Persistent varices in cured patients: Understanding the role of hepatic venous pressure gradient.

Background & Aims: Etiologic factor removal (ER) drives recompensation and improves portal hypertension in cirrhosis. Esophageal varices (EV) and portosystemic shunts (PSS) have been found in patients despite hepatic venous pressure gradient (HVPG) dropping below 10 mmHg after ER, questioning HVPG accuracy in reflecting true portal pressure in the setting of ER. We aim to evaluate the correlation of HVPG with direct portal pressure (DPP) in patients with persistence of EV after ER despite HVPG <10 mmHg. Methods: This is a bicentric 'proof of concept' study evaluating HVPG and ultrasound-guided percutaneous DPP in patients with HCV or alcohol-related cirrhosis with persistent varices and HVPG <10 mmHg after at least 5 years of ER. Results: Seven patients with HCV and three with alcohol-related cirrhosis with persistent varices and HVPG <10 mmHg after at least 5 years of ER were included. At evaluation, all patients had a patent portal vein and were compensated. The median platelet count was 129.5 (IQR 95-145) × 109/ml, and the median liver stiffness measurement was 16.15 (IQR 14.4-22.3) kPa. In five patients, EV remained the same size (two large and three small), and five downsized to small after ER. Wedge hepatic vein pressure (median 19 [IQR 16.5-20] mmHg) and portal pressure (median 18 [IQR 15-19.5] mmHg) had an excellent correlation (R = 0.93, p <0.0001). Portal pressure gradient (PPG) confirmed the absence of clinically significant portal hypertension as identified by HVPG across all the patients. Conclusions: HVPG accurately reflects PPG in the context of HCV and alcohol-related cirrhosis regression. After ER, EV may persist despite HVPG <10 mmHg. The benefit of prophylaxis in patients with EV and HVPG <10 mmHg is unknown. Future studies with clinical endpoints are needed to validate our findings. Impact and implications: Despite a favorable evolution after the removal of the etiologic factor, varices persist in some patients, and there is a lack of concise guidelines for the evaluation and management of portal hypertension in this population. Our research underscores the persistence of varices in the absence of clinically significant portal hypertension and significantly demonstrates the accuracy of hepatic venous pressure gradient (HVPG) in reflecting portal vein pressure in this specific patient group. These findings emphasize the crucial role of HVPG in the assessment of portal hypertension after etiologic factor removal and lay the groundwork for further investigation into clinical outcomes and the necessity of non-selective beta-blockers in individuals with persistent varices after the removal of etiologic factor.

Transjugular Intrahepatic Portosystemic Shunt (TIPS) for Treatment of Bleeding from Cardiofundal and Ectopic Varices in Cirrhosis.

Acute variceal bleeding in cirrhosis represents a critical clinical event that significantly impacts patient prognosis, with mortality rates increasing further after a second episode. This underscores the need for immediate intervention and optimal prophylaxis. The creation of a transjugular intrahepatic portosystemic shunt (TIPS) has been proven to be highly effective for managing esophageal variceal bleeding. However, the use of TIPS for managing cardiofundal gastric varices and ectopic varices remains debated due to their unique vascular anatomy and the limited data available. These varices, although less prevalent than esophageal varices, are complex and heterogeneous vascular shunts between the splanchnic venous system and the systemic veins. Indeed, while endoscopic therapy with tissue adhesives is widely endorsed for achieving hemostasis in active hemorrhage, there is no consensus regarding the optimal approach for secondary prophylaxis. Recent research emphasizes the efficacy of endovascular techniques over endoscopic treatments, such as TIPS and endovascular variceal embolization techniques. This review examines the use of TIPS in managing acute variceal bleeding in patients with cirrhosis, focusing specifically on cardiofundal gastric varices and ectopic varices, discussing optimal patient care based on the latest evidence, aiming to improve outcomes for this challenging subset of patients.

Evaluation of the impact of an online video game as an educational intervention on sexual health and the prevention, diagnosis, and treatment of sexually transmitted infection: A randomized controlled trial protocol.

BACKGROUND: The incidence of sexually transmitted infections (STIs) is increasing, especially among young people. Tools are needed to increase knowledge about sex education and STI prevention and treatment. Gamification can be a good training tool for both young people and health professionals. The primary objective of this study is to assess the impact of a training intervention on STI prevention, detection, and treatment in primary care professionals. METHODS/DESIGN: Multicentre cluster randomized controlled trial. Groups of primary care professionals will receive an intervention (online video game on sex education and STIs [SEXIT]) and will be compared with control groups that will not receive the intervention. Group assignments will be randomized by clusters. The study will consist of a pre-post evaluation of the intervention: a knowledge test will be administered before and after the intervention and 3 months after the intervention. This test will also be carried out on the same time sequence in the control groups. The impact of the training intervention will be assessed over a 6-month period, focusing on various variables associated with the clinical management of STIs. This evaluation entails the clinical records of diagnostic tests and antibiotic prescriptions related to the clinical approach to STIs. The required sample size is 262 (131 per group). DISCUSSION: Compared with those in the control group, improvements in knowledge and clinical behavioural outcomes after the intervention are expected for participants in the intervention groups. We plan to develop an educational video game to increase the knowledge about sexuality, STIs and violence. Protocol registered at ISRCTN with reference number ISRCTN17783607.

Adenoma detection rate and tolerability of 2 ultra-low-volume bowel preparations in screening: a noninferiority randomized controlled trial.

BACKGROUND AND AIMS: The adenoma detection rate (ADR), recognized as a surrogate marker for colorectal cancer (CRC) incidence and mortality reduction, is closely linked to the efficacy of bowel cleansing. However, there is a dearth of evidence examining the impact on ADR when using 2 distinct very-low-dose bowel cleansing products. This study sought to compare ADR in an immunochemical fecal occult blood test (iFOBT)-based organized screening program by using 1 L of polyethylene glycol plus ascorbate (1L-PEGA) versus sodium picosulfate with magnesium citrate (SPMC), both administered in a split-dose regimen. METHODS: We conducted a comparative, parallel, randomized, noninferiority, and low-intervention clinical trial targeting individuals from a population CRC screening program aged 50 to 69 years with a positive iFOBT result scheduled for a workup colonoscopy in the morning. Participants were randomized to either 1L-PEGA or SPMC for bowel cleansing. The main outcome was ADR, whereas secondary outcomes were bowel preparation quality, safety, tolerability, and satisfaction. RESULTS: A total of 1002 subjects, 501 were included in each group. There were no differences between groups with respect to pooled ADR (SPMC, 56.5% [95% CI, 52.1-60.8]; 1L-PEGA, 53.7% [95% CI, 49.3-58.0]; relative risk, .95 [95% CI, .85-1.06]); therefore, SPMC demonstrated noninferiority in ADR compared with 1L-PEGA (difference, 2.8%; 2-sided 95% lower confidence limit, -3.4). In addition, there were no significant differences in mean lesions regardless of size and location between arms. Bowel preparation favored 1L-PEGA (96.2% vs 89.2%, P < .001), whereas SPMC exhibited significantly higher safety and tolerability, as shown by fewer nonserious treatment-emergent adverse events. CONCLUSIONS: SPMC emerged as a noninferior laxative compared with 1L-PEGA concerning ADR. Despite the superior bowel preparation quality associated with 1L-PEGA, the safety, tolerability, and overall satisfaction of participants were higher with SPMC. (Clinical trial registration number: EudraCT: 2019-003186-18.).

Origen y evolución de una vía aérea permeable / The origin and evolution of a permeable airway

Resumen: A través de los siglos hemos descubierto la importancia de mantener permeable y segura la vía aérea. Desde Hipócrates en la antigua Grecia, hasta el siglo XX en oriente y occidente, se ha continuado con el desarrollo de herramientas que faciliten esta cotidiana tarea por lo que, con esta revisión sistemática, se establecieron como objetivos exponer el origen y los antecedentes del tubo endotraqueal, cánula orofaríngea y laringoscopio, así como discutir su utilidad en la práctica anestésica-quirúrgica, a través del tiempo hasta hoy en día.

Abstract: Over the centuries, we have discovered the importance of preserving a safe permeable airway. From Hippocrates in ancient Greece to the 20th century in the East and West, the development of multiple tools that enable this task continues through time, which is why with this systematic review we aim to uncover the origin and historical background of the endotracheal tube, the oropharyngeal cannula and the laryngoscope, discussing their effectiveness in the anesthetic-surgical practice over years to the present day.

Estrés, ansiedad y depresión en estudiantes de obstetricia de una universidad pública durante la pandemia por la COVID-19

Introducción: La pandemia por la COVID-19 ha generado repercusiones importantes en los estudiantes de educación superior. Su impacto ha permitido el desarrollo de afecciones en el aspecto académico y de salud, especialmente en la salud mental. Objetivo: Identificar el nivel de estrés, ansiedad y depresión durante la pandemia por la COVID-19 en los estudiantes de obstetricia de una universidad pública. Métodos: Estudio descriptivo y transversal, que se realizó en una muestra de 212 estudiantes de obstetricia quienes se seleccionaron de forma no probabilística. Se aplicaron 3 instrumentos: la escala de percepción global de estrés (EPGE), la escala de medición del desorden de ansiedad generalizada (GAD-7) y el cuestionario de salud del paciente (PHQ-9), todos con elevada confiabilidad. Se estimaron frecuencias absolutas y relativas. Resultados: La mayor proporción de los estudiantes era de sexo femenino (95,8 %) y tenía entre 21 y 25 años (66 %). Además, el 37,2 % se encontraba en cuarto año de la carrera y 6,1 % vivía solo. El eustrés moderado (85,8 %) y el alto distrés (66 %) se presentaron con mayor frecuencia. El 18,9 % tuvo un nivel grave de ansiedad, la preocupación (81,1 %) y la incapacidad para relajarse (80,7 %) fueron los síntomas más frecuentes. El 31,1 % y 11,8 % tuvo depresión leve y grave, respectivamente. Conclusión: Durante la pandemia por la COVID-19 la mayor parte de los estudiantes de obstetricia presentan niveles altos de estrés, depresión leve y ansiedad grave.

Introduction: The COVID-19 pandemic has generated significant repercussions in higher education students. Its impact has led to the development of academic and health conditions, especially in mental health. Objective: To identify the level of stress, anxiety and depression during the COVID-19 pandemic in midwifery students of a public university. Methods: Descriptive and cross-sectional study, which was carried out in a sample of 212 midwifery students who were selected in a non-probabilistic way. Three instruments were applied: the global perception of stress scale (EPGE), the generalized anxiety disorder measurement scale (GAD-7) and the patient health questionnaire (PHQ-9), all with high reliability. Absolute and relative frequencies were estimated. Results: The highest proportion of the students was female (95,8 %) and aged between 21 and 25 years (66%). In addition, 37,2% were in their fourth year and 6,1% lived alone. Moderate eustress (85,8%) and high distress (66%) occurred more frequently. 18,9% had a severe level of anxiety and worry (81,1%), and inability to relax (80,7%) were the most frequent symptoms. 31,1% and 11,8% had mild and severe depression, respectively. Conclusion: During the COVID-19 pandemic, most of the midwifery students present high levels of stress, mild depression and severe anxiety.

Microplastics transport in a low-inflow estuary at the entrance of the Gulf of California.

Microplastics (MPs) are recognized as a global emergent pollution impact, which can affect all food chains. Estimating MPs transport pathways in coastal ecosystems is needed to assess their likely effects. Here, we studied MPs accumulation and transport pathways in the Estero de Urias lagoon system (low-inflow estuary) using field data and a 3D particle model. Field results showed that the MPs present similar abundances throughout the study area during the dry and rainy seasons. Model simulations indicated that i) morphology and tidal currents caused the MPs discharged in the lagoon to remain inside, and ii) wind-induced currents caused the MPs in the coastal area to be transported to the southwest. These transport processes may be responsible for homogenizing MPs concentrations through the studied area. In addition, model simulations suggested that EUL-dense waters can export MPs from the coastal area to the sea bottom.

TetraSOD®, a Unique Marine Microalgae Ingredient, Promotes an Antioxidant and Anti-Inflammatory Status in a Metabolic Syndrome-Induced Model in Rats.

Increased oxidative stress has been linked to the pathogenic process of obesity and can trigger inflammation, which is often linked with the risk factors that make up metabolic syndrome (MetS), including obesity, insulin resistance, dyslipidaemia and hypertension. TetraSOD®, a natural marine vegan ingredient derived from the microalgae Tetraselmis chuii that is high in the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) has recently demonstrated in vitro increased activity of these key antioxidant enzymes. In the present study, the potential bioactive effects of three dietary dosages of TetraSOD® in enhancing antioxidant and anti-inflammatory mechanisms to combat the metabolic disturbances that compose MetS were assessed in rats given a cafeteria (CAF) diet. Chronic supplementation with 0.17, 1.7, and 17 mg kg-1 day-1 of TetraSOD® for 8 weeks ameliorated the abnormalities associated with MetS, including oxidative stress and inflammation, promoting endogenous antioxidant defence mechanisms in the liver (GPx and GSH), modulating oxidative stress and inflammatory markers in plasma (NOx, oxLDL and IL-10), and regulating genes involved in antioxidant, anti-inflammatory and immunomodulatory pathways in the liver, mesenteric white adipose tissue (MWAT), thymus, and spleen. Overall, TetraSOD® appears to be a potential therapeutic option for the management of MetS.

Metabolic pathways for biosynthesis and degradation of starch in Tetraselmis chui during nitrogen deprivation and recovery.

Tetraselmis chui is known to accumulate starch when subjected to stress. This phenomenon is widely studied for the purpose of industrial production and process development. Yet, knowledge about the metabolic pathways involved is still immature. Hence, in this study, transcription of 27 starch-related genes was monitored under nitrogen deprivation and resupply in 25 L tubular photobioreactors. T. chui proved to be an efficient starch producer under nitrogen deprivation, accumulating starch up to 56% of relative biomass content. The prolonged absence of nitrogen led to an overall down-regulation of the tested genes, in most instances maintained even after nitrogen replenishment when starch was actively degraded. These gene expression patterns suggest post-transcriptional regulatory mechanisms play a key role in T. chui under nutrient stress. Finally, the high productivity combined with an efficient recovery after nitrogen restitution makes this species a suitable candidate for industrial production of high-starch biomass.

Relación morfológica entre el hueso hioides y la mandíbula en una muestra de esqueletos estudiados / Morphological relationship between the hyoid bone and the mandible in a sample of skeletons studied

Introducción: El crecimiento de los tejidos esqueléticos constituye una respuesta secundaria, compensatoria y mecánicamente obligada a cambiar las matrices funcionales. Cuando por alguna razón las matrices funcionales se ven afectadas en su crecimiento, los tejidos esqueléticos responden también con un grado de afectación dependiendo del momento en que esta se produzca. Entonces la mandíbula como parte del viscerocráneo debe presentar esa relación con el hueso hioides de forma directa. Objetivos: Asociar el comportamiento morfológico del hueso hioides con variables morfológicas de la mandíbula y verificar sí la morfología de los huesos pertenecientes a los esqueletos estudiados está determinada por el conjunto de tejidos blandos que los rodea y marcan el ritmo del proceso de remodelación de crecimiento. Material y Métodos: Se realizó la continuación del estudio osteológico en una muestra ósea de 82 esqueletos con mediciones morfométricas del hueso hioides y la mandíbula. Para evaluar la relación de la morfología del hueso hioides con respecto a la mandíbula, se utilizaron matrices de coeficiente de correlación lineal de Pearson en SPSS versión 22 de Window. Resultados: Se corrobora la relación de la morfología del hueso hioides con el crecimiento del viscerocráneo, debido a la correlación positiva y significativa entre varias variables morfológicas del hioides que se obtuvo, -tanto a nivel de su cuerpo como sus astas o cuernos mayores-, con la mandíbula. Conclusiones: Existe una asociación de la morfología del hueso hioides con respecto a la morfología de la mandíbula(AU)

Introduction: The growth of skeletal tissues constitutes a secondary, compensatory and mechanically obliged response to change the functional matrixes. When the growth of functional matrixes is affected for any reason, the skeletal tissues also respond with a degree of affectation depending on the moment in which it occurs. Then the mandible, as part of the viscerocranium, must present that relationship with the hyoid bone directly. Objective: To associate the morphological behavior of the hyoid bone with the morphological variables of the mandible and verify if the morphology of the bones belonging to the skeletons studied is determined by the set of soft tissues that surround them and set the pace of the growth remodeling process. Material and Methods: The continuation of the osteological study was carried out in a bone sample of 82 skulls by performing morphometric measurements of the hyoid bone and the mandible. Pearson's linear correlation coefficient matrices in SPSS Version 22 were used to evaluate the relationship between the morphology of the hyoid bone and the bones of the mandible. Results: The relationship between the morphology of the hyoid bone and the growth of the viscerocranium is corroborated by the positive and significant correlation between several morphological variables of the hyoid bone obtained - both at the level of its body and its greater horns -, and the mandible. Conclusions: These findings corroborate the association between the morphology of the hyoid bone and the growth of the mandible(AU)

Relación morfológica entre el hueso hioides y el viscerocráneo en una muestra de esqueletos / Morphologic relationship between the hyoid bone and the viscerocranium in a sample of skeletons

Introducción: El movimiento corporal, obedece y produce actividad del músculo esquelético para lo cual debe existir un equilibrio muscular estático, a partir del cual se genere el desplazamiento de los elementos anatómicos, involucrados en él, ya sea como respuesta a la volición o a la percepción inconsciente al estímulo que lo demande. Objetivo: Asociar el comportamiento morfológico del hioides con ciertas variables morfológicas del viscerocráneo de esqueletos (excepto la mandíbula). Material y Métodos: Se realizó estudio osteológico en una muestra ósea de 82 esqueletos mediante mediciones morfométricas del hueso hioides y huesos del viscerocráneo. Se utilizaron matrices de coeficiente de correlación lineal de Pearson en SPSS 22 para evaluar la relación de la morfología del hioides con respecto a la morfología de los huesos de la cara. Variables morfológicas del viscerocráneo como ancho bicigomático (abc), ancho transversal externo del paladar óseo (pote), ancho sagital externo del paladar óseo (pose) y la altura del tercio medio de la cara (tmed). Resultados: Se obtuvo una gran correlación positiva y significativa de distintas variables morfológicas del hioides, -tanto de su cuerpo como de sus astas o cuernos mayores- con las variables morfológicas del viscerocráneo. Conclusiones: Se corrobora la asociación de la morfología del hueso hioides con el crecimiento de los huesos del viscerocráneo(AU)

Introduction: Body movement obeys and produces activity in the skeletal muscle for which there must be a static muscle equilibrium that produces the movement of the anatomic elements involved in it, either as a result of volition or as the unconscious perception of a stimulus. Objective: To associate the morphological behavior of the hyoid bone with some morphological variables of the viscerocranium of skeletons (except the jaw). Material and Methods: An osteological study was carried out in a bone sample of 82 skulls by performing morphometric measurements of the hyoid bone and the bones of the viscerocranium. Pearson's correlation coefficient and SPSS Version 22 were used to evaluate the relationship between the morphology of the hyoid bone and the facial bones. Morphological variables of the viscerocranium include: bizygomatic width (BW), external transverse width of the hard palate (ETWHP), external sagittal width of the hard palate (ESWHP), and the height of the middle third of the face (MTF). Results: A very strong positive correlation between different morphological variables of the hyoid bone, -both at the level of its antlers or greater horns- and the morphological variables of the viscerocranium was obtained. Conclusions: These findings corroborate the association between the hyoid bone and the growth of facial bones(AU)

Selection and validation of reference genes for quantitative real-time PCR in the green microalgae Tetraselmis chui.

Quantitative real-time reverse transcription PCR (RT-qPCR) is a highly sensitive technique that can be applied to analyze how genes are modulated by culture conditions, but identification of appropriate reference genes for normalization is a critical factor to be considered. For this reason, the expression stability of 18 candidate reference genes was evaluated for the green microalgae Tetraselmis chui using the widely employed algorithms geNorm, NormFinder, BestKeeper, the comparative ΔCT method, and RefFinder. Microalgae samples were collected from large scale outdoor photobioreactors during the growing phase (OUT_GP), and during the semi-continuous phase at different times of the day (OUT_DC). Samples from standard indoor cultures under highly controlled conditions (IND) were also collected to complement the other data. Different rankings for the candidate reference genes were obtained depending on the culture conditions and the algorithm employed. After comparison of the achieved ranks with the different methods, the references genes selected for samples from specific culture conditions were ALD and EFL in OUT_GP, RPL32 and UBCE in OUT_DC, and cdkA and UBCE in IND. Moreover, the genes EFL and cdkA or EFL and UBCE appeared as appropriate combinations for pools generated from all samples (ALL). Examination in the OUT_DC cultures of genes encoding the large and small subunits of ADP-glucose pyrophosphorylase (AGPL and AGPS, respectively) confirmed the reliability of the identified reference genes, RPL32 and UBCE. The present study represents a useful contribution for studies of gene expression in T. chui, and also represents the first step to set-up an RT-qPCR platform for quality control of T. chui biomass production in industrial facilities.

Unravelling the metabolic alterations of liver damage induced by thirdhand smoke.

BACKGROUND: Thirdhand smoke (THS) is the accumulation of tobacco smoke gases and particles that become embedded in materials. Previous studies concluded that THS exposure induces oxidative stress and hepatic steatosis in liver. Despite the knowledge of the increasing danger of THS exposure, the metabolic disorders caused in liver are still not well defined. OBJECTIVES: The aim of this study is to investigate the metabolic disorders caused by THS exposure in liver of male mice and to evaluate the effects of an antioxidant treatment in the exposed mice. METHODS: We investigated liver from three mice groups: non-exposed mice, exposed to THS in conditions that mimic human exposure and THS-exposed treated with antioxidants. Liver samples were analyzed using a multiplatform untargeted metabolomics approach including nuclear magnetic resonance (1H NMR), liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS) and laser desorption/ionization mass spectrometry imaging (MSI), able to map lipids in liver tissues. RESULTS: Our multiplatform approach allowed the annotation of eighty-eight metabolites altered by THS exposure, including amino acids, nucleotides and several types of lipids. The main dysregulated pathways by THS exposure were D-glutamine and D-glutamate metabolism, glycerophospholipid metabolism and oxidative phosphorylation and glutathione metabolism, being the last two related to oxidative stress. THS-exposed mice also presented higher lipid accumulation and decrease of metabolites involved in the phosphocholine synthesis, as well as choline deficiency, which is related to Non-Alcoholic Fatty Liver Disease and steatohepatitis. Interestingly, the antioxidant treatment of THS-exposed mice reduced the accumulation of some lipids, but could not revert all the metabolic alterations, including some related to the impairment of the mitochondrial function. CONCLUSIONS: THS alters liver function at a molecular level, dysregulating many metabolic pathways. The molecular evidences provided here confirm that THS is a new factor for liver steatosis and provide the basis for future research in this respect.

rMSIKeyIon: An Ion Filtering R Package for Untargeted Analysis of Metabolomic LDI-MS Images.

Many MALDI-MS imaging experiments make a case versus control studies of different tissue regions in order to highlight significant compounds affected by the variables of study. This is a challenge because the tissue samples to be compared come from different biological entities, and therefore they exhibit high variability. Moreover, the statistical tests available cannot properly compare ion concentrations in two regions of interest (ROIs) within or between images. The high correlation between the ion concentrations due to the existence of different morphological regions in the tissue means that the common statistical tests used in metabolomics experiments cannot be applied. Another difficulty with the reliability of statistical tests is the elevated number of undetected MS ions in a high percentage of pixels. In this study, we report a procedure for discovering the most important ions in the comparison of a pair of ROIs within or between tissue sections. These ROIs were identified by an unsupervised segmentation process, using the popular k-means algorithm. Our ion filtering algorithm aims to find the up or down-regulated ions between two ROIs by using a combination of three parameters: (a) the percentage of pixels in which a particular ion is not detected, (b) the Mann-Whitney U ion concentration test, and (c) the ion concentration fold-change. The undetected MS signals (null peaks) are discarded from the histogram before the calculation of (b) and (c) parameters. With this methodology, we found the important ions between the different segments of a mouse brain tissue sagittal section and determined some lipid compounds (mainly triacylglycerols and phosphatidylcholines) in the liver of mice exposed to thirdhand smoke.

Biomarkers of Exposure to Secondhand and Thirdhand Tobacco Smoke: Recent Advances and Future Perspectives.

Smoking is the leading preventable disease worldwide and passive smoking is estimated to be the cause of about 1.0% of worldwide mortality. The determination of tobacco smoke biomarkers in human biological matrices is key to assess the health effects related to the exposure to environmental tobacco smoke. The biomonitoring of cotinine, the main nicotine metabolite, in human biofluids-including urine, serum or saliva-has been extensively used to assess this exposure. However, the simultaneous determination of cotinine together with other tobacco biomarkers and the selection of alternative biological matrices, such as hair, skin or exhaled breath, would enable a better characterization of the kind and extent of tobacco exposure. This review aims to perform a critical analysis of the up-to-date literature focused on the simultaneous determination of multiple tobacco smoke biomarkers studied in different biological matrices, due to the exposure to secondhand smoke (SHS) and thirdhand smoke (THS). Target biomarkers included both tobacco-specific biomarkers-nicotine and tobacco specific nitrosamine biomarkers-and tobacco-related biomarkers, such as those from polycyclic aromatic hydrocarbons, volatile organic compounds, metals and carbon monoxide. To conclude, we discuss the suitability of determining multiple biomarkers through several relevant examples of SHS and THS exposure.

Assessing the potential of sputtered gold nanolayers in mass spectrometry imaging for metabolomics applications.

Mass spectrometry imaging (MSI) is a molecular imaging technique that maps the distribution of molecules in biological tissues with high spatial resolution. The most widely used MSI modality is matrix-assisted laser desorption/ionization (MALDI), mainly due to the large variety of analyte classes amenable for MALDI analysis. However, the organic matrices used in classical MALDI may impact the quality of the molecular images due to limited lateral resolution and strong background noise in the low mass range, hindering its use in metabolomics. Here we present a matrix-free laser desorption/ionization (LDI) technique based on the deposition of gold nanolayers on tissue sections by means of sputter-coating. This gold coating method is quick, fully automated, reproducible, and allows growing highly controlled gold nanolayers, necessary for high quality and high resolution MS image acquisition. The performance of the developed method has been tested through the acquisition of MS images of brain tissues. The obtained spectra showed a high number of MS peaks in the low mass region (m/z below 1000 Da) with few background peaks, demonstrating the ability of the sputtered gold nanolayers of promoting the desorption/ionization of a wide range of metabolites. These results, together with the reliable MS spectrum calibration using gold peaks, make the developed method a valuable alternative for MSI applications.

La política pública de seguridad y salud en el trabajo: el caso colombiano / Public Policy for Safety and Health at the Worksite: the Colombian Case / A política pública de segurança e saúde no trabalho: o caso colombiano

Resumen Se espera que el trabajo proporcione riqueza y bienestar al ser humano, pero toda actividad laboral incluye fatalidades, accidentes y enfermedades ocupacionales que afectan la productividad laboral y el desarrollo sostenible. La seguridad y la salud buscan construir una cultura de entornos laborales saludables, trabajo seguro y decente, y para ello el Estado colombiano promueve políticas públicas de seguridad a partir de recomendaciones de organismos internacionales, algunas de ellas enmarcadas en los retos del milenio. El objetivo de esta revisión es presentar como ha sido el desarrollo de la política pública colombiana en seguridad y salud en el trabajo, para lo cual se mostrarán las directrices internacionales postuladas por la OIT y la OMS, su despliegue en estrategias iberoamericanas y la aplicación de la política pública en los programas nacionales de seguridad y salud en el trabajo.

Abstract Work is expected to provide the human being with richness and well-being; notwithstanding all working activity implies fatalities, accidents and occupational diseases affecting the work productivity and the sustainable development. Safety and health are pivotal to build a culture of both healthy working environments and safe and respectable work. To accomplish this, the Colombian State is promoting safety public policies based on the recommendations by international agencies, some of them framed in the new millennium challenges. Ae review aims to show how the Colombian public policy for safety and health at the worksite has developed so far. To do so, the international guidelines set by both the ILO and the WHO will be outlined, showing how they are implemented through the Iberian-American strategies and the application of public policy in the national programs for safety and health at the worksite.

Resumo Espera-se o trabalho fornecer riqueza e bem-estar para o ser humano, mas toda atividade laboral inclui fatalidades, acidentes e doenças ocupacionais que afetam a produtividade laboral e o desenvolvimento sustentável. A segurança e a saúde visam construir uma cultura de ambientes laborais saudáveis, trabalho seguro e decente, e para isso o Estado colombiano promove políticas públicas de segurança a partir de recomendações de organismos internacionais, algumas delas enquadradas nos desafios do milénio. O objetivo desta revisão é apresentar como tem sido o desenvolvimento da política pública colombiana em segurança e saúde no trabalho, para o qual foram mostradas as diretrizes internacionais postuladas pela OIT e pela OMS, seu desfralde em estratégias ibero-americanas e a aplicação da política pública nos programas nacionais de segurança e saúde no trabalho.

Human Dendritic Cells: Ontogeny and Their Subsets in Health and Disease.

Dendritic cells (DCs) are a type of cells derived from bone marrow that represent 1% or less of the total hematopoietic cells of any lymphoid organ or of the total cell count of the blood or epithelia. Dendritic cells comprise a heterogeneous population of cells localized in different tissues where they act as sentinels continuously capturing antigens to present them to T cells. Dendritic cells are uniquely capable of attracting and activating naïve CD4⁺ and CD8⁺ T cells to initiate and modulate primary immune responses. They have the ability to coordinate tolerance or immunity depending on their activation status, which is why they are also considered as the orchestrating cells of the immune response. The purpose of this review is to provide a general overview of the current knowledge on ontogeny and subsets of human dendritic cells as well as their function and different biological roles.