Oral squamous cell carcinomas and oral potentially malignant disorders: A Latin American study.

OBJECTIVE: To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America. METHODS: A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential-OSCC versus OSCC-de novo (OSCC-dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t-test, and qualitative variables with chi-square. RESULTS: In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC-dn, while s-OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD. CONCLUSIONS: In Latin America, OSCC-dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon.

Development of New Experimental Dentifrice of Peruvian Solanum tuberosum (Tocosh) Fermented by Water Stress: Antibacterial and Cytotoxic Activity.

AIM: "Tocosh" is a potato that has undergone a process of hydraulic oxidation that enhances its antimicrobial properties so that this natural resource can be used in medical sciences. The aim of this study was to develop and evaluate the antibacterial and cytotoxic activity of a new experimental tooth based on Solanum tuberosum "Tocosh" on the cell lines 3T3 and DU145. MATERIALS AND METHODS: To evaluate the cytotoxicity, cell cultures 3T3 and DU145 were used. Cell viability was determined by the MTT assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) in a medium containing 10% calf serum where the cells were preincubated at a concentration of 1 × 106 cells/mL in culture medium for 3 hours at 37°C and 6.5% CO2. Then, the absorbance was measured using a microplate reader where the formazan crystals were diluted with acidic and cold isopropanol, and quantified in an ELISA reader. To evaluate the antibacterial effect, the Kirby Bauer inhibition halos method was used on strains of S. aureus (ATCC 25923), S. mutans (ATCC 25175), and S. mitis (ATCC 49456). RESULTS: Solanum tuberosum (tocosh) was not cytotoxic because it only had one CC50 at the concentration of 0.26927 mg/mL and 0.26845 mg/mL for the cell lines 3T3 and DU145, respectively. Tocosh toothpaste (TD) has an antibacterial effect against S. aureus and S. mutans. CONCLUSION: The new ecological dentifrice was not cytotoxic since it did not alter cell viability because its CC50 was only 0.268 and 0.269 µg/mL for the 3T3 and DU145 cell lines, respectively; however, it presented an optimal antimicrobial activity against the oral strains evaluated. CLINICAL SIGNIFICANCE: This research has great potential for clinical use because this new dentifrice has antimicrobial activity against different oral germs. How to cite this article: Mayta-Tovalino F, Sedano-Balbin G, Romero-Tapia P, et al. Development of New Experimental Dentifrice of Peruvian Solanum tuberosum (Tocosh) Fermented by Water Stress: Antibacterial and Cytotoxic Activity. J Contemp Dent Pract 2019;20(10):1206-1211.

MUC1 deficiency mediates corticosteroid resistance in chronic obstructive pulmonary disease.

BACKGROUND: Lung inflammation in COPD is poorly controlled by inhaled corticosteroids (ICS). Strategies to improve ICS efficacy or the search of biomarkers who may select those patients candidates to receive ICS in COPD are needed. Recent data indicate that MUC1 cytoplasmic tail (CT) membrane mucin can mediate corticosteroid efficacy in chronic rhinosinusitis. The objective of this work was to analyze the previously unexplored role of MUC1 on corticosteroid efficacy in COPD in vitro and in vivo models. METHODS: MUC1-CT expression was measured by real time PCR, western blot, immunohistochemistry and immunofluorescence. The inflammatory mediators IL-8, MMP9, GM-CSF and MIP3α were measured by ELISA. The effect of MUC1 on inflammation and corticosteroid anti-inflammatory effects was measured using cell siRNA in vitro and Muc1-KO in vivo animal models. RESULTS: MUC1-CT expression was downregulated in lung tissue, bronchial epithelial cells and lung neutrophils from smokers (n = 11) and COPD (n = 11) patients compared with healthy subjects (n = 10). MUC1 was correlated with FEV1% (ρ = 0.7479; p < 0.0001) in smokers and COPD patients. Cigarette smoke extract (CSE) decreased the expression of MUC1 and induced corticosteroid resistance in human primary bronchial epithelial cells and human neutrophils. MUC1 Gene silencing using siRNA-MUC1 impaired the anti-inflammatory effects of dexamethasone and reduced glucocorticoid response element activation. Dexamethasone promoted glucocorticoid receptor alpha (GRα) and MUC1-CT nuclear translocation and co-localization that was inhibited by CSE. Lung function decline and inflammation induced by lipopolysaccharide and cigarette smoke in Muc1 KO mice was resistant to dexamethasone. CONCLUSIONS: These results confirm a role for MUC1-CT mediating corticosteroid efficacy in COPD.

Association Between Self-Perceived Oral Health and Clinical Indicators.

PURPOSE: To determine whether self-perceived oral health impact and satisfaction measure oral health in the same way as do clinical indicators in adults and older adults. MATERIALS AND METHODS: The population consisted of adult patients aged 20 to 59 years receiving care at "Juan Pablo II" Health Care Centre and older adult patients aged 60 or more years from the home for the elderly "Virgen del Amor Hermoso", Lima, Peru. The indices Oral Impacts on Daily Performance (OIDP) and Oral Satisfaction Scale of 0-10 (OSS 0-10) were used to evaluate perceived impact of and satisfaction with oral health. In addition, the following internationally validated criteria established by the World Health Organization (WHO) were used as clinical indicators: Decayed-Missing-Filled Teeth (DMFT) Index, O'Leary's Hygiene Index, Community Periodontal Index, Motivation to Hygiene Index, Denture Situation Index, Need for Denture Index, Denture Hygiene Index and Oral Mucosal Lesion Index. RESULTS: Forty-four adults and 53 older adults participated. OIDP showed that the greatest perceived difficulty in daily performance was "eating and enjoying food" (adults: 77.3% and older adults: 79.2%). The OSS 0-10 showed that among adults, 43.1% were dissatisfied, 20.5% were neutral and 36.4% were satisfied, while among older adults, 45.3% were dissatisfied, 22.6% were neutral and 32.1% were satisfied. A statistically significant association was found between OSS 0-10 and 1. DMFT index in adults; 2. upper denture situation in older adults; and 3. denture hygiene in older adults. A highly significant inverse linear correlation was found between OIDP and OSS 0-10 in adults and older adults. CONCLUSION: The perceived impact of oral health does not have a demonstrable association with oral health problems when used as an instrument for measuring oral health status, whereas perceived satisfaction with oral health has a better association with the clinical indicators.

Visual cues and food intake: A preregistered replication of Wansink et al. (2005).

Imagine a bowl of soup that never emptied, no matter how many spoonfuls you ate-when and how would you know to stop eating? Satiation can play a role in regulating eating behavior, but research suggests visual cues may be just as important. In a seminal study by Wansink et al. (2005), researchers used self-refilling bowls to assess how visual cues of portion size would influence intake. The study found that participants who unknowingly ate from self-refilling bowls ate more soup than did participants eating from normal (not self-refilling) bowls. Despite consuming 73% more soup, however, participants in the self-refilling condition did not believe they had consumed more soup, nor did they perceive themselves as more satiated than did participants eating from normal bowls. Given recent concerns regarding the validity of research from the Wansink lab, we conducted a preregistered direct replication study of Wansink et al. (2005) with a more highly powered sample (N = 464 vs. 54 in the original study). We found that most results replicated, albeit with half the effect size (d = 0.45 instead of 0.84), with participants in the self-refilling bowl condition eating significantly more soup than those in the control condition. Like the original study, participants in the self-refilling condition did not believe they had consumed any more soup than participants in the control condition. These results suggest that eating can be strongly controlled by visual cues, which can even override satiation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Acquired Perforating Dermatosis and Dermatology Life Quality Index in Patients Receiving hemodialysis.

INTRODUCTION: Acquired perforating dermatosis (APD) is a frequent disorder in hemodialysis patients and the effect on the quality of life is poorly described. We investigated the prevalence of APD in hemodialysis patients, measured and compared APD-associated quality of life. METHODS: We developed a prospective, observational, and descriptive study. We invited patients over the age of 18 in hemodialysis. Data was obtained from their electronic file and a dermatological examination was performed. The Dermatology Life Quality Index (DLQI) was applied. Descriptive analysis of demographic variables, clinical features, and dermoscopy findings, as well as comparison of DLQI scores, was made. RESULTS: The sample consisted of 46 patients, with a prevalence of APD of 11%. Patients with APD were leaner and younger compared to patients without APD. The time on hemodialysis was longer in patients with APD compared to those without APD, with a median of 90 versus 32 months (p = 0.015). The impact on quality of life was greater in patients with APD compared to those without APD, with some effect in all patients with APD and 33% in patients without APD (p = 0.001). Patients with APD had more frequent pruritus compared to those without APD (p = 0.007). CONCLUSIONS: Age, time on hemodialysis and BMI are associated with the presence of APD. Patients with APD had a higher prevalence of pruritus and a greater impact on quality of life in dermatology compared to patients without APD.

Farmworker Mobility and COVID-19 Vaccination Strategies: Yuma County, Arizona, 2021.

Farmworkers, a group of essential workers, experience a disproportionately high burden of COVID-19 due to their living and working conditions. This project characterized farmworker mobility in and around Yuma County, Arizona, to identify opportunities to improve farmworker access to COVID-19 vaccination. We collected qualitative and geospatial data through a series of in-person and virtual focus group discussions, key informant interviews, and intercept interviews with participatory mapping. Participants included farmworkers, employers, and representatives of local institutions who serve or interact with farmworkers. We identified participants through purposive and referential sampling and grouped people by sociodemographic characteristics for interviews. We used qualitative and geospatial analyses to identify common themes and mobility patterns. The team interviewed 136 people from February 26 to April 2, 2021. Common themes emerged about how farmworkers have little or no access to COVID-19 vaccination unless offered at their workplaces or at locations where they congregate at convenient times. Further, farmworkers described how their demanding work schedules, long commute times, and caretaker commitments make it challenging to access vaccination services. Geospatial analyses identified three geographic areas in Yuma County where farmworkers reported living and working that did not have a COVID-19 vaccine clinic within walking distance. Coordination between local public health authorities and key partners, including employers and trusted representatives from local community-based organizations or the Mexican consulate, to offer vaccination at worksites or other locations where farmworkers congregate can help improve access to COVID-19 vaccines and booster doses for this population.

Malignant lymphoma of the oral cavity and the maxillofacial region: overall survival prognostic factors.

OBJECTIVE: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. STUDY DESIGN: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox's regression tests. RESULTS: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). CONCLUSION: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus.

Sporotrichosis in Argentina: clinical and epidemiological analysis / Esporotricosis en Argentina: análisis clínico y epidemiológico

Introduction: Sporotrichosis is an implantation mycosis caused by Sporothrix spp. It is distributed worldwide and can be found in vegetation and soil. The most frequent route of infection is by trauma with elements contaminated with fungal propagules. Since domestic cats are the most affected animals and can transmit this infection to humans, sporotrichosis is considered a zoonosis. Clinical presentations include nodular lymphangitis, fixed cutaneous, pulmonary (rare), and disseminated (exceptional). Objectives: To analyze the epidemiology of sporotrichosis in Argentina during 2010 and 2022. To describe the clinical presentation, diagnostic methods, and treatment of cases diagnosed during this period. To know the circulating genotypes and to observe possible associations with the geographic location where the infection was acquired. Materials and methods: Analytical, retrospective, and observational study. We analyzed the medical records of patients with sporotrichosis from 12 health institutions in Argentina, between 2010 and 2022. Results: We present 54 cases in which the most frequent clinical form was nodular lymphangitis, and the treatment of choice was itraconazole. Conventional diagnosis was made in all cases. Culture of clinical samples was more sensitive than direct examination because it allowed the isolation of Sporothrix spp. in all 54 cases. Molecular identification was performed in 22 cases, with Sporothrix schenkii sensu stricto being the most frequently isolated species. Conclusions: This study allowed to know the epidemiology of this mycosis in Argentina, as well as the availability of diagnostic methods and the treatment of choice.

Introducción: La esporotricosis es una micosis de implantación causada por Sporothrix spp. Este se encuentra distribuido mundialmente y se puede encontrar en la vegetación y en el suelo. La ruta más frecuente de adquisición de la infección es por traumatismos con elementos contaminados con propágulos del hongo. Los gatos domésticos son los animales más afectados y pueden transmitirla a los humanos, por lo que es considerada una zoonosis. Las formas clínicas incluyen: la linfangítica nodular, la cutánea fija, la pulmonar (poco habitual) y la diseminada (excepcional). Objetivo: Analizar la epidemiología de la esporotricosis en Argentina entre los años 2010 y 2022. Describir la presentación clínica, los métodos de diagnóstico y el tratamiento de los casos diagnosticados en este período. Conocer los genotipos circulantes y observar su relación con el lugar geográfico de adquisición de la infección. Materiales y métodos. Se llevó a cabo un estudio analítico, retrospectivo y observacional, en el que se analizaron las historias clínicas de los pacientes con esporotricosis de 12 instituciones de salud de Argentina, entre los años 2010 y 2022. Resultados: Se presentan 54 casos en los que la forma clínica más frecuente fue la linfangítica nodular y el tratamiento de elección fue el itraconazol. En todos los casos se realizó diagnóstico convencional. El cultivo de las muestras clínicas resultó más sensible que el examen directo, ya que permitió el desarrollo de Sporothrix spp. en los 54 casos. En 22 casos se hizo identificación molecular y Sporothrix schenkii sensu stricto fue la especie más frecuentemente aislada. Conclusiones: Este estudio permitió conocer la epidemiología de esta micosis en Argentina, así como la disponibilidad de métodos diagnósticos y el tratamiento de elección.

Systematic review of lymphoma in oral cavity and maxillofacial region.

The aim of this paper is to determine, compare and summarize presentation characteristics of patients with lymphoma of the oral cavity and maxillofacial region using the results of different primary studies. Articles from the PubMed database published between 1990 and 2010 were reviewed. The key words "Lymphoma" and "Oral" were used to search for titles, identifying 215 articles, of which 178 were excluded and 37 were used for this review. After evaluation, the researchers agreed to include 15 of the papers in the study. This paper describes the author year published, number of cases, sex, age, location, signs and symptoms, classification, diagnosis, staging and treatment reported in each of the 15 studies. A total 714 patients are described. In 11 out of 13 studies, there were more cases in males than females. Ages ranged from 3 to 96 years. Presentation was most frequently the gingiva and the main sign was swelling. Staging was described for only 177 cases and treatment was described for only 110 cases. It is concluded that the presentation of most of the lymphomas of the oral cavity and maxillofacial region is extranodal, non-Hodgkin's. The most common locations are gingiva in the oral activity and Waldeyers's ring in the maxillofacial region. Although these lymphomas are rare pathological entities, it is important to describe the complete manifestation of their natural history in order to provide knowledge of their development.

Plastic residues produced with confirmatory testing for COVID-19: Classification, quantification, fate, and impacts on human health.

In March 2020, several international organizations started making recommendations regarding the need for prompt coronavirus-based diagnosis in order to prevent its spread among the world's population. The most widely used test for confirmation of COVID-19 is real-time PCR (RT-PCR). This technique uses plastic supplies in its procedures, which are 100% disposable to avoid cross-contamination and biological risks. The scientific community has become increasingly worried because of the environmental impacts associated with the current COVID-19 pandemic, such as medical plastic residues. We classified and estimated the amount of plastic residues generated as a consequence of COVID-19 diagnostic tests and analyzed the relationships of the plastics generated with number of confirmed cases, population size, and gross domestic product in each country. We evidenced that the RT-PCR generates 37.27 g of plastic residues per sample. All patients COVID-19 tested with RT-PCR have generated 15,439.59 tons of plastic residue worldwide, until August 2020. The plastic residues generated by the COVID-19 tests have no relation with size population or gross domestic product of the countries. There is also no relationship between the plastic residues generated by the COVID-19 tests and the confirmed cases. About 97% of the plastic residues from diagnostic tests for coronavirus are incinerated due to their hazardous nature to humans, but toxic chemicals are released into the environment during the process. In the short term, there is a need to reduce plastic waste and improve controls of gas emissions from incineration plants in countries where there is a deficit. In the long term, biodegradable biomedical manufacturing that are free of releasing toxic chemicals when they are incinerated, must be considered.

Dermatosis perforante adquirida e Índice de Calidad de Vida en Dermatología en pacientes en hemodiálisis / Acquired perforating Dermatology Life Quality Index in dermatology in patients receiving hemodialysis

Introducción: La dermatosis perforante adquirida (DPA) es un trastorno frecuente en pacientes en hemodiálisis, y el efecto en la calidad de vida está poco descrito. Investigamos la prevalencia de DPA en pacientes en hemodiálisis, medimos y comparamos la calidad de vida asociada a DPA. Métodos: Desarrollamos un estudio prospectivo, observacional y descriptivo. Invitamos a pacientes mayores de 18 años en hemodiálisis. Se obtuvieron datos de su expediente electrónico, y se realizó exploración dermatológica. Se aplicó el Índice de Calidad de Vida en Dermatología (DLQI). Se hizo un análisis descriptivo de las variables demográficas, de las características clínicas y de los hallazgos de dermatoscopia, así como la comparación de los puntajes del DLQI. Resultados: La muestra fue de 46 pacientes, con una prevalencia de DPA del 11%. Los pacientes con DPA eran más delgados y jóvenes en comparación con los pacientes sin DPA. El tiempo en hemodiálisis fue mayor en los pacientes con DPA en comparación a los pacientes sin DPA, con una mediana de 90 versus 32 meses (p=0,015). La afección en calidad de vida fue mayor en los pacientes con DPA en comparación a los pacientes sin DPA, con un algún efecto en todos los pacientes con DPA y un 33% en los pacientes sin DPA (p=0,001). Los pacientes con DPA tuvieron con más frecuencia prurito en comparación con los pacientes sin DPA (p=0,007). Conclusiones: La edad, el tiempo en hemodiálisis y el índice de masa corporal se asocian con la presencia de DPA. Los pacientes con DPA tuvieron una prevalencia más alta de prurito y mayor afección en la calidad de vida en dermatología en comparación con los pacientes sin DPA. (AU)

Introduction: Acquired perforating dermatosis (APD) is a frequent disorder in hemodialysis patients and the effect on the quality of life is poorly described. We investigated the prevalence of APD in hemodialysis patients, measured and compared APD-associated quality of life. Methods: We developed a prospective, observational, and descriptive study. We invited patients over the age of 18 in hemodialysis. Data was obtained from their electronic file and a dermatological examination was performed. The Dermatology Life Quality Index (DLQI) was applied. Descriptive analysis of demographic variables, clinical features, and dermoscopy findings, as well as comparison of DLQI scores, was made. Results: The sample consisted of 46 patients, with a prevalence of APD of 11%. Patients with APD were leaner and younger compared to patients without APD. The time on hemodialysis was longer in patients with APD compared to those without APD, with a median of 90 versus 32 months (P=.015). The impact on quality of life was greater in patients with APD compared to those without APD, with some effect in all patients with APD and 33% in patients without APD (P=.001). Patients with APD had more frequent pruritus compared to those without APD (P=.007). Conclusions: Age, time on hemodialysis and BMI are associated with the presence of APD. Patients with APD had a higher prevalence of pruritus and a greater impact on quality of life in dermatology compared to patients without APD. (AU)

In vitro anti-inflammatory effects of AZD8999, a novel bifunctional muscarinic acetylcholine receptor antagonist /ß2-adrenoceptor agonist (MABA) compound in neutrophils from COPD patients.

Recent evidence indicates that AZD8999 (LAS190792), a novel muscarinic acetylcholine receptor antagonist and ß2-adrenoceptor agonist (MABA) in development for chronic respiratory diseases, induces potent and sustained relaxant effects in human bronchi by adressing both muscarinic acetylcholine receptors and ß2-adrenoceptor. However, the anti-inflammatory effects of the AZD8999 monotherapy or in combination with corticosteroids are unknown. This study investigates the anti-inflammatory effects of AZD8999 in monotherapy and combined with fluticasone propionate in neutrophils from healthy and chronic obstructive pulmonary disease (COPD) patients. Peripheral blood neutrophils from healthy and COPD patients were incubated with AZD8999 and fluticasone propionate, individually or in combination, for 1h followed by lipopolysaccharide (LPS) stimulation for 6h. The IL-8, MMP9, IL-1ß, and GM-CSF release was measured in cell culture supernatants. AZD8999 shows ~ 50% maximum inhibitory effect and similar potency inhibiting the released cytokines in neutrophils from healthy and COPD patients. However, while fluticasone propionate suppresses mediator release in neutrophils from healthy patients, COPD neutrophils are less sensitive. The combination of non-effective concentrations of AZD8999 (0.01nM) with non-effective concentrations of fluticasone propionate (0.1nM) shows synergistic anti-inflammatory effects. The studied mechanisms that may be involved in the synergistic anti-inflammatory effects of this combination include the increase of glucocorticoid receptor (GR)α and MKP1 expression, the induction of glucocorticoid response element (GRE) activation and the decrease of ERK1/2, P38 and GR-Ser226 phosphorylations compared with monotherapies. In summary, AZD8999 shows anti-inflammatory effects in neutrophils from COPD patients and induces synergistic anti-inflammatory effects when combined with fluticasone propionate, supporting the use of MABA/ICS combination therapy in COPD.

Esporotricosis en Argentina: análisis clínico y epidemiológico / Sporotrichosis in Argentina: clinical and epidemiological analysis

Introducción. La esporotricosis es una micosis de implantación causada por Sporothrix spp. Este se encuentra distribuido mundialmente y se puede encontrar en la vegetación y en el suelo. La ruta más frecuente de adquisición de la infección es por traumatismos con elementos contaminados con propágulos del hongo. Los gatos domésticos son los animales más afectados y pueden transmitirla a los humanos, por lo que es considerada una zoonosis. Las formas clínicas incluyen: la linfangítica nodular, la cutánea fija, la pulmonar (poco habitual) y la diseminada (excepcional). Objetivo. Analizar la epidemiología de la esporotricosis en Argentina entre los años 2010 y 2022. Describir la presentación clínica, los métodos de diagnóstico y el tratamiento de los casos diagnosticados en este período. Conocer los genotipos circulantes y observar su relación con el lugar geográfico de adquisición de la infección. Materiales y métodos. Se llevó a cabo un estudio analítico, retrospectivo y observacional, en el que se analizaron las historias clínicas de los pacientes con esporotricosis de 12 instituciones de salud de Argentina, entre los años 2010 y 2022. Resultados. Se presentan 54 casos en los que la forma clínica más frecuente fue la linfangítica nodular y el tratamiento de elección fue el itraconazol. En todos los casos se realizó diagnóstico convencional. El cultivo de las muestras clínicas resultó más sensible que el examen directo, ya que permitió el desarrollo de Sporothrix spp. en los 54 casos. En 22 casos se hizo identificación molecular y Sporothrix schenkii sensu stricto fue la especie más frecuentemente aislada. Conclusiones. Este estudio permitió conocer la epidemiología de esta micosis en Argentina, así como la disponibilidad de métodos diagnósticos y el tratamiento de elección.

Introduction. Sporotrichosis is an implantation mycosis caused by Sporothrix spp. It is distributed worldwide and can be found in vegetation and soil. The most frequent route of infection is by trauma with elements contaminated with fungal propagules. Since domestic cats are the most affected animals and can transmit this infection to humans, sporotrichosis is considered a zoonosis. Clinical presentations include nodular lymphangitis, fixed cutaneous, pulmonary (rare), and disseminated (exceptional). Objective. To analyze the epidemiology of sporotrichosis in Argentina during 2010 and 2022. To describe the clinical presentation, diagnostic methods, and treatment of cases diagnosed during this period. To know the circulating genotypes and to observe possible associations with the geographic location where the infection was acquired. Materials and methods. Analytical, retrospective, and observational study. We analyzed the medical records of patients with sporotrichosis from 12 health institutions in Argentina, between 2010 and 2022. Results. We present 54 cases in which the most frequent clinical form was nodular lymphangitis, and the treatment of choice was itraconazole. Conventional diagnosis was made in all cases. Culture of clinical samples was more sensitive than direct examination because it allowed the isolation of Sporothrix spp. in all 54 cases. Molecular identification was performed in 22 cases, with Sporothrix schenkii sensu stricto being the most frequently isolated species. Conclusions. This study allowed to know the epidemiology of this mycosis in Argentina, as well as the availability of diagnostic methods and the treatment of choice.

Selective Inhibition of Phosphodiesterases 4A, B, C and D Isoforms in Chronic Respiratory Diseases: Current and Future Evidences.

Chronic respiratory diseases affect millions of people every day. According to the World Health Organization estimates, ~235 million people suffer from asthma, ~64 million suffer from chronic obstructive pulmonary disease (COPD), and millions more suffer from allergic rhinitis around the world. In recent last years, the first phosphodiesterase 4 (PDE4) inhibitor, roflumilast, was approved as a treatment to reduce the risk of exacerbations in stable and severe COPD associated with chronic bronchitis and a history of exacerbations. PDE4 exists as four subtypes (A, B, C, and D) each with a capacity to degrade cAMP, a second messenger involved in inflammatory responses. PDE4 inhibitors inhibit PDE4 activity, consequently increasing cAMP levels. This results in an anti-inflammatory effect, improving lung function. Roflumilast is a selective and non-specific PDE4 inhibitor, with the potential to inhibit all PDE4 isoforms to some degree. Despite the pharmacological effects of roflumilast, its lack of specificity can induce side effects, such as diarrhea, nausea, and dizziness. Thus, there is a continuing need to develop more specific inhibitors of the individual PDE4 subtypes. PDE4B and D inhibitors have been investigated the most, because the levels of these two subtypes are upregulated in moderate and severe COPD. Current and new evidences show that PDE4B and D inhibitors are the most studied, because their expressions are up-regulated in moderate and severe COPD. This review highlights the major advantages of the selective specific inhibition of PDE4A, B, C, and D versus selective, non-specific inhibitors as treatments for chronic respiratory diseases.

Dulce Wireless Tijuana: A Randomized Control Trial Evaluating the Impact of Project Dulce and Short-Term Mobile Technology on Glycemic Control in a Family Medicine Clinic in Northern Mexico.

BACKGROUND: The global epidemic of diabetes calls for innovative interventions. This study evaluated the effectiveness of the Project Dulce model, with and without wireless technology, on glycemic control and other clinical and self-reported outcomes in patients with poorly controlled type 2 diabetes in Mexico. SUBJECTS AND METHODS: Adults with type 2 diabetes and a glycated hemoglobin A1c (HbA1c) level of ≥8% were recruited from Family Medical Unit #27 of the Instituto Mexicano del Seguro Social (IMSS) in Tijuana, México, and randomly assigned to one of three groups: Project Dulce-only (PD); Project Dulce technology-enhanced with mobile tools (PD-TE); or IMSS standard of care/control group (CG). Clinical and self-reported outcomes were assessed at baseline, Month 4, and Month 10. Time-by-group interactions and within-group changes were analyzed. RESULTS: HbA1c reductions from baseline to Month 10 were significantly greater in PD-TE (-3.0% [-33 mmol/mol]) and PD (-2.6% [-28.7 mmol/mol]) compared with CG (-1.3% [-14.2 mmol/mol]) (P = 0.009 and 0.001, respectively). PD-TE and PD also exhibited significant improvement in diabetes knowledge when compared with CG (P < 0.05 for both). No statistically significant differences were detected between PD and PD-TE on these indicators (P = 0.54 and 0.86, respectively). Several within-group improvements were observed on other clinical and self-report indicators but did not vary significantly across groups. CONCLUSIONS: Project Dulce with and without wireless technology substantially improved glycemic control and diabetes knowledge in high-risk patients with type 2 diabetes in a Mexican family medical unit, suggesting that integrating peer-led education, nurse coordination, and 3G wireless technology is an effective approach for improving diabetes outcomes in high-risk populations.

Una mirada a la calidad de vida y salud de las educadoras de párvulos / A look to the life and health quality of kindergarten teachers

INTRODUCCIÓN: La medición de la calidad de vida desde la perspectiva de la salud y su relación en el ámbito laboral de las Educadoras de Párvulos como agentes fundamentales en el desarrollo cognitivo y socioemocional en la primera infancia es de relevancia, pues existen aspectos claves para conseguir una buena calidad pedagógica en concordancia con los anhelos de las nuevas políticas en educación implementadas en Chile. OBJETIVO: determinar con qué factores se asocian la calidad de vida relacionada con la salud de las Educadoras de Párvulos, desde los elementos sociodemográficos y laborales concernientes en sus actividades profesionales. MÉTODO: Diseño metodológico descriptivo, correlacional, de corte transversal en 156 Educadoras de Párvulos de una comuna de Chillán, Chile. Resultados: las Educadoras de Párvulos, que se desempeñan casi en su totalidad en el aula, refieren un rol físico, función física y rol emocional óptimo, con una regular vitalidad y función social, una buena salud mental y mal dolor corporal, con relaciones altamente significativas en la función física con el ausentismo y dependencia laboral, y significativa con el número de niños a cargo y años laborales. También altamente relacionados en forma significativa el dolor corporal y los días de ausentismo, significativamente la vitalidad y el número de niños a cargo, y el rol emocional con los días de ausentismo laboral, entre otros. DISCUSIÓN: Estos antecedentes podrían ser determinantes en la orientación de las prácticas educativas y ponen en manifiesto que las nuevas disposiciones y políticas gubernamentales no aseguran condiciones que propicien una buena calidad de vida docente.

INTRODUCTION: the measurement of life quality from a health perspective and its relationship on the labor field of Kindergarten Teachers as main agents on the cognitive and socio emotional development in early childhood, is relevant, since there are key aspects in order to get a good pedagogical quality according to the desires of the new educational politics implemented in Chile. OBJECTIVE: to determinate which factors are associated to the quality of life related to the health of Kindergarten Teachers, from sociodemographic and labor elements concerning their professional activities. Method: descrip tive methodological design, correlational, cross sectional in 156 Kindergarten Teachers from a commune in Chillán, Chile. RESULTS: the Kindergarten Teachers, who mostly perform in the classroom, relate a physical role, physical function and an optimal emotional role, with a regular vitality and social function, a good mental health and body ache, with highly meaningful relations in the physical function with absenteeism and labor dependency. Also, body ache and days of absenteeism are highly related in a meaningful way, as well as vitality and the amount of kids they are in charge of, and the emotional role with the days of labor absenteeism, among others. DISCUSSION: these antecedents may be determinant on the guidance of the teaching practices and show that the new regulations and governmental politics do not ensure conditions that promote good quality in docent life.

Instrumento para valoración del cuidado humanizado brindado por profesionales de enfermería a personas hospitalizadas / Assessment instrument to humanized care provided by nurses to hospital patients

Objetivo: Diseñar y determinar la validez de contenido y confiabilidad de un instrumento que evalúe la percepción del paciente en relación al cuidado humanizado recibido por el profesional de enfermería. Metodología: Estudio cuantitativo y transversal desarrollado en tres fases: elaboración del instrumento, validez de contenido, y evaluación de validez y confiabilidad. Resultados y discusión: Se creó un instrumento de 36 ítems, con 7 dimensiones fácticas y una consistencia interna adecuada. El principal enfoque del cuidado humanizado es la vivencia personal de la enfermedad y cómo el profesional de enfermería ayuda a entender y vivir este proceso, a través de la expresión de sentimientos. Los procedimientos y entrega de cuidados personalizados, profundizan la relación enfermero-paciente a través del equilibrio entre habilidades y competencias técnicas. Conclusiones: El instrumento permite identificar la percepción de los usuarios respecto al carácter humanizado del cuidado brindado por el profesional de enfermería en pacientes hospitalizados

Objective: To design and determine the content validity and reliability of an instrument to assess the patient's perception regarding the humane care received by the nurse. Methodology: This quantitative and transversal study for the validation of an instrument was conducted through three phases: preparation of the instrument, content validity, and other evidence of validity and reliability. Results and discussion: The instrument was composed of 36 items, 7 factual dimensions, with adequate internal consistency. The results establish that the main focus of humanized care is the personal experience of the disease and how the nurse helps to understand and live this process, through the expression of feelings. The procedures and delivery of personalized care, deepen the nurse - patient relationship through the balance of skills and expertise. Conclusions: The instrument allows to identify the perception of users regarding the humanized nature of care provided by the nurse in hospitalized patients

Los pacientes del programa alivio del dolor y cuidados paliativos: razones y significados para enfermeras/os / Patients of the pain relief and palliative care programme: reasons and meaning for nurses

Objetivo: Estudio exploratorio de abordaje cualitativo, cuyo propósito fue comprender razones y significados que tiene para el profesional de enfermería el trabajar en el Programa Alivio del Dolor y Cuidados Paliativos. Material y método: A una muestra de 32 profesionales de Centros de Salud Familiar de Chillan se aplicó, mediante técnica Delphi, un cuestionario sociodemográfico y preguntas abiertas. Analizadas en base a Minayo, se originaron dos Escala de Likert. Resultados: Entre los discursos emitidos destacan el compromiso, los conocimientos, la entrega, la vocación y cumplir con cierto perfil; significa desgaste y no se permanece indiferente frente al dolor; reconocen la formación de pregrado, pero necesitan mayor capacitación por ser un área compleja; los pacientes enfrentan complicaciones y es difícil enfrentarlas solos; dar tranquilidad y paz permite serenidad en los últimos momentos y la carga emocional, espiritual y física es más llevadera; etapa de gran vulnerabilidad; el rol cobra importancia en lo clínico y en lo humano al entregar apoyo emocional en fallecimiento y duelo; se requiere coordinación efectiva entre los niveles de atención; no están todos los recursos; el trabajo tiene tiempo limitado, por tanto deben existir horas definidas. Conclusiones: Conocer significados, razones profesionales y/o personales permitirá diseñar estrategias y aportar a la formación de pregrado y postítulo en el área; es necesario aumentar número de enfermeras/os dedicados a este programa, para optimizar la calidad del cuidado de enfermería y satisfacer las necesidades de pacientes cuando enfrentan una enfermedad oncológica incurable avanzada.

Objective: An exploratory study with a qualitative approach, whose purpose was to understand the reasons and meanings that working in the Pain Relief and Palliative Care Programme has for nursing professionals. Methods: By using a Delphi technique, a sociodemographic questionnaire and open questions were applied to a sample of 32 professionals of Family Health Centers of Chillán. Based on Minayo's theme analysis, they originated two Likert Scales. Results: Among the main concepts obtained are commitment, knowledge, dedication, vocation and the idea of fulfilling a certain profile; this means wearing yourself out and not remaining indifferent to pain; they recognize undergraduate training, but they need more training, since it is a complex area; patients face complications and it is tough to face them alone; giving the patients peace and calm allows them to have serenity in their last moments; thus, the emotional, spiritual and physical burden is more bearable; period of great vulnerability; the nurse's role becomes important in human as well as clinical terms as emotional support is provided in times of death and mourning; effective coordination between levels of care is required; not all resources are available; there are time limitations; therefore, times must be assigned. Conclusions: Learning about nurses' meanings and professional and/or personal reasons will allow for the development of strategies and will contribute to undergraduate and post-graduate formation in this area; it is necessary to increase the number of nurses dedicated to this programme so as to optimize the quality of nursing care and meet the needs of patients when faced with an advanced incurable cancer disease.

Prognostic factors in patients with jaw sarcomas.

The aim of this study was to identify the prognostic factors related to the survival of patients with sarcomas of the jaw treated in the Dr. Eduardo Caceres Graziani National Institute for Neoplastic Diseases, Lima, Peru. Age, gender, delay in consultation, diagnostic delay, therapeutic delay, tumor size, tumor location, facial asymmetry, pain, treatment type, and histopathological diagnosis were all evaluated as possible prognostic factors that would influence survival in those with jaw sarcomas. In the analysis, the following was used: mortality tables, Kaplan-Meier's product-limit method, log-rank, and Breslow and Tarone-Ware tests; for the prognostic factors, Cox's Regression Model was used. The overall survival rate, with the patient being free from disease at two years, was 55%, and that at five years was 45%. In the independent analysis of the prognostic factors, four variables were statistically significant in influencing survival: gender (p = 0.043), histopathologic diagnosis (p = 0.019), tumor location (p = 0.019), and treatment type (p = 0.030). According to Cox's Regression Model for the multivariate analysis, statistically significant prognostic factors were: gender (p = 0.086), tumor location (p = 0.020), and treatment type (p = 0.092). Thus, the variables of gender, tumor location, and treatment type were determined to be predictive factors for prognosis of survival.