Microvesicles and inflammatory markers in an animal model of chronic postcapillary pulmonary hypertension.

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La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos de Cesar, Huila y Putumayo

Desde los ejes temáticos del modelo sistémico se propone en este apartado hacer un énfasis mediante el análisis de relatos en el enfoque narrativo, este desde sus posturas teóricas permite que el sujeto mediante la narrativa de historias visibilicé desde su pasado las situaciones de tragedia, dolor y sufrimiento, que determinada situación le causa y que repercute para darle conclusiones negativas a la misma, en esa medida desde el papel del profesional lo que se intenta tras el análisis de su relato es identificar los aspectos que denotan caracteres donde la víctima puntualiza fortalezas, esto con la idea que desde el recontar la historia se pueda construir nuevas alternativas en el relato para fundamentar estrategia de intervención con un lineamiento resiliente y empoderado partiendo de esa narrativa. Representando lo antes mencionado se ostenta desde el caso de Ana Ligia un análisis mediante la articulación de preguntas que dan cuenta la asertividad del profesional para distinguir desde los focos subjetivos de la víctima, recursos resilientes y de empoderamiento que al ser sustraídos se lograría reconstruir una nueva historia de carácter mucho más esperanzador, partiendo de la realidad donde esta ubica la víctima. De igual forma y para apoyar esta iniciativa se aborda mediante el estudio del caso de peñas coloradas, donde se parte de la identificación de los emergentes psicosociales para comprender en buena medida los ejes subjetivos que relacionan los hechos de este relato, dándole consistencia a la construcción de estrategias psicosociales que suministren recursos para el afrontamiento de las diferentes situaciones que vivenciaron la comunidad del caso de peñas coloradas. Tras estos mismos lineamientos se coloca en consideración mediante el ejercicio de foto voz, la representación de diferentes situaciones de violencia que han padecido diversas regiones del país, este análisis permite dar a conocer no solo los hechos de violencia sufridos, sino que nos acerca a reconocer las fortalezas que se logran encontrar en cada región, de las cuales fueron partícipe de este ejercicio integrando la narrativa, y la colocación en escena de las fotografías permite que se visibilice situaciones o necesidades comunitarias que a simple vista se naturaliza por otros.From the thematic axes of the systemic model, it is proposed in this section to emphasize the analysis of stories in the narrative approach, this from its theoretical positions allows the subject through the narrative of stories to make visible from his past the situations of tragedy, pain, and suffering that a certain situation causes him and that has repercussions to give negative conclusions to it, to that extent from the role of the professional what is tried after the analysis of his story is to identify the aspects that denote characters where the victim points out strengths, this with the idea that from the retelling of the story, new alternatives can be built in the story to base an intervention strategy with a resilient and empowered guideline based on that narrative. Representing the aforementioned, from the case of Ana Ligia, an analysis of the articulation of questions that account for the assertiveness of the professional is shown to distinguish, from the subjective focuses of the victim, resilient and empowering resources that when removed would be able to reconstruct a new story of a much more hopeful character, starting from the reality where the victim is located. In the same way, and to support this initiative, it is approached through the study of the case of Peñas Coloradas where it starts from the identification of psychosocial emergencies to understand to a large extent the subjective axes that relate the facts of this story, giving consistency to the construction of psychosocial strategies that provide resources for coping with the different situations experienced by the community in the case of peñas coloradas. Following these same guidelines, the representation of different situations of violence that different regions of the country have suffered is taken into consideration through the exercise of photo voices, this analysis allows us to make known not only the acts of violence suffered but also brings us closer to recognizing the strengths that can be found in each region that participated in this exercise by integrating the narrative, and the placement of the photographs on the scene allows situations or community needs to be made visible that a simple view is naturalized by others

Compassionate communities: How to assess their benefit? A protocol of a collaborative study between different countries.

BACKGROUND Communities and local governments invest in compassionate communities (CCs) a great deal of time, money, effort, and work. However, it is not known whether the CCs are having the effect they are expected to have, so the value of continuing with these initiatives is unknown, and there is a need for a model for evaluating CCs to solve the question. OBJECTIVES To identify a set of core outcomes or benefits that should be measured to assess the impact of the CCs. DESIGN Multiple-methods study involving three communities, each in a different country (Argentina, Colombia, and Switzerland). METHODS AND ANALYSIS To identifying the set of core outcomes, which is the first step in developing the CC evaluation model, five phases will follow: online meetings, literature review, fieldwork, Delphi survey, and social transfer. We will involve members of the local communities of Bern, Buenos Aires, and Medellin at three different levels: (1) citizens (e.g. patients, caregivers, and family members), (2) organizations and institutions involved in the program implementation (e.g. health care organizations, churches, non-governmental organizations, and schools), and (3) political and governmental sectors. ETHICS The study will be conducted following existing international regulations and guidance such as the Declaration of Helsinki. The ethics committee of Pallium Latin America and the ethics committee of the canton of Bern considered our application exempt from the need for approval. Ethics approval in Bern and Buenos Aires is in the process of being obtained. The ethics committee of the Pontifical Bolivarian University approved this protocol. DISCUSSION We expect that this project will help bridge the gap in knowledge regarding the measurable impact of the CCs and enhance more CC development

Métodos utilizados para quantificar a carga de trabalho de enfermagem em unidades de terapia intensiva: uma revisão da literatura

Introduction: Nursing workload in intensive care units (ICUs) is related to efficiency and quality of care; however, there are no methods to quantify the nurses needed per shift in ICUs. Objective: To identify the most used tools to measure ICU nursing workload. Methods: An integrative literature review was performed using original articles in English, Spanish or Portuguese, published between 1991 and 2017 in the databases ScienceDirect, BVS, Scopus, and Embase. The search strategy was “nursing and workload and intensive critical or ICU and measure.” Duplicate articles or articles about intermediate care units were excluded. The quality of the articles was assessed using the Strobe checklist. Results: Thirty-six articles with a total of 19,036 patients were included; 50% (n=18) used NAS, 27.7% (n=10) used a combination of methods such as NAS, NEMS, TISS-28 or VACTE; 13.8% (n=5) used TISS-28, 5.6% (n=2) used video camera recording, and 2.7% (n=1) used NEMS to quantify the time spent by nurses in care. Discussion: There is currently no consensus on workload measurement methods in nursing. In this sense, more validation and comparison studies are needed to improve nursing care management in the ICUs. Conclusion: The most used tool to quantify workload in nursing is the Nursing Activities Score (NAS). Other tools identified were NEMS, TISS-28, and VACTE.  How to cite this article: Cáceres Rivera Diana Isabel, Ruiz Sandoval Jessica Paola, Cristancho Zambrano Luisa Yaneth, Pulido Montes Maria Andreina, López Romero Luis Alberto. Métodos empleados para cuantificar la carga de trabajo en Enfermería en las unidades de cuidados intensivos: Una revisión de la literatura. Revista Cuidarte. 2022;13(3):e2301. http://dx.doi.org/10.15649/cuidarte.2301Introducción: La carga de trabajo de Enfermería en unidades de cuidado intensivo está relacionada con la eficiencia y calidad de la atención, sin embargo, no existen métodos para cuantificar las enfermeras necesarias por turno en UCI. Objetivo: Identificar las herramientas más utilizadas para medir la carga de trabajo de Enfermería en UCIs. Materiales y métodos: Se realizó una revisión de literatura tipo integradora, utilizando artículos originales en inglés, español o portugués, publicados entre 1991 hasta 2017 en las bases de datos: Science@direct, BVS, Socupus y Embase, empleando la estrategia de búsqueda: Nursing and workload and intensive critical or ICU unit and measure, se excluyeron artículos duplicados y/o desarrollados en UCIs de cuidado intermedio, la calidad de los artículos fue valorada usando la lista de chequeo Strobe. Resultados: Se incluyeron 36 artículos con un total de 19.036 pacientes; el 50% (n=18) empleo el NAS, 27.7%(n=10) utilizó una combinación de métodos como el NAS, NEMS, TISS-28 o el VACTE, el 13.8%(n=5) empleo el TISS-28, el 5.6%(n=2) empleo registro de cámaras de video y un 2.7%(n=1) empleo el NEMS para cuantificar el tiempo empleado por enfermería en el cuidado. Discusión: actualmente no existe un consenso sobre métodos de medición de carga de trabajo en enfermería, en este sentido, es necesario realizar más estudios de validación y comparación que permitan mejorar la gestión del cuidado de enfermería en UCI.  Conclusión: La herramienta más utilizada para cuantificar la carga de trabajo en enfermería es el Nursing Activities Score (NAS), otras herramientas identificadas fueron: NEMS, TISS-28 y VACTE. Cómo citar este artículo: Cáceres Rivera Diana Isabel, Ruiz Sandoval Jessica Paola, Cristancho Zambrano Luisa Yaneth, Pulido Montes Maria Andreina, López Romero Luis Alberto. Métodos empleados para cuantificar la carga de trabajo en Enfermería en las unidades de cuidados intensivos: Una revisión de la literatura. Revista Cuidarte. 2022;13(3):e2301. http://dx.doi.org/10.15649/cuidarte.2301Introdução: A carga de trabalho de enfermagem em unidades de terapia intensiva está relacionada à eficiência e qualidade da assistência, entretanto, não existem métodos para quantificar  o número de enfermeiros necessários por turno na UTI. Objetivo: Identificar os instrumentos mais utilizados para mensurar a carga de trabalho de Enfermagem nas UTIs. Metodologia: Foi realizada uma revisão integrativa da literatura, utilizando artigos originais em inglês, espanhol ou português, publicados entre 1991 e 2017 nas bases de dados: Science@direct, BVS, Socupus e Embase, utilizando a estratégia de busca: Nursing and workload and intensivo critical ou unidade e medida de UTI, artigos duplicados e/ou desenvolvidos nas UTIs de cuidados intermediários foram excluídos, a qualidade dos artigos foi avaliada por meio do Strobe checklist. Resultados: foram incluídos 36 artigos com um total de 19.036 pacientes; 50% (n=18) utilizaram o NAS, 27,7%(n=10) utilizaram uma combinação de métodos como NAS, NEMS, TISS-28 ou VACTE, 13,8%(n=5) utilizaram o TISS-28, 5,6% (n=2) utilizaram registros de câmeras de vídeo e 2,7%(n=1) utilizaram o NEMS para quantificar o tempo gasto pela enfermagem no cuidado. Discussão: atualmente não há consenso sobre métodos de mensuração da carga de trabalho em enfermagem, nesse sentido, faz-se necessária a realização de mais estudos de validação e comparação para melhorar o gerenciamento do cuidado de enfermagem em UTI. Conclusão: O instrumento mais utilizado para quantificar a carga de trabalho de enfermagem é o Nursing Activities Score (NAS), outros instrumentos identificados foram: NEMS, TISS-28 e VACTE. Como citar este artigo: Cáceres Rivera Diana Isabel, Ruiz Sandoval Jessica Paola, Cristancho Zambrano Luisa Yaneth, Pulido Montes Maria Andreina, López Romero Luis Alberto. Métodos empleados para cuantificar la carga de trabajo en Enfermería en las unidades de cuidados intensivos: Una revisión de la literatura. Revista Cuidarte. 2022;13(3):e2301. http://dx.doi.org/10.15649/cuidarte.230

Lymphocytic infiltration in stage II microsatellite stable colorectal tumors: A retrospective prognosis biomarker analysis

Background: Identifying stage II patients with colorectal cancer (CRC) at higher risk of progression is a clinical priority in order to optimize the advantages of adjuvant chemotherapy while avoiding unnecessary toxicity. Recently, the intensity and the quality of the host immune response in the tumor microenvironment have been reported to have an important role in tumorigenesis and an inverse association with tumor progression. This association is well established in microsatellite instable CRC. In this work, we aim to assess the usefulness of measures of T-cell infiltration as prognostic biomarkers in 640 stage II, CRC tumors, 582 of them confirmed microsatellite stable. Methods and findings: We measured both the quantity and clonality index of T cells by means of T-cell receptor (TCR) immunosequencing in a discovery dataset (95 patients with colon cancer diagnosed at stage II and microsatellite stable, median age 67, 30% women) and replicated the results in 3 additional series of stage II patients from 2 countries. Series 1 and 2 were recruited in Barcelona, Spain and included 112 fresh frozen (FF, median age 69, 44% women) and 163 formalin-fixed paraffin-embedded (FFPE, median age 67, 39% women) samples, respectively. Series 3 included 270 FFPE samples from patients recruited in Haifa, Northern Israel, as part of a large case-control study of CRC (median age 73, 46% women). Median follow-up time was 81.1 months. Cox regression models were fitted to evaluate the prognostic value of T-cell abundance and Simpson clonality of TCR variants adjusting by sex, age, tumor location, and stage (IIA and IIB). In the discovery dataset, higher TCR abundance was associated with better prognosis (hazard ratio [HR] for ≥Q1 = 0.25, 95% CI 0.10-0.63, P = 0.003). A functional analysis of gene expression on these tumors revealed enrichment in pathways related to immune response. Higher values of clonality index (lower diversity) were not associated with worse disease-free survival, though the HR for ≥Q3 was 2.32 (95% CI 0.90-5.97, P = 0.08). These results were replicated in an independent FF dataset (TCR abundance: HR = 0.30, 95% CI 0.12-0.72, P = 0.007; clonality: HR = 3.32, 95% CI 1.38-7.94, P = 0.007). Also, the association with prognosis was tested in 2 independent FFPE datasets. The same association was observed with TCR abundance (HR = 0.41, 95% CI 0.18-0.93, P = 0.03 and HR = 0.56, 95% CI 0.31-1, P = 0.042, respectively, for each FFPE dataset). However, the clonality index was associated with prognosis only in the FFPE dataset from Israel (HR = 2.45, 95% CI 1.39-4.32, P = 0.002). Finally, a combined analysis combining all microsatellite stable (MSS) samples demonstrated a clear prognosis value both for TCR abundance (HR = 0.39, 95% CI 0.26-0.57, P = 1.3e-06) and the clonality index (HR = 2.13, 95% CI 1.44-3.15, P = 0.0002). These associations were also observed when variables were considered continuous in the models (HR per log2 of TCR abundance = 0.85, 95% CI 0.78-0.93, P = 0.0002; HR per log2 or clonality index = 1.16, 95% CI 1.03-1.31, P = 0.016). Limitations: This is a retrospective study, and samples had been preserved with different methods. Validation series lack complete information about microsatellite instability (MSI) status and pathology assessment. The Molecular Epidemiology of Colorectal Cancer (MECC) study had information about overall survival instead of progression-free survival. Conclusion: Results from this study demonstrate that tumor lymphocytes, assessed by TCR repertoire quantification based on a sequencing method, are an independent prognostic factor in microsatellite stable stage II CRC

Acute stomal necrosis, conservative management. Case report and literature review

It is estimated that in the world in 2019 there were 1.3 million people living with an ostomy, and that each year in the US around 100,000 colostomies are made, most of which are performed due to trauma or cancer, offering a fairly good alternative In acute cases but they are not exempt from complications , one of the less frequent is ostomal necrosis which is generally managed surgically , we present the case of a patient who due to advanced cervical cancer had to undergo an urgent loop colostomy due to intestinal obstruction , which on the second day presented a purplish coloration and was managed conservatively and resolved spontaneously . We present this case as an alternative treatment for this ostomy complication for the knowledge of the scientific community

De Nueva España a México : El universo musical mexicano entre centenarios (1517-1917)

742 págs. Imágenes color y b/n. Partituras musicales.El fenómeno de las conmemoraciones culturales siempre ha sido un terreno abonado para la producción cultural y artística del que se han valido los Estados para ofrecer interpretaciones legitimadoras e ideologizadas de la historia, articuladas en torno a las ideas de memoria, nación y progreso. El presente volumen, resultado de una triple conmemoración (el centenario de la Revolución Mexicana y la publicación de la primera historia de la música en México de Alba Herrera –1917–, por un lado; y la llegada del militar andaluz Francisco Hernández de Córdoba a la costa de la península del Yucatán –1517–, por otro), presenta una visión retrospectiva de la historia musical mexicana a lo largo de esas cuatro centurias. Frente a la rígida división cronológica impuesta por ciertas narrativas, se ofrece así una noción inclusiva, actual e informada del universo musical mexicano en toda su multiplicidad y riqueza de matices, integrando las épocas colonial e independiente como lo que realmente son: partes constitutivas de la memoria musical, histórica, cultural y política del país, con las luces y las sombras propias de cualquier otro periodo