Comprehensive Evaluation of Neuropsychiatric and Mucocutaneous Manifestations in the Diagnosis of Systemic Lupus Erythematosus: A Complete Clinical Approach to a Case.

Systemic lupus erythematosus is a chronic, autoimmune, multisystemic, potentially fatal disease that commonly affects young women between puberty and menopause. It is a multifactorial disease associated with an elevated risk of premature death. The diagnosis is complex due to the broad clinical spectrum as well as the severity at the time of presentation. It is based on clinical manifestations and complementary studies of antibodies. Diagnostic criteria are not available, and classification criteria, such as the ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) of 2019 are often used for diagnosis. Despite its clinical heterogeneity, SLE is an autoimmune disease that can affect multiple systems, and its early diagnosis is essential to avoid damage to vital organs and improve clinical outcomes. This case report shows atypical manifestations of a patient with neuropsychiatric and dermatological symptoms that were essential within the clinical picture to make the diagnosis of systemic lupus erythematosus.

[Depression and anxiety among medical students in virtual education during COVID-19 pandemic]. / Depresión y ansiedad en estudiantes de medicina en la educación virtual durante la pandemia por COVID-19.

Background: The lockdown derived from the declaration of a pandemic due to SARS-CoV-2 in March 2020 by the World Health Organization altered daily activities, including the academic ones, which were adapted to virtuality. In Ecuador, the new modality of study had an increase in the use of electronic devices that triggered new problems. Objective: To stablish the prevalence of depression and anxiety among medical students from the Universidad Central del Ecuador (Central University of Ecuador) in virtual education during the COVID-19 pandemic. Material and methods: Cross-sectional analytic study conducted between June and July of 2021 in students from first to tenth semester during virtual education. All studied subjects were evaluated using an electronic survey, depression and anxiety variables were assessed with the BDI-II and GAD-7 scales, respectively. In addition, sociodemographic data were collected, including the family APGAR. A response rate of 63.3% (1528 students) was obtained. Results: Overall prevalence of depression was 37.8% and the prevalence of anxiety 30.3%. Lower-years students were the most affected by these pathologies. The protective factors found were physical activity and psychological support in religion, whereas the main risk factors found were a dysfunctional family, lack of an exclusive study space and low academic performance. Furthermore, the frequency of depression and anxiety was significantly higher in women. Conclusion: The virtual modality showed a high prevalence of depression and anxiety in medical students.

Introducción: el confinamiento derivado de la declaración de pandemia por SARS-CoV-2 en marzo de 2020 por la Organización Mundial de la Salud alteró las actividades diarias, incluidas las académicas, que se adaptaron a la virtualidad. En Ecuador, la nueva modalidad de estudio tuvo un aumento del uso de dispositivos electrónicos que desencadenó nuevos problemas. Objetivo: determinar la prevalencia de depresión y ansiedad en estudiantes de medicina de la Universidad Central del Ecuador en el ciclo de educación virtual durante la pandemia por COVID-19. Material y métodos: estudio analítico transversal realizado entre junio y julio de 2021 en estudiantes de medicina de primero a décimo semestre durante la educación virtual. Por medio de una encuesta electrónica enviada a todos los sujetos de estudio, se evaluaron las variables depresión y ansiedad mediante las escalas BDI-II y GAD-7 respectivamente. Además, se recopilaron datos sociodemográficos, incluido el APGAR familiar. Se obtuvo una tasa de respuesta del 63.3% (1528 estudiantes). Resultados: la prevalencia de depresión fue de 37.8% y la de ansiedad 30.3%. Los estudiantes de años inferiores fueron los más afectados. Los factores protectores fueron la actividad física y el apoyo psicológico en la religión, mientras que los factores de riesgo fueron tener una familia disfuncional, la ausencia de un espacio exclusivo de estudio y un bajo rendimiento académico. Asimismo, la frecuencia de depresión y ansiedad fue significativamente superior en mujeres. Conclusión: durante la modalidad virtual se observó una alta prevalencia de sintomatología de depresión y ansiedad en estudiantes de medicina.

Large-Scale Immigration Worksite Raids and Mixed-Status Families: Separation, Financial Crisis, and Family Role Rearrangement.

Mixed-status families-whose members have multiple immigration statuses-are common in US immigrant communities. Large-scale worksite raids, an immigration enforcement tactic used throughout US history, returned during the Trump administration. Yet, little research characterizes the impacts of these raids, especially as related to mixed-status families. The current study (1) describes a working definition of a large-scale worksite raid and (2) considers impacts of these raids on mixed-status families. We conducted semistructured interviews in Spanish and English at 6 communities that experienced the largest worksite raids in 2018. Participants were 77 adults who provided material, emotional, or professional support following raids. Qualitative analysis methods were used to develop a codebook and code all interviews. The unpredictability of worksite raids resulted in chaos and confusion, often stemming from potential family separation. Financial crises followed because of the removal of primary financial providers. In response, families rearranged roles to generate income. Large-scale worksite raids result in similar harms to mixed-status families as other enforcement tactics but on a much larger scale. They also uniquely drain community resources, with long-term impacts. Advocacy and policy efforts are needed to mitigate damage and end this practice.

In vitro antimicrobial activity of mexican plants on bovine mastitis bacteria: preliminary studies / Atividade antimicrobiana in vitro de plantas mexicanas sobre bactérias de mastite bovina: estudos preliminares

The present study aimed to evaluate the efficacy of traditionally used antibacterial plants (Euphorbia prostrata, Schinus molle, Brickellia veronicaefolia and Lepidium virginicum) in Santa Rosa Range in Guanajuato against major mastitis-causing pathogens. The selected plants were phytochemically screened for alkaloids, flavonoids, polyphenols, saponins, anthraquinone, cardiac glycosides, steroids and terpenoids. Moreover, to achieve the main purpose of the present research, extracts of selected plants were tested for in vitro antibacterial activity against Staphylococcus aureus, Escherichia coli, Shigella spp., Bacillus subtilis, Clavibacter spp., Proteus vulgaris and Salmonella spp. All these bacterial were isolated from clinical mastitis in dairy cows. The results indicated that the ethanolic extract of the aerial part of L. virginicum exhibited the strongest antimicrobial activity, and it could be potential candidate specie for the development of novel veterinary drugs with low cost and fewer side effects.

O presente estudo teve como objetivo investigar a eficácia de plantas antibacterianas tradicionalmente usadas (Euphorbia prostrata, Schinus molle, Brickellia veronicaefolia e Lepidium virginicum) na cordilheira Santa Rosa, em Guanajuato, contra os principais patógenos causadores de mastite. As plantas selecionadas foram rastreadas fitoquimicamente quanto a alcalóides, flavonóides, polifenóis, saponinas, antraquinona, glicosídeos cardíacos, esteróides e terpenóides. Além disso, para atingir o objetivo principal da presente pesquisa, extratos de plantas selecionadas foram testados quanto à atividade antibacteriana in vitrocontra Staphylococcus aureus, Escherichia coli, Shigella spp., Bacillus subtilis, Clavibacter spp., Proteus vulgaris e Salmonella spp. Todas essas bactérias foram isoladas de mastite clínica em vacas leiteiras. Os resultados indicaram que o extrato etanólico da parte aérea de L. virginicum exibia a atividade antimicrobiana mais forte e poderia ser uma espécie potencial candidata ao desenvolvimento de novos medicamentos veterinários com baixo custo e menos efeitos colaterais.

Síndrome de Parsonage-Turner en paciente sometido a cirugía de revascularización miocárdica. caso clínico / Parsonage-Turner syndrome: report of one case

We report a 59-year-old male who, three weeks after a coronary revascularization surgery, reported a sudden intense burning pain in his left upper limb. Two weeks later, he reports a paresis with difficulty to extend his left wrist and fingers. The electromyography showed a severe axonal damage of the radial nerve with distal denervation signs. This clinical picture probably corresponds to a neuralgic amyotrophy, an inflammatory disorder of the brachial plexus known by a number of terms, including Parsonage-Turner syndrome.

[Parsonage-Turner syndrome. Report of one case]. / Síndrome de Parsonage-Turner en paciente sometido a cirugía de revascularización miocárdica. Caso clínico.

We report a 59-year-old male who, three weeks after a coronary revascularization surgery, reported a sudden intense burning pain in his left upper limb. Two weeks later, he reports a paresis with difficulty to extend his left wrist and fingers. The electromyography showed a severe axonal damage of the radial nerve with distal denervation signs. This clinical picture probably corresponds to a neuralgic amyotrophy, an inflammatory disorder of the brachial plexus known by a number of terms, including Parsonage-Turner syndrome.

Iron toxicity in neurodegeneration.

Iron is an essential element for life on earth, participating in a plethora of cellular processes where one-electron transfer reactions are required. Its essentiality, coupled to its scarcity in aqueous oxidative environments, has compelled living organisms to develop mechanisms that ensure an adequate iron supply, at times with disregard to long-term deleterious effects derived from iron accumulation. However, iron is an intrinsic producer of reactive oxygen species, and increased levels of iron promote neurotoxicity because of hydroxyl radical formation, which results in glutathione consumption, protein aggregation, lipid peroxidation and nucleic acid modification. Neurons from brain areas sensitive to degeneration accumulate iron with age and thus are subjected to an ever increasing oxidative stress with the accompanying cellular damage. The ability of these neurons to survive depends on the adaptive mechanisms developed to cope with the increasing oxidative load. Here, we describe the chemical and thermodynamic peculiarities of iron chemistry in living matter, review the components of iron homeostasis in neurons and elaborate on the mechanisms by which iron homeostasis is lost in Parkinson's disease, Alzheimer's disease and other diseases in which iron accumulation has been demonstrated.

Effect of mitochondrial complex I inhibition on Fe-S cluster protein activity.

Iron-sulfur (Fe-S) clusters are small inorganic cofactors formed by tetrahedral coordination of iron atoms with sulfur groups. Present in numerous proteins, these clusters are involved in key biological processes such as electron transfer, metabolic and regulatory processes, DNA synthesis and repair and protein structure stabilization. Fe-S clusters are synthesized mainly in the mitochondrion, where they are directly incorporated into mitochondrial Fe-S cluster-containing proteins or exported for cytoplasmic and nuclear cluster-protein assembly. In this study, we tested the hypothesis that inhibition of mitochondrial complex I by rotenone decreases Fe-S cluster synthesis and cluster content and activity of Fe-S cluster-containing enzymes. Inhibition of complex I resulted in decreased activity of three Fe-S cluster-containing enzymes: mitochondrial and cytosolic aconitases and xanthine oxidase. In addition, the Fe-S cluster content of glutamine phosphoribosyl pyrophosphate amidotransferase and mitochondrial aconitase was dramatically decreased. The reduction in cytosolic aconitase activity was associated with an increase in iron regulatory protein (IRP) mRNA binding activity and with an increase in the cytoplasmic labile iron pool. Since IRP activity post-transcriptionally regulates the expression of iron import proteins, Fe-S cluster inhibition may result in a false iron deficiency signal. Given that inhibition of complex I and iron accumulation are hallmarks of idiopathic Parkinson's disease, the findings reported here may have relevance for understanding the pathophysiology of this disease.

[Critical reading of reports of educational research in teachers of IMSS. Multicenter study]. / Lectura crítica de informes de investigación educativa en profesores del IMSS. Estudio multicéntrico.

AIM: To determine the effect of an educational strategy promoting participation in the development of critical reading of educational research reports on professors of Educational Research and Teacher Education (CIEFD's). MATERIAL AND METHODS: We performed an intervention study, multicenter professors (medical specialists) who enrolled in the courses: Diploma in teaching methodological level 1 and 2 (n = 46, n = 29, respectively) in the six CIEFD's (D.F. Siglo XXI, DF. La Raza, Nuevo León, Sonora, Puebla and Jalisco), in the period March to August 2007. A tool was built that assessed the variables critical appraisal of educational research reports, the construct validity, content and reliability was assessed by experts in education research. The educational strategy developed in the form of seminars, which were held three times a week in the Certification in teaching methodological level 1 and twice per week in the Certification Level 2 in teaching methodology duration per session: 6 h. The instrument was applied at the beginning and end of the course. RESULTS: In the two Graduates it was observed in the total group, an advance in the three indicators of critical reading, which was expressed with statistically significant differences; in the global score of the Diploma level 1 (final vs. initial measurement) the following mediums were observed: 36-67 (p = 0.0001); in the Diploma level 2, it was observed in its overall rating: 42-78 (p = 0.0001). DISCUSSION: This inquiry from the results observed some of theoretical approaches to mainstreaming participatory. CONCLUSION: An educational strategy promoting participation produced a breakthrough in the three indicators (to interpret, to judge and to formulate proposals) for critical reading of educational research reports.

Efecto del peróxido de hidrógeno al 3% sobre el Biofilm del cepillo dental utilizado por estudiantes de tercer grado de cuatro centros escolares ubicados en los municipios de Atiquizaya, Cacaopera, Jucuapa y Santiago de María / Effect of 3% hydrogen peroxide on the Biofilm of the toothbrush used by third grade students from four schools located in the municipalities of Atiquizaya, Cacaopera, Jucuapa and Santiago de María

El cepillo dental, es un aditamento de uso personal y básico para el mantenimiento de la salud bucal, este se encuentra expuesto a las bacterias de la cavidad oral y del medio ambiente, lo que pudiera contaminarlo; normalmente se utiliza y luego suele enjuagarse con agua, esta acción mantiene la multiplicación de los microorganismos con el transcurrir de las horas hasta su próximo uso. Lo que lleva a la necesidad de utilizar un método adicional de limpieza que ayude a prevenir infecciones bucales recurrentes. El presente trabajo de investigación proporciona el peróxido de hidrogeno al 3% como sustancia descontaminante; esto se realizó a través de un estudio experimental tomando como muestra los cepillos dentales que fueron entregados nuevos a una población de 122 estudiantes pertenecientes al 3er grado de cuatro diferentes Centros Escolares para que se utilizarán cotidianamente en sus hogares por un período de 15 días. Posteriormente las muestras fueron recolectadas en cada una de sus casas y transportadas al laboratorio dividiéndolas en grupo control y grupo experimental. Cada muestra del grupo control se suspendió en caldo de tripticasa soya; y cada muestra del grupo experimental se suspendió en peróxido de hidrógeno al 3% y posteriormente en caldo de tripticasa soya, después de 24 horas los resultados demostraron presencia de turbidez únicamente en los tubos de ensayos pertenecientes al grupo control y ausencia de la misma en el grupo experimental. Como conclusión el peróxido de hidrógeno es un efectivo método de limpieza, económico y accesible para la población.

The toothbrush is an accessory for personal and basic use for the maintenance of oral health, it is exposed to bacteria in the oral cavity and the environment, which could contaminate it; It is normally used and then it is usually rinsed with water, this action maintains the multiplication of microorganisms over the hours until its next use. Which leads to the need for an additional cleaning method to help prevent recurring mouth infections. The present research work provides 3% hydrogen peroxide as a decontaminating substance; This was carried out through an experimental study taking as a sample the toothbrushes that were delivered new to a population of 122 students belonging to the 3rd grade of four different School Centers to be used daily in their homes for a period of 15 days. Later, the samples were collected in each of their houses and transported to the laboratory, dividing them into a control group and an experimental group. Each sample from the control group was suspended in trypticase soy broth; and each sample from the experimental group was suspended in 3% hydrogen peroxide and subsequently in trypticase soy broth, after 24 hours the results showed the presence of turbidity only in the test tubes belonging to the control group and its absence in the experimental group. In conclusion, hydrogen peroxide is an effective cleaning method, inexpensive and accessible to the population.

Divalent metal transporter 1 (DMT1) contributes to neurodegeneration in animal models of Parkinson's disease.

Dopaminergic cell death in the substantia nigra (SN) is central to Parkinson's disease (PD), but the neurodegenerative mechanisms have not been completely elucidated. Iron accumulation in dopaminergic and glial cells in the SN of PD patients may contribute to the generation of oxidative stress, protein aggregation, and neuronal death. The mechanisms involved in iron accumulation also remain unclear. Here, we describe an increase in the expression of an isoform of the divalent metal transporter 1 (DMT1/Nramp2/Slc11a2) in the SN of PD patients. Using the PD animal model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) intoxication in mice, we showed that DMT1 expression increases in the ventral mesencephalon of intoxicated animals, concomitant with iron accumulation, oxidative stress, and dopaminergic cell loss. In addition, we report that a mutation in DMT1 that impairs iron transport protects rodents against parkinsonism-inducing neurotoxins MPTP and 6-hydroxydopamine. This study supports a critical role for DMT1 in iron-mediated neurodegeneration in PD.

[Exploratory study of ethics, norms and communication skills in medical residents]. / Estudio exploratorio de los conocimientos sobre ética, normativa y comunicación en los aspirantes a residencias médicas.

Medical schools teach technical-scientific knowledge more than social abilities. Confidence in the doctor-patient relationship is obtained through appropriate communication. The predominant medical education model assumes that communication abilities are acquired by the experienced physician in clinical practice. The present study presents a first approach and exploration of three central subjects for the development of a suitable doctor-patient relationship. We observed that the integration of evaluated knowledge was low: communication 21.1%, ethics 40.5%, legal issues 0.1% and doctor-patient conflicts 1.5%. In the analysis of communication models by genre, we found that women were more paternalist and men were more deliberative; the predominant model of communication is paternalism (40.2%). Physicians between 21 and 25 years of age integrated the knowledge better (communication, ethics and doctor-patient conflicts) than at other ages. Physicians between 41 and 45 years of age integrated ethical concepts with significantly less frequency. Parental education was associated with models of communication and integration of knowledge (p <0.001). The results demonstrate the lack of knowledge related to these topics.

The alpha2-adrenoceptor antagonist dexefaroxan enhances hippocampal neurogenesis by increasing the survival and differentiation of new granule cells.

The generation of new neurons in the hippocampus is a dynamic process regulated by environmental, endocrine, and pharmacological factors. Since enhancement of hippocampal neurogenesis has been associated with learning and memory, and the locus coeruleus-noradrenergic system has been shown to modulate these cognitive functions, we hypothesized that activation of noradrenergic neurotransmission might enhance neurogenesis in the adult hippocampus. To test this hypothesis in vivo, we induced the release of noradrenaline in the hippocampus by blocking presynaptic inhibitory autoreceptors with the selective alpha2-adrenoceptor antagonist dexefaroxan. Confocal microscopy showed that noradrenergic afferents make contact with proliferating and differentiating cells, suggesting a direct noradrenergic influence on neurogenesis. Chronic systemic treatment of rats with dexefaroxan did not affect cell proliferation per se in the dentate gyrus (as monitored by bromodeoxyuridine-labeling), but promoted the long-term survival of newborn neurons by reducing apoptosis. Dexefaroxan treatment also enhanced the number and complexity of the dendritic arborizations of polysialated neural cell adhesion molecule-positive neurons. The trophic effects of dexefaroxan on newborn cells might involve an increase in brain-derived neurotrophic factor, which was upregulated in afferent noradrenergic fiber projection areas and in neurons in the granule cell layer. By promoting the survival of new endogenously formed neurons, dexefaroxan treatment represents a potential therapeutic strategy for maintaining adult neurogenesis in neurodegenerative conditions, such as Alzheimer's disease, that affect the hippocampus.

Progressive iron accumulation induces a biphasic change in the glutathione content of neuroblastoma cells.

Glutathione (GSH) constitutes the single most important antioxidant in neurons, whereas iron causes oxidative stress that leads to cell damage and death. Although GSH and iron produce opposite effects on redox cell status, no mechanistic relationships between iron and GSH metabolism are known. In this work, we evaluated in SH-SY5Y neuroblastoma cells the effects of iron accumulation on intracellular GSH metabolism. After 2 d exposure to increasing concentrations of iron, cells underwent concentration-dependent iron accumulation and a biphasic change in intracellular GSH levels. Increasing iron from 1 to 5 microM resulted in a marked increase in intracellular oxidative stress and increased GSH levels. Increased GSH levels were due to increased synthesis. Further increases in iron concentration led to significant reduction in both reduced (GSH) and total (GSH + (2 x GSSG)) glutathione. Cell exposure to high iron concentrations (20-80 microM) was associated with a marked decrease in the GSH/GSSG molar ratio and the GSH half-cell reduction potential. Moreover, increasing iron from 40 to 80 microM resulted in loss of cell viability. Iron loading did not change GSH reductase activity but induced significant increases in GSH peroxidase and GSH transferase activities. The changes in GSH homeostasis reported here recapitulate several of those observed in Parkinson's disease substantia nigra. These results support a model by which progressive iron accumulation leads to a progressive decrease in GSH content and cell reduction potential, which finally results in impaired cell integrity.

Condiciones sedimentológicas de la laguna La Restinga, Isla de Margarita, Venezuela / Sedimentology conditions of the La Restinga lagoon, Margarita Island, Venezuela

La laguna La Restinga, en el sureste del Mar Caribe, es una laguna costera que comprende pequeñas lagunas rodeadas de manglares, conformando el sistema lagunar más importante de la Isla de Margarita. Se comunica con el mar, al sur, a través de una boca de 800m de largo, 80-100m de ancho y profundidad promedio de 6m. Está separada del mar, al norte, por un istmo o restinga de 23,5km, y sus drenajes naturales se evidencian solamente en la época de lluvia. Se estudiaron algunos aspectos de la sedimentología de este sistema lagunar determinándose la distribución espacial de sedimentos y algunas de sus características químicas. En febrero de 1994 se extrajeron 31 muestras de sedimentos superficiales, 25 en la laguna y 6 en el mar adyacente a la boca, mediante una draga Ekman, y se preservaron a 10ºC, realizándoseles análisis granulométrico y químico. Se determinó un fondo lagunar areno limoso. La materia orgánica y el contenido hídrico, en la laguna, estuvieron asociados al sedimento de textura fina y se localizaron en las áreas más amplias, someras y protegidas por cinturones de manglares, donde las corrientes de fondo fueron escasas o nulas (baja energía cinética media). El alto porcentaje de carbonato de calcio estuvo asociado con la fracción gruesa del sedimento y se localizó en la boca y los caños que interconectan las sublagunas internas, donde las corrientes de fondo son rápidas (alta energía cinética media). El grado de escogimiento del sedimento fue muy pobre y la distribución de la agudeza gráfica fue generalmente aguda y muy aguda, dependiendo de las diferentes fracciones encontradas en el sedimento