Placental inflammation in a fetal demise of a SARS-CoV-2-asymptomatic, COVID-19-unvaccinated pregnant woman: a case-report.

BACKGROUND: Intrauterine fetal demise is a recognized complication of coronavirus disease 2019 in pregnant women and is associated with histopathological placental lesions. The pathological mechanism and virus-induced immune response in the placenta are not fully understood. A detailed description of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced inflammation in the placenta during fetal demise is crucial for improved clinical management. CASE PRESENTATION: We report the case of a 27-week gestation SARS-CoV-2-asymptomatic unvaccinated pregnant woman without comorbidities or other risk factors for negative pregnancy outcomes with a diagnosis of intrauterine fetal demise. Histopathological findings corresponded to patterns of subacute inflammation throughout the anatomic compartments of the placenta, showing severe chorioamnionitis, chronic villitis and deciduitis, accompanied by maternal and fetal vascular malperfusion. Our immunohistochemistry results revealed infiltration of CD68+ macrophages, CD56+ Natural Killer cells and scarce CD8+ T cytotoxic lymphocytes at the site of placental inflammation, with the SARS-CoV-2 nucleocapsid located in stromal cells of the chorion and chorionic villi, and in decidual cells. CONCLUSION: This case describes novel histopathological lesions of inflammation with infiltration of plasma cells, neutrophils, macrophages, and natural killer cells associated with malperfusion in the placenta of a SARS-CoV-2-infected asymptomatic woman with intrauterine fetal demise. A better understanding of the inflammatory effects exerted by SARS-CoV-2 in the placenta will enable strategies for better clinical management of pregnant women unvaccinated for SARS-CoV-2 to avoid fatal fetal outcomes during future transmission waves.

Effect of Vagus Nerve Stimulation on the GASH/Sal Audiogenic-Seizure-Prone Hamster.

Vagus nerve stimulation (VNS) is an adjuvant neuromodulation therapy for the treatment of refractory epilepsy. However, the mechanisms behind its effectiveness are not fully understood. Our aim was to develop a VNS protocol for the Genetic Audiogenic Seizure Hamster from Salamanca (GASH/Sal) in order to evaluate the mechanisms of action of the therapy. The rodents were subject to VNS for 14 days using clinical stimulation parameters by implanting a clinically available neurostimulation device or our own prototype for laboratory animals. The neuroethological assessment of seizures and general behavior were performed before surgery, and after 7, 10, and 14 days of VNS. Moreover, potential side effects were examined. Finally, the expression of 23 inflammatory markers in plasma and the left-brain hemisphere was evaluated. VNS significantly reduced seizure severity in GASH/Sal without side effects. No differences were observed between the neurostimulation devices. GASH/Sal treated with VNS showed statistically significant reduced levels of interleukin IL-1ß, monocyte chemoattractant protein MCP-1, matrix metalloproteinases (MMP-2, MMP-3), and tumor necrosis factor TNF-α in the brain. The described experimental design allows for the study of VNS effects and mechanisms of action using an implantable device. This was achieved in a model of convulsive seizures in which VNS is effective and shows an anti-inflammatory effect.

Rbfox1 controls alternative splicing of focal adhesion genes in cardiac muscle cells.

Alternative splicing is one of the major cellular processes that determine the tissue-specific expression of protein variants. However, it remains challenging to identify physiologically relevant and tissue-selective proteins that are generated by alternative splicing. Hence, we investigated the target spectrum of the splicing factor Rbfox1 in the cardiac muscle context in more detail. By using a combination of in silico target prediction and in-cell validation, we identified several focal adhesion proteins as alternative splicing targets of Rbfox1. We focused on the alternative splicing patterns of vinculin (metavinculin isoform) and paxillin (extended paxillin isoform) and identified both as potential Rbfox1 targets. Minigene analyses suggested that both isoforms are promoted by Rbfox1 due to binding in the introns. Focal adhesions play an important role in the cardiac muscle context, since they mainly influence cell shape, cytoskeletal organization, and cell-matrix association. Our data confirmed that depletion of Rbfox1 changed cardiomyoblast morphology, cytoskeletal organization, and multinuclearity after differentiation, which might be due to changes in alternative splicing of focal adhesion proteins. Hence, our results indicate that Rbfox1 promotes alternative splicing of focal adhesion genes in cardiac muscle cells, which might contribute to heart disease progression, where downregulation of Rbfox1 is frequently observed.

Septic Shock After Endoscopic Sleeve Gastroplasty: A Post-procedural Complication?

BACKGROUND: ESG is a safe and effective technique in the obesity management, usually indicated in class I and II obesity. It is also an acceptable treatment in patients with class III obesity who have high surgical risk or refuse surgery. This procedure results in a significant weight loss and important improvement in metabolic comorbidities. Nevertheless, there are several procedure-related complications. Few cases of gastric perforation following ESG have been reported. We present a case of septic shock after ESG with preoperative diagnostic uncertainties. METHODS: We present the case of a 54-year-old male with a BMI of 43.6 kg/m2 who underwent ESG 7 days before in an external center. The patient came to the emergency department presenting abdominal pain, nausea, and vomiting since the day after the procedure. Physical examination revealed hemodynamic instability, altered level of consciousness, diffuse abdominal pain, and a painful umbilical lump due to a complicated umbilical hernia. Emergent surgery was decided after preoperative assessment. RESULTS: Intraoperative gastroscopy was performed, viewing a gastric ischemic ulcer covered with fibrin and a mucosal defect and suspecting a covered gastric perforation. Firstly, we performed an open approach to the complicated umbilical hernia. Subsequently, an exploratory laparoscopy was performed through the hernial ring, where a fibrin-covered area was evidenced in the anterior face of the gastric body, adhered to the round ligament by a transmural suture of the ESG. Additionally, multiple transmural sutures were observed adhered to the greater omentum and lesser sac and an intramural hematoma in the greater gastric curvature. No intra-abdominal free fluid was evidenced. A laparoscopic barbed suture of the area covered with fibrin was performed, after its release from the round ligament. The adhesions of the sutures and metallic material from the ESG were released. Finally, two abdominal drains were placed in the anterior and posterior gastric face. The patient presented superficial incisional surgical site infection and was discharged 6 days after laparoscopic surgery. CONCLUSIONS: ESG is a novel procedure, which has proven to be an effective alternative in the treatment of obesity. However, this technique may have major complications that can require urgent surgery.

Assessing the Effectiveness of Eslicarbazepine Acetate in Reducing Audiogenic Reflex Seizures in the GASH/Sal Model of Epilepsy.

Eslicarbazepine acetate (ESL) is a third-generation antiepileptic drug indicated as monotherapy for adults with newly diagnosed epilepsy and as adjunctive therapy for the treatment of partial seizures. Our aim was to assess the effectiveness and safety of both acute and repeated ESL administration against reflex audiogenic seizures, as shown by the Genetic Audiogenic Seizures Hamster from Salamanca (GASH/Sal). Animals were subject to the intraperitoneal administration of ESL, applying doses of 100, 150 and 200 mg/kg for the acute study, whereas a daily dose of 100 mg/kg was selected for the subchronic study, which lasted 14 days. In both studies, the anticonvulsant effect of the therapy was evaluated using neuroethological methods. To assess the safety of the treatment, behavioral tests were performed, hematological and biochemical liver profiles were obtained, and body weight was monitored. In addition, the ESL levels in blood were measured after the acute administration of a 200 mg/kg dose. Treatment with ESL caused a reduction in seizure severity. No statistically significant differences were detected between the selected doses or between the acute or repeated administration of the drug. To summarize, the intraperitoneal administration of ESL is safe and shows an anticonvulsant effect in the GASH/Sal.

In Vitro Embryos of Romosinuano and Tropical Milking Cattle during Three Seasons in Veracruz, Mexico.

One of the main factors that influences the fertility of cattle in grazing systems in hot tropical climates is heat stress. The objective of this study was to evaluate the effect of season, breed, hormonal and physiological condition on the quantity and quality of cumulus-oocyte complexes (COCs) and embryos produced in vitro, from Romosinuano (RM) and Tropical Milking (TM) donors. Three ovum pick-up and in vitro fertilization (OPU-IVF) were performed, one per season: hot dry (HD; 10, 10), hot humid (HH; 9, 9) and fresh dry (FD; 7, 10) in RM and LT donors. Serum levels of cortisol, insulin and glucose were measured, in addition to heart rate (HR), respiratory rate (RR) and rectal temperature (RT). Effect of season x genotype interaction (p ≤ 0.05) was observed in all COC variables and only in cleavage embryos (CLI) (p ≤ 0.05). Body weight (BW) affected all COC variables (p ≤ 0.01), except unviable (UNV) although affected degenerated embryos (DEG) (p ≤ 0.01) and total blastocysts (BLAST) (p ≤ 0.01). Cow age only affected viable COCs (VIAB) (p ≤ 0.05), code one blastocysts (BC1) and BLAST (p ≤ 0.01). Cortisol affected total COCs (COCsT), VIAB and total matured in vitro (TMIV) (p ≤ 0.01), as well as CLI, BC1 (p ≤ 0.01) and BLAST (p ≤ 0.05). Insulin affected COCsT (p ≤ 0.01), UNV (p ≤ 0.05), denuded oocytes (DE) (p ≤ 0.01), BC1 and code two blastocysts (BC2) (p ≤ 0.01). Glucose affected all COC variables (p ≤ 0.01), except UNV and all embryo variables except BC2. HR affected COCsT, DE, TMIV (p ≤ 0.01), CLI, BLAST and DEG (p ≤ 0.05). RR affected COCsT, UNV, VIAB, CLI (p ≤ 0.05), BC1, BLAST and DEG (p ≤ 0.01). RT only affected DE, VIAB (p ≤ 0.01) and BLAST (p ≤ 0.05). The seasonal climatic year variation of Veracruz and changes in physiological and hormonal variables have diverse effects on the cumulus-oocyte complexes and embryos produced by RM and TM donors.

Mix and measure II: joint high-energy laboratory powder diffraction and microtomography for cement hydration studies.

Portland cements (PCs) and cement blends are multiphase materials of different fineness, and quantitatively analysing their hydration pathways is very challenging. The dissolution (hydration) of the initial crystalline and amorphous phases must be determined, as well as the formation of labile (such as ettringite), reactive (such as portlandite) and amorphous (such as calcium silicate hydrate gel) components. The microstructural changes with hydration time must also be mapped out. To address this robustly and accurately, an innovative approach is being developed based on in situ measurements of pastes without any sample conditioning. Data are sequentially acquired by Mo Kα1 laboratory X-ray powder diffraction (LXRPD) and microtomography (µCT), where the same volume is scanned with time to reduce variability. Wide capillaries (2 mm in diameter) are key to avoid artefacts, e.g. self-desiccation, and to have excellent particle averaging. This methodology is tested in three cement paste samples: (i) a commercial PC 52.5 R, (ii) a blend of 80 wt% of this PC and 20 wt% quartz, to simulate an addition of supplementary cementitious materials, and (iii) a blend of 80 wt% PC and 20 wt% limestone, to simulate a limestone Portland cement. LXRPD data are acquired at 3 h and 1, 3, 7 and 28 days, and µCT data are collected at 12 h and 1, 3, 7 and 28 days. Later age data can also be easily acquired. In this methodology, the amounts of the crystalline phases are directly obtained from Rietveld analysis and the amorphous phase contents are obtained from mass-balance calculations. From the µCT study, and within the attained spatial resolution, three components (porosity, hydrated products and unhydrated cement particles) are determined. The analyses quantitatively demonstrate the filler effect of quartz and limestone in the hydration of alite and the calcium aluminate phases. Further hydration details are discussed.

Synergistic impact of innate immunity hyper-activation and endothelial dysfunction on the magnitude of organ failure in the infection-sepsis continuum.

OBJECTIVES: Identifying host response biomarkers implicated in the emergence of organ failure during infection is key to improving the early detection of this complication. METHODS: Twenty biomarkers of innate immunity, T-cell response, endothelial dysfunction, coagulation, and immunosuppression were profiled in 180 surgical patients with infections of diverse severity (IDS) and 53 with no infection (nIDS). Those better differentiating IDS/nIDS in the area under the curve were combined to test their association with the sequential organ failure assessment score by linear regression analysis in IDS. Results were validated in another IDS cohort of 174 patients. RESULTS: C-reactive protein, procalcitonin, pentraxin-3, lipocalin-2 (LCN2), tumoral necrosis factor-α, angiopoietin-2, triggering receptor expressed on myeloid cells-1 (TREM-1) and interleukin (IL)-15 yielded an area under the curve ≥0.75 to differentiate IDS from nIDS. The combination of LCN2, IL-15, TREM-1, angiopoietin-2 (Dys-4) showed the strongest association with sequential organ failure assessment score in IDS (adjusted regression coefficient; standard error; P): Dys-4 (3.55;0.44; <0.001), LCN2 (2.24; 0.28; <0.001), angiopoietin-2 (1.92; 0.33; <0.001), IL-15 (1.78; 0.40; <0.001), TREM-1(1.74; 0.46; <0.001), tumoral necrosis factor-α (1.60; 0.31; <0.001), pentraxin-3 (1.12; 0.18; <0.001), procalcitonin (0.85; 0.12; <0.001). Dys-4 provided similar results in the validation cohort. CONCLUSIONS: There is a synergistic impact of innate immunity hyper-activation (LCN2, IL-15, TREM-1) and endothelial dysfunction (angiopoietin-2) on the magnitude of organ failure during infection.

Evaluation of a pre-co-seasonal and a perennial schedule of a single multiallergen depigmented-polymerized subcutaneous immunotherapy in paediatric patients

Aim: Compare a pre-co-seasonal with a perennial schedule using an undiluted mixture of a depigmented-polymerized grass/Olea europaea immunotherapy (2,000 DPP/mL) in pediatric patients with rhinitis/rhinoconjunctivitis with or without controlled asthma. Material and Methods: Primary objective was to determine the non-superiority of a perennial compared to a pre-co-seasonal schedule by means of Paediatric/Adolescent Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ/AdolRQLQ). Secondary objectives were Paediatric Asthma/Caregiver´s Quality of Life Questionnaire (PAQLQ/PACQLQ) Asthma Control Test (ACT), Visual Analogue Scale global assessment of allergic disease (VAS), use of resources and immunological response. All variables were compared during the pollen season (April-June) without (2015) and with (2016) immunotherapy. Results: Forty patients were included in the study of which 29 patients were assigned to the perennial and 11 to the pre-co-seasonal schedule. During 2016 pollen season a significant improvement in the PRQLQ/AdolRQLQ, PAQLQ/AdolAQLQ, ACT and VAS score were observed both in perennial and pre-co-seasonal schedule group. No significant differences were seen between treatment schedules for PRQLQ/AdolRQLQ, PAQLQ/AdolAQLQ and ACT scores comparing both pollen seasons. A significant increase in sIgG4 and reduction in the number of rescue medications used and number of patients who needed visit to any specialist was observed in both treatment schedules during 2016 pollen season. No relevant differences were found in the safety profile of any treatment schedule. Discussion: Treatment with undiluted mixture of a depigmented-polymerized Grass/Olea europaea allergen immunotherapy has proven to be effective both using a perennial and a pre-co-seasonal schedule and therefore suitable for polyallergic patients (AU)

Nutritional status and food intake in women with humanpapillomavirus

Introduction: Human papilloma virus (HPV) is the mainlycause of cervical cancer. Nutritional management considerationswith antioxidant rich diet, an adequate BMI range are protectivefactors that can modify the disease natural progression. Objective: To evaluate the nutritional status and foodintake in women with HPV. Methods: A cross-sectional study in 75 women of 18 to 35years old, selected by simple availability. A frequency foodintake was applied and analyzed with adequacy percentage.Nutritional status and risk factors as tobacco smoke wereassessed. Results: A 66% of women were obese or overweight.Tobacco was positive in 36%. The energy intake was covered in73%, 84% for lipid, 52% for protein and 66% for carbohydrates.Micronutrient intake was according recommendations.MaritalStatus, Smoking, Firs sexual intercourse age <18, obesity oroverweight, Waist circumference >80cm were risk factorsassociated between group 18 to 28 years vs 29 to 35 years old.Frecuency food intake were low for foods rich in acid folic,carotenoids, vitamin C mainly. Conclusions: This evidence showed the poor nutrimentsintake in the participants related with antioxidant function,that is important for treatment in premalignant lesion forHPV. These results highlight the importance of nutritionalmanagement considerations in prevention for resolution ofhuman papillomavirus premalignant lesions. (AU)

Food insecurity in homes of mothers of premature newborns with anthropometric alterations at birth

INTRODUCTION: Preterm newborns are physiologically immature and have special nutritional needs for growing and developing adequately. There are not enough studies that show a relationship between food insecurity in households with premature infants. OBJECTIVE: To analyze food insecurity in the homes of preterm infants and identify its association with variables like family status and newborn anthropometry (weight, length, and head circumference). METHODS: A Cross sectional study was conducte in 45 mothers who were applied the Latin American and Caribbean Household Food Security Scale, with preterm newborns from 30 to 37 weeks of gestation (WG) in a public hospital. RESULTS: A 49% households had food security while 51% had food insecutiry (28.8%, 8.8%, 13.3% had mild, moderate, and severe food insecurity respectively). There were differences between the groups more than 1 day of hospital stay (72% households with food security vs 95% households with food insecurity, p = 0.044). The anthropomethric variables showed significant differences for the weight (p = 0.015), length (p = 0.027) and head circumference (p = 0.002) for the newborns with and without food security. CONCLUSIONS: It is not only important to control nutrition during pregnancy, but also food security, especially severe food insecurity that the anthropometric variables of preterm newborns can have an impact

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COVID-19 y embarazo. Revisión y actualización / COVID-19 and pregnancy. Review and update / COVID-19 and pregnancy. Review and update

RESUMEN Objetivo . Buscar toda la información y evidencia disponible sobre el SARS-CoV-2 -que surgió en estos primeros 4 meses de 2020y el embarazo. Metodología . Revisión sistemática en las bases de datos PubMed y Google Scholar, hasta el 25 de abril de 2020. Se buscó artículos publicados relacionados con mujeres embarazadas infectadas con SARS-CoV-2. No hubo restricción de idioma. La búsqueda se extendió a las referencias de los artículos encontrados. Resultados . La enfermedad COVID-19 en mujeres embarazadas se caracteriza porque más del 90% de las pacientes evoluciona en forma leve, 2% requiere ingresar a las unidades de cuidados intensivos. Una muerte materna ha sido reportada. La prematuridad es alrededor de 25%, con predominio de recién nacidos prematuros tardíos; aproximadamente el 9% se complica con rotura prematura de membranas; la mortalidad perinatal es baja o similar a la de la población general y no se ha demostrado la transmisión vertical. Conclusiones . Los ginecólogos obstetras deben prepararse para atender cada vez más casos con COVID-19 y, por lo tanto, es necesario tener su conocimiento. La enfermedad evoluciona de la misma manera que en las no embarazadas, genera mayor prematuridad, no se ha demostrado la transmisión vertical, pero hay altas posibilidades de transmisión horizontal durante el parto vaginal.

ABSTRACT Objective : To search for all the information and available evidence on infection with SARS-CoV-2, a virus that appeared during the first 4 months of 2020, and pregnancy. Methods : Systematic review in PubMed and Google Scholar databases until April 25, 2020. We searched for published articles related to pregnant women infected with SARS-CoV-2. There was no language restriction. The search was extended to the references of the articles found. Results : In pregnant women with COVID-19, more than 90% of patients evolve mildly, 2% require intensive care. One maternal death has been reported. Prematurity occurs in approximately 25% of the cases, with predominance of late preterm infants; premature rupture of membranes presents in about 9%. Perinatal mortality is lower or similar to that of the general population, and vertical transmission has not been shown. Conclusions : Obstetrician-gynecologists must prepare to attend more cases with COVID-19 and therefore they need to know this disease. COVID-19 progresses similarly in pregnant and non-pregnant women, although it is associated to prematurity. While vertical transmission has not been demonstrated, horizontal transmission during vaginal birth is very likely.

Percutaneous cholecystostomy: an unusual route of dissemination of gallbladder carcinoma

A 78-year-old male with high-risk surgical presented severe acute cholecystitis and required cholecystostomy. The patient was referred later for assessment of the surgical treatment. A cholangio-MRI revealed a lesion on the gallbladder fundus with hepatic lesions suggestive of metastatic gallbladder carcinoma, which was confirmed in the histological analysis. The tumor progressed despite the chemotherapy through the cholecystostomy tract and developed peritoneal carcinomatosis. The patient did not respond to chemotherapy and he died 12 months later. (AU)

Anastomosis gastroyeyunal con separación gástrica parcial frente al tratamiento endoscópico para el tratamiento del síndrome de obstrucción antroduodenal de causa maligna / Stomach-partitioning gastrojejunostomy versus stent placement for the treatment of malignant gastric outlet obstruction

Introducción: El síndrome de obstrucción antroduodenal es una complicación presente en neoplasias avanzadas. Se caracteriza por clínica de obstrucción gastrointestinal alta, con desnutrición progresiva, y se asocia con una disminución de la supervivencia. La derivación mediante gastroyeyunostomía y el tratamiento endoscópico (TE) son las alternativas para el tratamiento del síndrome de obstrucción antroduodenal. El objetivo de este estudio es comparar la eficacia y la supervivencia de ambas. Métodos: Estudio monocentro, observacional y prospectivo de 58 pacientes con síndrome de obstrucción antroduodenal que recibieron tratamiento quirúrgico mediante gastroyeyunostomía con separación gástrica parcial (GYSGP) o TE con prótesis enterales autoexpandibles entre los años 2007-2018. Resultados: A 30 pacientes se les realizó GYSGP y a 28 pacientes TE. La edad media de los pacientes con GYSGP fue significativamente menor (69 vs. 78 años, p = 0,001). No hubo diferencias en cuanto al sexo, el riesgo anestésico-quirúrgico ni la etiología de la neoplasia. Las complicaciones posprocedimiento fueron superiores, aunque no significativas, en el grupo de GYSGP (p = 0,156). El TE se asoció con una menor estancia hospitalaria (p = 0,02) y una mayor precocidad de la tolerancia oral (p < 0,0001). Sin embargo, los pacientes presentaron tasas más altas de obstrucción persistente y recurrente (p = 0,048 y 0,01, respectivamente), unos peores objetivos energéticos (p = 0,009) y una supervivencia menor (9,61 vs. 4,47 meses, p = 0,008). Conclusiones: La GYSGP obtiene una mayor permeabilidad luminal, una mejor tolerancia a la vía oral y una mayor supervivencia. El TE estaría recomendado para pacientes no subsidiarios de la cirugía con un pronóstico limitado a corto plazo

Introduction: Gastric outlet obstruction is a complication of advanced tumors. It causes upper gastrointestinal obstruction, with progressive malnutrition and reduced survival. Currently, gastrojejunostomy or stent placement (SP) are feasible alternatives for the treatment of malignant gastric outlet obstruction. The aim of this study is to compare the efficacy and survival of both techniques. Methods: Single-center observational and prospective study of 58 patients with gastric outlet obstruction who underwent surgical treatment with stomach-partitioning gastrojejunostomy (SPGJ) or SP with self-expanding intraluminal prostheses between 2007 and 2018. Results: Thirty patients underwent SPGJ and 28 SP. The mean age of the first group was significantly lower (69 vs. 78 years, respectively; P = .001). There were no statistically significant differences in terms of sex, perioperative risk or tumor etiology. Postoperative complications were non-significantly higher in the SPGJ group (P = .156). SP was associated with a shorter hospital stay (P = .02) and faster oral intake (P < .0001). However, SP had significantly higher rates of persistent and recurrent obstruction (P = .048 and .01, respectively), poorer energy targets (P=.009) and shorter survival (9.61 vs. 4.47 months; P = .008). Conclusions: SPGJ presents greater luminal permeability, better oral intake and greater survival than SP. SP is preferable for non-surgical patients with a limited short-term prognosis

Experiencias en torno a la falta de acceso al agua en hogares del Estado de Guanajuato, México / Experiences around the lack of access to water in homes in the State of Guanajuato, Mexico

Fundamentos: Se analiza la experiencia en hogares del Estado de Guanajuato, México, que padecen limitaciones en torno al acceso al agua en calidad y cantidad. Métodos: Se aplicó una encuesta de 17 ítems a 352 hogares (jefas de familia) para medir las experiencias en torno al acceso al agua, además de la seguridad alimentaria, escolaridad y aspectos sociodemográficos. Resultados: Un 33,4% de los hogares reportaron preocupación de no tener acceso al agua y el 74,8% no tuvo acceso. El 70,8% tuvo que comprar agua para beber y el 5,7% se enfermó y lo relacionó con el consumo de agua. Un 65,6% de los hogares presentó inseguridad alimentaria. La correlación fue significativa para nivel de escolaridad de las jefas de familia, el número de hogares con niños de 1 y 12 años con el uso de agua de la llave para beber, preparar leche en polvo para los niños, y para los alimentos en casa y agua fresca. Conclusiones: Estas experiencias de los hogares en torno al acceso al agua contribuyen a la discusión y al desarrollo de escalas sobre inseguridad al agua, considerando la seguridad alimentaria

Background: We analyze the experience in households in the State of Guanajuato, Mexico that suffer from limitations regarding access to water in quality and quantity. Methods: A survey of 17 items was applied to 352 households (female heads of household) to measure experiences regarding access to water, in addition to food security, schooling and sociodemographic aspects. Results: Where 33,4% of households reported concern about not having access to water and 74,8% did not have access. 70,8% had to buy water to drink and 5,7% got sick and related it to water consumption. 65,6% of households showed food insecurity. The correlation was significant for the level of education of female heads of household, households with children under 1 and 12 years old with the use of tap water, preparing powdered milk for children, and for food at home and water. Conclusions: These experiences of households around access to water contribute to the discussion and development of scales that insecurity to water, considering food security

Riesgo cardiometabólico en adolescentes con y sin obesidad: Variables metabólicas, nutricionales y consumo de refresco / Cardiometabolic risk in adolescents with and without obesity: Metabolic, nutritional and soft drink consumption variables

Resumen El consumo alto de azúcares añadidos (AZA) se asocia a mayor sobrepeso y obesidad; sin embargo, la posesión de un peso corporal adecuado puede no descartar dicho consumo. El objetivo del presente estudio fue investigar la asociación de los principales factores de riesgo cardiometabólico con el estado nutricio, el consumo de refresco (CNR) y de otras bebidas con AZA. Participaron 89 adolescentes de 10-15 años de edad (53 con obesidad [OG] y 36 sin obesidad [WOG]). Las medidas recabadas fueron: porcentaje de grasa corporal, índice de masa corporal, presión arterial, ácido úrico y glucosa sanguínea; además de un recordatorio de alimentación (24 hrs) y un cuestionario de frecuencia de consumo de alimentos. Del OG, 31% presentó hipertensión, 71% acantosis nigricans, 13% hiperuricemia y 17% valores altos de glucosa. No obstante, el WOG registró mayor consumo de refresco, así como valores limítrofes en los demás factores de riesgo. Aunque no hubo diferencia entre los grupos en el consumo de carbohidratos, si en la frecuencia y cantidad del consumo de azúcar simple y de bebidas con AZA, entre ellas el refresco. Destaca la importancia de integrar a los factores de riesgo ya conocidos, el análisis pormenorizado del CNR y otras bebidas con AZA.

Abstract A high added sugars (AS) intake is associated with greater overweight and obesity; however, having normal weight does not mean low intake of AS. The objective of this study was to associate the main cardiometabolic risk factors with nutritional status, soft drink intake (SDI) and other beverages with AS. Participants were 89 adolescents 1015 years old (53 with obesity [OG] and 36 without obesity [WOG]). The measures were: body fat percentage, body mass index, blood pressure, uric acid and blood glucose; besides a food reminder of 24 hours and a food intake frequency questionnaire. From the OG, 31% had hypertension, 71% acanthosis nigricans, 13% hyperuricemia and 17% high values of glucose. However, the WOG increased the consumption of soft drinks, as well as the limit values in other risk factors. Although there were no differences between the groups in the consumption of carbohydrates, there were in the frequency and amount of simple sugar and drinks with AS, for instance soft drinks. It is highlighted the importance to include the already known risk factors and a detailed analysis of SDI and other soft drinks with AS.

Angiosarcoma epitelioide intraabdominal / Intra-abdominal epithelioid angiosarcoma

El angiosarcoma epiteiloide es un subtipo de sarcoma muy infrecuente (< 1 % de todos los sarcomas). La localización más frecuente es en extremidades siendo la región axial menos habitual. Resulta esencial el diagnóstico diferencial con otras variantes histológicas de angiosarcomas intraabdominales hepáticos y esplénicos. La cirugía constituye el tratamiento de elección no existiendo evidencia actual sobre el manejo en casos con afectación locorregional o a distancia. (AU)

El laboratorio clínico en colombia: orígenes, historia, nacimiento y desarrollo / The clinical laboratory in Colombia: origins, history, birth and development

El laboratorio clínico, tal como se conoce en la actualidad, ha vivido un proceso de transformación histórica que contempla desde lo empírico, lo sistemático y lo organizacional.Teniendo sus orígenes en los saberes, conocimientos y técnicas aplicadas, de las ciencias exactas y sus disciplinas, impulsados por la necesidad de implementar un recurso diagnóstico en el manejo y tratamiento de las enfermedades.En Colombia el laboratorio clínico, tiene sus inicios a principios del s XX, acorde con las necesidades económicas y sanitarias de la época. El mayor impulso a la consolidación del laboratorio se realizó a través del surgimiento del Instituto Nacional de Salud como organismo nacional de referencia, adoptando modelos estructurales y organizativos de Europa y Estados Unidos.La intención de este documento es dar un vistazo a través de los orígenes, la historia, el nacimiento y desarrollo del laboratorio clínico en Colombia...(AU)

The clinical laboratory as it is known today has undergone a process of historical transformation that viewed from the empirical, the systematic and organizational. Given its origins in knowledge, skills and applied techniques of exact sciences and disciplines, driven by the need to implement a diagnostic tool in the management and treatment of diseases.In Colombia the clinical laboratory, has its beginnings in the early twentieth s, according to the economic and health needs of the time. The greatest impetus to laboratory consolidation was conducted through the emergence of the National Institute of Health as the national reference, adopting structural and organizational models in Europe and the United States.The intent of this document is to look through the origins, history, the birth and development of the clinical laboratory in Colombia...(AU)

Aneurisma micótico de la arteria hepática, una complicación infrecuente de la endocarditis aórtica / No disponible

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