Colorectal cancer screening program implementation: biennial adherence and participation patterns.

INTRODUCTION AND AIM: Adherence to colorectal cancer (CRC) screening is essential for the effectiveness of screening programs. Even though organized screening programs can improve the quality of the process and adherence, there are still challenges to overcome. The aim of the present study, in which we implemented a biennial organized screening program for CRC, was to describe adherence and participation patterns. MATERIALS AND METHODS: A longitudinal, descriptive study was conducted, in which a team of trained patient navigators carried out interventions, with reminders via cellphone communication, to follow a cohort of 301 subjects eligible for CRC screening, utilizing a fecal immunochemical test (FIT). All the follow-up subjects received a FIT kit. RESULTS: A total of 747 cellphone calls were made and divided into three interventions. From the initial cohort, 126 subjects completed their biennial screening process through the FIT, indicating a consistent adherence rate of 41.8% to our program. The participation patterns were: 126 consistent participants (41.8%), 160 inconsistent participants (53.2%), and 15 participants that were never contacted (5%). CONCLUSIONS: In conclusion, our study underlines the importance of organized screening programs in the early detection of CRC. The implementation of follow-up interventions, through reminders and the training of patient navigators, can improve adherence, but there is a need for examining new strategies, to overcome barriers to communication via cellphone.

Optimizing cellulose fraction for enhanced utility: Comparative pre-treatment of Agave tequilana Weber var. blue bagasse fiber for sustainable applications.

In recent decades, natural fibers have emerged as an alternative to synthetic fibers due to their renewable nature, lower environmental impact, and comparable strength properties. Agave bagasse, a byproduct of agave juice extraction in Mexico, stands out for its potential in various industrial applications, notably biocomposite production. Bagasse is rich in cellulose, along with hemicellulose and lignin. Cellulose is the most suitable to be converted into valuable products, and it is versatile, renewable, and biodegradable. An effective pre-treatment is crucial to enrich its fraction. This study aims to determine the optimal pre-treatment conditions for the agave bagasse. Three different pre-treatments were tested, acid (H2SO4), enzymatic (Cellic® HTec2 enzymatic preparation), and sequence of acid-enzymatic (sulfuric acid and Cellic® HTec2), to determine which pre-treatment got the optimal cellulose fraction increase. The acid pre-treatment was conducted over three time ranges (5, 10, and 15 min) at different acid concentrations (1%, 1.5%, and 2%). Enzymatic reactions were conducted over 24 h, testing three different enzyme concentrations (1.5%, 3%, 4.5%). The sequential pre-treatment utilized the optimal conditions derived from the acid experiments (1.5% H2SO4 for 10 min), followed by enzymatic reactions carried out over three different durations (6, 12, and 24 h). The findings revealed that a 1.5% acid concentration applied for 10 min was the most efficient pre-treatment method. This pre-treatment resulted in a 1.9-fold increase in the cellulose fraction while reducing hemicellulose content by 30%. The hemicellulose reduction was confirmed through Fourier Transform IR spectroscopy (FTIR) analysis, complemented by scanning electron microscopy (SEM) observations highlighting physical alterations in the fiber structure. Furthermore, thermogravimetric analysis (TGA) demonstrated improved thermal stability, suggesting potential use in biocomposites. Future research should evaluate the environmental impact of optimized pre-treatment methods for agave bagasse.

Biological and chemical characterization in relation to the yield of radish (Raphanus sativus L.) nourished with humus from plant residues.

The increase in prices of fertilizers, energy and other materials necessary for the industry triggered a global economic crisis. Reason that was investigated on the biological and chemical characteristics in relation to the yield of radish nourished with humus from plant residue. The objective was to determine the appropriate dose of humus to obtain greater yield and its relationship with the chemical and biological characteristics of the radish. It is based on applied methodology with an experimental approach; Therefore, the Completely Random Block Design model was used, which consisted of 3 blocks and 5 treatments that were T1 with 0, T2 with 4, T3 with 6, T4 with 8 and T5 with 10 t/ha of humus and They applied 15 days after sowing. The physical characteristics of the radish were evaluated and processed using analysis of variance and Duncan. Concentration of elements in leaves and stomatal density were also analyzed. It was determined that T5 stood out in total plant length with 28.95 cm, plant weight with 76.87 g, equatorial diameter with 4,404 cm and commercial yield with 20,296 t/ha. Nitrogen consumption in relation to yield with 247.44 kg/ha. Stomatal density 459 stomata/mm2 and profitability with 150% and nutrient concentration in leaves highlighted T4 with N, K, Ca, Mg, Mo and Zn. It concludes that T5 stood out with 20,296 t/ha, which differed by 26.04% in relation to the control (T1) with 15,011 t/ha. Therefore, this dose added nutrients to the soil that improved the availability for plant absorption and this influenced the concentration of nutrients in leaves such as N, P and Fe and stomatal density with 459 stomata/mm2, which had a response in good development, strengthening against environmental stress and therefore greater performance.

Promotion of self-efficacy in mothers with infants discharged from neonatal intensive care units.

INTRODUCTION: The mothers of newborns who are discharged from a neonatal intensive care unit (NICU) experience stress and anxiety due to the specialized care their child requires at home, affecting their perception of maternal self-efficacy. OBJECTIVE: To evaluate the effect of the nursing intervention called Hospital Discharge Plan (HDP) on the promotion of self-efficacy in mothers of newborns discharged from the NICU. METHOD: Quantitative study, quasi-experimental design with pre-test/post-test in a single group, using the Parental Evaluation Scale applied to a convenience sample of 72 mothers of high-risk newborns from a NICU located in the city of Villavicencio (Colombia). The first measurement was taken between days 3 and 4 before discharge and at 15 days' post-discharge. Data processing was carried out using the statistical program SPSS, version 21. The intervention was based on the four concepts of self-efficacy by Barbara Resnick. RESULTS: The perception of maternal self-efficacy before the intervention showed a median of 8.9 points (RI 7.6-9.5); after the intervention it showed a median of 9.6 points (RI of 10-8.7); a statistically significant p-value<0.001 was obtained before and after the intervention with the Wilcoxon rank test. CONCLUSIONS: Education and follow-up promoted the development of knowledge and skills in mothers for the care of high-risk newborns. This contributed to the experience of mastery and vicarious experience from the teaching-learning process and contact with the experience of other mothers, which contributes to the effective development of motherhood.

Worldwide comparison between the potential distribution of Rhipicephalus microplus (Acari: Ixodidae) under climate change scenarios.

The cattle tick Rhipicephalus microplus (Acari: Ixodidae) has demonstrated its ability to increase its distribution raising spatially its importance as a vector for zoonotic hemotropic pathogens. In this study, a global ecological niche model of R. microplus was built in different scenarios using Representative Concentration Pathway (RCP), Socio-Economic Pathway (SSP), and a climatic dataset to determine where the species could establish itself and thus affect the variability in the presentation of the hemotropic diseases they transmit. America, Africa and Oceania showed a higher probability for the presence of R. microplus in contrast to some countries in Europe and Asia in the ecological niche for the current period (1970-2000), but with the climate change, there was an increase in the ratio between the geographic range preserved between the RCP and SSP scenarios obtaining the greatest gain in the interplay of RCP4.5-SSP245. Our results allow to determine future changes in the distribution of the cattle tick according to the increase in environmental temperature and socio-economic development influenced by human development activities and trends; this work explores the possibility of designing integral maps between the vector and specific diseases.

A case of natural infection with Dirofilaria immitis in a coati (Nasua narica) from Mexico.

This paper aims to describe the natural infection with Dirofilaria immitis in Nasua narica (white-nosed coati) from Yucatán, Mexico. Two carcasses of N. narica were collected on a highway that crosses through a dense forest with patches used for agriculture and livestock activities. We performed necropsies, and two female adult nematode parasites from the heart of one specimen were collected and preserved for their molecular identification using a conventional PCR directed at a fragment of the small subunit (18S) ribosomal RNA (18S-rRNA) gene. Bioinformatic analysis showed a similarity of 99 % with three sequences from D. immitis (two from Japan). Additionally, we performed a phylogenetic tree with the recovered sequence. All these analyses showed that D. immitis is present in N. narica from Mexico. The transmission of D. immitis toward populations of Nasua sp. may be due to indirect and accidental contact with domestic dogs or wild canids that share the same environment.

Prevalence of metabolic associated fatty liver disease (MAFLD) in patients with gallstone disease. Study on a cohort of cases in South-Southeastern Mexico.

INTRODUCTION: Metabolic (dysfunction) associated fatty liver disease (MAFLD) and gallstone disease are entities that share similar risk factors. Numerous publications confirm their elevated frequency, but few studies have considered their prevalence and possible association. AIMS: To determine the prevalence of MAFLD in patients with gallstone disease and the usefulness of liver biopsy for diagnosing the liver disease. MATERIALS AND METHODS: A prospective study was conducted on patients that underwent laparoscopic cholecystectomy, in whom liver biopsy was performed. VARIABLES ANALYZED: Anthropometric characteristics, biochemical profile, conventional ultrasound, risk factors, and histopathologic study of the liver biopsy. STATISTICAL ANALYSIS: Descriptive statistics were carried out for the quantitative variables and the Student's t test and multivariate analysis through binary logistic regression were employed for the continuous variables, utilizing IBM-SPSS, 25.0 (Windows) software. RESULTS: A total of 136 patients were classified into 2 groups: 40 (29.41%) with normal liver and 96 (70.59%) with MAFLD. Of the 136 patients, 71 patients (52.21%) corresponded to hepatic steatosis, 21 (15.44%) to steatohepatitis, and 4 (2.94%) to cirrhosis. Perisinusoidal inflammation was found in 39 cases (28.68%) and fibrosis was found in 10 (7.35%). The risk factors for both groups were age, diabetes, high blood pressure, and obesity. Glucose, triglyceride, and aminotransferase levels were significantly higher in the MAFLD group and conventional ultrasound demonstrated moderate concordance for its detection. DISCUSSION AND CONCLUSIONS: The results confirmed the elevated frequency of MAFLD associated with gallstone disease, justifying liver biopsy during cholecystectomy for diagnosing MAFLD.

Prevalence and clinical-epidemiologic characteristics of a Mexican population with metabolic (dysfunction) associated fatty liver disease: An open population study.

INTRODUCTION AND AIMS: The risk factors for fatty liver disease are frequent in the Mexican population and the available studies appear to underestimate its prevalence. Our aims were to know the prevalence of metabolic (dysfunction) associated fatty liver disease (MAFLD) in an open population and determine the clinical and sociodemographic characteristics, nutritional status, physical activity level, and prevalence of metabolic syndrome, in the affected population. MATERIALS AND METHODS: Volunteers from the general public were invited to take part in the study. Three separate questionnaires were applied to 1) determine the sociodemographic characteristics and health status of the participants, 2) evaluate the quality of their diet, and 3) to evaluate their level of physical activity. The participants underwent somatometry, laboratory tests, liver ultrasound, and FIB-4 index determination, and transition elastography (FibroScan®) was carried out on all subjects with signs suggestive of liver fibrosis that agreed to undergo the procedure. The statistical analysis was carried out using SPSS for Windows, version 22, software. RESULTS: A total of 585 volunteers were studied, resulting in a prevalence of MAFLD of 41.3%, a predominance of men above 50 years of age, poor dietary habits, and sedentary lifestyle. Male sex, obesity, metabolic syndrome, and elevated ALT were risk factors for the disease and 40% of those affected had advanced fibrosis. CONCLUSIONS: The prevalence of MAFLD in our population is one of the highest in the world. The conditioning factors of the disease can be modified. Therefore, public policies that redirect the current trend are required.

Compromiso sensitivo y polineuropatía periférica como manifestación inicial de enfermedad de Creutzfeldt-Jakob. A propósito de un caso

La enfermedad de Creutzfeldt-Jakob (ECJ) es una rara enfermedad neurodegenerativa con una alta incidencia en Chile respecto del resto del mundo. El cuadro se caracteriza principalmente por desarrollo de demencia rápidamente progresiva y diversos signos neurológicos inespecíficos, siendo el más frecuente la mioclonía. El caso que se describirá a continuación destaca por las manifestaciones iniciales atípicas que presentó el paciente, tales como compromiso sensitivo en región cráneo-cérvico-dorsal y polineuropatía periférica de extremidades inferiores (EEII), lo que significó un retraso en el diagnóstico clínico de la ECJ. Es importante conocer los diferentes síntomas y signos que pueden presentarse en el cuadro clínico de ECJ, tanto típicos como aquellos menos frecuentes, para así poder dar con el diagnóstico de la enfermedad en etapas más tempranas. De igual manera, es fundamental contar con herramientas diagnósticas como la detección de proteína 14-3-3 o proteína Tau en los centros de salud de nuestro país. Esto permitiría al equipo de salud, brindar un manejo de soporte adecuado y oportuno a estos pacientes.

Creutzfeldt-Jakob disease is a rare neurodegenerative disease with a high incidence in Chile compared to the rest of the world. The condition is mainly characterized by the development of rapidly progressive dementia and various nonspecific neurological signs, the most common being myoclonus. The case that will be described below stands out for the atypical initial manifestations that the patient presented, such as sensory compromise in the cranio-cervico-dorsal region and peripheral polyneuropathy of the lower extremities, which meant a delay in the clinical diagnosis of the disease. It is important to know the different symptoms and signs that can be present in the clinical picture of CJD, both typical and those less frequent, in order to be able to diagnose the disease in earlier stages. Similarly, it is essential to have diagnostic tools such as the detection of 14-3-3 protein or Tau protein in health centers in our country. This would allow the health team to provide adequate and timely support management to these patients.

AtZAT4, a C2H2-Type Zinc Finger Transcription Factor from Arabidopsis thaliana, Is Involved in Pollen and Seed Development.

Pollen plays an essential role in plant fertility by delivering the male gametes to the embryo sac before double fertilization. In several plant species, including Arabidopsis, C2H2-type zinc-finger transcription factors (TFs) have been involved in different stages of pollen development and maturation. ZINC FINGER of Arabidopsis thaliana 4 (AtZAT4) is homologous to such TFs and subcellular localization analysis has revealed that AtZAT4 is located in the nucleus. Moreover, analysis of AtZAT4 expression revealed strong levels of it in flowers and siliques, suggesting a role of the encoded protein in the regulation of genes that are associated with reproductive development. We characterized a T-DNA insertional heterozygous mutant Atzat4 (+/−). The relative gene expression analysis of Atzat4 (+/−) showed significant transcript reductions in flowers and siliques. Furthermore, the Atzat4 (+/−) phenotypic characterization revealed defects in the male germline, showing a reduction in pollen tube germination and elongation. Atzat4 (+/−) presented reduced fertility, characterized by a smaller silique size compared to the wild type (WT), and a lower number of seeds per silique. Additionally, seeds displayed lower viability and germination. Altogether, our data suggest a role for AtZAT4 in fertilization and seed viability, through the regulation of gene expression associated with reproductive development.

Using different multivariate approaches to assess water quality of qanats in arid zones of Southern Central Mexico.

Qanats in the aquifer of the Tehuacán Valley (Mexico) represent an ancient way of using groundwater that is still practiced today. They are used mainly for agricultural irrigation. However, anthropogenic activities have jeopardized the use of these aquifers. We analyzed 24 qanats in the Tehuacán Valley to assess water quality. Based on 24 physicochemical variables, a water quality index (WQI) was constructed on a zero-to-100 scale, divided into five water quality classes. A decision-tree analysis was applied to identify the parameters with the highest influence on the WQI, considering the water quality classes as categorical responses and the values of physicochemical variables as drivers of these categories. We produced interpolation maps to identify trends. The relationship between the WQI and the normalized difference indices of vegetation and salinity (NDVI and NDSI, respectively) was analyzed using a ternary diagram. WQI scores showed that 12.5% of the qanats have very good quality; 25%, good quality; and the remaining (62.5%) range from moderate to unacceptable quality. The CHAID classification-tree method correctly explained 83.3% of the categories, with sulfates, alkalinity, conductivity, and nitrates as the main parameters that explain water quality. WQI was inversely related to NDVI and NDSI, showing seasonal differences. Interpolation maps suggest a better water quality in the northern zone of the aquifer.

Spatial and seasonal analysis and geovisualization of Fasciola hepatica-free bovine bacillary hemoglobinuria outbreaks in eastern Uruguay, 1999-2019.

Bovine bacillary hemoglobinuria (BBH) produced by Clostridium novyi type D, is an endemic, highly fatal disease of cattle in the temperate grassland region of eastern Uruguay. A previous study showed that in this region, BBH is not associated with Fasciola hepatica or any other known focal-ischemic liver injury, so the reasons for its high incidence remains undetermined. The objective of this study was to analyze data from 45 Fasciola hepatica-free BBH outbreaks (1999-2019) in order to find common animal, seasonal and/or geographical risk factors, which may explain the occurrence of the epizootics. Fisher's goodness-of-fit testing showed a significantly higher case proportion of adult cows (N = 368, 80.5%) and lower of calves (N =8, 1.8%), as compared to the expected proportions of the censused population in the study area and historical submissions computed from the laboratory database (Chi-Sq = 346.2 and 174.8, df = 7, P < 0.00). Time series decomposition showed a bi-seasonal pattern, with a larger peak in spring and early summer (October to January) and a smaller increase in autumn (March-May). The lowest seasonal indices were on mid-summer (February) and winter (June-September). A combination of spatial statistics was used to assess the different spatial features of the disease and consistency of the findings. Global spatial autocorrelation showed BBH was significantly clustered (Moran's I = 0.407, P < 0.001). Both smoothed Anselin's Local Indicator of Spatial Autocorrelation and Kulldorff's spatial scan Poisson and Bernoulli models, detected roughly the same high-risk areas in the southeastern part of the Merin Lagoon basin, with the most likely cluster centered in the large wetland biosphere reserve "Eastern Wetlands and Coastal Strip" (RR = 9.12, P < 0.001). Outbreaks were georeferenced (latitude, longitude) and thematic dot-mapping geovisualization in Google Earth™ showed that the results were robust and truly geographic in nature. Most outbreaks (40/45, 88.8%) occurred on wetlands areas and large river valleys, characterized by poorly drained and frequently flooded soils, indicating that moisture-laden soils are the natural habitat of C. novyi type D. Grasslands in these endemic areas support rapid fattening of cattle during spring-summer, and somewhat less in autumn, in almost exact correspondence with BBH peaks, suggesting a close causal association in high-risk areas. Risk is significantly higher in adult cows probably because the spore content in the liver is highest in this category. The altered lipid metabolism and lipotoxicity in the liver may be the precipitating factor for spore germination and epizootic occurrence.

[Tumors that cause bone metastases]. / Tumores que producen metástasis óseas.

INTRODUCTION: A metastasis is the tumor cell capacity to migrate from the primary tumor and implant itself in tissues of an organ at a distance by hematogenous, lymphatic or contiguity. The main causes of bone metastases are: breast, prostate and lung cancer. It usually occurs in patients over 50 years of age. There is a predilection for metastasizing to the axial skeleton. OBJECTIVE: To determine the frequency of tumors that produce bone metastases in our institution. MATERIAL AND METHODS: Observational, cross-sectional, descriptive study, for retrospective analysis of the cases of patients diagnosed with bone metastases. RESULTS: 193 cases; 121 women and 72 men with an age range of 42 to 84 years. Cancers associated with bone metastases were breast, lung, prostate, cervical and renal cancers; to a lesser extent other such as colon, thyroid, liver and skin. The most affected bones were axial skeleton: lumbar and dorsal spine, and in appendicular skeleton the femur in the diaphysiary region and in the humerus the proximal third. At present it has not been possible to improve the effectiveness of timely detection strategies, so bone pain should begin with a protocol of tumor suspicion. CONCLUSIONS: More than 80% of the patients came for fracture. All patients had a history of pain greater than 12 months with no prior study protocol.

INTRODUCCIÓN: Una metástasis es la capacidad celular tumoral para migrar del tumor primario e implantarse en tejidos de un órgano a distancia por vía hematógena, linfática o contigüidad. Las principales causas de metástasis óseas son: cáncer de mama, próstata y pulmón. Habitualmente se da en pacientes mayores de 50 años. Existe predilección por metastatizar al esqueleto axial. OBJETIVO: Determinar la frecuencia de los tumores que producen metástasis óseas en nuestra institución. MATERIAL Y MÉTODOS: Estudio observacional, transversal, descriptivo, para análisis retrospectivo de los casos con diagnóstico de metástasis ósea. RESULTADOS: Ciento noventa y tres casos; 121 mujeres y 72 hombres con rango de edad de 42 a 84 años. Los cánceres asociados a metástasis ósea fueron cáncer de mama, pulmón, próstata, cervicouterino y renal; en menor proporción otros como colon, tiroides, hígado y piel. Los huesos más afectados fueron esqueleto axial: columna lumbar y dorsal; en esqueleto apendicular el fémur en la región diafisaria y en el húmero el tercio proximal. En la actualidad, no se ha logrado mejorar la efectividad de estrategias de detección oportuna, por lo que los cuadros de dolor óseo deben iniciar con un protocolo de sospecha tumoral. CONCLUSIONES: Más de 80% de los pacientes acudieron por fractura. Todos tenían historial de dolor mayor a 12 meses sin protocolo de estudio previo.

Acaricidal activity of the hexanic and hydroethanolic extracts of three medicinal plants against southern cattle tick Rhipicephalus (Boophilus) microplus (Acari: Ixodidae).

The southern cattle tick Rhipicephalus microplus is a major problem for the cattle industry in tropical and subtropical areas worldwide. Chemical products are commonly applied to control it; however, their indiscriminate use has resulted in the appearance of resistant lineages. In the last decades, plants have been used as an alternative to conventional acaricidal drugs, as several plant compounds repel activity, decrease the reproductive potential and reduce the survival rate of ticks. For this reason, the in vitro efficacy of hexanic and hydroalcoholic extracts of Randia aculeata, Moringa oleifera and Carica papaya were evaluated against the larvae and engorged females of R. microplus. Larval packet tests and adult immersion tests were performed with seven concentrations of each of the extracts. The extracts obtained with hydroethanolic solution (polar solvent) exhibited a higher acaricidal activity than extracts prepared with n-hexane (non-polar solvent). Hydroethanolic extracts of R. aculeata seed and shell showed the highest larvicidal activity against R. microplus (100 and 91% mortality, respectively) at a concentration of 100 mg/mL. Randia aculeata (seed and shell), M. oleifera and C. papaya treatments at the same concentration (100 mg/mL) also resulted in adult mortality of 85, 75, 66 and 55%, respectively. The adult immersion test showed that hydroethanolic extracts derived from R. aculeata seed significantly reduced the index of egg laying and increased the percentage inhibition of oviposition of female ticks at a concentration of 100 mg/mL. These results indicate that the tested extracts exhibit acaricidal activity and could be considered as potential agents for the development of alternative natural acaricides against R. microplus.

An updated Axiom buffalo genotyping array map and mapping of cattle quantitative trait loci to the new water buffalo reference genome assembly.

The objectives of this study were to provide the buffalo research community with an updated SNP map for the Axiom Buffalo Genotyping (ABG) array with genomic positions for SNP currently unmapped and to map all cattle QTL from the CattleQTLdb onto the buffalo reference assembly. To update the ABG array map, all SNP probe sequences from the ABG array were re-aligned against the UOA_WB_1 assembly. With the new map, the number of mapped markers increased by approximately 10% and went from 106 778 to 116 708, which reduced the average marker spacing by approximately 2 kb. A comparison of results between signatures of autozygosity study using the ABG and the new map showed that, when the additional markers were used there was an increase in the autozygosity peaks and additional peaks in BBU5 and BBU11 could be identified. After sequence alignment and quality control, 64 650 (UMD3.1) and 76 530 (ARS_UCD1.2) cattle QTL were mapped onto the buffalo genome. The mapping of the bovine QTL database onto the buffalo genome should be useful for genome-wide association studies in buffalo and, given the high homology between the two species, the positions of cattle QTL on the buffalo genome can serve as a stepping stone towards a water buffalo QTL database.

The effect of process variables on the physical properties and microstructure of HOPO nanoemulsion flakes obtained by refractance window.

Refractance window (RW) drying is considered an emerging technique in the food field due to its scalability, energy efficiency, cost and end-product quality. It can be used for obtaining flakes from high-oleic palm oil (HOPO) nanoemulsions containing a high concentration of temperature-sensitive active compounds. This work was thus aimed at studying the effect of temperature, thickness of the film drying, nanoemulsion process conditions, and emulsion formulation on the flakes' physical properties and microstructure. The results showed that HOPO flakes had good physical characteristics: 1.4% to 5.6% moisture content and 0.26 to 0.58 aw. Regarding microstructure, lower fractal dimension (FDt) was obtained when RW drying temperature increased, which is related to more regular surfaces. The results indicated that flakes with optimal physical properties can be obtained by RW drying of HOPO nanoemulsions.

Pronación: Tecnología de enfermería que produce bienestar en el cuidado de los pacientes COVID-19, en el Hospital General Dr. Manuel Gea González en la Ciudad de México / Pronation: A nursing technology that promotes wellbeing among COVID-19 patients at General Hospital Dr. Manuel Gea Gonzalez in México City

Introduction: pronation is a procedure used at the Intensive Care Unit with patients presenting Acute Respiratory Distress Syndrome (ARDS) with severe hypoxemia. Bibliographical references clearly support the application of this procedure due to the improvement it produces in oxygenation and the increased survival rate in patients. The main foundation behind this technology is that Ventral Decubitus (VD) promotes an improved redistribution of ventilation toward the dorsal regions of the lung, which are mainly collapsed during Dorsal Decubitus. Nursing staff have used this procedure because VD has proven to be a strategy with a useful and accessible impact over respiratory physiology. Objective: to analyze Pronation as a nursing technology and its promotion of COVID-19 patients' wellbeing at the General Hospital Dr. Manuel Gea González, in Mexico City. Material and methods: a nonexperimental, quantitative, cross-sectional, prolective, descriptive study to analyze pronation, as a nursing technology that promotes wellbeing in the care of COVID-19 patients at General Hospital Dr. Manuel Gea González, in Mexico City. Pronation as a nursing technology was the variable being measured. The universe was 530 nursing professionals working at the Hospital. The population and sample were 52 nursing specialists working with COVID-19 patients, representing 9.81% of the Universe. Results: as for training and experience with Pronation, 50% of the staff consider they have received sufficient training in regards to the SARS-CoV-2 virus, but they are still under training. Additionally, 84.62 % consider that Pronation promotes a remarkable recovery in the patients, with oxygen saturations between 80 to 100 %; 71.16 % believe that patients do show hemodynamic instability due to the position shift, but not in every case; and 80.77 % consider they make sure their patients do not develop pressure ulcers, given that 65.39 % practice patient hygiene and movement to prevent such ulcers. Discussion: from the interviewed staff, 50.01 % consider they have received sufficient training regarding COVID and the pronation of patients. This is consistent with Hernandez et al., who describe the need of a team trained specifically on the procedure, preferably comprised of Nurses specialized in Intensive Care. Likewise, 84.62% of staff members believe Pronation improves oxygen saturation in patients from 80% to 100%, this is contrasted with Barrantes and Vargas, who indicate that if Pronation does not result in 5% improvement in oxygen saturation, the patient must be returned to dorsal decubitus. Conclusion: ventilation in prone position is a pulmonary protective action used for over 30 years that produces an evident and continuous improvement in blood oxygenation and the respiratory physiology. Therefore, nursing specialists caring for COVID-19 patients recommend its use.

Introducción: la pronación es una maniobra utilizada en las unidades de cuidados intensivos, en pacientes que presentan síndrome de distrés respiratorio agudo (SDRA), cuando la hipoxemia es severa. Apoyada por una sólida evidencia científica, tiene impacto en la forma en que se ventila a los pacientes como parámetro de seguridad, esto aumenta la supervivencia. Objetivo: analizar la pronación, como tecnología de enfermería, que produce bienestar en el cuidado de los pacientes COVID-19, en el Hospital General Dr. Manuel Gea González, en la Ciudad de México. Material y métodos: estudio de carácter cuantitativo, no experimental, transversal, prospectivo, descriptivo. Variable medida: la pronación, como tecnología de enfermería. El universo 530 profesionales de enfermería que trabajan en el hospital, muestra: 52 especialistas de enfermería que trabajan con pacientes COVID-19. Resultados: en relación a la capacitación y experiencia en pronación, el 50% del personal manifiestan que sí recibieron suficiente capacitación sobre el virus SARS-CoV-2, aunque siguen capacitándose en ésta área; el 84.62 % consideran que en la pronación, los pacientes mejoran bastante, saturando entre el 80 y 100 % de oxígeno y el 80.77 % siempre cuidan que los pacientes no tengan úlceras por presión.Discusión: el 50.01 % del personal entrevistado manifiesta que sí recibió suficiente capacitación sobre la COVID-19 para pronar a los pacientes, lo que es semejante a la investigación de Hernández GD., et al.¹ Conclusión: la ventilación en posición prono es una medida de protección pulmonar utilizada hace más de 30 años que produce una mejoría evidente y sostenida de la oxigenación de la sangre y en la fisiología respiratoria, por lo que los especialistas de enfermería que atiende pacientes COVID-19 recomiendan su aplicación, pues está asociada al aumento de probabilidad de supervivencia.

Tumores que producen metástasis óseas / Tumors that cause bone metastases

Resumen: Introducción: Una metástasis es la capacidad celular tumoral para migrar del tumor primario e implantarse en tejidos de un órgano a distancia por vía hematógena, linfática o contigüidad. Las principales causas de metástasis óseas son: cáncer de mama, próstata y pulmón. Habitualmente se da en pacientes mayores de 50 años. Existe predilección por metastatizar al esqueleto axial. Objetivo: Determinar la frecuencia de los tumores que producen metástasis óseas en nuestra institución. Material y métodos: Estudio observacional, transversal, descriptivo, para análisis retrospectivo de los casos con diagnóstico de metástasis ósea. Resultados: Ciento noventa y tres casos; 121 mujeres y 72 hombres con rango de edad de 42 a 84 años. Los cánceres asociados a metástasis ósea fueron cáncer de mama, pulmón, próstata, cervicouterino y renal; en menor proporción otros como colon, tiroides, hígado y piel. Los huesos más afectados fueron esqueleto axial: columna lumbar y dorsal; en esqueleto apendicular el fémur en la región diafisaria y en el húmero el tercio proximal. En la actualidad, no se ha logrado mejorar la efectividad de estrategias de detección oportuna, por lo que los cuadros de dolor óseo deben iniciar con un protocolo de sospecha tumoral. Conclusiones: Más de 80% de los pacientes acudieron por fractura. Todos tenían historial de dolor mayor a 12 meses sin protocolo de estudio previo.

Abstract: Introduction: A metastasis is the tumor cell capacity to migrate from the primary tumor and implant itself in tissues of an organ at a distance by hematogenous, lymphatic or contiguity. The main causes of bone metastases are: breast, prostate and lung cancer. It usually occurs in patients over 50 years of age. There is a predilection for metastasizing to the axial skeleton. Objective: To determine the frequency of tumors that produce bone metastases in our institution. Material and methods: Observational, cross-sectional, descriptive study, for retrospective analysis of the cases of patients diagnosed with bone metastases. Results: 193 cases; 121 women and 72 men with an age range of 42 to 84 years. Cancers associated with bone metastases were breast, lung, prostate, cervical and renal cancers; to a lesser extent other such as colon, thyroid, liver and skin. The most affected bones were axial skeleton: lumbar and dorsal spine, and in appendicular skeleton the femur in the diaphysiary region and in the humerus the proximal third. At present it has not been possible to improve the effectiveness of timely detection strategies, so bone pain should begin with a protocol of tumor suspicion. Conclusions: More than 80% of the patients came for fracture. All patients had a history of pain greater than 12 months with no prior study protocol.

Inbreeding coefficients and runs of homozygosity islands in Brazilian water buffalo.

Characterization of autozygosity is relevant to monitor genetic diversity and manage inbreeding levels in breeding programs. Identification of autozygosity hotspots can unravel genomic regions targeted by selection for economically important traits and can help identify candidate genes for selection. In this study, we estimated the inbreeding levels of a Brazilian population of Murrah buffalo undergoing selection for milk production traits, particularly milk yield. We also studied the distribution of runs of homozygosity (ROH) islands and identified putative genes and quantitative trait loci (QTL) under selection. We genotyped 422 Murrah buffalo for 51,611 SNP; 350 of these had ROH longer than 10 Mb, indicating the occurrence of inbreeding in the last 5 generations. The mean length of the ROH per animal was 4.28 ± 1.85 Mb. Inbreeding coefficients were calculated from the genomic relationship matrix, the pedigree, and the ROH, with estimates varying between 0.242 and 0.035. Inbreeding estimates from the pedigree had a low correlation with the genomic estimates, and estimates from the genomic relationship matrix were much higher than those from the pedigree or the ROH. Signatures of selection were identified in 6 genomic regions, located on chromosomes 1, 2, 3, 5, 16, and 18, encompassing a total of 190 genes and 174 QTL. Many of the genes (e.g., APRT and ACSF3) and QTL identified are related to milk production traits, such as milk yield, milk fat yield and percentage, and milk protein yield and percentage. Other genes are associated with reproduction and immune response traits as well as morphological aspects of the buffalo species. Inbreeding levels in this population are still low but are increasing due to selection and should be managed to avoid future losses due to inbreeding depression. The proximity of genes linked to milk production traits with genes associated with reproduction and immune system traits suggests the need to include these latter genes in the breeding program to avoid negatively affecting them due to selection for production traits.