Distribution and ecological risk of metals in an urban natural protected area in the Riviera Maya, Mexico.

Urbanization can negatively impact natural protected areas near or surrounded by cities, and such impacts include untreated wastewater discharge, leachates from dumpsters, e-waste, and road dust. In this research, we show that not only large cities with industry are prone to be polluted, but also young touristic cities with high population increase rate can suffer from urban contamination. We evaluated metal pollution in a natural protected area within a 50-year-old city without conventional industry that was likely contaminated by the urban sprawl around the protected area. We tested water, zooplankton, sediment and plant samples for metallic elements to evaluate their bioaccumulation in zooplankton, enrichment factors and geoaccumulation index values in sediments, and translocation factors in plants. Finally, we evaluated the ecological risk due to metal contamination. Metals at levels above our detection limit (20 µg/L) were not found in the water and zooplankton samples. The sediments and plants in the storm drain section of the protected area had a greater concentration of metals and wastewater indicators (coliforms) than those in the rest of the lagoon. Moreover, signs of Al, Cu, Ni, Zn, Cr, Pb, and Ti contamination were found in the plant tissues. We estimated that the ecological risk of this natural protected area surrounded by the city of Cancun (Mexico) ranged from mild to strong, with Zn being the metal of most concern. The results highlight that young touristic cities around the world will endure contamination from urban sources; signs or early warnings of contamination must be identified to prevent and resolve such issues.

Accumbens brain-derived neurotrophic factor (BDNF) transmission inhibits cocaine seeking.

Brain-derived neurotrophic factor (BDNF) regulates a variety of physiological processes, and several studies have explored the role of BDNF in addiction-related brain regions like the nucleus accumbens core (NAcore). We sought to understand the rapid effects of endogenous BDNF on cocaine seeking. Rats were trained to self-administer cocaine and extinguished. We then microinjected two inhibitors of BDNF stimulation of tropomyosin receptor kinase B (TrkB), the non-competitive receptor antagonist ANA-12 and TrkB/Fc, a fusion protein that binds BDNF and prevents TrkB stimulation. Blocking TrkB or inactivating BDNF in NAcore potentiated active lever pressing, showing that endogenous BDNF tone was present and supplying inhibitory tone on cue-induced reinstatement. To determine if exogenous BDNF also negatively regulated reinstatement, BDNF was microinjected into NAcore 15 minutes before cue-induced reinstatement. BDNF decreased cocaine seeking through TrkB receptor binding, but had no effect on inactive lever pressing, spontaneous or cocaine-induced locomotion, or on reinstated sucrose seeking. BDNF-infusion potentiated within trial extinction when microinjected in the NAcore during cue- and context + cue induced reinstatement, and the inhibition of lever pressing lasted at least 3 days post injection. Although decreased reinstatement endured for 3 days when BDNF was administered prior to a reinstatement session, when microinjected before an extinction session or in the home cage, BDNF did not alter subsequent cued-reinstatement. Together, these data show that endogenous BDNF acts on TrKB to provide inhibitory tone on reinstated cocaine seeking, and this effect was recapitulated by exogenous BDNF.

Sacituzumab govitecan for hormone receptor-positive HER2-negative advanced breast cancer.

INTRODUCTION: Initial treatment for hormone-receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer (ABC) typically involves endocrine therapy (ET) combined with different targeted agents. When hormonal therapies fail, until recently, the only option available was chemotherapy (ChT), presenting a significant therapeutic challenge. However, the recent introduction of antibody-drug conjugates (ADCs) has provided new treatment alternatives in this context. Sacituzumab govitecan (SG), a novel trophoblast cell-surface antigen 2 (Trop-2)-targeting ADC, has been evaluated following disease progression to ET and ChT in HR+/HER2- ABC. AREAS COVERED: This review examines the latest clinical trials, including phase I/II and III studies and evaluates the impact of SG on HR+/HER2- ABC. The literature search focused on clinical outcomes, particularly regarding efficacy and safety, comparing them with traditional ChT. EXPERT OPINION: SG has demonstrated to be an effective treatment for patients with HR+/HER2- ABC after progression to ET and cyclin-dependent kinase 4/6 inhibitors (CDKi) in any setting, and at least two ChT-containing regimens in the advanced setting. With a manageable toxicity profile, SG represents a significant advancement in the treatment landscape for this patient population. However, further research is essential to optimize its application and establish long-term benefits.

Intraoperative angiography with indocyanine green, an aid in the diagnosis and treatment of obscure digestive tract bleeding, a case report.

Lower digestive tract bleeding occurs distal to the angle of Treitz. While many cases remit spontaneously; some pose a diagnostic challenge for surgeons. We present the case of a 68-year-old man with unexplained digestive tract bleeding. Despite various diagnostic efforts, the source remained unknown. Faced with the challenge of persistent bleeding and hemodynamic instability, surgery became necessary. During the procedure, intraoperative angiography with indocyanine green was used to facilitate the identification of the bleeding site, revealing a gastrointestinal stromal tumor in the small bowel. Resection was performed with favorable outcomes. Indocyanine green staining has become popular for locating intestinal bleeding during emergency surgeries, aiding surgeons in making precise decisions.

Heavy metals in the sediments of urban sinkholes in Cancun, Quintana Roo.

Soils in urban areas can accumulate heavy metals as a result of anthropogenic inputs. This research focuses on a young coastal tourist city that has been urbanized over the last 52 years and shows accelerated demographic growth and urban development. Deposition of heavy metals in soils is caused by human economic activities, which has significant implications for the environment. We evaluated heavy metal concentrations in urban sinkholes, which are sites for the natural accumulation of water and sediments. These locations also receive rainfall runoff or have been used as unregulated dumps. By performing a multistage extraction to address availability and risk, we found that Zn, Fe and Al were the predominant metals; Cu, Pb and Ni were only detected in some sinkholes. The contamination factor was high for Zn and moderate for Pb. The geoaccumulation index showed that Zn is the most abundant and available metal in urban sinkholes and the metal with the highest potential ecological risk. Between 12 and 50% of the total concentration of all metals was extracted from the organic matter phase. Correlations were found between the degree of urbanization of the city and the degree of pollution, and the trends were stronger in older sections of the city. Zn is the most prevalent element and has high concentrations. The metal concentrations in the sediments can be used as warning signs for their potential risk to environmental and human health, and these results can be compared with those of other tourist cities in karstic environments around the world.

A multi-approach assessment of land use effects on groundwater quality in a karstic aquifer.

Groundwater represents almost half of the drinking water worldwide and more than one third of water used for irrigation. Agro-industrial activities affect water resources in several manners; one of the most important is leaching of agrochemical residues. This research identifies the major contributors of changes in groundwater quality comparing two contrasting land uses in a karstic area of the Yucatan peninsula as case study. Using a multiple approach, we assess the impact of land use with physicochemical data, multivariate analyses, hydrogeochemistry and nitrate isotopic composition. We confirmed that agricultural land use has a greater impact on groundwater quality, observed in higher concentration of nitrates, ammonium, potassium and electrical conductivity. Seasonality has an influence on phosphates and the chemical composition of the groundwater, increasing the concentration of dissolved substances in the rainy season. There was a clear effect of manure application in the agricultural zone and the nitrate isotopic composition of groundwater points toward recharge in certain areas. We consider that seasonality and land use effects are intertwined and sometimes difficult to separate, likely because of land use intensity and hydrogeochemical process at a local scale. Finally, we observed poor groundwater quality in the agricultural area during the wet season; thus, it is desirable to maintain non-agricultural areas that provide groundwater of appropriate quality.

Acretismo placentario en el primer trimestre del embarazo como causa de choque hipovolémico: reporte de un caso / Placentary acretism in the first quarter of pregnancy as a cause of hypovolemic shock: a case report

Resumen ANTECEDENTES: El acretismo es la adherencia anormal de la placenta al miometrio debida a la ausencia parcial o total de la decidua basal y desarrollo incompleto de la capa de Nitabuch. CASO CLÍNICO: Paciente de 45 años, con antecedente de tres embarazos, dos abortos, una cesárea y amenorrea de 12 semanas. El padecimiento actual se inició dos días antes, con sangrado transvaginal intermitente. A su ingreso a Urgencias se encontró con datos de bajo gasto e inmediatamente pérdida del estado de alerta; tensión arterial 40-20 mmHg, frecuencia cardiaca de 125 lpm. La parte posterior del cuello uterino se encontró dehiscente, con sangrado transvaginal abundante, prueba inmunológica de embarazo positiva, fracción β-GCH de 2878 mU/mL. Al asociar los datos de la exploración física se integró el diagnóstico de aborto incompleto y se ingresó a la unidad tocoquirúrgica, para legrado uterino instrumentado. CONCLUSIONES: De acuerdo con las búsquedas bibliográficas, todo indica que éste es el primer reporte mexicano de un caso de acretismo placentario en el primer trimestre del embarazo. Se sugiere la búsqueda de factores de riesgo que permitan la sospecha y faciliten establecer el diagnóstico de acretismo placentario a partir de las primeras semanas de embarazo para evitar desenlaces obstétricos fatales.

Abstract BACKGROUND: Accretism is the abnormal adherence of the placenta to the myometrium due to partial or total absence of the basal decidua and incomplete development of the Nitabuch's layer. CLINICAL CASE: 45-year-old patient, with a history of three pregnancies, two abortions and one cesarean section; amenorrhea of 12 weeks. The current condition started two days earlier, with intermittent transvaginal bleeding. On admission to the ED she was found to have low output and immediate loss of alertness; blood pressure 40-20 mmHg, heart rate 125 bpm. The posterior cervix was found to be dehiscent, with abundant transvaginal bleeding, positive immunological pregnancy test, HCG fraction 2878 mU/mL. By associating the physical examination data, the diagnosis of incomplete abortion was integrated, and she was admitted to the tocosurgical unit, for instrumented uterine curettage. CONCLUSIONS: According to the bibliographic searches, everything indicates that this is the first Mexican report of a case of placental accretism in the first trimester of pregnancy. It is suggested to search for risk factors that allow suspicion and facilitate the diagnosis of placental accretism from the first weeks of pregnancy to avoid fatal obstetric outcomes.

Mechanisms of salt tolerance in habanero pepper plants (Capsicum chinense Jacq.): Proline accumulation, ions dynamics and sodium root-shoot partition and compartmentation.

Despite its economic relevance, little is known about salt tolerance mechanisms in pepper plants. To address this question, we compared differences in responses to NaCl in two Capsicum chinense varieties: Rex (tolerant) and Chichen-Itza (sensitive). Under salt stress (150 mM NaCl over 7 days) roots of Rex variety accumulated 50 times more compatible solutes such as proline compared to Chichen-Itza. Mineral analysis indicated that Na(+) is restricted to roots by preventing its transport to leaves. Fluorescence analysis suggested an efficient Na(+) compartmentalization in vacuole-like structures and in small intracellular compartments in roots of Rex variety. At the same time, Na(+) in Chichen-Itza plants was compartmentalized in the apoplast, suggesting substantial Na(+) extrusion. Rex variety was found to retain more K(+) in its roots under salt stress according to a mineral analysis and microelectrode ion flux estimation (MIFE). Vanadate-sensitive H(+) efflux was higher in Chichen-Itza variety plants, suggesting a higher activity of the plasma membrane H(+)-ATPase, which fuels the extrusion of Na(+), and, possibly, also the re-uptake of K(+). Our results suggest a combination of stress tolerance mechanisms, in order to alleviate the salt-induced injury. Furthermore, Na(+) extrusion to apoplast does not appear to be an efficient strategy for salt tolerance in pepper plants.

Validación de la escala de morisky de 8 ítems en pacientes con enfermedad renal crónica / Validation of the morisky 8 items scale in patients with chronic kidney disease / Validação da escala de morisky 8 em pacientes com doença do renal crônica

Introducción: Es importante proveer un adecuado y oportuno manejo a largo plazo de la ERC, por medio de estrategias farmacológicas y no farmacológicas, sin embargo, la baja adherencia de los pacientes al tratamiento farmacológico pone en riesgo la efectividad de la intervención. Objetivo: Traducir al español, validar y adaptar la escala de adherencia al tratamiento de Morisky de 8 items a pacientes con ERC. Materiales y Métodos: La traducción del MMAS-8 se realizó de acuerdo con las directrices para la traducción y la adaptación de instrumentos de medida para ser utilizados en investigación médica, se validó mediante juicio de expertos siguiendo el método Delphi. Se realizó un estudio piloto corte transversal, donde se encuesto a 30 pacientes que acudieron a consulta de predialisis de la unidad renal del hospital militar central en Bogotá Colombia. Resultados: La escala MMAS-8 traducida al español fue sometida a los jueces para su validación obteniéndose un porcentaje de acuerdo igual o mayor al 80% para todas las preguntas, se calculó el coeficiente de concordancia W de Kendall que en este caso fue 0,8 con un p valor de 0,0001 y se interpretó como un alto grado de concordancia entre las valoraciones hechas por los jueces a los diferentes ítems del cuestionario. Se aplicó el MMAS-8 a 30 pacientes con una media de edad de 75,9 años (+/- 15), el nivel de adherencia al tratamiento se analizó según el puntaje de la escala de Morisky de 8 items, clasificándose como baja adherencia al tratamiento en el 62,5% de los casos con puntaje menor de 6, mediana adherencia 28,1% de los pacientes puntaje entre 6 y 7 y alta adherencia solo el 9,4% de los pacientes con puntaje mayor de 8. Conclusiónes: La escala de medición de adherencia al tratamiento de Morisky de 8 items es válida para medir la adherencia al tratamiento farmacológico de pacientes con enfermedad renal crónica según juicio de expertos.

Introduction: It is important to provide long-term, adequate and timely treatment of the Chronic kidney disease, by pharmacological and non-pharmacological strategies, however, low adherence of patients to drug treatment puts at risk the effectiveness of the intervention. Objective: Translate to Spanish, validate and adapt the scale of adherence Morisky 8 items patients with chronic kidney disease. Materials and methods: Translation from MMAS-8 was performed according to the guidelines for the translation and adaptation of measuring instruments for use in medical research. It was validated by expert judgment following the Delphi method. A pilot study was conducted cross-sectional, where 30 patients who consulted predialysis renal unit of the central military hospital in Bogota Colombia was surveyed. Results: MMAS-8 Scale translated into Spanish was submitted to the judges for validation, obtaining a percentage of agreement equal to or greater than 80% for all questions, the coefficient of Kendall W in this case was 0.8 with a p value of 0.0001 was calculated and it is interpreted as a high degree of consistency between the assessments made by the judges to the different items of the questionnaire. MMAS-8 is applied to 30 patients with a mean age 75.9 years (+/- 15), the level of adherence to treatment is performed according to the scale score Morisky 8 items, classified as low adherence to treatment in 62.5% of cases with lower score of 6, adhesion median 28.1% of patients score between 6 and 7, and high adhesion only 9.4% of patients with major score of 8. Conclusions: The scale measuring adherence Morisky 8 items It is valid to measure adherence to drug treatment of patients with chronic kidney disease according to expert judgment.

Introdução: É importante fornecer um tratamento a longo prazo, adequado e oportuno da doença renal crónica, através de estratégias farmacológicas e não farmacológicas, no entanto, a baixa adesão dos doentes ao tratamento medicamentoso põe em risco a eficácia da intervenção. Objetivo: Traduzir para o espanhol, validar e adaptar a escala de adesão Morisky 8 itens pacientes com doença renal crônica. Materiais e métodos: A tradução do MMAS-8 foi realizada de acordo com as diretrizes para a tradução e adaptação de instrumentos de medição para uso em uma investigação médica. Foi validado por um juízo especialista seguindo o método Delphi. Um estudo piloto foi realizado em corte transversal, onde foram entrevistados 30 pacientes que consultaram a unidade pré-diálise renal do hospital militar central em Bogotá Colômbia. Resultados: A escala de MMAS-8 traduzida para o espanhol foi submetida aos juízes para validação, obtendo-se uma percentagem de concordância igual ou superior a 80% para todas as questões, o coeficiente de Kendall W neste caso 0,8 com um valor de p de 0,0001 foi calculado e interpretado como um alto grau de consistência entre as avaliações feitas pelos juízes aos diferentes itens do questionário. O MMAS-8 é aplicado a 30 pacientes com idade média de 75,9 anos (+/- 15), o nível de aderência ao tratamento é realizado de acordo com o escore Morisky 8 itens, classificados como baixa adesão ao tratamento em 62,5% dos casos com Menor pontuação de 6, adesão mediana 28,1% dos pacientes pontuação entre 6 e 7, e alta adesão apenas 9,4% dos pacientes com pontuação maior de 8. Conclusões: A adesão escala de medição para tratamento Morisky 8 itens é válido para medir a adesão ao tratamento medicamentoso de pacientes com doença renal crônica, de acordo com o julgamento cientistas de investigação.