Assessing the Occurrence and Influence of Cancer Chemotherapy-Related Pharmacogenetic Alleles in the Chilean Population.

BACKGROUND: Pharmacogenomic knowledge as a biomarker for cancer care has transformed clinical practice, however, as current guidelines are primarily derived from Eurocentric populations, this limits their application in Latin America, particularly among Hispanic or Latino groups. Despite advancements, systemic chemotherapy still poses challenges in drug toxicity and suboptimal response. This study explores pharmacogenetic markers related to anticancer drugs in a Chilean cohort, filling a gap in Latin American research. Notably, the influence of native South American Mapuche-Huilliche ancestry. METHODS: To explore pharmacogenetic markers related to anticancer drugs, we utilized an ethnically Admixed Chilean genome-wide association studies (GWAS) dataset of 1095 unrelated individuals. Pharmacogenomic markers were selected from PharmGKB, totaling 36 level 1 and 2 evidence single nucleotide polymorphisms (SNPs) and 571 level 3 SNPs. Comparative analyses involved assessing SNP frequencies across diverse populations from the 1000 Genomes Project. Haplotypes were estimated, and linkage disequilibrium was examined. Ancestry-based association analyses explored relationships between SNPs and Mapuche-Huilliche and European ancestries. Chi-square distribution with p ≤ 0.05 and Bonferroni's multiple adjustment tests determined statistical differences between allele frequencies. RESULTS: Our study reveals significant disparities in SNP frequency within the Chilean population. Notably, dihydropyrimidine dehydrogenase (DPYD) variants (rs75017182 and rs67376798), linked to an increased risk of severe fluoropyrimidine toxicity, exhibit an exceptionally low frequency (minor allele frequency (MAF) < 0.005). Nudix hydrolase 15 (NUDT15) rs116855232, associated with hematological mercaptopurine toxicity, is relatively common (MAF = 0.062), and is further linked to Mapuche-Huilliche ancestry. Thiopurine methyltransferase enzyme (TPMT), implicated in severe toxicity to mercaptopurines, SNPs rs1142345 and rs1800460 of TMPT gene demonstrate higher MAFs in Admixed Americans and the Chilean population (MAF range 0.031-0.057). Finally, the variant in the UDP-glucuronosyltransferase 1 gene (UGT1A1) rs4148323, correlated with irinotecan neutropenia, exhibits the highest MAF in East Asian (MAF = 0.136) and Chilean (MAF = 0.025) populations, distinguishing them from other investigated populations. CONCLUSIONS: This study provides the first comprehensive pharmacogenetic characterization of cancer therapy-related SNPs and highlights significant disparities in SNP frequencies within the Chilean population. Our findings underscore the necessity for inclusive research and personalized therapeutic strategies to ensure the equitable and effective application of precision medicine across diverse global communities.

Microplastics in the maximum chlorophyll layer along a north-south transect in the Mediterranean Sea in comparison with zooplankton concentrations.

The aim of this study was to characterize and quantify microplastics (MPs) at the chlorophyll maximum layer (CML), around 30 to 60 m depth, during a cruise dedicated to the study of contaminants in plankton, the MERITE-HIPPOCAMPE project, along a north-south transect in the western Mediterranean Sea (Tedetti et al., 2023). Plankton were collected by horizontal net tows in this layer using a multinet Hydrobios Midi equipped with 60 µm mesh-size nets. The collected plankton were fractionated through a sieve column for various later contaminant measurements and for zooplankton analysis (Fierro-González et al., 2023). For all stations, samples were also fully examined for microplastics (MPs) for fractions >300 µm. MPs were found at all stations in the CML layer (mean: 42.9 ± 45.4 MPs m-3), of which 96 ± 4 % were fibers. The ratios of mesozooplankton/MPs and detritus/MPs in this CML were respectively 223 ± 315 and 2544 ± 2268. These data are analyzed together with MPs concentrations from sea- surface sampled with a 300 µm net-size Manta net at the same stations. Overall, our observations highlight the very high density of fibers at the CML, mainly associated with aggregates, raising the hypothesis of their interactions with marine snow. Therefore, the importance of marine snow and vertical layering will have to be considered in future MP distribution modelling efforts.

Evaluación del formato remoto en tiempos de pandemia

En el contexto de la pandemia de COVID 19 durante el año 2020 y hasta la fecha se diseñó un formato de evaluación para nuestros alumnos de pre y posgrado bajo el alero de los exámenes clínicos objetivos estructurados (ECOE) en un formato remoto. Se revisó la literatura al respecto y se diseñó un instrumento que diera cuenta en forma oportuna y estandarizada del desempeño de nuestros alumnos y residentes. Estas experiencias están siendo evaluadas en estudios con metodología mixta. Sin embargo, decidimos compartir esta experiencia, por su impacto en el desarrollo docente de las ciencias de la salud.

In the context of the COVID-19 pandemic during 2020 and to date, an evaluation format has been designed for our undergraduate and graduate students under the design of the objective structured clinical examinations (OSCE) in a remote format. The literature was reviewed, and an instrument was designed to account for the performance of our students and residents in a timely and standardized manner. These experiences are being evaluated in studies with mixed methodology. However, we wanted to convey this experience due to its impact on the educational development of health sciences.

Zooplankton biomass, size structure, and associated metabolic fluxes with focus on its roles at the chlorophyll maximum layer during the plankton-contaminant MERITE-HIPPOCAMPE cruise.

Recent studies have demonstrated that plankton can be a key pathway for the uptake and transfer of contaminants entering the marine environment up to top predators. The plankton-contaminant MERITE-HIPPOCAMPE cruise was devoted to quantifying contaminants in water and the whole plankton size range (10 size fractions) at 10 stations along a north-south transect in the western Mediterranean Sea from the French to the Tunisian coasts through the Provençal and Algerian basins. Pumping and filtering devices and net sampling have been used for collecting very high amounts of small particles and planktonic organisms in the chlorophyll maximum layer (CML). The present paper characterizes the zooplankton components for which the contaminant measurements were carried out. At each station, a horizontal towed Hydro-Bios net with a 60 µm mesh-size net was used to discriminate 5 size-fractions from 60 µm to a few mm. For each size-fraction, one part of the sample was used for dry weight measurements and the other one for estimating the contribution to biomass of detritus, phytoplankton, and among zooplankton of the major taxonomic groups based on the imagery tools ZOOSCAN and FLOWCAM. In each zooplankton size fraction, metabolic rates were calculated from the size spectrum to estimate trophic and excretion fluxes flowing through this fraction. These observations were compared to a similar analysis of tows in the upper layer (vertical) and the surface layer (horizontal). The total sampled biomass concentration at the CML was higher than in the water column (COL) and much higher than at the surface (SURF) in most of the stations, but in the CML and COL a substantial contribution was due to detritus mostly concentrated in the smallest size-fractions (60-200 µm and 200-500 µm). Absolute values of zooplankton biomass show neither a clear spatial pattern nor a significant difference between strata. The CML layer was dominated by copepods similarly to COL and SURF, but presented a higher contribution of nauplii and a near absence of appendicularians. At some stations, crustaceans and gelatinous plankton could be important contributors to CML. The zooplankton biomass composition of the two smallest fractions (<500 µm) was dominated by nauplii, small copepods and, occasionally, by small miscellaneous organisms (mostly pteropodes). In contrast, clear differences between stations appeared for the largest fractions (>500 µm) due to large crustaceans, gelatinous organisms, and chaetognaths. These changes in biomass composition according to size fractions suggest a progressive trophic shift from dominant herbivory in the smallest fractions to more contrasted trophic structure (including carnivory) in the largest fractions. The daily carbon demand and the N and P excretion of zooplankton were on average higher at the CML but with no significant difference with COL. The zooplankton grazing represented 2.7 to 22.7 % of the phytoplankton stock per day, whereas its excretion represented a daily N and P recycling compared to dissolved inorganic nitrogen and phosphorus stocks ranging respectively from 0.2 to 19 % and from 0 to 21 %. This information should help in the interpretation of the content of various contaminants in zooplankton fractions.

Deregulated expression of the 14q32 miRNA cluster in clear cell renal cancer cells.

Clear cell renal cell carcinomas (ccRCC) are characterized by arm-wide chromosomal alterations. Loss at 14q is associated with disease aggressiveness in ccRCC, which responds poorly to chemotherapeutics. The 14q locus contains one of the largest miRNA clusters in the human genome; however, little is known about the contribution of these miRNAs to ccRCC pathogenesis. In this regard, we investigated the expression pattern of selected miRNAs at the 14q32 locus in TCGA kidney tumors and in ccRCC cell lines. We demonstrated that the miRNA cluster is downregulated in ccRCC (and cell lines) as well as in papillary kidney tumors relative to normal kidney tissues (and primary renal proximal tubule epithelial (RPTEC) cells). We demonstrated that agents modulating expression of DNMT1 (e.g., 5-Aza-deoxycytidine) could modulate 14q32 miRNA expression in ccRCC cell lines. Lysophosphatidic acid (LPA, a lysophospholipid mediator elevated in ccRCC) not only increased labile iron content but also modulated expression of a 14q32 miRNA. Through an overexpression approach targeting a subset of 14q32 miRNAs (specifically at subcluster A: miR-431-5p, miR-432-5p, miR-127-3p, and miR-433-3p) in 769-P cells, we uncovered changes in cellular viability and claudin-1, a tight junction marker. A global proteomic approach was implemented using these miRNA overexpressing cell lines which uncovered ATXN2 as a highly downregulated target. Collectively, these findings support a contribution of miRNAs at 14q32 in ccRCC pathogenesis.

Spatial variations of biochemical content and stable isotope ratios of size-fractionated plankton in the Mediterranean Sea (MERITE-HIPPOCAMPE campaign).

Plankton represents the main source of carbon in marine ecosystems and is consequently an important gateway for contaminants into the marine food webs. During the MERITE- HIPPOCAMPE campaign in the Mediterranean Sea (April-May 2019), plankton was sampled from pumping and net tows at 10 stations from the French coast to the Gulf of Gabès (Tunisia) to obtain different size fractions in contrasted regions. This study combines various approaches, including biochemical analyses, analyses of stable isotope ratios (δ13C, δ15N), cytometry analyses and mixing models (MixSiar) on size-fractions of phyto- and zooplankton from 0.7 to >2000 µm. Pico- and nanoplankton represented a large energetic resource at the base of pelagic food webs. Proteins, lipids, and stable isotope ratios increased with size in zooplankton and were higher than in phytoplankton. Stable isotope ratios suggest different sources of carbon and nutrients at the base of the planktonic food webs depending on the coast and the offshore area. In addition, a link between productivity and trophic pathways was shown, with high trophic levels and low zooplankton biomass recorded in the offshore area. The results of our study highlight spatial variations of the trophic structure within the plankton size-fractions and will contribute to assess the role of the plankton as a biological pump of contaminants.

Contamination of planktonic food webs in the Mediterranean Sea: Setting the frame for the MERITE-HIPPOCAMPE oceanographic cruise (spring 2019).

This paper looks at experiential feedback and the technical and scientific challenges tied to the MERITE-HIPPOCAMPE cruise that took place in the Mediterranean Sea in spring 2019. This cruise proposes an innovative approach to investigate the accumulation and transfer of inorganic and organic contaminants within the planktonic food webs. We present detailed information on how the cruise worked, including 1) the cruise track and sampling stations, 2) the overall strategy, based mainly on the collection of plankton, suspended particles and water at the deep chlorophyll maximum, and the separation of these particles and planktonic organisms into various size fractions, as well as the collection of atmospheric deposition, 3) the operations performed and material used at each station, and 4) the sequence of operations and main parameters analysed. The paper also provides the main environmental conditions that were prevailing during the campaign. Lastly, we present the types of articles produced based on work completed by the cruise that are part of this special issue.

High-Temperature Stress Effect on the Red Cusk-Eel (Geypterus chilensis) Liver: Transcriptional Modulation and Oxidative Stress Damage.

Environmental stressors, such as temperature, are relevant factors that could generate a negative effect on several tissues in fish. A key fish species for Chilean aquaculture diversification is the red cusk-eel (Genypterus chilensis), a native fish for which knowledge on environmental stressors effects is limited. This study evaluated the effects of high-temperature stress on the liver of red cusk-eel in control (14 °C) and high-temperature (19 °C) groups using multiple approaches: determination of plasmatic hepatic enzymes (ALT, AST, and AP), oxidative damage evaluation (AP sites, lipid peroxidation, and carbonylated proteins), and RNA-seq analysis. High-temperature stress generated a significant increase in hepatic enzyme activity in plasma. In the liver, a transcriptional regulation was observed, with 1239 down-regulated and 1339 up-regulated transcripts. Additionally, high-temperature stress generated oxidative stress in the liver, with oxidative damage and transcriptional modulation of the antioxidant response. Furthermore, an unfolded protein response was observed, with several pathways enriched, as well as a heat shock response, with several heat shock proteins up regulated, suggesting candidate biomarkers (i.e., serpinh1) for thermal stress evaluation in this species. The present study shows that high-temperature stress generated a major effect on the liver of red cusk-eel, knowledge to consider for the aquaculture and fisheries of this species.

Pathological characterization of a novel mouse model expressing the PD-linked CHCHD2-T61I mutation.

Coiled-coil-helix-coiled-coil-helix domain containing 2 (CHCHD2) is a mitochondrial protein that plays important roles in cristae structure, oxidative phosphorylation and apoptosis. Multiple mutations in CHCHD2 have been associated with Lewy body disorders (LBDs), such as Parkinson's disease (PD) and dementia with Lewy bodies, with the CHCHD2-T61I mutation being the most widely studied. However, at present, only CHCHD2 knockout or CHCHD2/CHCHD10 double knockout mouse models have been investigated. They do not recapitulate the pathology seen in patients with CHCHD2 mutations. We generated the first transgenic mouse model expressing the human PD-linked CHCHD2-T61I mutation driven by the mPrP promoter. We show that CHCHD2-T61I Tg mice exhibit perinuclear mitochondrial aggregates, neuroinflammation, and have impaired long-term synaptic plasticity associated with synaptic dysfunction. Dopaminergic neurodegeneration, a hallmark of PD, is also observed along with α-synuclein pathology. Significant motor dysfunction is seen with no changes in learning and memory at 1 year of age. A minor proportion of the CHCHD2-T61I Tg mice (~10%) show a severe motor phenotype consistent with human Pisa Syndrome, an atypical PD phenotype. Unbiased proteomics analysis reveals surprising increases in many insoluble proteins predominantly originating from mitochondria and perturbing multiple canonical biological pathways as assessed by ingenuity pathway analysis, including neurodegenerative disease-associated proteins such as tau, cofilin, SOD1 and DJ-1. Overall, CHCHD2-T61I Tg mice exhibit pathological and motor changes associated with LBDs, indicating that this model successfully captures phenotypes seen in human LBD patients with CHCHD2 mutations and demonstrates changes in neurodegenerative disease-associated proteins, which delineates relevant pathological pathways for further investigation.

Percepción de los padres sobre la vacunación infantil / Parents' perception of child vaccination

La percepción de padres ante los programas de vacunación de los niños para la prevención de enfermedades, así como las campañas de información y conocimiento sobre las vacunas, motiva el interés científico por conocer y evaluar los factores relacionados al grado de conocimiento, aptitudes y fuentes de información de la población sobre las vacunas, siendo la inmunización un método que permite adquirir inmunidad contra las enfermedades comunes y mortales y reduce gastos por tratamientos para la mejoría de la salud. Objetivo: Describir la percepción de los padres sobre la vacunación infantil. Metodología: Investigación cualitativa, a través del estudio de revisión de contenido relacionado con el descriptor vacunación, donde se recopila la información de interés según su aparición en la búsqueda. El estudio está basado en el paradigma positivista con observación y registro de información relevante con el tema. Resultados: La falta de información sobre los riesgos y beneficios de la vacunación es un factor que induce a la desconfianza e inseguridad respecto a las vacunas; gran parte de los padres considera útil la vacuna, necesaria y beneficiosa pero prevalece la idea que la inmunización puede ser algo peligroso y con efectos indeseables y secuelas graves por información mediática no bién conducida. Conclusiones: Diversos estudios señalan factores que impiden que los padres de los niños cumplan con los esquemas de vacunación, entre estos la falta de información y conocimiento sobre las vacunas, que evitan las enfermedades en los menores reforzando el sistema inmunológico, así como, otra de las razones es la falta de vacunas en los centros asistenciales, que genera desinterés y dificulta el cumplimiento de los programas de vacunación, además, servicios lentos y poca empatía del personal que presta atención en los centros de salud aumentan la percepción negativa sobre la vacunación(AU)

The perception of parents regarding the vaccination programs for children for the prevention of diseases, as well as the information and knowledge campaigns about vaccines, motivates the scientific interest in knowing and evaluating the factors related to the degree of knowledge, aptitudes and sources of information for the population about vaccines, immunization being a method that allows acquiring immunity against common and deadly diseases and reduces expenses for treatments to improve health. Objective: To describe the perception of parents about childhood vaccination. Materials and Methods Qualitative research, through a content review study related to the vaccination descriptor, where the information of interest is compiled according to its appearance in the search. The study is based on the positivist paradigm with observation and recording of information relevant to the subject. Results: The lack of information about the risks and benefits of vaccination is a factor that induces mistrust and insecurity regarding vaccines; A large part of the parents considers the vaccine useful, necessary and beneficial, but the idea prevails that immunization can be something dangerous and with undesirable effects and serious sequelae due to misguided media information. Conclusnios: Various studies point to factors that prevent parents of children from complying with vaccination schedules, including lack of information and knowledge about vaccines, which prevent diseases in minors by strengthening the immune system, as well as another of The reasons are the lack of vaccines in health centers, which generates disinterest and makes it difficult to comply with vaccination programs, in addition, slow services and little empathy of the personnel who provide care in health centers increase the negative perception about vaccination(AU)

Tale of two kinases: Protein kinase A and Ca2+/calmodulin-dependent protein kinase II in pre-diabetic cardiomyopathy.

Metabolic syndrome is a pre-diabetic state characterized by several biochemical and physiological alterations, including insulin resistance, visceral fat accumulation, and dyslipidemias, which increase the risk for developing cardiovascular disease. Metabolic syndrome is associated with augmented sympathetic tone, which could account for the etiology of pre-diabetic cardiomyopathy. This review summarizes the current knowledge of the pathophysiological consequences of enhanced and sustained ß-adrenergic response in pre-diabetes, focusing on cardiac dysfunction reported in diet-induced experimental models of pre-diabetic cardiomyopathy. The research reviewed indicates that both protein kinase A and Ca2+/calmodulin-dependent protein kinase II play important roles in functional responses mediated by ß1-adrenoceptors; therefore, alterations in the expression or function of these kinases can be deleterious. This review also outlines recent information on the role of protein kinase A and Ca2+/calmodulin-dependent protein kinase II in abnormal Ca2+ handling by cardiomyocytes from diet-induced models of pre-diabetic cardiomyopathy.

Estrategias para fomentar la higiene de manos en la atención ambulatoria / Interventions aimed to improve clinical handwashing in an outpatient setting

Introducción: se realizó un análisis de la evidencia disponible sobre intervenciones orientadas a mejorar la adherencia al lavado de manos, para generar recomendaciones para los centros de atención en salud ambulatoria.Materiales y métodos: se realizó una búsqueda en Pubmed, Embase y Epistemonikos, y en las referencias de guías sobre el tema, seleccionando aquellos estudios no observacionales en que se realizaran intervenciones para aumentar la adherencia al lavado de manos en atención en salud. Se clasificaron las estrategias descritas según tipo de intervención, y se evaluaron según su efectividad en mejorar la adherencia al lavado de manos y el seguimiento en el tiempo.Resultados: se seleccionaron 34 estudios experimentales prospectivos, que se clasificaron en 10 grupos según el tipo de intervención realizada, y se evaluaron según efectividad y seguimiento en una escala del I al VII. 24 de 34 estudios mostraron un aumento estadísticamente significativo de la adherencia al lavado de manos mayor al 15% desde el basal o en comparación al grupo control, correspondiendo en su mayoría a estrategias multimodales y de feedback. Discusión: las intervenciones más efectivas para mejorar la adherencia al lavado de manos fueron las que incluían abordajes multimodales y las que incluían feedback. Se hace urgente generar mayor evidencia sobre esta temática en el contexto de atención ambulatoria.

Introduction: To analyze the available evidence on interventions aimed at improving adherence to handwashing, to generate re-commendations for outpatient health care centers. Methods: A search was made in Pubmed, Embase and Epistemonikos, and in the references of guides on the subject, selecting those non-observational studies in which interventions were carried out to increase adherence to handwashing in health care. The strategies described were classified according to the type of intervention, and evaluated according to their effectiveness in improving adherence to handwashing, and its follow-up time afterward. Results: 34 prospective experimental studies were selected, which were classified into 10 groups according to the type of intervention performed, and were evaluated according to effectiveness and follow-up on a scale from I to VII. 24 of 34 studies showed a statistically significant increase in handwashing adherence greater than 15% from baseline or compared to the control group, corresponding mostly to multimodal and feedback strategies. Discussion: The most effective interventions to improve adherence to handwashing were those that included multimodal approaches and the ones that included feedback. It is urgent to generate more evidence on the subject in the context of ambulatory care.

Mitochondrial CHCHD2: Disease-Associated Mutations, Physiological Functions, and Current Animal Models.

Rare mutations in the mitochondrial protein coiled-coil-helix-coiled-coil-helix domain containing 2 (CHCHD2) are associated with Parkinson's disease (PD) and other Lewy body disorders. CHCHD2 is a bi-organellar mediator of oxidative phosphorylation, playing crucial roles in regulating electron flow in the mitochondrial electron transport chain and acting as a nuclear transcription factor for a cytochrome c oxidase subunit (COX4I2) and itself in response to hypoxic stress. CHCHD2 also regulates cell migration and differentiation, mitochondrial cristae structure, and apoptosis. In this review, we summarize the known disease-associated mutations of CHCHD2 in Asian and Caucasian populations, the physiological functions of CHCHD2, how CHCHD2 mutations contribute to α-synuclein pathology, and current animal models of CHCHD2. Further, we discuss the necessity of continued investigation into the divergent functions of CHCHD2 and CHCHD10 to determine how mutations in these similar mitochondrial proteins contribute to different neurodegenerative diseases.

[Therapeutic use of robotics in children with Autism Spectrum Disorder]. / Uso terapéutico de robótica en niños con Trastorno del Espectro Autista.

INTRODUCTION: Robot-assisted Therapy (RAT) can improve the behavior of children with Autism Spectrum Disorder (ASD) in a spontaneous and entertaining way. There are no previous experiences of this type of inter vention in our country. OBJECTIVE: To describe a clinical experience of using RAT and its impact on the behaviors of a group of children with ASD, in a therapeutic context. PATIENTS AND METHOD: Quasi experimental clinical experience type study. 4 children with a clinical diagnosis of ASD were selected, supported by the ADOS-2 (Autism Diagnostic Observation Schedule); aged between 9 and 13 years, and normal IQ according to the WISC-III (Wechsler Intelligence Scale for Children). This study was approved by the Central Metropolitan Ethics Committee. Patients attended 10 structured robot-as sisted therapy sessions, working collaboratively in pairs. Workshop attendance and parent and child satisfaction were evaluated through surveys, the adaptive behavior with the Vineland scale, and so cial interaction with video coding guidelines. RESULTS: Patients presented a very good adherence and satisfaction with the activity. There was an improvement in socialization behaviors and social age. Video-coding showed an increase in social interaction and improvement in the behavior of the pa tients after attending workshops. CONCLUSIONS: We observed that the experience with RAT, adapted to the context of a Chilean public health center, was highly attractive and beneficial for patients with ASD, improving core symptoms such as difficulties in social interaction and behavioral problems.

Práticas de atenção ao parto na experiência de puérperas: análise à luz da humanização / Prácticas de atención de parto en la experiencia de las mujeres puerperales: análisis a la luz de la humanización / Delivery care practices in the experience of puerperal women: analysis in the light of humanization

Objetivo: analisar as experiências de puérperas acerca das práticas profissionais desenvolvidas na atenção ao parto à luz do aporte teórico da humanização. Método: pesquisa qualitativa, com a participação de dez puérperas que vivenciaram parto vaginal, por meio de entrevista semiestruturada, desenvolvida entre setembro e novembro de 2019. Adotou-se a análise temática. Resultados: predominaram práticas que se distanciaram da humanização, como enema, restrição hídrica e alimentar, exames vaginais frequentes, episiotomia, manobras de Valsalva e de Kristeller. As práticas que se aproximaram da humanização foram a presença do acompanhante, utilização de métodos de alívio da dor no parto e contato cutâneo precoce entre mãe e bebê. Conclusão: as experiências das puérperas foram marcadas, principalmente, por condutas profissionais prejudiciais ou ineficazes, realizadas de forma inadequada e com poucas evidências científicas sobre a sua eficácia. Espera-se subsidiar a reflexão quanto à necessidade de revisão e atualização quanto às boas práticas de atenção ao parto.

Objective: to analyze the experiences of puerperal women about the professional practices developed in delivery care in the light of the theoretical contribution of humanization. Method: qualitative research, with the participation of ten puerperal women who experienced vaginal delivery, through semi-structured interviews, developed between September and November 2019. Thematic analysis was adopted. Results: practices that distanced themselves from humanization, such as enema, water and food restriction, frequent vaginal examinations, episiotomy, Valsalva and Kristeller maneuvers, predominated. The practices that approached humanization were the presence of the companion, use of methods of pain relief in the delivery and early skin contact between mother and baby. Conclusion: the experiences of the puerperal women were mainly marked by harmful or ineffective professional behaviors, performed inappropriately and with little scientific evidence about their efficacy. It is expected to support the reflection on the need for review and updating regarding good practices of delivery care.

Objetivo: analizar las experiencias de las mujeres puerperales sobre las prácticas profesionales desarrolladas en la atención del parto a la luz de la contribución teórica de la humanización. Método: investigación cualitativa, con la participación de diez mujeres puerperales que experimentaron el parto vaginal, a través de entrevistas semiestructuradas, desarrolladas entre septiembre y noviembre de 2019. Se adoptó un análisis temático. Resultados: predominaron las prácticas que se distanciaron de la humanización, como el enema, la restricción del agua y los alimentos, los exámenes vaginales frecuentes, la episiotomía, las maniobras de Valsalva y Kristeller. Las prácticas que se acercaron a la humanización fueron la presencia del compañero, el uso de métodos de alivio del dolor en el parto y el contacto temprano de la piel entre la madre y el bebé. Conclusión: las experiencias de las mujeres puerperales estuvieron marcadas principalmente por conductas profesionales dañinas o ineficaces, realizadas de manera inapropiada y con poca evidencia científica sobre su eficacia. Se espera que apoye la reflexión sobre la necesidad de revisar y actualizar las buenas prácticas de la atención al parto.

Physiological and molecular responses to thermal stress in red cusk-eel (Genypterus chilensis) juveniles reveals atrophy and oxidative damage in skeletal muscle.

The red cusk-eel (Genypterus chilensis) is a native species with strong potential to support Chilean aquaculture diversification. Environmental stressors, such as temperature, may generate important effects in fish physiology with negative impact. However, no information exists on the effects of thermal stress in Genypterus species or how this stressor affects the skeletal muscle. The present study evaluated for the first time the effect of high temperature stress in red cusk-eel juveniles to determine changes in plasmatic markers of stress (cortisol, glucose and lactate dehydrogenase (LDH)), the transcriptional effect in skeletal muscle genes related to (i) heat shock protein response (hsp60 and hsp70), (ii) muscle atrophy and growth (foxo1, foxo3, fbxo32, murf-1, myod1 and ddit4), and (iii) oxidative stress (cat, sod1 and gpx1), and evaluate the DNA damage (AP sites) and peroxidative damage (lipid peroxidation (HNE proteins)) in this tissue. Thermal stress generates a significant increase in plasmatic levels of cortisol, glucose and LDH activity and induced heat shock protein transcripts in muscle. We also observed an upregulation of atrophy-related genes (foxo1, foxo3 and fbxo32) and a significant modulation of growth-related genes (myod1 and ddit4). Thermal stress induced oxidative stress in skeletal muscle, as represented by the upregulation of antioxidant genes (cat and sod1) and a significant increase in DNA damage and lipid peroxidation. The present study provides the first physiological and molecular information of the effects of thermal stress on skeletal muscle in a Genypterus species, which should be considered in a climate change scenario.

Effects of crowding on the three main proteolytic mechanisms of skeletal muscle in rainbow trout (Oncorhynchus mykiss).

BACKGROUND: Skeletal muscle is one of the tissues most affected by stress conditions. The protein degradation in this tissue is vital for the supply of energy mediated by different proteolytic pathways such as the ubiquitin-proteasome (UPS), autophagy-lysosome (ALS) and the calpain/calpastatin system (CCS). Nevertheless, the regulation of this proteolytic axis under stress conditions is not yet completely clear. Chile is the main producer of rainbow trout (Oncorhynchus mykiss) in the world. This intensive fish farming has resulted in growing problems as crowding and stress are one of the major problems in the freshwater stage. In this context, we evaluated the crowding effect in juvenile rainbow trout kept in high stocking density (30 kg/m3) for 15, 45 and 60 days, using a control group of fish (10 kg/m3). RESULTS: Plasmatic cortisol and glucose were evaluated by enzyme immunoassay. The mRNA levels of stress-related genes (gr1, gr2, mr, hsp70, klf15 and redd1), markers of the UPS (atrogin1 and murf1) and CCS (capn1, capn1, cast-l and cast-s) were evaluated using qPCR. ALS (LC3-I/II and P62/SQSTM1) and growth markers (4E-BP1 and ERK) were measured by Western blot analysis. The cortisol levels increased concomitantly with weight loss at 45 days of crowding. The UPS alone was upregulated at 15 days of high stocking density, while ALS activation was observed at 60 days. However, the CCS was inactivated during the entire trial. CONCLUSION: All these data suggest that stress conditions, such as crowding, promote muscle degradation in a time-dependent manner through the upregulation of the UPS at early stages of chronic stress and activation of the ALS in long-term stress, while the CCS is strongly inhibited by stress conditions in the rainbow trout muscle farmed during freshwater stage. Our descriptive study will allow perform functional analysis to determine, in a more detailed way, the effect of stress on skeletal muscle physiology as well as in the animal welfare in rainbow trout. Moreover, it is the first step to elucidate the optimal crop density in the freshwater stage and improve the standards of Chilean aquaculture.

End-of-Life Admission to the Emergency Department: Experience of Mexico's National Cancer Institute of a Developing Country.

BACKGROUND: Admission to the emergency department (ED) of patients with advanced or end-of-life (EoL) cancer saturates the services that provide active medical attention to the complications of anticancer therapy, and the lack of specific protocol limits proper handling. OBJECTIVE: The aim of this study was to describe the characteristics of patients with advanced cancer admitted to the ED at the EoL in a comprehensive cancer center in Mexico. PATIENTS AND METHODS: We conducted a retrospective analysis of patients admitted to ED of the National Cancer Institute of Mexico City, with 3 or less days before they died, between January 2011 and December 2018. The data collected included clinical and demographic characteristics, reason for admission to the ED, number of admissions to ED in the last month of life, and cancer treatment received. RESULTS: A total of 426 patients were included; 60.8% were female with a median age of 60 years; 71.6% patients were receiving some kind of disease-modifying treatment, although the oncologist had considered they could die within 6 months, and 16 of them were receiving concomitant PC. 8.9% of these patients had been admitted 3 or more times to the ED in the last month. The principal reasons for admission to ED were dyspnea, uncontrolled pain, 12 patients were admitted in active death and 94 died within hours of admission to ED. CONCLUSIONS: Palliative care approach in oncological patients admitted to ED is important to avoid unnecesary suffering at the EoL.

Correspondencia entre el índice de placa y el recuento de Streptococcus mutans y Lactobacillus sp. en una población infantil: Un estudio transversal / Correspondence between plaque index and Streptococcus mutans and Lactabacillus spp. counts in a child population: A cross-sectional study

Antecedentes: La identificación de microorganismos como Streptococcus mutans(SM) y Lactobacillus sp. (LB) es un predictor del desarrollo de caries, sin embargo los métodos de identificación son de acceso limitado por su alto costo. Objetivo:determinar la correlación entre la biopelícula dental medida por el índice de placa bacteriana de (IPB) Silness y Löe modificado y el recuento de SM y LB en niños colombianos en edad preescolar. Este es un estudio descriptivo de corte transversal y correlacional. Materiales y métodos: Se tomaron 202 muestras de niños entre los 3 y 4 años de edad de tres jardines Infantiles de Cali, Colombia, pertenecientes al estrato socioeconómico 1 y 2, evaluados en cuatro tiempos (0, 3, 6 y 9 meses). Resultados: Hubo una correlación entre el IPB más alto y el mayor recuento de unidades formadoras de colonia de SMsólo a los 3 meses (p = 0,003*). Los recuentos de LB fueron homogéneos en todos los niños y no presentaron correlación con el IPB. Conclusión: Se observaron resultados mixtos sobre la relación entre IPB y los recuentos de SM presentes en la saliva, por lo cual se requiere un análisis de múltiples factores.

Background:The identification of microorganisms such as Streptococcus mutans(SM) and Lactobacillusspp. (LB) is a predictor of the development of caries, however the identification methods are of limited access due to their high cost. Aim:To determine the correlation between the dental biofilm measured by the modified Silness and Löe dental plaque index (DPI)) and the SM and LB count, in preschool children from Colombia. Materials and methods: This is a descriptive cross-sectional and correlational study. We took202 samples from children between 3 and 4 years of age from three kindergartens in Cali, Colombia, belonging to socioeconomic stratum 1 and 2, evaluated at four times (0, 3, 6 and 9 months). Results: We found a correlation between the highest IPB and thehighest count of SM colony forming units only at 3 months (p = 0.003*). LB counts were homogeneous in all children and there was no correlation with IPB. Conclusion: We observed mixed results on the relationship between IPB and the counts of SM present in the saliva, therefore an analysis of multiple factors is required.KEY WORDSDental plaque;Streptococcus mutans;Lactobacillus spp;dental caries.1