Ageing decreases the healing of wounds in the skin of alcohol-preferring rats.

OBJECTIVE: Alcohol consumption combined with ageing alters the healing process of the skin. We evaluated whether ageing decreases the healing of incisional wounds in the skin of Wistar rats of Universidade de Chile of variety B (UChB). METHOD: A total of 20 adult rats and 20 older UChB rats, divided into two groups which underwent surgical aggression in the anterior region of the abdomen, were used: G1, adult rats (100 days old, control) with water and 10% ethanol; G2, aged rats (540 days old, experimental) with water and 10% ethanol; evaluated at 4, 7, 14 and 21 days after surgery. RESULTS: Ageing did not alter the rupture force and collagen elasticity and resistance. There were increases in telomerase with the implementation of cellular senescence, in interleukin 1-alpha (IL-1α) at 14 days of healing, in epidermal growth factor (EGF) at 14 and 21 days of healing with delayed growth and development of keratinocytes, also an increase of IL-ß at 4 days, and decrease in tumour necrosis factor (TNFα) at 7 days, associated with chronic scarring. There was an increase in vascular endothelial growth factor (VEGF) at 4 and 7 days, responsible for the early vessels re-establishment. There was a decrease in transforming growth factor 2-beta (TGFß2) and ß3 at 4 and 7 days of healing respectively, and estradiol at 4 days. CONCLUSION: Ageing decreases the skin healing in incisional wounds in alcohol-preferring rats.

Cellular bases of hypofractionated radiotherapy protocols for lung cancer.

The extreme demand on health systems due to the COVID-19 pandemic has led to reconsider hypofractionation. Although the best clinical efficacy of these schemes is being demonstrated, the biological bases have not been established. Thus, after validating basic clinical parameters, through complementary in vitro models, we characterized the cellular and molecular mechanisms of hypofractionation protocols. Cell cultures of human lung cancer cell line A549 were irradiated with 0, 2, 4, 8, 12, 16 and 20 Gy. The clastogenic, cytotoxic, proliferative and clonogenic capacities and bystander effect were evaluated. In addition, we assessed survival and toxicity in a retrospective study of 49 patients with lung cancer. Our findings showed that the greater efficacy of ablative regimens should not only be attributed to events of direct cell death induced by genotoxic damage, but also to a lower cell repopulation and the indirect action of clastogenic factors secreted. These treatments were optimal in terms of 1- and 2-year overall survival (74 and 65%, respectively), and progression-free survival at 1 and 2 years (71 and 61%, respectively). The greater efficacy of high doses per fraction could be attributed to a multifactorial mechanism that goes beyond the 4Rs of conventional radiotherapy.

Pregnancy outcome in women with prior placenta accreta spectrum disorders treated with conservative-reconstructive surgery: analysis of 202 cases.

AIM: To report the outcome of pregnant women with a prior pregnancy complicated by placenta accreta spectrum (PAS) disorders treated with resective-conservative surgery at the time of cesarean section. MATERIALS AND METHODS: Retrospective analysis of pregnant women treated with conservative surgery in the prior pregnancy complicated by PAS disorders. The primary outcome was spontaneous preterm birth with intact membranes or following a preterm labor rupture of the membranes before 37 weeks of gestation. Secondary outcomes were uterine rupture, need for hysterectomy due to severe ante or intrapartum maternal hemorrhage, myometrial thinning at the time of cesarean section, 5 min Apgar score, birth weight centile, and the occurrence of small for gestational age newborns. All these outcomes were observed in women with prior PAS treated with conservative resective surgery divided according to the topographical surgical classification. RESULT: Pregnancies included: 89.6% (181/202) related to PAS type 1; 7.9% (16/202) related to PAS type 2, and 2.5% (5/202) related to PAS type 3. 90% of cases (162/179) (95 CI: 90.3-90.6) completed the pregnancy at term (greater than 37 weeks). The average intergenesic period was 15 months for PAS type 1 and 2 (SD 4,76) (Q1:12; Q3:19), and 18 months for PAS 3 (SD 6,56) (Q1:14; Q3:19). A few mothers presented some complications PPROM 1; premature labor 4; hypertension 2; atony 1; overweight 1; and gestational diabetes 2. The mean age was 30 years (T1), 31 years (T2), and 36 years (T3·). The uterine segment was thicker than usual except for one case of partial uterine dehiscence (twins). There were no placenta previa or PAS, a uterine atony case, and there was one case of hysterectomy by patient request. CONCLUSIONS: Subsequent pregnancies after use of resective-reconstructive for PAS has demonstrated to have similar maternal and neonatal outcomes to typical gestation and cesarean delivery.

Neonatal outcome after conservative-reconstructive surgery for placenta accreta spectrum disorders.

AIM: To report the neonatal outcome after conservative-reconstructive surgery for placenta accreta spectrum (PAS) disorders. MATERIALS AND METHODS: Inclusion criteria were women undergoing conservative-reconstructive surgery for PAS. The outcomes explored were: 5 min Apgar score, birth weight, and need for ventilatory support (RS1 supplementary oxygen, RS2 nasal positive pressure ventilation, or RS3 mechanical ventilatory assistance). Descriptive statistics (means and standard deviations for quantitative and percentage and interquartile range for quantitative variables) were sued to report the data. RESULTS: 84% of women with PAS type 1 were delivered between 35 and 37 weeks of gestation. There was only one case of small for gestational age (SGA) newborn 81% of the newborns required admission to the NICU and 11% respiratory support of those pregnancies complicated by PAS type 2, 59% were delivered between 35 and 36.6 weeks. Neonatal birth weight was consistent with gestational age at birth for all the included cases, and there was no SGA newborn in this group. 84% of the newborns required admission to the NICU, while 21% respiratory support. All women with PAS type 3 were delivered between 30 and 33 weeks of gestation. Although all newborns were admitted to NICU and 73% required ventilatory support, there was no SGA case. Pregnancies complicated by PAS type 4 completed their pregnancy between weeks 35 and 37. There was no case affected by SGA; although all newborns were admitted to NICU, none required ventilatory support. CONCLUSIONS: Conservative surgery in pregnancies complicated by PAS does not seem to increase the risk of adverse neonatal outcomes. Early gestational age at birth and invasion in the inferior third of the lower uterine segment is associated with an increased incidence of neonatal complications, likely due to the earlier gestational age at delivery for these pregnancies.

Placenta accreta spectrum: a hysterectomy can be prevented in almost 80% of cases using a resective-reconstructive technique.

OBJECTIVE: To describe the use of surgical repair (One-step resective-conservative surgery) in all cases of placenta accreta spectrum. STUDY DESIGN: Multicentre retrospective case series from tertiary referral hospitals in Argentina. A total of 452 patients were accepted from 12 hospitals presenting suspicion of invasive placenta by auxiliary methods (ultrasound, Doppler and MRI). At the time of the surgery, placenta accreta spectrum was classified according to invasion topography (specific blood supply) and local features (proximity to other structures, adhesion process, and multiple anastomotic blood vessels). Type 1: upper posterior bladder; type 2: parametrial; type 3: low posterior bladder; and type 4: low posterior bladder and fibrosis. After the ligature of newly formed vessels between the uterus and pelvic organs, the fetus was delivered through an upper segmental hysterotomy. Hemostasis was achieved by selective ligature of vesical-uterine and colpo-uterine vessels. Then, the invaded myometrium and the entire placenta were removed totally in bloc and until detected healthy tissue in both edges, to guarantee the most physiological hysterotomy in the uterine segment. The uterus was closed with a polyglactin suture, double-layer technique. The main outcome measurements were the uterine conservation, the blood loss and other complications classified according to intrasurgical classification. RESULTS: From 452 accepted patients, 326 patients had a confirmed diagnosis of placenta accreta spectrum by histology analysis and surgical-clinical findings. In 126 cases, placenta accreta spectrum was excluded used the same diagnostic criteria (Type 0 or false positive PAS). They were identified 248 cases as type 1, 44 as type 2, 23 as type 3 and 11 as type 4. Uterine conservation was possible in the 81% of type 1 invasion with 500 mL of blood loss (interquartile range, IQR = Q3 - Q1). The modified Pfannenstiel was the most commonly used incision, while midline incision was chosen in all emergencies or in patients with a previous midline incision. Hysterotomy made in the upper part of the uterine segment presented normally attached placentas and not accreta. Selective vessel ligature, also named custom-made hemostasis method (CMHM) was effective at stopping or preventing bleeding associated with PAS. The entire placenta and the invaded area are removed in block, to guarantee to perform the uterine repair with healthy tissue and to avoid a recurrence in the subsequent cesarean. The uterine-ovary artery axis is never occluded or obliterate to guarantee the uterine-endometrial and ovary blood supply as before surgery. No significant differences existed according to the population; however, the presence of total occlusive placenta previa was more frequent in types 3 and 4, which were also associated with older mothers and age-related collagen changes. Lateral and lower segment invasions (types 2 and 3) were most commonly associated with previous terminations of pregnancy, curettage, and manual removal of the placenta. Blood loss and technical difficulty were clearly associated to the invaded area, while invasion degree was a poor marker to predicting bleeding or complications in all locations Uterine conservation was possible in 202/248 (81.5%) of type 1, 21/44 (47.7%) of type 2, 5/23 (21.8%) of type 3 and 0/11 (0%) of type four cases. Type 0 (false positive) were excluded of statistical analysis, and the uterus was preserved in 100% of cases. In a separate report, we will describe the maternal and fetal outcomes as well as 204 subsequent pregnancies after the use of one-step resective reconstructive technique. CONCLUSIONS: Using the resective-reconstructive approach (one-step conservative surgery) to the management of invasive placenta, the uterus can be preserved with minimal morbidity and reduced blood loss in almost 80% of cases. Précis preventing hysterectomy in 80% of placenta accreta spectrum.

Caffeine consumption attenuates ethanol-induced inflammation through the regulation of adenosinergic receptors in the UChB rats cerebellum.

Caffeine consumption is able to interfere in cellular processes related to inflammatory mechanisms by acting through the adenosinergic system. This study aimed to recognize alterations related to adenosinergic system and inflammatory process in the cerebellum of University of Chile Bibulous (UChB) rats after the consumption of ethanol and caffeine. UChB and Wistar rats, males at 5 months old, were divided into the groups (n = 15/group): (i) Control (Wistar rats receiving water); (ii) Ethanol group (UChB rats receiving ethanol solution at 10%) and (iii) Ethanol+caffeine group (UChB rats receiving ethanol solution at 10% added of 3 g/L of caffeine). The cerebellar tissue was collected and processed for immunohistochemistry, Reverse transcription polymerase chain reaction (RT-PCR) and western blotting techniques for the adenosinergic receptors A1 and A2a and inflammatory markers, including Nuclear factor kappa B (NFkB), TLR4, TLR2, MyD88, TNF-α, COX-2, iNOS and microglial marker Iba-1. Results showed ethanol and caffeine consumption differentially altering the immunolocalization of adenosinergic receptors and inflammatory markers in the cerebellar tissue. The A2a receptor was overexpressed in the Ethanol group and was evident in the glial cells. The Ethanol group had increased protein levels for NFκB and TLR4, expressively in Bergmann glia and Purkinje cells. Caffeine reduced the expression of these markers to levels similar to those found in the Control group. The A1 gene was upregulated the Ethanol group, but not its protein levels, suggesting post-transcriptional interference. In conclusion, caffeine seems to attenuate ethanol-induced inflammation in the cerebellum of UChB rats through the A1 and A2a modulation, playing a neuroprotective role in the chronic context of ethanol consumption.

Retinopatía del prematuro: resultados de un programa de prevención, detección y tratamiento

RESUMEN Introducción: La Retinopatía del Prematuro (ROP) es una de las principales causas de ceguera prevenibles en la infancia. La Fundación Visión implementa; el Programa de Prevención, Detección y Tratamiento en el año 2015. Objetivos: Describir los resultados de implementación y los resultados alcanzados por un programa de ROP en su accesibilidad, efectividad y calidad de atención. Materiales y Métodos: Estudio descriptivo, ambispectivo, de casos consecutivos de recién nacidos prematuros con criterios de evaluación; de una población evaluada en el año 2009 y del 2015 al 2019. Resultados: Las unidades neonatales incluidas aumentaron de 3 a 7; cubriendo Asunción, área Central, Caaguazú y Alto Paraná. De los registros se constato que la cobertura aumento de 36% en el año 2009 a 97% en el 2019. Desde que se instaló el programa; en el primer año la proporción del número de evaluaciones aumento entre el 28 y el 216%; y los resultados globales de julio 2015 a diciembre 2019 fueron: número totales de pacientes con criterio: 2397 pacientes; número totales de pacientes evaluados: 2080 (86,8%), número de pacientes con ROP: 416/2080 pacientes (20%), número de pacientes con ROP que requirieron tratamiento: 76/416 pacientes (18,2%), proporción global de ROP grave con tratamiento: 76/2080 pacientes (3,4%). Conclusiones: El programa a través de un equipo multidisplinario y la inovación con telemedicina logró aumentar la proporción de cobertura y la disminución de los casos graves que requirieron tratamiento.

ABSTRACT Introduction: Retinopathy of Prematurity (ROP) is one of the main preventable causes of blindness in childhood. The Vision Foundation implemented the Prevention, Detection and Treatment Program in 2015. Objective: To describe the implementation results and the outcomes achieved by a ROP program regarding its accessibility, effectiveness and quality of care. Materials and Methods: This was a descriptive and ambispective study of consecutive cases of premature newborns with criteria for evaluation, of a population evaluated in the year 2009 and from 2015 to 2019. Results: The participating neonatal units increased from 3 to 7; covering Asunción, the Central, Caaguazú and Alto Paraná Departments. From the records, it was found that program coverage increased from 36% in 2009 to 97% in 2019. Since the beginning of the program, during the first year the proportion of the number of evaluations increased between 28 and 218%; the global results from July 2015 to December 2019 were: total number of patients with criteria: 2397 patients; total number of patients evaluated: 2,080 (88%), number of patients with ROP: 416/2080 patients (20 %), number of patients with ROP requiring treatment: 76/416 patients (18.3%), overall proportion of severe ROP with treatment: 76/2080 patients (3.4%). Conclusions: The program, using a multidisciplinary team and the innovation of telemedicine, managed to increase the proportion of coverage and the reduction of serious cases that require treatment.

Expression of AIF, PARP, and miRNAs MIR-145, MIR-210, and MIR-486 associated with apoptosis in the corpus cavernosum of rats subjected to chronic alcoholism model / Expresión de AIF, PARP y miRNAs MIR-145, MIR-210 y MIR-486 asociados con apoptosis en el cuerpo cavernoso de ratas sometidas a modelo de alcoholismo crónico

SUMMARY: Previous studies from our group described the consequences of using ethanol on penile erection. Nevertheless, the molecular mechanisms surrounding microRNAs, apoptosis process and their relationship with erectile dysfunction associated with alcohol consumption are still poorly understood. The objective of this analysis was to evaluate the mechanism of apoptosis by the expression of AIF and PARP, as well as their regulatory microRNAs: miR-145, miR-210 and miR-486, in the corpus cavernosum of rats submitted to a semivoluntary alcoholism model. For this study 24 Wistar rats were divided into two groups: control (C) and treated with 20 % ethanol (A) for seven weeks. The corpus cavernosum samples were prepared for immunohistochemical analysis of AIF and PARP protein expression, and microRNAs miR-145, miR-210, miR-486 gene expression in cavernous tissue was performed by real time PCR. The immunohistochemical analysis showed little nuclear positive labeling for the protein PARP and AIF in the corpus cavernosum of control and ethanol treated animals. After analysis of miR-145, -210 and -486 microRNA expression in the 12 animals studied, no results were found with significant statistical difference between the control and alcoholized groups. The expression of AIF and PARP and their regulatory microRNAs involved in apoptotic process (miR-145, miR-210 and miR-486) were not altered in the corpus cavernosum of rats submitted to semivoluntary alcoholism.

RESUMEN: Estudios previos de nuestro grupo describieron las consecuencias del uso de etanol en la erección del pene. Sin embargo, los mecanismos moleculares que rodean a los microARN, el proceso de apoptosis y su relación con la disfunción eréctil asociada con el consumo de alcohol aún no se conocen bien. El objetivo de este análisis fue evaluar el mecanismo de apoptosis mediante la expresión de AIF y PARP, así como sus microARN reguladores: miR-145, miR-210 y miR-486, en el cuerpo cavernoso de ratas sometidas a un modelo de alcoholismo semivoluntario. Se dividieron 24 ratas Wistar en dos grupos: control (C) grupo de ratas tratadas con etanol al 20 % (A) durante siete semanas. Las muestras del cuerpo cavernoso se prepararon para el análisis inmunohistoquímico de la expresión de la proteína AIF y PARP, y la expresión del gen microRNAs miR-145, miR-210, miR-486 en tejido cavernoso se realizó por PCR en tiempo real. El análisis inmunohistoquímico mostró escaso etiquetado nuclear positivo para la proteína PARP y AIF en el cuerpo cavernoso de los animales de control y tratados con etanol. Después del análisis de la expresión de microARN miR-145, -210 y -486 no se encontraron resultados con diferencias estadísticas significativas entre los grupos control y alcoholizados. La expresión de AIF y PARP y sus microARN reguladores involucrados en el proceso apoptótico (miR-145, miR-210 y miR-486) no se alteraron en el cuerpo cavernoso de las ratas sometidas a alcoholismo semivoluntario.

Stabilization and application of spray-dried tannase from Aspergillus fumigatus CAS21 in the presence of different carriers.

The Aspergillus fumigatus CAS21 tannase was spray dried with ß-cyclodextrin, Capsul® starch, soybean meal, lactose, and maltodextrin as adjuvants. The moisture content and water activity of the products ranged from 5.6 to 11.5% and from 0.249 to 0.448, respectively. The maximal tannase activity was achieved at 40-60 ºC and pH 5.0-6.0 for the powders containing ß-cyclodextrin and Capsul® starch, which was stable at 40 ºC and 40-60 ºC for 120 min, respectively. For all the dried products, tannase retained its activity of over 80% for 120 min at pH 5.0 and 6.0. Salts and solvents influenced the activity of the spray-dried tannase. The activity of the spray-dried tannase was maintained when preserved for 1 year at 4 ºC and 28 ºC. Spray-dried tannase reduced the content of tannins and polyphenolic compounds of leather effluent and sorghum flour and catalyzed the transesterification reaction. The spray drying process stabilized the tannase activity, highlighting the potential of dried products for biotechnological applications.

Spray Drying of Coloring Extracts Produced by Fungi Isolated from Brazilian Caves

Abstract Pigments produced by submerged fermentation of three filamentous fungi isolated from Brazilian caves, namely Aspergillus keveii, Penicillium flavigenum, and Epicoccum nigrum, were submitted to spray drying in presence of the adjuvants maltodextrin, modified starch or gum arabic. Yellow fine powders with low moisture content and water activity, and high color retention (> 70%) were successfully generated with a high product recovery ratio (> 50%), independently of the adjuvant used. The dried products have enhanced stability and potential to might be used as a natural colorant in food and pharmaceutical applications.

P-MAPA and Interleukin-12 Reduce Cell Migration/Invasion and Attenuate the Toll-Like Receptor-Mediated Inflammatory Response in Ovarian Cancer SKOV-3 Cells: A Preliminary Study.

Immunotherapies have emerged as promising complementary treatments for ovarian cancer (OC), but its effective and direct role on OC cells is unclear. This study examined the combinatory effects of the protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride, known as P-MAPA, and the human recombinant interleukin-12 (hrIL-12) on cell migration/invasion, apoptosis, toll-like receptor (TLR)-mediated inflammation, and cytokine/chemokine profile in human OC cell line SKOV-3. P-MAPA and IL-12 showed cancer cell toxicity under low doses after 48 h. Although apoptosis/necrosis and the cell cycle were unchanged by the treatments, P-MAPA enhanced the sensitivity to paclitaxel (PTX) and P-MAPA associated with IL-12 significantly reduced the migratory potential and invasion capacity of SKOV-3 cells. P-MAPA therapy reduced TLR2 immunostaining and the myeloid differentiation factor 88 (MyD88), but not the TLR4 levels. Moreover, the combination of P-MAPA with IL-12 attenuated the levels of MyD88, interferon regulatory factor 3 (IRF3) and nuclear factor kappa B (NF-kB p65). The IL-12 levels were increased and P-MAPA stimulated the secretion of cytokines IL-3, IL-9, IL-10, and chemokines MDC/CCL22 and, regulated on activation, normal T cells expressed and secreted (RANTES)/CCL5. Conversely, combination therapy reduced the levels of IL-3, IL-9, IL-10, MDC/CCL22, and RANTES/CCL5. Collectively, P-MAPA and IL-12 reduce cell dynamics and effectively target the TLR-related downstream molecules, eliciting a protective effect against chemoresistance. P-MAPA also stimulates the secretion of anti-inflammatory molecules, possibly having an immune response in the OC microenvironment.

SWEET Transporters for the Nourishment of Embryonic Tissues during Maize Germination.

In maize seed germination, the endosperm and the scutellum nourish the embryo axis. Here, we examined the mRNA relative amount of the SWEET protein family, which could be involved in sugar transport during germination since high [14-C]-glucose and mainly [14-C]-sucrose diffusional uptake were found in embryo tissues. We identified high levels of transcripts for SWEETs in the three phases of the germination process: ZmSWEET4c, ZmSWEET6b, ZmSWEET11, ZmSWEET13a, ZmSWEET13b, ZmSWEET14b and ZmSWEET15a, except at 0 h of imbibition where the abundance of each ZmSWEET was low. Despite the major sucrose (Suc) biosynthesis capacity of the scutellum and the high level of transcripts of the Suc symporter SUT1, Suc was not found to be accumulated; furthermore, in the embryo axis, Suc did not decrease but hexoses increased, suggesting an efficient Suc efflux from the scutellum to nourish the embryo axis. The influx of Glc into the scutellum could be mediated by SWEET4c to take up the large amount of transported sugars due to the late hydrolysis of starch. In addition, sugars regulated the mRNA amount of SWEETs at the embryo axis. These results suggest an important role for SWEETs in transporting Suc and hexoses between the scutellum and the embryo axis, and differences in SWEET transcripts between both tissues might occur because of the different sugar requirements and metabolism.

Polifarmacia en adulto mayor, impacto en su calidad de vida: revision de literatura / Polypharmacy in older adults and impact on their quality of life: literature review / Polifarmácia em idosos, impacto em sua qualidade de vida: revisão da literatura

RESUMEN: Objetivo: Conocer mediante el análisis del estado del conocimiento, el impacto de polifarmacia en calidad de vida de adultos mayores y cuál ha sido el rol de enfermería frente a esta problemática de salud. Métodos: Revisión descriptiva de 62 artículos originales de diversos diseños metodológicos, en bases de datos: EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS y Dialnet. Resultados: La polifarmacia en adultos mayores se presenta con mayor frecuencia en el sexo femenino, en personas con bajo nivel de escolaridad, sumados a factores socioeconómico. Un gran porcentaje de adultos mayores presenta efecto cascada en consumo de fármacos, por cantidad de medicamentos consumidos y número de médicos consultados, produciendo interacciones farmacológicas, afectando funcionalidad y calidad de vida. Conclusiones: Es necesario mayor control de medicamentos consumidos por adultos mayores, para evitar efectos nocivos. Los profesionales de enfermería deben tener un rol educativo en este grupo etario, para disminuir polifarmacia e impulsar estilos de vida que fomenten el envejecimiento saludable.(AU)

ABSTRACT: Objective: To know, by analyzing the state of knowledge, the impact of the polypharmacy on the quality of life of older adults and the role of nursing when dealing with this health problem. Materials and Methods: Descriptive review of 62 original articles with multiple methodological designs, in the databases EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS and Dialnet. Results: Polypharmacy in older adults is more frequent in the female sex and people with low level of education, and is associated with socioeconomic factors. A large percentage of older adults present with prescription cascade due to the amount of drugs consumed and the number of doctors consulted, leading to pharmacological interactions that affect functionality and quality of life. Conclusions: More control of drugs consumed by older adults is needed to avoid harmful effects. Nursing professionals should have an educational role in this age group to reduce polypharmacy and promote lifestyles that foster healthy ageing.(AU)

RESUMO: Objetivo: Conhecer, através da análise do estado do conhecimento, o impacto da polifarmácia na qualidade de vida do idoso e qual o papel da enfermagem diante desse problema de saúde. Métodos: Revisão descritiva de 62 artigos originais de vários desenhos metodológicos, nas bases de dados: EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS e Dialnet. Resultados: A polifarmácia em idosos ocorre mais frequentemente no sexo feminino, em pessoas com baixa escolaridade, somada a fatores socioeconômicos. Uma grande porcentagem de idosos apresenta efeito cascata no consumo de medicamentos, pela quantidade de medicamentos consumidos e número de médicos consultados, produzindo interações farmacológicas, afetando a funcionalidade e a qualidade de vida. Conclusões: É necessário um maior controle dos medicamentos consumidos por idosos para evitar efeitos nocivos. Os profissionais de enfermagem devem ter papel educativo nessa faixa etária, para diminuir a polifarmácia e promover estilos de vida que promovam o envelhecimento saudável.(AU)

[Polypharmacy in older adults and impact on their quality of life. Literature review]. / Polifarmacia en adulto mayor, impacto en su calidad de vida. Revision de literatura.

OBJECTIVE: To know, by analyzing the state of knowledge, the impact of the polypharmacy on the quality of life of older adults and the role of nursing when dealing with this health problem. MATERIALS AND METHODS: Descriptive review of 62 original articles with multiple methodological designs, in the databases EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS and Dialnet. RESULTS: Polypharmacy in older adults is more frequent in the female sex and people with low level of education, and is associated with socioeconomic factors. A large percentage of older adults present with prescription cascade due to the amount of drugs consumed and the number of doctors consulted, leading to pharmacological interactions that affect functionality and quality of life. CONCLUSIONS: More control of drugs consumed by older adults is needed to avoid harmful effects. Nursing professionals should have an educational role in this age group to reduce polypharmacy and promote lifestyles that foster healthy ageing.

OBJETIVO: Conocer mediante el análisis del estado del conocimiento, el impacto de polifarmacia en calidad de vida de adultos mayores y cuál ha sido el rol de enfermería frente a esta problemática de salud. MÉTODOS: Revisión descriptiva de 62 artículos originales de diversos diseños metodológicos, en bases de datos: EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS y Dialnet. RESULTADOS: La polifarmacia en adultos mayores se presenta con mayor frecuencia en el sexo femenino, en personas con bajo nivel de escolaridad, sumados a factores socioeconómico. Un gran porcentaje de adultos mayores presenta efecto cascada en consumo de fármacos, por cantidad de medicamentos consumidos y número de médicos consultados, produciendo interacciones farmacológicas, afectando funcionalidad y calidad de vida. CONCLUSIONES: Es necesario mayor control de medicamentos consumidos por adultos mayores, para evitar efectos nocivos. Los profesionales de enfermería deben tener un rol educativo en este grupo etario, para disminuir polifarmacia e impulsar estilos de vida que fomenten el envejecimiento saludable.

P-MAPA and IL-12 Differentially Regulate Proteins Associated with Ovarian Cancer Progression: A Proteomic Study.

To investigate the potential role of immunotherapies in the cellular and molecular mechanisms associated with ovarian cancer (OC), we applied a comparative proteomic toll using protein identification combined with mass spectrometry. Herein, the effects of the protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride, known as P-MAPA, and the human recombinant interleukin-12 (hrIL-12) were tested alone or in combination in human SKOV-3 cells. The doses and period were defined based on a previous study, which showed that 25 µg/mL P-MAPA and 1 ng/mL IL-12 are sufficient to reduce cell metabolism after 48 h. Indeed, among 2,881 proteins modulated by the treatments, 532 of them were strictly concordant and common. P-MAPA therapy upregulated proteins involved in tight junction, focal adhesion, ribosome constitution, GTP hydrolysis, semaphorin interactions, and expression of SLIT and ROBO, whereas it downregulated ERBB4 signaling, toll-like receptor signaling, regulation of NOTCH 4, and the ubiquitin proteasome pathway. In addition, IL-12 therapy led to upregulation of leukocyte migration, tight junction, and cell signaling, while cell communication, cell metabolism, and Wnt signaling were significantly downregulated in OC cells. A clear majority of proteins that were overexpressed by the combination of P-MAPA with IL-12 are involved in tight junction, focal adhesion, DNA methylation, metabolism of RNA, and ribosomal function; only a small number of downregulated proteins were involved in cell signaling, energy and mitochondrial processes, cell oxidation and senescence, and Wnt signaling. These findings suggest that P-MAPA and IL-12 efficiently regulated important proteins associated with OC progression; these altered proteins may represent potential targets for OC treatment in addition to its immunoadjuvant effects.

Interactions of ethanol and caffeine on apoptosis in the rat cerebellum (voluntary ethanol consumers).

Ethanol alters motricity, learning, cognition, and cellular metabolism in the cerebellum. The combination of ethanol with caffeine by consuming "energy drinks" is becoming increasingly popular among young people. We analyzed the use of ethanol and caffeine on apoptosis in the cerebellum of UChB rats. The adult rats were divided into three groups (n = 14/group): UChB group: rats fed with 1:10 (v/v) ethanol ad libitum (free choice for water or ethanol) drinking from >1.9 mL of ethanol/kg body weight/day, Control group and UChB/caffeine group (free choice for water or ethanol + caffeine 300 mg/L). The treatments occurred from Day 100 till Day 150, totalizing 50 days of ethanol/caffeine ingestion. Cerebellar sections were subjected to immunohistochemistry and gene expression for Real Time-PCR (RT-PCR) for Caspase-3, XIAP, and insulin-like growth factor 1-receptor (IGF-1R). The results showed a significant increase in the gene expression of Caspase-3 and XIAP in UChB group. On the other hand, the animals of the UChB/caffeine group showed similar results to the Controls. Regarding IGFR-1, there was greater expression in the UChB groups with strong labeling in Purkinje cells. Ethanol produces neuronal and glial neurodegeneration on the cerebellum of UChB rats. The simultaneous ingestion of ethanol and caffeine reversed the ethanol damages acting caffeine with a neuroprotective effect.

Preferencias étnicas en niños bolivianos: Tras la huella de la exclusión / Ethnic preferences in Bolivian children: On the track of exclusion

Resumen: La presente investigación busca evidencia científica acerca de las preferencias étnicas (PE) como alternativa para el estudio acerca del desarrollo de la identidad en niños por debajo de los 12 años. Con este propósito, se evaluaron las PE y del desarrollo cognitivo en una muestra de 388 niños de ambos sexos, 192 varones (49,5%) y 196 mujeres (50,5%), provenientes de zonas urbanas y peri urbanas de tres ciudades de Bolivia. Se postuló, en concordancia con la multidimensionalidad de las PE que, la edad, el origen étnico de los niños, las destrezas cognitivas, el entorno social y cultural en el que se desarrollan (homogéneo-heterogéneo) y el auto-reconocimiento con respecto a las características de su endogrupo, podrían ser factores de importante influencia sobre sus preferencias. Los resultados mostraron que los niños no consolidan su identidad antes de los 12 años. Sin embargo, resultó evidente que las PE evolucionan y modifican desde la infancia hasta el inicio de la adolescencia, siguiendo un patrón más o menos constante asociado con las variables anteriormente mencionadas.

Abstract: The present research seeks scientific evidence about ethnic preferences (EP) as an alternative for the study on the development of identity in children below 12 years old. With this purpose, the EP and cognitive development was evaluated in a sample of 388 children of both sexes, 192 boys (49.5%) and 196 women (50.5%) from urban and peri-urban of three cities of Bolivia. It was postulated, according with the multidimensionality of EP that, in addition to the age, the ethnicity of children, their cognitive skills, the social and cultural environment in which they develop (homogeneous-heterogeneous) and the self-recognition with respect to the in-group characteristics, could be factors with important influence in their preferences. The results showed that children do not consolidate their identity before 12 years. However, it became clear that ethnic preferences develop and change from childhood to early adolescence, following a more or less constant pattern associated with the aforementioned variables.

Prevalencia de litiasis biliar en personas concurrentes al hospital de clínicas / Prevalence of gallstones in persons who are present at the hospital de clínicas

Introducción: La prevalencia de la litiasis biliar ha sido demostrada en varios países. En nuestro país es la causa principal de patologías quirúrgicas en varios servicios de cirugía, existen pocos estudios sobre el comportamiento de esta patología en el Paraguay. Objetivo: Determinar la prevalencia de litiasis biliar en personas asintomáticas en un hospital paraguayo de referencia. Material y Métodos:En este estudio observacional descriptivo de corte transversal, se analizan por ecografía abdominal personas concurrentes al Hospital de Clínicas, que cumplen con los criterios de inclusión para detección de litiasis vesicular.Utilizando métodos ecográficos estudiamos 58 personas: 30 Mujeres y 28 Hombres con edades de entre 20 a 70 Años. Estimada por el análisis estadístico para estudios descriptivos de una variable dicotómica con nivel de confianza del 95% y seleccionados por conveniencia. Resultados: Se encontraron 4 casos de 58 personas estudiadas (prevalencia de 7%), todos los casos fueron en mujeres de entre 32 a 56 años, 2 personas en edad fértil y 2 personas en edad no fértil. Conclusión:La prevalencia ecográfica de litiasis vesicular en personas asintomáticas fue de 7%. Es un tema novedoso a nivel nacional y latinoamericano. Este estudio podría ser de mucho valor para investigaciones futuras relacionadas al tema.

Introduction: The prevalence of gallstones has been demonstrated in several countries. In our country is the main cause of surgical pathologies in several surgical services, there are few studies on the behavior of this pathology in Paraguay. Objetive: Show the prevalence of gallstones in asymptomatic patients in a Paraguayan referral hospital. Materials and methods: In this cross-sectional, observational, descriptive study, are analyzed by abdominal ultrasonography patients attending the Hospital de Clínicas, who meet the inclusion criteria for vesicular lithiasis. Using ultrasound methods, we studied 58 people: 30 women and 28 men with ages between 20 and 70 years. Estimated by statistical analysis for descriptive studies of a dichotomous variable with 95% confidence level and selected for convenience. Results: Four cases of 58 people were studied (prevalence of 7%), all cases were in women between 32 to 56 years, 2 people of childbearing age and 2 people of nonfertile age. Conclusion: The ultrasound prevalence of vesicular lithiasis in asymptomatic individuals was 7%. It is a new topic at national and Latin American level. This study could be of great value for future research related to the subject.

Melatonin Reduces Angiogenesis in Serous Papillary Ovarian Carcinoma of Ethanol-Preferring Rats.

Angiogenesis is a hallmark of ovarian cancer (OC); the ingrowth of blood vessels promotes rapid cell growth and the associated metastasis. Melatonin is a well-characterized indoleamine that possesses important anti-angiogenic properties in a set of aggressive solid tumors. Herein, we evaluated the role of melatonin therapy on the angiogenic signaling pathway in OC of an ethanol-preferring rat model that mimics the same pathophysiological conditions occurring in women. OC was chemically induced with a single injection of 7,12-dimethylbenz(a)anthracene (DMBA) under the ovarian bursa. After the rats developed serous papillary OC, half of the animals received intraperitoneal injections of melatonin (200 µg/100 g body weight/day) for 60 days. Melatonin-treated animals showed a significant reduction in OC size and microvessel density. Serum levels of melatonin were higher following therapy, and the expression of its receptor MT1 was significantly increased in OC-bearing rats, regardless of ethanol intake. TGFß1, a transforming growth factor-beta1, was reduced only after melatonin treatment. Importantly, vascular endothelial growth factor (VEGF) was severely reduced after melatonin therapy in animals given or not given ethanol. Conversely, the levels of VEGF receptor 1 (VEGFR1) was diminished after ethanol consumption, regardless of melatonin therapy, and VEGFR2 was only reduced following melatonin. Hypoxia-inducible factor (HIF)-1α was augmented with ethanol consumption, and, notably, melatonin significantly reduced their levels. Collectively, our results suggest that melatonin attenuates angiogenesis in OC in an animal model of ethanol consumption; this provides a possible complementary therapeutic opportunity for concurrent OC chemotherapy.

Quantitative Proteomic Profiling Reveals That Diverse Metabolic Pathways Are Influenced by Melatonin in an in Vivo Model of Ovarian Carcinoma.

To obtain more information into the molecular mechanisms underlying ovarian cancer (OC), we proposed a comparative proteomic analysis in animals receiving long-term melatonin as therapy or only vehicle using multidimensional protein identification combined with mass spectrometry. To induce tumor, a single dose of 100 µg 7,12-dimethylbenz(a)anthracene (DMBA) dissolved in 10 µL of sesame oil was injected under the left ovarian bursa of 20 Fischer 344 rats. The right ovaries were injected with sesame oil only. After tumors were developed, half of the animals received intraperitoneal administration of melatonin (200 µg/100g body weight/day) for 60 days. Melatonin therapy promoted down-regulation in numerous proteins involved in OC signaling pathways. The most significant portion of these proteins are involved in several metabolic processes, mainly those associated with mitochondrial systems, generation of metabolites and energy, hypoxia-inducible factor-1 signaling, antigen processing and presentation, endoplasmic reticulum stress-associated pathways, and cancer-related proteoglycans. A small number of proteins that were overexpressed by melatonin therapy included ATP synthase subunit ß, fatty acid-binding protein, and 10-kDa heat shock protein. Taken together, our findings suggest that melatonin therapy efficiently modulated important signaling pathways involved in OC, and these proteins might be further targets that should be explored in new therapeutic opportunities for OC.