Sleep Quality, Insomnia, and Perceived Stress among Colombian Healthcare Workers during the COVID-19 Pandemic.

Objective The COVID-19 pandemic has imposed a great burden on healthcare workers worldwide. The aim of the present study was to assess sleep quality, insomnia, and perceived stress in healthcare workers of a high complexity hospital located in Bogota, Colombia. Methods Cross-sectional study in which 1,155 healthcare workers at the Hospital Universitario San Ignacio in Bogotá, Colombia were included, between September and October 2020. Using an online-based survey, self-reported variables were assessed including demographics, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and 10 item Perceived Stress Scale (PSS-10). Associations between these variables were evaluated. Results Fifty percent of the respondents were between 31 and 45 years old, and 76 percent were women. Most of the surveyed were the nursing staff. Poor sleep quality, insomnia, and high perceived stress was found in 74.9, 12.4, and 13.2%, respectively. Poor sleep quality was predominantly found in females, in the 31 to 45 years old group and in married personnel. Also, poor sleep quality was found in relation to a moderate to high perceived risk of COVID-19 infection by the family of the workers surveyed. Discussion Poor sleep quality, moderate rates of insomnia, and perceived stress were found among healthcare workers committed to COVID-19 infected patients in Colombia. The identification of workers at greater risk and the implementation of targeted interventions are called upon as the results.

Longitudinal assessment of the eating pattern of people with dementia and its association with problems for feeding and malnutrition: a prospective follow-up study protocol.

INTRODUCTION: Dementia conditions the patient's nutrition from the beginning and vice versa. Generating difficulties for feeding (FEDIF) will influence its evolution. There are currently few nutritional longitudinal studies in people with dementia. Most focus on problems already established. The Edinburgh Feeding Evaluation in Dementia (EdFED) Scale identifies FEDIF of patients with dementia by studying their behaviours while eating or being fed. It also indicates areas of potential clinical interventions. METHODS AND ANALYSIS: Prospective multicentre observational study carried out in nursing homes, Alzheimer's day care centres and primary healthcare centres. The study population will be dyads composed by the patient (diagnosed of dementia, over 65 years of age and who have feeding difficulties) and their family caregiver. Sociodemographic variables and nutritional status (body mass index, Mini Nutritional Assessment, blood test and calf and arm circumference) will be assessed. The Spanish version of the EdFED Scale will be completed and the presence of nursing diagnoses related to feeding behaviours will be collected. Follow-up will take place for 18 months. ETHICS AND DISSEMINATION: All data will be carried out respecting European legislation 2016/679 in data protection, and the Spanish 'Organic Law 3/2018 of December 2005'. The clinical data will be kept segregated and encrypted. The informed consent has been obtained. The research has been authorised by the Costa del Sol Health Care District on 27 February 2020 and the Ethics Committee on 2 March 2021. It has obtained funding from the Junta de Andalucía on 15 February 2021. Findings of the study will be presented at provincial, national and international conferences and published in peer-reviewed journals.

Use of health care services according to functional performance in community-dwelling older adults in Spain. An approach using GAMLSS models.

Functional performance in older adults is a predictor of survival and other health outcomes and its measurement is highly recommended in primary care settings. Functional performance and frailty are closely related concepts, and frailty status is associated with the use of health care services. However, there is insufficient evidence on the utilization of services profile according to the functional performance of older adults. The aim of this study was to assess the relationship between functional performance and the use of a wide range of health services in community-dwelling older adults. Generalized additive models for location, scale and shape were used to study these complex data of services utilization, from primary to hospital care. A total of 749 participants from two Spanish regions were followed up for 2 years. Of those, 276 (37%) presented low functional performance and 473 (63%) normal performance according to the Timed Up and Go test. The results showed that even after adjusting for burden of comorbidity and polypharmacy, participants with low functional performance used primary and secondary care health services more intensively, visited emergency rooms more often, and were hospitalized more frequently and for longer periods of time. A negative binomial distribution and a variant thereof were found to be the best models to describe health service utilization data. In conclusion, functionality should be considered as an important health indicator for tailoring the provision of health services for older adults.

Cardiovascular risk factors and comorbidities in people living with HIV: A cross-sectional multicenter study from Colombia comorbidities in a Colombian PLWHIV population.

INTRODUCTION: HIV is an independent risk factor for cardiovascular diseases (CVD). There is insufficient information regarding comorbidities and cardiovascular risk factors in the Colombian HIV population. The aim of this study is to describe the prevalence of cardiovascular risk factors and comorbidities in patients from the HIV Colombian Group VIHCOL. METHODS: This is a multicenter, cross-sectional study conducted in the VIHCOL network in Colombia. Patients 18 years or older who had at least 6 months of follow-up were included. A stratified random sampling was performed to estimate the adjusted prevalence of cardiovascular risk factors and comorbidities. RESULTS: A total of 1616 patients were included. 83.2% were men, and the median age was 34 years. The adjusted prevalence for dyslipidemia, active tobacco use, hypothyroidism, and arterial hypertension was 51.2% (99% CI: 48.0%-54.4%), 7.6% (99% CI: 5.9%-9.3%), 7.4% (99% CI: 5.7%-9.1%), and 6.3% (99% CI: 4.8%-7.9%), respectively. CONCLUSIONS: In this Colombian HIV cohort, there is a high prevalence of modifiable CVD risk factors such as dyslipidemia and active smoking. Non-pharmacological and pharmacological measures for the prevention and management of these risk factors should be reinforced.

Experiencia cubana en planificación de los recursos humanos de enfermería en la epidemia por COVID-19 / Cuban experience in human resources planning for epidemic nursing COVID-19

Introducción: la pandemia por el virus SARS-CoV-2 ha provocado numerosas víctimas en el plano mundial. A partir de los primeros casos diagnosticados en Cuba, la máxima Dirección del Estado y el Ministerio de Salud Pública dispusieron el reordenamiento de los servicios del Sistema Nacional de Salud para garantizar la atención a los pacientes confirmados con la enfermedad y los programas priorizados con el aseguramiento de los recursos humanos de enfermería, además del desarrollo de acciones para garantizar la continuidad y calidad de las prestaciones proporcionadas. Desarrollo: se organizaron grupos de pesquisa diaria del 100% de la población en las viviendas para identificar a pacientes sintomáticos y se crearon centros para la vigilancia de acuerdo con la clasificación del paciente, ya fuera con- tacto, sospechoso o confirmado. En estos centros, el personal de enfermería mantiene una vigilancia para la detección oportuna de síntomas o agravamiento del estado de salud y efectúa el control de las pruebas diagnósticas por PCR evolutiva y el cumplimiento de los tratamientos médicos hasta su alta. En los hospitales se atienden los casos confirmados y sospechosos de alto riesgo de COVID-19. En estas instituciones se estableció un sistema de trabajo-vigilancia-descanso con el objetivo de garantizar la atención con el personal estrictamente necesario. Conclusiones: este trabajo permite compartir las experiencias vivenciales en la planificación del recurso humano de enfermería en cada una de las etapas y destaca la colaboración médica como muestra de solidaridad y humanismo que caracteriza a la sociedad. Los resultados obtenidos permitirán establecer líneas de trabajo con una clara visión de este fenómeno, con utilización óptima de los recursos materiales y humanos, además de contribuir a la preparación de los profesionales para el intercambio y la experiencia con otros países.

Introduction: The pandemic caused by the SARS-CoV-2 virus has hit numbers of victims worldwide, from the first cases diagnosed in Cuba, the highest state administration and the Ministry of Public Health provides the reorganization of the services of the National System of Health, guaranteeing care for patients confirmed with the disease and prioritized programs with the assurance of nursing human resources and the development of actions to guarantee the continuity and quality of the services provided for what the purpose is outlined. Development: Daily investigation groups of 100% of the population were organized in the homes to detect symptomatic patients, surveillance centers were created according to the classification of the patient as contact, suspect and confirmed, in these centers the nurse maintains a surveillance for the timely detection of symptoms or worsening of their health, controls the performance of the evolutionary PCR and compliance with medical treatments until discharge. In hospitals, confirmed and suspected high-risk cases of COVID-19 are treated. In these institutions, a work-surveillance-rest system was established in order to guarantee care with the strictly necessary personnel. Conclusions: In this article we share the experiential experiences in the planning of the nursing human resource in each of the stages and medical collaboration stands out as a sign of solidarity and humanism that characterizes our society. The results obtained will allow establishing lines of work with a clear vision of this phenomenon with optimal use of material and human resources, as well as contributing to the preparation of professionals with a view to exchange and experience with other countries.

Identification of miRNAs linked to peanut nodule functional processes.

microRNAs (miRNAs) are non-coding small RNAs that regulate gene expression at post-transcriptional level. Thousands of miRNAs have been identified in legumes, but studies about miRNAs linked to peanut nodule functionality are scarce. In this work we analyzed transcriptional changes in peanut nodules to identify miRNAs involved in functional processes of these organs. We found 32 miRNAs precursors differentially expressed in nodules compared with roots, and predicted the potential targets of their corresponding mature miRNAs. Among them, 20 belong to 14 conserved miRNAs families and 12 are Arachis hypogaea-specific miRNAs. Expression levels of 3 miRNAs (ahy-miR399, ahy-miR159 and ahy-miR3508) were confirmed experimentally by qPCR. We also demonstrated that the expression of these miRNAs was not affected by inoculation of a biocontrol bacterium or a fungal pathogen. The catalogue of differentially expressed miRNA precursors and the expression of the corresponding mature miRNA potential targets in the nodules of A. hypogaea obtained in this work is a database of strong candidates, including A. hypogaea-specific miRNAs, for the regulation of the nodule functionality. The analysis of their role in this process will certainly lead to the characterization of essential regulators in these particular aeschynomenoid nodules.

Description of frail older people profiles according to four screening tools applied in primary care settings: a cross sectional analysis.

BACKGROUND: Regarding the health care of older populations, WHO recommends shifting from disease-driven attention models towards a personalized, integrated and continuous care aimed to the maintenance and enhancement of functional capacities. Impairments in the construct of functional intrinsic capacity have been understood as the condition of frailty or vulnerability. No consensus has been yet reached regarding which tools are the most suitable for screening this kind of patients in primary care settings. Tools based on the measurement of functional performance such as Timed up and go test (TUG), Short Physical Performance battery (SPPB), self-completed questionnaires like Tilburg Frailty Indicator (TFI) and clinical judgement, as the Gerontopole Frailty Scale (GFS) may be adequate. The objective of this work is to describe and compare characteristics of community-dwelling individuals identified as vulnerable or frail by four tools applied in primary care settings. METHODS: Cross sectional analysis developed in primary care services in two regions of Spain. Community-dwelling independent individuals aged 70 or more willing to participate were recruited and data was collected via face-to-face interviews. Frailty was assessed by TUG, SPPB, TFI and GFST. Also socio-demographic characteristics, lifestyle habits and health status data (comorbidities, polypharmacy, self-perceived health), were collected. Multiple correspondence analysis (MCA) and cluster analysis were used to identify groups of individuals with similar characteristics. RESULTS: Eight hundred sixty-five individuals were recruited, 53% women, with a mean age of 78 years. Four clusters of participants emerge. Cluster 1 (N = 263) contained patients categorized as robust by most of the studied tools, whereas clusters 2 (N = 199), 3 (N = 183) and 4 (N = 220) grouped patients classified as frail or vulnerable by at least one of the tools. Significant differences were found between clusters. CONCLUSIONS: The assessed tools identify different profiles of patients according to their theoretical construct of frailty. There is a group of patients that are identified by TUG and SPPB but not by GFS or TFI. These tools may be useful in primary care settings for the implementation of a function- driven clinical care of older patients.

Capacidades para la gestión de resultados de investigación en sistemas y servicios de salud de enfermería en Cuba / Capacities for managing the results of health systems and health services research by nurses in Cuba

Introducción: Los resultados de las investigaciones en sistemas y servicios de salud trascienden el alcance de los objetivos previstos. Su gestión permite el cierre del ciclo investigativo y es para los profesionales de enfermería en Cuba uno de los retos a vencer en la visualización de su práctica investigativa. Por ello, se desarrolló una experiencia de la práctica que contribuyó a la consolidación de la gestión de los resultados de las investigaciones en sistemas y servicios de salud por los profesionales de enfermería en Cuba. Desarrollo: Se llevaron a cabo talleres con el objetivo de desarrollar en los profesionales de enfermería cubanos las capacidades institucionales e individuales para la gestión de los resultados de las investigaciones en sistemas y servicios de salud. Las primeras se hicieron con la designación de un responsable de investigación para la gestión institucional de este tipo de estudio y la creación de un repositorio que compilara los resultados de las investigaciones existentes. Las segundas recayeron en los responsables seleccionados y estuvieron relacionadas con la obtención de la categoría de investigadores, la gestión de publicación de artículos, la protección legal de resultados y su registro oficial en el sistema nacional de investigaciones del país. Conclusiones: las capacidades desarrolladas contribuyeron a la gestión de los resultados de los profesionales de enfermería de las instituciones participantes. Estas se integran a la etapa de sostenibilidad que implica el nivel nacional de capacidades para la investigación.

Introduction: The results of research in health systems and health services go beyond the significance of the expected target. Managing these results allows the closure of the research cycle and is one of the challenges that Cuban professional nurses have to confront in order to make visible their results. Due to this situation, a practical experience was developed to consolidate the management of research results in health systems and health services. Development: Workshops were carried out in order to develop institutional and individual capacities in Cuban professional nurses so that they could manage the results of health Systems and health services research. Institutional capacities were developed by designating a professional nurse researcher, responsible for the institutional management of this kind of studies and the creation of a repository to gather the results of the existent research. Individual capacities were carried out by the selected professionals and had to do with obtaining the researcher category, the publication of results, the legal protection of results, and the official registration in the national research system. Conclusions: The developed capacities contributed with the management of the research results of professional nurses of each participating institution. Those capacities are part of the sustainability stage that includes the national level of capacities for research.

Avaliação familiar de pacientes idosos com hepatopatia / Family assessment of elderly patients with liver disease

Objetivo: analisar a estrutura, desenvolvimento e funcionamento de famílias de pacientes idosos com hepatopatia. Método: trata-se de estudo qualitativo, de campo, que utilizou o Modelo Calgary de Avaliação Familiar. O estudo teve como cenário de investigação um hospital filantrópico. A população do estudo constituiu-se por cinco famílias de pacientes idosos hospitalizados com hepatopatia. Resultados: das cinco famílias avaliadas, duas caracterizavam-se como extensa, uma como família reconstruída, uma era composta por irmãos sem laços de consanguinidade e apenas uma como família nuclear. Foi possível, ainda, verificar que os familiares do sexo feminino apresentam-se ainda como o principal cuidador, e que todas as famílias apresentavam a média mensal de dois salários mínimos. Conclusão: levando em consideração que a participação da família no processo do adoecimento apresenta-se como fator determinante para o prognóstico satisfatório dos pacientes, o papel da enfermagem frente a avaliação e intervenção no contexto familiar contribuirá significante para melhora da condição de saúde e bem-estar dos pacientes e familiares.(AU)

Validation of the Spanish version of the Edinburgh Feeding Evaluation in Dementia Scale for older people with dementia.

AIMS: To adapt the Edinburgh Feeding Evaluation in Dementia Scale (EdFED) for use in a Spanish-speaking population and to assess its validity and reliability in patients with dementia. METHOD: A cross-sectional study was carried out in two stages: 1. Cross-cultural adaptation (translation, back-translation, review by committee of experts, pilot test and weighting of results); 2. Clinimetric validation comprising interobserver reliability assessment, test-retest reliability and internal consistency. To determine construct validity, confirmatory factorial analysis and principal components analysis were performed by oblique rotations. Criteria validity was analysed using the Pearson correlation (p<0.05) with the BMI, MNA and analytical values of albumin, transferrin, cholesterol, absolute lymphocytes and total proteins. Data collection was carried out for six months in 2016 in nursing homes and Alzheimer's day centers in the province of Málaga (Spain), at nine centers, with 262 patients (aged over 60 years and presenting feeding difficulties), 20 nurses, 20 professional caregivers and 103 family caregivers. RESULTS: A version of EdFED culturally adapted to Spanish was obtained. The sample presented the following characteristics: 76.3% women, mean age 82.3 years (SD: 7.9); MNA 18.73 (SD: 4.44); BMI 23.99 (SD: 4.72); serum albumin 3.79 mg/dl (SD: 0.36). A Cronbach's alpha of 0.88 was obtained, with an inter-item global correlation of 0.43 and a homogeneity index ranging from 0.42 to 0.73. The exploratory factor analysis reproduced the three-factor model identified by the original authors, explaining 62.32% of the total variance. The criterion validity showed a good inverse correlation with MNA and a moderate one with albumin, total proteins, transferrin and BMI. DISCUSSION: The Spanish version of EdFED is reliable and valid for use in elderly people with dementia. The most appropriate for our environment is the three-factor model, which maintains the original factors, with a slight redistribution of the items.

Induced systemic resistance and symbiotic performance of peanut plants challenged with fungal pathogens and co-inoculated with the biocontrol agent Bacillus sp. CHEP5 and Bradyrhizobium sp. SEMIA6144.

Synergism between beneficial rhizobacteria and fungal pathogens is poorly understood. Therefore, evaluation of co-inoculation of bacteria that promote plant growth by different mechanisms in pathogen challenged plants would contribute to increase the knowledge about how plants manage interactions with different microorganisms. The goals of this work were a) to elucidate, in greenhouse experiments, the effect of co-inoculation of peanut with Bradyrhizobium sp. SEMIA6144 and the biocontrol agent Bacillus sp. CHEP5 on growth and symbiotic performance of Sclerotium rolfsii challenged plants, and b) to evaluate field performance of these bacteria in co-inoculated peanut plants. The capacity of Bacillus sp. CHEP5 to induce systemic resistance against S. rolfsii was not affected by the inoculation of Bradyrhizobium sp. SEMIA6144. This microsymbiont, protected peanut plants from the S. rolfsii detrimental effect, reducing the stem wilt incidence. However, disease incidence in plants inoculated with the isogenic mutant Bradyrhizobium sp. SEMIA6144 V2 (unable to produce Nod factors) was as high as in pathogen challenged plants. Therefore, Bradyrhizobium sp. SEMIA6144 Nod factors play a role in the systemic resistance against S. rolfsii. Bacillus sp. CHEP5 enhanced Bradyrhizobium sp. SEMIA6144 root surface colonization and improved its symbiotic behavior, even in S. rolfsii challenged plants. Results of field trials confirmed the Bacillus sp. CHEP5 ability to protect against fungal pathogens and to improve the yield of extra-large peanut seeds from 2.15% (in Río Cuarto) to 16.69% (in Las Vertientes), indicating that co-inoculation of beneficial rhizobacteria could be a useful strategy for the peanut production under sustainable agriculture system.

Validation of the Spanish version of the Edinburgh feeding evaluation in dementia scale applied to institutionalized older persons with dementia: a study protocol.

AIM: The aim of this study was to obtain a Spanish version of the Edinburgh Feeding Evaluation in Dementia Scale version, to assess its reliability for use by medical staff and caregivers at residential care homes, to evaluate by confirmatory methods its construct validity. A further aim was to determine the criterion validity with respect to biochemical markers of malnutrition such as serum albumin, transferrin, cholesterol and lymphocytes, the body mass index and the mini nutritional assessment. DESIGN: Clinimetric cross-validation study. METHODS: Institutionalized subjects with dementia will be observed while consuming meals and evaluated with the instrument independently by nurses and caregivers.

Sequence and expression analysis of putative Arachis hypogaea (peanut) Nod factor perception proteins.

Peanut, like most legumes, develops a symbiotic relationship with rhizobia to overcome nitrogen limitation. Rhizobial infection of peanut roots occurs through a primitive and poorly characterized intercellular mechanism. Knowledge of the molecular determinants of this symbiotic interaction is scarce, and little is known about the molecules implicated in the recognition of the symbionts. Here, we identify the LysM extracellular domain sequences of two putative peanut Nod factor receptors, named AhNFR1 and AhNFP. Phylogenetic analyses indicated that they correspond to LjNFR1 and LjNFR5 homologs, respectively. Transcriptional analysis revealed that, unlike LjNFR5, AhNFP expression was not induced at 8 h post bradyrhizobial inoculation. Further examination of AhNFP showed that the predicted protein sequence is identical to GmNFR5 in two positions that are crucial for Nod factor perception in other legumes. Analysis of the AhNFP LysM2 tridimensional model revealed that these two amino acids are very close, delimiting a zone of the molecule essential for Nod factor recognition. These data, together with the analysis of the molecular structure of Nod factors of native peanut symbionts previously reported, suggest that peanut and soybean could share some of the determinants involved in the signalling cascade that allows symbiosis establishment.

Interrelationships between Bacillus sp. CHEP5 and Bradyrhizobium sp. SEMIA6144 in the induced systemic resistance against Sclerotium rolfsii and symbiosis on peanut plants.

Plant-growth-promoting bacteria are often used to enhance crop yield and for biological control of phytopathogens. Bacillus sp. CHEP5 is a biocontrol agent that induces systemic resistance (ISR) in Arachis hypogaea L. (peanut) against Sclerotium rolfsii, the causal agent of root and stem wilt. In this work, the effect of the co-inoculation of Bacillus sp. CHEP5 and the peanut nodulating strain Bradyrhizobium sp. SEMIA 6144 was studied on induction of both systemic resistance and nodulation processes. Bradyrhizobium sp. SEMIA 6144 did not affect the ability of Bacillus sp. CHEP5 to protect peanut plants from S. rolfsii by ISR and the priming in challenged-plants, as evidenced by an increment in phenylalanine ammonia-lyase enzyme activity. Additionally, the capacity of Bradyrhizobium sp. SEMIA 6144 to induce nodule formation in pathogen-challenged plants was improved by the presence of Bacillus sp. CHEP5.

Presentación de una paciente con miocardiopatía restrictiva / Presentation of a Restrictive Myocardiopathy Patient

Las miocardiopatías se definen como enfermedades primarias del miocardio y se presentan tanto en niños como en adultos. Se presentó una paciente de 15 años portadora de miocardiopatía restrictiva. Esta enfermedad es una de las menos frecuentes entre las miocardiopatías y comprende alrededor del 5 por ciento, del total de ellas. El tratamiento está dirigido a mejorar los síntomas congestivos, por la frecuencia de trombos, dilatación y fibrilación atriales ; la mayoría de los pacientes se tratan con anticoagulantes(AU)

Cardiomyopathies are defined as primary myocardial disease and occur in both children and adults. A ,15, year old patient with restrictive cardiomyopathy was presented in this paper. T his disease is one of the less common of all cardiomyopathies, and represents about ,5 percent, of all. Treatment is aimed at improvingcongestive symptoms due to the frequency of thrombi, atrial fibrillation and dilation. The most of patients is treated with anticoagulants(AU)

Presentación de un paciente con diagnóstico de miocardiopatía hipertrófica / Presentation of a Patient with Hypertrophic Cardiomyopathy

Se presentó una paciente femenina de 16 años con diagnóstico de miocardiopatía hipertrófica desde l os 12 días de nacida. La miocardiopatía hipertrófica es una enfermedad genética de herencia autosómica dominante, caracterizada por un incremento de la masa muscular y desorganización miofibrilar, con alto riesgo de muerte súbita, que no tiene predisposición racial o étnica. Tiene una prevalencia de 1/500 familias. Los pacientes afectados por lo general tienen las arterias coronarias intramurales anormales; la característica que más ha atraído la atención de esta enfermedad es el gradiente dinámico de presión a través del tracto de salida del ventrículo izquierdo. El grado de obstrucción varía de un paciente a otro(AU)

A ,16, year old female patient with hypertrophic cardiomyopathy diagnosed ,12, days after birth was presented in this paper. This is a genetic autosomal dominant inheritance disease characterized by increased muscle mass and myofibrillar disarray with high risk of sudden death, which has no racial or ethnic bias. It has a prevalence of, 1 / 500, families. Affected patients usually have abnormal intramural coronary arteries, and the dynamic pressure gradient across the outflow tract of the left ventricle is the most representative of this disease.The degree of obstruction varies from patient to patient(AU)

Reporte de un caso con diagnóstico de anillo vascular / Report of a Patient with Vascular Ring

Se presentó un paciente masculino de cuatro meses portador de un anillo vascular, operado de mielomeningocele con antecedentes de infecciones respiratorias frecuentes, broncoespasmo, estridor laríngeo y reflujo gastroesofágico. Es común que estas malformaciones vasculares se asocien con otros defectos cardíacos congénitos, fundamentalmente defectos septales y troncoconales. Representan alrededor del 1 por ciento de todas las anomalías cardiovasculares congénitas. Se ha comunicado una mayor frecuencia de anillos vasculares en el sexo masculino. Varios tipos de anillos vasculares están asociados con un arco aórtico a la derecha Los síntomas en la edad pediátrica son principalmente respiratorios y digestivos, por compresión traqueal y esofágica que producen trastornos en la deglución que se manifiestan por vómitos o intolerancia a la alimentación y que agravan los síntomas respiratorios como resultado de broncoaspiración(AU)...

A male patient case of 4 month of age with vascular ring thet underwent surgery of myelomeningocele and a history of frequent respiratory infections, bronchospasm, laryngeal stridor, and gastroesophageal reflux was presented in this paper. These vascular malformations are commonly associated with other congenital heart defects like septal and truncoconal defects. Vascular rings represent about ,1, percent of all congenital heart anomalies and have been frequently reported in males. Several types of vascular rings are associated with right aortic arch. Symptoms in children are mainly respiratory and digestive because of tracheal and esophageal compression resulting in swallowing disorders presented by vomiting or food intolerance. These disorders worsen respiratory symptoms as a result of pulmonary aspiration(AU)...

A polymorphism in PTPN2 gene is associated with an earlier onset of type 1 diabetes.

The Wellcome Trust Case Control Consortium (WTCCC) genome-wide study found association of PTPN2 with three autoimmune diseases, among them is type 1 diabetes (T1D). This result was confirmed by a follow-up study that pointed to new independent signals within the region. However, both studies were performed in patients with an early-onset T1D. We aimed at replicating the previous results and studying the influence of these polymorphisms in the age at T1D debut. We genotyped 439 T1D Spanish subjects (age at onset, 1 to 65 years) and 861 controls for two PTPN2 single nucleotide polymorphisms (SNPs), rs2542151 and rs478582, and studied the effect of both polymorphisms in age at onset through stratified and continuous analyses. The frequency of rs2542151*G carriers was significantly higher in the early-onset group compared with late-onset patients (p = 0.023) and with controls (OR = 1.61 [1.14-2.26]; p = 0.005). No significant differences were found between controls and late-onset patients. The log-rank chi-square test for the Kaplan-Meier plots (carriers of susceptibility allele vs non carriers) was statistically significant (χ (1df) (2) = 4.485; p = 0.034), yielding an earlier disease debut for G carriers. The analysis of the SNP rs478582 did not reach statistical significance. In summary, we replicate the association detected by the WTCCC and propose that the rs2542151*G allele confers risk to an earlier onset of T1D.