Prader-Willi syndrome in a large sample from Spain: general features, obesity and regular use of psychotropic medication.

BACKGROUND: Prader-Willi syndrome (PWS), a genetically determined disorder, the most frequent cause of early onset obesity, is associated with physical and cognitive dysfunctions and behavioural disturbances; these disturbances are frequently treated with psychotropic medication. The aim of this cross-sectional study was to describe the characteristics of the first large national sample of persons with PWS in Spain and analyse the relationships of those characteristics with key demographic and clinical factors, particularly with obesity and the regular use of psychotropic medication. METHODS: Participants were recruited among all members of the Spanish Prader-Willi Association who agreed to take part in the study and fulfilled its inclusion criteria. Family and patient demographic features, family size and birth order, intelligence quotient (IQ), anthropometric measures, lifestyle habits, behavioural disturbances (with the Aberrant Behavior Checklist) and clinical data, as well as use of psychotropic drugs and their side effects (with the UKU scale), were collected in genetically confirmed cases of PWS. Bivariate and logistic regression analyses were used for determining the associations of demographic and clinical factors with both obesity and the regular use of psychotropic medication. RESULTS: The cohort included 177 participants (aged 6-48 years), that is, 90 (50.8%) males and 87 (49.2%) females. Behavioural disturbances were present in a range of 75% to 93% of participants; psychotropic medication was prescribed to 81 (45.8%) of them. Number of siblings showed a direct correlation with IQ, especially among males, and inappropriate speech was more intense in only-child females. Obesity was, in parallel, strongly associated with ascending age and with not being currently under growth hormone (GH) treatment. Participants taking any psychotropic medication were characterised by more frequent age ≥30 years, high level of hyperactivity and a psychiatric diagnosis. CONCLUSIONS: Characterisation of persons with PWS in Spain confirms their physical and behavioural phenotype and supports the long-term application of GH therapy and the rational use of psychotropic medication.

Effect of rhizobium and gibberellin on the production of hydroponic green forage of red clover (Trifolium pratense L.) variety quiñequeli.

The purpose of the present investigation was to determine the effect of rhizobium and gibberellin on the production of hydroponic green forage from red clover (Trifolium pratense L.) variety quiñequeli, four variables were measured: plant height, biomass weight, grass weight and root weight. The treatments were T0: 0%, T1: 10%, T2: 20%, T3: 30% and T4: 40% of Rhizobium before germination and Gibberellin T0: 0g, T1: 2.4g; T2: 3.3g; T3: 4.3 and T4: 5.3g each treatment with 6 repetitions, three applications on days 5, 10, 15 and 20 of growth. Data were analyzed with DCA, ANOVA and DUNCAN's multiple comparisons test; the results obtained were: first measurement with rhizobium without gibberellin there were no statistical differences, second and third measurement with Gibberellin application did not present statistical differences and the fourth measurement presented statistical difference (α=0.05), average height of the plant with a mean of 12.82 cm, T4 was higher, in biomass a statistical difference was obtained with a mean of 3.056 kg, T3 was higher, weight of grass and root did not present statistical differences; concluding that the use of rhizobium and gibberellin could be a usable alternative in the production of hydroponic green fodder, to alleviate the problems of fodder scarcity in dry season, its use being recommended in high Andean livestock.

Volatilome Analysis of Soursop Fruits for the Determination of Kairomone Components That Attract the Annonaceae Fruit Weevil (Optatus palmaris Pascoe).

Soursop possesses the largest fruit size of the Annona genus. However, this species is threatened by the Annonaceae fruit weevil (Optatus palmaris), which can cause the destruction of whole soursop fruits. Recently, the potential of semiochemicals for the management of this insect is highlighted, and its aggregation pheromone has been elucidated. This pheromone works well only when mixed with soursop volatiles. Thus, the aim of this research was to determine specific kairomone components to potentiate the aggregation pheromone of this Annonaceae fruit weevil. This task was carried out via volatilome analysis of soursop fruits, which was correlated with the biological activity of the identified volatiles. The GC-MS analysis of aroma collections of mature soursop fruits and flowers, determined using multivariate data analysis, confirmed a volatile differentiation between these organs. The volatile variation between fruits and flowers was reflected in weevils' preference for mature fruits instead of flowers. Moreover, weevils' response to soursop fruits increased with more mature fruits. This was correlated with volatile changes throughout the phenological stages of soursop fruits. The two volatiles most correlated with weevils' attraction were benzothiazole and (E)-ß-caryophyllene. These volatiles only evoked a response when mixed and potentiated the attraction of the aggregation pheromone. Thus, these two volatiles are active kairomone components with the potential for being used in combination with the aggregation pheromone of Annonaceae fruit weevils in field trials.

[Moyamoya in Aragon: epidemiology and self-perception of quality of life]. / Moyamoya en Aragón. Epidemiología y calidad de vida autopercibida.

INTRODUCTION: Moyamoya angiopathy is a vasculopathy caused by stenosis/occlusion of one or both intracranial internal carotid arteries. Although more common in Eastern countries, its prevalence is increasing in the West. An angioresonance or angiography is essential for its diagnosis. There are two options for treatment: conservative (medical) treatment or surgical bypass techniques. PATIENTS AND METHODS: Nineteen patients were selected using International Classification of Diseases codes, and their demographic characteristics and health outcomes were studied. They were administered a scale for the screening of anxious-depressive syndrome (the Hospital Anxiety and Depression Scale - HADS) and another scale for self-perceived quality of life (SF-36). After applying the inclusion/exclusion criteria, eight of these patients were studied. RESULTS: Nineteen patients were studied (52.63% male, 57.89% European) and the Aragonese prevalence was estimated at 1.37/100,000 inhabitants. The most frequent clinical presentation was ischaemic stroke (73.68%). The HADS detected two positive cases of anxiety and one case of depression. According to the SF-36, the worst self-rated aspects were vitality (median: 35/100) and general health (median: 42.5/100), while the best rated was physical function (mean: 93.57/100). CONCLUSIONS: This is the Spanish series with the highest prevalence and the only one that addresses self-perceived health and screening of the anxious-depressive syndrome. Further research is needed to address this entity and determine its true prevalence in the West.

TITLE: Moyamoya en Aragón. Epidemiología y calidad de vida autopercibida.Introducción. La angiopatía de moyamoya es una vasculopatía originada por la estenosis/oclusión de una o ambas carótidas internas intracraneales. Aunque es más frecuente en países orientales, está aumentando su prevalencia en Occidente. Para su diagnóstico es imprescindible una angiorresonancia o una angiografía. En su tratamiento hay dos opciones: el tratamiento conservador (médico) o las técnicas quirúrgicas de bypass. Pacientes y métodos. Se seleccionó a 19 pacientes mediante códigos de la Clasificación internacional de enfermedades, y se estudiaron sus características demográficas y resultados en salud. Se les administró una escala para el cribado de síndrome ansiosodepresivo ­escala de ansiedad y depresión hospitalaria (HADS)­ y otra de autopercepción de calidad de vida (SF-36). De estos pacientes, se estudió a ocho al aplicar los criterios de inclusión/exclusión. Resultados. Se estudió a 19 pacientes (52,63%, hombres; 57,89%, europeos) y se estimó la prevalencia aragonesa en 1,37/100.000 habitantes. La clínica más frecuente fue el ictus isquémico (73,68%). La HADS detectó dos casos positivos para ansiedad y un caso de depresión. Según el SF-36, los aspectos peor autopercibidos fueron la vitalidad (mediana: 35/100) y la salud general (mediana: 42,5/100); mientras que el mejor valorado fue la función física (media: 93,57/100). Conclusiones. Se trata de la serie española con mayor prevalencia y la única que aborda la salud autopercibida y el cribado del síndrome ansiosodepresivo. Son necesarios más estudios que permitan abordar esta entidad y cuál es la verdadera prevalencia en Occidente.

Moyamoya en Aragón. Epidemiología y calidad de vida autopercibida / Moyamoya in Aragon: epidemiology and self-perception of quality of life

Introducción La angiopatía de moyamoya es una vasculopatía originada por la estenosis/oclusión de una o ambas carótidas internas intracraneales. Aunque es más frecuente en países orientales, está aumentando su prevalencia en Occidente. Para su diagnóstico es imprescindible una angiorresonancia o una angiografía. En su tratamiento hay dos opciones: el tratamiento conservador (médico) o las técnicas quirúrgicas de bypass. Pacientes y métodos Se seleccionó a 19 pacientes mediante códigos de la Clasificación internacional de enfermedades, y se estudiaron sus características demográficas y resultados en salud. Se les administró una escala para el cribado de síndrome ansiosodepresivo –escala de ansiedad y depresión hospitalaria (HADS)– y otra de autopercepción de calidad de vida (SF-36). De estos pacientes, se estudió a ocho al aplicar los criterios de inclusión/exclusión. Resultados Se estudió a 19 pacientes (52,63%, hombres; 57,89%, europeos) y se estimó la prevalencia aragonesa en 1,37/100.000 habitantes. La clínica más frecuente fue el ictus isquémico (73,68%). La HADS detectó dos casos positivos para ansiedad y un caso de depresión. Según el SF-36, los aspectos peor autopercibidos fueron la vitalidad (mediana: 35/100) y la salud general (mediana: 42,5/100); mientras que el mejor valorado fue la función física (media: 93,57/100). Conclusiones Se trata de la serie española con mayor prevalencia y la única que aborda la salud autopercibida y el cribado del síndrome ansiosodepresivo. Son necesarios más estudios que permitan abordar esta entidad y cuál es la verdadera prevalencia en Occidente. (AU)

INTRODUCTION Moyamoya angiopathy is a vasculopathy caused by stenosis/occlusion of one or both intracranial internal carotid arteries. Although more common in Eastern countries, its prevalence is increasing in the West. An angioresonance or angiography is essential for its diagnosis. There are two options for treatment: conservative (medical) treatment or surgical bypass techniques. PATIENTS AND METHODS Nineteen patients were selected using International Classification of Diseases codes, and their demographic characteristics and health outcomes were studied. They were administered a scale for the screening of anxious-depressive syndrome (the Hospital Anxiety and Depression Scale – HADS) and another scale for self-perceived quality of life (SF-36). After applying the inclusion/exclusion criteria, eight of these patients were studied. RESULTS Nineteen patients were studied (52.63% male, 57.89% European) and the Aragonese prevalence was estimated at 1.37/100,000 inhabitants. The most frequent clinical presentation was ischaemic stroke (73.68%). The HADS detected two positive cases of anxiety and one case of depression. According to the SF-36, the worst self-rated aspects were vitality (median: 35/100) and general health (median: 42.5/100), while the best rated was physical function (mean: 93.57/100). CONCLUSIONS This is the Spanish series with the highest prevalence and the only one that addresses self-perceived health and screening of the anxious-depressive syndrome. Further research is needed to address this entity and determine its true prevalence in the West. (AU)

Disorder effect on intersubband optical absorption ofn-typeδ-doped quantum well in GaAs.

The inevitable structural disorder associated with the fluctuation of the applied external electric field, laser intensity, and bidimensional density in the low dimensional quantum system can affect noticeably optical absorption properties and the related phenomena. In this work, we study the effect of structural disorder on the optical absorption properties in delta-doped quantum wells (DDQWs). Starting from effective mass approximation and the Thomas-Fermi approach as well as using the matrix density, the electronic structure and the optical absorption coefficients of DDQWs are determined. It is found that the optical absorption properties depend on the strength and the type of structural disorder. Particularly, the bidimensional density disorder suppresses strongly the optical properties. Whilst, the disordered external applied electric field fluctuates moderately in the properties. In contrast, the disordered laser holds absorption properties unalterable. So, our results specify that to have and preserve good optical absorption properties in DDQWs, requires precise control of the bidimensional. Besides, the finding may improve the understanding of the impact of the disorder on the optoelectronic properties based on DDQWs.

[Proposal for initial management of uncomplicated ST elevation myocardial infarction in centers without percutaneous coronary intervention capacity in Peru]. / Propuesta de manejo inicial del infarto de miocardio con elevación del segmento ST no complicado en centros sin capacidad de intervención coronaria percutánea en el Perú.

ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy as the main form of reperfusion treatment in our country.

Human papillomavirus infection and lung adenocarcinoma: special benefit is observed in patients treated with immune checkpoint inhibitors.

BACKGROUND: Human papilloma virus (HPV) has been associated with the development and modulation of response in a series of neoplasms. In the case of lung adenocarcinoma, its role in etiology and pathogenesis is still controversial. Considering that this infection brings foreign epitopes, it could be of prognostic significance in patients with lung adenocarcinoma treated with immunotherapy. METHODS: In a retrospective cohort study we evaluated the presence of HPV genomic material in lung adenocarcinoma primary lesions with the INNO-LiPA platform. Viral replication was also evaluated by detecting the presence of oncoprotein E6/E7 messenger RNA (mRNA) by quantitative RT-PCR. To confirm possible hypotheses regarding viral oncogenesis, vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 (HIF1) were evaluated with stromal fibrosis and immunoscore. RESULTS: A total of 133 patients were included in the analysis, of whom 34 tested positive for HPV, reaching an estimated prevalence of 25.6% [95% confidence interval (CI) 18.2% to 32.9%]. E6/7 mRNA was identified in 28 out of the 34 previously positive cases (82.3%). In immune checkpoint inhibitor (ICI)-treated patients, the median overall survival reached 22.3 months [95% CI 19.4 months- not reached (NR)] for HPV-negative and was not reached in HPV-positive (HPV+) ones (95% CI 27.7-NR; P = 0.008). With regard to progression-free survival, HPV- patients reached a median of 9.2 months (95% CI 7.9-11.2 months) compared to 14.3 months (95% CI 13.8-16.4 months) when HPV was positive (P = 0.001). The overall response rate for HPV+ patients yielded 82.4% compared to 47.1% in negative ones. No differences regarding programmed death-ligand 1, VEGF, HIF1, stromal fibrosis, or immunoscore were identified. CONCLUSIONS: In patients with HPV+ lung adenocarcinoma, a significant benefit in overall response and survival outcomes is observed.

Rat age-related benign prostate hyperplasia is concomitant with an increase in the secretion of low ramified α-glycosydic polysaccharides.

This work analysed the expression of prostate polysaccharides in rats with age-related benign prostatic hyperplasia (BPH) for a better understanding of the possible relationship between prostate polysaccharides secretion and BPH onset. For this, prostatic glands from 1 month-old, 3 months-old, 6 months-old and 12 months-old Sprague-Dawley rats were processed in order to identify their overall polysaccharide content. Additionally, serum testosterone was also determined. One-month old rats showed significantly (P < 0.05) lower testosterone levels (0.77 ng/mL±0.12 ng/mL) compared with the other groups, which showed no significant difference among them. PAS staining showed positive polysaccharides markings in both the prostatic lumen and inside of luminal prostatic cells in all groups. Semiquantitative analysis of intraluminal PAS showed that one month-old rats had significantly (P < 0.005) lower PAS intensity when compared with all other groups (100.0 ± 0.5, arbitrary units vs. 107.3 ± 0.6, arbitrary units in 3 months-old ones), whereas 12 months-old ones showed significantly (P < 0.005) higher values when compared with all other groups (133.6 ± 3.5, arbitrary units in 12 months-old rats vs. 108.6 ± 1.4, arbitrary units in 6 months-old ones). The PAS + content practically disappeared when tissues were pre-incubated with either α-amylase or amyloglucosidase, regardless of a previous incubation with proteinase K. Incubation of prostate extracts from 12 months-old rats for 2 h with α-amylase yielded a significantly higher amount of free glucose (1.47 nmol/mg protein±0.23 nmol/mg protein vs. 0.32 nmol/mg protein±0.01 nmol/mg protein in untreated extracts). Similar results were obtained when extracts were pre-incubated with amyloglucosidase. Contrarily, pre-incubation with N-glycosidase induced a significantly (P < 0.05), much lower increase of free glucose. Pre-treatment with proteinase K did not significantly modify these results, which indicate that BPH is related to an increase in the secretion of low ramified ductal α-glycosydic polysaccharides that were not protected against lysis by any type of protein protective core. These changes seem to not be related with concomitant variations in serum testosterone levels.

Registro de casos de indicación farmacéutica y derivaciones al médico utilizando la herramienta SEFAC e_XPERT / Registration of pharmaceutical indication cases and referrals to the doctor using the SEFAC e_XPERT tool

JUSTIFICACIÓN: según Foro, la Indicación Farmacéutica es un Servicio profesional farmacéutico asistencial (SPFA), en la que el farmacéutico, juega un papel fundamental en la mejora/alivio de problemas de salud autolimitados. Se deben emplear, para ello, protocolos consensuados con otros profesionales sanitarios para la derivación y emplear guías farmacológicas para el abordaje correcto de estas situaciones en Farmacia Comunitaria (FC). La plataforma SEFAC e_XPERT®. favorece la toma de decisiones en este SPFA.OBJETIVOS: cuantificar el número de Servicios de Indicación Farmacéutica (SIF) por problemas de salud consultado, así como el número de pacientes que han requerido derivación a otro profesional.METODOLOGÍA: estudio observacional, descriptivo y multicéntrico en FC realizado por alumnos de Prácticas Tuteladas (PT) de la Universidad de Alcalá, utilizando la plataforma SEFAC_eXPERT®.Se siguió el protocolo de Foro de Atención Farmacéutica en FC para realizar el servicio de indicación farmacéutica. Todos los datos registrados fueron anónimos. Para el análisis de los datos se utilizó Excel®.RESULTADOS: se han realizado 2249 casos de SIF, agrupados según síntomas: 21,1 % digestivos; 16,4 % respiratorios; 17,6 % dermatológicos; 17,8 % dolor y 27,1 % otros. Las actuaciones se han dividido si se ha indicado tratamiento farmacológico o no farmacológico, si sólo medidas higiénico-dietéticas (MHD) o ambas, siendo los síntomas más prevalentes: Ojo seco: 71 pacientes con tratamiento, 6 con MHD y 9 ambas: Insomnio: 65, 8, 8; Tos: 62, 7, 11; Dolor articular: 57, 36, 20; Síntomas catarrales: 53, 0, 1; Estreñimiento: 52, 4, 2.El número de derivaciones ha sido 430 (19 %), siendo los digestivos (132), “otros” (133) y respiratorios (121) los más numerosos. (AU)

The onset of age-related benign prostatic hyperplasia is concomitant with increased serum and prostatic expression of VEGF in rats: Potential role of VEGF as a marker for early prostatic alterations.

The onset of age-related benign prostate hyperplasia (BPH) is linked with changes in the expression of specific prostatic chemokines. The aim of this work was to characterize those most relevant changes through the simultaneous analysis of 34 chemokines in both prostatic tissue and serum in rats at different ages with the aim to identify clinically workable parameters for the detection of early prostatic alterations. The study included 28 healthy Sprague-Dawley male rats that were distributed in four groups, 1 month-old (prepuberal; n = 7), 3 months-old (young; n = 7), 6 months-old (mature; n = 7) and 12 months-old (elder; n = 7). Chemokines were analyzed through a commercial mini-array system specially designed for rat tissues. Serum testosterone levels and prostatic histological status were also evaluated. Histological lesions indicative of BPH were detected in three mature rats and in all elder ones. Mini-arrays from prostatic tissue showed that young animals had an overall decreased expression of most of the analyzed chemokines when compared with prepuberal rats, with the exception of agrin, which showed a significant (P < 0.05) increase (100.0 ± 1.3, arbitrary units in prepuberal rats vs.148.2 ± 4.1, arbitrary units in young ones). Older animals showed further specific changes in 4 out 34 analyzed chemokines, namely agrin, platelet-derived growth factor (PDGF), tissue inhibitor of metalloproteinase-1 (TIMP-1) and vascular endothelial growth factor (VEGF). Additionally, elder rats showed the lowest intensity levels of agrin combined with the highest ones for PDGF, TIMP1 and VEGF when compared with all other groups. Finally, a significant increase of serum VEGF was detected in elder, BPH-affected rats when compared with young ones. Results indicated that the onset of both rat puberty and BPH would be related with specific changes in the prostatic expression of chemokines such as VEGF. Otherwise, the observed changes in serum VEGF levels could suggest the future possible utilization of serum VEGF levels to detect early pathological prostatic processes.

Psychometric instruments for the assessment of depressive symptoms in patients with delusional disorder: A systematic review.

Patients with delusional disorder (DD) are at an increased risk for the development of depressive symptoms. We aimed to examine the literature dealing with assessment tools to assess depressive symptoms in DD. A systematic review was performed by searching PubMed, Scopus and clinicaltrials.gov databases from inception until June 2021 (PRISMA guidelines). From 1863 initial retrieved records, 11 studies were included (N = 715 DD patients). Depressive comorbidity ranged from 20.9% to 53.5%. Seven studies used semistructured/structured interviews: OPCRIT 4.0 (n = 1), Manual for Assessment and Documentation of Psychopathology in Psychiatry (AMDP System) (n = 2), the MINI interview (n = 1), DSM-IV (n = 1), ICD-10 (n = 1); and the Diagnostic Interview Schedule (DIS-R) (n = 1). Seven studies used at least one observer-rated scale: Positive and Negative Syndrome Scale (PANSS)-depressive component (n = 2), Hamilton Rating Scale for Depression (HRSD, n = 3), Montgomery-Asberg Depression Rating Scale (MADRS, n = 1), Clinical Global Impression Scale (CGI, n = 1) and the Bipolar Affective Disorder Dimension Scale (BADDS, n = 1). Assessment scales administered in depressive disorders and schizophrenia are applied to DD. This is the first systematic review exploring the use of assessment tools for depressive symptoms in DD. The use of the MADRS to assess depressive symptoms can be recommended in combination with other clinical scales, for instance, the CGI.

Fear of COVID-19, mental health, and pregnancy outcomes in the pregnancy during the COVID-19 pandemic study: Fear of COVID-19 and pregnancy outcomes.

BACKGROUND: Sustained fear during pregnancy has the potential to increase psychological distress and obstetric risk. This study aimed to (1) identify factors and characteristics associated with fear of COVID-19, (2) investigate the relationship between fear of COVID-19 and maternal anxiety and depression, and (3) determine the relationship between fear of COVID-19 and pregnancy outcomes. METHODS: 9251 pregnant Canadians were recruited between April - December 2020. Participants self-reported (scale of 0-100) the degree of threat they perceived from the SARS-CoV-2 virus in relation to themselves and their unborn baby. RESULTS: Mean fear scores indicated moderate to elevated concern. In multivariable linear regression, fear of COVID-19 was associated with food insecurity, ethnicity, geographic location, history of anxiety prior to pregnancy, having a chronic health condition, pre-pregnancy BMI, parity, and stage of pregnancy at study enrollment. Higher COVID-19 fear was associated with increased odds of depression, adjusted odds ratio (aOR) = 1.75, p < 0.001, 95% CI 1.66-1.85, and anxiety, aOR=2.04, p < 0.001, 95% CI 1.94-2.15). Furthermore, fear of COVID-19 was associated with a 192-gram reduction in infant birthweight, and a 6.1-day reduction in gestational age at birth. LIMITATIONS: The sample has higher education compared to the Canadian population and cannot test causal effects. CONCLUSION: This study suggests that sociodemographic, health, and obstetric factors may contribute to increased fear of COVID-19 and associated adverse psychological and pregnancy outcomes.

Complicaciones neurológicas asociadas al tratamiento con oxigenación por membrana extracorpórea (ECMO) en pacientes adultos. Estudio de una serie de casos / Neurological complications associated with extracorporeal membrane oxygenation (ECMO) therapy in adult patients. A study of a case series

Introducción: La ECMO es una técnica avanzada de soporte ventilatorio y circulatorio. Sin embargo, puede asociarse a complicaciones neurológicas. Se propone describir las características clínicas y el perfil de las complicaciones neurológicas en pacientes sometidos a ECMO. Pacientes y métodos: Estudio descriptivo retrospectivo de una serie de casos. Se realizó un análisis descriptivo y un análisis bivariado con la finalidad de comparar las principales variables clínicas de interés. Resultados: Se evaluó a 136 adultos sometidos a ECMO con edad promedio de 51 años (17-78). Las complicaciones neurológicas se presentaron en 51 pacientes (37,5%), de los cuales correspondieron a ictus 22 (16,17%); a encefalopatía hipóxica, 13 (9,5%); a hemorragia intracerebral (HIC), 12 (8,8%), y a hemorragia subaracnoidea (HSA), cuatro (2,9%). Siete (13,7%) de los pacientes con complicaciones neurológicas presentaron crisis epilépticas. Las complicaciones neurológicas se presentaron en 12 pacientes (23,53%) con la ECMO venovenosa y en 39 (76,47%) con la ECMO venoarterial (p = 0,86). La mortalidad global fue del 51,47% (70/136 pacientes) y del 64,7% (33/51) para la población con complicaciones neurológicas. La mortalidad en el ictus fue del 54,5% (12/22), del 91,6% (11/12) en la HIC y del 100% (4/4) en la HSA (p = 0,03). La mortalidad en la ECMO venoarterial fue del 77,14%, frente al 22,86% de la de la ECMO venovenosa (p = 0,015). Conclusiones: La ECMO es una herramienta terapéutica útil en casos de elevada gravedad clínica. En nuestro estudio, identificamos una elevada tasa de complicaciones neurológicas que contribuyen a la morbimortalidad asociada. La realización temprana de estudios de neuroimagen en estos casos podría permitir una detección temprana de estas complicaciones.(AU)

Introduction: ECMO is an advanced technique of ventilatory and circulatory support. However, it can be associated with neurological complications. The proposal is to describe the clinical characteristics and neurological complications profile in patients under ECMO support. Patients and methods: To descriptive a case series study. A descriptive and retrospective analysis and a bivariate analysis were performed in order to compare the main clinical variables of interest. Results: 136 adults undergoing ECMO with an average age of 51 years (17-78) were evaluated. Neurological complications were observed in 51 patients (37.5%), corresponding to stroke 22 (16.17%), hypoxic encephalopathy 13 (9.5 %), cerebral hemorrhage (HIC) in 12 (8.8%) and subarachnoid hemorrhage (HSA) in 4 patients (2.9%). Seven (13.7%) of patients with neurological complications had seizures. Neurological complications occurred in 23.53% in venovenous ECMO and in 76.47% with veno-arterial ECMO (p = 0.86). The overall mortality was 51.47% (70/136) for all patients in ECMO and 64.7% (33/51) for the population with neurological complications. The mortality in stroke was 54.5% (12/22), 91.6% (11/12) in HIC and 100% (4) in HSA (p = 0.03). Mortality was higher in veno-arterial ECMO (77.14%) versus venous-venous ECMO (22.86% of total), (p = 0.015). Conclusions: ECMO is a useful therapeutic tool in cases of high clinical severity. In our study, we identified a high rate of neurological complications that contribute to associated morbidity and mortality. Early neuroimaging studies in these cases could allow early detection of these complications.(AU)

[Neurological complications associated with extracorporeal membrane oxygenation (ECMO) therapy in adult patients. A study of a case series]. / Complicaciones neurológicas asociadas al tratamiento con oxigenación por membrana extracorpórea (ECMO) en pacientes adultos. Estudio de una serie de casos.

INTRODUCTION: ECMO is an advanced technique of ventilatory and circulatory support. However, it can be associated with neurological complications. The proposal is to describe the clinical characteristics and neurological complications profile in patients under ECMO support. PATIENTS AND METHODS: To descriptive a case series study. A descriptive and retrospective analysis and a bivariate analysis were performed in order to compare the main clinical variables of interest. RESULTS: 136 adults undergoing ECMO with an average age of 51 years (17-78) were evaluated. Neurological complications were observed in 51 patients (37.5%), corresponding to stroke 22 (16.17%), hypoxic encephalopathy 13 (9.5 %), cerebral hemorrhage (HIC) in 12 (8.8%) and subarachnoid hemorrhage (HSA) in 4 patients (2.9%). Seven (13.7%) of patients with neurological complications had seizures. Neurological complications occurred in 23.53% in venovenous ECMO and in 76.47% with veno-arterial ECMO (p = 0.86). The overall mortality was 51.47% (70/136) for all patients in ECMO and 64.7% (33/51) for the population with neurological complications. The mortality in stroke was 54.5% (12/22), 91.6% (11/12) in HIC and 100% (4) in HSA (p = 0.03). Mortality was higher in veno-arterial ECMO (77.14%) versus venous-venous ECMO (22.86% of total), (p = 0.015). CONCLUSIONS: ECMO is a useful therapeutic tool in cases of high clinical severity. In our study, we identified a high rate of neurological complications that contribute to associated morbidity and mortality. Early neuroimaging studies in these cases could allow early detection of these complications.

TITLE: Complicaciones neurológicas asociadas al tratamiento con oxigenación por membrana extracorpórea (ECMO) en pacientes adultos. Estudio de una serie de casos.Introducción. La ECMO es una técnica avanzada de soporte ventilatorio y circulatorio. Sin embargo, puede asociarse a complicaciones neurológicas. Se propone describir las características clínicas y el perfil de las complicaciones neurológicas en pacientes sometidos a ECMO. Pacientes y métodos. Estudio descriptivo retrospectivo de una serie de casos. Se realizó un análisis descriptivo y un análisis bivariado con la finalidad de comparar las principales variables clínicas de interés. Resultados. Se evaluó a 136 adultos sometidos a ECMO con edad promedio de 51 años (17-78). Las complicaciones neurológicas se presentaron en 51 pacientes (37,5%), de los cuales correspondieron a ictus 22 (16,17%); a encefalopatía hipóxica, 13 (9,5%); a hemorragia intracerebral (HIC), 12 (8,8%), y a hemorragia subaracnoidea (HSA), cuatro (2,9%). Siete (13,7%) de los pacientes con complicaciones neurológicas presentaron crisis epilépticas. Las complicaciones neurológicas se presentaron en 12 pacientes (23,53%) con la ECMO venovenosa y en 39 (76,47%) con la ECMO venoarterial (p = 0,86). La mortalidad global fue del 51,47% (70/136 pacientes) y del 64,7% (33/51) para la población con complicaciones neurológicas. La mortalidad en el ictus fue del 54,5% (12/22), del 91,6% (11/12) en la HIC y del 100% (4/4) en la HSA (p = 0,03). La mortalidad en la ECMO venoarterial fue del 77,14%, frente al 22,86% de la de la ECMO venovenosa (p = 0,015). Conclusiones. La ECMO es una herramienta terapéutica útil en casos de elevada gravedad clínica. En nuestro estudio, identificamos una elevada tasa de complicaciones neurológicas que contribuyen a la morbimortalidad asociada. La realización temprana de estudios de neuroimagen en estos casos podría permitir una detección temprana de estas complicaciones.

Caracterización de la gingivitis crónica en la población adolescente

Introducción: la gingivitis crónica es el proceso inflamatorio que afecta el periodonto de protección yaltera las características normales de la encía, con elevada prevalencia en los adolescentes.Objetivo: caracterizar la gingivitis crónica en los adolescentes de 11 a 19 años del Área Norte de Sancti Spíritus.Métodos: se realizó un estudio observacional, descriptivo y transversal cuyo universo quedó constituido por 61 adolescentes, que acudieron a la Clínica Estomatológica Docente Provincial durante el período de septiembre de 2019 a enero de 2020. Las variables estudiadas fueron: edad, sexo, factores de riesgo,aspecto anatomo clínico, gravedad de la enfermedad y conocimientos sobre gingivitis crónica. Se emplearon métodos del nivel teórico, empírico y de la estadística descriptiva.Resultados: predominó el grupo de edades de 17 a 19 años (45,9 Porciento), la higiene bucal deficiente (78,7Porciento) seguida de la caries dental (47,5Porciento) y el tabaquismo (40,9 Porciento). El nivel de conocimientos fue malo enel 72,1 Porciento y la gingivitis edematosa fue la que más afectó a los adolescentes, con mayor incidencia en elgrupo de 14 a 16 años (36,1 Porciento).Conclusiones: la gingivitis crónica, principalmente de tipo edematosa fue común en adolescentes masculinos y de edades entre 17 y 19 años. Factores de riesgo como una higiene bucal deficiente condicionan la aparición de la enfermedad. Es necesario incidir en el nivel de conocimientos de los adolescentes para prevenir la aparición de la enfermedad.[AU]

Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking.

BACKGROUND: This study has two main objectives: to describe the prevalence of undetected chronic obstructive pulmonary disease (COPD) in a clinical sample of smokers with severe mental illness (SMI), and to assess the value of the Tobacco Intensive Motivational Estimated Risk tool, which informs smokers of their respiratory risk and uses brief text messages to reinforce intervention. METHOD: A multicenter, randomized, open-label, and active-controlled clinical trial, with a 12-month follow-up. Outpatients with schizophrenia (SZ) and bipolar disorder were randomized either to the experimental group-studied by spirometry and informed of their calculated lung age and degree of obstruction (if any)-or to the active control group, who followed the 5 A's intervention. RESULTS: The study sample consisted of 160 patients (71.9% SZ), 78.1% of whom completed the 12-month follow-up. Of the patients who completed the spirometry test, 23.9% showed evidence of COPD (77.8% in moderate or severe stages). TIMER was associated with a significant reduction in tobacco use at week 12 and in the long term, 21.9% of patients reduced consumption and 14.6% at least halved it. At week 48, six patients (7.3%) allocated to the experimental group achieved the seven-day smoking abstinence confirmed by CO (primary outcome in terms of efficacy), compared to three (3.8%) in the control group. CONCLUSION: In this clinical pilot trial, one in four outpatients with an SMI who smoked had undiagnosed COPD. An intensive intervention tool favors the early detection of COPD and maintains its efficacy to quit smoking, compared with the standard 5 A's intervention.

Photocatalytic behavior for the phenol degradation of ZnAl layered double hydroxide functionalized with SDS.

Functionalized ZnAl layered double hydroxide based photocatalyst was obtained by the addition of sodium dodecyl sulfate (SDS) during the synthesis by the coprecipitation method, and further calcination at 400 °C. Bare and modified materials were characterized by X-ray diffraction, nitrogen adsorption-desorption, IR, UV-Vis, EPR and XPS spectroscopies, SEM and HRTEM. The synthesized material was evaluated in the photodegradation of phenol in a 40 ppm aqueous solution (4.25 × 10-4 mol of phenol/L), under UV light irradiation. An increasing in the degradation of phenol from 62 to 95%, and from 62 to 82% in the mineralization of phenol was obtained using SDS functionalized ZnAl LDH, in comparison with the unmodified material. This increase could be attributed to the presence of sulfate radicals, confirmed by the EPR study.