Is older age an independent prognostic factor of survival in metastatic colorectal cancer?

INTRODUCTION: Older patients (>75 years) with advanced colorectal cancer (CRC) may have worse survival than non-older patients. We hypothesized that, rather than age alone, concurrent factors may be more relevant for real-world survival. METHODS: Patients diagnosed with CRC in a 5-year period (2014-2018) were analyzed to determine which factors influenced in overall survival (OS). Kaplan-Meier method was used to estimate OS. Univariate and multivariate analysis was conducted by Cox regression analysis. The study was approved by Ethic Committee. RESULTS: Out of 477 patients diagnosed with CRC, 231 had advanced disease. 92 patients (40%) were older than 75 years, median OS (mOS) was 17.1m (CI95% 14.3-23.3), p<0.001. In non-older patients, mOS was 26.7m (CI95% 21.9-32.6), p<0.001. We evaluated eighteen concurrent factors that included: characteristics related to the patient (age, sex, comorbidities, polypharmacy, Eastern Cooperative Oncology Group (ECOG) and nutritional status), to the tumor (stage at diagnosis, tumor side, molecular profile, tumor burden, location, and number of metastasis) and to the treatment administered (systemic treatment for advanced disease, chemotherapy schedule and number of lines, severe adverse events and dose reductions, and surgery of liver metastasis). In the univariate analysis, age at diagnosis, ECOG, nutritional status, tumor side, molecular profile, tumor burden, systemic treatment for advanced disease, and surgery of liver metastases had significant impact on survival. However, multivariate analysis revealed that only four factors (tumor burden, nutritional status, systemic treatment for advanced disease, and surgery of liver metastases) were independently associated with OS, but not older age at diagnosis. CONCLUSION: Older age is not an independent survival prognostic factor for advanced CRC. Tumor burden, nutritional status, systemic treatment for advanced disease and surgery of liver met were significant factors associated with OS. These findings suggest that older patients should not be excluded from cancer treatment based on age alone.

Unraveling the diversity of Trypanosoma species from Central Mexico: Molecular confirmation on the presence of Trypanosoma dionisii and novel Neobat linages.

Bats are one of the groups of mammals with the highest number of associated Trypanosoma taxa. There are 50 Trypanosoma species and genotypes infecting more than 75 species of bats across five continents. However, in Mexico, the inventory of species of the genus Trypanosoma associated with bats is limited to only two species (Trypanosoma vespertilionis and Trypanosoma cruzi) even though 140 species of bats inhabit this country. Specifically, 91 bat species have been recorded in the state of Veracruz, but records of trypanosomatids associated with this mammalian group are absent. Due to the complex Trypanosoma-bat relationship, the high diversity of bat species in Veracruz, as well as the lack of records of trypanosomatids associated with bats for this state, the aim of this work was to analyze the diversity of species of the genus Trypanosoma and their presence from a bat community in the central area of the state of Veracruz, Mexico. During the period of January to August 2022 in the Tequecholapa Environmental Management Unit where bats were collected using mist nets and blood samples were obtained from their thumbs. We extracted genetic material and amplified a fragment of 800 bp of the 18S ribosomal gene of the genus Trypanosoma by conventional PCR. The positive amplicons were sequenced, and phylogenetic reconstruction was performed to identify the parasite species. A total of 285 bats (149♀, 136♂) belonging to 13 species from 10 genera and a single family (Phyllostomidae) were collected. Twenty-three specimens from six species tested positive for the presence of Trypanosoma dionisii, Trypanosoma sp. Neobat 4, and a potential novelty species provisionally named as Trypanosoma sp. Neobat 6. The results of the present work increase the number of species of the genus Trypanosoma infecting bats in Mexico and in the Neotropical region.

Confirmation of the presence of Rickettsia felis infecting Ornithodoros puertoricensis in Mexico.

Soft ticks are neglected competent vectors of a wide range of pathogenic microorganisms, among which bacteria of the genera Rickettsia and Borrelia stand out. In Mexico, previous studies have shown the presence of a member of the Ornithodoros talaje complex in the Virginia opossum (Didelphis virginiana Didelphimorphia: Didelphidae Kerr) from southeastern Mexico. However, its specific identification has not been achieved. Two D. virginiana were treated in a private clinic during the period of April-May 2022. Tick larvae were manually removed, DNA extraction was performed, and some genes from various bacterial and parasitic pathogens were amplified and sequenced. A total of 96 larvae were recovered, which were morphologically identified as Ornithodoros puertoricensis (Ixodida: Argasidae Fox); the 16 S sequences showed a similarity of 96.79%-99.51% with sequences of O. puertoricensis from Panama and Colombia. The presence of Rickettsia felis (Rickettsiales: Rickettsiaceae Bouyer et al.) was detected in 15 specimens from one host. The soft tick O. puertoricensis is recorded for the first time as an ectoparasite of the Virginia opossum in America and represents the second report for this soft tick in Mexico since 1963. This represents the most northern record of this tick species in its geographic distribution and brings a new soft tick-Rickettsia association.

Molecular detection of Coxiella-like endosymbionts and absence of Coxiella burnetii in Amblyomma mixtum from Veracruz, Mexico.

Ticks are obligate ectoparasites associated with a wide range of vertebrate hosts, including domestic animals. Moreover, ticks are capable of transmitting many pathogens such as Coxiella. To date, Coxiella burnetii, the etiological agent of coxiellosis or Q fever, is the only valid species of the genera. Nevertheless, a wide range of agents denominated Coxiella-like have been detected in recent studies, mainly associated with ticks. The pathogenicity of these Coxiella-like agents is controversial as some of them can infect both birds and humans. In Mexico, knowledge about Q fever is scarce and limited to historical serological records, and there is an overall lack of molecular proof of any agent of the genus Coxiella circulating in the country. Therefore, the aim of this study was to detect the presence of Coxiella in ticks associated with cattle in all 10 regions of Veracruz, Mexico. To accomplish this objective, first, we identified ticks collected from cattle and horses in Veracruz. Then, for Coxiella detection, DNA extraction from ticks and PCR amplification of the 16S-rDNA of Coxiella was performed. Finally, we performed a phylogenetic reconstruction to determine the Coxiella lineages detected. From the 10 regions sampled we collected 888 ticks grouped in 180 pools, and only five Amblyomma mixtum from the locality of Castán, and one from Los Angeles from Tuxpan were found positive, which represents a frequency of 20% for each locality. This study represents the first attempt at molecular detection of Coxiella in ticks associated with cattle in the state of Veracruz, the major livestock producer in the country. The findings of the present study are relevant as they establish a precedent regarding the circulation of Coxiella-like agents, as well as the absence in three municipalities of the state of Veracruz of C. burnetii, an abortive agent of livestock importance.

End of life of the cancer patient: patient, family and physician perceptions / Fin de vida del paciente oncológico: percepciones de pacientes, familiares y médicos

Abstract Chronic diseases such as cancer have imposed challenges on health systems. Colombia has worked on the construction and implementation of a legal framework for palliative care, but a comprehensive approach to the care provided to cancer patients at the end of their lives is still lacking. Such an approach should be based on understanding of the perceptions of its different actors in order to allow for adequate decision-making and improved support during this stage. Currently, the infrastructure to provide adequate oncological support is insufficient, the administrative procedures that patients and families have to go through to get authorization for treatments and medications for symptom relief are overwhelming and, many times, costs must be paid out of pocket. On the other hand, it is important to train healthcare personnel to develop communication skills to approach patients from a place of compassion, personal development and reflection, creating spaces in which patients can speak openly about their wishes, fears and worries, even if they come together with the desire to accelerate the end of life. In addition, healthcare staff should support and initiate conversations about life and the end of life between patients and their families if this communication is complicated, given its importance for healthcare, quality of life and death. This article seeks to reflect on the end of life of the cancer patient from the perceptions of the actors involved, namely, patients, caregivers and healthcare professionals.

Resumen Las enfermedades crónicas, como el cáncer, han impuesto retos a los sistemas de salud; Colombia ha trabajado en la construcción e implementación de un marco legal de los cuidados paliativos, pero la atención brindada en el fin de vida del paciente oncológico aún carece de un abordaje integral basado en la comprensión de las percepciones de sus diferentes actores, que permita una adecuada toma de decisiones y mejor acompañamiento en esta etapa. Actualmente, la infraestructura para brindar un adecuado soporte oncológico es insuficiente, los trámites que debe realizar el paciente y su familia en la autorización de tratamientos o medicamentos para el alivio de síntomas se vuelven desgastantes y en muchas ocasiones los costos deben ser asumidos por ellos mismos. Por otra parte, es importante fortalecer la formación del personal de salud en comunicación hacia el paciente y su familia, la cual debe ser compasiva, fundamentada en el desarrollo personal y la reflexión, mediante espacios en los que el paciente pueda hablar abiertamente de sus deseos, miedos y preocupaciones, incluso si estos acompañan el deseo de acelerar el fin de vida. Además, el personal de salud deberá apoyar e iniciar conversaciones sobre la vida y el fin de vida entre pacientes y sus familiares si esta comunicación es complicada, dada su importancia para la atención en salud, calidad de vida y muerte. Este artículo busca reflexionar sobre el fin de vida del paciente oncológico desde las percepciones de los actores involucrados: pacientes, cuidadores y el personal de salud.

Apolipoprotein L1 is increased in frontotemporal lobar degeneration post-mortem brain but not in ante-mortem cerebrospinal fluid.

AIMS: Frontotemporal Dementia (FTD) is caused by frontal-temporal lobar degeneration (FTLD), characterized mainly by brain protein aggregates of tau (FTLD-Tau) or TDP-43 (FTLD-TDP). The clinicopathological heterogeneity makes ante-mortem diagnosis of these pathological subtypes challenging. Our proteomics study showed increased Apolipoprotein L1 (APOL1) levels in CSF from FTD patients, which was prominently expressed in FTLD-Tau. We aimed to understand APOL1 expression in FTLD post-mortem brain tissue and to validate its potential as a CSF biomarker for FTD and its pathological subtypes. METHODS: APOL1 levels were analyzed in the frontal cortex of FTLD (including FTLD-Tau and FTLD-TDP) and non-demented controls by immunohistochemistry (FTLD total = 18 (12 FTLD-Tau and 6 FTLD-TDP); controls = 9), western blot (WB), and a novel prototype ELISA (FTLD total = 44 (21 FTLD-Tau and 23 FTLD-TDP); controls = 9). The association of APOL1 immunoreactivity with phosphorylated Tau (pTau) and TDP-43 (pTDP-43) immunoreactivity was assessed. CSF APOL1 was analyzed in confirmed FTD patients (n = 27, including 12 FTLD-Tau and 15 FTLD-TDP) and controls (n = 15) using the same ELISA. RESULTS: APOL1 levels were significantly increased in FTLD post-mortem tissue compared to controls as measured by immunohistochemistry, WB, and ELISA. However, no differences between the pathological subtypes were observed. APOL1 immunoreactivity was present in neuronal and glial cells but did not co-localize with pTau or pTDP-43. CSF APOL1 levels were comparable between FTD patients and controls and between pathological subtypes. CONCLUSION: APOL1 is upregulated in FTLD pathology irrespective of the subtypes, indicating a role of this novel protein in FTD pathophysiology. The APOL1 levels detected in brain tissue were not mirrored in the CSF, limiting its potential as a specific FTD biofluid-based biomarker using our current immunoassay.

Un (que)hacer posible sobre salud mental / A possible approach on mental health

En el marco de la emergencia sanitaria por COVID-19, el programa "Cuidar a los que Cuidan" se estableció como una estrategia para el acompañamiento y contención de los equipos de salud en diversos efectores del sistema público en la Provincia de Buenos Aires. En este trabajo, se hará alusión a las estrategias de intervención desarrolladas a partir de la llamada "segunda ola" del virus en el Servicio de Guardia del Hospital Interzonal Especializado de Agudos y Crónicos San Juan de Dios. Apenas se asistió al servicio, la detección de no contar con algún espacio vinculado a la salud mental, introdujo la pregunta de cómo instalar un dispositivo que tuviera relación con un aspecto de la salud que se encontraba ausente. Por tal motivo, no se trató de protocolos insuficientes al momento de abordar los casos, sino de crear una nueva forma de trabajo y cómo dar lugar a la misma a partir de las problemáticas emergentes. En consecuencia, y en consonancia con los objetivos específicos del programa, la estrategia de abordaje psico-social se focalizó en dos ejes: por un lado, con los equipos de salud de cada una de las guardias, las cuales cambiaban diariamente, a partir de la posibilidad de abrir un espacio de intercambio y diálogo en presencia; por otro lado, en el acompañamiento con los familiares y pacientes COVID-19 positivos que estuvieran atravesando la enfermedad en ese servicio. En función de ello, construir herramientas para pensar sobre los escenarios posibles, según el pronóstico de cada paciente. A partir de estas coordenadas, en el presente trabajo se hará hincapié en las decisiones estratégicas para las intervenciones llevadas a cabo en la Guardia. Éstas, formuladas en clave comunitaria, llevadas al territorio a través del fortalecimiento del trabajo en red intersectorial e interdisciplinario, como así también problematizando las tensiones inherentes

Species diversity and blood meal sources of phlebotomine sand flies (Diptera: Psychodidae) from Los Tuxtlas, Veracruz, Mexico.

Phlebotomine sand flies can transmit several species of the genus Leishmania, that cause leishmaniasis, a serious neglected tropical disease worldwide. Although Mexico is an endemic country for the disease, studies on the biology, ecology, and the identification of blood meal sources of phlebotomine sand flies in some states remain unexplored. For this reason, this study aimed to evaluate the species diversity of sand flies, and identify their blood meal sources in the Biosphere Reserve Los Tuxtlas, Veracruz, an area with a high prevalence of Leishmania infantum. The cumulative sampling effort of sand flies covered 300 trap-nights between March 2011 and May 2013. For estimating species diversity, we calculated the species richness (q = 0), the diversity of the species (q = 1) and the dominant species (q = 2). To identify the blood meal sources, we amplified and sequenced a fragment of ≈400 bp of the vertebrate Cytb gene. A total of 951 specimens belonging to 15 species were collected. Psathyromyia aclydifera and Psychodopygus panamensis were the most abundant species. We were able to identify seven terrestrial vertebrate species, among which human beings were the most common source of the blood meal. In this study, relevant information on the structure of sand fly populations and their blood meal sources was obtained, providing basic and important information about the interactions between sand flies, hosts and Leishmania species.

Echinoderes unispinosus (Kinorhyncha: Cyclorhagida), a new record from deep-sea sediments in the Gulf of Mexico.

Kinorhyncha is a phylum of exclusively marine, meiofaunal invertebrates (Sørensen Pardos 2008). Currently, the knowledge about the worldwide distribution of most of its species is considerably patchy, as several taxa have been reported from a single or few localities, usually within a limited geographic area (Sørensen Pardos 2008; Yamasaki et al. 2018a). This even becomes more evident for deep-sea kinorhynchs, as noticed by Sørensen et al. (2018). Given the particular value of new records from the deep-sea to increase our understanding in the distribution of meiofaunal organisms plus the observed relationship of morphological variation through the bathymetric gradient, we aim to report the first record of Echinoderes unispinosus Yamasaki, Neuhaus George, 2018 in the southern edge of the Gulf of Mexico (GoM), and contribute with new information about the morphological intraspecific variation of this species. In Mexico, studies of kinorhynch biodiversity are limited to the northern Gulf of California (50-1570m depth) (Álvarez-Castillo et al. 2015, 2018; Cepeda et al. 2019) and the Yucatán Peninsula (Sánchez Martínez 2019). The GoM is a semi-closed basin located in a transition zone with both subtropical and tropical weather. Deep-sea muddy sediment samples of the present study were collected during the expedition XIXIMI-5 (10-24 June 2016) and processed according to Cisterna-Céliz et al. (2019). Kinorhynch specimens were mounted, measured and photographed according to Cepeda et al. (2019). Two adult males were identified as E. unispinosus, one from station B11 (2298 m depth) and another from station B15 (3708m depth). Kinorhynch specimens were deposited at the Aquatic Invertebrates Collection of the Facultad de Ciencias, Universidad Nacional Autónoma de México (UNAM), Mexico, under accession numbers: KGM.001 and KGM.002.

Antifungal Activity of Ethanol-extracted Bixa orellana (L) (Achiote) on Candida albicans, at Six Different Concentrations.

AIM: The aim of the study was to determine the antifungal activity of six different concentrations of the ethanol extract of Bixa orellana (L) (Achiote) on the strains of Candida albicans (ATCC 90028). MATERIALS AND METHODS: The ethanol extract of Bixa orellana (L) (BEE) was prepared in six different concentrations (5%, 10%, 20%, 40%, 60%, and 100%), which were confronted with the positive control group (Nystatin 100,000 UI/mL). The total sample consisted of n = 174 wells inoculated with each concentration evaluated in the Petri dishes. The cultivation procedure was carried out at a temperature of 37°C, and then the 6 mm diameter wells on which the sowing of the Candida albicans in suspension was carried out. Subsequently, the BEE (Achiote) was inoculated in all the concentrations mentioned in the same way for Nystatin; finally, the inhibition halos were evaluated by the Kirby-Bauer method at the scheduled times of 24, 48, and 72 hours. RESULTS: The highest antifungal activity was found at 24 hours and this increased directly proportional to the concentration of BEE (5%, 10%, 20%, 40%, 60%, and 100%): 11 ± 0, 11 ± 0, 13.1 ± 1.3, 17.2 ± 0.8, 19.1 ± 1.0, and 21.4 ± 1.3 mm, respectively. However, there was no statistically significant difference when compared with Nystatin, at p > 0.05 Conclusion: It was shown that 5%, 10%, 20%, 40%, 60%, and 100% BEE had an antifungal effect against Candida albicans. However, there were no statistically significant differences against the effect of Nystatin at 100,000 IU/mL, who has an inhibitory effect greater than BEE, with a significance level of p < 0.05. CLINICAL SIGNIFICANCE: This article describes the antifungal activity and the possible impact on dentistry that the use of Bixa orellana (L) may have because according to our results it had an antifungal effect against strains of Candida albicans. This opens a great line of research to potentially use this natural resource in dentistry. How to cite this article: Poma-Castillo L, Espinoza-Poma M, Mauricio F, et al. Antifungal Activity of Ethanol-extracted Bixa orellana (L) (Achiote) on Candida albicans, at Six Different Concentrations. J Contemp Dent Pract 2019;20(10):1159-1163.

Interaction Promotes the Adaptation of Referential Conventions to the Communicative Context.

Coordination between speakers in dialogue requires balancing repetition and change, the old and the new. Interlocutors tend to reuse established forms, relying on communicative precedents. Yet linguistic interaction also necessitates adaptation to changing contexts or dynamic tasks, which might favor abandoning existing precedents in favor of better communicative alternatives. We explored this tension using a maze game task in which individual participants and interacting pairs had to describe figures and their positions in one of two possible maze types: a regular maze, in which the grid-like structure of the maze is highlighted, and an irregular maze, in which specific parts of the maze are salient. Participants repeated this task several times. Both individuals and interacting pairs were affected by the different maze layouts, initially using more idiosyncratic description schemes for irregular mazes and more systematic schemes for regular mazes. Interacting pairs, but not individuals, abandoned their unsystematic initial descriptions in favor of a more systematic approach, which was better adapted for repeated interaction. Our results show communicative conventions are initially shaped by context, but interaction opens up the possibility for change if better alternatives are available.

Central sleep apnea in children with obstructive sleep apnea syndrome and improvement following adenotonsillectomy.

BACKGROUND: Although the pathogenesis of central and obstructive events seems to be different, these two entities may somehow be related. We aimed to determine whether, as reported in previous research, the number of central sleep apnea (CSA) cases in a population of children with obstructive sleep apnea syndrome (OSAS) was greater than in patients without obstructive events, and if CSA worsens with increasing OSAS severity. As a second objective, we analyzed changes in central apnea index (CAI) after adenotonsillar surgery compared to changes when no surgery has been performed. METHODS: We retrospectively reviewed nocturnal polysomnography (PSG) data from children between 1 and 14 years of age with no neurological conditions or syndromes. Patients with CAI values greater than 5 per hour were diagnosed as having CSA. Improvements of greater than 50% in CAI on repeat PSG were considered to represent a real change. RESULTS: Data were available from 1279 PSG studies, resulting in 72 children with a CAI greater than 5 per hour (5.6%). Patients with OSAS showed a higher CAI (2.16) compared with those without OSAS (1.17), and this correlation increased with higher degrees of obstructive apnea severity. When adenotonsillectomy was performed due to OSAS, the CAI decreased by 1.37. The average decrease in PSG values was only 0.38 in cases where no surgery was performed. CONCLUSION: The results of this study suggest that although CSA is perceived to be mostly associated with central nervous system ventilatory control, there may be a connection with airway obstruction and in children with CSA and OSA diagnosis adenotonsillectomy may improve both conditions.

Chewing lice (Insecta: Phthiraptera) associated with vertebrates in Mexico.

The chewing lice (Insecta: Phthiraptera: Amblycera and Ischnocera) of Mexico have been little studied and many publications include isolated records. This paper summarizes current knowledge of chewing lice recorded from Mexico resulting from an exhaustive search of the literature published from 1866 to 2017. We found 342 louse species associated with 206 bird and 28 mammal species. As a result, we provide a checklist of the chewing lice recorded from Mexico, including a host-parasite list and their geographical distribution within the country.

Intervención en crisis: estrategia de enfermería para el afrontamiento de la vivencia dolorosa / Intervention in crisis: nursing strategy for coping with painful life

INTRODUCCIÓN: la enfermera, debido a su quehacer como profesional del cuidado, mantiene una cercanía mayor que el resto de los profesionales de salud con los usuarios que son sujetos de sus cuidados, muchos de los que experimentarán dolor en distintas intensidades. esta cercanía emplaza a las enfermeras en una ubicación estratégica para detectar el dolor precozmente e intervenir de manera oportuna, desde una mirada holística. el dolor como concepto se trata de un constructo universalmente conocido por todos los seres humanos, pero a la vez vivenciado por cada uno de nosotros de manera única e individual. sobre la vivencia dolorosa participan factores multidimensionales, más allá del biológico, destacando el componente emocional, del cual se ha investigado sobre su relación bidireccional con la sensación dolorosa. desde esta relación bidireccional, es que la vivencia dolorosa puede convertirse en una crisis situacional con consecuencias graves para la salud mental del individuo, la contención emocional que pueda realizar un profesional de enfermería a través de la intervención en crisis favorecerá el afrontamiento emocional más efectivo posible de la vivencia dolorosa. OBJETIVOS: realizar una revisión bibliográfica respecto a la aplicación de la intervención en crisis, como estrategia para la entrega de cuidados de enfermería dirigidos a usuarios portadores de dolor, considerando la estrecha relación existente entre el dolor y calidad de vida. MATERIAL Y MÉTODO: revisión bibliográfica de estudios sobre la participación de enfermería en pacientes que sufren dolor físico, de tipo agudo y/o crónico, a través de intervención en crisis, disponible y publicado en revistas chilenas e internacionales en idioma español o inglés. búsqueda bibliográfica de información publicada en bases de datos electrónicas nacionales e internacionales, que publican información científica nacional e internacional: Scopus, Enferteca y Google Académico. los descriptores en inglés y en español que se utilizaron en la búsqueda fueron: pain (dolor), nursing (enfermería), crisis intervention (intervención en crisis). para la búsqueda en español se utilizaron los siguientes descriptores: dolor, enfermería, intervención en crisis. RESULTADOS: una vez realizada la revisión bibliográfica, se confirma escasez de publicaciones vinculadas a la intervención en crisis con participación específica de profesionales de enfermería en personas que presentan dolor físico. se acepta que la preparación emocional previa, así como el acompañamiento emocional de quien sufre dolor, tienen impacto sobre la intensidad del dolor, sin embargo no es posible cuantificar. DISCUSIÓN: la intervención en crisis de enfermería tiene impacto sobre los factores psicológicos, emocionales y sociales asociados a la vivencia dolorosa. adquiere protagonismo la realización de una valoración de enfermería integral y multidimensional en el momento que la persona reporta dolor, con la finalidad de planificar cuidados integrales que aborden los factores determinantes de dolor identificados de una manera integral, tanto en la etapa de preparación, afrontamiento y posterior a la vivencia dolorosa. es necesario capacitar al profesional de enfermería en salud mental a través de técnicas de intervención, considerando que se constituye como el primero en la cadena de atención de la persona que sufre dolor.

INTRODUCTION: nurses, as professional caretakers, have a proportionally closer relation than other health professionals with the users who are subjected to their care, many of whom will experience pain of varying intensity. this closeness places nurses in a strategic position to detect pain precociously and intervene in a timely manner from a holistic viewpoint. as a concept, pain is a construct universally known by all human beings, but at the same time it is experienced by each of us in a unique and individual way. multidimensional factors participate in the pain experience, beyond the purely biological, with the emotional component standing out, with research being done on its bidirectional relation with the painful feeling. from this bidirectional relation the painful experience can turn into a situational crisis with serious consequences to the individual's mental health, so the emotional containment that a nursing professional can be realized through the crisis intervention will favor the most effective emotional handling of this painful experience. OBJECTIVES: to make a literature review on the application of crisis intervention as a strategy to deliver nursing care aimed at pain bearers, considering the close relation existing between the pain and the quality of life. MATERIAL AND METHODS: a literature review of studies published on nursing interventions by performing crisis interventions to take care of patients suffering acute and/or chronic physical pain, published in chilean and international journals in spanish or english language, available in national and international electronic data bases that publish national and international scientific information, like Scopus, Enferteca, and Academic Google. the descriptors that were used for the search were pain, nursing, and crisis intervention in english, and dolor, enfermería, and intervención en crisis in spanish. results: tthe literature review confirmed the scarcity of publications on crisis intervention with specific participation of nursing professionals in people presenting physical pain. it is accepted that the previous emotional training, as well as the emotional support of those suffering pain, have an impact on the intensity of pain, yet it cannot be quantified. DISCUSSION: nursing crisis intervention has an impact on the psychological, emotional, and social factors associated with a painful experience. making an integral and multidimensional nursing valuation at the time the person reports pain takes on a greater role, with the purpose of planning integral care that will deal with the factors determining the pain identified in an integral manner, in preparing, coping with, and following the painful experience. It is necessary to train the nurse in mental health through intervention techniques, considering that this professional becomes the first one in the attention chain of the person who suffers pain.

Correction: Socioeconomic Status Is Not Related with Facial Fluctuating Asymmetry: Evidence from Latin-American Populations.

[This corrects the article DOI: 10.1371/journal.pone.0169287.].

Socioeconomic Status Is Not Related with Facial Fluctuating Asymmetry: Evidence from Latin-American Populations.

The expression of facial asymmetries has been recurrently related with poverty and/or disadvantaged socioeconomic status. Departing from the developmental instability theory, previous approaches attempted to test the statistical relationship between the stress experienced by individuals grown in poor conditions and an increase in facial and corporal asymmetry. Here we aim to further evaluate such hypothesis on a large sample of admixed Latin Americans individuals by exploring if low socioeconomic status individuals tend to exhibit greater facial fluctuating asymmetry values. To do so, we implement Procrustes analysis of variance and Hierarchical Linear Modelling (HLM) to estimate potential associations between facial fluctuating asymmetry values and socioeconomic status. We report significant relationships between facial fluctuating asymmetry values and age, sex, and genetic ancestry, while socioeconomic status failed to exhibit any strong statistical relationship with facial asymmetry. These results are persistent after the effect of heterozygosity (a proxy for genetic ancestry) is controlled in the model. Our results indicate that, at least on the studied sample, there is no relationship between socioeconomic stress (as intended as low socioeconomic status) and facial asymmetries.

Revisión sistemática: cuidados de enfermería en personas portadoras de dolor fantasma de miembro amputado / Systematically review: nursing care in people with phantom pain of amputated limb

Introducción: actualmente, el envejecimiento poblacionaly la tendencia al aumento de las enfermedades crónicas notransmisibles dan cuenta de un contexto epidemiológico dondese espera que exista un aumento sostenido de las enfermedadesque constituyen las principales causas de amputación en adultosmayores de 50 años, dentro de las cuales se encuentra la diabetes.Objetivos: Realizar una revisión respecto de los cuidados yatención de Enfermería dirigida a los pacientes portadores dedolor tipo fantasma, considerando la estrecha relación existenteentre amputación y síndrome del miembro fantasma y suimpacto en la calidad de vida de las personas. Para los pacientesportadores de dolor tipo fantasma, la valoración de Enfermeríacobra relevancia para lograr un correcto abordaje, evaluación ytratamiento del dolor.Material y Método: Revisión sistemática sobre “Cuidados deEnfermería en personas portadoras de dolor tipo fantasma demiembro amputado”. La búsqueda de información fue realizadaen bases de datos Up To Date, Scopus, Pubmed, Proquest.Los descriptores en inglés y en español que se utilizaron enla búsqueda fueron: epidemiology (epidemiología), phantompain (dolor fantasma) y amputation (amputación). Para lacombinación de estos términos se utilizaron los conectoresbooleanos NOT, AND y OR (“pain”[MeSH Terms] OR “pain”[AllFields] OR “dolor”[All Fields]) AND fantasma [All Fields]. Para labúsqueda en español se utilizaron los siguientes descriptores:epidemiología, dolor fantasma y amputación.Resultados: Una vez realizada la búsqueda sistemática, seconfirma la importancia de la revisión de este tema, dado elcontexto epidemiológico actual, que demuestra un aumento dela prevalencia de enfermedades crónicas no transmisibles, comoprincipales causantes de amputación en adultos...

Introduction: currently, population aging and the trend ofincreasing of non transmissible chronic illnesses, accountfor an epidemiology that expects a sustained rising of thediseases as main causes of amputation of older adults agingup 50 years, including diabetes among them.Objectives: We made an appropriate review about thecares and nursing attention services addressed to patientswho carries a phantom pain, considering close relationshipbetween amputation and ghost pain syndrome and its peoplequality life impact. To the patients who carry the phantomtype pain, nursing assesment takes relevance to get a rightapproach, evaluation and pain treatment.Materials and Methods: Bibliographic reviews about“Nursing care in people with phantom pain of amputatedlimb”. The information research was elaborated from databases: Up to Date, Scopus, Medline, Pubmed, Proquest.The English and Spanish descriptors used on this researchwere: epidemiology (epidemiología), phantom pain (dolorfantasma), amputation (amputación). On the combinationof these terms were used Boolean connectors: NOT, AND,OR (“pain”[MeSH Terms] OR “pain”[All Fields] OR “dolor”[AllFields]) AND fantasma [All Fields]. On the Spanish researchwere used the following descriptors: epidemiology, phantompain and amputation.Results: Once the systematic search, the importance ofthe review of this topic given the current epidemiologicalcontext, demonstrating an increased prevalence of chronicnon-transmissible diseases, as the main cause of amputationin adults is confirmed...

Valoración de enfermería del dolor neuropático asociado a pie diabético en el paciente adulto mayor / Nursing evaluation of neuropathic pain related to diabetic foot in elderly pacients

En relación al contexto de la diabetes mellitus y el aumento de la población longeva es relevante estudiar el proceso de valoración del dolor neuropático asociado al síndrome del pie diabético en el adulto mayor desde todas sus multidimensiones, por su gran impacto en los sistemas de salud, laboral económico y calidad de vida de la persona. La valoración de Enfermería en este grupo humano cobra real importancia para lograr una correcta valoración, evaluación y tratamiento del dolor en las personas de edad avanzada que padecen este síndrome. Metodología: Revisión bibliográfica sobre “Valoración de Enfermería del dolor neuropático asociado a pie diabético en el paciente adulto mayor”. La búsqueda de información fue realizada en bases de datos Up To Date, Scopus, Medline, Envejecimiento en Red, Pubmed. Los descriptores en inglés y en español que se utilizaron en la búsqueda fueron: painful (dolor), pain (dolor), neuropathy (neuropatía), diabetic (diabetes), epidemiology (epidemiologia). Para la combinación de estos términos se utilizó los conectores booleanos NOT, AND y OR. Para la búsqueda en español se utilizaron los siguientes descriptores: epidemiologia, diabetes, Chile, dolor, percepción, envejecimiento, valoración, enfermeira...

Regarding to the context of diabetes mellitus and the increasingly aging population number, it is relevant to study the process of evaluation of neuropathic pain associated to the diabetic foot syndrome in elderly people from a multidimensional point of view, due to the great impact on health and working systems, and people`s quality of life. The nursing valuation in this human group has a great importance in order to achieve a correct evaluation, valuation, and treatment of the pain on the elderly people who suffer from this syndrome. Methodology: Bibliographic revision about “Nursing Evaluation of neuropathic pain related to diabetic foot in elderly patients”. The information research was elaborated from data bases: Up to Date, Scopus, Medline, Envejecimiento en Red, Pubmed. The English and Spanish descriptors used on this research were: painful (dolor), pain (dolor), neuropathy (neuropatía), diabetic (diabetes), epidemiology (epidemiología). On the combination of these terms were used Boolean connectors: NOT, AND, OR. On the Spanish research were used the following descriptors: epidemiology, diabetes, Chile, pain, perception, aging, valuation, and nursing...

Facial asymmetry and genetic ancestry in Latin American admixed populations.

Fluctuating and directional asymmetry are aspects of morphological variation widely used to infer environmental and genetic factors affecting facial phenotypes. However, the genetic basis and environmental determinants of both asymmetry types is far from being completely known. The analysis of facial asymmetries in admixed individuals can be of help to characterize the impact of a genome's heterozygosity on the developmental basis of both fluctuating and directional asymmetries. Here we characterize the association between genetic ancestry and individual asymmetry on a sample of Latin-American admixed populations. To do so, three-dimensional (3D) facial shape attributes were explored on a sample of 4,104 volunteers aged between 18 and 85 years. Individual ancestry and heterozygosity was estimated using more than 730,000 genome-wide markers. Multivariate techniques applied to geometric morphometric data were used to evaluate the magnitude and significance of directional and fluctuating asymmetry (FA), as well as correlations and multiple regressions aimed to estimate the relationship between facial FA scores and heterozygosity and a set of covariates. Results indicate that directional and FA are both significant, the former being the strongest expression of asymmetry in this sample. In addition, our analyses suggest that there are some specific patterns of facial asymmetries characterizing the different ancestry groups. Finally, we find that more heterozygous individuals exhibit lower levels of asymmetry. Our results highlight the importance of including ancestry-admixture estimators, especially when the analyses are aimed to compare levels of asymmetries on groups differing on socioeconomic levels, as a proxy to estimate developmental noise.

Evaluating microevolutionary models for the early settlement of the New World: the importance of recurrent gene flow with Asia.

Different scenarios attempting to describe the initial phases of the human dispersal from Asia into the New World have been proposed during the last two decades. However, some aspects concerning the population affinities among early and modern Asians and Native Americans remain controversial. Specifically, contradictory views based mainly on partial evidence such as skull morphology or molecular genetics have led to hypotheses such as the "Two Waves/Components" and "Single Wave" or "Out of Beringia" model, respectively. Alternatively, an integrative scenario considering both morphological and molecular variation has been proposed and named as the "Recurrent Gene Flow" hypothesis. This scenario considers a single origin for all the Native Americans, and local, within-continent evolution plus the persistence of contact among Circum-Arctic groups. Here we analyze 2D geometric morphometric data to evaluate the associations between observed craniometric distance matrix and different geographic design matrices reflecting distinct scenarios for the peopling of the New World using basic and partial Mantel tests. Additionally, we calculated the rate of morphological differentiation between Early and Late American samples under the different settlement scenarios and compared our findings to the predicted morphological differentiation under neutral conditions. Also, we incorporated in our analyses some variants of the classical Single Wave and Two Waves models as well as the Recurrent Gene Flow model. Our results suggest a better explanatory performance of the Recurrent Gene Flow model, and provide additional insights concerning affinities among Asian and Native American Circum-Arctic groups.