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Species distribution modeling helps understand how environmental factors influence species distribution, creating profiles to predict presence in unexplored areas and assess ecological impacts. This study examined the habitat use and population ecology of the Chilean dolphin in Seno Skyring, Chilean Patagonia. We used three models-random forest (RF), generalized linear model (GLM), and artificial neural network (ANN)-to predict dolphin distribution based on environmental and biotic data like water temperature, salinity, and fish farm density. Our research has determined that the RF model is the most precise tool for predicting the habitat preferences of Chilean dolphins. The results indicate that these dolphins are primarily located within six kilometers of the coast, strongly correlating with areas featuring numerous fish farms, sheltered waters close to the shore with river inputs, and shallow productive zones. This suggests a potential association between dolphin presence and fish-farming activities. These findings can guide targeted conservation measures, such as regulating fish-farming practices and protecting vital coastal areas to improve the survival prospects of the Chilean dolphin. Given the extensive fish-farming industry in Chile, this research highlights the need for greater knowledge and comprehensive conservation efforts to ensure the species' long-term survival. By understanding and mitigating the impacts of fish farming and other human activities, we can better protect the habitat and well-being of Chilean dolphins.

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Urban wetlands are essential to the longstanding health and well-being of cities. Acknowledged as rich in biodiversity and highly productive ecosystems, they provide ecosystem services represented in aspects such as air purification, urban climate regulation, physical and mental health, recreation, and contemplation, among a wide variety of other goods and services on which the quality of life of the inhabitants of large cities such as Bogota depends largely. We used cellular automata to model and simulate urban wetland changes in Bogota, Colombia. The study applied the coupled Markov-Future Land Use Simulation (FLUS) model to simulate and analyze land use/land cover (LULC) change over 20 years. First, we used an orthomosaic (1998) and two WorldView-2 satellite images (2004 and 2010), to detect land cover changes. Then, using the artificial neural network FLUS module, we calculated the relationships between land classes and associated drivers and estimated the probability of occurrence of each land class. Finally, we applied Intensity Analysis to examine the observed and projected LULC change (1998-2034). Results indicate that gains in areas of crops and pastures are at the expense of wetlands. In addition, simulation outputs show that wetlands will likely represent less than 2% of the total study area in 2034, representing a 14% decrease in 24 years. The importance of this project lies in its potential contribution to the decision-making process within the city and as an instrument of natural resource management. Additionally, the results of this study could contribute to the United Nations Sustainable Development Goal 6, "Clean water and sanitation," and climate change mitigation.

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Background: Acute intermittent porphyria (AIP) is an uncommon metabolic disease, being the most common of the acute porphyrias. The most frequent symptom is acute abdominal pain, although can be accompanied by seizures, neuro-psychiatric alterations or symmetrical motor neuropathies, which in some patients can progress to respiratory musculature paralysis. Objective: To describe an atypical presentation of acute porphyria to be considered as differential diagnoses in abdominal pain. Clinical case: We present a case of a patient with AIP, presenting acute abdomen, seizures, later developed neuropsychiatric compromise and symmetrical motor neuropathy, and was admitted to mechanical ventilation. Due to the severity of the neurological involvement, he received hemin arginate, presenting with transient hypertransaminemia, an adverse event not previously reported. The evolution was favorable, with mechanical ventilation and hospital discharge withdrawn. Conclusions: The diagnosis of AIP should be considered in cases of acute abdominal pain associated with neurological and/or psychiatric symptoms, particularly young women. The administration of hemin is considered the standard of treatment, and even late could have beneficial effects.

Introducción: la porfiria aguda intermitente (PAI) es una enfermedad metabólica infrecuente, siendo la más común de las porfirias agudas. El síntoma más frecuente es el dolor abdominal agudo, aunque también pueden acompañarse de convulsiones, alteraciones neuro-psiquiátricas o neuropatías motoras simétricas, y que en algunos pacientes puede progresar a la parálisis de la musculatura respiratoria. El objetivo de este trabajo es describir una forma atípica de presentación de una porfiria aguda, a fin de considerar como diagnósticos diferenciales en dolor abdominal. Caso clínico: paciente con PAI, que presenta abdomen agudo, convulsiones, posteriormente compromiso neuro-psiquiátrico y neuropatía motora simétrica, ingresando a ventilación mecánica. Por la gravedad del compromiso neurológico recibió arginato de hemina, cursando con hipertransaminemia transitoria, evento adverso no reportado previamente. La evolución fue favorable, retirándosele la ventilación mecánica y el alta hospitalaria. Conclusiones: se debe considerar el diagnóstico de PAI en casos de dolor abdominal agudo asociado a síntomas neurológicos y/o psiquiátricos, particularmente en mujeres jóvenes. La administración de hemina es considerada el estándar de tratamiento, y aun en forma tardía podría tener efectos beneficiosos.

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The aim of this work was to monitor the quality, antioxidant capacity and digestibility of chickpea exposed to different modified atmospheres. Chickpea quality (proximal analysis, color, texture, and water absorption) and the antioxidant capacity of free, conjugated, and bound phenol fractions obtained from raw and cooked chickpea, were determined. Cooked chickpea was exposed to N2 and CO2 atmospheres for 0, 25, and 50 days, and the antioxidant capacity was analyzed by DPPH (2,2'-diphenyl-1-picrylhydrazyl), ABTS (2,2'-azino-bis-[3ethylbenzothiazoline-6-sulfonic acid]), and total phenols. After in vitro digestion, the antioxidant capacity was measured by DPPH, ABTS, FRAP (ferric reducing antioxidant power), and AAPH (2,2'-Azobis [2-methylpropionamidine]). Additionally, quantification of total phenols, and UPLC-MS profile were determined. The results indicated that this grain contain high quality and high protein (18.38%). Bound phenolic compounds showed the highest amount (105.6 mg GAE/100 g) and the highest antioxidant capacity in all techniques. Cooked chickpeas maintained their quality and antioxidant capacity during 50 days of storage at 4 and -20 °C under a nitrogen atmosphere. Free and conjugated phenolic compounds could be hydrolyzed by digestive enzymes, increasing their bioaccessibility and their antioxidant capacity during each step of digestion. The majority compound in all samples was enterodiol, prevailing the flavonoid type in the rest of the identified compounds. Chickpea contains biological interest compounds with antioxidant potential suggesting that this legume can be exploited for various technologies.

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Abstract Recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. In this context, the aim was to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: A rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: Recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.

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El presente estudio se propuso caracterizar los cursos de posgrado del Movimiento iSchools en América del Norte, Asia Pacífico y Europa. Se enuncian los aspectos teóricos conceptuales referentes al posgrado, además de la génesis y desarrollo del movimiento iSchools. Se utiliza el enfoque cuantitativo, apoyado del método análisis de contenido y la técnica análisis documental para analizar el tipo, la modalidad, duración, evaluación y contenidos de los posgrados en el movimiento iSchools. Se consultan los campos semánticos del Docutes para la identificación de los principales contenidos presentes en los programas de posgrado. Dentro de los principales resultados se identificaron las maestrías como tipología de posgrado más frecuentes. La modalidad a tiempo completo fue la más utilizada por las tres regiones geográficas. Los tipos de evaluación de mayor cuantía fueron las tesis. Los contenidos más relevantes en los tres capítulos continentales se encuentran asociados a los campos semánticos Sistemas de Información y Representación y recuperación de información(AU)

The present study aimed to characterize the graduate courses of the iSchools Movement in North America, Asia Pacific and Europe. The theoretical and conceptual aspects of postgraduate studies are enunciated, as well as the genesis and development of the iSchools movement. The quantitative approach is used, supported by the content analysis method and the documentary analysis technique to analyze the type, modality, duration, evaluation and content of postgraduate courses in the iSchools movement. The semantic fields of the Docutes were consulted for the identification of the main contents present in the postgraduate programs. Among the main results, master's degrees were identified as the most frequent postgraduate typology. The full-time modality was the most used by the three geographical regions. The types of evaluation with the highest amount were theses. The most relevant contents in the three continental chapters are associated with the semantic fields Information Systems and Information representation and retrieval(AU)

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Navicula incerta is a marine microalga distributed in Baja California, México, commonly used in aquaculture nutrition, and has been extended to human food, biomedical, and pharmaceutical industries due to its high biological activity. Therefore, the study aimed to optimize culture conditions to produce antioxidant pigments. A central composite experimental design and response surface methodology (RSM) was employed to analyze the best culture conditions. The medium (nitrogen-deficient concentrations), salinity (PSU = Practical Salinity Unity [g/kg]), age of culture (days), and solvent extraction (ethanol, methanol, and acetone) were the factors used for the experiment. Chlorophyll a (Chl a) and total carotenoids (T-Car), determined spectroscopically, were used as the response variables. The antioxidant capacity was evaluated by DPPH• and ABTS•+ radical inhibition, FRAP, and anti-hemolytic activity. According to the overlay plots, the optimum growth conditions for Chl a and T-Car production were the following conditions: medium = 0.44 mol·L-1 of NaNO3, salinity = 40 PSU, age of culture: 3.5 days, and solvent = methanol. The pigment extracts obtained in these optimized conditions had high antioxidant activity in ABTS•+ (86.2-92.1% of inhibition) and anti-hemolytic activity (81.8-96.7% of hemolysis inhibition). Low inhibition (33-35%) was observed in DPPH•. The highest value of FRAP (766.03 ± 16.62 µmol TE/g) was observed in the acetonic extract. The results demonstrated that RSM could obtain an extract with high antioxidant capacity with potential applications in the biomedical and pharmaceutical industry, which encourages the use of natural resources for chemoprevention of chronic-degenerative pathologies.

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Introducción estudios recientes han reportado fenómenos trombóticos o coagulopatía en pacientes con COVID-19. Hay posiciones divergentes en cuanto a la prevención, el diagnóstico y el tratamiento de estos fenómenos, y la práctica clínica actual está basada únicamente en deducciones por extensión a partir de estudios retrospectivos, series de casos, estudios observacionales y guías internacionales desarrolladas previas a la pandemia. Objetivo establecer una serie de recomendaciones sobre prevención, diagnóstico y manejo de las complicaciones trombóticas asociadas a COVID-19. Métodos se desarrolló una guía rápida en la que se aplicó el marco de la evidencia a la decisión (EtD) de GRADE y un sistema de participación iterativo, con análisis estadísticos y cualitativos de sus resultados. Resultados se generaron 31 recomendaciones clínicas enfocadas a: a) Pruebas de coagulación en adultos sintomáticos con sospecha de infección o infección confirmada por SARS-CoV-2; b) Tromboprofilaxis en personas adultas con diagnóstico de COVID-19 (escalas de riesgo, tromboprofilaxis de manejo ambulatorio, intrahospitalario y duración de tromboprofilaxis después del egreso de hospitalización), c) Diagnóstico y tratamiento de las complicaciones trombóticas y d) Manejo de personas con indicación previa a usar agentes anticoagulantes. Conclusiones las recomendaciones clínicas de este consenso orientan la toma de decisiones clínicas respecto a prevención, diagnóstico y tratamiento de fenómenos trombóticos en pacientes con COVID-19, y representan un acuerdo que ayudará a disminuir la dispersión en las prácticas clínicas acorde con el desafío que impone la pandemia.

Abstract Introduction: recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. Objective: to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: a rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.

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Microalbuminuria is a term to describe a moderate increase in the level of albumin in urine. It is an important prognostic marker for kidney damage in diseases such as diabetes mellitus and hypertension. A simple sandwich-type ultramicroELISA assay (UMELISA) has been developed for the measurement of albumin in human urine samples. Strips coated with a high affinity monoclonal antibody directed against albumin are used as solid phase, to ensure the specificity of the assay. The albumin assay was completed in 1 hr and 30 min, with a measuring range of 1.44-200 ng/mL. The intra- and inter-assay coefficients of variation were 3.98-4.35% and 7.59-8.92%, respectively, depending on the albumin concentrations evaluated. Percentage recovery ranged from 94.26 to 98.50%. Regression analysis showed a good correlation with the commercial quantitative turbidimetric test Microalbumin-turbilatex (n = 240, r = 0.994, p < .01). The analytical performance characteristics of our UMELISA MICROALBUMINA endorse its use for the quantification of albumin in human urine samples. This test will make a cost-effective diagnostic kit accessible to low-income countries such as Latin American countries and is now available in the Cuban Public Health System.

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Legume proteins are precursors of bioactive components, such as peptides. In the present paper, different types of legume as sources of bioactive peptides and hydrolysates are considered and discussed based on their anti-inflammatory effect. Peptides with anti-inflammatory activity were included from in vitro and in vivo studies. Current strategies for obtaining bioactive peptides, as well as their structure and impact on health, were also reviewed. It was discovered that peptides derived from legume protein, mainly soybean and bean, can regulate several inflammatory markers, which include prostaglandin E2 (PGE2), nitric oxide (NO), inducible nitric oxide synthase (iNOS), cyclooxygenase 2 (COX- 2), cytokines, and chemokines. So far, lunasin, VPY and γ-glutamyl peptides have been identified with anti-inflammatory activity but their mechanisms have not been fully elucidated. Furthermore, it is necessary to gather more information about hydrolysates containing peptides and single peptides with antiinflammatory activity. Considering the wide diversity, legume may be promising components to produce peptides efficient to ameliorate inflammatory disorders.

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Congenital hypothyroidism (CH) is one of the most frequent inherited-metabolic diseases in the world, and the main cause of treatable mental retardation in children. Because signs and symptoms of this disease are often scarce and not easily recognizable, newborns are screened for the early CH detection at birth. The Center of Immunoassay (CIE) has developed the UMELISA® TSH Neonatal and UMELISA® TSH to determine neonatal thyroid-stimulating hormone (TSH) levels in dried blood and serum samples. Both reagent kits use the same polystyrene plates coated with anti-ß-TSH monoclonal antibodies (MAbs), but one of these is commercially acquired. Obtaining appropriate anti-TSH MAbs at the CIE would guarantee economic independence and security in the production of these kits. Immunization of mice with TSH led to the generation of 7G11E3, an anti-ß-TSH IgG1-secreting hybridoma. The high affinity of 7G11E3 MAb and its characteristic epitopic recognition explain its better performance when adsorbed to UMELISA® plates for capturing low amounts of TSH in comparison with the studied MAbs. Performance of assays using polystyrene plates coated with 7G11E3 MAb was studied. Recovery percentages (100.0-106.7% for UMELISA® TSH NEONATAL and 97.3-99.0% for UMELISA® TSH) and intra (5.2-7.9% for UMELISA® TSH NEONATAL and 3.2-5.3% for UMELISA® TSH) and inter (6.6-7.7% for UMELISA® TSH NEONATAL and 5.2-8.0% for UMELISA® TSH) coefficients of variation were similar to the ones described for the commercial kits. Limits of detection and quantification were 1.0 and 3.8 mIU/L for UMELISA® TSH NEONATAL, and 0.3 and 0.6 mIU/L for UMELISA® TSH, respectively. The results also showed high overall concordance between assays (n = 2 019, ρc = 0.90 for UMELISA® TSH NEONATAL and n = 200, ρc = 0.94 for UMELISA® TSH). The 7G11E3 MAb meets the requirements for its use in the plates of UMELISA® TSH kits for CH newborn screening in Cuba. Abbreviations: CECMED, Center for the State Control of Medicaments and Medical Equipment and Devices; CH, congenital hypothyroidism; CIE, Center of Immunoassay; CLSI, Clinical and Laboratory Standards Institute; CV coefficient of variation; DBS, dried blood spots; LOB, limit of blank; LOD, limit of detection; LOQ, limit of quantitation; SD, standard deviation; Sr, repeatability standard deviation; SUMA, Ultra Micro Analytic System; UMELISA, ultramicro enzyme-linked immunosorbent assay.

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Para la esclerosis sistémica no existe un tratamiento efectivo demostrado que modifique la enfermedad. El tratamiento de este padecimiento está encaminado a controlar los síntomas y signos, así como el daño orgánico con compuestos cuya acción tiene por objetivo prevenir o revertir la enfermedad como los que se administran en otras enfermedades reumáticas en dependencia de las manifestaciones en cada paciente. Para esta investigación se aplicó el método Delphi. Estudios realizados por investigadores de la Rand Corporation señalan que, si bien parece necesario contar con un mínimo de siete expertos, pues así el error disminuye notablemente por cada uno de ellos, no se aconseja más de 30. Esta investigación contó con 15 expertos. Desde el punto de vista científico, se obtiene una conducta terapéutica diferente desde las etapas tempranas del diagnóstico, en las cuales se les administra a los pacientes ciclofosfamida como inmunosupresor de primera elección. El procesamiento estadístico y la validación de la terapéutica mediante el método Delphi permitieron aplicar la conducta trazada para tratar a los enfermos desde los estadios clínicos iniciales. El objetivo de la investigación es validar la conducta terapéutica a seguir con los enfermos de esclerosis sistémica(AU)

In the systemic sclerosis does not exist an effective therapy modifier of the confirmed disease. The treatment is centered on the control of symptoms and signs, as well as the organic commitment and not quite in a background processing whose action does not have for objective the control of the symptoms, but his prevention or reversion, as it has been utilized in another rheumatic diseases in dependence of the presentation in each patient. The method applied over himself Delphi, studies accomplished by the Rand's investigatorsCorporation, they indicate than even though a minimum of seven because the error decreases for each expert, to recur in addition to 30 it is not advisable, this investigation notably seems necessary required 15 experts. From the scientific point of view, a therapeutic different conduct from premature stages of the diagnosis is obtained, that the cyclophosphamide like inmunosoppressor of front line utilizes for affected patients. The statistical processing and the validation of the intervening therapeutics the method Delphi permitted the application of the conduct designed for the sick persons from clinical initial stadiums(AU)

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La esclerosis sistémica es una enfermedad multisistémica y multiorgánica, de perfil autoinmune, con una etiopatogenia poco dilucidada. Se observan algunos avances desde hace cinco años a la fecha, fundamentalmente de los principales eventos que se presentan: anormal respuesta del sistema inmunológico, vasculopatía y fibrosis. La atención médica precoz a pacientes con ES, es muy difícil, requiere de la identificación temprana de los pacientes de alto riesgo, diagnóstico precoz de la enfermedad, evaluación de la afectación de órganos internos, y el diseño de una conducta terapéutica adecuada. El diseño fue de serie de casos con inicio en enero del 2013-2014. Universo 44 pacientes mayores de 18 años, con diagnóstico de esclerosis sistémica en la provincia de Holguín, según criterios de ACR. De ellos se tomó una muestra de 31 pacientes vivos para establecer estadios clínicos de la enfermedad, en correspondencia con la severidad de la toma orgánica para cada paciente, según método estadístico aplicado. Se obtuvo cuatro estadios clínicos útiles para la clasificación de los pacientes y evaluación posterior en otros momentos investigativos(AU)

The systemic sclerosis is a multi-systemic and multi-organic disease, of autoimmune profile, with an ethiopatogenia little elucidated. They observe some advances for five years to date, fundamentally of the principal events that present itself : Abnormal answer of the immune system, vasculopatía and fibrosis. The precocious medical attention to patients with. It is very difficult, you call for the premature recognition of the patients of loud risk, precocious diagnosis of the disease, evaluation of the affectation of internal organs, and a therapeutic adequate conduct's design. The design went from series of cases with start in January of the 2013-2014. Universe 44 patient elders of 18 years, with diagnosis of systemic sclerosis at Holguín's province, according to criteria of ACR. You took 31 alive patients' sign to establish clinical stadiums of the disease in mail, with the severity of organic the overtaking for each patient, according to applied statistical method of them. Four clinical useful stadiums for the patients' classification and later evaluation in another investigating moments were obtained(AU)

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Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder caused by the deficiency of one of the five enzymes involved in the biosynthesis of corticosteroids. The most common form of the disease is the lack of 21-hydroxylase which provokes an accumulation of high levels of 17α-hydroxyprogesterone (17-OHP), the main biochemical marker for illness detection. Given the significance of neonatal diagnosis for ensuring a timely treatment to patients suffering from CAH, newborn screening is worldwide performed for the determination of 17-OHP from dried blood spots on filter paper. The non-specificity of antisera employed in immunoassays and the cross-reaction with fetal adrenal hormones produce an overestimation in the 17-OHP quantification. Immunization of mice with 17-OHP-3-(O-carboxymethyl) oxime-bovine serum albumin led to the generation of 15 anti-17-OHP IgG1-and-IgG2b-secreting hybridomas. The 6E2G9 monoclonal antibody presents cross-reactivity values similar to those achieved by rabbit antibodies employed in the solid phase of UMELISA® 17-OH Progesterona Neonatal, assay for the newborn screening of CAH in Cuba. Additionally, the use of 6E2G9 in the evaluation of dried blood spots samples from newborns on filter paper showed a decrease in the mean 17-OHP levels, thus demonstrating it can replace the conventional rabbit antisera.

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INTRODUCTION: Healthcare-associated pneumonia (HCAP) is the leading cause of infection in a hospital setting and is associated with a high mortality rate. This study aimed to evaluate the performance of the pneumonia severity index (PSI) and confusion, urea, respiratory rate, blood pressure, age≥65 (CURB-65) systems in predicting 30-day mortality in HCAP in adult patients. PATIENTS AND METHODS: A cross-sectional study took place and data from 109 non-immunocompromised individuals aged>18 years were analyzed. The clinical diagnosis of HCAP included the presence of radiographic infiltrates in patients≥48hours after hospital admission. The PSI and CURB-65 scores were calculated and performance measures were estimated. Summary statistics were used to describe the study sample. The PSI and CURB-65 scores were calculated based on 20 and 5 criteria, respectively, and the performance indicators of the screening tools were estimated. RESULTS: The overall 30-day mortality was 59.6%. At every given threshold, PSI sensitivity was higher, but showed a lower specificity than the CURB-65, and the highest Youden index (0.392) was observed at cut-off V in the PSI. The area under the ROC curve was 0.737 (95% CI: 0.646-0.827) and 0.698 (95% CI: 0.600-0.797) using the PSI and CURB-65 systems, respectively (P=.323). CONCLUSION: Our findings suggest that the performance of the PSI and CURB-65 is reasonable for predicting 30-day mortality in adult HCAP patients and may be used in healthcare settings.

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Objetivo: describir las intervenciones de enfermería en neonatos con presión positiva continua con prongs, hospitalizados en una unidad neonatal mexicana. Métodos: corte transversal en una muestra no aleatoria por conveniencia, conformada por veinticinco enfermeras que tenían bajo sus cuidados a recién nacidos con sistema de presión positiva con prongs. La recolección de datos fue realizada con un cuestionario autoplicado. El análisis fue descriptivo, y se obtuvieron medidas de tendencia central de las variables cuantitativas que mostraron una distribución normal. Las variables cualitativas se describen con valores relativos. Se respetaron aspectos éticos según la reglamentación vigente mexicana. Resultados: participaron veinticinco enfermeras con grado académico: el 88% con licenciatura y solo el 24% especialistas neonatólogas. Los neonatos usan la presión positiva continua: el 52% de 3 a 5 días; el 20% de 6 a 7 días y el 28% de 8 a 12 días. El nivel de lesión nasal y los resultados con prongs, mediante el cuidado constante de la enfermera sobre la aparición de estas, evidenciaron que el 60% de los neonatos presentó lesión leve; el 36%, moderada, y el 4%, severa. Conclusiones: las intervenciones de cuidado del neonato deben dirigirse a minimizar las lesiones de piel y tabique nasal para contribuir con las normas internacionales de seguridad del neonato.

Objective: To describe nursing interventions in neonates with continuous positive airway pressure with prongs, Mexican hospitalized in neonatal unit. Methods: Cross-section in a nonrandom convenience sample, composed of 25 nurses who were under their care to newborns, positive pressure system with prongs. Data collection was performed with self-administered survey. Data analysis was descriptive, measures of central tendency for quantitative variables that showed a normal distribution were obtained. The qualitative variables are described in relative values. Ethical aspects were respected as required by regulations. Results: 25 nurses participated degree: 88% graduate and only 24% neonatologist specialists, Infants use continuous positive airway pressure: 52% of 3-5 days 20% of 6-7 days and 28% of 8-12 days with respect to the level of nasal lesions, results with prongs, through constant care nurse about the appearance of these, 60% of neonates presented mild injury, 36% moderate and 4% severe. Conclusions: It requires nursing care interventions careful of the newborn to minimize skin lesions and nasal septum and contribute to international safety standards neonate.

Objetivo: describir as intervenções de enfermagem em neonatos com pressão positiva contínua com prongs, internados em uma unidade neonatal mexicana. Métodos: de corte transversal em uma amostra por conveniência não aleatória, composta por 25 enfermeiros que dão cuidados ao recém-nascido com sistema de pressão positiva com prongs. A coleta de dados foi realizada com um questionário autoaplicável. A análise dos dados foi descritiva, foram obtidas medidas de tendência central para variáveis quantitativas que apresentaram distribuição normal. As variáveis qualitativas são descritos em valores relativos. Aspectos éticos foram respeitados conforme exigidos pelos regulamentos mexicanos. Resultados: 25 enfermeiros com grau académico: 88% licenciatura e apenas 24% neonatologas especialistas. Os neonatos com o uso da pressão positiva contínua: 52% de 3-5 dias, o 20% de 6-7 dias e o 28% de 8-12 dias, com respeito ao nível de lesões nasais, os resultados com prongs, o 60% de neonatos apresentou lesão leve, 36% moderada e 4% grave. Conclusões: as intervenções de cuidado devem ser encaminhadas a minimizar lesões de pele e septo nasal e contribuir com as normas de segurança internacionais do neonato.

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Se realizó un compendio de los principales factores etiopatogénicos causantes de la expresividad clínica de la esclerosis sistémica, aún no bien establecida, la asociación genética, herencia, factores ambientales y respuesta inflamatoria, su relación con infecciones endógenas comportándose de manera especial en otras enfermedades reumáticas inflamatorias. El objetivo del artículo fue describir los elementos de la etiopatogenia que distinguen a esta enfermedad del colágeno. Los mecanismos etiopatogénicos basados en anormalidades moleculares, pueden ser correctas en la esclerosis sistémica. Su espectro clínico heterogéneo responde a una etiopatogenia distinta en cada individuo, así como, a eventos complejos que pueden ocurrir en fases iniciales de la enfermedad y no a una patogenia única.

A summary of the main ethiopathogenic factors that cause the clinical expressiveness of the Systemic Sclerosis, still as soon as established, the genetic association, inheritance, environmental factors and inflammatory response, their relationship with endogenous infections behaving from a special way to other inflammatory rheumatic illnesses. The objective of this article was to describe the ethiopathogenic elements that distinguish this illness of the collagen. The ethiopathogenic mechanisms based on molecular abnormalities can be correct in the systemic sclerosis. Its heterogenic clinical spectrum responds to a different etiopathogeny in each individual, as well as to complex events that can happen in initial phases of the illness and not to a unique pathogenic.

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Se realizó una búsqueda de los antecedentes del uso de diferentes terapéuticas en pacientes con esclerosis sistémica, se abordó las ventajas del uso de la ciclofosfamida, el fracaso de terapéuticas ya ensayadas, posibilidades presentes y futuras, con el objetivo de demostrar las ventajas del uso de la ciclofosfamida, como terapéutica de primera línea en los pacientes incluidos en diferentes estudios, además de sensibilizar a la comunidad científica de la Especialidad de Reumatología, sobre el riesgo y beneficio del uso de este medicamento, en los pacientes con una enfermedad de un pronóstico muy desfavorable. La selección de los pacientes con esclerosis sistémica que serán sometidos a tratamiento con ciclofosfamida, en estudios controlados requiere de fases preclínicas o iniciales sin exclusión alguna de sus formas clínicas existentes. La irreversibilidad que muestran las formas severas de la enfermedad, así como, el periodo de duración de la medicación menor de dos años, pudiera ser causas del fracaso terapéutico. Los resultados de esta amplia revisión motiva a la comunidad científica a insistir en su modo de empleo.

A search on the history of different therapies use in patients with systemic sclerosis was done, the advantages of the use of cyclophosphamide was approached, therapeutic failure and tested, present and future possibilities, in order to demonstrate the advantages of using cyclophosphamide as first-line therapy in patients included in different studies, and sensitize the scientific community of the specialty of rheumatology, on the risk benefit of using this drug in patients with a disease of a very poor prognosis . The selection of patients with systemic sclerosis will undergo treatment with cyclophosphamide in controlled studies required preclinical or early phases without any of its existing clinical forms exclusion, irreversibility showing severe forms of the disease, as well as the period duration of two years less medication could be causes of treatment failure. The results of this comprehensive review motivate the scientific community to insist on how to use it.

RESUMO

BACKGROUND: Elevated body mass index (BMI) is a risk factor for cardiovascular disease, diabetes, cancer, and other diseases. Inflammation or oxidative stress induced by high BMI may explain some of these effects. Millions of people drink arsenic-contaminated water worldwide, and ingested arsenic has also been associated with inflammation, oxidative stress, and cancer. OBJECTIVES: To assess the unique situation of people living in northern Chile exposed to high arsenic concentrations in drinking water and investigate interactions between arsenic and BMI, and associations with lung and bladder cancer risks. METHODS: Information on self-reported body mass index (BMI) at various life stages, smoking, diet, and lifetime arsenic exposure was collected from 532 cancer cases and 634 population-based controls. RESULTS: In subjects with BMIs <90th percentile in early adulthood (27.7 and 28.6 kg/m(2) in males and females, respectively), odds ratios (OR) for lung and bladder cancer combined for arsenic concentrations of <100, 100-800 and >800 µg/L were 1.00, 1.64 (95% CI, 1.19-2.27), and 3.12 (2.30-4.22). In subjects with BMIs ≥90th percentile in early adulthood, the corresponding ORs were higher: 1.00, 1.84 (0.75-4.52), and 9.37 (2.88-30.53), respectively (synergy index=4.05, 95% CI, 1.27-12.88). Arsenic-related cancer ORs >20 were seen in those with elevated BMIs in both early adulthood and in later life. Adjustments for smoking, diet, and other factors had little impact. CONCLUSION: These findings provide novel preliminary evidence supporting the notion that environmentally-related cancer risks may be markedly increased in people with elevated BMIs, especially in those with an elevated BMI in early-life.

Assuntos

RESUMO

Arsenic concentrations greater than 100 µg/L in drinking water are a known cause of cancer, but the risks associated with lower concentrations are less well understood. The unusual geology and good information on past exposure found in northern Chile are key advantages for investigating the potential long-term effects of arsenic. We performed a case-control study of lung cancer from 2007 to 2010 in areas of northern Chile that had a wide range of arsenic concentrations in drinking water. Previously, we reported evidence of elevated cancer risks at arsenic concentrations greater than 100 µg/L. In the present study, we restricted analyses to the 92 cases and 288 population-based controls who were exposed to concentrations less than 100 µg/L. After adjustment for age, sex, and smoking behavior, these exposures from 40 or more years ago resulted in odds ratios for lung cancer of 1.00, 1.43 (90% confidence interval: 0.82, 2.52), and 2.01 (90% confidence interval: 1.14, 3.52) for increasing tertiles of arsenic exposure, respectively (P for trend = 0.02). Mean arsenic water concentrations in these tertiles were 6.5, 23.0, and 58.6 µg/L. For subjects younger than 65 years of age, the corresponding odds ratios were 1.00, 1.62 (90% confidence interval: 0.67, 3.90), and 3.41 (90% confidence interval: 1.51, 7.70). Adjustments for occupation, fruit and vegetable intake, and socioeconomic status had little impact on the results. These findings provide new evidence that arsenic water concentrations less than 100 µg/L are associated with higher risks of lung cancer.

Assuntos