Principales características clínicas y epidemiológicas de pacientes con miocardiopatía periparto

Introducción: Las enfermedades cardiovasculares representan una causa importante de morbilidad y mortalidad durante la gestación, entre las que se destaca la miocardiopatía, que cursa como un síndrome de insuficiencia cardíaca. Objetivo: Caracterizar a pacientes con miocardiopatía periparto según variables clínicas y epidemiológicas de interés para la investigación. Métodos: Se realizó un estudio descriptivo y transversal de las 18 pacientes con diagnóstico de miocardiopatía periparto, asistidas en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba en el período comprendido desde octubre de 2015 hasta diciembre de 2022. Resultados: En la serie predominaron las pacientes mayores de 35 años de edad (edad promedio de 32,6 años), además de la descendencia africana (50,0 %), la hipertensión arterial crónica (44,4 %) y la multiparidad (8,9 %) como factores de riesgo y la insuficiencia del ventrículo izquierdo como manifestación clínica. La fracción de eyección de dicho ventrículo estuvo regularmente disminuida y la respuesta al tratamiento farmacológico fue satisfactoria en el total de la muestra. Conclusiones: La miocardiopatía en el periparto es de baja incidencia en este centro; sin embargo, por la gravedad que representa, se impone el diagnóstico temprano y la intervención del personal especializado para evitar complicaciones.

Introduction: Cardiovascular diseases represent an important cause of morbidity and mortality during pregnancy, cardiomyopathy is notable as a syndrome of heart failure. Objective: To characterize patients with peripartum cardiomyopathy according to clinical and epidemiological variables of interest for the investigation. Methods: A descriptive and cross-sectional study of 18 patients with diagnosis of peripartum cardiomyopathy was carried out. They were assisted at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba from October, 2015 to December, 2022. Results: In the series there was a prevalence of patients over 35 years (32.6 average age), besides African descendant (50.0 %), chronic hypertension (44.4 %) and multiparity (8.9 %) as risk factors and the left ventricle failure as clinical manifestation. The ejection fraction of this ventricle was regularly diminished and the pharmacological treatment response was satisfactory in all the sample. Conclusions: Peripartum cardiomyopathy is of low incidence in this center; however, due to its seriousness, the early diagnosis and the specialized staff intervention are necessary to avoid complications.

Transcriptomic and lipid profiling analysis reveals a functional interplay between testosterone and growth hormone in hypothyroid liver.

Preclinical and clinical studies suggest that hypothyroidism might cause hepatic endocrine and metabolic disturbances with features that mimic deficiencies of testosterone and/or GH. The absence of physiological interactions between testosterone and GH can be linked to male differentiated liver diseases. Testosterone plays relevant physiological effects on somatotropic-liver axis and liver composition and the liver is a primary organ of interactions between testosterone and GH. However, testosterone exerts many effects on liver through complex and poorly understood mechanisms. Testosterone impacts liver functions by binding to the Androgen Receptor, and, indirectly, through its conversion to estradiol, and cooperation with GH. However, the role of testosterone, and its interaction with GH, in the hypothyroid liver, remains unclear. In the present work, the effects of testosterone, and how they impact on GH-regulated whole transcriptome and lipid composition in the liver, were studied in the context of adult hypothyroid-orchiectomized rats. Testosterone replacement positively modulated somatotropic-liver axis and impacted liver transcriptome involved in lipid and glucose metabolism. In addition, testosterone enhanced the effects of GH on the transcriptome linked to lipid biosynthesis, oxidation-reduction, and metabolism of unsaturated and long-chain fatty acids (FA). However, testosterone decreased the hepatic content of cholesterol esters and triacylglycerols and increased fatty acids whereas GH increased neutral lipids and decreased polar lipids. Biological network analysis of the effects of testosterone on GH-regulated transcriptome confirmed a close connection with crucial proteins involved in steroid and fatty acid metabolism. Taken together, this comprehensive analysis of gene expression and lipid profiling in hypothyroid male liver reveals a functional interplay between testosterone and pulsed GH administration.

The global development of community psychology as reflected in the American Journal of Community Psychology.

This commentary presents a virtual special issue on the global growth of community psychology (CP), particularly, but not exclusively, as reflected in the American Journal of Community Psychology (AJCP). CP exists in at least 50 countries all over the world, in many of those for over 25 years. Yet, aside from several early Israeli articles, AJCP rarely published work from or about countries outside the US and Canada until the early 2000s, when the number of international articles began to rise sharply. The focus of CP developed differently in different continents. CP in Australia and New Zealand initially followed North America's emphasis on improving social service systems, but has since focused more on environmental and indigenous cultural and decolonial issues that are as salient in those countries as in North America, but have drawn much more attention. CP came later to most of Asia, where it also tended to follow the North American path, but starting in Japan, India, and Hong Kong and now in China and elsewhere, it is establishing its own way. The other two global hotspots for CP for over 40 years have been Europe and Latin America. The level and focus of CP in Europe varies in each country, with some focused on applied developmental psychology and/or community services and others advancing critical and liberation psychology. CP in Latin America evolved from social psychology, but like CP in Sub-Saharan Africa, is also more explicitly political due to a history of political oppression, social activism, and the limitations of individualistic psychology to focus on social change, overcoming poverty, and interventions by (not just for) community members. Despite those differences, CP literature over the past 23 years suggests an increasingly common interest in social justice, multinational collaborations, and decoloniality. There is still a need for more truly (bidirectional) cross-cultural, comparative work for mutual learning, sharing of ideas, methods, and intervention practices, and for CP to develop in countries and communities throughout the globe where it could have the greatest impact.

Effects of Fructose and Palmitic Acid on Gene Expression in Drosophila melanogaster Larvae: Implications for Neurodegenerative Diseases.

One of the largest health problems worldwide is the development of chronic noncommunicable diseases due to the consumption of hypercaloric diets. Among the most common alterations are cardiovascular diseases, and a high correlation between overnutrition and neurodegenerative diseases has also been found. The urgency in the study of specific damage to tissues such as the brain and intestine led us to use Drosophila melanogaster to study the metabolic effects caused by the consumption of fructose and palmitic acid in specific tissues. Thus, third instar larvae (96 ± 4 h) of the wild Canton-S strain of D. melanogaster were used to perform transcriptomic profiling in brain and midgut tissues to test for the potential metabolic effects of a diet supplemented with fructose and palmitic acid. Our data infer that this diet can alter the biosynthesis of proteins at the mRNA level that participate in the synthesis of amino acids, as well as fundamental enzymes for the dopaminergic and GABAergic systems in the midgut and brain. These also demonstrated alterations in the tissues of flies that may help explain the development of various reported human diseases associated with the consumption of fructose and palmitic acid in humans. These studies will not only help to better understand the mechanisms by which the consumption of these alimentary products is related to the development of neuronal diseases but may also contribute to the prevention of these conditions.

Zearalenone Does Not Show Genotoxic Effects in the Drosophila melanogaster Wing Spot Test, but It Induces Oxidative Imbalance, Development, and Fecundity Alterations.

Zearalenone (ZEN) is a non-steroidal mycoestrogen produced by the Fusarium genus. ZEN and its metabolites compete with 17-beta estradiol for cytosolic estrogen receptors, causing reproductive alterations in vertebrates. ZEN has also been associated with toxic and genotoxic effects, as well as an increased risk for endometrial adenocarcinomas or hyperplasia, breast cancer, and oxidative damage, although the underlying mechanisms remain unclear. Previous studies have monitored cellular processes through levels of transcripts associated with Phase I Xenobiotic Metabolism (Cyp6g1 and Cyp6a2), oxidative stress (hsp60 and hsp70), apoptosis (hid, grim, and reaper), and DNA damage genes (Dmp53). In this study, we evaluated the survival and genotoxicity of ZEN, as well as its effects on emergence rate and fecundity in Drosophila melanogaster. Additionally, we determined levels of reactive oxygen species (ROS) using the D. melanogaster flare and Oregon R(R)-flare strains, which differ in levels of Cyp450 gene expression. Our results showed that ZEN toxicity did not increase mortality by more than 30%. We tested three ZEN concentrations (100, 200, and 400 µM) and found that none of the concentrations were genotoxic but were cytotoxic. Taking into account that it has previously been demonstrated that ZEN administration increased hsp60 expression levels and apoptosis gene transcripts in both strains, the data agree with an increase in ROS and development and fecundity alterations. Since Drosophila lacks homologous genes for mammalian estrogen receptors alpha and beta, the effects of this mycotoxin can be explained by a mechanism different from estrogenic activity.

Variation in resistance to oxidative stress in Oregon-(R)R-flare and Canton-S strains of Drosophila melanogaster.

All aerobic organisms are susceptible to damage by reactive oxygen species (ROS). ROS-induced damage has been associated with aging and diseases such as metabolic syndrome and cancer. However, not all organisms develop these diseases, nor do they age at the same rate; this is partially due to resistance to oxidative stress, a quantitative trait attributable to the interaction of factors including genetics and environmental. Drosophila melanogaster represents an ideal system to study how genetic variation can affect resistance to oxidative stress. In this work, oxidative stress (total and mitochondrial ROS), antioxidant response, and Cap 'n' collar isoform C and Spineless gene expression, one pesticide resistant (Oregon R(R)-flare) and wild-type (Canton-S) strains of D. melanogaster, were analyzed to test resistance to basal oxidative stress. ROS, catalase, and superoxide dismutase were determined by flow cytometry, and Cap 'n' collar isoform C and Spineless expression by qRT-PCR. The intensity of oxidative stress due to the pro-oxidant zearalenone in both was evaluated by flow cytometry. Data confirm expected differences in oxidative stress between strains that differ in Cyp450s levels. The Oregon (R)R-flare showed greater ROS, total and mitochondrial, compared to Canton-S. Regarding oxidative stress genes expression Cap 'n' collar isoform C and Spineless (Ss), Oregon R(R)-flare strain showed higher expression. In terms of response to zearalenone mycotoxin, Canton-S showed higher ROS concentration. Our data show variation in the resistance to oxidative stress among these strains of D. melanogaster.

Genotoxicity and cytotoxicity evaluation of two thallium compounds using the Drosophila wing somatic mutation and recombination test.

Thallium (Tl) is a heavy and toxic metal and a byproduct of several human activities, such as cement production, mining, and coal combustion. Thallium is found in fruits, vegetables, and animal fodder with high Tl contamination; therefore, it is an environmental pollution issue and a toxicological contamination problem for human beings and other organisms when exposed to it. The mutagenic potential of Tl and its compounds is controversial, and there are few in vivo studies on its effects. We conducted the animal bioassay Drosophila wing somatic mutation and recombination test (SMART) to test for genotoxicity and assessed the genotoxic effects of Tl acetate (TlCH3COO) and Tl sulfate (Tl2SO4) on Drosophila melanogaster. Third instar larvae from the SMART standard cross (ST) were fed Tl acetate [0.2, 2, 20, 200, 600 and 1200 µM] and Tl sulfate [0.2, 2, 20, 200, and 600 µM]. Hexavalent chromium [CrO3, 500 µM] served as the positive control, and Milli-Q water served as the negative control. Only the high Tl2SO4 [600 µM] concentration resulted in genotoxicity with 87.6% somatic recombination, and both salts disrupted cell division of wing imaginal disc cells, showing the expected cytotoxic effects. Genotoxic risks due to high metal levels by bioaccumulation of Tl+1 or its compounds require further evaluation with other in vivo and in vitro assays.

A cross-sectional study on the level of severity of dental caries in adults / Estudio transversal sobre nivel de severidad de caries dental en adultos

Introduction: Oral diseases affect some 3.9 billion people worldwide, the most prevalent are dental caries, gingivitis, and periodontitis. Untreated dental caries lesions affect 35% of the population. Objective: To determine the level of severity of dental caries lesions in adults treated at public dental services in the cities of Asunción and Pirayú, Paraguay, in 2 017. Material and Methods: Sociodemographic and clinical variables of oral health status were evaluated by means of a cross-sectional study using consecutive sampling. Two dentists were calibrated to perform the oral examination. Caries experience was evaluated using the DMF-T index. The Chi square test and Fisher's exact test were applied, with a confidence level of 95%. Results:333 subjects with a mean age of 35 years participated in the study, 77.2% were females, and 64.0% did not have access to private health care services. The DMF-T index was 11.43 (SD=6.7); 12.6% obtained a very low level, 35.7% low level, 41.7% had a medium level, and 9.9% had a high level in the DMF-T index. The DMF-T index was significantly higher in females (p=0.001), in the age range of 50 to 59 years (p<0.001), in those who did not have access to private health services (p=0.008), in those who reported a negative self-evaluation of their oral health (p=0.04), in those with a normal molar ratio (p=0.023) and a very severe aesthetic index (p<0 . 0 01). Conclusion: The general level of severity of global caries was medium and associated with sociodemographic and clinical variables.

Introducción: Las enfermedades orales afectan a 3,9 billones de personas a nivel mundial, siendo las más prevalentes la caries dental, la gingivitis y periodontitis; afectando al 35% de la población las lesiones de caries dental no tratadas. Objetivo: Determinar el nivel de severidad de lesiones de caries dental en adultos que acuden a servicios odontológicos públicos en las ciudades de Asunción y Pirayú, en el Paraguay, en el año 2017. Material y Métodos: Estudio transversal donde se evaluaron variables sociodemográficas y clínicas del estado de salud oral. El muestreo fue de casos consecutivos. Dos odontólogos fueron calibrados para realizar el examen oral. La experiencia de caries fue evaluada mediante el índice CPO-D. Se aplicaron las pruebas Chi cuadrado y Test exacto de Fisher, con un nivel de confianza del 95%. Resultados: Participaron del estudio 333 sujetos, con edad promedio de 35 años, el 77,2% mujeres y el 64,0% no tenía acceso a servicios de salud privado. El índice CPO-D fue de 11,43 (DE = 6,7). El 12,6% obtuvo un nivel muy bajo, el 35,7% nivel bajo, el 41,7% tuvo nivel medio y el 9,9% nivel alto del CPO-D, siendo significativamente más elevado en mujeres (p= 0, 0 01), en la edad de 50 a 59 años (p<0,001), en aquellos que no cuentan con acceso a servicios de salud privado (p=0,008), los que relataron una autoevaluación negativa de su salud bucal (p=0,04), los que tenían una relación molar normal (p=0,023) e índice de estética muy grave (p<0, 0 01). Conclusión: El nivel general de severidad de caries global fue medio, se asoció con variables sociodemográficas y clínicas.

CLARITY with neuronal tracing and immunofluorescence to study the somatosensory system in rats.

BACKGROUND: The CLARITY technique enables researchers to visualize different neuronal connections along the nervous system including the somatosensory system. NEW METHOD: The present work describes the antero-lateral and dorsal column pathways until the thalamic and cortical stations, as well as descending oxytocinergic and vasopressinergic innervations by means of combined CLARITY, neuronal tracing, and immunofluorescence techniques. We used male Sprague-Dawley rats of 13, 30, and 60 days. RESULTS: The main results are as follows: A) CLARITY is a reliable technique that can be combined with fluorescent neuronal tracers and immunofluorescence techniques without major procedure modifications; B) at spinal level, some primary afferent fibers were labeled by CGRP, as well as the presence of neuronal populations that simultaneously project to the gracile and ventral posterolateral thalamic nuclei; C) corticothalamic connections were visible when retrograde tracers were injected at thalamic level; D) oxytocin receptors were expressed in the spinal dorsal horn by GABAergic-positive neurons, reinforcing previous outcomes about the possible mechanism for oxytocin blocking the primary afferent sensory input. COMPARISON WITH EXISTING METHODS AND CONCLUSIONS: The CLARITY technique lets us observe in a transparent way the entire processed tissue compared with classical histological methods. CLARITY is a potentially useful tool to describe neuroanatomical structures and their neurochemical stratus.

Educational intervention in caregivers and its impact on elderly oral hygiene / Intervención educativa en cuidadores y su impacto en la higiene bucal de adultos mayores institucionalizados

Objective: To develop an educational intervention in caregivers and to know its impact on oral hygiene of older adults. Materials and methods: An intervention study was conducted with pre- and post-test design in a group of older adults of a rest house in Guadalajara, Jalisco, Mexico, 2018. The oral hygiene of older adults was evaluated through the simplified index of oral hygiene. Once a week, an educational intervention was performed on oral health issues in caregivers. Results: 6 older adults participated, all of them women (100%). The mean age was 82.50 years (± 9.7). The impact of the intervention improved the level of oral hygiene of older adults by 33.72%. Conclusions: Educational intervention in older caregivers achieved significant changes in oral hygiene. Future intervention programmes should include assessments in the following months to assess long-term effects.

Objetivo: Desarrollar una intervención educativa en cuidadores y conocer su impacto en la higiene bucal de los adultos mayores institucionalizados. Materiales y métodos: Se realizó un estudio de intervención con diseño de pre y postprueba en un grupo de adultos mayores institucionalizados de una casa de descanso en Guadalajara, Jalisco, México, 2018. La higiene bucal de los adultos mayores se evaluó por medio del Índice de Higiene Oral Simplificado. Una vez a la semana se realizaba una intervención educativa sobre temas de salud bucal en los cuidadores. Resultados: Participaron 6 adultos mayores de los cuales todos eran mujeres (100%). La edad media fue de 82.50 años (± 9.7). El impacto de la intervención mejoró el nivel de higiene bucal de los adultos mayores en un 33.72%. Conclusiones:La intervención educativa en los cuidadores de adultos mayores logró cambios significativos en la higiene bucal. Dentro de los futuros programas de intervención debería incluirse el hacer evaluaciones en los siguientes meses para valorar los efectos a largo plazo.

Association between self-assessment and clinical oral health status in adults, Paraguay / Asociación entre la autoevaluación y el estado clínico de salud oral en adultos, Paraguay

Introduction: Oral health can be defined as the absence of pathologies and disorders that affect the stomatognathic system. Objetives: This study aimed to determine the characteristics of self-assessment oral health status, in the clinical experience of dental caries, periodontal status, periodontal fixation loss and to investigate the association between self-reported and clinical oral health status among Paraguayans adults during early 2017. Material and Methods: The design is cross-sectional. Two dentists carried out the oral examinations following the recommendations of the World Health Organization (WHO). Results: There were 333 adult participants with a mean age of 35 ± 13 years. Most (77.2%) of the participants were female. Missing teeth (5.32±6), filled teeth (3.56±4), and decayed teeth (2.55±3) were also detected. Almost half (48.0%) of participants had dental calculus, while 5.8% had a periodontal pocket and 48.6% periodontal fixation loss. The self-perception of oral health was poor in 12.3% of participants, fair in 29.8%, normal in 31.8%, good in 16.2%, and excellent in 9.9%. Oral health self-assessment was positive in 58.0% and negative in 42.0%. A statistically significant difference was found when comparing the DMFT index according to self-perception of oral health, the score being higher in those who had negative self-perception; obtaining similar results in the decayed component. Conclusion: Negative oral health self-perception was associated with a high DMFT index, of this, the decayed component was the only one that presented statistically significant differences.

Introducción: La salud bucodental puede ser definida como la ausencia de patologías y trastornos que afectan el sistema estomatognático. Objetivos: Este estudio tuvo como objetivo determinar las características de la autoevaluación del estado de salud bucal, en la experiencia clínica de la caries dental, el estado periodontal, la fijación de la pérdida periodontal e investigar la asociación entre el estado de salud bucal autoinformado y clínico entre los adultos paraguayos a principios de 2017. Material y Métodos: El diseño es transversal. Dos odontólogos fueron calibrados para el examen bucal, siguiendo las recomendaciones de la Organización Mundial de la Salud (OMS). Resultados: Participaron 333 sujetos, el promedio de edad fue de 34.93 (DE=12.64) años, 77.2% eran mujeres. El 21.1% de las piezas dentarias estaban perdidas, el 12.2% obturadas y el 9.2% cariadas. El 48.0% presentó cálculo dental, 5.8% el bolsa periodontal y el 48.6% pérdida de fijación. La autopercepción de salud bucal fue para el 12.3% pobre, el 29.8% regular, el 31.8% normal, el 16.2% buena y el 9.9% excelente. Tuvieron una autoevaluación de su salud oral positiva el 58.0% y negativa el 42.0%. Se encontró diferencia estadísticamente significativa al comparar el DMFT index según la autopercepción de salud oral, siendo mayor el puntaje en los negativos; obteniéndose resultados similares con el componente cariado. Conclusión: La autopercepción de salud oral negativa se asoció con un elevado DMFT index, de este, el componente cariado fue el único que presentó diferencias estadísticamente significativas.

The impact of frailty in aortic valve surgery.

BACKGROUND: Frailty is a geriatric syndrome that diminishes potential functional recovery after any surgical procedure. Preoperative surgical risk assessment is crucial to calibrate the risk and benefit of cardiac surgery. The aim of this study was to test usefulness of FRAIL Scale and other surgical-risk-scales and individual features of frailty in cardiac aortic valve surgery. METHODS: Prospective study. From May-2014 to February-2016, we collected 200 patients who underwent aortic valve replacement, either surgically or transcatheter. At 1-year follow-up, quality of life measurements were recorded using the EQ-5D (EuroQol). Univariate and multivariate analyses correlated preoperative condition, features of frailty and predicted risk scores with mortality, morbidity and quality of life at 1 year of follow-up. RESULTS: Mean age 78.2y, 56%male. Mean-preoperative-scores: FRAIL scale 1.5(SD 1.02), STS 2.9(SD 1.13), BI 93.8(SD 7.3), ESlog I 12.8(SD 8.5) and GS 7.3 s (SD 1.9). Morbidity at discharge, 6 m and 1 year was 51, 14 and 28%. Mortality 4%. Survival at 6 m/ 1-y was 97% / 88%. Complication-rate was higher in TAVI group due to-vascular complications. Renal dysfunction, anemia, social dependence and GS slower than 7 s were associated with morbidity. On multivariate analysis adjusted STS, BI and GS speed were statistically significant. Quality of life at 1-year follow-up adjusted for age and prosthesis type showed a significant association with STS and FRAIL scale scores. CONCLUSIONS: Frailty increases surgical risk and is associated with higher morbidity. Preoperative GS slower 7 s, and STS and FRAIL scale scores seem to be reliable predictors of quality of life at 1-year follow-up.

Validation of the oral health impact profile in spanish for paraguayan adults (OHIP-14Py) / Validación del perfil de impacto de salud oral en español para adultos paraguayos (OHIP-14Py)

Objetive: The objective of this study was to culturally adapt and validate the short version of the Oral Health Impact Profile (OHIP) instrument into Spanish for use by Paraguayan adults who attended dental clinics. Material and methods: The design was a cross-sectional observational study based on Classical Test Theory (CTT). The original English language version was subjected to a forward-backward translation processes; a calibration of the examiners and pilot test were performed. The questionnaire was applied by dentists through interviews; the same dentists also made the oral examination. The dimensionality of the questionnaire was evaluated using Confirmatory Factorial Analysis (CFA). The total and item-total internal consistencies were evaluated using Cronbach's alpha. To evaluate the discriminating validity, the Mann-Whitney and Kruskal-Wallis tests were used. Spearman's correlation analysis was used to measure convergent validity for total-dimension, self-assessment of oral health, and dental caries experience index with the DMFT Index. Results: Three-hundred-thirty-three patients participated in the study. The CFA indicates the Paraguayan's OHIP (OHIP-14Py) is considered a multi-dimensional instrument. The Cronbach's alpha values were appropriate for both the total (α=0.061) and for item total (α=0.80) correlation. The OHIP-14Py discriminated for the variable self-perception of oral health (p=0.001), symptoms of the temporomandibular joint (TMJ) (p=0.026), need of upper dental prosthesis (p=0.001), need of lower dental prosthesis (p=0.001), and ≥20 teeth healthy (p=0.001). For measuring convergent validity, all coefficients of correlation were statistically significant (p=0.001). Conclusion: The OHIP-14Py is a reliable and valid questionnaire for the evaluation of oral health-related quality of life in Paraguayan adults.

Objetivo: El objetivo del estudio fue adaptar culturalmente y validar el instrumento Perfil de Impacto de Salud Oral (OHIP) en la versión corta de 14 ítems en español, en adultos paraguayos que acudieron a consultorios odontológicos durante el primer trimestre del año 2017. Material y Métodos: El diseño del estudio fue transversal, basado en la Teoría Clásica de los Test (TCT). La versión original en inglés fue sometida al proceso de traducción-retraducción. Se realizó calibración de exa-minadores y prueba piloto. El cuestionario fue aplicado por odontólogos mediante entrevista, quienes además realizaron examen bucal. Se evaluó la dimensionalidad del cuestionario mediante el Análisis Factorial Confirmatorio (AFC). La consistencia interna fue evaluada mediante Alfa de Cronbach (α) para total e ítem-total. Se evaluó la validez discriminante utilizando las pruebas de Mann-Whitney y Kruskal-Wallis, validez convergente utilizando correlación de Spearman para total-dominio, autoevaluación del estado de salud oral e índice de experiencia de caries CPO-D. Resultados: Participaron del estudio 333 pacientes de 18 a 59 años. El AFC se consideró al instrumento multidimensional. Para el total α=0,861 y para correlación ítem-total al suprimir cada elemento α=0,80 siendo todos adecuados. Discriminó para las variables autoevaluación de salud bucal (p=0,001), síntomas de ATM (p=0,026), necesidad de prótesis superior (p=0,001) e inferior (p=0,001) y ≥20 dientes sanos (p=0,001). Todos los coeficientes de correlación de Spearman resultaron estadísticamente significativos con p=0,001. Conclusión: El OHIP-14Py es un cuestionario fiable y válido para la evaluación de la calidad de vida relacionada con la salud oral en adultos paraguayos.

Oxytocin prevents neuronal network pain-related changes on spinal cord dorsal horn in vitro.

Recently, oxytocin (OT) has been studied as a potential modulator of endogenous analgesia by acting upon pain circuits at the spinal cord and supraspinal levels. Yet the detailed action mechanisms of OT are still undetermined. The present study aimed to evaluate the action of OT in the spinal cord dorsal horn network under nociceptive-like conditions induced by the activation of the N-methyl-d-aspartate (NMDA) receptor and formalin injection, using calcium imaging techniques. Results demonstrate that the spontaneous Ca2+-dependent activity of the dorsal horn cells was scarce, and the coactivity of cells was mainly absent. When NMDA was applied, high rates of activity and coactivity occurred in the dorsal horn cells; these rates of high activity mimicked the activity dynamics evoked by a neuropathic pain condition. In addition, although OT treatment increased activity rates, it was also capable of disrupting the conformation of coordinated activity previously consolidated by NMDA treatment, without showing any effect by itself. Altogether, our results suggest that OT globally prevents the formation of coordinated patterns previously generated by nociceptive-like conditions on dorsal horn cells by NMDA application, which supports previous evidence showing that OT represents a potential therapeutic alternative for the treatment of chronic neuropathic pain.

Respuesta anticlases mayores de anticuerpos humanos séricos en antisueros hiperinmunes obtenidos en carneros / Characterization of hyperimmune anti-human serum produced in sheep

Introducción: La inmunoelectroforesis es una técnica de precipitación que permite la caracterización de muestras biológicas complejas. En el Departamento de Inmunología del Instituto de Ciencias Básicas y Preclínicas Victoria de Girón se cuenta con un antisuero hiperinmune obtenido por inmunizaciones de carneros contra proteínas totales séricas humanas y con otro antisuero anti IgA de calostro humano. Objetivo: Identificar IgG, IgM e IgA en suero humano y determinar respuesta anti IgM humana en el antisuero anti IgA de calostro humano obtenido en carnero. Material y Métodos: Se realizó un estudio observacional, descriptivo y transversal desde noviembre de 2017 hasta junio de 2018. Se desarrolló una inmunoelectroforesis de suero humano normal empleando el antisuero hiperinmune. Resultados: Se identificaron IgG, IgM e IgA además de albúmina y otras fracciones proteicas y se determinó respuesta anti IgM humana en el antisuero anti IgA de calostro humano obtenido en carnero. Conclusiones: Este trabajo permitió identificar y determinar la respuesta anticlases mayores de inmunoglobulinas en la muestra de estudio(AU)

Introduction: Immunoelectrophoresis is a precipitation technique that allows the characterization of complex biological samples. The Immunology Department of the Institute of Basic and Pre-Clinical Sciences Victoria de Girón has a hyperimmune antiserum obtained by immunization of sheep against human serum total proteins and it also has an anti-human IgA antiserum obtained from human colostrum. Objective: The aim of this study was to identify IgG, IgM and IgA in human serum and to determine response to anti-human IgM in human colostral IgA with antiserum obtained in sheep. Material and Methods: An observational descriptive cross-sectional study was conducted from November 2017 to June 2018. Immunoelectrophoresis of normal human serum was performed using hyperimmune antiserum. Results: These procedures allowed to identify IgG, IgM and IgA in addition to albumin and other protein fractions and to determine response to anti-human IgM in human colostral IgA with antiserum obtained in sheep. Conclusions: This work allowed us to identify and determine significant anti-class responses of immunoglobulins in the sample studied(AU)

Resilience, Coloniality, and Sovereign Acts: The Role of Community Activism.

Puerto Rico has been a U.S. colony since 1898. For the past decades, it has been mired in public debt, social problems, and ineffective and corrupt governance. In 2017, the island was hit by hurricanes which devastated our country. After the event, the term "resilience" became ubiquitous. Labeling Puerto Ricans' capacity to tolerate misfortune and suffering "resilient" gave people a false sense of hope and offered government a pretext to postpone or inequitably dispense aid. So-called "resilience" also allowed Puerto Ricans to avoid the impact of colonialism and coloniality on pre-existing conditions which hurricanes accentuated. In this context, community activism played a major role. Community organizations initially provided aid and generated chains of solidarity. They initiated "sovereign acts" which are mostly guided by principles and values espoused by community psychology. Thus, we have a duty to contribute to efforts which can promote liberating our island from colonialism and coloniality.

Genotoxicity assessment of four novel quinazoline-derived trypanocidal agents in the Drosophila wing somatic mutation and recombination test.

Chagas disease, caused by the protozoan Trypanosoma cruzi, has increased in the world due to migration, travelling and climate change; at present, the principal problem is that common trypanocidal agents have resulted in toxic or inconvenient side effects. We tested for genotoxicity in the standard (ST) and high bioactivation (HB) crosses of Drosophila wing somatic mutation and recombination test, four novel trypanocidal agents derived from 2, 4, 6-triaminquinazoline (TAQ): 2,4-diamino-6 nitro-1,3 diazonaftalene (S-1QN2-1), 2,4-diacetamino-6-amino 1,3 diazonaftalene (D-1), N6-(4,methoxybenzyl)quinazoline-2,4,6-triamine (GHPM) and N6-[4-(trifluoromethoxy)benzyl]quinazoline-2,4,6-triamine (GHPMF) at 1.9, 3.9, 7.9 and 15 µM, respectively. Also, high-pressure liquid chromatography (HPLC) analysis was run to determine the remanence of either drug in flare, and Oregon R(R)-flare flies emerged from treated larvae. S-1QN2-1 showed genotoxicity only in the ST cross, increasing the small, large and total spot frequencies at all concentrations and twin spots only at 1.9 µM; D-1 and GHPM showed significant increments of large spots only at 15 µM in the ST cross; GHPMF was not genotoxic at any concentration or either cross. In the mwh clones accumulated distribution frequencies analysis, associated with disrupted cell division, S-1QN2-1 caused alterations in the ST cross at all concentrations but only at 15 µM in the HB cross; D-1 caused alterations at 3.9, 7.9 and 15 µM in the ST cross and at 1.9 and 15 µM in the HB cross; GHPM caused alterations at 7.9 and 15 µM in the ST cross and also at 1.9, 3.9 and 7.9 µM in the HB cross; GHPMF caused those alterations at all concentrations in the ST cross and at 1.9, 3.9 and 7.9 µM in the HB cross. The HPLC results indicated no traces of either agent in the flare and Oregon R(R)-flare flies. We conclude that S-1QN2-1 is clearly genotoxic, D-1 and GHPM have an unclear genotoxicity and GHPMF was not genotoxic; all quinazoline derivatives disrupted cell division. GHPMF is a good candidate to be tested in other genotoxicity and cytotoxic bioassays. The differences in the genotoxic activity of these trypanocidal agents are correlated with differences in their chemical structure.

Chemical Characteristics, Therapeutic Uses, and Legal Aspects of the Cannabinoids of Cannabis sativa: A Review

Abstract Marijuana (Cannabis sativa) is an important annual medicinal plant that belongs to the Cannabaceae family. It contains 421 substances of 18 chemical types-the most significant compound is δ-9-tetrahydrocannabinol, which causes several effects, both in the Central Nervous System and in several peripheral locations in the organism. The objectives of this scientific review are to mention the anatomical distribution, chemical characteristics and biosynthesis of cannabinoids, as well as its actions mechanisms. The endogenous cannabinoid system, the therapeutic properties of C. sativa and its action on the nociceptive control are described. Finally, the modulators of the cannabinoid system in clinical use are indicated, together with marijuana legalization benefits.

Vacuna antitetánica adyuvada en alúmina en inmunización simultánea por vías mucosa y parenteral / Alum adjuvant tetanus vaccine in simultaneous immunization by mucosal and parenteral routes

El tétanos es causado por Clostridium tetani, bacteria Gram+ esporulada que produce una potente neurotoxina. Las vacunas parenterales producen IgG antitoxina tetánica (anti TT) protectores en múltiples dosis inductoras y de reactivación; vax-TET® es una vacuna cubana parenteral adsorbida en alúmina. La IgAS (secretora), principal anticuerpo protector mucoso, sólo es inducida por la vía mucosa. La vía oral, la inducción de IgA y su papel protector no han sido exploradas. SinTimVaS se aplica por vía mucosa y parenteral simultánea que induce IgG sistémica similares a la vía parenteral y adiciona de respuesta de IgA mucosa. Evaluamos el efecto de vax-TET® aplicado en SinTimVaS en ratones Balb/c y exploramos la influencia del adyuvante sobre la inducción de IgA anti TT. SinTimVaS indujo similares respuestas de IgG anti TT séricas que dos dosis de vax-TET® intramusculares; pero superiores a una dosis. Tres dosis de vax-TET® orales no indujeron IgG anti TT sérica, mientras que la adyuvación con el adyuvante Finlay Cocleato 1 (AFCo1) sí la indujeron. No se logró determinar la inducción de IgA anti TT mucosa con ninguna de las formulaciones adjuvadas con alúmina; pero si con la formulación AFCo1+TT. Podemos concluir que vax-TET® en SinTimVaS funcionó de forma similar a la inmunización parenteral establecida, por lo que sería posible reducir los esquemas multidosis con formulaciones de adyuvantes más potentes y se confirma que se requieren potentes adyuvantes para inducir IgA mucosa(AU)

Tetanus is caused by Clostridium tetani, a sporulated Gram+ bacterium that produces a potent neurotoxin. Parenteral vaccines produce protective tetanus antitoxin (anti TT) IgG in multiple induction and reactivation doses; vax-TET® is a Cuban parenteral vaccine adsorbed onto alumina. IgAS (secretory), the main mucosal protective antibody, is only induced by the mucous membrane. The oral route, the induction of IgA and its protective role have not been explored. SinTimVaS is applied by simultaneous mucosal and parenteral route that induces systemic IgG similar to the parenteral route and adds an IgA mucosal response. We evaluated the effect of vax-TET® applied in SinTimVaS in Balb/c mice and we explored the influence of adjuvant on the induction of anti-TT IgA. SinTimVaS induced similar serum anti TT IgG responses to two intramuscular doses of vax-TET®; but higher than one dose. Three doses of oral vax-TET® did not induce serum anti-TT IgG, whereas adjuvanted with adjuvant Finlay Cocleate 1 (AFCo1) did induce it. It was not possible to determine the IgA anti-TT mucous induction with any of the formulations adjuvanted with alumina; but with the formulation AFCo1 + TT it was induced. We can conclude that vax-TET® in SinTimVaS worked in a similar way to the established parenteral immunization, so it would be possible to reduce the multi-dose vaccination schemes with more potent adjuvant formulations and it is confirmed that powerful adjuvants are required to induce mucosal IgA(AU)

Necesidades de aprendizaje de médicos de atención primaria sobre reperfusión coronaria en el infarto agudo del miocardio / Learning necessities of primary care doctors on coronary reperfusion in the acute myocardial infarction

Introducción: el conocimiento sobre reperfusión coronaria en el infarto agudo del miocardio con elevación del segmento ST en el nivel primario de atención es de extraordinaria importancia para disminuir las complicaciones y la mortalidad. Objetivo: determinar las necesidades de aprendizaje de médicos de atención primaria sobre reperfusión coronaria en el infarto agudo del miocardio. Método: se realizó un estudio descriptivo de 65 galenos que laboraban en 5 policlínicos principales de urgencias de Santiago de Cuba en noviembre del 2017, para lo cual se aplicó una encuesta con variables de interés, que se calificó según metodología de evaluación y estándar previamente establecida por el equipo de trabajo. Resultados: del total de preguntas, solo una (5,9 por ciento) cumplió con el estándar de más de 70 por ciento de médicos con respuestas adecuadas; los años de experiencia y haber recibido adiestramiento influyeron positivamente en el número de dichas respuestas. La falta de capacitación fue la causa por la cual no se aplicó el tratamiento, y la planificación de esta, así como la creación de algoritmos de trabajo resultaron las medidas más propuestas por los galenos. Ninguno de ellos refirió sentirse adiestrado correctamente. Conclusiones: los médicos que laboraban en los 5 policlínicos principales de urgencias mostraron necesidades de aprendizaje y capacitación sobre el proceso de reperfusión coronaria.

Introduction: the knowledge on coronary reperfusion in the acute myocardial infarction with elevation of the ST segment in the primary care level is of extraordinary importance to decrease complications and mortality. Objective: to determine the necessities of doctors from primary care on coronary reperfusion in the acute myocardial infarction. Method: a descriptive study of 65 physicians who worked in 5 main polyclinics for emergencies of Santiago de Cuba was carried out in November, 2017 for which a survey with variables of interest was applied which was qualified according to evaluation methodology and previously established standard by the working team. Results: of all questions, only one (5.9 percent) fulfilled the standard of more than 70 percent of doctors with appropriate responses; the years of experience and receiving a previous training influenced positively in the number of these responses. The lack of training was the cause for which the treatment was not applied, and its planning, as well as the creation of working algorithms were the measures mostly proposed by the physicians. None of them referred to be correctly trained. Conclusions: doctors who worked in the 5 main emergency polyclinics showed learning necessities and training on the management for coronary reperfusion.