Does the esv3587290 Copy Number Variation in the VANGL1 Gene Differ as a Genetic Factor for Developing Nephritis in Mexican Childhood-Onset Systemic Lupus Erythematosus Patients?

A ~3-kb deletion-type DNA copy number variation (CNV, esv3587290) located at intron 7 of the VANGL1 gene (1p13.1, MIM*610132) has been proposed as a genetic factor in lupus nephritis (LN) development in adult systemic lupus erythematosus (SLE) patients across European-descent populations, but its replication in other ethnicities has been inconsistent and its association with LN in childhood-onset SLE (cSLE) remains unknown. Here, we performed an exploratory association study in a sample of 66 unrelated cSLE Mexican patients (11 males, 55 females; ages 7.8 to 18.6 years). Two stratified groups were compared: cSLE patients with (N = 39) or without (N = 27) LN, as diagnosed by renal biopsy (N = 17), proteinuria (N = 33), urinary protein-creatinine ratio > 0.2 (N = 34), and erythrocyturia and/or granular casts in urinary sediment (N = 16). For esv3587290 CNV genotyping, we performed an end-point PCR assay with breakpoint confirmation using Sanger sequencing. We also determined the allelic frequencies of the esv3587290 CNV in 181 deidentified ethnically matched individuals (reference group). The obtained genotypes were tested for Hardy-Weinberg equilibrium using the χ2 test. Associations between LN and esv3587290 CNV were tested by calculating the odds ratio (OR) and using Pearson's χ2 tests, with a 95% confidence interval and p ≤ 0.05. The esv3587290 CNV allele (OR 0.108, 95% CI 0.034-0.33, p = 0.0003) and the heterozygous genotype (OR 0.04, 95% CI 0.119-0.9811, p = 0.002) showed a significant protective effect against LN development. Finally, we characterized the precise breakpoint of the esv3587290 CNV to be NG_016548.1(NM_138959.3):c.1314+1339_1315-897del in our population. This report supports the notion that a broad genetic heterogeneity underlies the susceptibility for developing LN.

Microbial-Based Biofungicides Mitigate the Damage Caused by Fusarium oxysporum f. sp. cubense Race 1 and Improve the Physiological Performance in Banana.

Fusarium wilt of banana (FWB) is the most limiting disease in this crop. The phytosanitary emergency caused by FWB since 2019 in Colombia has required the development of ecofriendly control methods. The aim of this study was to test the effectiveness of microbial-based biofungicides against FWB caused by Fusarium oxysporum f. sp. cubense race 1 (Foc R1) and correlate such effect with plant physiological parameters. Five Trichoderma (T1 to T4 and T9) and four Bacillus (T5 to T8)-based biofungicides were evaluated in pot experiments. In vitro, dual confrontation tests were also carried out to test whether the in vitro effects on Foc growth were consistent with the in vivo effects. While Trichoderma-based T3, T4, and T9, and Bacillus-based T8, significantly reduced the growth of Foc R1 in vitro, Trichoderma-based T1, T3, T4, and T9 temporarily reduced the Foc population in the soil. However, the incidence progress of FWB was significantly reduced by Bacterial-based T7 (74% efficacy) and Trichoderma-based T2 (50% efficacy). The molecular analysis showed that T7 prevented the inner tissue colonization by Foc R1 in 80% of inoculated plants. The T2, T4, T7, and T9 treatments mitigated the negative effects caused by Foc R1 on plant physiology and growth. Our data allowed us to identify three promising treatments to control FWB, reducing the progress of the disease, delaying the colonization of inner tissue, and mitigating physiological damages. Further studies should be addressed to determine the modes of action of the biocontrol agents against Foc and validate the utilization in the field.

Segmental Clavicle Fracture in a Polytraumatized Patient: Case Report.

Clavicle fracture represents 5% of the fractures in adults. However, segmental clavicle fractures are infrequent and have been understudied in the current literature. Cases have been reported showing adequate results with both surgical and conservative management, and yet, it has not been possible to reach a consensus regarding diagnosis or management of such condition. A patient with a middle and lateral segmental clavicle fracture is reported, after presenting multiple trauma in a road traffic accident, also suffering trauma to the right hemi body, multiple rib segmental fractures and hemothorax. After stabilization, he was taken to surgery for open reduction and internal fixation of the clavicle using a double plate technique, as it has been rarely described in the literature. The functional result was shown to be adequate and satisfactory in the postoperative follow-up. Despite the limited evidence available on the management of this type of pathology, surgical management is a valid option given the risk of non-union. The foregoing is concluded by the potential harm in patient functionality.

Hydrogel capsules as new delivery system for Trichoderma koningiopsis Th003 to control Rhizoctonia solani in rice (Oryza sativa).

The incorporation of biological control agents (BCAs) such as Trichoderma spp. in agricultural systems favors the transition towards sustainable practices of plant nutrition and diseases control. Novel bioproducts for crop management are called to guarantee sustainable antagonism activity of BCAs and increase the acceptance of the farmers. The encapsulation in polymeric matrices play a prominent role for providing an effective carrier/protector and long-lasting bioproduct. This research aimed to study the influence of biopolymer in hydrogel capsules on survival and shelf-life of T. koningiopsis. Thus, two hydrogel capsules prototypes based on alginate (P1) and amidated pectin (P2), containing conidia of T. koningiopsis Th003 were formulated. Capsules were prepared by the ionic gelation method and calcium gluconate as crosslinker. Conidia releasing under different pH values of the medium, survival of conidia in drying capsules, storage stability, and biocontrol activity against rice sheath blight (Rhizoctonia solani) were studied. P2 prototype provided up to 98% survival to Th003 in fluid bed drying, faster conidia releasing at pH 5.8, storage stability greater than 6 months at 18 °C, and up to 67% of disease reduction. However, both biopolymers facilitate the antagonistic activity against R. solani, and therefore can be incorporated in novel hydrogel capsules-based biopreparations. This work incites to develop novel biopesticides-based formulations with potential to improve the delivery process in the target site and the protection of the active ingredient from the environmental factors.

Behavior and Use of Quaternary Ammonium-Based Disinfectants in Biosafety Protocols Against Fusarium oxysporum f. sp. cubense Race 1 and Tropical Race 4.

The banana is one of Colombia's main export products. However, production is seriously affected by Fusarium wilt of banana, which is the most destructive disease caused by the fungus Fusarium oxysporum f. sp. cubense tropical race 4 (Foc TR4). Currently, management strategies focus on containment and biosecurity protocols to prevent its spread to territories that are free of this disease. This study aimed to evaluate nine quaternary ammonium-based disinfectants (i.e., quaternary ammonium compounds [QACs]) in vitro in Colombia on reproductive (microconidia and macroconidia) and resistance structures (chlamydospores) of Foc race 1 (R1) and tropical race 4 (TR4), with and without soil, to determine the influence of organic matter and soil texture on the action of QACs. A method for inhibiting the action of QACs was standardized and evaluated at 1,200 ppm with a contact time of ≤30 s while evaluating the soil-inoculum and soil-disinfectant interactions. In the soil-inoculum interaction, the efficacy of QACs was 100% in the reproductive and resistance structures of Foc R1 and TR4 without soil. However, in the soil-disinfectant interaction, only QAC4 controlled the pathogen at 100%. The presence of organic matter influenced the biocidal action of the QACs, and fine textures had a greater reducing effect on the concentration. The soil decreased the efficacy of the QACs and, therefore, must be removed from contaminated boots before treatments are applied.

Segmental Clavicle Fracture in a Polytraumatized Patient: Case Report / Fratura segmentar da clavícula em paciente politraumatizado: Relato de caso

Abstract Clavicle fracture represents 5% of the fractures in adults. However, segmental clavicle fractures are infrequent and have been understudied in the current literature. Cases have been reported showing adequate results with both surgical and conservative management, and yet, it has not been possible to reach a consensus regarding diagnosis or management of such condition. A patient with a middle and lateral segmental clavicle fracture is reported, after presenting multiple trauma in a road traffic accident, also suffering trauma to the right hemi body, multiple rib segmental fractures and hemothorax. After stabilization, he was taken to surgery for open reduction and internal fixation of the clavicle using a double plate technique, as it has been rarely described in the literature. The functional result was shown to be adequate and satisfactory in the postoperative follow-up. Despite the limited evidence available on the management of this type of pathology, surgical management is a valid option given the risk of non-union. The foregoing is concluded by the potential harm in patient functionality.

Resumo A fratura de clavícula representa 5% das fraturas em adultos. No entanto, as fraturas segmentares da clavícula são infrequentes e pouco estudadas na literatura atual. Há relatos de casos com bons resultados após o tratamento cirúrgico ou conservador, mas não existe consenso quanto ao diagnóstico ou manejo dessas lesões. Relata-se um paciente com fratura segmentar média e lateral da clavícula após politraumatismo em acidente de trânsito. O paciente também apresentava traumatismo em hemicorpo direito, múltiplas fraturas segmentares da costela e do hemotórax. Após estabilização, ele foi encaminhado à cirurgia para redução aberta e fixação interna da clavícula pela técnica de placa dupla, raramente descrita na literatura. O resultado funcional foi considerado satisfatório e adequado no acompanhamento pós-operatório. Apesar das poucas evidências sobre o manejo desse tipo de patologia, o tratamento cirúrgico é uma opção válida devido ao risco de não união, apesar da possível diminuição da funcionalidade do paciente.

Factores de riesgo y medidas preventivas del cáncer de mama en pacientes mujeres atendidas en el Centro de Salud Subtanjalla, Ica ­2019 / Risk factors and preventive measures for breast cancer in female patients treated at the Subtanjalla health center, Ica ­2019

El estudio tuvo como Objetivo: Identificar los factores de riesgo y medidas preventivas del cáncer de mama en pacientes mujeres atendidas en el centro de salud Subtanjalla de Ica -2019. Material y métodos: De tipo no experimental, descriptivo, transversal, con muestra de 108 mujeres, aplicándose un cuestionario estructurado de 15 preguntas, validado por expertos, y con Alfa de Cronbach de 0.77. Resultados: Los factores más relevantes menarquia precoz, que fue a los 12 años en el 35%, los antecedentes familiares con cáncer con un 51%, el 44% utiliza el inyectable como método anticonceptivo, el 65% a veces consume bebidas alcohólicas; en las medidas preventivas el 75% no realiza actividad física, el 49% no consume frutas y verduras frecuentemente, el 44% no se realiza el autoexamen de mama; según los factores de riesgo; el 44% de mujeres tienen entre 21 a 30 años; el 35% de mujeres tuvo su primera menstruación a los 12 años; el 32% de mujeres no utiliza ningún método anticonceptivo;, el 51% de mujeres tienen antecedentes de cáncer; el 81% de mujeres no consume cigarrillos, el 69% de mujeres consume bebidas alcohólicas a veces. El 75% de mujeres no realiza actividad preventiva, el 49% de mujeres tienen dieta saludable; el 44% de mujeres refiere realizar cada mes el autoexamen de mama. Conclusiones: Los datos estadísticos demuestran que existen factores de riesgo y medidas preventivas del cáncer de mama.

The study was Objective: To identify the risk factors and preventive measures of breast cancer in female patients treated at the Subtanjalla health center in Ica -2019. Material and methods:Non-experimental, descriptive, cross-sectional, with a sample of 108 women, applying a structured questionnaire of 15 questions, validated by experts, and with Cronbach's Alpha of 0.77. Results:The most relevant factors were early menarche, which was at 12 years of age in 35%, a family history of cancer with 51%, 44% used injectables as a contraceptive method, 65% sometimes consumed alcoholic beverages; In preventive measures, 75% do not perform physical activity, 49% do not consume fruits and vegetables frequently, 44% do not perform breast self-examination; according to risk factors; 44% of women are between 21 and 30 years old; 35% of women had their first menstruation at age 12; 32% of women do not use any contraceptive method; 51% of women have a history of cancer; 81% of women do not consume cigarettes, 69% of women sometimes consume alcoholic beverages. 75% of women do not carry out preventive activity, 49% of women have a healthy diet; 44% of women report performing a breast self-examination every month. Conclusions:Statistical data demonstrate that there are risk factors and preventive measures for breast cancer.Keywords: Risk factors, preventive measures, cancer.

Analysis of Adverse Drug Reactions in Pediatric Patients with Epilepsy: An Intensive Pharmacovigilance Study.

Epilepsy is a chronic neurological disease characterized by the presence of spontaneous seizures, with a higher incidence in the pediatric population. Anti-seizure medication (ASM) may produce adverse drug reactions (ADRs) with an elevated frequency and a high severity. Thus, the objective of the present study was to analyze, through intensive pharmacovigilance over 112 months, the ADRs produced by valproic acid (VPA), oxcarbazepine (OXC), phenytoin (PHT), and levetiracetam (LEV), among others, administered to monotherapy or polytherapy for Mexican hospitalized pediatric epilepsy patients. A total of 1034 patients were interviewed; 315 met the inclusion criteria, 211 patients presented ADRs, and 104 did not. A total of 548 ASM-ADRs were identified, and VPA, LEV, and PHT were the main culprit drugs. The most frequent ADRs were drowsiness, irritability, and thrombocytopenia, and the main systems affected were hematologic, nervous, and dermatologic. LEV and OXC caused more nonsevere ADRs, and PHT caused more severe ADRs. The risk analysis showed an association between belonging to the younger groups and polytherapy with ADR presence and between polytherapy and malnutrition with severe ADRs. In addition, most of the severe ADRs were preventable, and most of the nonsevere ADRs were nonpreventable.

Central venous-to-arterial CO2 difference as a biomarker of outcome in children who underwent surgery for congenital heart disease.

BACKGROUND: In congenital heart surgery, low cardiac output syndrome (LCOS) is a major cause of morbidity in the immediate post-operative period. A decrease in cardiac output leads to an increase in tissue oxygen consumption. Several biomarkers such as venous oxygen saturation (SvO2), arteriovenous oxygen difference (DavO2), and lactate can assess tissue perfusion in the presence of LCOS. Recently, central venous to arterial CO2 difference (ΔCO2) has been proposed as a biomarker of tissue ischemia that could be used as a predictor of death in neonatal patients. This study aimed to analyze the relationship between ΔCO2 and immediate post-operative outcomes in pediatric patients undergoing congenital heart surgery and its correlation with DavO2, SvO2, and lactate. METHODS: We conducted a longitudinal study of patients aged 0-18 years who underwent congenital heart surgery with or without cardiopulmonary bypass at the Instituto Nacional de Pediatría, from March 2019 to March 2021. RESULTS: Eighty-two patients were included; the median age was 17 months. About 59% had a ΔCO2 ≥ 6 mmHg. Patients with ΔCO2 ≥ 6 mmHg had a vasoactive-inotropic score > 5 (p < 0.001), DavO2 > 5 mL/dL (p = 0.048), and lactate > 2 mmol/L (p = 0.027), as well as a longer hospital stay (p = 0.043). Patients with ΔCO2 > 6 mmHg and vasoactive-inotropic score ≥ 10 were 12.6 times more likely to die. CONCLUSION: ΔCO2 is a good marker of tissue hypoperfusion and outcome in the post-operative period of congenital heart surgery.

INTRODUCCIÓN: En la cirugía cardiaca de malformaciones congénitas, el síndrome de bajo gasto cardiaco (SBGC) es una de las principales causas de morbilidad en el postoperatorio inmediato. La caída del gasto cardiaco aumenta el consumo de oxígeno en los tejidos. Varios biomarcadores, como la saturación venosa de oxígeno (SvO2), la diferencia arteriovenosa de oxígeno (DavO2) y el lactato han sido utilizados como indicadores hipoperfusión tisular en presencia de SBGC. Recientemente, la diferencia arteriovenosa de CO2 (ΔCO2) se ha propuesto como otro biomarcador de isquemia tisular que podría utilizarse como predictor de muerte en pacientes en edad neonatal. El objetivo de este estudio fue analizar la relación entre la ΔCO2 y la evolución postoperatoria de pacientes pediátricos operados de cardiopatías congénitas y correlacionarlo con la DavO2, SvO2 y lactato. MÉTODOS: Se realizó un estudio longitudinal en pacientes de 0 a 18 años operados de corazón con empleo de bomba de circulación extracorpórea en el Instituto Nacional de Pediatría. RESULTADOS: Se incluyeron 82 pacientes; la mediana de edad fue de 17 meses. El 59% presentó un ΔCO2 > 6 mmHg. Los pacientes con un ΔCO2 > 6 mmHg mostraron un puntaje de inotrópicos > 5 (p < 0.001), DavO2 > 5 mL/dL (p = 0.048) y lactato > 2 mmol/L (p = 0.027), así como mayor estancia hospitalaria (p = 0.043). Los pacientes con ΔCO2 > 6 mmHg y un puntaje de inotrópicos ≥ 10 presentaron una probabilidad de muerte 12.6 veces mayor. CONCLUSIONES: El ΔCO2 en el periodo postoperatorio de una cirugía cardiaca congénita es un buen marcador de hipoperfusión tisular y de desenlace.

Relaciones institucionales en la implementación de estrategias de promoción, protección y apoyo de la lactancia materna: una revisión integrativa / Institutional relationships in the implementation of breastfeeding promotion, protection and support strategies: an integrative review

Fundamentos: la importancia que tiene la lactancia materna en la salud y calidad de vida de los individuos hace necesario que las políticas establecidas para su promoción sean operadas mediante la participación y articulación de instituciones y a través de redes interinstitucionales. Métodos: para la compilación de la información se hizo una revisión integrativa de literatura, cuyo propósito fue ampliar la comprensión de un tema a partir de la recopilación, sistematización y análisis de producciones científicas. Resultados: se seleccionaron 14 artículos publicados entre 2013 y 2020 y, en su mayoría, escritos en inglés, provenientes de países como Estados Unidos, Alemania, Reino Unido y Samoa. Los temas más recurrentes fueron el análisis de políticas públicas, la coordinación de programas y la percepción del funcionamiento de las estrategias de promoción, protección y apoyo a la lactancia materna. En conclusión: las relaciones intra e interinstitucionales son claves a la hora de implementar políticas de promoción de la lactancia materna. Sin embargo, para su puesta en marcha, se requiere financiación y articulación en los niveles operativos de sistemas de salud. En definitiva, las labores de articulación, seguimiento y evaluación requieren relaciones fortalecidas que fomenten, protejan, promuevan y apoyen la práctica de la lactancia materna. (AU)

Background: the importance of breastfeeding in the health and quality of life of individuals makes it necessary for the policies established for its promotion to be implemented through the participation and coordination of institutions and through inter-institutional networks. Methods: for the compilation of the information, an integrative literature review was carried out, the purpose of which was to broaden the understanding of a topic through the collection, systematization and analysis of scientific productions. Results: 14 articles published between 2013 and 2020 and mostly written in English were selected from countries such as the United States, Germany, United Kingdom and Samoa. The most recurrent themes were the analysis of public policies, program coordination and perceptions of the functioning of breastfeeding promotion, protection and support strategies. Conclusions: Intra- and inter-institutional relationships are key to the implementation of breastfeeding promotion policies. However, their implementation requires funding and coordination at the operational levels of health systems. In short the articulation, monitoring and evaluation require strengthened relationships that encourage, protect, promote and support the practice of breastfeeding. (AU)

Central venous-to-arterial CO2 difference as a biomarker of outcome in children who underwent surgery for congenital heart disease / Diferencia arteriovenosa de CO2 como biomarcador de desenlace en niños operados de cardiopatías congénitas

Abstract Background: In congenital heart surgery, low cardiac output syndrome (LCOS) is a major cause of morbidity in the immediate post-operative period. A decrease in cardiac output leads to an increase in tissue oxygen consumption. Several biomarkers such as venous oxygen saturation (SvO2), arteriovenous oxygen difference (DavO2), and lactate can assess tissue perfusion in the presence of LCOS. Recently, central venous to arterial CO2 difference (ΔCO2) has been proposed as a biomarker of tissue ischemia that could be used as a predictor of death in neonatal patients. This study aimed to analyze the relationship between ΔCO2 and immediate post-operative outcomes in pediatric patients undergoing congenital heart surgery and its correlation with DavO2, SvO2, and lactate. Methods: We conducted a longitudinal study of patients aged 0-18 years who underwent congenital heart surgery with or without cardiopulmonary bypass at the Instituto Nacional de Pediatría, from March 2019 to March 2021. Results: Eighty-two patients were included; the median age was 17 months. About 59% had a ΔCO2 ≥ 6 mmHg. Patients with ΔCO2 ≥ 6 mmHg had a vasoactive-inotropic score > 5 (p < 0.001), DavO2 > 5 mL/dL (p = 0.048), and lactate > 2 mmol/L (p = 0.027), as well as a longer hospital stay (p = 0.043). Patients with ΔCO2 > 6 mmHg and vasoactive-inotropic score ≥ 10 were 12.6 times more likely to die. Conclusion: ΔCO2 is a good marker of tissue hypoperfusion and outcome in the post-operative period of congenital heart surgery.

Resumen Introducción: En la cirugía cardiaca de malformaciones congénitas, el síndrome de bajo gasto cardiaco (SBGC) es una de las principales causas de morbilidad en el postoperatorio inmediato. La caída del gasto cardiaco aumenta el consumo de oxígeno en los tejidos. Varios biomarcadores, como la saturación venosa de oxígeno (SvO2), la diferencia arteriovenosa de oxígeno (DavO2) y el lactato han sido utilizados como indicadores hipoperfusión tisular en presencia de SBGC. Recientemente, la diferencia arteriovenosa de CO2 (ΔCO2) se ha propuesto como otro biomarcador de isquemia tisular que podría utilizarse como predictor de muerte en pacientes en edad neonatal. El objetivo de este estudio fue analizar la relación entre la ΔCO2 y la evolución postoperatoria de pacientes pediátricos operados de cardiopatías congénitas y correlacionarlo con la DavO2, SvO2 y lactato. Métodos: Se realizó un estudio longitudinal en pacientes de 0 a 18 años operados de corazón con empleo de bomba de circulación extracorpórea en el Instituto Nacional de Pediatría. Resultados: Se incluyeron 82 pacientes; la mediana de edad fue de 17 meses. El 59% presentó un ΔCO2 > 6 mmHg. Los pacientes con un ΔCO2 > 6 mmHg mostraron un puntaje de inotrópicos > 5 (p < 0.001), DavO2 > 5 mL/dL (p = 0.048) y lactato > 2 mmol/L (p = 0.027), así como mayor estancia hospitalaria (p = 0.043). Los pacientes con ΔCO2 > 6 mmHg y un puntaje de inotrópicos ≥ 10 presentaron una probabilidad de muerte 12.6 veces mayor. Conclusiones: El ΔCO2 en el periodo postoperatorio de una cirugía cardiaca congénita es un buen marcador de hipoperfusión tisular y de desenlace.

Vacunación de BCG en el medio rural y la importancia del conocimiento de sus beneficios / BCG vaccination in rural areas and the importance of knowledge of its benefits

Objetivo General: Establecer nivel de conocimiento sobre tuberculosis y vacuna, BCG., de padres y representantes, en Ambulatorio Gabriel Trompiz, Tucacas, Estado Falcón. Metodología: Es un estudio descriptivo de tipo transversal, con una muestra poblacional de 180 madres, padres y representantes entre octubre y diciembre de 2022. Se utilizaron encuestas, formularios elaborados y validados en estudios anteriores; la información fue procesada con el programa estadístico Microsoft Excel. Resultados: la mayor parte de la población respondió que la tuberculosis es una enfermedad producida por un virus, con respecto a la importancia de las inmunizaciones, un 20% desconocía la importancia de la vacunación. El 77% conocían información básica acerca de la vacuna BCG. En cuanto a las enfermedades prevenibles por esta vacuna, un 54% respondió que se trataba sobre la tuberculosis, mientras que casi la mitad de la población estudiada tenía la creencia que tenía que ver con el resfriado común. El 72% de la población considera que la fiebre es una contraindicación para la aplicación de la vacuna BCG. Se demostró que existía una gran desinformación con respecto a la vacunación en la población infantil en el medio rural venezolano(AU)

To establish the level of knowledge about tuberculosis and BCG vaccine., of parents and representatives in the Gabriel Trompiz outpatient clinic, Tucacas, Falcon State. Methodology: it is a descriptive cross-sectional study, with a population sample of 180 mothers, fathers and representatives between October and December 2022. Surveys, forms prepared and validated in previous studies were used, the information was processedwith the Microsoft Excel statistical program. Results: most of the population answered that tuberculosis was a disease caused by a virus, regarding the importance of immunizations, 20% were unaware of the importance of vaccination. 77% knew basic information about the BCG vaccine. Regarding the diseases preventable by this vaccine, 54% answered that it was about tuberculosis, while almost half of the population studied believed that it had to do with the common cold. 72% of the population considers that fever is a contraindication for the application of the BCG vaccine. It was demonstrated that there was a great amount of misinformation regarding vaccination in the child population in rural Venezuela(AU)

Risk factors for reamputation in patients with diabetic foot: A case-control study.

BACKGROUND: Reamputation as a complication of diabetic foot ulcers presents a high economic burden and represents a therapeutic failure. It is paramount to identify as early as possible patients in whom a minor amputation may not be the best option. The purpose of this investigation was to do a case-controlled study to determine risk factors associated with re-amputation in patients with DFU (diabetic foot ulcers) at two University Hospitals. METHODS: Multicentric, observational, retrospective, case-control study from clinical records of 2 university hospitals. Our study included 420 patients, with 171 cases (re-amputations), and 249 controls. We performed a multivariate logistic regression analysis and time-to-event survival analysis to identify re-amputation risk factors. RESULTS: Statistically significant risk factors were artery history of tobacco use (p = 0.001); male sex (p = 0.048); arterial occlusion in Doppler ultrasound (p = 0.001); percentage of stenosis in arterial ultrasound >50 % (p = 0.053); requirement of vascular intervention (p = 0.01); and microvascular involvement in photoplethysmography (p = 0.033). The most parsimonious regression model suggests that history of tobacco use, male sex, arterial occlusion in ultrasound, and percentage of stenosis in arterial ultrasound >50 % remained statistically significant. The survival analysis identified earlier amputations in patients with larger occlusion in arterial ultrasound, high leukocyte count, and elevated ESR. CONCLUSION: Direct and surrogate outcomes in patients with diabetic foot ulcers identify vascular involvement as an important risk factor for reamputation. LEVEL OF EVIDENCE: III.

Maternal anti-Toxoplasma gondii antibodies IgG2, IgG3 and IgG1 are markers of vertical transmission and clinical evolution of toxoplasmosis in the offspring.

Toxoplasma gondii can be transmitted vertically during pregnancy and may cause neurological, ocular, and even systemic damage to the offspring. Congenital toxoplasmosis (CT) can be diagnosed during gestation and/or after birth in the postnatal period. The timely diagnosis is highly relevant for efficient clinical management. The most common laboratory methods for diagnosing CT are based on Toxoplasma-specific humoral immune responses. However, these methods are of low sensitivity or specificity. In a previous study with a small number of cases, the comparison of anti-T. gondii IgG subclasses between mothers and their offspring showed promising results for CT diagnosis and prognosis. Thus, in this work, we analyzed specific IgG subclasses and IgA in 40 T. gondii-infected mothers and their children, of which 27 were congenitally infected and 13 uninfected. A higher frequency of anti-Toxoplasma IgG2, IgG3, IgG4, and IgA antibodies was observed in mothers and congenitally infected offspring. Of these, IgG2 or IgG3 were statistically the most conspicuous. In the CT group, maternal IgG3 antibodies were significantly associated with severe disease of the infants and IgG1 and IgG3 with disseminated disease. The results support that maternal anti-T. gondii IgG3, IgG2 and IgG1 are markers of congenital transmission and severity/spread of disease in the offspring.

Multicenter evaluation of a high-throughput microarray platform for extensive red blood cell phenotyping and antibody screening.

BACKGROUND: Blood typing and antibody screening are key elements of transfusion safety. However, available single platform, flexible, and affordable technologies are limited, especially for extended phenotyping. Microarray-based technology allows for this extended phenotyping with the flexibility of piecemeal analysis. STUDY DESIGN AND METHODS: This study was conducted in three blood donor laboratories to determine the performance of a high-throughput microarray-based system for ABO, RH1-RH5, and KEL1 typing, ABS and extended phenotyping (RH8, KEL2&3, FY1&2, JK1, MNS3). Specimens were tested simultaneously on local platforms and on the microarray-based system. When discrepancies were identified, resolver testing were performed. RESULTS: In total, 4862 blood samples were tested for standard phenotype, 4257 for antibody screening and 2194 for extended phenotype. Results were available for 92.12% of the samples. The overall percent agreements were: 100% for ABO, 99.8% for RH1, 99.24% for RH2-5 and 99.86% for KEL1, 93.16% for antibody screening, and 99.68% for extended phenotype. CONCLUSIONS: This microarray-based system provides highly comparable results to current CE marked assays. The ability to continuously test 3000 microarrays in 1 day, providing simultaneously both extended RBC phenotyping and antibody detection drives laboratory efficiencies. The results of our study validate the performance of this new technology; however, the percentage of samples without results must be reduced and further analysis is required to interpret the ABS screening performances. This could constitute a real breakthrough in transfusion, making it possible in the long term, on a single platform, to carry out all the analyses necessary for the qualification of donations.

Conocimientos, actitudes y prácticas sobre lactancia materna en minorías étnicas colombianas / Breastfeeding knowledge, attitudes and practices among Colombian ethnicminorities

Introducción: la lactancia materna tiene beneficios tanto para la madre como para el bebé. Así, las actitudes,conocimientos, influencias de familiares, personas cercanasy personal de salud influyen positivamente al momento deamamantar.Objetivo: describir los conocimientos, actitudes, prácticas y factores relacionados con la decisión de practicar la lactancia materna, específicamente en el caso de madres lactantes afrodescendientes e indígenas que asisten al programa decrecimiento y desarrollo en Jamundí, Colombia. Métodos y materiales: estudio cualitativo descriptivo con perspectiva etnográfica realizado en el municipio de Jamundí,Valle con la participación de 27 madres entre los 18 y 49 años que se identifican a sí mismas como parte de etnias indígenas o afrodescendientes. El instrumento principal para la recolección de información fue la entrevista semi estructurada. Resultados: Buena parte de las madres entrevistadas tienen una actitud positiva frente a la lactancia. Además, mostraron conocimientos básicos a pesar de no haber sido capacitadas en ocasiones anteriores. Conclusión: las prácticas de lactancia materna son influenciadas por factores familiares y sociales.(AU)

Introduction: Breastfeeding has benefits for both motherand baby. The attitudes, knowledge, influences of relatives,close people and health personnel can positively influence themoment of breastfeeding, as well as the influence of closepeople, health personnel and family members.Objective:Describe the knowledge, attitudes and practices, as well as the factors related to the decision to breastfeed in the case of Afrodescendant and indigenous breastfeeding mothers who attend the growth and developmentprogram in Jamundí, Colombia.Methods and materials: Descriptive qualitative study withan ethnographic perspective carried out in the municipality ofJamundí with the participation of 27 mothers between the agesof 18 and 49 who consider themselves to be part of indigenousor Afrodescendant ethnic groups. The main instrument forgenerating information was the semistructured interview.Results: Many of the mothers interviewed have a positiveattitude towards breastfeeding. In addition, they showed basic knowledge despite not having been trained on previousoccasions. Conclusion: The practices are influenced by family andsocial factors.(AU)

El Ser del Terapeuta: A narrative examination into family-of-origin influence on the professional self of students in family therapy training in Colombia.

This qualitative narrative study aimed to examine how a family of origin influenced the professional self of Colombian students pursuing a profession in family therapy. Few research studies have investigated the development of self among native Spanish speakers from Colombia. Undergraduate and graduate students enrolled in clinical psychology and family therapy internships (N = 16) from the Colombian cities of Medellín, Pereira, and Santa Marta participated in this study. Data collection using personal diaries, family albums, autobiographies, and in-depth interviews served as sources for narrative analysis. Two themes and four subthemes representing positive and negative aspects of influences of families of origin helped organize the findings. Student experiences illustrate abilities, skills, and potentialities in the narratives. Implications for clinical training and future research recommendations highlight a path forward.

Fact-Checking Journalism: A Palliative Against the COVID-19 Infodemic in Ibero-America.

This study explores how fact-checkers understand information disorder in Ibero-America, in particular the COVID-19 disinformation. We conducted a quantitative content analysis of the LatamChequea Coronavirus alliance database and in-depth interviews with journalists from the network. Evidence found that one of the most prevalent disinformation topics was the government's restrictive measures, threatening to jeopardize the effectiveness of public health campaigns. This, added to disinformation that eroded the trust in the institutions and the press, and the opacity of governments constituted a political crisis in Ibero-America. Under this scenario, fact-checkers created relevant journalistic collaborations and strategies to fight disinformation in the region.

Percepción de la imagen corporal relacionado al nivel de autoestima en estudiantes del quinto grado de secundaria de la I.E. José Toribio Polo, Ica. 2019 ­2020 / Perception of body image related to the level of self-esteem in students of the fifth grade of secondary school of the I.E. Jose Toribio Polo, Ica. 2019 ­2020

El presente estudio tuvo como Objetivo: Establecer la relación entre la percepción de la imagen corporal y el nivel de autoestima en estudiantes del quinto grado de secundaria de la I.E. José Toribio Polo, Ica. 2019 ­2020. Material y métodos: Es una investigación cuantitativa, de diseño descriptivo de corte transversal. La muestra estuvo constituida por 75 estudiantes. Resultados: El 58,67% de estudiantes tiene moderada insatisfacción corporal, el 25,33% tiene leve insatisfacción corporal, el 13,33% tiene severa insatisfacción corporal y el 2,67% no tiene insatisfacción corporal. El 53,33% de estudiantes tienen autoestima media, el 46,67% tienen autoestima baja y el 1,33% tiene autoestima elevada. Conclusiones: Con la prueba estadística se demuestra que existe relación entre la percepción de la imagen corporal relacionado al nivel de autoestima en estudiantes del quinto grado de secundaria de la I.E. José Toribio Polo, Ica. 2019 ­2020. (AU)

The Objective of this study was to: Establish the relationship between the perception of body image and the level of self-esteem in students of the fifth grade of secondary school of the I.E. Jose Toribio Polo, Ica. 2019 ­2020. Material and methods: It are quantitative research, with a descriptive cross-sectional design. The sample consisted of 75 students. Results:58.67% of students have moderate body dissatisfaction, 25.33% have mild body dissatisfaction, 13.33% have severe body dissatisfaction and 2.67% do not have body dissatisfaction. 53.33% of students have medium self-esteem, 46.67% have low self-esteem and 1.33% have high self-esteem. Conclusions: With the statisticaltest, it is shown that there is a relationship between the perception of body image related to the level of self-esteem in students of the fifth grade of secondary school of the I.E. Jose Toribio Polo, Ica. 2019 ­2020. (AU)