BACKGROUND:Dental fluorosis produces enamel opacities and discolorations that compromise esthetics and often require minimally invasive treatments. Although several modalities are available including microabrasion, bleaching, resin infiltration, and remineralization, their comparative performance remains unclear. OBJECTIVE:To evaluate and rank the esthetic masking efficacy of minimally invasive treatments for dental fluorosis using a network meta-analysis. METHODS:A systematic review and network meta-analysis were conducted in accordance with PRISMA-NMA. Seven controlled clinical studies (13 interventions; 555 participants) met eligibility criteria. Random-effects network models were performed in R and independently replicated in MetaInsight. Treatment rankings were generated with SUCRA/P-scores, and certainty of evidence was assessed using CINeMA. RESULTS:Multimodal protocols combining microabrasion with in-office bleaching achieved the highest esthetic performance across immediate, three-month, and 6-month evaluations. Microabrasion + in-office bleaching (MAB + IOB) ranked first (highest SUCRA probability) and produced the largest ΔE improvements, followed by MAB + IOB + CPP-ACP and MAB + RI. Resin infiltration alone showed consistent, clinically meaningful effects and emerged as the most effective standalone technique. In contrast, microabrasion alone, CPP-ACP, and sodium hypochlorite demonstrated modest or unstable changes. Cross-platform triangulation between R and MetaInsight produced fully concordant effect estimates and identical treatment hierarchies. CINeMA indicated no major incoherence and moderate confidence for most comparisons. CONCLUSION:Combined minimally invasive strategies, particularly MAB + IOB, with or without CPP-ACP, provide the greatest and most durable esthetic masking of fluorosis-related discoloration. Resin infiltration remains the strongest single-modality option. Remineralization and oxidizing agents alone show limited effectiveness. These findings establish a clinically relevant hierarchy to guide conservative management of dental fluorosis. CLINICAL SIGNIFICANCE:Sequential multimodal protocols integrating surface modification, bleaching, and resin-based refractive adjustment maximize esthetic outcomes while preserving enamel, supporting their use as first-line approaches for mild-to-moderate fluorosis. TRIAL REGISTRATION:PROSPERO; registration number CRD420251234096.
Foundation: women of reproductive age have a protective factor against cardiovascular disease due to the effect of estrogen on the vascular endothelium. However, during perimenopause and postmenopause, states of hypoestrogenemia occur, leading to an increased risk of cardiovascular disease and death. Objective: to determine the frequency of the main cardiovascular risk factors in perimenopausal and postmenopausal women. Method: a cross-sectional study was conducted on 332 women who attended the menopause and perimenopause clinic at the 19 de Abril University Polyclinic in the Plaza de la Revolución municipality between 2018 and 2020. The variables studied were: hypertension, type 2 diabetes mellitus, overweight and obesity, abdominal obesity, hypercholesterolemia, smoking, sedentary lifestyle, perimenopause, and postmenopause. The mean and standard deviation were determined for the variables that required and the typical measures of association (Odds Ratios and contingency coefficients) to evaluate the binary associations between the variables. Results: cardiovascular risk factors are more frequent in the postmenopausal stage compared to the perimenopausal stage, with sedentary lifestyle being the most prevalent in 214 patients (78.7 %), followed by excess weight in 179 patients (65.8 %). Patients with 3 risk factors represented 82.1 % of the postmenopausal patients, while those with 7 represented 94.7 %. Conclusion: the high prevalence of atherosclerotic risk factors in the postmenopausal stage highlights the need for specific preventive strategies to reduce the cardiovascular burden in menopausal women.
El aumento de la esperanza de vida ha generado más personas dependientes, destacando el papel crucial de los cuidadores informales. En esta revisión sistemática se evaluó la efectividad de21 intervenciones, para mejorar el bienestar físico, emocional y psicosocial de los cuidadores mediante la metodología PRISMA. Dichas intervenciones incluyeron la formación, el apoyo psicológico, las terapias cognitivo-conductuales y la tecnología. En general, se demostró que las intervenciones son efectivas, especialmente cuando incorporan componentes psicoeducativos y apoyo social. Sin embargo, las limitaciones tienen que ver con la falta de generalización, las muestras pequeñas y la sobreestimación de los efectos. Además, el uso de autoinformes y la heterogeneidad de los diseños afectaron los resultados. Recibido: 13/03/2025Aceptado: 21/03/2025
Preventing diabetic foot is a priority challenge for healthcare systems, given its high prevalence and the serious consequences it has for patients and society. This article reflects on the training of nursing students in health promotion and highlights experiences in the province of Cienfuegos. It emphasizes the need to integrate theoretical content with community and hospital-based practices, as well as to strengthen the educational and communication skills of future professionals, to guarantee comprehensive and high-quality preventive care.
Rhodococcus species display remarkable metabolic versatility and adaptation to extreme environments, yet their antimicrobial potential remains largely unexplored, particularly in strains representing undescribed genomic lineages. This study investigated whether the genome of Rhodococcus sp. GB-02, a strain isolated from Antarctic soil, encodes antimicrobial peptides with demonstrable activity against clinically relevant pathogens. Hybrid genome assembly revealed a 6.58 Mb high-quality draft genome belonging to a previously undescribed genomic lineage within the genus Rhodococcus, based on average nucleotide identity and digital DNA-DNA hybridization analyses. Genome mining identified 20 biosynthetic gene clusters, predominantly non-ribosomal peptide synthetases, several of which showed low or no similarity to known pathways. Eight putative antimicrobial peptides (AMPs) were computationally predicted; among these, three lacked detectable homology to sequences in current databases, and experimental validation of one predicted peptide, designated Peptide 5764, demonstrated antibacterial activity at high micromolar concentrations against Gram-positive and Gram-negative pathogens and concentration-dependent inhibition of biofilm formation, particularly in Pseudomonas aeruginosa. However, Peptide 5764 exhibited considerable hemolytic activity at antibacterial concentrations, indicating that optimization for membrane selectivity will be required before therapeutic application. These findings establish Rhodococcus sp. GB-02 as an underexplored Antarctic lineage with a diverse biosynthetic repertoire and provide proof-of-concept that genome-guided AMP prediction can identify experimentally active peptide scaffolds from this lineage.
