In vitro Acaricidal Activity of Serratia Ureilytica Against the Dust Mite Tyrophagus Putrescentiae and Identification of Genes Related to Biocontrol.

The present study evaluated the acaricidal activity of three Serratia strains isolated from Mimosa pudica nodules in the Lancandon zone Chiapas, Mexico. The analysis of the genomes based on the Average Nucleotide Identity, the phylogenetic relationships allows the isolates to be placed in the Serria ureilytica clade. The size of the genomes of the three strains is 5.4 Mb, with a GC content of 59%. The Serratia UTS2 strain presented the highest mortality with 61.41% against Tyrophagus putrescentiae followed by the Serratia UTS4 strain with 52.66% and Serratia UTS3 with 47.69% at 72 h at a concentration of 1X109 cell/mL. In the bioinformatic analysis of the genomes, genes related to the synthesis of chitinases, proteases and cellulases were identified, which have been reported for the biocontrol of mites. It is the first report of S. ureilytica with acaricidal activity, which may be an alternative for the biocontrol of stored products with high fat and protein content.

Using Principles of Digital Development for a Smartphone App to Support Data Collection in Patients With Acute Myocardial Infarction and Physical Activity Intolerance: Case Study.

BACKGROUND: Advances in health have highlighted the need to implement technologies as a fundamental part of the diagnosis, treatment, and recovery of patients at risk of or with health alterations. For this purpose, digital platforms have demonstrated their applicability in the identification of care needs. Nursing is a fundamental component in the care of patients with cardiovascular disorders and plays a crucial role in diagnosing human responses to these health conditions. Consequently, the validation of nursing diagnoses through ongoing research processes has become a necessity that can significantly impact both patients and health care professionals. OBJECTIVE: We aimed to describe the process of developing a mobile app to validate the nursing diagnosis "intolerance to physical activity" in patients with acute myocardial infarction. METHODS: We describe the development and pilot-testing of a mobile system to support data collection for validating the nursing diagnosis of activity intolerance. This was a descriptive study conducted with 11 adults (aged ≥18 years) who attended a health institution for highly complex needs with a suspected diagnosis of coronary syndrome between August and September 2019 in Floridablanca, Colombia. An app for the clinical validation of activity intolerance (North American Nursing Diagnosis Association [NANDA] code 00092) in patients with acute coronary syndrome was developed in two steps: (1) operationalization of the nursing diagnosis and (2) the app development process, which included an evaluation of the initial requirements, development and digitization of the forms, and a pilot test. The agreement level between the 2 evaluating nurses was evaluated with the κ index. RESULTS: We developed a form that included sociodemographic data, hospital admission data, medical history, current pharmacological treatment, and thrombolysis in myocardial infarction risk score (TIMI-RS) and GRACE (Global Registry of Acute Coronary Events) scores. To identify the defining characteristics, we included official guidelines, physiological measurements, and scales such as the Piper fatigue scale and Borg scale. Participants in the pilot test (n=11) had an average age of 63.2 (SD 4.0) years and were 82% (9/11) men; 18% (2/11) had incomplete primary schooling. The agreement between the evaluators was approximately 80% for most of the defining characteristics. The most prevalent characteristics were exercise discomfort (10/11, 91%), weakness (7/11, 64%), dyspnea (3/11, 27%), abnormal heart rate in response to exercise (2/10, 20%), electrocardiogram abnormalities (1/10, 9%), and abnormal blood pressure in response to activity (1/10, 10%). CONCLUSIONS: We developed a mobile app for validating the diagnosis of "activity intolerance." Its use will guarantee not only optimal data collection, minimizing errors to perform validation, but will also allow the identification of individual care needs.

Prevalent role of homologous recombination in the repair of specific double-strand breaks in Rhizobium etli.

Double-strand breaks (DSBs) are the most dangerous injuries for a genome. When unrepaired, death quickly ensues. In most bacterial systems, DSBs are repaired through homologous recombination. Nearly one-quarter of bacterial species harbor a second system, allowing direct ligation of broken ends, known as Non-Homologous End Joining (NHEJ). The relative role of both systems in DSBs repair in bacteria has been explored only in a few cases. To evaluate this in the bacterium Rhizobium etli, we used a modified version of the symbiotic plasmid (264 kb), containing a single copy of the nifH gene. In this plasmid, we inserted an integrative plasmid harboring a modified nifH gene fragment containing an I-SceI site. DSBs were easily inflicted in vivo by conjugating a small, replicative plasmid that expresses the I-SceI nuclease into the appropriate strains. Repair of a DSB may be achieved through homologous recombination (either between adjacent or distant repeats) or NHEJ. Characterization of the derivatives that repaired DSB in different configurations, revealed that in most cases (74%), homologous recombination was the prevalent mechanism responsible for repair, with a relatively minor contribution of NHEJ (23%). Inactivation of the I-SceI gene was detected in 3% of the cases. Sequence analysis of repaired derivatives showed the operation of NHEJ. To enhance the number of derivatives repaired through NHEJ, we repeated these experiments in a recA mutant background. Derivatives showing NHEJ were readily obtained when the DSB occurred on a small, artificial plasmid in a recA mutant. However, attempts to deliver a DSB on the symbiotic plasmid in a recA background failed, due to the accumulation of mutations that inactivated the I-SceI gene. This result, coupled with the absence of derivatives that lost the nonessential symbiotic plasmid, may be due to an unusual stability of the symbiotic plasmid, possibly caused by the presence of multiple toxin-antitoxin modules.

Improving motor imagery through a mirror box for BCI users.

The aim of this study was to evaluate mirror visual feedback (MVF) as a training tool for brain-computer interface (BCI) users. This is because approximately 20-30% of subjects require more training to operate a BCI system using motor imagery. Electroencephalograms (EEGs) were recorded from 18 healthy subjects, using event-related desynchronization (ERD) to observe the responses during the movement or movement intention of the hand for the conditions of control, imagination, and the MVF with the mirror box. We constituted two groups: group 1: control, imagination, and MVF; group 2: control, MVF, and imagination. There were significant differences in imagination conditions between groups using MVF before or after imagination (right-hand, P = 0.0403; left-hand, P = 0.00939). The illusion of movement through MVF is not possible in all subjects, but even in those cases, we found an increase in imagination when the subject used the MVF previously. The increase in the r2s of imagination in the right and left hands suggests cross-learning. The increase in motor imagery recorded with EEG after MVF suggests that the mirror box made it easier to imagine movements. Our results provide evidence that the MVF could be used as a training tool to improve motor imagery.NEW & NOTEWORTHY The increase in motor imagery recorded with EEG after MVF (mirror visual feedback) suggests that the mirror box made it easier to imagine movements. Our results demonstrate that MVF could be used as a training tool to improve motor imagery.

Infections in the first year after heart transplantation in a Latin American country.

BACKGROUND: Heart transplantation is the therapy of choice in patients with advanced heart failure refractory to other medical or surgical management. However, heart transplants are associated with complications that increase posttransplant morbidity and mortality. Infections are one of the most important complications after this procedure. Therefore, infections in the first year after heart transplantation were evaluated. METHODS: A retrospective cohort study of infections after heart transplants was conducted in a teaching hospital in Colombia between 2011 and 2019. Patients registered in the institutional heart transplant database (RETRAC) were included in the study. Microbiological isolates and infectious serological data were matched with the identities of heart transplant recipients and data from clinical records of individuals registered in the RETRAC were analyzed. The cumulative incidences of events according to the type of microorganism isolated were estimated using Kaplan-Meier survival analyses. RESULTS: Seventy-nine patients were included in the study. Median age was 49 years (37.4-56.3), and 26.58% of patients were women. Eighty-seven infections were documented, of which 55.17% (48) were bacterial, 22.99% (20) were viral, and 12.64% (11) were fungal. Bacterial infections predominated in the first month. In the first year, infections caused 38.96% of hospital admissions and were the second cause of death after heart transplants (25.0%). CONCLUSION: Posttransplant infections in the first year of follow-up were frequent. Bacterial infections predominated in the early posttransplant period. Infections, mainly bacterial, were the second most common cause of death and the most common cause of hospitalization in the first year after heart transplantation.

Psychometric properties of the needs scale for families of adults with intellectual disabilities, Colombian version.

Aim: Assess the psychometric properties of reliability and validity of the Family Needs Assessment (FNA) questionnaire designed for adults in Colombia. Conducting research studies to validate the FNA questionnaire in other contexts and age groups is important. Methods: Five hundred fifty-four caregivers of adults with intellectual disabilities participated in the study (298 men and 256 women). The ages of the individuals with disabilities ranged from 18 to 76 years. The authors carried out the linguistic adaptation of the items and cognitive interviews to identify if the items evaluated what was intended. A pilot test with 20 participants was also conducted. An initial confirmatory factor analysis was carried out. Given that, this analysis did not show a good adjustment of the theoretical model initially proposed, an exploratory factor analysis was carried out to elucidate the most appropriate structure for the Colombian population.. Results: The factor analysis found five factors, each with a high ordinal alpha (Caregiving and family interaction, social interaction and future planning, Economy, and recreation, independent living skills or autonomy, and Services related to disability). Of the 76 items, 59 were preserved, which had a factorial load greater than 0.40; and 17 were left out because they did not meet this requirement.. Conclusion: Future research considers corroborating the five factors found and establishing their clinical applications. Concerning the concurrent validity, the families perceive that high need for social interaction and future planning and little support for the person with an intellectual disability.

Objetivo: Evaluar las propiedades psicométricas de confiabilidad y validez del cuestionario FNA versión adultos en Colombia. Se justifica realizar investigaciones que validen el cuestionario FNA (Family Needs Assessment) en otros contextos y grupos etarios. Métodos: Participaron 554 cuidadores de adultos con discapacidad intelectual (madres, padres o cuidadores). La edad de la persona con discapacidad osciló entre 18-76 años, 298 hombres y 256 mujeres. Se realizó la adaptación lingüística de los ítems, entrevistas cognitivas para identificar si los ítems evaluaban lo que se pretendía, y una prueba piloto a 20 participantes. Se llevó a cabo el análisis factorial confirmatorio, dado que éste no evidenció un buen ajuste del modelo teórico inicialmente propuesto, se realizó un análisis factorial exploratorio para dilucidar la estructura propia para Colombia. Resultados: El análisis factorial encontró cinco factores cada uno con un alfa ordinal alto (Cuidado e interacción familiar, Interacción social y planeación de futuro, Economía y recreación, habilidades de vida independiente y autonomía y Servicios relacionados con la discapacidad). De los 76 ítems se conservaron 59, aquellos que tuvieron una carga factorial superior a 0.40; y se eliminaron 17 debido a que no cumplieron este requis. Conclusión: En el campo investigativo, los cinco factores encontrados se deben corroborar en estudios posteriores, así como, establecer sus aplicaciones clínicas. En cuanto a la validez concurrente, las familias perciben que alta necesidad en Interacción social y planeación del futuro y poco apoyo a la persona con discapacidad intelectual en este aspecto.

Coexistence of Thyrolipomatosis and Tongue Squamous Cell Carcinoma: A Case Report.

Thyrolipomatosis, a diffuse non-neoplastic infiltration of fatty tissue in the thyroid gland, is an extremely rare condition with only about 30 cases reported worldwide. A few of these cases report the concurrency of thyrolipomatosis and malignant neoplasms in the thyroid or colon, but never with tongue cancer. A 44-year-old female patient with an infiltrative tongue mass suggestive of carcinoma presented for an outpatient consultation. Cervical imaging revealed multiple lymphadenopathies and a multinodular goitre with diffuse fatty infiltration, suggestive of thyrolipomatosis. Surgical intervention included partial resection of the tongue and thyroid (left hemiglossectomy and right hemithyroidectomy, respectively) and lymphadenectomy. The thyroid specimen showed diffuse fat metaplasia of the stromal thyroid tissue, confirming incidental thyrolipomatosis. During post-operative follow-up, the patient presented with recurrence of squamous cell carcinoma as indicated by new right-sided thyroid nodules, left-sided lymphadenopathies with confirmatory biopsy, and a growing neck mass that became infected. The patient developed septic shock and later died. Thyrolipomatosis causes thyroid swelling and can be clinically detected as goitres or as an incidental finding. Diagnosis is suggested by cervical imaging (ultrasonography, computed tomography or magnetic resonance), but confirmation is histological after thyroidectomy. Although thyrolipomatosis is benign, it could develop concurrently with neoplastic diseases, especially on embryologically related tissues (e.g. thyroid and tongue). This case report is the first in the literature describing the coexistence between thyrolipomatosis and tongue cancer in an adult Peruvian patient.

New Evidence on BPA's Role in Adipose Tissue Development of Proinflammatory Processes and Its Relationship with Obesity.

Bisphenol A (BPA) is a xenobiotic with endocrine disruptor properties which interacts with various receptors, eliciting a cellular response. In the plastic industry, BPA is widely used in the production of polycarbonate and epoxy-phenolic resins to provide elastic properties. It can be found in the lining of canned foods, certain plastic containers, thermal printing papers, composite dental fillings, and medical devices, among other things. Therefore, it is a compound that, directly or indirectly, is in daily contact with the human organism. BPA is postulated to be a factor responsible for the global epidemic of obesity and non-communicable chronic diseases, belonging to the obesogenic and diabetogenic group of compounds. Hence, this endocrine disruptor may be responsible for the development of metabolic disorders, promoting in fat cells an increase in proinflammatory pathways and upregulating the expression and release of certain cytokines, such as IL6, IL1ß, and TNFα. These, in turn, at a systemic and local level, are associated with a chronic low-grade inflammatory state, which allows the perpetuation of the typical physiological complications of obesity.

MIDO GDM: an innovative artificial intelligence-based prediction model for the development of gestational diabetes in Mexican women.

Given the barriers to early detection of gestational diabetes mellitus (GDM), this study aimed to develop an artificial intelligence (AI)-based prediction model for GDM in pregnant Mexican women. Data were retrieved from 1709 pregnant women who participated in the multicenter prospective cohort study 'Cuido mi embarazo'. A machine-learning-driven method was used to select the best predictive variables for GDM risk: age, family history of type 2 diabetes, previous diagnosis of hypertension, pregestational body mass index, gestational week, parity, birth weight of last child, and random capillary glucose. An artificial neural network approach was then used to build the model, which achieved a high level of accuracy (70.3%) and sensitivity (83.3%) for identifying women at high risk of developing GDM. This AI-based model will be applied throughout Mexico to improve the timing and quality of GDM interventions. Given the ease of obtaining the model variables, this model is expected to be clinically strategic, allowing prioritization of preventative treatment and promising a paradigm shift in prevention and primary healthcare during pregnancy. This AI model uses variables that are easily collected to identify pregnant women at risk of developing GDM with a high level of accuracy and precision.

Psychometric properties of the needs scale for families of adults with intellectual disabilities, Colombian version

Aim: Assess the psychometric properties of reliability and validity of the Family Needs Assessment (FNA) questionnaire designed for adults in Colombia. Conducting research studies to validate the FNA questionnaire in other contexts and age groups is important. Methods: Five hundred fifty-four caregivers of adults with intellectual disabilities participated in the study (298 men and 256 women). The ages of the individuals with disabilities ranged from 18 to 76 years. The authors carried out the linguistic adaptation of the items and cognitive interviews to identify if the items evaluated what was intended. A pilot test with 20 participants was also conducted. An initial confirmatory factor analysis was carried out. Given that, this analysis did not show a good adjustment of the theoretical model initially proposed, an exploratory factor analysis was carried out to elucidate the most appropriate structure for the Colombian population.. Results: The factor analysis found five factors, each with a high ordinal alpha (Caregiving and family interaction, social interaction and future planning, Economy, and recreation, independent living skills or autonomy, and Services related to disability). Of the 76 items, 59 were preserved, which had a factorial load greater than 0.40; and 17 were left out because they did not meet this requirement.. Conclusion: Future research considers corroborating the five factors found and establishing their clinical applications. Concerning the concurrent validity, the families perceive that high need for social interaction and future planning and little support for the person with an intellectual disability.

Objetivo: Evaluar las propiedades psicométricas de confiabilidad y validez del cuestionario FNA versión adultos en Colombia. Se justifica realizar investigaciones que validen el cuestionario FNA (Family Needs Assessment) en otros contextos y grupos etarios. Métodos: Participaron 554 cuidadores de adultos con discapacidad intelectual (madres, padres o cuidadores). La edad de la persona con discapacidad osciló entre 18-76 años, 298 hombres y 256 mujeres. Se realizó la adaptación lingüística de los ítems, entrevistas cognitivas para identificar si los ítems evaluaban lo que se pretendía, y una prueba piloto a 20 participantes. Se llevó a cabo el análisis factorial confirmatorio, dado que éste no evidenció un buen ajuste del modelo teórico inicialmente propuesto, se realizó un análisis factorial exploratorio para dilucidar la estructura propia para Colombia. Resultados: El análisis factorial encontró cinco factores cada uno con un alfa ordinal alto (Cuidado e interacción familiar, Interacción social y planeación de futuro, Economía y recreación, habilidades de vida independiente y autonomía y Servicios relacionados con la discapacidad). De los 76 ítems se conservaron 59, aquellos que tuvieron una carga factorial superior a 0.40; y se eliminaron 17 debido a que no cumplieron este requis. Conclusión: En el campo investigativo, los cinco factores encontrados se deben corroborar en estudios posteriores, así como, establecer sus aplicaciones clínicas. En cuanto a la validez concurrente, las familias perciben que alta necesidad en Interacción social y planeación del futuro y poco apoyo a la persona con discapacidad intelectual en este aspecto.

'It is in our hands-Why wait until you are sick?': Perceptions about diabetes prevention of Latina mothers in Mexico and the United States.

AIMS: This study aimed to understand the perceptions driving type 2 diabetes mellitus prevention and management behaviours of Mexican and Latina mothers in Mexico and the United States. METHODS: Low-income Mexican mothers in San Luis Potosí, Mexico and Latina mothers in Illinois, United States, were recruited by the Holistic Obesity Prevention Study (HOPS). Verbatim transcripts of the semistructured interviews conducted in Spanish (n = 24) and English (n = 1) were analysed using the Health Belief Model (HBM) framework. RESULTS: Of the 25 participants, 22 (88%) indicated 'knowing someone with diabetes'-specifically a father (n = 8), mother (n = 6) or grandparent (n = 7). Using the HBM, themes showed that mothers perceived: that Type 2 diabetes can happen to anyone, are attributable to genetic predisposition and may be driven by strong emotions (perceived susceptibility). Type 2 diabetes introduces severe comorbidities and emotional difficulties for people and their families (perceived severity). Adopting a healthier diet, exercising and staying in good spirits were recognized as benefits of Type 2 diabetes prevention (perceived benefits). The costs of food, challenges of exercising, dieting, modifying habits and time limitations were recognized as perceived costs. Cues to action included doctors' recommendations (external) and fear (internal). Mothers acknowledged they could live a healthy life by controlling their weight, exercising, adhering to treatments/medications and having the determination to carry-on (self-efficacy). CONCLUSIONS: Mothers sought to prevent Type 2 diabetes and live healthy lives, particularly, after receiving a diagnosis of gestational diabetes or when learning about their children's risks for Type 2 diabetes but perceived significant barriers to Type 2 diabetes prevention.

Improving Lurasidone Hydrochloride's Solubility and Stability by Higher-Order Complex Formation with Hydroxypropyl-ß-cyclodextrin.

The biopharmaceutical classification system groups low-solubility drugs into two groups: II and IV, with high and low permeability, respectively. Most of the new drugs developed for common pathologies present solubility issues. This is the case of lurasidone hydrochloride-a drug used for the treatment of schizophrenia and bipolar depression. Likewise, the stability problems of some drugs limit the possibility of preparing them in liquid pharmaceutical forms where hydrolysis and oxidation reactions can be favored. Lurasidone hydrochloride presents the isoindole-1,3-dione ring, which is highly susceptible to alkaline hydrolysis, and the benzisothiazole ring, which is susceptible to a lesser extent to oxidation. Herein, we propose to study the increase in the solubility and stability of lurasidone hydrochloride by the formation of higher-order inclusion complexes with hydroxypropyl-ß-cyclodextrin. Several stoichiometric relationships were studied at between 0.5 and 3 hydroxypropyl-ß-cyclodextrin molecules per drug molecule. The obtained products were characterized, and their solubility and stability were assessed. According to the obtained results, the formation of inclusion complexes dramatically increased the solubility of the drug, and this increased with the increase in the inclusion ratio. This was associated with the loss of crystalline state of the drug, which was in an amorphous state according to infrared spectroscopy, calorimetry, and X-ray analysis. This was also correlated with the stabilization of lurasidone by the cyclodextrin inhibiting its recrystallization. Phase solubility,1H-NMR, and docking computational characterization suggested that the main stoichiometric ratio was 1:1; however, we cannot rule out a 1:2 ratio, where a second cyclodextrin molecule could bind through the isoindole-1,3-dione ring, improving its stability as well. Finally, we can conclude that the formation of higher-order inclusion complexes of lurasidone with hydroxypropyl-ß-cyclodextrin is a successful strategy to increase the solubility and stability of the drug.

Utilidad de la midodrina para controlar el síncope vasovagal: ¿la recomienda la evidencia? / Usefulness of Midodrine for the Control of Recurrent Vasovagal Syncope: Does the Evidence Recommend it? / Utilidade da midodrina no controle da síncope vasovagal: as evidencias a recomendam?

Introducción:El síncope vasovagal es la principal causa de pérdida transitoria de la conciencia, y es un motivo de consulta cada vez más frecuente en pediatría y medicina del adulto. La midodrina es un agonista de los recepto-res alfa, de acción periférica, empleada principalmente en el manejo de la hipotensión ortostática; sin embargo, también se ha evaluado en el síncope vasovagal, con resultados prometedores.Objetivo:Analizar la evidencia más reciente sobre la utilidad de la midodrina para el control y la prevención del síncope vasovagal.Materiales y métodos: Se realizó una búsqueda bibliográfica utilizando términos de búsqueda como Vasovagal Syncope y Midodrine, así como sinónimos, que se combinaron con operadores booleanos, en cinco bases de datos, hasta octubre del 2022. Se incluyeron estudios originales, revisiones sistemáticas y metanálisis, publicados tanto en inglés como en español.Resultados:Ensayos controlados aleatorizados y revisiones sistemáticas y metanálisis difieren ligeramente entre resultados, pero estos demuestran un efecto global protector. La evidencia más reciente y completa indica que utilizar este agente reduce significativamente la positividad al realizar la prueba de la mesa inclinada y que previene la aparición de episodios sincopales.Conclusiones:Aunque la evidencia actual sobre la eficacia de la midodrina respecto a la prevención y control del síncope vasovagal es limitada, se observa un efecto protector significativo, porque disminuye el riesgo de sufrir un episodio sincopal, aproximadamente hasta en un 50 %.Palabras clave: midodrina; síncope vasovagal; síncope; adrenérgicos; medicina basada en la evidencia

Introduction: Vasovagal syncope is the main cause of transient loss of consciousness, being an in-creasingly frequent reason for consultation in pediatrics and adult medicine. Midodrine, a periphe-rally acting alpha-receptor agonist, is mainly used in the management of orthostatic hypotension. However, it has also been evaluated in vasovagal syncope, with promising results. Objective: To analyze the most recent evidence on the usefulness of midodrine for the control and prevention of vasovagal syncope. Materials and Methods: A literature search was performed using search terms such as "Vasovagal Syncope" and "Midodrine," as well as synonyms, which were combined with Boolean operators, in 5 databases until October 2022. Original studies, systematic reviews and meta-analyses, published in both English and Spanish, were included. Results: Randomized controlled trials and systematic reviews and meta-analyses differ slightly between results, but these demonstrate an overall protective effect. The most recent and complete evidence shows that using this agent significantly reduces the probability of positivity when performing the tilt table test and prevents the occurrence of syncopal episodes. Conclusions: Although current evidence on the efficacy of midodrine with respect to the prevention and control of vasovagal syncope is limited, a significant protective effect is observed, reducing the risk of suffering syncopal episode by approximately up to 50%

Introdução: a síncope vasovagal é a principal causa de perda transitória de consciência e é um motivo cada vez mais comum de consulta em pediatria e medicina de adultos. A midodrina é um agonista do receptor alfa de ação periférica usado principalmente no tratamento da hipotensão ortostática; no entanto, ela também foi avaliada na síncope vasovagal, com resultados promissores. Objetivo: Revisar as evidências mais recentes sobre a utilidade da midodrina para o controle e a pre-venção da síncope vasovagal. Materiais e métodos: Foi realizada uma pesquisa na literatura usando termos de pesquisa como Va-sovagal, Syncope e Medodrine, bem como sinônimos, que foram combinados com operadores boo-leanos, em cinco bancos de dados, até outubro de 2022. Foram incluídos estudos originais, revisões sistemáticas e metanálises, publicados em inglês e espanhol. Resultados: Os ensaios clínicos randomizados, as revisões sistemáticas e as metanálises diferem ligei-ramente entre os resultados, mas demonstram um efeito protetor geral. As evidências mais recentes e abrangentes indicam que o uso desse agente reduz significativamente a positividade no teste de inclinação da mesa e evita a ocorrência de episódios de síncope. Conclusões: Embora as evidências atuais sobre a eficácia da midodrina em relação à prevenção e ao controle da síncope vasovagal sejam limitadas, observa-se um efeito protetor significativo, pois ela diminui o risco de sofrer um episódio sincopal em aproximadamente 50%

Diagnostic Accuracy of Capillary Blood Glucometer Testing for Gestational Diabetes.

Purpose: Few pregnant women in low-resource settings are screened for gestational diabetes mellitus (GDM) using the gold standard oral glucose tolerance test (OGTT). This study compared capillary blood glucose testing with 2-h plasma glucose measurements obtained using the 75-g OGTT to screen for GDM at primary healthcare clinics in Mexico. Patients and Methods: Pregnant women who participated in a previous prospective multicenter longitudinal cohort study and who had not been previously diagnosed with diabetes were included. Participants were evaluated using the plasmatic 2-h 75-g OGTT with simultaneous capillary blood glucose measurements using a glucometer. The study endpoint was the comparability of the glucometer results to the gold standard OGTT when collected simultaneously. Sensitivity, specificity, and area under the curve of the glucose measurements obtained for capillary blood compared with venous plasma (gold standard) were calculated to determine diagnostic accuracy. Results: The study included 947 pregnant women who had simultaneous glucose measurements available (blood capillary [glucometer] and venous blood OGTT). Overall, capillary blood glucose testing was very sensitive (89.47%); the specificity was 66.58% and the area under the curve (95% confidence interval) was 0.78 (0.74-0.81). The sensitivity, specificity and area under the curve of each capillary measurement were: 89.47%, 66.58% and 0.78 (0.74-0.82) for the fasting measurement, 91.53%, 93.24% and 0.92 (0.88-0.96) for the one-hour measurement, and 89.80%, 93.32%, 0.91 (0.87-0.95) for the second-hour measurement, respectively. No adverse events were reported. Conclusion: Capillary OGTT is a valid alternative to the gold standard OGTT for screening of GDM in low-resource situations or in situations where there are other limitations to performing the OGTT as part of primary healthcare services.

Nematicidal, Acaricidal and Plant Growth-Promoting Activity of Enterobacter Endophytic Strains and Identification of Genes Associated with These Biological Activities in the Genomes.

In the present study, the nematicidal and acaricidal activity of three Enterobacter endophytic strains isolated from Mimosa pudica nodules was evaluated. The percentages of mortality of Enterobacter NOD4 against Panagrellus redivivus was 81.2%, and against Nacobbus aberrans 70.1%, Enterobacter NOD8 72.4% and 62.5%, and Enterobacter NOD10 64.8% and 58.7%, respectively. While against the Tyrophagus putrescentiae mite, the mortality percentages were 68.2% due to Enterobacter NOD4, 64.3% due to Enterobacter NOD8 and 77.8% due to Enterobacter NOD10. On the other hand, the ability of the three Enterobacter strains to produce indole acetic acid and phosphate solubilization, characteristics related to plant growth-promoting bacteria, was detected. Bioinformatic analysis of the genomes showed the presence of genes related to IAA production, phosphate solubilization, and nitrogen fixation. Phylogenetic analyzes of the recA gene, phylogenomics, and average nucleotide identity (ANI) allowed us to identify the strain Enterobacter NOD8 related to E. mori and Enterobacter NOD10 as E. asburiae, while Enterobacter NOD4 was identified as a possible new species of this species. The plant growth-promoting, acaricidal and nematicidal activity of the three Enterobacter strains makes them a potential agent to include in biocontrol alternatives and as growth-promoting bacteria in crops of agricultural interest.

Particulate matter (PM10) induces in vitro activation of human neutrophils, and lung histopathological alterations in a mouse model.

The epidemiological association between exposure to particulate matter (PM10) and various respiratory and cardiovascular problems is well known, but the mechanisms driving these effects remain unclear. Neutrophils play an essential role in immune defense against foreign agents and also participate in the development of inflammatory responses. However, the role of these cells in the PM10 induced inflammatory response is not yet fully established. Thus, this study aims to evaluate the effect of PM10 on the neutrophil-mediated inflammatory response. For this, neutrophils from healthy adult human donors were in vitro exposed to different concentrations of PM10. The cell viability and cytotoxic activity were evaluated by MTT. LDH, propidium iodide and reactive oxygen species (ROS) were quantified by flow cytometry. Interleukin 8 (IL-8) expression, peptidyl arginine deiminase 4 (PAD4), myeloperoxidase (MPO), and neutrophil elastase (NE) expression were measured by RT-PCR. IL-8 was also quantified by ELISA. Fluorescence microscopy was used to evaluate neutrophil extracellular traps (NETs) release. The in vivo inflammatory responses were assessed in BALB/c mice exposed to PM10 by histopathology and RT-PCR. The analysis shows that PM10 exposure induced a cytotoxic effect on neutrophils, evidenced by necrosis and LDH release at high PM10 concentrations. ROS production, IL-8, MPO, NE expression, and NETs release were increased at all PM10 concentrations assessed. Neutrophil infiltration in bronchoalveolar lavage fluid (BALF), histopathological changes with inflammatory cell infiltration, and CXCL1 expression were observed in PM10-treated mice. The results suggest that lung inflammation in response to PM10 could be mediated by neutrophils activation. In this case, these cells migrate to the lungs and release pro-inflamatory mediators, including ROS, IL-8, and NETs. Thus, contributing to the exacerbation of respiratory pathologies, such as allergies, infectious and obstructive diseases.

Specialized Proresolving Lipid Mediators: A Potential Therapeutic Target for Atherosclerosis.

Cardiovascular disease (CVD) is a global public health issue due to its high morbidity, mortality, and economic impact. The implementation of innovative therapeutic alternatives for CVD is urgently required. Specialized proresolving lipid mediators (SPMs) are bioactive compounds derived from ω-3 and ω-6 fatty acids, integrated into four families: Lipoxins, Resolvins, Protectins, and Maresins. SPMs have generated interest in recent years due to their ability to promote the resolution of inflammation associated with the pathogeneses of numerous illnesses, particularly CVD. Several preclinical studies in animal models have evidenced their ability to decrease the progression of atherosclerosis, intimal hyperplasia, and reperfusion injury via diverse mechanisms. Large-scale clinical trials are required to determine the effects of SPMs in humans. This review integrates the currently available knowledge of the therapeutic impact of SPMs in CVD from preclinical and clinical studies, along with the implicated molecular pathways. In vitro results have been promising, and as such, SPMs could soon represent a new therapeutic alternative for CVD.

Standardized Nutritional Intervention in Patients with COVID-19 Admitted to a Hospital in Bogotá, Colombia / Intervención nutricional estandarizada en pacientes hospitalizados por COVID-19 admitidos en un Hospital en Bogotá, Colombia

Summary Background: Patients with coronavirus disease 2019 (COVID-19) present an increase in oxidative stress, characterized by the production of reactive oxygen species and a concomitant deficiency of antioxidants. There are multiple defense mechanisms including enzymatic scavengers and non-enzymatic molecules (glutathione and vitamins A, C, D, E, and zinc). Methods: In this observational, cross-sectional, retrospective study, we aimed to describe the clinical behavior of patients hospitalized due to COVID-19 (those trea ted with a standardized nutritional intervention versus those who received the COVID-19 standard treatment available at the time). A total of 214 medical records of patients hospitalized due to COVID-19 who required nutritional intervention were analyzed. Descriptive analyses of continuous and categorical variables were performed, and an ANOVA test was performed for numerical variables. A logistic regression model and a propensity score matching determined the differences between the matched groups. Findings: 33·6% of the patients were admitted to the Intensive Care Unit (ICU), 28·5% required invasive mechanical ventilation, and the overall mortality was 19·6%. 44·8% of the patients received the standardized nutritional intervention. There were no statistically significant differences between intervention groups, except for the intervention time, in which the standardized nutritional intervention (days) was identified as a protective factor OR=0·550 (p <0·05; CI=0·324-0·936). Conclusions: This is the first study in Colombia to consider a standardized nutritional intervention in patients hospitalized due to COVID-19. Despite not being able to meet the primary objectives, controlled experiments must be carried out to determine the role and possible therapeutic effects of micro and macronutrients in patients with COVID-19.

Resumen Antecedentes: los pacientes con enfermedad por coronavirus 2019 (COVID-19) presentan un aumento del estrés oxidativo, caracterizado por la producción de especies reactivas de oxígeno y una deficiencia concomitante de antioxidantes. Existen múltiples mecanismos de defensa que incluyen eliminadores enzimáticos y moléculas no enzimáticas (glutatión y vitaminas A, C, D, E y zinc). Métodos: En este estudio observacional, transversal y retrospectivo, el objetivo fue describir el comportamiento clínico de los pacientes hospitalizados por CO VID-19 (aquellos tratados con una intervención nutricional estandarizada versus aquellos que recibieron el tratamiento estándar COVID-19 disponible en el tiempo). Un total de 214 historias clínicas de los pacientes hospitalizados por COVID-19 que requirieron intervención nutricional. Se realizaron análisis descriptivos de variables continuas y categóricas. Se realizó una prueba de ANOVA para las variables numéricas. Un modelo de regresión logística y un emparejamiento por puntuación de propensión determinaron las diferencias entre los grupos emparejados. Resultados: el 33,6% de los pacientes ingresaron en la Unidad de Cuidados Intensivos (UCI), el 28,5% requirió ventilación mecánica invasiva y la mortalidad global fue del 19,6%.44 · 8% de los pacientes recibieron la intervención nutricional estandarizada. No hubo diferencias estadísticamente significativas entre los grupos de intervención, excepto por el tiempo de intervención, en el que la intervención nutricional estandarizada (días) se identificó como factor protector OR = 0 · 550 (p <0 · 05; IC = 0 · 324-0 · 936). Conclusiones: Este es el primer estudio en Colombia que considera una intervención nutricional estandarizada en pacientes hospitalizados por COVID-19. A pesar de no poder alcanzar los objetivos primarios, se deben realizar experimentos controlados para determinar el papel y los posibles efectos terapéuticos de los micro y macronutrientes en pacientes con COVID-19

The burden of illness of rheumatoid arthritis in Latin America-A systematic literature review.

Rheumatoid arthritis (RA) is a chronic autoimmune disease which, when left untreated, may result in the destruction of multiple joints and damage a wide variety of body systems, including the skin, eyes, lungs, heart, and blood vessels. The objective of this study was to conduct a systematic review of disease burden for RA in Argentina, Brazil, Colombia, Mexico, and Venezuela. PubMed/Medline, Embase, and Web of Science were searched for publications in English, Spanish, or Portuguese from 2008 through June 2018. A total of 1700 records were retrieved and 36 articles were included. The estimated prevalence of RA for these countries ranged from 0.15% (Colombia) to 2.8% (Mexico). The Global Burden of Disease initiative 2019 estimated that RA accounted for 0.13% of world disability-adjusted life-years. For Latin America, these figures were higher: Argentina 0.16%, Brazil 0.16%, Colombia 0.21%, Mexico 0.30%, and Venezuela 0.24%. RA has a negative impact on physical, mental, and emotional well-being as shown by substantially lower scores on measures of quality of life (SF-36) compared with the general population. The annual direct cost in Mexico was estimated at US$3599 per person. For patients with severe RA in Brazil these costs were approximately US$10 000. Data from other studied countries were similar. Though evidence of the full cost and impact of RA in Latin American countries is scarce and additional studies are needed, the burden of RA in these regions is significant and comparable to other parts the world.

Nematicidal Activity of the Endophyte Serratia ureilytica against Nacobbus aberrans in Chili Plants (Capsicum annuum L.) and Identification of Genes Related to Biological Control.

The genus Serratia is widely distributed in soil, water, plants, animals, invertebrates, and humans. Some species of this genus have antifungal, antibacterial, and nematicidal activity. In this work, the nematicidal activity of the endophytic strain of Serratia sp. in chili, Capsicum annuum L., is reported, where at a bacterial concentration of 4 × 109 cel/mL, the penetration of nematodes into the roots significantly decreased by 91 and 55% at 7 and 21 days after inoculation. This bacterial concentration also significantly decreased the number of galls, eggs, egg masses and reproduction factor produced by Nacobbus aberrans in Chili plants, with respect to the control where this bacterial strain was not applied. In the analysis of the genome of the strain, based on average nucleotide identity (ANI), the isolate could be affiliated to the species Serratia ureilytica. The size of the genome is 5.4 Mb, with a 59.3% content of GC. Genes related to the synthesis of chitinases, siderophores, proteases C, serralisins, hemolysin, and serrawettin W2 that have been reported for biocontrol of nematodes were identified in the genome. It is the first report of Serratia ureilytica with nematicidal activity. Based on these results of nematicidal activity, this strain can be evaluated in the field as an alternative in the biocontrol of Nacobbus aberrans in chili cultivation.