Retinoic acid signalling regulates branchiomeric neck muscle development at the head trunk interface.

Skeletal muscles of the head and trunk originate in distinct lineages with divergent regulatory programs converging on activation of myogenic determination factors. Branchiomeric head and neck muscles share a common origin with cardiac progenitor cells in cardiopharyngeal mesoderm (CPM). The retinoic acid (RA) signalling pathway is required during a defined early time window for normal deployment of cells from posterior CPM to the heart. Here we show that blocking RA signalling in the early mouse embryo also results in selective loss of the trapezius neck muscle, without affecting other skeletal muscles. RA signalling is required for robust expression of myogenic determination factors in posterior CPM and subsequent expansion of the trapezius primordium. Lineage specific activation of a dominant negative RA receptor reveals that trapezius development is not regulated by direct RA signalling to myogenic progenitor cells in CPM, or through neural crest cells, but indirectly through the somitic lineage, closely apposed with posterior CPM in the early embryo. These findings suggest that trapezius development is dependent on precise spatiotemporal interactions between cranial and somitic mesoderm at the head/trunk interface.

Cognitive reserve, depressive symptoms, obesity, and change in employment status predict mental processing speed and executive function after COVID-19.

The risk factors for post-COVID-19 cognitive impairment have been poorly described. This study aimed to identify the sociodemographic, clinical, and lifestyle characteristics that characterize a group of post-COVID-19 condition (PCC) participants with neuropsychological impairment. The study sample included 426 participants with PCC who underwent a neurobehavioral evaluation. We selected seven mental speed processing and executive function variables to obtain a data-driven partition. Clustering algorithms were applied, including K-means, bisecting K-means, and Gaussian mixture models. Different machine learning algorithms were then used to obtain a classifier able to separate the two clusters according to the demographic, clinical, emotional, and lifestyle variables, including logistic regression with least absolute shrinkage and selection operator (LASSO) (L1) and Ridge (L2) regularization, support vector machines (linear/quadratic/radial basis function kernels), and decision tree ensembles (random forest/gradient boosting trees). All clustering quality measures were in agreement in detecting only two clusters in the data based solely on cognitive performance. A model with four variables (cognitive reserve, depressive symptoms, obesity, and change in work situation) obtained with logistic regression with LASSO regularization was able to classify between good and poor cognitive performers with an accuracy and a weighted averaged precision of 72%, a recall of 73%, and an area under the curve of 0.72. PCC individuals with a lower cognitive reserve, more depressive symptoms, obesity, and a change in employment status were at greater risk for poor performance on tasks requiring mental processing speed and executive function. Study registration: www.ClinicalTrials.gov , identifier NCT05307575.

Cognitive and emotional predictors of quality of life and functioning after COVID-19.

OBJECTIVE: A long-term decline in health-related quality of life (HRQoL) has been reported after coronavirus disease 2019 (COVID-19). Studies with people with persistent symptoms showed inconsistent outcomes. Cognition and emotion are important determinants in HRQoL, but few studies have examined their prognostic significance for HRQoL and functionality in post-COVID patients with persisting symptoms. We aimed to describe QoL, HRQoL, and functioning in individuals post-COVID with varying COVID-19 severities and to investigate the predictive value of cognitive and emotional variables for QoL, HRQoL, and functioning. METHODS: In total, 492 participants (398 post-COVID and 124 healthy controls) underwent a neurobehavioral examination that included assessments of cognition, mood, QoL/HRQoL (WHOQOL-BREF, EQ-5D), and functioning (WHODAS-II). Analysis of covariance and linear regression models were used to study intergroup differences and the relationship between cognitive and emotional variables and QoL and functioning. RESULTS: The Physical and Psychological dimensions of WHOQoL, EQ-5D, and WHODAS Cognition, Mobility, Life Activities, and Participation dimensions were significantly lower in post-COVID groups compared with a control group. Regression models explaining 23.9%-53.9% of variance were obtained for the WHOQoL-BREF dimensions and EQ-5D, with depressive symptoms, post-COVID symptoms, employment status, income, and mental speed processing as main predictors. For the WHODAS, models explaining 17%-60.2% of the variance were obtained. Fatigue, depressive symptoms, mental speed processing, and post-COVID symptoms were the main predictors. INTERPRETATION: QoL/HRQoL and functioning after COVID-19 in individuals with persistent symptoms were lower than in non-affected persons. Depressive symptoms, fatigue, and slower mental processing speed were predictors of lower QoL/HRQoL and functioning.

The Challenges and Opportunities of Sustaining Academia-Sponsored Community Service Programs for Latinx Youth During the COVID-19 Pandemic.

The COVID-19 pandemic has widely affected existing academia-sponsored community service initiatives. Little is known about the strategies to sustain these initiatives during a public health crisis and the potential effects on community well-being and education. In this case study, we describe the impact of the pandemic on service partnerships between our medical school and the Latinx community, discuss the challenges and opportunities of transitioning to a virtual community service model, and offer solutions and considerations.

La pandemia de COVID-19 ha afectado ampliamente las iniciativas de servicio comunitario existentes y apoyadas por la academia. Poco se sabe acerca de las estrategias para sostener esas iniciativas durante una crisis de salud pública, y los efectos potenciales en el bienestar y educación comunitarios. En este estudio de caso, describimos el impacto de la pandemia en alianzas de servicio entre nuestra escuela de medicina y la comunidad latinx, discutimos los retos y las oportunidades en la transición a una comunidad modelo de servicio virtual, y ofrecemos soluciones y consideraciones.

¿El fin del superciclo del cobre y de las reformas sociales en Chile? / The end of the copper super cycle and the social reforms in Chile?

Chile es un país mundialmente conocido por su elevada producción de cobre. También reviste especial importancia el aporte de ingresos que realiza al Estado provenientes de las exportaciones. A partir del año 2003, se inicia el "super ciclo del cobre" como resultado del significativo aumento del precio a nivel internacional. Esta tendencia impactó positivamente en diversos sectores de la sociedad: académicos, empresarios y gobernantes; al punto de impulsar nuevos proyectos y millonarias inversiones. En este periodo, los mayores traspasos al fisco permitieron no solo ahorrar parte de los ingresos fiscales, sino que también financiar gastos estatales y varias reformas sociales comprometidas por los gobiernos de la época. A partir de 2013, se inicia una caída de los precios, incluso dramáticamente en los años siguientes, arrastrando a la industria a una compleja crisis. En los últimos quince años la productividad ha caído permanentemente y la producción se ha visto estancada, cuyo trasfondo son la reducción sostenida de las leyes del mineral y el alza de los costos de producción. Esta severa crisis "económica" que enfrenta el ciclo de explotación capitalista del cobre está en contradicción con la degradación indiscriminada e irreversible del ciclo de vida del metal y los recursos naturales. Esta situación, más el fracaso de la reforma tributaria, ha tenido serias repercusiones para las cuentas fiscales.

Chile is known worldwide for its high copper production. The export income that it generates for the state is also especially important. In 2003, the copper super cycle was unleashed as a result of the significant jump in copper prices. This trend had a positive impact on various sectors of society - academics, businessmen and government - sparking new projects and millions in investments. In this period, large transfers to the treasury not only permitted saving part of this tax revenue, but also financed state expenditures and various social reforms undertaken by governments during this time. In 2013, prices started dropping, even dramatically in the following years, dragging the industry into a complicated crisis. In the last 15 years, productivity has permanently fallen and production has been stagnant, set against the sustained decrease in ore grades and rising production costs. This severe "economic" crisis facing the capitalist copper mining cycle is in contradiction with the indiscriminate and irreversible degradation of the life cycle of metal and natural resources. This situation, combined with the failure of the tax reform, has had serious consequences on tax revenues.

Carcinoma escamoso sarcomatoide de la unión gastroesofágica: caso clínico / Esophageal sarcomatoid squamous carcinoma: Report of one case

Sarcomatoid squamous carcinoma (ESC) is a rare esophageal neoplasm, with a clinical, etiological and pathological behavior that differs from squamous cancer. From the histological point of view it has a dual configuration. The squamous epithelial component is usually limited to small areas, while the major part is constituted by mesenchymatous (sarcomatoid) polypoid tissue. Treatment is esophagectomy or total esophagogastrectomy depending on the tumor location. Early detection is critical in terms of survival. For large lesions, preoperative chemo-radiotherapy can be considered. We report a 78-year-old male presenting with dysphagia. An upper gastrointestinal endoscopy showed a tumor located below the cardia. The patient was subjected to a total esophageal and gastric resection. In a second operation, the digestive transit was reconstituted in 2 steps. The pathology report informed a sarcomatoid squamous carcinoma. After 18 months of follow up, the patient is ambulatory.

Bezoar gástrico como complicación de banda gástrica en manejo de obesidad mórbida: caso clínico / Gastric bezoar as complication of gastric banding: report of one case

Laparoscopic adjustable gastric banding (LAGB) is used for the management of morbid obesity. Phytobezoars are rarely reported as a complication of this operation and are usually extracted by endoscopic means. We report a 48 year-old male subjected to a gastric banding, that consulted for progressive dysphagia, six months after the operation. A barium meal x-ray examination demonstrated the presence of a bezoar that was dissolved in one week using papain. A control barium meal confirmed the disappearance of the bezoar.

Moral de mercado versus seguridad alimentaria: una aproximación desde la ética del bien común / Market morality versus food safety: an approach from common good ethics

La persistencia del hambre en el mundo, a pesar de su insuficiente visibilidad en los medios de comunicación, replantea con urgencia la temática de la seguridad alimentaria. Actualmente los modelos y políticas económicas y las guerras son factores más importantesen el hambre que los desastres naturales o el decaimiento de la producción agrícola incriminados en otras épocas. También es claro que no es posible explicar el hambre por la escasez de alimentos en el mundo. Sin embargo, estas certezas no producen conductas y políticas coherentes, puesto que la lógica neoliberal impide, en particular, al Estado inmiscuirse en las reglas del mercado. Junto con el problema del hambre se acentúa la dependencia de muchos países de la Región respecto de la oferta alimentaria, generándose una verdadera inseguridadalimentaria. En este contexto convendría entender el problema de la seguridad alimentaria como un tema ético, en la perspectiva del bien común con objeto de reaccionar adecuada y oportunamente.

Field evaluation of a diagnostic protocol for Chagas' disease and rangeliosis

The present paper evaluates the protocol for the diagnosis of Chagas' diseases and rangeliosis that is suitable for use in remote and scarcely populated rural areas. Beginning with a blood sample taken by venipuncture in the rural dispensary from 350 inhabitants of Caser­o La Sierra, Cojedes State, Venezuela, samples were analyzed at a laboratory located at a distance of 150 Km. Each blood sample was analyzed for blood and clot culture, artificial xenodiagnosis, inoculation into mice, complement fixation reaction (CFR), and indirect fluorescent antibodies test (IFA). Nine isolates of trypanosomes were obtained and identified as Trypanosoma rangeli, 29.4 percent of the blood samples showed seropositivity for Trypanosoma cruzi, 7.1 percent of total of persons between 6 and 18 years were found infected with T. rangeli, suggesting active transmission of this trypanosome in an endemic area for Chagas' disease. Results indicate that this protocol of study is reliable, economical and sufficiently versatile to study both rangeliosis and Chagas' disease

Tratamiento médico de perforación esofágica secundaria a cuerpo extraño / Medical treatment of esophageal perforation secondary to foreign body

Se reporta el caso de un paciente con perforación esofágica producida por un fragmento de hueso de pavo asociada a una colección mediastínica. El tratamiento conservador, con atibióticos y alimentación parenteral exclusiva fue exitoso. Aunque el tratamiento de esta complicación es discutible nos parece esencial elegir estrategias que mejor se adapten al cuadro clínico y al paciente de manera específica.

Ileo postoperatorio: su diagnóstico diferencial / Postoperative ileus: differential diagnosis

Se realiza una revisión de la clínica y fisiopatología del ileo postoperatorio adinámico y obstructivo, en atención a su diagnóstico diferencial. La dificultad de éste, nos lleva a plantear el uso de métodos auxiliares básicamente iconográficos. De estos, la radiología, el más frecuentemente usado, requeriría en un 20 a 30 por ciento de los casos, completarse con otros métodos, tales como la ecografía y la tomografía axial computada, muy utilizados en el exterior, estandarizados, altamente sensibles y específicos y bien tolerados por el paciente. En nuestra realidad clínica asistencial, la radiología con contraste bario/hypaque es capaz de proporcionar la certeza de una obstrucción mecánica, sin la necesidad de movilizar a un paciente, usando para ello un equipo de rayos portátil. La ecografía por otra parte, surge como una herramienta ideal, que debemos empezar a utilizar en nuestros pacientes, por cuestión de costos, disponibilidad, nula invasividad y extrema certeza en menos entrenadas

Alteraciones electrocardiográficas y su repercusión en el cuadro clínico de los pacientes hospitalizados por hemorragia subaracnoidea en el Hospital Universitario "Dr. Angel Larralde" en el paríodo de 1979-1988 / Electrocardiographic modifications and its repercussion in clinic frame of patients hospitalized by subaracnoid haemorrhage at Hospital Universitario \"Dr. Angel Larralde\" during the period 1979-1988

Cambios en el patrón electrocardiográfico normal asociado a enfermedad cerebrovascular han sido descritos desde 1954. Para estudiar la repercusión que las alteraciones electrocardiográficas como signo de disfunción electrofisiológicas del corazón pudiera traer la evolución del cuadro clínico de los retrospectivo analizando las historias de los pacientes hospitalizados con esta entidad en el lapso comprendido entre 1979-1988. A la mayoría de los pacientes el registro electrocardiográfico se les practicó a las cuarenta y ocho (48) horas de hospitalización. En relación con la anormalidad del electrocardiograma en los 56 pacientes a los cuales les fue realizado, no se observó influencia específica de las alteraciones electrocardiográficas sobre las variables: arritmias, alteraciones de conciencia y muerte; no obstante al realizar esta comparación en los electrocardiogramas practicados en las primeras 48 horas si se observa diferencia significativa, sugiriéndonos que cuando se asocian en los primeros momentos de instalada la Hemorragía Subaracnoidea son signos de mal pronóstico