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Background: Patients with lung cancer experience higher rates of hospitalization due to their elevated mortality and associated comorbidities. Hospital admissions among oncology patients often indicate organ vulnerability and are linked to poor prognosis. This study aimed to assess the characteristics and potential prognostic factors of hospitalized lung cancer patients. Methods: We retrospectively analyzed 646 patients admitted from June 2021 to May 2022 to the Medical Oncology Service at La Paz University Hospital (Madrid, Spain). Results: During this period, 158 patients admitted had lung cancer (24.5%). The median overall survival since admission (mOSSA) was 3.3 months (95%CI: 1.86–7.74). In the univariate analysis, poorer mOSSA was associated with admission for tumor-related causes (1.33 vs. 7.30 months, p < 0.001), ECOG ≥ 2 (2.43 vs. 8.50 months, p < 0.001), NLR ≥ 6 (1.87 vs. 7.40 months), PNI ≤ 40 (1.67 vs. 4.97 months), and LDH ≥ 210 (2.27 vs. 7.87 months, p = 0.044). In the multivariate analysis, independent prognostic factors included admission for tumor-related causes (p = 0.032, aHR 1.81, 95%CI: 1.05–3.11) and ECOG ≥ 2 (p = 0.041, aHR 1.80, 95%CI: 1.03–3.16). Conclusions: Hospital admission for lung cancer is a poor prognostic event, particularly when associated with tumor-related causes or a decline in performance status.

Background: Clinically important perioperative atrial fibrillation (POAF) is a common cardiac complication after noncardiac surgery. Little is known about how patients with POAF are managed acutely and whether practices have changed over time. Methods: We conducted an observational substudy of patients who had POAF, were at elevated cardiovascular risk, and were enrolled in the PeriOperative Ischemic Evaluation (POISE)-1, 2 and 3 trials between 2002 and 2021. POAF was defined as new, clinically important atrial fibrillation occurring within 30 days after surgery. We assessed the use of rhythm-control and anticoagulation treatment in response to POAF, at hospital discharge and at 30 days after surgery. We assessed for temporal trends using multivariable logistic regression. Results: Of the 27,896 patients included, 545 (1.9%) developed clinically important POAF. Patients received rhythm-control treatment in 48.6% of cases. The level of use of rhythm-control treatment increased over the course of the trials (POISE-1 vs POISE-2 vs POISE-3; 40.9% vs 49.5% vs 59.1%). A later randomization date was associated independently with use of rhythm-control treatment (odds ratio, 1.05 per year; 95% confidence interval, 1.01-1.09). Anticoagulation treatment was prescribed in 21% of POAF cases. The level of anticoagulation treatement use was higher in POISE-3, compared to that in the 2 previous trials (POISE-1 vs POISE-2 vs POISE-3—16.4% vs 16.5% vs 33.6%). A later randomization date was associated independently with use of anticoagulation treatment (odds ratio, 1.06 per year; 95% confidence interval, 1.02-1.11). Conclusions: Despite the absence of randomized controlled trials, the level of use of rhythm-control and anticoagulation treatment for POAF is rising. High-quality trials are needed urgently to determine whether these interventions are safe and effective in this population. Résumé: Contexte: En chirurgie non cardiaque, la fibrillation auriculaire postopératoire (FAPO) d’importance clinique est une complication cardiaque fréquente. La prise en charge ponctuelle des patients présentant une FAPO est mal connue et on ne sait pas précisément si les pratiques ont évolué au fil du temps. Méthodologie: Nous avons mené une sous-étude d’observation auprès de patients ayant présenté une FAPO et dont le risque cardiovasculaire était élevé, et qui avaient participé aux études 1, 2 ou 3 du programme d’essais cliniques POISE (PeriOperative Ischemic Evaluation) entre 2002 et 2021. La FAPO était définie comme un nouvel épisode de fibrillation auriculaire (FA) d’importance clinique au cours des 30 jours suivant une intervention chirurgicale. Nous avons évalué l’utilisation d’un traitement visant à régulariser le rythme cardiaque et de l’anticoagulothérapie dans la prise en charge d’une FAPO, au moment du congé de l’hôpital, puis 30 jours après l’intervention chirurgicale. Nous avons procédé à l’évaluation des tendances temporelles par régression logistique multivariée. Résultats: Sur les 27 896 patients inclus dans l’analyse, 545 (1,9 %) ont présenté une FAPO d’importance clinique. Dans 48,6 % des cas, les patients ont reçu un traitement visant à régulariser le rythme cardiaque. Le taux d’utilisation d’un traitement visant à régulariser le rythme cardiaque a augmenté d’une étude à l’autre (étude POISE-1 vs étude POISE-2 vs étude POISE-3; 40,9 % vs 49,5 % vs 59,1 %, respectivement). Une date plus tardive de la répartition aléatoire était un facteur indépendant de l’utilisation d’un traitement visant à régulariser le rythme cardiaque (rapport de cotes = 1,05 par an; intervalle de confiance [IC] à 95 % : 1,01-1,09). Une anticoagulothérapie a été prescrite à 21 % des patients ayant présenté une FAPO. Le taux d’utilisation d’une anticoagulothérapie était plus élevé dans l’étude POISE-3, comparativement aux deux essais précédents (étude POISE-1 vs étude POISE-2 vs étude POISE-3; – 16,4 % vs 16,5 % vs 33,6 %, respectivement). Une date plus tardive de la répartition aléatoire était un facteur indépendant d’utilisation d’une anticoagulothérapie (rapport de cotes = 1,06 par an; IC à 95 % : 1,02-1,11). Conclusions: Malgré l’absence d’essais comparatifs avec répartition aléatoire, le taux d’utilisation d’un traitement visant à régulariser le rythme cardiaque ou d’une anticoagulothérapie chez les patients présentant une FAPO est en augmentation. Il existe un besoin urgent de réaliser des études cliniques de grande qualité afin de déterminer si ces interventions sont sûres et efficaces dans cette population de patients.

COVID-19 affects the respiratory system, reducing the oxygen saturation level, leading to hypoxemia and increasing the metabolic oxygenation need. Objective: To describe the nursing interventions related to the need for oxygenation in hospitalized adults with severe COVID-19 disease in the Intensive Care Unit. Method: This was an observational, retrospective and descriptive study in a population of 2205 patients with a convenience sample of n = 430 and based on the North American Nursing Diagnosis Association (NANDA), the Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC). The analysis was performed with a non-parametric test to determine the association between the nursing interventions and the need for oxygenation. Results: The findings are aimed at improving nursing interventions with statistical associations as follow: oxygen therapy (p < 0.000), airway suctioning (p < 0.000), airway management (p = 0.029), invasive mechanical ventilation (p < 0.000) and non-invasive mechanical ventilation (p = 0.022). NOC taxonomy expected outcomes in ventilation, 34% (146), alteration in gas exchange, 33.7% (145), and respiratory status, 558.9% (253), were severely compromised. Conclusions: The nursing interventions to maintain the respiratory status are focused on airway care and oxygen therapy in order to increase the oxygen saturation level and decrease the severity of the need for oxygenation.

IntroductionThis study seeks to compare expectations regarding systemic cancer treatment for advanced lung cancer from the perspectives of both patient and medical oncologist.MethodsA cross-sectional study involving 17 medical oncologists from 13 Spanish hospitals between 2021 and 2022. Patients with advanced, unresectable lung cancer were recruited prior to initiating systemic cancer treatment. Both patients and oncologists completed the NEOetic-EIT and the STAR.ResultsSeventeen medical oncologists specializing in lung cancer participated, with a mean age of 36.2 years (range 28–56); 65% were female. The study included 298 patients with advanced, unresectable lung cancer, predominantly non-small cell type (72%), and most at stage IV (77%). Most patients were retired or unemployed (71%), and married or partnered (77%). Treatment approaches varied, with 44% based on biomarkers. Oncologists had greater expectations of positive outcomes for participants with better baseline prognosis, such as ECOG 0, newly diagnosed, locally advanced, unresectable non-small cell lung cancer, and those receiving biomarker-based treatments. In contrast, patients’ treatment expectations did not vary based on sociodemographic or clinical factors. Generally, patients had high expectations of cure, in contrast to oncologists’ lower expectations, though both anticipated similar quality-of-life improvements. Patients anticipated more side effects than oncologists. Among oncologists, expectations varied by gender and decreased with age and experience, with no differences detected among patients based on gender, age, or doctor-patient relationship.ConclusionThis study reveals the complex expectations of patients and oncologists in advanced lung cancer treatment. It underscores the need for effective communication in oncology to align patient expectations with clinical realities.

Abstract In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52–0.84; OR 0.72, 95% CI 0.56–0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43–0.92), depression (OR 0.55, 95% CI 0.37–0.81), and somatization (OR 0.59, 95% CI 0.42–0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.

En base al material depositado en el Museo Entomológico de la Universidad Nacional de Tumbes, cuyas etiquetas de colecta registran tres distritos de la región Tumbes, en este artículo se presenta el registro de Fulgora ceariensis (Da Fonseca, 1932) (Hemiptera Fulgoridae) para la región de Tumbes.

Abstract Small extracellular vesicles (sEVs) in the blood of cancer patients contain higher amounts of tumor markers than those identified as free-circulating. miRNAs have significant biomedical relevance due to their high stability and feasible detection. However, there is no reliable endogenous control available to measure sEVs-miRNA content, impairing the acquisition of standardized consistent measurements in cancer liquid biopsy. In this study, we identified three miRNAs from a panel of nine potential normalizers that emerged from a comprehensive analysis comparing the sEV-miRNA profile of six lung and ovarian human cancer cell lines in the absence of or under different conditions. Their relevance as normalizers was tested in 26 additional human cancer cell lines from nine different tumor types undergoing chemotherapy or radiotherapy treatment. The validation cohorts were comprised of 242 prospective plasma and ascitic fluid samples from three different human tumor types. Variability and normalization properties were tested in comparison to miR-16, the most used control to normalize free-circulating miRNAs in plasma. Our results indicate that miR-151a is consistently represented in small extracellular vesicles with minimal variability compared to miR-16, providing a novel normalizer to measure small extracellular vesicle miRNA content that will benefit liquid biopsy in cancer patients.

Financial difficulties experienced by cancer patients negatively impact the mental health of the patients. The objective of this study was to examine the mediating role of financial difficulties between physical symptoms and depression in patients with advanced cancer. A prospective, cross-sectional design was adopted in the study. The data were collected from 861 participants with advanced cancer in 15 different tertiary hospitals in Spain. The participants’ socio-demographic characteristics were collected using a standardized self-report form. Hierarchical linear regression models were used to explore the mediating role of financial difficulties. In the results, 24% of patients reported a high level of financial difficulties. Physical symptoms were positively associated with financial difficulties and depression (β = 0.46 and β = 0.43, respectively), and financial difficulties was positively associated with depression (β = 0.26). Additionally, financial difficulties played a role in explaining the relationship between physical symptoms and depression, showing a standardized regression coefficient of 0.43 which decreased to 0.39 after the financial difficulties were controlled. Healthcare professionals should consider the importance of providing financial resources and emotional support to help patients and their families cope with the financial burden associated with cancer treatment and its symptoms.

As cancer progresses, patients may experience physical decline, which can impair their ability to carry out essential daily tasks. The aim of this study was to analyze the levels of physical activity in patients with advanced cancer undergoing systemic treatment and its relationship with sociodemographic, clinical, and psychological factors. A prospective, cross-sectional, multicenter study was carried out in 15 oncology departments in Spain. Patients with locally advanced, unresectable, or metastatic cancer who were candidates for systemic treatment were included. Participants completed demographic information and psychological scales. In total, 508 patients were included in the study, the majority of whom were male, over the age of 65, and diagnosed with bronchopulmonary tumors (36%) and metastatic disease. Based on their physical activity levels, participants were categorized as sedentary (20%, n = 190), engaging in light physical activity (43%, n = 412), or demonstrating moderate physical activity (37%, n = 351). Patients who were over 65 years old; had a worse baseline status (ECOG ≥ 1); lacked a partner; had a lower educational level; or were retired or unemployed were found to have lower levels of physical activity. Those with sedentary physical activity reported higher levels of psychological distress, anxiety, depression, somatization, and physical symptoms, as well as worse functional status, global health status, and well-being. Understanding the complex interplay between physical activity and sociodemographic, clinical, and psychological factors can help neuroscientists develop tailored exercise interventions that address the unique needs of advanced cancer patients.

Abstract Purpose Patients with advanced cancer suffer significant decline of their psychological state. A rapid and reliable evaluation of this state is essential to detect and treat it and improve quality of life. The aim was to probe the usefulness of the emotional function (EF) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EF-EORTC-QLQ-C30) to assess psychological distress in cancer patients. Methods This is a multicenter, prospective, observational study involving 15 Spanish hospitals. Patients diagnosed with unresectable advanced thoracic or colorectal cancer were included. Participants completed the Brief Symptom Inventory 18 (BSI-18), the current the gold standard, and the EF-EORTC-QLQ-C30 to assess their psychological distress prior to initiating systemic antineoplastic treatment. Accuracy, sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) were calculated. Results The sample comprised 639 patients: 283 with advanced thoracic cancer and 356 with advanced colorectal cancer. According to the BSI scale, 74% and 66% displayed psychological distress with an EF-EORTC-QLQ-C30 accuracy of 79% and 76% in detecting psychological distress in individuals with advanced thoracic and colorectal cancer, respectively. Sensitivity was 79 and 75% and specificity was 79 and 77% with a PPV of 92 and 86% and a NPV of 56 and 61% (scale cut-off point, 75) for patients with advanced thoracic and colorectal cancer, respectively. The mean AUC for thoracic cancer was 0.84 and, for colorectal cancer, it was 0.85. Conclusion This study reveals that the EF-EORTC-QLQ-C30 subscale is a simple and effective tool for detecting psychological distress in people with advanced cancer.

A cancer diagnosis can have a substantial impact on a patient’s mental health and quality of life. The aim of this study was to investigate the prevalence of fatigue, emotional distress, and uncertainty and examine the predictive value they have on the quality of life of advanced cancer patients. A prospective, multicenter study was conducted between February 2020 and May 2021 of individuals diagnosed with an advanced, unresectable neoplasm prior to initiating systemic antineoplastic treatment. Participants completed questionnaires to quantify fatigue, emotional distress, disease uncertainty, and quality of life. A linear regression analysis was performed to study the predictive QoL variables. The study population comprised 508 patients, 53.7% of whom were male and had a mean age of 54.9 years. The most common cancers were digestive (40.6%), bronchopulmonary (29.1%), and breast (8.5%); the most frequent histology was adenocarcinoma (63%); and most were stage IV (79.7%). More than half (55.7%) suffered fatigue, and 47.7% exhibited emotional distress; both were more prevalent among women. Fatigue, emotional distress, and disease uncertainty all correlate with diminished quality of life. Similarly, ECOG performance status and the demographic variables of age, sex, and comorbidities impacted quality of life. This patient sample displayed a high prevalence of fatigue and emotional distress, together with illness uncertainty, which are clearly linked to waning quality of life. To decrease the experience of fatigue and improve mental health treatment in cancer patients, interventions based on a biopsychosocial model must be intensified.

Background. Animal feeding and nutrition constitute the main limitation in livestock farming in arid and semi-arid zones, because it depends to a large extent on imported concentrated feed. Hydroponic green fodder (FVH) represents an efficient and economical alternative to obtain food with high nutritional value for domestic animals. However, little has been used due to ignorance of the method to produce it and its benefits. Objective. To analyze the scientific information available on the agronomic, productive and nutritional attributes of HGF, and its potential as a forage resource in animal feed. Methodology. A bibliographic review was carried out based in the following databases: Scopus, NCBI, Springer, Science direct, Google Scholar, Redalyc, ResearchGate and other digital repositories, using keywords in Spanish and English, such as hydroponic green fodder, hydroponic technology, hydroponic food and alternative fodder. Results. The HGF production cycle is basically carried out in six stages: i) seed selection, ii) seed washing and disinfection, iii) seed hydration, iv) sowing and germination, v) growth, and vi) harvest. Biomass production increases progressively in relation to a higher seed sowing density. The optimum harvest period for forage is from 12 to 14 days after sowing. However, the volume and yield of production must be assessed in terms of the nutritional quality of harvested fodder. In prolonged harvest periods, the crude protein content increases, while the dry matter content decreases. In cattle and goats, partial diet supplementation with HGF improves milk production and composition, as well as the weight gain rate and feed ratio, due to increased feed intake and nutrients digestibility. In monogastrics, the total replacement of conventional feed with HGF affects feed intake and growth rate. Implications. More research is required to determine the adequate portion of HGF in the supplementation of animal diets, without affecting their productive performance, especially in the case of monogastrics. Conclusion. The HGF technology represents a viable and economical alternative to counteract the scarcity of fresh and nutritious food, especially in dry seasons of arid and semi-arid areas; as well as in urban or suburban areas where there is limited land area for conventional fodder production.

Abstract Introduction Most cancers occur in older individuals, who are more vulnerable due to functional impairment, multiple comorbidities, cognitive impairment, and lack of socio-familial support. These can undermine patients’ sense of dignity. This study seeks to compare dignity scores in older patients with advanced cancer on sociodemographic and clinical variables and analyze the predictive value of anxiety, depression, functional limitations, and social support on dignity scores. Methods A prospective, multicenter, observational study conducted with participation of 15 hospitals in Spain from February 2020 to October 2021. Patients with newly-diagnosed, advanced cancer completed the dignity (PPDS), anxiety and depression (BSI), Social Support (Duke–UNC-11), and functional limitations (EORTC-C30) scales. Lineal regression analyses explored the effects of anxiety, depression, functional status, and social support on dignity, adjusting for sociodemographic and clinical variables. Results A total of 180 subjects participated in this study. The results of the correlation analysis revealed that dignity correlated negatively with anxiety, depression, and sex, and positively with social support, functional status, and longer estimated survival. Thus, women, and more anxious and depressed individuals scored lower on the dignity scale, whereas patients with more social support, fewer functional limitations, and longer estimated survival scored higher. Conclusion In conclusion, being female, having a lower educational level, lower estimated survival, depression, anxiety, less social support, and limited functionality are correlated with less dignity in the elderly with advanced cancer. It is a priority to manage both physical and psychological symptoms in patients with unresectable advanced cancer to mitigate psychological distress and increase their sense of dignity.

We present a catalog of stellar parameters (effective temperature T _eff , surface gravity $\mathrm{log}g$ , age, and metallicity [Fe/H]) and elemental-abundance ratios ([C/Fe], [Mg/Fe], and [ α /Fe]) for some five million stars (4.5 million dwarfs and 0.5 million giant stars) in the Milky Way, based on stellar colors from the Javalambre Photometric Local Universe Survey (J-PLUS) DR3 and Gaia EDR3. These estimates are obtained through the construction of a large spectroscopic training set with parameters and abundances adjusted to uniform scales, and trained with a kernel principal component analysis. Owing to the seven narrow/medium-band filters employed by J-PLUS, we obtain precisions in the abundance estimates that are as good as or better than those derived from medium-resolution spectroscopy for stars covering a wide range of the parameter space: 0.10–0.20 dex for [Fe/H] and [C/Fe], and 0.05 dex for [Mg/Fe] and [ α /Fe]. Moreover, systematic errors due to the influence of molecular carbon bands on previous photometric-metallicity estimates (which only included two narrow/medium-band blue filters) have now been removed, resulting in photometric-metallicity estimates down to [Fe/H] ∼ −4.0, with typical uncertainties of 0.40 dex and 0.25 dex for dwarfs and giants, respectively. This large photometric sample should prove useful for the exploration of the assembly and chemical-evolution history of our Galaxy.

Plant extracts are a valuable alternative for the control of phytopathogenic fungi in horticultural crops. In the present work, the in vitro antifungal effect of ethanol and aqueous extracts from different vegetative parts of 40 native plants of the Yucatan Peninsula on Curvularia lunata ITC26, a pathogen of habanero pepper (Capsicum chinense), and effects of the most active extracts on postharvest fruits were investigated. Among these, the ethanol extracts of Mosannona depressa (bark from stems and roots) and Piper neesianum (leaves) inhibited 100% of the mycelial growth of C. lunata. The three extracts were partitioned between acetonitrile and n-hexane. The acetonitrile fraction from M. depressa stem bark showed the lowest mean inhibitory concentration (IC50) of 188 µg/mL against C. lunata. The application of this extract and its active principle α-asarone in the postharvest fruits of C. chinense (500 µg/mL) was shown to inhibit 100% of the severity of the infection caused by C. lunata after 11 days of contact. Both samples caused the distortion and collapse of the conidia of the phytopathogen when observed using electron microscopy at 96 h. The spectrum of M. depressa enriched antifungal action is a potential candidate to be a botanical fungicide in the control of C. lunata in cultivating habanero pepper.

ObjectiveLoss of dignity is one of the main reasons for wishing for an early death in patients with incurable diseases such as cancer and is strongly associated with psychological distress and loss of quality of life. The present study aims to analyze the perceived dignity of patients with advanced cancer undergoing systemic treatment and their relationship with sociodemographic, clinical, and psychological factors.MethodsA prospective, cross-sectional, multicenter study was conducted in 15 oncology departments in Spain. Patients with locally advanced, unresectable, or metastatic cancer who were candidates for systemic treatment were included. Participants completed demographic information and Palliative Patients’ Dignity Scale, Brief Symptom Inventory, Mental Adjustment to Cancer, Functional Social Support Questionnaire, and Illness Uncertainty.ResultsA total of 508 patients were recruited between February 2020 and October 2021. Most were male, aged > 65 years, with digestive tumors (41%), and metastatic disease at diagnosis. Subjects were classified as having low (56%, N = 283) or high (44%, N = 225) perceived dignity. Patients ≥ 65 years, with worse baseline status (ECOG ≥ 1), and worse estimated 18-month survival had lower levels of perceived dignity. People with lower perceived dignity scored higher for anxious preoccupation and hopelessness and lower for positive attitude. They also displayed higher levels of anxiety, depression, and somatic symptoms, greater uncertainty, and less social support.ConclusionSelf-perceived dignity in advancer cancer patients is significantly associated with psychological factors, psychological distress, uncertainty, less social support. Knowledge of these specific interactions is importance for adequate, comprehensive palliative care.

Several platforms for noninvasive EGFR testing are currently used in the clinical setting with sensitivities ranging from 30% to 100%. Prospective studies evaluating agreement and sources for discordant results remain lacking. Herein, seven methodologies including two next‐generation sequencing (NGS)‐based methods, three high‐sensitivity PCR‐based platforms, and two FDA‐approved methods were compared using 72 plasma samples, from EGFR‐mutant non‐small‐cell lung cancer (NSCLC) patients progressing on a first‐line tyrosine kinase inhibitor (TKI). NGS platforms as well as high‐sensitivity PCR‐based methodologies showed excellent agreement for EGFR‐sensitizing mutations (K = 0.80–0.89) and substantial agreement for T790M testing (K = 0.77 and 0.68, respectively). Mutant allele frequencies (MAFs) obtained by different quantitative methods showed an excellent reproducibility (intraclass correlation coefficients 0.86–0.98). Among other technical factors, discordant calls mostly occurred at mutant allele frequencies (MAFs) ≤ 0.5%. Agreement significantly improved when discarding samples with MAF ≤ 0.5%. EGFR mutations were detected at significantly lower MAFs in patients with brain metastases, suggesting that these patients risk for a false‐positive result. Our results support the use of liquid biopsies for noninvasive EGFR testing and highlight the need to systematically report MAFs.

Resumen: A lo largo de la historia las mujeres han luchado por ser incluidas y reconocidas en el desarrollo de la ciencia médica. En la actualidad, las mujeres tienen mayor participación no solo en el estudio y ejercicio de la medicina sino en el liderazgo de diversas áreas médicas. Este artículo ofrece un panorama histórico de las primeras mujeres que formaron parte de la Academia Nacional de Medicina de México, así como una recopilación de la participación de las mujeres en puestos directivos; desde Jefaturas de Departamentos Académicos en la Universidad Nacional Autónoma de México hasta el sector salud. Abstract: Throughout history women have been fighting to be included and recognized in the development of medical science. Actually, women have more participation not only in the study and practice of medicine, but in the leadership of various medical areas. This article provides a historical review of the first women it formed part of the National Academy of Medicine of Mexico as well as a compilation of the participation of women in management positions, from Headquarters of academic departments at the National Autonomous University of Mexico including health sector.

Objective: Long-term survivors (LS) of non-small cell lung cancer (NSCLC) without driver alterations, displaying an overall survival (OS) of more than 3 years, comprise around 10% of cases in several series treated with chemotherapy. There are classical prognosis factors for these cases [stage, Eastern Cooperative Oncology Group (ECOG), etc.], but more data are required in the literature. In this multi-center study, we focused on LS of advanced NSCLC with OS above 36 months to perform a clinical-pathological and molecular characterization. Methods: In the first step, we conducted a clinical-pathological characterization of the patients. Afterwards, we carried out a genetic analysis by comparing LS to a sample of short-term survivors (SS) (with an OS less than 9 months). We initially used whole-genome RNA-seq to identify differentiating profiles of LS and SS, and later confirmed these with reverse transcription-polymerase chain reaction (RT-PCR) for the rest of the samples. Results: A total of 94 patients were included, who were mainly men, former smokers, having adenocarcinoma (AC)-type NSCLC with an ECOG of 0–1. We obtained an initial differential transcriptome expression, displaying 5 over- and 33 under-expressed genes involved in different pathways: namely, the secretin receptor, surfactant protein, trefoil factor 1 (TFF1), serpin, Ca-channels, and Toll-like receptor (TLRs) families. Finally, RT-PCR analysis of 40 (20 LS/20 SS) samples confirmed that four genes (surfactant proteins and SFTP) were significantly down-regulated in SS compared to LS by using an analysis of covariance (ANCOVA) model: SFTPA1 (P = 0.023), SFTPA2 (P = 0.027), SFTPB (P = 0.02), and SFTPC (P = 0.047). Conclusions: We present a sequential genetic analysis of a sample of NSCLC LS with no driver alterations, obtaining a differential RNA-seq/RT-PCR profile showing an abnormal expression of SF genes.

Contaminated surfaces are one of the ways that coronavirus disease 2019 (COVID-19) may be transmitted. SARS-CoV-2 can be detected on environmental surfaces; however, few environmental sampling studies have been conducted in nonclinical settings. The objective of this study was to detect SARS-CoV-2 RNA on environmental surfaces in public areas in Las Vegas, Nevada. In total, 300 surface samples were collected from high-touch surfaces from high-congregate public locations and from a public health facility (PHF) that was visited by COVID-19 patients. Environmental samples were analyzed with quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) using SARS-CoV-2 specific primers and probes for three target genes. Results showed that 31 out of 300 (10.3%) surface samples tested positive for SARS-CoV-2, 24 at the PHF and 7 in high-congregate public locations. Concentrations ranged from 102 to 106 viral particles per 3 ml sample on a wide variety of materials. The data also showed that the N gene assay had greater sensitivity compared to the S and ORF gene assays. Besides frequently touched surfaces, SARS-CoV-2 was detected in restrooms, on floors and surfaces in contact with floors, as well as in a mop water sample. The results of this study describe the extent and distribution of environmental SARS-CoV-2 contamination in public areas in Las Vegas, Nevada. A method using the N gene PCR assay was developed for SARS-CoV-2 environmental monitoring in public areas. Environmental monitoring with this method can determine the specific sites of surface contamination in the community and may be beneficial for prevention of COVID-19 indirect transmission, and evaluation and improvement of infection control practices in public areas, public health facilities, universities, and businesses.

Abstract Background Use of minimally invasive surgical techniques for lung resection surgery (LRS), such as video-assisted thoracoscopy (VATS), has increased in recent years. However, there is little information about the best anesthetic technique in this context. This surgical approach is associated with a lower intensity of postoperative pain, and its use has been proposed in programs for enhanced recovery after surgery (ERAS). This study compares the severity of postoperative complications in patients undergoing LRS who have received lidocaine intraoperatively either intravenously or via paravertebral administration versus saline. Methods/design We will conduct a single-center randomized controlled trial involving 153 patients undergoing LRS through a thoracoscopic approach. The patients will be randomly assigned to one of the following study groups: intravenous lidocaine with more paravertebral thoracic (PVT) saline, PVT lidocaine with more intravenous saline, or intravenous remifentanil with more PVT saline. The primary outcome will be the comparison of the postoperative course through Clavien-Dindo classification. Furthermore, we will compare the perioperative pulmonary and systemic inflammatory response by monitoring biomarkers in the bronchoalveolar lavage fluid and blood, as well as postoperative analgesic consumption between the three groups of patients. We will use an ANOVA to compare quantitative variables and a chi-squared test to compare qualitative variables. Discussion The development of less invasive surgical techniques means that anesthesiologists must adapt their perioperative management protocols and look for anesthetic techniques that provide good analgesic quality and allow rapid rehabilitation of the patient, as proposed in the ERAS protocols. The administration of a continuous infusion of intravenous lidocaine has proven to be useful and safe for the management of other types of surgery, as demonstrated in colorectal cancer. We want to know whether the continuous administration of lidocaine by a paravertebral route can be substituted with the intravenous administration of this local anesthetic in a safe and effective way while avoiding the risks inherent in the use of regional anesthetic techniques. In this way, this technique could be used in a safe and effective way in ERAS programs for pulmonary resection. Trial registration EudraCT, 2016–004271-52; ClinicalTrials.gov, NCT03905837. Protocol number IGGFGG-2016 version 4.0, 27th April 2017.

Antecedentes: Las metástasis tiroideas son tremendamente infrecuentes, situándose su incidencia en torno al 1-3% según los diferentes datos. El cáncer de colon es el segundo tumor que con más frecuencia produce metástasis en este órgano. Caso clínico: Se expone un caso de cáncer de colon de larga evolución con patrón metastásico atípico y aparición de metástasis tiroidea. Además, se señala la importancia del manejo multidisciplinario de esta patología y la necesidad emergente de establecer paneles de secuenciación masiva para una mejor caracterización molecular.

Presentamos un caso clínico de un tumor fibroso solitario pleural (TFSP) de comportamiento anómalo por su alta agresividad y mal pronóstico a corto plazo, en el que se identificó una translocación de ALK. El TFSP es un tumor infrecuente, con una incidencia estimada en torno a 8 casos por 100,000 habitantes y con pocos reportes en la literatura. Lo más habitual es que se trate de una neoplasia de comportamiento benigno, con debut como una masa localizada y cuyo tratamiento de elección es la resección quirúrgica. Todos los datos de la literatura contrastan con nuestra experiencia, que presentamos a continuación.

The coronavirus 19 disease (COVID-19) pandemic affected virtually all activities worldwide. One of them was education, especially Health Sciences. In the world, many medical schools ceased their face-to-face activities and implemented institutional reorganization actions. According to their characteristics and possibilities, institutions adopted different strategies and tools to continue providing their services online during this health crisis. These situations implied enormous challenges, especially for specific regions, such as Latin America. This article exposes a quick overview of the pandemic experience at the biggest Mexican School of Medicine (UNAM School of Medicine): forecasting, reorganization, actions, challenges, and learnings. Among the most challenging situations experienced were: effective communication strategies; resistance to migrating from face-to-face activities to remote activities; technological development; students and teachers training to implement work and study in virtual spaces; students digital gap; internet and computers access; construction and application of online evaluations; online evaluation of practical skills, and the impossibility of maintaining students in clinical clerkships given the pandemic risks. UNAM School of Medicine reorganized to provide integral care to its community, but it also participated in tasks for Mexico's health and other countries' health benefits. We had a great amount of work, reorganization efforts, and creativity resulting in efficient innovations and new projects. This health crisis showed the best in our community. Actions will remain along the pandemic period and a progressive reincorporation to in-place activities at the end of the health crisis. Some strategies, such as remote activities within teaching, learning, work, evaluation, and research, will be maintained. When this situation ends, we will hopefully have learned and applied those new experiences to improve our School of Medicine, transitioning into a more robust, more united, and enriched community after the crisis caused by this pandemic.

Background. In Mexico, the transition from a welfare state to a minimal state in the eighties generated a change in public policies that affected the poorest farmers in the country. Objective. This study analyzes the transformation of agroecosystem management practices in an area of the Mexican sub-humid tropics as a result of government abandonment of this productive sector. Methodology. This research is qualitative and requires techniques such as in-depth interviews and fieldwork. Thirty-seven (37) interviews were conducted with farmers over 60 years old. Participants were identified based on an intentional sample using the "snowball" technique. These findings are theoretically interpreted through Luhmann's complexity paradox. Results. The change in public policies, as well as the reduction in public spending assigned to the agricultural sector, led to changes in the management practices of agroecosystems, especially among producers with fewer resources that led to a process of differentiation between them and, at the same time, the existence of multiple interdependencies between them, as a way of dealing with the complexity derived from the conditions imposed by the predominance of a market economy, the abandonment of the government and, in recent years, the uncertainty in the behavior of the main agroclimatic variables. Implications. This work is qualitative and carried out in a local context but provides highlights on changes in areas relatively similar to the study area. Conclusion. The process of differentiation and interdependence among agroecosystems is based on the use of various technical-productive strategies, in addition to the use of collective work and social trust as social resources that help producers with fewer resources to deal with a complex problem.

The coronavirus 19 (COVID-19) pandemic affected virtually all activities worldwide. One of them was education, especially Health Sciences. Globally, many medical schools ceased their face-to-face activities and implemented institutional reorganization actions. According to their characteristics and possibilities, institutions adopted diverse strategies and tools to continue providing their services online during this health crisis. These situations implied huge challenges, especially for certain regions, such as Latin America. This article exposes a quick overview of the pandemic experience at the biggest Mexican Med School (UNAM Med School): forecasting, reorganization, actions, challenges, and learnings. Among the most challenging situations experienced were: effective communication strategies; resistance to migrate from face-to-face activities to distance activities; technological development; students and teachers training to implement work and study in virtual spaces; students digital gap; internet and computers access; construction and application of online evaluations; online evaluation of practical skills, and the impossibility of maintaining students in clinical clerkships given the pandemic hazardousness. UNAM Med School was not only reorganized to provide integral care to its community, but it also participated in tasks for the health benefit of Mexico as well as for other countries. We had a huge amount of work, reorganization efforts and creativity resulting in very helpful innovations and new projects. This health crisis showed the best of our community. Actions will remain along the pandemic period and a progressive reincorporation to in-place activities at the end of the health crisis. Some strategies such as virtual activities within teaching, learning, work, evaluation and research will be maintained. When this situation ends, we will hopefully have learned and applied that new experiences to improve our Med School, transitioning into a stronger, more united, and enriched community after the crisis caused by this pandemic.

Lung cancer (LC) continues to be the leading cause of cancer-related deaths in both men and women worldwide. After complete tumour resection, around half of the patients suffer from disease relapse, emphasising the critical need for robust relapse predictors in this disease. In search of such biomarkers, 83 patients with non-microcytic lung cancer and 67 healthy volunteers were studied. Pre-operative levels of sSIGLEC5 along with other soluble immune-checkpoints were measured and correlated with their clinical outcome. Soluble SIGLEC5 (sSIGLEC5) levels were higher in plasma from patients with LC compared with healthy volunteers. Looking into those patients who suffered relapse, sSIGLEC5 and sLAG3 were found to be strong relapse predictors. Following a binary logistic regression model, a sSIGLEC5 + sLAG3 score was established for disease relapse prediction (area under the curve 0.8803, 95% confidence intervals 0.7955–0.9652, cut-off > 2.782) in these patients. Based on score cut-off, a Kaplan–Meier analysis showed that patients with high sSIGLEC5 + sLAG3 score had significantly shorter relapse-free survival (p ≤ 0.0001) than those with low sSIGLEC5 + sLAG3 score.Our study suggests that pre-operative sSIGLEC5 + sLAG3 score is a robust relapse predictor in LC patients.

In recent years, laser resection of lung metastases has been established as the standard procedure worldwide. To avoid airway fire, it is necessary to collapse the surgical lung. The selective lobar bronchial blockade is a technique that allows one-lung ventilation while the operated lobe is collapsed in patients with previous pulmonary resection requiring subsequent resection or with limited pulmonary reserve. We report a clinical case about our experience of a selective lobar bronchial blockade technique with a bronchial blocker (Coopdech endobronchial blocker) that was employed successfully with a double-lumen endotracheal tube in a patient with previous contralateral pulmonary resection who was scheduled for atypical resections of pulmonary metastases by laser. We selectively blocked the right intermediate bronchus for management of hypoxemia during one-lung ventilation. This technique provided adequate ventilation and oxygenation during surgery, avoiding the need of two-lung ventilation during lung metastases resection by laser. Conclusion: This case shows that if a properly positioned double-lumen tube was already in place and the patient does not tolerate one-lung ventilation because of hypoxemia, it would be possible to provide selective lobar blockade by placing a bronchial blocker through the lumen of the double-lumen tube, avoiding the use of continuous positive airway pressure during laser surgery. This technique does not disturb the operative field or interrupt the operative procedure during resection by laser, which would occur during two-lung ventilation or used of continuous positive airway pressure. Resumo: Nos últimos anos, a ressecção de metástases pulmonares com o uso de laser foi estabelecida como o procedimento padrão em todo o mundo. Para evitar queimadura das vias aéreas, o colapso cirúrgico do pulmão é necessário. O bloqueio brônquico seletivo é uma técnica que permite a ventilação de um lobo, enquanto o lobo operado é colapsado nos pacientes com ressecção pulmonar anterior que requerem ressecção subsequente ou que possuem reserva pulmonar limitada. Relatamos um caso clínico de nossa experiência com a técnica de bloqueio brônquico seletivo com bloqueador brônquico (bloqueador endobrônquico Coopdech), usado com sucesso com um tubo endotraqueal de duplo lúmen em um paciente com ressecção pulmonar contralateral prévia, agendado para ressecção atípica de metástases pulmonares com o uso de laser. Seletivamente bloqueamos o brônquio intermediário direito para o controle de hipoxemia durante a ventilação monopulmonar. Essa técnica proporcionou ventilação e oxigenação adequadas durante a cirurgia, evitando a necessidade de ventilar os dois pulmões durante a ressecção de metástases pulmonares com o uso de laser. Conclusão: Este caso mostra que, se um tubo de duplo lume estiver corretamente posicionado e o paciente não tolerar a ventilação monopulmonar devido à hipoxemia, seria possível fornecer bloqueio lobar seletivo com a colocação de um bloqueador brônquico através do lume do tubo de duplo lume, evitando o uso de pressão positiva contínua de vias aéreas (PPCVA) durante a cirurgia a laser. Essa técnica não interfere no campo operatório ou interrompe o procedimento durante a ressecção por laser, que poderia ocorrer durante a ventilação dos dois pulmões ou uso de PPCVA. Keywords: Bronchial blocker, One-lung ventilation, Laser, Thoracic surgery, Palavras-chave: Bloqueador bronquial, Ventilação monopulmonar, Laser, Cirurgia torácica

This research aims to present an analysis of the compliance with applicable legal requirements relating to safety and health at work, using seven MoLE regulatory standards, in a textile laundry located in the city of São Gabriel da Palha/ES, Brazil, in 2013. The research methodology used was exploratory for field activities, bibliographic and qualitatively through interviews, analysis and inspection of documents in the workplace. The results showed unsatisfactory security conditions for work, given that the index of non-conformity to compliance with the requirements of the standards is high. The study suggests the development of a work plan for attendance to regulatory requirements. This research aims to present an analysis of the compliance with applicable legal requirements relating to safety and health at work, using seven MoLE regulatory standards, in a textile laundry located in the city of São Gabriel da Palha/ES, Brazil, in 2013. The research methodology used was exploratory for field activities, bibliographic and qualitatively through interviews, analysis and inspection of documents in the workplace. The results showed unsatisfactory security conditions for work, given that the index of non-conformity to compliance with the requirements of the standards is high. The study suggests the development of a work plan for attendance to regulatory requirements.

Background and objectives: Neuromuscular relaxants are essential during general anesthesia for several procedures. Classical anesthesiology literature indicates that the use of neuromuscular blockade in thoracic surgery may be deleterious in patients in lateral decubitus position in one-lung ventilation. The primary objective of our study was to compare respiratory function according to the degree of patient neuromuscular relaxation. Secondary, we wanted to check that neuromuscular blockade during one-lung ventilation is not deleterious. Methods: A prospective, longitudinal observational study was made in which each patient served as both treated subject and control. 76 consecutive patients programmed for lung resection surgery in Gregorio Marañon Hospital along 2013 who required one-lung ventilation in lateral decubitus were included. Ventilator data, hemodynamic parameters were registered in different moments according to train-of-four response (intense, deep and moderate blockade) during one-lung ventilation. Results: Peak, plateau and mean pressures were significantly lower during the intense and deep blockade. Besides compliance and peripheral oxygen saturation were significantly higher in that moments. Heart rate was significantly higher during deep blockade. No mechanical ventilation parameters were modified during measurements. Conclusions: Deep neuromuscular blockade attenuates the poor lung mechanics observed during one-lung ventilation. Resumo: Justificativa e objetivos: Os relaxantes neuromusculares são essenciais durante a anestesia geral para vários procedimentos. A literatura clássica de anestesiologia indica que o uso do bloqueio neuromuscular em cirurgia torácica pode ser prejudicial em pacientes posicionados em decúbito lateral com ventilação seletiva. O objetivo primário deste estudo foi comparar a função respiratória de acordo com o grau de relaxamento neuromuscular do paciente. O objetivo secundário foi verificar que o bloqueio neuromuscular durante a ventilação seletiva não é prejudicial. Métodos: Estudo observacional, prospectivo e longitudinal no qual cada paciente serviu como indivíduo de estudo e controle. Foram incluídos 76 pacientes consecutivos, agendados para cirurgia de ressecção do pulmão no Hospital Gregorio Marañon ao longo de 2013, submetidos à ventilação seletiva em decúbito lateral. Os dados do ventilador e os parâmetros hemodinâmicos foram registrados em diferentes momentos de acordo com a resposta por sequência de quatro estímulos (bloqueio intenso, profundo e moderado) durante a ventilação seletiva. Resultados: As pressões de pico, platô e média foram significativamente menores durante os bloqueios intenso e profundo. Além disso, complacência e saturação periférica de oxigênio foram significativamente maiores nesses momentos. A frequência cardíaca foi significativamente maior durante o bloqueio profundo. Não houve alteração dos parâmetros da ventilação mecânica durante as mensurações. Conclusões: O bloqueio neuromuscular profundo atenua a mecânica pulmonar deficiente observada durante a ventilação seletiva. Keywords: Neuromuscular block, One-lung ventilation, Lung resection surgery, Palavras-chave: Bloqueio neuromuscular, Ventilação seletiva, Cirurgia de ressecção pulmonar

The objective of the present essay is to present a conceptual theoretical model for the study of the homegarden from Luhmann's agroecological approach and theory of autopoietic social systems, from which the family is conceptualized as a social system. This to explore new theories that help explain and understand from another dimension the complexity of the socio-environmental phenomena that occur in this unit of study. This analysis required the revision of up-to-date scientific literature regarding the main theoretical approaches used in recent decades on the homegarden, as well as the principles that support the Luhmannian theory in question. In this way, a theoretical assembly between families was designed as a social system and a homegarden agroecosystem, whose relevance lies in exposing the subjectivity that implies the understanding of a phenomenon from first order observation carried out by the family and the second order observation that carried out by the researcher. Consequently, the second-order observer (the researcher) recognizes the existence of an immanent blind spot and the influence that his epistemic framework has on the analysis of the results of his research and what this implies in the dissemination and use of the knowledge generated. Topical issue in the design of government strategies focused on strengthening the homegarden as a key element in the economy and family well-being in rural contexts.

Fusarium equiseti strain FCHE and Fusarium oxysporum strain FCHJ were isolated from the roots of wilting habanero pepper (Capsicum chinense Jacq.) seedlings with root rot. Toward developing a biorational control of these serious phytopathogenic strains, ethanolic (EE) and aqueous (AE) extracts of different vegetative parts of 40 tropical native plants of the Yucatán Peninsula were screened for antifungal activity. Extracts of six out of 40 assayed plants were effective, and the most inhibitory extracts were studied further. EEs from Mosannona depressa (bark from stems and roots), Parathesis cubana (roots), and Piper neesianum (leaves) inhibited mycelial growth of both strains. Each active EE was then partitioned between hexane and acetonitrile. The acetonitrile fraction from M. depressa stem bark (MDT-b) had the lowest minimum inhibitory concentration of 1000 µg/mL against both pathogens and moderate inhibitory concentration (IC50) of 462 against F. equiseti and 472 µg/mL against F. oxysporum. After 96 h treatment with EE from M. depressa stem bark, both strains had distorted hyphae and conidia and collapsed conidia in scanning electron micrographs. Liquid chromatography–ultraviolet–high resolution mass spectrometry analysis revealed that the major component of the fraction was α-asarone. Its antifungal effect was verified using a commercial standard, which had an IC50 of 236 µg/mL against F. equiseti and >500 µg/mL against F. oxysporum. Furthermore, the P. cubana hexane fraction and P. neesianum acetonitrile fraction had antifungal activity against both Fusarium pathogens. These compounds provide new options for biorational products to control phytopathogenic fungi.

La diabetes mellitus es un problema epidemiológico nacional poco tratado en los estudios de género. La obesidad, la inadecuada alimentación y el sedentarismo son factores de riesgo de esta patología que se diagnostica con mayor frecuencia a edades más tempranas, impactando en el equilibrio de las familias. Aunque esta enfermedad se presenta en ambos géneros, la prevalencia es más elevada en mujeres. Se realizó un estudio de diseño transversal con una muestra no probabilística de 239 personas de dos comunidades del Estado de México, a quienes previo consentimiento informado se aplicó un cuestionario para analizar el género como factor de riesgo para el autocuidado en diabetes mellitus tipo 2. El estudio da a conocer los factores no clínicos que pueden considerarse como diferenciales de género. La prevención considera aspectos educativos de autocuidado con un abordaje transdisciplinario e incorporando a la familia para el cuidado de la salud, por sus creencias, saberes y prácticas.

Las condiciones de vida del ser humano han cambiado, con ello la salud de grupos etáreos. El individuo se expone a prácticas de salud acorde a sus patrones culturales y la influencia de las redes sociales. Este estudio identificó la salud física de preescolares en una comunidad suburbana de Toluca, México. Se entrevistaron a preescolares, contando con la autorización y presencia de los padres. La morbilidad identificada fue en infecciones respiratorias agudas, enfermedades infecciosas gastrointestinales y malnutrición con factores predisponentes de prácticas de higiene personal y ambiental deficientes, entre otras. A través de los patrones de salud funcional de Gordón se estructuraron los diagnósticos de enfermería; siendo el más relevante: conocimientos deficientes para mejorar la percepción del control de la salud y prevención de la enfermedad, relacionado con la deficiente información que reciben de sus padres y maestros. Se proponen cambios en programas de educación para la salud, favoreciendo el fomento, la prevención, control, tratamiento y referencia a servicios de salud.As condições de vida do ser humano têm sofrido transformações na sociedade e na saúde dos grupos etários. O indivíduo expõe as práticas de saúde em concordância com seus padrões culturais e a influência das redes sociais. Este estudo identificou a saúde física de pré-escolares em uma comunidade do município de Toluca, México. Foram entrevistados pré-escolares contando com autorização e presença dos pais. As doenças identificadas foram as infecções respiratórias agudas, infecciosas e gastrointestinais e subnutrição, com fatores predisponentes de práticas de higiene pessoal e ambiental deficientes, entre outras. Os padrões da saúde funcional de Gordón foram utilizados, e foram estruturados os diagnósticos da enfermagem, sendo os mais relevantes: os conhecimentos deficientes para a melhora da percepção do controle da saúde e prevenção da doença, relacionados com a deficiente informação que recebem de seus pais e professores. Propõem-se mudanças nos programas da instrução para a saúde, favorecendo a prevenção, o controle, o tratamento e a referência aos serviços da saúde.The conditions of life of the human being have changed, with it the health of etáreos groups. The human being exposes to practices of agreed health to its cultural patterns and the influence of the social networks. This study identified physical health of prestudents in suburban community of Toluca, Mexico. They were entrevisted to prestudents, counting on the authorization and is present at of the parents. The identified morbidity was in acute respiratory infections, gastrointestinales infectious diseases and malnutrición with predisponentes factors of deficient practices of personal and environmental hygiene, among others. Through the patterns of functional health of Gordón the diagnoses of nursing were structured; it was the main: deficient knowledge to improve the perception of the control of the health and prevention of the disease, related to the deficient information that receive from their parents and teachers. Changes in programs of education for the health set out, favoring the promotion, the prevention, control, treatment and reference to services of health.

El arrendamiento de las tierras como principal vía de explotación era una de las características que definía a la nobleza indígena en la Nueva España durante el siglo XVIII. En este artículo estudiamos las consecuencias que esta decisión tuvo para su posición socioeconómica cuando la Compañía de Jesús, uno de sus arrendatarios, fue expulsada en 1767 y sus bienes fueron embargados. Para ello, analizamos el caso de los caciques Cruz, originarios de Tepexi de la Seda (Puebla, México), quienes arrendaron tierras de su cacicazgo a la hacienda de San Jerónimo, perteneciente al Colegio del Espíritu Santo (Puebla, México).Renting Land was one of the characteristics that defined the indigenous nobility in New Spain during the eighteenth century since it meant a major channel of exploitation. In this paper, we study the consequences this decision had for their socioeconomic level when the Society of Jesus, one of the tenants, was expelled in 1767 and their properties were seized. In order to do so, we analyse the case of the Cruz caciques, natives of Tepexi de la Seda (Puebla, México), who rented their cacicazgo's lands to San Geronimo's hacienda, property of the Holly Ghost College (Puebla, México).

In the South African deep mines, a variety of biofilms growing in mine corridor walls as water seeps from intersections or from fractures represents excellent proxies for deep-subsurface environments. However, they may be greatly affected by the oxygen inputs through the galleries of mining activities. As a consequence, the interaction between the anaerobic water coming out from the walls with the oxygen inputs creates new conditions that support rich microbial communities. The inherent difficulties for sampling these delicate habitats, together with transport and storage conditions may alter the community features and composition. Therefore, the development of in situ monitoring methods would be desirable for quick evaluation of the microbial community. In this work, we report the usefulness of an antibody-microarray (EMChip66) immunoassay for a quick check of the microbial diversity of biofilms located at 1.3 km below surface within the Beatrix deep gold mine (South Africa). In addition, a deconvolution method, previously described and used for environmental monitoring, based on graph theory and applied on antibody cross-reactivity was used to interpret the immunoassay results. The results were corroborated and further expanded by 16S rRNA gene sequencing analysis. Both culture-independent techniques coincided in detecting features related to aerobic sulfur-oxidizers, aerobic chemoorganotrophic Alphaproteobacteria and metanotrophic Gammaproteobacteria. 16S rRNA gene sequencing detected phylotypes related to nitrate-reducers and anaerobic sulfur-oxidizers, whereas the EMChip66 detected immunological features from methanogens and sulfate-reducers. The results reveal a diverse microbial community with syntrophic metabolisms both anaerobic (fermentation, methanogenesis, sulphate and nitrate reduction) and aerobic (methanotrophy, sulphur oxidation). The presence of oxygen-scavenging microbes might indicate that the system is modified by the artificial oxygen inputs from the mine galleries.

ABSTRACT Objective: To know the ways and means of comfort perceived by the older adults hospitalized in a medical service. Method: Ethnographic study with a qualitative approach. We conducted semi-structured interviews with 22 older adults and participant observation of care situations. Results: The ways and means of providing comfort are centered on strategies for promoting care mobilized by nurses and recognized by patients(clarifying/informing, positive interaction/communication, music therapy, touch, smile, unconditional presence, empathy/proximity relationship, integrating the older adult or the family as partner in the care, relief of discomfort through massage/mobilization/therapy) and on particular moments of comfort (the first contact, the moment of personal hygiene, and the visit of the family), which constitute the foundation of care/comfort. Final considerations: Geriatric care is built on the relationship that is established and complete with meaning, and is based on the meeting/interaction between the actors under the influence of the context in which they are inserted. The different ways and means of providing comfort aim to facilitate/increase care, relieve discomfort and/or invest in potential comfort.