Nationwide epidemiology and health resource use among children with COVID-19 in Japan.

BACKGROUND: The COVID-19 pandemic posed substantial challenges to healthcare systems. Understanding the responses of pediatric health services is crucial for future pandemic planning and preparedness, yet such data remains limited. METHODS: In this retrospective cohort study, we analyzed data from administrative databases developed by Japan Medical Data Center and DeSC Healthcare Inc. The dataset comprised records of 2,612,511 children, totaling 60,224,888 person-months, from January 2020 to May 2022. Multivariate generalized estimation equations were used to examine the incidence rates of COVID-19 and associated health resource use. RESULTS: Our analysis revealed that the incidence rates of COVID-19 gradually increased from Wave I (2.2 cases per 100,000 person-months) to Wave V (177.8cases per 100,000 person-months), with a notable elevation during Wave VI (2367.7 cases per 100,000 person-months). While nucleic acid amplification tests were primarily used during Waves I-V, the use of rapid antigen tests markedly increased in Wave VI. The hospitalization rates increased gradually from 0.2 in Wave I to 10.2 events per 100,000 person-months in Wave VI, and the case-hospitalization risk decreased from 14.9% in Wave II to 0.7% in Wave VI. Additionally, we observed decreasing trends in the use of antibiotics (Wave I, 31.8%; Wave VI, 9.0%), whereas antipyretic use rose from Wave I (56.1%) to Wave VI (86.6%). CONCLUSIONS: Our study highlighted essential changes in the nationwide pediatric healthcare system's response to the COVID-19 pandemic. These findings provide valuable insights into the future pandemic planning and preparedness.

Cambio cultural en cuidadores indígenas. Bases etnográficas para la enfermería transcultural / Mudança cultural nos cuidadores indígenas. Bases etnográficas para enfermagem transcultural / Cultural change in the indigenous caregivers. Ethnographical bases for transcultural nursing

Este estudio tiene como objetivo comprender las prácticas delos cuidadores indígenas en contexto de cambio cultural. Partede la idea de la necesidad de construir bases etnográficas quesirvan de insumos para la implementación de los enfoquesde salud intercultural y enfermería transcultural, así comoparte de la evidencia que facilite las prácticas de salud, a partirde descripciones competentes que ayuden a comprender ladiversidad cultural de las poblaciones humanas. El abordajemetodológico se realizó desde la investigación cualitativa,con enfoque etnográfico, combinando revisión documental yentrevistas semiestructuradas a 44 personas. Se identificaroncódigos, agrupados en subcategorías y categorías. Se encontraronvarios tipos de cuidadores, de los cuales, se consideraronrelevantes el médico tradicional y la partera. Sus prácticasse basan en saberes de la dimensión material y espiritual,entre las que se destaca el uso de plantas medicinales,rezo, interpretación de los sueños y ceremonias colectivas.Además, su labor depende del reconocimiento social, estatusdel cuidador y rol en la organización social. Los modelosinterculturales deben tener en cuenta a los cuidadores, enel marco de estrategias basadas en el diálogo de saberes yla participación.(AU)

The objective of this study is to understand the practices ofindigenous caregivers in the context of cultural change. Partof the idea of the need to build ethnographic bases that serve as inputs for the implementation of cross-cultural healthand cross-cultural nursing approaches, as well as part of theevidence that facilitates health practices, based on competentdescriptions that help to understand the cultural diversityof human populations. The methodological approach wascarried out from qualitative research, with an ethnographicapproach, combining documentary review and semi-structuredinterviews with 44 people. Codes were identified, grouped intosubcategories and categories. Several types of caregivers werefound, of which the traditional doctor and the midwife wereconsidered relevant. Their practices are based on knowledgeof the material and spiritual dimension, among which theuse of medicinal plants, prayer, dream interpretation andcollective ceremonies is highlighted. In addition, their workdepends on social recognition, caregiver status and rolein social organization. Intercultural models must considercaregivers, within the framework of strategies based on thedialogue of knowledge and participation.(AU)

Este estudo tem como objetivo compreender as práticas decuidadores indígenas no contexto de mudança cultural. Parteda ideia da necessidade de construir bases etnográficas quesirvam de subsídios para a implementação de abordagensinterculturais de saúde e enfermagem transcultural, bemcomo parte das evidências que facilitem as práticas desaúde, a partir de descrições competentes que ajudem acompreender a diversidade cultural das populações humanas.A abordagem metodológica foi realizada a partir de pesquisaqualitativa, com abordagem etnográfica, combinando revisãodocumental e entrevistas semiestruturadas com 44 pessoas.Os códigos foram identificados, agrupados em subcategoriase categorias. Foram encontrados vários tipos de cuidadores,dos quais o médico tradicional e a parteira foram consideradosrelevantes. Suas práticas são baseadas no conhecimento dadimensão material e espiritual, entre as quais se destacam ouso de plantas medicinais, oração, interpretação de sonhose cerimônias coletivas. Além disso, seu trabalho dependede reconhecimento social, status do cuidador e papel naorganização social. Os modelos interculturais devem levarem consideração os cuidadores, no marco de estratégiasbaseadas no diálogo de conhecimento e participação.(AU)

The prevalence of end-of-life chemotherapy and targeted therapy in Japan, assessed using a health claims database.

PURPOSE: This study aimed to investigate the current status of end-of-life chemotherapy and targeted therapy and explore the aggressiveness of end-of-life care in Japan using the DeSC database, a large administrative claims database. METHODS: We identified fatal cases of at least one cancer-related diagnosis between April 2015 and November 2020. Patients prescribed at least one anticancer drug were analyzed, and chemotherapy regimens were categorized based on the combination of concomitant anticancer drugs prescribed. RESULTS: Among 1,095,713 individuals enrolled in the National Health Insurance database, 7,300 deaths with cancer-related diagnosis were identified. Of these, 4,010 cases were identified in which at least one anticancer drug was prescribed, and 11.6% of 7,300 death had been prescribed anticancer drugs in their last 30 days of life. The most commonly used regimen was S-1 (tegafur, gimeracil, and oteracil potassium combination) monotherapy, followed by nivolumab monotherapy and nab-paclitaxel plus gemcitabine. Immune checkpoint inhibitor monotherapy was more likely prescribed to patients whose last chemotherapy dose was in the last 30 days of life (p = 0.0066, chi-squared test). CONCLUSIONS: This study provides insights into the current status of end-of-life chemotherapy and targeted therapy in Japan, using a large administrative claims database. The results of this study will inform future research on end-of-life chemotherapy and targeted therapy, and help develop strategies to improve the quality of life of patients with advanced cancer.

Increased Expression of TMPRSS11E Is Involved in LPS- or Poly(I:C)-mediated Inflammation.

Transmembrane serine proteases are a group of enzymes that are implicated in diverse biological processes. Transmembrane serine protease 11E (TMPRSS11E) is expressed in epithelial cells. Previous studies on TMPRSS11E mainly focused on its function in tumor progression. In this study, we investigated the association of TMPRSS11E with the inflammatory response. We found that TMPRSS11E levels were upregulated in the BAL fluid of patients with acute respiratory distress syndrome and LPS-stimulated cultured epithelial cells. In an LPS-induced acute lung injury mouse model and a cercal ligation and puncture-induced sepsis model, increased expression levels of TMPRSS11E were also observed in the lung tissues. Knockdown of TMPRSS11E suppressed the proinflammatory cytokine release and alleviated lung injury. In addition, increased TMPRSS11E expression was detected in lung tissues of poly(I:C)-challenged mice, and overexpression of TMPRSS11E aggregated the lung injury. Unexpectedly, ectopic TMPRSS11E expression in macrophages was observed. Protease-activated receptor-1 was proteolytically activated by TMPRSS11E and enhanced the levels of proinflammatory cytokines. Taken together, our results indicate that TMPRSS11E can be induced during inflammatory response triggered by infection. Therefore, interventions with TMPRSS11E can aid in the treatment of pulmonary inflammation.

Fever, Seizures and Encephalopathy: From Bush Fires to Firestorms.

Fever-associated seizures and febrile encephalopathy are common neurological problems in children. Infections of the nervous system are responsible for the majority of cases. However, there is a spectrum of infection-associated and inflammatory conditions associated with the triad of fever, seizures, and encephalopathy. Apart from complex febrile seizures and febrile status epilepticus, fever infection-related epilepsy syndrome of childhood (FIRES), infantile hemiconvulsion hemiplegia epilepsy syndrome (IHHE), acute encephalopathy with delayed diffusion restriction (AESD), acute necrotizing encephalopathy of childhood (ANE), and reversible splenial lesion syndrome (RESLES) are age-related clinical phenotypes of fever-related epilepsy and encephalopathy. Awareness of these entities is important for appropriate diagnosis and the prompt use of immunomodulatory/immunosuppressive therapies. In this review, we discuss the pathophysiology, clinical phenotypes, and management approaches of these fever-related seizure and encephalopathy states.

The Thai version of the nursing delirium screening scale-Thai: Adaptation and validation study in postoperative patients.

Background: The Nursing Delirium Screening Scale (Nu-DESC) is an effective instrument for assessing postoperative delirium (POD). This study translated the Nu-DESC into Thai ("Nu-DESC-Thai"), validated it, and compared its accuracy with the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Methods: The translation process followed the International Society for Pharmacoeconomics Outcome Research guidelines. Recruited participants were ≥ 70 years old, fluent in Thai, and scheduled for surgery. The exclusion criteria were cancellation or postponement of an operation, severe visual or auditory impairment, and patients with a Richmond Agitation Sedation Scale score of -4 or less before delirium assessment. Post-anesthesia care unit (PACU) nurses and residents on wards each used the Nu-DESC to assess delirium in 70 participants (i.e., 140 assessments) after the operation and after patient arrival at wards, respectively. Geriatricians confirmed the diagnoses using video observations and direct patient contact. Results: The participants' mean age was 76.5 ± 4.6 years. The sensitivity and specificity of the Nu-DESC-Thai at a threshold of ≥ 2 were 55% (95% CI, 31.5-76.9%) and 90.8% (84.2-95.3%), respectively, with an area under a receiver operating characteristic curve (AUC) of 0.73. At a threshold of ≥ 1, the sensitivity and specificity were 85% (62.1-96.8%) and 71.7% (62.7-79.5%), respectively (AUC, 0.78). Adding 1 point for failing backward-digit counting (30-1) to the Nu-DESC-Thai and screening at a threshold of ≥ 2 increased its sensitivity to 85% (62.1-96.8%) with the same specificity of 90.8% (84.2-95.3%). Conclusion: The Nu-DESC-Thai showed good validity and reliability for postoperative use. Its sensitivity was inadequate at a cutoff ≥ 2. However, the sensitivity improved when the threshold was ≥ 1 or with the addition of backward counting to Nu-DESC-Thai and screening at a threshold of ≥ 2.

The family in preventing delirium in the intensive care unit: Scoping review.

INTRODUCTION: Delirium is cognitive impairment related to negative inpatient outcomes in the Intensive Care Unit (ICU), family interventions have been shown to be effective in reducing the incidence of this condition. OBJECTIVE: To identify strategies that include the family in the prevention of delirium in the adult intensive care unit that can be integrated into ABCDEF. INCLUSION CRITERIA: Studies describing actions and interventions involving caregivers and family members in the ICU for the prevention of delirium, conducted in the last five years, available in full text, in English and Spanish, Portuguese and in adults. METHODS: A scope review was conducted using the keywords "Critical Care, Delirium, Family, Primary Prevention" in 11 databases (PubMed, Virtual Health Library, Cochrane Library, TRIP Data base, EBSCO, Ovid Nursing, Springer, Scopus, Dialnet, Scielo, Lilacs) and other sources (Open Gray, Google Scholar), between August - October 2019; 8 studies were considered relevant and were analysed. RESULTS: The results were described in 3 categories: flexibility vs. restriction of visits in the ICU, Reorientation as a prevention strategy and post-ICU syndrome in the family. CONCLUSION: Extended visits, development of family-mediated activities, and redirection are non-pharmacological strategies that reduce the incidence of delirium in the ICU and offer multiple benefits to the patient and family/caregiver.

La familia en la prevención del delirium en la unidad de cuidados intensivos: scoping review / The family in preventing delirium in the intensive care unit: Scoping review

Introducción: El delirium es una alteración cognitiva relacionada con resultados negativos en el paciente interno en la unidad de cuidados intensivos (UCI), las intervenciones familiares han demostrado ser efectivas para reducir la incidencia de esta condición.Objetivo: Identificar las estrategias que incluyen a la familia en la prevención del delirium en la UCI del adulto que pueden ser integradas al ABCDEF. Criterios de inclusión: Estudios que describieran acciones e intervenciones que incluyan a cuidadores y familiares en la UCI para la prevención del delirium en adultos, realizados en los últimos 5 años, disponibles en texto completo, en español, portugués e inglés.Métodos: Se realizó una revisión de alcance utilizando las palabras clave «Critical Care, Delirium, Family, Primary Prevention» en 11 bases de datos (PubMed, Biblioteca Virtual de Salud, Cochrane Library, TRIP Data base, EBSCO, Ovid Nursing, Springer, Scopus, Dialnet, Scielo, Lilacs) y otras fuentes (Open Gray, Google Scholar), entre los meses de agosto-octubre de 2019; 8 estudios se consideraron relevantes y fueron analizados.Resultados: Los resultados fueron descritos en 3 categorías: flexibilidad vs. restricción de visitas en la UCI, reorientación como estrategia de prevención y síndrome post-UCI en la familia.Conclusión: Las visitas extendidas, el desarrollo de actividades mediadas por la familia y la reorientación son estrategias no farmacológicas que reducen la incidencia del delirium en la UCI y ofrecen múltiples beneficios para el paciente y su familiar/cuidador.

Introduction: Delirium is cognitive impairment related to negative inpatient outcomes in the Intensive Care Unit (ICU), family interventions have been shown to be effective in reducing the incidence of this condition.Objective: To identify strategies that include the family in the prevention of delirium in the adult intensive care unit that can be integrated into ABCDEF. Inclusion criteria: Studies describing actions and interventions involving caregivers and family members in the ICU for the prevention of delirium, conducted in the last five years, available in full text, in English and Spanish, Portuguese and in adults.Methods: A scope review was conducted using the keywords “Critical Care, Delirium, Family, Primary Prevention” in 11 databases (PubMed, Virtual Health Library, Cochrane Library, TRIP Data base, EBSCO, Ovid Nursing, Springer, Scopus, Dialnet, Scielo, Lilacs) and other sources (Open Gray, Google Scholar), between August - October 2019; 8 studies were considered relevant and were analysed.Results: The results were described in 3 categories: flexibility vs. restriction of visits in the ICU, Reorientation as a prevention strategy and post-ICU syndrome in the family.Conclusion: Extended visits, development of family-mediated activities, and redirection are non-pharmacological strategies that reduce the incidence of delirium in the ICU and offer multiple benefits to the patient and family/caregiver.

2 ． Overview of the DeSC Database and Utilization for Clinical Epidemiology and Pharmacoepidemiology Research / 薬剤疫学

Studies using real-world data are recently increasing worldwide. Various types of real-world data are available in Japan. Administrative claims databases include the National Database (NDB) and other types of databases including several commercially available databases. This article describes the DeSC database, newly constructed by DeSC Healthcare Co., Ltd. in 2020. One of the features of the DeSC database is that it includes data from the National Health Insurance, Health Insurance, and Advanced Elderly Medical Service System. In the present article, we referred to our previous study on population representativeness of the DeSC database and explained its overview. Estimated prevalence of some diseases were described for each type of insurance. Furthermore, we discussed the use of the DeSC database for clinical epidemiology and pharmacoepidemiology research.

HDAC8 Activates AKT through Upregulating PLCB1 and Suppressing DESC1 Expression in MEK1/2 Inhibition-Resistant Cells.

Inhibition of the RAF-MEK1/2-ERK signaling pathway is an ideal strategy for treating cancers with NRAS or BRAF mutations. However, the development of resistance due to incomplete inhibition of the pathway and activation of compensatory cell proliferation pathways is a major impediment of the targeted therapy. The anthrax lethal toxin (LT), which cleaves and inactivates MEKs, is a modifiable biomolecule that can be delivered selectively to tumor cells and potently kills various tumor cells. However, resistance to LT and the mechanism involved are yet to be explored. Here, we show that LT, through inhibiting MEK1/2-ERK activation, inhibits the proliferation of cancer cells with NRAS/BRAF mutations. Among them, the human colorectal tumor HT-29 and murine melanoma B16-BL6 cells developed resistance to LT in 2 to 3 days of treatment. These resistant cells activated AKT through a histone deacetylase (HDAC) 8-dependent pathway. Using an Affymetrix microarray, followed by qPCR validation, we identified that the differential expression of the phospholipase C-ß1 (PLCB1) and squamous cell carcinoma-1 (DESC1) played an important role in HDAC8-mediated AKT activation and resistance to MEK1/2-ERK inhibition. By using inhibitors, small interference RNAs and/or expression vectors, we found that the inhibition of HDAC8 suppressed PLCB1 expression and induced DESC1 expression in the resistant cells, which led to the inhibition of AKT and re-sensitization to LT and MEK1/2 inhibition. These results suggest that targeting PLCB1 and DESC1 is a novel strategy for inhibiting the resistance to MEK1/2 inhibition.

The family in preventing delirium in the intensive care unit: Scoping review. / La familia en la prevención del delirium en la unidad de cuidados intensivos: scoping review.

INTRODUCTION: Delirium is cognitive impairment related to negative inpatient outcomes in the Intensive Care Unit (ICU), family interventions have been shown to be effective in reducing the incidence of this condition. OBJECTIVE: To identify strategies that include the family in the prevention of delirium in the adult intensive care unit that can be integrated into ABCDEF. INCLUSION CRITERIA: Studies describing actions and interventions involving caregivers and family members in the ICU for the prevention of delirium, conducted in the last five years, available in full text, in English and Spanish, Portuguese and in adults. METHODS: A scope review was conducted using the keywords "Critical Care, Delirium, Family, Primary Prevention" in 11 databases (PubMed, Virtual Health Library, Cochrane Library, TRIP Data base, EBSCO, Ovid Nursing, Springer, Scopus, Dialnet, Scielo, Lilacs) and other sources (Open Gray, Google Scholar), between August - October 2019; 8 studies were considered relevant and were analysed. RESULTS: The results were described in 3 categories: flexibility vs. restriction of visits in the ICU, Reorientation as a prevention strategy and post-ICU syndrome in the family. CONCLUSION: Extended visits, development of family-mediated activities, and redirection are non-pharmacological strategies that reduce the incidence of delirium in the ICU and offer multiple benefits to the patient and family/caregiver.

Preoperative Cognitive Impairment and the Prevalence of Postoperative Delirium in Elderly Cancer Patients-A Prospective Observational Study.

Preoperative cognitive impairment (PCI) in cancer patients includes a broad spectrum of neurocognitive changes produced by complex interplay of patient, tumoural and treatment-related factors. Reduced preoperative cognitive reserve can favour the emergence of postoperative delirium (POD). The study aims to document PCI prevalence and to assess the relationship with POD in elderly cancer patients. The prospective observational study included consecutive patients scheduled for elective surgery; PCI was assessed with Mini-Cog test and defined at a score ≤ 3, POD was screened using Nursing Delirium Screening Scale (Nu-DESC) and defined at a score ≥ 2. Data on education, American Society of Anesthesiologists (ASA) score, preoperative medications, substance use, comorbidities, sensorial deficits, surgery and anaesthesia type, anaesthetic drugs, Mini-Cog score, postoperative pain, Nu-DESC were collected. In total, 131 patients were enrolled, mean age 72.1 ± 5.9 years. PCI prevalence was 51.9% (n = 68). POD prevalence was 19.8% (n = 26), with significantly higher value in PCI patients (27.9% vs. 11.1%, p = 0.016). In multivariate analysis, Mini-Cog score ≤ 3 (OR = 2.6, p = 0.027), clock draw (OR: 2.9, p = 0.013), preoperative renal dysfunction (OR = 2.6, p = 0.012), morphine (OR = 2.7, p = 0.007), metoclopramide (OR = 6.6, p = 0.006), and high pain score (OR = 1.8, p = 0.018) had a significant association with POD development. In this sample of elderly patients, PCI had a high prevalence and predicted the emergence of POD. Incorporating Mini-Cog test into the preoperative evaluation of onco-geriatric patients seems valuable and feasible.

LncRNA LOXL1-AS1 promotes esophageal squamous cell carcinoma progression by targeting DESC1.

Recently, ample evidence indicated that numerous aberrantly expressed long non-coding RNAs (lncRNAs) participated in the development of multiple malignancies. However, the expression and function of lncRNA LOXL1-AS1 in mediating esophageal squamous cell carcinoma (ESCC) carcinogenesis remains largely elusive. Here we validated that LOXL1-AS1 was significantly upregulated in ESCC tissues compared with the corresponding adjacent non-neoplastic tissues, and LOXL1-AS1 expression was positively correlated with ESCC patients' lymph node metastasis. Besides, LOXL1-AS1 knockdown impaired ESCC cells proliferation, migration and invasion capabilities in vitro. Furthermore, inhibiting LOXL1-AS1 in ESCC cells increased the percentage of cells at the G1 phase, accompanied by reducing in S phase in contrast to scramble control, and silencing of LOXL1-AS1 evoked ESCC cell apoptosis. From high throughput RNA sequencing (RNA-seq) analysis, we identified that differentially expressed in squamous cell carcinoma 1 (DESC1) was a critical downstream target of LOXL1-AS1. Taken together, we demonstrated the function and mechanism of LOXL1-AS1 in contributing ESCC progression for the first time, and indicated LOXL1-AS1 may be a novel therapeutic biomarker of ESCC.

Ketamine vs. haloperidol for prevention of cognitive dysfunction and postoperative delirium: A phase IV multicentre randomised placebo-controlled double-blind clinical trial.

STUDY OBJECTIVE: Delirium is frequently observed in the postoperative and intensive care unit (ICU) population. Due to the multifactorial origin of delirium and according to international guidelines (e.g., American Geriatrics Society; Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) guideline), there are several but no incontestable options for prevention and symptomatic treatment. The purpose of the Baden PRIDe (Prevention and Reduction of Incidence of postoperative Delirium) trial was to determine whether postoperative cognitive dysfunction and delirium could be prevented by the combination of possible preventive agents such as haloperidol and ketamine. In addition, pre- and postoperative levels of the biomarkers cortisol, neuron specific enolase (NSE) and S100ß were measured to investigate their dynamics in delirious and non-delirious patients after surgery. DESIGN: The Baden PRIDe Trial was an investigator-initiated, phase IV, two-centre, randomised, placebo-controlled, double-blind clinical trial. SETTING: Perioperative care. PATIENTS: 182 adult patients that underwent elective or emergency surgery under general or combined (i.e., general and regional) anaesthesia. INTERVENTIONS: Pre-anaesthetic, pharmacologic prevention of postoperative brain dysfunction with haloperidol, ketamine, and the combination of both vs. placebo. MEASUREMENTS: Assessment of cognitive performance pre- and postoperatively with the MMSE, the DOS, the Nursing Delirium Screening Scale (Nu-DESC) or the Intensive Care Delirium Screening Checklist (ICDSC) during ICU stay. MAIN RESULTS: None of the three study arms - haloperidol, ketamine, or both drugs combined - was significantly superior to placebo for prevention of postoperative brain dysfunction and delirium (P = 0.39). Measured levels of postoperative cortisol were significantly higher in delirious patients. S-100ß levels were significantly higher in all postoperative outcome groups (cognitive impairment, delirium, no cognitive decline), whereas postoperative NSE levels declined in all groups. CONCLUSIONS: The study results offer no possibility for a novel recommendation for prevention of postoperative cognitive decline including delirium. Perioperative S-100ß trajectories in patients with cognitive deterioration suggest affection of glial cells in particular. TRIAL REGISTRATION: ClinicalTrials.govNCT02433041; registered on April 7, 2015.

Nivel de conocimiento de Sífilis en adolescentes de dos Instituciones Educativas del distrito de Buenaventura / Level of knowledge of Syphilis in adolescents of two Educational Institutions of the Buenaventura district

Objetivo: Establecer el nivel de conocimiento de sífilis en adolescentes de dos Instituciones Educativas del distrito de Buenaventura de grados: noveno, décimo y once. Material y métodos: Estudio descriptivo de corte transversal en jóvenes entre 12 y 18 años; muestra a conveniencia de 420 estudiantes. Se aplicó una encuesta anónima dividida en 5 secciones. Se determinaron características sociodemográficas, hábitos, vida sexual y conocimiento sobre ITS. Resultados: 91% manifestó conocer sobre las ITS; 22,4% expresó conocer los signos y síntomas. 3,1& presentó diagnóstico de ITS; no reportaron casos de sífilis; 51,9% manifestó conocer la sífilis; el 10% expresó conocer signos y síntomas. 16% manifestó conocer mecanismo de prevención. 4% de los estudiantes tiene un buen nivel de conocimiento sobre sífilis. Sobre actividad sexual, 58,7% había iniciado vida sexual, 28% tuvo su primer encuentro a los 11 años o menos, siendo mayormente de género masculino. 33,8% habían tenido 1 pareja sexual, seguido de 23,8% con 6 o más parejas sexuales. El análisis de conocimiento sobre sífilis según institución educativa evidenció que el 8,9% y el 3% de los estudiantes tenía un nivel bueno de conocimiento, en la institución rural y urbana respectivamente. Al evaluar el conocimiento sobre ETS, se encontró que el 85% y 96% de estudiantes en zona rural y urbana respectivamente afirman tener conocimiento; sobre la sintomatología, 21% y 23 % es conocedor de esta, en área rural y urbana respectivamente. Conclusiones: Un alto porcentaje de estudiantes encuestados tienen un bajo nivel de conocimiento sobre sífilis; las mayores falencias se presentan en manifestaciones clínicas, la prevención y la cura de dicha enfermedad; aunque los adolescentes tienen múltiples fuentes de conocimiento, dicha información es deficiente, especialmente la transmitida por los padres y la pareja.

Objective: To establish the level of knowledge about syphilis in adolescents of two Educational Institutions in the district of Buenaventura of the ninth, tenth and eleventh grades. Material and methods: Descriptive cross-sectional study in young people between 12 and 18 years; convenience sample of 420 students. An anonymous survey divided into five sections was applied. Sociodemographic characteristics, habits, sexual life, and knowledge about STIs were determined. Results: 91% said they know about STIs, and 22.4% said they knowing the signs and symptoms. STI diagnoses were presented in 3.1%; not report syphilis cases. 51.9% said that knew about syphilis, 10% said they know signs and symptoms. 16% said they knew about mechanism prevention. 4% of students have a good level of knowledge about syphilis. About sexual activity 58.7% had started sexual life, 28% had their first encounter at age 11 or less, they were principally male. 33.8% had one sexual partner, followed by 23.8% with six or more sexual partners. Institutional Analysis showed that 8.9% (rural) and 3% (urban) of the students, were at a good level of knowledge. When evaluating knowledge about STDs, it was found that 85% (urban) and 96% (rural) students say they know, however, when inquiring about the symptoms, in rural and urban areas, 21 % and 23% respectively are aware of it. Conclusions: The highest percentage of students surveyed has a bad level of knowledge about syphilis, where the highest % was in clinical manifestations, the prevention, and cure of said disease; although adolescents have multiple sources of knowledge, this information is deficient, especially that shared by the parents and the couple.

Sorción de humedad y resistencia a la disolución ácida de dos ionómeros de vidrio de restauración: estudio in vitro / Sorption of moisture and resistance to acid dissolution of two restoration glass ionomers: in vitro study

Resumen Introdución: En general el Ionómero de vidrio tiene algunas desventajas en la parte clínica, como es la fragilidad y la sensibilidad inicial a la humedad, lo que puede causar una disminución de la vida útil de la restauración. Estos efectos que sufre el ionómero como la sorción de humedad y la solubilidad a los ácidos puede causar daño a la restauración, facilitar su fractura y filtración marginal, lo que puede conllevar a una recidiva de caries y pérdida de sus propiedades. Objetivo: comparar in vitro la sorción de humedad y disolución ácida de dos ionómeros de restauración. Método: Se elaboraron 20 muestras de ionómero de vidrio Ketac molar y 20 de Fuji II. Se realizó una primera medición del peso con balanzas de precisión, obteniéndose un peso inicial. Los especímenes fueron sumergidos en agua destilada durante 24 horas, almacenadas en un calefactor; cada muestra fue pesada con una balanza de precisión, estableciéndose el porcentaje de humedad sorbida a partir del peso inicial. Posteriormente las muestras fueron sumergidas en solución de ácido cítrico al 3% durante 24 horas, para volver a ser pesadas, evaluándose la perdida de material por acción erosiva del ácido en porcentaje de peso. Conclusiones: La sorción de humedad en peso fue de 2,59% en el ketac molar y 1,45% en el Fuji II; al comparar las muestras mediante la prueba t, se obtuvo diferencias estadísticamente significativas. El porcentaje de pérdida de material por acción erosiva del ácido fue de 10,81% para Ketac molar y 18,62% para el Fuji II; al comparar las muestras mediante la prueba t, se obtuvo diferencias estadísticamente significativas. Se concluyó que la sorción de humedad fue mayor en el Ketac molar y la mayor solubilidad a la acción del ácido cítrico fue del Fuji II.

Abstract Introduction: Glass Ionomer has certain clinical disadvantages, such as fragility and moisture sensitivity, which might reduce the restauration´s lifespan. This effects, such as water absorption and acid solubility may damage the restauration, cause fracture and marginal filtration, this could trigger cavity relapse and the loss of the correct mechanical properties. Objective: Compare in vitro moisture sorption and acid solution of two restoration ionomers. Method: 20 samples of Ketac molar glass ionomer and 20 of Fuji II were made. A first weight measurement was made with precision scales, obtaining an initial weight. The specimens were submerged in distilled water for 24 hours, stored in a heater; Each sample was weighed with a precisión balance, establishing the percentage of moisture absorbed from the initial weight. Subsequently, the samples were submerged in 3% citric acid solution for 24 hours, to be re-weighed, evaluating the loss of material due to erosive action of the acid in percentage of weight. Conclusions: The moisture sorption by weight was 2.59% in the molar ketac and 1.45% in the Fuji II; When comparing the samples using the t-test, statistically significant differences were obtained. The percentage of material loss due to erosive action of the acid was 10.81% for molar Ketac and 18.62% for Fuji II; When comparing the samples using the t-test, statistically significant differences were obtained. It was concluded that the moisture sorption was higher in the molar Ketac and the greatest solubility to the action of citric acid was Fuji II.

Inhibitors of type II transmembrane serine proteases in the treatment of diseases of the respiratory tract - A review of patent literature.

INTRODUCTION: Type II transmembrane serine proteases (TTSPs) of the human respiratory tract generate high interest owing to their ability, among other roles, to cleave surface proteins of respiratory viruses. This step is critical in the viral invasion of coronaviruses, including SARS-CoV-2 responsible for COVID-19, but also influenza viruses and reoviruses. Accordingly, these cell surface enzymes constitute appealing therapeutic targets to develop host-based therapeutics against respiratory viral diseases. Additionally, their deregulated levels or activity has been described in non-viral diseases such as fibrosis, cancer, and osteoarthritis, making them potential targets in these indications. AREAS COVERED: Areas covered: This review includes WIPO-listed patents reporting small molecules and peptide-based inhibitors of type II transmembrane serine proteases of the respiratory tract. EXPERT OPINION: Expert opinion: Several TTSPs of the respiratory tract represent attractive pharmacological targets in the treatment of respiratory infectious diseases (notably COVID-19 and influenza), but also against idiopathic pulmonary fibrosis and lung cancer. The current emphasis is primarily on TMPRSS2, matriptase, and hepsin, yet other TTSPs await validation. Compounds listed herein are predominantly peptidomimetic inhibitors, some with covalent reversible mechanisms of action and high potencies. Their selectivity profile, however, are often only partially characterized. Preclinical data are promising and warrant further advancement in the above diseases.

Leptospira patógena en murciélagos de Campeche y Yucatán, México / Pathogenic Leptospira in bats from Campeche and Yucatán, Mexico

RESUMEN Objetivo. Reportar la infección con Leptospira en ríñones de murciélagos de Campeche y Yucatán, México, a través de la amplificación por PCR de dos fragmentos distintos del gen 16S RNA ribosomal. Materiales y métodos. Se realizaron capturas en un sitio de Campeche y dos de Yucatán. A los murciélagos capturados se les aplicó la eutanasia y se les realizó una necropsia para recolectar tejido renal que se usó en la extracción de ADN total. Se realizaron dos PCR convencionales para la amplificación de los fragmentos de 16S RNA ribosomal. Se obtuvieron las secuencias de algunos productos positivos y se analizaron con herramientas bioinformáticas para identificar la especie infectante de Leptospira. Resultados. Se capturaron 69 murciélagos pertenecientes a cuatro familias y a ocho especies distintas. La familia con mayor diversidad fue Phyllostomidae con cinco especies. La especie con mayor frecuencia de captura fue Artibeusjamaicensis (41, 59.4%). Las PCR arrojaron una frecuencia global de infección de 21.7%. Las especies infectadas fueron A. jamaicensis, Pteronotus parnellii y Chiroderma villosum. El análisis bioinformático arrojó un 99.0% de identidad para Leptospira noguchii, Leptospira borgpetersenii y Leptospira santarosai. Conclusiones. Algunas especies de murciélagos de Yucatán y Campeche son portadores renales de leptospiras patógenas, por lo que podrían participar en el ciclo silvestre de transmisión en la región. La frecuencia de infección encontrada en los riñones de los murciélagos utilizados es mayor en comparación con aquellas obtenidas en otros reservorios de Yucatán y Campeche. Nuevas especies de murciélagos son reportadas como portadores de Leptospira para México.

ABSTRACT Objective. To report the infection with Leptospira in the kidneys of bats from Campeche and Yucatán, Mexico, through the amplification by PCR of two different 16S RNA ribosomal gene fragments. Materials and methods. Bat captures were carried out at one site in Campeche and two sites in Yucatán. Euthanasia was applied to the captured bats and a necropsy was performed to collect a renal tissue sample that was used in the total DNA extraction. Two different conventional PCR were performed for the amplification of the 16S RNA ribosomal gene fragments. Some sequences from positive products were obtained and analyzed with bioinformatics tools to identify the infectious species of Leptospira. Results. Sixty-nine bats belonging to four families and eight different species were captured. The family with the greatest diversity was Phyllostomidae with five species. The most captured species was Artibeus jamaicensis (41, 59.4%). Both PCR showed a global infection frequency of 21.7%. The infected species were A. jamaicensis, Pteronotus parnellii, and Chiroderma villosum. The bioinformatic analysis of the positive products yielded a 99.0% identity for Leptospira noguchii, Leptospira borgpetersenii, and Leptospira santarosai. Conclusions. Some bat species of Yucatán and Campeche, Mexico, are renal carriers of pathogenic Leptospira, therefore participating in the transmission cycle in the region. The frequency of infection found in the renal tissue of the captured bats is higher than the one obtained from other reservoirs captured in Yucatán and Campeche. New species of bats are reported as renal Leptospira carriers in Mexico.

Arteria renal doble en Cerdocyon thous / Double Renal Artery in Cerdocyon thous

RESUMEN Objetivo. El propósito de este estudio fue explorar la duplicidad de la arteria renal en un espécimen de Cerdocyon thous, centrándose en las posibilidades de la implicación clínico-quirúrgica de esta variación anatómica. Materiales y Métodos. Fueron disecados 32 especímenes de Cerdocyon thous, obtenidos de las colecciones del Laboratorio de Enseñanza e Investigación en Morfología de los Animales Domésticos y Salvajes del Departamento de Anatomía Animal y Humana, de la Universidad Federal Rural del Rio de Janeiro y del Laboratorio de Anatomía Animal de la Universidad Federal del Pampa. Resultados. Fue observada una variación numérica en la arteria renal izquierda en un cadáver hembra adulto. El riñón izquierdo tenía dos arterias renales, una craneal y otra caudal. La primera arteria renal del riñón izquierdo, midiendo 2,25 cm de longitud, se ha originado lateralmente desde la aorta abdominal a nivel de la tercera vértebra lumbar. Además, emanaba dos ramas prehiliares, una dorsal y otra ventral, con la rama ventral suministrando también a la glándula suprarrenal. La segunda arteria renal también se ha originado lateralmente desde la aorta abdominal a nivel de la tercera vértebra lumbar, midiendo 2,36 cm de longitud. También ha emitido dos ramas prehiliares, una craneal y otra caudal, las cuales emitieron la rama uretral. Conclusiones. Las variaciones numéricas de las arterias renales deben ser consideradas en la ejecución de procedimientos quirúrgicos, radiológicos y experimentales, con los fines de evitar errores ocasionados por la falta de conocimiento de la posibilidad de estas variaciones tanto en animales domésticos como salvajes.

ABSTRACT Objective. The aim of this study was explored the duplicity of renal artery in a specimen of Cerdocyon thous, focusing on the possibilities of clinical-surgical implication of this anatomical variation. Materials and methods. Were dissected 32 specimens of Cerdocyon thous, obtained from the collections of the Laboratório de Ensino e Pesquisa em Morfologia dos Animais Domésticos e Selvagens do Departamento de Anatomia Animal e Humana, da Universidade Federal Rural do Rio de Janeiro e Laboratório de Anatomia Animal da Universidade Federal do Pampa. Results. Were observed a numerical variation in the left renal artery in an adult female cadaver. The left kidney had two renal arteries, one cranial and another caudal. The first renal artery of the left kidney, measuring 2.25 cm in length, originated laterally from the abdominal aorta at the level of the third lumbar vertebra. Moreover, it emanated two pre-hilar branches, one dorsal and one ventral, with the ventral branch supplying also to the adrenal gland. The second renal artery also originated laterally from the abdominal aorta at the level of the third lumbar vertebra and measured 2.36 cm in length. It also emitted two pre-hilar branches, one cranial and another caudal, which emitted the ureteral branch. Conclusions. Numerical variations of the renal arteries should be considered in the execution of surgical, radiological and experimental procedures in order to avoid mistakes made due to lack of knowledge of the possibility these variations both in domestic and wild animals.

Vigilancia epidemiológica del virus Occidental del Nilo en las llanuras orientales de Colombia / Epidemiological surveillance of West Nile virus in the Eastern Plains of Colombia

RESUMEN Objetivo. Identificar la presencia del virus del Oeste del Nilo en equinos y mosquitos en ocho municipios del departamento del Meta. Materiales y métodos. La investigación contó con el aval del Comité de bioética de la Universidad de los Llanos. Se analizaron mediante pruebas serológicas y moleculares 613 muestras de equinos criollos y de raza cuarto de milla, destinados a actividades deportivas y de trabajo, con un rango de edad de 2 a 15 años, en los transectos: Villavicencio-Restrepo-Cumaral, San Martín - Castilla la Nueva-Granada y Puerto López-Puerto Gaitán, analizados en 62 pool y 213 mosquitos. Los pool de sueros de equinos y mosquitos fueron analizados por ELISA y PCR. Resultados. No se encontraron animales seropositivos mediante la prueba de ELISA y las pruebas moleculares también fueron negativas. Conclusiones. Aunque en este estudio no se evidenció la presencia de anticuerpos IgM por la técnica de Elisa y las pruebas moleculares (RT-PCR) también fueron negativas para circulación viral, en los municipios objeto de estudio, es importante indicar que la detección molecular en sueros, requiere unos niveles de viremia representativos y que el animal se encuentre en la fase aguda de la enfermedad. Aunque es posible que la población equina se mantenga libre de contacto con el virus, se debe mantener la vigilancia epidemiológica frente a este importante patógeno para la salud humana, especialmente por la presentación de brotes de otros virus zoonóticos como la Encefalitis Equina del Este y Encefalitis Equina Venezolana en los departamentos del Meta y Casanare, contiguo a este.

ABSTRACT Objective. Identify the presence of West Nile virus in horses and mosquitoes in eight municipalities of the department of Meta. Materials and methods. The research was supported by the Bioethics Committee of the University of Los Llanos. 613 samples of Creole and quarter-mile equine horses, intended for sports and work activities, with an age range of 2 to 15 years, were analyzed using serological and molecular tests in the transects: Villavicencio-Restrepo-Cumaral, San Martín- Castilla la Nueva-Granada and Puerto López-Puerto Gaitán, analyzed in 62 pools and 213 mosquitoes. The pool of sera of horses and mosquitoes were analyzed by ELISA and PCR. Results. No seropositive animals were found by the ELISA test and molecular tests were also negative. Conclusions. Although in this study the presence of IgM antibodies was not evidenced by the Elisa technique, and molecular tests (RT-PCR) were also negative for viral circulation, in the municipalities under study, it is important to indicate that the molecular detection in sera, it requires representative levels of viremia and that the animal is in the acute phase of the disease. Although it is possible that the equine population remains free of contact with the virus, epidemiological surveillance should be maintained against this important pathogen for human health, especially due to the outbreak of other zoonotic viruses such as Eastern Equine Encephalitis and Encephalitis Venezuelan Equine in the departments of Meta and Casanare, adjacent to this.