Layer 1 NDNF interneurons are specialized top-down master regulators of cortical circuits.

Diverse types of inhibitory interneurons (INs) impart computational power and flexibility to neocortical circuits. Whereas markers for different IN types in cortical layers 2-6 (L2-L6) have been instrumental for generating a wealth of functional insights, only the recent identification of a selective marker (neuron-derived neurotrophic factor [NDNF]) has opened comparable opportunities for INs in L1 (L1INs). However, at present we know very little about the connectivity of NDNF L1INs with other IN types, their input-output conversion, and the existence of potential NDNF L1IN subtypes. Here, we report pervasive inhibition of L2/3 INs (including parvalbumin INs and vasoactive intestinal peptide INs) by NDNF L1INs. Intersectional genetics revealed similar physiology and connectivity in the NDNF L1IN subpopulation co-expressing neuropeptide Y. Finally, NDNF L1INs prominently and selectively engage in persistent firing, a physiological hallmark disconnecting their output from the current input. Collectively, our work therefore identifies NDNF L1INs as specialized master regulators of superficial neocortex according to their pervasive top-down afferents.

Effects of botulinum toxin in two indicators of loss of domain and hernia size among patients with large ventral hernias.

BACKGROUND: In patients with large ventral hernias, botulinum toxin to external and internal oblique muscles decreases thickness and increases length. We examined the impact of botulinum toxin in the amount of loss of domain according to two ratios and in hernia size. METHODS: Between October 2021 and November 2023, 20 patients with ventral hernias measuring 10 cm or more on the horizontal size underwent the administration of 50 units of botulinum toxin to each external and each internal oblique muscle 4 weeks before their surgery. Incisional hernia volume to peritoneal volume ratio, volume ratio, and hernia size were compared before and 4 weeks after the injection of botulinum toxin. Comparisons between all variables obtained before and after the administration of botulinum toxin were performed using either the paired t-test or the Wilcoxon signed-rank test. Pearson correlation coefficient was used to analyze associations between initial conditions and further changes observed after botulinum toxin injection. RESULTS: We observed a 42% reduction in muscle amplitude, 16% increase in intra-abdominal volume, 28% decrease in herniated volume, decreases of 6% in IHV/PV ratio and of 11% in V ratio, 11% reduction of hernia width, and decrease of 10% in rectangular and elliptical hernia areas. CONCLUSIONS: In patients with large ventral hernias, botulinum toxin is associated with reduction of hernia size and decrease in loss of domain, the latter not being significant when less than 10% of the visceral block is herniated.

Initial evaluation and external validation of 68Ga-PSMA-11 PET/CT in tubarial gland characterization.

INTRODUCTION: Radiotracer 68Ga-PSMA-11 used in PET/CT scans allows for identification and localization of gland tissue. It allows for their consideration in clinical scenarios and to design further and stronger research to answer pertinent questions regarding their function and implications. We aimed to externally validate first reported findings of location, size, and ligand uptake of the tubarial glands using 68Ga-PSMA-11 PET/CT. MATERIALS AND METHODS: A cross-sectional study was performed with 68Ga-PSMA-11 PET/CT studies of patients with prostate cancer confirmed diagnosis from the database of the Radiology Department from 2018 to 2022. The maximum cephalocaudal length (CCL) in the tubarial glands and the Maximum Standardized Uptake Value (SUVmax) of major glands were recorded. RESULTS: A total of 202 patients were included (mean age 67.43 ± 8.5). The mean CCL of the tubarial glands was 37.38 ± 9.84 and a SUVmax of 6.56 ± 2.14. The rest of the glands were as follows: parotid 15.12 ± 4.43, submandibular 16.82 ± 5.43 and sublingual 5.84 ± 3.24. No differences were found between laterality. A weak correlation between age and SUVmax of tubarial glands was identified. Tubarial glands had a similar 68Ga-PSMA-11 uptake to that of sublingual glands. CONCLUSION: This study corroborates the existence of a conglomerate of glands in the nasopharynx roof, near the posterolateral pharyngeal recess. It serves as validation in a different population with similar results in previous research. Without 68GA-PSMA-11 PET/CT the abundance, configuration and potential clinical relevance of these glands would probably not have been identified. Radiotracer uptake was similar amongst the major salivary glands, with a more similar uptake to that shown by the sublingual gland.

Comparison of open anterior component and open transversus abdominus release in repair of large subcostal hernias.

BACKGROUND: Large subcostal incisional hernias are considered as complex defects, and a few different approaches have been described for repair. The purpose of this comparative cross-sectional study is to evaluate the outcomes of patients with large subcostal incisional hernias treated with either the open anterior components separation technique (ACS) or with the open transversus abdominis release technique (TAR). METHODS: From the database of patients with large complex incisional hernias who underwent abdominal wall reconstruction with open techniques between April 2007 and October 2022 at our institution, on May 25th, 2023 we identified those whose hernias were located in the subcostal areas and who underwent reconstruction with a components separation technique and mesh. Perioperative variables and outcomes were compared between the patients with large subcostal hernias who underwent abdominal wall reconstruction with either the ACS or the TAR techniques. RESULTS: Thirty-one patients with large subcostal hernias were included in the study. ACS and intra-abdominal mesh was used in 11 patients; TAR and retro-muscular mesh was performed in 20 patients. More postoperative local abdominal wall complications were seen in patients who had ACS as opposed to TAR (55% vs 15%, p = 0.02). Hernia recurrence was more common in patients who had ACS as opposed to TAR (55% vs 5%, p = 0.008). CONCLUSIONS: More post-operative complications and recurrences were seen in patients who had ACS as opposed to TAR.

VALIDACIÓN DE LA VERSIÓN EN ESPAÑOL DE LA ESCALA PERSPECTIVA ESPIRITUAL DE P. REED EN PERSONAS MAYORES, CHILE / VALIDATION OF THE SPANISH VERSION OF P. REED'S SPIRITUAL PERSPECTIVE SCALE IN OLDER PEOPLE IN CHILE

El envejecimiento global es uno de los grandes desafíos sanitarios del siglo XXI, el 2030 una de cada seis personas tendrá ≥ 60 años. En Chile se proyecta un 32,1% para el 2050. Esta realidad demográfica desafía a la enfermería en el abordaje multidimensional del envejecimiento. La espiritualidad como atributo de la autotrascendencia es un factor condicionante de acciones promotoras de salud en las personas mayores. Desde la perspectiva de la Dra. Reed, se presentan los resultados de validación de su Escala de Perspectiva Espiritual. La población fue de 202 personas mayores en promedio de 71 años (D.E.= 8,2338). El método utilizado fue diseño psicométrico y corte transversal. La escala general presentó; α de Cronbach=0,92; dimensiones prácticas espirituales α de Cronbach= 0,822; dimensión creencias espirituales α de Cronbach=0,914. El análisis de modelo de un factor (CFI=0,956, RMSEA=0,167 IC95% [0,147 - 0,188] y un c2=232,762; p=0,000), como de dos factores coherentes con la estructura teórica propuesta por Reed (CFI=0,984; RMSEA=0,102 IC95% [0,081 ­ 0,125] y c2=105,890; p=0,000), presentaron cargas factoriales altas y relativamente homogéneas. La escala general y las subescalas de creencias y prácticas espirituales mostraron adecuada confiabilidad. El análisis de modelos anidados mostró un mejor ajuste del modelo de dos factores. Los resultados suman para afirmar que la Escala de Perspectiva Espiritual, contribuye a la precisión empírica, potencial heurístico y verificabilidad de la Teoría de Transcendencia de Reed. Se vislumbra que la espiritualidad es un factor mediador en la relación entre la vulnerabilidad, autotrascendencia y bienestar de la persona mayor.

Global aging is one of the great health challenges of the 21st century. By 2030, one in six people will be ≥60 years of age, with 32.1% projected for Chile by 2050. This demographic reality challenges nursing in the multidimensional approach to aging. The dimension of spirituality as an attribute of self-transcendence is a conditioning factor of health promoting actions in the elderly. The validation results of Dr. Reed's Spiritual Perspective Scale are presented. The population included 202 people older than 71 years on average (SD= 8.2338). The method used was a psychometric and cross-sectional design. The general scale presented Cronbach's α=0.92; spiritual practical dimension, Cronbach's α=0.822; spiritual beliefs dimension, Cronbach's α=0.914. The analysis of a one-factor model (CFI=.956, RMSEA=0.167 IC95% [0.147-0.188] and c2=232.762; p=0.000), as two factors consistent with the theoretical structure proposed by Reed (CFI=0.984; RMSEA=0.102 IC95% [0.081-0.125] and c2=105.890; p=0.000), presented high and relatively homogeneous factorial loads. The general scale and the subscales of spiritual beliefs and practices showed adequate reliability. The analysis of nested models showed a better adjustment of the two-factor model. The results collectively affirm that the Spiritual Perspective Scale contributes to the empirical precision, heuristic potential, and verifiability of Reed's Theory of Transcendence. It is observed that spirituality is a mediating factor in the relationship between vulnerability, self-transcendence, and well-being of humans.

Morning blood pressure surge as a predictor of cardiovascular events in patients with hypertension.

BACKGROUND: The prognostic value of ambulatory blood pressure (BP) monitoring (ABPM) is poorly understood in Latin American populations. METHODS: A prospective observational study was conducted on 1339 patients with hypertension who underwent 24-h BP monitoring between 2015 and 2019. The incidence of serious adverse cardiovascular events (MACE) was analysed using a Cox proportional hazards model adjusted for potential confounders. Three previously reported morning surge definitions were evaluated for SBP and DBP using different ABPM components: sleep-through morning surge, pre-awakening, and morning night-time difference. RESULTS: The mean age was 62 years, 52% were female, 32.8% had dyslipidaemia, 27.2% were smokers, and 7.8% had diabetes. During a median follow-up period of 32 months, 197 MACE occurred. In men, the adjusted hazard ratio (HR) was 1.84 [95% confidence interval (CI), 1.35-2.49; P < 0.001). The HR increased to 2.03 (95% CI, 1.89-2.17; P < 0.001) with a cut-off value of 35 mmHg for a 10 mmHg increase in sleep-through morning surge. The increased adjusted HR associated with the morning rise persisted for each secondary endpoint, including 21 cardiovascular deaths [HR: 2.70 (95% CI, 2.03-3.60; P < 0.001)], 78 myocardial infarctions [HR: 1.92 (95% CI, 1.72-2.15; P < 0.001)], 24 hospitalisations for heart failure [HR: 1.77 (95% CI, 1.48-2.12; P < 0.001)], 22 strokes [HR: 2.32 (95% CI, 1.85-2.91; P < 0.001)], and 52 atrial fibrillations [HR: 1.94 (95% CI, 1.71-2.20; P < 0.001)]. CONCLUSION: The morning BP rise was the most important circadian prognostic factor for MACE in patients with hypertension, which deserves more attention.

Evaluation of Hepatic Hemodynamics (Hepatic Venous Pressure Gradient) During Right Heart Catheterization: A Comprehensive Review.

Centers for the research of patients with pulmonary hypertension (PH) usually perform right cardiac catheterization (RHC) to document this hemodynamic condition; traditionally, the procedure is performed by the interventional cardiologist, while the interventional radiologist generally conducts the study of hepatic hemodynamics. In our center, where the leading cause of catheterization of the hepatic veins is orthotopic liver transplantation, the cardio-pulmonologist performs the procedure to diagnose the possibility of porto-pulmonary hypertension and its implications. Routine measurement of the hepatic venous pressure gradient (HVPG) during RHC is not recommended but is performed to confirm the diagnosis of portal hypertension (PoH). Our objective in this review was to graphically describe the technique of hemodynamic recording of suprahepatic veins in patients with chronic liver disease and PoH who are in liver transplant protocol. The concepts included in this manuscript are measuring portal pressure, the definition of the hepatic venous pressure gradient (HVPG), procedures for a correct measurement of the HVPG, techniques associated with a suprahepatic vein catheterization, contraindications, and complications of HVPG, and clinical applications of HVPG. Clinically significant PoH is defined as an increase in GPVH ≥10 mmHg. HVPG measurement is currently the best available method for assessing the presence and severity of PoH. The RHC is the standard gold method for diagnosing PoPH that confirms its existence and provides additional data to exclude other causes of PAH in liver transplant candidates.

Anaphylaxis in Cold Induced Urticaria: A Case Report and Review of The Literature.

Cold-induced urticaria is considered as a subtype of physical urticaria and also the second most common type of chronic inducible urticaria. Contact with cold surfaces or the environment may cause systemic reactions, especially during aquatic activities. A 22-year-old female patient with a history of sulfa drug allergy began her condition 2 years before the presence of generalized pruritic erythema with hives as well as 2 episodes that had been characterized by facial angioedema and syncope 3-5 minutes after being in contact with cold air or surfaces.  On both events, she had just been outdoors on a cold, winter day. She was suspected to have cold-induced urticaria; thereby she had a positive reaction to the ice cube test. Due to the previous episodes of anaphylaxis, the patient was trained to administer intramuscular epinephrine. After 4 weeks of starting the treatment with antihistamines, no new events or injuries had occurred. Cold-induced urticaria may cause life-threatening reactions. The rate of anaphylaxis in these patients is low however, this case is presented to inform the importance of identifying this type of systemic reaction and preventing strategies.

Electrochemical (Bio)Sensors Enabled by Fused Deposition Modeling-Based 3D Printing: A Guide to Selecting Designs, Printing Parameters, and Post-Treatment Protocols.

The 3D printing (or additive manufacturing, AM) technology is capable to provide a quick and easy production of objects with freedom of design, reducing waste generation. Among the AM techniques, fused deposition modeling (FDM) has been highlighted due to its affordability, scalability, and possibility of processing an extensive range of materials (thermoplastics, composites, biobased materials, etc.). The possibility of obtaining electrochemical cells, arrays, pieces, and more recently, electrodes, exactly according to the demand, in varied shapes and sizes, and employing the desired materials has made from 3D printing technology an indispensable tool in electroanalysis. In this regard, the obtention of an FDM 3D printer has great advantages for electroanalytical laboratories, and its use is relatively simple. Some care has to be taken to aid the user to take advantage of the great potential of this technology, avoiding problems such as solution leakages, very common in 3D printed cells, providing well-sealed objects, with high quality. In this sense, herein, we present a complete protocol regarding the use of FDM 3D printers for the fabrication of complete electrochemical systems, including (bio)sensors, and how to improve the quality of the obtained systems. A guide from the initial printing stages, regarding the design and structure obtention, to the final application, including the improvement of obtained 3D printed electrodes for different purposes, is provided here. Thus, this protocol can provide great perspectives and alternatives for 3D printing in electroanalysis and aid the user to understand and solve several problems with the use of this technology in this field.

New conductive filament ready-to-use for 3D-printing electrochemical (bio)sensors: Towards the detection of SARS-CoV-2.

The 3D printing technology has gained ground due to its wide range of applicability. The development of new conductive filaments contributes significantly to the production of improved electrochemical devices. In this context, we report a simple method to producing an efficient conductive filament, containing graphite within the polymer matrix of PLA, and applied in conjunction with 3D printing technology to generate (bio)sensors without the need for surface activation. The proposed method for producing the conductive filament consists of four steps: (i) mixing graphite and PLA in a heated reflux system; (ii) recrystallization of the composite; (iii) drying and; (iv) extrusion. The produced filament was used for the manufacture of electrochemical 3D printed sensors. The filament and sensor were characterized by physicochemical techniques, such as SEM, TGA, Raman, FTIR as well as electrochemical techniques (EIS and CV). Finally, as a proof-of-concept, the fabricated 3D-printed sensor was applied for the determination of uric acid and dopamine in synthetic urine and used as a platform for the development of a biosensor for the detection of SARS-CoV-2. The developed sensors, without pre-treatment, provided linear ranges of 0.5-150.0 and 5.0-50.0 µmol L-1, with low LOD values (0.07 and 0.11 µmol L-1), for uric acid and dopamine, respectively. The developed biosensor successfully detected SARS-CoV-2 S protein, with a linear range from 5.0 to 75.0 nmol L-1 (0.38 µg mL-1 to 5.74 µg mL-1) and LOD of 1.36 nmol L-1 (0.10 µg mL-1) and sensitivity of 0.17 µA nmol-1 L (0.01 µA µg-1 mL). Therefore, the lab-made produced and the ready-to-use conductive filament is promising and can become an alternative route for the production of different 3D electrochemical (bio)sensors and other types of conductive devices by 3D printing.

Batch injection analysis with amperometric detection for fluoroquinolone determination in urine, pharmaceutical formulations, and milk samples using a reduced graphene oxide-modified glassy carbon electrode.

In this work, the batch injection analysis system with amperometric detection using reduced graphene oxide as a modifier of glassy carbon electrode (GCE) was investigated for the simple, fast, and sensitive monitoring of levofloxacin (LEVO) and ciprofloxacin (CIPRO) in samples of pharmaceutical formulations, synthetic urine, and milk (low- and high-fat content). LEVO and CIPRO were quantified in seven samples using amperometric measurements at +1.10 V vs Ag/AgCl, KCl(sat). The developed methods showed excellent analytical performance with limits of detection of 0.30 and 0.16 µmol L-1, linear range from 3.0 to 50 µmol L-1 and 1.0 to 50 µmol L-1, relative standard deviation below 9.7 and 3.1%, and recovery ranges ranging from 80 to 107% and from 78 to 109% for LEVO and CIPRO, respectively. In addition, the minimum sample preparation (simple dilution) combined with a high analytical frequency (130 to 180 analyses per hour) can be highlighted. Thus, the methods are promising for implementation in routine analysis and quality control to different samples.

Adsorptive stripping voltammetric determination of chloramphenicol residues in milk samples using reduced graphene oxide sensor.

In this paper, the electrochemical response of chloramphenicol (CHL) was investigated on a bare glassy carbon electrode (GCE) and after modification with reduced graphene oxide (GCE/rGO). Preliminary studies by cyclic voltammetry demonstrated an adsorption-controlled mass transport regime of CHL species and a pH-dependent behavior on both electrode surfaces. An adsorptive stripping differential pulse voltammetry (AdSDPV) method was proposed and under optimized instrumental conditions, a comparison of the analytical characteristics of both sensors was performed. The GCE/rGO sensor showed an increase in sensitivity (10-fold), and an anticipation of the reduction potential (200 mV), compared to the bare electrode, due to the adsorptive character (pre-concentration of the CHL species) and the electrocatalytic effect of the nanomaterial. The method was applied to skimmed and whole milk samples, which were simply diluted (50-fold) in supporting electrolyte. The results by AdSDPV using GCE/rGO showed adequate detectability (0.22 µmol L-1), good precision with a 6% relative standard deviation (RSD) and satisfactory recovery ranging from 93 to 108%. The obtained results were statistically similar (95% confidence level) with those performed through ultra-fast liquid chromatography (UFLC). Furthermore, the sensor showed an improvement in the analytical performance for CHL detection, when compared to other sensors reported in the literature. Therefore, the developed method is reliable and promising for implementation in monitoring CHL residues in milk samples.

Electrochemical methods for the determination of antibiotic residues in milk: A critical review.

Several antibiotics have been applied to veterinary medicine due to their broad-spectrum of antibacterial activity and prophylactic power. Residues of these antibiotics can be accumulated in dairy cattle, in addition to promoting contamination of the environment and, in more serious cases, in milk, causing a public health problem. Different regulatory agencies establish maximum residue limits for these antibiotics in milk, so it becomes important to develop sensitive analytical methods for monitoring these compounds. Electrochemical techniques are important analytical tools in analytical chemistry because they present low cost, simplicity, high sensitivity, and adequate analytical frequency (sample throughput) for routine analyses. In this sense, this review summarizes the state of the art of the main electrochemical sensors and biosensors, instrumental techniques, and sample preparation used for the development of analytical methods, published in the last five years, for the monitoring of different classes of antibiotics: aminoglycosides, amphenicols, beta-lactams, fluoroquinolones, sulfonamides, and tetracyclines, in milk samples. The different strategies to develop electrochemical sensors and biosensors are critically compared considering their analytical features. The mechanisms of electrochemical oxidation/reduction of the antibiotics are revised and discussed considering strategies to improve the selectivity of the method. In addition, current challenges and future prospects are discussed.

An indirect electrochemical method for aqueous sulfide determination in freshwaters using a palladium chelate as a selective sensor.

Sulfide anion is a highly toxic and corrosive compound and its presence above the threshold concentrations (i.e. µmol L-1) in freshwaters may indicate environmental pollution. Besides, the increase in sulfide concentration results in modifications of the organoleptic proprieties of water and air. Many analytical methodologies have been designed for aqueous sulfide quantification, however, due to the high reactivity and instability of sulfide, the pursue of a simple, sensitive, selective, and portable analytical method is still a current demand. In this study, an indirect electrochemical method for the determination of sulfide based on its interaction with a palladium complex - bis(2-aminobenzoate) palladium(II) - acting as a selective chemosensor is described. The reaction leads to the demasking of the electroactive ligand 2-aminobenzoic acid (i.e. anthranilic acid) and square wave voltammetry is employed to monitor its concentration using a glassy carbon electrode (GCE). Experimental conditions were optimized and the reaction was performed in Britton-Robinson (BR) buffer at pH 5 for 4 min, providing the higher magnitude of the analytical signal. A linear relation (r2 > 0.99) from 3 to 30 µmol L-1 of sulfide was obtained with a limit of detection of 0.10 µmol L-1. Recovery experiments using freshwater samples spiked with sulfide revealed overall satisfactory results for the limit concentration levels permitted by regulatory agencies. Therefore, the proposed methodology shows advantages in terms of portability, selectivity, sensitivity, low-cost, and easiness-to-use enabling monitoring of sulfide in a variety of waters.

Biosensing strategies for the electrochemical detection of viruses and viral diseases - A review.

Viruses are the causing agents for many relevant diseases, including influenza, Ebola, HIV/AIDS, and COVID-19. Its rapid replication and high transmissibility can lead to serious consequences not only to the individual but also to collective health, causing deep economic impacts. In this scenario, diagnosis tools are of significant importance, allowing the rapid, precise, and low-cost testing of a substantial number of individuals. Currently, PCR-based techniques are the gold standard for the diagnosis of viral diseases. Although these allow the diagnosis of different illnesses with high precision, they still present significant drawbacks. Their main disadvantages include long periods for obtaining results and the need for specialized professionals and equipment, requiring the tests to be performed in research centers. In this scenario, biosensors have been presented as promising alternatives for the rapid, precise, low-cost, and on-site diagnosis of viral diseases. This critical review article describes the advancements achieved in the last five years regarding electrochemical biosensors for the diagnosis of viral infections. First, genosensors and aptasensors for the detection of virus and the diagnosis of viral diseases are presented in detail regarding probe immobilization approaches, detection methods (label-free and sandwich), and amplification strategies. Following, immunosensors are highlighted, including many different construction strategies such as label-free, sandwich, competitive, and lateral-flow assays. Then, biosensors for the detection of viral-diseases-related biomarkers are presented and discussed, as well as point of care systems and their advantages when compared to traditional techniques. Last, the difficulties of commercializing electrochemical devices are critically discussed in conjunction with future trends such as lab-on-a-chip and flexible sensors.

Does stress run through the leash? An examination of stress transmission between owners and dogs during a walk.

Humans and dogs have co-evolved for over 10,000 years. Recent research suggests that, through the domestication process, dogs have become proficient at responding to human commands, attention and emotional states. However, the extent to which a companion dog responds to human emotions, such as stress, remains to be understood. This study examines whether a companion dog's stress, as measured by cortisol levels and heart rate, increases during a familiar outdoor walk in response to its owner's experience of stress. Sixty-eight owner/dog dyads participated in this study. The dyads were randomly assigned to an Experimental or Control group. Owners in the Experimental group were informed the walk would be digitally recorded for subsequent evaluation of their handling skills, whereas those in the Control group were informed the walk would be digitally recorded for archival purposes (no evaluation). This manipulation was implemented to induce a mild stress response in the owners. Salivary cortisol samples were collected from the owner and their dog before and after the walk. The dyad was also fitted with monitoring devices to record heart rate throughout the walk. Finally, personality information regarding the owner and their dog was collected. We found that cortisol production within the dyad showed a marginal inverse correlation. We also found that owners' Openness to Experience and dogs' Fearfulness influenced the heart rate of the other during the first minute of a walk. These results support that although stress may be detected within a dyad, this does not result in an associated significant change in cortisol or heart rate.

Prevalence of sexual dysfunction among pregnant women attending prenatal care at a hospital in Rionegro, Colombia, 2020-2021 / Prevalencia de disfunción sexual en gestantes en control prenatal en una institución hospitalaria en Rionegro, Colombia, 2020-2021

Objective: To describe the prevalence of sexual dysfunction in a group of pregnant women, and to explore potential factors associated with this condition in this population. Material and methods: Descriptive cross-sectional study in pregnant women 15 years of age and older, sexually active during gestation, receiving prenatal care at the San Juan de Dios Hospital in Rionegro between January and March, 2021. The exclusion criteria were patients with disabilities or cognitive impairment, or classified as having a mental disorder according to the World Health Organization (WHO); pregnant women with chronic, placental, ovulation, hemorrhagic or infectious conditions; and patients whose pregnancy was the result of sexual assault. The Female Sexual Function Index (FSFI) questionnaire was applied, and sociodemographic and sexual and reproductive health variables were measured. Results are expressed as absolute and relative frequencies for qualitative variables, and as medians and interquartile ranges for quantitative variables. Results: The mean age in years was 27.5 (IQR: 21.3-31.0) and the mean gestational age was 28.5 weeks (IQR: 21.3-34.8). After administering the FSFI, it was found that 37 women (37.7%) had sexual dysfunction (score < 26.5). The median scores for the participants without sexual dysfunction and those with sexual dysfunction were 29.4 (IQR 26.8-32) and 22.3 (IQR 20-24), respectively. The mean scores for each domain were: desire 3.6 (IQR: 3.0-4.2); arousal 4.5 (IQR: 3.6-5.1); lubrication 4.8 (IQR: 3.9-5.4); orgasm 4.4 (IQR: 3.6-5.2); pain 4.4 (IQR: 3.6-6.0); and satisfaction 5.4 (IQR: 4.8-6.0). The total score (p<0.05) was better in older women and those with one or more children. Conclusion: Sexual dysfunction occurs at least in one third of pregnant women, especially during the third trimester. Sexual dysfunction should be considered in daily clinical practice, given that approaching the topic from an education perspective can help reduce a problem that affects the couple and quality of life. It is critical to undertake additional research that includes assessment of the effectiveness and safety of educational strategies in this population with sexual dysfunction.

Objetivo: describir la prevalencia de la disfunción sexual en un grupo de mujeres gestantes y hacer una exploración de posibles factores asociados a la disfunción sexual en estas mujeres. Materiales y métodos: estudio descriptivo y trasversal en mujeres gestantes cuyas edades son de 15 años o más, con actividad sexual en la gestación, que asistieron al control prenatal en el Hospital San Juan de Dios de Rionegro entre los meses de enero y marzo del 2021. Se excluyeron pacientes con limitaciones o discapacidad cognitiva, o clasificadas con trastorno mental según la Organización Mundial de la Salud (OMS), gestantes con patologías crónicas, placentarias, ovulares, hemorrágicas e infecciosas, y las pacientes cuya gestación fue resultado de violencia sexual. Se aplicó el cuestionario Índice de Función Sexual Femenina (FSFI), se midieron variables sociodemográficas y de salud sexual y reproductiva. Los resultados se expresan en frecuencias absolutas y relativas para las variables cualitativas y medianas, y rangos intercuartílicos para las variables cuantitativas. Resultados: la mediana de edad fue de 27,5 años (RIC: 21,3-31,0); de edad gestacional 28,5 semanas (RIC: 21,3-34,8). Tras la aplicación del FSFI, 37 mujeres (37,7%) tuvieron disfunción sexual (puntaje < 26,5). La mediana del puntaje de las participantes sin disfunción sexual fue de 29,4 (RIC 26,8-32), mientras que por el lado de las que tienen disfunción sexual fue de 22,3 (RIC 20-24). La media del puntaje para cada dominio fue: deseo: 3,6 (RIC: 3,0-4,2); excitación: 4,5 (RIC: 3,6-5,1); lubricación: 4,8 (RIC: 3,9-5,4); orgasmo: 4,4 (RIC: 3,6-5,2); dolor: 4,4 (RIC: 3,6-6,0); y satisfacción: 5,4 (RIC: 4,8-6,0). Fueron factores protectores no tener hijos ni cesáreas previas. La ausencia de compañero y menor edad estuvieron asociados a disfunción sexual. Conclusión: la disfunción sexual se presenta en por lo menos un tercio de las gestantes, especialmente en el tercer trimestre. En la práctica clínica diaria se hace necesario abordar la disfunción sexual, ya que se puede contribuir desde el abordaje de la educación a un problema que puede afectar las relaciones de pareja y la calidad de vida. Es fundamental generar nuevas investigaciones que incluyan la evaluación de la efectividad y seguridad de estrategias educativas en este grupo poblacional con disfunción sexual.

Second week methyl-prednisolone pulses improve prognosis in patients with severe coronavirus disease 2019 pneumonia: An observational comparative study using routine care data.

OBJECTIVE: To analyze the effects of a short course of methyl-prednisolone pulses (MP) during the second week of disease (week-2) in patients with severe coronavirus disease 2019 (COVID-19) pneumonia. METHODS: Comparative observational study using data collected from routine care at Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain in patients with COVID-19 pneumonia. We compared patients who received week-2-MP (125-250 mg/d x3) with those who did not, with the end-points time to death and time to death or endotracheal intubation. RESULTS: We included 242 patients with COVID-19 pneumonia and elevated inflammatory markers at admission. Sixty-one patients (25%) received week-2-MP. Twenty-two patients (9%) died and 31 (12.8%) suffered death or intubation. The adjusted HRs for death and death or intubation for patients in the week-2-MP group were 0.35 (95%CI 0.11 to 1.06, p = 0.064) and 0.33 (95%CI 0.13 to 0.84, p = 0.020), respectively. These differences were specifically seen in the subcohort of patients with a SpO2/FiO2 at day 7 lower than 353 (adjusted HR 0.31, 95% CI 0.08 to 1.12, p = 0.073 and HR 0.34, 95%CI 0.12 to 0.94, p = 0.038, respectively) but not in patients with higher SpO2/FiO2. Patients receiving out-of-week-2-MP, non-pulse glucocorticoids or no glucocorticoids had an increased adjusted risk for both outcomes compared with week-2-MP group: HR 5.04 (95% CI 0.91-27.86), HR 10.09 (95% CI 2.14-47.50), HR 4.14 (95% CI 0.81-21.23), respectively, for death; HR 7.38 (95% CI 1.86-29.29), HR 13.71 (95% CI 3.76-50.07), HR 3.58 (95% CI 0.89-14.32), respectively, for death or intubation. These differences were significant only in the subgroup with low SpO2/FiO2. CONCLUSIONS: Week-2-MP are effective in improving the prognosis of patients with COVID-19 pneumonia with features of inflammatory activity and respiratory deterioration entering the second week of disease. The recognition of this high-risk population should prompt early use of MP at this point.

[Antifungal activity of mouthwashes against Candida albicans and Rhodotorula mucilaginosa: An in vitro study]. / Actividad antifúngica de los enjuagues bucales frente a Candida albicans y Rhodotorula mucilaginosa: un estudio in vitro.

BACKGROUND: Candida albicans and Rhodotorula mucilaginosa are yeasts of clinical importance in the oral cavity. In immunocompromised patients they can cause some pathologies that must be controlled with antimicrobials. AIMS: To evaluate and compare the antimicrobial efficacy of commercially available mouthrinses against strains of C. albicans and R. mucilaginosa. METHODS: The six mouthwashes studied in vitro were formulated (alone or in combination) with chlorhexidine (CHX) 0.12%, CHX 0.1%, CHX 0.05%, cetylpyridinium chloride (CPC) 0.075%, CPC 0.05%, and essential oils. Ten C. albicans and R. mucilaginosa isolates each were studied. The agar diffusion method (Mueller Hinton II), with incubation at 32°C was used to evaluate the antifungal activity. RESULTS: The results of this study indicate that mouthwashes with CHX 0.1%, CHX 0.12%, CHX 0.05% + CPC 0.05%, CHX 0.12% + CPC 0.05% and CPC 0.075% have an antifungal effect against C. albicans and R. mucilaginosa. CHX 0.1% led to the broadest inhibition zone for C. albicans and R. mucilaginosa (25.65±2.39mm and 40.05±3.31mm). Essential oils did not show any antifungal activity. Statistical analysis showed no statistical difference between mouth rinses CHX 0.1%, CHX 0.12% and CHX 0.12% + CPC 0.05% (p=0.0001) against C. albicans and R. mucilaginosa. CONCLUSIONS: Mouthwashes with CHX showed higher antifungal activity against C. albicans and R. mucilaginosa than other mouthwashes studied.

Actividad antifúngica de los enjuagues bucales frente a Candida albicans y Rhodotorula mucilaginosa: un estudio in vitro / Antifungal activity of mouthwashes against Candida albicans and Rhodotorula mucilaginosa: an in vitro study

ANTECEDENTES: Candida albicans y Rhodotorula mucilaginosa son levaduras de importancia clínica en la cavidad oral. En pacientes inmunocomprometidos estas levaduras pueden producir enfermedades que deben ser controladas con antimicrobianos. OBJETIVOS: Evaluar y comparar la eficacia antifúngica de seis enjuagues bucales comerciales frente a aislamientos de C. albicans y R. mucilaginosa. MÉTODOS: Fue evaluada in vitro la eficacia de seis enjuagues bucales formulados (solos o en combinación) con clorhexidina (CHX) 0,12%; CHX 0,1%; CHX 0,05%; cloruro de cetilpiridinio (CPC) 0,075%; CPC 0,05% y aceites esenciales. Fueron utilizados diez aislamientos de C. albicans y otros diez de R. mucilaginosa. Mediante el método de difusión en placa con agar Mueller Hinton (modificado) se midieron los halos de inhibición previa incubación a 32°C. RESULTADOS: Los resultados de este estudio indican que enjuagues bucales con CHX 0,1%; CHX 0,12%; CHX 0,05% + CPC 0,05%; CHX 0,12% + CPC 0,05% y CPC 0,075% ejercen un efecto antifúngico frente a C. albicans y R. mucilaginosa. CHX 0,1% dio lugar a la mayor zona de inhibición para C. albicans y R. mucilaginosa (25,65±2,39mm y 40,05±3,31mm). El enjuague con aceites esenciales no tuvo actividad antifúngica alguna. El análisis estadístico no mostró diferencia entre los enjuagues bucales CHX 0,1%; CHX 0,12% y CHX 0,12% + CPC 0,05% (p = 0,0001) frente a C. albicans y R. mucilaginosa. CONCLUSIONES: Los enjuagues bucales con CHX mostraron una mejor actividad antifúngica contra C. albicans y R. mucilaginosa que los restantes enjuagues estudiados

BACKGROUND: Candida albicans and Rhodotorula mucilaginosa are yeasts of clinical importance in the oral cavity. In immunocompromised patients they can cause some pathologies that must be controlled with antimicrobials. AIMS: To evaluate and compare the antimicrobial efficacy of commercially available mouthrinses against strains of C. albicans and R. mucilaginosa. METHODS: The six mouthwashes studied in vitro were formulated (alone or in combination) with chlorhexidine (CHX) 0.12%, CHX 0.1%, CHX 0.05%, cetylpyridinium chloride (CPC) 0.075%, CPC 0.05%, and essential oils. Ten C. albicans and R. mucilaginosa isolates each were studied. The agar diffusion method (Mueller Hinton II), with incubation at 32°C was used to evaluate the antifungal activity. RESULTS: The results of this study indicate that mouthwashes with CHX 0.1%, CHX 0.12%, CHX 0.05% + CPC 0.05%, CHX 0.12% + CPC 0.05% and CPC 0.075% have an antifungal effect against C. albicans and R. mucilaginosa. CHX 0.1% led to the broadest inhibition zone for C. albicans and R. mucilaginosa (25.65±2.39mm and 40.05±3.31mm). Essential oils did not show any antifungal activity. Statistical analysis showed no statistical difference between mouth rinses CHX 0.1%, CHX 0.12% and CHX 0.12% + CPC 0.05% (p = 0.0001) against C. albicans and R. mucilaginosa. CONCLUSIONS: Mouthwashes with CHX showed higher antifungal activity against C. albicans and R. mucilaginosa than other mouthwashes studied