Diseño y validación del caso de estudio “Determinación de sustancias ilícitas” para la enseñanza-aprendizaje de la Química Analítica

Artículo número 5 de la Sección 1. Educación Química.Esta investigación tiene por objetivo estudiar la metodología de “Estudio de caso” como un modelo educativo innovador para diseñar casos de estudio a partir de hechos reales, estudios y artículos científicos, centrado en el Área de la Química Analítica. En este trabajo se presenta un caso del tema de la detección de sustancias ilegales. Para los estudiantes, la propuesta del estudio de las técnicas cromatográficas resultó atractiva al presentar su aplicación en situaciones reales, aumentó su curiosidad por investigar más sobre los temas de la asignatura y su habilidad crítica se desarrolló de mejor forma. La metodología del estudio de casos comprobó ser una propuesta altamente viable para la enseñanza de la Química Analítica.This research aims to study the "Case Study" methodology as an innovative educational model to design case studies based on real facts, studies and scientific articles, focused on the area of Analytical Chemistry. This paper presents a case study of the detection of illegal substances. For the students, the proposal of the study of chromatographic techniques was attractive as it presented their application in real situations, increased their curiosity to investigate more about the topics of the subject and their critical skills were better developed. The methodology of the case study proved to be a highly viable proposal for the teaching of Analytical Chemistry

microRNA-34a and Long Non-Coding RNA MALAT1 Is Associated With HPV Status and Viral Load In Premalignant Cervical Lesions

Background: Cervical cancer (CC) is one of the most common gynecological malignancies in the world, and human papillomavirus (HPV) infection is the most important risk factor for their development. Although there are methods for the early detection of CC and HPV infection, but there are not highly sensitive and specific, for it´s necessary to investigate alternatives such as miR-34a and MALAT1, implicated in the pathogenesis of CC. The objective was to evaluate the association of HPV status, viral load, the presence of coinfections, and the grade of CC precursor lesions with miR-34a and MALAT1 expression in patients with high and low-grade cervical lesions (CL) and patients without CL but HPV+. Methods: Liquid-based cervical cytology (LBCC) specimens were obtained from 67 women diagnosed with low and high-grade CL, as well as LBCC HPV+, from which DNA and RNA were extracted. From DNA we genotyped and quantified the viral load for HPV 16, 18, and 51. From RNA, we performed a retrotranscription and evaluated the expression of MALAT1 (n=67) and miR-34a (n=29), all using a droplet-digital PCR assay. Statistical analysis was performed with SPSS 27.0 software using U Mann-Whitney and Kruskal-Wallis tests. Results: We identified a statistically significant association between the under-expression of miR-34a, HPV+ status (p=0.010), coinfections (p=0.030), low (p =0.042), and high viral load (p=0.014), but not with the lesion grade. Also, MALAT1 overexpression was associated with HPV+ status (p=0.008) and high viral load (p =0.027), but not with co-infections or the grade of CC precursor lesions. Conclusions: The expression of MALAT1 and miR-34a are associated with HPV status and viral load, but not with the grade of CC precursor lesions

Implementing HPV testing in 9 Latin American countries : the laboratory perspective as observed in the ESTAMPA study

Correspondence: Maribel Almonte [email protected] article was submitted to Infectious Diseases - Surveillance, Prevention and Treatment, a section of the journal Frontiers in Medicine.Background: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings. Methods: We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described. Results: Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs. Conclusion: High readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a "culture of quality" should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening.Consejo Nacional de Ciencia y TecnologíaPrograma Paraguayo para el Desarrollo de la Ciencia y Tecnología. Proyectos de investigación y desarroll

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Diseño y validación de un instrumento para medir la autoeficacia para lactar de mujeres embarazadas mexicanas

Exclusive breastfeeding (EB) is a health behavior with a greatest health protective value for children and mothers. Self-efficacy is a predictor of different health behaviors. The objective of this research was to design and validate aninstrument to measure self-efficacy to breastfeed in pregnant women. An instrumental study was conducted with users of two primary health care centers, selected through a non-probabilistic sampling. Those women who wereilliterate or had a medical condition that contraindicated EB were excluded. Descriptive, bivariate and multivariate analysis were used to obtain the psychometric properties of the instrument. 369 women participated. An exploratory factorial analysis resulted in a 15 items unidimensional structure that explained 83% of the total variance of the scale (Cronbach’s alpha = .93). In addition, self-efficacy for breastfeeding was associated (p<.05) with intention to breastfeed, age and scholarship. The breastfeeding self-efficacy scale obtained showed adequate psychometric properties. So, it can be useful to identify women who may be at risk of not initiate breastfeeding from birth, as well as, it seems to be the first breastfeeding self-efficacy scale in Mexico.La lactancia materna exclusiva (LME) es una de las conductas saludables con mayor valor protector para la salud del niño y de la madre. La autoeficacia es un predictor de diferentes conductas saludables. El objetivo de esta investigaciónfue diseñar y validar un instrumento para medir la autoeficacia para lactar en mujeres embarazadas. Se realizó un estudio instrumental con usuarias de dos centros de salud de primer nivel de atención, seleccionadas a través de unmuestreo no probabilístico. Se excluyeron aquellas mujeres que fueran analfabetas o tuvieran alguna condición médica que contraindicara la LME. Se utilizaron análisis descriptivos, bivariados y multivariados para obtener las propiedades psicométricas del instrumento. Participaron 369 mujeres. A través de un análisis factorial exploratorio se obtuvo una estructura unidimensional de 15 reactivos que explicó el 83% de la varianza total del instrumento (alfa de Cronbach = .93). Además, la autoeficacia para lactar se asoció (p <.05) con la intención para lactar, la edad y la escolaridad. El instrumento de autoeficacia para lactar obtenido mostró propiedades psicométricas adecuadas por lo que puede ser útil para identificar a las mujeres que están en riesgo de no iniciar la LME desde el nacimiento de su hijo, además, parece ser el primer instrumento de autoeficacia para lactar en México

Glomerulonephritis Associated with Cerebrospinal Fluid Shunt

La nefritis por derivación es una glomerulonefritis mediada por inmunocomplejos,que saturan el sistema reticuloendotelial y se depositan en los capilares glomerulares,con lo que activan la cascada del complemento y la reacción inflamatoria crónica que lleva a una lesión renal. El diagnóstico clínico de las infecciones no es fácil; se da por gérmenes de baja virulencia que producen una infección crónica. Sin embargo, los cultivos pueden ser negativos. En este artículo se presenta un caso de nefritis por derivación tras dos años de colocación de una válvula ventriculoatrial, confirmada con biopsia renal, con posterior resolución tras su retiro. Los cultivos del paciente, así como los de la válvula, fueron negativos.Shunt nephritis is an immune complex-mediatedglomerulonephritis, with deposits in the glomerularcapillaries which saturate the reticuloendothelialsystem, causing activation of thecomplement cascade and chronic inflammatorywhich leads to renal injury. The clinical diagnosisof infection is not easy, it is caused by lowpathogenic germs that cause chronic infection,and however, the cultures can be negative. Wepresent a case of shunt - nephritis, after twoyears of atrial ventricle valve placement withconfirmation by renal biopsy and subsequentresolution after valve removal. The cultures ofpatient and valve were negative

CD24+CD44+CD54+EpCAM+ gastric cancer stem cells predict tumor progression and metastasis: clinical and experimental evidence

Abstract Background Gastric cancer (GC) is a leading cause of cancer-related deaths worldwide. Specific and thorough identification of cancer cell subsets with higher tumorigenicity and chemoresistance, such as cancer stem cells (CSCs), could lead to the development of new and promising therapeutic targets. For better CSC identification, a complete or extended surface marker phenotype is needed to provide increased specificity for new cell targeting approaches. Our goal is to identify and characterize a putative extended phenotype for CSCs derived from patients with GC before treatment, as well as to evaluate its clinical value. In addition, we aim to ensure that cells with this phenotype have stemness and self-renewal capabilities. Methods This is a cohort study including 127 treatment-naïve patients with GC who attended the Instituto Nacional de Cancerología. Multiparametric flow cytometry analysis was performed to determine the extended phenotype of cells derived from gastric biopsies. The tumorigenic capability of cells identified in patients was assessed in a zebrafish model. Results CD24+CD44+CD54+EpCAM+ cells were present in all treatment-naïve patients included, with a median abundance of 1.16% (0.57–1.89%). The percentage of CD24+CD44+CD54+EpCAM+ cells was categorized as high or low using 1.19% as the cutoff for the CD24+CD44+CD54+EpCAM+ cell subset. Additionally, a higher TNM stage correlated with a higher percentage of CD24+CD44+CD54+EpCAM+ cells (Rho coefficient 0.369; p < 0.0001). We also demonstrated that a higher percentage of CD24+CD44+CD54+EpCAM+ cells was positively associated with metastasis. The metastatic potential of these cells was confirmed in a zebrafish model. Ultimately, under our conditions, we conclude that CD24+CD44+CD54+EpCAM+ cells are true gastric cancer stem cells (GCSCs). Conclusion The CD24+CD44+CD54+EpCAM+ cells present in tissue samples from patients are true GCSCs. This extended phenotype results in better and more specific characterization of these highly tumorigenic cells. The relative quantification of CD24+CD44+CD54+EpCAM+ cells has potential clinical value, as these cells are associated with metastatic disease, making their presence an additional prognostic marker and possibly a target for the design of new antineoplastic treatments in the era of precision oncology. Overall, the extended CD24+CD44+CD54+EpCAM+ phenotype of GCSCs could support their isolation for the study of their stemness mechanisms, leading to the identification of better molecular targets for the development of both new therapeutic approaches such as oncoimmunotherapy and new diagnostic and clinical prognostic strategies for GC

De los métodos y las maneras, número 9

Por novena ocasión el Posgrado en Diseño de la división de Ciencias y Artes para el Diseño, en colaboración con el comité organizador de “De los métodos y las maneras”, logró reunir investigaciones de especialistas en el ámbito del diseño y la investigación, así como de alumnos de cuatro de las siete líneas de investigación del posgrado de diseño. Este libro constata la persistencia en presentar temas en torno a las metodologías para hacer investigación en Diseño, además de ser una herramienta teórico - práctica, para apoyar tanto a docentes como estudiantes de los posgrados en diseño.Coordinación del Posgrado de Ciencias y Artes para el DiseñoSalvador Ulises Islas Barajas, coordinador; Sandra Rodríguez Mondragón, editora; Martín Lucas Flores Carapia, Ilustración de portada