Infections of cardiac implantable electronic devices and how to improve transvenous lead extraction by the virtual reality.

Introduction: Infections in cardiac implantable electronic devices (CIED) are increasing over time and associated with substantially mortality and healthcare costs. The best approach is the complete removal of the system by transvenous lead extraction (TLE). However, when leads are more than 10 years old, this technique requires considerable expertise and failures with the result of abandoned leads or serious complications may occur. The aim of this study is to describe our experience using virtual and mixed reality in the preoperative planning of complex cases. Patients and methods: Consecutive patients from a referral centre with CIED infections in which TLE was judged difficult. Synchronized computed tomography (CT) scan images were processed and transferred to a fully immersive virtual reality room and also to the operative room (mixed reality) for better guidance during the extracting procedure. Results: Ten patients (seven with local and three with systemic infections) were preoperative evaluated. Processed images and virtual reality showed intense adherences of the leads to the veins, right ventricle, and right atrium endocardium and between them that preclude a difficult extraction and required a carefully planning and sometimes a different technical approach. The anticipated difficulty was confirmed by the higher times of fluoroscopy. All leads were extracted and no complications were registered. Conclusions: Preoperative planning is essential for evaluation of TLE difficulty and prevention of unexpected situations. Virtual reality seems an estimable aid for operators in planning difficult cases and also an excellent tool for teaching. Supplementary information: The online version contains supplementary material available at 10.1007/s12055-023-01663-9.

Safety and efficacy of hydroset cranioplasty as an adjunct to gasket-seal and nasoseptal flap closure of the skull base. A case-controlled study.

BACKGROUND: Cerebrospinal fluid leak after endoscopic skull base surgery remains a significant complication. Several investigators have suggested Hydroset cranioplasty to reduce leak rates. We investigated our early experience with Hydroset and compared the rate of nasal complications and CSF leak rates with case-controlled historic controls. METHODS: We queried a prospective database of patients undergoing first time endoscopic, endonasal resection of suprasellar meningiomas and craniopharyngiomas from 2015 to 2023. We compared cases closed with a gasket seal, Hydroset, and a nasoseptal flap with those closed with only a gasket seal and nasoseptal flap. Demographics, technical considerations and postoperative outcomes (SNOT-22) were compared. RESULTS: Seventy patients met inclusion criteria, twenty patients in the Hydroset group (meningioma n = 12; craniopharyngioma n = 8) and 50 control patients (meningioma n = 25; craniopharyngioma n = 25). CSF diversion was used in fewer Hydroset patients (75%, 15/20) compared with control group (94%, 47/50; p = 0.02). CSF leak was less frequent in the Hydroset than the control group (5% versus 12%, p = 0.38). One Hydroset patient required delayed nasal debridement. SNOT-22 responses demonstrated no significant difference in sinonasal complaints between groups (Hydroset average SNOT-22 score 22.45, control average SNOT-22 score 25.90; p = 0.58). CONCLUSIONS: We demonstrate that hydroxyapatite reconstruction leads to improved CSF leak control above that provided by the gasket-seal and nasoseptal flap, without significant associated morbidity as long as the cement is fully covered with vascularized tissue.

Lateral Transorbital Endoscope-Assisted Resection of Anterior Temporal Lobe Neoplasm: 2-Dimensional Operative Video.

Transorbital neuroendoscopic surgery (TONES) is a minimally invasive approach, providing excellent access to extradural pathology of the sphenoid wing, orbital apex, Meckel's cave, and lateral cavernous sinus.1-10 Few cases of intradural pathology, such as gliomas or epileptic foci of the temporal lobe, have been described, apart from cadaveric anatomic studies.11-13 In this video, we present the case of a 63-year-old man with first time seizure. MRI demonstrated a fluid-attenuated inversion recovery hyperintense, noncontrast enhancing medial temporal lobe lesion consistent with low grade glioma. While frontotemporal craniotomy is the standard approach for this lesion, the TONES approach detailed in the video (the patient consented to the procedure and to the publication of his image) provided excellent access to the lesion, which minimized unnecessary trauma or removal of the lateral temporal lobe during the approach.4,14,15 The dura was closed primarily, overlayed with abdominal fat and fibrin glue, and a lumbar drain was left in place for 24 hours. The TONES approach avoided not only temporal lobe violation but also temporalis muscle disruption and any sort of external bone manipulation, which expedited the patient's recovery.16 The patient's eyelid incision was barely visible as early as postoperative day 7 with minimal ecchymosis. Postoperative MRI demonstrated a gross total resection. Pathology was consistent with a central nervous system World Health Organization grade 1 dysembryoplastic neuroepithelial tumor, a low-grade lesion with low risk of recurrence.17,18.

Endonasal endoscopic surgery for pituitary adenomas.

Pituitary adenomas are slow-growing, benign intracranial tumors that can be characterized as functional (hormone-producing) or non-functional (non-hormone producing). Symptoms therefore arise from either endocrinologic abnormalities or mass effect on surrounding structures resulting in symptoms such as visual impairment and headache. In the last two decades, technical innovations have shifted surgical resection of such adenomas to endoscopic endonasal approaches. In this review, we describe the evolving approach to pituitary adenomas in the modern endoscopic era, including preoperative multidisciplinary review, relevant surgical anatomy, and a description of the technical nuances of standard and expanded approaches to the anterior skull base.

Intraurban Geographic and Socioeconomic Inequalities of Mortality in Four Cities in Colombia.

Mortality inequalities have been described across Latin American countries, but less is known about inequalities within cities, where most populations live. We aimed to identify geographic and socioeconomic inequalities in mortality within the urban areas of four main cities in Colombia. We analyzed mortality due to non-violent causes of diseases in adults between 2015 and 2019 using census sectors as unit of analysis in Barranquilla, Bogotá, Cali, and Medellín. We calculated smoothed Bayesian mortality rates as main health outcomes and used concentration indexes (CInd) for assessing inequalities using the multidimensional poverty index (MPI) as the socioeconomic measure. Moran eigenvector spatial filters were calculated to capture the spatial patterns of mortality and then used in multivariable models of the association between mortality rates and quintiles of MPI. Social inequalities were evident but not consistent across cities. The most disadvantaged groups showed the highest mortality rates in Cali. Geographic inequalities in mortality rates, regardless of the adults and poverty distribution, were identified in each city, suggesting that other social, environmental, or individual conditions are impacting the spatial distribution of mortality rates within the four cities.

Extended resection for seizure control of pure motor strip focal cortical dysplasia during awake craniotomy: illustrative case.

BACKGROUND: Focal cortical dysplasias (FCD) represent highly intrinsically epileptogenic lesions that require complete resection for seizure control. Resection of pure motor strip FCD can be challenging. Effective control of postoperative seizures is crucial and extending the boundaries of resection in an eloquent zone remains controversial. OBSERVATIONS: The authors report a 52-year-old right-handed male with refractory epilepsy. The seizure phenotype was a focal crisis with preserved awareness and a clonic motor onset of right-hemibody. Epilepsy surgery protocol demonstrated a left pure motor strip FCD and a full-awake resective procedure with motor brain mapping was performed. Further resection of surgical boundaries monitoring function along intraoperative motor tasks with no direct electrical stimulation corroborated by intraoperative-neuromonitorization was completed as the final part of the surgery. In the follow-up period of 3-years, the patient has an Engel-IB seizure-control with mild distal lower limb palsy and no gate compromise. LESSONS: This report represents one of the few cases with pure motor strip FCD resection. In a scenario similar to this case, the authors consider that this variation can be useful to improve seizure control and the quality of life of these patients by extending the resection of a more extensive epileptogenic zone minimizing functional damage.

Financiamiento en investigación en salud: obteniendo financiamiento. Consejos útiles para aumentar las chances de éxito. Parte 2 / Health research funding: obtaining grants. Tips to improve the success rate. Part 2

Esta es la segunda parte de un artículo sobre la búsqueda de financiamiento para un proyecto de investigación. Todo proyecto de investigación requiere una fuente de financiamiento para poder ser llevado adelante. La búsqueda de fondos es una tarea que lleva tiempo y esfuerzo con una baja tasa de éxito. Compartimos algunos consejos que podrían ayudar a aumentar esa tasa de éxito en relación con: 1) cómo reconocer la necesidad de búsqueda de una fuente de financiamiento externo, 2) de dónde provienen los fondos, 3) qué gastos se pueden financiar habitualmente con los fondos y 4) cómo mejorar la escritura y la presentación a una convocatoria. (AU)

This is the second part of our series on searching funds for a research plan. Every research proposal requires a source of funding to be carried out. Looking for funds is a time and effort consuming task with a low success rate. We share some tips that may help to improve that success rate related to (1) how to recognize the need of an external funding source, (2) where the funds are coming from, (3) what costs can be funded and (4) how to improve a proposal writing and submission. (AU)

Surgical treatment of a ruptured internal carotid artery pseudoaneurysm following transsphenoidal surgery.

Development of Internal Carotid Artery pseudoaneurysms (ICAp) after transsphenoidal surgery is extremely rare, occurring only in 0.4% of cases. Surgical treatment of ICAp poses a real challenge to the neurosurgeon as treatment may require parent vessel sacrifice or artery reconstruction with bypass grafting. Furthermore, surgical resolution of these lesions is rarely reported in the literature. The internal carotid artery is prone to iatrogenic injury in transsphenoidal surgery due to its frequent involvement in pituitary adenomas. Intracranial pseudoaneurysms may be at high risk for rupture and increased morbidity and mortality. Here we present a case of a patient with an ICAp rupture two months after transsphenoidal surgery for a pituitary adenoma.

Automatic Integration of Clinical and Genetic Data Using cBioPortal.

Precision medicine seeks to improve the prevention, diagnosis and treatment of patients based on genetic characteristics unique to each person. In oncology, therapeutic decisions have been established based on the genomic characteristics of each patient's tumor. Data integration is key for the successful implementation of precision medicine since it is necessary for both studying a large volume of data from different sources and working with an interdisciplinary and translational vision. In this work, a bioinformatic process was successfully implemented that allows the integration of patients' genomic data, from two molecular biology laboratories, with their clinical data provided by their electronic medical records. For this, the REDCap data capture software, the cBioPortal visualization and analysis software, and a computer tool developed to automate the processing and annotation of the information in REDCap were used to be included in cBioPortal, for the "Map of Tumor Genomic Actionability of Argentina" project.

Financiamiento en investigación: ¿qué necesito antes de comenzar a buscar una fuente de financiamiento?: parte 1 / Research funding: what do I need before I start looking for a funding source?: part 1

Esta es la primera parte de un artículo sobre la búsqueda de financiamiento para un proyecto de investigación. Esta entrega resume los principales ítems para tener en consideración a la hora de postularse a una convocatoria. Requerimientos del proceso: 1. Tiempo protegido. 2. Propuesta de investigación sólida. 3. Equipo calificado y con experiencia. 4. Definición y organización de actividades. 5. Cronograma de actividades. 6. Estimación de costos. (AU)

This is the first part of an article about finding funding for a research project. This delivery summarizes the main ítems to take into consideration when applying for a call. Process requirements: 1. Protected time. 2. Strong research proposal. 3. Qualified and experienced team. 4. Definition and organization of activities. 5. Schedule of activities. 6. Cost estimate. (AU)

Tobacco advertisement, promotion and sponsorship ban enforcement index at sales points in Panama, 2017.

INTRODUCTION: We assess the tobacco advertisement, promotion and sponsorship (TAPS) ban enforcement in sales points in Panama in 2017. METHODS: A nationwide observational survey to assess TAPS ban enforcement in sales points was conducted and involved retail sale in non-specialized stores with food, beverages or tobacco predominating according to the International Standard Industrial Classification of All Economic Activities Rev. 4. A TAPS ban enforcement index was developed from factorial analysis by principal component with a polychoric correlation matrix to calculate the mean national index value. RESULTS: The national TAPS ban enforcement index value was found to be 3.03. The index value in sales points according to the tobacco products advertisement was 1.98, which was significantly lower where the advertisement was present and 3.09 where it was absent (t=7.57, p<0.05). Each of the three health regions corresponding to Indigenous Territories had an index below the national mean: Emberá-Wounáan (2.52), Guna-Yala (2.65), and Ngäbe-Buglé (2.91). Similar findings were observed among health regions with a west national border: Chiriquí (2.80) and Bocas Del Toro (2.93). On the other hand, the top indices were observed in Panama Metro (3.25), Darién (3.53) and Coclé (3.63). CONCLUSIONS: There is a high level of enforcement of the TAPS ban as a consequence of the full implementation of the FCTC as a law in Panama. However, indigenous territories and west national border areas had the lowest TAPS ban enforcement, making these populations vulnerable. A fertile ground for future research includes the identification of possible vulnerable targets for tobacco products advertisement, particularly in urban areas.

Relación entre los atributos del sueño y el cambio en la presión arterial. Análisis de la cohorte CHICAMOCHA / Relationship between the attributes of sleep and the change in blood pressure: Analysis of the CHICAMOCHA cohort

Resumen Introducción: la hipertensión arterial es responsable de gran parte de la carga de enfermedad cardiovascular; sin embargo, el papel del sueño en su etiología aun es controversial. Objetivo: determinar la asociación entre atributos del sueño y cambio de la presión arterial. Métodos: estudio de cohorte prospectiva, de base comunitaria, en adultos jóvenes asintomáticos para enfermedad cardiovascular, seguidos por 12,4 años. En la línea de base se determinaron factores sociodemográficos y del comportamiento, y se caracterizó el sueño nocturno usual en términos de calidad, duración y presencia de ronquido. Se realizó medición estandarizada de índices antropométricos y presión arterial. La hipertensión arterial se definió como reporte de tratamiento antihipertensivo o cifras de presión arterial ≥140/90 mm Hg. Resultados: se evaluaron de manera prospectiva 1.032 participantes (media de edad: 36,8 años, 64% hombres; en la línea de base). La incidencia de hipertensión arterial fue de 15,1% (IC95%: 12,8 - 17,4), con evidencia de mayor riesgo en los roncadores, atenuado posteriormente al ajuste por adiposidad (p>0,05). Se observó un gradiente entre la duración del sueño y el cambio en la presión arterial sistólica/diastólica (2,2/1,3 mm Hg en quienes reportaron 6-8 horas/día y 2,7/1,6 mm Hg en quienes reportaron > 8 horas/día, respecto a < 6 horas/día). Ni la calidad subjetiva del sueño ni el reporte de siesta se asociaron con la presión arterial. Conclusión: los resultados sugieren que la duración prolongada del sueño podría incrementar la presión arterial en la población.

Abstract Introduction: Arterial hypertension is responsible for large part of the cardiovascular disease load. However, the role of sleep in its aetiology remains controversial. Objective: To determine the relationship between sleep attributes and the change in blood pressure. Methods: A prospective cohort study was carried out on a community basis in young adults asymptomatic for cardiovascular disease, followed up for 12.4 years. At baseline, sociodemographic and behavioural factors were determined. At the same, time nocturnal sleep was characterised in terms of quality, duration and presence of snoring. Standardised anthropometric indices and blood pressure were measured. Arterial hypertension was defined as a report of anti-hypertension treatment or blood pressure figures ≥140/90 mm Hg. Results: A total of 1,032 participants were prospectively evaluated (mean age 36.8 years, 64% males; at baseline). The incidence of arterial hypertension was 15.1% (95% CI: 12.8 - 17. 4), with evidence of a higher risk in snorers, with a subsequent reduction on adjusting for adiposity (P>.05). A gradient was observed between the duration of sleep and the change in systolic/diastolic arterial pressure (2.2/1.3 mmHg in those who reported 6-8 hours/day, and 2.7/1.6 mmHg in those who reported > 8 hours/day, compared to < 6 horas/day). Neither the subjective quality of the sleep nor the report of a siesta was associated with the blood pressure. Conclusion: The results suggest that the prolonged duration of sleep could increase blood pressure in the population.

Assessing the knowledge, attitudes and perceptions of tobacco-associated diseases and how it is influenced by tobacco products advertisement, promotion and sponsorship while enforcing a strong and comprehensive ban in Panama: a cross-sectional study.

OBJECTIVES: Assessing the knowledge, attitudes and perceptions (KAP) of tobacco-associated diseases, and how it is influenced by tobacco products' advertisement, promotion and sponsorship (TAPS) while enforcing a strong and comprehensive ban. DESIGN: The Panamanian implementation of the Global Adult Tobacco Survey: an international standardised cross-sectional survey study. SETTING: National Panamanian population aged between 15 years and 29 years old. PARTICIPANTS: There were 4796 responding participants (n=905 830 in the expanded sample). PRIMARY AND SECONDARY OUTCOMES: An index was developed using factorial analysis using TAPS and KAP variables. The primary outcomes were: (1) The national median index value. (2) The index value stratified by sex, age, occupation, income quintile and geographical areas. (3) The first and second factor loadings (FFL and SFL, respectively) for variables included in the KAP index. RESULTS: Fifteen out of the 16 variables comprising the index were variables related to KAP and one variable was related to TAPS. The top three variables according to their FFL were 'KAP that cigarette is associated to …': (1) '… bladder cancer'. (2) '… breast cancer'. (3) '… stomach cancer'. The top three variables according to the SFL were 'KAP that cigarette is associated to …': (1)'… chronic bronchitis'. (2) '… myocardial infarction'. (3) '… lung cancer'. Illegal tobacco advertisement in posters was the only TAPS variable included in the index. The national KAP index value was 0.26. Our results show that current smokers, teens, men, people with the lowest income quintile, and those living in Guna Yala Indigenous Territory (health region with the highest smoking prevalence) had a lower median value than the national median. CONCLUSIONS: Men, young adults and deprived youth had the lowest median KAP index. Illegal TAPS had no influence on the KAP of tobacco-associated diseases when a strong and comprehensive ban is enforced.

Estrategias y determinantes para recuperar participantes tras 12 años: cohorte CHICAMOCHA, Bucaramanga, Colombia / Strategies and determinants for recovering participants after 12 years: CHICAMOCHA cohort, Bucaramanga, Colombia / Estratégias e determinantes para recuperar participantes após 12 anos: coorte CHICAMOCHA, Bucaramanga, Colômbia

Resumen: Este artículo describe los resultados de un protocolo de recuperación de participantes (PRP) en la cohorte CHICAMOCHA, tras 12 años desde el último seguimiento, e identificar factores asociados al re-contacto. En un estudio de cohorte prospectiva de 1.644 participantes en Bucaramanga, Colombia (edad media 36 años; desviación estándar = 8.5 años; 63% hombres), se implementó el PRP que incluyó 4 estrategias secuenciales: (1) contacto telefónico; (2) envío de correspondencia; (3) visita al domicilio; y (4) publicación de avisos de prensa. Luego de los pasos 1-2, se buscó refrescar la información de contacto en bases de datos gubernamentales para reaplicar paralelamente la secuencia 1-2 en no contactados. Se calcularon tasas de contacto crudas y ponderadas por estrategia del PRP y el rendimiento global. Se estimó la asociación entre las características de los participantes en línea de base y su estado después del PRP mediante regresión logística múltiple. Se contactaron 1.258 (76,4%) participantes; el 65% (n = 825) por contacto telefónico. Las tasas de contacto ponderadas fueron: 41% contacto telefónico, 14,6% correspondencia y 31% visitas. El contacto por avisos de prensa fue virtualmente nulo. Una edad > 36 años (OR = 1,48); estrato socioeconómico bajo (OR = 1,42) y ser propietario de vivienda en la línea de base (OR = 2,05) se asociaron al re-contacto. Consistente con otros reportes, el contacto telefónico es la estrategia de re-contacto con mayor rendimiento en estudios longitudinales. Los individuos con características que aumentan la movilidad geográfica podrían requerir de periodos de seguimiento más estrechos y estrategias de contacto adicionales.

Abstract: This article seeks to describe the results of a participant recovery protocol in the CHICAMOCHA cohort after 12 years of follow-up and to identify factors associated with re-contact. In a prospective cohort study with 1,644 participants in Bucaramanga, Colombia (mean age 36 years; standard deviation = 8.5 years; 63% men), we implemented a participant recovery protocol that included 4 sequential strategies: (1) phone contact; (2) sending mail; (3) visiting the household; and (4) Publishing notices in the press local. Following steps 1-2, we attempted to update contact information through government databases in order to once again apply steps 1-2 for individuals who had not been contacted. We calculated crude and weighted rates of contact by participant recovery protocol strategy and overall return. We estimated the association between baseline participant characteristics and their state after participant recovery protocol through multiple logistical regression. We contacted 1,258 (76.4%) participants; 65% (n = 825) through phone contact. Weighted rates of contact were: 41% phone contact, 14.6% mail and 31% visits. Contact through newspaper ads was practically null. Age > 36 years (OR = 1.48); low socioeconomic stratum (OR = 1.42) or being a home owner at baseline (OR = 2.05) were associated with re-contact. Consistent with other descriptions, phone contact is the re-contacting strategy with greatest returns in longitudinal studies. Individuals with characteristics that increase geographical mobility may require shorter follow-up periods and additional contact strategies.

Resumo: Este artigo trata de descrever os resultados de um protocolo de recuperação dos participantes na coorte CHICAMOCHA, após 12 anos sem acompanhamento, e identificar fatores associados ao re-contato. Em um estudo de coorte prospectiva com 1.644 participantes em Bucaramanga, Colômbia (idade media 36 anos; desvio padrão = 8.5 anos; 63% homens), foi implementado protocolo de recuperação dos participantes que incluiu quatro estratégias sequenciais: (1) contato telefônico; (2) envio de correspondência; (3) visita ao domicílio; e (4) publicação de avisos na imprensa. Depois dos passos 1-2, tentou-se refrescar a informação de contato em bases de dados governamentais para voltar a aplicar paralelamente a sequência 1-2 nas pessoas que não foram contatadas. Foram calculadas as taxas de contacto brutas e ponderadas por estratégia do protocolo de recuperação dos participantes e o rendimento global. Foi estimada a associação entre as características dos participantes na linha de base e o seu estado depois do protocolo de recuperação dos participantes por meio de regressão logística múltipla. Foram contatados 1.258 (76,4%) participantes; o 65% (n = 825) através de contacto telefônico. As taxas de contato ponderadas foram: 41% contato telefônico, 14,6% correspondência e 31% visitas. O contato através de avisos no jornal foi virtualmente nulo. Uma idade > 36 anos (OR = 1,48); estrato socioeconômico baixo (OR = 1,42) ou ser proprietário de casa na linha de base (OR = 2,05) foram associados ao re-contato. Consistente com outras descrições, o contato telefônico é a estratégia do re-contato com maior rendimento em estudos longitudinais. Os indivíduos com características que aumentam a mobilidade geográfica poderiam precisar de períodos de acompanhamento mais estreitos e estratégias de contacto adicionais.

NIVELES SANGUÍNEOS DE BIOMARCADORES DE DAÑO GENÉTICO EN ERITROCITOS DE Lepidochelys olivácea (Cheloniidae) EN COLOMBIA / Genotoxic Biomarkers in Erythrocytes of Lepidochelys olivácea (Cheloniidae) from Colombia

RESUMEN Esta investigación se realizó en el municipio de Bahía Solano, Colombia y tuvo como objetivos: 1) detectar la circulación de eritrocitos con lesiones nucleares en 55 hembras adultas de tortuga golfina (Lepidochelys olivácea), empleando la inmunotinción de naranja de acridina y 2) correlacionar sus frecuencias con aspectos biométricos y fisiológicos. Se determinó una frecuencia de eritrocitos con micronúcleos (EMN) de 0,6 ± 0,6 y de protuberancias nucleares (EPN) de 2,1 ± 1,9. Mediante un análisis multivariado a través de la correlación de Pearson y de Kruskal-Wallis (p<0,05), no se encontró ninguna correlación positiva entre el nivel de frecuencia de EPN ni de EMN con los parámetros biométricos y fisiológicos evaluados. Se estableció una diferencia estadísticamente significativa (p= 0,035) entre las frecuencias de EPN y de EMN. Los resultados hallados indican que esta especie presenta eritrocitos circulantes con los daños nucleares mencionados y reporta por primera vez la presencia de estrés genotóxico para la especie en Colombia. Así mismo, brinda información clave para investigaciones posteriores en el área de la ecotoxicología de especies marinas amenazadas.

ABSTRACT This research was conducted in the municipality of Bahia Solano, Colombia, and had as a goal to detect damage erythrocytes circulating with nuclear lesions in fifty-five Olive Ridley adult females using acridine orange immunostain, and correlate its frequencies with some physiological and biometric parameters. We determine a micronucleated erythrocytes (MNE) frequency of 0.6 ± 0.6 and nuclear buds (NBE) of 2.1 ± 1.9. We not found any relationship between the nuclear lesions with physiological or biometric parameters evaluated (Pearson and Kruskal-Wallis, p<0.05). We define a significative statistical difference (p=0.035) between both nuclear lesions frequencies. This results show nuclear damages in erythrocytes of Olive Ridley sea turtle for the first time in Colombia as an outcome of genotoxic stress. Also contributes key information for future research in the ecotoxicology area for endangered marine species.

Baseline characteristics, survival and direct costs associated to treatment of gastric cancer patients at the National Oncology Institute of Panama from 2012 to 2015: a hospital-based observational study.

OBJECTIVES: Comprehensive epidemiological and economic studies of gastric cancer (GC) in Panama are limited. This study aims to evaluate the association between socioeconomic and clinical variables with survival, describe the survival outcomes according to clinical stage and estimate the direct costs associated to GC care in a Panamanian population with GC. DESIGN AND SETTING: A retrospective observational study was conducted at the leading public institution for cancer treatment in Panama. PARTICIPANTS: Data were obtained from 611 records of patients diagnosed with gastric adenocarcinoma (codes C16.0-C16.9 of the International Classification of Diseases 10th revision), identified between 1 January 2012 and 31 December 2015. METHODS: Cox proportional hazards models were used to calculate HRs with 95% CI to examine associations between the variables and survival. Kaplan-Meier curves were used to assess overall and stage-specific survival. Direct costs (based on 2015 US$) were calculated per patient using standard costs provided by the institution for hospital admission (occupied bed-days), radiotherapy, surgery and chemotherapy, yielding total and overall mean costs (OMC). A comparison of OMC between groups (sex, social security status, clinical stage) was performed applying the bootstrap method with a t-test of unequal variances. RESULTS: An increased risk of dying was observed for patients without social security coverage (HR: 2.02; 95% CI 1.16 to 3.53), overlapping tumours (HR: 1.50; 95% CI 1.02 to 2.22), poorly differentiated tumours (HR: 2.27; 95% CI 1.22 to 4.22) and stage IV disease (HR: 5.54; 95% CI 3.38 to 9.08) (adjusted models). Overall 1-year survival rate was 41%. The estimated OMC of GC care per patient was 4259 US$. No statistically significant differences were found in OMC between groups. CONCLUSIONS: Socioeconomic disparities influence GC outcomes and healthcare utilisation. Policies addressing healthcare disparities related to GC are needed, as well as in-depth studies evaluating barriers of access to GC-related services.

Caracterización del estado de salud de las personas en su periodo de convalecencia de un episodio de dengue / Characterization of the health condition of people convalescing from a dengue episode

Introducción. El dengue y sus manifestaciones agudas se han descrito ampliamente en la literatura, sin embargo, los síntomas en la fase de convalecencia se han estudiado poco. Objetivo. Describir las manifestaciones clínicas de una población durante su periodo de convalecencia de un episodio de dengue. Materiales y métodos. Se hizo un estudio observacional en sujetos que estuvieron hospitalizados con dengue diagnosticado por serología. Después del alta se les visitó para evaluar la persistencia de la sintomatología clínica, la fatiga (evaluada mediante el Fatigue Questionnaire de Chalder) y la calidad de vida (evaluada mediante el cuestionario EuroQoL-5D). Se determinó como fatiga significativa aquella con un puntaje igual o superior a cuatro en la escala empleada. Se hizo seguimiento telefónico y domiciliario de los participantes con fatiga hasta tres meses después del alta hospitalaria. Resultados. La prevalencia de fatiga en los 32 sujetos seleccionados (edad media: 35 años, sexo femenino: 59 %) fue de 34,4 % (IC 95% 17,0-51,8). No se observaron diferencias sociodemográficas en relación con la fatiga, pero sí con relación a una mayor frecuencia de cansancio físico (100,0 % Vs . 47,6 %; p=0,005) y mental (54,6 % Vs . 9,5 %; p=0,010). Aunque los pacientes con fatiga reportaron una peor calidad de vida, esta no fue estadísticamente diferente a la del grupo sin fatiga al ajustar por edad y sexo (OR=5,5; IC 95% 0,83-36,5). Además, el puntaje de fatiga decayó en promedio medio punto por cada diez días de seguimiento (p=0,007). Conclusiones. Estos resultados demuestran que la carga de enfermedad de la infección por el virus del dengue no se ha descrito del todo, pues en la fase de convalecencia se siguen presentando síntomas clínicos que dificultan la recuperación normal del individuo.

Introduction: Although dengue and its acute manifestations have been broadly described in the literature, the symptoms during the convalescence phase have so far been little studied. Objective: To describe the clinical manifestations of a population during the convalescence phase from a dengue episode. Materials and methods: We conducted an observational study in individuals that were in the hospital after being serologically diagnosed with dengue. After being discharged from the hospital, they were visited in order to verify the persistence of clinical symptoms, fatigue (assessed using the Chalder´s Fatigue Questionnaire) and quality of life (assessed with the EuroQoL-5D questionnaire). Significant fatigue was defined with a score equal to or greater than four in the corresponding scale. Participants with positive + fatigue signs were supervised by phone and/or by visiting them in their places of residence until the symptoms disappeared, with a maximum follow-up term of three months. Results: We included 32 individuals in the study (average age: 35 years old, 59% women) and a fatigue prevalence of 34.4% was observed (CI 95% 17.0-51.8). Sociodemographic differences were not defined as determinants with regard to fatigue; by contrast, we found a greater frequency of physical tiredness (100% vs 47.6%; p-0.005) and mental tiredness (54.6% vs 9.5%; p=0.010). Even though patients with fatigue had a poor quality of life, this sign was not statistically different from the group not reporting fatigue when we adjusted by age and sex (OR=5.5; CI 95% 0.83-36.5). In addition, fatigue scores dropped half point in average every 10 days of follow-up. Conclusions: Our results demonstrated that the burden of disease in dengue has not been entirely described, as clinical signs are still present during the convalescence phase, and this represents an obstacle for the normal recovery of individuals.

La revista Salus durante los años 2010 - 2015 / The Salus magazine during the years 2010 - 2015

Este artículo caracteriza el proceso de gestión editorial llevado a cabo durante el período comprendido entre el año 2010 hasta el 2015 en la Revista Salus. Con el mismo se pretende dar a conocer no sólo el alcance de esta gestión, sino también la producción de artículos científicos publicados en la revista, como órgano de divulgación científica multidisciplinaria, editado por la Facultad de Ciencias de la Salud de la Universidad de Carabobo, Valencia - Venezuela. Actualmente la revista Salus se publica en formatos impreso y electrónico, con visibilidad internacional y libre acceso a través de repositorios internacionales y nacionales. Este trabajo realiza una descripción detallada del flujo editorial utilizado por la revista y al que se someten los artículos enviados a la misma. Los resultados muestran que tipos de manuscritos se publican, cuántos son recibidos y tramitados, así como el tiempo promedio de duración del arbitraje y de todo el proceso editorial. Con este manuscrito se deja constancia de los años de gestión citados, donde se ha trabajado para mejorar la calidad científica, distribución y difusión de la Revista Salus, tal como exige el nivel actual nacional y latinoamericano. Sin embargo, queda mucho por hacer, por mejorar y por continuar. Como producto de la evaluación que se genera del presente trabajo, surge como propuesta, adscribirse o diseñar un sistema automatizado de gestión editorial que, sin duda alguna, contribuirá a la esperada profesionalización de la edición científica.

This article discusses the editorial management process carried out during the period from 2010 to 2015 in the journal Salus. The aim is to inform not only the scope of this effort, but also the production of scientific papers published in the journal, as a body of multidisciplinary scientific publication, reproduced by the Faculty of Health Sciences at the University of Carabobo, Valencia - Venezuela. Currently, Salus is published in print and electronic formats, with international visibility and free access by international and national repositories. This paper makes a detailed description of the editorial workflow used by the journal and the process of the papers submitted to the journal. The results show what kind of manuscripts are published, how many are received and processed, the average timeline of the evaluation and the entire editorial process. This manuscript records the years of editorial management, in which worked has done to improve the scientific quality, distribution and diffusion of Salus, as required by national and Latin American current level. However, much remains to be done, and continue to improve. As a result of the evaluation of this work, it emerges a proposal of the design of an automated editorial management system that will undoubtedly contribute to the expected professionalization of scientific publishing.

Cytotoxicity and in vitro activity of chard (Beta vulgaris L. var Cicla) extracts on porcine pancreatic islets / Citotoxicidad y actividad in vitro de extractos de acelga (Beta vulgaris L. var Cicla) en islotes pacreáticos porcinosa / Citotocidae e atividade in vitro de extratos de acelga (Beta vulgaris L. var Cicla) em ilhotas pancreáticas porcinas

Background: reports from traditional medicine suggest that chard (Beta vulgaris L. var Cicla) can have remarkable effects in diabetes therapy. Objective: to evaluate the cytotoxic activity of chard extracts in cell lines and determine the viability of cultured porcine pancreatic islets added with or without chard extracts. Methods: cytotoxic activity of chard extracts was assessed in non-tumor and tumor cell lines using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] technique, and the ability of extracts to maintain porcine pancreatic islets viability and regeneration in vitro was tested. Results: the 50% cytotoxic concentration (CC50) of extracts for non-tumor cell lines was above 1,000 μg/mL, while it was 825 μg/mL, 283 μg/mL, 136 μg/mL and 380 μg/mL, for hexane, ethyl acetate, ethanol and water extracts in the tumor cell line, respectively. The CC50 ratio between cell lines indicates that ethanol extract is 7.5 times more toxic to tumor than non-tumor cell lines. There was an increase in viability of porcine pancreatic islets cultured with aqueous, ethyl acetate, and ethanol extracts compared with standard media (CMRL1066) and Cyclosporine A (CsA) control groups. Furthermore, a greater than one regeneration index of islets cultured with ethanol extract at 1,000 μg/mL and 500 μg/mL concentrations during 15 days was observed, which remained constant and was significantly higher than CsA group. Conclusions: these results suggest that chard metabolites should be researched to develop antitumor therapies and human pancreatic islets recovery in diabetes treatment.

Antecedentes: reportes de medicina tradicional sugieren que la planta acelga (Beta vulgaris L. var Cicla) es importante en el tratamiento de enfermedades como la diabetes. Objetivo: evaluar la citotoxicidad de concentraciones de extractos de acelga en líneas celulares y determinar la viabilidad de islotes pancreáticos porcinos cultivados con y sin extracto de acelga. Método: se evaluó la actividad citotóxica en líneas celulares tumorales y no tumorales, con la técnica del MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]. Específicamente se hicieron ensayos para comprobar si los extractos de acelga tienen la capacidad de mantener la viabilidad de islotes pancreáticos porcinos aislados e influir en su regeneración in vitro. Resultados: la concentración citotóxica al 50% (CC50) de los extractos en líneas no tumorales fue mayor de 1.000 μg/mL, mientras que para los extractos en hexano, acetato de etilo, etanol y agua fue de 825 μg/mL, 283 μg/mL, 136 μg/mL y 380 μg/mL, respectivamente, en líneas tumorales. La proporción CC50 encontrada indica que el extracto en etanol es 7,5 veces más tóxico para las líneas celulares tumorales que para las no tumorales. Igualmente encontramos un aumento en la viabilidad de los islotes pancreáticos porcinos cultivados con extracto acuoso, de acetato en etilo y etanol en comparación con el medio de cultivo estándar (CMRL1066) y un control inhibidor que contenía medio con Ciclosporina A (CsA). Además, se encontró que el índice de regeneración era mayor de uno en los islotes cultivados con el extracto en etanol a concentraciones de 1.000 μg/mL y 500 μg/mL durante 15 días, que se mantuvo constante y fue significativamente mayor en comparación con el grupo de CsA. Conclusión: estos resultados sugieren que los metabolitos de la acelga podrían ser utilizados en la investigación de nuevos fármacos para el desarrollo de terapias antitumorales y recuperación de islotes pancreáticos en el tratamiento de la diabetes.

Antecedentes: relatos encontrados em medicina sugerem que a planta acelga (Beta vulgaris L. var Cicla) tem un papel importante no tratamento das doenças como a diabetes. Objetivo: avaliar a citotoxicidade de concentrações de extratos em linhagens celulares e determinar a viabilidade de ilhotas pancreáticas de porcos cultivadas com e sem extrato de acelga. Métodos: neste trabalho foi avaliada a atividade citotóxica dos extratos da acelga em linhagens celulares tumorais e não tumorais, usando a técnica do MTT [3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide]; além disso, foram feitos ensaios para verificar a capacidade que têm os extratos para manter a viabilidade das ilhotas pancreáticas isoladas de porcos e a influência em sua regeneração in vitro. Resultados: a concentração citotóxica ao 50% (CC50) dos extratos em linhagens não tumorais está acima de 1000 μg/mL, enquanto para os extratos de hexano, acetato de etilo, etanol y água é de 825 μg/mL, 283 μg/mL, 136 μg/mL y 380 μg/mL, respectivamente, em linhagens tumorais. A proporção CC50 entre a célula indica que o extrato de etanol é 7,5 vezes mais tóxico para as linhas celulares tumorais que para as linhas não tumorais. Houve um aumento na viabilidade dos isolados pancreáticos de porcos cultivados com extrato aquoso, de acetato de etilo y etanol, em comparação com o meio de cultura padrão (CMRL 1066) e um controle inibitório contendo meio com Ciclosporina A (CsA). Encontrou-se também uma taxa de regeneração maior do que um em ilhotas cultivadas com concentrações de 1000 μg/mL e 500 μg/mL durante 15 días, que se manteve constante e foi significativamente mais elevada em comparação com a CsA. Conclusões: estes resultados sugerem que os metabolitos da acelga poderiam ser usados para a pesquisa de novas drogas para o desenvolvimento de terapias antitumorais e recuperação de ilhotas pancreáticas para o tratamento da diabetes.

The association of tobacco control policies and the risk of acute myocardial infarction using hospital admissions data.

OBJECTIVE: To evaluate the association of a nationwide comprehensive smoking ban (CSB) and tobacco tax increase (TTI) on the risk of acute myocardial infarctions (AMI) in Panama for the period of 2006 - 2010 using hospital admissions data. METHODS: Data of AMI cases was gathered from public and private hospitals in the country for the period of January 1, 2006 to December 31, 2010. The number of AMI cases was calculated on a monthly basis. The risk of AMI was estimated for the pre-CSB period (January 2006 to April 2008) and was used as a reference point. Three post-intervention periods were examined: (1) post-CSB from May 2008 to April 2009 (12 months); (2) post-CSB from May 2009 to November 2009 (7 months); and (3) post-TTI from December 2009 to December 2010 (13 months). Relative risks (RR) of AMI were estimated for each post intervention periods by using a Poisson regression model. Mortality registries for the country attributed to myocardial infarction (MI) were obtained from January 2001 to December 2012. The annual percentage change (APC) of the number of deaths from MI was calculated using Joinpoint regression analysis. RESULTS: A total sample size of 2191 AMI cases was selected (monthly mean number of cases 36.52 ± 8.24 SD). Using the pre-CSB as a reference point (RR = 1.00), the relative risk of AMI during the first CSB period, the second CSB period and post-TTI were 0.982, 1.049, and 0.985, respectively. The APC of deaths from MI from January 2001 to April 2008 was 0.5%. From January 2001 to June 2010 the APC trend was 0.47% and from July 2010 to December 2012 the APC was -0.3%. CONCLUSIONS: The implementation of a CSB and TTI in Panama were associated with a decrease in tobacco consumption and a reduction of the RR of AMI.