[Upper gastrointestinal endoscopy in pediatrics: experience of a high complexity center in Latin-America]. / Endoscopia digestiva superior en pediatría: experiencia de un centro de alta complejidad de Latinoamérica.

OBJECTIVE: To characterize pediatric patients undergoing esophagogastroduodenoscopy (EGD) in a high-complexity hospital. PATIENTS AND METHOD: Retrospective study in patients under 14 years of age who underwent EGD at the Hospital San Vicente Fundación de Medellín, between January 2019 and June 2020. The following sociodemographic characteristics were evaluated: age, sex, type of health insurance, place of origin, service where the procedure was indicated, indications for endoscopy, type of care, purpose of the procedure, endoscopic findings, endoscopic intervention, complications associated with the procedure or anesthesia, and relevance of the procedure. RESULTS: 466 patients who underwent 552 endoscopies were included. Fifty-seven percent of the patients were male. In diagnostic EGD, the main indications were abdominal pain (23%) and upper gastrointestinal bleeding (17%). In therapeutic EGD, the most frequently performed procedures were percutaneous endoscopic gastrostomy (41%), foreign body removal (27%), and esophageal dilation (24%). The complication rate related to the procedure was 0.5% and in relation to anesthesia was 0.7%. CONCLUSIONS: EGD in pediatric patients is an effective and safe tool if performed with an appropriate indication. One-third of therapeutic EGD could be avoided from primary prevention.

ST101 induces a novel 17 kDa APP cleavage that precludes Aß generation in vivo.

OBJECTIVE: Inhibiting Aß generation is a prime therapeutic goal for preventing or treating Alzheimer disease. Here we sought to identify any disease-modifying properties of an azaindolizinone derivative, spiro[imidazo[1,2-a]pyridine-3,2-idan]-2(3H)-one (ST101 or ZSET1446). METHODS: The effects of ST101 were studied in 3xTg-AD mice and young cynomolgus monkeys using a combination of biochemical and histological analyses. RESULTS: Here we describe that ST101 induces cleavage of APP protein at a novel site, generating a 17 kDa C-terminal fragment. This 17 kDa APP cleavage product does not appear to be a substrate for either α- or ß-secretase, and thus bypasses generation of Aß. ST101 is orally active, efficacious at low doses, improves memory function, and robustly reduces brain Aß in transgenic mice and nonhuman primates. INTERPRETATION: Using rodent and nonhuman primate models, we show that ST101 represents a novel class of small molecules that reduce central nervous system levels of Aß by inducing an alternate pathway of APP cleavage.

Lack of pathology in a triple transgenic mouse model of Alzheimer's disease after overexpression of the anti-apoptotic protein Bcl-2.

Alzheimer's disease (AD) is characterized by the accumulation of plaques containing beta-amyloid (Abeta) and neurofibrillary tangles (NFTs) consisting of modified tau. Although Abeta deposition is thought to precede the formation of NFTs in AD, the molecular steps connecting these two pathologies is not known. Previous studies have suggested that caspase activation plays an important role in promoting the pathology associated with AD. To further understand the contribution of caspases in disease progression, a triple transgenic Alzheimer's mouse model overexpressing the anti-apoptotic protein Bcl-2 was generated. Here we show that overexpression of Bcl-2 limited caspase-9 activation and reduced the caspase cleavage of tau. Moreover, overexpression of Bcl-2 attenuated the processing of APP (amyloid precursor protein) and tau and reduced the number of NFTs and extracellular deposits of Abeta associated with these animals. In addition, overexpression of Bcl-2 in 3xTg-AD mice improved place recognition memory. These findings suggest that the activation of apoptotic pathways may be an early event in AD and contributes to the pathological processes that promote the disease mechanisms underlying AD.

High diversity of human polyomaviruses in environmental and clinical samples in Argentina: Detection of JC, BK, Merkel-cell, Malawi, and human 6 and 7 polyomaviruses.

New human polyomaviruses have been recently described. The aim of this work was to detect and characterize human polyomaviruses circulating in Argentina by recovering viruses from environmental and sewage samples and evaluating their potential role as viral indicators of human waste contamination. Analysis was performed in a wider context including viruses from clinical samples from an immunocompromised population. River water and sewage samples were analyzed as a strategy to study the molecular epidemiology of viruses excreted by millions of people. Samples belonged to the Matanza-Riachuelo River (2005-2006: n=25 and 2012: n=20) and sewage from Buenos Aires city and suburbs (2011 and 2013: n=24). Viral detection was performed by PCR and the amplified viral genomes were characterized by phylogenetic analysis. Polyomaviruses were detected in 95.8% of sewage samples, identifying BKPyV (87.5%), JCPyV (83.3%), MCPyV (8.3%) and HPyV6 (8.3%). Besides, one sample collected in 2009 resulted positive for HPyV7. In 2005-2006, polyomaviruses were detected in 84.0% of river water samples, with the highest detection for MCPyV (52.0%), followed by BKPyV (44.0%), JCPyV (20.0%) and MWPyV (4.0%). In 2012, polyomaviruses were detected in 85.0% of river samples, finding JCPyV (85.0%), BKPyV (75.0%), MCPyV (25.0%) and HPyV6 (25.0%). Also, polyomaviruses, including JCPyV, BKPyV and MCPyV, were detected in 63.2% of urine samples from patients infected with HIV (n=19). Characterization indicated the coexistence of different genotypes and variants for each virus, particularly in sewage. MCPyV sequences (the only sequences from Argentina) formed a monophyletic group with the single sequence available for South America (French Guiana). The high level of detection and viral diversity found by environmental surveillance, which involved the characterization of viruses not previously described in South America, reinforces the usefulness of this approach to monitor viral contamination and describe the viral epidemiology in the general population.

Momento aductor de la cadera durante la marcha en adultos mayores asintomáticos / Hip adductor moment during gait in asymptomatic older adults

Resumen Introducción: El momento articular durante la marcha se ha relacionado con diferentes procesos clínicos en la población adulto mayor, en Colombia no se cuentan con reportes propios. Objetivo: Analizar el momento aductor de la cadera durante la marcha de adultos mayores asintomáticos. Materiales y métodos: Se evaluó a 110 participantes siguiendo las referencias del software VICON NEXUS 2.8.1 modelo Full Body, se utilizó 2 plataformas de fuerza y el volumen de captura estuvo delimitado por 8 cámaras opto eléctricas Bonita 10. Se incluyó variables antropométricas, sociodemográficas, espaciotemporales y cinéticas durante la fase de apoyo, resaltando los dos picos máximos del momento aductor. Resultados: Las cifras del Pico Momento Aductor 1 y 2 (PMA1 y PMA2) fueron de 0,76 y 0,70 Nm/Kg respectivamente, estos picos se relacionaron con masa, talla e índice de masa corporal. Se construyó así una referencia para el análisis de adultos mayores asintomáticos. Conclusiones: La gráfica del momento aductor de la cadera es similar a la descrita por otros investigadores, pero en menor magnitud que en la población sintomática de coxartrosis.

Abstract Introduction: Although joint moment during waking has been associated with different clinical processes in the elderly population, there is a lack of reports in Colombia. Objective: To analyze the hip adductor moment during gait in asymptomatic older adults. Materials and methods: 110 participants were assessed using the VICON NEXUS 2.8.1. Full Body model software. 2 force platforms were used and the capture volume was delimited through 8 Bonita-10 optoelectronic cameras. Anthropometric, sociodemographic, spatiotemporal, and kinetic variables were included during the support phase, highlighting the two maximum peaks of the adductor moment. Results: The figures for Adductor Moment Peaks 1 and 2 (AMP1 and AMP2) were 0.76 and 0.70 Nm/Kg, respectively, which were related to mass, height and body mass index. Thus, a reference for the analysis of asymptomatic older adults was developed. Conclusion: The hip adductor moment graph is similar to that described by other researchers, but to a lesser extent than the values seen in coxarthrosis symptomatic population.

Atención prehospitalaria de infarto agudo de miocardio en Manizales, Colombia, 2009 / Prehospital care of acute myocardial infarction in Manizales, Colombia, 2009

Introducción: La mayoría de las muertes por infarto agudo de miocardio se dan en la primera hora de ocurrido el evento y antes de recibir atención por el equipo de salud; se considera entonces que la atención prehospitalaria debe dar respuesta a esta situación. Por ello, surge el interés de investigar cómo se encuentra la atención prehospitalaria de infarto agudo de miocardio en Manizales (Colombia). Materiales y métodos: Se realizó un estudio tipo descriptivo utilizando como medio de recolección de datos encuestas y entrevistas cara a cara, evaluando como variables al personal, la institución y la dotación de las ambulancias. La población a estudiar comprendió las siguientes entidades de atención prehospitalaria de Manizales–Colombia: Cuerpo Oficial de Bomberos, ASSBASALUD ESE, BYR, GER, SER y Cruz Roja; sin embargo las dos últimas entidades no participaron en el estudio por algunos inconvenientes con sus respectivos directores. Resultados: Este estudio provee información importante para el desarrollo y mejoramiento de nuevas políticas de atención prehospitalaria y plantea la necesidad en la remodelación de los recursos con los que se cuenta. A pesar de la capacitación satisfactoria del personal las instituciones prestadoras de este servicio no cuentan con ambulancias medicalizadas necesarias para la atención adecuada y oportuna de un evento coronario. Conclusión: En Manizales no se cuenta con un sistema interinstitucional y coordinado de atención prehospitalaria de infarto agudo de miocardio, ni con recursos suficientes que brinden una oportuna atención, aunque existe un marcado interés por su implementación.