Sweet Cherry Plants Prioritize Their Response to Cope with Summer Drought, Overshadowing the Defense Response to Pseudomonas syringae pv. syringae.

Disease severity and drought due to climate change present significant challenges to orchard productivity. This study examines the effects of spring inoculation with Pseudomonas syringae pv. syringae (Pss) on sweet cherry plants, cvs. Bing and Santina with varying defense responses, assessing plant growth, physiological variables (water potential, gas exchange, and plant hydraulic conductance), and the levels of abscisic acid (ABA) and salicylic acid (SA) under two summer irrigation levels. Pss inoculation elicited a more pronounced response in 'Santina' compared to 'Bing' at 14 days post-inoculation (dpi), and those plants inoculated with Pss exhibited a slower leaf growth and reduced transpiration compared to control plants during 60 dpi. During differential irrigations, leaf area was reduced 14% and 44% in Pss inoculated plants of 'Bing' and 'Santina' respectively, under well-watered (WW) conditions, without changes in plant water status or gas exchange. Conversely, water-deficit (WD) conditions led to gas exchange limitations and a 43% decrease in plant biomass compared to that under WW conditions, with no differences between inoculation treatments. ABA levels were lower under WW than under WD at 90 dpi, while SA levels were significantly higher in Pss-inoculated plants under WW conditions. These findings underscore the influence on plant growth during summer in sweet cherry cultivars that showed a differential response to Pss inoculations and how the relationship between ABA and SA changes in plant drought level responses.

Time Course of Mechanical Ventilation Driving Pressure Levels in Pediatric Acute Respiratory Distress Syndrome: Outcomes in a Prospective, Multicenter Cohort Study From Colombia, 2018-2022.

OBJECTIVES: High driving pressure (DP, ratio of tidal volume (V t ) over respiratory system compliance) is a risk for poor outcomes in patients with pediatric acute respiratory distress syndrome (PARDS). We therefore assessed the time course in level of DP (i.e., 24, 48, and 72 hr) after starting mechanical ventilation (MV), and its association with 28-day mortality. DESIGN: Multicenter, prospective study conducted between February 2018 and December 2022. SETTING: Twelve tertiary care PICUs in Colombia. PATIENTS: One hundred eighty-four intubated children with moderate to severe PARDS. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The median (interquartile range [IQR]) age of the PARDS cohort was 11 (IQR 3-24) months. A total of 129 of 184 patients (70.2%) had a pulmonary etiology leading to PARDS, and 31 of 184 patients (16.8%) died. In the first 24 hours after admission, the plateau pressure in the nonsurvivor group, compared with the survivor group, differed (28.24 [IQR 24.14-32.11] vs. 23.18 [IQR 20.72-27.13] cm H 2 O, p < 0.01). Of note, children with a V t less than 8 mL/kg of ideal body weight had lower adjusted odds ratio (aOR [95% CI]) of 28-day mortality (aOR 0.69, [95% CI, 0.55-0.87]; p = 0.02). However, we failed to identify an association between DP level and the oxygenation index (aOR 0.58; 95% CI, 0.21-1.58) at each of time point. In a diagnostic exploratory analysis, we found that DP greater than 15 cm H 2 O at 72 hours was an explanatory variable for mortality, with area under the receiver operating characteristic curve of 0.83 (95% CI, 0.74-0.89); there was also increased hazard for death with hazard ratio 2.5 (95% CI, 1.07-5.92). DP greater than 15 cm H 2 O at 72 hours was also associated with longer duration of MV (10 [IQR 7-14] vs. 7 [IQR 5-10] d; p = 0.02). CONCLUSIONS: In children with moderate to severe PARDS, a DP greater than 15 cm H 2 O at 72 hours after the initiation of MV is associated with greater odds of 28-day mortality and a longer duration of MV. DP should be considered a variable worth monitoring during protective ventilation for PARDS.

Pelvic lymph node involvement and risk of recurrence in HPV-associated endocervical adenocarcinoma stage IA2-IB1 according to Silva's system in two Colombian cancer centers.

OBJECTIVE: To compare the pelvic lymph node involvement and risk of recurrence in patients with human papillomavirus (HPV)-associated endocervical adenocarcinoma stage IA2-IB1 undergoing hysterectomy and/or trachelectomy plus lymphadenectomy, according to Silva's classification system. METHODS: A retrospective cohort study was performed in two Colombian cancer centers. The cases were classified according to the Silva classification system. Clinical, surgical, and histopathological variables were evaluated. Recurrence risk was analyzed by patterns A, B, or C. A logistic regression model was performed for tumor recurrence. The Kaplan-Meier method was used to estimate overall survival and disease-free survival (DFS). A weighted kappa was performed to determine the degree of concordance between pathologists. RESULTS: A total of 100 patients were identified, 33% pattern A, 29% pattern B, and 38% pattern C. The median follow-up time was 42.5 months. No evidence of lymph node involvement was found in patients classified as A and B, while in the C pattern was observed in 15.8% (n = 6) of cases (P < 0.01). There were 7% of cases with recurrent disease, of which 71.5% corresponded to type C pattern. Patients with Silva pattern B and C had 1.22- and 4.46-fold increased risk of relapse, respectively, compared with pattern A. The 5-year DFS values by group were 100%, 96.1%, and 80.3% for patterns A, B, and C, respectively. CONCLUSION: For patients with early-stage HPV-associated endocervical adenocarcinoma, the type C pattern presented more lymph node involvement and risk of recurrence compared to the A and B patterns. The concordance in diagnosis of different Silva's patterns by independents pathologists were good.

On a deterministic mathematical model which efficiently predicts the protective effect of a plant extract mixture in cirrhotic rats.

In this work, we propose a mathematical model that describes liver evolution and concentrations of alanine aminotransferase and aspartate aminotransferase in a group of rats damaged with carbon tetrachloride. Carbon tetrachloride was employed to induce cirrhosis. A second groups damaged with carbon tetrachloride was exposed simultaneously a plant extract as hepatoprotective agent. The model reproduces the data obtained in the experiment reported in [Rev. Cub. Plant. Med. 22(1), 2017], and predicts that using the plants extract helps to get a better natural recovery after the treatment. Computer simulations show that the extract reduces the damage velocity but does not avoid it entirely. The present paper is the first report in the literature in which a mathematical model reliably predicts the protective effect of a plant extract mixture in rats with cirrhosis disease. The results reported in this manuscript could be used in the future to help in fighting cirrhotic conditions in humans, though more experimental and mathematical work is required in that case.

Development of a Genome-Informed Protocol for Detection of Pseudomonas amygdali pv. morsprunorum Using LAMP and PCR.

One of the causal agents of bacterial canker is Pseudomonas amygdali pv. morsprunorum-Pam (formerly Pseudomonas syringae pv. morsprunorum). Recently detected in Chile, Pam is known to cause lesions in the aerial parts of the plant, followed by more severe symptoms such as cankers and gummosis in the later stages of the disease. This study presents the design of PCR and LAMP detection methods for the specific and sensitive identification of Pseudomonas amygdali pv. morsprunorum (Pam) from cherry trees. Twelve Pseudomonas isolates were collected, sequenced, and later characterized by Multi-locus Sequence Analysis (MLSA) and Average Nucleotide Identity by blast (ANIb). Three of them (11116B2, S1 Pam, and S2 Pam) were identified as Pseudomonas amygdali pv. morsprunorum and were used to find specific genes through RAST server, by comparing their genome with that of other Pseudomonas, including isolates from other Pam strains. The effector gene HopAU1 was selected for the design of primers to be used for both techniques, evaluating sensitivity and specificity, and the ability to detect Pam directly from plant tissues. While the PCR detection limit was 100 pg of purified bacterial DNA per reaction, the LAMP assays were able to detect up to 1 fg of purified DNA per reaction. Similar results were observed using plant tissues, LAMP being more sensitive than PCR, including when using DNA extracted from infected plant tissues. Both detection methods were tested in the presence of 30 other bacterial genera, with LAMP being more sensitive than PCR.

Transcriptome Analysis of Sweet Cherry (Prunus avium L.) Cultivar 'Lapins' upon Infection of Pseudomonas syringae pv. syringae.

Bacterial canker caused by Pseudomonas syringae pv. syringae (Pss) is responsible for substantial loss to the production of sweet cherry in Chile. To date, the molecular mechanisms of the Pss-sweet cherry interaction and the disease-related genes in the plant are poorly understood. In order to gain insight into these aspects, a transcriptomic analysis of the sweet cherry cultivar 'Lapins' for differentially expressed genes (DEGs) in response to Pss inoculation was conducted. Three Pss strains, A1M3, A1M197, and 11116_b1, were inoculated in young twigs, and RNA was extracted from tissue samples at the inoculation site and distal sections. RNA sequencing and transcriptomic expression analysis revealed that the three strains induced different patterns of responses in local and distal tissues. In the local tissues, A1M3 triggered a much more extensive response than the other two strains, enriching DEGs especially involved in photosynthesis. In the distal tissues, the three strains triggered a comparable extent of responses, among which 11116_b1 induced a group of DEGs involved in defense responses. Furthermore, tissues from various inoculations exhibited an enrichment of DEGs related to carbohydrate metabolism, terpene metabolism, and cell wall biogenesis. This study opened doors to future research on the Pss-sweet cherry interaction, immunity responses, and disease control.

Clinical value of Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales to predict hospital-associated functional decline in an acute geriatric unit in Colombia.

Background: Older adults admitted to a hospital for acute illness are at higher risk of hospital-associated functional decline during stays and after discharge. Objective: This study aimed to assess the calibration and discriminative abilities of the Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales as predictors of hospital-associated functional decline at discharge in a cohort of patients older than age 65 receiving management in an acute geriatric care unit in Colombia. Methods: This study is an external validation of ISAR and HARP prediction models in a cohort of patients over 65 years managed in an acute geriatric care unit. The study included patients with Barthel index measured at admission and discharge. The evaluation discriminate ability and calibration, two fundamental aspects of the scales. Results: Of 833 patients evaluated, 363 (43.6%) presented hospital-associated functional decline at discharge. The HARP underestimated the risk of hospital-associated functional decline for patients in low- and intermediate-risk categories (relation between observed/expected events (ROE) 1.82 and 1.51, respectively). The HARP overestimated the risk of hospital-associated functional decline for patients in the high-risk category (ROE 0.91). The ISAR underestimated the risk of hospital-associated functional decline for patients in low- and high-risk categories (ROE 1.59 and 1.11). Both scales showed poor discriminative ability, with an area under the curve (AUC) between 0.55 and 0.60. Conclusions: This study found that HARP and ISAR scales have limited discriminative ability to predict HAFD at discharge. The HARP and ISAR scales should be used cautiously in the Colombian population since they underestimate the risk of hospital-associated functional decline and have low discriminative ability.

Antecedentes: los adultos mayores ingresados en un hospital por una enfermedad aguda tienen un mayor riesgo de deterioro functional hospitalario durante su estancia y después del alta. Objetivo: este estudio tuvo como objetivo evaluar las capacidades de calibración y discriminación de las escalas Hospital Admission Risk Profile (HARP) e Identification of Seniors at Risk (ISAR) como predictores de deterioro funcional hospitalario al alta en una cohorte de pacientes mayores de 65 años que recibieron manejo en una unidad geriátrica de agudos en Colombia. Métodos: este estudio es una validación externa de los modelos de predicción ISAR y HARP en una cohorte de pacientes mayores de 65 años atendidos en una unidad geriátrica de agudos. El estudio incluyó pacientes con índice de Barthel medido al ingreso y al alta y la evaluación de la capacidad de discriminación y calibración, dos aspectos fundamentales para esta medición. Resultados: de 833 pacientes evaluados, 363 (43.6%) presentaron deterioro funcional hospitalario al momento del alta. La escala HARP subestimó el riesgo de deterioro funcional hospitalario para los pacientes en las categorías de riesgo bajo e intermedio (relación entre eventos observados /esperados (ROE) 1.82 y 1.51, respectivamente). El HARP sobrestimó el riesgo de deterioro funcional hospitalario para pacientes en la categoría de alto riesgo (ROE 0.91). El ISAR subestimó el riesgo de deterioro hospitalario para pacientes en categorías de bajo y alto riesgo (ROE 1.59 y 1.11). Ambas escalas mostraron una pobre capacidad de discriminación, con un área bajo la curva (AUC) entre 0.55 y 0.60. Conclusiones: este estudio encontró que las escalas HARP e ISAR tienen una capacidad de discriminación limitada para predecir deterioro funcional hospitalario al alta. Las escalas HARP e ISAR deben usarse con cautela en la población colombiana ya que subestiman el riesgo de deterioro funcional hospitalario y tienen baja capacidad de discriminación.

Clinical value of Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales to predict hospital-associated functional decline in an acute geriatric unit in Colombia

Background: Older adults admitted to a hospital for acute illness are at higher risk of hospital-associated functional decline during stays and after discharge. Objective: This study aimed to assess the calibration and discriminative abilities of the Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales as predictors of hospital-associated functional decline at discharge in a cohort of patients older than age 65 receiving management in an acute geriatric care unit in Colombia. Methods: This study is an external validation of ISAR and HARP prediction models in a cohort of patients over 65 years managed in an acute geriatric care unit. The study included patients with Barthel index measured at admission and discharge. The evaluation discriminate ability and calibration, two fundamental aspects of the scales. Results: Of 833 patients evaluated, 363 (43.6%) presented hospital-associated functional decline at discharge. The HARP underestimated the risk of hospital-associated functional decline for patients in low- and intermediate-risk categories (relation between observed/expected events (ROE) 1.82 and 1.51, respectively). The HARP overestimated the risk of hospital-associated functional decline for patients in the high-risk category (ROE 0.91). The ISAR underestimated the risk of hospital-associated functional decline for patients in low- and high-risk categories (ROE 1.59 and 1.11). Both scales showed poor discriminative ability, with an area under the curve (AUC) between 0.55 and 0.60. Conclusions: This study found that HARP and ISAR scales have limited discriminative ability to predict HAFD at discharge. The HARP and ISAR scales should be used cautiously in the Colombian population since they underestimate the risk of hospital-associated functional decline and have low discriminative ability.

Antecedentes: los adultos mayores ingresados en un hospital por una enfermedad aguda tienen un mayor riesgo de deterioro functional hospitalario durante su estancia y después del alta. Objetivo: este estudio tuvo como objetivo evaluar las capacidades de calibración y discriminación de las escalas Hospital Admission Risk Profile (HARP) e Identification of Seniors at Risk (ISAR) como predictores de deterioro funcional hospitalario al alta en una cohorte de pacientes mayores de 65 años que recibieron manejo en una unidad geriátrica de agudos en Colombia. Métodos: este estudio es una validación externa de los modelos de predicción ISAR y HARP en una cohorte de pacientes mayores de 65 años atendidos en una unidad geriátrica de agudos. El estudio incluyó pacientes con índice de Barthel medido al ingreso y al alta y la evaluación de la capacidad de discriminación y calibración, dos aspectos fundamentales para esta medición. Resultados: de 833 pacientes evaluados, 363 (43.6%) presentaron deterioro funcional hospitalario al momento del alta. La escala HARP subestimó el riesgo de deterioro funcional hospitalario para los pacientes en las categorías de riesgo bajo e intermedio (relación entre eventos observados /esperados (ROE) 1.82 y 1.51, respectivamente). El HARP sobrestimó el riesgo de deterioro funcional hospitalario para pacientes en la categoría de alto riesgo (ROE 0.91). El ISAR subestimó el riesgo de deterioro hospitalario para pacientes en categorías de bajo y alto riesgo (ROE 1.59 y 1.11). Ambas escalas mostraron una pobre capacidad de discriminación, con un área bajo la curva (AUC) entre 0.55 y 0.60. Conclusiones: este estudio encontró que las escalas HARP e ISAR tienen una capacidad de discriminación limitada para predecir deterioro funcional hospitalario al alta. Las escalas HARP e ISAR deben usarse con cautela en la población colombiana ya que subestiman el riesgo de deterioro funcional hospitalario y tienen baja capacidad de discriminación.

Delayed radiation myelopathy: a case and treatment algorithm proposal.

Delayed radiation myelopathy is a rare but severe complication that causes progressive and irreversible patient deterioration. Although it is an exclusion diagnosis, there are factors associated with radiation doses and administration areas that may reduce the risk of its incidence. To date, there is no known first-line and effective treatment available to alleviate the symptoms.

Cáncer de pulmón, tendencias desde la perspectiva del cuidado / Lung cancer, trends from a care perspective / Cancro do pulmão, tendências de uma perspectiva de cuidados

Objetivo: identificar las tendencias de investigación sobre el cáncer de pulmón durante los últimos cinco años, desde la perspectiva del cuidado de enfermería. Método: revisión bibliométrica y exploratoria realizada a partir de la base de datos de web of science. Se utilizaron los descriptores, lung neoplasm and nursing care con aplicación de filtros, obteniendo un total de 62 artículos publicados entre los años 2017-2021. El análisis bibliométrico fue realizado mediante bibliometrix con el total de los documentos obtenidos; para el análisis exploratorio se utilizaron 30 artículos que describen las principales tendencias temáticas identificadas en la estructura conceptual. Resultados: los indicadores bibliométricos muestran un promedio de publicación de 12 artículos por año, predominaron las publicaciones con enfoque cuantitativo (66,7 %) y de nivel de evidencia baja (56,7 %). El mayor número de artículos publicados por fuente y autor fue de 4. Los resultados exploratorios muestran cinco temáticas relevantes relacionadas con: el diagnóstico del cáncer de pulmón, síntomas, cuidado paliativo, calidad de vida y práctica avanzada de enfermería. Conclusión: se logra identificar publicaciones que enfatizan las temáticas mencionadas, con un nivel de evidencia bajo y con escasas intervenciones realizadas por parte de enfermería. Los estudios se enfocan en el control de síntomas y cuidados en el fin de vida.

Objective: identify trends in lung cancer research over the past five years from a nursing care perspective. Method: bibliometric and exploratory review based on the web of science database. The descriptors, lung neoplasm and nursing care were used with application of filters, obtaining a total of 62 articles published between the years 2017-2021. The bibliometric analysis was performed using bibliometrix with the total number of documents obtained; 30 articles describing the main thematic trends identified in the conceptual structure were used for the exploratory analysis. Results: bibliometric indicators show an average publication rate of 12 articles per year, with a predominance of publications with a quantitative approach (66.7 %) and a low level of evidence (56.7 %). The highest number of articles published per source and author was 4. The exploratory results show five relevant topics related to: lung cancer diagnosis, symptoms, palliative care, quality of life and advanced nursing practice. Conclusion: it is possible to identify publications that emphasize the aforementioned topics, with a low level of evidence and with few interventions carried out by nurses. The studies focus on symptom control and end-of-life care.

Objectivo: identificar tendências na investigação do cancro do pulmão ao longo dos últimos cinco anos, numa perspectiva de cuidados de enfermagem. Método: revisão bibliométrica e exploratória realizada utilizando a teia de dados científicos. Os descritores, neoplasma pulmonar e cuidados de enfermagem foram utilizados com a aplicação de filtros, obtendo um total de 62 artigos publicados entre 2017-2021. A análise bibliométrica foi realizada utilizando a bibliometria com o número total de documentos obtidos; 30 artigos descrevendo as principais tendências temáticas identificadas na estrutura conceptual foram utilizados para a análise exploratória. Resultados: os indicadores bibliométricos mostram uma taxa média de publicação de 12 artigos por ano, com uma predominância de publicações com uma abordagem quantitativa (66,7 %) e um baixo nível de evidência (56,7 %). O maior número de artigos publicados por fonte e autor foi de 4. Os resultados exploratórios mostram cinco tópicos relevantes relacionados com: diagnóstico do cancro do pulmão, sintomas, cuidados paliativos, qualidade de vida e prática avançada de enfermagem. Conclusão: conseguimos identificar publicações que enfatizam os tópicos acima mencionados, com um baixo nível de evidência e com poucas intervenções realizadas por enfermeiros. Os estudos centram-se no controlo dos sintomas e nos cuidados de fim de vida.

Refractory iron deficiency anemia as an early manifestation of autoimmune gastritis in a teenager / Anemia ferropénica refractaria como presentación temprana de gastritis autoinmune en un adolescente

Abstract Autoimmune gastritis is an underdiagnosed disease in the pediatric population due to the absence of specific signs and symptoms and late clinical manifestations. Iron deficiency anemia has recently been identified as an early hematological manifestation, allowing an early diagnostic approach. We present the case of a Colombian teenager, with no history of autoimmunity, with refractory iron deficiency. He underwent extension studies; biopsies and serology compatible with autoimmune gastritis were documented, requiring parenteral iron in its evolution. This pathology is underdiagnosed in our context since early diagnosis requires a high index of suspicion to prevent associated complications.

Resumen La gastritis autoinmune es una enfermedad subdiagnosticada en la población pediátrica. Lo anterior se debe a la ausencia de signos y síntomas específicos y manifestaciones clínicas tardías. Recientemente se ha identificado la anemia ferropénica como una manifestación hematológica precoz, lo que permite un enfoque diagnóstico temprano. Se presenta el caso de un adolescente colombiano, sin antecedentes de autoinmunidad, con ferropenia refractaria, en el que se realizaron estudios de extensión y se documentaron biopsias y serología compatible con gastritis autoinmune, con requerimiento de hierro parenteral en su evolución. Esta patología es subdiagnosticada en nuestro medio, ya que el diagnóstico temprano requiere un alto índice de sospecha, lo que permite la prevención de las complicaciones asociadas.

COVID-19 y vulnerabilidad frente a vejez exitosa y salud mental / COVID-19 and vulnerability vs. successful aging and mental health / COVID-19 e vulnerabilidade à velhice bem-sucedida e saúde mental

RESUMEN Introducción: La COVID-19 y las medidas generadas para proteger a los adultos mayores han marcado mucho más la vulnerabilidad de este grupo, incrementando factores de riesgos psicosociales como la desvinculación, el maltrato, la ansiedad, lo que demandó examinar patrones de vejez exitosa que generan y garantizan salud mental en personas de esta edad. Objetivo: Caracterizar aquellos indicadores de una vejez exitosa que promueven salud mental, a través de su expresión concreta en un paciente. Método: Enfoque cualitativo, privilegiando el estudio de caso único de carácter crítico. Para evaluar los criterios de salud mental y vulnerabilidad, se utilizó una entrevista semiestructurada. Para la caracterización de la vejez se trabajó con método biográfico y la técnica de historia de vida durante los meses de agosto a noviembre de 2021. Resultados: Se identificaron criterios de vulnerabilidad como la viudez y la soledad, pero predominaron fortalezas a nivel individual, micro y macrosocial, lo que se consolida con un estado mental saludable que se expresó en evidente funcionamiento y bienestar psicológico. Se presentaron en la paciente, todos los indicadores de vejez exitosa que se definieron, garantizando el tránsito satisfactorio por la etapa. Conclusiones: La paciente con una vejez exitosa posee redes de integración, activación y trascendencia que le permiten reestructurar su campo de acción en un contexto como el que ha implicado la COVID-19, garantizando autovaloración y sentido de vida, expresados de forma desarrolladoras para favorecer su salud mental y su desarrollo psicológico.

ABSTRACT Introduction: COVID-19 and the measures generated to protect older adults have marked much more the vulnerability of this group, increasing psychosocial risk factors such as disengagement, mistreatment, anxiety; which required examining patterns of successful old age that generate and guarantee mental health in the elderly. Objective: To characterize those indicators of a successful old age that promote mental health, through its concrete expression in a patient. Method: Qualitative approach, favoring the single critical case study. To assess the mental health and vulnerability criteria, a semi-structured interview was used. For the characterization of old age, we worked with the biographical method and the life history technique, from August to November 2021. Results: Vulnerability criteria such as widowhood and loneliness were identified, but prevailed micro and macrosocial strengths at an individual level, which is consolidated with a healthy mental state that was expressed in evident functioning and psychological well-being. All the indicators of successful aging that were defined were presented in the patient, guaranteeing satisfactory transit through the stage. Conclusions: The patient with a successful old age has networks of integration, activation and transcendence that allow him to restructure his field of action in a context such as COVID-19; guaranteeing self-assessment and a sense of life, expressed in a developing way to favor their mental health and psychological development.

RESUMO Introdução: A COVID-19 e as medidas geradas para proteger os idosos marcaram muito mais a vulnerabilidade desse grupo, aumentando fatores de risco psicossociais como desengajamento, maus-tratos, ansiedade, o que exigiu examinar padrões de velhice bem-sucedida que geram e garantem a saúde mental em pessoas desta idade. Objetivo: Caracterizar os indicadores de uma velhice bem-sucedida que promovem a saúde mental, por meio de sua expressão concreta em um paciente. Método: Abordagem qualitativa, privilegiando o estudo de caso único crítico. Para avaliar os critérios de saúde mental e vulnerabilidade, foi utilizada uma entrevista semiestruturada. Para a caracterização da velhice, trabalhou-se com o método biográfico e a técnica de história de vida durante os meses de agosto a novembro de 2021. Resultados: Foram identificados critérios de vulnerabilidade como viuvez e solidão, mas prevaleceram as forças no nível individual, micro e macrossocial, que se consolidou com um estado mental saudável que se expressou em evidente funcionamento e bem-estar psicológico. Todos os indicadores de envelhecimento bem-sucedido que foram definidos foram apresentados no paciente, garantindo um trânsito satisfatório pelo estágio. Conclusões: O paciente com velhice bem-sucedida possui redes de integração, ativação e transcendência que lhe permitem reestruturar seu campo de ação em um contexto como o que a COVID-19 implicou, garantindo autoavaliação e sentido de vida, expressa de forma crescente para favorecer sua saúde mental e desenvolvimento psicológico.

Psychosis associated with suspected SARS-CoV-2 encephalitis with response to steroids: a case report.

INTRODUCTION: The SARS-Cov-2 infection has multiple neurologic manifestations including encephalitis in multiple cases reported, however the psychosis as principal manifestation of this condition is infrequently. CASE REPORT: We report the case of a 48-year-old woman with a confirmed diagnosis of SARS-CoV-2 who developed paranoid and self-referential ideas with behavioural alteration and multiple findings on mental examination. Encephalitis associated with Covid-19 was suspected due to the neurological clinical presentation (persistent despite resolve hypoxaemia and systemic symptoms) and brain magnetic resonance image (MRI) that showed asymmetric hippocampal hyperintensities, although cerebrospinal fluid and electroencephalogram (EEG) were normal. The patient received medical treatment with methylprednisolone for 5 days with complete resolution of her symptoms. DISCUSSION: The current SARS-CoV-2 pandemic has neurological complications either by direct involvement or by para-infectious or post-infectious phenomena. Encephalitis occurs in a small proportion of the cases, while psychiatric symptoms have been described in a variable percentage of the events. However, a psychotic picture such as the one reported in our case is unusual. MRI, cerebrospinal fluid and EEG are important for the diagnostic evaluation of these patients but not obligatory to the diagnosis. The treatment of this condition with corticosteroids has been successful even in cases associated with Anti-NMDA. Our case is the second reported in Colombia, the first to be associated with psychosis.

Reduced levels of convalescent neutralizing antibodies against SARS-CoV-2 B.1+L249S+E484K lineage.

The E484K mutation at the SARS-CoV-2 Spike protein emerged independently in different variants around the world and has been widely associated with immune escape from neutralizing antibodies generated during previous infection or vaccination. In this work, the B.1 + L249S+E484K lineage was isolated along with A.1, B.1.420, and B.1.111 SARS-CoV-2 lineages without the E484K mutation and the neutralizing titer of convalescent sera was compared using microneutralization assays. While no significant differences in the neutralizing antibody titers were found between A.1 and B.lineages without the E484K mutation, the neutralizing titers against B.1 + L249S+E484K were 1.5, 1.9, 2.1, and 1.3-fold lower than against A.1, B.1.420, B.1.111-I, and B.1.111-II, respectively. However, molecular epidemiological data indicate that there is no increase in the transmissibility rate associated with this new lineage. This study supports the capability of new variants with the E484K mutation to be resistant to neutralization by humoral immunity, and therefore the need to intensify surveillance programs to determine if these lineages represent a risk for public health.

Palmo-plantar hyperkeratosis associated with HTLV-1 infection: a case report.

BACKGROUND: Palmoplantar hyperkeratosis is a cutaneous manifestation that had not been clearly associated with infection by the human T-cell lymphotropic virus, which is a retrovirus that in most cases does not develop clinical pathologies and its symptoms may be undetected. The skin is one of the most affected organs, however until now only seborrheic dermatitis, xerosis/ichthyosis and infective dermatitis associated with HTLV-1 have been described as cutaneous clinical manifestations of this disease. CASE PRESENTATION: We present the case of a 36-year-old male patient with serologically documented HTLV-1 infection, who presented symptoms of diarrhea, malabsorption due to Strongyloides stercoralis, and in whom a physical examination revealed an association with generalized xerosis and palmoplantar keratoderma confirmed by skin biopsy. Other infectious etiologies and malignancy were ruled out. This clinical manifestation was managed with dermal hydration, and skin care which improved the thickened skin and make it less noticeable. CONCLUSIONS: According to our experience, this is the first reported case of palmoplantar keratoderma associated with a human lymphotropic virus infection. This is a skin manifestation that has not been confirmed in conjunction with HTLV-I before. This implies that palmoplantar keratoderma is a new clinical manifestation of this infection, that should be considered in the initial approach of patients in endemic areas with these dermatological characteristics.

Prunus Hexokinase 3 genes alter primary C-metabolism and promote drought and salt stress tolerance in Arabidopsis transgenic plants.

Hexokinases (HXKs) and fructokinases (FRKs) are the only two families of enzymes in plants that have been identified as able to phosphorylate Glucose (Glc) and Fructose (Fru). Glc can only be phosphorylated in plants by HXKs, while Fru can be phosphorylated by either HXKs or FRKs. The various subcellular localizations of HXKs in plants indicate that they are involved in diverse functions, including anther dehiscence and pollen germination, stomatal closure in response to sugar levels, stomatal aperture and reducing transpiration. Its association with modulating programmed cell death, and responses to oxidative stress and pathogen infection (abiotic and biotic stresses) also have been reported. To extend our understanding about the function of HXK-like genes in the response of Prunus rootstocks to abiotic stress, we performed a detailed bioinformatic and functional analysis of hexokinase 3-like genes (HXK3s) from two Prunus rootstock genotypes, 'M.2624' (Prunus cerasifera Ehrh × P. munsoniana W.Wight & Hedrick) and 'M.F12/1' (P. avium L.), which are tolerant and sensitive to hypoxia stress, respectively. A previous large-scale transcriptome sequencing of roots of these rootstocks, showed that this HXK3-like gene that was highly induced in the tolerant genotype under hypoxia conditions. In silico analysis of gene promoters from M.2624 and M.F12/1 genotypes revealed regulatory elements that could explain differential transcriptional profiles of HXK3 genes. Subcellular localization was determinates by both bioinformatic prediction and expression of their protein fused to the green fluorescent protein (GFP) in protoplasts and transgenic plants of Arabidopsis. Both approaches showed that they are expressed in plastids. Metabolomics analysis of Arabidopsis plants ectopically expressing Prunus HXK3 genes revealed that content of several metabolites including phosphorylated sugars (G6P), starch and some metabolites associated with the TCA cycle were affected. These transgenic Arabidopsis plants showed improved tolerance to salt and drought stress under growth chamber conditions. Our results suggest that Prunus HXK3 is a potential candidate for enhancing tolerance to salt and drought stresses in stone fruit trees and other plants.

Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile.

BACKGROUND: Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. METHODS: We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1-69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). RESULTS: H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10-19 year olds, 60% in the 20-29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. CONCLUSIONS: The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. IMPACT: The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.

Promoción del lavado de manos en la población con manos en la población con discapacidad auditiva / Promoting handwashing among people with hearing impairment

Introducción: las campañas de promoción y prevención del lavado de manos son estrategias económicas y de alto impacto según la OMS/OPS. Las personas con discapacidad auditiva presentan dificultades para acceder a estas. Objetivo: realizar una reflexión sobre la promoción del lavado de manos en población con discapacidad auditiva mediante la virtualidad. Desarrollo: la experiencia con la aplicación de un OVA en estudiantes con discapacidad auditiva permite comprender que diseñar y aplicar herramientas a partir de las TICs para transmitir educación en salud a la población con discapacidad auditiva, requiere recursos tecnológicos, humanos y financieros que pueden ser financiados por entes gubernamentales y asociaciones que apoyen esta población. Conclusiones: los profesionales del área de la salud deben diseñar programas de promoción y prevención virtual para comunidades con discapacidades o diferentes vulnerabilidades para generar un aporte desde la salud.

ntroduction: According to the WHO/PHO handwashing promotion campaigns are high-impact economic strategies. People with hearing disability have difficulties for accessing these campaigns. Objective: to conduct a discussion exercise on promoting handwashing among people with hearing disability by means of a virtual campaign. Development: the experience applying VLA (virtual learning objects) in students with hearing disability allows understanding that designing and applying information and communication technology (ICT) tools to transmit heath education to people with hearing challenges, requires technological, human and financial resources which may be provided by the state and organizations supporting this population. Conclusions: healthcare professionals must design virtual promotion and prevention programs targeted at communities with disabilities and various vulnerabilities, as a contribution from the health sector.

A polyvalent coral snake antivenom with broad neutralization capacity.

Coral snakes of the genus Micrurus have a high diversity and wide distribution in the Americas. Despite envenomings by these animals being uncommon, accidents are often severe and may result in death. Producing an antivenom to treat these envenomings has been challenging since coral snakes are difficult to catch, produce small amounts of venom, and the antivenoms produced have shown limited cross neutralization. Here we present data of cross neutralization among monovalent antivenoms raised against M. dumerilii, M. isozonus, M. mipartitus and M. surinamensis and the development of a new polyvalent coral snake antivenom, resulting from the mix of monovalent antivenoms. Our results, show that this coral snake antivenom has high neutralizing potency and wide taxonomic coverage, constituting a possible alternative for a long sought Pan-American coral snake antivenom.

La intervención de la psiquiatría en el tratamiento de los niños difíciles en Uruguay (1930-1950) / A intervenção da psiquiatria no tratamento das crianças difíceis no Uruguai (1930-1950) / The intervention of psychiatry in the treatment of difficult children in the Uruguay (1930-1950)

Resumen: El artículo presenta y discute la intervención de la psiquiatría en el abordaje de los niños difíciles, entendidos como aquellos que mostraban conductas desviadas: eran inquietos, distraídos, apáticos o indisciplinados. Preocupada por la infancia como futuro de la nación, la psiquiatría intentó detectar estos niños mediante la aplicación de test e implementar medidas correctivas para encauzarlos. Estos acontecimientos se analizan a partir de la noción de medicalización, entendida como la expansión del saber médico a otros campos no médicos así como la definición de problemas como desviaciones. Este proceso se debió a la consolidación de la psiquiatría en el período y por una demanda sociopolítica para atender comportamientos que podrían atentar contra el progreso social.

Resumo: O artigo apresenta e discute a intervenção da psiquiatria na abordagem das crianças difíceis, sendo aqueles que mostravam condutas desviadas tais como desassossego, apatia ou falta de disciplina. Preocupada pela infância como futuro da nação, a psiquiatria tentou caracterizar essas crianças por meio do uso de testes e desenvolver medidas corretivas para canalizá-los. Estes acontecimentos analisam-se a partir da noção de medicalização, entendida como a expansão do saber médico a diversos campos não médicos bem como a definição de problemas como desvios. Este processo ocorreu pela consolidação da psiquiatria nesse período e por uma demanda sociopolítica de atender comportamentos que poderiam atentar contra o progresso social.

Abstract: The article presents and discusses the intervention of psychiatry in the approach of difficult children, understood as those that showed deviant behaviors: they were restless, distracted, apathetic or undisciplined. Concerned about childhood as the future of the nation, psychiatry tried to detect these children through the application of tests and implement corrective measures to channel them. These events will be analyzed from the notion of medicalization, understood as the expansion of medical knowledge to various non-medical fields as well as the definition of problems as deviations. This process was due to the consolidation of psychiatry in the period and a sociopolitical demand to address behaviors that could threaten social progress.