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Introducción: El cáncer de pulmón (CP) es una enfermedad con gran impacto a nivel mundial en el número de muertes y en costos en salud. La alta incidencia y mortalidad de esta enfermedad asociada al diagnóstico tardío, y la mejoría del pronóstico ante una detección temprana, determinan que sea una patología pasible de beneficiarse mediante detección temprana. La tomografía de baja dosis de radiación (TCBD) demostró ser un método que se pue- de realizar periódicamente a un grupo de personas con alto riesgo de desarrollar CP y así reducir la mortalidad por esta enfermedad. Sin embargo, este beneficio es tal cuan- do se encuentra desarrollado bajo un programa organizado y con participación multi- disciplinaria especializada en cáncer de pulmón. Métodos: Se plantea determinar lineamientos básicos para el desarrollo de la detección temprana de cáncer de pulmón en América Latina para que pueda ser realizada en forma uniforme, con el menor riesgo y el máximo beneficio esperado. Se analizaron las principales publicaciones referidas a este tema, contemplando la diversidad de atención y acceso de América Latina. Resultado: Se desarrollan requerimientos mínimos para la implementación de un pro- grama. Discusión: El número de programas en la región es escaso y depende más de esfuerzos individuales que de políticas generales de salud. Consideramos que estos lineamien- tos pueden servir de apoyo para el desarrollo de más programas en la región y de for- ma más homogénea.

Introduction: Lung cancer (LC) is a disease with a great impact worldwide in the number of deaths and health costs. The high incidence and mortality of this disease associated with late diagnosis and the improved prognosis with early detection determine that it is a pathology that can benefit from early detection. Low radiation dose tomography (LDCT) demonstrated a method that can be performed periodically to a group of people at high risk of developing CP and thus reduce mortality from this disease. However, this benefit is such when it is developed under an organized program with multidisciplinary participation specialized in lung cancer. Methods: It is proposed to determine basic guidelines for the development of early de- tection of lung cancer in Latin America so that it can be carried out uniformly, with the lowest risk and the maximum expected benefit. The main publications referring to this topic were analyzed, considering the diversity of care and access in Latin America. Result: Minimum requirements are developed for the implementation of a program. Discussion: The number of programs in the region is small and depends more on individual efforts than on general health policies. We consider that these guidelines can serve as support for the development of more programs in the region and in a more ho- mogeneous way.

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Petroleum-based plastics dominate everyday life, necessitating the exploration of natural polymers as alternatives. Starch, abundant and biodegradable, is a promising raw material. However, understanding the molecular mechanisms underlying starch plasticization has proven challenging. To address this, we employ molecular dynamics simulations, focusing on amylose as a model. Our comprehensive evaluation revealed that chain size affects solubility, temperature influenced diffusivity and elastic properties, and oleic acid expressed potential as an alternative plasticizer. Furthermore, blending glycerol or oleic acid with water suggested the enhancement amylose's elasticity. These findings contribute to the design of sustainable and improved biodegradable plastics.

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The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.

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In this work, the effect of iron(III) in the preparation of a conductive porous composite using a biomass waste-based starch template was evaluated. Biopolymers are obtained from natural sources, for instance, starch from potato waste, and its conversion into value-added products is highly significant in a circular economy. The biomass starch-based conductive cryogel was polymerized via chemical oxidation of 3,4-ethylenedioxythiophene (EDOT) using iron(III) p-toluenesulfonate as a strategy to functionalize porous biopolymers. Thermal, spectrophotometric, physical, and chemical properties of the starch template, starch/iron(III), and the conductive polymer composites were evaluated. The impedance data of the conductive polymer deposited onto the starch template confirmed that at a longer soaking time, the electrical performance of the composite was improved, slightly modifying its microstructure. The functionalization of porous cryogels and aerogels using polysaccharides as raw materials is of great interest for applications in electronic, environmental, and biological fields.

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The application of nanomaterials in the agri-food industry can lead us to the formulation of new sustainable and effective pesticides for the control of fungi such as Fusarium oxysporum f. sp. lycopersici (Fol). This is a fungal plant pathogen for the tomato plant. In this work, silver nanoparticles (AgNPs) were synthesized by a green methodology from Geranium leaf extract as a reducing agent. The poisoned food technique was used to determine the percentage of inhibition of Fol mycelial growth by the action of AgNPs. They were characterized by transmission electron microscopy (TEM, JEOL JEM-2100, Tokyo, Japan) and ultraviolet-visible spectroscopy (UV-VIS, DU 730 Beckman Coulter, Brea, CA, USA). Five different concentrations of AgNPs (10, 20, 40, 75, and 150 mg/L) were evaluated in vitro in order to determine the minimum inhibitory concentration (MIC) as well as the behavior of their antifungal activity in tomato fruit. Nanoparticles with spherical morphology and average diameters of 38.5 ± 18.5 nm were obtained. The maximum percentage of inhibition on the mycelial growth of Fol was 94.6 ± 0.1%, which was obtained using the AgNPs concentration of 150 mg/L and it was determined that the MIC corresponds to 75 mg/L. On the other hand, in a qualitative way, it was possible to observe an external inhibitory effect in the tomato fruit from the concentration of 10 mg/L. Finally, we can conclude that AgNPs are a viable alternative for alternative formulations applied in the agri-food industry as pesticide solutions.

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Abstract Introduction Previous data suggest that healthcare students, such as nursing students, might have a differential risk of presenting burnout syndrome caused by the stress they are subjected to. However, the evidence is still scarce and inconclusive. Objective To evaluate the association between nursing training and burnout syndrome among undergraduate students in Hidalgo, Mexico. Method A cross-sectional analytical study was conducted on 566 undergraduate students (56% were nursing students and the rest were non-healthcare students). Burnout syndrome was identified using the Spanish version of the Maslach Burnout Inventory-Student Survey, consisting of subscales: emotional exhaustion, depersonalization, and diminished academic efficacy. The association between the variables of interest was evaluated using logistic regression models adjusted for confounders. Results In the depersonalization subscale, nursing students, compared with non-healthcare students, had an adjusted Odds Ratio (aOR) of moderate/high burnout syndrome of 2.08 (95% confidence interval [CI] = [1.34, 3.22]). In addition, the association was stronger among students in the third and fourth school years (aOR = 3.58; 95% CI = [1.62, 7.89]) compared with those in the first and second school years (aOR = 1.20; 95% CI = [.71, 2.03]). Discussion and conclusion It is necessary that universities provide nursing students with tools that allow them to cope with stressful situations during their academic training and their future life as health professionals.

Resumen Introducción Datos previos sugieren que los estudiantes del cuidado a la salud, como es el caso de enfermería, podrían tener un riesgo diferencial de presentar síndrome de burnout debido al estrés al que están sometidos, no obstante, la evidencia aun es escaza y no concluyente. Objetivo Evaluar la asociación entre la formación académica en enfermería con el síndrome de burnout en estudiantes universitarios de Hidalgo, México. Método Estudio trasversal analítico realizado en una muestra de 566 estudiantes universitarios (56% eran estudiantes de enfermería y el resto de las áreas diferentes a la salud). Para determinar la presencia de síndrome de burnout se utilizó la versión en español de la escala Maslach Burnout Inventory-Student Survey, conformada por las subescalas: agotamiento, eficacia académica y despersonalización. La asociación entre las variables de interés se evalúo mediante modelos de regresión logística ajustados por confusores. Resultados En la subescala de despersonalización los estudiantes de enfermería tuvieron mayores posibilidades de presentar síndrome de burnout medio/alto en comparación con los de las otras formaciones académicas (razón de momios ajustada [RMa] = 2.08; intervalo de confianza [IC] al 95% = [1.34, 3.22]). Además, la asociación fue más fuerte entre aquellos que cursaban el tercer y cuarto año escolar (RMa = 3.58; IC 95% = [1.62, 7.89]) a diferencia de los que cursaban los primeros dos años escolares (RMa = 1.20; IC 95% = [.71, 2.03]). Discusión y conclusión Es importante que las universidades brinden a los estudiantes de enfermería herramientas que les permitan sobrellevar las situaciones estresantes durante su formación académica y su futura vida profesional.

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Dimorphic species of Mucor, which are cosmopolitan fungi belonging to subphylum Mucoromycotina, are metabolically versatile. Some species of Mucor are sources of biotechnological products, such as biodiesel from Mucor circinelloides and expression of heterologous proteins from Mucor lusitanicus. Furthermore, Mucor lusitanicus has been described as a model for understanding mucormycosis infections. However, little is known regarding the relationship between Mucor lusitanicus and other soil inhabitants. In this study, we investigated the potential use of Mucor lusitanicus as a biocontrol agent against fungal phytopathogens, namely Fusarium oxysporum f. sp. lycopersici, Fusarium solani, and Alternaria solani, which destroy economically important crops. Results showed that aerobic cell-free supernatants of the culture broth (SS) from Mucor lusitanicus inhibited the growth of the fungal phytopathogens in culture, soil, and tomato fruits. The SS obtained from a strain of Mucor lusitanicus carrying the deletion of rfs gene, which encodes an enzyme involved in the synthesis of siderophore rhizoferrin, had a decreased inhibitory effect against the growth of the phytopathogens. Contrarily, this inhibitory effect was more evident with the SS from an rfs-overexpressing strain compared to the wild-type. This study provides a framework for the potential biotechnological use of the molecules secreted from Mucor lusitanicus in the biocontrol of fungal phytopathogens.

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INTRODUCTION: There is evidence that the percentage of adolescents that practice testicular self-examination is low. OBJECTIVE: To assess the short-term and long-term (6 months) impact in male adolescents of an educational intervention on the knowledge of testicular self-examination and attitude toward it. METHODS: We conducted a quasi-experimental pre-test post-test study in male adolescents. A questionnaire was validated to assess knowledge on testicular self-examination and attitudes towards it (awareness, intentions, and behaviour). The educational intervention was group-based and consisted in an instructional talk with the aid of diagrams and brochures. The questionnaire was administered before and after the intervention. A follow-up was scheduled 6 months later, and the talk was delivered again, with administration of the questionnaire before and after. RESULTS: The study included 139 adolescents with a median age of 14 years. We found an improvement in knowledge (18.3% vs 78.9%; P = 0.02) and attitude (5.6% vs 53.5%; P = 0.02) after the initial intervention. At the 6-month follow-up (n=98), there was no change in knowledge (87.0% vs 93.0%; P = 0.671), but attitude improved after the second intervention (58.0% vs 78.0%; P = 0.009). CONCLUSION: An educational intervention on testicular self-examination improved the proportion of adolescents with an adequate attitude (5.6% vs 53.5%) and adequate knowledge (18.3% vs 78.9%). The repetition of the intervention at 6 months increased the proportion of adolescents with an adequate attitude (53.5% vs 86.4%).

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Abstract The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.

Resumo O objetivo do presente estudo foi identificar os motivos das extrações dentárias em pacientes que procuram atendimento odontológico em uma clínica odontológica universitária no México. Este é um estudo transversal que avaliou 284 pacientes consecutivos na Faculdade de Odontologia da Universidad Autónoma del Estado de México entre agosto de 2017 e novembro de 2018. No total, foram realizadas 505 extrações. A variável dependente foi o motivo da extração: 0) cárie dentária e sequelas subsequentes (categoria de referência); 1) doença periodontal e sequelas subsequentes; e 2) outros motivos. Variáveis sociodemográficas, socioeconômicas e clínicas foram incluídas como variáveis independentes. A análise foi feita com regressão logística multinomial (Stata 14.0). De todas as extrações, 63,6% (n=321) foram devidas a cárie dentária e sequelas subsequentes; 22,0% (n=111) foram devidas a doença periodontal e sequelas subsequentes; 5,3% (n=27) a insucesso endodôntico; 5,1% (n=26) a indicações protéticas; 1,6% (n=8) a indicações ortodônticas; e o restante (2,4%) foi devido a outros motivos. No modelo multivariado, as extrações por doença periodontal vs. cárie dentária foram associadas ao tabagismo ocasional (Odds Ratio, OR=3,90) ou ao uso diário de tabaco (OR=3,19); ao fato de o dente a ser extraído ter sido restaurado anteriormente (OR=2,35); à extração de dentes anteriores em vez de posteriores (OR=2,63); e a pacientes com extrações múltiplas (OR=2,68). No caso de extrações devido a "outros motivos", nenhuma variável foi significativa. A cárie dentária e a doença periodontal foram os principais motivos de extração dentária nessa amostra. Diversas variáveis, principalmente clínicas, foram associadas às extrações por motivos periodontais.

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Infections caused by micro-organisms of the genus Candida are becoming a growing health problem worldwide. These fungi are opportunistic commensals that can produce infections-clinically known as candidiasis-in immunocompromised individuals. The indiscriminate use of different anti-fungal treatments has triggered the resistance of Candida species to currently used therapies. In this sense, propolis has been shown to have potent antimicrobial properties and thus can be used as an approach for the inhibition of Candida species. Therefore, this work aims to evaluate the anti-Candida effects of a propolis extract obtained from the north of Mexico on clinical isolates of Candida species. Candida species were specifically identified from oral lesions, and both the qualitative and quantitative anti-Candida effects of the Mexican propolis were evaluated, as well as its inhibitory effect on C. albicans isolate's germ tube growth and chemical composition. Three Candida species were identified, and our results indicated that the inhibition halos of the propolis ranged from 7.6 to 21.43 mm, while that of the MFC and FC50 ranged from 0.312 to 1.25 and 0.014 to 0.244 mg/mL, respectively. Moreover, the propolis was found to inhibit germ tube formation (IC50 ranging from 0.030 to 1.291 mg/mL). Chemical composition analysis indicated the presence of flavonoids, including pinocembrin, baicalein, pinobanksin chalcone, rhamnetin, and biochanin A, in the Mexican propolis extract. In summary, our work shows that Mexican propolis presents significant anti-Candida effects related to its chemical composition, and also inhibits germ tube growth. Other Candida species virulence factors should be investigated in future research in order to determine the mechanisms associated with antifungal effects against them.

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El abuso del uso de las redes sociales genera dificultades en los individuos para las relaciones interpersonales, laborales y académicas. Se desarrolló una investigación con el objetivo de determinar la relación entre adicción a redes sociales y la procrastinación académica en estudiantes de una universidad privada de la selva peruana, durante el segundo período académico de 2021. El diseño metodológico fue no experimental con alcance correlacional y corte transversal. La población estuvo compuesta por universitarios matriculados en el período académico 2021-II, a partir de la cual se seleccionaron 304 alumnos mediante muestreo no probabilístico por sujetos voluntarios. Los instrumentos aplicados fueron: el Cuestionario de Adicción a Redes Sociales y la Escala de Procrastinación Académica. El 78,6% de la muestra tenía edades entre 18 y 26 años y el 62,2% correspondió al sexo femenino. La mayoría estaba matriculada en la Facultad de Ciencias de la Salud (50%) y el 27,6% cursaban el cuarto año. La distribución de los datos no resultó normal (p<0,05). Los valores globales de adicción a redes sociales y procrastinación académica no se correlacionaron estadísticamente (p>0,05). En las dos variables: adicción a las redes sociales y procrastinación, además de sus correspondientes dimensiones, la mayoría de los estudiantes involucrados se catalogaron en el nivel medio. No existió correlación estadística entre las dos variables principales del estudio; sin embargo, sí existió en lo referente a la adicción a las redes sociales en relación con la autorregulación académica y la postergación de actividades

The abuse of the use of social networks generates difficulties in people for interpersonal, work, and academic relationships. This research aimed to determine the relationship between addiction to social networks and academic procrastination in students at a private university from the Peruvian jungle, during the second academic period of 2021. The methodological design was non-experimental with a correlational scope, and cross-sectional. The population was constitu-ted by university students enrolled in the academic period 2021-II. 304 students were selected through non-probabilistic sampling by volunteer subjects. The instruments applied were the Social Network Addiction Questionnaire and the Academic Procrastination Scale. 78.6% of the sample were between 18 and 26 years of age and 62.2% were female. Most of them were enro-lled in the Faculty of Health Sciences (50%) and 27.6% were in their fourth year. The data distri-bution was not normal (p<0.05). The global values of addiction to social networks and academic procrastination were not statistically correlated (p>0.05). In the two variables (addiction to social networks and procrastination), most of the students involved were classified in the medium level. There was no statistical correlation between the two main variables of the study; however, it did exist in relation to addiction to social networks in relation to academic self-regu-lation and the postponement of activities.

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The genus Fusarium can be utilized to produce a great variety of secondary metabolites under specific culture conditions, including pigments of increasing biotechnological interest, such as bikaverin. Such pigments are important due to the biological properties they possess, including antitumor and antibiotic activities, among others. In Fusarium fujikuroi, bik1-bik6 have been identified as the genes that are responsible for the synthesis of bikaverin. Therefore, in this study, we screened for the presence of bik genes and examined changes in mRNA levels of the bik genes under the influence of NH4NO3 (0.024, 0.048, 0.50, 1.0, and 4.60 g L-1) and NH4Cl (0.50 and 1.0 g L-1) as nitrogen sources for the phytopathogen Fusarium oxysporum f. sp. lycopersici. Our results indicated the presence of at least six bik (bik1-bik6) genes and showed increased mRNA levels for bik4, bik5, and bik6 in conditions where NH4NO3 was used at pH 3.0. The characteristic coloration of bikaverin was obtained in 10 out of 16 culture conditions, except when the fungus was grown with higher concentrations of NH4NO3 (1.0 and 4.60 g L-1). The pigment was chloroform-extracted from the culture conditions of NH4NO3 (0.024, 0.048, and 0.50 g L-1) and NH4Cl (0.50 and 1.0 g L-1) with 3 and 9 days of incubation. Analysis via visible spectroscopy and matrix-assisted laser desorption ionization-time of flight mass spectrometry were used for the identification of bikaverin.

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Fusarium oxysporum f. sp. lycopersici is an important plant pathogen that has been used to understand the virulence mechanisms that soil inhabiting fungi exhibit during the infection process. In F. oxysporum many of the virulence factors are secreted, and the secretion process requires the formation of vesicles. Arf family members, represented by Arf (ADP- Ribosylation Factor), Arl (Arf-like), and Sar (Secretion-associated and Ras-related) proteins, are involved in the vesicle creation process. In this study we identified the Arf family members in F. oxysporum f. sp. lycopersici, which includes seven putative proteins: Arf1, Arf3, Arl1 through Arl3, Arl8B, and Sar1. Quantification of the mRNA levels of each arf encoding gene revealed that the highest expression corresponds to arf1 in all tested conditions. The phylogenetic analysis revealed that no other Arf1 paralogue, such as Arf2 from yeast, is present in F. oxysporum f. sp. lycopersici. The essential function suggested of Arf1 in F. oxysporum f. sp. lycopersici was corroborated experimentally when, after several attempts, it was impossible to obtain a knockout mutant in arf1. Moreover, arl3 mRNA levels increased significantly when plant tissue was added as a sole carbon source, suggesting that the product of these genes could play pivotal roles during plant infection, the corresponding mutant ∆arl3 was less virulent compared to the wild-type strain. These results describe the role of arl3 as a critical regulator of the virulence in F. oxysporum f. sp. lycopersici and stablish a framework for the arf family members to be studied in deeper details in this phytopathogen.

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Amphipterygium adstringens (cuachalalate) contains anacardic acids (AAs) such as 6-pentadecyl salicylic acid (6SA) that show immunomodulatory and antitumor activity with minimal or no secondary adverse effects. By contrast, most chemotherapeutic agents, such as 5-fluorouracil (5-FU) and carboplatin (CbPt), induce myelosuppression and leukopenia. Here, we investigated the myeloprotective and antineoplastic potential of an AA extract or the 6SA as monotherapy or in combination with commonly used chemotherapeutic agents (5-FU and CbPt) to determine the cytoprotective action of 6SA on immune cells. Treatment of Balb/c breast tumor-bearing female mice with an AA mixture or 6SA did not induce the myelosuppression or leukopenia observed with 5-FU and CbPt. The co-administration of AA mixture or isolated 6SA with 5-FU or CbPt reduced the apoptosis of circulating blood cells and bone marrow cells. Treatment of 4T1 breast tumor-bearing mice with the AA mixture or 6SA reduced tumor growth and lung metastasis and increased the survival rate compared with monotherapies. An increased effect was observed in tumor reduction with the combination of 6SA and CbPt. In conclusion, AAs have important myeloprotective and antineoplastic effects, and they can improve the efficiency of chemotherapeutics, thereby protecting the organism against the toxic effects of drugs such as 5-FU and CbPt.

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INTRODUCCIÓN. La fosa pterigopalatina es una zona anatómica de difícil acceso, que al presentar masas tumorales genera un alto riesgo de morbimortalidad en población juvenil y adulta, que precisa determinar las complicaciones asociadas a cirugía. OBJETIVO. Evaluar los tipos de abordaje quirúrgico, complicaciones e identificar la estirpe histológica de los tumores de fosa pte-rigopalatina. MATERIALES Y MÉTODOS. Estudio transversal retrospectivo. Población y muestra conocida de 29 Historias Clínicas de pacientes con hallazgos de imagen e histopatológico de tumores con invasión a fosa pterigopalatina divididos en dos grupos: A) resección de masa tumoral y B) biopsia de masa tumoral, operados en el Hospital de Especialidades Carlos Andrade Marín en el período de enero 2017 a diciembre de 2020. RESULTADOS. El 82,76% (24; 29) fueron hombres, con promedio de edad de 30,6 años. El 82,76% (24; 29) de las masas tumorales se originaron en nasofaringe; no se reportaron casos primarios. El tumor más frecuente fue el Angio-fibroma Nasofaringeo Juvenil 68,97% (20; 29), seguido por los tumores malignos con el 20,69% (6; 29), siendo usual el carcinoma adenoideo quístico. En el 62,07% (18; 29) el tumor invadió Fosa Infratemporal y en el 44,83% (13; 29) hacia esfenoides. En el grupo A, el abordaje quirúrgico empleado en el 20,83% (5; 24) fue mediante técnica abierta y en el 79,17% (19; 24) con técnica endoscópica, tanto uni 31,58% (6; 19) como multiportal 68,42% (13; 19). La complicación fue la hiposensibilidad facial en el 12,5% (3; 24), todos en abordajes abiertos. CONCLUSIÓN. Se evaluó los tipos abordaje quirúrgico y se identificó la estirpe histológica de los tumores de fosa pterigopalatina

INTRODUCTION. The pterygopalatine fossa is an anatomical area of difficult access, which when presenting tumor masses generates a high risk of morbimortality in the juvenile and adult popula-tion, which needs to determine the complications associated with surgery. OBJECTIVE. To eva-luate the types of surgical approach, complications and identify the histologic type of pterygopala-tine fossa tumors. MATERIALS AND METHODS. Retrospective cross-sectional study. Population and known sample of 29 Clinical Histories of patients with imaging and histopathological findings of tumors with invasion to pterygopalatine fossa divided into two groups: A) resection of tumor mass and B) biopsy of tumor mass, operated at the Carlos Andrade Marín Specialty Hospital in the period from january 2017 to december 2020. RESULTS. The 82,76% (24; 29) were men, with an average age of 30,6 years. 82,76% (24; 29) of the tumor masses originated in nasopharynx; no primary cases were reported. The most frequent tumor was juvenile nasopharyngeal angiofibroma 68,97% (20; 29), followed by malignant tumors with 20,69% (6; 29), being usual the adenoid cystic carcinoma. In 62,07% (18; 29) the tumor invaded the Infratemporal Fossa and in 44,83% (13; 29) into the sphenoid. In group A, the surgical approach used in 20,83% (5; 24) was by open technique and in 79,17% (19; 24) by endoscopic technique, both uni 31,58% (6; 19) and multiportal 68,42% (13; 19). The complication was facial hyposensitivity in 12,5% (3; 24), all in open approaches. CONCLUSION. The types of surgical approach were evaluated and the histologic type of pterygo-palatine fossa tumors was identified.

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INTRODUCTION: Several studies demonstrate the therapeutic superiority of thrombolysis plus mechanical thrombectomy versus thrombolysis alone to treat stroke. OBJECTIVE: To analyze the cost-utility of thrombolysis plus mechanical thrombectomy versus thrombolysis in patients with ischemic stroke due to large vessel occlusion. METHODS: Cost-utility analysis. The model used is blended: Decision Tree (first 90 days) and Markov in the long term, of seven health states based on a disease-specific scale, from the Chilean public insurance and societal perspective. Quality-Adjusted Life-Years and costs are evaluated. Deterministic (DSA) and probabilistic (PSA) analyses were carried out. RESULTS: From the public insurance perspective, in the base case, mechanical thrombectomy is associated with lower costs in a lifetime horizon, and with higher benefits (2.63 incremental QALYs, and 1.19 discounted incremental life years), at a Net Monetary Benefit (NMB) of CLP 37,289,874, and an Incremental Cost-Utility Ratio (ICUR) of CLP 3,807,413/QALY. For the scenario that incorporates access to rehabilitation, 2.54 incremental QALYs and 1.13 discounted life years were estimated, resulting in an NMB of CLP 35,670,319 and ICUR of CLP 3,960,624/QALY. In the scenario that incorporates access to long-term care from a societal perspective, the ICUR falls to CLP 951,911/QALY, and the NMB raises to CLP 43,318,072, improving the previous scenarios. In the DSA, health states, starting age, and relative risk of dying were the variables with the greatest influence. The PSA for the base case corroborated the estimates. CONCLUSIONS: Thrombolysis plus mechanical thrombectomy adds quality of life at costs acceptable for decision-makers versus thrombolysis alone. The results are consistent with international studies.

INTRODUCCIÓN: Diversos estudios demuestran la superioridad terapéutica de la trombólisis más trombectomía mecánica, versus trombólisis sola, en el tratamiento del accidente vascular cerebral. OBJETIVOS: Analizar el costo utilidad de la trombólisis más trombectomía versus trombólisis sola en pacientes con accidente vascular cerebral isquémico con oclusión de grandes vasos. MÉTODOS: Evaluación de costo utilidad. Se ha utilizado un modelo mixto: árbol de decisión (primeros 90 días) y Markov en el largo plazo, de siete estados de salud definidos en escala específica de enfermedad, desde la perspectiva del seguro público chileno y societal. Se evalúan costos y años de vida ajustados por calidad. Se realizó análisis de incertidumbre determinístico y probabilístico. RESULTADOS: Bajo la perspectiva de seguro público, en el caso base la trombectomía mecánica se relaciona con menores costos en un horizonte de por vida, con mayores beneficios (2,63 años de vida ajustados por calidad incrementales, y 1,19 años de vida incrementales descontados), a un beneficio monetario neto de $37 289 874 pesos chilenos, y una razón incremental de costo utilidad de $3 807 413 pesos por años de vida ajustados por calidad. Para el escenario que agrega acceso a rehabilitación se estimaron 2,54 años de vida ajustados por calidad incremental y 1,13 años de vida descontados, resultando en un beneficio monetario neto de $35 670 319 pesos y razón incremental de costo utilidad de $3 960 624 pesos por años de vida ajustados por calidad. En el escenario que agrega el efecto de acceso a cuidados de larga duración con perspectiva societal, la razón incremental de costo utilidad cae hasta $951 911 pesos por años de vida ajustados por calidad y el beneficio monetario neto se eleva a $43 318 072 pesos, superando las estimaciones anteriores. En el análisis de incertidumbre determinístico, los estados de salud, edad de inicio de la cohorte y riesgo relativo de morir, fueron las variables con mayor influencia. El análisis de incertidumbre probabilístico para el caso base, corroboró las estimaciones. CONCLUSIONES: La trombólisis más trombectomía mecánica agrega calidad de vida a costos aceptables por el tomador de decisión, versus trombólisis sola. Los resultados son consistentes con los estudios internacionales.

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Objective: Although physical training has been associated with an increase in survival, its role in reducing Exercise-induced arrhythmias (EIA) in patients with heart disease has not yet been dilucidated. We aim to compare the effect of physical training on the occurrence of EIA in patients with heart disease. Methodology: We evaluated a retroprospective and self-controlled cohort of patients older than 18 years with heart disease who entered the cardiac rehabilitation program of the National Institute of Cardiology Ignacio Chávez in México, during January 2015 to December 2016. In all patients, cardiovascular risk was stratified, including a cardiopulmonary exercise test, which was also performed at the end of the program. The occurrence of arrhythmias was evaluated before and after the training program. Results: 160 patients were analyzed, of which 126 (79%) were male. The proportion of patients who developed EIA in the first exercise testing was 56% and in the second one was 48%. In the first group 35% of patients did not developed EIA in the second test. Of the 71 patients who did not present EIA at the beginning of the program, twenty (28%) presented arrhythmias at second test. In relation to the effect of the training program on the occurrence of arrhythmias, we could observe that it had a protective effect, with a RR = 0.49 (95% CI: 0.35-0.67, p <0.001). Conclusion: In this study, physical training was associated with a decreased risk of developing EIA.

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Recently, tissue engineering and regenerative medicine studies have evaluated smart biomaterials as implantable scaffolds and their interaction with cells for biomedical applications. Porous materials have been used in tissue engineering as synthetic extracellular matrices, promoting the attachment and migration of host cells to induce the in vitro regeneration of different tissues. Biomimetic 3D scaffold systems allow control over biophysical and biochemical cues, modulating the extracellular environment through mechanical, electrical, and biochemical stimulation of cells, driving their molecular reprogramming. In this review, first we outline the main advantages of using polysaccharides as raw materials for porous scaffolds, as well as the most common processing pathways to obtain the adequate textural properties, allowing the integration and attachment of cells. The second approach focuses on the tunable characteristics of the synthetic matrix, emphasizing the effect of their mechanical properties and the modification with conducting polymers in the cell response. The use and influence of polysaccharide-based porous materials as drug delivery systems for biochemical stimulation of cells is also described. Overall, engineered biomaterials are proposed as an effective strategy to improve in vitro tissue regeneration and future research directions of modified polysaccharide-based materials in the biomedical field are suggested.

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INTRODUCTION: Healthcare systems are developed in imperfect scenarios, in which there are constant failures (uncertainty, information asymmetry, agency relationship problem, and supply-induced demand). These failures, based on the imperfection of the sector, determine the relationships and incentives between the actors. It is within this context that payment mechanisms regulate aspects of the system behavior and incentives, acting as instruments for the purchasing of health care from providers, mediated by health insurance on behalf of users. OBJECTIVE: To characterize the basic elements of most frequent payment mechanisms to help providers in their relationship with payers. METHODS: A review of the evidence was conducted in PubMed, Google, Google Scholar, and strategic snowball selection. Payment mechanisms consist of three classical microeconomics variables, fixed or variable: price, quantity, and expense. Time dimensions are used to analyze their attributes and effects. Different mechanisms emerge from the combination of these variables. RESULTS: Among the most used are: Fee-For-Service, Global Budget, Bundled Payments, Diagnosis-Related Groups, Per-capita, Performance Pay, and Risk-Sharing Agreements. A fourth has also gained importance: Financial Risk. CONCLUSIONS: Payment mechanisms are essential to link health efforts with clinical practice. They make it possible to regulate relationships between insurers, providers, and users, which, depending on the architecture of the mechanism, can become beneficial or hinder the fulfillment of the objectives of the health system.

INTRODUCCIÓN: Los sistemas de salud se desarrollan en ámbitos complejos y con fallas constantes (incertidumbre, asimetría de información, problema de relación de agencia e inducción de demanda). Estas fallas determinan las relaciones e incentivos entre los actores y se basan en la imperfección del sector. Frente a ello, los mecanismos de pago regulan aspectos del comportamiento e incentivos del sistema, participando como instrumentos de compra de atenciones de salud a prestadores, mediados por los seguros de salud en representación de los usuarios. OBJETIVO: Caracterizar los elementos básicos de las tipologías más frecuentes de los mecanismos de pago con el propósito de para apoyar la labor de los prestadores en su relación con pagadores. MÉTODOS: Se condujo una revisión dirigida de la evidencia en PubMed, Google, Google Scholar y selección estratégica en bola de nieve. Los mecanismos de pago están conformados por tres variables microeconómicas clásicas fijas o variables: precio, cantidad y gasto; y dimensiones temporales utilizadas para analizar sus atributos y efectos. De la combinación de estas variables surgen distintos mecanismos. RESULTADOS: Entre los más utilizados se describen: pago por servicio, presupuesto global, Bundled Payments, grupos relacionados de diagnóstico, per cápita, pago por desempeño y acuerdos de riesgo compartido. Dentro de sus variables ha cobrado importancia una cuarta, el riesgo financiero. CONCLUSIONES: Los mecanismos de pago resultan esenciales para concatenar esfuerzos sanitarios con la práctica clínica. Permiten regular relaciones entre seguros, prestadores y usuarios. Dependiendo de la arquitectura del mecanismo, estas pueden tornarse beneficiosas o entorpecer el cumplimiento de los objetivos del sistema sanitario.

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INTRODUCCIÓN: Los sistemas de salud se desarrollan en ámbitos complejos y con fallas constantes (incertidumbre, asimetría de información, problema de relación de agencia e inducción de demanda). Estas fallas determinan las relaciones e incentivos entre los actores y se basan en la imperfección del sector. Frente a ello, los mecanismos de pago regulan aspectos del comportamiento e incentivos del sistema, participando como instrumentos de compra de atenciones de salud a prestadores, mediados por los seguros de salud en representación de los usuarios. OBJETIVO: Caracterizar los elementos básicos de las tipologías más frecuentes de los mecanismos de pago con el propósito de para apoyar la labor de los prestadores en su relación con pagadores. MÉTODOS: Se condujo una revisión dirigida de la evidencia en PubMed, Google, Google Scholar y selección estratégica en bola de nieve. Los mecanismos de pago están conformados por tres variables microeconómicas clásicas fijas o variables: precio, cantidad y gasto; y dimensiones temporales utilizadas para analizar sus atributos y efectos. De la combinación de estas variables surgen distintos mecanismos. RESULTADOS: Entre los más utilizados se describen: pago por servicio, presupuesto global, Bundled Payments, grupos relacionados de diagnóstico, per cápita, pago por desempeño y acuerdos de riesgo compartido. Dentro de sus variables ha cobrado importancia una cuarta, el riesgo financiero. CONCLUSIONES: Los mecanismos de pago resultan esenciales para concatenar esfuerzos sanitarios con la práctica clínica. Permiten regular relaciones entre seguros, prestadores y usuarios. Dependiendo de la arquitectura del mecanismo, estas pueden tornarse beneficiosas o entorpecer el cumplimiento de los objetivos del sistema sanitario.

INTRODUCTION: Healthcare systems are developed in imperfect scenarios, in which there are constant failures (uncertainty, information asymmetry, agency relationship problem, and supply-induced demand). These failures, based on the imperfection of the sector, determine the relationships and incentives between the actors. It is within this context that payment mechanisms regulate aspects of the system behavior and incentives, acting as instruments for the purchasing of health care from providers, mediated by health insurance on behalf of users. OBJECTIVE: To characterize the basic elements of most frequent payment mechanisms to help providers in their relationship with payers. METHODS: A review of the evidence was conducted in PubMed, Google, Google Scholar, and strategic snowball selection. Payment mechanisms consist of three classical microeconomics variables, fixed or variable: price, quantity, and expense. Time dimensions are used to analyze their attributes and effects. Different mechanisms emerge from the combination of these variables. RESULTS: Among the most used are: Fee-For-Service, Global Budget, Bundled Payments, Diagnosis-Related Groups, Per-capita, Performance Pay, and Risk-Sharing Agreements. A fourth has also gained importance: Financial Risk. CONCLUSIONS: Payment mechanisms are essential to link health efforts with clinical practice. They make it possible to regulate relationships between insurers, providers, and users, which, depending on the architecture of the mechanism, can become beneficial or hinder the fulfillment of the objectives of the health system.

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