Krebs von den Lungen-6 glycoprotein circulating levels are not useful as prognostic marker in COVID-19 pneumonia: A large prospective cohort study.

Coronavirus disease 2019 (COVID-19) has rapidly expanded worldwide. Currently, there are no biomarkers to predict respiratory worsening in patients with mild to moderate COVID-19 pneumonia. Small studies explored the use of Krebs von de Lungen-6 circulating serum levels (sKL-6) as a prognostic biomarker of the worsening of COVID-19 pneumonia. We aimed at a large study to determine the prognostic value of sKL-6 in predicting evolving trends in COVID-19. We prospectively analyzed the characteristics of 836 patients with COVID-19 with mild lung disease on admission. sKL-6 was obtained in all patients at least at baseline and compared among patients with or without respiratory worsening. The receiver operating characteristic curve was used to find the optimal cutoff level. A total of 159 (19%) patients developed respiratory worsening during hospitalization. Baseline sKL-6 levels were not higher in patients who had respiratory worsening (median {IQR} 315.5 {209-469} vs. 306 {214-423} U/ml p = 0.38). The last sKL-6 and the change between baseline and last sKL-6 were higher in the respiratory worsening group (p = 0.02 and p < 0.0001, respectively). The best sKL-6 cutoff point for respiratory worsening was 497 U/ml (area under the curve 0.52; 23% sensitivity and 85% specificity). sKL-6 was not found to be an independent predictor of respiratory worsening. A conditional inference tree (CTREE) was not useful to discriminate patients at risk of worsening. We found that sKL-6 had a low sensibility to predict respiratory worsening in patients with mild-moderate COVID-19 pneumonia and may not be of use to assess the risk of present respiratory worsening in inpatients with COVID-19 pneumonia.

Formación continua y calidad de vida de los adultos mayores / Continuous Education and Quality of Life in Older Adults

Introducción: La población adulta mayor en el mundo experimenta un crecimiento acelerado, que impone retos a la sociedad para mantener y elevar la calidad de vida de este grupo etario. Objetivo: Exponer la influencia de la formación continua en la calidad de vida de los adultos mayores. Desarrollo: La calidad de vida en el adulto mayor está fuertemente influenciada por el apoyo social, que le permite hacer un mejor uso de sus habilidades y capacidades. La formación continua influye de forma positiva en la calidad de vida de los adultos mayores al prepararlos para un proceso de envejecimiento activo, una longevidad satisfactoria, y una vida digna y saludable. Al respecto, se han analizado publicaciones de autores latinoamericanos, fundamentalmente, y se han tenido en cuenta las experiencias de las Cátedras Universitarias del Adulto Mayor en Cuba. Conclusiones: Las experiencias de la participación de los adultos mayores en la formación continua universitaria demuestran que contribuye a elevar la calidad de vida de estas personas, así como a su inserción plena en la comunidad(AU)

Introduction: The older adult population worldwide is increasingly growing, which imposes challenges on society to maintain and improve the quality of life of this age group. Objective: To present the influence of continuous training on the quality of life of older adults. Development: Quality of life in the older adult is strongly influenced by social support, which allows them to make better use of their skills and capabilities. Continuous training influences the quality of life of older adults positively, by preparing them for an active aging process, a satisfactory longevity, as well as a dignified and healthy life. In this regard, publications by Latin American authors have been analyzed, fundamentally; while the experiences of the Elderly University Chairs in Cuba have been taken into account. Conclusions: The experiences of the older adults' participation in university continuous education show that it contributes to raising the quality of life of these people, as well as their full insertion in the community(AU)

Marketing social y políticas públicas para la atención integral al adulto mayor en Riobamba, Ecuador / Social marketing and public policies for comprehensive care for the elderly in Riobamba, Ecuador

Introducción: En Ecuador se han establecido políticas públicas encaminadas al tratamiento de la problemática social de los adultos mayores. Sin embargo, en la ciudad de Riobamba las acciones que se realizan para implementar estas políticas son aisladas e insuficientes, sin involucrar a todos los actores en el cambio social necesario. Objetivo: Diseñar un plan de marketing social como contribución a la implementación de las políticas públicas relacionadas con la atención integral al adulto mayor en el Gobierno Autónomo Descentralizado de Riobamba. Métodos: El análisis y síntesis de la información obtenida mediante la revisión documental, la aplicación de encuestas y entrevistas y la realización de grupos focales permitieron establecer las bases teóricas y metodológicas, identificar el problema existente y diseñar el plan de marketing social. Resultados: A partir de la convergencia existente entre el proceso de diseño e implementación de las políticas públicas y los planes de marketing social fue posible contribuir a la atención integral al adulto mayor. El plan de marketing social diseñado y validado propone un programa con seis proyectos encaminados a influir en la aceptación de ideas y la modificación de comportamientos en los públicos objetivo en beneficio de los adultos mayores, para su atención integral, con el uso de las herramientas del marketing. Conclusiones: El uso del marketing social posibilita dar el salto de la institucionalidad y la normatividad vigente al diseño de programas con verdadera coordinación entre todos los actores públicos y de la sociedad civil, garantizando la sostenibilidad y la participación en la implementación de las políticas públicas(AU)

Introduction: In Ecuador, public policies that have been established are aimed to address the social problems of the elderly. However, in the city of Riobamba the actions taken to implement these policies are isolated and insufficient, without involving all actors in the necessary social change. Objective: Design a social marketing plan as a contribution to the implementation of public policies related to comprehensive care for the elderly in the Decentralized Autonomous Government of Riobamba. Methods: The analysis and synthesis of the information obtained through the documentary review, the application of surveys and interviews and the realization of focus groups allowed to establish the theoretical and methodological bases, identify the existing problem and design the social marketing plan. Results: From the convergence between the process of design and implementation of public policies and social marketing plans, it was possible to contribute to comprehensive care for the elderly. The designed and validated social marketing plan proposes a program with six projects aimed at influencing the acceptance of ideas and the modification of behaviors in the target audiences for the benefit of older adults, for their comprehensive care, with the use of marketing tools. Conclusions: The use of social marketing makes it possible to make the leap from institutionality and current regulations to the design of programs with true coordination between all public and civil society actors, guaranteeing sustainability and participation in the implementation of public policies(AU)

Reflexión sobre las competencias docentes en los institutos superiores tecnológicos en Ecuador / Reflection about teaching competencies in Ecuadorian Higher Technological Institutes

Introducción: El desempeño de los institutos superiores tecnológicos depende en última instancia de su capital humano, con las competencias requeridas para garantizar el desempeño exitoso del proceso educativo. Objetivo: Exponer las competencias docentes que se necesitan en la actualidad para dar respuesta a las demandas de la formación superior tecnológica en Ecuador. Desarrollo: En la actualidad se han producido cambios importantes en el proceso de enseñanza aprendizaje, de forma que se priorizan los enfoques centrados en el estudiante y un amplio uso de las tecnologías de la información y las comunicaciones, así como las exigencias de la constante actualización en los saberes y habilidades de tecnólogo superior en la profesión específica. Asimismo, el desarrollo profesional y el desempeño exitoso de la institución educativa también demanda que los docentes posean competencias relacionadas no solo con la docencia, sino también con el resto de las funciones universitarias como: la investigación, la vinculación con la sociedad y la gestión de la institución educativa. En respuesta a estas demandas, los docentes de los institutos superiores tecnológicos deben adquirir competencias específicas para las cuatro funciones: docencia, investigación, vinculación con la sociedad y gestión. Conclusiones: Los institutos superiores tecnológicos deben realizar adecuadas estrategias de gestión de su capital humano, que posibiliten la obtención de las competencias necesarias para el desarrollo de la carrera profesional de los docentes, y, sobre esta base, contribuir al éxito sostenido de estas instituciones en respuesta a las demandas de la sociedad ecuatoriana(AU)

Introduction: The functioning of higher technological institutes ultimately depends on their human capital, as far as they possess the competencies required for guaranteeing the successful advance of the educational process. Objective: To show the teaching competencies currently needed to respond to the demands of higher technological training in Ecuador. Development: Currently, there have been important changes in the teaching-learning process, in such a way that student-centered approaches, as well as a wide use of information and communication technologies, are prioritized, together with the demands of continuous updating regarding the knowledge and skills of a graduate technologist for the specific profession. Also, professional development and the successful functioning of any educational institution demand that professors possess competencies related not only to teaching, but also to the rest of the university functions, such as research, society outreach and management of the educational institution. In response to these demands, professors of higher technological institutes must acquire specific competencies for the four functions: teaching, research, connection with society and management. Conclusions: Higher technological institutes must implement adequate strategies for managing their human capital, which make it possible to obtain the necessary competencies for the development of the professional career of professors, and, based on this, contributing to the sustained success of these institutions in response to the demands of the Ecuadorian society(AU)

New model of pharmacoresistant seizures induced by 3-mercaptopropionic acid in mice.

About 30% of the patients with epilepsy do not respond to clinically established anticonvulsants, despite having effective concentrations of the antiepileptic drug in plasma. Therefore, new preclinical models of epilepsy are needed to identify more efficacious treatments. We describe here a new drug-resistant seizure model in mice to be used at the early stages of pre-clinical trials. This model consists in inducing daily generalized seizures for 23 consecutive days by administration of 3-mercaptopropionic acid (MP). As a result, 100% of animals become resistant to phenytoin and 80% to phenobarbital. Such resistance is strongly associated with the overexpression of P-glycoprotein (Pgp), observed in cerebral cortex, hippocampus and striatum while resistance to Pgp nonsubstrate drugs such as carbamazepine, diazepam and levetiracetam is not observed. This model could be useful for screening novel anticonvulsant drugs with a potential effect on pharmacoresistant seizures treatment.

Involvement of the GABAergic system in the neuroprotective and sedative effects of acacetin 7-O-glucoside in rodents.

PURPOSE: Characterization of sedative, possible anticonvulsant, and protective effects of Acacetin-7-O-glucoside (7-ACAG). METHODS: 7-ACAG was separated and its purity was analyzed. Its sedative and anti-seizure effects (1, 10, 20, and 40 mg/kg) were evaluated in male mice. Synaptic responses were acquired from area CA1 of hippocampal slices obtained from male Wistar rats. Rats were subjected to stereotaxic surgeries to allow Electroencephalographic (EEG) recordings. Functional recovery was evaluated by measuring the time rats spent in completing the motor task. Then the rats were subjected to right hemiplegia and administered 7-ACAG (40 mg/kg) 1 h or 24 h after surgery. Brains of each group of rats were prepared for histological analysis. RESULTS: Effective sedative doses of 7-ACAG comprised those between 20 and 40 mg/kg. Latency and duration of the epileptiform crisis were delayed by this flavonoid. 7-ACAG decreased the synaptic response in vitro, similar to Gamma-aminobutyric acid (GABA) effects. The flavonoid facilitated functional recovery. This data was associated with preserved cytoarchitecture in brain cortex and hippocampus. CONCLUSIONS: 7-ACAG possesses anticonvulsive and sedative effects. Results suggest that GABAergic activity and neuroprotection are involved in the mechanism of action of 7-ACAG and support this compound's being a potential drug for treatment of anxiety or post-operative conditions caused by neurosurgeries.

Nerve root degeneration and regeneration by intrathecal phenol in rats: a morphologic approach.

Intrathecal injection of phenol (ITP) has been used to control intractable pain and spasticity. Direct caustic nerve damage has been postulated as the mechanism of analgesia. Sensation is commonly recovered, suggesting that a spontaneous regeneration process takes place. There is, however, a lack of mechanistic information on ITP therapy. To define morphologically the neurolysis and regeneration phenomena produced by ITP, anesthetized rats were subjected to laminectomy at L5; 5 microl of 22% phenol in saline solution or vehicle (control) was injected. Light and electron microscopy studies of nerve roots were performed at 2, 14, and 60 days after injection. Rats given ITP showed at the early stage a variable amount of roots with signs of infarction characterized by loss of axon-myelin units and thrombosis of intra-root vessels. At 14 days, abundance of macrophages removing debris, open vessels, and nerve sprouts was identified in damaged roots. At this time, non-myelinating glial fibrillary acidic protein-positive Schwann cells were observed in both damaged and apparently undamaged roots. At 60 days, abundance of 2',3'-cyclic nucleotide 3'-phosphodiesterase-positive Schwann cells myelinating newly formed axons was observed in damaged roots. Control rats did not show signs of neural or vascular pathology. Attempting to prevent thrombosis, another group of rats received heparin before ITP; these anti-coagulated rats developed radicular thrombosis, neurolysis, and hemorrhage. In conclusion, neurolysis produced by ITP is associated with acute ischemia (not prevented by heparin) and is followed by vascular, nerve, and myelin regeneration. Our results help understand the lack of efficacy of and some complications by ITP clinical therapy.

Meningioma: presentación de un caso / Meningioma: case study

Aunque no sean los más frecuentes, los tumores primarios son particularmente importantes en razón de su benignidad. Es esencial realizar el diagnóstico precoz cuando su volumen es pequeño para que el tratamiento neuroquirúrgico pueda contar con todas las probabilidades de un buen pronóstico. En este grupo de tumores se encuentran los meningiomas. Se narra un caso de meningioma en un paciente con antecedentes de hipertensión arterial no controlada. Se hace una revisión de la bibliografía de esta patología; epidemiología, clasificación, manifestaciones clínicas y tratamiento.

Brain tumors are not very common. One group of tumors is primary brain tumors that originate in the brain itself. Most of them are benign but others can have different grades of malignancy. It is important to make an early diagnosis so that the surgical treatment can give the patient a good prognosis. In this group of tumors we can find meningiomas. We present a clinical case of a patient with meningioma who has a clinical history of uncontrolled hypertension. Bibliographic reference is done of the pathology, epidemiology, classification, symptoms and treatment.

Concentration determination of extracellular and intracellular red pigments produced by Monascus sp

Monascus sp. é um fungo filamentoso cuja principal aplicação industrial está relacionada à sua capacidade de produzir pigmentos vermelhos, utilizados como corantes naturais em alimentos, em substituição aos sintéticos. Neste trabalho a produção de pigmentos vermelhos foi avaliada (por meio de espectrofotometria de varredura) em meio semi-sintético, empregando sete cepas de Monascus sp., através de cultivos conduzidos em incubador rotativo. As cepas isoladas no LEB/DEQ/EPUSP apresentaram média dos valores de absorbância dos pigmentos vermelhos extracelulares maior em relação às demais cepas (13,0 e 9,6 U, respectivamente), sendo que para as primeiras, a produção específica dos referidos pigmentos foi de 1,7 a 3,5 vezes maior que a produção específica dos pigmentos intracelulares.

Tofupill lacks peripheral estrogen-like actions in the rat reproductive tract.

OBJECTIVE: The objective of this study was to evaluate the estrogenic effect of phytoestrogens contained in a commercial food supplement (Tofupill) on the reproductive tract of ovariectomized rats. METHODS: Food supplement (3.4 or 10.2 mg/kg) and conjugated equine estrogens (CEE, 31 or 100 microg/kg) were orally administered, daily during 14 days to ovariectomized rats. At the end of treatment, the following determinations were done: dry and wet uterine weight, vaginal epithelium condition, and uterine serotonin-induced contractile response. A group treated with 17beta-estradiol was included as control for serotonin-induced contractile response. RESULTS: Food supplement did not display clear estrogenic effects on vaginal epithelium, uterine weight or myometrial sensitivity to serotonin, whereas high doses of conjugated equine estrogens showed estrogenic action. CONCLUSIONS: The present data showed that Tofupill displayed a lower estrogenic effect than conjugated equine estrogens, which are one of the most commonly used hormone replacement therapy for postmenopausal women. However, further studies are needed to evaluate the risk associated to the use of Tofupill as an alternative to hormone replacement therapy for postmenopausal women.

Spontaneous and induced aberrant sprouting at the site of injury is irrelevant to motor function outcome in rats with spinal cord injury.

In the absence of effective regeneration following spinal cord (SC) injury, sprouting from undamaged axons has been regarded as an underlying factor for functional improvement after incomplete SC injury. The influence of spontaneous and induced axonal sprouting at the injury site on motor function was tested using rats subjected to moderate SC contusion at T9 level, using megadoses of methylprednisolone (MP) and intralesion implantation of cells from sciatic nerve (PNI). Groups using MP and PNI combined, implant vehicle, and injury with no treatment were also included. Amount of sprouting at the injury sites was significantly different depending on treatment. It was abundant in PNI-treated rats, moderate in rats treated with vehicle or nontreated, and limited in rats given MP with or without PNI (chi2, p=0.0084). This sprouting showed an aberrant course and was located in proliferating tissue at the site of injury, characterized by the presence of ependymal cells, macrophages, and myelinating and nonmyelinating Schwann cells. Functional scores and amount of spared white matter were not significantly different among groups. Correlation of the amount of sprouting vs. functional outcome or vs. amount of spared tissue was not significant, while correlation of functional outcome vs. amount of spared tissue was significant (p<0.0001). In conclusion, PNI increase aberrant sprouting at the injury site, while MP limits such sprouting, in either case without impact on motor function outcome. Missing guiding channels for sprouting axons could explain the absence of any functional improvement.

Evaluation of GABA system and cell damage in parahippocampus of patients with temporal lobe epilepsy showing antiepileptic effects after subacute electrical stimulation.

PURPOSE: The gamma-aminobutyric acid (GABA) system and neuronal loss were evaluated in the parahippocampal cortex (PHC) of patients with intractable mesial temporal lobe epilepsy (MTLE) who received subacute electrical stimulation and showed antiepileptic effects. METHODS: GABA tissue content, GABA(A) and benzodiazepine (BZD) receptor levels, as well as neuronal density were determined in PHC of five patients (ESAE group) with an MTLE history of 14.8 +/- 2.5 years and seizure frequency of 11 +/- 2.9 per month, two (40%) of them with mesial sclerosis. This group demonstrated antiepileptic effects after subacute electrical stimulation (130 Hz, 450 micros, 200-400 microA), applied continuously during 16 to 20 days in PHC. Values were compared with those obtained from patients with severe MTLE (history of 21.7 +/- 2.8 years and seizure frequency of 28.2 +/- 14 per month) in whom electrical stimulation did not induce antiepileptic effects (ESWAE group, n = 4), patients with MTLE in whom no electrical stimulation was applied (MTLE group, n = 4), and autopsy material acquired from subjects without epilepsy (n = 4 obtained from three subjects). RESULTS: The ESAE group demonstrated high GABA tissue levels (219%), as well as a significantly higher cell count (58.5%) when compared with the MTLE group. The ESWAE group showed enhanced BZD-receptor levels (38%), whereas their values for GABA tissue levels and GABA(A) receptor were similar to those obtained from the MTLE group. CONCLUSIONS: It is suggested that subacute electrical stimulation of PHC is more effective in patients with less severe epilepsy, an effect associated with a high GABA tissue content and a low rate of cell loss.