Secuencia anemia-policitemia en la gestación monocorial. Manejo prenatal y resultados perinatales / Twin anaemia polycythemia polycythemia sequence in monochorionic gestation. Prenatal management and perinatal outcomes

Introducción: El objetivo de este trabajo consiste en describir y analizar los resultados perinatales de una serie de casos de anemia-policitemia (TAPS) seguidos y tratados en un centro de referencia en Medicina Fetal, en términos del tipo TAPS y la conducta prenatal aplicada. Métodos: Análisis estadístico descriptivo e inferencial con el programa IBM SPSS Statistics. Resultados: Se diagnosticaron 13 casos de TAPS en un total de 510 gestaciones monocoriales. La mayoría de TAPS espontáneos se diagnosticaron en estadios precoces (5 casos), mientras que, en TAPS posláser, 3/6 casos se diagnosticaron en estadios avanzados. Cuatro fetos (4/26; 15,4%) presentaron alteraciones en la neurosonografía, 3 (3/14; 21,4%) en TAPS espontáneos y uno (1/12, 8,3%) en TAPS posláser (p = 0,308). Se detectó hipertrofia miocárdica en 7 fetos, 5 (71,4%) de los cuales correspondían a TAPS en estadios avanzados. Cuatro eran TAPS espontáneos (4/14; 28,6%) y 3 TAPS posláser (3/12; 25%) (p = 0,797). Ocho casos (8/13; 62,5%) precisaron algún procedimiento de terapia fetal. Se produjeron 3 muertes fetales anteparto y una pareja decidió interrupción legal del embarazo (19,23%). Las 5 pérdidas se produjeron en estadio IV (p=0,008).La supervivencia global fue del 80,8% (21/26 recién nacidos vivos). No hubo diferencias significativas en función del tipo TAPS (p = 0,159) y la conducta prenatal adoptada (p = 0,746). Conclusiones: El TAPS espontáneo es, por tanto, una entidad clínica con un impacto en los resultados perinatales similar al posláser. Parece que la conducta expectante y el láser consiguen mayor edad gestacional al nacimiento.(AU)

Introduction: The aim of this paper is to describe and analyze the perinatal outcomes of a series of TAPS cases followed and treated in a Fetal Medicine referral center, in terms of the type of TAPS and the prenatal behavior applied. Methods: Descriptive and inferential statistical analysis with IBM SPSS Statistics software. Results: Thirteen cases of TAPS were diagnosed in a total of 510 monocorial gestations. Most of the spontaneous TAPS were diagnosed at early stages (5 cases), whereas, in post-laser TAPS, 3/6 cases were diagnosed at advanced stages. Four fetuses (4/26; 15.4%) presented alterations in neurosonography, 3 (3/14; 21.4%) in spontaneous TAPS and one (1/12, 8.3%) in post-laser TAPS (P=0.308). Myocardial hypertrophy was detected in 7 fetuses, 5 (71.4%) of which corresponded to advanced stage TAPS. Four were spontaneous TAPS (4/14; 28.6%) and 3 were post-laser TAPS (3/12; 25%) (P=0.797). Eight cases (8/13; 62.5%) required some fetal therapy procedure. There were 3 antepartum fetal deaths and one couple decided to legally terminate the pregnancy (19.23%). All 5 losses were stage IV (P=0.008). Overall survival was 80.8% (21/26 live newborns). There were no significant differences according to the type of TAPS (P= 0.159) and the prenatal behavior adopted (P=0.746).Conclusions: Spontaneous TAPS is therefore a clinical entity with an impact on perinatal outcomes similar to post-laser. It seems that expectant management and laser achieve higher gestational age at birth.(AU)

Progress and challenges in valorisation of biomass waste from ornamental trees pruning through pyrolysis processes. Prospects in the bioenergy sector.

Nowadays, the scarcity of energy resources is promoting the search for alternative energy sources, boosting interest in the use of forest lignocellulosic residue in the energy sector. In this study, the focus is on the energy recovery from two lignocellulosic residues originated during the pruning of ornamental trees (Horse Chestnut, CI, and False Acacia, FA). Both conventional and flash pyrolysis techniques were applied. The experimental pyrolysis variables were obtained from the study of the thermal behaviour of the pruning residues in thermogravimetric analysis. It was carried out under 5 heating rates and kinetic parameters were estimated using Flynn-Wall-Ozawa method. Results denoted higher maximum mass loss rate values for the same release temperature regions under FA experiments. Also, FA samples had lower final residues for the processes. However, activation energy values were so close for both species. FA was also linked to the faster reactions according frequency factor outcomes. Conventional pyrolysis of pruning residues was carried out in a horizontal oven of original design at a heating rate of 25 °C/min, at 750 °C and 60 min of permanence at that temperature; flash pyrolysis was tested in that oven at 750 and 850 °C. In these pyrolysis processes, three fractions were obtained: bio-char, bio-oil and gas. The physicochemical attributes of the bio-chars suggested their potential utility as biofuels (28.4-29.8 MJ/kg), adsorbent precursors or soil additives. Conventional pyrolysis bio-oils had a dominant monoaromatic hydrocarbons nature, with phenols being the most abundant (≥60%), while flash bio-oils contain mainly polycyclic aromatic hydrocarbons. Conventional pyrolysis gases contained up to 60 vol% of CO2; flash pyrolysis gases had high combustible gas content (CO, CH4, H2) and a low CO2 content (<25 vol%). As a result, their calorific value (18.06 MJ/kg) exhibited a threefold increase compared to the gas produced through conventional pyrolysis (6.04 MJ/kg).

Linfoma difuso de célulasB grandes primario de cérvix. A propósito de un caso / Primary diffuse large Bcell lymphoma of the cervix: Clinical case

Introducción: La afectación primaria del tracto genital femenino por linfoma no Hodgkin es muy poco frecuente, por lo que no existe un consenso sobre el tratamiento, y por ello presentamos este caso clínico y el tratamiento realizado, así como el pronóstico de nuestra paciente. Hallazgos clínicos: La paciente presentada es una mujer de 72años que consulta por hemorragia vaginal. Diagnóstico Se diagnostica de linfoma no Hodgkin extranodal primario de cérvix de inmunofenotipoB de alto grado citológico y elevado índice proliferativo. Intervenciones terapéuticas y resultados: El tratamiento de elección fue únicamente quimioterápico. Esta paciente ha presentado una supervivencia libre de enfermedad de 5años. Actualmente se encuentra en seguimiento mediante la realización de controles analíticos anuales. Conclusión: Los síntomas de este tipo de tumor son altamente inespecíficos y la citología es frecuentemente negativa, por lo que es necesario recurrir a la biopsia. La inmunohistoquímica resulta fundamental tanto para el diagnóstico como para el pronóstico. Existen múltiples técnicas de imagen empleadas tanto para estudio de extensión como para seguimiento, destacando el papel del FDG-PET. Actualmente parece que el tratamiento más recomendable es la pauta quimioterápica R-CHOP seguida de radioterapia. El pronóstico en general es bueno, con hasta un 80% de supervivencia a los 5años.(AU)

Introduction: Primary involvement of the female genital tract by non-Hodgkin lymphoma is very rare, so there is no consensus on treatment, and for this reason we present this clinical case and the treatment performed, as well as the prognosis of our patient. Clinical findings: The patient presented is a 72-year-old woman who consulted for vaginal bleeding. Diagnosis: Primary extranodal non-Hodgkin lymphoma of the cervix with immunophenotypeB of high cytological grade and high proliferative index was diagnosed. Therapeutic interventions and results: The treatment of choice was chemotherapy only. This patient has presented a disease-free survival of 5years. It is currently being monitored by carrying out annual analytical controls. Conclusion: The symptoms of this type of tumor are highly non-specific, as well as cytology is frequently negative, which is why it is necessary to resort to biopsy. Immunohistochemistry is essential for both diagnosis and prognosis. There are multiple imaging techniques used for both extension study and follow-up, highlighting the role of FDG-PET. It currently seems that the most recommendable treatment is the R-CHOP chemotherapy regimen followed by radiotherapy.The prognosis is generally good, with up to 80% survival at 5years.(AU)

Role of the placenta in developmental programming: Observations from models using large animals.

Developmental programming, which proposes that "insults" or "stressors" during intrauterine or postnatal development can have not only immediate but also long-term consequences for healthy and productivity, has emerged as a major biological principle, and based on studies in many animal species also seems to be a universal phenomenon. In eutherians, the placenta appears to be programmed during its development, which has consequences for fetal growth and development throughout pregnancy, and likewise has long-term consequences for postnatal development, leading to programming of organ function of the offspring even into adulthood. This review summarizes our current understanding of the placenta's role in developmental programming, the mechanisms involved, and the challenges remaining.

Clinical validation of an automatic classification algorithm applied on cleavage stage embryos: analysis for blastulation, euploidy, implantation, and live-birth potential.

STUDY QUESTION: Is a commercially available embryo assessment algorithm for early embryo evaluation based on the automatic annotation of morphokinetic timings a useful tool for embryo selection in IVF cycles? SUMMARY ANSWER: The classification provided by the algorithm was shown to be significantly predictive, especially when combined with conventional morphological evaluation, for development to blastocyst, implantation, and live birth, but not for euploidy. WHAT IS KNOWN ALREADY: The gold standard for embryo selection is still morphological evaluation conducted by embryologists. Since the introduction of time-lapse technology to embryo culture, many algorithms for embryo selection have been developed based on embryo morphokinetics, providing complementary information to morphological evaluation. However, manual annotations of developmental events and application of algorithms can be time-consuming and subjective processes. The introduction of automation to morphokinetic annotations is a promising approach that can potentially reduce subjectivity in the embryo selection process and improve the workflow in IVF laboratories. STUDY DESIGN, SIZE, DURATION: This observational, retrospective cohort study was performed in a single IVF clinic between 2018 and 2021 and included 3736 embryos from oocyte donation cycles (423 cycles) and 1291 embryos from autologous cycles with preimplantation genetic testing for aneuploidies (PGT-A, 185 cycles). Embryos were classified on Day 3 with a score from 1 (best) to 5 (worst) by the automatic embryo assessment algorithm. The performance of the embryo classification model for blastocyst development, implantation, live birth, and euploidy prediction was assessed. PARTICIPANTS/MATERIALS, SETTING, METHODS: All embryos were monitored by a time-lapse system with an automatic cell-tracking and embryo assessment software during culture. The embryo assessment algorithm was applied on Day 3, resulting in embryo classification from 1 to 5 (from highest to lowest developmental potential) depending on four parameters: P2 (t3-t2), P3 (t4-t3), oocyte age, and number of cells. There were 959 embryos selected for transfer on Day 5 or 6 based on conventional morphological evaluation. The blastocyst development, implantation, live birth, and euploidy rates (for embryos subjected to PGT-A) were compared between the different scores. The correlation of the algorithm scoring with the occurrence of those outcomes was quantified by generalized estimating equations (GEEs). Finally, the performance of the GEE model using the embryo assessment algorithm as the predictor was compared to that using conventional morphological evaluation, as well as to a model using a combination of both classification systems. MAIN RESULTS AND THE ROLE OF CHANCE: The blastocyst rate was higher with lower the scores generated by the embryo assessment algorithm. A GEE model confirmed the positive association between lower embryo score and higher odds of blastulation (odds ratio (OR) (1 vs 5 score) = 15.849; P < 0.001). This association was consistent in both oocyte donation and autologous embryos subjected to PGT-A. The automatic embryo classification results were also statistically associated with implantation and live birth. The OR of Score 1 vs 5 was 2.920 (95% CI 1.440-5.925; P = 0.003; E = 2.81) for implantation and 3.317 (95% CI 1.615-6.814; P = 0.001; E = 3.04) for live birth. However, this association was not found in embryos subjected to PGT-A. The highest performance was achieved when combining the automatic embryo scoring and traditional morphological classification (AUC for implantation potential = 0.629; AUC for live-birth potential = 0.636). Again, no association was found between the embryo classification and euploidy status in embryos subjected to PGT-A (OR (1 vs 5) = 0.755 (95% CI 0.255-0.981); P = 0.489; E = 1.57). LIMITATIONS, REASONS FOR CAUTION: The retrospective nature of this study may be a reason for caution, although the large sample size reinforced the ability of the model for embryo selection. WIDER IMPLICATIONS OF THE FINDINGS: Time-lapse technology with automated embryo assessment can be used together with conventional morphological evaluation to increase the accuracy of embryo selection process and improve the success rates of assisted reproduction cycles. To our knowledge, this is the largest embryo dataset analysed with this embryo assessment algorithm. STUDY FUNDING/COMPETING INTEREST(S): This research was supported by Agencia Valenciana de Innovació and European Social Fund (ACIF/2019/264 and CIBEFP/2021/13). In the last 5 years, M.M. received speaker fees from Vitrolife, Merck, Ferring, Gideon Richter, Angelini, and Theramex, and B.A.-R. received speaker fees from Merck. The remaining authors have no competing interests to declare. TRIAL REGISTRATION NUMBER: N/A.

Características clínico-epidemiológicas de sepsis neonatal temprana en un hospital público, Lima, Perú

Objetivo: Determinar características clínico-epidemiológicas de neonatos con sepsis neonatal temprana en hospital público, Lima-Perú, 2016-2017. Materiales y métodos: Estudio observacional, retrospectivo. Se consideró todos los neonatos nacidos vivos en el Hospital Nacional Dos de Mayo diagnosticados con sepsis neonatal temprana el 2016-2017, excepto historias clínicas incompletas, totalizando 303. Se estudiaron variables maternas (edad, educación, estado civil, control prenatal, RPM, tipo de parto, infección urinaria, corioamnionitis, anemia) y neonatales (sexo, edad gestacional, peso, Apgar 1/5 minutos, clínica, hemocultivo, agente aislado, tratamiento y sensibilidad antibiótica). El programa Excel se usó para el procesamiento de datos; SPSSv25 para el análisis descriptivo. Se calculó incidencia de sepsis neonatal temprana. Resultados: Incidencia de sepsis neonatal temprana en 67,08/1000 nacidos vivos en el 2016 y 12,785 en el 2017, la cual fue confirmada en 2,98 (2016) y 4,7 (2017). 45 % de madres sin control prenatal adecuado o sin controles; la cuarta parte presentó anemia, infección urinaria, antecedente de aborto. Clínica de neonatos: taquipnea (52,80 %), taquicardia (17,50 %), hipotonía (18,20 %), fiebre (9,20 %); tratamiento ampicilina-amikacina en sepsis probable (86,54 %) y sepsis confirmada (85 %). Se aisló gérmenes en 8,40 % de casos, mayoría Gram positivos; Staphylococcus coagulasa-negativa, el más frecuente, resistente a clindamicina, oxacilina, ampicilina, cefotaxima, gentamicina y sensible a linezolid, vancomicina. Burkholderia gladioli, única bacteria Gram negativa encontrada, sensible a levofloxacino, ciprofloxacino, ceftriaxona, pero resistente a gentamicina y amikacina. Conclusiones: Clínica de sepsis neonatal temprana caracterizada por taquipnea, taquicardia, hipotonía y fiebre. Bacterias Gram positivas las más aisladas; predominó Staphylococcus coagulasa-negativa.

Objective: To determine the clinical-epidemiological characteristics of newborns with early-onset neonatal sepsis in a public hospital in Lima, Peru, 2016-2017. Materials and methods: An observational, retrospective study of 303 newborns born in Hospital Nacional Dos de Mayo, diagnosed with early-onset neonatal sepsis (2016-2017) and with complete medical records. Maternal variables: age, education, marital status, prenatal care, PROM, type of delivery, UTI, chorioamnionitis, anemia; neonatal variables: sex, gestational age, weight, Apgar, clinical signs, hemoculture, isolated organism, treatment, antibiotic sensitivity. Data processed in Excel and analyzed in SPSS Statistics V25. The incidence of early-onset neonatal sepsis was determined. Results: Incidence of early-onset neonatal sepsis: 67.08/1,000 (2016) and 127.85/1,000 (2017) live births. Incidence of confirmed early-onset neonatal sepsis: 2.98 (2016) and 4.7 (2017). Out of all mothers, 45 % received no adequate prenatal checkup or no checkups; 25 % presented anemia, UTI, history of abortion. Newborns had tachypnea (52.80 %), tachycardia (17.50 %), hypotonia (18.20 %), fever (9.20 %). The therapy included ampicillin-amikacin for probable (86.54 %) and confirmed (85 %) sepsis. Germs, mostly gram positive, were isolated from 8.4 % of the newborns. Coagulase-negative Staphylococcus was the most common bacteria, resistant to clindamycin, oxacillin, ampicillin, cefotaxime, gentamicin, and sensitive to linezolid, vancomycin. Burkholderia gladioli was the only identified gramnegative organism, sensitive to levofloxacin, ciprofloxacin, ceftriaxone but resistant to gentamicin, amikacin. Conclusions: The clinical presentation of neonatal sepsis included tachypnea, tachycardia, hypotonia and fever. Grampositive bacteria were the most commonly isolated species, prevailing coagulase-negative Staphylococci.

Food industrial biowaste-based magnetic activated carbons as sustainable adsorbents for anthropogenic mercury emissions.

Bio-derived magnetic activated carbons from industrial chestnut shell waste have been obtained through a novel, optimized and sustainable methodology where impregnation, pyrolysis, acid washing or other intermediate steps commonly used in the activation process were eliminated saving time, energy and costs. The resulting materials (MACs) were obtained at 220-800 °C showed interesting properties: textural (SBET up to 568 m2 g-1) and magnetic (different iron species developed), depending on the activation temperature employed. Data showed outstanding results when MACs were tested for Hg removal in pollution emissions at 150 °C in lab-scale device. In MACs obtained at 500-600 °C, where the highest concentration of magnetite was found, the best Hg adsorption capacity was achieved, while it decreased when metallic iron or iron carbides were present (MACs obtained at 800 °C). Moreover, the difference of Hg0 removal/adsorption in N2+O2 and Simulated Flue Gas atmosphere between MACs obtained at 500 and 600 °C pointed out the influence on Hg removal of additional parameters, as surface chemistry and the existence of sulfur or chloride. The determination of Hg species in post-retention solids confirmed the mercury oxidation by high-valence iron ions (Fe3+) and the involvement of physisorption and chemisorption processes for the gas-solid interaction mechanism.

Human microbiome and metabolic health: An overview of systematic reviews.

To summarize the microbiome's role in metabolic disorders (insulin resistance, hyperglycemia, type 2 diabetes, obesity, hyperlipidemia, hypertension, nonalcoholic fatty liver disease [NAFLD], and metabolic syndrome), systematic reviews on observational or interventional studies (prebiotics/probiotics/synbiotics/transplant) were searched in MEDLINE and Embase until September 2020. The 87 selected systematic reviews included 57 meta-analyses. Methodological quality (AMSTAR2) was moderate in 62%, 12% low, and 26% critically low. Observational studies on obesity (10 reviews) reported less gut bacterial diversity with higher Fusobacterium, Lactobacillus reuteri, Bacteroides fragilis, and Staphylococcus aureus, whereas lower Methanobrevibacter, Lactobacillus plantarum, Akkermansia muciniphila, and Bifidobacterium animalis compared with nonobese. For diabetes (n = 1), the same was found for Fusobacterium and A. muciniphila, whereas higher Ruminococcus and lower Faecalibacterium, Roseburia, Bacteroides vulgatus, and several Bifidobacterium spp. For NAFLD (n = 2), lower Firmicutes, Rikenellaceae, Ruminococcaceae, whereas higher Escherichia and Lactobacillus were detected. Discriminating bacteria overlapped between metabolic disorders, those with high abundance being often involved in inflammation, whereas those with low abundance being used as probiotics. Meta-analyses (n = 54) on interventional studies reported 522 associations: 54% was statistically significant with intermediate effect size and moderate between-study heterogeneity. Meta-evidence was highest for probiotics and lowest for fecal transplant. Future avenues include better methodological quality/comparability, testing functional differences, new intervention strategies, and considerating other body habitats and kingdoms.

Causas de la lesión de isquiosurales en fútbol: una revisión bibliográfica desde las etapas formativas hasta la profesional / Causes of hamstring injury in soccer: a review from high-level youth academy to proffesional level / Causas do prejuízo dos isquiotibiais no futebol: uma revisão bibliográfica das etapas de formação ao profissional

OBJETIVOS: identificar las principales causas de lesión de isquiosurales en las diferentes etapas de formación, desde la etapa sub-12 hasta la etapa profesional, y establecer la influencia de la lesión previa de isquiosurales como causa principal de sufrir una nueva lesión. MÉTODO: la búsqueda bibliográfica se realizó en Dialnet, Pubmed, Web of Science, Scopus y SportDISCUS, entre las fechas de enero de 2010 hasta mayo de 2020. RESULTADOS: la búsqueda concluyó que el patrón de lesión isquiosural más concurrido es el de jugador de edad avanzada, con mayores valores de fuerza y menores valores de flexibilidad, y con un mayor grado de anteversión pélvica. El envejecimiento, los movimientos compensatorios en patrones motores fundamentales y otros factores de la competición se presentaron como las principales causas de lesión en jugadores profesionales. CONCLUSIONES: la lesión previa, con el mayor número de casos registrados de incidencia lesional, se estableció como principal factor de riesgo de lesión de la musculatura isquiosural

OBJECTIVES: to identify the main causes of hamstring injury in the different training stages, from the under-12 stage to the professional stage, and to establish the influence of the previous hamstring injury as the main cause of suffering a new injury. METHOD: the bibliographic search was carried out in Dialnet, Pubmed, Web of Science, Scopus and SportDISCUS, between the dates of January 2010 to May 2020. RESULTS: the search concluded that the most frequent hamstring injury pattern is that of an elderly player, with higher strength values ​​and lower flexibility values, and a higher degree of pelvic anteversion. Aging, compensatory movements in fundamental motor patterns and other factors of the competition were presented as the main causes of injury in professional players. CONCLUSIONS: previous injury, with the highest number of recorded cases of injury incidence, was established as the main risk factor for hamstring injury

OBJETIVOS: identificar as principais causas de lesão de isquiotibiais nas diferentes etapas do treinamento, desde a fase de menores de 12 anos até a profissional, e estabelecer a influência da lesão anterior de isquiotibiais como principal causa de nova lesão. MÉTODO: o levantamento bibliográfico foi realizado no Dialnet, Pubmed, Web of Science, Scopus e SportDISCUS, entre as datas de janeiro de 2010 a maio de 2020. RESULTADOS: a pesquisa concluiu que o padrão de lesão dos isquiotibiais mais comum é o de um jogador idoso, com maiores valores de força e menores valores de flexibilidade, e com maior grau de anteversão pélvica. O envelhecimento, os movimentos compensatórios nos padrões motores fundamentais e outros fatores da competição foram apresentados como as principais causas de lesões em jogadores profissionais. CONCLUSÕES: a lesão prévia, com maior número de casos registrados de incidência de lesões, foi apontada como o principal fator de risco para lesão de isquiotibiais

Nuevos modelos transgénicos para el estudio de la enfermedad de Parkinson basados en sistemas de edición con nucleasas / New transgenic models of Parkinson's disease using genome editing technology

INTRODUCCIÓN: La enfermedad de Parkinson (EP) es el segundo trastorno neurodegenerativo más común, caracterizado por la pérdida selectiva de neuronas dopaminérgicas en la substancia nigra pars compacta, produciendo depleción en los niveles de dopamina y dando como resultado las manifestaciones clínicas de la enfermedad que se pueden clasificar como síntomas motrices y no motrices. DESARROLLO: En los últimos años, la generación de nuevos modelos animales basados en los sistemas de edición genética por nucleasas: ZFN, TALEN, CRISPR/Cas9, permiten la realización de modificaciones personalizadas en el genoma, replicando características clave que definen a la EP y consecuentemente avances significativos en la comprensión del proceso fisiopatológico de este trastorno. CONCLUSIÓN: En esta revisión recopilamos los estudios más novedosos de esta nueva generación de modelos in vitro e in vivo de la EP que permiten emular síntomas clave y tener una mayor comprensión de la etiología o los mecanismos involucrados en el proceso de iniciación o desarrollo de la enfermedad y la futura prueba de terapias realmente eficaces para detener o ralentizar su progresión

INTRODUCTION: Parkinson's disease (PD) is the second most common neurodegenerative disorder. It is characterised by selective loss of dopaminergic neurons in the substantia nigra pars compacta, which results in dopamine depletion, leading to a number of motor and non-motor symptoms. DEVELOPMENT: In recent years, the development of new animal models using nuclease-based genome-editing technology (ZFN, TALEN, and CRISPR/Cas9 nucleases) has enabled the introduction of custom-made modifications into the genome to replicate key features of PD, leading to significant advances in our understanding of the pathophysiology of the disease. CONCLUSIONS: We review the most recent studies on this new generation of in vitro and in vivo PD models, which replicate the most relevant symptoms of the disease and enable better understanding of the aetiology and mechanisms of PD. This may be helpful in the future development of effective treatments to halt or slow disease progression

Electrochemical genosensor for Klotho detection based on aliphatic and aromatic thiols self-assembled monolayers.

Changes in expression of Klotho gene are associated with chronic kidney disease and its potential as early biomarker is being studied. We report, for the first time, the detection of Klotho gene by a biosensor platform. Self-assembled mixed monolayers (SAMs) as DNA immobilization method in screen-printed gold electrodes and a sandwich format detection were used in the development of an electrochemical genosensor for the detection of a 100-mer DNA fragment, copy of the partial region of the mRNA Klotho gene. The use of different binary and ternary SAMs based on aliphatic (mercaptohexanol, MCH, and hexanedithiol, HDT) and aromatic (mercaptophenylacetic acid, MPAA) thiol diluents and capture probe (CP) as sensing phases was evaluated by cyclic voltammetry and electrochemical impedance spectroscopy. Multiple configurations were studied, changing the order of component addition and comparing co-immobilization and two-step immobilization processes. The procedure for binary SAM preparation consisting of sequential addition of a thiol diluent followed by CP was found to have the least detrimental impact on electrochemical performance. The signal-to-blank ratios increased considerably in the case of thioaromatic binary DNA monolayers, MPPA/CP, compared to the values obtained for aliphatic SAMs. Ternary monolayers formed by MCH and HDT rendered good fractional coverage levels and generated more reversible redox reactions at the surface, mostly when CP was firstly immobilized, CP/HDT/MCH. A significant reduction of the blank and non-specific (non-complementary sequence) signals was obtained with this ternary SAM, compared to binary SAMs and an increase of 2.42-fold of the S/B ratio (10 nM of target) compared with MPAA/CP SAMs. A linear response in the range of 5·10-10 to 5·10-8 M was obtained with CP/HDT/MCH monolayer, with a detection limit of 0.5 nM and RSD of 8.10%.

New transgenic models of Parkinson's disease using genome editing technology. / Nuevos modelos transgénicos para el estudio de la enfermedad de Parkinson basados en sistemas de edición con nucleasas.

INTRODUCTION: Parkinson's disease (PD) is the second most common neurodegenerative disorder. It is characterised by selective loss of dopaminergic neurons in the substantia nigra pars compacta, which results in dopamine depletion, leading to a number of motor and non-motor symptoms. DEVELOPMENT: In recent years, the development of new animal models using nuclease-based genome-editing technology (ZFN, TALEN, and CRISPR/Cas9 nucleases) has enabled the introduction of custom-made modifications into the genome to replicate key features of PD, leading to significant advances in our understanding of the pathophysiology of the disease. CONCLUSIONS: We review the most recent studies on this new generation of in vitro and in vivo PD models, which replicate the most relevant symptoms of the disease and enable better understanding of the aetiology and mechanisms of PD. This may be helpful in the future development of effective treatments to halt or slow disease progression.

Evaluación de la atención farmacéutica y del envío domiciliario de medicación a pacientes con leucemia mieloide crónica: proyecto TICAFAN / Evaluation of pharmaceutical care and home delivery of medication to patients with chronic myeloid leukemia - TICAFAN Project

OBJETIVO: Describir y analizar los resultados obtenidos con el desarrollo del proyecto "Tecnologías de la Información y la Comunicación adaptadas a la Atención Farmacéutica No presencial" (TICAFAN). Confirmar la validez del modelo para prestar atención farmacéutica a pacientes con leucemia mieloide crónica. MÉTODO: Estudio antes-después del cambio en el modelo de dispensación y de atención farmacéutica. Se analizó la evolución de la enfermedad, las intervenciones farmacéuticas, la adherencia al tratamiento, el número de dispensaciones realizadas mediante envío domiciliario y sus incidentes desde el 1 de febrero del 2014 al 31 de octubre del 2016. En mayo del 2015 se realizó una encuesta de satisfacción. RESULTADOS: Se incluyeron 21 pacientes en el programa, la edad media en el momento de inclusión fue de 55 años (DE 17). Se realizaron 470 envíos, con una disminución del 80% (DE 15) en los desplazamientos de los pacientes al hospital. Hubo 2 incidentes, por olvido de los pacientes del día del envío. Se registraron 49 intervenciones farmacéuticas y se atendieron 30 consultas a demanda fuera de las programadas, lo que supuso un mayor número de intervenciones que en el periodo anterior. No hubo diferencias en la adherencia antes y después de la inclusión en el programa. La respuesta se mantuvo en 9 pacientes, mejoró en otros 9 y empeoró en 3, recuperándose posteriormente. La satisfacción de los pacientes con el proyecto fue de 9,7 (DE 0,6) sobre 10. CONCLUSIONES: El proyecto TICAFAN ha conseguido mantener la atención farmacéutica a los pacientes incluidos en el mismo, la adherencia y la respuesta al tratamiento, evitando desplazamientos al hospital para la dispensación de medicación

OBJECTIVES: To describe and analyze the results of the development of the "Information and communications technology adapted to remote pharmaceutical care" (TICAFAN, by its Spanish acronym) project and confirm its validity to provide pharmaceutical care to chronic myelogenous leukemia patients. METHODS: Before and after study of a modified pharmaceutical care model. The course of the disease, pharmaceutical interventions, treatment adherence, and number of home deliveries and their incidents were analyzed from February 1, 2014 to October 31, 2016. A satisfaction survey was conducted in May 2015. RESULTS: Twenty one patients were included in the program until October 31, 2016. The mean age at the time of inclusion was 55 years (SD 17). There were 470 home deliveries, with an 80% (SD 15) reduction in the trips to the hospital. There were 2 incidents owing to the fact that the patients did not remember the shipment date. Forty nine pharmaceutical interventions were registered and 30 on-demand inquiries were answered, apart from the scheduled monthly consultations. This meant a greater number of interventions than in a previous period. There were no differences in adherence before and after the inclusion in the program. Response was maintained in 9 patients, improved in 9 and worsened, but recovered afterwards, in 3 patients. Patients gave the project a score of 9.7 (SD 0.6) out of 10. CONCLUSIONS: The TICAFAN project has managed to keep providing pharmaceutical care as well as to maintain adherence and treatment response, reducing hospital visits for drug collection

Detection of Approximal Caries Lesions in Adults: A Cross-sectional Study.

Detection and management of posterior approximal caries lesions are still problematic. Inspection of approximal surfaces is challenging, and bitewing radiographs are used when direct vision is not possible. Unfortunately, there is no definite radiographic appearance to identify lesion cavitation with absolute certainty. Many lesions detected radiographically within the outer half of dentin are not cavitated, often resulting in unnecessary restorative treatment. Our study compared radiographic depth of approximal caries lesions with presence of cavitation in adults using visual inspection following temporary tooth separation (TTS). We conducted this observational descriptive cross-sectional study at two dental schools in two cities in Chile. Clinicians were unaware of radiographic depths of lesions and examined 147 participants (57.3% female and 42.7% male) following TTS. Using the common classification system that consists of E0 (no lesion), E1 (lesion within the outer half of enamel), E2 (lesion within the inner half of enamel), D1 (lesion within the outer third of dentin), D2 (lesion within the middle third of dentin), and D3 (lesion within the inner third of dentin), a trained dentist evaluated all the processed films. Cavitation was detected in only three sites (0.22%) within the E0 category, seven sites (3.41%) in E1, five sites (14.8%) in E2, four sites (14.8%) in D1, six sites (50%) in D2, and eight sites (61.5%) in D3. Considering that restorative treatment should be indicated strictly for cavitated lesions, our findings support indication for restorative treatment for D3 lesions and the rationale for TTS for D1-D2 caries lesions to allow direct visual inspection to determine whether there is surface cavitation.

Hydrochars from industrial macroalgae "Gelidium Sesquipedale" biomass wastes.

Macroalgae wastes from the Agar-Agar industry were used as a feedstock to obtain hydrochars by means of hydrothermal carbonization. The effect of temperature (200 °C and 230 °C) and time (2 h and 6 h) on the yield, higher heating value (HHV) and chemical-morphological-textural properties of the hydrochars was studied. The carbon content and the higher heating value were observed to increase with the hydrothermal carbonization. The hydrochars yields (up to 60%) were much higher than yields obtained using conventional char (27.5-33.5%). The hydrochar obtained at 230 °C and after 6 h showed a HHV of 23.25 MJ/kg, which is similar to that of lignite HHV. The H/C and O/C atomic ratios decreased as a consequence of the dehydration and decarboxilation reactions. Hydrothermal carbonization barely changed the vegetal structure of the macroalgae waste. The hydrochars were found to be essentially meso-macroporous with average pore sizes of up to 110.5 nm.

Sewage biogas efficient purification by means of lignocellulosic waste-based activated carbons.

The present paper evaluates the efficiency of sustainable activated carbons obtained from the valorization of lignocellulosic waste in removing siloxanes and volatile organic compounds for the purification of anaerobic digester biogas. Pyrolized and non-pyrolized lignocellulosic residues generated in food and wood industries were used as precursor materials to obtain experimental adsorbents by a chemical activation process using several activating agents. The highest porosity was obtained by non-pyrolized residue activated by K2CO3 at 900 °C. The performance of the experimental materials was compared with that of commercial activated carbons in gas adsorption tests of siloxanes (octamethylcyclotetrasiloxane and hexamethyldisiloxane) and volatile organic compounds (toluene and limonene). The waste-based activated carbons developed in this work proved to be more efficient for the removal of both siloxanes and VOCs than the commercial samples in most of the conditions tested. Adsorption capacities correlated with porosity, while the more relevant pore size depends on the adsorbate.

18F-FDG PET/TC con contraste intravenoso en el seguimiento estandarizado de pacientes con linfoma / 18F-FDG PET/contrast enhanced CT in the standard follow-up of patients with lymphoma

Objetivo. Valorar la capacidad diagnóstica de la 18F-FDG PET/TC con contraste intravenoso (PET/TCciv) en la detección de recidivas asintomáticas de pacientes con linfoma. Material y métodos. Se realizó una PET/TCciv en pacientes con linfoma para seguimiento estandarizado y en remisión completa clínica. Tanto la 18F-FDG PET como la TCciv fueron evaluadas de forma independiente por 2 observadores y clasificadas como positiva o negativa para recurrencia. Adicionalmente se realizó una valoración combinada de ambas exploraciones. El diagnóstico final se estableció por análisis histopatológico o seguimiento clínico superior a 6 meses. Se calcularon los parámetros diagnósticos estadísticos y los niveles de concordancia entre ambas técnicas diagnósticas. Resultados. Se analizaron un total de 114 exploraciones pertenecientes a 90 pacientes. Solo 4 pacientes fueron diagnosticados de recurrencia asintomática durante el seguimiento. La 18F-FDG PET/TCciv, la 18F-FDG PET y la TCciv mostraron asociación con el diagnóstico final (p=0,002 y χ2=11,96; p<0,001 y χ2=15,60; p=0,001 y χ2=11,96, respectivamente). La concordancia entre la 18F-FDG PET y la TCciv fue moderada/alta y significativa (kappa=0,672; p<0,001). Se obtuvo una sensibilidad y especificidad del 50 y 88% para la 18F-FDG PET/TCciv, del 50 y 93% para la 18F-FDG PET y del 50 y 91% para la TCciv. Conclusión. El uso combinado de la 18F-FDG PET/TCciv no ofreció ventaja con respecto a ambas técnicas por separado en la detección de recidiva asintomática por linfoma

Aim. To assess the diagnostic accuracy of 18F-FDG PET/contrast enhanced computed tomography (ceCT) in the detection of asymptomatic recurrences in patients with lymphoma. Material and methods. Patients with lymphoma and clinical complete remission underwent 18F-FDG PET/ceCT for standard follow-up.18F-FDG PET and ceCT were evaluated blindly by two independent observers, and classified as positive or negative for recurrence. Additionally a combined evaluation of both techniques was performed. The final diagnosis was established by histopathological analysis or a clinical follow-up longer than 6 months. Statistical diagnostic parameters and concordance levels between both diagnostic techniques were calculated. Results. A total of 114 explorations on 90 patients were analyzed. Only 4 patients were diagnosed as asymptomatic recurrence during the follow-up. 18F-FDG PET/ceCT, 18F-FDG PET and ceCT showed an association with the final diagnosis (p=0.002 and χ2=11.96; p<0.001 and χ2=15.60; p=0.001 and χ2=11.96, respectively). The concordance between 18F-FDG PET and ceCT was moderate/high and significant (kappa=0.672; p<0.001). A sensitivity and specificity of 50% and 88% was obtained for the 18F-FDG PET/ceCT civ, 50% and 93% for the 18F-FDG PET, and 50% and 91% for the ceCT. Conclusion. The combined use of 18F-FDG PET/ceCT did not offer any advantage compared to any isolated diagnostic technique in the detection of asymptomatic lymphoma recurrence

18F-FDG PET/contrast enhanced CT in the standard follow-up of patients with lymphoma. / 18F-FDG PET/TC con contraste intravenoso en el seguimiento estandarizado de pacientes con linfoma.

AIM: To assess the diagnostic accuracy of 18F-FDG PET/contrast enhanced computed tomography (ceCT) in the detection of asymptomatic recurrences in patients with lymphoma. MATERIAL AND METHODS: Patients with lymphoma and clinical complete remission underwent 18F-FDG PET/ceCT for standard follow-up.18F-FDG PET and ceCT were evaluated blindly by two independent observers, and classified as positive or negative for recurrence. Additionally a combined evaluation of both techniques was performed. The final diagnosis was established by histopathological analysis or a clinical follow-up longer than 6 months. Statistical diagnostic parameters and concordance levels between both diagnostic techniques were calculated. RESULTS: A total of 114 explorations on 90 patients were analyzed. Only 4 patients were diagnosed as asymptomatic recurrence during the follow-up. 18F-FDG PET/ceCT, 18F-FDG PET and ceCT showed an association with the final diagnosis (p=0.002 and χ2=11.96; p<0.001 and χ2=15.60; p=0.001 and χ2=11.96, respectively). The concordance between 18F-FDG PET and ceCT was moderate/high and significant (kappa=0.672; p<0.001). A sensitivity and specificity of 50% and 88% was obtained for the 18F-FDG PET/ceCT civ, 50% and 93% for the 18F-FDG PET, and 50% and 91% for the ceCT. CONCLUSION: The combined use of 18F-FDG PET/ceCT did not offer any advantage compared to any isolated diagnostic technique in the detection of asymptomatic lymphoma recurrence.

Tromboprofilaxis en pacientes médicos y quirúrgicos: resultados de un estudio multicéntrico realizado en hospitales de la Ciudad de México / Thromboprophylaxis in medical and surgical patients: results of a multicenter study in hospitals of Mexico City

Resumen: ANTECEDENTES: la enfermedad tromboembólica venosa es una complicación que puede manifestarse durante o después de la hospitalización. Existen pocos antecedentes en nuestro país que evalúan el comportamiento médico en este tema. OBJETIVO: conocer la prescripción relacionada con el tipo, duración y posibles causas de la omisión de tromboprofilaxis en pacientes hospitalizados. MATERIAL Y MÉTODO: estudio descriptivo, transversal y no probabilístico en el que de septiembre a noviembre de 2016 se evaluaron médicos de Medicina Interna, Cirugía General, Terapia Intensiva y Urgencias. Se recolectaron datos por cuestionario y presentación de resultados a través de estadística descriptiva. También se evaluó la duración de la prescripción y la dosis administrada. RESULTADOS: se encuestaron 556 médicos adscritos, 14 jefes de servicio y 234 residentes total: 804 de siete hospitales de la Ciudad de México pertenecientes al sistema de salud. El 30% refirió que su hospital cuenta con un programa de tromboprofilaxis; 97.7% la considera segura y 1.2%, riesgosa. El 96% respondió que prescribe tromboprofilaxis en sus pacientes; 592 74% utilizan alguna escala de previsión clínica de enfermedad tromboembólica venosa. El 71% recomienda heparina de bajo peso molecular para tromboprofilaxis y 0.74% administra anticoagulantes orales de nueva generación. CONCLUSIONES: la enfermedad tromboembólica venosa es potencialmente prevenible; sin embargo, la prescripción muestra oportunidades de mejoría en aspectos de farmacología.

Abstract: BACKGROUND: Venous thromboembolic disease VTE is a complication that may occur during or after hospitalization. There are few antecedents in our country that evaluate the medical behavior in this subject. OBJECTIVE: To know the prescription related to type, duration and possible causes for omission of thromboprophylaxis in hospitalized patients. MATERIAL AND METHOD: A descriptive, transversal and non-probabilistic study was done, in which from September to November 2016 physicians of Internal Medicine, General Surgery, Intensive Care and Urgency were evaluated through a data collection by questionnaire and presentation of results through descriptive statistics. We also evaluated duration of prescription and dose administered. RESULTS: A total of 556 seconded physicians, 14 service heads, and 234 residents 804 in total were surveyed in seven hospitals in Mexico City belonging to the health system. Thirty percent reported that their hospital has a thromboprophylaxis program; 97.7% consider it safe and 1.2% risky; 96% responded that they prescribe thromboprophylaxis in their patients; 592 73.6% used some clinical prediction scale for VTE; 71% recommended low molecular weight heparin for thrombo prophylaxis and 0.74% administered new generation oral anticoagulants. CONCLUSIONS: Venous thromboembolic disease is potentially preventable; however, prescription shows opportunities for improvement in aspects of pharmacology.

Association Between Body Mass Index and Caries Lesions in Preschool Children in Santiago, Chile / Asociación entre Lesiones de Caries y Estado Nutricional en Niños Preescolares de la Región Metropolitana

ABSTRACT: The objective of the study was to determine the association between caries prevalence and body mass index (BMI) in preschool children in Santiago, Chile. Children aged 2 and 3 years old (n = 342) attending 16 nursery schools in Santiago, Chile were examined to record the status of dental caries using the modified criteria of the International Caries Detection and Assessment System (ICDAS II) (International Caries Detection and Assessment System (ICDAS) Coordinating Committee, 2005). BMI was calculated for each of the subjects and their nutritional state was classified as underweight, normal-weight, overweight and obesity according to the WHO. The caries prevalence (ICDAS 2-6 > 0) of the children was 45.9 % (IC 95 % 40.50 - 51.21). Data showed that none of the preschoolers were underweight. 39.1 % were classified as normal-weight (IC 95 % 33.98 - 44.38), 34.8 % as overweight (IC 95 % 29.72 - 39.86) and 26 % as obese (IC 95 % 21.34 - 30.96). Normal-weight children had a prevalence of 51.5 % of ICDAS 2-6 lesions and prevalence of 28.3 % of ICDAS 5-6 lesions. Children with overweight had prevalence of 51.4 % ICDAS 2-6 lesions and of 19.3 % ICDAS 5-6 lesions, and obese children of 39.5 % and 25.8 % respectively. Subjects with normal-weight presented a mean of ICDAS 2-6 caries lesions significantly higher (p < 0.05) than the rest of the children. In conclusion, normal-weight preschool children presented a higher prevalence of caries lesions than those with overweight and obesity. Iso-BMI was found to be associated with lower dental caries and severity. Future studies should address which specific factors related to overweight in children might be protective against dental caries.

RESUMEN: La caries dental es una enfermedad crónica multifactorial que afecta a niños denominada Caries Temprana de la Infancia (CTI). Su etiología es multifactorial y se asocia a determinantes biológicos, conductuales y sociodemográficos. Entre estos, se ha planteado la obesidad como presunto factor de riesgo para el desarrollo de caries en población infantil. El objetivo de este estudio fue establecer si existía o no asociación entre la presencia de lesiones de caries y el estado nutricional en una muestra de 342 preescolares entre 1 y 4 años de edad, que asisten a jardines infantiles de la Fundación INTEGRA, en la Región Metropolitana de Santiago. Se realizaron exámenes clínicos dentales y medición de la talla y peso. Se calculó IMC para cada uno de los sujetos y su estado nutricional fue clasificado como por debajo del peso adecuado, peso normal o normopeso, sobrepeso y obesidad según los gráficos y tablas de la OMS. La prevalencia total de lesiones de caries (ICDAS II = 2 -6) fue de 45,9 % (IC 95 % 40,59 - 51,21). El estado nutricional de la muestra completa fue de 0 % bajo el peso normal, 134 (39,1 %) niños presentaron peso normal (IC 95 % 33,98 - 44,38), 119 niños (34,8 %) presentaron sobrepeso (IC 95 % 29,72 - 39,86) y a 89 (26 %) niños se les diagnosticó obesidad (IC 95 % 21,34 - 30,96). Los sujetos con normopeso presentaron un promedio de lesiones de caries (ICDAS II = 2 - 6) significativamente mayor (p < 0,05). Por lo tanto, se puede concluir que los preescolares con peso normal presentaron mayor número de lesiones de caries de acuerdo al criterio ICDAS II, que aquellos preescolares con sobrepeso y obesidad.