Submental Flap Versus Radial Forearm Free Flap for the Reconstruction of Medium Size Soft Tissue Defect in the Oral Cavity.

The aim of this work is to compare the functional and esthetic outcome of the submental flap and radial forearm free flap for the reconstruction of medium-sized soft tissue defect in the oral cavity. Patients diagnosed with squamous cell carcinoma of the oral cavity and reconstructed with a submental flap or radial forearm free flap between 2015 and 2020 were reviewed and analyzed. Tumor site, complication at the donor site, complication at the recipient site, duration of the hospital stay, local or cervical recurrence, and esthetic results were also analyzed to compare the difference in outcomes between the two groups. Submental flap represents a safe and useful reconstructive recourse for head and neck reconstructive surgeons when it is correctly indicated. Lower rate of complication at the donor site, better esthetic result, and a shorter hospital stay represent the strengths of this flap when it is not necessary to perform compartment surgery. However, more studies are needed with a larger number of patients.

Salmonella in Chicken and Pork Meat as a Likely Major Contributor to Foodborne Illness in Peru.

Nontyphoidal Salmonella is one of the major causes of self-limiting diarrheal disease and the most common foodborne pathogen worldwide. It is an important contributor to the burden of foodborne illness in South America, including Peru, where chicken and pork are important vehicles for Salmonella infection. Salmonella infections are underreported, particularly in low- and middle-income countries where concerted action tackling Salmonella along the chicken and pork chains, from primary production to retail, is urgently needed. To support and inform the implementation of new strategies to reduce Salmonella contamination of chicken and pork, this study describes the frequency and distribution of foodborne outbreaks attributed to Salmonella in Peru and evaluates the level of Salmonella in chicken and pork meat sold in markets of three regions of Peru. To that end, we analyzed historical reports of foodborne outbreaks, levels of Salmonella in chicken and pork sold in markets, and the number of mesophiles in the collected meat samples. As a result, the microbiological analysis reveals a widespread contamination of chicken (77.1%) and pork (26.8%) with Salmonella. It also pinpoints Salmonella as the causative agent in nearly half of the outbreaks (47.0%) where the potential origin is identified over a 11-year period with chicken, mayonnaise, and pork being the most likely food vehicles. These results suggest that Salmonella is a major contributor to foodborne illness in Peru and that the monitoring of mesophiles could be a good strategy for surveillance, generating data to support source attribution studies and ultimately evidence-informed policies.

Guidelines of the French Society of Otorhinolaryngology and Head and Neck Surgery (SFORL) for vestibular rehabilitation in children with vestibular dysfunction. A systematic review.

INTRODUCTION: The consequence of complete or partial uncompensated vestibular dysfunction in children is usually balance disorders, with the risk of falls and increased fatigue, particularly during tasks requiring postural control. The aim of these recommendations is to establish guidelines for vestibular rehabilitation (VR) in children with vestibular impairment. MATERIAL AND METHODS: The guidelines were developed based on a systematic review of the international literature, validated by a multidisciplinary group of French-speaking otorhinolaryngologists, scientists, and physiotherapists. They are classified as grade A, B, C, or expert opinion according to a decreasing level of scientific evidence. RESULTS: A PubMed search of studies published between January 1990 and December 2021 was carried out using the keywords "vestibular," "rehabilitation," and "children". After filtering and reviewing the articles, a total of 10 publications were included to establish the recommendations. CONCLUSION: It is recommended that a vestibular assessment be carried out before VR, including a study of vestibulo-ocular reflex, otolithic function, and postural control. In cases of vestibular dysfunction, physiotherapy treatment is recommended from an early age to train different aspects of postural control, including anticipatory and reactive postural adjustments. VR adapted to the pediatric population is recommended for children whose vestibular dysfunction leads to functional disorders or symptoms of vertigo for those who have suffered head trauma. It is recommended that children with bilateral vestibular impairment be treated using gaze stabilization exercises for adaptation and substitution. Optokinetic stimulation and virtual reality are not recommended for children and young adolescents.

Transformation of a long-standing phosphaturic tumor-inducing osteomalacia into malignancy.

Key Clinical Message: Tumor-induced osteomalacia is a paraneoplastic syndrome characterized by renal phosphate wasting and deranged bone turnover. Clinicians should consider tumor-induced osteomalacia in unexplained hypophosphatemia and investigate for underlying tumors. Abstract: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, which leads to deranged bone turnover. TIO is usually associated with benign mesenchymal tumors, although it has also been reported in malignant tumors. We present the case of a 56-year-old individual who experienced a protracted 6-year clinical course characterized by hypophosphatemia, weakness, and kyphosis, alongside the presence of a foot tumor. Subsequently, this lesion displayed malignant behavior and was ultimately diagnosed as a high-grade sarcoma. To date, this case is among the 10 reported cases in the literature of a mesenchymal tumor associated with TIO undergoing malignant transformation. This report underscores the importance of a comprehensive evaluation of patients with unexplained hypophosphatemia and highlights the need for diligent follow-up to detect possible malignant transformation of the underlying tumor. Clinicians should consider TIO in the differential diagnosis of hypophosphatemia and promptly investigate for the presence of an underlying tumor, as early detection may improve the patient's prognosis.

AF and in-hospital mortality in COVID-19 patients.

Background: There are conflicting data on whether new-onset atrial fibrillation (AF) is independently associated with poor outcomes in COVID-19 patients. This study represents the largest dataset curated by manual chart review comparing clinical outcomes between patients with sinus rhythm, pre-existing AF, and new-onset AF. Objective: The primary aim of this study was to assess patient outcomes in COVID-19 patients with sinus rhythm, pre-existing AF, and new-onset AF. The secondary aim was to evaluate predictors of new-onset AF in patients with COVID-19 infection. Methods: This was a single-center retrospective study of patients with a confirmed diagnosis of COVID-19 admitted between March and September 2020. Patient demographic data, medical history, and clinical outcome data were manually collected. Adjusted comparisons were performed following propensity score matching between those with pre-existing or new-onset AF and those without AF. Results: The study population comprised of 1241 patients. A total of 94 (7.6%) patients had pre-existing AF and 42 (3.4%) patients developed new-onset AF. New-onset AF was associated with increased in-hospital mortality before (odds ratio [OR] 3.58, 95% confidence interval [CI] 1.78-7.06, P < .005) and after (OR 2.80, 95% CI 1.01-7.77, P < .005) propensity score matching compared with the no-AF group. However, pre-existing AF was not independently associated with in-hospital mortality compared with patients with no AF (postmatching OR: 1.13, 95% CI 0.57-2.21, P = .732). Conclusion: New-onset AF, but not pre-existing AF, was independently associated with elevated mortality in patients hospitalised with COVID-19. This observation highlights the need for careful monitoring of COVID-19 patients with new-onset AF. Further research is needed to explain the mechanistic relationship between new-onset AF and clinical outcomes in COVID-19 patients.

Failing in reverse: a case report of reverse Takotsubo syndrome complicating peripartum.

Background: Pregnancy and the peripartum are states of stress for the cardiovascular system. These conditions can trigger different cardiomyopathies. Among these, Takotsubo cardiomyopathy (TC) has been increasingly recognized as a cause of transient left ventricular dysfunction associated with pregnancy. Case summary: We present the case of a 31-year-old multiparous woman with an unusual variant of TC after caesarean delivery. Discussion: Peripartum cardiomyopathy and TC are particularly interesting differential diagnoses for new systolic dysfunction in pregnancy. Some features, such as the time of presentation, regional or diffuse wall motion abnormalities, evolution, and biomarkers, can guide the clinician to the right diagnosis.

A novel mutation c.457C > T p.Q153 in the HMBS gene in a Mexican woman with acute intermittent porphyria.

Key Clinical Message: The detection of a novel HMBS gene mutation (c.457C > T) in a Mexican woman with acute intermittent porphyria underscores the importance of expanding genetic analyses in diverse populations to improve diagnosis, management, and knowledge of the disease's clinical implications. Abstract: Acute intermittent porphyria (AIP) is an autosomal dominant disorder caused by a deficiency in the enzymatic activity of porphobilinogen deaminase (HMBS), resulting in the accumulation of toxic heme metabolites. In this report, we present the case of a Mexican woman with AIP who experienced recurrent episodes of severe abdominal pain, weakness, vomiting, and insomnia. Despite the challenges in diagnosis and treatment, genetic analysis revealed a novel HMBS mutation, c.457C > T (p.Q153X), located in exon 9. This mutation induces a premature translational stop codon and had not been previously reported in medical literature among individuals with AIP. Remarkably, the patient exhibited a positive response to RNA interference therapy. We hypothesize that this novel HMBS mutation may potentially account for the more severe clinical presentation observed in this case. However, further research is necessary to establish a definitive link between this specific mutation and disease severity. The prevalence and genetic variants of AIP in Mexico remain largely unknown, underscoring the importance of conducting additional research and expanding genetic analyses to gain a better understanding of the clinical implications associated with these mutations.

Non-Excitatory Amino Acids, Melatonin, and Free Radicals: Examining the Role in Stroke and Aging.

The aim of this review is to explore the relationship between melatonin, free radicals, and non-excitatory amino acids, and their role in stroke and aging. Melatonin has garnered significant attention in recent years due to its diverse physiological functions and potential therapeutic benefits by reducing oxidative stress, inflammation, and apoptosis. Melatonin has been found to mitigate ischemic brain damage caused by stroke. By scavenging free radicals and reducing oxidative damage, melatonin may help slow down the aging process and protect against age-related cognitive decline. Additionally, non-excitatory amino acids have been shown to possess neuroprotective properties, including antioxidant and anti-inflammatory in stroke and aging-related conditions. They can attenuate oxidative stress, modulate calcium homeostasis, and inhibit apoptosis, thereby safeguarding neurons against damage induced by stroke and aging processes. The intracellular accumulation of certain non-excitatory amino acids could promote harmful effects during hypoxia-ischemia episodes and thus, the blockade of the amino acid transporters involved in the process could be an alternative therapeutic strategy to reduce ischemic damage. On the other hand, the accumulation of free radicals, specifically mitochondrial reactive oxygen and nitrogen species, accelerates cellular senescence and contributes to age-related decline. Recent research suggests a complex interplay between melatonin, free radicals, and non-excitatory amino acids in stroke and aging. The neuroprotective actions of melatonin and non-excitatory amino acids converge on multiple pathways, including the regulation of calcium homeostasis, modulation of apoptosis, and reduction of inflammation. These mechanisms collectively contribute to the preservation of neuronal integrity and functions, making them promising targets for therapeutic interventions in stroke and age-related disorders.

Developing a serious game for gaze stability rehabilitation in children with vestibular hypofunction.

BACKGROUND: Children with vestibular hypofunction (VH) may have gaze instability, balance disorders, and delayed postural-motor development. Gaze stabilization exercises (GSE) are designed to improve dynamic visual acuity (DVA). We aimed to assess the acceptability of a serious game prototype called Kid Gaze Rehab (KGR) designed to implement GSE training in children with VH, combined with traditional vestibular rehabilitation. Effects on DVA and motor performance were also analyzed. METHODS: Twelve children (6 to 9 years old) were included. Sessions were held at the hospital twice a week, for 5 weeks. An adapted French version of The Child Simulator Sickness Questionnaire (SSQ) and the Face Scale Pain-Revised (FPS-R) were used to assess pain in the cervical region and undesirable side effects after each session. Vestibular and motor function parameters (active and passive DVA and Movement Assessment Battery for Children-Second Edition, MABC-2) were assessed before and after the training. RESULTS: All children included completed the 10 sessions. The FPS-R visual analog scale and SSQ showed good cervical tolerance and no oculomotor or vegetative adverse effects nor spatial disorientation. After training, active DVA scores were significantly improved for the right, left, and up directions (p < 0.05). Passive DVA scores were significantly improved for the left and down directions (p < 0.01 and p < 0.05, respectively). MABC-2 scores were improved in the balance and ball skill sections (p < 0.05). CONCLUSION: An innovative pediatric training method, the use of a dedicated serious game for gaze stabilization was well-tolerated as a complement to conventional vestibular rehabilitation in children with VH. Moreover, both DVA and motor performance were found to improve in the study sample. Although replication studies are still needed, serious game-based training in children with VH could represent a promising rehabilitation approach for years to come. TRIAL REGISTRATION: The study was conducted in accordance with the Declaration of Helsinki and approved by an Institutional Review Board (local ethics committee, CPP Sud-Est IV, ID 2013-799). The study protocol was registered on ClinicalTrials.gov (NCT04353115).

Identification of Non-excitatory Amino Acids and Transporters Mediating the Irreversible Synaptic Silencing After Hypoxia.

The contribution of excitatory amino acids (AA) to ischemic brain injury has been widely described. In addition, we reported that a mixture of non-excitatory AA at plasmatic concentrations turns irreversible the depression of synaptic transmission caused by hypoxia. Here, we describe that the presence of seven non-excitatory AA (L-alanine, L-glutamine, glycine, L-histidine, L-serine, taurine, and L-threonine) during hypoxia provokes an irreversible neuronal membrane depolarization, after an initial phase of hyperpolarization. The collapse of the membrane potential correlates with a great increase in fiber volley amplitude. Nevertheless, we show that the presence of all seven AA is not necessary to cause the irreversible loss of fEPSP after hypoxia and that the minimal combination of AA able to provoke a solid, replicable effect is the mixture of L-alanine, glycine, L-glutamine, and L-serine. Additionally, L-glutamine seems necessary but insufficient to induce these harmful effects. We also prove that the deleterious effects of the AA mixtures on field potentials during hypoxia depend on both the identity and concentration of the individual AA in the mixture. Furthermore, we find that the accumulation of AA in the whole slice does not determine the outcome caused by the AA mixtures on the synaptic transmission during hypoxia. Finally, results obtained using pharmacological inhibitors and specific substrates of AA transporters suggest that system N and the alanine-serine-cysteine transporter 2 (ASCT2) participate in the non-excitatory AA-mediated deleterious effects during hypoxia. Thus, these AA transporters might represent therapeutical targets for the treatment of brain ischemia.

Echocardiographic manifestations during the first 3 months after an episode of COVID-19 and their relationship with disease severity and persistence of symptoms.

BACKGROUND: Cardiovascular manifestations in patients with COVID-19 are associated with dire outcomes. Long COVID syndrome is the persistence of symptoms after acute disease and is found in up to 40% of subjects. There is little information regarding subacute echocardiographic manifestations after COVID-19, and no study has included a Mexican mestizo population. METHODS: This cross-sectional study included subjects older than 18 with an episode of COVID-19 in the last 3 months. Those with previously known cardiovascular disease were excluded. The patient´s medical history and COVID-19 information were obtained from clinical charts. We performed a transthoracic echocardiogram in every subject and determined left ventricular (LV) index mass, LV ejection fraction (LVEF), left ventricular global longitudinal strain (LV GLS), right ventricular (RV) GLS, and tricuspid annular plane systolic excursion (TAPSE). A descriptive and comparative analysis was performed based on symptom severity and persistence. RESULTS: One hundred subjects were included; 63% were classified with mild and 37% with moderate to severe COVID-19. The median of LVEF was 60% (55-60), LV GLS and RV GLS was impaired in 34% and 74% of patients, respectively. Patients with moderate to severe disease had significantly lower LVEF (Mean Difference: -3.3), TAPSE (mean difference: -1.8), and higher (worse) LV GLS (Mean Difference: 2.5) and RV GLS (mean difference: 2.9). Persistent symptoms were associated with lower TAPSE and higher RVGLS. CONCLUSIONS: Patients who recover from COVID-19 have a high prevalence of subtle RV and LV dysfunction using GLS analysis. A moderate to severe episode was associated with worse RV and LV function measured by RV GLS, TAPSE, and LV GLS. Subjects with persistent symptoms had worse RVGLS and TAPSE.

"MiR-7 controls cholesterol biosynthesis through posttranscriptional regulation of DHCR24 expression".

Dysregulation of cholesterol homeostasis is associated with several pathologies including cardiovascular diseases and neurological disorders such as Alzheimer's disease (AD). MicroRNAs (miRNAs) have emerged as key post-transcriptional regulators of cholesterol metabolism. We previously established the role of miR-7 in regulating insulin resistance and amyloidosis, which represents a common pathological feature between type 2 diabetes and AD. We show here an additional metabolic function of miR-7 in cholesterol biosynthesis. We found that miR-7 blocks the last steps of the cholesterol biosynthetic pathway in vitro by targeting relevant genes including DHCR24 and SC5D posttranscriptionally. Intracranial infusion of miR-7 on an adeno-associated viral vector reduced the expression of DHCR24 in the brain of wild-type mice, supporting in vivo miR-7 targeting. We also found that cholesterol regulates endogenous levels of miR-7 in vitro, correlating with transcriptional regulation through SREBP2 binding to its promoter region. In parallel to SREBP2 inhibition, the levels of miR-7 and hnRNPK (the host gene of miR-7) were concomitantly reduced in brain in a mouse model of Niemann Pick type C1 disease and in murine fatty liver, which are both characterized by intracellular cholesterol accumulation. Taken together, the results establish a novel regulatory feedback loop by which miR-7 modulates cholesterol homeostasis at the posttranscriptional level, an effect that could be exploited for therapeutic interventions against prevalent human diseases.

Neuroblastoma intracraneal en una niña / Intracranial neuroblastoma in a girl I: en

Se describe el caso clínico de una niña de 13 meses de edad, quien fue asistida en el Servicio de Neurocirugía del Hospital Infantil Sur Dr. Antonio María Béguez César de Santiago de Cuba, y posteriormente en el Servicio de Oncología de la institución, remitida del área de salud por presentar proptosis, exoftalmos del ojo derecho y aumento del perímetro craneal. Luego de realizados el examen clínico y los estudios complementarios pertinentes, incluidos resonancia magnética simple y contrastada de cráneo, estudio histopatológico, así como aspiración y biopsia bilateral de médula ósea, se confirmó que se trataba de un neuroblastoma parameníngeo con infiltración medular (estadio IV), sin evidencia de tumor primario. La evolución luego de la quimioterapia fue satisfactoria.

The case report of a 13 months girl is described who was assisted in the Neurosurgery Service of Antonio María Béguez Cesar Southern Children Hospital in Santiago de Cuba, and later on in the Oncology Service of the institution, referred from the health area due to proptosis, exophthalmos of the right eye and increase of the cranial perimeter. After the clinical exam and the pertinent complementary studies, including simple and contrasted magnetic resonance of skull, histopatologic study, as well as aspiration and bilateral biopsy of bone marrow, the presence of a parameningeal neuroblastoma with medullary infiltration (stage IV), without evidence of primary tumor was confirmed. The evolution after the chemotherapeutic treatment was satisfactory.

Pérdida de peso no intencionada, un diagnóstico de patología orgánica con costos a la salud.

No disponible.

Long-term safety of spinal cord stimulation systems in a prospective, global registry of patients with chronic pain.

Aim: The availability of long-term (>2 years) safety outcomes of spinal cord stimulation (SCS) remains limited. We evaluated safety in a global SCS registry for chronic pain. Methods: Participants were prospectively enrolled globally at 79 implanting centers and followed out to 3 years after device implantation. Results: Of 1881 participants enrolled, 1289 received a permanent SCS implant (1776 completed trial). The annualized rate of device explant was 3.5% (all causes), and 1.1% due to inadequate pain relief. Total incidence of device explantation >3 years was 7.6% (n = 98). Of these, 32 subjects (2.5%) indicated inadequate pain relief as cause for removal. Implant site infection (11 events) was the most common device-related serious adverse event (<1%). Conclusion: This prospective, global, real-world study demonstrates a high-level of safety for SCS with low rate of explant/serious adverse events. Clinical Trial Registration: NCT01719055 (ClinicalTrials.gov).

Estrés académico, procrastinación y usos del Internet en universitarios durante la pandemia por covid-19 / Academic Stress, Procrastination, and Internet Uses Among College Students During the covid-19 Pandemic / Estresse acadêmico, procrastinação e uso da Internet em estudantes universitários durante a pandemia de covid-19

La pandemia por covid-19 repercutió en las prácticas educativas y convirtió a las tecnologías de la información y la comunicación ­sobre todo Internet­ en medios indispensables para continuar con las actividades académicas; pero a la par incrementaron el riesgo de que los estudiantes usen mal estas herramientas y con ello aparezcan fenómenos como la procrastinación. Por tanto, el objetivo fue analizar la relación entre el estrés académico, el uso problemático de Internet, la adicción a las redes sociales y la procrastinación académica. Materiales y métodos: estudio cuantitativo, no experimental, de corte transversal. Se utilizó el inventario sisco de estrés académico, el cupo para uso problemático de Internet, la smas-sf de adicción a redes sociales y la Escala de Procrastinación Académica. La muestra la conformaron 448 estudiantes universitarios mexicanos entre los 17 y los 34 años. Resultados: se hallaron diferencias significativas por sexo, en cuanto a las reacciones ante el estrés académico, y en la categoría de la autorregulación, donde los hombres indicaron una baja autorregulación. Por su parte, en la sub-muestra de mujeres se encontró una relación positiva y significativa entre el uso de las redes sociales y la procrastinación académica; mientras que, en los hombres, entre los problemas por el uso de las redes sociales y las reacciones psicológicas ante el estrés. Conclusión: el cambio de modalidad de estudio (de presencial a virtual) ha generado consecuencias en los universitarios, como estrés académico, procras-tinación y usos inadecuados de Internet.

The covid-19 pandemic has affected educational practices, turning the information and communication technologies and the Internet into essential means to continue academic activities while increasing the risk of students misusing these tools, favoring phenomena such as procrastination. This study aimed to analyze the relationship between academic stress, problematic Internet use, social media addiction, and academic procrastination. Materials and methods: In this quantitative, non-experimen-tal, and cross-sectional study, the sisco inventory for academic stress, cupi for problematic Internet use, smas-sf for addiction to social networks, and academic procrastination scale were used. The sample was made up of 448 Mexican university students aged 17­34 years. Results: Significant differences were found by sex in terms of reactions to academic stress and in the category of self-regulation, where men indicated low self-regulation. Moreover, a positive and significant relationship was found between the use of social networks and academic procrastination in women and the problems due to the use of social networks and psychological reactions to stress in men. Conclusion: The change from face-to-face to virtual modality has led to consequences such as academic stress, procrastination, and inappropriate use of the Internet among university students.

a pandemia do covid-19 impactou as práticas educacionais, tornando as Tecnologias da Informação e Comunicação (tic) e principalmente a Internet meios indispensáveis para a continuidade das atividades acadêmicas; mas ao mesmo tempo aumenta o risco de que os alunos façam mau uso dessas ferramentas e com isso apareçam fenômenos como a procrastinação. Portanto, o objetivo do presente estudo foi analisar a relação entre estresse acadêmico, uso problemático da Internet, vício em redes sociais e procrastinação acadêmica. Materiais e métodos: estudo quantitativo, não experimental e transversal. Foram utilizados o Inventário sisco de estresse acadêmico, o cupi para uso problemático da Internet, o smas-sf para vício em redes sociais e a escala de procrastinação acadêmica (epa). A amostra foi composta por 448 estudantes universitários mexicanos com idades entre 17 e 34 anos. Resultados: foram encontradas diferenças significativas em função do sexo nas reações ao estresse acadêmico e na catego-ria de auto-regulamentação, onde os homens indicaram baixa auto-regulamentação. Por outro lado, foi encontrada uma relação positiva e significativa, na subamostra de mulheres, entre o uso de redes sociais e procrastinação acadêmica, enquanto que para os homens houve relação positiva e significativa entre problemas devido ao uso de redes sociais e reações psicológicas ao estresse. Conclusão: a mudança da modalidade presencial para a virtual gerou consequências em universitários como estresse acadêmico, procrastinação e uso inadequado da Internet.

Textiles Functionalized with Copper Oxides: A Sustainable Option for Prevention of COVID-19.

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and healthcare-associated infections (HAIs) represent severe problems in health centers and public areas. Polyester/cotton (PES/CO) blend fabrics have been functionalized with copper oxides on an industrial scale. For functionalization, the impregnation dyeing technique was applied. The functionalized samples were tested virologically against SARS-CoV-2 and human coronavirus (229E) according to ISO 18184-2019 and microbiologically against Escherichia coli (ATCC 25922) bacteria according to ASTM E2149-2013. The results show that the fabric functionalized with copper oxides inactivated both viruses after 30 min of exposure, presenting excellent virucidal activity against 229E and SARS-CoV-2, respectively. Furthermore, its inactivation efficiency for SARS-CoV-2 was 99.93% and 99.96% in 30 min and 60 min exposure, respectively. The fabric inhibited bacterial growth by more than 99% before and after 10 and 20 washes. In conclusion, 265 m of PES/CO fabric (wide 1.7 m) was functionalized in situ on an industrial scale with copper oxide nanoparticles. The functionalized fabric presented virucidal and bactericidal properties against SARS-CoV-2 and Escherichia coli.

Frecuencia de hiponatremia posoperatoria en pacientes sometidos a cirugía mayor en un centro de tercer nivel

Contexto la hiponatremia posoperatoria es una complicación frecuente que se encuentra hasta en el 4 % de los pacientes sometidos a cirugía y que además es un factor independiente de mortalidad intrahospitalaria. Hasta ahora, los estudios se enfocan en las primeras horas posteriores a la cirugía, existiendo poca literatura que abarque hasta el periodo posoperatorio tardío. Objetivo evaluar la frecuencia y las características de hiponatremia en la primera semana posoperatoria. Metodología se incluyeron pacientes sometidos a cirugía mayor durante un periodo de 18 meses. Se determinó el nivel de sodio a las 24 horas, al tercer, quinto y séptimo día del procedimiento. Se clasificó de acuerdo con el tipo de cirugía realizada y se documentó la presencia de datos clínicos y desenlaces de los pacientes. Resultados 280 pacientes fueron estudiados, de los cuales 20 (7,1 %) desarrollaron hiponatremia durante el primer día posoperatorio, 34 (12,1 %) en el tercero, 30 (10,7 %) en el quinto día y 31 (11 %) en el séptimo día. En el primer día posoperatorio, los pacientes sometidos a cirugías urológicas y gastrointestinales desarrollaron hiponatremia con mayor frecuencia. Ninguno de los pacientes desarrolló complicaciones graves y no hubo relación entre la edad, el género o el tipo de soluciones y el desarrollo de hiponatremia. Conclusiones la hiponatremia es una complicación frecuente de varios tipos de procedimientos quirúrgicos que puede desarrollarse en los primeros siete días posoperatorios.

Background Postoperative hyponatremia is a frequent complication that is found in more than 4% of patients undergoing surgery. It is also an independent factor of in-hospital mortality. Until now, previous studies have focused on the first hours after surgery, so there is little information regarding hyponatremia in the late postoperative period. Purpose evaluate the frequency and characteristics of hyponatremia in the first postsurgical week. Methodology Patients undergoing major surgery over a period of 18 months were included. Sodium level was determined at 24 hours, third, fifth and seventh day of the procedure. Hyponatremia was classified according to surgery type and presence of clinical symptoms and outcomes were documented. Results 280 patients were studied. 20 (7.1%) developed hyponatremia on the first postoperative day, 34 (12.1%) on the third, 30 (10.7%) on the fifth day, and 31 (11%) on the seventh day. On the first postoperative day, patients undergoing urological and gastrointestinal surgeries developed hyponatremia more frequently. None of the patients developed serious complications. There was no relationship between age, gender or type of solutions and the development of hyponatremia. Conclusions hyponatremia is a frequent complication of surgical procedures that can develop in the first seven postoperative days.

Novel mechanism of hypoxic neuronal injury mediated by non-excitatory amino acids and astroglial swelling.

In ischemic stroke and post-traumatic brain injury (TBI), blood-brain barrier disruption leads to leaking plasma amino acids (AA) into cerebral parenchyma. Bleeding in hemorrhagic stroke and TBI also release plasma AA. Although excitotoxic AA were extensively studied, little is known about non-excitatory AA during hypoxic injury. Hypoxia-induced synaptic depression in hippocampal slices becomes irreversible with non-excitatory AA, alongside their intracellular accumulation and increased tissue electrical resistance. Four non-excitatory AA (l-alanine, glycine, l-glutamine, l-serine: AGQS) at plasmatic concentrations were applied to slices from mice expressing EGFP in pyramidal neurons or astrocytes during normoxia or hypoxia. Two-photon imaging, light transmittance (LT) changes, and electrophysiological field recordings followed by electron microscopy in hippocampal CA1 st. radiatum were used to monitor synaptic function concurrently with cellular swelling and injury. During normoxia, AGQS-induced increase in LT was due to astroglial but not neuronal swelling. LT raise during hypoxia and AGQS manifested astroglial and neuronal swelling accompanied by a permanent loss of synaptic transmission and irreversible dendritic beading, signifying acute damage. Neuronal injury was not triggered by spreading depolarization which did not occur in our experiments. Hypoxia without AGQS did not cause cell swelling, leaving dendrites intact. Inhibition of NMDA receptors prevented neuronal damage and irreversible loss of synaptic function. Deleterious effects of AGQS during hypoxia were prevented by alanine-serine-cysteine transporters (ASCT2) and volume-regulated anion channels (VRAC) blockers. Our findings suggest that astroglial swelling induced by accumulation of non-excitatory AA and release of excitotoxins through antiporters and VRAC may exacerbate the hypoxia-induced neuronal injury.