Focused ultrasound on the substantia nigra enables safe neurotensin-polyplex nanoparticle-mediated gene delivery to dopaminergic neurons intranasally and by blood circulation.

Neurotensin-polyplex nanoparticles provide efficient gene transfection of nigral dopaminergic neurons when intracerebrally injected in preclinical trials of Parkinson's disease because they do not cross the blood-brain barrier (BBB). Therefore, this study aimed to open BBB with focused ultrasound (FUS) on the substantia nigra to attain systemic and intranasal transfections and evaluate its detrimental effect in rats. Systemically injected Evans Blue showed that a two-pulse FUS opened the nigral BBB. Accordingly, 35 µL of neurotensin-polyplex nanoparticles encompassing the green fluorescent protein plasmid (79.6 nm mean size and + 1.3 mV Zeta-potential) caused its expression in tyrosine hydroxylase(+) cells (dopaminergic neurons) of both substantiae nigrae upon delivery via internal carotid artery, retro-orbital venous sinus, or nasal mucosa 30 min after FUS. The intracarotid delivery yielded the highest transgene expression, followed by intranasal and venous administration. However, FUS caused neuroinflammation displayed by infiltrated lymphocytes (positive to cluster of differentiation 45), activated microglia (positive to ionized calcium-binding adaptor molecule 1), neurotoxic A1 astrocytes (positive to glial fibrillary acidic protein and complement component 3), and neurotrophic A2 astrocytes (positive to glial fibrillary acidic protein and S100 calcium-binding protein A10), that ended 15 days after FUS. Dopaminergic neurons and axonal projections decreased but recuperated basal values on day 15 after transfection, correlating with a decrease and recovery of locomotor behavior. In conclusion, FUS caused transient neuroinflammation and reversible neuronal affection but allowed systemic and intranasal transfection of dopaminergic neurons in both substantiae nigrae. Therefore, FUS could advance neurotensin-polyplex nanotechnology to clinical trials for Parkinson's disease.

Enhancing routine HIV and STI testing among young men who have sex with men: primary outcomes of the get connected clinical randomized trial (ATN 139).

BACKGROUND: Regular HIV and STI testing remain a cornerstone of comprehensive sexual health care. In this study, we examine the efficacy of Get Connected, a WebApp that combines test locators with personalized educational resources, in motivating young men who have sex with men (YMSM) to undergo regular HIV and STI testing. METHODS: Participants were randomly placed in one of two conditions. The first condition included the full version of GC (GC-PLUS), which included content tailored to users' psychosocial characteristics (e.g., age, race/ethnicity, relationship status, HIV/STI testing history). The second condition served as our attention-control and only included the testing locator (GC-TLO) for HIV/STI testing services. Participants were recruited from three cities (Houston, Philadelphia, and Atlanta) characterized by high HIV incidence. Assessments were collected at 1, 3-, 6-, 9- and 12-month follow-ups. RESULTS: Both versions of GC were acceptable and efficacious in increasing routine HIV and STI testing over a 12-month period. 40% of the sample reported testing at least twice, with no main effects observed across the two intervention arms (OR = 1.11; 95% CI: 0.69, 1.80), p =.66). Greater intervention effects were observed among YMSM who engaged more frequently with the intervention, with regional differences observed. CONCLUSIONS: Our findings underscore the need to cater to the diverse needs of YMSM through multilevel approaches. Broadly, mHealth HIV/STI testing interventions, such as Get Connected, would benefit from matching technologies to the local context to have the greatest impact. TRIAL REGISTRATION: This study is registered on ClinicalTrials.gov (NCT03132415).

Biological and chemical characterization in relation to the yield of radish (Raphanus sativus L.) nourished with humus from plant residues.

The increase in prices of fertilizers, energy and other materials necessary for the industry triggered a global economic crisis. Reason that was investigated on the biological and chemical characteristics in relation to the yield of radish nourished with humus from plant residue. The objective was to determine the appropriate dose of humus to obtain greater yield and its relationship with the chemical and biological characteristics of the radish. It is based on applied methodology with an experimental approach; Therefore, the Completely Random Block Design model was used, which consisted of 3 blocks and 5 treatments that were T1 with 0, T2 with 4, T3 with 6, T4 with 8 and T5 with 10 t/ha of humus and They applied 15 days after sowing. The physical characteristics of the radish were evaluated and processed using analysis of variance and Duncan. Concentration of elements in leaves and stomatal density were also analyzed. It was determined that T5 stood out in total plant length with 28.95 cm, plant weight with 76.87 g, equatorial diameter with 4,404 cm and commercial yield with 20,296 t/ha. Nitrogen consumption in relation to yield with 247.44 kg/ha. Stomatal density 459 stomata/mm2 and profitability with 150% and nutrient concentration in leaves highlighted T4 with N, K, Ca, Mg, Mo and Zn. It concludes that T5 stood out with 20,296 t/ha, which differed by 26.04% in relation to the control (T1) with 15,011 t/ha. Therefore, this dose added nutrients to the soil that improved the availability for plant absorption and this influenced the concentration of nutrients in leaves such as N, P and Fe and stomatal density with 459 stomata/mm2, which had a response in good development, strengthening against environmental stress and therefore greater performance.

Unilateral rNurr1-V5 transgene expression in nigral dopaminergic neurons mitigates bilateral neuropathology and behavioral deficits in parkinsonian rats with α-synucleinopathy.

JOURNAL/nrgr/04.03/01300535-202409000-00039/figure1/v/2024-01-16T170235Z/r/image-tiff Parkinsonism by unilateral, intranigral ß-sitosterol ß-D-glucoside administration in rats is distinguished in that the α-synuclein insult begins unilaterally but spreads bilaterally and increases in severity over time, thus replicating several clinical features of Parkinson's disease, a typical α-synucleinopathy. As Nurr1 represses α-synuclein, we evaluated whether unilateral transfected of rNurr1-V5 transgene via neurotensin-polyplex to the substantia nigra on day 30 after unilateral ß-sitosterol ß-D-glucoside lesion could affect bilateral neuropathology and sensorimotor deficits on day 30 post-transfection. This study found that rNurr1-V5 expression but not that of the green fluorescent protein (the negative control) reduced ß-sitosterol ß-D-glucoside-induced neuropathology. Accordingly, a bilateral increase in tyrosine hydroxylase-positive cells and arborization occurred in the substantia nigra and increased tyrosine hydroxylase-positive ramifications in the striatum. In addition, tyrosine hydroxylase-positive cells displayed less senescence marker ß-galactosidase and more neuron-cytoskeleton marker ßIII-tubulin and brain-derived neurotrophic factor. A significant decrease in activated microglia (positive to ionized calcium-binding adaptor molecule 1) and neurotoxic astrocytes (positive to glial fibrillary acidic protein and complement component 3) and increased neurotrophic astrocytes (positive to glial fibrillary acidic protein and S100 calcium-binding protein A10) also occurred in the substantia nigra. These effects followed the bilateral reduction in α-synuclein aggregates in the nigrostriatal system, improving sensorimotor behavior. Our results show that unilateral rNurr1-V5 transgene expression in nigral dopaminergic neurons mitigates bilateral neurodegeneration (senescence and loss of neuron-cytoskeleton and tyrosine hydroxylase-positive cells), neuroinflammation (activated microglia, neurotoxic astrocytes), α-synuclein aggregation, and sensorimotor deficits. Increased neurotrophic astrocytes and brain-derived neurotrophic factor can mediate the rNurr1-V5 effect, supporting its potential clinical use in the treatment of Parkinson's disease.

"Nursing (Her) Storytelling": An Ethnographic Fiction Proposal for Exploring Feminist Health Activism in Spain.

The aim of this article is to share theoretical and methodological reflections on a project on feminist epistemologies and health activism. Based on the analysis of 12 life stories and 1 group interview, an approach based on ethnographic fiction is proposed through the creation of a serial story in podcast format. This approach helps in generating emotions to facilitate understanding and awareness of the issues raised and in showing everyday practices as ways of constructing knowledge. It also avoids turning life stories into academic artifacts with little transformational capacity.

The Atacama Rover Astrobiology Drilling Studies (ARADS) Project.

With advances in commercial space launch capabilities and reduced costs to orbit, humans may arrive on Mars within a decade. Both to preserve any signs of past (and extant) martian life and to protect the health of human crews (and Earth's biosphere), it will be necessary to assess the risk of cross-contamination on the surface, in blown dust, and into the near-subsurface (where exploration and resource-harvesting can be reasonably anticipated). Thus, evaluating for the presence of life and biosignatures may become a critical-path Mars exploration precursor in the not-so-far future, circa 2030. This Special Collection of papers from the Atacama Rover Astrobiology Drilling Studies (ARADS) project describes many of the scientific, technological, and operational issues associated with searching for and identifying biosignatures in an extreme hyperarid region in Chile's Atacama Desert, a well-studied terrestrial Mars analog environment. This paper provides an overview of the ARADS project and discusses in context the five other papers in the ARADS Special Collection, as well as prior ARADS project results.

3D solid of SARS-CoV-2 viral particles applying Legendre polynomials from tomography Fourier analysis.

We show the construction of 3D solids (volumetric 3D models) of SARS-CoV-2 viral particles from the tomographic studies (videos) of SARS-CoV-2-infected tissues. To this aim, we propose a video analysis (tomographic images) by frames (medical images of the virus), which we set as our metadata. We optimize the frames by means of Fourier analysis, which induces a periodicity with simple structure patterns to minimize noise filtering and to obtain an optimal phase of the objects in the image, focusing on the SARS-CoV-2 cells to obtain a medical image under study phase (MIS) (process repeated over all frames). We build a Python algorithm based on Legendre polynomials called "2DLegendre_Fit," which generates (using multilinear interpolation) intermediate images between neighboring MIS phases. We used this code to generate m images of size M×M, resulting in a matrix with size M×M×M (3D solid). Finally, we show the 3D solid of the SARS-CoV-2 viral particle as part of our results in several videos, subsequently rotated and filtered to identify the glicoprotein spike protein, membrane protein, envelope, and the hemagglutinin esterase. We show the algorithms in our proposal along with the main MATLAB functions such as FourierM and Results as well as the data required for the program execution in order to reproduce our results.

Incidencia, circunstancias y consecuencias de caídas en sujetos con accidente cerebrovascular: un año de seguimiento / Incidence, circumstances and consequences of falls in subjects with stroke: One year of follow-up

Introducción: Luego del accidente cerebrovascular (ACV), una de las complicaciones más frecuentes son las caídas, impactando negativamente en la rehabilitación. Objetivos: Estudiar la incidencia, las circunstancias y las consecuencias de las caídas en sujetos con ACV hasta 12meses de iniciado el tratamiento kinésico ambulatorio. Materiales y métodos: Diseño prospectivo, serie de casos. Muestreo consecutivo. Pacientes ingresados en el Hospital de Día entre junio de 2019 y mayo de 2020. Se incluyeron: adultos con diagnóstico de primer ACV supratentorial y puntuación ≥3 en la Functional Ambulatory Category. Criterios excluyentes: otra afección que afecte la locomoción. Variables principales: número de caídas, circunstancias y consecuencias. Se midieron las características clínico-demográficas y funcionales. Resultados: Un total de 21 sujetos incluidos; 13 sufrieron al menos una caída. Reportaron 41 caídas: 15 fueron hacia el lado más afectado, 35 en el interior del hogar, 28 sin el equipamiento indicado, en 29 ocasiones estaban solos durante el evento y en 2 situaciones se requirió asistencia médica. Hubo diferencias estadísticamente significativas (p<0,05) en el desempeño funcional (equilibrio, velocidad de marcha) entre los que se cayeron con respecto a los que no. No se hallaron diferencias significativas entre la resistencia de la marcha y las caídas. Conclusión: Más de la mitad sufrieron caídas, estando solos, hacia el lado más débil y sin el equipamiento indicado. Con esta información se podría disminuir la incidencia desarrollando medidas preventivas.(AU)

Introduction: Falls are among the most frequent complications following stroke (CVA), and have a negative impact on rehabilitation. Objectives: To study the incidence, circumstances, and consequences of falls in stroke patients up to 12months after starting outpatient kinetic treatment. Materials and methods: Prospective design, case series. Consecutive sampling. Patients admitted to the day hospital between June 2019 and May 2020. Included: adults with a diagnosis of first supratentorial stroke and functional ambulatory category score ≥3. Exclusion criteria: other condition affecting locomotion. Main variables: number of falls, circumstances, and consequences. Clinical, demographic, and functional characteristics were measured. Results: Twenty-one subjects were included, 13 suffered at least one fall. The subjects reported 41 falls: 15 were to the most affected side, 35 inside the home, 28 without the indicated equipment, they were alone when the event occurred on 29 occasions, and in two situations medical assistance was required. There were statistically significant differences (P<.05) in functional performance (balance, gait velocity) between those who fell and those who did not. No significant differences were found between gait endurance and falls. Conclusion: More than half suffered a fall, alone, to the weaker side, and without the appropriate equipment. With this information the incidence could be reduced by preventive measures.(AU)

Visually-Induced Motor Imagery Effects on Motor Adaptation to Reverse Steering Cycling. A Randomized Controlled Trial.

Purpose: First, testing an intervention of neuromodulation based on motor imagery and action observation as a promoter of motor adaptation of a complex motor task involving balance. Second, determining what prior balance factors can affect the motor adaptation task. Methods: A double-blind randomized controlled trial was performed. Forty-eight healthy subjects were recruited. The balance of all participants during gait and standing was assessed before adapting to the complex, multi-limb motor task of riding an inverse steering bicycle (ISB). Two interventions were carried out interleaved among trials of adaptation to the motor task: the experimental group (n = 24) was asked to perform neuromodulation (EN) by watching first-person ISB riding through immersive VR glasses and, simultaneously, mentally mimicking the movements. The control group (CG) was asked to watch a slideshow video of steady landscape images. Results: The results showed that the EN group did not improve the motor adaptation rate and induced higher adaptation times with respect to the CG. However, while the motor adaptation success showed a significant dependence on the prior proprioceptive participation in balance in the CG, the EN group did not present any relationship between the prior balance profile and motor adaptation outcome. Conclusions: Results point to a benefit of the visually guided neuromodulation for the motor adaptation of the subjects with low participation of proprioception in balance. Moreover, the results from the control group would allow to disclose prognostic factors about the success of the motor adaptation, and also prescription criteria for the proposed neuromodulation based on the balance profile.

Primary ciliary dyskinesia diagnosis and management and its implications in America: a mini review.

Introduction: Primary ciliary dyskinesia (PCD) is a rare genetic disorder that can result in significant morbidity and mortality if left untreated. Clinical manifestations of PCD include recurrent respiratory infections, laterality defects, and infertility, all of which arise from impaired or absent ciliary motility. Diagnostic approaches for PCD may include high-speed video microscopy, measurement of nasal nitric oxide levels, and genetic testing; however, no single definitive diagnostic test exists. The present study aims to highlight the lack of standardized diagnostic and treatment guidelines for PCD in Latin America (Central and South America, and the Caribbean). To this effect, we compared North American and European recommendations for the diagnosis and management of PCD and found that certain diagnostic tools and treatment options mentioned in these guidelines are not readily accessible in many Latin American countries. Methods & Results: This review gathers disease information in North America, Europe, and Latin America organizing guideline results into tables for clarity and potential interventions. Management information for Latin America is inferred from case reports, as most findings are from North American recommendations and studies on PubMed, Google Scholar, and Scopus. Treatment and management information is based on North American and European standards.Among 5,774 publications reviewed, only 15 articles met the inclusion criteria (focused on PCD management, peer-reviewed, and located in America). No clinical guideline for PCD in Latin America was found, but recommendations on respiratory management from Colombia and Chile were discovered. The lack of guidelines in Latin America may originate from limited resources and research on the disease in those countries. Discussion: PCD lacks documentation, research, and recommendations regarding its prevalence in Latin America, likely due to unfavorable economic conditions. This disadvantage results in limited access to diagnostic tests available in North America and Europe. The PICADAR score, discussed in this review, can be used in low-income nations as a screening tool for the disorder.

[Incidence, circumstances and consequences of falls in subjects with stroke: One year of follow-up]. / Incidencia, circunstancias y consecuencias de caídas en sujetos con accidente cerebrovascular: un año de seguimiento.

INTRODUCTION: Falls are among the most frequent complications following stroke (CVA), and have a negative impact on rehabilitation. OBJECTIVES: To study the incidence, circumstances, and consequences of falls in stroke patients up to 12months after starting outpatient kinetic treatment. MATERIALS AND METHODS: Prospective design, case series. Consecutive sampling. Patients admitted to the day hospital between June 2019 and May 2020. Included: adults with a diagnosis of first supratentorial stroke and functional ambulatory category score ≥3. EXCLUSION CRITERIA: other condition affecting locomotion. MAIN VARIABLES: number of falls, circumstances, and consequences. Clinical, demographic, and functional characteristics were measured. RESULTS: Twenty-one subjects were included, 13 suffered at least one fall. The subjects reported 41 falls: 15 were to the most affected side, 35 inside the home, 28 without the indicated equipment, they were alone when the event occurred on 29 occasions, and in two situations medical assistance was required. There were statistically significant differences (P<.05) in functional performance (balance, gait velocity) between those who fell and those who did not. No significant differences were found between gait endurance and falls. CONCLUSION: More than half suffered a fall, alone, to the weaker side, and without the appropriate equipment. With this information the incidence could be reduced by preventive measures.

Influence of synoptic meteorology on airborne allergenic pollen and spores in an urban environment in Northeastern Iberian Peninsula.

The influence of the most frequent patterns of synoptic circulation on the dynamics of airborne pollen/spores recorded at the Barcelona Aerobiological Station (BCN) was analysed. Six pollen types (Platanus, Cupressaceae, Olea, Poaceae, Urticaceae and Amaranthaceae), and one fungal spore (Alternaria) were selected for their high allergenic effect in sensitive people. Six synoptic meteorological patterns were identified through cluster analysis of sea level pressure fields as the main responsible of the weather conditions in the Iberian Peninsula. The local meteorological conditions in Barcelona associated with each one of the synoptic types were also stablished. Different statistical methods were applied to analyse possible relationships between concentrations and timing of the recorded aerobiological particles and specific synoptic types. The study, focused in the 19-year period 2001-2019, shows that one of the scenarios, frequent in winter and linked to high stability and air-mass blockage, registered the highest mean and median values for Platanus and Cupressaceae, but it was not very relevant for the other taxa. It was also this scenario that turned out to be the most influent on the pollination timing showing a significant influence on the start occurrence of Urticaceae flowering and on the peak date of Platanus. On the other hand, the most frequent synoptic type in the period, relevant in spring and summer, was linked to sporadic episodes of levels considered to be of high risk of allergy to Platanus, Poaceae, and Urticaceae pollen, and Alternaria fungal spore. This synoptic pattern, characterized by the presence of the Azores anticyclone and the Atlantic low located in the north of the United Kingdom, was associated with high temperatures, low relative humidity and moderate winds from the NW in Barcelona. The identification of an interaction between synoptic meteorology and pollen/spore dynamics will allow better abatement measures, reducing adverse health effects on sensitive population.

Embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate in patients with hemoptysis: A retrospective single-center study.

OBJECTIVES: To evaluate the safety and efficacy of the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate (NBCA) in patients with hemoptysis. METHODS: We analyzed a total of 55 consecutive patients with hemoptysis (14 mild, 31 moderate, and 10 massive) treated with the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate between November 2013 and January 2020. The main variables analyzed were the rates of technical success, of clinical success, of recurrence, and of complications. Statistics included a descriptive analysis and Kaplan-Meier survival curves. RESULTS: Embolization was a technical success in 55 (100%) and a clinical success in 54 (98.2%). During follow-up (mean, 23.8 months; interquartile range, 9.7-38.2 months), hemoptysis recurred in 5 (9.3%) patients. The nonrecurrence rate was 91.9% one year after the initial procedure and 88.7% two years and four years after the initial procedure. Minor complications related with the procedure occurred in 6 (10.9%); no major complications occurred. CONCLUSIONS: The embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate is safe and efficacious for controlling hemoptysis, resulting in low recurrence rates.

Extubação paliativa em uma unidade de terapia intensiva cardiológica ­ um relato de caso / Palliative extubation in a cardiac intensive care unit ­ a case report

INTRODUÇÃO: A extubação paliativa é descrita como a retirada do tubo traqueal e da ventilação mecânica, quando todas as possibilidades de desmame ventilatório falharam ou o prognóstico do paciente é desfavorável. É um procedimento que evita prolongar a vida de maneira artificial e deve ser acordado juntamente com os familiares e a equipe. OBJETIVO: Relatar um caso de extubação paliativa numa unidade de terapia intensiva cardiológica. MÉTODO: Relato de caso RESULTADOS: Paciente do sexo feminino, portadora de Miocardiopatia Dilatada deu entrada no pronto-socorro em Insuficiência Cardíaca perfil C. Após a realização das medidas farmacológicas e o uso de ventilação não invasiva, não houve resposta satisfatória, evoluindo para intubação orotraqueal. A extubação ocorreu após 6 dias, porém em 24 horas houve falha de extubação, seguida de parada cardiorrespiratória (PCR) de 15 minutos. Foram realizadas todas as medidas pós PCR e mesmo a compensação clínica, não houve resposta neurológica favorável para progredir com uma nova extubação, desse modo, a equipe definiu os Cuidados Paliativos. O filho da paciente trouxe o relato de que ela não gostaria de viver de forma artificial e mesmo estando apreensivo com a possibilidade de óbito iminente após a extubação, visto que a mãe não tinha resposta favorável, ele não gostaria que mantivéssemos as medidas invasivas. Após uma conferência familiar com consenso entre a equipe e os familiares optou-se por realizar a extubação paliativa, para tal houve a suspensão de medicamentos não essenciais e foi otimizado as medicações para prevenir o estridor laríngeo. Para a extubação, foi realizado aspiração de alívio e o teste de respiração espontânea com resposta satisfatória e após 19 dias de intubação a paciente foi extubada, o procedimento ocorreu de maneira tranquila, não houve necessidade de aspiração ou suplementação com oxigênio, a paciente permaneceu com um Glasgow 6, eupneica em ar ambiente com uma fisionomia confortável, sem sinais de desconforto respiratório ou de dor. O atendimento fisioterapêutico foi mantido visando manter o conforto, a paciente teve o acompanhamento dos familiares com visita estendida e veio a falecer após 4 dias da extubação. CONCLUSÃO: A extubação paliativa ocorreu com o suporte da equipe e dos familiares, livre de dor ou desconforto e a paciente veio a falecer 4 dias após o procedimento. Esse relato de caso reforça a importância do alinhamento de condutas, da presença da família e a possibilidade de sobrevida após uma extubação paliativa.

Embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil-cianoacrilato en pacientes con hemoptisis: un estudio monocéntrico y retrospectivo / Embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate in patients with hemoptysis: a retrospective single-center study

Objetivos Evaluar la seguridad y la eficacia de la embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil-cianoacrilato en pacientes con hemoptisis. Métodos Se han analizado un total de 55 pacientes consecutivos con hemoptisis (14 leves, 31 moderadas y 10 masivas) tratados mediante embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil- cianoacrilato entre noviembre de 2013 y enero de 2020. Las variables principales estudiadas son tasa de éxito técnico, tasa de éxito clínico, tasas de recurrencia y complicaciones. Se ha realizado un análisis estadístico descriptivo y un análisis de supervivencia mediante el método de Kaplan-Meier. Resultados En 55 (100%) pacientes se ha realizado la embolización con éxito técnico y en 54 (98,2%), con éxito clínico. Durante el seguimiento (media, 23,8 meses; rango intercuartílico, 9,7-38,2) ha recurrido en 5 de los 54 (9,3%) pacientes. La tasa de no recurrencia al año ha sido del 91,9%, y a los 2 y 4 años, del 88,7% después del procedimiento inicial. Ha habido 6 (10,9%) complicaciones menores relacionadas con el procedimiento y ninguna mayor. Conclusiones La embolización de arterias bronquiales y arterias sistémicas no bronquiales con n-butil-cianoacrilato es segura y eficaz para controlar la hemoptisis con tasas de recurrencia bajas (AU)

Objectives To evaluate the safety and efficacy of the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate (NBCA) in patients with hemoptysis. Methods We analyzed a total of 55 consecutive patients with hemoptysis (14 mild, 31 moderate, and 10 massive) treated with the embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate between November 2013 and January 2020. The main variables analyzed were the rates of technical success, of clinical success, of recurrence, and of complications. Statistics included a descriptive analysis and Kaplan-Meier survival curves. Result Embolization was a technical success in 55 (100%) and a clinical success in 54 (98.2%). During follow-up (mean, 23.8 months; interquartile range, 9.7 – 38.2 months), hemoptysis recurred in 5 (9.3%) patients. The nonrecurrence rate was 91.9% one year after the initial procedure and 88.7% two years and four years after the initial procedure. Minor complications related with the procedure occurred in 6 (10.9%); no major complications occurred. Conclusions The embolization of bronchial arteries and nonbronchial systemic arteries with n-butyl-cyanoacrylate is safe and efficacious for controlling hemoptysis, resulting in low recurrence rates (AU)

Immune dysregulation and pathophysiology of alcohol consumption and alcoholic liver disease.

Alcoholic liver disease (ALD) is a clinical-pathologic entity caused by the chronic excessive consumption of alcohol. The disease includes a broad spectrum of anomalies at the cellular and tissual level that can cause acute-on-chronic (alcoholic hepatitis) or chronic (fibrosis, cirrhosis, hepatocellular cancer) injury, having a great impact on morbidity and mortality worldwide. Alcohol is metabolized mainly in the liver. During alcohol metabolism, toxic metabolites, such as acetaldehyde and oxygen reactive species, are produced. At the intestinal level, alcohol consumption can cause dysbiosis and alter intestinal permeability, promoting the translocation of bacterial products and causing the production of inflammatory cytokines in the liver, perpetuating local inflammation during the progression of ALD. Different study groups have reported systemic inflammatory response disturbances, but reports containing a compendium of the cytokines and cells involved in the pathophysiology of the disease, from the early stages, are difficult to find. In the present review article, the role of the inflammatory mediators involved in ALD progression are described, from risky patterns of alcohol consumption to advanced stages of the disease, with the aim of understanding the involvement of immune dysregulation in the pathophysiology of ALD.

LPS Triggers Acute Neuroinflammation and Parkinsonism Involving NLRP3 Inflammasome Pathway and Mitochondrial CI Dysfunction in the Rat.

Whether neuroinflammation leads to dopaminergic nigrostriatal system neurodegeneration is controversial. We addressed this issue by inducing acute neuroinflammation in the substantia nigra (SN) with a single local administration (5 µg/2 µL saline solution) of lipopolysaccharide (LPS). Neuroinflammatory variables were assessed from 48 h to 30 days after the injury by immunostaining for activated microglia (Iba-1 +), neurotoxic A1 astrocytes (C3 + and GFAP +), and active caspase-1. We also evaluated NLRP3 activation and Il-1ß levels by western blot and mitochondrial complex I (CI) activity. Fever and sickness behavior was assessed for 24 h, and motor behavior deficits were followed up until day 30. On this day, we evaluated the cellular senescence marker ß-galactosidase (ß-Gal) in the SN and tyrosine hydroxylase (TH) in the SN and striatum. After LPS injection, Iba-1 (+), C3 (+), and S100A10 (+) cells were maximally present at 48 h and reached basal levels on day 30. NLRP3 activation occurred at 24 h and was followed by a rise of active caspase-1 (+), Il-1ß, and decreased mitochondrial CI activity until 48 h. A significant loss of nigral TH (+) cells and striatal terminals was associated with motor deficits on day 30. The remaining TH (+) cells were ß-Gal (+), suggesting senescent dopaminergic neurons. All the histopathological changes also appeared on the contralateral side. Our results show that unilaterally LPS-induced neuroinflammation can cause bilateral neurodegeneration of the nigrostriatal dopaminergic system and are relevant for understanding Parkinson's disease (PD) neuropathology.

Prevalence of Plasmid-Associated Tetracycline Resistance Genes in Multidrug-Resistant Escherichia coli Strains Isolated from Environmental, Animal and Human Samples in Panama.

Antimicrobial resistance bacteria are nowadays ubiquitous. Its presence has been reported in almost every type of source, from water for agricultural and recreative use, water distribution pipes, and wastewater, to food, fomites, and clinical samples. Enterobacteriaceae, especially Escherichia coli, are not the exception, showing an increased resistance to several antibiotics, causing a global health and economic burden. Therefore, the monitoring of fecal microbiota is important because it is present in numerous reservoirs where gene transfer between commensal and virulent bacteria can take place, representing a potential source of resistant E. coli. In this work, antibiotic resistance profiles of 150 E. coli isolates from environmental, animal, and human samples, collected in three rural areas in Panama, were analyzed. A total of 116 isolates were resistant to at least one of the nine antibiotics tested. Remarkably, almost 100% of these exhibited resistance to tetracycline. Plasmid-associated tetA and tetB genes were detected in 42.86% of the isolates analyzed, tetA being the most prevalent. These results suggest that tetracycline resistance would be used as a convenient indicator of genetic horizontal transfer within a community.

Tinnitus: una revisión narrativa / Tinnitus: A narrative review / Tinnitus: uma revisão narrativa

El tinnitus o acúfeno es la percepción de sonido en ausencia de un estímulo acústico externo; es uno de los motivos de consulta más comunes en el área de otorrinolaringolo­gía. Se ha asociado a diversas etiologías tales como ototoxicidad, tumores, traumatismo craneoencefálico y trastornos psiquiátricos, siendo también las causas de carácter idio­pático ampliamente conocidas. Las características clínicas de los tinnitus son variables de paciente a paciente, por lo que su diagnóstico, tratamiento y seguimiento son un desafío clínico Si bien recientes estudios han propuesto distintos manejos clínicos y terapéuticos, estos continúan hoy en día en estudio. Esta revisión narrativa pretende realizar una actualización sobre el abordaje diagnóstico, clínico y terapéutico de los tinnitus en la última década.

Tinnitus, the perception of sound in the absence of an external acoustic stimulus, is one of the most common reasons for consultation in the area of otorhinolaryngology. It has been associated with various etiologies such as ototoxicity, tumors, head trauma, and psychiatric disorders; idiopathic causes are also widely known. The clinical characteristics of tinnitus are variable from patient to patient; therefore, its diagnosis, treatment, and follow-up are a clinical challenge. Although recent studies have proposed different clinical and therapeutic approaches, these are still under analysis today. This narrative review aims to update the diagnostic, clinical and therapeutic approach to tinnitus in the last decade.

Tinnitus ou zumbido é a percepção do som na ausência de um estímulo acústico externo; é um dos motivos mais comuns de consulta na área de otorrinolaringologia. Tem sido associada a várias etiologias, como ototoxicidade, tumores, traumatismo craniano e distúrbios psiquiátricos, sendo também amplamente conhecidas causas idiopáticas. As características clínicas do zumbido são variáveis de paciente para paciente, por isso seu diagnóstico, tratamento e acompanhamento são um desafio clínico, embora estudos recentes tenham proposto diferentes abordagens clínicas e terapêuticas, ainda hoje estão em estudo. Esta revisão narrativa visa atualizar a abordagem diagnóstica, clínica e terapêutica do zumbido na última década.

Use of the Woven EndoBridge Device for Sidewall Aneurysms: Systematic Review and Meta-analysis.

BACKGROUND: The Woven EndoBridge device was originally approved to treat intracranial wide-neck saccular bifurcation aneurysms. Recent studies have suggested its use for the treatment of sidewall intracranial aneurysms with variable success. PURPOSE: Our aim was to evaluate the safety and efficacy of the Woven EndoBridge device for sidewall aneurysms using a meta-analysis of the literature. DATA SOURCES: We performed a systematic review of all studies including patients treated with the Woven EndoBridge device for sidewall aneurysms from inception until May 2022 on Scopus, EMBASE, MEDLINE, the Web of Science, and the Cochrane Central Register of Controlled Trials. STUDY SELECTION: Ten studies were selected, and 285 patients with 288 sidewall aneurysms were included. DATA ANALYSIS: A random-effects meta-analysis of proportions using a generalized linear mixed model was performed as appropriate. Statistical heterogeneity across studies was assessed with I2 statistics. DATA SYNTHESIS: The adequate occlusion rate at last follow-up was 89% (95% CI, 81%-94%; I2, = 0%), the composite safety outcome was 8% (95% CI, 3%-17%; I2 = 34%), and the mortality rate was 2% (95% CI, 1%-7%; I2 = 0%). Aneurysm width (OR = 0.5; P = .03) was the only significant predictor of complete occlusion. LIMITATIONS: Given the level of evidence, our results should be interpreted cautiously until confirmation from larger prospective studies is obtained. CONCLUSIONS: The initial evidence evaluating the use of the Woven EndoBridge device for the treatment of wide-neck sidewall intracranial aneurysms has demonstrated high rates of adequate occlusion with low procedural complications. Our findings favor the consideration of the Woven EndoBridge device as an option for the treatment of sidewall aneurysms.