Effectiveness of different toothbrushing patterns among schoolchildren in an urban area of Argentina.

AIM: To identify toothbrushing patterns among schoolchildren with no prior dental hygiene training and associate them with effectiveness for eliminating dental biofilm. MATERIALS AND METHODS: Eight calibrated dentists assessed dental biofilm, toothbrushing procedure and dental status and registered: grip, bristle angle with respect to tooth, type of movement, surfaces brushed, simultaneous brushing of both jaws, including all six sextants and duration of brushing dental biofilm before and after brushing was determined in 944 children. Frequency distribution was calculated for nominal variables and central tendency and dispersion for quantitative variables of the toothbrushing procedure. Effectiveness was evaluated in 236 children by calculating differences between biofilm levels before and after brushing using Student's test. A cutoff value was established for the difference in reductions in biofilm levels by means of an ROC curve. RESULTS: The variables including all 6 sextants and bristle angle showed positive association with biofilm reduction. The cutoff point for biofilm reduction for including all 6 sextants was 66.85% (OR 6.4 [3.6-11.38]). The cutoff value for biofilm reduction for bristle angle was 68.35% (OR 3.2 [1.83-5.8]). CONCLUSION: The variables associated with biofilm reduction can be used to optimize the modality of future educational interventions in schoolchildren.

Baseline Severity and Inflammation Would Influence the Effect of Simvastatin on Clinical Outcomes in Cirrhosis Patients.

BACKGROUND: Simvastatin administration to decompensated cirrhosis patients improved Child-Pugh (CP) at the end of a safety trial (EST). AIM: To evaluate whether simvastatin reduces cirrhosis severity through a secondary analysis of the safety trial. METHODS: Thirty patients CP class (CPc) CPc A (n = 6), CPc B (n = 22), and CPc C (n = 2) received simvastatin for one year. PRIMARY ENDPOINT: cirrhosis severity. Secondary endpoints: health-related quality of life (HRQoL) and hospitalizations for cirrhosis complications. RESULTS: Cirrhosis severity decreased baseline versus EST only across CP score (7.3 ± 1.3 versus 6.7 ± 1.7, P = 0.041), and CPc: 12 patients lessened from CPc B to CPc A, and three patients increased from CPc A to CPc B (P = 0.029). Due to cirrhosis severity changes and differences in clinical outcomes, 15 patients completed the trial as CPc AEST and another 15 as CPc B/C. At baseline, CPc AEST showed greater albumin and high-density lipoprotein cholesterol concentrations than CPc B/C (P = 0.036 and P = 0.028, respectively). Comparing EST versus baseline, only in CPc AEST, there was a reduction in white-cell blood (P = 0.012), neutrophils (P = 0.029), monocytes (P = 0.035), and C-reactive protein (P = 0.046); an increase in albumin (P = 0.011); and a recovery in HRQoL (P < 0.030). Finally, admissions for cirrhosis complications decreased in CPc AEST versus CPc B/C (P = 0.017). CONCLUSIONS: Simvastatin would reduce cirrhosis severity only in CPc B at baseline in a suitable protein and lipid milieu, possibly due to its anti-inflammatory effects. Furthermore, only in CPc AEST would improve HRQoL and reduce admissions by cirrhosis complications. However, as these outcomes were not primary endpoints, they require validation.

An Alternative Technique for Topical Application of Acidulated Phosphate Fluoride (APF) Gel: A Two-Years Double-Blind Randomization Clinical Trial (RCT).

Background and Objectives: Dental caries is still a dramatic public health problem. The effectiveness of an alternative technique using acidulated phosphate fluoride (APF) gel pH 3.5 was evaluated and compared with conventional treatments in reducing dental caries incidence. Materials and Methods: A double-blind randomized controlled trial was conducted, involving 180 children aged 4-11 years. Three groups were formed: NaF varnish (NaFV), APF in tray (APFt), and APF in toothbrush (APFtbru). Clinical examinations were performed using standardized criteria and the ICDAS Index was assessed. The Caries Treatment Needs Index (CTNI) was calculated. Dental examinations were conducted at baseline, 12 months, and 24 months. Results: At baseline, 16,719 dental surfaces were included, with 15,434 surfaces being sound. After 24 months, the Kaplan-Meier analysis showed significant differences between the APFtbru group and the other two groups (p = 0.03). Cox regression analysis revealed that the surfaces treated with NaF varnish had the lowest survival rates (HR = 0.51 95%CI = 0.33/0.81). Occlusal surfaces had the lowest cumulative survival, while other tooth surfaces showed similar performance. Conclusions: The alternative technique of APF gel application with a toothbrush resulted in maintaining dental health over 24 months. This technique can be cost-effective and may offer advantages over traditional fluoride varnish application.

Fluoride concentration in dentifrices marketed In Argentina.

OBJECTIVES: The objective of this study was to determine the different forms of fluoride available in dentifrices commercialized in Argentina. METHODS: Thirty three different brands of fluoridated dentifrices were purchased in different cities of Argentina. The total fluoride (TF), total soluble fluoride (TSF) and ionic fluoride (IF) of two samples of each brand were analysed (µg F/ml) by ion-specific fluorine electrodes. RESULTS: A total of 67% of dentifrices showed fluoride content that compromises anti-caries activity. A total of 54.5% was formulated with sodium fluoride (NaF), 36.3% formulated with sodium monofluorophosphate (MFP), 3% NaF associated with MFP and 9% formulated with stannous fluoride (SnF2). The TF found was less than the amount declared by the manufacturer in all the brands analysed. The concentration of TF found in the fluoride dentifrices ranged from 590.3 to 1381.4 µg/ml F, TSF ranged from 343.1 to 1258.3 µg/ml F, and IF ranged from 13.1 to 913 µg/ml F. CONCLUSION: The concentrations of TF were below the reported values. TSF and IF were lower than the total fluoride concentration. Most of the samples studied have TSF concentration that compromises anti-caries effect. Additional studies with a larger number of samples are suggested to obtain more data.

Disease activity and subcutaneous nodules are associated to severe periodontitis in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) was significantly associated with increased overall risk of periodontitis, both chronic, inflammatory pathologies leading to connective tissue breakdown and bone destruction. To identify clinical and/or serological variables routinely evaluated during follow-up of people with RA which are associated with the severity of their periodontal disease. An observational, cross-sectional study was carried out, which included RA patients according to ACR/EULAR 2010 criteria having chronic periodontal disease. RA clinical parameters (disease duration, erythrocyte sedimentation rate, serum C-reactive protein, disease activity (DAS28) and rheumatoid factor, presence of bone erosions and rheumatic nodules) and also corticosteroid therapy were considered. Periodontitis was evaluated according to the American Academy of Periodontology (1999) and chronic periodontitis was assessed by full mouth periapical radiographic examination, periodontal probing depth, clinical attachment level and bleeding index. A total of 110 subjects with RA and chronic periodontitis were included. The female/male relation was 5.1, and no significant differences between genres were found in rheumatic or oral variables. RA patients with longer disease duration, higher disease activity and with rheumatic nodules had significantly greater periodontitis severity. Multivariate analysis confirmed that severe periodontitis was associated with DAS283 4.1 (OR 51.4, CI 95% 9.4-281.5) and the presence of rheumatic nodules (OR 6.4, CI 95% 1.3-31.6). Disease activity and rheumatic nodules were strongly associated with severe periodontitis. Based on these findings it would be desirable to include interdisciplinary management at an early stage of RA to ensure comprehensive treatment of both pathologies.

Fish oil encapsulated in soy protein particles by lyophilization. Effect of drying process.

BACKGROUND: Fish oil is an important source of healthy ω-3 fatty acids to be used in functional foods. However, its autoxidation susceptibility, aroma and solubility make it difficult to use. Its encapsulation could reduce these disadvantages. This manuscript focuses on the drying stage of the encapsulation process. Its objective was to study the encapsulation of fish oil with soy proteins by emulsification and lyophilization and compare microparticles characteristics with those processed identically but spray dried. RESULTS: Microparticles with different protein/oil ratios were prepared by emulsification and lyophilization. Soy proteins encapsulated fish oil in matrix-type microcapsules masking its typical odor and oily appearance. Microparticles dried by lyophilization showed a better solid recovery but lower encapsulation efficiency than those spray dried. Increasing protein/oil mass ratio of initial formulations seemed to favor initial lipid oxidation, but these differences were not appreciated when analyzing the oxidative stability over time (measured by Rancimat test). Porous structure and large surface area of lyophilized samples would favor oxygen easy penetration and exposition to free radicals, increasing lipid oxidation over time, while spray dried microparticles showed a good oxidative stability over time, like that of free oil. CONCLUSION: Drying processes were determinants in the morphology of microcapsules, the efficiency of encapsulation and protection exerted on the oil. Although emulsifying and drying processes caused certain initial oil oxidation, soy proteins managed to mask fish oil flavors and spray dried systems showed a good perspective of oxidative stability of fish oil over time, better than that of lyophilized microparticles. © 2021 Society of Chemical Industry.

Increased dietary availability of selenium in rainbow trout (Oncorhynchus mykiss) improves its plasma antioxidant capacity and resistance to infection with Piscirickettsia salmonis.

Salmonid Rickettsial Septicaemia (SRS), caused by Piscirickettsia salmonis, is the most important infectious disease in the Chilean salmon farming industry. An opportunity to control this disease is to use functional micronutrients to modulate host mechanisms of response to the infection. Since P. salmonis may affect the host antioxidant system in salmonids, particularly that dependent on selenium (Se), we hypothesized that fish's dietary selenium supplementation could improve the response to the bacterial infection. To address this, we defined a non-antibiotic, non-cytotoxic concentration of selenium to evaluate its effect on the response to in vitro infections of SHK-1 cells with P. salmonis. The results indicated that selenium supplementation reduced the cytopathic effect, intracellular bacterial load, and cellular mortality of SHK-1 by increasing the abundance and activity of host glutathione peroxidase. We then prepared diets supplemented with selenium up to 1, 5, and 10 mg/kg to feed juvenile trout for 8 weeks. At the end of this feeding period, we obtained their blood plasma and evaluated its ability to protect SHK-1 cells from infection with P. salmonis in ex vivo assays. These results recapitulated the observed ability of selenium to protect against infection with P. salmonis by increasing the concentration of selenium and the antioxidant capacity in fish's plasma. To the best of our knowledge, this is the first report of the protective capacity of selenium against P. salmonis infection in salmonids, becoming a potential effective host-directed dietary therapy for SRS and other infectious diseases in animals at a non-antibiotic concentration.

Safety of Chronic Simvastatin Treatment in Patients with Decompensated Cirrhosis: Many Adverse Events but No Liver Injury.

BACKGROUND: The high mortality rate of decompensated cirrhosis underlines the need for new treatments. Experimental models of cirrhosis and its reported relationship with atherosclerotic cardiovascular disease have provided data supporting the rational use of statins in these patients. However, little is known about the safety of statins in this setting. AIM: We evaluate the safety of chronic simvastatin treatment in patients with decompensated cirrhosis. METHODS: We conducted a prospective, open, uncontrolled, phase 2a trial in 30 patients with Child-Pugh class A (n = 6), B (n = 22), and C (n = 2) decompensated cirrhosis. The patients received standard treatment throughout the trial plus simvastatin 20 mg/day for 2 weeks and thereafter simvastatin 40 mg/day up to 1 year. RESULTS: Sixteen out of 30 patients (53.3%) showed adverse events, including gastrointestinal toxicity (36.7%), muscle injury (MI) (36.7%), and headache (13.3%). No liver injury was registered. Due to MI alone, simvastatin dosage was reduced in 23.4% of cases and transiently interrupted in 13.3%. Once these adverse events were overcome, simvastatin was resumed until the end of the trial. MI was associated with baseline MELD score > 12 (p = 0.035) and with baseline Child-Pugh class C. No MI was associated with final Child-Pugh score ≤ 6 (p = 0.030) or final Child-Pugh class A (p = 0.020). CONCLUSIONS: Chronic treatment with simvastatin 40 mg/day in patients with decompensated cirrhosis was associated with several adverse events, being MI the only clinically significant one, which appears to be related to the simvastatin dosage and the degree of cirrhosis severity. Noticeably, no liver injury was recorded.

Minimally invasive surgery for haemophilic pseudotumour of the limbs: 28 years of experience.

INTRODUCTION: Haemophilic pseudotumour (HP) is an encapsulated haematoma in patients with haemophilia (PWH) which has a tendency to progress and produce clinical symptoms related to its anatomical location. AIM: To show the experience of one surgeon who has been using mini-invasive technique to treat pseudotumours of limbs in PWH with and without inhibitors at one centre for 28 years. MATERIALS AND METHODS: Thirty-three patients with 39 HP were treated. All patients had haemophilia A. Twenty-four patients had no inhibitors (72.8%), and 9 had inhibitors (27.2%). The mean follow-up was 16 years (1-25). All patients had x-rays and MRIs. All of them received Buenos Aires protocol as conservative treatment for 6 weeks. MRIs were repeated after 6 weeks' treatment to assess response to treatment. Surgery was performed in patients who did not respond to conservative treatment. RESULTS: After Buenos Aires protocol, four pseudotumours did not shrink (10.24%), 33 (84.61%) shrank, and two (5.12%) healed. Thirty-seven pseudotumours had surgery, 35 pseudotumours (94.59%) healed with minimally invasive treatment, and two did not heal (5.41%). No infection was observed with this treatment. The mortality rate for the series was 0%. CONCLUSION: The minimally invasive treatment of pseudotumours was effective in 95% of the cases and resulted in no mortality in this series after 28 years.

Pharmacological iron-chelation as an assisted nutritional immunity strategy against Piscirickettsia salmonis infection.

Salmonid Rickettsial Septicaemia (SRS), caused by Piscirickettsia salmonis, is a severe bacterial disease in the Chilean salmon farming industry. Vaccines and antibiotics are the current strategies to fight SRS; however, the high frequency of new epizootic events confirms the need to develop new strategies to combat this disease. An innovative opportunity is perturbing the host pathways used by the microorganisms to replicate inside host cells through host-directed antimicrobial drugs (HDAD). Iron is a critical nutrient for P. salmonis infection; hence, the use of iron-chelators becomes an excellent alternative to be used as HDAD. The aim of this work was to use the iron chelator Deferiprone (DFP) as HDAD to treat SRS. Here, we describe the protective effect of the iron chelator DFP over P. salmonis infections at non-antibiotic concentrations, in bacterial challenges both in vitro and in vivo. At the cellular level, our results indicate that DFP reduced the intracellular iron content by 33.1% and P. salmonis relative load during bacterial infections by 78%. These findings were recapitulated in fish, where DFP reduced the mortality of rainbow trout challenged with P. salmonis in 34.9% compared to the non-treated group. This is the first report of the protective capacity of an iron chelator against infection in fish, becoming a potential effective host-directed therapy for SRS and other animals against ferrophilic pathogens.

Physical, structural and antioxidant properties of brewer's spent grain protein films.

BACKGROUND: The development of brewer's spent grain protein (BSG-PC) films with potential active packaging properties was investigated. Films were prepared by casting protein dispersions at different pH values (2, 8, 11), plasticizers [polyethylene glycol (PEG) or glycerol] and levels (0-0.25 g g-1 ) of PEG. Mechanical, water-barrier and solubility, optical, antioxidant (reducing power, ABTS•+ and lipidic radical scavenging), and antimicrobial properties of films were determined. Also, the structural characteristics of films were evaluated by attenuated total reflectance-Fourier transform infrared spectroscopy. RESULTS: Only films prepared at pH 2 and plasticized by PEG were homogeneous in appearance and could be manipulated; thus, different levels of PEG were studied at this pH. Higher PEG concentrations increased water solubility, water vapor permeability and elongation at break, and decreased tensile strength and elastic modulus. PEG increased α-helix structure only when 0.10 g PEG g-1 BSG-PC was used. This could be related to the better mechanical properties of F0.10 films (higher tensile strength, and elastic modulus) with respect to the other films. Antioxidant activity depended on PEG concentration, whereas no antimicrobial properties against Bacillus cereus, Salmonella newport and Penicillium corylophylum were detected. CONCLUSION: The formulations with 0.10 and 0.15 g PEG g-1 BSG-PC appear to be the most promising, balancing mechanical, water-barrier properties and the antioxidant capacity of these films. Moreover, BSG proteins could be a cheap alternative for the preparation of biodegradable films, which are capable of being used as active food packaging. © 2020 Society of Chemical Industry.

Disinfection behavior of a UV-treated wastewater system using constructed wetlands and the rate of reactivation of pathogenic microorganisms.

The use of constructed wetlands as a wastewater treatment system is a feasible solution for rural areas. However, these systems do not efficiently eliminate pathogenic microorganisms. Therefore, it is necessary to implement disinfection systems such as ultraviolet (UV) disinfection systems in constructed wetlands. To evaluate the behavior of a UV system, a pilot system of artificial wetlands connected to one such disinfection system was operated. The results show that when the total suspended solids (TSS) of the influent (already treated by the system of constructed wetlands) reached values of 26.7 mg/L, a reduction of 2.03 uLog in fecal coliforms was obtained. However, when the TSS increased to 34.7 mg/L, the reduction was only 0.33 uLog. In addition to the influence of the TSS on the fecal coliform reduction efficiency, there is a direct relationship between the transmittance and the sizes of the particles present in the influent. After UV treatment, the microorganisms showed a peak in photoreactivation of 27.8% at 4 h after irradiation with visible radiation, while under conditions of darkness, no reactivation was observed.

Ceratocorys mariaovidiorum sp. nov. (Gonyaulacales), a new dinoflagellate species previously reported as Protoceratium reticulatum.

The family Ceratocoryaceae includes the genera Ceratocorys, Protoceratium, and Schuettiella, whose phylogenetic relationships are poorly known. Here, the new non-yessotoxin-producing species of the genus Ceratocorys, Ceratocorys mariaovidiorum sp. nov., previously reported as the toxic Protoceratium reticulatum, is described from examinations by light and scanning electron microscopy, molecular phylogeny, and toxin analyses. The species description is made from culture samples of strains CCMP1740 and CCMP404 from USA waters. Ceratocorys mariaovidiorum is globular and has thick and strongly reticulated plates with one pore within each reticule, just like P. reticulatum, but the key difference between the two species is the presence of five precingular plates in C. mariaovidiorum instead of six as in P. reticulatum. The thecal plate formula is Po, 4', 0a, 5″, 6c, ~7s, 5‴, 0p, 2''''. The apical pore plate is oval with a λ-shaped pore. The first apical plate is narrow with a ventral pore on the right anterior side; it contacts the apical pore plate and its contact with the anterior sulcal plate is slight or absent. The fourth precingular plate of other Gonyaulacales is absent. Ceratocorys mariaovidiorum may have small spines on the second antapical plate. A phylogenetic study based on internal transcribed spacer/5.8SrDNA supports the morphological classification of C. mariaovidiorum as a new species of Ceratocorys and in a different clade from P. reticulatum.

Benthic flattened cells of the phylogenetically related marine dinoflagellates Protoceratium reticulatum and Ceratocorys mariaovidiorum (Gonyaulacales): a new type of cyst?

A planktonic-benthic relationship has been described for many dinoflagellate species as part of their ecological strategy to overcome highly variable aquatic environments. Here, the phylogenetically and morphologically related marine dinoflagellates Protoceratium reticulatum and Ceratocorys mariaovidiorum were studied in relation to an unknown benthic life form. In vivo and fixed samples from cultures were analyzed in detail by light and scanning electron microscopy. In both species, a cell type with a morphology different from that of vegetative cells was observed in cultures grown until stationary phase. This cell type was always benthic, swimming sporadically only when it was disturbed. Its main feature included a strong dorsoventral compression. These cells originated from vegetative cells whose protoplasm underwent a progressive flattening, resulting in a gradual detachment of the reticulate and thick thecal plates and the formation of very thin non-reticulated new plates with pores. When returned to fresh full-strength medium, the cells recovered their spherical vegetative-like morphology, including new reticulated thick plates and subsequent cell divisions. The kinetics of flattened cell formation showed that in both species, this cell type increased exponentially until the onset of the culture stationary phase and then decreased. The results of this study are discussed in the context of the planktonic-benthic coupling in dinoflagellate life cycles, including those newly appreciated to be well adapted to the benthic environment.

[Foundations for the development and implementation of a women's and perinatal health information model for management in Latin AmericaFundamentos do desenvolvimento e implementação de um modelo de informação em saúde da materna e perinatal orientado à gestão na América Latina]. / Bases para el desarrollo e implementación de un modelo de información en salud de la mujer y perinatal orientado a la gestión en Latinoamérica.

OBJECTIVE: The Perinatal Information System (SIP) represents a milestone in the use of systematized information in the Region of the Americas. What has been learned from the system has contributed to the development of a model based on a set of core indicators (SCI). The objective of the study was to describe the historical and methodological process involved in the development, implementation, and territorial scaling-up of an SCI to monitor and evaluate women's and perinatal health policies, programs, and services geared to management (SIP-GESTIÓN). METHODS: The study was conducted in two stages: 1) a four-phase validation of an SCI in a hospital network: a) construction of the theoretical indicator model, b) operations research, c) final selection of the indicators, and d) the definition of reference standards; and 2) territorial scaling-up. RESULTS: A total of 17 indicator models were identified. The initial model included 177 indicators divided into seven dimensions (context, habits, accessibility, use of services, quality of care, maternal and fetal impact, and maternal and neonatal impact), with 21 indicators remaining after three Delphi rounds. The final model (SIP-GESTIÓN), which included 40 indicators, was then used to study 240,021 (79.1%) of the 303,559 deliveries attended in 122 selected maternity facilities in 24 jurisdictions (100%) in Argentina. The information is presented in national terms and by health region, province, and hospital. CONCLUSIONS: This model has made it possible to achieve high levels of information coverage and quality and territorial scaling-up and is useful for management, research, and the reorientation of programs and policies.

OBJETIVO: O Sistema de Informação Perinatal (SIP) é um marco no uso de informação sistematizada na Região das Américas. A experiência obtida contribuiu para o desenvolvimento de um modelo baseado em um conjunto mínimo de indicadores (CMI). O objetivo do estudo foi descrever o processo histórico e metodológico do desenvolvimento, implementação e dimensionamento territorial do CMI para monitorar e avaliar políticas, programas e serviços de saúde materna e perinatal orientado à gestão (SIP-gestão). MÉTODOS: O estudo foi realizado em duas etapas. A primeira etapa consistiu da validação em quatro fases de um CMI em uma rede de hospitais: a) construção do modelo teórico de indicadores, b) implementação da pesquisa operacional, c) seleção final dos indicadores e d) definição dos padrões de referência. A segunda etapa consistiu da determinação da escala territorial. RESULTADOS: Foram identificados 17 modelos de indicadores. O modelo inicial incluiu 177 indicadores agrupados em sete dimensões (contexto, hábitos, acessibilidade, utilização de serviços, qualidade do atendimento, impacto materno-fetal e impacto materno-neonatal) que foram reduzidas a 21 após três rodadas de aplicação da técnica Delphi. O modelo final (SIP-gestão) inclui 40 indicadores. Foram analisados 240.021 partos (79,1%) de um número total de 303.559 casos atendidos nas 122 maternidades selecionadas em 24 jurisdições (100%) da Argentina. Os dados são apresentados ao nível nacional e desagregados por região de saúde, província e hospital. CONCLUSÕES: O modelo desenvolvido atingiu altos níveis de cobertura e qualidade da informação e determinação da escala territorial, e pode ser usado na gestão, pesquisa e reorientação de programas e políticas.

The Reactivity and Reaction Pathway of Fenton Reactions Driven by Substituted 1,2-Dihydroxybenzenes.

Fenton systems are interesting alternatives to advanced oxidation processes (AOPs) applied in soil or water remediation. 1,2-Dihydroxybenzenes (1,2-DHBs) are able to amplify the reactivity of Fenton systems and have been extensively studied in biological systems and for AOP applications. To develop efficient AOPs based on Fenton systems driven by 1,2-DHBs, the change in reactivity mediated by different 1,2-DHBs must be understood. For this, a systematic study of the reactivity of Fenton-like systems driven by 1,2-DHBs with different substituents at position 4 was performed. The substituent effect was analyzed using the Hammett constant (σ), which has positive values for electron-withdrawing groups (EWGs) and negative values for electron-donating groups (EDGs). The reactivity of each system was determined from the degradation of a recalcitrant azo dye and hydroxyl radical (HO·) production. The relationship between these reactivities and the ability of each 1,2-DHB to reduce Fe(III) was determined. From these results, we propose two pathways for HO· production. The pathway for Fenton-like systems driven by 1,2-DHBs with EDGs depends only on the Fe(III) reduction mediated by 1,2-DHB. In Fenton-like reactions driven by 1,2-DHBs with EWGs, the Fe(III) reduction is not primarily responsible for increasing the HO· production by this system in the early stages.

Proton pump inhibitor therapy does not increase the incidence of spontaneous bacterial peritonitis in cirrhosis: a multicenter prospective study.

BACKGROUND & AIM: Retrospective studies show an association between proton pump inhibitor (PPI) therapy and spontaneous bacterial peritonitis (SBP). We investigate the relationship between PPI and SBP in decompensated cirrhotic patients in a large nationwide prospective study. METHODS: Seven hundred seventy patients with a diagnosis of decompensated cirrhosis were admitted consecutively in 23 hospitals in Argentina from March 2011 to April 2012; the patients were carefully investigated for PPI consumption in the previous 3 months. In total, 251 patients were excluded because of active gastrointestinal hemorrhage, antibiotic use during the preceding weeks, HIV-positive status and immunosuppressive therapy. RESULTS: Two hundred twenty-six out of 519 patients (43.5%) had received PPI therapy within the last 3 months. In 135 patients, PPIs were administered for longer than 2 weeks. A bacterial infection was shown in 255 patients (49.1%). SBP was diagnosed in 95 patients out of 394 patients with ascites (24.7%). There was no significant difference in the rate of PPI consumption between the infected and the non-infected patients (44.3% vs. 42.8%) or between the SBP patients and the patients with ascites without SBP (46% vs. 42%). In the SBP patients, the duration of PPI administration did not influence the rate of SBP occurrence. The type of bacteria and the origin of SBP infection were similar in the patients with and without PPI. CONCLUSION: In the current large, multicenter, prospective study, PPI therapy, specifically evaluated at admission of consecutive cirrhotic patients, was not associated with a higher risk of SBP.

[Model for a comprehensive approach to maternal mortality and severe maternal morbidity]. / Modelo para abordar integralmente la mortalidad materna y la morbilidad materna grave.

Maternal mortality is an important public health and human rights problem and reflects the effects of social determinants on women's health. Understanding the extent and causes of maternal death has been insufficient to achieve the Millennium Development Goals. This article proposes a model for a comprehensive approach to maternal mortality, covering seven areas: prioritization and definition of the problem, contextual description, methodological scope, knowledge management, innovation, implementation, and a monitoring and evaluation system. This model helps address problems associated with maternal mortality and severe maternal morbidity through early monitoring of potentially fatal complications in the reproductive process. Knowledge management is important for the reorientation of policies, programs, and health care. Interaction and synergies among people, communities, and actors in the health system should be strengthened in order to improve the results of health programs. More validated scientific information is needed on how actions should be implemented in different environments. It is essential to strengthen communication among research centers, cooperation agencies, and government organizations and to include them in programs and in the definition of a new women's health agenda in the Region of the Americas.

Sources and profiles of toxins in shellfish from the south-central coast of Chile (36°â€’ 43° S).

The study of marine toxins in shellfish is of the utmost importance to ensure people's food safety. Marine toxins in shellfish and microalgae in the water column off the south-central coast of Chile (36°â€’43° S) were studied in a network of 64 stations over a 14-month period. The relative abundance of harmful species Alexandrium catenella, Alexandrium ostenfeldii, Protoceratium reticulatum, Dinophysis acuminata, Dinophysis acuta, Pseudo-nitzschia seriata group and P. delicatissima group was analyzed. The detection and quantification of lipophilic toxins and domoic acid (DA) in shellfish was determined by UHPLC-MS/MS, and for Paralytic Shellfish Toxins (PSTs) by HPLC-FD with post-column oxidation, while for a culture of A. ostenfeldii a Hylic-UHPLC-MS/MS was used. Results showed that DA, gonyautoxin (GTX)-2, GTX-3 and pectenotoxin (PTX)-2 were detected below the permitted limits, while Gymnodimine (GYM)-A and 13-desmethylespirolide C (SPX-1) were below the limit of quantitation. According to the distribution and abundance record of microalgae, DA would be associated to P. seriata and P. delicatissima-groups, PTX-2 to D. acuminata, and GTX-2, GTX-3, GYM-A, and SPX-1 to A. ostenfeldii. However, the toxin analysis of an A. ostenfeldii culture from the Biobío region only showed the presence of the paralytic toxins C2, GTX-2, GTX-3, GTX-5 and saxitoxin, therefore, the source of production of GYM and SPX is still undetermined.

In Situ Synthesis of Cu2O Nanoparticles Using Eucalyptus globulus Extract to Remove a Dye via Advanced Oxidation.

Water pollution, particularly from organic contaminants like dyes, is a pressing issue, prompting exploration into advanced oxidation processes (AOPs) as potential solutions. This study focuses on synthesizing Cu2O on cellulose-based fabric using Eucalyptus globulus leaf extracts. The resulting catalysts effectively degraded methylene blue through photocatalysis under LED visible light and heterogeneous Fenton-like reactions with H2O2, demonstrating reusability. Mechanistic insights were gained through analyses of the extracts before and after Cu2O synthesis, revealing the role of phenolic compounds and reducing sugars in nanoparticle formation. Cu2O nanoparticles on cellulose-based fabric were characterized in terms of their morphology, structure, and bandgap via SEM-EDS, XRD, Raman, FTIR, UV-Vis DRS, and TGA. The degradation of methylene blue was pH-dependent; photocatalysis was more efficient at neutral pH due to hydroxyl and superoxide radical production, while Fenton-like reactions showed greater efficiency at acidic pH, primarily generating hydroxyl radicals. Cu2O used in Fenton-like reactions exhibited lower reusability compared to photocatalysis, suggesting deterioration. This research not only advances understanding of catalytic processes but also holds promise for sustainable water treatment solutions, contributing to environmental protection and resource conservation.