La importancia del autocuidado en profesionales de primera línea durante la emergencia sanitaria del COVID – 19

El presente trabajo de investigación se realizó con la finalidad de determinar la importancia que dieron a las actividades de autocuidado los profesionales de primera línea durante la emergencia sanitaria del COVID – 19. Para el estudio participaron seis personas que formaron parte de la primera línea de atención durante la pandemia, entre los cuales se encuentran médicos y personal de enfermería. Para ello se hizo usó de una metodología investigación cualitativa y estudio de caso. Mediante entrevistas, la población brindó un acercamiento a su rutina antes y después del COVID, qué efectos psicológicos y físicos les trajo atender a la población que había contraído la enfermedad y la valoración que el personal da a las actividades de autocuidado y cuáles eran sus percepciones ante las mismas. Los resultados cualitativos indican que existió una alteración en el estado psicológico de los entrevistados al atender pacientes con sintomatología COVID- 19, lo que los llevo a adoptar medidas de autocuidado con un fin recreativo. Esto trae beneficios a nivel laboral e interpersonal, pues encontraron nuevos mecanismos para hacer frente a las consecuencias de la pandemia.This research was undertaken to determine the importance that front-line workers gave to self care during the COVID-19 health crisis. There were six participants, who were on the front line during the pandemic, including doctors and nursing staff. We used a method of case studies and qualitative research. Throughout interviews participants offered a window into their routines before and after covid; the psychological and physical effects of caring for those who had contracted the virus; the value they gave to their personal self care; and their own perceptions of these things. The qualitative results indicate that there was a change in the psychological state of the participants after attending patients with COVID-19, which drove them to adopt self care routines with recreational goals. This brought them benefits at work and interpersonally. They even found new ways to cope with the consequences of the pandemic

Variación espacial y temporal del índice gonadal de Diadema antillarum (Echinodermata: Echinoidea) en las Islas Canarias

Diadema antillarum Philippi occurs in high density populations in the Canary Islands, creating extensive barren areas. During one year we determined seasonal changes in the algal abundance and population densities, test diameter, gut contents and gonad index of sea urchins in two localities (Abades and Boca Cangrejo). Boca Cangrejo shows higher algae cover and species richness than Abades. The sea urchin population at Abades had a higher density and smaller urchins than Boca Cangrejo. Boca Cangrejo sea urchins showed higher specific richness in gut contents than Abades urchins. The sea urchin population at Abades did not have a clearer reproductive periodicity or higher gonad index than the Boca Cangrejo population. Temporal and spatial changes in gonad periodicity of Diadema antillarum are attributed, at least in part, to benthic food availability (algal cover and algal species number) and intra-specific competition.Diadema antillarum Philippi presenta unas densidades altísimas en las islas Canarias, eliminando casi por completo la cubierta vegetal de los fondos rocosos litorales. Durante un año, hemos muestreado estacionalmente los cambios en la abundancia de algas y las densidades poblacionales, diámetros de caparazón, contenidos intestinales e índice gonadal de los erizos en dos localidades (Abades y Boca Cangrejo). Boca Cangrejo presenta mayores coberturas y riqueza algal que Abades. La población de erizos en Abades es más densa y esta formada por erizos de menor tamaño que en Boca Cangrejo. La riqueza algal en los contenidos estomacales es mayor en los erizos de Boca Cangrejo que la de los de Abades. Los erizos de Boca Cangrejo presentan una clara periodicidad reproductiva e índices gonadales superiores a los erizos de Abades. Las variaciones espaciales y estacionales en la periodicidad gonadal de Diadema antillarum pueden ser atribuidas, al menos en parte, a la disponibilidad bentónica de alimento (recubrimiento y número de especies de algas) y a la competencia intraespecífica.

Centro juvenil para la convivencia social y el desarrollo de habilidades creativas para jóvenes de 15 a 25 años de Tehuacán que forman parte de una “bedroom culture”

"El objetivo de esta tesis es aprovechar y mejorar el interés y la preferencia que los jóvenes tienen hacia el uso de la tecnología y medios digitales para generar en ellos el interés hacia la socialización, la convivencia y puedan desarrollar sus habilidades creativas con el uso de estos mismos medios digitales, esto para crear un interés y motivación en los jóvenes para que al retomar la socialización y los factores que implica la misma también puedan definirse a ellos mismos con talentos y habilidades desarrolladas en un ambiente creativo, dinámico y tecnológico"

Predictive Value of Cardiovascular Global Risk Calculation

Cardiovascular diseases constitute the main morbidity and mortality cause of death worldwide. The best tool to set priorities in primary cardiovascular prevention is the precise estimation of the global cardiovascular risk. This work was aimed at explaining the predictive value for cardiovascular diseases, for which a documentary review of a total of 27 bibliographic sources was done. Among these 26 international impact articles from journals and a thesis, among other sources were reviewed, to which it was accessed through the main information managers. Risk mobility prediction has been an essential element in preventive clinical guidelines for these diseases and has become a useful tool for the family doctor, to set priorities in primary health care, which will allow making progress in studying complex associations that may impact cardiovascular risk

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America : the ESTAMPA screening study protocol

Q1Q1Introduction Human papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC. Methods and analysis Women aged 30–64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre. Ethics and dissemination The study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant safety, advice on scientific conduct and analysis and suggest protocol improvements. Study findings will be published in peer-reviewed journals and presented at scientific meetings. Trial registration number NCT01881659Revista Internacional - Indexad

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016