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Abstract Introduction: Cannabis is the most widely used illicit drug worldwide and the second most smoked substance after tobacco. In recent years, numerous studies have attempted to assess its impact on respiratory health with conflicting results. Objective: To study the effect of inhaled cannabis on respiratory symptoms and lung function compared to tobacco and non-smokers. Methods: Adults from cannabis clubs and public institutions in our country were included. Questionnaires on sociodemographic characteristics, respiratory symptoms, and consumption habits were conducted. This was complemented with pulmonary function testing. Participants were divided into 4 groups: cannabis group (C), tobacco group (T), cannabis-tobacco group (C-T), and non-smokers group (NS). Results: A total of 375 individuals were studied: cannabis group (63), tobacco (117), cannabis-tobacco (50), and non-smokers (145). The cannabis, cannabis-tobacco, and tobacco groups showed a higher prevalence of at least one chronic respiratory symptom (wheezing, cough, and sputum) compared to the non-smokers group (p<0.001). Forced vital capacity was significantly higher in cannabis users (C, C-T). No other significant spirometry alterations were found. Conclusions: Smoking cannabis is associated with chronic respiratory symptoms. Although no clinically relevant changes in lung function were detected, further long-term studies are required. Inquiry about cannabis use should be incorporated into clinical practice, with education on potential health risks.

Resumo Introdução: A cannabis é a droga ilícita mais consumida no mundo e a segunda substância mais fumada depois do tabaco. Nos últimos anos, numerosos estudos tentaram avaliar o seu impacto na saúde respiratória, com resultados conflitantes. Objetivo: Estudar o efeito da cannabis inalada nos sintomas respiratórios e na função pulmonar em comparação com o tabaco e não fumantes. Métodos: Foram incluídos adultos provenientes de clubes de cannabis e instituições públicas do nosso país. Foram aplicados questionários sobre características sociodemográficas, sintomas respiratórios e hábitos de consumo. Complementou-se com estudo funcional respiratório. Os participantes foram divididos em 4 grupos: grupo cannabis (C), grupo tabaco (T), grupo cannabis-tabaco (C-T) e grupo não fumantes (NF). Resultados: Foram estudados 375 indivíduos: grupo cannabis (63), tabaco (117), cannabis-tabaco (50) e não fumantes (145). Os grupos cannabis, cannabis-tabaco e tabaco apresentaram maior prevalência de pelo menos um sintoma respiratório crônico (sibilos, tosse e expectoração) em comparação com o grupo não fumantes (p<0,001). A capacidade vital forçada foi significativamente maior nos grupos consumidores de cannabis (C, C-T). Não foram encontradas outras alterações significativas na espirometria. Conclusões: Fumar cannabis está associado a sintomas respiratórios crônicos. Embora não tenham sido detectadas alterações clinicamente relevantes na função pulmonar, são necessários mais estudos de longo prazo. Questionar sobre o consumo de cannabis deve ser incorporado à prática clínica, com educação sobre os potenciais riscos à saúde.

Resumen Introducción: El cannabis es la droga ilícita más consumida a nivel mundial y la segunda sustancia más fumada luego del tabaco. En los últimos años numerosos estudios han intentado valorar su impacto en la salud respiratoria con resultados discordantes. Objetivo: Estudiar el efecto del cannabis inhalado en síntomas respiratorios y función pulmonar en comparación con el tabaco y con no fumadores. Métodos: Se incluyeron adultos provenientes de clubes cannábicos e instituciones públicas de nuestro país. Se realizaron cuestionarios sobre características sociodemográficas, síntomas respiratorios y hábitos de consumo. Se complementó con estudio funcional respiratorio. Se dividieron en 4 grupos: grupo cannabis (C), grupo tabaco (T), grupo cannabis-tabaco (C-T) y grupo no fumadores (NF). Resultados: Se estudiaron 375 individuos: grupo cannabis (63), tabaco (117), cannabis-tabaco (50), no fumadores (145). El grupo cannabis, cannabis-tabaco, y tabaco, presentaron mayor prevalencia de al menos un síntoma respiratorio crónico (sibilancias, la tos y la expectoración) comparado con el grupo no fumador (p<0,001). La capacidad vital forzada fue significativamente mayor en los grupos consumidores de cannabis (C, C-T). No se hallaron otras alteraciones significativas en la espirometría. Conclusiones: Fumar cannabis se asocia con síntomas respiratorios crónicos. Si bien no se han detectado cambios clínicamente relevantes en la función pulmonar, se requieren más estudios a largo plazo. Interrogar sobre el consumo de cannabis debería incorporarse en la práctica clínica, educando sobre los potenciales riesgos en salud.

https://doi.org/10.29193/rmu.41.1.5

Inteligencia artificial en la formación médica: riesgos y desafíos en estudiantes de medicina en Latinoamérica
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Torres-Salinas, Carlos

Pediatría (Asunción)

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apr 2025, Volume 52 N. 1 Pages 5 - 6

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.31698/ped.52032025002

Hematoma subcapsular posterior a la colangiopancreatografía retrógrada endoscópica (CPRE), casos difíciles con necesidad de intervención abierta y endovascular: reportes de caso
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Castillo-Orrego, Javier Del

; Conrado-Jiménez, Héctor

; Gómez-Zuleta, Martín Alonso

; Martínez-Montalvo, Carlos Mauricio

; Torres-Méndez, Andrés Felipe

Revista colombiana de Gastroenterología

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mar 2025, Volume 40 N. 1 Pages 99 - 103

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Endoscopic retrograde cholangiopancreatography (ERCP) is an essential diagnostic and therapeutic procedure for managing biliopancreatic disease; however, it carries a complication rate of up to 6.85%. Subcapsular hepatic hematoma is a rare occurrence, which in most cases can be effectively managed with conservative and expectant medical care. In certain exceptional situations, invasive corrective interventions such as angiography with vascular embolization or open surgical exploration are required. This report presents two cases of young adult female patients with no significant pre-existing comorbidities who developed abdominal pain, anemia, and hypotension following ERCP. They were subsequently diagnosed with post-ERCP subcapsular hepatic hematoma. Both patients underwent comprehensive treatment through a multidisciplinary approach, requiring different interventions-one with percutaneous endovascular management and the other with open drainage-both yielding equally favorable outcomes.

Resumen La colangiopancreatografía retrógrada endoscópica (CPRE) es un procedimiento diagnóstico y terapéutico indispensable en el manejo de la enfermedad biliopancreática; sin embargo, tiene una tasa de complicaciones hasta del 6,85%. El hematoma subcapsular hepático es un evento muy infrecuente, el cual en la mayoría de los casos se beneficia del manejo médico conservador y expectante. En ocasiones muy particulares requiere de intervenciones invasivas correctivas, como la angiografía y la embolización vascular o la exploración abierta. Se presentan los casos de dos pacientes mujeres adultas jóvenes, sin comorbilidades de importancia previa, quienes después de la intervención con CPRE presentaron clínica de dolor abdominal, anemia e hipotensión, diagnosticadas con la presencia de un hematoma subcapsular hepático post CPRE. Recibieron intervención de forma integral, bajo una aproximación multidisciplinaria, y requirieron intervenciones diferentes, percutáneo endovascular y drenaje abierto, con resultados igual de favorables.

https://doi.org/10.22516/25007440.1203

Enfermedad de Fahr en un adulto mayor, una visión geriátrica
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Damián-Mucha, Milagros

; Takami-Angeles, Graciela

; Arroyo-Zevallos, Carla

; Gamarra-Samaniego, María

; Torres-Salinas, Carlos

Horizonte Médico (Lima)

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jan 2025, Volume 25 N. 1 elocation 2855

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN La enfermedad de Fahr es un padecimiento inusual, caracterizado por calcificaciones intracraneales simétricas y bilaterales. Se presenta el caso de un adulto mayor de 75 años que ingresó a la emergencia por un cuadro obstructivo biliar subsecuente a una neoplasia periampular. Durante su estancia, tuvo una caída tras un episodio de agitación psicomotriz sin causa aparente, por lo que se decidió realizar una tomografía cerebral, en la que se evidenciaron lesiones cálcicas bilaterales en los núcleos de la base y globus pallidus. Se tuvo un manejo exclusivo de la enfermedad, pero existieron falencias en el abordaje integral del adulto mayor. Posteriormente, durante la valoración geriátrica integral, se detectó que el paciente era a un adulto mayor frágil, con desacondicionamiento adquirido, desnutrición, vulnerabilidad social y sobrecarga del cuidador. Esto sugiere que el abordaje del paciente adulto mayor frágil en las áreas de hospitalización es alarmantemente insuficiente y se ve reflejado en un vacío crítico en la formación y el desarrollo de prácticas geriátricas especializadas. La falta de conocimiento adecuado sobre las complejidades y necesidades específicas de esta población vulnerable da como resultados una atención subóptima, estancias hospitalarias prolongadas y un incremento en las tasas de complicaciones y readmisiones, no solo por la enfermedad, sino por el contexto social inobservado. Esta deficiencia resalta la urgente necesidad de priorizar el manejo conjunto de los adultos mayores por todas las especialidades y la geriatría, promoviendo una capacitación más robusta para los profesionales de salud y el desarrollo de protocolos específicos que garanticen una atención integral, segura y digna.

ABSTRACT Fahr’s disease is an unusual condition, characterized by bilateral and symmetrical intracranial calcifications. We present the case of a 75-year-old man, who was admitted to the emergency room due to a biliary obstruction following a periampullary neoplasm. During his stay, the patient fell after an episode of psychomotor agitation without apparent cause; therefore, it led to a computed tomography (CT) scan of the brain, which revealed bilateral calcified lesions in the basal nuclei and globus pallidus. The disease was managed exclusively, but there were shortcomings in the integrated approach to the older adult. Subsequently, during the comprehensive geriatric assessment, it was detected that the was a frail elderly patient, with acquired deconditioning, malnutrition, social vulnerability, and caregiver overload. This suggests that the approach to frail older adult patients in hospitalization areas is alarmingly insufficient and is reflected in a critical gap in the training and development of specialized geriatric practices. The lack of adequate knowledge about the complexities and specific needs of this vulnerable population results in suboptimal care, prolonged hospital stays, and an increase in complication and readmission rates, not only due to the disease but also because of the overlooked social context. This deficiency highlights the urgent need to prioritize the comprehensive management of older adults across all specialties and geriatrics, promoting more robust training for healthcare professionals and the development of specific protocols that ensure integrated, safe, and dignified care.

https://doi.org/10.24265/horizmed.2025.v25n1.14

Desarrollo de las lágrimas artificiales sin preservo, solución oftálmica
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Peña-Roche, Yudilay Libet

; Ramírez-Torres, Gisela

; Madrazo-Alonso, Odalys

; Fernández-Cervera, Mirna

; Romeu-Carballo, Carlos Rafael

Tecnología Química

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2025, Volume 45 Pages 81 - 95

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Hypromellose, in ophthalmic solution, has the purpose of increasing the humidity of the ocular surface, lubricating the blinking movement and reducing the symptoms of the patient affected by dry eyes syndrome. The National Health System does not have a formulation of artificial tears, without a preservative, in single-dose bottles, for the treatment of this pathology. The objective of this work was to develop a preservative-free artificial tear formulation of pharmaceutical quality. A formulation similar in composition to human tears was developed. Once the controls of the three pilot batches prepared were approved, they were formed, dosed and sealed in the Bottelpack TYP 321 machine, in transparent vials of 0.5 mL capacity. The operating parameters were verified and the quality control of the batches was carried out. The parameters evaluated during scaling demonstrated that each of the technological processes involved in obtaining the ophthalmic solution, such as speed and time of agitation, dissolution, pH and filtration, met the established requirements. The sterility of the product was guaranteed by sterilizing filtration, carried out during the filling process of the ophthalmic solution, demonstrating the integrity of each of the membranes used, in each type of filter used in the production process. The evaluation of the physical, chemical and microbiological parameters demonstrated the quality of the newly prepared batches. The reproducibility of the manufacturing process of preservative-free artificial tears is demonstrated, in single-dose vials, according to the existing conditions at the UEB Julio Trigo López Laboratory.

RESUMEN La hipromelosa, en solución oftálmica, tiene la finalidad de aumentar la humedad de la superficie ocular, lubricar el movimiento del parpadeo y disminuir la sintomatología del paciente afectado por el síndrome de ojos secos. El Sistema Nacional de Salud no cuenta con una formulación de lágrimas artificiales, sin preservo, en frascos monodosis, para el tratamiento de esta patología. El objetivo del presente trabajo fue desarrollar una formulación de lágrimas artificiales sin preservo, de calidad farmacéutica. Se desarrolló una formulación de composición similar a las lágrimas humanas. Una vez aprobados los controles de los tres lotes pilotos elaborados, se procedió a la conformación, dosificación y sellado en la máquina Bottelpack TYP 321, en viales transparentes de 0,5 mL de capacidad. Se verificaron los parámetros de operación y se realizó el control de calidad de los lotes. Los parámetros evaluados durante el escalado demostraron que cada uno de los procesos tecnológicos involucrados en la obtención de la solución oftálmica, como velocidad y tiempo de agitación, disolución, pH y filtración cumplió con los requisitos establecidos. La esterilidad del producto se garantizó por filtración esterilizante, realizada durante el proceso de llenado de la solución oftálmica, demostrándose la integridad de cada una de las membranas empleadas, en cada tipo de filtro utilizado en el proceso productivo. La evaluación de los parámetros físicos, químicos y microbiológicos demostraron la calidad de los lotes recién elaborados. Se demuestra la reproducibilidad del proceso de fabricación de las lágrimas artificiales sin preservo, en viales monodosis, según las condiciones existentes en la UEB Laboratorio Julio Trigo López.

Integrating comprehensive surgical, intensive, and emergency care systems into the Pan American Health Organization’s health agenda
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Garcia Fuentes, Maria Jose Gerk, Ayla Campos, Leticia Torres, Alejandro Wurdeman, Taylor Kumar, Nikathan Jimbo-Sotomayor, Ruth Salamea, Juan Carlos dos Reis Falcão, Luiz Fernando Parquet, Guido Meara, John G. Uribe-Leitz, Tarsicio Vega, Alfredo Borrero

Revista Panamericana de Salud Pública

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2025, Volume 49 elocation e16

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Em outubro de 2024, a Organização Pan-Americana da Saúde (OPAS) integrou formalmente os cuidados de emergência, intensivos e cirúrgicos à sua agenda de saúde. Essa integração ocorreu após eventos importantes, como a aprovação, em junho de 2024, da Estratégia de integração de cuidados de emergência, intensivos e cirúrgicos 2025–2030 pelo Comitê Executivo da OPAS. Essa estratégia está fundamentada na Resolução WHA68.15 da Assembleia Mundial da Saúde de 2015, que reconheceu a cirurgia como um elemento essencial para a cobertura universal de saúde, e na Resolução WHA76.2 da Assembleia Mundial da Saúde de 2023, que exigiu a padronização da preparação e resposta a emergências. Tendo em vista que 365 milhões de latino-americanos não têm acesso a serviços cirúrgicos essenciais, é urgente dispor de um plano de ação regional. O Equador, o primeiro país da América Latina a elaborar um plano nacional de cirurgia, obstetrícia e anestesia (NSOAP, na sigla em inglês), destacou a necessidade de cuidados cirúrgicos integrados para abordar as disparidades de saúde na Região. Embora a integração formal pela OPAS seja louvável, seu sucesso dependerá de engajamento político sustentado, compromisso financeiro e monitoramento robusto. Este artigo descreve os fundamentos dessa estratégia, os mecanismos necessários para o sucesso de sua implementação e o papel da OPAS e de seus Estados Membros no fortalecimento dos sistemas cirúrgicos como uma prioridade em saúde pública. Ao focar em grupos vulneráveis e promover a colaboração, essa iniciativa pode reduzir as iniquidades em saúde em toda a Região das Américas, fortalecendo a cobertura universal de saúde e melhorando o acesso a procedimentos cirúrgicos seguros, oportunos e economicamente viáveis.

ABSTRACT In October 2024, the Pan American Health Organization (PAHO) formally integrated surgical, intensive, and emergency care into its health agenda. This followed important events, including the June 2024 endorsement of the Strategy on Integrated Emergency, Critical and Operative Care 2025–2030 by the PAHO Executive Committee. This strategy builds on the 2015 World Health Assembly (WHA) Resolution 68.15, which recognized surgery as essential to universal health coverage, and the 2023 WHA Resolution 76.2, which called for standardized emergency preparedness and response. With 365 million Latin Americans lacking access to essential surgical services, the need for a regional action plan is urgent. Ecuador, the first country in Latin America to develop a national surgical, obstetric, and anesthesia plan (NSOAP), highlighted the need for integrated surgical care to address health disparities in the region. While PAHO’s formal integration is commendable, its success will rely on sustained political engagement, financial commitment, and robust monitoring. This article outlines the foundations for this strategy, the mechanisms required for successful implementation, and the role of PAHO and its Member States in strengthening surgical systems as a public health priority. By focusing on vulnerable groups and leveraging collaboration, this initiative can reduce health inequities across the Americas, reinforcing universal health coverage and access to safe, timely, and affordable surgical care.

RESUMEN En octubre del 2024, la Organización Panamericana de la Salud (OPS) integró formalmente la atención quirúrgica, y los cuidados intensivos y de urgencias en su agenda de salud. Esto ocurrió después de otros acontecimientos importantes como el respaldo, en junio del 2024, de la Estrategia de la atención quirúrgica y los cuidados intensivos y de urgencias 2025-2030 por el Comité Ejecutivo de la OPS. Esta estrategia se basa en la resolución WHA68.15 de la Asamblea Mundial de la Salud, aprobada en el 2015, en la que se reconoce que la atención quirúrgica es esencial para la cobertura universal de salud, y en la resolución WHA76.2 del 2023, en la que se insta a estandarizar la preparación y la respuesta ante emergencias. En América Latina hay 365 millones de personas sin acceso a servicios quirúrgicos esenciales, por lo que la necesidad de un plan de acción regional es urgente. Ecuador, el primer país de América Latina en elaborar un plan nacional de servicios de atención quirúrgica, obstétrica y de anestesia, destacó la necesidad de una atención quirúrgica integrada para hacer frente a las desigualdades de salud en la Región. Aunque la integración formal de este tema en la OPS es encomiable, su éxito dependerá del compromiso político sostenido, del compromiso financiero y del seguimiento sólido. En este artículo se describen los fundamentos de esta estrategia, los mecanismos necesarios para una aplicación satisfactoria, y el papel de la OPS y sus Estados Miembros en el fortalecimiento de los sistemas de atención quirúrgica como prioridad de salud pública. Esta iniciativa se centra en los grupos vulnerables y en aprovechar la colaboración, de manera de que esta iniciativa pueda reducir las inequidades en materia de salud en la Región de las Américas, y reforzar la cobertura universal de salud y el acceso a una atención quirúrgica segura, oportuna y asequible.

https://doi.org/10.26633/rpsp.2025.16

Long-term exposure to PM2.5 and cardiorespiratory mortality: an ecological small-area study in five cities in Colombia
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Marín, Diana

; Herrera, Víctor

; Piñeros-Jiménez, Juan Gabriel

; Rojas-Sánchez, Oscar Alberto

; Mangones, Sonia C.

; Rojas, Yurley

; Cáceres, Jhon

; Agudelo-Castañeda, Dayana M.

; Rojas, Néstor Y.

; Belalcazar-Ceron, Luis Carlos

; Ochoa-Villegas, Jonathan

; Montes-Mejía, María Leonor

; Lopera-Velasquez, Veronica Maria

; Castillo-Navarro, Sanit María

; Torres-Prieto, Alexander

; Baumgartner, Jill

; Rodríguez-Villamizar, Laura A.

Cadernos de Saúde Pública

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2025, Volume 41 N. 4 elocation e00071024

Abstract: Es Pt En | Text: Es Pt En | PDF: Es | PDF: Pt | PDF: En

Resumen: La exposición prolongada a material particulado fino (MP2,5) es un factor de riesgo para la mortalidad cardiorrespiratoria. Sin embargo, se sabe poco sobre la distribución de MP2,5 y su impacto sobre la salud de la población que vive en las grandes ciudades de los países de ingresos medianos-bajos (donde la exposición ha aumentado en las últimas décadas). Este estudio ecológico evaluó la asociación entre la concentración de MP2,5 y la mortalidad cardiorrespiratoria en adultos de los sectores censales (SC) intraurbanos de las cinco ciudades más pobladas de Colombia (2015-2019). Estimamos la razón de las tasas de incidencia (RTI; por 5μg/m3), con ajustes de las regresiones binomiales negativas a las tasas de mortalidad bayesiana (TMB) suavizadas para MP2,5 que se estimaron a partir de modelos de regresión del uso de la tierra (RUT), ajustando la estructura demográfica del SC, el índice de pobreza multidimensional y la autocorrelación espacial. La mediana de MP2,5 por SC varió de 8,1μg/m3 en Bucaramanga a 18,7μg/m3 en Medellín. Por otra parte, Bogotá concentró la mayor variabilidad (IIQ = 29,5μg/m3) y mortalidad cardiorrespiratoria (TMB = 2.560 por 100.000). La exposición prolongada a MP2,5 aumentó la mortalidad cardiorrespiratoria en Bucaramanga (RTI = 1,15; IC95%: 1,02; 1,31), la única sin evidencia de agrupamiento espacial, y la mortalidad cardiovascular (RTI = 1,06; IC95%: 1,01; 1,12) y respiratoria (RTI = 1,07; IC95%: 1,02; 1,13) en Medellín. La mortalidad cardiorrespiratoria se agrupó espacialmente en algunas ciudades colombianas y se asoció con la exposición prolongada a MP2,5 en áreas urbanas donde los modelos RUT presentaron una mayor precisión predictiva, lo que destaca la necesidad de incorporar evaluaciones de exposición de alta calidad y alta resolución para comprender mejor el impacto de la contaminación del aire en la salud de la población e informar las intervenciones de salud pública en entornos urbanos.

Resumo: A exposição prolongada a material particulado fino (MP2,5) configura um fator de risco à mortalidade cardiorrespiratória. No entanto, pouco se sabe sobre a distribuição de MP2,5 e seu impacto na saúde em grandes cidades de países de renda média-baixa (em que a exposição da população aumentou nas últimas décadas). Este estudo ecológico avaliou a associação entre a concentração de MP2,5 e mortalidade cardiorrespiratória em adultos no nível do setor censitário (SC) intraurbano das cinco cidades mais populosas da Colômbia (2015-2019). Estimamos as razões das taxas de incidência (RTI; por 5μg/m3), ajustando regressões binomiais negativas às taxas de mortalidade bayesianas suavizadas (TMB) para MP2,5 que foram previstas a partir de modelos de regressão do uso da terra (RUT), ajustando-se à estrutura demográfica do SC, índice de pobreza multidimensional e autocorrelação espacial. A mediana de MP2,5 por SC variou de 8,1μg/m3 em Bucaramanga a 18,7μg/m3 em Medellín. No entanto, Bogotá apresentou a maior variabilidade (IIQ = 29,5μg/m3) e mortalidade cardiorrespiratória (TMB = 2.560 por 100.000). A exposição prolongada a MP2,5 aumentou a mortalidade cardiorrespiratória em Bucaramanga (RTI = 1,15; IC95%: 1,02; 1,31) - a única sem evidência de agrupamento espacial - e mortalidades cardiovascular (RTI = 1,06; IC95%: 1,01; 1,12) e respiratória (RTI = 1,07; IC95%: 1,02; 1,13) em Medellín. A mortalidade cardiorrespiratória agrupou-se espacialmente em algumas cidades colombianas e foi associada à exposição prolongada ao MP2,5 em áreas urbanas onde os modelos RUT tiveram a maior precisão preditiva, destacando a necessidade de incorporar-se avaliações de exposição de alta qualidade e alta resolução para entender melhor o impacto da poluição do ar na saúde e informar as intervenções de saúde pública em ambientes urbanos.

Abstract: Long-term exposure to the fine particulate matter (PM2.5) is a risk factor for cardiorespiratory mortality. However, little is known about its distribution and health impact in large cities in low-middle-income countries where population exposure has increased during the last decades. This ecological study evaluated the association between PM2.5 concentration and adult cardiorespiratory mortality at the intraurban census sector (CS) level of Colombia’s five most populated cities (2015-2019). We estimated incidence rate ratios (IRR; per 5µg/m3) by fitting negative binomial regressions to smoothed Bayesian mortality rates (BMR) on PM2.5 predicted from land use regression (LUR) models, adjusting for CS demographic structure, multidimensional poverty index, and spatial autocorrelation. CS median PM2.5 ranged from 8.1µg/m3 in Bucaramanga to 18.7µg/m3 in Medellín, whereas Bogotá had the highest variability (IQR = 29.5µg/m3) and cardiorespiratory mortality (BMR = 2,560 per 100,000). Long-term exposure to PM2.5 increased cardiorespiratory mortality in Bucaramanga (IRR = 1.15; 95%CI: 1.02; 1.31), without evidence of spatial clustering, and cardiovascular (IRR = 1.06; 95%CI: 1.01; 1.12) and respiratory (IRR = 1.07; 95%CI: 1.02; 1.13) mortality in Medellín. Cardiorespiratory mortality spatially clustered in some Colombian cities and was associated with long-term exposure to PM2.5 in urban areas where the LUR models had the highest predictive accuracy. These findings highlight the need to incorporate high-quality, high-resolution exposure assessments to better understand the health impact of air pollution and inform public health interventions in urban environments.

https://doi.org/10.1590/0102-311xen071024

Priming cycles with elicitors of salt stress tolerance in seeds of the cowpea
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Pereira, Kleane Targino Oliveira

; Benedito, Clarisse Pereira

; Oliveira, Carlos Eduardo Alves de

; Albuquerque, Cynthia Cavalcanti de

; Peixoto, Tayd Dayvison Custódio

; Arruda, Maria Valdiglêzia de Mesquita

; Torres, Salvador Barros

; Sá, Francisco Vanies da Silva

Revista Ciência Agronômica

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2025, Volume 56 elocation e202392215

Abstract: En | Text: En | PDF: En

ABSTRACT Exposing seeds to agents that elicit tolerance to abiotic stress, such as phytohormones and organic acids, during hydration and dehydration cycles can determine their response to later stimuli, e.g. exposure to salt stress. The aim of this study was to evaluate the action of priming cycles with different eliciting agents of salt stress tolerance on seeds of the cowpea varieties Sempre Verde and Pingo de Ouro. The seeds were subjected to the following treatments: 0.0 mM NaCl (control); 100 mM NaCl (salt stress); salt stress + three seed-priming cycles (PC) in water; salt stress + PC in gibberellic acid; salt stress + PC in hydrogen peroxide; salt stress + PC in salicylic acid; salt stress + PC in ascorbic acid. The following variables were analysed: germination, growth, dry weight, salt tolerance index, total soluble sugars, total free amino acids and proline. Salt stress (100 mM NaCl) reduced germination, length and biomass accumulation in the Sempre Verde and Pingo de Ouro varieties. These showed the best response to the priming cycles with gibberellic and salicylic acids, which promoted greater germination potential, length and biomass under a salt stress of 100 mM NaCl, affording greater tolerance via osmotic regulation, especially in the Sempre Verde variety.

https://doi.org/10.5935/1806-6690.20250019

Simulated performance of a tractor equipped with two types of tyre under two levels of soil moisture
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Silva, João Pedro Rodrigues da

; Souza, Cristiano Márcio Alves de

; Orlando, Roberto Carlos

; Barbosa, Jackson Antônio

; Bahia, Tainara Regina Cerutti Torres

Revista Ciência Agronômica

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2025, Volume 56 elocation e202292763

Abstract: En | Text: En | PDF: En

ABSTRACT Due to the importance of grain production, and the need to work the soil under limited moisture, the aim of this study was to develop computer software to predict the tractive capacity of wheeled tractors for two types of tyre, the effect of different inflation pressures and levels of soil moisture. A mathematical model was developed to predict the tractive capacity of a 4 x 2 AFT tractor. Software was developed and tested by comparing the computational data with those from tests of a working tractor in the field. The parameters under evaluation were drawbar force and front and rear drive wheel slip. At both moisture levels, the bias tyres had the lowest front to rear slip ratio at the lower pressure; the ratios were similar when equipped with radial tyres. The bias tyres show maximum force at a slip ratio of 1.09 at the higher pressure and 1.03 at the lower, while for the radial tyres the ratio was 1.05 at the higher pressure and 1.07 at the lower. Software was developed to process data from the model, with the results used for estimating the tractive force of the tractor. The tractive force was overestimated by the model, which needs further adjustment for direct application in the field.

https://doi.org/10.5935/1806-6690.20250022

10.

Brazilian Thoracic Association recommendations for the management of lymphangioleiomyomatosis
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Baldi, Bruno Guedes

; Feitosa, Paulo Henrique Ramos

; Rubin, Adalberto Sperb

; Amaral, Alexandre Franco

; Freitas, Carolina Salim Gonçalves

; Costa, Cláudia Henrique da

; Mancuzo, Eliane Viana

; Nascimento, Ellen Caroline Toledo do

; Araujo, Mariana Sponholz

; Rocha, Marcelo Jorge Jacó

; Oliveira, Martina Rodrigues de

; Galvão, Tatiana Senna

; Torres, Pedro Paulo Teixeira e Silva

; Carvalho, Carlos Roberto Ribeiro

Jornal Brasileiro de Pneumologia

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2025, Volume 51 N. 1 elocation e20240378

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A linfangioleiomiomatose (LAM) é uma doença rara, caracterizada como uma neoplasia de baixo grau, com potencial metastatizante, que atinge principalmente mulheres em idade reprodutiva, em que se evidencia proliferação de células musculares lisas atípicas (células LAM) e formação de cistos pulmonares difusos. A LAM pode ocorrer na forma esporádica ou associada ao complexo de esclerose tuberosa. Vários progressos ocorreram no entendimento da fisiopatologia e no manejo da LAM nas últimas décadas, determinando melhora do seu prognóstico, incluindo: identificação dos principais aspectos genéticos e do papel da via da proteína alvo mecanístico da rapamicina (mTOR); relação com fatores hormonais, principalmente estrogênio; caracterização das manifestações pulmonares e extrapulmonares em exames de imagem; identificação e importância no diagnóstico do VEGF-D; abordagem diagnóstica sistematizada, muitas vezes sem necessidade de biópsia pulmonar; uso e indicações dos inibidores de mTOR, principalmente sirolimo, para quadros pulmonares e extrapulmonares; reabilitação pulmonar, abordagem de complicações, como pneumotórax e quilotórax; e papel e indicações do transplante pulmonar. Não havia até o momento uma publicação nacional com recomendações para a ampla abordagem da doença. Este documento se caracteriza como uma revisão não sistemática da literatura, realizada por 12 pneumologistas, um radiologista e um patologista, que visa atualizar os tópicos mais importantes relacionados principalmente ao diagnóstico, tratamento e seguimento da LAM, incluindo aspectos práticos e multidisciplinares do seu manejo.

ABSTRACT Lymphangioleiomyomatosis (LAM) is a rare disease, characterized as a low-grade neoplasm with metastatic potential that mainly affects women of reproductive age, in which there is proliferation of atypical smooth muscle cells (LAM cells) and formation of diffuse pulmonary cysts. It can occur in a sporadic form or in combination with tuberous sclerosis complex. In recent decades, a number of advances have been made in the understanding of the pathophysiology and management of LAM, leading to improvements in its prognosis: identification of the main genetic aspects and the role of the mechanistic target of rapamycin (mTOR) pathway; relationship with hormonal factors, mainly estrogen; characterization of pulmonary and extrapulmonary manifestations in imaging studies; identification and importance in the diagnosis of VEGF-D; a systematic diagnostic approach, often without the need for lung biopsy; use of and indications for the use of mTOR inhibitors, mainly sirolimus, for pulmonary and extrapulmonary manifestations; pulmonary rehabilitation and the management of complications such as pneumothorax and chylothorax; and the role of and indications for lung transplantation. To date, no Brazilian recommendations for a comprehensive approach to the disease have been published. This document is the result of a non-systematic review of the literature, carried out by 12 pulmonologists, a radiologist, and a pathologist, which aims to provide an update of the most important topics related to LAM, mainly to its diagnosis, treatment, and follow-up, including practical and multidisciplinary aspects of its management.

https://doi.org/10.36416/1806-3756/e20240378

11.

Evidence-based clinical standard for the diagnosis and treatment of candidemia in critically ill patients in the intensive care unit
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Cortés, Jorge Alberto

; Valderrama-Rios, Martha Carolina

; Peçanha-Pietrobom, Paula M.

; Silva Júnior, Moacyr

; Diaz-Brochero, Cándida

; Robles-Torres, Rafael Ricardo

; Espinosa-Almanza, Carmelo José

; Nocua-Báez, Laura Cristina

; Nucci, Marcio

; Álvarez-Moreno, Carlos Arturo

; Queiroz-Telles, Flavio

; Rabagliati, Ricardo

; Rojas-Fermín, Rita

; Finquelievich, Jorge L.

; Riera, Fernando

; Cornejo-Juárez, Patricia

; Corzo-León, Dora E.

; Cuéllar, Luis E.

; Zurita, Jeannete Hernández, Augusto Raúl Colombo, Arnaldo Lopes

Brazilian Journal of Infectious Diseases

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2025, Volume 29 elocation 104495

Abstract: En | Text: En | PDF: En

Abstract Candidemia is the predominant form of invasive candidiasis and the most frequently occurring serious fungal infection in critically ill patients in Intensive Care Units (ICU). Studies carried out in Latin America reveal a higher incidence of candidemia and higher mortality rates when compared to North America or Europe. This highlights the need to develop guidelines for correctly diagnosing and treating candidemia in critically ill patients in the ICU. These guidelines are part of the efforts to implement antifungal optimization programs in the region to obtain better clinical outcomes and promote rational antifungal use. This evidence-based clinical standard, established through expert consensus for the Latin American context, contains recommendations and algorithms for diagnosing and treating candidemia in critically ill ICU patients.

https://doi.org/10.1016/j.bjid.2024.104495

12.

Immune thrombocytopenia possibly triggered by multiple tick bites
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Silva-Ramos, Carlos Ramiro

; Prieto-Torres, Andrés Eduardo

; Zuñiga, Abraham Katime

; Cortés-Vecino, Jesús A.

; Ortiz, Bertha Lacouture

; Cuellar, Constanza

; Medina-Lozano, Leidy J.

; Faccini-Martínez, Álvaro A.

Revista do Instituto de Medicina Tropical de São Paulo

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2025, Volume 67 elocation e1

Abstract: En | Text: En | PDF: En

ABSTRACT Immune thrombocytopenia (ITP) is an autoimmune hematological condition characterized by a markedly isolated decrease in platelets without any apparent associated clinical conditions, resulting in bleeding and bruising of the skin, mucous membranes, and major organs. It is often triggered by preceding illness or several immune stimulants such as immunizations, infections, allergic reactions, among others. While uncommon, arthropod bites can trigger acute ITP. Four cases have been reported due to bee stings and insect bites, as well as a case of ITP following honeybee-venom therapy. Here, we report a case of acute ITP possibly triggered by multiple tick bites.

https://doi.org/10.1590/s1678-9946202567001

13.

Operating performance of an agricultural tractor fitted with two types of tyres under two types of terrain
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Bahia, Tainara Regina Cerutti Torres

; Souza, Cristiano Marcio Alves de

; Barbosa, Jackson Antonio

; Orlando, Roberto Carlos

Revista Ciência Agronômica

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2025, Volume 56 elocation e202292749

Abstract: En | Text: En | PDF: En

ABSTRACT The correct use of tyres on agricultural tractors, in respect of the terrain and the type and internal pressure of the tyre, are factors that influence the performance of the tractor. The aim of the present study was to evaluate the operating performance of an agricultural tractor fitted with two types of traction device (radial and diagonal tyres) at different pressures, and operating on soil with two levels of moisture. The experiment was conducted on a dystrophic Red Yellow Argisol, with tests to evaluate the performance of the tyres under specific working conditions. Tractive power and tractive force, wheel slip and fuel consumption were evaluated. For each of the conditions under evaluation, the radial configuration showed better performance than the diagonal configuration, the effect being more significant at the lower pressure and under low soil moisture. The use of radial tyres led to an increase in traction capacity and drawbar power, with a reduction in fuel consumption, especially at higher slip rates.

https://doi.org/10.5935/1806-6690.20250011

14.

Aging and post-polymerization effects on conversion degree and properties of additive splint materials
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SANTIS, Leandro Ruivo de

; FERNANDES, Lucas Silveira

; VASQUES, Mayra Torres

; ZAMBRANA, Nataly Rabelo Mina

; VIANA, Ítallo Emídio Lira

; FORLIN, Taís Scaramucci

; SAAVEDRA, Guilherme de Siqueira Ferreira Anzaloni

; FRANCCI, Carlos Eduardo

Brazilian Oral Research

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2025, Volume 39 elocation e017

Abstract: En | Text: En | PDF: En

Abstract The study objective was to analyze dimensional change, flexural strength, surface hardness, wear profile, and conversion degree of different additive splint materials under various post-polymerization conditions of time and artificial aging. Two additive manufacturing systems (Cara Print 4.0, Dima Print Ortho, Kulzer; SprintRay Pro, SprintRay Splint, SprintRay), and a thermally activated resin control (Clássico) were evaluated in artificial aging (deionized water or saliva; 28 or 84 days at 37°C), with recommended or doubled post-polymerization cycles. Dimensional change (surface metrology), flexural strength (ISO 20795-1:2013), fractography (SEM), Knoop hardness, two-body wear profilometry (150,000 cycles; 3mmØ; 20N; 2.1Hz), and conversion degree (FTIR spectroscopy) were assessed. Two-way ANOVA and post-hoc Tukey tests were used for parametric data, and Kruskal-Wallis and post-hoc Dunn tests, for non-parametric data (α = 0.05). Results indicated no statistically significant differences in dimensional change or flexural strength among the materials. Recommended post-polymerization cycles resulted in lower hardness for additive resins than the thermally activated control. Doubling post-polymerization time significantly increased flexural strength and hardness of Dima Print Ortho, but decreased flexural strength of SprintRay Splint, and did not affect wear resistance. Dima Print Ortho demonstrated the highest wear resistance. Artificial aging did not affect flexural strength, surface wear, or dimensional change, but negatively impacted the hardness of all materials except Dima Print Ortho. The conversion degree was unaffected by post-polymerization time, and no significant differences were found among the materials. Overall, additive materials exhibited mechanical and dimensional properties comparable to thermally activated resin, with doubling post-polymerization time positively influencing the properties.

https://doi.org/10.1590/1807-3107bor-2025.vol39.017

15.

NanoSSIEFARL polymeric nanoparticles-based immunotherapeutic for the treatment of genital herpes
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Zorzetto, Renata

; Peña, Flávia Pires

; Oliveira, Aline Cláudio de

; Ferreira Neto, Jayme de Castilhos

; Hilario, Gabriel Tardin Mota

; Frozza, Fernanda Teresa Bovi

; Lins, Marvin Paulo

; Poletto, Fernanda

; Eberhardt, Marcelo Jung

; Romão, Pedro Roosevelt Torres

; Aguirre, Tanira Alessandra Silveira

; Rodrigues Junior, Luiz Carlos

Polímeros

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2025, Volume 35 N. 2 elocation e20250014

Abstract: En | Text: En | PDF: En

Abstract This study aimed to investigate the therapeutic potential of a nanoparticle formulation containing the immunodominant peptide SSIEFARL from Herpes simplex virus 2 glycoprotein B A against genital herpes. A nanoparticle formulation (NanoSSIEFARL) was engineered and characterized for its physicochemical and immunomodulatory properties. NanoSSIEFARL displayed mean particle size of 212 ± 5 nm, polydispersity index of 0.12 ± 0.01 and zeta potential of -7.4 ± 2.5 mV, exhibiting spherical morphology. pH stability remained consistent over 30 days (day 0: 4.5 ± 0.5; day 30: 5.0 ± 0.5). A novel high-performance liquid chromatography method was validated for SSIEFARL quantification. Peptide association efficiency reached 98.3% ± 2.1, with 41.6% ± 4.4 peptide release from nanoparticles after 4 hours. Cytotoxicity assessment revealed cellular viability exceeding 90%, with macrophage uptake observed after 4 hours. Altogether, these results suggest that NanoSSIEFARL is a promising candidate for effective immunotherapy against genital herpes.

https://doi.org/10.1590/0104-1428.20240042

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