Epigenetic mechanisms of particulate matter exposure: air pollution and hazards on human health.

Environmental pollution nowadays has not only a direct correlation with human health changes but a direct social impact. Epidemiological studies have evidenced the increased damage to human health on a daily basis because of damage to the ecological niche. Rapid urban growth and industrialized societies importantly compromise air quality, which can be assessed by a notable accumulation of air pollutants in both the gas and the particle phases. Of them, particulate matter (PM) represents a highly complex mixture of organic and inorganic compounds of the most variable size, composition, and origin. PM being one of the most complex environmental pollutants, its accumulation also varies in a temporal and spatial manner, which challenges current analytical techniques used to investigate PM interactions. Nevertheless, the characterization of the chemical composition of PM is a reliable indicator of the composition of the atmosphere, the quality of breathed air in urbanized societies, industrial zones and consequently gives support for pertinent measures to avoid serious health damage. Epigenomic damage is one of the most promising biological mechanisms of air pollution-derived carcinogenesis. Therefore, this review aims to highlight the implication of PM exposure in diverse molecular mechanisms driving human diseases by altered epigenetic regulation. The presented findings in the context of pan-organic cancer, fibrosis, neurodegeneration and metabolic diseases may provide valuable insights into the toxicity effects of PM components at the epigenomic level and may serve as biomarkers of early detection for novel targeted therapies.

Early Feeding versus Traditional Feeding in Children with Ileostomy Closure.

Context: Elective intestinal anastomosis is a frequently used surgical procedure in pediatric surgery. Aims: This study aimed to compare postoperative complications and hospital stay in children who underwent ileostomy closure with early feeding in the 1st 24 h versus those in whom the oral route was initiated traditionally. Settings and Design: Observational, comparative, cross-sectional, ambispective, and single-center study that included pediatric patients who had undergone ileostomy closure from January 2017 to August 2019. Materials and Methods: Data were analyzed in SPSS. Statistical analysis was used: the variables were analyzed using the Chi-square test or Fisher's exact test when the former could not be applied. Results: They were divided into the following two groups: group 1 included patients who started the oral route early (n = 25) and Group 2 included patients who started the oral route late (n = 20). The average in-hospital stay for Group 1 was 5.48 days and that for Group 2 was 8.35 days. In Group 1, the oral route was started with a mean of 9.32 h and in Group 2 at 146.4 h. Those in Group 1 at 32.9 h presented their first evacuation and Group 2 at 131.45 h. Group 1 reached their normal diet on average at 79.96 h and Group 2 at 172.8 h. Conclusions: This comparison between early oral feeding and traditional oral feeding suggests that various benefits exist when enteral nutrition is initiated early after ileostomy closure in pediatric patients. The benefits and importance of initiating early oral feeding in adults have been reported, but there are few studies on pediatric populations.

Epigenetic Regulation in Exposome-Induced Tumorigenesis: Emerging Roles of ncRNAs.

Environmental factors, including pollutants and lifestyle, constitute a significant role in severe, chronic pathologies with an essential societal, economic burden. The measurement of all environmental exposures and assessing their correlation with effects on individual health is defined as the exposome, which interacts with our unique characteristics such as genetics, physiology, and epigenetics. Epigenetics investigates modifications in the expression of genes that do not depend on the underlying DNA sequence. Some studies have confirmed that environmental factors may promote disease in individuals or subsequent progeny through epigenetic alterations. Variations in the epigenetic machinery cause a spectrum of different disorders since these mechanisms are more sensitive to the environment than the genome, due to the inherent reversible nature of the epigenetic landscape. Several epigenetic mechanisms, including modifications in DNA (e.g., methylation), histones, and noncoding RNAs can change genome expression under the exogenous influence. Notably, the role of long noncoding RNAs in epigenetic processes has not been well explored in the context of exposome-induced tumorigenesis. In the present review, our scope is to provide relevant evidence indicating that epigenetic alterations mediate those detrimental effects caused by exposure to environmental toxicants, focusing mainly on a multi-step regulation by diverse noncoding RNAs subtypes.

Protocolos de ultrasonografía en una Unidad Pediátrica de Quemados / Ultrasonography protocols in a Pediatric Burn Unit / Protocolos de ultrassom em uma unidade de queimados pediátrica

Resumen: Introducción: En las unidades pediátricas de quemados se atienden pacientes de urgencias y cuidados intensivos. La aplicación del ultrasonido como herramienta básica en el cuidado de pacientes gravemente enfermos en tiempo real, ha permitido responder a preguntas específicas sobre su condición clínica y se utiliza como una herramienta que guía diferentes procedimientos necesarios para el cuidado adecuado de este tipo de pacientes. Con estos antecedentes, y además del hecho de que el entorno de cuidados críticos está integrando las aplicaciones básicas del ultrasonido al monitoreo no invasivo, consideramos importante revisar los usos de la ecografía en una unidad pediátrica de quemados. Objetivo: Presentar los aspectos más importantes de los protocolos de ultrasonido más comunes en una unidad pediátrica de quemados. Material y métodos: Se realizó un estudio retrospectivo, observacional, descriptivo, longitudinal y homodémico sobre protocolos de ultrasonido en la Unidad de Quemados de los Servicios de Salud del Estado de Puebla anexa al Hospital para el Niño Poblano, especificando su importancia en la toma de decisiones en el manejo integral de pacientes pediátricos quemados. Resultados: Se encontró que cuatro protocolos eran los más utilizados en los pediátricos quemados: Focus Assessment Sonography in Trauma, Rapid Ultrasound In Shock, ecocardiografía enfocada y diámetro de la vaina del nervio óptico. Conclusión: La ecografía está cubriendo un campo más amplio en unidades de cuidados intensivos pediátricos. En la Unidad de Quemados de los Servicios de Salud del Estado de Puebla consideramos que es una herramienta de diagnóstico que no se puede posponer.

Abstract: Introduction: In pediatric burn units, emergency and intensive care patients are attended. The application of ultrasound as a basic tool in the care of seriously ill patients in real time, has allowed responding to specific questions about their clinical condition and used as a tool that guides different procedures necessary in the proper care of this type of patients. With this background and in addition to the fact that the critical care environment is integrating the basic applications of ultrasound in non-invasive monitoring, we consider it important to review the uses of ultrasonography in a pediatric burn unit. Objective: To present the most important aspects of the most common ultrasound protocols in a pediatric burn unit. Material and methods: A retrospective, observational, descriptive, longitudinal and homodemic study was conducted on ultrasound protocols in the Unidad de Quemados de los Servicios de Salud del Estado de Puebla anexa al Hospital para el Niño Poblano, specifying its importance in the decision making in the integral management of burned pediatric patients. Results: Four protocols were found to be the most used in the burned pediatric patients: FAST, RUSH, focused echocardiography and DVNO. Conclusion: Ultrasound is covering a wider field in pediatric intensive care units. In the Unidad de Quemados de los Servicios de Salud del Estado de Puebla we consider that it is a diagnostic tool that can not be postponed.

Resumo: Introdução: Nas unidades de queimados pediátrica são atendidos pacientes de emergência e terapia intensiva. A aplicação do ultrassom como ferramenta básica no atendimento de pacientes graves em tempo real, permitiu-nos responder a perguntas específicas sobre sua condição clínica e é utilizada como ferramenta que orienta os diferentes procedimentos necessários para o atendimento adequado desse tipo de paciente. Com esse pano de fundo e além do fato de o ambiente de cuidados intensivos integrar as aplicações básicas do ultrassom ao monitoramento não invasivo, consideramos importante revisar os usos do ultrassom em uma unidade de queimados pediátrica. Objetivo: Apresentar os aspectos mais importantes dos protocolos de ultrassom mais comuns em uma unidade de queimados pediátrica. Material e métodos: Foi realizado um estudo retrospectivo, observacional, descritivo, longitudinal e homodêmico dos protocolos de ultrassom no UQSSEP-HNP, especificando sua importância na tomada de decisão no manejo integral de pacientes pediátricos queimados. Resultados: Verificou-se que quatro protocolos foram os mais utilizados em pacientes pediátricos queimados: FAST, RUSH, ecocardiografia focada e DVNO. Conclusão: O ultrassom está cobrindo um campo mais amplo nas unidades de terapia intensiva pediátrica. No UQSSEP, consideramos uma ferramenta de diagnóstico que não pode ser posposta.