Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic.

BACKGROUND: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. METHOD: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. RESULTS: Four hundred fifty-three pediatric onco-hematologists from 20 countries responded to the first survey, with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active ongoing patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (odds ratio [OR]: 1.84, 95% CI: 1.19-2.8), surgeries (OR: 3, 95% CI: 1.9-4.6) and radiotherapy (OR: 6, 95% CI: 3.5-10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR: 3, 95% CI: 1.4-6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR: 3.48, 95% CI: 1.6-7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability. CONCLUSION: Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic.

Coupling/Uncoupling Reversibility in Isolated Mitochondria from Saccharomyces cerevisiae.

The yeast Saccharomyces cerevisiae uses fermentation as the preferred pathway to obtain ATP and requires the respiratory chain to re-oxidize the NADH needed for activity of Glyceraldehyde-3-phosphate. This process is favored by uncoupling of oxidative phosphorylation (OxPhos), which is at least partially controlled by the mitochondrial unspecific pore (ScMUC). When mitochondrial ATP synthesis is needed as in the diauxic phase or during mating, a large rise in Ca2+ concentration ([Ca2+]) closes ScMUC, coupling OxPhos. In addition, ScMUC opening/closing is mediated by the ATP/ADP ratio, which indicates cellular energy needs. Here, opening and closing of ScMUC was evaluated in isolated mitochondria from S. cerevisiae at different incubation times and in the presence of different ATP/ADP ratios or varying [Ca2+]. Measurements of the rate of O2 consumption, mitochondrial swelling, transmembrane potential and ROS generation were conducted. It was observed that ScMUC opening was reversible, a high ATP/ADP ratio promoted opening and [Ca2+] closed ScMUC even after several minutes of incubation in the open state. In the absence of ATP synthesis, closure of ScMUC resulted in an increase in ROS.

Pregnancy Inhibits Mammary Carcinogenesis by Persistently Altering the Hypothalamic-Pituitary Axis.

Early full-term pregnancy is known to reduce the lifetime risk of breast cancer. Although the phenomenon of parity-induced protection is well-established, the physiological mechanisms involved in this protection are not clear. Earlier reports have shown that pregnancy results in alterations of hormone levels. How pregnancy affects hypothalamic hormones and how the change, if any, influences breast cancer is not well understood. Seven-week-old female Lewis rats were given N-methyl-N-nitrosourea. Two weeks post carcinogen exposure, a set of females were housed with males to generate the parous rats and another set of rats served as the nulliparous controls. Mammary tumorigenesis was assessed for 9 months. Hypothalamic and pituitary levels of hormones were measured at various timepoints. Further, animals were also challenged with growth hormone and prolactin secretagogues to test the effect of pregnancy on the hypothalamic-pituitary hormonal axis. Persistent alterations in the level of growth hormone-releasing hormone, thyrotropin releasing hormone, dopamine, and somatostatin in the hypothalamus of parous animals was observed. Further, we also observed that pregnancy had a significant effect on the pituitary gland and its response to growth hormone and prolactin secretagogues. Our studies using the rodent model system demonstrate that pregnancy could be reducing the risk of breast cancer by persistently altering the hypothalamic-pituitary axis, which could have implications for breast cancers in humans as well.

Metabolism, ATP production and biofilm generation by Staphylococcus epidermidis in either respiratory or fermentative conditions.

Staphylococcus epidermidis is a Gram-positive saprophytic bacterium found in the microaerobic/anaerobic layers of the skin that becomes a health hazard when it is carried across the skin through punctures or wounds. Pathogenicity is enhanced by the ability of S. epidermidis to associate into biofilms, where it avoids attacks by the host and antibiotics. To test the effect of oxygen on metabolism and biofilm generation, cells were cultured at different oxygen concentrations ([O2]). As [O2] decreased, S. epidermidis metabolism went from respiratory to fermentative. Remarkably, the rate of growth decreased at low [O2] while a high concentration of ATP ([ATP]) was kept. Under hypoxic conditions bacteria associated into biofilms. Aerobic activity sensitized the cell to hydrogen peroxide-mediated damage. In the presence of metabolic inhibitors, biofilm formation decreased. It is suggested that at low [O2] S. epidermidis limits its growth and develops the ability to form biofilms.

Wolbachia pipientis grows in Saccharomyces cerevisiae evoking early death of the host and deregulation of mitochondrial metabolism.

Wolbachia sp. has colonized over 70% of insect species, successfully manipulating host fertility, protein expression, lifespan, and metabolism. Understanding and engineering the biochemistry and physiology of Wolbachia holds great promise for insect vector-borne disease eradication. Wolbachia is cultured in cell lines, which have long duplication times and are difficult to manipulate and study. The yeast strain Saccharomyces cerevisiae W303 was used successfully as an artificial host for Wolbachia wAlbB. As compared to controls, infected yeast lost viability early, probably as a result of an abnormally high mitochondrial oxidative phosphorylation activity observed at late stages of growth. No respiratory chain proteins from Wolbachia were detected, while several Wolbachia F1 F0 -ATPase subunits were revealed. After 5 days outside the cell, Wolbachia remained fully infective against insect cells.

Perfill de pacientes con cáncer en un centro de oncología en Bogotá / Profile of Cancer Patients at an Oncology Center in Bogotá / Perfil de pacientes com câncer em um centro de oncologia em Bogotá

Introducción: La experiencia de vivir con un cáncer repercute significativamente en la vida, pues afecta todo el ser, lo que demanda de enfermería comprender las características del cuidado de las personas y de sus seres queridos para poderlo cuidar. Objetivo: Describir y comparar la caracterización para el cuidado de los pacientes con cáncer. Método: Estudio descriptivo comparativo realizado con 131 pacientes con cáncer atendidos en tres servicios oncológicos, determinando el perfil sociodemográfico, la carga percibida y la apropiación de las tecnologías para el cuidado. El análisis se realizó utilizando estadística descriptiva, la comparación con prueba chi cuadrado y de Kruskal-Wallis. Resultados: Predomina el género femenino, edad promedio de 54 años (DE: 17,4), baja dependencia y estado cognitivo intacto, baja escolaridad, falta de ocupación laboral, nivel socioeconómico bajo y alto nivel de apoyo familiar. La percepción de bienestar es positiva en el aspecto físico, social y espiritual, para la mayoría. La apropiación de las tecnologías es media. Excepto por algunas variaciones, los pacientes presentan condiciones comunes para el cuidado. Conclusión: Los pacientes perciben apoyo, en especial familiar, bienestar físico, social y espiritual, excepto psicológico, lo que permite planear un cuidado de enfermería que garantice mejor acceso, seguridad y continuidad.

Introduction: The experience of living with cancer impacts significantly the life as it affects the whole being. In the nursing practice all this demands to understand the care characteristics of people living with cancer and their beloved ones in order to be able to care them. Objective: To describe and compare the characterization of care for cancer patients. Method: This is a comparative descriptive study conducted using 131 cancer patients who received health care in three oncologic services; it is intended to determine the sociodemographic profile, the measured load and the appropriation of care technologies. The analysis was carried out by using descriptive statistics and comparisons based on chi-square and Kruskal-Wallis tests. Results: Most of the patients were women with an average age of 54 years (SD: 17.4); they showed low drug-dependence, intact cognitive condition, and low schooling levels; many of them lacked a job and had a low socio-economic status but with strong family support. The well-being perception was positive regarding the physical, social, and spiritual aspects for most of the patients. There was a mean appropriation of technologies. Except for some variations, the patients show some conditions requiring a common care. Conclusion: Patients perceive support, especially from their families, with physical, social and spiritual wellbeing, but not psychological well-being. This allows to plan the nursing care so as to ensure a better access, safety and continuity.

Introdução: A experiência de conviver com cancro afeta significativamente a vida, pois magoa o ser tudo, e isso demanda da enfermagem compreender as carateristicas do cuidado das pessoas e seus seres queridos para puderem cuidá-los. Objetivo: Descrever e comparar a caracterização para o atendimento de pacientes com cancro. Método: Estudo descritivo comparativo realizado com 131 pacientes com cancro atendidos em três serviços oncológicos, determinando o perfil sociodemográfico, a sobrecarga percebida e a apropriação das tecnologias para o cuidado. A análise foi feita mediante estatística descritiva, a comparação com teste qui-quadrado e de Kruskal-Wallis. Resultados: Predomina o género feminino, idade média de 54 anos (SD: 17,4), baixa dependência e estado cognitivo intacto, baixa escolaridade, falta de ocupação laborai, baixas rendas e alto nível de apoio familiar. A percepção de bem-estar é positiva no aspecto físico, social e espiritual, para a maioria. A apropriação das tecnologias é média. Com exceção de algumas variações, os pacientes apresentam condições comuns para o cuidado. Conclusão: Os pacientes percebem apoio, em especial familiar, bem-estar físico, social e espiritual, exceto psicológico, o que permite planejar um cuidado de enfermagem garantindo melhor acesso, segurança e continuidade.

Percepción de comportamientos de cuidado de pacientes y de enfermería oncológica: estudio comparativo / Perception of caring behaviors of patients and oncology nursing: comparative study

Objetivo. Describir y comparar la percepción del comportamiento del cuidado de los pacientes y el personal de enfermería en servicios de hospitalización, hematología y urgencias en una institución de oncología de referencia de Bogotá. Metodología. Estudio descriptivo comparativo realizado con 131 pacientes y 78 integrantes del personal de enfermería en tres servicios oncológicos. La percepción de cuidado se valoró con el Instrumento comportamiento profesional de cuidado de Horner. La comparación se realizó con pruebas no paramétricas. Resultados. Los pacientes de 54 años en promedio, mayoría femenina, independientes, con baja escolaridad presentaron una percepción de comportamientos de cuidado de enfermería de 77,3% en promedio siendo mejor en hematología (81,3%), seguida de medicina interna (77,3%) y más baja en urgencias (73,3%). Ellos perciben en su orden atributos de cortesía, relación, compromiso e interacción. El personal de enfermería con el 19% profesional, 81% auxiliar, de mayoría femenina con más de 6 años de experiencia, presentó una percepción de comportamientos de cuidado de 85,9% siendo similar en los tres servicios. Conclusión: Las características de los pacientes y del personal de enfermería en los diferentes servicios son similares. Para los pacientes la percepción de comportamientos de cuidado de enfermería por servicios total y en las dimensiones interacción y compromiso es positiva y diferente (p < 0,05). Para el personal de enfermería la percepción de comportamientos de cuidado es similar entre servicios y superior a la de los pacientes en su totalidad y en las dimensiones cortesía e interacción (AU)

Hematology, and Emergency. Methodology. This was a descriptive comparative study conducted with 131 patients and 78 members from the nursing staff in three oncology services. The perception of care was evaluated with Homer’s Professional Caring Behaviors Instrument. Comparison was performed through non-parametric tests. Results. Patients were on average 54 years of age, mostly females, independent, with low schooling and presented a perception of nursing care behaviors of 77.3%, with hematology averaging better (81.3%), followed by internal medicine (77.3%) and lower in emergency (73.3%). They perceive, in order, attributes of courtesy, relationship, commitment, and interaction. The nursing staff were 19% professionals, 81% aides, mostly females with over six years experience, presented perception of caring behaviors of 85.9% and similar in the three services. Conclusion. The characteristics of patients and of the nursing staff in the different services are similar. For patients, the perception of nursing care behaviors per total services and in the dimensions of interaction and commitment is positive and different (p < 0.05). For the nursing staff, the perception of caring behaviors is similar among services and above that of the patients in their totality and in the dimensions of courtesy and interaction (AU)

Pneumococcal Conjugate Vaccine and Pneumonia Prevention in Children with Congenital Heart Disease.

BACKGROUND: A successful strategy to prevent Streptococcus pneumoniae infections is the administration of pneumococcal conjugate vaccines (PCVs). OBJECTIVE: To analyze the effectiveness of the 7- and 13-valent PCV for the prevention of all-cause pneumonia. MATERIALS AND METHODS: A retrospective cohort of children younger than 5 years of age, with congenital heart disease (CHD) and different vaccination schedules, was analyzed. History of vaccination was confirmed with verifiable records. The outcome measure was all-cause pneumonia or bronchopneumonia. Protocol was approved by the Institutional Review Board. For comparisons, we used inferential statistics with Chi-square and Fisher's exact test; a p ≤ 0.5 was considered statistically significant. Relative and absolute risks reduction and number needed to treat were also calculated. RESULTS: A total of 348 patients were included: 196 with two or more doses of PCV (considered the vaccinated group), and 152 in the unvaccinated group. There was a statistically significant difference for pneumonia events (p < 0.001) between the vaccinated (26/196) and unvaccinated (51/152) groups. The relative risk reduction was 60.5%, and the absolute risk reduction, 20.3%. There were no differences between patients who received two, three or four doses. The number needed to vaccinate to prevent one event of pneumonia was 5 children. CONCLUSIONS: At least two doses of PCV in children with CHD reduced the risk of all-cause pneumonia.

Efectividad de la tintura de pasiflora asociada al tratamiento convencional de pacientes con hipertensión arterial esencial / Effectiveness of passiflora stint associated with conventional treatment of patients with hypertension

Se realizó una intervención terapéutica para evaluar la efectividad del uso de la tintura de pasiflora asociada al tratamiento convencional en 120 pacientes con hipertensión arterial esencial, atendidos en un consultorio médico del municipio de Manzanillo, provincia de Granma, desde octubre del 2014 hasta abril del 2015. La población quedó distribuida en 2 grupos: uno de estudio y otro de control. Al primero se le indicó la tintura de pasiflora combinada con medicamentos convencionales, según las enfermedades asociadas y riesgos personales; al segundo, tratamiento médico convencional, con iguales requisitos. Se evaluó a los 15 y 30 días hasta 6 meses. Predominaron los pacientes mayores de 60 años (35,0 por ciento) y el sexo femenino. El tratamiento resultó efectivo en 42 (70,0 por ciento) integrantes del grupo de estudio y en 27 (45,6 por ciento) de los controles. Se concluyó que la tintura de pasiflora asociada al tratamiento convencional fue eficaz en el control de las cifras tensionales(AU)

A therapeutic intervention to evaluate the effectiveness of using passiflora stint associated with the conventional treatment in 20 patients suffering from essential hypertension, who were assisted in a family doctor's office of Manzanillo Granma, was carried out from October, 2014 to April, 2015. The population was distributed in 2 groups: study and control. The first group was prescribed with passiflora stint combined with conventional medicines, according to associated diseases and personal risks, the second group received conventional medical treatment with the same requirements. An evaluation was carried out after 15 and 30 days to 6 months. There was a prevalence of sixty years and over patients (35.0 percent) and female sex. The treatment was effective in 42 members of the study group (70.0 percent) and 27 members of the control group (45.6 percent). It was concluded that passiflora stint associated with conventional treatment was effective to control tension numbers(AU)

Efectividad de la tintura de pasiflora asociada al tratamiento convencional de pacientes con hipertensión arterial esencial / Effectiveness of passiflora stint associated with conventional treatment of patients with hypertension

Se realizó una intervención terapéutica para evaluar la efectividad del uso de la tintura de pasiflora asociada al tratamiento convencional en 120 pacientes con hipertensión arterial esencial, atendidos en un consultorio médico del municipio de Manzanillo, provincia de Granma, desde octubre del 2014 hasta abril del 2015. La población quedó distribuida en 2 grupos: uno de estudio y otro de control. Al primero se le indicó la tintura de pasiflora combinada con medicamentos convencionales, según las enfermedades asociadas y riesgos personales; al segundo, tratamiento médico convencional, con iguales requisitos. Se evaluó a los 15 y 30 días hasta 6 meses. Predominaron los pacientes mayores de 60 años (35,0 por ciento) y el sexo femenino. El tratamiento resultó efectivo en 42 (70,0 por ciento) integrantes del grupo de estudio y en 27 (45,6 por ciento) de los controles. Se concluyó que la tintura de pasiflora asociada al tratamiento convencional fue eficaz en el control de las cifras tensionales.

A therapeutic intervention to evaluate the effectiveness of using passiflora stint associated with the conventional treatment in 20 patients suffering from essential hypertension, who were assisted in a family doctor's office of Manzanillo Granma, was carried out from October, 2014 to April, 2015. The population was distributed in 2 groups: study and control. The first group was prescribed with passiflora stint combined with conventional medicines, according to associated diseases and personal risks, the second group received conventional medical treatment with the same requirements. An evaluation was carried out after 15 and 30 days to 6 months. There was a prevalence of sixty years and over patients (35.0 percent) and female sex. The treatment was effective in 42 members of the study group (70.0 percent) and 27 members of the control group (45.6 percent). It was concluded that passiflora stint associated with conventional treatment was effective to control tension numbers.

[Study Plan 2016 of the licentiate of medical surgery of the faculty of higher studies iztacala]. / Plan de Estudios 2016 de la Licenciatura de Médico Cirujano de la Facultad de Estudios Superiores Iztacala.

The 2016 undergraduate medical degree curriculum at the Facultad de Estudios Superiores Iztacala of the Universidad Nacional Autónoma de México (UNAM) is presented. It is the result of a long institutional reflection and academic dialog process of approximately three years, which culminated in its approval by UNAM's Academic Council for the Biology, Chemistry, and Health Sciences areas on January 25, 2016. Its most relevant characteristics are: modular organization, four knowledge areas (biomedical, methodological, socio-psychological, and humanistic and medical practice), and new modules such as Seminar of socio-psycho-biological integration; Genetics and molecular biology; Biochemistry and cellular biology; Pharmacological basis of therapeutics; Infectious diseases, microbiology and parasitology; Medical ethics; Public health; and Evidence-based medicine - clinical epidemiology. To achieve a more flexible curriculum, optional modules were included. To make possible the curricular change, improving the teaching strategies, innovating the learning assessment methods, supporting the training and updating of the teaching staff, and establishing a curriculum development committee for following up and evaluating the program, are necessary. Curricular changes are difficult and complex processes; they suppose challenges and opportunities. It is mandatory to plan them carefully and sensitively to allow a successful transition and avoid conflicts for the students, the teachers and the institution.

Música, religión y chakras energéticos / Music, religion and energy chakras

Se realizó un análisis sobre musicoterapia, los chakras energéticos y sus posibles relaciones con los orishas de la religión yoruba, con el objetivo de interpretar de una manera científica y lógica, los efectos beneficiosos para la salud, que en muchas ocasiones proporcionan en el ser humano sus prácticas musicales, teniendo en cuenta las relaciones e interconexiones energéticas que pudieran existir entre estos tres aspectos, que de esta forma, justifica las respuestas que experimentan algunas personas al escuchar o danzar ante la ejecución de estos ritos tan frecuentes y arraigados en este medio(AU)

An analysis about musical therapy, the energy chakras and their possible relationships with the orishas of yoruba religion was carried out, with the objective of interpreting in a scientific and logical way, the beneficial effects for health that provide in the human being their musical practices in many occasions, taking into account the relationships and energy interconnections that could exist among these three aspects and that this way, justifies the responses that some people experience when listening or dancing the performance of these rites deeply rooted and so frequent in this environment(AU)

Música, religión y chakras energéticos / Music, religion and energy chakras

Se realizó un análisis sobre musicoterapia, los chakras energéticos y sus posibles relaciones con los orishas de la religión yoruba, con el objetivo de interpretar de una manera científica y lógica, los efectos beneficiosos para la salud, que en muchas ocasiones proporcionan en el ser humano sus prácticas musicales, teniendo en cuenta las relaciones e interconexiones energéticas que pudieran existir entre estos tres aspectos, que de esta forma, justifica las respuestas que experimentan algunas personas al escuchar o danzar ante la ejecución de estos ritos tan frecuentes y arraigados en este medio.

An analysis about musical therapy, the energy chakras and their possible relationships with the orishas of yoruba religion was carried out, with the objective of interpreting in a scientific and logical way, the beneficial effects for health that provide in the human being their musical practices in many occasions, taking into account the relationships and energy interconnections that could exist among these three aspects and that this way, justifies the responses that some people experience when listening or dancing the performance of these rites deeply rooted and so frequent in this environment.

Relación y diferencias entre la historia clínica convencional y la homeopática / Relationship and differences between the conventional and homeopathic medical records

Se realizó una revisión bibliográfica sobre los aspectos que comprende la confección de una historia clínica, tanto convencional como homeopática. Aunque ambos documentos tienen como fin recoger los datos objetivos proporcionados por el paciente, así como los subjetivos, obtenidos de los exámenes físico y complementario, difieren en cuanto a los síntomas utilizados para el diagnóstico, por lo cual se considera oportuno complementar los criterios al evaluar al paciente desde el punto de vista holístico(AU)

A literature review on the aspects involved in making either a conventional or homeopathic medical record was carried out. Although both aim at collecting the objective data provided by the patient, as well as the subjective ones, obtained from the physical and complementary exams, they differ as for the symptoms used for the diagnosis, reason why it is convenient to supplement the approaches when evaluating the patient from the holistic point of view(AU)

Relación y diferencias entre la historia clínica convencional y la homeopática / Relationship and differences between the conventional and homeopathic medical records

Se realizó una revisión bibliográfica sobre los aspectos que comprende la confección de una historia clínica, tanto convencional como homeopática. Aunque ambos documentos tienen como fin recoger los datos objetivos proporcionados por el paciente, así como los subjetivos, obtenidos de los exámenes físico y complementario, difieren en cuanto a los síntomas utilizados para el diagnóstico, por lo cual se considera oportuno complementar los criterios al evaluar al paciente desde el punto de vista holístico

A literature review on the aspects involved in making either a conventional or homeopathic medical record was carried out. Although both aim at collecting the objective data provided by the patient, as well as the subjective ones, obtained from the physical and complementary exams, they differ as for the symptoms used for the diagnosis, reason why it is convenient to supplement the approaches when evaluating the patient from the holistic point of view

Algunas consideraciones sobre miasma y homeopatía / Some considerations on miasma and homeopathy

La medicina homeopática, disciplina capaz de ampliar el nivel de conocimiento con una óptica naturista, ayuda a elevar el dominio clínico y terapéutico de profesionales de la salud, a la vez que permite tener una visión más amplia del enfermo a partir de su integración consigo mismo y con el medio. El miasma en homeopatía es la alteración de la energía vital del individuo que lo predispone a padecer determinadas enfermedades. A tales efectos se realizó una revisión bibliográfica exhaustiva sobre el tema y se ofrece la interpretación de las definiciones antiguas relacionadas con la concepción actual. Todo lo anterior facilitará el diagnóstico diferencial entre los medicamentos homeopáticos que pueden ser utilizados(AU)

The homeopathic medicine, a discipline which widens the knowledge level with a naturist vision, helps to elevate the clinical and therapeutic control of the health professionals, at the same time that allows to have a wider vision of the patient taking into account his integration with himself and with the environment. Miasma in homeopathy is the alteration of the individual's vital energy that predisposes him to suffer certain illnesses. To such effects, an exhaustive literature review on the topic was carried out and the interpretation of the old definitions related to the current conception is offered. All the above-explained will facilitate the differential diagnosis among the homeopathic medications that can be used(AU)

Algunas consideraciones sobre miasma y homeopatía / Some considerations on miasma and homeopathy

La medicina homeopática, disciplina capaz de ampliar el nivel de conocimiento con una óptica naturista, ayuda a elevar el dominio clínico y terapéutico de profesionales de la salud, a la vez que permite tener una visión más amplia del enfermo a partir de su integración consigo mismo y con el medio. El miasma en homeopatía es la alteración de la energía vital del individuo que lo predispone a padecer determinadas enfermedades. A tales efectos se realizó una revisión bibliográfica exhaustiva sobre el tema y se ofrece la interpretación de las definiciones antiguas relacionadas con la concepción actual. Todo lo anterior facilitará el diagnóstico diferencial entre los medicamentos homeopáticos que pueden ser utilizados

The homeopathic medicine, a discipline which widens the knowledge level with a naturist vision, helps to elevate the clinical and therapeutic control of the health professionals, at the same time that allows to have a wider vision of the patient taking into account his integration with himself and with the environment. Miasma in homeopathy is the alteration of the individual's vital energy that predisposes him to suffer certain illnesses. To such effects, an exhaustive literature review on the topic was carried out and the interpretation of the old definitions related to the current conception is offered. All the above-explained will facilitate the differential diagnosis among the homeopathic medications that can be used

Beneficial Effects of Enteral Docosahexaenoic Acid on the Markers of Inflammation and Clinical Outcomes of Neonates Undergoing Cardiovascular Surgery: An Intervention Study.

BACKGROUND: Neonates undergoing surgery are at risk for uncontrolled inflammatory response and adverse clinical outcomes. Docosahexaenoic acid (DHA) ameliorates inflammation, improving clinical outcomes. However, its effect has not been evaluated in neonates undergoing surgery. We evaluated the effect of DHA on markers of inflammation and clinical outcomes in neonates undergoing surgery. METHODS: A double-blind clinical trial evaluated the effect of enteral DHA (DHA group) versus sunflower oil (SO group) perioperatively administered in neonates scheduled for cardiovascular surgery. Inflammation was evaluated by percentage of cells+ for cytokines and CD69 in mononuclear cells at baseline, 24 h and 7 days post surgery. Clinical outcomes measured were sepsis, organ dysfunctions (ODs), length of stay in intensive care and bleeding. Repeated measures analysis of variance and logistic regression were applied. RESULTS: Sixteen neonates received DHA and 18 received SO. Cells+ from neonates in the DHA group showed an early increase in receptor antagonist of interleukin (IL)-1+ (IL-1ra+) and IL-10+ and a late decrease in IL-6+. IL-1ß+ and IL-10+ changes were different between groups. After adjusting for confounders, less cells from DHA group were IL-1ß+, IL-6+, IL-1ra+ and IL-10+. DHA group presented less sepsis, ODs and shorter stay, but no difference in CD69+CD4+ cells or bleeding between groups. CONCLUSIONS: Administration of enteral DHA ameliorates markers of inflammation and improves clinical outcomes in surgical neonates.

PERCEPCIÓN DEL CUIDADO DE ENFERMERÍA DADO A LOS PACIENTES CON CÁNCER HOSPITALIZADOS / PERCEPTION OF NURSING CARE GIVEN TO CANCER PATIENTS HOSPITALIZED / PERCEPÇÃO DO CUIDADO DE ENFERMAGEM DADO PARA OS PACIENTES COM CÂNCER HOSPITALIZADOS

El objetivo principal de este artículo es describir el estado del arte sobre la percepción del cuidado de enfermería a pacientes oncológicos hospitalizados. Para esto, se hizo una revisión integrativa realizada en 16 bases de datos entre 1994 y 2014, teniendo en cuenta los descriptores percepción, relación enfermero-paciente, hospitalización y oncología, con sus respectivas traducciones al inglés y orientada por el descriptor boleano AND. Se encontraron de esta manera 52 publicaciones sobre la relación enfermera-paciente oncológico hospitalizado; asimismo, se evidenció que estas han ido en incremento, particularmente en la última década. La mayor parte de las publicaciones son de tipo cualitativo, revisiones o reflexiones. Al revisar en conjunto la productividad académica, se identificaron múltiples formas de abordar esta relación desde el punto de vista conceptual; sin embargo, parece ser su condición de reciprocidad la que resulta más enriquecedora para las partes, lo que permite que los sujetos que intercambian en medio del cuidado de la vida cuando se tiene un cáncer crezcan como personas y ganen en introspección. Así pues, la relación enfermera-paciente con cáncer hospitalizado es un punto central para poder comprender y cualificar las prácticas de cuidado de esta población. Se hace necesario desarrollar estrategias de medición y cualificación de esta interacción.

The main objective of this article is to describe the state of the art on the perception of nursing care for hospitalized cancer patients. For this, an integrative review was performed in 16 databases between 1994 and 2014, taking into account the perception descriptors, nurse-patient relationship, hospitalization, and oncology, with their translations in English and directed by the descriptor Boolean AND. Thus found 52 publications on nurse-patient relationship hospitalized cancer; also it became clear that these have been increasing, particularly in the last decade. Most of the publications are qualitative, revisions or reflections. In reviewing overall academic productivity, multiple ways to approach this relationship from a conceptual point of view were identified; however, it seems to be its condition of reciprocity that is most enriching parts, allowing subjects exchanged between life care when you have cancer grow as people and win in introspection. So the nurse-patient relationship with hospital cancer is central to understanding and to qualify care practices of this population. It is necessary to develop measurement strategies and qualification of this interaction.

O objetivo principal deste pressente artigo é descrever o estado da arte sobre a percepção do cuidado de enfermagem para pacientes oncológicos hospitalizados. Para isto, foi feita uma revisão integrativa realizada em 16 bases de dados entre 1994 e 2014, tendo em conta aos descritores: percepção, relação enfermeiro-paciente, hospitalização e oncologia, com sua correspondente tradução para inglês e dirigido pelo descritor Booleano AND. É assim que foram achadas 52 publicações sobre a relação enfermeiro-paciente oncológico hospitalizado; do mesmo, ficou claro que estes têm vindo a aumentar, particularmente na última década. A maioria das publicações é de tipo qualitativo, de revisões ou de reflexões. Ao rever em conjunto a produtividade acadêmica, foram identificadas múltiplas maneiras de abordar este relacionamento a partir do ponto de vista conceitual; no entanto, parece ser sua condição de reciprocidade aquela que resulta mais enriquecedora para as partes, permitindo-lhe que os indivíduos que intercambiam no meio do cuidado da vida quando se tem um câncer que possam crescer como pessoas e possam ganhar em introspecção. Assim, então, a relação enfermeiro-paciente com câncer hospitalizado é um eixo fundamental para puder compreender e puder qualificar as práticas de cuidado dessa população. Faz-se necessário desenvolver estratégias de medição e de qualificação dessa interação.

Coprotiella venezuelensis: a new record of cleistothecia genus of the ascomycetes in the world

A new record, Coprotiella venezuelensis was isolate on rhinoce-rosdung collected at south park Maracaibo zoo in Zulia State, Venezuela. The genus is compared with Coprotus and C.gongylospora having ascospores possessing De Bary bubbles.

Un nuevo registro, Coprotiella venezuelensis, fue aislado en heces de rinocerontes, colectados en el Parque Sur Zoológico en el estado Zulia, Venezuela. El género es comparado con Coprotus y C. gongylospora presentando ascósporas con burbujas de Bary.