Neuroinflammation as a cause of differential Müller cell regenerative responses to retinal injury.

Unlike mammals, some nonmammalian species recruit Müller glia for retinal regeneration after injury. Identifying the underlying mechanisms may help to foresee regenerative medicine strategies. Using a Xenopus model of retinitis pigmentosa, we found that Müller cells actively proliferate upon photoreceptor degeneration in old tadpoles but not in younger ones. Differences in the inflammatory microenvironment emerged as an explanation for such stage dependency. Functional analyses revealed that enhancing neuroinflammation is sufficient to trigger Müller cell proliferation, not only in young tadpoles but also in mice. In addition, we showed that microglia are absolutely required for the response of mouse Müller cells to mitogenic factors while negatively affecting their neurogenic potential. However, both cell cycle reentry and neurogenic gene expression are allowed when applying sequential pro- and anti-inflammatory treatments. This reveals that inflammation benefits Müller glia proliferation in both regenerative and nonregenerative vertebrates and highlights the importance of sequential inflammatory modulation to create a regenerative permissive microenvironment.

Prognostic Factors and Epidemiology of Amyotrophic Lateral Sclerosis in Southeastern United States.

Objective: To assess the performance of known survival predictors and evaluate their stratification capability in patients with amyotrophic lateral sclerosis (ALS). Patients and Methods: We analyzed demographic and clinical variables collected at the Mayo Clinic, Florida ALS center during the first clinical visit of 1442 (100%) patients with ALS. Results: Our cohort had a median (interquartile range [IQR]) age at diagnosis of 64.8 (57-72) years; 1350 (92%) were non-Hispanic White; and 771 (53.5%) were male. The median (IQR) diagnostic delay was 10.1 (6-18) months, body mass index was 25.4 (23-49), and forced vital capacity was 72% (52%-87%). Approximately 12% of patients tested carried a pathologic C9orf72 hexanucleotide repeat expansion. Median (IQR) ALS functional rating scale-revised score was 35 (29-40) and ALS cognitive behavioral screen score was 15 (12-17). The median (IQR) survival after diagnosis was 17.2 (9-31) months, and survival from symptom onset was 30 (20-48) months. We found that older age decreased forced vital capacity, and fast-progressing ALS functional rating scale-revised scores significantly (P<.0001) influence survival curves and associated hazard risk. Conclusion: Although results obtained from our cohort are consistent with other reports (eg, men with spinal onset experience a longer survival than women with bulbar onset), they remind us of the complexity of the disease's natural history and the limited prognostic power of the most common clinical predictors.

The Prevalence of HIV Seroconversion in Healthcare Workers Following Sharp Injuries and Exposure to Biofluids.

Background and objective Workplace accidents (WPAs) are a common problem worldwide. They are often considered a public health concern due to the potential transmission of infections such as HIV, hepatitis B, and hepatitis C through sharp devices or direct exposure to biofluids. Post-exposure prophylaxis (PEP) has demonstrated effectiveness in such instances, especially immediately after exposure. The present study aimed to report the prevalence rate of HIV seroconversion following such exposure among healthcare workers (HCWs). Methods We conducted a cross-sectional study involving a database analysis of cases from 2015 to 2024. Central tendency measures were used to describe population characteristics, and rates were calculated using standard methods. Results A total of 514 HCWs were included in the study. The prevalence of WPAs was 13 per 100 HCWs. Regarding WPAs related to HIV exposure, the prevalence was 0.9 per 100 HCWs, with 0% seroconversion thanks to timely PEP. Conclusions WPAs related to HIV exposure are a serious issue for public health systems worldwide. Although protocols are available and no seroconversion cases were reported in the present study, PEP is not always accessible in several settings, increasing the risk of seroconversion. International public policy measures should be uniformly implemented to provide faster access to prophylaxis, educate the personnel, raise awareness about bloodborne diseases, and reduce excessive red tape.

Concordance between LDL-C estimated by various formulas and directly measured LDL-C.

BACKGROUND: Although direct measurement of LDL cholesterol (LDL-C) in blood is possible, there are several formulas for its estimation. The performance and concordance of these formulas have not been evaluated in Colombia. OBJECTIVE: To determine the concordance between LDL-C directly measured using the enzymatic technique and existing methods to calculate it. METHODS: Study of diagnostic tests, and concordance. We analyzed complete lipid profile samples, which included direct measurement of LDL-C, from 2014 to 2022 at Hospital Universitario San Ignacio (Bogotá, Colombia). The direct LDL-C measurements were compared with estimations using the DeLong, Sampson, Friedewald, extended Martin/Hopkins, Anandaraja, and Cordova methods. Lin's concordance correlation coefficient (CCC) and Bland-Altman plots were employed, conducting subgroup analyses based on triglycerides (TG), and LDL-C levels. Kappa coefficients assessed agreement in LDL-C risk categories according to dyslipidemia guidelines. RESULTS: A total of 2144 samples were evaluated. The formulas with the best CCC were DeLong (0.971) and Sampson (0.969), with no relevant differences. The extended Martin/Hopkins formula (0.964) and the Friedewald formula (0.964) also performed well. The Anandaraja (0.921) and Cordova (0.881) equations exhibited inferior performance. For all formulas, a decrease in concordance was observed when triglycerides were ≥400 mg/dL or when LDL-C was <100 mg/dL. Most formulas demonstrated optimal agreement when assessed using risk categories according to dyslipidemia guidelines, except for Anandaraja and Cordova. CONCLUSIONS: The DeLong, Sampson, extended Martin/Hopkins, and Friedewald formulas show the best concordance with directly measured LDL-C, so in most cases the results can be considered interchangeable. However, the Anandaraja and Cordova formulas are not recommended.

Chemical Reactivity Parameters to Analyze Psychedelics: How Do We Explain the Potency of the Drugs?

Psychedelics are psychoactive substances that produce changes in thoughts and feelings and modifications in perceptions of reality. The most potent psychedelic is also the first semisynthetic hallucinogen (lysergic acid diethylamide). Psychedelics have been investigated for decades because of their potential therapeutic effects in the treatment of neuropsychiatric diseases and also because these drugs are useful in controlling addictions to other substances. In this investigation, we analyze 27 psychedelic molecules. These compounds are serotonergic psychedelics; that is, they are serotonin agonists. We analyze the electron transfer properties to better understand the mechanism of action of these substances. We found that the electron acceptance capacity is related to the potency of the drugs: the best electron acceptor is also the most potent drug. We also used global softness as a parameter of reactivity. Molecules with greater global softness are more polarizable and also have greater potency. These results are useful to continue our understanding of the mechanism of action of psychotropic drugs.

Artificial Intelligence and Deep Learning in Revolutionizing Brain Tumor Diagnosis and Treatment: A Narrative Review.

The emergence of artificial intelligence (AI) in the medical field holds promise in improving medical management, particularly in personalized strategies for the diagnosis and treatment of brain tumors. However, integrating AI into clinical practice has proven to be a challenge. Deep learning (DL) is very convenient for extracting relevant information from large amounts of data that has increased in medical history and imaging records, which shortens diagnosis time, that would otherwise overwhelm manual methods. In addition, DL aids in automated tumor segmentation, classification, and diagnosis. DL models such as the Brain Tumor Classification Model and the Inception-Resnet V2, or hybrid techniques that enhance these functions and combine DL networks with support vector machine and k-nearest neighbors, identify tumor phenotypes and brain metastases, allowing real-time decision-making and enhancing preoperative planning. AI algorithms and DL development facilitate radiological diagnostics such as computed tomography, positron emission tomography scans, and magnetic resonance imaging (MRI) by integrating two-dimensional and three-dimensional MRI using DenseNet and 3D convolutional neural network architectures, which enable precise tumor delineation. DL offers benefits in neuro-interventional procedures, and the shift toward computer-assisted interventions acknowledges the need for more accurate and efficient image analysis methods. Further research is needed to realize the potential impact of DL in improving these outcomes.

Analyzing classification and feature selection strategies for diabetes prediction across diverse diabetes datasets.

Introduction: In the evolving landscape of healthcare and medicine, the merging of extensive medical datasets with the powerful capabilities of machine learning (ML) models presents a significant opportunity for transforming diagnostics, treatments, and patient care. Methods: This research paper delves into the realm of data-driven healthcare, placing a special focus on identifying the most effective ML models for diabetes prediction and uncovering the critical features that aid in this prediction. The prediction performance is analyzed using a variety of ML models, such as Random Forest (RF), XG Boost (XGB), Linear Regression (LR), Gradient Boosting (GB), and Support VectorMachine (SVM), across numerousmedical datasets. The study of feature importance is conducted using methods including Filter-based, Wrapper-based techniques, and Explainable Artificial Intelligence (Explainable AI). By utilizing Explainable AI techniques, specifically Local Interpretable Model-agnostic Explanations (LIME) and SHapley Additive exPlanations (SHAP), the decision-making process of the models is ensured to be transparent, thereby bolstering trust in AI-driven decisions. Results: Features identified by RF in Wrapper-based techniques and the Chi-square in Filter-based techniques have been shown to enhance prediction performance. A notable precision and recall values, reaching up to 0.9 is achieved in predicting diabetes. Discussion: Both approaches are found to assign considerable importance to features like age, family history of diabetes, polyuria, polydipsia, and high blood pressure, which are strongly associated with diabetes. In this age of data-driven healthcare, the research presented here aspires to substantially improve healthcare outcomes.

Safety and oncological effectiveness after desensitization in patients with previous hypersensitivity reactions to chemotherapy.

INTRODUCTION: Taxanes and platinum are first-line treatments in gynecological tumors with high rates of hypersensitivity reactions (HSRs), leading to discontinuation of treatment. Desensitization involves induction of temporary tolerance to previously sensitized medications. The aims of this study are to describe HSRs to paclitaxel and carboplatin and evaluate the safety and effectiveness of desensitization protocols in gynecological cancer patients. METHODS: Original, retrospective, descriptive, analytical study, approved by Bioethics and Research Committee, included >18-year-old patients with gynecological tumors experiencing HSRs to first-line chemotherapy. Patients underwent 3-bag-12-step desensitization. RESULTS: 174 desensitization (95 paclitaxel, 79 carboplatin) in 33 female patients, mean age 45.5 years (18-71y). Cancer diagnosis: breast 8 (24.2%), ovarian 14 (42.2%), endometrial 2 (6.1%) and cervix 9 (27.2%). HSR occurred in paclitaxel during cycles 1-2 and in carboplatin after 6 cycles. The most frequently seen HSR symptom was cardiovascular with paclitaxel (94.7%), and cutaneous (93.3%) with carboplatin. Three-bags 12-steps desensitization protocol (initial dilution 1:100) in 5.67hrs. All patients reached total dose desensitization: 82% with no reaction, 12% mild, 6% moderate and 0% severe reaction. Mean disease-free interval and progression-free interval in months (m): breast cancer 29 m and 14 m, ovarian 22 m and 9 m, endometrial 40 m and cervical cancer: 67.5 m and 27 m. Twenty-five patients (73.5%) are still alive. CONCLUSION: HSRs to paclitaxel manifest in the first 1-2 cycles and to carboplatin after 6 cycles. Symptoms include cardiovascular, atypical neuromuscular and urticaria. Changing treatment lines impacts prognosis. Our study revealed that ovarian cancer patients undergoing desensitization protocols achieved longer progression-free intervals. All patients successfully reached total dose desensitization. This study provides evidence of the effectiveness and safety of desensitization and promising perspective for continuing first-line treatment with HSRs.

Characteristics and completeness of reporting of systematic reviews of prevalence studies in adult populations: a metaresearch study.

OBJECTIVES: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, first published in 2009, has been widely endorsed and compliance is high in systematic reviews (SRs) of intervention studies. SRs of prevalence studies are increasing in frequency, but their characteristics and reporting quality have not been examined in large studies. Our objectives were to describe the characteristics of SRs of prevalence studies in adults, evaluate the completeness of reporting, and explore study-level characteristics associated with the completeness of reporting. STUDY DESIGN AND SETTING: We did a metaresearch study. We searched 5 databases from January 2010 to December 2020 to identify SRs of prevalence studies in adult populations. We used the PRISMA 2009 checklist to assess completeness of reporting and recorded additional characteristics. We conducted a descriptive analysis of review characteristics and linear regression to assess the relationship between compliance with PRISMA and publication characteristics. RESULTS: We included 1172 SRs of prevalence studies. The number of reviews increased from 25 in 2010 to 273 in 2020. The median PRISMA score for SRs without meta-analysis was 17.5 of a maximum of 23, and for SRs with meta-analysis, 22 of a maximum of 25. Completeness of reporting, particularly for key items in the methods section, was suboptimal. SRs that included a meta-analysis or reported using a reporting or conduct guideline were the factors most strongly associated with increased compliance with PRISMA 2009. CONCLUSION: Reporting of SRs of prevalence was adequate for many PRISMA items. Nonetheless, this study highlights aspects for which special attention is needed. Development of a specific tool to assess the risk of bias in prevalence studies and an extension to the PRISMA statement could improve the conduct and reporting of SRs of prevalence studies.

A Comparative Study on Aesthetic and Pain Outcomes in Flap Versus Implant Breast Reconstruction After Mastectomy.

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among women worldwide. Surgical treatments, including mastectomy and subsequent breast reconstruction, are critical components of breast cancer management. This systematic review compares the outcomes of flap versus implant reconstruction post-mastectomy, focusing on aesthetic differences, pain, recovery, and psychological adaptation. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we conducted a comprehensive literature search across PubMed, Cochrane, and ScienceDirect databases. Inclusion criteria targeted studies comparing aesthetic outcomes, pain, recovery costs, duration, and psychological adaptation between flap and implant breast reconstructions. We excluded non-English and non-Spanish studies, case reports, and those without full-text availability. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). From an initial pool of 25,881 articles, 16 high-quality studies involving 14,196 participants were selected for synthesis. Flap reconstruction was associated with higher patient satisfaction regarding aesthetic outcomes and psychological well-being but also had higher complication rates, including infections and wound dehiscence. Implant reconstruction showed fewer complications but did not achieve the same level of patient satisfaction. Flap reconstruction, despite its higher complication rates, tends to provide superior aesthetic and psychological outcomes compared to implant reconstruction. These findings highlight the importance of personalized treatment plans considering individual patient needs and preferences. Future research should focus on long-term randomized controlled trials (RCTs) and standardized outcome measures to further delineate the comparative effectiveness of these reconstruction techniques. Personalized care and ongoing research are essential to improving the quality of life for breast cancer survivors undergoing reconstruction.

Therapeutic hypothermia for neonates with hypoxic-ischaemic encephalopathy in low- and lower-middle-income countries: a systematic review and meta-analysis.

Hypoxic-ischaemic encephalopathy (HIE) is a major cause of mortality and neurodevelopmental disability, especially in low-income countries. While therapeutic hypothermia has been shown to reduce morbidity and mortality in infants with HIE, some clinical trials in low-income countries have reported an increase in the risk of mortality. We conducted a systematic review and meta-analysis of all randomized and quasi-randomized controlled trials conducted in low-income and lower-middle-income countries that compared cooling therapy with standard care for HIE. Our primary outcome was composite of neonatal mortality and neurodevelopmental disability at 6 months or beyond. The review was registered with PROSPERO (CRD42022352728). Our review included 11 randomized controlled trials with 1324 infants with HIE. The composite of death or disability at 6 months or beyond was lower in therapeutic hypothermia group (RR 0.78, 95% CI 0.66-0.92, I2 = 85%). Neonatal mortality rate did not differ significantly between cooling therapy and standard care (RR 0.92, 95% CI 0.76-1.13, I2 = 61%). Additionally, the cooled group exhibited significantly lower rates of neurodevelopmental disability at or beyond 6 months (RR 0.34, 95%CI 0.22-0.52, I2 = 0%). Our analysis found that neonatal mortality rate did not differ between cooled and noncooled infants in low- and lower-middle-income countries. Cooling may have a beneficial effect on neurodevelopmental disability and the composite of death or disability at 6 months or beyond.

Biocompatibility and expression of transcription factors of a type B gelatin-Extracellular Matrix of Porcin Urinary Blader scaffold.

OBJECTIVE: to evaluate a membrane based on type B gelatin (G) and porcine urinary bladder extracellular matrix (PUB-EM), highlighting the potential effect of the combination evaluated by biocompatibility and regulation of the expression of transcription factors involved in tissue regeneration. G-PUB-EM membranes were prepared at 12.5, 25, and 50% w/v, and evaluated for biocompatibility with Fibroblast. Chemical characterization by FTIR-ATR showed complex spectra during crosslinking process with glutaraldehyde. Physical tests were performed in deionized water and PBS for 48 h. A significant increase in swelling was observed during the first 2 h. Biocompatibility testing (MTS) and evaluation of the expression profile of genes involved in the cell cycle (Cyclin-D1 VEGF, TNF and NF-κ-B) by PCR showed an increase in viability in a PUB-EM content-dependent way, except for 50% PUB-EM membrane which showed cytotoxic effects with a decrease in cell viability below 70%. The membranes showed an increase in the expression of some factors of cell cycle, as well as inflammatory processes that could promote tissue repair. 12.5 and 25% gelatin type B/porcine urinary bladder extracellular matrix (G/PUB-EM) based membranes have potential for tissue regeneration applications. IMPACT STATEMENT: The use of membranes based on type B gelatin and porcine urinary bladder for tissue engineering represents a novel strategy. Biocompatibility and signaling pathways play a primary role in tissue repair and wound recovery. Transcription factors that mediate signaling, cell division and vascularization are part of molecules that intervene in the regenerative potential of cells. These techniques will have a significant impact on tissue repair and regeneration and thus stop depending on tissue donors or other surgical sites from the same patient, as is the case with burn patients.

Polarization and health-related behaviours and outcomes during the COVID-19 pandemic: a systematic review protocol.

Introduction: The COVID-19 pandemic affected people's health behaviours and health outcomes. Political or affective polarization could be associated with health behaviours such as mask-wearing or vaccine uptake and with health outcomes, e.g., infection or mortality rate. Political polarization relates to divergence or spread of ideological beliefs and affective polarization is about dislike between people of different political groups, such as ideologies or parties. The objectives of this study are to investigate and synthesize evidence about associations between both forms of polarization and COVID-19 health behaviours and outcomes. Methods: In this systematic review, we will include quantitative studies that assess the relationship between political or affective polarization and COVID-19-related behaviours and outcomes, including adherence to mask mandates, vaccine uptake, infection and mortality rate. We will use a predetermined strategy to search EMBASE, Medline (Ovid), Cochrane Library, Cochrane COVID-19 Study Register, Global Health (Ovid), PsycInfo (Ovid), Web of Science, CINAHL, EconLit (EBSCOhost), WHO COVID-19 Database, iSearch COVID-19 Portfolio (NIH) and Google Scholar from 2019 to September 8 2023. One reviewer will screen unique records according to eligibility criteria. A second reviewer will verify the selection. Data extraction, using pre-piloted electronic forms, will follow a similar process. The risk of bias of the included studies will be assessed using the JBI checklist for analytical cross sectional studies. We will summarise the included studies descriptively and examine the heterogeneity between studies. Quantitative data pooling might not be feasible due to variations in measurement methods used to evaluate exposure, affective and political polarization. If there are enough relevant studies for statistical data synthesis, we will conduct a meta-analysis. Discussion: This review will help to better understand the concept of polarization in the context of the COVID-19 pandemic and might inform decision making for future pandemics. Protocol registration: PROSPERO ID: CRD42023475828.

Bowman Layer Transplantation With Stromal Inclusion Using Femtosecond Laser: 3-year Results.

PURPOSE: The aim of this study was to evaluate the 3-year clinical results of Bowman layer with stromal inclusion (Bowman layer) transplantation using femtosecond laser for patients with advanced keratoconus. METHODS: This single-center retrospective study included 7 eyes of 7 patients diagnosed with progressive keratoconus who underwent Bowman layer transplantation with stromal inclusion between 2018 and 2020. Follow-up was carried out from the date of surgery until 36 months later. Bowman layer grafts were positioned into a mid-stromal pocket performed by a femtosecond laser and patients were evaluated up to 3 years after surgery. RESULTS: Corneal flattening of 5.49 D (P = 0.0020) in Kmax was observed, increased in corneal pachymetry, and an improvement best-corrected visual acuity measured in logarithm of minimum angle of resolution (LogMAR) from 0.89 to 0.60 and tolerance to contact lens from 42% of the patients to 100% of them. Stabilization of the cornea was achieved in 100% with no further progression of the keratoconus; all surgical procedures were uneventful, and no complications were observed during the 3 years of follow-up. CONCLUSIONS: Bowman layer transplantation with stromal inclusion flattened the cornea improving best-corrected visual acuity and contact lens tolerance and stabilized keratoconus in 100% of the patients during 3 years of follow-up and may be a feasible option in patients with advanced and progressive KC to delay or avoid the need for PK or DALK.

PBAT is biodegradable but what about the toxicity of its biodegradation products?

CONTEXT: Poly(butylene adipate-co-terephthalate) (PBAT) is a biodegradable plastic. It was introduced to the plastics market in 1998 and since then has been widely used around the world. The main idea of this research is to perform quantum chemical calculations to study the potential toxicity of PBAT and its degradation products. We analyzed the electron transfer capacity to determine its potential toxicity. We found that biodegradable products formed with benzene rings are as good electron acceptors as PBAT and OOH•. Our results indicate that the biodegradation products are potentially as toxic as PBAT. This might explain why biodegradation products alter the photosynthetic system of plants and inhibit their growth. From this and other previous investigations, we can think that biodegradable plastics could represent a potential environmental risk. METHODS: All DFT computations were performed using the Gaussian16 at M062x/6-311 + g(2d,p) level of theory without symmetry constraints. Electro-donating (ω-) and electro-accepting (ω +) powers were used as response functions.

The role of PSA kinetics in men with a negative MRI-targeted prostate biopsy.

OBJECTIVE: To evaluate rebiopsy rates and clinicopathologic outcomes in patients after a negative MRI-guided biopsy to better inform the management of these patients. METHODS: Patients were included with a clinical suspicion of prostate cancer (PCa) referred for fusion biopsy for a PI-RADS v2.1 lesion ≥ 3 on multiparametric MRI and a negative MRI fusion biopsy. Biopsies included targeted and systematic cores. Patients with a prior cancer diagnosis were excluded. Both baseline and follow-up clinicopathological data, and long-term PSA values were examined in these patients. Statistical analyses included Wilcoxon rank-sum test and one-way tests. RESULTS: Of 685 total patients, 188 (27%) had a negative fusion biopsy. Of these 88 (47%), 74 (39%), and 26 (14%) had PI-RADS 3, 4, 5 lesions, respectively. Complete follow-up was available for 182/188 patients (97%), with a median of 24 months (interquartile range: 12-38). Post-biopsy PSA levels decreased the first and the second year (-0.24; and -0.84 ng/ml/yrs respectively). In follow-up, 44 patients had an MRI (24%) and 20 had a biopsy (10%). A positive PSA velocity was the only predictive variable for repeat MRI in univariate analysis. On repeat MRI, 9 (27%) patients had disappearance of the initial lesion, 21 (48%) had a lower PIRADS score and 14 (32%) higher. Only 12/182 (6.6%) were found to have PCa during follow-up, of those 7 (3.8%) were clinically significant. CONCLUSION: For patients with nonmalignant biopsy findings after an initial mpMRI showing a suspicious PI-RADS lesion, the majority of patients will have their PSAs return to baseline over time. To support this, repeat MRI frequently demonstrated a disappearance or downgrading of PIRADS lesions. These data support monitoring patients with this clinical scenario.

Emergence of Quantum Dots as Innovative Tools for Early Diagnosis and Advanced Treatment of Breast Cancer.

Quantum dots (QDs) semiconducting nanomaterials, have garnered attention due to their distinctive properties, including small size, high luminescence, and biocompatibility. In the context of triple-negative breast cancer (TNBC), notorious for its resistance to conventional treatments, QDs exhibit promising potential for enhancing diagnostic imaging and providing targeted therapies. This review underscores recent advancements in the utilization of QDs in imaging techniques, such as fluorescence tomography and magnetic resonance imaging, aiming at the early and precise detection of tumors. Emphasis is placed on the significance of QD design, synthesis and functionalization processes as well as their use in innovative strategies for targeted drug delivery, capitalizing on their ability to selectively deliver therapeutic agents to cancer cells. As the research in this field advances rapidly, this review covers a classification of QDs according to their composition, the characterization techniques than can be used to determine their properties and, subsequently, emphasizes recent findings in the field of TNBC-targeting, highlighting the imperative need to address challenges, like potential toxicity or methodologies standardization. Collectively, the findings explored thus far suggest that QDs could pave the way for early diagnosis and effective therapy of TNBC, representing a significant stride toward precise and personalized strategies in treating TNBC.

A Bioorthogonal Dual Fluorogenic Probe for the Live-Cell Monitoring of Nutrient Uptake by Mammalian Cells.

Cells rely heavily on the uptake of exogenous nutrients for survival, growth, and differentiation. Yet quantifying the uptake of small molecule nutrients at the single cell level is difficult. Here we present a new approach to studying the nutrient uptake in live single cells using Inverse Electron-Demand Diels Alder (IEDDA) chemistry. We have modified carboxyfluorescein-diacetate-succinimidyl esters (CFSE)-a quenched fluorophore that can covalently react with proteins and is only turned on in the cytosol of a cell following esterase activity-with a tetrazine. This tetrazine serves as a second quencher for the pendant fluorophore. Upon reaction with nutrients modified with an electron-rich or strained dienophile in an IEDDA reaction, this quenching group is destroyed, thereby enabling the probe to fluoresce. This has allowed us to monitor the uptake of a variety of dienophile-containing nutrients in live primary immune cell populations using flow cytometry and live-cell microscopy.

[Cerebrospinal fluid rhinorrhea secondary to ethmoidal carcinoma: case report]. / Rinorrea de líquido cefalorraquídeo secundaria a carcinoma etmoidal: reporte de caso.

BACKGROUND: The first report of cerebrospinal fluid rhinorrhea (CSFR) was described in 1679. In 1826 it was reported that one of the possible causes of CSFR was a fistula between the subarachnoid space and the nasal cavity. In 1903, chemical analysis of the fluid was proposed as a diagnostic criterion. In Mexico there has been 32 case reports. CASE REPORT: Forty-nine years old female with a history of nasal polyposis, profuse rhinorrhea and cephalea who attends the allergy department with the suspicion of allergic rhinitis. After anamnesis and physical evaluation, CSFR was suspected. Chemical analysis of the fluid, head CT and biopsy of nasal polyp were performed. An etmoidal fistula associated with carcinoma was confirmed. CONCLUSIONS: Spontaneous fistulas are rare but can erosionate the bone and adjacent tissues. Diagnosis is based on the clinical findings, patient's history and complementary studies such as beta-2-transferrin determination in nasal fluid.

ANTECEDENTES: En 1679 se describió el primer caso de rinorrea de líquido cefalorraquídeo. En 1826 se reportó como causa una fistula entre el espacio subaracnoideo y la cavidad nasal. Para 1903 se propuso el análisis químico como criterio diagnóstico. En México sólo se han reportado 32 casos de rinorrea de líquido cefalorraquídeo. REPORTE DE CASO: Paciente femenina de 49 años, con antecedente de poliposis nasal, rinorrea abundante y cefalea, quien acudió a consulta para descartar rinitis alérgica. Luego de la anamnesis y la exploración física se sospechó de fuga de líquido cefalorraquídeo secundaria a fístula nasal. Con la histoquímica de moco, tomografía de cráneo y biopsia del pólipo nasal se estableció el diagnóstico de fístula etmoidal secundaria a carcinoma. CONCLUSIÓN: La fístulas espontáneas son excepcionales, pueden erosionar el hueso y los tejidos adyacentes. El diagnóstico se establece con la historia clínica y los antecedentes médicos, además de estudios complementarios y la determinación de Beta-2-transferrina en moco.

Calidad de vida y características clínicas de pacientes con trasplante renal con y sin rinosinusitis crónica / Quality of life and clinical characteristics of renal transplant patients with and without chronic rhinosinusitis

RESUMEN Introducción: El trasplante es el tratamiento de elección en pacientes con enfermedad renal crónica (ERC). Requiere inmunosupresión, que predispone al desarrollo de complicaciones; la rinosinusitis crónica (RSC) es una de las más importantes. Objetivo: Comparar las características de pacientes con ERC con y sin RSC en protocolo de trasplante en un hospital de concentración en Puebla, en México. Métodos: Estudio comparativo, transversal, retrospectivo, en pacientes de un hospital de tercer nivel de atención, con ERC y en protocolo de trasplante renal. Se aplicaron las escalas SNOT-22 y Lund-Mackay. Se utilizó estadística descriptiva y pruebas U de Mann-Whitney, exacta de Fisher y coeficiente de Phi; p<0.05, por lo que se consideró significativa. Resultados: Se reclutaron 360 pacientes: 49 presentaron RSC; prevalencia, 13.61 %; medias edad, 39.22 ±12.09 años y tiempo de evolución, 17.73 ±5.91 semanas. Presentaron poliposis nasosinusal 14.3 %; obstrucción nasal, 95.9 %; algia facial, 67.3%; rinorrea, 49 % e hiposmia/anosmia, 40.8 %. Factores de riesgo asociados: alergia a ácido acetilsalicílico (p=0.014) y atopia (p=0.000). Variantes anatómicas en pacientes con y sin RSC, respectivamente: Celdilla Agger-Nasi 95 % y 15.4 %; desviación septal, 50 % y 6.4 %; hipertrofia de cornetes, 50 % y 1.3 %; concha bullosa, 30 % y 4.2 % y cornete paradójico, 10 % y 1.6 %. La afectación de calidad de vida predominante en pacientes con y sin RSC fue moderada con un 53.1 % y leve, 97.1 % (p=0.000). Conclusión: La prevalencia de RSC fue 13.61 %; los factores de riesgo asociados, alergia al ácido acetilsalicílico y atopia y la variante anatómica predominante, Agger-nasal. La severidad tomográfica fue leve y la afectación de la calidad de vida, moderada.

ABSTRACT Introduction: Transplantation is the treatment of choice for patients with chronic kidney disease (CKD). It requires immunosuppression, which predisposes to the development of complications; chronic rhinosinusitis (CRS) is one of the most significant. Objetive: To compare the characteristics of patients with CKD and without CRS in a renal transplant protocol at a specialized hospital in Puebla, Mexico. Methods: A comparative, cross-sectional, retrospective study in patients with CKD and in renal transplant protocol at a third-level care hospital. The SNOT-22 and Lund-Mackay scales were applied. Descriptive statistics, Mann-Whitney U tests, Fisher's exact test, and Phi coefficient were used; p<0.05 was considered significant. Results: 360 patients were recruited: 49 presented with CRS; prevalence: 13.61%; mean age: 39.22 ± 12.09 years and duration of progression: 17.73 ± 5.91 weeks. Naso-sinusal polyposis was present in 14.3%; nasal obstruction in 95.9%; facial pain in 67.3%; rhinorrhea in 49% and hyposmia/anosmia in 40.8%. Associated risk factors: allergy to acetylsalicylic acid (p=0.014) and atopy (p=0.000). Anatomical variants in patients with and without CRS, respectively: Agger nasi cell 95% and 15.4%; septal deviation, 50% and 6.4%; turbinate hypertrophy, 50% and 1.3%; concha bullosa, 30% and 4.2%; and paradoxical turbinate, 10% and 1.6%. The predominant quality of life impact in patients with and without CRS was moderate at 53.1% and mild at 97.1% (p=0.000). Conclusion: The prevalence of CRS was 13.61%; the associated risk factors were allergy to acetylsalicylic acid and atopy, and the predominant anatomical variant was Agger nasi. The tomographic severity was mild, and the impact on quality of life was moderate.