Peripartum Takotsubo Cardiomyopathy: A Review and Insights from a National Registry.

Takotsubo syndrome (TTS) during the peripartum period is a relevant cause of morbidity in this population; its clinical course and prognosis, compared to the general TTS population, is yet to be elucidated. Our aim was to analyze the clinical features and prognosis of peripartum TTS in a nationwide prospective specifically oriented registry database and consider the published literature. Peripartum TTS patients from the prospective nationwide RETAKO registry-as well as peripartum TTS patients from the published literature-were included, and multiple comparisons between groups were performed in order to assess for statistically and clinically relevant prognostic differences between the groups. Patients with peripartum TTS exhibit a higher prevalence of secondary forms, dyspnea, atypical symptoms, and echocardiographic patterns, as well as less ST-segment elevation than the general TTS population. In the literature, patients with peripartum TTS had a higher Killip status on admission. TTS during the peripartum period has a higher prevalence of angina and dyspnea, as well as physical triggers, neither of which are related to a worse prognosis. Killip status on admission was higher in the literature for patients with TTS but with excellent mid- and long-term prognoses after the acute phase, despite mostly being secondary forms.

Brief COPE Short Version (Mini-COPE): A Proposal of Item and Factorial Reduction in Mexican Population.

The factorial reduction of Brief COPE has not been successfully replicated by independent studies, and few have been performed in Spanish-speaking populations; therefore, the objective of this study was to perform a factorial reduction of the instrument in a large sample of the Mexican population and perform a convergent and divergent validity of the factors obtained. We distributed a questionnaire via social networks with sociodemographic and psychological variables, including the Brief COPE and the scales of the CPSS, GAD-7, and CES-D to measure stress, anxiety, and depression. A total of 1283 persons were included, most of whom (64.8%) were women and had a bachelor's degree (55.2%). After performing the exploratory factorial analysis, we did not find a model with an adequate fit and a reduced number of factors; therefore, we decided to reduce the number of items according to the most representative ones of adaptive, maladaptive, and emotional coping strategies. The resulting model with three factors showed good fit parameters and good internal consistency of the factors. In addition, the nature and naming of the factors were confirmed by convergent and divergent validity, with significant negative correlations between factor 1 (active/adaptive) and stress, depression, and anxiety, significant positive correlations between factor 2 (avoidant/maladaptive) and these three variables, and no significant correlation between factor 3 (emotional/neutral) and stress or depression. This shortened version of the brief COPE (Mini-COPE) is a good option to evaluate adaptive and maladaptive coping strategies in Spanish-speaking populations.

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

Relationship between lifestyle and positive psychological functioning in university administrative staff / Relación entre el estilo de vida y el funcionamiento psicológico positivo en personal administrativo universitario

Abstract In Mexico, healthy lifestyle has a low prevalence. The importance of a healthy lifestyle lies in avoiding the emergence of a chronic non-communicable disease. Thus, university administrative personnel are a vulnerable population due to working conditions that prevent them from having a healthy lifestyle, so it is necessary to analyze psychological variables that can explain how to promote and develop a healthy lifestyle. The purposes of this study were to identify relationships among lifestyle (LS) and positive psychological functioning (PPF) and their differences by gender in the administrative staff; a cross-sectional and correlational study was conducted. University administrative staff (n = 102), were recruited using the snowball sampling method, forming a non-probabilistic sample, completed the Fantastic Lifestyle Questionnaire and the Positive Psychological Functioning Scale. LS has a statistically significant correlation with PPF (r = .355, p = .001); in addition, it is worth pointing out that showing a low level of PPF implies a lower probability of having a healthy LS (Ψ = 28.333, 4.965 - 161.675). Results suggest the relevance of interventions to develop psychological resources in people seeking the adoption of a healthy LS.

Resumen En México, el estilo de vida saludable tiene una baja prevalencia. La importancia de un estilo de vida saludable radica en evitar la aparición de una enfermedad crónica no transmisible. Así, el personal administrativo universitario es una población vulnerable debido a las condiciones laborales que les impiden tener un estilo de vida saludable, por lo que es necesario analizar las variables psicológicas que pueden explicar cómo promoverlo y desarrollarlo. Los propósitos de este estudio fueron identificar las relaciones entre el estilo de vida (EV) y el funcionamiento psicológico positivo (FPP) y sus diferencias por sexo en personal administrativo universitario para lo cual se realizó un estudio transversal y correlacional. El personal administrativo universitario (n = 102) reclutado mediante el método de muestreo de bola de nieve, completó el Cuestionario de Estilo de Vida Fantástico y la Escala de Funcionamiento Psicológico Positivo. El EV presentó una correlación estadísticamente significativa con el FPP (r = .355, p = .001); además, vale la pena señalar que tener un bajo nivel de FPP implica una menor probabilidad de tener un EV saludable (Ψ = 28.333, 4.965 - 161.675). Los resultados sugieren la relevancia de las intervenciones para desarrollar recursos psicológicos en personas que buscan la adopción de un EV saludable.

Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry.

BACKGROUND AND AIMS: SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflammation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. RESULTS: Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p < 0.001). Despite similar pre and postprocedural TIMI flow, we observed a trend in higher use of GP IIb-IIIa inhibitors and a significantly higher use of thrombectomy in the SARS-CoV-2 positive patients. SARS-CoV-2 positivity was associated with a remarkably higher in hospital mortality (29% vs 5.5%, p < 0.001), definite in-stent thrombosis (8.1% vs 1.6%, p = 0.004) and heart failure (22.6% vs 10.6%, p = 0.001) that was confirmed after adjustment for confounding factors. CONCLUSIONS: Our study showed that among STEMI patients, SARS-CoV-2 positivity is associated with larger thrombus burden, a remarkably higher mortality but also higher rates of in-stent thrombosis and heart failure.

Impact of renin-angiotensin system inhibitors on mortality during the COVID Pandemic among STEMI patients undergoing mechanical reperfusion: Insight from an international STEMI registry.

BACKGROUND: Concerns have been raised on a potential interaction between renin-angiotensin system inhibitors (RASI) and the susceptibility to coronavirus disease 2019 (COVID-19). No data have been so far reported on the prognostic impact of RASI in patients suffering from ST-elevation myocardial infarction (STEMI) during COVID-19 pandemic, which was the aim of the present study. METHODS: STEMI patients treated with primary percutaneous coronary intervention (PPCI) and enrolled in the ISACS-STEMI COVID-19 registry were included in the present sub-analysis and divided according to RASI therapy at admission. RESULTS: Our population is represented by 6095 patients, of whom 3654 admitted in 2019 and 2441 in 2020. No difference in the prevalence of SARSCoV2 infection was observed according to RASI therapy at admission (2.5% vs 2.1%, p = 0.5), which was associated with a significantly lower mortality (adjusted OR [95% CI]=0.68 [0.51-0.90], P = 0.006), confirmed in the analysis restricted to 2020 (adjusted OR [95% CI]=0.5[0.33-0.74], P = 0.001). Among the 5388 patients in whom data on in-hospital medication were available, in-hospital RASI therapy was associated with a significantly lower mortality (2.1% vs 16.7%, OR [95% CI]=0.11 [0.084-0.14], p < 0.0001), confirmed after adjustment in both periods. Among the 62 SARSCoV-2 positive patients, RASI therapy, both at admission or in-hospital, showed no prognostic effect. CONCLUSIONS: This is the first study to investigate the impact of RASI therapy on the prognosis and SARSCoV2 infection of STEMI patients undergoing PPCI during the COVID-19 pandemic. Both pre-admission and in-hospital RASI were associated with lower mortality. Among SARSCoV2-positive patients, both chronic and in-hospital RASI therapy showed no impact on survival.

Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry.

BACKGROUND: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19. METHODS: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality. RESULTS: A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73-0.85, p < 0.0001) and without diabetes (IRR 0.81 (95% CI: 0.78-0.85, p < 0.0001) (p int = 0.40). We observed a significant heterogeneity among centers in the population with and without diabetes (p < 0.001, respectively). The heterogeneity among centers was not related to the incidence of death due to COVID-19 in both groups of patients. Interaction was observed for Hypertension (p = 0.024) only in absence of diabetes. Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic. TRIAL REGISTRATION NUMBER: NCT04412655.

Complexity and inclusivity of intrasituational behavior: empirical analysis / Complejidad e inclusividad del comportamiento intrasituacional: Análisis empírico

Abstract Ribes and López's (1985) taxonomy proposed that psychological behavior is progressively complex and inclusive. In that respect, there is little research and data are not robust. A study was conducted with the purpose to increase data related to the complexity and inclusivity of the three less complex behaviors of the taxonomy, with three training sequences, namely: 1) ascending (contextual-supplementary-selector), 2) descending-ascending (supplementary -contextual-selector) and 3) descending (selector-supplementary-contextual). The objective was to evaluate the effect of the interaction history (related to training sequences) on differential (contextual), effective (supplementary) and precise (selector) behavior adjustment process. Results showed that a greater number of training sessions were required to improve the performance in functional organizations with greater complexity when participants lacked an interaction history related to programmed contingencies. But, when the interaction history participated in the functional organization, as a previous interaction with the contingencies, a facilitating effect was found in the behavioral adjustment, regardless of whether the transition was ascending or descending. It is discussed whether the increase in the number of sessions is related to the complexity of each level of functional organization. Regarding the functional training transitions, ascending and descending, its effects on facilitation in learning are discussed in relation to the assumption of functional inclusivity.

Resumen En la taxonomía de Ribes y López (1985) se propone que el comportamiento psicológico es progresivamente complejo e inclusivo; sin embargo, en la literatura sobre el tema se encuentran pocas investigaciones y los datos no son robustos. Teniendo esto en cuenta, y con el propósito de aumentar la evidencia de la complejidad e inclusividad de los tres primeros niveles de complejidad conductual de la taxonomía en tres secuencias de entrenamiento -ascendente (contextual-suplementario-selector), descendente-ascendente (suplementario-contextual-selector) y descendente (selector-suplementario-contextual)-, el presente estudio tuvo como objetivo evaluar el efecto de la historia de interacción -por medio de secuencias de entrenamiento- sobre el proceso de ajuste diferencial (contextual), efectivo (suplementario) y preciso (selector). En general, los resultados muestran que cuando los participantes carecían de historia de interacción ante las contingencias programadas se requirió de un mayor número de sesiones de entrenamiento para mejorar el desempeño en organizaciones funcionales de mayor complejidad; y que cuando la historia de interacción estaba presente en la organización funcional -en tanto interacción previa con las contingencias- se encontró un efecto de facilitación en el ajuste conductual, independientemente de si la transición fue ascendente o descendente. Al final se indaga sobre si el incremento en el número de sesiones se relaciona con la complejidad de cada nivel de organización funcional, y se discute, respecto a las transiciones de entrenamiento funcional, ascendente y descendente, sus efectos en la facilitación en el aprendizaje y su relación con el supuesto de inclusividad funcional.

Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI.

BACKGROUND: The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality. OBJECTIVES: The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of "at-risk" patient cohorts for failure to present or delays to treatment. METHODS: This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020. Main outcomes are the incidences of PPCI, delayed treatment, and in-hospital mortality. RESULTS: A total of 6,609 patients underwent PPCI in 77 centers, located in 18 countries. In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio: 0.811; 95% confidence interval: 0.78 to 0.84; p < 0.0001). The heterogeneity among centers was not related to the incidence of death due to COVID-19. A significant interaction was observed for patients with arterial hypertension, who were less frequently admitted in 2020 than in 2019. Furthermore, the pandemic was associated with a significant increase in door-to-balloon and total ischemia times, which may have contributed to the higher mortality during the pandemic. CONCLUSIONS: The COVID-19 pandemic had significant impact on the treatment of patients with STEMI, with a 19% reduction in PPCI procedures, especially among patients suffering from hypertension, and a longer delay to treatment, which may have contributed to the increased mortality during the pandemic. (Primary Angioplasty for STEMI During COVID-19 Pandemic [ISACS-STEMI COVID-19] Registry; NCT04412655).

Behavioral and structural barriers to accessing human post-exposure prophylaxis and other preventive practices in Arequipa, Peru, during a canine rabies epidemic.

A canine rabies epidemic started in early 2015 in Arequipa, Peru and the rabies virus continues to circulate in the dog population. Some city residents who suffer dog bites do not seek care or do not complete indicated post-exposure prophylaxis (PEP) regimens, increasing the risk of human rabies. The objectives of our study are to qualitatively assess knowledge about rabies, and preventive practices, such as rabies vaccine administration, following a dog bite. We conduct eight focus group discussions in peri-urban and urban communities with 70 total participants. In our results, we observe low awareness of rabies severity and fatality, and different practices following a dog bite, depending on the community type: for example, whereas participants in the urban communities report cleaning the wound with hydrogen peroxide rather than soap and water, participants in peri-urban areas cover the wound with herbs and hair from the dog that bit them. Misconceptions about rabies vaccines and mistreatment at health centers also commonly prevent initiating or completing PEP. We identify important behavioral and structural barriers and knowledge gaps that limit evidence-based preventive strategies against rabies and may threaten successful prevention of dog-mediated human rabies in this setting.

Gaudiebility and health status perception in a Mexican sample / Gaudibilidade e percepção do estado de saúde em uma amostra mexicana / Gaudibilidad y percepción de estado de salud en una muestra mexicana

Abstract The current approach to the health-illness process requires, in addition to disease control, the preservation of the person's quality of life. This study has the purpose of identifying the relationship between gaudiebility and the perception of health status in a Mexican sample, as well as comparing these variables by gender. A cross-sectional and correlational study was conducted for such purposes. Gaudiebility was measured with the Gaudiebility Scale and the perception of health status with the MOS 36-Item Short-Form Health Survey (SF-36). The sample consisted of 285 people between the ages of 14 and 78 (M = 32.13, SD = 13.38), who were recruited with the snowball sampling method, forming a non-probability sample. Results indicate a statistically significant positive and moderate relationship between gaudiebility and the General Health of people (p = .433, p < .001). Thus, people with high gaudiebility perceive less risks to their General Health compared with people who have low and moderate gaudiebility (RM = 4.527, 2.434 - 8.419). Furthermore, a statistically significant difference was identified by gender regarding Physical Functioning (z = -2.293, p = .022) and Mental Health (z = -2.243, p = .025) on the SF-36, where men reported a higher level in both cases. It was concluded that gaudiebility has a relevant influence on the perception of health status.

Resumo Na atualidade, para a abordagem do processo saúde-doença requer-se, além de controlar a doença, preservar, na medida do possível, a qualidade de vida da pessoa. Nesse sentido, o objetivo do presente trabalho foi identificar a relação entre a gaudibilidade e a percepção do estado de saúde em uma amostra de mexicanos e comparar tais variáveis de acordo com o gênero dos participantes. Para isso, utilizou-se um desenho transversal e correlacional com a aplicação da Escala de Gaudibilidade e a versão curta do Questionário de Saúde (SF-36). No total, participaram 285 pessoas com idades entre 14 e 78 anos (M = 32.13, DP = 13.38) recrutados por meio da técnica de bola de neve, com quem se formou uma amostra não probabilística. Os resultados indicaram uma relação estatisticamente significativa, positiva e moderada entre a gaudibilidade e a saúde geral dos participantes (p = .407, p < .001), devido ao fato de que as pessoas com alta gaudibilidade perceberam menos riscos em saúde geral em comparação com as pessoas com gaudibilidade baixa e moderada (RM = 4.527, 2.434 - 8.419). Igualmente, identificou-se uma diferença estatisticamente significativa com respeito ao gênero nos fatores funcionamento físico (z = -2.293, p = .022) e saúde mental (z = -2.243, p = .025) do SF-36, já que os homens indicaram um maior nível em ambos os casos. Conclui-se que a gaudibilidade tem uma influência relevante sobre a percepção do estado de saúde.

Resumen En la actualidad, para el abordaje del proceso salud-enfermedad se requiere, además de controlar la enfermedad, preservar en lo posible la calidad de vida de la persona. En este sentido, el objetivo del presente trabajo fue identificar la relación entre la gaudibilidad y la percepción del estado de salud en una muestra de mexicanos, y comparar dichas variables según el género de los participantes. Para esto, se utilizó un diseño transversal y correlacional con la aplicación de la Escala de Gaudibilidad y la versión corta del Cuestionario de Salud (SF-36). En total, participaron 285 personas de entre 14 y 78 años (M = 32.13, DE = 13.38), reclutados por medio de la técnica de bola de nieve, con quienes se formó una muestra no probabilística. Los resultados indicaron una relación estadísticamente significativa, positiva y moderada entre la gaudibilidad y la salud general de los participantes (p = .407, p < .001), debido a que las personas con alta gaudibilidad percibieron menos riesgos en salud general en comparación con las personas con baja y moderada gaudibilidad (RM = 4.527, 2.434 - 8.419). Asimismo, se identificó una diferencia estadísticamente significativa en cuanto al género en los factores funcionamiento físico (z = -2.293, p = .022) y salud mental (z = -2.243, p = .025) del SF-36, ya que los hombres refirieron un nivel mayor en ambos casos. Se concluye que la gaudibilidad tiene una influencia relevante sobre la percepción del estado de salud.

Usefulness of Cone Beam Intra-Arterial CTA for Evaluation of Flow Diverters: A Practical Approach for Daily Use.

Cone beam computed tomography (CBCT), initially used for evaluation of intraprocedural complications such as hemorrhage, has evolved to provide details of implanted devices such as flow diverters. The study aim is to present our experience in using CBCT with intra-arterial injection and provide a step-by-step approach for postprocessing in a practical protocol for daily use. IRB approval was obtained, and the neurointerventional database was retrospectively reviewed from July 2012 to June 2017. Patients who underwent cone beam intra-arterial CT angiography for evaluation of implanted flow diverter devices were reviewed. Patient demographics, aneurysm location (internal carotid artery [ICA]-cavernous, ICA-paraclinoid, and ICA-distal; middle cerebral artery [MCA], anterior cerebral artery [ACA]-acom, ACA-pericallosal, vertebral artery [VA]), type (saccular, dissecting fusiform, or blister) and size, device, injection technique (contrast dilution, rate, and volume), and reconstruction protocol were recorded. Acquired images were postprocessed using a Philips Xtravision workstation. Eighty patients (63 women and 17 men) met the inclusion criteria of our study. Age range was 25-80 years old. Treated aneurysms were located in the ICA-paraclinoid in 48 cases (60%), ICA-distal in 12 cases, ICA-cavernous in 8 cases, MCA in 4 cases, VA in 4 cases, ACA-acom in 2 cases, ACA-pericallosal in 2 cases; 69 were saccular, 8 fusiform, and 3 ruptured blister aneurysms. There were 52 small, 20 large, and 8 giant aneurysms. Pipeline (Medtronic, MN, USA) was the predominant device used in 77 procedures. Two injection techniques were used: 2.5 mL/s for a total volume of 55 mL with a 2-s imaging delay or 3 mL/s for a total volume of 70 mL with a 3-s imaging delay; contrast (Ioxilan 300 mgI/mL) dilution was 10-20% in all cases. The device's landing zones, conformability, presence of deformities, and wall apposition were successfully visualized in all cases. Metal artifact reduction program was applied in 9 coiled aneurysms, and this was satisfactory as well.

Psychological capital and its relationship with lifestyle of Mexican university students / Capital psicológico y su relación con el estilo de vida de universitarios mexicanos

Background: University students don't have a healthy lifestyle so it is necessary to identify psychosocial variables that can increase it. Objective: To determine the relationship between the psychological capital (CapPsi) and lifestyle (EV) of Mexican university students. Method: A cross-sectional and correlational study was carried out among 320 students of a public university. The sample was non probabilistic by quotas. To assess the factors of CapPsi were used the General Scale of Self-efficacy, the Scale of Hope for Adults, Questionnaire of Resilience, the Life Orientation Test and; to assess the lifestyle was used the Fantastic questionnaire. Results: The variables of the CapPsi correlated with the healthy lifestyle; resilience (r = 0.505, p < 0.01); hope (r = 0.432, p < 0.01); optimism (r = 0.412, p < 0.01); and self-efficacy (r = 0.400, p < 0.01). The 33.3 of the total variance of the lifestyle was explained by the CapPsi (R2 = 0.333). Conclusions: Based on the results, it is assumed that the CapPsi improve lifestyle; however, further research is necessary to determine if the influence of CapPsi is in the adoption and / or maintenance of healthy lifestyle and identify how each one of its factors infl uences it particularly. The CapPsi has a representative percentage of prediction of healthy lifestyle. It is necessary that health promotion and prevention programs incorporate the approach of CapPsi to achieve a healthy lifestyle in the university students.

Introducción: en algunos estudios se ha reportado que los universitarios no tienen un estilo de vida saludable (EVS) por lo que es necesario identificar no solo las variables psicosociales negativas, sino también las variables de Psicología Positiva que pueden favorecerlo. Objetivo: Determinar la relación entre el capital psicológico (CapPsi) y el estilo de vida (EV) de estudiantes universitarios mexicanos. Método: se realizó un estudio transversal y correlacional con 320 estudiantes de una universidad pública. La muestra fue no probabilística por cuotas. Para evaluar los factores del CapPsi se utilizaron los instrumentos Escala General de Autoeficacia, Escala de Esperanza para Adultos, Cuestionario de Resiliencia y Test de Orientación en la Vida (optimismo); para evaluar el EV se usó el Cuestionario Fantástico. Resultados: las variables del CapPsi mostraron una correlación estadísticamente significativa con el EV; resiliencia (r = 0,505, p < 0,01); esperanza (r = 0,432, p < 0,01); optimismo (r = 0,412, p < 0,01); autoeficacia (r = 0,400, p < 0,01). El 33,3 de la varianza total del EV es explicado por el CapPsi (R2 = 0,333). Conclusiones: con base en los resultados, se asume que el CapPsi favorece el EVS; no obstante, es necesario que futuras investigaciones detallen si la influencia es en la adopción y/o mantenimiento del EVS, así como identificar cómo influye particularmente en cada factor del EV. El CapPsi tiene un porcentaje representativo de predicción del EV saludable. Es necesario que los programas de promoción y prevención en salud incorporen el abordaje del CapPsi para lograr un EV saludable en los universitarios.

Capital psicológico y su relación con el estilo de vida de universitarios mexicanos / Psychological capital and its relationship with lifestyle of Mexican university students

Introducción: en algunos estudios se ha reportado que los universitarios no tienen un estilo de vida saludable (EVS) por lo que es necesario identificar no solo las variables psicosociales negativas, sino también las variables de Psicología Positiva que pueden favorecerlo. Objetivo: Determinar la relación entre el capital psicológico (CapPsi) y el estilo de vida (EV) de estudiantes universitarios mexicanos. Método: se realizó un estudio transversal y correlacional con 320 estudiantes de una universidad pública. La muestra fue no probabilística por cuotas. Para evaluar los factores del CapPsi se utilizaron los instrumentos Escala General de Autoeficacia, Escala de Esperanza para Adultos, Cuestionario de Resiliencia y Test de Orientación en la Vida (optimismo); para evaluar el EV se usó el Cuestionario Fantástico. Resultados: las variables del CapPsi mostraron una correlación estadísticamente significativa con el EV; resiliencia (r = 0,505, p < 0,01); esperanza (r = 0,432, p < 0,01); optimismo (r = 0,412, p < 0,01); autoefi cacia (r = 0,400, p < 0,01). El 33,3 de la varianza total del EV es explicado por el CapPsi (R2 = 0,333). Conclusiones: con base en los resultados, se asume que el CapPsi favorece el EVS; no obstante, es necesario que futuras investigaciones detallen si la influencia es en la adopción y/o mantenimiento del EVS, así como identificar cómo influye particularmente en cada factor del EV. El CapPsi tiene un porcentaje representativo de predicción del EV saludable. Es necesario que los programas de promoción y prevención en salud incorporen el abordaje del CapPsi para lograr un EV saludable en los universitarios (AU)

Background: University students don’t have a healthy lifestyle so it is necessary to identify psychosocial variables that can increase it. Objective: To determine the relationship between the psychological capital (CapPsi) and lifestyle (EV) of Mexican university students. Method: A cross-sectional and correlational study was carried out among 320 students of a public university. The sample was non probabilistic by quotas. To assess the factors of CapPsi were used the General Scale of Self-effi cacy, the Scale of Hope for Adults, Questionnaire of Resilience, the Life Orientation Test and; to assess the lifestyle was used the Fantastic questionnaire. Results: The variables of the CapPsi correlated with the healthy lifestyle; resilience (r = 0.505, p < 0.01); hope (r = 0.432, p < 0.01); optimism (r = 0.412, p < 0.01); and self-effi cacy (r = 0.400, p < 0.01). The 33.3 of the total variance of the lifestyle was explained by the CapPsi (R2 = 0.333). Conclusions: Based on the results, it is assumed that the CapPsi improve lifestyle; however, further research is necessary to determine if the infl uence of CapPsi is in the adoption and / or maintenance of healthy lifestyle and identify how each one of its factors influences it particularly. The CapPsi has a representative percentage of prediction of healthy lifestyle. It is necessary that health promotion and prevention programs incorporate the approach of CapPsi to achieve a healthy lifestyle in the university students (AU)

Barriers to dog rabies vaccination during an urban rabies outbreak: Qualitative findings from Arequipa, Peru.

BACKGROUND: Canine rabies was reintroduced to the city of Arequipa, Peru in March 2015. The Ministry of Health has conducted a series of mass dog vaccination campaigns to contain the outbreak, but canine rabies virus transmission continues in Arequipa's complex urban environment, putting the city's 1 million inhabitants at risk of infection. The proximate driver of canine rabies in Arequipa is low dog vaccination coverage. Our objectives were to qualitatively assess barriers to and facilitators of rabies vaccination during mass campaigns, and to explore strategies to increase participation in future efforts. METHODOLOGY/PRINCIPAL FINDINGS: We conducted 8 focus groups (FG) in urban and peri-urban communities of Mariano Melgar district; each FG included both sexes, and campaign participants and non-participants. All FG were transcribed and then coded independently by two coders. Results were summarized using the Social Ecological Model. At the individual level, participants described not knowing enough about rabies and vaccination campaigns, mistrusting the campaign, and being unable to handle their dogs, particularly in peri-urban vs. urban areas. At the interpersonal level, we detected some social pressure to vaccinate dogs, as well as some disparaging of those who invest time and money in pet dogs. At the organizational level, participants found the campaign information to be insufficient and ill-timed, and campaign locations and personnel inadequate. At the community level, the influence of landscape and topography on accessibility to vaccination points was reported differently between participants from the urban and peri-urban areas. Poor security and impermanent housing materials in the peri-urban areas also drives higher prevalence of guard dog ownership for home protection; these dogs usually roam freely on the streets and are more difficult to handle and bring to the vaccination points. CONCLUSIONS: A well-designed communication campaign could improve knowledge about canine rabies. Timely messages on where and when vaccination is occurring could increase dog owners' perception of their own ability to bring their dogs to the vaccination points and be part of the campaign. Small changes in the implementation of the campaign at the vaccination points could increase the public's trust and motivation. Location of vaccination points should take into account landscape and community concerns.

Influence of Statin Therapy on Aneurysm Sac Regression after Endovascular Aortic Repair.

PURPOSE: To determine whether statin therapy is associated with abdominal aortic aneurysm (AAA) sac regression after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: A total of 109 patients treated with EVAR were retrospectively analyzed (no-statin group, n = 45; statin group, n = 64). The primary endpoint was the incidence of AAA sac regression. To investigate independent predictors of AAA sac regression, regression analysis was performed. The mean age was 74 years (range, 55-90 y), and 87.2% of patients were men. RESULTS: The no-statin group had higher rates of AAA sac regression than the statin group at 1 year (no-statin group, 66.7%; statin group, 45.3%; P = .028). The incidence of AAA sac regression increased over time in the statin group, and no statistical difference was seen between the two groups at 2 years (no-statin group, 66.7%; statin group, 57.8%; P = .350). The difference between the changes in maximum AAA diameter was significant between groups at 1 year (no-statin group vs statin group, -4.9 mm ± 5.9; P = .041), but the difference did not reach statistical significance at 2 years (no-statin group, -10.0 mm ± 10.1; statin group, -8.0 mm ± 9.6; P = .306). Statin therapy was not associated with AAA sac regression on univariate (odds ratio [OR], 0.685; 95% confidence interval [CI], 0.310-1.516; P = .351) and multivariate analyses (OR, 0.617; 95% CI, 0.215-1.772; P = .369). CONCLUSIONS: Statin therapy had no effect on AAA sac regression at 2 years. There is insufficient evidence to recommend statin therapy for AAA sac regression.

Effects of Percutaneous Transluminal Angioplasty on Diastolic Function in Patients With Chronic Occlusion of Lower-Extremity Artery.

OBJECTIVE: We investigated whether successful revascularization of total occlusion of a large lower-extremity artery is associated with improvement of left ventricular (LV) diastolic function. BACKGROUND: Total occlusion of a large lower-extremity artery might affect the systemic vascular resistance and increase the afterload, because the left ventricle must work harder to eject blood into a smaller vascular bed. Chronic elevation of afterload is a cause of LV diastolic dysfunction. METHODS: This is a single-center retrospective analysis of 20 patients (10 men, age 69.6 ± 12.3 years) with chronic total occlusions (CTOs) of the aorto-iliac and femoropopliteal segments who underwent a successful endovascular revascularization. Baseline and postprocedural evaluation of diastolic function was performed, and the primary endpoint was improvement in LV diastolic function, which was defined as any decrease of the baseline E/E' ratio or any increase of the baseline E' velocity after the index procedure. RESULTS: There was a significant effect of successful revascularization on the E/A ratio (from 1.5 ± 1.1 to 1.0 ± 0.3; P=.046) because of a significant increase of A velocity (from 86.3 ± 30.4 cm/s to 98.3 ± 21.8 cm/s; P=.03). The E' velocity (from 7.4 ± 2.0 cm/s to 8.3 ± 2.3 cm/s; P=.07) did not show a significant increase, but there was a significant reduction in E/E' ratio (from 14.6 ± 3.9 to 12.4 ± 3.3; P=.02). Logistic regression analysis did not identify possible predictors of improvement in LV diastolic function. CONCLUSION: Our results showed that a successful revascularization was associated with improvement in the echocardiographic parameters of LV diastolic function in patients with CTO of large lower-extremity artery, and these changes may be related to the afterload reduction.

The Influence of Statin Therapy on Restenosis in Patients Who Underwent Nitinol Stent Implantation for de Novo Femoropopliteal Artery Disease: Two-Year Follow-up at a Single Center.

PURPOSE: To determine whether statin therapy is associated with reduced restenosis following nitinol stent implantation for de novo femoropopliteal artery disease. MATERIALS AND METHODS: A total of 135 limbs in 135 patients (mean age, 72 y) implanted with nitinol stents in femoropopliteal occlusions were analyzed (statin arm, n = 91; nonstatin arm, n = 44). The patients were treated with one type of nitinol stent. RESULTS: At baseline, lesions and procedural characteristics were comparable between groups, except that the statin group had more hypertension, coronary artery disease, and hyperlipidemia. There were significant differences in the incidence of binary restenosis between groups at 1 year (45.5% for nonstatin group vs 28.6% for statin group; P = .05) and 2 years (56.8% for nonstatin group vs 38.5% for statin group; P = .04). Primary patency rates at 1 year were 50.5% in the nonstatin group and 72.5% in the statin group (P = .01). Two-year target lesion revascularization rates were 54.5% in the nonstatin group and 35.2% in the statin group (P = .03). On univariate analysis, statin therapy was associated with decreased relative risk of binary restenosis at 1 year (odds ratio [OR], 0.480; 95% confidence interval [CI], 0.227-1.014; P = .050). On multivariate analysis, statin therapy did not significantly affect the odds of binary restenosis (OR, 0.415; 95% CI, 0.071-2.437; P = .330). CONCLUSIONS: The incidence of binary restenosis was significantly lower in the statin group than in the nonstatin group following nitinol stent implantation for de novo femoropopliteal artery disease.

Spatial positioning of all 24 chromosomes in the lymphocytes of six subjects: evidence of reproducible positioning and spatial repositioning following DNA damage with hydrogen peroxide and ultraviolet B.

The higher-order organization of chromatin is well-established, with chromosomes occupying distinct positions within the interphase nucleus. Chromatin is susceptible to, and constantly assaulted by both endogenous and exogenous threats. However, the effects of DNA damage on the spatial topology of chromosomes are hitherto, poorly understood. This study investigates the organization of all 24 human chromosomes in lymphocytes from six individuals prior to- and following in-vitro exposure to genotoxic agents: hydrogen peroxide and ultraviolet B. This study is the first to report reproducible distinct hierarchical radial organization of chromosomes with little inter-individual differences between subjects. Perturbed nuclear organization was observed following genotoxic exposure for both agents; however a greater effect was observed for hydrogen peroxide including: 1) More peripheral radial organization; 2) Alterations in the global distribution of chromosomes; and 3) More events of chromosome repositioning (18 events involving 10 chromosomes vs. 11 events involving 9 chromosomes for hydrogen peroxide and ultraviolet B respectively). Evidence is provided of chromosome repositioning and altered nuclear organization following in-vitro exposure to genotoxic agents, with notable differences observed between the two investigated agents. Repositioning of chromosomes following genotoxicity involved recurrent chromosomes and is most likely part of the genomes inherent response to DNA damage. The variances in nuclear organization observed between the two agents likely reflects differences in mobility and/or decondensation of chromatin as a result of differences in the type of DNA damage induced, chromatin regions targeted, and DNA repair mechanisms.

Miopatía autoinmune necrotizante / Necrotizing autoimmune myositis

Mujer de 21 años, procedente de Camisea, Cusco, con dos semanas de debilidad muscular progresiva que llego inclusive a la falla ventilatoria, elevación extrema de crantina sérica total, patrón miopático en la electromiografía y con presencia de necrosis masiva sin infiltrado inflamatorio en la biopsia muscular. La pciente mejoró clínica y por los estudios de laboratorio con el tratamiento inmunosupresor.

A 21 year-old woman, from Camisea, Cusco, with two weeks of progressive muscle weakness that came even to ventilatory failure, extreme elevation of total serum creatine phosphokinase (CPK) a myopathic pattern in electromyography and presence of massive necrosis without inflammatory infiltrate in the muscle biopsy. The patient improved the clinical and laboratory parameters with immunosuppressive treatment.