Una Sola Salud. Un Enfoque Multisectorial y Transdisciplinario / One Health. A Multisectoral and Transdisciplinary Health Approach

Una sola salud (USS), es un enfoque integral y unificador diseñado para equilibrar y optimizar la salud tanto de seres humanos, animales y ecosistemas, aprovechando la interrelación entre estos ámbitos para establecer nuevas metodologías de vigilancia y control de enfermedades. Es así como, la forma en que se utiliza el suelo puede influir en el número de casos de malaria; las condiciones meteorológicas y controles artificiales del agua pueden afectar enfermedades como el dengue; el comercio de animales salvajes vivos puede aumentar la probabilidad de que ciertas enfermedades infecciosas se transmitan de animales a humanos (zoonosis), entre otros ejemplos. Es decir, un esfuerzo integrador de múltiples disciplinas que trabajan de manera colaborativa a nivel local, nacional y global en todos los aspectos del cuidado de la salud de los seres humanos, los animales y el medio ambiente. El objetivo de este manuscrito fue reportar y discutir el concepto USS, como nuevo enfoque sanitario inter y transdisciplinario. Debemos adoptar la filosofía de USS desde el nivel global hasta el más local para reducir entre otras, los riesgos de pandemias que pueden ocurrir con mayor frecuencia considerando el crecimiento exponencial de la población mundial y la urbanización.

SUMMARY: One Health (OH) represents a comprehensive and unifying approach designed to balance and optimize the health of humans, animals, and ecosystems. By leveraging the interdependent links among these domains, OH establishes new methodologies for disease surveillance and control. The manner in which land is utilized can influence the incidence of malaria; meteorological conditions and artificial water controls can impact diseases such as dengue, and the trade of live wildlife can escalate the likelihood of certain infectious diseases being transmitted from animals to humans (zoonoses), among other interconnected factors. That is, an integrative effort of multiple disciplines working collaboratively and locally, nationally, and globally in all aspects of health care for humans, animals, and the environment. The aim of this manuscript was to elucidate and discuss the OH concept as an interdisciplinary and transdisciplinary paradigm in healthcare. In conclusion,it is imperative to embrace the OH philosophy from a global to local scale in order to mitigate, among other concerns, the heightened risks of pandemics. This consideration is especially pertinent given the exponential growth of the global population and urbanization trends, which may contribute to an increased frequency of pandemic occurrences.

Primary hepatic pleomorphic liposarcoma: Case report and literature review.

Primary hepatic liposarcoma is an extremely rare malignant tumour derived from adipocytes and is part of the group of mesenchymal tumours. We present the case of a 43-year-old Hispanic male patient with a pleomorphic hepatic liposarcoma and absence of MDM2 gene amplification. Two years and six months after surgery, the patient is asymptomatic. The present case is the first report of this entity with positive immunohistochemical testing for p16, p53, S100, vimentin and absence of MDM2 gene amplification.

Supercritical transesterification of vegetable oil and ethanol: temperature and residence time effects on phase formation and water content

Supercritical transesterification has emerged as a readily available alternative for biodiesel production since no catalyst is required, thereby generating fewer waste products. In this research, the supercritical transesterification of refined vegetable oil and aqueous ethanol was carried out at temperatures 400 to 480 °C and a 12:1 ethanol to oil molar ratio, to assess the effect of temperature and residence time in the formation of a homogeneous phase, effluent appearance and increased water content derived from glycerol etherification. The results showed that water was produced at temperatures higher than 400 °C, as expected from the occurrence of glycerol etherification, and that prolonged times resulted in gas and soot formation, indicating esters decomposition. Through water mass balances, it was possible to identify the set of operation conditions in which the water formed from glycerol etherification matched with the maximum expected according to the proposed reaction scheme.

La transesterificación supercrítica se ha propuesto como una alternativa para la producción de biodiesel ya que no requiere catalizador de esta manera se generan menos residuos. En esta investigación, la transesterificación supercrítica de aceite vegetal refinado y etanol acuoso se llevó a cabo a temperaturas en el rango 400 a 480 °C y relación molar etanol a aceite de 12:1, para evaluar el efecto de la temperatura y el tiempo de residencia en la formación de una fase homogénea, apariencia del efluente e incremento del contenido de agua resultado de las reacciones de eterificación del glicerol. Los resultados mostraron que se produjo agua a temperaturas mayores a 400°C, atribuida a la eterificación del glicerol, y que tiempos de residencia prolongados resultaron en formación de gas y hollín, indicativo de reacciones de descomposición de esteres. A través de balances de masa, fue posible identificar el conjunto de condiciones de operación a las cuales el agua formada por la eterificación del glicerol coincide con el valor máximo esperado de acuerdo con el esquema de reacción propuesto.

A transesterificação supercrítica foi proposta como uma alternativa para a produção de biodiesel porque não requer catalisador e, dessa forma, gera menos resíduos. Nesta pesquisa, a transesterificação supercrítica de aceite vegetal refinado e etanol acuoso foi conduzida a temperaturas entre 400 e 480 °C e uma relação molar de etanol e aceite de 12: 1, para avaliar o efeito da temperatura e do tempo de residência na formação de uma fase homogênea, apariência do efluente e aumento do conteúdo de água resultante das reações de eterificação do glicerol. Os resultados mostraram que se produziu água a temperaturas maiores que 400°C, atribuída à eterificação do glicerol, e que os tempos de residência prolongados resultaram na formação de gás e hollín, indicativo de reações de decomposição de ésteres. Por meio de balanças de massa, foi possível identificar o conjunto de condições de operação em que a água formada pela eterificação do glicerol coincide com o valor máximo esperado de acordo com o esquema de reação proposto.

¿Cuánto tiempo debe permanecer un stent traqueal implantado? Curación de la estenosis luego de 10, 16 y 22 años de implante / How Long Should a Tracheal Stent Remain Implanted? Healing of Stenosis 10, 16, and 22 Years After Implantation

Tres stents traqueales fueron removidos luego de 10, 16 y 22 años, a lo que le siguió la correspondiente curación de la estenosis traqueal. Se reportan dos nuevos casos de estenosis traqueal benigna, tratados con prótesis de silicona, que se presentaron a control luego de muy largas ausencias: 16 años en uno y 22 en otro. Se suman a un caso anteriormente publicado y curado luego de 10 años de permanencia del stent, que también presentó una amplia y estable luz traqueal luego la remoción. Se describen los hallazgos endoscópicos, y se incluyen reflexiones sobre la curación de la estenosis observada en todos ellos y su probable relación con el largo tiempo de permanencia de las prótesis. Se investigan las propiedades físicas de los stents, luego de tan prolongado lapso de implante y se las compara con un dispositivo nuevo. Se emite una propuesta que podría conducir a la curación de las estenosis traqueales con tratamiento endoscópico y stent por tiempo prolongado.

Three tracheal stents were removed after 10, 16, and 22 years, followed by healing of tracheal stenosis. Two new cases of benign tracheal stenosis are reported, treated with silicone pros theses, which presented for follow-up after very long absences: 16 years in one case and 22 years in the other. They add to a previously published case that was healed 10 years after the stent was implanted, which also had a wide and stable tracheal lumen after removal. The endoscopic findings are described, and reflections are included on the healing of the observed stenosis in all cases and its probable relationship with the prolonged indwelling of the prostheses. The physical properties of the stents are inves tigated after such a long period since implantation, and they are compared with a new device. A proposal is put forward that could lead to the healing of tracheal stenosis with endoscopic treatment and prolonged indwelling of the stent.

Association of the rs5186 polymorphism of the AGTR1 gene with decreased eGFR in patients with type 2 diabetes from Mexico City.

BACKGROUND: Early biomarkers search for Diabetic Kidney Disease (DKD) in patients with Type 2 Diabetes Mellitus (T2DM), as genetic markers to identify vulnerable carriers of the disease even before Glomerular Filtration Rate (GFR) decline or microalbuminuria development, has been relevant during the last few years. The rs5186 (A116C) polymorphism of the Angiotensin II Receptor Type I gene (AGTR1), has been associated to multiple effects of renal injury risk, commonly detected in patients with Diabetes Mellitus (DM). It has been described that rs5186 could have an effect in stability proteins that assemble Angiotensin II Receptor Type I (AT1), modifying its action, which is why it should be considered as a risk factor for Chronic Kidney Disease (CKD), characterized by a GFR progressive reduction. Even though, the association between rs5186 AGTR1 gene polymorphism and DKD in patients with T2DM has been controversial, inconclusive, and even absent. This disputable issue might be as a result of association studies in which many and varied clinical phenotypes included are contemplated as CKD inductors and enhancers. Although, the sample sizes studied in patients with T2DM are undersized and did not have a strict inclusion criteria, lacking of biochemical markers or KDOQI classification, which have hindered its examination. OBJECTIVE: The aim of our study was to establish an association between rs5186 AGTR1 gene polymorphism and GFR depletion, assessed as a risk factor to DKD development in patients with T2DM. METHODS: We analyzed 297 not related patients with T2DM, divided into 221 controls (KDOQI 1) and 76 cases (KDOQI 2). Arterial pressure, anthropometric and biochemical parameters were measured. rs5186 of AGTR1 genotyping was performed by TaqMan assay real-time PCR method. Allele and genotype frequencies, and Hardy-Weinberg equilibrium were measured. Normality test for data distribution was analyzed by Shapiro-Wilk test, variable comparison by Student's t-test for continuous variables, and Chi-squared test for categorical variables; ANOVA test was used for mean comparison of more than two groups. Effect of rs5186 to DKD was estimated by multiple heritability adjustment models for risk variables of DKD. Statistical significance was indicated by p<0.05. Data was analyzed using Statistical Package STATA v11 software. RESULTS: Dominant and Over-dominant models showed a likelihood ratio to GFR depletion of 1.89 (1.05-3.39, p=0.031) and 2.01 (1.08-3.73, p=0.023) in patients with T2DM. Risk factor increased to 2.54 (1.10-5.89) in women in Over-dominant model. CONCLUSION: In clinical practice, most of nephropathies progress at a slow pace into a total breakdown of renal function, even asymptomatic. This is the first study, reporting that rs5186 polymorphism of AGTR1 gene contribution to GFR depletion, and this could be evaluated as a predisposing factor for DKD in patients with T2DM.

Do antihypertensive drugs combinations in single-pill combination improve cardiovascular outcomes? / ¿Las combinaciones de medicamentos antihipertensivos en un solo comprimido mejoran los resultados cardiovasculares?

Abstract Recommendations and guidelines propose to com bine antihypertensive drugs to improve BP control, highlighting the advantages of single-pill combinations (SPCs) to improve treatment adherence. It is speculated that, compared with free-dose combinations (Free-DCs), SPC should achieve a reduction in cardiovascular (CV) events and mortality through better adherence and BP control. However, there is little information in this regard. For this reason, the objective of this review was to provide a descriptive analysis the differences in CV outcomes between SPCs antihypertensive drugs treat ments vs. Free-DCs treatments. Ten studies were found and none had a randomized controlled design. Medi cation adherence was higher with SPCs, but outcomes were not adjusted for the adherence/persistence. When groups were compared according to similar adherence degrees, the statistical significance in favor of SPCs disappeared. Thus, randomized controlled studies are necessary to evaluate if SPCs have any effect beyond the improvement of the adherence to hypertensive treatment.

Resumen Las recomendaciones y las guías proponen combinar fármacos antihipertensivos para mejorar el control de la presión arterial, destacando las ventajas de las combi naciones en un solo comprimido para mejorar la adhe rencia al tratamiento. Se especula que, en comparación con las combinaciones en varios comprimidos, deberían lograr una reducción de los eventos cardiovasculares y de la mortalidad a través de una mejor adherencia y con trol de la presión. Sin embargo, hay poca información al respecto. Por esta razón, el objetivo de esta revisión fue proporcionar un análisis descriptivo de las diferencias en los resultados cardiovasculares y la mortalidad entre los tratamientos con combinaciones de antihipertensi vos en un solo comprimido vs. combinaciones de los mismos grupos de fármacos en varios comprimidos. Se encontraron diez estudios, pero ninguno tenía un dise ño controlado aleatorio. La adherencia a la medicación fue mayor con las combinaciones en un comprimido, pero los resultados no se ajustaron por la adherencia/ persistencia. Cuando se compararon los grupos según grados de adherencia similares, la significación estadís tica a favor de las combinaciones en un comprimido se perdió. Por lo tanto, son necesarios estudios controlados aleatorios para evaluar si las combinaciones de antihi pertensivos en un comprimido tienen algún efecto más allá de la mejora de la adherencia al tratamiento.

Identificación de polimorfismos obesogénicos en mexicanos / Identification of obesogenic polymorphisms in Mexicans

Introducción. La obesidad es una enfermedad metabólica caracterizada por el aumento del índice de la masa corporal. El riesgo de obesidad depende de factores ambientales, del estilo de vida y de la presencia de variantes genéticas originadas por mutaciones únicas y polimorfismos de un solo nucleótido (SNPs). Estudios han mostrado la importancia de la etnia en la heredabilidad de las variantes genéticas asociadas al desarrollo de la obesidad. En México, la prevalencia de sobrepeso y la obesidad es del 38.8 % y 32.4 %, respectivamente. Objetivo. El objetivo de este estudio es determinar SNPs que influyen de manera distintiva en el desarrollo de la obesidad de mexicanos. Materiales y métodos. Se realizó un estudio bibliográfico en la base de datos Pubmed con 70 artículos que estudian la asociación de diferentes SNPs con el desarrollo de la obesidad en mexicanos. Resultados. Se identifican los SNPs rs17782313 (MC4R), rs6548238 (TMEM18), rs6265 (BDNF) y rs7488665 (SH2B1) con un comportamiento diferencial respecto a los resultados obtenidos en población caucásica y el SNPs rs6232 del gen PCSK1 asociado con la aparición de la obesidad en edades juveniles en la población mexicana. Conclusiones. Concluyendo que la caracterización detallada de los genes de mayor incidencia en las distintas etnias contribuye a establecer estrategias personalizadas en particular de la población mexicana y que permitan desarrollar un sistema de alta sensibilidad para determinar la susceptibilidad a la obesidad(AU)

Introduction. Obesity is a metabolic disease characterized by an increase in the body mass index. The risk of obesity depends on environmental factors, lifestyle and the presence of genetic variants caused by single mutations and single nucleotide polymorphisms (SNPs). Studies have shown the importance of ethnicity in the heritability of genetic variants associated with the development of obesity. In Mexico, the prevalence of overweight and obesity is 38.8% and 32.4%, respectively. Objective. The objective of this study is to determine SNPs that have a distinctive influence on the development of obesity in Mexicans. Materials and Methods. A bibliographical study was carried out in the Pubmed database and 70 papers were found that study the association of different SNPs with the development of obesity in Mexicans. Results. The SNPs rs17782313 (MC4R), rs6548238 (TMEM18), rs6265 (BDNF) and rs7488665 (SH2B1) with a differential behavior with respect to the results obtained in the Caucasian population, and the SNPs rs6232 of the PCSK1 gene associated with the appearance of obesity in youth in the Mexican population. Conclusions. Concluding that the detailed characterization of the genes with the highest incidence in the different ethnic groups contributes to establish personalized strategies in particular of the Mexican population and that allow the development of a highly sensitive system to determine susceptibility to obesity(AU)

Effects of the Pelotas (Brazil) Peace Pact on violence and crime: a synthetic control analysis.

Background: City-led interventions are increasingly advocated to achieve the UN's Sustainable Development Goal to reduce violence for all. We used a new quantitative evaluation method to examine whether a flagship programme, called the "Pelotas Pact for Peace" (the Pacto), has been effective in reducing violence and crime in the city of Pelotas, Brazil. Methods: We used synthetic control methodology to assess the effects of the Pacto from August 2017 to December 2021, and separately before and during the COVID-19 pandemic. Outcomes included monthly rates of homicide and property crime, and yearly rates of assault against women and school drop-out. We constructed synthetic controls (counterfactuals) based on weighted averages from a donor pool of municipalities in Rio Grande do Sul. Weights were identified using pre-intervention outcome trends and confounders (sociodemographics, economics, education, health and development, and drug trafficking). Findings: The Pacto led to an overall 9% reduction in homicide and 7% reduction in robbery in Pelotas. These effects were not uniform across the full post-intervention period as clear effects were only seen during the pandemic period. A 38% reduction in homicide was also specifically associated with the criminal justice strategy of Focussed Deterrence. No significant effects were found for non-violent property crimes, violence against women, and school dropout, irrespective of the post-intervention period. Interpretation: City-level interventions that combine public health and criminal justice approaches could be effective in tackling violence in Brazil. Continued monitoring and evaluation efforts are increasingly needed as cities are proposed as key opportunities for reducing violence for all. Funding: This research was funded by the Wellcome Trust [grant number: 210735_Z_18_Z].

The 2030 agenda and brazilian internalization / A agenda 2030 e a internalização brasileira

Introduction: the Sustainable Development Goals define the goals that were defined to be achieved by the signatory member countries to reach by 2030 with the purpose of reducing indicators to promote equality and equity for all.Objective: to describe the path taken towards the adoption of the 2030 Agenda, from its antecedents, main concepts and innovations, resulting in a fundamental and guiding element in the formulation of public policies.Methods: study based on secondary sources of literature relevant to the topic, considering articles from national and international journals and recent productions on the Sustainable Development GoalsResults: the challenges of internalizing the Sustainable Development Goals, with the definition of national goals and indicators, addresses the challenges and setbacks in their implementation, especially with the national reorientation aimed at fulfilling the 2030 Agenda from this year onwards, especially in light of mid-cycle assessments, to take place this year.Conclusion: the demobilization in the adoption of the 2030 Agenda at the Federal level, from 2019 onwards, as the global political scenario of successive crises has severely impacted the fulfillment of the agreed objectives, an accelerated effort to resume policies is necessary, involving public agents , civil society and academia, so that the second half of the time frame for implementing the 2030 Agenda is more assertive and achieves the proposed objectives and goals, without effectively leaving anyone behind

Introdução: os Objetivos do Desenvolvimento Sustentável definem as metas que foram definidas para ser alcançadas pelos países membros signatários para alcançar até 2030 com o propósito de diminuir indicadores para promoção de igualdade e equidade de todos. Objetivo: descrever o caminho percorrido para a adoção da Agenda 2030, desde seus antecedentes, principais conceitos e inovações, resultando em elemento fundamental e orientador na formulação de políticas públicas. Método: estudo consubstanciado em fontes secundárias da literatura pertinente à temática, considerando artigos de periódicos nacionais e internacionais e produções recentes sobre os Objetivos de Desenvolvimento Sustentável.Resultados: os desafios da internalização dos Objetivos de Desenvolvimento Sustentável, com a definição de metas e indicadores nacionais aborda os desafios e revezes na sua implementação, especialmente com a reorientação nacional visando o cumprimento da Agenda 2030 à partir do presente ano, em especial à luz das avaliações de meio de ciclo, a ocorrer este ano.Conclusão: a desmobilização na adoção da Agenda 2030 na esfera Federal, a partir de 2019, como o cenário político mundial de sucessivas crises, impactaram severamente no cumprimento dos objetivos pactuados, é necessário um esforço acelerado de retomada de políticas, que envolva agentes públicos, sociedade-civil e academia, para que a segunda metade do intervalo temporal de implementação da Agenda 2030 seja mais assertivo e alcance os objetivos e metas propostos, sem deixar efetivamente ninguém para trás

Perspectives and challenges for implementing the expert patient program: a scoping review / Perspectivas y desafíos para la implementación del programa "paciente experto": revisión de alcance / Perspectivas e desafios para implementação do programa paciente experto: revisão de escopo

ABSTRACT Objective: to map diverse evidence on perspectives and challenges for implementing the Expert Patient Program. Method: this is a scoping review, guided by the method proposed by the JBI and which followed the recommendations set forth in the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, with its research protocol registered in the Open Science Framework, with DOI:10.17605/OSF.IO/D7K6A. The search for studies was carried out in July 2022 in databases and in national and international portals of theses and dissertations. Results: the final sample consisted of six scientific articles, all written in English. Health professionals' qualification, to identify and qualify expert patients, management's commitment to the program, use of mobile technologies and Evidence-Based Practice are among the perspectives for implementation. The challenges are related to lack of understanding of the term "self-management" and to the deficit of public policies and financial investment. Conclusion: the results found emphasize the importance of implementing the Patient Expert Program for the public health context, mainly in relation to the population with chronic non-communicable diseases.

RESUMEN Objetivo: mapear diversa evidencia sobre las perspectivas y los desafíos para la implementación del Programa "Paciente Experto". Método: revisión de alcance, orientada a partir del método propuesto por el JBI y en la que se siguieron las recomendaciones de Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, con registro del protocolo de investigación en Open Science Framework (DOI:10.17605/OSF.IO/D7K6A). La búsqueda de estudio se realizó en julio de 2022, tanto en las bases de datos como en portales de tesis y disertaciones nacionales e internacionales. Resultados: la muestra final estuvo compuesta por seis artículos científicos, todos redactados en inglés. Entre las perspectivas para la implementación se incluyen las siguientes: calificación de los profesionales de la salud, para identificar y calificar pacientes expertos; compromiso de la gerencia con el programa; uso de las tecnologías móviles y Práctica Basada en Evidencia. Por el otro lado, los desafíos están relacionados con no comprender el término "autogestión" y con el déficit de políticas públicas e inversiones financieras. Conclusión: los resultados encontrados enfatizan la importancia de implementar el Programa "Paciente Experto" para el contexto de la salud pública, principalmente en relación con la población que padece enfermedades crónicas no transmisibles.

RESUMO Objetivo: Mapear evidências sobre as perspectivas e desafios para implementação do Programa Paciente Experto. Método: Trata-se de uma scoping review, orientada a partir do método proposto pelo JBI, e seguiu as recomendações do Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, com o protocolo de pesquisa registrado no Open Science Framework DOI:10.17605/OSF.IO/D7K6A. A busca pelos estudos foi realizada no mês de julho de 2022, e ocorreu nas bases de dados e em portais de teses e dissertações nacionais e internacionais. Resultados: A amostra final foi composta por seis artigos científicos, todos redigidos na língua inglesa. Entre as perspectivas para implementação, estão a qualificação dos profissionais de saúde, para identificar e qualificar pacientes expertos, o comprometimento da gestão com o programa, o uso das tecnologias móveis e a Prática Baseada em Evidência. Já os desafios são relacionados à falta de compreensão do termo "autogestão" e ao déficit de políticas públicas e investimento financeiro. Conclusão: Os resultados encontrados enfatizam a importância da implementação do Programa Paciente Experto para o contexto de saúde pública, principalmente, em relação à população portadora de doenças crônicas não transmissíveis.

Modelo teórico-metodológico de elaboração e validação de tecnologia educacional para a área da enfermagem / Modelo teórico-metodológico con el objetivo de crear y validar tecnología educativa para el área de enfermería / Theoretical-methodological model to develop and validate educational technology for the nursing area

Objetivo: apresentar um modelo teórico-metodológico para nortear a elaboração e validação de tecnologia educacional do tipo cartilhas educativas para a área da Enfermagem. Método: trata-se de um estudo teórico-reflexivo, baseado na Taxonomia de Bloom. Resultados: o estudo apresentou um modelo teórico-metodológico que descreve a elaboração do roteiro e conteúdo do material educativo seguindo as recomendações da Taxonomia de Bloom, na dimensão do processo cognitivo. Ainda, apresentou os passos para elaboração e validação de cartilhas educativas: diagnóstico situacional, revisão de literatura e documental, seleção e sumarização de conteúdo, elaboração do roteiro, criação e diagramação de imagens, validação com especialistas e com o público-alvo. Considerações finais: a proposição do modelo teórico-metodológico solidifica o conhecimento da literatura e auxilia enfermeiros e pesquisadores na elaboração de cartilhas educativas com maior rigor científico e passíveis de efetividade.

Objetivo: presentar un modelo teórico-metodológico para orientar la creación y validación de tecnología educativa del tipo folletos didácticos para el área de Enfermería. Método: estudio teórico-reflexivo basado en la Taxonomía de Bloom. Resultados: el estudio presentó un modelo teórico-metodológico que describe la elaboración del guión y contenido del material educativo siguiendo las recomendaciones de la Taxonomía de Bloom, en la dimensión del Proceso cognitivo. También presentó los pasos para crear y validar folletos educativos: Diagnóstico situacional, Revisión de documental y de la literatura, Selección e sumario del contenido, Elaboración del guión, Creación y diagramación de imágenes, y Validación con especialistas y con la población objetivo. Consideraciones finales: la propuesta del modelo teórico-metodológico consolida el conocimiento existente en la literatura y auxilia enfermeros e investigadores en la creación de folletos educativos con mayor rigor científico y buenas perspectivas de efectividad.

Objective: to present a theoretical-methodological framework guiding the development and validation of educational technology, specifically didactic booklets for the Nursing area. Method: this is a theoretical-reflexive study grounded on Bloom's Taxonomy. Results: the study presented a theoretical-methodological model outlining the educational material script and content development in accordance with Bloom's Taxonomy recommendations, in the Cognitive Process dimension. Additionally, it outlined the steps for creating and validating educational booklets: situational analysis, literature and documentary review, content selection and summarization, script development, creation and layout of the illustrations, validation with experts, and validation with the target audience. Final considerations: the theoretical-methodological model proposal consolidates the knowledge existing in the literature and assists nurses and researchers in creating educational booklets with greater scientific rigor, increasing their effectiveness potential.

Oral manifestations and injuries related to covid- 19: an experience report on the role of hospital dentistry / Manifestações orais e lesões relacionadas à covid-19: um relatório de experiência sobre o papel da odontologia hospitalar / Manifestaciones orales y lesiones relacionadas con covid- 19: un informe de experiencia sobre el papel de la odontología hospitalaria

SARS-COV-2 is transmitted among human beings by saliva droplets that come in direct contact with the oral cavity, nose, and eyes. Since the mouth is one of the anatomical sites primarily contaminated, oral manifestations have also been reported beyond the serious consequences inherent to progressive respiratory failure. This study aimed to identify oral manifestations possibly related to the infection by COVID-19 in hospitalized patients. A prospective study was carried out with patients diagnosed with COVID-19 in the period between March and June 2021, admitted to the Moderate COVID-19 Care Unit of the Hans Dieter Schmidt Regional Hospital, by applying a form and performing a clinical exam of the oral cavity. Out of all patients (n=45), 33.3% reported both olfactory (anosmia) and taste dysfunction (dysgeusia), with an average duration of 5.9 ±3.0 days. Regarding other oral manifestations evaluated, two patients reported dry and burning mouth and one patient reported a change in taste associated with plaque-like changes in the tongue. No patients presented ulcers or other lesions in the oral cavity. Olfactory and taste dysfunction were symptoms recognized of the novel coronavirus disease (COVID-19). However, the association with other oral manifestations is still controversy. Unfortunately, dentistry professionals are still not part of most teams in the hospital environment, mostly because of the lack of prioritization of dental care. Working with a multidisciplinary team may avoid possible systemic complications due to poor dental care.

Sars-COV-2 é transmitida entre os seres humanos por gotículas de saliva que entram em contato direto com a cavidade oral, nariz e olhos. Uma vez que a boca é um dos sítios anatômicos principalmente contaminados, as manifestações orais também foram relatadas para além das graves consequências inerentes à insuficiência respiratória progressiva. Este estudo teve como objetivo identificar manifestações orais possivelmente relacionadas à infecção por Covid-19 em pacientes hospitalizados. Foi realizado um estudo prospetivo com pacientes diagnosticados com Covid-19 no período entre março e junho de 2021, internados na Unidade de Atendimento Moderado contra a Covid-19 do Hospital Regional Hans Dieter Schmidt, aplicando um formulário e realizando um exame clínico da cavidade oral. De todos os pacientes (n=45), 33,3% relataram disfunção olfativa (anosmia) e gustativa (disgeusia), com duração média de 5,9 ±3,0 dias. Em relação a outras manifestações orais avaliadas, dois pacientes relataram boca seca e ardente e um paciente relatou alteração no paladar associada a alterações semelhantes a placas na língua. Nenhum paciente apresentou úlceras ou outras lesões na cavidade oral. Disfunção olfativa e gustativa foram sintomas reconhecidos do novo coronavírus (Covid-19). No entanto, a associação com outras manifestações orais ainda é controversa. Infelizmente, os profissionais de odontologia ainda não fazem parte da maioria das equipes do ambiente hospitalar, principalmente por causa da falta de priorização dos cuidados odontológicos. Trabalhar com uma equipe multidisciplinar pode evitar possíveis complicações sistêmicas devido a cuidados odontológicos deficientes.

SARS-COV-2 se transmite entre los seres humanos por las gotitas de saliva que entran en contacto directo con la cavidad oral, la nariz y los ojos. Dado que la boca es uno de los sitios anatómicos principalmente contaminados, también se han informado manifestaciones orales más allá de las consecuencias graves inherentes a la insuficiencia respiratoria progresiva. El objetivo de este estudio fue identificar las manifestaciones bucales posiblemente relacionadas con la infección por COVID-19 en pacientes hospitalizados. Se realizó un estudio prospectivo con pacientes diagnosticados de COVID-19 en el periodo comprendido entre marzo y junio de 2021, ingresados en la Unidad de Cuidados Moderados de COVID-19 del Hospital Regional Hans Dieter Schmidt, mediante la aplicación de un formulario y la realización de un examen clínico de la cavidad oral. De todos los pacientes (n=45), el 33,3% notificó tanto disfunción olfativa (anosmia) como gustativa (disgeusia), con una duración media de 5,9 ±3,0 días. En cuanto a las demás manifestaciones orales evaluadas, dos pacientes notificaron sequedad y ardor de boca y un paciente notificó un cambio en el gusto asociado a cambios en la lengua en forma de placa. Ningún paciente presentó úlceras u otras lesiones en la cavidad oral. La disfunción olfativa y gustativa fueron síntomas reconocidos de la nueva enfermedad por coronavirus (COVID-19). Sin embargo, la asociación con otras manifestaciones orales es aún controvertida. Desafortunadamente, los profesionales de la odontología todavía no son parte de la mayoría de los equipos en el entorno hospitalario, principalmente debido a la falta de priorización de la atención odontológica. Trabajar con un equipo multidisciplinario puede evitar posibles complicaciones sistémicas debido a la mala atención dental.

Duplicación 10q23q24, un rearreglo cromosómico asociado a anomalías congénitas múltiples / 10q23q24 duplication, a chromosome rearrangement associated with multiple congenital anomalies

La duplicación en el brazo largo del cromosoma 10 (10q) es una cromosomopatía poco frecuente caracterizada clínicamente por retraso en el crecimiento prenatal y postnatal asociado a hipotonía, retraso en el desarrollo y hallazgos faciales específicos; que representa un reto diagnóstico en el ámbito clínico. Se presenta el caso de una recién nacida remitida para valoración multidisciplinara al Hospital Universitario San Ignacio en Bogotá, Colombia; en quien se documentó al momento del nacimiento fisura de labio y paladar, hipertelorismo, pabellón auricular con implantación baja e hipertrofia de labios menores. Se realizó resonancia magnética cerebral, la cual reportó pequeños quistes connatales adyacentes a las astas frontales de los ventrículos laterales, sin significado patológico, aparente malrotación de ambos hipocampos, hipertelorismo y queilopalatosquisis bilateral. El reporte del cariotipo con bandeo G confirmó complemento cromosómico 46,XX,dup(10)(q23q24); siendo el primer caso reportado en Colombia.

Duplication on the long arm of chromosome 10 (10q) is a rare chromosomopathy characterized clinically by delayed prenatal and postnatal growth associated with hypotonia, delayed development, and specific facial findings, which represents a diagnostic challenge in the clinical setting. We present the case of a newborn referred for multidisciplinary evaluation at the Hospital Universitario San Ignacio in Bogotá, Colombia; in whom cleft lip and palate, hypertelorism, low-set auricle and hypertrophy of the labia minora were documented at birth. Magnetic resonance imaging of the brain was performed, which reported small connatal cysts adjacent to the frontal horns of the lateral ventricles, without pathological significance, apparent malrotation of both hippocampi, hypertelorism, and bilateral cheilopalatoschisis. The G-band karyotype report confirmed chromosomal complement 46, XX, dup (10) (q23q24); being the first reported case in Colombia.

Violência Íntima entre Homens que se Relacionam com Homens - Revisão da Literatura / Intimate Partner Violence among Men in relationships with Men - Literature Review / Violencia Íntima entre Hombres que se Relacionan con Hombres - Revisión de Literatura

O objetivo deste estudo foi analisar a literatura sobre a violência por parceiro íntimo nas relações entre homens que se relacionam com homens. Trata-se de uma revisão integrativa. Foram analisados 66 artigos publicados entre 2012-2019 em língua inglesa, espanhola e portuguesa nas bases SCIELO, Biblioteca Virtual de Saúde, Redalyc, Dialnet e no Portal Periódicos CAPES. Os dados foram analisados de maneira descritiva, a partir da elaboração de um instrumento chamado de "Protocolo". Os dados possibilitaram a construção de quatro categorias: 1) Masculinidades; 2) Estresse social minoritário; 3) O uso de álcool e outras drogas; 4) Mecanismos utilizados pela vítima para lidar com a VPI, que demonstraram as principais formas de violência íntima entre esse público, fatores socioculturais relacionados às mesmas e os mecanismos que as vítimas utilizaram para lidar com elas. A teoria do estresse social minoritário é aceita como forma de explicar a violência íntima entre homens que se relacionam com homens e isso alia-se a categorias de gênero que denotam como aceitável o uso da violência por homens. A principal forma para lidar com a violência relatada na literatura foi a informal, através de amigos, mostrando uma lacuna nas políticas públicas sobre o tema para pessoas não-heterossexuais.

The objective of this study was to analyze the literature on intimate partner violence in male to male relationships. This is an integrative review. We analyzed 66 articles published between 2012-2019 in English, Spanish and Portuguese in SCIELO, Virtual Health Library, Redalyc, Dialnet and in Portal Periódicos CAPES. The data obtained were analyzed in a descriptive way, based on the elaboration of an instrument called the "Protocol". They also allowed the construction of four categories: 1) Masculinities; 2) Minority social stress; 3) The use of alcohol and other drugs; 4) Mechanisms used by the victim to deal with IPV, that demonstrated the main forms of intimate partner violence between male to male relationships, sociocultural factors related to them and the mechanisms that the victims used to deal with it. The minority social stress theory is accepted as a way of explaining intimate violence among male to male relationships and this is allied to gender categories that denote that the use of violence by men is acceptable. The main way to deal with violence reported in the literature was informal, through friends, showing a gap in public policies on the subject for non-heterosexual people.

El objetivo de este estudio fue analizar la literatura sobre la violencia de un compañero íntimo en las relaciones entre hombres. Esta es una revisión integradora. Se analizaron 66 artículos publicados entre 2012-2019 en inglés, español y portugués en SCIELO, Biblioteca Virtual de Salud, Redalyc, Dialnet y en Portal Periódicos CAPES. Los datos fueron analizados de forma descriptiva, a partir de un instrumento denominado "Protocolo". Los datos permitieron la construcción de cuatro categorías: 1) Masculinidades; 2) Estrés social de las minorías; 3) El uso de alcohol y otras drogas; 4) Mecanismos utilizados por la víctima para hacer frente a la violencia, que evidenciaron las principales formas de violencia de un compañero íntimo entre los hombres que se relacionan con hombres, los factores socioculturales relacionados con ellos y los mecanismos que las víctimas utilizaron para enfrentarlo. La teoría del estrés social minoritario se acepta como una forma de explicar la violencia de un compañero íntimo entre hombres y se alía con categorías de género que denotan como aceptable el uso de la violencia por parte de los hombres. La principal forma de enfrentar la violencia reportada en la literatura fue informal, a través de amigos, mostrando un vacío en las políticas públicas sobre el tema para las personas homosexuales.

Revisión de los factores de riesgo y factores protectores para el cáncer de mama

Objetivo: Revisar los aspectos clínicos necesarios a tomar en cuenta por el médico tratante al interpretar los reportes de los hallazgos radiológicos en la mamografía y de otras pruebas diagnósticas para un diagnóstico integral del cáncer de mama. Métodos: Se realizó una revisión sistemática de manuscritos publicados entre el 2010 y el 2020 sobre factores de riesgo y factores protectores que pueden verse involucrados en la incidencia del cáncer de mama. Se revisaron publicaciones de investigaciones realizadas en mujeres con diagnóstico de cáncer de mama de tipo ensayos clínicos aleatorizados, casos y controles, revisiones sistemáticas, metaanálisis y guías internacionales. Se buscó en las bases de datos bibliográficas PubMed, EBSCO y Scopus, publicaciones en inglés o español, utilizando términos provenientes de los Descriptores en Ciencias de la Salud (DeCS). Resultados: Se identificaron un total de 735 artículos en las búsquedas, de los cuáles se excluyeron 508 por su poca relevancia de acuerdo con el título. De los 227 restantes se excluyeron 22 por estar repetidos en las distintas bases, 12 porque no cumplían con los criterios de inclusión, 83 durante la revisión del resumen, y 28 al revisar el texto completo. En total se incluyeron 82 artículos para elaborar esta revisión. Los factores identificados en la revisión de la literatura se clasificaron en tres áreas: fisiopatológicos, gíneco-obstétricos y ambientales. Los factores de riesgo fisiopatológicos son la historia familiar, hiperplasia epitelial atípica, etnia, mayor edad, diabetes tipo II, síndrome metabólico, mayor peso y talla y mutaciones genéticas; los gíneco-obstétricos son la menarquía temprana, la menopausia tardía y la nuliparidad; y los ambientales incluyen fármacos, hábitos de vida, procedimientos médicos y alimentación. Mientras que, entre los factores protectores, los factores fisiopatológicos son el hipotiroidismo, el asma y la rinitis alérgica; los gínecoobstétricos son la multiparidad, el primer embarazo a una edad temprana y dar lactancia; y los ambientales incluyen fármacos, procedimientos médicos y alimentación.

Aim: To review relevant clinical aspects for the attending physician to consider when interpreting the reports of radiological findings in the mammogram and other diagnostic tests for a comprehensive breast cancer diagnosis. 2 ISSN 0001-6012 • eISSN 2215-5856 / Acta méd. costarric. 2022 / octubre-diciembre; 64 (4): 1-11 Cáncer mama factores de riesgo y de protección Methods: A systematic literature review was carried out focusing on risk and protective factors associated with breast cancer incidence, within peer-reviewed scientific articles published between 2010 and 2020. Published research on women with a breast cancer diagnoses who participated in randomized clinical trials, case control studies, systematic reviews, meta-analysis, and international guides were used. Research terms were searched on PubMed, EBSCO and Scopus databases, published in Spanish and English, using terms from the Medical Subject Headings (MeSH). Results: A total of 735 publications were found of which 508 were excluded due to title content being irrelevant to the review. Of the remainder 227, 22 were excluded due to been repeated across the different databases used, 12 because they did not meet the inclusion criteria, 83 after abstract review, and 28 after reading the whole text. A total of 82 papers were used for this review. The identified factors were categorized in three areas: pathophysiological, gynecological and obstetrics, and environmental factors. The pathophysiological risk factors are, family history, atypical hyperplasia, ethnicity, age, diabetes type II, metabolic syndrome, greater weight and height and genetic mutations; the gynecological and obstetric factors are early menarche, late menopause and nulliparity; and the environmental factors include prescription drugs, lifestyle habits, medical procedures and eating habits. Regarding the protector factors, the pathophysiological factors include hypothyroidism, asthma and allergic rhinitis; in the gynecological and obstetrics category are multiparity, the first pregnancy at early age and breast feeding; lastly, the environmental factors include prescription drugs, medical procedures and eating habits. Conclusions: Considering the risk and protector factors for breast cancer would allow a more comprehensive approach in the diagnosis and treatment of breast cancer.

"Crime sem vítimas?" Um estudo sobre corrupção, vitimização e crenças no mundo justo / "Victimless crime?" A study on corruption, victimization and beliefs in a just world" / ¿Crimen sin víctimas?" Un estudio sobre corrupción, victimización y creencias en el mundo justo

A corrupção se configura como um importante problema no Brasil, embora seja entendido como um "crime sem vítimas". Frente à importância do tema, o presente estudo buscou avaliar a influência da categoria social de uma vítima de corrupção na relação entre crenças no mundo justo e intenção de corrupção. A amostra foi composta por 127 estudantes universitários de cursos relacionados às áreas de gestão e negócios. Os participantes responderam a medidas de CMJ, intenção de corrupção e informaram dados sociodemográficos. Verificou-se que, quando uma vítima de corrupção é alguém distante do indivíduo, a intenção de corrupção é maior se comparado a uma condição em que a vítima é próxima. Adicionalmente, verificou-se que o efeito da CMJ na corrupção foi restrito quando da avaliação de uma vítima próxima. Os resultados indicam a importância de articular variáveis grupais (distância social) e pessoais (CMJ) no estudo da corrupção.

Corruption is a major problem in Brazil, although it is understood as a "victimless crime". Given the importance of the topic, this study aimed to assess the influence of the social category of a corruption victim on the relationship between beliefs in a just world and the intention of corruption. The sample consisted of 127 university students from courses related to the areas of management and business. Participants responded to measurements of BJW, the intention of corruption and reported sociodemographic data. It was found that, when a victim of corruption is someone distant from the individual, the intention of corruption is greater compared to a condition in which the victim is close. Additionally, it was found that the effect of BJW on corruption was restricted when assessing a close victim. The results indicate the importance of articulating group (social distance) and personal variables (BJW) in the study of corruption.

La corrupción es un problema importante en Brasil, aunque se entiende como un "crimen sin víctimas". Dada la importancia de la temática, el presente estudio buscó evaluar la influencia de la categoría social de una víctima de corrupción en relación a las creencias del mundo justo (CMJ) y la intención a la corrupción. La muestra consistió en 127 estudiantes universitarios de grados de gestión y negocios. Los participantes respondieron a las escalas de CMJ, intención de corrupción y reportaron datos sociodemográficos. Se ha encontrado que cuando una víctima de corrupción está lejos del individuo, la intención de corrupción es mayor en comparación a una condición en la cual la víctima está cerca. Además, se descubrió que el efecto de CMJ sobre la corrupción estaba restringido al evaluar a una víctima cercana. Los resultados indican la importancia de articular las variables grupales (distancia social) y personales (CMJ) en el estudio de la corrupción.

Global Health Strategies in the Face of the COVID-19 Pandemic and Other Unprecedented Threats.

Global health is evolving as a discipline aiming at exploring needs and offering equitable health services for all people. Over the past four decades, several global initiatives have been introduced to improve the accessibility of primary health care (PHC) and solve most health issues at this level. Historically, the 1978 Alma-Ata and 2018 Astana Declarations were perhaps the most important documents for a comprehensive approach to PHC services across the world. With the introduction of the United Nations Sustainable Development Goals in 2015, developments in all spheres of human life and multi-sectoral cooperation became the essential action targets that could contribute to improved health, well-being, and safety of all people. Other global initiatives such as the Riyadh Declaration on Digital Health and São Paulo Declaration on Planetary Health called to urgent action to employ advanced digital technologies, improve health data processing, and invest more in research management. All these initiatives are put to the test in the face of the coronavirus disease 2019 (COVID-19) pandemic and other unprecedented threats to humanity.

She deserved it: Analysis of variables that influence the accountability of victims of sexual violence / Ella se lo merecía: Análisis de variables que influyen en la rendición de cuentas de las víctimas de violencia sexual

Abstract This article aims to analyze the effect of the combination of the variables - victim characteristics (skin color and normativity), observer sex, Belief in a Just World, and ambivalent sexism - on sexual violence victim blaming. Three studies were conducted with university students (Study 1, N=288; Study 2, N=226; Study 3, N=307), who were asked to answer some items on victim blaming, Belief in a Just World, and Ambivalent Sexism. The ANOVA and ANCOVA analyses have shown that the combination of these variables resulted in higher black and counter-normative victim blaming. The results confirmed that victim skin color, victim normativity, and the observer sex influence victim blaming for sexual violence (study 1); that BJW predicts the attribution of the victim's accountability for sexual violence (study 2), and that only benevolent sexism, together with BJW, was responsible for predicting victim blaming for sexual violence (study 3).

Abstract La mayoría de los estudios que investigan la culpabilización de las mujeres que son víctimas de violencia sexual indican que algunas características de la víctima y del observador están estrechamente relacionadas con este fenómeno. Este artículo propone analizar el efecto de la combinación de las variables características de la víctima (color de la piel y normatividad), el sexo del observador, la Creencia en un Mundo Justo y el sexismo ambivalente, en la culpabilización de la víctima de la violencia sexual. Desarrollamos tres estudios realizados con estudiantes universitarios (Estudio 1, N = 288; Estudio 2, N = 226; Estudio 3, N = 307), que fueron instruidos para responder algunos ítems sobre culpar a la víctima, creer en un mundo justo y sexismo ambivalente. Los análisis, ANOVA y ANCOVA, mostraron que la combinación de estas variables dio como resultado una mayor culpa atribuida a la víctima negra y la contranormativa. Los resultados confirmaron que el color de la piel de la víctima, la normatividad de la víctima y el sexo del observador influencian en la responsabilización de la víctima de violencia sexual (estudio 1), que la CMJ predice la responsabilización de la víctima de violencia sexual (estudio 2) y que solamente el sexismo benevolente, junto con la CMJ, fue responsable por prever la culpabilización de la víctima de violencia sexual (estudio 3).

The rs1800795 single nucleotide polymorphism in the IL6 gene is not associated with primary open angle glaucoma in Mexican population.

PURPOSE: Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (-174 G>C) SNP and a higher risk for POAG is present in western Mexican population. METHODS: One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. RESULTS: There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (p > 0.05). CONCLUSION: Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population.