Early Genomic, Epidemiological, and Clinical Description of the SARS-CoV-2 Omicron Variant in Mexico City.

Omicron is the most mutated SARS-CoV-2 variant-a factor that can affect transmissibility, disease severity, and immune evasiveness. Its genomic surveillance is important in cities with millions of inhabitants and an economic center, such as Mexico City. Results. From 16 November to 31 December 2021, we observed an increase of 88% in Omicron prevalence in Mexico City. We explored the R346K substitution, prevalent in 42% of Omicron variants, known to be associated with immune escape by monoclonal antibodies. In a phylogenetic analysis, we found several independent exchanges between Mexico and the world, and there was an event followed by local transmission that gave rise to most of the Omicron diversity in Mexico City. A haplotype analysis revealed that there was no association between haplotype and vaccination status. Among the 66% of patients who have been vaccinated, no reported comorbidities were associated with Omicron; the presence of odynophagia and the absence of dysgeusia were significant predictor symptoms for Omicron, and the RT-qPCR Ct values were lower for Omicron. Conclusions. Genomic surveillance is key to detecting the emergence and spread of SARS-CoV-2 variants in a timely manner, even weeks before the onset of an infection wave, and can inform public health decisions and detect the spread of any mutation that may affect therapeutic efficacy.

Knee Dislocation With Vascular and Nerve Injury in a Professional Football Player: Return to Play.

Traumatic knee dislocations are serious and complex injuries, defined as clinical and/or radiological loss of tibiofemoral congruence, which may represent real emergencies to the integrity of the affected limb. This lesion is responsible for multi-ligament tears but the most serious possible complications are related to vascular and peripheral nerve injuries. Recent studies show that surgical treatment has better functional results and higher return rates to sports practice compared to conservative treatment. However, there is still no consensus on the ideal surgical technique and the timing of surgery. After conservative management or surgical treatment, rehabilitation treatment plays a key role in the recovery process. There are few studies evaluating the return to competition after traumatic knee dislocation and those athletes who return have difficulty reaching the pre-injury level. Here, we report the case of a professional football player who suffered a traumatic knee dislocation, with multiple ligament tears associated with vascular and neurological damage. Three hours after the initial lesion a double interposition bypass was done with the great saphenous vein, returning flow distally. It was decided not to perform ligament surgery. Two years after a long and intense rehabilitation program the athlete successfully returned to competition.

Revealing the differential protein profiles behind the nitrogen use efficiency in popcorn (Zea mays var. everta).

We investigated the proteomic profiles of two popcorn inbred lines, P2 (N-efficient and N-responsive) and L80 (N-inefficient and nonresponsive to N), under low (10% of N supply) and high (100% of N supply) nitrogen environments, associated with agronomic- and physiological-related traits to NUE. The comparative proteomic analysis allowed the identification of 79 differentially accumulated proteins (DAPs) in the comparison of high/low N for P2 and 96 DAPs in the comparison of high/low N for L80. The NUE and N uptake efficiency (NUpE) presented high means in P2 in comparison to L80 at both N levels, but the NUE, NUpE, and N utilization efficiency (NUtE) rates decreased in P2 under a high N supply. DAPs involved in energy and carbohydrate metabolism suggested that N regulates enzymes of alternative pathways to adapt to energy shortages and that fructose-bisphosphate aldolase may act as one of the key primary nitrate responsive proteins in P2. Proteins related to ascorbate biosynthesis and nitrogen metabolism increased their regulation in P2, and the interaction of L-ascorbate peroxidase and Fd-NiR may play an important role in the NUE trait. Taken together, our results provide new insights into the proteomic changes taking place in contrasting inbred lines, providing useful information on the genetic improvement of NUE in popcorn.

Ultrasound-Guided Procedures in the Cervical Spine.

Cervical pain is a common symptom among the general population. When conservative strategies fail to provide pain relief, cervical spine injections may be considered. Compared with cervical surgery, cervical injections have low major complications and, with the right indication, have demonstrated good results. Traditionally, these types of procedures have been performed under fluoroscopy; however, in recent years, ultrasound has become a more common imaging modality to guide spinal injections. Although ultrasound presents an excellent quality image for soft tissue and allows ​the observation of vascular tissues, nerves, and the contour of bone surfaces, the cervical region has a complicated neurovascular network and a comprehensive understanding of the cervical sonoanatomy should remain as the basis before one can plan cervical ultrasound-guided intervention. This paper aims to show the advantages of ultrasound in facilitating the performance of cervical spine procedures, including facet joint injections, medial branch blocks, and selective nerve root blocks; analyze the sonoanatomy and landmarks of commonly intervened cervical structures; and illustrate how these procedures can be performed safely and precisely under ultrasound guidance.

The Evolutionary Landscape of SARS-CoV-2 Variant B.1.1.519 and Its Clinical Impact in Mexico City.

The SARS-CoV-2 pandemic is one of the most concerning health problems around the globe. We reported the emergence of SARS-CoV-2 variant B.1.1.519 in Mexico City. We reported the effective reproduction number (Rt) of B.1.1.519 and presented evidence of its geographical origin based on phylogenetic analysis. We also studied its evolution via haplotype analysis and identified the most recurrent haplotypes. Finally, we studied the clinical impact of B.1.1.519. The B.1.1.519 variant was predominant between November 2020 and May 2021, reaching 90% of all cases sequenced in February 2021. It is characterized by three amino acid changes in the spike protein: T478K, P681H, and T732A. Its Rt varies between 0.5 and 2.9. Its geographical origin remain to be investigated. Patients infected with variant B.1.1.519 showed a highly significant adjusted odds ratio (aOR) increase of 1.85 over non-B.1.1.519 patients for developing a severe/critical outcome (p = 0.000296, 1.33-2.6 95% CI) and a 2.35-fold increase for hospitalization (p = 0.005, 1.32-4.34 95% CI). The continuous monitoring of this and other variants will be required to control the ongoing pandemic as it evolves.

Supporting Physiological Trait for Indirect Selection for Grain Yield in Drought-Stressed Popcorn.

The identification of traits associated with drought tolerance in popcorn is a contribution to support selection of superior plants under soil water deficit. The objective of this study was to choose morphological traits and the leaf greenness index, measured on different dates, to estimate grain yield (GY) and popping expansion (PE), evaluated in a set of 20 popcorn lines with different genealogies, estimated by multiple regression models. The variables were divided into three groups: morpho-agronomic traits-100-grain weight (GW), prolificacy (PR), tassel length (TL), number of tassel branches, anthesis-silking interval, leaf angle (FA) and leaf rolling (FB); variables related to the intensity of leaf greenness during the grain-filling period, at the leaf level, measured by a portable chlorophyll meter (SPAD) and at the canopy level, calculated as the normalized difference vegetation index (NDVI). The inbred lines were cultivated under two water conditions: well-watered (WW), maintained at field capacity, and water stress (WS), for which irrigation was stopped before male flowering. The traits GY (55%) and PE (28%) were most affected by water restriction. Among the morpho-agronomic traits, GW and PR were markedly reduced (>10%). Under dry conditions, the FA in relation to the plant stalk tended to be wider, the FB curvature greater and leaf senescence accelerated (>15% at 22 days after male flowering). The use of multiple regression for the selection of predictive traits proved to be a useful tool for the identification of groups of adequate traits to efficiently predict the economically most important features of popcorn (GY and PE). The SPAD index measured 17 days after male flowering proved useful to select indirectly for GY, while, among the morphological traits, TL stood out for the same purpose. Of all traits, PR was most strongly related with PE under WS, indicating its use in breeding programs. The exploitation of these traits by indirect selection is expected to induce increments in GY and PE.

Phenotyping Latin American Open-Pollinated Varieties of Popcorn for Environments with Low Water Availability.

Drought is a common abiotic stress in tropical and subtropical regions that limits the growth and development of agricultural crops, mainly impacting grain yield. Acting through plant breeding is the most viable alternative for obtaining genotypes more tolerant of environments with stress. This work aims to select popcorn genotypes for environments with drought and to identify discriminating traits for the evaluation of drought tolerance in popcorn germplasm. Fifteen Latin American populations of popcorn were evaluated in water stress (WS) and well-watered (WW) conditions. The evaluated traits were based in morpho-agronomic, physiological and radicular descriptors. Data were submitted to individual and joint ANOVA and GT Biplot analysis. Variability was detected between populations for all traits in both conditions. The drought caused a reduction of 30.61% and 3.5% in grain yield and popping expansion, respectively. Based in GT biplot analysis, 880POP was the most stable in WS and WW, being indicated as a promising population for cultivation in environments with water limitation. This study is going to allow the establishment of a collection of great importance to maize germplasm and to provide information to facilitate the process of selection in breeding programs focused on drought tolerance.

Saliva is a reliable and accessible source for the detection of SARS-CoV-2.

OBJECTIVES: The aim of this study was to investigate the feasibility of saliva sampling as a non-invasive and safer tool to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to compare its reproducibility and sensitivity with nasopharyngeal swab samples (NPS). The use of sample pools was also investigated. METHODS: A total of 2107 paired samples were collected from asymptomatic healthcare and office workers in Mexico City. Sixty of these samples were also analyzed in two other independent laboratories for concordance analysis. Sample processing and analysis of virus genetic material were performed according to standard protocols described elsewhere. A pooling analysis was performed by analyzing the saliva pool and the individual pool components. RESULTS: The concordance between NPS and saliva results was 95.2% (kappa 0.727, p = 0.0001) and 97.9% without considering inconclusive results (kappa 0.852, p = 0.0001). Saliva had a lower number of inconclusive results than NPS (0.9% vs 1.9%). Furthermore, saliva showed a significantly higher concentration of both total RNA and viral copies than NPS. Comparison of our results with those of the other two laboratories showed 100% and 97% concordance. Saliva samples are stable without the use of any preservative, and a positive SARS-CoV-2 sample can be detected 5, 10, and 15 days after collection when the sample is stored at 4 °C. CONCLUSIONS: The study results indicate that saliva is as effective as NPS for the identification of SARS-CoV-2-infected asymptomatic patients. Sample pooling facilitates the analysis of a larger number of samples, with the benefit of cost reduction.

Comparison of Selection Traits for Effective Popcorn (Zea mays L. var. Everta) Breeding Under Water Limiting Conditions.

Climate change is expected to intensify water restriction to crops, impacting on the yield potential of crops such as popcorn. This work aimed to evaluate the performance of 10 field cultivated popcorn inbred lines during two growing seasons, under well-watered (WW) and water stressed (WS) (ψsoil≥ -1.5 MPa) conditions. Water stress was applied by withholding irrigation in the phenological phase of male pre-anthesis. Additionally, two contrasting inbred lines, P7 (superior line) and L75 (low performer) were compared for grain yield (GY) and expanded popcorn volume (EPV), selected from previous studies, were tested under greenhouse conditions. In the field, no genotype x water condition x crop season (G×WC×CS) interaction was observed, whereas GY (-51%), EPV (-55%) and leaf greenness (SPAD index) measured 17 days after anthesis (DAA) (> -10%) were highly affected by water limitation. In general, root traits (angles, number, and density) presented G×WC×CS interaction, which did not support their use as selection parameters. In relation to leaf senescence, for both WS and WW conditions, the superior inbred lines maintained a stay-green condition (higher SPAD index) until physiological maturity, but maximum SPAD index values were observed later in WW (48.7 by 14 DAA) than in WS (43.9 by 7 DAA). Under both water conditions, negative associations were observed between SPAD index values 15 and 8 days before anthesis DBA), and GY and EPV (r ≥ -0.69), as well as between SPAD index 7, 17, and 22 DAA, and angles of brace root (AB), number of crown roots (NC) and crown root density (CD), in WS (r ≥ -0.69), and AB and CD, in WW (r ≥ -0.70). Lower NC and CD values may allow further root deepening in WS conditions. Under WS P7 maintained higher net photosynthesis values, stomatal conductance, and transpiration, than L75. Additionally, L75 exhibited a lower (i.e., more negative) carbon isotope composition value than P7 under WS, confirming a lower stomatal aperture in L75. In summary, besides leaf greenness, traits related to leaf photosynthetic status, and stomatal conductance were shown to be good indicators of the agronomic performance of popcorn under water constraint.

Limited Nitrogen and Plant Growth Stages Discriminate Well Nitrogen Use, Uptake and Utilization Efficiency in Popcorn.

The extensive use of nitrogen (N) in agriculture has caused negative impacts on the environment and costs. In this context, two pot experiments were performed under different N levels and harvested at different vegetative stages to assess two popcorn inbred lines (P2 and L80) and their hybrid (F1 = P2 × L80) for the N use, uptake and utilization efficiency (with the inclusion and exclusion of root N content); to find the contrasting N levels and vegetative stages that effect nitrogen use efficiency (NUE) and to understand the relationship between the traits related to NUE. The hybrid and P2 were confirmed better than L80 for all the studied traits. NUE is mainly affected by the shoot dry weight, uptake and utilization efficiency. Extremely low and high N levels were found to be more discriminating for N use and dry weight, respectively. At the V6 (six fully expanded leaf) stage, root N content (RNC) should be considered; in contrast, at the VT (tasseling stage) stage, RNC should not be considered for the uptake and utilization efficiency. The genetic parameter performance for N use, uptake, shoot dry weight and N content could favor the achievement of the genetic gain in advanced segregating generations.

A local hemostatic agent for the management of postpartum hemorrhage due to placenta previa and placenta accreta: a cross-sectional study.

PURPOSE: To describe the use of a local hemostatic agent (LHA) for the management of postpartum hemorrhage (PPH) due to bleeding of the placental bed in patients taken to caesarean section at Fundación Santa Fe de Bogotá University Hospital. SAMPLE: A total of 41 pregnant women who had a caesarean section and developed PPH. METHODS: A cross-sectional study. Analysis of all cases of PPH during caesarean section presented from 2006 up to and including 2012 at Fundación Santa Fe de Bogotá University Hospital. MAIN OUTCOME MEASURE: Emergency hysterectomy due to PPH. RESULTS: The proportion of hysterectomies was 5 vs. 66 % for the group that received and did not receive management with a LHA respectively (PR 0.07, CI 95 % 0.01-0.51 p < 0.01). For the group managed without a LHA, 80 % of patients needed hemoderivatives transfusion vs. 20 % of patients in the group managed with a LHA (PR 0.24, CI 95 % 0.1-0.6 p < 0.01). A reduction in the mean days of hospitalization in addition to a descent in the proportion of patients admitted to the intensive care unit (ICU) was noticed when comparing the group that received a LHA versus the one that did not. CONCLUSION: An inverse association between the use of a LHA in patients with PPH due to bleeding of the placental bed and the need to perform an emergency obstetric hysterectomy was observed. Additionally there was a significant reduction in the mean duration of hospital stay, use of hemoderivatives and admission to the ICU.

El incivismo y el acoso sexual en el trabajo: impacto en la salud ocupacional / Incivility and sexual harassment at the workplace: occupational health impact

En los últimos años ha habido un incremento en el interésy en las investigaciones en torno al tema de la agresiónlaboral, al ser un problema serio de salud ocupacional quetrae consecuencias negativas tanto para los trabajadores comopara las organizaciones. Objetivo: analizar las relacionesentre diferentes formas de agresión laboral (incivismo y acososexual), las conductas contraproducentes y la satisfacciónlaboral. Metodología: estudio de tipo transversal, en elque participaron 460 trabajadores del sector servicios de laComunidad de Madrid, España. Se les aplicaron cuestionariosde autoinforme para evaluar su posible exposición a situacionesde agresión laboral, así como su nivel de satisfacción con eltrabajo y la manifestación de comportamientos negativoshacia la organización. Resultados: se encontró una asociaciónnegativa y significativa entre las diferentes formas de agresiónevaluadas y la satisfacción laboral y una asociación positivay significativa entre las formas de agresión y las conductascontraproducentes. Conclusiones: la agresión laboral puedetener consecuencias negativas para la organización, queafectan la satisfacción de los empleados y facilitan la expresiónde conductas contraproducentes; por lo tanto, es importante,dentro del campo de la salud ocupacional, la implementaciónde programas de prevención de la agresión laboral, así comode protocolos claros de intervención en caso de que surja.

In recent years, interest and research on workplace aggressionhave increased, since it is a serious occupational healthproblem with negative consequences for both employeesand organizations. Objective: to analyze the relationshipsbetween different forms of workplace aggression (incivilityand sexual harassment), counterproductive work behaviors,and job satisfaction. Methodology: a cross-sectional study,involving 460 employees from the services sector of Madrid,Spain. Self-report questionnaires were used to assess theemployees’ potential exposure to workplace aggression, aswell as their level of job satisfaction, and the manifestationof negative behaviors towards the organization. Results: asignificant negative association was found between the studiedforms of workplace aggression and job satisfaction. Likewise,a significant positive association between the forms ofworkplace aggression and counterproductive work behaviorswas also found. Conclusions: workplace aggression may havenegative consequences for a company. It can affect employeesatisfaction and encourage counterproductive behaviors.Therefore, it is important, within the field of occupational.

Estrés traumático secundario: personalidad y sacudida de creencias / Secondary traumatic stress: personality and shattered assumptions

El trauma ha recibido una gran atención en los últimos años. Una línea de trabajo en el tema ha consistido en analizar la importancia de las variables personales en la resistencia y vulnerabilidad ante el trauma (Figley, 1995) y, como consecuencia, el efecto que dicho trauma tiene sobre el profesional (Stamm, 2003). Este trabajo empírico examina, en una muestra de 419 profesionales sanitarios, el papel de determinadas variables de personalidad (empatía, comprensibilidad, reto y sentido del humor) como moderadoras en la relación entre determinadas variables laborales (tarea traumática y sobrecarga laboral) y el cambio de creencias y valores sobre el mundo (Janoff-Bulman, 1992). La medida del síndrome se realiza a partir del Cuestionario de Estrés Traumático Secundario (Moreno et al., 2004). Los resultados indican que tales variables de personalidad parecen desempeñar un importante papel en el proceso de sacudida de creencias. Finalmente, la discusión enfatiza la necesidad de centrar la atención en la interacción entre los factores de personalidad y las demandas laborales y contextuales para avanzar en la compresión del proceso del trauma en trabajadores de emergencias

Trauma has received a great deal of attention in recent years. One line of research in this field focuses on the importance of personality variables in the resistance and vulnerability to trauma (Figley, 1995) and on the consequences of trauma on emergency professionals (Stamm, 2002). The purpose of this study was to examine in a sample of 419 emergency professionals the role of several personality variables (empathy, comprehensibility, challenge and sense of humor) as moderators of the relationship between job demands (traumatic task and overload) with shattered assumptions (Janoff-Bulman, 1992). Secondary traumatic stress was measured with measured with Secondary Traumatic Stress Measure (Moreno et al., 2004). Results indicate these personality variables seem to have an important role in the change of assumptions process. Finally, further implications of the finding are discussed

CAT del estudio WHI / CAT of WHI study

La siguiente publicación es acerca de la Evaluación Crítica ("CAT : Critically Appraised Topic") del Estudio "WHI" Women's Health Initiative). El "CAT" es una estrategia para ayudar a los clínicos y practicantes en formación, a formular preguntas clínicas, a buscar la mejor evidencia, evaluarla, organizaría y resumirla. El CAT del estudio WHI es un ejemplo sobre la evaluación de un artículo relevante acerca de la Terapia Hormonal de Reemplazo. La Pregunta que se formuló como punto de partida fue la siguiente: "¿Se debe o no tratar la mujer menopáusica sana con Terapia Hormonal de Reemplazo?" (¿Los beneficios superan los riesgos?). En una forma resumida, este artículo presenta una evaluación crítica sobre el diseño y los resultados del estudio WHI. La elaboración de todo este proceso se hizo con el fin de mostrar a los lectores con muchas ocupaciones, la información más relevante sobre ese tema y en una forma rápida, para que pueda ser incorporada a la práctica clínica

Hiperplasia endometrial

El presente artículo es una revisión de la epidemiología, etiopatogenia, diagnóstico y tratamiento de la hiperplasia endometrial, en donde se pretende entregar al especialista una actualización de la clasificación, un esquema específico de manejo y seguimiento de esta condición, para que pueda hacer un enfoque más racional de la hiperplasia endometrial

Manejo de la hiperplasia endometrial con acetato de medroxiprogesterona de depósito

Un total de 41 pacientes con diagnóstico histológico de Hiperplasia Endometrial, fueron sometidos a tratamiento médico con Acetato de Medroxiprogesterona de Depósito(AMPD). Un grupo de 26 pacientes (Grupo I), recibió una dosis de 2.5 mg/Kg peso/semana de AMPD durante 8 semanas, y otro grupo de 15 pacientes (Grupo II), recibió una dosis de 5 mgr/Kg peso/semana de AMPD durante el mismo tiempo. Se hizo un seguimeinto clínico-histológico, que varió de 6 a 54 meses, con un promedio de 18 meses. Se observó mejoría histológica al mes de iniciada la terapia en el 63 por ciento de los pacientes, y un mes después de terminada la misma, en 100 por ciento de los pacientes de ambos grupos no existía indicios del diagnóstico inicial. A través del seguimiento se observó mejoría clínica en el 61 por ciento de los pacientes del Grupo I(16/26), y en el 87 por ciento del Grupo II (13/15). Hubo 10 casos (38 por ciento) de recurrencia clínica en el Grupo I y 3 casos (20 por ciento) en el Grupo II. Solo hubo 1 caso de recurrencia histológica en el Grupo I y ninguna en el grupo II. Aquellos pacientes que presentaron recurrencia, recibieron un segundo ciclo de tratamiento con el doble de la dosis inicial, y de estos 3 casos se consideraron fracasos por evolución clínica desfavorable; sin embargo, al ser intervenidos quirúrgicamente se encontró una causa orgánica(adenomiosis miomatosis), posiblemente responsable de la evolución clínica de estos casos. Finalmente en forma paralela severificó la confiabilidad de la Biopsia de Endometrio para el seguimiento de estos casos, encontrándosae una excelente correlación entre los resultados histopatológicos encontrados en el Legrado Uterino y la Biopsia de Endometrio practicados a una misma paciente (Coeficiente de Correlación, r=0.870 p menor 0.001). El manejo médico de la Hiperplasia ofrece ventajas para aquellas pacientes de riesgo quirúrgico alto, o para quienes no acepten esta via