Facial thermal and blood perfusion patterns of human emotions: Proof-of-Concept.

In this work, a preliminary study of proof-of-concept was conducted to evaluate the performance of the thermographic and blood perfusion data when emotions of positive and negative valence are applied, where the blood perfusion data are obtained from the thermographic data. The images were obtained for baseline, positive, and negative valence according to the protocol of the Geneva Affective Picture Database. Absolute and percentage differences of average values of the data between the valences and the baseline were calculated for different regions of interest (forehead, periorbital eyes, cheeks, nose and upper lips). For negative valence, a decrease in temperature and blood perfusion was observed in the regions of interest, and the effect was greater on the left side than on the right side. In positive valence, the temperature and blood perfusion increased in some cases, showing a complex pattern. The temperature and perfusion of the nose was reduced for both valences, which is indicative of the arousal dimension. The blood perfusion images were found to be greater contrast; the percentage differences in the blood perfusion images are greater than those obtained in thermographic images. Moreover, the blood perfusion images, and vasomotor answer are consistent, therefore, they can be a better biomarker than thermographic analysis in identifying emotions.

Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry.

BACKGROUND: Patients with inflammatory bowel disease (IBD) may present extraintestinal manifestations (EIMs) that affect the joints, skin, eyes, and hepatobiliary area, among others. AIMS: Our aim was to analyse the prevalence and characteristics of EIMs in patients with IBD and to identify the possible risk factors associated with the development of EIMs in the largest series published to date. METHODS: Observational, cross-sectional study including patients from the Spanish ENEIDA registry promoted by GETECCU. We retrospectively identified all cases of EIMs in the ENEIDA registry until January 2018. RESULTS: The study included 31,077 patients, 5779 of whom had at least one EIM (global prevalence 19%; 95% CI 18.2-19.0). Among the different types of EIMs, rheumatic manifestations had a prevalence of 13% (95% CI 12.9-13.7; 63% of EIMs), with a prevalence of 5% (95% CI 4.7-5.2) for mucocutaneous manifestations, 2.1% (95% CI 1.9-2.2) for ocular manifestations, and 0.7% (95% CI 0.6-0.8) for hepatobiliary manifestations. The multivariable analysis showed that the type of IBD (Crohn's disease, p < 0.001), gender (female, p < 0.001), the need for an immunomodulator (p < 0.001) or biologic drugs (p < 0.001), a previous family history of IBD (p < 0.001), and an extensive location of IBD (p < 0.001) were risk factors for the presence of EIMs. CONCLUSIONS: One-fifth of patients with IBD may have associated EIMs, with rheumatic manifestations as the most frequent (> 60% of EIMs). Female patients with severe Crohn's disease represent the group with the highest risk of developing EIMs. These patients should therefore be specially monitored and referred to the corresponding specialist when suggestive symptoms appear.

[Helicobacter cinaedi bacteremia: Presentation of the first cases reported in Argentina]. / Bacteriemia por Helicobacter cinaedi: presentación de los primeros casos descritos en Argentina.

Two cases of bacteremia caused by Helicobacter cinaedi are presented. The first case was diagnosed in a 76-year-old male patient, and was secondary to a vascular access device placement; the second case corresponded to a febrile infant of 37 days of life, and was associated with acute gastroenteritis. H. cinaedi is a microorganism difficult to grow in different culture media and also to identify to species level. In both cases, the microscopic observation of blood culture bottles, the use of mass spectrometry and the subsequent sequencing of the hsp60 gene were essential. In the recent literature, H. cinaedi infections are being reported more frequently. In this report we present the first documented cases of bacteremia caused by H. cinaedi in Argentina.

[A front-of-pack labelling system for food and beverages for Mexico: a strategy of healthy decision-making.] / Sistema de etiquetado frontal de alimentos y bebidas para México: una estrategia para la toma de decisiones saludables.

The Mexican Ministry of Health requested the National Institute of Public Health to constitute a group of independent, free of conflict-of-interest academic experts on front-of-pack labelling (FOP). This group was instructed to created a positioning paper to contribute to the development of a FOP system for industrialized products that offers useful information for purchase decision making. This position paper uses the best available scientific evidence, and recommendations from experts of international organizations. The FOP proposal focuses on the contents of energy, nutrients, ingredients and components that if consumed in excess on the diet, can be harmful to people's health, such as added sugars, sodium, total fat, saturated fat and energy. The academic expert group recommends the implementation of a FOP that provides an easy way to quickly assess the quality of a product. It is essential that this FOP provides direct, simple, visible and easily understandable information.

La Secretaría de Salud solicitó al Instituto Nacional de Salud Pública la conformación de un grupo de expertos académicos en etiquetado de alimentos y bebidas, independientes y libres de conflictos de interés, que tuvieran la encomienda de emitir una postura para contribuir al desarrollo de un sistema de etiquetado frontal para productos industrializados que proporcione información útil para facilitar la decisión de compra. La postura utiliza la mejor evidencia científica disponible y recomendaciones de expertos convocados por organismos internacionales. Así, la propuesta de etiquetado frontal se centra en el contenido de energía, nutrimentos, ingredientes y componentes cuyo exceso en la dieta puede ser perjudicial para la salud, como azúcares añadidos, sodio, grasas totales, grasas saturadas y energía. El grupo recomienda implementar un etiquetado frontal que, de forma sencilla, permita evaluar de manera rápida la calidad de un producto al momento de realizar una compra; por ello, es indispensable que éste proporcione información directa, sencilla, visible y fácil de entender.

[Study of Staphylococcus aureus infections in a general acute care hospital (2002-2013)]. / Estudio de las infecciones por Staphylococcus aureus en un hospital general de agudos (2002-2013).

A twelve-year retrospective review of Staphylococcus aureus infections in adult and pediatric patients (AP and PP respectively) assisted in the Hospital Interzonal General de Agudos Evita in Lanús was performed to determine the incidence, foci of infection, the source of infection and to analyze the profile of antimicrobial resistance. An amount of 2125 cases of infection in AP and 361 in PP were documented. The incidence in AP decreased significantly in the last three years (χi2; p<0.05); in PP it increased significantly during the last five years (χ2; p<0.0001). In both populations was detected a notable increase in skin infections and associated structures (PEA) in bacteremia to the starting point of a focus on PEA, and in total S. aureus infections of hospital-onset (χ2; p < 0.005). Methicillin-resistance (MRSA) increased from 28 to 78% in PP; in AP it remained around 50%, with significant reduction in accompanying antimicrobial resistance to non-ß-lactams in both groups of MRSA. In S. aureus documented from community onset infections (CO-MRSA) in the last three years, the percentage of methicillin-resistance was 57% in PP and 37% in AP; in hospital-onset infections it was 43% and 63% respectively. Although data showed that S. aureus remains a pathogen associated with the hospital-onset, there was an increase of CO-MRSA infections with predominance in PEA in both populations.

Ungual squamous cell carcinoma mimicking a chronic paronychia: clinical, pathological and radiological correlation.

Squamous cell carcinoma is a malignant skin tumor that is rarely located in the nails. Its presentation, can sometimes be confused with an inflammatory process as onychomycosis or psoriatic onychopathy or other tumors as viral warts. We report the case of a 73-year-old woman with a locally invasive squamous cell carcinoma reaching the bone, simulating a chronic paronychia.

Tonsillar chancre as unusual manifestation of primary syphilis.

Primary syphilis with oropharyngeal manifestations should be kept in mind, though. Lips and tongue ulcers are the most frequently reported lesions and tonsillar ulcers are much more rare. We report the case of a 24-year-old woman with a syphilitic ulcer localized in her left tonsil.

[Association between neontal morbidity, gestational age and developmental delays in moderate to late preterm children]. / Asociación entre morbilidad neonatal, edad gestacional y déficit de desarrollo psicomotor en prematuros moderados y tardíos.

INTRODUCTION: There is evidence that children born moderate-to-late preterm (MLP) have a higher risk of hospitalisation, neonatal morbidity, and developmental delay (DD). OBJECTIVE: To determine the association between DD, gestational age, and neonatal morbidity in MLP children. PATIENTS AND METHOD: A case control study design nested in a cohort of MLP children born between 2006 and 2009 at a private hospital located in the Metropolitan area of Santiago. The children were assessed with the Bayley-III Scales of Infant Development at 8 or 18 months corrected age, or at 30 months of chronological age. Neonatal records were retrospectively reviewed. A multivariate analysis was performed to determine the effect of neonatal morbidity on development. RESULTS: A total of 130 MLP children, 25 cases and 105 controls, were studied. Most of them (83.8%) were hospitalised during the neonatal period. Significant differences between cases and controls regarding maternal age and symptomatic hypoglycaemia were observed (crude OR 3.5, adjusted OR 8.18). It was concluded that the variables that negatively affect the rate of development are male gender, being a twin, and gestational age. CONCLUSIONS: Symptomatic hypoglycaemia is the main risk factor for DD, while being a twin, male gender, and gestational age influenced the total development rate obtained. It is essential to develop strategies for prevention, screening, and early management of this metabolic disorder to prevent future DD.

Design of a video game for assessment of executive functions in deaf and hearing children.

This study investigates the effectiveness of a computerized cognitive test battery embedded within a video game to assess executive functions (EF) in deaf and hearing children. We evaluated a diverse cohort of 290 elementary school students aged 5 to 13 years (mean age = 8.86, SD = 1.96), comprising 74 sign language users, 14 Spanish-speaking deaf participants, 23 children with mixed communication methods, and 179 typically hearing individuals. Our statistical analysis focused on item discrimination, reliability, and criterion validation of the game-based assessments. The results indicated high reliability and effective discrimination of EF across the game's three primary stages. External validation was conducted using the Matrices Test, educational attainment, and age as variables. A significant positive correlation (r = 0.377, p < 0.001) was observed between the Matrices Test scores and game-based achievement scores. Furthermore, linear regression analysis revealed education (Standardized Beta = 0.339) and age (Standardized Beta = 0.179) as significant predictors of performance in these scores. This study underscores the value of integrating computerized cognitive assessments within a video game environment for comprehensive neuropsychological evaluations, highlighting its potential in diverse child populations.

[Dissemination of blaIMP-8 among Enterobacteriaceae isolates from a Buenos Aires Hospital]. / Diseminación de blaIMP-8 en enterobacterias aisladas en un hospital de Buenos Aires.

From August 2008 to December 2011, six metallo-ß-lactamase-producing isolates, four Enterobacter cloacae, one Klebsiella oxytoca and one Citrobacter freundii, were detected at Hospital Interzonal General de Agudos "Evita" in Lanús. All six isolates showed multiresistant profiles and the presence of the blaIMP-8 gene. Five isolates also expressed PER-2 extended spectrum ß-lactamase. The blaIMP-8 gene was found as the first cassette in a class 1 integron. However, the 3´ conserved sequence could not be detected in three isolates. In all cases, blaIMP-8 was transferred by conjugation to azide-resistant Escherichia coli J53. PFGE analysis revealed that the four E. cloacae isolates were not genetically related. These are the first metallo-ß-lactamases detected in this institution and our results suggest a possible intra- and inter-species horizontal dissemination of blaIMP-8.

Differentiation of function among the RsbR paralogs in the general stress response of Bacillus subtilis with regard to light perception.

The general stress response of Bacillus subtilis can be activated by a wide range of signals, including low intensities of visible light. It is regulated by a dedicated σ factor via a complex signal transduction pathway that makes use of stressosomes: hetero-oligomeric complexes that include one or more of the RsbR proteins (RsbRA, RsbRB, RsbRC, and RsbRD). The response to blue light is mediated by the photoreceptor YtvA. We show here which of the four RsbR proteins are necessary for the activation of the σ(B) response by blue light. Experiments performed with single-, double-, and triple-deletion strains in the rsbR genes show that RsbRB and RsbRA function antagonistically, with the former being a negative regulator and the latter a positive regulator of the YtvA-dependent light activation of the stress response. A strain with RsbRB as the only RsbR protein is unable to respond to light-activation of σ(B). Furthermore, RsbRC and RsbRD can replace RsbRA's function only in the absence of RsbRB. This differentiation of function is confined to light stress, since strains with RsbRA or RsbRB as the only RsbR protein behave similarly in our experimental conditions in response to physicochemical stresses. Interestingly, RsbRB's absence is sufficient to result in light activation of the general stress response at wild-type expression levels of ytvA, while it was previously reported that YtvA could only activate σ(B) when overproduced, or when cells are supplemented with an additional environmental stress.

Novel OTX2 loss of function variant associated with congenital hypopituitarism without eye abnormalities.

OBJECTIVES: The normal development of the pituitary gland requires multiple induction signals and transcription factors encoded by more than 30 genes, including OTX2. OTX2 mutations have been described with eye abnormalities and variable congenital hypopituitarism, but rarely with hypopituitarism without ocular manifestations. CASE PRESENTATION: We report a girl with hypopituitarism associated with pituitary hypoplasia and pituitary stalk atrophy, without ocular manifestations. NGS revealed a novel heterozygous mutation in OTX2 c.426dupC:p.(Ser143Leufs*2). CONCLUSIONS: Mutations in the transcription factor OTX2 have been associated with ocular, craniofacial, and pituitary development anomalies. Here we describe a novel mutation in OTX2 associated with hypopituitarism without an ocular phenotype.

Patients With Fibromyalgia, Depression, and/or Anxiety and Sex Differences.

Fibromyalgia is a syndrome characterized by chronic widespread pain, with a multifactorial etiopathogenesis and high incidence of neuropsychiatric comorbidity. It has been inaccurately considered a pathological condition affecting only middle-aged women. The study aimed to explore the association of sociodemographic and clinical factors in patients with fibromyalgia with depression and/or anxiety. The present study is an analysis of a cross-sectional study of a secondary source. The prevalence ratio (PR) between the demographic and clinical variables of patients with fibromyalgia and concomitant depression and/or anxiety was calculated. Overall, 1,106 medical records were obtained with a confirmed diagnosis of fibromyalgia between 2010 and 2016; of these, 318 (28.75%) patients had an associated diagnosis of depression and/or anxiety. Approximately 28% women (295 of 1,052) and 42.6% men (23 of 54) suffered from depression and/or anxiety. In the adjusted explanatory model of depression and/or anxiety in patients with fibromyalgia, the relationship between sex (female PR = 0.5 [0.28-0.86]) and low socioeconomic strata (PR = 0.53 [0.33-0.70]) remained constant. In the study population, patients with fibromyalgia belonging to lower social strata were less likely to present with depression and anxiety. The male sex may pose as a risk factor for depression and/or anxiety in patients with fibromyalgia. Fibromyalgia has a huge impact on men's physical as well as mental health.

Ocular trauma by kinetic impact projectiles during civil unrest in Chile.

BACKGROUND: The use of kinetic impact projectiles (KIPs) for crowd-control has increased worldwide. Despite having been created as non-lethal weapons, significant damage to several organs, including the eye, has been reported. In this study, we investigated cases of ocular trauma from KIPs during the civil unrest in Chile. To our knowledge, this is the largest case series recorded in international literature. METHODS: We included all patients who sought care or were referred to the Eye Trauma Unit, a national referral centre in Santiago, Chile, during the civil unrest from October 18 to November 30, 2019. We reviewed paper medical records and extracted data on suspected cause of trauma, type of trauma, visual acuity and sociodemographic data. RESULTS: We included 259 patients, out of which in 182 cases (70.5%) KIPs were the suspected cause. Cases by KIPs were predominantly male (86.6%), young (median age 26.3, interquartile range 22.0-31.4) and living in the Metropolitan Region. Eighty-nine patients (48.9%) had severe visual impairment or were blind at the first examination. The trauma was an open-globe injury in 20.3% of cases and 13 cases required evisceration of the ocular content. Compared to other causes of ocular trauma, KIPs were related to a more severe loss of visual acuity and a higher frequency of open-globe injuries. CONCLUSIONS: The use of KIPs during a period of civil unrest in Chile resulted in severe ocular trauma, visual impairment and permanent disability. KIPs should be avoided as a method of crowd-control.

Update of the Mexican College of Rheumatology Guidelines for the Pharmacological Treatment of Rheumatoid Arthritis, 2018. / Actualización de las guías del tratamiento farmacológico de la artritis reumatoide del Colegio Mexicano de Reumatología 2018.

Therapeutic advances in rheumatoid arthritis require periodic review of treatment guidelines. OBJECTIVE: To update the Mexican College of Rheumatology guidelines on the pharmacological treatment of rheumatoid arthritis. METHOD: Board certified rheumatologists from different health institutions and regions of the country participated. Work teams were formed that reviewed the previous guidelines, elaborated new questions, reviewed the literature, and scored the evidence that was presented and discussed in plenary session. The conclusions were presented to infectologists, gynaecologists and patients. Recommendations were based on levels of evidence according to GRADE methodology. RESULTS: Updated recommendations on the use of available medications for rheumatoid arthritis treatment in Mexico up to 2017 are presented. The importance of adequate and sustained control of the disease is emphasized and relevant safety aspects are described. Bioethical conflicts are included, and government action is invited to strengthen correct treatment of the disease. CONCLUSIONS: The updated recommendations of the Mexican College of Rheumatology on the pharmacological treatment of rheumatoid arthritis incorporate the best available information to be used in the Mexican health care system.

Red light activates the sigmaB-mediated general stress response of Bacillus subtilis via the energy branch of the upstream signaling cascade.

The sigma(B)-dependent general stress response in the common soil bacterium Bacillus subtilis can be elicited by a range of stress factors, such as starvation or an ethanol, salt, or heat shock, via a complex upstream signaling cascade. Additionally, sigma(B) can be activated by blue light via the phototropin homologue YtvA, a component of the environmental branch of the signaling cascade. Here we use a reporter-gene fusion to show that sigma(B) can also be activated by red light via the energy branch of its upstream signaling cascade. Deletion mutagenesis and homologous overproduction experiments indicate that the RsbP protein (composed of an N-terminal Per-ARNT-Sim [PAS] domain and a C-terminal PP2C-type phosphatase domain) is involved in the red light response. This second light input pathway functions complementarily to YtvA; it shows broader spectral sensitivity but requires higher light intensities. These results are confirmed by transcriptome analyses, which show that both light effects result in upregulation of the sigma(B) regulon, with minimal activation of other responses.

In vivo mutational analysis of YtvA from Bacillus subtilis: mechanism of light activation of the general stress response.

The general stress response of Bacillus subtilis can be activated by stimuli such as the addition of salt or ethanol and with blue light. In the latter response, YtvA activates sigma(B) through a cascade of Rsb proteins, organized in stressosomes. YtvA is composed of an N-terminal LOV (light, oxygen, and voltage) domain and a C-terminal STAS (sulfate transporter and anti-sigma factor) domain and shows light-modulated GTP binding in vitro. Here, we examine the mechanism of YtvA-mediated activation of sigma(B) in vivo with site-directed mutagenesis. Constitutive off and constitutive on mutations have been identified. Disruption of GTP binding in the STAS domain eliminates light activation of sigma(B). In contrast, modification of sites relevant for phosphorylation of STAS domains does not affect the stress response significantly. The data obtained are integrated into a model for the structure of full-length YtvA, which presumably functions as a dimer.