Well-being among university students in the post-COVID-19 era: a cross-country survey.

University students have to handle crucial challenges for their future lives, such as succeeding in academic studies and finding attachment figures. These processes could potentially involve their well-being and mental health, with possible sociocultural differences based on the country of study. In order to explore such potential differences, a cross-sectional, multi-center survey was performed involving students from the University of Torino (Italy), Sevilla (Spain), and Lusòfona (Portugal). The survey, conducted from May to November 2023, investigated students' demographic and educational details, socioeconomic status, social support, mental health, academic environment, perceived COVID-19 pandemic impact, and future plans. Demographic profiles showed a predominance of female participants and straight sexual orientation, followed by bisexuality. Italian students showed the lowest levels of mental well-being and the highest rates of mental problems (anxiety and depression) and suicidal risk across the three countries despite the relatively similar profiles of social support. The prevalence of the students' confidence in their professional future is higher in Spain than in Italy and Portugal. This study provides a comprehensive examination of university students' mental health and well-being in three Southern European countries, addressing the major mental health challenges among university students and offering valuable insights for public health purposes.

Muscle cell-derived Ccl8 is a negative regulator of skeletal muscle regeneration.

Skeletal muscles undergo robust regeneration upon injury, and infiltrating immune cells play a major role in not only clearing damaged tissues but also regulating the myogenic process through secreted cytokines. Chemokine C-C motif ligand 8 (Ccl8), along with Ccl2 and Ccl7, has been reported to mediate inflammatory responses to suppress muscle regeneration. Ccl8 is also expressed by muscle cells, but a role of the muscle cell-derived Ccl8 in myogenesis has not been reported. In this study, we found that knockdown of Ccl8, but not Ccl2 or Ccl7, led to increased differentiation of C2C12 myoblasts. Analysis of existing single-cell transcriptomic datasets revealed that both immune cells and muscle stem cells (MuSCs) in regenerating muscles express Ccl8, with the expression by MuSCs at a much lower level, and that the temporal patterns of Ccl8 expression were different in MuSCs and macrophages. To probe a function of muscle cell-derived Ccl8 in vivo, we utilized a mouse system in which Cas9 was expressed in Pax7+ myogenic progenitor cells (MPCs) and Ccl8 gene editing was induced by AAV9-delivered sgRNA. Depletion of Ccl8 in Pax7+ MPCs resulted in accelerated muscle regeneration after barium chloride-induced injury in both young and middle-aged mice, and intramuscular administration of a recombinant Ccl8 reversed the phenotype. Accelerated regeneration was also observed when Ccl8 was depleted in Myf5+ or MyoD+ MPCs by similar approaches. Our results suggest that muscle cell-derived Ccl8 plays a unique role in regulating the initiation of myogenic differentiation during injury-induced muscle regeneration.

Seroprevalence of trypanosomosis and associated risk factors in cattle from coast and amazonian provinces of Ecuador.

Trypanosomosis is a tropical disease caused by various protozoan haemoparasites, which affects wild and domestic animals, the latter ones related to worldwide livestock production systems. Species such as Trypanosoma vivax and Trypanosoma evansi have been described using serological and molecular tools in several countries from South and Central America. However, Ecuador presents a relevant knowledge gap in the associated general epidemiology and risk factors of the disease. Therefore, the objective of this study was to determine the seroprevalence of trypanosomosis in cattle from different regions of Ecuador. 745 serum samples from 7 Coastal and 3 Amazon provinces were screened for IgG anti-Trypanosoma spp. antibodies, using an in-house indirect ELISA. The seropositivity was explored and associated with several variables such as sex, age, breed, region, management, and province, using statistical tools. The general seroprevalence of trypanosomosis was 19.1% (95% CI: 16.30-22.1%). The Amazonian provinces of Sucumbíos and Napo and the Coastal province of Esmeraldas presented the highest seroprevalence values of 36.7% (95% CI: 27.67-46.47%), 23.64% (95% CI: 16.06-32.68%) and 25% (95% CI: 15.99-35.94%), respectively. Statistical significance was found for the region, province, and management variables, indicating as relevant risk factors the extensive management and Amazon location of the cattle analyzed. Specific actions should be taken to identify the exact species on reservoirs and susceptible hosts, evaluate the implication of farm management and cattle movement as risk factors, and implement surveillance and treatment plans for affected herds.

Have acute appendicitis complications increased in children as a result of SARS-CoV-2? / ¿Han aumentado las complicaciones de las apendicitis agudas en niños por el impacto del SARS-CoV-2?

INTRODUCTION: The impact of the SARS-CoV-2 pandemic on healthcare has already been described, since it has caused an increase in diagnostic delay and morbidity. Our objective was to assess its influence on the development of complications in children with acute appendicitis. MATERIALS AND METHODS: A retrospective cohort study was carried out. It included acute appendicitis patients under 15 years of age treated from January 1, 2019 to December 31, 2020. They were classified according to diagnosis date as before the pandemic (B) (January 2019-February 2020) and during the pandemic (D) (March 2020-December 2020). According to operative findings, they were classified as complicated appendicitis (perforated/abscess/plastron/peritonitis) and non-complicated appendicitis (catarrhal/phlegmonous/gangrenous). Demographic data, progression time, and postoperative complications were analyzed. RESULTS: A total of 309 patients were included, 193 (62.5%) in Group B, and 116 (37.5%) in Group D, with an age of 9.2 ± 0.4 and 9.4 ± 0.6 years, respectively (CI = 95%). Diagnostic time was 1.35 and 1.43 days (p>0.05) in Groups B and D, respectively, with ≥ 3 days representing 15.5% of cases in Group B, and 16.4% of cases in Group D (p = 0.84). The proportion of complicated appendicitis was 23.3% in Group B vs. 21.6% in Group D (p>0.05). Postoperative complications were observed in 11.4% of patients in Group B, and in 13.8% of patients in Group D (p>0.05), with intra-abdominal abscess being the most frequent complication in both groups (54.5% of the total complications in Group B vs. 65.5% in Group D; p>0.05). CONCLUSIONS: The management of acute appendicitis and its complications in pediatric patients has not been impacted by the SARS-CoV-2 pandemic or the safety measures enforced.

INTRODUCCION: Se ha descrito el impacto de la pandemia del SARS-CoV-2 en la atención sanitaria, al suponer un aumento del retraso diagnóstico y morbilidad. Nuestro objetivo es evaluar su influencia en el desarrollo de complicaciones en las apendicitis agudas en niños. METODOLOGIA: Estudio retrospectivo de cohortes, incluyendo los pacientes menores de 15 años tratados por apendicitis aguda desde 01/01/2019 hasta 31/12/2020. Se distribuyeron según su fecha de diagnóstico en: antes de la pandemia (A) (enero/2019-febrero/2020) y durante la pandemia (P) (marzo-diciembre/2020). Según los hallazgos quirúrgicos se clasificaron en: apendicitis complicadas (perforadas/abscesos/plastrones/peritonitis) y no complicadas (catarrales/flemonosas/gangrenosas). Se analizaron datos demográficos, tiempo de evolución y complicaciones postoperatorias. RESULTADOS: Se incluyeron un total de 309 pacientes, 193 pacientes (62,5%) en el grupo A y 116 (37,5%) en el P, con edades de 9,2 ± 0,4 y 9,4 ± 0,6 años respectivamente (IC = 95%). Los días al diagnóstico fueron 1,35 y 1,43 (p>0,05) en A y P respectivamente, siendo ≥ 3 días en 15,5% de A y 16,4% en P (p = 0,84). La proporción de apendicitis complicada fue un 23,3% en A vs. 21,6% en P; con p>0,05. Se observaron complicaciones postoperatorias en 11,4% de A y 13,8% de P (p>0,05), siendo la más frecuente el absceso intraabdominal en ambos grupos (54,5% del total de complicaciones vs 65,5%; en A y P respectivamente; p>0,05). CONCLUSIONES: La atención sanitaria de la apendicitis aguda y sus complicaciones en pacientes pediátricos no se ha visto modificada por la pandemia del SARS-CoV-2 o las medidas de seguridad adoptadas durante la misma.

¿Han aumentado las complicaciones de las apendicitisagudas en niños por el impacto del SARS-CoV-2? / Have acute appendicitis complications increased in children as a result of SARS-CoV-2?

Introducción: Se ha descrito el impacto de la pandemia del SARS-CoV-2 en la atención sanitaria, al suponer un aumento del retraso diagnóstico y de la morbilidad. Nuestro objetivo es evaluar su influenciaen el desarrollo de complicaciones en las apendicitis agudas en niños. Metodología: Estudio retrospectivo de cohortes, incluyendo lospacientes menores de 15 años tratados por apendicitis aguda desde01/01/2019 hasta 31/12/2020. Se distribuyeron según su fecha dediagnóstico en: antes de la pandemia (A) (enero/2019-febrero/2020) ydurante la pandemia (P) (marzo-diciembre/2020). Según los hallazgosquirúrgicos se clasificaron en: apendicitis complicadas (perforadas/abscesos/plastrones/peritonitis) y no complicadas (catarrales/flemonosas/gangrenosas). Se analizaron datos demográficos, tiempo de evolucióny complicaciones postoperatorias. Resultados: Se incluyeron un total de 309 pacientes, 193 pacientes(62,5%) en el grupo A y 116 (37,5%) en el P, con edades de 9,2 ± 0,4y 9,4 ± 0,6 años respectivamente (IC = 95%). Los días al diagnósticofueron 1,35 y 1,43 (p > 0,05) en A y P respectivamente, siendo ≥ 3 díasen el 15,5% de A y el 16,4% en P (p = 0,84). La proporción de apendicitis complicada fue un 23,3% en A vs. un 21,6% en P; con p > 0,05.Se observaron complicaciones postoperatorias en un 11,4% de A y un 13,8% de P (p > 0,05), siendo la más frecuente el absceso intraabdominalen ambos grupos (54,5% del total de complicaciones vs. 65,5%, en Ay P respectivamente; p > 0,05). Conclusiones: La atención sanitaria de la apendicitis aguda y suscomplicaciones en pacientes pediátricos no se ha visto modificada por la pandemia del SARS-CoV-2 o las medidas de seguridad adoptadasdurante la misma.(AU)

Introduction: The impact of the SARS-CoV-2 pandemic on health-care has already been described, since it has caused an increase in diagnostic delay and morbidity. Our objective was to assess its influence on the development of complications in children with acute appendicitis. Materials and methods: A retrospective cohort study was carriedout. It included acute appendicitis patients under 15 years of age treatedfrom January 1, 2019 to December 31, 2020. They were classified according to diagnosis date as before the pandemic (B) (January 2019-February2020) and during the pandemic (D) (March 2020-December 2020). According to operative findings, they were classified as complicated appendicitis (perforated/abscess/plastron/peritonitis) and non-complicatedappendicitis (catarrhal/phlegmonous/gangrenous). Demographic data,progression time, and postoperative complications were analyzed. Results: A total of 309 patients were included, 193 (62.5%) inGroup B, and 116 (37.5%) in Group D, with an age of 9.2 ± 0.4 and9.4 ± 0.6 years, respectively (CI = 95%). Diagnostic time was 1.35 and1.43 days (p > 0.05) in Groups B and D, respectively, with ≥ 3 daysrepresenting 15.5% of cases in Group B, and 16.4% of cases in GroupD (p = 0.84). The proportion of complicated appendicitis was 23.3% inGroup B vs. 21.6% in Group D (p > 0.05). Postoperative complicationswere observed in 11.4% of patients in Group B, and in 13.8% of patientsin Group D (p > 0.05), with intrabdominal abscess being the mostfrequent complication in both groups (54.5% of the total complicationsin Group B vs. 65.5% in Group D; p > 0.05). Conclusions: The management of acute appendicitis and its complications in pediatric patients has not been impacted by the SARS-CoV-2pandemic or the safety measures enforced.(AU)

Pandemic's impact on inguinal hernia management in infants. / Impacto de la pandemia en el manejo de la hernia inguinal en lactantes.

INTRODUCTION: The SARS-CoV-2 pandemic brought about a reduction in surgical activity. The objective of this work was to analyze its impact on inguinal hernia morbidity. MATERIAL AND METHODS: A retrospective study of cases and controls was carried out. Patients under 18 months of age undergoing inguinal hernia surgery from January 1, 2019 to August 31, 2020 were included. They were divided into two groups: patients undergoing surgery before (group A) or after (group D) the state of alarm was declared in Spain. Primary variables: episodes of incarceration and postoperative complications. Secondary variable: urgent or scheduled surgery. Demographic variables: sex, gestational age (GA), previous pathologies, age at diagnosis (AD), and age at surgery (AS) (months). RESULTS: 64 patients were included - 43 in group A and 21 in group D. In group A, median GA was 37+3, 90.5% of patients were male, median AD was 2.33, and median AS was 3.27. In group D, median GA was 31+2, 72.1% of patients were male, median AD was 3, and median AS was 3.63. There were no statistically significant differences. However, differences in terms of previous pathologies were significant (16.3% for Group A vs. 38.1% for group D) (p = 0.05). Regarding the primary variable, 25.6% of patients in group A had incarcerations vs. 33.3% of patients in group D (p = 0.51), whereas 9.3% of patients in group A had postoperative morbidity vs. 14.3% of patients in group D (p = 0.41). Regarding the secondary variable, 88.4% of surgeries in group A were scheduled vs. 90.5% of surgeries in group D (p = 0.583). CONCLUSION: In spite of reduced surgical activity, inguinal hernia morbidity did not surge in our environment. An increase in patients with previous pathologies was noted, which means severe patients should be prioritized.

INTRODUCCION: La pandemia del SARS-CoV-2 supuso una reducción de las jornadas quirúrgicas. Analizamos el efecto en la morbilidad de la hernia inguinal. MATERIAL Y METODOS: Estudio retrospectivo de casos y controles. Incluimos menores de 18 meses intervenidos de hernia inguinal desde 01/01/2019 hasta 31/08/2020, divididos en 2 grupos: intervenidos antes (grupo A) o después (grupo D) de la declaración del estado de alarma. Variables principales: episodios de incarceraciones y complicaciones postoperatorias. Variable secundaria: intervención urgente o programada. Variables poblacionales: sexo, edad gestacional (EG), patología previa, edad al diagnóstico(ED) y a la intervención (EI) (meses). RESULTADOS: Incluimos 64 pacientes, 43 grupo A y 21 grupo D. En el grupo A la mediana de EG fue 37+3, el 90,5% fueron varones, la mediana ED fue 2,33 y EI 3,27. En el grupo B la mediana de EG fue 31+2, el 72,1% fueron varones, la mediana ED fue 3 y EI 3,63. No hubo diferencias estadísticamente significativas. Si fueron significativas las diferencias en patología previa 16,3% A y 38,1% D (p = 0,05). Sobre la variable principal: 25,6% del A sufrieron incarceraciones frente a 33,3% del D (p = 0,51) y un 9,3% tuvieron morbilidad postoperatoria en A frente a 14,3% en D (p = 0,41). Respecto a la variable secundaria un 88,4% se realizaron de forma programada en el grupo A y un 90,5% en el grupo D (p = 0,583). CONCLUSION: Pese a la reducción de jornadas quirúrgicas no ha aumentado la morbilidad de la hernia inguinal en nuestro medio. Hemos observado un aumento de pacientes con patología previa, implicando la priorización de los pacientes más graves.

Impacto de la pandemia en el manejo de la hernia inguinal en lactantes / Pandemic’s impact on inguinal hernia management in infants

Introducción: La pandemia del SARS-CoV-2 supuso una reducciónde las jornadas quirúrgicas. Analizamos el efecto en la morbilidad dela hernia inguinal.Material y método: Estudio retrospectivo de casos y controles.Incluimos menores de 18 meses intervenidos de hernia inguinal desde01/01/2019 hasta 31/08/2020, divididos en dos grupos: intervenidos an-tes (grupo A) o después (grupo D) de la declaración del estado de alarma.Variables principales: episodios de incarceraciones y complicacionespostoperatorias. Variable secundaria: intervención urgente o programada.Variables poblacionales: sexo, edad gestacional (EG), patología previa,edad al diagnóstico (ED) y a la intervención (EI) (meses).Resultados: Incluimos 64 pacientes, 43 grupo A y 21 grupo D. En el grupo A la mediana de EG fue 37+3, el 90,5% fueron varones, la mediana ED fue 2,33 y EI 3,27. En el grupo B la mediana de EG fue 31+2, el 72,1% fueron varones, la mediana ED fue 3 y EI 3,63. No hubo diferencias estadísticamente significativas. Sí fueron significativas las diferencias en patología previa: 16,3% A y 38,1% D (p = 0,05). Sobre la variable principal, 25,6%, del A sufrieron incarceraciones frente a 33,3% del D (p = 0,51) y un 9,3% tuvieron morbilidad postoperatoriaen A frente al 14,3% en D (p = 0,41). Respecto a la variable secundaria, un 88,4% se realizaron de forma programada en el grupo A y un 90,5% en el grupo D (p = 0,583). Conclusión: Pese a la reducción de jornadas quirúrgicas, no ha aumentado la morbilidad de la hernia inguinal en nuestro medio. Hemos observado un aumento de pacientes con patología previa, implicando la priorización de los pacientes más graves.

Introduction: The SARS-CoV-2 pandemic brought about a reduction in surgical activity. The objective of this work was to analyze its impact on inguinal hernia morbidity.Materials and methods: A retrospective study of cases and controls was carried out. Patients under 18 months of age undergoing inguinal hernia surgery from January 1, 2019 to August 31, 2020 were included. They were divided into two groups: patients undergoing surgery before (group A) or after (group D) the state of alarm was declared in Spain.Primary variables: episodes of incarceration and postoperative complications. Secondary variable: urgent or scheduled surgery. Demographic variables: sex, gestational age (GA), previous pathologies, age at diagnosis (AD), and age at surgery (AS) (months).Results: 64 patients were included – 43 in group A and 21 in group D. In group A, median GA was 37+3, 90.5% of patients were male, median AD was 2.33, and median AS was 3.27. In group D, median GA was 31+2, 72.1% of patients were male, median AD was 3, and medianAS was 3.63. There were no statistically significant differences. However, differences in terms of previous pathologies were significant (16.3% for Group A vs. 38.1% for group D) (p = 0.05). Regarding the primary variable, 25.6% of patients in group A had incarcerations vs. 33.3% ofpatients in group D (p = 0.51), whereas 9.3% of patients in group A had postoperative morbidity vs. 14.3% of patients in group D (p = 0.41). Regarding the secondary variable, 88.4% of surgeries in group A were scheduled vs. 90.5% of surgeries in group D (p = 0.583).Conclusion. In spite of reduced surgical activity, inguinal hernia morbidity did not surge in our environment. An increase in patients with previous pathologies was noted, which means severe patients should be prioritized.

Monitorización de concentraciones plasmáticas de vancomicina en pacientes críticos de un hospital público de Córdoba, Argentina / Monitoring of plasma vancomycin concentrations in critically ill patients in a public hospital of Córdoba, Argentina

Introducción: La monitorización de las concentraciones plasmáticas de antimicrobianos utilizados para tratar infecciones en pacientes críticos es una de las estrategias propuestas para mejorar los resultados clínicos. La monitorización de vancomicina reduce el riesgo de resistencia bacteriana y de nefrotoxicidad relacionada con altas concentraciones plasmáticas. El estudio fue realizado en un hospital público de la provincia de Córdoba, Argentina, que contiene 43 unidades críticas de atención al paciente. Aunque la indicación de vancomicina es frecuente, la solicitud de niveles plasmáticos de fármacos es inusualMétodo: El Servicio de Farmacia realizó un estudio piloto prospectivo durante 14 semanas, implementando el monitoreo de las concentraciones plasmáticas de vancomicina y el cálculo del índice ABC24/CIM (área bajo la curva de concentración-tiempo durante un período de 24 horas/concentración inhibitoria mínima).Objetivos: Determinar el porcentaje de pacientes con concentraciones plasmáticas valle fuera del rango terapéutico descrito en la literatura y la dosis que sería necesaria para obtener un ABC24/CIM ≥400.Resultados: Se realizaron 36 solicitudes de monitorización de vancomicina en 31 pacientes. El 78% de las concentraciones plasmáticas determinadas estaban fuera del rango terapéutico y sólo en 8 pacientes se obtuvo un ABC24/CIM ≥400.Conclusiones: Este estudio fue el primer paso para implementar la farmacocinética clínica en la institución y evidenció la importancia de la monitorización terapéutica y la individualización de la dosis. En pacientes críticos y con un aclaramiento de creatinina elevado se necesitarían dosis mayores a las utilizadas en este estudio. (AU)

Introduction: Monitoring plasma concentrations of antimicrobials used to treat infections in critically ill patients is one of the strategies proposed to improve clinical results. Vancomycin monitoring reduces the risk of bacterial resistance and nephrotoxicity related to high plasma concentrations. The study was carried out in a public hospital in the province of Córdoba, Argentina, which contains 43 critical patient care units. Although the indication for vancomycin is frequent, the request for plasma levels of drugs is unusual.Method: The Pharmacy Service carried out a prospective pilot study for 14 weeks, implementing the monitoring of plasma vancomycin concentrations and the calculation of the ABC24/MIC index (area under the concentration-time curve over a 24-hour period/inhibitory concentration minimum).Objectives: To determine the percentage of patients with trough plasma concentrations outside the therapeutic range described in the literature and the dose that would be necessary to obtain an ABC24/CIM ≥400.Results: 36 requests for vancomycin monitoring were made in 31 patients. 78% of the determined plasma concentrations were outside the therapeutic range and only in 8 patients was an ABC24/CIM ≥400 obtained.Conclusions: This study was the first step to implement clinical pharmacokinetics in the institution and showed the importance of therapeutic monitoring and dose individualization. In critically ill patients with high creatinine clearance, higher doses than those used in this study would be required. (AU)

Effectiveness of contact tracing to reduce fatality from COVID-19: preliminary evidence from Colombia.

OBJECTIVES: Conducting contact tracing (CT) programs in low- and middle-income countries is challenging, and there is no evidence of their effectiveness in Latin America. We evaluated the effectiveness of CT on reducing fatality from COVID-19 in Colombia. STUDY DESIGN: The study design is a retrospective cohort study with nation-wide data of suspected and confirmed cases of severe acute respiratory syndrome (SARS-CoV-2) infection and their registered contacts. METHODS: We analyzed confirmed and suspected COVID-19 cases and their chains of contact using a nation-wide registry from March 28, 2020 to January 13, 2021. To estimate the effect of CT on fatality, we adjusted a multilevel negative binomial model using the number of deaths and the number of people within a chain of contacts as the outcome variable and offset variable, respectively. Sensitivity analysis was conducted using different cutoff values of contacts traced and a logistic model for the effect of CT on death at an individual level. RESULTS: We analyzed 1.4 million cases, 542,936 chains of contact, and 46,087 deaths. Only, 5.8% of total cases and contacts were included in a chain of a case and five or more contacts. We found that tracing of at least five contacts per case reduces fatality by 48% (95% confidence interval: 45-51), and, at the current levels of tracing in Colombia, it prevents 1.8% of deaths. Results obtained from the sensitivity analysis were consistent with the reduction of fatality at an individual level and higher protective effect with the higher number of contacts traced. CONCLUSIONS: In Colombia, tracing of at least five contacts per case reduces fatality from COVID-19. The coverage and intensity of tracing needs to be increased as a strategy to mitigate fatality in Colombia.

Holistic numerical calibration of the iMESA electrostatic analyzer.

A drifted Maxwellian velocity distribution is the most common model used to interpret the data from low-energy charged-particle instruments onboard spacecraft that are used to investigate the ambient plasma environment in the low Earth orbit (LEO). An original method is presented for determining the flow parameters (density, temperature, and flow energy) of such a distribution from the output of the integrated miniaturized electrostatic analyzer, which has been successfully flown on several LEO missions. Rather than attempting to deconvolve from the on-orbit data the analyzer's response to an ideal, monoenergetic input, numerical simulation is used to predict and parameterize the response of the device to an input distribution that includes an isotropic, non-zero temperature, yielding a straightforward method for extracting the flow parameters from the spacecraft data. The method is computationally simple enough to be incorporated into a robust algorithm suitable for rapid batch processing or real-time analysis of data.

Manejo de los efectos adversos de apremilast desde un abordaje multidisciplinar / Multidisciplinary Management of the Adverse Effects of Apremilast

En el presente artículo, en base a una revisión de la literatura y su experiencia personal, un equipo multidisciplinar de 14 profesionales sanitarios (incluyendo dermatólogos, reumatólogos, neurólogos, gastroenterólogos, farmacéuticos y enfermeras) ha elaborado una serie de recomendaciones generales y específicas (basadas en la fisiopatología) para el manejo de los efectos adversos secundarios a apremilast que con mayor frecuencia conducen a la suspensión del tratamiento (diarrea, náuseas y cefalea). Se aportan algoritmos sencillos de manejo que incluyen aspectos clínicos de evaluación y sugerencias de tratamiento farmacológico. Los efectos adversos de apremilast pueden ser abordados desde un punto de vista multidisciplinar y la optimización en su manejo pretende proporcionar un beneficio clínico a los pacientes que los sufren

We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients

Multidisciplinary Management of the Adverse Effects of Apremilast. / Manejo de los efectos adversos de apremilast desde un abordaje multidisciplinar.

We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients.

Disfunción endotelial. Mecanismos e implicancias en Covid-19 / Endothelial dysfunction. Mechanisms and implications on Covid-19

Endothelium is the inner layer of vessels that separates circulating blood from the rest of the body tissues. Since its discovery, it has been involved in various functions, both systemic and organ specific. Currently, endothelial damage and failure in its functions is considered a key element in pathophysiology of various clinical scenarios, among which we may find COVID-19.Hence, it has been a target in development of strategies that seek to maintain, enhance or repair its function. The purpose of the following review is to describe what an endothelial function is about, its relation with current medical practice, and its implications in the SARS- CoV-2 pandemic. (AU)

The integrated miniaturized electrostatic analyzer: A space plasma environment sensor.

The integrated Miniaturized Electrostatic Analyzer (iMESA) was a satellite-based ionospheric sensor that operated on NASA's Space Test Program Satellite (STPSat-3) from December 2013 to July 2019. The instrument's scientific objective was to (1) measure the plasma density in low Earth orbit, (2) measure the plasma temperature in low Earth orbit, and (3) quantify the spacecraft potential with respect to the ambient plasma potential in the ionosphere. iMESA sampled the ionosphere every 10 s by measuring the ion current density through the ESA as a result of the motion of the spacecraft through the plasma. Current density spectra were transmitted to the ground where they were post-processed into ion density spectra and then analyzed numerically to determine the ion density, ion temperature, and spacecraft potential. This article discusses the instrument design and simulation, the determination of a geometric factor, and data processing procedures and evaluates the final data product with regard to the mission success criteria. The ion density and ion temperature captured by the iMESA instrument are on the same order and range as the values predicted in the literature. The spacecraft potential was also quantified. The conclusion after the evaluation of the instrument's data product is that the scientific mission is successful on all three points.

Association of alcohol control policies with adolescent alcohol consumption and with social inequality in adolescent alcohol consumption: A multilevel study in 33 countries and regions.

Background Previous research found inconsistent associations between alcohol control policies and socioeconomic inequality with adolescent drinking outcomes. This study expands the focus beyond individual associations to examine whether a combination of policies is related to socioeconomic inequality in adolescent drinking outcomes and whether this relationship varies across survey years. Methods Multilevel modelling of 4 waves of repeat cross-sectional survey data (2001/02, 2005/06, 2009/10, and 2013/14) from the Health Behaviour in School-aged Children (HBSC) study was carried out. The sample was composed of 671,084 adolescents (51% girls) aged 11, 13, and 15 (mean age=13.58; SD=1.65) from 33 European and North American countries/regions. The dependent variables were lifetime alcohol consumption, weekly alcohol consumption, and lifetime drunkenness. Independent variables were of three types: individual-level variables (age, sex, Family Affluence Scale, and the Perceived Family Wealth), time-level variable (survey year), and context-level variables (minimum legal drinking age, physical availability, advertising restrictions, a total alcohol policy index, and affordability of alcohol). Results The total alcohol policy index showed a negative relationship with both lifetime and weekly consumption. Higher affordability of alcohol was related to higher lifetime and weekly consumption and higher lifetime drunkenness. Family Affluence Scale was positively related to all three alcohol measures and Perceived Family Wealth was negatively related to lifetime drunkenness, with these associations increasing across survey years. The total alcohol policy index buffered the associations of Family Affluence Scale and Perceived Family Wealth with adolescent drinking outcomes. Conclusion A combination of alcohol control policies is more effective in reducing adolescent drinking outcomes than single policy measures. Reducing the affordability of alcohol stood out as the most successful single measure. Socioeconomic inequalities (i.e. higher alcohol consumption and drunkenness in adolescents with higher family affluence and higher drunkenness in adolescents perceiving their families to be poor) have persisted and even increased across survey years. A combined alcohol control policy can help in tackling them.

A laminated energetic electrostatic analyzer for 0-5 keV charged particles.

A compact electrostatic energy bandpass filter based on a laminated analyzer design has been developed to measure charged particle fluxes at energies ranging from 0 to 5 keV. The sensor head has been successfully tested against a low energy magnetically filtered plasma source and an ion beam source capable of producing energetic ions in the range of 100-1250 eV. Additionally, the instrument has demonstrated the ability to accurately measure negative spacecraft frame charging using a low Earth orbit plasma simulator. The effects of the spacecraft frame charging on the measured energy distribution measurements and the impact regarding the derived charged particle density and temperature parameters are also examined.

Accidente vascular isquémico: Anestesia para trombectomía mecánica / Acute ischemic stroke: Anesthesia for mechanical thrombectomy

The management of patients presenting with an ischemic vascular accident has evolved in recent years. Several studies opened the possibility for endovascular treatment of these patients, improving their functional results. The evidence-based anesthetic management has changed thanks to new relevant literature. In this article we want to briefly describe the changes in the state of the art according to the new clinical evidence.

El manejo de los pacientes que presentan un accidente vascular isquémico ha evolucionado en los últimos años. Varios estudios abrieron la posibilidad para el tratamiento endovascular de estos pacientes, mejorando sus resultados funcionales. El manejo anestésico basado en evidencia a cambiado gracias a nueva literatura relevante. En este artículo queremos describir brevemente los cambios en el estado del arte según la nueva evidencia clínica.

Catéter de drenaje de líquido cefalorraquídeo: usos, técnica y complicaciones para el anestesiólogo / Spinal fluid drainage catheter: uses, technique, and complications for the anesthesiologist

Spinal drainage catheter installation is a procedure indicated essentially in the repair of aortic aneurysms and the neurosurgery setting. It is not always a simple procedure where dilemmas arise about the indication, technique, and complications. The following article reviews each of these topics.

La instalación de un catéter de drenaje espinal es un procedimiento indicado principalmente en la reparación de aneurismas aórticos y en el escenario de neurocirugía. No siempre es un procedimiento fácil de realizar donde surgen dudas sobre indicación, técnica y eventuales complicaciones. En el siguiente artículo revisamos cada uno de estos temas.

Correction to: Ouabain Accelerates Collective Cell Migration Through a cSrc and ERK1/2 Sensitive Metalloproteinase Activity.

The original version of the article unfortunately contained an error in the author group. Dr. Isabel Larré was not submitted and published in the original version.