Organoides en Odontología. Avances en este Nuevo Enfoque de Investigación: Revisión Sistemática Exploratoria

Los Organoides (O) son un tipo de cultivo celular 3D, que reproducen las características morfológicas y funcionales de diversos órganos o tejidos en un entorno in vivo. Se logran a través de la proliferación y diferenciación de Células Madres (CM) en distintas líneas celulares con capacidad de autoorganizarse. Son capaces de reproducir forma, función, expresión génica o repuesta a estímulos de la misma forma que el órgano original. Esto le ha permitido servir de base para múltiples investigaciones en el ámbito médico y odontológico. En los últimos años, se ha podido recrear con éxito, prácticamente, todos los órganos de nuestro cuerpo, como pulmones, hígado, tracto reproductivo, cerebro y muchos otros (Bartfeld, 2021). De la misma forma, son varias las líneas de investigación odontológicas desarrolladas. En específico, la creación de O de órganos orales como dientes y glándulas salivales, son las más reportadas (Oshima et al., 2017). Sin embargo, no son del común conocimiento del odontólogo general. Esta revisión sistemática exploratoria, tiene como objetivo presentar una visión general de la evidencia acumulada, determinado las áreas odontológicas de investigación, así como sus resultados. La investigación odontológica, en base al uso de O, es de alta calidad y de vanguardia, mostrando resultados prometedores, que auguran un gran futuro, tanto para la odontología como para los pacientes.

Organoids (O) are a type of 3D cell culture, which reproduce the morphological and functional characteristics of various organs or tissues in an in vivo environment. They are achieved through the proliferation and differentiation of Stem Cells (SC) into different cell lines with the ability to self-organize. They are capable of reproducing form, function, gene expression, or responses to stimuli in the same way as the original organ. This has allowed it to serve as the basis for multiple investigations in the medical and dental field. In recent years, it has been possible to successfully recreate practically all human organs, such as the lungs, liver, reproductive tract, brain and many others (Bartfeld, 2021). In the same way, there are several lines of dental research developed, specifically, the creation of O from oral organs such as teeth and salivary glands, are the most reported (Oshima et al., 2017). However, they are not common knowledge of the general dentist. This exploratory systematic review aims to present an overview of the accumulated evidence, determining the dental research areas, as well as their results. Dental research, based on the use of O, is of high quality and cutting-edge, showing promising results and a favorable future, both for dentistry and for patients.

Intranasal Versus Intravenous Dexamethasone to Treat Hospitalized COVID-19 Patients: A Randomized Multicenter Clinical Trial.

BACKGROUND: SARS-CoV2 induces flu-like symptoms that can rapidly progress to severe acute lung injury and even death. The virus also invades the central nervous system (CNS), causing neuroinflammation and death from central failure. Intravenous (IV) or oral dexamethasone (DXM) reduced 28 d mortality in patients who required supplemental oxygen compared to those who received conventional care alone. Through these routes, DMX fails to reach therapeutic levels in the CNS. In contrast, the intranasal (IN) route produces therapeutic levels of DXM in the CNS, even at low doses, with similar systemic bioavailability. AIMS: To compare IN vs. IV DXM treatment in hospitalized patients with COVID-19. METHODS: A controlled, multicenter, open-label trial. Patients with COVID-19 (69) were randomly assigned to receive IN-DXM (0.12 mg/kg for three days, followed by 0.6 mg/kg for up to seven days) or IV-DXM (6 mg/d for 10 d). The primary outcome was clinical improvement, as defined by the National Early Warning Score (NEWS) ordinal scale. The secondary outcome was death at 28 d between IV and IN patients. Effects of both treatments on biochemical and immunoinflammatory profiles were also recorded. RESULTS: Initially, no significant differences in clinical severity, biometrics, and immunoinflammatory parameters were found between both groups. The NEWS-2 score was reduced, in 23 IN-DXM treated patients, with no significant variations in the 46 IV-DXM treated ones. Ten IV-DXM-treated patients and only one IN-DXM patient died. CONCLUSIONS: IN-DMX reduced NEWS-2 and mortality more efficiently than IV-DXM, suggesting that IN is a more efficient route of DXM administration.

Health-care policies during the COVID-19 pandemic in Mexico: A continuous case of heterogeneous, reactive, and unequal response.

Background: The pandemic in Mexico underlined pre-existing health-care system inequalities. Within the first six months of the COVID-19 pandemic, 154 health policies across health institutions were found to be uncoordinated and heterogeneous, leading to health inequalities in access and potential health outcomes. Data & methods: Using a rapid qualitative research methodology, data was collected using purposive sampling of institutional policies published for public access on the official websites of the four public health institutions in Mexico from June 16th, 2020 to October 30th, 2021. This policy review used archival analysis to understand the differences in health-care policies during the COVID-19 pandemic in Mexico. These policies were classified under the RREAL framework and as a continuation of our first publication. Results: During this study, categories of public health response and vaccination dominated the policies enacted. The SSA was the main author of publications. There seems to be a more unified policy response. However, health inequalities persist. Conclusions: The Mexican government continued to be reactive to the increase in cases or the arrival of new variants, rather than preventative. Research and development of policies need to work together in soaring cases like COVID-19 to work more effectively against the economic and epidemiological burden of a pandemic. It is suggested that this "vaccination" should be included in the RREAL classification. Other sectors (i.e. the ministry of foreign affairs) should be considered relevant players in the future management of a pandemic.

Facial Seborrheic Dermatitis in HIV-Seropositive Patients: Evaluation of the Efficacy and Safety of a Non-Steroidal Cream Containing Piroctone Olamine, Biosaccharide Gum-2 and Stearyl Glycyrrhetinate - A Case Series.

Facial seborrheic dermatitis is common in HIV-positive patients, and the presence of facial lesions can affect quality of life. The management and control of lesions can be frustrating for both physicians and patients. In this pilot clinical study, we clinically evaluated the effectiveness of a topical non-steroidal cream in treating mild to moderate facial seborrheic dermatitis in 20 HIV-positive patients. The patients applied a twice-a-day topical cream containing zinc PCA, piroctone olamine, hydroxyphenyl propamidobenzoic acid, biosaccharide gum-2, and stearyl glycyrrhetinate for 12 weeks with no topical or oral antifungal or corticosteroid treatment. Signs and symptoms and tolerance were assessed before, during, and at the end of treatment. All of the patients showed clinical improvement after 4 and 12 weeks of treatment. None of the patients had no response to treatment, and no adverse effects were reported. No rescue therapy with corticosteroids was needed. The patients reported a very noticeable improvement in their skin which contributed to high compliance with the protocol requirement.

Intranasal dexamethasone: a new clinical trial for the control of inflammation and neuroinflammation in COVID-19 patients.

BACKGROUND: By end December of 2021, COVID-19 has infected around 276 million individuals and caused over 5 million deaths worldwide. Infection results in dysregulated systemic inflammation, multi-organ dysfunction, and critical illness. Cells of the central nervous system are also affected, triggering an uncontrolled neuroinflammatory response. Low doses of glucocorticoids, administered orally or intravenously, reduce mortality among moderate and severe COVID-19 patients. However, low doses administered by these routes do not reach therapeutic levels in the CNS. In contrast, intranasally administered dexamethasone can result in therapeutic doses in the CNS even at low doses. METHODS: This is an approved open-label, multicenter, randomized controlled trial to compare the effectiveness of intranasal versus intravenous dexamethasone administered in low doses to moderate and severe COVID-19 adult patients. The protocol is conducted in five health institutions in Mexico City. A total of 120 patients will be randomized into two groups (intravenous vs. intranasal) at a 1:1 ratio. Both groups will be treated with the corresponding dexamethasone scheme for 10 days. The primary outcome of the study will be clinical improvement, defined as a statistically significant reduction in the NEWS-2 score of patients with intranasal versus intravenous dexamethasone administration. The secondary outcome will be the reduction in mortality during hospitalization. CONCLUSIONS: This protocol is currently in progress to improve the efficacy of the standard therapeutic dexamethasone regimen for moderate and severe COVID-19 patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT04513184 . Registered November 12, 2020. Approved by La Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS) with identification number DI/20/407/04/36. People are currently being recruited.

Hallazgos en piel en pacientes con infección por VIH en Bogotá / Skin findings in patients with HIV infection in Bogotá

RESUMEN Objetivo Describir los hallazgos en piel y las características sociodemográficas de pacientes VIH positivos atendidos en un centro de remisión en Bogotá. Métodos Se realizó un estudio observacional descriptivo, incluyendo adultos con infección por VIH atendidos en el Hospital Universitario San Ignacio de Bogotá, entre abril de 2019 y febrero de 2020. A partir de un interrogatorio, un examen físico y la revisión de historias clínicas, se registraron hallazgos en piel, datos de terapia antirretroviral recibida, conteo de linfocitos CD4+ y carga viral para VIH, así como pruebas micológicas e histopatológicas (cuando fueron necesarias). Resultados Se evaluó un total de 168 pacientes que, en su mayoría, eran hombres (88,7%), en la cuarta década de la vida, de orientación HSH (77,4%), con fototipos del II al IV (97%) y manejados con terapia antirretroviral (94,6%). Se encontraron hallazgos en piel en el 97,6% de los pacientes, siendo más frecuentes las infecciones (43,8%), específicamente los condilomas anogenitales, principalmente en pacientes con <200 linfocitos CD4+/mm3, seguidas por las condiciones inflamatorias (35,4%), principalmente dermatitis seborreica y acné. Este último, más frecuente en pacientes con >200 linfocitos CD4+/mm3. Conclusiones Los hallazgos más frecuentes en piel fueron: dermatitis seborreica, condilomas anogenitales, verrugas virales, moluscos contagiosos y micosis superficiales, que se asemeja a lo reportado en poblaciones con buen control inmunovirológico de la enfermedad. La alta prevalencia de condilomas anogenitales nos invita a implementar estrategias de tamización para VPH, así como de educación en infecciones de transmisión sexual.

ABSTRACT Objetive To describe the skin findings and sociodemographic characteristics of HIV-positive patients attended at a medical center in Bogotá. Methods Descriptive observational study, including adults with HIV infection attended at the Hospital Universitario San Ignacio de Bogotá, between April 2019 and February 2020. Based on an interrogation, physical examination and review of medical records, skin fin-dings, data on antiretroviral therapy received, CD4+ lymphocyte count and viral load for HIV, as well as mycological and histopathological tests (when necessary) were recorded. Results A total of 168 patients were evaluated, most of whom were men (88.7%), in the fourth decade of life, of MSM orientation (77.4%), with phototypes II to IV (97%) and managed with antiretroviral therapy (94.6%). Skin findings were found in 97.6% of patients, with infections being more frequent (43.8%), specifically anogenital condylomas, mainly in patients with <200 CD4+ lymphocytes/mm3, followed by inflammatory conditions (35.4%), mainly seborrheic dermatitis and acne. The latter, more frequent in patients with >200 CD4+ lymphocytes/mm3. Conclusions The most frequent skin findings were: seborrheic dermatitis, anogenital condylomas, viral warts, molluscum contagiosum and superficial mycosis, which is similar to that reported in populations with good immunovirological control of the disease. The high prevalence of anogenital condylomas invites us to implement screening strategies for HPV, as well as education on sexually transmitted infections.

Health-care guidelines and policies during the COVID-19 pandemic in Mexico: A case of health-inequalities.

BACKGROUND: Heterogeneous government responses have been reported in reaction to COVID-19. The aim of this study is to generate an exploratory review of healthcare policies published during COVID-19 by health-care institutions in Mexico. Analyzing policies within different health sub-systems becomes imperative in the Mexican case due to the longstanding fragmentation of the health-care system and health inequalities. DATA AND METHODS: Policies purposely included in the analysis were published by four public health institutions (IMSS, ISSSTE, SSA and PEMEX) during the COVID-19 epidemic in Mexico (from February 29th to June 15th, 2020) on official institutional websites. Researchers reviewed each document and classified them into seven policy categories set by the Rapid Research Evaluation and Appraisal Lab (RREAL): public health response, health-care delivery, human resources, health-system infrastructure and supplies, clinical response, health-care management, and epidemiological surveillance. RESULTS: Policy types varied by health institution. The largest number of policies were aimed at public health responses followed by health-care delivery and human resources. Policies were mainly published during the community transmission phase. CONCLUSIONS: The pandemic exposed underlying health-care system inequalities and a reactive rather than prepared response to the outbreak. Additionally, this study outlines potential policy gaps and delays in the response that could be avoided in the future.

Infectious and non-infectious diseases burden among Haitian immigrants in Chile: a cross-sectional study.

Chile has become a popular destination for migrants from South America and the Caribbean (low- and middle-income countries migration). Close to 200.000 Haitian migrants have arrived in Chile. Infectious and non-infectious disease burden among the Haitian adult population living in Chile is unknown. This study aimed to acquire the basic health information (selected transmissible and non-transmissible conditions) of the Haitian adult population living in Chile. A cross-sectional survey was performed, inviting Haitian-born residents in Chile older than 18 years old. Common conditions and risk factors for disease were assessed, as well as selected transmissible conditions (HIV, HBV, and HCV). 498 participants (60.4% female) from 10 communities in two regions of Chile were surveyed. Most subjects had never smoked (91.5%), and 80% drank less than one alcohol unit per month. The mean BMI was 25.6, with 45% of participants having a normal BMI (20-25). Hypertension was present in 31.5% (33% in the 25-44 age group). Prevalence of HIV was 2.4% (95 CI 1.3-4.2%), hepatitis B (HBsAg positive) was 3.4% (95 CI 2.1-5.5%), and hepatitis C was 0% (95 CI 0.0-0.9%). Quality of life showed a significant prevalence of depression and anxiety markers, particularly in those arriving in Chile less than 1 year ago. Low prevalence of obesity, diabetes, smoking, and drinking and estimated cardiovascular risk were found. Nonetheless, hypertension at a younger age, disproportionately higher prevalence of HIV and HBV infection and frequent markers of anxiety and depression were also found. Public policies for detecting and treating hypertension, HIV, and HBV screening, offering HBV vaccination, and organizing mental health programs for Haitian immigrants, are urgently needed.

Direct and indirect victimization and post-traumatic stress symptoms in university students in Northeastern Mexico / Victimización directa e indirecta y síntomas de estrés postraumático en estudiantes universitarios del Noreste de México

Abstract In recent years, violence has been exacerbated in several northeastern states of México, with implications for the mental health of young people, as is the development of symptoms of post-traumatic stress disorder (PTSD). The present study aims to identify the types of victimization (direct or indirect) experienced by university students, determine the symptoms of post-traumatic stress they present and see the relationship between the types of victimization and PTSD symptoms. The Victimization Scale and the Short Scale of Post-Traumatic Stress Disorder were applied to 500 young people of Tamaulipas. The university students report on average 7 direct and indirect victimization events, the indirect being more frequent. Although there is a relationship between direct and indirect victimization, with the presence of PTSD symptoms, only indirect victimization is a predictive variable of PTSD symptoms in university students. It is proposed that, together with policies of crime prevention and reduction, policies of the reduction of fear of crimes should be created.

Resumen En México, sobre todo en los estados del noreste del país, en los últimos años la violencia se ha exacerbado y, a su vez, ha incrementado sus implicaciones en la salud mental de los jóvenes, principalmente con el desarrollo de síntomas del trastorno por estrés postraumático (TEPT). Teniendo esto en cuenta, en el presente estudio se tuvo como objetivo identificar los tipos de victimización (directa o indirecta) que viven los jóvenes universitarios ante la violencia comunitaria, así como determinar los síntomas de estrés postraumático que presentaban, e identificar la relación entre los tipos de victimización y los síntomas del TEPT. En total, participaron 500 jóvenes universitarios de un estado del noreste del país, a quienes se les aplicó la Escala de Victimización y la Escala Breve del Desorden del Estrés Postraumático. Como resultados, los participantes reportaron un promedio de siete sucesos de victimización tanto directa como indirecta, siendo más frecuente la indirecta. Aunque se observa una relación directa e indirecta entre la victimización y la presencia de síntomas del TEPT, solo la victimización indirecta resultó ser una variable predictora de síntomas del TEPT. Se propone que, junto a las políticas de prevención y reducción del delito, deben crearse políticas de reducción del miedo al crimen en la población.

Extracellular Vesicles in NAFLD/ALD: From Pathobiology to Therapy.

In recent years, knowledge on the biology and pathobiology of extracellular vesicles (EVs) has exploded. EVs are submicron membrane-bound structures secreted from different cell types containing a wide variety of bioactive molecules (e.g., proteins, lipids, and nucleic acids (coding and non-coding RNA) and mitochondrial DNA). EVs have important functions in cell-to-cell communication and are found in a wide variety of tissues and body fluids. Better delineation of EV structures and advances in the isolation and characterization of their cargo have allowed the diagnostic and therapeutic implications of these particles to be explored. In the field of liver diseases, EVs are emerging as key players in the pathogenesis of both nonalcoholic liver disease (NAFLD) and alcoholic liver disease (ALD), the most prevalent liver diseases worldwide, and their complications, including development of hepatocellular carcinoma. In these diseases, stressed/damaged hepatocytes release large quantities of EVs that contribute to the occurrence of inflammation, fibrogenesis, and angiogenesis, which are key pathobiological processes in liver disease progression. Moreover, the specific molecular signatures of released EVs in biofluids have allowed EVs to be considered as promising candidates to serve as disease biomarkers. Additionally, different experimental studies have shown that EVs may have potential for therapeutic use as a liver-specific delivery method of different agents, taking advantage of their hepatocellular uptake through interactions with specific receptors. In this review, we focused on the most recent findings concerning the role of EVs as new structures mediating autocrine and paracrine intercellular communication in both ALD and NAFLD, as well as their potential use as biomarkers of disease severity and progression. Emerging therapeutic applications of EVs in these liver diseases were also examined, along with the potential for successful transition from bench to clinic.

Urinary Tract Infections in College and Non-College Women from Colombia.

OBJECTIVE: To compare college and non-college women in terms of the frequency of, etiology of, and risk factors associated with urinary tract infections. METHODS: This was a cross-sectional study conducted in Cartagena, Colombia, with 258 female college students and 256 female non-college students from 15 to 34 years old. The participants were interviewed and completed a questionnaire assessing the risk factors associated with urinary tract infections. Urine samples were examined by urinalysis and to look for signs of urinary tract infection, when found, were confirmed by culture. Isolated bacteria were tested for antimicrobial susceptibility using the Kirby-Bauer test. A chi-square test and binary logistic regression were used to analyze the data. RESULTS: Urinary tract infections were found in 7.8% of the participating college women and 9.4% of the participating non-college women. E. coli was the most frequent uropathogen found in the members of the 2 groups. The majority of the isolated bacteria were highly resistant to ß-lactams. Binary logistic regression analysis showed that in the college women, the predictor variables of having a urinary tract infection were the presence of nitrites, leucocytes, and urinary urgency. In the case of the non-college women, the predictor variables were the presence of nitrites and cystitis in the last 2 years. CONCLUSION: The frequencies of urinary tract infection were similar in both groups. These individuals might have been taking non-prescribed antibiotics or failing to comply with a prescribed treatment or bacteria are of hospital origin.

Diseño y validación de una escala de actitudes hacia la paternidad para muestras colombianas / Design and validation of the attitudes toward parenthood scale, in a colombian sample

Resumen La familia es el sistema transmisor de comportamientos por excelencia y la pareja, en el momento de decidir tener un hijo, reflexiona acerca de ciertos ideales y expectativas con respecto a la forma de crianza que, en los hombres, determina el valor de la carga emocional y poder en el género masculino. Por lo anterior, el objetivo de este estudio fue diseñar y validar una escala para medir las actitudes hacia la paternidad, que delimitan aspectos comportamentales eficaces para una buena crianza. Para ello se realizó una tabla de especificaciones y se construyeron los reactivos, los cuales fueron sometidos a validación por jueces. Se realizó el ajuste de la escala, y fue aplicada a 240 hombres colombianos con edades comprendidas entre los 18 y 52 años (media=24,7). Tras hacer el análisis factorial exploratorio, se agruparon los reactivos con base a lo sugerido por el programa y se hizo la depuración pertinente según los resultados obtenidos. Ulteriormente, dichos resultados se sometieron a un análisis factorial confirmatorio, verificando el ajuste del modelo. Los índices de validez y concordancia indicaron que los ítems eran esenciales, el análisis de correlaciones indicó homogeneidad entre los ítems y el instrumento mostró tener alta fiabilidad. En conclusión, se puede afirmar que la Escala de actitudes hacia la paternidad es una escala válida y confiable para ser utilizada en población colombiana, recomendando repetir el estudio para replicar estos hallazgos y estimar la plausibilidad de ser extrapolada al género femenino.

Abstract The family is the main transmitting system of behaviors and a couple, when deciding to have a child, reflects on the ideals and expectations regarding the appropiate way of upbringing a child which in men, determines the value of the emotional load and power in the masculine gender. The present study had as main objective to design and validate a scale that measures attitudes toward parenthood which determine effective behavioral aspects for a suitable child rearing. In order to achieve this, a specification chart was designed and items were constructed and then submitted to be validated by judges. The scale was adjusted based on the judges opinions and applied to 240 Colombian men with an age range of 18-52 years old (media=24,7 years old). After conducting an exploratory factor analysis, the reactants were grouped according to what was suggested by the program and those which were not appropriate were extracted. Results were submitted to a confirmatory analysis verifying the model's adjustment. Ratings for validity and agreement showed that the items were essential, the correlation analysis showed homogeneity between them and the test showed high reliability. As a conclusion, it is said that the Attitudes toward parenthood scale is a valid and reliable scale to be used in Colombian population, suggesting to replicate the study in order to evaluate its generalizability and estimate the plausibility of extrapolating it to female gender.

Author Correction: Selection of reference genes for microRNA analysis associated to early stress response to handling and confinement in Salmo salar.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.

Estrangulación suicida atípica / Atypical self-induced strangulation

Resumen El hallazgo de un cadáver con signos de suspensión y en circunstancias dudosas plantea la posibilidad de que la muerte esté relacionada a la intervención de terceros. Presentamos el caso de un varón de 36 años que fue encontrado muerto, con una compresión cervical mecánica extrínseca, en una vía pública, sin testigos del hecho. Inicialmente, se investigó el caso como un homicidio, con diagnóstico diferencial de suicidio. El estudio exhaustivo del sitio de la muerte, más el examen post-mórtem completo, incluyendo: autopsia, histopatología y toxicología, permitió descartar la posibilidad de la acción de terceros y confirmar la hipótesis diagnóstica de una estrangulación autoinducida, de ubicación atípica, ejecutada con lazo.

Abstract Finding a suspended body in doubtful circumstances raises the possibility that the manner of death is homicide. We present the case of a 36 years-old male who was found dead, with extrinsic mechanical cervical compression, on a public place, there were no witnesses of the fact. Initially, the case was investigated as a homicide, with differential diagnosis of suicide. The comprehensive analysis of the scene and a complete post-mortem examination: including autopsy, histopathology and toxicology results, allowed us to rule out the possibility of the action of third parties and confirm the hypothesis of a self-induced atypical strangulation.

Modeling the pressure inactivation of Escherichia coli and Salmonella typhimurium in sapote mamey ( Pouteria sapota (Jacq.) H.E. Moore & Stearn) pulp.

High hydrostatic pressure inactivation kinetics of Escherichia coli ATCC 25922 and Salmonella enterica subsp. enterica serovar Typhimurium ATCC 14028 ( S. typhimurium) in a low acid mamey pulp at four pressure levels (300, 350, 400, and 450 MPa), different exposure times (0-8 min), and temperature of 25 ± 2℃ were obtained. Survival curves showed deviations from linearity in the form of a tail (upward concavity). The primary models tested were the Weibull model, the modified Gompertz equation, and the biphasic model. The Weibull model gave the best goodness of fit ( R2adj > 0.956, root mean square error < 0.290) in the modeling and the lowest Akaike information criterion value. Exponential-logistic and exponential decay models, and Bigelow-type and an empirical models for b'( P) and n( P) parameters, respectively, were tested as alternative secondary models. The process validation considered the two- and one-step nonlinear regressions for making predictions of the survival fraction; both regression types provided an adequate goodness of fit and the one-step nonlinear regression clearly reduced fitting errors. The best candidate model according to the Akaike theory information, with better accuracy and more reliable predictions was the Weibull model integrated by the exponential-logistic and exponential decay secondary models as a function of time and pressure (two-step procedure) or incorporated as one equation (one-step procedure). Both mathematical expressions were used to determine the td parameter, where the desired reductions ( 5D) (considering d = 5 ( t5) as the criterion of 5 Log10 reduction (5 D)) in both microorganisms are attainable at 400 MPa for 5.487 ± 0.488 or 5.950 ± 0.329 min, respectively, for the one- or two-step nonlinear procedure.

Selection of reference genes for microRNA analysis associated to early stress response to handling and confinement in Salmo salar.

MicroRNAs are key non-coding RNA molecules that play a relevant role in the regulation of gene expression through translational repression and/or transcript cleavage during normal development and physiological adaptation processes like stress. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) has become the approach normally used to determine the levels of microRNAs. However, this approach needs the use of endogenous reference. An improper selection of endogenous references can result in confusing interpretation of data. The aim of this study was to identify and validate appropriate endogenous reference miRNA genes for normalizing RT-qPCR survey of miRNAs expression in four different tissues of Atlantic salmon, under handling and confinement stress conditions associated to early or primary stress response. Nine candidate reference normalizers, including microRNAs and nuclear genes, normally used in vertebrate microRNA expression studies were selected from literature, validated by RT-qPCR and analyzed by the algorithms geNorm and NormFinder. The results revealed that the ssa-miR-99-5p gene was the most stable overall and that ssa-miR-99-5p and ssa-miR-23a-5p genes were the best combination. Moreover, the suitability of ssa-miR-99-5p and ssa-miR-23a-5p as endogeneuos reference genes was demostrated by the expression analysis of ssa-miR-193-5p gene.

Visita restrictiva / visita no restrictiva en una unidad de paciente crítico adulto / Restricted/Unrestricted Visits to Adult Patients in the Intensive Care Unit / Visita proibida/visita não proibida numa unidade de paciente crítico adulto

Objetivo: buscar evidencia que responda a la pregunta ¿cuál es el impacto en el paciente, familia y personal de salud de visitas no restrictivas versus restrictivas? Método: revisión sistemática. Estrategia de búsqueda: 1993-2016 en Cochrane Library, Joanna Briggs, EBSCO, PubMed, CINHAL, Trip DataBase, con términos Mesh y palabras clave. Criterios de selección de artículos: revisiones sistemáticas, ensayos clínicos randomizados, no randomizados, cohortes, casos controles, estudios descriptivos correlacionales, UCI adultos, español e inglés. Recolección y análisis: selección inicial de 293 artículos, aplicando criterios de selección quedaron 13 artículos para análisis crítico. Calidad metodológica analizada con guías CASPe. Resultados: la visita no restrictiva no incrementa riesgo de infección, la ansiedad del paciente es menor, la satisfacción de enfermeras es mayor, la presencia familiar ayuda a la recuperación del paciente, la familia está más informada, satisfecha y con mejor conocimiento de situación. La frecuencia de complicaciones cardiovasculares es mayor en pacientes con visitas restrictivas. Conclusiones: las visitas no restrictivas en UCI no generan daño al paciente, por el contrario, contribuyen a la recuperación de su salud física y emocional.

Objective: To search for evidence to answer the question: How do unrestricted visits affect patients, their families and healthcare professionals, as opposed to restricted visits? Method: Systemic review. Search strategy: 1993-2016 in Cochrane Library, Joanna Briggs, EBSCO, PubMed, CINHAL, Trip DataBase, with Mesh terms and key words. Criteria for selecting articles: systematic reviews, randomized and nonrandomized clinical trials, cohort studies, control studies, descriptive correlational studies, ICU adults, Spanish and English. Collection and analysis: initial selection of 293 articles and a final selection of 13 articles for critical analysis after applying the selection criteria. The researchers used the CASPe guidelines to assess methodological quality. Results: Unrestricted visits do not increase risk of infection, patient's anxiety is lower, nurses are more satisfied, family presence helps in patient recovery, families are better informed, more satisfied and have a better understanding of the situation. The frequency of cardiovascular complications is higher in patients with restricted visits. Conclusions: Unrestricted visits to the ICU do not harm the patient but instead contribute to their physical and emotional health.

Objetivo: buscar evidência que responda à pergunta: qual é o impacto no paciente, na família e no pessoal de saúde de visitas não proibidas versus proibidas? Método: revisão sistemática. Estratégia de busca: 1993-2016 em Cochrane Library, Joanna Briggs, EBSCO, PubMed, CINHAL, Trip DataBase, com termos Mesh e palavras-chave. Critérios de seleção de artigos: revisões sistemáticas, ensaios clínicos randomizados, não randomizados, coortes, casos controle, estudos descritivos correlacionais, UTI adultos, espanhol e inglês. Coleta e análise: seleção inicial de 293 artigos; após seleção, ficaram 13 artigos para análise crítica. Qualidade metodológica analisada com guias CASPe. Resultados: a visita não proibida não aumenta o risco de infeção, a ansiedade do paciente é menor, a satisfação de enfermeiras é maior, a presença familiar ajuda a recuperação do paciente, a família está mais informada, satisfeita e com melhor conhecimento da situação. A frequência de complicações cardiovasculares é maior em pacientes com visitas proibidas. Conclusão: as visitas não proibidas em UTI não prejudicam o paciente; ao contrário, contribuem para a recuperação de sua saúde física e emocional.