Cannabis approval and perceived risk of use among minority U.S. Army Reservists.

This study examined how minoritized U.S. Army Reserve/National Guard service members perceive cannabis use amid a continuously evolving societal and legal landscape in the United States. Logistic regression analyses were conducted to examine relationships between cannabis perceptions and race while considering illicit drug use norms, posttraumatic stress disorder symptomatology, and current drug use. Non-Hispanic Black soldiers had lower odds of approval for medicinal cannabis use and Hispanic soldiers had higher odds of perceived risk of cannabis use, both of which persisted when considering key covariates. These findings may be partly explained by a confluence of societal and cultural factors.

What's race got to do with it? Factors contributing to self-change from cocaine use disorder among Black adults.

INTRODUCTION: A substantial number of people with substance use disorders recover without formal treatment, though we know little about the process of self-change among Black adults with cocaine use disorder (CUD) and whether racism contributes to the development of CUD and these adults' process of self-change. METHODS: The study team conducted qualitative interviews with 29 Black adults using a narrative and phenomenological approach. At the time of the interview, all participants met criteria for DSM-5 CUD prior to the past year but did not meet criteria for CUD in the past year and reported that they reduced their cocaine use without formal treatment. Participants completed a qualitative interview followed by the UConn Racial/Ethnic Stress & Trauma Survey. Thematic analyses informed key themes from the qualitative interviews. RESULTS: Qualitative analyses indicated several major factors that contributed to self-change from CUD: racial identity, responsibility to family, social regard, spirituality, turning point for change, and changing one's environment. These results highlight that self-change from CUD is a complex, ongoing, and multifaceted process. The identified themes align with several theories of recovery, including social control theory and the theory of stress and coping. Furthermore, the results suggest that experiences of racism are common among Black adults recovering from CUD, and that the multiple strategies employed for coping with racism may be consistent with the process of self-change. CONCLUSIONS: This study shows that multiple race-related factors contribute to the development of, maintenance of, and self-change from CUD among Black adults. Better understanding these factors can help to inform drug treatment.

Integrative data analysis of clinical trials network studies to examine the impact of psychosocial treatments for black people who use cocaine: Study protocol.

BACKGROUND: Cocaine overdose death rates among Black people are higher than that of any other racial/ethnic group, attributable to synthetic opioids in the cocaine supply. Understanding the most effective psychostimulant use treatment interventions for Black people is a high priority. While some interventions have proven effective for the general population, their comparative effectiveness among Black people remains unknown. To address this gap, our NIDA-funded Clinical Trials Network (CTN) study (0125), will use Integrative Data Analysis (IDA) to examine treatment effectiveness across 9 CTN studies. This manuscript describes the study protocol for CTN-0125. METHODS: Of the 59 completed randomized clinical trials in the CTN with available datasets, nine met our inclusion criteria: 1) behavioral intervention, 2) targeted cocaine use or use disorder, 3) included sub-samples of participants who self-identified as Black and 4) included outcome measures of cocaine and psychostimulant use and consequences. We aim to 1) estimate scale scores of cocaine use severity while considering study-level measurement non-invariance, 2) compare the effectiveness of psychosocial treatments for psychostimulant use, and 3) explore individual (e.g., concomitant opioid use, age, sex, employment, pre-treatment psychiatric status) and study-level moderators (e.g., attendance/retention) to evaluate subgroup differences in treatment effectiveness. CONCLUSION: The NIDA CTN provides a unique collection of studies that can offer insight into what interventions are most efficacious for Black people. Findings from our CTN-0125 study have the potential to substantially inform treatment approaches specifically designed for Black people who use psychostimulants.

Investigating the associations of acute psychedelic experiences and changes in racial trauma symptoms, psychological flexibility, and substance use among People with Racial and Ethnic Minoritized Identities in the United States and Canada.

INTRODUCTION: Evidence suggests that psychedelics may serve as a therapeutic approach to reduce substance use; however, people with racial and ethnic minoritized (REM) identities are often excluded from this research. We investigated whether psychedelic use affects other substance use among REM people and whether perceived changes in psychological flexibility and racial trauma mediates this association. METHODS: REM people in the United States and Canada (N = 211; 32 % Black, 29 % Asian, 18 % American Indian/Indigenous Canadian, 21 % Native Hawaiian/Pacific Islander; 57 % female; mean age = 33.1, SD = 11.2) completed an online survey retrospectively reporting their substance use, psychological flexibility, and racial trauma symptoms 30 days before and after their most memorable psychedelic experience. RESULTS: Analyses showed a significant perceived reduction in alcohol (p < .0001, d = 0.54) and drug use (p = .0001, d = 0.23) from before to after the psychedelic experience. Preliminary associations found perceived reductions in racial trauma symptoms were associated with perceived reductions in alcohol use and this association varied by race, dose, ethnic identity, and change in depressive symptoms. Specifically, Indigenous participants experienced greater perceived reductions in alcohol use relative to participants who identified as Asian, Black, or other. Those who took a high dose of psychedelics experienced greater perceived reductions in alcohol use relative to those who took a low dose. Participants with a stronger ethnic identity and those with a perceived reduction in depressive symptoms experienced a perceived reduction in alcohol use. Serial mediation indicated a perceived increase in psychological flexibility and reduction in racial trauma symptoms mediated the association between acute psychedelic effects and perceived reductions in alcohol and drug use. CONCLUSION: These findings suggest that psychedelic experiences may contribute to an increase in psychological flexibility and reduction in racial trauma symptoms and alcohol and drug use among REM people. REM people have been largely excluded from psychedelic treatment research even though psychedelic use is considered a traditional healing practice in many communities of color. Longitudinal studies of REM people should replicate our findings.

Racial centrality mediates the association between adolescent racial discrimination and adult cigarette smoking outcomes among Black Americans.

OBJECTIVE: The objective of this study was to investigate racial centrality as a mediator of the association between Black adolescents' racial discrimination experiences and their cigarette use in early adulthood. METHODS: The data were drawn from the Family and Community Health Study, which is a longitudinal study of Black American families that began in 1996. Families with a child in 5th grade who identified as Black or African American were recruited from Iowa and Georgia. At baseline, there were 838 Black American children. Hierarchical regressions and bootstrap tests of the indirect effects were used to investigate whether racial centrality at Wave 5 (mean age = 21.6 years) mediated the association between adolescent discrimination at Waves 1-4 (mean ages = 10.5-18.8 years) and adult cigarette use at wave 6 (mean age = 23.5 years). RESULTS: Bivariate associations indicated racial discrimination was significantly associated positively with racial centrality and adult use of cigarettes. Racial centrality indirectly affected the association between racial discrimination and cigarette use such that greater racial centrality was associated with less cigarette use. Further, racial centrality predicted cessation among those who had smoked. Finally, racial centrality was higher among those who never smoked and those who had smoked and quit, relative to those who currently smoke. CONCLUSIONS: These findings suggest that having strong Black racial centrality is a mediator that reduces the risk of cigarette use among young adults who experience racial discrimination in adolescence. In addition, racial centrality also predicts smoking cessation among young Black Americans who smoke. Translational implications of these findings are discussed.

La percepción local de la transformación del paisaje en San Juan Teposcolula, Oaxaca México / Local perception of landscape transformation in San Juan Teposcolula, Oaxaca Mexico

RESUMEN Los suelos degradados y sin plantas de la Mixteca Alta de Oaxaca (México) fueron, por un largo tiempo, como el paisaje habitual de la región; sin embargo, la organización de los campesinos y las intervenciones de los programas de reforestación configuraron un nuevo paisaje con bosques. Desde 1935, la Mixteca Alta experimenta reforestaciones en su territorio, lo que originó una paulatina mejoría del paisaje. Para estudiar esta transformación, se aplicó una metodología cualitativa, la cual, se apoyó en la planeación de escenarios y de entrevistas semiestructuradas con las autoridades comunales. Los resultados muestran que los entrevistados perciben a las forestaciones como el factor que cambió su paisaje y, al mismo tiempo, identifican los servicios ecosistémicos que les brindan, como un clima local más agradable, la aparición de pequeños arroyos y fauna silvestre. Los resultados del estudio muestran la intención que tienen los entrevistados para hacer uso y aprovechamiento de las plantaciones.

ABSTRACT The degraded and deforested soils of the Mixteca Alta of Oaxaca (Mexico) were for a long time the usual landscape of the region. However, the organization of the farmers and the interventions of reforestation programs configured a new forested landscape. Since 1935, the Mixteca Alta has been subject to reforestation processes in its territory, which has led to a gradual improvement of the landscape. To study this transformation, a qualitative methodology was applied, based on scenario planning and semi-structured interviews with community authorities. The results show that the interviewees perceive the forestations as the factor that changed their landscape and at the same time identify the ecosystem services they provide, such as a more pleasant local climate, the appearance of small streams and wildlife. The results of the study show the intention of the interviewees to use and take advantage of the plantations.

Improving Structure-Based Virtual Screening with Ensemble Docking and Machine Learning.

One of the main challenges of structure-based virtual screening (SBVS) is the incorporation of the receptor's flexibility, as its explicit representation in every docking run implies a high computational cost. Therefore, a common alternative to include the receptor's flexibility is the approach known as ensemble docking. Ensemble docking consists of using a set of receptor conformations and performing the docking assays over each of them. However, there is still no agreement on how to combine the ensemble docking results to obtain the final ligand ranking. A common choice is to use consensus strategies to aggregate the ensemble docking scores, but these strategies exhibit slight improvement regarding the single-structure approach. Here, we claim that using machine learning (ML) methodologies over the ensemble docking results could improve the predictive power of SBVS. To test this hypothesis, four proteins were selected as study cases: CDK2, FXa, EGFR, and HSP90. Protein conformational ensembles were built from crystallographic structures, whereas the evaluated compound library comprised up to three benchmarking data sets (DUD, DEKOIS 2.0, and CSAR-2012) and cocrystallized molecules. Ensemble docking results were processed through 30 repetitions of 4-fold cross-validation to train and validate two ML classifiers: logistic regression and gradient boosting trees. Our results indicate that the ML classifiers significantly outperform traditional consensus strategies and even the best performance case achieved with single-structure docking. We provide statistical evidence that supports the effectiveness of ML to improve the ensemble docking performance.

Growth Patterns in Seedling Roots of the Pincushion Cactus Mammillaria Reveal Trends of Intra- and Inter-Specific Variation.

Genetic mechanisms controlling root development are well-understood in plant model species, and emerging frontier research is currently dissecting how some of these mechanisms control root development in cacti. Here we show the patterns of root architecture development in a gradient of divergent lineages, from populations to species in Mammillaria. First, we show the patterns of variation in natural variants of the species Mammillaria haageana. Then we compare this variation to closely related species within the Series Supertexta in Mammillaria (diverging for the last 2.1 million years) in which M. haageana is inserted. Finally, we compared these patterns of variation to what is found in a set of Mammillaria species belonging to different Series (diverging for the last 8 million years). When plants were grown in controlled environments, we found that the variation in root architecture observed at the intra-specific level, partially recapitulates the variation observed at the inter-specific level. These phenotypic outcomes at different evolutionary time-scales can be interpreted as macroevolution being the cumulative outcome of microevolutionary phenotypic divergence, such as the one observed in Mammillaria accessions and species.

Mass SARS-CoV-2 serological screening, a population-based study in the Principality of Andorra.

BACKGROUND: Andorra is a small country located in the Pyrenees attracting millions of visitors for tourism, mostly associated with skiing, and nature-related activities. As its neighbouring countries, Spain and France, it has been heavily affected by the COVID-19 pandemic. We estimated SARS-CoV-2 seroprevalence in the entire country by universal serological testing under a lockdown environment. METHODS: A total of 77,543 inhabitants of Andorra were invited to participate in the study. From 4-28 May, 2020, two cross sectional serological surveys were conducted using a rapid serological test (nCOV IgG/IgM) on a finger prick blood sample in 59 drive-through or walk-through checkpoints, all over Andorra. We calculated seroprevalence of antibodies against SARS-CoV-2 and analysed the main sociodemographic factors associated with being seropositive. FINDINGS: 70,494 inhabitants (90.9% of the population) participated in at least one survey. Overall seroprevalence was 11.0%. The most affected age groups were those over 90 years old (15.2%) and 80-89 (13.8%), followed by adults 50-59 (13.6%) and adolescents 10-19 (13.7%). Most seropositive participants, 6,061 (95.1%), were asymptomatic before the surveys. The multivariable analysis showed that the odds of being seropositive was higher among seasonal workers (OR 2.41; 95% CI 1.07-5.45) or in the population living in La Massana region, a popular ski-related area (OR 2.66; 95% CI 2.44-2.89). A higher seroprevalence was observed in those familiar nuclei with greater numbers of cohabitants: 18% in families with 6 household members or more; 13% in medium size families (3/4/5 people) and 12% in small size (1 to 2 people) nuclei. INTERPRETATION: The prevalence of antibodies against SARS-CoV-2 in the population of Andorra was high during the first wave of the pandemic. Seasonal workers and inhabitants based in La Massana presented a higher seroprevalence. Mass antibody screening allows to identify infection hotspots and should contribute to the design of tailored interventions to prevent SARS-CoV-2 transmission in Andorra. FUNDING: Andorran Ministry of Health, Andorran Health Services.

[Health-related quality of life in hypertension: a gender-differentiated analysis in population of Cantabria.] / Calidad de vida relacionada con la salud (CVRS) en la hipertensión arterial: un análisis diferenciado por género sobre población de Cantabria.

OBJECTIVE: Hypertension is a major public health problem due to its high prevalence and morbi-mortality. It is associated with a worse health-related quality of life (HRQOL). The aim has been to know the HRQOL of the hypertensive population in a gender-differentiated analysis. METHODS: Cross-sectional study. Hypertensive patients attended in Primary Care were enrolled in the study. We evaluated HRQOL (using the EuroQol-5D questionnaire), four covariates related to hypertension (degree of control, duration of disease, use of antihypertensive drugs and target organ damage -TOD-), and sociodemographic, lifestyle and clinical variables. Bivariate analysis was performed and two multivariate models were developed, with the EuroQol-5D index (iEQ) as the dependent variable. RESULTS: We analyzed 198 women (55.7%) and 157 men. Significantly, females had a lower educational level, spent more time alone, consumed more psychotropic medication, their iEQ was lower [0.887 (0.2) vs. 0.914 (0.1); p=0.0001] and scored worse in self-care, usual activities, pain / discomfort and anxiety / depression. In women, no variable related to hypertension presented a significant association with the iEQ after adjusting for confounders, and functional capacity was the most important covariate (ß=0.35; p=0.0001). In males, TOD (ß=0.18) and duration of the disease (ß=0.16) were significantly associated with the iEQ, with the consumption of psychotropic medication being the most relevant covariate in the regression model (ß=0.42; p=0.005). CONCLUSIONS: Notable differences in HRQOL of women and men with hypertension have been noted. Detecting these differences allows us to know the frailest states of our patients.

OBJETIVO: La hipertensión arterial (HTA), por su elevada prevalencia y morbimortalidad, es un importante problema de Salud Pública. Se asocia a una peor calidad de vida relacionada con la salud (CVRS). El objetivo de este trabajo fue conocer la CVRS de la población hipertensa en un análisis diferenciado por género. METODOS: Se realizó un estudio transversal. Partici-paron cinco cupos de Medicina de Familia. Se evaluó la CVRS (mediante el cuestionario EuroQol-5D), cuatro variables relacionadas con la HTA (grado de control, duración de la enfermedad, uso de fármacos antihipertensivos y lesión de órgano diana -LOD-), variables sociodemográficas, de estilo de vida y clínicas. Se realizó análisis bivariado y se elaboraron dos modelos multivariados, con el índice EuroQol-5D (iEQ) como variable dependiente. RESULTADOS: Fueron analizadas 198 mujeres (55,7%) y 157 varones. Las mujeres, significativamente, tenían menor nivel educativo, pasaban más tiempo solas, consumían más psicofármacos, su iEQ fue menor (0,887 [0,2] frente a 0,914 [0,1]; p=0,0001) y puntuaron peor en cuidado personal, actividades cotidianas, dolor/malestar y ansiedad/depresión. En las mujeres, tras ajustar por confusores, ninguna variable relacionada con la HTA presentó una asociación significativa con el iEQ, y la capacidad funcional fue la variable más importante (ß=0,35; p=0,0001). En los varones, la LOD (ß=0,18) y la duración de la HTA (ß=0,16) se asociaron significativamente con el iEQ, siendo el consumo de psicofármacos la variable más relevante del modelo de regresión (ß=0,42; p=0,005). CONCLUSIONES: Se observan notables diferencias en la CVRS de las mujeres y los varones con HTA. Detectar dichas diferencias permite conocer los perfiles más frágiles de nuestros pacientes.

Calidad de vida relacionada con la salud (CVRS) en la hipertensión arterial: un análisis diferenciado por género sobre población de cantabria / Health-related quality of life in hypertension: a gender-differentiated analysis in population of Cantabria

OBJETIVO: La hipertensión arterial (HTA), por su elevada prevalencia y morbimortalidad, es un importante problema de Salud Pública. Se asocia a una peor calidad de vida relacionada con la salud (CVRS). El objetivo de este trabajo fue conocer la CVRS de la población hipertensa en un análisis diferenciado por género. MÉTODOS: Se realizó un estudio transversal. Participaron cinco cupos de Medicina de Familia. Se evaluó la CVRS (mediante el cuestionario EuroQol-5D), cuatro variables relacionadas con la HTA (grado de control, duración de la enfermedad, uso de fármacos antihipertensivos y lesión de órgano diana -LOD-), variables sociodemográficas, de estilo de vida y clínicas. Se realizó análisis bivariado y se elaboraron dos modelos multivariados, con el índice EuroQol-5D (iEQ) como variable dependiente. RESULTADOS: Fueron analizadas 198 mujeres (55,7%) y 157 varones. Las mujeres, significativamente, tenían menor nivel educativo, pasaban más tiempo solas, consumían más psicofármacos, su iEQ fue menor (0,887 [0,2] frente a 0,914 [0,1]; p = 0,0001) y puntuaron peor en cuidado personal, actividades cotidianas, dolor/malestar y ansiedad/depresión. En las mujeres, tras ajustar por confusores, ninguna variable relacionada con la HTA presentó una asociación significativa con el iEQ, y la capacidad funcional fue la variable más importante (beta=0,35; p = 0,0001). En los varones, la LOD (beta=0,18) y la duración de la HTA (beta=0,16) se asociaron significativamente con el iEQ, siendo el consumo de psicofármacos la variable más relevante del modelo de regresión (beta=0,42; p = 0,005). CONCLUSIONES: Se observan notables diferencias en la CVRS de las mujeres y los varones con HTA. Detectar dichas diferencias permite conocer los perfiles más frágiles de nuestros pacientes

OBJECTIVE: Hypertension is a major public health problem due to its high prevalence and morbi-mortality. It is associated with a worse health-related quality of life (HRQOL). The aim has been to know the HRQOL of the hypertensive population in a gender-differentiated analysis. METHODS: Cross-sectional study. Hypertensive patients attended in Primary Care were enrolled in the study. We evaluated HRQOL (using the EuroQol-5D questionnaire), four covariates related to hypertension (degree of control, duration of disease, use of antihypertensive drugs and target organ damage -TOD-), and sociodemographic, lifestyle and clinical variables. Bivariate analysis was performed and two multivariate models were developed, with the EuroQol-5D index (iEQ) as the dependent variable. RESULTS: We analyzed 198 women (55.7%) and 157 men. Significantly, females had a lower educational level, spent more time alone, consumed more psychotropic medication, their iEQ was lower [0.887 (0.2) vs. 0.914 (0.1); p = 0.0001] and scored worse in self-care, usual activities, pain / discomfort and anxiety / depression. In women, no variable related to hypertension presented a significant association with the iEQ after adjusting for confounders, and functional capacity was the most important covariate (Beta=0.35; p = 0.0001). In males, TOD (Beta=0.18) and duration of the disease (Beta=0.16) were significantly associated with the iEQ, with the consumption of psychotropic medication being the most relevant covariate in the regression model (Beta=0.42; p = 0.005). CONCLUSIONS: Notable differences in HRQOL of women and men with hypertension have been noted. Detecting these differences allows us to know the frailest states of our patients

A Linear Model to Describe Branching and Allometry in Root Architecture.

Root architecture is a complex structure that comprises multiple traits of the root phenotype. Novel platforms and models have been developed to better understand root architecture. In this methods paper, we introduce a novel allometric model, named rhizochron index (m), which describes lateral root (LR) branching and elongation patterns across the primary root (PR). To test our model, we obtained data from 16 natural accessions of Arabidopsis thaliana at three stages of early root development to measure conventional traits of root architecture (e.g., PR and LR length), and extracted the rhizochron index (m). In addition, we tested previously published datasets to assess the utility of the rhizochron index (m) to distinguish mutants and environmental effects on root architecture. Our results indicate that rhizochron index (m) is useful to distinguish the natural variations of root architecture between A. thaliana accessions, but not across early stages of root development. Correlation analyses in these accessions showed that m is a novel trait that partially captures information from other root architecture traits such as total lateral root length, and the ratio between lateral root and primary root lengths. Moreover, we found that the rhizochron index was useful to distinguish ABA effect on root architecture, as well as the mutant pho1 phenotype. We propose the rhizochron index (m) as a new feature of the root architectural system to be considered, in addition to conventional traits in future investigations.

Molecular modeling simulation studies reveal new potential inhibitors against HPV E6 protein.

High-risk strains of human papillomavirus (HPV) have been identified as the etiologic agent of some anogenital tract, head, and neck cancers. Although prophylactic HPV vaccines have been approved; it is still necessary a drug-based treatment against the infection and its oncogenic effects. The E6 oncoprotein is one of the most studied therapeutic targets of HPV, it has been identified as a key factor in cell immortalization and tumor progression in HPV-positive cells. E6 can promote the degradation of p53, a tumor suppressor protein, through the interaction with the cellular ubiquitin ligase E6AP. Therefore, preventing the formation of the E6-E6AP complex is one of the main strategies to inhibit the viability and proliferation of infected cells. Herein, we propose an in silico pipeline to identify small-molecule inhibitors of the E6-E6AP interaction. Virtual screening was carried out by predicting the ADME properties of the molecules and performing ensemble-based docking simulations to E6 protein followed by binding free energy estimation through MM/PB(GB)SA methods. Finally, the top-three compounds were selected, and their stability in the E6 docked complex and their effect in the inhibition of the E6-E6AP interaction was corroborated by molecular dynamics simulation. Therefore, this pipeline and the identified molecules represent a new starting point in the development of anti-HPV drugs.

The impact of dispositional optimism on symptoms and treatment choices in patients with pelvic floor disorders.

INTRODUCTION AND HYPOTHESIS: The objective of this study is to evaluate dispositional optimism, pelvic floor disorder symptoms, and treatment decisions. METHODS: Scores of the Life Orientation Test-Revised were used to categorize women seeking clinical treatment for pelvic floor disorders as pessimists (scores in lowest third) or optimists (scores in highest third). Participants also listed their treatment goals and quantified pelvic floor symptom severity by completing the Pelvic Floor Distress Inventory (PFDI-20). We compared symptoms, goals, and treatment choices between optimists and pessimists. RESULTS: Three hundred sixteen patients were included, 31% pessimists and 38% optimists. Pessimists reported more goals and different types of treatment goals. Pessimists were also more likely to elect surgical treatment over more conservative treatment methods, although this trend did not reach statistical significance. Among patients with prolapse (≥stage 2), PFDI-20 prolapse subscale scores were inversely correlated with level of optimism, with pessimists reporting a higher level of bother than optimists. CONCLUSIONS: In our study, pessimists reported more treatment goals, were more bothered by prolapse symptoms, and tended to be more likely to choose surgical treatments for their pelvic floor disorders than optimistic women.

Síndrome de Burn Out o Estrés Profesional en el personal de Enfermería: primer semestre 2006 / Burn-out or proffesional stress syndrome in the Nursing staff frist semester, 2006

En nuestro país el trabajo de enfermería en los diferentes niveles de atención y sobre todo en la atención primaria de salud, genera un nivel de adaptación superior, lo cual trae consigo el estrés. Se realizó un estudio descriptivo-transversal, en la policlínica Mártires del 8 de Abril durante el primer semestre del año 2006. De un universo de 116 enfermeros, se escogió como muestra los 29 licenciados por el muestreo intencional con el objetivo de identificar aquellos factores que generan el estrés en el personal de enfermería y el grado de repercusión del mismo para estos profesionales. Se aplicaron dos encuestas como instrumentos de obtención de los datos, las variables utilizadas fueron: factores intrínsecos y extrínsecos y repercusión del estrés, se contó con el consentimiento informado de los individuos de la muestra para participar en el mismo. Se comprobó que dentro de los factores intrínsecos que mayor estrés provocó ,fueron en mayor cuantía los relacionados con los problemas domésticos es decir, dinero, relaciones familiares, vida cotidiana con el 93,1 por ciento, dentro de los factores extrínsecos se obtuvo como resultado con un 100 por ciento las preocupaciones por el trabajo ,también se comprobó que el primer blanco del síndrome de burms- Out es la propia enfermera y que dentro de las consecuencias mas relevantes fueron las alteraciones del sueño con un 100 por ciento, la perdida de la autoestima y la confianza para un 96,5 por ciento y un 93,4 por ciento respectivamente .Concluyendo que fue altamente significativa la repercusión del Estrés en los profesionales de Enfermería(AU)es

Cistoadenoma papilar bilateral: a propósito de un caso raro descrito por primera vez en nuestro medio / Papillary bilateral cystoadenoma: report o f a rare case described for the first time

Se presenta un paciente de 58 años de edad, del sexo masculino, que acudió a la consulta de Otorrinolaringología con aumento de volumen de ambas regiones parotideas, sin otros síntomas acompañantes. Después de realizar diversos estudios, incluyendo biopsia por aspiración con aguja fina se definió el patrón celular compatible con un tumor de Warthin, por lo que al realizar el tratamiento hubo plena coincidencia con la biopsia por parafina. Dado lo infrecuente de esta tumoración en nuestro medio se realizó el presente trabajo

Cistoadenoma papilar bilateral: a propósito de un caso raro descrito por primera vez en nuestro medio / Papillary bilateral cystoadenoma: report o f a rare case described for the first time

Se presenta un paciente de 58 años de edad, del sexo masculino, que acudió a la consulta de Otorrinolaringología con aumento de volumen de ambas regiones parotideas, sin otros síntomas acompañantes. Después de realizar diversos estudios, incluyendo biopsia por aspiración con aguja fina se definió el patrón celular compatible con un tumor de Warthin, por lo que al realizar el tratamiento hubo plena coincidencia con la biopsia por parafina. Dado lo infrecuente de esta tumoración en nuestro medio se realizó el presente trabajo(AU)