Germline pathogenic variants in BRCA1, BRCA2, PALB2 and RAD51C in breast cancer women from Argentina.

PURPOSE: Each year, 17,000 new breast cancer cases are diagnosed in Argentina, and 5400 women die of breast cancer. The contribution of cancer-related mutations to the incidence of breast cancer in Argentina has not yet been explored. METHODS: We sequenced the entire coding regions of BRCA1, BRCA2, PALB2 and RAD51C in 112 unselected Argentinian breast cancer patients. RESULTS: A pathogenic genetic variant was found in 12 of 112 (10.7%) patients; two in BRCA1 (1.8%), five in BRCA2 (4.5%), four in PALB2 (3.6%) and one in RAD51C (0.9%). Three of four (75%) PALB2 mutation carriers carried the same variant (c.1653T > A). CONCLUSIONS: A founder mutation in PALB2 accounts for up to 4% of breast cancer patients in Argentina. BRCA1, BRCA2, PALB2 and RAD51C should be included in the genetic testing panel of breast cancer patients in Argentina.

Evaluation of stress tolerance and design of alternative culture media for the production of fermentation starter cultures in cacao.

Ecuador is one of the world's leading producers of cacao beans, and Nacional x Trinitario cacao represents one of the most distinctive varieties due to its flavor and aroma characteristics. This study aimed to evaluate the effect of the starter culture isolated from microbial diversity during the spontaneous fermentation of Nacional x Trinitario cacao. A total of 249 microbial isolates were obtained from spontaneous culture, with Lactiplantibacillus (45 %), Saccharomyces (17 %), and Acetobacter (2 %) being the most relevant genera for fermentation. Tolerance tests were conducted to select microorganisms for the starter culture. Lactiplantibacillus plantarum exhibited the highest tolerance at pH 5 and 6 % ethanol and tolerated concentrations up to 15 % for glucose and fructose. Acetobacter pasteurianus grew at pH 2 and 6 % ethanol, tolerating high sugar concentrations of up to 15 % for glucose and 30 % for fructose, with growth observed in concentrations up to 5 % for lactic and acetic acid. Subsequently, a laboratory-scale fermentation was conducted with the formulated starter culture (SC) comprising S. cerevisiae, L. plantarum, and A. pasteurianus, which exhibited high tolerance to various stress conditions. The fermentation increased alcoholic compounds, including citrusy, fruity aromas, and floral notes such as 2-heptanol and phenylethyl alcohol, respectively 1.6-fold and 5.6-fold compared to the control. Moreover, the abundance of ketones 2-heptanone and 2-nonanone increased significantly, providing sweet green herbs and fruity woody aromas. Cacao fermented with this SC significantly enhanced the favorable aroma-producing metabolites characteristic of Fine-aroma cacao. These findings underscore the potential of tailored fermentation strategies to improve cacao product quality and sensory attributes, emphasizing the importance of ongoing research in optimizing fermentation processes for the cacao industry.

The Estrogen Receptor Alpha Regulates the Sex-dependent Expression and Pronociceptive Role of Bestrophin-1 in Neuropathic Rats.

Bestrophin-1, a calcium-activated chloride channel (CaCC), is involved in neuropathic pain; however, it is unclear whether it has a dimorphic role in female and male neuropathic rats. This study investigated if 17ß-estradiol and estrogen receptor alpha (ERα) activation regulate bestrophin-1 activity and expression in neuropathic rats. Neuropathic pain was induced by L5-spinal nerve transection (SNT). Intrathecal administration of CaCCinh-A01 (.1-1 µg), a CaCC blocker, reversed tactile allodynia induced by SNT in female but not male rats. In contrast, T16Ainh-A01, a selective anoctamin-1 blocker, had an equal antiallodynic effect in both sexes. SNT increased bestrophin-1 protein expression in injured L5 dorsal root ganglia (DRG) in female rats but decreased bestrophin-1 protein in L5 DRG in male rats. Ovariectomy prevented the antiallodynic effect of CaCCinh-A01, but 17ß-estradiol replacement restored it. The effect of CaCCinh-A01 was prevented by intrathecal administration of MPP, a selective ERα antagonist, in rats with and without prior hormonal manipulation. In female rats with neuropathy, ovariectomy prevented the increase in bestrophin-1 and ERα protein expression, while 17ß-estradiol replacement allowed for an increase in both proteins in L5 DRG. Furthermore, ERα antagonism (with MPP) prevented the increase in bestrophin-1 and ERα protein expression. Finally, ERα activation with PPT, an ERα selective activator, induced the antiallodynic effect of CaCCinh-A01 in neuropathic male rats and prevented the reduction in bestrophin-1 protein expression in L5 DRG. In summary, data suggest ERα activation is necessary for bestrophin-1's pronociceptive action to maintain neuropathic pain in female rats. PERSPECTIVE: The mechanisms involved in neuropathic pain differ between male and female animals. Our data suggest that ERα is necessary for expression and function of bestrophin-1 in neuropathic female but not male rats. Data support the idea that a therapeutic approach to relieving neuropathic pain must be based on patient's gender.

T cell Ca2+ microdomains through the lens of computational modeling.

Cellular Ca2+ signaling is highly organized in time and space. Locally restricted and short-lived regions of Ca2+ increase, called Ca2+ microdomains, constitute building blocks that are differentially arranged to create cellular Ca2+ signatures controlling physiological responses. Here, we focus on Ca2+ microdomains occurring in restricted cytosolic spaces between the plasma membrane and the endoplasmic reticulum, called endoplasmic reticulum-plasma membrane junctions. In T cells, these microdomains have been finely characterized. Enough quantitative data are thus available to develop detailed computational models of junctional Ca2+ dynamics. Simulations are able to predict the characteristics of Ca2+ increases at the level of single channels and in junctions of different spatial configurations, in response to various signaling molecules. Thanks to the synergy between experimental observations and computational modeling, a unified description of the molecular mechanisms that create Ca2+ microdomains in the first seconds of T cell stimulation is emerging.

Adhesion to laminin-1 and collagen IV induces the formation of Ca2+ microdomains that sensitize mouse T cells for activation.

During an immune response, T cells migrate from blood vessel walls into inflamed tissues by migrating across the endothelium and through extracellular matrix (ECM). Integrins facilitate T cell binding to endothelial cells and ECM proteins. Here, we report that Ca2+ microdomains observed in the absence of T cell receptor (TCR)/CD3 stimulation are initial signaling events triggered by adhesion to ECM proteins that increase the sensitivity of primary murine T cells to activation. Adhesion to the ECM proteins collagen IV and laminin-1 increased the number of Ca2+ microdomains in a manner dependent on the kinase FAK, phospholipase C (PLC), and all three inositol 1,4,5-trisphosphate receptor (IP3R) subtypes and promoted the nuclear translocation of the transcription factor NFAT-1. Mathematical modeling predicted that the formation of adhesion-dependent Ca2+ microdomains required the concerted activity of two to six IP3Rs and ORAI1 channels to achieve the increase in the Ca2+ concentration in the ER-plasma membrane junction that was observed experimentally and that required SOCE. Further, adhesion-dependent Ca2+ microdomains were important for the magnitude of the TCR-induced activation of T cells on collagen IV as assessed by the global Ca2+ response and NFAT-1 nuclear translocation. Thus, adhesion to collagen IV and laminin-1 sensitizes T cells through a mechanism involving the formation of Ca2+ microdomains, and blocking this low-level sensitization decreases T cell activation upon TCR engagement.

Biosurfactant from Bacillus subtilis DS03: Properties and Application in Cleaning Out Place System in a Pilot Sausages Processing.

Biosurfactants (BS) are amphiphilic molecules that align at the interface reducing the surface tension. BS production is developed as an alternative to synthetic surfactants because they are biodegradable, with low toxicity and high specificity. BS are versatile, and this research proposes using a biosurfactant crude extract (BCE) as part of cleaning products. This paper reported the BCE production from Bacillus subtilis DS03 using a medium with molasses. The BCE product was characterized by different physical and chemical tests under a wide pH range, high temperatures, and emulsifying properties showing successful results. The water surface tension of 72 mN/m was reduced to 34 mN/m with BCE, achieving a critical micelle concentration at 24.66 ppm. BCE was also applied to polystyrene surface as pre-treatment to avoid microbial biofilm development, showing inhibition in more than 90% of Escherichia coli, Staphylococcus aureus, and Listeria monocytogenes above 2000 ppm BCE. The test continued using BCE as post-treatment to remove biofilms, reporting a significant reduction of 50.10% Escherichia coli, 55.77% Staphylococcus aureus, and 59.44% Listeria monocytogenes in a concentration higher than 250 ppm BCE. Finally, a comparison experiment was performed between sodium lauryl ether sulfate (SLES) and BCE (included in commercial formulation), reporting an efficient reduction with the mixtures. The results suggested that BCE is a promising ingredient for cleaning formulations with applications in industrial food applications.

Gender Norms, Control Over Girls' Sexuality, and Child Marriage: A Honduran Case Study.

PURPOSE: This study explores links among marianismo, girls' mobility and sexuality, and child marriage among adolescent girls in rural areas of Honduras. METHODS: We analyze quantitative and qualitative data collected in 2008-2016 for a longitudinal cohort study of rural Honduran adolescent girls. These data include interviews (n = 10 married before age 18) and surveys (n = 563; 155 married early). We also use qualitative data from focus groups in 2016 that included students, parents, teachers, and community members (n = 120). RESULTS: We find that girls who scored higher on a scale of traditional gender norms were more likely to marry early. Furthermore, our qualitative findings indicate that girls experienced control over their mobility and their sexuality because of rigid gender norms prevalent in their communities. The control girls experience clashes with undergoing psychosocial changes that are associated with increased desire for autonomy and intimacy as well as increased awareness of their sexuality. In some cases, girls believed that marriage was better than staying in their restrictive households, and/or they viewed marriage as the only way to have a romantic relationship. DISCUSSION: Rigid gender norms that promote excessive regulation of girls' behavior and sexuality influence girls' decision-making processes to enter child marriage. Educational initiatives that challenge sexist gender norms and explain and normalize attraction and intimacy during adolescence should be a central component of child marriage prevention programming for adolescents, parents, and community members.

Conventional and non-conventional disinfection methods to prevent microbial contamination in minimally processed fruits and vegetables.

Pandemic COVID-19 warned the importance of preparing the immune system to prevent diseases. Therefore, consuming fresh fruits and vegetables is essential for a healthy and balanced diet due to their diverse compositions of vitamins, minerals, fiber, and bioactive compounds. However, these fresh products grew close to manure and irrigation water and are harvested with equipment or by hand, representing a high risk of microbial, physical, and chemical contamination. The handling of fruits and vegetables exposed them to various wet surfaces of equipment and utensils, an ideal environment for biofilm formation and a potential risk for microbial contamination and foodborne illnesses. In this sense, this review presents an overview of the main problems associated with microbial contamination and the several chemicals, physical, and biological disinfection methods concerning their ability to avoid food contamination. This work has discussed using chemical products such as chlorine compounds, peroxyacetic acid, and quaternary ammonium compounds. Moreover, newer techniques including ozone, electrolyzed water, ultraviolet light, ultrasound, high hydrostatic pressure, cold plasma technology, and microbial surfactants have also been illustrated here. Finally, future trends in disinfection with a sustainable approach such as combined methods were also described. Therefore, the fruit and vegetable industries can be informed about their main microbial risks to establish optimal and efficient procedures to ensure food safety.

Digital Fabrication and Theater: Developing Social Skills in Young Adults With Autism Spectrum Disorder.

An action research project was carried out, using theater workshops and basic digital fabrication technology workshops to improve social skills-such as the expression of emotions, communication, self-control, and teamwork-in a group of 10 young individuals with autism spectrum disorder (ASD). This article focuses on the digital fabrication workshops, where participants worked on the fundamentals of electronics and programming, as well as 3D design and printing, to make props that were later used on stage in the theatrical performances in which they participated. These workshops were systematized through observation guides. According to the results, it was evident that the participants not only enjoyed and gained technological knowledge, but that their social skill development needs were addressed. Professionals from the Special Education Faculty and the Fab Lab Kä Träre, both from Universidad Estatal a Distancia in Costa Rica, were in charge of the study during its first phase, executed in 2016 and 2017.

Mechanisms and functions of calcium microdomains produced by ORAI channels, d-myo-inositol 1,4,5-trisphosphate receptors, or ryanodine receptors.

With the discovery of local Ca2+ signals in the 1990s the concept of 'elementary Ca2+ signals' and 'fundamental Ca2+ signals' was developed. While 'elementary Ca2+signals' relate to optical signals gained by activity of small clusters of Ca2+channels, 'fundamental signals' describe such optical signals that arise from opening of single Ca2+channels. In this review, we discuss (i) concepts of local Ca2+ signals and Ca2+ microdomains, (ii) molecular mechanisms underlying Ca2+ microdomains, (iii) functions of Ca2+ microdomains, and (iv) mathematical modelling of Ca2+ microdomains. We focus on Ca2+ microdomains produced by ORAI channels, D-myo-inositol 1,4,5-trisphosphate receptors, or ryanodine receptors. In summary, research on local Ca2+ signals in different cell models aims to better understand how cells use the Ca2+ toolkit to produce Ca2+ microdomains as relevant signals for specific cellular responses, but also how local Ca2+ signals as building blocks merge into global Ca2+ signaling.

Distribution, habitat suitability, conservation state and natural history of endangered salamander Bolitoglossa pandi.

BACKGROUND: Pandi's mushroom-tongue salamander (Bolitoglossa pandi) is one of the threatened amphibians in South America, as well as a flagship species for the Colombian conservation agenda. This species is endemic to the Andean cloud forests of the western slope of the Cordillera Oriental of Colombia, occurring only in the department of Cundinamarca within a narrow elevational range. At night, B. pandi can be seen perching on the upper side of leaves at heights ranging from ground level to 2.5 m. During the day, it can be found under leaf litter or cover objects. Few studies have provided relevant information that can help the Colombian government to formulate lines of action for the conservation of this species; consequently, its threat assessments so far have been based on very limited information. METHODS: We conducted surveys for salamanders in four municipalities of Cundinamarca, Colombia, using two approaches: visual encounter surveys (Guaduas and Villeta) and the basic sampling protocol for single-species occupancy modeling (Supatá and Venecia). Multivariate analyses were employed to explore the correlation between habitat structure and natural history traits, abundance, and detection/non-detection of B. pandi. We evaluated the B. pandi activity pattern through kernel density curves for each sampling occasion and explored the variability of salamander abundance during their activity period by performing a nested ANOVA. RESULTS: We report the discovery of two new populations of B. pandi, which represent the most northwestern records known. A significant correlation between body length, body mass, and habitat structure was observed. Multivariate analyses indicated that leaf litter depth, mean temperature, percent vegetation cover, and altitude were the habitat variables that together explained 60.3% of the B. pandi abundance variability, as well as the main determinants of its optimal habitat. Bolitoglossa pandi exhibits an activity pattern characterized by two main activity peaks, in which niche time-partitioning was observed. Across the surveyed area, we found a healthy, stable, highly dense population of B. pandi (>1,300 individuals), with seasonal variability between development stages. DISCUSSION: Given the high habitat specificity of B. pandi, the species is highly vulnerable to local changes. Thus, we recommend that B. pandi be retained as Endangered (EN) on the IUCN Red List, based on the IUCN Criterion B, given its restricted extent of occurrence (ca. 2,500 km2) and the ongoing threats from agriculture, cattle ranching, logging, and urban development, which continue to reduce its suitable habitat.

Relationship between skeletal Class II and Class III malocclusions with vertical skeletal pattern.

OBJECTIVE: The purpose of this study was to establish the association between sagittal and vertical skeletal patterns and assess which cephalometric variables contribute to the possibility of developing skeletal Class II or Class III malocclusion. METHODS: Cross-sectional study. The sample included pre-treatment lateral cephalogram radiographs from 548 subjects (325 female, 223 male) aged 18 to 66 years. Sagittal skeletal pattern was established by three different classification parameters (ANB angle, Wits and App-Bpp) and vertical skeletal pattern by SN-Mandibular plane angle. Cephalometric variables were measured using Dolphin software (Imaging and Management Solutions, Chatsworth, Calif, USA) by a previously calibrated operator. The statistical analysis was carried out with Chi-square test, ANOVA/Kruskal-Wallis test, and an ordinal multinomial regression model. RESULTS: Evidence of association (p< 0.05) between sagittal and vertical skeletal patterns was found with a greater proportion of hyperdivergent skeletal pattern in Class II malocclusion using three parameters to assess the vertical pattern, and there was more prevalent hypodivergence in Class III malocclusion, considering ANB and App-Bpp measurements. Subjects with hyperdivergent skeletal pattern (odds ratio [OR]=1.85-3.65), maxillary prognathism (OR=2.67-24.88) and mandibular retrognathism (OR=2.57-22.65) had a significantly (p< 0.05) greater chance of developing skeletal Class II malocclusion. Meanwhile, subjects with maxillary retrognathism (OR=2.76-100.59) and mandibular prognathism (OR=5.92-21.50) had a significantly (p< 0.05) greater chance of developing skeletal Class III malocclusion. CONCLUSIONS: A relationship was found between Class II and Class III malocclusion with the vertical skeletal pattern. There is a tendency toward skeletal compensation with both vertical and sagittal malocclusions.

3D Printing characteristics and mechanical properties of a bio scaffold obtained from a Micro-CT Scan, using the fused deposition modeling technique

The objective is to determine which biopolymer has the best 3D printing characteristics and mechanical properties for the manufacture of a bioscaffold, using the fused deposition printing technique, with models generated from an STL file obtained from a Micro-CT scan taken from a bovine iliac crest bone structure. Through an experimental exploratory study, three study groups of the analyzed biopolymers were carried out with thirteen printed structures of each one. The first is made of 100% PLA. The second, 90B, we added 1g of diatom extract, and the third, 88C, differs from the previous one in that it also contains 1g of calcium phosphate. The 39 printed structures underwent a visual inspection test, which required the fabrication of a gold standard scaffold in resin, with greater detail and similarity to the scanned bone structure. Finally, the structures were subjected to a compressive force (N) to obtain the modulus of elasticity (MPa) and compressive strength (MPa) of each one of them. A statistically significant difference (p=0.001) was obtained in the printing properties of the biomaterial 88C, compared to 90B and pure PLA and the 88C presented the best 3D printing characteristics. In addition, it also presented the best mechanical properties compared to the other groups of materials. Although the difference between these was not statistically significant (p=0.388), in the structures of the 88C biomaterial, values of compressive strength (8,84692 MPa) and modulus of elasticity (43,23615 MPa) were similar to those of cancellous bone in the jaws could be observed. Because of this result, the 88C biomaterial has the potential to be used in the manufacture of bioscaffolds in tissue engineering.

El objetivo es determinar cuál biopolímero presenta las mejores características de impresión 3D y propiedades mecánicas para la fabricación de un bioandamiaje, utilizando la técnica de impresión por deposición fundida, con modelos generados a partir de un archivo en formato STL que se obtuvo de un Micro-CT Scan de una estructura osea de cresta iliaca bovina. Mediante un estudio exploratorio, se realizaron 3 grupos de estudio con trece estructuras impresas de cada uno. El primero, se compone 100% de PLA. El segundo, 90B, se le agrega 1g de extracto de diatomea, y el tercero, 88C, se diferencia del anterior ya que contiene además, 1g de fosfato de calcio. A las 39 estructuras impresas se les realizó una prueba de inspección visual, por lo que se requirió la confección de un patrón de oro en resina, con mayor detalle y similitud a la estructura ósea escaneada. Finalmente, las estructuras fueron sometidas a una fuerza compresiva (N) para la obtención del módulo de elasticidad (MPa) y de la resistencia compresiva (MPa) de cada una de ellas. Se obtuvo una diferencia estadísticamente significativa (p=0,001) en las propiedades de impresión del biomaterial 88C, con respecto al 90B y al PLA puro, presentando las mejores características de impresión 3D. Además, obtuvo las mejores propiedades mecánicas en comparación con los otros grupos de materiales. Aunque la diferencia entre estos no fue estadísticamente significativa (p=0,388), en las estructuras del biomaterial 88C, se pudieron observar valores de resistencia compresiva (8,84692 MPa) y módulo de elasticidad (43,23615 MPa) que son semejantes a los del hueso esponjoso de los maxilares. A razón de este resultado, el biomaterial 88C cuenta con el potencial para ser utilizado en la fabricación de bioandamiajes en la ingeniería tisular.

Presentación de Caso Clínico: Carcinoma de mama luego de mastectomía de reducción de riesgo en paciente con mutación BRCA1 / Case report: Breast carcinoma after risk reducing mastectomy in a BRCA+ patient

Las pacientes sanas portadoras de mutaciones patogénicas del gen BRCA1 tiene un riesgo muy elevado de desarrollar cáncer de mama y ovario, con cifras reportadas que ascienden a 84% y 59% respec- tivamente.¹ Esto motivó a implementar distintas medidas de segui- miento y de reducción de riesgo, como la mastectomía bilateral de reducción de riesgo (MRR) y la salpingo-ooforectomía de reducción de riesgo (SORR). Pero aún así, distintas experiencias publicadas re- fieren que en pacientes portadoras de mutacion BRCA1 sometidas a MRR, el riesgo subsiguiente de desarrollar un cáncer primario de mama puede llegar al 10%.2 Por otro lado, las técnicas de mastectomías en general han experi- mentado modificaciones en menos, conservando las estructuras te- gumentarias y el tejido adiposo que la recubre. Últimamente se ha expuesto que, con la guía de las imágenes, se puede resecar menos tejido aun, fundamentalmente en los contornos mamarios donde se observa tejido adiposo y nada (o muy escaso) tejido glandular.3 Esta recomendación hoy es empírica, ya que no hay evidencia de la segu- ridad oncológica de conservar estos tejidos

Impresión 3D de modelos estereolitográficos con protocolo abierto / 3D Printing of Stereolithographic Models with Open Protocol

RESUMEN: Se realizó un estudio descriptivo y exploratorio con el objetivo de proponer y validar un protocolo abierto para hacer impresiones 3D de modelos estereolitográficos, que esté a disposición de profesionales en el área de la Odontología. Se capacitó mediante sesiones teórico prácticas, a nueve personas operadoras (estudiantes de último año de la carrera de Odontología), sin previa experiencia en el uso de software y hardware para impresión 3D, divididos en dos grupos; el A trabajó con tres tomografías helicoidales (TAC) y el B con tres Tomografías Computarizadas de Haz Cónico (CBCT), todas en formato DICOM, convertidas en archivos STL. En total se aplicó el protocolo en 99 estructuras óseas correspondientes a 33 mandíbulas, 33 axis y 33 macizos faciales-bases de cráneo, y se imprimieron un total de 33 mandíbulas en filamento PLA (ácido poliláctico). Al finalizar el estudio, no se encontró diferencia estadísticamente significativa en la implementación del protocolo propuesto entre los operadores, las mediciones de las piezas impresas por cada uno de ellos, el patrón de oro, la TAC y el CBCT, con lo cual no solo se validó el protocolo, sino que se logró determinar los recursos necesarios para realizar este tipo de impresiones 3D.

ABSTRACT: A descriptive and exploratory study was carried out with the aim of proposing and validating an open protocol for making 3D impressions of stereolithographic models, which is available to professionals in the area of Dentistry. Nine operators (senior students of the Dentistry degree), without previous experience in the use of software and hardware for 3D printing, divided into two groups were trained through theoretical and practical sessions. The A worked with three helical tomographies (TAC) and the B with three cone beam computed tomography (CBCT), all in DICOM format, converted to STL files. In total, 99 bone structures corresponding to 33 jaws, 33 axis and 33 facial masses-skull bases were analyzed, and a total of 33 jaws were printed in PLA (polylactic acid filament). At the end of the study, no statistically significant difference was found in the implementation of the proposed protocol between the operators, the measurements of the pieces printed by each of them, the gold standard, the TAC and the CBCT, with which not only validated the protocol, but it was possible to determine the resources necessary to carry out this type of 3D printing.

Efectividad de la ozonopuntura en pacientes con artrosis cervical / Effectiveness of ozonepuncture in patients with cervical osteoarthritis

Introducción: La artrosis vertebral es frecuente. Las causas y procesos fisiopatológicos que contribuyen a su avance son variados. Se plantea que 80 % de las personas mayores de 55 años de edad presentan alteraciones en la columna cervical. Objetivo: Evaluar la efectividad de la ozonopuntura para el alivio de síntomas y signos en pacientes con artrosis cervical. Métodos: Se realizó un estudio de intervención terapéutica en 80 pacientes con artrosis cervical, atendidos en la Consulta de Ortopedia y remitidos al Servicio de Medicina Tradicional y Natural del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde mayo del 2017 hasta marzo del 2019. Se dividieron aleatoriamente en 2 grupos: de estudio y de control, con 40 integrantes cada uno. Resultados: La enfermedad prevaleció en los pacientes de 50-59 años de edad, tanto del grupo de estudio como de control (35,0 y 30,0 %, respectivamente) y en el sexo femenino (85,0 % en el primero y 82,5 % en el segundo). La evolución fue buena y excelente en casi la totalidad de los integrantes del grupo de estudio. Conclusiones: La ozonopuntura fue efectiva en los pacientes con artrosis cervical y no se presentaron reacciones secundarias relacionadas con su aplicación. La evolución resultó satisfactoria y se observó una respuesta mayor en la desaparición de los síntomas y signos clínicos con la terapéutica acupuntural que con la convencional.

Introduction: The vertebral osteoarthritis is frequent. The pathophysiological causes and processes that contribute to its advance are varied. It is said that the 80 % of people over 55 years present cervical spine disorders. Objective: To evaluate the effectiveness of the ozonepuncture for the relief of symptoms and signs in patients with cervical osteoarthritis. Methods: A study of therapeutic intervention in 80 patients with cervical osteoarthritis was carried out, they were assisted in the Orthopedics Service and referred to the Traditional and Natural Medicine Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from May, 2017 to March, 2019. They were divided at random in 2 groups: study and control groups, with 40 members each one. Results: The disease prevailed in the 50-59 age group, in both groups (35.0 and 30.0 %, respectively) and in the female sex (85.0 % in the first one and 82.5 % in the second). The clinical course was good and excellent in almost all the members of the study group. Conclusions: The ozonepuncture was effective in the patients with cervical osteoarthritis and adverse reactions related to its application were not presented. The clinical course was satisfactory and a higher response was observed in the disappearance of the symptoms and clinical signs with the acupuntural therapeutic than with the conventional one.

Efectividad de la analgesia quirúrgica acupuntural en pacientes operados de catarata / Effectiveness of the acupunctural surgical analgesia in patients operated for cataract

Introducción: La catarata constituye una de las principales causas de ceguera a escala mundial. Es más frecuente en los ancianos y el tratamiento de elección es el quirúrgico. Objetivo: Evaluar la efectividad de la analgesia acupuntural en pacientes operados de catarata. Métodos: Se realizó un estudio de intervención terapéutica en 136 pacientes mayores de 40 años con diagnóstico de catarata, operados en el Servicio de Oftalmología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba en el período 2016-2018. La muestra se dividió aleatoriamente en 2 grupos (de estudio y de control), con 68 integrantes cada uno. Resultados: Predominaron los pacientes de 70 años y más y del sexo femenino. Las variables hemodinámicas no sufrieron modificaciones significativas con el proceder terapéutico. Conclusiones: La analgesia quirúrgica acupuntural fue más efectiva que la convencional, pues se logró una sedación mayor en casi la totalidad de los pacientes durante la operación, así como mayor permanencia de su efecto durante el período posoperatorio; asimismo, hubo menor número de afectados con edema y hemorragia.

Introduction: The cataract constitutes one of the main causes of blindness worldwide. It is more frequent in the elderly and the election treatment is the surgical one. Objective: To evaluate the effectiveness of the acupunctural analgesia in patients operated for cataract. Methods: A study of therapeutic intervention was carried out in 136 patients older than 40 years with diagnosis of cataract, operated in the Ophthalmology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba in the period 2016-2018. The sample was divided at random in 2 groups (study and control), with 68 members each one. Results: The 70 years and over patients of the female sex prevailed. The hemodynamic variables didn't suffer significant modifications with the therapeutical procedure. Conclusions: The acupunctural surgical analgesia was more effective than the conventional one, because a higher sedation was achieved in almost all the patients during the operation, as well as higher permanency of its effect during the postoperatory period; also, there was smaller number of patients affected with edema and hemorrhages.

Puntaje de tinción ocular en pacientes con diagnóstico de síndrome de Sjögren en una institución de salud en Medellín, Colombia / Ocular staining score in patients diagnosed with Sjögren syndrome in a health institution in Medellín, Colombia

RESUMEN Introducción: El síndrome de Sjögren es una enfermedad autoinmune asociada a múltiples factores, tanto genéticos como ambientales, que afecta principalmente a las glándulas salivales y lagrimales con infiltración celular de estas, lo cual causa síntomas secos. Con frecuencia se describe la queratoconjuntivitis sicca y sus complicaciones. Sus criterios clasificatorios han cambiado a lo largo de los años por la diversidad de los órganos implicados y los espectros clínicos de la enfermedad. Hoy se cuenta con parámetros clínicos y paraclínicos para su identificación; uno de estos, el puntaje de tinción ocular ocular staining score (OSS, por sus siglas en inglés), estandarizado a partir de la cohorte SICCA. Objetivo: Describir los hallazgos en la evaluación ocular, el resultado de las pruebas que hacen parte del OSS y las características clínicas de los criterios clasificatorios en pacientes con síndrome de Sjögren en el servicio de consulta externa de reumatología de un hospital universitario en el noroccidente colombiano. Método: Se condujo un estudio observacional, descriptivo y de corte transversal. Se describieron las características de los criterios clasificatorios del síndrome de Sjögren, incluyendo el puntaje de tinción ocular durante un año. Se realizaron las pruebas clínicas y tinciones oculares estandarizadas, evaluando características de la superficie ocular, producción lagrimal y tinciones con verde lisamina y fluoresceína sobre la conjuntiva y la córnea. Según los hallazgos se asignó una puntuación a cada parámetro para evaluar positividad, de acuerdo con el estándar clasificatorio. Las variables cualitativas se expresaron por medio de frecuencias absolutas y relativas y las cuantitativas como mediana y rango intercuartílico (P25-P75), según la distribución de los datos. Se empleó el paquete estadístico Epidat, versión 4.2. Resultados: Se incluyeron 28 pacientes. Los síntomas de ojo seco estuvieron presentes en el 89,2% de ellos; un 96,4% tuvo hallazgos positivos en el examen ocular y el 78,5% alcanzó un puntaje a favor de los criterios clasificatorios en la evaluación del OSS. La mediana del OSS fue 6,14; los anticuerpos anti-Ro fueron positivos en un 57,1%. Conclusión: La evaluación ocular por medio de pruebas objetivas es un método sencillo y reproducible en los pacientes con síndrome de Sjögren. Los índices más afectados fueron aquellos de disminución en la producción lagrimal. Las tinciones oculares no tuvieron una relación directa con la positivad de anticuerpos ni del factor reumatoide.

ABSTRACT Introduction: Sjögren's syndrome is an autoimmune disease associated with multiple genetic and environmental factors. It mainly affects the salivary and lacrimal glands with cellular infiltration leading to dry eye symptoms, with keratoconjunctivitis sicca and its complications often being described. Its classification criteria have changed over the years, due to the diversity in the organs involved and clinical spectrum of the disease. Today, there are clinical and para-clinical parameters for its identification. One of these is the ocular staining score (OSS), standardised from the SICCA cohort. Objective: To describe the findings in the ocular evaluation, the results of the tests of the OSS, and the clinical characteristics of the classification criteria in patients with Sjögren syndrome in the outpatient service of Rheumatology Outpatient Department a university hospital in north-western Colombia. Methods: An observational, descriptive, cross-sectional study was conducted. The characteristics of the Sjögren syndrome classification criteria were described, including the OSS score for one year. Clinical tests and standardised ocular stains were performed, evaluating characteristics of the ocular surface, tearproduction, and lissamine green and fluorescein stains on the conjunctiva and cornea, assigning, according to the findings, a score to each parameter in order to assess positivity according to the classification standard. The qualitative variables were expressed by means of absolute and relative frequencies, and the quantitative ones as the median and interquartile range (P25-P75), according to the distribution of the data. Epidat statistical package, version 4.2, was used. Results: A total of 28 patients were included. Dry eye symptoms were present in 89.2%, 96.4% had positive findings in the eye examination, and 78.5% had a score on the OSS according to the classification criteria. The median OSS was 6.14, and anti-Ro antibodies were positive in 57.1%. Conclusion: Eye evaluation by objective tests is a simple and reproducible method in patients with Sjögren's syndrome. The most affected indices were those of a decrease in tearproduction. The ocular stains did not have a direct relationship with the positivity of antibodies, nor rheumatoid factor.

Mastectomía de reducción de riesgo: Experiencia del Centro Mamario del Hospital Universitario Austral / Risk reducing-mastectomy: Experience of the Hospital Universitario Austral Breast Center

Antecedentes: dada la mayor disponibilidad de estudios genéticos, en los últimos años se incrementaron significativamente las mastectomías de reducción de riesgo (MRR). Objetivo: analizar la experiencia institucional en MRR. Material y métodos: se tuvieron en cuenta las pacientes sanas sometidas a MRR bilateral simultánea y también las pacientes con antecedentes de cáncer de mama que luego fueron sometidas a MRR contralateral. No fueron tenidas en cuenta las mastectomías realizadas como tratamiento actual de un cáncer, pero sí la mastectomía contralateral. Resultados: se realizaron 70 MRR en 49 pacientes que cumplían con los criterios de inclusión para el análisis. La edad promedio fue de 44 años (rango 34-64). En 60 casos se conservó el complejo areola-pezón. En 50 casos, la reconstrucción mamaria fue con implante protésico directo. En 57 pacientes la incisión fue radiada en cuadrante superoexterno. En 57 casos no presentaron complicaciones y, de las restantessolo en 1 (1,4%) se perdió el implante. En un solo caso se detectó un carcinoma de mama oculto, y, en la evolución, una paciente desarrolló un carcinoma pequeño en la mama operada. Conclusión: la MRR es una alternativa válida y segura en mujeres con alto riesgo de cáncer de mama, pues logra disminuir en forma significativa la probabilidad de padecer la enfermedad, con buenos resultados estéticos y alto nivel de satisfacción.

Background: The number of risk-reducing mastectomies (RRM) has increased over the past years as genetic testing has become more readily available. Objective: The aim of this study was to analyze the experience of our institution with RRM. Material and methods: The analysis included healthy patients undergoing simultaneous bilateral RRM and those with a history of breast cancer who underwent contralateral RRM. Patients with mastectomies performed as treatment of breast cancer were not considered, but those with contralateral mastectomies were included. Results: Seventy RRM were performed in 49 patients who fulfilled the inclusion criteria for the analysis. Mean age was 44 years (range: 34-64). The nipple-areola complex was preserved in 60 cases. In 50 cases, a prosthesis was implanted for breast reconstruction during the same procedure. The breast was approach through a radial incision in the upper outer quadrant in 57 patients. Fifty-seven patients did not present complications, and in the rest of the cases the implant failed in only one (1.4%) case. An occult breast cancer was detected in only one patient. During follow-up, one patient developed a small carcinoma in the operated breast. Conclusion: RRM is a valid and safe option for women at high risk for breast cancer, since it significantly reduces the probability of developing the disease, with good aesthetic results and a high level of patient satisfaction.

Validación del Minnesota Living with Heart Failure questionnaire (MLFHQ) en pacientes con falla cardíaca en Colombia / Validation of the Minnesota Living with Heart Failure questionnaire in patients with heart failure in Colombia

Resumen Objetivo: Validar el cuestionario de calidad de vida `` Minnesota Living with Heart Failure'' en pacientes con falla cardíaca para su uso en población colombiana. Materiales y métodos: Estudio observacional de validación de una escala, prospectivo en tres momentos: en el primero se hizo la traducción, la retrotraducción y la adaptación cultural; en el segundo se hizo la evaluación de la validez de contenido, constructo, criterio convergente y divergente con el SF36, WHODASII y DASI, y se evaluó la consistencia interna y la fiabilidad intra e interobservador, y en el tercero, longitudinal, se evaluó la sensibilidad al cambio. Resultados: Se incluyeron 134 pacientes, con clase funcional I-IV de la NYHA, fracción de eyección ≤ 50%. El análisis confirmatorio se ajustó a las tres dimensiones de la escala original. Hubo mejor calidad de vida en quienes tuvieron mejor capacidad física de acuerdo con los MET alcanzados. La validez de criterio convergente fue superior a 0,6 y la divergente menor a 0,4 con el SF36, WHODAS II y DASI. Se encontraron diferencias estadísticamente significativas entre el inicio, el primero, el tercero y el sexto mes. El mínimo cambio detectable (MCD) fue para la dimensión física de 6,0, para la dimensión emocional de 4,8 y para el total de 12,6. Conclusiones: La escala de "Minnesota Living with Heart Failure" (MLHFQ) es válida, confiable y tiene una buena sensibilidad al cambio para ser utilizada en las personas con falla cardiaca en Colombia.

Abstract Objective: To validate the "Minnesota Living with Heart Failure" quality of life questionnaire in patients with heart failure, for its use in a Colombian population. Materials and methods: An observational, prospective study with validation of a scale at three points was conducted. First of all, a translation, back-translation, and cultural adaptation were performed. This was followed by the evaluation of the content validity, construct, convergent and divergent criteria with the SF36, WHODAS II and DAS I questionnaires, as well as the assessment of internal consistency and the within- and between-observer reliability. Finally, a longitudinal study was carried out to evaluate the sensitivity to change. Results: The study included a total of 134 patients, with NYHA functional class I-IV, and an ejection fraction ≤ 50%. The confirmatory analysis was adjusted to the three dimensions of the original scale. There was a better quality of life in those that had a better physical capacity according to the MET achieved. The validity of the convergent criteria was greater than 0.6, with the divergent being less than 0.4 with the SF36, WHODAS II and DASI. Statistically significant differences were found between the beginning and the first, third, and sixth month. The minimum detectable change was for the physical dimension, 0.6, for the emotional dimension, 4.8, and for the total, 12.6. Conclusions: The "Minnesota Living with Heart Failure" scale is valid and reliable, and has a good sensitivity to change, in order to be used in the populations with heart failure in Colombia.