[Pheochromocytoma as a simulator of cardiac pathology]. / Feocromocitoma como simulador de patología cardiaca.

Pheochromocytomas are rare neuroendocrine tumors that can present as hypertensive crises or serious cardiac and cerebrovascular complications that endanger the patient's life. Two unusual cases of adrenergic crises induced by pheochromocytoma with cardiovascular manifestations are presented, one with multiple complications/multiorgan failure, fatal outcome and definitive diagnosis in the post mortem autopsy, and another with a satisfactory evolution after diagnosis and appropriate treatment.

The fundamental role of pH in CH4 bioconversion into polyhydroxybutyrate in mixed methanotrophic cultures.

Climate change and plastic pollution are likely the most relevant challenges for the environment in the 21st century. Developing cost-effective technologies for the bioconversion of methane (CH4) into polyhydroxyalkanoates (PHAs) could simultaneously mitigate CH4 emissions and boost the commercialization of biodegradable polymers. Despite the fact that the role of temperature, nitrogen deprivation, CH4:O2 ratio or micronutrients availability on the PHA accumulation capacity of methanotrophs has been carefully explored, there is still a need for optimization of the CH4-to-PHA bioconversion process prior to becoming a feasible platform in future biorefineries. In this study, the influence of different cultivation broth pH values (5.5, 7, 8.5 and 10) on bacterial biomass growth, CH4 bioconversion rate, PHA accumulation capacity and bacterial community structure was investigated in a stirred tank bioreactor under nitrogen deprivation conditions. Higher CH4 elimination rates were obtained at increasing pH, with a maximum value of 50.4 ± 2.7 g CH4·m-3·h-1 observed at pH 8.5. This was likely mediated by an increased ionic strength in the mineral medium, which enhanced the gas-liquid mass transfer. Interestingly, higher PHB accumulations were observed at decreasing pH, with the highest PHB contents recorded at a pH 5.5 (43.7 ± 3.4 %w·w-1). The strong selective pressure of low pH towards the growth of Type II methanotrophic bacteria could explain this finding. The genus Methylocystis increased its abundance from 34 % up to 85 and 90 % at pH 5.5 and 7, respectively. On the contrary, Methylocystis was less abundant in the community enriched at pH 8.5 (14 %). The accumulation of intracellular PHB as energy and carbon storage material allowed the maintenance of high CH4 biodegradation rates during 48 h after complete nitrogen deprivation. The results here obtained demonstrated for the first time a crucial and multifactorial role of pH on the bioconversion performance of CH4 into PHA.

Middle-age abolishes cardioprotection conferred by thioredoxin-1 in mice.

Thioredoxin-1 (Trx1) has cardioprotective effects on ischemia/reperfusion (I/R) injury, although its role in ischemic postconditioning (PostC) in middle-aged mice is not understood. This study aimed to evaluate if combining two cardioprotective strategies, such as Trx1 overexpression and PostC, could exert a synergistic effect in reducing infarct size in middle-aged mice. Young or middle-aged wild-type mice (Wt), transgenic mice overexpressing Trx1, and dominant negative (DN-Trx1) mutant of Trx1 mice were used. Mice hearts were subjected to I/R or PostC protocol. Infarct size, hydrogen peroxide (H2O2) production, protein nitration, Trx1 activity, mitochondrial function, and Trx1, pAkt and pGSK3ß expression were measured. PostC could not reduce infarct size even in the presence of Trx1 overexpression in middle-aged mice. This finding was accompanied by a lack of Akt and GSK3ß phosphorylation, and Trx1 expression (in Wt group). Trx1 activity was diminished and H2O2 production and protein nitration were increased in middle-age. The respiratory control rate dropped after I/R in Wt-Young and PostC restored this value, but not in middle-aged groups. Our results showed that Trx1 plays a key role in the PostC protection mechanism in young but not middle-aged mice, even in the presence of Trx1 overexpression.

Espiradenoma écrino en muslo de mujer: reporte de un caso

Introducción: El espiradenoma ecrino es un tumor anexial benigno raro que surge de las glándulas sudoríparas écrinas. Comúnmente se presenta como un nódulo de crecimiento lento en la parte superior del tronco y la región de la cabeza y el cuello, principalmente en el rango de edad de 15 a 35 años, sin predominio de género. Por lo general, se presentan como pequeños nódulos solitarios que pueden crecer varios centímetros, a menudo muy dolorosos. El diagnóstico de esta entidad es de suma importancia ya que puede albergar un componente maligno con desenlaces catastróficos, ya que pueden pasar desapercibidos por su gran parecido con lesiones benignas. Caso Clínico: Aquí presentamos el caso de una mujer 41 años que presentó una lesión cutánea de crecimiento similar a un papiloma en la cara externa de tercio superior del muslo, con el diagnóstico de espiradenoma écrino posterior a la extirpación.

Introduction: Eccrine spiradenoma is a rare, benign adnexal tumor arising from the eccrine sweat glands. It commonly presents as a slow-growing nodule on the upper trunk, and head and neck region, mostly in the age bracket of 15 - 35 years, with no gender preference. Typically, they present as small solitary nodules that can grow to several centimeters, often they are strikingly painful. The diagnosis of this entity is extremely important as it can harbour a malignant component with catastrophic outcomes wich may be missed due to its strong resemblance to benign lesions. Case Report: We present the case of a 41-year-old woman who presented with a papilloma-like growth on the upper lateral aspect of the thigh which was diagnosed as eccrine spiradenoma upon excision.

Effect of graphite oxide electrochemically exfoliated over a multimode interference filter.

In this work, we study multimodal interference filters with a graphite oxide coating. Use of the multimodal interference filter shows a distinctive peak in the signal spectrum, and when using the exfoliated graphite coated multimodal interference filter, the signal shows different spectral changes, such as the full width at half maximum of the curve, the maximum power, and central wavelength, which indicates that graphite oxide absorbs part of the energy. In addition, microscope observations when a He-Ne laser is passed through the filter confirm that graphite oxide is adhered to the filter.

Optical fiber pH sensor based on a multimode interference device with polymer overlay.

An optical fiber pH sensor based on a multimode interference structure is presented. The sensitive element is a piece of no-core fiber (NCF) coated with a mixture of polyallylamine hydrochloride and polyacrylic acid by a modified layer-by-layer (LbL) self-assembly method. It is experimentally shown that by reducing the diameter of the NCF by chemical etching, the sensitivity is increased from -0.31n m/p H to -2n m/p H. The sensor exhibits a high linear response of 0.997 over a pH range from 5 to 11.3 with a rapid response time lower than 1 s.

Analysis of the average duration of sick leave due to electrical contact in the primary, secondary and tertiary sectors in Spain (2013-2019).

The analysis of the economic impact of occupational health and safety has been side-lined for many years. Various studies have acknowledged the importance of analysing the seriousness of accidents on the basis of the number of working days lost due to injuries sustained in such accidents in different economic sectors. In this longitudinal comparative study, we analyse the average duration of sick leave associated with 4,098,520 accidents that occurred in Spain between 2013 and 2019, and more specifically with 5724 accidents involving direct and indirect electrical contact. Based on the number of lost workdays, the relationship between the seriousness of electrical accidents and the economic sectors where they occur is explored via contingency tables in which statistical Chi-square value (χ2) was calculated. The main results obtained show that the average duration of sick leave shows an upward year-on-year trend in all three economic sectors. In addition, accidents due to direct and indirect electrical contact occur in all sectors, and the injuries produced in this type of accident are more severe than those produced in the sum of all accidents in Spain. Our figures show that the longest duration of sick leave occurs in the primary sector, followed by the tertiary and the secondary sectors. These results should prompt the competent authorisites to require businesses to maintain the equipment and facilities in good order, and to introduce effective supervision programmes that guarantee compliance with the measures enforced and reduce the serious consequences of electrical accidents.

Impact of the COVID-19 pandemic on the mental health of the general population and health care workers.

The Health Sciences Foundation has assembled a multidisciplinary group around a series of questions about the impact of the COVID-19 pandemic on the mental health of the general population and specific groups within that population, particularly healthcare workers. In the general population, the most prevalent mental disorders have been anxiety, sleep disorders and affective disorders, primarily depression. There has been a considerable increase in suicidal behavior, especially in young women and men over 70 years of age. There has been an increase in alcohol abuse and nicotine, cannabis and cocaine use. In contrast, the use of synthetic stimulants during periods of confinement has decreased. With regard to non-substance addictions, gambling was very limited, pornography consumption increased significantly and there was an increase in compulsive shopping and the use of video games. Particularly vulnerable groups include adolescents and patients with autism spectrum disorders. Healthcare workers suffered an increase in depression, anxiety and post-traumatic stress, especially those who were exposed during the early stages of the pandemic. Female sex, being a nurse, proximity to patients with COVID-19, working in a rural environment and having previous psychiatric or organic illnesses were some of the most frequently repeated factors in various studies in this population group. The media have shown a good degree of knowledge about these problems and have dealt with them frequently and from the point of view of ethics, crisis situations, such as the one experienced, have triggered not only physical but also moral claudications.

Agreement between isokinetic eccentric hamstring strength, Nordic hamstring strength and Nordic break-point angle in a sample of trained and healthy individuals.

Different eccentric strength assessments are used to identifying the risk of hamstring injury in athletes. However, there is scarce information to determine the association between Nordic-based measurements and the gold standard measurement of eccentric hamstring strength in an isokinetic dynamometer. To investigate the relationship of different measures of eccentric hamstring strength (break-point angle and eccentric strength during Nordic exercise) with eccentric hamstring peak torque measured with an isokinetic dynamometer. Forty-six participants volunteered to participate in this study. Eccentric peak force in the Smart-Nordic System and break-point angle measured as trunk lowering at >20°/s and >150°/s2 during the Nordic exercise via high-frequency video-analysis were compared to eccentric hamstring peak torque in an isokinetic dynamometer set to produce knee extension at 30°/s. There was a moderate association between peak eccentric strength with the Smart-Nordic and isokinetic eccentric hamstring peak torque (r = -0.65, p < 0.001, 95%CI = [-0.76-(-0.50)]). The association between Nordic break-point angle measured at 20°/s (r = 0.49, p < 0.001, 95%CI = [0.30-0.64]) and at 150°/s2 (r = 0.52, p < 0.001, 95%CI = [0.33-0.66]) presented statistically significant but lower associations with isokinetic eccentric hamstring peak torque. All Nordic-based measurements presented acceptable associations with the gold standard isokinetic eccentric hamstring peak torque. However, peak eccentric force measured on the Smart-Nordic device had a better agreement with eccentric peak torque measured with an isokinetic dynamometer than the video-based measurements.Highlights Peak eccentric force measured on the isometric strain-gauges device had a better agreement with eccentric hamstring peak torque measured with an isokinetic dynamometer than the break-point angle.The Nordic-based measurements are an alternative cost-effective method to assess eccentric muscle strength and weakness when the access to isokinetic dynamometry is not feasible.Caution should be taken with certain variables such as participants body mass, hip position and movement speed when interpreting the results of Nordic-based measurements.

The Dominant Anterior Thoracic Artery of the Spinal Cord.

BACKGROUND AND PURPOSE: Dominant radiculomedullary arteries such as the artery of lumbar enlargement and the artery of cervical enlargement are well-documented. However, variability exists as to the size, number, and location of other radiculomedullary arteries contributing supply to the anterior spinal artery. The aim of this anatomic study was to document the prevalence and characteristics of the dominant anterior thoracic artery in cadaveric specimens. MATERIALS AND METHODS: Microsurgical dissection of cadaveric human spinal cord specimens (n = 50) was conducted. The artery of lumbar enlargement was injected with colored latex until the small-caliber arterial vessels were filled. The dominant anterior thoracic artery was identified, injected, and filled with diluted industrial paint. The course, diameter, and location of the dominant anterior thoracic artery, artery of lumbar enlargement, and artery of cervical enlargement were documented. RESULTS: The artery of lumbar enlargement was identified between T3 and L2 in all 50 specimens (100%), and the artery of cervical enlargement was identified in 84% of specimens (42/50). At least 1 dominant anterior thoracic artery distinct from the artery of lumbar enlargement and the artery of cervical enlargement was identified between T1 and T11 in 47 of the 50 specimens (94%). The most frequent origin of the dominant anterior thoracic artery was at the level of T4 on the left. The average size of the dominant anterior thoracic artery was 0.446 mm (range, 0.300-0.759 mm on the left and 0.270-0.569 mm on the right). CONCLUSIONS: A dominant anterior thoracic artery is present in 94% of individuals. Variations of the arterial supply to the anterior thoracic cord are of great importance due to their implications for ischemic events as well as surgical and endovascular procedures.

Comparison of production-related responses to hyperinsulinemia and hypoglycemia induced by clamp procedures or heat stress of lactating dairy cattle.

Hyperinsulinemia concurrent with hypoglycemia is one of a myriad of physiological changes typically experienced by lactating dairy cows exposed to heat stress, the consequences of which are not yet well defined or understood. Therefore, the objective of this experiment was to separate the production-related effects of hyperinsulinemia with hypoglycemia from those of a hyperthermic environment. Multiparous lactating Holstein cows (n = 23; 58 ± 4 d in milk, 3.1 ± 0.3 lactations) were housed in temperature-controlled rooms and all were subjected to 4 experimental periods as follows: (1) thermoneutral (TN; temperature-humidity index of 65.1 ± 0.2; d 1-5), (2) TN + hyperinsulinemic-hypoglycemic clamp (HHC; insulin infused at 0.3 µg/kg of BW per h, glucose infused to maintain 90 ± 10% of baseline blood glucose for 96 h; d 6-10), (3) heat stress (HS; temperature-humidity index of 72.5 ± 0.2; d 16-20), and (4) HS + euglycemic clamp (EC; glucose infused to reach 100 ± 10% of TN baseline blood glucose for 96 h; d 21-25). Cows were fed and milked twice daily. Feed refusals were collected once daily for calculation of daily dry matter intake, and milk samples were collected at the beginning and end of each period for component analyses. Circulating insulin concentrations were measured in daily blood samples, whereas glucose concentrations were measured more frequently and variably in association with clamp procedures. Rectal temperatures and respiration rates were greater during HS than TN, as expected, and states of hyperinsulinemia and hypoglycemia were successfully induced by the HHC and high ambient temperatures (HS and EC). Feed intake differed based upon thermal environment as it was similar during TN and HHC periods, and declined for HS and EC. Milk production was not entirely reflective of feed intake as it was greatest during TN, intermediate during HHC, and lowest during HS and EC. All milk components differed with the experimental period, primarily in response to the thermal environment. Interestingly, TN baseline glucose concentrations were highly correlated with the change in glucose from TN to HS, and were related to glycemic status during HS. Furthermore, although few in number, those cows that failed to become hypoglycemic during HS tended to have a greater reduction in milk yield. The work presented here addresses a critical knowledge gap by broadening our understanding of the physiological response to heat stress and the related changes in glycemic state. This broadened understanding is fundamental for the development of novel, innovative management strategies as the dairy industry is compelled to become increasingly efficient in spite of global warming.

COVID-19 and Dermal Fillers: Should We Really Be Concerned? / COVID y rellenos faciales ¿realmente debemos preocuparnos?

SARS-CoV-2 has caused millions of infections and deaths worldwide and case numbers continue to rise. Besides the effect of the virus on key organs - leading to respiratory illness, anosmia, diarrhea, and fever and other complications - delayed inflammatory reactions to hyaluronic acid dermal fillers, mainly in the face, have also been reported to occur after confirmed SARS-CoV-2 infections and in vaccinated individuals. While delayed inflammatory reactions tend to be self-limiting, they should be diagnosed and treated with corticosteroids, hyaluronidase, and/or antibiotics when necessary. The inflammation is generally not severe, yet these complications are classified as serious adverse events by the US Food and Drug Administration. They appear to be delayed type IV hypersensitivity reactions triggered by the immune system in the presence of SARS-CoV-2 or other viruses, such as those causing influenza, although the underlying mechanisms have not been fully elucidated. Because the longevity of dermal fillers is increasing, while the pandemic continues to evolve and new vaccines are under development, the long-term effects on hyaluronic acid fillers and other bioimplant materials should be studied. Physicians must also be encouraged to report these reactions, however mild, to ensure accurate records.

[Expert opinion on strategies to improve vaccination coverage against seasonal influenza]. / Documento de opinión de expertos para la mejora de la cobertura vacunal frente a la gripe estacional.

Seasonal flu continues to be a major public health concern, and the influenza vaccine remains the most effective preventive measure. In Spain, vaccination coverage data from previous seasons show vaccination rates well below official targets; however, these figures improved significantly after the COVID-19 pandemic. Given the importance of achieving and maintaining high vaccination rates in order to avoid the clinical and economic impact of influenza, our multidisciplinary group of experts on vaccines analyzed the impact of low vaccination rates in Spain and drafted a series of measures to boost influenza vaccination coverage, particularly among priority groups.

Associations of the COVID-19 pandemic with social well-being indicators in Mexico.

BACKGROUND: Public health measures for COVID-19 containment have implied economic and social life disruptions, which have been particularly deleterious in low- and middle-income countries (LMIC) due to high rates of informal employment, overcrowding, and barriers to accessing health services, amongst others social determinants. Mexico, a LMIC, is a country with a high COVID-19 mortality in which there has been a very limited governmental response to help mitigate such COVID-related disruptions. This study analyzes the association of the first wave of the COVID-19 crisis in Mexico with four well-being indicators: income, employment, anxiety, and food security. METHODS: It uses pooled cross-sectional data (n = 5453) of five monthly nationally representative surveys collected between April and August 2020. Probit models are estimated to assess the association of the pandemic with job loss and anxiety; a multinomial logistic regression is estimated for food security, and an ordinary least squares regression assesses the association between the pandemic and changes in household's income. RESULTS: Females were significantly associated with worse outcomes for the 4 well-being measures with an average reduction of 2.3% in household income compared to pre-COVID-19 levels, an increased probability (6.4 pp) of being in a household that had lost jobs, decreased probability of food security (6.9 pp), and an increased risk of anxiety symptoms (8.5 pp). In addition, those with lower SES and household with children also reported worse outcomes for employment, income and food security. The month variable was also statistically significant in these models suggesting that as more months of the pandemic elapsed the effects persisted. CONCLUSION: The currents study documents how the COVID-19 pandemic is associated with different well-being indicators in a LMIC. It suggests the urgent need to take actions to support vulnerable groups, particularly women, households with children and those in the lowest SES. If policy actions are not taken, the pandemic will increase social and gender disparities, and will jeopardize childhood development.

Stereotactic body radiation therapy in patients with metachronous oligorecurrent prostate cancer: A single-center experience.

INTRODUCTION AND OBJECTIVE: Metachronous oligorecurrence in prostate cancer (PCa) occurs in patients with localized disease who, after failed radical treatment, develop oligometastases. Metastasis-directed stereotactic radiotherapy (SBRT) aims to delay androgen deprivation therapy. In this study, we report our experience to elucidate the role of SBRT in a selected population of patients with metachronous oligorecurrence. MATERIAL AND METHODS: Retrospective analysis of patients treated with SBRT for oligorecurrent PCa between November 2015 and December 2020. We detailed clinicopathological characteristics at disease onset (age, PSA, stage, primary treatment), clinical scenario at diagnosis of oligorecurrence (PSA, PSA velocity, metastases characteristics), progression-free survival, castration resistance-free survival, dose, and toxicity of SBRT. RESULTS: Thirty-eight SBRT treatments were applied to 13 lymph node and 25 bone metastases in a total of 28 patients. After a follow-up of 34.57 months (21.17-57.59), 17 patients had radiological progression of the disease and 11 presented castration resistant PCa. PFS and CRFS were 21.93 and 44.13 months, respectively. Only 2 patients presented grade 1 toxicity. CONCLUSIONS: In patients with metachronous oligorecurrent PCa, SBRT constitutes a safe and effective treatment that allows delaying the onset of androgen deprivation therapy and the time to castration resistance, assuming low levels of toxicity.

Suicide-related thoughts and behavior and suicide death trends during the COVID-19 in the general population of Catalonia, Spain.

The COVID-19 pandemic is expected to increase suicidal behavior. However, data available to date are inconsistent. This study examines suicidal thoughts and behaviors and suicide trends in 2020 relative to 2019 as an approximation to the impact of the pandemic on suicidal behavior and death in the general population of Catalonia, Spain. Data on suicide-related thoughts and behaviors (STBs) and suicidal mortality were obtained from the Catalonia Suicide Risk Code (CSRC) register and the regional police, respectively. We compared the monthly crude incidence of STBs and suicide mortality rates of 2020 with those of 2019. Joinpoint regression analysis was used to assess changes in trends over time during the studied period. In 2020, 4,263 consultations for STBs and 555 suicide deaths were registered in Catalonia (approx. 7.5 million inhabitants). Compared to 2019, in 2020 STBs rates decreased an average of 6.3% (incidence rate ratio, IRR=0.94, 95% CI 0,90-0,98) and overall suicide death rates increased 1.2% (IRR=1.01, 95% CI 0.90-1.13). Joinpoint regression results showed a substantial decrease in STBs rates with a monthly percent change (MPC) of -22.1 (95% CI: -41.1, 2.9) from January-April 2020, followed by a similar increase from April-July 2020 (MPC=24.7, 95% CI: -5.9, 65.2). The most restrictive measures implemented in response to the COVID-19 pandemic reduced consultations for STBs, suggesting that the "stay at home" message may have discouraged people from contacting mental health services. STBs and mortality should continue to be monitored in 2021 and beyond to understand better the mid-to-long term impact of COVID-19 on suicide trends.

Inheritance of the SLICK1 allele of PRLR in cattle.

The slick-hair phenotype in cattle is due to one of a series of mutations in the prolactin receptor (PRLR) that cause truncation of the C-terminal region of the protein involved in JAK2/STAT5 activation during prolactin signaling. Here we evaluated whether the inheritance of the SLICK1 allele, the first slick mutation discovered, is inherited in a fashion consistent with Hardy-Weinberg equilibrium. It was hypothesized that any deleterious effect of inheriting the allele on embryonic or fetal function would result in reduced frequency of the allele in offspring. A total of 525 Holstein and Senepol cattle produced from matings involving one or both parents with the SLICK1 allele were genotyped. The observed frequency of the SLICK1 allele (0.247) was not significantly different than the expected frequency of 0.269. These results support the idea that inheritance of the SLICK1 allele does not act in the embryo or fetus to modify its competence to complete development to term.

Correlation between proximal serrated polyp detection and clinically significant serrated polyps: inter-endoscopist variability.

INTRODUCTION AND AIMS: The adenoma detection rate (ADR) is the most important quality indicator for the prevention of colorectal cancer but serrated polyps are also precursor lesions of the disease. The aim of our study was to compare the detection rate of proximal serrated polyps (PSPs) and that of clinically significant serrated polyps (CSSPs) between endoscopists and analyze the relation of those parameters to the ADR. METHODS: An observational, prospective, cross-sectional study was conducted on all patients that underwent colonoscopy at the Policlínico Peruano Japonés within the time frame of July 2015 and August 2016. The ADR and PSP and CSSP detection rates between endoscopists were compared through multivariate logistic regression and the association between those parameters was calculated through the Pearson correlation coefficient. RESULTS: The study included 15 endoscopists and 1,378 colonoscopies. The PSP detection rate ranged from 1.8-17% between endoscopists and had an almost perfect correlation with the CSSP detection rate (p = 0.922), as well as strongly correlating with the ADR (p = 0.769). CONCLUSIONS: There was great variability in the PSP detection rate between endoscopists. It also had an almost perfect correlation with the CSSP detection rate and strongly correlated with the ADR. Those results suggest a high CSSP miss rate at endoscopy and a low PSP detection rate.