Emergency visits and mortality caused by ischemic heart disease attributable to fine particulate matter during the COVID-19 pandemic in Chile.

POSITION DU PROBLèME: Le confinement mis en place au deuxième trimestre 2020 a entrainé une amélioration de la qualité de l'air de Santiago, capitale et plus grande ville du Chili, caractérisée par de fortes concentrations en particules fines PM2,5 liées, en grande partie, au trafic routier. L'objectif était de mettre en évidence une potentielle réduction des visites aux urgences pour infarctus du myocarde aigu (IDM) et des décès dus à une cardiopathie ischémique (CPI) attribuable à l'émission de PM2,5, en comparant les périodes équivalentes de 2019 et de 2020. MéTHODES: À Santiago, la surveillance de la qualité de l'air se fait grâce à neuf moniteurs situés dans neuf communes différentes : Cerro Navia, Cerrillos, El Bosque, Pudahuel, Independencia, La Florida, Quilicura, Santiago centre-ville et Las Condes (classées de la plus haute à la plus basse en matière de pauvreté multidimensionnelle). La concentration moyenne quotidienne de PM2,5 a été décrite avec des séries temporelles, et les visites aux urgences pour IDM et les décès dus à une CPI ont été analysés de façon trimestrielle pour chaque année. Pour estimer l'impact de l'excès de PM2,5, les fractions de risque attribuables (FRA) pour les visites aux urgences pour IDM et les décès pour CPI ont été calculées. RéSULTATS: La moyenne quotidienne des PM2,5 a diminué dans huit des neuf communes de Santiago. Cependant, la réduction n'a été significative que dans trois communes. Les visites aux urgences pour IDM et les décès par CPI attribuables aux PM2,5 ont diminué légèrement mais significativement dans ces trois communes. Les FRA dans les autres communes sont restées similaires à 2019. CONCLUSIONS: Une réduction significative de la FRA des PM2,5 pour les décès par CPI et les visites aux urgences d'IDM n'a été observée que dans les communes avec une réduction significative de la concentration quotidienne moyenne de PM2,5 pendant la pandémie de COVID-19.

Combination of light-driven co-delivery of chemodrugs and plasmonic-induced heat for cancer therapeutics using hybrid protein nanocapsules.

BACKGROUND: Improving the water solubility of hydrophobic drugs, increasing their accumulation in tumor tissue and allowing their simultaneous action by different pathways are essential issues for a successful chemotherapeutic activity in cancer treatment. Considering potential clinical application in the future, it will be promising to achieve such purposes by developing new biocompatible hybrid nanocarriers with multimodal therapeutic activity. RESULTS: We designed and characterised a hybrid nanocarrier based on human serum albumin/chitosan nanoparticles (HSA/chitosan NPs) able to encapsulate free docetaxel (DTX) and doxorubicin-modified gold nanorods (DOXO-GNRs) to simultaneously exploit the complementary chemotherapeutic activities of both antineoplasic compounds together with the plasmonic optical properties of the embedded GNRs for plasmonic-based photothermal therapy (PPTT). DOXO was assembled onto GNR surfaces following a layer-by-layer (LbL) coating strategy, which allowed to partially control its release quasi-independently release regarding DTX under the use of near infrared (NIR)-light laser stimulation of GNRs. In vitro cytotoxicity experiments using triple negative breast MDA-MB-231 cancer cells showed that the developed dual drug encapsulation approach produces a strong synergistic toxic effect to tumoral cells compared to the administration of the combined free drugs; additionally, PPTT enhances the cytostatic efficacy allowing cell toxicities close to 90% after a single low irradiation dose and keeping apoptosis as the main cell death mechanism. CONCLUSIONS: This work demonstrates that by means of a rational design, a single hybrid nanoconstruct can simultaneously supply complementary therapeutic strategies to treat tumors and, in particular, metastatic breast cancers with good results making use of its stimuli-responsiveness as well as its inherent physico-chemical properties.

Posterior wall as atypical localization of left atrial myxoma : Diagnosis and management.

Atrial myxomas are the most common benign cardiac neoplasms. Although the majority occur in the left atrium (LA) and are attached to the interatrial septum (75-80 % of cases), they can arise from any part of the LA and the cardiac chambers. We report the case of a 65-year-old woman who presented with features of worsening dyspnea and persistent headache. During transthoracic echocardiography, a suspected cardiac myxoma was found arising from the posterior wall of the LA.

Metastatic liposarcoma of the heart. Case series and brief literature review.

Secondary cardiac tumors are 20-40 times more frequent than primary lesions. Primary cardiac lesions are represented by myxomas when related to benign tumors, and by sarcomas in terms of malignant disease. Metastases to the heart from liposarcomas are very rare. We present three cases of secondary liposarcomas involving the left atrium, the right atrium, and the pericardium.

Variation, during Shelf Life, of Functional Properties of Biscuits Enriched with Fibers Extracted from Artichoke (Cynara scolymus L.).

To boost revaluation of industrial by-products of artichoke, this research tries to determine the stability throughout storage of phenolic compounds and their antioxidant activity in biscuits enriched with fiber-rich powders extracted from b y-products of artichokes (FRPA). To determine the most stable extraction method, biscuits were formulated with FRPA extracted by two different environmentally friendly extraction solvents: water (W) and a solution of 1% CaCl2∙5H2O (CA) and compared with biscuits made with pea fiber (P) and control biscuits (B) without fiber added. Initially and during storage, the biscuits enriched with FRPA (W, CA) showed a higher content of bioavailable polyphenols and antioxidant activity compared to the control biscuits (B) and the reference fiber (P, pea fiber). In conclusion, FRPA are an excellent source of bioavailable fiber with antioxidant activity, but especially the FRPA extracted with 1% CaCl2∙5H2O (CA), and they could present a good alternative to the use of pea fiber.

Group Psychotherapy Could Improve Depression in Cirrhotic Patients on the Liver Transplant Waiting List.

BACKGROUND: It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients. OBJECTIVES: To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy. METHODS: Study population: patients on the LT waiting list who received group psychotherapy (n = 15). CONTROL GROUP: patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered. RESULTS: More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases. CONCLUSIONS: Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.

Quality of Life and Group Psychological Intervention in Patients With Cirrhosis on Liver Transplant Waiting List.

BACKGROUND: The patients on the liver transplant (LT) waiting list usually present with deterioration in their quality of life. Previous studies on psychological intervention have shown how the quality of life can be improved. OBJECTIVE: To analyze preliminary results of the influence of group psychotherapy on the quality of life of patients on the LT waiting list. METHOD: Fifteen patients on the LT waiting list who accepted receiving group psychotherapy were selected. The development of each 1 of these sessions was carried out at fortnightly periods for 6 months (12 sessions). Those patients who received a transplant and those patients who did not attend more than 6 group psychotherapy sessions were excluded. The Nottingham Health Profile was used to assess the quality of life. It consists of 38 items belonging to 6 health dimensions: energy, pain, physical mobility, emotional reaction, sleep, and social isolation. The study population was given a questionnaire before starting group psychotherapy and after it was finished. RESULTS: Of the 15 patients selected from the study population, 3 patients were given a transplant before the psychotherapy had finished, and 5 patients were excluded for not having attended more than 50% of the sessions. Therefore, the study was completed on 7 patients (n = 7). Overall, a better assessment can be seen in the second questionnaire. CONCLUSIONS: Group psychotherapy might favorably influence the quality of life of patients on the LT waiting list; therefore, it might be interesting to carry out studies on a larger scale in order to confirm these results.

[Diagnostic utility of the polymerase chain reaction for the diagnosis of Mycoplasma pneumoniae in elderly patients with community-acquired pneumonia]. / Utilidad de la reacción de polimerasa en cadena para la detección de Mycoplasma pneumoniae en adultos mayores con neumonía adquirida en la comunidad.

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP) in children and young adults, but limited information about its prevalence in the elderly is available. The polymerase chain reaction (PCR) with primers targeting the cytadhesine P1 gene and the 16S rRNA gene was analyzed for detecting M. pneumoniae in throat washings of 84 patients, aged 60-96 years, with clinical diagnosis of CAP, from September 2002 through August 2004, in Santiago, Chile. PCR results were compared with serology performed by indirect immunofluorescence (IFI). Specimens from 11 of 84 patients (13.1%) were positive for M. pneumoniae by any test. The IFI test was positive in 8 (72.7%) patients and PCR in 7 (63.6%) cases. The acute phase sera allowed diagnosis of M. pneumoniae in 5 of 11 patients (45.4%), 4 of them showing an IgM response. PCR was negative in 4 patients with positive serology and 3 patients were positive only by PCR. The two PCR primers showed 100% correlation, and a similar sensitivity; no inhibitory specimens for PCR were detected. In conclusion, M. pneumoniae should be considered as a potential etiologic agent of CAP in the elderly. Its detection must be performed by a combination of PCR and serology.

Recommendations of the Spanish Brachytherapy Group of SEOR for HDR endoluminal treatments. Part 1: Oesophagus.

The endoesophageal brachytherapy technique provides good results in the treatment of oesophageal cancer, when indicated. In a consensus meeting, the Spanish Brachytherapy Group of SEOR and the Spanish Society of Medical Physics (SEFM) agreed on the indications, dose, fractionation schedule, prescription and reporting to be performed in endoesophageal brachytherapy. The results of this consensus are presented here as recommendations for medical practice.

[Treatment of genital condylomatous diseases with electric fulguration and interferon]. / Trattamento della condilomatosi dei genitali con elettrofolgorazione ed interferon.

The therapeutical effectiveness of beta-interferon and the possibility of reducing the incidence of relapses were evaluated by submitting two groups of 10 patients each to various treatment. The first group has been treated only by electro-fulguration and the second also by parenteral administration of beta-interferon. We obtained 60% of relapse (good result in 4 cases) in the first group and 20% (good result in 8 cases) in the second group. No side effects have been reported by patients treated by interferon. We conclude that systemic beta-interferon can be active in treating patients with condylomata acuminata in association with electro-fulguration.

[Role of ultrasonography in the differential diagnosis of acute scrotum]. / Ruolo della ecografia nella diagnosi differenziale dello scroto acuto.

Forty-five patients with acute scrotal disorders underwent gray-scale and color-Doppler ultrasonography. The aim of the study was to evaluate the role of the US in order to distinguish inflammatory diseases from testicular torsion. Gray-scale with color-Doppler US allows for evaluation of morphologic findings and perfusion and enables accurate diagnosis of most scrotal disorders especially in the earlier clinical observations.

PCR with Paracoccidioides brasiliensis specific primers: potential use in ecological studies.

The precise microenvironment of Paracoccidioides brasiliensis has not yet been discovered perhaps because the methods used are not sensitive enough. We applied to this purpose the polymerase chain reaction (PCR) using three sets of specific primers corresponding to two P. brasiliensis genes. This fungus as well as several other fungi, were grown and their DNA obtained by mechanical disruption and a phenol chloroform isoamylalcohol-based purification method. The DNA served for a PCR reaction that employed specific primers from two P. brasiliensis genes that codify for antigenic proteins, namely, the 27 kDa and the 43 kDa. The lowest detection range for the 27 kDa gene was 3 pg. The amplification for both genes was positive only with DNA from P. brasiliensis; additionally, the mRNA for the 27 kDa gene was present only in P. brasiliensis, as indicated by the Northern analysis. The standardization of PCR technology permitted the amplification of P. brasiliensis DNA in artificially contaminated soils and in tissues of armadillos naturally infected with the fungus. These results indicate that PCR technology could play an important role in the search for P. brasiliensis' habitat and could also be used in other ecological studies.

[Risk factors for psychomotor development among infants born under optimal biological conditions]. / Factores de riesgo para el desarrollo psicomotor en lactantes nacidos en óptimas condiciones biológicas.

OBJECTIVE: The objective of this study is to evaluate the effect of risk factors on infant development, among low socioeconomic children born under optimal biological conditions, and who are exposed to adverse social circumstances. METHOD: Infants of both sexes, in the amount of 788, were studied and controlled prospectively at between 6 and 12 months. Their mental (MDI) and psychomotor (PDI) development was evaluated using the Bayley Scale of Infant Development. Eighteen risk factors were identified and dichotomized (high or low risk). RESULTS: Breast feeding, child temperament, maternal intelligence and home stimulation are consistently associated with lower MDI and PDI. After adjustment for co-variables, home stimulation persisted as a significant factor for explaining the variation of both developmental indexes and child sex also appears as a risk factor for motor skills development. The accumulated effect of 7 or more risk factors is associated with a significant decrease of development scores. The combination of risk categories of child temperament, maternal IQ, paternal role and home stimulation shows higher prediction power for infant development than other combinations analyzed in this study. CONCLUSION: The findings suggest than even for children born under optimal biological conditions their psychomotor development is negatively affected by the presence of simultaneous adverse environmental conditions.

[Evolution of child undernutrition in Chile and some of its conditioning factors: a time series analysis]. / Evolución de la desnutrición infantil en Chile y algunos de sus factores condicionantes: un análisis de series temporales.

The objective of this study was to determine the evolution of the nutritional status of the population under five years of age during the period 1975-1990. Several conditioning factors were also assessed. The information was evaluated through time series analysis by using the AREG procedure. This procedure allows for the estimation of a regression model correcting by the autocorrelation of errors. Results indicates a significant trend to decreased undernutrition rates (p < 0.0001). A seasonal effect on undernutrition was observed, being higher the prevalences in summer. Analysis of selected conditioning factors, as well as the familiar buying capacity remained stable during the period. An exception to the lack of association among undernutrition and the conditioning factors evaluated, was seen during the period 1975-1982 when clear inverse relationship was evidenced. In conclusion, the decrease of infant undernutrition in Chile during the period 1975-1990 was not related to the changes observed in certain socioeconomic indices.

PIP: Changes in the nutritional status of the population under five years of age enrolled in Chile's National System of Health Services between 1975 and 1990 were studied, and their relationship to changes in the purchasing power of the population and to nutrition programs was assessed. A time series was constructed using quarterly data from 1975 to 1990 for the dependent and independent variables. The dependent variable was the nutritional status of children under five, assessed by weight for age from Ministry of Health records. The independent variables were income, purchasing power, cost of the basic food basket, and supplementary feeding programs. Various sources of official statistics were utilized in constructing the indicators. A multiple regression analysis was carried out for each series to determine the origin of variation. The procedure allowed for estimation of a regression model correcting by the autocorrelation of errors. A negative trend was observed in the total malnutrition rate for children under five, which was attributed to the decline between 1975 and 1982. After the first quarter of 1982 the trend stabilized at around 8 to 9%. The series also showed a pattern of seasonality, with the greatest prevalence of malnutrition in the first quarter corresponding to the summer. Purchasing power remained stable, especially in low income groups, and also presented seasonal trends, with purchasing power greatest in the summer months. Spending on nutrition programs did not present significant variation. It was concluded that a trend to decline of malnutrition occurred but was not related to the behavior of the other series studied except during 1975-82, when the socioeconomic indicators improved and malnutrition declined.

[Frontal extranasal glioma]. / Glioma frontal extranasal.

Extranasal gliomas are very rare tumours, being difficult to diagnose preoperatively due to the unspecific nature of symptoms and, at times, of the test. A newborn baby, prenatally diagnosed with frontal tumour, which on exploration showed a mass at the root of the nose, red-violet in colour and which seemed to become tenser. Skull x-ray and brain ultra-sound were normal. Ultra-sound of the tumour area and TAC showed a mass with solid content, with possible intracraneal communication. Faced with this possibility, removal by neurosurgical procedures was performed with no communications with SNC being observed. Histological diagnosis: extra-nasal glioma. Tumours situated at the root of the nose can have normal skin covering whose aspect is similar to the tumour mentioned above. Test carried out may not show accurately whether the tumour communicates with SNC or not, which may lead to surgical errors. We recommend that these malformations be treated directly by surgical teams which include neurosurgical specialists.

The sensitivity of interferon-gamma release assays is not compromised in tuberculosis patients with diabetes.

SETTING AND OBJECTIVES: the sensitivity of the interferon-gamma release assays (IGRAs) in the detection of Mycobacterium tuberculosis infection or disease may be affected by immune dysregulation in diabetes. As millions of type 2 diabetes patients are at risk for tuberculosis (TB) worldwide, it is important to determine if the sensitivity of IGRAs is compromised in this vulnerable population. DESIGN: the sensitivity of the IGRAs QuantiFERON®-TB Gold (QFT-G) and T-SPOT®.TB was evaluated among specimens from newly diagnosed adults with microbiologically confirmed TB with and without diabetes. We also evaluated the association between QFT-G results and diabetes-associated conditions (dyslipidemia, obesity). RESULTS: QFT-G sensitivity was 70% among TB patients. Patients with diabetes, chronic hyperglycemia or overweight/obesity were more than twice as likely to have positive test results in multivariate models (P < 0.05). Low high-density lipoprotein cholesterol or high triglycerides were not associated with assay results. In a separate group of TB patients (n = 43), T-SPOT.TB was 93% sensitive, with similar performance in patients with and without diabetes. CONCLUSION: IGRA sensitivity is not compromised by diabetes in TB patients. Accordingly, IGRAs may also be suitable for diagnosing TB infection in diabetes patients, which is required to assess TB risk.

Photoactivated release of cargo from the cavity of polyelectrolyte capsules to the cytosol of cells.

Polyelectrolyte capsules with metal nanoparticles in their walls and fluorescently labeled polymers as cargo inside their cavity were prepared. Capsules were ingested by living cells with no uncontrolled release of the cargo upon the incorporation process. Photoinduced heating of the metal nanoparticles in the capsule walls lead to rupture of the capsule walls, and the polymeric cargo was released to the whole cytosol. Viability tests demonstrate that opening of capsules at moderate light intensities does not impair the cellular metabolism, whereas capsule opening at high light intensities ultimately leads to cell death.