Identification of potential new T cell activation molecules: a Bioinformatic Approach.

T-cell activation is central for the initiation of T cell mediated adaptive immune response and is the result of the close communication between the Antigen Presenting Cell (APC) and the T lymphocyte. Although T-cell activation is currently well understood, and many intracellular pathways are well characterized, nevertheless new players are constantly identified, and this complements the known protein interactome. In this work we aimed to identify new proteins involved in T cell activation. We reviewed and analyzed results of microarray gene expression datasets reported in the public database GEO-NCBI. Using data from GSE136625, GSE50971, GSE13887, GSE11989 and GSE902 we performed different comparisons using R and other bioinformatic tools including GEO2R and we report here upregulated genes that have no previous reports in immune related functions and with potential participation upon T-cell activation. Our results indicate that RND3, SYT10, IgSF6 and PIN1 are potential new T-cell activation molecules.

Upregulated Nuclear Expression of Soluble Epoxide Hydrolase Predicts Poor Outcome in Breast Cancer Patients: Importance of the Digital Pathology Approach.

Breast cancer (BC) is the most common cancer in women, with incidence rates increasing globally in recent years. Therefore, it is important to find new molecules with prognostic and therapeutic value to improve therapeutic response and quality of life. The polyunsaturated fatty acids (PUFAs) metabolic pathway participates in various physiological processes, as well as in the development of malignancies. Although aberrancies in the PUFAs metabolic pathway have been implicated in carcinogenesis, the functional and clinical relevance of this pathway has not been well explored in BC. To evaluate the clinical significance of soluble epoxide hydrolase (EPHX2) expression in Mexican patients with BC using tissue microarrays (TMAs) and digital pathology (DP). Immunohistochemical analyses were performed on 11 TMAs with 267 BC samples to quantify this enzyme. Using DP, EPHX2 protein expression was evaluated solely in tumor areas. The association of EPHX2 with overall survival (OS) was detected through bioinformatic analysis in public databases and confirmed in our cohort via Cox regression analysis. Clear nuclear expression of EPHX2 was identified. Receiver operating characteristics (ROC) curves revealed the optimal cutoff point at 2.847062 × 10-3 pixels, with sensitivity of 69.2% and specificity of 67%. Stratification based on this cutoff value showed elevated EPHX2 expression in multiple clinicopathological features, including older age and nuclear grade, human epidermal growth factor receptor 2 (HER2) and triple negative breast cancer (TNBC) subtypes, and recurrence. Kaplan-Meier curves demonstrated how higher nuclear expression of EPHX2 predicts shorter OS. Consistently, multivariate analysis confirmed EPHX2 as an independent predictor of OS, with a hazard ratio (HR) of 3.483 and a 95% confidence interval of 1.804-6.724 (p < 0.001). Our study demonstrates for the first time that nuclear overexpression of EPHX2 is a predictor of poor prognosis in BC patients. The DP approach was instrumental in identifying this significant association. Our study provides valuable insights into the potential clinical utility of EPHX2 as a prognostic biomarker and therapeutic target in BC.

The Role of PTEN in Chemoresistance Mediated by the HIF-1α/YY1 Axis in Pediatric Acute Lymphoblastic Leukemia.

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Current chemotherapy treatment regimens have improved survival rates to approximately 80%; however, resistance development remains the primary cause of treatment failure, affecting around 20% of cases. Some studies indicate that loss of the phosphatase and tensin homolog (PTEN) leads to deregulation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, increasing the expression of proteins involved in chemoresistance. PTEN loss results in deregulation of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and induces hypoxia-inducible factor 1-alpha (HIF-1α) expression in various cancers. Additionally, it triggers upregulation of the Yin Yang 1 (YY1) transcription factor, leading to chemoresistance mediated by glycoprotein p-170 (Gp-170). The aim of this study was to investigate the role of the PTEN/NF-κB axis in YY1 regulation via HIF-1α and its involvement in ALL. A PTEN inhibitor was administered in RS4;11 cells, followed by the evaluation of PTEN, NF-κB, HIF-1α, YY1, and Gp-170 expression, along with chemoresistance assessment. PTEN, HIF-1α, and YY1 expression levels were assessed in the peripheral blood mononuclear cells (PBMC) from pediatric ALL patients. The results reveal that the inhibition of PTEN activity significantly increases the expression of pAkt and NF-κB, which is consistent with the increase in the expression of HIF-1α and YY1 in RS4;11 cells. In turn, this inhibition increases the expression of the glycoprotein Gp-170, affecting doxorubicin accumulation in the cells treated with the inhibitor. Samples from pediatric ALL patients exhibit PTEN expression and higher HIF-1α and YY1 expression compared to controls. PTEN/Akt/NF-κB axis plays a critical role in the regulation of YY1 through HIF-1α, and this mechanism contributes to Gp-170-mediated chemoresistance in pediatric ALL.

p38 Molecular Targeting for Next-Generation Multiple Myeloma Therapy.

Resistance to therapy and disease progression are the main causes of mortality in most cancers. In particular, the development of resistance is an important limitation affecting the efficacy of therapeutic alternatives for cancer, including chemotherapy, radiotherapy, and immunotherapy. Signaling pathways are largely responsible for the mechanisms of resistance to cancer treatment and progression, and multiple myeloma is no exception. p38 mitogen-activated protein kinase (p38) is downstream of several signaling pathways specific to treatment resistance and progression. Therefore, in recent years, developing therapeutic alternatives directed at p38 has been of great interest, in order to reverse chemotherapy resistance and prevent progression. In this review, we discuss recent findings on the role of p38, including recent advances in our understanding of its expression and activity as well as its isoforms, and its possible clinical role based on the mechanisms of resistance and progression in multiple myeloma.

Distribution of PD-L1, TROP2 and HER2- "lowness" in early triple-negative breast cancer: an opportunity for treatment de-escalation.

BACKGROUND: HER2, TROP2 and PD-L1 are novel targets in triple-negative breast cancer (TNBC). The combined expression status of these targets, and whether they can define prognostic subgroups, is currently undefined. METHODS: Immunohistochemistry was used to determine HER2, TROP2 and PD-L1 levels in 459 TNBC cases, that received in the adjuvant/neoadjuvant setting active surveillance, CMF, anthracycline-, anthracycline plus taxane-, or carboplatin-containing regimes. RESULTS: HER2-low patients with PD-L1 > 1 CPS (double-positive, herein "DP") had a mean PFS of 4768 days (95% CI: 4267-5268) versus 3522 days (95% CI: 3184-3861) for non-DP patients (P = 0.002). Regarding the received adjuvant treatment, DP patients (versus non-DP) receiving anthracyclines plus taxanes exhibited a mean PFS time of 4726 (95% CI: 4022-5430) versus 3302 (95% CI: 2818-3785) days (P = 0.039). Finally, 100% of DP patients that received a carboplatin-based regimen were long-term disease-free. CONCLUSIONS: Early HER2-low, PD-L1-positive TNBC patients have a very good prognosis, particularly if treated with anthracycline/taxane- or carboplatin-containing regimes.

Rabbit Fibroma Virus infection in domestic rabbits (Oryctolagus cuniculus) in Mexico.

Rabbit Fibroma is a Leporipoxviral disease and is considered the third most common cutaneous neoplasm in pet rabbits. Two domestic rabbits (Oryctolagus cuniculus) were submitted to the veterinary clinic due to the presence of a nodule on the lip. Histologically, epithelial cells of the epidermis and hair follicles showed mild to moderate ballooning degeneration, spongiosis, and several eosinophilic intracytoplasmic inclusion bodies. The dermis was expanded by atypical spindle cells that also showed eosinophilic intracytoplasmic inclusion bodies. The tissues were evaluated by using transmission electron microscopy. In both cases, keratinocytes exhibit several electron dense and pleomorphic intracytoplasmic viral particles consistent with Poxviruses. To our knowledge, this is the first case report of Rabbit Fibroma Virus infection in Domestic Rabbits in Mexico.

Growth Performance and Fecal Microbiota of Dairy Calves Supplemented with Autochthonous Lactic Acid Bacteria as Probiotics in Mexican Western Family Dairy Farming.

Probiotic supplementation in dairy cattle has achieved several beneficial effects (improved growth rate, immune response, and adequate ruminal microbiota). This study assessed the effects on the growth parameters and gut microbiota of newborn dairy calves supplemented with two Lactobacillus-based probiotics, individually (6BZ or 6BY) or their combination (6BZ + 6BY), administrated with the same concentration (1 × 109 CFU/kg weight) at three times, between days 5 and 19 after birth. The control group consisted of probiotic-unsupplemented calves. Growth parameters were recorded weekly until eight weeks and at the calves' ages of three, four, and five months. Fecal microbiota was described by high-throughput sequencing and bioinformatics. Although no significant effects were observed regarding daily weight and height gain among probiotic-supplemented and non-supplemented calves, correlation analysis showed that growth rate was maintained until month 5 through probiotic supplementation, mainly when the two-strain probiotics were supplied. Modulation effects on microbiota were observed in probiotic-supplemented calves, improving the Bacteroidota: Firmicutes and the Proteobacteria ratios. Functional prediction by PICRUSt also showed an increment in several pathways when the two-strain probiotic was supplemented. Therefore, using the three-administration scheme, the two-strain probiotic improved the growth rate and gut microbiota profile in newborn dairy calves. However, positive effects could be reached by applying more administrations of the probiotic during the first 20 days of a calf's life.

IMT504 protects beta cells against apoptosis and maintains beta cell identity, without modifying proliferation.

We have demonstrated that oligodeoxynucleotide IMT504 promotes significant improvement in the diabetic condition in diverse animal models. Based on these results, here we evaluated whether these effects observed in vivo could be due to direct effects on ß-cells. We demonstrate by immunofluorescence that IMT504 enters the cell and locates in cytoplasm where it induces GSK-3ß phosphorylation that inactivates this kinase. As GSK-3ß tags Pdx1 for proteasomal degradation, by inactivating GSK-3ß, IMT504 induces an increase in Pdx1 protein levels, demonstrated by Western blotting. Concomitantly, an increase in Ins2 and Pdx1 gene transcription was observed, with no significant increase in insulin content or secretion. Enhanced Pdx1 is promising since it is a key transcription factor for insulin synthesis and is also described as an essential factor for the maintenance ß-cell phenotype and function. Dose-dependent inhibition of H2 O2 -induced apoptosis determined by ELISA as well as decreased expression of Bax was also observed. These results were confirmed in another ß-cell line, beta-TC-6 cells, in which a cytokine mix induced apoptosis that was reversed by IMT504. In addition, an inhibitor of IMT504 entrance into cells abrogated the effect IMT504. Based on these results we conclude that the ß-cell recovery observed in vivo may include direct effects of IMT504 on ß-cells, by maintaining their identity/phenotype and protecting them from oxidative stress and cytokine-induced apoptosis. Thus, this work positions IMT504 as a promising option in the framework of the search of new therapies for type I diabetes treatment.

Formation of silver halos by Sphingomonas paucimobilis MX8 and its bioleaching of silver from computer keyboard printed circuit boards.

Silver (Ag) is currently obtained from primary and secondary sources through hydrometallurgical and pyrometallurgical processes. However, these processes consume high amounts of energy and are environmentally unfriendly. The search for bacteria tolerant with a high leaching capacity for to Ag is therefore a necessary requirement as part of the development of bioleaching technologies with reduced impact on the environment and lower energy expenditure. In this sense, the objective of this research was to evaluate the tolerance of Sphingomonas paucimobilis MX8 to Ag added to nutrient agar, and to determine whether this tolerance could favor the bioleaching of Ag present on the printed circuit boards (PCBs) of computer keyboards. The bacteria Sphingomonas paucimobilis MX8 was cultured in Petri dishes with nutrient agar and four different concentrations of AgNO3 (200, 400, 600, and 800 mg L-1) at 28 °C for 10 days. For the bioleaching experiment, the bacteria were grown in a mineral medium with computer keyboard PCBs for 30 days at room temperature (17 to 22 °C) and centrifugation at 150 rpm. The results indicate that Sphingomonas paucimobilis MX8 is tolerant to Ag and forms a silvery halo around its growth in the presence of this metal. Furthermore, Sphingomonas paucimobilis MX8 was able to bioleach 12% of the Ag found in computer keyboard PCBs. The results obtained could help generate more environmentally friendly silver bioleaching processes in which the silver bioleaching capacity of this bacterium is increased.

The Experience of Testing for Coronavirus Disease (COVID-19) at a Single Diagnostic Center in Paraguay before the Introduction of Vaccination.

Soon after the declaration of the COVID-19 pandemic, the Institute for Health Sciences Research (IICS) of the National University of Asunción, Paraguay became a testing laboratory (COVID-Lab) for SARS-CoV-2. The COVID-Lab testing performance was assessed from 1 April 2020 to 12 May 2021. The effect of the pandemic on the IICS and how the COVID-Lab contributed to the academic and research activities of the institute were also assessed. IICS researchers and staff adjusted their work schedules to support the COVID-Lab. Of the 13,082 nasopharyngeal/oropharyngeal swabs processed, 2704 (20.7%) tested positive for SARS-CoV-2 by RT-PCR. Of the individuals testing positive, 55.4% were female and 48.3% were aged 21-40 years. Challenges faced by the COVID-Lab were unstable reagent access and insufficient staff; shifting obligations regarding research, academic instruction, and grantsmanship; and the continuous demands from the public for information on COVID-19. The IICS provided essential testing and reported on the progress of the pandemic. IICS researchers gained better laboratory equipment and expertise in molecular SARS-CoV-2 testing but struggled to manage their conflicting educational and additional research obligations during the pandemic, which affected their productivity. Therefore, policies protecting the time and resources of the faculty and staff engaged in pandemic-related work or research are necessary components of healthcare emergency preparedness.

Validation into Spanish of a Scale to Detect the Post-intensive Care Syndrome.

OBJECTIVES: This work sought to validate the Spanish version of the scale Healthy Aging Brain-Care Monitor (HABC-M) scale as clinical tool to detect the Post-intensive Care Syndrome. METHODS: Psychometric study, conducted in adult intensive care units from two high-complexity university hospitals in Colombia. The sample was integrated by 135 survivors of critical diseases with mean age of 55 years. The translation of the HABC-M was carried out through transcultural adaptation, evaluating content, face, and construct validity and determining the scale's reliability. RESULTS: A replica was obtained of the HABC-M scale in its version into Spanish, semantically and conceptually equivalent to the original version. The construct was determined through confirmatory factor analysis (CFA), evidencing a three-factor model comprised of the subscales: cognitive (6 items), functional (11 items), and psychological (10 items), with a confirmatory factor index (CFI) of 0.99, a Tucker Lewis index (TLI) of 0.98, and an approximate root-mean-square error (RMSE) of 0.073 (90% CI: 0.063 - 0.084). Internal consistency was determined through Cronbach's alpha coefficient, obtaining 0.94, (95% CI 0.93 - 0.96). CONCLUSIONS: The Spanish of the HABC-M scale is a tool with adequate psychometric properties, validated and reliable to detect the Post-intensive Care Syndrome.

Validation into Spanish of a Scale to Detect the Post-intensive Care Syndrome / Validación al español de una escala para detectar el Síndrome Poscuidado Intensivo / Validação em espanhol de uma escala para detectar a Síndrome de Cuidados Pós-Intensivos

Objective. This work sought to validate the Spanish version of the scale Healthy Aging Brain-Care Monitor (HABC-M) scale as clinical tool to detect the Post-intensive Care Syndrome. Methods. Psychometric study, conducted in adult intensive care units from two high-complexity university hospitals in Colombia. The sample was integrated by 135 survivors of critical diseases with mean age of 55 years. The translation of the HABC-M was carried out through transcultural adaptation, evaluating content, face, and construct validity and determining the scale's reliability. Results. A replica was obtained of the HABC-M scale in its version into Spanish, semantically and conceptually equivalent to the original version. The construct was determined through confirmatory factor analysis (CFA), evidencing a three-factor model comprised of the subscales: cognitive (6 items), functional (11 items), and psychological (10 items), with a confirmatory factor index (CFI) of 0.99, a Tucker Lewis index (TLI) of 0.98, and an approximate root-mean-square error (RMSE) of 0.073 (90% CI: 0.063 ­ 0.084). Internal consistency was determined through Cronbach's alpha coefficient, obtaining 0.94, (95% CI 0.93 ­ 0.96). Conclusion. The Spanish of the HABC-M scale is a tool with adequate psychometric properties, validated and reliable to detect the Post-intensive Care Syndrome.

Objetivo. Validar la versión en español de la escala Healthy Aging Brain-Care Monitor (HABC-M) como herramienta clínica para la detección del síndrome poscuidado intensivo. Métodos. Estudio psicométrico, el cual se llevó a cabo en unidades de cuidado intensivo adulto de dos hospitales universitarios de alta complejidad en Colombia. La muestra fue integrada por un total de 135 sobrevivientes a enfermedades críticas con edad promedio de 55 años. La traducción del HABC-M se realizó mediante adaptación transcultural, evaluándose la validez de contenido, facial, constructo y determinándose la confiabilidad de la escala. Resultados. Se obtuvo una réplica de la escala HABC-M en su versión al español, semántica y conceptualmente equivalente a la versión original. El constructo se determinó a través de análisis factorial confirmatorio (AFC), evidenciando un modelo de tres factores compuesto por las subescalas: cognitiva (6 ítems), funcional (11 ítems) y psicológica (10 ítems), con un índice de factores confirmatorios (CFI) de 0.99, un índice de Tucker Lewis (TLI) de 0.98 y una raíz cuadrada del error cuadrático medio aproximado (RMSEA) de 0.073 (IC 90 %: 0.063 ­ 0.084). La consistencia interna se determinó mediante el coeficiente alfa de Cronbach, obteniendo e 0.94, (IC 95 % 0.93 ­ 0.96). Conclusión. La versión en español de la escala HABC-M es una herramienta con adecuadas propiedades psicométricas, válida y confiable para la detección del síndrome poscuidado intensivo.

Objetivo. Para validar a versão espanhola da escala Healthy Aging Brain-Care Monitor (HABC-M) como uma ferramenta clínica para a detecção da síndrome do cuidado pós-cuidado. Métodos. Estudo psicométrico, que foi realizado em unidades de terapia intensiva para adultos de dois hospitais universitários de alta complexidade na Colômbia. A amostra consistiu em 135 sobreviventes de doenças críticas. A tradução do HABC-M foi realizada por meio de adaptação transcultural, avaliando o conteúdo, facial e construção de validade e determinando a confiabilidade da escala. Resultados.Uma réplica da escala HABC-M foi obtida em sua versão em espanhol, semântica e conceitualmente equivalente à versão original. A construção foi determinada através da análise fatorial confirmatória, mostrando um modelo de três fatores composto pelas subescalas: cognitiva (6 itens), funcional (11 itens) e psicológica (10 itens), com um índice fator confirmatório (CFI) de 0.99, um índice de Tucker Lewis (TLI) de 0.98 e um erro médio quadrático aproximado da raiz (RMSEA) de 0.073 (90% CI: 0.063 ­ 0.084). A consistência interna foi determinada pelo coeficiente alfa do Cronbach, com de 0.94 (95 % CI 0.93 ­ 0.96). Conclusão. A versão espanhola da escala HABC-M é uma ferramenta com propriedades psicométricas adequadas, válida e confiável para a detecção da síndrome do pós-cuidado intensivo

Tumor P70S6K hyperactivation is inversely associated with tumor-infiltrating lymphocytes in triple-negative breast cancer.

PURPOSE: Triple-negative breast cancer (TNBC) is characterized by large heterogeneity and relative lack of available targeted therapies. To find therapeutic strategies for distinct patients with TNBC, several approaches have been used for TNBC clustering, including recently immune and phosphoproteomic patterns. Based on 70-kDa ribosomal protein S6 kinase (P70S6K)-TNBC clustering, the current study explores the immune profiling in TNBC tumors. METHODS: Stromal tumor-infiltrating lymphocytes (sTILs) were evaluated in human TNBC tumor samples. Furthermore, immunohistochemistry staining for CD8, CD4, Foxp3, and CD20 was performed in tissue microarrays (TMA) sections. RESULTS: Histological analysis showed decreased sTILs, CD20+ cells, and CD8+/CD4+ ratio in high phosphorylated P70S6K (p-P70S6K) tumors. Moreover, p-P70S6K score was directly correlated with CD4+ and Foxp3+ T cells, while it was inversely correlated with CD8+/CD4+ and CD8+/Foxp3+ ratios. CONCLUSION: sTIL infiltration and lymphocyte profiling vary in the context of hyperactivation of P70S6K in TNBC tumors.

Mecanismos plasmídicos de resistencia a quinolonas, betalactámicos y colistina en Salmonella enterica. Paraguay 2020-2021

Las bacterias son capaces de desarrollar mecanismos de resistencia a los antimicrobianos, aquellos adquiridos y transmisibles son los más significativos debido al potencial de diseminación. La aparición de Salmonella enterica con resistencia a C3aG, quinolonas y a colistina representa una amenaza progresiva. El objetivo fue determinar la resistencia a los antimicrobianos y la presencia de los mecanismos de resistencia plasmídicos a quinolonas, ß-lactámicos y colistina en aislados de Salmonella provenientes de la vigilancia integrada de enteropatógenos. Fueron estudiadas 501 cepas de Salmonella spp. colectadas entre los años 2020 y 2021, por la red de enteropatógenos del Laboratorio Central de Salud Pública. Se investigó la resistencia a las C3aG, quinolonas y colistina, en aislamientos de humanos, alimentos, animales de consumo y ambiente. Las cepas estudiadas exhibieron resistencia a tetraciclina (32,5%), ácido nalidíxico (29%), ampicilina (13,2%), nitrofurantoína (11,6%), C3aG (7,2%), cotrimoxazol (5,8%), ciprofloxacina (2,2%). El 18% (90/501) presentaron resistencia trasferible por plásmidos, fueron detectados 111 genes (71 cepas con un gen, 17 cepas dos genes y 2 cepas tres genes diferentes). Qnr B: 41,1% (37/90), mcr-1: 38,9% (35/90), CMY: 23,3% (21/90), CTX-M: 16,7% (15/90) y Qnr S: 3,3% (3/90). Heidelberg fue el serovar predominante en muestras de pollo y el mayor portador de genes de resistencia de tipo CMY y mcr-1. La detección de genes en alimentos y animales de consumo, que pueden transmitirse fácilmente al ser humano es motivo de alerta y resalta la importancia de continuar fortaleciendo la vigilancia multisectorial y multidisciplinaria.

Bacteria can develop antimicrobial resistance mechanisms, those acquired and transmissible being the most significant due to the potential for dissemination. The emergence of Salmonella enterica with resistance to third-generation cephalosporins, quinolones, and colistin represents a progressive threat. The objective was to determine antimicrobial resistance and the presence of plasmid resistance mechanisms to quinolones, ß-lactams, and colistin in Salmonella isolates from integrated surveillance of enteropathogens. Five hundred and one strains of Salmonella spp. collected between 2020 and 2021 were studied by the enteropathogen network of the Laboratorio Central de Salud Publica (Central Public Health Laboratory). Research was conducted on the resistance to third-generation cephalosporins, quinolones, and colistin, isolated from humans, foodstuffs, animals for consumption, and the environment. The strains studied exhibited resistance to tetracycline (32.5%), nalidixic acid (29%), ampicillin (13.2%), nitrofurantoin (11.6%), third-generation cephalosporins (7.2%), cotrimoxazole (5.8%), and ciprofloxacin (2.2%). Eighteen percent (90/501) presented plasmid-transferable resistance, 111 genes were detected (71 strains with one gene, 17 strains with two genes, and 2 strains with three different genes). Qnr B: 41.1% (37/90), mcr-1: 38.9% (35/90), CMY: 23.3% (21/90), CTX-M: 16.7% (15/90), and Qnr S: 3.3% (3/90). Heidelberg was the predominant serovar in chicken samples and the largest carrier of CMY and mcr-1 resistance genes. The detection of genes in foodstuffs and animals for consumption, which can be easily transmitted to humans, is a cause for alarm and highlights the importance of continuing to strengthen multisectoral and multidisciplinary surveillance.

Cumplimiento de la política transfusional restrictiva en el Instituto de Cardiología y Cirugía Cardiovascular 2019-2021 / Compliance with the restrictive transfusional policy at the Institute of Cardiology and Cardiovascular Surgery 2019-2021

Introducción: A principios del siglo XXI el déficit de sangre y los riesgos de la transfusión, determinaron la adopción de una política transfusional restrictiva, con cifras de hemoglobina entre 70 y 100 g/L para pacientes cardiovasculares en el mundo. En el Instituto de Cardiología y Cirugía Cardiovascular se adoptó esta política, por lo cual es necesario controlar su cumplimiento, para hacer un uso racional y seguro de este recurso. Objetivo: Evaluar el cumplimiento de la política transfusional restrictiva del Instituto de Cardiología y Cirugía Cardiovascular entre 2019 y 2021. Métodos: Se realizó un estudio observacional descriptivo transversal, mediante la revisión del registro de pacientes transfundidos y las órdenes de transfusión, lo que permitió llegar a resultados. Resultados: Se transfundieron 5408 hemocomponentes, 64,1 por ciento concentrados de eritrocitos. Los servicios con mayor consumo fueron: la unidad de cuidados intensivos posquirúrgicos 53,2 por ciento, el salón de operaciones 22,8 por ciento y la unidad de cuidados intensivos de emergencia 10,8 por ciento. La media de las cifras de hematocrito/hemoglobina de los pacientes transfundidos fue 0,24/79,2 g/L, inferior 0,22/72,6 g/L para los operados por valvulopatías cardíacas severas. El 95,9 por ciento de las órdenes de transfusión reunieron los requisitos normados. El principal problema fue la omisión de los antecedentes transfusionales. Conclusiones: Se cumplió la política transfusional restrictiva. La media de las cifras de hematocrito/hemoglobina fue menor a las recomendadas para pacientes cardiovasculares en las guías cubanas. La calidad de las órdenes de transfusión fue adecuada(AU)

Introduction: At the beginning of the 21st century, the blood deficit and transfusion risks determined the adoption of a restrictive transfusion policy, with hemoglobin levels between 70 and 100 g/L for cardiovascular patients in the world. In the Institute of Cardiology and Cardiovascular Surgery, this policy was adopted for which it is necessary to control compliance, to make a rational and safe use of this resource. Objective: Evaluate compliance with the restrictive transfusion policy of the Institute of Cardiology and Cardiovascular Surgery between 2019 and 2021. Method: An observational descriptive cross-sectional study was carried out by reviewing the records of transfused patients and transfusion orders, which allowed reaching results. Results: 5 408 hem components were transfused, 64,1 percent were packed erythrocytes. The services with the highest consumption were the post-surgical intensive care unit 53,2 percent, the operating room 22,8 percent and the emergency intensive care unit 10,8 percent. The mean of the hematocrit/hemoglobin values of the transfused patients was 0,24/79,2 g/L, lower 0,22/72,6 g/L for those operated on for severe heart valve disease. 95,9 percent of the transfusion orders met the regulatory requirements. The main problem was the omission of transfusion history. Conclusion: The restrictive transfusion policy was complied with. The mean hematocrit/hemoglobin values were lower than those recommended for cardiovascular patients in The Cuban guidelines. The quality of the transfusion orders was adequate(AU)

Sangramiento posextracción dentaria y medidas para su control en pacientes tratados con antiagregantes plaquetarios / Bleeding after tooth extraction and measures for its control in patients treated with antiplatelet agents

Introducción: El desarrollo de las ciencias médicas trae consigo un incremento en la expectativa de vida, junto a la detección temprana de un gran número de enfermedades crónicas como las cerebrovasculares y cardiovasculares, que son tratadas rutinariamente con medicamentos antiagregantes plaquetarios. El conocimiento del manejo de estos pacientes ante los procedimientos quirúrgicos estomatológicos constituye un reto en la práctica diaria profesional. Objetivo: Determinar el nivel de sangramiento posextracción dentaria en pacientes con enfermedad cardiovascular y cerebrovascular, según el tipo de antiagregantes plaquetarios y grupo dentario, así como la frecuencia de utilización de las medidas para su control. Métodos: Se efectuó un estudio observacional, descriptivo, longitudinal y prospectivo con un universo de 136 pacientes de más de 20 años, remitidos por su cardiólogo y que necesitaban realizarse extracciones dentarias sin modificar su tratamiento con antiagregantes plaquetarios. Las variables estudiadas fueron la enfermedad sistémica, el tipo de antiagregante plaquetario, el nivel de sangramiento, grupo dentario intervenido y método hemostático utilizado. Resultados: La mitad de los pacientes estudiados no presentó sangramiento posextracción dentaria. En los pacientes tratados con aspirina o clopidogrel predominaron los sujetos sin sangramiento para un 84,3 por ciento y 62,5 por ciento, respectivamente. En los de doble antiagregación prevaleció el sangramiento moderado con un 46,3 por ciento. Los grupos dentarios incisivo, canino y premolar no presentaron episodios de sangramiento para un 64,1 por ciento, 51,6 por ciento y 53,3por ciento, respectivamente. El método hemostático más utilizado fue la compresión de las corticales y termoterapia fría (47,8 por ciento). Conclusiones: La mitad de los pacientes con enfermedades cardiovasculares y cerebrovasculares no presentaron sangramiento posextracción dentaria(AU)

Introduction: The development of medical sciences brings with it an increase in life expectancy, together with the early detection of a large number of chronic diseases such as cerebrovascular and cardiovascular diseases, which are routinely treated with antiplatelet aggregation drugs. Knowledge on the treatment of these patients before stomatological surgical procedures constitutes a challenge in daily professional practice. Objective: To determine the level of bleeding after tooth extraction in patients with cardiovascular and cerebrovascular disease, according to the type of antiplatelet agents and dental group, as well as the frequency of use of measures for their control. Methods: An observational, descriptive, longitudinal and prospective study was carried out with a universe of 136 patients over 20 years of age, referred by their cardiologist, who needed dental extractions without modifying their treatment with antiplatelet agents. The variables studied were systemic disease, type of antiplatelet agent, level of bleeding, dental group treated and hemostatic method used. Results: Half of the patients studied did not present bleeding after tooth extraction. In patients treated with aspirin or clopidogrel, 84.3 percent and 62.5por ciento, respectively, had no bleeding. In those with double antiplatelet therapy, modera te bleeding prevailed with 46.3 The incisor, canine and premolar tooth groups did not present bleeding episodes (64.1 percent, 51.6and 53.3 percent respectively). The most commonly used hemostatic method was cortical compression and cold thermotherapy (47.8%). Conclusions: Half of the patients with cardiovascular and cerebrovascular diseases did not present bleeding after tooth extraction(AU)

Scales to measure post intensive care syndrome, a scoping review.

INTRODUCTION: Post Intensive Care Syndrome is a recently studied syndrome that affects between 50% and 70% of patients admitted to the ICU, its detection is complex due to the great variety of affected components. OBJECTIVE: To determine the most widely used assessment instruments for the detection of post-intensive care syndrome, according to the evidence in the last 5 years. METHODOLOGY: A scoping review was carried out in the databases: Academic Search, ScienceDirect, Scielo, Biblioteca Virtual en Salud, Medline, and Springer Link, with terms «Postintensive care syndrome¼ and «Post-intensive care syndrome¼. This review included 22 articles that met the criteria of: research or review typology, English, Spanish or Portuguese language, with access to the full text and published between 2015 and 2020. CONCLUSIONS: Most of the instruments used to measure post-intensive care syndrome are divided according to the components of physical affectation (the Medical Research Council scale, the Katz index and the Barthel index); cognitive (Repeatable Battery for the Assessment of Neuropsychological Status, and the Montreal Cognitive Assessment test); and mental (Hospital Anxiety and Depression Scale, Beck's anxiety test, Depression Inventory Second Edition scale and Post Traumatic Stress Syndrome-14 scale). In addition, two tools were found that measure the event in its entirety with its three components, such as the Healthy Aging Brain Care Monitor and the Post-Intensive Care Syndrome Questionnaire.

Laparoscopic nephrectomy in patients with renal exclusion secondary to urolithiasis. Which factors can predispose conversion to open surgery?

BACKGROUND: The prevalence of urolithiasis is 7-10% and has increased over the past years. Simple nephrectomy is, therefore, indicated when renal exclusion is associated with recurrent urinary tract infections and/or chronic pain. OBJECTIVE: The aim of the study was to describe the surgical experience of laparoscopic nephrectomy (LPN) due to urolithiasis in Mexican South-east and which factors can predispose conversion to open surgery. METHODS: This was a retrospective study including patients with renal exclusion secondary to urolithiasis, who underwent laparoscopic simple nephrectomy between 2016 and 2019. RESULTS: Forty simple LPN for renal exclusion due to urolithiasis was performed between 2016 and 2019. Mean age was 47 ± 10.8 and 82.5% were female. The mean BMI was 30.2 ± 5 kg/m2, mean operative time was 165.2 ± 64. Conversion rate was 12.5% (n = 5). Conversion was significantly associated with abnormal hilum vascular anatomy (p = 0.001), hilum adherences (p = 0.001), and hydronephrosis (p = 0.001). CONCLUSION: LPN is a safe surgical technique for renal exclusion due to urolithiasis. Hydronephrosis, abnormal vascular anatomy, and the adherences that involved de hilum are the factors that could predictive conversion to open surgery.

INTRODUCCIÓN: La prevalencia the urolitiasis es del 7-10% sin embargo a presentado un incremento del numero de casos en los ultimos años. La nefrectomia simple laparoscopica esta indicada en pacientes con exclusión renal asociado a cuadros repetitivos de infecciones en el tracto urinario y o dolor cronico a nivel fosa renal. OBJETIVO: Describir la experiencia de nefrectomia simple laparoscopica en pacientes con exclusion renal secundario litiasis en un hospital del sur de México, y que factores pueden predisponer la conversión a cirugia abierta. MATERIALS Y METODOS: Estudio restrospectivo que incluyo pacientes con exclusion renal secundario a urolitiasis durante el periodo comprendido entre 2016 y 2019. RESULTADOS: Se realizaron 40 nefrectomias simples laparoscopica durante el periodo comprendido 2016 y 2019 en paciente con exclusion renal asociada a litiasis. La media edad 47 ± 10.8 años, el 82.5% de los pacientes fueron del sexo femenino. La media de Indice de masa corporal fue de 30.2 ± 5 kg/m2, La tasa de conversion fue del 12.5% (n = 5), los factores que se asociaron a conversion a cirugia abierta fueron anormalidades dependientes del hilio vascular renal (p = 0.001)., adherencias dependientes del hilio renal (p = 0.001). e hidronefrosis (p = 0.001). CONCLUSIÓN: La nefrectomia simple laparocopica es un procedimiento seguro en pacienres con exclusion renal secundaria a urolitiasis. Hidronefrosis, anormalidades dependientes del hilio vascular renal y adherencias que involucren el hilio renal son factores que pueden predisponer conversion a cirugia abierta.

Role of MicroRNA-7 (MiR-7) in Cancer Physiopathology.

miRNAs are non-coding RNA sequences of approximately 22 nucleotides that interact with genes by inhibiting their translation through binding to their 3' or 5' UTR regions. Following their discovery, the role they play in the development of various pathologies, particularly cancer, has been studied. In this context, miR-7 is described as an important factor in the development of cancer because of its role as a tumor suppressor, regulating a large number of genes involved in the development and progression of cancer. Recent data support the function of miR-7 as a prognostic biomarker in cancer, and miR-7 has been proposed as a strategy in cancer therapy. In this work, the role of miR-7 in various types of cancer is reviewed, illustrating its regulation, direct targets, and effects, as well as its possible relationship to the clinical outcome of cancer patients.

Omega-6 Polyunsaturated Fatty Acids Enhance Tumor Aggressiveness in Experimental Lung Cancer Model: Important Role of Oxylipins.

Lung cancer is currently the leading cause of cancer death worldwide; it is often diagnosed at an advanced stage and bears poor prognosis. It has been shown that diet is an important environmental factor that contributes to the risk and mortality of several types of cancers. Intake of ω-3 and ω-6 PUFAs plays an important role in cancer risk and progression. Current Western populations have high consumption of ω-6 PUFAs with a ratio of ω-6/ω-3 PUFAs at 15:1 to 16.7:1 This high consumption of ω-6 PUFAs is related to increased cancer risk and progression. However, whether a diet rich in ω-6 PUFAs can contribute to tumor aggressiveness has not been well investigated. We used a murine model of pulmonary squamous cell carcinoma to study the aggressiveness of tumors in mice fed with a diet rich in ω-6 PUFAs and its relationship with oxylipins. Our results shown that the mice fed a diet rich in ω-6 showed a marked increase in proliferation, angiogenesis and pro-inflammatory markers and decreased expression of pro-apoptotic proteins in their tumors. Oxylipin profiling revealed an upregulation of various pro-tumoral oxylipins including PGs, HETEs, DiHETrEs and HODEs. These results demonstrate for the first time that high intake of ω-6 PUFAs in the diet enhances the malignancy of tumor cells by histological changes on tumor dedifferentiation and increases cell proliferation, angiogenesis, pro-inflammatory oxylipins and molecular aggressiveness targets such as NF-κB p65, YY1, COX-2 and TGF-ß.