic musculoskeletal neck disorders and cervical radiculopathy. A systematic review with meta-analysis of randomized clinical trials involving the use of neural mobilization techniques for the treatment of chronic musculoskeletal neck disorders and cervical radiculopathy was conducted. Methodological quality was assessed by the Cochrane Risk of Bias Tool and PEDro scale. Data were pooled and a meta-analysis was performed using a random effects model with Review Manager 5 software. Seven articles were included in our review. Significant differences were found in mobility but not in pain in favor of using routine physical therapy with neural mobilization for the treatment of chronic musculoskeletal neck disorders and cervical radiculopathy. Our results show that routine physical therapy accompanied by neural mobilization is superior for improving mobility in comparison with routine physical therapy alone in patients with musculoskeletal neck disorders and cervical radiculopathy.

Criteria and indicators to evaluate quality of care in genitourinary tumour boards.

PURPOSE: Genitourinary (GU) multidisciplinary tumour boards (GUMTBs) are key components of patient care, as they might lead to changes in treatment plan, improved survival, and increased adherence to guidelines. However, there are no guidelines on how GUMTBs should operate or how to assess their quality of performance. METHODS: A systematic literature review was conducted to identify criteria and indicators to evaluate quality in GUMTBs. A scientific committee-comprising 12 GU cancer specialists from seven disciplines-proposed a list of criteria and developed indicators, evaluated in two rounds of Delphi method. Appropriateness and utility of indicators were scored using a 9-point Likert scale. Consensus was defined as at least two-thirds of Delphi respondents selecting a score sub-category that encompassed the median score of the group. RESULTS: Forty-five criteria were selected to evaluate the quality of GUMTBs covering five dimensions: organisation, personnel, protocol and documentation, resources, and interaction with patients. Then, 33 indicators were developed and evaluated in the first round of Delphi, leading to a selection of 26 indicators in two dimensions: function, governance and resources, and GUMTB sessions. In the second round, consensus was reached on the appropriateness of all 26 indicators and on the utility of 24 of them. Index cards for criteria and indicators were developed to be used in clinical practice. CONCLUSIONS: Criteria and indicators were developed to evaluate the quality of GUMTBs, aiming to serve as a guide to improve quality of care and health outcomes in patients with GU cancer.

Behavioural traits related with resilience or vulnerability to the development of cocaine-induced conditioned place preference after exposure of female mice to vicarious social defeat.

Exposure to stress induced by intermittent repeated social defeat (IRSD) increases vulnerability to the development of cocaine-induced conditioned place preference (CPP) among male mice; however, some defeated mice are resilient to these effects of stress. In the present study we evaluated the effects of vicarious IRSD (VIRSD) in female mice and explored behavioural traits that are potentially predictive of resilience. C57BL/6 female mice (n = 28) were exposed to VIRSD, which consisted of the animals witnessing a short experience of social defeat by a male mouse on postnatal day (PND) 47, 50, 53 and 56. The control group (n = 10) was not exposed to stress. Blood samples were collected on PND 47 and 56 for corticosterone and interleukin-6 determinations. On PND 57-58, female mice performed several behavioural tests (elevated plus maze, hole-board, object recognition, social interaction, TST and splash tests). Three weeks later, the effects of cocaine (1.5 mg/kg) on the CPP paradigm were assessed. VIRSD decreased corticosterone levels (on PND 56), increased interleukin-6 levels, enhanced novelty-seeking, improved recognition memory and induced anxiety- and depression-like symptoms. Control and VIRSD female mice did not acquire CPP, although some stressed individuals with certain behavioural traits - including a high novelty-seeking profile or the development of depression-like behaviour in the splash test shortly after VIRSD - acquired cocaine CPP. Our results confirm that some behavioural traits of female mice are associated with vulnerability or resilience to the long-term effects of social stress on cocaine reward, as previously observed in males.

Extracellular Vesicles and Their Renin-Angiotensin Cargo as a Link between Metabolic Syndrome and Parkinson's Disease.

Several studies showed an association between metabolic syndrome (MetS) and Parkinson's disease (PD). The linking mechanisms remain unclear. MetS promotes low-grade peripheral oxidative stress and inflammation and dysregulation of the adipose renin-angiotensin system (RAS). Interestingly, brain RAS dysregulation is involved in the progression of dopaminergic degeneration and PD. Circulating extracellular vesicles (EVs) from MetS fat tissue can cross the brain-blood barrier and may act as linking signals. We isolated and characterized EVs from MetS and control rats and analyzed their mRNA and protein cargo using RT-PCR and the ExoView R200 platform, respectively. Furthermore, cultures of the N27 dopaminergic cell line and the C6 astrocytic cell line were treated with EVs from MetS rats. EVs were highly increased in MetS rat serum, which was inhibited by treatment of the rats with the angiotensin type-1-receptor blocker candesartan. Furthermore, EVs from MetS rats showed increased pro-oxidative/pro-inflammatory and decreased anti-oxidative/anti-inflammatory RAS components, which were inhibited in candesartan-treated MetS rats. In cultures, EVs from MetS rats increased N27 cell death and modulated C6 cell function, upregulating markers of neuroinflammation and oxidative stress, which were inhibited by the pre-treatment of cultures with candesartan. The results from rat models suggest EVs and their RAS cargo as a mechanism linking Mets and PD.

Calidad de las imágenes, la lectura y el servicio de mamografía en cuatro centros de imagenología de Manizales, Colombia / Image quality, reading, and mammography service in four diagnostic imaging centers in Manizales, Colombia

Resumen | Introducción. La calidad de la mamografía está directamente relacionada con la capacidad para detectar anormalidades y, por ello, es necesario el control de calidad en los centros de imágenes diagnósticas. Objetivo. Evaluar la calidad de la imagen, la lectura y el servicio de mamografía de algunos centros de imágenes diagnósticas en Manizales, Colombia. Materiales y métodos. Cuatro centros participaron de forma voluntaria y bajo acuerdos de confidencialidad en el estudio. De las 520 mujeres atendidas en ellos, a 318 se les hicieron mamografías. A partir de una inspección visual del servicio, se evaluaron la infraestructura, la tecnología y el personal de la unidad. Un radiólogo experto en lectura e interpretación clínica de imágenes mamarias evaluó la calidad de la imagen y la de su lectura. El análisis estadístico se hizo utilizando un anova y determinando el índice kappa y el porcentaje de desacuerdo. Resultados. Se encontró falta de calidad de las imágenes obtenidas, principalmente, por presencia de artificios en el 75 % de ellas, e identificación y rotulación deficientes; además, en la toma de la proyección oblicua medio-lateral, se encontró falta de visualización del ángulo inframamario. El grado de concordancia en el reporte BI-RADS fue bajo en los cuatro centros, con diferencias importantes en el informe y la descripción de los hallazgos. Conclusión. Los centros de imágenes diagnósticas evaluados están habilitados para el funcionamiento, pero se encontraron deficiencias importantes en la calidad de las imágenes y en su lectura, lo que pone de manifiesto la necesidad de establecer estándares de calidad y mejorar los aspectos que se puedan mejorar.

Abstract | Introduction: Mammography quality is directly related to the ability to detect an abnormality and, therefore, quality control is necessary for diagnostic imaging centers. Objective: To evaluate image quality, reading, and mammography service in some diagnostic imaging centers in Manizales, Colombia. Materials and methods: Four diagnostic imaging centers participated voluntarily in the study under confidentiality agreements. Out of 520 women attending the centers, 318 had a mammography. The infrastructure, technology, and human resources of each unit were evaluated based on visual inspections. A radiologist expert in reading and clinical interpretation of mammary images evaluated the quality of the image and the reading. We made the statistical analysis using anova, the kappa index, and the percentage of disagreement. Results: We found images of diminished quality mainly due to the presence of artifacts in 75 % of those evaluated, as well as non-compliance with identification criteria and image labeling. There were difficulties in taking the lateral median oblique projection given the absence of the inframammary. The level of agreement in the BI-RADS reporting was low in the four centers with important differences in the report and description of findings. Conclusion: The city's diagnostic centers under evaluation are authorized for their operation. However, there are important deficiencies in image quality and reading, which highlights the need to seek quality standards starting from those aspects that can be improved upon.

Importancia del manejo interdisciplinario de pacientes con Fisuras Labiopalatinas y Anemia de Blackfan Diamond. Reporte de caso: seguimiento a 2 años / Importância da abordagem interdisciplinar de paciente com Fissura Labiopalatina e Anemia de Blackfan Diamond: acompanhamento de dois anos / Importance interdisciplinary management of Diamond-Blackfan anemia and Cleft lip and palate sequel: Accompaniment of two years

Las fisuras labiopalatinas (FLP) son las malformaciones craneofaciales congénitas más comunes. La anemia de Diamond-Blackfan o anemia aneritroblástica es una hipoplasia congénita selectiva de la serie roja, asociada a alteraciones cardiacas, renales, malformaciones en manos, hipertelorismo y retraso en el crecimiento. La presentación de las FLP y pacientes con Anemia de Diamond-Blackfan es del 10.3%. Objetivo: Presentar un reporte de caso de un paciente de 12 años con anemia de Diamond-Blackfan y secuela de FLP de la Clínica Interdisciplinaria de LPH de la Pontificia Universidad Javeriana (Bogotá-Colombia) donde el abordaje interdisciplinario, el casomanejo del comportamiento y el apoyo psicológico brindado a la familia fueron fundamentales para lograr la adherencia, clarificar el diagnóstico y obtener los resultados terapéuticos esperados. Resultados: se logró la adherencia al tratamiento y el éxito de éste en apoyo con otras especialidades, permitiendo un seguimiento de 2 años. Conclusiones: El manejo multidisciplinario e interdisciplinario con especialidades odontológicas, médicas, y de la salud en general para el manejo de pacientes con FLP y síndromes asociados, resulta importante para el éxito en el tratamiento.

As fissura labiopalatina são as malformações craniofaciais congênitas mais comuns. A anemia do Diamante-Blackfan ou anemia aneritroblástica seletiva é uma hipoplasia congênita da série vermelha, associada com o coração, rim, malformações mãos, hipertelorismo e distúrbios retardo de crescimento. A apresentação de Fissura labiopalatina e pacientes com anemia do Diamante-Blackfan é de 10,3% dos casos. Objetivo: Apresentar um caso clínico de um paciente de 12 anos com anemia do Diamante-Blackfan e Fissura labiopalatina sequela do Interdisciplinar Clinic LPH da Pontificia Universidad Javeriana (Bogotá Colômbia), onde a abordagem interdisciplinar, gestão de comportamento e apoio psicológico prestado aos família foram fundamentais para alcançar a adesão a esclarecer o diagnóstico e obter os resultados terapêuticos esperados. Resultado: a adesão ao tratamento e seu sucesso no apoio de outras especialidades de saúde alcançados. Conclusões: O tratamento multidisciplinar e interdisciplinar com especialidades odontológicas, médicas e de saúde em geral para o tratamento de pacientes com FLP e síndromes associadas, é importante para o sucesso do tratamento

Cleft lip and palate (CLP) are the most common congenital craniofacial malformations. The Diamond-Blackfan anemia or congenital erythroblastic anemia is a selective red cell hypoplasia associated with heart, kidney, malformed hands, hypertelorism and stunted alterations. The presentation of Cleft lip and palate in patients with Diamond-Blackfan anemia is 10.3% of cases. Aim: To present a case report of a patient of 12 years with Diamond-Blackfan anemia and Cleft lip and palate sequel from the Interdisciplinary Clinic LPH of the Pontificia Universidad Javeriana (Bogota Colombia) where the interdisciplinary approach, behavior management and psychological support provided to the family were instrumental in achieving the expected therapeutic results. Results: Adherence to treatment and its success in supporting other health specialties during two years is slown. Conclusions: The multidisciplinary and interdisciplinary management with dental specialties, medical, and health in general for the management of patients with FLP and associated syndromes, it is important for successful treatment

Tendencias de investigación en torno al cuidado espiritual de enfermería: Revisión de la literatura / Research trends spiritual care in nursing: Literature review / Tendências da pesquisa em torno do cuidado espiritual em enfermagem: revisão da literatura

Introducción. El cuidado espiritual es un área que cada vez cobra mayor relevancia en la práctica de enfermería ante situaciones de salud que generan cambios en la perspectiva de vida y donde la tras-cendencia y la atención integral son fundamentales. Objetivo. Identificar las tendencias de investigación en torno al cuidado espiritual de enfermería en el periodo comprendido entre 2008-2018.Materiales y métodos. Es una revisión de la literatura, cuya ruta metodológica contempló cuatro fases (búsqueda e identificación, filtro, elegibilidad y exclusión e inclusión). Las unidades de análisis correspondieron a los artículos de estudios cuantitativos, cualitativos y mixtos de 34 artículos que fueron publicados en las bases de datos PubMed, Science Direct, ProQuest y ClinicalKey Nursing. Para la elaboración del artículo y corroboración de la calidad de la presente revisión, se realizó la compro-bación de los aspectos propuestos en la declaración PRISMA.Resultados. Emergieron cinco ejes temáticos de la revisión: educación y formación en el cuidado espiritual de enfermería, características de los escenarios y las intervenciones de cuidado espiritual, conceptualización de la dimensión espiritual, participantes en el cuidado espiritual, medición de la espiritualidad y del cuidado espiritual.Conclusiones. Las tendencias identificadas indican que el cuidado de la dimensión espiritual es de gran importancia en el ámbito de la salud y de la enfermería. A la vez, estos resultados son un punto de referencia a nivel latinoamericano e instan a que el conocimiento y formación académica en el área de interés, sea dada desde el pregrado y posgrado, con un impacto en la mejora del cuidado de enfermería desde la disciplina.

Introduction. Spiritual care is becoming to increase relevant in nursing practice in health situations that generate changes in the perspective of life and where transcendence and integral care are fun-damental.Objective. Identify research trends on nursing spiritual care within the period of 2008 to 2018. Materials and methods. This literature review was did followed a four phases methodology: sear-ching and identification, screening, eligibility, exclusion and inclusion. 34 published articles within the period of review, and found in PubMed, Science Direct, ProQuest and ClinicalKey Nursing databases were obtained. Papers with quantitative, qualitative and mixed studies design were analyzed. The methodological quality was achieved by PRISMA statement. Results. Five thematic points emerged from this review: education and training about spiritual care; characteristics of spiritual care settings and intervention, conceptualization of spiritual dimension, spiritual care participants, measuring of spirituality and spiritual care. Conclusions. The identified trends indicate that spiritual care is highly important in the health and nursing field. Besides, these results represent a reference for Latin America about the state of spiritual nursing care research. It also invites to implement this knowledge in both undergraduate and gradua-te levels of formation to improve the care developed by the practice within this discipline.

Introdução. O cuidado espiritual é uma área que se torna cada vez mais importante na prática da enfermagem, diante de situações de saúde que geram mudanças na perspectiva da vida e onde a transcendência e o cuidado integral são fundamentais.Objetivo. Identificar tendências de pesquisa em torno do cuidado em enfermagem espiritual no período entre 2008 e 2018.Materiais e métodos. Trata-se de uma revisão da literatura, cuja rota metodológica contemplou quatro fases (busca e identificação, filtro, elegibilidade e exclusão e inclusão). As unidades de análise corresponderam aos artigos de estudos quantitativos, qualitativos e mistos de 34 artigos publicados nas bases de dados PubMed, Science Direct, ProQuest e ClinicalKey Nursing. Para a elaboração do artigo e comprovação da qualidade desta revisão, foram checados os aspectos propostos na decla-ração PRISMA.Resultados. Emergiram cinco eixos temáticos da revisão: educação e treinamento em formação es-piritual de enfermagem, características dos cenários e intervenções de cuidados espirituais, concei-tuação da dimensão espiritual, participantes em cuidados espirituais, mensuração de espiritualidade e cuidado espiritual.Conclusões. As tendências identificadas indicam que o cuidado da dimensão espiritual é de grande importância no campo da saúde e da enfermagem. Ao mesmo tempo, esses resultados são um ponto de referência no nível latino-americano e exigem que o conhecimento e a formação acadêmica na área de interesse sejam ministrados na graduação e na pós-graduação com impacto na melhora da assistência de enfermagem da disciplina

Competência educativa parental: estudo de propriedades psicométricas da escala com amostra brasileira / Parenting sense of competence: a study of the psychometric properties of the scale with a Brazilian sample / Competencia educativa parental: estudio de las propiedades psicométricas de la escala con una muestra brasileña

O Questionário de Autoavaliação da Competência Educativa Parental (QACEP) é um instrumento que tem por objetivo avaliar a percepção de competência dos pais em suas funções. No Brasil, sua utilização é escassa e o objetivo desta pesquisa é analisar as propriedades psicométricas do QACEP. Foi utilizada uma amostra de 151 mães e pais, a maioria com nível de escolaridade até o ensino médio e renda até dois salários mínimos. A análise fatorial confirmatória do modelo proposto com dois fatores - a percepção de eficácia e de satisfação - revelou bom ajustamento global aos dados recolhidos. Análises posteriores revelam que a satisfação parental aumenta com a idade dos pais, com o nível de escolaridade e salário auferido. Tendo em conta os diversos processos de validação conduzidos, recomenda-se o uso dessa versão do QACEP na investigação e prática clínica com pessoas de baixa renda no Brasil. (AU)

The Self-Assessment Questionnaire for Parental Educational Competency (PEC-SAQ) is an instrument that aims to evaluate the perception of parental competence in its functions. In Brazil, it is scarcely used and the objective of this research is to analyze the psychometric properties of PEC-SAQ. A sample of 151 mothers and fathers was used, the majority with education level up to high school and income up to two minimum wages. Confirmatory factor analysis of a proposed two-factor model (perception of efficacy and satisfaction) revealed a good overall adjustment to the data collected. Later analyses revealed that parental satisfaction increases with the parents' age, with the level of schooling and salary earned. Taking into account the different validation processes conducted, it is recommended to use this version of PEC-SAQ in research and clinical practice with low-income people in Brazil. (AU)

El Cuestionario de Autoevaluación de Competencia Educativa Parental (QACEP) es un instrumento que tiene por objetivo evaluar la percepción de competencia de los padres en sus tareas. En Brasil, su utilización es escasa y el objetivo de esta investigación es analizar las propiedades psicométricas del QACEP. Se utilizó una muestra de 151 madres y padres, la mayoría con nivel de escolaridad hasta Enseñanza Secundaria y una renta media familiar hasta dos salarios mínimos. El análisis factorial confirmatorio del modelo propuesto con dos factores - Eficacia y Satisfacción - mostró buen ajuste global a los datos recogidos. Análisis posteriores revelan que la satisfacción parental aumenta con la edad de los padres, con el nivel de escolaridad y con los ingresos familiares. Se recomienda el uso de esta versión del QACEP en la investigación y práctica clínica con personas de bajos ingresos en Brasil. (AU)

High risk serotypes of the human papillomavirus (HPV) in patients with exofitic lesions in the oral cavity / Serotipos de alto riesgo del virus de papiloma humano (VPH) en pacientes con lesiones exofiticas en la cavidad oral

Abstract Objective: To determine the prevalence of high-risk serotypes of human papillomavirus in verrucous lesions of the oral cavity in a hospital in Cartagena during July 2014 to July 2015. Methodology: An observational, descriptive, prospective study was conducted in 73 patients with verrucous lesions of the oral cavity, in which socio-demographic characteristics, clinical and histopathological diagnosis were determined, and high-risk DNA HPV genotypes 16 and 18 were identified, as well as 12 other high-risk genotypes (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68), by means of the real-time multiplex PCR test. The study complied with legal and ethical standards. The results were analyzed using descriptive statistics with the Stata program v13.2. Results: The prevalence of HPV in the sample studied during the 2014-2015 period was 9.59% (n: 7). In none of the cases positive for HPV in the histopathological study, some high-risk genotype was identified. Serotypes of HPV were more prevalent in patients in the third decade of life (29.5 years, SD ± 10.60), the average age was 62.8 years SD ± 17.74. The population came mainly from the rural area. The most common site was the labial mucosa. A high percentage of participants (87.6%) reported consuming tobacco. Conclusion: In the present study no high-risk HPV genotypes were found in the samples evaluated.

Resumen Objetivo: Determinar la prevalencia de serotipos de alto riesgo del virus del papiloma humano en lesiones verrugosas de la cavidad bucal en un hospital de Cartagena durante el mes de julio de 2014 y julio de 2015. Metodología: Se realizó un estudio observacional, descriptivo y prospectivo en 73 pacientes. con lesiones verrugosas de la cavidad bucal, en las que se determinaron las características sociodemográficas, el diagnóstico clínico e histopatológico y se identificaron los genotipos 16 y 18 de alto riesgo de VPH del ADN, así como otros 12 genotipos de alto riesgo (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 y 68), mediante la prueba de PCR multiplex en tiempo real. El estudio cumplió con las normas legales y éticas. Los resultados se analizaron utilizando estadísticas descriptivas con el programa Stata v13.2. Resultados: La prevalencia de VPH en la muestra estudiada durante el período 2014-2015 fue del 9,59% (n: 7). En ninguno de los casos positivos para el VPH en el estudio histopatológico, se identificaron algunos genotipos de alto riesgo. Los serotipos de HPV fueron más prevalentes en pacientes en la tercera década de la vida (29.5 años, SD ± 10.60), la edad promedio fue de 62.8 años SD ± 17.74. La población provenía principalmente del área rural. El sitio más frecuente fue la mucosa labial. Un alto porcentaje de participantes (87.6%) reportó consumir tabaco. Conclusión: En el presente estudio no se encontraron genotipos de VPH de alto riesgo en las muestras evaluadas

Eficacia de la técnica infraorbitaria en incisivos y premolares maxilares usando lidocaína al 2% con epinefrina 1:80,000 / Anesthetic efficacy of the infraorbital nerve block in maxillary incisors and premolars using 2% lidocaine with epinephrine 1:80,000

Objetivos: Los autores condujeron un ensayo clínico no controlado para determinar la efectividad de la técnica infraorbitaria, para proporcionar anestesia pulpar profunda en incisivos y premolares maxilares. Material y métodos: Diecinueve adultos voluntarios recibieron 1.8 mililitros de lidocaína al 2% con epinefrina 1:80,000 con una técnica infraorbitaria intraoral. Los investigadores usaron un electric pulp tester (vitalómetro) para medir la anestesia pulpar en incisivos y premolares maxilares. Los participantes informaron sobre anestesia en tejidos blandos, y molestias durante la inyección además de que valoraron el tiempo de inicio de la anestesia y la duración de la misma. Los autores analizaron los datos usando el programa estadístico STATA 9®. Resultados: La mayoría de los sujetos tenía 21 años (30%), el sexo más común fue el sexo femenino (n = 12-60%). Los autores evaluaron con escala visual análoga (VAS), la percepción del dolor al momento de aplicar la anestesia, encontrando que el 57.9% de los pacientes (n = 11) lo catalogaron como moderado (escala de 3-6). Al evaluar el éxito anestésico, observaron un mayor número de episodios en el canino y el primer premolar (57.9%, n = 9 - IC 95%), Los autores observaron un importante número de fallas en la anestesia pulpar de incisivos centrales y laterales (100-84.2%, respectivamente). El inicio de la anestesia fue a los 12-19 minutos, siendo el canino el de mayor número de reportes con un 47.4%. La incidencia de sensación subjetiva de anestesia de los tejidos blandos en piel de párpado, ala de la nariz y piel de labio superior fue del 100%, los autores observaron que el 100% de los sujetos la calificaron como desagradable (VAS). Conclusiones: La técnica infraorbitaria produce anestesia exitosa en sólo el 57.9% de los caninos y primeros premolares maxilares; es ineficaz para anestesiar incisivos centrales y laterales, luego de ser evaluada con un riguroso test de vitalometría, se produce anestesia de tejidos blandos que es catalogada como incomoda. Los autores consideran que la utilidad de la técnica infraorbitaria en odontología es cuestionable y se deben considerar otras técnicas para los incisivos y premolares maxilares.

Objectives: The authors conducted a clinical-trial, uncontrolled study to determine infraorbital nerve block effectiveness. Material and methods: Nineteen adult volunteers received 1.8 mL of lidocaine 2% with epinephrine 1:80,000 with an intraoral, infraorbital nerve block. Researchers used an electric pulp tester to measure pulp anesthesia in maxillary incisors and premolars. Participants reported soft tissue anesthesia and discomfort during the injection procedure; anesthesia onset time and its duration were also assessed and analyzed. Authors analyzed data using STATA statistical program 9®. Results: Most of the subjects in our trial were 21 years old (30%); the number of female participants (n = 12 - 60%) was greater than that of male participants. Authors evaluated pain perception when injecting anesthesia with a visual analogue scale (VAS), finding that 57.9% of patients (n = 11) categorized the pain as moderate (in a scale of 3-6). When assessing anesthesia success, it was observed that a greater number of canine teeth and first premolars (57.9%, n = 9 - CI 95%) were anesthetized. The authors also observed a significant greater number of nonresponse (non-anesthetized) cases in central and lateral incisors (100-84.2%, respectively). Anesthesia onset was at 12 to 19 minutes, with canines exhibiting the largest number of anesthetized reports with 47.4%. There was a 100% incidence of subjective feeling of soft tissue anesthesia in lower eyelid skin, skin of the nose and skin of the upper lip. Authors noted that 100% of the subjects rated it as unpleasant (VAS). Conclusions: Infraorbital anesthesia technique achieved successful anesthesia in only 57.9% of upper canines and first premolars; it proved ineffective for anesthetizing central and lateral incisors. This was demonstrated after these teeth were evaluated using rigorous pulp vitality testing. Soft tissue anesthesia occurred and it was classified as uncomfortable. Authors consider that usefulness of infraorbital nerve block technique in dentistry was questionable.

Perception of discomfort during injection and the need for supplemental anesthesia in the intraosseous technique using 4 per cent articaine / Percepción de incomodidad durante la inyección y necesidad de anestesia suplementaria en anestesia intraósea usando articaína al 4

The authors conducted an experimental study to determine patient perception of discomfort during injection and the need for supplemental anesthesia using the intraosseous technique with 4% articaine with 1:100,000 epinephrine in patients with symptomatic pulpitis in mandibular molars. At different clinical sessions, researchers used 4% articaine with 1:100,000 epinephrine to apply intraosseous injection (Group 1) or inferior alveolar nerve block (Group 2). Each technique was applied in 35 patients. In each group, the need for additional anesthesia was determined and patient discomfort during injection was assessed with a Visual Analogue Scale (VAS) test. In the intraosseous group, no supplemental technique was needed in 22 patients (62.85 %), and results were similar for the inferior alveolar technique (n: 23 65.71%). The intraosseous technique proved to be more comfortable than the mandibular technique (18 patients - 25.7%). This study found that the use of intraosseous technique with 4% articaine shows promising results regarding patient comfort and reducing the need for additional anesthesia.

Los autores condujeron un estudio experimental para deter minar la eficacia de la técnica anestésica intraósea usando articaína al 4% con epinefrina 1:100.000, en pacientes con pulpitis aguda en molares mandibulares. En diferentes sesiones clínicas, los miembros del equipo de investigadores usaron articaína al 4% con epinefrina 1:100.000 para inducir anestesia mandibular con la técnica intraósea (Grupo 1) o con el bloqueo del nervio alveolar inferior (Grupo 2), se aplicó cada técnica en 35 pacientes con diagnóstico de pulpitis aguda en molares inferiores. En cada grupo, se determinó la necesidad de hacer anestesia complementaria y la comodidad del paciente con un test Escala Visual Analoga. Un total de 70 pacientes fueron enrolados en este estudio (35 sujetos por grupo). En el grupo de intraósea no fue necesaria la aplicación de técnicas complementarias en 22 pacientes (31.4%), resultados similares en la técnica alveolar inferior (n: 23 32.8%). La técnica intraósea demostró ser más cómoda al compararla con técnica mandibular (18 pacientes 25.7%). Este estudio demostró que el uso de la técnica intraósea conarticaína al 4%, arrojó resultados prometedores en lo que a comodidad y reducción en la anestesia complementaria hace referencia.

Entrevista inicial como suporte para intervenções em grupos de orientação a pais / Initial interview as support to interventions in parent orientation groups / Entrevista inicial de apoyo para intervenciones en grupos de orientacíon a los padres

O uso de instrumentos de coleta de dados previamente ao planejamento de intervenções tem se revelado de fundamental importância nos trabalhos em Psicologia. A literatura destaca a inter-relação entre as fases de diagnóstico e intervenção, considerando que a avaliação deve ser feita antes, durante e mesmo após o término da intervenção. Este artigo apresenta os resultados obtidos em entrevistas iniciais com mães participantes de grupos de orientação realizados em uma clínica-escola. As questões colocadas nas entrevistas possibilitaram-lhes ampliar o relato de suas queixas, direcionando-as para aspectos referentes aos ambientes que a criança frequentava, para outros comportamentos e características dos filhos e para seu próprio comportamento enquanto educadora. Os resultados indicaram a necessidade de trabalhar a percepção da influência recíproca entre os comportamentos da mãe e da criança e refletir sobre a melhor forma de ajustá-los com o intuito de potencializar o desenvolvimento infantil.

The use of data collection instruments before the intervention planning is very relevant in the psychologist’s work. The literature emphasizes the relation between the diagnosis and intervention phases. This article presents the results obtained with initial interviews applied to participant mothers in orientation groups offered in a psychological service. The questions posed lead the mothers to enlarge the information about their complaints directing their attention to aspects of environments where their children used to be, to other characteristics and behavior of the children and to their own behavior as an educator. The results reveal the need to discuss the mutual influence between mother’s and children’s behaviors in order to adjust them and contribute to the children’s development.

El uso de instrumentos para recopilación de datos previos al planeamiento de intervenciones ha demostrado ser fundamental en los trabajos de Psicología. La literatura destaca la interrelación entre las fases de diagnóstico e intervención, teniendo en cuenta que la evaluación debe hacerse antes, durante e incluso después de la intervención. En este artículo se presentan los resultados obtenidos en las entrevistas iniciales con las madres que participan de grupos de orientación realizadas en una clínica-escuela. Las preguntas de las entrevistas les permite ampliar los informes de sus quejas, dirigiéndolas hacia aspectos relacionados con los ambientes que el niño frencuenta, para otros comportamientos y características de los niños y para su propio comportamiento como educador. Los resultados indican la necesidad de trabajar la percepción de la interacción entre el comportamiento de la madre y el niño y reflexionar sobre la mejor manera de ajustarlos con el fin de mejorar el desarrollo del niño.

Efeito do treino de isostretching na flexibilidade e na força muscular / Effect of isostretching training on flexibility and muscle strength

Objetivo: Avaliar efeitos do treino de exercícios de isostreching na flexibilidade e força muscular.Método: Trinta e um indivíduos saudáveis (27 mulheres), de 18 a 28 anos, divididos em 2 grupos:Grupo A, isostretching, submeteu-se a programa de exercícios baseados na técnica isostretchinge Grupo B, padrão, submeteu-se aos mesmos exercícios utilizando princípios técnicos clássicos doalongamento, por 12 semanas, duas vezes por semana, uma hora por sessão. Foram avaliadas nopré e pós-teste, flexibilidade por meio de fotogrametria pesquisando a distância punho-chão e aclassificação da postura segundo categorias de encurtamentos musculares descritas por Kendalle, força muscular por meio de dinamometria. Resultados: Não houve diferença estatisticamentesignificante no teste de flexibilidade nos dois grupos. Análise de significância clínica e melhorapelo Índice de Mudança Confiável (IMC) mostrou ganho na flexibilidade atingindo 14 participantesde ambos os grupos. Análise de contorno do corpo do grupo A apresentou atenuações nascurvaturas da coluna cervical, lombar e torácica e ângulo de flexão de quadril. O grupo Bapresentou atenuações na curvatura da coluna cervical e ângulo de flexão de quadril. Em relaçãoà força muscular, o grupo A apresentou diferença estatisticamente significante em alguns gruposmusculares específicos, porém sem significância clínica. Conclusão: As duas intervenções afetam aflexibilidade de forma estatisticamente semelhante, porém com impacto diferente nas curvaturasda coluna. O isostretching afetou clinicamente a flexibilidade de indivíduos saudáveis, com indíciosde que treinamentos mais intensos ou longos possam afetar a força muscular

Objective: To evaluate effects of the isostretching exercise training on flexibility and musclestrength. Method: Thirty-one healthy subjects (27 women), aged between 18 and 28 years, dividedinto two groups: Group A, isostretching, which has undergone a program of exercises based on theisostretching technique, and Group B, standard, which was subjected to the same exercises usingthe general technical principles of traditional stretching. The training went on for 12 weeks, twiceper week, one hour per session. Flexibility was evaluated through photogrammetry in pre- andpost-test, evaluating the wrist-floor distance and classifying posture according to the categoriesof muscle shortening described by Kendall, while muscle strength was assessed using a handgripdynamometer. Results: There was no statistically significant difference between the results foreach group in the flexibility test. Analysis of clinical significance and improvement by the ReliableChange Index (RCI) showed an improvement in flexibility affecting 14 subjects from both groups.Analysis of body contour in group A showed attenuation in the curvatures of the cervical, thoracic,and lumbar spine, as well as the hip flexion angle, and group B showed attenuation in the curvatureof the cervical spine and hip flexion angle. Group A showed statistically significant differencesin some specific muscle groups, but with no clinical significance. Conclusion: Both interventionsaffected flexibility in a statistically similar way, but had a different impact on the curvatures of thespine. Isostretching training clinically changed the flexibility of healthy individuals, with evidencethat more intense or longer workouts can affect muscle strength.

Formação e atuação em psicologia social comunitária / Formation and operation in community social psychology

A pesquisa objetivou identificar as opiniões de estudantes de psicologia sobre a formação acadêmica para atuação profissional na área da psicologia social comunitária. Participaram da pesquisa 114 estudantes do 5º ano do curso de psicologia. Os participantes responderam a um questionário estruturado com perguntas fechadas e abertas sobre a formação e atuação em psicologia social comunitária. Os estudantes demonstraram satisfação com os aspectos gerais e específicos da formação, e as disciplinas de psicologia social e psicologia comunitária representaram as principais bases teóricas. As estratégias de ensino foram consideradas satisfatórias, e os conteúdos apresentados nas aulas contribuem para a formação profissional, mas destacou-se que as instituições de ensino precisam oferecer estágios e pesquisas com o propósito de facilitar a preparação para atuação profissional. Os resultados evidenciam que a formação na área da psicologia social comunitária necessita priorizar as inter-relações de ensino, prática e pesquisa, por se considerar que esses pontos contribuem para a contextualização das demandas sociais.

The research aimed to identify psychology students' opinions about the academic formation for professional operation in the area of community social psychology. Thus, 114 students from the 5th year of the psychology course participated in the research. The participants answered a structured questionnaire with closed and open ended questions about the formation and operation in community social psychology. The students demonstrated satisfaction with the general and specific aspects of the formation, and the disciplines of social psychology and community psychology represented the main theoretical bases. The teaching strategies were considered satisfactory, and the contents presented in classes contribute to the professional formation, but it was highlighted that teaching institutions need to offer internships and research with the purpose of facilitating the preparation for professional operation. The results show that the formation in community social psychology needs to prioritize the inter-relations of teaching, practice and research, by considering that these points contribute to the contextualization of the social demands.

Eficacia de cremas dentales con fluoruros sobre lesiones de mancha blanca, ensayo clínico aleatorizado / Toothpaste efficacy with different Fluoride concentrations on white spot lesions, a randomized clinical trial

Introducción y objetivo: El uso de cremas dentales para prevención de caries es considerada la estrategia preventiva de mayor eficacia, aunque es necesario implementar protocolos adecuados al riesgo individual, gravedad de la lesión y edad del niño, para prevenir efectos secundarios irreversibles. Evaluar los efectos remineralizantes de las cremas dentales fluoradas sobre lesiones de mancha blanca. Materiales y métodos: Ensayo clínico aleatorizado doble ciego en 112 lesiones de mancha blanca en superficies lisas, las cuales recibieron 4 tipos de cremas dentales de (0, 500, 1100 y 1500 ppm de flúor). Los participantes fueron seleccionados de una población colombiana con alto riesgo de caries y evaluados durante seis semanas. Para medir la variable respuesta se utilizaron criterios visuales ICDAS; progresión, estabilidad y reversión. Las diferencias de proporciones entre grupos se analizaron con la prueba exacta de Fisher. Las diferencias en promedios de placa se analizaron con Kruskall Wallis y las diferencias antes-después de cada intervención con McNemar. El análisis multivariado se realizó por medio de la regresión logística. Resultados: Se encontró diferencias sólo en la sexta semana, siendo más alta la probabilidad de revertir las lesiones para el grupo tratado con crema dental de 1500 ppm de flúor. Entre los grupos que recibieron bajo o ningún contenido de flúor no hubo diferencias. Conclusiones: Las pastas dentales con alto contenido de flúor producen un mejor efecto de reversión de las lesiones, pero este efecto es equilibrado con el resto de los grupos después de seis semanas. Los efectos producidos con bajo contenido de flúor y sin flúor son similares, lo que muestra la importancia de la eliminación mecánica de la placa dental.

Introduction and objective: Toothpastes use for caries prevention are considered the most effective preventive strategy, although it is necessary to implement appropriate protocols based on individual risk, severity and age of the child, in order to prevent irreversible side effects. The purpose of this study was to evaluate the remineralizing effects on white spot lesions of fluoridated toothpastes. Materials and methods: A double blind randomized clinical trial was carried out in a Colombian high caries risk population; 112 white spot lesions assigned to four groups of toothpastes (0, 500, 1100, 1500 ppm) fluoride were assessed. ICDAS visual criteria which included progression, stability or reversal of the initial lesions were used in order to measure the response variable. Differences in proportions between groups were analyzed with Fisher´s test, the differences in dental plaque with Kruskall Wallis test and the McNemar test was used to compare differences before and after intervention. A multivariate analysis was performed with logistical regression. Forma de citar: Carmona-Arango LE, González-Martínez F, Lujan-Pardo MP. Eficacia de cremas dentales con fluoruros sobre lesiones de mancha blanca, ensayo clínico aleatorizado. Results: A statistical significance was found only at six weeks, with the possibility of reversal of the lesions higher for the group treated with 1500 ppm. Between the groups which received low content fluoride toothpastes and without fluoride there were no differences. Conclusions: Toothpastes with high ppm fluoride content produce a better effect at the beginning of the follow up period by reversal of white spot lesions, which is then balanced with the other groups with lower fluoride content, after six weeks. However, differences we observed between the effects produced with low and moderate fluoride content and without fluoride toothpastes, which reveals the importance of mechanical dental plaque removal.

Grupo de orientação de mães no contexto de uma clínica-escola / Group of parental education in the context of a school-clinic / Grupo de orientación de madres en el contexto de una escuela clínica

O ambiente familiar vem merecendo atenção de estudiosos que analisam a influência de diferentes ambientes sociais no desenvolvimento infantil. Elaborou-se uma proposta de grupo de orientação para mães de crianças em fila de espera para atendimento psicoterápico. Os objetivos do presente estudo são descrever as características de funcionamento desse grupo e analisar seus resultados sob a perspectiva dos orientadores do grupo e das próprias mães. Os dados foram coletados em entrevistas iniciais e finais e no decorrer dos encontros. Procedeu-se à análise de conteúdo das informações relacionadas às falas das mães e aos procedimentos de intervenção. Os resultados indicaram estar ocorrendo aumento nos diálogos com os filhos, preocupação em dedicar-lhes mais tempo e a entender seus pontos de vista, busca em estabelecer limites, envolvendo também outras pessoas da família. Tais mudanças revelaram, portanto, alterações no funcionamento do microssistema familiar.

Family has received special attention from scholars who analyze the influence of different social environments in children's development. It was carried out a study with a parent group whose children were waiting for psychotherapy. The aims of this study are to describe the functioning characteristics of such group and analyze their results from the view point of group leaders and mothers themselves. The data was collected from interviews that happened in the beginning and the final processes and throughout the meetings. The content of the information was analyzed concerning mother's opinions and the intervention procedures. The results indicated an increase in the numbers of dialogues with children, preoccupation with dedicating more time to them, understand their points of view and also look forward to establish limits involving other members of the family. Such changes revealed alterations in the familiar microsystem functioning.

Los especialistas que analizan la influencia de los diferentes ambientes sociales en el desarrollo del niño se dedican a estudios en torno del ambiente familiar. En este trabajo, se ha elaborado una propuesta para grupo de orientación a las madres. El objetivo consistió en describir las características de funcionamiento de ese grupo y analizar sus resultados desde el punto de vista de los orientadores y de las madres. Los datos fueron recolectados a través de entrevistas iniciales, finales y durante los encuentros. Se procedió al análisis de contenido de las informaciones relacionadas a los puntos de vista de las madres y a los procedimientos de la intervención. Los resultados revelaron un aumento en los diálogos con los hijos, además de preocupación por dedicarles más tiempo y comprender sus puntos de vista, intentando establecer límites que también involucran a otras personas de la familia. Dichos cambios revelan alteraciones en el microsistema familiar.