El papel de las emociones en mujeres con cáncer de mama

El cáncer de mama se ubica como la primera causa de muerte de cáncer de la mujer en México, es catalogado como un problema de salud pública y es multifactorial por lo que debe ser abordado desde un enfoque bio-psico-socio-trascendente, que coadyuve a mejorar la calidad de vida en estas mujeres. Mi condición de ser una mujer diagnosticada con cáncer de mama, aunado a recientes estudios científicos sobre la relación del papel de las emociones y el proceso de enfermar, motivó el propósito de esta investigación-acción respecto a indagar más en el tema. Se utilizó una metodología mixta, obteniendo la información cualitativa mediante la aplicación del método fenomenológico y existencial, en la primera etapa con una entrevista fenomenológica y en la segunda etapa, a través de una intervención desarrollada con el taller de “Conectando con mi corazón” desde el Enfoque Centrado en la Persona, que se impartió en 12 sesiones de dos horas cada una, a un grupo aproximado de 10 mujeres que fueron diagnosticadas con cáncer de mama, con la pretensión de que las participantes ampliaran su conocimiento personal a partir de la recuperación de su historia de vida, ofreciendo las condiciones propicias donde pudieran identificar, expresar y contactar con sus emociones para que en la profundización de la experiencia se detonara su tendencia actualizante y pudieran transitar de un estado de vulnerabilidad al de vida plena, en un proceso de crecimiento personal constante, obteniendo resultados favorables en relación a lo que cada participante identificó como una oportunidad de desarrollo.ITESO, A. C

Preparação de sabão com propriedades fitoterápicas e emolientes a partir do óleo vegetal de cozinha.

Diariamente são descartados litros e litros de óleo doméstico usado, uma parte desse descarte se dá em latas de lixo, rede de esgoto, poucos são aqueles que reservam esse tipo de material para reciclagem, uma parte é por não saber como tratar os resíduos contidos em seu meio. Os projetos de preparação de sabão com propriedades fitoterápicas têm por objetivo dar um destino ao descarte desse óleo residual doméstico, promovendo a interação da comunidade local da região da Vila C a fazer desde a parte do tratamento de resíduo do óleo até a mistura de outros reagentes para a produção de um sabão para o banho de animais domésticos e que possa ser utilizável para limpeza de utensílios domésticos. Para a preparação deste material é considerado o fácil acesso aos reagentes envolvidos como a soda cáustica, a qual ainda é comercialmente vendida em mercearias locais e acesso às plantas medicinais que já tem suas propriedades conhecidas, como no caso a erva baleeira, calêndula, e citronela, também é realizado junto a comunidade, oficinas informando sobre os cuidados em manipular produtos químicos, como agir em caso de acidentes durante o manuseio, a quem é indicado a fazer esse tipo de tratamento e como preparar o produto. Existem análises laboratoriais que são acompanhadas e orientadas, as quais são necessárias para testes em pequena escala antes de cada oficina, essas análises são feitas para poder corrigir o pH do produto e mensurar a quantidade de aditivos na produção do sabão, após essas análises o modelo de produção é replicado em escala maior, já com a certeza dos resultados na qualidade do produto final. Desta forma se faz necessário uma investigação mais detalhada ao produto final, por meio de utilização de equipamentos cromatográficos e espectrofotômetros, como ferramenta na identificação dos compostos e/ou princípios ativos na composição, os quais dão a característica de fitoterápicos e comparar desta forma, com o que já temos em literatura conhecida

Where I am from matters: factors influencing behavioral and emotional changes in autistic individuals during COVID-19 in Latin America

Background: The COVID-19 pandemic brought an increased incidence of disease and mortality in the world at large, making it a particularly salient and stressful life event. For those individuals residing in Latin America, the pandemic was met with fragmented healthcare systems, economic downturn, and sociopolitical crisis which puts autistic individuals at risk for more detrimental outcomes. Behavioral and emotional challenges experienced by autistic individuals at the beginning of the pandemic could later develop into more severe symptomatology as the pandemic progresses. The present study aimed to explore changes in dysregulated (overt and internalizing) behaviors and preoccupation with getting sick during the COVID-19 pandemic among autistic children in 7 Latin American countries. Method: Sample consisted of 1,743 caregivers, residing in: Argentina (n = 677, 38.8%) Brazil (n = 156, 9%), Chile (n = 251, 14.4%), Dominican Republic (n = 171, 9.8%), Mexico (n = 126, 7.2%), Uruguay (n = 259, 14.9%) and Venezuela (n = 103, 5.9%). The majority of caregivers who completed the questionnaire were mothers (85.1%), and most had a male autistic child (81.6%). A series of independent sample t-tests were conducted to assess country differences in dysregulated behaviors and preoccupation with getting sick. Linear regressions were conducted to identify which demographic characteristics and micro-level contextual factors predicted dysregulated overt behaviors and psychological changes. Results: Contextual factors, such as country of residence, were related to preoccupation with getting sick and dysregulated behavior. Particularly, residing in Mexico and Brazil were related to changes in preoccupation with getting sick and mental health concerns. Coexistence predicted dysregulated internalizing behaviors, while being older significantly predicted preoccupation with getting sick. Increased screen time only predicted anxiety. Conclusion: Our findings highlight differences and predictions of behavioral challenges and psychological changes based on certain contextual factors and individual characteristics while experiencing severe life stressors such as a worldwide pandemic. This knowledge could help inform policies and decrees aimed at protecting those most vulnerable due to their increased difficulty adapting to change

Prevalancia de caries dental, factores de riesgo, enfermedad periodontal y hábitos de higiene oral en estudiantes de ciencias de la salud.

La caries dental y la enfermedad periodontal son consideradas como los eventos de mayor prevalencia en la morbilidad bucal

Experiencia de extensión universitaria en huertas comunitarias de organizaciones barriales

With the population growth in the last years, urban agriculture has had a great development. In Argentina, some workers’ movements have been developing community vegetable gardens under agroecological systems in working-class neighbourhoods. The production is carried out on urban soils, whose natural characteristics have been modified. There is no previous information either of these soils or about effects of the agroecological system. This information is important to detect problems and to adapt the management to the local situation. Education and extension programs help to pursue this aim and participatory workshops allow committed participants to reflect collaboratively. In this sense, the aim of this work was to foster equity, mutual understanding and exchanges so as to contribute to the improvement of local community production systems functioning on urban soils. Two workshops on community vegetable gardens were held in two working-class neighbourhoods from La Plata. In these workshops a diagnosis of soil health was carried out and also water was analysed. In addition to this, proposal agreements emerged to improve the existing production systems. The experience has generated exchanges and mutual understanding between the educational community and vegetable garden keepers. Also, vegetable garden keepers’ necessities and topics that require greater attention in future extension programs were highlighted. One of the greatest challenges for the future is to increase assistance and intervention of vegetable garden keepers in community spaces.Con el crecimiento poblacional de los últimos años la agricultura urbana ha alcanzado un gran desarrollo. En el caso de Argentina, algunos movimientos de trabajadores, vienen desarrollando huertas comunitarias bajo sistemas agroecológicos dentro de barrios populares. La producción se realiza sobre suelos urbanos, cuyas características naturales están modificadas. No existe información previa de estos suelos ni de los efectos del sistema agroecológico, lo cual es importante para detectar problemas y adecuarse a la situación local. La educación y los programas de extensión colaboran con este fin y los talleres participativos, permiten una reflexión colectiva de los actores comprometidos. En este sentido, el objetivo del trabajo fue generar espacios de vinculación, mutuo conocimiento e intercambio y así contribuir a la mejora en el funcionamiento de los sistemas productivos comunitarios locales sobre suelos urbanos. Se realizaron dos talleres en huertas comunitarias dentro de dos barrios populares de La Plata. En el marco de los talleres se realizó el diagnóstico del estado de salud de los suelos, se analizó el agua y surgieron propuestas de manejo consensuadas para mejorar los sistemas productivos existentes. La experiencia facilitó la generación de espacios de intercambio y mutuo conocimiento entre la comunidad educativa y los huerteros. También, se pudieron visibilizar las necesidades de quienes trabajan en las huertas y las temáticas que requieren una mayor promoción en futuros programas de extensión. Uno de los mayores desafíos que se presentan hacia el futuro es aumentar la asistencia e intervención de los huerteros en los espacios de vinculación

Carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-haematopoietic stem cell transplant: a retrospective cohort study

Background Risk factors for carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-HSCT have not been thoroughly explored. Methods All children with cancer or post-HSCT who developed Enterobacterales bloodstream infections in two cancer referral centres in major Colombian cities between 2012 and 2021 were retrospectively examined. When the infection episode occurred, carbapenem resistance mechanisms were evaluated according to the available methods. Data were divided in a training set (80%) and a test set (20%). Three internally validated carbapenem-resistant Enterobacterales (CRE) prediction models were created: a multivariate logistic regression model, and two data mining techniques. Model performances were evaluated by calculating the average of the AUC, sensitivity, specificity and predictive values. Results A total of 285 Enterobacterales bloodstream infection episodes (229 carbapenem susceptible and 56 carbapenem resistant) occurred [median (IQR) age, 9 (3.5–14) years; 57% male]. The risk of CRE was 2.1 times higher when the infection was caused by Klebsiella spp. and 5.8 times higher when a carbapenem had been used for ≥3 days in the previous month. A model including these two predictive variables had a discriminatory performance of 77% in predicting carbapenem resistance. The model had a specificity of 97% and a negative predictive value of 81%, with low sensitivity and positive predictive value. Conclusions Even in settings with high CRE prevalence, these two variables can help early identification of patients in whom CRE-active agents are unnecessary and highlight the importance of strengthening antibiotic stewardship strategies directed at preventing carbapenem overuse.Q1Q1Los factores de riesgo de resistencia a los carbapenémicos en las infecciones del torrente sanguíneo por Enterobacterales entre niños con cáncer o después de un TCMH no se han explorado a fondo. Métodos Se examinaron retrospectivamente todos los niños con cáncer o post-TCMH que desarrollaron infecciones del torrente sanguíneo por Enterobacterales en dos centros de referencia de cáncer en las principales ciudades de Colombia entre 2012 y 2021. Cuando ocurrió el episodio de infección, se evaluaron los mecanismos de resistencia a los carbapenémicos según los métodos disponibles. Los datos se dividieron en un conjunto de entrenamiento (80%) y un conjunto de prueba (20%). Se crearon tres modelos de predicción de Enterobacterales resistentes a carbapenémicos (CRE) validados internamente: un modelo de regresión logística multivariante y dos técnicas de minería de datos. El rendimiento del modelo se evaluó calculando el promedio del AUC, la sensibilidad, la especificidad y los valores predictivos. Resultados Se produjeron un total de 285 episodios de infección del torrente sanguíneo por Enterobacterales (229 susceptibles a carbapenémicos y 56 resistentes a carbapenémicos) [mediana de edad (RIQ), 9 (3,5 a 14) años; 57% hombres]. El riesgo de CRE fue 2,1 veces mayor cuando la infección fue causada por Klebsiella spp. y 5,8 veces mayor cuando se había utilizado un carbapenem durante ≥3 días en el mes anterior. Un modelo que incluía estas dos variables predictivas tuvo un rendimiento discriminatorio del 77% en la predicción de la resistencia a los carbapenémicos. El modelo tuvo una especificidad del 97% y un valor predictivo negativo del 81%, con baja sensibilidad y valor predictivo positivo. Conclusiones Incluso en entornos con una alta prevalencia de CRE, estas dos variables pueden ayudar a la identificación temprana de pacientes en quienes los agentes activos de CRE son innecesarios y resaltar la importancia de fortalecer las estrategias de administración de antibióticos dirigidas a prevenir el uso excesivo de carbapenémicos.N/AS

Análisis de los servicios de test del VIH de cinco centros comunitarios españoles para la mejora de nuevas estrategias de promoción del diagnóstico precoz

Background: In recent years, the number of people tested for HIV has experienced a significant increase. The purpose of this study is to analyze data obtained in Spain in the HIV testing services of five Community Centres members of Agrupación Prueba de VIHda throughout 2014 and 2015,to determine its effectiveness and to characterize the subpopulation with a HIV reactive result. Study design and methods: agrupación Prueba de VIHda performed free, anonymous and confidential HIV tests according to the Consolidated guidelines on HIV testing services of WHO (2015). Data were collected using the questionnaire of the COBATEST network, developed by the COBATEST Project, and its significance was determined statistically. Results: 3061 HIV tests were performed during 2014 and 2015, with a prevalence of reactive results of 2.5%. Heterosexual and bisexual men got tested at older ages than homosexual men and women. Non-Spanish origin seems to be a risk factor for HIV infection within the sample. Bisexual men showed as high prevalence of reactive test as homosexual men, as well as they reported less previous HIV tests. Finally, index testing performed by HIV positive peer educators to the sexual partners of newly diagnosed patients showed higher prevalence than that of the classical Voluntary Counselling and Testing approach outreach most at risk populations. Conclusion:The analysis of the data shows higher prevalence of reactive results in people of non-Spanish origin compared to that of the Spanish subgroup, the former still facing barriers to access the public health system in Spain. It also demonstrates the need of new and adapted approaches for promoting early diagnosis specifically in bisexual men. Index testing by peer HIV positive educators is a highly effective method for testing people at high risk of acquiring HIV infection.Antecedentes: En los últimos años, el número de personas sometidas a pruebas frente al VIH ha experimentado un aumento significativo. El propósito de este estudio es analizar los datos de prevalencia de la infección por VIH obtenidos por cinco centros comunitarios en España pertenecientes a la Agrupación Prueba de VIHda entre 2014 y 2015, determinar su efectividad y caracterizar la subpoblación con un resultado preliminar reactivo. Diseño experimental y métodos: La Agrupación Prueba de VIHda realizó pruebas de VIH gratuitas, anónimas y confidenciales de acuerdo con las directrices consolidadas por la OMS (2015). Los datos fueron recogidos mediante el cuestionario desarrollado por el Proyecto COBATEST y su significación se determinó estadísticamente. Resultados: Durante 2014 y 2015 se realizaron un total de 3061 pruebas frente al VIH, obteniendo una prevalencia de resultados preliminares positivos del 2,5%. Los hombres heterosexuales y bisexuales se realizaron la prueba a edades más avanzadas que los hombres homosexuales y las mujeres. Las personas de origen no español parecieron mostrar un mayor riesgo de infección frente al VIH. Hombres bisexuales mostraron una prevalencia elevada similar a la de hombres homosexuales, así como declararon menos pruebas anteriores frente al VIH. Finalmente, las pruebas realizadas a través de indextesting por los educadores pares de VIH a parejas sexuales de pacientes recién diagnosticados mostraron una prevalencia superior a la obtenida por el modelo tradicional de counselling y testado voluntario ofrecido desde los centros comunitarios a poblaciones de mayor riesgo. Conclusión: El análisis de los datos muestra mayores prevalencias de resultados preliminares reactivos en personas de origen no español comparadas con aquellas del subgrupo de personas españolas, el primero de ellos todavía enfrentando barreras de acceso al sistema sanitario público en España, El análisis también demuestra la necesidad de nuevos enfoques adaptados para promover el diagnóstico precoz especialmente entre hombres bisexuales. Las pruebas realizadas a través de indextesting por educadores pares VIH positivos es un método muy eficaz para el testado de las personas con alto riesgo de contraer la infección por VIH

The impact of insect herbivory on biogeochemical cycling in broadleaved forests varies with temperature

Herbivorous insects alter biogeochemical cycling within forests, but the magnitude of these impacts, their global variation, and drivers of this variation remain poorly understood. To address this knowledge gap and help improve biogeochemical models, we established a global network of 74 plots within 40 mature, undisturbed broadleaved forests. We analyzed freshly senesced and green leaves for carbon, nitrogen, phosphorus and silica concentrations, foliar production and herbivory, and stand-level nutrient fluxes. We show more nutrient release by insect herbivores at non-outbreak levels in tropical forests than temperate and boreal forests, that these fluxes increase strongly with mean annual temperature, and that they exceed atmospheric deposition inputs in some localities. Thus, background levels of insect herbivory are sufficiently large to both alter ecosystem element cycling and influence terrestrial carbon cycling. Further, climate can affect interactions between natural populations of plants and herbivores with important consequences for global biogeochemical cycles across broadleaved forests

Imported malaria in pregnancy in Madrid

<p>Abstract</p> <p>Background</p> <p>Malaria in pregnancy is associated with maternal and foetal morbidity and mortality in endemic areas, but information on imported cases to non-endemic areas is scarce.</p> <p>The aim of this study was to describe the clinical and epidemiological characteristics of malaria in pregnancy in two general hospitals in Madrid, Spain.</p> <p>Methods</p> <p>Retrospective descriptive study of laboratory-confirmed malaria in pregnant women at the Fuenlabrada University Hospital and the Príncipe de Asturias University Hospital, in Madrid, over a six- and 11-year period, respectively. Relevant epidemiological, clinical and laboratory data was obtained from medical records.</p> <p>Results</p> <p>There were 19 pregnant women among 346 malaria cases (5.4%). The average age was 27 years. The gestational age (trimester) was: 53% 3^rd, 31% 1st, 16% 2^nd. All but one were multigravidae. Three were HIV positive. All were sub-Saharan immigrants: two were recently arrived immigrants and seventeen (89%) had visited friends and relatives. None had taken prophylaxis nor seeked pre-travel advice. Presentation: 16 symptomatic patients (fever in fourteen, asthenia in two), three asymptomatic. Median delay in diagnosis: 7.5 days. Laboratory tests: anaemia (cut off Hb level 11 g/dl) 78.9% (mild 31.6%, moderate 31.6%, severe 15.8%) thrombocytopaenia 73.7%, hypoglycaemia 10.5%. All cases were due to <it>Plasmodium falciparum</it>, one case of hyperparasitaemia. Quinine + clindamycin prescribed in 84%. Outcomes: no severe maternal complications or deaths, two abortions, fifteen term pregnancies, no low-birth-weight newborns, two patients were lost to follow-up.</p> <p>Conclusions</p> <p>Though cases of malaria in pregnancy are uncommon, a most at risk group is clearly defined: young sub-Saharan mothers visiting friends and relatives without pre-travel counselling and recently-arrived immigrants. The most common adverse maternal and foetal effects were anaemia and stillbirth. Given that presentation can be asymptomatic, malaria should always be considered in patients with unexplained anaemia arriving from endemic areas. These findings could help Maternal Health programme planners and implementers to target preventive interventions in the immigrant population and should create awareness among clinicians.</p

Allylic Oxidation of Alkenes Catalyzed by a Copper−Aluminum Mixed Oxide

A strategy for the allylic oxidation of cyclic alkenes with a copper−aluminum mixed oxide as catalyst is presented. The reaction involves the treatment of an alkene with a carboxylic acid employing tert-butyl hydroperoxide as the oxidant. In all cases, the corresponding allylic esters are obtained. When L-proline is employed, the allylic alcohol or ketone is obtained. The oxidation of cyclohexene and valencene has been optimized by design of experiments (DoE) statistical methodology