CardioHotspots: a database of mutational hotspots for cardiac disorders.

Mutational hotspots are DNA regions with an abnormally high frequency of genetic variants. Identifying whether a variant is located in a mutational hotspot is critical for determining the variant's role in disorder predisposition, development, and treatment response. Despite their significance, current databases on mutational hotspots are limited to the oncology domain. However, identifying mutational hotspots is critical for any disorder in which genetics plays a role. This is true for the world's leading cause of death: cardiac disorders. In this work, we present CardioHotspots, a literature-based database of manually curated hotspots for cardiac diseases. This is the only database we know of that provides high-quality and easily accessible information about hotspots associated with cardiac disorders. CardioHotspots is publicly accessible via a web-based platform (https://genomics-hub.pros.dsic.upv.es:3099/). Database URL: https://genomics-hub.pros.dsic.upv.es:3099/.

Relationship between diabetic peripheral neuropathy and adherence to the Mediterranean diet in patients with type 2 diabetes mellitus: an observational study.

PURPOSE: The main study goal is to assess the relationship between adherence to the mediterranean diet (MD) and the presence of diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). METHODS: Observational pilot study of 174 patients diagnosed with T2DM. Sociodemographic and anthropometric variables, physical activity, smoking habits, blood biochemical parameters and comorbidities were recorded. The presence of alterations in sensitivity to pressure, pain, thermal and vibration was explored. Good MD adherence was a score ≥ 9 the 14-point MD adherence questionnaire (MEDAS-14). RESULTS: The study population consisted of 174 patients (61.5% men and 38.5% women), with a mean age of 69.56 ± 8.86 years; 19% of these patients adhered to the MD. The score obtained in the MEDAS-14 was higher in patients who did not present alterations in sensitivity to pressure (p = 0.047) or vibration (p = 0.021). The patients without diabetic peripheral neuropathy were more likely to comply with the MD and had a higher score on the MEDAS-14 (p = 0.047). However, multivariate analysis showed that only altered sensitivity to pressure was associated with adherence to the MD (altered sensitivity OR = 2.9; 95%CI 1.02-8.22; p = 0.045). CONCLUSIONS: Although the patients with DPN had lower scores on the MEDAS questionnaire and therefore poorer adherence to the mediterranean diet, the only parameter significantly associated with the MD was that of sensitivity to pressure (monofilament test).

The consequences of data dispersion in genomics: a comparative analysis of data sources for precision medicine.

BACKGROUND: Genomics-based clinical diagnosis has emerged as a novel medical approach to improve diagnosis and treatment. However, advances in sequencing techniques have increased the generation of genomics data dramatically. This has led to several data management problems, one of which is data dispersion (i.e., genomics data is scattered across hundreds of data repositories). In this context, geneticists try to remediate the above-mentioned problem by limiting the scope of their work to a single data source they know and trust. This work has studied the consequences of focusing on a single data source rather than considering the many different existing genomics data sources. METHODS: The analysis is based on the data associated with two groups of disorders (i.e., oncology and cardiology) accessible from six well-known genomic data sources (i.e., ClinVar, Ensembl, GWAS Catalog, LOVD, CIViC, and CardioDB). Two dimensions have been considered in this analysis, namely, completeness and concordance. Completeness has been evaluated at two levels. First, by analyzing the information provided by each data source with regard to a conceptual schema data model (i.e., the schema level). Second, by analyzing the DNA variations provided by each data source as related to any of the disorders selected (i.e., the data level). Concordance has been evaluated by comparing the consensus among the data sources regarding the clinical relevance of each variation and disorder. RESULTS: The data sources with the highest completeness at the schema level are ClinVar, Ensembl, and CIViC. ClinVar has the highest completeness at the data level data source for the oncology and cardiology disorders. However, there are clinically relevant variations that are exclusive to other data sources, and they must be considered in order to provide the best clinical diagnosis. Although the information available in the data sources is predominantly concordant, discordance among the analyzed data exist. This can lead to inaccurate diagnoses. CONCLUSION: Precision medicine analyses using a single genomics data source leads to incomplete results. Also, there are concordance problems that threaten the correctness of the genomics-based diagnosis results.

Evaluation of polycyclic aromatic hydrocarbons in sediments of Balsas River Mouth, Pacific Coast, Mexico: Sources, risks, and genotoxicity.

Polycyclic aromatic hydrocarbons (PAHs) were assessed in sediments (n = 7) collected from the mouth of the Balsas River, Pacific Coast, Mexico. The total PAH levels ranged between 142.1 and 3944.07 µg kg-1 in the summer and 137.65-3967.38 µg kg-1 in the winter, probably reflecting the anthropogenic activities of the region. Calculation of the four analytical ratios of [Anthracene/(Anthracene + Phenanthrene)]: [Fluoranthene/(Fluoranthene + Pyrene)], [Fluoranthene/Pyrene: Fluoranthene/(Fluoranthene + Pyrene)], [Indeno [123-cd]Pyrene/(Indeno [123-cd]Pyrene + Benzo [ghi]Perylene)]: [Benzo [a]anthracene/(Benzo [a]Anthracene + Chrysene)], and [Anthracene/Phenanthrene]: [Fluoranthene/(Fluoranthene + Pyrene)] revealed a mixed PAH source, from petroleum and biomass combustion. Significant statistical correlations (r2 = 0.90) between the 4 and 5 ringed PAHs denote that adsorption is the principal mechanism for accumulation in sedimentary archives. Ecotoxicological indices (Mean Effect Range Medium Quotient and Mean Probable Effect Level Quotient) indicated moderate pollution with adverse biological impacts on ambient benthonic organisms. The calculations of Toxicity Equivalent Quotient and Mutagen Equivalent Quotient values proposed that the region is highly polluted by mutagenic and carcinogenic PAH compounds. The genotoxic evaluation of Lutjanus guttatus (Spotted rose snapper) presented significant DNA damage and discrepancies in Ethoxyresorufin-O-Deethylase activity. Based on the toxicological and genotoxicological evaluation of PAHs in sediments, the region was observed to be largely impacted from biological damage.

Adherence to the Mediterranean diet in first-year university students and its association with lifestyle-related factors: A cross-sectional study.

INTRODUCTION: Students' dietary habits are moving from Mediterranean diet guidelines towards unhealthy eating patterns. The aim of this study was to determine adherence to the Mediterranean diet in a sample of Spanish university students and its association with lifestyle factors. MATERIAL AND METHODS: A descriptive cross-sectional study was conducted with 685 university students who completed a self-report questionnaire. The data collected included demographic characteristics, dietary habits, smoking habits, alcohol consumption and physical activity. Mediterranean diet adherence was assessed by measuring the consumption of the foods that compose this type of diet through a score (range 0-10). Adherence to the Mediterranean diet was considered poor, average, or good. RESULTS: The mean adherence score for the Mediterranean diet was 4.9 (1.2) points out of 10. A higher degree of adherence to the Mediterranean diet was observed in physically active students (OR=2.31, 95% CI: 1.05-5.10; p=0.038). Students who performed ≥150min/week of physical activity (OR=0.45, 95% CI: 0.33-0.62; p<0.001) and those over 25 years old (OR=0.44, 95% CI: 0.26-0.73; p=0.002) were less prone to low adherence to the Mediterranean diet than sedentary and younger students. CONCLUSION: The university students have poor adherence to the Mediterranean diet. The results of the current study indicate that age and physical activity are associated with Mediterranean diet adherence. It is urgent to raise awareness among university students and implement intervention programmes promoting a healthy lifestyle.

Un caso de neumonía organizada tras la ruptura intracapsular de implantes mamarios de silicona / A case of organized pneumonia after intracapsular rupture of silicone breast implants

La neumonía organizada es una entidad poco frecuente, caracterizada por la formación de conglomerados fibroblásticos intraalveolares conocidos como cuerpos de Masson, que puede ser criptogénica o secundaria a una respuesta inmunitaria a diversos estímulos, tales como enfermedades hematológicas, autoinmunitarias, exposición a sustancias químicas, fármacos, tóxicos, etc. Detectada y tratada de forma precoz, suele tener una buena respuesta a la corticoterapia, aunque si se diagnostica de forma tardía, la afectación pulmonar puede ser extensa, y, además, si el estímulo antigénico persiste, la respuesta al tratamiento será incompleta. Presentamos el caso clínico de una paciente de 65 años de edad quien hace 18 meses aproximadamente presentó la rotura intracapsular de sus implantes mamarios, 27 años después de su colocación. Con el mismo tiempo de evolución ha desarrollado progresivamente disnea, tos seca y dolor inframamario, habiendo llegado al diagnóstico de neumonía organizada bilateral difusa, asociada a dicha rotura de implantes.

Organizing pneumonia is a rare entity, characterized by the formation of intraalveolar fibroblastic conglomerates known as Masson bodies, which may be cryptogenic or secondary to an immune response to various stimuli, such as hematological, autoimmune diseases, exposure to chemical substances, drugs, toxics, etc. If it is detected and treated early, it usually has a good response to corticosteroid therapy, although if it is diagnosed late, the lung involvement can be extensive, and furthermore, if the antigenic stimulus persists, the response to treatment will be incomplete. We present the clinical case of a 65-year-old patient who had intracapsular rupture of her breast implants approximately 18 months ago, 27 years after their placement. With the same evolution time, she progressively developed dyspnea, dry cough and under mammary pain, having reached the diagnosis of diffuse bilateral organizing pneumonia, associated with implant rupture.

The effect of polymorphisms in FSHR gene on late follicular phase progesterone and estradiol serum levels in predicted normoresponders.

STUDY QUESTION: Does the presence of FSHR single-nucleotide polymorphisms (SNPs) affect late follicular phase progesterone and estradiol serum levels in predicted normoresponders treated with rFSH? SUMMARY ANSWER: The presence of FSHR SNPs (rs6165, rs6166, rs1394205) had no clinically significant impact on late follicular phase serum progesterone and estradiol levels in predicted normoresponders undergoing a GnRH antagonist protocol with a fixed daily dose of 150 IU rFSH. WHAT IS KNOWN ALREADY: Previous studies have shown that late follicular phase serum progesterone and estradiol levels are significantly correlated with the magnitude of ovarian response. Several authors have proposed that individual variability in the response to ovarian stimulation (OS) could be explained by variants in FSHR. However, so far, the literature is scarce on the influence of this genetic variability on late follicular phase steroidogenic response. Our aim is to determine whether genetic variants in the FSHR gene could modulate late follicular phase serum progesterone and estradiol levels. STUDY DESIGN, SIZE, DURATION: In this multicenter multinational prospective study conducted from November 2016 to June 2019, 366 patients from Vietnam, Belgium and Spain (166 from Europe and 200 from Asia) underwent OS followed by oocyte retrieval in a GnRH antagonist protocol with a fixed daily dose of 150 IU rFSH. All patients were genotyped for 3 FSHR SNPs (rs6165, rs6166, rs1394205) and had a serum progesterone and estradiol measurement on the day of trigger. PARTICIPANTS/MATERIALS, SETTING, METHODS: Included patients were predicted normal responder women <38 years old undergoing their first or second OS cycle. The prevalence of late follicular phase progesterone elevation (PE), as well as mean serum progesterone and estradiol levels on the day of trigger were compared between the different FSHR SNPs genotypes. PE was defined as >1.50 ng/ml. MAIN RESULTS AND THE ROLE OF CHANCE: The overall prevalence of PE was 15.8% (n = 58). No significant difference was found in the prevalence of PE in Caucasian and Asian patients (17.5% versus 14.5%). Estradiol levels on the day of trigger and the number of retrieved oocytes were significantly higher in patients with PE (4779 ± 6236.2 versus 3261 ± 3974.5 pg/ml, P = 0.003, and 16.1 ± 8.02 versus 13.5 ± 6.66, P = 0.011, respectively). Genetic model analysis, adjusted for patient age, body mass index, number of retrieved oocytes and continent (Asia versus Europe), revealed a similar prevalence of PE in co-dominant, dominant and recessive models for variants FSHR rs6166, rs6165 and rs1394205. No statistically significant difference was observed in the mean late follicular phase progesterone serum levels according to the genotypes of FSHR rs6166 (P = 0.941), rs6165 (P = 0.637) and rs1394205 (P = 0.114) in the bivariate analysis. Also, no difference was found in the genetic model analysis regarding mean late follicular phase progesterone levels across the different genotypes. Genetic model analysis has also revealed no statistically significant difference regarding mean estradiol levels on the day of trigger in co-dominant, dominant and recessive models for variants FSHR rs6166, rs6165 and rs1394205. Haplotype analysis revealed a statistically significant lower estradiol level on the day of trigger for rs6166/rs6165 haplotypes GA, AA and GG when compared to AG (respectively, estimated mean difference (EMD) -441.46 pg/ml (95% CI -442.47; -440.45), EMD -673.46 pg/ml (95% CI -674.26; -672.67) and EMD -582.10 pg/ml (95% CI -584.92; -579.28)). No statistically significant differences were found regarding the prevalence of PE nor late follicular phase progesterone levels according to rs6166/rs6165 haplotypes. LIMITATIONS, REASONS FOR CAUTION: Results refer to a population of predicted normal responders treated with a normal/low fixed dose of 150 IU rFSH throughout the whole OS. Consequently, caution is needed before generalizing our results to all patient categories. WIDER IMPLICATIONS OF THE FINDINGS: Based on our results, FSHR SNPs rs6165, rs6166 and rs1394205 do not have any clinically significant impact neither on late follicular phase serum progesterone nor on estradiol levels in predicted normal responders. These findings add to the controversy in the literature regarding the impact of individual genetic susceptibility in response to OS in this population. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by an unrestricted grant by Merck Sharp & Dohme (MSD, IISP56222). N.P.P. reports grants and/or personal fees from MSD, Merck Serono, Roche Diagnostics, Ferring International, Besins Healthcare, Gedeon Richter, Organon, Theramex and Institut Biochimique SA (IBSA). C.A. reports conference fees from Merck Serono, Medea and Event Planet. A.R.N., C.B., C.S., P.Q.M.M., H.T., C.B., N.L.V., M.T.H. and S.G. report no conflict of interests related to the content of this article. TRIAL REGISTRATION NUMBER: NCT03007043.

Aniridia and the ocular surface: Medical and surgical problems and solutions.

Congenital aniridia is a multisystemic genetic disease due to a mutation in PAX6 gene which severely affects the development and functionality of the human eyes. In patients affected by the mutation, aside from the absence or defects of iris tissue formation, abnormalities in position or opacities of the crystalline lens, macular hypoplasia, ocular surface disease is the main cause of visual loss and the deterioration of the quality of life of most patients. Limbal stem cell deficiency combined with tear film instability and secondary dry eye cause aniridic keratopathy which, in advanced stages, ends up in corneal opacification. In this paper, the actual knowledge about congenital aniridia keratopathy physiopathology and medical and surgical treatment options and their efficacy are discussed. Indications and results of topical treatments with artificial tears and blood-derivatives in its initial stages, and different surgical techniques as limbal stem cell transplantation, keratoplasty and keratoprostheses are reviewed. Finally, recent advances and results in regenerative medicine techniques with ex vivo stem cell cultivation or other types of cultivated cells are presented.

Modelo campo de salud para el estudio de la hipertensión arterial en estudiantes universitarios / Health field model for the study of arterial hypertension in university students

Introducción: el modelo campo de salud se agrupa en cuatro segmentos; biología humana [BH], medio ambiente [MA], Estilos de vida [EV] y servicios de salud [SS] descrito por primera vez por Mack Lalonde, es un instrumento para un análisis integral de la hipertensión arterial [HTA]. Objetivo: analizar las divisiones del campo de salud y su asociación con la HTA en estudiantes universitarios. Material y métodos: se trata de un estudio no experimental, descriptivo, transversal y prospectivo; muestra por conveniencia de 200 estudiantes universitarios. Se utilizó cuestionario Simão (2005) y medidas antropométricas y medición de la presión arterial [PA]. Estadística descriptiva y no paramétrica x2 y U de Mann Whitney. Resultados: la división del campo de salud con mayor prevalencia fueron los SS (62%). Hubo asociación estadísticamente significativa en presión arterial sistólica [PAS] con la BH (x2=9.53, gl=2, p=.009) y MA (x2=6.79, gl=2, p=.034) y en presión arterial diastólica [PAD] con BH (x2=6.13, gl=2, p=.047) y MA (x2=6.79, gl=2, p=.05). Conclusiones: el modelo de Lalonde permite valorar los factores causales y la prevalencia de la HTA en estudiantes universitarios.

Introduction: the health field model is grouped into four segments: human biology [HB], environment [E], lifestyles [LS] and health services [HS]. First described by Mack Lalonde, is an instrument for a comprehensive analysis of arterial hypertension [HBP]. Objective: analyze the divisions of the health field and its association with the HBP in university students. Material and methods: this is a non experimental, descriptive, cross-sectional and prospective study; convenience sample of 200 college students. A Simão questionnaire (2005), anthropometric measurements and measurement of blood pressure [BP] were used. Descriptive and non-parametric statistics x2 and Mann Whitney's U. Results: the division of the health field with the highest prevalence was the HS (62%). There was a statistically significant association in systolic blood pressure [SBP] with HB (x2=9.53, gl=2, p=.009) and E (x2=6.79, gl=2, p=.034) and in diastolic blood pressure [DBP] with HB (x2=6.13, gl=2, p=.047) and E (x2=6.79, gl=2).05. Conclusion: Lalonde model allows us to assess the causal factors and the prevalence of hypertension in university students.

Active Versus Passive Flow Control in UVC FILTERs for COVID-19 Containment.

Ultraviolet radiation as a germicide is widely used in the health field and even in domestic hygiene. Here, we propose an improvement in low-cost portable units of filtration for indoor air, which is based on ultraviolet radiation. In the current technology, to carry out an air filtration with a suspension of aerosols in which there is a likely concentration of pathogens, whether viral, bacterial or molds, the air is forced to pass as close as possible to the ionizing radiation source (near field). Since the optical mass is very small, the desired effect can be achieved in a considerably short time, deactivating the infective potential of these biological agents. The proposal of this work is the regulation of the flow or speed control of passage through these filters by passive elements instead of by electronic control systems. For this, two devices have been designed, simulated, and built, obtaining similar net pathogen inactivation rates under different flow rates. The passive flow control device has demonstrated higher performance in terms of flow rate and lower cost of production since they do not require electronics and are produced with fewer diodes. This passive device has also shown a lower projection of maintenance cost, lower energy consumption rate (higher efficiency), and longer projection of useful life.

Conocimientos y prácticas sobre foto protección en bañistas de ocho playas de Lima / Knowledge and practices of photoprotection in bathers of eight beaches of Lima

Resumen INTRODUCCIÓN : La radiación ultravioleta solar puede resultar perjudicial para la salud y provocar desde quemaduras hasta enfermedades como el cáncer, por ello, el cuidado frente a la alta radiación solar es importante. OBJETIVOS : El objetivo general del presente estudio fue determinar si existe asociación entre los conocimientos y las prácticas sobre foto protecciónen los bañistas peruanos. MATERIALES Y MÉTODOS : Se realizó un estudio trasversal analítico con 380 bañistas peruanos en ocho playas de Lima. Los participantes respondieron un cuestionario donde se recopiló información de los conocimientos y las prácticas de foto protección. Los conocimientos se categorizaron en altos y bajos, y las prácticas en adecuadas e inadecuadas. Para el análisis se empleó la prueba de Chi cuadrado de Pearson y el modelo de regresión de Poisson ajustado por la edad, sexo, nivel educativo y estado civil. RESULTADOS : Se encontró que la práctica de protección adecuada más frecuente fue el uso de foto protector(63%) y la menos frecuente fue el uso adecuado de manga larga y pantalón largo (9,7%). También se evidenció una relación entre los conocimientos altos y tres prácticas fundamentales: uso de foto protector, sombrilla y lentes de sol. CONCLUSIONES : En la muestra de bañistas peruanos, los participantes reportaronde manera general prácticas de foto proteccióndeficientes; además, el poseer conocimientos acerca de la protección solar no aseguró una práctica adecuada de todas las medidas de foto protección.

Abstract INTRODUCTION : Ultraviolet rays can have damaging health effects and cause from sunburn all the way up to diseases such as cancer. Thus, precautionary measures against intense solar radiation are important. OBJECTIVES: The overall objective of this study was to determine whether there is an association between photoprotection knowledge and practices in Peruvianbeach-goers. MATERIALS AND METHODS : An analytical cross-sectional study comparing survey and observational data obtained from 380 Peruvians at eight beaches in Lima was conducted. The participants answered a questionnaire where knowledge was categorized into high and low, and reported practices were dichotomized as appropriate and inappropriate. For variable analysis, Chi square test of Pearson and Poisson regression model adjusted for age, sex, education level and marital status were used. RESULTS : It was found that the most common reported appropriate practice of photoprotection was the use of sunscreen (63%) and the least frequent was the appropriate use of a long sleeve t-shirt and long pants (9.7%). It was also evident that there is a significant relationship between high knowledge and three core practices, including use of sunscreen, beach umbrellas and sunglasses. CONCLUSIONS : In this sample of Peruvian beach-goers, participants generally reported poor photoprotection practices; furthermore, knowledge about sun protection did not assure the practice of all photoprotection measures.

Uso de Tai Chi para la salud del adulto mayor: revisión bibliográfica / Use of Tai Chi for the health of the elderly: A bibliographic review / Uso do Tai Chi para a saúde de idosos: uma revisão bibliográfica

RESUMEN Introducción: La población de adultos mayores está incrementando y se observa la necesidad emergente de implementar estrategias dirigidas a recuperar o conservar su salud para que puedan gozar de una vejez plena. Técnicas como el Tai Chi podrían contribuir, ya que han mostrado tener múltiples beneficios para quien la práctica, tales como mejoras en la concentración, memoria, marcha, equilibrio, reducción del riesgo de caídas, fortalecimiento del sistema cardiovascular, reducción del estrés y la depresión, entre otros beneficios. Objetivo: Analizar la evidencia científica del uso del Tai Chi para conservar la salud del adulto mayor. Desarrollo: Revisión bibliográfica realizada durante el periodo 2013-2019 en distintas bases de datos como: Pubmed, Dialnet, SciELO, LILACS, ScienceDirect y Google Académico. Se utilizaron las palabras Tai Chi Chuan, Tai Ji Quan, Tai Chi. Aplicando los criterios de elegibilidad se seleccionaron 29 artículos. Resultados: Gran porcentaje de los artículos revisados estudian la atención de síntomas físicos que deterioran la movilidad del adulto mayor, sin embargo, también se encontraron investigaciones dirigidas a la parte psicológica, como el estrés, la ansiedad, el insomnio, la depresión y el enfado-tensión, en las cuales la práctica del Tai Chi demostró mejoría. Conclusiones: El Tai Chi es una terapia alternativa para prevenir y conservar la salud del adulto mayor, fácil de aprender y de bajo costo. En la revisión bibliográfica realizada no se reportan reacciones adversas durante ni después de la práctica de la técnica; el profesional de enfermería puede recomendarla ampliamente para ser implementada como un cuidado dirigido al adulto mayor.

ABSTRACT Introduction: The population of older adults is increasing and an emergent need to implement strategies aimed at recovering or maintaining their health is observed. In this sense, techniques such as Tai Chi could contribute because they have demonstrated bringing diverse benefits for those who practice them, including improvements in the concentration, memory, gait, and equilibrium, a reduction in the risk of falls, a strengthening of the cardiovascular system, and a reduction of stress and depression, among other benefits. Objective: To analyze the scientific evidence on the use of Tai Chi as a health promoter and preserver among older adults. Development: This bibliographic review was conducted during 2013-2019 on the Pubmed, Dialnet, SciELO, LILACS, ScienceDirect and Academic Google databases. The keywords used were Tai Chi Chuan, Tai Ji Quan, and Tai Chi. After filtering through the eligibility criteria, 29 articles were selected for the review. Results: An important percentage of the articles were focused on the attention to physical symptoms which impair the mobility of older adults; nevertheless, some studies addressed psychological issues such as stress, anxiety, sleep disorders, depression, and anger-tension, as well. In these studies, the practice of Tai Chi was associated with health improvements among older adults. Conclusions: Tai Chi is an alternative therapy to promote and maintain health among older adults. This technique is easy to learn, and its practice is not expensive. No adverse reactions during or after the practice of this technique were reported in the studies of this literature review. Therefore, the nursing professional can recommend Tai Chi practice to be implemented as a complementary healthcare measure for older adults.

RESUMO Introdução: A população de idosos está aumentando e observa-se a necessidade emergente de implementação de estratégias que visem a recuperação ou preservação da saúde para que possam desfrutar de uma velhice plena. Técnicas como o Tai Chi podem contribuir, dado que têm se mostrado múltiplos benefícios para quem o pratica, tais como melhora na concentração, memória, marcha, equilíbrio, redução do risco de quedas, fortalecimento do sistema cardiovascular, redução de estresse e depressão, entre outros benefícios. Objetivo: Analisar a evidência científica do uso do Tai Chi na preservação da saúde de idosos. Desenvolvimento: Revisão bibliográfica realizada no período 2013-2019 em diferentes bases de dados como: Pubmed, Dialnet, SciELO, LILACS, ScienceDirect e Google Academic. Foram utilizadas as palavras Tai Chi Chuan, Tai Ji Quan, Tai Chi. Aplicando os critérios de elegibilidade, foram selecionados 29 artigos. Resultados: Grande porcentagem dos artigos revisados estuda a atenção aos sintomas físicos que prejudicam a mobilidade do idoso, porém, as pesquisas também foram direcionadas à parte psicológica, como estresse, ansiedade, insônia, depressão e raiva-tensão, em que a prática do Tai Chi demonstrou melhora. Conclusões: O Tai Chi é uma terapia alternativa para prevenir e preservar a saúde do idoso, de fácil aprendizado e de baixo custo. Na revisão bibliográfica realizada, não foram relatadas reações adversas durante ou após a prática da técnica; o profissional de enfermagem pode recomendar veementemente que seja implementada como cuidado ao idoso.

Continuous saline bladder irrigation after blue light transurethral resection of bladder tumor increases recurrence-free survival in low- to intermediate-risk non-muscle invasive bladder cancer.

OBJECTIVES: To evaluate the efficacy of Continuous Saline Bladder Irrigation (CSBI) after blue light transurethral resection of bladder tumor (TURBT) to prevent recurrence of low- to intermediate-risk Non-Muscle Invasive Bladder Cancer (NMIBC). PATIENTS AND METHODS: We conducted a retrospective study including patients with low- to intermediate-risk NMIBC who underwent TURBT in two urological centers between January 2017 and December 2018. Each TURBT was performed using blue light after intravesical instillation of hexaminolaevulinic acid. The experimental group included patients who received CSBI while the control group included patients without CSBI. When practice, CSBI was started immediately after the surgery and was interrupted 24 hours thereafter. Low-risk NMIBC had a surveillance while intermediate NMIBC had 8 adjuvant endovesical instillations of Mitomycin. The primary endpoint was bladder tumor recurrence free-survival which was defined as the time between the initial TURBT and the date of TURBT for bladder recurrence. RESULTS: A total of 167 patients (median age: 71 years) were included: 20% female, 15% low-risk, 85% intermediate-risk NMIBC. CSBI was performed in 95 cases (57%). No complication related to irrigation was reported. Bladder recurrence was observed in 55 cases (32.9%): 22 (23.1%) in the CSBI group vs. 33 (45.8%) in the control group (P=0.002). Multivariate stepwise logistic regression analysis with backward selection revealed that CSBI (HR 0.47 [0.27-0.81]; P=0.006) and MMC (HR 0.55 [0.31-0.95]; P=0.034) were significantly associated with reduced risk of bladder recurrence. CONCLUSIONS: Continuous saline bladder irrigation reduced the risk of bladder recurrence after blue light TURBT in patients with low- to intermediate-risk NMIBC while being safe. Prospective randomized study is needed to confirm these results. LEVEL OF EVIDENCE: 3.

Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future.

BACKGROUND: This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases. MATERIALS AND METHODS: A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019. RESULTS: Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples. CONCLUSIONS: The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe.

Prevalence, incidence and risk factors for foot pressure ulcers in hospitalized elderly patients. An observational and prospective study.

BACKGROUND: Incidence and clinical characteristics of foot pressure ulcers (FPU) in hospitalized elderly patients are not well known. The aim of the study was to determine the incidence of FPU during hospitalization, to describe main FPU characteristics and to assess main risk factors for FPU in hospitalised elderly subjects. METHODOLOGY: An observational prospective study was performed in which patients 65 years or older admitted to Vascular Surgery, Orthopaedic or Geriatric departments were followed from admission to discharge. Trained nurses evaluated all recruited patients on a daily basis for possible FPU. Main characteristics of the patient (age, sex and co-morbidities) and the ulcer (location, grade) were registered. RESULTS: 299 patients were recruited (62.2% women, mean age 82.3 years, mean number of co-morbidities 2.8). Prevalence of FPU was 30.1% at admission and 73.9% at discharge. Incidence of FPU during hospitalization was 9.5 new FPU/100 person-day. 97.0% of the new FPU were grade 1 (erythema) and the most common locations were in the heel (57.6%), the external lateral part of the foot (13.1%), and the hallux of the fist toe (11.8%). Apart from immobility, main risk factors for FPU are age, geriatric residence origin and not able to outdoor life. CONCLUSIONS: FPU has a high incidence among hospitalised elderly patients; most of them are grade 1 and located in the heel. More attention must be paid in the prevention of pressure ulcers in hospitalized frail subjects.

PRL3 enhances T-cell acute lymphoblastic leukemia growth through suppressing T-cell signaling pathways and apoptosis.

T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy of thymocytes and is largely driven by the NOTCH/MYC pathway. Yet, additional oncogenic drivers are required for transformation. Here, we identify protein tyrosine phosphatase type 4 A3 (PRL3) as a collaborating oncogenic driver in T-ALL. PRL3 is expressed in a large fraction of primary human T-ALLs and is commonly co-amplified with MYC. PRL3 also synergized with MYC to initiate early-onset ALL in transgenic zebrafish and was required for human T-ALL growth and maintenance. Mass-spectrometry phosphoproteomic analysis and mechanistic studies uncovered that PRL3 suppresses downstream T-cell phosphorylation signaling pathways, including those modulated by VAV1, and subsequently suppresses apoptosis in leukemia cells. Taken together, our studies have identified new roles for PRL3 as a collaborating oncogenic driver in human T-ALL and suggest that therapeutic targeting of the PRL3 phosphatase will likely be a useful treatment strategy for T-ALL.

A sustainable approach by using microalgae to minimize the eutrophication process of Mar Menor lagoon.

The present study evaluates the removal capacity of microalgae photobioreactors of environmental pollutants present in wastewater from the dry riverbed El Albujón, as a way to minimize the eutrophication process of the Mar Menor. Particularly, the capacity of four autochthonous microalgae consortia collected from different locations of the salty lagoon to remove emerging contaminants (simazine, atrazine, terbuthylazine, adenosine and ibuprofen), nitrates, and phosphates, was evaluated. Among the four microalgae consortia, consortium 1 was the best in terms of biomass productivity (0.11 g L-1 d-1) and specific growth rate (0.14 d-1), providing 100% removal of emerging contaminants (simazine, atrazine, terbuthylazine, adenosine and ibuprofen), and a maximal reduction and consumption of macronutrients, especially nitrates and phosphates, reaching levels below 28 mg L-1, that is, a decrease of 89.90 and 99.70% of nitrates and phosphates, respectively. Therefore, this consortium (Monoraphidium sp., Desmodesmus subspicatus, Nannochloris sp.) could be selected as a green filter for successful large-scale applications. This study is the first one that combines the successful removal of herbicides, ibuprofen and adenosine as emerging contaminants, and nitrate removal.

Metástasis ganglionar como presentación de un carcinoma papilar de tiroides oculto, variedad folicular: reporte de caso / Lymph node metastasis as a presentation of an occult papillary thyroid carcinoma, follicular variety: case report

El carcinoma oculto de tiroides está poco reportado. Se presenta el caso de una mujer de 59 años. Durante un control por hipotiroidismo se solicitó ecografía cervical, la que mostró áreas hipoecogénicas en lóbulo derecho, una formación nodular hiperecogénica circunscrita no sospechosa de 8 mm y una adenopatía cervical periglandular derecha de 20 x 12 x 8 mm con áreas quísticas y microcalcificaciones, asociadas a hipervascularización. Se solicitó punción aspirativa por aguja fina del ganglio linfático, con resultado de citología negativa para células neoplásicas. El examen microscópico es compatible con tiroiditis, por lo que no es posible descartar metástasis. Se realizó biopsia del ganglio linfático, el que se informa como metástasis ganglionar linfática de 1.3 cm, histología de carcinoma papilar variedad folicular, sin invasión extracapsular. Se realizó tiroidectomía total y disección cervical derecha. El estudio anatomopatológico reportó una tiroiditis crónica de Hashimoto con un nódulo fibroso hialinizado de 0,4 cm negativo para tumor maligno y metástasis en 4 de 28 ganglios linfáticos, sin invasión extracapsular. El tamaño de la metástasis fue de 0,3 a 0,9 cm. Posteriormente se administró 100 mci de radioyodo. Actualmente, la paciente está en buenas condiciones y mantiene controles con ecografía y tiroglobulina periódicos.

Occult thyroid carcinoma is under-reported. The case of a 59-year-old woman is presented. During a check-up for hypothyroidism, a cervical ultrasound was requested, which showed hypoechogenic areas in the right lobe, an 8 mm nonsuspicious circumscribed hyperechogenic nodular formation and a 20 x 12 x 8 mm right cervical periglandular lymphadenopathy with cystic areas and microcalcifications, associated with hypervascularisation. Fine needle aspiration of the lymph node was requested, with negative cytology results for neoplastic cells. Microscopic examination was compatible with thyroiditis, so metastasis could not be ruled out. A biopsy of the lymph node was performed, which was reported as a 1.3 cm lymph node metastasis, histology of papillary carcinoma of the follicular variety, without extracapsular invasion. Total thyroidectomy and right cervical dissection were performed. The anatomopathological study reported chronic Hashimoto's thyroiditis with a 0.4 cm hyalinised fibrous nodule negative for malignant tumour and metastases in 4 of 28 lymph nodes, without extracapsular invasion. The size of the metastasis was 0.3 to 0.9 cm. Subsequently, 100 mci of radioiodine was administered. The patient is currently in good condition and maintains regular ultrasound and thyroglobulin monitoring.