Acute liver failure: Management update and prognosis.

Acute liver failure is a rare but serious syndrome, with an incidence of approximately 2,000 to 3,000 cases per year in North America. Its pathophysiology and clinical course vary, depending on the cause of the primary liver injury, and can lead to high morbidity and mortality or the need for liver transplantation, despite available therapies. This syndrome involves excessive activation of the immune system, with damage in other organs, contributing to its high mortality rate. The most accepted definition includes liver injury with hepatic encephalopathy and coagulopathy within the past 26 weeks in a patient with no previous liver disease. The main causes are paracetamol poisoning, viral hepatitis, and drug-induced liver injury, among others. Identifying the cause is crucial, given that it influences prognosis and treatment. Survival has improved with supportive measures, intensive therapy, complication prevention, and the use of medications, such as N-acetylcysteine. Liver transplantation is a curative option for nonresponders to medical treatment, but adequate evaluation of transplantation timing is vital for improving results. Factors such as patient age, underlying cause, and severity of organ failure influence the post-transplant outcomes and survival.

The elucidation of the life cycle of Saccocoelioides nanii Szidat, 1954 (Digenea: Haploporidae) using molecular techniques.

In South America, the knowledge of trematode diversity parasitizing freshwater fishes is still scarce, as less than 5% of the freshwater fish fauna has been examined for parasites. A similar situation applies to studies on digenean life cycles, which have become increasingly rare. Among the digenean families parasitizing freshwater fishes in the region, Haploporidae is considered the richest in species diversity. However, information about the developmental stages of haploporid life cycles remains fragmentary. Particularly, in Argentina, nine cercariae attributed to the family Haploporidae have been described using morphological analysis, and only two life cycles of this family have been completely elucidated. In this study a new type of cercaria, morphologically assigned to the family Haploporidae and collected from the snail Heleobia parchappii (Cochliopidae) in Los Padres shallow lake, Buenos Aires province, was identified using morphological and molecular techniques. The molecular analysis, based on 28S and ITS2 sequences, revealed that the cercariae were 100% identical to adult specimens of Saccocoelioides nanii (Haploporidae) parasitizing the fish Prochilodus lineatus (Prochilodontidae) from Los Talas, Buenos Aires province. Our results not only provide information about the life cycle of S.nanii but also show that a molecular and morphological approach can be extremely useful in identifying the developmental stages of digeneans and elucidating their life cycles.

Methodological Proposal for the Adequate Use of the Osteotechnics Technique / Propuesta Metodológica para el uso Adecuado de la Técnica Osteotécnica

SUMMARY: Osteotechnics is one of the different anatomical preservation techniques and can be defined as the technique designed to prepare, clean, obtain and preserve bone structures that can be used in the teaching, museographic or research field. The osteotechnical technique procedure consists of the following phases: debulk and disjoint, maceration, cooking, cleaning, degreasing, bleaching, and labeling to obtain bone material. Seven phases will be explained in detail, as well as the materials, instruments, quantities of the substances used, and the time required to obtain human bone material. We consider that this article can serve as a guide, given that all the experimentation was carried out with human biological material. This methodological proposal could be consolidated and established based on the experience acquired during the creation of the contemporary skeletal collection of the department of innovation in human biological material (DIMBIH). Therefore, the purpose of our proposal is to provide tools that facilitate the work of those who carry out this work and fundamentally to avoid irreversible or irreparable damage to the osteological material, since it is of great value and difficult to acquire for disciplines as anatomy, veterinary, physical and forensic anthropology, medicine, dentistry and biology.

La osteotecnia es una de las técnicas diferentes de conservación anatómica y puede definirse como la técnica destinada a preparar, limpiar, obtener y conservar estructuras óseas que pueden ser utilizadas en el ámbito docente, museográfico o de investigación. El procedimiento de la técnica osteotécnica consta de las siguientes fases: descarnado y desarticulado, maceración, cocción, limpieza, desengrase, blanqueo y marcaje para la obtención de material óseo. Se explicarán en detalle siete fases, así como los materiales, instrumentos, cantidades de las sustancias utilizadas y el tiempo necesario para obtener material óseo humano. Consideramos que este artículo puede servir de guía, dado que toda la experimentación se realizó con material biológico humano. Esta propuesta metodológica pudo consolidarse y establecerse a partir de la experiencia adquirida durante la creación de la colección esquelética contemporánea del Departamento de Innovación en Material Biológico Humano (DIMBIH). Por lo tanto, el propósito de nuestra propuesta es brindar herramientas que faciliten el trabajo de quienes realizan este trabajo y fundamentalmente evitar daños irreversibles o irreparables en el material osteológico, ya que es de gran valor y difícil adquisición para las disciplinas como la anatomía, veterinaria, antropología física y forense, medicina, odontología y biología.

Human papilloma virus presence and its physical status in primary pterygium.

Pterygium is one of the most frequent pathologies in ophthalmology, and is a benign, overgrowth of fibrovascular tissue, often with a wing-like appearance, from the conjunctiva over the cornea. It is composed of an epithelium and highly vascular, sub-epithelial, loose connective tissue. There is much debate surround the pathogenesis of pterygium and a number of theories have been put forward including genetic instability, cellular proliferation, inflammatory influence, and degeneration of connective tissue, angiogenesis, aberrant apoptosis and viral infection. At present, the involvement of human papillomavirus (HPV) in the genesis of pterygium is controversial, as have reported that HPV is present in 58% of cases, while others have failed to detect HPV in pterygium. In this study, we evaluated the presence and viral genotype of HPV DNA in pterygia and healthy conjunctiva sample, and virus integration into the cellular genome. Forty primary pterygia samples and 12 healthy conjunctiva samples were analyzed to HPV DNA presence by polymerase chain reaction, using MY09/MY11 primers of HPV-L1 gene. Viral genotype was identified by DNA sequence analysis of this amplicon. HPV integration into the cellular genome was analyzed by western blot detecting HPV-L1 capsid protein. Presence of HPV was observed in 19 of the 40 pterygia samples. In contrast, healthy conjunctiva samples were negative. To determine virus type, sequence analyses were performed. Interestingly, 11 out of the 19-pterygium samples were identified as HPV-11 type, meanwhile, the remaining 8 pterygium samples were identified as HPV-18. HPV-L1 capsid protein were found only in 3 out of the 10 samples studied. In conclusion, our study identified the presence of HPV DNA exclusively in pterygium samples and described HPV-11 and -18 genotypes. Our results suggest that HPV may be involved in the pathogenesis of pterygium. On the other hand, the expression of the L1-HPV protein suggests viral integration into the cellular genome.

Branched chain amino acids catabolism as a source of new drug targets in pathogenic protists.

Leucine, isoleucine, and valine, collectively termed Branched Chain Amino Acids (BCAA), are hydrophobic amino acids (AAs) and are essential for most eukaryotes since in these organisms they cannot be biosynthesized and must be supplied by the diet. These AAs are structurally relevant for muscle cells and, of course, important for the protein synthesis process. The metabolism of BCAA and its participation in different biological processes in mammals have been relatively well described. However, for other organisms as pathogenic parasites, the literature is really scarce. Here we review the BCAA catabolism, compile evidence on their relevance for pathogenic eukaryotes with special emphasis on kinetoplastids and highlight unique aspects of this underrated pathway.

Relación entre alteraciones de la tomografía computarizada de tórax en pacientes hospitalizados por neumonia COVID-19 y la recuperacion funcional respiratoria a los 3 meses del alta / Relationship between alterations of CT tomography of the thorax in patients hospitalized for pneumonía COVID-19 and respiratory functional recovery 3 months after discharge

Introducción: La neumonía por coronavirus SARS-CoV-2 es una enfermedad nueva, por lo que las secuelas a largo plazo siguen siendo poco claras y los reportes del tema son aún escasos. El presente estudio buscó describir los hallazgos tomográficos al ingreso hospitalario y luego de 3 meses de neumonía asociada a COVID-19 y correlacionarlos con la alteración de las pruebas de función pulmonar a los 3 meses de la hospitalización. Pacientes y Métodos: Estudio de cohorte prospectivo que evaluó las secuelas funcionales pulmonares y la evolución del compromiso imagenológico a los tres meses de hospitalización por neumonía asociada a COVID-19. Todos los exámenes fueron revisados por un radiólogo experto. Se identificó el patrón tomográfico predominante y se estableció la extensión de las alteraciones mediante un puntaje, previamente validado. En las TC de seguimiento, se evaluó la extensión del compromiso imagenológico, el porcentaje de reducción del compromiso del espacio aéreo y presencia de otras alteraciones. Estos hallazgos se relacionaron con las pruebas de función pulmonar (PFP) a los 3 meses (espirometría, DLCO y test de caminata de 6 min: TC6M). Para estos análisis los pacientes se agruparon según la oxigenoterapia utilizada en la hospitalización: oxigenación estándar (O2), cánula nasal de alto flujo (CNAF) o ventilación mecánica invasiva (VMI). Resultados: Se evaluaron un total de 116 pacientes, de los cuales 75 eran hombres, edad promedio fue 60,6 ± 14,5 años. Los pacientes fueron seguidos en promedio 100 días. 70 pacientes pertenecieron al grupo O2 estándar, 25 CNAF y 21 VMI. La TC control a los 3 meses mostró que 78 pacientes presentaron recuperación tomográfica mayor a 50%. El promedio del puntaje de extensión del compromiso tomográfico fue significativamente mayor en el grupo con PFP alterada, comparado con el grupo con PFP normal (espirometría 6,8 vs. 4,6, p = 0,03; DLCO 5,7 vs. 4,1, p = 0,04, TC6M 7,0 vs. 4,2, p = 0,002). Conclusiones: En el seguimiento de los pacientes adultos hospitalizados por neumonía asociada a COVID-19, los pacientes con mayor extensión del compromiso imagenológico pulmonar fueron los que presentaron alteraciones funcionales pulmonares significativas.

Introduction: SARS-CoV-2 pneumonia is an emergent disease, then long term sequelae are still on investigation. This study evaluated the imaging features at the admission to the hospital and then 3 months after discharge of patients hospitalized with COVID-19 pneumonia and compared findings with functional respiratory recovery. Patients and Methods: Prospective cohort study of patients hospitalized with SARS-CoV-2 pneumonia in "Hospital Naval Almirante Nef", Viña del Mar Chile. Imaging evolution and respiratory function were analyzed after 3 months discharge. All the imagens were reviewed by an expert radiologist, who identified a predominant pattern and defined an extension score previously validated. These findings were compared with 3 months CT and respiratory function evaluated with spirometry, DLCO and 6 minutes walking test (6MWT). Also, patients were categorized in 3 different group, depending on oxygen support: conventional oxygen, high-flow nasal cannula (HFNC) and mechanical ventilation. Results: 116 patients were evaluated, 75 men with a mean age of 60.6 ± 14.5 years-old. The median follow-up was 100 days. 70 patients were on conventional oxygen group, 25 in high-flow nasal cannula and 21 in mechanical ventilation. 3-month CT control showed tomographic recovery > 50% in 78 patients. The mean score of extension was significant higher in the group with altered respiratory functional test, compared with the group with normal results (spirometry 6.8 vs. 4.6, p = 0.03; DLCO 5.7 vs. 4.1, p = 0.04; 6MWT 7.0 vs. 4.2, p = 0.002). Conclusion: 3 months after discharge of COVID-19 pneumonia, patients with higher tomographic score present significant abnormalities in respiratory functional test.

Recuperación laboral clínica y funcional a 3 meses del alta en pacientes hospitalizados por neumonía por SARS-CoV-2: relación con la terapia recibida / Clinical and functional recovery and return to work 3 months after discharge in patients hospitalized for SARS-CoV-2 pneumonia: relationship with the therapy received

Resumen Introducción: La presentación clínica de neumonía por COVID-19 ha sido bien documentada; sin embargo, sus repercusiones a largo plazo son aún motivo de investigación. Objetivo: Evaluar la recuperación laboral, clínica y funcional respiratoria, a 3 meses del egreso de pacientes hospitalizados por neumonía por SARS-CoV-2, en relación con la terapia ventilatoria recibida. Pacientes y Métodos: Se analizó una cohorte prospectiva de 116 pacientes con neumonía por COVID-19 del Hospital Naval Almirante Nef de Viña del Mar, con seguimiento clínico y funcional respiratorio 3 meses después de su alta. Resultados: Mediana del seguimiento: 100 días. Constitución de la cohorte: 75 hombres, mediana de edad 60 años, 50% obesos, 34,5% fumadores y 13,8% con comorbilidad respiratoria. 16% recibió rehabilitación. Se reportó disnea en 48,3% y fatigabilidad en 33,6%. Solo 54,8% retornó al trabajo. El 65,2% que utilizó oxigenoterapia (O2) volvió a trabajar comparado con 44% que utilizó cánula nasal de alto flujo (CNAF) y 33,3% con ventilación mecánica invasiva (VMI). Mayoritariamente el grupo de O2 volvió a la vida normal en comparación con CNAF y VMI (71,4 versus 17,5% y 11,1% respectivamente). La función pulmonar fue normal en 39 pacientes (33,6%). La serie que volvió a vida normal tuvo mayor porcentaje de DLCO y test de caminata de 6 minutos normales. En comparación con la serie O2, la serie CNAF tuvo mayor frecuencia de alteración de DLCO (OR = 5) seguido por la serie VMI (OR = 3,6). Conclusión: A 3 meses de seguimiento, se evidenció ausentismo laboral, persistencia de síntomas y alteración funcional respiratoria (DLCO), especialmente en quienes recibieron soporte ventilatorio adicional a oxigenoterapia.

Introduction: The clinical presentation of COVID-19 pneumonia has been well documented; however, its long-term repercussions are still a matter of investigation. Objective: to evaluate the occupational, clinical and functional respiratory recovery, 3 months after the discharge of patients hospitalized for SARS-CoV-2 pneumonia, in relation to the ventilatory therapy received. Patients and Methods: A prospective cohort of 116 patients with COVID-19 pneumonia from Hospital Naval Almirante Nef (Viña del Mar, Chile) was analyzed, with clinical and functional respiratory follow-up at 3 months after being discharged. Results: Median follow-up: 100 days. Composition of the cohort: 75 men, median age 60 years-old, 50% obese, 34.5% smokers and 13.8% with respiratory comorbidity. 16% received rehabilitation. Dyspnea was reported in 48.3% and fatigue in 33.6%. Only 54.8% returned to work. 65.2% who used oxygen therapy (O2) returned to work compared to 44% who used high-flow nasal cannula (HFNC) and 33.3% with invasive mechanical ventilation (IMV). Mostly the O2 group returned to normal life compared to HFNC and VMI (71.4 versus 17.5% and 11.1% respectively). Lung function was normal in 39 patients (33.6%). The series that returned to normal life had higher percentage of normal DLCO and six-minute walk test. Compared to the O2 series, the CNAF series had a higher frequency of DLCO alteration (OR = 5) followed by the VMI series (OR = 3.6). Conclusion: At 3 months of follow-up, absenteeism from work, persistence of symptoms and respiratory functional alteration (DLCO) were evident, especially in those who received ventilatory support in addition to oxygen therapy.

Inverse Hartmann test for radius of curvature measurement in a corneal topography calibration sphere.

In this article, the use of a square Hartmann screen test to measure the radius of curvature of a corneal topography calibration test sphere is presented. The proposed technique is based on the image formation principle by specular reflection on convex reflective surfaces. Applying an inverse Hartmann test, a de-magnified virtual image (Hartmanngram) is obtained; considering their own scaled reference screen plate, a zonal wavefront retrieval approach is used and the radius of curvature obtained. Experimental setup along the obtained results is presented. A simulated spherical wavefront is used as a method to evaluate the error in the wavefront reconstruction. Since the measurements of radius of curvature fits in to ISO 10343, through suitable modifications the proposed method is potentially applicable in small F/# convex specular surfaces, as is the case in keratometry and corneal topography measurements.

Bioactive ingredients of huitlacoche (Ustilago maydis), a potential food raw material.

Huitlacoche (Ustilago maydis) is a staple food traditionally consumed in Mexico. On one hand, it is considered a pathogen and a devastating disease for maize (Zea mays), and, conversely, some reports highlight it as a culinary delight and a food alternative for its nutritional and functional characteristics. The present work aimed to compare two different methods: maceration and ultrasound-assisted extraction (UAE), in order to achieve the highest amount of total phenolic compounds (TPC), followed by the antioxidant capacity (AC) measurement, as well as the effect of the in vitro digestion. UAE produced the highest TPC content (13.44 mg GAE/mg ds) for a 1:5 huitlacoche:solvent ratio using ethanol at 75%. The maximum values for AC were 22.5 mg TE/mL (for DPPH assay) and 45.26 mg TE/mL (for ABTS assay). The in vitro digestion showed that AC is maintained and increased through the digestion process. Thus, huitlacoche can be revalorised as a potential food raw material for human nutrition and health.

Eficacia y seguridad de las aminoquinolinas para el tratamiento de infecciones a SARS-CoV-2: Una revisión sistemática de la literatura / Efficacy and safety of aminoquinolines for treating patients infected with SARS-CoV-2: A systematic review of the literature

INTRODUCTION: Amoniquinolines such as hydroxycholorquine have shown to inhibit SARS-CoV2 replication in-vitro. However, their benefit in clinical terms are controversial. OBJECTIVES: To synthesize the available evidence regarding the use of aminoquinolines for treating patients with COVID-19. METHODS: A systematic review was undertaken. Five databases were searched for randomized trials assessing chloroquine o hydroxychloroquine in the treatment of patients infected with SARS-CoV-2. All studies were assessed using the criteria endorsed by the Cochrane Collaboration. Metaanalyses were undertaken whenever possible. RESULTS: The literature search yielded 852 references, and 5 randomized trials were included. All were at high risk of bias. All studies included several cointerventions, such as antibiotics, steroids and antivirals and only two of them included critically-ill patients. When meta-analyses were conducted, aminoquinolines showed no benefit in terms of viral clearance or clinical improvement. However, a significant increase in the incidence of adverse events was observed (RR 3.11,95CI% 1.64-5.89, p < 0.001). DISCUSSION: The inhibitory properties of aminoquinolines do not seem to translate in clinical benefits amongst patients with COVID-19. The perceived high risk of bias of included studies along the significant increase in terms of adverse events recommends against the routine use of these drugs for treating patients with COVID-19.

INTRODUCCIÓN: Las aminoquinolinas como hidroxicloroquina han mostrado eficacia en inhibir la replicación del SARS-CoV-2 in vitro. Sus efectos en pacientes reales son controversiales. OBJETIVOS: Sintetizar la evidencia disponible respecto al uso de aminoquinolinas en el tratamiento de pacientes con COVID-19. METODOLOGÍA: Revisión sistemática de la literatura de ensayos clínicos aleatorizados (ECA) que evaluaron la eficacia de cloroquina o hidroxicloroquina en el tratamiento de pacientes infectados con SARS-CoV-2. Se buscó evidencia en 5 bases de datos, sólo incluyendo ECAs que fueron evaluados mediante los criterios de calidad de la colaboración Cochrane. Los resultados fueron sintetizados en un metaanálisis siempre que fue posible. RESULTADOS: Se evaluaron 852 referencias, incluyéndose 5 ensayos clínicos aleatorizados con alto riesgo de sesgo. Sólo dos estudios incluyeron pacientes críticamente enfermos. No se apreciaron beneficios en términos de aclaramiento viral o mejoría clínica al realizar el metaanálisis. Se detectó un incremento significativo en la incidencia de reacciones adversas (RR 3,11, IC95% 1,64-5,89, p < 0,001), si bien la mayoría fueron reportadas como leves. DISCUSIÓN: Las aminoquinolinas poseen efectos inhibitorios in vitro que no han demostrado traducirse en beneficios clínicos. El incremento significativo en la incidencia de reacciones adversas asociado a la baja calidad de los estudios evaluados no permite recomendar este tratamiento para pacientes con COVID-19.

Pronación: Tecnología de enfermería que produce bienestar en el cuidado de los pacientes COVID-19, en el Hospital General Dr. Manuel Gea González en la Ciudad de México / Pronation: A nursing technology that promotes wellbeing among COVID-19 patients at General Hospital Dr. Manuel Gea Gonzalez in México City

Introduction: pronation is a procedure used at the Intensive Care Unit with patients presenting Acute Respiratory Distress Syndrome (ARDS) with severe hypoxemia. Bibliographical references clearly support the application of this procedure due to the improvement it produces in oxygenation and the increased survival rate in patients. The main foundation behind this technology is that Ventral Decubitus (VD) promotes an improved redistribution of ventilation toward the dorsal regions of the lung, which are mainly collapsed during Dorsal Decubitus. Nursing staff have used this procedure because VD has proven to be a strategy with a useful and accessible impact over respiratory physiology. Objective: to analyze Pronation as a nursing technology and its promotion of COVID-19 patients' wellbeing at the General Hospital Dr. Manuel Gea González, in Mexico City. Material and methods: a nonexperimental, quantitative, cross-sectional, prolective, descriptive study to analyze pronation, as a nursing technology that promotes wellbeing in the care of COVID-19 patients at General Hospital Dr. Manuel Gea González, in Mexico City. Pronation as a nursing technology was the variable being measured. The universe was 530 nursing professionals working at the Hospital. The population and sample were 52 nursing specialists working with COVID-19 patients, representing 9.81% of the Universe. Results: as for training and experience with Pronation, 50% of the staff consider they have received sufficient training in regards to the SARS-CoV-2 virus, but they are still under training. Additionally, 84.62 % consider that Pronation promotes a remarkable recovery in the patients, with oxygen saturations between 80 to 100 %; 71.16 % believe that patients do show hemodynamic instability due to the position shift, but not in every case; and 80.77 % consider they make sure their patients do not develop pressure ulcers, given that 65.39 % practice patient hygiene and movement to prevent such ulcers. Discussion: from the interviewed staff, 50.01 % consider they have received sufficient training regarding COVID and the pronation of patients. This is consistent with Hernandez et al., who describe the need of a team trained specifically on the procedure, preferably comprised of Nurses specialized in Intensive Care. Likewise, 84.62% of staff members believe Pronation improves oxygen saturation in patients from 80% to 100%, this is contrasted with Barrantes and Vargas, who indicate that if Pronation does not result in 5% improvement in oxygen saturation, the patient must be returned to dorsal decubitus. Conclusion: ventilation in prone position is a pulmonary protective action used for over 30 years that produces an evident and continuous improvement in blood oxygenation and the respiratory physiology. Therefore, nursing specialists caring for COVID-19 patients recommend its use.

Introducción: la pronación es una maniobra utilizada en las unidades de cuidados intensivos, en pacientes que presentan síndrome de distrés respiratorio agudo (SDRA), cuando la hipoxemia es severa. Apoyada por una sólida evidencia científica, tiene impacto en la forma en que se ventila a los pacientes como parámetro de seguridad, esto aumenta la supervivencia. Objetivo: analizar la pronación, como tecnología de enfermería, que produce bienestar en el cuidado de los pacientes COVID-19, en el Hospital General Dr. Manuel Gea González, en la Ciudad de México. Material y métodos: estudio de carácter cuantitativo, no experimental, transversal, prospectivo, descriptivo. Variable medida: la pronación, como tecnología de enfermería. El universo 530 profesionales de enfermería que trabajan en el hospital, muestra: 52 especialistas de enfermería que trabajan con pacientes COVID-19. Resultados: en relación a la capacitación y experiencia en pronación, el 50% del personal manifiestan que sí recibieron suficiente capacitación sobre el virus SARS-CoV-2, aunque siguen capacitándose en ésta área; el 84.62 % consideran que en la pronación, los pacientes mejoran bastante, saturando entre el 80 y 100 % de oxígeno y el 80.77 % siempre cuidan que los pacientes no tengan úlceras por presión.Discusión: el 50.01 % del personal entrevistado manifiesta que sí recibió suficiente capacitación sobre la COVID-19 para pronar a los pacientes, lo que es semejante a la investigación de Hernández GD., et al.¹ Conclusión: la ventilación en posición prono es una medida de protección pulmonar utilizada hace más de 30 años que produce una mejoría evidente y sostenida de la oxigenación de la sangre y en la fisiología respiratoria, por lo que los especialistas de enfermería que atiende pacientes COVID-19 recomiendan su aplicación, pues está asociada al aumento de probabilidad de supervivencia.

miR-19b-3p and miR-20a-5p are associated with the levels of antiphospholipid antibodies in patients with antiphospholipid syndrome.

Monocytes play a key role in pathophysiology of antiphospholipid syndrome (APS), nevertheless it is unclear if microRNA expression is associated with particular APS features. Identify whether miR-19b-3p and miR-20a-5p expression in monocytes are associated with hallmarks of the APS. Fifty-seven APS patients and 18 healthy controls were studied. Expression of miR-19b-3p and miR-20a-5p was measured in monocytes by RT-qPCR. Both miR-19b-3p (AUC = 0.835, 95% CI 0.733-0.938; P < 0.001) and miR-20a-5p (AUC = 0.857, 0.757-0.957; P < 0.001) discriminated APS patients from healthy individuals. A cut-off point of 1.98 for miR-19-3p and 2.18 for miR-20a-5p showed that APS patients with low microRNA expression had higher levels of IgM and IgG anticardiolipin antibodies than patients with high microRNA expression. In addition, APS patients with low microRNA expression had higher IgG anti-ß2 glycoprotein I antibody levels than their counterparts with high microRNA expression. Finally, miR-19b-3p and miR-20a-5p expression levels were significantly higher in APS patients using oral anticoagulants. Monocyte expression of miR-19b-3p and miR-20a-5p is low in APS, and patients with the lowest microRNA expression presented the highest levels of antiphospholipid antibodies.

Genetic predisposition to fetal and neonatal cancer.

BACKGROUND: Neonatal tumors represent an extremely rare and heterogeneous disease with an unknown etiology. Due to its early onset, it has been proposed that genetic factors could play a critical role; however, germline genetic analysis is not usually performed in neonatal cancer patients PATIENTS AND METHODS: To improve the identification of cancer genetic predisposition syndromes, we retrospectively review clinical characteristics in 45 patients with confirmed tumor diagnosis before 28 days of age, and we carried out germline genetic analysis in 20 patients using next-generation sequencing and directed sequencing. RESULTS: The genetic studies did not find any germline mutation except patients diagnosed with bilateral retinoblastoma who harbored RB1 germline mutations. CONCLUSIONS: Our results suggest that genetic factors have almost no higher impact in most neonatal tumors. However, since the heterogeneity of the tumors and the small sample size analyzed, we recommend complementary and centralized germline studies to discard the early onset as an additional criterion to take into account to improve the identification of cancer genetic predisposition syndromes in neonates.

Fungal volatiles emitted by members of the microbiome of desert plants are diverse and capable of promoting plant growth.

Fungi represent a group of eukaryotic microorganisms that are an important part of the plant microbiome. They produce a vast array of metabolites, including fungal volatile organic compounds (fVOCs). However, the diversity and biological activities of fVOCs emitted by the mycobiota of plants native to arid and semi-arid environments remain under-explored. We characterized the chemical diversity of fVOCs produced by 22 representative members of the microbiome of agaves and cacti using SPME-GC-MS. We further tested the effects of pure compounds on the growth and development of Arabidopsis thaliana and host plants. Members of the Sordariomycetes (nine strains), Eurotiomycetes (three), Dothideomycetes (eight), Saccharomycetes (one) and Mucoromycetes (one) were included in our study. We identified 94 fungal organic volatiles classified into nine chemical classes. Terpenes showed the greatest chemical diversity, followed by alcohols and aliphatic compounds. We discovered that camphene and benzyl benzoate, together with the widely distributed and already tested benzyl alcohol, 2-phenylethyl alcohol and 3-methyl-1-butanol, improved plant growth and development of A. thaliana, Agave tequilana and Agave salmiana. Our studies on the fungal VOCs from desert plants underscore an untapped chemical diversity with promising biotechnological applications.

Proposal of a pathway for enteric virus groups detection as indicators of faecal contamination to enhance the evaluation of microbiological quality in freshwater in Argentina.

An environmental survey was conducted in order to assess the frequency of detection of picobirnavirus (PBV), human adenovirus (HAdV) and infective enterovirus (iEV) as indicators of faecal contamination in freshwater, and to determine their potential as reporters of the presence of other enteric viruses, such as group A rotavirus (RVA). The study was carried out over a three-year period (2013-2015) in the San Roque Dam, Córdoba, Argentina. The overall frequency detection was 62.9% for PBV, 64.2% for HAdV and 70.4% for iEV. No significant differences were observed in the rates of detection for any of these viruses through the years studied, and a seasonal pattern was not present. Whenever there was RVA detection in the samples analyzed, there was also detection of iEV and/or HAdV and/or PBV. At least one of the viral groups analyzed was demonstrated in the 100% of the samples with faecal coliforms values within the guideline limits. In this setting, especially in those samples which reveal faecal indicator bacteria within the guideline limit, we propose to carry out a pathway, involving PBV, HAdV and iEV detection in order to enhance the evaluation of microbiological quality in freshwater in Argentina. The proposed methodological strategy could report faecal contamination in water, mainly of human origin, and the condition of the matrix to maintain viral viability. In addition, the viral groups selected could report the presence of RV.

[Efficacy of lumbopelvic stabilization exercises in patients with lumbalgia]. / Eficacia de los ejercicios de estabilización lumbopélvica en pacientes con lumbalgia.

INTRODUCTION: Low back pain is one of the main causes of work disability in Mexico, conservative treatment includes performing exercises. OBJECTIVE: To assess the effects of lower back pain with a controlled exercise program to improve flexibility and strength in the core or center of the body. MATERIAL AND METHODS: We included 18 people, 12 women and six men between 24 and 70 years of age, with low back pain, with a score of 2 to 10 using the visual analogue scale (VAS), with or without referred pain in the lower limb. Participants were advised to refrain from taking medications, alcohol and intense physical activities during the treatment period. The participants carried out 12 sessions of 10 exercises in 3 sets of 10 repetitions, 3 times per week, evaluating: weight, distance toes, anterior rectum strength, abdominal diameter, initial and final Oswestry index. RESULTS: The results were analyzed with the Wilcoxon test, showing a decrease not only in pain (p 0.01), but an improvement in weight, flexibility and perception of disability due to the Oswestry scale (p 0.01) showing that the series of exercises proposed is an alternative to the management of low back pain. DISCUSSION: It is recommended the presence of a therapist who accompanies and corrects the postures so that the exercises are performed well, as well as giving value to the degree of disability caused by pain in the daily performance of the people who present it.

INTRODUCCIÓN: El dolor lumbar es una de las principales causas de incapacidad laboral en México; dentro del tratamiento conservador, se incluye la realización de ejercicios para la disminución del dolor. OBJETIVO: Valorar los efectos en la disminución del dolor lumbar con un programa controlado de ejercicios diseñados para mejorar la flexibilidad y fuerza en el núcleo o centro del cuerpo (core). MATERIAL Y MÉTODOS: Se incluyeron a 18 personas: 12 mujeres y seis hombres de entre 24 y 70 años con dolor lumbar, el cual estaba referido con una puntuación de 2 a 10 utilizando la escala visual análoga (EVA), con o sin dolor en la extremidad inferior. Se aconsejó a los participantes abstenerse de tomar medicamentos, alcohol y de realizar actividades físicas intensas durante el período de tratamiento. Los participantes realizaron 12 sesiones de 10 ejercicios en tres series de 10 repeticiones, tres veces por semana, evaluándose durante estas sesiones: peso, distancia dedos piso, fuerza de recto anterior, diámetro abdominal e índice de Oswestry inicial y final. RESULTADOS: Los datos se analizaron con la prueba de Wilcoxon. Se evidenció disminución no sólo en el dolor (p 0.01), sino una mejoría en el peso, la flexibilidad y la percepción de incapacidad por la escala de Oswestry (p 0.01), mostrando que la serie de ejercicios propuestos es una alternativa para al manejo del dolor lumbar. DISCUSIÓN: Se recomienda la presencia de un terapeuta que acompañe y corrija las posturas para que los ejercicios sean bien realizados, así como darle valor al grado de incapacidad que produce el dolor en el desempeño cotidiano de las personas que lo presentan.

Low-trauma ankle fractures in Brazil: secular trends in patients over 50 years old from 2004 to 2013.

PURPOSE: The most common sites of low-energy trauma fractures are the femur, vertebra, humerus, and forearm. Ankle fractures have significant morbidity and high costs for surgical procedure. Forearm fractures are common nonvertebral fractures. Forearm fractures are classified as fragility fractures and predictive for fractures at other sites, although do not allow osteoporosis diagnosis. It is controversial whether ankle fractures are osteoporosis fractures. METHODS: Retrospective observational study, with secular trend analysis, in patients over 50 years old admitted in the Brazilian Public Health System, from 2004 to 2013. We collected hospitalization data according to the ICD-10 for low-trauma ankle and forearm fractures. Fracture rate was calculated according to gender, age, and geographic region, performed linear regression analysis, and estimated fracture rates for 2030. Comparison of ankle and forearm rates was also performed, grouping them in 3-year block. ANOVA test was used to compare each block. RESULTS: Ankle fracture rate was 21.39 fractures per 100,000 inhabitants, 23.98 in females and 18.49 in males. Fracture rates were higher in the South and Southeast regions. In absolute numbers, although ankle fracture rate increased with age, there was a significant decrease in the population over 80 years old. Data showed stabilization in ankle fractures from 2004 to 2013, in women and men. In 3-year block analysis, men had higher ankle fracture rates than forearm. However, in women, forearm rates were higher than ankle. CONCLUSION: Our data suggest that ankle fractures in men would be considered as a sentinel fracture with a similar clinical impact of forearm fracture.

Usefulness of autocidal gravid ovitraps for the surveillance and control of Aedes (Stegomyia) aegypti (Diptera: Culicidae) in eastern Colombia.

In the past decade, new strategies have been developed to control the Aedes aegypti (Diptera: Culicidae) mosquito vector, as well as a broad range of arboviral agents. Vector control surveillance programmes in Puerto Rico and Australia have implemented the Centers for Disease Control and Prevention autocidal gravid ovitrap (AGO), which has had an impact on vector density and, consequently, the epidemiology of arboviral infections. Colombia intends to establish the AGO as a new tool for the surveillance and control of the A. aegypti vector. AGOs were evaluated in a hyperendemic area for dengue virus during an 8-week period in Villavicencio city, eastern Colombia. The results indicated that the AGOs detect a high density of A. aegypti, with positive results for these traps of over 80% and an average catch of six individuals per trap per week. Acceptance of AGOs in the community exceeded 95%, and adherence was around 89%. This study's results demonstrate, for the first time in Colombia, that traps are a useful tool for the surveillance of A. aegypti. Future studies must consider the implementation of AGOs in the region.

Eficacia de los ejercicios de estabilización lumbopélvica en pacientes con lumbalgia / Efficacy of lumbopelvic stabilization exercises in patients with lumbalgia

Resumen: Introducción: El dolor lumbar es una de las principales causas de incapacidad laboral en México; dentro del tratamiento conservador, se incluye la realización de ejercicios para la disminución del dolor. Objetivo: Valorar los efectos en la disminución del dolor lumbar con un programa controlado de ejercicios diseñados para mejorar la flexibilidad y fuerza en el núcleo o centro del cuerpo (core). Material y métodos: Se incluyeron a 18 personas: 12 mujeres y seis hombres de entre 24 y 70 años con dolor lumbar, el cual estaba referido con una puntuación de 2 a 10 utilizando la escala visual análoga (EVA), con o sin dolor en la extremidad inferior. Se aconsejó a los participantes abstenerse de tomar medicamentos, alcohol y de realizar actividades físicas intensas durante el período de tratamiento. Los participantes realizaron 12 sesiones de 10 ejercicios en tres series de 10 repeticiones, tres veces por semana, evaluándose durante estas sesiones: peso, distancia dedos piso, fuerza de recto anterior, diámetro abdominal e índice de Oswestry inicial y final. Resultados: Los datos se analizaron con la prueba de Wilcoxon. Se evidenció disminución no sólo en el dolor (p < 0.01), sino una mejoría en el peso, la flexibilidad y la percepción de incapacidad por la escala de Oswestry (p < 0.01), mostrando que la serie de ejercicios propuestos es una alternativa para al manejo del dolor lumbar. Discusión: Se recomienda la presencia de un terapeuta que acompañe y corrija las posturas para que los ejercicios sean bien realizados, así como darle valor al grado de incapacidad que produce el dolor en el desempeño cotidiano de las personas que lo presentan.

Abstract: Introduction: Low back pain is one of the main causes of work disability in Mexico, conservative treatment includes performing exercises. Objective: To assess the effects of lower back pain with a controlled exercise program to improve flexibility and strength in the core or center of the body. Material and methods: We included 18 people, 12 women and six men between 24 and 70 years of age, with low back pain, with a score of 2 to 10 using the visual analogue scale (VAS), with or without referred pain in the lower limb. Participants were advised to refrain from taking medications, alcohol and intense physical activities during the treatment period. The participants carried out 12 sessions of 10 exercises in 3 sets of 10 repetitions, 3 times per week, evaluating: weight, distance toes, anterior rectum strength, abdominal diameter, initial and final Oswestry index. Results: The results were analyzed with the Wilcoxon test, showing a decrease not only in pain (p < 0.01), but an improvement in weight, flexibility and perception of disability due to the Oswestry scale (p < 0.01) showing that the series of exercises proposed is an alternative to the management of low back pain. Discussion: It is recommended the presence of a therapist who accompanies and corrects the postures so that the exercises are performed well, as well as giving value to the degree of disability caused by pain in the daily performance of the people who present it.