Alteraciones psiquiátricas en pacientes con antecedentes de infección por SARS-CoV-2 / Psychiatric alterations in patients with a history of SARS-CoV-2 infection

Objetivo: Caracterizar los trastornos mentales de los pacientes consultantes del Servicio de Psiquiatría del Hospital Universitario de Caracas enero 2020 ­enero 2021, que acudieron por primera vez y habían presentado infección por COVID-19 3 a 6 meses antes de consultar. Métodos: Se realizó un estudio observacional, descriptivo, retrospectivo, de corte transversal en pacientes que acudieron al Servicio de Psiquiatría del Hospital Universitario de Caracas para emergencia (por primera vez y sucesivas) por presentar patologías mentales durante y posterior a infección por COVID-19 durante el periodo enero 2020-enero 2021. Resultados: De 718 pacientes, 53 que acudieron con patologías mentales habían presentado infección previa por COVID-19 representando el 7,38%. Edad promedio 27-29 años (66,03 %). La mayoría del sexo femenino (71,69 %). El 77,35 % provenían del Distrito Capital; el 18,86 % del estado Miranda, siendo el estado civil predominante la soltería con 73,58 %; el 56,60 % estaban desempleados y el 79,24 % no poseían nivel de instrucción. En relación a los diagnósticos: trastorno depresivo mayor con síntomas ansiosos (30,18 %), trastorno depresivo (18,86 %), episodio maniforme (1,88 %) episodio psicótico agudo (18,86 %), trastorno de ansiedad generalizada (7,54 %), entre otros. Conclusión: Los síntomas psiquiátricos originados por infección por COVID-19 aparecen de forma más tardía y persisten después de la infección. Las mujeres manifestaron mayor riesgo de presentar síntomas relacionados con la salud mental; se asocia a alto nivel de vulnerabilidad a causa de la influencia de los roles sociales, ciclo reproductivo y mayor morbilidad psiquiátrica(AU)

Objective: To characterize the mental disorders of the consulting patients of the Psychiatry Service of the University Hospital of Caracas January 2020 -January 2021, who came for the first time and hapresented COVID-19 infection 3 to 6 monthsbefore consulting. Methods: An observational, descriptive, retrospective, cross-sectional study was carried out in patients who attended the Psychiatry Service of the University Hospital of Caracas for emergencies (for the first time and successive ones) due to presenting mental pathologies during and after COVID-19 during the period January 2020-January 2021. Results: Of 718 patients, 53 who came with mental pathologies had previous COVID-19 infection, representing 7.38%. Average age 27-29 years(66.03%). The majority were female (71.69%). 77.35% came from the Capital District; 18.86% from the state of Miranda, with the predominant marital status being single with 73.58%; 56.60% were unemployed and 79.24% had no educational level. In relation to the diagnoses: major depressive disorder with anxious symptoms (30.18%), depressive disorder (18.86%), maniform episode (1.88%), acute psychotic episode (18.86%), generalized anxiety disorder (7.54%), among others. Conclusion: Psychiatric symptoms caused by COVID-19 infection appear later and persist after infection. Women expressed a greater risk of presenting symptoms related to mental health; It is associated with a high level of vulnerability due to the influence of social roles, reproductive cycle and greater psychiatric morbidit(AU)

Late bedtime combined with more screen time before bed increases the risk of obesity and lowers diet quality in Spanish children.

This cross-sectional study aimed to investigate whether the combination of bedtime and screen time (ST) before bed were associated with obesity and diet quality in toddlers and school-aged children. Parents reported children's bedtimes and ST before bed (0 min, 1-30 min, >30 min). We then defined bed + screen time behavior using bedtime median cut-offs (early [EB] or late [LB]) and ST responses, resulting in four groups: EB-0'ST, EB ≤ 30'ST/LB-0'ST, EB > 30'ST/LB ≤ 30'ST, and LB > 30'ST. For all participants (n = 1133; 5.4 ± 2.7 years, 49.7% girls, 51.9% school-aged) we evaluated body mass index (BMI), diet quality, sleep-related variables, physical activity, and health-related quality of life (HRQoL). Outcome variables were compared across bed + screen time behavior groups, stratified by age group (toddlers and school-aged children) using general linear models for continuous variables, as well as chi-squared tests or logistic regressions for categorical variables. Additionally, we calculated linear p-trends. Analyses were adjusted for sociodemographic variables, BMI, and physical activity (unless the variable was tested). The results showed that toddlers and school-aged children in the LB ≥ 30'ST group were more likely to have overweight/obesity (OR: 3.42 [95%CI:1.41,8.26] and OR: 2.53 [95%CI:1.10,5.03], respectively) than those in the EB-0'ST group. Additionally, toddlers and school-aged children in the EB > 30'ST/LB ≤ 30'ST and LB > 30'ST groups showed significantly lower adherence to the Mediterranean diet compared to the other groups (p < 0.001). Regarding sleep-related outcomes, we observed that the combination of LB and more ST was associated with poorer sleep quality and shorter sleep duration in toddlers and school-aged children (p < 0.001). These findings emphasize the importance of promoting earlier bedtimes and limiting ST before bed as part of obesity prevention strategies for children. Furthermore, such intervention could benefit the quality of children's diet and overall lifestyle.

Menstrual blood-derived mesenchymal stromal cells: impact of preconditioning on the cargo of extracellular vesicles as potential therapeutics.

BACKGROUND: Mesenchymal stromal cells (MSCs) have been shown to exert their therapeutic effects through the secretion of broad spectrum of paracrine factors, including extracellular vesicles (EVs). Accordingly, EVs are being pursued as a promising alternative to cell-based therapies. Menstrual blood-derived stromal cells (MenSCs) are a type of MSC that, due to their immunomodulatory and regenerative properties, have emerged as an innovative source. Additionally, new strategies of cell priming may potentially alter the concentration and cargo of released EVs, leading to modification of their biological properties. In this study, we aimed to characterize the EVs released by MenSCs and compare their therapeutic potential under three different preconditioning conditions (proinflammatory stimuli, physioxia, and acute hypoxia). METHODS: MenSCs were isolated from five healthy women. Following culturing to 80% confluence, MenSCs were exposed to different priming conditions: basal (21% O2), proinflammatory stimuli (IFNγ and TNFα, 21% O2), physioxia (1-2% O2), and acute hypoxia (< 1% O2) for 48-72 h. Conditioned media from MenSCs was collected after 48 h and EVs were isolated by a combination of ultra-filtration and differential centrifugation. An extensive characterization ranging from nano-flow cytometry (nFC) to quantitative high-throughput shotgun proteomics was performed. Bioinformatics analyses were used to derive hypotheses on their biological properties. RESULTS: No differences in the morphology, size, or number of EVs released were detected between priming conditions. The proteome analysis associated with basal MenSC-EVs prominently revealed their immunomodulatory and regenerative capabilities. Furthermore, quantitative proteomic analysis of differentially produced MenSC-EVs provided sufficient evidence for the utility of the differential preconditioning in purpose-tailoring EVs for their therapeutic application: proinflammatory priming enhanced the anti-inflammatory, regenerative and immunomodulatory capacity in the innate response of EVs, physioxia priming also improves tissue regeneration, angiogenesis and their immunomodulatory capacity targeting on the adaptive response, while acute hypoxia priming, increased hemostasis and apoptotic processes regulation in MenSC-EVs, also by stimulating immunomodulation mainly through the adaptive response. CONCLUSIONS: Priming of MenSCs under proinflammatory and hypoxic conditions affected the cargo proteome of EVs released, resulting in different therapeutic potential, and thus warrants experimental exploration with the aim to generate better-defined MSC-derived bioproducts.

Metodología 'SLIDE-4-U' para implicar al alumnado en el desarrollo de la clase presencial / How to involve students in the development of the face-to-face class: the 'SLIDE-4-U' methodology

Introducción: Desde hace unos años, tanto en grupos grandes como pequeños, y principalmente en clases en línea, se hapuesto en práctica la metodología ‘SLIDE-4-U’ o ‘una diapositiva para ti’ (2020PID-UB/023), con el objetivo de implicar alestudiante en su propio proceso de aprendizaje y en el de sus compañeros. Se consiguió mediante la participación delalumnado en la explicación en clase de diapositivas específicamente diseñadas para este fin. Métodos: La experiencia se llevó a cabo en el primer semestre del curso 2021-22 en la asignatura Nutrición Molecular delgrado de Nutrición Humana y Dietética (Universitat de Barcelona). Se preparó una sesión de seminario presencial centrada en inmunonutrición. El profesor dirigió la sesión seleccionando de forma aleatoria al estudiante, que debía explicar ladiapositiva sin preparación previa. Las explicaciones del alumnado fueron complementadas o corregidas por el profesordurante el desarrollo de la actividad. Al final del seminario se realizó una encuesta de opinión en la que se constató labuena aceptación de esta iniciativa (puntuaciones medias superiores a 4,2 sobre 5). Resultados: El alumnado consideró que era un reto explicar una diapositiva sin prepararla previamente y que este hecho,asociado a no saber quién haría la explicación, había provocado un cierto clima de nerviosismo. Ahora bien, la mayoríaestaba de acuerdo en que los esquemas/imágenes aportados fueron suficientes para poder desarrollar la actividad y quelas explicaciones hechas por los compañeros eran suficientemente correctas. Asimismo, también valoraban positivamente la participación del profesor a la hora de completar las explicaciones de sus compañeros. En general, la metodologíautilizada hizo que el alumnado fuera más consciente de que las diapositivas tienen una estructura y un objetivo, y de ladificultad de comunicar correctamente...(AU)

Introduction: Lately, both in large and small groups and mainly in online classes, the 'SLIDE-4-U' or 'one slide for you' methodology (2020PID-UB/023) has been put into practice, with the aim of involving the student in their own learning process and that of their classmates. It is achieved through the participation of the students in the explanation of slides in class, specially designed for this purpose. Methods: The experience was carried out in the first semester of the 2021-22 academic year in the subject Molecular Nutrition of the Human Nutrition and Dietetics degree (Universitat de Barcelona). A face-to-face seminar session focused on immunonutrition was prepared with this type of material. The teacher led the session by randomly selecting the student, who had to explain the slide without prior preparation. The explanations of the students were complemented and/or corrected by the teacher, during the development of the activity. At the end of the seminar, an opinion survey was carried out in which the good acceptance of this initiative was verified (average scores higher than 4.2 out of 5). Results: The students considered that it was a challenge to explain a slide without previously preparing it, and that this fact, associated with not knowing who would do the explanation, had caused a certain climate of nervousness. However, the majority agreed that the diagrams/images provided were sufficient to be able to carry out the activity and that the explanations made by the classmates were correct enough. Likewise, they also positively valued the teacher's participation when completing the explanations of their classmates. In general, the methodology used made the students more aware that the slides have a structure and an objective, and of the difficulty of communicating correctly...(AU)

Effects of Fructose and Palmitic Acid on Gene Expression in Drosophila melanogaster Larvae: Implications for Neurodegenerative Diseases.

One of the largest health problems worldwide is the development of chronic noncommunicable diseases due to the consumption of hypercaloric diets. Among the most common alterations are cardiovascular diseases, and a high correlation between overnutrition and neurodegenerative diseases has also been found. The urgency in the study of specific damage to tissues such as the brain and intestine led us to use Drosophila melanogaster to study the metabolic effects caused by the consumption of fructose and palmitic acid in specific tissues. Thus, third instar larvae (96 ± 4 h) of the wild Canton-S strain of D. melanogaster were used to perform transcriptomic profiling in brain and midgut tissues to test for the potential metabolic effects of a diet supplemented with fructose and palmitic acid. Our data infer that this diet can alter the biosynthesis of proteins at the mRNA level that participate in the synthesis of amino acids, as well as fundamental enzymes for the dopaminergic and GABAergic systems in the midgut and brain. These also demonstrated alterations in the tissues of flies that may help explain the development of various reported human diseases associated with the consumption of fructose and palmitic acid in humans. These studies will not only help to better understand the mechanisms by which the consumption of these alimentary products is related to the development of neuronal diseases but may also contribute to the prevention of these conditions.

Zearalenone Does Not Show Genotoxic Effects in the Drosophila melanogaster Wing Spot Test, but It Induces Oxidative Imbalance, Development, and Fecundity Alterations.

Zearalenone (ZEN) is a non-steroidal mycoestrogen produced by the Fusarium genus. ZEN and its metabolites compete with 17-beta estradiol for cytosolic estrogen receptors, causing reproductive alterations in vertebrates. ZEN has also been associated with toxic and genotoxic effects, as well as an increased risk for endometrial adenocarcinomas or hyperplasia, breast cancer, and oxidative damage, although the underlying mechanisms remain unclear. Previous studies have monitored cellular processes through levels of transcripts associated with Phase I Xenobiotic Metabolism (Cyp6g1 and Cyp6a2), oxidative stress (hsp60 and hsp70), apoptosis (hid, grim, and reaper), and DNA damage genes (Dmp53). In this study, we evaluated the survival and genotoxicity of ZEN, as well as its effects on emergence rate and fecundity in Drosophila melanogaster. Additionally, we determined levels of reactive oxygen species (ROS) using the D. melanogaster flare and Oregon R(R)-flare strains, which differ in levels of Cyp450 gene expression. Our results showed that ZEN toxicity did not increase mortality by more than 30%. We tested three ZEN concentrations (100, 200, and 400 µM) and found that none of the concentrations were genotoxic but were cytotoxic. Taking into account that it has previously been demonstrated that ZEN administration increased hsp60 expression levels and apoptosis gene transcripts in both strains, the data agree with an increase in ROS and development and fecundity alterations. Since Drosophila lacks homologous genes for mammalian estrogen receptors alpha and beta, the effects of this mycotoxin can be explained by a mechanism different from estrogenic activity.

Are Emotional Eating and Other Eating Behaviors the Missing Link in the Relationship between Inadequate Sleep and Obesity? A Systematic Review.

Evidence is emerging to explain that the relationship between inadequate sleep and obesity could be influenced by emotional eating and other eating behaviors such as disinhibition. Therefore, our aim was to conduct a systematic review to analyze the potential role of emotional eating and other eating behaviors in the relationship between inadequate sleep and obesity. We conducted a comprehensive search on 2 databases (Medline and Scopus) looking for records from 1 January 2011 until 31 December 2022 without language restrictions. Cross-sectional, longitudinal, and interventional studies were included if they assessed the association between sleep and emotional eating, as well as the role of emotional eating on the relationship between inadequate sleep and obesity. Secondary outcomes included studies analyzing the link between sleep and other eating behaviors as well as their role in the sleep-obesity relationship. Our results showed that emotional eating and disinhibition play a significant role in the relationship between inadequate sleep and obesity, especially in women. Furthermore, we provide evidence of other eating behaviors (e.g., external eating, eating competence, and hunger), which are also associated with poor sleep outcomes. However, these behaviors do not seem to be determinants of the association between sleep and obesity. In conclusion, our results suggest that individuals with inadequate sleep who are prone to emotional eating and/or disinhibition may require tailored approaches for obesity prevention and treatment.

Alarming incidence of reinfections after treatment for Chlamydia trachomatis and gonorrhoea: Can we predict and prevent them? / Alarmante incidencia de reinfecciones tras el tratamiento de Chlamydia trachomatis y gonorrea: ¿podemos predecirlas y prevenirlas?

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. Methods: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. Results: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9–19.7) and 24.65% (CI95%: 21.9–27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3–2.6), men who have sex with men (OR=1.8; CI95%: 1.3–2.6), number of sexual partners (OR=4.3; CI95%: 2.7–6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08–2.6), not always using a condom (OR=1.4; CI95%: 1.02–1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5–9.5) were associated with reinfection by any STI. Conclusion: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.(AU)

Introducción: Las infecciones por Chlamydia trachomatis (CT) y Neisseria gonorrhoeae (NG) son un problema de salud pública, agravado por frecuentes reinfecciones, cuya incidencia desconocemos en España. Objetivos: Estimar en pacientes diagnosticados de NG, CT o infección mixta (NG y CT): 1) la incidencia de reinfecciones por el mismo germen, 2) la incidencia total de infecciones de transmisión sexual (ITS), tanto por el mismo germen, como por infecciones diferentes a la inicial y 3) identificar características que predicen la reinfección. Métodos: Estudio observacional prospectivo de una serie de casos: 986 pacientes diagnosticados de CT y/o NG en las consultas de ITS de Bizkaia (España) entre septiembre de 2016 a enero de 2019. Resultados: En 6 meses de seguimiento promedio la incidencia de reinfección por el mismo germen fue del 17,24% (IC95%: 14,9-19,7) y la de cualquier ITS (reinfección u otra) del 24,65% (IC95%: 21,9-27,4). Los factores asociados con la reinfección por cualquier ITS fueron: ser inmigrante (OR=1,8; IC95%: 1,3-2,6), hombre que tiene sexo con hombres (OR=1,8; IC95%: 1,3-2,6), número de parejas sexuales (OR=4,3; IC95%: 2,7-6,8 para más de 5 parejas), tener una pareja nueva (OR=1,7; IC95%: 1,08-2,6), no utilizar siempre preservativo (OR=1,4; IC95%: 1,02-1,9) y consumo de alcohol en relación al sexo (OR=3,8; IC95%: 1,5-9,5). Conclusión. Estas características sirven para identificar pacientes de alto riesgo en los que priorizar el rescreening de ITS tras una infección, que debe ser completo, incluyendo otras infecciones diferentes a la inicial.(AU)

Relative Validity and Reliability of the Remind App as an Image-Based Method to Assess Dietary Intake and Meal Timing in Young Adults.

Image-based dietary records have been validated as tools to evaluate dietary intake. However, to determine meal timing, previous studies have relied primarily on image-based smartphone applications without validation. Noteworthy, the validation process is necessary to determine how accurately a test method measures meal timing compared with a reference method over the same time period. Thus, we aimed to assess the relative validity and reliability of the Remind® app as an image-based method to assess dietary intake and meal timing. For this purpose, 71 young adults (aged 20-33 years, 81.7% women) were recruited for a 3-day cross-sectional study, where they completed a 3-day image-based record using the Remind app (test method) and a 3-day handwritten food record (reference method). The relative validity of the test method versus the reference method was assessed using multiple tests including Bland-Altman, % difference, paired t-test/Wilcoxon signed-rank test, Pearson/Spearman correlation coefficients, and cross-classification. We also evaluated the reliability of the test method using an intra-class correlation (ICC) coefficient. The results showed that, compared to the reference method, the relative validity of the test method was good for assessing energy and macronutrient intake, as well as meal timing. Meanwhile, the relative validity of the test method to assess micronutrient intake was poor (p < 0.05) for some micronutrients (iron, phosphorus, potassium, zinc, vitamins B1, B2, B3, B6, C, and E, and folates) and some food groups (cereals and grains, legumes, tubers, oils, and fats). Regarding the reliability of an image-based method to assess dietary intake and meal timing, results ranged from moderate to excellent (ICC 95% confidence interval [95% CI]: 0.50-1.00) for all nutrients, food groups (except oils and fats, which had low to moderate reliability), and meal timings. Thus, the results obtained in this study provide evidence of the relative validity and reliability of image-based methods to assess dietary intake (energy, macronutrients, and most food groups) and meal timing. These results open up a new framework for chrononutrition, as these methods improve the quality of the data collected and also reduce the burden on users to accurately estimate portion size and the timing of meals.

Menstrual blood-derived stromal cells: insights into their secretome in acute hypoxia conditions.

BACKGROUND: Despite constant advances in regenerative medicine, the closure of chronic wounds is still challenging. Therapeutic approaches using locally administered MSCs have been considered a promising option. However, the viability of these cells is seriously threatened by acute hypoxic stress linked to wound healing. In this work, we aimed to study the tolerance of Menstrual blood-derived stromal cells (MenSCs) to acute hypoxia and their therapeutic paracrine effect. METHODS: Isolated MenSCs were phenotypically characterized and evaluated in terms of proliferation, viability, and gene expression, under acute hypoxia (AH) compared with conventional cultured condition or normoxia (N). A step further, the secretome of MenSCs under acute hypoxia was analyzed with respect to their miRNAs content and by in vitro functional assays. For the analysis of differences between the two groups, Student's t-test was performed and one-way ANOVA and Tukey's multiple comparisons test for multiple groups were used. RESULTS: Our results revealed that the viability of MenSCs was not affected under acute hypoxia, although proliferation rate slowed down. Gene analysis revealed 5 up-regulated (BNIP3, ANGPTL4, IL6, IL1B, and PDK1) and 4 down-regulated genes (IDO1, HMOX1, ANGPTL2, and HGF) in AH compared to N. Global gene expression analysis revealed a decrease in the gene ontology functions of migration and wound response with respect to the normoxic condition. In contrast, functions such as angiogenesis were enriched under the AH condition. Regarding the secretome analysis, two miRNAs involved in angiogenic processes (hsa-miR-148a-3p and hsa-miR-378a-3p), were significantly up-expressed when compared to the normoxic condition, being MYC gene, the unique target of both. Functional assays on HUVECs revealed a potential pro-angiogenic capacity of MenSCs cultured in both oxygen conditions (N and AH) based on the wound closure and tube formation results of their released paracrine factors. However, when compared to normoxia, the paracrine factors of MenSCs under acute hypoxia slightly reduced the proliferation, migration, and in vitro wound closure of HUVECs. CONCLUSIONS: MenSC exhibited a good survival capacity under acute hypoxic conditions as well as beneficial properties applicable in the field of tissue regeneration through their secretome, which makes them a potential cell source for wound healing interventions.

Protocol-driven therapy for lower extremity ulcers: a case series supporting the use of porcine intestine extracellular matrix.

INTRODUCTION: Chronic ulcers pose a public health challenge. Thus, it is imperative to be aware of and assess new management strategies that contribute to patient quality of life and optimize health resources. This study evaluated the efficacy of a new protocol for chronic wound management that includes porcine intestine ECM. MATERIALS AND METHODS: Twenty-one patients with chronic wounds of different etiologies were included in this study. A new healing protocol that incorporates the use of porcine ECM was initiated for a maximum period of 12 weeks. Follow-up included a weekly visit to photograph the ulcers and record their size. RESULTS: Wounds ranged in size from 0.5 cm2 to 10 cm2 at the outset of the study. Two of the 21 patients who started the protocol withdrew, 1 for nonadherence to the protocol and 1 for health complications unrelated to the study. Most lesions occurred in the lower limbs. All patients who completed the treatment protocol achieved wound regeneration and total wound closure within an average of 4.5 weeks. The average percentage closure rate was 100% at 8 weeks, with no AEs. CONCLUSIONS: The findings of this study demonstrate the efficacy of an evidence-based wound management protocol in achieving safe, complete tissue regeneration in a short period of time.

Transcriptome Profile Reveals Differences between Remote and Ischemic Myocardium after Acute Myocardial Infarction in a Swine Model.

Acute myocardial infarction (AMI) is the consequence of an acute interruption of myocardial blood flow delimiting an area with ischemic necrosis. The loss of cardiomyocytes initiates cardiac remodeling in the myocardium, leading to molecular changes in an attempt to recover myocardial function. The purpose of this study was to unravel the differences in the molecular profile between ischemic and remote myocardium after AMI in an experimental model. To mimic human myocardial infarction, healthy pigs were subjected to occlusion of the mid-left anterior descending coronary artery, and myocardial tissue was collected from ischemic and remote zones for omics techniques. Comparative transcriptome analysis of both areas was accurately validated by proteomic analysis, resulting in mitochondrion-related biological processes being the most impaired mechanisms in the infarcted area. Moreover, Immune system process-related genes were up-regulated in the remote tissue, mainly due to the increase of neutrophil migration in this area. These results provide valuable information regarding differentially expressed genes and their biological functions between ischemic and remote myocardium after AMI, which could be useful for establishing therapeutic targets for the development of new treatments.

Alarming incidence of reinfections after treatment for Chlamydia trachomatis and gonorrhoea: Can we predict and prevent them?

BACKGROUND: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. METHODS: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. RESULTS: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9-19.7) and 24.65% (CI95%: 21.9-27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3-2.6), men who have sex with men (OR=1.8; CI95%: 1.3-2.6), number of sexual partners (OR=4.3; CI95%: 2.7-6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08-2.6), not always using a condom (OR=1.4; CI95%: 1.02-1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5-9.5) were associated with reinfection by any STI. CONCLUSION: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.

Comparison of shear bond strength of metallic brackets bonded to ceramic surfaces utilizing different adhesive systems: An in vitro study.

OBJECTIVE: To compare the shear bond strength (SBS) of orthodontic brackets bonded to three different types of ceramic surfaces (feldspathic, lithium disilicate, and zirconium) using Assure® Plus All and Transbond™ XT adhesives. MATERIALS AND METHODS: The sample comprised 72 monolithic computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic samples that were randomly divided into six groups of 12 specimens each. Three groups (G1, feldspathic ceramic; G3, lithium disilicate ceramic; G5, zirconium surfaces) were bonded to metal brackets using Assure® Plus All adhesive, whereas the remaining three groups (G2, G4, G6; with the ceramic type in the same order as that in the previous groups) were bonded to metal brackets using Transbond™ XT. The samples were then subjected to 10,000 thermocycles. The SBS was calculated using the shear tests. The site of bonding failure was classified using the adhesive remnant index (ARI) score. One-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used for statistical analyses at a 5% significance level. RESULTS: Statistically significant differences were observed in the mean SBS values of the groups (P < 0.001). The mean SBS for G6 (zirconium plus Transbond™ XT) (2.52 MPa) was significantly lower than that for all other groups. Furthermore, statistically significant differences were found in the ARI score distribution among the groups (P < 0.001). Differences were identified between G6 and G3 (lithium disilicate Plus All Assure® Plus All) and G5 (zirconium plus Assure® Plus All). CONCLUSIONS: The mean bonding strength of brackets with Assure® Plus All was higher than that with Transbond™ XT for all three types of ceramics. However, all groups, except the zirconium plus Transbond™ XT group, showed acceptable bonding strength for orthodontic purposes. The application of hydrofluoric acid followed by silane and finally the Assure® Plus All adhesive system is adequate for bonding brackets to any of the ceramic tested surfaces.

Sleep dimensions are associated with obesity, poor diet quality and eating behaviors in school-aged children.

Objectives: The aim of this cross-sectional study was to investigate the association between sleep dimensions (duration, patterns, and disturbances) with body mass index (BMI), diet quality, and eating behaviors in school-aged children. Additionally, we aimed to investigate whether obesogenic eating behaviors (higher food responsiveness, lower satiety responsiveness, and less slowness in eating) and poor diet quality could mediate the potential association between sleep and obesity in school-aged children. Materials and methods: For all participants (n = 588 children, age 5-12 years; 51% girls) we evaluated: sleep dimensions, BMI, diet quality, eating behaviors (food responsiveness, satiety responsiveness and slowness in eating). Linear regression models were used to test associations between exposure and outcome variables. Additionally, path analysis was conducted to test whether eating behaviors mediated the relationship between sleep and obesity. Results: Shorter sleep duration (ß = -0.722, p = 0.009) and greater sleep disturbances (ß = 0.031, p = 0.012) were significantly associated with BMI. Additionally, we observed that diet quality was significantly associated with sleep duration (ß = 0.430, p = 0.004), the midpoint of sleep (ß = -0.927, p < 0.001), and sleep disturbances (ß = -0.029, p < 0.001). Among other findings, greater sleep disturbances were associated with food responsiveness (ß = 0.017, p < 0.001), satiety responsiveness (ß = 0.015, p < 0.001), and slowness in eating (ß = 0.012, p < 0.001). Importantly, food responsiveness was found as significant mediator of the relationship between sleep and BMI (R = 0.427, R 2 = 0.182, p < 0.001). Conclusions: Late sleep patterns, short sleep duration, and greater sleep disturbances are significantly related with what and how school-aged children eat. Importantly, poor diet quality was significantly related to all three sleep dimensions, while eating behaviors had a significant relationship with greater sleep disturbances. These findings may be relevant to the development of behavioral targets to prevent childhood obesity, including sleep hygiene guidelines as a strategy to improve children's eating habits, as well as their BMI.

Características clínicas y epidemiológicas de la infección por Chlamydia trachomatis en pacientes de consultas de infecciones de transmisión sexual / Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients

Introducción: Las infecciones por Chlamydia trachomatis (CT) son un problema de salud pública por su alta incidencia y consecuencias sobre la salud reproductiva. Nuestro objetivo es describir las características sociodemográficas, conductuales y clínicas de los pacientes con infección por CT para adaptar las intervenciones preventivas a los grupos con mayor riesgo. Métodos: Serie de casos prospectiva de todos los pacientes diagnosticados de CT entre septiembre del 2016 a enero del 2019 en las consultas de referencia para infecciones de transmisión sexual (ITS) de Osakidetza en Bizkaia.Resultados: Aceptaron participar 847 pacientes (88,2%): 41% mujeres, 33,8% varones heterosexuales y 25% hombres que tenían sexo con hombres (HSH); 33% eran inmigrantes y 26% menores de 25 años (33% entre las mujeres). Un 20% utilizaba siempre preservativo. Un 36% había tenido ITS anteriormente y 28% tenía otra ITS simultánea. El 55% de las infecciones fueron asintomáticas (70% entre las mujeres). El recto fue la localización más frecuente entre los HSH (69,5%), seguida de la uretra (31,4%) y la faringe (14,5%). En las mujeres, la infección afectó principalmente el cérvix (86,5% de los casos), seguido del recto (17,6%) y la faringe (13,8%). Se estudió a los contactos del 58% de los pacientes. La tasa de reinfección a las cuatro semanas fue del 17% entre aquellos con criterios para realizar un test de cura.Conclusión: Estos resultados justifican la implantación de cribados oportunistas en mujeres menores de 25 años e inmigrantes jóvenes de ambos sexos, con toma de muestras genitales y extra-genitales, y el establecimiento de guías apropiadas para la notificación de contactos.(AU)

Background: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. Methods: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain). Results: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. Conclusion: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.(AU)

Adherence to Healthy Lifestyle Habits Is a Determinant of the Effectiveness of Weight Loss among Patients Undergoing Endoscopic Bariatric Therapies.

Endoscopic bariatric therapies (EBTs) are promising strategies for the treatment of obesity. However, there is still great variability in its effectiveness in weight loss. Thus, we investigated whether adherence to healthy lifestyle habits is a significant determinant of weight loss effectiveness among patients undergoing EBTs. Additionally, the role of eating behaviors and psychological traits in the effectiveness of weight loss was studied. A cohort of 361 participants (81.4% women; age 41.8 ± 9.5 years; BMI 37.8 ± 4.3 kg/m2) was followed for 1 year after EBT. Anthropometric parameters, adherence to healthy lifestyle habits, emotional eating, and psychological traits (anxiety and depression) were evaluated. General linear models were used to compare outcome variables according to weight loss effectiveness groups (poor vs. good weight-loss-responders). Additionally, a hierarchical linear regression model was used to determine whether adherence to healthy lifestyle habits, emotional eating, or psychological traits were significant predictors of excess weight loss (%EWL). One year after EBT, weight loss differed significantly between good and poor weight-loss-responders (67.5% EWL [95% CI: 64.2, 70.8] vs. 28.2% EWL [95% CI: 25.5, 30.9], p < 0.001). Participants who adhered to good lifestyle habits had 4.37 more odds [95% CI: 2.19, 8.88] of being good weight-loss-responders. We also observed that eating four to five meals/day and practicing muscle-strengthening activities >2 times/week were the two lifestyle habits that most significantly determined weight loss response. Furthermore, our results revealed that while adherence to healthy lifestyle habits was a significant determinant of %EWL 3, 6, and 12 months after EBT (p < 0.001), emotional eating was a significant determinant of %EWL only 3 and 6 months after the intervention (p < 0.01 and p < 0.05, respectively). Regarding psychological traits, we observed that neither anxiety nor depression were significant determinants of %EWL. Our results revealed that adherence to healthy lifestyle habits is a significant determinant for weight loss effectiveness among patients with obesity undergoing EBT. These findings highlight the importance of implementing an adequate nutritional intervention program, especially since patients who adhere to good lifestyle habits are able to achieve a weight loss that would be comparable with bariatric surgery.

Intrapericardial Administration of Secretomes from Menstrual Blood-Derived Mesenchymal Stromal Cells: Effects on Immune-Related Genes in a Porcine Model of Myocardial Infarction.

Acute myocardial infarction (AMI) is a manifestation of ischemic heart disease where the immune system plays an important role in the re-establishment of homeostasis. We hypothesize that the anti-inflammatory activity of secretomes from menstrual blood-derived mesenchymal stromal cells (S-MenSCs) and IFNγ/TNFα-primed MenSCs (S-MenSCs*) may be considered a therapeutic option for the treatment of AMI. To assess this hypothesis, we have evaluated the effect of S-MenSCs and S-MenSCs* on cardiac function parameters and the involvement of immune-related genes using a porcine model of AMI. Twelve pigs were randomly divided into three biogroups: AMI/Placebo, AMI/S-MenSCs, and AMI/S-MenSCs*. AMI models were generated using a closed chest coronary occlusion-reperfusion procedure and, after 72 h, the different treatments were intrapericardially administered. Cardiac function parameters were monitored by magnetic resonance imaging before and 7 days post-therapy. Transcriptomic analyses in the infarcted tissue identified 571 transcripts associated with the Gene Ontology term Immune response, of which 57 were differentially expressed when different biogroups were compared. Moreover, a prediction of the interactions between differentially expressed genes (DEGs) and miRNAs from secretomes revealed that some DEGs in the infarction area, such as STAT3, IGFR1, or BCL6 could be targeted by previously identified miRNAs in secretomes from MenSCs. In conclusion, the intrapericardial administration of secretome early after infarction has a significant impact on the expression of immune-related genes in the infarcted myocardium. This confirms the immunomodulatory potential of intrapericardially delivered secretomes and opens new therapeutic perspectives in myocardial infarction treatment.

Age-Dependent Effects of Chronic Stress on Zebrafish Behavior and Regeneration.

Stress can have a significant impact on many aspects of an organism's physiology and behavior. However, the relationship between stress and regeneration, and how this relationship changes with age remains poorly understood. Here, we subjected young and old zebrafish to a chronic stress protocol and evaluated the impact of stress exposure on multiple measures of zebrafish behavior, specifically thigmotaxis (open field test) and scototaxis (light/dark preference test), and on regeneration ability after partial tail amputation. We found evidence that young and older adult fish are differentially impacted by stress. Only young fish showed a significant change in anxiety-like behaviors after being exposed to chronic stress, while their regeneration ability was not affected by the stress protocol. On the other hand, older fish regenerated their caudal fin significantly slower compared to young fish, but their behavior remained unaffected after being exposed to stress. We further investigated the expression of two candidate genes (nlgn1 and sam2) expressed in the central nervous system, and known to be associated with stress and anxiety-like behavior. The expression of stress-related gene candidate sam2 increased in the brain of older individuals exposed to stress. Our results suggest there is a close relationship between chronic stress, regeneration, and behavior in zebrafish (Danio rerio), and that the impact of stress is age-dependent.