AI-guided pipeline for protein-protein interaction drug discovery identifies a SARS-CoV-2 inhibitor.

Protein-protein interactions (PPIs) offer great opportunities to expand the druggable proteome and therapeutically tackle various diseases, but remain challenging targets for drug discovery. Here, we provide a comprehensive pipeline that combines experimental and computational tools to identify and validate PPI targets and perform early-stage drug discovery. We have developed a machine learning approach that prioritizes interactions by analyzing quantitative data from binary PPI assays or AlphaFold-Multimer predictions. Using the quantitative assay LuTHy together with our machine learning algorithm, we identified high-confidence interactions among SARS-CoV-2 proteins for which we predicted three-dimensional structures using AlphaFold-Multimer. We employed VirtualFlow to target the contact interface of the NSP10-NSP16 SARS-CoV-2 methyltransferase complex by ultra-large virtual drug screening. Thereby, we identified a compound that binds to NSP10 and inhibits its interaction with NSP16, while also disrupting the methyltransferase activity of the complex, and SARS-CoV-2 replication. Overall, this pipeline will help to prioritize PPI targets to accelerate the discovery of early-stage drug candidates targeting protein complexes and pathways.

Polyglutamine disease proteins: Commonalities and differences in interaction profiles and pathological effects.

Currently, nine polyglutamine (polyQ) expansion diseases are known. They include spinocerebellar ataxias (SCA1, 2, 3, 6, 7, 17), spinal and bulbar muscular atrophy (SBMA), dentatorubral-pallidoluysian atrophy (DRPLA), and Huntington's disease (HD). At the root of these neurodegenerative diseases are trinucleotide repeat mutations in coding regions of different genes, which lead to the production of proteins with elongated polyQ tracts. While the causative proteins differ in structure and molecular mass, the expanded polyQ domains drive pathogenesis in all these diseases. PolyQ tracts mediate the association of proteins leading to the formation of protein complexes involved in gene expression regulation, RNA processing, membrane trafficking, and signal transduction. In this review, we discuss commonalities and differences among the nine polyQ proteins focusing on their structure and function as well as the pathological features of the respective diseases. We present insights from AlphaFold-predicted structural models and discuss the biological roles of polyQ-containing proteins. Lastly, we explore reported protein-protein interaction networks to highlight shared protein interactions and their potential relevance in disease development.

Characterization of a spring pendulum phase-space trajectories.

We study the geometrical properties of phase-space trajectories (or orbits) of a spring pendulum as functions of the energy. Poincaré maps are used to describe the properties of the system. The points in the Poincaré maps of regular orbits (non-chaotic) cluster around separated segments or in chains of islands. Looking at how segments are formed, we conclude that the orbits are closely related to torus knots. Examining the toroidal and poloidal turns of the orbits, we introduce the definition of a rational parameter Ω, which is closely related to the concept of frequency used in the analysis of dynamical systems. Algorithms were developed to calculate Ω, and we found that this parameter naturally describes the orbits in terms of Farey sequences; also, calculations show that orbits with the same Ω have similar dynamics. Orbits corresponding to chains of islands are identified with cable knots that can be characterized using two parameters analogous to Ω. In some cases, non-trivial cable knots were found. With the analysis presented in this study, it is shown that Ω follows predictable distributions in the (z,Ω) space.

Magnetic liver retraction in bariatric surgery: Is it possible?

One of the recent advances in bariatric surgery is the use of magnetic devices. This research paper describes magnetic liver retraction in morbidly obese patients during bariatric surgery. A descriptive, prospective and observational study was carried out, analyzing 100 patients in whom magnetic retraction was used. Mean and SD body mass index was 46.1 ± 5.09 kg/m2. The magnetic system was successfully used for liver retraction in 95% of cases; in only 5% of cases was its use not possible due to hepatomegaly and severe hepatic steatosis. According to the results, magnetic liver retraction can be safe and used in bariatric surgery, regardless of body mass index and with a low percentage of complications.

Impact of adding papain to sous vide cooking on texture and sensorial traits of marinated semitendinosus beefsteaks.

Sous vide meat is an emerging food category, the consumption of which has increased owing to greater convenience, sensory traits, elderly consumers acceptance, and low-cost cuts use. However, required prolonged thermal treatment to achieve desired tenderness, impact energy-consumption besides triggering lipid oxidation, undesired off-flavors, and cooked meat profiles. Using a response surface methodology (RSM), this study evaluated the effects of the vegetal proteolytic papain (0 to 20 mg/kg) and low-temperature sous vide cooking (SVC) time (1 to 8 h at 65°C) in low-value marinated M. semitendinosus beefsteaks on technological characteristics associated with tenderness, and lipid oxidation. Additionally, the sensory profile traits of the pre-selected treatments were described using check-all-that-apply (CATA) and preference mapping. Shear force (WBsSF) was reduced with greater papain addition, whereas higher cooking losses (CL) were observed with longer SVC cooking times. Both the released total collagen and TBARS values increased with increasing papain concentrations and SVC times. Combining high levels of papain (>10 mg/kg) and SVC time (>6 h) resulted in lower WBsSF values (<20 N) but higher CL (>27%) and the CATA descriptors "aftertaste" and "mushy." The optimized conditions (14 mg/kg papain; 2 h SVC) also reduced WBsSF values (<26 N) with lower CL (<20%) and were most preferred and described as "juicy" and "tender" by consumers. Observed results suggest that combined mild SVC and papain may potentiate tenderness, conjointly favor juiciness and oxidation, further representing a promising tool for reducing SVC time without compromising valued sous vide sensory traits.

Freezing/thawing as an accelerating process of wet- and dry-aged Nellore beef.

This study aimed to evaluate the use of freezing/thawing as a way of accelerating the aging processes of beef from Nellore animals. Non-frozen (NF) or freezing/thawing (FT) strip loins were aged (for 14 and 28 days) using two systems: bone-in dry-aging (DA); boneless wet-aging (WA). FT-treated samples had greater weight losses (P < 0.05) during aging than NF-treated samples, especially using the DA process. However, the weight loss of the FT 14-days DA beef samples was comparable to that of NF 28-days DA. FT beef had lower fragmentation index and shear force values (P < 0.05), as well as its maximum sensorial tenderness was achieved earlier (P < 0.05) than the NF counterpart. With 28 days of aging, DA beef showed higher (P < 0.05) tenderness and juiciness scores and lower lightness values than WA beef. The FT process decreased the reducing capacity of meat samples, generating more metmyoglobin and lower amounts of chroma than NF. The expected volatile profile of DA beef was achieved faster in FT-treated samples, but the freezing treatments did not compromise the microbial count for either aging system. Our findings indicate that accelerated DA by the FT process could improve the palatability of Nellore beef, allowing the desired tenderness and flavor profile to be achieved in a shorter time, without increasing costs with weight losses or adversely affecting physicochemical, chemical, and microbial characteristics.

Technological and sensory characteristics in development of innovative symbiotic boneless dry-cured lamb meat snack.

Novel shelf-stable and high-protein meat products that are affordable, convenient, and healthy are hot topic in current food innovation trends. To offer technological databases for developing new functional lamb meat products, this study aimed to evaluate the technological and sensory aspects of dry-cured lamb meat snacks incorporated with the probiotic culture Lactobacillus paracasei and the prebiotic lactulose. Four formulations were analyzed: control (without prebiotic or probiotic); PREB (with 2% lactulose); PROB (with 107 CFU/g of L. paracasei); and SYMB (with 2% lactulose and 107 CFU/g of L. paracasei). Fitted curves revealed that weight-loss behavior during snack ripening was not affected (P > 0.05) by treatments. Snack moisture, water activity, pH, titratable acidity, lipid oxidation, and residual nitrite were affected (P < 0.05) only by ripening time. The target probiotic strain stood out against competitive flora and was detected at 107 CFU/g in the snack-supplemented formulations (PROB and SYMB). In snacks supplemented with prebiotics (PREB and SYMB), the lactulose content was maintained at 2.17%. Significant differences were not observed in the chemical composition, texture profiles, and CIE color indices between the proposed functional snacks and the control. In addition to texture, flavor, and overall impression evaluation, only color attributes were positively impacted (P < 0.05) in the acceptance and multiple comparison tests against the control. The proposed formulation and bench process parameters produced potential nutritionally and sensory-appreciated, microbiologically stable, and safe (multi-hurdle perspective) functional high-protein restructured lamb snacks.

New Formulation of a Subunit Vaccine Candidate against Lawsonia intracellularis Increases Humoral and Cellular Immune Responses.

Previously, we designed a subunit vaccine candidate based on three L. intracellularis antigens with promising results in pigs. In this study, antigens were produced individually to achieve an even antigen ratio in the formulation. The emulsion characterization included the drop size and the mechanical and thermal stability. Immune response was evaluated by indirect and sandwich ELISAs, qPCR, and flow cytometry. The vaccine candidate's safety was assessed by histopathology and monitoring the clinical behavior of animals. The average production yielded for the chimeric antigen as inclusion bodies was around 75 mg/L. The formulation showed mechanical and thermal stability, with a ratio Hu/Ho > 0.85 and a drop size under 0.15 nm. Antigens formulated at a ratio of 1:1:1 induced a significant immune response in inoculated pigs that persisted until the end of the experiment (week 14). The dose of 200 µg significantly activated cellular response measured by transcriptional and translational levels of cytokines. The cell proliferation assay revealed an increment of lymphocytes T CD4+ at the same dose. Animals gained weight constantly and showed proper clinical behavior during immunization assays. This research demonstrated the immunological robustness of the new subunit vaccine candidate against Porcine Proliferative Enteropathy evenly formulated with three chimeric antigens of L. intracellularis.

Índice predictivo de cardiopatía isquémica en personas con diabetes mellitus

Introducción: Los individuos con diabetes mellitus tienen un riesgo de cardiopatía isquémica 2 a 4 veces superior a la observada en la población general. Objetivo: Diseñar un índice, basado en los factores de riesgo identificados, para predecir el desarrollo de cardiopatía isquémica en pacientes con diabetes mellitus. Métodos: Se realizó un estudio analítico de tipo casos y controles en 330 pacientes con diabetes mellitus. El índice se derivó del análisis de regresión logística binaria de los factores de riesgo cardiovasculares. Resultados: El índice propuesto mostró elevada morbilidad en las categorías de riesgo alto (48,9 %) y riesgo muy alto (100 %); sus valores promedio fueron significativamente mayores en los pacientes con cardiopatía isquémica, en comparación con aquellos que no la desarrollaron (7,98 x 3,67; p= 0,000). La curva COR del índice propuesto tiene buena capacidad para discriminar los pacientes que tendrán una cardiopatía isquémica de los que no desarrollarán la enfermedad (0,902; p= 0,000). Conclusiones: El índice que se propone es capaz de predecir el desarrollo de cardiopatía isquémica en pacientes con diabetes mellitus.

Introduction: Individuals with diabetes mellitus have a risk of ischemic heart disease 2 to 4 times higher than that observed in the general population. Objective: To design an index, based on the identified risk factors, to predict the development of ischemic heart disease in patients with diabetes mellitus. Methods: An analytical case-control study was carried out in 330 patients with diabetes mellitus. The index was derived from binary logistic regression analysis of cardiovascular risk factors. Results: The proposed index showed a high morbidity in the categories of high risk (48.9%) and very high risk (100%). Likewise, their mean values ​​were significantly higher in patients with ischemic heart disease compared to those who did not develop it (7.98 x 3.67; p= 0.000). The ROC curve of the proposed index has a good ability to discriminate patients who will have ischemic heart disease from those who will not develop the disease (0.902; p= 0.000). Conclusions: The proposed index is capable of predicting the development of ischemic heart disease in patients with diabetes mellitus.

Gastrite isquêmica grave por isquemia mesentérica crônica / Severe ischemic gastritis caused by chronic mesenteric ischemia

Resumo A gastrite isquêmica é uma doença rara, podendo ocorrer por insuficiência vascular focal ou sistêmica. Essa condição é raramente vista na prática médica devido à vasta rede colateral arterial do estômago pelo tronco celíaco e mesentérica superior. A apresentação clássica da isquemia crônica é formada pela tríade de dor pós-prandial, perda de peso e sopro abdominal. A intervenção está indicada naqueles pacientes sintomáticos, sendo o tratamento endovascular uma alternativa à cirurgia em pacientes com alta comorbidade, tendo bons resultados. Reportamos um caso de gastrite isquêmica grave com úlceras e sangramento que foi causado por isquemia mesentérica crônica, em uma paciente de 71 anos, com oclusão do tronco celíaco e mesentérica inferior, além de estenose crítica da superior. O diagnóstico foi confirmado por exame de imagem, e a paciente foi submetida a tratamento endovascular. Trata-se de uma condição rara de diagnóstico e tratamento desafiadores, a qual requer uma equipe multidisciplinar para o manejo adequado.

Abstract Ischemic gastritis is a rare illness caused by localized or systemic vascular insufficiency. This condition is rarely seen in medical practice due to the vast arterial collateral blood supply to the stomach through the celiac trunk and superior mesenteric artery and also because other etiologies are much more frequent. The classic presentation of chronic ischemia is comprises the triad of postprandial pain, weight loss, and abdominal bruit. Intervention is indicated in symptomatic patients and endovascular treatment is an alternative to surgery in patients with high comorbidity that offers good results. We report a case of a 71-year-old female patient with severe ischemic gastritis with ulcers and bleeding caused by chronic mesenteric ischemia with occlusion of the celiac trunk and inferior mesenteric artery and critical stenosis of the superior mesenteric artery. The diagnosis was confirmed by imaging, and the patient underwent endovascular treatment. This is a rare condition that is difficult to diagnose and treat and a multidisciplinary team is needed for proper management.

Liver transplantation in patients with primary sclerosing cholangitis: a multicentric study / Transplante hepático em pacientes com colangite esclerosante primária: estudo multicêntrico

ABSTRACT BACKGROUND: The prevalence of primary sclerosing cholangitis (PSC) in the general population has not yet been clearly established. The management of PSC should focus on delaying the progression of the disease and restraining its complications. The only curative therapy for the disease remains liver transplantation (LT). PSC is currently the fifth most common indication for LT and corresponds to 5% of all LT indications in adults. AIMS: Our objective is to evaluate the indications and outcomes of PSC patients undergoing LT in three liver transplantation centers in southern Brazil - Hospital Santa Isabel in Blumenau, Santa Catarina state, and Hospital das Clínicas and Hospital Nossa Senhora das Graças, in Curitiba, Parana state). METHODS: This is a longitudinal observational study of patients with PSC who underwent LT in three major Brazilian medical centers. Electronic medical records and study protocols of all patients subjected to LT from January 2011 to December 2021 were retrospectively reviewed. RESULTS: Of the 1,362 transplants performed in the three medical centers, 37 were due to PSC. Recurrence of PSC occurred in three patients (8.1%) in 3.0±2.4 years (range, 1-4 years). The 1-year and 5-year survival rates after the first LT were 83.8 and 80.6%, respectively. The 1-year and 5-year graft survival rates were, respectively, 83.8 and 74.8%. CONCLUSIONS: Our experience with LT in patients with PSC demonstrated good patient and graft survival results. Most deaths were due to common factors in patients undergoing LT.

RESUMO RACIONAL: A prevalência de colangite esclerosante primária (CEP) na população em geral ainda não foi claramente estabelecida. O manejo da CEP deve se concentrar em retardar a progressão da doença e gerenciar suas complicações. A única terapia curativa para a doença continua sendo o transplante hepático (TH). A CEP é atualmente a 5ª indicação mais comum de TH e corresponde a 5% de todas as indicações de TH em adultos OBJETIVOS: O nosso objetivo é avaliar as indicações e os resultados do transplante de fígado em pacientes com CEP submetidos a TH em três centros de transplante de fígado no sul do Brasil (Hospital Santa Isabel, Blumenau, Santa Catarina; Hospital das Clínicas, Curitiba, Paraná; e Hospital Nossa Senhora das Graças, Curitiba, Paraná). MÉTODOS: Este é um estudo observacional longitudinal de pacientes com colangite esclerosante primária que foram submetidos a transplante hepático em três grandes centros médicos brasileiros. Os prontuários eletrônicos de todos os pacientes submetidos a TH de Janeiro de 2011 a Dezembro de 2021, foram avaliados retrospectivamente. RESULTADOS: De um total de 1.362 transplantes realizados nos três centros médicos, 37 eram devidos à CEP. A recorrência de CEP ocorreu em 3 pacientes (8,1%) em 3±2,4 anos (intervalo, 1-4 anos). A taxa de sobrevida de 1 ano e 5 anos após o 1° TH foi respectivamente de 83,8 e 80,6%. As taxas de sobrevida dos enxertos em 1 ano e 5 anos foram, respectivamente, 83,8 e 74,8%. CONCLUSÕES: A nossa experiência com TH em pacientes com CEP demonstrou bons resultados de sobrevida dos pacientes e dos enxertos. A maioria dos óbitos ocorreu devido a fatores comuns em pacientes submetidos a TH.

Características clínicas de pacientes con diabetes mellitus complicados con cardiopatía isquémica

RESUMEN Introducción: en las personas con diabetes mellitus la cardiopatía isquémica muestra una morbilidad y una mortalidad 2-4 veces superior a la observada en la población general. Objetivo: describir las características clínicas de pacientes con diabetes mellitus complicados con cardiopatía isquémica. Métodos: se realizó un estudio descriptivo de corte transversal en 459 pacientes con diabetes mellitus, atendidos en los servicios de Endocrinología y Cardiología del Hospital General Provincial "Carlos Manuel de Céspedes" del municipio Bayamo, provincia de Granma, desde el 1ro de enero de 2015 hasta el 31 de diciembre de 2020. Estadígrafos: Chi Cuadrado y T de Student. Resultados: la frecuencia de hipertensión arterial (0,0000), hipertrofia ventricular izquierda (0,0000), tabaquismo (0,0128) y otras complicaciones vasculares de la diabetes, fue superior en los pacientes con cardiopatía isquémica con respecto a los que no poseen esta complicación. Asimismo, los casos con cardiopatía isquémica exhibieron una edad (0,0000), un tiempo de DM (0,0000) y niveles de HA1c (0,0002), colesterol (0,0266), triglicéridos (0,0432), cociente colesterol/HDL (0,0001), microalbuminuria (0,0000) y ácido úrico (0,0000), significativamente superiores que los sin cardiopatía isquémica. Conclusiones: los pacientes con diabetes complicados con cardiopatía isquémica tienen una frecuencia de factores de riesgo cardiovasculares superior a aquellos sin esta complicación. Se hace necesario otras investigaciones para determinar el papel de estos factores en el desarrollo de la enfermedad.

ABSTRACT Introduction: in people with diabetes mellitus, ischemic heart disease shows morbidity and mortality 2-4 times higher than that observed in the general population. Objective: to describe the clinical characteristics of patients with diabetes mellitus complicated by ischemic heart disease. Methods: a descriptive cross-sectional study was carried out in 459 patients with diabetes mellitus, treated at the Endocrinology and Cardiology services of the "Carlos Manuel de Céspedes" Provincial General Hospital of the Bayamo municipality, Granma province, since January 1, 2015. until December 31, 2020. Statisticians: Chi Square and Student's T. Results: the frequency of arterial hypertension (0.0000), left ventricular hypertrophy (0.0000), smoking (0.0128) and other vascular complications of diabetes was higher in patients with ischemic heart disease than in those without have this complication. Likewise, the cases with ischemic heart disease exhibited an age (0.0000), a time of DM (0.0000) and levels of HA1c (0.0002), cholesterol (0.0266), triglycerides (0.0432), ratio cholesterol/HDL (0.0001), microalbuminuria (0.0000) and uric acid (0.0000), significantly higher than those without ischemic heart disease. Conclusions: patients with diabetes complicated by ischemic heart disease have a higher frequency of cardiovascular risk factors than those without this complication. Other research is necessary to determine the role of these factors in the development of the disease.

RESUMO Introdução: em pessoas com diabetes mellitus, a cardiopatia isquêmica apresenta morbidade e mortalidade 2-4 vezes maior do que a observada na população geral. Objetivo: descrever as características clínicas de pacientes com diabetes mellitus complicado por cardiopatia isquêmica. Métodos: estudo transversal descritivo realizado em 459 pacientes com diabetes mellitus, atendidos nos serviços de Endocrinologia e Cardiologia do Hospital Geral Provincial "Carlos Manuel de Céspedes" do município de Bayamo, província de Granma, desde 1 de janeiro de 2015. até 31 de dezembro de 2020. Estatísticos: Chi Square e Student's T. Resultados: a frequência de hipertensão arterial (0,0000), hipertrofia ventricular esquerda (0,0000), tabagismo (0,0128) e outras complicações vasculares do diabetes foi maior nos pacientes com cardiopatia isquêmica do que naqueles sem essa complicação. Da mesma forma, os casos de cardiopatia isquêmica apresentaram idade (0,0000), tempo de DM (0,0000) e níveis de HA1c (0,0002), colesterol (0,0266), triglicerídeos (0,0432), relação colesterol/HDL (0,0001), microalbuminúria (0,0000) e ácido úrico (0,0000), significativamente maior do que aqueles sem cardiopatia isquêmica. Conclusões: pacientes com diabetes complicado por cardiopatia isquêmica apresentam maior frequência de fatores de risco cardiovascular do que aqueles sem essa complicação. Outras pesquisas são necessárias para determinar o papel desses fatores no desenvolvimento da doença.

Magnetic device in reduced port and single port bariatric surgery: First 170 cases experience / Dispositivo magnético en cirugía bariátrica por puerto reducidos y puerto único: Primera experiencia de 170 casos

Introduction: Magnetic devices have been successfully used in bariatric surgery. To the date, the only reported use of the magnet was for liver retraction. Our purpose in this study is to demonstrate the safety and viability of using a magnetic system in different steps in single port and reduced port bariatric surgery.MethodsProspective and observational study was performed. Patients older than 18 years, undergoing primary laparoscopic sleeve gastrectomy (SG), one-anastomosis gastric bypass (OAGB), and Roux-en-Y gastric bypass (RYGB) or revisional surgery by single-port or reduced-port approach between July 2020 and June 2021 were included.ResultsA total of 170 patients (mean BMI, 41.47kg/m2; mean age 36.92 yrs) completed laparoscopic bariatric surgery (54 single-port sleeve gastrectomy [SPSG], 16 reduced-port SG, 83 RYGB, 4 OAGB and 14 revision surgeries), using the magnetic surgical system in different steps of the surgery. Mean surgical time for SPSG and reduced-port SG was 65.52min and 59.36min respectively; and for RYGB 74.19min, OAGB 70.98min, and revisional surgeries 88.38min. As for intraoperative complications, 2.94% mild liver laceration without significant bleeding was reported. There were no 30-day mortalities and no major complications.ConclusionMagnetic assistance in single-port and reduced-port bariatric surgery is an innovative technique. With this prospective study we attempt to demonstrate the safety profile and potential uses that may improve the implementation of new surgical approaches in bariatric surgery (AU)

Introducción: Los dispositivos magnéticos se han usado satisfactoriamente en cirugía bariátrica. Hasta la fecha, el único uso reportado de los imanes ha sido para la retracción hepática. Nuestro propósito con este estudio es demostrar la seguridad y viabilidad de usar dispositivos magnéticos en diferentes pasos de la cirugía bariátrica por puerto único y por puerto reducido.MétodosSe realizó un estudio prospectivo y observacional. Se incluyeron pacientes mayores de 18 años que fueron sometidos a cirugía laparoscópica primaria de manga gástrica (MG), bypass gástrico de una sola anastomosis (BAGUA), bypass gástrico en Y de Roux (BGYR) y cirugía de revisión por abordaje de puerto único o puerto reducido entre los meses de julio de 2020 y junio de 2021.ResultadosA un total de 170 pacientes (media IMC, 41,47 kg/m2; media edad 36,92 años) se les realizó una cirugía bariátrica laparoscópica (54 MG por puerto único, 16 MG por puerto reducido, 4 BAGUA y 14 cirugías de revisión) utilizando el dispositivo magnético en diferentes pasos del proceso quirúrgico. El tiempo promedio de la MG por puerto único y MG por puerto reducido fueron 65,52 min y 59,36 min, respectivamente; mientras que para BGYR 74,19 min, BAGUA 70,98 min y cirugías de revisión 88,38 min. Entre las complicaciones intraoperatorias se reportaron 2,94% de laceraciones hepáticas leves sin sangrado significante. No hubo ningún porcentaje de mortalidad ni de complicaciones mayores a los 30 días.ConclusionesLa asistencia magnética en cirugía bariátrica por puerto único y por puerto reducido es una técnica innovadora. Con este estudio prospectivo intentamos demostrar el perfil de seguridad y los usos potenciales que pueden mejorar la implementación de nuevos abordajes quirúrgicos en cirugía bariátrica (AU)

Endomarketing para la adherencia al tratamiento de enfermedades dermatológicas estigmatizantes / Endomarketing for adherence to the treatment of stigmatizing dermatological diseases

Las enfermedades cutáneas son una amplia gama de afecciones que afectan la piel, de origen bacteriano, viral, fúngica, reacción alérgica, cáncer, parásito, hereditarias, ideopáticas; por sus sintomatologías pueden generar estigma. Por tal motivo, la Organización Mundial para la Salud, alienta a los Estados miembros a que se involucren en actividades de promoción para aumentar la concienciación con el fin de combatir la discriminación que perciben los pacientes con enfermedades dermatológicas estigmatizantes (EDE), tanto por la comunidad y en los establecimientos de salud, pudiendo repercutir negativamente en la adherencia del tratamiento. El objetivo de este estudio fue valorar el uso de endomarketing para la adherencia al tratamiento de EDE. Se realizó una investigación cuantitativa. Se les aplicó encuesta de endomarketing a 279 participantes; además con 147 pacientes con EDE se indago la percepción de actitudes estigmatizantes. Los resultados mostraron un alcance sobre el endomarketing de 0,62 en personal de atención directa y 0,45 para atención indirecta; los pacientes con mayor percepción de actitudes estigmatizantes fueron los que presentaban afecciones en piel tipo infecciosas, mayormente proveniente de la atención indirecta. Se infiere que el conocimiento sobre las EDE disminuye las expresiones de rechazos. Como alternativas para la formación del personal con una mayor satisfacción en el trabajo, competencia para gestionar y elevado sentido de espiritualidad corporativa, que garantice atención humanitaria a estos pacientes, se sugiere el uso de endomarketing, para conciliar los objetivos e intereses del recurso humano interno a las necesidades y expectativas de los pacientes con EDE(AU)

Skin diseases are a wide range of conditions that affect the skin, of bacterial, viral, fungal origin, allergic reaction, cancer, parasite, hereditary, idiopathic; due to their symptoms they can generate stigma. For this reason, the World Health Organization encourages Member States to engage in promotional activities to raise awareness in order to combat the discrimination perceived by patients with stigmatizing dermatological diseases (SDD), both for the community and in health establishments, which may have a negative impact on adherence to treatment. The objective of this study was to assess the use of endomarketing for adherence to DTS treatment. A quantitative investigation was carried out. An endomarketing survey was applied to 279 participants; In addition, with 147 patients with EDE, the perception of stigmatizing attitudes was investigated. The results showed a reach on endomarketing of 0.62 in direct attention personnel and 0.45 for indirect attention; The patients with the highest perception of stigmatizing attitudes were those who presented infectious-type skin conditions, mostly from indirect care. It is inferred that knowledge about DTS decreases the expressions of rejections. As alternatives for the training of personnel with greater job satisfaction, competence to manage and a high sense of corporate spirituality, which guarantees humanitarian attention to these patients, the use of endomarketing is suggested, to reconcile the objectives and interests of internal human resources. to the needs and expectations of patients with DTS(AU)

Modificaciones en el consumo recreativo de cannabis durante el confinamiento domiciliario en la pandemia por la COVID-19 / Changes in recreational cannabis use during home confinement in the COVID-19 pandemic

El objetivo del presente artículo fue analizar la influencia del confinamiento poblacional en la experiencia de consumo de cannabis e identificar los factores que modulan el patrón de consumo de esta sustancia en un grupo de usuarios de drogas residentes en la comunidad autónoma de Aragón (España). Para ello, se realizó un estudio de tipo cualitativo basado en la realización de dieciséis entrevistas personales semiestructuradas a consumidores de cannabis según un muestreo no aleatorio en bola de nieve. Tras el análisis de su discurso se observaron modificaciones tanto de aumento como de disminución en la experiencia de consumo, además de una posible relación entre los cambios producidos en el patrón de consumo de estos usuarios y las restricciones decretadas por el gobierno de este país. Así se concluyó que el confinamiento poblacional generó modificaciones en el patrón de consumo de los usuarios de drogas, el incremento del consumo se dio en usuarios con un aumento del tiempo libre disponible y que realizaron acopio de cannabis previo al asilamiento. Mientras, la reducción se relacionó con la disminución de las oportunidades para consumir cannabis, desconocimiento de proveedores y ampliación de las jornadas laborales, principalmente. (AU)

The aim of this article was to analyse the influence of population confinement on the experience of cannabis use and to identify the factors that modulate the pattern of cannabis use in a group of drug users living in the autonomous community of Aragón (Spain). For this purpose, a qualitative study was carried out based on sixteen semi-structured personal interviews with cannabis users according to a non-random snowball sampling. After analysing their discourse, changes were observed both in terms of an increase and a decrease in the experience of consumption, as well as a possible relationship between the changes in the consumption pattern of these users and the restrictions decreed by the government of this country. Thus, it was concluded that the population confinement generated changes in the consumption pattern of drug users, with an increase in consumption occurring in users with an increase in available free time and who had collected cannabis prior to asylum. Meanwhile, the reduction was related to the decrease in opportunities to consume cannabis, lack of knowledge of suppliers and longer working hours, mainly.

Enfermedad cardiovascular aterosclerótica según el sexo en personas de edad mediana con diabetes mellitus / Atherosclerotic cardiovascular disease according to sex in middle-aged people with diabetes mellitus

Introducción: El sexo influye en la susceptibilidad de las personas de ambos géneros con relación a la mayoría de las enfermedades comunes, incluidas la diabetes mellitus y la aterosclerosis. Objetivo: Identificar si existen diferencias en la presentación de la enfermedad cardiovascular aterosclerótica entre hombres y mujeres de edad mediana con diabetes mellitus. Métodos: Se realizó un estudio descriptivo de corte transversal en 1449 pacientes con diabetes mellitus en edad mediana (40 a 59 años) que ingresaron en el Centro de Atención al Diabético de Bayamo, Granma, desde el año 2010 al 2019. Se empleó la prueba de Chi Cuadrado para comprobar la relación entre las variables cualitativas, y T de Student para comparar los valores promedio de las variables cuantitativas. Resultados: La proporción de enfermedad cardiovascular aterosclerótica en el sexo masculino fue similar a la del femenino (51,4 por ciento x 48,6 por ciento, p=0.2328). No hubo discrepancias importantes en el porcentaje de la enfermedad, entre ambos sexos, en los diferentes grupos etarios. El riesgo de enfermedad cardiovascular aterosclerótica en los hombres fue mayor que en las mujeres premenopausicas (OR=2,19, IC: 1,4-3,3 p=0,0002), pero inferior respecto a las posmenopáusicas. (OR=1.12, IC: 0.8-1.4, p=0.4129). El análisis multivariado mostró al tiempo de la diabetes >10 años y a la hipertensión arterial como riesgo de enfermedad cardiovascular aterosclerótica en ambos sexos. Asimismo, se evidenció en la edad mayor de 45 años en los hombres (OR=2.5, IC: 1.4-4.6) y la menopausia en las mujeres (OR=1.8, IC: 1.1-3.07). Conclusiones: La frecuencia de la enfermedad cardiovascular aterosclerótica en las personas de edad mediana con diabetes mellitus es similar en ambos sexos. El sexo masculino tiene mayor riesgo de enfermarse que las mujeres premenopausicas, pero menor que las posmenopáusicas. La hipertensión arterial y el tiempo de la diabetes son factores de riesgo comunes para uno y otro sexo(AU)

Introduction: Sex influences the susceptibility of people of both genders to most common diseases, including diabetes mellitus (DM) and atherosclerosis. Objective: Identify if there are differences in the presentation of atherosclerotic cardiovascular disease between middle-aged men and women with diabetes mellitus. Methods: A descriptive cross-sectional study was conducted in 1449 patients with DM in middle age (40 to 59 years) who were admitted to the Diabetic´s Care Center of Bayamo, Granma province, from 2010 to 2019. The Chi-Square test was used to check the relation between the qualitative variables, and the T Student test to compare the average values of the quantitative variables. Results: The proportion of atherosclerotic cardiovascular disease in males was similar to that of females (51.4 percent x 48.6 percent, p=0.2328). There were no major discrepancies in the percentage of atherosclerotic cardiovascular disease, between both sexes, in the different age groups. The risk of atherosclerotic cardiovascular disease in men was higher than in pre-menopausal women (OR=2.19, CI: 1.4-3.3 p=0.0002), but lower than in post-menopausal women. (OR=1.12, CI: 0.8-1.4, p=0.4129). Multivariate analysis showed diabetes >10 years and arterial hypertension as a risk of atherosclerotic cardiovascular disease in both sexes. It was also evidenced in ages over 45 years in men (OR=2.5, CI: 1.4-4.6) and menopause in women (OR=1.8, CI: 1.1-3.07). Conclusions: The frequency of atherosclerotic cardiovascular disease in middle-aged people with diabetes mellitus is similar in both sexes. Males have a higher risk of atherosclerotic cardiovascular disease than pre-menopausal women, but lower than post-menopausal women. High blood pressure and diabetes time are common risk factors for both sexes(AU)

Simultaneous laparoscopic inguinal hernia repair and cholecystectomy: does it cause mesh infection? / Colecistectomia e herniorrafia inguinal laparoscópica simultâneas: causa infecção de tela?

ABSTRACT Background: Repair of inguinal hernia concomitant with cholecystectomy was rarely performed until more recently when laparoscopic herniorrhaphy gained more adepts. Although it is generally an attractive option for patients, simultaneous performance of both procedures has been questioned by the potential risk of complications related to mesh, mainly infection. Aim: To evaluate a series of patients who underwent simultaneous laparoscopic inguinal hernia repair and cholecystectomy, with emphasis on the risk of complications related to the mesh, especially infection. Methods: Fifty patients underwent simultaneous inguinal repair and cholecystectomy, both by laparoscopy, of which 46 met the inclusion criteria of this study. Results: In all, hernia repair was the first procedure performed. Forty-five (97,9%) were discharged within 24 h after surgery. Total mean cost of the two procedures performed separately ($2,562.45) was 43% higher than the mean cost of both operations done simultaneously ($1,785.11). Up to 30-day postoperative follow-up, seven (15.2%) presented minor complications. No patient required hospital re-admission, percutaneous drainage, antibiotic therapy or presented any other signs of mesh infection after three months. In long-term follow-up, mean of 47,1 months, 38 patients (82,6%) were revaluated. Three (7,8%) reported complications: hernia recurrence; chronic discomfort; reoperation due a non-reabsorbed seroma, one in each. However, none showed any mesh-related complication. Satisfaction questionnaire revealed that 36 (94,7%) were satisfied with the results of surgery. All of them stated that they would opt for simultaneous surgery again if necessary. Conclusion: Combined laparoscopic inguinal hernia repair and cholecystectomy is a safe procedure, with no increase in mesh infection. In addition, it has important advantage of reducing hospital costs and increase patient' satisfaction.

RESUMO Racional: Reparo da hérnia inguinal concomitante à colecistectomia era raramente realizado até mais recentemente, quando a herniorrafia laparoscópica ganhou mais adeptos. Embora geralmente seja opção atraente para pacientes, a realização simultânea tem sido questionada pelo risco potencial de complicações relacionadas à tela, principalmente infecção. Objetivo: Avaliar uma série de pacientes submetidos a colecistectomia e herniorrafia inguinal laparoscópica simultâneas, com ênfase no risco de complicações relacionadas a tela, em especial infecção. Métodos: Cinquenta pacientes foram submetidos a herniorrafia e colecistectomia simultâneas por videolaparoscopia, dos quais 46 atenderam aos critérios de inclusão. Resultados: Em todos, a herniorrafia foi realizada inicialmente. Quarenta e cinco (97,9%) tiveram alta em 24 h. O custo médio total dos dois procedimentos realizados separadamente ($2.562,45) foi 43% maior do que o custo médio das duas operações feitas simultaneamente ($1.785,11). Após 30 dias de acompanhamento pós-operatório, sete (15,2%) apresentaram complicações menores. Após três meses, nenhum necessitou de readmissão hospitalar, drenagem, antibioticoterapia ou sinal de infecção de tela. No seguimento em longo prazo, média de 47,1 meses, 38 (82,6%) foram reavaliados. Três (7,8%) relataram complicações: recorrência de hérnia; desconforto crônico; reoperação por seroma não reabsorvido. No entanto, nenhum apresentou qualquer complicação relacionada à tela. Questionário de satisfação revelou que 36 (94,7%) ficaram satisfeitos com o resultado da operação. Todos afirmaram que optariam pela ela simultânea novamente se necessário. Conclusão: O reparo da hérnia inguinal concomitante com colecistectomia por laparoscopia é procedimento seguro, sem aumento de infecção da tela. Além disso, tem a vantagem importante de reduzir custos hospitalares e aumentar a satisfação do paciente.

Preservative of Essential Oil Blends: Control of Clostridium perfringens Type a in Mortadella

Abstract The aim of this study was to evaluate the antimicrobial effect of the essential oils of cinnamon, cardamom, clove, oregano, and thyme and their synergism on vegetative cells and endospores of Clostridium perfringens type A inoculated in meat sausage (mortadella), as well as the influence of blends on the color, and lipid oxidation through the determination of thiobarbituric acid reactive substances (TBARS index). The anticlostridial action of the oil blends was established. The two added oil blends (Treat. 1: oregano, clove, and thyme; Treat. 2: oregano, clove, and cinnamon) in combination with reduced nitrite content (75 ppm) promoted a lower growth of C. perfringens in mortadella stored at 15 °C for 21 days in comparison to treatments containing only 75 ppm of nitrite. The essential oil blends showed antioxidant action and did not alter food color, thus possessing potential application as a preservative for the meat products industry.

Resistencia antimicrobiana y factores de virulencia en aislados de Vibrio cholerae O1. Cuba, 2012-2015 / Antimicrobial resistance and virulence factors in Vibrio cholerae O1 isolates. Cuba, 2012-2015

Introducción: El cólera es una infección intestinal aguda causada por cepas toxigénicas de Vibrio choleare. La rápida diseminación y emergencia de la multirresistencia que caracteriza a este patógeno, podría interferir en el éxito de la terapia antimicrobiana, por lo que constituye una prioridad monitorear los cambios en los patrones de susceptibilidad, como parte trascendental de la política de control de la resistencia antimicrobiana. Objetivo: Determinar el comportamiento de la resistencia antimicrobiana frente a los antimicrobianos de interés empleados en el tratamiento, la presencia de factores de virulencia enzimáticos y si existe relación entre ambos. Métodos: Se realizó un estudio descriptivo de corte transversal durante julio de 2012 a diciembre de 2015. Se estudiaron 500 aislamientos pertenecientes al cepario del Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí, procedentes de brotes de enfermedades diarreicas agudas de la red nacional de laboratorios de Microbiología de Cuba. Se aplicaron métodos convencionales fenotípicos para determinar el comportamiento de la resistencia antimicrobiana, la presencia de factores enzimáticos y la relación de estos con la resistencia antimicrobiana. Resultados: Los mayores porcentajes de sensibilidad se obtuvieron frente a azitromicina (98 por ciento), doxiciclina (96 por ciento) y ciprofloxacina (93 por ciento) y de resistencia frente a ampicilina (100 por ciento) y trimetoprim-sulfametoxazol (99,4 por ciento). Se encontraron 44 aislados (8,8 por ciento) multirresistente. Todos los aislamientos poseían al menos dos enzimas extracelulares como factores de virulencia, las más frecuentes: gelatinasa (96 por ciento) y lecitinasa (95 por ciento). Conclusiones: Se evidencia una relación directa y proporcional entre la presencia de los factores de virulencia y resistencia antimicrobiana, sinergismo que surgiere mayor patogenicidad de los aislados estudiados procedentes de brotes epidémicos(AU)

Introduction: Cholera is an acute intestinal infection caused by toxigenic strains of Vibrio choleare. The rapid dissemination and emergence of the multiresistance that characterizes this pathogen could interfere with the success of antimicrobial therapy, so it is a priority to monitor changes in susceptibility patterns, as a transcendental part of the resistance control policy antimicrobial. Objective: To determine the behavior of antimicrobial resistance against the antimicrobials of interest used in the treatment, the presence of enzymatic virulence factors and whether there is a relationship between them. Methods: A descriptive cross-sectional study was conducted during July 2012 to December 2015. Where 500 isolates belonging to the cepary of the National Reference Laboratory for Acute Diarrheal Diseases of the Institute of Tropical Medicine Pedro Kourí, from outbreaks of EDA of the national network of Microbiology laboratories in Cuba. Conventional phenotypic methods were applied to determine the behavior of antimicrobial resistance, the presence of enzymatic factors and their relationship with antimicrobial resistance. Results: The highest percentages of sensitivity were obtained against azithromycin (98 percent), doxycycline (96 percent) and ciprofloxacin (93 percent) and resistance to ampicillin (100 percent) and trimethoprim-sulfamethoxazole (99.4 percent). 44 isolated (8.8 percent) multi-resistant were found. All isolates had at least two extracellular enzymes as virulence factors, the most frequent: gelatinase (96 percent) and lecithinase (95 percent). Conclusions: There is a direct and proportional relationship between the presence of virulence factors and antimicrobial resistance, synergism that arises greater pathogenicity of the isolates studied from epidemic outbreaks(AU)

Drogas imunossupressoras afetam os núcleos hipotalâmicos envolvidos na ingestão alimentar ? estudo experimental / Do the immunosuppressive drugs affect the hypothalamic nuclei involved in the regulation of food intake? an experimental study

RESUMO - RACIONAL: Drogas imunossupressoras são indispensáveis para pacientes pós-transplante, diminuindo, significativamente, os riscos de rejeição inerentes a este tipo de procedimento. No entanto, seus efeitos colaterais sobre os núcleos hipotalâmicos envolvidos na regulação da ingestão de alimentos e o efeito no excessivo ganho de peso e suas comorbidades associadas são desconhecidos. OBJETIVO: Analisar a ocorrência de alterações morfológicas dos núcleos paraventricular, área hipotalâmica lateral, dorsomedial, ventromedial e arqueado em ratos Wistar submetidos ao tratamento imunossupressor com Tacrolimus (TAC) ou Micofenolato Mofetil (MMF). MÉTODOS: Foram utilizados Ratos Wistar machos adultos distribuídos, randomicamente, em quatro grupos de acordo com o tratamento oral utilizado por 14 semanas: Controle; Sham (Placebo); Tacrolimus (TAC 1mg/kg peso) e Micofenolato Mofetil (MMF 30mg/kg peso). Ao final do tratamento, os animais foram eutanasiados e seus encéfalos fixados para o processamento histológico. Posteriormente, as lâminas foram fotodocumentadas para o desenvolvimento da análise estereológica dos corpos celulares dos neurônios dos núcleos hipotalâmicos, tendo como parâmetros a densidade neuronal e no número de neurônios. RESULTADOS: Todos os grupos estudados mostraram curva de ganho de peso ponderal durante todo o período de experimento. Não houve diferença significativa na densidade neuronal e no número de neurônios hipotalâmicos dos núcleos hipotalâmicos entre os grupos estudados. Não foram detectadas alterações morfológicas dos corpos celulares dos neurônios hipotalâmicos capazes de serem imputadas ao uso dos imunossupressores envolvidos no estudo. CONCLUSÃO: O tratamento dos animais experimentais com os imunossupressores não evidenciou alterações no número e densidade dos corpos celulares dos neurônios dos núcleos hipotalâmicos estudados.

ABSTRACT - BACKGROUND: Immunosuppressive drugs are essential for reducing the rejection risk in post-transplant patients, which is commonly associated with this procedure. However, side effects of those drugs on the hypothalamic nuclei involved in the food intake regulation, excessive weight gain, and also associated comorbidities are still unknown. PURPOSE: The purpose of this study was to analyze possible changes in the neuronal morphology and cell density in the paraventricular nuclei, lateral hypothalamic area, dorsomedial nuclei, and ventromedial and arcuate nuclei in Wistar rats submitted to immunosuppressive treatment with tacrolimus (TAC) or mycophenolate mofetil (MMF). METHODS: Adult male Wistar rats were randomly assigned to the following groups according to the oral treatment administered for 14 weeks: control, sham (placebo), TAC (1 mg/kg of weight), and MMF (30 mg/kg of weight). After treatment, the animals were sacrificed and their brains fixed for later histological staining. Subsequently, the slides were photodocumented for stereological analysis of the hypothalamic nuclei. RESULTS: All experimental groups showed a weight gain throughout the study. There was no significant difference in neuronal density/number of cells in the hypothalamic nuclei between groups. Morphological changes were not detected in the hypothalamic neurons. CONCLUSION: Treatments with immunosuppressants could not modify the morphological and cell density aspects of the hypothalamic nuclei during this supplementation period.