Suicide in Later Life in Uruguay: A Suicide Note Analysis.

Suicide is a significant public health challenge worldwide, with inconsistent behavioral patterns. This study examined the psychological processes underlying 191 suicide notes left by older adults in Uruguay, a country doubling global and regional suicide rates, with the highest prevalence among those aged 60+. Uruguay highlights in the region as a high-income country. Through content analysis with an inter-judge strategy, the notes revealed that loneliness, loss of interest, and loss of meaning for life, were prevalent. Financial hardship was not a primary reason for suicide. Social connectedness was highlighted as a factor for reducing suicide risk in older adults, particularly those with ill health and physical impairment. The study sheds light on the need to expand social services aimed at reducing loneliness and the need to combat ageism and social prejudice towards suicide in Uruguay, providing valuable insights into suicide prevention strategies for older adults in diverse social settings.

Crea reflexión: experiencias de aprendizaje en prácticas clínicas / Create reflection: learning experiences in clinical practices

Objetivo: diseñar e incorporar un instrumento estructurado deregistro reflexivo de prácticas clínicas en formato e-portafoliopara alumnos de Grado de Enfermería en las prácticas clínicaspediátricas.Método: estudio longitudinal prospectivo cuanti-cualitativo.Sujetos de estudio: alumnos de cuarto curso de Grado de Enfer-mería. Instrumentalización: diarios reflexivos, rúbricas, CaliforniaCritical Thinking Disposition Scale, Emotional IntelligenceAssesment Scale, Wong Law Emotional Intelligence Scale, In-ventario de roles de sexo de Bem, tutorías académico-formati-vas. Las características de la muestra se describirán con esta-dísticos de tendencia central y dispersión, acorde a su tipo ydistribución. La valoración de la efectividad se estimará con elcambio en las puntuaciones respecto a los patrones de referen-cia del estado previo a la formación en práctica reflexiva y delestado con formación y experiencia en práctica reflexiva. Laspruebas de contraste de hipótesis empleadas en estos análisisserán bilaterales, a un nivel de significación p< 0,05. El procesa-miento de los datos se realizará con SPSS 25.0. Para análisis decontenido de los registros se identificarán códigos, categoríasemergentes y reglas de categorización para generar la creaciónde conceptos. Se utilizará el programa AtlasTi-8.Resultados esperados: guía metodológica de práctica re-flexiva, rúbrica de evaluación, portafolio digital. Desarrollo dehabilidades en herramientas ofimáticas para registros amiga-bles y profundización en el conocimiento de práctica reflexivay juicio crítico en alumnos de Grado de Enfermería en el entornode prácticas clínicas pediátricas.(AU)

Objective: to design and incorporate a structured instrument for reflective record of clinical practices in e-portfolio format for Nursing Degree students in paediatric clinical practices.Method: a quanti-qualitative prospective longitudinal study; subjects: fourth year Nursing Degree students. Instrumentalization: reflective diaries, rubrics, California Critical Thinking Disposition Scale, Emotional Intelligence Assessment Scale, Wong Law Emotional Intelligence Scale, Bem Sex-Role Inventory, academic-formative tutoring. Sample characteristics will be described with central tendency and dispersion, according to their type and distribution. The assessment of effectiveness will be estimated through the change in scores compared with the patterns of reference of the status previous to training in reflective practice, and the status with training and experience on reflective practice. The tests used for hypothesis testing in these analysis will be bilateral, with a p< 0,05 significance level. Data processing will be conducted with SPSS 25.0. Codes, emerging categories and categorization rules will be identified for the content analysis of records, in order to generate creation of concepts. The AtlasTi-8 program will be used.Expected results: methodological guidelines for reflective practice, evaluation rubrics, digital portfolio. Development in skills on office tools for friendly records and deepening into the knowledge of reflective practice and critical judgment in Nursing Degree students within the setting of paediatric clinical practices.(AU)

Anisakis infection in anchovies (Engraulis encrasicolus) from Iberian waters, southwestern Europe: Post-mortem larval migration.

The Anisakis larvae presence in fish for human consumption is a health risk that needs to be monitored. The anchovy is a fish that is highly appreciated by consumers and that can harbour Anisakis. It is thus necessary to periodically evaluate the presence of anisakid larvae in them. So, anchovies from Iberian Peninsula coasts were analysed. Fish examination for macroscopic nematodes showed L3s of both Anisakis type I and Hysterothylacium aduncum. The Anisakis prevalence varies with the catching area and the fish size. The muscle prevalence was 7.45% (mean intensity 1.75; range 1-5). Molecular analysis showed 110 A. simplex s.s. (17 in muscle), 22 A. pegreffii (3) and 7 hybrid genotype individuals (1). Considering that most of the Iberian Peninsula coasts are a sympatry area between these two Anisakis species, it has been observed that A. simplex s.s./A. pegreffii ratio increases from south to north in a clockwise direction. Also, 19 larvae were detected on the fish surface from the Bay of Biscay, indicating the ability of these larvae to migrate after the fish death. The A. simplex s.s./A. pegreffii larvae proportion found on the anchovy surface is similar to the found in viscera and lower than in muscle, suggesting that most of the larvae migrating to the surface must have come from the visceral package. This confirms the importance of removing fish viscera immediately after capture, for those fish species where this is possible. As both species cause anisakiasis/anisakidosis, these data show a real risk to human health, especially in dishes highly prized in Mediterranean countries prepared with raw or semi-raw anchovies.

Complexing CpG adjuvants with cationic liposomes enhances vaccine-induced formation of liver TRM cells.

Tissue resident memory T cells (TRM cells) can provide effective tissue surveillance and can respond rapidly to infection. Vaccination strategies aimed at generating TRM cells have shown promise against a range of pathogens. We have previously shown that the choice of adjuvant critically influences CD8+ TRM cell formation in the liver. However, the range of adjuvants tested was limited. Here, we assessed the ability of a broad range of adjuvants stimulating membrane (TLR4), endosomal (TLR3, TLR7 and TLR9) and cytosolic (cGAS, RIG-I) pathogen recognition receptors for their capacity to induce CD8+ TRM formation in a subunit vaccination model. We show that CpG oligodeoxynucleotides (ODN) remain the most efficient inducers of liver TRM cells among all adjuvants tested. Moreover, their combination with the cationic liposome DOTAP further enhances the potency, particularly of the class B ODN CpG 1668 and the human TLR9 ligand CpG 2006 (CpG 7909). This study informs the design of efficient liver TRM-based vaccines for their potential translation.

Manifestaciones autoinmunes asociadas a la enfermedad por coronavirus 2019 / Autoimmune manifestations associated with coronavirus disease 2019

Introducción: La enfermedad por coronavirus 2019 (Coronavirus Disease 2019 o COVID-19), causada por un nuevo coronavirus: el síndrome respiratorio agudo severo 2 (severe acute respiratory syndrome coronavirus 2), ha teniendo un impacto devastador en todo el mundo. Su fisiopatología es el resultado de los efectos citopáticos directos del SARS-CoV-2 sobre el epitelio respiratorio, el endotelio y otros tipos de células específicas de órganos, con la posterior inducción de una tormenta de citocinas proinflamatorias y una inmunidad adaptativa desregulada que causa daño tisular severo. Objetivo: Describir las características autoinmunes presentes durante la infección por SARS-CoV-2. Métodos: Se realizó una revisión bibliográfica sobre COVID-19 y manifestaciones autoinmunes en los sitios web: Pubmed, Medline, SciELO. Se hizo un análisis y resumen de la información revisada. Análisis y síntesis de la información: Los virus se han considerado los principales agentes infecciosos que desencadenan fenómenos autoinmunes en individuos genéticamente susceptibles. El SARS-CoV-2 ya se ha relacionado con una larga lista de afecciones autoinflamatorias y autoinmunes que pueden ser inducidas por varios mecanismos propuestos para explicar la autoinmunidad inducida por virus. En esta patología, el más descrito, es el mimetismo molecular. La COVID-19 comparte similitudes con las enfermedades autoinmunes en sus manifestaciones clínicas, mecanismos fisiopatológicos y respuesta terapéutica, de forma que potentes reacciones inmunes participan en la patogénesis de ambas enfermedades. Conclusiones: La infección por SARS-CoV-2 puede representar al vínculo complejo e interrelacionado entre las infecciones y la autoinmunidad(AU)

Introduction: Coronavirus disease 2019 (COVID-19), caused by a new coronavirus. Severe acute respiratory syndrome coronavirus 2 is having a devastating impact throughout the world. Its pathophysiology is the result of direct cytopathic effects of SARS-CoV-2 on respiratory epithelium, endothelium, other organ-specific cell types and the subsequent induction of a pro-inflammatory cytokine storm and dysregulated adaptive immunity, causing severe tissue damage. Objective: To describe autoimmune characteristics present during SARS-Cov-2 infection. Methods: A literature review on COVID-19 and autoimmune manifestations was carried out. The articles were selected from a search of the following websites: Pubmed, Medline, SciELO. An analysis and summary of the reviewed information was made. Analysis and synthesis of information: Viruses have been considered the main infectious agents that trigger autoimmune phenomena in genetically susceptible individuals. SARS-CoV-2 has already been linked to a long list of autoinflammatory and autoimmune conditions that can be induced by various mechanisms proposed to explain virus-induced autoimmunity. In this pathology, the most described, is molecular mimicry. COVID-19 shares similarities with autoimmune diseases in its clinical manifestations, pathophysiological mechanisms and therapeutic response, such powerful immune reactions participate in the pathogenesis of both entities. Conclusions: SARS-CoV-2 infection may represent the complex and interrelated link between infections and autoimmunity(AU)

Cell chirality exhibition of brain microvascular endothelial cells is dependent on micropattern width.

Left-right asymmetry is a conserved property in nature and observed in the human body, a property known as cell chirality. Cell chirality is often studied using micropatterned in vitro models. However, micropattern geometry and size often varies across different studies, making it challenging to compare results. Here, we utilized micropatterned RGD-peptide lines on hyaluronic acid hydrogels to investigate the effect of the micropattern width on the exhibited cell chirality bias of brain microvascular endothelial cells. Overall, this cell type exhibited a negative chirality bias on micropatterned lines ranging from 10 µm to 400 µm in width, where the negative bias was most pronounced on the 100 µm wide lines. We also observed that this exhibited chirality bias varied across the line width. This work serves as a guide to determine optimal micropattern width for further investigations on cell chirality bias and its prominence in e.g., disease states or upon exposure to toxic substances.

Learning curves and association of pathologist's performance with the diagnostic accuracy of linear endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA): a cohort study in a tertiary care reference centre.

OBJECTIVES: We aimed to assess the learning curves and the influence of the pathologist's performance on the endobronchial ultrasound transbronchial needle aspiration's (EBUS-TBNA's) diagnostic accuracy in a real-world study. DESIGN/SETTING: Cohort study conducted in a tertiary care university hospital (single centre) with patients referred for EBUS-TBNA. PARTICIPANTS/INTERVENTION: We initially evaluated 376 patients (673 lymph nodes), 368 (660 lymph nodes) of whom were recruited. The inclusion criterion was EBUS-TBNA indicated for the study of mediastinal or hilar lesions. The exclusion criteria were the absence of mediastinal and hilar lesions during EBUS confirmed by a normal mediastinum and hilum on chest CT (except in cases of mediastinal staging of cancer) and lost to follow-up. PRIMARY AND SECONDARY OUTCOME MEASURES: Diagnostic accuracy and related outcomes. METHODS: We included patients from a prospectively constructed database. We performed a logistic regression multivariate analysis to adjust for potential confounders of the association between pathologist performance and EBUS-TBNA accuracy. The Cumulative Summation (CUSUM) analysis was used to assess pathologists' performance and learning curves. RESULTS: Most indications for EBUS were suspicion of malignancy, including intrathoracic tumours (68.3%), extrathoracic tumours (9.8%) and cancer staging (7.0%). The patients' mean age was 63.7 years, and 71.5% were male. Overall EBUS-TBNA accuracy was 80.8%. In the multivariate logistic regression model, the factors independently associated with EBUS-TBNA accuracy included certain pathologists (ORs ranging from 0.16 to 0.41; p<0.017), a lymph node short-axis diameter <1 cm (OR: 0.36; 95% CI 0.21 to 0.62; p<0.001), and the aetiology of lymph node enlargement (ORs ranging from 7 to 37; p<0.001). CUSUM analysis revealed four different learning curve patterns, ranging from almost immediate learning to a prolonged learning phase, as well as a pattern consistent with performance attrition. CONCLUSIONS: Pathologists' proficiency conditioned EBUS-TBNA accuracy. This human factor is a potential source of error independent of factors conditioning tissue sample adequacy.

Optimization of Mesenchymal Stromal Cell (MSC) Manufacturing Processes for a Better Therapeutic Outcome.

MSCs products as well as their derived extracellular vesicles, are currently being explored as advanced biologics in cell-based therapies with high expectations for their clinical use in the next few years. In recent years, various strategies designed for improving the therapeutic potential of mesenchymal stromal cells (MSCs), including pre-conditioning for enhanced cytokine production, improved cell homing and strengthening of immunomodulatory properties, have been developed but the manufacture and handling of these cells for their use as advanced therapy medicinal products (ATMPs) remains insufficiently studied, and available data are mainly related to non-industrial processes. In the present article, we will review this topic, analyzing current information on the specific regulations, the selection of living donors as well as MSCs from different sources (bone marrow, adipose tissue, umbilical cord, etc.), in-process quality controls for ensuring cell efficiency and safety during all stages of the manual and automatic (bioreactors) manufacturing process, including cryopreservation, the use of cell banks, handling medicines, transport systems of ATMPs, among other related aspects, according to European and US legislation. Our aim is to provide a guide for a better, homogeneous manufacturing of therapeutic cellular products with special reference to MSCs.

Tabaquismo activo en adolescentes de noveno grado. Cienfuegos, 2019

RESUMEN Fundamento: el consumo de tabaco es un factor de riesgo que predispone a diversas enfermedades. La adolescencia es la etapa donde fundamentalmente se inician los fumadores, por tanto es necesario el trabajo preventivo desde etapas tempranas de la vida. Objetivo: determinar las características del tabaquismo activo en adolescentes. Métodos: estudio descriptivo de corte transversal, con estudiantes de noveno de la Secundaria Básica Frank País García, de Cienfuegos. Se analizaron las variables edad, sexo, características clínicas (dadas por intensidad, frecuencia y señales de dependencia), conocimientos acerca del tabaquismo y actitudes hacia este. Resultados: la muestra quedó conformada por 180 estudiantes; 56,6 % femeninos y 43,3 % masculinos. Predominaron los estudiantes de 14 años y no fumadores. El nivel de conocimiento sobre el tabaquismo fue inadecuado para ambos grupos. No hubo relación significativa entre el sexo, el conocimiento y el hábito de fumar; la mayoría mostró una actitud de rechazo al cigarro. Más de la mitad de los fumadores consumía casi todos los días del mes. La frecuencia fue de 6 a 10 cigarros al día, un grupo menor de estudiantes (30,8 %) presentó dependencia nicotínica. Conclusiones: se corroboró que el consumo de tabaco estuvo presente en algunos de los estudiantes de la muestra y también la dependencia nicotínica lo cual es de gran relevancia debido a la etapa de la vida en que se encuentran.

ABSTRACT Background: tobacco use is a risk factor that predisposes to various diseases. Adolescence is the stage where smokers mainly start, therefore preventive work is necessary from the early stages of life. Objective: to determine the characteristics of active smoking in adolescents. Methods: descriptive cross-sectional study with ninth-grade students from Frank País García Elementary School in Cienfuegos. The variables age, sex, clinical characteristics (given by intensity, frequency and signs of dependence), knowledge about smoking and attitudes towards it were analyzed. Results: the sample was made up of 180 students; 56.6% female and 43.3% male. 14-year-old non-smoking students predominated. The level of knowledge about smoking was inadequate for both groups. There was no significant relationship between sex, knowledge, and smoking; the majority showed an attitude of rejection of cigarettes. More than half of the smokers consumed almost every day of the month. The frequency was 6 to 10 cigarettes a day, a smaller group of students presented nicotinic dependence (30.8%). Conclusions: it was confirmed that tobacco consumption was present in some of the students in the sample and also nicotinic dependence, which is of great relevance due to the stage of life in which they are.

Confocal imaging dataset to assess endothelial cell orientation during extreme glucose conditions.

Confocal microscopy offers a mean to extract quantitative data on spatially confined subcellular structures. Here, we provide an imaging dataset of confocal z-stacks on endothelial cells spatially confined on lines with different widths, visualizing the nucleus, F-actin, and zonula occludens-1 (ZO-1), as well as the lines. This dataset also includes confocal images of spatially confined endothelial cells challenged with different glucose conditions. We have validated the image quality by established analytical means using the MeasureImageQuality module of the CellProfilerTM software. We envision that this dataset could be used to extract data on both a population and a single cell level, as well as a learning set for the development of new image analysis tools.

Tumor cardíaco en edad pediátrica

RESUMEN Introducción: Los tumores cardíacos no son frecuentes en pediatría. Su incidencia estimada es del 0,001 % en estudios necrópsicos y de hasta 0,3 % en estudios ecocardiográficos. Objetivo: Mostrar la localización infrecuente de un mixoma en el ventrículo derecho. Presentación de caso: Lactante de 30 días de edad que comienza con dificultad respiratoria leve y al examen clínico se constata la presencia de soplo cardiaco; se admite en hospital Juan B. Viñas en Palma Soriano provincia de Santiago de Cuba, con la sospecha de cardiopatía congénita. Se realizan exámenes complementarios, el estudio radiológico muestra cardiomegalia, en la ecocardiografía en modo B se observa tumoración en ventrículo derecho y derrame pericárdico; se traslada al Cardiocentro Nacional Pediátrico "William Soler" donde se realiza la exptirpación parcial de la tumoración. El estudio histopatológico concluye mixoma del ventrículo derecho. Conclusiones: La ecocardiografía en modo B es una herramienta muy importante para el diagnóstico de las tumoraciones intracardiacas, brinda la localización, dimensiones y estimación del grado de repercusión de la masa intracardiaca. La indicación quirúrgica depende más del efecto hemodinámico de la tumoración que de su origen anatomopatológico.

ABSTRACT Introduction: Cardiac tumors are not frequent in pediatrics. Its estimated incidence is 0.001% in autopsy studies and up to 0.3% in echocardiographic studies. Objective: To show the rare location of a myxoma in the right ventricle. Case report: A 30-day-old infant started to have mild respiratory distress and the clinical examination revealed the presence of a heart murmur. He was admitted to Juan B. Viñas Hospital in Palma Soriano, Santiago de Cuba province under the suspicion of congenital heart disease. Complementary examinations were performed, the radiological study showed cardiomegaly, B-mode echocardiography revealed a tumor in the right ventricle and pericardial effusion. He was transferred to William Soler National Pediatric Cardio Institute, to the partial removal of the tumor. The histopathological study revealed a myxoma of the right ventricle. Conclusions: B-mode echocardiography is a very important tool for the diagnosis of intracardiac tumors, it provides the location, dimensions and estimation of the degree of repercussion of the intracardiac mass. The surgical indication depends more on the hemodynamic effect of the tumor than on its pathological origin.

Molecular Epidemiology of Anisakis spp. in Wedge Sole, Dicologlossa cuneata (Moreau, 1881), from Fishmarkets in Granada (Southern Spain), Caught in Two Adjacent NE and CE Atlantic Areas.

The presence of third stage larvae (L3) of Anisakis spp. in wedge sole, Dicologlossa cuneata (Moreau, 1881), purchased in fishmarkets in the city of Granada (Andalusia, southern Spain) was assessed. The wedge sole were caught in two FAO zones: area 27.IXa NE Atlantic (SW Spain coast) and area 34.1.11 CE Atlantic (NW Morocco coast). Only Anisakis larvae, type I, were detected in the largest fish (>20 cm) from the CE Atlantic. These were molecularly identified as A. simplex s.s. The prevalence (P) of Anisakis in this area was 12.5% and the mean intensity (MI) was 1. The presence of Hysterothylacium spp. larvae was also detected in the fish from both areas, with the prevalence being approximately double in the CE Atlantic area (12.5 vs. 5.7). A comparison between the Anisakis-infected and non-infected fish from this area showed that the former were significantly longer than the latter (p < 0.01). These results show that Anisakis parasitization of wedge sole sold in the markets of the city of Granada is of low prevalence and intensity (P = 4.5, MI = 1), especially in those from area 27.IXa (P = 0), indicating that the risk of human infection is low, particularly as this fish is traditionally prepared by deep-frying in oil in Andalusia (southern Spain).

Brain microvasculature endothelial cell orientation on micropatterned hydrogels is affected by glucose level variations.

This work reports on an effort to decipher the alignment of brain microvasculature endothelial cells to physical constrains generated via adhesion control on hydrogel surfaces and explore the corresponding responses upon glucose level variations emulating the hypo- and hyperglycaemic effects in diabetes. We prepared hydrogels of hyaluronic acid a natural biomaterial that does not naturally support endothelial cell adhesion, and specifically functionalised RGD peptides into lines using UV-mediated linkage. The width of the lines was varied from 10 to 100 µm. We evaluated cell alignment by measuring the nuclei, cell, and F-actin orientations, and the nuclei and cell eccentricity via immunofluorescent staining and image analysis. We found that the brain microvascular endothelial cells aligned and elongated to these physical constraints for all line widths. In addition, we also observed that varying the cell medium glucose levels affected the cell alignment along the patterns. We believe our results may provide a platform for further studies on the impact of altered glucose levels in cardiovascular disease.

Efficacy and safety of intramuscular administration of allogeneic adipose tissue derived and expanded mesenchymal stromal cells in diabetic patients with critical limb ischemia with no possibility of revascularization: study protocol for a randomized controlled double-blind phase II clinical trial (The NOMA Trial).

BACKGROUND: Chronic lower limb ischemia develops earlier and more frequently in patients with type 2 diabetes mellitus. Diabetes remains the main cause of lower-extremity non-traumatic amputations. Current medical treatment, based on antiplatelet therapy and statins, has demonstrated deficient improvement of the disease. In recent years, research has shown that it is possible to improve tissue perfusion through therapeutic angiogenesis. Both in animal models and humans, it has been shown that cell therapy can induce therapeutic angiogenesis, making mesenchymal stromal cell-based therapy one of the most promising therapeutic alternatives. The aim of this study is to evaluate the feasibility, safety, and efficacy of cell therapy based on mesenchymal stromal cells derived from adipose tissue intramuscular administration to patients with type 2 diabetes mellitus with critical limb ischemia and without possibility of revascularization. METHODS: A multicenter, randomized double-blind, placebo-controlled trial has been designed. Ninety eligible patients will be randomly assigned at a ratio 1:1:1 to one of the following: control group (n = 30), low-cell dose treatment group (n = 30), and high-cell dose treatment group (n = 30). Treatment will be administered in a single-dose way and patients will be followed for 12 months. Primary outcome (safety) will be evaluated by measuring the rate of adverse events within the study period. Secondary outcomes (efficacy) will be measured by assessing clinical, analytical, and imaging-test parameters. Tertiary outcome (quality of life) will be evaluated with SF-12 and VascuQol-6 scales. DISCUSSION: Chronic lower limb ischemia has limited therapeutic options and constitutes a public health problem in both developed and underdeveloped countries. Given that the current treatment is not established in daily clinical practice, it is essential to provide evidence-based data that allow taking a step forward in its clinical development. Also, the multidisciplinary coordination exercise needed to develop this clinical trial protocol will undoubtfully be useful to conduct academic clinical trials in the field of cell therapy in the near future. TRIAL REGISTRATION: ClinicalTrials.gov NCT04466007 . Registered on January 07, 2020. All items from the World Health Organization Trial Registration Data Set are included within the body of the protocol.

Managing school interaction networks during the COVID-19 pandemic: Agent-based modeling for evaluating possible scenarios when students go back to classrooms.

The most unexpected and toughest phenomenon that has occurred in recent times is the global COVID-19 pandemic. One of the first measures to prevent the spread of the disease was to close educational institutions. The students were forced to start a learning process through social networks and web platforms. In some countries, a return to face-to-face classes was established. However, weeks later, some of them had to return to virtual activities due to an upswing in the COVID-19 cases. In Mexico, classes have been held virtually, with face-to-face activities only re-established in two of the 32 states. In our state, Yucatan, scholarly activities are still virtual. In this work, the dispersion of COVID-19 at different academic establishments in Yucatan was simulated. Networks of Friendship, noncordial treatment, family ties and study groups were considered. Based on these networks, we evaluated the possibility of returning to school without inducing a rebound in the COVID-19 cases in the state. Agent-based simulations were used, with each student as an agent. Interaction rules were established based on international research regarding good practices in times of COVID-19. We used seven networks from different academic institutions, ranging from primary through college level. As a result, possible contagion curves were obtained for different scenarios, which leads to a discussion about the measures that would be relevant once a return to face-to-face classes is overseen. Simulations show that isolating students and reducing the number of students in the same classroom are good strategies and substantially reduce the possible contagiousness.

Panorama of the Intracellular Molecular Concert Orchestrated by Actinoporins, Pore-Forming Toxins from Sea Anemones.

Actinoporins (APs) are soluble pore-forming proteins secreted by sea anemones that experience conformational changes originating in pores in the membranes that can lead to cell death. The processes involved in the binding and pore-formation of members of this protein family have been deeply examined in recent years; however, the intracellular responses to APs are only beginning to be understood. Unlike pore formers of bacterial origin, whose intracellular impact has been studied in more detail, currently, we only have knowledge of a few poorly integrated elements of the APs' intracellular action. In this review, we present and discuss an updated landscape of the studies aimed at understanding the intracellular pathways triggered in response to APs attack with particular reference to sticholysin II, the most active isoform produced by the Caribbean Sea anemone Stichodactyla helianthus. To achieve this, we first describe the major alterations these cytolysins elicit on simpler cells, such as non-nucleated mammalian erythrocytes, and then onto more complex eukaryotic cells, including tumor cells. This understanding has provided the basis for the development of novel applications of sticholysins such as the construction of immunotoxins directed against undesirable cells, such as tumor cells, and the design of a cancer vaccine platform. These are among the most interesting potential uses for the members of this toxin family that have been carried out in our laboratory.

A propósito de complicaciones infrecuentes de enfermedades comunes. Síndrome de Ekiri / About Infrequent complications of common diseases: Ekiri Syndrome

Resumen La infección por enterobacterias desencadena usualmente síntomas gastrointestinales caracterizados por vómito, diarrea y dolor abdominal, de severidad y curso variable. El compromiso extraintestinal esta descrito, inclusive sin las manifestaciones gastrointestinales clásicas lo que favorece diagnósticos y tratamientos tardíos pudiendo llegar a ser incapacitantes y letales. El síndrome de Ekiri, también denominado síndrome de encefalopatía letal tóxico, se caracteriza por una disfunción aguda del sistema nervioso central secundaria a infección por enterobacterias las cuales favorecen el desarrollo de microtrombos a nivel cerebral con inflamación mediada por el factor de necrosis tumoral α e IL- 1β y disfunción de la barrera hematoencefálica con una alta tasa de mortalidad. Dentro de nuestro conocimiento, presentamos el primer caso reportado en Colombia sobre el síndrome de Ekiri.

Abstract Gastrointestinal infection usually manifests with nausea, vomit and abdominal pain, all of them wit course and variable severity. Extrainstestinal compromise is described, even without gastrointestinal symptoms, what causes a delay on diagnosis and treatment, worsening the prognosis. Ekiri syndrome, also known as lethal toxic encephalopathy is characterized by an acute neurological dysfunction secondary to enterobacterial infection which favor thrombi development and local inflammation mediated by tumor necrosis factor alpha and IL-1β with blood brain barrier dysfunction and high mortality. As we know, we present the first Ekiri syndrome case reported in Colombia.