Emotional Intelligence and Personality Traits of University Students in Dentistry, Medicine and Pharmacy Degrees.

BACKGROUND: This study aimed to characterize dentistry, medicine and pharmacy students in terms of emotional intelligence (EI) and personality traits (PTs). It also sought to identify whether differences existed according to gender and degree program and the relationship between them. METHODS: Students enrolled in dentistry (115), medicine (85) and pharmacy (57) degree programs participated voluntarily in the research, including 59 men and 198 women. The following questionnaires were used: (1) the Trait Meta-Mood Scale (TMMS-24) to evaluate EI; (2) the NEO Five-Factor Inventory (NEO-FFI) to assess PT. The Qualtrics XM platform was used for data collection. RESULTS: There were no statistically significant differences between three components of EI, either according to gender or degree program. The only difference in PTs was found in neuroticism, where women scored higher than men. There were statistically significant differences between students on different degree programs in openness to experience and responsibility. The five PTs correlated significantly with the three components of EI, except responsibility and emotional attention. The strongest associations were found between neuroticism and emotional repair (-0.439). CONCLUSIONS: High percentages of the student population were observed to have weaknesses in emotional clarity and emotional repair. Neuroticism is a personality trait that seems to occur more frequently in women.

[Experience in COVID-19 in hospitalized patients in pediatric critical units during pandemic period]. / Experiencia en COVID-19 en pacientes hospitalizados en unidades de paciente crítico pediátrico durante el periodo pandémico.

OBJECTIVES: To characterize the COVID-19 disease profile in Chilean children hospitalized in pediatric intensive care units (PICU) and to evaluate risk factors associated with severe COVID-19. PATIENTS AND METHOD: A multicenter prospective cohort study with patients 0-18 years of age with confirmed SARS-CoV-2 hospitalized in PICU. Clinical, laboratory, imaging, and therapeutic variables were recorded. We compared "mild/moderate COVID-19" with ''severe COVID-19" using median with interquartile range (IQR), Mann-Whitney U test, two-tailed Fisher's test, and forward binary multivariate analysis to adjust variables for "severe COVID-19". A p < 0.05 was considered significant. RESULTS: From 16 PICUs, 219 patients were recruited, 55.3% were male, with a median age of 86 months (IQR: 13.5-156). The most frequent comorbidities were obesity and respiratory diseases. Overall mortality was 3.6%. "Severe COVID-19" (26.5%) showed more leukopenia, lymphopenia, increased inflammatory parameters, and altered organ function (p < 0.05). It also developed more sepsis/shock, ARDS, and organ dysfunction, requiring more hemodynamic, anti-inflammatory, anticoagulation, and antibiotic therapy, with a longer stay in the PICU/hospital (p < 0.05), and 13.8% of mortality. Risk factors associated with "severe COVID-19" were shock on admission to the PICU [aOR 28.44 (95%CI 10.45-77.4)], obesity [aOR 3.55 (95%CI 1.3-9.6)], consolidation [aOR 3.1 (95%CI 1.1 -8.7)], atelectasis [aOR: 8.7 (95%CI 1.17-64.3)], stress dose of corticosteroids [aOR 7.7 (95%CI 1.9-30.6)], early antibiotic therapy [aOR: 12.02 (95%CI 1.11-130.02)], acquired/congenital immunodeficiency [aOR: 19.2 (95%CI: 1.19-321)], and oncological pathology [aOR 10.7 (95%CI 2.14-47.8)]. CONCLUSION: In this Chilean pediatric cohort, most patients with COVID-19 admitted to de PICU were male, of school age, with associated comorbidity. Risk factors for developing severe COVID-19 were the presence of comorbidities such as acquired/congenital immunodeficiency, oncological pathology, and obesity, in addition to shock on admission and consolidations on X-rays.

Plasma A2AR Measurement Can Help Physicians Identify Patients Suspected of Coronary Chronic Syndrome: A Pilot Study.

The evaluation of suspected coronary artery disease (CAD) in the medical community is challenging. Patients with suspected coronary chronic syndrome (CCS) are referred by the medical community to be assessed by specialists for the performance of noninvasive tests that have high rates of false positives and false negatives. While troponins are the gold standard for evaluate myocardial injuries, there is no biomarker to assess myocardial ischemia in patient populations with negative electrocardiography or without an increase in troponin level. A2A adenosine receptors control the coronary blood flow through its vasodilating properties. It has been shown that patients with CAD have a lower A2AR expression on peripheral blood mononuclear cells, suggesting a link between A2AR production and the severity of CAD. Herein, we present a new and innovative method of inhibition ELISA for A2AR in the plasma of patients who permit the evaluation of the amount of soluble A2AR. For this analysis, the total study sample was 54, including 31 patients with CAD with stenosis > 50% and a significant fractional flow reserve (FFR < 0.8) (Group 1) and 23 patients with normal or non-obstructive coronary arteries (stenosis < 50% and nonsignificant FFR > 0.8) (Group 2). The % inhibition (which is linked to the presence of soluble receptors) with the plasma of patients with FFR < 0.8 was significantly lower than that of patients with FFR > 0.8 (median [range]: 68% [20.7−86.9] vs. 83% [67−88.4]; p < 0.001). The ROC curve indicated a good sensitivity/specificity ratio with a cut off of 72.5% and an area under the curve of 0.87. In conclusion, a rapid ELISA to assess soluble A2AR in the plasma shows promise to screen patients suspected of having CAD.

Implementation of a hospital-at-home (HAH) unit for hematological patients during the COVID-19 pandemic: safety and feasibility.

BACKGROUND: "Hospital-at-home" (HAH) programs have been shown to optimize resource utilization, shorten hospitalization and prevent nosocomial infection. METHODS: We retrospectively analysed data regarding implementation of an HAH unit for caring patients with hematological malignancies in our center, during the COVID-19 pandemic. RESULTS: Between January and November 2020, 105 patients were treated in the HAH unit for a total of 204 episodes. Nine patients with multiple myeloma (MM) received autologous HSCT (auto-HSCT). Three patients with acute myeloid leukemia (AML) received consolidation therapy, 32 patients underwent clinical and analytical monitoring, 20 were transplant recipients early discharged (5 auto-HSCT and 15 allo-HSCT) and 2 had received CART cells therapy. Azacitidine, bortezomib and carfilzomib were administered at home to 54 patients with AML, myelodysplastic syndrome (MDS) or MM. A median of 17 (IQR 13-19) days of admission per patient and a total of 239 visits to the Hematology day-care hospital were avoided. Overall, 28 patients (14% of all episodes) needed admission to the hospital, 4 of them due to COVID-19. CONCLUSIONS: Implementation of a Hematology HAH unit was feasible and safe, and provided thorough advanced care to a high-risk population. Advanced care-at-home strategies can be crucial during times of COVID-19 to minimize treatment interruptions and reduce the risk of cross-infections.

Bienestar psicológico y social de funcionarios de centro de salud pública y su relación con personalidad y eficacia colectiva / Psycological and social well-being of public health center employees and their relationship with personality and collective effectiveness

Resumen Introducción: Los funcionarios de Salud Pública presentan el mayor número de patologías mentales asociadas a la esfera laboral, tornando urgente el adoptar medidas para prevenir los riesgos psicosociales y favorecer su bienestar psicológico y social. Objetivo: Establecer los rasgos de personalidad y categorías de eficacia colectiva que se relacionan con el bienestar psicológico y social de funcionarios de un centro de salud pública. Método: Estudio transeccional correlacional, con uso de metodología cuantitativa. Muestra no probabilística conformada por 51 participantes, entre 20 y 63 años; 30 % hombres, 70 % mujeres, 62,75 % profesionales, 25,5 % técnicos y 11,76 % otros. Resultados: Se encuentra una correlación positiva entre Apertura a la experiencia y Autoaceptación (rho = 0,391), al igual que entre Amabilidad y Propósito en la vida (rho =0,360). La misma tendencia se devela entre Competencias Grupales Positivas y Pertenencia Social (rho = 0,471) e Interacción Social en el trabajo (rho = 0,413). Al igual que entre Elementos Positivos influyentes en las tareas y Pertenencia Social en el trabajo (rho=0,395). Conclusiones: Los rasgos de personalidad establecidos por John, Donahue & Kentle (1991) de Apertura a la experiencia y Amabilidad, en conjunto con las dimensiones de eficacia colectiva de Competencias grupales positivas y Análisis de elementos positivos influyentes en las tareas, se relacionan positivamente con el bienestar psicológico y social en el trabajo, en funcionarios de salud pública.

Abstract Introduction: Public Health employees present the greatest number of mental pathologies associated with the workplace, making it urgent to adopt measures to prevent psychosocial risks and promote their psychological and social well-being. Objective: To establish the personality traits and categories of collective efficacy that are related to the psychological and social well-being of officials of the Public Health Center. Method: Cross-correlational study, using quantitative methodology. Non-probability sample made up of 51 participants, between 20 and 63 years old; 30% men, 70% women, 62,75% professionals, 25,5% technicians and 11,76% others. Results: positive correlation was found between Openness to experience and Self-acceptance (rho = 0,391), as well as between Kindness and Purpose in life (rho = 0,360). The same trend is revealed between Positive Group Competencies and Social Belonging (rho = 0,471) and Social Interaction at work (rho = 0,413). As between positive influencing elements in tasks and social belonging at work (rho = 0,395). Conclusions: The personality traits established by John, Donahue & Kentle (1991) of Openness to experience and Friendliness, together with the collective efficacy dimensions of Positive group competences and Analysis of positive influencing elements in tasks, are positively related to psychological and social well-being at work, in workers of public health center.

Upper respiratory tract SARS-CoV-2 RNA loads in symptomatic and asymptomatic children and adults.

OBJECTIVES: Studies comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA load in the upper respiratory tract (URT) between children and adults-who either presented with coronavirus disease 2019 (COVID-19) or were asymptomatic-have yielded inconsistent results. Here, we conducted a retrospective, single-centre study to address this issue. PATIENTS AND METHODS: Included were 1184 consecutive subjects (256 children and 928 adults) testing positive for SARS-CoV-2 RNA in nasopharyngeal exudates (NPs); of these, 424 (121 children and 303 adults) had COVID-19 and 760 (135 children and 625 adults) were asymptomatic close contacts of COVID-19 patients. SARS-CoV-2 RNA testing was carried out using the TaqPath COVID-19 Combo Kit (Thermo Fisher Scientific, MS, USA). The AMPLIRUN® TOTAL SARS-CoV-2 RNA Control (Vircell SA, Granada, Spain) was used for estimating SARS-CoV-2 RNA loads (in copies/mL). SARS-CoV-2 RNA loads at the time of laboratory diagnosis (single specimen/patient) were used for comparison purposes. RESULTS: Median initial SARS-CoV-2 RNA load was lower (p 0.094) in children (6.98 log10 copies/mL, range 3.0-11.7) than in adults (7.14 log10 copies/mL, range 2.2-13.4) with COVID-19. As for asymptomatic individuals, median SARS-CoV-2 RNA load was comparable (p 0.97) in children (6.20 log10 copies/mL, range 1.8-11.6) and adults (6.48 log10 copies/mL, range 1.9-11.8). Children with COVID-19 symptoms displayed SARS-CoV-2 RNA loads (6.98 log10 copies/mL, range 3.0-11.7) comparable to those of their asymptomatic counterparts (6.20 log10 copies/mL, range 1.8-11.6) (p 0.61). Meanwhile in adults, median SARS-CoV-2 RNA load was significantly higher in symptomatic (7.14 log10 copies/mL, range 2.2-13.4) than in asymptomatic subjects (6.48 log10 copies/mL, range 1.9-11.8) (p < 0.001). Overall, the observed URT SARS-CoV-2 RNA clearance rate was faster in children than in adults. CONCLUSIONS: Based on viral load data at the time of diagnosis, our results suggest that SARS-CoV-2-infected children, with or without COVID-19, may display NP viral loads of comparable magnitude to those found in their adult counterparts. However, children may have shorter viral shedding than adults.

Enfrentamiento del paciente con poliartralgias y poliartritis / Patient's facing polyarthralgia and polyarthritis

El dolor articular es un motivo de consulta frecuente en la práctica clínica. La distinción del tipo de dolor, su distribución, los síntomas acompañantes, el examen físico y la evaluación de algunos exámenes de laboratorio ayudan a orientar acerca de las posibles causas y a pesquisar enfermedades graves que pueden causar destrucción articular o compromiso de otros órganos, con el fin de dar tratamiento oportuno y eficaz. En este artículo se dan algunas pautas que se pueden realizar en la consulta de Atención Primaria para distinguir cuadros de poliartralgias y poliartritis agudas y crónicas. Además, se dan nociones de algunas de las enfermedades reumatológicas más frecuentes.

Joint pain is a frequent reason for consultation in clinical practice. The distinction of the type of pain, its distribution, the accompanying symptoms, the physical examination and the evaluation of some laboratory test help to guide about the possible causes and to investigate serious diseases that can cause joint destruction or involvement other organs, in order to provide timely and effective treatment. This article gives some guidelines that can be carried out in the Primary Care consultation to distinguish acute and chronic polyarthralgia and polyarthritis. In addition, notions of some of the most frequent rheumatological diseases are given.

Evaluation of a rapid antigen detection test (Panbio™ COVID-19 Ag Rapid Test Device) as a point-of-care diagnostic tool for COVID-19 in a pediatric emergency department.

We evaluated the Panbio™ COVID-19 Ag Rapid Test Device as a point-of-care diagnostic tool for COVID-19 in 357 patients at a pediatric emergency department. Thirty-four patients tested positive by reverse transcription polymerase chain reaction, of which 24 were positive by the antigen assay. The sensitivity and specificity of the assay were 70.5% and 100%, respectively.

Paediatric Emergencies During the COVID-19 Pandemic.

The state of alarm decreed by the Spanish Government, due to the Coronavirus Disease-19 (COVID-19) pandemic, has demanded the lockdown of children and has conditioned a new organization of the Emergency Departments (ED). A pre-triage station and 2 independent circuits were established: suspected COVID-19 and not suspected COVID-19. The ED visits decreased 84,5% from pre-alarm with no increase in the level of urgencies. During the alarm state, 40.97% of the children were classified as suspected COVID-19. Fever and respiratory symptoms, used as discriminators, generated 2 groups of patients with different characteristics. Although the interruption of sports activities and isolation of children at home contributed to the decrease in emergencies, it was also probably conditioned by adults' fear of contagion, who avoided going to the hospital in situations that would never have really required ED and resolved themselves in primary care or spontaneously.

Recomendaciones de manejo del paciente con pie diabético. Curso de instrucción / Management recommendations for diabetic foot patients. Instructional course

El ataque de pie diabético es uno de los desenlaces más fatídicos para el paciente con diabetes, lo que demuestra la importancia del control en una enfermedad que avanza hasta presentar cambios macroscópicos importantes en el miembro inferior. Durante la progresión de la Diabetes, la enfermedad puede derivar en un aumento de la morbilidad e intervenciones invasivas y limitantes para el paciente, de ahí la importancia de la detección e intervención temprana y oportuna de la patología por parte del equipo médico. Estas recomendaciones van dirigida a médicos generales y especialistas en diversas ramas médicas, con el objetivo de enfatizar el cómo se debe realizar el abordaje integral del paciente con pie diabético. Abarcando la prevención, diagnóstico inicial, evaluación de la progresión de la patología, estratificación con las clasificaciones propuestas, y por último el tratamiento según el estadio en el que se encuentre el paciente. Esto con el fin de minimizar desenlaces, intervenciones y complicaciones derivadas de la progresión del pie diabetico. Hablamos de recomendaciones y no de guías debido a la ausencia en un gran número de oportunidades de evidencia científica debidamente estructurada (I y II). Tal vez lo más importante por recalcar en todas estas recomendaciones es recordarle al lector que en los casos de afectación de un pie diabético, siempre se debe tener en cuenta que el pie contralateral también ha estado sometido a la misma enfermedad durante el mismo tiempo y por lo tanto aunque no tenga síntomas se debe considerar igualmente enfermo y se debe examinar también.

Diabetic foot is one of the most fatal outcomes for patients with diabetes; the importance of control in a disease that progresses until presenting important macroscopic changes in the lower limb is absolutely relevant. Along diabetes progression, the disease can lead to increased morbidity and invasive and limiting interventions for the patient, hence the importance of early and timely detection and intervention of the pathology by the medical team. These recommendations are addressed to general practitioners and specialized faculty in various medical branches, emphasizing how a comprehensive approach to the patient with diabetic foot should be carried out. Covering prevention, initial diagnosis, evaluation of the progression of the pathology, stratification with the proposed classifications, and finally the treatment according to the stage in which the patients are, is actually well described herein in order to minimize unsatisfactory outcomes, interventions and complications derived from the progression of diabetic foot. We are talking about recommendations and not guidelines due to the absence in a large number of opportunities of properly structured scientific evidence (I and II). Perhaps, the most important thing to emphasize in all these recommendations is to remind the reader that in cases of treating a diabetic foot, it should always be kept in mind that the contralateral foot is not healthy because it has also been subjected to the same disease, for the same period of time and stressed equally as well. Therefore, even if the contralateral foot does not have symptoms, it should be considered equally ill and should be examined and treated likewise.

Management recommendations for diabetic foot patients. Instructional course / Recomendaciones de manejo del paciente con pie diabético. Curso de instrucción

Diabetic foot is one of the most fatal outcomes for patients with diabetes; the importance of control in a disease that progresses until presenting important macroscopic changes in the lower limb is absolutely relevant. Along diabetes progression, the disease can lead to increased morbidity and invasive and limiting interventions for the patient, hence the importance of early and timely detection and intervention of the pathology by the medical team. These recommendations are addressed to general practitioners and specialized faculty in various medical branches, emphasizing how a comprehensive approach to the patient with diabetic foot should be carried out. Covering prevention, initial diagnosis, evaluation of the progression of the pathology, stratification with the proposed classifications, and finally the treatment according to the stage in which the patients are, is actually well described herein in order to minimize unsatisfactory outcomes, interventions and complications derived from the progression of diabetic foot. We are talking about recommendations and not guidelines due to the absence in a large number of opportunities of properly structured scientific evidence (I and II). Perhaps, the most important thing to emphasize in all these recommendations is to remind the reader that in cases of treating a diabetic foot, it should always be kept in mind that the contralateral foot is not healthy because it has also been subjected to the same disease, for the same period of time and stressed equally as well. Therefore, even if the contralateral foot does not have symptoms, it should be considered equally ill and should be examined and treated likewise.

El ataque de pie diabético es uno de los desenlaces más fatídicos para el paciente con diabetes, lo que demuestra la importancia del control en una enfermedad que avanza hasta presentar cambios macroscópicos importantes en el miembro inferior. Durante la progresión de la Diabetes, la enfermedad puede derivar en un aumento de la morbilidad e intervenciones invasivas y limitantes para el paciente, de ahí la importancia de la detección e intervención temprana y oportuna de la patología por parte del equipo médico. Estas recomendaciones van dirigida a médicos generales y especialistas en diversas ramas médicas, con el objetivo de enfatizar el cómo se debe realizar el abordaje integral del paciente con pie diabético. Abarcando la prevención, diagnóstico inicial, evaluación de la progresión de la patología, estratificación con las clasificaciones propuestas, y por último el tratamiento según el estadio en el que se encuentre el paciente. Esto con el fin de minimizar desenlaces, intervenciones y complicaciones derivadas de la progresión del pie diabetico. Hablamos de recomendaciones y no de guías debido a la ausencia en un gran número de oportunidades de evidencia científica debidamente estructurada (I y II). Tal vez lo más importante por recalcar en todas estas recomendaciones es recordarle al lector que en los casos de afectación de un pie diabético, siempre se debe tener en cuenta que el pie contralateral también ha estado sometido a la misma enfermedad durante el mismo tiempo y por lo tanto aunque no tenga síntomas se debe considerar igualmente enfermo y se debe examinar también.

Dengue in Santander State, Colombia: fluctuations in the prevalence of virus serotypes are linked to dengue incidence and genetic diversity of the circulating viruses.

OBJECTIVE: To investigate the link between fluctuations in the prevalence of dengue virus (DENV) serotypes and the number of dengue cases in the metropolitan area of Bucaramanga, Santander State, Colombia, in the 2007-2010 and 2014-2017 periods. METHOD: Viruses were isolated from febrile patient samples by direct application to C6/36-HT cells and typed using monoclonal antibodies. We performed autocorrelation and cross-correlation analyses to determine whether fluctuations in the prevalence of DENV serotypes and dengue cases were correlated. Full envelope (E) gene sequences were employed to examine the genetic diversity of serotypes circulating by using a phylogenetic approach. RESULTS: All four dengue virus serotypes were detected. DENV-1 was the dominant serotype in both periods followed by DENV-3 or DENV-2 depending on the period; DENV-4 was the least prevalent virus in both periods. Cross-correlation analyses suggest a temporal relation between the fluctuations in the prevalence of DENV serotypes, which were almost simultaneous (lag = 0) or related to recent past fluctuations (lag > 1.0) in the number of dengue cases. Data suggest that a sustained predominance of DENV-1, an increase of the DENV-4 prevalence, and a switch from DENV-3 to DENV-2 could be linked to an outbreak. Circulating viruses were grouped into Genotype V, Asia/American III and II for DENV-1, -2, -3 and -4, respectively; intragenotypic diversity was detected. CONCLUSIONS: The present work highlights the need of comprehensive studies on dynamics of DENV in Colombia to understand transmission of dengue and evaluate the effectiveness of a vaccination programme.

OBJECTIF: Etudier le lien entre les fluctuations de la prévalence des sérotypes du virus de la dengue (DENV) et le nombre de cas de dengue dans la région métropolitaine de Bucaramanga, dans l'Etat de Santander, en Colombie, au cours des périodes 2007-2010 et 2014-2017. MÉTHODE: Les virus ont été isolés à partir d'échantillons de patients fébriles par application directe sur des cellules C6/36-HT et typés à l'aide d'anticorps monoclonaux. Nous avons effectué des analyses d'autocorrélation et de corrélation croisée afin de déterminer si les fluctuations de la prévalence des sérotypes du DENV et des cas de dengue étaient corrélées. Des séquences de gènes d'enveloppe complète (E) ont été utilisées pour examiner la diversité génétique des sérotypes en circulation en utilisant une approche phylogénétique. RÉSULTATS: Tous les quatre sérotypes du virus de la dengue ont été détectés. DENV-1 était le sérotype dominant dans les deux périodes, suivi de DENV-3 ou DENV-2, selon la période; le virus DENV-4 était le moins prévalent au cours des deux périodes. Les analyses de corrélation croisée suggèrent une relation temporelle entre les fluctuations de la prévalence des sérotypes de DENV, qui étaient presque simultanées (lag = 0) ou liées aux fluctuations passées récentes (lag > 1,0) du nombre de cas de dengue. Les données suggèrent qu'une prédominance durable de DENV-1, qu'une augmentation de la prévalence de DENV-4 et qu'un passage de DENV-3 à DENV-2 pourraient être liés à une éclosion. Les virus en circulation ont été regroupés dans les génotypes V, Asie/Amérique III et II pour DENV-1, -2, -3 et -4, respectivement; une diversité intra-génotypique a été détectée. CONCLUSIONS: Le présent travail souligne la nécessité d'études approfondies sur la dynamique du DENV en Colombie afin de comprendre la transmission de la dengue et évaluer l'efficacité d'un programme de vaccination.

First international descriptive and interventional survey for cholesterol and non-cholesterol sterol determination by gas- and liquid-chromatography-Urgent need for harmonisation of analytical methods.

Serum concentrations of lathosterol, the plant sterols campesterol and sitosterol and the cholesterol metabolite 5α-cholestanol are widely used as surrogate markers of cholesterol synthesis and absorption, respectively. Increasing numbers of laboratories utilize a broad spectrum of well-established and recently developed methods for the determination of cholesterol and non-cholesterol sterols (NCS). In order to evaluate the quality of these measurements and to identify possible sources of analytical errors our group initiated the first international survey for cholesterol and NCS. The cholesterol and NCS survey was structured as a two-part survey which took place in the years 2013 and 2014. The first survey part was designed as descriptive, providing information about the variation of reported results from different laboratories. A set of two lyophilized pooled sera (A and B) was sent to twenty laboratories specialized in chromatographic lipid analysis. The different sterols were quantified either by gas chromatography-flame ionization detection, gas chromatography- or liquid chromatography-mass selective detection. The participants were requested to determine cholesterol and NCS concentrations in the provided samples as part of their normal laboratory routine. The second part was designed as interventional survey. Twenty-two laboratories agreed to participate and received again two different lyophilized pooled sera (C and D). In contrast to the first international survey, each participant received standard stock solutions with defined concentrations of cholesterol and NCS. The participants were requested to use diluted calibration solutions from the provided standard stock solutions for quantification of cholesterol and NCS. In both surveys, each laboratory used its own internal standard (5α-cholestane, epicoprostanol or deuterium labelled sterols). Main outcome of the survey was, that unacceptably high interlaboratory variations for cholesterol and NCS concentrations are reported, even when the individual laboratories used the same calibration material. We discuss different sources of errors and recommend all laboratories analysing cholesterol and NCS to participate in regular quality control programs.

Actualización en el estudio de granulomatosis con poliangeitis (granulomatosis de Wegener) / Update in study of granulomatosis with polyangiitis (Wegener's granulomatosis)

Resumen:La granulomatosis con poliangeítis (GPA) es una vasculitis sistémica de pequeño vaso, que afecta más frecuentemente el tracto respiratorio y el riñón. Sus criterios diagnósticos se basan en la clínica, exámenes de laboratorio, imágenes e histología. El 90% son ANCA (anticuerpos anticitoplasma de neutrófilos) positivos. La histología muestra inflamación granulomatosa, necrosis y vasculitis. Los exámenes de imagen son de vital importancia en su estudio inicial y seguimiento, correspondiendo principalmente a técnicas tomográficas. La tomografía Computada (TC) es el método de elección para la evaluación de vía aérea superior y pulmón, con alta sensibilidad en afectación de cavidades nasal/paranasales, árbol bronquial y pulmón. La Resonancia Magnética está indicada en compromiso del sistema nervioso central y corazón. El PET/CT presenta alta sensibilidad en enfermedad tóraco-abdominal, es de utilidad en detectar lesiones no visibles con otras técnicas, y en control de tratamiento. El compromiso renal, de alta ocurrencia en GPA, presenta escasa traducción en las imágenes y es frecuentemente indetectable con imágenes, aunque el PET/CT puede ser positivo en casos de glomerulonefritis acentuada. La radiología simple no debe ser utilizada en el estudio de GPA dado su bajo rendimiento diagnóstico. El tratamiento se basa en terapia corticoidea e inmunosupresora. Las recaídas son frecuentes, por lo que estos pacientes requieren seguimiento a largo plazo.

Abstract:Granulomatosis with polyangiitis (GPA) is a systemic type of vasculitis that affects small vessels, most commonly involving the respiratory tract and kidneys. Diagnosis is based on clinical criteria, laboratory tests, imaging and histology. Ninety percent are ANCA (anti-neutrophilic cytoplasmic antibodies) positive. Histology demonstrates granulomatous inflammation, necrosis and vasculitis. Imaging studies are vital for the initial work-up and follow-up. Computed Tomography (CT) is the method of choice for evaluation of the upper airway and lungs, because of its high sensitivity detecting anomalies of paranasal sinuses, bronchial tree and lungs. Magnetic Resonance is indicated for evaluation of the central nervous system and heart. PET/CT has high sensitivity for thoracic and abdominal disease, is useful at detecting lesions not seen with other imaging techniques, and for follow-up. Renal involvement, very frequent on GPA, is usually undetectable at imaging, but may be seen at PET/CT in cases of marked glomerulonephritis. Plain X-rays should not be used for evaluation of GPA because of their low diagnostic performance. Treatment is based on corticosteroid and immunosuppressive therapy. Relapses are frequent, so these patients require long-term follow-up.

Evolutionary history and spatio-temporal dynamics of dengue virus serotypes in an endemic region of Colombia.

Dengue is a prevalent disease in Colombia and all dengue virus serotypes (DENV-1 to -4) co-circulate in the country since 2001. However, the relative impact of gene flow and local diversification on epidemic dynamics is unknown due to heterogeneous sampling and lack of sufficient genetic data. The region of Santander is one of the areas with the highest incidence of dengue in Colombia. To provide a better understanding of the epidemiology of dengue, we inferred DENV population dynamics using samples collected between 1998 and 2015. We used Bayesian phylogenetic analysis and included 143 new envelope gene sequences from Colombia, mainly from the region of Santander, and 235 published sequences from representative countries in the Americas. We documented one single genotype for each serotype but multiple introductions. Whereas the majority of DENV-1, DENV-2, and DENV-4 strains fell into one single lineage, DENV-3 strains fell into two distinct lineages that co-circulated. The inferred times to the most recent common ancestors for the most recent clades of DENV-1, DENV-2, and DENV-4 fell between 1977 and 1987, and for DENV-3 was around 1995. Demographic reconstructions suggested a gradual increase in viral diversity over time. A phylogeographical analysis underscored that Colombia mainly receives viral lineages and a significant diffusion route between Colombia and Venezuela. Our findings contribute to a better understanding of the viral diversity and dengue epidemiology in Colombia.

Oxidation of sitosterol and campesterol in foods upon cooking with liquid margarines without and with added plant sterol esters.

Plant sterol (PS) oxidation products (POP) derived from sitosterol and campesterol were measured in 15 foods cooked with liquid margarine without (control) and with added 7.5% PS. POP were analyzed using a GC-MS method. PS liquid vs. control margarine resulted in a higher median POP content per food portion (1.35mg, range 0.08-13.20mg versus 0.23mg, 0.06-0.90mg), a lower PS oxidation rate (0.63 vs. 1.29%) and lower oxidation susceptibility of sitosterol vs. campesterol. POP formation was highest in shallow-fried potatoes with PS liquid margarine (64.44mg per portion food plus residual fat). Mean relative abundances of epoxy-, 7-keto-, 7-hydroxy- and triol-PS derived from sitosterol and campesterol were 40.0, 34.4, 21.5 and 4.0% with control vs. 44.1, 23.8, 29.6 and 2.4% with PS liquid margarine. In conclusion, PS liquid margarine increased POP content in foods with a POP profile characterized by a higher ratio of epoxy- to 7-keto-derivatives.

Development and validation of methodologies for the quantification of phytosterols and phytosterol oxidation products in cooked and baked food products.

Chromatography-mass spectrometry (GC-MS) methodologies for the analysis of the main phytosterols (PS) and phytosterol oxidation products (POPs) present in 19 different foodstuffs cooked or baked using margarines with or without added plant sterols are presented. Various methods for fat extraction were evaluated to allow the GC-MS analysis of large numbers of prepared vegetable, fish and meat products, egg and bakery items in a practically feasible manner. The optimized methods resulted in a good sensitivity and allowed the analysis of both PS and POPs in the broad selection of foods at a wide range of concentrations. Calibration curves for both PS and POPs showed correlation coefficients (R(2)) better than 0.99. Detection limits were below 0.24mgkg(-1) for PS and 0.02mgkg(-1) for POPs, respectively. Average recovery data were between 81% and 105.1% for PS and between 65.5 and 121.8% for POPs. Good results were obtained for within- and between-day repeatability, with most values being below 10%. Entire sample servings were analyzed, avoiding problems with inhomogeneity and making the method an exact representation of the typical use of the food by the consumer.

Formation of Plant Sterol Oxidation Products in Foods during Baking and Cooking Using Margarine without and with Added Plant Sterol Esters.

Plant sterols (PS) in foods are subject to thermal oxidation to form PS oxidation products (POP). This study measured POP contents of 19 foods prepared by typical household baking and cooking methods using margarines without (control) and with 7.5% added PS (as 12.5% PS-esters, PS-margarine). Median POP contents per portion size of cooked foods were 0.57 mg (range 0.05-1.11 mg) with control margarine versus 1.42 mg (range 0.08-20.5 mg) with PS-margarine. The oxidation rate of PS (ORP) was 0.50% (median) with the PS-margarine and 3.66% with the control margarine. Using the PS-margarine, microwave-cooked codfish had the lowest POP content, with 0.08 mg per portion, while shallow-fried potatoes had the highest POP content, 20.5 mg per portion. Median POP contents in cookies, muffins, banana bread, and sponge cake baked with the control or PS-margarine were 0.12 mg (range 0.11-0.21 mg) and 0.24 mg (range 0.19-0.60 mg) per portion, with a corresponding ORP of 1.38% and 0.06%, respectively. POP contents in all the cooked and baked foods did not exceed 20.5 mg per typical portion size. A wide variation in the distribution of individual POP among different foods existed, with 7-keto-PS and 5,6-epoxy-PS being the major oxidation products.