Minimally invasive surgery versus laparotomy in women with high risk endometrial cancer: A multi-center study performed in Argentina.

Objective: Compare the perioperative outcomes and disease-free survival between minimally invasive and open surgery in women with stage I-II high-risk endometrial cancer. Methods: A retrospective, cohort study was performed involving twenty-four centers from Argentina. Patients with grade 3 endometrioid, serous, clear cell, undifferentiated carcinoma or carcinosarcoma who underwent hysterectomy, bilateral salpingo-oophorectomy, and staging between January 2010-2018 were included. Cox hazard regression analysis and Kaplan-Meier curves evaluated the association of surgical technique with survival. Results: Of 343 eligible patients, 214 (62 %) underwent open surgery and 129 (38 %) underwent laparoscopic surgery. No significant differences were seen between the two groups with respect to greater or equal grade III Clavien-Dindo postoperative complications (11 % in the open surgery group vs 9 % minimally invasive surgery group; P = 0.34) Minimally invasive surgery was not associated with worse disease-free survival at four years (79.14 % [95 % CI 69.42- 86.08] vs 78.80 % [95 % CI 70.61-84.96]), (p = 0.25), even after creating a Cox proportional model (hazard ratio [HR] 1.08 95 % CI 0.63-1.84); (p = 0.76). Conclusion: There was no difference between postoperative complications nor oncologic outcomes comparing minimally invasive and open surgery among patients with high-risk endometrial cancer.

Characteristics, hospital referrals and 60-day mortality of older patients living in nursing homes with COVID-19 assessed by a liaison geriatric team during the first wave: a research article.

BACKGROUND: The infection by SARS-CoV-2 (COVID-19) has been especially serious in older patients. The aim of this study is to describe baseline and clinical characteristics, hospital referrals, 60-day mortality, factors associated with hospital referrals and mortality in older patients living in nursing homes (NH) with suspected COVID-19. METHODS: A retrospective observational study was performed during March and April 2020 of institutionalized patients assessed by a liaison geriatric hospital-based team. Were collected all older patients living in 31 nursing homes of a public hospital catchment area assessed by a liaison geriatric team due to the suspicion of COVID-19 during the first wave, when the hospital system was collapsed. Sociodemographic variables, comprehensive geriatric assessment, clinical characteristics, treatment received including care setting, and 60-days mortality were recorded from electronic medical records. A logistic regression analysis was performed to analyze the factors associated with mortality. RESULTS: 419 patients were included in the study (median age 89 years old, 71.6 % women, 63.7 % with moderate-severe dependence, and 43.8 % with advanced dementia). 31.1 % were referred to the emergency department in the first assessment, with a higher rate of hospital referral in those with better functional and mental status. COVID-19 atypical symptoms like functional decline, delirium, or eating disorders were frequent. 36.9% had died in the 60 days following the first call. According to multivariate logistic regression age (p 0.010), Barthel index <60 (p 0.002), presence of tachypnea (p 0.021), fever (p 0.006) and the use of ceftriaxone (p 0.004) were associated with mortality. No mortality differences were found between those referred to the hospital or cared at the nursing home. CONCLUSIONS AND IMPLICATIONS: 31% of the nursing home patients assessed by a liaison geriatric hospital-based team for COVID-19 were referred to the hospital, being more frequently referred those with a better functional and cognitive situation. The 60-days mortality rate due to COVID-19 was 36.8% and was associated with older age, functional dependence, the presence of tachypnea and fever, and the use of ceftriaxone. Geriatric comprehensive assessment and coordination between NH and the hospital geriatric department teams were crucial.

Analysis of Polyhydroxyalkanoates Granules in Haloferax mediterranei by Double-Fluorescence Staining with Nile Red and SYBR Green by Confocal Fluorescence Microscopy.

Haloferaxmediterranei is a haloarchaeon of high interest in biotechnology because it produces and mobilizes intracellular polyhydroxyalkanoate (PHA) granules during growth under stress conditions (limitation of phosphorous in the culture media), among other interesting metabolites (enzymes, carotenoids, etc.). The capability of PHA production by microbes can be monitored with the use of staining-based methods. However, the staining of haloarchaea cells is a challenging task; firstly, due to the high ionic strength of the medium, which is inappropriate for most of dyes, and secondly, due to the low permeability of the haloarchaea S-layer to macromolecules. In this work, Haloferax mediterranei is used as a halophilic archaeon model to describe an optimized protocol for the visualization and analysis of intracellular PHA granules in living cells. The method is based on double-fluorescence staining using Nile red and SYBR Green by confocal fluorescence microscopy. Thanks to this method, the capability of PHA production by new haloarchaea isolates could be easily monitored.

Caso clínico: atención integral de las necesidades paliativas en paciente nonagenario con cáncer de pene avanzado y herida tumoral / Case report: comprehensive care of palliative needs in a nonagenarian patient with advanced penile cancer and tumor ulcer

El cáncer de pene es una afección poco común que en el 4-5 % de los casos presenta recidiva local tras penectomía. Las úlceras tumorales son lesiones que aparecen en el contexto de tumores de alto grado de malignidad y/o fase avanzada de la enfermedad oncológica. Se caracterizan por tener un difícil manejo, ya que en la mayoría de los pacientes presentan dolor, mal olor, exudado abundante, sangrado y alto riesgo de infección. El objetivo de este artículo es describir el caso clínico de un varón con cáncer de pene avanzado que presentaba una lesión ulcerada tumoral con curas complejas, en el que se desestimaron medidas activas de tratamiento, optando por un enfoque paliativo. El abordaje del paciente oncológico con una úlcera tumoral supone un gran desafío para el equipo asistencial. El cuidado de las úlceras neoplásicas exige profesionales altamente cualificados en la materia debido a la complejidad y variabilidad de las curas así como la presencia de síntomas derivados. Gracias a la colaboración de todos los miembros del equipo, familia y paciente se controlaron los síntomas derivados de la úlcera tumoral, contribuyendo a la mejora en la calidad de vida en la etapa final de la enfermedad. (AU)

Cancer of the penis is a rare condition that in 4-5 % of cases presents with local recurrence after penectomy. Tumor ulcers are lesions that appear in the context of tumors with a high degree of malignancy and/or advanced phase of oncological disease. They are characterized by difficult management since in most patients they are associated with pain, bad odor, abundant exudate, bleeding, and high risk of infection. The objective of this article is to describe the clinical case of a man with advanced penile cancer who presented with an ulcerated tumor with complex management; active treatment measures were rejected, and a palliative approach was then selected. Approaching a cancer patient with a tumor ulcer is a great challenge for the healthcare team. Caring for neoplastic ulcers requires highly qualified professionals in the field due to the complexity and variability of the cures as well as the presence of derived symptoms. Thanks to the collaboration of all team members, the family, and the patient the symptoms derived from the tumor ulcer were controlled, contributing to improving quality of life in the final stage of the disease. (AU)

Haloarchaea as Cell Factories to Produce Bioplastics.

Plastic pollution is a worldwide concern causing the death of animals (mainly aquatic fauna) and environmental deterioration. Plastic recycling is, in most cases, difficult or even impossible. For this reason, new research lines are emerging to identify highly biodegradable bioplastics or plastic formulations that are more environmentally friendly than current ones. In this context, microbes, capable of synthesizing bioplastics, were revealed to be good models to design strategies in which microorganisms can be used as cell factories. Recently, special interest has been paid to haloarchaea due to the capability of some species to produce significant concentrations of polyhydroxyalkanoate (PHA), polyhydroxybutyrate (PHB), and polyhydroxyvalerate (PHV) when growing under a specific nutritional status. The growth of those microorganisms at the pilot or industrial scale offers several advantages compared to that of other microbes that are bioplastic producers. This review summarizes the state of the art of bioplastic production and the most recent findings regarding the production of bioplastics by halophilic microorganisms with special emphasis on haloarchaea. Some protocols to produce/analyze bioplastics are highlighted here to shed light on the potential use of haloarchaea at the industrial scale to produce valuable products, thus minimizing environmental pollution by plastics made from petroleum.

Synthesis, photophysical properties and theoretical studies of new bis-quinolin curcuminoid BF2-complexes and their decomplexed derivatives.

This paper presents the synthesis and characterization of two series of new bis-quinolin curcuminoid BF2-complexes 11 and their respective decomplexed bis-quinolin curcuminoid derivatives 12, in an attempt to understand their optical properties. The synthesized compounds showed interesting fluorescent characteristics in both solution and in solid-state. The characteristic of the electronic transitions involved in these systems were measured via Uv-vis spectroscopy and fluorescence spectroscopy. Results revealed that the absorption and emission bands are dependent of the structure of compounds 11 and 12 but also of the type of substituent, even showing a push-pull behavior in those derivatives substituted with methyl group. These findings were also confirmed through computational calculations at DFT level via simulations of the Uv-vis spectra and determining the topology of the border orbitals responsible for light absorption.

Monitoring polymer degradation under different conditions in the marine environment.

The perdurability of plastics in the environment is one of the major concerns of plastic pollution and, as a consequence, oceans are accumulating large amounts of plastic. The degradation of conventional and biobased materials was evaluated through a laboratory experiment for a year simulating four different conditions in the marine environment. The water column environmental compartment was simulated under euphotic and aphotic (with and without light availability) conditions. The seafloor environmental compartment was simulated with sediment under non-polluted and polluted conditions. By combining weight loss (%), spectroscopic and thermal analyses, the degradation patterns regarding the polymer structure were assessed. The studied biobased materials were polylactic acid (PLA) based materials and showed higher degradability than conventional ones. The weight loss of conventional materials was not influenced by the water column or sediment, while in PLA-based materials, the degradation rates were ca. 5 times greater in the sediment than in the water column. The absorbance (Abs) value at 3400 cm-1 for polyethylene terephthalate (PET), and carbonyl (CO) index for PET and PLA could be useful to detect early signs of degradation. The crystallization index could be a useful parameter to discriminate degradation stages. The obtained results highlight the different degradability rates of materials depending on the specific environmental marine conditions.

The Argentinean multiple sclerosis registry (RelevarEM): Methodological aspects and directions.

Despite that different registries already exist in various countries in Europe and North America, no ongoing nationwide registry exists in Latin America (LATAM), a region where the disease behaves differently than in other regions. The objective of this document is to describe the methodology behind RelevarEM, the first nationwide MS registry in Argentina and LATAM. METHODS: In this article, we described the creation, implementation and data management of the nationwide MS registry in Argentina. The registry contains information on the structure, ethical aspects, implementation and variables of the registry (Clinical Trials registry number NCT NCT03375177). CONCLUSION: RelevarEM is the first MS nationwide registry in Argentina, as well as in LATAM, with the objective of providing reliable real-world data of MS in the country.

Effects of long-term ingestion of white tea on oxidation produced by aging and acute oxidative damage in rats

The infusion tea extracted from the leaves of the plant Camellia sinensis can be used in the prevention of cancer, cardiovascular and neurodegenerative diseases, and aging, while adriamycin (ADR) is an anticancer drug that increases oxidative stress in cells. The present study evaluated the protective effect of the long-term consumption of white tea used at two different doses against the oxidative stress produced by aging and acute oxidation caused ADR treatment. At wearing, rats received distilled water (control), or 0.15 (dose 1) or 0.45 mg (dose 2) of solid tea extract/kilogram body weight in their drink. At 12 months, about half of the rats of each group were injected with a bolus of ADR, and six rats of the control group with an injection of saline solution and sacrificed. The rest of the animals continued in their cages until 24 months of age, when they were sacrificed. Lipid and protein oxidation of liver and brain microsomes was analyzed by measuring hydroperoxide and carbonyl levels. White tea consumption for 12 months at a non-pharmacological dose was seen to reverse the oxidative damage caused by ADR in both liver and brain, while the consumption of white tea for 20 months at a non-pharmacological dose had no effect on carbonyl or hydroperoxides in these tissues. The long-term ingestion of white tea protected tissues from acute oxidative stress but did not affect chronic oxidative agents such aging

Effects of long-term ingestion of white tea on oxidation produced by aging and acute oxidative damage in rats.

The infusion tea extracted from the leaves of the plant Camellia sinensis can be used in the prevention of cancer, cardiovascular and neurodegenerative diseases, and aging, while adriamycin (ADR) is an anticancer drug that increases oxidative stress in cells. The present study evaluated the protective effect of the long-term consumption of white tea used at two different doses against the oxidative stress produced by aging and acute oxidation caused ADR treatment. At wearing, rats received distilled water (control), or 0.15 (dose 1) or 0.45 mg (dose 2) of solid tea extract/kilogram body weight in their drink. At 12 months, about half of the rats of each group were injected with a bolus of ADR, and six rats of the control group with an injection of saline solution and sacrificed. The rest of the animals continued in their cages until 24 months of age, when they were sacrificed. Lipid and protein oxidation of liver and brain microsomes was analyzed by measuring hydroperoxide and carbonyl levels. White tea consumption for 12 months at a non-pharmacological dose was seen to reverse the oxidative damage caused by ADR in both liver and brain, while the consumption of white tea for 20 months at a non-pharmacological dose had no effect on carbonyl or hydroperoxides in these tissues. The long-term ingestion of white tea protected tissues from acute oxidative stress but did not affect chronic oxidative agents such aging.

Análisis de la sedación paliativa en pacientes mayores hospitalizados: efectividad de un protocolo / Analysis of palliative sedation in hospitalised elderly patients: Effectiveness of a protocol

Objetivo. Evaluar los cambios producidos en la práctica de la sedación paliativa en la agonía en pacientes mayores hospitalizados antes y después de la implantación de un protocolo hospitalario de sedación paliativa. Material y métodos. Estudio retrospectivo descriptivo tipo antes-después de pacientes mayores de 65 años que fueron tratados con midazolam y fallecieron durante la hospitalización en un hospital terciario en 2 trimestres, uno previo y otro posterior a la implantación del protocolo. Se excluyó a aquellos en quienes la indicación de midazolam no fue la sedación paliativa y los ingresados en cuidados intensivos. Se registraron las características de los pacientes y su servicio de ingreso, el consentimiento, la limitación del esfuerzo terapéutico y el proceso de sedación (síntoma refractario, dosis, evaluación y otros medicamentos). Se analizaron las asociaciones empleando la prueba de la chi al cuadrado y la t de Student. Resultados. Se incluyó a 143 pacientes sin diferencias relevantes entre ambos grupos en cuanto a características demográficas ni sintomatología. Se registró la indicación de no reanimación cardiopulmonar en aproximadamente el 70% de cada grupo y el consentimiento para la sedación en el 91% antes y el 84% después del protocolo. Las dosis de inducción y de mantenimiento de midazolam se adecuaban a las recomendaciones en el 1,31% de los pacientes antes y el 10,4% después del protocolo (p = 0,02) y las dosis de rescate en el 1,31 y el 11,9%, respectivamente (p = 0,01). La dosis de midazolam utilizada en pacientes en quienes se usó el protocolo fue significativamente menor que cuando no se empleó (9,86 mg vs. 18,67 mg, p < 0,001). La escala de Ramsay fue utilizada en el 8 y el 12% y el Equipo de Soporte Hospitalario de Cuidados Paliativos intervino en el 36 y el 16% de los casos, respectivamente (p = 0,008). Conclusiones. El uso de midazolam en la sedación paliativa en la agonía mejoró ligeramente tras la instauración de un protocolo hospitalario de sedación paliativa. El porcentaje de sedaciones adecuadas y el proceso general apenas mejoró con el protocolo. Es necesario continuar el proceso de formación y reevaluar la efectividad de estas medidas en el futuro (AU)

Objective. To measure changes in the practice of palliative sedation during agony in hospitalised elderly patients before and after the implementation of a palliative sedation protocol. Material and methods. A retrospective before-after study was performed in hospitalised patients over 65 years old who received midazolam during hospital admission and died in the hospital in two 3-month periods, before and after the implementation of the protocol. Non-sedative uses of midazolam and patients in intensive care were excluded. Patient and admission characteristics, the consent process, withdrawal of life-sustaining treatments, and the sedation process (refractory symptom treated, drug doses, assessment and use of other drugs) were recorded. Association was analysed using the Chi2 and Student t tests. Results. A total of 143 patients were included, with no significant differences between groups in demographic characteristics or symptoms. Do not resuscitate (DNR) orders were recorded in approximately 70% of the subjects of each group, and informed consent for sedation was recorded in 91% before vs. 84% after the protocol. Induction and maintenance doses of midazolam followed protocol recommendations in 1.3% before vs 10.4% after the protocol was implemented (P=.02) and adequate rescue doses were used in 1.3% vs 11.9% respectively (P=.01). Midazolam doses were significantly lower (9.86 mg vs 18.67 mg, P<.001) when the protocol was used than when it was not used. Ramsay sedation score was used in 8% vs. 12% and the Palliative Care Team was involved in 35.5% and 16.4% of the cases (P=.008) before and after the protocol, respectively. Conclusions. Use of midazolam slightly improved after the implementation of a hospital protocol on palliative sedation. The percentage of adequate sedations and the general process of sedation were mostly unchanged by the protocol. More education and further assessment is needed to gauge the effect of these measures in the future (AU)

[Analysis of palliative sedation in hospitalised elderly patients: Effectiveness of a protocol]. / Análisis de la sedación paliativa en pacientes mayores hospitalizados: efectividad de un protocolo.

OBJECTIVE: To measure changes in the practice of palliative sedation during agony in hospitalised elderly patients before and after the implementation of a palliative sedation protocol. MATERIAL AND METHODS: A retrospective before-after study was performed in hospitalised patients over 65 years old who received midazolam during hospital admission and died in the hospital in two 3-month periods, before and after the implementation of the protocol. Non-sedative uses of midazolam and patients in intensive care were excluded. Patient and admission characteristics, the consent process, withdrawal of life-sustaining treatments, and the sedation process (refractory symptom treated, drug doses, assessment and use of other drugs) were recorded. Association was analysed using the Chi(2) and Student t tests. RESULTS: A total of 143 patients were included, with no significant differences between groups in demographic characteristics or symptoms. Do not resuscitate (DNR) orders were recorded in approximately 70% of the subjects of each group, and informed consent for sedation was recorded in 91% before vs. 84% after the protocol. Induction and maintenance doses of midazolam followed protocol recommendations in 1.3% before vs 10.4% after the protocol was implemented (P=.02) and adequate rescue doses were used in 1.3% vs 11.9% respectively (P=.01). Midazolam doses were significantly lower (9.86mg vs 18.67mg, P<.001) when the protocol was used than when it was not used. Ramsay sedation score was used in 8% vs. 12% and the Palliative Care Team was involved in 35.5% and 16.4% of the cases (P=.008) before and after the protocol, respectively. CONCLUSIONS: Use of midazolam slightly improved after the implementation of a hospital protocol on palliative sedation. The percentage of adequate sedations and the general process of sedation were mostly unchanged by the protocol. More education and further assessment is needed to gauge the effect of these measures in the future.

[Blood pressure in infants]. / Presión arterial en neonatos. Medición no invasiva.

Presents a study whose information was exposed as a poster at the Congress SEUP (Spanish Society of Emergencies in Pediatrics) in Gijón 2011. Labor has emerged as a result of observed differences in criteria in the taking of blood pressure between our neonatal unit nurses.

Presión arterial en neonatos. Medición no invasiva / Blood pressure in infants

Se presenta un estudio parte de cuya información fue expuesta como póster en el congreso SEUP (Sociedad Española de Urgencias en Pediatría) en Gijón 2011. El trabajo ha surgido como consecuencia de observar diferencias de criterios en la toma de la presión arterial entre el personal de enfermería de nuestra unidad neonatal(AU)

Presents a study whose information was exposed as a poster at the Congress SEUP (Spanish Society of Emergencies in Pediatrics) in Gijón 2011. Labor has emerged as a result of observed differences in criteria in the taking of blood pressure between our neonatal unit nurses(AU)

Protective effect of white tea extract against acute oxidative injury caused by adriamycin in different tissues.

Adriamycin (ADR) is an anticancer agent that increases oxidative stress in cells. We evaluated the protective effect of the long term consumption of white tea at two different doses against this drug. For this purpose rats were given distilled water (controls), 0.15 mg (Dose 1) or 0.45 mg (Dose 2) of solid tea extract/kg body weight for 12 months. All the animals received an injection of ADR, except half of the control group, which were given an injection of saline solution. This gave four experimental groups: Control (C), C+ADR, Dose 1+ADR, and Dose 2+ADR. The antioxidant activity (in liver, heart and brain microsomes) was analysed. White tea consumption for 12 months, at a non-pharmacological dose, reversed the oxidative damage caused by ADR, on both protein and lipid levels in all three organs. The heart recovered its antioxidant activity only at the highest dose of tea.

White tea consumption slightly reduces iron absorption but not growth, food efficiency, protein utilization, or calcium, phosphorus, magnesium, and zinc absorption in rats

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We investigated the antinutritional effect of white tea extract (0, 15, and 45 mg of the tea solid extract per kilogram body weight) incorporated in the drinking water of rats for 3 and 30 days. Gender-based differences were found for all these variables, except apparent protein digestibility and the apparent absorption of calcium, phosphorus, and iron. White tea extract consumption did not significantly change body weight gain, food intake, food efficiency, protein efficiency ratio, apparent protein digestibility, nitrogen balance, or the apparent absorption of calcium, phosphorus, magnesium, and zinc. Nevertheless, the apparent absorption of iron was slightly (15–18%) but significantly (P < 0.05) lower in rats that consumed white tea at the highest dose compared with the control groups at both 3 and 30 days. Our results suggest that the usual consumption of white tea is safe, although its effect on long-term iron absorption at high doses warrants more detailed investigation (AU)

White tea consumption slightly reduces iron absorption but not growth, food efficiency, protein utilization, or calcium, phosphorus, magnesium, and zinc absorption in rats.

We investigated the antinutritional effect of white tea extract (0, 15, and 45 mg of the tea solid extract per kilogram body weight) incorporated in the drinking water of rats for 3 and 30 days. Gender-based differences were found for all these variables, except apparent protein digestibility and the apparent absorption of calcium, phosphorus, and iron. White tea extract consumption did not significantly change body weight gain, food intake, food efficiency, protein efficiency ratio, apparent protein digestibility, nitrogen balance, or the apparent absorption of calcium, phosphorus, magnesium, and zinc. Nevertheless, the apparent absorption of iron was slightly (15-18%) but significantly (P<0.05) lower in rats that consumed white tea at the highest dose compared with the control groups at both 3 and 30 days. Our results suggest that the usual consumption of white tea is safe, although its effect on long-term iron absorption at high doses warrants more detailed investigation.