Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves.

INTRODUCTION: Understanding the intricate dynamics between different waves of the COVID-19 pandemic and the corresponding variations in clinical outcomes is essential for informed public health decision-making. Comprehensive insights into these fluctuations can guide resource allocation, healthcare policies, and the development of effective interventions. This study aimed to compare the characteristics and clinical outcomes of COVID-19 at peak transmission points by including all patients attended during the first four pandemic waves in a referral center in Colombia. MATERIAL AND METHODS: In a prospective observational study of 2733 patients, clinical and demographic data were extracted from the Fundacion Valle de Lili's COVID-19 Registry, focusing on ICU admission, Invasive Mechanical Ventilation (IMV), length of hospital stay, and mortality. RESULTS: Our analysis unveiled substantial shifts in patient care patterns. Notably, the proportion of patients receiving glucocorticoid therapy and experiencing secondary infections exhibited a pronounced decrease across waves (p < 0.001). Remarkably, there was a significant reduction in ICU admissions (62.83% vs. 51.23% vs. 58.23% vs. 46.70 %, p < 0.001), Invasive Mechanical Ventilation (IMV) usage (39.25% vs. 32.22% vs. 31.22% vs. 21.55 %, p < 0.001), and Length of Hospital Stay (LOS) (9 vs. 8 vs. 8 vs. 8 days, p < 0.001) over the successive waves. Surprisingly, hospital mortality remained stable at approximately 18‒20 % (p > 0.05). Notably, vaccination coverage with one or more doses surged from 0 % during the initial waves to 66.71 % in the fourth wave. CONCLUSIONS: Our findings emphasize the critical importance of adapting healthcare strategies to the evolving dynamics of the pandemic. The reduction in ICU admissions, IMV utilization, and LOS, coupled with the rise in vaccination rates, underscores the adaptability of healthcare systems. Hospital mortality's persistence may warrant further exploration of treatment strategies. These insights can inform public health responses, helping policymakers allocate resources effectively and tailor interventions to specific phases of the pandemic.

Clinical and microbiological characterization of Salmonella spp. isolates from patients treated in a university hospital in South America between 2012-2021: a cohort study.

BACKGROUND: Salmonellosis is a major cause of morbidity and mortality and one of the most frequent etiologies of diarrhea in the world. Mortality due to Salmonellosis in Latin America still poorly understood, and there is a lack of studies that evaluate resistance and clinical manifestations. The aims of this study were to characterize patients infected with Salmonella spp. seen in a university hospital in Colombia between 2012 and 2021, to evaluate trends in antibiotic resistance and to determine the proportion of overall mortality and related factors. METHODS: Retrospective observational study. All patients with microbiological diagnosis of Salmonella spp. were included. The sociodemographic, clinical and microbiological characteristics were described, and the proportion of antibiotic resistant isolates per year was estimated. The prevalence of mortality according to age groups was calculated. Log binomial regression models were used to establish factors associated with mortality. RESULTS: Five hundred twenty-two patients were analyzed. Salmonellosis accounted for 0.01% of all medical consultations. The median age was 16 years old. The most common clinical presentation was gastroenteric syndrome (77.1%) and symptoms included diarrhea (79.1%), fever (66.7%), abdominal pain (39.6%) and vomiting (35.2%). Of the Salmonella spp. isolates, 78.2% were not classified, 19.1% corresponded to non-typhoidal Salmonella and 2.7% to Salmonella typhi. Mortality occurs in 4.02% of the patients and was higher in patients with hematologic malignancy (11.6%). When analyzing by age group, the proportion of deaths was 2.8% in patients aged 15 years or younger, while in those older than 15 years it was 5.4%. Factors associated to mortality where bacteremia (aPR = 3.41 CI95%: 1.08-10.76) and to require treatment in the ICU (aPR = 8.13 CI95%: 1.82-37.76). In the last 10 years there has been a steady increase in resistance rates to ciprofloxacin, ampicillin, ampicillin/sulbactam and ceftriaxone, reaching rates above 60% in recent years. CONCLUSIONS: Despite improved availability of antibiotics for the treatment of salmonellosis in the past decades, mortality due to salmonellosis continues occurring in children and adults, mainly in patients with hematological malignancies and bacteremia. Antibiotic resistance rates have increased significantly over the last 10 years. Public health strategies for the control of this disease should be strengthened, especially in vulnerable populations.

Co-Infection between Dengue Virus and SARS-CoV-2 in Cali, Colombia.

The co-occurrence of COVID-19 with endemic diseases is a public health concern that may affect patient prognosis and outcomes. The objective of this study was to describe the clinical characteristics of patients with dengue virus (DENV) and SARS-CoV-2 co-infections and compare their outcomes against those of COVID-19 patients without dengue. A cross-sectional study was conducted in patients with SARS-CoV-2 infection who attended a single center in Cali, Colombia, from March 2020 to March 2021. All patients who were tested by both real-time polymerase chain reaction for SARS-CoV-2 and IgM/NS1 for DENV were included. Dengue was diagnosed as having either an IgM- or an NS1- positive test. A total of 90 patients were included (72 with COVID-19 only and 18 with co-infection). Patients with co-infection had more dyspnea (61.1% versus 22.2%; P = 0.003) as well as higher oxygen desaturation (53.3% versus 13.4%; P = 0.002) and neutrophil-to-lymphocyte ratio (5.59 versus 3.84; P = 0.038) than patients with COVID-19 alone. The proportion of patients classified with moderate to severe COVID-19 was higher in the co-infection group (88.3% versus 47.8%; P = 0.002). Also, co-infection was associated with an increased need for mechanical ventilation (P = 0.06), intensive care unit (ICU) initial management (P = 0.02), and ICU admission during hospitalization (P = 0.04) compared with COVID-19 only. The ICU mortality rate was 66.6% in patients with co-infection versus 29.4% in patients infected with only SARS-CoV-2 (P < 0.05). The possibility of DENV and SARS-CoV2 co-infection occurred in the convergence of both epidemic waves. Co-infection was associated with worse clinical outcomes and higher mortality in ICU-admitted patients than in patients with the COVID-19 only.

Validación de clasificaciones de pie diabético en Argentina / Validation of diabetic foot classifications in Argentina

Introducción: las clasificaciones de pie diabético (PD) son una herramienta que tienen el objetivo de mejorar la comunicación entre los profesionales, la referencia y contrarreferencia; proporcionar un pronóstico; ayudar en la valoración de las lesiones, y contribuir con fines estadísticos. Objetivos: describir las características de los pacientes que se presentaron al consultorio o a la guardia con un PD durante un período de 3 meses, determinar el riesgo según cinco clasificaciones (Texas, IDSA, San Elián, WIfI y SINBAD) y evaluar su evolución a 6 meses en relación con el grado de gravedad determinada por cada clasificación. Materiales y métodos: se analizaron 312 pacientes de 15 instituciones en Argentina. Para el análisis se utilizó la calculadora de clasificaciones de pie diabético/score de riesgo del Comité de Pie Diabético de la Sociedad Argentina de Diabetes. Resultados: el 43% de los pacientes (n=133) requirió internación al momento de la primera consulta y el 61% (n=189) había consultado previamente. El porcentaje de amputación mayor total fue de 8,33% (IC 95%; 5,5-11,9) (n=26) y el de amputación menor de 29,17% (IC 95%; 24,2-34,6) (n=91). A los 6 meses, el porcentaje de muerte fue de 4,49% (IC 95%; 2,5-7,4) (n=14), el 24,3% (IC 95%;19,6-29,5) presentaba la herida aún abierta (n=76), el 58,0% (IC 95%; 52,3-66,5) (n=181) cicatrizó y el 7,37% se perdió del seguimiento (n=23). Las clasificaciones de San Elián y WIfI se relacionaron con amputación mayor, cicatrización y muerte. En relación a la clasificación de Texas, el 49% de los pacientes presentó herida penetrante a hueso o articulación (Texas 3), con o sin infección. El 65,3% de las amputaciones mayores y el 78,6% de las muertes se produjeron en pacientes con isquemia. El punto de corte de San Elián para amputación mayor fue 20. Conclusiones: conocer los datos locales permite organizar los recursos para mejorar la atención de los pacientes.

Introduction: the classifications of diabetic foot (DF) are a tool that aims to improve communication between professionals, referral and counter-referral, provide a prognosis, help in the assessment of lesions, and contribute to statistical purposes. Objectives: to describe the characteristics of patients who presented to the clinic or emergency department with DF over a period of 3 months, determine the risk according to 5 classifications (Texas, IDSA, SEWSS, WIfI, and SINBAD), and evaluate their evolution at 6 months in relation to the severity degree determined by each classification. Materials and methods: 312 patients from 15 institutions in Argentina were analyzed. The Diabetic Foot Classification Calculator/Risk Score from the Diabetic Foot Committee of the Argentina Argentina Diabetes Society was used for the analysis. Results: 43% of patients (n=133) required hospitalization at the time of the first consultation and 61% (n=189) had previously consulted. The total major amputation percentage was 8.33% (95%CI; 5.5-11.9) (n=26), and the minor amputation percentage was 29.17% (95% CI; 24.2-34.6) (n=91). At 6 months, the death rate was 4.49% (95% CI; 2.5-7.4) (n=14), 24.3% (95% CI; 19.629.5) had an open wound (n=76), 58.0% (95% CI; 52.3-66.5) (n=181) had healed, and 7.37% were lost to follow-up (n=23). The SEWSS and WIfI classifications were related to major amputation, healing, and death. Regarding the Texas classification, 49% of patients had a penetrating wound to bone or joint (Texas 3), with or without infection. 65.3% of major amputations and 78.6% of deaths occurred in patients with ischemia. The SEWSS cut-off point for major amputation was 20. Conclusions: knowing local data allows organizing resources to improve patient care.

Maternal dietary exposure to mycotoxin aflatoxin B1 promotes intestinal immune alterations and microbiota modifications increasing infection susceptibility in mouse offspring.

Mycotoxins are secondary metabolites produced by fungi occurring in food that are toxic to animals and humans. Early-life mycotoxins exposure has been linked to diverse pathologies. However, how maternal exposure to mycotoxins impacts on the intestinal barrier function of progeny has not been explored. Here, exposure of pregnant and lactating C57Bl/6J female mice to aflatoxin B1 (AFB1; 400 µg/kg body weight/day; 3 times a week) in gelatine pellets, from embryonic day (E)11.5 until weaning (postnatal day 21), led to gut immunological changes in progeny. The results showed an overall increase of lymphocyte number in intestine, a reduction of expression of epithelial genes related to microbial defence, as well as a decrease in cytokine production by intestinal type 2 innate lymphoid cells (ILC2). While susceptibility to chemically induced colitis was not worsened, immune alterations were associated with changes in gut microbiota and with a higher vulnerability to infection by the protozoan Eimeria vermiformis at early-life. Together these results show that maternal dietary exposure to AFB1 can dampen intestinal barrier homeostasis in offspring decreasing their capability to tackle intestinal pathogens. These data provide insights to understand AFB1 potential harmfulness in early-life health in the context of intestinal infections.

Photochemical Optimization of a Silver Nanoprism/Graphene Oxide Nanocomposite's Antibacterial Properties.

Optimizing the antibacterial properties of nanocomposites is a fundamental challenge for many biomedical applications. Here, we study how we may optimize the antibacterial activity of narrow-sized anisotropically flat silver nanoprisms (S-NPs) on graphene oxide (GO) against Escherichia coli. To do so, we transformed silver nanoparticles (AgNPs) into S-NPs and anchored them to GO via a facile and low-cost photochemical reduction method by varying the irradiation wavelength during the synthesis process in the visible range (440 to 650 nm and white light). We performed a physicochemical characterization of the resulting S-NP/GO nanocomposite using a combination of UV-vis spectroscopy, X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Our results reveal a synergistic effect between the silver nanoprism and the oxygen functional groups of the GO surface. The antibacterial activity of the S-NPs/GO nanocomposite shows a significantly higher 53% inhibition efficiency after being irradiated with a 540 nm wavelength light source, compared to AgNPs with a 1% inhibition efficiency, respectively. In so doing, we have demonstrated the utility of a low-cost photoreduction method to control the structural properties of silver nanoprism on GO and, in this way, enhance the antibacterial properties of the nanocomposite. These results should be of great interest in a wide range of biomedical applications and medical devices.

Actualización de áreas de riesgo y perfil epidemiológico de hantavirus en Paraguay (2013-2020)

El síndrome pulmonar por hantavirus (SPH) en el Paraguay es una infección relacionada a extensas áreas geográficas del Chaco o Región Occidental. Sin embargo, en los últimos años se han reportado casos fuera del área endémica conocida. Con el objetivo de describir el perfil epidemiológico de la enfermedad en nuestro país, y actualizar las áreas de transmisión, se realizó una revisión retrospectiva de los casos registrados desde el 2013 al 2020. Fueron confirmados 90 casos de SPH, siendo la Región Occidental la de mayor proporción de casos, con 92% en dicho periodo. La Región Oriental registró el 5,5% de los casos, mientras que en el 2,5% de los casos no fue posible determinar el territorio de ocurrencia del contagio. El perfil de la enfermedad en el país se presenta como una afección principalmente de hombres en la edad adulta - joven, ligados a actividades de campo. Los principales desafíos para el abordaje de esta enfermedad son sensibilizar a la población de las nuevas áreas de riesgo identificadas, fortalecer la vigilancia en dichos lugares a fin de captar en forma oportuna a los casos, y actualizar los conocimientos sobre los virus circulantes y los reservorios zoonóticos de la enfermedad.

Hantavirus Pulmonary Syndrome in Paraguay is an infection related to the Chaco area or Western Region. However, in recent years cases it has been reported outside the known endemic area. In order to describe the epidemiological profile of the disease in our country, and update the transmission areas, a retrospective review of the cases registered from 2013 to 2020. Ninety HPS cases were confirmed, being the Western Region the one that contributed the highest proportion of cases, with 92% in the study period. The Eastern Region registered 5.5% of the cases, while in 2.5% of the cases it was not possible to determine the place. The profile of the disease in the country is presented as a condition mainly of men in adulthood - young, linked to field activities. The main challenges were to sensitize the population of the newly identified risk areas, strengthen the surveillance in these places in order to capture cases in a timely manner and update knowledge about the circulating viruses and zoonotic reservoirs of the disease.

Recomendaciones de práctica clínica: diagnóstico de osteomielitis en pie diabético / Clinical practice recommendations for the diagnosis of osteomyelitis in the diabetic foot

La osteomielitis (OM) es una complicación de las úlceras en pie diabético que habitualmente es subdiagnosticada y tratada en forma tardía e inadecuada. La demora en el tratamiento de estos pacientes aumenta el riesgo de amputación. En esta revisión, se analiza la bibliografía actual acerca del diagnóstico de OM y se realizan recomendaciones en base a la misma, y a las características de los pacientes, los insumos y las posibilidades en nuestro medio.

Diabetic foot osteomyelitis (OM) is a diabetic foot ulcer complication. Usually, it is misdiagnosed and the treatment is delayed and inadequate. Delaying the treatment of these patients rises the risk of amputation. In this revision, current bibliography about this topic is updated and clinical practice recommendations are done, based on the publications and adapted to the characteristics of our country

Recomendaciones de práctica clínica: diagnóstico de osteomielitis en pie diabético / Clinical practice recommendations for the diagnosis of osteomyelitis in the diabetic foot

Resumen La osteomielitis (OM) es una complicación de las úlceras en pie diabético que habitualmente es subdiagnosticada y tratada en forma tardía e inadecuada. La demora en el tratamiento de estos pacientes aumenta el riesgo de amputación. En esta revisión, se analiza la bibliografía actual acerca del diagnóstico de OM y se realizan recomendaciones en base a la misma, y a las características de los pacientes, los insumos y las posibilidades en nuestro medio.

Abstract Diabetic foot osteomyelitis (OM) is a diabetic foot ulcer complication. Usually, it is misdiagnosed and the treatment is delayed and inadequate. Delaying the treatment of these patients rises the risk of amputation. In this revision, current bibliography about this topic is updated and clinical practice recommendations are done, based on the publications and adapted to the characteristics of our country.

Short-term exposure to an obesogenic diet during adolescence elicits anxiety-related behavior and neuroinflammation: modulatory effects of exogenous neuregulin-1.

Childhood obesity leads to hippocampal atrophy and altered cognition. However, the molecular mechanisms underlying these impairments are poorly understood. The neurotrophic factor neuregulin-1 (NRG1) and its cognate ErbB4 receptor play critical roles in hippocampal maturation and function. This study aimed to determine whether exogenous NRG1 administration reduces hippocampal abnormalities and neuroinflammation in rats exposed to an obesogenic Western-like diet (WD). Lewis rats were randomly divided into four groups (12 rats/group): (1) control diet+vehicle (CDV); (2) CD + NRG1 (CDN) (daily intraperitoneal injections: 5 µg/kg/day; between postnatal day, PND 21-PND 41); (3) WD + VEH (WDV); (4) WD + NRG1 (WDN). Neurobehavioral assessments were performed at PND 43-49. Brains were harvested for MRI and molecular analyses at PND 49. We found that NRG1 administration reduced hippocampal volume (7%) and attenuated hippocampal-dependent cued fear conditioning in CD rats (56%). NRG1 administration reduced PSD-95 protein expression (30%) and selectively reduced hippocampal cytokine levels (IL-33, GM-CSF, CCL-2, IFN-γ) while significantly impacting microglia morphology (increased span ratio and reduced circularity). WD rats exhibited reduced right hippocampal volume (7%), altered microglia morphology (reduced density and increased lacunarity), and increased levels of cytokines implicated in neuroinflammation (IL-1α, TNF-α, IL-6). Notably, NRG1 synergized with the WD to increase hippocampal ErbB4 phosphorylation and the tumor necrosis alpha converting enzyme (TACE/ADAM17) protein levels. Although the results did not provide sufficient evidence to conclude that exogenous NRG1 administration is beneficial to alleviate obesity-related outcomes in adolescent rats, we identified a potential novel interaction between obesogenic diet exposure and TACE/ADAM17-NRG1-ErbB4 signaling during hippocampal maturation. Our results indicate that supraoptimal ErbB4 activities may contribute to the abnormal hippocampal structure and cognitive vulnerabilities observed in obese individuals.

Social isolation after acquired brain injury: Exploring the relationship between network size, functional support, loneliness and mental health.

Social isolation can be a consequence of acquired brain injury (ABI). Few studies have examined the relationship between social isolation and mental health after ABI. In this cross-sectional and case-control study, we compared 51 ABI survivors and 51 matched healthy controls on measures of social isolation (network size, social support and loneliness) mental health and mental health problems. We explored the relationship between structural, functional and subjective components of social isolation and examined whether they were associated with mental health outcomes. No group differences were found on size of the network and perceived social support. The ABI group exhibited marginally higher levels of loneliness. The ABI group presented higher levels of depression, lower levels of quality of life and emotional wellbeing. In both groups, perception of social support was inversely related to subjective experience of loneliness. The relationship between network size and loneliness was only significant in the ABI group. Only loneliness significantly predicted quality of life, emotional wellbeing, depression and anxiety in people with brain injury. The relationship between social isolation variables in ABI is discussed, as well as the theoretical and clinical implications of focusing on loneliness to improve mental health after brain injury.

Carbon Nano-onions: Potassium Intercalation and Reductive Covalent Functionalization.

Herein we report the synthesis of covalently functionalized carbon nano-onions (CNOs) via a reductive approach using unprecedented alkali-metal CNO intercalation compounds. For the first time, an in situ Raman study of the controlled intercalation process with potassium has been carried out revealing a Fano resonance in highly doped CNOs. The intercalation was further confirmed by electron energy loss spectroscopy and X-ray diffraction. Moreover, the experimental results have been rationalized with DFT calculations. Covalently functionalized CNO derivatives were synthesized by using phenyl iodide and n-hexyl iodide as electrophiles in model nucleophilic substitution reactions. The functionalized CNOs were exhaustively characterized by statistical Raman spectroscopy, thermogravimetric analysis coupled with gas chromatography and mass spectrometry, dynamic light scattering, UV-vis, and ATR-FTIR spectroscopies. This work provides important insights into the understanding of the basic principles of reductive CNOs functionalization and will pave the way for the use of CNOs in a wide range of potential applications, such as energy storage, photovoltaics, or molecular electronics.

Infra-Red Active Dirac Plasmon Serie in Potassium Doped-Graphene (KC8) Nanoribbons Array on Al2O3 Substrate.

A theoretical formulation of the electromagnetic response in graphene ribbons on dielectric substrate is derived in the framework of the ab initio method. The formulation is applied to calculate the electromagnetic energy absorption in an array of potassium-doped graphene nanoribbons (KC8-NR) deposited on a dielectric Al2O3 substrate. It is demonstrated that the replacement of the flat KC8 by an array of KC8-NR transforms the Drude tail in the absorption spectra into a series of infrared-active Dirac plasmon resonances. It is also shown that the series of Dirac plasmon resonances, when unfolded across the extended Brillouin zones, resembles the Dirac plasmon. The Dirac plasmon resonances' band structure, within the first Brillouin zone, is calculated. Finally, an excellent agreement between the theoretical absorption and recent experimental results for differential transmission through graphene on an SiO2/Si surface is presented. The theoretically predicted micrometer graphene nanoribbons intercalation compound (GNRIC) in a stage-I-like KC8 is confirmed to be synthesized for Dirac plasmon resonances.

Corrosion of Steel Rebars in Anoxic Environments. Part I: Electrochemical Measurements.

The number of reinforced concrete structures subject to anoxic conditions such as offshore platforms and geological storage facilities is growing steadily. This study explored the behaviour of embedded steel reinforcement corrosion under anoxic conditions in the presence of different chloride concentrations. Corrosion rate values were obtained by three electrochemical techniques: Linear polarization resistance, electrochemical impedance spectroscopy, and chronopotenciometry. The corrosion rate ceiling observed was 0.98 µA/cm2, irrespective of the chloride content in the concrete. By means of an Evans diagram, it was possible to estimate the value of the cathodic Tafel constant (bc) to be 180 mV dec-1, and the current limit yielded an ilim value of 0.98 µA/cm2. On the other hand, the corrosion potential would lie most likely in the -900 mVAg/AgCl to -1000 mVAg/AgCl range, whilst the bounds for the most probable corrosion rate were 0.61 µA/cm2 to 0.22 µA/cm2. The experiments conducted revealed clear evidence of corrosion-induced pitting that will be assessed in subsequent research.

Corrosion of Steel Rebars in Anoxic Environments. Part II: Pit Growth Rate and Mechanical Strength.

Reinforced concrete may corrode in anoxic environments such as offshore structures. Under such conditions the reinforcement fails to passivate completely, irrespective of chloride content, and the corrosion taking place locally induces the growth of discrete pits. This study characterised such pits and simulated their growth from experimentally determined electrochemical parameters. Pit morphology was assessed with an optical profilometer. A finite element model was developed to simulate pit growth based on electrochemical parameters for different cathode areas. The model was able to predict long-term pit growth by deformed geometry set up. Simulations showed that pit growth-related corrosion tends to maximise as cathode area declines, which lower the pitting factor. The mechanical strength developed by the passive and prestressed rebar throughout its service life was also estimated. Passive rebar strength may drop by nearly 20% over 100 years, whilst in the presence of cracking from the base of the pit steel strength may decline by over 40%.

Estudio de factores de riesgo para el desarrollo de pie diabético: Campaña 1N / A study of risk factors in the development of diabetic foot: 1N Campaign

Introducción: el examen del pie es fundamental en pacientes con diabetes mellitus (DM). La correcta evaluación del pie en el paciente que concurre a control diabetológico es clave para establecer factores de riesgo para el desarrollo de úlceras, detectar lesiones, tomar medidas preventivas, realizar una derivación temprana y educar en cuidados del pie. Objetivos: en este estudio se examinaron los pies de personas con DM durante la Campaña de Concientización y Prevención del Pie Diabético el 1º de noviembre de 2019 con el fin de evaluar la presencia de síntomas y signos relacionados con neuropatía, enfermedad vascular periférica, y prevalencia de los mismos, y conocer el riesgo. Materiales y métodos: se analizaron 165 pacientes en cuatro centros: Sanatorio Güemes (Servicio de Diabetes y Endocrinología), PREDIGMA (Centro de Medicina Preventiva, Posadas, Misiones), Hospital Central de San Isidro, Nexo Centro Médico (Ciudad de Junín) y Hospital Municipal de General Viamonte (Provincia de Buenos Aires). Resultados: se encontró que el 43,6% presentaba algún síntoma en miembros inferiores y hasta el 57% alteración en las pruebas de tamizaje de neuropatía diabética o enfermedad arterial periférica, con mayor prevalencia a mayor tiempo de evolución de la DM. Los signos más frecuentemente hallados en el examen físico fueron: piel seca (71,5%), distrofia ungueal (60,6%) o alteración de la almohadilla plantar (52,1%). Las comorbilidades más frecuentes fueron: hipertensión (74,5%) y dislipemia (73,3%). La mediana de hemoglobina glicosilada fue de 7,40% (6,70-8,10), mayor en personas con antecedentes de retinopatía (7,8%; p<0,01) y en pacientes que refirieron tener calambres (7,85 a 7,30; p=0,03) o ardor (8,0 vs 7,3; p<0,01). El porcentaje de pacientes con pie de alto riesgo por antecedentes, inspección o tamizaje de neuropatía o enfermedad vascular representó desde el 40% en aquellos con DM de menos de cinco años de evolución hasta el 86% en quienes tenían más de 20 años. Conclusiones: el elevado porcentaje de pacientes con pie de riesgo identificado en este estudio sugiere que, además del correcto examen físico, se requiere la toma de conductas por parte del médico tratante, como la indicación de plantillas o calzado adecuado, así como una fluida derivación al técnico en ortesis, traumatólogo o fisiatra.

Introduction: foot examination is essential in patients with diabetes mellitus (DM). The correct evaluation of the foot in the patient who attends diabetes control is key to establish risk factors for the development of ulcers, detect injuries, take preventive measures, make an early referral and educate in foot care. Objectives: in this study, the feet of people with DM were examined during the Diabetic Foot Awareness and Prevention Campaign on November 1, 2019 in order to assess the presence of symptoms and signs related to neuropathy, peripheral vascular disease, prevalence of the same and know the risk. Materials and methods: 165 patients were analyzed in four centers: Sanatorio Güemes (Diabetes and Endocrinology Service), PREDIGMA (Preventive Medicine Center, Posadas, Misiones), Central Hospital of San Isidro, Nexo Medical Center (Junín City) and Hospital Municipal of General Viamonte (Province of Buenos Aires). Results: it was found that 43.6% had some symptoms in the lower limbs and up to 57% had an alteration in the screening tests for diabetic neuropathy or peripheral arterial disease, with a higher prevalence the longer the evolution of DM. The most frequent signs found in the physical examination were: dry skin (71.5%), nail dystrophy (60.6%) or alteration of the foot pad (52.1%). The lost frequent comorbidities were: hypertension (74.5%) and dyslipidemia (73.3%). The median glycated hemoglobin was 7.40% (6.70-8.10), higher in people with a history of retinopathy (7.8%; p <0.01) and in patients who reported having cramps (7, 85 to 7.30; p = 0.03) or burning (8.0 vs 7.3; p <0.01). The percentage of patients with high-risk foot due to antecedents, inspection or screening for neuropathy or vascular disease represented from 40% in those with DM of less than five years of evolution to 86% in those who were older than 20 years. Conclusions: this high percentage of patients with foot at risk identified in this study suggests that, in addition to the correct physical examination, the attending physician requires the taking of behaviors, such as the indication of appropriate footwear or insoles, as well as a fluid referral to the orthotic technician, orthopedic surgeon, or physiatrist.

Oxidative stress and neuroinflammation in a rat model of co-morbid obesity and psychogenic stress.

BACKGROUND: There is growing recognition for a reciprocal, bidirectional link between anxiety disorders and obesity. Although the mechanisms linking obesity and anxiety remain speculative, this bidirectionality suggests shared pathophysiological processes. Neuroinflammation and oxidative damage are implicated in both pathological anxiety and obesity. This study investigates the relative contribution of comorbid diet-induced obesity and stress-induced anxiety to neuroinflammation and oxidative stress. METHODS: Thirty-six (36) male Lewis rats were divided into four groups based on diet type and stress exposure: 1) control diet unexposed (CDU) and 2) exposed (CDE), 3) Western-like high-saturated fat diet unexposed (WDU) and 4) exposed (WDE). Neurobehavioral tests were performed to assess anxiety-like behaviors. The catalytic concentrations of glutathione peroxidase and reductase were measured from plasma samples, and neuroinflammatory/oxidative stress biomarkers were measured from brain samples using Western blot. Correlations between behavioral phenotypes and biomarkers were assessed with Pearson's correlation procedures. RESULTS: We found that WDE rats exhibited markedly increased levels of glial fibrillary acidic protein (185 %), catalase protein (215 %), and glutathione reductase (GSHR) enzymatic activity (418 %) relative to CDU rats. Interestingly, the brain protein levels of glutathione peroxidase (GPx) and catalase were positively associated with body weight and behavioral indices of anxiety. CONCLUSIONS: Together, our results support a role for neuroinflammation and oxidative stress in heightened emotional reactivity to obesogenic environments and psychogenic stress. Uncovering adaptive responses to obesogenic environments characterized by high access to high-saturated fat/high-sugar diets and toxic stress has the potential to strongly impact how we treat psychiatric disorders in at-risk populations.

Dual Emission of meso-Phenyleneethynylene-BODIPY Oligomers: Synthesis, Photophysics, and Theoretical Optoelectronic Study.

Two series of 2,5-di(butoxy)phenyleneethynylenes, one halogenated (nPEC4-X; n=2, 3, or 4) and the other boron-dipyrromethene (BODIPY) terminated (nPEC4-By; n=3, 4, or 5; By=BODIPY), were synthesized monodirectionally by the step-by-step approach and the molecular structure was corroborated by NMR spectroscopy (1 H, 13 C-DEPTQ-135, COSY, HSQC, HMBC, 11 B, 19 F) and MALDI-TOF mass spectrometry. The multiplicity and J-coupling constants of 1 H, 11 B, and 19 F/11 B NMR signals revealed, in the nPEC4-By series, that the phenyl in the meso position of BODIPY becomes electronically part of the conjugation of the phenyleneethynylene chain, whereas BODIPY is electronically isolated. The photophysical, electrochemical, and theoretical studies confirm this finding because the properties of nPEC4-By are comparable to those of the nPEC4-X oligomers and BODIPY, indicating negligible electron communication between BODIPY and the nPEC4 moieties. Nevertheless, energy transfer (ET) from nPEC4 to BODIPY was rationalized by spectroscopy and theoretical calculations. Its yield decreases with the nPEC4 conjugation length, according to the increase in distance between the two chromophores, resulting in dual emission for the longest oligomer in which ET is quenched.

Optimized and scalable synthesis of magnetic nanoparticles for RNA extraction in response to developing countries' needs in the detection and control of SARS-CoV-2.

Ecuador is one of the most affected countries, with the coronavirus disease 2019 (COVID-19) infection, in Latin America derived from an ongoing economic crisis. One of the most important methods for COVID-19 detection is the use of techniques such as real time RT-PCR based on a previous extraction/purification of RNA procedure from nasopharyngeal cells using functionalized magnetic nanoparticles (MNP). This technique allows the processing of ~ 10,000 tests per day in private companies and around hundreds per day at local Universities guaranteeing to reach a wide range of the population. However, the main drawback of this method is the need for specialized MNP with a strong negative charge for the viral RNA extraction to detect the existence of the SARS-CoV-2 virus. Here we present a simplified low cost method to produce 10 g of nanoparticles in 100 mL of solution that was scaled to one litter by parallelizing the process 10 times in just two days and allowing for the possibility of making ~ 50,000 COVID-19 tests. This communication helps in reducing the cost of acquiring MNP for diverse biomolecular applications supporting developing country budgets constraints and chemical availability specially during the COVID-19 International Health Emergency.