Use of Tenecteplase in Acute Ischemic Stroke in the Time of SARS-CoV-2.

Tenecteplase (TNK) is a fibrinolytic drug that is administrated in a single bolus, recommended in eligible patients with acute ischemic stroke prior to mechanical thrombectomy. This study explores its usefulness in adverse situations, such as the SARS-CoV-2 pandemic. We conducted a retrospective study involving consecutive patients with suspected acute ischemic stroke treated either with intravenous fibrinolysis with alteplase during 2019 or with TNK (.25 mg/kg) between March 2020 and February 2021. A comparative analysis was made to compare patient treatment times and prognosis. A total of 117 patients treated with alteplase and 92 with TNK were included. No significant differences were observed in age, main vascular risk factors or previous treatments. The median National Institutes of Health Stroke Scale was 8 in the alteplase group and 10 in those treated with TNK (P = .13). Combined treatment with mechanical thrombectomy was performed in 47% in the alteplase group and 46.7% in the TNK group; Thrombolysis In Cerebral Infarction scale 2b-3 recanalization was achieved in 83% and 90.7%, respectively (P = .30). There was a decrease in onset-to-needle median time (165 min vs 140 min, P < .01) and no significant variations in door-needle median time. There was no significant difference in the incidence of symptomatic hemorrhagic transformation in mortality or functional independence at 3 months. The easier administration of TNK has improved the accessibility of fibrinolytic therapy, even in adverse circumstances, such as the COVID-19 pandemic. Its use appears to be safe and effective, even in patients who are not candidates for mechanical thrombectomy.

Mechanical Thrombectomy for Acute Stroke in a 2-Month-Old Patient and Review of the Literature in Infancy.

Mechanical thrombectomy (MT) in pediatric stroke is supported by studies in adults, but there is controversy regarding younger patients. The main growth of intracranial vessels occurs up to 2 years when there can be more difficulties in MT.Description of the MT performed in a 2-month-old patient-the youngest infant published to date. We also review the literature on MT for stroke in infants.A 2-month-old patient presented with an awakening stroke secondary to an occlusion of the M1 segment of the left middle cerebral artery. A successful MT was performed with an aspiration device without clinically significant complications. An etiological study was completed, and neuroimaging showed focal cerebral arteriopathy. The 3-month outcome was excellent: the pediatric modified Rankin score was 0.Including this case, MT for acute stroke has been reported in only 10 infants. MT was successful in 90%, mostly using adult conventional stent retrievers. There were complications only in patients with mechanical circulatory support (MCS) devices; three patients died due to hemorrhagic transformation after MT and one patient died due to recurrent ischemic stroke.MT seems effective and safe in infants similarly to other pediatric ages. In children under 2 years of age, the presence of comorbidities requiring MCS devices is the main factor underlying poor prognosis.

In Vivo Nutritional Assessment of the Microalga Nannochloropsis gaditana and Evaluation of the Antioxidant and Antiproliferative Capacity of Its Functional Extracts.

Nannochloropsis gaditana is a microalga with interesting nutritional and functional value due to its high content of protein, polyunsaturated fatty acids, and bioactive compounds. However, the hardness of its cell wall prevents accessibility to these components. This work aimed to study the effect of a treatment to increase the fragility of the cell wall on the bioavailability of its nutrients and functional compounds. The antioxidant and antiproliferative capacity of functional extracts from treated and untreated N. gaditana was assessed, and the profile of bioactive compounds was characterized. Furthermore, to study the effect of treatment on its nutrient availability and functional capacity, an in vivo experiment was carried out using a rat experimental model and a 20% dietary inclusion level of microalgae. Functional extracts from treated N. gaditana exhibited higher antioxidant activity than the untreated control. Furthermore, the treated microalga induced hypoglycemic action, higher nitrogen digestibility, and increased hepatic antioxidant activity. In conclusion, N. gaditana has interesting hepatoprotective, antioxidant, and anti-inflammatory potential, thus proving itself an ideal functional food candidate, especially if the microalga is treated to increase the fragility of its cell wall before consumption.

Factores sociodemográficos asociados al rendimiento académico en estudiantes de la licenciatura en Médico Cirujano-Partero / Sociodemographic factors associated with academic performances of students in the bachelor's degree for Medical Surgeon Midwife

Introducción: Se han realizado estudios empleando diferentes metodologías con el objetivo de definir el rendimiento académico, su impacto, los factores involucrados en el mismo y los diferentes niveles en los que se puede identificar. Objetivo: Identificar los factores sociodemográficos asociados al rendimiento académico de los estudiantes de licenciatura en médico cirujano y partero del Centro de Estudios Superiores de Tepeaca, Puebla, México. Métodos: Se aplicó un instrumento a una muestra de n= 192 alumnos de la licenciatura en Medicina que cumplieron con los criterios de inclusión, obteniendo información acerca de 12 variables independientes. Se obtuvo el rendimiento académico de los alumnos en base a sus calificaciones por materia. Se realizó un análisis estadístico de tipo descriptivo e inferencial. Resultados: El análisis estadístico arrojó valores significativos a nivel estadístico, de las siguientes variables: sexo (t = -3,253, p< 0,05, r= 0,22), nivel académico de la madre (F= 2,272, p<0,05, n2= 0,57), trabajar y estudiar (F= 7,475, p< 0,05, 2= 0,73), ingreso familiar mensual (r= -0,223, p< 0,05) y promedio del nivel educativo previo a la licenciatura (r= 0,428, p< 0,05). Conclusiones: Los factores sociodemográficos asociados a un rendimiento académico alto, son: sexo femenino, alto nivel académico de la madre y un buen promedio en el nivel educativo previo a la licenciatura. Mientras que trabajar y estudiar e ingreso familiar mensual elevado son factores que se asocian a un rendimiento académico bajo(AU)

Introduction: Studies have been carried out using different methodologies in order to define academic performance, its impact, the factors involved in it and the different levels at which it can be identified. Objective: To identify the sociodemographic factors associated with academic performance of undergraduate students of surgery and midwifery at the Center for Advanced Studies in Tepeaca, Puebla, Mexico. Methods: An instrument was applied to a sample 192 students of the bachelor's degree in Medicine who met the inclusion criteria, obtaining information about 12 independent variables. The academic performance of the students was obtained based upon their grades by subject. A descriptive and inferential statistical analysis was carried out. Results: Statistical analysis showed statistically significant values ​​of the following variables: sex (t=-3.253, p< 0.05, r= 0.22), mother's academic level (F= 2.272, p<0.05, h²= 0.57), working and studying (F= 7.475, p<0.05, h²= 0.73), monthly family income (r =-0.223, p<0.05), and average educational level prior to the degree (r= 0.428, p< 0.05). Conclusions: The sociodemographic factors associated with a high academic performance are female sex, the mother's high academic level, and good average in educational level prior to the degree. While working and studying and high monthly family income are factors associated with low academic performance(AU)

Obesidad: efecto de la pérdida de peso sobre los valores de proteína C reactiva, fibrinógeno e insulino resistencia / Effect of weight loss on creative protein, fibrinogen and insulin-resistance in obese patients

La obesidad incrementa el riesgo de enfermedades cardiovasculares y morbi-mortalidad geberal. La proteína C reactiva y la insulinorresistencia han sido asociados de forma independiente a la obesidad. Determinar los efectos de la pérdida de peso sobre valores de proteína C reactiva, fibrinógeno e insulino-resistencia en pacientes obesos sin comorbilidad, sometidos a un programa integral de reducción de peso durante 3 meses. Estudio prospectivo longitudinal en el cual se realizaron determinaciones antropométricas y medicinones de proteína C reactiva, fibrinógeno, insulimenia y perfil lipídico en 40 pacientes obesos sometidos a durante 3 meses a una dieta de restricción calórica y cambios en estilo de vida; fueron divididos en 2 grupos según el valor de HOMA al ingreo en insulino-resistentes (IR, n=18) e insulino-sensibles (IS, n=22), similares en términos de edad (30,1 ± 4,7 versus 30,1 ± 7 años), cociente cintura-cadera (1,00 ± 0,03 versus 1,00 ± 0,03). El sexo femenino fue predominante (83,3 por ciento versus 90,9 por ciento). La relación del peso corporal ocurrió en ambos grupos estudiados, siendo estadísticamente signicativa en los insulinoresistentes (98,4 ± 14,2 versus 85,4 ± 7,8 kg) (p= 0,001). Los valores de proteína C reactiva al ingreso fueron mayores en IR (4,8 ± 1,58 versus 3,36 ± 1,32 mg/lt), disminuyendo en IR=3,50 ± 1,32 mg/dl y permaneciendo casi invariable en IS= 3,42 ± 1,39 mg/lt (p= 0,179) al final del estudio. El programa integral de reducción de peso durante 3 meses llevó a una disminución estadísticamente significativa de valores de HOMA y fibrinógeno, en ambos grupos, con mayor importancia clínica en los insulino-resistentes. Los valores de proteínas C reactiva mejoraron de forma no estdísticamente significativas en los IR durante el estudio