Sexual dysfunction worsens both the general and specific quality of life of women with irritable bowel syndrome. A cross-sectional study.

BACKGROUND: Irritable bowel syndrome (IBS) and sexual dysfunction (SxD) lowers quality of life (QOL) separately, but the effect of their overlap in unselected populations has not been studied. OBJECTIVE: To evaluate the QOL of IBS women with and without SxD and compare it with controls. METHODS: In this cross-sectional assessment, we studied 51 IBS women (Rome IV criteria) and 54 controls. SxD was determined using the female sexual function index questionnaire. QOL was evaluated by the Short Form 36 (SF-36) and IBS-QOL questionnaires. RESULTS: SxD prevalence was similar between IBS women (39.22%) and controls (38.89%). Compared with other groups, IBS patients with SxD showed lower scores in all domains as well as in the physical, mental summaries of the SF-36 and almost all domains (except for body image, food avoidance, and social reaction compared with IBS patients without SxD) and the total score of IBS-QOL. CONCLUSIONS: These findings show that SxD worsens both general and specific QOL of women with IBS. The consideration of SxD in patients with IBS will allow us to make a more effective diagnostic and therapeutic approach. Clinical trial registry in Mexico City General Hospital: DI/19/107/03/080. CLINICAL TRIALS REGISTRATION: NCT04716738.

Role of the Scavenger Receptor CD36 in Accelerated Diabetic Atherosclerosis.

Diabetes mellitus entails increased atherosclerotic burden and medial arterial calcification, but the precise mechanisms are not fully elucidated. We aimed to investigate the implication of CD36 in inflammation and calcification processes orchestrated by vascular smooth muscle cells (VSMCs) under hyperglycemic and atherogenic conditions. We examined the expression of CD36, pro-inflammatory cytokines, endoplasmic reticulum (ER) stress markers, and mineralization-regulating enzymes by RT-PCR in human VSMCs, cultured in a medium containing normal (5 mM) or high glucose (22 mM) for 72 h with or without oxidized low-density lipoprotein (oxLDL) (24 h). The uptake of 1,1'-dioctadecyl-3,3,3',3-tetramethylindocarbocyanine perchlorate-fluorescently (DiI) labeled oxLDL was quantified by flow cytometry and fluorimetry and calcification assays were performed in VSMC cultured in osteogenic medium and stained by alizarin red. We observed induction in the expression of CD36, cytokines, calcification markers, and ER stress markers under high glucose that was exacerbated by oxLDL. These results were confirmed in carotid plaques from subjects with diabetes versus non-diabetic subjects. Accordingly, the uptake of DiI-labeled oxLDL was increased after exposure to high glucose. The silencing of CD36 reduced the induction of CD36 and the expression of calcification enzymes and mineralization of VSMC. Our results indicate that CD36 signaling is partially involved in hyperglycemia and oxLDL-induced vascular calcification in diabetes.

Detecting affiliation in colaughter across 24 societies.

Laughter is a nonverbal vocal expression that often communicates positive affect and cooperative intent in humans. Temporally coincident laughter occurring within groups is a potentially rich cue of affiliation to overhearers. We examined listeners' judgments of affiliation based on brief, decontextualized instances of colaughter between either established friends or recently acquainted strangers. In a sample of 966 participants from 24 societies, people reliably distinguished friends from strangers with an accuracy of 53-67%. Acoustic analyses of the individual laughter segments revealed that, across cultures, listeners' judgments were consistently predicted by voicing dynamics, suggesting perceptual sensitivity to emotionally triggered spontaneous production. Colaughter affords rapid and accurate appraisals of affiliation that transcend cultural and linguistic boundaries, and may constitute a universal means of signaling cooperative relationships.

Partial substitution of soybean meal by Gliricidia sepium or Guazuma ulmifolia leaves in the rations of growing lambs.

The partial substitution of soybean meal by Gliricidia sepium or Guazuma ulmifolia leaves in the rations of growing lambs was evaluated at an experimental station in the dry tropics of Mexico. Sixteen weaned crossbred male Pelibuey × Blackbelly lambs (initial weight 19 ± 1.66 kg), distributed in a completely randomized design, were assigned to the following protein sources: (a) 100% soybean meal, (b) 50% soybean meal + 50% G. sepium, (c) 50 % soybean meal + 25% G. ulmifolia + 25% G. sepium, and (d) 50% soybean meal + 50% G. ulmifolia in isoproteic rations. The lambs were housed in individual pens and fed ad libitum. Substitution of protein from soybean meal with G. ulmifolia did not affect gain, intake, or feed conversion; however, the inclusion of G. sepium reduced (linear effect, P < 0.01) gain and intake and impaired feed conversion (linear effect, P < 0.01). Partial substitution up to 50% of soybean meal with 50% G. ulmifolia leaves resulted in similar growth and lamb performance, but inclusion of G. sepium leaves adversely affected lamb growth, presumably due to other factors not related to the protein content.

Does polyandry control population sex ratio via regulation of a selfish gene?

The extent of female multiple mating (polyandry) can strongly impact on the intensity of sexual selection, sexual conflict, and the evolution of cooperation and sociality. More subtly, polyandry may protect populations against intragenomic conflicts that result from the invasion of deleterious selfish genetic elements (SGEs). SGEs commonly impair sperm production, and so are likely to be unsuccessful in sperm competition, potentially reducing their transmission in polyandrous populations. Here, we test this prediction in nature. We demonstrate a heritable latitudinal cline in the degree of polyandry in the fruitfly Drosophila pseudoobscura across the USA, with northern population females remating more frequently in both the field and the laboratory. High remating was associated with low frequency of a sex-ratio-distorting meiotic driver in natural populations. In the laboratory, polyandry directly controls the frequency of the driver by undermining its transmission. Hence we suggest that the cline in polyandry represents an important contributor to the cline in sex ratio in nature. Furthermore, as the meiotic driver causes sex ratio bias, variation in polyandry may ultimately determine population sex ratio across the USA, a dramatic impact of female mating decisions. As SGEs are ubiquitous it is likely that the reduction of intragenomic conflict by polyandry is widespread.

Treatment of a complicated penetrating ulcer of the descending thoracic aorta using a scalloped stent graft.

We show the use of a proximal scalloped stent graft for an pseudoaneurysm of the descending thoracic aorta to avoid occlusion of the left subclavian artery. A 63-year-old man with sudden onset dysphonia was diagnosed with left vocal fold paralysis and the presence of a lung mass. A computed tomography scan revealed saccular dilatation of the aortic arch (proximal neck: <10 mm) with suggestive images of a penetrating ulcer and degenerative pseudoaneurysm. A RELAY Plus thoracic stent graft (Bolton Medical, Sunrise, FL) with proximal scallop was implanted to preserve the left subclavian artery. A custom made prosthesis with proximal scallop provides a good alternative to a carotid-subclavian bypass because it is less aggressive and can be used in nonurgent cases.

A parasitic selfish gene that affects host promiscuity.

Selfish genes demonstrate transmission bias and invade sexual populations despite conferring no benefit to their hosts. While the molecular genetics and evolutionary dynamics of selfish genes are reasonably well characterized, their effects on hosts are not. Homing endonuclease genes (HEGs) are one well-studied family of selfish genes that are assumed to be benign. However, we show that carrying HEGs is costly for Saccharomyces cerevisiae, demonstrating that these genetic elements are not necessarily benign but maybe parasitic. We estimate a selective load of approximately 1-2% in 'natural' niches. The second aspect we examine is the ability of HEGs to affect hosts' sexual behaviour. As all selfish genes critically rely on sex for spread, then any selfish gene correlated with increased host sexuality will enjoy a transmission advantage. While classic parasites are known to manipulate host behaviour, we are not aware of any evidence showing a selfish gene is capable of affecting host promiscuity. The data presented here show a selfish element may increase the propensity of its eukaryote host to undergo sex and along with increased rates of non-Mendelian inheritance, this may counterbalance mitotic selective load and promote spread. Demonstration that selfish genes are correlated with increased promiscuity in eukaryotes connects with ideas suggesting that selfish genes promoted the evolution of sex initially.

Serum concentrations of progesterone and prolactin as predictors of success in in vitro fertilization: A retrospective cohort study.

OBJECTIVE: The aim of this study is to determine whether the serum concentrations of progesterone and/or prolactin after fresh embryo transfer are associated with pregnancy rates in in vitro fertilization treatment. METHODS: This retrospective cohort study evaluated in vitro fertilization treatments with fresh embryo transfer, which were performed between 2013 and 2019 in a private clinic in Curitiba, Brazil. The serum concentrations of progesterone and prolactin were evaluated by chemiluminescence nine days after oocyte retrieval. The type of progesterone supplementation and pituitary blockage during the cycle of oocyte stimulation were evaluated. RESULTS: 330 fertilization cycles were performed in the 293 studied patients. The mean age of patients was 35.5±4.1years. The most seen isolated infertility factor was endometriosis (24.2% of the cases), while progesterone supplementation was performed intramuscularly in 73.9% of the cases. The progesterone values above 32.1ng/ml at day 9 (D9) were associated with better pregnancy rates. In cycles using antagonist and intramuscular luteal phase supplementation, higher pregnancy rates with progesterone values above 37.83ng/ml were observed. Moreover, prolactin showed no significant association with any of the studied variables. CONCLUSIONS: The serum progesterone concentrations above 32.1ng/ml at D9 that were taken one week before pregnancy testing were associated with successful in vitro fertilization treatment. Furthermore, prolactin showed no significant association with any of the studied variables.

Greater traditionalism predicts COVID-19 precautionary behaviors across 27 societies.

People vary both in their embrace of their society's traditions, and in their perception of hazards as salient and necessitating a response. Over evolutionary time, traditions have offered avenues for addressing hazards, plausibly resulting in linkages between orientations toward tradition and orientations toward danger. Emerging research documents connections between traditionalism and threat responsivity, including pathogen-avoidance motivations. Additionally, because hazard-mitigating behaviors can conflict with competing priorities, associations between traditionalism and pathogen avoidance may hinge on contextually contingent tradeoffs. The COVID-19 pandemic provides a real-world test of the posited relationship between traditionalism and hazard avoidance. Across 27 societies (N = 7844), we find that, in a majority of countries, individuals' endorsement of tradition positively correlates with their adherence to costly COVID-19-avoidance behaviors; accounting for some of the conflicts that arise between public health precautions and other objectives further strengthens this evidence that traditionalism is associated with greater attention to hazards.

Rubeosis iridis as a sign of underlying carotid stenosis.

Severe carotid stenosis may be associated with uncommon clinical symptoms. We report a case of ocular ischemic syndrome and subsequent rubeosis iridis due to a high-grade carotid stenosis. The patient recovered visual acuity and his normal iris coloring after carotid endarterectomy. Rubeosis iridis may be the only clinical sign associated with severe carotid stenosis, making it mandatory to rule out the presence of carotid narrowing when it is detected. Establishing an early diagnosis is essential to improve quality of life, prognosis, and patients' outcome.

Registered trials address questions already answered with high-certainty evidence: A sample of current redundant research.

OBJECTIVE: To identify clinical trials registered later than 2015, that study the effect of an intervention on a primary outcome whose "Certainty of Evidence" (CoE) has already been rated "high" in a Cochrane SR. STUDY DESIGN AND SETTING: We searched the Cochrane Library for all SRs from 2015. We analyzed SRs of interventions and excluded withdrawn reviews or those with no Summary of Findings (SoF) table. We retrieved the GRADE CoE ratings of each SR's primary outcomes in the SoF tables and identified those rated "high." We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials to identify records of clinical studies that tackled those outcomes and were registered after the date of publication of the respective 2015 SR. RESULTS: We selected 602 SRs. Eighty-one contained a "high" CoE rating on at least one primary outcome, totaling 152 primary outcomes rated "high." We found 39 clinical trials registered for primary outcomes with evidence already rated as "high" in a 2015 Cochrane SR. CONCLUSION: This study shows the existence of clinical trials registered to study primary outcomes whose CoE has already been rated "high" in a Cochrane SR.

A small effect of conservation agriculture on soil biodiversity that differs between biological kingdoms and geographic locations.

Larger easily visible animals and plants are negatively affected by agrochemicals used for intensive food production, but we do not understand the general spatial and temporal effects of agrochemicals on the multitudes of bacteria, fungi, and small invertebrate animals that underpin ecosystem productivity. We sequenced the 16S, ITS2, and COI DNA barcode regions from 648 New Zealand vineyard soil samples managed under either conventional or low-agrochemical-input conservation approaches across two regions and three seasons in 1 year and discovered at least 170,000 phylotypes (taxa) with >97% genetic identity. Management approach correlated with a significant 2%-10% difference in the abundances of phylotypes that differed over regions and seasons. Although the data show that agrochemicals do not have a large effect on soil biodiversity on average, the important finding is that the magnitude of impact differs between taxa types and locations, and some taxa most affected also influence the quality of agricultural produce.

Anthropogenic noise affects risk assessment and attention: the distracted prey hypothesis.

Many studies have focused on the effects of anthropogenic noise on animal communication, but only a few have looked at its effect on other behavioural systems. We designed a playback experiment to test the effect of noise on predation risk assessment. We found that in response to boat motor playback, Caribbean hermit crabs (Coenobita clypeatus) allowed a simulated predator to approach closer before they hid. Two hypotheses may explain how boat noise affected risk assessment: it masked an approaching predator's sound; and/or it reallocated some of the crabs' finite attention, effectively distracting them, and thus preventing them from responding to an approaching threat. We found no support for the first hypothesis: a silent looming object still got closer during boat motor playbacks than during silence. However, we found support for the attentional hypothesis: when we added flashing lights to the boat motor noise to further distract the hermit crabs, we were able to approach the crabs more closely than with the noise alone. Anthropogenic sounds may thus distract prey and make them more vulnerable to predation.

Panhypopituitarism and cranial mononeuropathy, manifestation of NK/T lymphoma that imitates meningeal tuberculosis.

INTRODUCCIÓN: El linfoma extranodal derivado de células NK/T (LNK/T) es una variedad de linfoma no Hodgkin; el tipo nasal constituye la presentación más común. Nuestro objetivo es presentar un caso de LNK/T con afección del sistema nervioso central (SNC) que simuló una tuberculosis meningea. CASO CLÍNICO: Varón de 31 años con sensación de obstrucción nasal, cefalea, fiebre, panhipopituitarismo y mononeuropatía craneal múltiple, con lesión hipofisaria por imagen de resonancia magnética y engrosamiento dural, que evolucionó con pancitopenia y úlcera en el paladar blando. El diagnóstico se realizó mediante biopsia de cornete nasal compatible con infiltración por linfoma de estirpe T maduro NK. CONCLUSIONES: La afección del LNK/T al SNC es una forma rara de presentación. El diagnóstico de LNK/T se puede ver retrasado por la presencia de síntomas heterogéneos. En nuestra población, la infección por Mycobacterium debe ser considerada como diagnóstico diferencial. BACKGROUND: Lymphoma of NK/T cells (LNK/T) is a variety of non-Hodgkin lymphoma; the nasal type is the most common presentation. The aim of this article is to present a case of LNK/T with affection to central nervous system that imitates meningeal tuberculosis. CASE REPORT: 31 years old man with nasal blockage feeling, headache, fever, panhypopituitarism and multiple cranial mononeuropathy, with a pituitary injury demonstrated by magnetic resonance image and meningeal thickening, that progress with pancytopenia and soft palate ulcer. The diagnosis was made by nasal concha biopsy compatible with lymphoma infiltration, of LNK/T cell linage. CONCLUSIONS: The affectation of LNK/T cell lymphoma in central nervous system is a rare presentation. the diagnosis could be delayed for the presence of heterogeneous symptoms. Mycobacterium infection must be considered as a differential diagnosis in our population.

Acquired hemophilia: clinical case of hemorrhage caused by inhibitors against factor VIII. / Hemofilia adquirida: caso clínico de hemorragia por inhibidores contra el factor VIII.

BACKGROUND: Acquired hemophilia is caused by antibodies against coagulation factors, especially against factor VIII. As it is a low prevalence disease, our objective is to present an idiopathic case of acquired hemophilia to facilitate decision-making in clinical practice for others, exposing the therapeutic modality used. CASE REPORT: 65 years old woman, started with non-trauma hematomas, with asthenia, adynamia and dyspnea. Laboratory studies showed anemia (hemoglobin 7.1 g/dl, hematocrit 21%, mean corpuscular volume 91 fl, mean corpuscular hemoglobin 29.6 pg) and long clotting times (activated partial thromboplastin time 100 seconds) and with prothrombin time and International Normalized Index (17 seconds and 1.2 seconds respectively). So, plasma dilution tests were performed with plasma, without aPTT correction (1:2, 76.6 seconds; 1: 4, 60 seconds; 1: 8, 45 seconds) evidencing the presence of the inhibitor. The diagnosis was confirmed by the decrease in factor VIII (1%) and the presence of the factor VIII inhibitor (256 UB). The treatment started with prednisone and cyclophosphamide. Due to the presence of severe bleeding, treatment with activated prothrombin complex concentrate (CCpa) was required. Subsequently, Rituximab was prescribed, with clinical improvement and increased levels of hgb and reduced aPTT from the first week of treatment. CONCLUSIONS: The approach of acquired hemophilia should include control of the bleeding, the search for the etiology ruling out of the main causes of malignant neoplasms according to age and gender, and the immediate initiation of immunosuppression to decrease inhibitor levels.

INTRODUCCIÓN: La hemofilia adquirida es ocasionada por anticuerpos contra los factores de la coagulación, en especial contra el factor VIII. Por ser de baja prevalencia, presentamos un caso de hemofilia adquirida idiopática exponiendo la modalidad terapéutica utilizada para facilitar a otros la toma de decisiones en la práctica clínica. CASO CLÍNICO: Mujer de 65 años que inició con hematomas no asociados a traumatismo, con astenia, adinamia y disnea. Los estudios de laboratorio mostraron anemia (hemoglobina 7.1 g/dl, hematocrito 21%, volumen corpuscular medio 91 fl, hemoglobina corpuscular media 29.6 pg) y tiempos de coagulación prolongados (tiempo de tromboplastina parcial activado [TTPa] 100 segundos), con tiempo de protrombina e INR (International Normalized Ratio) dentro de parámetros normales (17 y 1.2 segundos, respectivamente), por lo que se realizaron pruebas de dilución con plasma sin corrección del TTPa (1:2, 76.6 segundos; 1:4, 60 segundos; 1:8, 45 segundos), evidenciando la presencia del inhibidor. El diagnóstico se confirmó con la disminución del factor VIII (1%) y la presencia de inhibidor del factor VIII (256 UB). Se inició tratamiento con prednisona y ciclofosfamida. Por presentar hemorragia grave requirió tratamiento con concentrado de complejo de protrombina activado y posteriormente se indicó rituximab, con mejoría clínica, incremento en los niveles de hemoglobina y reducción del TTPa desde la primera semana de tratamiento. CONCLUSIONES: El abordaje de la hemofilia adquirida debe incluir el control de la hemorragia, la búsqueda de la etiología descartando las principales causas de neoplasias malignas de acuerdo con la edad y el sexo, y el inicio inmediato de inmunosupresión para disminuir los niveles de inhibidor.

Parry-Romberg, a neurocutaneous syndrome: presentation of three cases. / Parry-Romberg, un síndrome neurocutáneo: presentación de tres casos.

BACKGROUND: Parry-Romberg syndrome is characterized by progressive hemiatrophy of the skin, subcutaneous tissue, muscle and bones of the skull. Its incidence is low, with a progressive and slow course. Its etiology is unknown, but it has been associated with several factors. Its clinical presentation involves dermatological, musculoskeletal and neuropsychiatric manifestations. The treatment consists of medical and surgical strategies. The use of steroids, alone or in combination with immunomodulators, has the objective of slowing down progression. The surgical treatment lies in facial reconstruction or volumetric regeneration, to correct the appearance and function of facial structures. The objective is to show three cases of Parry-Romberg syndrome with the representative characteristics of the disease. CLINICAL CASEs: 1) A 41-year-old woman with atrophy and right supraciliary hypochromia associated with seizures and headache. 2) A 43-year-old woman with parietal deformation and right supraciliary atrophy, associated with facial paralysis, depression and headache. 3) A 36-year-old woman with right hemifacial atrophy associated with ocular involvement and headache. The indicated treatment was based on a systemic steroid plus a cytostatic agent. The surgical treatment was evaluated according to the affection of facial structures. CONCLUSIONS: Parry-Romberg syndrome is a rare disease, characterized by progressive atrophy. Clinical manifestations determine the diagnosis and early start of medical and surgical treatment.

INTRODUCCIÓN: El síndrome de Parry-Romberg se caracteriza por hemiatrofia progresiva de la piel, el tejido subcutáneo, los músculos y los huesos del cráneo. Su incidencia es baja, y su curso es progresivo y lento. Se desconoce su etiología, pero se ha asociado a diversos factores. Su presentación clínica involucra manifestaciones dermatológicas, musculoesqueléticas y neuropsiquiátricas. El tratamiento consiste en estrategias médicas y quirúrgicas. El uso de esteroides, solos o en combinación con inmunomoduladores, tiene el objetivo de frenar la progresión. El tratamiento quirúrgico consiste en reconstrucción facial o regeneración volumétrica, a fin de corregir la apariencia y la función de las estructuras faciales. Se presentan tres casos de síndrome de Parry-Romberg con las características representativas de la enfermedad. CASOS CLÍNICOS: 1) Mujer de 41 años, con atrofia e hipocromía supraciliar derecha, asociadas a crisis convulsivas y cefalea. 2) Mujer de 43 años, con deformación parietal y atrofia supraciliar derecha, asociadas a parálisis facial, depresión y cefalea. 3) Mujer de 36 años, con atrofia hemifacial derecha asociada a afección ocular y cefalea. El tratamiento se basó en esteroide sistémico más un agente citostático. El tratamiento quirúrgico se valoró de acuerdo con la afectación de la estructuras faciales. CONCLUSIONES: El síndrome de Parry-Romberg es una enfermedad rara caracterizada por una atrofia progresiva. Las manifestaciones clínicas determinan el diagnóstico y el inicio temprano del tratamiento médico y quirúrgico.

Asociación entre calidad y cantidad de sueño con índice de masa corporal en adolescentes universitarios: Estudio transversal / Association between sleep quality and quantity and body mass index in college adolescents: A cross-sectional study

Introducción: La modificación en los patrones de sueño incrementa la susceptibilidad para la ganancia de peso. Objetivo: Estimar la asociación entre la calidad y la cantidad de horas de sueño por noche con el Índice de Masa Corporal (IMC) en adolescentes universitarios mexicanos. Materiales y métodos: Estudio transversal en estudiantes de nuevo ingreso de Enfermería en una Universidad Pública de México. Muestreo por conveniencia de n=134 estudiantes (18­19 años), voluntarios y matriculados en la facultad. La calidad y cantidad de sueño se midió con el Índice de Calidad de Sueño de Pittsburgh. El IMC se calculó con la fórmula estándar. El protocolo fue aprobado por el Comité de Ética de la facultad, los participantes firmaron el Consentimiento Informado. Resultados: Edad promedio de 18,21 años (DE= ,42 años), 82,84% mujeres, 45,52% (IC 95%= 35,46 ­ 52,86%) con sobrepeso u obesidad. El 44,02% de los participantes reportó dormir ≤ 6 horas por noche, 50,00% refirió una mala calidad de sueño en las últimas cuatro semanas. Después de ajustar por edad, sexo y ocupación, la calidad del sueño no se asoció con el IMC (OR= 1,01; IC 95%= ,94 ­ 1,08; z= ,31; p= ,75); el incremento en el IMC se asoció con una mayor probabilidad de dormir 6 horas o menos (OR= 1,08; IC 95%= 1,01 ­ 1,16; z= 2,25; p= ,02). Discusión: Las alteraciones hormonales, los factores conductuales y el entorno pudieran explicar la asociación. Conclusiones: Es recomendable implementar estrategias educativas para mejorar la higiene del sueño en esta población.

Introduction: Changes in sleep patterns increase susceptibility to weight gain. Objective: To estimate the association between the quality and quantity of sleep hours per night and Body Mass Index (BMI) in Mexican college adolescents. Materials and methods: Cross-sectional study conducted among incoming nursing students in a public university in Mexico. Convenience sampling was used, involving n=134 students (18-19 years old), volunteers, and enrolled in the nursing program. Sleep quality and quantity were measured through the Pittsburgh Sleep Quality Index (PSQI). BMI was calculated using the standard formula. The protocol was approved by the School of Nursing Ethics Committee, and the participants signed informed consent. Results: Mean age 18.21 years (SD= .42 years), 82.84% female, 45.52% overweight or obese (95% CI= 35.46 - 52.86%). 44.02% of participants reported sleeping ≤ 6 hours per night, and 50.00% reported poor sleep quality in the past four weeks. After adjustment for age, sex, and occupation, sleep quality was not associated with BMI (OR= 1.01; 95% CI= .94 - 1.08; z= .31; p= .75); increased BMI was associated with a greater likelihood of sleeping 6 hours or less (OR= 1.08; 95% CI= 1.01 - 1.16; z= 2.25; p= .02). Discussion: Hormonal changes, behavioral factors, and the environment may explain the association. Conclusions: It is advisable to implement educational strategies to improve sleep hygiene among this population.

Introdução: A modificação nos padrões de sono aumenta a suscetibilidade ao ganho de peso. Objetivo: Estimar a associação entre a qualidade e a quantidade de sono por noite e o índice de massa corporal (IMC) em adolescentes universitários mexicanos. Materiais e métodos: Estudo transversal de estudantes de enfermagem ingressantes em uma universidade pública no México. Amostragem por conveniência de n=134 estudantes (18-19 anos de idade), voluntários e matriculados na faculdade. A qualidade e a quantidade do sono foram medidas com o Índice de Qualidade do Sono de Pittsburgh. O IMC foi calculado com a fórmula padrão. O protocolo foi aprovado pelo Comitê de Ética da faculdade e os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Resultados: Idade média de 18,21 anos (DP= ,42 anos), 82,84% do sexo feminino, 45,52% (IC 95%= 35,46 - 52,86%) com sobrepeso ou obesidade. 44,02% dos participantes relataram dormir ≤ 6 horas por noite, 50,00% relataram qualidade de sono ruim nas últimas quatro semanas. Após o ajuste para idade, sexo e ocupação, a qualidade do sono não foi associada ao IMC (OR= 1,01; IC 95%= ,94 - 1,08; z= ,31; p= ,75); o aumento do IMC foi associado a uma maior probabilidade de dormir 6 horas ou menos (OR= 1,08; IC 95%= 1,01 - 1,16; z= 2,25; p= ,02). Discussão: Alterações hormonais, fatores comportamentais e o ambiente podem explicar a associação. Conclusões: É aconselhável implementar estratégias educacionais para melhorar a higiene do sono nessa população.

Raised Fibrinogen Levels and Outcome in Outpatients With Peripheral Artery Disease.

The influence of raised fibrinogen levels on outcome in stable outpatients with peripheral arterial disease (PAD) has not been consistently investigated. We used data from the Factores de Riesgo y ENfermedad Arterial (FRENA) registry to compare ischemic events, major bleeding, and mortality in stable outpatients with PAD, according to their baseline plasma fibrinogen levels. Of 1363 outpatients with PAD recruited in FRENA, 558 (41%) had fibrinogen levels >450 mg/100 mL. Over 18 months, 43 patients presented with acute myocardial infarction, 37 had an ischemic stroke, 51 underwent limb amputation, 19 had major bleeding, and 90 died. Compared to patients with normal levels, those with raised fibrinogen levels had an over 2-fold higher rate of ischemic stroke (rate ratio [RR]: 2.30; 95% confidence interval [CI]: 1.19-4.59), limb amputation (RR: 2.58; 95% CI: 1.46-4.67), or death (RR: 2.27; 95% CI: 1.49-3.51) and an over 3-fold higher rate of major bleeding (RR: 3.90; 95% CI: 1.45-12.1). On multivariate analysis, patients with raised fibrinogen levels had an increased risk of developing subsequent ischemic events (hazard ratio [HR]: 1.61; 95% CI: 1.11-2.32) and major bleeding (HR: 3.42; 95% CI: 1.22-9.61). Stable outpatients with PAD and raised plasma fibrinogen levels had increased rates of subsequent ischemic events and major bleeding.

Early serum progesterone and prolactin analysis at day 9 of oocyte retrieval as a predictor of success in fresh ICSI cycles.

OBJECTIVE: To analyze progesterone and prolactin plasma levels nine days after oocyte retrieval and evaluate their correlation with pregnancy rates in in vitro fertilization cycles. To achieve pregnancy, several factors are analyzed before and during the in vitro fertilization cycle. Progesterone supplementation for adequate luteal phase support is indicated despite the presence of multiple corpus luteum in IVF stimulation cycles because of blockage caused by hypothalamic agonists and antagonists. The dosage of progesterone and prolactin on day 09 after follicular retrieval could function as a predictive marker of success in fertility treatments. METHODS: A retrospective study was performed using data from 238 patients submitted to intracytoplasmic sperm injection (ICSI) at a private infertility clinic from January 2013 to December 2015. Hormonal measurements were performed on day 09 after follicular uptake. The data was compared to assess the correlation between prolactin and progesterone dosages and pregnancy rates. RESULTS: The ICSI pregnancy rate was 40.8% (n=238). No statistically significant difference was observed when correlating the success of the procedure with the prolactin dosage (p=0.71). However, progesterone showed a significant difference (p=0.021). The cutoff point, indicated by the ROC curve fit according to which gestation would be identified, is 25.95ng/ml of progesterone. The sensitivity of this point is 61.9% and the specificity is 57.4%. CONCLUSION: Progesterone dosage may be one of the indicators of gestation on day 09 after follicular uptake. Such data can help physicians to monitoring and provides suitable early gestational care. More studies are needed to corroborate the data found.