Mental Well-being InSciEd Out: Health Partnerships with the Boys & Girls Clubs of Puerto Rico.

BACKGROUND: Mental health care is a top clinical concern for modern Puerto Rico, especially given a dramatically changing economic landscape paired with recurrent natural disasters. Youth are particularly at-risk due to long-term impacts of toxic stress and adverse childhood experiences on health and development. OBJECTIVES: Here we present a novel clinician-community-educator-scientist partnership to address Puerto Rican youth mental well-being and wellness. We deployed pilot health workshops within the Boys & Girls Clubs of Puerto Rico to build youth mental health conceptual understanding and competencies in stress recognition and management. The work in progress herein evaluates acceptability and feasibility of our curricular model. METHODS: Dialogue with community stakeholders guided curricular design of workshops for youth ages 6 to 13 and older. Prior to implementation, educators and volunteers attended a 1-day training on educational strategies. Workshop success was evaluated using qualitative approaches (i.e., narrative feedback, educator and volunteer reflections, youth Talking Drawings) to assess youth engagement, youth conceptual health understanding, and educator/volunteer impressions of feasibility and impact. RESULTS: Initial findings indicate high acceptability and feasibility of our curricular model. Youth engagement and enthusiasm were noted in educator feedback and continue to be sustained post-workshop. Preliminary analysis shows accompanying increases in youth conceptual mental health understanding, particularly for 6- to 12-year-olds in recognition of stress and healthy coping mechanisms. Reciprocal gains were observed for volunteers. CONCLUSIONS: Activities have evolved into a formal partnership called Semilla, which features expanded analysis of mental well-being and wellness outcomes. Our collaborative model continues to engage Puerto Rican youth in the science of their well-being.

Perinatal Mental Health Outcomes Following Natural Disasters.

This Viewpoint discusses mental health outcomes associated with natural disaster­related stressors during the perinatal period.

Mental health impact of the COVID-19 pandemic in perinatal women living in Puerto Rico.

BACKGROUND: Studies have reported an increase in mental health disorders during the perinatal period as a result of the COVID-19 pandemic and the quarantine restrictions imposed. The effects of untreated maternal mental health have an adverse impact on the mother, the development of the baby, and the family system. Determinants of health, recent natural disasters, and disparities in perinatal care that impact perinatal women in Puerto Rico place them at a higher risk of mental health difficulties. AIM: It is therefore, of extreme importance, to evaluate the effect that the COVID-19 pandemic has had on this vulnerable population. DESIGN: This is a cross-sectional observational study that interviewed 100 women in the perinatal period during the COVID-19 lockdown measures in Puerto Rico. Participants completed the Spanish version of the COVID-19 Perinatal Experiences (COPE-IS) questionnaire and assessments of clinical depression (PHQ-9) and anxiety (GAD-7). RESULTS: The prevalence of moderate to severe risk of depression in this sample is 14%, while 17% showed clinical signs of anxiety. Concerns about social impact and the quarantine mandate were the most common stressors reported. Additionally, our sample reported concerns about the impact the pandemic would have on future employment and finances. CONCLUSION: Perinatal women showed significantly higher prevalence of depression and anxiety during the COVID -19 pandemic when compared to the mental health prevalence of the general population pre-pandemic in Puerto Rico. The concerns identified during the pandemic provide information on the importance of a biopsychosocial approach to perinatal mental health care.

Pre- and peri-natal hurricane exposure alters DNA methylation patterns in children.

Hurricane Maria was the worst recorded natural disaster to affect Puerto Rico. Increased stress in pregnant women during and in the aftermath of the hurricane may have induced epigenetic changes in their infants, which could affect gene expression. Stage of gestation at the time of the event was associated with significant differences in DNA methylation in the infants, especially those who were at around 20-25 weeks of gestation when the hurricane struck. Significant differences in DNA methylation were also associated with maternal mental status assessed after the hurricane, and with property damage. Hurricane Maria could have long lasting consequences to children who were exposed to this disaster during pregnancy.

Exploring the antibacterial potential of venoms from Argentinian animals.

The resistance to antimicrobials developed by several bacterial species has become one of the main health problems in recent decades. It has been widely reported that natural products are important sources of antimicrobial compounds. Considering that animal venoms are under-explored in this line of research, in this study, we screened the antibacterial activity of venoms of eight snake and five lepidopteran species from northeastern Argentina. Twofold serial dilutions of venoms were tested by the agar well-diffusion method and the minimum inhibitory concentration (MIC) determination against seven bacterial strains. We studied the comparative protein profile of the venoms showing antibacterial activity. Only the viperid and elapid venoms showed remarkable dose-dependent antibacterial activity towards most of the strains tested. Bothrops diporus venom showed the lowest MIC values against all the strains, and S. aureus ATCC 25923 was the most sensitive strain for all the active venoms. Micrurus baliocoryphus venom was unable to inhibit the growth of Enterococcus faecalis. Neither colubrid snake nor lepidopteran venoms exhibited activity on any bacterial strain tested. The snake venoms exhibiting antibacterial activity showed distinctive protein profiles by SDS-PAGE, highlighting that we could reveal for the first time the main protein families which may be thought to contribute to the antibacterial activity of M. baliocoryphus venom. This study paves the way to search for new antibacterial agents from Argentinian snake venoms, which may be a further opportunity to give an added value to the local biodiversity.

The psychological impact of the COVID-19 pandemic on physicians in Puerto Rico: a cross-sectional study after the second wave in 2021.

Introduction: Health care providers faced a challenge with the emergence of COVID-19 and its rapid spread. Early studies measuring the psychological impact of COVID-19 on the general population found high levels of anxiety and sleep disorders. The primary goal of this project was to assess the psychological impact of COVID-19 on physicians in Puerto Rico. Materials and methods: A cross-sectional study of physicians in Puerto Rico was conducted anonymously and electronically from February 2021 through April 2021. The electronic survey included socio-demographic data and 4 self-administered assessment tools (Generalized Anxiety Disorder-7, Perceived Stress Scale-10, Pittsburgh Sleep Quality Index and COVID-19 Organizational Support) for anxiety, perceived stress, sleep disturbances, and organizational support during the COVID-19 pandemic. Results: A total of 145 physicians completed the survey, with a female predominance of 53.5% and a majority practicing in the San Juan metropolitan area (50.3%). Mild anxiety symptoms were reported in 26.9% of physicians, and 33.8% had moderate to severe anxiety symptoms. Moderate to high perceived stress was found in 69.9% of participants, and women reported statistically significantly higher levels of anxiety symptoms (8.84 ± 5.99; p = 0.037) and stress (19.0 ± 6.94, p = 0.001). The Pittsburgh Sleep Quality Index reported 67.9% of physicians with global scores associated with poor sleep quality. Assessment of perceived organizational support found a high perception of work support (65.7%) but low perception of personal support (43.4%) and risk support (30.3%). A correlation analysis found a negative correlation for work and personal support, but a positive correlation for risk support, all statistically significant. Conclusion: COVID-19 had a lasting psychological impact in health care providers in Puerto Rico a year after the beginning of the pandemic. Our data supports the importance of organizational support and its correlation with the development of anxiety. It is thus essential to develop strategies to identify individuals at risk of experiencing psychological disturbances and to provide effective support for medical professionals during medical emergencies for their well-being and optimal delivery of patient care.

Relationship between the Prenatal Diagnosis of Placenta Acreta Spectrum and Lower Use of Blood Components.

OBJECTIVE: To describe the clinical results of patients admitted and managed as cases of placenta accreta spectrum (PAS) at a Central American public hospital and the influence of the prenatal diagnosis on the condition. MATERIALS AND METHODS: A retrospective analysis of PAS patients treated at Hospital Bertha Calderón Roque, in Managua, Nicaragua, between June 2017 and September 2021. The diagnostic criteria used were those of the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, in French). The population was divided into patients with a prenatal ultrasonographic diagnosis of PAS (group 1) and those whose the diagnosis of PAS was established at the time of the caesarean section (group 2). RESULTS: During the search, we found 103 cases with a histological and/or clinical diagnosis of PAS; groups 1 and 2 were composed of 51 and 52 patients respectively. Regarding the clinical results of both groups, the patients in group 1 presented a lower frequency of transfusions (56.9% versus 96.1% in group 2), use of a lower number of red blood cell units (RBCUs) among those undergoing transfusions (median: 1; interquartile range: [IQR]: 0-4 versus median: 3; [IQR]: 2-4] in group 2), and lower frequency of 4 or more RBCU transfusions (29.4% versus 46.1% in group 2). Group 1 also exhibited a non-significant trend toward a lower volume of blood loss (1,000 mL [IQR]: 750-2,000 mL versus 1,500 mL [IQR]: 1,200-1,800 mL in group 2), and lower requirement of pelvic packing (1.9% versus 7.7% in group 2). CONCLUSION: Establishing a prenatal diagnosis of PAS is related to a lower frequency of transfusions. We observed a high frequency of prenatal diagnostic failures of PAS. It is a priority to improve prenatal detection of this disease.

Relationship between the Prenatal Diagnosis of Placenta Acreta Spectrum and Lower Use of Blood Components / Relação entre o diagnóstico prenatal de espectro da placenta acreta e menor uso de hemoderivados

Abstract Objective To describe the clinical results of patients admitted and managed as cases of placenta accreta spectrum (PAS) at a Central American public hospital and the influence of the prenatal diagnosis on the condition. Materials and Methods A retrospective analysis of PAS patients treated at Hospital Bertha Calderón Roque, in Managua, Nicaragua, between June 2017 and September 2021. The diagnostic criteria used were those of the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, in French). The population was divided into patients with a prenatal ultrasonographic diagnosis of PAS (group 1) and those whose the diagnosis of PAS was established at the time of the caesarean section (group 2). Results During the search, we found 103 cases with a histological and/or clinical diagnosis of PAS; groups 1 and 2 were composed of 51 and 52 patients respectively. Regarding the clinical results of both groups, the patients in group 1 presented a lower frequency of transfusions (56.9% versus 96.1% in group 2), use of a lower number of red blood cell units (RBCUs) among those undergoing transfusions (median: 1; interquartile range: [IQR]: 0-4 versus median: 3; [IQR]: 2-4] in group 2), and lower frequency of 4 or more RBCU transfusions (29.4% versus 46.1% in group 2). Group 1 also exhibited a non-significant trend toward a lower volume of blood loss (1,000 mL [IQR]: 750-2,000 mL versus 1,500 mL [IQR]: 1,200-1,800 mL in group 2), and lower requirement of pelvic packing (1.9% versus 7.7% in group 2). Conclusion Establishing a prenatal diagnosis of PAS is related to a lower frequency of transfusions. We observed a high frequency of prenatal diagnostic failures of PAS. It is a priority to improve prenatal detection of this disease.

Design and Study of a Photo-Switchable Polymeric System in the Presence of ZnS Nanoparticles under the Influence of UV Light Irradiation.

Recent progress in the field of photosensitive materials has prompted a need to develop efficient methods to synthesize materials with basic intermolecular architectural designs and novel properties. Accordingly, in this work we design and study a photoactive polymer as a photo-switchable polymeric system in the presence and absence of ZnS nanoparticles (average size < 10 nm) at 5 wt.%. The influence of UV light irradiation on its properties were also studied. The photoactive block copolymer was obtained from styrene (S) and methyl methacrylate (MMA) as monomers and 1-(2-hydroxyethyl)-3,3-dimethylindoline-6-nitrobenzopyran (SP) was grafted to the block copolymer backbone as a photochromic agent. Furthermore, the incorporation of ZnS (NPs) as photo-optical switch component into the system enhances the purple colored photo-emission, with the open form of the spiropyran derivative (merocyanine, MC). The ZnS stabilize the isomeric equilibrium in the MC interconversion of the photochromic agent. The photo-switchable properties of the PS-b-PMMA-SP in the presence of ZnS (NPs) were examined using UV-VIS spectroscopy, Photoluminescence (PL) spectroscopy, optical fluorescence and scanning electronic microscopy (SEM-EDX.). The observed changes in the absorbance, fluorescence and morphology of the system were associated to the reversible interconversion of the two states of the photochromic agent which regulates the radiative deactivation of the luminescent ZnS NPs component. After UV irradiation the photoactive polymer becomes purple in color. Therefore, these basic studies can lead to the development of innovative functional and nanostructured materials with photosensitive character as photosensitive molecular switches.

Unraveling the distinctive venomous features of the saturniid Hylesia sp.: An integrative approach of a public health concern in Argentina.

The saturniid genus Hylesia is well known for the cutaneous lepidopterism induced by airborne setae on contact with the skin. Although several cases of such dermatitis have been reported in Argentina, no information about their venoms and toxicological implications on human health is available yet. Thus, we conducted a morphological analysis of the setae/spines and a toxinological characterization (through biological assays and proteomic techniques) of the bristle extract from caterpillars and moths of Hylesia sp. from Misiones, Argentina. By scanning electron microscopy, we revealed the various and distinctive types of urticating structures: harpoon-shaped or spiny setae in caterpillars, and setae with barb-like structures in female moths. Their venom electrophoretic profiles were substantially different, presenting proteins related to toxicity, such as serpins and serine peptidases. The female moth venom exhibited higher caseinolytic activity than the caterpillar venom, and coincidentally only the former noticeably hydrolyzed fibrinogen and gelatin. In addition, the female venom displayed a dose-dependent procoagulant effect. The injection of this venom into mouse skin led to the rapid detection of an increased number of intact and degranulated mast cells in the dermis; a few areas of focal subcutaneous hemorrhage were also observed after 5 h of injection. Altogether, this study provides relevant information about the pathophysiological mechanisms whereby Hylesia sp. from northeastern Argentina can induce toxicity on human beings, and paves the way for treatment strategies of accidents caused by this saturniid lepidopteran.

Whole Genome Sequencing Links Mycobacterium bovis From Cattle, Cheese and Humans in Baja California, Mexico.

Mycobacterium bovis causes tuberculosis (TB) in cattle, which in turn can transmit the pathogen to humans. Tuberculosis in dairy cattle is of particular concern where the consumption of raw milk and dairy products is customary. Baja California (BCA), Mexico, presents high prevalence of TB in both cattle and humans, making it important to investigate the molecular epidemiology of the disease in the region. A long-term study was undertaken to fully characterize the diversity of M. bovis genotypes circulating in dairy cattle, cheese and humans in BCA by whole-genome sequencing (WGS). During a 2-year period, 412 granulomatous tissue samples were collected from local abattoirs and 314 cheese samples were purchased from local stores and vendors in BCA and sent to the laboratory for mycobacterial culture, histology, direct PCR and WGS. For tissue samples M. bovis was recovered from 86.8%, direct PCR detected 90% and histology confirmed 85.9% as mycobacteriosis-compatible. For cheese, M. bovis was recovered from 2.5% and direct PCR detected 6% of the samples. There was good agreement between diagnostic tests. Subsequently, a total of 345 whole-genome SNP sequences were obtained. Phylogenetic analysis grouped these isolates into 10 major clades. SNP analysis revealed putative transmission clusters where the pairwise SNP distance between isolates from different dairies was ≤3 SNP. Also, human and/or cheese isolates were within 8.45 (range 0-17) and 5.8 SNP (range 0-15), respectively, from cattle isolates. Finally, a comparison between the genotypes obtained in this study and those reported previously suggests that the genetic diversity of M. bovis in BCA is well-characterized, and can be used to determine if BCA is the likely source of M. bovis in humans and cattle in routine epidemiologic investigations and future studies. In conclusion, WGS provided evidence of ongoing local transmission of M. bovis among the dairies in this high-TB burden region of BCA, as well as show close relationships between isolates recovered from humans, cheese, and cattle. This confirms the need for a coordinated One Health approach in addressing the elimination of TB in animals and humans. Overall, the study contributes to the knowledge of the molecular epidemiology of M. bovis in BCA, providing insight into the pathogen's dynamics in a high prevalence setting.

First insights into the biochemical and toxicological characterization of venom from the Banded Cat-eyed Snake Leptodeira annulata pulchriceps.

With the aim to widen the current knowledge of toxinological implications of bites from rear-fanged snakes and biological roles of their venoms, this study focuses on the biochemical composition and toxic effects of the venom of Leptodeira annulata pulchriceps from Argentina. We analyzed the protein composition by electrophoresis and mass spectrometry, and enzymatic properties by quantitative assays on different substrates. Additionally, we evaluated local and systemic toxicity in mice, and tested its cross-reactivity with elapid and viperid antivenoms used in Argentina. This venom showed features reminiscent of venoms from snakes of Bothrops genus, containing components ranging from ~17 to 75 kDa, which are mainly tissue-damaging toxins such as proteinases. Although showing low lethality to mice (LD50 = 20 µg/g body weight), prominent hemorrhage developed locally in mice intramuscularly and intradermally injected with the venom, and the minimum hemorrhagic dose was found to be 12.7 µg/mouse. This study is the first comprehensive investigation of the venom of L. a. pulchriceps, and sheds new light on differences between this and those of the other two subspecies of L. annulata. Additionally, the study provides new insights into the venom components of "colubrid" snakes, advocating for considering bites from this rich diversity of snakes as a public health problem that needs to be addressed worldwide.

Estimating the air quality and health impacts of biomass burning in northern South America using a chemical transport model.

Biomass burning (BB) emissions significantly deteriorate air quality in many regions worldwide, impact human health and perturbing Earth's radiation budget and climate. South America is one of largest contributors to BB emissions globally. After Amazonia, BB emissions from open and agricultural fires of Northern South America (NSA) are the most significant. Recent evidence shows a strong correlation between fire counts in NSA and Brown Carbon in some Colombian cities, suggesting a substantial seasonal contribution of regional BB sources to air pollution levels in the densely populated areas of NSA. In this work we use the atmospheric regional chemical transport model WRF-Chem to assess the contribution of open BB events to pollutant concentration and to estimate potential health impacts associated with wildfire events in NSA. Three nested domains are used to simulate atmospheric composition in the Northern part of South America and the Caribbean. Simulations included biogenic and anthropogenic emissions from a global emission inventory merged with local emissions for the city of Bogotá. Two modelling scenarios were considered, a base case without BB emissions (NO_FIRE) and a sensitivity scenario with BB emissions. Simulations were carried out for periods of strong BB activity in NSA. In the NO_FIRE scenario, aerosol concentrations are unrealistically low. When BB emissions are is included background PM2.5 concentrations increase 80%. The increment in aerosol concentrations is mainly driven by Secondary Organic Aerosols. In the case of Bogotá, the most densely populated city in the domain, monthly mean increase in PM2.5 is 3.3 µg m-3 and 4.3 ppb for O3. Modeled meteorological and air pollution fields are in better agreement with observations when high spatial resolution (3 × 3 km) is used in the simulations. The total estimated short-term all-cause mortality associated to BB during February in the region is 171 cases, 88 PM2.5-related and 83 O3-related mortality.

Fundamentos y aplicaciones biomédicas de las principales tecnologías de secuenciación: una revisión de literatura / Biomedical Foundations and Applications of Major Sequencing Technologies: A Literature Review / Fundamentos e aplicações biomédicas das principais tecnologias de sequenciamento: uma re-visão da literatura

Introducción: el objetivo de la secuenciación es determinar la composición de los nucleótidos presentes en el ADN o el ARN. Desde la finalización del proyecto genoma humano, surgieron diversas tecnologías de secuenciación rápida como Roche 454, SOLiD, Illumina, Ion Torrent, PacBio y Oxford Nanopore, más precisas y costoeficientes, que permiten desarrollar proyectos a gran escala y estudiar genes y genomas, la composición de microbiomas, enfermedades metabólicas y enfermedades genéticas que afectan a la población. Objetivo: describir los fundamentos de los métodos de secuenciación de ADN y sus aplicaciones en las ciencias biomédicas. Métodos: revisión descriptiva de las principales estrategias de secuenciación de ADN de primera, segunda y tercera generación y su aplicación en el entorno biomédico, a partir de la búsqueda de artículos en bases de datos electró-nicas especializadas en investigación científica. Se encontraron 118 documentos, de los cuales se excluyeron 6, por no cumplir con los criterios de inclusión, y se seleccionaron 112, por cumplir con todos los requisitos. Conclusiones:el surgimiento de los métodos de secuenciación de siguiente generación arroja una gran canti-dad de datos, incluidos genomas secuenciados completamente de varias especies, con un rendimiento extenso, tiempos reducidos y costoeficiencia, que lleva a la completa transformación de las ciencias de la vida y logra un progreso sin precedentes en el análisis de genomas, la evaluación de la ecología microbiana y el diagnóstico de enfermedades.

Introduction: The purpose of sequencing is to determine the composition of the nucleotides present in DNA or RNA. Since the completion of the human genome project, several sequencing technologies such as Roche 454, SOLiD, Illumina, Ion Torrent, PacBio and Oxford Nanopore have emerged as tools for rapid sequencing, with greater precision and cost-efficiency, allowing the development of lar-ge-scale projects and the study of genes and genomes, along with the composition of microbiomes and the study of metabolic and genetic diseases that affect the population. Objective: To describe the foundations of the methods of DNA sequencing and their applications in the biomedical sciences. Methods: Descriptive review of the main strategies of first, second and third generation DNA sequencing and their application in the biomedical environment. This review was carried out by searching articles in electronic databases specialized in scientific research. A total of 118 papers were found, of which 6 were excluded as they did not meet the inclusion criteria and 112 were selected as meeting all the requirements. Conclusions: The emergence of next-generation sequencing methods yielding a wealth of data, including fully sequenced genomes of various species, with extensive throughput, reduced time and cost-effec-tiveness that has led to the complete transformation of the life sciences, achieving unprecedented progress in genome analysis, assessment of microbial ecology and disease diagnosis

Introdução: o objetivo do sequenciamento é determinar a composição dos nucleotídeos presentes no DNA ou RNA. Desde a conclusão do projeto do genoma humano, surgiram diversas tecnologias de sequenciamento rápida como Roche 454, SOLiD, Illumina, Ion Torrent, PacBio e Oxford Nanopore, mais precisas e econômicas, que permitem o desenvolvimento de projetos de grande escala e estudo de genes e genomas, composição de microbiomas, doenças metabólicas e genéticas que afetam a popula-ção. Objetivo: descrever os fundamentos dos métodos de sequenciamento de DNA e suas aplicações nas ciências biomédicas. Métodos: revisão descritiva das principais estratégias de sequenciamento de DNA de primeira, segunda e terceira geração e sua aplicação no ambiente biomédico, a partir da busca de artigos em bases de dados eletrônicas especializadas em pesquisa científica. Foram encontrados 118 documen-tos, dos quais 6 foram excluídos por não atenderem aos critérios de inclusão e 112 fo-ram seleciona-dos por atenderem a todos os requerimentos. Conclusões: o surgimento de métodos de sequenciamento de próxima geração rende uma riqueza de dados, incluindo genomas totalmente se-quenciados de várias espécies, com produção extensa, tempos reduzidos e eficiência de custo, levando à transformação completa das ciências da vida e alcançando um progresso sem precedentes no genoma análise, avaliação de ecologia microbiana e diagnóstico de doenças.

La evaluación psicológica en los campos de la psicología jurídica en Colombia: psicología forense / The psychological evaluation in the fields of legal psychology in Colombia: forensic psychology

Resumen En este estudio se buscó analizar los procesos de evaluación en el campo de la psicología forense en Colombia, teniendo como producto argumentativo un marco teórico acerca de la definición de la Psicología Forense (funciones y rol), sus problemas éticos, su aplicación en los diferentes campos del derecho, y sus contraflujos más recurrentes como el tipo de instrumentos y entrevistas que utiliza el psicólogo. De acuerdo con lo anterior y teniendo en cuenta los criterios de selección de los peritos para las pruebas, se diseñó una entrevista estructurada aplicada a una muestra de psicólogos del campo forense a nivel nacional realizando un análisis de corte cuantitativo sobre la experiencia del psicólogo forense, su participación en los diferentes clases de perito, las técnicas y criterios que usa como soporte en cualquier proceso, y por último, algunas conclusiones acerca del posicionamiento en que se encuentra el psicólogo forense en Colombia.

Abstract In this study, we sought to analyze the evaluation processes in the field of forensic psychology in Colombia, having as argumentative product a theoretical framework about the definition of forensic psychology (functions and role), its ethical problems, its application in different fields of law, and its most recurrent counter-flows as the type of instruments and interviews used by the psychologist. In accordance with the foregoing and taking into account the selection criteria of the experts for the tests, a structured interview was designed applied to a sample of forensic field psychologists at a national level performing a quantitative analysis on the experience of the forensic psychologist, their participation in the different types of expert works, the techniques and criteria used as support in any process, and finally, some conclusions about the position in which the forensic psychologist is in Colombia.

Evaluación de la disfagia en pacientes con enfermedades neurológicas y su relación con riesgo de desnutrición / Assessment of dysphagia in neurological disease patients and its relation to risk factor for malnutrition

Resumen: ANTECEDENTES Los pacientes con enfermedades neurológicas son susceptibles a padecer disfagia frecuentemente no diagnosticada. OBJETIVO Determinar la existencia de disfagia en pacientes con enfermedad neurológica atendidos en la consulta externa y su relación con el riesgo de desnutrición. MATERIAL Y MÉTODO Estudio descriptivo transversal, efectuado de enero a diciembre de 2016. Se realizó valoración clínica de las fases de la deglución, se aplicó el cuestionario EAT-10 versión en español, se tomaron medidas antropométricas, se estimó la ingesta calórica y se determinó el riesgo nutricional, el índice de Quetelet y la Evaluación Global Subjetiva. RESULTADOS Se analizaron 55 pacientes, 54.5% mujeres, con edad media de 47.29 años. La disfagia afectó a 49.1% de los pacientes; los pacientes con riesgo de desnutrición representaron 25.5%. Los pacientes con disfagia representaron 33.3% y tuvieron mayor riesgo de desnutrición vs 17.9% sin disfagia (p < 0.001). El género femenino (OR 1.23; IC95% 0.42-3.58; p = 0.451), la diabetes mellitus (OR 2.95; IC95% 0.52-16.75; p = 0.196), el antecedente de neumonía (OR 2.12; IC95% 1.59-2.81; p = 0.236) y la enfermedad neurológica crónica (OR 1.65; IC95% 0.49-5.53; p = 0.301) se relacionaron con incremento de disfagia. CONCLUSIONES La prevalencia de disfagia no diagnosticada es elevada y se asocia con mayor desnutrición.

Abstract: BACKGROUND Neurological diseases patients are susceptible to dysphagia, frequently not diagnosed. OBJECTIVE To determine the presence of dysphagia in patients attending for neurological pathology of extern consult and its relation with malnutrition. MATERIAL AND METHOD A prospective, cross-sectional study, performed from January to December 2016, that evaluated dysphagia symptoms, clinically phases of swallowing, and EAT-10 questionnaire validated to Spanish was applied. Risk factors were determined, as well as nutritional risk, Quetelet Index, Global Subjective Assessment, and demographics data. RESULTS Of the 55 patients, 54.5% were women; mean age was of 47.29 years. The prevalence of dysphagia was 49.1%; patients with risk malnutrition represented 25.5%. Dysphagia patients accounted for 33.3% and had a higher risk of malnutrition vs 17.9% without dysphagia (p < 0.001). The risk of dysphagia increased in women (OR 1.23, 95% CI 0.42-3.58, p = 0.45), diabetes mellitus (OR 2.95, 95 % CI 0.52-16.75, p = 0.19), patients with history of pneumonia (OR 2.12, 95% CI 1.59-2.81; p = 0.236) and chronic neurological disease (OR 1.65, 95% CI 0.49-5.53, p = 0.30). CONCLUSIONS There is high prevalence of undiagnosed dysphagia and it's associated with greater risk of malnutrition.

Shock Wave-Induced Damage and Poration in Eukaryotic Cell Membranes.

Shock waves are known to permeabilize eukaryotic cell membranes, which may be a powerful tool for a variety of drug delivery applications. However, the mechanisms involved in shock wave-mediated membrane permeabilization are still poorly understood. In this study, the effects on both the permeability and the ultrastructural features of two human cell lineages were investigated after the application of underwater shock waves in vitro. Scanning Electron Microscopy of cells derived from a human embryo kidney (HEK)-293 and Michigan Cancer Foundation (MCF)-7 cells, an immortalized culture derived from human breast adenocarcinoma, showed a small amount of microvilli (as compared to control cells), the presence of hole-like structures, and a decrease in cell size after shock wave exposure. Interestingly, these effects were accompanied by the permeabilization of acid and macromolecular dyes and gene transfection. Trypan blue exclusion assays indicated that cell membranes were porated during shock wave treatment but resealed after a few seconds. Deformations of the cell membrane lasted for at least 5 min, allowing their observation in fixed cells. For each cell line, different shock wave parameters were needed to achieve cell membrane poration. This difference was correlated to successful gene transfection by shock waves. Our results demonstrate, for the first time, that shock waves induce transient micro- and submicrosized deformations at the cell membrane, leading to cell transfection and cell survival. They also indicate that ultrastructural analyses of cell surfaces may constitute a useful way to match the use of shock waves to different cells and settings.

Schwannoma benigno de vía excretora renal / Benign schwannoma of renal excretory

Los tumores del retroperitoneo pueden ser malignos o benignos y se clasifican según el tejido donde se originan. Entre ellos, los tumores renales son los que cobran cada día mayor representatividad, en especial, el carcinoma renal de células claras, en sus disímiles formas de presentación clínica, incluyendo un numeroso grupo de pacientes asintomáticos. Se presentó el caso de una paciente femenina con dolor lumbo-abdominal izquierdo de carácter gravativo asociado a infecciones urinarias periódicas, de varios meses de evolución. Mediante ultrasonido halló una imagen compleja, predominantemente quística, en el polo superior del riñón izquierdo con elementos sólidos en su interior y finos tabiques, que no descartaba la posibilidad de un carcinoma variedad quística; después de ser sometida al tratamiento quirúrgico, el estudio histológico del tumor se demostró que se trataba de un schwannoma de cavidades renales, tipo benigno. La evolución de la paciente ha sido satisfactoria.

Retroperitoneal tumors can be malignant or benign and they are classified according to the tissue where they are originated. Among them, kidney tumors are those that are becoming increasingly representative, particularly renal clear cell carcinoma, in their different forms of clinical presentation, including a large group of asymptomatic patients. The case of a female patient with left lumbo-abdominal pain is presented, associated with recurrent urinary tract infections, several months of evolution. By ultrasound, one predominantly cystic complex picture was found in the upper pole of the left kidney with solid elements inside and thin walls, which did not rule out the possibility of a variety cystic carcinoma; after being subjected to surgical treatment, tumor histology showed that it was schwannoma of renal cavities, benign type. The evolution of this patient was successful.

Intercellular transfer along the trichomes of the invasive terminal heterocyst forming cyanobacterium Cylindrospermopsis raciborskii CS-505.

Cylindrospermopsis raciborskii CS-505 is an invasive freshwater filamentous cyanobacterium that when grown diazotrophically may develop trichomes of up to 100 vegetative cells while differentiating only two end heterocysts, the sole sites for their N2-fixation process. We examined the diazotrophic growth and intercellular transfer mechanisms in C. raciborskii CS-505. Subjecting cultures to a combined-nitrogen-free medium to elicit N2 fixation, the trichome length remained unaffected while growth rates decreased. The structures and proteins for intercellular communication showed that while a continuous periplasmic space was apparent along the trichomes, the putative septal junction sepJ gene is divided into two open reading frames and lacks several transmembrane domains unlike the situation in Anabaena, differentiating a 5-fold higher frequency of heterocysts. FRAP analyses also showed that the dyes calcein and 5-CFDA were taken up by heterocysts and vegetative cells, and that the transfer from heterocysts and 'terminal' vegetative cells showed considerably higher transfer rates than that from vegetative cells located in the middle of the trichomes. The data suggest that C. raciborskii CS-505 compensates its low-frequency heterocyst phenotype by a highly efficient transfer of the fixed nitrogen towards cells in distal parts of the trichomes (growing rapidly) while cells in central parts suffers (slow growth).