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ABSTRACT Objective: The Cancer Genome Atlas research program (TCGA) developed the molecular classification for endometrial cancer with prognostic and therapeutic utility, which was replaced by the ProMisE (Proactive Molecular Risk Classifier for Endometrial Cancer) classification by consensus and international guidelines due to its high cost. This article aims to present national recommendations from an expert consensus that allows unification and implementation of the molecular classification for women with endometrial cancer nationwide, with a rational use of resources and technology. Methods: Consensus of 36 experts in clinical oncology, oncological gynecology, pathology, and genetics, with clinical practice in the national territory. The leader group performed a literature review and structuring of questions rated 1 to 9 points. A modified nominal group technique was used. There was a face-to-face meeting with master presentations, deliberative dialogue, and Google Forms (Google LLC, Mountain View, CA, USA) questionnaire voting with analysis and discussion of responses. The non-consensual responses led to a second round of voting. The final manuscript was finally prepared and revised. Results: Seven recommendations were formulated integrating the panelist responses based on evidence, but adjusted to the Colombian context and reality. Recommendation 1. The molecular classification is recommended in all the endometrial cancers using the immunohistochemistry markers as subrogated results from the molecular profile initially proposed in the TCGA classification. Recommendation 2. The sequential test strategy is recommended, starting with the immunohistochemistry markers (p53, MLH1, MSH 2, MSH6, PMS2) simultaneously in all the patients, defining to request POLE (DNA polymerase epsilon) (if available) according to the risk classification based on the surgical piece. Recommendation 3. It is recommended, that the gynecologist oncologist should be the one to request the POLE (if available) according to the final pathology report. This test must be requested for all endometrial cancers stage I-II, except in low risk (stage IA low grade endometrioid histology without linfovascular invasion normal p53) and, stages III-IV without residual disease, without affecting the request of subrogated immunohistochemistry molecular markers upon histology. The consensus proposes that the POLE is requested after the immunohistochemistry and according to the categories in the risk classification established by the 2020 ESGO/ESTRO/ESP guidelines. Recommendation 4. It is recommended to perform immunohistochemistry for hormonal receptors for all women with endometrial cancer and the HER2 in patients with p53abn, simultaneously with the others immunohistochemistry markers. Recommendation 5. It is recommended to perform the immunohistochemistry markers (p53, MLH1, MSH2, MSH6 y PMS2) in an initial endometrial biopsy or curettage when the specimen is adequate and available. In case the initial immunohistochemistry is inconclusive, or there are histological discrepancies between the initial and definitive pathology, it is recommended to repeat the molecular profile in the surgical pathology. The immunohistochemistry markers must be reported in the pathology report according to the CAP (College of American Pathologists) recommendations, independently of the type of sample. Recommendation 6. It is recommended to perform MLH1 promoter methylation testing in patients who exhibit loss of expression of MLH1 in immunohistochemistry whether it is accompanied or not with loss of expression of PMS2. All the patients with deficient MMR (mismatch repair), should be sent for genetic counseling to rule out Lynch syndrome. Recommendation 7. It is recommended to consider the molecular classification in addition to the classical histopathological criteria when making adjuvant judgments, as incorporated by the classification of prognostic groups of the 2020 ESGO/ESTRO/ESP guidelines. Conclusions: It is necessary to implement the molecular classification of endometrial cancer in clinical practice in accordance to the Colombian context, due to its prognostic and probably predictive value. This will enable the characterization of the Colombian population in order to offer individualized guided treatments. This is an academic and non-regulatory document.

Resumen: El trabajo estudió la frecuencia de sensibilidad estacional en una muestra de población austral chilena, alta latitud sur y su relación con actividades laborales desarrolladas en diferentes turnos de trabajo y con variables de adaptación general. Un total de 465 personas participaron respondiendo instrumentos midiendo estacionalidad (SPAQ), felicidad subjetiva (Escala de Oxford), adaptación social (Bell) y ansiedad y depresión (MASQE30). Los resultados principales indican que la frecuencia de sensibilidad estacional es alta, su nivel declarado en promedio es moderado, en su límite superior, y es evaluada como de impacto negativo significativo en la vida diaria. Respecto de los patrones estacionales, el más numeroso fue el de verano, que indica que las personas perciben beneficios con el aumento de luz, lo que correlaciona negativamente con la felicidad. Los análisis según turno de trabajo mostraron perfiles diferenciales para cada uno. Se discuten estos resultados en torno a su importancia para el desarrollo de políticas públicas asociadas a la salud física y mental de poblaciones australes.

Abstract: This study is intended to determine the frequency of seasonal sensitivity in a sample of a Chilean high latitude (extreme southerly) population, and its correlation with labor activities involved in several types of shift work, with variables of general adaptation. A total of 465 participants took part in answering questionnaires to measure seasonality impacts through SPAQ (Seasonal Pattern Assessment Questionnaire), subjective happiness (Oxford scale), social adaptation (Bell), and anxiety and depression (MASQE30). The principal results indicate that the frequency of seasonal sensitivity in this sample was high, in a moderate level near the upper limit, and this is considered to have a significantly negative impact on daily life. Regarding seasonal patterns, the most common effect was in the summer profile, suggesting that people perceive benefits with the increase in sunlight, which correlates negatively with happiness. The analysis according to work-shift shows differential profiles for each one. These results are discussed relative to the importance for development of public policies to further the physical and mental health of extreme-southern populations.

Resumo: Este trabalho estudou a frequência de sensibilidade sazonal em uma amostra de população austral chilena, nas altas latitudes do sul, e sua relação com atividades laborais desenvolvidas em diferentes turnos de trabalho e com variáveis de adaptação geral. Um total de 465 pessoas participaram respondendo instrumentos que mediam a sazonalidade (SPAQ), a felicidade subjetiva (Escala de Oxford), a adaptação social (Bell) e a ansiedade e a depressão (MASQE30). Os principais resultados indicam que a frequência de sensibilidade estacional é alta, seu nível declarado em média é moderado em seu limite superior e é avaliado como de impacto negativo significativo na vida diária. Com respeito aos padrões estacionais, o mais numeroso foi o do verão, que indica que as pessoas percebem benefícios com o aumento da luz, o que se relaciona negativamente com a felicidade. As análises de acordo com o turno de trabalho mostraram perfis diferenciais para cada um deles. Discutem-se esses resultados em torno a sua importância para o desenvolvimento de políticas públicas associadas a saúde física e mental das populações austrais.

Resumen El tejocote (Crataegus mexicana) es una planta nativa de México. Su fruto no sólo es utilizado como alimento para el consumo humano, sino también como ornamento en celebraciones y en la medicina tradicional. A pesar de esto, se le considera un cultivo subutilizado y su aporte de compuestos con actividad antioxidante ha sido poco estudiado. El objetivo de este trabajo fue caracterizar e identificar metabolitos secundarios extraídos de las fracciones del fruto para determinar su potencial antioxidante: (1) cáscara, (2) pulpa y (3) semilla. Se cuantificó el contenido de fenoles y flavonoides totales, flavan-3-ol y proantocianidinas. Además, la actividad antioxidante de las tres fracciones fue cuantificada mediante dos métodos: (1) reducción del hierro (FRAP) e (2) inhibición del radical libre 2,2-difenil-1-picrilhidracilo (DPPH). Se identificaron los principales compuestos presentes en cada una de las fracciones a través de cromatografía de líquidos de alta resolución (HPLC). Los resultados indicaron que fue en el extracto de la semilla donde se presentó el mayor contenido de fenoles y flavonoides totales, así como el mejor potencial antioxidante, el cual estuvo directamente relacionado con el contenido de compuestos extraídos. En las tres fracciones del fruto se registró la presencia de epicatequina, quercetina 3-D-galactósido y ácido ascórbico. Además, en semilla se identificó la catequina y vitexina, mientras que en cáscara y pulpa se observó la presencia de ácido clorogénico y procianidina B2.

Abstract Tejocote (Crataegus mexicana) is a native plant from Mexico. Its fruit is not only used as food for human consumption but also as an ornament in celebrations and traditional medicine. Despite this, it is considered an underutilized crop, and its antioxidant-containing compounds have only been minimally studied. The objective of this work was to characterize and identify secondary metabolites extracted from three fruit fractions to determine their antioxidant potential: (1) peel, (2) pulp and (3) seed. Phenols and total flavonoid, flavan-3-ol, and proanthocyanidins contents were determined. Also, antioxidant activities of the three fractions were quantified by two methods: (1) iron reduction (FRAP) and (2) inhibition of the 2,2-diphenyl-1- picrylhydrazyl free radical (DPPH). The main compounds present in each of the fractions were identified through high-performance liquid chromatography (HPLC). The results showed that the seed extract exhibited the highest phenol and total flavonoid contents and the best antioxidant potential, which was directly related to the content of extracted compounds. The presence of epicatechin, quercetin 3-D-galactoside, and ascorbic acid was recorded in the three fractions of the fruit. In addition, catechin and vitexin were identified in seed, while in the peel and pulp the presence of chlorogenic acid and procyanidin B2 was detected.

Abstract Objective: Analyze the relationship between perceptions of the quality of discharge education and the readiness for discharge. Methods: The Quality of Discharge Teaching Scale (QDTS) and Readiness Hospital Discharge Scale (RDHS) were applied 1 to 2 hours prior to discharge. Results: Scores on the Quality of Discharge Teaching Scale explained 22% of the variance in the Readiness Hospital Discharge Scale. The way nurses delivery of education was a stronger predictor than the content itself. Conclusions: The perceived quality of discharge education may be a predictor of readiness for discharge.

Resumen Objetivo principal: Analizar la relación entre las percepciones de la calidad de educación al alta y la disposición de pacientes para ser dados de alta. Metodología: Se aplicaron la Escala de la Calidad de la Educación al alta (Quality of Discharge Teaching Scale - QDTS) y la Escala para ver si los pacientes están listos para el alta (Readiness Hospital Discharge Scale – RDHS), 1 a 2 horas previas al alta. Resultados principales: Los puntajes en la Escala de la Calidad de la Educación al alta explicaron el 22% de la varianza en las puntuaciones de la Escala de disposición para ser dado de alta. La forma en la que las enfermeras educaban fue un predictor más fuerte que el contenido mismo. Conclusión principal: La calidad percibida de la educación al alta podría ser un predictor de la disposición para ser dado de alta.

Abstract The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide. Objective This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Material and Methods Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach’s alpha and temporal stability was calculated using the Kappa-index. Results A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach’s alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. Conclusions The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents.

Objetivo Evaluar el efecto que ejerce el ruido ambiental en la salud auditiva, la aparición de síntomas neuropsicológicos, el desarrollo de actividades educativas y el descanso en estudiantes de una localidad en Bogotá. Metodología Estudio transversal de prevalencia en niños y adolescentes (n=581) de 10-17 años en dos instituciones educativas distritales definidas como de mayor exposición (>65dB) y de menor exposición (<65dB) según el mapa de ruido ambiental de la localidad, clasificación verificada posteriormente. Se aplicó una encuesta de antecedentes de salud, percepción de la exposición a ruido, hábitos relacionados con salud auditiva y una audiometría tonal liminal de la vía aérea, usando criterios recomendados en la guía GATI-HNIR. Resultados El colegio más expuesto excedía la normatividad para la zona de tranquilidad (7/8 mediciones), los niveles de las dos instituciones sobrepasan la recomendación de la OMS (15/16 mediciones). El 14,8 % de los estudiantes presentaban algún grado de Hipoacusia, no se identificaron diferencias según exposición, sin embargo, al comparar los promedios de umbral auditivo, fueron mayores en el grupo de mayor exposición. Se encontró más prevalencia de hipoacusia y síntomas neuropsicológicos en la jornada mañana, y del reporte de síntomas otológicos y dificultad para dormir en estudiantes con mayor exposición. Conclusión Existe diferencia entre los umbrales auditivos de los estudiantes según la exposición, lo cual podría sugerir alguna asociación con los niveles de ruido a los que se encuentran expuestos.

Objective Evaluating the effect of environmental noise on the auditory health of a group of students from a locality in Bogotá, their educational development and leisure activities and the appearance of neuropsychological symptoms. Methods This was an observational cross-sectional prevalence study in a sample of 581, 10-17 year-old children and adolescents in two district educational institutions, defined as higher (>65 dB) and lower exposure (<65 dB) according to an environmental noise map of the locality, such ranking being subsequently verified. A survey was made regarding their health-related background, perception of being exposed to noise and auditory health-related habits; a liminal tone audiometry of the airway was taken using the criteria recommended in the Infrastructure Technical Advisory Group'snoise-induced hearing loss (ITAG-NIHL) guidelines. Results The more exposed school exceeded the regulations concerning comfortable environmental noise levels (7/8 measurements). Both institutions' levels exceeded WHO recommendations (15/16 measurements); 14.8 % of students had some degree of hearing loss. No significant differences were identified regarding exposure; however, higher thresholds were found in the more exposed group when comparing mean hearing threshold. Students attending morning sessions had a greater prevalence of hearing loss and neuropsychological symptoms and neuro-otological symptoms and difficulty in sleeping was reported amongst the more exposed students. Conclusion A difference was found between students' hearing thresholds, depending on their exposure, suggesting an association with the levels of noise to which they are exposed.

Objetivo Evaluar el efecto que ejerce el ruido ambiental en la salud auditiva, la aparición de síntomas neuropsicológicos, el desarrollo de actividades educativas y el descanso en estudiantes de una localidad en Bogotá. Metodología Estudio transversal de prevalencia en niños y adolescentes (n=581) de 10-17 años en dos instituciones educativas distritales definidas como de mayor exposición (>65dB) y de menor exposición (<65dB) según el mapa de ruido ambiental de la localidad, clasificación verificada posteriormente. Se aplicó una encuesta de antecedentes de salud, percepción de la exposición a ruido, hábitos relacionados con salud auditiva y una audiometría tonal liminal de la vía aérea, usando criterios recomendados en la guía GATI-HNIR. Resultados El colegio más expuesto excedía la normatividad para la zona de tranquilidad (7/8 mediciones), los niveles de las dos instituciones sobrepasan la recomendación de la OMS (15/16 mediciones). El 14,8 % de los estudiantes presentaban algún grado de Hipoacusia, no se identificaron diferencias según exposición, sin embargo, al comparar los promedios de umbral auditivo, fueron mayores en el grupo de mayor exposición. Se encontró más prevalencia de hipoacusia y síntomas neuropsicológicos en la jornada mañana, y del reporte de síntomas otológicos y dificultad para dormir en estudiantes con mayor exposición. Conclusión Existe diferencia entre los umbrales auditivos de los estudiantes según la exposición, lo cual podría sugerir alguna asociación con los niveles de ruido a los que se encuentran expuestos.

Objective Evaluating the effect of environmental noise on the auditory health of a group of students from a locality in Bogotá, their educational development and leisure activities and the appearance of neuropsychological symptoms. Methods This was an observational cross-sectional prevalence study in a sample of 581, 10-17 year-old children and adolescents in two district educational institutions, defined as higher (>65 dB) and lower exposure (<65 dB) according to an environmental noise map of the locality, such ranking being subsequently verified. A survey was made regarding their health-related background, perception of being exposed to noise and auditory health-related habits; a liminal tone audiometry of the airway was taken using the criteria recommended in the Infrastructure Technical Advisory Group'snoise-induced hearing loss (ITAG-NIHL) guidelines. Results The more exposed school exceeded the regulations concerning comfortable environmental noise levels (7/8 measurements). Both institutions' levels exceeded WHO recommendations (15/16 measurements); 14.8 % of students had some degree of hearing loss. No significant differences were identified regarding exposure; however, higher thresholds were found in the more exposed group when comparing mean hearing threshold. Students attending morning sessions had a greater prevalence of hearing loss and neuropsychological symptoms and neuro-otological symptoms and difficulty in sleeping was reported amongst the more exposed students. Conclusion A difference was found between students' hearing thresholds, depending on their exposure, suggesting an association with the levels of noise to which they are exposed.

Avaliou-se a qualidade de vida em 30 pacientes com paralisia de Bell e 30 controles são, pareados por idade e gênero, tendo como objetivo estimar as diferenças nesta entre os pacientes e as pessoas sem paralisia. Utilizou-se a enquete SF-36 para avaliar a qualidade de vida, a escala House Brackmann para estimar o nível de severidade da paralisia, e uma enquete para determinar a idade, o gênero, o lado afetado do rosto e o tempo de evolução. Aplicou-se a prova de rangos assinalados de Wilcoxon, com o fim de obter as diferenças nas dimensões da qualidade de vida entre os pacientes e os controles sãos. Esta análise mostrou diferenças significativas nas dimensões de limitações no rol: problemas físicos (p=.002), e funcionamento social (p=.002). Por meio do coeficiente de correlação de Spearman se observou um nível de relação significativo entre estas mesmas dimensões da qualidade de vida (p= .000 e p=.003 respectivamente) e a severidade da paralisia. Através da prova U de Mann Whitney comparou-se a qualidade de vida de acordo com o lado afetado. A análise permitiu ver uma pontuação significativamente menor na dimensão de saúde geral nos pacientes com afetação do lado direito do rosto (p=.024). Não se encontraram diferenças associadas à idade, ao gênero ou ao tempo de evolução. Os resultados permitem sugerir a inclusão de aspectos relacionados com as dimensões limitações no rol: problemas físicos e funcionamento social nos programas de intervenção dirigidos a estes pacientes.

Se evaluó la calidad de vida en 30 pacientes con parálisis de Bell y 30 controles sanos, pareados por edad y género, teniendo como objetivo estimar las diferencias en esta entre los pacientes y las personas sin parálisis. Se utilizó la encuesta de Salud Forma Corta 36 (SF-36) para evaluar la calidad de vida, la escala House Brackmann para estimar el nivel de severidad de la parálisis, y una encuesta para determinar la edad, el género, el lado afectado de la cara y el tiempo de evolución. Se aplicó la prueba de rangos señalados de Wilcoxon, con el fin de obtener las diferencias en las dimensiones de la calidad de vida entre los pacientes y los controles sanos. Este análisis mostró diferencias significativas en las dimensiones de limitaciones en el rol: problemas físicos (p= .002), y funcionamiento social (p = .002). Por medio del coeficiente de correlación de Spearman se observó un nivel de relación significativo entre estas mismas dimensiones de la calidad de vida (p = .000 y p=.003 respectivamente) y la severidad de la parálisis. A través de la prueba U de Mann Whitney se comparó la calidad de vida de acuerdo con el lado afectado. El análisis permitió ver un puntaje significativamente menor en la dimensión de salud general en los pacientes con afectación del lado derecho de la cara (p=.024). No se encontraron diferencias asociadas a la edad, el género o al tiempo de evolución. Los hallazgos permiten sugerir la inclusión de aspectos relacionados con las dimensiones limitaciones en el rol: problemas físicos y funcionamiento social en los programas de intervención dirigidos a estos pacientes.

The quality of life of 30 Bell's palsy patients was compared to that of 30 paired controls without palsy. The Health Survey Short Form 36 (SF-36) was used to evaluate the quality of life, and the House Brackmann Scale was used to evaluate facial paralysis severity. Participants were also asked about their gender, age, the affected side of the face, and time since the onset of the illness. Wilcoxon test was used to compare the quality of life between patients and paired controls. Results showed significant differences in role-physical (p = .002) and social functioning (p= .002) scales between the two groups. A Spearman's correlation rank test showed that the same two scales of the SF-36 improved in time as the facial paralysis severity diminished (p= .000 and p = .003, respectively). The Mann-Whitney U test showed a lower score in general health scale in patients with right side affected of the face (p=-024). No statistical significant differences were found due to gender, age, or time since the onset of the illness.

Th17 cells, a recently described subtype of CD4+ effector lymphocytes, have been linked to cell-mediated autoimmune and inflammatory diseases as well as to cardiovascular diseases. However, the participation of IL-17A in myocardial ischemic injury has not been clearly defined. We therefore conducted the present study to evaluate IL-17A and Th17-related cytokine levels in a rat model of myocardial infarction (MI). MI was induced in male Sprague Dawley rats by coronary artery ligation. Controls were sham-operated (Sh) or non-operated (C). Blood and samples from the left ventricle (LV) were collected at weeks 1 and 4 post-MI. At week 1, MI animals exhibited increased IL-6, IL-23 and TGF-β mRNA levels with no apparent change in IL-17 mRNA or protein levels in whole LV. Only TGF-β mRNA remained elevated at week 4 post-MI. However, further analysis revealed that IL-17A mRNA and protein levels as well as IL-6 and IL-23 mRNA were indeed increased in the infarcted region, though not in the remote non infarcted region of the LV, except for IL-23 mRNA. The increased expression of IL-17A and Th17-related cytokines in the infarcted region of LV, suggests that this proinflammatory pathway might play a role in early stages of post MI cardiac remodelling.