Comparative Bioavailability of a Novel Fixed-dose Combination Etoricoxib and Tramadol.

Multimodal analgesia is defined as using several drugs or techniques simultaneously to target different pain pathways or receptors to avoid pain propagation. This study evaluated the pharmacokinetic profile and comparative bioavailability of etoricoxib 90 mg and tramadol 50 mg dosing alone (reference drugs) or in a novel fixed-dose combination (test drug) under fasting conditions in Mexican healthy volunteers. This was a randomized, open-label, 3-way, crossover, single-dose, prospective, and longitudinal study with a 14-day washout period. Eligible subjects were healthy Mexican adult volunteers. The drugs were dosing orally, according to the randomization sequence, after 10 hours of fasting and 4 hours before breakfast with 250 mL of water at room temperature. Serial blood samples were collected before and after dosing, both drugs were quantified using high-performance liquid chromatography coupled with tandem mass spectrometry. Forty-two subjects were enrolled and 38 completed the study (28 men and 14 women, mean age 25.2 years, mean weight 66.6 kg). Test products were considered to have comparative bioavailability if confidence intervals of natural log-transformed for (maximum plasma drug concentration (Cmax), (area under the plasma drug concentration-time curve form 0 up to last sampling time (AUC0-t), and (area under the plasma drug concentration-time curve from 0 up to infinity (AUC0-∞) data were within the range of 80%-125%. Non-serious adverse events were observed. The results demonstrate that the pharmacokinetic profile and bioavailability of the etoricoxib/tramadol fixed-dose combination are comparable to those of the reference products.

Experiencia en reconstrucción del paciente gran quemado agudo con microcirugía

Introducción: Las quemaduras son un trauma frecuente de ocurrencia en todo el mundo, que ha experimentado importantes aumentos de sobrevida. Su manejo requiere la reposición de la barrera cutánea, lo que se logra en la mayoría de los casos con el uso de injertos dermo-epidérmicos. Sin embargo, existen algunas veces lesiones complejas que no logran sanar mediante injertos, arriesgando la funcionalidad o vitalidad del área comprometida, que requerirán reparaciones complejas con el uso de colgajos microqui- rúrgicos (CM). Metodología: Estudio descriptivo retrospectivo en que incluimos todos los pacientes gran quemados agudos admitidos en Hospital de Urgencia de la Asistencia Pública, Servicio de Quemados y Rehabilitación, desde abril de 2019 hasta diciembre de 2020 los que fueron manejados con colgajo micro- quirúrgico. Revisión de ficha clínica para obtención de variables demográficas y del procedimiento con análisis de frecuencia de ocurrencia. Resultados: En nuestro período de estudio hubo 376 ingresos y 21 pacientes recibieron 25 CM. La mayoría hombres (96%), edad promedio 40 años, superficie comprometida promedio 16%, mecanismo más frecuente electricidad (64%) y fuego (32%). La ubicación más frecuente del colgajo fue en extremidades inferiores (64%) y el colgajo más utilizado fue el anterolateral de muslo (80%). Tiempo medio a reconstrucción fueron 40 días, no hubo pérdida total del colgajo. Discusión: se realizó un CM en 5,6% de nuestros ingresos, la mayoría durante el intervalo primario tardío, sin pérdidas totales. Estos resultados representan la consolidación de la técnica que permite su uso en el paciente gran quemado durante su etapa aguda, permitiendo coberturas complejas y manteniendo riesgo quirúrgico y tasa de complicaciones adecuada con enfoque en rehabilitación precoz.

Introduction: Burns are the fourth most common trauma. Microsurgery has evolved as a valuable tool in the acute setting allowing early closure of complex wounds in order to avoid infection, maintain function or even for limb salvage in one stage reconstruction. We present our experience at our burn center in Chile. Method: We performed a retrospective analysis of all major burn patients admitted in the National Burn Center in Chile who received a microsurgical flap in the period between April 2019 to December 2020. Results: A total of 21 patients had 25 free flaps. All patients but one were male (96%), mean age 40 years (range 20-69 years). Total body surface area means 16% (range 1-64%). Most of the injuries were caused by high voltage electricity (64%) and fire (32%). 64% were performed in lower limbs and 36% in upper limbs. In 80% of the cases, anterolateral thing flap was chosen. Mean time to reconstruction was 40 days. We didn't experience a total flap lost in this series. Discussion: In the acute phase microsurgery proved to be safe and feasible albeit a small surgical indication. We performed a flap in 5.6% of our admissions, mostly during late primary interval with no flaps lost. Our results acknowledge the consolidation of the technique for its use in the acutely burned setting, allowing complex coverage while maintaining the surgical risk and an internationally acceptable rate of losses and complications.

Performance of a vaginal self-collection device versus clinician collected cervical samples for the detection of high-risk human papillomavirus.

Objective: Screening for cervical cancer requires the participation of target women. Human papillomavirus (HPV) testing can be performed on vaginal self-samples and self-sampling can improve this participation. This study aims to validate the performance of the vaginal self-sampling device (Vitroveil®) to detect high risk human papillomavirus (hrHPV) in comparison to clinician collected samples and evaluate the degree of acceptability of the Vitroveil® device. Methods: A cross-sectional observational study was carried out in a cohort of 385 participating women (median age of 44 ± 10.47 years) attending primary care centers and cervical pathology services of Granada, Spain. Two paired samples (vaginal self-sample and clinician collected cervical sample) where collected from each participant to compare the detection of HPV with the Vitro HPV Screening assay (Vitro, Granada, Spain). A questionnaire was also provided to the participants to analyze the degree of satisfaction with the device and the preference for sampling method. Results: Overall concordance for hrHPV detection was substantial (ĸ 0.804). The prevalence of any hrHPV infection was higher in self-collected samples (30.6%) than in clinician-collected samples (24.3%). The participants found the self-sampling device easy to use and preferred self-collection as the collection method. Conclusion: The Vitroveil® self-sampling device enables safe and accruable hrHPV testing, obtaining equivalent results to those of the clinician collected samples. High acceptability of the device has been demonstrated among women in the study. Nevertheless, additional studies are necessary to verify the efficacy and reliability of the device's performance.

Health habits during lockdown for COVID-19 in Spain and its effect on weight.

BACKGROUND AND OBJECTIVES: a deterioration of health habits has been found in various studies caused by stressful situations such as mandatory and maintained confinement over time. This study aims to analyze the health habits of the Spanish adult population during confinement due to the COVID-19 pandemic, and the possible impact on their body weight. METHOD: two thousand eight hundred and thirty-four volunteer subjects participated in the study (69.3 % women). They completed an on-line questionnaire that evaluated their health habits, as well as various sociodemographic variables. RESULTS: the results show a statistically significant link between the subjects' body mass index (BMI) and the change in their weight during lockdown (2: 79.303; p: < 0.001). Besides, a statisti-cally significant relationship between the different health habits under analysis was also found, being moderate with respect to the link between eating habits and physical activity (Cramer's V: .226). A statistically significant relationship was also found between the participants' weight and the different health habits during lockdown. The effect size of the associations was moderate in relation to the participants' eating habits (Cramer's V: .409) and physical activity (Cramer's V: .292). CONCLUSIONS: it is suggested the development of prevention programs for long lockdown periods associated with high levels of stress so as to promote a healthy diet, as well as exercise using new technologies and a proper rest, especially in overweight or obese subjects.

Consumo alimentario en mujeres embarazadas, mujeres que dan de lactar y niños de 0 a 5 años. Centros de salud ciudad de La Paz - área urbana, 2018 / Food consumption in pregnant women, breastfeeding women and children from 0 to 5 years old. La Paz city health centers - urban area, 2018

OBJETIVO: Determinar el consumo de alimentos en mujeres embarazadas, mujeres que dan de lactar y niños de 0 a 5 años, atendidos en Centros de Salud de Primer Nivel en la ciudad de La Paz en el mes de septiembre de 2018. MATERIAL Y MÉTODOS: Estudió transversal descriptivo correlacional en 126 mujeres embarazadas, 120 mujeres que dan de lactar, 105 niños de 0 a 5 meses y 117 niños de 6 a 60 meses, que asistieron a consulta en Centros de Salud. Se aplicó el método de Recordatorio de 24 Horas (R24H) para determinar el consumo de alimentos, método antropométrico para la evaluación nutricional. RESULTADOS: La ingesta promedio en mujeres embarazadas 1999 kcal y mujeres que dan de lactar 1943 Kcal, es menor a la recomendada; inadecuada en grasas, calcio y zinc; suficiente en proteínas, hidratos de carbono, vitaminas A y C; el hierro es deficiente en embarazadas. Los niveles de adecuación de la dieta en niños de 6 a 23 meses en calcio 88,3%, hierro 75%. De 24 a 60 meses en: calorías 86,3%, grasas 46,9% y zinc 50,6%. CONCLUSIONES: El consumo promedio observado en mujeres y niños es inferior a las recomendaciones nutricionales. El estado nutricional no corresponde al exceso o déficit en la ingesta. La ingesta deficiente de micronutrientes, es debida al consumo insuficiente de verduras y frutas.

Btg1 and Btg2 regulate neonatal cardiomyocyte cell cycle arrest.

Rodent cardiomyocytes undergo mitotic arrest in the first postnatal week. Here, we investigate the role of transcriptional co-regulator Btg2 (B-cell translocation gene 2) and functionally-similar homolog Btg1 in postnatal cardiomyocyte cell cycling and maturation. Btg1 and Btg2 (Btg1/2) are expressed in neonatal C57BL/6 mouse left ventricles coincident with cardiomyocyte cell cycle arrest. Btg1/2 constitutive double knockout (DKO) mouse hearts exhibit increased pHH3+ mitotic cardiomyocytes compared to Wildtype at postnatal day (P)7, but not at P30. Similarly, neonatal AAV9-mediated Btg1/2 double knockdown (DKD) mouse hearts exhibit increased EdU+ mitotic cardiomyocytes compared to Scramble AAV9-shRNA controls at P7, but not at P14. In neonatal rat ventricular myocyte (NRVM) cultures, siRNA-mediated Btg1/2 single and double knockdown cohorts showed increased EdU+ cardiomyocytes compared to Scramble siRNA controls, without increase in binucleation or nuclear DNA content. RNAseq analyses of Btg1/2-depleted NRVMs support a role for Btg1/2 in inhibiting cell proliferation, and in modulating reactive oxygen species response pathways, implicated in neonatal cardiomyocyte cell cycle arrest. Together, these data identify Btg1 and Btg2 as novel contributing factors in mammalian cardiomyocyte cell cycle arrest after birth.

Myo1e overexpression in lung adenocarcinoma is associated with increased risk of mortality.

This study aims to perform a comprehensive genomic analysis to assess the influence of overexpression of MYO1E in non-small cell lung carcinoma (NSCLC) and whether there are differences in survival and mortality risk in NSCLC patients depending on both DNA methylation and RNA expression of MYO1E. The DNA methylation probe cg13887966 was inversely correlated with MYO1E RNA expression in both LUAD and LUSC subpopulations showing that lower MYO1E RNA expression was associated with higher MYO1E DNA methylation. Late stages of lung cancer showed significantly lower MYO1E DNA methylation and significantly higher MYO1E RNA expression for LUAD but not for LUSC. Low DNA methylation as well as high RNA expression of MYO1E are associated with a shorter median survival time and an increased risk of mortality for LUAD, but not for LUSC. This study suggests that changes in MYO1E methylation and expression in LUAD patients may have an essential role in lung cancer's pathogenesis. It shows the utility of MYO1E DNA methylation and RNA expression in predicting survival for LUAD patients. Also, given the low normal expression of MYO1E in blood cells MYO1E DNA methylation has the potential to be used as circulating tumor marker in liquid biopsies.

Subclinical bowel inflammation increases healthcare resources utilization and steroid use before diagnosis of inflammatory bowel disease.

BACKGROUND: Previous data support that the inflammatory process underlying ulcerative colitis (UC) and Crohn's disease (CD) can start years before the diagnosis. The aim of this study was to determine if patients with an incidental diagnosis of UC or CD demonstrate an increase in healthcare utilization in the years preceding the symptomatic onset of the disease. METHODS: We performed a multicenter, retrospective, hospital-based, case-control study. Patients with an incidental diagnosis of UC or CD during the colorectal cancer screening program at 9 hospitals were included. Cases were matched 1:3 and compared separately with two control populations: one including healthy non-IBD subjects adjusted by gender, age, and date, excluding those with visits to Gastroenterology; and a second control cohort of UC/CD patients with symptomatic onset. RESULTS: A total of 124 patients with preclinical inflammatory bowel disease (IBD) were included (87 UC, 30 CD, 7 IBD unclassified; median age 56 years). Patients with preclinical IBD showed an increase in the number of visits to Primary Care up to 3 and 5 years before diagnosis (aIRR 1.59, 95% CI [1.37-1.86], p = 0.001; aIRR 1.43, 95% CI [1.24-1.67], p = 0.01) and more frequent use of steroids (aOR 2.84, 95% CI [1.21-6.69], p = 0.03; aOR 2.25, 95% CI [1.06-4.79], p = 0.04) compared to matched non-IBD healthy controls, respectively. In contrast, patients with a symptomatic onset visited Primary Care less frequently, but they had an increase in the number of visits to Emergency Department, specialist care, sick-leaves, CT/ultrasound examinations, and use of antibiotics or systemic steroids. CONCLUSIONS: There is an increased need for medical assistance and use of systemic steroids during the presymptomatic phase of IBD. These results will help in establishing new tools for early identification of IBD in the future.

Experiencia formativa de académicos en dos universidades latinas en diplomado de simulación clínica en enfermería / Training Experience with Scholars from two Latin-American Universities during a Diploma Course in Nursing Clinical Simulation

Introducción: Capacitar en simulación clínica asegura calidad de la enseñanza e incrementa conocimientos necesarios para realizar procesos dinámicos que involucren creación de entornos hipotéticos de representaciones auténticas de realidades sanitarias. Esta estrategia reviste importancia para concretar productos e insumos derivados de entrenamientos en simulación, ligados a satisfacción de profesionales que finalizan estas experiencias formativas. Objetivo: Conocer la satisfacción general de académicos y el producto obtenido de una experiencia formativa en modalidad de diplomado en simulación clínica de alta fidelidad. Métodos: Estudio descriptivo, de corte trasversal, con análisis teórico-lógico-reflexivo desde la literatura que respaldó el diseño didáctico del proyecto. Se trabajó con la totalidad de académicos de la Facultad de Enfermería, Universidad de Panamá (N = 146), durante mayo-julio del 2022. Hubo clases sincrónicas y asincrónicas y una semana presencial para exposiciones de escenarios. Se evaluó la estrategia con cuestionario de cinco dimensiones validado por criterios de jueces. El puntaje Alfa de Cronbach final fue 0,89. Se incluyeron profesores con más de 92 por ciento de asistencia a clases, los que tuvieron conexiones inestables a encuentros se excluyeron. Se realizó análisis estadístico descriptivo en programa SPSS. Se siguieron normas éticas y recomendaciones para estudios con seres humanos. Resultados: El 99 por ciento evaluó la capacitación con nivel de satisfacción muy alto. Se obtuvieron productos clave, como reglamentos, consentimientos informados y banco de escenarios validados, como insumos de trabajo para la facultad. Conclusiones: Los resultados configuraron respuestas de un grupo de académicos capacitados en simulación clínica, con valoración de muy alta satisfacción. Los productos obtenidos se encaminaron a normativas y guías para uso de simulación(AU)

Introduction: Clinical simulation training ensures the quality of teaching and increases the knowledge necessary to carry out dynamic processes involving the creation of hypothetical environments of authentic representations of health realities. This strategy is important for the realization of products and inputs derived from simulation training, linked to the satisfaction of professionals who complete these training experiences. Objective: To know the general satisfaction of scholars and the product obtained from a training experience as a diploma course in high-fidelity clinical simulation. Methods: A descriptive and cross-sectional study was carried out, following a theoretical-logical-reflexive analysis from the literature, which supported the didactic design of the project. The working methodology included all the scholars from the Nursing School at University of Panama (N=146), during May-July 2022. There were synchronous and asynchronous classes, as well as a face-to-face week for scenario presentations. The strategy was evaluated with a five-dimension questionnaire validated by judges' criteria. The final Cronbach's alpha score was 0.89. Professors with more than 92 percent of class attendance were included; those with unstable connections to meetings were excluded. A descriptive statistical analysis was performed in the SPSS software. Ethical norms and recommendations for studies with human beings were followed. Results: 99 percent assessed the training with a very high level of satisfaction. Key products were obtained, such as regulations, informed consents and a stock of validated scenario, as working inputs for the school. Conclusions: The outcomes included responses from a group of scholars trained in clinical simulation, with very high satisfaction ratings. The products obtained were directed towards regulations and guidelines for the use of simulation(AU)

Linfoma cardíaco primario en el paciente anciano / Primary cardiac lymphoma in the elderly patient

Resumen Se presenta un caso clínico de linfoma cardíaco primario en un paciente anciano, y se explica tanto la aproximación diagnóstica, como el tratamiento que llevó a su remisión completa.

Abstract A clinical case of primary cardiac lymphoma in an elderly patient is presented, and both the diagnostic approach and the treatment that led to its complete remission are explained.

Efecto del extracto etanólico Erythroxylum novogranatense var. truxillense y Erythroxylum coca var. coca frente al Streptococcus mutans / Effect of the ethanolic extract of Erythroxylum novogranatense var. truxillense and Erythroxylum coca var. coca front to Streptococcus mutans

RESUMEN Objetivos : Comparar el efecto antibacteriano in vitro de los extractos etanólico de dos variedades de hoja de coca: Erythroxylum coca var. coca y Erythroxylum novogranatense var. truxillense sobre el Streptococcus mutans. Material y métodos: Mediante el método de difusión por discos, se procedió a la aplicación de los extractos etanólicos de las dos variedades a las concentraciones 100%, 50%, 25% y 12,5% con controles positivo de Clorhexidina 0,12 % y negativo de Alcohol 96º en los cultivos de la cepa de Streptococcus mutans (ATCC 25175) sembrados en Agar Tripticasa Soya. La incubación se realizó a 37 °C por 48 horas en condiciones de anaerobiosis parcial. El análisis estadístico se realizó con el programa SPSS Versión 22. Mediante la Prueba U de Mann Whitney y Kruskal Wallis. Resultados: El extracto etanólico de Erythroxylum coca var. coca al 100% y 50% presentaron mayor halo de inhibición 18,65± 2,434 y 17,10 ± 2,654 con respecto al extracto etanólico de Erythroxylum novogranatense var. truxillense que fueron de 15,30 ± 1,895 y 14,05 ± 1.932. respectivamente. Conclusiones: Se determinó que el extracto etanólico de Erythroxylum coca var. coca al 100% y 50% tiene mayor efecto antibacteriano que la variedad Erythroxylum novogranatense var. truxillense al 100% frente al Streptococcus mutans.

ABSTRACT Objectives : To compare the antibacterial effect of the ethanolic extracts of two varieties of coca leaf "in vitro": Erythroxylum coca var. coca and Erythroxylum novogranatense var. truxillense on Streptococcus mutans. Material and methods: Using the method of diffusion by discs, the ethanolic extracts of the two varieties were applied at concentrations 100%, 50%, 25% and 12.5% with positive controls of Chlorhexidine 0.12% and negative of 96º Alcohol in the cultures of the Streptococcus mutans strain (ATCC 25175) sown in Tripticasa Soya Agar. Incubation was performed at 37 ° C for 48 hours under conditions of partial anaerobiosis. The statistical analysis was carried out with the SPSS Version 22 program by means of the Mann Whitney U Test and Kruskal Wallis. Results: Erythroxylum coca var. coca 100% and 50% had a greater inhibition halo 18.65 ± 2.434 and 17.10 ± 2.654 with respect to the ethanolic extract of Erythroxylum novogranatense var. truxillense that were 15.30 ± 1.895 and 14.05 ±1.932. respectively. Conclusions : It was determined that the ethanolic extract of Erythroxylum coca var. coca 100% and 50% has a greater antibacterial effect than the Erythroxylum novogranatense var. truxillense 100% against Streptococcus mutans.

La formación doctoral e investigación científica en el área de la enfermería en Ecuador / Doctoral training and scientific research in nursing in Ecuador

El objetivo del estudio que se presenta fue describir sintéticamente el estado de las capacidades y posibilidades de formación profesional, desarrollo científico y especialización en enfermería en Ecuador, comparándolo con el de otras naciones de la región. Se estableció un diagnóstico concreto que pueda constituir una base para la toma de medidas al respecto. Se realizó revisión reflexiva de fuentes confiables de información en bases científicas regionales y páginas Web de instituciones nacionales e internacionales reconocidas como reguladoras de los procesos del fenómeno investigado. El estado de la investigación y oferta académica doctoral en el área de la enfermería requiere de la generación de políticas y acciones en Ecuador, para potenciar los correspondientes indicadores que muestran mejores cifras en algunos de sus vecinos de la región sudamericana.

This study aimed to describe synthetically the state of the capacities and possibilities of profes-sional training, scientific development, and specialization in nursing in Ecuador, comparing it with other ones of other nations in the region. It was established a concrete diagnosis that can constitute a basis for taking measures in this regard. A reflexive review of reliable sources of information in regional scientific bases and web pages of national and international institutions recognized as regulators of the processes of the phenomenon under investigation was carried out. The state of research and doctorate academic offerings in the nursing area requires the gene-ration of policies and actions in Ecuador to enhance the corresponding indicators that show better figures in some of its neighbors in the South American region.

Valores de referencia del Senior Fitness Test en mujeres adultas mayores físicamente activas / Reference values of the Senior Fitness Test for physically active elderly women

Introducción: El proceso de envejecimiento en los adultos mayores puede conducir a la disminución de la condición física funcional. Por ello resulta importante su valoración para poder establecer programas de ejercicio físico que mejoren las capacidades físicas, así como la funcionalidad y calidad de vida en esta población. Objetivo: Establecer los valores de referencia de la condición física funcional en las mujeres físicamente activas pertenecientes a Centros Vida de la ciudad de Bucaramanga. Métodos: Estudio descriptivo transversal en 113 mujeres mayores entre 60-85 años. Se evalúo la condición física funcional con el Senior Fitness Test y medidas antropométricas de talla y peso. Los valores de referencia están en percentiles y distribuidos por rangos de edad. Resultados: Según los valores de referencia del Senior Fitness Test, las mujeres de nuestro estudio se encuentran por encima en los valores de fuerza de miembros inferiores y superiores. En la prueba de resistencia cardiovascular y flexibilidad en miembros inferiores y superiores se encuentran por debajo. En los valores de la prueba de agilidad el tiempo de ejecución es mayor. Conclusiones: Se observa una disminución en las capacidades físicas funcionales conforme avanza la edad, sin embargo, la capacidad física que menos disminuye es la fuerza(AU)

Introduction: The aging process may lead to a reduction of functional physical condition in the elderly. Its analysis is therefore necessary to implement physical exercise programs aimed at improving physical capacities, functionality and quality of life in this population. Objective: Establish the reference values for functional physical condition in physically active women from Life Centers in the city of Bucaramanga. Methods: A cross-sectional descriptive study was conducted of 113 elderly women aged 60-85 years. Functional physical condition was evaluated with the Senior Fitness Test and anthropometric measurements of height and weight. Reference values are expressed in percentiles and distributed by age ranges. Results: The women in our study are above the reference values of the Senior Fitness Test in upper and lower limb force. Upper and lower limb cardiovascular resistance and flexibility are below SFT reference values. Values for the agility test show a longer performance time. Conclusions: A reduction is observed in functional physical capacities as people grow older. However, force is the physical capacity that diminishes the least(AU)

Características clínicas y sociodemográficas de una población adulta con tumores neuroendocrinos

Introducción: Los tumores neuroendocrinos representan un grupo de neoplasias de baja incidencia que derivan de células neuroendocrinas distribuidas en todo el cuerpo en especial sistema respiratorio y gastrointestinal. Objetivo: Determinar las características clínicas y sociodemográficas de una población adulta con padecimiento de tumores neuroendocrinos. Materiales y métodos: Estudio descriptivo transversal, se evaluaron 91 historias clínicas con diagnóstico de tumores neuroendocrinos confirmados por patología entre los años 2013 a 2020. Análisis realizado en Microsoft Excel 2013 y EpiInfo 7.2. Resultados: La media de edad fue 60 años, con predominio en hombres (57%). Los principales antecedentes fueron el tabaquismo (35%), hipertensión arterial (22%) y EPOC (9%). Los principales síntomas fueron el dolor abdominal (43%), pérdida de peso (31%) y tos (26%). Según el origen, fueron más frecuentes los de intestino anterior (75%), predominando los de tracto respiratorio (39,5%). En el 21,9%, el origen fue desconocido. Teniendo en cuenta la clasificación 2019 de la OMS, predominaron los carcinomas neuroendocrinos (56%), de los cuales el más frecuente fue el carcinoma de células pequeñas. Entre los bien diferenciados (44%), fueron más frecuentes los de bajo grado (58%) seguido grado intermedio (24%) y bajo grado (17%). Las metástasis se registraron en 37% de los casos con afectación principalmente hepática (49%), ganglios (21%) y sistema nervioso central (9%). La muerte se presentó en el 24% de los casos. Conclusiones: Los resultados del presente estudio concuerdan con lo reportado a nivel mundial, resaltando el predominio de los tumores de origen pulmonar, como también clínica semejante según los órganos afectados.

Introduction: Neuroendocrine tumors represent a group of low-incidence neoplasms derived from neuroendocrine cells distributed throughout the body, especially the respiratory and gastrointestinal systems. Objective: To determine the clinical and sociodemographic characteristics of an adult population with neuroendocrine tumors. Materials and methods: In a descriptive cross-sectional study, 91 medical records with a diagnosis of neuroendocrine tumors confirmed by pathology were evaluated between the years 2013 and 2020. Analysis carried out in Microsoft Excel 2013 and EpiInfo 7.2. Results: The mean age was 60 years, with a predominance in men (57%). The main antecedents were smoking (35%), arterial hypertension (22%), and COPD (9%). The main symptoms were abdominal pain (43%), weight loss (31%), and cough (26%). According to the origin, those of the foregut were more frequent (75%), predominantly those of the respiratory tract (39.5%). In 21.9%, the origin was unknown. Taking into account 2019 WHO classification, neuroendocrine carcinomas predominated (56%), of which the most frequent was small cell carcinoma. Among the well-differentiated (44%), low-grade (58%) followed by intermediate grade (24%) and low-grade (17%). Metastases were registered in 37% of the cases with mainly liver involvement (49%), lymph nodes (21%), and central nervous system (9%). Death occurred in 24% of cases. Conclusions: The results of the present study coincide with those reported worldwide, highlighting the predominance of tumors of pulmonary origin, as well as similar clinical symptoms according to the affected organs

A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of a Polyphenolic Extract (Hibiscus sabdariffa and Lippia citriodora) for Reducing Blood Pressure in Prehypertensive and Type 1 Hypertensive Subjects.

Hypertension is an important factor of cardiovascular diseases and contributes to their negative consequences including mortality. The World Health Organization estimated that 54% of strokes and 47% of cases of ischemic heart illness are related to high blood pressure. Recently, Hibiscus sabdariffa (HS) and Lippia citriodora (LC) have attracted scientific interest, and they are recognized for their high content of polyphenols as these may prevent several disease factors, such as hypertension. The aim of the present study is to determine if supplementation with an HS-LC blend (MetabolAid®) may be effective for the treatment of type 1 hypertensive sedentary populations. A total of 80 type 1 hypertensive subjects of both sexes were included in the study and were treated with placebo or the HS-LC extract, and both groups were treated over 84 days. The blood pressure (diastolic, systolic, and pulse pressure) was measured throughout the day, for each of the days of the study duration and determined using Ambulatory Blood Pressure Monitoring (ABPM). Physical activity was determined throughout the study to ensure similar conditions related to exercise. The results showed the capacity for reducing the blood pressure parameters in the case of the HS-LC extract. The daily consumption of the HS-LC extract but not the placebo over 84 days was able to reduce the daytime parameters related to blood pressure. The most remarkable results were observed in the measurements performed during the daytime, especially in the systolic blood pressure showing statistically significant variation.

COVID-19 en terapia intensiva: ¿qué pacientes tienen más riesgo de requerir ventilación mecánica? / COVID-19 in intensive care: which patients are most at risk of requiring mechanical ventilation?

Introducción: En COVID-19 grave, identificar pacientes con mayor riesgo de ventilación mecánica (VM) ayuda a optimizar el manejo. Materiales y métodos: Análisis retrospectivo de características clínico-epidemiológicas de pacientes con COVID-19 ingresados a UTI entre marzo/septiembre 2020. Se utilizó estadística descriptiva, análisis univariado (p significativa <0.05) y multivariado (variables significativas en el univariado).Resultados: Ingresaron 114 pacientes, 91 (79,8%) hombres, edad promedio 54,6 ±14,8 años. 66 (57,9%) eran obesos, 44 (38,6%) ≥ 60 años, 38 (33,3%) hipertensos (33,3%) y 28 (24,6%) diabéticos. 39 (23%) tenían ferritina elevada, 62 (76,5%) linfopenia y 33 (41,3%) LDH aumentada. Mortalidad global 34%. 72 pacientes (63,1%) requirieron VM. Los predictores independientes de requerimiento de VM en el análisis multivariado fueron sexo masculino, edad ≥60 años, diabetes, linfopenia y ferritina y LDH aumentadas. Conclusiones: En pacientes con COVID-19 grave, los predictores independientes de necesidad de VM fueron sexo masculino, edad ≥ 60 años, diabetes, niveles elevados de ferritina y LDH y linfopenia

Introduction: In severe COVID-19, identifying patients with a higher risk of mechanical ventilation (MV) helps to optimize management.Materials and methods: Retrospective analysis of clinical-epidemiological characteristics of patients with COVID-19 admitted to ICU between March / September 2020. Descriptive statistics, univariate and multivariate analysis were used. Results: 114 patients were admitted, 91 (79.8%) were men, mean age 54.6 ± 14.8 years. 66 (57.9%) were obese, 44 (38.6%) ≥60 years, 38 (33.3%) were hypertensive (33.3%) and 28 (24.6 %) diabetics. 39 (23%) had elevated ferritin, 62 (76.5%) had lymphopenia, and 33 (41.3%) had increased LDH. Overall mortality 34%. 72 patients (63.1%) required MV. The independent predictors of MV requirement in the multivariate analysis were male sex, age ≥60 years, diabetes, lymphopenia, and increased ferritin and LDH.Conclusions: In patients with severe COVID-19, the independent predictors of the need for MV were male sex, age ≥ 60 years, diabetes, elevated levels of ferritin and LDH, and lymphopenia