Flp-recombinase mouse line for genetic manipulation of ipRGCs.

Light has myriad impacts on behavior, health, and physiology. These signals originate in the retina and are relayed to the brain by more than 40 types of retinal ganglion cells (RGCs). Despite a growing appreciation for the diversity of RGCs, how these diverse channels of light information are ultimately integrated by the ~50 retinorecipient brain targets to drive these light-evoked effects is a major open question. This gap in understanding primarily stems from a lack of genetic tools that specifically label, manipulate, or ablate specific RGC types. Here, we report the generation and characterization of a new mouse line (Opn4FlpO), in which FlpO is expressed from the Opn4 locus, to manipulate the melanopsin-expressing, intrinsically photosensitive retinal ganglion cells. We find that the Opn4FlpO line, when crossed to multiple reporters, drives expression that is confined to ipRGCs and primarily labels the M1-M3 subtypes. Labeled cells in this mouse line show the expected intrinsic, melanopsin-based light response and morphological features consistent with the M1-M3 subtypes. In alignment with the morphological and physiological findings, we see strong innervation of non-image forming brain targets by ipRGC axons, and weaker innervation of image forming targets in Opn4FlpO mice labeled using AAV-based and FlpO-reporter lines. Consistent with the FlpO insertion disrupting the endogenous Opn4 transcript, we find that Opn4FlpO/FlpO mice show deficits in the pupillary light reflex, demonstrating their utility for behavioral research in future experiments. Overall, the Opn4FlpO mouse line drives Flp-recombinase expression that is confined to ipRGCs and most effectively drives recombination in M1-M3 ipRGCs. This mouse line will be of broad use to those interested in manipulating ipRGCs through a Flp-based recombinase for intersectional studies or in combination with other, non-Opn4 Cre driver lines.

Assessment of seasonal and annual patterns in phosphorus content in a monitored catchment through a partitioning approach based on hydrometeorological data.

High amounts of phosphorus (P) in rivers come mainly from two sources: fertilizers washed off from agricultural and urban areas by runoff water (non-point sources) and urban and industrial development which are translated in P discharges from wastewater treatment plants (WWTP). This work analyses the content of P in water for nearly 40 years inquiring into the origin of the sources, based on the hypothesis of runoff generation from the detection of river streamflow increases during the P contribution episode and the previous precipitation. For this purpose, the Guadaira River, which is located in the South of Spain and has a drainage surface of 1524 km2, was selected. In this watershed agricultural land use converges with numerous human activities resulting in high pressures on water quality. We found 40% of the P contribution episodes found seem to come from the runoff generated after the heaviest rainfall events, which normally occur between November and May. The remaining 60% of the P contribution episodes were found to be linked to point sources, which become more relevant from June to September, reaching the highest concentration values (6-17 mg/L). The results highlight that the target phosphate concentration value of 0.34 mg PO4/L imposed by the national legislation for a good state following the Water Framework Directive 2000/60/EC is exceeded by 96% of the measurements during the period from 1981 to 2022. On a monthly basis, PO4 loads showed a linear relationship with river streamflow (R2 = 0.94). However, on field measurements scale, a potential relationship between both variables was found, which changed according to the improvement in the wastewater treatment and facilities for 1982-1994, 1995-2017 and 2018-2022. In these three periods, different significant decreasing trends of the P content were found, mainly marked by the setup of each individual WWTP.

Alumina-Hydroxyapatite Millimetric Spheres for Cadmium(II) Removal in Aqueous Medium.

Heavy metals can act as selective agents in the development and proliferation of antibiotic-resistant bacteria through a process called coselection. In the year 2050, an estimated 10 million deaths will be caused by antibiotic-resistant bacteria; therefore, the presence of heavy metals in bodies of water represents an environmental and sanitary threat that requires efficient treatment processes and/or materials for their removal. In the present study, the effect of the hydroxyapatite coating on the adsorbent capacity of cadmium in alumina spheres was evaluated. The hydroxyapatite coating on the alumina sphere increased the surface area from 0.66 to 0.96 m2/g and the number of acid sites from 0.064 to 0.306 meq/g and displaced the IEP of hydroxyapatite from 5.37 to 4.2, increasing the Cd2+ adsorbing capacity from 59.87 mg/g to 89.37 mg/g and promoting adsorption by surface complexation. Alumina-hydroxyapatite spheres stand out for their improved adsorbent properties and easy handling, which positioned this material as a potential alternative in adsorption processes.

Accounting for the annual variability when assessing non-point source pollution potential in Mediterranean regulated watersheds.

The characterization of non-point source pollution at the watershed scale difficult owing to its distributed nature combined with the lack of suitable measurements for validation. This study proposes the classification of land within a Mediterranean watershed according to its potential source of non-point pollution, considering interannual precipitation variability and dam regulation effects. For this purpose, the potential non-point pollution index (PNPI) developed by the Italian Environmental Protection Agency was modified to include annual local precipitation behavior, named local annual PNPI (APNPI). PNPI and APNPI were computed for the Guadalquivir River (Spain), which has a drainage surface of 57,500 km2 and is highly regulated by >60 reservoirs. The results reflect the vulnerability along the Guadalquivir River in terms of the spatially variable non-point pollutant nature of its contributing watersheds. The annual average nitrate concentration values on the southern side exceeded the average value on the northern side by almost five times and showed a statistically significant power fit with the PNPI, with an R2 of 0.65. Long-term available nitrate data (1981/82-2006/07) on a monthly scale at the outlets of some watersheds allowed us to rank priority pollutant source areas within the watershed. The power fits between the annual average nitrate loads and the APNPI (R2 = 0.51-0.99) were statistically significant, which validated the utility of adding the variability of precipitation at an annual scale as a dynamic factor in the index. The APNPI can constitute a simple dynamic classification index for assessing the relative risk of non-point source pollution across a large area, especially in data-scarce situations.

[Rotator cuff injuries with nighttime pain and sleep quality before and after treatment]. / Lesiones del manguito rotador con dolor nocturno y calidad de sueño antes y después del tratamiento.

INTRODUCTION: Growing evidence suggests that shoulder injuries involving the rotator cuff cause severe pain and deterioration of quality of life and sleep. OBJECTIVE: To present the results of a systematic review on the association of rotator cuff injuries with nighttime pain and sleep quality before and after treatment. MATERIAL AND METHODS: We searched PubMed limited to humans, with no language, age and time period limit with the following terms: [rotator cuff tear and (nocturnal pain OR sleep)]. We used the PRISMA criteria for systematic reviews. Information was extracted on the frequency of nighttime pain and sleep quality in patients with rotator cuff injuries. RESULTS: Of 123 records found, 10 studies were included for meeting criteria, including 1,516 patients. Nighttime pain affected 91-93% of patients; its average intensity was 5.5 points of the EVA. 100% of the studies reported alterations in sleep quality associated with rotator cuff injury. After repair, a decrease in pain to inferior scores of 2 and improvement in sleep quality were reported. CONCLUSION: Rotator cuff injuries produce nighttime pain and sleep quality disturbances that improve with treatment. Alterations in sleep quality are due not only to pain but to alterations in shoulder functionality.

INTRODUCCIÓN: Evidencia creciente sugiere que las lesiones del hombro que involucran al manguito rotador causan dolor severo y deterioro de la calidad de vida y del sueño. OBJETIVO: Presentar los resultados de una revisión sistemática sobre la asociación de lesiones del manguito rotador con dolor nocturno y calidad de sueño antes y después del tratamiento. MATERIAL Y MÉTODOS: Se realizó una búsqueda en PubMed limitada a humanos, sin límite de idioma, edad y período de tiempo con los siguientes términos: [rotator cuff tear and (nocturnal pain OR sleep)]. Se utilizaron los criterios PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) para revisiones sistemáticas. Se extrajo información sobre la frecuencia de dolor nocturno y calidad del sueño en pacientes con lesiones del manguito rotador. RESULTADOS: De 123 registros encontrados, 10 estudios fueron incluidos por cumplir criterios, incluyendo 1,516 pacientes. El dolor nocturno afectó de 91-93% de los pacientes; su intensidad media fue de 5.5 puntos de la escala visual análoga (EVA). Cien por ciento de los estudios reportaron alteraciones en la calidad de sueño asociado a lesión del manguito rotador. Tras la reparación, en todos los estudios se reportó disminución de dolor a puntuaciones inferiores a 2 y mejoría de la calidad del sueño. CONCLUSIÓN: Las lesiones del manguito rotador producen dolor nocturno y alteraciones de la calidad del sueño que mejoran con el tratamiento. Las alteraciones de la calidad del sueño se deben no sólo a dolor, sino a alteraciones en la funcionalidad del hombro.

[Content validation for the Chilean population of the quality of life assessment instrument in children, adolescents and adults with Cystic Fibrosis: CFQ-R CYSTIC FIBROSIS QUESTIONNAIRE-REVISED version in Spanish, Chile]. / Validación de contenido del instrumento de evaluación de calidad de vida en niños, adolescentes y adultos con Fibrosis Quística: CFQ-R CYSTIC FIBROSIS QUESTIONNAIRE-REVISED versión en español, Chile.

INTRODUCTION: Cystic Fibrosis (CF) is the most frequent chronic hereditary disease in the white race. Although the impact on the quality of life of this disease is significant, there are no validated instruments in the Chilean population to measure it. OBJECTIVE: To carry out a cultural and linguistic adaptation and validate the content and reliability of the CFQ-R Cystic Fibrosis Questionnaire, Spanish version 2.0. PATIENTS AND METHOD: The process was carried out in two stages. The first stage consists of an ins trumental design to adapt it culturally and linguistically, evaluate content validity by consulting ex perts, and test the comprehension of the questionnaire in patients and parents through qualitative interviews and a focus group. In the second stage with an observational and cross-sectional design in a sample of 122 people with CF or their caregivers, the behavior of the questionnaire was analyzed using descriptive statistics and Cronbach's alpha for reliability. RESULTS: Stage 1: the instrument in its three versions is considered valid with Lynn's index > 0.8 and Validity Coefficient > 0.7. Stage 2: The adolescent/adult and parent/caregiver versions obtain Cronbach's a > 0.7 and an average > 3 in most dimensions. CONCLUSION: The questionnaire is adapted and validated in the Chilean population and requires minor modifications. This version is reliable, valid, and allows the assessment of the quality of life in people with CF. It is suggested to increase the sample for the analysis of construct validity with a larger number of patients.

Lesiones del manguito rotador con dolor nocturno y calidad de sueño antes y después del tratamiento / Rotator cuff injuries with nighttime pain and sleep quality before and after treatment

Resumen: Introducción: Evidencia creciente sugiere que las lesiones del hombro que involucran al manguito rotador causan dolor severo y deterioro de la calidad de vida y del sueño. Objetivo: Presentar los resultados de una revisión sistemática sobre la asociación de lesiones del manguito rotador con dolor nocturno y calidad de sueño antes y después del tratamiento. Material y métodos: Se realizó una búsqueda en PubMed limitada a humanos, sin límite de idioma, edad y período de tiempo con los siguientes términos: [rotator cuff tear and (nocturnal pain OR sleep)]. Se utilizaron los criterios PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) para revisiones sistemáticas. Se extrajo información sobre la frecuencia de dolor nocturno y calidad del sueño en pacientes con lesiones del manguito rotador. Resultados: De 123 registros encontrados, 10 estudios fueron incluidos por cumplir criterios, incluyendo 1,516 pacientes. El dolor nocturno afectó de 91-93% de los pacientes; su intensidad media fue de 5.5 puntos de la escala visual análoga (EVA). Cien por ciento de los estudios reportaron alteraciones en la calidad de sueño asociado a lesión del manguito rotador. Tras la reparación, en todos los estudios se reportó disminución de dolor a puntuaciones inferiores a 2 y mejoría de la calidad del sueño. Conclusión: Las lesiones del manguito rotador producen dolor nocturno y alteraciones de la calidad del sueño que mejoran con el tratamiento. Las alteraciones de la calidad del sueño se deben no sólo a dolor, sino a alteraciones en la funcionalidad del hombro.

Abstract: Introduction: Growing evidence suggests that shoulder injuries involving the rotator cuff cause severe pain and deterioration of quality of life and sleep. Objective: To present the results of a systematic review on the association of rotator cuff injuries with nighttime pain and sleep quality before and after treatment. Material and methods: We searched PubMed limited to humans, with no language, age and time period limit with the following terms: [rotator cuff tear and (nocturnal pain OR sleep)]. We used the PRISMA criteria for systematic reviews. Information was extracted on the frequency of nighttime pain and sleep quality in patients with rotator cuff injuries. Results: Of 123 records found, 10 studies were included for meeting criteria, including 1,516 patients. Nighttime pain affected 91-93% of patients; its average intensity was 5.5 points of the EVA. 100% of the studies reported alterations in sleep quality associated with rotator cuff injury. After repair, a decrease in pain to inferior scores of 2 and improvement in sleep quality were reported. Conclusion: Rotator cuff injuries produce nighttime pain and sleep quality disturbances that improve with treatment. Alterations in sleep quality are due not only to pain but to alterations in shoulder functionality.

Biochemical characterization and insecticidal activity of isolated peptides from the venom of the scorpion Centruroides tecomanus.

The venom of scorpions is a mixture of components that constitute a source of bioactive molecules. The venom of the scorpion Centruroides tecomanus contains peptides toxic to insects, however, to date no toxin responsible for this activity has yet been isolated and fully characterized. This communication describes two new peptides Ct-IT1 and Ct-IT2 purified from this scorpion. Both peptides contain 63 amino acids with molecular weight 6857.85 for Ct-IT1 and 6987.77 Da for Ct-IT2. The soluble venom was separated using chromatographic techniques of molecular size exclusion, cationic exchange, and reverse phase chromatography, allowing the identification of at least 99 components of which in 53 the insecticidal activity was evaluated. The LD50 determined for Ct-IT1 is 3.81 µg/100 mg of cricket weight, but low amounts of peptides (0.8 µg of peptide) already cause paralysis in crickets. The relative abundance of these two peptides in the venom is 2.1% for Ct-IT1 and 1% for Ct-IT2. The molecular masses and N-terminal sequences of both insecticidal toxins were determined by mass spectrometry and Edman degradation. The primary structure of both toxins was compared with other known peptides isolated from other scorpion venoms. The analysis of the sequence alignments revealed the position of a highly conserved amino acid residue, Gly39, exclusively present in anti-insect selective depressant ß-toxins (DBTXs), which in Ct-IT1 and Ct-IT2 is at position Gly40. Similarly, a three-dimensional structure of this toxins was obtained by homology modeling and compared to the structure of known insect toxins of scorpions. An important similarity of the cavity formed by the trapping apparatus region of the depressant toxin LqhIT2, isolated from the scorpion Leiurus quinquestriatus hebraeus, was found in the toxins described here. These results indicate that Ct-IT1 and Ct-IT2 toxins have a high potential to be evaluated on pests that affect economically important crops to eventually consider them as a potential biological control method.

Calidad de vida en demencia Alzheimer: un nuevo desafío / Quality of life in Alzheimer's dementia: a new challenge

Resumen El progresivo envejecimiento de la población mundial se encuentra directamente asociado al aumento de las patologías neurodegenerativas. Dentro de estas, la Enfermedad de Alzheimer es el tipo de demencia de mayor prevalencia a nivel mundial y se asocia a un mayor deterioro de la calidad de vida, no solo en los pacientes, sino que también en sus cuidadores y entorno familiar. Frente a este escenario, durante los últimos años ha adquirido especial importancia el evaluar la calidad de vida en pacientes con demencia Alzheimer, siendo un aspecto de creciente interés en el ámbito clínico y de la salud pública al ser considerado como un indicador en la medición de la efectividad de los distintos tipos de intervenciones, farmacológicas y no farmacológicas, sobre la enfermedad y su evolución. El conocer el concepto calidad de vida por parte de los equipos de salud y la evaluación clínica de esta en pacientes con demencia Alzheimer se ha vuelto un pilar fundamental tanto en el manejo, como en el uso de la información para la toma de decisiones en relación a políticas públicas relacionadas a pacientes con demencia. En este trabajo se abordará la temática desde tres ámbitos, la importancia de la enfermedad de Alzheimer, la calidad de vida a lo largo de los años, y como ésta puede ser utilizada en el manejo de patologías neurodegenerativas como la demencia.

The progressive aging of the world population is directly associated with the increase in neurodegenerative pathologies. Among these, Alzheimer's disease is the most prevalent type of dementia worldwide which is associated with a greater deterioration in the quality of life, not only in patients but also in their caregivers and family environment. In this context, during the last years has become important to evaluate the quality of life in patients with Alzheimer's dementia to be an area of growing interest in clinical and public health because it is considered as an indicator in effectiveness measurement of the different types of interventions, pharmacological and non-pharmacological, on the disease and its evolution. Heath teams know the concept of quality of life and its clinical evaluation in patients with Alzheimer's dementia and it has become fundamental support for both management and the use of information for decision-making in the field of public policies related to patients with dementia. In this viewpoint the theme will be addressed from three areas, the importance of Alzheimer's disease, quality of life throughout history, and how it can be used in the management of neurodegenerative diseases such as dementia.

Estrés percibido en madres mexicanas de niños con necesidades especiales: un estudio etnográfico / Perceived stress among mexican mothers of children with special needs: an ethnographic study / Estresse percebido em mães mexicanas de crianças com necessidades especiais: um estudo etnográfico

RESUMEN Objetivo: Examinar las percepciones sobre los factores exploratorios, las manifestaciones y consecuencias del estrés en madres cuidadoras de niños con necesidades especiales en Veracruz, México. Métodos: Estudio cualitativo con diseño etnográfico focalizado. La muestra (n=20) se obtuvo de un grupo de madres cuidadoras del estado de Veracruz, México. El criterio de participación fue ser el tutor principal del niño dependiente. Los datos se recolectaron a través de cuatro grupos de discusión conformado cada uno por cinco cuidadoras. Las discusiones fueron audio-grabadas y los datos transcritos textualmente previo análisis. La información fue tratada mediante análisis temático, con el apoyo del programa QUIRKOS. Resultados: Las madres de los niños fueron el cien por ciento de las cuidadoras. La edad promedio de ellas fue de 36.95 años (DE= ±7.66). Las temáticas que surgieron del análisis inductivo fueron las siguientes: a) la situación económica familiar, b) el comportamiento de los niños, c) la falta de información sobre el diagnóstico del niño y, d) los problemas conyugales. Estas se identificaron como categorías que juegan un rol importante en el estrés percibido por las cuidadoras. Discusión y Conclusiones: Es claro que el rol y la responsabilidad de las madres cuidadoras es muy demandante, provocando manifestaciones físicas, mentales y emocionales. El profesional de enfermería juega un papel importante en el diseño de intervenciones de salud que favorezcan la reducción de los factores causales del estrés percibido, además de implementar estrategias que restrinjan sus manifestaciones.

ABSTRACT Objective: To explore factors, manifestations, and consequences related to the stress perceived by Mexican mothers of children with special needs in Veracruz, Mexico. Methods: This is a qualitative study with a focalized ethnographic design. The sample (n=20) was constituted by healthcare providing mothers of the state of Veracruz, Mexico. The participation requirement was being the main tutor of a dependent child. Data were collected in four discussion groups of 5 healthcare providing mothers each. The discussions were recorded and the data were transcribed. The information was produced through a thematic analysis using the QUIRKOS program. Results: The average age of these mothers was 36.95 years old (SD= ±7.66). The topics arising from the analysis were: a) the economical situation of the family; b) the behavior of the children; c) the lack of information regarding the child's diagnosis; and d) the marital problems. All these categories were important sources of the stress perceived by these healthcare providers. Discussion and Conclusions: It is clear that the role and the responsibility of healthcare mothers is very demanding, provoking diverse physical, mental, and emotional responses. The nursing professionals play an important role in the design of health interventions which can favor the reduction of the perceived stress causing factors and thus the reduction of their associated impacts.

RESUMO Objetivo: Examinar as percepções sobre os fatores exploratórios, as manifestações e consequências do estresse em mães cuidadoras de crianças com necessidades especiais em Veracruz, México. Métodos: Estudo qualitativo com desenho etnográfico focalizado. A amostra (n=20) foi obtida de um grupo de mães cuidadoras do estado de Veracruz, México. O critério de participação era ser o cuidador principal da criança dependente. Os dados foram coletados através de quatro grupos de discussão, cada um conformado por cinco cuidadoras. As discussões foram áudio-gravadas e os dados transcritos textualmente antes da análise. A informação foi tratada por meio de análise temática, com apoio do programa QUIRKOS. Resultados: As mães das crianças eram cem por cento das cuidadoras. A idade média delas era de 36.95 anos (DE= ±7.66). As temáticas que emergiram da análise indutiva foram as seguintes: a) a situação económica familiar, b) o comportamento das crianças, c) a falta de informação sobre o diagnóstico da criança, e d) os problemas conjugais. Estas foram identificadas como categorias que desempenham um papel importante no estresse percebido pelas cuidadoras. Discussão e Conclusões: Fica claro que o papel e a responsabilidade das mães cuidadoras é muito exigente, provocando manifestações físicas, mentais e emocionais. O profissional de enfermagem desempenha um papel importante no desenho de intervenções de saúde que favorecem a redução dos fatores causais do estresse percebido, além de implementar estratégias que restrinjam suas manifestações.

Adaptación e implementación del modelo de prevención de consumo de sustancias Planet Youth en Chile / Adaptation and implementation of the Planet Youth substance use prevention model in Chile

Resumen El consumo de sustancias en adolescentes es altamente prevalente en varias regiones del mundo, y especialmente en Chile, siendo su prevención un importante desafío para la salud pública. Este artículo describe el modelo islandés de prevención del consumo de sustancias en adolescentes "Planet Youth", su adaptación y factibilidad de implementación en Chile, como primera experiencia en Latinoamérica. Este modelo comunitario está enfocado en la prevención ambiental y en la promoción de la salud de niños, niñas y adolescentes, basado en un diagnóstico local y oportuno de factores protectores y de riesgo, con colaboración de la autoridad local y la academia. Seis comunas de la región metropolitana en colaboración con la Universidad de Chile y el Icelandic Centre for Social Research and Analysis inician su implementación en 2018. Se tradujo y adaptó la encuesta islandesa que fue aplicada a 7354 estudiantes de 2° medio, cuyos resultados se retroalimentaron a colegios y municipalidades para trabajar en la modificación de los principales factores de riesgo y protección. En 2020, el proceso ha requerido algunas adaptaciones debido a la pandemia por COVID-19. Se discute acerca de factores socioculturales relevantes en la adaptación de estrategias basadas en evidencia internacional que se transfieren a un país diferente. La implementación del modelo Planet Youth es factible en Chile y ofrece una importante oportunidad para prevenir el consumo de sustancias en jóvenes de manera efectiva en Latinoamérica.

The prevalence of substance use is high among adolescents in several region around the world, specifically in Chile, and its prevention is an important public health challenge. We describe the adaptation and the feasibility to implement the Icelandic model of substance use prevention in adolescents "Planet Youth" in Chile as first experience in Latin America. This community prevention model focuses on the environment, culture and the promotion of health in adolescents, informed by local risk and protective factors. Implementation requires collaboration between academia and municipal authorities. Six municipalities of the Metropolitan Region, the University of Chile and the Icelandic Centre for Social Research and Analysis collaborated in the implementation of the Planet Youth model since 2018 in Chile. A substance use survey was translated, adapted, and applied to 7354 tenth grade students. The results were informed to schools and municipalities in order to work on modifications of the main risk and protective factors in their own community. In 2020, the prevention process has required some adaptation due to COVID-19 pandemic. We discuss sociocultural factors in the adaptation of this international prevention model transferred to Latin America. The implementation of the Planet Youth model is feasible in Chile and offers an opportunity to effectively prevent the substance use behaviors of adolescents in Latin America.

Biological removal of hexavalent chromium: evaluation of the metabolic activity of native and Cr(VI)-acclimated activated sludge using a respirometric method.

Hexavalent chromium becomes in one of the tops internationally concern environmental issues due to its wide usage in several industrial activities. There are two stable oxidation states of chromium in the environment which differ significantly on its toxicity; Cr(III) has lower solubility, mobility and lesser biological toxicity in comparison with Cr(VI). While Cr(VI) is a well-known carcinogen, Cr(III) is an essential dietary element. For this reason, most technologies focus attention on the reduction of Cr(VI) to Cr(III). On this context, the ability of microorganisms to reduce Cr(VI) to Cr(III) has gained attention. The objectives of the present work were to analyze the effect of Cr(VI) on the activated sludge community in a continuous reactor, and to evaluate the differences on the metabolic activity of native (NAS) and Cr(VI)-acclimated activated sludge (CrAAS) using a respirometric method. Results showed that the activated sludge community had the capability to acclimate to the presence of Cr(VI). On the other hand, the increase of the initial Cr(VI) concentration from 0 to 100 mgCr/L leads to a decrease in the specific exogenous respiration rate (qEx ) values, but this reduction was more noticeably in the case of NAS in comparison with CrAAS. The respirometric curves were well described by the proposed mathematical model. It was concluded that the CrAAS tolerated a Cr(VI) concentration about one order of magnitude higher than NAS, which was positively reflected in the respiration rate first-order decay constant (kd ), the specific maximum exogenous respiration rate (qExm ), and the observed oxidation coefficient (YO/S ) values.

Cutaneous Manifestations in Patients With COVID-19: Clinical Characteristics and Possible Pathophysiologic Mechanisms. / Manifestaciones cutáneas en pacientes con COVID-19: características clínicas y mecanismos fisiopatológicos postulados.

The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections soon led to a pandemic with serious health, economic, political, and cultural repercussions across the globe. The disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19), is a multisystemic disease that requires a multidisciplinary approach involving specialists from all fields and levels of care. In this article, we review the literature on the diverse cutaneous manifestations associated with COVID-19. We also describe the pathophysiologic mechanisms proposed to date and their possible association with these manifestations. Finally, we propose a system for classifying the cutaneous manifestations of COVID-19 according to their underlying pathophysiologic mechanisms and prognosis.

Intervención educativa para mejorar conocimientos sobre úlceras por presión en enfermeros de Veracruz, México / Educational intervention aimed at improving knowledge on pressure ulcers in nurses from Veracruz, Mexico / Intervenção educativa para melhorar o conhecimento sobre úlceras por pressão em enfermeiros de Veracruz, México

Resumen Introducción: En México, las úlceras por presión (UPP) son un indicador de calidad en el Sistema Nacional de Salud, se otorga relevancia a los conocimientos de los profesionales de la salud en cuanto al abordaje integral de las úlceras para el mejoramiento de la seguridad del paciente. Objetivo: Evaluar la efectividad de una intervención educativa como herramienta para mejorar los conocimientos de enfermería en la prevención y tratamiento de las UPP. Método: Estudio pre-experimental basado en una intervención educativa aplicada a un grupo con medición pre y post. La muestra estuvo constituida por 90 licenciados de enfermería que laboran en hospitales públicos de segundo y tercer nivel de atención, ubicados en el puerto de Veracruz. Se diseñaron doce sesiones de 120 minutos cada una para la intervención; en estas se abordaron tópicos de prevención, cuidado y tratamiento de las úlceras. Resultados: La variable prevención, en el indicador adecuado según tus conocimientos, obtuvo un promedio inicial de 74±15 que incrementó en la segunda medición a 91±9. t (p=.003). En la variable tratamiento, el indicador adecuado según tus conocimientos, obtuvo un promedio inicial de 57±16 y en la segunda medición pasó a 76±9. t (p=.002). Conclusión: La aplicación de la intervención educativa permitió mejorar el conocimiento sobre prevención y tratamiento de las UPP, aunque la utilización en la práctica asistencial fue menor.

Abstract Introduction: In Mexico, pressure ulcers are a quality indicator of the National Health System. In order to improve patient security, health professionals need to demonstrate adequate knowledge regarding the handling and addressing of pressure ulcers. Objective: To assess the effectiveness of an educational intervention aimed at improving the knowledge of nursing professionals regarding the prevention and treatment of pressure ulcers. Method: This is a pre-experimental study based on an educational intervention with pre and post measurements. The sample was constituted by 90 graduate nurses working in public hospitals of second and third level located at the port of Veracruz, Mexico. Twelve 120 minutes educational sessions were designed to address the topics of prevention, care, and treatment of pressure ulcers. Results: The variable prevention had a score of 74±15 at pre measurement and 91±9 at post measurement t (p=.003). The variable treatment had an initial score of 57±16, which then increased to 76±9, t (p=.002) after the intervention. Conclusion: The educational intervention improved the knowledge on prevention and treatment of pressure ulcers, without evidence of improving nursing care practice.

Resumo Introdução: No México, as úlceras por pressão (UPP) são um indicador de qualidade no Sistema Nacional de Saúde, sendo relevantes os conhecimentos dos professionais de saúde quanto à abordagem integral das úlceras para o melhoramento da segurança do paciente. Objetivo: Avaliar a efetividade de uma intervenção educativa como ferramenta para melhorar os conhecimentos de enfermagem na prevenção e tratamento das UPP. Método: Estudo pré-experimental baseado em uma intervenção educativa aplicada a um grupo com pré e post medição. A amostra esteve constituída por 90 graduados de enfermagem que laboram em hospitais públicos de segundo e terceiro nível de atenção, localizados no porto de Veracruz. Desenharam-se doze sessões de 120 minutos cada uma para a intervenção; nestas foram abordados tópicos de prevenção, cuidado e tratamento das úlceras. Resultados: A variável prevenção, no indicador adequado segundo com seus conhecimentos, obteve uma média inicial de 74±15 que incrementou na segunda medição para 91±9. t (p=.003). Na variável tratamento, o indicador adequado conforme seus conhecimentos, obteve uma média inicial de 57±16 e na segunda medição passou a 76±9. t (p=.002). Conclusão: A aplicação da intervenção educativa possibilitou melhorar o conhecimento sobre a prevenção e o tratamento das UPP, embora a utilização na prática assistencial tenha sido menor.

Consenso chileno para la atención integral de niños y adultos con fibrosis quística

Resumen La Fibrosis Quística (FQ) es la enfermedad hereditaria de pronóstico reservado más frecuente en raza blanca. Desde el año 2003, Chile inicia un Programa Nacional de Fibrosis Quística, de carácter integral, dirigido por la Unidad de Salud Respiratoria del Ministerio de Salud. Hasta la fecha, los principales resultados del Programa registran una significativa mayor sobrevida (promedio 27 años) y una significativa reducción en la edad de diagnóstico de los pacientes ingresados desde 2006 en adelante. El acceso a la canasta GES (Garantías Explícitas en Salud), la implementación del tamizaje neonatal en algunas regiones del país, la organización y la constitución de equipos entrenados en FQ de diversas especialidades, ha contribuido a mejorar los resultados. Si bien las principales manifestaciones son del aparato respiratorio y digestivo, el carácter multisistémico de la FQ obliga a conocer los distintos aspectos involucrados en su manejo, a fin de optimizar los resultados del tratamiento y los recursos invertidos, tanto en el sector público como privado. Este documento es una revisión y actualización sobre los principales aspectos del diagnóstico, seguimiento y tratamiento de las manifestaciones respiratorias y no respiratorias de la FQ.

Cystic Fibrosis (CF) is the most frequent hereditary disease in whites, with a reserved prognosis. Since 2003, Chile began a comprehensive National Cystic Fibrosis Program, directed by the Respiratory Health Unit of the Ministry of Health. To date, the main results of the Program record a significantly longer survival (average 27 years) and a significant reduction in the age of diagnosis of patients admitted from 2006 onwards. Access to Chilean Explicit Health Guarantees, the implementation of neonatal screening in some regions of the country, the organization and setting up of CF-trained teams of various specialties, has contributed to improving results. Although the main manifestations are of the respiratory and digestive system, the multisystemic nature of CF makes it necessary to know the different aspects involved in its management, in order to optimize the results of the treatment and the resources invested, both in the public and private sectors. This document is a review and an update on the main aspects of the diagnosis, monitoring and treatment of the respiratory and non-respiratory manifestations of CF.

Hemosiderosis pulmonar idiopática (HPI): presentación de un caso y revisión de la literatura / Idiopathic pulmonary hemosiderosis (IPH): a case report and review of the literature

We present the case-report of a one-month-old infant, admitted to the Emergency Department with hypovolemic shock secondary to pulmonary hemorrhage who required life-support measures, including vasoactive drugs and methylprednisolone pulses. She was discharged from the hospital after 13 days of evolution and then readmitted 5 days later for a new episode of hemoptysis with hemodynamic compromise. Fiberoptic bronchoscopy was performed 4 days after the first episode showed a normal anatomy, without active bleeding, with 20% of hemosiderophages in bronchoalveolar lavage. Diffuse infiltrates were found on the chest radiograph. Differents studies were performed for check-out infection, heart disease, immune disease, thrombophilia, celiac disease, swallowing disorder, vascular abnormalities and allergy to cow's milk protein were negative, which led to Idiopathic Pulmonary Hemosiderosis (IPH). It was managed with amino acid formula, daily oral prednisone until 6 months of age and then every other day, and permanent inhaled fluticasone. In subsequent controls, normal growth and development were found, with no recurrences up to the time of this report, at 1 year of age. The favorable evolution in this case is attributed to early diagnosis and timely treatment with systemic corticosteroids. A review of the topic of IPH in pediatrics is presented, and study and treatment algorithms are proposed.

Se presenta el caso de una lactante de un mes de edad, que se presentó en el Servicio de Urgencia con shock hipovolémico secundario a hemorragia pulmonar. Necesitó medidas de soporte vital, incluyendo drogas vasoactivas y pulsos de metilprednisolona. Egresó del hospital a los 13 días de evolución y reingresó 5 días después por nuevo episodio de hemoptisis con compromiso hemodinámico. La fibrobroncoscopía efectuada a los 4 días de evolución del primer episodio mostró una anatomía normal, sin sangrado activo, con 20% de hemosiderófagos en el lavado broncoalveolar. En la radiografía de tórax se encontró infiltrados difusos. Los estudios en busca de infección, cardiopatía, enfermedad inmunológica, trombofilia, enfermedad celíaca, trastorno de deglución, anomalías vasculares y alergia a la proteína de la leche de vaca resultaron negativos, por lo que se planteó una Hemosiderosis Pulmonar Idiopática (HPI). Se manejó con fórmula aminoacídica, prednisona oral diaria hasta los 6 meses de edad y después en días alternos y fluticasona inhalada permanente. En controles posteriores se constató crecimiento y desarrollo normal, sin recidivas hasta el momento de este reporte, con 1 año de edad. La evolución favorable en este caso se atribuye al diagnóstico precoz y tratamiento oportuno con corticoides sistémicos. Se presenta una revisión del tema de HPI en pediatría y se proponen algoritmos de estudio y tratamiento.