The dispersant Corexit 9500 and (dispersed) oil are lethal to coral endosymbionts.

Endosymbionts (Symbiodiniaceae) play a vital role in the health of corals. Seawater pollution can harm these endosymbionts and dispersants used during oil spill cleanup can be extremely toxic to these organisms. Here, we examined the impact of oil and a specific dispersant, Corexit-9500, on two representative endosymbionts - Symbiodinium and Cladocopium - from the Southwestern endemic coral Mussismilia braziliensis. The survival and photosynthetic potential of the endosymbionts decreased dramatically after exposure to the dispersant and oil by ~25 % after 2 h and ~50 % after 7 days. Low concentrations of dispersant (0.005 ml/l) and dispersed oil (Polycyclic Aromatic Hydrocarbons, 1132 µg/l; Total Petroleum Hydrocarbons, 595 µg/l) proved highly toxic to both Symbiodinium and Cladocopium. These levels triggered a reduction in growth rate, cell size, and cell wall thickness. After a few hours of exposure, cellular organelles were damaged or destroyed. These acute toxic effects underline the fragile nature of coral endosymbionts.

Acquired tracheomalacia due to SARS-CoV-2 pneumonia.

INTRODUCTION: Several studies mentioned parenchymal findings after SARS-CoV-2 pneumonia, but few studies have mentioned alterations in the airways. The aim of this study was to estimate the prevalence of tracheomalacia and to analyse the clinical characteristics in a cohort of patients with SARS-CoV-2. METHODS: The study population consisted of all patients with SARS-CoV-2 admitted a hospital serving a population of 500 000 inhabitants. Patients were visited between 2 and 6 months after hospital discharge. In this visit, all patients were subjected to an exhaustive clinical questionnaire and underwent clinical examination, pulmonary function tests and chest CT. RESULTS: From February 2020 to August 2021, 1920 patients were included in the cohort and tracheomalacia was observed in 15 (0.8%) on expiratory HRCT imaging. All patients with tracheomalacia also presented ground glass opacities in the CT scan and 12 patients had airway sequelae. CONCLUSIONS: Tracheomalacia is an exceptional sequela of SARS-CoV-2 survivors.

Position statement on infection screening, prophylaxis, and vaccination of pediatric patients with rheumatic diseases and immunosuppressive therapies, part 3: precautions in situations of surgery, fever, and opportunistic infections.

The objective of this study is to provide practical recommendations on the management of pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapies. The recommendations specifically address the cases of surgery, fever, and opportunistic infections (varicella, herpes-zoster, tuberculosis, invasive fungal disease). A qualitative approach was applied. A narrative literature review was performed via Medline. Primary searches were conducted using MeSH terms and free text to identify publications on infections and vaccinations in pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapies. The results were presented and discussed in a nominal group meeting, comprising a committee of 12 pediatric rheumatologists from the Infection Prevention and Treatment Working Group of the Spanish Society of Pediatric Rheumatology. Several recommendations were generated. A consensus procedure was implemented via a Delphi process; this was extended to members of the Spanish Society of Pediatric Rheumatology and Spanish Society of Pediatric Infectious Disease of the Spanish Association of Pediatrics. Participants produced a score ranging from 0 (totally disagree) to 10 (totally agree). Agreement was defined as a vote ≥ 7 by at least 70% of participants. The literature review included more than 400 articles. Overall, 63 recommendations (19 on surgery, fever, and opportunistic infections) were generated and voted by 59 pediatric rheumatologists and other pediatric specialists. Agreement was reached for all 63 recommendations. The recommendations on special situations cover management in cases of surgery, fever, and opportunistic infections (varicella, herpes-zoster, tuberculosis, and invasive fungal disease).  Conclusions: Hereby, we provided consensus and updated of recommendations about the management of special situations such as surgery, fever, and opportunistic in children with immune-mediated rheumatic diseases receiving immunosuppressive therapies. Several of the recommendations depend largely on clinical judgement and specific balance between risk and benefit for each individual and situation. To assess this risk, the clinician should have knowledge of the drugs, the patient's previous situation as well as the current infectious disease, in addition to experience. What is Known: • Infectious diseases and related complications are a major cause of morbidity and mortality in patients with immune-mediated rheumatic diseases. • Information on how to manage the treatment in situations of fever, opportunistic infections, and surgery in children is limited, and guidelines for action are often extrapolated from adults. What is New: • In the absence of strong evidence, a literature review and a Delphi survey were conducted to establish a series of expert recommendations that could support the clinical practice, providing a practical and simple day-to-day approach to be used by pediatric rheumatologists.

Sistema de acciones dirigido al proceso docente en contingencias epidemiológicas: experiencia en Guantánamo

Introducción: La pasada contingencia epidemiológica causada por el SARS-CoV-2, representó una grave situación sanitaria que impactó todas las esferas de la vida con consecuencias negativas, incluida la educación. Objetivo: Proponer un sistema de acciones diseñado para garantizar los resultados académicos del año terminal de la carrera de Medicina (curso 2020-2021) durante el rebrote de COVID-19 como propuesta metodológica ante contingencias epidemiológicas. Método: Se partió de los resultados de una Investigación-acción participativa como estudio cualitativo previo, utilizada como mecanismo para generar ideas y como método principal de recolección de datos, donde, mediante modalidades de muestreo intencional fueron seleccionados informantes clave entre estudiantes y docentes a los que le fueron aplicadas como técnicas la observación participante y la entrevista abierta activa previamente concebida. Los datos obtenidos en el trabajo de campo, fueron exhaustivamente analizados, codificados. La confección del informe final permitió el diseño de las acciones. Resultados: La puesta en marcha del sistema de acciones diseñado, amparada por los documentos normativos, permitió efectuar la descentralización del 6to. año de la carrera de Medicina hacia sus municipios de residencia, con garantías para el afianzamiento de conocimientos y habilidades, confirmado por los resultados obtenidos en los exámenes estatales. Conclusiones: Se propone la utilización, como herramienta metodológica, del sistema de acciones, el cual contribuyó de manera eficaz a sistematizar conocimientos y habilidades por los estudiantes durante el curso 2020-2021, demostrado por sus resultados académicos, lo cual avala su pertinencia en contingencias epidemiológicas.

Introduction: The past epidemiological contingency caused by SARS-CoV-2 represented a serious health situation that impacted all spheres of life with negative consequences, including education. Objective: Propose a system of actions designed to guarantee the academic results of the final year of the Medicine degree (2020-2021 academic year) during the outbreak of COVID-19 as a methodological proposal in the face of epidemiological contingencies. Method: We started from the results of a participatory action research as a previous qualitative study, used as a mechanism to generate ideas and as the main method of data collection, where, through intentional sampling modalities, key informants were selected among students and teachers to whom that participant observation and the previously conceived active open interview were applied as techniques. The data obtained in the field work were exhaustively analyzed and coded. The preparation of the final report allowed the design of the actions. Results: The implementation of the designed system of actions, supported by the regulatory documents, allowed the decentralization of the 6th. year of the Medicine degree towards their municipalities of residence, with guarantees for the strengthening of knowledge and skills, confirmed by the results obtained in the state exams. Conclusions: A system of actions is presented that effectively contributed to systematizing knowledge and skills by students during the 2020-2021 academic year, demonstrated by their academic results, which supports its relevance in epidemiological contingencies.

Introdução: A contingência epidemiológica passada causada pelo SARS-CoV-2 representou uma grave situação de saúde que impactou todas as esferas da vida com consequências negativas, incluindo a educação. Objetivo: Propor um sistema de ações destinadas a garantir os resultados acadêmicos do último ano do curso de Medicina (ano letivo 2020-2021) durante o surto de COVID-19 como proposta metodológica diante das contingências epidemiológicas. Método: Partimos dos resultados de uma pesquisa-ação participante como um estudo qualitativo prévio, utilizado como mecanismo de geração de ideias e como principal método de coleta de dados, onde, por meio de modalidades de amostragem intencional, foram selecionados informantes-chave entre alunos e professores para a quem foram aplicadas como técnicas a observação participante e a entrevista aberta ativa previamente concebida. Os dados obtidos no trabalho de campo foram exaustivamente analisados e codificados. A elaboração do relatório final permitiu o desenho das ações. Resultados: A implementação do sistema de ações desenhado, apoiado nos documentos normativos, permitiu a descentralização do 6º. ano do curso de Medicina para os seus municípios de residência, com garantias de fortalecimento de conhecimentos e competências, confirmadas pelos resultados obtidos nos exames estaduais. Conclusões: Apresenta-se um sistema de ações que contribuiu efetivamente para a sistematização de conhecimentos e competências dos estudantes durante o ano letivo 2020-2021, demonstrado pelos seus resultados académicos, o que sustenta a sua relevância em contingências epidemiológicas.

Real-time changes in rib cage expansion and use of abdominal mechanical stimulation in newborns: a quasi-experimental study / Mudanças na expansibilidade torácica com o uso de estímulo mecânico na região abdominal em recém-nascidos: um estudo quase-experimental

ABSTRACT Objective: To assess the rib cage expansion and respiratory rate in newborns using an abdominal stabilization band. Methods: The study included 32 newborns of both genders, with gestational age between 35 and 41 weeks. The abdominal stabilization band was used for 15 minutes between the xiphoid process and the anterosuperior iliac crest, with an abdominal contention 0.5cm smaller than the abdominal circumference. The rib cage expansion was evaluated by a breathing transducer (Pneumotrace II™) three minutes before using the band, during the use (15 minutes), and ten minutes after removing the band. The Shapiro-Wilk test verified data normality, and the Wilcoxon test compared the variables considering rib cage expansion and respiratory rate. Significance was set to p<0.05. Results: There was an increase in respiratory rate when comparing before and ten minutes after removing (p=0.008) the abdominal stabilization band, as well as when comparing during its use and ten minutes after its removal (p=0.001). There was also an increase in rib cage expansion when comparing before and during the use of the abdominal stabilization band (p=0.005). Conclusions: The use of the abdominal stabilization band promoted an increase in the rib cage expansion and respiratory rate in the assessed newborns and may be a viable option to improve the respiratory kinematics of this population.

RESUMO Objetivo: Avaliar a expansibilidade torácica e a frequência respiratória em recém-nascidos que fizeram uso de uma faixa de estabilização abdominal. Métodos: O estudo incluiu 32 recém-nascidos de ambos os sexos, com idade gestacional entre 35 e 41 semanas. A faixa de estabilização abdominal foi mantida por 15 minutos entre o processo xifoide e a espinha ilíaca anterossuperior, com contenção abdominal 0,5 cm menor do que a circunferência abdominal. A expansibilidade torácica foi avaliada por um transdutor piezoelétrico (Pneumotrace II™) 3 minutos antes do uso da faixa, durante 15 minutos, e 10 minutos após sua retirada. A normalidade das variáveis foi testada pelo teste de Shapiro-Wilk e a análise comparativa da expansibilidade torácica e da frequência respiratória foi realizada por meio do teste t pareado, considerando-se p<0,05. Resultados: Houve aumento da frequência respiratória quando comparados os tempos antes do uso da faixa e 10 minutos após a retirada (p=0,008), bem como quando comparados os tempos durante o uso e 10 minutos após a retirada da faixa (p=0,001). Houve aumento da expansibilidade torácica quando comparados os tempos antes e durante o uso da faixa (p=0,005). Conclusões: O uso da faixa de estabilização abdominal conferiu aumento da expansibilidade torácica e da frequência respiratória nos recém-nascidos estudados, podendo ser uma opção viável para a melhora da cinemática respiratória dessa população.

Magnetic Chitosan Bionanocomposite Films as a Versatile Platform for Biomedical Hyperthermia.

Responsive magnetic nanomaterials offer significant advantages for innovative therapies, for instance, in cancer treatments that exploit on-demand delivery on alternating magnetic field (AMF) stimulus. In this work, biocompatible magnetic bionanocomposite films are fabricated from chitosan by film casting with incorporation of magnetite nanoparticles (MNPs) produced by facile one pot synthesis. The influence of synthesis conditions and MNP concentration on the films' heating efficiency and heat dissipation are evaluated through spatio-temporal mapping of the surface temperature changes by video-thermography. The cast films have a thickness below 100 µm, and upon exposure to AMF (663 kHz, 12.8 kA m-1 ), induce exceptionally strong heating, reaching a maximum temperature increase of 82 °C within 270 s irradiation. Further, it is demonstrated that the films can serve as substrates that supply heat for multiple hyperthermia scenarios, including: i) non-contact automated heating of cell culture medium, ii) heating of gelatine-based hydrogels of different shapes, and iii) killing of cancerous melanoma cells. The films are versatile components for non-contact stimulus with translational potential in multiple biomedical applications.

Análisis molecular y filogenético del genotipo F de Chlamydia trachomatis aislados en México en 2011 / Molecular and phylogenetic analysis of the F genotype of Chlamydia trachomatis isolated in Mexico in 2011

Resumen Antecedentes: Chlamydia trachomatis es la bacteria que se detecta con mayor frecuencia en las infecciones de transmisión sexual. Se han identificado 20 genotipos de C. trachomatis mediante el gen ompA y varias genovariantes mediante el análisis de polimorfismo de un solo nucleótido (SNP). En México, el genotipo F es el más frecuente. Objetivo: Identificar la existencia de subtipos del genotipo F. Método: Se analizaron siete cepas del genotipo F de C. trachomatis aisladas en 2011, mediante secuenciación de nucleótidos y mapeo con enzimas de restricción. Resultados: El análisis de SNP mostró dos cepas con el mismo SNP en el nucleótido 288 (C288T), mientras que con enzimas de restricción se identificó una variante con diferente RFLP (polimorfismo de la longitud de fragmentos de restricción) cuando se tratan con la mezcla de enzimas HinfI y TaqI. Conclusión: En México se encuentran dos subtipos del genotipo F y solo las enzimas de restricción HinfI y TaqI pueden identificar la existencia de uno de estos genotipos F.

Abstract Background: Chlamydia trachomatis is the most frequently identified bacterium in sexually transmitted infections. Twenty C. trachomatis genotypes have been determined using the ompA gene and several genovariants by single nucleotide polymorphism (SNP) analysis. In Mexico, the F genotype is the most frequent. Objective: To identify subtypes of the F genotype. Method: Seven C. trachomatis genotype F strains isolated in 2011 were analyzed by nucleotide sequencing and restriction enzyme mapping. Results: SNP analysis showed two strains with the same SNP at nucleotide 288 (C288T), while with res-triction enzymes, a variant with different RFLP (restriction fragment length polymorphism) was identified when treated with the mixture of HinfI and TaqI enzymes. Conclusion: In Mexico, there are two subtypes of F, and only with restriction enzymes HinfI and TaqI can identify one of the genovariants of the F genotype.

Maltrato a estudiantes de medicina del Paraguay en 2022: encuesta multicéntrica

Introducción: los estudiantes de medicina son propensos a recibir maltratos de sus colegas, personal administrativo y pacientes. Objetivo: determinar las características del maltrato a estudiantes de medicina del Paraguay en 2022. Metodología: se aplicó un diseño observacional, de corte transversal. Se incluyó a estudiantes de medicina, de ambos sexos, que aceptaban participar de la encuesta telemática. El muestreo fue por conveniencia. Se midieron variables demográficas. La percepción del maltrato fue evaluada según cuatro componentes (psicológico, físico, académico y sexual) utilizando el cuestionario de Munayco-Guillén F et al, previamente validado. El estudio contó con la aprobación del Comité de ética de la Universidad Privada del Este, Paraguay. Resultados: el cuestionario fue contestado por 214 estudiantes, siendo 146 mujeres (edad media 24 ± 3 años) y 68 varones (edad media 25 ± 5 años). La mayoría reside en Asunción (29,4%) y asiste a universidades privadas (92%). La media ± DE del maltrato psicológico fue 1,89 ± 1,02, la del físico fue 1,64 ± 0,89, la del académico fue 2,01 ± 1,11 y la del sexual fue 1,4 ± 0,83. Aplicando puntos de corte en los percentiles 60 y 70, el maltrato fue leve en 126 estudiantes (58,9%), moderado en 24 (11,2%) y grave en 64 (29,9%). El motivo principal para no denunciarlo fue el miedo a ser señalado por los demás o recibir represalias (17,3%). Discusión: se detectó maltrato leve en 58,9%, moderado en 11,2% y grave en 29,9% de los estudiantes de medicina. Se requiere aplicar medidas de prevención y contención de los maltratos.

Introduction: medical students are prone to mistreatment from their colleagues, administrative staff, and patients. Objective: to determine the characteristics of the mistreatment of medical students in Paraguay in 2022. Method: an observational, cross-sectional design was applied. Medical students of both sexes who agreed to participate in the online survey were included. Sampling was for convenience. Demographic variables were measured. The perception of abuse was evaluated according to four components (psychological, physical, academic, and sexual) using the previously validated questionnaire by Munayco-Guillén F et al. The study was approved by the Ethics Committee of the Universidad Privada del Este, Paraguay. Results: the questionnaire was answered by 214 students, 146 being women (mean age 24 ± 3 years) and 68 men (mean age 25 ± 5 years). The majority reside in Asunción (29.4%) and attend private universities (92%). The mean ± SD of psychological abuse was 1.89 ± 1.02, physical abuse was 1.64 ± 0.89, academic abuse was 2.01 ± 1.11, and sexual abuse was 1.4 ± 0. 83. Applying cut-off points at the 60th and 70th percentiles, the abuse was mild in 126 students (58.9%), moderate in 24 (11.2%), and severe in 64 (29.9%). The main reason for not reporting it was fear of being singled out by others or receiving reprisals (17.3%). Discussion: mild abuse was detected in 58.9%, moderate in 11.2%, and severe in 29.9% of medical students. It is necessary to apply measures to prevent and contain abuse.

Mortalidade por covid-19 na região nordeste do brasil entre 2020 e 2021: um estudo ecológico / Mortality from COVID-19 in the Northeast region of Brazil between 2020 and 2021: an ecological study / Mortalidad por COVID-19 en la región Nordeste de Brasil entre 2020 y 2021: un estudio ecológico

Introdução:A pandemia do COVID-19 foi responsável por um número significativo de mortes em todo o mundo. No Brasil, o país atingiu o terceiro lugar no ranking mundial em número de casos, em um curto período de tempo. A região nordeste por sua vez apresenta altas taxas de incidência e mortalidade. Objetivo:Analisar a mortalidade por COVID-19 na região Nordeste do Brasil entre os anos de 2020 e 2021. Metodologia:Trata-se de um estudo ecológico, retrospectivo com abordagem quantitativa, utilizando dados secundários, disponíveis no Portal de Transparência do Registro Civil, considerando os registros das Semanas Epidemiológicas (SE). Foram incluídas as variáveis: quantidade de óbitos, sexo, faixa etária, estados e semana epidemiológica. Resultados:Observou-se a ocorrência de dois picos acentuados de óbito durante as SE 18ª e 30ª e 7ª e 25, nos anos de 2020 e 2021, respectivamente. O estado do Ceará manteve os maiores índices nas duas curvas, seguido da Paraíba e Sergipe. Quanto a faixa etária, a população idosa foi mais acometida e prevaleceu os óbitos entre sexo masculino. Conclusões:Os dados mostraram a magnitude da pandemia na região nordeste, fornecendo informações para subsidiar possíveis medidas sanitárias pelas autoridades competentes (AU).

Introduction:The pandemic of COVID-19 was responsible for a significant number of deaths worldwide. In Brazil, the country reached the third place in the world ranking in number of cases in a short period of time. The northeast region in turn has high incidence and mortality rates. Objective:To analyze the mortality from COVID-19 in the Northeast region of Brazil between the years 2020 and 2021. Methodology:This is an ecological, retrospective study with a quantitative approach, using secondary data available at the Civil Registry Transparency Portal, considering the records of the Epidemiological Weeks (SE). The variables were included: quantity of deaths, sex, age group, states and epidemiological week. Results: It was observed the occurrence of two sharp peaks of deaths during the SE 18th and 30th and 7th and 25th, in the years 2020 and 2021, respectively. The state of Cearamaintained the highest rates in the two curves, followed by Paraiba and Sergipe. As for the age bracket, the elderly population was more affected and male deaths prevailed.Conclusions:The data showed the magnitude of the pandemic in the northeast region, providing information to support possible health measures by the competent authorities (AU).

Introducción: La pandemia de COVID-19 fue responsable de un importante número de muertes en todo el mundo. En Brasil, el país alcanzó el tercer puesto del ranking mundial en número de casos en un corto periodo de tiempo. A su vez, la región del noreste presenta altas tasas de incidencia y mortalidad.Objetivo: Analizar la mortalidad por COVID-19 en la región Nordeste de Brasil entre los años 2020 y 2021. Metodología: Se trata de un estudio ecológico, retrospectivo con abordaje cuantitativo, utilizando datos secundarios, disponibles en el Portal de Transparencia del Registro Civil, considerando los registros de las Semanas Epidemiológicas (SE). Se incluyeron las variables: cantidad de muertes, género, grupo de edad, estados y semana epidemiológica. Resultados: Se observó la ocurrencia de dos picos agudos de muertes durante los días 18 y 30 y 7 y 25 de la SE, en los años 2020 y 2021, respectivamente. El estado de Ceará mantuvo las tasas más altas en las curvas, seguido de Paraíba y Sergipe. En cuanto al grupo de edad, la población anciana estaba más afectada y predominaban las muertes de hombres. Conclusiones: Los datos mostraron la magnitud de la pandemia en la región noreste, proporcionando información paraapoyar posibles medidas sanitarias por parte de las autoridades competentes (AU).

Cerebellar Hemangioblastoma with Leptomeningeal Spread and a Fatal Outcome: A Rare Case Report with MDM2 and EGFR Alterations.

Hemangioblastoma (HB) is a Central Nervous System (CNS) tumor with a generally favorable behavior and prognosis, classified as WHO grade 1. Sporadic HB is not related to any inherited disease, and it usually appears in a single location. Sporadic or VHL-related HBs show variable patterns of growth velocity. Cases of growing HB can cause mild symptoms such as headache, but some cases develop serious complications such as accumulation of cerebrospinal fluid in the brain with secondary neurological damage sometimes being irreversible when early treatment is not started. Our case showed some clinical characteristics more frequently observed in VHL-related HB rather than sporadic HB, and the presence of alterations in MDM2 and EGFR that could be related to the oncogenesis of these tumors. Even when the treatment of choice for HB is surgery, the presence of these genetic alterations could open a new window for research aimed at assessing the possibility of new therapies with TKIs-EGFR and anti-MDM2 inhibitors in those HB cases with multifocal recurrences or cases with an adverse clinical behavior.

Effect of Ferulago lutea (Poir.) Grande Essential Oil on Molecular Hallmarks of Skin Aging.

With the increase in global life expectancy, maintaining health into old age becomes a challenge, and research has thus concentrated on various strategies which aimed to mitigate the effects of skin aging. Aromatic plants stand out as promising sources of anti-aging compounds due to their secondary metabolites, particularly essential oils (EOs). The aim of this study was to ascribe to Ferulago lutea EO several biological activities that could be useful in the context of skin aging. The EO was obtained using hydrodistillation and characterized by gas chromatography-mass spectrometry (GC/MS). The anti-inflammatory potential was assessed using lipopolysaccharide (LPS)-stimulated macrophages. The effect on cell migration was disclosed using scratch wound assay. Lipogenesis was induced using T0901317, hyperpigmentation with 3-isobutyl-1-methylxantine (IBMX) and senescence with etoposide. Our results show that the EO was characterized mainly by α-pinene and limonene. The EO was able to decrease nitric oxide (NO) release as well as iNOS and pro-IL-1ß protein levels. The EO promoted wound healing while decreasing lipogenesis and having depigmenting effects. The EO also reduced senescence-associated ß-galactosidase, p21/p53 protein levels and the nuclear accumulation of γH2AX. Overall, our study highlights the properties of F. lutea EO that make it a compelling candidate for dermocosmetics applications.

Anti-Hla Donor-Specific Antibodies Are Associated to Infection and Not to the Engraftment Rate in Outpatient Haploidentical Hematopoietic Cell Transplantation.

Background: Recipients of a related haploidentical stem cell transplant (haplo-SCT) can have preformed antibodies to HLA donor's antigens. Objective: The aim of the study was to evaluate the engraftment rate and major clinical associations of anti-HLA donor-specific antibodies (DSA) at two mean fluorescence intensity (MFI) thresholds in recipients of an outpatient haplo-SCT. Methods: Seventy haplo-HCT recipients were analyzed. A virtual crossmatch was performed using the donor HLA typing and the recipient's anti-HLA DSA test results. Data for anti-HLA-A, -B, -C, and -DR were analyzed. Recipients with DSA ≥ 500 MFI were considered positive, and those with < 500 were considered negative; the same was adopted for MFI ≥ 1000. Results: Post-transplant infection was higher in recipients with DSA ≥ 500 MFI (84.6%, p = 0.041). First-year mortality was higher in DSA-positive patients ≥ 500 MFI, p = 0.004, and DSA ≥ 1000 MFI, p = 0.022, than in DSA-negative recipients. Graft failure in the first 100 days was not associated with DSA ≥ 500 or ≥ 1000 MFI. There was no difference in acute (a-GVHD) or chronic (c-GVHD) graft versus host disease between DSA-positive and negative patients. Conclusions: There was no association of anti-HLA DSA at MFI ≥ 500 and ≥ 1000 with graft failure, however, increased infection and 1st-year mortality were documented in related haplo-HCT at the MFI cutoffs studied.

Compliance and clinical benefit of deferasirox granule and dispersible tablet formulation in pediatric patients with transfusional iron overload: in a randomized, open-label, multicenter, phase II study.

CALYPSO (NCT02435212), a randomized, open-label, multicenter, phase 2 study evaluated the compliance, clinical benefits, and safety of deferasirox granules and dispersible tablets in pediatric patients with iron overload. Iron chelation therapy-naive and iron chelation therapy-pre-treated patients aged 2 to 0.5 mg/mg; 24.5% and 34.2%), upper respiratory tract infection (28.2% and 29.7%), and pyrexia (26.4% and 23.4%). In iron chelation therapy-naive patients, mean compliance and change from baseline in serum ferritin with both deferasirox formulations were not significantly different. The safety profile was comparable between granule and dispersible tablets formulations, and was consistent with the general safety profile of deferasirox.

Frecuencia de eventos cardiovasculares en pacientes con lupus eritematoso sistémico / Frequency of cardiovascular events in patients with systemic lupus erythematosus

Resumen Introducción: el progreso en los tratamientos para el lupus eritematoso sistémico (LES) resultó en una disminución de la mortalidad; sin embargo, la enfermedad cardiovascular y las complicaciones infecciosas aún son las principales causas de muerte. La evidencia apoya la participación del sistema inmunológico en la generación de la placa aterosclerótica, así como su conexión con las enfermedades autoinmunes. Objetivos: describir la frecuencia de eventos cardiovasculares (ECV) en el Registro de Lupus Eritematoso Sistémico de la Sociedad Argentina de Reumatología (RELESSAR) transversal, así como sus principales factores de riesgo asociados. Materiales y métodos: estudio descriptivo y transversal para el cual se tomaron los pacientes ingresados en el registro RELESSAR transversal. Se describieron las variables sociodemográficas y clínicas, las comorbilidades, score de actividad y daño. ECV se definió como la presencia de al menos una de las siguientes patologías: enfermedad arterial periférica, cardiopatía isquémica o accidente cerebrovascular. El evento clasificado para el análisis fue aquel posterior al diagnóstico del LES. Se conformaron dos grupos macheados por edad y sexo 1:2. Resultados: 1515 pacientes mayores de 18 años participaron del registro. Se describieron 80 pacientes con ECV (5,3%). En este análisis se incluyeron 240 pacientes conformando dos grupos. La edad media fue de 47,8 (14,4) y 47,6 (14,2) en el grupo con y sin ECV respectivamente. Los pacientes con ECV tuvieron mayor duración del LES en meses, mayor índice de Charlson, mayor SLICC (Systemic Lupus International Collaborating Clinics/American College of Rheumatology), mayor frecuencia de manifestaciones neurológicas, síndrome antifosfolípido, hospitalizaciones y uso de ciclofosfamida. Las únicas variables asociadas en el análisis multivariado fueron el índice de Charlson (p=0,004) y el SLICC (p<0,001). Conclusiones: los ECV influyen significativamente en nuestros pacientes, y se asocian a mayor posibilidad de daño irreversible y comorbilidades.

Abstract Introduction: progress in treatments for systemic lupus erythematosus (SLE) has resulted in a decrease in mortality; however, cardiovascular and infectious diseases remain the leading causes of death. Evidence supports the involvement of the immune system in the generation of atherosclerotic plaque, as well as its connection to autoimmune diseases. Objectives: to describe the frequency of cardiovascular disease (CVD) in the cross-sectional RELESSAR registry, as well as its associated variables. Materials and methods: a descriptive and cross-sectional study was performed using patients admitted to the cross-sectional RELESSAR registry. Sociodemographic variables, clinical variables, comorbidities, activity and damage scores were described. CVD was defined as at least one of the following: peripheral arterial disease, ischemic heart disease, or cerebrovascular accident. All patients with at least one CVD were included in our analysis (heart attack, central nervous system vascular disease, and peripheral arteries atherosclerotic disease). The event classified for the analysis was that after the diagnosis of SLE. SLE diagnosis was previous to CVD. Two groups matched by age and sex, 1:2 were formed. Results: a total of 1515 patients older than 18 years participated in the registry. Eighty patients with CVD (5.3%) were described in the registry. Two-hundred and forty patients were included, according to two groups. The mean age was 47.8 (SD 14.4) and 47.6 (SD 14.2) in patients with and without CVD, respectively. Patients with CVD had a longer duration of SLE in months, a higher Charlson index, a higher SLICC, increased frequency of neurological manifestations, antiphospholipid syndrome, hospitalizations, and use of cyclophosphamide. The associated variables in the multivariate were the Charlson Index (p=0.004) and the SLICC (p<0.001). Conclusions: CVDs have a significant influence on our patients, being associated with a greater possibility of damage and comorbidities.

Levels of inflammatory markers are differentially expressed in sickle cell anemia and sickle cell trait.

Although sickle cell anemia (SCA) is related to inflammation, the profile of inflammatory markers in sickle cell trait (SCT) is poorly studied. This is a cross-sectional study of inflammatory biomarkers carried out involving adults with SCA in steady state, SCT and controls. The SCA group had higher levels of lactato dehydrogenase, IL-1ß, IL-6, IL-10, and tumor necrosis factor alpha than the others, while the SCT group had similar levels to control group. In addition, SCA group had lower IL-8/IL-10 and soluble triggering receptor expressed on myeloid cells-1/IL-10 ratios. These findings indicate that individuals with SCT do not have a chronic inflammatory profile and reinforce that cytokines are involved in the maintenance of the inflammatory state in SCA.

Molecular characterization and genotyping of isolates from cancer patients with Clostridioides difficile infection or asymptomatic colonization.

Introduction. Cancer patients with Clostridioides difficile infection (CDI) are at a higher risk for adverse outcomes. In addition, a high prevalence of Clostridioides difficile asymptomatic colonization (CDAC) has been reported in this vulnerable population.Gap Statement. The molecular characteristics and potential role of CDAC in healthcare-related transmission in the cancer population have been poorly explored.Aim. We aimed to compare the molecular and genotypic characteristics of C. difficile isolates from cancer patients with CDAC and CDI.Method. We conducted a prospective cohort study of cancer patients with CDAC or CDI from a referral centre. Molecular characterization, typification and tcdC gene expression of isolates were performed.Results. The hospital-onset and community-onset healthcare facility-associated CDI rates were 4.5 cases/10 000 patient-days and 1.4 cases/1 000 admissions during the study period. Fifty-one C. difficile strains were isolated: 37 (72 %) and 14 (28 %) from patients with CDI or CDAC, respectively. All isolates from symptomatic patients were tcdA+/tcdB+, and four (10 %) were ctdA+/ctdB+. In the CDAC group, 10 (71 %) isolates were toxigenic, and none were ctdA+/ctdB+. The Δ18 in-frame tcdC deletion and two transition mutations were found in five isolates. After bacterial typing, 60 % of toxigenic isolates from asymptomatic carriers were clonal to those from patients with C. difficile-associated diarrhoea. No NAP1/027/BI strains were detected.Conclusions. We found a clonal association between C. difficile isolates from patients with CDAC and CDI. Studies are needed to evaluate the potential role of asymptomatic carriers in the dynamics of nosocomial transmission to support infection control measures and reduce the burden of CDI in high-risk groups.

Potential benefits of microalgae intake against metabolic diseases: beyond spirulina-a systematic review of animal studies.

CONTEXT: Microalgae are a diverse source of bioactive molecules, such as polyphenols, carotenoids, and omega-3 fatty acids, with beneficial properties in biomarkers of metabolic diseases. Unlike the rest of the microalgae genera, Arthrospira sp., commonly called spirulina, has been widely studied. OBJECTIVE: This review aims to describe the current knowledge about microalgae, besides spirulina, focusing on their beneficial properties against metabolic diseases. DATA SOURCES: A systematic research of MEDLINE (via PubMed), Cochrane, and Scopus databases was conducted to identify relevant studies published after January 2012. In vivo animal studies including microalgae consumption, except for spirulina, that significantly improved altered biomarkers related to metabolic diseases were included. These biomarkers included body weight/composition, glucose metabolism, lipid metabolism, oxidative damage, inflammation markers, and gut microbiota. DATA EXTRACTION: After the literature search and the implementation of inclusion and exclusion criteria, 37 studies were included in the revision out of the 132 results originally obtained after the application of the equation on the different databases. DATA ANALYSIS: Data containing 15 microalgae genera were included reporting on a wide range of beneficial results at different levels, including a decrease in body weight and changes in plasma levels of glucose and lipoproteins due to molecular alterations such as those related to gene expression regulation. The most reported beneficial effects were related to gut microbiota and inflammation followed by lipid and glucose metabolism and body weight/composition. CONCLUSIONS: Microalgae intake improved different altered biomarkers due to metabolic diseases and seem to have potential in the design of enriched foodstuffs or novel nutraceuticals. Nevertheless, to advance to clinical trials, more thorough/detailed studies should be performed on some of the microalgae genera included in this review to collect more information on their molecular mechanisms of action.

CO to formaldehyde transformation study on pristine and Au-modified BaTiO3(001) through DFT calculations.

CONTEXT: BaTiO3 is one of the most important ferroelectric oxides in electronic applications. Also, it has attractive properties for catalysis that could be used for reducing contamination levels, especially carbon monoxide, CO. CO is one of the main gaseous pollutants generally released from the combustion of fossil fuel. In this work, the CO transformation on pristine and Au-modified BaTiO3 perovskite for H2CO obtention is studied. The CO adsorption and hydrogenation on pristine BaTiO3 leads to formaldehyde synthesis as the most stable product through two possible routes. Furthermore, hydrogenation stages are less probable on pristine BaTiO3. On Au-modified BaTiO3 formaldehyde is the principal product too but Au adatom generates H2CO competition with HCOH. After BaTiO3 modification with Au unpaired electrons were generated. These unpaired electrons are related to the adatom reactivity. According to the obtained results, pristine and Au-modified BaTiO3 can adsorb and hydrogenate CO generating formaldehyde as the principal product. BaTiO3 modifications with Au increase the reactivity of the perovskite in the CO hydrogenation reactions. CO hydrogenation process on Au suggests that further hydrogenation stages beyond formaldehyde are possible. METHODS: The study was performed through ab initio calculations using the periodic spin-polarized Density Functional Theory (DFT) as implemented in Quantum ESPRESSO. DFT calculations were carried out using the Plane Wave self-consistent field (PWscf). Spin density difference allows us to identify reactive regions related to dangling bonds and unpaired electrons. A plane wave basis set was used to represent the electron states. Vanderbilt pseudopotentials with nonlinear core correction were used to model the ionic cores and valence electrons interaction. Exchange-correlation energies were treated within the generalized gradient approximation (GGA) with the Perdew-Burke-Ernzerhof (PBE) parameterization.

Prospective study to evaluate quality of life in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative rare disease characterized by symptoms and signs in the upper and lower motor neurons, leading to progressive neuro-degeneration and muscle atrophy. Our objective was to analyse the quality of life (QoL) in patients with ALS and compare with general population and with patients with cancer. Prospective study from consecutive ALS patients in one center. In order to assess quality of life, during the first visit three questionnaires were administered: Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Short Form-36 (SF-36) and EuroQoL 5D (EQ-5D). We compared SF-36 of ALS patients with a reference population (n = 9151), and we compared the EQ-5D index score of ALS patients versus patients with cancer in the same area and in the same period (2015-2018). Between June 2015 and September 2017, 23 were included. The mean age was 65.1 ± 12.6 years and 56.5% were women. Compared with the general population, patients with ALS showed lowest QoL (p < 0.05) in all the dimensions, with a very important impairment in physical function (median: 0; p25-75: 0-10) and physical role (median: 0; p25-75: 0-6.25). In EQ-5D questionnaire, patients with ALS presented an EQ-5D index score of 0.21 ± 0.39 (mean ± standard deviation) with a visual analog scale (VAS) score of 0.32 ± 0.24. Compared with an oncological population, patients with ALS had a worse EQ-5D index score both clinically and statistically (0.21 ± 0.39 vs. 0.77 ± 0.27; p < 0.05). We demonstrate a poorer quality of life in patients with ALS is poor, and clinically and statistically worse than in patients with cancer or general population. New studies need to evaluate the impact of strategies in this population to improve the quality of life.

The Impact of Liquid Biopsies Positive for EGFR Mutations on Overall Survival in Non-Small Cell Lung Cancer Patients.

In recent years, non-small cell lung cancer treatment has been revolutionized. EGFR tyrosine kinase inhibitors and our improved understanding of its alterations have driven new diagnostic strategies. Liquid biopsies have emerged as a useful tool in these contexts, showing potential utility in early diagnosis combined with low-dose CT scans, as well as potential in monitoring treatment response and predicting the development of patients. We studied the circulating tumor DNA (ctDNA) of 38 EGFR-mutated non-small cell lung cancer patients at diagnosis in different moments of their disease by liquid biopsy techniques. Our results show that mean overall survival was significantly lower when a liquid biopsy was positive for the detection of EGFR mutations compared with wild-type patients in their liquid biopsy in both univariate (29 ± 4 vs. 104 ± 19 months; p = 0.004) and multivariate analysis (p = 0.008). Taking this into consideration, liquid biopsies could be key to improving the control of this disease.