Diastasis Recti with Concomitant Ventral Hernia Repair: An Initial Experience in the United Arab Emirates Population.

Introduction: Diastasis recti (DR) is characterized by an abnormal separation between the rectus abdominis muscles. Traditional repair includes only plication; however, complications may arise in the presence of concurrent ventral hernias (VH). This study aims to evaluate the safety and feasibility of diastasis repair in a United Arab Emirates (UAE) population. Methods and Procedures: This retrospective cohort study was conducted with IRB approval. All patients who underwent a DR repair (DRR) with concomitant ventral hernia repair between October 2022 and February 2024 were included. Results: A total of 20 patients were included in the study. The cohort was 80% female, with a mean overall age of 44.05 years. The mean body mass index was 27.4 kg/m2. All patients (100%) presented with DR associated with an abdominal wall defect; 17 patients (85%) with umbilical hernia, 2 patients (10%) with umbilical and incisional hernia, and 1 patient (5%) with umbilical with epigastric hernia. A total of 12 (60%) patients underwent laparoscopic DRR concomitant with VH repair, 5 (25%) patients underwent open DRR with VH repair and abdominoplasty, and 1 patient (5%) underwent DRR with VH repair and liposuction. All cases were successful without complications or conversions. Complications within 30 days included only seromas in 6 patients (30%), one requiring drainage. Conclusion: Our initial experience suggests that DR repair with concomitant VH repair and/or abdominoplasty is feasible and safe in the UAE population. Our experience demonstrated surgical outcomes compared to other regions in the world.

Coordinated inflammation and immune response transcriptional regulation in breast cancer molecular subtypes.

Breast cancer, characterized by its complexity and diversity, presents significant challenges in understanding its underlying biology. In this study, we employed gene co-expression network analysis to investigate the gene composition and functional patterns in breast cancer subtypes and normal breast tissue. Our objective was to elucidate the detailed immunological features distinguishing these tumors at the transcriptional level and to explore their implications for diagnosis and treatment. The analysis identified nine distinct gene module clusters, each representing unique transcriptional signatures within breast cancer subtypes and normal tissue. Interestingly, while some clusters exhibited high similarity in gene composition between normal tissue and certain subtypes, others showed lower similarity and shared traits. These clusters provided insights into the immune responses within breast cancer subtypes, revealing diverse immunological functions, including innate and adaptive immune responses. Our findings contribute to a deeper understanding of the molecular mechanisms underlying breast cancer subtypes and highlight their unique characteristics. The immunological signatures identified in this study hold potential implications for diagnostic and therapeutic strategies. Additionally, the network-based approach introduced herein presents a valuable framework for understanding the complexities of other diseases and elucidating their underlying biology.

Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines.

BACKGROUND: Metformin, a widely prescribed antidiabetic drug, has shown several promising effects for cancer treatment. These effects have been shown to be mediated by dual modulation of the AMPK-mTORC1 axis, where AMPK acts upstream of mTORC1 to decrease its activity. Nevertheless, alternative pathways have been recently discovered suggesting that metformin can act through of different targets regulation. METHODS: We performed a transcriptome screening analysis using HeLa xenograft tumors generated in NOD-SCID mice treated with or without metformin to examine genes regulated by metformin. Western Blot analysis, Immunohistochemical staining, and RT-qPCR were used to confirm alterations in gene expression. The TNMplot and GEPIA2 platform were used for in silico analysis of genes found up-regulated by metformin, in cervical cancer patients. We performed an AMPK knock-down using AMPK-targeted siRNAs and mTOR inhibition with rapamycin to investigate the molecular mechanisms underlying the effect of metformin in cervical cancer cell lines. RESULTS: We shown that metformin decreases tumor growth and increased the expression of a group of antitumoral genes involved in DNA-binding transcription activator activity, hormonal response, and Dcp1-Dcp2 mRNA-decapping complex. We demonstrated that ZFP36 could act as a new molecular target increased by metformin. mTORC1 inhibition using rapamycin induces ZFP36 expression, which could suggest that metformin increases ZFP36 expression and requires mTORC1 inhibition for such effect. Surprisingly, in HeLa cells AMPK inhibition did not affect ZFP36 expression, suggesting that additional signal transducers related to suppressing mTORC1 activity, could be involved. CONCLUSIONS: These results highlight the importance of ZFP36 activation in response to metformin treatment involving mTORC1 inhibition.

Acercamiento imagenológico e histológico para el diagnóstico de lesiones pulmonares por SARS-CoV-2. Informe de un caso / Imaging and Histological Approach for the Diagnosis of Pulmonary Lesions by SARS-CoV-2. Report of a Case

Resumen Se trata de paciente del sexo femenino, de 52 años de edad, caucásica, maestra de profesión, sin antecedentes patológicos personales de interés, ingresó a la unidad de cuidados intensivos con neumonía por COVID-19, tras varios tratamientos farmacológicos y 20 días con un patrón ventilatorio restrictivo severo, sin mejoría y finalmente falleció. Se obtuvieron imágenes por radiografía digital y tomografía axial computarizada de tórax, y se realizó estudio histológico pulmonar. La aplicación de los estudios imagenológicos permite observar los cambios histopatológicos para la identificación clínica y la implementación de estrategias terapéuticas eficaces. Se reportan los hallazgos imagenológicos que se corroboraron por el estudio histopatológico.

Abstract This is a 52-year-old Caucasian female patient, a teacher by profession, with no personal pathological history of interest, who was admitted to the intensive care unit with COVID-19 pneumonia, after several pharmacological treatments and 20 days with a severe restrictive ventilatory pattern, without improvement and finally died. Images were obtained by digital radiography and computed axial tomography of the chest, and a lung histological study was performed. The application of imaging studies allows the observation of histopathological changes for the adequate clinical identification of patients and the implementation of effective therapeutic strategies. The imaging findings that were corroborated by the histopathological study are reported.

Spatially Preserved Multi-Region Transcriptomic Subtyping and Biomarkers of Chemoimmunotherapy Outcome in Extensive-Stage Small Cell Lung Cancer.

PURPOSE: Transcriptomic subtyping holds promise for personalized therapy in extensive-stage small cell lung cancer (ES-SCLC). In this study, we aimed to assess intratumoral transcriptomic subtype diversity and to identify biomarkers of long-term chemoimmunotherapy benefit in human ES-SCLC. EXPERIMENTAL DESIGN: We analyzed tumor samples from 58 patients with ES-SCLC enrolled in two multicenter single-arm phase IIIb studies evaluating frontline chemoimmunotherapy in Spain: n = 32 from the IMfirst trial and n = 26 from the CANTABRICO trial. We used the GeoMx Digital Spatial Profiler system to perform multi-region transcriptomic analysis. For subtype classification, we performed hierarchical clustering using the relative expression of ASCL1 (SCLC-A), NEUROD1 (SCLC-N), POU2F3 (SCLC-P), and YAP1 (SCLC-Y). RESULTS: Subtype distribution was found to be similar between bothcohorts, except for SCLC-P, which was not identified in the CANTABRICO_DSP cohort. A total of 44% of the patients in both cohorts had tumors with multiple coexisting transcriptional subtypes. Transcriptional subtypes or subtype heterogeneity was not associated with outcomes. Most potential targets did not show subtype-specific expression. Consistently in both cohorts, tumors from patients with long-term benefit (time to progression ≥12 months) contained an IFNγ-dominated mRNA profile, including enhanced capacity for antigen presentation. Hypoxia and glycolytic pathways were associated with resistance to chemoimmunotherapy. CONCLUSIONS: This work suggests that intratumoral heterogeneity, inconsistent association with outcome, and unclear subtype-specific target expression might be significant challenges for subtype-based precision oncology in SCLC. Preexisting IFNγ-driven immunity and mitochondrial metabolism seem to be correlates of long-term efficacy in this study, although the absence of a chemotherapy control arm precludes concluding that these are predictive features specific for immunotherapy.

UDC- COVID 19: herramienta digital para predecir el retiro de la ventilación mecánica invasiva de pacientes con COVID-19

En diciembre de 2019 las Autoridades de la República Popular China, comunicaron a la OMS varios casos de neumonía de etiología desconocida en Wuhan, una ciudad situada en la provincia china de Hubei. Una semana más tarde confirmaron que se trataba de un nuevo coronavirus que fue denominado SARS-CoV-2, este virus causa diversas manifestaciones clínicas englobadas bajo el término COVID-19. El presente trabajo presenta un prototipo de aplicación con el nombre UDC-COVID19 que propone una herramienta digital sobre la base de una revisión actualizada de la evaluación ultrasonográfica del diafragma como elemento predictivo para retirar la ventilación mecánica invasiva en pacientes con COVID-19, proporcionando una excelente herramienta digital para la evaluación de la estructura y función dinámica diafragmática, es precisa, reproducible, sin radiación ionizante, fácil de realizar a la cabecera del paciente y costo efectiva en pacientes críticamente enfermos.

In December 2019, the Authorities of the People's Republic of China reported to the WHO several cases of pneumonia of unknown etiology in Wuhan, a city located in the Chinese province of Hubei. A week later, they confirmed that it was a new coronavirus called SARS-CoV-2, which causes various clinical manifestations encompassed under the term COVID-19. The present work presents an application prototype with the name UDC-COVID19 that proposes a digital tool based on an updated review of the ultrasonographic evaluation of the diaphragm as a predictive element to withdraw invasive mechanical ventilation in patients with COVID-19, providing an excellent digital tool for the evaluation of the diaphragmatic structure and dynamic function since it is precise, reproducible, without ionizing radiation, easy to perform at the patient's bedside and cost effective in critically ill patients; mechanical ventilation.

Covered Rutile-TiO2 Nanoparticles Enhance Tomato Yield and Growth by Modulating Gas Exchange and Nutrient Status.

Nanotechnology has developed materials that can increase food production while reducing the use of conventional fertilizers. In this study, the effect of two forms of application (foliar and drench) as well as covering or non-covering of the surface of titanium dioxide nanoparticles (nTiO2) with maltodextrin (MDX) at 1500 ppm was investigated on tomato plants. The results show that treatment of tomato with nTiO2 increased yield (+21%), while covering the surface of the NPs resulted in a further yield increase (+27%). Similar trends were observed in the dry weight of vegetative plant parts. Fruit firmness (+33%) and total soluble solids (+36%) were enhanced by MDX-covered nTiO2. Application of nTiO2 resulted in enhanced SPAD index, photosynthesis rate, NO3-, K, and Ca concentration in the petiole sap, whereas in the fruits there was an increase in P and K in MDX-covered nTiO2. Considering the dilution effect due to the higher fruit yield, N, P, Mg, Cu, and B increased in plants treated with nTiO2. Covering the surface with MDX resulted in an enhanced response to nTiO2, as fruit yield and quality increased compared to plants treated with non-covered nTiO2.

Methylation-related genes involved in renal carcinoma progression.

Renal carcinomas are a group of malignant tumors often originating in the cells lining the small tubes in the kidney responsible for filtering waste from the blood and urine production. Kidney tumors arise from the uncontrolled growth of cells in the kidneys and are responsible for a large share of global cancer-related morbidity and mortality. Understanding the molecular mechanisms driving renal carcinoma progression results crucial for the development of targeted therapies leading to an improvement of patient outcomes. Epigenetic mechanisms such as DNA methylation are known factors underlying the development of several cancer types. There is solid experimental evidence of relevant biological functions modulated by methylation-related genes, associated with the progression of different carcinomas. Those mechanisms can often be associated to different epigenetic marks, such as DNA methylation sites or chromatin conformation patterns. Currently, there is no definitive method to establish clear relations between genetic and epigenetic factors that influence the progression of cancer. Here, we developed a data-driven method to find methylation-related genes, so we could find relevant bonds between gene co-expression and methylation-wide-genome regulation patterns able to drive biological processes during the progression of clear cell renal carcinoma (ccRC). With this approach, we found out genes such as ITK oncogene that appear hypomethylated during all four stages of ccRC progression and are strongly involved in immune response functions. Also, we found out relevant tumor suppressor genes such as RAB25 hypermethylated, thus potentially avoiding repressed functions in the AKT signaling pathway during the evolution of ccRC. Our results have relevant implications to further understand some epigenetic-genetic-affected roles underlying the progression of renal cancer.

Necesidad de aprendizaje del médico general sobre Imagenología durante la COVID-19 para su formación laboral / The General Practitioner's Need for Learning Imaginology during COVID-19

Para afrontar la reciente emergencia global por COVID-19, la comunidad científica y los profesionales de la salud en Cuba trabajan constantemente en el desarrollo de nuevos tratamientos y tecnologías que posibiliten el diagnóstico precoz de esta enfermedad, todo ello para facilitar el manejo general de esta pandemia.1) De ahí que se requiere el perfeccionamiento continuo de este proceso en correspondencia con los principios de la medicina, con una formación humanista, científica y con una visión integral de los problemas de salud como elemento esencial que caracteriza la formación de profesionales de la salud en territorio cubano donde la especialidad de Medicina General Integral constituye la principal disciplina integradora de contenidos, para ofrecer una atención preventiva, sistemática y continua al paciente a lo largo del tiempo, donde el médico en formación sea expresión de sus cualidades humanas. Coherente con esto, en 1984 se inició en Cuba la formación de especialistas en Medicina General Integral (MGI). Esta especialidad no tenía antecedentes en el país, por lo cual su propuesta constituye el perfeccionamiento del enfoque social de la medicina, que desde su implantación es la premisa básica del sistema de salud cubano. La formación de estos profesionales ocurre en la propia comunidad, con una alta calidad en los servicios que se brindan a la población.2 Para cumplir con esta función...(AU)

Urethral Slings for Irradiated Patients With Male Stress Urinary Incontinence: A Meta-analysis.

OBJECTIVE: To systematically compare success, cure and complication rates of urethral sling surgeries in stress urinary incontinence patients with and without a history of pelvic radiotherapy (RT). MATERIALS AND METHODS: We searched PUBMED, EMBASE, and Web of Science to identify relevant articles. The primary outcomes were the success and cure rates. The secondary outcomes included the rates of infection, urethral erosion, total complications, explantation, and satisfaction. Outcomes were analyzed using a random-effects model to calculate the unadjusted odds ratio (OR) in patients with a history of RT compared with those without prior RT. RESULTS: On pooled analysis, we found significantly lower odds of success (OR 0.68; 95% confidence interval [CI] 0.53-0.87, P < .001) and cure (OR 0.67; 95% CI 0.55-0.82, P < .001) in radiated patients than in nonirradiated patients. Subgroup analysis by type of sling showed significantly lower odds of success in Advance subgroup (OR 0.66; 95% CI 0.45-0.95, P < .001) and significantly lower odds of cure in Advance (OR 0.59; 95% CI 0.36-0.95, P < .001) and Atoms subgroups (OR 0.70; 95% CI 0.54-0.93, P < .001). We also found significantly greater odds of sling explantation (OR 2.93; 95% CI 1.62-5.29, P < .001) and infection (OR 3.06, 95% CI 1.03-9.07, P < .001) in radiated patients than in nonradiated patients. CONCLUSION: Patients with a history of pelvic RT have lower odds of success and cure and higher odds of infection and sling explantation than those without a history of pelvic RT.

Análisis de los formatos de consentimiento informado en los establecimientos de salud Reflexiones bioéticas y jurídicas en el contexto peruano

en la actividad asistencial desarrollada por los profesionales de la salud, el consentimiento informado (CI) instrumentaliza la aquiescencia otorgada por el paciente respecto al procedimiento y/o intervención quirúrgica. Existe una regulación dispersa en el ordenamiento legal peruano en relación con el CI. En el ámbito del sistema interamericano se resuelven precedentes importantes que establecen el contenido mínimo que se debe informar al paciente previo al consentimiento. Se evalúo el cumplimiento de 22 elementos necesarios y nueve deseables en los formatos de CI, en atención al ordenamiento normativo vigente y a lo previsto a nivel supranacional por la Corte Interamericana de Derechos Humanos (Corte IDH). Dichas categorías fueron validadas mediante el juicio de expertos abogados y profesionales de la salud. La población objetivo estuvo conformada por 456 formatos de consentimiento aplicados en los establecimientos de salud públicos de Lima Metropolitana, durante los años 2019-2021. En todos los formatos se cumplen los elementos necesarios asociados con datos del paciente, el profesional de la salud y el nombre del procedimiento o intervención quirúrgica. No hay elemento deseable que se cumpla en la totalidad de estos formatos. En ese sentido, se advierten brechas en el contenido de los esos formatos en los establecimientos de salud peruanos, por lo que se debe reivindicar el aspecto informativo para lograr actos de consentimiento plenamente eficaces.

in the healthcare activity carried out by health professionals, informed consent (IC) instrumentalizes the acquiescence of the patient concerning the procedure and/or surgical intervention. There is a scattered regulation in the Peruvian legal system about IC. In the Inter-American system, essential precedents establish the minimum content the patient should be informed of before consent. Compliance with 22 necessary elements and nine desirable elements in the IC forms was evaluated under the current legal system and the supranational provisions of the Inter-American Court of Human Rights (IACHR Court). These categories were validated through the judgment of expert lawyers and health professionals. The target population consisted of 456 consent forms applied in public health facilities in Metropolitan Lima from 2019-2021. In all the formats, the necessary elements associated with patient data, the health professional, and the name of the procedure or surgical intervention are fulfilled. There is no desirable element that is fulfilled in all of these formats. In this sense, there are gaps in the content of these forms in Peruvian health facilities, so the informative aspect should be vindicated to achieve fully effective acts of consent.

na atividade assistencial desenvolvida pelos profissionais da saúde, o consentimento informado (CI) instrumentaliza a aquiescência outorgada pelo paciente a respeito do procedimento e/ou intervenção cirúrgica. Existe uma regulamentação dispersa no ordenamento legal peruano com relação ao CI. No âmbito do sistema interamericano, são resolvidos precedentes importantes que estabelecem o conteúdo mínimo que deve ser informado ao paciente prévio ao consentimento. Foi avaliado o cumprimento de 22 elementos necessários e nove desejáveis nos modelos de CI, em atenção ao ordenamento normativo vigente e ao previsto no âmbito supranacional pela Corte Interamericana de Direitos Humanos (Corte IDH). Essas categorias foram validadas mediante o julgamento de especialistas advogados e profissionais da saúde. A população-alvo esteve conformada por 456 formulários de consentimento aplicados nos estabelecimentos de saúde públicos de Lima Metropolitana, durante 2019-2021. Em todos os formulários, são cumpridos os elementos necessários associados com dados do paciente, o profissional da saúde e o nome do procedimento ou intervenção cirúrgica. Não há elemento desejável que se cumpra na totalidade desses formulários. Nesse sentido, são apresentadas lacunas no conteúdo desses formulários nos estabelecimentos de saúde peruanos, por isso o aspecto informacional deve ser reivindicado para conseguir atos de consentimento plenamente eficazes.

Efectividad de la acupuntura en el tratamiento de la bursitis subacromial calcificada

Se presenta el caso de una paciente femenina de 52 años, raza blanca, enfermera de profesión, con antecedentes patológicos personales de hipertensión arterial compensada y tratamiento regular. Manifestó dolor en el hombro derecho y se remitió del Servicio de Ortopedia a la consulta de Medicina Natural y Tradicional del Hospital Clínico Quirúrgico "Lucía Íñiguez Landín". Dos años atrás le habían diagnosticado bursitis subacromial calcificada y había recibido varios tratamientos, pero sin mejoría. Se le corroboró el diagnóstico mediante radiografía digital y ultrasonido. El tratamiento con acupuntura redujo el tamaño de las calcificaciones y alivió los síntomas. La novedad del caso radica en la pertinencia del uso de la acupuntura en el tratamiento de esta patología.

It is presented the case of a female patient of 52 years, white skin, nurse by profession, with a personal pathological history of compensated arterial hypertension and regular treatment. She showed pain in the right shoulder and was referred to the Natural and Traditional Medicine clinic of the "Lucía Íñiguez Landín" Clinical Surgical Hospital. For two years she had been diagnosed with calcific subacromial bursitis and had received several treatments, but without obtaining improvement. The diagnosis was confirmed by digital radiography and ultrasound. Acupuncture treatment reduced the size of calcifications and alleviated symptoms. The novelty of the case lies in the relevance of the use of acupuncture in the treatment of this pathology.

Perfil epidemiológico de los accidentes de tránsito en México, 2010-2019 / Epidemiological profile of road traffic accidents in México, 2010-2019

Resumen: Objetivo: Describir las características del perfil epidemiológico de los accidentes de tránsito (AT) en México, en el periodo 2010 - 2019. Materiales y métodos: Estudio descriptivo, retrospectivo, se analizaron como fuentes secundarias las bases de datos Accidentes del tránsito, parque vehicular y Mortalidad del Instituto Nacional de Estadística y Geografía (INEGI). Además, se agregó un análisis descriptivo utilizando chi-cuadrada. Resultados: En el periodo estudiado se produjeron 3,808,981 AT, el 19.8% de éstos sucedieron en Nuevo León. Los automóviles y las camionetas representan los tipos de vehículo más veces involucrados en estos accidentes. La imprudencia del conductor es la principal causa de siniestralidad. El tipo de accidente más común es la colisión con vehículo automotor (67.6%). Los AT han provocado 52,387 muertos en el lugar del accidente y 1,126,709 lesionados en México en la década estudiada. Conclusiones: Los AT son un problema de salud pública en México. Se registra una tendencia a la baja en las cifras de fallecimientos y heridos, así como en la tasa de mortalidad y morbilidad por AT, pero no así en la tasa de letalidad por AT en el periodo estudiado. Aunque los ocupantes de vehículos son las principales víctimas de accidentes fatales y no fatales, los peatones figuran como el grupo más vulnerable en mortalidad. El estudio abona a la literatura mexicana en materia de seguridad vial buscando servir en la toma de decisiones de las instituciones involucradas.

Abstract Objective: To describe the characteristics and epidemiological profile of road traffic accidents (RTAs) in Mexico during the period 2010-2019. Materials and methods: The study is descriptive and retrospective. As secondary sources were analyzed the database "Road Accidents", "Vehicle fleet" and "Mortality" of the National Institute of Statistics and Geography (INEGI). In addition, a descriptive analysis was added using chi square. Results: In the period studied, there were 3,808,981 RTAs, 19.8% of these occurred in Nuevo León. Cars and trucks are the types of vehicle most often involved in these accidents. The recklessness of the driver is the main cause of traffic accidents. The most common type of accident is a collision with a motor vehicle (67.7%). RTAs have caused 52,387 deaths at the accident site and 1,126,709 injured in Mexico in the period. Conclusions: RAs are a public health problem in Mexico. There is a downward trend in the mortality and morbidity figures from RA in the period studied. Although vehicle occupants are the main victims of fatal and non-fatal accidents, pedestrians are the most vulnerable group in terms of mortality. The study adds to the Mexican literature on road safety, seeking to serve in the decision-making of the institutions involved.

Asociación entre el nivel del establecimiento de salud y el cumplimiento de los elementos informativos en los formatos de consentimiento informado, 2019-2021

Objetivo: Identificar la relación entre el nivel de los establecimientos de salud públicos y el cumplimiento de los elementos informativos necesarios y deseables de los formatos de consentimiento informado (CI), Lima Metropolitana, 2019-2021. Materiales y métodos: Estudio descriptivo y transversal. Se analizaron 455 formatos de CI aplicados en establecimientos de salud públicos del tercer nivel de atención: hospitales (III-1, III-E) e institutos especializados (III-2), donde se evaluó el cumplimiento de 22 elementos necesarios y 9 elementos deseables identificados en la regulación peruana vigente y lo previsto a nivel de la Corte Interamericana de Derechos Humanos (Corte IDH). Dicha matriz se sometió a un juicio de expertos constituido por 11 profesionales abogados y de salud, registrando un coeficiente de Kappa de "1" en correlato a "perfecto". Además, se valoró el coeficiente de competencia experta (K), registrando un promedio entre los especialistas de "0,92" compatible a una "alta influencia". Se aplicaron las pruebas estadísticas de correlación de Spearman, chi cuadrado, prueba exacta de Fisher y phi de Cramer. Resultados: Los institutos especializados (66,00 %) elaboraron predominantemente los formatos de CI, y la actividad médica (96,90 %) fue la mayoritaria en dichos formatos. El cumplimiento de los elementos informativos necesarios (Rho = 0,69) y deseables (Rho = 0,64) registraron una relación significativa (p 0,00). Los elementos "Duración del procedimiento", "Contraindicaciones" y "Absolución de preguntas" registraron una relación significativa negativa (p < 0,05; Φ < 0,00). Conclusiones: Existe asociación entre el nivel del establecimiento de salud y el cumplimiento de los elementos informativos necesarios y deseables de los formatos de CI en los establecimientos de salud públicos de Lima Metropolitana entre 2019 y 2021.

Objective: To identify the relationship between public health care facility level and compliance with the essential and desired informative elements of informed consent (IC) forms, Lima Metropolitan Area, 2019-2021. Materials and methods: A descriptive and cross-sectional study. A total of 455 IC forms used in public tertiary health care facilities-hospitals (III-1, III-E) and specialized health care institutions (III-2)-were analyzed to assess the compliance of 22 essential and nine desired elements set forth in the current Peruvian laws and regulations and provided by the Inter-American Court of Human Rights (IACHR). This matrix was submitted to the opinion of a group of experts made up of 11 lawyers and health professionals, registering a Kappa coefficient of 1, which implies a "perfect agreement." In addition, expert competence coefficient (K) was assessed, registering among the specialists an average of 0.92, which represents a "high influence." Statistical tests such as Spearman's correlation coefficient, chi-square test, Fisher's exact test and Cramér's phi were performed. Results: IC forms were mostly developed by the specialized health care institutions (66.00 %) and the medical activity (96.90 %) prevailed in said forms. Compliance with the essential (Rho = 0.69) and desired (Rho = 0.64) informative elements showed a significant relationship (p 0.00). The elements "Procedure duration," "Contraindications" and "Solution to questions" showed a significant negative relationship (p < 0.05; Φ < 0.00). Conclusions: There is an association between health care facility level and compliance with the essential and desired informative elements of IC forms in public health care facilities in Lima Metropolitan Area between 2019 and 2021.

Neuroprotective properties of queen bee acid by autophagy induction.

Autophagy is a conserved intracellular catabolic pathway that removes cytoplasmic components to contribute to neuronal homeostasis. Accumulating evidence has increasingly shown that the induction of autophagy improves neuronal health and extends longevity in several animal models. Therefore, there is a great interest in the identification of effective autophagy enhancers with potential nutraceutical or pharmaceutical properties to ameliorate age-related diseases, such as neurodegenerative disorders, and/or promote longevity. Queen bee acid (QBA, 10-hydroxy-2-decenoic acid) is the major fatty acid component of, and is found exclusively in, royal jelly, which has beneficial properties for human health. It is reported that QBA has antitumor, anti-inflammatory, and antibacterial activities and promotes neurogenesis and neuronal health; however, the mechanism by which QBA exerts these effects has not been fully elucidated. The present study investigated the role of the autophagic process in the protective effect of QBA. We found that QBA is a novel autophagy inducer that triggers autophagy in various neuronal cell lines and mouse and fly models. The beclin-1 (BECN1) and mTOR pathways participate in the regulation of QBA-induced autophagy. Moreover, our results showed that QBA stimulates sirtuin 1 (SIRT1), which promotes autophagy by the deacetylation of critical ATG proteins. Finally, QBA-mediated autophagy promotes neuroprotection in Parkinson's disease in vitro and in a mouse model and extends the lifespan of Drosophila melanogaster. This study provides detailed evidences showing that autophagy induction plays a critical role in the beneficial health effects of QBA.

Defunciones por mieloma múltiple en Chile entre 2018-2022 por sexo, edad, temporalidad y región nacional / Deaths from multiple myeloma in Chile between 2018-2022 by sex, age, temporality, and national region

Introducción: Chile es el país con la mayor tasa de mortalidad por mieloma múltiple (MM) en Latinoamérica, sin embargo, no existen estudios actualizados que describan esto. El objetivo de este estudio es describir las defunciones por MM según año, sexo, grupo etario y región en Chile, en el periodo 2018-2022. Metodología: Estudio ecológico de las defunciones por MM en el periodo 2018-2022 según año, sexo, grupo etario y región (n=2433). Se calculó el número de defunciones y las tasas de mortalidad por causa específica. Datos obtenidos del Departamento de Estadísticas e Información de Salud. No se requirió comité de ética. Resultados: El promedio de la tasa de mortalidad por año fue de 2.51 por 100.000 habitantes en el periodo estudiado, y fue menor a este valor en 2020 y 2021. El sexo masculino obtuvo un 52.2% del total de las defunciones. Las personas de 80-89 años obtuvieron la mayor tasa de mortalidad (27.57 por 100.000 habitantes). La región con mayor tasa de mortalidad es la de Ñuble (3.45 por 100.000 habitantes). Discusión: La disminución en la tasa de mortalidad para MM en los años 2020-2021 podría deberse al COVID-19. Las tasas entre sexos son similares, pese a que las estadísticas internacionales indican mayor prevalencia en hombres. Los grupos etarios más afectados son los de mayor edad, pues es factor de riesgo para MM. Las regiones con mayor tasa de mortalidad son las del centro-sur, aunque es difícil establecer causalidad. Las investigaciones respecto a este tema en Chile son escasas, este trabajo podría ser útil para futuras investigaciones.

Introduction: Chile is the country with the highest mortality rate from multiple myeloma (MM) in Latin America, however, there are no updated studies that describe this. The objective of this study is to describe the functions by MM according to year, sex, age group and region in Chile, in the period 2018-2022. Methodology: Ecological study of the functions by MM in the period 2018-2022 according to year, sex, age group and region (n=2433). The number of deaths and cause-specific mortality rates were calculated. Data obtained from the Department of Health Statistics and Information. No ethics committee was required. Results: The average mortality rate per year was 2.51 per 100,000 inhabitants in the period studied, and it was lower than this value in 2020 and 2021. The male sex obtained 52.2% of all deaths. People aged 80-89 years had the highest mortality rate (27.57 per 100,000 inhabitants). The region with the highest mortality rate is Ñuble (3.45 per 100,000 inhabitants). Discussion: The decrease in the mortality rate for MM in the years 2020-2021 could be due to COVID-19. The rates between sexes are similar, despite the fact that international statistics indicate a higher prevalence in men. The most affected age groups are the older ones, as it is a risk factor for MM. The regions with the highest mortality rate are those of the center-south, although it is difficult to establish causality. Research on this topic in Chile is scarce, this work could be useful for future research.

Quemaduras y corrosiones: una descripción epidemiológica según sexo y rango etario periodo 2018 - 2022, en Chile / Burns and corrosions: an epidemiological description by gender and age range for the period 2018-2022 in Chile

Introducción: Las quemaduras son lesiones de gravedad variable causadas por exceso de calor. En Chile, son causa importante de hospitalización y muerte, especialmente en niños, lo que ha llevado a la implementación de medidas como su adición a las Garantías Explícitas en Salud, y la creación de un registro nacional para mejorar la atención. El siguiente estudio busca describir las tasas de egresos hospitalarios y mortalidad de pacientes con quemaduras y corrosiones en Chile, durante el período 2018-2022, con la finalidad de contribuir a la epidemiología actual. Metodología: Se realizó un estudio retrospectivo utilizando datos del DEIS sobre quemaduras y corrosiones en la población chilena entre 2018 y 2022. Se analizaron los datos por año, sexo y rango etario. No requirió consentimiento informado ni revisión ética debido a la disponibilidad pública de los datos. Resultados: Se observó una tendencia a la disminución de los egresos hospitalarios desde 2018 hasta 2022, con el máximo en 2019. En cuanto a la mortalidad, se registró la mayor cifra en 2022 y la menor en 2019, con una tendencia al alza a lo largo del periodo. Los hombres presentaron una mayor proporción de egresos hospitalarios y mortalidad en comparación con las mujeres. Discusión: Las quemaduras y corrosiones mostraron una disminución en los egresos hospitalarios durante el periodo estudiado, mientras que la mortalidad aumentó. Se destacaron eventos específicos que podrían explicar los años con mayores egresos hospitalarios y mortalidad, como ataques incendiarios e incendios forestales. Con tal de reducir la incidencia y mortalidad de estas lesiones, se resalta la importancia de promover medidas de prevención y educación, y fortalecer los protocolos de atención y tratamiento.

Introduction: Burns are injuries of variable severity caused by excessive heat. In Chile, they are an important cause of hospitalization and death, especially in children, which has led to the implementation of measures such as their addition to the Explicit Health Guarantees, and the creation of a national registry to improve care. The following study seeks to describe the hospital discharge and mortality rates of patients with burns and corrosions in Chile, during the period 2018-2022, with the aim of contributing to the current epidemiology. Methodology: A retrospective study was conducted using DEIS data on burns and corrosions in the Chilean population between 2018 and 2022. Data were analyzed by year, gender, and age range. Informed consent and ethical review were not required due to the public availability of the data. Results: A decreasing trend in hospital discharges for burns was observed from 2018 to 2022, with a peak in 2019. For mortality, the highest number of deaths was recorded in 2022 and the lowest in 2019, with an upward trend throughout the period. Males had a higher proportion of hospital discharges and mortality compared to females. Discussion: Burns and corrosions showed a decrease in hospital admissions during the period studied, while mortality increased. Specific events that could explain the years with higher hospital admissions and mortality were highlighted, such as arson attacks and forest fires. In order to reduce the incidence and mortality of these injuries, the importance of promoting prevention and education measures and strengthening care and treatment protocols is highlighted.

Rucaparib in recurrent ovarian cancer: real-world experience from the rucaparib early access programme in Spain - A GEICO study.

BACKGROUND: Rucaparib is a poly(ADP-ribose) polymerase inhibitor approved in Europe as maintenance therapy for recurrent platinum-sensitive (Pt-S) ovarian cancer (OC). The Rucaparib Access Programme (RAP) was designed to provide early access to rucaparib for the above-mentioned indication, as well as for patients with BRCA-mutated Pt-S or platinum-resistant (Pt-R) OC and no therapeutic alternatives. METHODS: In this observational, retrospective study we analysed the efficacy and safety of rucaparib within the RAP in Spain. Hospitals associated with the Spanish Ovarian Cancer Research Group (GEICO) recruited patients with high-grade epithelial ovarian, fallopian tube, or primary peritoneal cancer treated with rucaparib 600 mg twice daily as maintenance or treatment (Pt-S/Pt-R) in the RAP. Baseline characteristics, efficacy, and safety data were collected. RESULTS: Between July 2020 and February 2021, 51 patients treated in 22 hospitals in the RAP were included in the study. Eighteen patients with a median of 3 (range, 1-6) prior treatment lines received rucaparib as maintenance; median progression-free survival (PFS) for this group was 9.1 months (95% confidence interval [CI], 4.2-11.6 months). Among 33 patients (median 5 [range, 1-9] prior treatment lines) who received rucaparib as treatment, 7 and 26 patients had Pt-S and Pt-R disease, respectively. Median PFS was 10.6 months (95% CI, 2.5 months-not reached) in the Pt-S group and 2.2 months (95% CI, 1.1-3.2 months) in the Pt-R group. Grade ≥ 3 treatment-emergent adverse events were reported in 39% of all patients, the most common being anaemia (12% and 15% in the maintenance and treatment groups, respectively). At data cut-off, 5 patients remained on treatment. CONCLUSION: Efficacy results in these heavily pre-treated patients were similar to those from previous trials. The safety profile of rucaparib in real life was predictable and manageable.

Delay of EGF-Stimulated EGFR Degradation in Myotonic Dystrophy Type 1 (DM1).

Myotonic dystrophy type 1 (DM1) is an autosomal dominant disease caused by a CTG repeat expansion in the 3' untranslated region of the dystrophia myotonica protein kinase gene. AKT dephosphorylation and autophagy are associated with DM1. Autophagy has been widely studied in DM1, although the endocytic pathway has not. AKT has a critical role in endocytosis, and its phosphorylation is mediated by the activation of tyrosine kinase receptors, such as epidermal growth factor receptor (EGFR). EGF-activated EGFR triggers the internalization and degradation of ligand-receptor complexes that serve as a PI3K/AKT signaling platform. Here, we used primary fibroblasts from healthy subjects and DM1 patients. DM1-derived fibroblasts showed increased autophagy flux, with enlarged endosomes and lysosomes. Thereafter, cells were stimulated with a high concentration of EGF to promote EGFR internalization and degradation. Interestingly, EGF binding to EGFR was reduced in DM1 cells and EGFR internalization was also slowed during the early steps of endocytosis. However, EGF-activated EGFR enhanced AKT and ERK1/2 phosphorylation levels in the DM1-derived fibroblasts. Therefore, there was a delay in EGF-stimulated EGFR endocytosis in DM1 cells; this alteration might be due to the decrease in the binding of EGF to EGFR, and not to a decrease in AKT phosphorylation.