Time above range and no coefficient of variation is associated with diabetic retinopathy in individuals with type 1 diabetes and glycated hemoglobin within target.

AIMS: This study aimed to investigate the association between glucose metrics and diabetic retinopathy in type 1 diabetes (T1D) patients using flash continuous glucose monitoring (FGM) systems, including those maintaining glycated hemoglobin (HbA1c) within the target range. METHODS: We conducted a cross-sectional study involving 1070 T1D patients utilizing FGM systems. Data on clinical, anthropometric, and socioeconomic characteristics were collected and retinopathy was classified based on international standards. RESULTS: Patients' mean age was 47.6 ± 15.0 years, with 49.4% of them being females. Within the cohort, 24.8% of patients presented some form of retinopathy. In the analysis involving the entire sample of subjects, male gender (OR = 1.51, p = 0.027), Time Above Range (TAR) > 250 mg/dL (OR = 1.07, p = 0.025), duration of diabetes (OR = 1.09, p < 0.001), smoking (OR = 2.30, p < 0.001), and history of ischemic stroke (OR = 5.59, p = 0.025) were associated with diabetic retinopathy. No association was observed between the coefficient of variation and diabetic retinopathy (p = 0.934). In patients with HbA1c < 7%, the highest quartile of TAR > 250 was independently linked to diabetic retinopathy (OR = 8.32, p = 0.040), in addition to smoking (OR = 2.90, p = 0.031), duration of diabetes (OR = 1.09, p < 0.001), and hypertension (OR = 2.35, p = 0.040). CONCLUSION: TAR > 250 mg/dL significantly emerges as a modifiable factor associated with diabetic retinopathy, even among those patients maintaining recommended HbA1c levels. Understanding glucose metrics is crucial for tailoring treatment strategies for T1D patients.

Pre-Surgical Factors Influencing Post-Surgical Outcomes in Orthognathic Surgery Patients: A Longitudinal Study.

Background/Objectives: This study aims to assess the relationship between physical and psychosocial pre-surgical factors and post-surgical evolution in patients undergoing orthognathic surgery. Methods: A cohort study with 3 months of follow-up after maxillofacial surgery was conducted. Participants were recruited from the Maxillofacial Surgery Unit of Hospital Universitario La Paz in Madrid, Spain. Primary variables included the range of motion of mouth opening, protrusion tongue force, anxiety, depression and kinesiophobia. Assessments were realised on-site or via video call. Statistical analysis was conducted using mixed-effects models. Results: The initial recruitment yielded 22 patients, with 19 ultimately eligible for analysis. The study found significant impacts of pre-surgical factors on post-surgical evolution. Both ranges of motion and anxiety showed influences from baseline measures, with the range of motion affected by a pre-surgical range of motion (estimate: 3.89) and positive expectations (estimate: 4.83). Anxiety was influenced by both pre-surgical (estimate: 0.48) and baseline anxiety levels (estimate: 0.64). Kinesiophobia demonstrated a trend toward significance, with baseline levels affecting post-surgical evolution (estimate: 0.77). Conclusions: Our results highlight the relationship between pre-surgical factors and post-surgical outcomes in orthognathic surgery patients. Pre-surgical range of motion and positive expectations were found to influence post-surgical range of motion, while pre-surgical anxiety levels impacted post-surgical anxiety evolution. Pre-surgical kinesiophobia also showed potential as a post-surgical kinesiophobia predictor, but further investigation is needed to confirm this relationship.

Quality of life, craniomandibular function, and psychosocial factors related to pain and movement in patients with head and neck cancer.

PURPOSE: To describe the characteristics of and the associations between health-related quality of life, pain, craniomandibular function, and psychosocial factors related to pain and fear of movement in patients with head and neck cancer. METHODS: Seventy-eight patients diagnosed with HNC were recruited. Measurements of the maximum mouth opening range and pressure pain thresholds on the masseter muscle and the distal phalanx of the thumb were conducted, as well as a battery of self-report questionnaires were administrated, including the QoL Questionnaire (EORT QLQ-H&N35), Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), the Spanish translation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD), and the short version of the Craniofacial Pain and Disability Inventory (CF-PDI-11). RESULTS: The study sample (66.7% men, mean age 60.12 [11.95] years) experienced a moderate impact on their QoL levels (57.68 [18.25] EORT QLQ-H&N35) and high kinesiophobia values (20.49 [9.11] TSK-TMD). Pain was present in 41% of the patients, but only 3.8% reported severe pain. 26.4% had a restricted mouth opening range, and 34.62% showed significant catastrophism levels. There were strong positive correlations between EORT QLQ-H&N35 and CF-PDI-11 (r = 0.81), between NRS and CF-PDI-11 (r = 0.74), and between PCS and CF-PDI-11 (r = 0.66). CONCLUSION: Patients with HNC experience negative effects in their QoL, related to their impairment in craniomandibular function. Fear of movement, pain intensity, and catastrophism are associated with poorer functionality; relationships that should be considered when attempting to improve health care.

Intrafamilial phenotypic heterogeneity in siblings with pseudohypoparathyroidism 1B due to maternal STX16 deletion.

OBJECTIVES: Pseudohypoparathyroidism (PHP1B) is most commonly caused by epigenetic defects resulting in loss of methylation at the GNAS locus, although deletions of STX16 leading to GNAS methylation abnormalities have been previously reported. The phenotype of this disorder is variable and can include hormonal resistances and severe infantile obesity with hyperphagia. A possible time relationship between the onset of obesity and endocrinopathies has been previously reported but remains unclear. Understanding of the condition's natural history is limited, partly due to a scarcity of literature, especially in children. CASE PRESENTATION: We report three siblings with autosomal dominant PHP1B caused by a deletion in STX16 who presented with early childhood onset PTH-resistance with normocalcemia with a progressive nature, accompanied by TSH-resistance and severe infantile obesity with hyperphagia in some, not all of the affected individuals. CONCLUSIONS: PHP1B from a STX16 deletion displays intrafamilial phenotypic variation. It is a novel cause of severe infantile obesity, which is not typically included in commercially available gene panels but must be considered in the genetic work-up. Finally, it does not seem to have a clear time relationship between the onset of obesity and hormonal resistance.

Distraction osteogenesis versus induced membrane technique for infected tibial non-unions with segmental bone loss: a systematic review of the literature and meta-analysis of available studies.

INTRODUCTION: Infected tibial non-unions with associated bone loss can be challenging to manage. At present, the two main methods utilized in the management of these fractures include the Ilizarov technique of Distraction Osteogenesis (DO) using external fixator devices, or alternatively, the Induced Membrane Technique (IMT), devised by Masquelet. As there is a paucity of data directly comparing the outcomes of these techniques, there is no universal agreement on which strategy a surgeon should choose to use. AIMS: This systematic review and meta-analysis aimed to summarize the outcomes of both DO and IMT, in terms of primary outcomes (bone union and infection elimination), and secondary outcomes (complication rates and functional outcomes). METHODS: A PRISMA strategy was used. Medline, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar library databases were interrogated using pre-defined MeSH terms and Boolean operators. Quality of evidence was evaluated using OCEBM and GRADE systems. RESULTS: Thirty-two studies with 1136 subjects met the inclusion criteria. With respect to the primary outcomes of interest, union was observed in 94.6% (DO method) and 88.0% (IMT method); this difference, however, was not significant between the two techniques (p = 0.45). In addition, infection elimination rates were also higher in the Ilizarov DO group when compared to Masquelet (Mq) IMT (93.0% vs 80.4% respectively). Again, no significant difference was observed (p = 0.06). For all secondary outcomes assessed (unplanned re-operations, re-fracture rates amputation rate), no statistically significant differences were documented between the treatment options. CONCLUSION: This study demonstrated that there is no clinical difference in outcomes for patients treated with Ilizarov DO versus Mq IMT techniques. The evidence base at present is relatively sparse and, therefore, we would recommend for further Level I studies to be conducted, to make more meaningful conclusions.

Fabricación y caracterización de pozos cuánticos para el estudio de la interacción luz-materia / Fabrication and characterization of quantum wells for the study of light-matter interaction

RESUMEN Los pozos cuánticos representan la base de una gran variedad de dispositivos electrónicos, entre ellos los ledes, láseres, fotodetectores y moduladores. Las propiedades optoelectrónicas de estos sistemas dependen de su composición química y del espesor de las capas crecidas. Por dicha razón, es necesario tener un control preciso durante su crecimiento. El presente trabajo tuvo como objetivo inducir el crecimiento epitaxial de pozos cuánticos intrínsecos (sin ningún dopaje) asimétricos acoplados y desacoplados de AlGaAs/ GaAs/AlGaAs, así como, establecer su caracterización mediante técnicas de espectroscopía óptica, como lo son la reflectancia diferencial, también conocida como espectroscopía de reflectancia anisotrópica (RAS) y la fotoluminiscencia (PL). Se realizó un estudio experimental de las interacciones entre niveles de energía en los pozos cuánticos asimétricos acoplados. Este tipo de estructuras son especialmente interesantes por permitir la formación y observación, no solo de excitones directos, dentro del mismo pozo, sino también, de excitones y triones indirectos, que se forman entre electrones de un pozo y huecos de otro pozo vecino (Transiciones intra-QW). Se hicieron crecer tres pozos intrínsecos, basados en arseniuro de galio (GaAs): un pozo individual (desacoplado) y un par de pozos asimétricos acoplados, a través de epitaxia por haces moleculares (MBE). Se observó el efecto del rompimiento de simetría (de D2d a C2v) en las propiedades espintrónicas de la estructura, a través de PL y RAS, a una temperatura de ~ 30 K. Se lograron establecer las técnicas y métodos necesarios para el crecimiento de pozos cuánticos intrínsecos, que constituyen la base para la creación de dispositivos y estructuras más complejas. El uso de técnicas espectroscópicas permitió demostrar la presencia de anisotropías ópticas, que repercuten en el comportamiento del espín de los excitones en pozos cuánticos.

ABSTRACT Quantum Wells are the basis for a great variety of electronic devices such as leds, lasers, photodetectors and modulators. Their optoelectronic properties depend on their chemical composition and the thickness of each layer. Therefore, a precise control during their growth is needed. This work has the objective of presenting the epitaxial growth of coupled and uncoupled asymmetric AlGaAs/GaAs/AlGaAs quantum wells and their characterization using optical techniques such as reflectance anisotropy spectroscopy (RAS) and photoluminescence (PL). An experimental study of the different interactions between the confined levels of energy in coupled quantum wells was carried on. This kind of structures is of special interest because they allow the formation and observation not only of direct excitons and trions inside a single quantum well, but of indirect excitons and trions, which are only formed by electrons of one quantum well and holes of the neighbor quantum well (IntraQW transitions). Three intrinsic quantum wells based on gallium arsenide (GaAs) were grown by molecular beam epitaxy (MBE), one single QW and a pair of coupled asymmetric QWs. The effect of breaking symmetry (from de D2d a C2v) on the spintronic properties of the structure was observed by RAS and PL measurements at ~ 30 K. The main techniques and methods for the growth of intrinsic quantum wells were established, which are the basis for the creation of devices with more complex structures. The use of spectroscopic techniques for the study of quantum wells allowed the demonstration of the presence of optical anisotropies that influence the behavior of exciton's spins at quantum wells.

Leuprolide Protects Ovarian Reserve in Adolescents Undergoing Gonadotoxic Therapy.

Purpose: Treatment sequelae compromising reproductive health are highly prevalent in childhood cancer survivors, and a main determinant of health and quality of life. Follicular reserve determines ovarian function life span; thus, its preservation is important in the care of female survivors. Anti-Müllerian hormone (AMH) is a biomarker to measure functional ovarian reserve. We aimed to evaluate the effect of leuprolide during gonadotoxic therapy on pubertal females' post-treatment functional ovarian reserve using AMH levels. Methods: We conducted a single-center retrospective study including all pubertal females who had undergone gonadotoxic treatments between January 2010 and April 2020, and had an AMH level after completion of therapy. We used multivariable linear regressions to compare AMH-level beta coefficients in patients stratified by gonadotoxic risk, adjusting for leuprolide use. Results: Fifty-two females meeting study eligibility were included, of which 35 received leuprolide. The use of leuprolide was associated with higher post-treatment AMH levels in the lower gonadotoxic risk group (beta 2.74, 95% CI 0.97-4.51; p = 0.004). This association was lost in the higher gonadotoxic risk groups. Conclusions: Leuprolide may have a protective effect on the functional ovarian reserve. However, this is limited by increasing treatment gonadotoxicity. Larger, prospective studies are needed to elucidate the potential benefits of gonadotropin-releasing hormone agonist on preservation of ovarian reserve among children receiving gonadotoxic therapies, as cancer survivors.

Diversidad de especies de Candida recuperadas de la cavidad bucal de pacientes oncológicos en Barranquilla, Colombia Candida spp bucal y cáncer / Species diversity of the genus Candida in the oral cavity of cancer patients in Barranquilla, Colombia

Resumen Se caracterizaron especies de Candida recuperadas de la cavidad bucal de pacientes oncológicos en una institución prestadora de salud de Barranquilla, Colombia. La investigación tuvo un diseño de corte transversal, mediante un muestreo a conveniencia se seleccionaron 60 pacientes oncológicos con candidiasis oral. Las muestras obtenidas se cultivaron en agar Sabouraud cloranfenicol, CHROMagar® Candida y agar Sabouraud dextrosa. Los microorganismos aislados se identificaron y se estableció el perfil de sensibilidad a los antifúngicos. Se aplicó estadística descriptiva, prueba de X 2 y análisis bivariado utilizando el programa Statgraphics Centurión XVII, con razón de momios (OR) para probabilidad de ocurrencia. Se identificaron un total de 107 cepas de Candida correspondientes a 15 especies, distribuidas del siguiente modo: C. albicans 23%, C. glabrata 18%, C. tropicalis 13%, C. krusei 10%, C. intermedia y C. lipolytica con 1,5%. En 77% de los casos estuvieron implicadas especies diferentes de C. albicans. Se identificó la existencia de relación entre cáncer del sistema reproductor y C. guilliermondii (p = 0,0001, < 0,05; OR 17) y entre C. colliculosa y cánceres respiratorios (p = 0,0003 < 0,05; OR 19,5). El 99% de las especies de Candida identificadas fueron sensibles a los antifúngicos: fluconazol, voriconazol, caspofungina y micafungina. Solo una cepa de C. krusei fue resistente. Se concluye que existió diversidad de especies de Candida en la cavidad bucal de pacientes oncológicos, ya sea como colonizantes únicos o en combinación, de modo que más de una especie de Candida podría ser responsable de la infección micótica en la cavidad bucal de estos enfermos.

Abstract Candida spp. was characterized in the oral cavity of cancer patients in a health care center in Barranquilla, Colombia. This is a cross-sectional investigation including 60 oncological patients with oral candidiasis, selected by convenience sampling, from whom samples were subjected to culture in Sabouraud chloramphenicol agar, CHROMagar® Candida and Sabouraud dextrose agar were taken. The antifungal susceptibility profile was then identified and established. Descriptive statistics, Chi square test, and bivariate analysis were conducted using the Statgraphics Centurion XVII software with odds ratio (OR) for the probability of occurrence. A total of 107 Candida strains were identified belonging to 15 species, C. albicans with 23%, C. glabrata with 18%, C. tropicalis 13%, C. krusei 10%, C intermedia, and C. lipolytica with 1.5%. Species other than C. albicans were identified in 77% of the cases. A relationship between reproductive system cancer and C. guilliermondii was identified (p = 0.0001, <0.05) OR: 17.0. Between C. colliculosa and respiratory cancer (p = 0.0003, <0.05) OR 19.5. With regard to antifungal susceptibility, 99% of the identified Candida species were susceptible to the following antifungals: fluconazole, voriconazole, caspofungin, and micafungin. Only one strain of C. krusei was resistant. It is concluded that there was a diversity of Candida species, either single or mixed in cancer patients, which could determine that only one species is not responsible for fungal infection in the oral cavity.

Effectiveness of Physical Therapy in Orthognathic Surgery Patients: A Systematic Review of Randomized Controlled Trials.

Orthognathic surgery (OS) can present many complications that affect patients' rehabilitation. However, there have been no systematic reviews that assessed the effectiveness of physiotherapy interventions in the postsurgical rehabilitation of OS patients. The aim of this systematic review was to analyze the effectiveness of physiotherapy after OS. The inclusion criteria were randomized clinical trials (RCTs) of patients who underwent OS and who received therapeutic interventions that included any physiotherapy modality. Temporomandibular joint disorders were excluded. After the filtering process, five RCTs were selected from the 1152 initially obtained (two had acceptable methodological quality; three had insufficient methodological quality). The results obtained showed that the effects of the physiotherapy interventions studied in this systematic review on the variables of range of motion, pain, edema and masticatory muscle strength were limited. Only laser therapy and LED showed a moderate level of evidence in the postoperative neurosensory rehabilitation of the inferior alveolar nerve compared with a placebo LED intervention.

[Species diversity of the genus Candida in the oral cavity of cancer patients in Barranquilla, Colombia]. / Diversidad de especies de Candida recuperadas de la cavidad bucal de pacientes oncológicos en Barranquilla, Colombia.

Candida spp. was characterized in the oral cavity of cancer patients in a health care center in Barranquilla, Colombia. This is a cross-sectional investigation including 60 oncological patients with oral candidiasis, selected by convenience sampling, from whom samples were subjected to culture in Sabouraud chloramphenicol agar, CHROMagar® Candida and Sabouraud dextrose agar were taken. The antifungal susceptibility profile was then identified and established. Descriptive statistics, Chi square test, and bivariate analysis were conducted using the Statgraphics Centurion XVII software with odds ratio (OR) for the probability of occurrence. A total of 107 Candida strains were identified belonging to 15 species, C. albicans with 23%, C. glabrata with 18%, C. tropicalis 13%, C. krusei 10%, C intermedia, and C. lipolytica with 1.5%. Species other than C. albicans were identified in 77% of the cases. A relationship between reproductive system cancer and C. guilliermondii was identified (p = 0.0001, <0.05) OR: 17.0. Between C. colliculosa and respiratory cancer (p = 0.0003, <0.05) OR 19.5. With regard to antifungal susceptibility, 99% of the identified Candida species were susceptible to the following antifungals: fluconazole, voriconazole, caspofungin, and micafungin. Only one strain of C. krusei was resistant. It is concluded that there was a diversity of Candida species, either single or mixed in cancer patients, which could determine that only one species is not responsible for fungal infection in the oral cavity.

Impacto de la Maestría de Cirugía de Mínimo Acceso en los Objetivos de Desarrollo Sostenible / Impact of the Master's Degree Course in Minimal Access Surgery on Sustainable Development Goals

Introducción: El Programa de Maestría en Cirugía de Mínimo Acceso responde a necesidades sociales y perspectivas del Sistema Nacional de Salud. Los resultados de sus investigaciones impactan en los Objetivos de Desarrollo Sostenible No. 3 Salud y bienestar y No. 4 Educación de calidad. Objetivo: Exponer cómo la Maestría en Cirugía de Mínimo Acceso impacta en el desarrollo sostenible, a partir de las investigaciones realizadas. Métodos: Se realizó una investigación cualitativa y retrospectiva en el Centro Nacional de Cirugía de Mínimo Acceso. La técnica de investigación empleada fue el análisis documental y bibliográfico, con la revisión de los informes de las tesis finales de maestría y de la autoevaluación del programa, en sus dos primeras ediciones (2015 y 2018), según el Sistema de Evaluación y Acreditación de Maestrías. Resultados: El Programa contó con 30 egresados, cuyas investigaciones abordaron el tratamiento laparoscópico del cáncer entre otros temas. Asimismo, la producción científica en la Edición 02 resultó de 100 publicaciones, 159 reconocimientos sociales relevantes y la edición de 3 libros. Conclusiones: La investigación y la creación de conocimiento e innovación en el Programa de Maestría en Cirugía de Mínimo Acceso han permitido fomentar soluciones de desarrollo sostenible en esta área del conocimiento. La producción científica y la socialización de los resultados obtenidos en eventos nacionales e internacionales propician su implementación en el Sistema Nacional de Salud. De esta forma, los resultados de investigación del programa contribuyen al logro de los Objetivos de Desarrollo Sostenible(AU)

Introduction:The program of the Master's degree in Minimal Access Surgery responds to social needs and perspectives of the national health system. The results of its research have an impact on Sustainable Development Goals 3, "Good health and well-being, and 4, Quality education. Objective: To present how the Master's Degree Course in Minimal Access Surgery impacts on sustainable development, upon the base of the researches conducted. Methods: A qualitative and retrospective research was carried out at the National Center for Minimal Access Surgery. The research technique used was the document and bibliographic analysis, with the review of the reports of the final master's theses and the self-evaluation of the program, in its first two editions (2015 and 2018), according to the Evaluation and Accreditation System for Master's Degree Programs. Results: The program had 30 graduates, whose researches addressed, among other topics, the laparoscopic treatment of cancer. Also, the scientific production in the Edition 02 turned out to be one hundred publications, 159 relevant social recognitions, and the edition of three books. Conclusions: Research and the creation of knowledge and innovation in the Master's Degree Program in Minimal Access Surgery have allowed fostering sustainable development solutions in this area of knowledge. The scientific production and the socialization of the results obtained in national and international events favor their implementation in the national health system. Thus, the research results of the program contribute to the achievement of the Sustainable Development Goals(AU)

Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19

ABSTRACT Background: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. Objectives: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). Methods: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. Results: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom were discharged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176-3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A total of 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029-0.498). Conclusion: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.

Modelo estadístico para estimar el impacto histórico de la influenza sobre la mortalidad en Cuba / Statistical model to estimate the historical impact of influenza on mortality in Cuba

Introducción: La influenza tiene elevado impacto en la mortalidad humana y en Cuba la categoría influenza y neumonía ocupa el cuarto lugar entre sus causales generales. En los países templados, con marcada estacionalidad, esto se capta con modelos estadísticos, tarea que se dificulta en el trópico y pendiente en Cuba por la ausencia de igual definición estacional. Objetivo: Estimar el impacto histórico de la influenza tipo A y B y los subtipos A(H3N2) y A(H1N1) sobre la mortalidad mediante el ajuste de un modelo de regresión a las condiciones estacionales específicas de Cuba. Métodos: Se ejecutó un estudio longitudinal y retrospectivo. En un primer paso se ajustaron dos modelos de Poisson con la mortalidad influenza y neumonía total y las personas ≥ 65 años de edad como variables respuestas en los cinco meses de mayor positividad en influenza, desde la temporada 1987-1988 hasta la 2004-2005 y los positivos en tipo A y en tipo B como explicatorias. En otro par de modelos se estimó el impacto del A(H3N2) y el A(H1N1), considerando como respuesta los fallecidos atribuidos previamente al tipo A. Resultados: Se atribuyeron a la influenza 7803 fallecidos entre todas las edades y 6152 entre las personas ≥ 65 años de edad, con un 56,3 por ciento asociados al A(H3N2), el 17,6 por ciento al A(H1N1) y el 26,1 por ciento al tipo B. Conclusiones. Se logró estimar el impacto de la influenza sobre la mortalidad mediante el ajuste para Cuba de un modelo estadístico que permitió demostrar la asociación de la circulación de estos virus con la mortalidad en el país, lo que ratifica la necesidad de reforzar la vigilancia, el control y la vacunación contra esta infección viral. Se demuestra la posibilidad de ajustar estos modelos de regresión a otros virus respiratorios y a la actual pandemia por la COVID-19, en las condiciones estacionales de Cuba(AU)

Introduction: Influenza has a high impact on human mortality and in Cuba influenza and pneumonia rank fourth among its general causes. In temperate climate countries, with marked seasonality, this is captured by statistical models, a task that is difficult in the tropics and pending in Cuba due to the absence of the same seasonal definition. Objective: Estimate the historical impact of influenza type A and B and subtypes A(H3N2) and A(H1N1) on mortality, by adjusting a regression model to the specific seasonal conditions of Cuba. Methods: A longitudinal and retrospective study was performed. In a first step, two Poisson models were adjusted with influenza and total pneumonia mortality and people ≥ 65 years old as response variables in the five months with the highest positivity to influenza in the period 1987-1988 to 2004-2005, and the positive ones to type A and type B as explanatory variables. In another pair of models was estimated the impact of A(H3N2) and A(H1N1), considering as a response the deaths previously attributed to type A. Results: 7 803 deaths among all ages and 6 152 among 65-year-olds were attributed to influenza, with 56.3 percent associated to A(H3N2), 17.6 percent to A(H1N1) and 26.1 percent to type B. Conclusions: It was possible to estimate the impact of influenza on mortality by adjusting for Cuba a statistical model that demonstrated the association of the circulation of these viruses with the mortality in the country, which confirms the need to strengthen surveillance, control and vaccination against this viral infection. The possibility of adjusting in the seasonal conditions of Cuba these regression models to other respiratory viruses and the current pandemic by COVID-19 is demonstrated(AU)

Reducing Salmonella enterica serovar Enteritidis contamination in food: lytic bacteriophages in a homemade mayonnaise-like matrix / Reducción de la contaminación por Salmonella enterica serovar Enteritidis en alimentos: bacteriófagos líticos en una matriz similar a la mayonesa casera / Redução da contaminação por Salmonella enterica serovar Enteritidis em alimentos: bacteriófagos líticos em uma matriz caseira semelhante à maionese

Abstract Background: Salmonella enterica serovar Enteritidis (SE) is one of the major causes of food-borne disease worldwide, mainly associated with the consumption of poultry products, such as eggs. Several control methods have been implemented in the egg production process, but they have not effectively reduced the outbreaks. Therefore, the use of bacteriophages for the biocontrol of food-borne pathogens is gaining increasing acceptance. Objective: To evaluate a bacteriophage cocktail's effectiveness in reducing SE counts in an experimentally contaminated mayonnaise-like matrix. Methods: Homemade mayonnaise was contaminated with SE (103 CFU/ml) with equal volume to a matrix (1:1) treated with a bacteriophage cocktail (five phages, MOI 105), and stored at 21 °C for 24 and 72 h. Bacterial counts were performed to evaluate the bio-controlling activity of the cocktail and compared with a contaminated but not treated group. Results: Significant reductions (up to 3.75 log10 CFU/ml) were observed in the bacteriophage-treated groups (p<0.0001). Conclusions: These results demonstrate the effectiveness of bacteriophages as biocontrol agents for Salmonella Enteritidis in a raw-egg-derivative foodstuff. Further studies are needed to prove the reduction in an undiluted homemade mayonnaise.

Resumen Antecedentes: La Salmonella enterica, serovar Enteritidis (SE), es una de las principales causas de enfermedades transmitidas por alimentos en todo el mundo, asociadas principalmente al consumo de productos avícolas tales como los huevos. Diferentes métodos de control se han ensayado en el proceso de producción de huevos, pero no han sido capaces de reducir eficazmente los brotes de salmonelosis en las personas. Por esta razón, el uso de bacteriófagos para el control biológico de patógenos transmitidos por los alimentos está ganando cada vez más aceptación. Objetivo: Evaluar la eficacia de un cóctel de bacteriófagos para reducir los recuentos de SE en una matriz similar a la de mayonesa contaminada experimentalmente. Método: La mayonesa casera fue contaminada con SE (103 UFC/ml) en igual volumen que la matriz (1:1), tratada con una mezcla de bacteriófagos (cinco fagos, MOI 105), y almacenada a 21 °C por 24 y 72 h. Se realizaron recuentos bacterianos para evaluar la actividad biocontroladora de la mezcla y compararlos con un grupo contaminado, pero no tratado. Resultados: Se observaron reducciones significativas (hasta 3,75 log10 CFU/ml) en los grupos tratados con bacteriófagos (p<0,0001). Conclusiones: Estos resultados demuestran la efectividad del uso de bacteriófagos como agentes de biocontrol de Salmonella Enteritidis en un alimento crudo derivado del huevo. Sin embargo, se necesita realizar más estudios para comprobar la reducción en mayonesa casera no diluida.

Resumo Antecedentes: Salmonella enterica serovar Enteritidis (SE) é uma das principais causas de doenças transmitidas por alimentos em todo o mundo, principalmente associada ao consumo de produtos derivados de aves, como ovos. Diferentes métodos de controle foram implementados no processo de produção de ovos, mas não foram capazes de reduzir efetivamente os surtos nas pessoas. Por esse motivo, o uso de bacteriófagos para o controle biológico de patógenos de origem alimentar está ganhando crescente aceitação. Objetivo: Avaliar a eficácia de um coquetel de bacteriófagos na redução da contagem de SE em uma matriz experimentalmente semelhante a maionese contaminada. Método: A maionese caseira foi contaminada com SE (103 UFC/ml) no mesmo volume da matriz (1:1), tratada com uma mistura de bacteriófagos (cinco fagos, MOI 105) e armazenada a 21 °C por 24 e 72 h. As contagens bacterianas foram realizadas para avaliar a atividade de biocontrole da mistura e comparadas com um grupo contaminado, mas não tratado. Resultados: Reduções significativas (até 3,75 log10 UFC/ ml) foram observadas nos grupos tratados com bacteriófagos (p<0,0001). Conclusões: Esses resultados demonstram a eficácia do uso de bacteriófagos como agentes de biocontrole de Salmonella Enteritidis em alimentos crus derivados de ovos, mas são necessários mais estudos para verificar a redução da maionese caseira não diluída.

Duodenoyeyunostomía laparoscópica en el Síndrome de la Arteria Mesentérica Superior / Laparoscopic duodenojejunostomy for Superior Mesenteric Artery Syndrome

Introducción: El Síndrome de la Arteria Mesentérica Superior es causa poco frecuente de obstrucción duodenal. Los síntomas varían desde una obstrucción leve hasta emergencias agudas. El examen físico no siempre ayuda al diagnóstico, que se basa en los hallazgos imagenológicos. Objetivo: preconizar, recomendar el uso de las técnicas mínimamente invasivas en el manejo quirúrgico del Síndrome de la Arteria Mesentérica Superior. Presentación del caso: Mujer de 49 años de edad, antecedentes de pérdida de peso después de quimioterapia con náuseas, vómitos y dolor abdominal posprandial de dos años de evolución. Tratada exitosamente con duodenoyeyunostomía laparoscópica. El tratamiento inicial suele ser conservador. Publicaciones recientes respaldan que la duodenoyeyunostomía laparoscópica es un método seguro y efectivo para su tratamiento. Conclusiones: El tratamiento quirúrgico es cada vez más exitoso, la mayoría de los pacientes no presenta síntomas después de la cirugía(AU)

Introduction: Superior Mesenteric Artery Syndrome is an uncommon cause of duodenal obstruction. Symptoms may vary from mild obstruction to acute life-threatening emergencies. Physical examination does not always help in establishing the diagnosis which is based on findings from imaging studies. Objective: To recommend the laparoscopic approach for the surgical treatment of this entity. Case presentation: A 49-year old female patient with prior history of weight loss after chemotherapy and a two-year history of postprandial nausea, vomiting, and abdominal pain who was successfully treated by laparoscopic duodenojejunostomy is presented. Discussion: Initial treatment is usually conservative. Recently published studies support that laparoscopic duodenojejunostomy is a safe and effective method of treatment. Conclusions: Surgical treatment is becoming more successful and the majority of patients are symptom-free after surgery(AU)

A View from the past into our collective future: the oncofertility consortium vision statement.

PURPOSE: Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. METHODS: The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. RESULTS: This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. CONCLUSION: The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future.

Prevalence of Adrenal Insufficiency and Glucocorticoid Use in Pediatric Pseudotumor Cerebri Syndrome.

BACKGROUND: The pathophysiology underlying pseudotumor cerebri syndrome (PTCS) is complex and not well understood. There are clear differences between PTCS in adults and pediatrics. Few and isolated case reports have suggested that adrenal function may be involved, yet no large cohort study has examined this relationship. METHODS: We conducted a retrospective single-center study of children who presented with a diagnosis of PTCS and had cortisol testing measured between January 2010 and September 2019. We included all subjects meeting the revised PTCS diagnostic criteria after the chart review. Based on morning, random or 1-µg cosyntropin stimulated cortisol levels, adrenal functioning was classified as: (1) insufficient (peak cortisol <16 µg/dL and AM cortisol <5 µg/dL), (2) at risk (peak cortisol 16-20 µg/dL, AM cortisol 5-13 µg/dL, or random <13 µg/dL), or (3) sufficient (peak cortisol >20 µg/dL and AM or random cortisol >13 µg/dL). RESULTS: A total of 398 individuals were reviewed, and 64 were included for analysis. Of these, 40.6% were men, of mixed race and ethnicity with a mean age of 10.5 (SD 4.7) years. Of these, 23% and 52% had insufficient or at-risk cortisol levels. The majority of those in the insufficient (70%) or at-risk (80%) groups were exposed to topical, nasal, or inhaled glucocorticoids but not systemic. Only 60% and 12% of those with PTCS with insufficient or at-risk cortisol testing, respectively, underwent definitive testing with a stimulation test. CONCLUSIONS: Glucocorticoid use and hypocortisolism are prevalent in PTCS and need consideration as a potential underlying cause. Most children had insufficient or at-risk cortisol levels, and many did not undergo further testing/workup. Children who present with PTCS, particularly young, males should be evaluated for adrenal insufficiency and its risk factors, including nonsystemic steroids. Prospective studies are necessary to further evaluate the effect of cortisol in relation to pediatric PTCS.