Disease activity is associated with changes in the innate immune function in patients with systemic lupus erythematosus.

OBJECTIVE: To address the relationship between systemic lupus erythematosus (SLE) disease activity and the functional parameters of the innate immunity. METHODS: We evaluated a cohort of 26 adult SLE patients and 10 sex and age-paired healthy donors. When the patients had a disease flare (baseline) and when they achieve clinical response (follow-up), we assessed the systemic lupus erythematosus disease activity index 2 K (SLEDAI 2 K) and the following parameters with flow cytometry and confocal microscopy: monocyte subsets, their expression of TLR2, phagocytic monocytes and neutrophils using the pHrodo Red E. coli BioParticles, the respiratory burst with 123-dihydrorhodamine in neutrophils, and the spontaneous and lipopolysaccharide (LPS)-induced production of neutrophil extracellular traps (NETs). We used the Wilcoxon test to compare the paired medians with interquartile range (IQR) and the Mann-Whitney U test for independent medians. To assess the effect of prednisone and SLEDAI 2 K on the mentioned parameters, we applied a generalized mixed linear model. RESULTS: Twenty-three patients (88.4%) were women. The SLEDAI 2 K was higher at baseline 8 (6-14) in comparison to that at follow-up (6 (4-8), P = 0.028). At baseline, SLE patients had a decreased percentage of intermediate monocytes, a higher expression of TLR2 in total monocytes, increased phagocytosis in monocytes and neutrophils, a decreased respiratory burst intensity, and an increased production of NETs. In the mix model, the SLEDAI 2 K was the main factor influencing these functional innate immune parameters. CONCLUSION: Disease activity regulates the innate immune function in SLE which may contribute to the clinical features and infection predisposition. Key points • This is the first cohort study addressing the effect of disease activity and prednisone use on the innate immune function of lupus patients. • Our results show that the disease activity is a key regulator of the respiratory burst, phagocytosis, and the production of neutrophil extracellular traps. • Also, we observed a differential proportion of monocyte subsets according to SLE disease activity. • We consider that our manuscript contributes to the evidence addressing the intrinsic immune abnormalities of patients with SLE regardless of the use of immunosuppressants and set the bases for new research work considering the disease activity as an element to decide the prescription and duration of antibiotic prophylaxis in SLE patients, which is of interest to all rheumatologists.

Pandemic grief in El Salvador: factors that predict dysfunctional grief due to a COVID-19 death among Salvadoran adults.

Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dysfunctional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans (M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dysfunctional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety (p = .003), depression (p = .021), and COVID-19 obsession (p = .032) were significant (χ2 = 84.31; Nagelkerke R2 = .242) and predict a 24.2% chance of dysfunctional bereavement.

A postmortem study of patients vaccinated for SARS-CoV-2 in Colombia.

INTRODUCTION AND OBJECTIVE: A new coronavirus produces a disease designated as coronavirus disease 2019 (COVID-19). Vaccination against COVID-19 has resulted in decreased mortality. Postmortems of vaccinated patients play an important part in the forensic analysis of adverse effects after vaccination, which is essential for determining its efficacy and security. The main objective of this study was to describe the results of autopsies of patients vaccinated for SARS-CoV-2 carried out in two major centers in Colombia. MATERIALS AND METHODS: A descriptive cross-sectional study of 121 autopsies was performed following Colombian regulations in two main hospitals in Bogotá, Colombia, between March 1st and April 31st, 2021. RESULTS: 118 of the 121 patients (97.52%) had been vaccinated with CoronaVac (Sinovac); only 3 had received other vaccines. Sudden cardiac death was the leading cause of death, with pulmonary embolism another critical finding. No relation between the cause of death and vaccination against SARS-CoV-2 was found. CONCLUSIONS: A clinical autopsy is a vital for an accurate post-mortem diagnosis. Any relation between the SARS-CoV-2 vaccine and the cause of death should be carefully studied in order to provide the general public with evidence-based information about the safety of the vaccination.

Pandemic grief in El Salvador: factors that predict dysfunctional grief due to a COVID-19 death among Salvadoran adults

Abstract Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dysfunctional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans ( M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dysfunctional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety ( p = .003), depression ( p = .021), and COVID-19 obsession ( p = .032) were significant ( χ 2 = 84.31; Nagelkerke R 2 = .242) and predict a 24.2% chance of dysfunctional bereavement.

Incidence of Cytomegalovirus disease and viral replication kinetics in seropositive liver transplant recipients managed under preemptive therapy in a tertiary-care center in Mexico City: a retrospective cohort study.

BACKGROUND: In the absence of an adequate prevention strategy, up to 20% of CMV IgG+ liver transplant recipients (LTR) will develop CMV disease. Despite improved reporting in CMV-DNAemia, there is no consensus as to what the ideal CMV-DNAemia cutoff for a successful preemptive strategy is. Each transplant centre establishes their own threshold. We aimed to determine the effectiveness of our preventive strategy in CMV IgG+ LTR, and evaluate CMV replication kinetics. METHODS: In this retrospective study we determined the incidence of CMV disease in the first 6 months following transplantation in CMV seropositive LTR in a tertiary-care centre in Mexico. Secondary outcomes were determining the number of patients who required preemptive therapy (treatment cutoff ≥ 4000 UI/ml), adherence to the centre's prevention protocol and calculation of viral replication kinetics. RESULTS: One-hundred and twenty-four patients met inclusion criteria. Four patients (3.2%) developed CMV disease. Ninety-six (85%) had detectable DNAemia and 25 (22%) asymptomatic patients received preemptive therapy, none of them developed CMV disease. The highest viral loads were observed on the second posttransplant month. The number of viral load measurements decreased over time. Patients with DNAemia ≥ 4000 UI/ml had a faster viral load growth rate, shorter viral load duplication time, and higher basic reproductive number. Viral load growth rate and autoimmune hepatitis were associated with development of DNAemia ≥ 4000 UI/ml. CONCLUSION: Cytomegalovirus disease occurred in 3.2% of the study subjects. Preemptive therapy using a threshold of CMV ≥ 4000 UI/ml was effective in reducing the incidence of end-organ disease. The viral replication parameters described in this population highlight the importance of frequent monitoring, a challenging feat for transplant programs in low- and middle-income countries.

Immunology of Fungal Infections.

Complex processes mediate immunity to fungal infections. Responses vary depending on the organism, morphogenic state, and infection site. Innate immune effectors such as epithelia, phagocytes, and soluble molecules detect pathogens, kill fungi, release cytokines, and prime the adaptive response. Adaptive responses to mucocutaneous or invasive disease are markedly different but intersect at certain pathways (molecules required for IL-23 and IL-12 signaling). Many of these pathways have been elucidated from the study of inborn errors of immunity. This review explores the general aspects of antifungal immunity and delves into the mechanisms that mediate protection from frequently encountered fungi.

Cardiopatías congénitas, tratamiento quirúrgico y sus complicaciones en población pediátrica del Hospital Vicente Corral Moscoso, 2017 - Agosto 2019 / Congenital heart diseases, surgical treatment and complications in pediatric sample of Hospital Vicente Corral Moscoso, 2017-August 2019.

INTRODUCCIÓN: El corazón es el órgano más comúnmente afectado por anormalidades congénitas, con una incidencia de 0.8 por cada 100 nacidos vivos. Cerca de dos tercios de todos los procedimientos son en la actualidad realizados antes del año de edad, lo que mejora la sobrevida y la calidad de vida. Este estudio busca determinar cuáles son las principales intervenciones quirúrgicas realizadas para tratar las cardiopatías congénitas y sus complicaciones. MATERIALES Y MÉTODOS: Se realizó un estudio observacional, descriptivo de corte transversal; con 70 pacientes pediátricos diagnosticados y tratados quirúrgicamente por cardiopatías congénitas. Los datos fueron tomados de las historias clínicas mediante un formulario. El análisis estadístico se realizó utilizando el programa SPSS versión 15. RESULTADOS: La mediana de la edad fue de 1.1 años, el 60% fueron de sexo femenino. El 90% de las cardiopatías fueron no cianógenas. El diagnóstico más frecuente fue la persistencia del conducto arterioso (58.57%), seguido de la comunicación interventricular (12.86%). Según el tipo de procedimiento el 58.57% se realizaron para cierre de persistencia del conducto arterioso y un 12.86% fueron reparaciones quirúrgicas para cierre de comunicación interventricular. La mediana de estadía en la unidad de cuidados intensivos fue de 4 días y la mediada de estadía en la sala general de 5 días. La principales complicaciones observadas en esta población pediátrica sometida a un procedimiento quirúrgico fueron: la neumonía (11.4%) y la sepsis de origen no especificado (8.6%). CONCLUSIÓN: Los tratamientos para las cardiopatías congénitas se realizaron a edades tempranas (Media =2.5 ± 3.2 años). Más de la mitad de los procedimientos quirúrgicos realizados para cardiopatías quirúrgicas fueron para corregir la persistencia del conducto arterioso y la principal complicación fue la neumonía.

BACKGROUND: The heart is the most commonly affected organ by congenital diseases, with and incidence of 0.8 per 100 newborns. Nearly two thirds of all the surgical procedures are now a days performed before the first year of life, improving survival rate and life quality. This study aims to determine the frequency of the surgical interventions performed to treat congenital heart diseases and its complications. METHODS: An observational, descriptive cross sectional study was carried out; with 70 pediatric patients diagnosed and surgically treated for congenital heart diseases. The data was collected from the patient's medical records using a form. Statistical analysis was performed using SPSS version 15 software. RESULTS: The median age was 1.1 years, 60% of the sample were women. 90% of the heart diseases were non-cyanogenic. The most frequent diagnosis was: persistence of the arterial duct (58.57%), followed by interventricular communication (12.86%). The type of procedures corresponds to the heart disease, thus 58.57% were performed for closure of arterial duct persistence and 12.86% were surgical repairs for closure of interventricular communication. The median stay in the intensive care unit was 4 days and the median stay in general hospitalization room was 5 days. The main complications in this pediatric population undergoing a surgical procedure were: pneumonia (11.4%) and sepsis of unspecified origin (8.6%). CONCLUSION: Treatment for heart diseases were performed at early ages (average age= 2.5±3.2). More than half of the surgical procedures for congenital heart disease were performed to correct the persistence of the ductus arteriosus, the main complication was pneumonia.

Intervenciones de la aorta ascendente: Estudio transversal en dos Instituciones de Salud de la Ciudad de Cuenca, Ecuador / Ascending aorta surgical interventions: Cross- Sectional Study in two Health Institutions in Cuenca, Ecuador.

INTRODUCCIÓN: El tratamiento de las patologías aneurismáticas de la aorta ascendente (AA) ha evolucionado a través de los años. La técnica quirúrgica propuesta para esta patología es siempre en pro de conservar en medida de lo posible los tejidos nativos. La dilatación aórtica puede ser secundaria a otras patologías. Existe relación con HTA, EPOC, tabaquismo, aterosclerosis, insuficiencia cardiaca congestiva, enfermedad coronaria, síndrome de Marfan. El objetivo del presente estudio fue caracterizar a los pacientes intervenidos quirúrgicamente de la aorta ascendente en dos centros médicos de la ciudad de Cuenca- Ecuador, entre Enero del 2014 hasta Agosto 2019. MATERIALES Y MÉTODOS: Estudio descriptivo y de correlación, de corte transversal. La población de estudio estuvo conformada por 23 pacientes sometidos a intervención quirúrgica de aorta ascendente en la ciudad de Cuenca-Ecuador, en el Hospital José Carrasco Arteaga y la Clínica Santa Inés desde enero de 2014 hasta agosto 2019. La información se obtuvo de las historias clínicas únicas. RESULTADOS: El rango de edad fue de 27 a 74 años, con una media de 55.57 años. Las comorbilidades encontradas con mayor frecuencia fueron hipertensión arterial (56.5%) y diabetes tipo 2 (17.4%); además un 8.7% de pacientes presentó síndrome de Marfan. El 39% fueron casos de aneurisma de aorta ascendente sin afección valvular importante. La gran mayoría de pacientes fueron sometidos a cirugía con técnica de Bentall-De Bono (91%). La mayoría de pacientes (52.2%) no presentó ninguna complicación postquirúrgica. La tasa de mortalidad encontrada en la población de estudio fue 1.3 por cada 10. CONCLUSIONES: Los hombres presentaron con mayor frecuencia cirugía por patología de la aorta. La edad media fue de 55 años. Los diagnósticos en los pacientes estudiados fueron heterogéneos entre SAA y afecciones aórticas primarias o secundarias a valvulopatías. Los síntomas principales fueron angina y disnea; no se encontró una relación entre la presentación clínica con un aumento en la mortalidad. Las comorbilidades más frecuentes fueron HTA y Diabetes Mellitus II. No se lograron identificar relaciones estadísticamente significativas entre las complicaciones y las demás variables. La complicación más común fue la re-intervención por sangrado. La mortalidad en nuestro estudio tuvo una disminución progresiva desde el 2014.

BACKGROUND: The treatment of ascending aorta (AA) aneurysms has evolved over the years. The surgical technique for this pathology should always be chosen in favor of preserving native tissues, as much as possible. Aortic dilation can be secondary to other pathologies. There is an association with arterial hypertension, COPD, smoking, atherosclerosis, congestive heart failure, coronary heart disease, Marfan syndrome. The aim of this study was to characterize patients who underwent ascending aorta surgery in two medical centers in Cuenca- Ecuador, between January 2014 and August 2019. METHODS: Cross-Sectional descriptive and correlation study. The study population was formed by 23 patients undergoing an ascending aortic surgical intervention, in the city of Cuenca-Ecuador, at Hospital José Carrasco Arteaga or Clínica Santa Inés, from January 2014 to August 2019. Data was obtained from the patient's medical records. RESULTS: The age range went from 27 to 74 years with an average of 55.5 7 years. The most frequently found comorbidities were hypertension (56.5%) and type 2 diabetes (17.4%), 8.7% of the patients presented with Marfan syndrome. The most common diagnosis was ascending aortic aneurysm without significant valve damage (39%). 91% percent of the patients underwent surgery with the Bentall-De Bono technique. The majority of patients (52.2%) did not present any post-surgical complications. The mortality rate found in this population was 1.3 per 10 patients. CONCLUSIONS: Men were more frequently affected. The mean age was 55 years. The studied pathologies were heterogeneous, from SAA to primary or secondary aortic diseases. The main symptoms were angina and dyspnea; there was no significant association between clinical onset and mortality. The most frequent comorbidities were Arterial Hypertension and type II Diabetes. We didn't found any significant associations between complications and the other variables. The most common complication was bleeding that needed re-intervention. Mortality decreased progressively since 2014.

Caso clínico: adulto con anomalía de Ebstein / Clinical case: adult with Ebstein anomaly

Introducción: la anomalía de Ebstein se caracteriza por la implantación baja de las valvas septal y posterior de la tricúspide; por lo tanto, la aurícula derecha es amplia y su ventrículo es pequeño. Al ser una patología bastante rara en nuestro medio se encuentra subdiagnosticada y no recibe el tratamiento oportuno. Por ende, la importancia de conocerla para no retrasar su manejo clínico quirúrgico.Caso clínico: paciente de 46 años de edad, masculino, con antecedente de hipoacusia congénita, presentó disnea (clase funcional III) más palpitaciones y dolor torácico atípico hace 1 año aproximadamente. Al examen físico evidenció soplo holosistólico en foco tricuspídeo y uso moderado de musculatura accesoria. Al ecocardiograma transesofágico, se observó arritmia auricular más implante bajo de las valvas de la tricúspide y se inició tratamiento clínico más ablación del flutter. En la evolución presentó mejoría de la sintomatología y dependiendo del deterioro de la clase funcional, tratamiento quirúrgico Conclusiones: en el presente caso se ajustó tratamiento clínico y ablación del flutter de acuerdo a sintomatología del paciente, mostrando mejoría (AU);

Introduction: Ebstein's anomaly is characterized by low implantation of the septal and posterior tricuspid leaflets; therefore, the right atrium is wide and its ventricle is small. Being a rather rare pathology in our environment, it is underdiagnosed and does not receive the appropriate treatment. Therefore, it is important to know it to avoid a delay in its clinical surgical management.Clinical case: The patient is 46-year-old male, with a history of congenital hearing loss, who presented dyspnea (functional class III) plus palpitations and atypical chest pain approximately 1 year ago. In the physical examination, he revealed a holosystolic murmur in the tricuspid focus and moderate use of accessory muscles. A transesophageal echocardiogram revealed atrial arrhythmia plus implantation of the tricuspid leaflets and it was started a clinical treatment plus flutter ablation. In the evolution he presented improvement of the symptoms and depending on the deterioration of the functional class, surgical treatment.Conclusions: in this case, clinical treatment and flutter ablation were adjusted according to the patient's symptoms, showing improvement (AU);

Genetic, Immunological, and Clinical Features of the First Mexican Cohort of Patients with Chronic Granulomatous Disease.

PURPOSE: Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by an inability of phagocytes to produce reactive oxygen species, impairing their killing of various bacteria and fungi. We summarize here the 93 cases of CGD diagnosed in Mexico from 2011 to 2019. METHODS: Thirteen Mexican hospitals participated in this study. We describe the genetic, immunological, and clinical features of the 93 CGD patients from 78 unrelated kindreds. RESULTS: Eighty-two of the patients (88%) were male. All patients developed bacterial infections and 30% suffered from some kind of fungal infection. Fifty-four BCG-vaccinated patients (58%) presented infectious complications of BCG vaccine. Tuberculosis occurred in 29%. Granulomas were found in 56% of the patients. Autoimmune and inflammatory diseases were present in 15% of patients. A biological diagnosis of CGD was made in 89/93 patients, on the basis of NBT assay (n = 6), DHR (n = 27), and NBT plus DHR (n = 56). The deficiency was complete in all patients. The median age of biological diagnosis was 17 months (range, 0-186 months). A genetic diagnosis was made in 83/93 patients (when material was available), corresponding to CYBB (n = 64), NCF1 (n = 7), NCF2 (n = 7), and CYBA (n = 5) mutations. CONCLUSIONS: The clinical manifestations in these Mexican CGD patients were similar to those in patients elsewhere. This cohort is the largest in Latin America. Mycobacterial infections are an important cause of morbidity in Mexico, as in other countries in which tuberculosis is endemic and infants are vaccinated with BCG. X-linked CGD accounted for most of the cases in Mexico, as in other Latin American countries. However, a significant number of CYBA and NCF2 mutations were identified, expanding the spectrum of known causal mutations.

Bilateral Proximal Forearm Transplantation: Case Report at 7 Years.

BACKGROUND: Although return of function has been reported in patients undergoing proximal forearm transplantations (PFTs), reports of long-term function are limited. In this study, we evaluated the clinical progress and function 7 years postoperatively in a patient who underwent bilateral PFT. CASE PRESENTATION: A 58-year-old man underwent bilateral PFT in May 2012. Transplantation involved all of the flexor and extensor muscles of the forearm. Neurorrhaphies of the median, ulnar, and radial nerves were epineural and 7 cm proximal to the elbow. Immunosuppressive maintenance medications during the first 3 years postoperatively were tacrolimus, mycophenolate, and steroids, and later, tacrolimus, sirolimus, and steroids. Forearm function was evaluated annually using the Disabilities of the Arm, Shoulder, and Hand; Carroll; Hand Transplantation Score System; Short Form-36; and Kapandji scales. We also evaluated his grip and pinch force. RESULTS: Postoperatively, the patient developed hypertriglyceridemia and systemic hypertension. He experienced 6 acute rejections, and none were resistant to steroids. Motor function findings in his right/left hand were: grip strength: 10/13 kg; key pinch: 3/3 kg; Kapandji score: 6/9 of 10; Carroll score: 66/80; Hand Transplantation Score System score: 90/94. His preoperative Disabilities of the Arm, Shoulder, and Hand score was 50 versus 18, postoperatively; his Short Form-36 score was 90. This function improved in relation with the function reported in the second year. CONCLUSIONS: Seven years following PFT, the patient gained limb strength with a functional elbow and wrist, although with diminished digital dexterity and sensation. Based on data presented by other programs and our own experience, PFT is indicated for select patients.

TREATMENT STRATEGIES AND OUTCOME OF PARVOVIRUS B19 INFECTION IN KIDNEY TRANSPLANT RECIPIENTS: A CASE SERIES AND LITERATURE REVIEW OF 128 PATIENTS.

BACKGROUND: There is no specific antiviral treatment for parvovirus B19 (PVB19) infection. OBJECTIVE: The objective of this study was to study the treatment and outcome of PVB19 infection in kidney transplant recipients (KTR) at our institution, and cases published in the medical literature. METHODS: We conducted a retrospective review of PVB19 infection in KTR at an academic medical center over a 16-year period and summarized the data on its treatment and outcome in 120 KTR in the medical literature. RESULTS: In our cohort of eight patients, the median time to the onset of PVB19 disease was 7.2 weeks after transplantation. All patients had severe aregenerative anemia (mean hemoglobin (Hb) of 6.2 ± 1.0 g/dl); all were treated with a reduction in their immunosuppressive regimen and the administration of single-dose intravenous immunoglobulin (IVIG) (mean total dosage of 0.87 ± 0.38 g/kg). The median time to anemia improvement (Hb >10 g/dl) was 3-week post-treatment. No recurrences were documented during follow-up (median 25 months). Among 128 patients (including our cohort of 8 and 120 reported in literature), therapeutic strategies included: 43% IVIG alone, 39% IVIG and reduced immunosuppression, 9% reduction of immunosuppression, and 9% conservative therapy. Clinical relapses were observed in 35% of 71 reported cases. CONCLUSIONS: In KTR, decreasing immunosuppression and the administration of low-dose immunoglobulin seem to be not worse than the standard dose in PVB19 infection.

Treatment strategies and outcome of parvovirus b19 infection in kidney transplant recipients: a case series and literature review of 128 patients.

Abstract Background There is no specific antiviral treatment for parvovirus B19 (PVB19) infection. Objective The objective of this study was to study the treatment and outcome of PVB19 infection in kidney transplant recipients (KTR) at our institution, and cases published in the medical literature. Methods We conducted a retrospective review of PVB19 infection in KTR at an academic medical center over a 16-year period and summarized the data on its treatment and outcome in 120 KTR in the medical literature. Results In our cohort of eight patients, the median time to the onset of PVB19 disease was 7.2 weeks after transplantation. All patients had severe aregenerative anemia (mean hemoglobin (Hb) of 6.2 ± 1.0 g/dl); all were treated with a reduction in their immunosuppressive regimen and the administration of single-dose intravenous immunoglobulin (IVIG) (mean total dosage of 0.87 ± 0.38 g/kg). The median time to anemia improvement (Hb >10 g/dl) was 3-week post-treatment. No recurrences were documented during follow-up (median 25 months). Among 128 patients (including our cohort of 8 and 120 reported in literature), therapeutic strategies included: 43% IVIG alone, 39% IVIG and reduced immunosuppression, 9% reduction of immunosuppression, and 9% conservative therapy. Clinical relapses were observed in 35% of 71 reported cases. Conclusions In KTR, decreasing immunosuppression and the administration of low-dose immunoglobulin seem to be not worse than the standard dose in PVB19 infection.

Relación entre consumo de oxígeno, porcentaje de grasa e índice de masa corporal en universitarios / Relationship between oxygen consumption, percentage of body fat and body mass index in university students / Relação entre conssumo de oxígeno, porcentagem de obesidade corporal e índice de massa corporal em universitarios

El VO2max es indicador de capacidad de trabajo e integridad del sistema cardiovascular. Objetivo: Correlacionar VO2max, porcentaje de grasa corporal, suma de pliegues cutáneos e IMC en estudiantes universitarios de Villavicencio, Colombia. Materiales y métodos: Estudio prospectivo, observacional, con alcance descriptivo y relacional, de corte transversal. Fue evaluada una muestra no probabilística, ni estrati cada de 390 estudiantes (186 hombres, 204 mujeres) con edad media 21,34 D.E. 4,49 años, matriculados en cuatro universidades. El VO2max fue calculado a partir del Queens College Step Test y sus resultados analizados con las tablas del ACSM, el porcentaje de grasa mediante adipometría siguió los procedimientos estandarizados por la ISAK. Con el programa SPSS se evaluó la normalidad de la distribución (KS) y fueron calculadas media, desviación típica y correlación. Los participantes rmaron un consentimiento informado según Resolución 8430 de 1994. Resultados: Para toda la población evaluada se encontraron correlaciones negativas débiles entre el VO2max y la suma de pliegues de tríceps y subescapular (r=-0,198**, P=0,000), porcentaje de grasa (r=-0,216**, P=0,000). La correlación entre el VO2max y el IMC no fue signi cativa (P > 0,05). En hombres hubo correlaciones signi cativas negativas entre VO2max y suma de pliegues de tríceps y subescapular (r=-0,264**, p=0,000), tríceps y pierna media (r=-0,294, p=0,000), porcentaje de grasa (r=-0,286, p=0,000). En mujeres no se encontraron correlaciones signi cativas (p>0,05) entre VO2max y composición corporal. Conclusiones: Se encontraron correlaciones negativas débiles entre VO2max, suma de pliegues cutáneos y porcentaje de grasa corporal solamente en hombres; no se halló relación entre VO2max e IMC.

VO2max is an indicator of work capacity and integrity of the cardiovascular system. Objective: To Correlate VO2max, body fat percentage, sum of skinfolds and BMI in university students of Villavicencio, Colombia. Materials and methods: Prospective, observational cross-sectional study, with a descriptive and relational scope. A non-probabilistic or strati ed sample of 390 students (186 men, 204 women) with average age 21.34 D.E. 4.49 years, enrolled in four universities, was evaluated. The VO2max was calculated from the Queens College Step Test and its results were evaluated with the ACSM tables, the percentage of body fat by skinfold thickness measurement followed the procedures standardized by ISAK. The normality of the distribution (KS) was evaluated with the SPSS program and mean, standard deviation, and correlation were calculated. The participants signed an informed consent following Resolution 8430 of 1994. Results. Weak negative correlations were found between VO2max and the sum of triceps and subscapular folds (r = -0.198 **, P = 0.000), body fat percentage (r = -0.216 **, P = 0.000). The correlation between VO2max and BMI was not signi cant (P > 0.05) for all the population evaluated. In men, there were signi cant negative correlations between VO2max and sum of triceps and subscapular folds (r = -0.264 **, p = 0.000), triceps and middle leg (r = -0.294, p = 0.000), percentage of fat (r = -0.286, p = 0.000). In women, no signi cant correlations were found (p >0.05) between VO2max and body composition. Conclusions: Weak negative correlations were found between VO2max, sum of skinfolds and percentage of body fat only in men. No relationship was found between VO2max and BMI.

O VO2max é indicador de capacidade de trabalho e integridade do sistema cardiovascular. Objetivo: Correlacionar VO2max, porcentagem de gordura corporal, soma de pregues cutâneos e IMC em estudantes universitários de Villavicencio, Colômbia. Materiais e métodos: Estudo prospectivo, observacional, com alcance descritivo e relacional, de corte transversal. Foi avaliada uma amostra não probabilística, nem estrati cada de 390 estudantes (186 homens, 204 mulheres) com idade média 21,34 D.E. 4,49 anos, matriculados em quatro universidades. O VO2max foi calculado a partir do Queens College Step Test e seus resultados analisados com as tabelas do ACSM, a porcentagem de obesidade mediante adipometria seguiu os procedimentos estandardizados pela ISAK. Com o programa SPSS se avaliou a normalidade da distribuição (KS) e foram calculadas meias, desvio típico e correlação. Os participantes assinaram um consentimento informado segundo Resolução 8430 de 1994. Resultados: Para toda a povoação avaliada se encontraram correlações negativas fracas entre o VO2max e a soma de pregues de tríceps e subescapular (r=-0,198**, P=0,000), porcentagem de obesidade (r=-0,216**, P=0,000). A correlação entre o VO2max e o IMC não foi signi cativa (P > 0,05). Em homens houve correlações signi cativas negativas entre VO2max e soma de pregues de tríceps e subescapular (r=-0,264**, p=0,000), tríceps e perna meia (r=-0,294, p=0,000), porcentagem de obesidade (r=-0,286, p=0,000). Em mulheres não se encontraram correlações signi cativas (p>0,05) entre VO2max e composição corporal. Conclusões: Encontram se correlações negativas fracas entre VO2max, soma de pregues cutâneos e porcentagem de obesidade corporal somente em homens; não se encontrou relação entre VO2max e IMC.

Aspergillus infection of the larynx in a solid organ transplant recipient.

Primary laryngeal aspergillosis is a rare condition. Only a few cases have been reported in the past years. Most of them have been reported in healthy patients or with a mild immunocompromised state. We report a case of primary laryngeal aspergillosis in a solid organ transplant recipient (SOT), an infection not previously described in this population; we reviewed the published literature in all populations.

Association Between Frailty and HIV-Associated Neurodegenerative Disorders Among Older Adults Living with HIV.

The population of aging adults living with human immunodeficiency virus (HIV) is growing worldwide and evidence suggests that frailty occurs prematurely among them. In turn, frailty has been associated with cognitive decline. It is unknown, however, if people with both frailty and HIV infection have a higher risk of cognitive impairment compared with nonfrail HIV-infected persons. Therefore, the main objective of this study was to determine the association between the phenotype of frailty and HIV-associated neurocognitive disorders (HAND) among adults aged 50 years or older living with HIV/AIDS. A cross-sectional study was conducted on 206 adults living with HIV receiving care in a university-affiliated tertiary care hospital in Mexico City. Frailty was defined as per the Fried criteria. The presence of HAND was established according to the Antinori criteria: HIV-associated asymptomatic neurocognitive impairment (ANI), HIV-associated mild neurocognitive disorder (MND), or cognitively nonimpaired. Multinomial logistic regression models were used to test the independent association between frailty and HAND adjusting for potential confounders. Mean age of participants was 60.5 ± 6.3 years and 84.9% were male. Prevalence of HAND and frailty phenotype was 66.0% and 2.9%, respectively. The unadjusted analysis showed that both prefrail and frail statuses were associated with MND but not with ANI. However, after adjustment, the association with MND remained significant only among prefrail participants and no longer for frail persons (risk ratio [RR] = 5.7, 95% confidence intervals [CI] 1.09-29.82; p = .039 and RR = 18.3, 95% CI 0.93-362.6; p = .056, respectively). Prefrailty is associated with symptomatic neurocognitive disorders in older adults living with HIV. The spectrum of the frailty phenotype in this already vulnerable population should serve as an indicator of concomitant cognitive decline.