Bio-Inspired Fluorescent Calcium Sulfate for the Conservation of Gypsum Plasterwork.

In this work, the potential of bio-inspired strategies for the synthesis of calcium sulfate (CaSO4·nH2O) materials for heritage conservation is explored. For this, a nonclassical multi-step crystallization mechanism to understand the effect of calcein- a fluorescent chelating agent with a high affinity for divalent cations- on the nucleation and growth of calcium sulfate phases is proposed. Moving from the nano- to the macro-scale, this strategy sets the basis for the design and production of fluorescent nano-bassanite (NB-C; CaSO4·0.5H2O), with application as a fully compatible consolidant for the conservation of historic plasterwork. Once applied to gypsum (CaSO4·2H2O) plaster specimens, cementation upon hydration of nano-bassanite results in a significant increase in mechanical strength, while intracrystalline occlusion of calcein in newly-formed gypsum cement improves its weathering resistance. Furthermore, under UV irradiation, the luminescence produced by calcein molecules occluded in gypsum crystals formed upon nano-bassanite hydration allows the easy identification of the newly deposited consolidant within the treated gypsum plaster without altering the substrate's appearance.

Host space, not energy or symbiont size, constrains feather mite abundance across passerine bird species.

Comprehending symbiont abundance among host species is a major ecological endeavour, and the metabolic theory of ecology has been proposed to understand what constrains symbiont populations. We parameterized metabolic theory equations to investigate how bird species' body size and the body size of their feather mites relate to mite abundance according to four potential energy (uropygial gland size) and space constraints (wing area, total length of barbs and number of feather barbs). Predictions were compared with the empirical scaling of feather mite abundance across 106 passerine bird species (26,604 individual birds sampled), using phylogenetic modelling and quantile regression. Feather mite abundance was strongly constrained by host space (number of feather barbs) but not by energy. Moreover, feather mite species' body size was unrelated to the body size of their host species. We discuss the implications of our results for our understanding of the bird-feather mite system and for symbiont abundance in general.

ChatGPT as an information tool in rhinology. Can we trust each other today?

PURPOSE: ChatGPT (Chat-Generative Pre-trained Transformer) has proven to be a powerful information tool on various topics, including healthcare. This system is based on information obtained on the Internet, but this information is not always reliable. Currently, few studies analyze the validity of these responses in rhinology. Our work aims to assess the quality and reliability of the information provided by AI regarding the main rhinological pathologies. METHODS: We asked to the default ChatGPT version (GPT-3.5) 65 questions about the most prevalent pathologies in rhinology. The focus was learning about the causes, risk factors, treatments, prognosis, and outcomes. We use the Discern questionnaire and a hexagonal radar schema to evaluate the quality of the information. We use Fleiss's kappa statistical analysis to determine the consistency of agreement between different observers. RESULTS: The overall evaluation of the Discern questionnaire resulted in a score of 4.05 (± 0.6). The results in the Reliability section are worse, with an average score of 3.18. (± 1.77). This score is affected by the responses to questions about the source of the information provided. The average score for the Quality section was 3.59 (± 1.18). Fleiss's Kappa shows substantial agreement, with a K of 0.69 (p < 0.001). CONCLUSION: The ChatGPT answers are accurate and reliable. It generates a simple and understandable description of the pathology for the patient's benefit. Our team considers that ChatGPT could be a useful tool to provide information under prior supervision by a health professional.

Complement-Mediated Thrombotic Microangiopathy after Kidney Transplant: Should Treatment with C5 Inhibitor Be Lifelong?

Complement-mediated thrombotic microangiopathy (CM-TMA) is a rare and life-threatening complication that can occur in kidney transplant recipients, with various potential triggers including immunosuppressive medications. The optimal management and duration of treatment with C5 inhibitors (C5i) for CM-TMA in this patient population remain areas of ongoing investigation. We present the case of a 38-year-old female with a history of IgA nephropathy who underwent preemptive living-related kidney transplantation and subsequently developed CM-TMA 7 years post-transplant. Treatment with ravulizumab led to a rapid hematologic response and stabilized platelet counts. Serial measurements of complement functional tests and clinical stability guided the discontinuation of C5i therapy. The case highlights the complexity of managing CM-TMA in kidney transplant recipients, particularly in determining the appropriate duration of C5i therapy. The absence of an established protocol for discontinuation necessitates a personalized approach based on clinical and laboratory stability, absence of complement gene variants, and serial complement functional tests. Further prospective investigations are warranted to define the optimal strategies for monitoring and safely discontinuing C5i therapy in this unique patient population. This case underscores the importance of individualized care in the management of CM-TMA post-kidney transplantation, offering insights into potential criteria for therapy discontinuation.

Cochlear dysfunction as an early biomarker of cognitive decline in normal hearing and mild hearing loss.

INTRODUCTION: Age-related hearing loss is an important risk factor for cognitive decline. However, audiogram thresholds are not good estimators of dementia risk in subjects with normal hearing or mild hearing loss. Here we propose to use distortion product otoacoustic emissions (DPOAEs) as an objective and sensitive tool to estimate the risk of cognitive decline in older adults with normal hearing or mild hearing loss. METHODS: We assessed neuropsychological, brain magnetic resonance imaging, and auditory analyses on 94 subjects > 64 years of age. RESULTS: We found that cochlear dysfunction, measured by DPOAEs-and not by conventional audiometry-was associated with Clinical Dementia Rating Sum of Boxes (CDR-SoB) classification and brain atrophy in the group with mild hearing loss (25 to 40 dB) and normal hearing (<25 dB). DISCUSSION: Our findings suggest that DPOAEs may be a non-invasive tool for detecting neurodegeneration and cognitive decline in the older adults, potentially allowing for early intervention.

Unraveling the pathological biomineralization of monosodium urate crystals in gout patients.

Crystallization of monosodium urate monohydrate (MSU) leads to painful gouty arthritis. Despite extensive research it is still unknown how this pathological biomineralization occurs, which hampers its prevention. Here we show how inflammatory MSU crystals form after a non-inflammatory amorphous precursor (AMSU) that nucleates heterogeneously on collagen fibrils from damaged articular cartilage of gout patients. This non-classical crystallization route imprints a nanogranular structure to biogenic acicular MSU crystals, which have smaller unit cell volume, lower microstrain, and higher crystallinity than synthetic MSU. These distinctive biosignatures are consistent with the template-promoted crystallization of biotic MSU crystals after AMSU at low supersaturation, and their slow growth over long periods of time (possibly years) in hyperuricemic gout patients. Our results help to better understand gout pathophysiology, underline the role of cartilage damage in promoting MSU crystallization, and suggest that there is a time-window to treat potential gouty patients before a critical amount of MSU has slowly formed as to trigger a gout flare.

Ru-terpyridine complexes containing clotrimazole as potent photoactivatable selective antifungal agents.

The overuse of antimicrobial agents in medical and veterinary applications has led to the development of antimicrobial resistance in some microorganisms and this is now one of the major concerns in modern society. In this context, the use of transition metal complexes with photoactivatable properties, which can act as drug delivery systems triggered by light, could become a potent strategy to overcome the problem of resistance. In this work several Ru complexes with terpyridine ligands and the clotrimazole fragment, which is a potent antimycotic drug, were synthesized. The main goal was to explore the potential photoactivated activity of the complexes as antifungal agents and evaluate the effect of introducing different substituents on the terpyridine ligand. The complexes were capable of delivering the clotrimazole unit upon irradiation with visible light in a short period of time. The influence of the substituents on the photodissociation rate was explained by means of TD-DFT calculations. The complexes were tested against three different yeasts, which were selected based on their prevalence in fungal infections. The complex in which a carboxybenzene unit was attached to the terpyridine ligand showed the best activity against the three species under light, with minimal inhibitory concentration values of 0.88 µM and a phototoxicity index of 50 achieved. The activity of this complex was markedly higher than that of free clotrimazole, especially upon irradiation with visible light (141 times higher). The complexes were more active on yeast species than on cancer cell lines.

Ir(III) Half-Sandwich Photosensitizers with a π-Expansive Ligand for Efficient Anticancer Photodynamic Therapy.

One approach to reduce the side effects of chemotherapy in cancer treatment is photodynamic therapy (PDT), which allows spatiotemporal control of the cytotoxicity. We have used the strategy of coordinating π-expansive ligands to increase the excited state lifetimes of Ir(III) half-sandwich complexes in order to facilitate the generation of 1O2. We have obtained derivatives of formulas [Cp*Ir(C∧N)Cl] and [Cp*Ir(C∧N)L]BF4 with different degrees of π-expansion in the C∧N ligands. Complexes with the more π-expansive ligand are very effective photosensitizers with phototoxic indexes PI > 2000. Furthermore, PI values of 63 were achieved with red light. Time-dependent density functional theory (TD-DFT) calculations nicely explain the effect of the π-expansion. The complexes produce reactive oxygen species (ROS) at the cellular level, causing mitochondrial membrane depolarization, cleavage of DNA, nicotinamide adenine dinucleotide (NADH) oxidation, as well as lysosomal damage. Consequently, cell death by apoptosis and secondary necrosis is activated. Thus, we describe the first class of half-sandwich iridium cyclometalated complexes active in PDT.

Effectiveness of Omega-3 Fatty Acid Supplementation in Improving the Metabolic and Inflammatory Profiles of Mexican Adults Hospitalized with COVID-19.

BACKGROUND AND OBJECTIVES: The development of severe COVID-19 is related to the preexistence of comorbidities and an inadequate nutritional status. The latter is a critical factor for the development of infection and the progression of the disease. Notably, optimal nutrition impacts immune system function, as malnutrition is related to high cytokine levels in the late phase of the disease, correlating with a poor prognosis. In this sense, omega-3 fatty acids (O3FAs) have anti-inflammatory properties that may reduce morbidity and mortality from COVID-19 infection. O3FAs are linked to a better prognosis in COVID-19 patients. MATERIALS AND METHODS: In this randomized, double-blind clinical trial, we evaluate the administration of O3FAs to unvaccinated Mexican patients for two weeks starting after the first two hours of hospitalization. RESULTS: The findings support the notion that O3FAs (in a dose high enough to satisfy human physiological requirements in a short time, one capsule of 1.4 g O3FAs daily) exert a comprehensive multi-systemic modulatory influence, affecting inflammatory and metabolic pathways. Significant perturbations in biomarkers, including absolute neutrophil count, hematocrit, and platelet indices, underscore the compound's anti-inflammatory effect. Concurrently, the intervention modulates pivotal metabolic and hepatic parameters, attenuating cardiovascular risk profiles and expediting patient convalescence. These multifarious effects are likely orchestrated through intricate biochemical mechanisms and are subject to individual variations predicated on metabolic factors. CONCLUSIONS: The results of this trial support the notion that O3FA supplementation has beneficial effects on COVID-19 patients with moderate presentation by regulating metabolism and limiting inflammation.

Lactate-carried Mitochondrial Energy Overflow.

We addressed the question of mitochondrial lactate metabolism using genetically-encoded sensors. The organelle was found to contain a dynamic lactate pool that leads to dose- and time-dependent protein lactylation. In neurons, mitochondrial lactate reported blood lactate levels with high fidelity. The exchange of lactate across the inner mitochondrial membrane was found to be mediated by a high affinity H+-coupled transport system involving the mitochondrial pyruvate carrier MPC. Assessment of electron transport chain activity and determination of lactate flux showed that mitochondria are tonic lactate producers, a phenomenon driven by energization and stimulated by hypoxia. We conclude that an overflow mechanism caps the redox level of mitochondria, while saving energy in the form of lactate.

Precision nutrition impact on metabolic health and quality of life in aging population after a 3-month intervention: A randomized intervention.

OBJECTIVES: Innovative precision dietary procedures are required to promote healthy aging. This study aimed to evaluate the effects of a personalised strategy based on the inclusion of individualised foods and digital tools on overall health status and quality of life within a follow-up of 3 months in older adults with overweight or obesity. METHODS: 127 men and women aged between 50 and 80 years with overweight/obesity participated in the study-between January 2020 and September 2020 at the Center for Nutrition Research-University of Navarra and IMDEA-ALIMENTACIÓN-and were randomly assigned to a usual-care group (standard recommendations) or precision group (precision nutrition strategy based on the inclusion of individualised foods and a mobile application). Anthropometry, body fat percentage, biochemical parameters, diet, and quality of life (SF-36 Health Survey) were assessed at baseline and after 3 months. RESULTS: Both strategies were found to improve overall metabolic health; however, the precision approach demonstrated significantly better outcomes. The precision strategy reduced body weight at 3 months (-4.3 kg; p < 0.001) with significant improvements in body fat percentage, blood pressure and general metabolic health (glycated haemoglobin; alanine aminotransferase; aspartate aminotransferase; hepatic steatosis index) in comparison with the standard recommendations. The precision approach significantly enhanced the quality of life (SF-36) of individuals, with additional improvements in emotional well-being (p = 0.024) and vitality (p = 0.008). Adherence to the Mediterranean diet was significantly associated with a higher quality of life and vitality. CONCLUSION: These results support the benefit of precision nutrition approaches for promoting healthy aging and emotional well-being, enhancing the quality of life in aging populations, during the COVID-19 pandemic.

Un nuevo desafío para los médicos del Paraguay: la nefritis intersticial crónica de comunidades agrícolas (CINAC)

RESUMEN Se presenta revisión narrativa sobre nefritis intersticial crónica de comunidades agrícolas (CINAC, siglas del inglés Chronic Interstitial Nephritis in Agricultural Communities). Se discute la etiología, manifestaciones clínicas, manejo diagnóstico y terapéutico de esta afección.

ABSTRACT A narrative review on Chronic Interstitial Nephritis in Agricultural Communities (CINAC) is presented. The etiology, clinical manifestations, diagnostic and therapeutic management of this condition are discussed.

Hallazgos ultraestructurales renales de pacientes con nefritis intersticial crónica de las comunidades agrícolas en El Salvador / Renal ultrastructural findings of patients with chronic interstitial nephritis from farming communities in El Salvador

Introducción: Desde hace 20 años se presenta en Centroamérica una enfermedad renal crónica que fundamentalmente afecta a hombres agricultores y no asociada a las causas tradicionales. Se caracteriza por presentar una nefritis intersticial crónica, en tanto las características ultraestructurales no se conocen con exactitud. En su origen se invoca el uso de agroquímicos y otros agentes nefrotóxicos, la deshidratación crónica, el consumo de medicamentos, entre otros factores. Objetivo: Describir las características ultraestructurales de la nefritis intersticial crónica en comunidades agrícolas. Método: Se realizó un estudio descriptivo de corte transversal. Se estudiaron muestras de biopsias renales de ocho pacientes con diagnóstico de nefritis intersticial crónica de las comunidades agrícolas. Resultados: De los ocho pacientes estudiados, dos (25 por ciento) trabajaban en labores agrícolas y cinco eran del sexo femenino (62,5 por ciento). Dos de los pacientes (25 por ciento) presentaban una enfermedad renal crónica estadio 2, y seis (75 por ciento) estadio 3. En cinco pacientes se hallaron fagolisosomas con presencia de componente lipídico entremezclado con material electrodenso en células del túbulo distal. En igual cantidad de pacientes se observaron cuerpos mieloides con zonas laminadas y núcleo central en células de túbulo proximal y de los vasos sanguíneos. Conclusiones: En pacientes de comunidades agrícolas que padecen nefritis intersticial crónica se evidencian fagolisosomas y estructuras mieloides en túbulos y vasos renales, cuyo contenido y origen se desconocen(AU)

Introduction: Chronic kidney disease mainly affecting male farmers and not associated to traditional causes has been present in Central America for twenty years. The condition is characterized by the presence of chronic interstitial nephritis, but its ultrastructural features are not fully known. Factors suggested as responsible for its occurrence include the use of agrochemicals and other nephrotoxic agents, chronic dehydration and medicine consumption. Objective: Describe the ultrastructural characteristics of chronic interstitial nephritis in farming communities. Method: A cross-sectional descriptive study was conducted of renal biopsy samples from eight patients diagnosed with chronic interstitial nephritis in farming communities. Results: Of the eight patients studied, two (25 percent) were farm workers and five (62.5percent) were female. Two of the patients (25 percent) had stage 2 and six (75 percent) stage 3 chronic kidney disease. In five patients evidence was found of phagolysosomes with lipid component mixed with electrodense material in distal tubule cells. An equal number of patients had myeloid bodies with laminated areas and central nucleus in proximal tubule and blood vessel cells. Conclusions: Evidence of phagolysosomes and myeloid structures of unknown content and origin was found in renal tubules and vessels of patients from farming communities diagnosed with chronic interstitial nephritis(AU)

The chronic kidney disease epidemic in El Salvador: the influence of agrochemicals / La epidemia de enfermedad renal crónica en El Salvador: la influencia de los agroquímicos

Introduction: An epidemic of chronic kidney disease (CKD) of devastating consequences has been taking place in El Salvador over the last few decades. In a significant portion of affected subjects, no other common cause of chronic kidney disease is present, such as diabetes and hypertension. This illness is usually called Chronic Kidney Disease from Non-Traditional Causes (CKDnT). Previous studies have shown a high prevalence of exposure to agrochemicals in affected populations, particularly in rural areas. In addition to sustained exposure to agrochemicals, the other leading hypothesis to explain this epidemic is prolonged exposure to high temperatures and dehydration in a context of exhausting agricultural work. Objectives: To assess the possible causal effect of exposure to agrochemicals in the emergence of the CKD epidemic in the adult population of El Salvador. Methods: We conducted a case-control analysis based on the 2015 survey of Chronic Diseases in Adults in El Salvador, a national probabilistic sample that covered 4,817 adults ;20 years old. Those suffering from CKD were considered cases; the rest were managed as controls. Self-reported agrochemical exposures, other risk factors and health conditions were recorded. For binary exposures, the odds ratio (OR) of CKD and CKDnT was estimated. For variables measuring length of exposure, the average valu 8203; 8203;for cases and for controls were compared. In all cases, the corresponding 95 percent confidence intervals were calculated. Multivariate logistic regression was used to examine the association between exposure to agrochemicals and CKD while controlling for potential confounding variables. Results: Regardless of how past exposure to agrochemicals was characterized (e.g., contact with paraquat or aerial fumigation) the OR of both CKD and CKDnT was always greater than 1.0 (range, 1.36 to 3.75). Similarly, the average number of years of exposure was consistently higher for cases than for controls for all continuous variables examined (greater than 2 years in most cases). Conclusions: The results of this study are consistent with previous epidemiologic and toxicological evidence and support the hypothesis that exposure to agrochemicals may be causally implicated in the ongoing CKD epidemics in El Salvador(AU)

Introducción: Durante las últimas décadas, una epidemia de enfermedad renal crónica (ERC) de consecuencias devastadoras ha tenido lugar en El Salvador. Una parte importante de los sujetos afectados, no padece de una causa frecuente para padecer enfermedad renal crónica, tal como como diabetes e hipertensión. En tal caso, suele distinguirse la dolencia mediante el nombre de Enfermedad Renal Crónica de Causas no Tradicionales (ERCnT). Estudios previos muestran una alta prevalencia de exposición a agroquímicos en las poblaciones afectadas, particularmente en las zonas rurales. Además de la exposición sostenida a agroquímicos, la otra hipótesis principal para explicar esta epidemia es la exposición prolongada a altas temperaturas y deshidratación, en un contexto de trabajo agrícola agotador. Objetivos: Evaluar el posible efecto causal de la exposición a agroquímicos en la irrupción de la epidemia de ERC en la población adulta de El Salvador. Métodos: Se realizó un estudio de casos y controles, a partir de la Encuesta de Enfermedades Crónicas no Transmisibles en Adultos en El Salvador, basada en una muestra probabilística nacional que abarcó 4,817 adultos de 20 o más años de edad, concluida en 2015. Fueron considerados casos todos aquellos que padecían ERC; el resto dos restantes participantes se manejaron como controles. Se registraron las exposiciones a agroquímicos, así como a otros factores de riesgo y condiciones de salud según testimonio de los participantes. Para las exposiciones binarias, se estimó la razón de odds (OR) con respecto a padecer ERC y ERCnT. Para las variables que medían la duración de la exposición, se compararon los valores medios para casos y controles. En todos los casos, se calcularon los respectivos intervalos de confianza al 95 por ciento. Se utilizó la regresión logística multivariada para examinar la asociación entre la exposición a agroquímicos y la ERC, controlando las posibles variables confusoras. Resultados: Independientemente de cómo fuera caracterizada la exposición pasada a agroquímicos (por ejemplo, contacto con paraquat o fumigación aérea), el OR de ERC y ERCnT siempre fue mayor que 1.0 (rango, 1.36 a 3.75). Del mismo modo, la media de años de exposición fue consistentemente más alta para los casos que para los controles, para todas las variables continuas examinadas (más de 2 años en la mayoría de los casos). Conclusiones: Los resultados de este estudio son consistentes con la evidencia epidemiológica y toxicológica previa y respaldan la hipótesis de que la exposición a agroquímicos puede estar causalmente implicada en la epidemia de ERC que se registra en El Salvador(AU)

La investigación sobre calidad de la atención en el Instituto Mexicano del Seguro Social: estudio bibliométrico / Research on quality of health care from the Mexican Social Security Institute: a bibliometric study

Objetivo. Identificar las investigaciones sobre calidad de la atención en el IMSS. Material y métodos. Estudio bibliométrico, transversal, retrospectivo y descriptivo, sobre las publicaciones del IMSS de 1992 a 2011. Resultados. Se identificaron 881 investigaciones sobre calidad de la atención (11% IC95% 10.6-12.0) de 7 762 trabajos. Se publicaron 946 artículos (8.9% IC95% 8.4-9.5) relacionados con la calidad. Conclusiones. Se identificó interés en realizar investigación sobre calidad del servicio. Habrá que establecer cuál ha sido el impacto en la mejora de la atención, y su contribución a la toma de decisiones en materia de salud.

Objective. To identify studies on quality of health care in the IMSS. Materials and methods. A bibliometric, descriptive cross-sectional and retrospective study was conducted, from 1992 to 2011. Results. We identified 881 research studies related to the issue of quality (CI95% 10.6-12.0) of 7 762 studies presented at the annual research meetings. 10 521 articles were published in this period of time and only 946 (CI95% 8.4-9.5) were linked to the issue of quality. Conclusions. The results of this study allowed us to identify the interest about research on quality. Further research is needed to establish what has been the impact on the improvement of quality in health care.

Laparoscopia quirúrgica en cáncer de cuello uterino, en el Hospital IV Huancayo EsSalud / Surgical laparoscopy in cervical cancer, in Huancayo EsSalud Hospital IV

Introducción: El cáncer de cérvix es la causa más frecuente de muerte en la sierra central peruana. El tratamiento quirúrgico (histerectomía total laparoscópica e histerectomía radical más linfadenectomía pélvica laparoscópica) es el recurso terapéutico mayormente curativo en los estadios iníciales (Ia1, Ia2 y Ib1). Hace un año en el Servicio de Ginecología del Hospital IV Huancayo iniciamos el tratamiento quirúrgico laparoscópico en estos estadios. Objetivos: Revisar los resultados de histerectomía laparoscópica en cáncer microinvasivo de cuello uterino. Diseño: Estudio retrospectivo. Institución: Servicio de Ginecología, Hospital IV Huancayo, EsSalud, Junín, Perú. Pacientes: Doce mujeres sometidas a histerectomía laparoscópica por carcinoma microinvasivo de cérvix. Intervenciones: En seis mujeres con diagnóstico preoperatorio de cáncer de cérvix por conización cervical y estadio clínico Ia1 se les realizó histerectomía laparoscópica, con un tiempo operatorio de 59,16 minutos y tiempo de estancia hospitalaria de 4,1 días. A otras seis mujeres con estadio clínico Ia2-Ib1 se les realizó histerectomía radical más linfadenectomía pélvica laparoscópica, con un tiempo operatorio de 3 horas 58 minutos y tiempo de estancia hospitalaria de 10,1 días. Principales medidas de resultados: Curación clínica. Resultados: Todos los diagnósticos fueron confirmados con la pieza operatoria, y todas las pacientes estaban teóricamente curadas (márgenes libres, ganglios negativos); una paciente presentó complicaciones, requiriendo estancia prolongada (8,3%). Conclusiones: La histerectomía total laparoscópica y la histerectomía radical más linfadenectomía pélvica laparoscópica pueden ser realizadas de manera más rápida y radical con respecto a la histerectomía convencional por laparotomía. Ambas son intervenciones factibles y seguras, que pueden garantizar la curación en el carcinoma microinvasivo de cuello uterino.

Efecto de la suplementación con leucaena (leucaena leucocephala lam. De wit) sobre la degradabilidad ruminal del pasto alemán (echinochloa polystachya h.b.k. Hitch) / Effect of Leucaena Supplementation (Leucaena leucocephala Lam. De Wit) on Ruminal Degradability of Aleman-Grass (Echinochloa polystachya H.B.K. Hitch)

Para evaluar el efecto de la suplementación con Leucaena sobre la degradabilidad de la materia seca (MS) del pasto Alemán (PA), se determinó in situ la degradabilidad potencial (a+b), fracción soluble (a), máxima a 96 h (b), tasa de degradación (c), pH ruminal y nitrógeno amoniacal. Se utilizaron tres machos Criollo Limonero castrados, con 14 días de adaptación a la dieta (F1) y 4 días de incubación (F2). Las dietas fueron: T1: PA + alimento concentrado (AC), T2: PA + Leucaena 2 kg una vez al día y T3, PA + Leucaena 2 kg suministrada 1 kg en la mañana otro en la tarde. Durante F2 las bolsas de nylon se incubaron secuencialmente, a 0; 6; 12; 24; 48; 72 y 96 horas. Se midió el pH del líquido ruminal en F2 a las 0; 3; 6; 9; 12 y 24 h. Se utilizó un diseño en cuadrado latino con tres repeticiones, la degradabilidad ruminal se analizó mediante regresión no lineal. No se encontró diferencia para a, b y c entre los tratamientos, mientras que para la a+b el valor alto (P < 0,05) se obtuvo para T3 (62,91%) en comparación con T1 y T2 (58,31 y 59,17%, respectivamente). El pH ruminal mas alto (P < 0,05) se observó en T3 (6,74), comparado con T1 y T2 (6,66; 6,65; respectivamente). Los valores de nitrógeno ruminal fueron 405,00; 486,14 y 508,25 mg L-1 para T1, T2 y T3, respectivamente. Se concluye que el suministro de L. leucocephala dos veces por día, mejora la degradabilidad del pasto Alemán.

To evaluate the effects of Leucaena supplementation on in situ ruminal dry matter (DM) degradability of Aleman-grass (AG), DM potential degradability (a+b), soluble fraction (a), maximum degradability (DM), degradation rate (c), ruminal pH and ammonia nitrogen, three ruminal cannulated Criollo Limonero steers were fed at 14-day adaptation period (F1) and samples were taken during the following 4-day period (F2). Diets were: T1, Aleman-grass (AG) + concentrate (CO); T2, PA + 2 kg Leucaena once a day and T3, PA + 2 kg Leucaena twice a day. During F2 nylon bags were sequentially incubated on 0; 6; 12; 24; 48; 72 and 96 h, and rumen contents pH were measured on 0; 3; 6; 9; 12 y 24 h post feeding. A Latin Square design with three replications was used and ruminal degradability data was analyzed by nonlinear regression model. No differences between treatments were found for a, b and c. a+b was higher (P < 0.05) on T3 (62.91%) than T1 (58.31%) or T2 (59.17%). Ruminal pH was higher (P < 0.05) in T3 (6.74) than T1 (6.66) and T2 (6.65). Ammonia nitrogen values were 405.00; 486.14 and 508.25 mg L-1 for T1, T2 y T3, respectively. It was conclude that L. leucocephala fed twice a day increases DM degradability of Aleman-grass.

Abordaje epidemiológico de un brote de trastorno conversivo epidémico en adolescentes

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Abstract: Introduction Several outbreaks of Epidemic Conversión Disorder are occurring in different groups of people in the world. Rather than being viewed as a number of people suffering from individual conversion disorder, epidemic hysteria is considered as a social phenomenon involving otherwise healthy people. We received a report letter from Dirección General de Epidemiología, about the existence of a large number of possible food poisoning cases among students, attending morning sessions at a technical high school, located in the downtown area of Mexico City. Twelve students were driven to the Mexican Red Cross Hospital due to fainting. The aims of this study were to determine the cause of such outbreak in a group of adolescents; to get an adequate explanation about the origin of the event; to identify the event dissemination ways and associates risk factors. Methods Study design: A matched case-control study was carried out to identify factors associated with the illness. Two control cases were randomly selected from the list of nonill students for each case. Fifty two cases and 104 controls were included. Hypotheses: Following the good health status determined by the physician at the hospital, we started the initial interview with the students. We reached the following possible hypotheses regarding the origin of this outbreak: first, the event was due to food poisoning; second, to the inhalation of a toxic gas such as carbon monoxide and thirdly, by exposure to high levels of contaminants. Finnaly, it might be a mass event of conversion disorder. Variables: Among the variables included in the study were: sex, age, class group, location of the student at the time of the out-break, and foods eaten during recess and immediately before the outbreak. All the students present at the time of the outbreak were interviewed using a standard questionnaire. Laboratory Simultaneously, samples of the food-products sold in and around the school that day were collected for bacteriologic and chemical analyses, the existence of a gas leak, carbon monoxide source, or any other airborne pollutant was investigated by the research team. Analyses: The demographic characteristics were analyzed by descriptive statistic; association between risk factors as possible causes of the event was determined by multivariate analysis at 95% confidence interval. Results: The outbreak occurred in the building of a downtown public school in Mexico City. The school has three floors, surrounding a central yard. There are 11 classrooms, two laboratories, an art workshop and a school medical clinic. The total duration of outbreak was 15 minutes. There were 455 students enrolled in the morning program, all of them were interviewed. A total of 52 cases was identified, among the 455 students, for an attack rate of 11.4%. There were three groups in which no cases were found. The attack rate in girls was 3.9 times higher than in boys. Sixty five percent of the cases occurred in two of the nine classrooms (1° B and 2° A). All the students of one group had been waiting at the patio for over an hour during an interclass break. Case cero was a girl from this group with a previous history of fainting. The outbreak occurred outside class-room in the central yard. Five female classmates of case cero fainted while they were with her in the yard. Cases then spread rapidly to the first floor with an attack rate of 13.2 percent, the second floor had 7.7 percent, and finally the third floor had 2.1 percent. All cases had fainted as per case definition. Additionally, headache was a prominent symptom occurring in 88 percent, paresthesias in 56 percent, and perceived difficulty in moving arms or legs in 35 percent. Also almost a quarter of the cases complained of irritation of the eyes and nose. Within one hour, all had completely recovered. Five days after the problem, three girls fainted; no outbreak occurred. Being a girl or belonging to class groups 1°B or 2°A, were the most significant risk factors, with (p 0.001). Also being less than 15 years of age was a significant risk factor for illness. The analysis of food preference data in the cases and controls showed that drinking a fruit beverage "X" was not related to the illness. Foods such as sandwiches, brought from home and cookies, candies and popcorn bought from street venders, had a borderline significant association with the illness. However, the number of cases attributable to these foods was very low. Also, it was difficult to figure out how sandwiches were prepared by mothers of individual students and how this factor could be implicated. No pathogen toxin or toxic chemical were identified in the food samples. Some foods studied in the crude analysis were ruled out in the multivariate analysis. A thorough environmental was negative, there being no evidence of a continuing gas leak or other causes. The pollution levels during that week were reported as being within the normal range, by the Metropolitan Index of Air Quality (IMECA). In order to evaluate psychological factors, individual interviews were carried out. The psychologist found that the cases tended to have one or both parents absent from home due to divorce or death, and their family have been damaged by eco-nomic problems. In addition, psychological testing showed that these cases had higher anxiety levels than controls. Discussion According to our findings, this outbreak appears as a Epidemic Conversion Disorder. First, no biologic cause was found for the cases. In addition, there was not any evidence to implicate food poisoning, no source of toxic gas could be identified at the school, and the levels of air pollution were not above normal levels. The clinical presentation was not different from the fainting and paresthesia reported in others studies, nor was sex distribution. One possible explanation for the initial case was the time of sun exposure in the schoolyard. Subsequent spread of the outbreak was due to psychological and extra-medical factors, including publicity by the mass media. Interestingly the spread was stopped immediately after closure of the school for one day. All the findings of the psychological reports, applied by another researcher group add further weight to this conclusion. In support to our results, many studies has been reported in which the clinical manifestations are the same that we found. In these reports, the outbreak occurred frequently among women, teenagers, students of elementary and secondary schools and chorus, in whom no organic etiology or precipitant causes can be identified. Some authors have reported that the phenomena is more evident in groups with hormonal changes, rigid discipline used in music bands, and during periods of exams or situations under stress. Such circumstances are more related to the outbreak. Some studies have demonstrated that dysfunctional families, divorced or dead parents, play a mayor role in comparison with other factors such as socioeconomic level, religion or ethnicity. The mechanisms of these events have not been clearly identified. The typical course of a psychogenic epidemic at a workplace progresses from sudden onset, often with dramatic symptoms, to a rapidly attained peak that draws much publicity and is followed by quick disappearance of the symptoms. Over 90% of the affected people are women, and the signs range from dizziness, vomiting, nausea, and fainting to epileptic type seizures, and hyperventilation. Predisposing factors include boredom, physical stressors, poor labor-management relations, impaired interpersonal communications and lack of social support. The rapid spread in the conversion disorder, is by visual contact; the treatment should be directed towards the underlying stressors but the out-break may be prolonged. In Epidemic Conversion Disorder the abnormality is confined to group interactions. This outbreak shows the importance of psychological support in populations with risk factors of presenting the illness. The social problems among large populations produce an unforgettable painful experience, mainly among teenagers who dealt with the psychological damage with-out any support.

Asociación del genotipo de la il-1b + 3953 en pacientes con y sin enfermedad periodontal crónica: Medellín 2004 estudio de casos y controles / Case and control study of the association of il-1b +3953 in patients with chronic periodontal disease: Medellín 2004

La enfermedad periodontal presenta una etiología multifactorial donde están implicados varios factores de riesgo, entre ellos la interleuqina 1Beta, citoquina proinflamatoria asociada con reabsorción ósea y con el catabolismo de la matriz extracelular. Se han descrito polimorfismos genéticos en la interleuqina -1, entre ellos, la presencia del alelo 2 en la IL-1b+3953, asociada a pacientes no fumadores, 60 con enfermedad periodontal crónica moderada o severa y 60 pacientes sanos. Se realizaron evaluaciones clínicas para el grupo control; el grupo caso fue seleccionado radiográficamente. Para determinar el genotipo, se extrajo el DNA de muestras salivares, se utilizó el método de reacción en cadena de polimerasa (PCR), digestión de enzimas de restricción (RFLP) y electroforésis. Se encontró el alelo 2 para la IL-1â+3953 (genotipo homocigótico ½ + genotipo heterocigótico 2/2), en el 32.5 por ciento y no se observaron diferencias estadísticamente significativas entre casos y controles para la presencia del alelo 2 de la IL-1â+3953. (59 por ciento vs 41 por ciento). En este estudio no se encontró asociación entre el polimorfismo de la IL-1B+3953 y la presencia de enfermedad periodontal crónica severa. Se sugiere otros estudios donde se evalúen otros alelos para la interleuquina 1...