Severity and mortality of acute respiratory failure in pediatrics: A prospective multicenter cohort in Bogotá, Colombia.

Background and Aims: Acute respiratory failure (ARF) is the most frequent cause of cardiorespiratory arrest and subsequent death in children worldwide. There have been limited studies regarding ARF in high altitude settings. The aim of this study was to calculate mortality and describe associated factors for severity and mortality in children with ARF. Methods: The study was conducted within a prospective multicentric cohort that evaluated the natural history of pediatric ARF. For this analysis three primary outcomes were studied: mortality, invasive mechanical ventilation, and pediatric intensive care unit (PICU) length of stay. Eligible patients were children older than 1 month and younger than 18 years of age with respiratory difficulty at the time of admission. Patients who developed ARF were followed at the time of ARF, 48 h later, at the time of discharge, and at 30 and 60 days after discharge. It was conducted in the pediatric emergency, in-hospital, and critical-care services in three hospitals in Bogotá, Colombia, from April 2020 to June 2021. Results: Out of a total of 685 eligible patients, 296 developed ARF for a calculated incidence of ARF of 43.2%. Of the ARF group, 90 patients (30.4%) needed orotracheal intubation, for a mean of 9.57 days of ventilation (interquartile range = 3.00-11.5). Incidence of mortality was 6.1% (n = 18). The associated factors for mortality in ARF were a history of a neurologic comorbidity and a higher fraction of inspired oxygen at ARF diagnosis. For PICU length of stay, the associated factors were age between 2 and 5 years of age, exposure to smokers, and respiratory comorbidity. Finally, for mechanical ventilation, the risk factors were obesity and being unstable at admission. Conclusions: ARF is a common cause of morbidity and mortality in children. Understanding the factors associated with greater mortality and severity of ARF might allow earlier recognition and initiation of prompt treatment strategies.

Impact of squat set configuration on mechanical performance in paired sets of upper-body exercises.

BACKGROUND: Paired sets and alternative set configurations (e.g., cluster sets) are frequently employed by strength and conditioning practitioners; however, their synergistic impact remains underexplored in research. This study aimed to elucidate whether the set configuration used in a lower-body exercise affects mechanical performance during paired sets of upper-body exercises. METHODS: Twenty-one resistance-trained individuals (14 men and 7 women) randomly completed three experimental sessions that involved four sets of five repetitions at 75%1RM during both the bench press and bench pull exercises. The three experimental sessions varied solely in the activity conducted during the inter-set rest periods of each upper-body exercise: (i) Traditional squat - six squat repetitions without intra-set rest at 65%1RM; (ii) Rest redistribution squat - two clusters of three repetitions of the squat exercise at 65%1RM with 30 s of intra-set rest; and (iii) Passive rest - no exercise. RESULTS: The rest redistribution set configuration allowed the sets of the squat exercise to be performed at a faster velocity than the traditional set configuration (p = 0.037). However, none of the mechanical variables differed between the exercise protocols neither in the bench press (p ranged from 0.279 to 0.875) nor in the bench pull (p ranged from 0.166 to 0.478). CONCLUSIONS: Although rest redistribution is an effective strategy to alleviate fatigue during the sets in which it is implemented, it does not allow subjects to perform better in subsequent sets of the training session.

Which Strength Manifestation Is More Related to Regional Swimmers' Performance and In-Water Forces? Maximal Neuromuscular Capacities Versus Maximal Mechanical Maintenance Capacity.

PURPOSE: To explore the association of the load-velocity (L-V) relationship variables and ability to maintain maximal mechanical performance during the prone bench-pull exercise with sprint swimming performance and in-water forces. METHODS: Eleven competitive adult male swimmers (50-m front crawl World Aquatics points: 488 [66], performance level 4) performed 1 experimental session. The L-V relationship variables (L0 [ie,  maximal theoretical load at 0 velocity]; v0 [ie, maximal theoretical velocity at 0 load], and Aline [ie, area under the L-V relationship]) and maximal mechanical maintenance capacity were assessed at the beginning of the session. Afterward, sprint swimming performance and in-water force production were tested through a 50-m front-crawl all-out trial and 15-s fully-tethered swimming, respectively. RESULTS: Only v0 presented high positive associations with 50-m time and swimming kinematics (r > .532; P < .046). The L0, v0, and Aline showed very high positive associations with the in-water forces during tethered swimming (r > .523; P < .049). However, the ability to maintain maximal mechanical performance, assessed by the mean velocity decline during the prone bench pull, was only significantly correlated with stroke rate (r = -.647; P = .016) and stroke index (r = .614; P = .022). CONCLUSIONS: These findings indicate that maximal neuromuscular capacities, especially v0, have a stronger correlation with swimming performance and in-water force production than the ability to maintain maximal mechanical performance in level 4 swimmers.

Impact of Lifting Straps on the Relationship Between Maximum Repetitions to Failure and Lifting Velocity During the Prone Bench Pull Exercise.

BACKGROUND: Fastest mean (MVfastest) and peak (PVfastest) velocity of the set have been proposed to predict the maximum number of repetitions to failure (RTF) during the Smith machine prone bench pull (PBP) exercise. HYPOTHESIS: Goodness-of-fit would be higher for individualized compared with generalized RTF-velocity relationships and comparable for both execution equipment conditions (with or without straps), and the MVfastest and PVfastest associated with each RTF would be comparable between execution equipment and prediction methods (multiple- vs 2-point method). STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: After determining the PBP 1-repetition maximum (1RM), 20 resistance-trained male athletes performed 2 sessions randomly, with and without lifting straps, consisting of single sets to failure against the same load sequence (60% to 80% to 70% 1RM). Generalized (pooling data from all subjects) and individualized (separately for each subject using multiple-point or 2-point methods) RTF-velocity relationships were constructed. RESULTS: Individualized RTF-velocity relationships were always stronger than generalized RFT-velocity relationships, but comparable with (MVfastest: r2 = 0.87-0.99]; PVfastest: r2 = 0.88-1.00]) and without (MVfastest: r2 = 0.82-1.00; PVfastest: r2 = 0.89-0.99]) lifting straps. The velocity values associated with each RTF were comparable between execution equipment (P ≥ 0.22), but higher for the multiple-point compared with the 2-point method (P < 0.01). CONCLUSION: The use of lifting straps during the Smith machine PBP exercise does not affect the goodness-of-fit of the RTF-velocity relationships or the velocity values associated with different RTFs. However, caution should be exercised when using different methods. CLINICAL RELEVANCE: The benefits of the RTF-velocity relationships can be extrapolated when using lifting straps, and the 2-point method can also be used as a quick and more fatigue-free procedure. Nevertheless, it is imperative for coaches to ensure that these relationships are reflective of fatigue experienced during training.

Performance evaluation of Trichoderma reseei in tolerance and biodegradation of diuron herbicide in agar plate, liquid culture and solid-state fermentation.

The present study evaluated the performance of the fungus Trichoderma reesei to tolerate and biodegrade the herbicide diuron in its agrochemical presentation in agar plates, liquid culture, and solid-state fermentation. The tolerance of T. reesei to diuron was characterized through a non-competitive inhibition model of the fungal radial growth on the PDA agar plate and growth in liquid culture with glucose and ammonium nitrate, showing a higher tolerance to diuron on the PDA agar plate (inhibition constant 98.63 mg L-1) than in liquid culture (inhibition constant 39.4 mg L-1). Diuron biodegradation by T. reesei was characterized through model inhibition by the substrate on agar plate and liquid culture. In liquid culture, the fungus biotransformed diuron into 3,4-dichloroaniline using the amide group from the diuron structure as a carbon and nitrogen source, yielding 0.154 mg of biomass per mg of diuron. A mixture of barley straw and agrolite was used as the support and substrate for solid-state fermentation. The diuron removal percentage in solid-state fermentation was fitted by non-multiple linear regression to a parabolic surface response model and reached the higher removal (97.26%) with a specific aeration rate of 1.0 vkgm and inoculum of 2.6 × 108 spores g-1. The diuron removal in solid-state fermentation by sorption on barley straw and agrolite was discarded compared to the removal magnitude of the biosorption and biodegradation mechanisms of Trichoderma reesei. The findings in this work about the tolerance and capability of Trichoderma reesei to remove diuron in liquid and solid culture media demonstrate the potential of the fungus to be implemented in bioremediation technologies of herbicide-polluted sites.

Relationship between perceptual and mechanical markers of fatigue during bench press and bench pull exercises: impact of inter-set rest period length.

This study aimed to explore whether the relationship between perceptual (rating of perceived exertion; RPE) and mechanical (maximal number of repetitions completed [MNR], fastest set velocity, and mean velocity decline) variables is affected by the length of inter-set rest periods during resistance training sets not leading to failure. Twenty-three physically active individuals (15 men and eight women) randomly completed 12 testing sessions resulting from the combination of two exercises (bench press and bench pull), three inter-set rest protocols (1, 3, and 5 min), and two minimal velocity thresholds (farther from muscular failure [MVT0.45 for bench press and MVT0.65 for bench pull] and closer to muscular failure [MVT0.35 for bench press and MVT0.55 for bench pull]). The duration of inter-set rest periods did not have a significant impact on RPE values (p ranged from 0.061 to 0.951). Higher proximities to failure, indicated by lower MVTs, were associated with increased RPE values (p < 0.05 in 19 out of 24 comparisons). Moreover, as the number of sets increased, an upward trend in RPE values was observed (p < 0.05 in seven out of 12 comparisons). Finally, while acknowledging some inconsistencies, it was generally observed that higher magnitudes of the mechanical variables, especially MNR (rs < -0.55 in three out of four comparisons), were associated with lower RPE values. These results, which were comparable for the bench press and bench pull exercises, suggest that post-set RPE values are affected by the fatigue experienced at both the beginning and end of the set.

The Greatwall-Endosulfine-PP2A/B55 pathway controls entry into quiescence by promoting translation of Elongator-tuneable transcripts.

Quiescent cells require a continuous supply of proteins to maintain protein homeostasis. In fission yeast, entry into quiescence is triggered by nitrogen stress, leading to the inactivation of TORC1 and the activation of TORC2. Here, we report that the Greatwall-Endosulfine-PPA/B55 pathway connects the downregulation of TORC1 with the upregulation of TORC2, resulting in the activation of Elongator-dependent tRNA modifications essential for sustaining the translation programme during entry into quiescence. This process promotes U34 and A37 tRNA modifications at the anticodon stem loop, enhancing translation efficiency and fidelity of mRNAs enriched for AAA versus AAG lysine codons. Notably, some of these mRNAs encode inhibitors of TORC1, activators of TORC2, tRNA modifiers, and proteins necessary for telomeric and subtelomeric functions. Therefore, we propose a novel mechanism by which cells respond to nitrogen stress at the level of translation, involving a coordinated interplay between the tRNA epitranscriptome and biased codon usage.

Incidence and risk factors related to SARS-CoV-2 infection, reinfection, and seroconversion: Analysis of a healthcare workers cohort from a university hospital in Colombia.

Objectives: To determine the incidence and factors associated with SARS-CoV-2 infection and seroconversion among healthcare workers (HCWs) during the COVID-19 pandemic in a university hospital in Colombia. Methods: We analyzed the CoVIDA-Fundación Santa Fe de Bogotá (FSFB) cohort, consisting of 419 HCWs from the FSFB university hospital. The cohort was followed during active surveillance (June 25, 2020, to April 30, 2021) and passive surveillance (May 01, 2021, to March 16, 2022) periods. Incidence rates for SARS-CoV-2 infection, reinfection, and seroconversion were estimated, considering pre- and post-COVID-19 vaccination. Cox proportional-hazards models were used to identify factors related to infection and seroconversion during the active surveillance period. Results: COVID-19 incidence rate ranged between 16-52 cases per 1000 person-month. SARS-CoV-2 reinfections were rare, ranging between less than one case to 13 cases per 1000 person-month. The seroconversion rates ranged between 52-55 cases per 1000 person-month. High socioeconomic level was a protective factor for SARS-CoV-2 infection, while SARS-CoV-2 infection was the main factor associated with seroconversion. Conclusion: This study provides insights into the incidence and risk factors of SARS-CoV-2 infection among HCWs in a Colombian university hospital. The findings may offer valuable guidance for reducing virus spread within healthcare settings.

Differences in Various Strength Manifestations Between the Flat and Retracted Bench Press Variants: Are They Affected by Subjects' Experience or Strength Levels?

ABSTRACT: Piepoli, A, Miras-Moreno, S, Janicijevic, D, Martínez-Amat, A, and García-Ramos, A. Differences in various strength manifestations between the flat and retracted bench press variants: are they affected by subjects' experience or strength levels? J Strength Cond Res 37(12): 2339-2345, 2023. The objective of this study was to explore the effect of retracting the scapulae during the free-weight bench press (BP) exercise on various strength manifestations and perceptual variables. Twenty-eight recreationally trained male lifters (BP 1-repetition maximum [1RM] = 96.1 ± 20.8 kg) randomly performed in 2 different sessions: the flat BP (scapulae free to move during the movement) and retracted BP (shoulders retracted during the movement). Three strength manifestations were evaluated: (a) explosive strength -mean velocity (MV) achieved against 3 submaximal loads (40, 60, and 80%1RM); (b) maximal strength -1RM; and (c) endurance strength -number of repetitions completed to failure against the 70%1RM. Discomfort and ratings of perceived exertion (RPE) values were also recorded immediately after completing each test. The upward displacement of the barbell was lower for the retracted BP compared with the flat BP at the 3 submaximal loads ( p ≤ 0.024), but no significant differences between the BP variants were observed for the MV at submaximal loads ( p ≥ 0.473), 1RM ( p = 0.147), number of repetitions completed to failure ( p = 0.447), RPE at submaximal loads ( p ≥ 0.363), or discomfort during any test ( p ≥ 0.611). Subjects always demonstrated a greater strength performance with the BP variant most used in their training programs, but the differences between the flat and retracted BP were not affected by subjects' maximal strength values ( p ≥ 0.162). These results suggest that retracting the scapulae during the BP exercise presents minor effects on different strength manifestations and perceptual measures of effort and discomfort.

Lifting velocity predicts the maximum number of repetitions to failure with comparable accuracy during the Smith machine and free-weight prone bench pull exercises.

This study compared the accuracy of the fastest mean velocity from set (MVfastest) to predict the maximum number of repetitions to failure (RTF) between 2 variants of prone bench pull (PBP) exercise (Smith machine and free-weight) and 3 methods (generalized, individualized multiple-point, and individualized 2-point). Twenty-three resistance-trained males randomly performed 2 sessions during Smith machine PBP and 2 sessions during free-weight PBP in different weeks. The first weekly session determined the RTF-MVfastest relationships and subjects completed single sets of repetitions to failure against 60-70-80-90%1RM. The second weekly session explored the accuracy of RTFs prediction under fatigue conditions and subjects completed 2 sets of 65%1RM and 2 sets of 85%1RM with 2 min of rest. The MVfastest associated with RTFs from 1 to 15 were greater for Smith machine compared to free-weight PBP (F ≥ 42.9; P < 0.001) and for multiple-point compared to 2-point method (F ≥ 4.6; P ≤ 0.043). The errors when predicting RTFs did not differ between methods and PBP variants, whereas all RTF-MVfastest relationships overestimated the RTF under fatigue conditions. These results suggest that RTF-MVfastest relationships present similar accuracy during Smith machine and free-weight PBP exercises and it should be constructed under similar training conditions.

MBMethPred: a computational framework for the accurate classification of childhood medulloblastoma subgroups using data integration and AI-based approaches.

Childhood medulloblastoma is a malignant form of brain tumor that is widely classified into four subgroups based on molecular and genetic characteristics. Accurate classification of these subgroups is crucial for appropriate treatment, monitoring plans, and targeted therapies. However, misclassification between groups 3 and 4 is common. To address this issue, an AI-based R package called MBMethPred was developed based on DNA methylation and gene expression profiles of 763 medulloblastoma samples to classify subgroups using machine learning and neural network models. The developed prediction models achieved a classification accuracy of over 96% for subgroup classification by using 399 CpGs as prediction biomarkers. We also assessed the prognostic relevance of prediction biomarkers using survival analysis. Furthermore, we identified subgroup-specific drivers of medulloblastoma using functional enrichment analysis, Shapley values, and gene network analysis. In particular, the genes involved in the nervous system development process have the potential to separate medulloblastoma subgroups with 99% accuracy. Notably, our analysis identified 16 genes that were specifically significant for subgroup classification, including EP300, CXCR4, WNT4, ZIC4, MEIS1, SLC8A1, NFASC, ASCL2, KIF5C, SYNGAP1, SEMA4F, ROR1, DPYSL4, ARTN, RTN4RL1, and TLX2. Our findings contribute to enhanced survival outcomes for patients with medulloblastoma. Continued research and validation efforts are needed to further refine and expand the utility of our approach in other cancer types, advancing personalized medicine in pediatric oncology.

A single dose of dihydrocapsiate does not improve neuromuscular performance in resistance-trained young adults: A randomised, triple-blinded, placebo-controlled, crossover trial.

Capsinoids may exert ergogenic effects on resistance exercises. However, the acute effects of capsinoids on neuromuscular performance in humans are unknown. Here, we aimed to investigate the acute effects of dihydrocapsiate on lower- and upper-body neuromuscular performance parameters in resistance-trained individuals. 25 young adults (n = 6 women; age = 26 ± 3 years; body mass index = 24.3 ± 2.8 kg/m2) with ≥ 1-year resistance training experience were included in this triple-blind (participants, intervention researchers, and data analysts were blinded), placebo-controlled, crossover study. Lower- and upper-body ballistic strength (countermovement jump [CMJ] height and bench press throw [BPT] peak velocity), maximum dynamic strength (estimated 1 repetition maximum in squat and bench press [BP]), and strength-endurance (mean set velocity [squat] and number of repetitions to failure [bench press]) were assessed in 2 independent sessions (≥7 days separation). Participants ingested 12 mg of dihydrocapsiate or placebo 30 min before each trial. We found no significant differences between dihydrocapsiate and placebo conditions in ballistic strength, (CMJ height 33.20 ± 8.07 vs 33.32 ± 7.85 cm; BPT peak velocity 2.82 ± 0.77 vs 2.82 ± 0.74 m/s) maximal dynamic strength (estimated squat 1RM: 123.76 ± 40.63 vs 122.66 ± 40.97 kg; estimated BP 1RM: 99.47 ± 43.09 vs 99.60 ± 43.34 kg), and strength-endurance (squat mean set velocity 0.66 ± 0.07 vs 0.66 ± 0.05 m/s; number BP repetitions to failure 13.00 ± 3.56 vs 13.00 ± 4.78) (all P ≥ 0.703). We conclude that dihydrocapsiate does not acutely improve neuromuscular performance in trained young adults.

Capsinoids ­ non-pungent analogs of capsaicin ­ have been recently proposed as potential ergogenic compounds in humans.However, the effects of a single dose of capsinoids on neuromuscular performance parameters in humans remains unknown.12 mg of dihydrocapsiate does not improve neuromuscular performance in resistance-trained young adults.Dihydrocapsiate should not be recommended as an ergogenic aid to acutely increase neuromuscular performance.

Frequency of allergic reactions in egg allergic patients after receiving the yellow fever vaccine.

BACKGROUND: Immunization with live attenuated viral yellow fever vaccine (YFV) grants effective immunity in most cases, and is recommended and prioritized for residents and travelers of endemic countries. YFV is seldom administered to egg-allergic patients (EAP) since it is cultivated in embryonated chicken eggs and may contain residual egg proteins, being a problem for egg-allergic residents and travelers of endemic countries. OBJECTIVE: Describe the frequency of allergic reactions after YFV administration in confirmed EAP from an allergy outpatient center in Bogotá, Colombia. METHODS: An observational, retrospective, cross-sectional, and descriptive study was conducted from January 2017 to December 2019. EAP whose allergy was confirmed with a positive Skin Prick Test (SPT) and/or egg protein-specific IgE levels who hadn't received the YFV were included. Every patient had an SPT, severe EAP, and an additional Intradermal Test (IDT) done with the vaccine. If the vaccine SPT and IDT were negative, the YFV was administered as a single dose; if either were positive, the YFV was administered in graded doses. Statistical analysis was done in Stata16MP. RESULTS: Seventy one patients were included, 24 (33.8%) of those had a history of egg anaphylaxis. All patients had negative YFV SPTs, and two of the five YVF IDTs were positive. Two patients, with previous egg-anaphylaxis, presented allergic reactions to the vaccine. CONCLUSIONS: YFV did not trigger allergic reactions in EAP without history of egg-anaphylaxis. With further research, safe single-dose vaccination to this population could be considered; however, patients with previous egg-anaphylaxis should be evaluated by an allergist before vaccination.

Effect of a High-Intensity Handball-Specific Fatigue Protocol Focused on the Leg Contralateral to the Throwing Arm on Interlimb Asymmetries.

ABSTRACT: Janicijevic, D, Pérez-Castilla, A, Miras-Moreno, S, Ortega-Becerra, M, Morenas-Aguilar, MD, Smajla, D, Sarabon, N, and García-Ramos, A. Effect of a high-intensity handball-specific fatigue protocol focused on the leg contralateral to the throwing arm on interlimb asymmetries. J Strength Cond Res 37(7): 1382-1389, 2023-This study aimed to elucidate which countermovement jump (CMJ) variant (unilateral or bilateral) is more sensitive to detect the decrement in kinetic CMJ-derived variables of the leg more actively involved in a handball-specific fatigue protocol. Seventeen female handball players (age: 20.6 ± 2.5 years) performed a fatigue protocol consisting of 8 repetitions of the following circuit separated by 10 seconds: 10 m sprint, 180° change of direction with the leg contralateral to the throwing arm, 10 m sprint with ball reception at 7 m, and handball throw preceded by a jump over a 40 cm hurdle with the leg contralateral to the throwing arm. Before and after the fatigue protocol, 6 unilateral CMJs (3 with each leg) and 3 bilateral CMJs were performed on a dual Kistler force platform (model 9260AA6). Bilateral CMJ height was reduced by 5.4% after the fatigue protocol (p < 0.001). However, the fatigue protocol did not promote any significant change in peak force, mean force, and propulsive impulse or in their asymmetry values (17 of 18 comparisons). The decrement of 6.1% during the unilateral CMJ in the propulsive impulse developed by the leg ipsilateral to the throwing arm (less involved in the fatigue protocol) was the only variable that reached statistical significance (p = 0.038). The pre-post fatigue changes in asymmetry values presented negligible correlations between both CMJ variants (rs = 0.01 to -0.19). These results suggest that neither unilateral nor bilateral CMJs are able to detect changes in interlimb asymmetries after a high-intensity handball-specific fatigue protocol.

Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study

Abstract Introduction Septoplasty and turbinoplasty are common surgical interventions used to relieve nasal obstructive symptoms. Since it is difficult to measure the degree of nasal blockage, current literature wonders about the frequent performance of these procedures. Objective To evaluate the perceived change in the nasal obstruction and the quality of life (QoL) of patients that underwent a septoplasty along with a turbinoplasty by applying subjective scales, to describe the correlation between those scales, and to study the impact of clinical factors in the postoperative outcomes. Methods Prospective observational study. The Nasal Obstruction Symptom Evaluation (NOSE), the Visual Analog Scale (VAS), and the Glasgow Benefit Inventory (GBI) were assessed. The paired sample Wilcoxon test was used to evaluate the difference between the pre- and postoperative surveys. The correlation coefficient between the subjective scales was calculated. A quantile regression was performed to evaluate the effect of surgery on the results adjusted for clinical and demographic variables. Results A total of 115 patients were interviewed. Postoperative NOSE scores were 45 points lower (95% confidence interval [CI]: - 53.53-- 35.46; p < 0.001) in comparison with the NOSE preoperative scores. Obesity was the only statistically significant factor associated with worse outcomes. Additionally, we found a high correlation between the NOSE and VAS scores and a negative correlation between the GBI and postoperative VAS scores. Conclusion Nasal septoplasty, when paired with a turbinoplasty, decreases nasal obstruction and improves QoL. Obesity was associated with worse results. There was a strong correlation between the NOSE and the VAS results and between the GBI and postoperative VAS results.

Improvement in Nasal Obstruction and Quality of Life after Nasal Septoplasty with Turbinoplasty: A Pre- and Post-study.

Introduction Septoplasty and turbinoplasty are common surgical interventions used to relieve nasal obstructive symptoms. Since it is difficult to measure the degree of nasal blockage, current literature wonders about the frequent performance of these procedures. Objective To evaluate the perceived change in the nasal obstruction and the quality of life (QoL) of patients that underwent a septoplasty along with a turbinoplasty by applying subjective scales, to describe the correlation between those scales, and to study the impact of clinical factors in the postoperative outcomes. Methods Prospective observational study. The Nasal Obstruction Symptom Evaluation (NOSE), the Visual Analog Scale (VAS), and the Glasgow Benefit Inventory (GBI) were assessed. The paired sample Wilcoxon test was used to evaluate the difference between the pre- and postoperative surveys. The correlation coefficient between the subjective scales was calculated. A quantile regression was performed to evaluate the effect of surgery on the results adjusted for clinical and demographic variables. Results A total of 115 patients were interviewed. Postoperative NOSE scores were 45 points lower (95% confidence interval [CI]: - 53.53-- 35.46; p < 0.001) in comparison with the NOSE preoperative scores. Obesity was the only statistically significant factor associated with worse outcomes. Additionally, we found a high correlation between the NOSE and VAS scores and a negative correlation between the GBI and postoperative VAS scores. Conclusion Nasal septoplasty, when paired with a turbinoplasty, decreases nasal obstruction and improves QoL. Obesity was associated with worse results. There was a strong correlation between the NOSE and the VAS results and between the GBI and postoperative VAS results.

Effects of phenylcapsaicin on aerobic capacity and physiological parameters in active young males: a randomized, triple-blinded, placebo-controlled, crossover trial.

Objective: Phenylcapsaicin (PC) is a new capsaicin analog which has exhibited a higher bioavailability. This sudy assessed the effects of a low dose (LD) of 0.625 mg and a high dose (HD) of 2.5 mg of PC on aerobic capacity, substrate oxidation, energy metabolism and exercise physiological variables in young males. Materials and methods: Seventeen active males (age = 24.7 ± 6.0 years) enrolled to this randomized, triple-blinded, placebo-controlled, crossover trial. Participants attended the laboratory on 4 sessions separated by 72-96 h. A submaximal exercise test [to determine maximal fat oxidation (MFO) and the intensity at MFO (FATmax)] followed by a maximal incremental test (to determine VO2max) were performed in a preliminary session. The subsequent sessions only differed in the supplement ingested [LD, HD or placebo (PLA)] and consisted of a steady-state test (60 min at FATmax) followed by a maximal incremental test. Energy metabolism, substrate oxidation, heart rate, general (gRPE) and quadriceps (RPEquad) rate of perceived exertion, skin temperature and thermal perception were tested. Results: Clavicle thermal perception was lower in HD compared to PLA and LD (p = 0.04) across time. HD reduced maximum heart rate in comparison to PLA and LD (p = 0.03). LD reported higher general RPE (RPEg) values during the steady-state test compared to PLA and HD across time (p = 0.02). HD and LD elicited higher peak of fat oxidation during the steady-state test compared with PLA (p = 0.05). Intra-test analyses revealed significant differences for fat oxidation (FATox) in favor of HD and LD compared to PLA (p = 0.002 and 0.002, respectively), and for carbohydrate oxidation (CHOox) (p = 0.05) and respiratory exchange ratio (RER) (p = 0.03) for PLA. In the incremental test, only general RPE at 60% of the maximal intensity (W) differed favoring HD (p ≤ 0.05). Conclusion: Therefore, PC may contribute to increase aerobic capacity through the improvement of fat oxidation, maximum heart rate and perceptual responses during exercise.

Effectiveness and safety of dupilumab in adults with moderate and severe atopic dermatitis in Colombia: Real-life experience.

Background: Dupilumab is a treatment approved for uncontrolled moderate-to-severe atopic dermatitis (AD). Tropical and developing countries such as Colombia have characteristics that may impact the natural history of AD and access to medical treatments. In that sense, we aimed to describe the effectiveness and safety of dupilumab in adults with moderate to severe AD in a Colombian multicenter cohort. Methods: Multicenter descriptive study that included patients who started treatment between March 2018 and May 2020 in 6 centers. Disease severity was assessed using the following: Scoring Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), Patient Oriented Eczema Measure (POEM), and Dermatology Life Quality Index (DLQI). These measurements were collected according to availability at baseline, 3-5 months, 6-12 months, and more than 12 months. Days of sick leave, hospitalizations, and AD flares before and after dupilumab treatment were reported. Adverse events (AEs) were recorded during follow-up. Results: Ninety-three patients were included, with a median age of 32 years (IQR: 24.0; 40.0) and a disease evolution time of 21 years (IQR: 16.0; 29.5). 88.2% had at least 1 allergic disease other than AD. An improvement greater than or equal to 75% EASI was observed in 41.7% of patients at 3-5 months, in 73.7% of patients at 6-12 months, and in 75.0% of patients after 12 months. For those reporting SCORAD and POEM, the median percent change ([IQR], n) from baseline in SCORAD was -67.1 ([-79.2; -54.2], n = 16), -70.5 ([-85.8; -47.9], n = 36) and -66.7 ([-77.3; -51.0], n = 13); and POEM, -58.6 ([-66.4; -55.5], n = 4), -73.0 ([-86.5; -66.7], n = 16) and -87.3 ([-93.4; -69.6], n = 8), respectively. Before initiation of dupilumab treatment, 82 (88.2%) patients reported at least 1 flare of AD in the past 12 months. During the follow-up period, 30 (32.3%) patients reported at least 1 exacerbation or flare. Twelve patients (12.9%) presented an AE and 3 (3.2%) patients discontinued dupilumab for this cause. Conclusions: Dupilumab was effective and safe for the treatment of moderate to severe AD in point-of-care settings, with results similar to randomized controlled and other real-life studies. These positive results are still maintained even though a high number of patients had short interruptions in the use of dupilumab due to administrative problems.

The role of SPECT/CT in painful, noninfected knees after knee arthroplasty: a systematic review and meta-analysis-a diagnostic test accuracy review.

PURPOSE: The aim of this systematic review was to present the current evidence on the clinical use of single-photon emission computed tomography/computed tomography (SPECT/CT) in the evaluation of noninfected painful knees after knee arthroplasty. METHODS: Embase, PubMed, Google Scholar, Ovid, Scopus, Science Direct and the Cochrane Database of Systematic Reviews were searched from database inception to May 2022 following the PRISMA guidelines. As a primary outcome, we defined the role of SPECT/CT in the diagnostic approach to noninfected painful knee arthroplasty; as a secondary objective, we described the noninfection-related factors linked to painful knee arthroplasty. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio values and other indicators were calculated; receiver operating characteristic (ROC) curve analysis results and a summary of the areas under the curve (AUCs) from the included studies were reported. A Fagan plot, likelihood ratio plot and Deeks' funnel plot were generated and analysed. Methodological quality was assessed using the QUADAS-2 tool, and the certainty of evidence was assessed by the GRADE approach. RESULTS: A total of 493 publications were identified, of which eight met the inclusion criteria, with a final pooled sample size of 308 patients. The pooled sensitivity and specificity of SPECT/CT in diagnosing the source of pain in painful knee prostheses were 0.86 (95% CI: 0.75-0.93) and 0.90 (95% CI: 0.79-0.96), respectively, with pooled +LR and -LR values of 8.9 (95% CI: 4.11-19.19) and 0.15 (95% CI: 0.09-0.28). The pooled diagnostic odds ratio was 57.35, and the area under the curve was 0.94. SPECT/CT highly accurately identified different sources of pain, such as loosening of the prosthetic components, patellofemoral overloading, instability, malalignment of the components and degeneration of the patellofemoral compartment. The confidence of the estimates was moderate according to the GRADE approach. CONCLUSION: With demonstrated high sensitivity and specificity, as a diagnostic tool, SPECT/CT can identify the source of pain in painful knees after knee arthroplasty, particularly in cases of loosening, patellofemoral disorders and component malalignment (level of evidence III). These findings have significant clinical repercussions, such as in changing the initial diagnosis, identifying or excluding different causes of painful knee arthroplasties, guiding subsequent treatment and positively impacting the final clinical outcome. We moderately recommend the use of SPECT/CT for identifying the source of pain after knee arthroplasty according to the GRADE assessment. This review was preregistered in Prospero under code CRD42022320457.