Current state of proton therapy for tumors of the central nervous system in Spain: physical bases, indications, controversies and perspectives.

The unique biophysical properties of proton therapy (PT), regarding the precise dose distribution, a remarkable better sparing of surrounding normal tissues, and the decreasing costs have promoted the spread of this technique worldwide. In Spain, eleven new PT centers, added to the currently two in function, are expected to be available in the near future. Indications for PT are currently evolving. The suitability of PT in central nervous system tumors of the adult population has been extrapolated from the favorable experience in children and adolescents. Given the lack of appropriate randomized trials, controversies remain regarding its use in lower grade tumors, re-irradiation, and other clinical scenarios in which an a priori dose distribution benefit is expected compared to photon-based radiotherapy. PT is a reasonable option in many brain and spinal tumors associating long life expectancy, in which cognitive decline, and the appearance of radiation-induced neoplasms can be minimized.Estado actual de la terapia con protones en los tumores del sistema nervioso central en España: bases físicas, indicaciones, controversias y perspectivas.

State of the art of cervical cancer treatment in rare histologies.

The objective of this review is to summarize the current scientific evidence to formulate clinical recommendations regarding the classification, diagnostic approach, and treatment of rare histological subtypes of cervical cancer; neuroendocrine carcinoma, gastric-type mucinous adenocarcinoma, and glassy cell adenocarcinoma. These histological subtypes are generally characterized by their low frequency, aggressive biological behavior, certain chemoradioresistance, and consequently, high recurrence rates with a deleterious impact on survival. Molecular studies have identified several associated mutations in neuroendocrine carcinoma (PIK3CA, MYC, TP53, PTEN, ARID1A, KRAS, BRCA2) and gastric-type adenocarcinoma (KRAS, ARID1A, PTEN) that may serve as molecular targets. While adenocarcinomas are typically treated and classified based on squamous histology across early, locally advanced, and advanced stages, the treatment strategies for neuroendocrine carcinomas in early stages or locally advanced cases differ, particularly in the sequencing of administering chemotherapy, chemoradiotherapy, or surgery. The chemotherapy regimen is based on etoposide plus cisplatin (EP). Unlike squamous cell carcinomas, immune checkpoint inhibitors are yet to establish a standard role in the treatment of recurrent neuroendocrine carcinomas due to the absence of clinical trials. Regarding glassy cell adenocarcinomas and gastric-type adenocarcinoma, the potential use of immunotherapy in advanced stages/disease requires further evaluation through international collaborations, given the limited number of cases.

Methylation marks in blood DNA reveal breast cancer risk in patients fulfilling hereditary disease criteria.

Less than 15-20% of patients who meet the criteria for hereditary breast and ovarian cancer (HBOC) carry pathogenic coding genetic mutations, implying that other molecular mechanisms may contribute to the increased risk of this condition. DNA methylation in peripheral blood has been suggested as a potential epigenetic marker for the risk of breast cancer (BC). We aimed to discover methylation marks in peripheral blood associated with BC in 231 pre-treatment BC patients meeting HBOC criteria, testing negative for coding pathogenic variants, and 156 healthy controls, through methylation analysis by targeted bisulfite sequencing on 18 tumor suppressor gene promoters (330 CpG sites). We found i) hypermethylation in EPCAM (17 CpG sites; p = 0.017) and RAD51C (27 CpG sites; p = 0.048); ii) hypermethylation in 36 CpG-specific sites (FDR q < 0.05) in the BC patients; iii) four specific CpG sites were associated with a higher risk of BC (FDR q < 0.01, Bonferroni p < 0.001): cg89786999-FANCI (OR = 1.65; 95% CI:1.2-2.2), cg23652916-PALB2 (OR = 2.83; 95% CI:1.7-4.7), cg47630224-MSH2 (OR = 4.17; 95% CI:2.1-8.5), and cg47596828-EPCAM (OR = 1.84; 95% CI:1.5-2.3). Validation of cg47630224-MSH2 methylation in one Australian cohort showed an association with 3-fold increased BC risk (AUC: 0.929; 95% CI: 0.904-0.955). Our findings suggest that four DNA methylation CpG sites may be associated with a higher risk of BC, potentially serving as biomarkers in patients without detectable coding mutations.

El papel de la enfermera en la promoción de la lactancia materna en el ámbito rural / The role of the nurse in the promotion of breastfeeding in rural areas

OBJETIVOS: El objetivo general del trabajo es conocer la efectividad entre la educación sanitaria sobre la lactancia materna en mujeres embarazadas en últimas semanas de fecha de parto en relación a su decisión de amamantar a sus hijos/as. MATERIALES Y MÉTODOS: En primer lugar, se realiza una revisión bibliográfica del estado actual de la producción científica enfermera sobre la efectividad de la educación en la población relacionado con la lactancia materna. A continuación se realiza un estudio de enfoque cuantitativo, medición de la variable y diseño con intervención siendo este cuasi experimental con una muestra de 102 mujeres embarazadas. RESULTADOS: Tras la aplicación de los test preeducacional y posteducacional en las sesiones de educación maternal sobre la lactancia materna la comparativa es positiva respecto a la adquisición de nivel de conocimientos de las mujeres embarazadas de la lactancia materna con el objetivo de aumentar la tasa de lactancia materna exclusiva en la población. CONCLUSIONES: En la actualidad existe evidencia científica de un notable descenso de madres que amamantan a sus hijos debido a una carencia de información adecuada sobre el tema. Para ello, se hace necesaria la realización de educación sanitaria, los programas de educación tienen un afán promotor en el uso de la lactancia natural.

OBJECTIVES: The general objective of the work is to know the effectiveness among health education on breastfeeding in pregnant women in the last weeks of the date of delivery in relation to their decision to breastfeed their children. MATERIALS AND METHODS: First, a bibliographic review of the current state of nursing scientific production on the effectiveness of education in the population related to breastfeeding is carried out. A quantitative approach, measurement of the variable and design with intervention study is carried out, this quasi-experimental being with a sample of 102 pregnant women. RESULTS: After the application of the preeducational and posteducational tests in the maternal education sessions on breastfeeding, the comparison is positive regarding the acquisition of the level of knowledge of pregnant women of breastfeeding in order to increase the rate of exclusive breastfeeding in the population. CONCLUSIONS: Currently there is scientific evidence of a notable decline in mothers who breastfeed their children due to a lack of adequate information on the subject. For this, it is necessary to carry out health education, education programs have a promoting desire in the use of breastfeeding.

Recommendations on the pharmacological treatment of epithelial ovarian cancer in Mexico.

Ovarian cancer is the third most frequent gynaecological malignancy worldwide and in Mexico, with a high mortality rate, due to that in many cases its diagnosis is made in advanced stages. Prognosis is important for determining the subtype and the degree of evolution. During lasts years, the management of ovarian cancer has undergone an important evolution with the incorporation of new therapeutic options, which in turn represent an increase in the survival of these patients. We present recommendations for the management of ovarian cancer developed by an expert panel Mexican based on available evidence so far and the characteristics of health care in the country.

El cáncer de ovario es la tercera neoplasia maligna ginecológica más frecuente globalmente y también en México, con una elevada tasa de mortalidad debido a que en muchos casos su diagnóstico se realiza en etapas avanzadas. Para establecer su pronóstico es importante la determinación del subtipo y del grado de evolución. En los últimos años, el manejo del cáncer de ovario ha sufrido una importante evolución con la incorporación de nuevas opciones terapéuticas, que a su vez representan un incremento en la supervivencia de estas pacientes. Se presentan las recomendaciones para el manejo del cáncer de ovario elaboradas por un panel de expertos mexicanos basadas en la evidencia disponible hasta el momento y en las características de la atención sanitaria del país.

Recomendaciones sobre el tratamiento farmacológico del cáncer de ovario epitelial en México / Recommendations on the pharmacological treatment of epithelial ovarian cancer in Mexico

Resumen El cáncer de ovario es la tercera neoplasia maligna ginecológica más frecuente globalmente y también en México, con una elevada tasa de mortalidad debido a que en muchos casos su diagnóstico se realiza en etapas avanzadas. Para establecer su pronóstico es importante la determinación del subtipo y del grado de evolución. En los últimos años, el manejo del cáncer de ovario ha sufrido una importante evolución con la incorporación de nuevas opciones terapéuticas, que a su vez representan un incremento en la supervivencia de estas pacientes. Se presentan las recomendaciones para el manejo del cáncer de ovario elaboradas por un panel de expertos mexicanos basadas en la evidencia disponible hasta el momento y en las características de la atención sanitaria del país.

Abstract Ovarian cancer is the third most frequent gynaecological malignancy worldwide and in Mexico, with a high mortality rate, due to that in many cases its diagnosis is made in advanced stages. Prognosis is important for determining the subtype and the degree of evolution. During lasts years, the management of ovarian cancer has undergone an important evolution with the incorporation of new therapeutic options, which in turn represent an increase in the survival of these patients. We present recommendations for the management of ovarian cancer developed by an expert panel Mexican based on available evidence so far and the characteristics of health care in the country.

[Osteo-articular infections by Kingella kingae in children in a highly complex pediatric hospital: epidemiology and associated factors]. / Infecciones osteo-articulares por Kingella kingae en niños en un hospital pediátrico de alta complejidad: epidemiología y factores asociados.

BACKGROUND: The epidemiology of osteoarticular infections (IOA) has changed in recent years. The incidence of Kingella kingae in Latin America is unknown. AIMS: To describe the epidemiology in patients with IOA in a children hospital. To estimate the incidence of IOA due to K. kingae and compare with other etiologies. METHODS: Prospective cohort. Patients older than 1 month hospitalized between March, 1th 2017 and February, 28th 2019 with suspected IOA and diagnostic procedure (biopsy or arthrocentesis) were included. STATA 13 was used. RESULTS: n: 84 patients. The etiology was identified in 58 patients (69.1%). Staphylococus aureus predominated (n: 44; 52.4%) and K. kingae (n: 9; 10.8%). In the period studied, the incidence of IOA by K. kingae was 10.8 cases per 100 hospitalized IOA. In multivariate analysis, age less than 4 years (OR 13.8, 95% CI 5.5-82.7), recent respiratory symptoms (OR 5.7, 95% CI 3.5-31.6, p 0.04) and normalization before the fifth day of C-reactive protein (CRP) (OR 3.38 95% CI 1.8-16.3, p 0.01) were associated with IOA by K. kingae. CONCLUSIONS: In this cohort of children the incidence of K. kingae was 10.8 cases per 100 IOA. Kingella kingae represented the second documented etiology, after S. aureus. Age under 4 years, recent respiratory symptoms and normalization before the fifth day of quantitative CRP were statistically associated with IOA by K. kingae.

Infecciones osteo-articulares por Kingella kingae en niños en un hospital pediátrico de alta complejidad: epidemiología y factores asociados / Osteo-articular infections by Kingella kingae in children in a highly complex pediatric hospital: epidemiology and associated factors

Resumen Introducción: La epidemiología de las infecciones osteo-articulares (IOA) se ha modificado en los últimos años. La incidencia de Kingella kingae en Latinoamérica es desconocida. Objetivo: Describir la epidemiología de los niños con IOA. Estimar la incidencia de IOA causadas por K. kingae y compararlas con otras etiologías. Material y Métodos: Cohorte prospectiva. Se incluyeron pacientes mayores de 1 mes de edad, hospitalizados entre el 1 de marzo de 2017 y 28 de febrero de 2019, con sospecha de IOA y procedimiento diagnóstico (biopsia o artrocentesis). Se utilizó STATA 13. Resultados: n: 84 pacientes. Se identificó la etiología en 58 pacientes (69,1%). Predominaron Staphylococcus aureus (n: 44; 52,4%) y K. kingae (n: 9; 10,8%). En el período estudiado, la incidencia de IOA por K. kingae fue de 10,8 casos cada 100 IOA hospitalizadas. En el análisis multivariado, la edad inferior a 4 años (OR 13,8, IC95% 5,5-82,7), el cuadro respiratorio reciente (OR 5,7, IC95% 3,5-31,6, p 0,04) y la normalización antes del quinto día de la proteína C reactiva (PCR) (OR 3,8 IC95% 1,8- 16,3, p 0,01) se asociaron con las IOA por K. kingae. Conclusiones: En esta cohorte de niños, la incidencia de K.kingae fue de 10,8 casos cada 100 IOA. Kingella kingae representó la segunda etiología documentada, luego de S. aureus. La edad inferior a 4 años, el cuadro respiratorio reciente y la normalización antes del quinto día de la PCR cuantitativa se asociaron estadísticamente con IOA por K. kingae.

Abstract Background: The epidemiology of osteoarticular infections (IOA) has changed in recent years. The incidence of Kingella kingae in Latin America is unknown. Aims: To describe the epidemiology in patients with IOA in a children hospital. To estimate the incidence of IOA due to K. kingae and compare with other etiologies. Methods: Prospective cohort. Patients older than 1 month hospitalized between March, 1th 2017 and February, 28th 2019 with suspected IOA and diagnostic procedure (biopsy or arthrocentesis) were included. STATA 13 was used. Results: n: 84 patients. The etiology was identified in 58 patients (69.1%). Staphylococus aureus predominated (n: 44; 52.4%) and K. kingae (n: 9; 10.8%). In the period studied, the incidence of IOA by K. kingae was 10.8 cases per 100 hospitalized IOA. In multivariate analysis, age less than 4 years (OR 13.8, 95% CI 5.5-82.7), recent respiratory symptoms (OR 5.7, 95% CI 3.5-31.6, p 0.04) and normalization before the fifth day of C-reactive protein (CRP) (OR 3.38 95% CI 1.8-16.3, p 0.01) were associated with IOA by K. kingae. Conclusions: In this cohort of children the incidence of K. kingae was 10.8 cases per 100 IOA. Kingella kingae represented the second documented etiology, after S. aureus. Age under 4 years, recent respiratory symptoms and normalization before the fifth day of quantitative CRP were statistically associated with IOA by K. kingae.

Impacto de la educación para la salud en la lactancia materna. Beneficios para el recién nacido / Impact of health education on breastfeeding. Benefits for the newborn

OBJETIVOS El objetivo general del trabajo es conocer la efectividad entre la educación sanitaria sobre la lactancia materna en mujeres embarazadas en últimas semanas de fecha de parto en relación a su decisión de amamantar a sus hijos/as. MATERIALES Y MÉTODOS En primer lugar, se realiza una revisión bibliográfica del estado actual de la producción científica enfermera sobre la efectividad de la educación en la población relacionado con la lactancia materna. A continuación, se realiza un estudio de enfoque cuantitativo, medición de la variable y diseño con intervención siendo este cuasi experimental con una muestra de 102 mujeres embarazadas. RESULTADOS Tras la aplicación de los test preeducacional y posteducacional en las sesiones de educación maternal sobre la lactancia materna la comparativa es positiva respecto a la adquisición de nivel de conocimientos de las mujeres embarazadas de la lactancia materna con el objetivo de aumentar la tasa de lactancia materna exclusiva en la población. CONCLUSIONES En la actualidad existe evidencia científica de un notable descenso de madres que amamantan a sus hijos debido a una carencia de información adecuada sobre el tema. Para ello, se hace necesaria la realización de educación sanitaria, los programas de educación tienen un afán promotor en el uso de la lactancia natural.

OBJECTIVES The general objective of the work is to know the effectiveness among health education on breastfeeding in pregnant women in the last weeks of the date of delivery in relation to their decision to breastfeed their children. MATERIALS AND METHODS First, a bibliographic review of the current state of nursing scientific production on the effectiveness of education in the population related to breastfeeding is carried out. A quantitative approach, measurement of the variable and design with intervention study is carried out, this quasi-experimental being with a sample of 102 pregnant women. RESULTS After the application of the preeducational and posteducational tests in the maternal education sessions on breastfeeding, the comparison is positive regarding the acquisition of the level of knowledge of pregnant women of breastfeeding in order to increase the rate of exclusive breastfeeding in the population. CONCLUSIONS Currently there is scientific evidence of a notable decline in mothers who breastfeed their children due to a lack of adequate information on the subject. For this, it is necessary to carry out health education, education programs have a promoting desire in the use of breastfeeding.

Regulation of the cutinases expressed by Aspergillus nidulans and evaluation of their role in cutin degradation.

Four cutinase genes are encoded in the genome of the saprophytic fungus Aspergillus nidulans, but only two of them have proven to codify for active cutinases. However, their overall roles in cutin degradation are unknown, and there is scarce information on the regulatory effectors of their expression. In this work, the expression of the cutinase genes was assayed by multiplex qRT-PCR in cultures grown in media containing both inducer and repressor carbon sources. The genes ancut1 and ancut2 were induced by cutin and its monomers, while ancut3 was constitutively expressed. Besides, cutin induced ancut4 only under oxidative stress conditions. An in silico analysis of the upstream regulatory sequences suggested binding regions for the lipid metabolism transcription factors (TF) FarA for ancut1 and ancut2 while FarB for ancut3. For ancut4, the analysis suggested binding to NapA (the stress response TF). These binding possibilities were experimentally tested by transcriptional analysis using the A. nidulans mutants ANΔfarA, ANΔfarB, and ANΔnapA. Regarding cutin degradation, spectroscopic and chromatographic methods showed similar products from ANCUT1 and ANCUT3. In addition, ANCUT1 produced 9,10-dihydroxy hexadecanoic acid, suggesting an endo-cleavage action of this enzyme. Regarding ANCUT2 and ANCUT4, they produced omega fatty acids. Our results confirmed the cutinolytic activity of the four cutinases, allowed identification of their specific roles in the cutinolytic system and highlighted their differences in the regulatory mechanisms and affinity towards natural substrates. This information is expected to impact the cutinase production processes and broaden their current biotechnological applications.

Parto extrahospitalario cuidados del recién nacido en la sala de partos / Out-of-hospital delivery care of the newborn in the delivery room

Consideramos el parto como un proceso fisiológico dentro de la naturaleza y que normalmente, en España, suele acontecer en el medio hospitalario, por lo que pasa a ser un proceso controlado o cuando menos observado. Se considera parto extrahospitalario o de urgencia al que se presenta de forma inesperada y no se ha planeado previamente. Es considerado una emergencia debido a las potenciales complicaciones materno-fetales, y al tener que asistirlo sin las condiciones ideales que nos proporciona un paritorio. El parto es un acontecimiento fisiológico y natural, que en la gran mayoría de los casos nuestra intervención se limitará a la de ser meros "espectadores activos". Se ha realizado una búsqueda bibliográfica de la producción científica enfermera hasta el momento actual en las siguientes bases de datos: Cuiden, Pubmed y Liliacs.

We consider birth as a physiological process within nature and that normally, in Spain, it usually happens in the hospital environment, so it becomes a controlled or at least observed process. It is considered extra-hospital or urgent delivery to the one that occurs unexpectedly and has not been previously planned. It is considered an emergency due to the potential maternal-fetal complications, and having to assist it without the ideal conditions that a parlor provides. Childbirth is a physiological and natural event, which in the vast majority of cases our intervention will be limited to being mere "active spectators". A bibliographic search of nursing scientific production has been carried out up to the present time in the following databases: Cuiden, Pubmed and Liliacs.

Advancing clinical research globally: Cervical cancer research network from Mexico.

Cervical cancer is the fourth most common cancer in women with 85% of the mortality burden occurring in less-developed regions of the world. The Cervix Cancer Research Network (CCRN) was founded by the Gynecologic Cancer InterGroup (GCIG) with a mission to improve outcomes in cervix cancer by increasing access to high-quality clinical trials worldwide, with particular attention to less-developed, underrepresented sites. The CCRN held its second international educational symposium in Mexico City with ninety participants from fifteen Latin America countries in January 2017. The purpose of this symposium was to advance knowledge in cervix cancer therapy, promote recruitment to CCRN clinical trials, and to identify relevant future CCRN clinical trial concepts that could improve global care standards for women with cervical cancer.

Cuidados del recién nacido en la sala de partos / Care of the newborn in the delivery room

El nacimiento de un niño es uno de los momentos más maravillosos de la vida. Pocas experiencias pueden compararse con este suceso. Los recién nacidos tienen capacidades sorprendentes y, sin embargo, dependen por completo de los demás en todos los aspectos: alimentación, calor y bienestar. Si existen señales que indican que hay algún problema, puede administrarse el tratamiento indicado en la sala de partos misma. El médico o la partera y otros miembros del equipo del cuidado de la salud trabajan juntos para ayudar a que el bebé elimine el exceso de fluido y comience a respirar. El objetivo general de este trabajo es conocer el estado actual de la producción científica enfermera sobre los cuidados de enfermería al Recién Nacido en la sala de partos. Se ha realizado una búsqueda bibliográfica de la producción científica enfermera hasta el momento actual en las siguientes bases de datos: Cuiden, Pubmed y Liliacs. Un adecuado Plan de Cuidados de Enfermería al Recién Nacido en la Sala de Partos deberá ir encaminado a Secar, estimular y reposicionar, colocar piel con piel con la madre si es posible, cuidados del cordón umbilical y la placenta.

The birth of a child is one of the most wonderful moments of life. Few experiences can be compared with this event. Newborns have surprising abilities and, nevertheless, depend completely on others in all aspects: food, heat and well-being. If there are signs indicating that there is a problem, the treatment indicated in the delivery room itself can be administered. The doctor or midwife and other members of the health care team work together to help the baby remove excess fluid and start breathing. The general objective of this work is to know the current state of nursing scientific production on nursing care for the Newborn in the delivery room. A bibliographic search of nursing scientific production has been carried out up to the present time in the following databases: Cuiden, Pubmed and Liliacs. An adequate Nursing Care Plan for the Newborn in the Delivery Room should be aimed at drying, stimulating and repositioning, placing skin with skin with the mother if possible, care of the umbilical cord and the placenta.

El gran valor de la lactancia materna / The great value of breastfeeding

Un banco de leche materna es un centro especializado en la promoción, el fomento, la recolección y el procesamiento de la lactancia materna, además de concienciar a la sociedad de la importancia y el valor de la lactancia materna, garantizando el suministro de un producto seguro y de alta calidad para aquellos neonatos que lo necesiten, las indicaciones más comunes para prescribir leche de banco son: nutricionales, terapéuticas y preventivas (1). Los bancos de leche benefician: A prematuros o nacidos con bajo peso al nacer. RN infectados. Portadores de deficiencias inmunológicas. Diarrea persistente. Casos excepcionales (2) En los últimos cinco años la cifra de Bancos de Leche Materna ha crecido de forma considerable en todo el mundo, en paralelo con la toma de consciencia de la importancia de leche materna en los bebés de alto riesgo, como para los prematuros, para los que se trata no sólo de un alimento, sino que se podría considerar una medicina. La evidencia científica acumulada a lo largo del siglo XXI, sobre la importancia de la leche materna para la salud y supervivencia de bebés ingresados en unidades neonatales, muy superior a cualquier fórmula específica., el aumento continuado de las tasas de inicio y prevalencia de la lactancia materna a nivel social, junto a la implementación de nuevos modelos sanitarios de atención neonatal ha contribuido a este cambio de tendencia (3). El objetivo general de este trabajo es conocer el estado actual de la producción científica enfermera sobre los bancos de leche.

A breast milk bank is a center specialized in the promotion, promotion, collection and processing of breastfeeding, as well as raising awareness of the importance and value of breastfeeding, ensuring the delivery of a safe product and high quality for those infants who need it, the most common indications for prescribing bank milk are: nutritional, therapeutic and preventive (1). Milk banks benefit: A preterm or born with low birth weight. Infected RN. Carriers of deficiencies immunological conditions. Persistent diarrhea. Special cases (2) In the last five years, the number of breast milk banks has grown considerably worldwide, in parallel with the awareness of the importance of breast milk in high-risk babies, as well as premature babies, for whom it is not just a food, but a medicine. The scientific evidence accumulated throughout the twenty-first century, on the importance of breast milk for the health and survival of infants admitted to neonatal units, far superior to any specific formula., The continuous increase of the rates of onset and prevalence of the breastfeeding at the social level, together with the implementation of new health models of neonatal care has contributed to this trend change (3). The general objective of this work is to know the current state of scientific nursing production on milk banks.

Coaching de la enfermera de pediatría / Coaching of the pediatric nurse

Coaching es un proceso orientado a ayudar a una persona sana. Las preguntas específicas que se hacen se enfocan a los objetivos y a los procesos internos de la persona. El Coaching profesional es un proceso de entrenamiento personalizado y confidencial mediante un gran conjunto de herramientas que ayudan a cubrir el vacío que existe en una persona. En la relación de Coaching el coach ayuda al desarrollo personal elevando la conciencia y generando un mayor nivel de responsabilidad y construyendo la confianza en sí mismo. El objetivo general de este trabajo es conocer el estado actual de la producción científica enfermera sobre la figura de coaching de la enfermera en pediatría. Se ha llevado a cabo un estudio descriptivo realizando una revisión bibliográfica hasta el momento actual en las siguientes bases de datos: Cuiden, Liliacs, Cochrane plus, TripDatabase, Cinhal y Pubmed. Se encontraron 89 artículos relacionados con el coaching, pero se desestiman 50 por no estar relacionados con pediatría, quedando tan sólo 39 artículos donde se menciona la figura de enfermería como coach en pediatría. Según el lugar de publicación, 15 (38,46%) de ellos son de Australia, 10 (25,64%)de EEUU, 9 (23,07%) de Japón y 5 (12,82%) de Reino Unido. Según su ámbito de aplicación, 30 (76,92%) están relacionados con la enfermera en el ámbito rural, haciendo hincapié en su labor de educación sanitaria y 9 (23,07%) en medio hospitalario. Se realiza un planning a seguir, con distintas etapas basadas en la educación sanitaria. Dentro de las conclusiones, se puede decir que: El coaching va más allá, no es solamente educación para la salud en pediatría, pretende potenciar habilidades, aptitudes y actitudes del paciente pediátrico y su familia; y facilita el desarrollo al máximo de su potencial fomentando la responsabilidad, autonomía y seguridad del paciente en su día a día, para conseguir sus metas u objetivos.

Coaching is a process aimed at helping a healthy person. The specific questions that are asked focus on the individual's goals and internal processes. Professional coaching is a personalized and confidential training process through a large set of tools that help fill the void that exists in a person. In the Coaching relationship the coach helps personal development by raising awareness and generating a higher level of responsibility and building self confidence The general objective of this work is to know the current state of the scientific production nurse on the coaching figure of the nurse in pediatrics. A descriptive study has been carried out, carrying out a bibliographic review up to the present moment in the following databases: Cuiden, Liliacs, Cochrane plus, TripDatabase, Cinhal and Pubmed. We found 89 articles related to coaching, but 50 are discounted because they are not related to pediatrics, leaving only 39 articles that mention the figure of nursing as coach in pediatrics. According to the place of publication, 15 (38.46%) of them are from Australia, 10 (25.64%) from the United States, 9 (23.07%) from Japan and 5 (12.82%) from the United Kingdom. According to their scope of application, 30 (76.92%) are related to the nurse in rural areas, emphasizing their health education work and 9 (23.07%) in a hospital setting. There is a planning to follow, with different stages based on health education. Within the conclusions, it can be said that: Coaching goes beyond, it is not only health education in pediatrics, it seeks to enhance the abilities, aptitudes and attitudes of the pediatric patient and his family; And facilitates the development to the maximum of its potential by promoting the responsibility, autonomy and safety of the patient in his day to day, to achieve his goals or objectives.

Regeneración in vitro de plantas de piña ( Ananas comosus ) ecotipo amazónico Gobernadora / In vitro regeneration of Amazonian pineapple ( Ananas comosus ) plants ecotype Gobernadora

Resumen En Venezuela existen cultivares y ecotipos de piña (A. comosus) de importancia local, entre ellos los amazónicos, cultivados principalmente por los aborígenes Piaroa. Ellos siembran los propágulos lo cual restringe la disponibilidad de material para el cultivo a gran escala. Se abordó la limitación recurriendo al cultivo de tejidos vegetales para la propagación in vitro de plantas de piña, ecotipo amazónico Gobernadora, mediante embriogénesis somática (ES) y organogénesis adventicia (OA). El material vegetal empleado correspondió a secciones basales e intermedias de hojas. Sólo las secciones de base foliar (SBF) fueron morfogénicamente inducidas. El mayor número de vitroplantas (1,58 plantas/explante) se obtuvo del callo embriogénico inducido en medio MS con Picloram 10 mg.L-1 + Tidiazuron 2 mg.L-1, transferido a MS sin hormonas. En el proceso organogénico, se obtuvo el mayor número de plantas/explante (5) por vía directa en MS con ácido naftalenoacético 5 mg.L-1 + bencilaminopurina 0,25 mg.L-1, transferido a MS. Siendo este último el mejor sistema de cultivo in vitro por su productividad y por ser una ruta que minimiza la variación somaclonal.

Abstract There are a number of pineapple (Ananas comosus) cultivars and ecotypes of local commercial importance in Venezuela, among them the Amazonian ones, cultivated mainly by the aboriginal Piaroa, are of relevance. They sow the propagules, which restricts the availability of material for large-scale cultivation. This limitation was approached by plant tissue culture for in vitro propagation of Amazonian pineapple plants, Gobernadora ecotype, through somatic embryogenesis (ES) and adventitious organogenesis (OA). Basal and intermediate sections of leaves were tested. Only the leaf base sections (FBS) were morphogenically induced. The highest number of vitroplants (1.58 plants / explant) was obtained from the embryogenic callus induced in MS medium with Picloram 10 mg.L-1 + Thidiazuron 2 mg.L-1, transferred to MS medium without hormones. In the organogenic process, the highest number of plants / explants (5) was obtained directly in MS with naphthaleneacetic acid 5 mg.L-1 + benzylaminopurine 0.25 mg.L-1, transferred to MS. The latter being the best in vitro culture system due to its productivity and for being a method that minimizes somaclonal variation.

Prevalence trends of wood use as the main cooking fuel in Mexico, 1990-2013.

OBJECTIVE:: To determine prevalence trends of using Wood as the Main Cooking Fuel (WMCF) in Mexico and household characteristics that predict its use. MATERIALS AND METHODS:: Estimates were obtained from the 1990, 2000 and 2010 censuses and from a national survey performed in 2012 and 2013. RESULTS:: In 2012-2013, 9.5% of the 66 321 surveyed households and 10.9% of their 252 011 residents used WMCF. Prevalence was higher in rural (40.5%) than urban areas (1.5%), p<0.0001. From 1990 to 2013 wood use decreased by 53% overall and by 28.6% in rural areas, gas use increased respectively by 17.5 and 52.7%. Predictors of using WMCF were living in rural or suburban areas and those associated with low socioeconomic status. CONCLUSION:: Use of WMCF has decreased substantially in Mexico but at a slower pace in rural areas. Improving household characteristics and socioeconomic status may decrease use of WMCF at a higher rate.

[Burden of hospitalization for pneumonia in a Spanish tertiary hospital. Period 2009-2014]. / Carga de hospitalización por neumonía en un hospital terciario español. Período 2009-2014.

BACKGROUND: The aim of this paper is to estimate the burden of hospitalization for community-acquired pneumonia and pneumococcal pneumonia at a tertiary level hospital in the Spanish National Health System. METHODS: A retrospective study which compiles data from the Minimum Data Set using clinical codes of the International Code of Diseases, as well as the hospitalization rate index per thousand inhabitants, the hospitalization rate per thousand population, mortality and fatality rate, using as denominator the demographic data of the population of the Health Area. RESULTS: The discharge of 5758 episodes coded with CIE codes 480 to 486 related to pneumonia, indicates an hospitalization rate of 3.54 people hospitalized per 1000 inhabitants, 65.34 % of all hospital admissions occured in Internal Medicine Services and Pneumology. The average hospital stay per year is 16.63 days. The crude death rate is 69.15 per 100 000 inhabitants and the fatality rate is 19.56 % being higher in adults over 65 years. CONCLUSIONS: Despite the current therapeutic and preventive measures, the incidence and mortality of community-acquired pneumonia in adults remains high, which justifies the strengthening and awareness to address new strategies and prevention such as vaccination.

Introducción: el objetivo de este trabajo es estimar la carga de hospitalización por neumonía adquirida en la comunidad y neumonía neumocócica en un hospital de nivel terciario del Sistema Nacional de Salud Español. Métodos: estudio retrospectivo en el que se recogen los datos del Conjunto Mínimo de Datos Básicos que usa códigos clínicos del Código Internacional de Enfermedades, asi como el índice de hospitalización por mil habitantes, la tasa de hospitalización por mil habitantes, el índice de mortalidad y la tasa de letalidad, usando como denominador los datos demográficos de la población del Área de Salud. Resultados: la descarga de 5758 episodios codificados con los códigos CIE 480 a 486 relativos a neumonía, señalan un índice de hospitalización de 3.54 personas hospitalizadas por cada 1000 habitantes, 65.34% del total de ingresos hospitalarios se produce en los Servicios de Medicina Interna y de Neumología. La estancia media hospitalaria por año es de 16.63 días. La tasa bruta de mortalidad es de 69.15 cada 100 000 y la tasa de letalidad de 19.56%, siendo más elevadas en adultos mayores de 65 años. Conclusiones: a pesar de las medidas terapéuticas y preventivas actuales, la incidencia y la mortalidad por neumonía adquirida en la comunidad en adultos se mantienen elevadas, lo que justifica fortalecer y abordar nuevas estrategias de concienciación y prevención.

Prevalence trends of wood use as the main cooking fuel in Mexico, 1990-2013 / Tendencias en la prevalencia del uso de leña como principal combustible utilizado para cocinar en México, 1990-2013

Abstract: Objective: To determine prevalence trends of using Wood as the Main Cooking Fuel (WMCF) in Mexico and household characteristics that predict its use. Materials and methods: Estimates were obtained from the 1990, 2000 and 2010 censuses and from a national survey performed in 2012 and 2013. Results: In 2012-2013, 9.5% of the 66 321 surveyed households and 10.9% of their 252 011 residents used WMCF. Prevalence was higher in rural (40.5%) than urban areas (1.5%), p<0.0001. From 1990 to 2013 wood use decreased by 53% overall and by 28.6% in rural areas, gas use increased respectively by 17.5 and 52.7%. Predictors of using WMCF were living in rural or suburban areas and those associated with low socioeconomic status. Conclusion: Use of WMCF has decreased substantially in Mexico but at a slower pace in rural areas. Improving household characteristics and socioeconomic status may decrease use of WMCF at a higher rate.

Resumen: Objetivo: Determinar las tendencias temporales de prevalencia del uso de leña utilizada para cocinar (ULPC) y características del hogar que lo predicen. Material y métodos:. Los estimados se obtuvieron de los censos 1990, 2000 y 2010 y de la encuesta nacional de 2012-2013. Resultados: En el periodo 2012-2013, 9.5% de los 66 321 hogares y 10.9% de sus 252 011 residentes usaron LPC. La prevalencia fue mayor en áreas rurales (40.5%) que las urbanas (1.5%), p<0.0001. De 1990 a 2013 el ULPC disminuyó 53% en todo el país y 28.6% en áreas rurales. Contrariamente, el uso de gas incrementó 17.5 y 52.7% respectivamente. Los predictores del ULPC fueron el vivir en áreas rurales o suburbanas, y aquellos asociados al nivel socioeconómico bajo. Conclusión: El ULPC ha disminuido pero a ritmo lento en las áreas rurales de México. Mejorar las características del hogar y nivel socioeconómico pudiera disminuir el ULPC a mayor ritmo.

ANCUT2, a Thermo-alkaline Cutinase from Aspergillus nidulans and Its Potential Applications.

Biochemical characterization of purified ANCUT2 cutinase from Aspergillus nidulans is described. The identified amino acid sequence differs from that predicted in Aspergillus genomic databases in amino acids not relevant for catalysis. The enzyme is thermo-alkaline, showing its maximum activity at pH 9 and 60 °C, and it retains more than 60% of its initial activity after incubation for 1 h at 60 °C for pH values between 6 and 10. ANCUT2 is more active towards long-chain esters and it hydrolyzes cutin; however, it also hydrolyzes short-chain esters. Cutinase is inhibited by metal ions, PMSF, SDS, and EDTA (10 mM). It retains 50% of its activity in most of the solvents tested, although it is more stable in hydrophobic solvents. According to its found biochemical properties, preliminary assays demonstrate its ability to synthesize methyl esters from sesame oil and the most likely application of this enzyme remains in detergent formulations.