Outcomes and Predictors for Re-stenosis of Esophageal Stricture in Epidermolysis Bullosa: A Multicenter Cohort Study.

BACKGROUND: Esophageal strictures are the common gastrointestinal complications in patients with epidermolysis bullosa (EB) requiring dilation. There is limited information on the best type of intervention, outcomes, and predictors for re-stenosis. OBJECTIVES: We aimed to investigate the frequency, clinical presentation of esophageal strictures in EB patients, and to ascertain the predictors of re-stenosis. METHODS: We conducted a retrospective, multicenter cohort study involving 7 specialized, international EB centers on patients who were 0 to 50 years of age. Descriptive statistics and hazard risks for re-stenosis were calculated. RESULTS: We identified 125 patients with 497 esophageal stricture episodes over a mean period of observation of 17 (standard deviation [SD] = 11.91) years. Dilations were attempted in 90.74% of episodes, using guided fluoroscopy 45.23%, retrograde endoscopy 33.04%, and antegrade endoscopy 19.07%. Successful dilation was accomplished in 99.33% of attempts. Patients experienced a median of 2 (interquartile range [IQR]: 1-7) stricture episodes with a median interval between dilations of 7 (IQR: 4-12) months. Predictors for re-stenosis included: number of strictures (2 vs 1 stricture: χ = 4.293, P = 0.038, hazard ratio [HR] = 1.294 (95% confidence interval [CI]: 1.014--1.652 and 3 vs 1 stricture:χ = 7.986, P = 0.005, HR = 1.785 [95% CI: 1.194, 2.667]) and a long (≥1 cm) segment stricture (χ = 4.599, P = 0.032, HR = 1.347 (95% CI: 1.026--1.769). Complications were more common with the endoscopic approach (8/86, antegrade endoscopy; 2 /149, retrograde endoscopy vs 2/204, fluoroscopy; χ = 17.39, P-value <0.000). CONCLUSIONS: We found excellent dilation outcomes irrespective of the dilation procedure; however, with higher complications in the endoscopic approach. Long (>1 cm) segment involvement and multiple locations were predictive of stricture reoccurrence.

Assessment of Antibacterial and Antifungal Properties and In Vivo Cytotoxicity of Peruvian Passiflora mollisima.

AIM: The antimicrobial activity of Passiflora mollissima is largely due to its aliphatic and aromatic hydrocarbons, terpenes, alkaloids, ketones, esters, alcohols, and lactones. The objective of this research was to evaluate the antimicrobial activity of the compounds in the Passiflora mollissima (Tumbo) fruit and leaves included also on cultured strains of the microorganisms Streptococcus mutans, Streptococcus oralis, Streptococcus sanguinis and Candida albicans. MATERIALS AND METHODS: Antimicrobial activity was analyzed by the disk diffusion method and evaluated in terms of their zones of inhibition. The cytotoxic activity of these compounds was determined in a bioassay involving sea urchin eggs (Tetrapygusniger) in which the inhibition percentage of artificially fertilized ovules was equivalent to their cytotoxic activity after 26 hours. RESULTS: This study demonstrated the antimicrobial activity of ethanolic Passiflora mollissima extract against the cultured strains of Streptococcus mutans, Streptococcus oralis, and Streptococcus sanguinis with zones of inhibition after the incubation period. CONCLUSION: There was no evidence of activity against the pathogenic Candida albicans, which demonstrates a null antifungal capacity of the evaluated extracts. However, cytotoxic activity was found, and the compounds led to the complete inhibition of 100% of sea urchin ovules after 26 hours of exposure. CLINICAL IMPORTANCE: The results of the study serve as a guide. in the industrial use of this natural resource "tumbo" due to the discovery of a potential medicine based on this plant that would be a great development in the field of antimicrobial therapies.

A Formative Evaluation of an Online Meal Kit and Grocery Platform for Supplemental Nutrition Assistance Program Recipients.

OBJECTIVE: To assess the barriers and facilitators to online food purchasing through a meal kit and grocery shopping website titled NY SNAP Express among Supplemental Nutrition Assistance Program (SNAP) beneficiaries. METHODS: A purposive sample of SNAP-eligible adults residing in New York State participated in interviews guided by the Capabilities, Opportunities, Motivations, and Behaviors Model. RESULTS: Barriers to online food purchasing among participants (n = 32) include physiological and health conditions, the weight of food, technology, language, the price of foods, transportation challenges, the stigma associated with SNAP, and concerns regarding the quantity and quality of meal kits. Facilitators include health and nutrition improvements, knowledge and skills, saving money, culturally relevant meals, increased efficiency in food purchases and preparation, and customization. CONCLUSIONS AND IMPLICATIONS: Online platforms such as NY SNAP Express have the potential to increase nutritious food access and resources among SNAP recipients; however, improvements are necessary to meet the needs of its audience.

Diseño de una metodología para la co-creación de ambientes saludables en entornos educativos universitarios / Design of a methodology for the co-creation of health environments in university educational contexts / Desenho de uma metodologia para a co-criação de ambientes saudáveis ambiente educativos universitários

Resumen Este proyecto se desarrolló en la Universidad de Ibagué entre los años 2016 y 2018, y, se sitúa como una alternativa participativa en procesos de promoción y educación para la salud. Esta es la cuarta etapa de un macroproyecto titulado Estudio sistémico de una Universidad Saludable. Los primeros momentos del proyecto buscaron estructurar la situación actual del modelo de universidad promotora de la salud, luego, estudiar las concepciones y representaciones de constructos como universidad saludable, salud y salud mental desde las narrativas de los miembros de la universidad. Objetivo: en esta fase se buscó diseñar una metodología para la co-creación de ambientes saludables en contexto universitario. Materiales y métodos: se siguió una metodología cualitativa de investigación-creación en tres fases. Una fase de co-creación, una fase de prototipado y desarrollo de propuestas y una fase de evaluación y diseño metodológico. Resultados: se dio cuenta del diseño de una metodología y la co-creación de tres prototipos de ambientes saludables. Conclusiones: los procesos de co-creación de ambientes saludables son una ruta para la educación y promoción de la salud, y favorecen el reconocimiento de necesidades locales, culturalmente viables e incentivan la participación de todas las personas involucradas.

Abstract This project was developed at Universidad de Ibague between 2016 and 2018, and it is situated as a participatory alternative in health promotion and education processes. This is the fourth stage of a macro project entitled Systemic Study of a Healthy University. The first moments of the project sought to structure the current situation of the Health Promoting University model and then to study the conceptions and representations of constructs such as healthy university and health and mental health from the narratives of members of the university. Objective: In this phase it was sought to design a methodology for the co-creation of healthy environments in a university context. Materials and methods: A qualitative research-creation methodology was followed in three phases: A co-creation phase, a prototyping and proposal development phase, and an evaluation and methodological design phase. Results: The design of a methodology and the co-creation of three prototypes of healthy environments were carried out. Conclusions: The processes of co-creation of healthy environments are a route for education and health promotion, favor the recognition of local culturally viable needs, and encourage the participation of all the people involved.

Resumo Este projeto se desenvolveu na Universidade de Ibagué entre os anos 2016 e 2018, e, situa-se como una alternativa participativa em processos de promoção e educação para a saúde. Esta é a quarta etapa de um macroprojecto titulado Estudo sistémico de uma Universidade Saudável. Os primeiros momentos do projeto buscaram estruturar a situação atual do modelo de universidade promotora da saúde, logo, estudar as concepções e representações de constructos como universidade saudável, saúde e saúde mental desde as narrativas dos membros da universidade. Objetivo: nesta fase se procurou desenhar uma metodologia para a co-criação de ambientes saudáveis em contexto universitário. Materiais e métodos: seguiu-se uma metodologia qualitativa de pesquisa criação em três fases. Uma fase de co-criação, uma fase de protótipo e desenvolvimento de propostas e uma fase de avaliação e desenho metodológico. Resultados: dar-se conta de um desenho de uma metodologia e a co-criação de três protótipos de ambientes saudáveis. Conclusões: os processos de co-criação de ambientes saudáveis são uma via para a educação e promoção da saúde, e favorecem o reconhecimento de necessidades locais, culturalmente viáveis e incentivam a participação de todas as pessoas involucradas.

Treatment of infantile hemangiomas with short-term application of imiquimod 5% cream.

Ten patients with superficial infantile hemangiomas were treated with imiquimod 5% cream for up to 16 weeks. Four patients achieved complete clinical resolution, 3 had excellent improvement, one showed moderate improvement, and one patient did not respond to therapy. Imiquimod may be an effective alternative for the treatment of superficial hemangiomas.

Influencia de los pares en la manifestación del bullying en estudiantes de secundaria en Arequipa Metropolitana / Influence of the pairs in the expression of bullying in high school students in Arequipa

El objetivo del presente estudio fue determinar el grado de influencia que ejerce la cercanía de los alumnos de secundaria con pares que transgreden normas, sobre el rol que asumen estos alumnos dentro del bullying (agresor, víctima o espectador) en el área metropolitana de la ciudad de Arequipa, teniendo en cuenta sexo y grado de instrucción. Se evaluó a 3979 estudiantes de educación secundaria de colegios estatales, privados y paraestatales de 19 distritos de la provincia de Arequipa, con edades comprendidas entre 11 y 19 años. Se realizó un análisis descriptivo y de regresión lineal múltiple y logística binaria para modelar la asociación entre variables. Los resultados muestran una mayor tendencia de los varones hacia las conductas agresivas y a asumir roles de "bully". La influencia de pares transgresores de normas favorece en mayor grado la práctica de roles de agresor o víctima. En cuanto a la frecuencia de bullying, existe una alta prevalencia de agresores y víctimas entre los encuestados, cercana a la mitad de la muestra, mientras que la otra parte corresponde a los espectadores ya sean estos reforzadores del bullying o prosociales.

The aim of this study was to determine the degree of influence of the proximity of high school students with peers who break rules on the role assumed these students within the bullying (bully, victim or viewer) in the metropolitan area of ​​the city Arequipa, considering sex and level of education. We evaluated 3979 high school students from state, private and parastatal schools in 19 districts in the province of Arequipa, aged between 11 and 19 years. A descriptive and binary logistic regression and multiple linear analysis was performed to model the association between variables. The results show a greater tendency of men to aggressive behavior and assume roles of "bully". The influence of offenders pairs of rules favors greater practical role of aggressor or victim. As for the frequency of bullying, there is a high prevalence of perpetrators and victims among respondents, nearly half of the sample, while the other part is for the spectators whether these enhancers bullying or prosocial.

La inclusión laboral de personas con discapacidad: Una mirada desde la productividad y el desarrollo humano / Labor inclusion of people with disabilities: a view from the productivity and human development

El presente es un artículo de tipo académico que expone el resultado de un análisis realizado a la situación por la que atraviesa la población con discapacidad en cuanto a su inclusión laboral en el contexto colom-biano. Para este análisis se plantea la relación productividad-desarrollo humano desde el enfoque de la responsabilidad social, con el propósito de conocer cómo el sector empresarial puede aplicar este tipo de inclusión y a su vez, cómo la población con discapacidad encuentra en el mercado laboral oportunidades. En este proceso, se consultaron fuentes de información secundarias tales como libros, sitos web, bases de datos, estudios de entidades públicas y privadas que desarrollan su misión por medio de actividades relacionadas con la población objetivo. Como resultado de este proceso, se pudo concluir que la inclusión laboral debe ser vista como una oportunidad para que el sector empresarial actúe de manera protagónica en la construcción de escenarios de justicia, haciendo posible que las necesidades sociales sean resueltas en un marco de respeto por la diversidad. De igual forma, se considera relevante fortalecer los procesos formativos por medio de los cuales la cualificación laboral sea más eficiente y competitiva con base en el trabajo conjunto que surge de la relación empresa-academia.

This is an article of academic type that exposes the initial result of an analysis of the situation being expe-rienced by people with disabilities in their labor inclusion in the Colombian context. For this analysis, it is considered the relation human productivity-development from the perspective of social responsibility, in order to know how business sector can apply this type of inclusion and in turn, how people with disabi-lities find opportunities in the labor market. In this process, they were consulted secondary sources such as books, web sites, databases, studies of public and private entities that carry out their mission through the target population-related activities. As a result of this process, it was concluded that labor inclusion should be seen as an opportunity for the business sector acting a leading role in building scenarios of justi-ce, enabling social needs are resolved within a framework of respect for diversity. Likewise, it is considered important to strengthen the learning processes through which the occupational qualifications are more efficient and competitive, based on the joint work arising from the business-academy relationship.

Hiperinsulinismo en recién nacido / Hyperinsulinismo in a newborn infant

Se describen 2 pacientes, recién nacidos, con hipoglicemia secundaria a hiperinsulinemia. Se confirmó la hipersecreción de la hormona mediante radioinmunoanálisis en el plasma. Se extirpó 95% del tejido pancreático en ambos casos, lográndose el control de la hipoglicemia. Los dos pacientes tuvieron hiperglicemia transitoria en las primeras horas después de la operación, pero diez días más tarde sus insulinemias y glicemias eran normales y tres meses después mostraban desarrollos pondoestaturales y psicomotrices adecuados. El estudio histológidco preliminar reveló nesidioblastosis y leve componente de displasia endocrina en uno de los casos y displasia endocrina con leve componente de nesidioblastosis en el otro