International External Validation of Risk Prediction Model of 90-Day Mortality after Gastrectomy for Cancer Using Machine Learning.

BACKGROUND: Radical gastrectomy remains the main treatment for gastric cancer, despite its high mortality. A clinical predictive model of 90-day mortality (90DM) risk after gastric cancer surgery based on the Spanish EURECCA registry database was developed using a matching learning algorithm. We performed an external validation of this model based on data from an international multicenter cohort of patients. METHODS: A cohort of patients from the European GASTRODATA database was selected. Demographic, clinical, and treatment variables in the original and validation cohorts were compared. The performance of the model was evaluated using the area under the curve (AUC) for a random forest model. RESULTS: The validation cohort included 2546 patients from 24 European hospitals. The advanced clinical T- and N-category, neoadjuvant therapy, open procedures, total gastrectomy rates, and mean volume of the centers were significantly higher in the validation cohort. The 90DM rate was also higher in the validation cohort (5.6%) vs. the original cohort (3.7%). The AUC in the validation model was 0.716. CONCLUSION: The externally validated model for predicting the 90DM risk in gastric cancer patients undergoing gastrectomy with curative intent continues to be as useful as the original model in clinical practice.

NADPH oxidase 2 activity disrupts Calmodulin/CaMKIIα complex via redox modifications of CaMKIIα-contained Cys30 and Cys289: Implications in Parkinson's disease.

Ca2+/calmodulin-dependent protein kinase II α (CaMKIIα) signaling in the brain plays a critical role in regulating neuronal Ca2+ homeostasis. Its dysfunctional activity is associated with various neurological and neurodegenerative disorders, including Parkinson's disease (PD). Using computational modeling analysis, we predicted that, two essential cysteine residues contained in CaMKIIα, Cys30 and Cys289, may undergo redox modifications impacting the proper functioning of the CaMKIIα docking site for Ca2+/CaM, thus impeding the formation of the CaMKIIα:Ca2+/CaM complex, essential for a proper modulation of CaMKIIα kinase activity. Our subsequent in vitro investigations confirmed the computational predictions, specifically implicating Cys30 and Cys289 residues in impairing CaMKIIα:Ca2+/CaM interaction. We observed CaMKIIα:Ca2+/CaM complex disruption in dopamine (DA) nigrostriatal neurons of post-mortem Parkinson's disease (PD) patients' specimens, addressing the high relevance of this event in the disease. CaMKIIα:Ca2+/CaM complex disruption was also observed in both in vitro and in vivo rotenone models of PD, where this phenomenon was associated with CaMKIIα kinase hyperactivity. Moreover, we observed that, NADPH oxidase 2 (NOX2), a major enzymatic generator of superoxide anion (O2●-) and hydrogen peroxide (H2O2) in the brain with implications in PD pathogenesis, is responsible for CaMKIIα:Ca2+/CaM complex disruption associated to a stable Ca2+CAM-independent CaMKIIα kinase activity and intracellular Ca2+ accumulation. The present study highlights the importance of oxidative stress, in disturbing the delicate balance of CaMKIIα signaling in calcium dysregulation, offering novel insights into PD pathogenesis.

Association of embryonic inositol status with susceptibility to neural tube defects, metabolite profile, and maternal inositol intake.

Maternal nutrition contributes to gene-environment interactions that influence susceptibility to common congenital anomalies such as neural tube defects (NTDs). Supplemental myo-inositol (MI) can prevent NTDs in some mouse models and shows potential for prevention of human NTDs. We investigated effects of maternal MI intake on embryonic MI status and metabolism in curly tail mice, which are genetically predisposed to NTDs that are inositol-responsive but folic acid resistant. Dietary MI deficiency caused diminished MI in maternal plasma and embryos, showing that de novo synthesis is insufficient to maintain MI levels in either adult or embryonic mice. Under normal maternal dietary conditions, curly tail embryos that developed cranial NTDs had significantly lower MI content than unaffected embryos, revealing an association between diminished MI status and failure of cranial neurulation. Expression of inositol-3-phosphate synthase 1, required for inositol biosynthesis, was less abundant in the cranial neural tube than at other axial levels. Supplemental MI or d-chiro-inositol (DCI) have previously been found to prevent NTDs in curly tail embryos. Here, we investigated the metabolic effects of MI and DCI treatments by mass spectrometry-based metabolome analysis. Among inositol-responsive metabolites, we noted a disproportionate effect on nucleotides, especially purines. We also found altered proportions of 5-methyltetrahydrolate and tetrahydrofolate in MI-treated embryos suggesting altered folate metabolism. Treatment with nucleotides or the one-carbon donor formate has also been found to prevent NTDs in curly tail embryos. Together, these findings suggest that the protective effect of inositol may be mediated through the enhanced supply of nucleotides during neural tube closure.

15-Lipoxygenase-Mediated Lipid Peroxidation Regulates LRRK2 Kinase Activity.

Mutations in leucine-rich repeat kinase 2 (LRRK2) that increase its kinase activity are strongly linked to genetic forms of Parkinson's disease (PD). However, the regulation of endogenous wild-type (WT) LRRK2 kinase activity remains poorly understood, despite its frequent elevation in idiopathic PD (iPD) patients. Various stressors such as mitochondrial dysfunction, lysosomal dyshomeostasis, or vesicle trafficking deficits can activate WT LRRK2 kinase, but the specific molecular mechanisms are not fully understood. We found that the production of 4-hydroxynonenal (4-HNE), a lipid hydroperoxidation end-product, is a common biochemical response to these diverse stimuli. 4-HNE forms post-translational adducts with Cys2024 and Cys2025 in the kinase activation loop of WT LRRK2, significantly increasing its kinase activity. Additionally, we discovered that the 4-HNE responsible for regulating LRRK2 is generated by the action of 15-lipoxygenase (15-LO), making 15-LO an upstream regulator of the pathogenic hyperactivation of LRRK2 kinase activity. Pharmacological inhibition or genetic ablation of 15-LO prevents 4-HNE post-translational modification of LRRK2 kinase and its subsequent pathogenic hyperactivation. Therefore, 15-LO inhibitors, or methods to lower 4-HNE levels, or the targeting of Cys2024/2025 could provide new therapeutic strategies to modulate LRRK2 kinase activity and treat PD.

AAV-mediated expression of mouse or human GLDC normalises metabolic biomarkers in a GLDC-deficient mouse model of Non-Ketotic Hyperglycinemia.

Non-Ketotic Hyperglycinemia (NKH) is a rare inborn error of metabolism caused by impaired function of the glycine cleavage system (GCS) and characterised by accumulation of glycine in body fluids and tissues. NKH is an autosomal recessive condition and the majority of affected individuals carry mutations in GLDC (glycine decarboxylase). Current treatments for NKH have limited effect and are not curative. As a monogenic condition with known genetic causation, NKH is potentially amenable to gene therapy. An AAV9-based expression vector was designed to target sites of GCS activity. Using a ubiquitous promoter to drive expression of a GFP reporter, transduction of liver and brain was confirmed following intra-venous and/or intra-cerebroventricular administration to neonatal mice. Using the same capsid and promoter with transgenes to express mouse or human GLDC, vectors were then tested in GLDC-deficient mice that provide a model of NKH. GLDC-deficient mice exhibited elevated plasma glycine concentration and accumulation of glycine in liver and brain tissues as previously observed. Moreover, the folate profile indicated suppression of folate one­carbon metabolism (FOCM) in brain tissue, as found at embryonic stages, and reduced abundance of FOCM metabolites including betaine and choline. Neonatal administration of vector achieved reinstatement of GLDC mRNA and protein expression in GLDC-deficient mice. Treated GLDC-deficient mice showed significant lowering of plasma glycine, confirming functionality of vector expressed protein. AAV9-GLDC treatment also led to lowering of brain tissue glycine, and normalisation of the folate profile indicating restoration of glycine-derived one­carbon supply. These findings support the hypothesis that AAV-mediated gene therapy may offer potential in treatment of NKH.

In vitro antitumor effects of aqueous extract and protease inhibitors from Sterculia striata st. Hil. et naud and metabolite profiling.

The present study aims to assess the cytotoxic effect of the aqueous and protease inhibitors extracts of Sterculia striata on breast cancer cell lines. The in vitro results showed significant reductions in the highest concentrations from the S. striata seed extract for all cell lines. The aqueous extract reduced the viability by up to 35% in the MCF-7, 25% in the 4T1, and 35% in the MDA-MB-231 cell lines. Regarding the protease inhibitor extract, a 50% reduction in cell viability was observed in the MDA-MB-231 at concentration of 333 µg/mL. The aqueous and the protease inhibitor extracts showed mild reduction in the viability of macrophage cell lines. Chemical characterisation analysis revealed several polyphenols such as flavonoids, tannins, phenolic acids, and other secondary metabolites including terpenes, steroids, fatty acids, and organic acids, which may be related to the promising bioactivity observed. The S. striata showed antitumor activity, emphasising its pharmacological potential.

The Differential Translation Capabilities of the Human DHFR2 Gene Indicates a Developmental and Tissue-Specific Endogenous Protein of Low Abundance.

A functional role has been ascribed to the human dihydrofolate reductase 2 (DHFR2) gene based on the enzymatic activity of recombinant versions of the predicted translated protein. However, the in vivo function is still unclear. The high amino acid sequence identity (92%) between DHFR2 and its parental homolog, DHFR, makes analysis of the endogenous protein challenging. This paper describes a targeted mass spectrometry proteomics approach in several human cell lines and tissue types to identify DHFR2-specific peptides as evidence of its translation. We show definitive evidence that the DHFR2 activity in the mitochondria is in fact mediated by DHFR, and not DHFR2. Analysis of Ribo-seq data and an experimental assessment of ribosome association using a sucrose cushion showed that the two main Ensembl annotated mRNA isoforms of DHFR2, 201 and 202, are differentially associated with the ribosome. This indicates a functional role at both the RNA and protein level. However, we were unable to detect DHFR2 protein at a detectable level in most cell types examined despite various RNA isoforms of DHFR2 being relatively abundant. We did detect a DHFR2-specific peptide in embryonic heart, indicating that the protein may have a specific role during embryogenesis. We propose that the main functionality of the DHFR2 gene in adult cells is likely to arise at the RNA level.

Does parental stress improve after pediatric tonsillectomy?

OBJETIVE: Parental stress is defined as a subjective perception that parenting demands are higher than their resources and is reportedly higher in parents who have children with both chronic and acute illnesses. Ear-nose-throat (ENT) disorders, such as recurrent infections and obstruction sleep disorders, are one of the most prevalent comorbidities in pediatric age. Worldwide, tonsillectomy stands as the surgical treatment for these conditions, associated with a significant burden on both the children and their parents. The purpose of this study is to determine parental stress levels before and after tonsillectomy and to ascertain whether these levels improve after the children's surgery. METHODS: This is a prospective cohort study enrolling 48 parents accompanying their children aged 3-10 for outpatient tonsillectomy surgery in a tertiary portuguese hospital. Consent for participation in this study was obtained and parental stress was determined using the portuguese version of Parental Stress Scale (PSS). All parents completed PSS before surgery and at the 6-month follow-up evaluation. RESULTS: Of the 48 surveys obtained, 38 were mothers aged from 24 to 45 years. The median age of children was 3 (3-9) years and half were girls. Surgery was performed due to obstruction sleep disorders in about 71 % of children. The overall average stress level was 29,19 (standard deviation 7,5), with higher scores being associated with male children. At the 6-month reevaluation PSS was significantly lower (26,98), with a prominent reduction in the parental stress subscale in mothers comparing to fathers. CONCLUSIONS: These results highlight the importance of prompt diagnosis and treatment of children requiring tonsillectomy, as this condition may affect not only their physical health, but also parental relations, reflecting on their upbringing.

Tumor necrosis factor α, and agonist and antagonists of cannabinoid receptor type 1 and type 2 alter the immunophenotype of stem cells from human exfoliated deciduous teeth

ABSTRACT Objective To verify the involvement of the endocannabinoid system in the immunomodulatory profile of stem cells from human exfoliated deciduous teeth, in the presence or absence of TNF-α, and agonist and antagonists of CB1 and CB2. Methods Stem cells from human exfoliated deciduous teeth were cultured in the presence or absence of an agonist, anandamide, and two antagonists, AM251 and SR144528, of CB1 and CB2 receptors, with or without TNF-α stimulation. For analysis of immunomodulation, surface molecules linked to immunomodulation, namely human leukocyte antigen-DR isotype (HLA-DR), and programmed death ligands 1 (PD-L1) and 2 (PD-L2) were measured using flow cytometry. Results The inhibition of endocannabinoid receptors together with the proinflammatory effect of TNF-α resulted in increased HLA-DR expression in stem cells from human exfoliated deciduous teeth, as well as, in these cells acquiring an anti-inflammatory profile by enhancing the expression of PD-L1 and PD-L2. Conclusion Stem cells from human exfoliated deciduous teeth respond to the endocannabinoid system and TNF-α by altering key immune response molecules.

Dermatomiositis paraneoplásica como presentación de linfoma. Reporte de caso y revisión de la literatura / Paraneoplastic dermatomyositis as presentation of lymphoma. Case report and literature review

RESUMEN Los síndromes paraneoplásicos neurológicos se presentan en menos del 1% de los tumores sólidos y son infrecuentes en linfomas. Se asocian a tumores con alta actividad biológica y condicionan deterioro funcional y discapacidad. La dermatomiositis se asocia a cáncer, por tanto obliga al estudio de neoplasias ocultas; su diagnóstico como síndrome paraneoplásico se establece con criterios específicos. El pronóstico funcional depende del diagnóstico oportuno, control del cáncer y de la regulación de la respuesta inmunológica. Se presenta el caso de una mujer de 65 años con dermatomiositis en el curso de un linfoma B marginal variante convencional de primario cutáneo.

ABSTRACT Neurological paraneoplastic syndromes occur in less than 1% of solid tumours and are uncommon in lymphomas. They are related to tumours with high biological activity and cause functional impairment and disability. Dermatomyositis is associated with cancer, and requires the study of hidden neoplasms. Its diagnosis as a paraneoplastic syndrome is established with specific criteria. Functional prognosis depends on early diagnosis, cancer control, and regulation of the immune response. The case is presented of a 65 year-old woman with dermatomyositis during the course of a conventional variant of a primary cutaneous B marginal lymphoma.

Hemangiolinfangioma con extensión abdominal y pélvica. Reporte de caso / Hemangiolymphangioma with abdominal and pelvic extension. Case report

El hemangiolinfangioma es una malformación vascular de rara ocurrencia. Posee componentes mixtos, venosos y linfáticos, y su manejo es limitado en casos de gran extensión. Se presenta el caso de un hombre con alteración vascular de bajo flujo, de predominio linfático, con extensión intrabdominal, retroperitoneal, pélvica y de miembros inferiores.

Hemangiolymphangioma is a vascular malformation of rare occurrence. It has mixed venous and lymphatic components and its management is limited in cases of large extension. We present the case of a man with low-flow vascular alteration, predominantly lymphatic, with intra-abdominal, retroperitoneal, pelvic and lower limb extension.

Telemedicina una alternativa de atención durante la pandemia por Covid-1 / Telemedicine an alternative for medical practice during the Covid-19 pandemic. Review Article

La aparición de la pandemia por Covid-19, su alto contagio e impacto en la salud de poblaciones vulnerables y la necesidad de distanciamiento social, obligó a adaptar rápidamente los procesos de atención ambulatoria a pacientes por medio de herramientas tecnológicas con eventos de atención no presencial (teleconsulta). El propósito de este artículo es revisarla información más relevante sobre el uso de la telemedicina y su impacto actual

The emergence of the Covid-19 pandemic, its high contagion and impact on the health of vulnerable populations and the need for social distancing, forced the rapid adaptation of outpatient care processes by means of technological tools with non-face-to-face care events (teleconsultation). The purpose of this article is to review the most relevant information on the use of telemedicine and its current impact.

Compromiso del Sistema Nervioso Periférico en la infección por Sars-CoV-2 / Peripheral Nervous System involvement in Sars-CoV-2 infection

En diciembre de 2019 en China, inicia una de las pandemias más complejas del último siglo. En efecto, la infección por Sars-CoV-2 o Covid-19, como fue denominada por la Organización Mundial de la Salud, es sin duda una emergencia en salud pública que ha requerido implementar modificaciones de los sistemas de salud en el mundo para su atención. Los síntomas respiratorios son la base de las principales complicaciones de esta infección; sin embargo, se encuentra disponible información relevante sobre las manifestaciones neurológicas asociadas al Sars-CoV-2, en especial con relación al compromiso del sistema nervioso central (SNC); por el contrario, los estudios sobre el impacto del nervio periférico son más escasos. La presente revisión se centra en las manifestaciones neurológicas periféricas asociadas al Covid-19.

In December 2019 in China, one of the most complex pandemics of the last century begins. Indeed, the Sars-CoV-2 or Covid-19 infection, as it was named by the World Health Organization, is undoubtedly a public health emergency that has required the implementation of modifications in the world's health systems for its care. Respiratory symptoms are the basis of the main complications of this infection; however, relevant information is available on the neurological manifestations associated with Sars-CoV-2, especially in relation to central nervous system (CNS) involvement; in contrast, studies on the impact of the peripheral nerve are scarcer. The present review focuses on the peripheral neurological manifestations associated with Covid-19.

Adaptation and validation of the gratitude questionnaire GQ-6 for the Ecuadorian context / Adaptação e validação do questionário de gratidão GQ-6 para o contexto equatoriano / Adaptación y validación del cuestionario de gratitud GQ-6 para el contexto ecuatoriano

This paper evaluates the factor structure, reliability and validity of the gratitude scale (GQ-6) of McCullough, Emmons and Tsang (2002) and the five-item version proposed by Chen et al. (2009). Results of a sample of 1112 adults show that the fiveitem version has excellent internal consistency (α=.926; ω=.891; GLB=.913); high and significant factor loadings (greater than .8; p<.01), and excellent goodness of fit indexes (χ²(5)=23.837, p<.001; CFI=.997; TLI=.995; RMSEA=.082, p=.045; SRMSR=.035; WRMSR=.837). The criterion validity was evaluated applying subscales of the PERMA-Profiler: positive emotions (ρ=.5702, p=.021) and negative emotions (ρ=-.1786, p=.0316). Finally, we find psychometric equivalence between the sex of the participants. In conclusion, the five-item questionnaire is valid and reliable in the Ecuadorian context. (AU)

Este estudo avalia a estrutura fatorial, a confiabilidade e a validade da Escala de Gratidão (GQ-6) de McCullough, Emmons e Tsang (2002) e a versão de cinco itens proposta por Chen et al. (2009). Resultados de uma amostra de 1.112 adultos mostram que a versão de cinco itens tem excelente consistência interna (α=0,926; ω=0,891; GLB=0,913); cargas fatoriais altas e significativas (maior que 0,8; p<0,01), e excelentes índices de qualidade de ajuste (χ²(5)=23,837, p<0,001; CFI=0,997; TLI=0,995; RMSEA=0,082, p=0,045; SRMSR=0,035; WRMSR=0,837). A validade de critério foi avaliada aplicando-se subescalas do PERMA-Profiler: emoções positivas (ρ=0,5702, p=0,021) e emoções negativas (ρ=-0,1786, p=0,0316). Finalmente, encontra-se equivalência psicométrica entre o sexo dos participantes. Em conclusão, o questionário de cinco itens é válido e confiável no contexto equatoriano. (AU)

Este estudio evalúa la estructura factorial, la confiabilidad y la validez de la escala de gratitud (GQ-6) de McCullough, Emmons y Tsang (2002) y la versión de cinco ítems propuesta por Chen et al. (2009). Resultados de una muestra de 1112 adultos indican que la versión de cinco ítems tiene excelente consistencia interna (α=.926; ω=.891; GLB=.913); cargas factoriales altas y significativas (mayores a .8; p < .01), y excelentes índices de calidad de ajuste (χ²(5)=23.837, p<.001; CFI=.997; TLI=.995; RMSEA=.082, p=.045; SRMSR=.035; WRMSR=.837). La validez de criterio se evaluó aplicando subescalas del PERMA-Profiler: emociones positivas (ρ=.5702, p=.021) y emociones negativas (ρ=-.1786, p=.0316). Finalmente, se ha encontrado equivalencia psicométrica entre el sexo de los participantes. En conclusión, el cuestionario de cinco ítems es válido y fiable en el contexto ecuatoriano. (AU)

Aproximación de discapacidad en artritis reumatoide. Resultados de un programa de atención integral / Approach to disability in rheumatoid arthritis. Results of a comprehensive care program

Resumen Introducción: Los modelos de atención en artritis reumatoide consideran el abordaje sintomático y la intervención de discapacidad; sin embargo, es importante un modelo que integre los avances en el manejo farmacológico y las estrategias no farmacológicas. Materiales y métodos: Estudio retrospectivo, descriptivo, transversal, en el que incluimos a 640 pacientes con diagnóstico de artritis reumatoide que estaban participando en un programa de atención integral ambulatoria; tomamos las primeras valoraciones realizadas por terapia ocupacional con la evaluación funcional completa que incluían: índice de Barthel, escala Quick DASH y Health Assessment Questionnaire. El nivel de actividad de la enfermedad se calculó a través del DAS28. Resultados: Se evidenciaron puntuaciones más altas del HAQ a medida que el nivel de actividad de la enfermedad aumenta; no se encontraron diferencias significativas en cuanto al nivel de actividad de la enfermedad entre los sujetos que laboran y los que no. Encontramos una baja asociación entre el DAS28 y el Quick DASH en sus 2 módulos de evaluación (r = 0,399 para el instrumental y r = 0,291 para el módulo laboral; p < 0,005). De los 350 sujetos, el 66,7% presentó algún grado de actividad de la enfermedad y el porcentaje de pacientes que calificaron una limitación de moderada a severa en la función de su extremidad superior fue del 66,1% para el módulo laboral y del 84,75% para el módulo instrumental, con mayor limitación funcional a medida que aumenta el nivel de actividad de la enfermedad. Conclusiones: Este estudio ha permitido reevaluar dentro del programa la aplicación de escalas genéricas que abordan de forma general la funcionalidad.

Abstract Introduction: Although rheumatoid arthritis care models consider a symptomatic approach and intervention of disability, it is also important to have a model that integrates advances in the pharmacological management, as well as non-drug treatment strategies. Materials and methods: A descriptive cross-sectional retrospective study was conducted that included 640 patients diagnosed with rheumatoid arthritis and in an outpatient comprehensive care program. The first assessments made by occupational therapy with a full functional evaluation including the Barthel index, Quick DASH scale, and the Health Assessment Questionnaire. The activity of the disease was calculated using DAS28. Results: Higher HAQ scores were observed as the level of disease activity increased. There were no significant differences in the level of activity of the disease among subjects who worked and those who did not. A low correlation was found between the DAS28 and the Quick DASH in 2 evaluation modules (r=.399 for instrumental and r=.291 for the work module) (P<.005). Of the 350 subjects, 66.7% had some degree of disease activity and the percentage of patients shown to have a moderate to severe limitation in the functioning of the upper limb was 66.1% for the work module and 84.75% for the instrumental module, showing a greater functional limitation as the level of disease activity increased. Conclusion: This study has reassessed the applying of generic scales that deal with generally functionality, within the care program.

Valores de referencia de los estudios de Neuroconducción de miembros inferiores en adultos jóvenes / Young adults' lower limb neuroconduction study reference values

Objetivo Establecer valores de referencia de los estudios de neuroconducción de los nervios peroneo, tibial y sural en un grupo de adultos jóvenes. Materiales y Métodos Se realizaron neuroconducciones en 155 sujetos asintomáticos, de los nervios tibial, peroneo y sural, usando técnicas convencionales actuales y previo consentimiento informado. Se obtuvieron valores de referencia presentados con promedios, desviaciones estándar, percentiles y su correlación con parámetros como edad, peso y estatura a través de un análisis bivariado de correlación lineal utilizando la prueba de Spearman. Resultados Para el nervio peroneo el promedio de la latencia distal fue de 3,6ms (DE 0,4), la amplitud fue de 6,1mV (DE 2,0) y la velocidad de conducción 54,8m/s (DE 4,2). Para el nervio tibial el promedio de la latencia distal fue de 3,5ms (DE 0,4), la amplitud fue de 16,7mV (DE 4,7) y la velocidad de conducción 53m/s (DE 3,8). Para el nervio sural el promedio de la latencia al pico fue de 3,4ms (DE 0,3), la amplitud fue de 21,3mV (DE 5,0). El límite superior de la variación normal de la latencia lado a lado para el nervio peroneo y tibial fue de 0,8ms (promedio + 2DE) y para el nervio sural fue de 0,4ms (promedio + 2DE). Se encontró relación estadísticamente significativa con variables como peso, estatura y edad. Conclusiones Los valores obtenidos pueden ser utilizados en los laboratorios de electrofisiología de nuestro país como referencia en la evaluación de pacientes con patologías musculoesqueléticas y con diferentes tipos de polineuropatía.

Objective Establishing reference values for neuroconduction studies regarding the peroneal, tibial and sural nerves in a group of young adults. Materials and Methods Neuroconduction was tested (also known as nerve conduction velocity (NCV) tests) on 155 asymptomatic subjects' tibial, peroneal and sural nerves using current conventional techniques, after informed written consent had been obtained. Reference values were obtained and presented as averages, standard deviations and percentiles, along with their correlation with parameters such as age, weight and height, via bivariate analysis of linear correlation using Spearman's rank correlation test. Results Peroneal nerve average distal latency was 3.6ms (0.4 SD), amplitude 6.1mV (2.0 SD) and conduction velocity 54.8m/s (4.2 SD). Average tibial nerve distal latency was 3.5ms (0.4 SD), amplitude 16.7mV (4.7 SD) and conduction velocity 53m/s (3.8 SD). Average sural nerve peak latency was 3.4ms (0.3 SD) and amplitude 21.3V (5.0 SD). Peroneal and tibial nerve upper limit of normal side to side variation was 0.8ms (average+2DE) and 0.4ms (average + 2 SD) for the sural nerve. A statistically significant relationship was found with variables such as weight, height and age. Conclusions The values so obtained could be used in Colombia's electrophysiology laboratories as reference in evaluating patients' suffering musculoskeletal pathologies and different types of polyneuropathy.

Lower production of IL-17A and increased susceptibility to Mycobacterium bovis in mice coinfected with Strongyloides venezuelensis

The presence of intestinal helminths can down-regulate the immune response required to control mycobacterial infection. BALB/c mice infected with Mycobacterium bovis following an infection with the intestinal helminth Strongyloides venezuelensis showed reduced interleukin-17A production by lung cells and increased bacterial burden. Also, small granulomas and a high accumulation of cells expressing the inhibitory molecule CTLA-4 were observed in the lung. These data suggest that intestinal helminth infection could have a detrimental effect on the control of tuberculosis (TB) and render coinfected individuals more susceptible to the development of TB.

Evaluación fitoquímica y farmacológica de frutos de Erythroxylum minutifolium Griseb: (Erythroxylaceae) / Phytochemical and pharmacological evaluation of the fruits of Erythroxylum minutifolium Griseb: (Erythroxylaceae)

Fundamentos: el género Erythroxylum se encuentra ampliamente representado en Cuba con 21 especies de las cuales 16 son endémicas y algunas se utilizan con fines etnomédicos. Erythroxylum minutifolium Griseb. (Erythoxylaceae) es una especie endémica muy abundante en Cuba, sin embargo, sus frutos no han sido estudiados desde el punto de vista químico ni farmacológico. Objetivos: realizar una evaluación por grupos químicos del extracto total, efectuar el fraccionamiento fitoquímico con disolventes de diferentes polaridades para evaluar la detección de flavonoides, coumarinas y alcaloides y la acción antibacteriana a estos extractos. Métodos: se emplearon los métodos conocidos de detección fitoquímica y para el estudio de actividad antibacteriana se utilizó el ensayo de difusión por discos. Resultados: las evaluaciones fitoquímicas por grupos químicos para el extracto total y del fraccionamiento con 5 disolventes de diferentes polaridades revelan la presencia de flavonoides y la ausencia de alcaloides y coumarinas. El extracto total no muestra actividad antibacteriana frente a Escherichia coli, Pseudomonas aeruginosa y Staphylococcus aureus; mientras que presenta toxicidad hasta valores de 1 mg/mL. Conclusiones: en los frutos de la especie, el extracto total y los disolventes de diferentes polaridades muestran solo la presencia de flavonoides; el extracto total tiene baja toxicidad y no presenta actividad antibacteriana.

Foundations: the genus Erythroxylum is widely represented in Cuba with 21 species of which 18 are endemic and some are used with etnomedical ends. Erythroxylum minutifolium Griseb. (Erythoxylaceae) is a very abundant endemic species in Cuba, however, its fruits have not been studied from the chemical or pharmacological point of view. Objective: to carry out an evaluation of the total extract by chemical groups and to perform the phytochemical fractioning with solvents of different polarities to evaluate the detection of flavonoids, coumarins and alkaloids and the antibacterial action to these extracts. Methods: the known methods of phytochemical detection were used, whereas the by disc difussion test was utilized for the study of antibacterial activity. Results: the phytochemical evaluations by chemical groups for the total extract and of fractioning with 5 solvents of different polarities proved the presence of flavanoids and the absence of alkaloids and coumarins. The total extract did not show antibacterial activity against Escherichia coli, Pseudomonas aeruginosa y Staphylococcus aureus. It presented toxicity up to values of 1 mg/ml. Conclusions: in the fruits of the species, the total extract and the solvents of diverse polarities showed only the presence of flavonoids. The total extract had low toxicity and it did not show antibacterial activity.

Versão brasileira do Dynamic Gait Index / Dynamic Gait Index - Brazilian version

O Dynamic Gait Index (DGI) é um teste que avalia o equilíbrio e marcha do corpo humano. OBJETIVOS: Os objetivos deste estudo foram adaptar culturalmente o DGI para o português e avaliar a sua confiabilidade. MATERIAL E MÉTODO: Seguiu-se o método de Guillemin et al. (1993) para a adaptação cultural do instrumento. Trata-se de estudo prospectivo em que 46 pacientes foram avaliados na fase de adaptação cultural e os itens que apresentaram 20 por cento ou mais de incompreensão foram reformulados e reaplicados. A versão final do DGI em português foi aplicada em 35 idosos para examinar a confiabilidade intra e inter-observadores. O coeficiente de Spearman foi utilizado para correlacionar os escores inter e intra-observador e o teste de Wilcoxon para comparar as pontuações. A consistência interna foi analisada pelo coeficiente alfa de Cronbach. RESULTADOS: Houve correlações estatisticamente significantes entre os escores obtidos às avaliações inter e intra-observadores para todos os itens (p<0,001), classificadas como boa a muito forte (com de variação de r=0,655 a r=0,951). O DGI mostrou alta consistência interna entre seus itens nas avaliações inter e intra-observadores (variação de µ=0,820 a a=0,894). CONCLUSÃO: O DGI foi adaptado culturalmente para o português brasileiro, mostrando-se um instrumento confiável.

The Dynamic Gait Index (DGI) is a useful test to evaluate balance and gait. AIMS: The objectives of this study were to culturally adjust the DGI to the Portuguese language and to assess its reliability. METHODS: The method proposed by Guillemin et al. (1993) was used for a cultural adaptation of this tool. A prospective study was performed with 46 patients that were assessed in the cultural adaptation phase. The items that not understood by 20 percent or more patients were reworded and reapplied. The final Portuguese version of DGI was applied to 35 elderly in order to check intra and interobserver reliability. The Spearman rank coefficient was used to correlate intra and interobserver scores and the Wilcoxon test was applied to compare these scores. Internal consistency was analyzed by the Cronbach alpha coefficient. RESULTS: There were statistically significant correlations among the scores for intra and interobserver assessments for all items (p<0.001), which were classified as good and very strong correlations (ranging from r=0.655 to r=0.951). The DGI demonstrated high internal consistency in intra and interobserver assessments (varying from µ=0.820 to µ=0.894). CONCLUSION: The DGI was culturally adjusted to Brazilian Portuguese and proved to be a reliable tool.

Factores que influyen en la incorporación de un miembro de la familia al proceso de recuperación del paciente hospitalizado / Factors that influence in the addition of one family member to the rehabilitation process of the hospitalized patient

La familia es el comienzo y fin de todo individuo, por esto en presencia de enfermedad todo este núcleo esta involucrado, demostrándose que el apoyo y compañía de los seres queridos influye positivamente en el restablecimiento de la salud. Este trabajo, desarrollado en el Servicio de Pensionado General del Hospital Clínico U.C. durante el mes de agosto 1998, intenta identificar la influencia que tienen los factores familiares, características biosocioculturales, motivación personal y el impacto que la enfermedad tiene en el familiar responsable, los cuales facilitan o dificultan su incorporación al proceso de recuperación. Los resultados obtenidos, considerando una muestra de 55 personas, concluyen que en la mayoría de los casos el familiar responsable son mujeres cuyas características biosicosociales influye positivamente en el desempeño de esta tarea. Así mismo, se puede señalar que aquellos aspectos que han sido afectados, son el ámbito laboral, económico y algunos cambios en la conducta. Los cuales según la apreciación de los encuestados no les impide asumir el cuidado del paciente. El alto interés manifestado por los familiares para integrarse activamente al proceso de recuperación es un aspecto fundamental, que en conjunto con los factores mencionados anteriormente, resulta primordial evaluar a la hora de plantear estrategias de educación