Plasma Photoinactivation of Bacterial Isolated from Blood Donors Skin: Potential of Security Barrier in Transfusional Therapy.

The presence of skin bacteria capable of forming biofilm, exhibiting antibiotic resistance, and displaying virulence represents a significant challenge in the field of transfusion medicine. This underscores the necessity of enhancing the microbiological safety of blood and blood components against pathogens with virulent characteristics. The aim of this work was to demonstrate bacterial inactivation in plasma by using a photoinactivation method against virulent bacteria and to evaluate coagulation factors before and after treatment. Logarithmic loads of biofilm-producing, antibiotic-resistant, and virulent bacteria isolated from skin (Enterobacter cloacae, Klebsiella ozaenae, and Staphylococcus epidermidis) were used in artificial contamination assays of fresh frozen plasma bags and subjected to photoreduction. FVIII and FI activity were evaluated before and after photoinactivation. The photoinactivation of plasma was demonstrated to be an effective method for the elimination of these bacteria. However, the efficiency of this method was found to be dependent on the bacterial load and the type of test microorganism. Conversely, decay of coagulation factors was observed with net residual activities of 61 and 69% for FVIII and FI, respectively. The photoinactivation system could have a bias in its effectiveness that is dependent on the test pathogen. These findings highlight the importance of employing technologies that increase the safety of the recipient of blood and/or blood components, especially against virulent bacteria, and show the relevance of the role of photoinactivation systems as an option in transfusion practice.

[Primary immune thrombocytopenia linked to the ingestion of guinea pigs (Cavia porcellus) causality or coincidence?] / Trombocitopenia inmune primaria vinculada a la ingesta de cuy (Cavia porcellus). ¿casualidad o coincidencia?

The guinea pig in Ecuador is synonymous with our ancestral gastronomy and cultural tradition, but because of the diet rich in L-canavanine (alfalfa) that they receive; could limit its consumption in patients with primary immune thrombocytopenia (ITP). Ingestion of alfalfa in humans can cause kidney failure and lupus-like syndrome. The John Hopkins Lupus Center recommends avoiding it in the diet of patients with Systemic Lupus Erythematosus (SLE), as it aggravates inflammation by stimulating immune activity (flares). We present two cases of patients with ITP linked to guinea pig ingestion. It is probable

El cuy en el Ecuador es sinónimo de nuestra gastronomía ancestral y de tradición cultural, pero por la alimentación rica en L-canavanina (alfalfa) que reciben; podría limitar su consumo en pacientes con trombocitopenia inmune primaria (PTI). La ingesta de alfalfa en humanos puede propiciar insuficiencia renal y síndrome lupus-like.  El centro de Lupus John Hopkins recomiendan evitarla en la dieta de los pacientes con Lupus Eritematoso Sistémico (LES), al agravar la inflamación por estimulación de la actividad inmune (flares). Presentamos dos casos de pacientes con PTI vinculados con la ingesta de cuy.  ¿Es probable?

[Characterization of asthma phenotypes in children of the tropics]. / Caracterización de fenotipos de asma en niños del trópico.

OBJECTIVE: Determine the main asthma phenotypes in a population of asthmatic children in Cartagena, Colombia. METHODS: 107 children (7 to 17 years old) with a previous diagnosis of asthma were recruited. Biomarkers of T2 inflammation were evaluated by measuring FeNO, eosinophil count in peripheral blood by hemocytometry, and determination of specific IgE to mite allergens by ELISA. The study was approved by the ethics committee of the University of Cartagena (SGR, Grant BPIN2020000100405). RESULTS: The average age of patients was 10,9 years. 19,6% of the children did not show elevation of any of the T2 inflammation biomarkers evaluated (FeNO<20ppb, eos<300/ul, negative specific IgE), so they were considered patients with non-allergic asthma (non-T2). 71,9% of all patients were sensitized to at least one allergen, this phenotype was considered allergic asthma. 30,8% of the patients presented the three elevated biomarkers (FeNO>20ppb + eos >300/ul + positive specific IgE), this phenotype was classified as high T2 allergic asthma. A moderate correlation (Spearman rho=0,44, p<0,0001) was found between FeNO values and eosinophil counts. CONCLUSION: In this study, the following phenotypes were found: allergic asthma, high T2 asthma, and non-allergic asthma. Most patients presented a type 2 inflammatory phenotype with allergic sensitization. In addition to the measurement of specific IgE, the use of FeNO and eosinophil count in peripheral blood help to accurately determine those patients with high T2 asthma phenotypes.

OBJETIVO: Determinar los fenotipos principales de asma en una población de niños asmáticos en Cartagena, Colombia. MÉTODOS: Se reclutaron 107 niños (entre 7 y 17 años), con diagnóstico previo de asma. Se evaluaron biomarcadores de inflamación T2 mediante la medición de FeNO, conteo de eosinófilos en sangre periférica mediante hemocitometría, y la determinación de IgE específica a alergenos de ácaros mediante ELISA. El estudio fue aprobado por el Comité de Ëtica de la Universidad de Cartagena (SGR, Grant BPIN2020000100405). RESULTADOS: La edad media de los pacientes fue de 10,9 años. El 19,6% de los niños no mostró elevación de ninguno de los biomarcadores de inflamación T2 evaluados (FeNO<20 ppb, eos<300/ul, IgE específica negativa), por lo que se consideraron como pacientes con asma no alérgica (no-T2). El 71,9% de todos los pacientes estaban sensibilizados al menos a un alergeno considerándose este fenotipo como asma alérgica. El 30,8% de los pacientes presentaron los tres biomarcadores elevados (FeNO>20 ppb + eos >300/ul + IgE específica positiva), clasificando este fenotipo como asma alérgica T2 alta. Se encontró una correlación moderada (Spearman rho=0,44, p<0,0001) entre los valores de FeNO y los conteos de eosinófilos. CONCLUSIÓN: En este estudio se encontraron los siguientes fenotipos de asma alérgica: asma T2 alta y asma no alérgica. La mayoría de los pacientes presentó un fenotipo inflamatorio tipo 2 con sensibilización alérgica. Además de la medición de la IgE específica, el uso del FeNO y los conteos de eosinófilos en sangre periférica ayudan a determinar con mayor exactitud a aquellos pacientes con fenotipos de asma T2 alto.

[Circulating populations of CD4+ CD25+ CD127- regulatory t lymphocytes in peripheral blood of allergic asthmatic children]. / Determinación de poblaciones circulantes en sangre periférica de linfocitos T, reguladores CD4+ CD25+ CD127-, en niños asmáticos alérgicos.

OBJECTIVE: To carry out a preliminary analysis on the Treg lymphocyte counts present in the peripheral blood of allergic asthmatic children from the city of Cartagena, Colombia, compared to healthy controls. METHODS: We compared cytometry counts of ten asthmatic patients (age 7-16 years) and seven healthy controls (6-12 years), recruited in the city of Cartagena. Peripheral blood samples were stained using Cytek's 14-color cFluor Immunoprofiling kit (Cytek® cFluor® Immunoprofiling Kit 14 Color RUO kit), and analyzed on a Northern Lights™ spectral cytometer (Cytek® Biosciences, Fremont, CA, USA), to read 50.000 events per sample. The data obtained were analyzed in SpectroFlo® and FlowJo. The study was approved by the ethics committee of the University of Cartagena (SGR, Grant BPIN2020000100405). RESULTS: The frequency of CD3+, CD4+, CD25+, CD127- Tregs was 11% of all CD4+ T cells, with a range of minimum 8,1% and maximum 17,7%. There was no significant difference in the proportion of Tregs between allergic asthmatic patients and healthy controls (P = 0,2). CONCLUSIONS: With this preliminary sample size, no significant differences were found in the Treg lymphocyte population between allergic asthmatic patients and healthy controls. The 14-color multiplexed panel is a useful tool not only to count CD3+ and CD4+ populations, but also to obtain the percentage of regulatory T cells using cell surface markers.

OBJETIVO: Realizar un análisis preliminar sobre los conteos de linfocitos Tregs presentes en sangre periférica de niños asmáticos alérgicos de la ciudad de Cartagena, comparado con controles sanos. MÉTODOS: Se compararon los conteos de citometría de diez pacientes asmáticos (entre 7 y16 años) y siete controles sanos (entre 6 y12 años), reclutados en la ciudad de Cartagena. La muestra de sangre periférica fue teñida empleando el kit de inmunofenotipo multiplexado de 14 colores de Cytek (Cytek® cFluor® Immunoprofiling Kit 14 Color), y analizada en un citómetro espectral Northern Lights™ (Cytek® Biosciences, Fremont, CA, USA), a lectura de 50.000 eventos por muestra. Los datos obtenidos fueron analizados en SpectroFlo® y FlowJo. El estudio fue aprobado por el Comité de Ética de la Universidad de Cartagena. RESULTADOS: El panel de tinción funcionó apropiadamente y dentro de los parámetros apropiados. Se obtuvo un promedio de células Tregs CD3+, CD4+, CD25+ y CD127- del 11% de todos los CD4+ en las muestras estudiadas, con un rango de mínimo de 8,1% y un máximo de 17,7%. No hubo diferencias significativas en la proporción de linfocitos Tregs entre los pacientes asmáticos alérgicos y los controles sanos (P = 0.2). CONCLUSIONES: Con este tamaño de muestra preliminar, no se encontraron diferencias significativas en la población de linfocitos Tregs entre los pacientes asmáticos alérgicos y los controles sanos. El panel multiplexado de 14 colores es una herramienta útil no solo para derivar las poblaciones CD3+ y CD4+, sino también para obtener el porcentaje de células T reguladoras empleando marcadores de superficie celular.

Time Course of Mechanical Ventilation Driving Pressure Levels in Pediatric Acute Respiratory Distress Syndrome: Outcomes in a Prospective, Multicenter Cohort Study From Colombia, 2018-2022.

OBJECTIVES: High driving pressure (DP, ratio of tidal volume (V t ) over respiratory system compliance) is a risk for poor outcomes in patients with pediatric acute respiratory distress syndrome (PARDS). We therefore assessed the time course in level of DP (i.e., 24, 48, and 72 hr) after starting mechanical ventilation (MV), and its association with 28-day mortality. DESIGN: Multicenter, prospective study conducted between February 2018 and December 2022. SETTING: Twelve tertiary care PICUs in Colombia. PATIENTS: One hundred eighty-four intubated children with moderate to severe PARDS. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The median (interquartile range [IQR]) age of the PARDS cohort was 11 (IQR 3-24) months. A total of 129 of 184 patients (70.2%) had a pulmonary etiology leading to PARDS, and 31 of 184 patients (16.8%) died. In the first 24 hours after admission, the plateau pressure in the nonsurvivor group, compared with the survivor group, differed (28.24 [IQR 24.14-32.11] vs. 23.18 [IQR 20.72-27.13] cm H 2 O, p < 0.01). Of note, children with a V t less than 8 mL/kg of ideal body weight had lower adjusted odds ratio (aOR [95% CI]) of 28-day mortality (aOR 0.69, [95% CI, 0.55-0.87]; p = 0.02). However, we failed to identify an association between DP level and the oxygenation index (aOR 0.58; 95% CI, 0.21-1.58) at each of time point. In a diagnostic exploratory analysis, we found that DP greater than 15 cm H 2 O at 72 hours was an explanatory variable for mortality, with area under the receiver operating characteristic curve of 0.83 (95% CI, 0.74-0.89); there was also increased hazard for death with hazard ratio 2.5 (95% CI, 1.07-5.92). DP greater than 15 cm H 2 O at 72 hours was also associated with longer duration of MV (10 [IQR 7-14] vs. 7 [IQR 5-10] d; p = 0.02). CONCLUSIONS: In children with moderate to severe PARDS, a DP greater than 15 cm H 2 O at 72 hours after the initiation of MV is associated with greater odds of 28-day mortality and a longer duration of MV. DP should be considered a variable worth monitoring during protective ventilation for PARDS.

Implementation of a Bleeding Management Algorithm in Liver Transplantation: A Pilot Study.

Objectives: The aims of the study were to compare the consumption of blood products before and after the implementation of a bleeding management algorithm in patients undergoing liver transplantation and to determine the feasibility of a multicentre, randomized study. Background: Liver transplantation remains the only curative therapy for patients with end-stage liver disease, but it carries a high risk of surgical bleeding. Materials and Methods: Retrospective study of patients treated before (group 1) and after (group 2) implementation of a haemostatic algorithm guided by viscoelastic testing, including use of lyophilized coagulation factor concentrates (prothrombin complex and fibrinogen concentrates). Primary outcome was the number of units of blood products transfused in 24 h after surgery. Secondary outcomes included hospital stay, mortality, and cost. Results: Data from 30 consecutive patients was analysed; 14 in group 1 and 16 in group 2. Baseline data were similar between groups. Median total blood product consumption 24 h after surgery was 33 U (IQR: 11-57) in group 1 and 1.5 (0-23.5) in group 2 (p = 0.028). Significantly fewer units of red blood cells, fresh frozen plasma, and cryoprecipitate were transfused in group 2 versus group 1. There was no significant difference in complications, hospital stay, or in-hospital mortality between groups. The cost of haemostatic therapy was non-significantly lower in group 2 versus group 1 (7,400 vs. 15,500 USD; p = 0.454). Conclusion: The haemostatic management algorithm was associated with a significant reduction in blood product use during 24 h after liver transplantation. This study demonstrated the feasibility and provided a sample size calculation for a larger, randomized study.

In situ and in vitro evaluation of two antiseptics for blood bank based on chlorhexidine gluconate/isopropyl alcohol and povidone-iodine.

BACKGROUND: Poor disinfection is the main cause of blood contamination, so its elimination is key to limiting the entry of bacteria into the collection system. With the advancement of antiseptic technology, antiseptics with sterile, disposable applicators are now available. AIM: To evaluate in situ two antiseptics (with and without applicators) for blood banks and to demonstrate in vitro antiseptic activity on bacterial biofilms of importance in transfusion medicine. METHODS: Antiseptic A (2% sterile solution of chlorhexidine gluconate/70% isopropyl alcohol provided with applicator) and bulk antiseptic B (10% povidone-iodine) were evaluated. The deferred blood donor arms were subjected to disinfection with antiseptics A and B and the contralateral arms were cultured to determine the baseline bacterial load (control). Antiseptic activity was assessed by ANOVA and logaritmic reduction values (LRV) and percentage reduction values (PRV) were calculated. Finally, the in vitro activity of antiseptic A was analyzed by confocal laser scanning microscopy (CLSM) on biofilm models. RESULTS: Prior to disinfection tests, commensal and clinically important bacteria were identified; antiseptic A showed post-disinfection bacterial growth rates of zero compared to controls (p < 0.0001). The frequency of bacterial growth with antiseptic B was 74%. A significant difference was identified between both antiseptics, where antiseptic A showed higher activity (p < 0.5468). LRV and PRV were 0.6-2.5/100% and 0.3-1.7/66.7-99.7% for antiseptics A and B, respectively. Through CLSM, disinfectant A (without applicator) showed lower in vitro antiseptic activity on the tested biofilms at the exposure times recommended by the manufacturer. CONCLUSIONS: Sterile solution of chlorhexidine gluconate/isopropyl alcohol with applicator showed advantages disinfection in deferred blood donors over povidone-iodine.

Extracellular Vesicles from Immune Cells: A Biomedical Perspective.

Research on the role of extracellular vesicles (sEV) in physiology has demonstrated their undoubted importance in processes such as the transportation of molecules with significance for cell metabolism, cell communication, and the regulation of mechanisms such as cell differentiation, inflammation, and immunity. Although the role of EVs in the immune response is actively investigated, there is little literature revising, in a comprehensive manner, the role of small EVs produced by immune cells. Here, we present a review of studies reporting the release of sEV by different types of leukocytes and the implications of such observations on cellular homeostasis. We also discuss the function of immune cell-derived sEV and their relationship with pathological states, highlighting their potential application in the biomedical field.

Propiedades psicométricas de la "Escala de motivación académica" adaptada para la educación profesional en enfermería / Psychometric properties of the "Academic motivation scale" adapted for the professional nursing education

Resumen Objetivo: El presente trabajo tuvo por objetivo realizar una adaptación de la Escala de Motivación Académica (EMA) para su uso en la educación profesional en enfermería (EMA-Enf) y evaluar sus propiedades psicométricas. Materiales y métodos: Se realizó una adaptación a una versión en español de la EMA para su uso en el contexto de la educación profesional en enfermería. Se desarrolló un cuestionario estructurado y se aplicó a 447 estudiantes de Licenciatura en Enfermería en Michoacán, México. Se realizó análisis factorial confirmatorio (AFC) para probar el ajuste de diferentes modelos derivados de la Teoría de la Autodeterminación (TAD). Se utilizó el software SPSS para la gestión de base de datos y software R, para la estimación de los modelos considerando la naturaleza ordinal de los ítems. Se evaluó la consistencia interna a través de los Coeficientes α y ω. Resultados: En el AFC se observó que el modelo de siete factores correlacionados propuesto en la TAD logra el mejor ajuste (χ2= 951.88 p< 0.001, CFI= 0.927, RMSEA= 0.065, SRMR= 0.072). Los siete factores tuvieron consistencia interna aceptable (Coeficiente a con un rango entre 0.624 y 0.746; y el Coeficiente ω entre 0.719 y 0.896). Conclusión: La Escala EMA-Enf puede ser una propuesta viable en la investigación y práctica educativa relacionada con la formación de profesionales de la enfermería.

Abstract Objective: The present work carries out an adaptation of the Academic Motivation Scale (EMA) to be used in professional nursing education (EMA-Enf) and to evaluate its psychometric properties. Materials and method: An adaptation to a Spanish version of the EMA was made for its use in the context of professional nursing education. A structured questionnaire was developed and applied to 447 Nursing undergraduate students in Michoacán, Mexico. Confirmatory factor analysis (CFA) was performed to test the fit of different models derived from Self-Determination Theory (SDT). SPSS software was used for database management and R software for model estimation considering the ordinal nature of the items. The internal consistency was evaluated through the Coefficients α and ω. Results: In the AFC, it was observed that the model of seven correlated factors proposed in the SDT achieves the best fit (χ2= 951.88 p< 0.001, CFI= 0.927, RMSEA= 0.065, SRMR= 0.072). The seven factors had acceptable internal consistency (Coefficient a with a range between 0.624 and 0.746; and the Coefficient ω between 0.719 and 0.896). Conclusion: The EMA-Enf Scale can be a viable proposal in educational research and practice related to professional nursing education.

Propiedades psicométricas de la Escala de Valoración de la Capacidad de Autocuidado en adolescentes mexicanos / Propiedades psicométricas de la Escala de Valoración de la Capacidad de Autocuidado en adolescentes mexicanos / Propriedades psicométricas da Escala de Avaliação da Capacidade de Autocuidado em adolescentes mexicanos

Introducción: este trabajo tuvo por objetivo contribuir en el estudio de la validez y confiabilidad de la versión en español de la Escala de Valoración de Capacidad de Autocuidado (ASA) en adolescentes. Materiales y métodos: se construyó un cuestionario con los 24 ítems de la escala ASA, junto con ítems para explorar variables sociodemográficas, conductas y condiciones de salud. Se aplicó el cuestionario a 541 adolescentes mexicanos. Se realizaron como técnicas de análisis: análisis factorial exploratorio (AfE), análisis factorial confirmatorio (AfC), determinación de consistencia interna (coeficientes α y ω) y análisis de relación con otras variables basado en comparación de grupos. Se analizó el desempeño de diferentes estructuras de la escala ASA. Resultados: se lograron obtener dos propuestas basadas en la escala ASA para su uso en adolescentes: una basada en un modelo unidimensional (20 ítems) y otra basada en un modelo de tres factores (14 ítems). Estas propuestas tuvieron buen desempeño en el AfC, así como en consistencia interna. Además, presentaron evidencia de validez basada en la relación con conductas y condiciones relacionadas con la salud. Conclusión: se presentan hallazgos de validez y confiabilidad que sustentan el uso de dos versiones reducidas de la escala ASA en adolescentes.

Introduction: This study aimed to investigate the validity and reliability of the Spanish version of the Appraisal of Self-care Agency Scale (ASA scale) in adolescents. Materials and methods: A questionnaire was created with 24 items of the ASA scale together with items that explored the sociodemographic variables as well as health-related behaviors and conditions. The questionnaire was given to 541 Mexican adolescents. Different analysis techniques were performed, including exploratory factor analysis, confirmatory factor analysis (CfA), determination of internal consistency (coefficients α and ω), and other variables relationship based on group comparisons. The performance of the different factorial structures of the ASA scale was analyzed. Results: We obtained two proposals based on the ASA Scale that can be used in adolescents; one was based on a one-dimensional model (20 items) and the other was based on a three-factor model (14 items). These proposals performed well in the CfA as well as in internal consistency analysis techniques. Furthermore, these proposals presented validity evidence based on the relationship with health-related behaviors and conditions. Conclusion: We provide evidence for the validity and reliability of the two reduced versions of the ASA scale that supports its use in adolescents.

Introdução: este trabalho teve como objetivo contribuir para o estudo da validade e confiabilidade da versão em espanhol da Escala de Valoración de Capacidad de Autocuidado (ASA) em adolescentes. Materiais e Métodos: foi construído um questionário com os 24 itens da Escala ASA juntamente com itens para explorar variáveis sociodemográficas, comportamentos e condições de saúde. O questionário foi aplicado a 541 adolescentes mexicanos. Foram realizadas como técnicas de análise: análise fatorial exploratória (AfE); análise fatorial confirmatória (AfC); determinação da consistência interna (Coeficientes α e ω); e análise de relação com outras variáveis com base na comparação de grupos. Foi analisado o desempenho de diferentes estruturas da escala ASA. Resultados: foi possível obter duas propostas baseadas na Escala ASA para a sua utilização em adolescentes, uma baseada no modelo unidimensional (20 itens) e outra baseada no modelo de três fatores (14 itens). Essas propostas tiveram um bom desempenho na AfC, bem como na consistência interna. Além disso, apresentaram evidências de validade baseadas na relação com comportamentos e condições relacionadas à saúde. Conclusão: são apresentadas evidências de validade e confiabilidade que suportam o uso de duas versões reduzidas da escala ASA em adolescentes

Comparison of progressive hold and progressive response schedules of reinforcement.

Progressive ratio (PR) schedules have been widely used to study motivation to work for a reinforcer. After a post-reinforcer pause, subjects engage in pressing a lever until a reinforcer is obtained. However, the discrete nature of lever presses allows alternative behaviors during inter-response time and has led to several behavioral explanations of pauses and work time. A progressive hold-down (PH) is incompatible with alternative responses and may allow a precise estimation of work time. Performance of rats trained in both PR and PH that received sucrose or intracranial self-stimulation (ICSS) as reinforcer were compared. We observed that rats mastered the PR and PH schedules. Post-reinforcer pauses (PSRP), work time and inter-reinforcer time increased as a function of the response or hold requirement. However, rats' performance suggested that the PH progression may be experienced by the rats as easier that the PR progression. Elimination of consummatory behavior with ICSS reduced post-reinforcer pause in accordance with predictions of explanatory models of fixed and variable schedules of reinforcement. In the case of PH performance, pauses showed little variation across intermediate requirements but increased rapidly on later requirements; since rats controlled their pause length and work time was close to the hold requirement, time allocation between PR and PH schedules diverged. Finally, the Mathematical Principles of Reinforcement model of Bradshaw and Killeen (Psychopharmacology 2012, 222: 549) rendered a good description of the performance in both PR and PH schedules.

Genotipificación de haptoglobina como factor de riesgo cardiovascular en pacientes diabeticos del Hospital Clínico Viedma

Objetivo: en pacientes con diabetes mellitus el genotipo de haptoglobina es considerado un factor de riesgo para la aparición de una cardiopatía, se ha reportado que en diabéticos el genotipo Hp 2-2 genera un riesgo cinco veces mayor de presentar una enfermedad cardiovascular comparado con pacientes diabéticos con otro genotipo. Este estudio tiene como objetivo la determinación del genotipo de haptoglobina en pacientes diabéticos que acuden al laboratorio el Hospital Clínico Viedma de noviembre de 2018 a enero de 2019. Métodos: se analizaron 76 sueros de pacientes diabéticos en ayunas y que contaban con una solicitud de perfil lipídico. Para la determinación de los tres genotipos de haptoglobina se usó un kit comercial de enzimoinmunoanalisis (ELISA Hp-Epitope); para la determinación de la glicemia y el perfil lipídico se usó el método enzimático. Resultados: del total de la población estudiada de pacientes diabéticos un 12 % presenta el genotipo Hp 2-2 en aquellos pacientes no controlados, los valores de glicemia (201 mg/dl) son estadísticamente significativas en relación con los otros dos genotipos. También estos pacientes diabéticos no controlados con genotipo Hp 2-2 presentan niveles de colesterol, LDL, VLDL y triglicéridos significativamente elevados en relación con los otros dos genotipos. Conclusiones: nuestros resultados coinciden con estudios previos el cual señalan que pacientes diabéticos que poseen el genotipo Hp 2-2 tiene mayor riesgo a sufrir una enfermedad cardiovascular en comparación con los otros 2 genotipos.

Objective: in patients with diabetes mellitus, the haptoglobin genotype is considered a risk factor for the onset of heart disease. It has been reported that in diabetics, the Hp 2-2 genotype generates a five-fold greater risk of developing cardiovascular disease compared to diabetic patients with another genotype. This study aims to determine the haptoglobin genotype in diabetic patients who come to the Viedma Clinical Hospital laboratory from November 2018 to January 2019. Methods: 76 sera from fasting diabetic patients with a lipid profile request were analyzed. For the determination of the three haptoglobin genotypes, a commercial enzyme immunoassay kit (Hp-Epitope ELISA) was used; The enzymatic method was used to determine glycemia and lipid profile. Results: of the total studied population of diabetic patients, 12% have the Hp 2-2 genotype. In those uncontrolled patients, the glycemia values (201 mg/dl) are statistically significant in relation to the other two genotypes. These uncontrolled diabetic patients with the Hp 2-2 genotype also have significantly elevated levels of cholesterol, LDL, VLDL and triglycerides in relation to the other two genotypes. Conclusions: our results coincide with previous studies which indicate that diabetic patients who have the Hp 2-2 genotype have a greater risk of suffering from cardiovascular disease compared to the other 2 genotypes.

In Combo Studies for the Optimization of 5-Aminoanthranilic Acid Derivatives as Potential Multitarget Drugs for the Management of Metabolic Syndrome.

Metabolic syndrome is a set of risk factors that consist of abdominal obesity, arterial hypertension, alterations in the lipid profile, and hyperglycemia. The current therapeutic strategy includes polypharmacy, using three or more drugs to control each syndrome component. However, this approach has drawbacks that could lead to therapeutic failure. Multitarget drugs are molecules with the ability to act on different targets simultaneously and are an attractive alternative for treating complex diseases such as metabolic syndrome. Previously, we identified a triamide derivative of 5-aminoanthranilic acid that exhibited hypoglycemic, hypolipemic, and antihypertensive activities simultaneously. In the present study, we report the synthesis and in combo evaluation of new derivatives of anthranilic acid, intending to identify the primary structural factors that improve the activity over metabolic syndrome-related parameters. We found that substitution on position 5, incorporation of 3,4-dimethoxyphenyl substituents, and having a free carboxylic acid group lead to the in vitro inhibition of HMG-CoA reductase, and simultaneously the diminution of the serum levels of glucose, triglycerides, and cholesterol in a diet-induced in vivo model.

Programas de Intervención para la Promoción de Actividad Física y Hábitos Saludables en Escolares Chilenos: Una Revisión Narrativa / Intervention Programs for the Promotion of Physical Activity and Eating Habits in Chilean Schoolchildren: A Narrative Review

Introducción. Los programas de intervención escolar en actividad física y hábitos de vida saludable, surgen debido a que el sobrepeso y la obesidad infantil en Chile, han aumentado progresivamente, llegando en la actualidad a cifras que superan el 30 % de la totalidad en el país. Objetivo. sistematizar los efectos de programas de intervención para la promoción de actividad física y/o de hábitos saludables implementados en escolares chilenos. Metodos. Se revisaron artículos publicados entre los años 2011 y 2021, en las bases de datos de: Pubmed, Scopus y Dialnet. Resultados. Se contabilizaron un total de 237 artículos de los cuales luego de la lectura de títulos y resumen (53) y lectura del texto completo (21), las que una vez filtradas dejó un total de 5 artículos. En todos los programas se muestra que por medio de la educación nutricional mejoró el conocimiento alimentario de manera significativa, así también se demuestra que la actividad física realizada por profesionales favorecen el gasto energético y es efectiva en reducir la prevalencia de obesidad. Conclusión. El fomento de la AF y educación nutricional logran un efecto positivo para el logro del control del sobrepeso y obesidad en población infantil.

Background. School intervention programs in physical activity and healthy lifestyles arise because childhood overweight and obesity in Chile have progressively worsened, currently reaching figures that exceed 30% of the total in the country. Objective. to investigate in the literature the effects of intervention programs aimed at promoting physical activity and healthing habits in Chilean schoolchildren. Methods. Articles published between 2011 and 2021 are reviewed, in the databases of: Pubmed, Scopus and Dialnet. Results. A total of 237 articles were counted, of which after reading the titles and abstract (53) and reading the full text (21), which once filtered left a total of 5 articles. In all the programs it is shown that through nutrition, food knowledge improved significantly, as well as it is shown that physical activity carried out by professionals favors energy expenditure and is effective in reducing the prevalence of obesity. Conclusion. The promotion of PA and nutritional education achieved a positive effect in achieving control of overweight and obesity in the child population

Resident training in psychopathology and uncertainty in a clinical situation.

The central theme of this article is the way in which psychiatry physicians-in-training deal with uncertainty in the discussion of clinical cases in Mexico. Methodologically, it is approached from the field of clinical ethnography and the narrative interpretation of plots in performative actions where there are sequences of communicative exchanges. In this way, it focuses on a detailed description of situations where clinical cases are reviewed to decipher, explain, and understand intersubjective meanings in the face of the emergence of uncertainty, its management, and the implications on decisions and actions. The study finds that limitations within the field of psychiatry lie in the nosographic construction of disease and its translation into the diagnostic hypotheses made by clinicians, where there are wide margins of ambiguity. The strategies implemented in the face of uncertainty are use of drugs, the collegiate review of the case, and utilization of intuition as a spontaneous, preconscious daily practice. The specific case described here provides a microscopic observation of the complex scenarios in which uncertainty occurs in educational and teaching processes, clearly revealing how patient care is articulated. The narratives and their interpretation are materials for training/curriculum and psychiatric clinical practice.

Ionic complexation improves wound healing in deep second-degree burns and reduces in-vitro ciprofloxacin cytotoxicity in fibroblasts.

The development of new treatments capable of controlling infections and pain related to burns continues to be a challenge. Antimicrobials are necessary tools, but these can be cytotoxic for regenerating cells. In this study, antibiotic-anesthetic (AA) smart systems obtained by ionic complexation of polyelectrolytes with ciprofloxacin and lidocaine were obtained as films and hydrogels. Ionic complexation with sodium alginate and hyaluronate decreased cytotoxicity of ciprofloxacin above 70% in a primary culture of isolated fibroblasts (p < 0.05). In addition, the relative levels of the proteins involved in cell migration, integrin ß1 and p-FAK, increased above 1.5 times (p < 0.05) with no significant differences in cell mobility. Evaluation of the systems in a deep second-degree burn model revealed that reepithelization rate was AA-films = AA-hydrogels > control films > no treated > reference cream (silver sulfadiazine cream). In addition, appendage conservation and complete dermis organization were achieved in AA-films and AA-hydrogels. Encouragingly, both the films and the hydrogels showed a significantly superior performance compared to the reference treatment. This work highlights the great potential of this smart system as an attractive dressing for burns, which surpasses currently available treatments.

Emergence and evolution of SARS-CoV-2 genetic variants during the Cuban epidemic.

The SARS CoV-2 D614G variant circulated in Cuba in 2020. New viral variants were detected after the opening of the border in November 2020. We show the results of the genomic surveillance in Cuba from December 28, 2020, to September 28, 2021 and their relationship to the epidemiological situation in the country. A total of 1,406 nasopharyngeal exudates from COVID-19 patients were processed for RNA extraction and the 1836 bp fragment of the spike gene was amplified and sequenced. The mutations present were determined using the GISAID database. Prevalence ratios were estimated by fitting Poisson univariate and multivariate regression models to investigate associations between SARS-CoV-2 variant group (VOC, non-VOC) and disease outcome. Seventeen genetic variants were detected including VOC Alpha, Beta, Gamma and Delta, one variant of interest (VOI) (Lambda) and two previous VOI (A.2.5.1 and Zeta/P.2). Beta (34.77%), Delta (24.89%) and D614G (19%) variants were the most frequently detected. By June, Delta increased in frequency, displacing Beta. Disease severity increased significantly with age and VOC (PR =1.98, IC 95%: 1.33-3.05, p <0.05). Genomic surveillance allowed us to identify the upsurge of novel variants. Coinciding with the higher epidemic period, multiple variants were co-circulating. Although we cannot rule out that failure in the transmission containment measures occurred, the increase in the number of cases associated with the circulation of several variants, particularly the Beta and Delta variants is highly suggestive. A greater association of Beta variant with clinical severity and Delta variant with a greater transmissibility was observed.

Tiny Regulators in Viral Infection: Carving SARS-CoV-2 by miRNAs.

Viruses are microscopic biological entities that can cause diseases. Viruses require a host cell to replicate and generate progeny. Once inside, viruses hijack the main cellular machinery for their benefit, disrupting cell functions and causing detrimental effects on cell physiology. MicroRNAs are short, non-coding RNAs that regulate gene expression. Recent works have shown that cell-miRNAs can modulate antiviral defense during viral infection, and viruses can disrupt these existing miRNA networks. Furthermore, multiple RNA viruses encode their own miRNAs to evade the host immune response. In this review, we analyze the activities of both, miRNAs as pro-viral modulators and miRNAs as anti-viral agents and their relationship with the development of the disease.