Histopathological and statistical study of corneal repair in rabbits. A new way to understand corneal recovery.

The study aims to evaluate corneal healing post amniotic membrane transplantation in controlled corneal defects, justifying its application in routine ophthalmology practice. The objective is to establish a reliable method for assessing the repair process. In three groups of six adult New Zealand rabbits, keratectomy and a monolayer transplant of dehydrated human amniotic membrane (AM) were conducted in the left eye (OS) with the right eye (OD) serving as the control eye. Clinical signs were assessed, and both eyes were enucleated at 1, 2, and 4 weeks for optical coherence tomography (OCT) measurements and histological analysis, collecting data from different epithelium, stroma, and limbus regions. This study was conducted using a formula that combines histologic data categorizing their presence and/or type as beneficial for corneal repair. No statistically significant differences were found between the experimental and control eyes regarding all clinical signs and OCT measurements. However, a linear model using histopathological results showed a period-implant mode interaction with statistical significance (p=0.010). The use of the single-layer amniotic membrane resulted in improved corneal recovery with the stromal side showing better performance in the first week and the epithelial side proving to be more effective than the stromal side in the long term. For the first time, a statistical formula employing histopathological data is introduced to determine corneal recovery, potentially offering a more accurate and reliable method compared with the observation of clinical signs and corneal measurements with OCT.

New drug discovery strategies for the treatment of benznidazole-resistance in Trypanosoma cruzi, the causative agent of Chagas disease.

INTRODUCTION: Benznidazole, the drug of choice for treating Chagas Disease (CD), has significant limitations, such as poor cure efficacy, mainly in the chronic phase of CD, association with side effects, and parasite resistance. Understanding parasite resistance to benznidazole is crucial for developing new drugs to treat CD. AREAS COVERED: Here, the authors review the current understanding of the molecular basis of benznidazole resistance. Furthermore, they discuss the state-of-the-art methods and critical outcomes employed to evaluate the efficacy of potential drugs against T. cruzi, aiming to select better compounds likely to succeed in the clinic. Finally, the authors describe the different strategies employed to overcome resistance to benznidazole and find effective new treatments for CD. EXPERT OPINION: Resistance to benznidazole is a complex phenomenon that occurs naturally among T. cruzi strains. The combination of compounds that inhibit different metabolic pathways of the parasite is an important strategy for developing a new chemotherapeutic protocol.

Advancing air quality monitoring: A low-cost sensor network in motion - Part I.

In urban areas, high levels of air pollution pose significant risks to human health, emphasising the need for detailed air quality (AQ) monitoring. However, traditional AQ monitoring relies on the data from Reference Monitoring Stations, which are sparsely distributed and provide only hourly or daily data, failing to capture the spatial and temporal variability of air pollutant concentrations. Addressing this challenge, we introduce in this article the ExpoLIS system, an all-weather mobile AQ monitoring system that integrates various AQ low-cost sensors (LCSs), providing high spatio-temporal resolution data. This study demonstrates that the inclusion of an extended sampling device may mitigate the effect of the meteorological parameters and other disturbances on readings. At the same time, it did not reduce the quality of the data, both in static conditions and in motion, as we were able to maintain a certain level of agreement between the LCSs. In conclusion, the ExpoLIS system proves its versatility by enabling the collection of large quantities of accurate data, allowing a deeper understanding of the AQ dynamics in urban environments.

Suicidio consumado en Gran Canaria en el periodo 2017-2022 y su relación con antecedentes de trastorno mental / Consummated suicide in Gran Canaria in the period 2017-2022, and its relationship with a history of mental disorder

Introducción el suicidio sigue siendo una de las principales causas de muerte en todo el mundo. Debido a la relación entre la conducta suicida y el trastorno mental, nuestro objetivo es determinar el número de personas que recibían atención por la Red de Salud Mental entre el total de suicidios consumados entre 2017 y 2022 en Gran Canaria, así como las características de dicha población y de la atención recibida. Material y métodos estudio longitudinal observacional retrospectivo en el que la población de estudio fue extraída del total de suicidios de la base de datos del Instituto de Medicina Legal de Gran Canaria. Posteriormente, los datos fueron cotejados por las bases de datos de la Red de Salud Mental. Por último, se realizó un análisis estadístico univariante y los resultados fueron comparados en función del sexo y la atención en la Unidad de Salud Mental Comunitaria. Resultados solo un 39,4% había recibido atención por parte de la unidad de salud mental, siendo la mayoría mujeres (55,3% vs. 34,6%), con una media de edad de 50,9 años para ambos sexos. Los antecedentes de intentos previos fueron mucho más frecuentes en la población que recibía atención (45,4% vs. 7%), así como la atención en urgencias (42% vs. 5,7%) y los ingresos hospitalarios (25,3% vs. 0,7%). Conclusión menos de la mitad de las personas fallecidas tuvieron contacto con una unidad de salud mental comunitaria. Además, la atención por esta es mayor entre aquellas personas con intentos previos y entre el sexo femenino, siendo el diagnóstico más frecuente el de los trastornos afectivos monopolares. (AU)

Introduction Suicide remains one of the leading causes of death worldwide. Due to the relationship between suicidal behavior and mental disorder, our aim is to determine the number of people who received care by the Mental Health Network among the total number of suicides consummated between 2017 and 2022 in Gran Canaria, as well as the characteristics of that population and the care received. Material and methods Longitudinal observational retrospective study in which the study population was extracted from the total number of suicides in the database of the Legal Medicine Institute. Subsequently, the data were cross-checked by the Mental Health Network databases. Finally, a univariate statistical analysis was carried out and the results were compared according to sex and care in the Community Mental Health Unit. Results Only 39.4% had received care at the Mental Health Unit, the majority being women (55.3% vs. 34.6%), with a mean age of 50.9 years for both sexes. History of previous attempts was much more frequent in the population receiving care (45.4% vs. 7%), as well as emergency care (42% vs. 5.7%) and hospital admissions (25.3% vs. 0.7%). Conclusion Less than half of the deceased persons had contact with a Community Mental Health Unit. In addition, care by this unit was higher among those with previous attempts and among the female sex, with the most frequent diagnosis being monopolar affective disorders. (AU)

Effectiveness of the T-Control catheter: A study protocol.

Background: Foley catheters have been subject to limited development in the last few decades. They fulfil their basic function of draining urine from the bladder but cause other associated problems. T-Control is a new silicone Foley catheter with an integrated fluid control valve whose design aims to reduce the risks associated with bladder catheterisation by a multifactorial approach. The general purpose of this study is to evaluate the effectiveness and cost-effectiveness of the T-Control catheter versus the Foley-type catheter in patients with Acute Urine Retention (AUR). Study design: This is a pragmatic, open, multicentre, controlled clinical trial with random allocation to the T-Control catheter or a conventional Foley-type catheter in patients with AUR. Endpoints: The magnitude of infections will be analysed as a primary endpoint. While as secondary endpoint, the following will be analysed: rate of symptomatic and asymptomatic infections; days free of infection; quality of life-related to self-perceived health; indication of associated antibiotic treatments; determination of biofilm; number of catheter-related adverse events; use of each type of catheterisation's healthcare resources; level of satisfaction and workload of health professionals and acceptability of the T-Control device as well as the patient experience. Patients and methods: Eligible patients are male adults aged ≥50 years, with AUR and with an indication of bladder catheterisation for at least 2 weeks. The estimated sample size is 50 patients. Patient follow-up includes both the time of catheter insertion and its removal or change 2 weeks later, plus 2 weeks after this time when the patient will be called for an in-depth interview.

The Effect of Honey, Aloe Vera, and Hydrocolloid Dressing on the Healing Process of Murine Excisional Wounds.

Chronic ulcers are a major health problem associated with high costs and a loss of quality of life. Because of this, the search for products that accelerate wound healing is a constant, given the need for alternatives that help to alleviate this serious health problem. We analyzed the efficacy of 2 natural products-honey and aloe vera-versus hydrocolloid (HC) dressings as a control group in healing full-thickness wounds. For this purpose, we performed full-thickness excisions of the skin, including the panniculus carnosus, in mice. We inserted a nitrile ring into the subcutaneous cellular tissue simulating the second-intention wound healing course. We found that aloe vera reduced the diameter of the wounds compared to honey (p < .001) and the control group (p < .001).

Impact of hospitalization on nutritional status in persons aged 65 years and over (NUTRIFRAG Study): Protocol for a prospective observational study.

BACKGROUND: Malnutrition is a recurring problem that has become more relevant in recent years. The aim of this study is to assess the risk of malnutrition and nutritional status on admission and its evolution until discharge in patients aged 65 and over admitted to medical and surgical hospitalization units in hospitals of the Spanish National Health System. METHODS: Prospective observational study to be carried out in the medical-surgical hospitalization units of 9 public hospitals between 01/09/2022 and 31/12/2024. Using consecutive sampling, a total of 4077 patients will be included (453 in each hospital). Variables included are related to the care process, functionality, cognition and comorbidity, risk profile, nutritional status and dysphagia; as well as frailty, dietary quality and contextual variables. The incidence of risk of malnutrition, undernutrition and dysphagia during the care process and at discharge will be calculated. The association with risk factors will be studied with logistic regression models and multivariate Cox regression models. In addition, an analysis of participants' satisfaction with food services will be carried out. The study was approved by the Ethics and Research Committee on 30/09/2020, approved for funding on 02/12/2021 and with registration number RBR-5jnbyhk in the Brazilian clinical trials database (ReBEC) for observational studies. DISCUSSION: Some studies address nutritional status or dysphagia in older people in various care settings. However, there is a lack of large sample studies including both processes of the impact of hospitalization. The results of the project will provide information on the incidence and prevalence of both pathologies in the study subjects, their associated factors and their relationship with the average length of stay, mortality and early readmission. In addition, early detection of a problem such as malnutrition related to the disease and/or dysphagia during a hospital stay will favor the action of professionals to resolve both pathologies and improve the health status of patients.

A Multiarmed Bandit Approach for LTE-U/Wi-Fi Coexistence in a Multicell Scenario.

Recent studies and literature reviews have shown promising results for 3GPP system solutions in unlicensed bands when coexisting with Wi-Fi, either by using the duty cycle (DC) approach or licensed-assisted access (LAA). However, it is widely known that general performance in these coexistence scenarios is dependent on traffic and how the duty cycle is adjusted. Most DC solutions configure their parameters statically, which can result in performance losses when the scenario experiences changes on the offered data. In our previous works, we demonstrated that reinforcement learning (RL) techniques can be used to adjust DC parameters. We showed that a Q-learning (QL) solution that adapts the LTE DC ratio to the transmitted data rate can maximize the Wi-Fi/LTE-Unlicensed (LTE-U) aggregated throughput. In this paper, we extend our previous solution by implementing a simpler and more efficient algorithm based on multiarmed bandit (MAB) theory. We evaluate its performance and compare it with the previous one in different traffic scenarios. The results demonstrate that our new solution offers improved balance in throughput, providing similar results for LTE and Wi-Fi, while still showing a substantial system gain. Moreover, in one of the scenarios, our solution outperforms the previous approach by 6% in system throughput. In terms of user throughput, it achieves more than 100% gain for the users at the 10th percentile of performance, while the old solution only achieves a 10% gain.

Massive spontaneous portosystemic shunt is a solid, easily identifiable prognostic factor in patients with cirrhosis.

OBJECTIVES: Spontaneous portosystemic shunts (SPSSs) are associated with complications and death in cirrhosis. We evaluated chronic portosystemic encephalopathy (CPSE) and survival in cirrhotic patients with massive (>10 mm diameter) SPSS (MSPSS). METHODS: We have retrospectively compared 77 cirrhotic patients with MSPSS and 77 paired-matched patients without SPSS. RESULTS: More patients with MSPSS presented with CPSE (40.3% vs. 20.8%, P = 0.010) or died (33.8% vs. 18.2%, P = 0.039). Model for Endstage Liver Disease (MELD) score [hazard ratio (HR) 1.146, 95% confidence interval (CI) 1.099-1.195], follow-up (FU) ascites (HR 5.128, 95% CI 2.396-10.973) and age (HR 1.048, 95% CI 1.017-1.080) were associated with CPSE; and MELD score (HR 1.082, 95% CI 1.035-1.131), FU renal failure (HR 9.319, 95% CI 3.595-24.158), and FU ascites (HR 4.320, 95% CI 1.615-11.555) were associated with death. Liver function worsened faster in the MSPSS group. Among patients with better liver function (MELD < 11.5), MSPSS patients presented worse survival (P = 0.048, Breslow test). Comparing patients by the Child-Pugh group, we did not find differences in survival; in patients from Child-Pugh group B + C, the MSPSS group presented less time free of CPSE (P < 0.05, log-rank test). Patients with splenorenal MSPSS presented better survival (P = 0.04, log-rank test), and patients with umbilical MSPSS had shorter time free of CPSE (P < 0.016, log-rank test). CONCLUSION: MSPSS increased CPSE and death risks during long FU. Even with better liver function (MELD < 11.5), MSPSS was associated with lower survival. Splenorenal MSPSS presented better survival and the umbilical type was associated with shorter time free of CPSE.

An Educational Game to Teach Children about Air Quality Using Augmented Reality and Tangible Interaction with Sensors.

Air pollution is known to be one of the main causes of injuries to the respiratory system and even premature death. Gases, particles, and biological compounds affect not only the air we breathe outdoors, but also indoors. Children are highly affected by the poor quality of the air they breathe because their organs and immune systems are still in the developmental stages. To contribute to raising children's awareness to these concerns, this article presents the design, implementation, and experimental validation of an serious augmented reality game for children to playfully learn about air quality by interacting with physical sensor nodes. The game presents visual representations of the pollutants measured by the sensor node, rendering tangible the invisible. Causal knowledge is elicited by stimulating the children to expose real-life objects (e.g., candles) to the sensor node. The playful experience is amplified by letting children play in pairs. The game was evaluated using the Wizard of Oz method in a sample of 27 children aged between 7 and 11 years. The results show that the proposed game, in addition to improving children's knowledge about indoor air pollution, is also perceived by them as easy to use and a useful learning tool that they would like to continue using, even in other educational contexts.

A Low-Cost Sensor System Installed in Buses to Monitor Air Quality in Cities.

Air pollution is an important source of morbidity and mortality. It is essential to understand to what levels of air pollution citizens are exposed, especially in urban areas. Low-cost sensors are an easy-to-use option to obtain real-time air quality (AQ) data, provided that they go through specific quality control procedures. This paper evaluates the reliability of the ExpoLIS system. This system is composed of sensor nodes installed in buses, and a Health Optimal Routing Service App to inform the commuters about their exposure, dose, and the transport's emissions. A sensor node, including a particulate matter (PM) sensor (Alphasense OPC-N3), was evaluated in laboratory conditions and at an AQ monitoring station. In laboratory conditions (approximately constant temperature and humidity conditions), the PM sensor obtained excellent correlations (R2≈1) against the reference equipment. At the monitoring station, the OPC-N3 showed considerable data dispersion. After several corrections based on the k-Köhler theory and Multiple Regression Analysis, the deviation was reduced and the correlation with the reference improved. Finally, the ExpoLIS system was installed, leading to the production of AQ maps with high spatial and temporal resolution, and to the demonstration of the Health Optimal Routing Service App as a valuable tool.

Thyroid Fine Needle Aspiration, the Bethesda System, and the BRAFV600E Mutation in Papillary Thyroid Carcinoma: Association and Prediction for Biopsy.

INTRODUCTION: BRAFV600E mutations have been associated with papillary thyroid carcinoma (PTC) histological types including tall-cell and classical, peritumoral infiltration, and nuclear signs, whereas cytological features such as plump cells and sickle nuclei have also been associated with favorable thyroid fine needle aspiration (FNA) results for this tumor. BRAF and RAS are considered early driver mutations that contribute to the development of BRAF-like PTCs and RAS-like PTCs. Our aim was to assess the possible association between all Bethesda System cytological features and thyroid FNAs for PTC and their potential predictive value for future BRAFV600E-related biopsies. METHODS: Our study analyzed 63 cases of PTCs operated on at our hospital over a 5-year period between 2005 and 2017 that had previously undergone FNA and had been classified by the Bethesda System. BRAFV600E was identified by pyrosequencing paraffin-embedded tissues and comparing the cytological signs with the Bethesda System. In addition, a statistical and predictive study of the diagnostic factors "non-follicular," "non-round nuclei," and "non-clear chromatin" was performed to discriminate BRAF-like signs from other hypothetical RAS-like follicular signs. RESULTS: BRAFV600E was detected in 43/63 cases (68.2%). Histological types were significant (p < 0.001), with the classical variant being the most prevalent 31/63 (49.2%) and independent by multivariate analysis odds ratio of 10.58 [2.67; 41.97]. Follicular cytological signs are negatively associated with BRAFV600E: follicular structure (p < 0.001), round nuclei (p = 0.015), and clear chromatin (p = 0.049), while the diagnostic factors: "non-follicular" (positive predictive value [PPV] 82.9, sensitivity 79.1, negative predictive value [NPV] 59.1, specificity 65.0), "non-round nuclei" (PPV 76.6, sensitivity 83.7, NPV 56.3, specificity 45.0), and "non-clear chromatin" (PPV 75.6, sensitivity 79.1, NPV 50.0, specificity 45.0) have predictive value for the mutation. There was no individual significance for the remaining cytological features. CONCLUSIONS: Our study found no association between cytomorphological signs of thyroid FNA and BRAFV600E mutation. Considering the Bethesda System, there is an association (p = 0.045) with numerous cases of mutated PTC in categories V and VI. Our results indicate, however, that the presence of signs referred to as "non-follicular," "non-round nuclei," and "non-clear chromatin" in biopsy of papillary thyroid carcinoma is predictive of BRAF type mutation, whereas follicular signs indicate a RAS type PTC, according to published literature. These results need to be confirmed or modified by further research.

Strategic use of organoids and organs-on-chip as biomimetic tools.

Organoid development and organ-on-a-chip are technologies based on differentiating stem cells, forming 3D multicellular structures resembling organs and tissues in vivo. Hence, both can be strategically used for disease modeling, drug screening, and host-pathogen studies. In this context, this review highlights the significant advancements in the area, providing technical approaches to organoids and organ-on-a-chip that best imitate in vivo physiology.

Organoides de cérebro como modelos de doenças de Alzheimer e Parkinson: uma revisão narrativa sobre as perspectivas para medicina regenerativa e personalizada / Brain organoids as models of Alzheimer's and Parkinson's diseases: a narrative review on perspectives for regenerative and personalized medicine

Há muitos anos a cultura celular bidimensional (2D) é utilizada como modelo de estudo de doenças, possuindo grande importância na medicina regenerativa, apesar de ainda conter limitações significativas. A fim de contornar essas limitações, a cultura celular tridimensional (3D) propõe uma organização mais complexa e sustentável que pode ser produzida a partir de células-tronco adultas (ASCs), células-tronco embrionárias (ESCs) ou células-tronco pluripotentes induzidas (iPSCs). A cultura 3D possibilitou o cultivo de células em um ambiente mais próximo do fisiológico, levando à formação de distintos tecidos órgãos-específicos. Em outras palavras, a cultura de células 3D possibilita a criação de estruturas orgânicas muito semelhantes aos órgãos de um ser humano, tanto estruturalmente, quanto funcionalmente. Desse modo, tem-se o que é chamado de organoides. O uso dos organoides tem crescido exponencialmente em ambientes in vitro, permitindo a análise e observação dos diversos fenômenos fisiológicos existentes. Como exemplo, pode-se citar os organoides cerebrais ("mini-brains") reproduzidos in vitro buscando delinear as peculiaridades e complexidades do cérebro humano, com o objetivo de compreender algumas disfunções neurológicas que acometem esse sistema, como as duas principais doenças neurodegenerativas: Doenças de Alzheimer e Parkinson. Portanto, os organoides cerebrais podem permitir notável avanço da medicina regenerativa aplicada a doenças neurodegenerativas, já que esses "mini-brains" podem ser produzidos a partir de células do próprio paciente. Isso permitirá intervenções personalizadas, como testagens farmacológicas, a fim de definir qual seria o melhor tratamento medicamentoso. Consequentemente, essa tecnologia pode permitir terapias mais eficientes e individualizadas - o que é fundamental para a Medicina Personalizada (AU).

For many years, two-dimensional (2D) cell culture has been used as a model to study diseases, having great importance in regenerative medicine, despite still having significant limitations. In order to circumvent these limitations, three-dimensional (3D) cell culture proposes a more complex and sustainable organization that can be produced from adult stem cells (ASCs), embryonic stem cells (ESCs) or induced pluripotent stem cells (iPSCs). The 3D culture enabled the cultivation of cells in an environment closer to the physiological one, leading to the formation of different organ-specific tissues. In other words, 3D cell culture makes it possible to create organic structures very similar to the organs of a human being, both structurally and functionally. In this way, we have what are called organoids. The use of organoids has grown exponentially in in vitro environments, allowing the analysis and observation of the various existing physiological phenomena. As an example, we can mention the brain organoids ("mini-brains") reproduced in vitro, seeking to delineate the peculiarities and complexities of the human brain, in order to understand some neurological dysfunctions that affect this system, such as the two main neurodegenerative diseases: Alzheimer's and Parkinson's Diseases. Therefore, brain organoids may allow a remarkable advance in regenerative medicine applied to neurodegenerative diseases, as these "mini-brains" can be produced from the patient's own cells. This will allow for personalized interventions, such as drug testing, in order to define what would be the best drug treatment. Consequently, this technology can enable more efficient and individualized therapies - which is fundamental for Personalized Medicine (AU).

El primer año de la “Unidad de Cuidados Paliativos Pediátricos y Patología Crónica Compleja” en Gran Canaria / The first year of the “Pediatric Palliative Care and Complex Chronic Disease Unit” in Gran Canaria

Introducción: Los avances en la ciencia y tecnología y la mejora de la atención pediátrica han logrado un descenso en la mortalidad y un aumento en la supervivencia infantil. Estos pacientes requieren atención integral y coordinada, desempeñando un papel fundamental los cuidados paliativos pediátricos (CPP). En los últimos años su importancia ha crecido exponencialmente en España, lo que fomentó la creación de unidades de CPP. Se presentan características de los pacientes seguidos por la UCPP-PCC del Complejo Hospitalario Universitario Insular Materno Infantil (CHUIMI) de Las Palmas de Gran Canaria durante su primer año de funcionamiento. Material y métodos: Estudio epidemiológico, observacional, descriptivo y bidireccional de pacientes atendidos en la UCPP-PCC del CHUIMI desde noviembre de 2019 hasta enero de 2021. Resultados: Total 86 pacientes, 73 (84,88 %) paliativos, 13 (15,12 %) no-paliativos, 40 (54,79 %) no oncológicos, 33 (45,21 %) oncológicos. Grupo-1 ACT (46,6 %), por grupo de patología predominaron la neurológica (36 %) y desórdenes genéticos (15,1 %). Problemas principales: dolor (70,9 %), problemas gastrointestinales (65,1 %), neurológicos (64 %). Exitus 21 (24,42 % de la muestra), 90,5 % en el hospital. Mediana de E-PaPas 18 puntos, mediana CV 64,4 puntos oncológicos-39,2 puntos no oncológicos. Mayor frecuencia de dolor y fallecimientos en pacientes con gran necesidad de CPP. A mayor necesidad de CPP y mayor número de problemas gastrointestinales, menor puntuación de calidad de vida. (AU)

Introduction: Advances in science and technology and improved pediatric care have achieved a decrease in mortality and an increase in child survival. These patients require comprehensive and coordinated care, with pediatric palliative care (PPC) playing a fundamental role. In recent years its importance has grown exponentially in Spain, which has encouraged the creation of PPC units. We present the characteristics of the patients followed by the CHUIMI PPC-PPC Unit during its first year of operation. Material and methods: Epidemiological, observational, descriptive and bidirectional study of patients seen in the CHUIMI UCPP-PCC from November 2019 to January 2021. Results: Total of 86 patients, 73 (84.88 %) palliative, 13 (15.12 %) non-palliative, 40 (54.79 %) non-oncological, 33 (45.21 %) oncological. Group-1 ACT (46.6 %), by pathology group predominantly neurological (36 %) and genetic disorders (15.1 %). Main problems: pain (70.9 %), gastrointestinal problems (65.1 %), neurological problems (64 %). Exitus 21 (24.42 %) of the sample, 90.5 % in hospital. Mean E-PaPas 18 pts, mean QL 64.4 pts oncological and 39.2 pts non-oncological. Higher frequency of pain and death in patients with a high need for PPC. The greater the need for PPC and the greater the number of gastrointestinal problems, the lower the QL score. (AU)

Self-care deficit among older men in the COVID-19 pandemic: implications for nursing.

OBJECTIVES: to analyze self-care deficit among older men in the COVID-19 pandemic in Brazil and to discuss the implications for nursing practice. METHODS: web survey, multicentric, qualitative. A total of 120 older men participated, applying a form from April to June 2020 and April to August 2021. Reflective Thematic Analysis, interpreted by Orem's Self-Care Deficit Theory, was used. RESULTS: temporally, the self-care of older men was manifested in the self-care requirements - affective bonds, self-care for development - meditation and self-care with health deviations - remote consultations. Fully, partially compensatory, educational/support systems mobilized self-care. FINAL CONSIDERATIONS: as care managers, nurses can strengthen the support network for older men by activating professionals from the multidisciplinary team, family members, caregivers and the community to promote self-care and correct health deviations in times of crisis.

Drugs and Endogenous Factors as Protagonists in Neurogenic Stimulation.

Neurogenesis is a biological process characterized by new neurons formation from stem cells. For decades, it was believed that neurons only multiplied during development and in the postnatal period but the discovery of neural stem cells (NSCs) in mature brain promoted a revolution in neuroscience field. In mammals, neurogenesis consists of migration, differentiation, maturation, as well as functional integration of newborn cells into the pre-existing neuronal circuit. Actually, NSC density drops significantly after the first stages of development, however in specific places in the brain, called neurogenic niches, some of these cells retain their ability to generate new neurons and glial cells in adulthood. The subgranular (SGZ), and the subventricular zones (SVZ) are examples of regions where the neurogenesis process occurs in the mature brain. There, the potential of NSCs to produce new neurons has been explored by new advanced methodologies and in neuroscience for the treatment of brain damage and/or degeneration. Based on that, this review highlights endogenous factors and drugs capable of stimulating neurogenesis, as well as the perspectives for the use of NSCs for neurological and neurodegenerative diseases.

A Common Variant at the 3'untranslated Region of the CCL7 Gene (rs17735770) Is Associated With Decreased Susceptibility to Coronary Heart Disease.

Monocytes participate in the development of atherosclerosis through the action of cytokines and other inflammatory mediators. Among them, CCR2 and its ligands, CCL2 and CCL7 play an important role, so the main objective of this work was to determine whether genetic variants affecting their activity were associated with cardiovascular disease. A cohort of 519 patients that have suffered coronary events was analyzed under a propensity score-matching protocol selecting a homogeneous set of cases and controls, according to age, sex, smoking status, dyslipidemia, arterial hypertension and type 2 diabetes as risk factors. While dyslipidemia and arterial hypertension were more prevalent among patients with angina pectoris, current smoking status and elevated inflammatory markers, including total leukocyte and monocyte counts, were more likely associated with acute coronary events. Propensity score matching analysis, performed to eliminate the influence of these risk factors and highlight genetic modifiers, revealed that a single nucleotide variant, rs17735770 at the 3'untranslated region of the CCL7 gene transcript, was associated with decreased cardiovascular risk in a group represented mostly by men, with an average age of 57, and without significant differences in traditional risk factors. Furthermore, the presence of this variant altered the local mRNA structure encompassing a binding site for miR-23ab, resulting in increased translation of a reporter gene in a miR23 independent fashion. The rs17735770 genetic variant led to increased expression of CCL7, a potential antagonist of CCR2 at inflammatory sites, where it could play a meaningful role during the evolution of atherosclerosis.

Education, but not occupation, is associated with cognitive impairment: The role of cognitive reserve in a sample from a low-to-middle-income country.

INTRODUCTION: Education, and less frequently occupation, has been associated with lower dementia risk in studies from high-income countries. We aimed to investigate the association of cognitive impairment with education and occupation in a low-middle-income country sample. METHODS: In this cross-sectional study, cognitive function was assessed by the Clinical Dementia Rating sum of boxes (CDR-SOB). We investigated the association of occupation complexity and education with CDR-SOB using adjusted linear regression models for age, sex, and neuropathological lesions. RESULTS: In 1023 participants, 77% had < 5 years of education, and 56% unskilled occupations. Compared to the group without education, those with formal education had lower CDR-SOB (1-4 years: ß $\beta \;$ = -0.99, 95% confidence interval [CI] = -1.85; -0.14, P = .02; ≥5 years: ß $\beta \;$ = -1.42, 95% CI = -2.47; -0.38, P = .008). Occupation complexity and demands were unrelated to cognition. DISCUSSION: Education, but not occupation, was related to better cognitive abilities independent of the presence of neuropathological insults.

Clinical and Pharmacological Parameters Determine Relapse During Clopidogrel Treatment of Acute Coronary Syndrome.

The therapeutic efficacy of clopidogrel as an antiplatelet drug varies among individuals, being the mainstream hypothesis that its bioavailability depends on the individual genetic background and/or interactions with other drugs. A total of 477 patients receiving double antiaggregation therapy with aspirin and clopidogrel, after suffering a first event, were followed for 1 year to record relapse, as a surrogate end point to measure their therapeutic response, as defined by presenting with an acute coronary event (unstable angina, ST-segment-elevation myocardial infarction, or non-ST-segment-elevation myocardial infarction), stent thrombosis/restenosis, or cardiac mortality. Anthropometric, clinical, and pharmacological variables along with CYP2C19 genotypes were analyzed for their association with the disease relapse phenotype. Only 75 patients (15%) suffered a relapse, which occurred during the first 6 months of therapy, with a peak at 4.5 months. An initial univariate analysis identified that patients in the relapse group were significantly older (67.4 ± 11.0 vs 61.6 ± 12.3 years old) and presented with diffuse coronary disease, insulin-dependent type 2 diabetes mellitus dyslipidemia, and arterial hypertension. A poor clinical response to the platelet antiaggregation regime also occurred more frequently among patients taking acenocoumarol and calcium channel blockers, along with aspirin and clopidogrel, while no association was found according to CYP2C19 genotypes. A retrospective multivariate analysis indicated that patients belonging to the nonresponder phenotype to treatment with aspirin and clopidogrel were older, presented with diffuse coronary disease, a group largely overlapping with type 2 insulin-dependent diabetes mellitus, and were taking dihidropyrimidinic calcium channel blockers.