Nightside condensation of iron in an ultrahot giant exoplanet.

Ultrahot giant exoplanets receive thousands of times Earth's insolation1,2. Their high-temperature atmospheres (greater than 2,000 kelvin) are ideal laboratories for studying extreme planetary climates and chemistry3-5. Daysides are predicted to be cloud-free, dominated by atomic species6 and much hotter than nightsides5,7,8. Atoms are expected to recombine into molecules over the nightside9, resulting in different day and night chemistries. Although metallic elements and a large temperature contrast have been observed10-14, no chemical gradient has been measured across the surface of such an exoplanet. Different atmospheric chemistry between the day-to-night ('evening') and night-to-day ('morning') terminators could, however, be revealed as an asymmetric absorption signature during transit4,7,15. Here we report the detection of an asymmetric atmospheric signature in the ultrahot exoplanet WASP-76b. We spectrally and temporally resolve this signature using a combination of high-dispersion spectroscopy with a large photon-collecting area. The absorption signal, attributed to neutral iron, is blueshifted by -11 ± 0.7 kilometres per second on the trailing limb, which can be explained by a combination of planetary rotation and wind blowing from the hot dayside16. In contrast, no signal arises from the nightside close to the morning terminator, showing that atomic iron is not absorbing starlight there. We conclude that iron must therefore condense during its journey across the nightside.

CTCs-derived xenograft development in a triple negative breast cancer case.

Triple-negative breast cancer (TNBC) is characterized by high rates of metastasis and no available molecular targets. CTCs derived xenografts (CDX) have demonstrated to be a promising tool for understanding cancer biology. In our study, a CDX from a TNBC patient was developed for the first time. After CDX characterization, WNT signaling was found as the main mechanism related with this tumor biology and potential CTCs markers were identified and subsequently validated in TNBC patients. In this cohort high levels of MELK expression were associated with poorer survival rates. Overall, our study demonstrates that CTCs from TNBC are tumorigenic and CDXs are a useful model to obtain valuable information about the tumor.

3D finite element model for writing long-period fiber gratings by CO2 laser radiation.

In the last years, mid-infrared radiation emitted by CO2 lasers has become increasing popular as a tool in the development of long-period fiber gratings. However, although the development and characterization of the resulting sensing devices have progressed quickly, further research is still necessary to consolidate functional models, especially regarding the interaction between laser radiation and the fiber's material. In this paper, a 3D finite element model is presented to simulate the interaction between laser radiation and an optical fiber and to determine the resulting refractive index change. Dependence with temperature of the main parameters of the optical fiber materials (with special focus on the absorption of incident laser radiation) is considered, as well as convection and radiation losses. Thermal and residual stress analyses are made for a standard single mode fiber, and experimental results are presented.

Characterization of grazing behaviour microstructure using point-of-view cameras.

Grazing patterns, intake structure, and diet selection are dynamic responses to animals' feeding environment. This study uses video sequences from animal-borne cameras to capture time- and scale-dependent grazing behaviour variables related to sward explanatory conditions. We observed grazing 'through' the sheep's eyes using point-of-view (POV) cameras coupled with event logging software. Time-specific sward features were measured by sampling 'really' grazed patches identified by applying a global navigation satellite system (GNSS) precision-grazing approach. Sward variables on a Mediterranean native sward were measured for two years during the active spring plant-growth cycle. Overall, the results demonstrate that POV cameras were able to capture grazing behaviour fine-tuning to changes in sward characteristics. Sheep compensate for the decrease in sward quantity and nutritive value by increasing the size and duration at each behavioural scale (i.e., meal, bout, and station) while increasing the bout rate and decreasing the station rate. Diet composition also changed as sward matured. The proportion of forbs in the diet remained high in early and late spring, and forbs and legumes were preferred to grasses in early spring. Grazing selectivity was more pronounced in late spring, with sheep favouring the middle stratum of the sward's vertical structure, preferring green vegetative material, while enlarging the feeding niches' span and spending more time at each niche, consequently reducing the station rate. Although data collected by individual animal-borne POV cameras were representative of the flock behaviour, they may underestimate the total grazing time outside major meals. The results indicate that the use of animal-borne video cameras is suitable for assessing variations in sheep grazing behaviour patterns in complex swards.

Analysis of a Real-World Cohort of Metastatic Breast Cancer Patients Shows Circulating Tumor Cell Clusters (CTC-clusters) as Predictors of Patient Outcomes.

Circulating tumor cell (CTC) enumeration has emerged as a powerful biomarker for the assessment of prognosis and the response to treatment in metastatic breast cancer (MBC). Moreover, clinical evidences show that CTC-cluster counts add prognostic information to CTC enumeration, however, their significance is not well understood, and more clinical evidences are needed. We aim to evaluate the prognostic value of longitudinally collected single CTCs and CTC-clusters in a heterogeneous real-world cohort of 54 MBC patients. Blood samples were longitudinally collected at baseline and follow up. CTC and CTC-cluster enumeration was performed using the CellSearch® system. Associations with progression-free survival (PFS) and overall survival (OS) were evaluated using Cox proportional hazards modelling. Elevated CTC counts and CTC-clusters at baseline were significantly associated with a shorter survival time. In joint analysis, patients with high CTC counts and CTC-cluster at baseline were at a higher risk of progression and death, and longitudinal analysis showed that patients with CTC-clusters had significantly shorter survival compared to patients without clusters. Moreover, patients with CTC-cluster of a larger size were at a higher risk of death. A longitudinal analysis of a real-world cohort of MBC patients indicates that CTC-clusters analysis provides additional prognostic value to single CTC enumeration, and that CTC-cluster size correlates with patient outcome.

Circulating Tumor Cells Characterization Revealed TIMP1 as a Potential Therapeutic Target in Ovarian Cancer.

BACKGROUND: Recent studies showed a relevant role of hematogenous spread in ovarian cancer and the interest of circulating tumor cells (CTCs) monitoring as a prognosis marker. The aim of the present study was the characterization of CTCs from ovarian cancer patients, paying special attention to cell plasticity characteristics to better understand the biology of these cells. METHODS: CTCs isolation was carried out in 38 patients with advanced high-grade serous ovarian cancer using in parallel CellSearch and an alternative EpCAM-based immunoisolation followed by RT-qPCR analysis to characterize these cells. RESULTS: Epithelial CTCs were found in 21% of patients, being their presence higher in patients with extraperitoneal metastasis. Importantly, this population was characterized by the expression of epithelial markers as MUC1 and CK19, but also by genes associated with mesenchymal and more malignant features as TIMP1, CXCR4 and the stem markers CD24 and CD44. In addition, we evidenced the relevance of TIMP1 expression to promote tumor proliferation, suggesting its interest as a therapeutic target. CONCLUSIONS: Overall, we evidenced the utility of the molecular characterization of EpCAM+ CTCs from advanced ovarian cancer patients to identify biomarkers with potential applicability for disseminated disease detection and as therapeutic targets such as TIMP1.

Looking for a Better Characterization of Triple-Negative Breast Cancer by Means of Circulating Tumor Cells.

Traditionally, studies to address the characterization of mechanisms promoting tumor aggressiveness and progression have been focused only on primary tumor analyses, which could provide relevant information but have limitations to really characterize the more aggressive tumor population. To overcome these limitations, circulating tumor cells (CTCs) represent a noninvasive and valuable tool for real-time profiling of disseminated tumor cells. Therefore, the aim of the present study was to explore the value of CTC enumeration and characterization to identify markers associated with the outcome and the aggressiveness of triple-negative breast cancer (TNBC). For that aim, the CTC population from 32 patients diagnosed with TNBC was isolated and characterized. This population showed important cell plasticity in terms of expression of epithelia/mesenchymal and stemness markers, suggesting the relevance of epithelial to mesenchymal transition (EMT) intermediate phenotypes for efficient tumor dissemination. Importantly, the CTC signature demonstrated prognostic value to predict the patients' outcome and pointed to a relevant role of tissue inhibitor of metalloproteinases 1 (TIMP1) and androgen receptor (AR) for TNBC biology. Furthermore, we also analyzed the usefulness of the AR and TIMP1 blockade to target TNBC proliferation and dissemination using in vitro and in vivo zebra fish and mouse models. Overall, the molecular characterization of CTCs from advanced TNBC patients identifies highly specific biomarkers with potential applicability as noninvasive prognostic markers and reinforced the value of TIMP1 and AR as potential therapeutic targets to tackle the most aggressive breast cancer.

Riesgo de depresión, ansiedad, estrés y suicidio en pacientes aislados por casos sospechosos de COVID-19 / Risk for Depression, Anxiety, Stress and Suicide in Patients Isolated for Being Suspected Cases of COVID-19

Introducción: El impacto psicológico de la pandemia en la población varía de acuerdo al tipo de afección, por el significado que implica a la persona y sus características. Objetivos: Determinar el riesgo de depresión, ansiedad, estrés y suicidio en pacientes en aislamiento por contacto de casos sospechosos de COVID-19. Métodos: Estudio observacional transversal en pacientes en aislamiento domiciliario por contacto de casos sospechosos de COVID-19, Policlínico José Martí Pérez del municipio Gibara, de noviembre del 2020 a febrero del 2021. El universo fue 417 pacientes, de ellos 399 fue la muestra mediante un muestreo no probabilístico y cumplieron los criterios de inclusión y exclusión. Se recolectó a través de test que evaluaron las alteraciones psicológicas. La información recogida fue almacenada en una base de datos, y se procesó mediante la utilización del paquete estadístico SPSS 17. Resultados: Predominaron pacientes aislados por contacto directo (194/48,62 por ciento) y en aislamiento por más a 10 días (203/50,89 por ciento). El ser contacto de cualquier tipo de paciente sospechoso de COVID-19 se relacionó con riesgo de depresión (OR: 1,81; IC 95 por ciento: 1,38-2,38), pero no con la ansiedad (OR: 1,05; IC 95 por ciento 0,88-1,25). El estrés no presentó significación estadística (p = 0,341) en relación al tiempo en aislamiento. La ideación suicida estuvo presente en 25 pacientes, relacionándose con el riesgo de sufrirla (OR: 1,39; IC 95 por ciento: 1,03-1,88) en pacientes contactos directos. Conclusiones: Durante el aislamiento, los pacientes presentaron ansiedad como principal alteración psicológica, al estar en contacto con pacientes positivos de COVID-19. Esta situación se relaciona estrechamente con el riesgo de sufrir depresión y presentar idea suicida(AU)

Introduction: The pandemic's psychological impact of the on the population varies depending on the type of condition, according to the meaning that it implies to the person and its characteristics. Objectives: To determine the risk of depression, anxiety, stress and suicide in patients in isolation due to contact with suspected cases of COVID-19. Methods: A cross-sectional and observational study was carried out with patients in home isolation due to contact with suspected cases of COVID-19. The patients belonged to the Policlínico José Martí Pérez, Gibara Municipality, from November 2020 to February 2021. From a study universe of 417 patients, 399 were selected by nonprobabilistic sampling, apart from the fact that they met the inclusion and exclusion criteria. The psychological alterations were evaluated through the application of a test. The collected information was stored in a database and processed using the SPSS 17 statistical package. Results: There was a predominance of patients isolated due to direct contact (194/48, 62 percent) and in isolation for more than 10 days (203/50, 89 percent). Having been in contact with any type of patient suspected of COVID-19 was associated with risk of depression (OR: 1.81; 95 percentI: 1.38-2.38), but not with anxiety (OR: 1.05; 95 percent CI: 0.88-1.25). Stress was not statistically significant (p = 0.341) in relation to the isolation time. Suicidal ideation was present in 25 patients, being related, in patients who were direct contact, to the risk of suffering from the disease (OR: 1.39; 95 percent I: 1.03-1.88). Conclusions: During isolation, patients presented anxiety as the main psychological alteration, since they had been in contact with COVID-19 positive patients. This situation is closely related to the risk of suffering depression and presenting suicidal ideation(AU)

A Role for CXCR4 in Peritoneal and Hematogenous Ovarian Cancer Dissemination.

Epithelial ovarian cancer is characterized by a low recovery rate because the disease is typically diagnosed at an advanced stage, by which time most patients (80%) already exhibit disseminated neoplasia. The cytokine receptor CXCR4 has been implicated in the development of metastasis in various tumor types. Using a patient-derived tissue macroarray and mRNA expression analysis, we observed high CXCR4 levels in high-grade serous epithelial ovarian carcinomas, the most metastatic tumor, compared with those in endometrioid carcinomas. CXCR4 inhibition by treatment with the CXCR4 antagonist AMD3100 or by expression of shRNA anti-CXCR4 similarly inhibited angiogenesis in several models of ovarian carcinomas orthotopically grown in nude mice, but the effect on tumor growth was correlated with the levels of CXCR4 expression. Moreover, CXCR4 inhibition completely blocked dissemination and metastasis. This effect was associated with reduced levels of active Src, active ERKs, the inhibition of EMT transition, and block of hematogenous ovarian cancer dissemination decreasing circulating human tumoral cells (CTC). In tumors, CXCR4-expressing cells also had more mesenchymal characteristics. In conclusion, our results indicate that CXCR4 expression confers a proinvasive phenotype to ovarian carcinoma cells. Thus, anti-CXCR4 therapy is a possible agent for a complementary treatment of advanced disseminated epithelial high-grade serous ovarian cancer patients. Mol Cancer Ther; 17(2); 532-43. ©2017 AACR.

Improving circulating tumor cells enumeration and characterization to predict outcome in first line chemotherapy mCRPC patients.

INTRODUCTION: There is a critical need of new surrogate markers for improving the therapeutic selection and monitoring of metastatic prostate cancer patients. Nowadays clinical management of these patients is been driven by biochemical and clinical parameters without enough accuracy to allow a real personalized medicine. The present study was conducted to go insight the molecular profile of circulating tumor cells (CTCs) isolated from advanced metastatic castration-resistant prostate cancer (mCRPC) with the aim of identifying prognostic marker with potential utility for therapy selection and monitoring. MATERIALS AND METHODS: CTCs isolation was carried out in peripheral blood samples from 29 mCRPC patients that undergo systemic chemotherapy based on taxanes (docetaxel/cabazitaxel) and 19 healthy controls using in parallel CellSearch and an alternative EpCAM-based immunoisolation followed by RT-qPCR analysis to characterize the CTC population. A panel of 17 genes related with prostate biology, hormone regulation, stem properties, tumor aggressiveness and taxanes responsiveness was analysed to identify an expression signature characterizing the CTCs. RESULTS: Patients with ≥ 5 CTCs/7.5ml of peripheral blood at baseline and during the treatment showed lower progression free survival (PFS) and overall survival (OS). Changes of CTCs levels during the treatment were also associated with the patient's outcome. These results confirmed previous data obtained using CellSearch in mCRPC. In addition, we found a CTC profile mainly characterized by the expression of relevant genes for the hormone dependent regulation of PCa such as AR and CYP19 together with genes strongly implicated in PCa progression and resistance development such as BIRC5, TUB1A, GDF15, RAB7 and SPINK1. Our gene-expression profiling also permitted the identification of valuable prognostic biomarkers. Thus, high levels of AR, CYP19 and GDF15 were associated with poor PFS rates while AR, GDF15 and BIRC5 were also found as reliable predictors of OS. Besides, a logistic model using KLK3 and BIRC5 showed a high specificity and sensitivity compared to CellSearch to discriminate patients with a more aggressive evolution. CONCLUSIONS: The molecular characterization of CTCs from advanced mCRPC patients provided with a panel of specific biomarkers, including genes related to taxanes resistance, with a promising applicability as "liquid biopsy" for the management of these patients.

Intervención educativa sobre los beneficios inmunológicos de la lactancia materna para los lactantes / Educative Intervention about the Immune Benefits of Breastfeeding for Infants

Introducción: La lactancia materna es el elemento más importante en el fortalecimiento inmunológico del lactante, porque aporta IgA, lactoferrina, citoquinas, caseína y otros componentes que permiten una acción antiinfecciosa, antimicrobiana y trófica del crecimiento intestinal, se logra así la integración del sistema inmune madre-hijo. Objetivo: Evaluar el resultado de la intervención educativa Un regalo para el recién nacido en las puérperas pertenecientes al Grupo Básico de Trabajo del Policlínico José Martí. Métodos: Se realizó un estudio cuasi-experimental de intervención educativa comunitaria en Gibara en el período de julio del 2019 a febrero del 2020. El universo estuvo constituido por 47 puérperas, se seleccionaron 35 pacientes que cumplieron los criterios de inclusión, exclusión y salida. Resultados: Después de aplicada la intervención, en el nivel de conocimientos sobre los beneficios de la lactancia materna fue adecuado en un 97,1 por ciento. Sobre el conocimiento y habilidad técnica adecuada para lactar antes de la intervención eran inadecuados y después un 100 por ciento de las pacientes adquirieron correctamente la habilidad. La evaluación de los conocimientos generales sobre los beneficios de la lactancia demostró el número de pacientes con conocimientos adecuados en un 94,3 por ciento. Conclusiones: La estrategia educativa sobre lactancia materna fue efectiva, porque se logró un nivel de conocimiento y de práctica alto en la mayoría de las mujeres y casi todas las madres lactaron a sus infantes como mínimo por seis meses(AU)

Introduction: Breastfeeding is the most important element for immune strengthening of the infant because it provides IgA, lactoferrin, cytokines, casein and other substances that allow antiinfectious, antimicrobial and trophic action of intestinal growth; thus the integration of the mother-child immune system is achieved. Objective: To evaluate the results of the educational intervention concerning breastfeeding "Un regalo para el recién nacido" [a gift for the newborn], developed with the puerperal women belonging to the basic work group of José Martí outpatient polyclinic. Methods: A quasiexperimental study of community educational intervention was carried out in Gibara Municipality, eastern Cuba, from July 2019 to February 2020. The universe consisted of 47 puerperal women and 35 patients who met the inclusion, exclusion and exit criteria were selected. Results: After the intervention was applied, the level of knowledge about the benefits of breastfeeding was adequate, accounting for 97.1 percent. Before the intervention, the knowledge and appropriate technical skills for breastfeeding were inadequate, while after the intervention, 100 percent of the patients acquired the skill appropriately. The assessment of general knowledge about the benefits of breastfeeding showed that the number of patients with adequate knowledge accounted for 94.3 percent. Conclusions: The educational strategy on breastfeeding was effective because a high level of knowledge and practice was achieved in most women, while almost all the mothers breastfed their infants for at least six months(AU)

Agregación familiar para la hipertensión arterial / Family aggregation of arterial hypertension

Introducción: La hipertensión arterial es una de las enfermedades crónicas causada por la interacción de los factores etiopatogénicos genéticos y ambientales. Objetivo: Determinar la existencia de agregación familiar en la hipertensión arterial. Material y Métodos: Se realizó un estudio observacional analítico de casos y controles, para determinar la agregación familiar de la hipertensión arterial. El universo estuvo constituido por todos los pacientes (257) con factores de riesgo de hipertensión arterial; la muestra quedó conformada por 60 pacientes distribuidos en 30 pacientes hipertensos (casos) y 30 pacientes sin el diagnostico (controles). La información recogida se procesó mediante la utilización del paquete estadístico Epinfo. Resultados: En el grupo casos, predominaron familiares de primer grado con antecedentes de hipertensión (43,9 por ciento) y para los controles, los familiares de grado 2 fueron los que representaron 44,1 por ciento. Los malos hábitos dietéticos se presentaron como el factor de riesgo de mayor frecuencia en ambos grupos con 28,7 por ciento y 47,5 por ciento, respectivamente. Para los pacientes con antecedentes familiares positivos (OR= 1,93, p= 0,008 IC 95 por ciento=1,18-3,16) tuvieron más riesgo de padecer hipertensión al igual que para el factor de riesgo obesidad (OR= 9,03, IC 95 por ciento= 2,80-29,1 p =0,0001). Conclusiones: Se determinó la existencia de agregación familiar para la hipertensión arterial, con mayor riesgo de padecer la enfermedad en las personas con historia familiar en primer grado positiva para la hipertensión y la presencia de obesidad(AU)

Introduction: Arterial hypertension is one of the chronic diseases caused by the interaction of genetic and environmental etiopathogenic factors. Objective: To determine the existence of family aggregation of arterial hypertension. Material and Methods: A cross-sectional analytical study of cases and controls was carried out to determine the family aggregation of arterial hypertension. The universe consisted of all (257) patients diagnosed with risk factors for high blood pressure; the sample was made up of 60 patients distributed in 30 hypertensive patients (cases) and 30 patients without diagnosis (controls). The information collected was processed using the Epi info statistical software. Results: In the group of cases, first-degree relatives with history of hypertension predominated (43.9 percent ). In the group of controls, second-degree relatives represented the 44.1 percent . Bad dietary habits were presented as the most frequent risk factor in both groups with 28.7 percent and 47.5 percent , respectively. Patients with positive family history (OR= 1.93, p = 0.008 95 percent CI = 1.18-3.16) and those suffering from obesity (OR = 9.03, 95 percent CI = 2.80-29.1 p = 0.0001) were at higher risk of developing hypertension. Conclusions: The existence of family aggregation of arterial hypertension was determined. People with first-degree positive family history of hypertension and presenting obesity were at higher risk of suffering from the disease(AU)

Implementación de las tecnologías de la información y la comunicación en la asignatura Medicina Interna / Implementation of information and communications technologies in Internal Medicine undergraduate courses

La informatización de la sociedad es una exigencia social que favorece la búsqueda de información y la actualización de contenidos mediante el trabajo colaborativo. Este trabajo se propuso evaluar la efectividad de una intervención educativa para la utilización de las tecnologías de la información y la comunicación en el proceso de enseñanza-aprendizaje de la asignatura Medicina Interna. Se realizó un estudio cuasi experimental en la Sede Universitaria del Municipio Gibara, en el período de septiembre de 2018 a junio del 2019. La población estuvo representada por 29 estudiantes y ocho profesores que cumplieron los criterios de inclusión y de exclusión, a quienes se les aplicaron cuestionarios de entrada y de salida. Entre los medios personales disponibles para el uso de las tecnologías de la información y la comunicación predominó el Smartphone (100 por ciento). La intervención demostró que los conocimientos sobre búsqueda, gestión y procesamiento de la información fueron adecuados en el 94,59 por ciento y reflejó que el 100 por ciento de los casos utilizó los métodos tradicionales en las actividades docentes de Medicina Interna. La evaluación de la alternativa por los profesores y estudiantes fue valorada de adecuada por el 100 por ciento de los participante(AU)

Informatization of society is a social need leading to collaborative information search and content updating. The purpose of the study was to evaluate the effectiveness of an educational intervention fostering the use of information and communications technologies in the teaching-learning process of Internal Medicine undergraduate courses. A quasi-experimental study was conducted at the branch university campus of the Municipality of Gibara from September 2018 to June 2019. The study population was 29 students and eight teachers meeting the inclusion and exclusion criteria, who answered input and output questionnaires. Smartphones prevailed among the personal aids available for the use of information and communications technologies (100percent). The intervention showed that knowledge about the search for, management and processing of information was adequate in 94.59percent, whereas 100percent of the participants use traditional methods in Internal Medicine teaching activities. The alternative method was evaluated as adequate by 100percent of the participant teachers and students(AU)

Current status of psychiatric rehabilitation in Portugal: A national survey.

OBJECTIVE: This article reports on the current state of psychiatric rehabilitation in Portugal. METHOD: A paper-and-pencil survey was sent to 70 institutions to inquire about the provision of psychiatric rehabilitation services and programs. RESULTS: With a response rate of 40%, 14% of institutions indicated that supported education was provided, 36% offered nonmainstream vocational training, and 29% provided supported employment; none provided evidence-based Individual Placement and Support. Permanent group homes in the community (29%) followed by transitional group homes on institutional grounds (18%) were the most common residential services, with supported housing services (14%) offered less frequently. Finally, 93% of institutions offered occupational activities, 61% provided multifamily psychoeducation, and 36% provided single-family psychoeducation. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Despite recent national initiatives promoting effective psychiatric rehabilitation services, supported employment, supported education, and supported housing are not widely implemented in Portugal. To achieve better outcomes for clients, it is critical that evidence-based and promising practices be extensively disseminated.

Características clínico-epidemiológicas de la COVID-19 / Clinical-epidemiological characteristics of COVID-19

RESUMEN Introducción: La COVID-19 es causada por el nuevo coronavirus que se descubrió en la ciudad de Wuhan, provincia de Hubei, China a finales de 2019. Objetivo: Describir las características clínico-epidemiológicas de la COVID-19. Material y Método: Se realizó una revisión bibliográfica a partir de un total de 33 referencias bibliográficas. Se utilizaron artículos e información de revistas nacionales e internacionales de las bases de datos OMS, OPS, Infomed. Se analizó la calidad, fiabilidad y validez de los artículos seleccionados para realizar una adecuada revisión. Desarrollo: La transmisión del SARS-COV-2 proveniente de una fuente animal a los primeros casos humanos no se ha confirmado. La vía de transmisión entre humanos más aceptada es de persona a persona por vía respiratoria, con un periodo de incubación de 1 a 14 días. Se presenta en la mayoría de casos con un cuadro clínico correspondiente a una infección respiratoria alta autolimitada, con variedad de sintomatología según grupos de riesgo, presentando una rápida progresión a una neumonía grave y fallo multiorgánico, generalmente fatal en personas de la tercera edad y con presencia de comorbilidades. Conclusiones: Estamos en presencia de una pandemia en la que el pilar más importante para combatirla es la prevención: tomar las medidas necesarias para detener la transmisión, lograr una atención diferenciada a los grupos de riesgo, realizar todas las acciones pertinentes con el fin de identificar y neutralizar los focos de propagación y lograr que la población se una al sistema de salud de cada nación y coopere para combatir esta enfermedad.

ABSTRACT Introduction: COVID-19 is caused by the new coronavirus that was discovered in Wuhan City, Hubei Province, China in the late 2019. Objective: To describe the clinical-epidemiological characteristics of COVID-19. Material and Method: A bibliographic review was made from a total of 33 bibliographic references. Articles and information from international organizations such as WHO, PAHO and electronic publications on the topic available from INFOMED were used. The quality, reliability and validity of the selected articles were analyzed to carry out an adequate review. Development: The transmission of SARS-COV-2 from an animal source to the first human cases has not been confirmed. The most accepted route of transmission between humans is from person to person via the respiratory route, with an incubation period between 1 and 14 days. In most cases, it presents with a clinical picture corresponding to a self-limited upper respiratory infection with a variety of symptoms according to risk groups, presenting a rapid progression to severe pneumonia and multi-organ failure, generally fatal in the elderly and in people with presence of comorbidities. Conclusions: We are in the presence of a pandemic in which prevention is the most important means of combating it: to take the necessary measures to stop transmission, to achieve differentiated attention to risk groups, to carry out all relevant actions in order to identify and neutralize the foci of spreading and to get the population to join the health system of each nation and cooperate to combat this disease.

Alternativas terapéuticas para el manejo de la COVID-19 / Therapeutic alternatives for the management of COVID-19

Introducción: La COVID-19 es una pandemia causada por el Coronavirus 2 del Síndrome Respiratorio Agudo Severo (SARS-CoV-2); no existe hasta el momento tratamiento específico completamente eficaz para esta enfermedad, pero el mundo está trabajando incesantemente para buscar una cura. Objetivo: Describir las alternativas terapéuticas de la COVID-19, según los mecanismos fisiopatológicos descritos hasta el momento. Material y Método: Se realizó una revisión bibliográfica a partir de un total de 31 referencias bibliográficas. Se revisaron artículos, en idioma inglés y español, en revistas nacionales e internacionales en bases de datos como Pubmed/Medline, y Elsevier. Se analizó la calidad, fiabilidad y validez de los artículos seleccionados para realizar una adecuada revisión. Desarrollo: La aparición de la COVID-19 ha causado revuelo internacional por la necesidad de encontrar tratamientos efectivos. Debido a que es una enfermedad frecuentemente autolimitada, se vuelve difícil probar si una estrategia terapéutica es eficaz o la enfermedad ha seguido su curso. Las fases del ciclo de vida viral del SARS-COV proporcionan los objetivos potenciales para la terapia con medicamentos, como son: los inhibidores de la fusión de membrana de la envoltura viral, inhibidores de la proteasa similar a la 3-quimotripsina, inhibidores de la ARN polimerasa dependiente de ARN viral, inhibidores de la entrada y endocitosis y otros medicamentos con alguna función inmunomuduladora. Conclusiones: La pandemia actual representa un desafío para la comunidad médica internacional. Aunque no hay tratamiento específico recomendado, se utilizan diversos medicamentos con cierta efectividad como la hidroxicloroquina, azitromicina, kaletra y el remdesivir con sus respectivas combinaciones(AU)

Introduction: COVID-19 is a pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), so far there is no fully effective specific treatment for this disease, but worldwide effort is incessant in the search for a cure. Objective: To describe the therapeutic alternatives for COVID-19 according to the pathophysiological mechanisms described up until now. Material and Method: A bibliographic review was made from a total of 31 bibliographic references. Articles, in English and Spanish, from national and international journals were searched over on-line databases such as Pubmed/Medline and Elsevier. The quality, reliability and validity of the selected articles were analyzed to carry out an adequate review. Development: The appearance of COVID-19 has caused an international stir due to the need to find effective treatments. Because it is a frequently self-limited disease, it becomes difficult to prove whether a therapeutic strategy is effective or the disease has run its course. The SARS-CoV viral life cycle phases provide potential targets for drug therapy, such as: viral envelope membrane fusion inhibitors, 3-chymotrypsin-like protease inhibitors, virus RNA-dependent RNA polymerase, endocytosis and entry inhibitors, and other medications with some immunomodulatory function. Conclusions: The current pandemic represents a challenge for the international medical community. Although there is no specific recommended treatment, various drugs are used with some effectiveness such as hydroxychloroquine, azithromycin, kaletra and remdesivir with their respective combinations(AU)

Alteraciones psicológicas en estudiantes de medicina durante la pesquisa activa de la COVID-19 / Psychological disorders in medicine students during the active investigation of COVID-19

Introducción: La COVID-19 ha traído consigo disímiles cambios y consecuencias en la sociedad. El personal de la salud ha sido uno de los más afectados en el ámbito psicológico, a causa del incremento de los estresores. Objetivo: Determinar manifestaciones psicológicas en estudiantes de medicina durante la pesquisa activa de la COVID-19. Métodos: Se realizó una investigación cuantitativa, observacional, descriptiva y transversal de 59 estudiantes de medicina, pertenecientes a la Sede Municipal de Ciencias Médicas del municipio de Gibara, provincia de Holguín, quienes realizaban la pesquisa activa de la COVID-19, en mayo del 2020. Resultados: La vulnerabilidad al estrés como síntoma no estuvo presente en 83,0 % de los estudiantes. La ansiedad probable y establecida se halló en 28,8 y 18,6 %, respectivamente. La depresión ausente o mínima predominó en 56 estudiantes (86,4 %) y solo 1 presentó idea suicida; 100 % tenía un nivel de funcionamiento neurótico y 54,2 % mostró afrontamiento enfocado a la emoción. Conclusiones: La mayoría de los estudiantes de medicina no presentaron alteraciones psicológicas ni idea suicida. El afrontamiento centrado en la emoción predominante junto al funcionamiento neurótico favorecieron la salud mental.

Introduction: COVID-19 has brought dissimilar changes and consequences in society. The health staff has been one of the most affected in the psychological environment, because of the increment of stress. Objective: To determine psychological manifestations in medicine students during the active investigation of COVID-19. Methods: A quantitative, observational, descriptive and cross-sectional investigation of 59 medicine students was carried out, they belonged to the Medical Sciences Municipal Head Office in Gibara, Holguin who carried out the active investigation of COVID-19, in May, 2020. Results: The vulnerability to stress as symptom was not present in 83.0 % of the students. The probable and established anxiety was in 28.8 % and 18.6 %, respectively. The absent or minimum depression prevailed in 56 students (86.4 %) and just 1 presented suicidal idea; 100 % had a level of neurotic performance and 54.2 % showed confrontation focused to the emotion. Conclusions: Most of the medicine students didn't present psychological disorders neither idea to commit suicide. The confrontation centered in the predominant emotion along with the neurotic performance favored the mental health.

Major and minor element geochemistry of deep-sea sediments in the Azores Platform and southern seamount region.

The Azores Platform and the Irving and Great Meteor seamounts south of the archipelago (38°N-29°N) have rarely been studied geochemically, a fact which is surprising given that they represent the south-eastern limit of region V outlined in the Convention for the Protection of the Marine Environment of the North-East Atlantic (OSPAR Convention). The main aim of the present work was therefore to characterise the spatial variability of major and minor elements in deep-sea sediment cores from these two regions. XRD and geochemical analyses revealed that whereas the Azores Platform sediments are composed of a mixture of biogenic and detrital volcanic material, those at the seamounts are characterised by carbonated biogenic remains. The latter sediments were found to contain very low amounts of volcanic or hydrothermal detrital material, being almost entirely comprised of CaCO3 (more than 80%).

Water column characterisation on the Azores platform and at the sea mounts south of the archipelago.

This study provides data concerning the hydrography and water chemistry of the Atlantic region between 29-38° N and 27-31° W, and establishes background values for dissolved Cu, Cd, Pb and As. Three water masses were identified: the Eastern North Atlantic Central Water (ENACW), the Mediterranean Water (MW) and the North Atlantic Deep Water (NADW). The ENACW exhibits a clear meridional gradient of temperature and salinity, with comparatively high values at the southern sites and lower values on the Azores platform. The ENACW, which includes the euphotic zone, also had comparatively high concentrations of oxygen and lower concentrations of nutrients and metals. The Cu, Cd and Pb results suggest that new background concentrations for OSPAR Region V (the Wider Atlantic) should be established as follows: 0.15-13 nM for Cu, 0.05-1.4 nM for Cd and 0.03-5 nM for Pb. The background concentrations of As for OSPAR Region V should be 7-28 nM.

Cholesterol-lowering effects of dietary blue lupin (Lupinus angustifolius L.) in intact and ileorectal anastomosed pigs.

The present study was undertaken to investigate the effect of cholesterol-enriched casein (CAS) and blue lupin seed (BL) diets on the cholesterol metabolism of intact (INT) and ileorectal anastomosed (IRA) pigs. For 3 weeks, four groups of six pigs were allocated to the treatments (CAS-INT, CAS-IRA, BL-INT, and BL-IRA). Diet-induced hypercholesterolemia was inhibited by the BL through a substantial decrease in plasma LDL-cholesterol. The BL also reduced liver esterified and total cholesterol, increased hepatic LDL receptor synthesis and HMG-CoA reductase activity, and stimulated intestinal bile acid reabsorption. The neutral sterol output was higher in BL- than in CAS-fed pigs. The bile acid output was lower in IRA than in INT pigs. Surgery also prevented steroid microbial transformation, but it did not influence plasma cholesterol levels. These results suggest that the hypocholesterolemic effect of the BL, compared with the CAS, is attributable to impaired intestinal cholesterol absorption, probably involving increased bile acid reabsorption and higher contents of dietary phytosterols, both factors that reduce the micellar solubilization of cholesterol. Furthermore, according to our data, the contribution of the large intestine to cholesterol metabolism is very weak.