The colonic polyphenol catabolite dihydroferulic acid (DHFA) regulates macrophages activated by oxidized LDL, 7-ketocholesterol, and LPS switching from pro- to anti-inflammatory mediators.

Macrophage activation plays a central role in the development of atherosclerotic plaques. Interaction with oxidized low-density lipoprotein (oxLDL) leads to macrophage differentiation into foam cells and oxylipin production, contributing to plaque formation. 7-Ketocholesterol (7KC) is an oxidative byproduct of cholesterol found in oxLDL particles and is considered a factor contributing to plaque progression. During atherosclerotic lesion regression or stabilization, macrophages undergo a transformation from a pro-inflammatory phenotype to a reparative anti-inflammatory state. Interleukin-10 (IL-10) and PGE1 appear to be crucial in resolving both acute and chronic inflammatory processes. After coffee consumption, the gut microbiota processes non-absorbed chlorogenic acids producing various lower size phenolic acids. These colonic catabolites, including dihydroferulic acid (DHFA), may exert various local and systemic effects. We focused on DHFA's impact on inflammation and oxidative stress in THP-1 macrophages exposed to oxLDL, 7KC, and lipopolysaccharides (LPS). Our findings reveal that DHFA inhibits the release of several pro-inflammatory mediators induced by LPS in macrophages, such as CCL-2, CCL-3, CCL-5, TNF-α, IL-6, and IL-17. Furthermore, DHFA reduces IL-18 and IL-1ß secretion in an inflammasome-like model. DHFA demonstrated additional benefits: it decreased oxLDL uptake and CD36 expression induced by oxLDL, regulated reactive oxygen species (ROS) and 8-isoprostane secretion (indicating oxidative stress modulation), and selectively increased IL-10 and PGE1 levels in the presence of inflammatory stimuli (LPS and 7KC). Finally, our study highlights the pivotal role of PGE1 in foam cell inhibition and inflammation regulation within activated macrophages. This study highlights DHFA's potential as an antioxidant and anti-inflammatory agent, particularly due to its ability to induce PGE1 and IL-10.

Hernia de Spiegel / Spigelian hernia

RESUMEN La hernia de Spiegel es un defecto de la pared abdominal en la que hay protrusión de la grasa preperitoneal, del peritoneo o de algún otro órgano, a través de la línea semilunar situada en el cruce de las fibras de los músculos oblicuos y transverso en el borde lateral del recto anterior del abdomen. Representa el 1 al 2% de todas hernias de la pared abdominal y, en total, ha habido menos de 1000 casos notificados. Se presenta el caso de una paciente de 80 años que consultó por dolor abdominal intermitente en flanco izquierdo. En el examen físico se identificó aumento de volumen de 6 cm en el flanco izquierdo (cinturón de Spiegel) que protruyó con la maniobra de Valsalva, reductible manualmente. Con diagnóstico clínico de hernia lumbar de Spiegel se le realizó una hernioplastia abierta con malla de polipropileno, sin complicaciones.

ABSTRACT Spigelian hernias are defined as a protrusion of preperitoneal fat, peritoneum or an organ through the semilunar line located in the junction of the fibers of the transverse and oblique abdominal muscles laterally to the rectus abdominis muscle. They account for 1% to 2% of all abdominal wall hernias with less than 1000 reported cases. We report the case of an 80-year-old female patient who sought medical care due to intermittent pain in the left lumbar region. On physical examination, an increase in volume of approximately 6 cm was observed in the left lumbar region (Spigelian belt). With the Valsalva maneuver, the structure protruded and was manually reduced. A diagnosis of Spigelian hernia was made, and the patient underwent open repair using polypropylene mesh, without complications.

A Novel Method for In Situ RT-PCR Based on Capsules from Centrifuge Tubes, Ideal for Transcripts Detection in Plant Tissues.

In situ RT-PCR presents advantages over other expression analysis methods due to its rapid processing and low-cost equipment. However, this technique is not without its challenges. A protocol based on a capsule made from centrifuge tubes that offers advantages over slides is presented. This capsule protects histological sections from drying out, and its easy assembly reduces time pauses between incubations. In addition, the container size where the sample is deposited allows the addition and withdrawal of the different solutions. The capsule does not need previous sealing after each incubation, and, above all, it is a low-cost and accessible material. A guideline for tissue sectioning using a cryostat that offers advantages over other sectioning methods is also described.

Evaluando habilidades en psiquiatría. Implementación y experiencia del ECOE para pregrado de Medicina / Assessing Skills in Psychiatry. Experience and Implementation of OSCE for Medical Students

resumen Introducción: La formación médica ha venido transformándose, así como las estrategias de evaluación, lo que permite abordar, además de los conocimientos, las habilidades clínicas. En salud mental estas habilidades desempeñan un rol central. El Examen Clínico Objetivo Estructurado (ECOE) es una de las evaluaciones que tiene este potencial. El objetivo del presente artículo es describir la implementación y el desempeño que han tenido los estudiantes de pregrado desde la introducción de este en el año 2015. Métodos: Se recuenta la implementación y se describen los ECOE realizados a estudiantes de pregrado de Medicina que cursan el segundo semestre de Salud Mental tomando las bases de datos de los exámenes prácticos finales. Además se describe la percepción de los docentes del área. Resultados: El ECOE de salud mental se implementó en 2015-2, se desarrolla en el Hospital Simulado de la Universidad y cuenta con 5 estaciones (entrevista, examen mental, diagnóstico, tratamiento e información a la familia y ética). Entre 2016-2 y 2019-2, 486 estudiantes pasaron el ECOE con una nota promedio de 3,85 (baremo de 0 a 5). Se observó que la nota obtenida al evaluarse trastornos de ansiedad estuvo por debajo del promedio; la de trastornos afectivos, por encima del promedio y la de trastornos psicóticos, dentro del promedio. Los docentes resaltan la versatilidad, la mirada objetiva integral de los aspectos prácticos y teóricos y la posibilidad de comparación entre los diferentes grupos. Conclusiones: El ECOE brinda la posibilidad de evaluar las competencias en acción de los estudiantes de Medicina y permite la identificación de qué aspectos mejorar en el proceso de enseñanza-aprendizaje.

abstract Introduction: Medical education has been changing, and the evaluation strategies that make it possible to address not only theoretical knowledge but also clinical skills. In Mental Health, these skills play a central role. The Objective Structured Clinical Examination (OSCE) is one of the evaluations that could assess clinical skills. This article describes the implementation and performance for the evaluation of undergraduate students since the OSCE's introduction in 2015. Methods: An explanation of the implementation is made, and a description of the OSCEs carried out to undergraduate medical students in the second semester of mental health, using the databases of the final practical examinations during those years. The perception of mental health teachers is also described. Results: The mental health OSCE implemented in 2015-2, is developed in the Simulated Hospital of the University and has five stations (interview, mental examination, diagnosis, treatment and information to the family and ethics). Between 2016-2 and 2019-2, 486 students performed OSCE with an average score of 3.85 (scale 0-5). It was observed that the grade obtained when evaluating anxiety disorders was below average, that of affective disorders above average, while that of psychotic disorders was within the average. The professors highlight the versatility, the comprehensive objective evaluation of the practical and theoretical aspects, and the possibility of comparison between the different groups. Conclusions: The OSCE is an examination that provides the possibility to evaluate the competences in psychiatry of medical students and allows the identification of the aspects to be improved in the teaching learning process.

Is EEG Entropy a Useful Measure for Alzheimer's Disease?

BACKGROUND: The number of individuals diagnosed with Alzheimer's disease (AD) has increased, and it is estimated to continue rising in the coming years. The diagnosis of this disease is challenging due to variations in onset and course, its diverse clinical manifestations, and the indications for measuring deposit biomarkers. Hence, there is a need to develop more precise and less invasive diagnostic tools. Multiple studies have considered using electroencephalography (EEG) entropy measures as an indicator of the onset and course of AD. Entropy is deemed suitable as a potential indicator based on the discovery that variations in its complexity can be associated with specific pathologies such as AD. METHODOLOGY: Following PRISMA guidelines, a literature search was conducted in 4 scientific databases, and 40 articles were analyzed after discarding and filtering. RESULTS: There is a diversity in entropy measures; however, Sample Entropy (SampEn) and Multiscale Entropy (MSE) are the most widely used (21/40). In general, it is found that when comparing patients with controls, patients exhibit lower entropy (20/40) in various areas. Findings of correlation with the level of cognitive decline are less consistent, and with neuropsychiatric symptoms (2/40) or treatment response less explored (2/40), although most studies show lower entropy with greater severity. Machine learning-based studies show good discrimination capacity. CONCLUSIONS: There is significant difficulty in comparing multiple studies due to their heterogeneity; however, changes in Multiscale Entropy (MSE) scales or a decrease in entropy levels are considered useful for determining the presence of AD and measuring its severity.

["If you are a woman, read this, it's good for you": the advertising of medicines targeted at mothers in the Colombian press, 1903-1945]. / "Si usted es mujer lea esto que le conviene": la publicidad de medicamentos de patentes dirigidos a las madres en la prensa colombiana, 1903-1945.

This article analyses the advertising of patent medicine directed at mothers, which circulated in newspapers between 1903 and 1945. It demonstrates that these advertisings played an important role in shaping women as a consumer demographic, promoting a scientific approach to motherhood intertwined with health challenges. The methodology employed included the analysis of advertisements in the newspapers El Tiempo, La Prensa, Rigoletto, El Faro and Evolución. Additionally, it examines the historiography of the subject in Colombia and other latitudes. The conclusion of this study asserts that motherhood was a significant target for pharmaceutical industries, leading to a commercial concept of motherhood.

Este artículo analiza la publicidad de medicamentos de patentes dirigida a las madres en la prensa colombiana entre 1903 y 1945. Muestra cómo estos anuncios jugaron un papel importante al momento de moldear a la mujer como una población objeto de consumo, estableciendo una maternidad científica por medio de la medicalización. La metodología incluyó el análisis de los avisos publicitarios en los periódicos El Tiempo, La Prensa, Rigoletto, El Faro y Evolución. Igualmente, dialogó con la historiografía de la temática producida en Colombia y otras latitudes. Concluyó que la maternidad fue un nicho importante para la venta de medicamentos, provocando la conformación de una idea comercial de lo materno.

Inventory of red algae (Rhodophyta) from the Sian Ka'an Biosphere Reserve, Mexican Caribbean / Inventário de algas vermelhas da Reserva da Biosfera Sian Ka'an, Caribe Mexicano

Abstract Studies of marine and estuarine red algae (Rhodophyta) are in the early stages in the littoral of the Sian Ka'an Biosphere Reserve, Mexico. The inventory of these organisms was made based on samples obtained from ten sampling during 2009 to 2015 in 22 localities, eight of them in marine and fourteen in estuarine environments. We found 182 species and subspecific taxa of Rhodophyta. The Rhodomelaceae family was the best represented with 65 taxa, followed by Ceramiaceae 13 and Delesseriaceae 12. Of the 182 taxa, 25 are new records Sian Ka'an Biosphere Reserve with Harveylithon rupestre, Spongites fruticulosus, Acrochaetium barbadense, Dasya harveyi, Chondria pumila, Spermothamnion repens, Metapeyssonnelia milleporoides and M. tangerina being new records for the Mexican Caribbean. Of the 182 species, 119 of them are epiphytes, most of them, 54, grew exclusively on other macroalgae, 29 on mangrove roots and 8 on Thalassia leaves. The floristic list is accompanied by data on seasonality, reproduction, habitat, and environment. Species diversity was compared between the winter rains, dry and rainy seasons during the period study. The Rhodophyta of the Sian Ka'an Biosphere Reserve is tropical, and the greatest diversity was found in the marine environment with 83 taxa and during the winter rains with 132.

Resumo: Os estudos de algas vermelhas marinhas e estuarinas (Rhodophyta) estão em fase inicial no litoral da Reserva da Biosfera de Sian Ka'na, México. O inventário desses organismos foi feito com base em amostras obtidas em oito amostragens no período do 2009 a 2015 em 22 localidades, sendo oito em ambientes marinhos e quatorze em ambientes estuarinos. Neste levantamento, foram identificadas um total de 182 espécies e táxons subespecíficos de Rhodophyta. A família Rhodomelaceae foi a mais representativa com 65 táxons, seguida por Ceramiaceae com 13 e Delesseriaceae com 12. Dos 182 táxons, 25 são referidos pela primeira vez para a Reserva da Biosfera Sian Ka'an, sendo Harveylithon rupestre, Spongites fruticulosus, Acrochaetium barbadense, Dasya harveyi, Chondria pumila, Spermothamnion repens, Metapeyssonnelia milleporoides e M. tangerina também novos registros para o Caribe mexicano. Das 182 espécies, 119 são epífitas, sendo a maioria, 54, aderidas exclusivamente em outras macroalgas, 29 em raízes de mangue e 8 em folhas de Thalassia. A lista florística apresentada é acompanhada de dados sobre sazonalidade, reprodução, habitat e ambiente. A diversidade de espécies foi comparada entre as temporadas de chuvas de inverno, seca e chuvas de verão durante o período estudado. Rhodophyta da Reserva da Biosfera Sian Ka'an săo tropicais, e a diversidade mais representativa foi encontrada no ambiente marinho com 83 táxons e durante as chuvas de inverno com um total de 132 táxons.

"Si usted es mujer lea esto que le conviene": la publicidad de medicamentos de patentes dirigidos a las madres en la prensa colombiana, 1903-1945 / "If you are a woman, read this, it's good for you": the advertising of medicines targeted at mothers in the Colombian press, 1903-1945

Resumen Este artículo analiza la publicidad de medicamentos de patentes dirigida a las madres en la prensa colombiana entre 1903 y 1945. Muestra cómo estos anuncios jugaron un papel importante al momento de moldear a la mujer como una población objeto de consumo, estableciendo una maternidad científica por medio de la medicalización. La metodología incluyó el análisis de los avisos publicitarios en los periódicos El Tiempo, La Prensa, Rigoletto, El Faro y Evolución. Igualmente, dialogó con la historiografía de la temática producida en Colombia y otras latitudes. Concluyó que la maternidad fue un nicho importante para la venta de medicamentos, provocando la conformación de una idea comercial de lo materno.

Abstract This article analyses the advertising of patent medicine directed at mothers, which circulated in newspapers between 1903 and 1945. It demonstrates that these advertisings played an important role in shaping women as a consumer demographic, promoting a scientific approach to motherhood intertwined with health challenges. The methodology employed included the analysis of advertisements in the newspapers El Tiempo, La Prensa, Rigoletto, El Faro and Evolución. Additionally, it examines the historiography of the subject in Colombia and other latitudes. The conclusion of this study asserts that motherhood was a significant target for pharmaceutical industries, leading to a commercial concept of motherhood.

Distribution of Escherichia coli Pathotypes along an Urban-Rural Gradient in Ecuador.

Diarrheal diseases are a leading cause of mortality and morbidity in low- and middle-income countries. Diarrhea is associated with a wide array of etiological agents including bacterial, viral, and parasitic enteropathogens. Previous studies have captured between- but not within-country heterogeneities in enteropathogen prevalence and severity. We conducted a case-control study of diarrhea to understand how rates and outcomes of infection with diarrheagenic pathotypes of Escherichia coli vary across an urban-rural gradient in four sites in Ecuador. We found variability by site in enteropathogen prevalence and infection outcomes. Any pathogenic E. coli infection, coinfections, diffuse adherent E. coli (DAEC), enteroinvasive E. coli (EIEC), and rotavirus were significantly associated with acute diarrhea. DAEC was the most common pathotype overall and was more frequently associated with disease in urban areas. Enteropathogenic E. coli (EPEC) and enterotoxigenic E. coli (ETEC) were more common in rural areas. ETEC was only associated with diarrhea in one site. Phylogenetic analysis revealed that associations with disease were not driven by any single clonal complex. Higher levels of antibiotic resistance were detected in rural areas. Enteropathogen prevalence, virulence, and antibiotic resistance patterns vary substantially by site within Ecuador. The variations in E. coli pathotype prevalence and virulence in this study have important implications for control strategies by context and demonstrate the importance of capturing within-country differences in enteropathogen disease dynamics.

Experiencia clínica de la terapia electroconvulsiva con anestesia y relajación en la Clínica Universidad de La Sabana: 2009-2017

Introducción: La terapia electroconvulsiva es un procedimiento efectivo y seguro, el cual se indica principalmente a pacientes con episodios depresivos tanto unipolares como bipolares, manía y esquizofrenia, cuando no responden a otros tratamientos. Objetivo: Describir las propiedades demográficas, sociales y clínicas de un grupo de pacientes tratados con terapia electroconvulsiva con anestesia y relajación (TECAR) en la Clínica Universidad de La Sabana por un periodo de 8 arios. Métodos: Se revisan las bases de datos y los registros de los procedimientos desde el 1 de enero de 2009 hasta el 31 de diciembre de 2017. Se realiza un análisis con estadística descriptiva. Resultados: En este periodo se realizaron 1.322 procedimientos a 143 pacientes, el 54,5% de ellos mujeres, y con diagnóstico asociado de depresión mayor en el 57% de los pacientes. El número de tratamientos por persona fue 9,2 y en el 3,8% se presentaron complicaciones, sin que se requiriese tratamiento invasivo en ninguna de ellas. Conclusiones: La terapia electroconvulsiva se aplica con seguridad a los pacientes y con parámetros diversos en cuanto a edad, sexo y diagnóstico más frecuente, en comparación con otros países de Latinoamérica y el mundo. Es importante sumar esfuerzos en investigación que permitan tener un panorama más completo de las características de su aplicación en el país.

Electroconvulsive therapy is an effective and safe procedure, which is indicated mainly in patients with both unipolar and bipolar depressive episodes, mania and schizophrenia, when they do not respond to other treatments. Objective: To describe the demographic, social and clinical properties of a group of patients treated with electroconvulsive therapy (ECT) with anaesthetic and muscular relaxant at the Universidad de La Sabana Clinic for a period of 8 years. Methods: The databases and records of the procedures were reviewed from 1 January 2009 to 31 December 2017. An analysis was performed with descriptive statistics. Results: In this period, 1,322 procedures were performed on 143 patients (54.5% women) with an associated diagnosis of major depression in 57%. The number of treatments per person was 9.2 and complications occurred in 3.8%, without any of them requiring invasive management. Conclusions: Electroconvulsive therapy is performed safely in patients and with different parameters in terms of age, gender and diagnosis, in comparison to other countries in Latin America and the world. It is important to join efforts in research that allow a more complete overview of the characteristics of its application in the country.

Rickettsia Vaccine Candidate pVAX1-OmpB24 Stimulates TCD4+INF-γ+ and TCD8+INF-γ+ Lymphocytes in Autologous Co-Culture of Human Cells.

BACKGROUND: In recent years, promising vaccination strategies against rickettsiosis have been described in experimental animal models and human cells. OmpB is considered an immunodominant antigen that is recognized by T and B cells. The aim of this study was to identify TCD4+INF-γ+ and TCD8+INF-γ+ lymphocytes in an autologous system with macrophages transfected with the vaccine candidate pVAX1-OmpB24. Lymphocytes and monocytes from 14 patients with Rickettsia were isolated from whole blood. Monocytes were differentiated into macrophages and transfected with the plasmid pVAX1-OmpB24 pVax1. Isolated lymphocytes were cultured with transfected macrophages. IFN-γ-producing TCD4+ and TCD8+ lymphocyte subpopulations were identified by flow cytometry, as was the percentage of macrophages expressing CD40+, CD80+, HLA-I and HLA-II. Also, we analyzed the exhausted condition of the T lymphocyte subpopulation by PD1 expression. Macrophages transfected with pVAX1-OmpB24 stimulated TCD4+INF-γ+ cells in healthy subjects and patients infected with R. typhi. Macrophages stimulated TCD8+INF-γ+ cells in healthy subjects and patients infected with R. rickettsii and R. felis. Cells from healthy donors stimulated with OmpB-24 showed a higher percentage of TCD4+PD1+. Cells from patients infected with R. rickettsii had a higher percentage of TCD8+PD-1+, and for those infected with R. typhi the larger number of cells corresponded to TCD4+PD1+. Human macrophages transfected with pVAX1-OmpB24 activated TCD4+IFN-γ+ and CD8+IFN-γ+ in patients infected with different Rickettsia species. However, PD1 expression played an important role in the inhibition of T lymphocytes with R. felis.

Putative intestinal permeability markers do not correlate with cardiometabolic health and gut microbiota in humans, except for peptides recognized by a widely used zonulin ELISA kit.

BACKGROUND AND AIMS: Cardiometabolic diseases refer to a group of interrelated conditions, sharing metabolic dysfunctions like insulin resistance, obesity, dyslipidemia, and hypertension. The gut microbiota has been associated with CMD and related conditions. Alterations in the intestinal epithelium permeability triggered by chronic stress and diet could bridge gut microbiota with inflammation and CMD development. Here, we assessed the relationship between intestinal permeability and circulating SCFAs with cardiometabolic health status (CMHS) and gut microbiota in a sample of 116 Colombian adults. METHODS AND RESULTS: Plasma levels of lipopolysaccharide-binding protein (LBP), intestinal fatty acid-binding protein (I-FABP), claudin-3, and purported zonulin peptides (PZP) were measured by ELISA, whereas plasmatic levels of acetate, propionate, butyrate, isobutyrate, and valerate were measured by gas chromatography/mass spectrometry. In addition, for further statistical analysis, we took data previously published by us on this cohort, including gut microbiota and multiple CMD risk factors that served to categorize subjects as cardiometabolically healthy or cardiometabolically abnormal. From univariate and multivariate statistical analyses, we found the levels of I-FABP, LBP, and PZP increased in the plasma of cardiometabolically abnormal individuals, although only PZP reached statistical significance. CONCLUSIONS: Our results did not confirm the applicability of I-FABP, LBP, claudin-3, or SCFAs as biomarkers for associating intestinal permeability with the cardiometabolic health status in these subjects. On the other hand, the poorly characterized peptides detected with the ELISA kit branded as "zonulin" were inversely associated with cardiometabolic dysfunctions and gut microbiota. Further studies to confirm the true identity of these peptides are warranted.

Winogradsky Bioelectrochemical System as a Novel Strategy to Enrich Electrochemically Active Microorganisms from Arsenic-Rich Sediments.

Bioelectrochemical systems (BESs) have been extensively studied for treatment and remediation. However, BESs have the potential to be used for the enrichment of microorganisms that could replace their natural electron donor or acceptor for an electrode. In this study, Winogradsky BES columns with As-rich sediments extracted from an Andean watershed were used as a strategy to enrich lithotrophic electrochemically active microorganisms (EAMs) on electrodes (i.e., cathodes). After 15 months, Winogradsky BESs registered power densities up to 650 µWcm-2. Scanning electron microscopy and linear sweep voltammetry confirmed microbial growth and electrochemical activity on cathodes. Pyrosequencing evidenced differences in bacterial composition between sediments from the field and cathodic biofilms. Six EAMs from genera Herbaspirillum, Ancylobacter, Rhodococcus, Methylobacterium, Sphingomonas, and Pseudomonas were isolated from cathodes using a lithoautotrophic As oxidizers culture medium. These results suggest that the tested Winogradsky BES columns result in an enrichment of electrochemically active As-oxidizing microorganisms. A bioelectrochemical boost of centenarian enrichment approaches, such as the Winogradsky column, represents a promising strategy for prospecting new EAMs linked with the biogeochemical cycles of different metals and metalloids.

[Grief and palliative home-care services for patients at the end of life during the COVID-19 pandemic in Colombia. Analysis from the relatives´ perspective]. / Duelo y atención domiciliaria para pacientes al final de la vida durante la pandemia por COVID-19 en Colombia.Análisis desde la perspectiva de familiares.

INTRODUCTION: End-of-life care is one of the most crucial experiences for both the patient and their loved ones. However, as a result of the changes generated by the COVID 19 pandemic, the dynamics of the end-of-life process has undergone changes at both the family, social and health levels. In turn, this has altered the perception and development of the grief of relatives of patients who died during the pandemic regardless of the cause of death. Then, the aim of this study is to analyze the perceptions and some aspects of bereavement of died patients` relatives during the pandemic of Covid 19. METHODS: Through the admission evaluation and follow-up of the relatives with an adapted version of the international Care Of the Dying Evaluation (iCODE) questionnaire. RESULTS: 239 relatives were surveyed, of which 112 completed the follow-up questionnaire. Most of the patients died at home and their family members were highly involved in their care. Medical attention was considered adequate and the symptom with the highest perception was pain. 87% of those surveyed participated in funeral rites, and 42% rated them as very sober. Regarding grief, the scale of personal growth predominates, however, in the negative aspects, the feeling of pressure in the chest and frequent crying predominates. CONCLUSIONS: The end of life of home-care patients during the pandemic was perceived as adequate, allowing family support and symptom control. The grieving process shows no complications. The training of health professionals in these fundamental aspects of patient care is important.

Formación Interprofesional en salud mental: un reto posible / Interprofessional training in mental health: a possible challenge

RESUMEN: Introducción: El abordaje de la salud mental requiere acciones interprofesionales, sin embargo, su enseñanza es tradicionalmente uniprofesional y en escenarios especializados, reforzando la creencia que la salud mental es cuestión de especialistas. Es por esto que se diseña la primera rotación interprofesional en salud mental de la que se tenga conocimiento en Colombia, en la cual rotan estudiantes de medicina y psicología. El objetivo del presente artículo es describir este proceso y la rotación. Material y método: Se describe cuáles fueron los pasos para el diseño y la implementación de la rotación interprofesional en salud mental. Resultados: Se describe la rotación, la cual cuenta con elementos clínicos y simulados y diversas metodologías de aprendizaje y evaluación. Conclusiones: La rotación interprofesional es una estrategia útil en el proceso de aprendizaje de competencias en salud mental y habilidades para el trabajo interprofesional.

ABSTRACT Background: Mental health approaches require interprofessional actions. However, education on mental health is traditionally uniprofessional and is performed in specialized scenarios which reinforces the belief that mental health is only a concern for specialists. This is the reason why the first interprofessional mental health rotation in Colombia was designed and launched. The aim of this paper is to describe that process and the rotation itself. Material and method: This work describes the steps for the design and implementation of an interprofessional rotation on mental health. which involve medicine and psychology students. Results: The structure of the rotation is detailed. It contains both a clinical component and a simulated one, and diverse methodologies for learning and assessment. Conclusions: This interprofessional rotation is a useful strategy in the learning process of specific competences in mental health, and it facilitates acquisition of skills for teamwork.

Factores influyentes en el desarrollo de competencias en Ortopedia y Traumatología durante el internado médico / Influential Factors in The Development of Competencies in Orthopedics and Traumatology During the Medical Internship

RESUMEN Introducción: Actualmente la salud es concebida como un derecho fundamental y para garantizarlo se debe propender por una adecuada formación de los profesionales de la salud. El internado rotatorio es la última etapa y la más importante del pregrado en Medicina. Objetivo: Explorar los factores desde la perspectiva de estudiantes y docentes, que influyen en el desarrollo de competencias en la rotación de Ortopedia y Traumatología durante el internado médico. Métodos: Estudio cualitativo con enfoque en teoría fundamentada. Para la recolección de datos se realizó un cuestionario semiestructurado a una muestra aleatoria de 14 participantes, 7 estudiantes y 7 docentes, que cumplían los criterios de inclusión. El análisis se basó en la codificación y categorización de los datos que posteriormente fueron sometidos a un proceso de triangulación para lograr la teorización final. Resultados: Los factores que favorecen el desarrollo de competencias están relacionados con la motivación intrínseca del estudiante, la flexibilidad y disponibilidad de recursos académicos, las características del programa de la rotación y el ambiente de práctica. Se identificaron como factores limitantes aquellos asociados a una formación deficiente en ciencias básicas médicas, la priorización del componente asistencial sobre el académico, la disponibilidad limitada de espacios y recursos de aprendizaje y los métodos de enseñanza tradicionales. Conclusiones: Es de vital importancia la identificación de los factores que favorecen y limitan el desarrollo de las competencias de los estudiantes de medicina en su última etapa de formación en ortopedia.

ABSTRACT Introduction: Few areas of orthopedic surgery have had such important technical changes in recent decades as in corrective spinal surgery. Fundamental changes have come with the new spinal instrumentation systems, which have been substantially modified and improved to facilitate three-dimensional correction of the deformity and provide secure spinal fixation, correction and stability. Objective: To evaluate the results achieved with the spinal instrumentation systems used in the correction of thoracolumbar kyphosis due to ankylosing spondylitis. Methods: A descriptive, retrospective and longitudinal study was carried out on 16 patients with thoracolumbar kyphosis due to ankylosing spondylitis operated on with the pedicle subtraction osteotomy technique and instrumented with Luque-type pedicle and sublaminar systems, in the Orthopedics service at Hermanos Ameijeiras Surgical Clinical Hospital, from March 2001 to March 2021. Results: All the patients were male, white skin color and average age of 39 years. More than 80% correction was achieved in the sagittal profile and an average of 34.3° per osteotomy, without major neurological complications. Good functional results were obtained, with high degree of patient satisfaction and improvement in their quality of life. Conclusions: The use of both spinal instrumentation systems is effective in maintaining the correction of thoracolumbar kyphosis due to ankylosing spondylitis.

Enseñando medicina en tiempos de pandemia: una experiencia desde el curso Salud Mental / Teaching medicine in pandemic times: An experience from mental health rotation

RESUMEN Introducción: la pandemia por la COVID-19 llevó a la implementación de medidas de protección en diversos ámbitos de la sociedad. Bajo esta premisa, en todos los niveles de la educación en Colombia se cancelaron las clases presenciales, ocasionando el cese asistencial de los estudiantes de medicina en los hospitales donde realizaban sus practices clínicas. Objetivos: describir las estrategias educativas aplicadas para continuar con las rotaciones clínicas, garantizando el desarrollo de las competencias necesarias en el programa de salud mental. Métodos: la rotación en salud mental del pregrado Medicina, posterior al aislamiento preventivo decretado por el gobierno colombiano, se empezó a realizar de manera virtual y remota con el uso de diversas herramientas tecnológicas. Con la apertura parcial se implementaron actividades semipresenciales y con pacientes reales. Se realizaron actividades sincrónicas y asincrónicas que incluyeron el aprendizaje de recursos tecnológicos, telesimulación, seminarios, talleres, Desarrollo de casos y clubes de revistas, entre otros. Resultados: la virtualidad permitió, además de brindar un aprendizaje de calidad, generar espacios de acompañamiento personalizado a los estudiantes por la situación relacionadacon la pandemia, así como el diseño de estrategias de enseñanza y mecanismos de evaluación novedosos. Conclusiones: la experiencia del cambio de la educación presencial a la virtual permitió múltiples aprendizajes personales y técnicos, y la implementación de nuevas metodologías y herramientas tecnológicas, obteniendo resultados favorables en la ejecución del curso y la evaluación de él mismo con una adecuada satisfacción, tanto en los docentes de psiquiatría como en los estudiantes.

SUMMARY Introduction: The COVID-19 pandemic led to the implementation of diverse safety measures in various aspects of society. Traditional in-person classes were canceled under this premise at all levels of education in Colombia, causing medical students to stop assisting to hospitals for their clinical practices. Objectives: Describe educational strategies applied to continue clinical rotations, securing the development of the necessary competences in the mental health program. Methods: The Medicine School's clinical rotation on mental health started being instructed virtually and remotely using diverse technological tools after the Colombian government decreed a preventive lockdown. Mixed modality activities with real patients restarted once lockdown was partially lifted. We performed synchronous and asynchronous activities that included learning using technological resources, telesimulation, seminaries, workshops, case developments, and journal clubs, among others. Results: Virtual instruction generated personalized tutorship spaces, the design of adapted teaching strategies and novel evaluation mechanisms while maintaining the quality of learning. Conclusion: The change from traditional in-person education to a virtual learning produced multiple personal and technical lessons with the implementation of new methodologies and technological tools, obtaining favorable results in execution, evaluation, and psychiatry teacher's and student's satisfaction.

The Adelante project: Realities, challenges and successes in addressing health disparities among central American immigrant youth.

OBJECTIVE: The Adelante intervention, implemented between 2013 and 2018, addressed an important syndemic health disparity for Central American immigrant youth approaching or in high school-the co-occurrence of substance abuse, sex risk (pregnancy, sexually transmitted infections, HIV), and interpersonal violence. Adelante was implemented and evaluated by the Avance Center for the Advancement of Immigrant/Refugee Health, which built on a university-community partnership that has been in place since 2005. Using a tailored, ecological positive youth development (PYD) approach, Adelante employed intervention strategies across ecological levels, including individual, family, peer, and community levels, with the use of social marketing and digital media strategies to link activities under one aspirational identity and support community engagement. METHOD: Using a Community Based Participatory Research approach with multiple community partners involved in the effort, the research assessed changes in co-occurring behavioral outcomes and tested hypotheses concerning relationships between PYD mediators and these outcomes. Multiple methods were used in collaboration with partners to assess intervention inputs and outcomes-detailed implementation process records; prepost surveys to assess changes in PYD assets, risk behavior knowledge, and prevention skills; a community survey in the intervention and comparison communities (total N = 3,600) at baseline and two follow-up waves; surveys of a high risk cohort (n = 238) at baseline and follow-up; and social marketing campaign surveys (n = 1,549) at baseline with 2 follow-up waves. RESULTS: Analysis showed multiple improvements in PYD mediators and risk behavior outcomes, including an overall 70% increase in knowledge and a 15% increase in prevention skills. Preliminary analysis of risk behavior outcomes demonstrated, for example, a significant, inverse effect on reported sexual activity (past 3 months) for both Adelante intervention community and cohort samples. In addition, self-reported exposure to the social marketing campaign was associated with positive effects on multiple outcomes, including drug use risk and violence attitudes, and improvement in violence/sexual risk behavior outcomes in the intervention versus comparison community. CONCLUSION: There are few models in the literature that provide a roadmap for how to address multiple, related health conditions in marginalized, immigrant communities, even as most health disparities are associated with complex social ecologies. The Adelante intervention adds a useful model of this nature to the evidence base, and provides support for the ecological approach to PYD with respect to such communities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Identification, analysis, and modeling of the YUCCA protein family genome-wide in Coffea canephora.

Auxin is involved in almost every aspect of plant growth and development, from embryogenesis to senescence. Indole-3-acetic acid (IAA) is the main known natural auxin that is synthesized by enzymes tryptophan aminotransferase of arabidopsis (TAA) and YUCCA (YUC) of the flavin-containing monooxygenases family (FMO) from one of the tryptophan-dependent pathways. Genome-wide identification and comprehensive analysis of the YUC-protein family have been conducted in Coffea canephora in the present study. A total of 10 members CcYUC gene family were identified in C. canephora. Phylogenetic analysis revealed that the CcYUC protein family is evolutionarily conserved, and they consist of four groups. In contrast, bioinformatic analysis predicted a hydrophobic transmembrane helix (TMH) for one CcYUC (YUC10) member only. Isoelectric point (pI), molecular mass (Ms), signal peptide, subcellular localization, and phosphorylation sites were predicted for CcYUC proteins. YUC enzymes require the prosthetic group flavin adenine dinucleotide (FAD) and the cofactor nicotinamide adenine dinucleotide phosphate (NADPH) for their enzymatic activity. Therefore, we include the molecular docking for CcYUC2-FAD-NADPH-IPyA and yucasin, which is a specific inhibitor for YUC activity. The docking results showed FAD and NADPH binding at the big and small domain sites, respectively, in CcYUC2. IPyA binds very close to FAD along the big domain, and yucasin competes for the same site as IPA, blocking IAA production. Furthermore, in silico point mutations affect the stability of the CcYUC2-4 proteins.