Título del artículo:

Sedación paliativa en cuidado domiciliario

Introduction: The palliative sedation at home is a management alternative in the control of refractory symptoms of people in end-of-life, reducing the suffering of the sick person and his/her family. Materials and methods: It’s a quantitative, descriptive, number of cases study, based on the review of clinical records of patients who received subcutaneous palliative sedation treatment as part of end-of-life care in a Palliative care home program in Bucaramanga, Colombia. It’s shown absolute and relative frequencies for qualitative variables, and measures of central tendency for quantitative variables. Results: Most patients presented dyspnea as only refractory symptom at the end-of-life, a combination of morphine and midazolam was used in most cases, and the average duration from the onset of sedation to death was 1.72 days. Discussion: Unlike other studies, the proportion of patients with oncological and non-oncological diseases was equivalent, the dyspnea continues to be the main at end-of-life, patient death occurred in less than 48 hours, which ratifies the indication for palliative sedation.

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Medicina Paliativa

Título del artículo:

Delphi Consensus on the Use of Fenofibrate as Systemic Therapy for the Prevention of Diabetic Retinopathy Progression

Background: Diabetic retinopathy remains a leading cause of preventable blindness worldwide, yet screening and management practices vary widely. Evidence suggests that systemic therapies, including fenofibrate, may slow diabetic retinopathy progression, but their use is inconsistent across clinical settings. This study aimed to establish an evidence-informed consensus among endocrinology experts on the screening, diagnosis, and treatment of diabetic retinopathy, with a particular focus on recommendations for the use of systemic therapy to prevent disease progression. Methods: A modified three-round Delphi process was conducted with 19 endocrinology experts from diverse geographic regions. A core panel of 10 experts and an extended panel of 9 reviewed and rated 19 evidence-based statements. Consensus was defined as > 75% agreement. Results: All 19 statements achieved consensus, with 14 receiving > 80% agreement. The panel endorsed frequent diabetic retinopathy screening based on diabetes type and risk level, early initiation of fenofibrate in patients with mild to moderate non-proliferative diabetic retinopathy, and continued therapy to sustain retinal protection. Fenofibrate was recognized for its pleiotropic effects, and the experts agreed that the transient rise in serum creatinine with fenofibrate is not indicative of renal damage and should not prompt discontinuation. Conclusions: This consensus highlights the need for multidisciplinary care, coordinated pathways, and patient education in diabetic retinopathy care. It also offers unified, evidence-informed recommendations for endocrinologists for the early initiation of fenofibrate to reduce diabetic retinopathy progression. While further studies are needed, these findings offer a practical framework for improving diabetic retinopathy management globally.

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Journal of Diabetes

Título del artículo:

Advancing Cardiac Rehabilitation in Latin America: INSIGHTS FROM A BIBLIOMETRIC REVIEW

Purpose: – This study, based on a bibliometric analysis in the field of cardiac rehabilitation in Latin America, aims to (1) describe the number of publications per year, journal, country affiliation, and contributing authors; (2) identify collaborative networks; and (3) determine emerging research trends. Review Methods: – A defined search strategy was implemented in Scopus for documents indexed up to September 2023. The retrieved records were analyzed using VantagePoint software (Search Technology, 15.2) to extract activity indicators (publication frequency, countries, institutions, and authors), relationship indicators (coauthorship among countries and authors), and research trends through author-included keywords in each article. Summary: – A total of 124 records were selected. The highest publication frequency was observed between 2019 and 2023, with Brazil and Canada leading in publication counts. Regarding international collaboration, studies were frequently coauthored by institutions in Brazil, Canada, Colombia, and the United States. Most records associated cardiovascular rehabilitation with cardiovascular diseases (coronary disease), exercise, and questionnaires. This investigation offers insights that are instrumental in shaping the trajectory of future studies by analyzing publication patterns and identifying potential collaborative partners in the region. Through a detailed examination of bibliometric data, it sets a foundation for advancing research agendas and fostering partnerships in cardiac rehabilitation within Latin America.

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Journal of Cardiopulmonary Rehabilitation and Prevention

Título del artículo:

Recognising the family physician in asthma and COPD guidelines: a necessary step for effective primary care implementation

Asthma and chronic obstructive pulmonary disease (COPD) are the most prevalent chronic respiratory conditions globally, with management predominantly occurring in primary care settings. International guidelines from the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) have been instrumental in standardising care; however, these documents consistently use generic terminology such as “primary care physician” or “healthcare provider” without explicitly recognising the family physician as a distinct medical specialty. This omission creates a conceptual gap that may undermine guideline ownership, implementation fidelity, and coordinated care pathways—particularly in low- and middle-income countries where family physicians constitute the backbone of chronic respiratory disease management. This letter argues that explicit recognition of family physicians in future GINA and GOLD updates, alongside inclusion of family medicine representatives in guideline development committees and creation of implementation toolkits for primary care settings, would strengthen guideline relevance, enhance primary care engagement, and ultimately improve respiratory health outcomes worldwide.

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Npj Primary Care Respiratory Medicine

Título del artículo:

Perceived stress, coping strategies and associated factors among Colombian undergraduate health science students

Background: Students involved in health sciences programs usually experience high levels of stress due to the academic loads, clinical responsibilities, and emotional demands from caring for patients. This situation can negatively impact student performance. In Latin America, few studies have investigated this problem. We sought to identify the prevalence of stress perceived by health science university students in northeastern Colombia, as well as the associated factors and the relationships between these factors and individual coping strategies. Methods: We conducted an analytic cross-sectional study involving 783 undergraduate students from thirteen academic programs in the health sciences. The students completed the Spanish versions of the Perceived Stress Scale (PSS-14) and the Brief Coping Orientation Problems Experienced Inventory (COPE-28). In addition, sociodemographic variables related to lifestyle and the academic environment were collected. Frequencies and proportions were calculated for the qualitative variables, and measures of central tendency and dispersion were calculated for the quantitative variables. A backward stepwise logistic regression analysis was performed to evaluate the association between covariates and perceived stress; this was not a causal study. A p value < 0.05 was considered to indicate statistical significance. Results: The median age of the participants was 21 years (interquartile range [IQR]: 20–25), and the sample included 550 (70.2%) females. The overall mean (± Standard deviations [SD]) PSS-14 score was 27.6 (± 7.5); additionally, high levels of perceived stress were reported by 345 (44.1%) students. Having a medication-taking routine (adjusted OR [AOR] = 2.43, 95% CI: 1.59–3.71) and attending a public university (AOR = 2.58, 95% CI: 1.60–4.15) were associated with high perceived stress, whereas male sex (AOR = 0.46, 95% CI: 0.32–0.66) and engaging in physical activity (AOR = 0.70, 95% CI: 0.51–0.96) were negatively associated (protective factors) with perceived stress. Regarding coping strategies, self-distraction (AOR = 1.15, 95% CI: 1.02–1.30), behavioral disengagement (AOR = 1.17, 95% CI: 1.03–1.32) and self-blame (AOR = 1.77, 95% CI: 1.54–2.03) increased the likelihood of high perceived stress, whereas the use of informational support (AOR = 0.82, 95% CI: 0.71–0.93), positive reframing (AOR = 0.86, 95% CI: 0.76–0.98), and planning (AOR = 0.76, 95% CI: 0.66–0.88) decreased the likelihood of high perceived stress. Conclusions: High perceived stress was reported by 44.1% of the participants. Students employed different coping strategies, in which context active coping exhibited the highest mean score and substance use exhibited the lowest mean score.

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BMC Medical Education

Título del artículo:

Parasporin-2-Derived Peptide Fragments: Characterization and Synergistic Anticancer Activity with Sacha Inchi and Curcumin

Background/Objectives: Parasporin PS2Aa1, recently designated as Mpp46Aa1, is recognized for its selective anticancer activity against various human cell lines. In this study, specific regions of the native protein were fragmented, and targeted amino acid substitutions were introduced to improve cytotoxic selectivity and potency. Methods: The modified fragments were evaluated individually and in combination with curcumin, a polyphenol with well-documented anticancer properties, and Sacha inchi-derived matrices, known for their antioxidant and antiproliferative activities. Results: Experimental results demonstrated that the substituted variant designated T104L-G108W exhibited superior anticancer activity compared to the native peptide P102-K11. Synergism assays revealed that curcumin-bioconjugated peptides were more effective against the tested cell lines, whereas combinations with Sacha inchi reduced cytotoxicity, suggesting possible interference in the mechanisms of action. Functional assays, including caspase 3/7 and 9 activation, Annexin V-Cy3 staining, and cell viability analysis with 6-CFDA, confirmed increased sensitivity in SiHa and HeLa cell lines, particularly for peptide T104L-G108W. Conclusions: Collectively, these findings support the effectiveness of a substitution-based strategy in improving parasporin fragments and underscore the therapeutic potential of peptide T104L-G108W as a novel anticancer candidate. Furthermore, this study provides preliminary evidence that natural biomolecules can be optimized through targeted modifications and rational combinations, establishing a framework for the development of sustainable and selective therapeutic approaches in cancer treatment.

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Cancers

Título del artículo:

Artificial Intelligence in Family Medicine: Opportunities, Challenges, and an Ethical Roadmap for its Implementation

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Revista Cubana De Medicina General Integral

Título del artículo:

Factors associated with disease severity in hospitalized children with Staphylococcus aureus infection

Staphylococcus aureus is a common cause of serious infections in children, with the incidence of methicillin-resistant Staphylococcus aureus (MRSA) rising in recent decades. To identify the factors associated with disease severity in pediatric patients hospitalized with S. aureus infection in high-complexity institutions in Santander, Colombia. A cross-sectional study was conducted among children under 18 years of age with S. aureus infection who were hospitalized (2018-21). Clinical characteristics and outcomes were compared between MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) infections. Factors associated with severity were identified through multivariate analysis with logistic and binomial regression. One hundred fifty-four cases of S. aureus infection were included, with 75 (48.7%) being MRSA. Among community-acquired infections, 55.7% (44/79) were caused by MRSA. Pediatric intensive care unit (PICU) admission was required in 55.8% of cases, and the infection-attributable case-fatality rate (CFR) was 1.9%. MRSA infections were associated with a greater need for vasopressor/inotropic support (prevalence ratio [PR], 2.06; 95% confidence interval [CI], 1.05-4.04; P = .036). Persistent bacteremia was associated with an increased PICU admission (PR 1.72; 95%CI: 1.19-2.46), mechanical ventilation (PR 8.63; 95%CI: 3.16-23.54), and vasopressor/inotropic support (PR 11.06; 95%CI: 4.59-26.58). S. aureus infections showed a high prevalence of MRSA, with a notable proportion of community-acquired cases. More than half required admission to PICU, but the infection-attributable CFR was low. MRSA infections and persistent bacteremia were associated with disease severity. These findings support the use of timely antibiotic therapy and reinforce the need for infection prevention and control strategies.

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Journal of Tropical Pediatrics

Título del artículo:

GUIDELINES AND PARAMETERS OF COOPERATION BETWEEN RUSSIA AND COLOMBIA IN THE FIELD OF EDUCATION

The article is devoted to the analysis of the indicators and parameters of cooperation between Russia and Colombia in the field of education in the context of the changing geopolitical situation and the actualization of the foreign policy of the Russian Federation. The key factors determining the relevance of educational cooperation are considered, including the internationalization of Russian education as a tool of \"soft power\", the progressive educational policy of Colombia, as well as the potential of bilateral partnership in the scientific, cultural, and economic spheres. Modern trends and promising areas for the development of integration processes – from academic mobility to the creation of joint research and educational platforms – are identified. The research underlines the importance of inter-university cooperation as a strategic tool for the formation of sustainable Russian-Colombian relations.

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Iberoamerica Russian Federation