Treatment With a Patented 3.6:1 Myo-Inositol to D-chiro-Inositol Ratio, Antioxidants, Vitamins and Minerals Food Supplement in Women With a History of Assisted Reproductive Technique (ART) Failures: A Series of Case Reports.

Infertility affects 15% of couples in reproductive age worldwide. In women in particular, infertility can be caused by various abnormalities, with polycystic ovary syndrome (PCOS) being the most common. Currently, there are many assisted reproductive techniques (ART) available to combat the burden of infertility. However, positive results are not guaranteed. The administration of inositol has been shown to increase positive reproductive outcomes in women undergoing ART. Here we present a series of clinical cases in which women with a history of infertility and previously failed ART, supplemented with a specific 3.6:1 MYO:DCI ratio, antioxidants, vitamins, and minerals for a period of 1 to 3 months before undergoing in vitro fertilization (IVF). In this series of case reports, we provide preliminary evidence that supplementation with a specific 3.6:1 MYO to DCI ratio, as well as antioxidants, vitamins, and minerals may contribute positively to female fertility in women undergoing IVF, with a history of primary or secondary infertility and previously failed ART.

Porcine Forebrain Vacuolization Associated with Wasting in Pigs: A Novel Pathological Outcome Associated with Vitamin-Mineral Deficiency?

The term wasting refers to a clinical sign used to describe a physical condition characterized by growth retardation, usually of multifactorial origin. The objective of the present study was to describe for the first time a pathological process characterized by forebrain neuropil vacuolization in pigs showing wasting without conspicuous neurological signs. To characterize the lesions pathologically, affected and non-affected pigs from eight of these farms were investigated. Histologically, the most consistent lesion was neuropil vacuolization of the prosencephalon, mainly located in the thalamic nuclei and in the transition between the white and grey matter of the neocortex (40/56 in sick and 4/30 in healthy pigs). In the most severe cases, the vacuolation also involved the midbrain, cerebellar nuclei and, to a lesser extent, the medulla oblongata. Vacuolization of the forebrain was associated with pigs experiencing marked emaciation and growth retardation. Although the specific cause of the present case remained unknown, the preventive use of multivitamin and mineral complexes in drinking water ameliorated the condition, strongly suggesting a metabolic origin of the observed condition.

Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study.

BACKGROUND: To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population. METHODS: We retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients. RESULTS: We analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients. CONCLUSION: The risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.

Tumor miofibroblástico inflamatorio tras cáncer de mama. Un reto en el diagnóstico diferencial. Revisión de la literatura / Myofibroblastic tumour after breast cancer. A challenge in differential diagnosis. Literature review

Introducción El tumor miofibroblástico inflamatorio (TMI) es un tumor mesenquimal benigno, con potencial de transformación maligna. Puede aparecer en múltiples órganos (pulmón, intestino…), siendo la mama una ubicación excepcional. Hallazgos clínicos: Se presenta el caso de una paciente de 53 años que tiene como antecedente un carcinoma de mama derecha, tipo ductal infiltrante G2, luminal A. Fue tratada con cirugía, radioterapia y quimioterapia, consiguiéndose curación. Transcurridos nueve años, reinició estudio por aparición de una tumoración sospechosa de 3 cm en la misma mama. Diagnósticos principales, intervenciones terapéuticas y resultados: Se realizó una biopsia con aguja gruesa. El estudio anatomopatológico no fue concluyente, por lo que se decidió realizar una exéresis de la lesión. Los resultados del análisis anatomopatológico fueron: tumor miofibroblástico inflamatorio. La paciente no precisó tratamiento adyuvante posterior y se encuentra libre de enfermedad actualmente. Conclusión: El TMI es una entidad poco frecuente, con pocos casos publicados hasta la fecha. Representa un reto diagnóstico, tanto a nivel radiológico como anatomopatológico. A pesar de ser una neoplasia con comportamiento benigno, está indicado realizar una exéresis amplia y completa de la lesión, ya que en algunos casos se ha descrito su recurrencia, y de forma excepcional se han descrito casos de metastatización. El conocimiento de su existencia y comportamiento es clave a la hora orientar el diagnóstico y tratamiento.(AU)

Introduction: Inflammatory myofibroblastic tumour (IMT) is a benign mesenchymal tumour, with potential for malignant transformation. It can appear in multiple organs (lung, intestine…), the breast being an exceptional location. Clinical findings: We present the case of a 53-year-old female patient with a history of right breast ductal infiltrating carcinoma, G2, Luminal A. She was treated with surgery, radiotherapy, and chemotherapy, achieving complete response. Nine years later, she was re-examined due to the appearance of a new suspicious tumour in the same breast, which measured three centimetres. Main diagnosis, therapeutic intervention, and outcomes: A core needle biopsy was performed. The anatomopathological study was inconclusive, so it was decided to perform total excision of the lesion. The results of the anatomopathological analysis were: Inflammatory Myofibroblastic Tumour. The patient did not require further adjuvant treatment and is disease free at present. Conclusions: IMT is a rare entity, with few cases published to date. It represents a diagnostic challenge, both radiologically and anatomopathologically. Although it is a tumour with benign behaviour, wide and complete excision of the lesion is indicated, as its recurrence has been described in some cases, as well as some exceptional cases of metastatisation. Knowledge of its existence and behaviour is a key factor in guiding diagnosis and treatment.(AU)

Macronutrient signals for adaptive modulation of intestinal digestive enzymes in two omnivorous Galliformes.

According to the adaptive modulation hypothesis, digestive enzyme activities are matched to their respective dietary substrate level so that ingested nutrients are not wasted in excreta due to insufficient digestive capacity, and so membrane space or expenditures building/maintaining the intestinal hydrolytic machinery are not wasted when substrate levels are low. We tested predictions in juvenile northern bobwhites (Colinus virginianus) and juvenile and adult domestic chickens (Gallus gallus domesticus) by feeding them on diets varying in starch, protein, and lipid composition for 7-9 d (bobwhites) or 15 d (chickens). Birds were euthanized, intestinal tissue harvested, and enzyme activities measured in tissue homogenates from proximal, medial and distal small intestine. We found that (1) α-glucosidase (AG; maltase and sucrase) activities were induced by dietary starch in both juvenile and adult chickens but not in northern bobwhites; (2) aminopeptidase-N (APN) activities were induced by dietary protein in both bobwhites and juvenile but not adult chickens; (3) AG activities were suppressed by an increase in dietary lipid in both bobwhites and juvenile but not adult chickens; and (4) APN activities were not suppressed by high dietary lipid in any birds. We review findings from 35 analogous trials in 16 avian species. 100% of avian omnivores modulate at least one enzyme in response to change in dietary substrate level. AG induction by dietary carbohydrate occurs in more members of Galloanserae than in Neoaves, and all omnivorous members of Neoaves tested so far increase APN activity on high dietary protein, whereas fewer of the Galloanserae do.

Upon heat stress processing of ribosomal RNA precursors into mature rRNAs is compromised after cleavage at primary P site in Arabidopsis thaliana.

Transcription and processing of 45S rRNAs in the nucleolus are keystones of ribosome biogenesis. While these processes are severely impacted by stress conditions in multiple species, primarily upon heat exposure, we lack information about the molecular mechanisms allowing sessile organisms without a temperature-control system, like plants, to cope with such circumstances. We show that heat stress disturbs nucleolar structure, inhibits pre-rRNA processing and provokes imbalanced ribosome profiles in Arabidopsis thaliana plants. Notably, the accuracy of transcription initiation and cleavage at the primary P site in the 5'ETS (5' External Transcribed Spacer) are not affected but the levels of primary 45S and 35S transcripts are, respectively, increased and reduced. In contrast, precursors of 18S, 5.8S and 25S RNAs are rapidly undetectable upon heat stress. Remarkably, nucleolar structure, pre-rRNAs from major ITS1 processing pathway and ribosome profiles are restored after returning to optimal conditions, shedding light on the extreme plasticity of nucleolar functions in plant cells. Further genetic and molecular analysis to identify molecular clues implicated in these nucleolar responses indicate that cleavage rate at P site and nucleolin protein expression can act as a checkpoint control towards a productive pre-rRNA processing pathway.

Simple-to-use and portable device for free chlorine determination based on microwave-assisted synthesized carbon dots and smartphone images.

A new portable and simple 3D printed device was designed for free chlorine determination in water samples. The analytical method was based on the quenching caused by free chlorine on the fluorescence emission of the carbon dots (CD) synthesized from citric acid and urea. The fluorescence was captured through the camera of a smartphone, which was coupled to the 3D printed device, and the images were processed using the RGB system by the ImageJ 1.51q software. The proposed method was selective and precise (RSD% 4.6, for n = 6), and the trueness of the results was evaluated by comparing the results obtained with those recovered by the spectrophotometric method 4500-Cl G (standard method), with good agreement between them. Moreover, the remarkable correlation between the CD signal and the free chlorine concentration resulted in a determination with low detection limits (limit of detection of 6 µg L-1 and limit of quantification of 20 µg L-1). Therefore, the new method and the related portable device could be considered a fast, economical and reliable alternative for the on-site determination of free chlorine in water samples.

Ceftaroline fosamil: clinical experience after 23-month prescription in a tertiary hospital.

OBJECTIVE: To determine the indications, success rate and adverse effects of ceftaroline fosamil treatment in a tertiary hospital. METHODS: In total, 84 cases from February 2018 to December 2019 were retrospectively analysed. No exclusion criteria were applied. RESULTS: Eighty-four patients, with a median age of 70 years, of which, 6.7% (56) were male, were treated with ceftaroline fosamil for a median of 14 days. Most indications were off-label, including 29 endocarditis (34.5%), 14 bacteraemia (16.6%), 5 Central nervous system (CNS) infections (6%) and 19 osteoarticular infections (22.6%). Staphylococcus aureus was the most frequently isolated microorganism, including 28 methicillin-sensitive S. aureus (MSSA; 33.3%) and 14 methicillin-resistant S. aureus (MRSA; 16.7%), followed by coagulase-negative Staphylococcus (23, 27.4%). The main reason for ceftaroline fosamil prescription was the failure of previous treatment (41.7% of cases). Treatment was successful in 60/84 patients (71.4%) and failed clinically or microbiologically in 14 (16.7%). Eight patients died for a reason not related to the infection and two were found to have a non-infectious condition. Twenty-two of thirty-five (62.8%) patients prescribed ceftaroline because of failure of previous treatment improved, including eight endocarditis and seven bacteraemia. Adverse effects were reported in five patients (5.9%) including neutropenia, thrombocytopenia, transaminases elevation and creatinine elevation; all except one were mild and all resolved after discontinuation of treatment. CONCLUSIONS: Ceftaroline fosamil is a well-tolerated cephalosporine, effective against multi- resistant gram-positive and many gram-negative microorganisms. Our experience suggests that it is effective as a rescue or first-line therapy in other indications than those currently approved.

Cancer-related fatigue and its determinants in a cohort of women with breast cancer: the DAMA Cohort.

Cancer-related fatigue (CRF) is one of the most prolonged discomforts suffered by people who have had cancer. Seventy-eight to ninety-six percent of cancer patients experience fatigue, especially while undergoing treatment. CRF is related to insomnia, anxiety, depression, and also varies depending on age. However, little is known about the factors contributing to CRF and better understanding of determinants of CRF makes it easier to identify early patients at risk and in designing intervention planning. The aim of this study was to assess the influence of precipitating factors (diagnosis of breast cancer and other clinical aspects) and perpetuating factors (social network, quality of life, mental disorders) on the presence of chronic fatigue in women from our cultural context, by social class each other determinants. METHODS: It was carried out a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were data from the Brief Fatigue Inventory questionnaire and hospital medical records. The dependent variable was fatigue and the independent variables were age, social class, time since diagnoses, cohabitation, comorbidity, relapse, body mass index, mental health (anxiety and depression), social network, social support, and quality of life. RESULTS: Seventy-two percent of the women in the DAMA cohort reported moderate to severe fatigue. Risk of suffering from severe fatigue was greatest among individuals with low social class, those aged under 50 years, those with chronic disorders who had relapsed, and those with symptoms of anxiety and depression. In our study, CRF did not appear to be related to the stage of the cancer at diagnosis, or to the time since diagnosis. CONCLUSIONS: CRF is an element that the professionals responsible for the control and monitoring of women should take into account as another element to be taken into consideration.

Health Education for preschool children in daycare centers.

BACKGROUND: The promotion of health is carried out in preventive services of medical units, in educational programs and textbooks from the general perspective of the population. OBJECTIVE: To determine baseline characteristics of health education for pre-school children, their parents and teachers, by means of specialist doctors. METHOD: Cross-sectional study of an educational program for preschool children. Life skills and health competencies were evaluated. RESULTS: The preschoolers developed resilience (84.12%), empathy (92.23%), assertive communication (93.5%), interpersonal relationships (91.0%), correct decision making (92.56%), problem solving (81.05%), creative thinking (98%), critical thinking (86.08%), emotion management (80.76%), physical activation (97.94%), self-knowledge (98.96%), hygienic habits (94.90%) and co-responsibility (86.25%); 95.59% liked the workshop and 95.75% chose the correct option in the problems described. 63.04% of parents generated changes in their habits and those of their children. CONCLUSION: The educational program implemented can promote empowerment in health from childhood.

[Educación para la salud en preescolares de guarderías].

BACKGROUND: The promotion of health is carried out in preventive services of medical units, in educational programs and textbooks from the general perspective of the population. OBJECTIVE: To determine baseline characteristics of health education for pre-school children, their parents and teachers, by means of specialist doctors. METHOD: Cross-sectional study of an educational program for preschool children. Life skills and health competencies were evaluated. RESULTS: The preschoolers developed resilience (84.12%), empathy (92.23%), assertive communication (93.5%), interpersonal relationships (91.0%), correct decision making (92.56%), problem solving (81.05%), creative thinking (98%), critical thinking (86.08%), emotion management (80.76%), physical activation (97.94%), self-knowledge (98.96%), hygienic habits (94.90%) and co-responsibility (86.25%); 95.59% liked the workshop and 95.75% chose the correct option in the problems described. 63.04% of parents generated changes in their habits and those of their children. CONCLUSION: The educational program implemented can promote empowerment in health from childhood.

ANTECEDENTES: La promoción de la salud se realiza en servicios preventivos de unidades médicas, en programas educativos y libros de texto desde la perspectiva general de la población. OBJETIVO: Determinar características basales de educación en salud a preescolares, sus padres y maestros, mediante médicos especialistas. MÉTODO: Estudio transversal de un programa educativo para preescolares en estancias infantiles. Se evaluaron habilidades para la vida y competencias para la salud. RESULTADOS: Los preescolares desarrollaron resiliencia (84.12%), empatía (92.23%), comunicación asertiva (93.5%), relaciones interpersonales (91.0%), toma correcta de decisiones correctas (92.56%), solución de problemas (81.05%), pensamiento creativo (98%), pensamiento crítico (86.08%), manejo de emociones (80.76%), activación física (97.94%), autoconocimiento (98.96%), hábitos higiénicos (94.90%) y corresponsabilidad (86.25%); al 95.59% les agradó el taller y el 95.75% eligió la opción correcta en los problemas descritos. El 63.04% de los padres generaron cambios en sus hábitos y en los de sus hijos. CONCLUSIÓN: El programa educativo implementado puede favorecer el empoderamiento en salud desde la infancia.

Educación para la salud en preescolares de guarderías / Health education in nursery preschoolers

Resumen Antecedentes: La promoción de la salud se realiza en servicios preventivos de unidades médicas, en programas educativos y libros de texto desde la perspectiva general de la población. Objetivo: Determinar características basales de educación en salud a preescolares, sus padres y maestros, mediante médicos especialistas. Método: Estudio transversal de un programa educativo para preescolares en estancias infantiles. Se evaluaron habilidades para la vida y competencias para la salud. Resultados: Los preescolares desarrollaron resiliencia (84.12%), empatía (92.23%), comunicación asertiva (93.5%), relaciones interpersonales (91.0%), toma correcta de decisiones correctas (92.56%), solución de problemas (81.05%), pensamiento creativo (98%), pensamiento crítico (86.08%), manejo de emociones (80.76%), activación física (97.94%), autoconocimiento (98.96%), hábitos higiénicos (94.90%) y corresponsabilidad (86.25%); al 95.59% les agradó el taller y el 95.75% eligió la opción correcta en los problemas descritos. El 63.04% de los padres generaron cambios en sus hábitos y en los de sus hijos. Conclusión: El programa educativo implementado puede favorecer el empoderamiento en salud desde la infancia.

Abstract Background: The promotion of health is carried out in preventive services of medical units, in educational programs and textbooks from the general perspective of the population. Objective: To determine baseline characteristics of health education for pre-school children, their parents and teachers, by means of specialist doctors. Method: Cross-sectional study of an educational program for preschool children. Life skills and health competencies were evaluated. Results: The preschoolers developed resilience (84.12%), empathy (92.23%), assertive communication (93.5%), interpersonal relationships (91.0%), correct decision making (92.56%), problem solving (81.05%), creative thinking (98%), critical thinking (86.08%), emotion management (80.76%), physical activation (97.94%), self-knowledge (98.96%), hygienic habits (94.90%) and co-responsibility (86.25%); 95.59% liked the workshop and 95.75% chose the correct option in the problems described. 63.04% of parents generated changes in their habits and those of their children. Conclusion: The educational program implemented can promote empowerment in health from childhood.

Bloqueo del plano del músculo erector espinal: estudio anatómico-cadavérico para determinar su mecanismo de acción / Erector spinae plane block: A cadaver study to determine its mechanism of action

Introducción: El bloqueo del plano del músculo erector (ESP) es una técnica novedosa para el tratamiento del dolor agudo y crónico. Su lugar y mecanismo de acción todavía no han sido explicados. Objetivos: Determinar el mecanismo de acción del anestésico local en el bloqueo ESP a través de la inyección del azul de metileno, describiendo su distribución desde la cara anterior del tórax. Hallar o determinar un paso o canal por el cual el anestésico atraviesa las estructuras musculares y óseas de posterior a anterior. Materiales y métodos: Se utilizaron 4 columnas de cadáveres frescos criopreservados. Se realizaron 9 bloqueos ESP ecoguiados en diferentes regiones de los especímenes con 20ml de azul de metileno al 0,01% por bloqueo. Se observó la distribución del colorante desde la cara anterior de tórax, midiendo la cantidad de espacios intercostales teñidos, antes y después de la extracción de la pleura parietal, y se registraron las estructuras en que se constató tintura. Resultados: En todos los bloqueos ESP se encontró colorante en el espacio paravertebral, los espacios intercostales y en algunos casos en la cadena prevertebral. Los bloqueos tuvieron un promedio de 4,6 espacios intercostales teñidos, con un máximo de 7 y un mínimo de 3. La intensidad del colorante fue mayor del lado de la inyección, dorsal a la columna, que el hallado en la parte ventral por debajo de la pleura. No se logró constatar un mecanismo claro por el que el colorante difundiera hacia el la zona anterior. Conclusiones: Por los datos recogidos en este trabajo se puede deducir que el bloqueo ESP tiene un mecanismo de acción anestésico similar a los bloqueos paravertebrales. El sitio por el cual el anestésico atravesaría desde el plano posterior de la columna a la región anterior del tórax no fue aclarado y debería ser investigado en futuros trabajos

Introduction: The erector spinae plane (ESP) block is a novel technique for the treatment of acute and chronic pain. Its mechanism and site of action has not yet been explained properly. Objectives: In order to explain the mechanism of action of the ESP block, injections were performed with methylene blue to simulate the local anaesthetics and to determine its distribution from the anterior side of the thorax. To find an aperture or channel through which the local anaesthetic passes from posterior to anterior through the muscular and bone structures. Materials and methods: Four spinal columns of fresh cryopreserved corpses were used. A total of 9 ultrasound-guided ESP blocks were performed in different regions of the specimens using 20ml of 0.01% methylene blue per block. The distribution of the dye was observed from the anterior side of the thorax, measuring the amount of intercostal spaces stained, before and after the removal of the parietal pleura, and the structures in which the stain was found were recorded. Results: In all blocks of the ESP, dye was found in the paravertebral space, intercostal spaces, and in some cases in the prevertebral chain. The blocks had a mean of 4.6 intercostal spaces stained, with a maximum of 7 and a minimum of 3. The intensity of the dye was greater on the side of the injection, dorsal to the column, than that found in the ventral part below of the pleura. It was not possible to verify a clear channel through which the dye diffuses towards the previous zone. Conclusions: From the data collected in this study, it can be deduced that the blockade of the ESP has a mechanism of anaesthetic action similar to paravertebral blocks. The site from which the anaesthetic would cross from the posterior plane of the spine to the anterior region of the thorax was not clear, and should be investigated in future works

Erector spinae plane block: A cadaver study to determine its mechanism of action. / Bloqueo del plano del músculo erector espinal: estudio anatómico-cadavérico para determinar su mecanismo de acción.

INTRODUCTION: The erector spinae plane (ESP) block is a novel technique for the treatment of acute and chronic pain. Its mechanism and site of action has not yet been explained properly. OBJECTIVES: In order to explain the mechanism of action of the ESP block, injections were performed with methylene blue to simulate the local anaesthetics and to determine its distribution from the anterior side of the thorax. To find an aperture or channel through which the local anaesthetic passes from posterior to anterior through the muscular and bone structures. MATERIALS AND METHODS: Four spinal columns of fresh cryopreserved corpses were used. A total of 9 ultrasound-guided ESP blocks were performed in different regions of the specimens using 20ml of 0.01% methylene blue per block. The distribution of the dye was observed from the anterior side of the thorax, measuring the amount of intercostal spaces stained, before and after the removal of the parietal pleura, and the structures in which the stain was found were recorded. RESULTS: In all blocks of the ESP, dye was found in the paravertebral space, intercostal spaces, and in some cases in the prevertebral chain. The blocks had a mean of 4.6 intercostal spaces stained, with a maximum of 7 and a minimum of 3. The intensity of the dye was greater on the side of the injection, dorsal to the column, than that found in the ventral part below of the pleura. It was not possible to verify a clear channel through which the dye diffuses towards the previous zone. CONCLUSIONS: From the data collected in this study, it can be deduced that the blockade of the ESP has a mechanism of anaesthetic action similar to paravertebral blocks. The site from which the anaesthetic would cross from the posterior plane of the spine to the anterior region of the thorax was not clear, and should be investigated in future works.

Anxiety and depression in women with breast cancer: Social and clinical determinants and influence of the social network and social support (DAMA cohort).

BACKGROUND: Anxiety and depression are the most prevalent mental health pathologies among women with breast cancer. Social, clinical and contextual variables may influence emotional stress among women with breast cancer. The aim of this work is to study anxiety and depression in a cohort of women diagnosed with breast cancer between 2003 and 2013 in Barcelona. We evaluate social and clinical determinants. METHODS: We performed a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were the Hospital Anxiety and Depression questionnaire and hospital medical records. Dependent variables were anxiety and depression; independent variables were social class, age, employment status, tumour stage at diagnosis, time since diagnosis, social network and social support. We performed a descriptive analysis, a bivariate analysis, and a multivariate logistic regression analysis. RESULTS: A total of 1086 (48.6%) women had some degree of anxiety-related problem. As for depression. In the case of depression, 225 (15%) women had some degree of depression-related problem. Low emotional support and social isolation were clear risk factors for having more anxiety and depression. Low social class was also a risk factor, and age also played a role. DISCUSSION: Our results show that women long period of cancer survival have high prevalences of anxiety than depression, and this prevalence of anxiety is higher than the general population. In addition, we found inequalities between social classes and the isolation and social support are worse too in low social class.

Evaluation of the plasmatic level of mepivacaine in different anatomical regions.

BACKGROUND: To evaluate the serum level of the local anesthetic mepivacaine 3% without vasoconstrictor in patients who underwent procedures performed in the anterior and posterior maxilla, through a method of possible extraction to quantify it in human plasma by high performance liquid chromatography (HPLC). MATERIAL AND METHODS: This was a hybrid study consisting of 18 patients (7 females and 11 males) classified as ASA I, adults and with normal body mass index, submitted to procedures in the anterior region (group I) and posterior region of the maxilla (group II). For 40 minutes, five 6 ml blood samples were collected every 10 minutes after infiltrative injection in each region of the maxilla. Serum levels of the drug were obtained through HPLC. Blood pressure (BP) and heart rate (HR) were measured throughout the procedure. RESULTS: When compared to the general average of the concentrations of each group, significant values (p <0.05) with greater absorption were observed for the anterior region of the maxilla (group I). There was no significant difference when comparing blood pressure (BP) and heart rate (HR) values. CONCLUSIONS: The concentrations found are safe for infiltrative anesthesia in the analyzed patients, there was a higher plasma level of the local anesthetic in the anterior region of the maxilla and there was no change in HR and BP in relation to the anesthetized area.

Review: Are we using probiotics correctly in post-weaning piglets?

Intensive farming may involve the use of diets, environments or management practices that impose physiological and psychological stressors on the animals. In particular, early weaning is nowadays a common practice to increase the productive yield of pig farms. Still, it is considered one of the most critical periods in swine production, where piglet performance can be seriously affected and where they are predisposed to the overgrowth of opportunistic pathogens. Pig producers nowadays face the challenge to overcome this situation in a context of increasing restrictions on the use of antibiotics in animal production. Great efforts are being made to find strategies to help piglets overcome the challenges of early weaning. Among them, a nutritional strategy that has received increasing attention in the last few years is the use of probiotics. It has been extensively documented that probiotics can reduce digestive disorders and improve productive parameters. Still, research in probiotics so far has also been characterized as being inconsistent and with low reproducibility from farm to farm. Scientific literature related to probiotic effects against gastrointestinal pathogens will be critically examined in this review. Moreover, the actual practical approach when using probiotics in these animals, and potential strategies to increase consistency in probiotic effects, will be discussed. Thus, considering the boost in probiotic research observed in recent years, this paper aims to provide a much-needed, in-depth review of the scientific data published to-date. Furthermore, it aims to be useful to swine nutritionists, researchers and the additive industry to critically consider their approach when developing or using probiotic strategies in weaning piglets.

Penile cancer in Maranhão, Northeast Brazil: the highest incidence globally?

BACKGROUND: The objectives of this study were to determine the minimum incidence of penile cancer in the poorest Brazilian state, and to describe the epidemiologic and clinical characteristics of patients diagnosed with the disease. METHODS: A retrospective study of 392 patients diagnosed with penile cancer in the three most important referral center in the state was conducted during 2004-2014. RESULTS: The age-standardized incidence was 6.15 per 100,000 and the crude annual incidence was 1.18 per 100,000. More than half (61.1%) of the tumors were histological grades 2 and 3, and 66.4% of tumors were classified as at least stage T2. The average age of patients was 58.6 ± 15.7 years (range, 18 to 103 years), with 20.8% of patients ≤40 years of age at diagnosis. The vast majority underwent penectomy (93%). Only 41.8% underwent lymphadenectomy, 58 patients (14.8%) received chemotherapy, and 54 patients (13.8%) received radiotherapy. Stage 3/4 and vascular invasion were statically significant at disease-free survival analysis. CONCLUSION: The state of Maranhão has the highest incidence of penile cancer in Brazil and globally. Tumors are locally advanced and at the time of diagnosis, and there is a high frequency among young individuals. Patients have a low socioeconomic status, making it difficult to complete treatment and receive appropriate follow-up.