Executive summary: Guidelines for the diagnosis and treatment of septic arthritis in adults and children, developed by the GEIO (SEIMC), SEIP and SECOT.

Infection of a native joint, commonly referred to as septic arthritis, is a medical emergency because of the risk of joint destruction and subsequent sequelae. Its diagnosis requires a high level of suspicion. These guidelines for the diagnosis and treatment of septic arthritis in children and adults are intended for use by any physician caring for patients with suspected or confirmed septic arthritis. They have been developed by a multidisciplinary panel with representatives from the Bone and Joint Infections Study Group (GEIO) belonging to the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Paediatric Infections (SEIP) and the Spanish Society of Orthopaedic Surgery and Traumatology (SECOT), and two rheumatologists. The recommendations are based on evidence derived from a systematic literature review and, failing that, on the opinion of the experts who prepared these guidelines. A detailed description of the background, methods, summary of evidence, the rationale supporting each recommendation, and gaps in knowledge can be found online in the complete document.

Soledad y fragilidad en personas mayores que viven en comunidad: Una revisión integrativa / Loneliness and frailty in community-dwelling older adults: An integrative review

CONTEXTO: Se proyecta un aumento del 6% en la población mundial de personas mayores para el 2050, generando desafíos sociales significativos, especialmente el crecimiento de la soledad en la vejez. Este fenómeno está estrechamente vinculado a problemas de salud notables, incluido el síndrome de fragilidad. OBJETIVO: Esta revisión de literatura tiene como objetivo proporcionar una comprensión actualizada de la relación entre fragilidad y soledad en adultos mayores que residen en la comunidad. METODOLOGÍA: Utilizando una revisión integradora, se recopilaron sistemáticamente artículos originales de las bases de datos de PubMed, Web of Science y CINAHL. RESULTADOS: Una revisión de 475 artículos publicados entre 2018 y 2022 identificó 17 estudios que cumplían con los criterios de inclusión y exclusión especificados. CONCLUSIÓN: Los hallazgos revelan sólida evidencia científica que respalda una asociación sustancial entre la soledad y la fragilidad en adultos mayores que viven en la comunidad. A pesar de la consistencia en la evidencia, persisten variaciones en los enfoques conceptuales y las metodologías de medición en los estudios revisados.

CONTEXT: The global elderly population is projected to increase 6% by 2050, posing significant social challenges, particularly the escalating prevalence of loneliness in old age. This phenomenon is closely linked to notable health issues, including the frailty syndrome. OBJECTIVE: This literature review aims to provide an updated understanding of the relationship between frailty and loneliness among older adults residing in the community. Methodology: Employing an integrative review, original articles were systematically gathered from PubMed, Web of Science, and CINAHL databases. RESULTS: A review of 475 articles published between 2018 and 2022 identified 17 studies meeting specified inclusion and exclusion criteria. CONCLUSION: Findings reveal robust scientific evidence supporting a substantial association between loneliness and frailty among older adults in community settings. Despite consistent evidence, variations persist in conceptual approaches and measurement methodologies across reviewed studies.

Effectiveness of using a chatbot to promote adherence to home physiotherapy after total knee replacement, rationale and design of a randomized clinical trial.

BACKGROUND: Rehabilitation is essential to optimize outcomes after surgical procedures in musculoskeletal disorders. However, adherence to rehabilitation continues to be an important barrier, since compliance with the programs is not always as desired, which may have a negative impact on clinical results. METHODS: Randomized controlled trial aimed at to determining the effectiveness of using a virtual assistant (i.e., chatbot) to promote adherence to home rehabilitation. Overall, seventy patients under 75, undergoing total knee replacement, who have a personal smartphone and are familiar with its use, will be assigned into the control (standard care) or the experimental (standard care plus virtual assistant) group. Adherence (primary outcome) will be assessed three months after surgery. The WOMAC questionnaire, knee pain and system usability scale will be also outcomes of interest at three months and one year. Overall, an analysis of variance will look for possible time, group and time*group interactions. DISCUSSION: The expected result is to determine whether the use of a chatbot that interacts with the patient can increase adherence to post-surgical home physiotherapy, and result in better clinical results (functional and pain) than standard care. TRIAL REGISTRATION: clinicaltrials.gov id. NCT05363137.

Pulsed magnetic field increases the effect of ultraviolet C radiation and thermal shock in aged yeasts.

The study of the effects of the magnetic field (MF) on living matter continues to be a dilemma. Until now, the interaction mechanisms of MF with living matter that explain the observed phenomena are unknown. Despite the existing literature and the multiple effects described to date, there are few published articles that study the combined effect of MF with other physical agents during the cellular aging process. In this sense, the aim of this work is to study whether low frequency and intensity pulsed and sinusoidal MF exposure produce alterations in the cell killing effect of ultraviolet C (UVC) radiation and thermal shock during the chronological aging of S. cerevisiae. Yeast cells were exposed to 2.45 mT (50 Hz) sinusoidal MF and 1.5 mT (25 Hz) pulsed MF, during 40 days of aging, in combination with UVC radiation (50 J/m2) and/or thermal shock (52°C). Cell survival was evaluated by clonogenic assay. The exposure of yeast to pulsed MF produces an acceleration of aging, which is not observed in cells exposed to sinusoidal MF. The pulsed MF modifies the cellular response to damaging agents only in aged S. cerevisiae cells. In this sense, the pulsed MF applied increases the damage induced by UVC radiation and by thermal shock. In contrast, the sinusoidal MF used has no effect.

Cutibacterium spp. Infections after Instrumented Spine Surgery Have a Good Prognosis Regardless of Rifampin Use: A Cross-Sectional Study.

Infection after spinal instrumentation (IASI) by Cutibacterium spp. is being more frequently reported. The aim of this study was to analyse the incidence, risk factors, clinical characteristics, and outcome of a Cutibacterium spp. IASI (CG) compared with non-Cutibacterium IASI (NCG) infections, with an additional focus on the role of rifampin in the treatment. All patients from a multicentre, retrospective, observational study with a confirmed IASI between January 2010 and December 2016 were divided into two groups: (CG and NCG) IASI. Baseline, medical, surgical, infection treatment, and follow-up data were compared for both groups. In total, 411 patients were included: 27 CG and 384 NCG. The CG patients were significantly younger. They had a longer median time to diagnosis (23 vs. 13 days) (p = 0.025), although 55.6% debuted within the first month after surgery. Cutibacterium patients were more likely to have the implant removed (29.6% vs. 12.8%; p = 0.014) and received shorter antibiotic regimens (p = 0.014). In 33% of Cutibacterium cases, rifampin was added to the baseline therapy. None of the 27 infections resulted in treatment failure during follow-up regardless of rifampin use. Cutibacterium spp. is associated with a younger age and may cause both early and late IASIs. In our experience, the use of rifampin to improve the outcome in the treatment of a Cutibacterium spp. IASI is not relevant since, in our series, none of the cases had therapeutic failure regardless of the use of rifampin.

Ozonoterapia en el dolor crónico osteoarticular

Introducción: El dolor crónico es una de las causas más frecuentes de consulta médica en el mundo, las de causa osteomioarticular son las más frecuentes. Esto genera un gran consumo de medicamentos, muchos de los cuales producen efectos adversos que comprometen la calidad de vida de los pacientes. Objetivos: Obtener información sobre la efectividad de la ozonoterapia en el dolor crónico osteoarticular. Método: Se realizó una revisión bibliográfica de los artículos publicados en los últimos 15 años sobre esta temática. A través del buscador Google Académico, se revisaron documentos de carácter académico como artículos, tesis, libros, patentes, documentos relativos a congresos y resúmenes de diferentes bases de datos, como son Web of Science, MEDLINE, SciELO, pubmed, todas ellas ajustadas al ámbito biomédico. En primer lugar, se realizó una búsqueda general, y en función de lo que se vio que era más relevante con respecto al tema, se realizaron posteriormente nuevas búsquedas con términos más concretos, en los idiomas español e inglés. No se aplicó ninguna restricción de ámbito geográfico, edad, ni campo de investigación. Se encontraron 750 resultados iniciales, de los cuales se seleccionaron un total de 36. Conclusiones: Se concluye que hay artículos sobre la ozonoterapia, que respaldan su uso como una herramienta terapéutica efectiva y económica en el tratamiento del dolor crónico osteomioarticular, con mayor evidencia en el tratamiento del dolor por enfermedades del disco intervertebral.

Introduction: Chronic pain is one of the most frequent causes of medical consultation in the world, those osteoarticular causes are the most frequent. This generates a large consumption of drugs, many of which produce adverse effects that compromise the quality of life of patients. Objectives: To obtain information on the effectiveness of ozone therapy in chronic osteoarticular pain. Method: A bibliographic review of the articles published in the last 15 years on this subject was carried out. Using the Google Scholar search engine, academic documents such as articles, theses, books, patents, conference papers and abstracts from different databases, such as Web of Science, MEDLINE, SciELO, PubMed, all of them adjusted to the biomedical field, were reviewed. First, a general search was carried out, and depending on what was seen to be most relevant to the topic, new searches were subsequently carried out with more specific terms, in Spanish and English. No restriction of geographic scope, age, or field of research was applied. A total of 750 initial results were found, of which a total of 36 were selected. Conclusions: It is concluded that there are articles on ozone therapy, which support its use as an effective and economical therapeutic tool in the treatment of chronic osteoarticular pain, with greater evidence in the treatment of pain due to intervertebral disc disease.

Manual sobre la estructura y desarrollo de la clase metodológica instructiva / Handbooks on the structure and development of the instructive methodological class

Fundamento: es necesario instruir a los docentes sobre la estructura y desarrollo de la clase metodológica instructiva como parte del trabajo metodológico. Objetivo: diseñar un manual para la preparación de los docentes en el desarrollo y estructura de la clase metodológica instructiva. Métodos: se realizó una investigación cualicuantitativa en la Universidad de Ciencias Médicas de Villa Clara, Facultad de Medicina, curso 2021-2022. Se utilizaron métodos teóricos y empíricos para la fundamentación de la investigación y recogida de la información. Los resultados de los instrumentos aplicados fueron procesados en análisis porcentuales. Se seleccionaron especialistas para la valoración del manual. Resultados: se constató en la caracterización del claustro una mayor frecuencia de docentes con 6 a 10 años de experiencia y de adquisición de los conocimientos para el desempeño de su labor a través de las preparaciones metodológicas. Predominó la categoría de profesor asistente y buen conocimiento sobre la estructura de la clase metodológica instructiva. Se diseñó un manual dirigido a instruir a los profesores en el desarrollo de la clase metodológica instructiva. Conclusiones: fue valorado con uniformidad de criterios positivos por especialistas con vasta experiencia en la docencia.

Background: it is necessary to instruct teachers on the structure and development of the instructive methodological class as part of the methodological work. Objective: to design a manual for the preparation of teachers in the development and structure of the instructive methodological class. Methods: a qualitative-quantitative research was carried out at the Villa Clara University of Medical Sciences, Faculty of Medicine, academic year 2021-2022. Theoretical and empirical methods were used to support the research and collect information. The results of the applied instruments were processed in percentage analysis. Specialists were selected to assess the manual. Results: in the characterization of the faculty, a higher frequency of teachers with 6 to 10 years of experience and acquisition of knowledge for the performance of their work through methodological preparations was found. The rank of assistant professor and good knowledge about the structure of the instructive methodological class predominated. A manual was designed aimed at instructing teachers in the development of the instructive methodological class. Conclusions: it was evaluated with uniformity of positive criteria by specialists with vast experience in teaching.

From Nucleus to Organs: Insights of Aryl Hydrocarbon Receptor Molecular Mechanisms.

The aryl hydrocarbon receptor (AHR) is a markedly established regulator of a plethora of cellular and molecular processes. Its initial role in the detoxification of xenobiotic compounds has been partially overshadowed by its involvement in homeostatic and organ physiology processes. In fact, the discovery of its ability to bind specific target regulatory sequences has allowed for the understanding of how AHR modulates such processes. Thereby, AHR presents functions in transcriptional regulation, chromatin architecture modifications and participation in different key signaling pathways. Interestingly, such fields of influence end up affecting organ and tissue homeostasis, including regenerative response both to endogenous and exogenous stimuli. Therefore, from classical spheres such as canonical transcriptional regulation in embryonic development, cell migration, differentiation or tumor progression to modern approaches in epigenetics, senescence, immune system or microbiome, this review covers all aspects derived from the balance between regulation/deregulation of AHR and its physio-pathological consequences.

Fall classification, incidence and circumstances in patients undergoing total knee replacement.

To propose a fall-classification framework for patients undergoing total knee replacement (TKR). In addition, we reinforced the available evidence on fall incidence and circumstances and compared the characteristics of fallers versus. nonfallers. Retrospective and prospective data were collected from 253 subjects with severe knee osteoarthritis who were waiting for primary TKR. Falls were classified considering the location of the destabilizing force, source of destabilization and fall precipitating factor. Fall incidence and circumstances were described; the characteristics of fallers and nonfallers in terms of functional and balance performance were compared with F-tests (95% CI). The fall incidence before surgery was 40.3% (95% CI 34.2% to 46.6%). This figure decreased to 13.1% (95% CI 9.2% to 18.0%) and to 23.4% (95% CI 17.8% to 29.6%) at 6 and 12 months after surgery, respectively. Most falls were caused by destabilizations in the base of support (n = 102, 72%) and were due to extrinsic factors (n = 78, 76%) and trip patterns. Significant differences between fallers and nonfallers were found in knee extensor strength and monopodal stability in the surgical limb (p < 0.05). Falls are prevalent in patients with severe knee osteoarthritis. Symptoms and functional performance improve after surgery, and fall incidence is reduced. Most fall events originate from disruptions in the base of support and are precipitated by extrinsic factors, generally trips during walking activities.

Liver regeneration after partial hepatectomy is improved in the absence of aryl hydrocarbon receptor.

The liver is among the few organs having the ability to self-regenerate in response to a severe damage compromising its functionality. The Aryl hydrocarbon receptor (Ahr) is a transcription factor relevant for the detoxification of xenobiotics but also largely important for liver development and homeostasis. Hence, liver cell differentiation is developmentally modulated by Ahr through the controlled expression of pluripotency and stemness-inducing genes. Here, 2/3 partial hepatectomy (PH) was used as a clinically relevant approach to induce liver regeneration in Ahr-expressing (Ahr+/+) and Ahr-null (Ahr-/-) mice. Ahr expression and activity were early induced after 2/3 PH to be gradually downmodulated latter during regeneration. Ahr-/- mice triggered liver regeneration much faster than AhR+/+ animals, although both reached full regeneration at the latest times. At initial stages after PHx, earlier regenerating Ahr-/- livers had upregulation of cell proliferation markers and increased activation of signalling pathways related to stemness such as Hippo-YAP and Wnt/ß-catenin, concomitantly with the induction of pro-inflammatory cytokines TNFa, IL6 and p65. These phenotypes, together with the improved metabolic adaptation of Ahr-/- mice after PHx and their induced sustained cell proliferation, could likely result from the expansion of undifferentiated stem cells residing in the liver expressing OCT4, SOX2, KLF4 and NANOG. We propose that Ahr needs to be induced early during regeneration to fine-tune liver regrowth to physiological values. Since Ahr deficiency did not result in liver overgrowth, its transient pharmacological inhibition could serve to improve liver regeneration in hepatectomized and transplanted patients and in those exposed to damaging liver toxins and carcinogens.

Translation, Cross-Cultural Adaptation and Validation of the Myofascial Adhesions for Patients after Breast Cancer (MAP-BC) Evaluation Tool: Spanish Version.

(1) Background: The Myofascial Adhesions for Patients after Breast Cancer (MAP-BC) evaluation tool is a quantitative measure for the evaluation of tissue adhesions in breast cancer patients. The aims of this study were to create a Spanish version of the MAP-BC and to test its convergent validity and responsiveness. (2) Methods: Translation and cross-cultural adaptation were performed in five phases according to international guidelines. For the analysis of the convergent validity and responsiveness, a sample of 77 patients after breast cancer surgery were analysed at two timepoints (T1: immediately after the stitches were taken out; T2: one month after surgery). The COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) guidelines and checklist were used to verify the whole adaptation and validation process. (3) Results: Translation and cross-cultural adaptation of the original English version resulted in an easily understandable Spanish version of the tool. A moderate convergent validity (r = 0.438) with the Patient and Observer Scar Assessment (POSAS) at T1 and a strong correlation at T2 (r = 0.816) were observed. A moderate standardised response mean (0.45) and effect size (0.63) were also observed. (4) Conclusions: The MAP-BC Spanish version is a useful tool that could be incorporated into the evaluation of scars and surrounding tissues in breast cancer patients. It has shown a moderate convergent validity and responsiveness.

Preliminary Study on the Effect of an Early Physical Therapy Intervention after Sentinel Lymph Node Biopsy: A Multicenter Non-Randomized Controlled Trial.

Selective sentinel lymph node biopsy (SLNB) represents a minimally invasive surgery in patients with breast cancer. The purpose of this study was to explore the possible effect of an early physiotherapy intervention for the recovery of the upper limb and the surgical scars after SLNB in comparison with usual care. A total of 40 patients were enrolled in either the control group (n = 20) or the experimental group (n = 20). The intervention group performed an early physiotherapy program based on functional exercises, scar manual therapy, and educational tips. The control group received usual care. Shoulder range of motion (ROM), grip strength, upper limb pain and disability (SPADI), scar recovery (POSAS), myofascial adhesions (MAP-BC), quality of life (EORTCQLA-BR-23) and the presence of axillary web syndrome (AWS) and lymphoedema were assessed at baseline and immediately after intervention. A follow-up period of 6 months was performed for lymphoedema surveillance. Between groups significant differences in favor of the intervention were found for ROM (r = 0.43), grip strength (r = 0.32), SPADI (d = 0.45), POSAS (d = 1.28), MAP-BC (d = 1.82) and EORTCQLQ-BR 23 general function subscale (d = 0.37) (p < 0.05 for all variables). Our results suggest that an early physical therapy program seems to be more effective than usual care in women after SLNB. However, results should be interpreted with caution and future randomized trial with a larger sample size is needed.

Infections after spine instrumentation: effectiveness of short antibiotic treatment in a large multicentre cohort.

BACKGROUND AND OBJECTIVES: Available information about infection after spine instrumentation (IASI) and its management are scarce. We aimed to analyse DAIR (debridement, antibiotics and implant retention) prognosis and evaluate effectiveness of short antibiotic courses on early forms. METHODS: Multicentre retrospective study of patients with IASI managed surgically (January 2010-December 2016). Risk factors for failure were analysed by multivariate Cox regression and differences between short and long antibiotic treatment were evaluated with a propensity score-matched analysis. RESULTS: Of the 411 IASI cases, 300 (73%) presented in the first month after surgery, 48 in the second month, 22 in the third and 41 thereafter. Infections within the first 2 months (early cases) occurred mainly to older patients, with local inflammatory signs and predominance of Enterobacteriaceae, unlike those in the later periods. When managed with DAIR, prognosis of early cases was better than later ones (failure rate 10.4% versus 26.1%, respectively; P = 0.02). Risk factors for DAIR failure in early cases were female sex, Charlson Score, large fusions (>6 levels) and polymicrobial infections (adjusted HRs of 2.4, 1.3, 2.6 and 2.26, respectively). Propensity score matching proved shorter courses of antibiotics (4-6 weeks) as effective as longer courses (failure rates 11.4% and 10.5%, respectively; P = 0.870). CONCLUSIONS: IASIs within the first 2 months could be managed effectively with DAIR and shorter antibiotic courses. Clinicians should be cautious when faced with patients with comorbidities, large fusions and/or polymicrobial infections.

A randomized controlled trial assessing the effects of preoperative strengthening plus balance training on balance and functional outcome up to 1 year following total knee replacement.

PURPOSE: To investigate the effects of including balance training in a preoperative strengthening intervention on balance and functional outcomes in patients undergoing total knee replacement (TKR) and compare these effects to those induced by preoperative strengthening and no intervention. METHODS: Eighty-two subjects scheduled for TKR were randomly allocated into the strengthening (ST, n = 28) group: a preoperative lower limb strengthening intervention; the strengthening + balance (ST + B, n = 28) group: same intervention augmented with balance training; and the control group (n = 26). The Berg Balance Scale (BBS) and the function in daily living subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-ADL) were the primary outcomes. The secondary measures included balance and mobility, self-reported status, and knee function. The outcomes were assessed at baseline, 1 week before surgery, and 2, (primary endpoint), 6 and 52 weeks after surgery. RESULTS: Compared with the controls, the participants in the ST and ST + B groups presented significant improvements from baseline to the end of the preoperative intervention in BBS (p = 0.005) and KOOS-ADL (p < 0.001). At 6 weeks post-surgery, the knee extensor strength values were similar in the two treatment groups and significantly higher than that in the controls. Overall, the participant outcomes in all groups stabilized at 1 year after surgery. CONCLUSION: A preoperative strengthening intervention, regardless of whether it is complemented with balance training, enhances strength but not balance or functional outcomes at 6 weeks after surgery. Patients are expected to present similar performance at 1 year postoperatively, but adequately statistically powered trials are needed to confirm the findings. LEVEL OF EVIDENCE: II. TRIAL REGISTRATION: NCT02995668.

Activation of Macrophages by Lysophosphatidic Acid through the Lysophosphatidic Acid Receptor 1 as a Novel Mechanism in Multiple Sclerosis Pathogenesis.

Multiple sclerosis (MS) is a neuroinflammatory disease whose pathogenesis remains unclear. Lysophosphatidic acid (LPA) is an endogenous phospholipid involved in multiple immune cell functions and dysregulated in MS. Its receptor LPA1 is expressed in macrophages and regulates their activation, which is of interest due to the role of macrophage activation in MS in both destruction and repair. In this study, we studied the genetic deletion and pharmaceutical inhibition of LPA1 in the mouse MS model, experimental autoimmune encephalomyelitis (EAE). LPA1 expression was analyzed in EAE mice and MS patient immune cells. The effect of LPA and LPA1 on macrophage activation was studied in human monocyte-derived macrophages. We show that lack of LPA1 activity induces milder clinical EAE course and that Lpar1 expression in peripheral blood mononuclear cells (PBMC) correlates with onset of relapses and severity in EAE. We see the same over-expression in PBMC from MS patients during relapse compared with progressive forms of the disease and in stimulated monocyte-derived macrophages. LPA induced a proinflammatory-like response in macrophages through LPA1, providing a plausible way in which LPA and LPA1 dysregulation can lead to the inflammation in MS. These data show a new mechanism of LPA signaling in the MS pathogenesis, prompting further research into its use as a therapeutic target biomarker.

Early Physical Rehabilitation after Sentinel Lymph Node Biopsy in Breast Cancer: Is It Feasible and Safe?

The primary purpose of this research was to investigate the feasibility and safety of delivering an early supervised physical therapy intervention to women after sentinel lymph node biopsy (SLNB); furthermore, we aimed to provide explorative data on its effects. This was a single-site feasibility study. Pre- and post-evaluation was conducted from baseline to follow-up at 6 months. Primary outcomes were participant recruitment, participant retention, compliance with the intervention, and safety. Secondary outcomes were shoulder range of motion, handgrip strength, upper limb pain and disability, scar recovery, quality of life, and the incidence of axillary web syndrome (AWS) and/or lymphoedema. A total of 43 participants (mean age 55.37 years) completed the trial and the follow-up period. A total of 91% of women who met the inclusion criteria agreed to participate, and the adherence rate was 80%. No adverse events were reported. Incidence of AWS was 9.3%, and there was no incidence of lymphoedema at 6 months. Our results support that this intervention is feasible and safe. The results presented in this study also provide preliminary evidence for the use of a rehabilitation program as a supportive intervention after SLNB, but future research on effectiveness is needed.

Effects of Acetogenins from Annona coriacea on the in Vitro Reactions of Photosynthesis.

Our search for candidates for photosynthesis inhibitors is allowing us to report the effect of two acetogenins identified in Annona coriacea Mart. leaves, ACG-A and ACG-B, a non-adjacent bis-THF and a mono-THF types, respectively. This is an important class of natural products which presents biological properties such as anticancer, neurotoxic, larvicidal and insecticidal. However, this is only the second report associated to its herbicidal activity. Their mechanisms of action on the light reactions of the photosynthesis were elucidated by polarographic techniques. Compounds inhibited the noncyclic electron transport on basal, phosphorylating, and uncoupled conditions from H2 O to methyl viologen (MV); therefore, they act as Hill reaction inhibitors. Studies on fluorescence of chlorophyll a (ChL a) indicated that they inhibited the acceptor side of PSII between P680 and PQ-pool, exactly as the commercial herbicide DCMU does.

Detección de fenotipos en gestantes sanas de peso adecuado / Phenotype detection in healthy normal- weight pregnant women

RESUMEN Introducción: diferentes manifestaciones de la composición corporal de las gestantes pueden ser indicativos de adiposidad abdominal. Dichos indicativos integran el cortejo del fenotipo normopeso obeso, y constituyen factores importantes que se deben tener en cuenta para la pesquisa y detección temprana de riesgos o alteraciones metabólicas en las gestantes de peso adecuado. Objetivo: identificar la presencia de fenotipos en gestantes sanas de peso adecuado a través de variables de adiposidad. Métodos: se realizó un estudio analítico-longitudinal-prospectivo en 326 gestantes sanas de peso adecuado (IMC 18,5-24,9), las cuales asistieron a la consulta de nutrición de estas áreas de salud: Policlínico Universitario «Chiqui Gómez Lubián¼, Policlínico Universitario «XX Aniversario¼ y Policlínico Universitario «Capitán Roberto Fleites¼, todos del municipio de Santa Clara. El estudio se realizó en el período comprendido de octubre 2016 a octubre 2017; la muestra seleccionada fue de 201 gestantes. Se estudiaron variables antropométricas y su posible agrupación según afinidad. Resultados: la variable suma de pliegues subescapular y tricipital alcanzó sus valores más altos, en relación al resto de las variables de adiposidad que participaron en la formación de los conglomerados. Conclusiones: las posibles alteraciones metabólicas en las gestantes sanas se pueden prever a través de la determinación de agrupaciones por afinidad de sus variables de adiposidad. Esto puede influir significativamente en la condición trófica de los recién nacidos.

ABSTRACT Introduction: different manifestations of body composition in pregnant women can be indicative of abdominal adiposity. These indicators are part of the metabolically- obese normal-weight phenotype, and are important factors that must be taken into account for the screening and early detection of risks or metabolic alterations in normal- weight pregnant women. Objective: to identify the presence of phenotypes in healthy normal-weight pregnant women through adiposity variables. Methods: an analytical, longitudinal, prospective study was conducted on 326 healthy normal-weight pregnant women (BMI 18.5-24.9), who came to the nutrition consultation of these health areas: "Chiqui Gómez Lubián" University Polyclinic, "XX Aniversario" University Polyclinic and "Capitán Roberto Fleites" University Polyclinic, all belonging to Santa Clara municipality. The study was conducted from October 2016 to October 2017 and the selected sample was 201 pregnant women. Anthropometric variables and their possible grouping according to affinity were studied. Results: the sum variable of the tricipital and subscapular skinfolds reached its highest values, in relation to the rest of the adiposity variables that participated in the formation of the conglomerates. Conclusions: the possible metabolic alterations in healthy pregnant women can be foreseen through the determination of groupings according to the affinity of their adiposity variables. This can significantly influence the trophic condition of newborns.

MymA Bioactivated Thioalkylbenzoxazole Prodrug Family Active against Mycobacterium tuberculosis.

Screening of a GSK-proprietary library against intracellular Mycobacterium tuberculosis identified 1, a thioalkylbenzoxazole hit. Biological profiling and mutant analysis revealed that this compound is a prodrug that is bioactivated by the mycobacterial enzyme MymA. A hit-expansion program including design, synthesis, and profiling of a defined set of analogues with optimized drug-like properties led to the identification of an emerging lead compound, displaying potency against intracellular bacteria in the low micromolar range, high in vitro solubility and permeability, and excellent microsomal stability.