La calidad de vida oral en un grupo de adultos mayores de la ciudad de Medellín, Colombia

Antecedentes/Objetivos: La transición demográfica que se presenta en la última década implica un esfuerzo para los profesionales de la salud bucal en conocer como es el comportamiento de los pacientes mayores de 65 años y en especial la comprensión de los impactos que se generan a nivel de su Calidad de Vida Oral-CVO. Muchos estudios se plantean hoy para el análisis en estas dimensiones subjetivas que resumen el vínculo estrecho entre la salud oral y general del paciente mayor, sin embargo, nuestro objetivo es conocer el impacto de las condiciones bucales en la calidad de vida de un grupo de pacientes mayores que frecuentan la red pública hospitalaria en la ciudad de Medellín. Métodos: Estudio de corte trasversal con muestreo aleatorio de 2 etapas en unidades hospitalarias y centros de salud de la red de salud pública “METROSALUD”. La muestra incluyó 352 adultos ≥ 65 años quienes se sometieron a un examen bucal y una encuesta estructurada. Se analizaron las características socio-demográficas y se aplicó el Índice de Calidad de Vida Oral en Geriatría –GOHAI con análisis por separado para los hombres (H) y mujeres (M). Resultados: Siendo enfocada la atención pública de la red hospitalaria principalmente para usuarios de niveles socioeconómico medio-bajo, los hallazgos ratifican que el 84% de los mayores viven particularmente en este entorno. Los indicadores muestran un CAOD de 23,8; IC95%: 22,7-24,8 (H: 23,3; IC95% 21,8-24,8 y M: 24,3; IC95% 23,0-25,6) y una tendencia del GOHAI hacia niveles bajos en el 67,9% de los entrevistados (M: 68,9%, M: 67,3%) con diferencias estadísticamente significativas según el sexo. Un indicador GOHAI de 44,42 (IC95%) en CVO indica una interpretación negativa del índice, sin embargo, estudios realizados con una metodología similar en países como Brasil (GOHAI: 33,8-CAOD: 26,7) y Arabia Saudí (GOHAI: 32,1-CAOD: 20,7), reportan valores muy negativos respecto a los encontrados en nuestro estudio. La Calidad de Vida Oral de los pacientes mayores de la ciudad de Medellín, se aproxima a niveles de comunidades estudiadas en China (GOHAI: 48,9-CAOD: 18,8), Malasia (GOHAI: 46,2-CAOD: 20,2) e incluso Francia (GOHAI: 46). Conclusiones: La calidad de vida oral con niveles bajos en la población adulta mayor de la ESE Metrosalud de Medellín, se ve impactada negativamente según los resultados asociados al estado de la dentición. Se plantea el análisis de las dimensiones de malestar psicológico, dolor físico y limitación funcional y la oportunidad para priorizar con estrategias que fortalezcan la Atención Primaria

El acceso a los servicios de salud bucodental para la población adulta mayor en la red hospitalaria pública de Medellín (Colombia)

Antecedentes/Objetivos: La población adulta mayor es un grupo poblacional significativo teniendo en cuenta los cambios demográficos de las últimas décadas. En el país y en la ciudad de Medellín, este grupo presenta alta vulnerabilidad social, así mismo se observan necesidades en salud bucal, descritas en los estudios nacionales y regionales en el tema. Aunque se han realizado investigaciones que tratan de identificar determinantes que afectan el acceso y la utilización de los servicios de salud, los estudios en salud bucal son más escasos y en especial en la población adulta mayor. Objetivo: identificar barreras y facilitadores de acceso a los servicios de salud bucal en población adulta mayor atendida en la red hospitalaria pública de Medellín desde la perspectiva del personal de salud. Métodos: Estudio cualitativo. Se realizaron 34 entrevistas semiestructuradas en personal que presta servicios de salud en la red Metrosalud de Medellín. Se identificaron barreras y facilitadores según el modelo de Tanahashi sobre cobertura en los servicios de salud a través de 4 categorías: disponibilidad (D), accesibilidad (A), aceptabilidad (P) y contacto con el servicio (C). Se utilizó la herramienta informática AtlasTi. Resultados: Se identificaron barreras relacionadas con: dificultades en la implementación de políticas sociales debido a que la salud bucal no es una prioridad; se han priorizado otras poblaciones para dar atención en salud bucal y existe insuficiente recurso humano para prestar los servicios de salud (D); la situación de discapacidad de los adultos mayores (A); aspectos educativos, culturales y de género (P); y la crisis del sector salud como una barrera estructural del sistema (C). En cuanto a los facilitadores se mencionan: la existencia de programas que facilitan la demanda inducida a programas de salud bucal y de mecanismos para hacer valer los derechos en salud a través de instancias gubernamentales y otras (D); la ubicación de las unidades y centros de salud en zonas de fácil acceso (A); la capacidad de los profesionales para atender esta población (P) y la articulación de la odontología con otras áreas (C). Conclusiones: Se identificaron determinantes que afectan el acceso a servicios sanitarios en la población adulta mayor, por lo que se requieren estrategias para mejorar la calidad de la atención en salud bucal en este grupo socialmente vulnerable.E.S.E Metrosalud. Medellín (Código: C02-E11-L3-01)

ETV5 transcription program links BDNF and promotion of EMT at invasive front of endometrial carcinomas

Myometrial infiltration represents a main clinical determinant of endometrial carcinomas (EC) presenting as aggressive high-grade deeply invasive neoplasms, substantially associated with risk of recurrence and death. The up-regulation of ETV5 transcription factor linked to the promotion of epithelial to mesenchymal transition is considered as a basic mechanism underlying the initial steps of EC invasion. In this work, we aimed to investigate the transcription program of tumor invasion regulated by ETV5. We performed a comparative Chip-on-chip analysis at invasive front and superficial area of human EC. ETV5 specific binding to promoter regions of genes related to cellular migration, adhesion and invasion at deep invasion tumor areas highlighted the relevance of neural networks associated with cellular plasticity. Interestingly, brain-derived neurotrophic factor (BDNF) demonstrated a principal role orchestrating ETV5-mediated epithelial-to-mesenchymal transition in endometrial cancer. Impairment of the BDNF/tropomyosin-related kinase B (TrkB)/extracellular signal-regulated kinase axis in endometrial cancer cell lines reversed the aggressive and invasive phenotype promoted by the up-regulation of ETV5 at the invasive front of EC. Likewise, BDNF directly impacted on the efficiency of ETV5 promoted metastasis in a mice model of endometrial distant dissemination. These results translate the recognized role of BDNF/TrkB on neural plasticity into a relevant cancer metastasis event; suggest common mechanisms shared by neural development and tumor invasion; and offer new therapeutic opportunities specifically directed against disseminated disease in endometrial cancer

Improving zebrafish embryo xenotransplantation conditions by increasing incubation temperature and establishing a proliferation index with ZFtool

Background Zebrafish (Danio rerio) is a model organism that has emerged as a tool for cancer research, cancer being the second most common cause of death after cardiovascular disease for humans in the developed world. Zebrafish is a useful model for xenotransplantation of human cancer cells and toxicity studies of different chemotherapeutic compounds in vivo. Compared to the murine model, the zebrafish model is faster, can be screened using high-throughput methods and has a lower maintenance cost, making it possible and affordable to create personalized therapies. While several methods for cell proliferation determination based on image acquisition and quantification have been developed, some drawbacks still remain. In the xenotransplantation technique, quantification of cellular proliferation in vivo is critical to standardize the process for future preclinical applications of the model. Methods This study improved the conditions of the xenotransplantation technique – quantification of cellular proliferation in vivo was performed through image processing with our ZFtool software and optimization of temperature in order to standardize the process for a future preclinical applications. ZFtool was developed to establish a base threshold that eliminates embryo auto-fluorescence and measures the area of marked cells (GFP) and the intensity of those cells to define a ‘proliferation index’. Results The analysis of tumor cell proliferation at different temperatures (34 °C and 36 °C) in comparison to in vitro cell proliferation provides of a better proliferation rate, achieved as expected at 36°, a maintenance temperature not demonstrated up to now. The mortality of the embryos remained between 5% and 15%. 5- Fluorouracil was tested for 2 days, dissolved in the incubation medium, in order to quantify the reduction of the tumor mass injected. In almost all of the embryos incubated at 36 °C and incubated with 5-Fluorouracil, there was a significant tumor cell reduction compared with the control group. This was not the case at 34 °C. Conclusions Our results demonstrate that the proliferation of the injected cells is better at 36 °C and that this temperature is the most suitable for testing chemotherapeutic drugs like the 5-FluorouracilThis research was funded by the Fondo de Investigación Sanitaria (Instituto Carlos III) - FIS project (PI13/01388). The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing of this manuscriptS

Dolor en personas ancianas con dependencia: programa de visita domiciliaria adaptado culturalmente a población rural

Objetivo Evaluar los efectos de un programa de visita domiciliaria culturalmente adaptado sobre la intensidad del dolor de personas ancianas en situación de discapacidad y pobreza en la población rural de Cáqueza-Cundinamarca.Método Estudio cuasi-experimental con pre-prueba y post-prueba. Participaron 34 mayores de 60 años con deficiencia física o visual y dependencia total o parcial. El programa de visita domiciliaria constó de siete visitas con un promedio de dos horas de duración y un intervalo de 13 a 15 días. Para el manejo del dolor se propuso un sincretismo entre medicamentos, plantas medicinales y remedios caseros. El dolor se evaluó con la escala verbal del dolor y en diario de campo fueron registrados los datos cualitativos. Se aplicó la prueba de rangos asignados de Wilcoxon.Resultados En la pre-prueba el 100 % tenían un tipo de dolor y en la post-prueba hubo efectos favorables y significativos (p.valor 0.001) en la disminución del dolor. Cualitativamente son atribuidos los cambios en parte al desarrollo del programa y otras explicaciones corresponden a los valores y creencias del grupo.Conclusiones El programa de visita domiciliaria adaptado culturalmente deja evidencia cómo ofrecer una respuesta donde se dialoga entre el saber popular y profesional logrando una práctica segura y adaptada al universo cultural de las personas. Latinoamerica requiere de profesionales culturalmente sensibles a las expresiones y percepciones de dolor con curiosidad para explorar en la evidencia las posibilidades terapéuticas de las propuestas provenientes del saber popular.Objective To assess the effects of a culturally adapted home visit program on pain intensity in elderly people with disability and poverty conditions in the rural population of Cáqueza-Cundinamarca, Colombia.Method Quasi-experimental study with pre-test and post-test. The study included 34 people over 60 years of age with physical or visual impairment and total or partial dependence. The home visit program consisted of seven visits paid for an average of two hours and an interval of 13 to 15 days. A syncretism of drugs, medicinal plants and home remedies was proposed for pain management. Pain was assessed using the verbal pain scale and qualitative data were recorded in the field diary. Wilcoxon signed-rank test was applied.ResultsDuring the pre-test, 100 % of the participants presented with a type of pain, while favorable and significant effects were observed in the post-test (p value s0.001) in relation to pain reduction. Changes are qualitatively attributed, partly, to the development of the program and other explanations include values and beliefs of the group.Conclusions The culturally adapted home visits program shows that it is possible to act in contexts where dialoguesoccur between popular and professional knowledge, achieving a safe practice adapted to the cultural universe of people.Latin America requires professionals culturally sensitive to expressions and perception

Cannabinoid receptor CB2 ablation protects against TAU induced neurodegeneration.

Tauopathies are a group of neurodegenerative diseases characterized by the alteration/aggregation of TAU protein, for which there is still no effective treatment. Therefore, new pharmacological targets are being sought, such as elements of the endocannabinoid system (ECS). We analysed the occurrence of changes in the ECS in tauopathies and their implication in the pathogenesis. By integrating gene expression analysis, immunofluorescence, genetic and adeno-associated virus expressing TAU mouse models, we found a TAU-dependent increase in CB2 receptor expression in hippocampal neurons, that occurs as an early event in the pathology and was maintained until late stages. These changes were accompanied by alterations in the endocannabinoid metabolism. Remarkably, CB2 ablation in mice protects from neurodegeneration induced by hTAU P301L overexpression, corroborated at the level of cognitive behaviour, synaptic plasticity, and aggregates of insoluble TAU. At the level of neuroinflammation, the absence of CB2 did not produce significant changes in concordance with a possible neuronal location rather than its classic glial expression in these models. These findings were corroborated in post-mortem samples of patients with Alzheimer’s disease, the most common tauopathy. Our results show that neurons with accumulated TAU induce the expression of the CB2 receptor, which enhances neurodegeneration. These results are important for our understanding of disease mechanisms, providing a novel therapeutic strategy to be investigated in tauopathiespost-print8580 K

Acciones para favorecer la permanencia. Universidad de Antioquía. 2011 Colombia

El presente documento describe diferentes acciones de la Universidad de Antioquia que tienen como propósito favorecer la graduación de los estudiantes y prevenir la deserción. En la primera parte del documento se definen conceptos como permanencia y retención, y posteriormente se presenta a la institución educativa en la que se desarrollan dichas acciones. En la segunda parte del documento se plantean estrategias institucionales relacionadas con ampliación de cobertura y acceso a la universidad, adaptación social y académica, y otras estrategias institucionales

Nitrogen-carbon graphite-like semiconductor synthesized from uric acid

A new carbon-nitrogen organic semiconductor has been synthesized by pyrolysis of uric acid. This layered carbon-nitrogen material contains imidazole-, pyridine (naphthyridine)- and graphitic-like nitrogen, as evinced by infrared and X-ray photoelectron spectroscopies. Quantum chemistry calculations support that it would consist of a 2D polymeric material held together by hydrogen bonds. Layers are stacked with an interplanar distance between 3.30 and 3.36 Å, as in graphite and coke. Terahertz spectroscopy shows a behavior similar to that of amorphous carbons, such as coke, with non-interacting layers. This material features substantial differences from polymeric carbon nitride, with some characteristics closer to those of nitrogen-doped graphene, in spite of its higher nitrogen content. The direct optical band gap, dependent on the polycondensation temperature, ranges from 2.10 to 2.32 eV. Although in general the degree of crystallinity is low, in the material synthesized at 600 °C some spots with a certain degree of crystallinity can be found

Groups without cultured representatives dominate eukaryotic picophytoplankton in the oligotrophic South East Pacific Ocean

Background: Photosynthetic picoeukaryotes (PPE) with a cell size less than 3 µm play a critical role in oceanic primary production. In recent years, the composition of marine picoeukaryote communities has been intensively investigated by molecular approaches, but their photosynthetic fraction remains poorly characterized. This is largely because the classical approach that relies on constructing 18S rRNA gene clone libraries from filtered seawater samples using universal eukaryotic primers is heavily biased toward heterotrophs, especially alveolates and stramenopiles, despite the fact that autotrophic cells in general outnumber heterotrophic ones in the euphotic zone. Methodology/Principal Findings: In order to better assess the composition of the eukaryotic picophytoplankton in the South East Pacific Ocean, encompassing the most oligotrophic oceanic regions on earth, we used a novel approach based on flow cytometry sorting followed by construction of 18S rRNA gene clone libraries. This strategy dramatically increased the recovery of sequences from putative autotrophic groups. The composition of the PPE community appeared highly variable both vertically down the water column and horizontally across the South East Pacific Ocean. In the central gyre, uncultivated lineages dominated: a recently discovered clade of Prasinophyceae (IX), clades of marine Chrysophyceae and Haptophyta, the latter division containing a potentially new class besides Prymnesiophyceae and Pavlophyceae. In contrast, on the edge of the gyre and in the coastal Chilean upwelling, groups with cultivated representatives (Prasinophyceae clade VII and Mamiellales) dominated. Conclusions/Significance: Our data demonstrate that a very large fraction of the eukaryotic picophytoplankton still escapes cultivation. The use of flow cytometry sorting should prove very useful to better characterize specific plankton populations by molecular approaches such as gene cloning or metagenomics, and also to obtain into culture strains representative of these novel groups

New ict and Traditional Educational Methods (tem) in Oral Health Education among Basic Primary Students

Introduccion: se pretende evidenciar los efectos mediadores de las nuevas TIC y los metodos educativos tradicionales (MET), en el tema del cuidado bucal, por medio de indicadores de higiene bucal, conocimientos, actitudes y practicas escolares en estudiantes de Basica Primaria de la Institucion Educativa Francisco Miranda, Medellin. Metodos : estudio evaluativo a traves de elementos de un estudio cuantitativo y descriptivo con datos de tres momentos en el tiempo: primer momento, marzo de 2011 (momento base o linea base); segundo momento, mayo de 2011 (luego de implementar MET); tercer momento, noviembre de 2011 (luego de implementar NTIC). Se hicieron examenes clinicos para indicadores de higiene bucal (IHO) y encuestas a escolares sobre conocimientos, actitudes y practicas respecto al cuidado bucal. Resultados : existe una mejoria en conocimientos y practicas de escolares participantes del estudio, la cual se visibilizo en el segundo momento, al implementar los MET. Se presento un cambio positivo en la higiene bucal, en la clasificacion buena, de 10 a 46%, e igualmente positiva en la clasificacion regular y mala, de 66 a 44% y de 24 a 10%, respectivamente. El uso de ntic puede arrojar resultados positivos en aprendizajes y conocimientos de habitos de higiene bucal, siempre y cuando estas sean constantes y motivadoras. Conclusiones : los indicadores observados permitieron evaluar positivamente los resultados del estudio; se invita al fortalecimiento de estrategias de Educacion para la Salud (EpS) mediadas por ntic para aprendizajes cognoscitivos significativos y por met para aprendizaje y desarrollo de habilidades practicas significativas, en proyectos educativos institucionales (PEI).Introduction: The aim is to show the mediating effects of new ICT and traditional educational methods (TEM) in the field of oral health, using indicators for oral hygiene, knowledge, attitudes and school practices Basic Primary Students at the Francisco Miranda Educational Institution in Medellín. Methods: an evaluative study using quantitative and descriptive elements with data from three moments in time: first moment, March 2011 (base moment or baseline); second moment, May 2011 (after TEM implementation); third moment November 2011 (after implementing NICT). Clinical examinations were performed for oral hygiene indicators (IHO from the Spanish acronym) and surveys were applied among the schoolchildren about oral health knowledge, attitudes and practices. Results: There has been an improvement in the knowledge and practices of primary school students participating in the study, which was evident during the second moment, which followed implementation of the TEM. There was a positive change in oral health, with those classified as good going from 10% to 46%, as well as among those classified as middling or deficient, increasing from 44% to 66% and from 10% to 24%, respectively. The use of nict can have positive results in learning and knowledge of oral health habits, as long as it is constant and motivating. Conclusions: The indicators observed led to a positive assessment of the results of the study; the study invites us to strengthen Health Education strategies using nict for significant cognitive learning and those using tem for learning and developing significant practical abilities in institutional educational projects (PEI from the Spanish acronym).Facultad de Ciencias Médica