Assessing the Relevance of Non-molecular Prognostic Systems for Myelodysplastic Syndrome in the Era of Next-Generation Sequencing.

Background: The Molecular International Prognostic Scoring System (IPSS-M) has improved the prediction of clinical outcomes for myelodysplastic syndromes (MDS). The Artificial Intelligence Prognostic Scoring System for MDS (AIPSS-MDS), based on classical clinical parameters, has outperformed the IPSS, revised version (IPSS-R). For the first time, we validated the IPSS-M and other molecular prognostic models and compared them with the established IPSS-R and AIPSS-MDS models using data from South American patients. Methods: Molecular and clinical data from 145 patients with MDS and 37 patients with MDS/myeloproliferative neoplasms were retrospectively analyzed. Results: Prognostic power evaluation revealed that the IPSS-M (Harrell's concordance [C]-index: 0.75, area under the receiver operating characteristic curve [AUC]: 0.68) predicted overall survival better than the European MDS (EuroMDS; C-index: 0.72, AUC: 0.68) and Munich Leukemia Laboratory (MLL) (C-index: 0.70, AUC: 0.64) models. The IPSS-M prognostic discrimination was similar to that of the AIPSS-MDS model (C-index: 0.74, AUC: 0.66) and outperformed the IPSS-R model (C-index: 0.70, AUC: 0.61). Considering simplified low- and high-risk groups for clinical management, after restratifying from IPSS-R (57% and 32%, respectively, hazard ratio [HR]: 2.8; P=0.002) to IPSS-M, 12.6% of patients were upstaged, and 5% were downstaged (HR: 2.9; P=0.001). The AIPSS-MDS recategorized 51% of the low-risk cohort as high-risk, with no patients being downstaged (HR: 5.6; P<0.001), consistent with most patients requiring disease-modifying therapy. Conclusions: The IPSS-M and AIPSS-MDS models provide more accurate survival prognoses than the IPSS-R, EuroMDS, and MLL models. The AIPSS-MDS model is a valid option for assessing risks for all patients with MDS, especially in resource-limited centers where molecular testing is not currently a standard clinical practice.

Case Report: Mycosis fungoides as an exclusive manifestation of common variable immunodeficiency in a family with a NFKB2 gene mutation.

Background: Common variable immunodeficiency disorders (CVIDs), which are primary immunodeficiencies characterized by the failure of primary antibody production, typically present with recurrent bacterial infections, decreased antibody levels, autoimmune features, and rare atypical manifestations that can complicate diagnosis and management. Although most cases are sporadic, approximately 10% of the patients may have a family history of immunodeficiency. Genetic causes involving genes related to B-cell development and survival have been identified in only a small percentage of cases. Case presentation: We present the case of a family with two brothers who presented with mycosis fungoides as an exclusive symptom of a common variable immunodeficiency disorder (CVID). Whole-exome sequencing of the index patient revealed a pathogenic variant of the NFKB2 gene. Based on this diagnosis and re-evaluation of other family members, the father and brother were diagnosed with this rare immune and preneoplastic syndrome. All CVID-affected family members presented with mycosis fungoides as their only symptom, which is, to the best of our knowledge, the first case to be reported. Conclusion: This case highlights the importance of high-throughput sequencing techniques for the proper diagnosis and treatment of hereditary hematological disorders.

Family Functioning Assessment Instruments in Adults with a Non-Psychiatric Chronic Disease: A Systematic Review.

There is little information on the evaluation of family functioning in adult patients with chronic non-psychiatric illness. The objective of this systematic review was to identify family functioning assessment instruments of known validity and reliability that have been used in health research on patients with a chronic non-psychiatric illness. We conducted a search in three biomedical databases (PubMed, Science Direct, and Web of Science), for original articles available in English or Spanish published between 2000 and 2019. The review was conducted in accordance with PRISMA guidelines. Fourteen articles were included in the review. The instruments Family Assessment Device, Family Adaptability and Cohesion Evaluation Scales, Family Functioning Health and Social Support, Family APGAR, Assessment of Strategies in Families-Effectiveness, Iceland Expressive Family Functioning, Brief Family Assessment Measure-III, and Family Relationship Index were identified. All of them are reliable instruments to evaluate family functioning in chronic patients and could be very valuable to help nurses identify families in need of a psychosocial intervention. The availability and clinical application of these instruments will allow nurses to generate knowledge on family health and care for non-psychiatric chronic conditions, and will eventually contribute to the health and wellbeing of adults with a non-psychiatric chronic disease and their families.

Correlación entre funcionamiento familiar y estilos de vida saludable en pacientes con cáncer colorrectal / Correlation between family functioning and healthy lifestyles in patients with colorectal cancer / Correlação entre funcionamento familiar e estilos de vida saudável em pacientes com câncer colorrectal

Resumen Objetivo: analizar la relación entre el funcionamiento familiar y los estilos de vida saludable en los pacientes con cáncer colorrectal. Materiales y métodos: se trató de un estudio descriptivo transversal correlacional realizado entre febrero y noviembre de 2016 en Bogotá (Colombia). Se encuestaron 78 pacientes a quienes se les evaluó el funcionamiento familiar y los estilos de vida promotores de salud con los cuestionarios ASF-E y HPLP II respectivamente. Se estudió el grado de relación lineal entre las dos variables mediante el coeficiente de correlación de Pearson. Resultados: existe una correlación positiva entre el funcionamiento familiar y estilos de vida promotores de salud (r: 0,224, p<0,05). La dimensión actividad física de los estilos de vida saludable fue la que se asoció con un mejor funcionamiento familiar global (r: 0,303, p<0,01) y con un mayor número de dimensiones (coherencia, individuación y mantenimiento) y metas (estabilidad, control y espiritualidad). Conclusiones: un mejor funcionamiento familiar de los pacientes con cáncer colorrectal se asocia positivamente con estilos de vida saludable. Conclusiones: un mejor funcionamiento familiar de los pacientes con cáncer colorrectal se asocia positivamente con estilos de vida saludable.

Abstract Objective: To analyze the relationship between family functioning and healthy lifestyles in patients with colorectal cancer. Materials and methods: A cross-sectional correlational study was conducted between February and November 2016 in Bogotá (Colombia). A total of 78 patients were evaluated for family functioning and for healthpromoting lifestyles using the ASF-E and HPLP II questionnaires, respectively. The degree of linear relationship between the two quantitative variables was quantified using the Pearson correlation coefficient. Results: There is a positive correlation between family functioning and health promoting lifestyles (r: 0.224, p<0.05). The physical activity dimension of healthy lifestyles was associated with a better global family functioning (r: 0.303, p<0.01) and with a greater number of dimensions (coherence, individuation, and maintenance) and goals (stability, control and spirituality). Conclusions: Better family functioning of patients with colorectal cancer is positively associated with healthy lifestyles.

Resumo Objetivo: analisar a relação entre o funcionamento familiar e os estilos de vida saudável nos pacientes com câncer colorrectal. Materiais e métodos: tratou-se de um estudo descritivo transversal correlacional feito entre fevereiro e novembro de 2016 em Bogotá (Colômbia). Entrevistaram-se 78 pacientes a quem foram avaliados com o funcionamento familiar e os estilos de vida promotores de saúde com os questionários ASF-E e HPLP II respectivamente. Estudou-se o grau de relação lineal entre as duas variáveis mediante o coeficiente de correlação de Pearson. Resultados: existe uma correlação positiva entre o funcionamento familiar e estilos de vida promotores de saúde (r: 0,224, p<0,05). A dimensão atividade física dos estilos de vida saudável foi a que se associou com um melhor funcionamento familiar global (r: 0,303, p<0,01) e com um maior número de dimensões (coerência, individualização e manutenção) e metas (estabilidade, controle e espiritualidade). Conclusões: um melhor funcionamento familiar dos pacientes com câncer colorrectal se associa positivamente com estilos de vida saudável.

[Living in nursing homes. Prognostic factor of mortality in respiratory infections?] / Vivir en residencias de ancianos ¿Factor pronóstico de mortalidad en infecciones respiratorias?

Respiratory infection is one of the most frequent diagnoses associated with high mortality. Living in a nursing home could be a predictive risk factor for mortality. The objective was to study the characteristics of patients with respiratory infection according to whether they came from their home or nursing homes, and to analyze whether their origin is a risk factor for mortality. It was a prospective cohort study, that included 208 patients with respiratory infection admitted to the Internal Medicine Service, that participated in the study. Clinical, analytical, epidemiological, prognostic and therapeutic variables were collected and a multivariate analysis was performed. Patients had an average age of 83 years and 64.9% came from their home. 44.7% had heart failure as a clinical history. Most of patients met criteria of pluripatology, polypharmacy and were moderately dependent according to Barthel's index. Mortality at admission was 16 patients (7.7%), and during the six-month follow-up of 37 patients (17.8%). Those coming from nursing homes had a higher mortality rate, 37%, than those who lived in their own home, 19.3% (p = 0.005). In the multivariate analysis, the prognostic factors for mortality were a higher level of urea at admission (OR = 2.33, IC 95% = 1.06-5.11) and the non-prescription of oxygen at discharge (OR = 2.96, IC 95% = 1.29-6.82). In conclusion, a higher percentage of mortality is observed in patients coming from nursing homes, however further research is needed to clarify whether living in a residence for elderly can be considered an independent risk factor for mortality.

La infección respiratoria es uno de los diagnósticos más frecuentes en el ámbito sanitario asociado a una elevada mortalidad. Residir en una residencia de ancianos podría ser un factor de riesgo predictivo de mortalidad. El objetivo fue estudiar las características de los pacientes con infección respiratoria según procedieran de su domicilio o de residencias de ancianos, y analizar si la procedencia es un factor de riesgo de mortalidad. Se trata de un estudio de cohortes prospectivo. Participaron 208 pacientes con infección respiratoria ingresados en un Servicio de Medicina Interna. Se recogieron variables clínicas, analíticas, epidemiológicas, pronosticas y terapéuticas realizándose un análisis multivariado. Los pacientes tuvieron una edad media 83 años y 135 (64.9%) procedían de su domicilio. El 44.7% presentaban insuficiencia cardiaca como antecedente clínico. La mayoría cumplían criterios de pluripatología, polifarmacia y tenían una dependencia moderada según índice de Barthel. La mortalidad durante el internamiento hospitalario fue de 16 pacientes (7.7%), y durante el seguimiento a seis meses de 37 (17.8%). Los procedentes de residencias de ancianos presentaron una mayor mortalidad, un 37%, que los que vivían en su propio domicilio, un 19,3% (p = 0.005). En el análisis multivariado los factores pronósticos de mortalidad fueron un mayor nivel de urea al ingreso (OR = 2.33, IC 95% = 1.06-5.11) y la no prescripción de oxígeno al alta (OR = 2.96, IC 95% = 1.29-6.82). En conclusión, se observó un mayor porcentaje de mortalidad en los pacientes procedentes de residencias de ancianos, sin embargo, es necesario realizar más investigaciones para clarificar si el residir en un centro geriátrico puede ser considerado un factor de riesgo independiente de mortalidad.

Vivir en residencias de ancianos ¿Factor pronóstico de mortalidad en infecciones respiratorias? / Living in nursing homes. Prognostic factor of mortality in respiratory infections?

Resumen La infección respiratoria es uno de los diagnósticos más frecuentes en el ámbito sanitario asociado a una elevada mortalidad. Residir en una residencia de ancianos podría ser un factor de riesgo predictivo de mortalidad. El objetivo fue estudiar las características de los pacientes con infección respiratoria según procedieran de su domicilio o de residencias de ancianos, y analizar si la procedencia es un factor de riesgo de mortalidad. Se trata de un estudio de cohortes prospectivo. Participaron 208 pacientes con infección respiratoria ingresados en un Servicio de Medicina Interna. Se recogieron variables clínicas, analíticas, epidemio lógicas, pronosticas y terapéuticas realizándose un análisis multivariado. Los pacientes tuvieron una edad media 83 años y 135 (64.9%) procedían de su domicilio. El 44.7% presentaban insuficiencia cardiaca como antecedente clínico. La mayoría cumplían criterios de pluripatología, polifarmacia y tenían una dependencia moderada según índice de Barthel. La mortalidad durante el internamiento hospitalario fue de 16 pacientes (7.7%), y durante el seguimiento a seis meses de 37 (17.8%). Los procedentes de residencias de ancianos presentaron una mayor mortalidad, un 37%, que los que vivían en su propio domicilio, un 19,3% (p = 0.005). En el análisis multivariado los factores pronósticos de mortalidad fueron un mayor nivel de urea al ingreso (OR = 2.33, IC 95% = 1.06-5.11) y la no prescripción de oxígeno al alta (OR = 2.96, IC 95% = 1.29-6.82). En conclusión, se observó un mayor porcentaje de mortalidad en los pacientes procedentes de residencias de ancianos, sin embargo, es necesario realizar más investigaciones para clarificar si el residir en un centro geriátrico puede ser considerado un factor de riesgo independiente de mortalidad.

Abstract Respiratory infection is one of the most frequent diagnoses associated with high mortality. Living in a nursing home could be a predictive risk factor for mortality. The objective was to study the characteristics of patients with respi ratory infection according to whether they came from their home or nursing homes, and to analyze whether their origin is a risk factor for mortality. It was a prospective cohort study, that included 208 patients with respiratory infection admitted to the Internal Medicine Service, that participated in the study. Clinical, analytical, epidemiologi cal, prognostic and therapeutic variables were collected and a multivariate analysis was performed. Patients had an average age of 83 years and 64.9% came from their home. 44.7% had heart failure as a clinical history. Most of patients met criteria of pluripatology, polypharmacy and were moderately dependent according to Barthel's index. Mortality at admission was 16 patients (7.7%), and during the six-month follow-up of 37 patients (17.8%). Those coming from nursing homes had a higher mortality rate, 37%, than those who lived in their own home, 19.3% (p = 0.005). In the multivariate analysis, the prognostic factors for mortality were a higher level of urea at admission (OR = 2.33, IC 95% = 1.06-5.11) and the non-prescription of oxygen at discharge (OR = 2.96, IC 95% = 1.29-6.82). In conclusion, a higher percentage of mortality is observed in patients coming from nursing homes, however further research is needed to clarify whether living in a residence for elderly can be considered an independent risk factor for mortality.

Herbaspirillum seropedicae expresses non-phosphorylative pathways for D-xylose catabolism.

Herbaspirillum seropedicae is a ß-proteobacterium that establishes as an endophyte in various plants. These bacteria can consume diverse carbon sources, including hexoses and pentoses like D-xylose. D-xylose catabolic pathways have been described in some microorganisms, but databases of genes involved in these routes are limited. This is of special interest in biotechnology, considering that D-xylose is the second most abundant sugar in nature and some microorganisms, including H. seropedicae, are able to accumulate poly-3-hydroxybutyrate when consuming this pentose as a carbon source. In this work, we present a study of D-xylose catabolic pathways in H. seropedicae strain Z69 using RNA-seq analysis and subsequent analysis of phenotypes determined in targeted mutants in corresponding identified genes. G5B88_22805 gene, designated xylB, encodes a NAD+-dependent D-xylose dehydrogenase. Mutant Z69∆xylB was still able to grow on D-xylose, although at a reduced rate. This appears to be due to the expression of an L-arabinose dehydrogenase, encoded by the araB gene (G5B88_05250), that can use D-xylose as a substrate. According to our results, H. seropedicae Z69 uses non-phosphorylative pathways to catabolize D-xylose. The lower portion of metabolism involves co-expression of two routes: the Weimberg pathway that produces α-ketoglutarate and a novel pathway recently described that synthesizes pyruvate and glycolate. This novel pathway appears to contribute to D-xylose metabolism, since a mutant in the last step, Z69∆mhpD, was able to grow on this pentose only after an extended lag phase (40-50 h). KEY POINTS: • xylB gene (G5B88_22805) encodes a NAD+-dependent D-xylose dehydrogenase. • araB gene (G5B88_05250) encodes a L-arabinose dehydrogenase able to recognize D-xylose. • A novel route involving mhpD gene is preferred for D-xylose catabolism.

Funcionamiento familiar y estilos de vida saludable en pacientes con cáncer colorrectal, según características sociodemográficas / Functioning and healthy lifestyles in patients with colorectal canceraccording to sociodemographic characteristics

INTRODUCCIÓN: Las familias funcionales se caracterizan por la efectividad al manejar situaciones estresantes como grupo. Los estilos de vida saludable son las maneras de vivir, en sintonía con la protección de la salud integral. OBJETIVO: Analizar la relación entre el funcionamiento familiar y los estilos de vida saludable, con las variables sociodemográficas en familias de pacientes con cáncer colorrectal. MÉTODOS: Estudio descriptivo transversal. Se determinaron las características sociodemográficas mediante encuestas autoadministradas a 78 pacientes en tratamiento o post-tratamiento, que cumplieron los criterios de inclusión. Los instrumentos fueron la Escala de Funcionamiento Familiar (ASF-E)y de Health Promoting Lifestyle Profile II (HPLP II) en español. El análisis estadístico fue univariado y bivariado. Corresponde a un estudio con riesgo mínimo. RESULTADOS: La mayor parte de los participantes percibieron funcionamiento familiar medio/alto y se asoció con un alto nivel de estudios, recibir apoyo familiar permanente y pertenecer a una familia nuclear. Las conductas promotoras de salud más practicadas fueron crecimiento espiritual, responsabilidad en salud y relaciones interpersonales, la menos practicada fue la actividad física. Se asociaron positivamente con ser mujer, tener más de 62 años, ocuparse de las labores del hogar y recibir todo tipo de apoyo. CONCLUSIONES: Es vital valorar el funcionamiento familiar y los estilos de vida saludable durante la atención integral al paciente con cáncer colorrectal e involucrar a las familias en el cuidado, a partir del apoyo en todas sus formas, la práctica de actividad física, el cambio de hábitos de vida y relaciones familiares.

INTRODUCTION: Functional families are characterized by effectiveness in handling stressful situations as a group. Healthy lifestyles are ways of living, in tune with the protection of integral health. OBJECTIVE: To analyze the relationship between family functioning and healthy lifestyles, with sociodemographic variables in families of patients with colorectal cancer. METHODS: Cross-sectional descriptive study. Sociodemographic characteristics were determined through self-administered surveys of 78 patients in treatment or post-treatment, who met the inclusion criteria. The instruments were the Family Functioning Scale (ASF-E) and the Health Promoting Lifestyle Profile II (HPLP II) in Spanish. Statistical analysis was univariate and bivariate. It corresponds to a minimal risk study. RESULTS: Most of the participants perceived medium / high family functioning and associated with a high level of education, receiving permanent family support and belonging to a nuclear family. The most practiced health promoting behaviors were spiritual growth, responsibility in health and interpersonal relationships, the least practiced was physical activity. They were positively associated with being a woman, being over 62 years old, taking care of household chores and receiving all kinds of support. CONCLUSIONS: It is vital to assess family functioning and healthy lifestyles during comprehensive care for patients with colorectal cancer and to involve families in care, based on support in all its forms, the practice of physical activity, the change of life habitsand family relationships.

Mortalidad hospitalaria de las infecciones respiratorias comunitarias y asociadas a cuidados socio-sanitarios: una revisión sistemática / Hospital mortality of community respiratory infections and associated with long-term care facilities: a systematic review

Resumen Introducción: Las infecciones respiratorias son causa de preocupación socio-sanitaria por su elevada mortalidad y el coste económico que conllevan. El número de pacientes procedentes de centros socio-sanitarios con infecciones respiratorias que requieren ingreso hospitalario está aumentando en las últimas décadas. Las particularidades de estos pacientes pueden influir en la evolución de estas infecciones. Objetivo: Analizar si existen diferencias entre las infecciones respiratorias de origen comunitario y las asociadas a cuidados sanitarios respecto a la mortalidad. Material y Métodos: Se realizó una revisión sistemática en tres bases de datos: Medline, Web of Science y Scopus. Se incluyeron estudios empíricos, publicados entre 2000 y 2016. Resultados: La procedencia de los enfermos, la edad y la malnutrición fueron los factores que se asociaron con peor pronóstico, junto con la presencia de co-morbilidad cardiaca o neurológica. La mortalidad fue más elevada en los pacientes procedentes de centros socio-sanitarios respecto a aquellos que procedían de su domicilio. Conclusión: Los profesionales de la salud deberían tener en cuenta la procedencia de los enfermos para dar un cuidado personalizado acorde a las particularidades de estos enfermos.

Background: Respiratory infections are a cause of socio-health concern due to their high mortality and the economic cost. The number of patients from social care centers with respiratory infections requiring hospital admission is increasing in recent decades. The particularities of these patients could influence the evolution of these infections. Aim: To analyze if there are differences respect to mortality between respiratory infections of community origin and those associated with social care centers. Methods: A systematic review was carried out in three databases: Medline, Web of Science and Scopus. Empirical studies, published between 2000 and 2016, were included. Results: The origin of the patients, age and malnutrition were the factors associated with worse prognosis, together with the presence of cardiac or neurological comorbidity. Mortality was higher in patients from social care centers compared to those who came from their home. Conclusion: Health professionals should take into account the origin of the patients in order to give a more personalized care according to the particularities of these patients.

[Hospital mortality of community respiratory infections and associated with long-term care facilities: a systematic review]. / Mortalidad hospitalaria de las infecciones respiratorias comunitarias y asociadas a cuidados socio-sanitarios: una revisión sistemática.

BACKGROUND: Respiratory infections are a cause of socio-health concern due to their high mortality and the economic cost. The number of patients from social care centers with respiratory infections requiring hospital admission is increasing in recent decades. The particularities of these patients could influence the evolution of these infections. AIM: To analyze if there are differences respect to mortality between respiratory infections of community origin and those associated with social care centers. METHODS: A systematic review was carried out in three databases: Medline, Web of Science and Scopus. Empirical studies, published between 2000 and 2016, were included. RESULTS: The origin of the patients, age and malnutrition were the factors associated with worse prognosis, together with the presence of cardiac or neurological comorbidity. Mortality was higher in patients from social care centers compared to those who came from their home. CONCLUSION: Health professionals should take into account the origin of the patients in order to give a more personalized care according to the particularities of these patients.

Modelo de supervisión integrativo: Construyendo una identidad profesionalen el campo de la Consejería Psicológica en Guatemala / Integrative supervision model: Building a professional identity in Psychological Counseling in Guatemalac

Este estudio contribuye a avanzar la incipiente investigaciónsobre la supervisión en Guatemala y tiene como objetivoevaluar elmodelo utilizado en un programa de maestría en Consejería Psicológica y Salud Mental de una universidad privada del país. Es un estudio cualitativo en el que cuatro supervisoras entrevistaron a 14 mujeres profesionales egresadas o estudiantes de este programa.La entrevistaincluyópreguntas sobre el significado y propósito, beneficios e importancia, impacto en el cliente, las habilidades personales y la alianza de supervisión. Las respuestas se codificaron, agruparon y analizaron por temas de las cuales surgieron: (a) la definición de supervisión como un proceso de aprendizaje y evaluación a través del acompañamiento y realimentación; (b) la confirmación que la supervisión tiene un impacto en el cliente; (c) la necesidad de definir el modelo, guía y estandarización del formato y práctica y (d) las características relevantes de la persona quien supervisa en la relación de supervisión. Las características encontradas más relevantes son: respeto, apoyo, orientación, escucha, confianza, habilidades de comunicación, responsabilidad, empatía, apertura, respeto a la diversidad, realimentación, aprendizaje y orden.Este trabajo abre la oportunidad para continuar investigaciones similares en ambientes académicos, comunitarios, profesionales y de formación que trasciendan los límites de este programa y se apliquen a otros contextos latinoamericanos.(AU)

Este estudo contribui para o avanço da pesquisa incipiente sobre supervisão na Guatemala e visa avaliar o modelo utilizado em um programa de mestrado em Aconselhamento Psicológico e Saúde Mental de uma universidade privada do país. Trata-se de um estudo qualitativo, no qual quatro orientadores entrevistaram 14 profissionais graduadas e alunas desse programa. A entrevista incluiu perguntas sobre o significado e propósito, benefícios e importância, impacto no cliente, habilidades pessoais e a aliança de supervisão. As respostas foram codificadas, agrupadas e analisadas por tópicos dos quais emergiram: (a) a definição de supervisão como processo de aprendizagem e avaliação por meio de acompanhamento e feedback, (b) confirmação de que a supervisão tem impacto no cliente, (c) a necessidade de definir o modelo orientador e a padronização do formato e da prática e (d) as características relevantes da pessoa que supervisiona a relação de supervisão. As características mais relevantes encontradas são: respeito, apoio, orientação, escuta, confiança, habilidades de comunicação, responsabilidade, empatia, abertura, respeito à diversidade, feedback, aprendizado e ordem. Este trabalho abre a oportunidade de continuar pesquisas semelhantes em ambientes acadêmicos, comunitários, profissionais e de treinamento que transcendem os limites deste programa e se aplicam a outros contextos latino-americanos.(AU)

This research is part of a series of pioneering studies on supervision in Guatemala and aims to evaluate the model used in a psychological counseling and mental healthmaster program of a private Guatemalan University. It is a qualitative study where 14 professionals, women graduated or students from this program were interviewed. The interview included questions about the meaning and purpose of supervision, benefits and importance of the process, impact on the client and personal skills, and the supervision alliance.Answers were coded, grouped, and analyzed by themes offering: a) the definition of supervision as a learning and assessment process with companionship and feedback; b) confirmation that supervision has an impact in client, c) the need of defining a model, guidelines, and format standardization for practicum; and d) the most relevant supervisor´s characteristics in the supervision relationship. In this study, the main characteristics of the supervision relationship are: respect, support, guidance, active listening, safe space, communication abilities, responsibility, empathy, openness, respect for cultural diversity, feedback, learning and structure. This research is an opportunity to pursue similar research in academic, community, professional environments, and training that transcend the geographic borders of this program and are applicable to other LatinAmerican contexts.(AU)

Propionic acid metabolism and poly-3-hydroxybutyrate-co-3-hydroxyvalerate production by a prpC mutant of Herbaspirillum seropedicae Z69.

Polyhydroxyalkanoates (PHAs) are thermoplastic polyesters produced by a wide range of bacteria as carbon and energy reserves. PHA accumulation is typically increased under unbalanced growth conditions and with carbon source in excess. Although polyhydroxybutyrate (PHB) could be used for specific applications, it is brittle and not a useful alternative for plastics like polypropylene. Far more useful polypropylene-like PHAs, are copolymers composed of 3-hydroxybutyrate and 3-hydroxyvalerate, P(3HB-co-3HV). Propionic acid is one of the carbon sources that can be used to generate 3HV. A mutant derived from Herbaspirillum seropedicae Z69, a strain previously described as capable of producing P(3HB-co-3HV) from propionic acid, was constructed to increase 3HV biosynthetic efficiency. The strategy involved elimination of a catabolic route for propionyl-CoA by deficiency marker exchange of a selected gene. The mutant (Z69Prp) was constructed by elimination of the 2-methylcitrate synthase (PrpC) gene of the 2-methylcitrate cycle for propionate catabolism. Strain Z69Prp was unable to grow on sodium propionate, but in cultures with glucose-propionate accumulated 50% of its dry weight as copolymer. Z69Prp had 14.1 mol% 3HV; greater than that of strain Z69 (2.89 mol%). The 3HV yield from propionic acid (Y3HV/prop) was 0.80 g g-1, and below the maximum theoretical value (1.35 g g-1).

Funcionalidad familiar y estilos de vida saludable en pacientes con linfoma Hodgkin en Bogotá / Family functionality and healthy lifestyles in patients with Hodgkin lymphoma, Bogota / Funcionalidade familiar e estilos de vida saudável em pacientes com linfoma de Hodgkin, em Bogota

Se realizó una investigación cuantitativa descriptiva y transversal en un grupo de pacientes con linfoma Hodgkin para determinar \r\nla relación entre funcionalidad familiar y los estilos de vida saludable. Se usaron los instrumentos Escala de Evaluación de la Funcio\r\n-\r\nnalidad Familiar y el Health Promoting Lifestyle Profile II, los dos en su versión en español. El informante familiar fue el paciente con \r\ndiagnóstico de linfoma Hodgkin. Se encontró predominio de un nivel bajo de funcionalidad familiar y frecuencia de estilos de \r\nvida saludable A veces y Frecuentemente; se determinó que solo hubo correlación con significancia estadística entre la dimensión \r\nRelaciones interpersonales\r\n, perteneciente a los estilos de vida saludable, y la funcionalidad familiar. Se requiere profundizar en esta \r\ntemática con otros grupos de pacientes para lograr un mejor conocimiento al respecto.

A descriptive and cross-quantitative investigation in a group \r\nof patients with Hodgkin lymphoma was conducted to \r\ndetermine the relationship between family functionality \r\nand healthy lifestyles. The instruments Evaluation Scale of \r\nFamily Functionality in Spanish and the Health Promoting \r\nLifestyle Profile II in its version of the Spanish language were \r\nused, the family informant was the patient diagnosed with \r\nHodgkin lymphoma. Predominance of a low level of family \r\nfunctionality and frequent healthy lifestyles of "Sometimes" \r\nand "Often" was found; it was determined that there were \r\nonly statistically significant correlation for the dimension of \r\ninterpersonal relationships\r\n, pertaining to healthy lifestyles, with \r\nfamily functionality. It is required to deepen this subject, with \r\nother patient groups to achieve a better knowledge about it.

Uma pesquisa descritiva e cross-quantitativa em um grupo de \r\npacientes com linfoma de Hodgkin foi realizado para deter\r\n-\r\nminar a relação entre o funcionamento familiar e estilos de \r\nvida saudáveis. Os instrumentos Escala de Avaliação da Família \r\nfuncionalidade em espanhol e promoção da saúde Lifestyle \r\nProfile II, na sua versão em espanhol utilizado, o informante da \r\nfamília era o paciente diagnosticado com linfoma de Hodgkin. \r\nPredominância de uma baixa frequência de funcionamento \r\nfamiliar e estilos de vida saudáveis "às vezes" e "Muitas vezes" \r\nfoi encontrado; determinou-se que havia apenas estatisti\r\n-\r\ncamente dimensão correlação significativa para as \r\nrelações \r\ninterpessoais\r\n, pertencentes a estilos de vida saudáveis, com o \r\nfuncionamento familiar. É necessário aprofundar este assunto, \r\ncom outros grupos de pacientes para alcançar um melhor \r\nconhecimento sobre o assunto.

TGFß2 regulates hypothalamic Trh expression through the TGFß inducible early gene-1 (TIEG1) during fetal development.

The hypothalamus regulates the homeostasis of the organism by controlling hormone secretion from the pituitary. The molecular mechanisms that regulate the differentiation of the hypothalamic thyrotropin-releasing hormone (TRH) phenotype are poorly understood. We have previously shown that Klf10 or TGFß inducible early gene-1 (TIEG1) is enriched in fetal hypothalamic TRH neurons. Here, we show that expression of TGFß isoforms (1-3) and both TGFß receptors (TßRI and II) occurs in the hypothalamus concomitantly with the establishment of TRH neurons during late embryonic development. TGFß2 induces Trh expression via a TIEG1 dependent mechanism. TIEG1 regulates Trh expression through an evolutionary conserved GC rich sequence on the Trh promoter. Finally, in mice deficient in TIEG1, Trh expression is lower than in wild type animals at embryonic day 17. These results indicate that TGFß signaling, through the upregulation of TIEG1, plays an important role in the establishment of Trh expression in the embryonic hypothalamus.

Biopsychosocial factors related to the length of hospital stay in older people / Variáveis biopsicossociais relacionadas à duração de hospitalização em idosos / Variables biopsicosociales relacionadas con la duración de la estancia hospitalaria en personas mayores

This study aimed to know what variables influence increased length of hospital stay. A descriptive, cross-sectional study was conducted through an integrated geriatric assessment of 81 people over 65 years of age, admitted to a tertiary acute care hospital. Data were collected through the Pfeiffer Scale, Barthel Index, Goldberg Questionnaire, Family APGAR and Gijón Scale. The length of hospital stay increased in people over 80 years, people living alone or in a retirement home, patients with great physical dependence and those with a risk or problem of social exclusion. The most influential variable for longer hospitalization was cognitive impairment (p<0.05), due to greater collaboration or desire to overcome the acute stage of the pathology that led to the hospital admission among patients without this condition.

Este estudo teve como objetivo conhecer quais as variáveis que influenciam o aumento do tempo de internação hospitalar. Trata-se de estudo descritivo e transversal, conduzido mediante ampla avaliação geriátrica de 81 pessoas com mais de 65 anos, internadas em hospital terciário de cuidados agudos. Os dados foram coletados através da Escala Pfeiffer, Índice de Barthel, Questionário de Goldberg, Apgar da Família e Escala de Gijón. Observou-se aumento no tempo de internação entre pessoas com mais de 80 anos, pessoas que vivem sozinhas ou em lar de idosos, pacientes que tinham grande dependência física, e entre aqueles com algum risco ou problema de exclusão social. A variável mais influente, para a maior duração da hospitalização, foi a deterioração cognitiva (p<0,05), em comparação à maior colaboração do paciente sem essa condição ou ao seu desejo de superar a fase aguda da patologia que levou à internação hospitalar.

Este estudio tuvo como objetivo conocer qué variables influyen en el aumento de la duración de la estancia hospitalaria. Se trata de un estudio descriptivo transversal en el que se realizó una Valoración Geriátrica Integral a 81 personas mayores de 65 años de edad que ingresaron en un hospital de agudos de tercer nivel. Para ello, los datos fueron recogidos por medio de la Escala de Pfeiffer, el Índice de Barthel, el Cuestionario de Goldberg, el APGAR familiar y la Escala de Gijón. Se observó un aumento de la duración de la estancia hospitalaria entre los mayores de 80 años, las personas que vivían solas o en una residencia geriátrica, los pacientes que presentaban gran dependencia física y también, entre quienes tenían un riesgo o problema de exclusión social. La variable que más influyó en la mayor duración de la hospitalización fue el deterioro cognitivo (p<0,05), por la mayor colaboración del enfermo o por la propia voluntad de superar el estado agudo de la patología que motivó el ingreso.

Phylotype diversity in a benthic cyanobacterial mat community on King George Island, maritime Antarctica.

Cyanobacterial 16S ribosomal RNA gene diversity was examined in a benthic mat on Fildes Peninsula of King George Island (62º09'54.4''S, 58º57'20.9''W), maritime Antarctica. Environmental DNA was isolated from the mat, a clone library of PCR-amplified 16S rRNA gene fragments was prepared, and amplified ribosomal DNA restriction analysis (ARDRA) was done to assign clones to seven groups. Low cyanobacterial diversity in the mat was suggested in that 83% of the clones were represented by one ARDRA group. DNA sequences from this group had high similarity with 16S rRNA genes of Tychonema bourrellyi and T. bornetii isolates, whose geographic origins were southern Norway and Northern Ireland. Cyanobacterial morphotypes corresponding to Tychonema have not been reported in Antarctica, however, this morphotype was previously found at Ward Hunt Lake (83ºN), and in western Europe (52ºN). DNA sequences of three of the ARDRA groups had highest similarity with 16S rDNA sequences of the Tychonema group accounting for 9.4% of the clones. Sequences of the remaining three groups (7.6%) had highest similarity with 16S rRNA genes of uncultured cyanobacteria clones from benthic mats of Lake Fryxell and fresh meltwater on the McMurdo Ice Shelf.

Biopsychosocial factors related to the length of hospital stay in older people.

This study aimed to know what variables influence increased length of hospital stay. A descriptive, cross-sectional study was conducted through an integrated geriatric assessment of 81 people over 65 years of age, admitted to a tertiary acute care hospital. Data were collected through the Pfeiffer Scale, Barthel Index, Goldberg Questionnaire, Family APGAR and Gijón Scale. The length of hospital stay increased in people over 80 years, people living alone or in a retirement home, patients with great physical dependence and those with a risk or problem of social exclusion. The most influential variable for longer hospitalization was cognitive impairment (p<0.05), due to greater collaboration or desire to overcome the acute stage of the pathology that led to the hospital admission among patients without this condition.