Memory in female adolescents with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

INTRODUCTION: In females with congenital adrenal hyperplasia (CAH), the influence of hyperandrogenism and glucocorticoid supplementation on neurocognition is controversial. OBJECTIVES: To identify possible differences in visual working memory and verbal memory in adolescent girls with CAH due to 21-hydroxylase deficiency and matched controls. Moreover, to study if any relationship between variables associated with CAH and the scores of the selected memory tests was present. MATERIAL AND METHODS: In total 39 individuals were studied, female adolescents with CAH and age and pubertal stage matched healthy male and female controls (13 in each group). Sociodemographic, clinical, hormonal, and neurocognitive variables were explored. In female adolescents with CAH, variables related to the disease (age at diagnosis, clinical form, time since diagnosis, and glucocorticoid doses) were correlated with the scores obtained for neurocognitive variables. RESULTS: The mean age was 13.9 ± 3.3 years. In female adolescents with CAH the results were worse compared to controls in Free Recall (p = 0.039) and in Visual Memory Span score (p = 0.016). Age at diagnosis was negatively correlated to number of hits (p = 0.04), number recalled backward (p = 0.03), Visual Memory Span test score (p = 0.04) and Total Free Recall (p = 0.04), i.e., memory was worse with later diagnosis. CONCLUSIONS: Female adolescents with CAH had worse visual working memory compared to matched controls, but not in verbal memory. Age at diagnosis was negatively associated with the memory tests.

Brazilian indigenous nonstarter lactic acid bacteria enhance the diversification of volatile compounds in short-aged cheese.

There is growing interest in using autochthonous lactic acid bacteria (LAB) that provide unique sensory characteristics to dairy products without affecting their safety and quality. This work studied the capacity of three Brazilian indigenous nonstarter LABs (NSLAB) to produce biogenic amines (BAs) and evaluated their effect on the volatile organic compounds (VOCs), microbial LAB communities, and physicochemical profile of short-aged cheese. Initially, the strain's potential for biosynthesis of BAs was assessed by PCR and in vitro assays. Then, a pilot-scale cheese was produced, including the NSLAB, and the microbial and VOC profiles were analyzed after 25 and 45 days of ripening. As a results, the strains did not present genes related to relevant BAs and did not produce them in vitro. During cheese ripening, the Lactococci counts were reduced, probably in the production of alcohols and acid compounds by the NSLAB. Each strain produces a unique VOC profile that changes over the ripening time without the main VOCs related to rancid or old cheese. Particularly, the use of the strain Lacticaseibacillus. paracasei ItalPN16 resulted in production of ester compounds with fruity notes. Thus, indigenous NSLAB could be a valuable tool for the enhancement and diversification of flavor in short-aged cheese.

PEGylation Strategy for Improving the Pharmacokinetic and Antitumoral Activity of the IL-2 No-alpha Mutein.

BACKGROUND: In a previous work, an IL-2Rßγ biased mutant derived from human IL-2 and called IL-2noα, was designed and developed. Greater antitumor effects and lower toxicity were observed compared to native IL-2. Nevertheless, mutein has some disadvantages, such as a very short half-life of about 9-12 min, propensity for aggregation, and solubility problems. OBJECTIVE: In this study, PEGylation was employed to improve the pharmacokinetic and antitumoral properties of the novel protein. METHODS: Pegylated IL-2noα was characterized by polyacrylamide gel electrophoresis, size exclusion chromatography, in vitro cell proliferation and in vivo cell expansion bioassays, and pharmacokinetic and antitumor studies. RESULTS: IL-2noα-conjugates with polyethylene glycol (PEG) of 1.2 kDa, 20 kDa, and 40 kDa were obtained by classical acylation. No significant changes in the secondary and tertiary structures of the modified protein were detected. A decrease in biological activity in vitro and a significant improvement in half-life were observed, especially for IL-2noα-PEG20K. PEGylation of IL-2noα with PEG20K did not affect the capacity of the mutant to induce preferential expansion of T effector cells over Treg cells. This pegylated IL-2noα exhibited a higher antimetastatic effect compared to unmodified IL-2noα in the B16F0 experimental metastases model, even when administered at lower doses and less frequently. CONCLUSION: PEG20K was selected as the best modification strategy, to improve the blood circulation time of the IL-2noα with a superior antimetastatic effect achieved with lower doses.

DyMnO3: Synthesis, Characterization and Evaluation of Its Photocatalytic Activity in the Visible Spectrum.

DyMnO3 is a p-type semiconductor oxide with two crystal systems, orthorhombic and hexagonal. This material highlights its ferroelectric and ferromagnetic properties, which have been the subject of numerous studies. Nevertheless, its photocatalytic activity has been less explored. In this work, the photocatalytic activity of DyMnO3 is evaluated through the photodegradation of MG dye. For the synthesis of this oxide, a novel and effective method was used: polymer-decomposition. The synthesized powders contain an orthorhombic phase, with a range of absorbances from 300 to 500 nm and a band gap energy of 2.4 eV. It is also highlighted that, when using this synthesis method, some of the main diffraction lines related to the orthorhombic phase appear at 100 °C. Regarding its photocatalytic activity, it was evaluated under visible light (λ = 405 nm), reaching a photodegradation of approximately 88% in a period of 30 min. Photocurrent tests reveal a charge carrier separation (e-,h+) at a 405 nm wavelength. The main reactive oxygen species (ROS) involved in the photodegradation process were radicals, OH•, and photo-holes (h+). These results stand out because it is the first time that the photodegradation capability of this oxide in the visible spectrum has been evaluated.

Modelling the Unidentified Abortion Burden from Four Infectious Pathogenic Microorganisms (Leptospira interrogans, Brucella abortus, Brucella ovis, and Chlamydia abortus) in Ewes Based on Artificial Neural Networks Approach: The Epidemiological Basis for a Control Policy.

Unidentified abortion, of which leptospirosis, brucellosis, and ovine enzootic abortion are important factors, is the main cause of disease spread between animals and humans in all agricultural systems in most developing countries. Although there are well-defined risk factors for these diseases, these characteristics do not represent the prevalence of the disease in different regions. This study predicts the unidentified abortion burden from multi-microorganisms in ewes based on an artificial neural networks approach and the GLM. METHODS: A two-stage cluster survey design was conducted to estimate the seroprevalence of abortifacient microorganisms and to identify putative factors of infectious abortion. RESULTS: The overall seroprevalence of Brucella was 70.7%, while Leptospira spp. was 55.2%, C. abortus was 21.9%, and B. ovis was 7.4%. Serological detection with four abortion-causing microorganisms was determined only in 0.87% of sheep sampled. The best GLM is integrated via serological detection of serovar Hardjo and Brucella ovis in animals of the slopes with elevation between 2600 and 2800 meters above sea level from the municipality of Xalatlaco. Other covariates included in the GLM, such as the sheep pen built with materials of metal grids and untreated wood, dirt and concrete floors, bed of straw, and the well water supply were also remained independently associated with infectious abortion. Approximately 80% of those respondents did not wear gloves or masks to prevent the transmission of the abortifacient zoonotic microorganisms. CONCLUSIONS: Sensitizing stakeholders on good agricultural practices could improve public health surveillance. Further studies on the effect of animal-human transmission in such a setting is worthwhile to further support the One Health initiative.

Mortality Prognosis Factors in Patients with Active Cancer Under Treatment, and Severe COVID-19.

BACKGROUND: COVID-19 is associated with systemic inflammation. This inflammatory response is further deregulated by oncological treatments increasing mortality in this population. However, there is conflicting information regarding the clinical factors that increase mortality in patients with severe COVID-19. OBJECTIVE: The aim of this study was to identify prognostic factors associated with mortality during severe COVID-19 in patients with active cancer. In addition, the correlation between oncologic codes and mortality related to severe COVID-19 was evaluated. PATIENTS AND METHODS: We analyzed a cohort of Mexican patients with active cancer and severe COVID-19 between March 2020 and February 2021. We collected information on patient demographic characteristics, COVID-19 symptoms, clinical and laboratory data, and treatments. Patients were classified according to oncologic code. We defined the oncological code based on clinical stage, treatment intention, performance status before COVID-19, and median overall survival with palliative treatment. A log-rank test was performed to determine survival. A multivariate logistic regression model was used to adjust for potential confounders. RESULTS: One hundred fifty-two patients with severe COVID-19 were analyzed. The red oncologic code was associated with an increased risk of mortality OR 22.8 (CI 95% 5.0-105.1, p <0.001), low oxygen saturation OR 5.4 (CI 95% 1.7-17.4, p = 0.005), chronic corticosteriod use OR 4.3 (CI 95% 1.0-18.1, p = 0.050) and high D-dimer level OR 3.2 (CI 95% 1.2-8.2, p = 0.019). CONCLUSIONS: The survival of patients with active cancer and severe COVID-19 was possible to identify, at the time of admission, specific oncological characteristics. Based on this code, decreased oxygen saturation, increased D-dimer levels, and chronic corticosteroid use were the main predictive factors related to mortality.

Determining the Photoelectrical Behavior and Photocatalytic Activity of an h-YMnO3 New Type of Obelisk-like Perovskite in the Degradation of Malachite Green Dye.

YMnO3 is a P-type semiconductor with a perovskite-type structure (ABO3). It presents two crystalline systems: rhombohedral and hexagonal, the latter being the most stable and studied. In the hexagonal system, Mn3+ ions are coordinated by five oxygen ions forming a trigonal bipyramid, and the Y3+ ions are coordinated by five oxygen ions. This arrangement favors its ferroelectric and ferromagnetic properties, which have been widely studied since 1963. However, applications based on their optical properties have yet to be explored. This work evaluates the photoelectric response and the photocatalytic activity of yttrium manganite in visible spectrum wavelengths. To conduct this, a rod-obelisk-shaped yttrium manganite with a reduced indirect bandgap value of 1.43 eV in its hexagonal phase was synthesized through the precipitation method. The synthesized yttrium manganite was elucidated by solid-state techniques, such as DRX, XPS, and UV-vis. It was non-toxic as shown by the 100% leukocyte viability of mice BALB/c.

Abscesos Hepáticos Piógenos Múltiples: ¿Una Patología Superada O Un Reto Médico Vigente?: Un Caso A Recordar

El absceso hepático piógeno es una patología que aún en nuestros días supone un reto médico, ya que su curso clínico suele ser grave, el diagnóstico frecuentemente tardío y la mortalidad elevada. En las últimas décadas hemos asistido a diversos avances, como la introducción de los antibióticos de amplio espectro y el desarrollo de técnicas de imagen e intervencionistas que han mejorado la eficacia diagnóstica y el pronóstico de esta patología. Pese a ello, la presencia de abscesos hepáticos piógenos múltiples no es una patología superada y presentamos un caso clínico que ilustre esta patología y justifique que ha de tenerse en cuenta en el arsenal diagnóstico para poder tratarlo precozmente y disminuir así su alta morbimortalidad. (provisto por Infomedic International)

Pyogenic liver abscess is a pathology that still poses a medical challenge today, since its clinical course is usually severe, diagnosis is often late, and mortality is high. In recent decades we have witnessed several advances, such as the introduction of broad-spectrum antibiotics and the development of imaging and interventional techniques that have improved the diagnostic efficacy and prognosis of this pathology. Despite this, the presence of multiple pyogenic liver abscesses is not a pathology that has been overcome and we present a clinical case that illustrates this pathology and justifies that it must be considered in the diagnostic arsenal in order to treat it early and thus reduce its high morbimortality. (provided by Infomedic International)

CONTROL DE Aedes aegypti (DIPTERA: CULICIDAE) MEDIANTE ACTINOBACTERIAS FORMADORAS DE BIOPELÍCULAS / Control of Aedes aegypti (Díptera: Culicidae) by means of biofilm-forming actinobacteria

RESUMEN Las actinobacterias incluyen miembros productores de compuestos multipropósitos restringidamente sobreexplotados al género Streptomyces. No obstante, es necesario reorientar la exploración de bacterias no estreptomiceas para el uso de nuevos bioagentes ecológicos con miras a evitar redescubrimientos y contrarrestar la resistencia a insecticidas químicos en Aedes aegypti. En esta investigación, se caracterizó actinobacterias formadoras de biopelículas para evaluar su dinámica de crecimiento, actividad larvicida y efectos subletales. La identificación, crecimiento y bioactividades de los patógenos se realizaron por cultivos, análisis de imágenes por fotomicrografía y bioensayos. Las biopelículas pertenecen a Pseudonocardiaceae (PsA1TA) y Corynebacteriaceae (CoA2CA) característicamente dependientes a crecer sobre sustratos con revestimiento cuticular específico. PsA1TA coloniza estructuras membranosas de tórax y abdomen de larvas. Las microcolonias desarrollan infectivamente a biopelículas mono y biestratificadas hasta cubrir cuatro veces la amplitud toracoabdominal (envergadura infectiva entre 1010 μm a 1036 μm). En contraste, CoA2CA envuelve radialmente estructuras esclerotizadas cefálica y anal al triplicar la amplitud de los órganos infectados (envergadura infectiva: 1820 a 2030 μm y 1650 a 1860 μm, respectivamente). Las biopelículas ejercen mortalidad diferenciada a todas las etapas larvarias, no obstante, PsA1TA resultó más mortal y virulento frente al segundo estadio (58 %-96 horas, TL50: 3,4 días), mientras que CoA2CA lo fue sobre el cuarto estadio larval (85 %-96 horas, TL50: 2,5 días). CoA2CA indujo emergencia incompleta de farados y despliegue de tarsos curvos en adultos emergentes, además de revestir cadáveres larvarios con robustas biopelículas. Los morfotipos actinobacterianos revelan efecto larvicida y subletal en A. aegypti por formación de biopelículas.

ABSTRACT Actinobacteria include several ubiquitous members involved in the synthesis of multipurpose bioactive compounds strictly derived from the genus Streptomyces. Nevertheless, new bacterial consortia based on non-streptomycetes actinobacteria are needed to be explored in order to avoid rediscoveries and minimize the development of insecticide resistance in Aedes aegypti. In accordance with the use of eco-friendly bioagents, in this study biofilm-forming actinobacteria were characterized on the basis of assessment their growth dynamics, larvicidal mortality and sublethal effects. Actinobacteria identification, biofilm growth and larvicidal bioactivities were performed by employing bacterial cultures, photomicrograph-based image analysis and bioassays. Bacterial morphotypes belong to Pseudonocardiaceae (PsA1TA) and Corynebacteriaceae (CoA2CA), which showed a distinctly substrate-dependent growth. PsA1TA microcolonies were randomly distributed on abdominal and thoracic membranous epicuticle. Afterwards, the thickness of mono-and bi-layered biofilms were increased fourfold the larval thoracoabdominal width (infectious breadth, 1010 μm - 1036 μm). In contrast, cephalic and anal sclerotized structures were radially encased by CoA2CA biofilms and increased threefold the size of both structures (infectious breadth, 1820 - 2030 μm y 1650 - 1860 μm, respectively). Although biofilms caused dissimilar mortality rates on the four larval instars, PsA1TA exerted highest larvicidal activity and virulence on second instar larvae (58 %-96 hours, LT50: 3.4 days) y CoA2CA on fourth instar larvae (85 %-96 hours, LT5G: 2.5 days). CoA2CA also induced incomplete release of pharate individuals as well as buckled protruding tarsi in newly emergent adults, whilst larval cadavers were overwhelmingly encased within massive biofilm aggregates. Biofilm-forming actinobacteria performed biolarvicidal activity and sublethal responses in A. aegypti.

Evaluation of Inhibitory Activity In Silico of In-House Thiomorpholine Compounds between the ACE2 Receptor and S1 Subunit of SARS-CoV-2 Spike.

At the end of 2019, the world was struck by the COVID-19 pandemic, which resulted in dire repercussions of unimaginable proportions. From the beginning, the international scientific community employed several strategies to tackle the spread of this disease. Most notably, these consisted of the development of a COVID-19 vaccine and the discovery of antiviral agents through the repositioning of already known drugs with methods such as de novo design. Previously, methylthiomorphic compounds, designed by our group as antihypertensive agents, have been shown to display an affinity with the ACE2 (angiotensin converting enzyme) receptor, a key mechanism required for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) entry into target cells. Therefore, the objective of this work consists of evaluating, in silico, the inhibitory activity of these compounds between the ACE2 receptor and the S1 subunit of the SARS-CoV-2 spike protein. Supported by the advances of different research groups on the structure of the coronavirus spike and the interaction of the latter with its receptor, ACE2, we carried out a computational study that examined the effect of in-house designed compounds on the inhibition of said interaction. Our results indicate that the polyphenol LQM322 is one of the candidates that should be considered as a possible anti-COVID-19 agent.

Efecto tóxico de los extractos de semillas de Annona muricata potenciados con dimetilsulfóxido sobre larvas IV y pupas de Aedes aegypti / Toxic effect of Annona muricata seed extracts potentiated with dimethyl sulfoxide on IV larvae and pupae of Aedes aegypti

Resumen El objetivo de este estudio fue demostrar que los principios activos de las semillas de Annona muricata combinados con el extracto etanólico y dimetilsulfóxido (EE-DMSO), incrementan la mortalidad de larvas IV y pupas de Aedes aegypti con relación a extractos acuosos (EA) y extractos etanólicos (EE). Las bioactividades se calcularon por comparación de los porcentajes de mortalidad a las 6, 12, 24 y 48 horas in vitro y campo simulado. Los resultados indicaron mortalidad progresiva dependiente de las concentraciones y tiempos de exposición en larvas y reacción knock-down en pupas. In vitro a 5 mg.L-1, EA y EE ejercieron 100% de mortalidad larvaria en 24 horas de exposición (CL50=46.16 y 19.28 mg.L-1 respectivamente), en contraste con EE-DMSO, que inició sobre 62% con 0.5 mg.L-1 a las 6 horas (CL50=20.33 mg.L-1). La acción pupicida de EA y EE reveló 100% de mortalidad desde 24 horas en todas las concentraciones, a diferencia de EE-DMSO que se alcanzó entre 6 y 12 horas. En campo simulado, EA y EE ejercieron 100% de mortalidad a las 24 horas en larvas (16.91 y 21.21 mg.L-1 ), mientras que en pupas (20.44 y 23.03 mg.L-1) ocurrió a las 12 horas, entretanto, la actividad pupicida de EE-DMSO fue 100% en 6 horas. Los efectos comparativos in vitro y campo simulado denotaron patrones similares de respuestas larvicida y pupicida, pero con mayor sensibilidad en pupas. Los principios activos de las semillas de A. muricata combinados con EE-DMSO potencian la respuesta mortal de larvas y pupas de A. aegypti in vitro y campo simulado.

Abstract The objective of this study was to demonstrate that active ingredients of Annona muricata seeds can be enhanced as a result of mixture of both ethanolic extract of A. muricata seeds and Dimethylsulfoxide (EE-DMSO). Percentage mortalities at 6, 12, 24 and 48 hours on fourth instar larvae and pupae of Aedes aegypti were calculated in order to compare bioactivities of aqueous (AE), ethanolic extracts (EE) and EE-DMSO under laboratory and simulated field conditions. Results showed larval mortality concentration- and time-dependent, and knock-down responses in pupae. In laboratory, AE and EE exerted 100% larval mortality at 5 mg.L-1 after 24 hours (LC50= 46.16 and 19.28 mg.L-1). Conversely, EE-DMSO showed between 62 - 100% mortality at 0.5 mg.L-1 for over 6 hours (LC50= 20.33 mg.L-1). Pupicidal effects in AE and EE revealed 100% mortality at 24 hours employing all concentrations, except in EE-DMSO which commenced when individuals were exposed between 6 and 12 hours. In simulated field, AE and EE provoked 100% larval mortality at 24 hours (16.91 y 21.21 mg.L-1) while pupal mortality at 12 hours (20.44 y 23.03 mg.L-1). Percentage mortality of pupae was 100% using EE-DMSO even before 6 hours. Comparative toxic effects of laboratory and simulated-field systems have shown to maintain a similar pattern of larval mortality and more sensitive responses in pupae. Accordingly, larval and pupal mortality responses of A. aegypti were enhanced with the use of EE-DMSO and active ingredients of A. muricata seeds under laboratory and simulated field conditions.

Prognostic importance of lymph node ratio after resection of ampullary carcinomas.

BACKGROUND: The prognosis of the lymph node ratio (LNR) in Vater's ampulla carcinomas (VACs) is recently studied. However, there are not enough data in several populations like Latin American people. Our aim is to demonstrate the prognosis significance of the LNR in this setting. METHODS: Pancreaticoduodenectomies for VACs were identified (n=128) from 1980 through 2015. Based on a ROC curve, a cut-off point of 0.1 was assigned for the LNR and the population was divided into two groups for comparison. RESULTS: The LNR ≥0.1 group was statistically significant associated with recurrence (38.5% vs. 19.5%), pT3-T4 tumors (69.2% vs. 29.3%), poorly differentiated tumors (46.2% vs. 17.5%), lymphovascular invasion (61.5 vs. 17.1%), perineural invasion (38.5% vs. 19.5%), and positive margins (15.4% vs. 2.4%). In the multivariate analysis, LNR (HR 2.891; CI: 1.987-3.458, P=0.02), LNM (HR 2.945; CI: 2.478-3.245, P=0.002), perineural invasion (HR 3.327; CI: 3.172-4.156, P=0.003), and recurrence (HR 3.490; CI: 2.896-4.122, P=0.001) were associated with lower survival. CONCLUSIONS: The LNR is a good predictor of survival and worse oncological outcomes for VACs after resection.

Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability.

INTRODUCTION: Colorectal medullary carcinoma (MC) is a rare subtype of poorly differentiated adenocarcinoma (PDA) with unclear prognostic significance. Microsatellite instable (MSI) colorectal carcinomas have demonstrated better prognosis in clinical stage II. AIM: To analyze the survival and clinicopathological characteristics of MCs versus PDAs with MSI in clinical stage III. MATERIAL AND METHODS: We studied 22 cases of PDAs with MSI versus 10 MCs. RESULTS: Of the 10 MCs, 7 patients were men; the mean age was 57.8 ±5.6 years. The mean tumor size was 9.6 ±4.1 cm, and the primary site was the right colon in 9; 7 patients showed lymph node metastases (LNM) and lymphovascular invasion (LVI). Of the 22 PDA cases, 12 (54.5%) were women with a mean age of 75 ±16.1 years. The mean tumor size was 6.4 ±3.2 cm. Twelve (54.5%) presented in the right colon, 21 (95.5%) showed LNM and 7 (31.8%) LVI. Follow-up was 32 ±8 months, with a 5-year overall survival of 42.9% for MCs and 76.6% for PDAs (p = 0.048). Univariate analysis found local recurrence (p = 0.001) and medullary subtype (p = 0.043) associated with lower survival. CONCLUSIONS: Medullary carcinomas were of greater tumor size and associated with more LVI and worse survival versus PDAs with MSI in stage III.

La ablación de fibrilación auricular en España

Introducción: la ablación de la fibrilación auricular es uno de los procedimientos más frecuentemente realizados en las unidades de arritmias. La información de los resultados proviene de estudios prospectivos, registros multicéntricos y registros nacionales. Objetivo: evaluar la situación de la ablación de la fibrilación auricular en España a través de los datos recogidos en el Registro Español de Ablación, auspiciado por la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología. Métodos: los datos analizados provienen de los formularios remitidos, de forma voluntaria y anónima, por los diferentes centros hospitalarios, tanto de financiación pública como privada, durante el período 2008-2013. Cada centro fue analizado, año a año, de forma independiente. Analizamos los recursos humanos y materiales de los centros que realizaron procedimientos de ablación de fibrilación auricular durante ese período de tiempo. Asimismo, analizamos la técnica utilizada, el tipo de energía, complicaciones, etcétera. Comparamos todas las variables de forma evolutiva, año a año. Dividimos a los centros en función del número de procedimientos de ablación realizados cada año: 1-49, grupo A; 50-99, grupo B, y 100 o más, grupo C. Resultados: trescientos noventa y un centros (n=391) y 8.926 procedimientos de ablación fueron analizados. Año a año ha aumentado el número de centros que realizan ablación de fibrilación auricular y el número de procedimientos que realiza cada centro. El porcentaje de complicaciones se ha mantenido estable reduciéndose ligeramente la mortalidad. Los centros con mayor volumen tienen mayor dotación de recursos humanos y materiales. Realizan ablación de fibrilación auricular persistente con mayor frecuencia y realizan crioablación con menor frecuencia. Asimismo, estos centros tienen una menor incidencia de complicaciones. Conclusiones: la ablación de fibrilación auricular en España ha aumentado en los últimos años y presenta resultados similares a los recogidos en otros registros nacionales y multinacionales.

Hematoma retroperitoneal tras punción lumbar diagnóstica. Caso clínico / Retroperitoneal haematoma following diagnostic lumbar puncture. Clinical case

Introduction: Iatrogenic retroperitoneal haematoma is an infrequent but serious complication of certain surgical procedures. Case presentation: We present the case of a female who developed retroperitoneal haemorrhage after an intradural lumbar puncture, resulting in multiple-organ failure. The diagnosis and treatment of this complication was more difficult than usual because of the presence of bilateral subclavian artery stenosis. Conclusion: Early diagnosis and prompt treatment with either conservative or interventional management is essential in order to decrease associated morbidity. Bilateral non-invasive arterial pressure measurements should be routinely performed in all cases, especially in patients with peripheral artery disease.

Introducción: El hematoma retroperitoneal iatrogénico es una complicación infrecuente pero, en ocasiones, de consecuencias fatales. Presentación del caso: En este artículo describimos el caso de una mujer que sufrió una hemorragia retroperitoneal secundaria a una punción lumbar intradural con evolución hacia el fallo multiorgánico, agravado en su manejo por la presencia de estenosis bilateral de arterias subclavias que dificultó el diagnóstico y el tratamiento. Conclusión: Un diagnóstico precoz y certero del hematoma retroperitoneal, unido a las medidas de soporte necesarias y a un abordaje quirúrgico eficiente cuando se requiera, se antojan fundamentales para evitar un desenlace mortal. Por otro lado, la medición de la presión arterial de forma bilateral debe ser una medida rutinaria en todos los pacientes, pero más aún en aquellos casos con enfermedad arterial periférica.

An Exopolysaccharide-Deficient Mutant of Lactobacillus rhamnosus GG Efficiently Displays a Protective Llama Antibody Fragment against Rotavirus on Its Surface.

Rotavirus is the leading cause of infantile diarrhea in developing countries, where it causes a high number of deaths among infants. Two vaccines are available, being highly effective in developed countries although markedly less efficient in developing countries. As a complementary treatment to the vaccines, a Lactobacillus strain producing an anti-rotavirus antibody fragment in the gastrointestinal tract could potentially be used. In order to develop such an alternative therapy, the effectiveness of Lactobacillus rhamnosus GG to produce and display a VHH antibody fragment (referred to as anti-rotavirus protein 1 [ARP1]) on the surface was investigated. L. rhamnosus GG is one of the best-characterized probiotic bacteria and has intrinsic antirotavirus activity. Among four L. rhamnosus GG strains [GG (CMC), GG (ATCC 53103), GG (NCC 3003), and GG (UT)] originating from different sources, only GG (UT) was able to display ARP1 on the bacterial surface. The genomic analysis of strain GG (UT) showed that the genes welE and welF of the EPS cluster are inactivated, which causes a defect in exopolysaccharide (EPS) production, allowing efficient display of ARP1 on its surface. Finally, GG (UT) seemed to confer a level of protection against rotavirus-induced diarrhea similar to that of wild-type GG (NCC 3003) in a mouse pup model, indicating that the EPS may not be involved in the intrinsic antirotavirus activity. Most important, GG (EM233), a derivative of GG (UT) producing ARP1, was significantly more protective than the control strain L. casei BL23.

Implicaciones para el desarrollo de las personas a través de la formación del profesorado en entornos donde existen procesos universales de desarrollo, mediada por interacciones virtuales / Implications for the development of people through teacher training in settings in which there are universal developmental processes, mediated by virtual interaction

El presente texto, recoge las discusiones y reflexiones derivadas de variasinvestigaciones en las que se describe, analiza y evidencia la participación de los actores que conforman la actual sociedad de la información como constantes de la educación superior en México, los paliativos que de ella se emanan, la transmisión de información y los procesos de formación actuales, el desafío de construir signos y símbolos cuando las señales ya no son controladas por el dispositivo pedagógico tradicional lo que exige, en un contexto cambiante, que la educación superior no sea más un interior autosuficiente, posibilitando la producción de subjetividades por las clases disciplinares y de control, legitimadas por medio de viejas y nuevas tecnologías.

The present text, includes discussions and reflections derived from several studies in which the participation of the actors that make up the current information society as constants of higher education in Mexico are described, analyzed, and madeevident, as well as the palliatives emanating from it, transmission of information and the current training processes, the challenge of building signs and symbols when the signals are no longer controlled by the traditional pedagogical device, which requires, in a changing context, that higher education is no longer a selfsufficient interior, making the production of subjectivity possible by the disciplinary and control classes, legitimized by means of old and new technologies.

The goal of blood pressure in the hypertensive patient with diabetes is defined: now the challenge is go from recommendations to practice.

The recent Latin American and European guidelines published this year has proposed as a goal for blood pressure control in patients with diabetes type 2 a value similar or inferior to 140/90 mmHg. High blood pressure is the leading cause of cardiovascular diseases and deaths globally. Although once hypertension is detected, 80% of individuals are on a pharmacologic therapy only a minority is controlled. Diabetes also is a risk factor for other serious chronic diseases, including cardiovascular disease. Whether specifically targeting lower fasting glucose levels can reduce cardiovascular outcomes remains unknown. Hypertension is present in 20% to 60% of patients with type 2 diabetes, depending on age, ethnicity, obesity, and the presence of micro or macro albuminuria. High blood pressure substantially increases the risk of both macro and micro vascular complications, doubling the risk of all-cause mortality and stroke, tripling the risk of coronary heart disease and significantly hastening the progression of diabetic nephropathy, retinopathy, and neuropathy. Thus, blood pressure lowering is a major priority in preventing cardiovascular and renal events in patients with diabetes and hypertension. During many years the BP goals recommended in patients with diabetes were more aggressive than in patients without diabetes. As reviewed in this article many clinical trials have demonstrated not only the lack of benefits of lowering the BP below 130/80 mmHg, but also the J-shaped relationship in DM patients. Overall we discuss the importance of define the group of patients in whom significant BP reduction could be particularly dangerous and, on the other hand, those with a high risk of stroke who could benefit most from an intensive hypotensive therapy. In any case, the big challenge now is avoid the therapeutic inertia (leaving diabetic patients with BP values of 140/90 mmHg or higher) at all costs, as this would lead to an unacceptable toll in terms of human lives, suffering, and socioeconomic costs.

Primary orbital mesenchymal chondrosarcoma: case report and review of the literature.

Orbital mesenchymal chondrosarcoma is a very uncommon lesion of the bone and extraskeletal tissue. To our knowledge, approximately 30 cases have been described. We present the case of a 52-year-old male who presented with a history of progressive proptosis and chemosis of the right eye caused by an orbital tumor. He underwent exenteration of the right orbit, and the histological examination revealed a mesenchymal orbital chondrosarcoma. This paper attempts to describe a rare entity that should be considered in the differential diagnosis of calcified orbital lesions, especially in young adults. Complete removal of the tumor is the mainstay of treatment, but adjuvant radiation therapy and chemotherapy should be considered.

Questionnaire of executive function for dancers: an ecological approach.

There is a current debate about the ecological validity of executive function (EF) tests. Consistent with the verisimilitude approach, this research proposes the ballet executive scale (BES), a self-rating questionnaire that assimilates idiosyncratic executive behaviors of classical dance community. The BES was administrated to 149 adolescents, students of the Cuban Ballet School. Results present a Cronbach's alpha coefficient of .80 and a split-half Spearman-Brown coefficient r (SB) = .81. An exploratory factor analysis describes a bifactorial pattern of EF dimensions, with a self-regulation component, which explains more than 40% of variance, and a Developmental component, which accounts for more than 20% of variance. The questionnaire's total scores fit linear regression models with two external criteria of academic records, confirming concurrent validity. These findings support the hypothesis that the internalization of specific contextual cultural meanings has a mediating influence in the development of EF.