Dendritic cell-based immunotherapy in non-small cell lung cancer: a comprehensive critical review.

Despite treatment advances through immunotherapies, including anti-PD-1/PD-L1 therapies, the overall prognosis of non-small cell lung cancer (NSCLC) patients remains poor, underscoring the need for novel approaches that offer long-term clinical benefit. This review examined the literature on the subject over the past 20 years to provide an update on the evolving landscape of dendritic cell-based immunotherapy to treat NSCLC, highlighting the crucial role of dendritic cells (DCs) in immune response initiation and regulation. These cells encompass heterogeneous subsets like cDC1s, cDC2s, and pDCs, capable of shaping antigen presentation and influencing T cell activation through the balance between the Th1, Th2, and Th17 profiles and the activation of regulatory T lymphocytes (Treg). The intricate interaction between DC subsets and the high density of intratumoral mature DCs shapes tumor-specific immune responses and impacts therapeutic outcomes. DC-based immunotherapy shows promise in overcoming immune resistance in NSCLC treatment. This article review provides an update on key clinical trial results, forming the basis for future studies to characterize the role of different types of DCs in situ and in combination with different therapies, including DC vaccines.

Invisible, Uncontrollable, Unpredictable: Illness Experiences in Women with Sjögren Syndrome.

Background/Objectives: Sjögren's Syndrome (SS) is a chronic degenerative rheumatic disease. Because of its chronic nature, it significantly affects the quality of life of those who suffer from it. Methods: This qualitative study investigated disease experience among women suffering from SS to understand its impact on their overall well-being. In-depth interviews were conducted with 15 women who suffer from SS. Interviews were analyzed using the Grounded Theory methodology, using open, axial, and selective coding. Results: Three central phenomena of disease experience were identified: invisibility; uncontrollability; and unpredictability. Conclusions: SS disease experience has a strong imprint on emotional well-being and sense of self-control among middle-aged women. Understanding SS impacts on women's lives is important to better understand the disease and contribute to recognizing potential areas of management and social support in relevant windows of opportunity within the health-disease continuum.

Therapeutic Effects of Amaranth: Analysis of the Antidiabetic Potential of the Plant.

Amaranth is a pseudocereal rich in macronutrients and micronutrients, with about 60 species cultivated worldwide. It is a high nutritional value food because of its many essential amino acids. Recent investigations demonstrate that the phytochemicals and extracts of amaranth have beneficial effects on health, including antidiabetic potential, a decrease in plasmatic cholesterol and blood pressure, and protection from oxidative stress and inflammation. Nowadays, type 2 diabetes has increased worldwide, becoming a problem of public health that makes it necessary to look for alternative strategies for its prevention and treatment. This review aims to summarize the antidiabetic potential of diverse species of the Amaranth genus. A bibliographical review was updated on the plant's therapeutic potential, including stem, leaves, and seeds, to know the benefits and potential as an adjuvant in treating and managing diabetes and associated pathologies (hypertension, dyslipidemia, and heart disease). This analysis contributes to the generation of knowledge about the therapeutic effects of amaranth, promoting the creation of new products, and the opportunity to conduct clinical trials to assess their safety and efficacy.

Knowledge, attitudes and practices related to oral health in participants of the institutional program for the inclusion of people with cognitive disabilities in higher education at the University of Costa Rica / Conocimientos, actitudes y prácticas relacionadas con la salud oral en participantes del Programa Institucional de Inclusión de Personas con Discapacidad Cognitiva a la Educación Superior de la Universidad de Costa Rica

Abstract People with cognitive disabilities face multiple challenges concerning oral health and frequently show oral tissue decay because of the barriers society imposes upon them, and due to financial issues, professional and family lack of knowledge, limitations regarding access to services, lack of empowering-driven actions, among others. Positive knowledge, attitudes and practices regarding oral health, developed during the course of a lifetime, help in preserving good health. The aim of the current study is to describe oral health knowledge, attitudes and practices in people with cognitive disabilities participating in the Institutional Program for the Inclusion of People with Cognitive Disabilities in Higher Education at the University of Costa Rica (PROIN, in Spanish), during 2021. A descriptive study with mixed focus was performed; a representative sample comprised of 86 students enrolled in PROIN was used for the quantitative approach, while the qualitative approach used a criteria sample along with an opinion sample, limiting size due to information overload. The survey, along with its corresponding questionnaire and the semi-structured interview, were used as data gathering techniques. It was evidenced that certain issues need to be readdressed, such as bleeding gums, the importance of preserving dental pieces, as well, the practice of flossing, which many students expressed difficulties doing. Good attitudes were found, such as dentist visits; however, access barriers for this population must be overthrown. This article showed the importance of training professionals in disabilities as well as developing oral health promotion programs aimed at people with cognitive disabilities.

Resumen La población con discapacidad cognitiva enfrenta múltiples retos en cuanto a la salud oral, presentado comúnmente un deterioro de los tejidos orales; esto como consecuencia a las barreras impuestas por la sociedad, factores económicos, desconocimiento de los profesionales y familiares, limitaciones en el acceso a la atención, falta de acciones para fomentar su autonomía, entre otras. Los conocimientos, actitudes y prácticas favorables en salud oral ayudan a conservar una buena salud, los cuales se desarrollan a lo largo de la vida. El objetivo del presente estudio es describir los conocimientos, actitudes y prácticas de salud oral en las personas con discapacidad cognitiva que participaron en el Programa Institucional de Inclusión de Personas con Discapacidad Cognitiva a la Educación Superior de la Universidad de Costa Rica (PROIN) durante el año 2021. Se realizó un estudio descriptivo con un enfoque mixto, para el enfoque cuantitativo se utilizó una muestra representativa de 86 estudiantes matriculados en PROIN y para la parte cualitativa se utilizó una muestra por criterio con un muestreo opinático, estableciendo el tamaño por saturación de la información. Se utilizaron como técnicas de recolección de datos la encuesta con su respectivo cuestionario y la entrevista semiestructurada. Se evidenció que existen temas que se deben reforzar, como lo es el sangrado de encías, la importancia de conservar las piezas dentales, así como la práctica de uso de hilo dental, donde la mayoría de los estudiantes expresaron tener dificultades para su utilización. Además, se encontró buenas actitudes con respecto a la visita al odontólogo, sin embargo, se debe derribar barreras de acceso que se presentan para esta población. Este estudio demostró la necesidad de capacitar a los profesionales en el tema de discapacidad y desarrollar programas de promoción de la salud oral específicos para personas con discapacidad cognitiva.

Covid-19 vaccination: a mixed methods analysis of health system resilience in Latin America.

BACKGROUND: This paper discusses the stages of health system resilience (HSR) and the factors underlying differences in HSR during the covid-19 pandemic, especially the vaccination challenge. We studied the relationship between vaccination strategies and macro-context backgrounds in 21 Latin American countries. Our objective was to capture the impact of those aspects in the SR and identify potential improvements for future crises and for vaccination programs in general. METHODS: The study uses mixed-methods research to provide insights into how the countries' backgrounds and vaccination strategies impact the HSR. Particularly, we used explanatory sequential mixed methods, which entails a quantitative-qualitative two-phase sequence. The quantitative phase was conducted using cluster and variance analysis, in which the HSR was measured using as a proxy the covid-19 vaccination outcomes in three cut-offs of reaching 25%, 50%, and 75% of population coverage. This approach allows us to discriminate covid-19 vaccination progress by stages and contrast it to the qualitative stage, in which we performed a country-case analysis of the background conditions and the changes in vaccination strategies that occurred during the corresponding dates. RESULTS: The paper provides a rich comparative case analysis of countries, classifying them by early, prompt, and delayed performers. The results show that differences in vaccination performance are due to flexibility in adapting strategies, cooperation, and the ability to design multilevel solutions that consider the needs of various actors in the health ecosystem. These differences vary depending on the vaccination stage, which suggests the importance of acknowledging learning, diffusion, and feedback processes at the regional level. CONCLUSIONS: We identified the importance of societal well-being as an ideal country antecedent for high and sustained levels of performance in covid-19 vaccination. Whereas in other countries where the set-up and beginning phases were rough, the value of the operational decisions and the learning on the move regarding their own and their peers' trajectories were crucial and were reflected in performance improvement. A contribution of this study is that the above-mentioned analysis was done using vaccination coverage cut-off points that allow a performance view that takes into consideration the stages of the vaccination progress and the learning process that goes with it. As well as framing this into the HSR shock cycles that allow to differentiate the stages of resilience on which countries must act.

N-acetylcysteine modulates redox imbalance and inflammation in macrophages and mice exposed to formaldehyde.

This study aimed to evaluate the protective role of N-acetylcysteine (NAC) in cells and mice exposed to formaldehyde. For the in vitro study, J774A.1 macrophages cells were incubated for 8, 16 and 24 h with formaldehyde or NAC to assess cell viability and reactive oxygen species (ROS). In the in vivo study, C57BL/6 mice (n = 48) were divided into 6 groups: control (CG), vehicle (VG) that received saline by orogastric gavage, a group exposed to formaldehyde 1% (FG) and formaldehyde exposed groups that received NAC at doses of 100, 150 and 200 mg/Kg (FN100, FN150 and FN200) for a period of 5 days. In vitro, formaldehyde promoted a decrease in cell viability and increased ROS, while NAC reduced formaldehyde-induced ROS production. Animals exposed to formaldehyde presented higher leukocyte counts in the blood and in the bronchoalveolar lavage fluid, and promoted secretion of inflammatory markers IL-6, IL-15, and IL-10. The exposure to formaldehyde also promoted redox imbalance and oxidative damage characterized by increased activities of superoxide dismutase, catalase, decreased GSH/GSSG ratio, as well as it increased levels of protein carbonyls and lipid peroxidation. NAC administration after formaldehyde exposure attenuated oxidative stress markers, secretion of inflammatory mediators and lung inflammation. In conclusion, both in in vitro and in vivo models, NAC administration exerted protective effects, which modulated the inflammatory response and redox imbalance, thus preventing the development airway injury induced by formaldehyde exposure.

Long-term e-cigarette aerosol exposure causes pulmonary emphysema in adult female and male mice.

This study aimed to evaluate long-term exposure to conventional cigarette smoke (CC) and electronic cigarette (EC) aerosol in adult male and female C57BL/6 mice. Forty-eight C57BL/6 mice were used, male (n = 24) and female (n = 24), both were divided into three groups: control, CC and EC. The CC and EC groups were exposed to cigarette smoke or electronic cigarette aerosol, respectively, 3 times a day for 60 consecutive days. Afterwards, they were maintained for 60 days without exposure to cigarettes or electronic cigarette aerosol. Both cigarettes promoted an influx of inflammatory cells to the lung in males and females. All animals exposed to CC and EC showed an increase in lipid peroxidation and protein oxidation. There was an increase of IL-6 in males and females exposed to EC. The IL-13 levels were higher in the females exposed to EC and CC. Both sexes exposed to EC and CC presented tissue damage characterized by septal destruction and increased alveolar spaces compared to control. Our results demonstrated that exposure to CC and EC induced pulmonary emphysema in both sexes, and females seem to be more susceptible to EC.

Water reclamation from anodizing wastewaters by removing reactive silica with adsorption and precipitation methods.

Water stress is a current environmental menace mainly driven by over exploitation of aquifers, which is triggering poor water quality with high concentration of minerals in extracted groundwater. Particularly, silica is widespread in natural water supplies due to weathering processes of silicates occurring in contact with water, light, air, and other factors. However, due to groundwater over extraction the concentration of silica has increased during the last years in aquifer reservoirs from Aguascalientes State (México). In this context, it is very important to note that the removal of silica compounds from water is challenging and different methods can be used to avoid embedding problems in different industries. In the present work, the removal of reactive silica from synthetic solutions as well as from real wastewaters from an industrial anodizing process was studied using adsorption and chemical precipitation methods. Twelve commercial materials of different nature were used for adsorption tests, while seven precipitant agents were applied in the precipitation experiments. Adsorption tests were performed in batch systems with constant stirring at 30 °C and at different pH values (7 and 9). Precipitation experiments were carried out in batch systems and the best conditions for silica removal were found using an L9 orthogonal array of the Taguchi method employing molar ratio, pH of wastewater, stirring time and temperature as experimental factors. Adsorption results showed that Ferrolox (Iron (III) hydroxide-base adsorbent) was the most efficient sorbent for reactive silica removal from synthetic solutions and the anodizing wastewater. Also, the reactive silica adsorption was higher at pH 9 as compared to that measured at pH 7 and the adsorbed quantity at pH 9 was 16.22 and 11.25 mg/g for the synthetic solution and anodizing wastewater, respectively. According to molecular simulation, the main interaction between Ferrolox and silica species was related to the formation of hydroxo-complexes and to the interaction of Fe with oxygen of silica species. Additionally, magnesium chloride was the best precipitating reagent for reactive silica achieving up to 87% removal. According to ANOVA analysis of Taguchi method, pH was the most influential factor during the precipitation of reactive silica with a variance value of 81.42, while values lower than 3 were obtained for the rest of parameters. Overall, the present work is reporting for the first time the removal of reactive silica from anodizing wastewaters with promising results that can be implemented at full scale for water reclamation, which may significantly contribute to manage water reservoir in the region sustainably.

Low-Intensity Resistance Training Improves Flow-Mediated Dilation in Young Hispanic Adults.

ABSTRACT: Briceño-Torres, JM, Carpio-Rivera, E, Solera-Herrera, A, Forsse, J, Grandjean, PW, and Moncada-Jiménez, J. Low-intensity resistance training improves flow-mediated dilation in young hispanic adults. J Strength Cond Res 37(2): 298-304, 2023-The purpose of this study was to compare the effects of 2 resistance exercise training (RET) intensities on brachial artery flow-mediated dilatation (FMD) in sedentary males. Thirty-four men (age = 20.6 ± 1.8 years, height = 171.3 ± 5.2 cm, body mass = 65.2 ± 10.6 kg, and DXA fat mass = 22.3 ± 7.4%) were randomly assigned to a control group (no exercise CTRL, n = 12), RET at 50% of 1 repetition maximum (1RM) (RET50%, n = 12), and RET at 80% 1RM (RET80%, n = 10). The RET program was performed twice per week for 8 weeks; subjects performed the same RET exercises at similar total workloads (1920 arbitrary units [AUs] for the RET80% and 1950 AUs for the RET50%). The FMD% was measured before and after 8 weeks by ultrasound. Mixed factorial analysis of variance (3 groups × 2 measurements), effect size (ES), and 95% confidence intervals (95% CIs) were computed for FMD%. The level of significance was set at p ≤ 0.05. A significant increase ( p = 0.001) was found on post-test FMD% in RET50% (mean = 9.9 ± 3.7%, ES = 1.9, and 95% CIs = 2.8-0.9) compared with CTRL (mean = 5.7 ± 1.7%, ES = 0.2, and 95% CIs = -0.4 to 0.8), and there were no significant differences found between RET50% and RET80% and between RET80% and CTRL. Results support the concept of training specificity and provide preliminary evidence that lower resistance and higher repetition RET elicit greater short-term reduced endothelium dysfunction than higher intensity RET at similar training volume.

¿Basta con el habla? Evaluación del desarrollo del lenguaje en niños sordos prelocutivos durante los primeros seis años de vida. Una revisión sistemática / Is speech enough? Language development evaluation in the first 6 years of prelingually deaf children. A systematic review

RESUMEN Objetivo Sintetizar la información científica relevante sobre la evaluación del desarrollo del lenguaje en niños sordos prelocutivos durante los primeros seis años de vida, con el fin de determinar si es suficientes para confirmar la presencia de algún desarrollo de lenguaje en esta población, o si se requiere un enfoque más integral. Estrategia de investigación Se realizó una revisión estructurada de la literatura científica en las siguientes bases de datos: PubMed, Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial y Nice. Criterios de selección revisiones sistemáticas, evaluaciones de tecnologías sanitarias, ensayos clínicos aleatorizados, estudios observacionales de cohorte y casos - controles; incluyendo publicaciones sobre evaluación de cualquier aspecto del desarrollo de lenguaje, cualquier intervención y en cualquier idioma, se excluyeron si únicamente evalúan audición o habla, sordera central, súbita, transitoria, sordoceguera, con otras discapacidades o con trastornos del espectro autista. Análisis de datos se usó la metodología GRADE para analizar la calidad de la evidencia. Resultados es factible realizar evaluaciones del desarrollo de lenguaje a niños sordos prelocutivos. Se obtiene una calidad de la evidencia moderada que sugiere cierta confianza en los resultados de las evaluaciones, siempre y cuando vengan acompañadas de una apreciación integral de otros elementos lingüísticos. Conclusión los resultados de las evaluaciones de lenguaje deben sostenerse, en mayor medida, en datos sobre el lenguaje receptivo y expresivo, y que cuyas evidencias pueden enriquecerse al adjuntar evaluaciones de elementos lingüísticos formales tanto de la modalidad oral como gestual, y de los componentes pragmáticos de los procesos comunicacionales.

ABSTRACT Purpose To synthesize the relevant scientific information regarding the assessment of language development in prelingually deaf children during their first six years of life, in order to determine whether it is sufficient to confirm the presence of some language development in this population, or if a more integrated approach would be more appropriate. Research strategies A structured review of the relevant scientific literature was carried out in the following databases: PubMed, Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial and Nice. Selection criteria Systematic reviews, health technology assessments, randomized clinical trials, observational cohorts and case-control studies; including publications of assessments concerning any aspect of language development or any intervention in any language. Evaluations related exclusively to hearing and speech, to central, sudden or transient deafness, to deaf-blindness, to further disabilities or to autism spectrum disorders, were excluded. Data analysis GRADE methodology was used to analyze evidence quality. Results It is possible to evaluate the language development of prelingually deaf children. A moderate quality of evidence was obtained, suggesting that the evaluations' results are fairly trustworthy, provided that the assessments are conducted within an integrated approach of other linguistic elements. Conclusion The results of the language evaluations must be supported mostly by receptive and expressive language data, and the found evidence can be improved by combining the assessments of the formal linguistic elements of both oral and gestural modalities with the pragmatic components of the communication process.

Illness Experience and Quality of Life in Sjögren Syndrome Patients.

Sjögren's syndrome (SS) is a disease with autoimmune features that affects mainly women and compromises the health-related quality of Life (HRQoL); it is important to evaluate illness experience for a better understanding of the life situation of the patient. The aim of the study was to summarize the individual life experiences and determine the impact of HRQoL and oral health-related quality of life (OHRQoL) and their correlation with health self-assessment in women with SS. The life experiences evaluation employed a concept mapping design to structure qualitative content obtained from semi-structured interviews. Hierarchical cluster analysis was used to analyze the patient's experiences. EQ-5D-5L and OHIP-14Sp were used. The correlation between appreciation of the general health status and OHIP-14 was evaluated. The experience classification by patients were analyzed and a dendrogram was obtained, identifying 10 clusters of disease experiences of SS, being limitations, pain and difficulties, coping and attitudes towards treatment the most common. Pain/discomfort in EQ-5D-5L and physical pain and psychological discomfort in OHIP-14 were the most affected dimensions in the patients. The results support the theoretical perspective that the experience of illness is relevant to describing the main difficulties of patients with SS and how it affects their quality of life.

In vitro assessment of the antimicrobial activity of tetracycline hydrochloride diluted in three different vehicles against Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum.

Background: The development and progression of periodontal diseases is a result of the dynamic interaction of microorganisms within their habitat, and changes in this habitat generate a dysbiotic state. Fusobacterium nucleatum and Prevotella intermedia are bridging microorganisms between the pioneer communities and other microorganisms responsible for periodontitis such as Porphyromonas gingivalis. Tetracycline hydrochloride (TTC-HCl) is commonly used as a coadjutant in periodontal treatment in the form of an antiseptic. However, there are no clear dilution or concentration protocols. Objective: This study aimed to evaluate the in vitro antimicrobial activity of TTC-HCl diluted in sterile water, saline solution, and 2% lidocaine with epinephrine 1:80,000 at concentration of 125, 250, and 500 mg, at three time points- 30, 60, and 120 s - on P. intermedia, F. nucleatum, and P. gingivalis using the Kelsey-Maurer technique. Materials and Methods: The antimicrobial activity of TTC-HCl was evaluated at the proposed concentrations and times, dissolved in the different vehicles at pH 1.9 and 7.0, on F. nucleatum, P. intermedia, and P. gingivalis. The Kelsey-Maurer test was used to verify the presence or absence of colony-forming units. Each test was performed in triplicates with its respective viability controls. Results: Inhibition of F. nucleatum, P. intermedia, and P. gingivalis was achieved with TTC-HCl at all concentrations, dissolved in distilled water, saline solution, and 2% lidocaine with epinephrine 1:80,000 for all times. Conclusions: The results show that TTC-HCl is a good antimicrobial alternative against F. nucleatum, P. intermedia, and P. gingivalis regardless of the vehicle in which it was dissolved, concentration, pH, or time used in this investigation.

Competitive adsorption of pollutants from anodizing wastewaters to promote water reuse.

Anodizing wastewater contains principally phosphate (PO43-) anions according to previous studies, but with the purpose to promote water reuse in this type of industry, a complete characterization of wastewater was made to remove other anions and cations also present in significant concentration. Particularly, the adsorption of sodium (Na+), potassium (K+), fluoride (F-), sulfate (SO42-) and phosphate (PO43-) was studied using different sorbents such as: coconut shell activated carbon, bone char, bituminous coal activated carbon, natural zeolite, silica, anionic and cationic exchange resins, a coated manganese-calcium zeolite, coconut shell activated carbon containing iron and iron hydroxide. All sorbents were characterized using FT-IR spectroscopy, potentiometric titration, nitrogen adsorption isotherms at 77 K, X-ray diffraction and SEM/EDX analysis to study the adsorption mechanism. The adsorption studies were performed in batch systems under constant agitation using both standard solutions of each ion and real anodizing wastewater. Results showed that, in general, the adsorption of all anions and cations is higher when mono-component standard solutions were used, since in the anodizing wastewater all species are competing for the active sites of the adsorbent. Na+ present in anodizing wastewater was efficiently adsorbed on coated manganese-calcium zeolite (20.55 mg/g) and natural zeolite (18.55 mg/g); while K+ was poorly adsorbed on all sorbents (less than 0.20 mg/g). Anions such as F-, SO42- and PO43-, were better adsorbed on the anionic resin (0.17, 45.38 and 2.92 mg/g, respectively), the iron hydroxide (0.14, 7.96 and 2.87 mg/g, respectively) and the bone char (0.34, 8.71 and 0.27 mg/g, respectively). All these results suggest that adsorption is a promising tertiary treatment method to achieve water reuse in the anodizing industry.

Development of Inclusion Complexes With Relative Humidity Responsive Capacity as Novel Antifungal Agents for Active Food Packaging.

Background: Allyl isothiocyanate is an excellent antimicrobial compound that has been applied in the development of active food packaging materials in the last years. However, the high volatility of this compound could prevent a lasting effect over time. In order to avoid this problem, cyclodextrin inclusion complexes have been proposed as an alternative, being beta-cyclodextrin (ß-CD) as the main candidate. In addition, ß-CD could act as a relative humidity-responsive nanoparticle. In this regard, the aim of this study was to develop inclusion complexes based on ß-CD and AITC as relative humidity-responsive agents, which can be used in the design of active food packaging materials. Methods: Two different ß-CD:AITC inclusion complexes (2:1 and 1:1 molar ratios) were obtained by the co-precipitation method. Entrapment efficiency was determined by gas chromatography, while inclusion complexes were characterized through thermal, structural, and physicochemical techniques. Antifungal capacity of inclusion complexes was determined in a headspace system. Furthermore, the AITC release from inclusion complexes to headspace at different percentages of relative humidity was evaluated by gas chromatography, and this behavior was related with molecular dynamic studies. Key Findings and Conclusions: The entrapment efficiency of inclusion complexes was over to 60%. Two coexisting structures were proposed for inclusion complexes through spectroscopic analyses and molecular dynamic simulation. The water sorption capacity of inclusion complexes depended on relative humidity, and they exhibited a strong fungicide activity against Botrytis cinerea. Furthermore, the AITC release to headspace occurred in three stages, which were related with changes in ß-CD conformational structure by water sorption and the presence of the different coexisting structures. In addition, a strong influence of relative humidity on AITC release was evidenced. These findings demonstrate that ß-CD:AITC inclusion complexes could be used as potential antifungal agents for the design of food packaging materials, whose activity would be able to respond to relative humidity changes.

Illness Experiences of Chilean Women With Sjögren's Syndrome: The Patient Perspective.

OBJECTIVE: Sjögren's syndrome (SS) challenges everyday functioning and well-being. The aim of this study was to structure and summarize the life experiences of Chilean women with SS in an integrated model. METHODS: Interviews from a previous study yielded 75 experiences of living with SS. A sample of 30 women with SS sorted these experiences by content and rated their level of agreement with each experience. A hierarchical cluster analysis was used to structure the experiences of the participants with SS in a comprehensive overview. A team-based consensus analysis was used to define the number of clusters. The level of agreement was examined with Wilcoxon's signed rank test. RESULTS: Ten clusters were identified and grouped into 6 main categories: symptoms (clusters: mucosal dryness and related symptoms), social environment, emotion management (clusters: fears and sadness), information (clusters: uncertainty and lack of knowledge), coping strategy (clusters: resilience and self-care), and health staff relationship. The clusters that describe the more common experiences among patients were resilience, self-care, uncertainty, lack of knowledge, health staff relationship, and mucosal dryness. CONCLUSION: This study provided an integrated and structured overview of disease experiences comprising both biomedical and psychosocial aspects as being of vital importance for the health of patients with SS. The overview can be used to get a quick impression of disease experiences that are important for an individual patient, in a therapeutic goal setting, and in the construction and evaluation of medical and nonmedical interventions or education.

Comparación del efecto del tipo de descanso al realizar ejercicio contra resistencia sobre la presión arterial de hombres normotensos / Effect of the type of rest on blood pressure of normotensive males undergoing resistance exercise

Resumen Actualmente, se recomienda el ejercicio contra resistencia (ECR) como una de las estrategias no farmacológicas para el control y tratamiento de la presión arterial (PA). Sin embargo, es necesario profundizar esta línea de investigación. El propósito del estudio fue comparar el efecto del tipo de descanso al realizar ECR sobre la PA de participantes normotensos. Participaron nueve hombres; siguiendo un diseño de investigación de medidas repetidas, realizaron tres condiciones experimentales en orden aleatorio: a) Descanso Activo (DA), b) Descanso Pasivo (DP), c) Sesión Control. En las 3 sesiones, se midió la PA y la frecuencia cardíaca (FC) pre-tratamiento, 1 minuto post-sesión y cada 10 minutos post-tratamiento durante 120 minutos. Las sesiones experimentales estuvieron precedidas por: mediciones antropométricas, familiarización y aplicación del test de 1RM. En el análisis estadístico se aplicó ANOVA de 2 vías para medidas repetidas, análisis de efectos simples y post hoc de Tukey. Entre los principales resultados, se encontró que, en comparación con la sesión control, los valores de PA disminuyen de forma significativa (p < .05): 1) al realizar ECR utilizando DP y DA a los 50, 100, 110 minutos post-ejercicio; 2) posterior a ejecutar ECR utilizando DA a los 20, 30, 70, 80,100, 120 minutos; 3) después de finalizada la sesión ECR con DP a los 10, 40 y 120 minutos. Respecto a la medición pre-test, los valores de PA disminuyeron de forma significativa (p < .05) a los 10, 20, 40, 50, 60, 100 y 120 minutos post ECR utilizando DP. En conclusión, al comparar con los valores de PA mostrados en un día de control, la ejecución de ECR aplicando DP y DA es funcional en el control de la PA de hombres jóvenes normotensos. En relación al pre-test, se podría indicar que el DP es el que promueve el efecto hipotensivo del ECR.

Abstract Resistance exercise is currently recommended as a non-pharmacological strategy to control and treat blood pressure, but further research is necessary concerning this topic. The purpose of this paper is to compare the effect of types of rest on the blood pressure of normotensive individuals while performing resistance exercise. Following a random methodological design with repeated measurements, nine men performed three experimental conditions on different days: a) Active Rest, b) Passive Rest, and c) Control Session. During the three sessions, blood pressure and heart rate measurements were taken pre-treatment, one-minute post-session, and every 10 minutes post-treatment for 120 minutes. Experimental sessions were preceded by anthropometric measurements, familiarization, and taking the 1RM test. The statistical analysis was conducted using two-way ANOVA with repeated measurements and Tukey post-hoc analysis. One of the main results indicated that, compared to the control session, blood pressure decreased significantly (p<0.05): 1) When performing resistance exercise with active and passive rest at 50, 100, 110 minutes post-exercise; 2) After executing resistance exercise with active rest at 20, 30, 70, 80,100, and 120 minutes; 3) After performing resistance exercise session with passive rest at 10, 40, and 120 minutes. With respect to pre-test levels, blood pressure decreased significantly (p<0.05) at 10, 20, 40, 50, 60, 100, and 120 minutes after performing resistance exercise with passive rest. In conclusion, compared with a control day, in the case of young normotensive males, the inclusion of both passive and active rest is functional for controlling blood pressure. In relation to the pre-test, passive rest promotes a hypotensive effect in the study population.

Resumo Recomenda-se, atualmente, o exercício contrarresistência (ECR) como uma das estratégias não farmacológicas para o controle e tratamento da pressão arterial (PA). Não obstante, é preciso aprofundamento nesta linha de pesquisa. O propósito do estudo foi comparar o efeito do tipo de descanso ao realizar ECR sobre a PA de participantes normotensos. Participaram nove homens; seguindo um desenho de pesquisa de medidas repetidas, realizaram três condições experimentais em ordem aleatória: a) Descanso Ativo (DA), b) Descanso Passivo (DP) e c) Sessão Controle. Nas 3 sessões, foram solicitadas a PA e a frequência cardíaca (FC) pré-tratamento, 1 minuto pós-sessão e a cada 10 minutos pós-tratamento durante 120 minutos. As sessões experimentais foram precedidas por: medições antropométricas, familiarização e aplicação do teste de 1RM. Na análise estatística aplicou-se a ANOVA de 2 vias com medidas repetidas, a análise de efeitos simples e o teste pós-hoc de Tukey. Entre os principais resultados, observou-se que, em comparação com a sessão controle, os valores de PA diminuíram de maneira significativa (p < 0,05): 1) ao realizar ECR, usando DP e DA nos 50, 100, 110 minutos pós-exercício; 2) posterior à execução do ECR usando DA nos 20, 30, 70, 80,100, 120 minutos; 3) depois de finalizar a sessão ECR com DP nos 10, 40 e 120 minutos. Com relação à medição pré-teste, os valores de PA diminuíram de maneira significativa (p < 0,05) nos 10, 20, 40, 50, 60, 100 e 120 minutos pós-ECR usando DP. Em conclusão, ao fazer a comparação com os valores de PA mostrados em um dia de controle, a execução de ECR aplicando DP e DA é funcional no controle da PA de homens jovens normotensos. Com relação ao pré-teste, poderia indicar-se que o DP é o promotor do efeito hipotensivo do ECR.

Dermatitis periorifical en niños: presentación de casos clínicos / Periorificial dermatitis in children: case reports

La dermatitis periorificial, es una erupción acneiforme que comúnmente afecta la región perioral y con frecuencia se extiende alrededor de la nariz y los ojos. Los mayores reportes son en mujeres de 20 a 45 años y en menor proporción en menores de 18 años. Su etiología es desconocida, pero se ha asociado al uso de glucocorticoides tópicos, inhalados y sistémicos. Objetivo: presentar una serie de casos de dermatititis periorificial, asociados con el uso indiscriminado de glucocorticoides, que respondieron eficazmente al tratamiento con metronidazol tópico, solo o combinado con doxiciclina. Presentación de casos clínicos: se describen cinco pacientes de sexo femenino, edades comprendidas entre 4 y 18 años, atendidos en la consulta ambulatoria de Dermatología. En cuatro casos, se documentó el uso prolongado de glucocorticoides tópicos/inhalados, de estos, tres presentaron lesiones papulares eritematosas o color piel, escasas pústulas, asintomáticas o prurito leve, localizadas a nivel perioral, perinasal y periocular; perioral y perinasal en uno y solamente perioral en otro. El tratamiento con metronidazol tópico fue exitoso en los cinco pacientes y en uno se combinó con doxiciclina oral. Conclusiones: el manejo de la dermatitis periorificial puede responder eficazmente al metronidazol tópico y dada su asociación al uso de glucocorticoides, se recomienda evitar el uso injustificado y prolongado de los mismos, tanto en forma tópica como inhalada o sistémica...(AU)

Cerebral hemodynamics in the non-alcoholic fatty liver.

INTRODUCTION AND OBJECTIVES: The association between non-alcoholic fatty liver disease and cerebral hemodynamics arises from cardiovascular damage mechanisms such as endothelial dysfunction, arterial wall increased stiffness, high thickness of the intimate index of the internal carotid artery, left ventricular hypertrophy, left diastolic dysfunction, calcification coronary arteries and increased epicardial fat. The multidirectional relationship between systemic inflammation and lipid metabolism constitutes a common and simultaneous mechanism that causes vascular damage. This study aims to provide insight into the relationship between non-alcoholic fatty liver disease and the function of systemic circulation and cerebral circulation using Doppler ultrasound. PATIENTS AND METHODS: Is an observational, cross-sectional, prospective, comparative study conducted at Medica Sur Hospital. Thirty-five patients were selected consecutively. The patients consulted neurological service for various symptoms without severity criteria, such as vertigo, primary headache and balance disturbances. RESULTS: There is a difference in the variables mean of the right MCA PI (p = 0.023), left MCA PI" (p = 0.004), and left VA PI (p = 0.036) between the control and NAFLD groups. The correlation analysis between these variables and the CAP showed a positive correlation of the three variables with the CAP, "right MCA PI" (r = 0.384), left MCA PI "(r = 0.509) and" left VA PI " (r = 0.551). CONCLUSIONS: This study demonstrates a subclinical process of the middle cerebral artery in subjects with NAFLD, which suggests it may be involved in the disease development and points the need to make decisions for this liver manifestation prevention and treatment.

[Allergic contact dermatitis to cobalt and nickel in a metal industry worker. Case report and literature review]. / Dermatitis de contacto alérgica a cobalto y níquel en un trabajador de la industria metalúrgica. Reporte de caso y revisión de la literatura.

BACKGROUND: Contact dermatitis is an eczematous skin reaction that is caused by repeated and direct exposure to an allergen: The prevalence of contact dermatitis to nickel is estimated at 17% in women and 3% in men, and 1-3% of the general population has allergic contact dermatitis to cobalt and chromium. Nickel, which is the leading cause of occupational dermatitis, shows reactivity to other metals; mainly chromium and cobalt. CLINICAL CASE: A 47-year old man, with previous sensitization to nickel in childhood, is a worker in the metal industry, with occupational exposure to nickel and cobalt, and showed dermatosis predominantly in the upper limbs. CONCLUSION: The risk of new sensitizations to metals (such as cobalt) has been increased by his previous sensitization to nickel that happened in childhood and his work in the metal industry.

Antecedentes: La dermatitis por contacto es una reacción eccematosa en piel causada por la exposición repetida y directa de un alérgeno; se estima que la prevalencia de dermatitis de contacto al níquel es de 17 % en mujeres y 3 % en hombres y que 1 a 3 % de la población general presenta dermatitis de contacto alérgica a cobalto y cromo. El níquel es la causa más importante de dermatitis ocupacional y presenta reactividad a otros metales, principalmente cromo y cobalto. Caso clinico: Hombre de 47 años, con previa sensibilización a níquel en la infancia, trabajador de la industria metalúrgica, con exposición laboral a níquel y cobalto, quien presentó dermatosis de predominio en miembros superiores. Conclusión: La sensibilización previa a níquel en la infancia y el trabajo en la industria metalúrgica incrementó el riesgo de nuevas sensibilizaciones a metales, como cobalto.

El efecto agudo del ejercicio en la presión intraocular: meta análisis / Effect of acute exercise in intraocular pressure: a meta-analysis / O Efeito agudo do exercício na pressão intraocular: meta- análise

Resumen La presión intraocular (PIO) alta afecta la salud visual, principalmente es un factor de riesgo para el glaucoma. El objetivo de este estudio fue conocer los efectos del ejercicio agudo sobre la PIO. Se meta analizaron estudios experimentales que evaluaron el efecto de la actividad física aguda sobre PIO. La búsqueda de datos abarcó ocho bases de datos multidisciplinarias. Se aplicó un protocolo PRISMA, con criterios de elegibilidad, calidad metodológicas y extracción de la información por dos investigadores para garantizar reproductibilidad. El meta análisis fue de efectos aleatorios, heterogeneidad con DerSimonian-Lairds. Como resultado, se analizaron veintinueve artículos para obtener los tamaños de efecto (TE), los grupos experimentales incluyeron a 1016 personas y los grupos control 120 personas. Un total de 102 TE delta fueron calculados. Los resultados de este estudio muestran para el grupo control un tamaño de efecto de 0.31 (IC 95% = de -0.46 a 1.08, Q = 16.15, I2=81.42 p ≤ 0.05). Para los grupos experimentales se obtuvo un efecto de -0.68 (IC 95% = de -0.95 a -0.41, Q = 1573.49, I2 = 99.80, p ≤ 0.05). En el caso de ejercicio aeróbico agudo el TE fue de -1.74 (IC 95% = de -2.11 a -1.36, Q = 723.48, I2 = 99.66, p ≤ 0.05), lo que muestra un efecto grande e indica una reducción de la PIO, por lo cual se señala una estrategia preventiva que se podría de tomar en cuenta. Con respecto al ejercicio contra resistencia, el TE fue de 0.13, lo que indica que no hay efecto. En conclusión, la PIO se reduce por medio del ejercicio aeróbico agudo.

Abstract High intraocular pressure (IOP) affects visual health, since it is the main risk factor for glaucoma. The objective of this study was to know the effects of intense exercise on IOP. The methodology was based on meta-analyzed experimental studies that evaluated the effect of intense physical activity on IOP. The research of data included eight multidisciplinary databases. A PRISMA protocol was applied, with criteria of eligibility, methodological quality, and extraction of information by two researchers to guarantee reproducibility. The meta-analysis was based on random effects, heterogeneity with DerSimonian-Laird. As a result, twenty-nine articles were analyzed to obtain the effect size (ES): experimental groups included 1,016 subjects and control groups included 120 subjects. A total of 102 delta ES were calculated. The results of this study show an ES of 0.31 (IC 95% = from -0.46 to 1.08, Q = 16.15, I2 = 81.42 p ≤ 0.05) for the control group and an ES of -0.68 (IC 95% = from -0.95 to -0.41, Q = 1573.49, I2 = 99.80, p ≤ 0.05) for experimental groups. ES for aerobic exercise was -1.74 (IC 95% = from -2.11 to -1.36, Q = 723.48, I2 = 99.66, p ≤ 0.05), which shows a large effect, indicating a reduction of IOP. This result indicates a preventive strategy that should be taken into consideration. In regards to strength exercise, ES was 0.13, which indicates that there is no effect. In conclusion, IOP is reduced with intense aerobic exercise.

Resumo A pressão intraocular (PIO) elevada afeta a saúde visual e é, principalmente, um fator de risco para o glaucoma. O objetivo deste estudo foi conhecer os efeitos do exercício agudo na PIO. Foi realizada a meta-análise de estudos experimentais que avaliaram o efeito da atividade física aguda na PIO. A busca de dados englobou oito bases de dados multidisciplinares. Foi aplicado um protocolo PRISMA com critérios de elegibilidade, qualidade metodológicas e extração da informação realizada por dois pesquisadores para assegurar a reprodutibilidade. A meta-análise foi de efeitos aleatórios e heterogeneidade com DerSimonian-Laird. Como resultado, foram analisados vinte e nove artigos para obter os tamanhos de efeito (TE), os grupos experimentais incluíram 1016 sujeitos e os grupos controle 120, sendo calculados um total de 102 TE delta. Os resultados deste estudo mostram para o grupo controle um tamanho de efeito de 0,31 (IC 95% = 0,46 a 1,08; Q = 1,615, I2 = 81,42 p ≤ 0,05); para os grupos experimentais foi obtido um efeito de -0,68 (IC 95% = -0,95 a -0,41; Q = 1573,49, I2 = 99,80, p ≤ 0,05). No caso de exercício aeróbico agudo o TE foi de -1,74 (IC 95% = de -2,11 a -1,36; Q = 723,48, I2 = 99,66, p ≤ 0,05), o que mostra um efeito grande e indica uma redução da PIO, indicando uma estratégia preventiva que poderia ser levada em conta. Com relação ao exercício contrarresistência, o TE foi de 0,13, o que indica que não há efeito. Em conclusão, a PIO é reduzida por meio de exercícios aeróbicos agudos.