RESUMEN

The rising prevalence of drug-resistant Mycobacterium tuberculosis (MTB) strains poses a significant challenge to global tuberculosis (TB) control efforts. This study aimed to analyze drug resistance patterns and investigate the molecular characteristics of 193 MTB clinical isolates to shed light on the mechanisms of drug resistance. Of the 193 MTB clinical isolates, 28.5% (n = 53) exhibited mono-drug or multidrug resistance. Pyrazinamide mono-drug resistance (PZAr) was the most prevalent (17%, n = 33), followed by isoniazid mono-drug resistance (3.6%, n = 7). Rifampicin resistance was associated with mutations in the rpoB gene (D435Y, D435V, S450L, L452P). Isoniazid resistance mutations were found in the katG (S315T), inhA (C[-15] T), and ndh (R268H) genes, whereas ethambutol resistance mutations were observed in the embB gene (M306V, M306I, M306L, G406S, Q497R). Surprisingly, 94% of PZAr isolates (n = 31) showed no mutations in the pncA or rpsA genes. The presence of the R268H mutation in the ndh gene, not previously linked to PZAr, was detected in 15% of PZAr isolates (n = 5), suggesting its potential contribution to PZAr in specific cases but not as a predominant mechanism. The specific molecular mechanisms underlying PZAr in the majority of the isolates remain unknown, emphasizing the need for further research to uncover the contributing factors. These findings contribute to the understanding of drug resistance patterns and can guide future efforts in TB control and management.

Asunto(s)

RESUMEN

Fungal pathogens pose a major threat to food production worldwide. Traditionally, chemical fungicides have been the primary means of controlling these pathogens, but many of these fungicides have recently come under increased scrutiny due to their negative effects on the health of humans, animals, and the environment. Furthermore, the use of chemical fungicides can result in the development of resistance in populations of phytopathogenic fungi. Therefore, new environmentally friendly alternatives that provide adequate levels of disease control are needed to replace chemical fungicides-if not completely, then at least partially. A number of alternatives to conventional chemical fungicides have been developed, including plant defence elicitors (PDEs); biological control agents (fungi, bacteria, and mycoviruses), either alone or as consortia; biochemical fungicides; natural products; RNA interference (RNAi) methods; and resistance breeding. This article reviews the conventional and alternative methods available to manage fungal pathogens, discusses their strengths and weaknesses, and identifies potential areas for future research.

RESUMEN

Neuronal injury during acute hypoxia, ischemia, and following reperfusion are partially attributable to oxidative damage caused by deleterious fluctuations of reactive oxygen species (ROS). In particular, mitochondrial superoxide (O2•-) production is believed to upsurge during lowoxygen conditions and also following reperfusion, before being dismutated to H2O2 and released into the cell. However, disruptions of redox homeostasis may be beneficially attenuated in the brain of hypoxia-tolerant species, such as the naked mole-rat (NMR, Heterocephalus glaber). As such, we hypothesized that ROS homeostasis is better maintained in the brain of NMRs during severe hypoxic/ ischemic insults and following reperfusion. We predicted that NMR brain would not exhibit substantial fluctuations in ROS during hypoxia or reoxygenation, unlike previous reports from hypoxiaintolerant mouse brain. To test this hypothesis, we measured cortical ROS flux using corrected total cell fluorescence measurements from live brain slices loaded with the MitoSOX red superoxide (O2•-) indicator or chloromethyl 2',7'-dichlorodihydrofluorescein diacetate (CM-H2-DCFDA; which fluoresces with whole-cell hydrogen peroxide (H2O2) production) during various low-oxygen treatments, exogenous oxidative stress, and reperfusion. We found that NMR cortex maintained ROS homeostasis during low-oxygen conditions, while mouse cortex exhibited a ~40% increase and a ~30% decrease in mitochondrial O2•- and cellular H2O2 production, respectively. Mitochondrial ROS homeostasis in NMRs was only disrupted following sodium cyanide application, which was similarly observed in mice. Our results suggest that NMRs have evolved strategies to maintain ROS homeostasis during acute bouts of hypoxia and reoxygenation, potentially as an adaptation to life in an intermittently hypoxic environment.

Asunto(s)

RESUMEN

Background: Communicating with children and adolescents with cancer during a needle procedure can prove challenging for healthcare professionals. Objective: Our aim was to explore the perceptions of children and adolescents with cancer regarding communication with nurses during needle procedures. Method: Thus was a qualitative phenomenological study. Data were gathered through seven in-depth interviews with a convenience sample of children and adolescents with cancer. Data were analyzed using a grounded theory approach to identify themes in the participants' narratives. Results: The analysis revealed three themes describing participants' experience: (1) nurses need to explain clearly what they are going to do while also allowing children to express their emotions without feeling coerced; (2) nurses need to be honest and approachable and relate to children as active participants in the treatment process; and (3) it is distressing to hear other children who are undergoing a needle procedure cry out in pain. Further application of the constant comparison method yielded a core theme: (4) the pressures faced by oncology nurses lead them to focus on the technical side of procedures at the expense of their young patients' communication needs. Conclusions: We suggest that hospital managers need to ensure that oncology nurses have sufficient training in communication skills and are confident in their ability to respect and respond to the communication preferences and needs of patients.

Asunto(s)

RESUMEN

PURPOSE: To explore the experience of hospitalization among children and adolescents in treatment for acute lymphoblastic leukemia. METHODS: Qualitative phenomenological study informed by grounded theory and involving a convenience sample of children and adolescents attending an oncology unit in Spain. Data were collected through in-depth interviews with seven children aged between 9 and 18 years and analyzed using ATLAS.Ti 7.1. software in order to identify themes in the participants' narratives. Specific strategies were applied to support the validity and reliability of the findings. RESULTS: The analysis of interviews revealed three themes in the participants' accounts of their experience of hospitalization: 1) It's normal to feel afraid when being treated in hospital; 2) Needle procedures are associated with pain, illness, and dying; and 3) Difficulty of expressing the suffering that is experienced in hospital. CONCLUSIONS: A core experience among children and adolescents who are hospitalized for cancer treatment is the spiritual pain that results from feeling afraid. These fears are especially associated with the needle procedures that are routinely performed in the diagnosis and treatment of acute lymphoblastic leukemia.

Asunto(s)

RESUMEN

CONTEXT: Oxycodone and morphine are recommended as first-choice opioids for moderate/severe cancer pain, but evidence about their relative tolerability has significant methodological limitations. OBJECTIVES: This study was mainly aimed at comparing the risk of developing adverse events (AEs) with controlled-release oral morphine vs. oxycodone; secondary aims were comparing their analgesic efficacy and testing heterogeneity in tolerability across different age and renal function subgroups. METHODS: An open-label multicenter RCT (EudraCT number: 2006-003151-21) was carried out in patients with moderate/severe cancer pain. At baseline, 7 and 14 days, patients scored on 0-10 rating scales (0-10 numerical rating scale) the intensity of pain and of a list of common opioid side effects. The primary end point was the percentage of patients reporting an AE (a worsening ≥ 2 points on any of the listed side effects); tolerability by subgroups and average follow-up pain intensity were compared through regression models. RESULTS: One hundred eighty-seven patients were enrolled (47% of originally planned). Intention to treat (ITT) analysis (N = 185, morphine 94, oxycodone 91) did not show any difference in the risk of developing AEs (risk difference -0.6%, 95% CI -11.0% to 9.9%) nor in analgesia (0-10 numerical rating scale pain intensity difference -0.28, 95% CI -0.83 to 0.27). No evidence of heterogeneity of tolerability across age and renal function patient subgroups emerged. CONCLUSION: This trial failed to show any difference in tolerability and analgesic efficacy of morphine and oxycodone as first-line treatment for moderate/severe cancer pain but results interpretation is difficult due to lack of power, potential bias from open-label design, and concerns about assay sensitivity. These data, however, can significantly contribute to future meta-analyses comparing WHO Step-III opioids and are relevant in designing future randomized studies.

Asunto(s)

RESUMEN

PURPOSE: This study reports our experience with CT-guided block in the superior hypogastric plexus, using a single needle and anterior approach, in patients with pelvic cancer. METHOD: Ten patients with pelvic malignancy underwent CT-guided hypogastric neurolytic block with alcohol via an anterior approach. A solution of 10, 15, or 20 ml of alcohol, 4 ml of bupivacaine HCl, and 2 ml of contrast medium was injected. The results were evaluated based on pain relief, using a four-grade analogue scale. RESULTS: CT images always showed spread of solution around the iliac vessels. Pain relief was complete in four cases, moderate in two, mild in three, and none in one. Best results were observed with the largest amounts of alcohol. CONCLUSION: CT-guided percutaneous superior hypogastric block is a safe, relatively easy, and effective procedure in patients with severe pain from pelvic malignancies.

Asunto(s)

RESUMEN

Se realiza un análisis de los objetivos educacionales en relación con el proceso docente educativo de nuestros alumnos de enfermería, y los lineamientos emanados del I Congreso del PCC, así como los enfoques de los pedagogos de ideas más avanzadas en el campo socialista. Con todos estos elementos, plasmamos el enfoque que debe prevalecer para la formación multilateral de los alumnos de enfermería, si tenemos en cuenta su educación intelectual, científico-técnica, física, espiritual, estética, ideo-política, moral, patriótico-militar y politécnica laboral, cumplimentando así lo planteado por nuestro Comandante en Jefe: "El trabajo es el mejor pedagogo de nuestra juventud"

Asunto(s)

RESUMEN

Se realiza un análisis de los objetivos educacionales en relación con el proceso docente educativo de nuestros alumnos de enfermería, y los lineamientos emanados del I Congreso del PCC, así como los enfoques de los pedagogos de ideas más avanzadas en el campo socialista. Con todos estos elementos, plasmamos el enfoque que debe prevalecer para la formación multilateral de los alumnos de enfermería, si tenemos en cuenta su educación intelectual, científico-técnica, física, espiritual, estética, ideo-política, moral, patriótico-militar y politécnica laboral, cumplimentando así lo planteado por nuestro Comandante en Jefe: "El trabajo es el mejor pedagogo de nuestra juventud"

Asunto(s)