Reviewing mathematical models of sperm signaling networks.

Dave Garbers' work significantly contributed to our understanding of sperm's regulated motility, capacitation, and the acrosome reaction. These key sperm functions involve complex multistep signaling pathways engaging numerous finely orchestrated elements. Despite significant progress, many parameters and interactions among these elements remain elusive. Mathematical modeling emerges as a potent tool to study sperm physiology, providing a framework to integrate experimental results and capture functional dynamics considering biochemical, biophysical, and cellular elements. Depending on research objectives, different modeling strategies, broadly categorized into continuous and discrete approaches, reveal valuable insights into cell function. These models allow the exploration of hypotheses regarding molecules, conditions, and pathways, whenever they become challenging to evaluate experimentally. This review presents an overview of current theoretical and experimental efforts to understand sperm motility regulation, capacitation, and the acrosome reaction. We discuss the strengths and weaknesses of different modeling strategies and highlight key findings and unresolved questions. Notable discoveries include the importance of specific ion channels, the role of intracellular molecular heterogeneity in capacitation and the acrosome reaction, and the impact of pH changes on acrosomal exocytosis. Ultimately, this review underscores the crucial importance of mathematical frameworks in advancing our understanding of sperm physiology and guiding future experimental investigations.

Linked selection and the evolution of altruism in family-structured populations.

Much research on the evolution of altruism via kin selection, group selection, and reciprocity focuses on the role of a single locus or quantitative trait. Very few studies have explored how linked selection, or selection at loci neighboring an altruism locus, impacts the evolution of altruism. While linked selection can decrease the efficacy of selection at neighboring loci, it might have other effects including promoting selection for altruism by increasing relatedness in regions of low recombination. Here, we used population genetic simulations to study how negative selection at linked loci, or background selection, affects the evolution of altruism. When altruism occurs between full siblings, we found that background selection interfered with selection on the altruistic allele, increasing its fixation probability when the altruistic allele was disfavored and reducing its fixation when the allele was favored. In other words, background selection has the same effect on altruistic genes in family-structured populations as it does on other, nonsocial, genes. This contrasts with prior research showing that linked selective sweeps can favor the evolution of cooperation, and we discuss possibilities for resolving these contrasting results.

Acute Myocardial Injury Assessed by High-Sensitivity Cardiac Troponin I Levels in Adult Patients with Early Sepsis at a Tertiary Referral Center in Mexico: An Exploratory Study.

The objective of the study was to describe the frequency of acute myocardial injury (AMI) assessed by high-sensitivity cardiac troponin I (hs-cTnI) levels and to determine the possible initial risk factors (related to the characteristics of the patient, the disease, and the initial management) in a population of adult patients with early sepsis (within the first 72 h of diagnosis) in a single tertiary hospital center in western Mexico. For the inferential statistics, the proportions of the categorical dichotomous variables were compared using the chi-square test. In all analyses, p values less than 0.05 with a 95% confidence interval were considered significant. We included a total of 64 patients diagnosed with early sepsis, of whom 46 presented elevated hs-cTnI and were classified as having AMI. In our study, the frequency of AMI in patients with early sepsis was 71.87%, and no significant differences were found in all of the characteristics of patients with early sepsis with and without AMI, nor was any significant association found with any of the variables analyzed. In the population of western Mexico, the frequency of AMI in patients with early sepsis, assessed by hs-cTnI levels, is high and similar to that reported in other populations worldwide.

Descripción de las caracteristicas clínicas de las neoplasias mieloproliferativas crónicas (NMPC). Primer informe del registro colombiano de NMPC / Description of the clinical characteristics of chronic myeloproliferative neoplasms (MPNs). First report of the colombian registry of MPNs

Resumen Introducción y objetivos: las neoplasias mieloproliferativas crónicas (NMPC) son relativamente raras, con incidencias que varían entre 0.47-1.03/100 000 habitantes. Se presenta el primer informe del trabajo del registro colombiano de NMPC, cuyo objetivo es describir las características clínicas de estos pacientes en nuestro país. Material y métodos: estudio descriptivo observacional, multicéntrico, retrospectivo y prospectivo en ocho centros del país, de abril de 2013 a diciembre de 2014. Las variables cualitativas se presentan con frecuencias absolutas y relativas; y las cuantitativas se resumen en medidas de tendencia central y dispersión. Resultados: once centros fueron aprobados, ocho ingresaron pacientes. En los primeros 179 casos reportados, 50% eran hombres, la edad promedio al diagnóstico 58.7 años (rango 19-92). Noventa y tres muestran trombocitemia esencial (TE); 55, policitemia vera (PV); y 31, mielofibrosis (MF). El 41% tenía esplenomegalia al diagnóstico; el 20% tuvo complicaciones trombóticas; y 12.85%, sangrado. Sólo en 57.5% se realizó JAK; de ellos, en 53.5% fue positivo, en especial sólo 60% de las PV. El 8% de los casos no tenía estudio de médula ósea, el 29.3% tiene algún grado de fibrosis. El hallazgo más frecuente fue hiperplasia megacariocítica en 59.78%. Más de 50% de pacientes estaban sintomáticos al diagnóstico. Sólo el 11% no recibió tratamiento farmacológico; los más frecuentes fueron hidroxiurea en 149 casos y ASA en 79. Con promedio de seguimiento de 52.6 meses; el 97.21% de los pacientes están vivos. Conclusiones: los hallazgos sugieren que algunas características de las NMPC podrían ser diferentes a lo reportado en otras series, lo que valida la importancia del esfuerzo de recoger información local.

Abstract Introduction and objectives: chronic MPNs are relatively rare, with incidences varying between 0.47-1.03 / 100 000 inhabitants. The first report of the work of the Colombian registry of chronic MPNs, whose objective is to describe the clinical characteristics of these patients in our country, is presented. Materials and methods: descriptive observational, multicenter, retrospective and prospective study in eight centers of the country, from April 2013 to December 2014. Qualitative variables are presented with absolute and relative frequencies, and the quantitative ones are summarized in measures of central tendency and dispersion. Results: eleven centers were approved; 8 admitted patients. In the first 179 cases reported, 50% were men; the average age at diagnosis was 58.7 years (range 19-92). Ninety-three present essential thrombocythemia (ET); 55, polycythemia vera (PV); and 31, myelofibrosis (MF). 41% had splenomegaly at diagnosis; 20% had thrombotic complications, and 12.85%, bleeding. JAK was performed in only 57.5%. Of them, in 53.5% was positive, especially in only 60% of the PV. 8% of the cases had no bone marrow study; 29.3% had some degree of fibrosis. The most frequent finding was megakaryocytic hyperplasia in 59.78%. More than 50% of patients were symptomatic at diagnosis. Only 11% did not receive pharmacological treatment, being the most frequent hydroxyurea in 149 cases and ASA in 79, with an average follow-up of 52.6 months. 97.21% of patients are alive. Conclusions: the findings suggest that some characteristics of chronic MPNs could be different from those reported in other series, which validates the importance of the effort to collect local information.

Caracterización clínica de los pacientes con síndrome mielodisplásico / Clinical characterization of patients with myelodysplastic syndrome

Objetivo: Describir las características clínicas, sociodemográficas y calidad de vida de los pacientes con síndrome mielodisplasico (MDS). Diseño: Estudio descriptivo de corte transversal. Marco de referencia: Hospital San José de Bogotá (institución de cuarto nivel). Población: Treinta y nueve pacientes con diagnóstico de MDS, mayores de 18 años, obtenidos en el departamento de estadística. Mediciones principales: Frecuencia de variables clínicas, sociodemográficas y calidad de vida medida por la escala FACT-G. Resultados: La edad promedio fue de 74 años, con un predominio en hombres. El diagnóstico más frecuente fue MDS tipo displasia mutilinaje, y la citopenia más prevalente fue anemia. La mayoría de los pacientes fue clasificado como muy bajo riesgo o bajo riesgo por la escala IPSS-R y WPSS, y bajo riesgo y riesgo intermedio -1 por la escala IPSS y MDACC. La progresión a leucemia mieloide aguda se presentó en 7.69%, mientras que la mortalidad en 15.38%. Existió una mayor frecuencia de muerte y transformación a leucemia en los pacientes clasificados como de alto riesgo. La calidad de vida fue inferior en los pacientes con anemia y fue superior en el MDS-(del5q). Conclusiones: Las características de la población estudiada son similares a las reportadas en la literatura (predominio en hombres, subtipo de MDS más frecuente, citopenia predominante y distribución de riesgo). Existieron diferencias con respecto a la edad, frecuencia de comorbilidades y su relación con mortalidad. La calidad de vida se correlacionó con el subtipo de MDS y citopenias. (Acta Med Colomb 2016; 41: 36-41).

Objective: To describe the clinical and socio-demographic characteristics and quality of life of patients with myelodysplastic syndrome (MDS). Design: a descriptive cross-sectional study. Framework: Hospital San José de Bogota (fourth level institution). Population: Thirty-nine patients diagnosed with MDS, older than 18 years, obtained in the statistics department. Main measurements: frequency of clinical and sociodemographic variables and quality of life measured by FACT-G scale. Results: The mean age was 74 years, with male predominance. The most frequent diagnosis was type mutilineage MDS dysplasia, and the most prevalent cytopenia was anemia. Most patients were classified as very low risk or low risk by IPSS-R and WPSS scale and low-risk and intermediate risk -1by IPSS and MDACC scale. Progression to acute myeloid leukemia occurred in 7.69%, while mortality occurred in 15.38%. There was a higher incidence of death and transformation to leukemia in patients classified as high risk. The quality of life was lower in patients with anemia and was higher in the MDS-(del 5q). Conclusions: The characteristics of the study population are similar to those reported in the literature (predominantly in men, subtype of MDS more frequent, predominant cytopenia and risk distribution). There were differences with respect to age, frequency of comorbidities and their relationship to mortality. Quality of life was correlated with the subtype of MDS and cytopenias. (Acta Med Colomb 2016; 41: 36-41).

Criterios de respuesta para definir éxito en la terapia de pacientes hemofílicos llevados a cirugía. Revisión ampliada de la literatura (RAL) / Evaluation of therapeutic response in hemophilic patients requiring surgical procedure. Extended review of the literature (RAL)

La hemofilia, enfermedad congénita de baja prevalencia en la población general, se clasifica en tipos A y B según su deficiencia sea del factor VIII o IX de la coagulación. Desde hace más de 40 años existen preparados plasmáticos de cada uno de los factores y en la actualidad contamos con derivados recombinantes. Los pacientes que requieren intervenciones quirúrgicas son un reto para los diferentes grupos de manejo, porque el estándar de criterios para definir la respuesta a la terapia no está claro. Se realizó esta revisión ampliada de la literatura con el fin de evaluar cuáles son los criterios de respuesta en las diferentes publicaciones. En las principales bases de datos médicos, se recolectaron y tabularon 61 artículos después de aplicar los criterios de inclusión y exclusión, encontrando que múltiples estudios aplicaban diferentes parámetros para evaluar el sangrado como son los niveles de factor de la coagulación, tromboelastografía, tiempo de generación de trombina, reintervención quirúrgica, duración de la hospitalización y evaluación de dolor, con lo cual concluimos que hay heterogeneidad en los parámetros que aplican los autores en relación con los objetivos principal y secundarios de nuestra revisión...(AU)

Hemophilia is an inherited low prevalence disorder among the general population classified as type A or B according to the deficiency of either coagulation factor VIII or IX. Coagulation factors in plasma prepared have been available for more than forty years, counting with recombinant factor products nowadays. Patients requiring surgical interventions are a challenge for treating physicians for the criteria standards of therapeutic response are not yet clear. This extended literature review was conducted to evaluate the therapeutic response criteria described in different publications. Sixty-one articles were retrieved from the main medical data bases and tabulated after applying the inclusion and exclusion criteria. Findings showed that many studies considered various parameters to monitor bleeding, such as, levels of coagulation factor, thromboelastography, thrombin generation time, surgical reintervention, length of hospital stay and level of pain. Thus, we conclude there is heterogeneity in the parameters authors apply regarding the primary and secondary objectives of our review...

Infarto agudo de miocardio posradioterapia mediastínica / Acute myocardial infarction after mediastinal radiotherapy

La radioterapia mediastínica puede producir distintos grados de afectación del corazón y los grandes vasos. Una de las formas de presentación puede ser la enfermedad coronaria y con menos frecuencia el infarto agudo de miocardio. Se presenta el caso de un paciente joven sin factores de riesgo coronario con antecedentes de radioterapia mediastínica por un linfoma de Hodgkin recidivado y se realizan consideraciones referentes a la radioterapia mediastínica como factor de riesgo para el desarrollo de enfermedad coronaria precoz.

Conocimientos y actitudes de los médicos de instituciones hospitalarias en Barranquillla sobre donación y trasplante de órganos Julio-noviembre de 1999 / Knowledge and attitudes about organ donation and transplantation by doctors at Hospitals in Barranquillla. July-November of 1999

Aim: To aim of this study was to determine the attitudes and to evaluate the knowledge of physiciansof hospitable Institutions in Barranquilla, Colombia in relation to the donation and transplantationoforgans.Methods: A cross-sectional study was designed in which a representative stratified random samplewas selected of 305 physicians (general practitioner and specialist). The source of information was astructured questionnaire. The questionnaire was adapted from Blanca, Frutos and Rosel with 29questions, divided in three sections. The first section: personal achievement (6 items); the secondsection: evaluation of the knowledge on donation and transplants by means of questions of multipleselection (11 items); and third section: it evaluates the attitudes using a likert scale (12 items). Thestudy was performed with the consent of the hospital centers.Results: We evaluated 274 physician (104 general practitioner) with a mean age of 48,7 years (S.D.=6.37). The ratio of specialist physicians to general practitioner doctor was of 1.6:1. With respect to thetheoretical knowledge, 50,73 percent of modal frequency were found to have a ranking of mediocre and41,24 percent were found to belong in the good rank. When this level of knowledge was compared with thatof the work place there was a significant difference in the level of knowledge between general andspecialist physicians (OR = 2,37 IC95 1,42 - 3,93). The physicians do not know the legal frame thatregulates the donation and transplant of organs. 72,3 percent of the participants do not know the existenceof the program for the donation and transplantation of organs in Barranquilla. With respect to themanner of obtaining information on this theme, 35 percent used books or medical journals. With respect tothe general knowledge of general practitioners and specialist physicians there was a statisticallysignificant difference found using a Z test (difference of proportions 3,91; p = 0.00007).Conclusions: The authors rec...

Aplicación de pruebas de ajuste de riesgo para predecir los tiempos de internación posoperatorios en cirugía cardíaca / Usefulness of risk models to predict hospital lenght of stay after cardiac surgery

Un aspecto clave de una buena administración de recursos en cirugía cardíaca consiste en prever y controlar el tiempo de estadía hospitalaria. Con ese fin se analizó la relación entre riesgo preoperatorio y tiempo de internación posquirúrgico con dos modelos de ajuste de riesgo. Para ello se comparó la mortalidad operatoria y el tiempo de internación de 320 pacientes sometidos a cirugía cardíaca con dos modelos de ajuste del PACCN y de Parsonnet. No se observaron diferencias significativas en la comparación de la mortalidad esperada y la observada con los dos tipos de índices. El tiempo de internación fue de 7 días (mediana) para un puntaje del PACNN menor de 6, y de 12 días para un valor superior. Con el modelo de Parsonnet, la estadía fue de 7 días para un puntaje menor de 15, de 8 días para valores entre 15 y 19 y de 10 días para puntajes mayores. En conclusión, los dos modelos de ajuste de riesgo predicen adecuadamente la mortalidad observada en este estudio. Asimismo ambos esquemas pueden ser usados para prever los tiempos posquirúrgicos probables de internación