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A description of new antimicrobial agents suitable for food industries has become necessary, and natural compounds are being considered as promising sources of new active derivatives to be used with the aim of improving food safety. We have previously described desirable antimicrobial and antibiofilm activities against foodborne bacteria by analogs to A-type proanthocyanidins (PACs) with a nitro (NO2) group at carbon 6 of the A-ring. We report herein the synthesis of eight additional analogs with chloro and bromo atoms at the A-ring and the systematic study of their antimicrobial and antioxidant activities in order to evaluate their possible application as biocides or food preservatives, as well as to elucidate new structure-activity relationships. The results from this study show that halogenated analogs to natural A-type proanthocyanidins rise above the nitro derivatives previously reported in their antimicrobial activities. Gram-positive bacteria are the most sensitive to all the analogs and combinations assayed, showing MICs from 10 to 50 µg/mL in most cases, as well as reductions in biofilm formation and the disruption of preformed biofilms of at least 75%. Some structure-activity relationships previously described have also been corroborated. Analogs with just one OH group at the B-ring show better antimicrobial activities than those with two OH groups, and those analogs with two or three OH groups in the whole structure are more active than those with four OH groups. In addition, the analogs with two OH groups at the B-ring and chloro at the A-ring are the most effective when antibiofilm activities are studied, especially at low concentrations.
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Antiinfecciosos , Antioxidantes , Biopelículas , Industria de Alimentos , Halogenación , Pruebas de Sensibilidad Microbiana , Proantocianidinas , Antioxidantes/farmacología , Antioxidantes/química , Antioxidantes/síntesis química , Proantocianidinas/farmacología , Proantocianidinas/química , Proantocianidinas/síntesis química , Biopelículas/efectos de los fármacos , Antiinfecciosos/farmacología , Antiinfecciosos/química , Antiinfecciosos/síntesis química , Relación Estructura-Actividad , Antibacterianos/farmacología , Antibacterianos/química , Antibacterianos/síntesis química , Bacterias Grampositivas/efectos de los fármacosRESUMEN
In ecosystems, natural radionuclides are present in the environment and living organisms. The 238U natural decay chain produces multiple radioactive elements, such as 234U, 226Ra, 210Pb, and 210Po. These radionuclides can be found in air, water, rocks, soil, and other biotic and abiotic components, mainly derived from minerals, such as zircon and apatite. In this study, we determined the activity concentration of radionuclides from the 238U decay chain in the sediment of a coastal ecosystem on the southern Mexican coast in the western Caribbean, an ecosystem minimally affected by industrial activities. Methods included high-resolution gamma-ray spectrometry and alpha-particle spectrometry. Results showed that the sediment samples had an activity concentration range of 18.2-36.6 Bq/kg for 238U, 25.0-41.4 Bq/kg for 234U, 10.1-37.3 Bq/kg for 210Pb, and 29.9-46.0 Bq/kg for 210Po. Water samples ranged between 17.9 and 36.3 mBq/L and 27.9-66.0 mBq/L for 238U and 234U, respectively. The activity concentration of these radionuclides in the sediment and water of this area is compared with that of other coral reefs worldwide, providing a radiometric baseline for comparison purposes.
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The bonding structures of CO3Li3+ and CS3Li3+ are studied by means of oriented quasi-atomic orbitals (QUAOs) to assess the possibility of these molecules being planar hexacoordinated carbon (phC) systems. CH3Li and CO32- are employed as reference molecules. It is found that the introduction of Li+ ions into the molecular environment of carbonate has a greater effect on the orbital structure of the O atoms than it does on the C atom. Partial charges computed from QUAO populations imply repulsion between the positively charged C and Li atoms in CO3Li3+. Upon the transition from CO3Li3+ to CS3Li3+, the analysis reveals that the substitution of O atoms by S atoms inverts the polarity of the carbon-chalcogen σ bond. This is linked to the difference in s- and p-fractions of the QUAOs of C and S, as element electronegativities do not explain the observed polarity of the CSσ bond. Partial charges indicate that the larger electron population on the C atom in CS3Li3+ makes C-Li attraction possible. Upon comparison with the C-Li bond in methyllithium, it is found that the C-Li covalent interactions in CO3Li3+ and CS3Li3+ have about 14% and 6% of the strength of the C-Li covalent interaction in CH3Li, respectively. Consequently, it is concluded that only CS3Li3+ may be considered to be a phC system.
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The bonding structures of infinitene, the Chemical and Engineering News 2021 Molecule of the Year, is studied by means of oriented quasi-atomic orbitals (QUAOs) to assess the degree of aromaticity within the molecule. It is found that the angularity introduced into infinitene when it takes on the helical shape of the infinity symbol has a profound effect on bond order, delocalization of bonding interactions, and the aromatic character of the system. In kekulene, a planar isomer of infinitene, the bonding analysis shows fluctuations of pocketed delocalization of bonding interactions in π-sextets associated with Clar's rule. Conversely, much smaller fluctuations are observed between the adjacent rings of infinitene. The observations drawn from the quasi-atomic bonding analysis support the idea that there is aromatic character across the entire infinitene molecule, not just localized around individual rings as in kekulene.
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BACKGROUND: The efficacy of ustekinumab and vedolizumab for treating complex perianal fistula in Crohn's disease has been barely studied. We aimed to assess treatment persistence, clinical remission, and safety of these drugs in this context. METHODS: Crohn's disease patients who had received ustekinumab or vedolizumab for the indication of active complex perianal fistula, were included. Clinical remission was defined according to Fistula Drainage Assessment Index (no drainage through the fistula upon gentle pressure) based on physicians' assessment. RESULTS: Of 155 patients, 136 received ustekinumab, and 35 vedolizumab (16 received both). Median follow-up for ustekinumab was 27 months. Among those on ustekinumab, 54 % achieved remission, and within this group, 27 % relapsed during follow-up. The incidence rate of relapse was 11 % per patient-year. Multivariate analysis found no variables associated with treatment discontinuation or relapse. Median follow-up time for patients receiving vedolizumab was 19 months. Remission was achieved in 46 % of the patients receiving vedolizumab, and among them, 20 % relapsed during follow-up. The incidence rate of relapse was 7 % per patient-year. Adverse events were mild in 6 % on ustekinumab and 8 % on vedolizumab. CONCLUSION: Ustekinumab and vedolizumab appear effective, achieving remission in around half of complex perianal fistula patients, with favorable safety profiles.
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INTRODUCTION: The increase in suicidal behavior among adolescents under 17 years of age in Catalonia between 2019 and 2022 has gone from 473 to 1425 cases, which entails a new healthcare challenge. The objective of the article is to explain the procedure and intervention of the Rapid Response Unit (RRU) for children and adolescents at risk of suicide. The RRU is a multidisciplinary unit designed to prevent relapse and increase link-up to treatment. The cases attended in its 14 months of operation are described. METHODOLOGY: 24 patients, 18 females and 6 males aged between 12 and 17 years, attended for the first time at the Child and Adolescent Health Centre of Cornellà for activation of the Suicide Risk Code (CRS) in hospital emergency departments during the period studied. RESULTS: After the intervention, high suicidal risk decreased from 29.17% to 0%, medium risk decreased from 37.5% to 20.83% and low risk increased from 33.33% to 79.17%. In addition, there was only one new CRS activation in the 3 months following the first activation. In the RRU, care was intensive: 52.7% of cases with visits once a week and more than once a week in 24.9%. During the intervention months 100% of cases were linked and no interruptions occurred. CONCLUSIONS: Rapid Response Unit (RRU) decreases the risk of recurrence of suicidal behavior and ensures therapeutic linkage.
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Intento de Suicidio , Suicidio , Masculino , Niño , Femenino , Humanos , Adolescente , Ideación Suicida , Recurrencia , Servicio de Urgencia en HospitalRESUMEN
The production of green hydrogen through alkaline water electrolysis is the key technology for the future carbon-neutral industry. Nanocrystalline Co3O4 catalysts are highly promising electrocatalysts for the oxygen evolution reaction and their activity strongly benefits from Fe surface decoration. However, limited knowledge of decisive catalyst motifs at the atomic level during oxygen evolution prevents their knowledge-driven optimization. Here, we employ a variety of operando spectroscopic methods to unveil how Fe decoration increases the catalytic activity of Co3O4 nanocatalysts as well as steer the (near-surface) active state formation. Our study shows a link of the termination-dependent Fe decoration to the activity enhancement and a significantly stronger Co3O4 near-surface (structural) adaptation under the reaction conditions. The near-surface Fe- and Co-O species accumulate an oxidative charge and undergo a reversible bond contraction during the catalytic process. Moreover, our work demonstrates the importance of low coordination surface sites on the Co3O4 host to ensure an efficient Fe-induced activity enhancement, providing another puzzle piece to facilitate optimized catalyst design.
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BACKGROUND: Congenital mirror movements (CMM) is a rare neurodevelopmental disorder characterized by involuntary movements from one side of the body that mirror voluntary movements on the opposite side. To date, five genes have been associated with CMM, namely DCC, RAD51, NTN1, ARHGEF7, and DNAL4. OBJECTIVE: The aim of this study is to characterize the genetic landscape of CMM in a large group of 80 affected individuals. METHODS: We screened 80 individuals with CMM from 43 families for pathogenic variants in CMM genes. In large CMM families, we tested for presence of pathogenic variants in multiple affected and unaffected individuals. In addition, we evaluated the impact of three missense DCC variants on binding between DCC and Netrin-1 in vitro. RESULTS: Causal pathogenic/likely pathogenic variants were found in 35% of probands overall, and 70% with familial CMM. The most common causal gene was DCC, responsible for 28% of CMM probands and 80% of solved cases. RAD51, NTN1, and ARHGEF7 were rare causes of CMM, responsible for 2% each. Penetrance of CMM in DCC pathogenic variant carriers was 68% and higher in males than females (74% vs. 54%). The three tested missense variants (p.Ile164Thr; p.Asn176Ser; and p.Arg1343His) bind Netrin-1 similarly to wild type DCC. CONCLUSIONS: A genetic etiology can be identified in one third of CMM individuals, with DCC being the most common gene involved. Two thirds of CMM individuals were unsolved, highlighting that CMM is genetically heterogeneous and other CMM genes are yet to be discovered. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Discinesias , Trastornos del Movimiento , Masculino , Femenino , Humanos , Netrina-1/genética , Receptor DCC/genética , Trastornos del Movimiento/genética , Mutación Missense/genética , Factores de Intercambio de Guanina Nucleótido Rho/genéticaRESUMEN
Developing high-performance carbonaceous anode materials for sodium-ion batteries (SIBs) is still a grand quest for a more sustainable future of energy storage. Introducing sulfur within a carbon framework is one of the most promising attempts toward the development of highly efficient anode materials. Herein, a microporous sulfur-rich carbon anode obtained from a liquid sulfur-containing oligomer is introduced. The sodium storage mechanism shifts from surface-controlled to diffusion-controlled at higher synthesis temperatures. The different storage mechanisms and electrode performances are found to be independent of the bare electrode material's interplanar spacing. Therefore, these differences are attributed to an increased microporosity and a thiophene-rich chemical environment. The combination of these properties enables extending the plateau region to higher potential and achieving reversible overpotential sodium storage. Moreover, in-operando small-angle X-ray scattering (SAXS) reveals reversible electron density variations within the pore structure, in good agreement with the pore-filling sodium storage mechanism occurring in hard carbons (HCs). Eventually, the depicted framework will enable the design of high-performance anode materials for sodium-ion batteries with competitive energy density.
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BACKGROUND: Working part-time or full-time is a persistent dilemma for women, especially mothers, as they strive to manage their time across various roles. However, the existing literature remains unclear on whether part-time work contributes more to life satisfaction than full-time work. OBJECTIVE: This study aims to describe and compare time-use patterns in different occupational roles and levels of life satisfaction among 795 mothers in Brazil who are employed either part-time or full-time. METHODS: Data was collected through an online survey and the snowball technique. Regression and correlation analyses were performed on the data obtained from the following instruments: the Role Checklist for assessing time-use within occupational roles, the Satisfaction with Life Scale, and demographic information. RESULTS: Our analysis revealed no significant differences in life satisfaction between mothers working full-time and those working part-time (t (793)=1.160, pâ=â0.24). However, life satisfaction scores were positively correlated with the number of occupational roles performed (râ=â0.222, pâ<â0.01), higher family income (Pâ<â0.001), and engagement in social roles such as Friend (râ=â0.106, pâ=â0.003), Hobbyist/Amateur (râ=â0.08, pâ=â0.018), and Caregiver (râ=â0.07, pâ=â0.026). CONCLUSION: While our society places significant emphasis on time spent at work, our findings highlight that life satisfaction extends far beyond the dichotomy of working part-time or full-time. There are deeper dimensions to consider, including the number of occupational roles, family income, and engagement in social roles, which have a more substantial impact on overall life satisfaction.
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Empleo , Madres , Femenino , Humanos , Brasil , Satisfacción Personal , RentaRESUMEN
Introduction: The increase in suicidal behavior among adolescents under 17 years of age in Catalonia between 2019 and 2022 has gone from 473 to 1425 cases, which entails a new healthcare challenge. The objective of the article is to explain the procedure and intervention of the Rapid Response Unit (RRU) for children and adolescents at risk of suicide. The RRU is a multidisciplinary unit designed to prevent relapse and increase link-up to treatment. The cases attended in its 14 months of operation are described. Methodology: 24 patients, 18 females and 6 males aged between 12 and 17 years, attended for the first time at the Child and Adolescent Health Centre of Cornellà for activation of the Suicide Risk Code (CRS) in hospital emergency departments during the period studied. Results: After the intervention, high suicidal risk decreased from 29.17% to 0%, medium risk decreased from 37.5% to 20.83% and low risk increased from 33.33% to 79.17%. In addition, there was only one new CRS activation in the 3 months following the first activation. In the RRU, care was intensive: 52.7% of cases with visits once a week and more than once a week in 24.9%. During the intervention months 100% of cases were linked and no interruptions occurred. Conclusions: Rapid Response Unit (RRU) decreases the risk of recurrence of suicidal behavior and ensures therapeutic linkage. (AU)
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Humanos , Masculino , Femenino , Niño , Adolescente , /métodos , Conductas de Riesgo para la Salud , Terapéutica/psicología , Cumplimiento y Adherencia al Tratamiento/psicologíaRESUMEN
The Occupational Self-Assessment version 2.2 (OSA) is a self-assessment of the client's occupational competence and values. To describe the process of cross-cultural adaptation of OSA into Brazilian Portuguese (OSA-Brazil) and examine its reliability and validity for use with the Brazilian population. Assessment translation was guided by two international guidelines for cross-cultural adaptation of standardized instruments. Face validity was tested with 24 participants. Internal consistency, test-retest reliability, and convergent validity were tested with a convenience sample of 40 participants. The cross-cultural adaptation process concluded with a consensus among the expert panel review (r > 80%) and evidence of strong face validity. The OSA-Brazil demonstrated appropriate test-retest reliability (r > 0.70) and convergent validity with the 36-Item Short-Form Health Survey (SF-36) (p < .05). The OSA-Brazil has good face validity, test-retest reliability, and convergent validity. The assessment can be used by the Brazilian occupational therapists to assess client's occupational competence.
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Comparación Transcultural , Autoevaluación (Psicología) , Humanos , Encuestas y Cuestionarios , Brasil , Reproducibilidad de los Resultados , Traducciones , PsicometríaRESUMEN
Childhood trauma is known to put individuals at risk for mental and physical challenges later in life. Retrospective assessment of early abuse and neglect is critical for prevention and intervention efforts targeted at reducing the negative impacts of childhood trauma. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a widely used measure to assess trauma among adolescents and adults, though there are some inconsistencies with regard to its factor structure and psychometric properties. The purpose of the current study was twofold: (1) to evaluate the hypothesized five-factor structure of CTQ-SF and (2) to test measurement invariance (equivalence) of the instrument across gender and race in a large, nationally representative sample of US adults (N = 863). Confirmatory factor analysis results indicate that the five-factor model fit the data well. The results also show that the five-factor model is generally invariant by gender and racial/ethnic groups and that the form's subscales positively correlate with depression, anxiety, and abnormal inflammatory biomarker activity. Assessment is critical for the advocacy and treatment of individuals who have experienced abuse and neglect as children and adolescents. Our findings suggest that the CTQ-SF is a valuable tool for assessing childhood trauma and can be used in advocacy and treatment efforts.
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Resumen La isquemia mesentérica aguda se asocia a una mortalidad de entre el 50 y el 100%, la causa más rara de esta es la trombosis venosa de los vasos mesentéricos (5%) y portal (1%). Las manifestaciones clínicas son diversas, siendo el dolor abdominal el principal síntoma. La tomografía computarizada con contraste intravenoso en fase portal es la imagen más precisa para el diagnóstico. El tratamiento en fase aguda se basa en anticoagulación, fluidos intravenosos, antibióticos profilácticos, descanso intestinal y descompresión. La laparotomía de control de daños, incluida la resección intestinal y el abdomen abierto, pueden estar justificados en última instancia para pacientes con necrosis intestinal y sepsis. Caso clínico: Hombre de 35 años, sin antecedentes de importancia, solo tabaquismo desde hace 15 años. Refirió que 5 días previos comenzó a presentar dolor en el epigastrio tipo cólico, de intensidad moderada, posteriormente refirió que el dolor se generalizó y aumentó de intensidad, acompañado de náusea, vómito, intolerancia a la vía oral y alza térmica. Al examen físico tuvo datos de respuesta inflamatoria sistémica, estaba consciente y orientado, con abdomen doloroso a la palpación superficial y profunda a nivel generalizado, pero acentuado en el flanco derecho, rebote positivo con resistencia, timpanismo generalizado, peristalsis ausente. Se ingresó a quirófano a laparotomía exploradora, encontrando lesión a intestinal isquémica-necrótica a 190-240 cm del ángulo de Treitz, y 400 cc de líquido hemático; se realizó resección de la parte intestinal afectada, con entero-enteroanastomosis término-terminal manual. Se envió pieza a patología, y se reportó un proceso inflamatorio agudo con necrosis transmural y congestión vascular. Ante estos hallazgos se realizó angiotomografía abdominal que reportó defecto de llenado en la vena mesentérica superior, secundario a trombosis que se extendía hasta la confluencia y la vena porta. Conclusión: La trombosis venosa mesentérica y portal es una patología muy infrecuente en pacientes jóvenes sin factores de riesgo en los que se presenta dolor abdominal. El diagnóstico es complejo debido a que los datos clínicos y de laboratorio son poco específicos. Sin embargo, debemos tenerla en cuenta en el diagnóstico diferencial de etiologías de dolor abdominal.
Abstract Acute Mesenteric Ischemia is associated with a mortality rate between 50% and 100%; the rarest cause of this is venous thrombosis of the mesenteric (5%) and portal (1%) vessels. The clinical manifestations are diverse, with abdominal pain being the main symptom. Computed tomography with intravenous contrast in the portal phase is the most accurate image for diagnosis. Treatment in the acute phase is based on anticoagulation, intravenous fluids, prophylactic antibiotics, intestinal rest, and decompression. Damage control laparotomy, including bowel resection and open abdomen, may ultimately be warranted for patients with bowel necrosis and sepsis. Clinical case: 35-year-old man, with no significant history, only smoking for 15 years. For 5 days before, he reported crampy epigastric pain of moderate intensity. He subsequently reported that the pain became generalized and increased in intensity, accompanied by nausea, vomiting, oral intolerance, and temperature rise. The physical examination showed signs of a systemic inflammatory response, conscious and oriented, abdomen painful on superficial and deep palpation at a generalized level but accentuated on the right flank, positive rebound with resistance, generalized tympanism, absent peristalsis. The operating room was entered for exploratory laparotomy, finding an ischemic-necrotic intestinal lesion at 190 - 240 cm from the angle of Treitz, and 400cc of blood fluid. Resection of the affected intestinal part is performed, with entire manual terminal end anastomosis. The specimen was sent to pathology, reporting an acute inflammatory process with transmural necrosis and vascular congestion. Given these findings, abdominal CT angiography was performed, which reported a filling defect in the superior mesenteric vein, secondary to thrombosis that extended to the confluence and the portal vein. Conclusion: Mesenteric and portal venous thrombosis is a very rare pathology in young patients without risk factors in whom abdominal pain occurs. The diagnosis is complex because the clinical and laboratory data are not very specific. However, we must take it into account in the differential diagnosis of abdominal pain etiologies.
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The bonding structures of tetrahedrane, phosphatetrahedrane, diphosphatetrahedrane and triphosphatetrahedrane are studied by employing an intrinsic quasi-atomic orbital analysis. Ethane, cyclopropane and tetrahedral P4 are employed as reference systems. The orbital analysis is paired with the computation of strain energies via isodesmic reactions. The results show that the increase in geometric strain upon transition from ethane to cyclopropane to tetrahedrane weakens the CC bonds, despite leading to shorter C-C interatomic distances. With the increase in strain, the orbitals centered on C and involved in the bonding of the cage structure are observed to have elevated p-character, and the orbital structure of C deviates from sp3 hybridization. The systematic substitution of CH groups by P atoms in the cage structure of tetrahedrane leads to stronger CC bonds, larger angles in the cage structures of the resulting phosphatetrahedranes, lower p-character in the orbitals involved in the bonding of the cages, and lower strain energies. It is found that P is more amenable to strained molecular arrangements than is C, and that the propensity of a given atom to hybridize s and p functions, or the lack thereof, has implications in the stability of molecules with strained geometries. The combination of the calculations presented here with the existing literature provides insight into the apparent propensity of tetrahedrane and P4 to 'break' their tetrahedral structures. Trends in the bonding interactions, such as bond strengths, s- and p-orbital characters and charge transfer are identified and related to the strain energy observed in each of the analyzed systems.
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The primary focus of GAMESS over the last 5 years has been the development of new high-performance codes that are able to take effective and efficient advantage of the most advanced computer architectures, both CPU and accelerators. These efforts include employing density fitting and fragmentation methods to reduce the high scaling of well-correlated (e.g., coupled-cluster) methods as well as developing novel codes that can take optimal advantage of graphical processing units and other modern accelerators. Because accurate wave functions can be very complex, an important new functionality in GAMESS is the quasi-atomic orbital analysis, an unbiased approach to the understanding of covalent bonds embedded in the wave function. Best practices for the maintenance and distribution of GAMESS are also discussed.
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Resumen El vólvulo de sigmoides ocurre como resultado de una torsión del eje mesentérico colónico, cuenta con una etiología multifactorial y controvertida, de fisiopatología no clara aún. Presenta un cuadro clínico de inicio inespecífico y posteriores signos y síntomas de oclusión intestinal; su diagnóstico se establece mediante tomografía computarizada, con una sensibilidad y especificidad mayor al 90%. El manejo dependerá de la condición clínica del paciente. Caso clínico: Hombre de 29 años con antecedente de síndrome de Asperger. Refirió que desde 7 días previos a su ingreso presentó dolor tipo cólico difuso, asociado a distensión abdominal e intolerancia a la vía oral. Acudió a valoración hospitalaria donde se realizóa tomografía computarizada con niveles hidroaéreos, torsión de arteria mesentérica inferior de aspecto de torbellino. Se realizó laparotomía exploradora a través de la cual se encontró sigmoides dilatado y volvulado, con perforación en la unión rectosigmoidea; se realizó sigmoidectomía con colorectoanastomosis. Al quinto día presentó datos de respuesta inflamatoria con abdomen agudo, por lo que ingresó a laparotomía exploradora donde se encontró dehiscencia de anastomosis; se realizó procedimiento de Hartmann. El paciente presentó choque séptico y falleció a las 24 horas del postquirúrgico. Discusión: La presentación de vólvulo sigmoides generalmente se presenta en personas mayores de 70 años, pocos casos se describen en personas jóvenes y están relacionados con enfermedad de dismotilidad intestinal. El paciente no contaba con factores predisponentes, el diagnóstico se estableció con imágenes características de la enfermedad, como la imagen en torbellino, se decidió manejo quirúrgico con la realización de resección con colorectoanastomosis. Conclusión: La oclusión intestinal por vólvulo sigmoides es una patología infrecuente en jóvenes y de clínica inespecífica. Ante un paciente que presente datos de oclusión intestinal deberá ser abordado de manera apropiada, sobre todo en pacientes en quienes hayan debutado con una clínica insidiosa y persistente de dolor abdominal secundario a oclusión intestinal, sean jóvenes con o sin factores de riesgo.
Abstract Sigmoid volvulus occurs due to a torsion of the colonic mesenteric axis, it has a multifactorial and controversial etiology, and its pathophysiology is not yet clear. Presenting a clinical picture of non-specific onset and later signs and symptoms of intestinal occlusion, its diagnosis is established with computed tomography with a sensitivity and specificity greater than 90%. Management will depend on the clinical condition of the patient. Clinical case: A 29-year-old man with a history of Asperger syndrome. He referred 7 days prior to admission with diffuse cramping pain, associated with abdominal distension and oral intolerance. He went to the hospital for evaluation where a computed tomography was performed with air-fluid levels, torsion of the inferior mesenteric artery with a whirlwind appearance. Exploratory laparotomy was performed, finding a dilated and volvulated sigmoid with perforation at the rectosigmoid junction. A sigmoidectomy with colorectal anastomosis was performed. On the fifth day, he presented data of inflammatory response with acute abdomen, entering exploratory laparotomy finding anastomosis dehiscence, Hartmann procedure was performed. The patient presented septic shock, died 24 hours after surgery. Discussion: The presentation of sigmoid volvulus generally occurs in people older than 70 years, few cases are described in young people and are related to intestinal dysmotility disease, the patient did not have predisposing factors, the diagnosis is established with characteristic images of the disease such as whirlwind image, surgical management is decided by performing resection with colorectal anastomosis. Conclusion: Intestinal occlusion due to sigmoid volvulus is an infrequent pathology in young people and with non-specific symptoms. When faced with a patient presenting evidence of intestinal occlusion, this should be appropriately addressed, especially in patients who have debuted with insidious and persistent symptoms of abdominal pain secondary to intestinal occlusion, whether they are young with or without risk factors.
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Objetivo: Identificar los factores asociados a la adherencia al tratamiento farmacológico en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Materiales y métodos: Estudio transversal y analítico en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Se integraron el grupo con adherencia al tratamiento (n = 145) y el grupo sin adherencia al tratamiento (n = 49), determinado por la escala de adherencia a la medicación de Morisky de 4 ítems (MMAS-4). Como factores asociados, se estudiaron sexo, vida en pareja, escolaridad, ocupación, edad agrupada en decenios y tiempo de evolución de la diabetes agrupada en menos de un año, de 1 a 5 años, de 6 a 10 años y más de 10 años. El plan de análisis estadístico incluyó la prueba de ji al cuadrado. Resultados: Se identificaron el sexo (p = 0,045), la vida en pareja (p = 0,045), la edad (p = 0,001) y el tiempo de evolución de la enfermedad (p = 0,001) como factores asociados a la adherencia al tratamiento farmacológico. La escolaridad no se identificó como un factor asociado a la adherencia terapéutica en el paciente con diabetes mellitus tipo 2 (p = 0,289). A mayor edad, menor adherencia al tratamiento farmacológico en el paciente con diabetes: el punto de corte se presenta a los 60 años; después de esta edad, el porcentaje en el grupo no adherente es mayor que en el grupo con adherencia (p = 0,001). A mayor tiempo de evolución de la diabetes, menor probabilidad de adherencia; en el grupo no adherente, el porcentaje de pacientes con más de 10 años de evolución es 67,3 % y en el grupo con adherencia el porcentaje corresponde a 33,8 % (p = 0,001). Conclusiones: Se identificaron los factores asociados a la adherencia al tratamiento farmacológico en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial.
Objective: To identify the factors associated with adherence to drug therapy among patients with type 2 diabetes mellitus without hypertension. Materials and methods: A cross-sectional, analytical study conducted with patients with type 2 diabetes mellitus without hypertension, divided into an adherent group (n = 145) and a non-adherent group (n = 49), determined by the 4-item Morisky Medication Adherence Scale (MMAS-4). The associated factors were sex, cohabitation, schooling, occupation, age in 10-year groups and diabetes progression time grouped in less than 1 year, from 1 to 5 years, from 6 to 10 years and more than 10 years. The statistical analysis plan included the chi-square test. Results: The factors associated with adherence to drug therapy were identified as sex (p = 0.045), cohabitation (p = 0.045), age (p = 0.001) and disease progression time (p = 0.001). Schooling was not identified as a factor associated with adherence to drug therapy among patients with type 2 diabetes mellitus (p = 0.289). The older the patient with diabetes, the lower the adherence to drug therapy; the cut-off point was 60 years of age, after which the percentage in the non-adherent group was higher than in the adherent group (p = 0.001). The longer the diabetes progression time, the lower the probability of adherence; in the non-adherent group the percentage of patients with more than 10 years of disease progression was 67.3 % and in the adherent group the percentage was 33.8 % (p = 0.001). Conclusions: The factors associated with adherence to drug therapy among patients with type 2 diabetes mellitus without hypertension were identified
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Although many novel gene-metabolite and gene-protein associations have been identified using high-throughput biochemical profiling, systematic studies that leverage human genetics to illuminate causal relationships between circulating proteins and metabolites are lacking. Here, we performed protein-metabolite association studies in 3,626 plasma samples from three human cohorts. We detected 171,800 significant protein-metabolite pairwise correlations between 1,265 proteins and 365 metabolites, including established relationships in metabolic and signaling pathways such as the protein thyroxine-binding globulin and the metabolite thyroxine, as well as thousands of new findings. In Mendelian randomization (MR) analyses, we identified putative causal protein-to-metabolite associations. We experimentally validated top MR associations in proof-of-concept plasma metabolomics studies in three murine knockout strains of key protein regulators. These analyses identified previously unrecognized associations between bioactive proteins and metabolites in human plasma. We provide publicly available data to be leveraged for studies in human metabolism and disease.
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Metabolómica , Proteómica , Humanos , Animales , Ratones , Transducción de Señal , Estudio de Asociación del Genoma Completo , Polimorfismo de Nucleótido Simple/genéticaRESUMEN
The physical factors governing the catalysis in Lewis acid-promoted carbonyl-ene reactions have been explored in detail quantum chemically. It is found that the binding of a Lewis acid to the carbonyl group directly involved in the transformation greatly accelerates the reaction by decreasing the corresponding activation barrier up to 25 kcal/mol. The Lewis acid makes the process much more asynchronous and the corresponding transition state less in-plane aromatic. The remarkable acceleration induced by the catalyst is ascribed, by means of the activation strain model and the energy decomposition analysis methods, mainly to a significant reduction of the Pauli repulsion between the key occupied π-molecular orbitals of the reactants and not to the widely accepted stabilization of the LUMO of the enophile.