Kidney transplant recipient with history of HIV, HBV, and past HCV infection.

Chronic viral infections caused by the human immunodeficiency virus (HIV), hepatitis C (HCV), and hepatitis B (HBV) are common among patients with end-stage renal disease (ESKD). These infections were once considered contraindications to kidney transplantation due to potential risks associated with long-term immunosuppression. Improved management and antiviral therapies have changed the prognosis and survival of this group of patients, along with an increased experience in transplanting people with these viral infections. We report the first successful kidney transplant in an ESKD patient on hemodialysis with a history of concomitant HIV, HCV and HBV infection in Mexico.

Self-reported dental pain in Mexican schoolchildren: a national ecological study.

The objective of this study was to quantify the prevalence of and identify the factors associated with dental pain among elementary- and middle-school students in Mexico. An ecological study was carried out with data from the 2008 National School-based Student-Health Survey. Information on dental pain from schoolchildren (aged 5 to 16 years) was collected from public schools across the 32 states of Mexico. In the original study, a questionnaire was used to explore various factors that affect the oral and dental health status of schoolchildren. The outcome variable was the prevalence rate (for dental pain) reported at state level. Various contextual socioeconomic variables were included, in addition to dental caries. Analyses were performed using Stata software. 52.9% of interviewees were girls; 26.9% of male and female schoolchildren in Mexico experienced gum or dental pain during the period analyzed (95% Confidence Interval = 26.02, 27.77%); according to the Spearman correlation results, self-reported dental pain was unrelated (p > 0.05) to the socioeconomic and sociodemographic variables that make up the Gross Domestic Product (GDP) and the Human Development (HDI), as well as the marginalization and the Gini indices. However, the estimated percentages of self-reported dental pain and caries were positively correlated in the elementary- (r = 0.8958, p < 0.0001), middle-school (r = 0.8958, p < 0.0001) and total populations (r = 0.8542, p < 0.0001). Prevalence of self-reported dental pain was 28%, or about one in three, of the Mexican children and adolescents in the study sample. The state-level sociodemographic and socioeconomic risk indicators were not associated with the prevalence of dental pain. Self-reported caries was positively correlated with self-reported dental pain.

Control of Dental Caries in Children and Adolescents Using Fluoride: An Overview of Community-Level Fluoridation Methods.

The maintenance of oral health is a crucial aspect of general well-being; however, a significant proportion of the worldwide population experiences a range of oral diseases. Dental caries is a highly prevalent non-communicable disease globally, especially in children and adolescents. Fluoride is involved in the control of dental caries, primarily by decreasing the critical pH for dental hard tissue dissolution and decreasing enamel solubility. Due to the substantial data supporting the efficacy of fluoride in controlling dental caries, many community-level fluoridation initiatives have been devised and executed as global public health preventive interventions. These initiatives encompass the fluoridation of water, salt, and milk. Water fluoridation is considered safe and effective when fluoride levels are maintained within the recommended range (0.6 to 1.1 mg/L). Salt fluoridation has a cariostatic potential similar to that of water fluoridation, and a fluoride concentration of 250 micrograms per gram in salt is not associated with an increased risk of developing dental fluorosis. However, there is currently an effort to reduce the consumption of table salt in order to mitigate the harmful effects of excessive salt consumption. It has been hypothesized that fluoride food supplementation, such as fluoridated milk, is associated with a decrease in caries experience in permanent teeth; however, the effect is not clear in primary teeth. Public-level fluoride interventions are more cost-effective than the operative care of caries lesions and limit the burden of care. The administration of fluorides should be conducted using safe methods, limiting ingestion, and adhering to the guidelines set by international and national health agencies in each country. This is particularly important when considering children with developing dentitions. Fluoride is an important tool in the control of dental caries, but it is crucial to combine it with good oral hygiene, a healthy diet, and regular visits to a dental professional to maintain long-term oral health.

DBD-FISH Using Specific Chromosomal Region Probes for the Study of Cervical Carcinoma Progression.

Genomic instability is an important biomarker in the progression of cervical carcinoma. DBD-FISH (DNA breakage detection-fluorescence in situ hybridization) is a sensitive method that detects strand breaks, alkali-labile sites, and incomplete DNA excision repair in cells of the cervical epithelium. This technique integrates the microgel immersion of cells from a vaginal lesion scraping and the DNA unwinding treatment with the capacity of FISH integrated into digital image analysis. Cells captured within an agarose matrix are lysed and submerged in an alkaline unwinding solution that generates single-stranded DNA motifs at the ends of internal DNA strand breaks. After neutralization, the microgel is dehydrated and the cells are incubated with DNA-labeled probes. The quantity of a hybridized probe at a target sequence corresponds to the measure of the single-stranded DNA produced during the unwinding step, which is equivalent to the degree of local DNA breakage. DNA damage does not show uniformly throughout the entire DNA of a cell; rather, it is confined to specific chromosomal sites. In this chapter, an overview of the technique is supplied, focusing on its ability for assessing the association between DNA damage in specific sequences and in the progressive stages of cervical carcinoma.

Effect of Exercise Programs on Physical Performance in Community-Dwelling Older Adults with and without Frailty: Systematic Review and Meta-Analysis.

BACKGROUND: The measurement of physical performance constitutes an indicator of the physical functional capacity of older adults with and without frailty. AIM: To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. METHOD: A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until 4 May 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. RESULT: We found 2483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB scores was significantly higher in the exercise group compared to control in non-frail older adults with MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]. CONCLUSION: Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity. This systematic review shows the differentiated effect of exercise training on physical performance in older adults with and without frailty. Scientific evidence reinforces the importance of implementing physical exercise programs in all older adults, including those who are frail. However, it is necessary to specify the types and doses (duration, frequency and intensity), for individualized groups, previously grouped according to the SPPB score.

Factores asociados con la edad a la que inicia la menopausia. Un análisis de la ENASEM-2018 / Factors associated with age at onset of menopause. An analysis of MHAS-2018

Resumen OBJETIVO: Identificar los factores sociodemográficos, patológicos, psicosociales y de estilo de vida relacionados con la edad a la que inicia la menopausia. MATERIALES Y MÉTODOS: Estudio secundario de corte transversal de la ronda 2018 del Estudio Nacional de Salud y Envejecimiento en México (ENASEM) que cuenta con 17,114 registros de sujetos de uno y otro sexo provenientes de toda la República Mexicana. Criterios de inclusión: mujeres de 40 años, con información de las variables: edad al inicio de la menopausia, lugar de residencia, estado civil, escolaridad, peso, estatura, tabaquismo, ingesta de alcohol, sedentarismo, depresión, hipertensión arterial, diabetes mellitus, algún tipo de cáncer e histerectomía. Se hizo un análisis comparativo de la edad a la menopausia con cada uno de los factores y un análisis multivariado para determinar los factores asociados. Las mujeres con histerectomía, y un grupo de mujeres con ≤ 6 años en la posmenopausia, se analizaron aparte. RESULTADOS: De 9017 mujeres registradas (con límites de edad de 40 y 90 años), 7132 (81%) conservaban el útero y los ovarios. El promedio de edad a la menopausia, sin ajuste, fue 47.8 ± 4.5 años. La histerectomía la anticipa en 2.3 años y la escolaridad mayor a la secundaria la retrasa 5 meses. La edad ajustada fue 48.0 ± 4.3 años y en el grupo con menopausia reciente 50.0 ± 2.8 años. CONCLUSIÓN: La menopausia natural se inicia entre los 48 y 50 años, la histerectomía la adelanta hasta dos años y la escolaridad de secundaria y superior la retrasa 6 meses por cada incremento de nivel escolar. El hecho de vivir en una zona rural o urbana también influye en el tiempo en que comienza la menopausia natural.

Abstract OBJECTIVE: To identify sociodemographic, pathological, psychosocial, and lifestyle factors associated with age at menopause onset. MATERIALS AND METHODS: Secondary cross-sectional study of the 2018 round of the National Study of Health and Aging in Mexico (ENASEM), with 17,114 records of male and female subjects from all over Mexico. Inclusion criteria: women aged 40 years with information on the following variables: age at onset of menopause, place of residence, marital status, education, weight, height, smoking, alcohol consumption, sedentary lifestyle, depression, hypertension, diabetes mellitus, any type of cancer and hysterectomy. A comparative analysis of age at menopause was made with each of these factors and a multivariate analysis was performed to determine the associated factors. Women with hysterectomy and a group of women ≤ 6 years postmenopausal were analyzed separately. RESULTS: Of 9017 women enrolled (with age limits of 40 and 90 years), 7132 (81%) retained uterus and ovaries. The mean age at menopause without adjustment was 47.8 ± 4.5 years. Hysterectomy brought it forward by 2.3 years and education beyond high school delayed it by 5 months. The adjusted age was 48.0 ± 4.3 years and in the recent menopause group 50.0 ± 2.8 years. CONCLUSION: Natural menopause occurs between 48 and 50 years of age, hysterectomy brings it forward by up to two years, and secondary and higher education delays it by 6 months for each additional year of schooling. Living in a rural or urban area also influences the time of onset of natural menopause.

Referentes teóricos sobre lectura y escritura en la formación académico-investigativa de los profesionales de la salud / Theoretical references on reading and writing in the academic-research training of health professionals / Referenciais teóricos sobre leitura e escrita na formação acadêmico-pesquisa de profissionais de saúde

Introducción: La lectura y la escritura constituyen prácticas esenciales en el aprendizaje, la investigación y la comunicación científica. Objetivo: Identificar las teorías y conceptos claves sobre la lectura y la escritura universitaria apropiados para sustentar la formación académico-investigativa de los profesionales de la salud. Método: Se desarrolló una revisión bibliográfica (octubre de 2022 - abril de 2023), a partir de las siguientes fases: búsqueda de información, evaluación, análisis y síntesis. Se utilizaron palabras clave combinadas en diferentes ecuaciones de búsqueda: formación investigativa, habilidades investigativas, comunicación de la ciencia, habilidades comunicativas, lectura, escritura. Se localizaron 238 documentos; se excluyeron 131a partir de los criterios determinados. Desarrollo: Se determinaron los principales aportesen la fase de evaluación, mediante lecturas recurrentes y fichas de análisis. En la fase de análisis se elaboraron fichas de contenido con los conceptos principales, previo agrupamiento de los artículos en grupos temáticos. En la fase de síntesis se identificaron los principales enfoques teóricos. El cuerpo de ideas resultante se organiza como sigue: la lectura y la escritura en la formación académico-investigativa, literacidad y alfabetización académica, lectura y pensamiento crítico, la escritura académica y lectura y escritura en entornos digitales. Consideraciones finales: Existe suficiente respaldo teórico para sustentar la comunicación científica enla formación académico-investigativa de los profesionales de la salud. Se confirma la posibilidad de sustentar pedagógicamente la interacción comunicativa en la apropiación de información y la construcción del conocimiento en contextos disciplinares.(AU)

Introduction: Reading and writing constitute essential practices in learning, research and scientific communication. Objective: To identify the key theories and concepts about college reading and writing appropriate to support the academic-research training of health professionals. Method: A bibliographic review was developed (October 2022 - April 2023), based on the following phases: information search, evaluation, analysis and synthesis.Keywords were used combined in different search equations: research training, research skills, science communication, communication skills, reading, writing.238 documents were located;131 were excluded based on the determined criteria. Development: The main contributions were determined in the evaluation phase, through recurring readings and analysis sheets.In the analysis phase, content sheets were prepared with the main concepts, after grouping the articles into thematic groups.In the synthesis phase, the main theoretical approaches were identified.The resulting body of ideas is organized as follows: reading and writing in academic-research training, literacy and academic literacy, reading and critical thinking, academic writing and reading and writing in digital environments. Final considerations: There is sufficient theoretical background to support scientific communication in the academic-research training of health professionals.The possibility of pedagogically supporting communicative interaction in the appropriation of information and the construction of knowledge in disciplinary contexts is confirmed.(AU)

Introdução: A leitura e a escrita constituem práticas essenciais na aprendizagem, na pesquisa e na comunicação científica. Objetivo: Identificar as principais teorias e conceitos sobre leitura e escrita universitária adequados para subsidiar a formação acadêmico-pesquisadora de profissionais de saúde. Método: Foi desenvolvida uma revisão bibliográfica (outubro de 2022 - abril de 2023), baseada nas seguintes fases: busca de informações, avaliação, análise e síntese.Foram utilizadas palavras-chave combinadas em diferentes equações de busca: formação em pesquisa, habilidades de pesquisa, comunicação científica, habilidades de comunicação, leitura, escrita.Foram localizados 238 documentos;131 foram excluídos com base nos critérios determinados. Desenvolvimento: as principais contribuições foram determinadas na fase de avaliação, por meio de leituras recorrentes e fichas de análise.Na fase de análise foram elaboradas fichas de conteúdo com os principais conceitos, após agrupamento dos artigos em grupos temáticos.Na fase de síntese foram identificadas as principais abordagens teóricas.O conjunto de ideias resultante está organizado da seguinte forma: leitura e escrita na formação académica-investigadora, alfabetização e literacia académica, leitura e pensamento crítico, escrita académica e leitura e escrita em ambientes digitais. Considerações finais: Há respaldo teórico suficiente para fundamentar a comunicação científica na formação acadêmico-pesquisadora dos profissionais de saúde.Confirma-se a possibilidade de apoiar pedagogicamente a interação comunicativa na apropriação da informação e na construção do conhecimento em contextos disciplinares.(AU)

Confiabilidad de cuestionarios electrónicos para evaluar calidad de vida y actitudes hacia la vejez en mujeres de 40 a 69 años / Reliability of electronic questionnaires to evaluate quality of life and attitudes towards old age in women aged 40 to 69 years

Introducción: el uso de cuestionarios electrónicos se ha convertido en algo común, sin embargo, depende de diversos factores (como la edad y las habilidades digitales), por lo que es necesario determinar la confiabilidad de estos instrumentos para su aplicación. Objetivo: determinar la concordancia y reproducibilidad de los cuestionarios Calidad de vida breve de la OMS (WHOQoL-B) y Actitudes autoevaluadas hacia la vejez (AAV) en formato electrónico para su aplicación vía remota a mujeres de edad madura y adulta mayor. Metodología: se realizó un estudio instrumental con el método test-retest con 35 mujeres (40-69 años). Se transfirieron ambos cuestionarios a un formulario de Google y se enviaron vía WhatsAppen dos ocasiones, con una diferencia mayor a 15 días entre la aplicación. Se calcularon los parámetros de confiabilidad por estabilidad temporal y concordancia estadística. Resultados: el WHOQoL-B obtuvo a y CCI = 0.880 y r = 0.785 en la calificación total; para sus dimensiones a > 0.740 y r > 0.590. La calificación total del AAV mostró a y CCI = 0.708 y r = 0.552 y sus dimensiones a > 0.710 y r de 0.295 a 0.508. Conclusiones: los cuestionarios WHOQoL-B y AAV en formato electrónico pueden ser utilizados para aplicación vía remota, aunque el AAV es menos consistente...(AU)

Abstract Introduction: The electronic tests have been used on a regular basis, although their use depends on several factors such as age and digital ability, therefore it is necessary to determine the confidence of these instruments for their application. Objective: To determine the agreement and reproducibility of the WHO Quality of Life-Bref (WHOQoL-B) and the Self-Assessed Attitudes Towards Old Age (SATO) questionnaires in electronic format for application in middle-aged and older women. Methods: An instrumental study with a test-retest method was carried out with 35 women (40-69 years). Both questionnaires were transferred to a Google form and sent to the women by WhatsApp twice with a difference of more than 15 days between applications. We calculate the confidence by temporal stability and the statistical agreement. Results: For the WHOQoL-B, an a and ICC= 0.880, and r = 0.785 were obtained in the total rating; for their dimensions the result for a was > 0.740, and r > 0.590. The total rating of SATO shows an a and ICC= 0.708, and r = 0.552; for their dimensions, the a was > 0.710, and r from 0.295 to 0.508. Conclusions: The electronic tests WHOQoL and SATO can be used for remote application, although SATO is less consistent.

Coherencia y pertinencia curricular de la formación en emergencias y desastres en programas de enfermería / Coherence and curricular relevance of training in emergencies and disasters in nursing programs / Coerência e relevância curricular da formação em emergências e desastres nos programas de enfermagem

Resumen En la actualidad, los riesgos climáticos y el mismo adelanto científico y técnico exigen de las profesiones respuestas pertinentes. En el caso de enfermería, la formación en el área de Emergencias y Desastres es un aspecto esencial que debe estar vinculado con la consolidación de la formación integral de los profesionales en enfermería. Esta área fundamental, algunas veces, no es explícita en los planes de estudios, lo que puede restringir el desempeño de rol profesional y ocultar el aporte de la profesión en este campo. Objetivo: valorar la coherencia y pertinencia de la formación de la enfermería en el área de Emergencias y Desastres desde un análisis de los microcurrículos de cuatro Instituciones de Educación Superior (IES) en Colombia y su relación con orientaciones en la formación de enfermeros a nivel internacional y nacional. Metodología: estudio mixto (cualitativo-cuantitativo) de diseño hermenéutico y descriptivo en donde se realizó la caracterización y análisis de microcurrículos en su contenido textual, apoyado en cuatro categorías de estudio y parámetros de formación por competencias académicas nacionales e internacionales. Las unidades de análisis fueron cuatro microcurrículos tomados por muestreo a conveniencia. Resultados: se evidencia baja producción investigativa, dilución de su formación en los planes de estudio, desconocimiento de lineamientos internacionales, inexistencia de lineamientos nacionales y la preocupante situación que enfrenta el desarrollo de la educación para la salud en emergencias y desastres. Conclusiones: existen vacíos en la consolidación posicionamiento de la educación para la salud en gestión del riesgo en emergencias y desastres en Colombia por la ausencia de estándares básicos de competencias claros.

Abstract Currently, climatic risks and scientific and technical progress demand relevant responses from the professions. In the case of nursing, training in the area of emergencies and disasters is an essential aspect that should be linked to the consolidation of the comprehensive training of nursing professionals. This fundamental area is sometimes not explicit in the curricula, which can restrict the performance of the professional role and hide the contribution of the profession in this field. Objective: To assess the coherence and relevance of Nursing training in the area of emergencies and disasters from an analysis of the micro curriculums of four Higher Education Institutions (HEIs) in Colombia and their relationship with guidelines in the training of nurses at the international and national level. Methodology: Mixed study (qualitative-quantitative) of hermeneutic and descriptive design where the characterization and analysis of micro curriculums in their textual content was carried out, supported by four study categories and training parameters by national and international academic competences. The units of analysis were four micro curriculums taken by convenience sampling. Results: Low research production, dilution of its training in the study plans, ignorance of international guidelines, non-existence of national guidelines and the worrying situation facing the development of health education in emergencies and disasters are evident. Conclusions: There are gaps in the consolidation of the positioning of health education in risk management in emergencies and disasters in Colombia due to the absence of clear basic competences standards.

Resumo Atualmente, os riscos climáticos e o mesmo progresso científico e técnico exigem respostas relevantes das profissões. No caso da enfermagem, a formação na área de emergências e desastres é um aspecto essencial que deve estar vinculado à consolidação da formação integral dos profissionais de enfermagem. Esta área fundamental por vezes não está explícita nos planos de estudos, o que pode condicionar o desempenho de uma função profissional e ocultar o contributo da profissão neste domínio. Objetivo: Avaliar a coerência e relevância da formação em Enfermagem na área de emergências e desastres a partir da análise dos microcurrículos de quatro Instituições de Ensino Superior (IES) na Colômbia e sua relação com as diretrizes na formação de enfermeiras em nível internacional e nacional. Metodologia: Estudo misto (qualitativo-quantitativo) de desenho hermenêutico e descritivo onde se procedeu à caracterização e análise de microcurrículos no seu conteúdo textual, sustentado por quatro categorias de estudo e parâmetros de formação por competências académicas nacionais e internacionais. As unidades de análise foram quatro microcurrículos tomados por amostragem de conveniência. Resultados: Evidencia-se a baixa produção de pesquisas, diluição de sua formação nos planos de estudo, desconhecimento das diretrizes internacionais, inexistência de diretrizes nacionais e a situação preocupante diante do desenvolvimento da educação em saúde em emergências e desastres. Conclusões: Existem lacunas na consolidação do posicionamento da educação em saúde na gestão de riscos em emergências e desastres na Colômbia devido à ausência de padrões claros de competência básica.

Soledad, ansiedad, depresión y adopción del rol del cuidador de personas con enfermedad crónica en San Gil, Colombia

Introducción: Los cuidadores de personas con enfermedad crónica adoptan un nuevo rol que puede implicar respuestas como ansiedad, depresión y soledad. Objetivo: Describir y correlacionar las variables de adopción del rol del cuidador, depresión, ansiedad y soledad en cuidadores familiares de personas con enfermedad crónica en la provincia de Guanentina, en San Gil, Santander (Colombia), durante el año 2021. Método: Estudio descriptivo, analítico de corte transversal realizado con 112 cuidadores familiares de personas con enfermedades crónicas. Se utilizó una ficha de caracterización y los instrumentos: Escala adopción del rol del cuidador ROL, escala de soledad de UCLA (University of California at Los Ángeles) y Escala Hospitalaria de Ansiedad y Depresión HADS. Resultados: El perfil de los cuidadores fue predominantemente mujer; de 49 años en promedio; casadas, solteras o en unión libre; grado máximo de escolaridad bachiller; de ocupación hogar y nivel socioeconómico medio bajo y bajo. Se encontraron niveles altos de ansiedad en el 18,3 % de ellas, depresión en el 4,3 % y soledad en el 0,9 %, además, se evidenciaron niveles de adopción del rol del cuidador satisfactorios en el 100 %. Se encontró una correlación débil entre ansiedad, depresión y soledad y una correlación inversa entre estas variables con la adopción del rol del cuidador. De igual manera, se encontró una correlación directa entre la edad del paciente y los meses de diagnóstico con las horas de cuidado al día. Por último, se halló carácter predictivo de la ansiedad y la depresión sobre la adopción del rol, de la ansiedad y la adopción del rol sobre la depresión, y de la soledad y la depresión sobre la ansiedad. Conclusiones: los cuidadores tenían niveles de ansiedad, depresión y soledad normales que, al correlacionarse entre sí y con la adopción del rol del cuidador, validan la idea de que, si se interviene a los cuidadores en su trayectoria con orientaciones sobre su rol en cuanto a las labores, la organización y las respuestas se puede contribuir en la disminución de la ansiedad, depresión y soledad. Discusión: la correlación directa observada entre la soledad, depresión y ansiedad es coherente con lo reportado en estudios previos con cuidadores. Acorde con lo reportado por la literatura el desempeño satisfactorio del rol facilita los desenlaces en los cuidadores, en este caso, la moderación de la ansiedad, depresión y soledad.

Introduction: Caregivers of people with chronic disease adopt a new role that may involve responses such as anxiety, depression, and loneliness. Objective: To describe and correlate the variables of adoption of the role of caregiver, depression, anxiety and loneliness in family caregivers of people with chronic disease in the Guanentina province in San Gil, Santander (Colombia), during the year 2021. Methods: Descriptive study, cross-sectional analysis carried out with 112 family caregivers of people with chronic diseases. A characterization sheet and the ROL, UCLA and HADS instruments were used. Results: the profile of the caregivers was predominantly female and average age of 49 years; married, single or in civil union; maximum degree of high school education; of household occupation and low and low-middle socioeconomic level. High levels of anxiety were found in 18,3% of them, depression in 4,3% and loneliness in 0,9%, in addition, satisfactory levels of adoption of the caregiver role were evidenced in 100%. A weak correlation was found between anxiety, depression and loneliness and an inverse correlation between these variables with the adoption of the caregiver role. Similarly, a direct correlation was found between the patient's age and the months of diagnosis with the hours of care per day. Finally, anxiety and depression were found to be predictive of role adoption, of anxiety and role adoption on depression, and of loneliness and depression on anxiety. Conclusions: the caregivers had normal levels of anxiety, depression and loneliness that, when correlated with each other and with the adoption of the caregiver role, validate the idea that, if caregivers are intervened in their trajectory with guidance on their role in terms of the tasks, the organization and the answers can contribute in the reduction of anxiety, depression and loneliness. Discussion: The direct connection observed between loneliness, depression and anxiety is consistent with what has been reported in previous studies with caregivers. In accordance with what has been reported in the literature, satisfactory performance of the role facilitates the outcomes in caregivers, in this case, the moderation of anxiety, depression and loneliness.

Treatment of osteonecrosis of the femoral head with multiple drilling and bone marrow mesenchymal stem cells expanded ex vivo plus biomolecules derived from platelet-rich plasma: a case report.

Osteonecrosis of the femoral head (ONFH) is a debilitating condition that predominantly affects young individuals, resulting in disability and involving significant healthcare costs. Therefore, it is crucial to develop an effective therapeutic strategy to treat this debilitating disease. In this context, autologous bone marrow-derived mesenchymal stem cells (auto-BM-MSCs) have emerged as a promising approach for treating ONFH. In this case report, we applied this therapy to a patient with ONFH and evaluated both its safety and therapeutic benefits. The treatment consisted of the administration of a single dose of 4×107 ex vivo-expanded auto-BM-MSCs combined with biomolecules derived from platelet-rich plasma. These therapeutic agents were injected into the necrotic zone after accessing it through the technique of multiple small drillings. Subsequently, the progression of ONFH was assessed after 18 months of the auto-BM-MSC administration. Radiographic evaluation showed that the initial femoral head flattening persisted, but no further progression or coxofemoral arthritic changes were observed. Nevertheless, magnetic resonance imaging (MRI) demonstrated a significant improvement in the affected femoral head's area, resulting in a Kerboull angle of 80°, without evidence of flattening or a notable collapse compared to the preoperative condition. Furthermore, the patient exhibited a remarkable functional improvement, as evidenced by a modified Harris hip score of 90 points. The absence of any additional surgery reinforces the positive outcomes achieved through this therapeutic intervention. In conclusion, our case study provides evidence for using the ex vivo-expanded auto-BM-MSCs in combination with platelet-rich plasma-derived biomolecules as a viable and safe treatment for ONFH. However, further research and clinical trials are necessary to validate these promising findings.

Antimicrobial Resistance Profiles of Staphylococcus Isolated from Cows with Subclinical Mastitis: Do Strains from the Environment and from Humans Contribute to the Dissemination of Resistance among Bacteria on Dairy Farms in Colombia?

Staphylococcus is a very prevalent etiologic agent of bovine mastitis, and antibiotic resistance contributes to the successful colonization and dissemination of these bacteria in different environments and hosts on dairy farms. This study aimed to identify the antimicrobial resistance (AMR) genotypes and phenotypes of Staphylococcus spp. isolates from different sources on dairy farms and their relationship with the use of antibiotics. An antimicrobial susceptibility test was performed on 349 Staphylococcus strains (S. aureus, n = 152; non-aureus staphylococci (NAS), n = 197) isolated from quarter milk samples (QMSs) from cows with subclinical mastitis (176), the teats of cows (116), the milking parlor environment (32), and the nasal cavities of milk workers (25). Resistance and multidrug resistance percentages found for S. aureus and NAS were (S. aureus = 63.2%, NAS = 55.8%) and (S. aureus = 4.6%, NAS = 11.7%), respectively. S. aureus and NAS isolates showed resistance mainly to penicillin (10 IU) (54.1% and 32.4%) and ampicillin (10 mg) (50.3% and 27.0%) drugs. The prevalence of AMR Staphylococcus was higher in environmental samples (81.3%) compared to other sources (52.6-76.0%). In S. aureus isolates, the identification of the blaZ (83.9%), aacAaphD (48.6%), ermC (23.5%), tetK (12.9%), and mecA (12.1%) genes did not entirely agree with the AMR phenotype. We conclude that the use of ß-lactam antibiotics influences the expression of AMR in Staphylococcus circulating on dairy farms and that S. aureus isolates from the environment and humans may be reservoirs of AMR for other bacteria on dairy farms.

Reproductive biology of the totoaba (Totoaba macdonaldi), an endangered species in the Gulf of California.

The totoaba (Totoaba macdonaldi) is an emblematic species endemic to the Gulf of California, which has been protected since the mid-70 s by Mexican and international laws. For the present study, 153 totoaba individuals were collected from 2011 to 2014, on which gonad histology analyses were carried out. We identified six ovarian phases and eleven oocyte subphases in the gonad development of females; in males, four development phases were identified. The totoaba is an iteroparous species based on the number of breeding opportunities. According to the organization of the ovary and the presence of oocyte subphases, ovarian dynamics can be considered asynchronous, as demonstrated by the multimodal distribution of oocyte diameter. The totoaba is a batch spawner that releases oocytes over several months. The reproductive period spans from February to May, with a reproductive peak in March. Likewise, the gonadosomatic index showed that the reproductive activity of totoaba peaked in March and April. The female:male sex ratio, although variable throughout the sampling period, yielded an overall value of 0.89:1, with non-significant differences between the number of females and males (P > 0.05). The length at first sexual maturity (L50%) was 1 354 mm TL for females and 1 299 mm TL for males. The average fecundity was 2 662 626 (standard error, s.e., 1 021 124) oocytes, and the average relative fecundity was 99 (s.e. 22) oocytes g-1 (ovary-free). The mean and maximum oocyte diameter showed a positive and non-significant (P > 0.05) relationship with the mean sea surface temperature.

Hydrogel capsules as new approach for increasing drying survival of plant biostimulant gram-negative consortium.

Several plant growth-promoting bacteria (PGPB) are gram-negative, and their cell viability is affected during the bio-inoculant production. Hence, formulation-drying processes provide challenges that limit the adoption of these beneficial microorganisms in sustainable agricultural production. Among delivery system strategies for gram-negative PGPB, the encapsulating cells in biopolymeric materials are emerging as a promising alternative. This research aims to evaluate the effect of additives and crosslinking agents on the survival of the consortium of Herbaspirillum frisingense AP21, Azospirillum brasilense D7, and Rhizobium leguminosarum T88 in hydrogel capsules. Three crosslinkers and diverse potential drying protectors were tested. Calcium gluconate provides notable consortium survival advantages regarding colony-forming units (CFUs) (losses of up to 4 log CFU) compared to calcium lactate and calcium chloride (up to 6 log CFU). Additives such as skimmed milk, whey protein, and Gelita® EC improve the recovery of viable cells after the drying process, demonstrating an increase in cell survival of the three bacteria by up to 4 log CFU. The combination of these substances into a capsule prototype extends the storage stability of bacterial consortium up to 3 months at 18 ± 2 °C. This study expands the knowledge for formulating gram-negative PGPB consortium, regarding the crosslinker and drying protector relationship on encapsulation processes with drying survival and further storage stability performance. KEY POINTS: • Hydrogel immobilization formulation approach for PGPB consortium • Enhancing drying survival of gram-negative PGPB consortium • Increasing storage stability of PGPB consortium at 18 °C.

A novel therapeutic management for diabetes patients with chronic limb-threatening ischemia: comparison of autologous bone marrow mononuclear cells versus allogenic Wharton jelly-derived mesenchymal stem cells.

BACKGROUND: Chronic limb-threatening ischemia (CLTI) represents the final stage of peripheral arterial disease. Approximately one-third of patients with CLTI are not eligible for conventional surgical treatments. Furthermore, patients with advanced stage of CLTI are prone to amputation and death. Thus, an effective therapeutic strategy is urgently needed. In this context, autologous bone marrow mononuclear cell (auto-BM-MNC) and allogeneic mesenchymal stem cells represent a promising therapeutic approach for treating CLTI. In this study, we compared the safety and beneficial therapeutic effect of auto-BM-MNC versus allogeneic Wharton jelly-derived mesenchymal stem cells (allo-WJ-MSCs) in diabetic patients with CLTI. METHODS: We performed a randomized, prospective, double-blind and controlled pilot study. Twenty-four diabetic patients in the advanced stage of CLTI (4 or 5 in Rutherford's classification) and a transcutaneous oxygen pressure (TcPO2) below 30 mmHg were randomized to receive 15 injections of (i) auto-BM-MNC (7.197 × 106 ± 2.984 × 106 cells/mL) (n = 7), (ii) allo-WJ-MSCs (1.333 × 106 cells/mL) (n = 7) or (iii) placebo solution (1 mL) (n = 10), which were administered into the periadventitial layer of the arterial walls under eco-Doppler guidance. The follow-up visits were at months 1, 3, 6, and 12 to evaluate the following parameters: (i) Rutherford's classification, (ii) TcPO2, (iii) percentage of wound closure, (iv) pain, (v) pain-free walking distance, (vi) revascularization and limb-survival proportion, and (vii) life quality (EQ-5D questionnaire). RESULTS: No adverse events were reported. Patients with CLTI who received auto-BM-MNC and allo-WJ-MSCs presented an improvement in Rutherford's classification, a significant increase in TcPO2 values‬, a reduction in the lesion size in a shorter time, a decrease in the pain score and an increase in the pain-free walking distance, in comparison with the placebo group. In addition, the participants treated with auto-BM-MNC and allo-WJ-MSCs kept their limbs during the follow-up period, unlike the placebo group, which had a marked increase in amputation. CONCLUSIONS: Our results showed that patients with CLTI treated with auto-BM-MNC and allo-WJ-MSCs conserved 100% of their limb during 12 months of the follow-up compared to the placebo group, where 60% of participants underwent limb amputation in different times. Furthermore, we observed a faster improvement in the allo-WJ-MSC group, unlike the auto-BM-MNC group. Trial registration This study was retrospectively registered at ClinicalTrials.gov (NCT05631444).

Coat Color in Local Goats: Influence on Environmental Adaptation and Productivity, and Use as a Selection Criterion.

This paper aims to review, systematically synthesize, and analyze fragmented information about the importance of coat color in local goats and its relationship with productivity and other important traits. Topics on current research on color expression are addressed, the relationship that has as a mechanism of environmental adaptation, its relationship with the production of meat, milk, and derivates, and the economic value of this characteristic. The use of this attribute as a tool to establish selection criteria in breeding programs based on results reported in the scientific literature is significant, particularly for low-income production systems, where the implementation of classic genetic improvement schemes is limited due to the lack of productive information, which is distinctive of extensive marginal or low scaled production systems around the world.

Advanced Activities of Daily Living in Community-Dwelling Older Adults: A Cross-Sectional Study of the Mexican Health and Aging Study (MHAS 2018).

BACKGROUND: The advanced activities of daily living (AADLs) in old age is a key indicator of the mobility domain for the intrinsic capacity of older adults living in the community; for this reason, it is relevant to know the prevalence and risk factors related to performing fewer AADLs in different populations. AIM: To determine the prevalence and factors associated with the ability to perform AADLs in older adults reported in the Mexican Study of Health and Aging (MSHA 2018). METHODS: A secondary cross-sectional analysis of the MSHA 2018 data was carried out, including a convenience sample of 6474 subjects ≥ 60 years of age, for both sexes, without cognitive deficits. Nine questions related to AADLs were selected from the database. Multiple logistic regression analysis was performed to determine factors associated with <3 AADLs, including sociodemographic, lifestyle, and health status factors. RESULTS: The prevalence of the ability to perform <3 AADLs was 63%. Age is the most important risk factor for <3 AADLs, which increases by the decade, followed by sedentary lifestyle (OR = 2.15, 95% CI: 1.91-2.42, p < 0.0001). CONCLUSIONS: Our findings suggest that age, schooling, urban residence, sedentary lifestyle, and comorbidity are the main risk factors for <3 AADLs in older Mexican adults.

Proteomics and Genetic Approaches Elucidate the Circulation of Low Variability Staphylococcus aureus Strains on Colombian Dairy Farms.

Staphylococcus aureus is one of the most prevalent pathogens causing bovine mastitis in the world, in part because of its ease of adaptation to various hosts and the environment. This study aimed to determine the prevalence of S. aureus in Colombian dairy farms and its relationship with the causal network of subclinical mastitis. From thirteen dairy farms enrolled, 1288 quarter milk samples (QMS) and 330 teat samples were taken from cows with positive (70.1%) and negative California Mastitis Test (CMT). In addition, 126 samples from the milking parlor environment and 40 from workers (nasal) were collected. On each dairy farm, a survey was conducted, and the milking process was monitored on the day of sampling. S. aureus was identified in 176 samples, i.e., 138 QMS, 20 from teats, 8 from the milking parlor environment, and 10 from workers' nasal swabs. Isolates identified as S. aureus underwent proteomics (clustering of mass spectrum) and molecular (tuf, coa, spa Ig, clfA, and eno genes) analysis. Regarding proteomics results, isolates were distributed into three clusters, each with members from all sources and all farms. Concerning molecular analysis, the virulence-related genes clfA and eno were identified in 41.3% and 37.8% of S. aureus isolates, respectively. We provide evidence on the circulation of S. aureus strains with limited variability among animals, humans, and the environment. The parameters with the lowest compliance in the farms which may be implicated in the transmission of S. aureus are the lack of handwashing and abnormal milk handling.

Tooth Loss and Associated Factors in Mexican Older Adults in Nursing Homes: A Multicenter Cross-Sectional Study.

The objective of this study was to determine the experience of tooth loss and associated factors in older adults and elderly residing in nursing homes. A cross-sectional study was conducted in Mexican older adults and elderly aged ≥60 years living in four nursing homes (two in Mexico City, Mexico: one in Cuernavaca, Morelos, and one in Oaxaca, Oaxaca). The data were collected at the facility (home nursing) by two dentists in 2019. To determine the number of tooth loss and DMFT, a clinical oral examination was performed. In addition, a questionnaire was applied to determine diverse independent variables (demographic, socioeconomic, and behavioral). The analysis was performed using nonparametric tests and negative binomial regression (p < 0.05). 257 subjects were included. The mean age was 81.25 ± 9.02 years, and 60.7% were women. The mean number of lost teeth was 18.78 ± 9.05 (women = 19.43 ± 8.59 and men = 17.77 ± 9.68; p > 0.05). In the multivariate negative binomial regression model, it was found that, for each one-year increase in age, the mean tooth loss increased 0.92% (p < 0.05). In current smokers (p < 0.01) and in those who brush their teeth < 2 times a day (p < 0.01), the average of tooth loss increased 22.04% and 61.46%, respectively. The experience of tooth loss in Mexican older adults and elderly was high. Demographic (age) and habit of behavior (tobacco use and less frequent tooth brushing) were associated with increased tooth loss. It is important to promote oral health programs for institutionalized older adults.