A restrictive stoma policy after colorectal anastomosis in ovarian cancer based on ghost ileostomy use.

BACKGROUND: The incidence of anastomotic leak after colorectal anastomosis in ovarian cancer has been reported to be much lower than that in colorectal cancer patients. Regarding the use of protective manoeuvres (diverting ileostomy) as suggested by clinical guidelines, the goal should be the implementation of a restrictive stoma policy for ovarian cancer patients, given the low rate of anastomotic leakage in this population. MATERIAL AND METHODS: Patients who underwent cytoreduction surgery in a single centre (University Hospital La Fe, Valencia Spain) due to ovarian cancer between January 2010 and June 2023 were classified according to two groups: a non-restrictive stoma policy group (Group A) and a restrictive stoma policy group (Group B). RESULTS: A total of 256 patients were included in the analysis (group A 52 % vs group B 48 %). The use of protective diverting ileostomy was lower in the restrictive stoma policy group (14 % vs 6.6 %), and the use of ghost ileostomy was 32 % vs 87 % in groups A and B, respectively (p < 0.00001). No differences were found in the anastomotic leak rate, which was 5.2 % in the non-restrictive group and 3.2 % in the restrictive stoma policy group (p = 0.54). CONCLUSION: The use of a restrictive stoma policy based on the use of ghost ileostomy reduces the rate of diverting ileostomy in patients with ovarian cancer after colorectal resection and anastomosis. Furthermore, this policy is not associated with an increased rate of anastomotic leakage nor with an increased rate of morbi-mortality related to the leak.

Glial Cx43 hemichannels and neuronal Panx1 hemichannels and P2X7 receptors orchestrate presynaptic homeostatic plasticity.

The emerging role of glial cells in modulating neuronal excitability and synaptic strength is a growing field in neuroscience. In recent years, a pivotal role of gliotransmission in homeostatic presynaptic plasticity has been highlighted and glial-derived ATP arises as a key contributor. However, very little is known about the glial non-vesicular ATP-release pathway and how ATP participates in the modulation of synaptic strength. Here, we investigated the functional changes occurring in neurons upon chronic inactivity and the role of the purinergic signaling, connexin43 and pannexin1 hemichannels in this process. By using hippocampal dissociated cultures, we showed that blocking connexin43 and pannexin1 hemichannels decreases the amount of extracellular ATP. Moreover, Ca2+ imaging assays using Fluo-4/AM revealed that blocking connexin43, neuronal P2X7Rs and pannexin1 hemichannels decreases the amount of basal Ca2+ in neurons. A significant impairment in synaptic vesicle pool size was also evidenced under these conditions. Interestingly, rescue experiments where Panx1HCs are blocked showed that the compensatory adjustment of cytosolic Ca2+ was recovered after P2X7Rs activation, suggesting that Panx1 acts downstream P2X7Rs. These changes were accompanied by a modulation of neuronal permeability, as revealed by ethidium bromide uptake experiments. In particular, the permeability of neuronal P2X7Rs and pannexin1 hemichannels is increased upon 24 h of inactivity. Taken together, we have uncovered a role for connexin43-dependent ATP release and neuronal P2X7Rs and pannexin1 hemichannels in the adjustment of presynaptic strength by modulating neuronal permeability, the entrance of Ca2+ into neurons and the size of the recycling pool of synaptic vesicles.

Historia de los Servicios de Salud Penitenciarios en Costa Rica / History of Prison Health Services in Costa Rica

La historia de los servicios médicos penitenciarios se remonta hace aproximadamente medio siglo, en la extinta Penitenciaria Nacional, donde al igual que, durante mucho tiempo estuvo a cargo de personeros de la Caja Costarricense del Seguro Social (CCSS). No es, hasta que al finalizar la década de los 80's, con el cierre del centro penal ubicado en la Isla San Lucas, se logra concretar la creación de plazas de salud propias del Ministerio de Justicia y Paz (MJP). En 1993 se logra el primer convenio interinstitucional entre la CCSS y el MJP, actualizado en 1998, el cual aún se encuentra refrendado por la Procuraduría General de la República. Actualmente, el MJP cuenta con 87 plazas asignas a puestos relacionados con servicios de salud a lo largo y ancho del territorio costarricense.

The history of prison medical services goes back approximately half a century, in the now extinct National Penitentiary, where, for a long time, it was in charge of representatives of CCSS. It is not, until at the end of the 80's, with the closure of the penal center located on San Lucas Island, the creation of health centers belonging to the Ministerio de Justicia y Paz (MJP) is achieved. In 1993, the first inter-institutional agreement between the CCSS and the MJP was reached, updated in 1998, which is still endorsed by the Attorney General's Office. Currently, the MJP has 87 positions assigned to positions related to health services throughout the Costa Rican territory.

Prevalencia de enfermedades crónicas no transmisibles en las personas privadas de la libertad en Costa Rica / Prevalence of chronic noncommunicable diseases in persons deprived of liberty in Costa Rica

Mediante un estudio cuantitativo, descriptivo y de corte transversal se realiza una comparación entre la población penal de la Unidad de Atención Integral (UAI) 20 de diciembre y la población penal total costarricense. Hasta no hace mucho tiempo, en el ámbito penitenciario se ha experimentado un cambio importante en la morbimortalidad de las personas privadas de la libertad, pasando de un modelo casi unicausal de origen infeccioso, a procesos de etiología múltiple, con desarrollo poco predecible y alto porcentaje del gasto público sanitario. En el siguiente estudio se determina la similitud existente en prevalencia de enfermedades crónicas no trasmisibles tanto a nivel país, sistema penitenciario nacional y UAI 20 de diciembre.

Through a quantitative, descriptive and cross-sectional study, a comparison is made between the prison population of the Unidad de Atención Integral (UAI) 20 de diciembre and the total Costa Rican prison population. Until recently, there has been an important change in the morbimortality of persons deprived of liberty in the penitentiary environment, going from an almost unicausal model of infectious origin, to processes of multiple etiology, with little predictable development and a high percentage of public health expenditure. The following study determines the existing similarity in the prevalence of chronic non-communicable diseases at the country level, the national prison system and the UAI December 20.

P2X7 receptors and pannexin1 hemichannels shape presynaptic transmission.

Over the last decades, since the discovery of ATP as a transmitter, accumulating evidence has been reported about the role of this nucleotide and purinergic receptors, in particular P2X7 receptors, in the modulation of synaptic strength and plasticity. Purinergic signaling has emerged as a crucial player in orchestrating the molecular interaction between the components of the tripartite synapse, and much progress has been made in how this neuron-glia interaction impacts neuronal physiology under basal and pathological conditions. On the other hand, pannexin1 hemichannels, which are functionally linked to P2X7 receptors, have appeared more recently as important modulators of excitatory synaptic function and plasticity under diverse contexts. In this review, we will discuss the contribution of ATP, P2X7 receptors, and pannexin hemichannels to the modulation of presynaptic strength and its impact on motor function, sensory processing, synaptic plasticity, and neuroglial communication, with special focus on the P2X7 receptor/pannexin hemichannel interplay. We also address major hypotheses about the role of this interaction in physiological and pathological circumstances.

Anti-Trypanosomatidae Activity of Essential Oils and Their Main Components from Selected Medicinal Plants.

Kinetoplastida is a group of flagellated protozoa characterized by the presence of a kinetoplast, a structure which is part of a large mitochondria and contains DNA. Parasites of this group include genera such as Leishmania, that cause disease in humans and animals, and Phytomonas, that are capable of infecting plants. Due to the lack of treatments, the low efficacy, or the high toxicity of the employed therapeutic agents there is a need to seek potential alternative treatments. In the present work, the antiparasitic activity on Leishmania infantum and Phytomonas davidi of 23 essential oils (EOs) from plants of the Lamiaceae and Asteraceae families, extracted by hydrodistillation (HD) at laboratory scale and steam distillation (SD) in a pilot plant, were evaluated. The chemical compositions of the EOs were determined by gas chromatography-mass spectrometry. Additionally, the cytotoxic activity on mammalian cells of the major components from the most active EOs was evaluated, and their anti-Phytomonas and anti-Leishmania effects analyzed. L. infantum was more sensitive to the EOs than P. davidi. The EOs with the best anti-kinetoplastid activity were S. montana, T. vulgaris, M. suaveolens, and L. luisieri. Steam distillation increased the linalyl acetate, ß-caryophyllene, and trans-α-necrodyl acetate contents of the EOs, and decreased the amount of borneol and 1,8 cineol. The major active components of the EOs were tested, with thymol being the strongest anti-Phytomonas compound followed by carvacrol. Our study identified potential treatments against kinetoplastids.

Factores de riesgo que predisponen a la realizacion de hernioplastia de emergencia en paciente adulto del Hospital Militar Central post hernioplastia desde enero 2020 hasta julio 2022 / Risk factors that predispose to performing emergency hernioplasty in an adult patient at the Central Military Hospital after hernioplasty from January 2020 to July 2022

Objetivo: Determinar cuáles son los factores de riesgo mayormente relacionados a cirugia de emergencia por hernia inguinal en pacientes que acuden al Hospital Militar Central de enero 2020 a julio 2022. Métodos: Estudio analítico, observacional retrospectivo, transversal y cuantitativo. En cuanto a los datos del manejo quirurgico de hernia inguinal, fueron obtenidos de las historias clínicas y recopiladas en una base de datos del sistema interno de gestion Hospitalaria del Hospital Militar central. Se relacionaron estadisticas descriptivas como porcentajes, promedios y tablas de frecuencias. Resultados: En el Hospital Militar Central se establece una edad de frecuencia de hernia inguinal de 60 - 79 años se presentan en 34% se establece que existe cirugia de emergencia por hernia inguinal, de los 50 - 79 años en principalmente.Con respecto a la variable sexo se observo que el femenino representan el 10% y los masculinos se establecen en 90% de ellos que presentan el diagnostico de hernia inguinal.Los pacientes que presentan antecedentes de enfermedad pulmonar crónica está presente en el 9% , como factor de riesgo de tabaqiuismo se establecio que se encuentra presente en el 67% de los pacientes que se incluyeron en este estudio, dentro de los cuales 80% fueron intervenidos de emergencia para hernioplastia y un 20% fueron intervenidos quirurgicamente de manera electiva.

Objective: To determine which are the risk factors mostly related to emergency surgery for inguinal hernia in patients who attend the central military hospital from January 2020 to July 2022. Methods: Analytical, observational, retrospective, cross-sectional and quantitative study. Regarding the data on the surgical management of inguinal hernia, they were obtained from the medical records and compiled in a database of the internal hospital management system of the central military hospital. For the descriptive analyzes we worked with percentages, means and frequency tables, the associations with Pearson's chi square. The odds ratio (OR) with 95% confidence intervals (CI) was calculated as a scale of strength of association. Results. In the central military hospital, an age frequency of inguinal hernia of x0 - x0 years is established, they are presented in % and patients with 61 - 70 years are present in 54.5% of them, it is established that there is emergency surgery for inguinal hernia, of the 50 - 60 years in mainly With respect to the sex variable, it was observed that the female represent the % and the male are established in % of them that present the diagnosis of inguinal hernia Patients with a history of chronic lung disease is present in the %, as a risk factor for smoking it was established that it is present in the % of the patients included in this study, in addition to the occupational situation of mainly high-ranking personnel. of %, within which % underwent emergency surgery for hernioplasty and % underwent elective surgery.

Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness.

A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and cost-effectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation.

Avaliação do risco de suicídio entre alunos no início, meio e fim do curso de medicina de uma universidade no Rio de Janeiro / Suicide risk assessment among students at the beginning, in the middle and at the end of the medicine course of a university in the city of Rio de Janeiro ­ Brazil

Objetivo: Avaliar o risco de suicídio e a existência de comportamento suicida entre acadêmicos nos estágios inicial, intermediário e final do curso de Medicina de uma universidade particular e analisar os fatores de risco possivelmente associados à ideação suicida nessa população. Materiais e métodos: Foram analisados, em estudo transversal, 376 estudantes. Todos os participantes responderam questionário autopreenchível, por meio da plataforma eletrônica Google Forms, composto por 3 seções: perguntas sobre questões pessoais, perguntas do Questionário de Comportamento Suicida Revisado (Suicide Behavior Questionnaire Revised: SBQ-R) e do Inventário de Ideação Suicida Positiva e Negativa (Positive and Negative Suicide Ideation: PANSI). Resultados: 34% dos alunos eram do 1º ano, outros 34% do 3º ano e 32%, do 6º ano. 71,8% da população do estudo é composta pelo sexo feminino e 39,6% possui idade entre 21 e 24 anos. Na classificação de risco de suicídio segundo o PANSI, 31,7% dos estudantes apresentaram médio risco e 5,3%, alto risco. Na análise por etapa do curso, o 3º ano apresentou-se com maior porcentagem em alto risco (70,0%). De acordo com o SBQ-R, 37,2% dos estudantes da população total apresentaram comportamento suicida. Dentre as variáveis analisadas, orientação sexual, história de bullying na infância, conflito com responsáveis, história familiar de transtorno mental, uso de drogas ilícitas, história de violência sexual e ansiedade autorreferida foram consideradas como fatores de risco para suicídio na população total e na subanálise feita por ano de faculdade. Conclusão: A população do estudo apresenta aumento das taxas de ideação e comportamento suicida em relação a população geral. Assim, é necessária a implantação de medidas dentro das universidades para promover a saúde mental e diminuir aspectos estressantes sobre os acadêmicos. [au]

Objective : The purpose of this study is to assess the risk of suicide and the existence of suicidal behavior among academics in the early, intermediate and final stages of a private medical school, and also to analyze risk factors possibly associated with suicidal ideation in this population. Methods: This is a cross-sectional study with 376 medical students. All the participants answered a self-fillable questionnaire through the electronic platform Google Forms composed of 3 sections: questions about personal issues; questions of the Suicide Behavior Questionnaire Revised (SBQ-R); and of the Positive and Negative Suicide Ideation (PANSI) Inventory. Results: 34% of the students were in the 1st year of graduation, 34% in the 3rd year, and 32%, in the 6thyear. 71.8% of the population is female and 39.6% are between 21 and 24 years old. In the suicide risk classification according to PANSI, 31.7% of the students were in the medium risk group and 5.3% in high risk group. In the analysis per year, the 3rd year showed a greater percentage of high risk (70.0%). According to the SBQ-R classification of suicide risk, 37.2% of students out of the total population revealed suicidal behavior. Among the analyzed variables, sexual orientation, history of childhood bullying, domestic conflict, presence of mental disorders in family, use of illicit drugs, history of sexual violence and self-reported anxiety were considered as risk factors for suicide. The highlighted results revealed the same pattern when analyzed per year of college. Conclusion: The survey population has increased rates of suicidal negative ideation and behavior compared to the general population. Therefore, it is necessary to implement programs in colleges to promote a greater state of well-being and reduce stressful aspects in academics. [au]

Análisis del impacto presupuestal en Colombia de la prueba de HPV con genotipificación comparada con la citología / Budget impact analysis of primary screening with the HPV test and genotyping against conventional cytology in Colombia

Introducción. La detección del virus del papiloma humano mediante la combinación de la prueba de HPV y otras técnicas como la citología, ha demostrado su eficacia en el diagnóstico y tratamiento oportuno de lesiones asociadas con el cáncer de cuello uterino. Objetivo. Estimar el impacto presupuestal de la estrategia de detección temprana del HPV mediante la prueba de genotipificación combinada con la citología en comparación con la citología convencional, en mujeres de 30 a 65 años participantes en el programa de tamizaje de cáncer de cuello uterino en una Entidad Administradora del Plan de Beneficios en salud (EAPB) en Colombia. Materiales y métodos. Utilizando un árbol de decisiones y un modelo de Markov, se estimaron las implicaciones clínicas y los costos directos anuales de dos ciclos de tamizaje, diagnóstico y tratamiento, en una cohorte de mujeres. Las prevalencias de los resultados clínicos y los costos se tomaron de la base de datos de una EAPB y la información de la progresión, persistencia y regresión de los estados de salud provinieron del estudio ATHENA. Resultados. El esquema de tamizaje con la prueba de HPV, la genotipificación y la citología resultó en un ahorro de costos comparado con la citología convencional. El costo promedio por ciclo de tamizaje con la prueba de HPV se estimó en COP $129'201.363 y con la citología en COP $186'309.952, es decir, un ahorro de COP $57'108.589 (30,7 %). Conclusión. La implementación de la estrategia de tamizaje evaluada sugiere que habría ahorros derivados de la detección temprana de los estados de salud asociados con el desarrollo de cáncer de cuello uterino.

Introduction: The detection of the human papillomavirus (HPV) through the combination of the HPV test and other techniques such as cytology has impacted the detection and timely treatment of lesions associated with cervical cancer. Objective: To estimate the budgetary impact of the strategy of early detection of HPV with DNA test genotyping with reflex cytology versus conventional cytology in women aged 30 to 65 years attending the cervical cancer screening program at a health benefit managing entity in Colombia. Materials and methods: Using a decision tree and a Markov model, the clinical implications and direct costs of screening, diagnosis, and treatment were estimated in a cohort of women. The analysis considered two screening cycles and their annual costs. The data on the prevalence of clinical results and the costs were taken from the health managing entity. The information on the progression, persistence, and regression of the health states were taken from the ATHENA study. Results: The screening scheme with the HPV test, genotyping, and reflex cytology compared to conventional cytology was cost-saving. The average cost per screening cycle with the HPV test was estimated at COP $ 129,201,363 and with cytology at COP $ 186,309,952, i.e., a saving of COP $ 57,108,589 (30.7%). Conclusion: The implementation of the screening strategy under evaluation suggests prospective savings derived from the early detection of health states associated with the development of cervical cancer.

Efectividad de la regeneración tisular guiada en lesiones de furcación dentarias mandibulares

RESUMEN Introducción: La lesión de furcación se define como la reabsorción patológica del hueso interradicular, con la consiguiente exposición de la furca, el aumento del riesgo de pérdida ósea y la aparición de defectos óseos difíciles de tratar, los que pueden mejorar con el uso de membranas a través de la regeneración tisular guiada. Objetivo: Determinar la efectividad de la regeneración tisular guiada en lesiones de furca dentarias mandibulares en la Clínica Estomatológica Provincial "Mártires del Moncada", de Santiago de Cuba, durante el periodo septiembre de 2018 a diciembre de 2019. Método: Se realizó un estudio cuasi-experimental de intervención terapéutica con una muestra de 20 pacientes con lesiones de furca mandibulares, seleccionados por muestreo no probabilístico intencional. Se conformaron 2 grupos aleatorios por orden de llegada de 10 pacientes cada uno. Un grupo estudio recibió la terapia regenerativa y un grupo control fue tratado de forma convencional. Ambos, cumplieron con el criterio diagnóstico y fueron examinados antes y después de los tratamientos a los 6 meses y al año. Resultados: Al evaluar al año de tratamiento, en el grupo I, el sangrado desapareció y la profundidad al sondaje disminuyó al menos 1 mm en el 100% de los casos, la ganancia de inserción tipo I se logró en el 60% de ellos, con marcada superioridad sobre el grupo control. Conclusiones: El tratamiento con regeneración tisular guiada demuestra ser efectivo en los pacientes tratados con lesión de furcación a diferencia del tratamiento convencional.

ABSTRACT Introduction: The furcation lesion is defined as a pathological resorption of the interradicular bone, with the consequent exposure of the furcation, increased risk of bone loss and the onset of difficult-to-treat bone defects, which can be improved with the use of membranes through guided tissue regeneration. Objective: To determine the effectiveness of guided tissue regeneration in mandibular dental furcation lesions at the Clínica Estomatológica Provincial "Mártires del Moncada" in Santiago de Cuba, from Septembre 2018 to December 2019. Method: A quasi-experimental study of therapeutic intervention was carried out with a sample of 20 patients with mandibular furcation lesions and selected by non-probabilistic purposive sampling. One cluster (study group) received regenerative therapy and the other cluster (control group) was treated conventionally. Both met the diagnostic criteria and were examined before and after the treatments (6 months after treatment and 1 year after treatment). Results: after assessed the year of treatment, in group I (study group), bleeding disappeared and probing depth decreased by at least 1 mm in 100% of the cases, type I insertion gain was achieved in 60% of them, with a marked superiority in the control group. Conclusions: Treatment with guided tissue regeneration has been shown to be effective in patients treated with furcation lesions in contrast to conventional treatment.

RESUMO Introdução: A lesão de furca é definida como a reabsorção patológica do osso interradicular, com a conseqüente exposição da furca, aumento do risco de perda óssea e aparecimento de defeitos ósseos de difícil tratamento, que podem melhorar com o uso de membranas através da regeneração tecidual guiada. Objetivo: Determinar a eficácia da regeneração tecidual guiada em lesões de furca dentária mandibular na Clínica Estomatológica Provincial "Mártires del Moncada", Santiago de Cuba, durante o período de setembro de 2018 a dezembro de 2019. Método: Foi realizado um quasi-estudo experimental de intervenção terapêutica com amostra de 20 pacientes com lesões de furca mandibular, selecionados por amostragem não probabilística intencional. 2 grupos randomizados foram formados em ordem de chegada de 10 pacientes cada. Um grupo de estudo recebeu terapia regenerativa e um grupo controle foi tratado de forma convencional. Ambos preencheram os critérios diagnósticos e foram examinados antes e depois dos tratamentos aos 6 meses e 1 ano. Resultados: Ao avaliar um ano de tratamento, no grupo I, o sangramento desapareceu e a profundidade de sondagem diminuiu em pelo menos 1 mm em 100% dos casos, o ganho de inserção tipo I foi alcançado em 60% deles, com acentuada superioridade sobre o grupo de controle. Conclusões: O tratamento com regeneração tecidual guiada mostra-se eficaz em pacientes tratados com lesão de furca, ao contrário do tratamento convencional.

Labor docente asistencial de los profesionales de la estomatología en el enfrentamiento a la COVID-19 / Assistance teaching work of the stomatology professionals in the confrontation to COVID-19

Introducción: La COVID-19 es una enfermedad infecciosa causada por el virus SARS-CoV-2, de ahí que, específicamente en el caso de la estomatología, deben tomarse las medidas de bioseguridad imprescindibles para preservar la salud del personal médico y de los pacientes. Objetivo: Caracterizar la labor docente asistencial de los profesionales de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba durante la COVID-19. Métodos: Se realizó un estudio observacional, descriptivo y transversal, con recolección retrospectiva de la información entre marzo de 2020 y septiembre de 2021. Resultados: En la labor docente, de un total de 75 estudiantes de pregrado promovieron 41 en el examen estatal y 24 de posgrado; también cambiaron de categorías, tanto científica como docente, 15 profesores. En la labor asistencial predominaron las consultas de urgencias en los tres períodos (62,5 %), seguidas de las especializadas (28,5 %). Conclusiones: La labor docente asistencial en las diferentes etapas de la epidemia se caracterizó por alcanzar las diferentes promociones en los estudios de pregrado y de posgrado, así como por la atención a pacientes con urgencias estomatológicas, fundamentalmente provenientes de otras áreas de salud, siempre con las exigencias y el control sobre el cumplimiento del plan de medidas de bioseguridad.

Introduction: The COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, that is why, specifically in the case of stomatology, the indispensable biosecurity measures should be taken to preserve the health of the medical personnel and patients. Objective: To characterize the assistance teaching work of health professionals in Mártires del Moncada Provincial Teaching Stomatological Clinic from Santiago de Cuba during the COVID-19. Methods: An observational, descriptive and cross-sectional study was carried out, with retrospective collection of the information between March, 2020 and September, 2021. Results: In the teaching work, from a total of 75 pregraduate degree students promoted 41 in the state exam and 24 of postgraduate degree students; also 15 professors changed categories, either scientific or teaching. In the assistance work the urgencies visits prevailed in the three periods (62.5 %), followed by the specialized visits (28.5 %). Conclusions: The assistance teaching work in the different stages of the epidemic was characterized to achieve the different promotions in the pregraduate degree and postgraduate degree studies, as well as for the care to patients with stomatological emergencies, fundamentally coming from other health areas, always with the demands and control on the fulfillment of the biosecurity measures plan.

Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness

A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and costeffectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation. (AU)

Desarrollo de la periodontología en Santiago de Cuba / Development of periodontology in Santiago de Cuba

Se realizó una investigación de carácter histórico con el fin de exponer brevemente el desarrollo de la periodontología en Santiago de Cuba desde 1974 hasta la actualidad. Esta especialidad se ha venido fomentando de forma paulatina y hoy día cuenta con profesionales preparados integralmente para brindar una atención estomatológica especializada de calidad; también se vincula a la actividad docente-asistencial, con un claustro de 14 profesores altamente calificados. Puede afirmarse, entonces, que la formación del capital humano se ha cumplimentado por años -de acuerdo a la demanda poblacional y a los requerimientos del Sistema Nacional de Salud-, pues se ha contribuido, en gran medida, al perfeccionamiento y la preparación de estos especialistas con vistas a preservar, durante el presente y en el futuro, la salud periodontal de la población santiaguera.

An investigation of historical character aimed at briefly exposing the development of periodontology was carried out in Santiago de Cuba from 1974 to the present time. This specialty has been encouraging gradually and nowadays it has integrally prepared professionals to offer a specialized stomatological care with quality; it is also linked to the teaching-assistance activity, with a staff of 14 highly qualified professors. It can be affirmed then, that the human capital training has been fulfilled per years -according to the populational demand and the requirements of the National Health System-, because it has been contributed, in such an extent, to the improvement and preparation of these specialists aiming at preserving, during present and future times, the periodontal health of people from Santiago de Cuba.

Invasive Species as Hosts of Zoonotic Infections: The Case of American Mink (Neovison vison) and Leishmania infantum.

Leishmania infantum produces an endemic disease in the Mediterranean Basin that affects humans and domestic and wild mammals, which can act as reservoir or minor host. In this study, we analyzed the presence of the parasite in wild American minks, an invasive species in Spain. We screened for L. infantum DNA by PCR using five primer pairs: Two targeting kinetoplast DNA (kDNA), and the rest targeting the ITS1 region, the small subunit of ribosomal RNA (SSU) and a repetitive sequence (Repeat region). The detection limit was determined for each method using a strain of L. infantum and a bone marrow sample from an infected dog. PCR approaches employing the Repeat region and kDNA (RV1/RV2 primers) showed higher sensitivity than the other PCR methods when control samples were employed. However, only PCR of the Repeat region and nested PCR of SSU (LnSSU) detected the parasite in the samples, while the other three were unable to do so. The majority of the analyzed animals (90.1%) tested positive. American mink may act as an incidental host of the disease for other mammals and should be further investigated, not only for their negative impact on the local fauna, but also as carriers of zoonotic diseases.

Enfermedades perimplantarias: realidades y consecuencias / Peri-implantar diseases: realities and consequences

Introducción: La utilización de implantes dentales como método para reemplazar dientes perdidos ha demostrado ser un tratamiento con una tasa de éxito superior a 89 % en periodos de observación entre 10-15 años; no obstante, el número de implantes continúa incrementándose y, con ello, la prevalencia de enfermedades perimplantarias. Objetivo: Profundizar los conocimientos sobre la enfermedad perimplantaria y los tratamientos existentes. Desarrollo: Como resultado del avance en la rehabilitación, el uso de implantes dentales ha tomado un gran auge en los últimos años y, en particular, en la provincia de Santiago de Cuba; sin embargo, con el uso de esta técnica también se han incremento las complicaciones y los fracasos por múltiples razones. Conclusiones: La enfermedad perimplantaria representa un problema de salud con incidencia creciente, que requiere de un enfoque multidisciplinario, lo que depende de varios principios biológicos que es preciso respetar, tales como el diagnóstico, el plan terapéutico, la ejecución cuidadosa del proceder, el seguimiento posoperatorio y la carga apropiada del implante, que son factores importantes para lograr el resultado deseado.

Introduction: The use of dental implant as method to replace lost teeth has demonstrated to be a treatment with a success rate higher than 89 % in periods of observation between 10-15 years; nevertheless, the number of implants is still increasing and, with it, the prevalence of peri-implantar diseases. Objective: To deepen the knowledge on the peri-implantar disease and the existing treatments. Development: As a result of the advance in rehabilitation, the use of dental implants has taken a great boom in the last years and, in particular, in the province of Santiago de Cuba; however, with the use of this technique the complications and failures have also increased due to multiple reasons. Conclusions: The peri-implantar disease represents a health problem with growing incidence that requires a multidisciplinary approach, what depends on several biological principles that is necessary to respect, such as the diagnosis, the therapeutic plan, the careful implementation of the procedure, the postoperative follow up and the appropriate load of the implant that are important factors to achieve the result desired.

A Systematic Review (1990-2021) of Wild Animals Infected with Zoonotic Leishmania.

Leishmaniasis are neglected diseases caused by several species of Leishmania that affect humans and many domestic and wild animals with a worldwide distribution. The objectives of this review are to identify wild animals naturally infected with zoonotic Leishmania species as well as the organs infected, methods employed for detection and percentage of infection. A literature search starting from 1990 was performed following the PRISMA methodology and 161 reports were included. One hundred and eighty-nine species from ten orders (i.e., Carnivora, Chiroptera, Cingulata, Didelphimorphia, Diprotodontia, Lagomorpha, Eulipotyphla, Pilosa, Primates and Rodentia) were reported to be infected, and a few animals were classified only at the genus level. An exhaustive list of species; diagnostic techniques, including PCR targets; infected organs; number of animals explored and percentage of positives are presented. L. infantum infection was described in 98 wild species and L. (Viania) spp. in 52 wild animals, while L. mexicana, L. amazonensis, L. major and L. tropica were described in fewer than 32 animals each. During the last decade, intense research revealed new hosts within Chiroptera and Lagomorpha. Carnivores and rodents were the most relevant hosts for L. infantum and L. (Viannia) spp., with some species showing lesions, although in most of the studies clinical signs were not reported.

Terapia regenerativa con plasma rico en plaquetas en adultos afectados por lesiones endoperiodontales / Regenerative therapy with platelets rich-plasm in adults affected by endoperiodontal lesions

Introducción: El uso de plasma rico en plaquetas para la regeneración de defectos óseos periodontales constituye una terapéutica eficaz. Objetivo: Identificar la evolución de pacientes con lesiones endoperiodontales tratados con plasma rico en plaquetas. Métodos: Se realizó un estudio observacional, descriptivo y longitudinal de 11 adultos con enfermedad endoperiodontal y tratamiento endodóntico finalizado, atendidos en la consulta de Periodoncia y Medicina Regenerativa del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde febrero del 2018 hasta diciembre del 2019, quienes requerían intervención quirúrgica periodontal y cumplían los criterios para recibir plasma rico en plaquetas. A tal efecto, se analizaron variables sociodemográficas, clínicas, radiográficas y de respuesta terapéutica, las que fueron expresadas estadísticamente por medio de frecuencias absolutas y relativas y de la media aritmética. Resultados: En la serie resultaron más frecuentes, antes de la terapia, el sangrado al sondaje (81,8 %), las características alteradas de las encías (72,7 %), la movilidad dentaria (72,7 %) y las bolsas periodontales de 7 a 9 milímetros, con pérdida ósea en el tercio apical (63,6 %); todo lo cual se revirtió a menores porcentajes luego de 6 meses de tratamiento. Conclusiones: La evolución de los pacientes afectados por lesiones periodontales fue satisfactoria con el empleo del plasma rico en plaquetas, lo que se evidenció clínica y radiográficamente.

Introduction: The use of platelets rich-plasm for the regeneration of periodontal bony defects constitutes an effective therapy. Objective: To identify the clinical course of patients with endoperiodontal lesions treated with platelets rich-plasm. Methods: An observational, descriptive and longitudinal study of 11 adults with endoperiodontal disease and concluded endodontics treatment was carried out. They were assisted in the Periodontics and Regenerative Medicine Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from February, 2018 to December, 2019; who required periodontal surgical intervention and fulfilled the approaches to receive platelets rich-plasm. To such an effect, sociodemographic, clinical, radiographic and of therapeutic response variables were analyzed, which were statistically expressed by means of absolute and relative frequencies and of mean arithmetic. Results: In the series, bleeding on probing (81.8 %), altered characteristics of the gums (72.7 %), dental mobility (72.7 %) and 7 to 9 millimeters periodontal bags, with bony loss in the third apical (63.6 %) were more frequent before therapy; all of which was reverted to lower percentages after 6 months of treatment. Conclusions: The clinical course of the patients affected by periodontal lesions was satisfactory with the use of platelets rich-plasm, which was clinical and radiographically evidenced.