Perfil epidemiológico de pacientes con papanicolau a realizarse en las UCSF de Apopa y Olocuilta en el período de mayo-junio 2018

El cáncer de cérvix es una enfermedad que cobra muchas vidas en países en desarrollo como el nuestro, conocer el perfil epidemiológico de las pacientes que acudieron a realizarse la citología cérvico vaginal a las unidades de salud de Apopa y Olocuilta, es importante para identificar porque no se amplía la cobertura en tamizaje de primera vez. Se realizó un estudio cuantitativo, descriptivo, longitudinal prospectivo

The Influence of the COVID-19 Pandemic on the Clinical Application of Evidence-Based Practice in Health Science Professionals

(1) Background: Evidence-based practice (EBP) informs daily clinical interventions with the purpose of seeking changes to traditional practice through scientific evidence that justifies the reasons for our actions. The objectives were to describe the barriers, beliefs, and attitudes in the application of EBP among university health professionals (not doctors) and to evaluate the influence of the COVID-19 pandemic among them. (2) Methods: This prospective study is both descriptive and observational. The individuals under study were university health professionals (not doctors) from various autonomous regions within Spain, in both public and private spheres. Sociodemographic and labor-related variables linked to the research and its completion were studied. Likewise, the survey instrument Health Sciences Evidence-Based Practice questionnaire (HS-EBP) was administered to evaluate the barriers to, beliefs in, and attitudes towards evidence-based practice. (3) Results: A total of 716 responses were gathered, of which 387 were collected during the period of confinement, and 343 in the COVID-19 post-confinement period. Possible associations that might help respond to the objectives were explored through a correlational study between the sociodemographic variables and each sub-scale of the HS-EBP 30 questionnaire (n = 716). (4) Conclusions: Barriers to, beliefs in, and attitudes towards evidence-based practice are described. There is a leadership gap where line management provides insufficient motivation to follow work routines. The COVID-19 pandemic has caused immense stress among health professionals. The post-confinement group showed a significant change in the variables "beliefs and attitudes", and likewise in the "evaluation" block, justified by the need to update knowledge and to apply evidence.This project has been financed with the help of IDIVAL, Project number NVAL 19/04 through the Marqués de Valdecilla Research Institute, IDIVAL, Spain

Restless legs syndrome in end-stage renal disease patients undergoing hemodialysis

ABSTRACT Restless legs syndrome (RLS) is a frequent complication of hemodialysis that has been associated with poor quality of life and increased risk for complications. Nevertheless, few studies regarding this entity exist in resource-limited settings. Objectives: To determine the prevalence of RLS among Mexican patients on hemodialysis; and compare these patients with a control group of the same population. Methods: We recruited 105 hemodialysis patients. Restless legs syndrome was diagnosed according to the updated criteria set out by the International RLS Study Group. We selected patients who did not meet the criteria, as controls. Results: We found an RLS prevalence of 18%. The RLS patients had a significantly higher prevalence of iron deficiency anemia and uremic pruritus. None of the patients reported RLS symptoms prior to hemodialysis initiation. Conclusions: Restless legs syndrome is common among Mexican patients on hemodialysis. Larger studies are required to address the impact of RLS in hemodialysis patients. Keywords: Restless legs syndrome; renal dialysis; renal insufficiency. RESUMEN El síndrome de piernas inquietas (SPI) es una complicación de la hemodiálisis que se ha asociado con menor calidad de vida y riesgo aumentado de complicaciones. Sin embargo, existen pocos estudios acerca de esta entidad en escenarios de recursos limitados. Objetivos: Determinar la prevalencia de SPI en pacientes mexicanos en hemodiálisis, y comparar las características con un grupo control de la misma población. Métodos: Reclutamos 105 pacientes en hemodiálisis. El SPI se diagnosticó de acuerdo con los criterios actualizados del grupo de estudio internacional del síndrome de piernas inquietas. Seleccionamos a los pacientes que no cumplieron dichos criterios como controles. Resultados: Encontramos una prevalencia de SPI del 18%. Los pacientes con SPI tenían una prevalencia más alta de anemia ferropénica, y prurito urémico. Ninguno de los pacientes reportó síntomas de SPI previo a iniciar la hemodiálisis. Conclusiones: El SPI es frecuente en pacientes mexicanos en hemodiálisis; se requieren estudios más grandes para evaluar el impacto del síndrome en ésta población. Palabras-clave: Síndrome de piernas inquietas; diálisis renal; insuficiencia renal

EMPLEABILIDAD Y GÉNERO EN UNA UNIVERSIDAD PRIVADA DE ASUNCIÓN

La empleabilidad en función al género, ha sido un tema que ocasionó y sigue generando mucha controversia. Actualmente constituye no sólo una discriminación positiva hacia un ser humano, sino que se traduce en un perjuicio y en un retroceso de la humanidad misma. En esta investigación se analiza la situación en la que se encuentra el género femenino en la Universidad Americana de Asunción, en cuanto a la igualdad de oportunidades al acceso de empleo. Para esto se ha analizado cuantitativamente la población de funcionarios que la conforman, en los distintos cargos ocupacionales. Se pudo constatar en base a los datos contrastados que en dicha institución educativa existe un techo de cristal para el género femenino ya que en las dos áreas ocupacionales de mayor relevancia, encargadas del trabajo estratégico y directivo, predominan los hombres y en la última área, encargada netamente del trabajo operativo, predomina una mayoría de mujeres

First-line treatment in lymphomatoid papulosis: a retrospective multicentre study

Background: Data regarding response to treatment in lymphomatoid papulosis (LyP) are scarce. Aim: To assess the daily clinical practice approach to LyP and the response to first-line treatments. Methods: This was a retrospective study enrolling 252 patients with LyP. Results: Topical steroids, methotrexate and phototherapy were the most common first-line treatments, prescribed for 35%, 20% and 14% of the patients, respectively. Complete response (CR) was achieved in 48% of treated patients. Eczematous lesions significantly increased relative risk (RR) of not achieving CR (RR = 1.76; 95% CI 1.16-2.11). Overall median time to CR was 10 months (95% CI 6-13 months), and 78% of complete responders showed cutaneous relapse; both results were similar for all treatment groups (P > 0.05). Overall estimated median disease-free survival (DFS) was 11 months (95% CI 9-13 months) but DFS for patients treated with phototherapy was 23 months (95% CI 10-36 months; P < 0.03). Having the Type A LyP variant (RR = 2.04; 95% CI 0.96-4.30) and receiving a first-line treatment other than phototherapy (RR = 5.33; 95% CI 0.84-33.89) were significantly associated with cutaneous early relapse. Of the 252 patients, 31 (13%) had associated mycosis fungoides unrelated to therapeutic approach, type of LyP or T-cell receptor clonality. Conclusions: Current epidemiological, clinical and pathological data support previous results. Topical steroids, phototherapy and methotrexate are the most frequently prescribed first-line treatments. Although CR and cutaneous relapse rates do not differ between them, phototherapy achieves a longer DFS. Presence of Type A LyP and use of topical steroid or methotrexate were associated with an increased risk of early relapse

Genetic Characterization and Clinical Features of Helicobacter pylori Negative Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Background: In Western countries, the prevalence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma has declined over the last three decades. Contemporaneously, H. pylori negative gastric MALT lymphoma is increasingly encountered, and their genetic basis and clinical features remain elusive. Methods: A total of 57 cases of H. pylori negative gastric MALT lymphoma were reviewed and investigated for chromosome translocation by fluorescence in-situ hybridization and for somatic mutations by the targeted sequencing of 93 genes. Results: MALT1 translocation, most likely t(11;18)(q21;q21)/BIRC3-MALT1, was detected in 39% (22/57) cases, and IGH translocation was further seen in 12 MALT1-negative cases, together accounting for 60% of the cohort. Targeted sequencing was successful in 35 cases, and showed frequent mutations in NF-κB signaling pathways (TNFAIP3 = 23%, CARD11 = 9%, MAP3K14 = 9%), together affecting 14 cases (40%). The NF-κB pathway mutations were mutually exclusive from MALT1, albeit not IGH translocation, altogether occurring in 86% of cases. There was no significant correlation between the genetic changes and clinicopathological parameters. The patients showed a median of progression-free survival (PFS) of 66.3 months, and a significant superior PFS when treated with systemic versus antibiotic therapy (p = 0.004). Conclusion: H. pylori negative gastric MALT lymphoma is characterized by highly frequent genetic changes in the NF-κB signaling pathways

Report of the Working Group of Biological Effects

The Working Group on Biological Effects of Contaminants (WGBEC) investigates the biological effects of contaminants in the marine environment. The group provides research and increases the understanding of contaminant interactions and effects, including the development of inte-grated biological effects monitoring strategies, which are used to support international research and monitoring. The WGBEC has contributed significantly to the implementation and harmonization of tech-niques that can be used to evaluate the biological effects of pollutants in national monitoring programmes. An overview of national effect-based monitoring programmes of Member States is provided with the aim to support European countries and Regional Seas Conventions on their implementation. A summary of the national effects-based monitoring programmes has been pro-vided by twelve European countries represented at the WGBEC meetings. The adoption of bio-logical effects monitoring can differ widely and comparisons between approaches and the choice of biological effects methods used acts as an important tool. A summary of the main findings is presented. Furthermore, OSPAR's Hazardous Substances and Eutrophication Committee (HASEC) has en-couraged contracting parties to perform targeted biological effects monitoring to enhance the assessment of contaminants in sediment and biota towards the OSPAR QSR2023. WGBEC mem-bers contributed to the integrated biological effects approach assessment by providing data from their national monitoring activities to produce maps and figures to enable interpretations. Revision of the biological effects methods, including new techniques and developments, and the quality assurance of existing methods are core activities for the WGBEC, which require continu-ous discussion and evaluation by the group. Activities include the production of new ICES TIMES documents as well as intercalibration exercises to ensure Member States are providing comparable data for national monitoring. To this end, intercalibration exercises were performed under the BEQUALM programme for two of the more commonly used biological effects meth-ods, including micronucleus formation in mussel haemocytes and PAH metabolites in fish bile. These intercalibrations were successful despite identifying some variation in reported values be-tween laboratories. Further intercalibration exercises are planned and the WGBEC strongly sup-port the need for such quality assurance. In addition to the national monitoring activities and the different methods and approaches for determining the effects of contaminants on biological systems, the WGBEC was interested in discussing some key questions related to the potential impacts of contaminants to marine life. These questions included: the direct and indirect effects of natural and synthetic particles; how climate change and acidification parameters can interact with contaminants and influence bioa-vailability and effect; whether the structure of marine communities can be used to indicate con-taminant exposure; to provide guidance on performing risk assessments for contaminants of emerging concern; and to evaluate the effects of contaminants in marine sediments and whether current sediment toxicity tests are adequate. In addition, and as a wider concept, the linkages between contaminants in the marine environment and human health were also described.S

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality