Effect of the Healthy Dish Method to Reduce Waist Circumference in Teachers with Abdominal Obesity of a Peruvian University.

Introduction: Obesity has increased steadily in recent decades, becoming a worldwide pandemic. Objective: To determine the effect of the "Healthy Dish" method to reduce waist circumference in teachers with abdominal obesity in a Peruvian University. Methods: Quasi-experimental, prospective study in 43 teachers, divided into 21 in the control group and 22 in the experimental group, who received a two-session workshop on abdominal obesity and the "Healthy Dish" method. The latter was applied for 2 months, monitored 5 days a week, the waist circumference of both groups was measured at one month and at two months and compared. For the statistical analysis, descriptive and inferential statistics or nonparametric statistics were applied (Mann-Whitney U-test, according to the assumption of normality). Results: The predominant age range was 40 to 49 years, women, married, overweight, with a family history of hypertension, cancer and diabetes mellitus. After the intervention, 40.9% of teachers in the experimental group decreased their waist circumference and 54.5% normalized it, while the control group decreased it by 23.8% and 47.6% normalized it. Only 4.54% of teachers in the experimental group showed no change in their waist circumference, compared to 19.0% in the control group, and 9.52% of teachers in the control group increased their waist circumference. Conclusion: The healthy dish method has a positive effect on decreasing waist circumference in teachers with abdominal obesity.

ETV6::NTRK3 Fusion-Positive Wild-Type Gastrointestinal Stromal Tumor (GIST) with Abundant Lymphoid Infiltration (TILs and Tertiary Lymphoid Structures): A Report on a New Case with Therapeutic Implications and a Literature Review.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with proto-oncogene, receptor tyrosine kinase (c-kit), or PDGFRα mutations detected in around 85% of cases. GISTs without c-kit or platelet-derived growth factor receptor alpha (PDGFRα) mutations are considered wild-type (WT), and their diverse molecular alterations and biological behaviors remain uncertain. They are usually not sensitive to tyrosine kinase inhibitors (TKIs). Recently, some molecular alterations, including neurotrophic tyrosine receptor kinase (NTRK) fusions, have been reported in very few cases of WT GISTs. This novel finding opens the window for the use of tropomyosin receptor kinase (TRK) inhibitor therapy in these subtypes of GIST. Herein, we report a new case of NTRK-fused WT high-risk GIST in a female patient with a large pelvic mass (large dimension of 20 cm). The tumor was removed, and the histopathology displayed spindle-predominant morphology with focal epithelioid areas, myxoid stromal tissue, and notable lymphoid infiltration with tertiary lymphoid structures. Ten mitoses were quantified in 50 high-power fields without nuclear pleomorphism. DOG1 showed strong and diffuse positivity, and CD117 showed moderate positivity. Succinate dehydrogenase subunit B (SDHB) was retained, Pan-TRK was focal positive (nuclear pattern), and the proliferation index Ki-67 was 7%. Next-generation sequencing (NGS) detected an ETV6::NTRK3 fusion, and this finding was confirmed by fluorescence in situ hybridization (FISH), which showed NTRK3 rearrangement. In addition, an RB1 mutation was found by NGS. The follow-up CT scan revealed peritoneal nodules suggestive of peritoneal dissemination, and Entrectinib (a TRK inhibitor) was administered. After 3 months of follow-up, a new CT scan showed a complete response. Based on our results and the cases from the literature, GISTs with NTRK fusions are very uncommon so far; hence, further screening studies, including more WT GIST cases, may increase the possibility of finding additional cases. The present case may offer new insights into the potential introduction of TRK inhibitors as treatments for GISTs with NTRK fusions. Additionally, the presence of abundant lymphoid infiltration in the present case may prompt further research into immunotherapy as a possible additional therapeutic option.

Improving management of hyponatraemia by increasing urine testing in the emergency department.

Hyponatraemia on hospital admission is associated with increased length of stay, healthcare expenditures and mortality. Urine studies collected before fluid or diuretic administration are essential to diagnose the underlying cause of hyponatraemia, thereby empowering admitting teams to employ the appropriate treatment. A multidisciplinary quality improvement (QI) team led by internal medicine residents performed a QI project from July 2020 through June 2021 to increase the rate of urine studies collected before fluid or diuretic administration in the emergency department (ED) in patients admitted with moderate to severe hyponatraemia. We implemented two plan-do-study-act (PDSA) cycles to address this goal. In PDSA Cycle #1, we displayed an educational poster in employee areas of the ED and met with nursing staff at their monthly meetings to communicate the project and answer questions. We also obtained agreement from ED attending physicians and nursing leaders to support the project. In PDSA Cycle #2, we implemented a structural change in the nursing triage process to issue every patient who qualified for bloodwork with a urine specimen container labelled with a medical record number on registration so that the patient could provide a sample at any point, including while in the waiting area. After PDSA Cycle #1, urine specimen collection increased from 34.5% to 57.5%. After PDSA Cycle #2, this increased further to 59%. We conclude that a combination of educational and structural changes led to a significant increase in urine specimen collection before fluid or diuretic administration among patients presenting with moderate-to-severe hyponatraemia in the ED.

Paraquat is toxic to the soil-dwelling arthropod, Folsomia candida (Collembola: Isotomidae), and has potential effects on its Wolbachia endosymbiont.

The springtail, Folsomia candida, is a soil arthropod commonly used to evaluate environmental toxins. Conflicting data on the toxicity of the herbicide paraquat prompted re-evaluation of its effects on F. candida survival and reproduction. Paraquat has an LC50 of about 80 µM when tested in the absence of charcoal; charcoal, often used in test arenas to facilitate visualization of the white Collembola, has a protective effect. Survivors of paraquat treatment fail to resume molting and oviposition, suggesting an irreversible effect on the Wolbachia symbiont that restores diploidy during parthenogenetic reproduction of this species.

Functionality and Quality of Life with Parkinson's Disease after Use of a Dynamic Upper Limb Orthosis: A Pilot Study.

Parkinson's disease (PD) is a chronic, neurodegenerative movement disorder, whose symptoms have a negative impact on quality of life and functionality. Although its main treatment is pharmacological, non-pharmacological aids such as the dynamic elastomeric fabric orthosis (DEFO) merit an evaluation. Our objective is to assess the DEFO in upper limb (UL) functional mobility and in the quality of life of PD patients. A total of 40 patients with PD participated in a randomized controlled crossover study, and were assigned to a control group (CG) and to an experimental group (EG). Both groups used the DEFO for two months, the experimental group the first two months of the study and the control group the last two. Motor variables were measured in the ON and OFF states at the baseline assessment and at two months. Differences from the baseline assessment were observed in some motor items of the Kinesia assessment, such as rest tremor, amplitude, rhythm or alternating movements in the ON and OFF states with and without orthosis. No differences were found in the unified Parkinson's disease rating scale (UPDRS) or the PD quality-of-life questionnaire. The DEFO improves some motor aspects of the UL in PD patients but this does not translate to the amelioration of the standard of functional and quality-of-life scales.

Láser de baja potencia como alternativa terapéutica al eritema multiforme idiopático. Informe de caso

El eritema multiforme es una enfermedad aguda de la piel y/o de las mucosas de naturaleza inmunológica, siendo está de etiología desconocida. Solo el 20% de los casos se dan en niños. El diagnóstico se basa en la historia clínica y el examen físico y el tratamiento no está sistematizado. La terapia con láser de baja potencia está siendo cada vez más utilizada en el campo estomatológico. El objetivo fue evidenciar los beneficios del láser de baja potencia como alternativa terapéutica. Este caso corresponde a un paciente de 10 años de edad, que acudió a la cátedra de Patología Bucal de la Facultad de Odontología de la Universidad Nacional de Asunción (UNA), derivado del Hospital General de Barrio Obrero con antecedentes de internación por presentar lesiones erosivas en labios, boca y máculas en toráx, abdomen, orejas y miembros. En el examen intraoral costras serohemáticas negruzcas en labios, lesiones ulceradas en lengua, piso de boca, paladar duro y mucosa yugal. Se procedió a hacer una lavado de la zona con agua oxigenada, en las áreas afectadas se colocó azul de metileno al 0,01% por 5 minutos, y para la aplicación de laserterapia se realizó una única sesión. El paciente mostró gran evolución a las 24 horas de la aplicación del tratamiento. A los 8 días estaba sin lesiones y asintomático. La fotobioestimulación a nivel celular que ofrece el láser de baja potencia es una herramienta verosímil que se suma a nuevas opciones terapéuticas.

Erythema multiforme is an acute disease of the skin and/or mucous membranes of an immunologic nature, the etiology of which is unknown. Only 20% of cases occur in children. Diagnosis is based on clinical history and physical examination and treatment is not systematized. Low power laser therapy is being increasingly used in the stomatological field. The objective was to demonstrate the benefits of low power laser as a therapeutic alternative. This case corresponds to a 10-year-old patient, who came to the Department of Oral Pathology of the Faculty of Dentistry of the National University of Asuncion (UNA), referred from the General Hospital of Barrio Obrero with a history of hospitalization for presenting erosive lesions on the lips, mouth and macules on the thorax, abdomen, ears and limbs. In the intraoral examination, blackish serohematic crusts on the lips, ulcerated lesions on the tongue, floor of the mouth, hard palate and jugal mucosa. The area was washed with hydrogen peroxide, methylene blue 0.01% was applied to the affected areas for 5 minutes, and only a single session was performed for the application of the laser therapy. The patient showed great evolution 24 hours after the application of the treatment. After 8 days he was completely free of lesions and asymptomatic. The photo-biostimulation at the cellular level offered by the low power laser is a credible tool that adds to new therapeutic options.

O eritema multiforme é uma doença aguda da pele e/ou mucosas de natureza imunológica, cuja etiologia é desconhecida. Apenas 20% dos casos ocorrem em crianças. O diagnóstico é baseado na história clínica e no exame físico. O tratamento não é sistematizado. A terapia laser de baixa potência é cada vez mais utilizada no campo estomatológico. O objectivo foi demonstrar os benefícios do laser de baixa potência como uma alternativa terapêutica. Este caso corresponde a um paciente de 10 anos de idade que veio ao Departamento de Patologia Oral da Faculdade de Odontologia da Universidade Nacional de Asunción (UNA) e foi encaminhado do Hospital Geral do Bairro Obrero com um historial de hospitalização por apresentar lesões erosivas nos lábios, boca e máculas no tórax, abdómen, orelhas e membros. No exame intraoral, crostas serohaemáticas negras nos lábios, lesões ulceradas na língua, chão da boca, palato duro e mucosa jugal. A área foi lavada com peróxido de hidrogénio, azul de metileno 0,01% foi aplicado nas áreas afectadas durante 5 minutos, e foi realizada uma única sessão de laserterapia. O paciente mostrou uma grande evolução 24 horas após a aplicação do tratamento. Após 8 dias, estava completamente livre de lesões e assintomático. A foto-biostimulação a nível celular oferecida pelo laser de baixa potência é uma ferramenta credível que se soma a novas opções terapêuticas.

Láser de baja potencia como alternativa terapéutica al eritema multiforme idiopático. Informe de caso

El eritema multiforme es una enfermedad aguda de la piel y/o de las mucosas de naturaleza inmunológica, siendo está de etiología desconocida. Solo el 20% de los casos se dan en niños. El diagnóstico se basa en la historia clínica y el examen físico y el tratamiento no está sistematizado. La terapia con láser de baja potencia está siendo cada vez más utilizada en el campo estomatológico. El objetivo fue evidenciar los beneficios del láser de baja potencia como alternativa terapéutica. Este caso corresponde a un paciente de 10 años de edad, que acudió a la cátedra de Patología Bucal de la Facultad de Odontología de la Universidad Nacional de Asunción (UNA), derivado del Hospital General de Barrio Obrero con antecedentes de internación por presentar lesiones erosivas en labios, boca y máculas en toráx, abdomen, orejas y miembros. En el examen intraoral costras serohemáticas negruzcas en labios, lesiones ulceradas en lengua, piso de boca, paladar duro y mucosa yugal. Se procedió a hacer una lavado de la zona con agua oxigenada, en las áreas afectadas se colocó azul de metileno al 0,01% por 5 minutos, y para la aplicación de laserterapia se realizó una única sesión. El paciente mostró gran evolución a las 24 horas de la aplicación del tratamiento. A los 8 días estaba sin lesiones y asintomático. La fotobioestimulación a nivel celular que ofrece el láser de baja potencia es una herramienta verosímil que se suma a nuevas opciones terapéuticas.

Erythema multiforme is an acute disease of the skin and/or mucous membranes of an immunologic nature, the etiology of which is unknown. Only 20% of cases occur in children. Diagnosis is based on clinical history and physical examination and treatment is not systematized. Low power laser therapy is being increasingly used in the stomatological field. The objective was to demonstrate the benefits of low power laser as a therapeutic alternative. This case corresponds to a 10-year-old patient, who came to the Department of Oral Pathology of the Faculty of Dentistry of the National University of Asuncion (UNA), referred from the General Hospital of Barrio Obrero with a history of hospitalization for presenting erosive lesions on the lips, mouth and macules on the thorax, abdomen, ears and limbs. In the intraoral examination, blackish serohematic crusts on the lips, ulcerated lesions on the tongue, floor of the mouth, hard palate and jugal mucosa. The area was washed with hydrogen peroxide, methylene blue 0.01% was applied to the affected areas for 5 minutes, and only a single session was performed for the application of the laser therapy. The patient showed great evolution 24 hours after the application of the treatment. After 8 days he was completely free of lesions and asymptomatic. The photo-biostimulation at the cellular level offered by the low power laser is a credible tool that adds to new therapeutic options.

O eritema multiforme é uma doença aguda da pele e/ou mucosas de natureza imunológica, cuja etiologia é desconhecida. Apenas 20% dos casos ocorrem em crianças. O diagnóstico é baseado na história clínica e no exame físico. O tratamento não é sistematizado. A terapia laser de baixa potência é cada vez mais utilizada no campo estomatológico. O objectivo foi demonstrar os benefícios do laser de baixa potência como uma alternativa terapêutica. Este caso corresponde a um paciente de 10 anos de idade que veio ao Departamento de Patologia Oral da Faculdade de Odontologia da Universidade Nacional de Asunción (UNA) e foi encaminhado do Hospital Geral do Bairro Obrero com um historial de hospitalização por apresentar lesões erosivas nos lábios, boca e máculas no tórax, abdómen, orelhas e membros. No exame intraoral, crostas serohaemáticas negras nos lábios, lesões ulceradas na língua, chão da boca, palato duro e mucosa jugal. A área foi lavada com peróxido de hidrogénio, azul de metileno 0,01% foi aplicado nas áreas afectadas durante 5 minutos, e foi realizada uma única sessão de laserterapia. O paciente mostrou uma grande evolução 24 horas após a aplicação do tratamento. Após 8 dias, estava completamente livre de lesões e assintomático. A foto-biostimulação a nível celular oferecida pelo laser de baixa potência é uma ferramenta credível que se soma a novas opções terapêuticas.

Producción científica de la maestría de farmacoepidemiología en Cuba: Revisión de trabajos de tesis / Scientific production of master's degree in pharmacoepidemiology in Cuba: Descriptive review of thesis works

Resumen Objetivo: Caracterizar las investigaciones realizadas en farmacoepidemiología a partir de las tesis de Maestría de Farmacoepidemiología de la Escuela Nacional de Salud Pública, La Habana, Cuba. Materiales y método: Estudio descriptivo; se analizaron 124 tesis defendidas en las cuatro ediciones de la maestría, entre los años 2010 y 2019. Las variables fueron profesión y lugar de residencia de los autores, línea de investigación de la maestría que se abordó, tipo de estudio, tipo de Estudio de Utilización de Medicamentos (EUM), grupos farmacológicos que se investigaron y si los resultados se publicaron en revistas científicas. Los resultados se resumieron en porcentajes. Resultados: La mayoría de los autores eran graduados de Medicina (50.0%) y residían en La Habana 53.2%. Las líneas de investigación más abordadas fueron calidad de la prescripción de medicamentos (43.5%) y farmacovigilancia, 30.6 %. Se identificaron 72 EUM y predominó el tipo prescripción-indicación (27.7%). Predominó el análisis de antimicrobianos (28.5%) y de los fármacos cardiovasculares (29.7%). Fueron publicadas en revistas científicas solo el 22.5% de las investigaciones. Conclusiones: Los temas de tesis de la maestría están en concordancia con las prioridades del sistema sanitario cubano para lograr un uso racional de los medicamentos; los informes de investigación que resultan como trabajo final de la maestría constituyen una referencia de la investigación en ese campo en Cuba. Se debe incentivar la participación de otros profesionales, el diseño de otros tipos de estudios y la publicación de los resultados.

Abstract Objective: To characterize the research carried out in pharmacoepidemiology based on the master's theses in Pharmacoepidemiology of the National School of Public Health, Havana, Cuba. Materials and method: It was done a descriptive study; 124 theses defended in the four editions of the master's degree were analyzed, between 2010 and 2019. The variables were profession and place of residence of authors, line of research of the master's degree that was addressed, type of study, type of Drug Utilization Research (DUR), pharmacological groups that were investigated and whether the results were published in scientific journals. The results were summarized in percentages. Results: Most of the authors were medicine graduates (50.0%) and 53.2% resided in Havana. The researched lines of most addressed were quality of drug prescription (43.5%) and pharmacovigilance, 30.6%. 72 DUR, prescription-indication type prevailed were identified (27.7%). The analysis of antimicrobials (28.5%) and cardiovascular drugs (29.7%) predominated. Only 22.5% of the investigations were published in scientific journals. Conclusions: The topics of the master's thesis are in accordance with the priorities of the Cuban health system to achieve a rational use of medicines; the research reports that result as the final work of the master's degree constitute a reference of the research in that field in Cuba. The participation of other professionals, the design of other types of studies and the publication of the results should be encouraged.

Prácticas y saberes de excombatientes de las FARC-EP sobre el tratamiento de la leishmaniasis cutánea / Practices and knowledge of ex-combatents of the FARC-EP on the treatment of cutaneous leishmaniasis

RESUMEN Introducción: La Leishmaniasis es una enfermedad infecciosa parasitaria zoonótica que afecta la piel, las mucosas y las vísceras. Es endémica en 98 países y hay más de 350 millones de personas en riesgo de transmisión. En Colombia, los campamentos de las antiguas Fuerzas Armadas Revolucionarias de Colombia, se ubicaban en zonas selváticas donde la enfermedad está presente. El objetivo del presente trabajo está dirigido a describir las prácticas y saberes de los excombatientes de las FARC-EP sobre la Leishmaniasis cutánea y su manejo en escenarios de combate al convivir con esta enfermedad. Métodos: El estudio es cualitativo/exploratorio, donde se abordaron los conocimientos sobre la enfermedad y su forma de transmisión, como también aquellas prácticas relacionadas con el uso de medicamentos para su tratamiento. Resultados: En el análisis de las entrevistas se encontró que los excombatientes conocen el ciclo de la enfermedad desde sus vivencias y por transmisión oral, como también de prácticas curativas propias adaptadas al contexto del conflicto armado, esta experiencia los llevó a desarrollar estrategias de gestión del conocimiento basado en la evidencia. Discusión: Las entrevistas dan cuenta del conocimiento empírico y clínico de los excombatientes sobre el ciclo de la enfermedad; no existe un registro documental, ni manuales de procedimientos realizados en la selva por las FARC-EP sobre tratamiento de enfermedades; los miembros de las FARC-EP a desarrollar estrategias de gestión del conocimiento basados en la evidencia; el contexto de conflicto afectó de manera importante el tiempo y los recursos técnicos para manejar la Leishmaniasis, esto posibilitó las respuestas alternativas a la enfermedad documentadas en este trabajo.

ABSTRACT Introduction: Leishmaniasis is a zoonotic parasitic infectious disease that affects the skin, mucous membranes and viscera. It is endemic in 98 countries and there are more than 350 million people at risk of transmission. In Colombia, the camps of the former Revolutionary Armed Forces of Colombia were located in jungle areas where the disease is present. The objective of this work is aimed at describing the practices and knowledge of ex-combatants of the FARC-EP about cutaneous Leishmaniasis and its management in combat scenarios when living with this disease. Methods: The study is qualitative/exploratory, where knowledge about the disease and its form of transmission were addressed, as well as those practices related to the use of medications for its treatment. Results: In the analysis of the interviews it was found that the ex-combatants know the cycle of the disease from their experiences and by oral transmission, as well as their own healing practices adapted to the context of the armed conflict, this experience led them to develop knowledge management strategies based on the evidence. Discussion: The interviews give an account of the empirical and clinical knowledge of the ex-combatants about the cycle of the disease; There is no documentary record, nor manuals of procedures carried out in the jungle by the FARC-EP on the treatment of diseases; the members of the FARC-EP to develop evidence-based knowledge management strategies; the context of conflict significantly affected the time and technical resources to manage Leishmaniasis, this made possible the alternative responses to the disease documented in this work.

Lactobacillus rhamnosus sepsis, endocarditis and septic emboli in a patient with ulcerative colitis taking probiotics.

A man in his 60s presented to the emergency room with fever and fatigue after a 2.5-month course of corticosteroids. His medical history was significant for bioprosthetic aortic valve replacement and moderately severe ulcerative colitis treated with balsalazide and daily lactobacillus-containing probiotics. Initial investigations revealed Lactobacillus rhamnosus bacteraemia without complication. Four days after hospital discharge, the patient experienced acute-onset right-sided paraesthesia and lower-limb paresis. On return to the emergency room, MRI of the brain demonstrated innumerable ring-enhancing lesions with haemorrhagic transformation. Transoesophageal echocardiogram revealed a small mobile density on the bioprosthetic aortic valve, raising the suspicion for L. rhamnosus infective endocarditis with secondary septic emboli to the brain. The patient was subsequently treated with intravenous gentamycin and ampicillin, with transition to indefinite oral amoxicillin suppressive therapy. The current case highlights the potential risk of lactobacilli translocation in an immunosuppressed patient with ulcerative colitis taking probiotics.

GECOP-MMC: phase IV randomized clinical trial to evaluate the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) with mytomicin-C after complete surgical cytoreduction in patients with colon cancer peritoneal metastases.

BACKGROUND: The French PRODIGE 7 trial, published on January 2021, has raised doubts about the specific survival benefit provided by HIPEC with oxaliplatin 460 mg/m2 (30 minutes) for the treatment of peritoneal metastases from colorectal cancer. However, several methodological flaws have been identified in PRODIGE 7, specially the HIPEC protocol or the choice of overall survival as the main endpoint, so its results have not been assumed as definitive, emphasizing the need for further research on HIPEC. It seems that the HIPEC protocol with high-dose mytomicin-C (35 mg/m2) is the preferred regime to evaluate in future clinical studies. METHODS: GECOP-MMC is a prospective, open-label, randomized, multicenter phase IV clinical trial that aims to evaluate the effectiveness of HIPEC with high-dose mytomicin-C in preventing the development of peritoneal recurrence in patients with limited peritoneal metastasis from colon cancer (not rectal), after complete surgical cytoreduction. This study will be performed in 31 Spanish HIPEC centres, starting in March 2022. Additional international recruiting centres are under consideration. Two hundred sixteen patients with PCI ≤ 20, in which complete cytoreduction (CCS 0) has been obtained, will be randomized intraoperatively to arm 1 (with HIPEC) or arm 2 (without HIPEC). We will stratified randomization by surgical PCI (1-10; 11-15; 16-20). Patients in both arms will be treated with personalized systemic chemotherapy. Primary endpoint is peritoneal recurrence-free survival at 3 years. An ancillary study will evaluate the correlation between surgical and pathological PCI, comparing their respective prognostic values. DISCUSSION: HIPEC with high-dose mytomicin-C, in patients with limited (PCI ≤ 20) and completely resected (CCS 0) peritoneal metastases, is assumed to reduce the expected risk of peritoneal recurrence from 50 to 30% at 3 years. TRIAL REGISTRATION: EudraCT number: 2019-004679-37; Clinicaltrials.gov: NCT05250648 (registration date 02/22/2022, ).

Tratamiento endoscópico combinado para el cierre de una fístula broncopleural de gran tamaño / Combined Endoscopic Treatment for the Closure of a Large Bronchopleural Fistula

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[Translated article] Combined Endoscopic Treatment for the Closure of a Large Bronchopleural Fistula / Tratamiento endoscópico combinado para el cierre de una fístula broncopleural de gran tamaño

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Risk of Collapse in Water Quality in the Guandu River (Rio de Janeiro, Brazil).

The Guandu River, one of the main rivers in the state of Rio de Janeiro, provides water for more than nine million people in the metropolitan region. However, the Guandu has suffered from massive domestic and industrial pollution for more than two decades, leading to high levels of dissolved total phosphorus, cyanobacteria, and enteric bacteria observed during the summers of 2020 and 2021. The use of Phoslock, a palliative compound, was not effective in mitigating the levels of phosphorus in the Guandu River. Furthermore, potable water driven from the river had levels of 2-MIB/geosmin and a mud smell/taste. With all these problems, several solutions are proposed for improving the Guandu River water quality, including establishment of (i) sewage treatment plants (STPs), (ii) strict water quality monitoring, (iii) environmental recovery (e.g., reforestation), and (iv) permanent protected areas. The objective of this paper is to verify the poor water quality in the Guandu and the ineffectiveness and undesired effects of Phoslock.

Mindfulness-Based Program for Anxiety and Depression Treatment in Healthcare Professionals: A Pilot Randomized Controlled Trial.

In primary health care, the work environment can cause high levels of anxiety and depression, triggering relevant expert and individual change. Mindfulness-Based Stress Reduction (MBSR) programs reduce signs of anxiety and depression. The purpose of this sub-analysis of the total project, was to equate the effectiveness of the standard MBSR curriculum with the abbreviated version in minimizing anxiety and depression. This randomized controlled clinical trial enrolled 112 mentors and resident specialists from Family and Community Medicine and Nurses (FCMN), distributed across six teaching units (TU) of the Spanish National Health System (SNHS). Experimental group participants received a MBRS training (abbreviated/standard). Depression and anxiety levels were measured with the Goldberg Anxiety and Depression Scale (GADS) at three different time periods during the analysis: before (pre-test) and after (post-test) participation, as well as 3 months after the completion of intervention. Taking into account the pre-test scores as the covariate, an adjusted analysis of covariance (ANCOVA) showed significant depletion in anxiety and depression in general (F (2.91) = 4.488; p = 0.014; η2 = 0.090) and depression in particular (F (2, 91) = 6.653; p = 0.002; η2 = 0.128 at the post-test visit, maintaining their effects for 3 months (F (2.79) = 3.031; p = 0.050; η2 = 0.071-F (2.79) = 2.874; p = 0.049; η2 = 0.068, respectively), which is associated with the use of a standard training program. The abbreviated training program did not have a significant effect on the level of anxiety and depression. The standard MBSR training program had a positive effect on anxiety and depression and promotes long-lasting effects in tutors and resident practitioners. New research is needed to demonstrate the effectiveness of abbreviated versions of training programs.

Situación actual, inquietudes y necesidades de los tutores de formación especializada de farmacia hospitalaria / Specialized training in hospital pharmacy: an overview of the concerns, needs and current situation of resident tutors

Objetivo: Conocer las necesidades formativas y de recursos de lostutores de formación especializada de farmacia hospitalaria de España,así como su motivación y satisfacción con la docencia.Método: Se realizó, mediante Google-forms®, una encuesta dirigida atutores de farmacia hospitalaria durante enero-marzo de 2019 con preguntas generales (tutor, hospital, servicio) y específicas (medios disponibles,actividades docentes, satisfacción con la docencia, necesidades formativas). Se realizó un análisis exploratorio univariante para estudiar posiblesfactores relacionados con la satisfacción y la motivación docente.Resultados: Respondieron 83 tutores (tasa de respuesta: 52,8%),de 15/17 comunidades autónomas. El número de residentes/año-tutorresultó 4 (rango intercuartílico = 2-4). El 96,4% realizan entrevistas (trimestrales [65,1%]-ninguna [3,6%]. También se ocupan principalmente dela gestión de rotaciones externas [97,6%], planificación de rotaciones [97,6%] y la evaluación anual [96,4%]). El 17,1% dispone de horas parala docencia insuficientes para el 71,4%. Un 70,7% de los tutores deocho comunidades autónomas con normativa sobre el tiempo de liberación carecen de dicho tiempo. Los tutores se declararon mayoritariamentesatisfechos con la docencia (66,7%) y motivados (63,0%). (AU)

Objective: To provide new insight into the training needs and resourcesrequired by hospital pharmacy resident tutors in Spain, as well as into theirlevel of motivation and satisfaction with their teaching.Method: Google Forms® was used to design a survey addressed to hospital pharmacy resident tutors between January and March 2019. Theysurvey consisted of generic (tutor, hospital, service) and specific questions(available resources, teaching activities, teaching satisfaction, trainingneeds). A univariate exploratory analysis was conducted to study possiblefactors related to teaching satisfaction and motivation.Results: Replies were received from 83 tutors (rate of response:52.8%), from 15/17 Spanish regions. The annual resident/tutor ratio was4 (IQR = 2-4). A total of 96.4% of tutors conducted interviews, of whom65.1% did so quarterly. Other activities included the management of external training rotations (97.6%), planning of rotations (97.6%) and annual appraisals (96.4%). Only 17.1% of respondents were given time off theirregular duties for their tutorship work, with 71.4% stating that the time theywere allowed was insufficient. A total of 70.7% of tutors from eight Spanish regions where the granting of protected time was regulated said werenot given any time off for their teaching endeavors. Most tutors declaredto be satisfied (66.7%) and motivated (63%) with their teaching work. (AU)