[Inflammageing in patients with idiopathic pulmonary fibrosis (IPF)]. / Inflammageing en pacientes con fibrosis pulmonar idiopática (FPI).

METHODS: We took Peripheral blood samples from adult patients over 60 years of age with a confirmed diagnosis of IPF through biopsy or clinical criteria. Plasma separation was performed, and proinflammatory cytokines were measured using CBA. This study received approval from the ethics and research committee of the Colombian Pulmonological Foundation. RESULTS: Patients with IPF exhibited an increase in cytokines such as IL-4, INFy, and IL-6 compared to healthy older adults. CONCLUSION: Inflammatory disease has been associated with the development and coexistence of multiple chronic non-communicable diseases that have a higher incidence after 65 years of age. The involvement of adaptive immunity in the pathogenesis of IPF has been described as an imbalance in the Th1/Th2 lymphocyte response. Further studies are required to identify additional markers of immunosenescence that correlate with IPF.

OBJETIVO: Identificar citoquinas proinflamatorias en el plasma de pacientes con FPI residentes en la altura de Bogotá. MÉTODOS: Se tomaron muestras de sangre periférica de pacientes adultos mayores de 60 años, con diagnóstico de FPI confirmado por biopsia o por criterios clínicos. Se realizó la separación de plasma y se midieron citoquinas proinflamatorias por CBA. Este trabajo fue aprobado por el Comité de Ética e Investigaciones de la Fundación Neumológica Colombiana. RESULTADOS: Los pacientes con FPI mostraron un aumento de citocinas como la IL-4, INFy e IL-6, en comparación con adultos mayores sanos. CONCLUSIÓN: El inflammaging ha sido asociado con el desarrollo y coexistencia de múltiples enfermedades crónicas no transmisibles que tienen mayor incidencia después de los 65 años. Se ha descrito la participación de la inmunidad adaptativa con la patogénesis de la FPI, como un desbalance en la respuesta de linfocitos Th1/Th2. Es necesario realizar más estudios que permitan identificar otros marcadores de inmunosenescencia que se correlacionen con la FPI.

Effect of neoadjuvant chemotherapy on tumor immune infiltration in breast cancer patients: Systematic review and meta-analysis.

The tumor immune infiltrate has an impact on cancer control and progression, additionally a growing body of evidence has proposed the role of neoadjuvant chemotherapy in modulating the contexture of the tumor immune infiltrate. Here, we performed a systematic review to evaluate the effect of chemotherapy in the immune infiltration of breast cancer tumors. We systematically searched Pubmed/MEDLINE, EMBASE, CENTRAL, and BVS databases with a cutoff date of 11/06/2022. Studies in patients with pathological diagnosis of BC, whose first line of treatment was only NAC, were included. Only published experimental studies that measured tumor immune infiltrate before and after NAC by hematoxylin and eosin (H&E) staining, immunohistochemistry (IHQ), or transcriptome were included. Reviews, studies with animal models and in-vitro models were excluded. Studies in which BC was not the primary tumor or studies with patients who received other types of neoadjuvant therapy were also excluded. The NIH quality assessment tool for before and after studies without control was used. We included 32 articles that evaluated the proximal tumor microenvironment before and after neoadjuvant chemotherapy in 2072 patients who received NAC as first line of treatment and who were evaluated for immune infiltrate in the pre- and post-chemotherapy tumor sample. Results were divided into two major categories immune cells and in-situ expression of immune checkpoints and cytokines. Qualitative synthesis was performed with the 32 articles included, and in nine of them a quantitative analysis was achieved, resulting in six meta-analyses. Despite high heterogeneity among the articles regarding treatment received, type of tumor reported, and techniques used to evaluate immune infiltrate, we found a significant decrease of TILs and FoxP3 expression after neoadjuvant chemotherapy. The study protocol was registered in PROSPERO 2021 (Protocol ID: CRD42021243784) on 6/29/2021.

Neoadjuvant chemotherapy modulates exhaustion of T cells in breast cancer patients.

Breast cancer is the leading cause of cancer deaths in women worldwide. It has been observed that the incidence of breast cancer increases linearly with age after 45, which suggest a link between cancer, aging, and senescence. A growing body of evidence indicates that the immunosuppressive tumor network in breast cancer patients can lead to T-cell exhaustion and senescence. Cytotoxic chemotherapy is a common treatment for many cancers, and it is hypothesized that its efficacy may be related to immune activation. However, the effects of neoadjuvant chemotherapy on T-cell dysfunction in breast cancer patients are not fully understood. This study aimed to evaluate the impact of neoadjuvant chemotherapy on the expression of exhaustion and senescence markers in T cells in women with breast cancer. Our results showed that T cells from breast cancer patients have a reduced ability to respond to stimulation in-vitro and an increased expression of senescence and exhaustion-associated markers, such as TIM-3, LAG3, and CD57. Furthermore, we found that neoadjuvant chemotherapy has an immunomodulatory effect and reduces the expression of exhaustion markers. Our observations of the immune phenotype of T cells during neoadjuvant chemotherapy treatment highlight its ability to stimulate the immune system against cancer. Therefore, monitoring the response of T cells during chemotherapy may enable early prediction of clinical response.

Salud bucal en ancianos del Hogar Provincial de Sancti Spíritus / Oral health in the elderly of the Provincial Home of Sancti Spíritus

RESUMEN Fundamento: Las personas de edad avanzada requieren atención estomatológica ajustada a su salud bucal. Objetivo: Describir la salud bucal de los ancianos pertenecientes al Hogar Provincial de Sancti Spíritus. Metodología: Se realizó un estudio observacional descriptivo transversal en el Hogar de ancianos provincial de Sancti Spíritus, entre diciembre de 2019 y agosto 2020. Se seleccionaron 72 ancianos, según criterios de inclusión. Se utilizaron métodos del nivel teórico, empírico y estadístico para estudiar las variables: Enfermedades bucales, factores de riesgo, higiene bucal, nivel de conocimientos sobre salud bucal y autopercepción de salud bucal. Resultados: En los ancianos predominó la enfermedad periodontal (29.4 %) y la disfunción masticatoria (28.6 %); los factores de riesgo que se observaron fueron la alimentación azucarada (12.8 %) y la diabetes mellitus (12.5 %), la higiene bucal deficiente (58.3 %), el nivel de conocimientos malo (51.4 %) y la autopercepción de salud bucal baja (54.2 %). Conclusiones: La salud bucal de los ancianos estudiados se caracterizó por presentar enfermedad periodontal y disfunción masticatoria en casi la tercera parte, con predominio de la alimentación azucarada y la diabetes mellitus como factores de riesgo y más de la mitad presentó higiene bucal deficiente, nivel de conocimientos malo y baja autopercepción de salud bucal.

ABSTRACT Background: Elderly people require dental care adjusted to their oral health. Objective: To describe the oral health of the elderly belonging to the Provincial Home of Sancti Spíritus. Methodology: A cross-sectional descriptive observational study was carried out in the Provincial Nursing Home of Sancti Spíritus, between December 2019 and August 2020. 72 elderly were selected, according to inclusion criteria. Theoretical, empirical and statistical level methods were used to study the variables: oral diseases, risk factors, oral hygiene, level of knowledge about oral health and self-perception of oral health. Results: In the elderly, periodontal disease (29.4 %) and masticatory dysfunction (28.6 %) predominated; the risk factors that were observed were sugary diet (12.8 %) and diabetes mellitus (12.5 %), poor oral hygiene (58.3%), poor level of knowledge (51.4 %) and low self-perception of oral health (54.2 %). Conclusion: The oral health of the elderly studied was characterized by presenting periodontal disease and masticatory dysfunction in almost a third of them, with a predominance of sugary diets and diabetes mellitus as risk factors, and more than half presented poor oral hygiene, level of poor knowledge and low self-perception of oral health.

Salud bucal en ancianos del Hogar Provincial de Sancti Spíritus / Oral health in the elderly of the Provincial Home of Sancti Spíritus

Fundamento: Las personas de edad avanzada requieren atención estomatológica ajustada a su salud bucal.Objetivo: Describir la salud bucal de los ancianos pertenecientes al Hogar Provincial de Sancti Spíritus.Metodología: Se realizó un estudio observacional descriptivo transversal en el Hogar de ancianos provincial deSancti Spíritus, entre diciembre de 2019 y agosto 2020. Se seleccionaron 72 ancianos, según criterios deinclusión. Se utilizaron métodos del nivel teórico, empírico y estadístico para estudiar las variables:Enfermedades bucales, factores de riesgo, higiene bucal, nivel de conocimientos sobre salud bucal yautopercepción de salud bucal.Resultados: En los ancianos predominó la enfermedad periodontal (29.4 %) y la disfunción masticatoria (28.6%); los factores de riesgo que se observaron fueron la alimentación azucarada (12.8 %) y la diabetes mellitus(12.5 %), la higiene bucal deficiente (58.3 %), el nivel de conocimientos malo (51.4 %) y la autopercepción desalud bucal baja (54.2 %).Conclusiones: La salud bucal de los ancianos estudiados se caracterizó por presentar enfermedad periodontaly disfunción masticatoria en casi la tercera parte, con predominio de la alimentación azucarada y la diabetesmellitus como factores de riesgo y más de la mitad presentó higiene bucal deficiente, nivel de conocimientosmalo y baja autopercepción de salud bucal [AU]

Infection Rate of Trypanosoma cruzi (Trypanosomatida: Trypanosomatidae) in Dipetalogaster maxima (Hemiptera: Reduviidae).

Chagas disease is caused by the infection of the parasite Trypanosoma cruzi (Chagas, 1909). Mexico is estimated to be among the countries with the highest rates of human infections. The southernmost region of the Baja California peninsula is home to the endemic, highly aggressive, and largest Triatominae vector, thus far described: Dipetalogaster maxima (Uhler 1894). Previous single-year studies have attempted to estimate the natural infection rate of T. cruzi in this species, none encompassing a multiyear sampling design nor a species-specific diagnostic tool. We report the infection rate based on more than 717 individuals examined via a PCR species-specific diagnosis. The infection rate of T. cruzi was of 4.4% (n = 5/112), 0.9% (n = 4/411), and 4.6% (n = 9/194) for 2016, 2017, and 2018, respectively, resulting in an infection rate of 2% across all sites and years (n = 18/717).

Aggregata polibraxiona n. sp. (Apicomplexa: Aggregatidae) from Octopus bimaculatus Verrill, 1883 (Mollusca: Cephalopoda) from the Gulf of California, Mexico.

The Apicomplexa Aggregata spp. are intracellular parasites of cephalopods that infect the intestinal tract of commercially important species such as Octopus bimaculatus, which sustains the octopus fishery in Baja California (B.C.), Mexico. In this study, Aggregata polibraxiona n. sp. was described from the cecum of O. bimaculatus collected from Bahia de Los Angeles, B. C. Light and electron microscopy revealed that oocysts and sporocysts were spherical to ovoid in shape. Sporulated oocysts (293-835 × 177-688 µm) contained 135-674 sporocysts (12-24 × 11-22 µm). The sporocyst wall was covered by tubular projections (0.55-2.19 µm in length) bifurcated in the top, unevenly distributed, covered by a thin membrane. Each sporocyst contains 11-13 sporozoites (16-26 × 1.20-3 µm). Three partial sequences of the 18S rDNA gene were obtained, and two phylogenetic approaches were performed according to Bayesian inference and Maximum Likelihood. In both phylogenetic reconstructions, the sequences of A. polibraxiona n. sp. were recovered as a monophyletic group within the genus Aggregata and placed as a sister group to Aggregata octopiana Lineage II. Aggregata polibraxiona n. sp. is the first Apicomplexa described from a cephalopod host from Mexico and extends the geographical range of Apicomplexa infecting cephalopods.

Personalized neoantigen-based cancer immunotherapy. A literature review / Inmunoterapia personalizada contra el cáncer basada en neoantígenos. Revisión de la literatura

Abstract Introduction: The progress made in cancer immunotherapy and the clinical response of patients who have undergone this type of therapy have made it the fourth pillar of cancer treatment. Objective: To briefly describe the biological rationale of personalized neoantigen-based cancer immunotherapy, the current perspectives regarding its development, and some of the clinical outcomes achieved with this therapy. Materials and methods: A literature search was performed in PubMed, Scopus and EBSCO using the following search strategy: type of articles: original experimental studies, clinical trials, and narrative and systematic reviews addressing methods to identify mutations found in tumors and cancer immunotherapy strategies based on neoantigen-based vaccines; study population: humans and animal models; publication period: January 1989 - December 2019; language: English and Spanish; search terms: "Immunotherapy", "Neoplasms", "Mutation" and "Cancer Vaccines". Results: The initial search started with 1 344 records. Once duplicates were removed (n=176), 780 studies were excluded after reading their abstract and title. The full text of 338 articles was read to confirm which met the inclusion criteria, finally including 73 studies for full analysis. All articles retrieved were published in English and were mainly conducted in the USA (43.83%) and Germany (23.65%). In the case of original studies (n=43), 20 were performed in humans only, 9 in animals only, 2 in both models, and 12 used in silico methodology. Conclusion: Personalized cancer immunotherapy with tumor neoantigen-based vaccines is strongly emerging as a new alternative to treat cancer. However, to achieve its appropriate implementation, it is necessary to use it in combination with conventional treatments, produce more knowledge that helps clarify cancer immunobiology, and reduce the costs associated with its production.

Resumen Introducción. Los avances que se han hecho en inmunoterapia contra el cáncer y la respuesta clínica de los pacientes que han recibido este tipo de terapia la han convertido en el cuarto pilar para el tratamiento del cáncer. Objetivo. Describir brevemente el fundamento biológico de la inmunoterapia personalizada contra el cáncer basada en neoantígenos, las perspectivas actuales de su desarrollo y algunos resultados clínicos de esta terapia. Materiales y métodos. Se realizó una búsqueda de la literatura en PubMed, Scopus y EBSCO utilizando la siguiente estrategia de búsqueda: tipo de artículos: estudios experimentales originales, ensayos clínicos y revisiones narrativas y sistemáticas sobre métodos de identificación de mutaciones generadas en los tumores y estrategias de inmunoterapia del cáncer con vacunas basadas en neoantígenos; población de estudio: humanos y modelos animales; periodo de publicación: enero de 1989 a julio de 2019; idioma: inglés y español; términos de búsqueda: "Immunotherapy", "Neoplasms", "Mutation" y "Cancer Vaccines". Resultados. La búsqueda inicial arrojó 1 344 registros; luego de remover duplicados (n = 176), 780 fueron excluidos después de leer su resumen y título, y se evaluó el texto completo de 338 para verificar cuáles cumplían con los criterios de inclusión, seleccionándose finalmente 73 estudios para análisis completo. Todos los artículos recuperados se publicaron en inglés, y fueron realizados principalmente en EE. A (43.83%) y Alemania (23.65%). En el caso de los estudios originales (n=43), 20 se realizaron únicamente en humanos, 9 solo en animales, 2 en ambos modelos, y 12 usaron metodología in silico. Conclusión. La inmunoterapia personalizada contra el cáncer con vacunas basadas en neoantígenos tumorales se está convirtiendo de forma contundente en una nueva alternativa para tratar el cáncer. Sin embargo, para lograr su implementación adecuada, es necesario usarla en combinación con tratamientos convencionales, generar más conocimiento que contribuya a aclarar la inmunobiología del cáncer y reducir los costos asociados con su producción.

The pterygospinous foramen (Civinini) and the pterygoalar (crotaphitico-buccinatorius): laboratory findings / El foramen pterigoespinoso (Civinini) y el pterigoalar (crotafítico-buccinatorius): hallazgos de laboratorio

SUMMARY: The Pterygospinous foramen and pterygoalar foramen (crotaphitico-buccinatorius) are variant and atavic formations of the skull base and arise respectively from complete or incomplete idiopathic ossifications of the pterygospinous and pterygoalar ligaments. By proximity with areas of relevance for diagnosis and surgery, such as access pathways to the parapharyngeal and retropharyngeal spaces, it is necessary to be aware of these conditions due to the difficulties generated in surgical maneuvers and the promotion of compressive syndromes of mandibular nerve branches. This study was conducted on 45 samples of dry skulls and disarticulated sphenoid bones belonging to the collection of the Federal University of Juiz de Fora, Governador Valadares campus, Minas Gerais, Brazil. Our results indicated a total incidence of complete and incomplete pterygospinous and pterygoalar foramen (crotaphitico- buccinatorius) in 15, 5 % (7 skulls), with a higher incidence for the incomplete form of pterygospinous foramen (Civinini foramen) in 4 skulls (8.8 %), with 3 presenting unilaterally and 3 presenting bilaterally. The pterygoalar foramen (crotaphitico-buccinatorius or Hyrtl) was noted bilaterally in 1 of the skulls (2.2 %). The pterygospinous foramen and pterygoalar foramen are important findings, sometimes incidental, of an area of great anatomical expressiveness and pathological occurrences, besides the indispensable and unclear studies of phylogenetic order.

RESUMEN: El foramen pterigoespinoso y el foramen pterigoalar (crotafítico-buccinatorius) son formaciones variantes y atávicas de la base del cráneo y surgen respectivamente de osificaciones idiopáticas completas o incompletas, de los ligamentos pterigoespinoso y pterigoalar. Debido a la proximidad con áreas de relevancia para el diagnóstico y la cirugía, como las vías de acceso a los espacios parafaríngeo y retrofaríngeo, es necesario conocer estas condiciones por las dificultades que se generan en las maniobras quirúrgicas. Este estudio se realizó en 45 muestras de cráneos secos y huesos esfenoides desarticulados pertenecientes a la colección de la Universidad Federal de Juiz de Fora, campus Governador Valadares, Minas Gerais, Brasil. Nuestros resultados indicaron una incidencia total de foramen pterigoespinoso y pterigoalar completo e incompleto (crotafítico-buccinatorius) en el 15,5 % (7 cráneos), con una mayor incidencia de la forma incompleta de foramen pterigoespinoso (agujero de Civinini) en 4 cráneos (8,8 %), con 3 de presentación unilateral y 3 de presentación bilateral. El foramen pterigoalar (crotaphitico-buccinatorius o Hyrtl) se observó bilateralmente en 1 de los cráneos (2,2 %). El foramen pterigoespinoso y pterigoalar son hallazgos importantes, a veces incidentales, de un área de gran expresividad anatómica y ocurrencias patológicas, además de los estudios indispensables y poco claros de orden filogenético.

Discovering the Value Creation System in IoT Ecosystems.

Internet of Things (IoT) should not be seen only as a cost reduction mechanism for manufacturing companies; instead, it should be seen as the basis for transition to a new business model that monetizes the data from an intelligent ecosystem. In this regard, deciphering the operation of the value creation system and finding the balance between the digital strategy and the deployment of technological platforms, are the main motivations behind this research. To achieve the proposed objectives, systems theory has been adopted in the conceptualization stage, later, fuzzy logic has been used to structure a subsystem for the evaluation of input parameters. Subsequently, system dynamics have been used to build a computational representation and later, through dynamic simulation, the model has been adjusted according to iterations and the identified limits of the system. Finally, with the obtained set of results, different value creation and capture behaviors have been identified. The simulation model, based on the conceptualization of the system and the mathematical representation of the value function, allows to establish a frame of reference for the evaluation of the behaviour of IoT ecosystems in the context of the connected home.

Human immune response to SARS-CoV-2: What is known? A scoping review / Respuesta inmune humana al SARS-CoV-2: ¿Qué se conoce? Una scoping review

Monitoring literature on the broad spectrum of the human immune response to SARS-CoV-2 is important to understand the mechanisms and progression of COVID-19. The present study undertakes a scoping review of the literature on human immune response to SARS-CoV-2 to determine the characteristics of innate and adaptive responses, as well as biomarkers and cells that play a role in the development of the infection. We searched papers in MEDLINE/PUBMED and EMBASE databases published since December 1st 2019 to to April 9th 2020 from which we selected 56 for this study. We found that the immune response is characterized by high levels of acute phase reactants, neutrophilia, low levels of NKs and eosinophils, lymphopenia, cytokine storm syndrome, exhausted T cells, impaired cytotoxic response, inadequate helper response and production of specific antibodies; concluding that immune dysregulation correlates with disease severity and high mortality.

El seguimiento de la literatura sobre la respuesta inmune humana al SARS-CoV-2 es importante para comprender los mecanismos y la progresión de COVID-19. En el presente estudio se realizó un Scoping Review de la literatura sobre la respuesta inmune humana al SARS-CoV-2 para determinar las características de la respuesta inmune innata y adaptativa, así como biomarcadores y células que juegan un papel en el desarrollo de la infección. Buscamos artículos en las bases de datos MEDLINE / PUBMED y EMBASE publicados desde el 1 de diciembre de 2019 hasta el 9 de abril de 2020, de los cuales seleccionamos 56 publicaciones para este estudio. Encontramos que la respuesta inmune se caracteriza por altos niveles de reactantes de fase aguda, neutrofilia, bajos niveles de NKs y eosinófilos, linfopenia, síndrome de tormenta de citoquinas, linfocitos T agotados, respuesta citotóxica alterada, respuesta T helper inadecuada y producción de anticuerpos específicos. En conclusión, el desequilibrio inmune se correlaciona con la severidad y la mortalidad de la enfermedad.

Design of a AFLP-PCR and PCR-RFLP test that identify the majority of discrete typing units of Trypanosoma cruzi.

BACKGROUND: Chagas disease, caused by the intracellular parasite Trypanosoma cruzi, is one of the most important parasitological infections in the Americas. It is estimated to infect approximately 6 million people from mostly low income countries in Latin America, although recent infections have been reported in southern US states. Several studies have described an extensive genetic diversity among T. cruzi isolates throughout its geographic distribution in the American continent. This diversity has been correlated with the pathology developed during an infection. However, due to a lack of a single reliable test, current diagnosis practices of the disease are not straightforward since several different tests are applied. The use of current genomic sequence data allows for the selection of molecular markers (MM) that have the ability to identify the Discrete Typing Unit (DTU) of T. cruzi in a given infection, without the need of any sequencing reaction. METHODOLOGY/PRINCIPAL FINDINGS: Applying three criteria on the genomic sequencing data of four different phylogenetic lineages of T. cruzi, we designed several molecular tests that can be used for the molecular typing of the parasite. The criteria used were: (1) single-copy orthologs of T. cruzi, (2) T. cruzi unique loci, and (3) T. cruzi polymorphic loci. All criteria combined allowed for the selection of 15 MM, 12 of which were confirmed to be functional and replicable in the laboratory with sylvatic samples. Furthermore, one MM produced distinct polymerase chain reaction (PCR) amplicon sizes among distinct T. cruzi DTUs, allowing the use of a AFLP-PCR test to distinguish DTUs I, II/IV, V and VI. Whereas two MM can differentiate DTUs I, II, IV and V/VI out of the six current DTUs with a PCR-RFLP test. CONCLUSIONS/SIGNIFICANCE: The designed molecular tests provide a practical and inexpensive molecular typing test for the majority of DTUs of T. cruzi, excluding the need to perform any sequencing reaction. This provides the scientific community with an additional specific, quick and inexpensive test that can enhance the understanding of the correlation between the DTU of T. cruzi and the pathology developed during the infection.

When tongue strength exercises reflect in the cervical region. / Quando exercícios de fortalecimento da língua refletem na região cervical.

PURPOSE: To compare the impact of isokinetic exercise (tongue suction on the palate) in the cervical region of Class I and Class II / 2nd Division participants, considering the average and the symmetry of Root Means Square (RMS) of suprahyoid and suboccipital muscles and cervical sensory reports. METHOD: 11 participants Class I and 19 Class II / 2nd Division, both genders, mean age 33.4 ± 14.1 years. For the analysis of RMS average and symmetry, electromyography was performed in the suboccipital and suprahyoid muscles, bilaterally, at rest and suction of water in the initial, intermediate and final phases. The cervical sensation was evaluated qualitatively during the exercises. RESULTS: the mean RMS did not differ between Classes (p=0.7), but showed an increase in the intermediate phase in the suboccipital musculature (p=0.0001) and decrease in the suprahyoid musculature. In symmetry, the suprahyoid musculature showed a significant difference between classes (p=0.0001) during the intermediate phase. In the Class I participant the symmetry was reestablished in the final phase, a fact that did not occur in Class II / 2nd Division. Regarding the cervical sensation, only the Class II / 2nd Division had expressive complaints. CONCLUSION: The Isokinetic suctioning exercise of the tongue against the palate, had an expressive repercussion with reports of discomfort and neck pain in the Class II / 2nd Division participants. On average RMS, there was no difference between the classes, but in the intermediate phase, the suboccipital muscles showed a significant increase in the activity. Symmetry in the suprahyoid musculature had a significant difference between the classes and asymmetry in the intermediate phase.

Immunosenescence Study of T Cells: A Systematic Review.

Background: Aging is accompanied by alterations in immune response which leads to increased susceptibility to infectious diseases, cancer, autoimmunity, and inflammatory disorders. This decline in immune function is termed as immunosenescence; however, the mechanisms are not fully elucidated. Experimental approaches of adaptive immunity, particularly for T cells, have been the main focus of immunosenescence research. This systematic review evaluates and discusses T cell markers implicated in immunosenescence. Objective: To determine the best flow cytometry markers of circulating T cells associated with immunosenescence. Methods: We systematically queried PubMed, MEDLINE, EBSCO, and BVS databases for original articles focused on two age groups of healthy humans: 18-44 (young adults) and >60 (older adults) years. In accordance with the Cochrane methodology, we synthesized data through qualitative descriptions and quantitative random effects meta-analysis due to extensive heterogeneity. Results: A total of 36 studies conducted in the last 20 years were included for the qualitative analysis and four out of these studies were used to perform the meta-analysis. A significant decrease in naïve T cell subset was observed in older adults compared to young adults. Primary markers used to identify senescent cells were loss of CD28 and increased expression of CD57 and KLRG1 in terminally-differentiated memory T cell subset in older adults. Moreover, we observed an increase in proinflammatory cytokines and decrease in telomere length in old adult T cells. It was not possible to perform quantitative synthesis on cell markers, cytokines, and telomere length because of the significant variations between the groups, which is attributed to differences in protocols and unreported measurements, thus generating a high risk of bias. Conclusions: Heterogeneity among studies in terms of data report, measurement techniques and high risk of bias were major impediments for performing a robust statistical analysis that could aid the identification of eligible flow cytometry markers of immunosenescence phenotype in T cells.

O efeito do crioalongamento e da massoterapia no trismo pós-neoplasia bucal / The impacts of cryotherapy and massage in post buccal-neoplasm trismus

Resumo Introdução O trismo é uma restrição na abertura bucal de até 3,5 cm e é um dos efeitos colaterais mais comuns da radioterapia na região da cabeça e pescoço. Tal condição afeta funções cotidianas simples, como: mastigar, deglutir, falar e até exercer higiene bucal, acarretando danos não só físicos como emocionais aos indivíduos acometidos. Evidencia-se assim a necessidade da busca de tratamentos que revertam ou atenuem tal quadro. Objetivo O objetivo do estudo é investigar o comportamento dos músculos masseter e supra-hioideos durante a deglutição antes e após o crioalongamento associado à massoterapia, em pacientes pós-neoplasia bucal com trismo devido à radioterapia. Material e método A amostra final foi constituída por oito sujeitos, com faixa etária entre 40 e 64 anos, gêneros masculino e feminino, com abertura bucal menor ou igual a 3,5 cm. Para a realização da pesquisa, foram realizadas duas avaliações eletromiográficas, uma no início e outra no final do tratamento. Com 15 atendimentos, uma vez por semana, com manobras de crioalongamento associado à massoterapia nos músculos masseter e grupo muscular dos supra-hioideos. Resultado Após a intervenção com crioalongamento e massoterapia, foi observada diferença significativa apenas no comportamento do grupo muscular dos supra-hioideos, fato não constatado no músculo masseter. Conclusão Foi encontrada diferença significativa no comportamento do grupo muscular supra-hioideo e melhora na abertura de boca dos sujeitos. Contudo, os resultados deste estudo devem ser confirmados em casuísticas maiores.

Abstract Introduction Trismus is a restriction in the buccal opening up to 3.5cm and is one of the most frequent side effect of head and neck regions radiotherapy. This condition affects simple daily activities such as chewing, swallowing speaking and even buccal hygiene, leading to not only physical but emotional damages to the subjects. This puts in evidence the need to find treatments to revert or soften this condition. Objective This study investigates the behavior of masseter and suprahyoid muscles during swallowing before and after the cryotherapy associated to the massage in patients post buccal neoplasm with trismus due to radiotherapy. Material and method The final sample was composed of 8 subjects, aged between 40 an 64 years, both female and male with buccal opening equal to or smaller than 3.5cm. Two electromyographic evaluations were conducted to perform this research, one in the beginning and one in the end of the treatment. The study was composed of 15 treatment sessions, once a week, consisting of cryotherapy maneuvers and massage in masseters and supra-hyoids muscle groups. Result There was a significant difference in the behavior of the supra-hyoid muscles group, this fact was not observed in the masseter muscles group. Conclusion The study concluded that after the intervention with cryotherapy and massage sessions, was observed a significant difference in the behavior of the upperhyoid muscles group and an improvement of the subjects' mouth opening capacity. However, the results of this study must be confirmed in a larger sample size.

Quando exercícios de fortalecimento da língua refletem na região cervical / When tongue strength exercises reflect in the cervical region

RESUMO Objetivo: Comparar o impacto do exercício isocinético "sucção da língua contra o palato" na região cervical em participantes Classe I e Classe II/2.ª Divisão, considerando a média e a simetria do Root Means Square (RMS) dos músculos supra-hióideos e suboccipitais, e relatos sensoriais cervicais. Método: Onze participantes Classe I e 19 Classe II/2.ª Divisão, ambos os gêneros, média de idade 33,4 ±14,1 anos. Para análise da média do RMS e da simetria, realizou-se eletromiografia dos músculos suboccipitais e supra-hióideos, bilateralmente, no repouso e na sucção de água nas fases inicial, intermediária e final. A sensação cervical foi avaliada qualitativamente durante os exercícios. Resultados: A média do RMS não apresentou diferença entre Classes (p=0,7), mas revelou, na fase intermediária, elevação na musculatura suboccipital (p=0,0001) e diminuição na musculatura supra-hióidea. Na simetria, a musculatura supra-hióidea mostrou diferença significativa entre classes (p=0,0001) durante a fase intermediária. No participante Classe I, foi restabelecida a simetria na fase final, fato que não ocorreu na Classe II/2.ª Divisão. Em relação à sensação cervical, somente os Classe II/2.ª Divisão apresentaram queixas expressivas. Conclusão: O exercício isocinético de sucção da língua contra o palato repercutiu de forma expressiva com relatos de desconforto e dor cervical nos participantes Classe II/2.ª Divisão. Na média do RMS, não houve diferença entre as classes, mas, na fase intermediária, a musculatura suboccipital apresentou elevação de atividade significativa. A simetria na musculatura supra-hióidea teve diferença significativa entre as classes e assimetria na fase intermediária.

ABSTRACT Purpose: To compare the impact of isokinetic exercise (tongue suction on the palate) in the cervical region of Class I and Class II / 2nd Division participants, considering the average and the symmetry of Root Means Square (RMS) of suprahyoid and suboccipital muscles and cervical sensory reports. Method: 11 participants Class I and 19 Class II / 2nd Division, both genders, mean age 33.4 ± 14.1 years. For the analysis of RMS average and symmetry, electromyography was performed in the suboccipital and suprahyoid muscles, bilaterally, at rest and suction of water in the initial, intermediate and final phases. The cervical sensation was evaluated qualitatively during the exercises. Results: the mean RMS did not differ between Classes (p=0.7), but showed an increase in the intermediate phase in the suboccipital musculature (p=0.0001) and decrease in the suprahyoid musculature. In symmetry, the suprahyoid musculature showed a significant difference between classes (p=0.0001) during the intermediate phase. In the Class I participant the symmetry was reestablished in the final phase, a fact that did not occur in Class II / 2nd Division. Regarding the cervical sensation, only the Class II / 2nd Division had expressive complaints. Conclusion: The Isokinetic suctioning exercise of the tongue against the palate, had an expressive repercussion with reports of discomfort and neck pain in the Class II / 2nd Division participants. On average RMS, there was no difference between the classes, but in the intermediate phase, the suboccipital muscles showed a significant increase in the activity. Symmetry in the suprahyoid musculature had a significant difference between the classes and asymmetry in the intermediate phase.

Dialyzable Leukocyte Extract (Transferon™) Administration in Sepsis: Experience from a Single Referral Pediatric Intensive Care Unit.

Immunomodulatory agents have been proposed as therapeutic candidates to improve outcomes in sepsis. Transferon™, a dialyzable leukocyte extract (DLE), has been supported in Mexico as an immunomodulatory adjuvant in anti-infectious therapy. Here we present a retrospective study describing the experience of a referral pediatric intensive care unit (PICU) with Transferon™ in sepsis. We studied clinical and laboratory data from 123 patients with sepsis (15 in the DLE group and 108 in the control group) that were admitted to PICU during the period between January 2010 and December 2016. Transferon™ DLE use was associated with lower C reactive protein (CRP), increase in total lymphocyte counts (TLC), and decrease in total neutrophil count (TNC) 72 hours after Transferon™ DLE administration. The control group did not present any significant difference in CRP values and had lower TLC after 72 hours of admission. There was no difference in PICU length of stay between control and Transferon™ DLE group. Transferon™ DLE administration was associated with a higher survival rate at the end of PICU stay. This study shows a possible immunomodulatory effect of Transferon™ on pediatric sepsis patients.

Evaluación de la calidad de la atención estomatológica de dos servicios de Estomatología General Integral. Sancti Spíritus. 2018 / Evaluation of the quality of dental care of two General Comprehensive Stomatology services. Sancti Spíritus. 2018

RESUMEN Fundamento: La calidad de la atención estomatológica está caracterizada en el proceso y factores que intervienen en la prestación de los servicios, dirigidos a alcanzar buenos resultados en lo que a salud bucal se refiere. Objetivo: Evaluar la calidad de la atención estomatológica de dos servicios de Estomatología General Integral de la provincia Sancti Spíritus. Metodología: Se Realizó una investigación en sistema y servicio de salud en la provincia Sancti Spíritus de enero a noviembre del 2016. De las 21 unidades asistenciales que prestan el servicio de Estomatología General Integral, se eligieron dos, una de la zona urbana y otra de la zona rural. El muestreo aleatorio simple fue el proceder que se empleó para efectuar esta elección en cada zona. El Policlínico Tipo II del municipio Cabaiguán fue la unidad seleccionada en la zona urbana y la Clínica Estomatológica Banao del municipio Sancti Spíritus en la zona rural. La muestra fueron 388 pacientes y 24 estomatólogos. Las variables: calidad del servicio, estructura, proceso y resultado, se utilizaron métodos del nivel teórico, empírico (encuesta) y de la estadística descriptiva. Resultados: En el servicio rural los pacientes estuvieron satisfechos en un 57.8 % y en el urbano en un 51.9 %; los profesionales se mostraron medianamente satisfechos en ambos servicios con 50.0 % y 71.4 % respectivamente. Conclusiones: La calidad de la atención estomatológica en la zona urbana fue evaluada de bien y en la rural de regular. Algunos indicadores de las variables estructura y resultado se identificaron con dificultad (AU)

ABSTRACT Background: The quality of dental care is characterized in the process and factors that interfere in the provision of services, aimed at achieving good results in terms of oral health. Objective: To evaluate the quality of dental care of two General Comprehensive Stomatology services in Sancti Spíritus province. Methodology: An investigation was carried out on the system and health service in Sancti Spíritus province from January to November 2016. From 21 health care units that provide General Comprehensive Stomatology service, two were chosen, one from the urban area and the other from the rural one. The procedure used to make this choice in each zone was the Simple random sample. The Type II Polyclinic in Cabaiguán was the selected unit from the urban area and the Dental Clinic Banao in Sancti Spíritus, from the rural one. The sample consisted of 388 patients and 24 dentists. The variables: quality of service, structure, process and result, methods of theoretical, empirical (survey) and descriptive statistics were used. Results: From the rural service the patient's satisfaction represents 57.8 % and from the urban one 51.9 %; the professional's satisfaction was moderately in both services which represent 50.0 % and 71.4 % respectively. Conclusions: The quality of dental care from the urban area was evaluated as good and from the rural area as regular. Some indicators of the structure and outcome variables were identified with difficulty.