Título del artículo:

Ultrastructural Features of Cryptococcus neoformans Histone Deacetylases Null Mutant Strains

Cryptococcus neoformans is a pathogen affecting predominantly immunocompromised individuals. Epigenetic regulation is pivotal for controlling C. neoformans virulence traits. Null mutants of histone deacetylase (HDAC) genes demonstrate reduced virulence. Here, we employed scanning (SEM) and transmission electron microscopy (TEM) to examine the ultrastructure of C. neoformans HDA1 and HOS2 null mutant strains. SEM revealed unipolar budding in the H99, hda1∆ and hos2∆ strains, whereas the hda1∆hos2∆ double mutant displayed evident multipolar budding. The hos2∆ strain exhibited defective capsule. TEM analysis showed a thicker cell wall for hda1∆ in comparison to H99, while the hos2∆ and hda1∆hos2∆ mutants displayed thinner cell walls. The hos2∆ and hda1∆/hos2∆ strains exhibited mitochondrial swelling. The hda1∆hos2∆ mutant also presented morphological features suggestive of cell degeneration. These findings highlight the critical role of HDACs in C. neoformans morphogenesis, which is essential to host cell-yeast interaction.

Acerca de la revista donde se publicó este artículo:

Indian Journal of Microbiology

Título del artículo:

Vagus Nerve Stimulation in Autoimmune Conditions: A Systematic Review

Objective: Systemic autoimmune conditions are characterized by increased inflammation and high disease burden. Vagus nerve stimulation (VNS) is known to activate the cholinergic anti-inflammatory pathway and can serve as a potential therapeutic modality for autoimmune conditions. This study aimed to conduct a preregistered systematic review to determine the effect of VNS on inflammation in autoimmune conditions, according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Methods: The databases of Medline/PubMed, Web of Science, Scopus, and CENTRAL were searched until September 2, 2024. Data pertaining to changes in inflammatory blood biomarkers and clinical outcomes in patients with autoimmune conditions receiving VNS were extracted. Studies were included if they provided measurements of peripheral blood biomarkers and clinical outcomes. Study screenings and full-text article reviews were conducted in duplicate. The design of the included studies was assessed using the National Health Lung and Blood Institute guidelines. Results: Twelve clinical trials studying the effect of VNS on rheumatoid arthritis, Crohn disease, polymyalgia rheumatica, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematous, and systemic sclerosis were reviewed. We found that >50% of studies found a reduction in the mean difference of pro-inflammatory cytokine levels before and after VNS (C-reactive protein decreased in 6 of 9 studies; tumor necrosis factor α decreased in 4 of 8 studies) with the most consistent reduction in IL-6 levels (6 of 7 studies). Conclusion: Although it can be suggested that VNS can decrease markers of pro-inflammation in autoimmune diseases, more clinical studies with robust design and quality are needed to more confidently support VNS as a therapeutic option for autoimmune conditions.

Acerca de la revista donde se publicó este artículo:

Acr Open Rheumatology

Título del artículo:

Agricultural Commercialization in Colombia from a Foresight Approach

This article analyzes agricultural commercialization in Colombia from a prospective perspective, proposing a network-based collaborative model supported by digital technologies. The objective was to identify critical variables, strategic actors, and contextual conditions that influence the transformation of the traditional commercialization system. The methodology combined tools such as political, economic, social, technological, legal, and environmental analysis; the study of strengths, opportunities, weaknesses, and threats; the matrix of cross impacts; and the matrix of actors and objectives. These methods made it possible to map the environment, identify key influences, and define strategic objectives. The findings reveal a current model marked by high intermediation, weak producer organization, and limited technological adoption. However, key factors such as rural connectivity, digital education, and producer associativity were identified as catalysts for change. A strong convergence of interests was also found among producers, associations, and consumers around collaborative digital platforms. The proposed model is viable if accompanied by territorial public policies, institutional strengthening, and technologies adapted to rural contexts.

Acerca de la revista donde se publicó este artículo:

Revista Venezolana De Gerencia

Título del artículo:

Consenso de expertos en torno a la vacunación como estrategia de prevención primaria para la mujer que se encuentra en edad reproductiva, gestando o en la edad adulta

OBJETIVO: generar recomendaciones para la vacunación de la mujer, en las diferentes etapas de su vida, a fin de disminuir la posible variabilidad de su uso actual en Colombia. Materiales y métodos: el grupo desarrollador estuvo conformado por profesionales pertenecientes al área de la salud. Todos los participantes declararon por escrito sus conflictos de interés. Se formularon preguntas clínicas contestables, se hizo la graduación de los desenlaces y la pesquisa de la información se realizó en Medline/PubMed, Embase y Lilacs. La búsqueda también abarcó fuentes de literatura gris y se actualizó el 14 de mayo de 2024 sin restricciones por fecha o idioma. Se implementó la metodología GRADE (Grading of Recommendations Assessment, Development and Evaluation) para establecer la calidad de la evidencia y la fuerza de la recomendación. En virtud de las limitaciones de los estudios recuperados, y especialmente cuando se trató de limitaciones en la aplicabilidad de la evidencia, se acudió a la opinión de expertos. Se realizó consenso formal acorde con la metodología RAND/UCLA (RAND Corporation/Universidad de California en Los Ángeles). Previo a la publicación, el documento fue objeto de revisión por pares. RESULTADOS: se desarrollaron las siguientes recomendaciones: • El grupo desarrollador sugiere que las mujeres no inmunes a las paperas, sarampión o rubeola (p. ej., IgG negativo) sean vacunadas durante el periodo preconcepcional. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere que todas las mujeres en periodo preconcepcional se vacunen contra la varicela si no tienen inmunidad natural confirmada (p. ej., anticuerpos IgG negativo para el virus varicela zóster). Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere que las mujeres que viven en regiones endémicas para fiebre amarilla se vacunen durante el periodo preconcepcional si no han sido previamente inmunizadas. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere vacunar adolescentes y adultas jóvenes con la vacuna para el virus del papiloma humano (VPH), de 3 dosis (0,2 y 6 meses) con el fin de reducir la incidencia y mortalidad por cáncer cervical. Calidad de evidencia: moderada ⨁⨁⨁◯ • El grupo desarrollador sugiere que las mujeres gestantes sean inmunizadas contra el tétano, la difteria y la tos ferina durante la gestación, con el objetivo de reducir el riesgo de infección en la madre y el neonato. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere la vacunación contra la influenza a cualquier edad gestacional, con el objetivo de reducir el riesgo de infección en la madre y el neonato hasta los seis meses de edad. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere la vacunación materna frente al COVID-19 a cualquier edad gestacional, con el objetivo de reducir el riesgo de hospitalización y muerte de la madre y el neonato durante los primeros cuatro meses de vida. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere la vacunación contra el virus sincitial respiratorio (VSR) en mujeres gestantes, con el objetivo de reducir el riesgo de hospitalización en el neonato. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el herpes zóster, con el fin de reducir la morbilidad asociada a esta condición. Calidad de la evidencia: moderada ⨁⨁⨁◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra la influenza a fin de reducir la incidencia de infección respiratoria aguda (IRA). Calidad de la evidencia: moderada ⨁⨁⨁◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el neumococo a fin de reducir la incidencia de neumonía y enfermedad neumocócica invasora. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el VSR a fin de reducir la incidencia de infección respiratoria aguda e infección respiratoria del tracto inferior. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere que la mujer adulta mayor que vive en regiones endémicas para fiebre amarilla se vacune si no ha sido previamente inmunizada. Calidad de la evidencia: muy baja ⨁◯◯◯ Conclusiones: se recomienda la vacunación como estrategia de prevención primaria a lo largo de las diferentes etapas de la vida en la mujer. Dada la calidad de la evidencia y las serias limitaciones en la aplicabilidad de algunos estudios, especialmente en mujeres gestantes, se requieren más investigaciones que evalúen la seguridad y la efectividad de esta intervención en esta etapa de la vida.

Acerca de la revista donde se publicó este artículo:

Revista Colombiana De Obstetricia Y Ginecologia

Título del artículo:

Sustainable Huila Agroecological Zoning

This study aims to assess the agroecological zoning (AEZ) of the Huila Department (Colombia) through the analysis of agro-environmental variables using Geographic Information Systems (GIS) and simulation models, with the objective of supporting the sustainable agricultural planning of strategic crops such as coffee, rice, avocado, and panela cane (Saccharum officinarum). The methodology followed a mixed approach, integrating quantitative analyses (GIS, spatial modeling, fuzzy inference systems) with a qualitative review of scientific literature. The results indicate that each crop requires specific conditions in terms of altitude, temperature, soil characteristics, and slope, enabling a precise delineation of suitable zones. The implementation of AEZ enhances productive efficiency, promotes environmental sustainability, and contributes to achieving SDGs 2 (Zero Hunger), 12 (Responsible Consumption and Production), and 15 (Life on Land). However, structural challenges such as informal labor, low technological adoption, and outdated regulatory frameworks hinder its implementation. In conclusion, agroecological zoning is a key tool to strengthen food security, mitigate land-use conflicts, and support resilient, territory-adapted agricultural models in the Huila region.

Acerca de la revista donde se publicó este artículo:

8th Congreso Internacional En Inteligencia Ambiental Ingenieria De Software Y Salud Electronica Y Movil Amitic 2025

Título del artículo:

Smart Application for Academic Programs: Note: Sub-titles are not captured in Xplore and should not be used

The study adopted a quantitative, descriptive-evaluative methodology to develop an interactive application with artificial intelligence aimed at automating and improving the construction of academic programs in accordance with Decree 1330 of 2019. Techniques such as document analysis, expert validation, and functional testing were applied to 40 faculty members specialized in curriculum design. Two main variables were assessed: software functionality and the level of regulatory compliance. The system was developed using Java and Spring Boot for the backend, Next.js for the frontend, and PostgreSQL as the database, integrating AI through Python and libraries such as spaCy and Transformers to interpret regulations and generate technical content. Results show a high level of knowledge of the Decree among respondents, but also highlight implementation difficulties, low information systematization, and limited use of ICT in quality assurance. 100% of participants considered a digital tool useful, and 75% expressed willingness to participate in its implementation. The software was validated using a checklist based on the ISO/IEC 25000 standard, ensuring usability, maintainability, and traceability. In conclusion, the research represents a viable solution to bridge the gap between regulations and practice in higher education institutions.

Acerca de la revista donde se publicó este artículo:

8th Congreso Internacional En Inteligencia Ambiental Ingenieria De Software Y Salud Electronica Y Movil Amitic 2025

Título del artículo:

Educational Inclusion and Cognitive Difficulties: An Analysis of Strategies and Technologies for Children and Youth Learning

This article presents the findings of a documentary analysis of 82 undergraduate theses focused on the educational support of students with cognitive difficulties in Colombian primary and secondary schools. The research aimed to identify pedagogical, technological, and methodological trends guiding inclusive education in diverse school contexts, particularly in rural areas. The main objective was to formulate an inclusive education model mediated by smart learning environments, based on the identification of effective practices, active methodologies, and digital resources, with the goal of strengthening the development of competencies in students with specific learning needs. Methodology. A mixed-methods approach was adopted, combining qualitative and quantitative analyses. The documentary review helped establish the frequency with which different cognitive difficulties such as dyslexia, ADHD, and intellectual disability were addressed, along with the methods employed. Techniques such as diagnostic testing, documentary analysis, pretests and posttests, interviews, surveys, and classroom observations in multiple case studies were analyzed. Results. The analysis revealed a predominant focus on dyslexia and ADHD, suggesting their high prevalence or complexity in school contexts. The use of active methodologies such as gamification, Project-Based Learning (PBL), and the ADDIE model stood out, along with educational tools like Google Classroom, Educaplay, and Wordwall. Technological infrastructure mainly computer labs and laptops played a fundamental role in the educational interventions examined. Conclusions. A six-phase inclusive education model was developed, integrating ethnographic, methodological, and technological factors to promote flexible, inclusive, and student-centered learning environments. The study concludes that it is essential to strengthen teacher training, ensure access to educational technology, and encourage the use of active pedagogical strategies to reduce learning and participation barriers in the classroom.

Acerca de la revista donde se publicó este artículo:

8th Congreso Internacional En Inteligencia Ambiental Ingenieria De Software Y Salud Electronica Y Movil Amitic 2025

Título del artículo:

Coercive Practices and Psychosocial Disability in People with Suicide Attempts in a Latin American Population

Despite the human rights approach given in public mental health policies, coercive practices persist in many mental health services. These practices tend to be more frequent in people with suicide attempts, which increases psychosocial disability and affects recovery. The aim of the present study was to analyze the relationship between variables associated with psychosocial disability and coercive practices in people with suicide attempts who attended emergency services in a Colombian context. A quantitative, analytical, cross-sectional study was conducted, with instruments that determined psychosocial disability, subjective well-being, depressive symptoms, resilience, loneliness, continuity of care in health services and the use of coercive practices, such as physical restraint, seclusion, involuntary sedation, being ignored by health personnel and not participating in the treatment plan. Multiple linear regression analysis explained 40.1% of the variance in psychosocial disability. When comparing scores on the resilience, subjective well-being, psychosocial disability and loneliness scales, statistically significant differences (<.001) were found between people who experienced coercive practices and those who did not. A negative impact of coercive practices on people with suicidal behavior was found, such as an increase in depressive symptoms, reduction of resilience and subjective well-being scores and a worse perception of health services.

Acerca de la revista donde se publicó este artículo:

Journal of Humanistic Psychology

Título del artículo:

Community-level infrastructure risk factors for motor vehicle injuries of car occupants and pedestrians: results from the PURE study

Disproportionately more of the world’s fatalities and injuries on the roads occur in low- and middle-income countries, despite these countries having approximately only 60% of the world’s vehicles. Injury rates due to motor-vehicles are related to a complex multidimensional array of risk factors, embedded in the social and economic infrastructure of a country or region. Whether environmental infrastructure factors differ in determining the risk of an injury for motor vehicle occupants compared to pedestrians and other vulnerable road users has not been extensively studied. We explored the role of environmental infrastructure factors on motor-vehicle-related non-fatal injury using the Prospective Urban and Rural Epidemiology (PURE) cohort study of 162,793 adults from 23 high-, middle- and low-income countries. As expected, low-income countries had slightly higher motor vehicle injury rates, with pedestrians tending to have higher injury rates in these countries. There was considerable variation in motor vehicle injury rates within country-income-categories, while there were similarities in motor vehicle injury rates despite large differences in motorization of countries. There was a meaningful community effect on motor vehicle injury rates. We found that community-level infrastructure risk factors for motor vehicle injuries differed for car occupants and for pedestrians, with road quality and alcohol use being the main factors associated with an injury for car occupants, while poor roadside infrastructure (streetlights, sidewalks) and alcohol use were the main risk factors for an injury as a pedestrian. Active transport, such as walking and bicycling, are being promoted as leading to healthy lifestyle habits and reduced pollution. These require improved walkability for pedestrians, but also separation from motorized vehicles, which leads to recommending that low-and middle-income countries devote more funds for roadway quality and streetlight infrastructure. Policies to reduce motor vehicle injuries should be supported at the national level, but should be specific at the community level, since they must be focused on the specific local infrastructure. Countermeasures for reducing road transport injuries for pedestrians have different risk factors than for reducing injuries for car occupants.

Acerca de la revista donde se publicó este artículo:

International Journal of Injury Control and Safety Promotion

Título del artículo:

Infiltrative squamous cell carcinoma in a high-anatomic risk area: A clinical challenge

Squamous cell carcinoma is a type of cancer that arises from squamous cells, which are found in the epidermis and certain mucous membranes. It is the second most common type of non-melanoma skin cancer, only behind basal cell carcinoma. It primarily affects men over the age of 50, especially those with immunosuppressive factors, as well as tobacco and alcohol consumers. This condition generally has a favorable prognosis; however, when diagnosed late, it often presents infiltrative and metastatic characteristics. Early diagnosis leads to a higher cure rate for patients.

Acerca de la revista donde se publicó este artículo:

Gaceta Medica De Caracas

Título del artículo:

Multiple sclerosis in a young patient: Diagnostic challenge in the post-COVID-19 context

Background: Demyelinating diseases of the central nervous system, such as multiple sclerosis (MS), may be influenced by environmental, immunological, and viral factors. The potential association between respiratory viral infections, including SARS-CoV-2, and the onset or exacerbation of inflammatory neurological disorders has gained increasing attention since the COVID-19 pandemic. Early diagnosis is crucial to avoid cumulative disability and improve long-term functional outcomes. Case report: A 40-year-old previously healthy male presented with progressive lower limb weakness, paresthesias, and gait disturbances following a SARS-CoV-2 infection. The initial episode was partially resolved without hospitalization or immunomodulatory treatment. Three years later, he experienced a new neurological relapse characterized by spastic paraparesis, hyperreflexia, bilateral Achilles clonus, and gait ataxia with postural instability. Brain and spinal cord MRI revealed T2-and FLAIR-hyperintense lesions, some with contrast enhancement and others without, suggestive of dissemination in time and space. Cerebrospinal fluid analysis showed positive oligoclonal bands, with normal glucose and protein levels. Based on the McDonald criteria, a diagnosis of relapsing-remitting multiple sclerosis (RRMS) was established, and treatment with intravenous corticosteroids and disease-modifying therapy was initiated. Conclusion: This case underscores the importance of considering MS in patients with recurrent neurological symptoms and radiological dissemination, particularly in the context of recent viral infections. Timely recognition and appropriate therapy can modify the natural history of the disease and prevent progressive disability.

Acerca de la revista donde se publicó este artículo:

Gaceta Medica De Caracas

Título del artículo:

Weaving peace from the classrooms: the role of university teachers in the formation of family values

University professors play a crucial role in educating conscious, critical citizens committed to peaceful coexistence, integrating global perspectives and empowering students to be agents of change. Through active and reflective methodologies, they foster independent thinking and social responsibility in diverse and complex contexts. From this perspective, this article aims to analyze the role of university professors in peace education, promoting the development of citizens committed to respect for diversity and contributing to the strengthening of family values. Methodologically, a qualitative research approach was conducted through a documentary study using the PRISMA methodology. From this process, 20 articles that met the selection criteria of the Scielo (5), Redalyc (5), Scopus (10), Independientes (6), and Research Papers (1) platforms were analyzed. Similarities were sought within the articles based on three categories of analysis: a) peace education, b) values education, and c) the role of the professor in research. Among the results, it can be noted that teachers focus on peace education, helping students analyze conflicts, violence, and inequalities, fostering critical skills, imparting theoretical and ethical values, teaching holistic approaches and applying them to everyday life, and creating educational policies and strategies. It is concluded that the role of university teachers in promoting peace education is crucial for the development of citizens committed to diversity. Teachers encourage critical thinking, help analyze social issues, and find creative solutions, promoting a culture of peace and values such as justice, equity, and human rights. Their research contributes to understanding social reality and formulating strategies for global peace.

Acerca de la revista donde se publicó este artículo:

Aibi Revista De Investigacion Administracion E Ingenierias

Título del artículo:

Macrolide resistance in Staphylococcus from COVID-19 patients in Santander

Introduction: Intensive use of macrolides, such as azithromycin, during the COVID-19 pandemic has facilitated the development of antimicrobial resistance in Gram-positive bacteria through multiple resistance mechanisms, including ribosomal RNA modification, efflux pumps, and enzymatic inactivation. Objective: To describe the prevalence of resistance genes in bacteria isolated from COVID-19 patients in Santander, Colombia. Materials and Methods: A descriptive study was conducted on 112 stored samples from nasopharyngeal and oropharyngeal swabs and tracheal aspirates collected from hospitalized COVID-19 patients in 2020, from which 48 Gram-positive strains were isolated. Macrolide resistance and the presence of the ermA, ermB, ermT, and mef(A/E) genes were evaluated through phenotypic and molecular tests. Results: Staphylococcus aureus was the most prevalent species at 58.33% (28), followed by Staphylococcus epidermidis at 31.25% (15). A total of 47.92% (23) of the strains showed phenotypic resistance to azithromycin, and 81.25% (39) displayed genotypic resistance, with ermB being the most prevalent at 58.33% (28) and ermT at 45.83% (22), with no detection of mef(A/E). Discussion: These findings reveal a high prevalence of macrolide resistance, which may be related to the extensive use of these antibiotics during the pandemic. Conclusions: The increase in macrolide resistance among Gram-positive bacteria represents a critical public health challenge, especially in the context of pandemics. These results underscore the urgent need to implement control measures in antibiotic use.

Acerca de la revista donde se publicó este artículo:

Revista Cuidarte

Título del artículo:

Safeguarding the Responsible Use and Equitable Benefit-Sharing of Biotechnology in an Age of Scientific Modernization

BiotechnologyBiotechnologymodernizationBiotechnology modernization, driven by advances in synthetic biology, AI, and automation, offers transformative solutions in health, agriculture, and sustainability but also holds a potential to fuel a biological arms race. This chapter maps approaches and tools for mitigating the potential of misuse and malign exploitation of biotechnologyBiotechnology knowledge, materials, and infrastructure without hindering legitimate access to novel scientific and technological advances. In particular, it demonstrates how research security can support equitable biotechnologyBiotechnologymodernizationBiotechnology modernization through strengthened international coordination and inclusive governanceGovernance. The chapter, first, identifies a set of structural prerequisites for the governanceGovernanceof biotechnologyBiotechnology-AI convergenceConvergence that impact states’ rate of capability adoption. Second, it examines research and innovation securityInnovation security as part of the norms of responsible use of biotechnologyBiotechnology. And third, it outlines practical options for integrating research and innovation securityInnovation securitywithin biotechnologyBiotechnologygovernanceGovernance to promote the collaborative nature of scientific and technological progress while mitigating risks of misuse and malign exploitation.

Acerca de la revista donde se publicó este artículo:

NATO Science for Peace and Security Series A Chemistry and Biology

Título del artículo:

Impact of artificial intelligence and robotics on the business model: A projected approach in social accounting.

— The background to this research shows the positive correlation in terms of artificial intelligence and operational profitability, however, the germ of current interest explains the impact of artificial intelligence and robotics in the design of business models, applicable in any economy and, above all, in countries where the circular economy and the green have been adopted as a synonym for profitability. To this end, through a documentary analysis and for the period between 2020 and 2024, was investigated.the mentioned impact. The information infer the different changes that have occurred in Social Accounting, bussines models and the international financial reporting regulations, IFRS. The findings show that companies that have invested in Artificial Intelligence have achieved greater profitability, better production quality, and reduced downtime. However, adverse factors exist, such as a lack of awareness regarding its applicability, investment costs, the omission of economic value added related to Artificial Intelligence in Financial Statements, and social reporting that includes non-monetary aspects. Therefore, it is concluded that progress is slow in terms of drafting sections in IFRS and configuring a comprehensive accounting model that incorporates the aforementioned findings. Nevertheless, it is noteworthy that those who have been applying this tool have obtained significant results.

Acerca de la revista donde se publicó este artículo:

Aibi Revista De Investigacion Administracion E Ingenierias

Título del artículo:

Predictors associated with ICU nursing workload in a sample of records collected before and during the first peak of the COVID-19 pandemic: An analytical study

Introduction: In recent years, the workload of nursing professionals in intensive care units (ICUs) has been described. Identifying associated factors may contribute to improving nursing care planning. Objective: To determine predictors associated with nursing workload in ICU settings using a sample of records collected before and during the first peak of the COVID-19 pandemic. Materials and Methods: This was an analytical cross-sectional study. A total of 97 ICU patient records were included. Descriptive and multivariate analyses were performed using robust linear regression, with the primary outcome being workload measured with the Nursing Activities Score (NAS). Results: The mean age was 57.67 ± 17.78 years, and 68.04% (n=66) were men. Statistically significant differences were observed between the pre-pandemic period and the first peak of the pandemic for variables such as disease category, ICU type, Sequential Organ Failure Assessment (SOFA) score, and number of nurses (p<0.001). A difference in median NAS values was observed, with 60.85 (Q1–Q3: 51.8–68.25) during the pre-pandemic period, compared with 183.40 (Q1–Q3: 149.30–204.40) during the first peak of the pandemic (p=0.001). Discussion: The workload levels identified in this study are consistent with those reported in similar studies. However, the specific scenario examined has scarcely been described in the existing literature. Conclusion: The pandemic increased the nursing staff\'s workload threefold. A weak, direct linear correlation was identified between workload and SOFA score. The pandemic year and the presence of cardiopulmonary conditions were identified as workload predictors.

Acerca de la revista donde se publicó este artículo:

Revista Cuidarte

Título del artículo:

Clinical outcomes in patients hospitalized due to heart failure with Chagas disease vs other etiologies in the USA

BACKGROUND: Chagas disease (CD) affects approximately 300 000 individuals in the USA. However, its impact on heart failure (HF) hospitalizations in the USA as non-endemic setting remains poorly characterized. We aimed to assess the clinical profile and acute clinical outcomes of HF hospitalizations in patients with CD compared with those without CD in the USA. METHODS: The National Inpatient Sample (2002-2021) was queried for adult hospitalizations with a primary diagnosis of HF. Multivariable regression models assessed the association between CD diagnosis and in-hospital mortality, length of stay and total healthcare costs. RESULTS: Among 2 990 959 HF hospitalizations, 154 (0.005%) had a CD diagnosis. After adjustment, CD was associated with longer length of stay (β=5.94 d, 95% CI 4.92 to 6.97) and higher total healthcare costs (β=US$94 886, 95% CI 79 282 to 110 490), but not differential mortality (OR=0.63, 95% CI 0.19 to 2.11). Sex-stratified analyses revealed longer hospitalizations in females (β=8.58 vs 3.75 d), but higher healthcare costs in males (β=US$106 667 vs 80 089) with CD compared with their non-CD counterparts. CONCLUSIONS: In the USA, HF hospitalizations with CD are characterized by increased healthcare utilization, despite similar mortality compared with non-CD admissions. Sex-specific differences in outcomes highlight the need for targeted approaches to care delivery. Larger studies focused on CD cases detection are needed to have a better understanding of the burden of this neglected disease in non-endemic settings.

Acerca de la revista donde se publicó este artículo:

Transactions of the Royal Society of Tropical Medicine and Hygiene

Título del artículo:

Caribbean and South American team-based strategy to control hypertension (CATCH): Rationale and study design of a cluster randomized trial

Rationale Hypertension disproportionately affects populations in low- and middle-income countries (LMICs), especially in Latin America and the Caribbean, due to its high prevalence and low control rate. Primary Hypothesis To close the knowledge-practice gap for blood pressure (BP) control, we are assessing the effectiveness and implementation of a team-based care strategy for BP control in primary care clinics in Colombia and Jamaica. Design The Caribbean and South American Team-based Strategy to Control Hypertension (CATCH) study is a cluster randomized trial using an effectiveness–implementation hybrid type-2 design. Clinics were randomly assigned to a team-based strategy or a provider-training strategy to implement current hypertension guidelines. The team-based strategy includes healthcare team training, care coordination, task sharing, BP audit and feedback, home BP monitoring, health coaching, single-pill combination therapy, and increased medication access. The primary clinical effectiveness outcome is difference in mean change of systolic BP from baseline to 18 months between randomized groups. The primary implementation outcome is a composite fidelity score to key implementation strategy components. Sites CATCH is conducted in 40 primary care clinics in Jamaica and Colombia. Enrollment Between February 2023 and August 2024, we recruited 1,707 participants, exceeding our planned enrollment. The planned sample size of 1,680 (42 patients per each of 40 clinics) has 90% statistical power to detect a 6.0 mm Hg difference in mean systolic BP change assuming 85% follow-up and a 2-sided significance level of 0.05. Current Status In follow-up Conclusions CATCH will provide evidence on effectiveness and implementation of a team-based care strategy to improve hypertension control in real-world, primary care settings. If proven effective, this approach can be scaled up in primary care throughout low- and middle-income countries (LMICs). Clinical Trial Registration Clinicaltrials.gov , NCT05405920 https://clinicaltrials.gov/study/ NCT05405920.

Acerca de la revista donde se publicó este artículo:

American Heart Journal

Título del artículo:

Reliability of the Modified Ashworth Scale in post-stroke spasticity assessment: cross-sectional study

Introduction. Spasticity evaluation in stroke survivors is crucial for effective rehabilitation. The Modified Ashworth Scale (MAS) is commonly used for this purpose, but its reliability when administered by less expe-rienced individuals like physiotherapy students remains understudied. Therefore, our objective is to assess the inter-observer reliability of the MAS among physiotherapy students for evaluating post-stroke lower limb spasticity. Methods. Thirty-two patients (24 males, 65.2 ± 13.9 years) with hemiplegia/hemiparesis at least six months post-stroke were enrolled. Extensors and flexors in the hip, knee, and ankle of each participant were assessed independently by two trained final-year physiotherapy students, approximately 5 min apart. The Weighted Cohen’s Kappa Index (K) was calculated. Results. The MAS showed substantial agreement for hip extensors (K = 0.78) and flexors (K = 0.70), knee flexors (K = 0.77), dorsiflexors (K = 0.64), and plantar flexors (K = 0.63), and fair agreement for knee extensors (K = 0.54). Conclusions. Novice physiotherapy students demonstrated reliable application of the MAS when evaluating spasticity in the lower limbs of individuals recovering from strokes. Substantial agreement in most muscle groups examined supports the use of the MAS as a valid tool for assessment, even during the initial phases of clinical education.

Acerca de la revista donde se publicó este artículo:

Physiotherapy Quarterly

Título del artículo:

Spinal chondrosarcoma

Chondrosarcomas are primary malignant tumors that may arise from the cranial skull base or axial skeleton and are characterized by neoplastic growth of hyaline cartilaginous tissue. Primary tumors of the spinal column are rare, and chondrosarcomas are the least frequent of these, but their propensity to recur and lack of effective chemotherapeutic options makes this a formidable tumor to treat. Despite an increased understanding of potential targets for chondrosarcoma treatment, patients must be considered for potential en bloc resection, as this is the only available option to cure the patient of this cancer. These tumors may metastasize, so all patients must undergo staging of their tumor prior to any surgical resection, as this may change the goals of surgery. In this chapter, we discuss the presentation and treatment of a patient with a chondrosarcoma of the spinal column and poll an expert panel of spine surgeons to highlight the possible management strategies.

Acerca de la revista donde se publicó este artículo:

Comparative Management of Spine Pathology

Título del artículo:

Understanding the Challenge of Complex Congenital Heart Palliation Follow-Up in a Middle-Income Latin American Country

Introduction. Congenital heart disease of great complexity like single ventricle are the most prevalent congenital defects, managing these requires multiple surgical procedures, usually three stages. Lethality during the interstage period has decreased due to practices as home monitoring. Given the significant resources invested in patient care, it is essential to improve long-term outcomes. There is limited research in cardiovascular disease within middle-income countries. Objective. To identify factors associated with lack of medical follow-up and lethality in children during first interstage period. Method. A retrospective cohort study was conducted including 173 children in their first interstage period after cardiovascular surgery for severe congenital heart disease. Reviewed clinical records and contacted caregivers through telephone/instant messaging software. Analysis included central tendency and dispersion measures. Associations between independent variables and the primary outcomes —loss to follow-up (LTF) and mortality during the interstage period— were evaluated using the Mann-Whitney, Chi-square or Fisher’s exact tests. Results. Of 173 patients, 65 (37.6%) patients LTF. The risk factors for LTF: rural residence (OR=5.05, CI95%1.32-19.26), lower educational level of parents. Global lethality was 13.3% (CI95%7.9-20.4) and factors associated were: rural origin (OR=22.78, CI95%3.68-140.83), malnutrition (OR=25.47, CI95%2.96-218.73), necrotizing enterocolitis (OR=13.34, CI95%2.34-75.97) and heterotaxia or situs inversus (OR=8.05, CI95%1.26-51.34). The number of visits were a protective factor for interstage lethality (OR=0.71, CI95%0.55-0.9). Conclusion. The interstage period entails significant challenges for patients and their families, which are possibly exacerbated by the socio-economic context of a middle-income country. Improving follow-up and support for caregivers of patients under similar conditions could help mitigate identified factors related to lethality.

Acerca de la revista donde se publicó este artículo:

Revista De Investigacion E Innovacion En Ciencias De La Salud

Título del artículo:

Striatal Nitric Oxide Activity Better Predicts Motor Disability Than Proto-Oncogenes

Extrapyramidal symptoms (EPS) are side effects observed after acute administration of D2 antagonists and nitric oxide synthase (NOS) inhibitors in rodents. To date, no study has examined NOS activity in parallel with c-Fos immunoreactivity (c-Fos-IR) following multiple doses of these compounds. The aim of the present study was to evaluate whether catalepsy and motor balance deficits resulting from specific acute doses of haloperidol (Hal), metoclopramide (MCP), and L-NOARG could correlate with changes in the number of c-Fos-IR and nNOS-positive cells, as well as NADPH-diaphorase activity in the striatum. Male Swiss mice received Hal (0.1-1 mg/kg, ip), MCP (1-45 mg/kg, ip), L-NOARG (15-45 mg/kg, ip), or saline. An increased cataleptic effect was observed in all experimental groups. All doses of Hal and the higher doses of MCP resulted in deficits in the Rota-rod test, whereas L-NOARG did not affect Rota-rod performance. Histochemical analysis revealed increased c-Fos-IR in the dorsal striatum following Hal, as well as in the dorsolateral striatum after low and intermediate clinically relevant doses of MCP. Both types of D2R antagonists led to an increase in NADPH-diaphorase activity in the dorsal striatum. Similarly, the higher catalepsy-inducing doses of L-NOARG resulted in increased NADPH-diaphorase activity in the dorsal striatum; however, these same doses also reduced c-Fos-IR in the dorsolateral striatum and nucleus accumbens (NAc). In conclusion, all drugs acutely induced catalepsy, with motor balance preserved after L-NOARG treatment. Our findings suggest that EPS side effects may be attributed to NADPH-diaphorase activity in the dorsal striatum.

Acerca de la revista donde se publicó este artículo:

European Journal of Neuroscience

Título del artículo:

Cardioneuroablation in the management of neurocardiogenic syncope with extracranial validation: efficacy and effects on the regulation of the cardiac autonomic system – a combined retrospective–prospective cohort study

Background: Neurocardiogenic syncope (NCS), particularly cardioinhibitory and mixed subtypes, remains a clinical challenge when refractory to conventional therapy. Cardioneuroablation (CNA) targeting the parasympathetic ganglionated plexi has emerged as a novel interventional option. This study evaluates the efficacy of biatrial CNA with extracardiac vagal stimulation (ECVS) validation in preventing recurrence and modulating cardiac autonomic regulation. Methods: A single-center combined retrospective–prospective cohort study was conducted at a fourth-level institution in Colombia, including patients with cardioinhibitory or mixed-type NCS refractory to conventional treatment. CNA was performed targeting both atria with three-dimensional mapping, followed by ECVS via the internal jugular vein for pre/post validation. Primary outcome was the recurrence of syncope. Secondary outcomes included changes in heart rate variability (HRV) and quality of life (QoL) as assessed by 24-hour Holter monitoring and the SF-36 questionnaire, respectively. Mean follow-up was 24 months. Statistical analysis was performed using SPSS Statistics 28.0.0.0. Results: Fifty-three patients (mean age 42.8 ± 10.1 years, 70% cardioinhibitory type) were included. Recurrence occurred in 7 patients (13.2%), with 86.8% syncope-free survival. HRV parameters decreased after CNA (SDNN: 137.03ms vs. 83.18ms; SDANN index: 79.12 vs. 39.35; RMSSD: 38.75ms vs. 13.91ms; p < 0.001), indicating vagal suppression. QoL improved significantly (SF-36 score: 81.91 vs. 94.62, p < 0.001). No major procedural complications or mortality were reported. Conclusion: CNA with ECVS validation is effective in reducing syncope recurrence, suppressing excessive parasympathetic tone, and improving QoL in patients with refractory neurocardiogenic syncope. These findings support its use as a therapeutic option in selected patients.

Acerca de la revista donde se publicó este artículo:

Journal of Interventional Cardiac Electrophysiology

Título del artículo:

Criteria of the Dutch Clinical Network and genetic testing in familial hyperlipidemia in a group of Colombian patients

Introduction: hyperlipidemia is a group of diseases, both hereditary and acquired, characterized by elevated levels of lipids in the human body, especially prevalent in the western hemisphere. Methods: this study seeks to identify patients with familial hyperlipidemia using the criteria of the Dutch Clinical Network applied to the subsidized population of Bucaramanga, Colombia, and evaluate their individual profiles. Results: the prevalence of heterozygous familial hypercholesterolemia (HeFH) is estimated to be 1 in 200 to 500 people, while the prevalence of homozygous familial hypercholesterolemia (HoFH) is 1 in 300,000 to 600,000 people. In Bucaramanga, it is projected that 240,000 people could have HeFH and from 160 to 300 cases of HoFH. Conclusions: despite the estimates, the real prevalence of the disease in Colombia is unknown, which justifies carrying out this study to obtain more precise data on familial hyperlipidemia in the region.

Acerca de la revista donde se publicó este artículo:

Revista De La Federacion Argentina De Cardiologia

Título del artículo:

Unusual presentation of Crohn disease associated with hemophagocytic lymphohistiocytosis syndrome: a case report

Crohn\'s disease (CD) is a chronic, multifactorial inflammatory condition that can affect any part of the gastrointestinal tract and is associated with systemic, extraintestinal, and atypical manifestations. Hemophagocytic lymphohistiocytosis (HLH), also known as macrophage activation syndrome, is a rare and severe inflammatory disorder that may occur secondary to infections, malignancies, or autoimmune diseases. Its association with CD is extremely uncommon. We report the case of an 8-year-old male who initially presented with nonspecific symptoms including lower limb pain, lumbalgia, and progressive abdominal pain, evolving into respiratory failure and cardiogenic shock, which required admission to the intensive care unit (ICU). He developed bicytopenia, persistent fever, rash, bilateral pleural effusion, hyperferritinemia, hypertriglyceridemia, and signs of systemic inflammation, raising clinical suspicion for HLH. Infectious and hematologic malignancies were ruled out. The patient received intravenous immunoglobulin, broad-spectrum antibiotics, antifungal agents, and immunomodulatory treatment. Gastrointestinal symptoms included melena-like diarrhea, hematochezia, abdominal distension, and elevated fecal calprotectin levels. Abdominal CT imaging showed colonic wall thickening and mesenteric lymphadenopathy. Esophagogastroduodenoscopy, colonoscopy, and histopathological analysis confirmed the diagnosis of CD. Treatment with infliximab was initiated, leading to a favorable clinical response. This case underscores an atypical presentation of CD associated with HLH, posing significant diagnostic and therapeutic challenges.

Acerca de la revista donde se publicó este artículo:

Revista De Gastroenterologia Del Peru Organo Oficial De La Sociedad De Gastroenterologia Del Peru