Supraclavius muscle observed during anterior scalenectomy for thoracic outlet syndrome: A report of two cases and review of the literature.

Background: Thoracic outlet syndrome (TOS) is a clinical diagnosis caused by compression of neurovascular structures in the thoracic outlet. There are a variety of structures that cause compression implicated in TOS. TOS patients frequently require surgical decompression. Various structural anomalies encountered during decompression have been reported in the literature. Case Description: We present two females (ages 42 and 45) that each underwent anterior scalenectomy for thoracic outlet decompression through a supraclavicular approach. A supraclavius muscle anomaly was observed in both patients. Analogous to the two reports previously described in the literature, the muscle inserted, along the medial superior undersurface of the clavicle and originated dorsally along the trapezius muscle. This is not to be confused with the subclavius posticus muscle, which originates from the first rib and inserts on the upper border of the scapula. Conclusion: These two cases represent just the third and fourth ever descriptions of a supraclavius muscle anomaly encountered during TOS surgery. Due to the wide variety of anatomical variations encountered during TOS surgery, it is not only crucial for continued reporting of such anatomical variations to be reported in the literature but equally important for clinicians that treat TOS to be aware of such variations.

[Clinical significance of sperm presence in post-vasectomy seminograms. Analysis of a 2,168 patients serie]. / Significación clínica de la presencia de espermatozoides en los seminogramas posvasectomía. Análisis de una serie de 2.168 pacientes.

INTRODUCTION: Vasectomy is a safe and effective technique to achieve azoospermia, although the failure rate of the technique is less than 1%. Sterility is not immediate so the post-vasectomy seminogram continues o be essential to ensure the success of the technique. The aim of this trial is to establish the attitude when dealing with immobile residual sperm patients. MATERIAL AND METHODS: Cross-sectional analysis of 2,168 vasectomies performed between January 2010 and March 2017. The first post-vasectomy seminogram was performed at 3 months. Those patients with azoospermia did not undergo further controls. Patients with immobile sperm (<100,000/ml o>100,000/ml) were considered potentially fertile and were followed with monthly seminograms until azoospermia was obtained. RESULTS: Of a total of 1,807 patients were included; 1,297 of these had azoospermia at 3 months seminogram and 501 patients had immobile residual sperm. Only 24 patients of this last group showed more than 100.000 sperm/ml; 9 cases showed mobile sperm. All patients who presented immobile residual sperm underwent serial seminograms. Azoospermia was achieved in an average time of 4,5 months in a rage of 4-10 months, regardless of the initial sperm count. An average of 2,5 tests were performed on each patient. All of the patients with mobile sperm required a reintervention. CONCLUSION: All patients with immobile sperm on the first post-vasectomy seminogram will achieve azoospermia regardless of the initial count. Therefore, serial controls until a negative seminogram is obtained are unnecessary.

Visualizing Human Protein-Protein Interactions and Subcellular Localizations on Cell Images Through CellMap.

Visualizing protein data remains a challenging and stimulating task. Useful and intuitive visualization tools may help advance biomolecular and medical research; unintuitive tools may bar important breakthroughs. This protocol describes two use cases for the CellMap (http://cellmap.protein.properties) web tool. The tool allows researchers to visualize human protein-protein interaction data constrained by protein subcellular localizations. In the simplest form, proteins are visualized on cell images that also show protein-protein interactions (PPIs) through lines (edges) connecting the proteins across the compartments. At a glance, this simultaneously highlights spatial constraints that proteins are subject to in their physical environment and visualizes PPIs against these localizations. Visualizing two realities helps in decluttering the protein interaction visualization from "hairball" phenomena that arise when single proteins or groups thereof interact with hundreds of partners. © 2019 The Authors. Basic Protocol 1: Visualizing proteins and their interactions on cell images Basic Protocol 2: Displaying all interaction partners for a protein.

Interaction between APOA5 -1131T>C and APOE polymorphisms and their association with severe hypertriglyceridemia.

BACKGROUND: Apolipoprotein A5 gene (APOA5) has been shown to modulate plasma triglyceride concentrations. The apolipoprotein E gene (APOE) has been implicated in cholesterol and triglyceride homeostasis in humans and plays an important role in atherogenesis. The aim of this study was to determine the genotypic distribution of the APOA5 -1131T>C and APOE polymorphisms and to identify the combined association of these variants between patients with and without severe hypertriglyceridemia (HTG). METHODS: We genotyped 96 individuals who had reached plasma TG concentrations of more than 10 mmol/L and 225 ischemic patients without severe HTG. RESULTS: Minor allele carriers were significantly more frequent in HTG group for all three polymorphisms (APOA5, APOE2 and APOE4). Adjusted individual risks for severe HTG were: APOA5 -1131C, OR=4.1 (95%CI:2.02-8.24); APOE2, OR=1.6 (95%CI:0.73-3.58); APOE4, OR=3.0 (95%CI:1.68-5.86). Adjusted risks for APOA5-APOE combinations were: APOA5 -1131C/APOE2, OR=45.2 (95%CI:4.92-415.5); APOA5 -1131C/APOE4, OR=6.4 (95%CI:2.28-18.01). CONCLUSIONS: These data provide evidence that APOA5 -1131T>C polymorphism is associated with risk for severe HTG. Furthermore, this effect is strongly increased when -1131C variant is combined with APOE variants.

[Lack of association between the APOE genotype and the response to statin treatment in patients with acute ischemic episodes]. / Ausencia de asociación entre el genotipo de la apolipoproteína E y la respuesta al tratamiento con estatinas en los pacientes con episodios isquémicos agudos.

BACKGROUND AND OBJECTIVE: APOE genotype has been shown to have an influence on lipid concentrations. However, its relation with response to lipid-lowering treatment is not well established. The aim of our work was to analyze whether this genotype is associated with changes in the lipid profile in response to statins treatment. PATIENTS AND METHOD: A total of 222 consecutive patients with acute ischemic episodes and subjected to treatment with statins were included in a retrospective study. The patients' lipid profile was determined at the first visit to the Lipids Unit and after one year on a statin regime. APOE genotypes were determined by PCR-RFLP, and separated in three groups: E2 (E2 carriers), E4 (E4 carriers) and E3 (E3/E3). E2/E4 patients were not included in the study. RESULTS: Relative frequencies of alleles epsilon2, epsilon3 and epsilon4 were 10.5%, 70.9% and 18.6% respectively. Significant differences among groups (p = 0.039) were observed for c-LDL concentrations. E2 group had lower c-LDL than E3 group (p = 0.017) and E4 group (p = 0.01). No significant differences in c-LDL, c-HDL and c-HDL/CT were observed among the three groups with regard to variation after statin treatment. CONCLUSION: APOE genotype does not significantly affect the lipid response in patients with acute ischemic episodes after statin treatment.

Postresection parathyroid hormone and parathyroid hormone decline accurately predict hypocalcemia after thyroidectomy.

Hypocalcemia is the most frequent complication after total thyroidectomy. Parathyroid hormone (PTH) measurement has been proposed as an early predictor of this condition. Total thyroidectomy was performed in 39 patients. Hypocalcemia was present in 15 cases (38%). Patients undergoing hemithyroidectomy (n = 13) were considered control subjects not developing hypocalcemia. PTH was measured before surgery and 10 minutes after resection of the gland using a rapid (15 minutes) chemiluminescent immunometric assay. Patients developing hypocalcemia had lower calcium and postresection PTH levels and higher PTH decline than patients not developing hypocalcemia (P < .0001). PTH decline (cutoff value, 62.5%) had the better sensitivity (93.3%) for predicting hypocalcemia, allowing for a fairly safe early discharge. However, the best overall results corresponded to the combination of postresection PTH level (< or = 18 pg/mL [< or = 1.9 pmol/L]) and PTH decline (>62.5%), with a sensitivity of 90% and a specificity of 97.9%. Perioperative PTH measures can accurately predict hypocalcemia after thyroidectomy, granting the laboratory a key role in the immediate decision about calcium supplementation for patients at risk.

Variations observed for insulin concentrations in an interlaboratory quality control program may be due to interferences between reagents and the matrix of the control materials.

The present study was carried out to observe the behaviour of insulin concentrations in an interlaboratory quality control program from BioRad Laboratories (Irving, CA) applied to Immulite 2000 (Diagnostics Product Corporation, Los Angeles, CA) for three control materials of Lyphocheck Immunoassay Plus Control. Insulin was measured for 261 consecutive working days in a year using a solid-phase immunometric chemiluminescent assay; likewise insulin was measured for 55 days during a period of 4 months in a pool of sera obtained from patients with insulin concentrations within the normal range of our laboratory. The results from each control material were classified in three groups according to the closeness among concentrations and time; mean concentrations were significantly different between consecutive groups for the three control materials (p<0.0001). However, no differences were observed in samples from pool sera. The variations observed in insulin concentrations of the control materials may be due to some interferences or matrix effect on the control material caused by the reagents to quantify insulin in the Immulite 2000.

Healthy Universities: Concepts, Dimensions and Approaches for the Construction of Healthy University Environments / Universidades saludables: conceptos, dimensiones y enfoques para la construcción de entornos universitarios saludables / Universidades saudáveis: conceitos, dimensões e enfoques para a construção de entornos universitários saudáveis

Abstract The purpose of this study was to analyse the health paradigms that prevail in the actions of the current university world by specifying the dimensions to guide interventions within the framework of Healthy Universities and by proposing a comprehensive and integrated vision of health for the construction of these interventions. Thus, a systematic review of the main available scientific databases based on an interpretative perspective was carried out. Forty-four articles, published between 2007 and 2018 and related to university environments or some of their stakeholders that included the addressed dimensions of Health: physical, mental, social, environmental and spiritual were selected. The results show that this field of study is growing, most studies point to the physical and mental dimension of the students. Few studies were found in the other addressed dimensions for teachers, employees and pensioners. In conclusion, the relevance of the five dimensions was identified; although the least studied were environmental and spiritual, they have great potential for the development of interventions. Healthy universities must articulate the five dimensions with the stakeholders that make up their communities from the holistic and salutogenic approach to overcome the bio-medical trend of current interventions.

Resumen El objetivo de este estudio fue analizar los paradigmas de salud que predominan en las acciones del mundo universitario actual, concretando las dimensiones para orientar intervenciones en el marco de Universidades Saludables, así mismo proponer una visión integral e integrada de lo saludable para la construcción de estas intervenciones. Para ello desde una perspectiva interpretativa se realizó una revisión sistemática de las principales bases de datos científicas disponibles, se seleccionaron 44 artículos publicados entre el año 2007 al 2018, con relación a entornos universitarios o con algunos de sus stakeholders que incluyeran las dimensiones de la salud abordadas: física, mental, social, ambiental y espiritual. Se encontró que este campo de estudio es incipiente, la mayoría de los estudios apuntan a la dimensión física y mental de los estudiantes, se encontraron pocos estudios en las otras dimensiones abordadas y para los docentes, empleados y pensionados. Como conclusión se identificó la relevancia de las cinco dimensiones, siendo las menos estudiadas la social, la ambiental y la espiritual, no obstante, con un gran potencial para el desarrollo de intervenciones. Las universidades saludables deben articular las cinco dimensiones y stakeholders que componen sus comunidades desde el enfoque holístico y el salutogénico, superando la tendencia bio-médica de las actuales intervenciones.

Resumo O objetivo deste estudo foi analisar os paradigmas da saúde que predominam nas ações do mundo universitário atual, concretando as dimensões para orientar intervenções no marco de Universidades Saudáveis, mesmo assim propor uma visão integral e integrada de o saudável para a construção destas intervenções. Para isto desde uma perspectiva interpretativa se fez uma revisão sistemática das principais bases de dados científicas disponíveis, se selecionaram 44 artigos publicados entre o ano 2007 ao 2018, com relação a entornos universitários ou com alguns de seus stakeholders que incluíram as dimensões da saúde abordadas: física, mental, social, ambiental e espiritual. Encontrou-se que este campo de estudo é incipiente, a maioria dos estudos apontam à dimensão física e mental dos estudantes, encontraram-se poucos estudos nas outras dimensões abordadas e para os docentes, empregados e aposentados. Como conclusão se identificou a relevância das cinco dimensões, sendo as menos estudadas a social, a ambiental e a espiritual, não obstante, com um grande potencial para o desenvolvimento de intervenções. As universidades saudáveis devem articular as cinco dimensões e stakeholders que compõem suas comunidades desde o enfoque holístico e o salutogênico, superando a tendencia biomédica das atuais intervenções.

CellMap visualizes protein-protein interactions and subcellular localization.

Many tools visualize protein-protein interaction (PPI) networks. The tool introduced here, CellMap, adds one crucial novelty by visualizing PPI networks in the context of subcellular localization, i.e. the location in the cell or cellular component in which a PPI happens. Users can upload images of cells and define areas of interest against which PPIs for selected proteins are displayed (by default on a cartoon of a cell). Annotations of localization are provided by the user or through our in-house database. The visualizer and server are written in JavaScript, making CellMap easy to customize and to extend by researchers and developers.

mBISON: Finding miRNA target over-representation in gene lists from ChIP-sequencing data.

BACKGROUND: Over-representation of predicted miRNA targets in sets of genes regulated by a given transcription factor (e.g. as defined by ChIP-sequencing experiments) helps to identify biologically relevant miRNA targets and is useful to get insight into post-transcriptional regulation. FINDINGS: To facilitate the application of this approach we have created the mBISON web-application. mBISON calculates the significance of over-representation of miRNA targets in a given non-ranked gene set. The gene set can be specified either by a list of genes or by one or more ChIP-seq datasets followed by a user-defined peak-gene association procedure. mBISON is based on predictions from TargetScan and uses a randomization step to calculate False-Discovery-Rates for each miRNA, including a correction for gene set specific properties such as 3'UTR length. The tool can be accessed from the following web-resource: http://cbdm.mdc-berlin.de/~mgebhardt/cgi-bin/mbison/home . CONCLUSION: mBISON is a web-application that helps to extract functional information about miRNAs from gene lists, which is in contrast to comparable applications easy to use by everyone and can be applied on ChIP-seq data directly.

Insulin resistance and increased leptin concentrations in noncompliant schizophrenia patients but not in antipsychotic-naive first-episode schizophrenia patients.

BACKGROUND: The onset of diabetes and impaired glucose metabolism among schizophrenic patients has been the topic of numerous recently published articles, with research implicating weight gain, the use of antipsychotic medication, history of diabetes mellitus in family members, and the diagnosis of schizophrenia itself as risk factors. Therefore, it was the aim of this study to determine the glucose metabolism parameters in noncompliant unmedicated schizophrenic patients (antipsychotic-free) and first-episode antipsychotic-naive schizophrenic patients to investigate whether there is a preexisting impairment of glucose metabolism in never-medicated schizophrenic patients. METHOD: Plasma glucose, insulin, C-peptide, and leptin concentrations were determined in 50 antipsychotic-free and 50 antipsychotic-naive DSM-IV schizophrenia patients and 50 healthy control subjects. Insulin resistance was calculated through the homeostatic model assessment (HOMA). The General Linear Model (univariate) procedure was used to perform analysis of covariance. Patients were recruited from July 2001 to December 2002. RESULTS: Antipsychotic-free patients showed significantly increased insulin (p = .001) and C-peptide (p = .02) concentrations and a significantly higher degree of insulin resistance (p = .003), as measured with the HOMA index, in comparison with the antipsychotic-naive patients and the control group. Significantly increased leptin concentrations (p = .000) were also noted in the antipsychotic-free patients and were attributed to the effects of body mass index (p = .000) and sex (p = .000). CONCLUSIONS: The results reported in this study suggest the effect of previous antipsychotic treatment on glucose metabolism parameters and weight-related hormones such as leptin, while ruling out a preexisting impairment of glucose metabolism in never-medicated first-episode schizophrenic patients.

The IGF-I system component concentrations that decrease with ageing are lower in obesity in relationship to body mass index and body fat.

The aim of this study was to investigate the GH-IGF-I axis in healthy adults and its relationship to obesity. We studied 268 subjects: 134 men and 134 women, and determined anthropometric and body composition variables. Serum total IGF-I was measured by radioimmunoassay, serum free IGF-I concentrations by enzyme linked immunosorbant assay and serum IGFBP3 concentrations by radioimmunoassay. In men, we observed a decrease in total IGF-I, free IGF-I and IGFBP-3 throughout decades. In women, the body mass index and fat mass were higher throughout decades, and we observed a similar decrease to that in men in total IGF-I, free IGF-I and IGFBP3. In men with obesity, as measured by body fat, free IGF-I concentrations were lower than those without obesity; in women with obesity, total IGF-I concentrations and free IGF-I concentrations were lower than in those with obesity. These changes were observed in relationship to obesity when the subjects were adjusted for differences in age. We showed that in controls randomly selected, the GH-IGF-I axis component concentrations that decrease with increasing age are lower in obesity, especially in women, and that this decrease is related to body mass index and body fat.

Different distributions of the 5-HT reuptake complex and the postsynaptic 5-HT(2A) receptors in Brodmann areas and brain hemispheres.

The aim of the present study was to determine the distribution of the presynaptic 5-HT reuptake complex and the 5-HT(2A) receptors through Brodmann areas from two control subjects, together with the possible existence of laterality between both brain hemispheres. A left laterality was observed in the postsynaptic 5-HT(2A) binding sites, with significantly higher B(max) values in the left frontal and cingulate cortex. In frontal cortex, [3H]imipramine and [3H]paroxetine binding showed the highest B(max) values in areas 25, 10 and 11. In cingulate cortex, the highest [3H]imipramine and [3H]paroxetine B(max) values were noted in Brodmann area 33 followed by area 24, while postsynaptic 5-HT(2A) receptors were mainly distributed through Brodmann areas 23 and 29. In temporal cortex, the highest [3H]imipramine and [3H]paroxetine B(max) was noted in Brodmann areas 28 and 34, followed by areas 35 and 38. All Brodmann areas from parietal cortex (1, 2, 3, 4, 5, 6, 7, 39, 40 and 43) showed similar presynaptic and postsynaptic binding values. In occipital cortex no differences were observed with regard to the brain hemisphere or to the Brodmann area (17, 18 and 19). These results suggest the need to carefully define the brain hemisphere and the Brodmann areas studied, as well to avoid comparisons between studies including different Brodmann areas or brain hemispheres.

The effect of social trust on citizens’ health risk perception in the context of a petrochemical industrial complex.

Perceived risk of environmental threats often translates into psychological stress with a wide range of effects on health and well-being. Petrochemical industrial complexes constitute one of the sites that can cause considerable pollution and health problems. The uncertainty around emissions results in a perception of risk for citizens residing in neighboring areas, which translates into anxiety and physiological stress. In this context, social trust is a key factor in managing the perceived risk. In the case of industrial risks, it is essential to distinguish between trust in the companies that make up the industry, and trust in public institutions. In the context of a petrochemical industrial complex located in the port of Castellón (Spain), this paper primarily discusses how trust - both in the companies located in the petrochemical complex and in the public institutions - affects citizens' health risk perception. The research findings confirm that while the trust in companies negatively affects citizens' health risk perception, trust in public institutions does not exert a direct and significant effect. Analysis also revealed that trust in public institutions and health risk perception are essentially linked indirectly (through trust in companies).

Factores de mal pronóstico en pacientes mayores de 70 años con síndromecoronario isquémico agudo / Poor prognostic factors in patients older than 70 years with acute coronary syndrome

La información sobre escalas pronósticas en el paciente geriátrico con síndrome coronario isquémico agudo (SICA) es escasa; por esto, nos planteamos como objetivo identificar a los factores que condicionen un deterioro en la función cardíaca y que fuesen valorables en este grupo de edad, en la población mexicana. Pacientes y método. Estudio descriptivo, retrospectivo. Se captaron los datos de pacientes mayores de 70 años diagnosticados con SICA, en el Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM), durante el periodo 1 de enero de 2006 al 30 de mayo de 2010; estos fueron analizados estadísticamente. Resultados. Se registraron los datos de 119 pacientes, 26 mujeres y 93 hombres, con media de edad de 75,91 +/- 4,68 y rango 70-94. Se encontró que la lesión de la arteria descendente anterior es una predictora, con los modelos de análisis de regresión lineal (método ôintroducirõ), regresión logística multinomial, estimación ponderada (para sexo), ecuación de regresión de Cox y regresión logística binaria (únicamente para el sexo masculino). Conclusiones. Las enfermedades de base no controladas adecuadamente y la lesión de la arteria descendente anterior son las principales variables predictoras de muerte en mayores de 70 años con SICA...

Since the information about prognostic scales in geriatric patients with acute coronary syndrome (ACS) is scarce, our main objective was to search the factors that conditioned deterioration in cardiac function and evaluate them in this age group in the Mexican population. Patients and method. This was a descriptive, retrospective study. Data from patients older than 70 years diagnosed with acute coronary syndrome at the Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM), during the period from January 1 of 2006 to May 30 of 2010 and these were statistically analyzed. Results. The data of 119 patients were recorded, with 26 women and 93 men, with mean age of 75,91 +/- 4,68 and range 70-94. The lesion of the anterior descending artery was found as predictive for mortality with the models linear regression analysis (enter method), multinomial logistic regression, weighted estimation (for sex), Cox regression and binary logistic regression (only for male). Conclusions. The underlying diseases not controlled properly and lesion of the anterior descending artery are the most important predictive variables of death in the Mexican population older of 70 years with acute coronary syndrome...

Valor pronóstico de la PCT y proteína C reactiva como marcadores de gravedad en neumonía adquirida en la comunidad en adultos mayores / Prognostic value of PCT and CRP as markers of severity in community acquired pneumonia in older adults

Introducción: La neumonía adquirida en la comunidad (NAC) es una de las principales causas de mortalidad en el mundo. La proteína C reactiva puede identificar a pacientes críticamente enfermos. La procalcitonina (PCT) ha sido referida como un marcador sensible de gravedad de la infección bacteriana y sepsis. Metodología: Se realizó un estudio cohorte prospectivo en el servicio de geriatría del Centro Médico ISSEMYM, Metepec, Estado de México, con todos los pacientes que ingresaron a hospitalización con diagnóstico de NAC entre mayo 2012 a marzo 2013. Se midieron PCR, PCT y laboratorios de rutina. Para la comparación de variables continuas se utilizó la T de Student ó U de Mann Whitney según su distribución. Para la comparación de variables cate-góricas se utilizo la prueba de X2. Para el análisis de supervivencia se utilizó el estimador de Kaplan-Meier. Para establecer el riesgo de mortalidad se empleó el modelo de regresión de COX obteniendo el Hazard Ratio. Para la correlación entre los niveles séricos de PCT y PCR se utilizó el coeficiente de correlación de Spearman. Resultados: Se registraron los datos de un total de 82 pacientes. La supervivencia media cuando PCT > de 0.5 ng/dl fue de 17 días (IC 95%, 11 a 23 días) versus 26 días (IC 95%, 17 a 35 días) para PCT < de 0.5 ng/dl (p < 0.01). Conclusiones: El nivel sérico de PCT mayor a 0.5 ng/dl mostró ser un marcador pronóstico en pacientes geriátricos con neumonía...(AU)

Altered 5-HT2A and 5-HT4 postsynaptic receptors and their intracellular signalling systems IP3 and cAMP in brains from depressed violent suicide victims.

Serotonin 5-HT2A and 5-HT4 binding parameters and their second messengers 1,4,5-inositol triphosphate (IP3) and cyclic adenosyl monophosphate (cAMP) were studied in the frontal cortex, hippocampus, caudate nucleus and amygdala of 19 control subjects and 19 antidepressant-free, violent suicide victims. A significantly higher number of 5-HT4 receptors and higher second messenger cAMP concentrations were found in the frontal cortex and caudate nucleus of the depressed suicide victims as compared with the control group. Furthermore, significantly increased 5-HT2A binding sites and IP3 concentrations were noted in the caudate nucleus of the suicide victims, together with a significantly reduced number of 5-HT2A binding sites, higher binding affinity and increased IP3 concentrations in the hippocampus. No significant alterations in 5-HT4 and cAMP or in 5-HT2A and IP3 concentrations were observed in the amygdala. The caudate nucleus of depressed suicide victims seems to be the brain region with the highest alteration of the serotonergic system, and hence with the most diagnostic sensitivity. Further studies on suicidality and depression should focus on the functionality of the caudate nucleus.