Effects of active exergames on physical performance in older people: an overview of systematic reviews and meta-analysis.

This overview assessed the available body of published peer-reviewed systematic reviews and meta-analyses related to the effects of active exergames compared with active/passive control on physical performance outcomes in older people. The methodological quality and certainty of evidence were assessed using PRISMA, AMSTAR 2, and GRADE. The protocol was registered in PROSPERO (code: CRD42023391694). The main outcomes indicate that 4,477 records, five systematic reviews, and 10 meta-analyses were included. The AMSTAR-2 reported six meta-analyses with high methodological quality, four moderate quality, two systematic reviews with low quality, and three very-low quality. Meta-analysis was performed on balance using the Berg Balance Scale (BBS) and Timed Up-and-Go (TUG) tests, on cardiorespiratory fitness using the 6-min walk test, and on upper and lower limbs muscle strength using the handgrip strength, knee extension, and 30-s chair stand tests. Significant differences in favor of the active exergames groups concerning active/passive groups were reported in BBS (SMD = 0.85; 95% CI = 0.12-1.58; I2 = 96%; p = 0.02), TUG (SMD = 1.44; 95% CI = 0.71-2.16; I2 = 97%; p < 0.0001), and 30-s chair stand test (SMD = 0.79; 95% CI = 0.33-1.25; I2 = 88%; p = 0.0008). However, no significant differences were reported in favor of the active exergames groups in 6-min walk (SMD = 0.93; 95% CI = -0.64 to 2.50; I2 = 95%; p = 0.24), handgrip strength (SMD = 0.67; 95% CI = -0.04 to 1.38; I2 = 84%; p = 0.06), and knee extension tests (SMD = 0.20; 95% CI = -0.05 to 0.44; I2 = 95%; p = 0.12) compared to active/passive control. However, it was impossible to perform a meta-analysis for the variables of walking speed as a fall risk due to the diversity of instruments and the small number of systematic reviews with meta-analysis. In conclusion, interventions utilizing active exergames have shown significant improvements in the static and dynamic balance and lower limb muscle strength of apparently healthy older people, compared to control groups of active/inactive participants, as measured by BBS, TUG, and 30-s chair stand tests. However, no significant differences were found in the 6-min walk, HGS, and knee extension tests. Systematic review registration: PROSPERO, CRD42023391694.

Political participation among deaf youth in Great Britain.

Variations in political participation are linked to demographic factors, socioeconomic disparities, and cultural-ethnic diversity. Existing research has primarily explored reduced political involvement among individuals with disabilities, particularly in electoral politics. However, little research has attended the involvement of deaf people specifically. This is of interest because deaf youth are at an intersection of disability, language and cultural identity with their language affiliations and rejection or acceptance of disability evolving through childhood. This study draws from original data collected via an online survey, comprising 163 deaf young respondents aged 16-19 in Great Britain. We compare their levels of political participation with those of general population peers to explore how sociodemographic factors, alongside variations in self-identification as deaf, and meaningful interactions with other deaf people contribute to explain their political engagement. The results challenge conventional wisdom by demonstrating that deaf youth participate more actively in politics than their hearing peers in various forms of political involvement, including collective, contact, and institutional activism. We also recognize differences among deaf youth and propose that social aspects of identity formation, particularly embracing a deaf identity and having deaf friends, can boost certain forms of political engagement. In summary, this study underscores the importance of acknowledging the diversity of deaf youth in terms of affiliation with various forms of deaf identity, rendering their experience different from both disabled and hearing youth. By identifying the factors driving heightened political participation, policymakers and advocates can develop strategies to enhance political engagement among all young people, regardless of their hearing status.

Impact of persistent barrier to gene flow and catastrophic events on red algae evolutionary history along the Chilean coast.

Historical vicariance events, linked to the existence of stable physical barriers to gene flow, generate concordant genetic breaks in co-distributed species while stochastic processes (e.g., costal uplift) could cause species-specific genetic breaks as a result of local strong demographic bottlenecks or extinction. In Chile, previous studies show that the area of the 30°S-33°S could correspond to a stable barrier to gene flow that have affected the genetic structure of various algae and marine invertebrates. Here we sequenced two organellar genes (COI and rbcL) in four taxonomically accepted co-distributed red seaweeds species characterized by a low dispersal potential: Mazzaella laminarioides, M. membranacea, Asterfilopsis disciplinalis, and Ahnfeltiopsis vermicularis. Our results revealed the existence of ten strongly differentiated linages in the taxa studied. Strong genetic breaks, concordant in both space and time (divergence estimated to have occurred some 2.9-12.4 million years ago), were observed between taxa distributed across the 33°S. Conversely, in the Central/South part of the Chilean coast, the localization of the genetic breaks/sub-structure observed varied widely (36°S, 38°S, 39°S, and 40°S). These results suggest that a major historical vicariance event has modeled the genetic structure of several Chilean marine organisms in the north of the Chilean coast during the mid-Miocene, while more recent stochastic events and genetic drift could be the driving forces of genetic divergence/structuration in the central-southern part of the coast.

A Phase I Dose-Escalation Clinical Trial to Assess the Safety and Efficacy of Umbilical Cord-Derived Mesenchymal Stromal Cells in Knee Osteoarthritis.

Osteoarthritis (OA) is the most common degenerative joint disease. Mesenchymal stromal cells (MSC) are promising cell-based therapy for OA. However, there is still a need for additional randomized, dose-dependent studies to determine the optimal dose and tissue source of MSC for improved clinical outcomes. Here, we performed a dose-dependant evaluation of umbilical cord (UC)-derived MSC (Celllistem) in a murine model and in knee OA patients. For the preclinical study, a classical dose (200.000 cells) and a lower dose (50.000 cells) of Cellistem were intra-articularly injected into the mice knee joints. The results showed a dose efficacy response effect of Cellistem associated with a decreased inflammatory and degenerative response according to the Pritzker OARSI score. Following the same approach, the dose-escalation phase I clinical trial design included 3 sequential cohorts: low-dose group (2 × 106 cells), medium-dose group (20 × 106), and high-dose group (80 × 106). All the doses were safe, and no serious adverse events were reported. Nonetheless, 100% of the patients injected with the high-dose experienced injection-related swelling in the knee joint. According to WOMAC total outcomes, patients treated with all doses reported significant improvements in pain and function compared with baseline after 3 and 6 months. However, the improvements were higher in patients treated with both medium and low dose as compared to high dose. Therefore, our data demonstrate that the intra-articular injection of different doses of Cellistem is both safe and efficient, making it an interesting therapeutic alternative to treat mild and symptomatic knee OA patients. Trial registration ClinicalTrials.gov NCT03810521.

Effects of combat sports on cognitive function in older people: a systematic review.

INTRODUCTION: This systematic review aimed to analyze the available body of published peer-reviewed studies on the effects of combat sports compared with active/passive control on cognitive function and electrophysiological markers of brain activity in older people. EVIDENCE ACQUISITION: The studies were searched in Scopus, Web of Science, PubMed, MEDLINE, and PsycINFO databases from deadline to June 2023. The PRISMA, TESTEX, RoB, and GRADE scales assessed the evidence's methodological quality and certainty of evidence. The protocol was registered in PROSPERO (code: CRD42022361695). EVIDENCE SYNTHESIS: After reviewing 3768 studies, seven combat sports interventions (score ≥60% in methodological quality) were selected, composed of 381 older people (63% female), with a mean age of 66 years. In the selected studies, interventions based on judo, karate, and taekwondo were carried out, where it was not possible to verify the benefits of combat sports in cognitive function and electrophysiological markers of brain activity regarding active/passive control groups, although the individual results of the analyzed studies indicate that the practice of combat sports favor selective attention, divided attention, executive function, visual perception, and cognitive processing speed in older people. CONCLUSIONS: The available evidence does not allow a definite recommendation regarding combat sports as an effective cognitive function intervention in older people.

Effects of Olympic Combat Sports on Cardiorespiratory Fitness in Non-Athlete Population: A Systematic Review of Randomized Controlled Trials.

This systematic review aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports (OCS) on cardiorespiratory fitness (CRF) in the non-athlete population. The methodological quality and certainty of evidence were evaluated using PRISMA, TESTEX, RoB, and GRADE scales. The protocol was registered in PROSPERO (code: CRD42023391433). From 4133 records, six randomized controlled trials were included, involving 855 non-athletes (mean age = 27.2 years old). The TESTEX scale reported all studies with a ≥ 60% (moderate-high quality) score. The GRADE scale indicated moderate to low certainty of evidence. It was only possible to perform a meta-analysis on direct methods to maximum oxygen consumption (VO2max). The main results indicated significant differences in favor of OCS compared to active/passive controls in VO2max (SMD = 4.61; 95%CI = 1.46 to 7.76; I2 = 99%; p = 0.004), while the individual results of the studies reported significant improvements in favor of the OCS on the indirect methods of the CRF. OCS improved CRF in a healthy non-athlete population of different ages, specifically showing a significant improvement in VO2max with direct tests, such as cardiopulmonary tests. However, moderate to low certainty of evidence is reported, so no definitive recommendations can be established.

[Pancreatic lipomatous hamartoma: A case report and literature review]. / Hamartoma lipomatoso pancreático: Reporte de caso y revisión de la literatura.

Pancreatic hamartomas (PH) are extremely unusual non-neoplastic tumor-like lesions and accounts for <1% of all hamartomas. Moreover, there is a distinct variant of PH denominated Pancreatic lipomatous hamartoma (PLH), that is even rarer, with only 5 cases, including the present case, reported in the literature. PLH lacks well-defined features and clinically can be mistaken with other lipomatous lesions of the pancreas, including lipoma, pancreatic lipomatosis, PEComa, liposarcoma, and malignant tumors with lipomatous components. Here, we describe a case of PLH in a 70-year-old male with abdominal pain and a lesion, which was preoperatively diagnosed as a pancreatic no functional low-grade neuroendocrine tumor, and subsequent underwent a laparoscopic enucleation of the tumor. The postoperative pathology and immunohistochemical analyses confirmed the diagnosis of PLH.

Hamartoma lipomatoso pancreático: Reporte de caso y revisión de la literatura

Los hamartomas pancreáticos (HP) son lesiones no neoplásicas extremadamente inusuales y representan < 1% de todos los hamartomas. Además, existe una variante distintiva denominada Hamartoma Lipomatoso Pancreático (HLP), que es aún más raro, con solo 5 casos, incluyendo el presente reporte, descritos en la literatura. HLP carecen de características específicas y clínicamente puede ser confundido con otras lesiones lipomatosas pancreáticas, como lipoma, lipomatosis pancreática, PEComa, liposarcoma y tumores malignos con componentes lipomatosos. El presente reporte describe un caso de HLP en un paciente varón de 70 años, que aquejaba de dolor y masa abdominal, preoperatoriamente diagnosticado como tumor neuroendocrino de bajo grado no funcionante pancreático. Subsecuentemente, fue sometido a enucleación laparoscópica del tumor. El reporte patológico postoperatorio y los estudios de inmunohistoquímica confirmaron el diagnóstico de HLP.

Pancreatic hamartomas (PH) are extremely unusual non-neoplastic tumor-like lesions and accounts for <1% of all hamartomas. Moreover, there is a distinct variant of PH denominated Pancreatic lipomatous hamartoma (PLH), that is even rarer, with only 5 cases, including the present case, reported in the literature. PLH lacks well-defined features and clinically can be mistaken with other lipomatous lesions of the pancreas, including lipoma, pancreatic lipomatosis, PEComa, liposarcoma, and malignant tumors with lipomatous components. Here, we describe a case of PLH in a 70-year-old male with abdominal pain and a lesion, which was preoperatively diagnosed as a pancreatic no functional low-grade neuroendocrine tumor, and subsequent underwent a laparoscopic enucleation of the tumor. The postoperative pathology and immunohistochemical analyses confirmed the diagnosis of PLH.

Introducing the READY Study: DHH Young people's Well-Being and Self-Determination.

READY is a self-report prospective longitudinal study of deaf and hard of hearing (DHH) young people aged 16 to 19 years on entry. Its overarching aim is to explore the risk and protective factors for successful transition to adulthood. This article introduces the cohort of 163 DHH young people, background characteristics and study design. Focusing on self-determination and subjective well-being only, those who completed the assessments in written English (n = 133) score significantly lower than general population comparators. Sociodemographic variables explain very little of the variance in well-being scores; higher levels of self-determination are a predictor of higher levels of well-being, outweighing the influence of any background characteristics. Although women and those who are LGBTQ+ have statistically significantly lower well-being scores, these aspects of their identity are not predictive risk factors. These results add to the case for self-determination interventions to support better well-being amongst DHH young people.

Safety and efficacy of clinical-grade, cryopreserved menstrual blood mesenchymal stromal cells in experimental acute respiratory distress syndrome.

Background: Treatment for critical care conditions, such as acute respiratory distress syndrome (ARDS), requires ready-to-administer injectable mesenchymal stromal cells (MSCs). A validated cryopreserved therapy based on MSCs derived from menstrual blood (MenSCs) is an attractive option that offers advantages over freshly cultured cells and allows its use as an off-the-shelf therapy in acute clinical conditions. The main goal of this study is to provide evidence on the impact of cryopreservation on different biological functions of MenSCs and to determine the optimal therapeutic dose, safety, and efficacy profile of clinical-grade, cryopreserved (cryo)-MenSCs in experimental ARDS. Methods: Biological functions of fresh versus cryo-MenSCs were compared in vitro. The effects of cryo-MenSCs therapy were evaluated in vivo in ARDS-induced (Escherichia coli lipopolysaccharide) C57BL/6 mice. After 24 h, the animals were treated with five doses ranging from 0.25×105 to 1.25×106 cells/animal. At 2 and 7 days after induction of ARDS, safety and efficacy were evaluated. Results: Clinical-grade cryo-MenSCs injections improved lung mechanics and reduced alveolar collapse, tissue cellularity, and remodelling, decreasing elastic and collagen fiber content in alveolar septa. In addition, administration of these cells modulated inflammatory mediators and promoted pro-angiogenic and anti-apoptotic effects in lung-injured animals. More beneficial effects were observed with an optimal dose of 4×106 cells/Kg than with higher or lower doses. Conclusion: From a translational perspective, the results showed that clinical-grade cryopreserved MenSCs retain their biological properties and exert a therapeutic effect in mild to moderate experimental ARDS. The optimal therapeutic dose was well-tolerated, safe, and effective, favouring improved lung function. These findings support the potential value of an off-the-shelf MenSCs-based product as a promising therapeutic strategy for treating ARDS.

The impact of Pleistocene glaciations and environmental gradients on the genetic structure of Embothrium coccineum.

The South American temperate forests were subjected to drastic topographic and climatic changes during the Pliocene-Pleistocene as a consequence of the Andean orogeny and glacial cycles. Such changes are common drivers of genetic structure and adaptation. Embothrium coccineum (Proteaceae) is an emblematic tree of the South American temperate forest (around 20°S of latitude) that has strongly been affected by topographic and climatic events. Previous studies have shown a marked genetic structure in this species, and distinct ecotypes have been described. Yet, little is known about their adaptive genetic responses. The main goal of this study was to investigate the effects of historical and contemporary landscape features affecting the genetic diversity and connectivity of E. coccineum throughout its current natural distribution. Using over 2000 single nucleotide polymorphisms (SNPs), we identified two genetic groups (a Northern and a Central-Southern group) that diverged around 2.8 million years ago. The level of genetic structure was higher among populations within the Northern genetic group than within the Central-Southern group. We propose that these differences in genetic structure may be due to differences in the assemblages of pollinators and in the evolutionary histories of the two genetic groups. Moreover, the data displayed a strong pattern of isolation by the environment in E. coccineum, suggesting that selection could have led to adaptive divergence among localities. We propose that in the Chilean temperate forest, the patterns of genetic variation in E. coccineum reflect both a Quaternary phylogenetic imprint and signatures of selection as a consequence of a strong environmental gradient.

Brechas en telemedicina: caracterización de consultas ambulatorias a teledermatología en Chile entre 2018-2020 / Gaps in telemedicine: characterization of ambulatory teledermatology consultations in Chile, between 2018 and 2020

Introducción: La teledermatología (TD) se ha desarrollado de manera importante en los últimos años. Además de mejorar el acceso de la población a consultas médicas, permite el diagnóstico precoz de lesiones complejas. En Chile, la TD forma parte de la plataforma Hospital Digital del Ministerio de Salud desde el 2018, en modalidad asincrónica. El objetivo de este estudio es la caracterización epidemiológica de las consultas ambulatorias a TD en Chile entre los años 2018-2020. Materiales y Métodos: Estudio descriptivo retrospectivo. Se analizaron las consultas ambulatorias a TD y a dermatología en el período 2018-2020, a partir de los datos del Departamento de Estadísticas e Información de Salud, y los datos de población total a partir del Instituto Nacional de Estadísticas, por lo que no se requirió comité de ética. Resultados: Del total de teleconsultas realizadas entre 2018-2020, un 14,2% correspondió a TD. De ellas, el 86,1% corresponden a consultas nuevas, y el 13,9% a controles. Del total de pacientes, el 63,0% fueron mujeres, mientras que el 78,9% fueron mayores de 15 años. Se realizaron 20,35 consultas a TD por cada 10.000 habitantes a nivel nacional, y 17,21 consultas dermatológicas por cada consulta a TD. Discusión: La TD es una de las principales aplicaciones de la telemedicina en Chile. La variación entre las regiones con respecto al número de consultas a TD podría deberse a factores que requieren mayor estudio. Es probable que la TD mantenga un rol creciente debido al desarrollo tecnológico y los beneficios demostrados de esta herramienta.

Introduction: Teledermatology (TD) has greatly developed in recent years. Besides improving access to medical consultations, it also allows the early diagnosis of complex lesions. In Chile, TD forms part of the Digital Hospital platform of the Ministry of Health since 2018, in a store-and-forward form. The objective of this study is to characterize ambulatory consultations with TD in Chile between 2018 and 2020. Materials and Methods: A retrospective descriptive study was performed. Ambulatory consultations with TD and dermatology between 2018-2020 were analyzed from data obtained from the Department of Statistics and Health Information, and population data were obtained from the Statistics National Institute, which did not require ethical approval. Results: Of the total teleconsultations made in the 2018-2020 period, 14.2% belonged to TD. From that, 86.1% were new consultations, and 13.9% were controls. Women represented 63.0% of the patients, while 78.9% were older than 15 years old. For every 10,000 inhabitants, 20.35 total consultations were made with TD nationwide, and 17.21 dermatological consultations were made for each consultation with TD. Discussion: TD is one of the main applications of telemedicine in Chile. The variation in the number of consultations with TD between regions could be caused by factors that require further study. It is likely that TD will keep a growing role due to technological development and benefits shown by this tool.

Narcotraficantes en Chile. Análisis estadístico-descriptivo de sujetos detenidos por tráfico de drogas durante el periodo 2017-2021 / Drug traffickers in Chile. Statistical-descriptive analysis of subjects arrested for drug trafficking during the period 2017-2021 / Os traficantes de drogas no Chile. Análise estatística-descritiva dos sujeitos presos por tráfico de drogas durante o período 2017-2021

Desde tiempos remotos, la conducta delictiva ha sido una de las principales preocupaciones de la sociedad. En particular, el narcotráfico ha movilizado a las instituciones del Estado y también a investigadores provenientes de distintas áreas del saber; pese a ello ­en Chile­ esta manifestación del crimen organizado ha sido un fenómeno poco abordado y con escasa evidencia científica. Mediante el lenguaje de programación R se realizó un estudio estadístico descriptivo dirigido a caracterizar el perfil actual del narcotraficante en Chile, a partir de los factores sociocriminógenos presentes en una muestra de 28 397 sujetos, quienes fueron detenidos por tráfico de drogas durante el periodo 2017­2021. Los resultados obtenidos dan cuenta de la inexistencia de un perfil único, sin embargo, se estableció que se trata ­mayoritariamente­ de un hombre adulto, de estado civil soltero, que promedia los 32.5 años, sin un trabajo u oficio formal, con antecedentes policiales y una carrera delictiva caracterizada por la versatilidad criminal. También se discutió el rol de los extranjeros, las mujeres y los adolescentes dentro del narcotráfico, pues, aun cuando su frecuencia estadística es mayor que en otros delitos, su participación dentro de la estructura criminal sigue limitándose a los eslabones más bajos de la organización.

Since ancient times, criminal behavior has been one of society's main concerns. In particular, drug trafficking has mobilized state institutions and researchers from different areas of knowledge; however, in Chile, this manifestation of organized crime has been a phenomenon that has been little addressed and with little scientific evidence. Using the R programming language, a descriptive statistical study was conducted aimed at characterizing the current profile of the drug trafficker in Chile, based on the sociocriminogenic factors present in a sample of 28 397 subjects, who were arrested for drug trafficking during the period 2017-2021. The results obtained show the inexistence of a unique profile, however, it was established that it is -mostly- an adult male, of single marital status, averaging 32.5 years of age, without a formal job or trade, with a police record and a criminal career characterized by criminal versatility. The role of foreigners, women and adolescents in drug trafficking was also discussed, since, although their statistical frequency is higher than in other crimes, their participation in the criminal structure continues to be limited to the lowest links in the organization.

Desde os tempos antigos, o comportamento criminoso tem sido uma das principais preocupações da sociedade. Em particular, o tráfico de drogas mobilizou instituições estatais e pesquisadores de diferentes áreas do conhecimento; entretanto, no Chile, esta manifestação do crime organizado tem sido um fenômeno pouco abordado e com poucas evidências científicas. Usando a linguagem de programação R, foi realizado um estudo estatístico descritivo para caracterizar o perfil atual do traficante de drogas no Chile, baseado nos fatores sócio-criminógenos presentes em uma amostra de 28.397 indivíduos que foram presos por tráfico de drogas durante o período 2017-2021. Os resultados obtidos mostram que não existe um perfil único, no entanto, foi estabelecido que se trata principalmente de um homem adulto, solteiro, com idade média de 32,5 anos, sem um emprego ou ocupação formal, com antecedentes criminais e uma carreira criminosa caracterizada pela versatilidade criminal. O papel dos estrangeiros, mulheres e adolescentes no tráfico de drogas também foi discutido, pois, embora sua freqüência estatística seja maior do que em outros crimes, sua participação na estrutura criminal ainda está limitada aos elos mais baixos da organização.

Experiencias educativas con la tutoría par en el bachillerato: reflexiones sobre la contingencia sanitaria COVID-19 / Educational Experiences with Peer Tutoring in High School: Reflections on the COVID-19 Health Contingency

A continuación, se presenta una indagación sobre la puesta en marcha de la tutoría entre pares en el Colegio de Bachilleres del Estado de Sinaloa a lo largo del ciclo escolar 2019-2020, con el objeto de describir su impacto en la Educación Media Superior. No obstante, además de explorar este fenómeno dentro de la modalidad presencial, se hacen algunas reflexiones respecto a su influencia en contextos adversos y emergentes como lo fue la pandemia del COVID-19. Esta investigación tuvo como objetivo general valorar el impacto del programa institucional Tutoría Par en la experiencia educativa de los educandos en contextos de educación formal e informal como la cuarentena provocada por la contingencia sanitaria del coronavirus. Los participantes del estudio fueron estudiantes de primer y segundo grado de bachillerato y docentes adscritos al plantel que lleva de nombre COBAES 60 “Profra. Jesusita Neda”. Se siguió un enfoque de investigación cualitativa bajo el método de la fenomenología; en este respecto, se aplicaron tres cuestionarios en línea y se realizaron registros de observación participante a lo largo del ciclo escolar. Los resultados arrojaron que la estrategia de aprendizaje conocida como tutoría par impacta positivamente en la experiencia, aprovechamiento académico, aprendizaje, e inclusión en la mayoría de los alumnos de nivel medio superior; sin embargo, se necesitan mejorar tanto los procesos para el funcionamiento del programa como el compromiso y comunicación entre los actores principales de la acción tutorial. Entre las conclusiones, se destaca que la mejora de habilidades pedagógicas, de acompañamiento, y el fomento de la confianza son factores sustanciales que optimizan la experiencia educativa de los educandos en la actividad tutorial.(AU)

Next, an inquiry is presented about the implementation of peer tutoring in the Colegio de Bachilleres del Estado de Sinaloa throughout the 2019-2020 school year, in order to describe its impact on High School Education. However, in addition to exploring this phenomenon within the face-to-face modality, some reflections are made regarding its influence in adverse and emerging contexts such as the COVID-19 pandemic. The main objective of this research was to value the impact of the Peer Tutoring institutional program on the educational experience of learners in contexts of formal and informal education such as the quarantine caused by the coronavirus health contingency. The study participants were first, and second grade students and teachers from the high school with the name of COBAES 60 “Profra. Jesusita Neda”. A qualitative research approach was followed under the method of phenomenology; in this regard, three online questionnaires were applied, and participant observation records were made throughout the school year. The results showed that the learning strategy known as peer tutoring has a positive impact on the experience, academic achievement, learning, and inclusion in the majority of high school students; nevertheless, both the processes for the operation of the program and the commitment and communication between the main actors of the tutorial action need to be improved. Among the conclusions, it is highlighted that the improvement of pedagogical skills, support, and the promotion of confidence are substantial factors that optimize the educational experience of the learners in the tutorial activity.(AU)

Clinicopathological factors associated with the presence of tumor deposits in resected gastric cancer patients.

PURPOSE: The role of tumor deposits (TDs) in the staging of gastric cancer is currently debatable. TDs are defined as tumoral nodules in perigastric adipose tissue with no evidence of lymphatic, vascular, or neural structures. Clinicopathological factors related to the presence of TDs are not well defined. This study aimed to identify the clinicopathological factors associated with the presence of TDs in resected gastric cancer patients. MATERIALS AND METHODS: This prospective study included patients diagnosed with gastric cancer and treated with D2 radical gastrectomy from January 2019 to January 2020. Univariate and multivariate analyses were performed to determine the factors related to the presence of TDs. RESULTS: A total of 111 patients were eligible and TDs were present in 31 of them (28%). In the univariate analysis, male gender (p = 0.027), tumor size ≥ 5cm (p = ≤0.001), serosa and adjacent organs invasion (pT4a and pT4b) (p = ≤0.001), ≥16 metastatic lymph nodes (pN3b) (p = ≤0.001), and TNM stage III tumors (p = ≤0.001) were significantly associated with the presence of TDs. The multivariate analysis showed that a tumors size ≥5 cm (OR = 3.69, 95% CI: 1.17-11.6), serosa and adjacent organs invasion (pT4a and pT4b) (OR = 3.78, 95% CI: 1.31-10.86) and ≥16 metastatic lymph nodes (pN3b) (OR = 3.21, 95%CI:1.06-9.7) were independent risk factors for the presence of TDs. CONCLUSIONS: Larger tumors (tumor size ≥ 5cm), serosa and adjacent organs invasion (pT4 and pT4b), and ≥16 metastatic lymph nodes (pN3b) were independent risk factors for the presence of TDs.

Recuperación mejorada después de cirugía en cáncer colorrectal. Instituto Nacional de Enfermedades Neoplásicas / Enhanced recovery after surgery in colorectal cancer. Instituto Nacional de Enfermedades Neoplásicas

RESUMEN Objetivo : Describir y analizar la seguridad de la aplicación del programa de "Recuperación Mejorada Después de Cirugía" (ERAS) para cirugía electiva por cáncer colorrectal. Materiales y Métodos : Estudio observacional retrospectivo de 272 pacientes con cáncer colorrectal operados con cirugía electiva entre enero 2019 y setiembre 2020 en el Instituto Nacional de Enfermedades Neoplásicas, Perú. Se utilizó la Prueba U de Mann-Whitney, Chi-cuadrado de Pearson, y odds ratios (OR) para el análisis estadístico. Resultados : 90 pacientes ingresaron al programa ERAS con una mediana de estancia hospitalaria postoperatoria de 3 días (rango 3-19). La cirugía laparoscópica se realizó en el 53 % de los casos, con una estancia hospitalaria significativamente menor que los pacientes con cirugía convencional (p=0,035). El inicio de la tolerancia oral < 24 horas se realizó en el 91 % de casos y la deambulación temprana en 89 %. La incidencia de complicaciones postoperatorias fue de 29 %, mayor en los pacientes con resección de recto/ano que en el grupo con resección de colon (40 % vs 20 %, p=0,043) (OR=2,67, IC del 95 %: 1,02 - 7,01). Ocho pacientes presentaron complicación mayor, 4 con dehiscencia de anastomosis y 4 requirieron readmisión hospitalaria. Conclusiones : El manejo según ERAS para cirugía electiva por cáncer colorrectal es seguro y factible con un riesgo de morbimortalidad perioperatoria aceptable.

ABSTRACT Aim : Describe and analyze the safety of the "Enhanced Recovery After Surgery" (ERAS) protocol in elective procedures for colorectal cancer. Materials and Methods : Observational study of 272 patients with colorectal cancer who underwent elective surgery from January 2019 to September 2020 at the "Instituto Nacional de Enfermedades Neoplásicas", Peru, were retrospectively collected. U Mann-Whitney test, Pearson chi-square test and odds ratios (OR) were used for statistical analysis. Results : 90 patients were included in the ERAS program with a median postoperative hospital stay of 3 days (range 3-19). Laparoscopic surgery was performed in 53% of the patients with significantly shorter postoperative hospital stay in comparison with the patients who had open surgery (p=0,035). Oral food intake less than 24 hours postoperatively was 91%, and early mobilization in 89% of the cases. The postoperative complication rate was 29%, higher in rectal/anus resection than in colonic resections (40% vs 20%, p=0,043) (OR=2,67, CI 95%: 1,02 - 7,01). Eight patients had a major postoperative complication, four with anastomotic leakage and four required hospital readmission. Conclusions : The perioperative management of ERAS program for colorectal cancer in elective surgery is safe and feasible with acceptable morbimortality risk.

Soluble neuropilin-1 in gingival crevicular fluid is associated with rheumatoid arthritis: An exploratory case-control study.

BACKGROUND: To explore the soluble Neuropilin-1 (sNRP-1) concentrations in gingival crevicular fluid (GCF) and the periodontal clinical status of patients with Rheumatoid Arthritis (RA). MATERIALS AND METHODS: We conducted an exploratory study with 40 study participants, 20 with RA, and 20 healthy controls. Clinical and periodontal data were recorded, and GCF samples were obtained. sNRP-1 levels in GCF were determined by ELISA assay. Descriptive statistics, Mann-Whitney U test, Unpaired t-test, logistic regression model, and Area Under Receiver Operating Characteristic Curve (AUC-ROC) were made to explore the diagnostic performance accuracy. RESULTS: RA patients had significantly higher levels of sNRP-1 in GCF (p â€‹= â€‹0.0447). The median levels of GCF-sNRP-1 were 208.85 â€‹pg/µl (IQR 131.03) in the RA group compared to 81.46 â€‹pg/µl (IQR 163.73) in the control group. We observed an association between the GCF-sNRP-1 concentrations and the RA diagnosis (OR:1.009; CI 1.00-1.001; p â€‹= â€‹0.047). The diagnosis of chronic periodontitis was also associated with RA (OR: 6.9; CI 1.52-31.37; p â€‹= â€‹0.012). Moreover, the AUC-ROC of GCF-sNRP-1 concentrations combined with periodontal clinical parameters such as periodontal probing depth and periodontal inflamed surface area was 0.80. CONCLUSION: This exploratory case-control study shows that RA patients had significantly higher levels of sNRP-1 in GCF. New longitudinal studies are necessary to evaluate the role of NRP-1 in periodontal tissues and consider it an oral biomarker with clinical value in RA.

Preoperative Predictors for 90-Day Mortality after Pancreaticoduodenectomy in Patients with Adenocarcinoma of the Ampulla of Vater: A Single-Centre Retrospective Cohort Study.

BACKGROUND: The standard treatment for ampullary adenocarcinoma is pancreaticoduodenectomy. Identification of preoperative risk factors might help the clinician to select patients fit for resection and potentially decrease morbidity and mortality after PD. We conducted a cohort study to determine the preoperative factors related to 90-day severe morbidity and mortality after PD. METHODS: We conducted a retrospective cohort study in patients with a diagnosis of ampullary adenocarcinoma who underwent an open PD between January 2010 and December 2019 at our tertiary centre. RESULTS: Independent preoperative predictors of mortality were the albumin-bilirubin (ALBI) grade 3 (OR: 21.7; CI 95: 2.1-226.9; p=0.01) and the estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 (OR: 17.7; CI 95: 1.8-172.6; p=0.013). The eGFR <90 mL/min/1.73 m2 (OR = 6.6; CI 95: 1.9-23.4; p=0.003) and prothrombin time (OR = 1.5; CI 95; 1.1-2.1; p=0.005) were independent predictors for severe morbidity. CONCLUSION: These findings suggest that baseline renal function measured by the eGFR and liver function categorized with the ALBI grading are predictors of severe morbidity and mortality. Thus, they should be considered when selecting patients for PD or the use of neoadjuvant treatments. Further research is warranted.

TransAnal Total Mesorectal Excision (TaTME) in Peru: Case series.

INTRODUCTION: Describe and demonstrate the feasibility and safety of TaTME in short term outcomes in the Instituto Nacional de Enfermedades Neoplásicas (INEN) in Peru. MATERIALS AND METHODS: Case series with retrospective and prospective data collection of patients with middle and inferior rectal cancer who underwent TaTME between January 2015 and March 2020. Patients and tumor characteristics, operative details, postoperative complications and pathological results were analyzed. RESULTS: Nineteen patients were included. The median age was 56 years old (range 40-69). Ten were female. The median distance from the anal verge was 4 cm (range 3-6) and 17 cases were located in the inferior rectum. Eleven patients with clinical stage III. Thirteen (68.4%) patients received neoadjuvant treatment. There was no conversion to open surgery reported. Ten (52.6%) cases had intersphincteric resection and 18 (94.7%) had primary coloanal anastomosis, 13 (72.2%) of them with hand-sewn. All patients had a diversion with ileostomy. The median operative time was 330 min (range 270-480). Median postoperative hospital stay of 5 days (range 3-18). The overall rate of postoperative complication was 21.1%, two cases (10.5%) had anastomotic leakage and mortality was present in one (5.3%) patient. 94.5% had an optimal TME specimen, only one case (5.3%) had positive circumferential resection margin and positive distal margin. The median tumor size in the specimen was 4 cm (range 2-11) and nine (47.4%) patients had ypT3 on pathology. CONCLUSION: TaTME is a safe and feasible technique with good pathological results.

Benign Multicystic Peritoneal Mesothelioma in a Male Teen: Case Report and Review of the Literature.

The case of a Peruvian 15-year-old male with a left-flank abdominal mass suspected to be a peritoneal pseudomyxoma is presented. The patient underwent a R0 surgery, and the pathology review showed a benign multicystic peritoneal mesothelioma. Characterized by recurrent mesothelial peritoneal cysts originating in the epithelial and mesenchymal elements of mesothelial tissue, this benign tumor is unusual among young males.