Analysis of SIRT1 genetic variants in young Mexican individuals: relationships with overweight and obesity.

The high prevalence of obesity in Mexico starting from the early stages of life is concerning and represents a major public health problem. Genetic association studies have reported that single nucleotide variants (SNVs) in SIRT1, an NAD+-dependent deacetylase that plays an important role in the regulation of metabolic cellular functions, are associated with multiple metabolic disorders and the risk of obesity. In the present study, we analyzed the effect that the SNVs rs1467568 and rs7895833 of the SIRT1 gene may have on cardiometabolic risk factors in a young adult population from Mexico. A cross-sectional study was carried out with young adults between the ages of 18 and 25 who had a body mass index (BMI) greater than 18.5 kg/m2. This study included 1122 young adults who were classified into the normal weight (n = 731), overweight group (n = 277), and obesity group (n = 114) according to BMI of whom 405 and 404 volunteers were genotyped for rs1467568 and rs7895833 respectively using TaqMan probes through allelic discrimination assays. We found that the male sex carrying the G allele of rs7895833 had slightly lower BMI levels (p = 0.009). Furthermore, subjects carrying rs1467568 (G allele) showed a 34% lower probability of presenting with hyperbetalipoproteinemia where female carrying rs1467568 had lower levels of total cholesterol (p = 0.030), triglycerides (p = 0.026) and LDL cholesterol (p = 0.013). In conclusion, these findings suggest that the presence of both SNVs could have a non-risk effect against dyslipidemia in the Mexican population.

Sodium Selenite Diminished the Regulatory T Cell Differentiation In Vitro.

Sodium selenite modulates the activity of lymphocytes. It negatively regulates the suppressive activity of cells and increases the immune response. In this study, we evaluated whether the regulatory T cell differentiation was modulated by sodium selenite. The percentages of CD4+CD25+Foxp3+, CD4+CD25+, and CD4+CTLA-4+ cells in CD4+ T cells cultures stimulated with IL-2 and TGF-ß in the presence or absence of selenium, in the form of sodium selenite (2.0×10-6M), were evaluated by flow cytometry. The mRNA expression of TET2/3 enzymes and IL-10 was analyzed by RT-qPCR and the levels of IL-10 were measured by an ELISA. We observed a decrease in CD4+CD25+Foxp3+ and CD4+CTLA-4+ cells in presence of selenium. However, normal percentages were reached again after selenium removal. An increase in CD4+CTL4-4+ cells was detected in selenium-primed cell cultures in absence of IL-2 and TGF-ß. In addition, we observed a decrease in TET3 in presence of selenium. Finally, we observed an augment in IL-10 transcription and protein levels and relative expression of TET2 in cultures exposed to selenium. We suggest that selenium reversibly affects the regulatory T cell differentiation in vitro. Likewise, selenium may modulate Treg percentages promoting optimal immune responses and, at the same time, the expression of specific suppressor molecules.

Suppression of Nonlinear Optical Rogue Wave Formation Using Polarization-Structured Beams.

A nonlinear self-focusing material can amplify random small-amplitude phase modulations present in an optical beam, leading to the formation of amplitude singularities commonly referred to as optical caustics. By imposing polarization structuring on the beam, we demonstrate the suppression of amplitude singularities caused by nonlinear self-phase modulation. Our results are the first to indicate that polarization-structured beams can suppress nonlinear caustic formation in a saturable self-focusing medium and add to the growing understanding of catastrophic self-focusing effects in beams containing polarization structure.

AIM2-inflammasome role in systemic lupus erythematous and rheumatoid arthritis.

The inflammasome AIM2 regulates multiple aspects of innate immune functions and serves as a critical mediator of inflammatory responses. AIM2 inflammasome activation leads to the production of pro-inflammatory cytokines, IL-1ß and IL-18 and participates triggering a pyroptosis response needed to counteract excessive cell proliferation. In addition, AIM2 expression and activation is wide regulated since alteration in its activity may derived in pathological consequences. Consequently, deregulated AIM2 activation contributes to the pathogenic processes of various inflammatory diseases. In this review, we will discuss the activation and function of AIM2 inflammasome, as well as its contribution in rheumatoid arthritis and systemic lupus erythematous pathology. Finally, we highlight the participation of the AIM2-inflammasome at the level of joint in rheumatoid arthritis and at kidney in systemic lupus erythematous. The development of therapeutic strategies based on modulation of AIM2-inflammasome activity should have a tissue-specific focus.

[Association between influenza vaccination and mortality due to COVID-19]. / Asociación entre la vacunación contra influenza y la mortalidad por COVID-19.

Background: It has recently been suggested that influenza vaccination may be a factor associated with decreased COVID-19 mortality. Methods: An age-matched case-control study based on hospital cases. We included subjects aged 18 years and older with a diagnosis of moderate to severe COVID-19. Infection was corroborated by RT-PCR test for SARS-COV-2. Deceased subjects were considered cases, controls were patients discharged due to improvement of acute symptoms. We used bivariate analysis to determine factors associated with death from COVID-19, and calculated odds ratios and 95% confidence intervals. Results: A total of 560 patients were included in the study, 214 (38.2%) were considered cases and 346 (61.7%) controls. A significant difference was observed with the presence of type 2 diabetes mellitus [54% vs. 39.3% between cases and controls, respectively (p=.04)] and having received influenza vaccination (p= .02). Type 2 diabetes mellitus was associated with higher COVID-19 mortality [OR 1.8 (95% CI 1.2-2.5) p=.01], whereas having been immunised against influenza in 2019 was associated with lower mortality in this group of patients [OR .6 (95% CI .4-.9) p=.02]. Conclusions: Influenza vaccination in the previous year appears to be associated with lower mortality from COVID-19; whereas type 2 diabetes mellitus is confirmed as a condition associated with higher mortality.

Síndrome de atrapamiento poplíteo / Popliteal entrapment syndrome

El síndrome del atrapamiento de la arteria poplítea, es una entidad nosológica no muy frecuente que afecta no solo a la arteria,sino también el componente venoso y nervioso de los segmentos situados a nivel del hueco poplíteo. Es una patología originada porla compresión de estas estructuras por elementos musculoesqueléticos situados en esta región anatómica que pueden ocasionar unasintomatología mas o menos intensa por la lesión de las estructuras que se comprimen. Existen diferentes formas anatómicas loque soporta una clasificación morfológica. Es preciso realizar el diagnostico diferencial con otros procesos en base a la clínica y lasdiferentes pruebas de imagen que suelen ser fundamentales y decisivas para el diagnóstico. La base del tratamiento es la liberación de la zona eliminando los elementos estructurales compresivos. (AU)

Popliteal artery entrapment syndrome is a rare nosological entity that affects not only the artery, but also the venous and nervouscomponent of the segments located at the level of the popliteal fossa. It is a pathology caused by the compression of these structuresby musculoskeletal elements located in this anatomical region that can cause more or less intense symptoms due to the injury of thestructures that are compressed. There are different anatomical forms which supports a morphological classification.It is necessary to carry out the differential diagnosis with other processes based on the clinic and the different imaging tests thatare usually fundamental and decisive for the diagnosis. The basis of the treatment is the liberation of the area, eliminating the compressive structural elements. (AU)

La atención sanitaria en los tercios españoles / Health care in the spanish tercios

Durante por más de dos siglos, los tercios españoles fueron la base de los ejércitos de España que participaron en numerosas batallas en las innumerables guerras en el que se vio envuelto el Imperio Español. Su organizador militar fue la base de sus triunfosque les hicieron merecedores de el termino de invencibles por su especial estrategia. La organización interna conllevaba un especialmétodo de asistencia sanitaria bien organizado con recursos y de efectividad para la época. Se analiza en el trabajo, la organización sanitaria los recursos disponibles, las enfermedades que se atendían tanto las comunes como las producidas en el campo debatalla por las diferentes armas de fuego como armas blancas y también de los efectos de la artillería como de las explosiones por el uso de la pólvora. (AU)

For more than two centuries, the Spanish Tercios were the base of the Spanish armies that participated in numerous battles in theinnumerable wars in which the Spanish Empire was involved. Their military organizer was the basis of their triumphs that madethem worthy of the term invincible for their special strategy. The internal organization entailed a special well-organized health caremethod with resources and effectiveness for the time. It is analyzed at work, the health organization, the available resources, thediseases that were treated, both the common ones and those produced on the battlefield by the different weapons, both firearms andbladed weapons, and also the effects of artillery and firearms. explosions due to the use of gunpowder. (AU)

Ernst Ferdinand Sauerbruch (1875-1951). El cirujano mas influyente de la primera mitad del siglo XX / Ernst Ferdinand Sauerbruch (1875-1951). The Most Influential Surgeon Of The First Half Of The Twentieth Century

Ernst Ferdinand Sauerbruch, se le considera como uno de los cirujanos más relevantes de la primera mitad del siglo XX. De unapersonalidad carismática, desarrolló su actividad en diferentes hospitales universitarios destacando los de Zúrich, Múnich y especialmente el de la Charité de Berlín. Realizo importantes aportaciones en el campo de la cirugía torácica, del tratamiento de lahidrocefalia, de la cirugía tiroidea, de la cirugía oncológica además de otras aportaciones como fue la cámara de vacío para tenerla posibilidad de abrir el tórax e intervenir sus órganos o el desarrollo de una mano protésica fundamentalmente utilizable por losenfermos amputados en la I Guerra Mundial. Fue maestro de numerosos cirujanos alemanes y también de otros países. Su declivecomienza tras terminar la Segunda Guerra Mundial al intentar seguir operando sufriendo un progresivo deterioro mental. El otroaspecto polémico de su figura, se centra al haber participado de forma activa tanto desde el punto de vista social, académico eincluso político durante el régimen nacionalsocialista en Alemania. (AU)

Ernst Ferdinand Sauerbruch is considered as one of the most relevant surgeons of the first half of the twentieth century. With a charismatic personality, he developed his activity in different university hospitals, highlighting those of Zurich, Munich and especiallythat of the Charité in Berlin. I make important contributions in the field of thoracic surgery, the treatment of hydrocephalus, thyroidsurgery, and oncological surgery as well as other contributions such as the vacuum chamber to have the possibility of opening thethorax and intervening its organs or development of a prosthetic hand fundamentally usable by the amputee patients in World WarI. He was a teacher of numerous German surgeons and of other countries. Its decline begins after the end of World War II when tryingto continue operating suffering a progressive mental deterioration. The other controversial aspect of his figure, focuses on havingactively participated both socially, academically and even politically during the National Socialist regime in Germany. (AU)

Expression of mBD4, mBD3 and CRAMP during type II collagen-induced arthritis/CIA and their association with inflammation and bone-remodeling markers.

The aim of this study was to analyze the expression of mBD4, mBD3 and CRAMP in joint of mice with type II collagen-induced arthritis/CIA and to explore its possible association with IL-10, IL-4, IFN-γ, IL-17, MMP3, RANK/RANKL/OPG and histological parameters. METHODS: CIA was induced in 44 DBA/1 J mice. The joints from mice were classified into the onset, peak and remission phase of CIA. Histological sections were stained with hematoxylin-eosin and safranin O. The expression of CRAMP, mBD-3, mBD-4, and MMP-3 was evaluated using reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry. The expression of IL-10, IL-4, IFN-γ, IL-17, RANK/RANKL/OPG was analyzed by RT-PCR. RESULTS: We observed that inflammation and immunostained cells for CRAMP increased in the peak and remission phases compared to the control group. In addition, increments in relative expressions of CRAMP were detected for the remission phase and in IL-4 and IL-17 in the peak phase compared to the control and onset phase. In addition, an increase in IL-10 in a peak phase compared to the control, as well as the relative expression of IFN-γ in remission phase was higher than in the onset phase. This was accompanied by an increase in cartilage damage in the peak phase compared to the control. Cells immunostained to MMP3 increased in the peak phase compared to the onset and control group, and relative expression of MMP3 was detected in the peak phase compared to the onset, remission, and control group. We observed that the relative expression of RANK and RANKL in the peak phase was higher than in control and onset phase. Finally, the relative expression of OPG in the peak phase compared to the onset, remission, and control group was detected. Regarding CRAMP behavior in the different phases studied, it was positively correlated with IL-4 and RANK, and showed a negative correlation with IFN-γ, IL-17, IL-10, RANKL, OPG and RANKL/OPG ratio in the control group. Also was positively correlated with IFN-γ, IL-17, IL-4, IL-10, as well as with RANK, RANKL, and OPG in the onset and peak phases of the CIA. In the peak phase, CRAMP showed a positive association with MMP3, and we observed a direct correlation between CRAMP and IFN-γ and RANKL/OPG ratio in remission phase. mBD3 correlates positively with IFN-γ, IL-17, IL-10, RANKL, OPG and RANKL/OPG ratio, and showed a negative correlation with CRAMP, MMP3, and RANK in the control group. Also, it was directly associated with IFN-γ, IL-17, IL-4, IL-10 and RANKL in the onset phase while it was inversely associated with CRAMP, MMP-3, RANK, RANKL, and OPG in the peak phase. Finally, mBD3 was inversely correlated with MMP3 in the remission phase and was directly associated with CRAMP, IFN-γ and RANKL/OPG ratio in this phase. mBD4 was directly associated with CRAMP, IFN-γ, IL-17, IL-4, IL-10, RANKL / OPG in the onset phase, and with CRAMP, IFN-γ, IL-17, IL-4, IL-10, MMP3, RANK, RANKL and OPG in the peak phase. Finally, mBD4 was positively associated with mBD3, IFN-γ, IL-17, IL-10, RANK, RANKL OPG and RANKL/OPG in the CIA remission phase. CONCLUSIONS: Our results demonstrate that CRAMP plays an important role in CIA progress and suggest that its abundance is associated with local pro- and anti-inflammatory status. This makes us propose CRAMP as a possible contributor of bone reconstruction in the last stage of CIA.

B regulatory cells associated with changes in biochemical and inflammatory parameters in normal-glycemic individuals, pre-diabetes and T2DM patients.

AIM: To determine the percentages of (CD19 + CD24 + CD38+, CD19 + CD24 + CD27+, CD19 + IL-10+)-Breg cells, IL-17 single and IL-17+/IFN-γ double producers T cells and IFN-γ+ T cells, in normal-glycemic individuals, prediabetes and T2DM patients, and to analyze the association of Breg cells with metabolic parameters of T2DM. METHODS: percentages of Breg cells, IL-17+ and IL-17 + IFN-γ+ T cells, IFN-γ+ T cells and IL-10 were determined by flow cytometry. IL-6 levels were evaluated by ELISA assay. RESULTS: increased IL-6 levels, IL-17+ and IL-17 + IFN-γ+ T cells and a diminution of IL-10 levels and CD19 + IL-10+ cells in T2DM patients were observed. We found that CD19 + CD24 + CD27+ cells and CD19 + CD24 + CD38+ cells were increased in T2DM patients. The percentages of CD19 + CD24 + CD38+ cells were associated with HOMA-B, TyG index, HDL and cholesterol values. In normal-glycemic individuals, CD19 + CD24 + CD27+ cells were inversely associated to triglycerides and TyG index. In prediabetes patients, CD19 + CD24 + CD38+ cells were inversely related with cholesterol and LDL. Finally, CD19 + CD24 + CD38+ cells were inversely related with HDL values in T2DM patients. CONCLUSION: Our results suggest that increased percentages of IL-17 single and IL-17/IFN-γ double producers T cells in T2DM patients may be a consequence of the initial CD19 + IL-10+ cells reduction. Furthermore, dyslipidemia could play an important role in percentages and activity of B regulatory cells.

Gingival Thickness and Outcome of Periodontal Plastic Surgery Procedures: A Meta-regression Analysis.

OBJECTIVE: To evaluate the impact of soft tissue thickness (STT) on root coverage achieved with different periodontal plastic surgery procedures. BACKGROUND: Gingival recession has been managed successfully through various surgical approaches, with great variability in outcomes. Anatomic characteristics of the recipient site and selected technique account in part for this variability. Gingival flap thickness is one of the most critical site-related characteristics. METHODS: An electronic search was conducted on the major databases (PubMed, Embase, Web of Science). Human prospective studies with at least 6 mo of follow-up and with a numeric baseline measurement for gingival thickness were eligible. Only studies including nonsmoking patients were considered. Variables included surgical approach, participant characteristics, local anatomic factors, and follow-up time. Primary outcome was mean percentage root coverage (%RC) achieved, and complete root coverage was a secondary outcome. RESULTS: A total of 42 studies were included (35 randomized controlled trials, 5 case series, 1 prospective cohort study, and 1 controlled clinical trial). Across studies, the pooled %RC was 81.9% (95% CI, 79.1% to 84.7%). The %RC was not significantly associated (P = 0.267) with baseline soft tissue thickness; however there was a significant (P = 0.031) inverse relationship between STT and %RC after 12-mo follow-up. Subgroup analysis showed that for no graft, there was a significant (P = 0.025) positive relationship between STT and %RC with the exclusion of the single outlier study based on STT. CONCLUSIONS: STT plays a limited role in predicting root coverage across all approaches; when flaps are performed with no graft, the effect of STT is most critical. The length of time following surgery appears to influence outcomes, with 12-mo follow-up offering greater insight. KNOWLEDGE TRANSFER STATEMENT: The results of this study can suggest to clinicians which periodontal plastic surgery technique to employ when treating challenging cases. In particular, it can be helpful when selecting the treatment approach to treat thin phenotype sites. This study could help clinicians provide a more appropriate treatment decision in such cases.

El declive del cirujano. De barberos a intervencionistas pasando por cirujanos / The decline of the surgeon. From barber to interventionists going through surgeons

La historia del perfil del cirujano como profesional de la medicina no se puede decir que data del principio de los tiempos como quizá pueda afirmarse de la del médico. El cirujano como tal se empezó a diferenciarse por esta actividad en la edad media por lotanto su historia data menos de 1000 años. Esta profesión nace con la realización de actividades consideradas quirúrgicas fundamentalmente al actuar sobre las dolencias con las manos o con instrumentos por parte de unos profesionales que se dedicaban a otras actividades como la barbería y que no tenían en general estudios médicos. Con el tiempo, el perfil del cirujano se fue acreditando en especial en el siglo XIX con la fundación de los Reales Colegios de Cirujanos en el mundo occidental, incluida España, hasta llegar al siglo XX al que se le ha reconocido y denominado como el siglo de los cirujanos. En siglo XXI se han empezado a desarrollar los denominados procedimientos terapéuticos y han sido desarrollados por la casi totalidad de especialidades, por lo que la figura del cirujano con el perfil de siglos anteriores se puede decir que esta en declive y algunos pensamos que puede llegar hasta su desaparición por lo menos con el perfil que ha tenido hasta casi el momento actual. (AU)

The history of the surgeon’s profile as a medical professional cannot be said to date from the beginning of time as perhaps that of the doctor can be said. The surgeon as such began to differentiate himself by this activity in the Middle Ages, therefore his history dates back less than 1000 years. This profession was born with the performance of activities considered surgical, fundamentally when acting on ailments with the hands or with instruments by professionals who were engaged in other activities such as barbershop and who generally did not have medical studies. Over time, the surgeon’s profile was credited especially in the 19th century with the founding of the Royal Colleges of Surgeons in the Western world, including Spain, until the 20th century, which has been recognized and referred to as the 20th century. of surgeons. In the 21st century, the so-called therapeutic procedures have begun tobe developed and have been developed by almost all specialties, so that the figure of the surgeon with the profile of previous centuries can be said to be in decline and some of us think that it may go as far as his disappearance at least with the profile that he has had until almost the present moment. (AU)

[Informed consents readability in vascular surgery and its progress over time]. / Legibilidad de los consentimientos informados en cirugía vascular y análisis de su evolución en el tiempo.

BACKGROUND AND OBJECTIVE: Doctors provide patients the information in written form by informed consents (IC), being the readability essential in the quality of care. The primary endpoint was to analyze the readability of IC published by the Chapter of Endovascular Surgery (CCEV) of the Spanish Society of Angiology and Vascular Surgery (SEACV) in 2019, and its evolution to those published by the SEACV in 2007. MATERIALS AND METHODS: The ICs were organized by sectors and we obtained the following parameters: syllables, words, phrases, average words/phrases and syllables/words, Flesch, Flesch-Szigriszt, Fernández-Huerta and Gunning-Fog indexes, as well as the grade on the Inflesz scale. RESULTS: The Flesch index classified the CCEV consents as very difficult, and the Gunning-Fog index reflected a readability equivalent to university texts. The Flesch-Szigriszt, Fernández-Huerta indexes and Inflesz scale classified them as normal. The ICs with less readability were those referring to supra-aortic trunks (SAT) and miscellaneous in the Fernández-Huerta (P<.020 and P<.05, respectively) and Flesch-Szigriszt (P<.05) indexes. However, ICs regarding venous pathology showed a better readability in this indexes (P<.006). CCEV consents were significantly longer than SEACV consents (P=.021). In addition, there was a decrease over time in the mean value of the Fernandez-Huerta and Flesch-Szigriszt indexes (P=.002). CONCLUSIONS: Although CCEV consents had a normal readability, it has been observed a decrease in the readability indexes compared to those published in 2007 by the SEACV. In addition the length and content of the ICs should be reviewed, especially those relating to SAT and miscellaneous.

Blood transfusion in children at a university hospital in a middle-income country: The need to reinforce adherence to current guidelines.

OBJECTIVES: Blood component transfusion is a common procedure used during hospital admissions; however, it is not risk-free. The evaluation of correct use of blood products (BP) is of vast importance considering the risks and costs implied in their use. Our principal objective was to evaluate the adherence to national guidelines for blood transfusion in pediatric patients at a third level university hospital. MATERIAL AND METHODS: A prospective and retrospective descriptive analytical study was conducted to report the incidence of incorrect use of BP in pediatric patients (1 month to 16 years of age). In a timeline period of 4 years, 579 medical records were randomly selected from a total of 6575 transfusions realized to create a statistically significant sample. The variables studied were volume, infusion time, and transfusion criteria. Indications were evaluated in patient's medical records according to national guidelines. RESULTS: Of the transfusions analyzed, 54% were classified as incorrect mainly due to lack of transfusion criteria fulfillment. Blood transfusion indications in pediatric patients adhered poorly to national guidelines. CONCLUSION: The implementation of effective programs for education and information on the use of BP are needed to increase compliance with current guidelines.

Sonographic Measurement of the Patellar Tendon Should Predict Autograft Bone Patellar Tendon Bone (BPTB) Size: Comparison of Anatomical and Clinical Findings.

The use of BPTB autograft is frequently used in ACL reconstruction, however, the risk of potential failure in patients with an anatomically unfavorable patellar tendon may predispose to reconstruction failure. Anatomical study of the extensor apparatus of the knee can provide knowledge about the best option obtain the graft and perform a better preoperative planning. Musculoskeletal ultrasound is a simple, reproducible, affordable technique that could be valid for patellar tendon evaluation. The objective of this study is to evaluate the reproducibility of the patellar tendon measurements by ultrasound and compare them with anatomical measurements, both in cadaver and patients undergoing ACLR. The study consists of two phases; first anatomical study in cadaver. The ultrasound measurement was performed by determining the length, width and thickness of the patellar tendon, both by ultrasound and anatomical dissection. The second phase is a cohort of 42 patients pending surgical ACLR. Previous ultrasound and intraoperative measurements were obtained. Regarding the anatomical study, statistical analysis did not show any differences comparing the measurements in length (p = ns) and thickness (p = ns) of the patellar tendon, although differences were obtained when comparing the results obtained for the width of the tendon after the ultrasound and anatomical measurement (p < 0.001). Same results were obtained in second phase of the study. The reproducibility of ultrasound measurements of the PT is comparable to intraoperatively measurements (without width measurement). These findings can be useful for preoperative planning in the reconstruction of ACL with BPTB Graft and to assess technical modifications prior to surgery.