Mexican Clinical Practice Guidelines for Adult Overweight and Obesity Management.

PURPOSE: To develop Mexico's first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers. RECENT FINDINGS: A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and expert consensus. Overweight and obesity negatively impact the health and well-being of individuals and populations in Mexico. This guideline aims to establish a new evidence-based, patient-centered, non-stigmatizing, and practical treatment and management framework, based on the fundamental principles of chronic disease prevention and management.

Voluntary Ethanol Intake and Anxiety Behavior in Wistar-Uis Rats.

Ethanol consumption is among the first five substances with higher risk associated with diseases, disability, and death in the world. Anxiety behavior has been linked to ethanol-addictive conduct. The aim of the present study was to evaluate three strains with differential anxiety behavior: a Wild-type strain; a "Reactive" strain, with an increase in anxiety-related behaviors; and a "Non-Reactive" strain, with lower anxiety-related behaviors, before and after the voluntary consumption of ethanol (10%) protocol. To evaluate anxiety, animals were exposed to the elevated plus-maze 24 h before and after the consumption protocol. On the voluntary consumption of ethanol protocol, the animals were exposed to a water and an ethanol bottle. The weight of the liquid consumed daily for 40 days was registered. Results: all strains increased ethanol vs water consumption: Wild-type: day 8; R: day 10; NR: day 31. Ethanol consumption reduced the number and percentage of open arms entries only on the Wild-type strain. Conclusion: anxiety can predispose to an increase in ethanol consumption and to the maintenance of anxiety-related behaviors.

El consumo de alcohol se encuentra dentro de las primeras cinco sustancias con mayor riesgo asociado con enfermedades, discapacidad y muerte en el mundo. El comportamiento ansioso se ha relacionado con la conducta adictiva al alcohol. El objetivo del presente estudio fue evaluar tres cepas con conductas de ansiedad diferenciales: una cepa normal; una cepa "Reac tiva", con aumento de conductas ansiosas; y una cepa "No-Reactiva", con menor comportamiento ansioso, antes y después del protocolo de consumo voluntario de etanol (10%). Para evaluar la ansiedad, los animales fueron expuestos al laberinto en cruz elevado 24 h antes y después del protocolo de consumo. En el protocolo de consumo voluntario de etanol, los animales fueron expuestos a una botella de agua y a una de etanol. Se registró el peso del líquido consumido durante 40 días. Resultados: todas las cepas aumentaron el consumo de alcohol vs agua: General: día 8; R: día 10; NR: día 31. El consumo de etanol redujo el número y el porcentaje de entradas de brazos abiertos solo en la cepa General. Conclusión: los niveles de ansiedad pueden predisponer a un aumento del consumo de etanol y mantenimiento de comportamientos relacionados con la ansiedad.

Exploring the association between urinary bisphenol A, S, and F levels and semen quality parameters: Findings from Led-Fertyl cross-sectional study.

Infertility is recognized as a multifaceted condition affecting approximately 15% of couples globally, influenced by various factors including genetic predisposition and environmental exposures. Among these environmental factors, bisphenol A (BPA) emerges as a prominent Endocrine-disrupting chemical (EDCs) widely distributed, leading to chronic human exposure in daily life. As regulations on BPA became more stringent, alternative substances such as bisphenol S (BPS) and bisphenol F (BPF) have emerged. Animal studies have demonstrated a dose-dependent decline in fertility and embryotoxicity following chronic exposure to BPA. However, literature data on human studies are limited and heterogeneous. Additionally, even less is known about the relationship between exposure to the BPA analogues (BPS and BPF) and sperm quality. Therefore, the present study aimed to examine the association between urinary concentrations of BPA, BPF, and BPS and semen quality parameters among 195 adult Spanish men from the Led-Fertyl study cohort using multiple linear regression models adjusted by potential confounding variables. Our results revealed an inverse association between log-transformed creatinine-adjusted concentration (ng/mg) of BPA and BPF levels and the percentage of sperm vitality (ß: 3.56 %; 95%CI: 6.48 to -0.63 and ß: 4.14 %; 95%CI: 6.97 to -1.31; respectively). Furthermore, participants in the highest quartile of BPA and BPF urinary concentration exhibited lower sperm vitality compared to those in the lowest quartile (ß: 6.90 %; 95%CI: 11.60 to -2.15 and ß: 9.68 %; 95%CI: 14.43 to -4.94; respectively). These results supply epidemiological evidence establishing a relationship between bisphenols urine exposure and sperm quality, suggesting that a re-evaluation of the overall safety of BPA alternatives is warranted.

Performance of instrumental activities of daily living in patients with haemophilic arthropathy. A cross-sectional cohort study.

BACKGROUND: The development of haemophilic arthropathy causes joint damage that leads to functional impairment that limits the performance of activities in patients with haemophilia. The aim was to identify the best predictive model for performing instrumental activities of daily living in adult patients with haemophilia arthropathy. METHODS: Cross-sectional cohort study. 102 patients were recruited. The dependent variable was the performance of instrumental activities of daily living (Lawton and Brody scale). The dependence on the performance of activities of daily living was the dependent endpoint (Barthel scale). The secondary variables were joint damage (Hemophilia Joint Health Score), pain intensity, and clinical, anthropometric, and sociodemographic variables. RESULTS: The degree of dependence, joint damage, pain intensity, and marital status (Cp = 5.60) were the variables that best explain the variability in the performance of instrumental activities of daily living (R2 adj = 0.51). Loss of predictive capacity is acceptable with good mean internal (R2 mean = 0.40) and external (R2-r2 = 0.09) validation. According to the predictive pattern obtained, patients with haemophilia, who were married, without joint pain or damage, and independent in their day-to-day lives, had a score of 7.91 points (95% CI: 7.42; 8.39) in the performance of instrumental activities of daily living. CONCLUSIONS: The predictive model for the functional capacity of instrumental activities of daily living in haemophilia patients encompasses factors such as level of autonomy, joint impairment, pain severity, and marital status. Notably, despite the presence of joint damage, individuals with haemophilia exhibit a significant level of independence in carrying out both basic daily tasks and instrumental activities of daily living. INTERNATIONAL REGISTRATION NUMBER: Id NCT04715100.

Investigation of the agricultural reuse potential of urban wastewater and other resources derived by using membrane bioreactor technology within the circular economy framework.

The European Union, as delineated in Regulation (EU) 2020/741, sets forth minimum criteria for the reuse of wastewater. Directive 86/278/CEE sets the regulations for the reuse of sewage sludge in agriculture. This study aimed to investigate the treated water derived from a pilot plant situated in Granada, Spain, that utilizes membrane bioreactor technology to process real urban wastewater with the quality standards necessary for agricultural reuse. Additionally, the study evaluated the utilization potential of other resources generated during wastewater treatment, including biogas and biostabilized sludge. The pilot plant incorporated a membrane bioreactor featuring four ultrafiltration membranes operating continuously alongside a sludge treatment line operating in batch mode. The pilot plant operated during four cycles, each with distinct hydraulic retention times (6 h and 12 h) and variable mixed liquor-suspended solids concentrations (ranging from 2688 mg L-1 to 7542 mg L-1). During these cycles, the plant was doped with increasing concentrations of emerging contamination compounds (diclofenac, ibuprofen, and erythromycin) to test their effect on the resources derived from the treatment. Subsequently, a tertiary treatment involving an advanced oxidation process was applied to the different water lines, which left the wastewater treatment plant for a period of 30 min and utilized varying concentrations of oxidant. The results indicate that the effluent obtained meets the required quality standards for agricultural use. Therefore, there is potential to use this waste as a resource, which is in line with the principles of the circular economy. Furthermore, the other resources generated during the treatment process, such as the biogas produced during the digestion process and the biostabilized sludge, have the potential to be used as resources according to the circular economy indicators.

Two forgotten guests: biliary and pancreatic stents retained after 14 years.

We present a 54-year-old man with a previous complicated choledocholithiasis 14 years ago, treated with sphincterotomy and biliary and pancreatic stents placement by endoscopic retrograde cholangiopancreatography (ERCP). The patient didn't attend the follow-up. On this occasion, seeks medical attention at this medical center for abdominal pain, jaundice, and fever. Laboratory tests report leukocytosis with neutrophilia, elevated C reactive protein, and hyperbilirubinemia with cholestasis. An ERCP was performed and showed inflammatory ampullary tissue with a previous pancreatic and biliary stent in situ, both were removed succesfully with cold snare. Cholangiogram revealed a dilated bile duct and filling defects compatible with large stones. Due to the soft consistency of the stones, some of them were removed by balloon catheter without complete extraction, therefore a double pig-tail plastic stent was placed (Figure 2) and new ERCP in 4 weeks. The patient received antibiotic therapy with piperacillin-tazobactam with a favorable evolution. During follow-up, a new ERCP was performed with extraction of stones and removal of the stent; there was no evidence of secondary biliary cirrhosis.

Evaluation of Glutathione (GSH) System in Porcine Saliva: Validation and Application of Colorimetric Method.

(1) Reduced glutathione (GSH) is considered the first line of antioxidant defense. During oxidative stress, it is oxidized to glutathione disulphide (GSSG). (2) A simple and quick spectrophotometric method based on sodium borohydride (NaBH4) as a reductant to measure the total and reduced GSH in porcine saliva was analytically validated and evaluated in two situations in this species: (a) in a physiological situation, involving sows during the late lactation and post-weaning periods, and (b) in a situation of sepsis in pigs experimentally induced by LPS administration. (3) The results of the analytical validation showed that the assay was precise and accurate in the porcine saliva samples. Higher total GSH and GSSG and lower reduced GSH were observed in the saliva of sows during the post-weaning period, as well as in pigs with experimentally induced sepsis. (4) In conclusion, the validated assay showed adequate analytical results and could be used to evaluate the GSH system of porcine saliva, as demonstrated during the clinical performance.

Healthy and unhealthy dietary patterns and sperm quality from the Led-Fertyl study.

BACKGROUND: Dietary patterns may affect sperm quality, but the scientific evidence is limited. OBJECTIVE: To evaluate the association between adherence to different a-priori dietary patterns and sperm quality parameters in healthy reproductive-age men. MATERIALS AND METHODS: A cross-sectional analysis was conducted using data from 200 young men enrolled in the Led-Fertyl study. Tertiles of six a-priori dietary patterns were estimated: four healthy dietary patterns [Mediterranean Diet Adherence Screener (MEDAS), Dietary Approaches to Stop Hypertension (DASH), Healthful Plant-Based Diet Index (hPDI) and EAT-Lancet Score], and two unhealthy dietary patterns [Western Diet and Unhealthful Plant-Based Diet Index (uPDI)]. Sperm quality parameters (count, concentration, vitality, total and progressive motility, and normal morphology) were considered the main outcomes. RESULTS: Compared with the lowest tertile, participants in the highest MEDAS tertile had higher total sperm count (ß = 3.2;95%CI: 1.0, 5.5) and concentration (ß = 1.8;95%CI: 0.6, 3.0), and total (ß = 8.2;95%CI: 1.3, 15.1) and progressive motility (ß = 7.1;95%CI: 0.2, 14.0). Similarly, participants in the highest hPDI tertile had higher total sperm count (ß = 3.4;95%CI: 1.4, 5.5) and concentration (ß = 1.2;95%CI: 0.0, 2.3) compared with those in the lowest tertile. When these dietary patterns were modelled as continuous variables (for each 1-point increment in the specific score), an inverse association was found between the uPDI and Western and total sperm count [(ß = -2.7;95%CI: -4.8, -0.7) and (ß = -3.8;95%CI: -5.8, -1.7), respectively] and sperm concentration [(ß = -1.2;95%CI: -2.4, -0.1) and (ß = -1.7;95%CI: -2.8, -0.5), respectively]. Compared with participants in the lowest tertile, those in the highest uPDI tertile presented higher odds of abnormal sperm concentration (OR: 4.6;95%CI: 1.0, 19.9) and one or more seminogram abnormalities (OR: 2.3;95%CI: 1.1, 5.0). CONCLUSIONS: Our findings suggest that higher adherence to healthy dietary patterns (Mediterranean and healthful plant-based diet) was positively associated with better sperm quality parameters, in contrast, greater adherence to unhealthy dietary patterns was inversely associated.

The Challenge of New Forms of Work, Innovative Technologies, and Aging on Decent Work: Opportunities for Occupational Safety and Health.

Occupational Safety and Health (OSH) can be relevant in achieving the United Nation's Sustainable Development Goal of decent work by 2030. However, further OSH actions are needed. This paper identifies the role of OSH in addressing two of many determinants of decent work: new forms of work/innovative technologies and worker aging. The authors conducted a discursive analysis of the two determinants and provided examples for consideration. New forms of work/innovative technologies can not only promote but also undermine the future of decent work, and unhealthy aging impedes longer working lives. With a focus on the OSH aspects of new forms of work/innovative technologies and aging, decent work is more likely to be achieved.

Genomic and phenotypic characterization of Pseudomonas aeruginosa isolates from two Mexican cystic fibrosis attention centers.

Thirty-nine clinical isolates of Pseudomonas aeruginosa collected from 11 cystic fibrosis (CF) patients at two CF attention centers over 10 years were subjected to whole genome sequencing (WGS). Phenotypic tests (i.e., elastase, motility, biofilm, growth rate, and antibiotic susceptibility) were performed to correlate results. A single strain of P. aeruginosa was found to persist over time in longitudinal isolates. No transmission between patients or centers was observed. A tendency to lack genes related to pyoverdine, flagellum, pili, and O-antigen was observed, whereas those related to biofilm, phenazine, and pyochelin were conserved among isolates. In a patient with a 10-year follow-up, a single strain of P. aeruginosa persisted and showed a gradual decrease in elastase activity and growth rate, demonstrating an adaptive phenotype.IMPORTANCEThis study investigates the genomic and phenotypic characteristics of Pseudomonas aeruginosa isolates from Mexican cystic fibrosis (CF) patients, an underrepresented group in CF research. To our knowledge, it is the first to use whole genome sequencing (WGS) to study longitudinally collected P. aeruginosa isolates from this population, evaluating both genomic features and clonal relationships. Remarkably, the study includes samples from one patient over 10 years, offering an extended observation time compared to existing literature. Unlike similar studies, which often lack phenotypic testing, this research incorporates various virulence-related phenotypic assays, enhancing our understanding of gene-to-phenotype correlations. Two potential mechanisms for the loss of elastolytic activity were identified. Furthermore, we conduct an in-depth mobilome analysis, an area that remains largely unexplored in CF contexts. Whole genome sequencing data are publicly available through the NCBI SRA database, facilitating further re-analysis for studies on P. aeruginosa in CF, as well as epidemiological and population structure research.

Epithelioid Hemangioendothelioma of Mandibular Gingiva: A Challenging Diagnosis.

Epithelioid hemangioendothelioma (EHE) is a rare neoplasm derived from the vascular endothelium. Although it can occur anywhere in the body, few cases have been described in the oral cavity. We report a 47-year-old woman presenting with a painful ulcerated lesion on the mandibular gingiva, suggestive of a traumatic decubitus ulcer. Histology and immunohistochemistry confirmed the diagnosis of epithelioid hemangioendothelioma. A literature review of EHE of mandibular gingiva was done. Pubmed were searched from 1975 through June 2024 using the following search terms: epithelioid hemangioentothelioma, vascular tumor, oral cavity and mandibular gingiva. Relevant manuscripts were selected and the results were used to update a narrative overview of the diagnosis and management of this entity. We found 38 cases of EHE in the oral cavity, of which 16 were located on the gingiva. Most of them were located on the mandibular gingiva as painless swelling, unlike our case. 70 % of the cases presenting in the mandibular gingiva had bone resorption on imaging. However, only half of those located in the maxillary gingiva had this bone resorption. Only 2 cases located in the mandibular gingiva presented recurrence and 1 of them debuted with nodal metastases after a 7-year follow-up. The clinical and histological diagnosis of EHE is complex and must be confirmed by immunohistochemistry. Upon diagnosing this entity, we should perform an excision with clear margins and conduct long-term follow-up due to the risk of local and distant recurrence. Key words:Epithelioid hemangioendothelioma, Gingival pathologies, Oral cavity, Mandibular Diseases, CD31, Immmunohistochemical markers, Vascular tumor.

Cardiovascular Ultrasound Predictors for Brain Alterations in Fetuses With Heart Disease: An Exploratory Review of the Literature.

OBJECTIVE: To identify cardiovascular ultrasound predictors for brain anomalies in fetuses with heart disease. METHODS: A literature search was performed in the following databases: MEDLINE through OVID, EMBASE, Cochrane Registry Center for Controlled Trials (CENTRAL), and LILACS, from their inception until May 2023. Clinical studies, cross-sectional studies, case-control studies, cohorts, and systematic reviews were included. Data extraction was performed, and the risk of bias was assessed using the QUADAS-2 tool. RESULTS: Among 2705 studies evaluated, after filtering information, 10 articles were selected that met the inclusion criteria. These studies noted the following outcomes: a decrease in fetal head circumference, changes in brain maturation measured in days, decreased depth of brain fissures, and a decrease in total brain volume. The studies show a statistically significant correlation with the presence of the following cardiovascular predictors: low or mixed oxygen content in the ascending aorta (p < 0.001), retrograde flow in the aortic arch (p < 0.001), lower z values of the MCA-PI (p < 0.05), higher UA-PI z values (p < 0.01), and lower CPR (p < 0.05). In addition, lower values of left ventricular flow (p < 0.01), ductus arteriosus (p < 0.0001), and combined cardiac output index (p < 0.01) were reported. CONCLUSIONS: This review describes the most relevant evidence correlating the effects of hemodynamic changes that lead to states of chronic hypoxia related to the aforementioned changes in the central nervous system.

Female-age-dependent changes in the lipid fingerprint of the mammalian oocytes.

STUDY QUESTION: Can oocyte functionality be assessed by observing changes in their intracytoplasmic lipid droplets (LDs) profiles? SUMMARY ANSWER: Lipid profile changes can reliably be detected in human oocytes; lipid changes are linked with maternal age and impaired developmental competence in a mouse model. WHAT IS KNOWN ALREADY: In all cellular components, lipid damage is the earliest manifestation of oxidative stress (OS), which leads to a cascade of negative consequences for organelles and DNA. Lipid damage is marked by the accumulation of LDs. We hypothesized that impaired oocyte functionality resulting from aging and associated OS could be assessed by changes in LDs profile, hereafter called lipid fingerprint (LF). STUDY DESIGN, SIZE, DURATION: To investigate if it is possible to detect differences in oocyte LF, we subjected human GV-stage oocytes to spectroscopic examinations. For this, a total of 48 oocytes derived from 26 young healthy women (under 33 years of age) with no history of infertility, enrolled in an oocyte donation program, were analyzed. Furthermore, 30 GV human oocytes from 12 women were analyzed by transmission electron microscopy (TEM). To evaluate the effect of oocytes' lipid profile changes on embryo development, a total of 52 C57BL/6 wild-type mice and 125 Gnpat+/- mice were also used. PARTICIPANTS/MATERIALS, SETTING, METHODS: Human oocytes were assessed by label-free cell imaging via coherent anti-Stokes Raman spectroscopy (CARS). Further confirmation of LF changes was conducted using spontaneous Raman followed by Fourier transform infrared (FTIR) spectroscopies and TEM. Additionally, to evaluate whether LF changes are associated with developmental competence, mouse oocytes and blastocysts were evaluated using TEM and the lipid dyes BODIPY and Nile Red. Mouse embryonic exosomes were evaluated using flow cytometry, FTIR and FT-Raman spectroscopies. MAIN RESULTS AND THE ROLE OF CHANCE: Here we demonstrated progressive changes in the LF of oocytes associated with the woman's age consisting of increased LDs size, area, and number. LF variations in oocytes were detectable also within individual donors. This finding makes LF assessment a promising tool to grade oocytes of the same patient, based on their quality. We next demonstrated age-associated changes in oocytes reflected by lipid peroxidation and composition changes; the accumulation of carotenoids; and alterations of structural properties of lipid bilayers. Finally, using a mouse model, we showed that LF changes in oocytes are negatively associated with the secretion of embryonic exosomes prior to implantation. Deficient exosome secretion disrupts communication between the embryo and the uterus and thus may explain recurrent implantation failures in advanced-age patients. LIMITATIONS, REASONS FOR CAUTION: Due to differences in lipid content between different species' oocytes, the developmental impact of lipid oxidation and consequent LF changes may differ across mammalian oocytes. WIDER IMPLICATIONS OF THE FINDINGS: Our findings open the possibility to develop an innovative tool for oocyte assessment and highlight likely functional connections between oocyte LDs and embryonic exosome secretion. By recognizing the role of oocyte LF in shaping the embryo's ability to implant, our original work points to future directions of research relevant to developmental biology and reproductive medicine. STUDY FUNDING/COMPETING INTEREST(S): This research was funded by National Science Centre of Poland, Grants: 2021/41/B/NZ3/03507 and 2019/35/B/NZ4/03547 (to G.E.P.); 2022/44/C/NZ4/00076 (to M.F.H.) and 2019/35/N/NZ3/03213 (to L.G.). M.F.H. is a National Agency for Academic Exchange (NAWA) fellow (GA ULM/2019/1/00097/U/00001). K.F. is a Diamond Grant fellow (Ministry of Education and Science GA 0175/DIA/2019/28). The open-access publication of this article was funded by the Priority Research Area BioS under the program "Excellence Initiative - Research University" at the Jagiellonian University in Krakow. The authors declare no competing interest. TRIAL REGISTRATION NUMBER: N/A.

Short bowel syndrome related intestinal failure outcomes in Latin America: Insights from the RESTORE Registry.

BACKGROUND: Short bowel syndrome is considered a low prevalence disease. The scant information available about intestinal failure in Latin America was the driving force to expand this registry. METHODS: A prospective, multicenter observational registry was created for patients with chronic intestinal failure short bowel at specialized centers in Latin America. Demographics, clinical characteristics, nutrition assessment, parenteral nutrition management, intestinal rehabilitation, related complications, clinical outcome, and survival were analyzed. RESULTS: From May 2020 to July 2023, 167 patients (115 adults, 52 children) from 20 centers were enrolled. For the adults, the mean age was 37.2 ± 18 years, 48% were female, and the mean follow-up was 22.6 ± 18.3 months. The main etiology was surgical resections (postsurgical complications: 37%; ischemia: 25%); the mean intestinal length was 73 ± 55 cm. The complications were as follows: infections: 0.4/1000 catheter-days; thrombosis: 0.24/1000 catheter-days; liver disease: 2.6%. The outcomes were as follows: 28% were rehabilitated, 15% died, 9.6% were lost to follow-up, 0.9% underwent transplant, and 45.6% continued follow-up. For the children, the mean age 48 ± 52 months, 48% were female, 52% were premature. The mean follow-up was 17.2 ± 5.6 months; the mean remaining intestinal length was 38 ± 45 cm. The leading etiologies were atresia (25%), NEC (23%), and gastroschisis (21%). The complication were as follows: infections: 2/1000 catheter-days; thrombosis: 2.22/1000 catheter-day; 25% developed liver disease. The outcomes were as follows: 7.7% died, 3.8% were rehabilitated, and 88.5% continued follow-up. CONCLUSION: The RESTORE amendment served as a registry and educational tool for the participating teams. The aspiration is to objectively show current aspects of intestinal failure in the region and carry them to international standards. Including all Latin American countries and etiologies of chronic intestinal failure besides short gut would serve to complete this registry.

In Vitro Study of the Differential Anti-Inflammatory Activity of Dietary Phytochemicals upon Human Macrophage-like Cells as a Previous Step for Dietary Intervention.

Chronic inflammatory diseases pose a substantial health challenge globally, significantly contributing to morbidity and mortality. Addressing this issue requires the use of effective anti-inflammatory strategies with fewer side effects than those provoked by currently used drugs. In this study, a range of phytochemicals (phenolic di-caffeoylquinic acid (Di-CQA), flavonoid cyanidin-3,5-diglucoside (Cy3,5DiG), aromatic isothiocyanate sinalbin (SNB) and aliphatic isothiocyanate sulforaphane (SFN)) sourced from vegetables and fruits underwent assessment for their potential anti-inflammatory activity. An in vitro model of human macrophage-like cells treated with a low dose of LPS to obtain a low degree of inflammation that emulates a chronic inflammation scenario revealed promising results. Cell viability and production of the key pro-inflammatory cytokines were assessed in the presence of various phytochemicals. The compounds Di-CQA and Cy-3,5-DiG, within low physiologically relevant doses, demonstrated notable anti-inflammatory effects by significantly reducing the production of key pro-inflammatory cytokines TNF-α and IL-6 without affecting cell viability. These findings underscore the potential of plant-derived bioactive compounds as valuable contributors to the prevention or treatment of chronic inflammatory diseases. These results suggest that these compounds, whether used individually or as part of natural mixtures, hold promise for their inclusion in nutritional interventions designed to mitigate inflammation in associated pathologies.

Comparison of Micro-CT and Morphometric Outcomes in a Modified Experimental Rat Model of Periodontitis.

AIM: To assess the correlation between micro-computed tomography (micro-CT) and linear morphometric measurements in terms of mandibular bone levels in a modified experimental periodontitis model in rodents to study the mechanisms of association between periodontal destruction and neuroinflammation. METHODS: The proposed in vivo experimental periodontitis model involves the administration of oral rinses with Porphyromonas gingivalis and Fusobacterium nucleatum, four times per week during 4, 8 or 12 weeks, in 24 male Wistar Hannover rats (180 g, 5 weeks old). After euthanasia, hemi-mandibles were collected. One hemi-mandible was analysed using morphometry, while the other was assessed with micro-CT. Linear measurements were taken at the buccal aspect and furcation level for both techniques, and volumetric measurements were also obtained with micro-CT. Passing-Bablok regression analysis was used to compare the results of both techniques, with morphometric measurements serving as the reference. Moreover, Lin's Concordance correlation coefficient was calculated to assess the level of agreement. Periodontal clinical variables with neuroinflammatory parameters from the frontal cortex were used to evaluate the association between the resulting condition and neuroinflammation. RESULTS: Twenty-one out of the initial 24 rats were analysed. The micro-CT linear measurements demonstrated high concordance values with the linear morphometric measurements at the buccal surfaces of the roots in molars (r = 0.714) but not at the furcation area (r = 0.052). At 12 weeks, there was a significant impact on neuroinflammation with significant decreases in iNOS levels and p-mTOR levels at 4 and 8 weeks. CONCLUSION: The proposed in vivo experimental periodontitis model demonstrated a high degree of correlation between morphometric and micro-CT measurements in buccal areas but not at the furcation level. Concomitantly, there was a significant temporary modulation of the neuroinflammatory response.

Somatic coliphages as bioindicators of contamination in Lake Guamuez, Colombia.

Lake Guamuez is the second largest lake in Colombia and economically supports hundreds of families in the area. The main activities carried out in the region have focused on tourism, agriculture, livestock, and rainbow trout production; however, these activities have been associated with contamination of the lake. This research aimed to evaluate the water quality of Lake Guamuez using somatic coliphages (SCs) as bioindicators. For this purpose, periodic sampling was carried out for six months at 9 strategic points of the lake. For the detection of SCs, the method described in 9211 D of the Standard Methods for the Examination of Water and Wastewater was used. The genomic variability and presence of virulence genes in the isolated SCs were determined. Water contamination in the lake is evident, and the SCs titer is greater in areas with a high flow of anthropogenic activities. An important degree of genetic diversity and a high prevalence of virulence genes could be observed among the SCs analyzed. The results when compared with guidelines and water quality standards from various countries, showed concentrations of SCs higher than those allowed. The high prevalence of gastrointestinal diseases in the region suggests a link to water contamination.

Real-World Evaluation of the Effectiveness and Safety of Dupilumab in Bullous Pemphigoid: An Ambispective Multicenter Case Series.

BACKGROUND: Bullous pemphigoid affects elderly individuals with multiple comorbidities, making conventional treatments unsuitable. OBJECTIVE: Evaluate the effectiveness and safety of dupilumab in the treatment of bullous pemphigoid. METHODS: A multicenter ambispective cohort study was conducted in 34 hospitals. Patients with bullous pemphigoid treated with Dupilumab were included. Most of patients (97.1%) received an initial 600 mg dose followed by 300 mg every two weeks. OUTCOMES AND MEASURES: The primary outcome was the proportion of patients achieving complete remission within 4 weeks, defined as Investigator Global Assessment score of 0 or 1. Complete remission at weeks 16, 24, and 52, adverse events, reductions in peak pruritus numerical rating scale, and systemic glucocorticoid use were also assessed. RESULTS: The study included 103 patients with a median age of 77.3 years, 58.0% male. Complete remission was achieved by 53.4% within 4 weeks and 95.7% by week 52. Peak pruritus scale reduced by 70.0% by week 4 and was completely controlled by week 24. Thirteen patients presented adverse events, most of which were mild. Systemic glucocorticoid use reduced by 82.1% by week 52. Shorter disease duration and exclusive cutaneous involvement predicted better response at 16 weeks. No differences in response rates to dupilumab were observed between drug-associated bullous pemphigoid and idiopathic cases. No significant difference in response rates was observed between patients treated with dupilumab in monotherapy and those receiving dupilumab with concomitant treatments. CONCLUSIONS: Dupilumab is effective, rapid, and safe in managing bullous pemphigoid, reducing the need for corticosteroids and other treatments. Early initiation and exclusive skin involvement predict better outcomes.

[Integrated social value generated in a specialized hospital for chronic patients]. / Valor social integrado generado en un hospital monográfico de pacientes crónicos.

INTRODUCTION: Measuring social value has always been a challenge for organizations that generate such value, including foundations, NGOs, social enterprises, and governmental entities. Often, the benefits of these initiatives are perceived as intangible or long-term, making them difficult to quantify. Assessing social value demonstrates the impact of investments and accountability to stakeholders.Healthcare organizations should be evaluated from a broad perspective, where the quality of healthcare services is an integral part of the social value with multiple beneficiaries.This study aims to determine the economic and social impact of Hospital Santa Marina on the Bizkaia (Basque Country) population in 2023, as well as to evaluate the evolution of the hospital's social value from 2018 to 2023. MATERIALS AND METHODS: The study was conducted from the multifaceted perspective of social accounting (stakeholder theory), utilizing the Social Return on Investment (SROI) tool. The economic value of the hospital (both direct and indirect) and the hospital's specific social value were calculated based on areas identified by stakeholders. Subsequently, the hospital's integrated social value and socio-emotional value were determined. RESULTS: The hospital contributed €34,696,178.20 to society in Direct and Indirect Market Social Value (SROI), and the Non-Market Social Value amounted to €119,758,230.71. This generated an integrated social value of the hospital of €154,454,408.91, which, considering the satisfaction index for the year 2023 was 0.9805, leads to a socio-emotional value of €211,998,238.76. CONCLUSIONS: Hospital Santa Marina generates significant economic value for the society, beyond its direct contribution to the population's health. These findings underscore the importance of adopting a broader perspective on health and highlight the role of healthcare institutions as drivers of sustainable development.

Assessing pesticide residue occurrence and risks in the environment across Europe and Argentina.

The widespread and extensive use of pesticides in European crop production to reduce losses from weeds, diseases, and insects may have serious consequences on the ecosystem and human health. This study aimed to identify 20 active substances of high health risk, based on their detection frequency within and across the environmental matrices (soil, crop, water, and sediment) and to identify their associated hazardous effects. A sampling campaign was conducted across 10 case study sites in Europe and 1 in Argentina and included conventional and organic farming systems. In 31% of cases, the detected substances were found at a higher concentration in the soil than in the corresponding crops, 93% of the compounds were fungicides, and the remainder were insecticides. 43% of the substances, 57% of which were insecticides, were detected only in soil. There was a clear relationship between soils and crops in terms of contamination, but not between water and sediment. Portuguese soil (wine grapes) had the highest number of substances (12) with average concentrations (AC) varying between 1 and 162 µg/kg, followed by French (11 substances in wine grapes) (1≤AC≤64 µg/kg) and Spanish soils (9 substances in vegetables) (3≤AC≤59 µg/kg). The crops corresponding to these soils contained a relatively high number of detected substances and several in high average concentrations (AC). The risk quotient was consistently higher for conventional farms than for organic farms. For the soils from conventional farms, 5 active substances (chlorpyrifos, glyphosate, boscalid, difenoconazole, lambda-cyhalothrin, and one metabolite: AMPA) were considered high risk. For water samples, 2 substances (dieldrin and terbuthylazine) found were high risk, and for sediment, there were 3 substances (metalaxyl-M, spiroxamine, and lambda-cyhalothrin). There were 6 substances detected in crops that are suspected to cause human health effects. Uncontaminated soil is a prerequisite for the adoption of sustainable alternatives to pesticides. Efforts are needed to elucidate the unknown effects of mixtures, including biocides and banned compounds in addition to the substances used in agriculture.