Interleukin-21 engineering enhances NK cell activity against glioblastoma via CEBPD.

Glioblastoma (GBM) is an aggressive brain cancer with limited therapeutic options. Natural killer (NK) cells are innate immune cells with strong anti-tumor activity and may offer a promising treatment strategy for GBM. We compared the anti-GBM activity of NK cells engineered to express interleukin (IL)-15 or IL-21. Using multiple in vivo models, IL-21 NK cells were superior to IL-15 NK cells both in terms of safety and long-term anti-tumor activity, with locoregionally administered IL-15 NK cells proving toxic and ineffective at tumor control. IL-21 NK cells displayed a unique chromatin accessibility signature, with CCAAT/enhancer-binding proteins (C/EBP), especially CEBPD, serving as key transcription factors regulating their enhanced function. Deletion of CEBPD resulted in loss of IL-21 NK cell potency while its overexpression increased NK cell long-term cytotoxicity and metabolic fitness. These results suggest that IL-21, through C/EBP transcription factors, drives epigenetic reprogramming of NK cells, enhancing their anti-tumor efficacy against GBM.

CD28 costimulation augments CAR signaling in NK cells via the LCK/CD3Z/ZAP70 signaling axis.

Multiple factors in the design of a chimeric antigen receptor (CAR) influence CAR T-cell activity, with costimulatory signals being a key component. Yet, the impact of costimulatory domains on the downstream signaling and subsequent functionality of CAR-engineered natural killer (NK) cells remains largely unexplored. Here, we evaluated the impact of various costimulatory domains on CAR-NK cell activity, using a CD70-targeting CAR. We found that CD28, a costimulatory molecule not inherently present in mature NK cells, significantly enhanced the antitumor efficacy and long-term cytotoxicity of CAR-NK cells both in vitro and in multiple xenograft models of hematologic and solid tumors. Mechanistically, we showed that CD28 linked to CD3Z creates a platform that recruits critical kinases, such as LCK and ZAP70, initiating a signaling cascade that enhances CAR-NK cell function. Our study provides insights into how CD28 costimulation enhances CAR-NK cell function and supports its incorporation in NK-based CARs for cancer immunotherapy.

Programa de inoculación de estrés para el manejo del malestar emocional asociado a la terapia de células CAR-T: caso clínico / Stress inoculation program for the management of emotional distress associated with CART Cell Therapy: A case study

Objetivo: se presenta un caso clínico de una paciente con linfoma B difuso candidata a recibir tratamiento de células CART, con la que se utiliza un programa de inoculación de estrés debido a las características de la enfermedad y del tratamiento médico, además de la incertidumbre asociada. Metodología: programa de diez sesiones de intervención que se divide en tres fases: conceptualización, que incluye el modelo teórico de estrés y de intolerancia a la incertidumbre; adquisición de estrategias y ensayo que incorpora técnicas de desactivación y cognitivas, planificación de actividades y entrenamiento en habilidades de comunicación; consolidación. Resultados: se evidencia una reducción del malestar emocional, de la sintomatología de ansiedad y bajo estado de ánimo, así como de los niveles de fatiga. Respecto a las estrategias de afrontamiento, tras la intervención psicológica se mantiene el estilo de preocupación ansiosa, aunque se observa un mejor uso de recursos asociados al afrontamiento de espíritu de lucha. Conclusión: la aplicación sistemática de programas para el manejo del estrés puede suponer una estrategia útil y efectiva para la mejora de la salud mental de los pacientes que van a someterse a tratamiento de células CART (AU)

Objective: A case report is presented of a patient with diffuse B lymphoma who is a candidate for CART cell therapy using a stress inoculation program due to the characteristics of the disease and medical treatment and the associated uncertainty. Methodology: psychological program intervention with 10 sessions, divided into three phases: Conceptualization, including the theoretical model of stress and uncertainty intolerance; strategy acquisition and rehearsal, incorporating deactivation and cognitive techniques, activity planning and communication skills training; consolidation. Results: there was a reduction in emotional distress, anxiety symptoms and mood, as well as fatigue levels. In terms of coping strategies, after the psychological intervention, the anxious worrying style is maintained, although a better use of the resources associated with coping with a fighting spirit is observed. Conclusion: Systematic application of stress management programs can be a useful and effective strategy for improving the mental health of patients undergoing CART cell treatment (AU)

La eficacia de la terapia cognitivo-conductual para el duelo prolongado / Efficacy of cognitive-behavioral therapy for prolonged grief

Antecedentes: El Duelo Prolongado (DP) es una forma patológica del duelo dados los síntomas patentes y el tiempo que perduran, generando malestar y limitando la funcionalidad psicosocial. Durante años se ha empleado la Terapia Cognitivo-Conductual (TCC) para el tratamiento del DP, pero se sugiere que la activación conductual no específica es suficiente, se hallan fallos metodológicos en las muestras de TCC, o se cuestiona si es necesaria la exposición. Objetivo: Analizar si la TCC es realmente eficaz para mejorar el DP en adultos. Método: Se realizó una revisión sistemática mediante la búsqueda en las bases de datos Medline, PsycINFO, PubMed, Scopus y Web of Science desde junio de 2022 hasta febrero de 2023, así como mediante una comunicación personal. Se identificaron 9 estudios que cumplían los criterios de inclusión y exclusión establecidos. Resultados: Se comparan las evaluaciones basales, del postratamiento y seguimiento. Todos los estudios reflejan mejorías superiores en la condición de TCC frente a otras modalidades terapéuticas o frente a la propia TCC sin exposición, a excepción de uno que establece igualdad de eficacia con Eye Movement Desensitization and Reprocessing (EMDR). Se analiza el riesgo de sesgo siguiendo los criterios Cochrane, presentando una adecuada calidad metodológica; el nivel de evidencia científica, 1+; y el grado de recomendación, A. Conclusiones: Los resultados respaldan la eficacia de la TCC para el tratamiento del DP en la población adulta, aunque es fundamental realizar nuevos estudios que fortalezcan esta evidencia. Hasta entonces, se recomienda su aplicación a quienes padezcan DP (AU)

Background: Prolonged Grief (PG) is a pathological form of bereavement given the overt symptoms and the period of time they endure, generating distress and limiting psychosocial functioning. For years, Cognitive Behavioral-Therapy (CBT) has been used for the treatment of PG. Nonetheless, it is suggested that non-specific behavioral activation could be sufficient, methodological problems are found in CBT samples, or it is questioned whether the exposure component is necessary or not. Objective: To analyze whether CBT is really effective to improve PG among the adult population. Methods: A systematic review was conducted through Medline, PsycINFO, PubMed, Scopus and Web of Science databases from June 2022 to February 2023, as well as by means of personal communication. 9 studies that met the established inclusion and exclusion criteria were identified. Results: Baseline post-treatment and follow-up assessments are compared. All studies reflect superior improvements in the CBT condition compared to other therapeutic modalities or compared to CBT without exposure, excluding one study that establishes equal efficacy with Eye Movement Desensitization and Reprocessing (EMDR). The risk of bias was analyzed according to Cochrane criteria, presenting an adequate methodological quality; the level of scientific evidence, 1+; and the grade of recommendation, A. Conclusions: The results support the efficacy of CBT for the treatment of PG in the adult population. Nevertheless, it is essential to conduct new studies that strengthen this evidence. Until then, it is recommended its application among those suffering from PG (AU)

Fisioterapia respiratoria en pacientes adultos post-COVID-19: revisión sistemática de la literatura / Respiratory physiotherapy in post-acute COVID-19 adult patients: Systematic review of literature

Introducción: los pacientes con SARS-CoV-2 presentan signos y síntomas que involucran principalmente el sistema respiratorio. Las secuelas son consecuencia de un deterioro de la calidad de vida, neumonía, fatiga, disnea y dolor articular. Objetivo: tener el sustento científico que permita evidenciar la importancia de la fisioterapia respiratoria y sus efectos sobre los pacientes adultos post-COVID-19 de fase aguda. Material y métodos: se hizo una revisión sistemática de la literatura en cuatro bases de datos (Scopus, Web of Science, PubMed y ScienceDirect). La búsqueda fue realizada en febrero de 2021 con un total de 1229 estudios. Finalmente, se incluyeron cinco estudios que cumplieron con los criterios de elegibilidad: dos ensayos clínicos, dos reportes de caso y un estudio transversal. La calidad metodológica de las publicaciones fue evaluada. Resultados: el entrenamiento de la musculatura respiratoria, las respiraciones dirigidas y el fortalecimiento general dan datos significativos en la mejora de la funcionalidad. La evidencia demuestra que hay efectos positivos de la fisioterapia respiratoria en pacientes adultos post-COVID-19, pues aumenta la resistencia al ejercicio, disminuye la fatiga, se reduce la disnea, mejora la funcionalidad y la calidad de vida. Conclusiones: es necesario que se desarrollen más ensayos clínicos aleatorizados y estudios de grupos de menor rango de edad y con enfoques individualizados.

Background: Patients with SARS-CoV-2 present signs and symptoms that primarily involve the respiratory system. The sequelae result in impaired quality of life, pneumonia, dyspnea, fatigue, and joint pain.

Argumentos para reconocer a los deportistas como trabajadores públicos civiles: más allá de la carrera dual / Arguments for recognizing athletes as civil public workers: beyond dual career / Argumentos para reconhecer atletas como trabalhadores públicos civis: Além da dupla carreira

RESUMEN El deporte es una actividad que se práctica de forma recreativa o profesional. Quienes lo hacen profesionalmente en ocasiones reciben aportes económicos y logran estudiar una carrera profesional, lo que se conoce como carrera dual. No obstante, hay quienes presentan esta actividad como su trabajo. El objetivo general del estudio fue analizar los argumentos de los deportistas chilenos para referirse a la práctica deportiva como una actividad laboral; el objetivo específico fue reflexionar críticamente sobre el desarrollo de la carrera dual en Chile. Para comprender estos argumentos, se realizó un estudio cualitativo por medio de entrevistas activas semiestructuradas a deportistas de alto rendimiento (DAR) y recreativos, olímpicos y paralímpicos. Los resultados muestran que los atletas demandan reconocimiento como trabajadores públicos por medio de tres argumentos: económico, subordinación y dependencia e identidad. Las conclusiones y discusiones sugieren debatir el reconocimiento de ellos y ellas como trabajadores públicos.

ABSTRACT Sport is an activity practiced recreationally or professionally. Those who do it professionally occasions receive financial contributions and manage to study a professional career, which is known as a dual career. However, there are those who present this activity as their work. The objective of the study was to analyze the arguments of Chilean athletes to refer to sports as a work activity. The specific objective was to critically reflect on the development of the dual career in Chile To understand these arguments, a qualitative study was conducted through semi-structured active interviews with high performance athletes and recreational, Olympic and Paralympic athletes. The results show that athletes demand recognition as public workers through three arguments: economic, subordination and dependency, and identity. The conclusions and discussions suggest to debate their recognition as public workers.

RESUMO O esporte é uma atividade praticada recreativa ou profissionalmente. Quem pratica profissionalmente às vezes recebe contribuições financeiras e consegue estudar uma carreira profissional, conhecida como carreira dupla. No entanto, há quem apresente essa atividade como trabalho. O objetivo do estudo foi analisar os argumentos de atletas chilenos para se referir ao esporte como atividade de trabalho. O objetivo específico foi refletir criticamente sobre o desenvolvimento da carreira dupla no Chile Para entender esses argumentos, foi realizado um estudo qualitativo, por meio de entrevistas ativas semiestruturadas com atletas de alto desempenho (DAR) e atletas recreativos, olímpicos e paralímpicos. Os resultados mostram que os atletas exigem reconhecimento como funcionários públicos por meio de três argumentos: econômico, subordinação e dependência e identidade. As conclusões e discussões sugerem debater seu reconhecimento como funcionários públicos.

Argumentos para reconocer a los deportistas como trabajadores públicos civiles: más allá de la carrera dual / Arguments for recognizing athletes as civil public workers: beyond dual career / Argumentos para reconhecer atletas como trabalhadores públicos civis: Além da dupla carreira

RESUMEN El deporte es una actividad que se práctica de forma recreativa o profesional. Quienes lo hacen profesionalmente en ocasiones reciben aportes económicos y logran estudiar una carrera profesional, lo que se conoce como carrera dual. No obstante, hay quienes presentan esta actividad como su trabajo. El objetivo general del estudio fue analizar los argumentos de los deportistas chilenos para referirse a la práctica deportiva como una actividad laboral; el objetivo específico fue reflexionar críticamente sobre el desarrollo de la carrera dual en Chile. Para comprender estos argumentos, se realizó un estudio cualitativo por medio de entrevistas activas semiestructuradas a deportistas de alto rendimiento (DAR) y recreativos, olímpicos y paralímpicos. Los resultados muestran que los atletas demandan reconocimiento como trabajadores públicos por medio de tres argumentos: económico, subordinación y dependencia e identidad. Las conclusiones y discusiones sugieren debatir el reconocimiento de ellos y ellas como trabajadores públicos.

ABSTRACT Sport is an activity practiced recreationally or professionally. Those who do it professionally occasions receive financial contributions and manage to study a professional career, which is known as a dual career. However, there are those who present this activity as their work. The objective of the study was to analyze the arguments of Chilean athletes to refer to sports as a work activity. The specific objective was to critically reflect on the development of the dual career in Chile To understand these arguments, a qualitative study was conducted through semi-structured active interviews with high performance athletes and recreational, Olympic and Paralympic athletes. The results show that athletes demand recognition as public workers through three arguments: economic, subordination and dependency, and identity. The conclusions and discussions suggest to debate their recognition as public workers.

RESUMO O esporte é uma atividade praticada recreativa ou profissionalmente. Quem pratica profissionalmente às vezes recebe contribuições financeiras e consegue estudar uma carreira profissional, conhecida como carreira dupla. No entanto, há quem apresente essa atividade como trabalho. O objetivo do estudo foi analisar os argumentos de atletas chilenos para se referir ao esporte como atividade de trabalho. O objetivo específico foi refletir criticamente sobre o desenvolvimento da carreira dupla no Chile Para entender esses argumentos, foi realizado um estudo qualitativo, por meio de entrevistas ativas semiestruturadas com atletas de alto desempenho (DAR) e atletas recreativos, olímpicos e paralímpicos. Os resultados mostram que os atletas exigem reconhecimento como funcionários públicos por meio de três argumentos: econômico, subordinação e dependência e identidade. As conclusões e discussões sugerem debater seu reconhecimento como funcionários públicos.

Prevalencia de consumo y exposición de tabaco en trabajadores del área de la salud / Prevalence of tobacco consumption and exposure in health care area workers

INTRODUCCIÓN: El conocimiento del consumo de tabaco en un entorno laboral de salud es fundamental para poder desarrollar medidas de gestión sobre las poblaciones vulnerables. OBJETIVO: Conocer la prevalencia de consumo de tabaco y la exposición al humo de tabaco en el ambiente laboral de la Obra Social de Empleados Públicos de Mendoza, Argentina (OSEP). MATERIALES Y MÉTODOS: Estudio transversal, descriptivo, observacional, realizado en OSEP, entre octubre del 2016 y marzo del 2017. Encuesta anónima y voluntaria; formato adaptado de la Encuesta Mundial de Tabaquismo. Análisis estadístico mediante el programa MedCalc, tablas de contingencia y χ2 (p < 0,05). RESULTADOS: Población: 1.603. Edad promedio: 42 años.63,8% mujeres. El 61,3% eran profesionales de la salud y el 22,7% personal administrativo. El 85,2% tenía nivel educativo terciario/universitario. La prevalencia de fumadores actuales fue del 22,02%, en hombres del 26,7% y mujeres del 19,5%. El 35,5% del personal administrativo era fumador actual en comparación con el 16,6% de los profesionales de la salud (p < 0,0001). El 39% de las personas con nivel educativo primario/secundario fumaban actualmente en comparación con el 18,5% de los que tenía nivel terciario/universitario (p < 0,0001). La exposición al humo de tabaco dentro del entorno laboral fue del 34,5%. CONCLUSIONES: La prevalencia global de consumo de tabaco fue del 22,02%, y la exposición al humo de tabaco fue del 34,5%. La población con mayor prevalencia de consumo de tabaco resultó ser el personal administrativo y la de menor nivel educativo

INTRODUCTION: Knowledge regarding tobacco consumption in a health work environment is essential in order to be able to develop management measures in vulnerable populations. PURPUSE: To know the prevalence of tobacco consumption and exposure to tobacco smoke in the Obra Social de Empleados Públicos de Mendoza, Argentina (OSEP) work environment. MATERIALS AND METHODS: Cross-sectional, descriptive, observational study carried out in OSEP, between October 2016 and March 2017. Anonymous and voluntary survey; format adapted from the Global Tobacco Survey. Statistical analysis using MedCalc program, contingency tables and χ2 (p < 0,05). RESULTS: Population: 1,603. Average age: 42, 63.8% women.61.3% were health professionals and 22.7% were administrative personnel.85.2% had university-level education. The prevalence of current smokers was 22.02%; in men, 26.7% and women, 19.5%.35.5% of administrative staff were current smokers compared to 16.6% of health professionals (p < 0.0001).39% of people with primary/secondary education were currently smoking compared to 18.5% of those with a university level. The exposure to tobacco smoke in the workplace was 34.5%. CONCLUSIONS: The overall prevalence of tobacco use was 22,02%, and exposure to tobacco smoke was 34,5%. The population with the highest prevalence of tobacco use proved to be the administrative staff and the lowest educational level

Bloques gemelos en el tratamiento del síndrome de clase II división 1 con trastornos temporomandibulares / Twin blocks in the treatment of class II division 1 syndrome with temporomandibular disorders

Introducción: Diversos estudios evidencian que las desarmonías del esqueleto provocan disfunciones temporomandibulares, pues la oclusión dentaria condiciona la posición de los cóndilos en la cavidad glenoidea. Los requisitos del tratamiento ortodóncico incluyen lograr una oclusión estable y equilibrada, una estética facial óptima y el funcionamiento saludable de la articulación temporomandibular. Objetivo: Describir los resultados obtenidos con los bloques gemelos en pacientes con síndrome de clase II, división 1, con trastornos temporomandibulares. Métodos: Se realizó un estudio descriptivo en los pacientes que ingresaron a la consulta de ortodoncia del policlínico "Juan Manuel Páez Inshausty", con edades entre 11 y 14 años, con síndrome de clase ΙΙ, división 1 y trastornos temporomandibulares, en el período comprendido entre febrero 2017 y enero 2018. Se describen 8 pacientes, con el análisis del índice de Helkimo al inicio y a los seis meses de instalados los bloques gemelos básicos. Resultados: Predominaron los pacientes leves con un 62,5 por ciento y el 87,5 por ciento presentó alteración en el funcionamiento de la articulación temporomandibular. A los 6 meses de tratamiento, se encontró que 7 estaban asintomáticos y solo un paciente persistía con alteraciones de la función de la articulación temporomandibular. Conclusiones: La mayoría de los pacientes pasaron a estar asintomáticos a los seis meses del tratamiento con los bloques gemelos(AU)

Introduction: Several studies show that disharmonies of the skeleton cause temporomandibular dysfunctions, since the dental occlusion determines the position of the condyles in the glenoid cavity. The requirements of orthodontic treatment includes achieving stable and balanced occlusion, optimal facial aesthetics and healthy functioning of the temporomandibular joint. Objective: To describe the results obtained with the twin blocks in patients with class II syndrome, division 1, with temporomandibular disorders. Methods: A descriptive study was carried out in the patients who entered the orthodontic clinic of the "Juan Manuel Páez Inshausty" polyclinic, aged between 11 and 14 year old, with class II syndrome, division 1 and temporomandibular disorders, in the period included between February 2017 and January 2018. 8 patients are described, with the analysis of the Helkimo index at the beginning and six months after the basic twin blocks were installed. Results: Mild patients predominated with 62.5 percent and 87.5 percent presented alteration in the temporomandibular joint function. After 6 months of treatment, 7 were found to be asymptomatic and only one patient persisted with alterations in temporomandibular joint function. Conclusions: Most patients became asymptomatic six months after treatment with the twin blocks

Diagnóstico terapéutico para la atención de pacientes con caries dental / Therapeutic diagnosis for the care of patients with dental caries

La caries dental es tan antigua como la humanidad misma, es considerada por la Organización Mundial de la Salud como el primer problema de salud bucal, su incremento se ha asociado al desarrollo social y a las variaciones en los hábitos dietéticos de las poblaciones. En estudios realizados en los últimos años, se ha determinado una tendencia a la disminución de esta enfermedad. El problema fundamental en el diagnóstico y tratamiento de la caries dental es la decisión de cuándo y cómo obturar un diente afectado por caries. El objetivo primario es ampliar la visión sobre las posibilidades terapéuticas y profundizar en los conocimientos teóricos y prácticos sobre los tratamientos preventivos, curativos no invasivos e invasivos utilizados contra la caries dental. Se realizó una revisión bibliográfica de textos impresos y búsqueda en internet sobre caries dental, frecuencia y conducta adecuada por parte los estomatólogos generales. Se concluye que todo estomatólogo general, debe conocer la importancia de la promoción y la prevención permanente en los pacientes para evitar las caries dentales, así como las indicaciones, técnica de empleo y los requisitos para aplicar en la práctica diaria, los materiales restaurativos(AU)

Dental caries is as old as human race, it is considered by the World Health Organization as the first oral health problem, its increase has been associated with social development and variations in dietary habits of populations. In studies carried out in recent years, a tendency to decrease this disease has been determined. The fundamental problem in the diagnosis and treatment of dental caries is the decision of when and how to seal a tooth affected by caries. The primary objective is to broaden the vision of the therapeutic possibilities and to deepen the theoretical and practical knowledge about preventive, non-invasive and invasive curative treatments used against dental caries. A literature review of printed texts and internet search on dental caries, frequency and appropriate behavior of general stomatologists was carried out. It is concluded that every general stomatologist should know the importance of the promotion and permanent prevention in patients to avoid tooth decay, as well as the indications, technique of use and requirements to apply restorative materials in daily practice.

Prevalência de interações medicamentosas envolvendo medicamentos de alta vigilância: estudo transversal / Drug interactions prevalence involving high-surveillance drugs: a cross-sectional study / Prevalencia de la interacción de drogas que incluyen medicamentos controlados: estudio transversal

OBJETIVO: estimar a prevalência de interações medicamentosas potenciais (IMP) relacionadas aos medicamentos de alta vigilância (MAV) usados por uma amostra de pacientes internados em um centro de terapia intensiva (CTI). MÉTODOS: estudo transversal, retrospectivo de abordagem quantitativa. A pesquisa apoiou-se na análise das prescrições dos pacientes internados no CTI no período de um ano (2014-2015) a fim de identificar as interações medicamentosas potenciais relacionadas aos MAVs nelas recorrentes. Para cada prontuário, foram analisadas das três às cinco primeiras prescrições, dependendo da disponibilidade destas e do período de internação do indivíduo. A identificação das IMPs foi feita a partir de consulta ao dispositivo Trissels da base de dados Micromedex 2.0. RESULTADOS: nas 244 prescrições medicamentosas foram identificadas 846 IMPs relacionadas aos MAVs e 112 pares diferentes de IMP envolvendo os MAVs. Os principais MAVs nas IMP foram: insulina regular, midazolam, fentanil e tramadol. Dos 112 tipos de IMP identificados, algumas foram recorrentes; a saber: tramadol e ondansetrona, fentanil e midazolam, midazolam e omeprazol, insulina regular e hidrocortisona, bem como insulina regular e noradrenalina. A prevalência das IMPs com MAV nessa amostra foi de 0,96 (96%). CONCLUSÃO: grande parte dos pacientes foi exposta à IMP envolvendo midazolam, fentanil ou insulina regular. Há de se estabelecer certa vigilância no sentido de se evitar interações desnecessárias ou quando a administração conjunta de determinados interagentes for indispensável, Deve-se possuir competências para manejar essa administração de forma mais adequada e com o menor risco possível para o paciente.(AU)

Objective: to estimate the prevalence of potential drug interactions (PDIs) related to the high-surveillance drugs (HSD) used by a sample of patients admitted to an intensive care unit (ICU). Methods: a cross-sectional, retrospective study with a quantitative approach. Research was based on the analysis of patients prescriptions admitted to the ICU over a one-year period (2014-2015) to identify potential drug interactions related to recurrent HSDs. For each medical record, they were analyzed from the first three to five prescriptions, depending on their availability and the period of individual hospitalization. PDIs identification was made by consulting the Trissels device from the Micromedex 2.0 database. Results: in the 244 drug prescriptions, 846 HSD-related PDIs and 112 different pairs of PDI involving the HSDs were identified. The main HSDs in PDI were: regular insulin, midazolam, fentanyl and tramadol. Of the 112 types of identified PDI, some were recurrent; namely: tramadol and ondansetron, fentanyl and midazolam, midazolam and omeprazole, regular insulin and hydrocortisone, as well as regular insulin and norepinephrine. HSD with PDIs prevalence in this sample was 0.96 (96%). Conclusion: most patients were exposed to PDI involving midazolam, fentanyl or regular insulin. Some vigilance should be...(AU)

Objetivo: estimar la prevalencia de posibles interacciones farmacológicas (IMP) relacionadas con los medicamentos controlados (MAV) utilizados por una muestra de pacientes ingresados en una unidad de cuidados intensivos (UCI). Métodos: estudio retrospectivo transversal de enfoque cuantitativo. La investigación se basó en el análisis de las prescripciones de los pacientes ingresados en la UCI por un período de un año (2014-2015) para identificar posibles interacciones farmacológicas relacionadas con los MAV recurrentes. Para cada registro médico, se analizaron las primeras tres a cinco recetas, según su disponibilidad y el período de hospitalización del individuo. La identificación de las IMP se realizó consultando el dispositivo Trissels de la base de datos Micromedex 2.0. Resultados: en las 244 recetas de medicamentos, se identificaron 846 IMP relacionadas con MAV y 112 pares diferentes de IMP que involucran MAV. Los principales MAV en las IMP fueron: insulina regular, midazolam, fentanilo y tramadol. De los 112 pares de IMP identificadas, algunas fueron recurrentes; a saber: tramadol y ondansetrón, fentanilo y midazolam, midazolam y omeprazol, insulina regular e hidrocortisona, así como insulina regular y noradrenalina. La prevalencia de las IMP con MAV en esta muestra fue de 0,96 (96%). Conclusión: la mayoría de los pacientes estuvo expuesta a IMP que involucran midazolam, fentanilo o insulina regular. Se debe establecer cierta vigilancia para evitar interacciones innecesarias o cuando la administración conjunta de ciertos interagentes sea indispensable. Debe haber competencia suficiente para manejar la administración de drogas de manera más apropiada, con el menor riesgo posible para el paciente.(AU)

Most frequent errors in inhalation technique of patients with asthma treated at a tertiary care hospital / Erros mais frequentes na técnica inalatória de pacientes com asma brônquica em tratamento em hospital terciário

ABSTRACT Objective: To demonstrate the most frequent errors in inhalation technique in patients with asthma undergoing treatment at a tertiary care hospital. Methods: A cross-sectional study with a convenience sample of asthma patients aged 18 years or over, treated at a pulmonology outpatient clinic of a tertiary care hospital. The assessment of inhalation technique of users of the dry powder inhalers Aerolizer®, Aerocaps and Diskus®, or metered-dose inhalers was based on the manufacturer's instructions for use of each inhaler device. Patients demonstrated the inhalation technique with empty inhaler devices, and it was considered correct when all stages were performed properly, or when errors probably did not interfere with the treatment outcome. Results: Among 71 participants, 43 (60.5%) performed inhalation technique incorrectly. Among metered-dose inhalers and dry powder inhalers users, inhalation technique errors were found in 84.2% and 51.9%, respectively (p=0.013). Errors were more frequent at the exhalation stage (67.4%), followed by breathing in (58.1%) and apnea (51.2%). In the group using dry powder inhalers, the most common errors occurred during exhalation and, for those using metered-dose inhalers, the most compromised stage was aspiration. Conclusion: Errors were more frequent among those using metered-dose inhalers compared with dry powder inhalers. Misconceptions are more common at the expiration stage among users of dry powder inhalers and in aspiration among those on metered-dose inhalers.

RESUMO Objetivo: Demonstrar os erros mais frequentes na técnica inalatória de pacientes com asma brônquica em tratamento em hospital terciário. Métodos: Estudo transversal, com amostra de conveniência de pacientes com asma, com 18 anos ou mais, em tratamento em ambulatório de pneumologia de um hospital terciário. A avaliação da técnica inalatória dos usuários dos dispositivos de pó seco Aerolizer ®, Aerocaps® ou Diskus®, ou de aerossóis dosimetrados teve como base as orientações da bula do fabricante de cada dispositivo inalatório. Os pacientes demonstraram a técnica inalatória com dispositivos inalatórios vazios, e ela foi considerada correta quando todas as etapas foram realizadas de forma apropriada, ou quando os equívocos provavelmente não interferiam no resultado do tratamento. Resultados: Entre os 71 participantes, 43 (60,5%) realizaram a técnica inalatória de forma incorreta. Dentre os usuários de aerossóis dosimetrados e dispositivos de pó seco, ocorreram erros de técnica inalatória em 84,2% e 51,9%, respectivamente (p=0,013). Os erros foram mais frequentes na etapa da expiração (67,4%), seguidos da aspiração (58,1%) e da apneia (51,2%). No grupo que usava dispositivos de pó seco, os erros mais comuns aconteceram na expiração e, nos que utilizavam aerossóis dosimetrados, a etapa mais comprometida foi a aspiração. Conclusão: Os erros foram mais frequentes entre os que usavam aerossóis dosimetrados em comparação com dispositivos de pó seco. Os equívocos foram mais comuns na etapa da expiração entre os usuários de dispositivos de pó seco e na aspiração entre os que usavam aerossóis dosimetrados.

Factors associated to potential drug interactions in one Intensive Care Unit: a cross-sectional study / Factores asociados a interacciones medicamentosas potenciales en un Centro de Terapia Intensiva: estudio transversal / Fatores associados a interações medicamentosas potenciais em um Centro de Terapia Intensiva: estudo transversal

ABSTRACT Objective: to identify the factors associated to Potential Drug Interactions with High Alert Medications in the Intensive Care Unit of a Sentinel Hospital. Methods: a cross-sectional, retrospective study using a quantitative approach carried out at a Sentinel Hospital in Rio de Janeiro. The research was based on the analysis of the prescriptions of patients hospitalized in the Intensive Care Unit of the Hospital, in a period of one year, in order to identify the drug interactions related to high alert medications in these prescriptions. Results: Of the 60 prescriptions analyzed, 244 were selected. In these prescriptions, 846 potential drug interactions related to high alert medications and 33 high alert medications were identified. Of the 112 types of potential drug interactions identified, some were more recurrent: tramadol e ondansetron, midazolam and omeprazole, regular insulin and hydrocortisone, fentanyl and midazolam, and regular insulin and noradrenaline. The variables polypharmacy, length of hospital stay, and some specific medications were associated with drug interactions with high alert medications. Conclusion and Implications for practice: It is important to strengthen strategies to reduce adverse drug events. Therefore, the relevance of studies that investigate the origin of these events is highlighted. Drug interactions can represent medication errors. It's indispensable to work with strategies to better manage the medication system.

RESUMEN Objetivo: identificar los puntos asociados a las Interacciones Medicamentos Potenciales con Medicamentos de alta vigilancia en un Centro de Cuidados Intensivos de un Hospital de Guardia. Métodos: estudio transversal, retrospectivo, de abordaje cuantitativo, realizado en un hospital de guardia en Rio de Janeiro. Esta investigación se basó en el análisis de las prescripciones medicamentosas de pacientes internados en un Centro de Cuidados Intensivos de un hospital, en un período de 1 año, con el objetivo de identificar las interacciones medicamentosas relacionadas con Medicamentos de alta Vigilancia recurrentes en las mismas. Resultados: de los informes analizados, se seleccionaron 244 prescripciones medicamentosas. En las 244 prescripciones de medicamentos, se pudieron identificar 846 Interacciones de Medicamentos Potenciales (IMP) relacionados a Medicamentos de Alta Vigilancia y 33 Medicamentos de Alta Vigilancia. De los 112 tipos de interacciones de medicamentos potenciales identificados, algunos han sido más recurrentes; a saber: tramadol y ondansetrón, midazolam y omeprazol, insulina regular e hidrocortisona, fentanilo y midazolam, insulina regular y noradrenalina. Las variables polifarmacia, tiempo de internación y algunos medicamentos específicos se asociaron a las interacciones medicamentosas potenciales con Medicamentos de Alta Vigilancia. Conclusión e Implicaciones para la práctica: es importante fortalecer las estrategias para reducir los eventos adversos relacionados con medicamentos. Por lo tanto, se destaca la relevancia de los estudios que plantean la naturaleza de estos eventos. Las interacciones medicamentosas pueden provocar errores de medicación. Es imprescindible trabajar con estrategias para administrar mejor el sistema de medicación.

RESUMO Objetivo: Identificar os fatores associados às Interações Medicamentosas Potenciais com Medicamentos de alta vigilância em Centro de Terapia Intensiva de um Hospital Sentinela. Métodos: Estudo transversal, retrospectivo, de abordagem quantitativa, realizado em um hospital sentinela no Rio de Janeiro. A pesquisa apoiou-se na análise das prescrições de pacientes internados no setor, com recorte temporal de 1 ano, a fim de identificar as interações medicamentosas relacionadas a medicamentos de alta vigilância recorrentes nas mesmas. Resultados: Dos 60 prontuários analisados, selecionaram-se 244 prescrições. Nelas identificaram-se 846 interações medicamentosas potenciais, relacionadas aos medicamentos de alta vigilância e 33 medicamentos de alta vigilância. Dos 112 pares de interações identificadas, foram mais recorrentes: tramadol e ondansetrona, midazolam e omeprazol, insulina regular e hidrocortisona, fentanil e midazolam, e insulina regular e noradrenalina. As variáveis polifarmácia, tempo de internação e alguns medicamentos específicos foram associadas às interações com medicamentos de alta vigilância. Conclusão e Implicações para a prática: É importante fortalecer as estratégias para reduzir os eventos adversos relacionados a medicamentos. Portanto, destaca-se a relevância de estudos que levantem a natureza desses eventos. As interações medicamentosas podem configurar erros de medicação. Portanto, é indispensável que se trabalhe com estratégias para melhor manejar o sistema de medicação.

Incorrect use of inhalation devices among patients with bronchial asthma. A hospital-based cross-sectional study in Rio de Janeiro, Brazil

ABSTRACT CONTEXT AND OBJECTIVE: Treatment of asthma implies inhalation of specific drugs to reach high concentrations in the respiratory tree and ensure low drug bioavailability and few adverse effects. This study aimed to evaluate the effectiveness of the inhalation technique among outpatients with asthma. DESIGN AND SETTING: Tertiary-care hospital-based cross-sectional study in Rio de Janeiro. METHODS: We evaluated inhalation practices in a convenience sample. A questionnaire was used to investigate sociodemographic data and assess disease control level, duration of use of the inhalation device, length of treatment and previous instructions provided by the prescribing physician. Patients demonstrated their inhalation technique using empty devices, and their technique was considered correct when all steps were appropriately performed or when errors did not interfere with the treatment outcome. RESULTS: Among the 71 participants, 53 (74.7%) had been using the same inhaler device for at least two years and 41 (57.8%) had been under treatment for two years or more. Twelve (17.1%) said that they had been taught once and 57 (81.4%) at least twice, while one (1.4%) reported not having received any guidance regarding use of inhaler devices. Eighteen patients (25.3%) presented controlled asthma and 28 (39.5%) performed the inhalation technique correctly. Incorrect technique was associated with fewer evaluations of the inhalation technique (P =0.04) and uncontrolled asthma (P = 0.01). CONCLUSIONS: Less than half of the sample performed the inhalation technique correctly. Incorrect inhalation technique was related to lower number of evaluations of the use of the inhalation device and uncontrolled asthma.

Teaching children to create metaphorical expressions

Metaphorical language is a type of non-literal language with multiple uses in communication. Despite its relevance, most studies about this topic have focused on measuring the performance of a variety of populations on this skill and relating it to biological substrates or other cognitive abilities and there are little or no published studies on procedures for training the creation of metaphorical expressions. The current study evaluated a multiple exemplar training procedure for training simple metaphorical expressions in 4 six-year-old participants. Results demonstrated that all participants acquired the skill and demonstrated generalization, suggesting that multiple exemplar training may be effective for teaching children to create simple metaphorical expressions (AU)

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Conhecimento de Profissionais de Enfermagem Acerca da Administração de Diazepam Intravenoso: estudo transversal / Knowledge of Nursing Professionals About Intravenous Diazepam Administration: A Cross Sectional Study

O objetivo é determinar o nível de conhecimento da equipe de enfermagem no preparo e administração do diazepam por via intravenosa. Estudo transversal em um Hospital Universitário, onde o preparo e administração do diazepam intravenoso é realizado no posto de enfermagem pela equipe de enfermagem. Foram entrevistados 60 profissionais de enfermagem no período de 30 dias. Observou-se baixo nível de resposta correta, onde 74,5% dos participantes afirmaram diluir o medicamento antes de administrá-lo e 40% preparam o diazepam de maneiras diferentes das recomendadas na bula do produto. No Centro de Terapia Intensiva todos os profissionais desconhecem o manejo correto do diazepam intravenoso.O conhecimento da equipe de enfermagem sobre o preparo e administração de diazepam por via intravenosa é insuficiente para garantir um cuidado de qualidade e livre de danos

Modelo Predictivo para el Consumo de Alcohol y Tabaco en Adolescentes de Campeche / Predictive Model for Alcohol and Teenage Snuff of Campeche

RESUMEN Introducción: en México se han propuesto pocos modelos explicativos sobre el consumo de tabaco y alcohol en adolescentes, por tal razón es de gran importancia para el personal de enfermería y de la salud tener información sobre modelos predictivos en población juvenil, con la posibilidad de desarrollar modelos explicativos. Objetivo: desarrollar un modelo predictivo de pros, contras, resiliencia y motivaciones para el consumo de alcohol y tabaco en adolescentes. Métodos: estudio descriptivo correlacional, muestreo aleatorio estratificado, la muestra se integró con 519 alumnos de preparatorias de la Universidad Autónoma de Campeche en 2012. Se aplicaron 7 instrumentos con una confiabilidad aceptable, el procesamiento de datos fue a través del programa estadístico Statical Package for the Social Sciences (SPSS) versión 18. Resultados: los beneficios percibidos para el consumo de alcohol fue sentirse más cómodo (32,4 por ciento) y para tabaco, el 29,3 por ciento se sienten más tranquilos al fumar. Entre las barreras percibidas para el consumo de alcohol al 94 por ciento le provoca desilusión, con respecto al tabaco, el 94,4 por ciento menciona que causa enfermedades pulmonares y el 94,1 por ciento, cáncer. La resiliencia de los adolescentes ante el consumo de sustancias, el 82 por ciento dijo sentirse orgulloso por lo que han logrado y el 81,9 por ciento su vida tiene sentido. Los motivos que inducen al consumo de alcohol son que disfrutan más las fiestas (17,3 por ciento) y para celebrar ocasiones especiales (14,7 por ciento). Entre los motivos para consumir tabaco destacan relajarse cuando están tensos 13, 5 por ciento y enojados 11,6 por ciento. El modelo utilizado para este estudio fue significativo p<0, 001. Conclusiones: el modelo que se observó en los adolescentes en cuanto a los beneficios y barreras percibidas en relación con las resiliencias y motivaciones para el consumo de alcohol y tabaco, fue que a mayor consumo y beneficio percibido de alcohol y tabaco la resiliencia es menor, mientras que a mayores barreras la resiliencia aumenta y el consumo disminuye.

ABSTRACT Introduction: In Mexico recently been proposed explanatory models on the consumption of snuff and alcohol use in adolescents, for this reason it is of great importance for nurses and health have information on predictive models on young people, with the possibility of developing explanatory models. Objective: To develop a predictive model for pros, cons, resilience and motivation for consumption of alcohol and snuff among adolescents. Methods: descriptive correlational study, stratified random sampling, the sample was composed of 519 students of high schools of the Autonomous University of Campeche in 2012. 7 instruments with acceptable reliability were applied, data processing was through the statistical program Statical Package for the Social Sciences (SPSS) version 18. Results: Perceived benefits for alcohol was feeling more comfortable 32,4 percent and 29,3 percent for snuff feel reassured by smoking. Among the perceived barriers to alcohol consumption 94 percent will cause disappointment, compared to 94,4 percent snuff mentions that cause lung disease and cancer 94,1 percent. The resilience of adolescents to substance use, 82 percent said they felt proud of what they have achieved 81,9 percent and their life has meaning. The reasons that lead to alcohol consumption are enjoyed by 17,3 percent over the holidays and for special occasions 14,7 percent. Among the reasons for taking snuff highlight relax when they are tense and angry 13,5 percent 11,6 percent. The model used for this study was significant p<0, 001. Conclusions: The model observed in adolescents as to the benefits and perceived barriers regarding the impact strengths and motivations for alcohol and snuff, was that higher consumption and perceived benefits of alcohol and snuff resilience is lower, while at higher barriers resilience increases and consumption decreases(AU)

Expressão de citocinas relacionadas à resposta th17 nos tecidos gengival e intestinal de pacientes com periodontite e doença inflamatória intestinal / Expression of Th17 related cytokines response in the gingival and intestinal tissue from patients with periodontitis and inflammatory bowel disease

Aim: The aim of this study was to analyze the levels of IL1-ß, IL-4, IL-6, IL10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, IFN-γ, TNF-α and sCD40L in the gingival tissue (G), and compare to the levels of the paired intestinal mucosa (MI)in patients having both chronic periodontitis and InflmmatoryBowel Disease (IBD). Material and methods: Twenty-two IBD patients with chronic periodontitis and IBD, mean age40.0 (±14.5),were enrolled in the study. Patients were assessed using anamnesis and periodontal examination. Gingival and intestinal biopsies were collected and homogenized using a cell disruptor. Cytokine's expression was evaluated through multiplex technology and then compensated by weight. Results: After statistical analysis, significant higher levels of gingival IL-23 (p=0.02) and IFN-γ (p=0.01), and significant lower levels of IL-31(p=0.02) and TNF-α (p=0.01) were found when compared to intestinal mucosa. Significant positive correlation between gingival and intestinal tissue were observedbetweenIL-6 (G) andIL-23 (MIand significant negative correlation between IL-23 (G) and IL-1ß (MI), IL-10 (MI), IL-17A (MI) and IFN-γ (MI). Conclusion: We conclude that IL-23 and IFN-γ are significantly increased in the gingival tissue, when compared to the intestinal tissue, suggesting an important role of these cytokines in the manifestation of periodontitis in patients with IBD.(AU)

Objetivo: O objetivo do estudo foi avaliar a expressão das citocinas: IL1-ß, IL-4, IL-6, IL10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, IFN-γ, TNF-α e do ligante solúvel do CD40 (sCD40L) no tecido gengival (G) e compará- la com a expressão na mucosa intestinal (MI) de forma pareada em pacientes com periodontite crônica e Doença Inflamatória Intestinal (DII). Material e métodos: Participaram do estudo 22 pacientes com DII, média de idade de 40 anos (DP ±14,5 anos). Foram registrados os parâmetros clínicos e periodontais, e foram coletadas biópsias gengivais e intestinais pareadas. As mesmas foram homogeneizadas usando um disruptor celular. Os níveis das citocinas foram analisados pelo método multiensaio multiplex e posteriormente compensados pelo peso das amostras. Resultados: Após análise estatística, observamos níveis significativamente maiores de IL-23 (p=0,02) e IFN-γ (p=0,01) e significantemente menores de IL-31 (p=0,02) e TNF-α (p=0,01) no tecido gengival quando comparamos com o intestinal. Correlações significantes ocorreram entre o tecido gengival e o intestinal de forma positiva para a IL-6 (G) com a IL-23(MI) e de forma negativa entre IL-23 (G) com IL-1ß (MI), IL-10(MI), IL-17A (MI) e IFN-γ (MI). Conclusão: Concluímos que a IL-23 e IFN-γ encontram-se significantemente aumentadas no tecido gengival, quando comparados à mucosa intestinal, sugerindo um papel importante destas citocinas na manifestação da periodontite em pacientes com DII.(AU)

Prevalence of human papillomavirus and genotype distribution in women undergoing cervical cancer screening in the area of Barbastro, Spain / Prevalencia del virus del papiloma humano y distribución de genotipos en las pacientes con cribado de cáncer de cérvix en el área de Barbastro, España

Study of cervical cancer screening using HPV and PAP co-testing. Target population (30-64 years of age) was 27,409 women using Cobas 4800 HPV testing.810 patients with positive HPV between 2012 and 2014. HPV prevalence, 8.3%.23% positive to HPV16, 8% to HPV18 and 69% to other genotypes.56.5% had benign cytology, 14.2% ASC-US and 14.9% LSIL.16/18 genotypes more frequent in the 30-45 age group. Women <30 years, infection by multiple genotypes was more frequent than infection by a single genotype.138 (17%) biopsies were CIN2+, 73 (52.9%) positive for HPV16/18 and 65 (47.1%) positive for other genotypes (p < 0.001).24.2% of the women with positive results for more than one genotype group had a CIN2+, 15.8% positive for a single genotype group (p = 0.024)

Estudio del cribado de cáncer cervical utilizando cotest (test de VPH y citología). La población diana (30-64 años) fue de 24.578 mujeres. El test de VPH se realizó con Cobas 4800. Ochocientas diez pacientes con VPH positivo entre 2012 y 2014. Prevalencia de VPH, 8,3%. Un 23% positivas a VPH16, 8% a VPH18 y 69% a otros genotipos. El 56,5% VPH positivos tenían una citología benigna, 14,2% ASC-US y 14,9% LSIL. VPH16/18 más frecuentes en el grupo de 30-45 años. Pacientes <30, la infección por múltiples genotipos fue más frecuente que la infección por un solo genotipo. Ciento treinta y ocho (17%) biopsias fueron CIN2+, 73(52,9%) positivas a VPH16/18 y 65(47,1%) a otros genotipos (p < 0,001). El 24,2% de las mujeres positivas a más de un genotipo tuvo CIN2+ y 15,8% de las positivas a un solo genotipo (p = 0,024)

Expressão de citocinas relacionadas à resposta Th17 nos tecidos gengival e intestinal de pacientes com periodontite e doença inflamatória intestinal / Expression of cytokines related to Th17 response in gingival and intestinal tissues of patients with periodontitis and inflammatory bowel disease

A periodontite e a doença inflamatória intestinal (DII) resultam de uma resposta imune exagerada iniciada ou não por uma agressão bacteriana. As citocinas IL-1ß, IL-4, IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL23, IL-25, IL-31, IL-33, IFN-γ, sCD40L e TNF-α são relevantes na via da resposta imune Th17, que desempenham um papel importante na patogênese de ambas as doenças. Porém, existe a necessidade de uma avaliação da coexistência destas citocinas. O objetivo do estudo foi avaliar a expressão das citocinas: IL1-ß, IL-4, IL-6, IL10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, IFN-γ, TNF-α e do ligante solúvel do CD40 (sCD40L) no tecido gengival (G) e compará-la com a expressão na mucosa intestinal (I) de forma pareada em pacientes com periodontite crônica e DII. Participaram do estudo 22 pacientes com DII, média de idade de 40,0±14,5 anos. Foram registrados os parâmetros clínicos e periodontais. As biópsias gengivais e intestinais foram coletadas e homogeneizadas usando um disruptor celular. Os níveis das citocinas foram analisados pelo método multiensaio multiplex e posteriormente compensados pelo peso das amostras. As comparações entre as variáveis foram analisadas pelos testes Mann-Whitney e Wilcoxon. As correlações foram realizadas pelo teste de Spearman. Níveis significativamente maiores de IL-23 (p=0,02) e IFN-γ (p=0,01) e significantemente menores de IL-31 (p=0,02) e TNF-α (p=0,01) foram encontrados no tecido gengival quando comparamos com o tecido intestinal. Correlações moderadas significantes ocorreram entre o tecido gengival e o tecido intestinal de forma positiva para a IL-6 (G) com a IL-23(I) e de forma negativa entre IL-23 (G) com IL-1ß (I), IL-10 (I), IL-17A (I) e IFN-γ (I). Concluímos que a IL-23 e IFN-γ encontram-se significantemente aumentadas no tecido gengival, quando comparados ao tecido intestinal, sugerindo um papel importante destas citocinas na manifestação da periodontite em pacientes com DII. A presença de correlações significantemente moderadas negativas entre IL-23 gengival com diversas citocinas do tecido intestinal sugere a importância da IL-23 na patogênese da periodontite em pacientes com DII.

Periodontitis and inflammatory bowel disease (IBD) result from an excessive immune response initiated or not by a bacterial challenge. The cytokines IL-1ß, IL-4, IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL23, IL-25, IL-31, IL-33, IFN-γ, sCD40L and TNF-α are related to Th17 response and play an important role in the pathogenesis of both diseases. Therefore, there is a need to evaluate the coexistence of these cytokines. The aim of this study was to analyze the levels of IL1-ß, IL-4, IL-6, IL10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, IFN-γ, TNF-α and sCD40L in the gingival tissue (G) and compare to the levels of the paired intestinal mucosa (I) in patients having both chronic periodontitis and IBD. Twenty-two IBD patients with chronic periodontitis and IBD, mean age 40.0±14.5, were enrolled in the study. Patients were assessed using anamnesis and periodontal examination. Gingival and intestinal biopsies were collected and homogenized using a cell disruptor. Cytokine's expression was evaluated through multiplex technology and then compensated by weight of samples. Mann-Whitney, Wilcoxon and Spearman correlation tests were used to analyze the data. Significant higher levels of gingival IL-23 (p=0.02) and IFN-γ (p=0.01), and significant lower levels of IL-31(p=0.02) and TNF-α (p=0.01) were found when compared to intestinal mucosa. Significant moderate correlations between gingival and intestinal tissue were noted to IL-6 (G) with IL-23(I) in a positive way and in a negative way to IL-23 (G) with IL-1ß (I), IL-10 (I), IL-17A (I) and IFN-γ (I). We conclude that IL -23 and IFN- γ are significantly increased in the gingival tissue, when compared to the intestinal tissue, suggesting an important role of these cytokines in the manifestation of periodontitis in patients with IBD. The presence of significantly moderate correlation between IL -23 gingival with various cytokines in the intestinal tissue suggest the importance of IL -23 in interrelation with periodontitis and inflammatory bowel disease.