Criteria and indicators to evaluate quality of care in genitourinary tumour boards.

PURPOSE: Genitourinary (GU) multidisciplinary tumour boards (GUMTBs) are key components of patient care, as they might lead to changes in treatment plan, improved survival, and increased adherence to guidelines. However, there are no guidelines on how GUMTBs should operate or how to assess their quality of performance. METHODS: A systematic literature review was conducted to identify criteria and indicators to evaluate quality in GUMTBs. A scientific committee-comprising 12 GU cancer specialists from seven disciplines-proposed a list of criteria and developed indicators, evaluated in two rounds of Delphi method. Appropriateness and utility of indicators were scored using a 9-point Likert scale. Consensus was defined as at least two-thirds of Delphi respondents selecting a score sub-category that encompassed the median score of the group. RESULTS: Forty-five criteria were selected to evaluate the quality of GUMTBs covering five dimensions: organisation, personnel, protocol and documentation, resources, and interaction with patients. Then, 33 indicators were developed and evaluated in the first round of Delphi, leading to a selection of 26 indicators in two dimensions: function, governance and resources, and GUMTB sessions. In the second round, consensus was reached on the appropriateness of all 26 indicators and on the utility of 24 of them. Index cards for criteria and indicators were developed to be used in clinical practice. CONCLUSIONS: Criteria and indicators were developed to evaluate the quality of GUMTBs, aiming to serve as a guide to improve quality of care and health outcomes in patients with GU cancer.

Radiosterilized Pig Skin, Silver Nanoparticles and Skin Cells as an Integral Dressing Treatment for Burns: Development, Pre-Clinical and Clinical Pilot Study.

Radiosterilized pig skin (RPS) has been used as a dressing for burns since the 1980s. Its similarity to human skin in terms of the extracellular matrix (ECM) allows the attachment of mesenchymal stem cells, making it ideal as a scaffold to create cellularized constructs. The use of silver nanoparticles (AgNPs) has been proven to be an appropriate alternative to the use of antibiotics and a potential solution against multidrug-resistant bacteria. RPS can be impregnated with AgNPs to develop nanomaterials capable of preventing wound infections. The main goal of this study was to assess the use of RPS as a scaffold for autologous fibroblasts (Fb), keratinocytes (Kc), and mesenchymal stem cells (MSC) in the treatment of second-degree burns (SDB). Additionally, independent RPS samples were impregnated with AgNPs to enhance their properties and further develop an antibacterial dressing that was initially tested using a burn mouse model. This protocol was approved by the Research and Ethics Committee of the INRLGII (INR 20/19 AC). Transmission electron microscopy (TEM) and dynamic light scattering (DLS) analysis of the synthesized AgNPs showed an average size of 10 nm and rounded morphology. Minimum inhibitory concentrations (MIC) and Kirby-Bauer assays indicated that AgNPs (in solution at a concentration of 125 ppm) exhibit antimicrobial activity against the planktonic form of S. aureus isolated from burned patients; moreover, a log reduction of 1.74 ± 0.24 was achieved against biofilm formation. The nanomaterial developed with RPS impregnated with AgNPs solution at 125 ppm (RPS-AgNPs125) facilitated wound healing in a burn mouse model and enhanced extracellular matrix (ECM) deposition, as analyzed by Masson's staining in histological samples. No silver was detected by energy-dispersive X-ray spectroscopy (EDS) in the skin, and neither by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in different organs of the mouse burn model. Calcein/ethidium homodimer (EthD-1), 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), and scanning electron microscopy (SEM) analysis demonstrated that Fb, Kc, and MSC could attach to RPS with over 95% cell viability. Kc were capable of releasing FGF at 0.5 pg above control levels, as analyzed by ELISA assays. An autologous RPS-Fb-Kc construct was implanted in a patient with SDB and compared to an autologous skin graft. The patient recovery was assessed seven days post-implantation, and the patient was followed up at one, two, and three months after the implantation, exhibiting favorable recovery compared to the gold standard, as measured by the cutometer. In conclusion, RPS effectively can be used as a scaffold for the culture of Fb, Kc, and MSC, facilitating the development of a cellularized construct that enhances wound healing in burn patients.

Effect of the Surface Chemical Composition on the Corrosion Resistance in the Mixture of FeCrMoNbB (140MXC) and FeCMnSi (530AS) Coatings Produced with the Electric Wire Arc Spraying Technique: Part I.

In this study, FeCrMoNbB (140MXC) and FeCMnSi (530AS) coatings were simultaneously projected on the substrate AISI-SAE 4340 using the electric wire arc spraying technique. The projection parameters, such as current (I), voltage (V), primary air pressure (1st), and secondary air pressure (2nd), were determined using the experimental model Taguchi L9 (34-2). Its main purpose is to produce dissimilar coatings and to evaluate the effect of the surface chemical composition on the corrosion resistance in the mixture of 140MXC-530AS as commercial coatings. Three phases were considered to obtain and characterize the coatings: Phase 1: Preparation of materials and projection equipment; Phase 2: Coatings production; and Phase 3: Coatings characterization. The characterization of the dissimilar coatings was carried out using the techniques of Scanning Electron Microscopy (SEM), Energy Dispersive Spectroscopy (EDX), Auger Electronic Spectroscopy (AES), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD). The results of this characterization corroborated the electrochemical behavior of the coatings. The presence of B was determined with the XPS characterization technique in the mixtures of the coatings in the form of Iron Boride. Moreover, the XRD technique showed Nb in the form of FeNb as a precursor compound for the 140MXC wire powder. The most relevant contributions are the pressures, provided that the quantity of oxides in the coatings decreases with respect to the reaction time between the molten particles and the atmosphere of the projection hood; moreover, for the corrosion potential, the operating voltage of the equipment does not exert any effect since these tend to remain constant.

Development of Radiosterilized Porcine Skin Electrosprayed with Silver Nanoparticles Prevents Infections in Deep Burns.

Extensive burns represent a significant challenge in biomedicine due to the multiple systemic and localized complications resulting from the major skin barrier loss. The functionalization of xenografts with nanostructured antibacterial agents proposes a fast and accessible application to restore barrier function and prevent localized bacterial contamination. Based on this, the objective of this work was to functionalize a xenograft by electrospray deposition with silver nanoparticles (AgNPs) and to evaluate its antibiofilm and cytotoxic effects on human fibroblasts. Initially, AgNPs were synthesized by a green microwave route with sizes of 2.1, 6.8, and 12.2 nm and concentrations of 0.055, 0.167, and 0.500 M, respectively. The AgNPs showed a size relationship directly proportional to the concentration of AgNO3, with a spherical and homogeneous distribution determined by high-resolution transmission electron microscopy. The surface functionalization of radiosterilized porcine skin (RPS) via electrospray deposition with the three AgNP concentrations (0.055, 0.167, and 0.500 M) in the epidermis and the dermis showed a uniform distribution on both surfaces by energy-dispersive X-ray spectroscopy. The antibiofilm assays of clinical multidrug-resistant Pseudomonas aeruginosa showed significant effects at the concentrations of 0.167 and 0.500 M, with a log reduction of 1.3 and 2.6, respectively. Additionally, viability experiments with human dermal fibroblasts (HDF) exposed to AgNPs released from functionalized porcine skin showed favorable tolerance, with retention of viability more significant than 90% for concentrations of 0.05 and 0.167 M after 24 h exposure. Antibacterial activity combined with excellent biocompatibility makes this biomaterial a candidate for antibacterial protection by inhibiting bacterial biofilms in deep burns during early stages of development.

Functional Foods, Nutraceuticals and Probiotics: A Focus on Human Health.

Functional foods are classified as traditional or staple foods that provide an essential nutritional level and share potentially positive effects on host health, including the reduction of disease by optimizing the immune system's ability to prevent and control infections by pathogens, as well as pathologies that cause functional alterations in the host. This chapter reviews the most recent research and advances in this area and discusses some perspectives on what the future holds in this area.

Antioxidant and Anti-Inflammatory Properties of Probiotic Candidate Strains Isolated during Fermentation of Agave (Agave angustifolia Haw).

Agave species are a source of diverse products for human use, such as food, fiber, and beverages, which include mezcal, a distilled beverage produced by spontaneous fermentation. Agave is an excellent source of high amounts of sugars, minerals, and phenolic compounds, which favor the growth of lactic acid bacteria (LAB) and yeast communities. In this work, 20 promising LAB strains with probiotic characteristics were isolated from the agave fermentation stage in mezcal production. The strains belonged to Lactobacillus plantarum (15), Lactobacillus rhamnosus (2), Enterococcus faecium (2), and Lactococcus lactis (1). These isolates were characterized for their resistance under gastrointestinal conditions, such as lysozyme, acid pH, and bile salts. In addition, the adherence of these LABs to human intestinal epithelial cells (Caco-2 and HT-29 cells) was tested in vitro and their antioxidant and immunomodulatory profile was determined using cellular models. Lactobacillus rhamnosus LM07 and Lactobacillus plantarum LM17 and LM19 strains were selected for their antioxidant properties, and their capacities in an oxidative stress model in intestinal epithelial cells IECs (Caco-2 and HT-29 cells) in the presence of hydrogen peroxide were evaluated. Interestingly, Lactobacillus rhamnosus LM07 and Lactobacillus plantarum LM17 and LM19 strains showed anti-inflammatory properties in TNF-α-stimulated HT-29 cells. Subsequently, bacterial strains exhibiting antioxidant and anti-inflammatory properties were tested in vivo in a mouse model with dinitrobenzene sulfonic acid (DNBS)-induced chronic colitis. Weight loss, intestinal permeability, and cytokine profiles were measured in mice as indicators of inflammation. One of the selected strains, Lactobacillus plantarum LM17, improved the health of the mice, as observed by reduced weight loss, and significantly decreased intestinal permeability. Altogether, our results demonstrate the potential of LAB (and lactobacilli in particular) isolated from the agave fermentation stage in mezcal production. Lactobacillus rhamnosus LM07 and Lactobacillus plantarum LM17 strains represent potential candidates for developing new probiotic supplements to treat inflammatory bowel disease (IBD).

Pretreatment of tamarind pericarp to increase antioxidant availability and its application in a functional food.

Diverse researchers have considered by-products of food and agricultural processing industries as a source of antioxidants. Tamarind (Tamarindus indica) is a leguminous tree, native from tropical Africa bearing edible fruit. The fruit is composed of 30% pulp, 40% seed, and 30% pericarp. Currently, tamarind pericarp is a waste from tamarind processing (approximately 54,400 tons of pericarp in 2012 worldwide) and is contributing to environmental contamination. This research aimed to determine the effect of maceration, microwaves, and ultrasound on the increase in the antioxidant availability in tamarind pericarp and its incorporation as a functional ingredient in cookies (5 and 10% substitution). Antioxidant content, antioxidant activity, proximate, and sensorial analysis of the cookies were conducted. The microwave method was the best pretreatment compared with sonication and maceration since it showed 1.3-fold higher amounts of phenolic compounds and 1.2-fold higher antioxidant capacity. The 10% substitution of tamarind pericarp powder in cookies, significantly increased the fiber content (four-fold) and phenolic compounds content (2.6-fold) and the product presented good acceptance in a sensorial test. Thus, tamarind pericarp powder could be considered as an antioxidant and fiber source and could be used as a functional ingredient in food products.

Image quality, reading, and mammography service in four diagnostic imaging centers in Manizales, Colombia / Calidad de las imágenes, la lectura y el servicio de mamografía en cuatro centros de imagenología de Manizales, Colombia.

Introduction: Mammography quality is directly related to the ability to detect an abnormality and, therefore, quality control is necessary for diagnostic imaging centers. Objective: To evaluate image quality, reading, and mammography service in some diagnostic imaging centers in Manizales, Colombia. Materials and methods: Four diagnostic imaging centers participated voluntarily in the study under confidentiality agreements. Out of 520 women attending the centers, 318 had a mammography. The infrastructure, technology, and human resources of each unit were evaluated based on visual inspections. A radiologist expert in reading and clinical interpretation of mammary images evaluated the quality of the image and the reading. We made the statistical analysis using anova, the kappa index, and the percentage of disagreement. Results: We found images of diminished quality mainly due to the presence of artifacts in 75 % of those evaluated, as well as non-compliance with identification criteria and image labeling. There were difficulties in taking the lateral median oblique projection given the absence of the inframammary. The level of agreement in the BI-RADS reporting was low in the four centers with important differences in the report and description of findings. Conclusion: The city's diagnostic centers under evaluation are authorized for their operation. However, there are important deficiencies in image quality and reading, which highlights the need to seek quality standards starting from those aspects that can be improved upon.

Introducción. La calidad de la mamografía está directamente relacionada con la capacidad para detectar anormalidades y, por ello, es necesario el control de calidad en los centros de imágenes diagnósticas. Objetivo. Evaluar la calidad de la imagen, la lectura y el servicio de mamografía de algunos centros de imágenes diagnósticas en Manizales, Colombia. Materiales y métodos. Cuatro centros participaron de forma voluntaria y bajo acuerdos de confidencialidad en el estudio. De las 520 mujeres atendidas en ellos, a 318 se les hicieron mamografías. A partir de una inspección visual del servicio, se evaluaron la infraestructura, la tecnología y el personal de la unidad. Un radiólogo experto en lectura e interpretación clínica de imágenes mamarias evaluó la calidad de la imagen y la de su lectura. El análisis estadístico se hizo utilizando un anova y determinando el índice kappa y el porcentaje de desacuerdo. Resultados. Se encontró falta de calidad de las imágenes obtenidas, principalmente, por presencia de artificios en el 75 % de ellas, e identificación y rotulación deficientes; además, en la toma de la proyección oblicua medio-lateral, se encontró falta de visualización del ángulo inframamario. El grado de concordancia en el reporte BI-RADS fue bajo en los cuatro centros, con diferencias importantes en el informe y la descripción de los hallazgos. Conclusión. Los centros de imágenes diagnósticas evaluados están habilitados para el funcionamiento, pero se encontraron deficiencias importantes en la calidad de las imágenes y en su lectura, lo que pone de manifiesto la necesidad de establecer estándares de calidad y mejorar los aspectos que se puedan mejorar.

Calidad de las imágenes, la lectura y el servicio de mamografía en cuatro centros de imagenología de Manizales, Colombia / Image quality, reading, and mammography service in four diagnostic imaging centers in Manizales, Colombia

Resumen | Introducción. La calidad de la mamografía está directamente relacionada con la capacidad para detectar anormalidades y, por ello, es necesario el control de calidad en los centros de imágenes diagnósticas. Objetivo. Evaluar la calidad de la imagen, la lectura y el servicio de mamografía de algunos centros de imágenes diagnósticas en Manizales, Colombia. Materiales y métodos. Cuatro centros participaron de forma voluntaria y bajo acuerdos de confidencialidad en el estudio. De las 520 mujeres atendidas en ellos, a 318 se les hicieron mamografías. A partir de una inspección visual del servicio, se evaluaron la infraestructura, la tecnología y el personal de la unidad. Un radiólogo experto en lectura e interpretación clínica de imágenes mamarias evaluó la calidad de la imagen y la de su lectura. El análisis estadístico se hizo utilizando un anova y determinando el índice kappa y el porcentaje de desacuerdo. Resultados. Se encontró falta de calidad de las imágenes obtenidas, principalmente, por presencia de artificios en el 75 % de ellas, e identificación y rotulación deficientes; además, en la toma de la proyección oblicua medio-lateral, se encontró falta de visualización del ángulo inframamario. El grado de concordancia en el reporte BI-RADS fue bajo en los cuatro centros, con diferencias importantes en el informe y la descripción de los hallazgos. Conclusión. Los centros de imágenes diagnósticas evaluados están habilitados para el funcionamiento, pero se encontraron deficiencias importantes en la calidad de las imágenes y en su lectura, lo que pone de manifiesto la necesidad de establecer estándares de calidad y mejorar los aspectos que se puedan mejorar.

Abstract | Introduction: Mammography quality is directly related to the ability to detect an abnormality and, therefore, quality control is necessary for diagnostic imaging centers. Objective: To evaluate image quality, reading, and mammography service in some diagnostic imaging centers in Manizales, Colombia. Materials and methods: Four diagnostic imaging centers participated voluntarily in the study under confidentiality agreements. Out of 520 women attending the centers, 318 had a mammography. The infrastructure, technology, and human resources of each unit were evaluated based on visual inspections. A radiologist expert in reading and clinical interpretation of mammary images evaluated the quality of the image and the reading. We made the statistical analysis using anova, the kappa index, and the percentage of disagreement. Results: We found images of diminished quality mainly due to the presence of artifacts in 75 % of those evaluated, as well as non-compliance with identification criteria and image labeling. There were difficulties in taking the lateral median oblique projection given the absence of the inframammary. The level of agreement in the BI-RADS reporting was low in the four centers with important differences in the report and description of findings. Conclusion: The city's diagnostic centers under evaluation are authorized for their operation. However, there are important deficiencies in image quality and reading, which highlights the need to seek quality standards starting from those aspects that can be improved upon.

Fink's integrated course design and taxonomy: The impact of their use in a "Basics of Dental Anatomy" course.

OBJECTIVE: This study aimed to assess whether the adjustment of Fink's Model of Integrated Course Design (ICD) with his Taxonomy of Significant Learning (hereinafter referred to as "ICD/SL") affected the academic performance of students at Universidad El Bosque in the "Basics of Dental Anatomy" course. DESIGN: For this purpose, 3 academic groups were selected: 2018/1 (55 students), 2018/2 (79 students), and 2019/1 (57 students). The control group, 2018/1, was taught without ICD/SL; the 2 treatment groups, 2018/2 and 2019/1, was taught with ICD/SL, which applied revised learning goals based on Fink's Taxonomy and new teaching and evaluation activities. The assessment of academic performance was based on a Likert scale to position student results in each grade score report. Statistical analysis was performed through the Kruskal-Wallis test and P-value through the Mann-Whitney U test and Fisher exact test. RESULTS: The results indicated that the treatment groups evidenced better academic performance in the summative assessment of the partial and final grades. In the treatment groups, 64% to 97% of students were in the High to Excellent segment; in comparison, this percentage in the control group was 44% to 65%. The course's rate of failure dropped from 10.9% in 2018/1 to only 1.7% in 2019/1. All the differences between the treatment and control groups were statistically significant (P < 0.0001). CONCLUSION: The use of ICD/SL improved the academic performance of students.

Obesity and Cardiovascular Risk Improvement Using Cacao By-Products in a Diet-Induced Obesity Murine Model.

In the production of chocolate, only cocoa seeds are used, generating by-products that are generally discarded, increasing the risk of environmental contamination. Given fiber, carbohydrates, proteins, and flavonoid content the use of cacao pod husks can generate nutraceutical products for human consumption. In contrast, obesity represents a major public health problem worldwide. Cacao derivatives are able to modulate overweight and lipid disorders. The objective of present work was to prepare and characterize products using cacao by-products and analyze their effects on altered cardiometabolic risk markers in an obesity model induced by high fat diet and fructose ingestion in rats. The effects of a pellet and extracts made with outer pod husk and kernel husk for 5 weeks were analyzed in an obesity rat model. The treatments significantly decreased body weight by 39%, systolic blood pressure by 27%, triglycerides by 55%, total cholesterol by 24%, low-density lipoprotein cholesterol by 37%, and the triglycerides/high-density lipoprotein ratio by 54%. Cacao by-products improved the metabolic function of obese animals, without causing secondary effects.

Tendencias de investigación en torno al cuidado espiritual de enfermería: Revisión de la literatura / Research trends spiritual care in nursing: Literature review / Tendências da pesquisa em torno do cuidado espiritual em enfermagem: revisão da literatura

Introducción. El cuidado espiritual es un área que cada vez cobra mayor relevancia en la práctica de enfermería ante situaciones de salud que generan cambios en la perspectiva de vida y donde la tras-cendencia y la atención integral son fundamentales. Objetivo. Identificar las tendencias de investigación en torno al cuidado espiritual de enfermería en el periodo comprendido entre 2008-2018.Materiales y métodos. Es una revisión de la literatura, cuya ruta metodológica contempló cuatro fases (búsqueda e identificación, filtro, elegibilidad y exclusión e inclusión). Las unidades de análisis correspondieron a los artículos de estudios cuantitativos, cualitativos y mixtos de 34 artículos que fueron publicados en las bases de datos PubMed, Science Direct, ProQuest y ClinicalKey Nursing. Para la elaboración del artículo y corroboración de la calidad de la presente revisión, se realizó la compro-bación de los aspectos propuestos en la declaración PRISMA.Resultados. Emergieron cinco ejes temáticos de la revisión: educación y formación en el cuidado espiritual de enfermería, características de los escenarios y las intervenciones de cuidado espiritual, conceptualización de la dimensión espiritual, participantes en el cuidado espiritual, medición de la espiritualidad y del cuidado espiritual.Conclusiones. Las tendencias identificadas indican que el cuidado de la dimensión espiritual es de gran importancia en el ámbito de la salud y de la enfermería. A la vez, estos resultados son un punto de referencia a nivel latinoamericano e instan a que el conocimiento y formación académica en el área de interés, sea dada desde el pregrado y posgrado, con un impacto en la mejora del cuidado de enfermería desde la disciplina.

Introduction. Spiritual care is becoming to increase relevant in nursing practice in health situations that generate changes in the perspective of life and where transcendence and integral care are fun-damental.Objective. Identify research trends on nursing spiritual care within the period of 2008 to 2018. Materials and methods. This literature review was did followed a four phases methodology: sear-ching and identification, screening, eligibility, exclusion and inclusion. 34 published articles within the period of review, and found in PubMed, Science Direct, ProQuest and ClinicalKey Nursing databases were obtained. Papers with quantitative, qualitative and mixed studies design were analyzed. The methodological quality was achieved by PRISMA statement. Results. Five thematic points emerged from this review: education and training about spiritual care; characteristics of spiritual care settings and intervention, conceptualization of spiritual dimension, spiritual care participants, measuring of spirituality and spiritual care. Conclusions. The identified trends indicate that spiritual care is highly important in the health and nursing field. Besides, these results represent a reference for Latin America about the state of spiritual nursing care research. It also invites to implement this knowledge in both undergraduate and gradua-te levels of formation to improve the care developed by the practice within this discipline.

Introdução. O cuidado espiritual é uma área que se torna cada vez mais importante na prática da enfermagem, diante de situações de saúde que geram mudanças na perspectiva da vida e onde a transcendência e o cuidado integral são fundamentais.Objetivo. Identificar tendências de pesquisa em torno do cuidado em enfermagem espiritual no período entre 2008 e 2018.Materiais e métodos. Trata-se de uma revisão da literatura, cuja rota metodológica contemplou quatro fases (busca e identificação, filtro, elegibilidade e exclusão e inclusão). As unidades de análise corresponderam aos artigos de estudos quantitativos, qualitativos e mistos de 34 artigos publicados nas bases de dados PubMed, Science Direct, ProQuest e ClinicalKey Nursing. Para a elaboração do artigo e comprovação da qualidade desta revisão, foram checados os aspectos propostos na decla-ração PRISMA.Resultados. Emergiram cinco eixos temáticos da revisão: educação e treinamento em formação es-piritual de enfermagem, características dos cenários e intervenções de cuidados espirituais, concei-tuação da dimensão espiritual, participantes em cuidados espirituais, mensuração de espiritualidade e cuidado espiritual.Conclusões. As tendências identificadas indicam que o cuidado da dimensão espiritual é de grande importância no campo da saúde e da enfermagem. Ao mesmo tempo, esses resultados são um ponto de referência no nível latino-americano e exigem que o conhecimento e a formação acadêmica na área de interesse sejam ministrados na graduação e na pós-graduação com impacto na melhora da assistência de enfermagem da disciplina

Importancia del manejo interdisciplinario de pacientes con Fisuras Labiopalatinas y Anemia de Blackfan Diamond. Reporte de caso: seguimiento a 2 años / Importância da abordagem interdisciplinar de paciente com Fissura Labiopalatina e Anemia de Blackfan Diamond: acompanhamento de dois anos / Importance interdisciplinary management of Diamond-Blackfan anemia and Cleft lip and palate sequel: Accompaniment of two years

Las fisuras labiopalatinas (FLP) son las malformaciones craneofaciales congénitas más comunes. La anemia de Diamond-Blackfan o anemia aneritroblástica es una hipoplasia congénita selectiva de la serie roja, asociada a alteraciones cardiacas, renales, malformaciones en manos, hipertelorismo y retraso en el crecimiento. La presentación de las FLP y pacientes con Anemia de Diamond-Blackfan es del 10.3%. Objetivo: Presentar un reporte de caso de un paciente de 12 años con anemia de Diamond-Blackfan y secuela de FLP de la Clínica Interdisciplinaria de LPH de la Pontificia Universidad Javeriana (Bogotá-Colombia) donde el abordaje interdisciplinario, el casomanejo del comportamiento y el apoyo psicológico brindado a la familia fueron fundamentales para lograr la adherencia, clarificar el diagnóstico y obtener los resultados terapéuticos esperados. Resultados: se logró la adherencia al tratamiento y el éxito de éste en apoyo con otras especialidades, permitiendo un seguimiento de 2 años. Conclusiones: El manejo multidisciplinario e interdisciplinario con especialidades odontológicas, médicas, y de la salud en general para el manejo de pacientes con FLP y síndromes asociados, resulta importante para el éxito en el tratamiento.

As fissura labiopalatina são as malformações craniofaciais congênitas mais comuns. A anemia do Diamante-Blackfan ou anemia aneritroblástica seletiva é uma hipoplasia congênita da série vermelha, associada com o coração, rim, malformações mãos, hipertelorismo e distúrbios retardo de crescimento. A apresentação de Fissura labiopalatina e pacientes com anemia do Diamante-Blackfan é de 10,3% dos casos. Objetivo: Apresentar um caso clínico de um paciente de 12 anos com anemia do Diamante-Blackfan e Fissura labiopalatina sequela do Interdisciplinar Clinic LPH da Pontificia Universidad Javeriana (Bogotá Colômbia), onde a abordagem interdisciplinar, gestão de comportamento e apoio psicológico prestado aos família foram fundamentais para alcançar a adesão a esclarecer o diagnóstico e obter os resultados terapêuticos esperados. Resultado: a adesão ao tratamento e seu sucesso no apoio de outras especialidades de saúde alcançados. Conclusões: O tratamento multidisciplinar e interdisciplinar com especialidades odontológicas, médicas e de saúde em geral para o tratamento de pacientes com FLP e síndromes associadas, é importante para o sucesso do tratamento

Cleft lip and palate (CLP) are the most common congenital craniofacial malformations. The Diamond-Blackfan anemia or congenital erythroblastic anemia is a selective red cell hypoplasia associated with heart, kidney, malformed hands, hypertelorism and stunted alterations. The presentation of Cleft lip and palate in patients with Diamond-Blackfan anemia is 10.3% of cases. Aim: To present a case report of a patient of 12 years with Diamond-Blackfan anemia and Cleft lip and palate sequel from the Interdisciplinary Clinic LPH of the Pontificia Universidad Javeriana (Bogota Colombia) where the interdisciplinary approach, behavior management and psychological support provided to the family were instrumental in achieving the expected therapeutic results. Results: Adherence to treatment and its success in supporting other health specialties during two years is slown. Conclusions: The multidisciplinary and interdisciplinary management with dental specialties, medical, and health in general for the management of patients with FLP and associated syndromes, it is important for successful treatment

High risk serotypes of the human papillomavirus (HPV) in patients with exofitic lesions in the oral cavity / Serotipos de alto riesgo del virus de papiloma humano (VPH) en pacientes con lesiones exofiticas en la cavidad oral

Abstract Objective: To determine the prevalence of high-risk serotypes of human papillomavirus in verrucous lesions of the oral cavity in a hospital in Cartagena during July 2014 to July 2015. Methodology: An observational, descriptive, prospective study was conducted in 73 patients with verrucous lesions of the oral cavity, in which socio-demographic characteristics, clinical and histopathological diagnosis were determined, and high-risk DNA HPV genotypes 16 and 18 were identified, as well as 12 other high-risk genotypes (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68), by means of the real-time multiplex PCR test. The study complied with legal and ethical standards. The results were analyzed using descriptive statistics with the Stata program v13.2. Results: The prevalence of HPV in the sample studied during the 2014-2015 period was 9.59% (n: 7). In none of the cases positive for HPV in the histopathological study, some high-risk genotype was identified. Serotypes of HPV were more prevalent in patients in the third decade of life (29.5 years, SD ± 10.60), the average age was 62.8 years SD ± 17.74. The population came mainly from the rural area. The most common site was the labial mucosa. A high percentage of participants (87.6%) reported consuming tobacco. Conclusion: In the present study no high-risk HPV genotypes were found in the samples evaluated.

Resumen Objetivo: Determinar la prevalencia de serotipos de alto riesgo del virus del papiloma humano en lesiones verrugosas de la cavidad bucal en un hospital de Cartagena durante el mes de julio de 2014 y julio de 2015. Metodología: Se realizó un estudio observacional, descriptivo y prospectivo en 73 pacientes. con lesiones verrugosas de la cavidad bucal, en las que se determinaron las características sociodemográficas, el diagnóstico clínico e histopatológico y se identificaron los genotipos 16 y 18 de alto riesgo de VPH del ADN, así como otros 12 genotipos de alto riesgo (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 y 68), mediante la prueba de PCR multiplex en tiempo real. El estudio cumplió con las normas legales y éticas. Los resultados se analizaron utilizando estadísticas descriptivas con el programa Stata v13.2. Resultados: La prevalencia de VPH en la muestra estudiada durante el período 2014-2015 fue del 9,59% (n: 7). En ninguno de los casos positivos para el VPH en el estudio histopatológico, se identificaron algunos genotipos de alto riesgo. Los serotipos de HPV fueron más prevalentes en pacientes en la tercera década de la vida (29.5 años, SD ± 10.60), la edad promedio fue de 62.8 años SD ± 17.74. La población provenía principalmente del área rural. El sitio más frecuente fue la mucosa labial. Un alto porcentaje de participantes (87.6%) reportó consumir tabaco. Conclusión: En el presente estudio no se encontraron genotipos de VPH de alto riesgo en las muestras evaluadas

Overview on radiation and tissue banking in Latin America.

The International Atomic Energy Agency (IAEA) played an important role in the establishment of new tissue banks and the improvement of already existing ones in Latin America. The Agency strongly supported, through regional, interregional and national technical cooperation projects, providing equipment, expert missions and training for the production and application of human tissues for transplantation. From 1999 to 2005 five regional courses were given in Buenos Aires under the modality of 1-year distance learning training courses and 1-week face to face courses. The courses were organized by the IAEA, through the National Atomic Energy Commission (CNEA) and the Faculty of Medicine of Buenos Aires University as Post Graduate Specialization Course. In 2005 the Latin American countries joined with Spain and Portugal, and created the Ibero American Network Council of Donation and Transplant (Red Consejo Iberoamericano de Donación y Trasplantes-RCIDT). The objective of this network is to cooperate among twenty-one Ibero American countries in organizational and legislative aspects, training of professionals, and ethical and social issues related to the donation and transplantation of organs, tissues and cells. The members of this Network work actively to harmonize the regulations and the control of donation and transplantation of human organs, tissues and cells. At present, in Latin America, more than 220 facilities of tissues banks are operating and tissue allografts are being produced by single and multi-tissue banks. The efforts made by the governments and professionals from the region allow the tissue banks to operate under quality systems and introduce new technologies.

Competência educativa parental: estudo de propriedades psicométricas da escala com amostra brasileira / Parenting sense of competence: a study of the psychometric properties of the scale with a Brazilian sample / Competencia educativa parental: estudio de las propiedades psicométricas de la escala con una muestra brasileña

O Questionário de Autoavaliação da Competência Educativa Parental (QACEP) é um instrumento que tem por objetivo avaliar a percepção de competência dos pais em suas funções. No Brasil, sua utilização é escassa e o objetivo desta pesquisa é analisar as propriedades psicométricas do QACEP. Foi utilizada uma amostra de 151 mães e pais, a maioria com nível de escolaridade até o ensino médio e renda até dois salários mínimos. A análise fatorial confirmatória do modelo proposto com dois fatores - a percepção de eficácia e de satisfação - revelou bom ajustamento global aos dados recolhidos. Análises posteriores revelam que a satisfação parental aumenta com a idade dos pais, com o nível de escolaridade e salário auferido. Tendo em conta os diversos processos de validação conduzidos, recomenda-se o uso dessa versão do QACEP na investigação e prática clínica com pessoas de baixa renda no Brasil. (AU)

The Self-Assessment Questionnaire for Parental Educational Competency (PEC-SAQ) is an instrument that aims to evaluate the perception of parental competence in its functions. In Brazil, it is scarcely used and the objective of this research is to analyze the psychometric properties of PEC-SAQ. A sample of 151 mothers and fathers was used, the majority with education level up to high school and income up to two minimum wages. Confirmatory factor analysis of a proposed two-factor model (perception of efficacy and satisfaction) revealed a good overall adjustment to the data collected. Later analyses revealed that parental satisfaction increases with the parents' age, with the level of schooling and salary earned. Taking into account the different validation processes conducted, it is recommended to use this version of PEC-SAQ in research and clinical practice with low-income people in Brazil. (AU)

El Cuestionario de Autoevaluación de Competencia Educativa Parental (QACEP) es un instrumento que tiene por objetivo evaluar la percepción de competencia de los padres en sus tareas. En Brasil, su utilización es escasa y el objetivo de esta investigación es analizar las propiedades psicométricas del QACEP. Se utilizó una muestra de 151 madres y padres, la mayoría con nivel de escolaridad hasta Enseñanza Secundaria y una renta media familiar hasta dos salarios mínimos. El análisis factorial confirmatorio del modelo propuesto con dos factores - Eficacia y Satisfacción - mostró buen ajuste global a los datos recogidos. Análisis posteriores revelan que la satisfacción parental aumenta con la edad de los padres, con el nivel de escolaridad y con los ingresos familiares. Se recomienda el uso de esta versión del QACEP en la investigación y práctica clínica con personas de bajos ingresos en Brasil. (AU)

Eficacia de la técnica infraorbitaria en incisivos y premolares maxilares usando lidocaína al 2% con epinefrina 1:80,000 / Anesthetic efficacy of the infraorbital nerve block in maxillary incisors and premolars using 2% lidocaine with epinephrine 1:80,000

Objetivos: Los autores condujeron un ensayo clínico no controlado para determinar la efectividad de la técnica infraorbitaria, para proporcionar anestesia pulpar profunda en incisivos y premolares maxilares. Material y métodos: Diecinueve adultos voluntarios recibieron 1.8 mililitros de lidocaína al 2% con epinefrina 1:80,000 con una técnica infraorbitaria intraoral. Los investigadores usaron un electric pulp tester (vitalómetro) para medir la anestesia pulpar en incisivos y premolares maxilares. Los participantes informaron sobre anestesia en tejidos blandos, y molestias durante la inyección además de que valoraron el tiempo de inicio de la anestesia y la duración de la misma. Los autores analizaron los datos usando el programa estadístico STATA 9®. Resultados: La mayoría de los sujetos tenía 21 años (30%), el sexo más común fue el sexo femenino (n = 12-60%). Los autores evaluaron con escala visual análoga (VAS), la percepción del dolor al momento de aplicar la anestesia, encontrando que el 57.9% de los pacientes (n = 11) lo catalogaron como moderado (escala de 3-6). Al evaluar el éxito anestésico, observaron un mayor número de episodios en el canino y el primer premolar (57.9%, n = 9 - IC 95%), Los autores observaron un importante número de fallas en la anestesia pulpar de incisivos centrales y laterales (100-84.2%, respectivamente). El inicio de la anestesia fue a los 12-19 minutos, siendo el canino el de mayor número de reportes con un 47.4%. La incidencia de sensación subjetiva de anestesia de los tejidos blandos en piel de párpado, ala de la nariz y piel de labio superior fue del 100%, los autores observaron que el 100% de los sujetos la calificaron como desagradable (VAS). Conclusiones: La técnica infraorbitaria produce anestesia exitosa en sólo el 57.9% de los caninos y primeros premolares maxilares; es ineficaz para anestesiar incisivos centrales y laterales, luego de ser evaluada con un riguroso test de vitalometría, se produce anestesia de tejidos blandos que es catalogada como incomoda. Los autores consideran que la utilidad de la técnica infraorbitaria en odontología es cuestionable y se deben considerar otras técnicas para los incisivos y premolares maxilares.

Objectives: The authors conducted a clinical-trial, uncontrolled study to determine infraorbital nerve block effectiveness. Material and methods: Nineteen adult volunteers received 1.8 mL of lidocaine 2% with epinephrine 1:80,000 with an intraoral, infraorbital nerve block. Researchers used an electric pulp tester to measure pulp anesthesia in maxillary incisors and premolars. Participants reported soft tissue anesthesia and discomfort during the injection procedure; anesthesia onset time and its duration were also assessed and analyzed. Authors analyzed data using STATA statistical program 9®. Results: Most of the subjects in our trial were 21 years old (30%); the number of female participants (n = 12 - 60%) was greater than that of male participants. Authors evaluated pain perception when injecting anesthesia with a visual analogue scale (VAS), finding that 57.9% of patients (n = 11) categorized the pain as moderate (in a scale of 3-6). When assessing anesthesia success, it was observed that a greater number of canine teeth and first premolars (57.9%, n = 9 - CI 95%) were anesthetized. The authors also observed a significant greater number of nonresponse (non-anesthetized) cases in central and lateral incisors (100-84.2%, respectively). Anesthesia onset was at 12 to 19 minutes, with canines exhibiting the largest number of anesthetized reports with 47.4%. There was a 100% incidence of subjective feeling of soft tissue anesthesia in lower eyelid skin, skin of the nose and skin of the upper lip. Authors noted that 100% of the subjects rated it as unpleasant (VAS). Conclusions: Infraorbital anesthesia technique achieved successful anesthesia in only 57.9% of upper canines and first premolars; it proved ineffective for anesthetizing central and lateral incisors. This was demonstrated after these teeth were evaluated using rigorous pulp vitality testing. Soft tissue anesthesia occurred and it was classified as uncomfortable. Authors consider that usefulness of infraorbital nerve block technique in dentistry was questionable.

Perception of discomfort during injection and the need for supplemental anesthesia in the intraosseous technique using 4% articaine.

The authors conducted an experimental study to determine patient perception of discomfort during injection and the need for supplemental anesthesia using the intraosseous technique with 4% articaine with 1:100,000 epinephrine in patients with symptomatic pulpitis in mandibular molars. At different clinical sessions, researchers used 4% articaine with 1:100,000 epinephrine to apply intraosseous injection (Group 1) or inferior alveolar nerve block (Group 2). Each technique was applied in 35 patients. In each group, the need for additional anesthesia was determined and patient discomfort during injection was assessed with a Visual Analogue Scale (VAS) test. In the intraosseous group, no supplemental technique was needed in 22 patients (62.85 %), and results were similar for the inferior alveolar technique (n: 23 65.71%). The intraosseous technique proved to be more comfortable than the mandibular technique (18 patients - 25.7%). This study found that the use of intraosseous technique with 4% articaine shows promising results regarding patient comfort and reducing the need for additional anesthesia.

Los autores condujeron un estudio experimental para deter minar la eficacia de la técnica anestésica intraósea usando articaína al 4% con epinefrina 1:100.000, en pacientes con pulpitis aguda en molares mandibulares. En diferentes sesiones clínicas, los miembros del equipo de investigadores usaron articaína al 4% con epinefrina 1:100.000 para inducir anestesia mandibular con la técnica intraósea (Grupo 1) o con el bloqueo del nervio alveolar inferior (Grupo 2), se aplicó cada técnica en 35 pacientes con diagnóstico de pulpitis aguda en molares inferiores. En cada grupo, se determinó la necesidad de hacer anestesia complementaria y la comodidad del paciente con un test Escala Visual Analoga. Un total de 70 pacientes fueron enrolados en este estudio (35 sujetos por grupo). En el grupo de intraósea no fue necesaria la aplicación de técnicas complementarias en 22 pacientes (31.4%), resultados similares en la técnica alveolar inferior (n: 23 32.8%). La técnica intraósea demostró ser más cómoda al compararla con técnica mandibular (18 pacientes 25.7%). Este estudio demostró que el uso de la técnica intraósea conarticaína al 4%, arrojó resultados prometedores en lo que a comodidad y reducción en la anestesia complementaria hace referencia.

Identification of novel anti-inflammatory probiotic strains isolated from pulque.

Probiotics are live microorganisms which when administered in adequate amounts, confer health benefits on the host. Their use is more and more widespread for both prevention and treatment of diseases, including traveler's diarrhea and inflammatory bowel diseases (IBDs). In this work, we isolated and characterized novel candidate probiotic strains from pulque (xaxtle), a traditional Mexican alcoholic fermented beverage. A total of 14 strains were obtained from xaxtle samples isolated from three different Mexican regions. Species identification was performed by biochemical methods and 16S rRNA gene targeted PCR. The isolates belonged to the Lactobacillus plantarum, Lactobacillus paracasei, Lactobacillus brevis, and Lactobacillus composti phylogenetic groups, with L. brevis being the most dominant group. Bacteria were tested for lysozyme, low pH, and bile acid resistance. Moreover, the strains were tested for adherence to human intestinal epithelial cells and screened for their immunomodulatory properties using a cellular model. Selected bacterial strains with anti-inflammatory properties were then tested in vivo in a dinitro-benzene sulfonic acid (DNBS)-induced chronic colitis mouse model, and weight loss, gut permeability, and cytokine profiles were measured as readouts of inflammation. One of the selected strains, Lactobacillus sanfranciscensis LBH1068, improved mice health as observed by a reduction of weight loss, significant decreases in gut permeability, and cytokine modulation. Altogether, our results highlighted the potential of lactobacilli isolated from pulque and in particular the strain L. sanfranciscensis LBH1068 as a novel probiotic to treat IBD.

Perception of discomfort during injection and the need for supplemental anesthesia in the intraosseous technique using 4 per cent articaine / Percepción de incomodidad durante la inyección y necesidad de anestesia suplementaria en anestesia intraósea usando articaína al 4

The authors conducted an experimental study to determine patient perception of discomfort during injection and the need for supplemental anesthesia using the intraosseous technique with 4% articaine with 1:100,000 epinephrine in patients with symptomatic pulpitis in mandibular molars. At different clinical sessions, researchers used 4% articaine with 1:100,000 epinephrine to apply intraosseous injection (Group 1) or inferior alveolar nerve block (Group 2). Each technique was applied in 35 patients. In each group, the need for additional anesthesia was determined and patient discomfort during injection was assessed with a Visual Analogue Scale (VAS) test. In the intraosseous group, no supplemental technique was needed in 22 patients (62.85 %), and results were similar for the inferior alveolar technique (n: 23 65.71%). The intraosseous technique proved to be more comfortable than the mandibular technique (18 patients - 25.7%). This study found that the use of intraosseous technique with 4% articaine shows promising results regarding patient comfort and reducing the need for additional anesthesia.

Los autores condujeron un estudio experimental para deter minar la eficacia de la técnica anestésica intraósea usando articaína al 4% con epinefrina 1:100.000, en pacientes con pulpitis aguda en molares mandibulares. En diferentes sesiones clínicas, los miembros del equipo de investigadores usaron articaína al 4% con epinefrina 1:100.000 para inducir anestesia mandibular con la técnica intraósea (Grupo 1) o con el bloqueo del nervio alveolar inferior (Grupo 2), se aplicó cada técnica en 35 pacientes con diagnóstico de pulpitis aguda en molares inferiores. En cada grupo, se determinó la necesidad de hacer anestesia complementaria y la comodidad del paciente con un test Escala Visual Analoga. Un total de 70 pacientes fueron enrolados en este estudio (35 sujetos por grupo). En el grupo de intraósea no fue necesaria la aplicación de técnicas complementarias en 22 pacientes (31.4%), resultados similares en la técnica alveolar inferior (n: 23 32.8%). La técnica intraósea demostró ser más cómoda al compararla con técnica mandibular (18 pacientes 25.7%). Este estudio demostró que el uso de la técnica intraósea conarticaína al 4%, arrojó resultados prometedores en lo que a comodidad y reducción en la anestesia complementaria hace referencia.