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Periapical lesions are common pathologies affecting the alveolar bone, often initiated by intraradicular lesions resulting from microbial exposure to dental pulp. These microorganisms trigger inflammatory and immune responses. When endodontic treatment fails to eliminate the infection, periapical lesions persist, leading to bone loss. The RANK/RANKL/OPG pathway plays a crucial role in both the formation and the destruction of the bone. In this study, the objective was to inhibit the RANK/RANKL pathway in vitro within exposed Thp-1 macrophages to endodontic microorganisms, specifically Enterococcus faecalis, which was isolated from root canals of 20 patients with endodontic secondary/persistent infection, symptomatic and asymptomatic, and utilizing an α-IRAK-4 inhibitor, we introduced endodontic microorganisms and/or lipoteichoic acid from Streptococcus spp. to cellular cultures in a culture plate, containing thp-1 cells and/or PBMC from patients with apical periodontitis. Subsequently, we assessed the percentages of RANK+, RANKL+, and OPG+ cells through flow cytometry and measured the levels of several inflammatory cytokines (IL-1ß, TNF-α, IL-6, IL-8, IL-10, and IL-12p70) in the cellular culture supernatant through a CBA kit and performed analysis by flow cytometry. A significant difference was observed in the percentages of RANK+RANKL+, OPG+ RANKL+ cells in thp-1 cells and PBMCs from patients with apical periodontitis. The findings revealed significant differences in the percentages of the evaluated cells, highlighting the novel role of the IRAK-4 inhibitor in addressing this oral pathology, apical periodontitis, where bone destruction is observed.
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Macrófagos , Periodontite Periapical , Ligante RANK , Receptor Ativador de Fator Nuclear kappa-B , Transdução de Sinais , Humanos , Ligante RANK/metabolismo , Macrófagos/metabolismo , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Células THP-1 , Receptor Ativador de Fator Nuclear kappa-B/metabolismo , Periodontite Periapical/metabolismo , Periodontite Periapical/microbiologia , Periodontite Periapical/patologia , Citocinas/metabolismo , Enterococcus faecalis , Lipopolissacarídeos , Cavidade Pulpar/microbiologia , Cavidade Pulpar/metabolismo , Masculino , Osteoprotegerina/metabolismo , Adulto , Ácidos Teicoicos/farmacologiaRESUMO
RESUMEN El eritema fijo pigmentado es una toxicodermia que puede afectar la piel o las mucosas. Tiende a recurrir en las mismas localizaciones tras la administración repetida del agente desencadenante. Los principales grupos farmacológicos asociados han sidoanalgésicos, antiepilépticos y AINES. Clínicamente, hayaparición de placaseritemato-edematosas redondas u ovaladas, definidas. Existen diferentes variantes;la generalizada es una de las menos frecuentes. Se reporta el caso de un paciente de mediana edad, quien presentó un cuadro deeritema fijo pigmentadogeneralizado, asociado al uso de ARA II. Es el primer caso reportado de esta patología secundaria al uso de dicho grupo farmacológico.
SUMMARY Pigmented fixed erythema is a toxicoderma, it can affect the skin or mucous membranes. It tends to recur in the same locations after repeated administration of the triggering agent.1 The main associated pharmacological groups have been: analgesics, antiepileptics and NSAIDs. Clinically, there is the appearance of defined round or oval erythematous-edematous plaques. There are different variants, the generalized is one of the least frequent. The case of a middle-aged patient is reported, who presented a generalized fixed pigmented erythema, associated with ARBS, it is the first reported case of this pathology secondary to the use of said pharmacological group.
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Protected areas are of paramount relevance to conserving wildlife and ecosystem contributions to people. Yet, their conservation success is increasingly threatened by human activities including habitat loss, climate change, pollution, and species overexploitation. Thus, understanding the underlying and proximate drivers of anthropogenic threats is urgently needed to improve protected areas' effectiveness, especially in the biodiversity-rich tropics. We addressed this issue by analyzing expert-provided data on long-term biodiversity change (last three decades) over 14 biosphere reserves from the Mesoamerican Biodiversity Hotspot. Using multivariate analyses and structural equation modeling, we tested the influence of major socioeconomic drivers (demographic, economic, and political factors), spatial indicators of human activities (agriculture expansion and road extension), and forest landscape modifications (forest loss and isolation) as drivers of biodiversity change. We uncovered a significant proliferation of disturbance-tolerant guilds and the loss or decline of disturbance-sensitive guilds within reserves causing a "winner and loser" species replacement over time. Guild change was directly related to forest spatial changes promoted by the expansion of agriculture and roads within reserves. High human population density and low nonfarming occupation were identified as the main underlying drivers of biodiversity change. Our findings suggest that to mitigate anthropogenic threats to biodiversity within biosphere reserves, fostering human population well-being via sustainable, nonfarming livelihood opportunities around reserves is imperative.
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Biodiversidade , Ecossistema , Humanos , Animais , Agricultura , Animais Selvagens , Mudança ClimáticaRESUMO
Oral protein delivery holds significant promise as an effective therapeutic strategy for treating a wide range of diseases. However, effective absorption of proteins faces challenges due to biological barriers such as harsh conditions of the stomach and the low permeability of mucous membranes. To address these challenges, this article presents a novel nano-in-nano platform designed for enteric protein delivery. This platform, obtained by electrospinning, involves a coaxial arrangement comprising poly(N-vinylcaprolactam) nanogels (NGs) enclosed within nanofibers of Eudragit® L100-55 (EU), a pH-responsive polymer. The pH-selective solubility of EU ensures the protection of NGs during their passage through the stomach, where the fibers remain intact at low pH, and releases them in the intestine where EU dissolves. The switchable characteristic of this nano-in-nano platform is confirmed by using NGs loaded with a model protein (ovalbumin), which is selectively released when the intestinal pH is achieved. The versatility of this nano-in-nano delivery platform is demonstrated by the ability to modify the fibers dissolution profile simply by adjusting the concentration of EU used in the electrospinning process. Furthermore, by tuning the properties of NGs, the potential applications of this platform can be further extended, paving the way for diverse therapeutic possibilities.
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Caprolactama/análogos & derivados , Sistemas de Liberação de Fármacos por Nanopartículas , Polímeros , Ácidos Polimetacrílicos , Nanogéis , Ácidos Polimetacrílicos/química , Concentração de Íons de HidrogênioRESUMO
We sought to evaluate the effect of endodontic-causative microorganisms of primary infections on mononuclear cells such as CD14+, CD4+, CD8+, CD19+ and Tregs Foxp3+. Facultative anaerobic microorganisms were isolated from radicular conducts and peripheral blood samples, which were taken from patients with primary infections. Cellular cultures were performed with peripheral blood mononuclear cells (PBMC) with and without Actinomyces spp. and Streptococcus spp. during 48, 72, and 96 h of contact in culture (concentration 5 × 105 cells/well) in a round plate bound with 48 wells. Later, PBMC was collected for analysis by flow cytometry, with the monoclonal antibodies αCD14, αCD4, αCD8, αCD19 and αFoxp3, and acquired using an FACSCanto II cytometer. The supernatant of cellular cultures was analyzed for the quantification of inflammatory cytokines. Data analysis was performed in FlowJo v10.8.2 and FCAPArray software, and statistical analysis was performed using GraphPad v5.0. software. We observed an increase in the percentage of CD14+ cells in patients at different hours of cellular culture in the presence of both Actinomyces spp. and Streptococcus spp. microorganisms, compared to healthy controls. This study demonstrates the role played by the innate immune system in the pathogeny of endodontic primary infections, explaining the effects that generate the more common microorganisms in this oral pathology.
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Leucócitos Mononucleares , Monócitos , Humanos , Actinomyces , Citocinas/metabolismo , Interleucina-12/metabolismo , Interleucina-8/metabolismo , Leucócitos Mononucleares/metabolismo , Monócitos/metabolismo , Streptococcus/metabolismoRESUMO
Abstract Osteomyelitis is defined as the inflammation of the either medullary, cortical, or cancellous bone, including nerves and blood vessels, causing necrosis and bone sequestrum formation; this condition has become a rare pathology, and odontogenic infections are considered the most frequent causal factor. This case shows a patient with bi-maxillary osteomyelitis caused by Actinomyces spp, which was worsened for severe COVID-19 infection. Patient was submitted at surgery as, amplified total bilateral maxillectomy through the surgical technique Weber-Fergusson, and prolonged use of combination of antibiotics, achieved a good recovery. Two years later follow- up, the patient no show imaging or clinical evidence of the infection of osteomyelitis. The present case shows an interesting relationship between a rare infection and its association with COVID-19.
Resumen La osteomielitis se define como la inflamación del hueso medular, cortical o esponjoso, incluyendo nervios y vasos sanguíneos, causando necrosis y formación de secuestro óseo; esta condición es una patología rara, y las infecciones odontogénicas son consideradas como el factor causal más frecuente. En este caso, se muestra un paciente con osteomielitis bi-maxilar causada por Actinomyces spp, la cual empeoró por la infección de COVID-19 severo. El paciente fue sometido a una cirugía, maxilectomía bilateral total amplificada, a través de la técnica quirúrgica de Weber- Fergusson, y el uso prolongado de una combinación de antibióticos, logrando una buena recuperación. A los 2 años de seguimiento, el paciente no mostró evidencia clínica o imagenológica de la infección de osteomielitis. El presente caso muestra una interesante relación entre una infección rara y su asociación con COVID-19.
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Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/diagnóstico por imagem , Actinomicose/tratamento farmacológico , Cirurgia Bucal , COVID-19RESUMO
Abstract Avoidant or Restrictive Food Intake Disorder (ARFID) is an eating disorder (ED) not common in adults. In this article we present a clinical case of ARFID in a 37-year-old male patient treated in an ED center in Medellin, Colombia; displaying anxious symptoms that began a year earlier and concomitant weight loss, following a traumatic event causing an overall impairment with that patient. Several medical evaluations/examinations looking for organic causes, were excluded. Interventions were implemented by a psychiatry, a psychotherapist using cognitive-behavior therapy (CBT), and a nutritionist, all in face-to-face modality, which were carried out weekly for the first three months, then biweekly and subsequently quarterly. each lasting approximately 40-60 minutes. After the set of pharmacological interventions and psychotherapy, a great improvement in the functionality of the patient was observed. Improvement was found with respect to eating in public, food variation and panic attacks. In the absence of guidelines, it is important to use standardized and replicable treatments in this population.
Resumen El trastorno evitativo restrictivo de la ingesta (TERIA) es un trastorno alimentario (TCA) raro en adultos. Se presenta el caso de un hombre de 37 años con TERIA y trastorno de pánico atendido en un centro para TCA en Medellín, Colombia, quien presentó un año de síntomas ansiosos y pérdida de peso después de evento traumático, generando disfuncionalidad. Fue evaluada y excluida organicidad. Se realizaron intervenciones por parte de psiquiatría, psicoterapia con enfoque cognitivo conductual y nutrición, todas en modalidad presencial, las cuales se realizaron semanalmente los primeros tres meses, luego quincenalmente y posteriormente trimestralmente. Cada una con una duración de 40-60 minutos aproximadamente por sesión. Posterior al conjunto de intervenciones farmacológicas y psicoterapia, se observó una gran mejoría la funcionalidad del paciente, se encontró mejoría con respecto a comer en público, variación en los alimentos y ataques de panico. Ante la ausencia de guías de manejo de TERIA en adultos es relevante realizar tratamientos estandarizados que puedan ser replicados.
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The global increase in solid waste pollution due to economic growth and population growth has led to severe ecological deterioration. This situation is exacerbated by the ongoing coronavirus disease (COVID-19) pandemic, which has significantly impacted consumer behavior and consumption habits. Proper management of solid waste has thus become critical in mitigating environmental degradation. In this study, we aim to examine the relationship between the outbreak of COVID-19, environmental attitudes (EATT), social norms (SN), environmental knowledge (EK), technological innovation (TI), and solid waste management (SWM) in Ecuadorian households during the pandemic. We collected data from 426 households in Ecuador using an online questionnaire and analyzed it using the Partial Least Squares Structural Equation Model method to test the hypotheses. Likewise, we validated the measurement and structural model. The results are novel about SWM, considering a developing country severely affected during the pandemic. Our findings suggest that COVID-19 has a negative impact on SWM, while EATT, SN, and TI have a positive influence on SWM. However, we found that EK does not significantly affect SWM.
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COVID-19 , Gerenciamento de Resíduos , Humanos , Resíduos Sólidos , COVID-19/epidemiologia , Gerenciamento de Resíduos/métodos , Inquéritos e Questionários , PandemiasRESUMO
La situación de Multiempleo (ME) en Argentina, entendido como la combinación de la práctica clínica en una o más instituciones con la realización de otras actividades, es reconocida por diversos autores(MTEySS, 2021, OPS, 2013) y se ve favorecida por las características de un sistema de salud descentralizado y de tipología mixta.La pandemia COVID-19 incrementó la carga de trabajo y expuso la situación delME en los profesionales de salud. Para ahondar en su caracterización, se propuso un estudio en el ámbito de la PBA, que combinó diversas técnicas metodológicas. El presente trabajo incluye los resultados obtenidos en la fase cualitativa del estudio, que tuvo lugar en 2021.
The multi-employment (ME) situation in Argentina, understood as the clinical practice in one or more institutions combined with other activities, is recognized by various authors (MTEySS, 2021, OPS, 2013) and it is facilitated by the characteristics of a decentralized and mixed healthcare system. The COVID-19 pandemic increased workload and revealed the ME situation health professionals undergo. To delve deeper into this scenario, a study was conducted in the Buenos Aires province that combined different methodological techniques. This article includes the results obtained during the qualitative phase of the study, which took place in 2021.
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Argentina , Condições de Trabalho , Mão de Obra em SaúdeRESUMO
Multiempleo (ME) y pluriempleo describen profesionales que combinan la práctica clínica con otras actividades, relacionadas o no con la atención de la salud. Entre los motivos que refieren para elegirlo se destacan la necesidad de aumentar los ingresos, la estabilidad y seguridad laboral, la búsqueda de prestigio, aprendizaje y diversificación de tareas. También influyen género, profesión o tipo de trabajo. La extensa jornada laboral resultante, el tiempo de traslado entre trabajos y las responsabilidades familiares dificultan la práctica e incrementan el cansancio de los profesionales.
Multi-employment (ME) and multiple employment describe professionals who combine clinical practice with other activities, whether related to healthcare or not. Among the reasons cited for this election are the need to increase income, job stability and security, the pursuit of prestige, learning, and diversification of tasks. Gender, profession, or type of job also influence this choice. The resulting extended workday, the time spent commuting between jobs, and family responsibilities hinder the practice and contribute to the professionals' fatigue
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Argentina , Condições de Trabalho , Mão de Obra em SaúdeRESUMO
To evaluate whether the WaveOne Gold and Reciproc single file instrumentation systems, are effective in reducing the microbial load of a mixed biofilm and the cleaning of apical third compared to the Twisted File Adaptive system (multiple- file system). Seventy mesial roots of the first and second molars were included and randomly divided into three experimental groups (n=20, n=10 controls). Biofilms were formed inside canals over 31 days. After instrumentation with the unique file systems, WaveOne Gold and Reciproc and the multiple file system Twisted File Adaptive, using 2.25% sodium hypochlorite as an irrigant in all cases, a count of colony forming units was performed using serial dilutions, cleaning of the apical third was evaluated using scanning electron microscopy. Comparisons amongst groups were made by using parametric and non-parametric statistics, according to a normal or non-normal data distribution, respectively. No significant differences in the reduction of the microbial load after employing a single-file system in comparison to the multiple-file system were found; in addition, the cleaning of the apical third was similar for the three different instrumentation systems. The single-file system is equal in effectiveness compared with the multiple-file system in reducing the microbial load.
Evaluar si los sistemas de instrumentación de lima única, como WaveOne Gold y Reciproc son efectivos para reducir la carga microbiana de un biofilm mixto y la limpieza del tercio apical, comparado con los sistemas de limas múltiples, como Twisted File Adaptive. Setenta raíces mesiales de primeros y segundos molares fueron incluidos y divididos de forma aleatoria en tres grupos experimentales (n=20, n=10 controles). El biofilm fue formado en el interior de los conductos durante 31 días. Después se instrumentó con los sistemas de lima única (WaveOne Gold y Reciproc) y el sistema de limas múltiples Twisted File Adaptive, usando hipoclorito de sodio al 2.5% en todos los casos. El conteo de unidades formadoras de colonias se realizó usando diluciones seriales, la limpieza del tercio apical se evaluó empleando el microscopio electrónico de barrido. La comparación entre grupos se realizó con pruebas paramétricas y no paramétricas, de acuerdo con la distribución normal y no normal de los datos, respectivamente. No hubo una diferencia significativa en la reducción de la carga microbiana después de emplear los sistemas de lima única en comparación a los de limas múltiples, además, la limpieza del tercio apical fue similar en los 3 diferentes sistemas de instrumentación. Los sistemas de lima única son igual de efectivos para reducir la carga microbiana comparados con los sistemas de limas múltiples.
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BACKGROUND: Despite the increasing use of comprehensive rehabilitation models for people with severe mental illness (SMI), there are still limitations to their implementation and replicability in a consensual way, particularly in Latin American countries. The REINTEGRA program aims to be a standardized model of comprehensive rehabilitation focused on psychosocial and cognitive improvement through a set of interventions on different areas of people's functionality, with the goal of reintegrating people with SMI into the labour market. In this paper we summarize the protocol for its subsequent implementation in a mental health institution in Mexico. METHOD: The protocol is based on a quasi-experimental, prospective longitudinal study, with a pragmatic or naturalistic control group. It will be carried out in three phases. Phase 1 consists of a series of interventions focused on psychosocial improvement; Phase 2 focuses on cognitive and behavioral improvement treatments; and Phase 3 targets psychosocial recovery through rehabilitation and reintegration into the labour market. The overall procedure will be monitored with standarized evaluations at different stages of the program. DISCUSSION: This study presents a model of integral rehabilitation of people with SMI. At the moment, one of the obstacles to overcome is the organization and procedural control of the different actors needed for its implementation (nurses, psychologists, doctors, companies, institutions, etc.). REINTEGRA will be the first comprehensive rehabilitation model that includes systematized procedures for job reinsertion for people with SMI in Mexico, which aims to be a standardized tool of easy adaptation and the replicability for other mental health centers and institutions.
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Transtornos Mentais , Humanos , Estudos Prospectivos , América Latina , Estudos Longitudinais , Transtornos Mentais/psicologia , Reabilitação VocacionalRESUMO
RESUMEN INTRODUCCIÓN La pandemia de COVID-19 expuso el impacto del multiempleo en los servicios de salud. El objetivo de este estudio fue caracterizar el multiempleo en médicos y enfermeros que trabajaron en internación general y cuidados críticos durante la pandemia en la provincia de Buenos Aires. MÉTODOS Se realizó un estudio exploratorio, descriptivo y transversal. Los datos se recolectaron en el primer trimestre de 2021 con una encuesta estructurada anónima autoadministrada mediante muestreo no probabilístico en cadena. RESULTADOS El 96,3% de los médicos y el 68,1% de los enfermeros declararon estar multiempleados. La media de empleos fue 3,1 para médicos (entre 1 y 5) y 1,9 para enfermeros (entre 1 y 3). Los enfermeros declararon trabajos con mayor carga horaria, predominio del empleo público y contratación estable. Los médicos multiempleados manifestaron mayor diversidad en la forma de contratación. En ambas profesiones el multiempleo es motivado principalmente por razones de índole económica. DISCUSIÓN El multiempleo es difícil de medir mediante los registros oficiales. La proporción de multiempleo autorreportado en este estudio supera las cifras comunicadas por las estadísticas e informes oficiales. Aun así, las diferencias halladas entre médicos y enfermeros respecto al número de empleos son coincidentes con estudios previos. El problema del multiempleo requiere ser abordado desde la desprecarización del empleo, con mejoras en las condiciones económicas y de trabajo.
ABSTRACT INTRODUCTION The COVID-19 pandemic exposed the impact of multi-employment in health services. The objective of this study was to characterize multi-employment among physicians and nurses working in general hospitalization and critical care during the pandemic in the province of Buenos Aires. METHODS An exploratory, descriptive, cross-sectional study was conducted. Data were collected in the first quarter of 2021 with a structured anonymous self-administered survey using non-probabilistic chain sampling. RESULTS A total of 96.3% of physicians and 68.1% of nurses reported being multi-employed. The mean number of jobs was 3.1 for physicians (between 1 and 5) and 1.9 for nurses (between 1 and 3). Nurses reported having jobs with longer hours, mostly public and stable employment. Multi-employed physicians reported greater variety in the form of hiring. In both professions, multi-employment is mainly motivated by economic reasons. DISCUSSION Multi-employment is difficult to measure through official records. The proportion of self-reported multiemployment in this study exceeds the figures shown by official statistics and reports. The differences found between physicians and nurses regarding the number of jobs are still consistent with previous studies. The problem of multi-employment needs to be tackled by making employment less precarious, with improvements in economic and working conditions.
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Introducción: Hoy día se requiere formar a estudiantes de la carrera de medicina que sean competentes en el cumplimiento de sus funciones en los niveles de atención en salud. Como parte de las funciones que se deben desarrollar en el estudiante de medicina, se deben formar competencias para la prevención de la salud. Objetivo: Proponer una metodología para la formación de la competencia prevención de la salud en estudiantes de medicina durante el trabajo comunitario integral. Métodos: Se realizó un estudio cuantitativo de tipo preexperimental. La población estuvo conformada por 669 estudiantes de tercer año de medicina de la Universidad de Ciencias Médicas de Holguín. De ellos se obtuvo una muestra de 100 estudiantes mediante un muestreo aleatorio simple. Se emplearon la observación directa en el terreno y la Prueba de Rangos con Signos de Wilcoxon para constar la hipótesis de investigación. Resultados: Se aportó la competencia de prevención de la salud y la metodología para su formación en estudiantes de medicina durante el trabajo comunitario integral, así como los principales logros y deficiencias demostrados durante las acciones realizadas en la educación en el trabajo. Conclusiones: La competencia prevención de la salud forma parte del perfil de competencias laborales que singularizan a la formación de un médico general competente. Es de tipo genérica y requiere para su formación de la combinación de acciones instructivas, educativas y desarrolladoras desde las potencialidades del trabajo comunitario integral que realizan los estudiantes como parte del componente laboral de la carrera(AU)
Introduction: Nowadays, it is necessary to train medical students to be competent in the fulfillment of their functions at the healthcare levels. As part of the functions to be developed among medical students, health prevention competences should be developed. Objective: To propose a methodology for the formation of health prevention competences among medical students during comprehensive community work. Methods: A quantitative preexperimental study was carried out. The population consisted of 669 third-year medical students from Universidad de Ciencias Médicas de Holguín. A sample of 100 students was obtained by simple random sampling. Direct observation in the field and the Wilcoxon's signed-ranks test were used to verify the research hypothesis. Results: The health prevention competence and the methodology for its formation among medical students during comprehensive community work were provided, as well as were the main achievements and deficiencies shown during the actions carried out in education at work. Conclusions: The health prevention competence is part of the profile of occupational competences that singularize the training of a competent general practitioner. It is generic and requires. for its formation. the combination of instructive, educational and developmental actions from the potentialities of comprehensive community work performed by students as part of the occupational component of the major(AU)
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Humanos , Serviços Preventivos de Saúde/métodos , Competência Profissional , Conhecimento , Capacitação Profissional , Promoção da Saúde/métodos , Prevenção Primária/educação , Estudantes de Medicina , Educação de Graduação em Medicina/métodosRESUMO
INTRODUCTION: One of the most important moments in a doctor's life occurs when they do a medical residency. This period imposes stress and academic demands, which, together with the educational environment, allows for greater or lesser mental wellbeing. The objective of this study was to determine how the educational environment and mental wellbeing of medical residents are related. METHODS: Analytical cross-sectional study, in residents of clinical-surgical specialties. The educational environment was assessed using the Postgraduate Hospital Educational Environment Measure (PHEEM), and mental wellbeing was assessed with the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Pearson's linear correlation was determined. Informed consent and approval by the university ethics committee were obtained. RESULTS: The study population comprised 131 students, 43.8% male, with a median age of 28 years (interquartile range 4). In total, 87.9% of residents answered the survey. Of these, 65.9% were doing medical residencies and 34.1% surgical residencies. The mean PHEEM score was 107.96⯱â¯18.88, the positive emotions subscale was 29.32⯱â¯5.18 and positive functioning 23.61⯱â¯3.57, with a mean total mental wellbeing of 52.96⯱â¯8.44. A positive and moderate correlation was found between the total PHEEM score and each of the two mental wellbeing subscales (pâ¯<â¯0.001). CONCLUSIONS: A positive correlation was found between a better perception of the educational environment and mental wellbeing by residents of clinical and surgical specialties with greater mental wellbeing.
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Educação de Pós-Graduação em Medicina , Internato e Residência , Humanos , Masculino , Adulto , Feminino , Estudos Transversais , Colômbia , HospitaisRESUMO
Introducción: Uno de los momentos más importantes en la vida de un médico ocurre cuando realiza la especialización médica. Este periodo impone estrés y exigencias académicas, lo cual, junto con el ambiente educacional, permite un mayor o menor bienestar mental. El objetivo del estudio es determinar cómo se relacionan el ambiente educacional y el bienestar mental de los residentes de Medicina. Métodos: Estudio transversal analítico en residentes de especialidades clínico-quirúrgicas. El ambiente educacional se evaluó mediante la escala Postgraduate Hospital Educational Envioro-ment Meassure (PHEEM) y el bienestar mental, con la escala de Warwick-Edinburgh (EBMWE). Se determinó la correlación lineal de Pearson. Se tomó el consentimiento informado y se obtuvo la aprobación del comité de ética universitario. Resultados: Integraron la población de estudio 131 estudiantes, el 43,8% varones, con una mediana de edad de 28 [intervalo intercuartílico, 4] arios. El 87,9% de los residentes respondieron a la encuesta. Hubo un 65,9% de posgrados médicos y un 34,1% de quirúrgicos. La puntuación media en la PHEEM fue de 107,96 ± 18,88; en la subescala de emociones positivas, 29,32 ± 5,18 y en funcionamiento positivo, 23,61 ± 3,57, con una media total de bienestar mental de 52,96 ± 8,44. Se encontró una moderada correlación positiva entre puntuación total de la PHEEM y cada una de las 2 subescalas de bienestar mental (p <0,001). Conclusiones: Se encontró una correlación positiva entre una mejor percepción del ambiente educacional y el bienestar mental de los residentes de especialidades clínicas-quirúrgicas con mayor bienestar mental
Introduction: One of the most important moments in a doctor's life occurs when they do a medical residency. This period imposes stress and academic demands, which, together with the educational environment, allows for greater or lesser mental wellbeing. The objective of this study was to determine how the educational environment and mental wellbeing of medical residents are related. Methods: Analytical cross-sectional study, in residents of clinical-surgical specialties. The educational environment was assessed using the Postgraduate Hospital Educational Environment Measure (PHEEM), and mental wellbeing was assessed with the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Pearson's linear correlation was determined. Informed consent and approval by the university ethics committee were obtained. Results:The study population comprised 131 students, 43.8% male, with a median age of 28 years (interquartile range 4). In total, 87.9% of residents answered the survey. Of these, 65.9% were doing medical residencies and 34.1% surgical residencies. The mean PHEEM score was 107.96 ± 18.88, the positive emotions subscale was 29.32 ± 5.18 and positive functioning 23.61 ± 3.57, with a mean total mental wellbeing of 52.96 ± 8.44. A positive and moderate correlation was found between the total PHEEM score and each of the two mental wellbeing subscales (p < 0.001). Conclusions: A positive correlation was found between a better perception of the educational environment and mental wellbeing by residents of clinical and surgical specialties with greater mental wellbeing.
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Syphilis, a sexually transmitted infection, has reemerged in many vulnerable groups around the world. The objective of the current study was to determine the prevalence and incidence of syphilis among people who attended a specialized HIV clinic in Mexico from 2011 to 2015. Databases from the laboratory were analyzed, and the following four groups were formed: people seeking HIV-1 voluntary counseling and testing (VCT), people in prison (PPr), people living with HIV (PLWH), and patients from primary care clinics (others). The diagnosis of syphilis was made using the reverse algorithm; antibody titers were examined to determine the stage of infection. Baseline data were analyzed and, with follow-up information, a retrospective dynamic cohort was formed. Factors associated with the seroprevalence of syphilis and active syphilis were evaluated by the chi-square test. Moreover, risk factors for the incidence of syphilis were described. A total of 81,863 baseline individuals were analyzed. The seroprevalence of syphilis was 9.9% in the VCT group, 8.2% in the PPr group, 37.0% in the PLWH group, and 8.7% in the others group; the prevalence of active syphilis was 1.7-13.1%. A total of 11,124 people were followed up. The incidence (cases per 100 person-years) was 3.5 among the VCT group, 16.0 among the PLWH group, and < 0.1 among both the PPr and others groups, respectively; moreover, the frequency of reinfections was 11.1-24.4%. The high prevalence and incidence of syphilis, active syphilis, and reinfections among men, transgender people, individuals aged 20-39 years, and people with a history of HIV or hepatitis B suggest that it is critical to improve prevention, diagnosis, and treatment measures to stop the reemergence of syphilis. There are also new factors such as methamphetamine use, group sex, or contacting partners over the internet that are associated with syphilis. In addition, HIV preexposure prophylaxis could contribute to the increased incidence of syphilis by providing false security in the prevention of STIs, thereby increasing risky sexual behaviors.
Assuntos
Infecções por HIV , Infecções Sexualmente Transmissíveis , Sífilis , Masculino , Humanos , Sífilis/epidemiologia , Sífilis/diagnóstico , Sífilis/prevenção & controle , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Estudos de Coortes , Incidência , Estudos Retrospectivos , México/epidemiologia , Reinfecção , Estudos Soroepidemiológicos , Infecções Sexualmente Transmissíveis/epidemiologia , PrevalênciaRESUMO
Describir los hallazgos ecográficos de las pacientes que acudieron por sangrado uterino anormal al servicio de Ginecología y Obstetricia del Hospital Dr. Domingo Luciani durante el período enero 2021 a enero 2022. Métodos: Estudio observacional-descriptivo, de tipo retrospectivo. Muestra no probabilística e intencional, integrada por 99 pacientes. Variables involucradas: edad, raza, paridad, antecedentes personales, ciclo menstrual, duración del período menstrual, fecha última de menstruación, uso de algún medicamento, método anticonceptivo y hallazgos ecográficos. Resultados: Los hallazgos ecográficos evidenciaron diferentes causas que explican el sangrado uterino anormal de las pacientes que integraron la muestra de estudio; las tres más frecuentes fueron: miomatosis uterina, sangrado uterino anormal por leiomioma o por endometrio, sangrado uterino anormal tipo L y tipo E(AU)
Objective: To describe the ultrasound findings ofpatients who came for abnormal uterine bleeding to theGynecology and Obstetrics service of the Dr. Domingo LucianiHospital during the period January 2021 to January 2022.Methods: This was an observational-descriptive, retrospectivestudy. The sample was non-probabilistic and intentional,consisting of 99 patients. The data were collected in an Excelsheet for analysis to determine their percentage frequencyaccording to the variables involved: age, ethnicity, parity,personal history, menstrual cycle, duration of menstrual period,last date of menstruation, use of some medication, contraceptivemethod and ultrasound findings. Results: The ultrasoundfindings showed different causes to explain the abnormal uterinebleeding of the patients who made up the study sample; however,the three most frequent were: uterine myomatosis, sangradouterino anormal tipo L y tipo E(AU)
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Hemorragia Uterina , Ultrassonografia , Anticoncepcionais , Ginecologia , Hemorragia , Mioma , ObstetríciaRESUMO
Low-cost adjuvants are urgently needed for the development of veterinary vaccines able to trigger strong immune responses. In this work, we describe a method to obtain a low-cost cage-like particles (ISCOMATRIX-like) adjuvant useful to formulate veterinary vaccines candidates. The main components to form the particles are lipids and saponins, which were obtained from egg yolk by ethanolic extraction and by dialyzing a non-refined saponins extract, respectively. Lipids were fully characterized by thin layer chromatography (TLC) and gas-chromatography (GC) and enzymatic methods, and saponins were characterized by TLC, HPLC and MALDI-TOF. Cage-like particles were prepared with these components or with commercial inputs. Both particles and the traditional Alum used in veterinary vaccines were compared by immunizing mice with Ovalbumin (OVA) formulated with these adjuvants and assessing IgG1, IgG2a anti OVA antibodies and specific Delayed-type Hypersensitivity (DTH). In the yolk extract, a mixture of phospholipids, cholesterol and minor components of the extract (e.g. lyso-phospholipids) with suitable proportions to generate cage-like particles was obtained. Also, semi-purified saponins with similar features to those of the QuilA® were obtained. Cage-like particles prepared with these components have 40-50 nm and triggers similar levels of Anti-OVA IgG1 and DTH than with commercial inputs but higher specific-IgG2a. Both adjuvants largely increased the levels of IgG1, IgG2a and DTH in relation to the formulation with Alum. The methods described to extract lipids from egg yolk and saponins from non-refined extract allowed us to obtain an inexpensive and highly effective adjuvant.
Assuntos
Saponinas , Vacinas , Adjuvantes Imunológicos/química , Animais , Imunoglobulina G , Camundongos , OvalbuminaRESUMO
In this paper, we report the synthesis of block and random copolymers of 2-acrylamido-2-methyl-1-propane sulfonic acid (AMPS) and methyl methacrylate (MMA), with different AMPS feed ratios. These solution-processable copolymers with strongly sulfonated acid groups resulted in membranes with tunable ion exchange (IEC) and water absorption capacities. AFM images confirmed the microphase separation of PAMPS-b-PMMA-1:1 block copolymer membrane, annealed under the appropriate conditions. The resulting copolymers from the random combination of a 1:1 molar ratio of AMPS and MMA monomers are effective at enhancing the esterification conversion of acetic acid, when compared with a reaction catalyzed by PAMPS-b-PMMA block copolymers and the previously studied catalytic membranes. With the PAMPS-co-PMMA-1:1 membrane, the esterification reaction using acetic acid achieved 85% isopropyl acetate. These results are closely correlated with the increase in IEC (2.63 mmol H+g-1) and the relationship between weight loss (20.3%) and swelling degree (68%) in 2-propanol.