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BACKGROUND: Recent studies have demonstrated that real-time CGM use reduce the incidence severe hypoglycemic events and impaired awareness of hypoglycemia (IAH) However, there are few real-world studies evaluating the effect of intermittently scanned continuous glucose monitoring (isCGM) on hypoglycemic episodes and hypoglycemia unawareness (IAH). The present study was designed to cover this research-practice gap. METHODS: This is a real-world, observational, prospective cohort study with 2 years of follow-up in which 60 subjects with T1D who experienced frequent hypoglycemic events were included. All the patients were invited to use isCGM type Abbott FreeStyle Libre 2® on a continuous basis for 2 years. Glucometric parameters were obtained during the initial 2 weeks using isCGM and compared with data collected for the same period at 1 year and at the end of follow-up. The IAH was evaluated using the Clarke questionnaire, and to assess psychological aspects related to hypoglycemia the Hypoglycemia Fear Survey (HFS) was used. RESULTS: After 2-years of follow-up using isCGM, we observed a decrease in glucose variability (40.3 ± 0.8 % vs. 37.1 ± 0.9 %, p = 0.003), time in low glucose range (54-69 mg/dL) (5.2 ± 0.4 % vs. 3.6 ± 0.3 %, p = 0.001), time in very low glucose range (<54 mg/dL) (3.2 ± 0.5 % vs. 0.8 ± 0.2 %, p < 0.001), less events related to low glucose levels (10.6 ± 1.1 vs 8.0 ± 1.0, p = 0.042) and a short duration of hypoglycemia episodes (106.1 ± 5.9 min vs. 85.7 ± 5.7 min, p = 0.008). In addition, participants presented a reduction of 47 % in the frequency of IAH, assessed by the Clarke questionnaire scores (24.6 % vs. 11.6 %, p = 0.034), as well as hypoglycemia fear (77.8 ± 2.4 vs 68.2 ± 2.1, p < 0.001). Furthermore, a reduction in total insulin dose was also observed (0.64 ± 0.30 UI/Kg/day vs 0.56 ± 0.11 UI/Kg/day, p = 0.018). CONCLUSIONS: In the real-world, long-term use of isCGM could reduce both hypoglycemic episodes and IAH in people with T1D.
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Automonitorización de la Glucosa Sanguínea , Glucemia , Diabetes Mellitus Tipo 1 , Hipoglucemia , Humanos , Hipoglucemia/sangre , Hipoglucemia/prevención & control , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/psicología , Masculino , Automonitorización de la Glucosa Sanguínea/métodos , Femenino , Estudios Prospectivos , Adulto , Glucemia/análisis , Persona de Mediana Edad , Alarmas Clínicas , Hipoglucemiantes/uso terapéutico , Hipoglucemiantes/administración & dosificación , Estudios de Seguimiento , Monitoreo Continuo de GlucosaRESUMEN
The potential presence of microplastics (MPs) in seafood products presents significant health concerns, demanding the adoption of standardized and validated methodologies. In this study, we introduce a validated method and an innovative technique for extracting MPs from mussels using an oxidizing agent, Corolase enzyme, and a surfactant, thus eliminating the need for mechanical agitation. Evaluation of the extraction process focused on three critical parameters: recovery percentage, repeatability, and chemical integrity, along with color stability. To ensure precision and reliability, low-density infrared spectroscopy (LDIR) was employed to analyze the effect of spectrum quality (Q). Ultimately, this methodology was applied to identify MPs in commercial mussels, with results showcasing the viability of the proposed validation stages for MPs extraction, maintaining MPs integrity with high recovery percentages.
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INTRODUCTION: Wilms' tumor (WT) is the most frequent renal tumor in childhood. Therapeutic management progression has increased survival rates, and as a result, long-term adverse effects. MATERIALS AND METHODS: A descriptive retrospective study of a case series from 1977 to 2023 was carried out. The characteristics of the treatments received and the adverse effects listed on medical records were analyzed via phone surveys. RESULTS: 50 patients (25 boys-25 girls) with a mean age of 3.6 years (3 months-11 years) at diagnosis were included. Most of them (94%) were treated according to the protocol established by the European standards of pediatric oncology, which are characterized by the use of neoadjuvant chemotherapy. In one patient, the American treatment scheme was followed. The most common drugs used were vincristine and actinomycin D (78%). Only 12 patients (28%) received anthracyclines. Unilateral nephrectomy was the most frequent surgical technique (84%). Renal disorders were the most common (46%). However, the occurrence of second neoplasias (9%) and reproductive disorders (8% between boys and girls) had a greater impact on patients' quality of life. Multiple - cardiac (23%), endocrine (26%), and pulmonary (15%) - disorders associated with the treatments received were reported. CONCLUSIONS: WT treatment has an impact on health. Adequate and rigorous surgery, close follow-up, and limiting chemotherapy doses and radiation exposure can minimize long-term sequels.
INTRODUCCION: El tumor de Wilms (TW) es el tumor renal más frecuente en la infancia. La evolución del manejo terapéutico ha incrementado la tasa de supervivencia y como consecuencia, los efectos secundarios a largo plazo. MATERIAL Y METODOS: Realizamos un estudio retrospectivo descriptivo a partir de una serie de casos entre 1977 y 2023. Estudiamos las características de los tratamientos recibidos y los efectos secundarios que constan en su historia clínica y a través de cuestionarios telefónicos. RESULTADOS: Localizamos 50 pacientes (25 hombres-25 mujeres) con edad media al diagnóstico de 3,6 años (3 meses-11 años). La mayoría fueron tratados según protocolo vigente de las guías europeas de oncología pediátrica (94%) caracterizadas por el uso de quimioterapia neoadyuvante. En un paciente Se siguió el esquema americano de tratamiento. Los fármacos más utilizados fueron vincristina y actinomicina D (78%); solo 12 pacientes (28%) recibieron antraciclinas. La nefrectomía unilateral fue la técnica quirúrgica más empleada (84%). Las alteraciones renales fueron las más frecuentes (46%). Sin embargo, la aparición de segundas neoplasias (9%) y aquellas alteraciones relacionadas con la reproducción (8% entre hombres y mujeres) suponen un mayor impacto en la calidad de vida de los pacientes. Se describen múltiples alteraciones: cardíacas (23%), endocrinas (26%) o pulmonares (15%) relacionadas con los tratamientos recibidos. CONCLUSIONES: El tratamiento del TW afecta a la salud general. Una cirugía adecuada y rigurosa, limitar las dosis de quimioterapia, minimizar la exposición a la radiación y un seguimiento estrecho puede minimizar las secuelas a largo plazo.
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Neoplasias Renales , Nefrectomía , Tumor de Wilms , Humanos , Tumor de Wilms/tratamiento farmacológico , Tumor de Wilms/terapia , Masculino , Estudios Retrospectivos , Femenino , Neoplasias Renales/terapia , Neoplasias Renales/tratamiento farmacológico , Lactante , Preescolar , Niño , Nefrectomía/métodos , Calidad de Vida , Terapia Neoadyuvante/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Factores de Tiempo , Neoplasias Primarias Secundarias , Tasa de Supervivencia , Dactinomicina/administración & dosificación , Dactinomicina/uso terapéuticoRESUMEN
The adulteration of milk presents significant challenges in the food industry, promoting the need for efficient detection methods. This study introduces a potentiometric electronic tongue for rapid and accurate milk adulteration detection. Utilizing polymeric membranes integrated with various additives, the electronic tongue distinguishes between different milk types and detects common adulterants. Experimental results demonstrate its effectiveness in discriminating raw, pasteurized, and medicated cow milk, as well as goat milk. Moreover, it successfully identifies adulterants like water and bovine milk in goat milk samples. Chemometric analyses, including Principal Component Analysis and Partial Least Squares regression, correlate sensor responses with traditional milk parameters such as fat, protein, and lactose content with up to a 0.97 R2 on the validation step. Strong correlations validate the electronic tongue's potential for rapid milk quality assessment. This innovative approach offers a cost-effective, reliable solution for detecting milk adulteration in contrast with current techniques that require numerous, time consuming experiments.
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Epithelial inclusion cysts (EIC) are a rare ocular disease and its physiopathology is not well-known. They consist on growths of ocular surface epithelial cells inside the anterior segment of the eye in the form of a cyst. To date several cases have been published in the literature, none of them related to glaucoma surgery. We describe two cases of EIC after glaucoma devices implantation. An 86 year-old male patient with primary open angle glaucoma develop an EIC in right eye three years after removal of PRESERFLO™ MicroShunt (Santen, Osaka, Japan) and a 9 year-old female patient with glaucoma secondary to uveitis for juvenile idiopathic arthritis develops an EIC under the tube of an Ahmed valve implant during postoperative period. EIC develop after ocular penetrating wounds and an inflammatory stimulus. They are benign proliferations, follow-up is necessary to detect space complications early, so less mutilating surgery is needed for removal.
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Implantes de Drenaje de Glaucoma , Complicaciones Posoperatorias , Humanos , Masculino , Femenino , Anciano de 80 o más Años , Complicaciones Posoperatorias/etiología , Implantes de Drenaje de Glaucoma/efectos adversos , Niño , Quistes/etiología , Quistes/cirugía , Glaucoma de Ángulo Abierto/cirugía , Glaucoma de Ángulo Abierto/etiología , Artritis Juvenil/complicaciones , Glaucoma/etiología , Glaucoma/cirugía , Uveítis/etiologíaRESUMEN
DNA methylation is an epigenetic mechanism involving the transfer of a methyl group onto the C5 position of the cytosine to form 5-methylcytosine (5mC). In general, DNA methylation in cancer is associated with the repression of the expression of tumor suppressor genes (TSG) and the demethylation with the overexpression of oncogenes. DNA methylation was considered a stable modification for a long time, but in 2009, it was reported that DNA methylation is a dynamic modification. The Ten-Eleven-Translocations (TET) enzymes include TET1, TET2, and TET3 and participate in DNA demethylation through the oxidation of 5mC to 5-hydroxymethylcytosine (5hmC). The 5hmC oxidates to 5-formylcytosine (5fC) and 5-carboxylcitosine (5caC), which are replaced by unmodified cytosines via Thymine-DNA Glycosylase (TDG). Several studies have shown that the expression of TET proteins and 5hmC levels are deregulated in gynecological cancers, such as cervical (CC), endometrial (EC), and ovarian (OC) cancers. In addition, the molecular mechanisms involved in this deregulation have been reported, as well as their potential role as biomarkers in these types of cancers. This review shows the state-of-art TET enzymes and the 5hmC epigenetic mark in CC, EC, and OC.
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Epigénesis Genética , Neoplasias , Humanos , Metilación de ADN , Oxidación-Reducción , Neoplasias/genética , Carcinogénesis/genética , Oxigenasas de Función Mixta/genética , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas/metabolismoRESUMEN
The Peruvian amazon is very diverse in native forestry species, the Guazuma crinita "Bolaina" being one of the most planted species in the country; however, little or no information about soil requirements and nutrient demands is known. The objective of this work was to assess the general conditions of soil fertility, biomass and macro- and micronutrient amounts in high-productivity Guazuma crinita plantations. Fields of high yielding Bolaina of different ages (1-10 years) were sampled in two regions. Soil and plant samples were collected in each field and biometric measurements of fresh weight, diameter at breast height and height were performed. For soil and plant analysis, both macro- (N, P, K, Ca, Mg, S) and micronutrients (B, Cu, Fe, Mn, Zn) were determined. Finally, allometric equations were constructed for biometric and nutrient amounts. This study is the first to assess and model macro- and micronutrient amounts in the productive cycle in this species, which grows in fertile soils. In the case of biometric equations, the logarithmic and logistic models performed better. For nutrient amounts, this species followed a pattern of Ca > N > K > P > S > Mg for macronutrients and Fe > B > Mn > Zn > Cu for micronutrients. The best prediction models for nutrients were the square root and logistic models.
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Oligoelementos , Árboles , Suelo , Oligoelementos/análisis , Micronutrientes , Nutrientes , BiometríaRESUMEN
Recent studies in mice have indicated that the gut microbiome can regulate bone tissue strength. However, prior work involved modifications to the gut microbiome in growing animals and it is unclear if the same changes in the microbiome, applied later in life, would change matrix strength. Here we changed the composition of the gut microbiome before and/or after skeletal maturity (16 weeks of age) using oral antibiotics (ampicillin + neomycin). Male and female mice (n=143 total, n=12-17/group/sex) were allocated into five study groups:1) Unaltered, 2) Continuous (dosing 4-24 weeks of age), 3) Delayed (dosing only 16-24 weeks of age), 4) Initial (dosing 4-16 weeks of age, suspended at 16 weeks), and 5) Reconstituted (dosing from 4-16 weeks following by fecal microbiota transplant from Unaltered donors). Animals were euthanized at 24 weeks of age. In males, bone matrix strength in the femur was 25-35% less than expected from geometry in mice from the Continuous (p= 0.001), Delayed (p= 0.005), and Initial (p=0.040) groups as compared to Unaltered. Reconstitution of the gut microbiota, however, led to a bone matrix strength similar to Unaltered animals (p=0.929). In females, microbiome-induced changes in bone matrix strength followed the same trend as males but were not significantly different, demonstrating sex-related differences in the response of bone matrix to the gut microbiota. Minor differences in chemical composition of bone matrix were observed (Raman spectroscopy). Our findings indicate that microbiome-induced impairment of bone matrix in males can be initiated and/or reversed after skeletal maturity. The portion of the femoral cortical bone formed after skeletal maturity (16 weeks) is small; however, this suggests that microbiome-induced changes in bone matrix occur without osteoblast/osteoclast turnover using an, as of yet unidentified mechanism. These findings add to evidence that the mechanical properties of bone matrix can be altered in the adult skeleton.
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Objetivo: Evaluar con técnica de diafanización el gra-do de filtración apical al utilizar dos selladores bio-cerámicos y la técnica de cono único con taper ex vivo. Materiales y métodos: Se utilizaron 60 premola-res inferiores humanos uniradiculares extraídos. La instrumentación se realizó con lima Primary 25/.07 (WaveOne Gold, Dentsply Maillefer), según protocolo del fabricante. Se irrigó con NaOCl 2,5% y EDTAC 17%. Para la obturación, la muestra se dividió aleatoria-mente en 4 grupos (n=15). Grupo 1: Cono único y Bio C Sealer. Grupo 2: Cono único y MTA Fillapex. Grupo control negativo: no se obturó. Grupo control positi-vo: Cono único y AH Plus. En todas las muestras se aplicaron dos capas de esmalte para uñas en toda la superficie dentaria con excepción del tercio apical y del grupo control positivo, que se esmaltó en su tota-lidad. Medio de filtración: tinta china negra por difu-sión pasiva. Se diafanizó con técnica de Robertson. Se usó programa AutoCad 2022, para medir filtración en milímetros lineales. Los datos se analizaron me-diante prueba de Kruskal-Wallis seguida por compa-raciones post hoc empleando el método de Conover (p<0,05, significativo). Resultados: La filtración con Bio C Sealer, MTA Fillapex, control negativo y control positivo tuvo una media (mínimo-máximo) de 0 (0-2), 1 (0-3), 6 (2-12) y 0 (0-0); sin diferencias significativas entre Bio C Sealer y MTA Fillapex (p>0,05), ni entre Bio C Sealer y control positivo (p>0,05); pero con di-ferencias significativas entre MTA Fillapex y control positivo (p<0,05), y entre control negativo y cual-quiera de los otros tres grupos (p<0,05). Conclusión: La obturación con Bio C Sealer lograría un nivel de sellado similar al que se obtiene con el control po-sitivo; mientras que la obturación con MTA Fillapex produciría un sellado ligeramente menos efectivo que el control positivo. Sin embargo, la filtración no variaría sustancialmente entre obturaciones con Bio C Sealer y MTA Fillapex (AU)
Objective: To evaluate the degree of apical filtration with diaphanization technique, using two bioceramic sealers and single cone technique with taper, ex vivo. Materials and methods: 60 extracted single-root human mandibular premolars were used. The instrumentation was carried out with primary file 25/.07 (WaveOne Gold, Dentsply Maillefer), according to the manufacturer's protocol. Irrigation was done with 2.5% NaOCl and 17% EDTAC. For obturation, the sample was randomly divided in 4 groups (n=15). Group 1: Single cone and Bio C Sealer. Group 2: Single cone and MTA Fillapex. Negative control group: it was not obturated. Positive control group: Single cone and AH Plus. In all samples, two layers of nail polish were applied to the entire tooth surface with exception of apical third and the positive control group, which was completely glazed. Filtration medium: black Chinese ink by passive diffusion. It was diaphanized with Robertson technique. AutoCad 2022 program was used to measure filtration in linear millimeters. Data were analyzed using Kruskal-Wallis test, followed by post hoc comparisons using Conover method (p < 0.05, significant). Results: Filtration with Bio C Sealer, MTA Fillapex, negative control and positive control had a mean (minimum-maximum) of 0 (0-2), 1 (0-3), 6 (2-12) and 0 (0-0); no significant differences between Bio C Sealer and MTA Fillapex (p > 0.05), nor between Bio C Sealer and positive control (p > 0.05); but with significant differences between MTA Fillapex and positive control (p < 0.05), and between negative control and any of the other three groups (p < 0.05). Conclusion: Obturation with Bio C Sealer would achieve a level of sealing similar to obtained with the positive control; while obturation with MTA Fillapex would produce a slightly less effective seal than the positive control. However, filtration would not vary substantially between fillings with Bio C Sealer and MTA Fillapex (AU)
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Materiales de Obturación del Conducto Radicular/química , Filtración Dental/diagnóstico , Ensayo de Materiales , Cerámicas Modificadas OrgánicamenteRESUMEN
The wide distribution and ecological plasticity of the red fox (Vulpes vulpes) make it a potential reservoir for many infectious diseases shared with domestic and wild carnivores. One of such diseases is canine distemper, which is caused by an RNA virus and its main domestic reservoir is the dog. However, other carnivores can also participate in its maintenance, as shown by the recent upsurge of reported cases in wildlife in many parts of the world, and by the fact that red foxes may act as true reservoirs for canine distemper virus (CDV). The lack of validated serological tests for wildlife or other non-target species may be a handicap for monitoring this virus. In this study, serological assays were compared in 147 red fox sera using a commercial ELISA validated for its use in dogs and a non-specific modified ELISA with Protein A peroxidase conjugate to detect bound antibodies. In addition, the presence of CDV RNA in brain, spleen, lung, and liver samples from 144 foxes was investigated by a RT-qPCR. Through the comparison of the results of both ELISAs and the use of a finite mixture model of the optical density values obtained by both techniques, we adjusted the cut-off point of the commercial ELISA to obtain the seroprevalence in foxes. The overall seroprevalence detected was 53.7% (79/147) and 57.1% (84/147) by the commercial and modified ELISA, respectively, with a moderate agreement according to Cohen's Kappa statistic (κ = 0.491, z = 5.97, p < 0.0001). CDV RNA was detected in 30 out of 144 foxes, which resulted in 20.8% of CDV-infected foxes. At individual level, the results obtained by relating the serological status and the presence/absence of RNA in different organs were explained in terms of the pathogenesis of the infection. Our results highlight the convenience of adjusting the cut-off point when using an ELISA assay developed in domestic dogs for its use in foxes. Moreover, Protein A is confirmed to be a good alternative to be used in red foxes, presenting a good reactivity towards its IgG.
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Carnívoros , Virus del Moquillo Canino , Moquillo , Enfermedades de los Perros , Animales , Perros , Zorros/genética , Virus del Moquillo Canino/genética , Estudios Seroepidemiológicos , Animales Salvajes , Moquillo/diagnóstico , Moquillo/epidemiología , Carnívoros/genética , Ensayo de Inmunoadsorción Enzimática/veterinaria , ARNRESUMEN
INTRODUCTION AND AIM: Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure. Clinical guidelines assess competence in ERCP through a defined number of procedures, but multiple factors are involved. Our aim was to analyze the morphology of the papilla of Vater as an independent factor in selective common bile duct cannulation during resident training. MATERIAL AND METHODS: Patients that underwent ERCP were studied consecutively. All ERCPs were begun by a resident in training. The type of papilla was classified according to Haraldsson, including those with previous sphincterotomy. Cannulation difficulty and success and their relation to the type of papilla were documented. The analysis was divided into three 4-month periods. RESULTS: Of the 429 patients, cannulation was difficult in 101 (23.5%). The residents achieved selective cannulation of the common bile duct in 276 (64.3%) and the cannulation success rate at the end of their training was 81.7%. Cannulation was performed with the least difficulty in papillae with previous sphincterotomy (2.8%), unlike the type 4 papilla, which was difficult to cannulate in 50% of the cases. The lowest overall cannulation success was in the type 2 papilla (81.8%). CONCLUSION: Papilla type can influence cannulation success, but it is not the only related factor. Patients that underwent previous sphincterotomy appear to be the cases in whom ERCP training can be started.
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INTRODUCTION: Infectious meningoencephalitis (IME) is a neurological emergency with a significant rate of morbidity and mortality. The Biofire FilmArray® meningitis/encephalitis (FAME) panel for testing in cerebrospinal fluid (CSF) has proven to be a valuable tool for the aetiological diagnosis of IME, facilitating targeted antimicrobial therapy. The aim is to determine the impact of the FAME panel on antimicrobial therapeutic decisions in patients with suspected IME in the first 24 hours of clinical assessment. PATIENTS AND METHODS: This is a descriptive observational study that comments on the clinical manifestations, the neuroimaging and paraclinical findings, and the antibiotic therapy of patients with suspected IME. An analysis was performed to determine the impact of FAME on antimicrobial therapy in the first 24 hours of the clinical assessment of patients. RESULTS: Altogether 44 patients were included. The average time required to obtain the result of the FAME panel for testing in CSF was nine hours, with 20.4% (9/44) of tests yielding positive results. Within 24 hours of clinical assessment, their outcome had an impact on antimicrobial treatment decisions in 75% (33/44) of cases. In patients with a high clinical suspicion of IME, the result of FAME made it possible to change the initial empirical therapy to a targeted therapy in 15% (3/20) of cases and to discontinue the initial empirical therapy in 35% (7/20) of the subjects. In patients with low clinical suspicion of IME, their result allowed 25% (6/24) to have their suspicion confirmed and they were started on targeted antibiotic therapy; in contrast, 70.8% (17/24) had their diagnosis ruled out and were not started on treatment. CONCLUSIONS: The result of the FAME panel for testing in CSF has a high impact on antimicrobial therapeutic decisions within 24 hours of clinical assessment. However, it must be interpreted with the clinical context, local epidemiology and other diagnostic studies.
TITLE: Experiencia con el Biofire FilmArray® para meningitis/encefalitis infecciosa en una institución de alta complejidad en Bogotá, Colombia.Introducción. La meningoencefalitis infecciosa (MEI) es una emergencia neurológica con importante morbimortalidad. El panel Biofire FilmArray? para meningitis/encefalitis (FAME) en el líquido cefalorraquídeo (LCR) ha demostrado ser una valiosa herramienta para el diagnóstico etiológico de la MEI, facilitando una terapia antimicrobiana dirigida. El objetivo es determinar el impacto del panel FAME en las decisiones terapéuticas antimicrobianas en pacientes con sospecha de MEI en las primeras 24 horas de la valoración clínica. Pacientes y métodos. Estudio observacional descriptivo que comenta las manifestaciones cínicas, los resultados de neuroimágenes y paraclínicos, y la antibioticoterapia de pacientes con sospecha de MEI. Se realizó un análisis del impacto que tiene el FAME en la terapia antimicrobiana en las primeras 24 horas de la valoración clínica de los pacientes. Resultados. Se incluyó a 44 pacientes. El tiempo promedio para obtener el resultado del panel FAME en el LCR fue de nueve horas, con un 20,4% (9/44) de pruebas positivas. En las primeras 24 horas de la valoración clínica, su resultado tuvo impacto en las decisiones terapéuticas antimicrobianas en el 75% (33/44) de los casos. En pacientes con alta sospecha clínica de MEI, el resultado del FAME permitió cambiar la terapia empírica inicial a una dirigida en el 15% (3/20) y suspender la terapia empírica inicial en el 35% (7/20) de los sujetos. En pacientes con baja sospecha clínica de MEI, su resultado permitió que al 25% (6/24) se le confirmara la sospecha y se le iniciara antibioticoterapia dirigida; y que al 70,8% (17/24) se le descartara el diagnóstico y no se le iniciara tratamiento. Conclusiones. El resultado del panel FAME en el LCR tiene alto impacto en la toma de decisiones terapéuticas antimicrobianas en las primeras 24 horas de la valoración clínica. Sin embargo, su interpretación debe hacerse con el contexto clínico, la epidemiología local y otros estudios diagnósticos.
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Encefalitis , Encefalitis Infecciosa , Meningitis , Humanos , Colombia , AntibacterianosRESUMEN
A completely randomized experimental design was conducted to evaluate the effect of the coadministration of Lactiplantibacillus fabifermentans (Lpb. fabifermentans) and inulin/agave fructans mixtures on gut microbiota of healthy Wistar rats. Inulin, Agave salmiana fructans or fructan mixtures (1:1) at 12.5 % w/w, and Lpb. fabifermentans at 109 CFU/mL/day were used in the rats' diet for 35 days. Biochemical parameters, short-chain fatty acids (SCFA), structural changes and the bacterial abundance in rats' cecum were evaluated. A significant decrease (p < 0.05) in glucose, cholesterol and triglycerides levels with fructan mixtures combined with Lpb. Fabifermentans was observed. The weight of the small and large intestines, and cecum was higher than the control; no changes were observed in the heart, liver, spleen and kidneys. SCFA concentration mainly, propionate and butyrate was improved (p < 0.05) throughout the gastrointestinal tract in all treatments. Finally, the administration of Lpb. fabifermentans alone or combined with the fructan mixtures promoted an increase in the abundance of cecum intestinal microbiota: Lactobacillus, Bifidobacterium, Prevotella, Blautia, Faecalibacterium, Butyricimonas, Coprococcus, Akkermansia, Methanobrevibacter, Adlercreutzia, Collinsella, Odoribacter, and Roseburia. The inclusion of fructan mixtures in combination with Lpb. fabifermentans could be a good alternative for the development of functional foods that enhance consumer health.
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Fructanos , Inulina , Ratas , Animales , Fructanos/farmacología , Ratas Wistar , Inulina/farmacología , Prebióticos , Ciego , Lactobacillus , Ácidos Grasos Volátiles/farmacologíaRESUMEN
Background: COVID-19 may be a new risk factor for stroke. Stroke in COVID-19 varies from 1.1 to 8.1%. Various pathophysiological pathways predispose SARS-CoV-2 infected patients to stroke. Aim: To describe COVID-19 patients with acute stroke in one Colombian Center. Methods: From March 6 2020 and March 6 2021 records of patients with acute stroke and in-hospital positive PCR (Polymerase Chain Reaction) test for Sars-CoV-2 infection were reviewed. Demographic, stroke and COVID-19 characteristics were extracted. Continuous variables were reported in means and ranges. Categorical variables were presented in frequencies and percentage. A descriptive narrative was performed. Results: Of 328 acute stroke patients 14 (4.2%) tested positive for PCR SARS-CoV-2. Mean age 56.4â¯years with 57% males. Five were (35.7%) without vascular risk factors but 9 (64.3%) overweight. Brain infarct diagnosed in 11 (78.5%), 53% with anterior circulation syndromes. Mean NIHSS score 11.8 and 7 (63%) received intravenous thrombolysis. Acute inflammatory blood biomarkers (D-dimer, ferritin, LDH elevated) were positive in all. 11 (78.5%) had symptomatic COVID-19 before stroke with a mean latency of 7â¯days. 12 (85.7%) had severe COVID-19 and 6 (42.8%) required mechanical ventilation. Outcome was unfavorable in 9 (64.3%) (The Modified Rankin Scale (mRS) > 2), mean hospital stay was 21.8â¯days and in-hospital case fatality rate was 14.2%. Conclusion: In susceptible individuals COVID-19 predisposes to stroke. Hypercoagulation and immune thrombosis may be at the culprit for this state. In Colombia, COVID-19 patients with stroke have similar characteristics to the described worldwide.
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INTRODUCTION: LEMVIDA is a real-world prospective study of 3-year follow-up on quality of life of patients with multiple sclerosis (MS) receiving alemtuzumab in Spain. METHODS: This is an interim analysis evaluating the baseline characteristics of patients who started alemtuzumab between October 2016-September 2018. For 3 additional subanalysis patients were categorised by baseline EDSS score; time of alemtuzumab initiation during the recruitment period (cohort 1: October 2016-March 2017, cohort 2: April-September 2017, cohort 3: October 2017-March 2018 and cohort 4: April-September 2018); and the presence of highly active MS criteria. RESULTS: 161 patients were analysed: 67.1% female, age 38.7 ± 9.4 years, MS duration 8.5 ± 6.0 years, EDSS 3.3 ± 1.7 and number of relapses in the previous 2 years 1.8 ± 1.3. 48.3% of patients presented gadolinium-enhanced (Gd+) lesions (mean: 5.2 ± 6.9) and 63.1% had received prior treatment with fingolimod or natalizumab. Baseline EDSS scores and number of Gd+ lesions were higher in cohort 1 than in cohort 4 (4.1 ± 1.8 vs 3.2 ± 1.7; P = .040 and 10.9 ± 11.9 vs 4.5 ± 5.7; P = .020). The frequency of prior treatment with fingolimod and natalizumab was lower in cohort 4 (60.6%) than in cohort 1 (70.6%) (comparison between groups not analysed). CONCLUSIONS: Unlike phase 3 studies of alemtuzumab, the patients included in LEMVIDA are older, have a longer duration of MS, higher disability and have received previous immunosuppressants. However, throughout the recruitment period, there is a tendency towards an early beginning of treatment with alemtuzumab, probably due to the evidence of higher effectiveness in the early stages of MS.
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OBJECTIVE: To assess the reproducibility of peripapillary, optic nerve head (PP-ONH) and macular vessel density (VD) by Spectral Domain optical coherence tomography angiography (SD OCT-A) in glaucoma patients and healthy subjects. METHODS: Cross-sectional study assessing 63 eyes of 63 subjects, including 33 glaucoma patients and 30 healthy subjects. Glaucoma was classified in mild, moderate, or advanced. Two consecutive scans were acquired by Spectralis Module OCT-A (Heidelberg, Germany), and provided images of the superficial vascular complex (SVC), nerve fiber layer vascular plexus (NFLVP), superficial vascular plexus (SVP); deep vascular complex (DVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP). VD (%) was calculated by AngioTool. Intraclass correlation coefficients (ICCs) and coefficients of variation (CV) were calculated. RESULTS: Among PP-ONH VD, better ICC presented advanced (ICC 0.86-0.96) and moderate glaucoma (ICC 0.83-0.97) compared with mild glaucoma (0.64-0.86). For the macular VD reproducibility, ICC results for superficial retinal layers were better for mild glaucoma (0.94-0.96) followed by moderated (0.88-0.93) and advanced glaucoma (0.85-0.91), and for deeper retinal layers ICC was better for moderate glaucoma (0.95-0.96) followed by advanced (0.80-0.86) and mild glaucoma (0.74-0.91). CVs ranged from 2.2% to 10.94%. Among healthy subjects, ICCs for the PP-ONH VD measurements (0.91-0.99) and for the macular VD measurements (0.93-0.97) were excellent in all layers, with CVs from 1.65% to 10.33%. CONCLUSIONS: SD OCT-A used to quantify macular and PP-ONH VD showed excellent and good reproducibility in most layers of the retina, both in healthy subjects and in glaucoma patients regardless of the severity of the disease.
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Glaucoma , Mácula Lútea , Disco Óptico , Humanos , Disco Óptico/diagnóstico por imagen , Disco Óptico/irrigación sanguínea , Tomografía de Coherencia Óptica/métodos , Estudios Transversales , Reproducibilidad de los Resultados , Angiografía con Fluoresceína/métodos , Vasos Retinianos/diagnóstico por imagen , Mácula Lútea/diagnóstico por imagen , Mácula Lútea/irrigación sanguínea , Glaucoma/diagnóstico por imagenRESUMEN
Dysbiosis has been implicated in childhood obesity. Oral intake of fermented milk containing Lacticaseibacillus casei strain Shirota preserves gut microbiota (GM) diversity in children and adults. This study was a double-blind trial involving 37 overweight or obese children aged 6-10 years. Children were followed over a 6-week intervention period in which they received different fermented milk products containing L. casei Shirota: 10 in the first group received just L. casei Shirota; 13 received L. casei Shirota with 3 g/day of inulin (L. casei+inulin); and 14 received L. casei Shirota with 3 g/day of fructans from Agave salmiana (L. casei+fructans). Principal component analysis showed the relationship between microbial abundance, GM metabolites, and other obesity-related markers. Supplementation with probiotics and synbiotics improved the HDL-cholesterol levels of overweight and obese children, although no changes in body composition were detected. We observed an increase in butyrate or propionate concentrations in the L. casei+fructans group compared to the end of the intervention (P<0.03). A diminished level of ANGPTL4 within the L. casei+fructans group (P=0.04) was also found, but no differences when lipopolysaccharide-binding protein was evaluated. The FFAR2+ cell frequency decreased between baseline and at the end of 6-week intervention in L. casei+inulin (P=0.02) and L. casei+fructans groups (P=0.04). In contrast, the percentage of CD14+FFAR3+ frequency increased in the same groups (P=0.04). The L. casei Shirota with inulin or fructans modulates GM, which improves the lipid profile and changes at a molecular level, such as expression of FFAR3 and FFAR2, ANGPTL4, propionate, and butyrate. It, therefore, could be considered an interesting therapeutic possibility for treating childhood overweight and obesity. The study was registered at ClinicalTrials.gov (ID: NCT05423015).
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Agave , Productos Lácteos Cultivados , Obesidad Infantil , Probióticos , Niño , Adulto , Humanos , Fructanos , Agave/química , Inulina/farmacología , Sobrepeso/tratamiento farmacológico , Obesidad Infantil/tratamiento farmacológico , Propionatos , BiomarcadoresRESUMEN
BACKGROUND AND AIMS: Retinal sensitivity (RS) and gaze fixation (GF) assessed by retinal microperimetry are useful and complementary tools for identifying mild cognitive impairment (MCI) in patients with type 2 diabetes (T2D). The hypothesis is that RS and GF examine different neural circuits: RS depends only on the visual pathway while GF reflects white matter complex connectivity networks. The aim of the study is to shed light to this issue by examining the relationship of these two parameters with visual evoked potentials (VEP), the current gold standard to examine the visual pathway. MATERIALS AND METHODS: Consecutive T2D patients > 65 years were recruited from the outpatient clinic. Retinal microperimetry (MAIA 3rd generation) and visual evoked potentials (VEP) (Nicolet Viking ED). RS (dB), GF (BCEA63%, BCEA95%) (MAIA) and VEP (Latency P100ms, Amplitude75-100 uV) were analyzed. RESULTS: Thirty three patients (45% women, 72.1 ± 4.6 years) were included. VEP parameters significantly correlated with RS but not with GF. CONCLUSIONS: These results confirm that RS but not GF depends on the visual pathway, reinforcing the concept that they are complementary diagnostic tools. Used together can further increase the value of microperimetry as screening test for identifying T2D population with cognitive impairment.
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Diabetes Mellitus Tipo 2 , Pruebas del Campo Visual , Humanos , Femenino , Masculino , Pruebas del Campo Visual/métodos , Campos Visuales , Diabetes Mellitus Tipo 2/complicaciones , Potenciales Evocados Visuales , RetinaRESUMEN
OBJECTIVES: This study compared the bonding properties of dentin of three 2-step etch-and-rinse adhesives (2-ERAs) to those of three universal adhesives (UAs) applied with an etch-and-rinse strategy (ER), immediately and after 1 year of water storage. METHODS: Sixty caries-free molars were divided into 6 groups according to the adhesive systems used (n = 10). The 2-ERA systems included were: 1) Adper Single Bond 2 (SB), 2) Tetric N-Bond (TB), and 3) Ambar (AM); and the UAs systems were: 4) Single Bond Universal (SBU) 5) Tetric N-Bond Universal (TBU), and 6) Ambar Universal (AMU). The occlusal third of each tooth was removed and the adhesives were applied. After the composite build-up, specimens were sectioned and tested for microtensile bond strength (µTBS) and nanoleakage (NL) immediately and after 1 year of water storage. In situ degree of conversion (DC) was only evaluated in the immediate time. For water sorption (WS), solubility (SO), and mass change (MC) tests, 48 disk-shaped specimens were prepared (n = 8) and assessed according to ISO 4049:2009. RESULTS: UAs showed higher µTBS and lower NL values than 2-ERAs did after 1 year of water storage (p = 0.001). Regarding DC, 2-ERAs showed higher DC values than UAs (p = 0.001). Regarding WS, 2-ERAs showed higher WS values than those of UAs (p = 0.00001), except for AM and AMU. Lower WS was observed for AM than for other 2-ERAs (p = 0.00001). CONCLUSION: The use of UAs applied with the ER strategy seems to be a more effective technique for maintaining adhesion to dentin substrate than 2-ERAS. CLINICAL SIGNIFICANCE: This study may support clinicians in selecting the most adequate adhesive system to be used in ER strategy in dentin, demonstrating that UAs were more effective, considering the longevity of the resin restorations.