Walking the talk for dementia: A unique immersive, embodied, and multi-experiential initiative.

Coping with dementia requires an integrated approach encompassing personal, health, research, and community domains. Here we describe "Walking the Talk for Dementia," an immersive initiative aimed at empowering people with dementia, enhancing dementia understanding, and inspiring collaborations. This initiative involved 300 participants from 25 nationalities, including people with dementia, care partners, clinicians, policymakers, researchers, and advocates for a 4-day, 40 km walk through the Camino de Santiago de Compostela, Spain. A 2-day symposium after the journey provided novel transdisciplinary and horizontal structures, deconstructing traditional hierarchies. The innovation of this initiative lies in its ability to merge a physical experience with knowledge exchange for diversifying individuals' understanding of dementia. It showcases the transformative potential of an immersive, embodied, and multi-experiential approach to address the complexities of dementia collaboratively. The initiative offers a scalable model to enhance understanding, decrease stigma, and promote more comprehensive and empathetic dementia care and research.

Exposure to bisphenol A: current levels from food intake are toxic to human cells.

In the present work, cell lines of different origin were exposed to BPA levels from food intake reported elsewhere. Specifically, we used an in vitro assay to determine cytotoxicity of BPA in three cell lines: MCF7 (breast cancer), PC3 (prostate cancer) and 3T3-L1 (mouse fibroblast). Cytotoxic effects were observed at concentrations higher than 50 µg/mL which is above the involuntary exposure level of BPA described before in fresh, canned and frozen foods and beverages. Furthermore, medial inhibitory concentrations (IC50) of 85.17 µg/mL and 88.48 µg/mL were observed for PC3 and 3T3-L1, respectively, and a slightly lower IC50 of 64.67 µg/mL for MCF7. These results highlight BPA's toxicity potential at current levels from food intake. The cell line-dependent divergent response to BPA reported herein is discussed.

[Metformin increases serum concentration of high molecular weight (HMW-adiponectin) in nondiabetic obese subjects]. / La metformina incrementa la concentración sérica de adiponectina de alto peso molecular (adiponectina-HMW) en obesos no diabéticos.

INTRODUCTION: Obesity is associated with low-intensity chronic systemic inflammation. OBJECTIVE: To evaluate the efficacy of two different doses of metformin in comparison with placebo on increased serum levels of high molecular weight (HMW) adiponectin. MATERIAL AND METHODS: An experimental design was developed with a crossover complete treatment and balanced design; 28 female and eight male nondiabetic obese adults participated. All participants received, during a week and in randomized order: placebo or metformin 500 or 850 mg twice daily; there was a week washout period between each treatment. The HMW adiponectin serum concentration (0 and 120 minutes) at the end of each treatment was measured. Analyses of variance (ANOVA), Bonferroni test, and size effect calculations were performed. RESULTS: Differences in concentrations of HMW adiponectin (t0', t120') were measured for each treatment by ANOVA, having values of p = 0.03 and 0.002, respectively. The post hoc analysis reported differences favoring treatment with metformin 850 mg (p = 0.025). The sizes of the effect at times t0 and t120 for metformin 500 mg were 34 and 35%, and for metformin 850 mg, 65 and 84%, respectively.

Validation of 3D-Printed Swabs for Sampling in SARS-CoV-2 Detection: A Pilot Study.

In this pilot study, we characterize and evaluate 3D-printed swabs for the collection of nasopharyngeal and oropharyngeal secretion samples for the SARS-CoV-2 detection. Swabs are made with the fused deposition modeling technique using the biopolymer polylactic acid (PLA) which is a medical-grade, biodegradable and low-cost material. We evaluated six swabs with mechanical tests in a laboratory and in an Adult Human Simulator performed by healthcare professionals. We proved the adequacy of the PLA swab to be used in the gold standard reverse transcriptase-polymerase chain reaction (qRT-PCR) for viral RNA detection. Then, we did in vitro validation for cell collection using the 3D-printed swabs and RNA extraction for samples from 10 healthy volunteers. The 3D-printed swabs showed good flexibility and maneuverability for sampling and at the same time robustness to pass into the posterior nasopharynx. The PLA did not interfere with the RNA extraction process and qRT-PCR test. When we evaluated the expression of the reference gene (RNase P) used in the SARS-CoV-2 detection, the 3D-printed swabs showed good reproducibility in the threshold cycle values (Ct = 23.5, range 19-26) that is comparable to control swabs (Ct = 24.7, range 20.8-32.6) with p value = 0.47. The 3D-printed swabs demonstrated to be a reliable, and an economical alternative for mass use in the detection of SARS-CoV-2.

Groin Flap for Reconstruction of Traumatic Degloving Hand Injury: A Report of 5 Cases.

Degloving is a type of avulsion injury that leads to the separation of the skin from its underlying tissues. It is usually caused by industrial machinery through smashing or traction mechanisms, where the patient typically tries to avoid severe trauma by pulling their hand off, resulting in this particular injury. Although free flaps have now become the standard of treatment in many institutions, the lack of this possibility makes pedicled flaps a good reconstructive option, with advantages such as low donor-site morbidity, low procedure costs, and relatively easy dissection of the flap. Since the description of the pedicled groin flap technique by McGregor and Jackson, this reconstructive option has become a versatile flap for the coverage of wounds on the hand and distal forearm. This axial-patterned cutaneous flap is based on the superficial circumflex arteriovenous system, which can provide soft-tissue coverage for moderate-to-severe injuries, especially those caused by work accidents. This article aims to describe our experience in treating five different cases of traumatic degloving hand injuries using a groin flap for coverage, with excellent aesthetic and functional results. Two of these cases resulted from degloving after a traction accident, one from a firework explosion, one from a gunshot, and finally, one as a result of an electric wound.

Clinical validation of 3D-printed swabs in adults and children for SARS-CoV-2 detection.

Throughout the entire coronavirus disease 19 (COVID-19) pandemic, there were disruptions in the supply chain of test materials around the world, primarily in poor- and middle-income countries. The use of 3D prints is an alternative to address swab supply shortages. In this study, the feasibility of the clinical use of 3D-printed swabs for oropharyngeal and nasopharyngeal sampling for the detection of SARS-CoV-2 infection was evaluated. For that purpose, paired samples with the 3D printed and the control swabs were taken from 42 adult patients and 10 pediatric patients, and the results obtained in the detection of SARS-CoV-2 by reverse transcription and quantitative polymerase chain reaction (RT-qPCR) were compared. Additionally, in those cases where the result was positive for SARS-CoV-2, the viral load was calculated by means of a mathematical algorithm proposed by us. For both adults and children, satisfactory results were obtained in the detection of SARS-CoV-2 by RT-qPCR; no significant differences were found in the quantification cycle values between the 3D-printed swab samples and the control samples. Furthermore, we corroborated that the 3D-printed swabs caused less discomfort and pain at the time of sampling. In conclusion, this study shows the feasibility of routinely using 3D-printed swabs for both adults and children. In this way, it is possible to maintain local and cheaper consumption along with fewer distribution difficulties.

Topical Antimicrobial Agents for the Prevention of Burn-Wound Infection. What Do International Guidelines Recommend? A Systematic Review.

Background: Choosing adequate topical antimicrobial agents in burn patients still represents a challenge. Therefore, this systematic review was conducted to compile and evaluate current recommendations in international clinical practice guidelines (CPGs) to develop more consistent clinical guidance. Methods: A systematic search for CPGs was conducted independently by two reviewers using PubMed, EMBASE, Google Scholar, and external citations. The quality of the selected CPGs was evaluated separately using the AGREE II instrument, and intraclass correlation coefficients were calculated. Statistical analysis was performed using R V 1.4.1 statistical software. Results: Eleven CPGs were included in the study. Most guidelines tend to recommend silver-containing dressings over antiseptics or antibiotics, regardless of the depth of the burn. Silver sulfadiazine is the most recommended topical antimicrobial in low-resource settings. An overall mean appraisal AGREE II score of 68.2% was obtained. The global intraclass correlation coefficient was 0.62 (95% confidence intervals 0.54-0.69), which corresponds to a substantial global concordance between both appraisers. Conclusions: Great heterogeneity was found between recommendations and CPGs. The three determining factors considered to issue a recommendation were the clinical scenario, burn-wound depth, and burn severity. There is consensus among the guidelines to use topical antimicrobials as a tool to prevent infection, and most of these recommend the use of silver-containing dressings for most scenarios. However, there is currently no ideal topical antimicrobial agent that can be recommended for all clinical scenarios. The development of more consistent recommendations is warranted to standardize clinical practice.

Modelo de aprendizaje basado en problemas (ABP-2×3): decisiones con evidencia en cuidados de heridas complejas / Problem-based learning (PBL-2x3) model: evidence based decision making in complex wound care

Introducción: El modelo ABP-2×3 integra técnicas de aprendizaje basado en problemas, uso de pensamiento crítico y práctica basada en evidencias, determinando un modelo de práctica óptimo para la toma de decisiones. Objetivos: a) Establecer un modelo de entrenamiento aprendizaje que permita orientar a las enfermeras hacia el análisis causal y clínico de cada problema o situación (pensamiento crítico), para facilitar la toma de decisiones basadas en la evidencia en el abordaje de heridas complejas; b) sentar las bases de actuación para que las enfermeras puedan trasladar esa sistemática metodológica a cualquier otra situación clínica en su ejercicio profesional, y c) determinar el nivel de satisfacción de los alumnos al utilizar este nuevo modelo formativo. Metodología: El desarrollo, implementación y evaluación del ABP-2×3 necesitó 4 fases: desarrollo de la situación clínica con preguntas clínicas para la toma de decisiones, organización metodológica, implementación (2 momentos/3 niveles) y evaluación (estudio de satisfacción cuantitativo-cualitativo). Resultados: Se impartió formación ABP-2×3 (virtual y presencial) a 1.112 enfermeras de toda España, obteniendo cuantitativamente Net Promoter Score de 80,25 (modalidad virtual) y 88,48 (presencial), y cualitativamente emergieron categorías relacionadas con metodología, pensamiento crítico, práctica basada en evidencias y conocimientos específicos. Conclusiones: El ABP-2×3, aplicado al cuidado de personas con heridas complejas, orienta la toma de decisiones basadas en evidencia, con alto grado de satisfacción de las enfermeras. Promueve el pensamiento crítico, la toma de decisiones basadas en evidencia y el desarrollo de competencias transversales, posibilitando que los participantes sean protagonistas de su propio aprendizaje. En definitiva, “aprendiendo a aprender” (AU)

Introduction: The ABP-2×3 model integrates problem-based learning techniques, use of critical thinking and evidence-based practice, resulting in an optimal Practice Decision-Making model. Objectives: a) establish a training-learning model to guide nurses towards causal and clinical case analysis of each problem or situation (critical thinking) to facilitate evidence based decision making in the management of complex wounds; b) lay the foundations for nurses to be able to transfer this systematic methodology to any other clinical situation in their professional practice; and c) determine the level of satisfaction of the students when using this new training model. Methodology: The development, implementation and evaluation of the ABP 2×3 required 4 phases: development of the clinical situation with clinical decision-making questions, methodological organization, implementation (2 moments/3 levels) and evaluation (quantitative qualitative satisfaction survey). Results: ABP-2×3 training (virtual and face-to-face) was provided to 1,112 nurses from all over Spain, with the following outcomes, quantitatively Net Promoter Score of 80.25 (virtual modality) and 88.48 (face-to-face), and qualitatively categories emerged related to methodology, critical thinking, evidence-based practice and specific knowledge. Conclusions: The ABP-2×3 applied to the care of people with complex wounds, guides evidence-based decision making, with a high degree of satisfaction among nurses. It promotes critical thinking, evidence based decision making and the development of transversal competencies, enabling participants to be the protagonists of their own learning. In essence, “learning how to learn” (AU)

[A foot in the future]. / Un pie en el futuro. Trabajo premiado.

This project won the First Edition 2007 VAC Therapy Prize. This project tells the story of a woman suffering from lesions in her left leg and running a fever whose prognosis was complicated. The article describes the nurses' evaluation of the patient's lesions, skin sores, and the application of a treatment plan using nursing diagnoses and the satisfactory treatment with negative topical pressure.

Environmental epigenomics: Current approaches to assess epigenetic effects of endocrine disrupting compounds (EDC's) on human health.

Environmental Epigenomics is a developing field to study the epigenetic effect on human health from exposure to environmental factors. Endocrine disrupting chemicals have been detected primarily in pharmaceutical drugs, personal care products, food additives, and food containers. Exposure to endocrine-disrupting chemicals (EDCs) has been associated with a high incidence and prevalence of many endocrine-related disorders in humans. Nevertheless, further evidence is needed to establish a correlation between exposure to EDC and human disorders. Conventional detection of EDCs is based on chemical structure and concentration sample analysis. However, substantial evidence has emerged, suggesting that cell exposure to EDCs leads to epigenetic changes, independently of its chemical structure with non-monotonic low-dose responses. Consequently, a paradigm shift in toxicology assessment of EDCs is proposed based on a comprehensive review of analytical techniques used to evaluate the epigenetic effects. Fundamental insights reported elsewhere are compared in order to establish DNA methylation analysis as a viable method for assessing endocrine disruptors beyond the conventional study approach of chemical structure and concentration analysis.

[Not Available]. / La suplementación con antioxidantes durante el tratamiento oncológico no tiene efecto sobre la recurrencia de cáncer cervicouterino.

Introducción y objetivos: la terapia con antioxidantes durante la quimioterapia y radioterapia en pacientes con cáncer cervicouterino es controvertida. Mientras existe evidencia que sugiere que el uso de antioxidantes disminuye los efectos secundarios propios del tratamiento contra el cáncer, hay datos que sugieren que los antioxidantes incrementan el riesgo de recurrencia de cáncer por la afectación de la terapia de los tratamientos. Métodos: se dirigió un estudio clínico controlado en pacientes con cáncer cervicouterino que fueron suplementados con una mezcla de antioxidantes o placebo, con seguimiento por 4 años posteriores al término de su tratamiento antineoplásico para evaluar el efecto de los antioxidantes en la recurrencia. Tomamos datos de niveles de hemoglobina y albúmina. Se analizaron las diferencias entre grupos con la prueba de Chi-cuadrado, la sobrevida se calculó con un análisis multivariado por medio de regresión de COX. Resultados: se dio seguimiento a 103 pacientes con cáncer cervicouterino en etapa clínica IIB y IIIB de los cuales 48% fueron tratados con suplementación de antioxidantes y el 52% con placebo, originalmente y de estos se dio seguimiento a 88 pacientes durante 4 años. El 23,9% de los pacientes tratados presentaron recurrencia por cáncer mientras que el 76,1% no la presentó. El 21,6% de los pacientes presentaron metástasis, el 8% de los pacientes perteneció al grupo de antioxidantes y el 15,9% al grupo placebo (p > 0,05). Implicaciones para los pacientes supervivientes: la suplementación con antioxidantes aparentemente no interfiere con la recurrencia por cáncer, sin embargo no hay evidencia suficiente para probarlo. Posiblemente una dosis distinta sea la clave para un mejor efecto, pero serán necesarios futuros estudios que prueben efectos sobre otro tipo de dosis. Conclusiones: la suplementación con antioxidantes durante el tratamiento de pacientes con cáncer cervicouterino no tiene efectos en la recurrencia por cáncer a 4 años de seguimiento.

Antioxidant supplementation during oncology treatment has no effect on cervical cancer recurrence / La suplementación con antioxidantes durante el tratamiento oncológico no tiene efecto sobre la recurrencia de cáncer cervicouterino

Introduction and aim: Antioxidant therapy with chemotherapy and radiotherapy in cervical cancer patients is controversial. While some evidence suggests that the use of antioxidants diminishes side effects from anticancer therapy, there is also data to suggest that antioxidants increase the risk of recurrence by affecting oncology treatments. Methods: We conducted a controlled clinical trial in cervical cancer patients supplemented with an antioxidant mixture or a placebo during four years after their antineoplastic treatment was completed and the effect on recurrence. We also conducted data on used hemoglobin and albumin levels. Differences between groups were analyzed using chi-square test. Survival was calculated by the Multivariate COX regression with omnibus test and the enter method. Results: 103 treated patients were in clinical stages IIB and IIIB of cervical cancer, 48% (n = 49) of the patients were treated with antioxidant supplementation and 52% (n =54) of the patients were in the placebo group. Of the original 103 patients, were able to follow up on 88 patients for an additional four years. 23.9% (n = 21) of the patients presented cancer recurrence and 76.1% (n = 67) did not, 21.6% (n = 19) patients showed metastasis. 8% (n = 7) patients were in the antioxidant group and 15.9% (n = 14) were in the placebo group (p > 0.05). Regarding implications of cancer survivors, antioxidant supplementation apparently seems not to have interference with recurrence in cervical cancer patients but there is not enough evidence to prove it. A different dosage may have the expected effect; however, further studies with another dosage and criteria are necessary. Conclusions: Supplementation with antioxidants during treatment of cervical cancer has no effect on cancer recurrence after 4 years of follow-up (AU)

Introducción y objetivos: la terapia con antioxidantes durante la quimioterapia y radioterapia en pacientes con cáncer cervicouterino es controvertida. Mientras existe evidencia que sugiere que el uso de antioxidantes disminuye los efectos secundarios propios del tratamiento contra el cáncer, hay datos que sugieren que los antioxidantes incrementan el riesgo de recurrencia de cáncer por la afectación de la terapia de los tratamientos. Métodos: se dirigió un estudio clínico controlado en pacientes con cáncer cervicouterino que fueron suplementados con una mezcla de antioxidantes o placebo, con seguimiento por 4 años posteriores al término de su tratamiento antineoplásico para evaluar el efecto de los antioxidantes en la recurrencia. Tomamos datos de niveles de hemoglobina y albúmina. Se analizaron las diferencias entre grupos con la prueba de Chi-cuadrado, la sobrevida se calculó con un análisis multivariado por medio de regresión de COX. Resultados: se dio seguimiento a 103 pacientes con cáncer cervicouterino en etapa clínica IIB y IIIB de los cuales 48% fueron tratados con suplementación de antioxidantes y el 52% con placebo, originalmente y de estos se dio seguimiento a 88 pacientes durante 4 años. El 23,9% de los pacientes tratados presentaron recurrencia por cáncer mientras que el 76,1% no la presentó. El 21,6% de los pacientes presentaron metástasis, el 8% de los pacientes perteneció al grupo de antioxidantes y el 15,9% al grupo placebo (p > 0,05). Implicaciones para los pacientes supervivientes: la suplementación con antioxidantes aparentemente no interfiere con la recurrencia por cáncer, sin embargo no hay evidencia suficiente para probarlo. Posiblemente una dosis distinta sea la clave para un mejor efecto, pero serán necesarios futuros estudios que prueben efectos sobre otro tipo de dosis. Conclusiones: la suplementación con antioxidantes durante el tratamiento de pacientes con cáncer cervicouterino no tiene efectos en la recurrencia por cáncer a 4 años de seguimiento (AU)

Assessment of medical residents' satisfaction.

BACKGROUND: Modern medical education is focused on students, and it is necessary to assess its level of satisfaction. A questionnaire was validated and we then conducted a study about the educational satisfaction level of medical residents of the Hospital General of Mexico. METHODS: An observational, descriptive, cross-sectional and prospective study was conducted. A questionnaire of 21 items was validated and then applied to a representative sample of medical residents. Each item was evaluated with a scale from 0 to 10 and then gathered in groups: 0-5 = poor, 6-7 = average, 8 = good, 9 = very good, and 10 = excellent. Descriptive and inferential statistics were carried out using SPSS v.17.0. RESULTS: The questionnaire had internal validity with Cronbach's alpha >0.91 by item. Included in the study were 355 medical residents representing 37 different specialties. The performance perception of the ìheadî professors showed a wide heterogeneity: excellent (23.7%), very good (20.6%), good (16.9%), average (23.1%), poor (15.8%). Fourth-year residents and upward valued the educational performance higher (p = 0.001) as well as medical/surgical residents (p = 0.02). Intermediate-level residents valued the professor higher (p = 0.001), similar to students who were married or living with a partner (p <0.001). Upon contrasting the evaluation of the teacher's performance with the overall course performance, a linear, direct and significant correlation was obtained with Spearman's correlation coefficient = 0.78 and regression coefficient (p <0.001). CONCLUSIONS: We found a wide range of heterogeneity of results. Performance of the professors was the basic component to judge the quality of the residents' courses.

Un pie en el futuro / A foot in the future

Trabajo ganador del Premio Terapia VAC 2007 en su primera edición. Relata el caso de una mujer aquejada de lesiones en pierna izquierda y cuadro febril, con evolución muy compleja. La valoración de enfermería, de las lesiones y de la úlcera, la aplicación de un plan de cuidados utilizando diagnósticos de enfermería y el tratamiento satisfactorio con presión negativa tópica son los componentes del artículo(AU)

This project won the First Edition 2007 VAC Therapy Prize. This project tells the story of a woman suffering from lesions in her left leg and running a fever whose prognosis was complicated. The article describes the nurses’ evaluation of the patient’s lesions, skin sores, and the application of a treatment plan using nursing diagnoses and the satisfactory treatment with negative topical pressure(AU)