Neutrophil-to-lymphocyte ratio may predict complications and patency in bile duct injury repair.

BACKGROUND: Bile duct injury (BDI) repair surgery is usually associated with morbidity/mortality. The neutrophil-to-lymphocyte ratio (NLR) easily assesses a patient's inflammatory status. The study aims to determine the possible relationship between preoperative NLR (pNLR) with postoperative outcomes in BDI repair surgery. METHODS: Approved Ethics/Research Committee retrospective study, in patients who had a Bismuth-Strasberg type E BDI repair (2008-2023). Data registered was: morbidity, mortality, and long-term outcomes (primary patency and loss of primary patency) (Kaplan-Meier). Group comparison (U Mann-Whitney), receiver operator characteristic (ROC): area under curve [AUC]; cut-off value, and Youden index [J], and logistic regression analysis were used for pNLR evaluation. RESULTS: Seventy-three patients were studied. Mean age was 44.4 years. E2 was the commonest BDI (38.4%). Perioperative morbidity/mortality was 31.5% and 1.4%. Primary patency was 95.9%. 8.2% have lost primary patency (3-year actuarial patency: 85.3%). Median pNLR was higher in patients who had any complication (4.84 vs. 2.89 p = 0.015), biliary complications (5.29 vs. 2.86 p = 0.01), and patients with loss of primary patency (5.22 vs. 3.1 p = 0.08). AUC's, cut-off values and (J) were: any complication (0.678, pNLR = 4.3, J = 0.38, p = 0.007), serious complication (0.667, pNLR = 4.3, J = 0.34, p = 0.04), biliary complications (0.712, pNLR = 3.64, J = 0.46, p = 0.001), and loss of primary patency (0.716, pNLR = 3.24, J = 0.52, p = 0.008). Logistic regression was significant in any complication (Exp [B]: 0.1, p = 0.002), serious complications (Exp [B]: 0.2, p = 0.03), and biliary complications (Exp [B]: 8.1, p = 0.003). CONCLUSIONS: pNLR is associated with complications in BDI repair with moderate to acceptable predictive capacity. pNLR could potentially predict patency of a BDI repair.

Polytomous Rasch Analyses of Surgeons' Decision-Making on Choice of Procedure in Endoscopic Lumbar Spinal Stenosis Decompression Surgeries.

BACKGROUND: With the growing prevalence of lumbar spinal stenosis, endoscopic surgery, which incorporates techniques such as transforaminal, interlaminar, and unilateral biportal (UBE) endoscopy, is increasingly considered. However, the patient selection criteria are debated among spine surgeons. OBJECTIVE: This study used a polytomous Rasch analysis to evaluate the factors influencing surgeon decision-making in selecting patients for endoscopic surgical treatment of lumbar spinal stenosis. METHODS: A comprehensive survey was distributed to a representative sample of 296 spine surgeons. Questions encompassed various patient-related and clinical factors, and responses were captured on a logit scale graphically displaying person-item maps and category probability curves for each test item. Using a Rasch analysis, the data were subsequently analyzed to determine the latent traits influencing decision-making. RESULTS: The Rasch analysis revealed that surgeons' preferences for transforaminal, interlaminar, and UBE techniques were easily influenced by comfort level and experience with the endoscopic procedure and patient-related factors. Harder-to-agree items included technological aspects, favorable clinical outcomes, and postoperative functional recovery and rehabilitation. Descriptive statistics suggested interlaminar as the best endoscopic spinal stenosis decompression technique. However, logit person-item analysis integral to the Rasch methodology showed highest intensity for transforaminal followed by interlaminar endoscopic lumbar stenosis decompression. The UBE technique was the hardest to agree on with a disordered person-item analysis and thresholds in category probability curve plots. CONCLUSION: Surgeon decision-making in selecting patients for endoscopic surgery for lumbar spinal stenosis is multifaceted. While the framework of clinical guidelines remains paramount, on-the-ground experience-based factors significantly influence surgeons' selection of patients for endoscopic lumbar spinal stenosis surgeries. The Rasch methodology allows for a more granular psychometric evaluation of surgeon decision-making and accounts better for years-long experience that may be lost in standardized clinical guideline development. This new approach to assessing spine surgeons' thought processes may improve the implementation of evidence-based protocol change dictated by technological advances was endorsed by the Interamerican Society for Minimally Invasive Spine Surgery (SICCMI), the International Society for Minimal Intervention in Spinal Surgery (ISMISS), the Mexican Spine Society (AMCICO), the Brazilian Spine Society (SBC), the Society for Minimally Invasive Spine Surgery (SMISS), the Korean Minimally Invasive Spine Society (KOMISS), and the International Society for the Advancement of Spine Surgery (ISASS).

Phytochemistry, Bioactivity, and Ethnopharmacology of the Genus Lepechinia Willd. (Lamiaceae): A Review.

The genus Lepechinia (Lamiaceae) involves several aromatic shrubs that are distributed only in the American continent, inhabiting mountain areas, mainly in the Andean region of South America. Based on the PRISMA approach, we selected and critically analyzed 48 research articles. From a phytochemical point of view, most of the secondary metabolites reported in Lepechinia spp. are terpenes and terpenoids, with a few exceptions comprising flavonoids and other shikimic acid derivatives. On the one hand, sesquiterpenoids of the guajane, aromadendrane, eudesmane, and cadinane groups are characteristic of essential oils, together with (E)-ß-caryophyllene as the main representative of its chemical family. On the other hand, abietane diterpenoids are the prevalent compounds described in non-volatile fractions. Many biological activities and traditional medical uses have been reported for both pure metabolites and complex mixtures (e.g., essential oils). Regarding ethno-medical uses, the treatment of muscle pain, headache, toothache, diabetes mellitus, uterine tumors, uterine infections, and diarrhea has been reported. Concerning their verified biological activities, insecticidal, antifungal, antioxidant, and anticholinesterase properties have been described. Furthermore, some data concerning anti-herpetic activity have been reported.

Influence of social support and stressful life events on adherence to colorectal cancer screening using faecal occult blood test in Spanish medium risk population.

INTRODUCTION: Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. Five-year survival rate in Spain is 57%. The most important prognostic factor is the stage of the tumor at the diagnosis. CRC can be early diagnosed, but the adherence to screening programs is low (<50%). This study aims to ascertain the influence of social support and stressful life events on the adherence to the population screening of CRC with fecal occult blood test in Spanish average risk population. METHODS: Multicenter case-control study. We conducted a simple random sampling among individuals invited to participate in the colorectal cancer screening program. We analyzed epidemiological and social variables associated with lifestyle and behavioral factors. We performed a descriptive and a bivariant analyses and a logistic regression analysis. RESULTS: Four hundred and eight patients (237 cases and 171 controls) were included. Multivariant analyses showed independent association between higher adherence to the screening program and older age (OR: 1.06; 95% CI: 1.01-1.10), stable partner (OR: 1.77, 95% CI: 1.08-2.89) and wide social network (OR: 1.68; 95% CI: 1.07-2.66). Otherwise, lower adherence was associated to perceiving barriers to participate in the program (OR: 0.92; 95% CI: 0.88-0.96). We find a statistically significant association between lower adherence and high impact stressful life events in the bivariant analyses, and the tendency was maintained (OR: 0.63, 95% CI: 0.37-1.08) in the multivariant. CONCLUSION: Social variables decisively influence the adherence to colorectal cancer screening. The implementation of social interventions that improve social support, reduce impact of stressful life events and the design of screening programs that decrease the perceived barriers, will contribute to increase the participation on these programs. Secondary, the colorectal cancer diagnosis will be made in early-stages with the consequent mortality reduction.

Potencial dendrocronológico de tres especies de Podocarpáceas de la Cordillera de los Andes / Dendrochronological potential of three Podocarpaceae species from the Andean Cordillera

Resumen Introducción: Poco se conoce del potencial dendrocronológico de las Podocarpáceas en el trópico. Objetivo: Explorar el potencial dendrocronológico de tres especies de podocarpáceas: Retrophyllum rospigliosii, Podocarpus oleifolius y Prumnopitys harmsiana. Métodos: De plantaciones no manejadas localizadas en los Andes colombianos, se muestrearon y analizaron 88 árboles: 30 muestras de R. rospigliosii provenientes de secciones transversales, 30 y 28 muestras de P. oleifolius y P. harmsiana, respectivamente, provenientes de núcleos de madera extraídos con barreno de incrementos. Las muestras se procesaron siguiendo las técnicas dendrocronológicas estándar. Resultados: En general, las características anatómicas de los anillos de crecimiento son similares para las tres especies, con una anatomía simple de traqueidas alineadas radialmente por tratarse de coníferas. Dado que la edad conocida de la plantación coincide con el número de anillos se considera una fuerte evidencia de la frecuencia anual de su formación en R. rospigliosii y P. oleifolius, las cuales presentaron buena sincronización (cofechado) con una inter-correlación promedio de 0.55 (r-Pearson). Para P. harmsiana no fue posible concretar series de ancho de anillos de las muestras recolectadas. Las series estandarizadas de R. rospigliosii y P. oleifolius mostraron una relación con los registros instrumentales de precipitación y temperatura, indicando que estas especies pueden ser promisorias para estudios adicionales. Conclusión: La investigación dendrocronología con especies de Podocarpáceas podría realizarse exitosamente con R. rospigliosii y P. oleifolius, pero no con P. harmsiana.

Abstract Introduction: Little is known about the dendrochronological potential of Podocarpaceaes in the tropics. Objective: To explore the dendrochronological potential of three Podocarpaceae species: Retrophyllum rospigliosii, Podocarpus oleifolius, and Prumnopitys harmsiana. Methods: From a non-managed plantation in the Andean cordillera in Colombia, a total of 88 trees were analyzed: 30 samples of cross-sections of R. rospigliosii, and 30 and 28 samples of P. oleifolius and P. harmsiana, respectively, obtained with an increment borer. Samples were processed according to standard dendrochronological methods. Results: The anatomical characteristics of the growth rings of the three species are similar, with a simple conifer anatomy with radially oriented tracheids. Since the known age of the plantation coincides with the number of tree rings this is strong evidence of annual tree-ring frequency of R. rospigliosii and P. oleifolius which also showed a satisfactory cross-dating with an average inter-correlation of 0.55 (r-Pearson). For P. harmsiana, it was not possible to build a tree-ring series from the collected samples. R. rospigliosii and P. oleifolius standardized ring-width chronologies showed a relationship with the instrumental records of rainfall and temperature, indicating these species may be promising further studies. Conclusions: Dendrochronological research with Podocarpaceae species could be carried out successfully with R. rospigliosii and P. oleifolius but not with P. harmsiana.

A Validated HPLC-UV-ESI-IT-MS Method for the Quantification of Carnosol in Lepechinia mutica, a Medicinal Plant Endemic to Ecuador.

The diphenolic diterpene carnosol was isolated from several species of the family Lamiaceae, including Lepechinia mutica, a medicinal plant endemic to Ecuador. The compound has exhibited high antioxidant, anti-inflammatory, antimicrobial, neuroprotective, and antifungal properties, as well as promising cytotoxicity against prostate, breast, skin, leukemia, and human colon cancer cell lines. In this paper, we developed and validated a simple, accurate, and reliable analytical HPLC-UV-ESI-IT-MS method, carried out on a C18 column, which is potentially suitable to quantify carnosol in plant extracts. The procedure complied with the established ICH validation parameters of analytical range (linearity in the range of 0.19-5.64 µg/g dried leaves; REAVERGE = 4.9%; R2 = 0.99907), analysis repeatability (RSD = 2.8-3.6%), intermediate precision (RSD = 1.9-3.6%), accuracy (estimated as % carnosol recovery in the range of 81 to 108%), and robustness. Finally, the LOD (0.04 µg/mg) and LOQ (0.19 µg/mg) values of carnosol/dried leaves were determined. Using this validated method, the content of carnosol in L. mutica was estimated to be 0.81 ± 0.04 mg/g of dried leaves (0.081%).

In-house standards derived from doping peptides: Enzymatic and serum stability and degradation profile of GHRP and GHRH-related peptides.

Matrix effect and sample pretreatment significantly affect the percentage recovery of peptides in biological matrices, affecting the method robustness and accuracy. To counteract this effect, an internal standard (IS) is used; however, in most cases this is not available, which limits the analytical method. It is important to identify short peptides that can be used as ISs in the quantification of peptides in biological matrices. In this study, doping peptides GHRP-4, GHRP-5, GHRP-6, Sermorelin (1-11), Sermorelin (13-20) and Sermorelin (22-29) were synthesized using solid-phase peptide synthesis. Treatment with human blood, trypsin and chymotrypsin was used to determine the stability of the peptides. Products were evaluated using the high-performance liquid chromatography-diode array detector (HPLC-DAD) method. The analytical methodology and sample pretreatment were effective for the analysis of these molecules. A unique profile related to protein binding and enzymatic stability of each peptide was established. GHRP-4, GHRP-6 and Sermorelin (22-29) can be considered as in-house ISs as they were stable to enzyme and blood treatment and can be used for the quantification of peptides in biological samples. Peptides GHRP-6 and Sermorelin (22-29) were used to analyse a dimeric peptide (26 [F] LfcinB (20-30)2 ) in four different matrices to test these peptides as in-house IS.

Impact of Bariatric Surgery on the Incidence of Various Cancers. Narrative Review

Obesity is a global epidemic. According to the World Health Organization (WHO), it is an abnormal or excessive accumulation of fat that can harm health. Its incidence is increasing alarmingly in developing countries. It is also a significant risk factor for developing chronic diseases such as type 2 diabetes mellitus, arterial hypertension, coronary disease, non-alcoholic fatty liver disease, and musculoskeletal disorders such as osteoarthritis. Furthermore, associations have been found between obesity and the development of prostate, liver, gallbladder, kidney, colon, endometrial, breast, and ovarian cancer. Bariatric and metabolic surgery is the most effective treatment for morbid obesity and its comorbidities. This surgery can reduce general mortality by 40% at ten years due to cardiovascular outcomes, diabetes, or cancer and improve metabolic diseases such as type 2 diabetes.

La obesidad es una epidemia global, según la Organización Mundial de la Salud (OMS) se define como una acumulación anormal o excesiva de grasa que puede ser perjudicial para la salud, su incidencia está aumentando de forma alarmante en los países en desarrollo. Asimismo, es un factor de riesgo importante para el desarrollo de enfermedades crónicas como la diabetes mellitus tipo 2, hipertensión arterial, enfermedad coronaria, enfermedad del hígado graso no alcohólico y trastornos musculoesqueléticos como la osteoartritis; además, se han encontrado asociaciones entre la obesidad y el desarrollo del cáncer de próstata, hígado, vesícula biliar, riñón, colon, endometrio, mama y ovarios. La cirugía bariátrica y metabólica es el tratamiento más eficaz para la obesidad mórbida y sus comorbilidades, esta cirugía puede reducir la mortalidad general en un 40% a los diez años por desenlaces cardiovasculares, diabetes o cáncer, como también mejorar enfermedades metabólicas como la diabetes tipo 2.

Perceived barriers and benefits in the participation in faecal occult blood test colorectal cancer screening programme.

BACKGROUND: Colorectal cancer is the second cancer-related cause of death in the world. Tumour stage at diagnosis is the principal prognosis factor of survival. However, the participation in the programme is around 50%. The aim of the study was to identify the benefits and barriers perceived by the population when participating in a colorectal cancer screening programme with faecal occult blood test. METHODS: We carried out a cases-controls study with 408 participants. We analyzed epidemiological and social variables associated with lifestyle and behavioural factors based in the Health Belief Model. We conducted a descriptive analysis, and identified variables associated to adherence by a logistic regression. RESULTS: Variables independently associated with the participation in a colorectal cancer screening programme were age (OR 1.06; 95% CI: 1.01-1.11), having a stable partner (OR 1.96; 95% CI: 1.20-3.18), the level of education (OR 1.59; 95% CI: 1.02-2.47) and two of the barriers to participate in the faecal occult blood test screening: "you don't know how to do one" (OR=0.46; 95% CI: 0.23-0.93) and "it is not that important right now" (OR=0.43; 95% CI: 0.24-0.78). CONCLUSION: The existing barriers for screening with faecal occult blood test are the best factor predicting. This is relevant when designing the intervention programmes, as they should focus on reducing perceived barriers to increase the participation in colorectal cancer screening, thereby reducing colorectal cancer mortality.

Fishes from Yarinacocha lake: an emblematic Amazonian ecosystem in the lower Ucayali River basin, Pucallpa, Peru / Peixes do lago Yarinacocha: um ecossistema amazônico emblemático na bacia do baixo rio Ucayali, Pucallpa, Peru

The Yarinacocha lake is an emblematic ecosystem of the Peruvian Amazon, representing the main point of fish landing and a tourist attraction in the city of Pucallpa. The wide fauna diversity in this area has made it the target of various studies, although for fish species most of them were focused on commercial species. In this work, we carried out the first ichthyofauna species inventory of the Yarinacocha lake, sampling throughout the entire lake during the rainy and dry seasons and considering also all previously recorded species deposited in the Ichthyological Collection of the MUSM with the same locality. A total of 164 fish species were recorded, representing 10 orders (plus Eupercaria), 34 families and 116 genera. Characiformes was the order with more species (68 spp., 41.5%) followed by Siluriformes (59 spp., 36%), Cichliformes (17 spp., 10.5%), and Gymnotiformes (8 spp., 4.9%). The most highly represented families, including almost 55.5% of the total diversity obtained, were Characidae (23 spp., 14%), followed by Cichlidae (17 spp., 10.4%), Loricariidae (14 spp., 8.5%), Pimelodidae (13 spp., 7.9%), Doradidae (13 spp., 7.4%) and Anostomidae (12 spp., 7.3%). From the total fish species recorded in this study, only 22 are considered protected species following the IUCN criteria and 109 species have commercial importance, including 90 ornamental species (54.8%). Our results contribute to the knowledge of the ichthyofauna of the Yarinacocha lake and can be used as a starting point for its conservation and sustainable management over time.

O lago Yarinacocha é um ecossistema emblemático da Amazônia peruana, representando o principal ponto de desembarque de peixes e também uma atração turística da cidade de Pucallpa. A grande diversidade faunística nesta área a tornou alvo de vários estudos, embora para as espécies de peixes a maioria deles tenha sido focada em espécies comerciais. Neste trabalho, realizamos o primeiro inventário da ictiofauna do lago Yarinacocha, amostrando todo o lago durante as estações chuvosa e seca, e também considerando todas as espécies depositadas na Coleção Ictiológica do MUSM dessa localidade. Um total de 164 espécies de peixes foram registradas, representando 10 ordens (mais Eupercaria), 34 famílias e 116 gêneros. Characiformes foi a ordem com mais espécies (68 espécies, 41,5%), seguida por Siluriformes (59 espécies, 36%), Cichliformes (17 espécies, 10,5%) e Gymnotiformes (8 espécies, 4,9%). As famílias mais representadas, incluindo quase 55,5% da diversidade total obtida, foram Characidae (23 spp., 14%), seguido por Cichlidae (17 spp., 10,4%), Loricariidae (14 spp., 8,5%), Pimelodidae (13 spp., 7,9%), Doradidae (13 spp., 7,4%) e Anostomidae (12 spp., 7,3%). Do total de espécies de peixes registradas neste estudo, apenas 22 são consideradas espécies protegidas seguindo os critérios da IUCN e 109 espécies têm importância comercial, incluindo 90 espécies ornamentais (54,8%). Nossos resultados contribuem para o conhecimento da ictiofauna do lago Yarinacocha e podem ser utilizados como ponto de partida para sua conservação e manejo sustentável ao longo do tempo.

Cannabis recreativo: Perfil de los cannabinoides presentes en muestras de marihuana suministradas por población consumidora / Recreational cannabis: Profile of cannabinoids present in marijuana samples supplied by the consuming population

RESUMEN El cannabis o marihuana es una de las sustancias psicoactivas más consumida en todo el mundo, por lo que conocer la composición y el tipo de cannabis que se comercializa en los entornos urbanos es un insumo necesario para el diseño de políticas en salud pública sustentadas en la evidencia científica. Este estudio caracterizó los principales fitocannabinoides de muestras de marihuana (cigarrillos o cogollos) obtenidas en áreas urbanas y rurales de la ciudad Medellín, en octubre de 2021. Se realizó un muestreo no probabilístico a conveniencia en el que se recolectaron 87 muestras de marihuana donadas por consumidores en diferentes puntos de recolección en toda la ciudad, aplicando las técnicas de cromatografía de gases masas e ionización de llama para la caracterización de los fitocanabinoides. Se encontró el tetrahidrocannabinol como el constituyente principal de la marihuana circulante en Medellín, donde el 67,8% de las muestras presentaba un rango toxicológico alto o superior para THC; lo anterior en un contexto donde el mercado desregulado limita la posibilidad que tienen los consumidores en la práctica de calibrar o decidir la concentración de cannabinoides en sus dosis.

ABSTRACT As cannabis/marijuana is one of the most consumed psychoactive substances in the world, knowing the composition and type of cannabis sold in urban environments is a necessary input for the design of public health policies based on scientific evidence. This study characterized the main phytocannabinoids of marijuana samples (cigarettes or buds) obtained in urban and rural areas of the city of Medellín in October 2021. Non-probabilistic convenience sampling was carried out in which 87 marijuana samples donated by consumers were collected at different collection points throughout the city, and gas chromatography-mass spectrometry and flame ionization techniques were employed for the characterization of phytocannabinoids. Tetrahydrocannabinol (THC) was found to be the main constituent of circulating marijuana in Medellín, where 67.8% of the samples had a high or higher toxicological range for THC; the foregoing in a context where the deregulated market in practice limits the possibility that consumers have to calibrate or decide the concentration of cannabinoids in their doses.

Development of a Nanostructured Electrochemical Genosensor for the Detection of the K-ras Gene.

In the scientific literature, it has been documented that electrochemical genosensors are novel analytical tools with proven clinical diagnostic potential for the identification of carcinogenic processes due to genetic and epigenetic alterations, as well as infectious diseases due to viruses or bacteria. In the present work, we describe the construction of an electrochemical genosensor for the identification of the k12p.1 mutation; it was based on use of Screen-Printed Gold Electrode (SPGE), Cyclic Voltammetry (CV), and Atomic Force Microscopy (AFM), for the monitoring the electron transfer trough the functionalized nanostructured surface and corresponding morphological changes. The sensitivity of the genosensor showed a linear response for the identification of the k12p.1 mutation of the K-ras gene in the concentration range of 10 fM to 1 µM with a detection limit of 7.96 fM in the presence of doxorubicin (Dox) as DNA intercalating agent and indicator of the hybridization reaction. Thus, the electrochemical genosensor developed could be useful for the identification of diseases related with the K-ras oncogene.

Impact of the SARS-CoV-2 Pandemic on the Prevalence and Incidence of Gastrointestinal Viruses in Children up to Five Years Old: a Retrospective Cohort Study.

The aim is determining the impact of non-pharmaceutical measures (NPIs) against SARS-CoV-2 in the incidence and prevalence of gastrointestinal viruses (GV) in children. Demographic, analytical, and clinical data of children from which samples were received at the Hospital Universitario La Paz (Madrid, Spain) and that had a gastrointestinal infection with a positive sample through multiplex-PCR for GV were collected. The time periods included were prepandemic (P1): March 14, 2019 to March 14, 2020 and pandemic (P2): March 15, 2020 to March 15, 2021. The global prevalence, relative incidence (RI, per 1,000 admissions) and absolute incidence (AI, per 100,000 population) of GV were compared for both time periods. The prevalence of GV versus SARS-CoV-2 was determined for P2. Seven-hundred and 50 out of 2,547 children analyzed in P1 and 106 out of 1,368 in P2 were positive by PCR for GV (46.3% decrease in P2). Prevalence and RI of GV declined in P2, except for the RI of rotavirus. Adenovirus showed the largest decreased of prevalence and RI (100%), followed by sapovirus. Astrovirus reduction was less pronounced (3.1% versus 0.4%). Norovirus was the most frequent virus in both time periods and its prevalence and RI also decreased in P2 (15.2% versus 4.7% and 3.40 versus 1.74, respectively). Rotavirus had the smallest decrease in prevalence (2.6% versus 2.5%), and its RI increased during P2 from 0.7 to 0.93. After removing the rotavirus vaccine strains from the analysis, the prevalence and RI decreased during P2 (2.1% to 0.7% and 0.5 to 0.3, respectively). The AI decreased during P2 in all GV, and the prevalence of SARS-CoV-2 and GV was inversely proportional over time. Prevalence and incidence of GV have decreased during the pandemic, probably due to the implementation of NPIs against this virus and the reduction of health care attention to infections other than COVID-19. The differences in the decrease of prevalence and incidence for each virus may be explained by differences in the transmission and the resistance in the environment. Prevalence and RI of rotavirus might be biased since the PCR used detects both the infecting and the vaccine strains. IMPORTANCE Our original article contains an analysis of the impact of the measures applied against SARS-CoV-2 on the prevalence and incidence of GV in children. The small number of studies published to date that analyze the impact of these measures individually on each of the GV makes our study of great interest at this time.

Genomic Signatures of Divergent Ecological Strategies in a Recent Radiation of Neotropical Wild Cats.

Ecological differentiation among diverging species is an important component of the evolutionary process and can be investigated in rapid and recent radiations. Here, we use whole genome sequences of five species from the genus Leopardus, a recently diversified Neotropical lineage with species bearing distinctive morphological, ecological, and behavioral features, to investigate genome-wide diversity, comparative demographic history and signatures of positive selection. Our results show that divergent ecological strategies are reflected in genomic features, for example a generalist species shows historically larger effective population size and higher heterozygosity than habitat specialists. The demographic history of these cats seems to have been jointly driven by climate fluctuations and habitat specialization, with different ecological adaptations leading to distinct trajectories. Finally, a gene involved in vertebrate retinal neurogenesis (POU4F2) was found to be under positive selection in the margay, a cat with notoriously large eyes that are likely associated with its nocturnal and arboreal specializations.

Tratamento de siringomas periorbitários: revisão da literatura científica nos últimos 5 anos / Treatment of periorbital syringomas: review of scientific literature in the last 5 years

Introdução: O siringomas são tumores anexais benignos com caraterísticas histopatológicas decorrentes dos ductos écrinos, em forma de pápulas amareladas ou cor da pele, de 1-3 mm, comumente na região periorbitária inferior, podendo causar problemas cosméticos importantes. O objetivo do tratamento é melhorar a aparência, através da destruição completa do tumor usando métodos minimamente invasivos e inclusa cirurgia. Existem na literatura múltiplas opções de tratamento com vários graus de sucesso, porém pouco se conhece sobre a eficácia. Em geral, a remoção completa não é bem-sucedida, e têm sido descritos efeitos colaterais, sendo a recorrência o mais frequente. Métodos: Trata-se de uma revisão narrativa de literatura, de publicações científicas no período de 2014-2019. Resultados: Após revisar 45 artigos, e identificar os publicados nos últimos cinco anos que tiveram registro de número de pacientes, descrição de tratamento, escalas de avaliação dos resultados e acompanhamento, foram selecionados seis artigos. Do número total de seis artigos, foram encontrados: uma revisão sistemática, e cinco estudos retrospectivos, sendo um comparativo. Foi designado um número para cada artigo analisado, e coletados o número de pacientes incluídos, tratamento realizado, escalas de avaliação e resultados, complicações e conclusões. Conclusões: Os siringomas periorbitários ainda são um desafio terapêutico, e até agora nenhum tratamento demostrou ser consistentemente eficaz. O laser CO2 continua sendo a primeira escolha de tratamento quando usado fracionado, e a eletrocoagulação intralesional representa uma segunda alternativa com resultados moderados e menor risco de complicações. Novos tratamentos como Laser Erbium Laser Erbium Yttrium Aluminum Garnet, Neodymium-Doped Yttrium Aluminum Garnet e monoterapia com toxina botulínica A poderiam ser boas alternativas. Estudos prospetivos comparativos são necessários.

Introduction: Syringomas are benign adnexal tumors with histopathological characteristics arising from the eccrine ducts, in yellowish or skin-colored papules, 1-3 mm, commonly in the lower periorbital region, which can cause important cosmetic problems. The goal of treatment is to improve appearance by destroying the tumor using minimally invasive methods and including surgery. There are multiple treatment options in the literature with varying degrees of success, but little is known about their effectiveness. Complete removal is unsuccessful, and side effects have been described, recurrence being the most frequent. Methods: This is a narrative review of the literature of scientific publications in the period 2014-2019. Results: After reviewing 45 articles and identifying those published in the last five years that had a record of the number of patients, treatment description, scales of evaluation of results and follow-up, six articles were selected. Of the total number of six articles, we found: a systematic review and five retrospective studies, one being a comparative one. A number was assigned to each article analyzed, and the number of patients included, treatment performed, assessment scales and results, complications and conclusions were collected. Conclusions: Periorbital syringomas are still a therapeutic challenge, and so far, no treatment is consistently effective. The CO2 laser remains the first choice of treatment when used fractionally, and intralesional electrocoagulation represents a second alternative with moderate results and a lower risk of complications. New treatments such as Laser Erbium Laser Erbium Yttrium Aluminum Garnet, Neodymium-Doped Yttrium Aluminum Garnet and botulinum toxin A monotherapy could be good alternatives. Comparative prospective studies are needed.

Rawl's questionnaire spanish validation for colorectal cancer screening with faecal occult blood testing. / Validación al castellano del cuestionario Rawl de cribado de cáncer colorrectal con sangre oculta en heces.

INTRODUCTION: Colorectal cancer 5-years-survival is 57%, partway due to a low rate of participation in screening programmes. Instruments analyzing causes of low adherence are needed. OBJECTIVE: To evaluate the validity and internal consistency of the Spanish version of Rawl's Questionnaire for the screening of colorectal cancer by faecal occult blood testing. TYPE OF STUDY: Questionnaire validation methodology. LOCATION: Three Primary Care Centres in Valencia. VARIABLES: Age, sex, civil status, educational level, social class, smoking, alcohol consumption, body mass index, personal and family history of cancer. RESULTS: We analyzed 408 individuals (237 cases and 171 controls). Mean age was 59.45 years (SD 5.17). Internal consistency of all variables reached a Cronbach's alfa of 0.796. The Cronbach's alfa benefit dimension of the screening was 0.871 and for the barrier dimension of the screening it was 0.817. Intraclass correlation coefficients of the test-retest for the benefit dimension of the screening was 0.809 (CI 95% 0.606-0.913) and 0.499 (CI 95% 0.126-0.750) for the barrier dimension. CONCLUSION: The Spanish version of Rawl's Questionnaire is valid, reliable and reproducible, so we have this validated instrument with which to identify barriers and benefits in a colorectal screening programme in Spain.

El impacto de la pandemia de COVID-19 en la salud mental de los trabajadores de la salud en Chile: datos iniciales de The Health Care Workers Study / Impact of COVID-19 pandemic on the mental health of healthcare workers

Background: Healthcare workers' mental health was affected by SARS-CoV-2 pandemic. Aim: To evaluate healthcare workers' mental health and its associated factors during the pandemic in Chile. Material and Methods: An online self-reported questionnaire was designed including the Goldberg Health Questionnaire, the Patient Health Questionnaire, (PHQ-9), and the Columbia-Suicide Severity Rating Scale among other questions. It was sent to 28,038 healthcare workers. Results: The questionnaire was answered by 1,934 participants, with a median age of 38 years (74% women). Seventy five percent were professionals, and 48% worked at a hospital. Fifty nine percent of respondents had a risk of having a mental health disorder, and 73% had depressive symptoms. Significant associations were found with sex, workplace, and some of the relevant experiences during the pandemic. Fifty one percent reported the need for mental health support, and 38% of them received it. Conclusions: There is a high percentage of health workers with symptoms of psychological distress, depression, and suicidal ideas. The gender approach is essential to understand the important differences found. Many health workers who required mental health care did not seek or received it.

Essential Oil and Major Non-Volatile Secondary Metabolites from the Leaves of Amazonian Piper subscutatum.

The essential oil and the major non-volatile secondary metabolites from the leaves of Piper subscutatum (Miq.) C. DC. (Family Piperaceae), collected in the Ecuadorian Amazon, were analyzed for the first time in the present study. The essential oil was submitted to chemical and enantioselective analyses by GC-MS and GC-FID. (E)-ß-caryophyllene (25.3-25.2%), ß-chamigrene (10.3-7.8%), (E)-nerolidol (8.1-7.7%), ß-selinene (7.2-7.7%), δ-cadinene (2.7-3.9%), bicyclogermacrene (3.7-2.4%), and ß-pinene (2.6-3.4%) were the major components. The enantioselective analysis, carried out on a ß-cyclodextrin-based column, showed four scalemic mixtures in which (1R,5R)-(+)-α-pinene, (1S,5S)-(-)-ß-pinene, (S)-(-)-limonene, and (1R,2S,6S,7S,8S)-(-)-α-copaene were the major enantiomers, with enantiomeric excesses of 28.8%, 77.8%, 18.4%, and 6.0%, respectively. The study was complemented with the chemical analysis of the organic fraction dissolved in the hydrolate, whose major components were 6-methyl-5-hepten-2-one (63.7-64.4%) and linalool (6.5-6.0%). Concerning the non-volatile fraction, five lignans were the major components. (-)-Beilshminol B, (-)-grandisin, (-)-3',4'-methylenedioxy-3,4,5-trimethoxy-7,7'-epoxylignan, (-)-3',4'-methylenedioxy-3,4,5,5'-tetramethoxy-7,7'-epoxylignan, and (-)-3,4,3',4'-dimethylenedioxy-5,5'-dimethoxy-7,7'-epoxylignan were identified by means of NMR spectroscopy, mass spectrometry and X-ray crystallography. The absolute configuration 7S,8S,7'S,8'S was tentatively assigned to all of them.

Chemical Composition and Anticholinesterase Activity of the Essential Oil of Leaves and Flowers from the Ecuadorian Plant Lepechinia paniculata (Kunth) Epling.

This work aimed to study the chemical composition, cholinesterase inhibitory activity, and enantiomeric analysis of the essential oil from the aerial parts (leaves and flowers) of the plant Lepechinia paniculata (Kunth) Epling from Ecuador. The essential oil (EO) was obtained through steam distillation. The chemical composition of the oil was evaluated by gas chromatography, coupled to mass spectrometry (GC-MS) and a flame ionization detector (GC-FID). The analyses led to the identification of 69 compounds in total, of which 40 were found in the leaves and 29 were found in the flowers of the plant. The major components found in the oil were 1,8-Cineole, ß-Pinene, δ-3-Carene, α-Pinene, (E)-Caryophyllene, Guaiol, and ß-Phellandrene. Flower essential oil showed interesting selective inhibitory activity against both enzymes AChE (28.2 ± 1.8 2 µg/mL) and BuChE (28.8 ± 1.5 µg/mL). By contrast, the EO of the leaves showed moderate mean inhibitory activity against acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), with IC50 values of 38.2 ± 2.9 µg/mL and 47.4 ± 2.3 µg/mL, respectively.