Biodiesel production as a solution to waste cooking oil (WCO) disposal. Will any type of WCO do for a transesterification process? A quality assessment.

Biodiesel production can be the solution to the problem of how to deal with waste cooking oils (WCO) and the associated problem of environmental contamination. Every year, tonnes of WCO are poured into toilets and drains, contaminating water supplies and creating serious problems in waste water treatment plants. WCO is a waste material that can be used to produce biodiesel. The main aim of this study is to determine how the type of WCO (and how much it has been used) affect the quality of the biodiesel obtained. Four types of WCO (sunflower, maize, olive and a blend of soybean, palm and sunflower) with two different levels of degradation were used to produce biodiesel. The WCO were subjected to a transesterification process, using NaOH and methanol as reagents, reaction temperatures of between 50 and 67.5 °C, a 60 min reaction time and magnetic stirring. The quality of the biodiesel that was obtained was measured on the basis of four parameters as set out in the UNE-EN 14214 standard: density at 15 °C, kinematic viscosity at 40 °C, acid number and iodine value. This characterisation forms part of the second aim of this research, namely to determine which types of WCO can produce a quality biodiesel via a single stage transesterification process. The results show that the biodiesel quality is closely related to that of the WCO, and that the transesterification method can be recommended for WCO with densities (at 15 °C) of up to 930 kg/m3, kinematic viscosity (at 40 °C) of up to 38.46 mm2/s, and acid numbers of up to 4.19 mg KOH/g. The production method used is a simple, economic and effective way of adding value to a hazardous and difficult to manage waste material like WCO.

Like noodles in a soup: Anthropogenic microfibers are being ingested by juvenile fish in nursery grounds of the Southwestern Atlantic Ocean.

The balance between marine health and ecosystem sustainability confronts a pressing threat from anthropogenic pollution. Estuaries are particularly susceptible to contamination, notably by anthropogenic microfibers originated from daily human activities in land and in fishing practices. This study examines the impact of anthropogenic microfibers on the whitemouth croaker in an estuarine environment of the Southwestern Atlantic Ocean during cold and warm seasons. The presence of anthropogenic microfibers was revealed in 64 % of juvenile gastrointestinal tracts, and 94 % of water samples, and concentrations were influenced by factors such as temperature, bay zone, and fish body length. Blue and black anthropogenic microfibers, with a rather new physical aspect, were dominant. This study highlights the impact of microfibers in a heavily anthropized body of water, subject to federal and local regulations due to the presence of commercially significant fish species inhabiting this area.

Case report: Microsatellite instability determination is not always black and white in Lynch syndrome diagnosis.

Introduction: Microsatellite instability (MSI) is a genetic marker that is useful in the detection and treatment of Lynch syndrome (Sd). Although conventional techniques such as immunohistochemistry (IHC) and polymerase chain reaction (PCR) are the standards for MSI detection, the advent of next-generation sequencing (NGS) has offered new possibilities, especially with circulating DNA. Case report: We present the case of a 26-year-old patient with Lynch Sd and a BRAF-mutated metastatic colon cancer. The discordant MSI results between the conventional methods and NGS posed challenges in making treatment decisions. Subsequent NGS analysis revealed a high MSI status, leading to participation in an immunotherapy trial, with remarkable clinical response. Conclusion: This case emphasizes the importance of comprehensive molecular profiling and strong interdisciplinary collaborations, especially in cases with ambiguous MSI results.

Impact of Clonal Hematopoiesis-Associated Mutations in Phase I Patients Treated for Solid Tumors: An Analysis of the STING Trial.

PURPOSE: With liquid biopsy's widespread adoption in oncology, an increased number of clonal hematopoiesis-associated mutations (CHm) have been identified in patients with solid tumors. However, its impact on patient outcomes remains unclear. This study aimed to analyze and describe CHm in a cohort of phase I patients. METHODS: Retrospective data collection from medical records and molecular profiles (Foundation One Liquid CDx Assay) was performed before first study drug administration at the Drug Development Department of Gustave Roussy (France) within the STING trial (ClinicalTrials.gov identifier: NCT04932525). CHm prevalence was assessed using any and ≥1% variant allele frequency (VAF) in epigenetic modifier genes (DNMT3A, TET2, and ASXL1). RESULTS: From January 2021 to December 2022, 255 patients were enrolled in a phase I clinical trial. A total of 55% were male, with a median age of 62 years (24-86). Principal tumor locations were GI (27%) and genitourinary (21%). Overall, 104 patients (41%) had at least one CHm in liquid biopsy, with 55 patients (22%) having a VAF of ≥ 1%. The most frequent mutation was DNMT3A 73% at any VAF (n = 76) and 22% at 1% VAF (n = 23). Median progression-free survival (PFS) and overall survival were 3.8 months (m) for the CHm group versus 3.2 m for nonclonal hematopoiesis (CH; P = .08) and 18.26 m CHm versus 15.8 m non-CH (P = .9), respectively. PFS increased in the CHm population treated with targeted therapy (hazard ratio, 0.6 [95% CI, 0.42 to 0.84]; P = .004). CONCLUSION: CHm was commonly found in patients with solid tumors treated in phase I trials, with a prevalence of 41% in our cohort. The most frequently mutated gene was DNMT3A. The presence of CHm had no impact on the population of patients treated in the phase I trials.

Immunosenescence, inflammaging, and cancer immunotherapy efficacy.

INTRODUCTION: Immunosenescence is a progressive remodeling of immune functions associated with a decreased ability of the immune system to set up an efficient immune response, both innate and adaptive, with an increase of highly differentiated T cells at the expense of naive T cells. The incidence and prevalence of most cancers increase with age, which can partly be explained by tumor escape mechanisms and decreased immunosurveillance. Aging is also associated with inflammaging, a low-grade proinflammatory state characterized by an increase in inflammatory mediators. Anti-cancer immunotherapy has profoundly changed the landscape of oncology therapy in the last 10 years. Modern T-cell targeted therapies such as bispecific T cell engagers, CAR-T cells, or immune checkpoint blockers may be theoretically affected by immunosenescence or inflammaging. AREAS COVERED: A bibliographic review through PubMed and Embase was carried out using the following search terms: 'immunosenescence,' 'immunotherapy,' 'inflammaging,' 'bispecific antibodies,' 'CAR-T cells,' 'immune checkpoint blockers,' and 'older patients.' EXPERT OPINION: This review explores the potential impact of immunosenescence and inflammaging on anti-cancer immunotherapy and therapeutic strategies that could counter immune senescence. A more dedicated research on immunosenescence biomarkers in future clinical trials is warranted for the development of new, more effective and safer therapies.

High-dose versus standard-dose amoxicillin/clavulanate for clinically-diagnosed acute bacterial sinusitis: A randomized clinical trial.

BACKGROUND: The recommended treatment for acute bacterial sinusitis in adults, amoxicillin with clavulanate, provides only modest benefit. OBJECTIVE: To see if a higher dose of amoxicillin will lead to more rapid improvement. DESIGN, SETTING, AND PARTICIPANTS: Double-blind randomized trial in which, from November 2014 through February 2017, we enrolled 315 adult outpatients diagnosed with acute sinusitis in accordance with Infectious Disease Society of America guidelines. INTERVENTIONS: Standard-dose (SD) immediate-release (IR) amoxicillin/clavulanate 875 /125 mg (n = 159) vs. high-dose (HD) (n = 156). The original HD formulation, 2000 mg of extended-release (ER) amoxicillin with 125 mg of IR clavulanate twice a day, became unavailable half way through the study. The IRB then approved a revised protocol after patient 180 to provide 1750 mg of IR amoxicillin twice a day in the HD formulation and to compare Time Period 1 (ER) with Time Period 2 (IR). MAIN MEASURE: The primary outcome was the percentage in each group reporting a major improvement-defined as a global assessment of sinusitis symptoms as "a lot better" or "no symptoms"-after 3 days of treatment. KEY RESULTS: Major improvement after 3 days was reported during Period 1 by 38.8% of ER HD versus 37.9% of SD patients (P = 0.91) and during Period 2 by 52.4% of IR HD versus 34.4% of SD patients, an effect size of 18% (95% CI 0.75 to 35%, P = 0.04). No significant differences in efficacy were seen at Day 10. The major side effect, severe diarrhea at Day 3, was reported during Period 1 by 7.4% of HD and 5.7% of SD patients (P = 0.66) and during Period 2 by 15.8% of HD and 4.8% of SD patients (P = 0.048). CONCLUSIONS: Adults with clinically diagnosed acute bacterial sinusitis were more likely to improve rapidly when treated with IR HD than with SD but not when treated with ER HD. They were also more likely to suffer severe diarrhea. Further study is needed to confirm these findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02340000.

Relación entre la deficiencia de vitamina D con el estado nutricional y otros factores en adultos de la región interandina del Ecuador / Relationship Between Vitamin D Deficiency with Nutritional Status and Other Factors in Adults from the Inter-Andean Region of Ecuador

Resumen Antecedentes: la deficiencia de vitamina D es un problema de salud pública asociado con diversas enfermedades en población adulta que podría estar relacionado con la actividad laboral. Objetivo: relacionar la deficiencia de vitamina D con el estado nutricional, la composición corporal y factores sociodemográficos en trabajadores de Quito, Ecuador. Materiales y métodos: estudio transversal en 245 trabajadores. Se evaluó vitamina D sérica por inmunofluorescencia, estado nutricional por Índice de Masa Corporal, composición corporal por bioimpedancia y otros factores sociodemo gráficos. Se usó regresión logística para identificar asociaciones entre deficiencia de vitamina D y variables de interés. Resultados: el 76 % de la población presentó deficiencia de vitamina D. El riesgo cardiovascular por circunferencia abdominal, edad y sexo estaban asociados con deficiencia de vitamina D. Por cada centímetro de incremento en la circunferencia abdominal, la prevalencia de deficiencia de vitamina D incrementaba 4,4 % (OR = 1,044 IC95 %:1,001-1,008; p = 0,043). Por cada año de edad de incremento, la prevalencia disminuía 4,1 % (OR = 0,96; IC95 %:0,93-0,99; p = 0,030). Las mujeres mostraron 2,33 veces más deficiencia de vitamina D en comparación con los hombres (OR = 2,33 IC95 %:1,28-6,94 p = 0,011). Conclusión: la deficiencia de vitamina D es alta en los traba jadores de la ciudad de Quito. Aparentemente, mujeres jóvenes con una circunferencia abdominal alta tienen mayor probabilidad de presentar esta deficiencia. El exceso de peso podría estar reduciendo la actividad física al aire libre, lo que disminuye a su vez la exposición a la luz solar y esto deriva en deficiencia de vitamina D.

Abstract: Background: Vitamin D Deficiency is a public health problem associated with various diseases in the adult population that could be related to work activity. Objective: To relate vitamin D deficiency with nutritional status, body composition, and sociodemographic factors in workers from Quito, Ecuador. Material and Methods: A cross-sectional study in 245 workers. Serum vitamin D was evaluated by immunofluorescence, nutritional status by Body Mass Index, body composition by bioimpedance, and other sociodemographic factors were also evaluated. The associations between vitamin D deficiency and variables of interest were examined by logistic regression. Results: Vitamin D deficiency was presented in 76% of the participants. Cardiovascular risk by abdominal circumference, age, and sex were associ ated with vitamin D deficiency. For each centimeter increase in abdominal circumference, the prevalence of vitamin D deficiency increased 4.4% (OR = 1.044 CI95%:1.001-1.008; p = 0.043). For each year of age increase, the prevalence decreased 4.1% (OR = 0.96; 95%CI:0.93-0.99; p = 0.030). Women showed 2.33 times more vitamin D deficiency than men (OR = 2.33 CI95%:1.28-6.94 p = 0.011). Conclusion: Vitamin D deficiency is high in workers in the city of Quito. Apparently, young female with a high abdominal circumference appear to be more likely to be this deficient. Excess weight likely influences outdoor physical activity, which in turn decreases exposure to sunlight and leads to vitamin D deficiency.

Relationship between dietary calcium intake and adiposity in female adolescents.

BACKGROUND AND OBJECTIVE: The prevalence and magnitude of obesity in children and adolescents increase rapidly. Besides genetic and environmental factors, calcium intake has recently been identified as a dietary factor that is inversely related with body mass index and development of overweight and obesity. The purpose of this study was to assess the correlation between dietary calcium intake and body mass index and fat distribution in female adolescents. MATERIALS AND METHODS: This was a cross-sectional study where anthropometric variables (weight, height, body mass index, waist and hip circumference) were collected in 244 female adolescents to establish total body adiposity and fat distribution. A 24-hour recall and a food frequency questionnaire were used to assess total calorie, calcium, and dairy products intake. RESULTS: Calcium intake was inversely related to body mass index (P<.05), waist circumference(P<.05), hip circumference (P>.05), and waist to hip ratio (P<.05).Overweight (8.3%) and obese (0.7%) adolescents had a lower mean calcium intake than adolescents of normal weight (P=.06). CONCLUSIONS: Dietary calcium intake and, to a lesser extent, consumption of dairy products are inversely related to total and abdominal adiposity, and also to the prevalence of overweight in this group of adolescents.

Impact of a Meditation Program on Pulse-Wave Velocity, C-reactive Protein and Quality of life / Impacto de un programa de meditación sobre la velocidad de onda de pulso, la proteína C-reactiva y la calidad de vida

background: Although various studies refer to the effect of meditation on blood pressure (BP), its impact on other cardiovascular clinical variables is unknown. Objective: The aim of this study was to evaluate the effects of a meditation program on pulse wave velocity (PWV), quality of life and ultrasensitive C-reactive protein (us-CRP) in patients with ischemic heart disease or chronic heart failure. Methods: This was a randomized study with two groups of patients: a meditation group (M) and an active control group (AC) with cardiovascular health education, evaluating the difference between initial and final values at 12 weeks of B P, PWV, quality of life (assessed by the SF-36 questionnaire) and us-CRP. results: Thirty-five patients were included in the M group and 35 in the AC group; mean age was 61 years and 80% were men. Both groups had similar baseline characteristics, except for higher number of smokers and triglyceride levels in the M group. At 12 weeks, no significant differences were found for ∆PWV: +0.51 (±1.40) in AC and +0.19 (±1.53) in M (p=0.37). Conversely, ∆SF-36 was +0.79 (±7.58) in AC vs. +5.40 (±9.69) (p=0.03) in M, and ∆us-PCR was +1.17 (±2.9) in AC vs. -0.69 (±0.89) in M (p=0.02). Conclusions: A meditation program did not significantly modify PWV at 12 weeks. However, patients allocated to this intervention improved their quality of life and us-PCR was significantly reduced. Larger studies are required to confirm these findings and explore the mechanisms involved in this improvement.

Asterion: frontera anatómica en los abordajes supra e infra tentoriales / Asterion: anatomical landmark in posterior fossa approaches

Resultados: la distancia entre el asterion y los puntos seleccionados (inion, CAE, mastoides) se mantiene dentro de rangos acotados. En la distancia Asterion-CAE se aprecia la menor variación en los valores medidos, mientras que en la distancia Asterion - Inion se objetiva la mayor variación entre los ejemplares estudiados. Por lo tanto, las distancias Asterion - CAE y Asterion- mastoides serian las mas seguras y confiables para la determinación de una referencia en la ubicación del asterion, sin que se halle expuesta la superficie ósea y guiándonos solo con puntos palpables.Conclusión: Hemos encontrado una fuerte correlación entre la posición del asterion y del seno transverso, por lo tanto, los orificios de trépano deberían situarse alejados de este punto craneométrico. A la vez, hemos observado que las distancias entre el asterion y los puntos seleccionados (inion, CAE, mastoides) se mantienen dentro de rangos acotados, lo cual permite su utilización en la práctica clínico- quirúrgica para la localización del asterion sin exponer la superficie ósea.

Results: the distance between selected points (inion, EAC, mastoid) and asterion remains within bounded ranges. The EAC-Asterion distance shows the least variation at the measured values while distance between Asterion-Inion manifest the greatest variation at the studied specimens. Therefore, the distances Asterion-EAC and Asterion-mastoid would be the most secures and reliables to locate the Asterion, without bone surface exposure and guided only by tangible points. Conclusion: We found a strong correlation between the position of the asterion and the transverse sinus, therefore, drill holes should be located far away from this point. Also we observed that the distances between asterion and selected points (inion, EAC, mastoid) remains within bounded ranges, allowing their use in clinical-surgical practice for asterion

Factores de riesgo reproductivo asociados al cáncer mamario, en mujeres colombianas / Reproductive risk factors associated with breast cancer in Columbian women

Introducción El cáncer de mama desde 1992 ha sido la segunda causa de muerte femenina en Colombia (tasa promedio anual de 4,5*100.000 hab.) y se reporta una tendencia ascendente por este tipo de neoplasia, y la información sobre los potenciales factores de riesgo del cáncer de la mama en los países Latinoamericanos es escasa. Los objetivos del trabajo fueron probar la protección ofrecida por la lactancia materna, y establecer los factores reproductivos asociados al cáncer de mama en Colombia. Métodos Se realizó un estudio de casos y controles hospitalarios pareados por edad (+ 2 años) de Julio 1995 a Marzo 1996 en Bogotá. La población de estudio quedó constituída por 171 casos histopatológicamente definidos y 171 controles. La historia reproductiva y sociodemográfica fué recolectada a través de un cuestionario y se utilizó la técnica de regresión logística condicionada para el análisis estadístico de la información. Resultados Se encontraron como factores de riesgo: la nuliparidad , al contrario de las mujeres con paridades mayores de 3 hijos (OR=3,35 IC 1,4 - 8,0), la edad al primer nacimiento (20 años vs. menores de 20. OR= 1,83 IC 0,7 - 4,8), el antecedente familiar de cáncer de mama y la lactancia al primer hijo (OR=0,09 IC 0,01-0,64 de 1-11 meses y OR= 0,01 IC 0,00-0,14 para los 12 meses) y la lactancia acumulada por encima de los 24 meses (p=0,001 prueba de tendencia) como principales factores protectores de la enfermedad. Conclusiones El estudio confirma la importancia de enfocarse en la promoción de la lactancia prolongada y ratifica que el nivel socioeconómico puede determinar los estilos de vida y los eventos reproductivos de las mujeres, explicando el aumento en la mortalidad por cáncer de mama en los países Latinoamericanos, con perfiles de fecundidad y factores de riesgo para el cáncer de mama, similares a los de los países desarrollados

Análisis clínicos y de la función hipofisiaria en pacientes con el síndrome de la silla turca vacía primaria / Analysis of clinical and hypophyseal function in patients with primary empty sella turcica syndrome

Se informan los hallazgos clínicos, hormonales y radiológicos en 22 casos de silla turca vacía primaria (STVP), en pacientes que tenían un promedio de edad de 44,5 años y además predominó en mujeres. El cuadro clínico consistió en cefalea (90,9%), síndrome quiasmático (18%) y fístula del líquido cefalorraquideo en 13,6 por ciento. Todos los pacientes tenían obesidad y prácticamente la mitad (45.4%) padecián hipertensión arterial. El diagnóstico se confirmó mediante una tomografia axial computada de cráneo usando como medio de contraste a la metrizamida. En todos los casos se encontró que la función hipofisaria, evaluada por la concentración de las hormonas circulantes, era normal. La presencia de fístula de líquido cefalorraquideo o de un síndrome quiasmático fueron las indicaciones para realizar cirugía transesfenoidal. Siete pacientes que fueron sometidos a cirugía, seis evolucionaron satisfactoriamente

Enteropatía por radiación, presentación de un caso clínico

Se presenta el caso clínico de una paciente femenina de 56 años, que nunca a estado embarazada y no tiene hijos. Se realizó apendicectomía hace 30 años, amigdalectomía hace 20 años, histerectomía y oforectomía bilateral por Ca. de ovario con quimio y radioterapia adyuvantes hace 3 años. Presentó peritonitis secundaria a perforación intestinal por catéter de Tenkof hace 2 años. Acude al hospital Carlos Andrade Marín porque hace 8 días presenta dolor abdominal generalizado de tipo cólico, sin causa aparente, de moderada intensidad, se acompaña de náusea que llega al vómito de tipo fecaloide. Es hospitalizada en urgencias, y al tercer día se le realiza una laparotomía exploratoria, con el diagnóstico de obstrucción intestinal...