Estruturação do plano de imunização no combate a covid-19: (des)ordem nos acordos entre os poderes / Structuring the immunization plan to fight covid-19: (dis)order in agreements between the powers / Estructura del plan de inmunización para combatir el covid-19: (des)orden en acuerdos entre potencias

Objetivo: Fomentar o debate acerca da ordenação do plano de vacinação nacional, considerando os aspectos organizacionais entre união, estados e municípios. Métodos: Revisão de literatura, tendo como base os periódicos Cientific Electronic Library Online (SCIELO), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e Biblioteca Virtual de Saúde (BVS), usando como descritores: Pandemia, Vacina e Plano de Imunização. Com essa busca foram encontradas, inicialmente, 48 publicações. Após a realização da análise, foram incluídos 11 artigos científicos na revisão. Os textos foram submetidos à análise de conteúdo semântica. Resultados: Foram levantadas duas categorias: estratégias de combate a pandemia do covid-19 no Brasil, e a manipulação da sociedade civil e a desordem da cobertura vacinal. Conclusão: as reflexões aqui apresentadas podem contribuir para que os profissionais de enfermagem desenvolvam uma postura reflexiva frente a demanda vacinal, processo de planejamento e percepções da sociedade civil, podendo desencadear uma melhora na preparação para a educação em saúde. (AU)

Objective: To encourage the debate about the ordering of the national vaccination plan, considering the organizational aspects between the union, states and municipalities. Methods: Literature review, based on scientific journals Electronic Library Online (SCIELO), Coordination for the Improvement of Higher Education Personnel (CAPES) and Virtual Health Library (VHL), using as descriptors: Pandemia, Vaccine and Immunization Plan. With this search, 48 publications were initially found. After the analysis, 11 scientific articles were included in the review. The texts were subjected to semantic content analysis. Results: Two categories were raised: strategies to combat the covid-19 pandemic in Brazil, and the manipulation of civil society and the disorder of vaccination coverage. Conclusion: The reflections presented here can contribute for nursing professionals to develop a reflexive posture in face of the vaccine demand, planning process and civil society perceptions, which can trigger an improvement in the preparation for health education. (AU)

Objetivo: Fomentar el debate sobre la ordenación del plan nacional de vacunación, considerando los aspectos organizativos entre sindicato, estados y municipios. Métodos: Revisión de la literatura, con base en revistas científicas Biblioteca Electrónica en Línea (SCIELO), Coordinación para el Perfeccionamiento del Personal de Educación Superior (CAPES) y Biblioteca Virtual en Salud (BVS), utilizando como descriptores: Pandemia, Vacuna y Plan de Inmunización. Con esta búsqueda se encontraron inicialmente 48 publicaciones. Después del análisis, se incluyeron 11 artículos científicos en la revisión. Los textos fueron sometidos a análisis de contenido semántico. Resultados: Se plantearon dos categorías: estrategias para combatir la pandemia de covid-19 en Brasil y la manipulación de la sociedad civil y el desorden de la cobertura de vacunación. Conclusión: Las reflexiones aquí presentadas pueden contribuir para que los profesionales de enfermería desarrollen una postura reflexiva ante la demanda de vacunas, el proceso de planificación y las percepciones de la sociedad civil, lo que puede desencadenar una mejora en la preparación para la educación en salud. (AU)

Plan estratégico intersectorial para el abordaje integral de la enfermedad renal crónica en El Salvador 2024-2028 / Intersectoral strategic plan for the comprehensive approach to chronic kidney disease in El Salvador 2024-2028

La enfermedad renal crónica (ERC) constituye un importante problema de salud pública en el mundo y la región de las Américas, teniendo una prevalencia poblacional del 10% al 13%. Generalmente la ERC se atribuye a causas tradicionales principalmente diabetes mellitus, hipertensión arterial y obesidad. El país actualmente se enfrenta a una doble carga de enfermedad renal crónica, una debida a causas tradicionales como diabetes, hipertensión y obesidad, entre otros y de otra carga debida a causas no tradicionales. En el caso de la ERC, que afecta a las comunidades agrícolas salvadoreñas, el fenómeno se hace más complejo porque está sustentado sobre profundas raíces sociales que generan esta enfermedad en interacción con factores ambientales y ocupacionales

Chronic kidney disease (CKD) constitutes an important public health problem in the world and the region of the Americas, with a population prevalence of 10% to 13%. CKD is generally attributed to traditional causes, mainly diabetes mellitus, high blood pressure and obesity. The country currently faces a double burden of chronic kidney disease, one due to traditional causes such as diabetes, hypertension and obesity, among others, and another burden due to non-traditional causes. In the case of CKD, which affects Salvadoran agricultural communities, the phenomenon becomes more complex because it is based on deep social roots that generate this disease in interaction with environmental and occupational factors

Plan técnico para la ejecución de la "Jornada a nivel nacional de acciones integrales e intersectoriales para la prevención de las Arbovirosis 2024"

Las arbovirosis en El Salvador son enfermedades reincidentes en la que se ven relacionados muchos factores determinantes, en los cuales el Ministerio de Salud está realizando grandes esfuerzos por superarlos, a fin de mantener controlado el riesgo de brotes o epidemias de estas enfermedades, conservando de esta manera la primicia fundamental de conservar la salud de todos los salvadoreños

Arboviruses in El Salvador are recurrent diseases in which they are related many determining factors, in which the Ministry of Health is making great efforts to overcome them, in order to keep the risk of outbreaks or epidemics of these diseases under control diseases, thus preserving the fundamental first of preserving the health of all Salvadorans

Plan de implementación de la red nacional de apoyo para el diagnóstico y tratamiento de la tuberculosis pediátrica / Implementation plan for the national support network for the diagnosis and treatment of paediatric tuberculosis

La tuberculosis en la edad pediátrica está íntimamente ligada a la enfermedad del adulto y se considera que los casos pediátricos son centinelas de lo que sucede en la comunidad en que la niña y el niño vive. Por lo antes expuesto, el Sistema Nacional Integrado de Salud (SNIS) debe sumar esfuerzos bajo el enfoque de la Ley Crecer Juntos, para garantizar el bienestar de la niñez y adolescencia, y alcanzar el Objetivo de Desarrollo Sostenible (ODS) "Salud y Bienestar", ya que considera fundamental crear un "Plan de implementación de la red nacional de apoyo para el diagnóstico 10 y tratamiento de la tuberculosis pediátrica en El Salvador: RedNaTBPediátrica-ES", que contribuya a cumplir con los documentos regulatorios como la "Guía clínica para la atención pediátrica de la Tuberculosis y la coinfección TB/VIH" y demás normativas relacionadas al control de la tuberculosis en esta edad

Tuberculosis in paediatric age is closely linked to adult disease and paediatric cases are considered to be sentinels of what happens in the community in which the child lives. In view of the foregoing, the National Integrated Health System (NIS) must join forces under the Grow Together Act to guarantee the well-being of children and adolescents and achieve the Sustainable Development Goal (SDG) "Health and Well-being"considers it essential to create a "Plan for the implementation of the national network of support for the diagnosis and treatment of pediatric tuberculosis in El Salvador: RedNaTBPediátrica-ES", which contributes to comply with regulatory documents such as the Clinical Guide for Pediatric Care of TB and TB/HIV Co-infection" and other regulations related to tuberculosis control at this age

Plan nacional para la prevención, el control y la eliminación de las enfermedades tropicales priorizadas en El Salvador 2024-2026 / National plan for prevention, control and elimination of tropical diseases prioritized in El Salvador 2024-2026

El presente Plan nacional integral e Inter programático para la prevención, el control y la eliminación de las enfermedades tropicales priorizadas en El Salvador 2024-2026, contiene el marco conceptual, categorización de las ET, datos estadísticos y epidemiológicos, definiciones, clasificaciones, distribución geográfica, manejo, tratamiento, desafíos del abordaje integral e intersectorial para cada enfermedad descrita y los recursos necesarios para llevar a cabo de manera satisfactoria las actividades planteadas

This comprehensive and inter-programmatic national plan for the prevention, control and elimination of prioritized tropical diseases in El Salvador 2024-2026, contains the conceptual framework, categorization of ETs, statistical and epidemiological data, definitions, classifications, geographical distribution , management, treatment, challenges of the comprehensive and intersectoral approach for each disease described and the resources necessary to satisfactorily carry out the proposed activities

Plan técnico para la ejecución de la "Jornada a nivel nacional de acciones integrales e intersectoriales para lucha contra las Arbovirosis en Centros Escolares y Centros de Votación 2024" / Technical plan for the implementation of the "National day of comprehensive and intersectoral actions to combat Arbovirosis in Schools and Voting Centers 2024

En la situación del dengue en El Salvador, inciden determinantes (ambientales, económicos, políticos y sociales), la constante migración del campo a la ciudad, una creciente urbanización sin planificación ni regulación alguna, pobreza, inequidad en el ingreso y condiciones de exclusión que relegan a la población en esta situación a exponerse permanentemente a condiciones de alto riesgo y vulnerabilidad que favorecen la persistencia de la transmisión de arbovirosis, entre ellos se pueden señalar crecimiento poblacional, construcción de viviendas inadecuadas que generan condiciones críticas de hacinamiento, deficiente abastecimiento de agua que obliga a las personas a almacenarla inadecuadamente, una deficiente recolección de desechos sólidos, todo lo cual genera condiciones adecuadas para la multiplicación del Aedes aegypti y la transmisión de la enfermedad. El Ministerio de Salud, anticipándose al retorno de alumnos a un aproximado de 5,000 centros escolares públicos y privados, además de la prevención en 1,600 centros de votación, se ha programado la ejecución de una jornada a nivel nacional de acciones, la cual tiene por objetivo el control del vector en su fase larvaria y adulta; así como, la realización de acciones gubernamentales de carácter preventivas, en el que se realizarán actividades de promoción de la salud encaminadas a la eliminación de criaderos y otras actividades que sean factibles de desarrollar por la comunidad.

In the situation of dengue in El Salvador, determinants (environmental, economic, political and social), the constant migration from the countryside to the city, a growing urbanization without any planning or regulation, affect poverty, inequity in income and conditions of exclusion that relegate the population in this situation to be permanently exposed to conditions of high risk and vulnerability that favor the persistence of transmission of arbovirosis, These include population growth, construction of inadequate housing that generates critical conditions of overcrowding, poor water supply that forces people to store it improperly, poor solid waste collection, all of which generates adequate conditions for the multiplication of Aedes aegypti and the transmission of the disease. The Ministry of Health, anticipating the return of students to approximately 5,000 public and private schools, in addition to prevention in 1,600 voting centers, has scheduled the execution of a day at the national level of actions, which has as its objective the control of the vector in its larval and adult phase; as well as the carrying out of preventive governmental actions, which will include health promotion activities aimed at the elimination of hatcheries and other activities that are feasible to develop by the community

Promoting implementation research and One Health approach to respond the four global health challenges: an interpretation of the Special Programme for Research and Training in Tropical Diseases (TDR) Strategy 2024—2029 / 中国血吸虫病防治杂志

Tropical diseases, notably neglected tropical diseases and infectious diseases of poverty, remain major health problems endangering the poorest and most-marginalized people in the world. The Special Programme for Research and Training in Tropical Diseases (TDR), which is co-sponsored by the World Health Organization, the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP) and the World Bank, is an important programme that helps facilitate, support, guide and coordinate global efforts to combat tropical diseases. On July 2023, TDR formally issued its 2024—2029 strategy, which proposed the direction and proprieties of global tropical disease prevention and control in the next six years. Based on its original focus on supporting researchers and research institutions from low and middle-income countries to conduct research on tropical diseases and building their research capabilities, this strategy proposed some new developments, which mainly included incorporating tropical disease prevention and control into the overall framework of addressing major global health challenges and achieving the health goals set by the United Nations Sustainable Development Goals (SDGs) to combat tropical diseases and contribute to achieving health goals of SDGs in a collaborative and integrated manner; supporting implementation research and encouraging practitioners and social innovators to participate in research to enable generation of solutions that may be used to solve local health problems; promoting and encouraging the One Health concept and interdisciplinary and cross-departmental collaboration; shifting gradually its focus from disease prevention and control to addressing the health needs of the poorest and most-marginalized populations. These new developments deserve the attention of personnel and institutions in China dedicated to the prevention and control of tropical diseases in order to help their future researches and activities.

Interpretation of the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) / 中国血吸虫病防治杂志

On June 16, 2023, National Disease Control and Prevention Administration of the People’s Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030). The implementation of this plan provides an important basis for achieving the targets set in the “Healthy China 2030” action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.

Application status of risk assessment models for periodontal disease / 口腔疾病防治

@#Risk assessment models for periodontal disease provide dentists with a precise and consolidated evaluation of the prognosis of periodontitis, enabling the formulation of personalized treatment plans. Periodontal risk assessment systems have been widely applied in clinical practice and research. The application fields of periodontal risk assessment systems vary based on the distinctions between clinical periodontal parameters and risk factors. The assessment models listed below are commonly used in clinical practice, including the periodontal risk calculator (PRC), which is an individual-based periodontal risk assessment tool that collects both periodontal and systemic information for prediction; the periodontal assessment tool (PAT), which allows for quantitative differentiation of stages of periodontal disease; the periodontal risk assessment (PRA) and modified periodontal risk assessment (mPRA), which are easy to use; and the classification and regression trees (CART), which assess the periodontal prognosis based on a single affected tooth. Additionally, there are orthodontic-periodontal combined risk assessment systems and implant periapical risk assessment systems tailored for patients needing multidisciplinary treatment. This review focuses on the current application status of periodontal risk assessment systems.

Pharmacotherapy plan for metastatic hormone-sensitive prostate cancer：a network meta-analysis / 中国药房

OBJECTIVE To determine the optimal therapeutic plan for metastatic hormone-sensitive prostate cancer （mHSPC）， and to provide reference for clinical decision-making. METHODS Retrieved from Medline， Embase， BIOSIS preview， the Cochrane Library and ClinicalTrials. gov systematically， randomized controlled trials about mHSPC therapy， with overall survival （OS） and radiographic progression-free survival （rPFS） as efficacy outcomes and the incidence of serious adverse events （SAEs） as safety outcome， were collected during the inception-Mar. 2022. Two researchers independently screened the literature， extracted data， and evaluated the risk of bias for the included study before conducting a Bayesian network meta-analysis. RESULTS Eight studies with 9 437 patients were finally included. The effectiveness and safety of 7 therapy plans were compared [abiraterone acetate， apalutamide， darolutamide+docetaxel， docetaxel， enzalutamide， standard non-steroidal antiandrogen （SNA） in addition to ADT， and ADT alone]. In terms of efficacy index， the most beneficial regimen （except for ADT+SNA） for OS was ADT+darolutamide+docetaxel （HR＝0.54， 95%CI of 0.44-0.66）， followed by ADT+abiraterone acetate （HR＝0.64，95%CI of 0.57- 0.71）， apalutamide （HR＝0.65， 95%CI of 0.53-0.79）， enzalutamide （HR＝0.66， 95%CI of 0.53-0.82）； the least beneficial regimen for OS was ADT+docetaxel （HR＝0.79， 95%CI of 0.71-0.88）. The most beneficial regimen （except for ADT+SNA） for rPFS was ADT+enzalutamide （HR＝0.39， 95%CI of 0.30-0.50）， followed by ADT+apalutamide （HR＝0.48， 95%CI of 0.39- 0.60）， abiraterone acetate （HR＝0.57， 95%CI of 0.51-0.64）， docetaxel （HR＝0.62， 95%CI of 0.56-0.69）. The results of the tumor- loading subgroup analysis were the same. In terms of safety， ADT+darolutamide+docetaxel （OR＝25.86， 95%CI of 14.08-51.33）， and ADT+docetaxel （OR＝23.35， 95%CI of 13.26-44.81） were associated with markedly increased SAEs； the incidence of SAEs caused by ADT+abiraterone acetate （OR＝1.42，95%CI of 1.10-1.82） was slightly increased， and those of other therapy plans had no significant difference. CONCLUSIONS Compared with ADT alone， ADT+ darolutamide+docetaxel may provide the most significant OS benefit， but the incidence of SAEs is increased greatly； compared with ADT+docetaxel， ADT+abiraterone acetate， apalutamide or enzalutamide provide more OS benefits. ADT+enzalutamide provide optimal rPFS benefits with no increased SAEs.

Plan nacional de abogacía, comunicación y movilización social para el control de la tuberculosis, 2023 ­ 2027 / National advocacy, communication and social mobilization plan for tuberculosis control, 2023 ­ 2027

Las estrategias de abogacía, comunicación y movilización social (ACMS) constituyen un proceso interactivo con las comunidades las cuales van más allá de la Información, Educación y Comunicación (IEC) que son empleadas para planificar intervenciones adecuadas a los desafíos del programa nacional de tuberculosis, con el fin de promover y mantener prácticas positivas entre poblaciones específicas, principalmente en grupos de mayor riesgo y vulnerabilidad, utilizando diversos canales de comunicación y mensajes. La ACMS es una estrategia fundamental para la integración de conocimientos, capacidades y habilidades que promueven la sensibilización y movilización de las personas hacia el cambio de comportamientos y entornos saludables. El plan tiene como propósito guiar las acciones de ACMS que realizará el personal de salud de las diferentes instituciones proveedoras de servicios de salud y organizaciones de la sociedad civil que trabajan para el control de la tuberculosis en el país

Advocacy, communication and social mobilization (ACMS) strategies are an interactive process with communities that go beyond Information, Education and Communication (IEC) which are used to plan interventions appropriate to the challenges of the national tuberculosis programme, in order to promote and maintain positive practices among specific populations, mainly in groups at higher risk and vulnerability, using various communication channels and message ACMS is a key strategy for integrating knowledge, skills and abilities that promote awareness and mobilization of people towards changing healthy behaviors and environments. The plan aims to guide the actions of ACMS to be carried out by the health personnel of the different health service providers and civil society organizations working for the control of tuberculosis in the country.s

Evolución histórica del Sistema Nacional de Salud venezolano(1909-2023) / Historical evolution of the Venezuelan National Health System (1909-2023)

Se hace un análisis de la Evolución Histórica del Sistema Nacional de Salud en Venezuela desde 1909 hasta el año 2023. Se realizó un desglose de seis etapas: etapa "A" o Gomecista (1905 ­ 1935), etapa "B" o de la Segunda Guerra Mundial (1936- 1945), etapa "C" o de la División de Hospitales(1946-1949), etapa "D" o Perezjimenista (1950 ­ 1958), etapa "E" o de inicio de la Democracia (1959 ­ 1963), etapa "F" de Modelo Curativo y de Expansión Hospitalaria (1963 ­ 1998),etapa "G" de la Revolución Bolivariana (1999 ­ 2023). Se analizó también el Plan Nacional de Salud 2019 ­ 2025(AU)

An analysis of the Historical Evolution of the National Health System in Venezuela is made from 1909 to the year 2023. A breakdown of six stages is made: stage "A" or Gomez (1905 - 1935), stage "B" or Second World War (1936-1945),stage "C" or the Hospital Division (1946-1949), stage "D" or Perezjimenista (1950-1958), stage "E" or the beginning of Democracy (1959-1963), stage "F" of the Curative Model and Hospital Expansion (1963-1998), stage "G" of the Bolivarian Revolution (1999 - 2023). The National Health Plan 2019 -2025 is also analyzed(AU)

Análisis del programa de Farmacología Clínica en el plan de estudio E para la carrera de Medicina / Analysis of the program of Clinical Pharmacology in the E plan study for the Medicine career i: en

Introducción: En Cuba han existido varias concepciones sobre planes de estudio. La necesidad de revisar y proponer cambios que aseguren los niveles de calidad deseados en el proceso de formación integral de los futuros profesionales motivó a investigar los elementos teóricos y metodológicos que regulan y orientan el proceso de enseñanza-aprendizaje en la asignatura Farmacología Clínica. Objetivo: Analizar el programa de Farmacología Clínica del plan de estudio E para la carrera de Medicina desde un enfoque crítico y sistematizado. Métodos: Se realizó un estudio cualitativo del programa de estudio de la asignatura Farmacología Clínica según el plan E, vigente en la Universidad de Ciencias Médicas de Santiago de Cuba, durante el 2022, para lo cual se utilizaron los métodos de revisión documental, los documentos rectores del proceso docente en la educación superior y la metodología propuesta por algunos autores. Resultados: Varios temas enunciaban un número excesivo de objetivos específicos sin tener en cuenta el nivel de asimilación; la forma de organización de la enseñanza más utilizada fue la conferencia. En las evaluaciones frecuentes no se tuvo en cuenta el trabajo investigativo independiente; en tanto, la bibliografía básica correspondió a una edición del 2002. Conclusiones: El programa no requirió trasformaciones temáticas, pero desde el punto de vista didáctico deben modificarse componentes del proceso de enseñanza-aprendizaje y, además, se debe actualizar la bibliografía básica pertinente.

Introduction: In Cuba several conceptions have existed on the study plans. The necessity to revise and propose changes that assure the levels of quality wanted in the process of integral formation of the future professionals motivated to investigate the theoretical and methodological elements that regulate and guide the teaching-learning process in the Clinical Pharmacology subject. Objective: To analyze the program of Clinical Pharmacology of the E plan study for the medicine career, from a critical and systematized approach. Methods: A qualitative study of the study program in the Clinical Pharmacology subject was carried out according to the E plan, effective in the University of Medical Sciences in Santiago de Cuba, during 2022, for which the methods of documental review, the rector documents of the teaching process in higher education and the methodology proposed by some authors were used. Results: Several topics enunciated an excessive number of specific objectives without taking into account the level of assimilation; the form of organization most used in teaching was the conference. Independent investigative work was not taken into account in frequent evaluations; meanwhile, the basic bibliography corresponded to an edition from 2002. Conclusions: The program did not require of thematic transformations, but from the didactic point of view components of the teaching-learning process should be modified, besides updating the pertinent basic literature.

Análise da imunoexpressão de BAX e MMP-9 no líquen plano oral / Analysis of BAX and MMP-9 immunoexpression in oral lichen planus

Introdução: O líquen plano oral é uma doença crônica imunologicamente mediada relativamente comum, que acomete a mucosa oral. Clinicamente, o LPO é classificado em seis padrões bem identificados: placa, reticular, bolhoso, atrófico, papular e erosivo.Sendo os mais comuns oos tipos reticulares e erosivos. A ativação dos linfócitos TCD4+ no LPO, pode induzir os ceratinócitos ao processo de apoptose através da respostaimunológica citotóxica. A proteína Bax desempenha uma função relevante para o processo apoptótico. Deste modo, a presente pesquisa consistiu em um estudo transversal retrospectivo, descritivo, quantitativo e comparativo. Objetivo: Avaliar a expressão imuno-histoquímica das proteínas MMP9 e Bax no LPO. Método: Foram utilizados 43 casos de LPO para análise da imunoexpressão de Bax e MMP-9. Os resultados foram analisados através dos testes estatísticos apropriados e serão considerados significativos, valores onde p<0,05. Resultado: A imunoexpressão de MMP9 foi significativamente maior nos ceratinócitos e quando analisados os subtipos de líquen plano oral, não foram observados diferenças estatísticas entre os tipos reticulares e erosivos para as proteínas analisadas. Conclusões: Com essas observações, infere-se que a alteração na expressão das proteínas estudadas sugere um distúrbio nos mecanismos apoptóticos, os quais estão associados às lesões de LPO, e podemos concluir também que as imunoexpressões dessas proteínas não apresentaram diferença, quando relacionada ao tipo clínico reticular ou erosivo. Com esse resultado pode-se contribuir para um maior entendimento sobre os possíveis mecanismos celulares envolvidos na etiopatogenia dessa lesão (AU).

Background: Oral lichen planus is a relatively common immune-mediated chronic disease that affects the oral mucosa. Clinically, OLP is classified into six well-identified patterns: plaque, reticular, bullous, atrophic, papular, and erosive. The most common being the reticular and erosive types. The activation of TCD4+ lymphocytes in the OLP can induce keratinocytes to the process of apoptosis through the cytotoxic immune response. Thus, the present research consisted of a retrospective, descriptive, quantitative and comparative crosssectional study. Objective: to evaluate the immunohistochemical expression of MMP-9 and Bax proteins in OLP. Methods: We used 20 cases of Inflammatory Fibrous Hyperplasia as control. The results were analyzed through the appropriate statistical tests and will be considered significant, values where p<0.05. Results: The immunoexpression of MMP-9 was significantly higher in keratinocytes and when the subtypes of oral lichen planus were analyzed, no statistical differences were observed between the reticular and erosive types for the proteins analyzed. Conclusions: With these observations, it is inferred that the alteration in the expression of the studied proteins suggests a disturbance in the proliferative and apoptotic mechanisms, which are associated with a pathological behavior of the oral mucosa, and consequently with a repercussion on the lesions of OLP, and we can also conclude that the immunoexpression of these proteins had no difference, when related to the reticular or erosive clinical type. This research aims to contribute to a greater understanding of the possible cellular mechanisms involved in the etiopathogenesis of this lesion, thus enabling the understanding of the clinical aspects of the pathology (AU).

Importancia social de la preparación pedagógica del tutor en la formación del médico general integral

Introducción: la figura del tutor es de vital importancia en la formación del especialista en medicina general integral. Objetivo: fundamentar la importancia del desempeño profesional pedagógico del tutor en la formación del especialista en medicina general integral en la sociedad cubana. Materiales y métodos: se realizó un análisis documental a partir de una búsqueda sobre el tema, de enero de 2020 a agosto de 2022, en las bases de datos PubMed y SciELO, y en el motor de búsqueda Google Académico. Se evaluaron artículos de revisión, de investigación y páginas web -en español, portugués e inglés- que hicieran referencia al tema a través del título. Fueron excluidos los artículos que no cumplieron con estas condiciones. Conclusiones: la medicina familiar es eminentemente social, por su objeto y misión en la comunidad, de ahí que garantizar la formación de profesionales integrales que involucren en su desarrollo los contenidos y habilidades de la especialidad, junto a valores y formas de actuación acorde con los principios de la sociedad socialista, supondrá una mayor resolutividad de los problemas de salud de la población y, por ende, una mayor calidad de vida.

Introduction: the figure of the tutor is of vital importance in the training of the specialist in comprehensive general medicine. Objective: to base the importance of the professional pedagogical performance in the training of the specialist in comprehensive general medicine in Cuban society. Materials and methods: a documental analysis was carried out froma search on the subject, from January 2020 to August in PubMed and SciELO databases and in the Google Scholar search engine. Review and research articles and web pages-in Spanish, Portuguese and English-that referred to the subject in the title were evaluated. Articles that did not meet this condition were excluded. Conclusions: family medicine is eminently social, due to its objective and mission in the community, hence guaranteeing the training of comprehensive professionals who involve the contents and skills of the specialty in their development, along with values and forms of action in accordance with the principles of the socialist society, will suppose a better resolution of the health problems of the population, and therefore, a better quality of life.

Plan interinstitucional para la atención en salud en el marco de los XXIV Juegos Centroamericanos y del Caribe, San Salvador 2023 / Inter-institutional plan for health care in the framework of the XXIV Central American and Caribbean Games, San Salvador 2023

Los Juegos Centroamericanos y del Caribe son un evento multideportivo, que se realizan cada 4 años desde 1926 en diferentes países de la región que comprenden América Central y la cuenca del Mar Caribe. Es el evento multidisciplinario regional más antiguo del mundo, son coordinados por la Organización Centro Caribe Sports. Para el año 2023 se estima que la fecha de realización de estos juegos será del 23 de junio al 8 de julio, esperando una afluencia masiva de atletas y delegaciones extrajeras. El Ministerio de Salud, como ente rector del Sistema Nacional Integrado de Salud, emite el presente Plan interinstitucional para la atención en salud en el marco de los XXIV Juegos Centroamericanos y del Caribe, San Salvador 2023, en la vigilancia epidemiológica, prevención y atención de la salud en casos de emergencias. El plan contiene estrategias de atención en casos de emergencias médicas (traumas, fracturas, intoxicaciones alimentarias, reacciones alérgicas, atenciones de primeros auxilios, atenciones masivas de víctimas en casos de desastres naturales y accidentes de tránsito), entre otros. Además, incluye una breve descripción del acceso a los puntos de atención médica y zonas de evacuación asignadas en los diferentes escenarios deportivos

The Central American and Caribbean Games are a multi-sport event, held every 4 years since 1926 in different countries of the region comprising Central America and the Caribbean Sea basin. It is the oldest regional multidisciplinary event in the world, coordinated by the Centro Caribe Sports Organization. For 2023 it is estimated that the date of these games will be from 23 June to 8 July, expecting a massive influx of athletes and foreign delegations. The Ministry of Health, as the governing body of the Integrated National Health System, issues this inter-institutional plan for health care within the framework of the twenty-third Central American and Caribbean Games, San Salvador 2023, in epidemiological surveillance, prevention and health care in emergencies The plan contains strategies for dealing with medical emergencies (traumas, fractures, food poisoning, allergic reactions, first-aid care, mass care of victims in cases of natural disasters and traffic accidents), among others. In addition, it includes a brief description of access to health care points and designated evacuation areas in different sports arenas

Factores asociados a la calidad de vida en pacientes con cáncer en una unidad de terapia del dolor de la seguridad social

Introducción: La calidad de vida es una de las principales preocupaciones de los pacientes con cáncer en cuidados paliativos, sin embargo, los estudios sobre la calidad de vida en estos pacientes son limitados. Objetivo: Determinar los factores asociados a la calidad de vida en pacientes con enfermedad oncológica en cuidados paliativos. Métodos: Estudio observacional, analítico en 184 pacientes oncológicos atendidos en una Unidad de Dolor y Cuidados Paliativos durante el 2021. La variable dependiente fue la calidad de vida; las independientes la edad, sexo, nivel de instrucción, ocupación, diagnóstico oncológico, tiempo y estadio de enfermedad. Se calculó la razón de prevalencias cruda (RP) y ajustada (RPa) con nivel de confianza de 95%. Resultados: La edad mediana fue 63 años, y el 66,3% fueron del sexo femenino. Los factores asociados a la calidad de vida fueron cáncer de mama (RPa=1,21; IC95%: 1,07-1,36; p!<0,010), de próstata (RPa=1,36; IC95%: 1,18-1,56; p!<0,010) o mieloma múltiple (RPa=1,33; IC95%: 1,15-1,53; p!<0,010), en comparación a otros cánceres como linfoma de Hodgkin, cáncer de estómago, renal o de páncreas; el tiempo de enfermedad mayor a 36 meses (RPa=1,13; IC95%: 1,01-1,27; p=0,040) y el estadio III (RPa=1,30; IC95%: 1,19-1,42; p!<0,010) también se asociaron a la calidad de vida. Conclusiones: Los factores asociados a la calidad de vida fueron tener cáncer de mama, de próstata o mieloma múltiple, en comparación con tener otro tipo de cáncer; además de un tiempo de enfermedad mayor a 36 meses y el estadio III frente al estudio I/II.

Introduction: Quality of life is one of the main concerns for cancer patients in palliative care; however, studies on quality of life in these patients are limited. Objective: To determine the factors associated with quality of life in patients with oncological disease in palliative care. Methods: Observational, analytical study in 184 cancer patients treated in a Pain and Palliative Care Unit during 2021. The dependent variable was quality of life; independent variables were age, sex, education level, occupation, oncological diagnosis, disease duration, and stage. Crude (RP) and adjusted (aRP) prevalence ratios were calculated with a 95% confidence level. Results: The median age was 63 years, and 66.3% were female. Factors associated with quality of life were breast cancer (aRP=1.21; 95% CI: 1.07-1.36; p!<0.010), prostate cancer (aRP=1.36; 95% CI: 1.18-1.56; p!<0.010), or multiple myeloma (aRP=1.33; 95% CI: 1.15-1.53; p!<0.010), compared to other cancers such as Hodgkin's lymphoma, stomach, kidney, or pancreatic cancer; disease duration longer than 36 months (aRP=1.13; 95% CI: 1.01-1.27; p=0.040), and stage III (aRP=1.30; 95% CI: 1.19-1.42; p!<0.010) were also associated with quality of life. Conclusions: Factors associated with quality of life were having breast, prostate, or multiple myeloma cancer, compared to having another type of cancer; in addition to a disease duration longer than 36 months and stage III compared to stage I/II.

Programa de Cannabis Medicinal en la provincia de Jujuy, Argentina. Un modelo integral de gestión pública / Medical Cannabis Program in the province of Jujuy, Argentina. A comprehensive model of public management

Resumen El desarrollo científico, tecnológico y económico del cannabis medicinal requiere la evolución de las normas y políticas públicas que abordan el fenómeno del redescubrimiento de la potencia científica y terapéutica del cannabis medicinal de calidad farmacéutica. Para encarar la problemática de la inexistencia de productos derivados de cannabis de industria nacional con aprobación sanitaria, el Gobierno de Jujuy decidió implementar un abordaje estatal integral de salud pública. En este artículo desarrollamos los ejes centrales de un modelo de gestión que comprende la creación de un marco legal e institucional, la implementación de un programa sanitario que incluye la capacitación profesional, la investigación y la elaboración de evidencia cientí fica de alta calidad, en el marco de un programa de producción pública de cannabis de grado farmacéutico que abarca toda la cadena productiva, desde el cultivo hasta la elaboración farmacéutica y la posterior distribución en farmacias bajo normas internacionales de buenas prácticas. El programa se encuentra en vigencia desde 2017, dentro de un panorama regulatorio nacional en desarrollo que convive con la estigmatización de la planta de cannabis en el marco social y médico, las dificultades de financiación y la escasa evidencia mundial en planes sanitarios efectivos de cannabis medicinal. Nuestra experiencia puede colaborar con otros administradores de salud, con semejante o diferente socio-demografía y entorno regulatorio, para resolver las barreras de acceso al cannabis medicinal y mejorar las condiciones de los pacientes que lo requieran.

Abstract The scientific, technological, and economic development of medicinal cannabis requires the evolution of public regulations and policies that address the phenomenon of the rediscovery of the scientific and therapeutic power of medicinal cannabis of pharmaceutical quality. To address the problem of the non-existence of cannabis-derived products from the national industry with health approval, the Government of Jujuy decided to implement a comprehensive state approach to public health. In this article we develop the central axes of a management model, which includes the creation of a legal and institutional framework, the implementation of a health program that includes professional training, research and the preparation of scientific evidence of high quality, within the framework of a program for the public production of pharmaceutical-grade cannabis that covers the entire pro duction chain, from cultivation to pharmaceutical preparation and subsequent distribution in pharmacies under international standards of good practice. The program has been in force since 2017, focusing on the challenges of a developing national regulatory landscape that coexists with the stigmatization of the cannabis plant in the social and medical framework, the difficulties of financing and the scarce world evidence in effective health plans of medical cannabis. Our experience can collaborate with other health administrators, with similar or different socio-demographics and regulatory environment, to resolve barriers to access to medical cannabis and improve the conditions of patients who require it.

Urgencias médicas durante el tratamiento estomatológico en los planes de estudio D y E de estomatología / Medical emergencies during oral treatment in the D and E study plans of the dental medicine major

Introducción: El objetivo fundamental de la práctica estomatológica contemporánea es dar solución no solo a aquellas entidades que afectan el aparato estomatognático, sino prevenir y tratar aquellas urgencias médicas que puedan presentarse durante el ejercicio de la profesión. Este propósito solo resulta posible mediante la formación de un estomatólogo con una elevada preparación científico-técnica. Objetivo: Evaluar los contenidos relacionados con las urgencias médicas durante la atención estomatológica en los planes de estudio D y E de la carrera de estomatología. Métodos: Se realizó un análisis documental de los planes de estudio D y E. Durante el cual se revisaron el perfil profesional, los modos de actuación, y los programas de la disciplina integradora Estomatología Integral y de las asignaturas. Asimismo, se valoraron los contenidos relacionados con las urgencias médicas durante la atención estomatológica, el semestre en que se imparte la asignatura, los objetivos, los temas, y el sistema de conocimientos y habilidades. Resultados: Las asignaturas y disciplinas que incorporaron contenidos relacionados con las urgencias médicas durante la atención estomatológica fueron: Operatoria Clínica, Atención Integral a la Familia III, Farmacología y Preparación para la Defensa. El análisis documental realizado y las entrevistas ejecutadas mostraron la existencia de diversos criterios en relación con estos contenidos en las asignaturas abordadas. Conclusiones: Los contenidos relacionados con las urgencias médicas durante la atención estomatológica en los programas de las asignaturas y disciplinas evaluados resultaron limitados e insuficientes, y presentaron algunas deficiencias desde el punto de vista didáctico(AU)

Introduction: The fundamental objective of contemporary oral care practice is to provide solutions not only to those entities that affect the oral apparatus, but also to prevent and treat those medical emergencies that may appear during professional practice. This purpose can be achieved only through the training of an oral physician with a high scientific-technical preparation. Objective: To assess the contents related to medical emergencies during oral care in the D and E study plans of the dental medicine major. Methods: A documentary analysis of the D and E study plans was carried out; the process consisted in reviewing the professional profile, the modes of action and the syllabuses of the integrating discipline Comprehensive Dental Medicine, as well as of the subjects. Likewise, an assessment was carried out of the contents related to medical emergencies during oral care, the semester in which the subject is taught, the objectives, the topics, as well as the system of knowledge and skills. Results: The subjects and disciplines including contents related to medical emergencies during oral care were Clinical Surgery, Comprehensive Family Care III, Pharmacology and Preparation for Defense. The conducted documentary analysis and the performed interviews showed the existence of diverse criterions with respect to these contents in the addressed subjects. Conclusions: The contents related to medical emergencies during oral care in the assessed syllabuses of subjects and disciplines were concluded to be limited and insufficient, as well as presented some deficiencies from the didactic point of view(AU)

Evaluating Diagnostic Performance of Three Cephalometric Vertical Parameters

Objectives: The goal of this research was to see how reliable and valid three selected parameters from different analysis were in detecting the vertical skeletal pattern. Methods: There were 94 cephalometric x?rays used in all. The vertical skeletal pattern was assessed using the mandibular plane angle by Steiner, Frankfort mandibular angle by Tweed, and facial axis angle by McNamara. According to the diagnostic results of the majority of the measures, the samples were classified as normo?divergent, hypodivergent, or hyperdivergent. Kappa statistics, positive predictive value, and sensitivity were employed to verify the validity and reliability of the analyses. Results: A statistically significant weak negative correlation was found between Frankfort mandibular angle and facial axis angle in female group (p value < 0.01). A good agreement was found between mandibular plane angle with final diagnosis (K = 0.726). The mandibular plane angle showed highest sensitivity and positive predictive value in hypodivergent group (0.939, 0.816) and normo?divergent group (0.795, 0.833), respectively. Conclusion: For determining the facial vertical growth pattern the most accurate indicators were identified to be mandibular plane angle (SN?GoGn) and Frankfort mandibular angle.