Valoración de la declaración del menor para establecer la paternidad legal

a presente investigación titulada “Valoración de la declaración del menor para establecer la paternidad legal” tiene como objetivo general: comprender si se debe valorar la declaración del menor para establecer la paternidad legal, para ello, se han desarrollado los conceptos de derecho a la identidad, a ser oído y al Principio del Interés Superior del Niño. Es de enfoque cualitativo, ya que durante el proceso han surgido nuevas interrogantes; es de tipo descriptivo, puesto que se basa en describir un fenómeno en específico a partir de la información obtenida; es de diseño fenomenológico, porque va a permitir comprender el fenómeno, a partir de las experiencias de los participantes. El instrumento de recolección de datos ha sido validado por 5 expertos, especializados en materia familia y civil, quienes lo aprobaron para su aplicación. Por lo que, el mismo ha sido aplicado a 5 participantes elegidos por sus conocimientos y experiencias, así pues, se tiene: un Juez de familia, una Fiscal de familia, un Especialista Legal, una Psicóloga del Equipo Multidisciplinario y una Madre de Familia. Finalmente, de acuerdo a los participantes, para establecer la paternidad legal, el Juez debe valorar la declaración del menor, pues conforme al Principio del Interés Superior del Niño, la decisión adoptada debe primar sus derechos, más aún cuando el menor manifiesta sentirse identificado con su padre legal, quien sin ser el biológico, ha desarrollado el rol como si realmente lo fuese, evidenciando que el vínculo afectivo tiene mayor valor que el biológico, como señalan diversos autores

Ultraestructura de las miofibrillas en cardiomiocitos durante el desarrollo embrionario tardío y postnatal temprano de ratón.

En este estudio se describen por medio del análisis ultraestructural los cambios en la citodiferenciación de las miofibrillas en los cardiomiocitos del tejido cardiaco en desarrollo embrionario tardío y postnatal temprano de ratón. El proceso de diferenciación progresiva en diferentes espacios celulares de las miofibrillas, es una manifestación propia de las etapas estudiadas. En algunas células se observa la ultraestructura propia de las sarcómeras, con sus respectivas bandas Z, I, A y H, en contraste con otras miofibrillas que no se evidencian éstas estriaciones, posiblemente porque están en proceso de formación. En edades embrionarias las miofibrillas están separadas unas de otras por un espacio interfibrilar irregular; mientras que en edades postnatales, tienen una mejor organización y muchas de ellas están empaquetadas en masas confluentes y compactas que se fusionan para formar f ibras largas, ramificadas y se disponen siguiendo el eje longitudinal de la célula, intercaladas con filas de mitocondrias. Esta conformación se relaciona con la forma alargada de los cardiomiocitos y con el aumento de la longitud de las miofibrillas; mientras que la presencia en el sarcoplasma de grandes áreas electrón- translucidas se reducen a medida que aumenta la maduración, producto de la diferenciación estructural de la síntesis, organización de las miofibrillas y otras organelas. Estos cambios morfológicos en la citoarquitectura son consecuencia de la adaptación del miocardio postnatal a las exigencias de trabajo p oco después del nacimiento y además, están relacionados con los cambios circulatorios que ocurren en el periodo neonatal

Efecto citotóxico de los compuestos de inclusión de paladio (II) en la beta-ciclodextrina

Introduction: Thiosemicarbazones and palladium (II) complexes have antineoplastic activities with mild side effects, for which they are considered new alternative antineoplastic drugs. However, the IC50 ranges of these complexes vary due to differences in their structure and solubility and their sensitivities for various cellular targets. Beta-cyclodextrin is an additive used to improve the solubility and stability of various drugs for therapeutic use, but the combination of beta-cyclodextrin with palladium (II) complexes and thiosemicarbazones has not been tested yet.Objective: To study the cytotoxic effect of palladium (II) inclusion complexes in beta-cyclodextrin.Materials and methods: We tested the cytotoxic activity of palladium complexes combined with beta-cyclodextrin in the breast cancer cell line MCF-7 using a sulforhodamine B assay.Results: We tested the antiproliferative activity of palladium (II) complexes with and without the ligands MePhPzTSC and Ph2PzTSC and with and without beta-cyclodextrin in MCF-7 cells and compared them to that of cisplatin. All combinations showed antiproliferative activity; however, the activity was greater for the combinations that included beta-cyclodextrin: ([Pd (MePhPzTSC) 2] • ß-CD and [Pd (Ph2PzTSC) 2] • ß-CD), at concentrations of 0.14 and 0.49 μM, respectively. The IC50 for this complex was 5-fold lower than that of the ligand-free combinations (1.4 and 2.9 μM, respectively). The IC50 for free palladium (II) complex was 0.571.24 μM and that for cisplatin was 6.87 μM.Conclusions: Beta-cyclodextrin significantly enhanced the cytotoxic activities of palladium (II) complexes and thiosemicarbazones probably by improving their solubility and bioavailability. The addition of beta-cyclodextrin is a possible strategy for designing new anticancer drugs.Introducción. Las tiosemicarbazonas y sus complejos de paladio (II) poseen actividad antineoplásica con pocos efectos secundarios, por lo cual se las considera como una nueva alternativa terapéutica. Sin embargo, existen diferencias en los rangos de la concentración inhibitoria media (CI50) asociada a la divergencia estructural y la solubilidad de los complejos, así como a la sensibilidad de los blancos celulares. La inclusión de fármacos en la beta-ciclodextrina con fines terapéuticos ha mejorado su solubilidad y estabilidad, pero los efectos de su combinación con los complejos de paladio (II) y las tiosemicarbazonas no se han comprobado aún.Objetivo. Estudiar el efecto citotóxico de los complejos de paladio en la beta-ciclodextrina.Materiales y métodos. La actividad citotóxica de los complejos de paladio en la beta-ciclodextrina se evaluó en la línea celular de cáncer de mama (MCF-7), empleando el método de la sulforodamina B.Resultados. Los ligandos MePhPzTSC y Ph2PzTSC, sus complejos de paladio (II) libres e incluidos en la beta-ciclodextrina y el cisplatino mostraron actividad citotóxica en la línea celular MCF-7; sin embargo, la citotoxicidad fue mayor con la inclusión en la beta-ciclodextrina ([Pd(MePhPzTSC)2]•ß-CD y [Pd(Ph2PzTSC)2]•ß-CD). La concentración inhibitoria media (CI50) para estos complejos se obtuvo en concentraciones de 0,14 y 0,49 μM, y con dosis hasta cinco veces inferiores comparadas con las concentraciones de los ligandos libres (1,4 y 2,9 μM), de los complejos de paladio (II) libres (0,57 y 1,24 μM) y del cisplatino (6,87 μM).Conclusiones. El uso de la beta-ciclodextrina mejoró significativamente la actividad citotóxica de las tiosemicarbazonas y sus complejos de paladio (II), lo cual probablemente está asociado al incremento de la solubilidad y biodisponibilidad del compuesto, estrategia que se puede sugerir para el diseño de futuros fármacos antineoplásicos

Pharmaceutical and Botanical Management of Pain Associated with Psychopathology: A Narrative Review

Generally, pain can be described as an unpleasant sensory or emotional experience associated with tissue damage. Chronic pain has become a public health problem because among 35 and 75% of the world population has shown the symptom. In particular, neuropathic pain has shown high comorbidity disorders such as anxiety and depression. Conventional therapies for treating pain include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, tricyclic antidepressants, anticonvulsants, and opioids, which usually cause some side effects such as gastritis, headache, liver and kidney toxicity, and drug dependence. Conventional pharmaceuticals also tend to be expensive, and they cannot be easily afforded in developing countries, which have led to the use of natural products as an alternative treatment. In this chapter, we reviewed the current research of natural products for pain treatment. We also describe preclinical studies that assess the effect of some natural products on pain therapy, phytochemistry research, toxicity, adverse effects, and biosecurity. We also describe how conventional pain is managed and the possible use of compounds obtained from vegetable species for pain treatment

Metabolitos secundarios de líquenes de la zona nival de la Sierra Nevada de Mérida-Venezuela y su papel en la absorción de la radiación ultravioleta

Photochemical analyses of secondary compounds in lichens from the venezuelan andean snow zone were carried out in order to know the absorbance capacity of UV radiation at the UVA, UVB and UVC ranges and to determine its probable UV protective function. Spectrophotometric (UV) and fine layer chromatographic techniques (TLC) were utilized to separate and identify the compounds. UV radiation values were obtained from the Red Bioclimática del Parque Nacional Sierra Nevada de Mérida which constitutes a program supported by the University of Los Andes, Venezuela. Results indicated the existence of 22 species of lichens at the snow zone; 55% of these species showed a strong resistance to UVC radiation, 95% to UVB radiation, whereas the 100% revealed a strong resistance to UVA radiation. The substances that have the highest resistance to UVA and UVB radiation are characterized by having ester bonds among phenolic units depsids and constitute the most abundant products in lichens, whereas the substances having both ester and ether bonds among the two phenolic units depsidones revealed a higher capacity to absorb UVC radiation that could indicate a primitive origin.Se hicieron análisis fotoquímicos de compuestos secundarios presentes en líquenes de la zona nival andina venezolana con la finalidad de conocer su capacidad de absorber las radiaciones ultravioletas UVA, UVB y UVC e inferir en la probable función protectora de estos compuestos ante estas radiaciones. Para la separación e identificación de sustancias se utilizaron técnicas espectrofotométricas (UV) y técnicas de cromatografía de capa fina (TLC). Para el estudio climático de la zona nival se utilizaron registros de la Red Bioclimática del Parque Nacional Sierra Nevada de Mérida, Programa de la Universidad de Los Andes, Venezuela. Los resultados revelaron que, de las 22 especies encontradas, el 55% presentó una resistencia potencial a la radiación UVC, el 95% a la radiación UVB y el 100% a la radiación UVA. Entre las sustancias identificadas, las que presentaron mayor resistencia a las radiaciones UVA y UVB se caracterizan por presentar enlaces tipo éster entre las unidades fenólicas (dépsidos) y constituyen los productos más abundantes en estos líquenes. Mientras que, las sustancias con enlaces tipo éster y éter entre las dos unidades fenólicas (depsidonas), tienen alta capacidad de absorber radiación UVC, lo cual sugiere que el fenómeno de protección podría ser de origen primitivo

Territorios sustentables en contexto de pandemia

La obra ofrece trabajos que brindan un conocimiento científico sobre el impacto de la pandemia en la salud, la economía, el ambiente y los territorios y se plantean desafíos para hacer más sostenible la vida en las ciudades y en el campo para insertarse y poder competir a nivel global

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

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings

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