The influence of social norms in the context of reducing sugar-sweetened beverages consumption.

OBJECTIVES: This study aimed to examine the factors associated with low sugar-sweetened beverage (SSB) consumption and intention to avoid these products as well as investigate the role of different types of social norms in the adoption of this behaviour. STUDY DESIGN: This study reports the results of a secondary data analysis from a cross-sectional telephone survey. METHODS: A total of 1000 adults were randomly recruited in the province of Québec, Canada, using a random-digit dialling procedure. Eligibility criteria were to be aged between 18 and 64 years; able to answer a questionnaire in French or English; and to reside in the province of Québec. SSB consumption, social norms and variables from the theory of planned behaviour were assessed by means of a questionnaire. Logistic regression analyses were conducted to examine factors associated with behaviour and intention. RESULTS: Consuming <1 SSB per day was significantly associated with intention, perceived behavioural control, and risk perception about tooth decay. Descriptive (perceived prevalence in the close surroundings of one person) and perceived societal norms (perceived broad societal approval/disapproval of the behaviour) were associated with behaviour. All theory of planned behaviour variables (including injunctive norm) and risk perception pertaining to chronic diseases predicted intention to avoid the consumption of ≥1 SSB per day. Sex, age, income, and risk perception pertaining to chronic diseases were associated with perceived societal disapproval of SSB consumption. CONCLUSIONS: This study confirms the importance of social norms in the prediction of SSB consumption but also highlights the need to address motivation and capacities in public health interventions to reduce SSB consumption.

A comparison of in-house and shared RapidPlan models for prostate radiation therapy planning.

Knowledge-based planning (KBP) can increase plan quality, consistency and efficiency. In this study, we assess the success of a using a publicly available KBP model compared with developing an in-house model for prostate cancer radiotherapy using a single, commercially available treatment planning system based on the ability of the model to achieve the centre's planning goals. Two radiation oncology centres each created a prostate cancer KBP model using the Eclipse RapidPlan software. These two models and a third publicly-available, shared model were tested at three centres in a retrospective planning study. The publicly-available model achieved lower rectum doses than the other two models. However, the planning-target-volume (PTV) doses did not meet the local planning goals and the model could not be adjusted to correct this. As a result, the plans most likely to satisfy local planning goals and requirements were created using an in-house model. For centres without an existing in-house model, a model created by another centre with similar planning goals was found to be preferred. Variations in local planning practices including contouring, treatment technique and planning goals can influence the relative performance of KBP. The value of publicly available KBP models could be enhanced through standardisation of planning goals and contouring guidelines, providing information related to the planning goals used to create the model and increased flexibility to allow local adaptation of the KBP model.

Determinantes socioeconómicos y sociodemográficos asociados al consumo de frutas y verduras de las madres de familia y los hogares de escolares de Jalisco / Socioeconomic and sociodemographic determinants associated with fruit and vegetable consumption among mothers and homes of schoolchildren in Jalisco

Introducción: incrementar el consumo de frutas y verduras es una prioridad, objetivo fundamental en las políticas públicas a nivel mundial. Dado que dicho consumo en los escolares de Jalisco (México) se encuentra por debajo de las recomendaciones alimentarias, es esencial identificar los determinantes que influyen en su consumo de frutas y verduras, para promover el desarrollo de acciones que contribuyan a mejorarlo. Objetivo: identificar los determinantes socioeconómicos y sociodemográficos del consumo de frutas y verduras en las madres de familia y los hogares de escolares de Jalisco, México. Método: estudio transversal analítico, realizado durante el primer trimestre del año 2020 utilizando una frecuencia de consumo de alimentos validada y un cuestionario sobre factores sociodemográficos y socioeconómicos. Resultados: el bajo nivel educativo de las madres de los escolares se asoció con un menor consumo de verduras y el bajo nivel de ingresos en el hogar se asoció con un menor consumo de frutas por los escolares. Conclusiones: el bajo nivel educativo de las madres y el bajo nivel de ingresos de los hogares fueron determinantes asociados al consumo de frutas y verduras de los escolares. Sin embargo, se presentaron diferencias en cuanto a los determinantes para las frutas y para las verduras. Estos factores y sus diferencias deben de tenerse en cuenta para la planificación de acciones que contribuyan a mejorar la ingesta de frutas y verduras en la población escolar (AU)

Introduction: increasing fruit and vegetable consumption is a priority. It has been prioritized as a fundamental objective of public policies worldwide. Given that such consumption in schoolchildren in Jalisco (Mexico) is below the dietary recommendations it is crucial to identify the determinants that influence this consumption to promote the development of contextualized actions that improve it. Objective: to identify the socioeconomic and sociodemographic determinants of fruit and vegetable consumption among mothers and households of schoolchildren in Jalisco, Mexico. Method: an analytical, cross-sectional study carried out during the first quarter of 2020. A validated food consumption frequency and a questionnaire on sociodemographic and socioeconomic factors were used for its development. Results: a lower educational level of the mothers of schoolchildren was associated with a lower consumption of vegetables by schoolchildren. In turn, a lower household income level was associated with a lower consumption of fruits in schoolchildren. Conclusions: a low educational level of mothers and a low household income were determinants associated with fruit and vegetable consumption in schoolchildren. However, there were differences in the determinants for fruits and vegetables. It is essential to consider these factors and their differences in order to plan actions that contribute to improving fruit and vegetable intake in the school population (AU)

[The experience of medical students as peer tutors]. / Rol de tutor par: experiencia de estudiantes de medicina.

BACKGROUND: Peer tutoring is a process of accompaniment carried out by a student with certain features and skills, whose objective is to support and guide, academically and emotionally, other students who may require it. AIM: To assess the experience of medical students who played the role of peer tutor. MATERIAL AND METHODS: We carried out semi-structured in-depth interviews, with prior informed consent, to a non-probabilistic and intentional sample of six students who performed the role of peer tutor, during 2017 and 2018. The data analysis followed the scheme of constant comparison and progressive reduction in a manual way, according to the comparative method, guaranteeing scientific rigor, maintaining criteria of credibility, dependence, confirmability, and transferability. RESULTS: The first level identified 234 units of meaning that originated in the third level, two qualitative domains, oriented to the contribution of peer tutors derived from their experience to strengthen both the process of peer tutor training and the management of peer tutoring. CONCLUSIONS: Peer tutoring as a teaching-learning strategy contributes to the development of generic competences and metacognitive skills, generating high levels of personal satisfaction and identification their teaching role.

Epidemiología de la Onicomicosis Pedis en adultos hospitalizados en un servicio de medicina en un hospital de tercer nivel en Chile / Epidemiology of Onychomycosis pedisinhospitalized adults at the internal medicine ward of a high complexity hospital in Chile

La prevalencia global de la onicomicosis pedis es de 4,3%, y en hospitalizados puede llegar hasta 8,9%. Aun así, se propone que está ampliamente subdiagnosticada. Personas añosas con comorbilidades presentan mayor riesgo de onicomicosis pedis y de sus complicaciones. Se examinaron aleatoriamente a 64 pacientes hospitalizados en el Servicio de Medicina del Hospital San José. A aquellos con signos clínicos de onicomicosis pedis se les realizó un examen micológico directo (MD) y estudio histopatológico de un corte de uña teñido con PAS (Bp/PAS). Muestra de 64 pacientes, un 78,1% presentó onicomicosis pedis clínica y en un 70,3% se confirmó el diagnóstico con MD y/o Bp/PAS positivo. De los pacientes con onicomicosis confirmada, el promedio de edad fue de 67,8 +/- 12,3 años. Un 44% correspondió al sexo femenino y un 56% al sexo masculino. La onicomicosis pedis en el servicio de medicina interna del Hospital San José es una condición frecuente. El conjunto de MD y Bp/PAS podría ser considerado como una buena alternativa diagnóstica. (AU)

Onychomycosis of the toenails has a global prevalence of 4,3% and can reach up to 8,9% in hospitalized patients. It has been hypothesized that it is widely under diagnosed. Aged patients with multiple diseases have an increased risk of Onychomycosis and its complications. 64 patients of the internal medicine ward were randomly selected. Those who had clinical signs of onychomycosis of the toenails were tested with direct microscopy and histological study of the nail plate with PAS staining. Of the 64 patients, 78,1% (50) had clinical signs of onychomycosis of the toenails and in 70,3% (45) the diagnosis was confirmed either by direct microscopy and/or by histological study of the nail plate with PAS staining. The mean age for the group with onychomycosis was 67,8 +/- 12,3 ages. 44% were female and 56% were male. Onychomycosis of the toenails is a frequent condition at the internal medicine ward of the San José Hospital. The direct microscopy together with the histological study of the nail plate with PAS staining seem to be a good diagnosis alternative. (AU)

Rol de tutor par: experiencia de estudiantes de medicina / The experience of medical students as peer tutors

Background: Peer tutoring is a process of accompaniment carried out by a student with certain features and skills, whose objective is to support and guide, academically and emotionally, other students who may require it. Aim: To assess the experience of medical students who played the role of peer tutor. Material and Methods: We carried out semi-structured in-depth interviews, with prior informed consent, to a non-probabilistic and intentional sample of six students who performed the role of peer tutor, during 2017 and 2018. The data analysis followed the scheme of constant comparison and progressive reduction in a manual way, according to the comparative method, guaranteeing scientific rigor, maintaining criteria of credibility, dependence, confirmability, and transferability. Results: The first level identified 234 units of meaning that originated in the third level, two qualitative domains, oriented to the contribution of peer tutors derived from their experience to strengthen both the process of peer tutor training and the management of peer tutoring. Conclusions: Peer tutoring as a teaching-learning strategy contributes to the development of generic competences and metacognitive skills, generating high levels of personal satisfaction and identification their teaching role.

Early laser surgery is not associated with very preterm delivery or reduced neonatal survival in TTTS.

OBJECTIVE: To evaluate the association of laser photocoagulation of placental anastomoses (LPA) prior to 18 weeks' gestation (early LPA) with very preterm delivery and neonatal survival in pregnancies with twin-twin transfusion syndrome (TTTS). METHODS: This was a retrospective cohort study of monochorionic diamniotic twin pregnancies with TTTS undergoing LPA between 2002 and 2018 at two institutions. The rates of delivery < 28, < 30 and < 32 weeks' gestation, preterm prelabor rupture of membranes (PPROM) and 30-day survival of one or both infants were compared between pregnancies undergoing early LPA and those undergoing LPA ≥ 18 weeks' gestation. Regression analysis was performed to determine the association of early LPA with very preterm delivery and 30-day survival, adjusted for Quintero stage, study phase, selective fetal growth restriction, gestational age at delivery, maternal age ≥ 35 years, body mass index > 35 kg/m2 , placental location, use of Seldinger method to place the operative trocar, size of the trocar, participating center, use of Solomon technique, cerclage and PPROM. Survival analysis using the Cox proportional hazard model was applied to examine the LPA-to-delivery interval according to the timing of surgery, adjusted for confounding variables. RESULTS: A total of 414 TTTS pregnancies were included in the study, of which 68 (16.4%) underwent early LPA. In the total cohort, the incidence of delivery at < 28, < 30 and < 32 weeks' gestation was 22.7%, 39.6% and 53.4%, respectively. Survival of both twins and survival of at least one twin at 30 days were 67.5% and 90.8%, respectively. No significant difference was noted between pregnancies that underwent early LPA and those that had LPA ≥ 18 weeks in the rate of delivery < 28 weeks (19.1% vs 23.4%; P = 0.4), < 30 weeks (38.2% vs 39.9%; P = 0.8) and < 32 weeks (44.1% vs 55.2%; P = 0.1) and PPROM (29.0% vs 24.1%; P = 0.4), or in the incidence of double-twin survival (63.9% vs 68.1%; P = 0.5) and survival of at least one infant (91.8% vs 90.6%; P = 0.7) at 30 days. Early LPA was not associated with very preterm delivery or neonatal survival in the regression analyses. Early LPA was associated with a longer LPA-to-delivery interval compared with LPA performed ≥ 18 weeks (median, 106.9 days (range, 2-164 days) vs median, 69.3 days (range, 0-146 days); P < 0.001) when adjusted for confounding variables (hazard ratio, 2.56 (95% CI, 1.76-3.73); P < 0.001). CONCLUSION: Laser surgery before 18 weeks is not associated with an increased rate of very preterm delivery and PPROM or with reduced neonatal survival when compared with LPA after 18 weeks. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Association between impedance to blood flow in umbilical arteries and infant survival in twin-to-twin transfusion syndrome.

OBJECTIVE: To evaluate infant survival according to the Doppler pattern of impedance to blood flow in the umbilical arteries (UAs) prior to laser surgery, in pregnancies with twin-to-twin transfusion syndrome (TTTS). METHODS: This was a retrospective study of women with a monochorionic diamniotic twin pregnancy who underwent laser surgery for TTTS between January 2012 and May 2018 at a single institution. Absolute intertwin difference in UA pulsatility index (DUAPI) was measured within 48 h prior to laser surgery. Twins with intermittent or persistent absent/reversed end-diastolic flow (EDF) in the UA (UA-EDF) were analyzed separately. Survival of both or at least one infant at birth and at 30 days postpartum was compared between pregnancies with an intertwin DUAPI of ≥ 0.4 and those with an intertwin DUAPI of < 0.4, as well as between fetuses with intermittent and those with persistent absent/reversed UA-EDF. Parametric and non-parametric tests were used for analysis. Regression analysis was performed to determine if intertwin DUAPI and intermittent or persistent absent/reversed UA-EDF were associated independently with infant survival, while controlling for gestational age at delivery, Quintero stage and other important confounding variables. RESULTS: Of 231 TTTS pregnancies that underwent laser surgery during the study period, UA Doppler information could be retrieved for 206 and delivery information was available for 184, which comprised the study population. Rates of double-twin survival at birth were significantly higher in pregnancies with an intertwin DUAPI of < 0.4 than in those with an intertwin DUAPI of ≥ 0.4 (83.9% (78/93) vs 50.0% (12/24); P < 0.001). Double-infant survival at birth was higher in pregnancies with intermittent compared to those with persistent absent/reversed UA-EDF (73.0% (27/37) vs 36.7% (11/30); P = 0.003). Regression analysis demonstrated that an intertwin DUAPI of < 0.4 was associated with increased survival of both twins at delivery (P < 0.001) and at 30 days postpartum (P = 0.002), as well as increased survival of at least one twin at delivery (P = 0.009). Similarly, intermittent absent/reversed UA-EDF was associated with increased survival of both twins at delivery (P = 0.007) and at 30 days after birth (P = 0.015). CONCLUSIONS: Evaluation of intertwin differences in UA impedance to blood flow as well as identification of intermittent or persistent absent or reversed UA-EDF prior to laser surgery could help in the prediction of double-infant survival at birth and to 30 days in twin pregnancies with TTTS. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Intraprostatic ethanol injection as an alternative therapy in patients with benign prostatic hyperplasia. / Inyección intraprostática de etanol como terapia alternativa en pacientes con hiperplasia prostática benigna.

INTRODUCTION: Benign prostatic hyperplasia is a high prevalence worldwide pathology. Amongst its therapeutic options, there are minimally invasive techniques that use locally injected substances (such as ethanol), which produce a chemoablation of this organ. OBJECTIVE: The present work aims to evaluate the efficacy of intraprostatic ethanol injection in the treatment of benign prostatic hyperplasia. MATERIAL AND METHODS: A prospective study was carried out, consisting of patients with symptomatic benign prostatic hyperplasia, who were injected with 95% ethanol transrectally, in a 25% prostate volume dose, divided into 3punctures per each lobe. Follow-up time was 12 months. RESULTS: The procedure was well tolerated. The mean urethrovesical catheter stay time was 10.68 days (CI 8.61-13.75, Range 3-30). The score on the international scale of prostatic symptoms improved by 47.58% (p<0.05) and quality of life by 43.94% (p>0.05); prostatic volume was reduced by 35.03% (p<0.05) as well as the post-voiding residual by 58.61% (p>0.05) The maximum urinary flow was increased by 84.83% (p<0.05). The most frequent side effects were hematuria, irritative symptoms and infection. CONCLUSIONS: Intraprostatic ethanol injection can be an effective, non-surgical alternative in the treatment of patients with benign prostatic hyperplasia.

Local oceanographic variability influences the performance of juvenile abalone under climate change.

Climate change is causing warming, deoxygenation, and acidification of the global ocean. However, manifestation of climate change may vary at local scales due to oceanographic conditions. Variation in stressors, such as high temperature and low oxygen, at local scales may lead to variable biological responses and spatial refuges from climate impacts. We conducted outplant experiments at two locations separated by ~2.5 km and two sites at each location separated by ~200 m in the nearshore of Isla Natividad, Mexico to assess how local ocean conditions (warming and hypoxia) may affect juvenile abalone performance. Here, we show that abalone growth and mortality mapped to variability in stress exposure across sites and locations. These insights indicate that management decisions aimed at maintaining and recovering valuable marine species in the face of climate change need to be informed by local variability in environmental conditions.

Efficacy of a high quality O1/Campos foot-and-mouth disease vaccine upon challenge with a heterologous Korean O Mya98 lineage virus in pigs.

In 2010 serotype O foot-and-mouth disease virus of the Mya98 lineage/SEA topotype spread into most East Asian countries. During 2010-2011 it was responsible for major outbreaks in the Republic of Korea where a monovalent O/Manisa vaccine (belonging to the ME-SA topotype) was applied to help control the outbreaks. Subsequently, all susceptible animals were vaccinated every 6 months with a vaccine containing the O/Manisa antigen. Despite vaccination, the disease re-occurred in 2014 and afterwards almost annually. This study focuses on the in vivo efficacy in pigs of a high quality monovalent commercial O1/Campos vaccine against heterologous challenge with a representative 2015 isolate from the Jincheon Province of the Republic of Korea. Initially, viral characterizations and r1 determinations were performed on six viruses recovered in that region during 2014-2015, centering on their relationship with the well characterized and widely available O1/Campos vaccine strain. Genetic and antigenic analysis indicated a close similarity among 2014-2015 Korean isolates and with the previous 2010 virus, with distinct differences with the O1/Campos strain. Virus neutralisation tests using O1/Campos cattle and pig post vaccination sera and recent Korean outbreak viruses predicted acceptable cross-protection after a single vaccination, as indicated by r1 values, and in pigs, by expectancy of protection. In agreement with the in vitro estimates, in vivo challenge with a selected field isolate indicated that O1/Campos primo vaccinated pigs were protected, resulting in a PD50 value of nearly 10. The results indicated that good quality oil vaccines containing the O1/Campos strain can successfully be used against isolates belonging to the O Mya98/SEA topotype.

Experiencia en el tratamiento quirúrgico del angiofibroma nasal juvenil en Hospital de Especialidades No 2 Lic. Luis Donaldo Colosio Murrieta. Instituto Mexicano del Seguro Social de Ciudad Obregón, Sonora / Experience in the surgical treatment of juvenile nasopharyngeal angiofibroma at the Hospital de Especialidades No. 2 "Lic. Luis Donaldo Colosio Murrieta", Mexican Social Security Institute, Ciudad Obregón, Sonora

Objetivo: Exponer nuestra experiencia y evaluar la recurrencia en el manejo quirúrgico del angiofibroma nasal juvenil, abordaje abierto contra endoscópico, en el servicio de otorrinolaringología del noroeste del país. Materiales y métodos: Estudio observacional, retrospectivo, analítico. Se revisaron los expedientes clínicos de los pacientes con diagnóstico de angiofibroma nasal juvenil de 2014 a 2017, atendidos en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello de esta institución. Resultados: Un total de 19 pacientes con diagnóstico de angiofibroma nasal juvenil, fueron sometidos a un procedimiento quirúrgico, 14 abiertos y 5 endoscópicos, la recurrencia fue de 50 % y 40 % respectivamente, lo cual no fue estadísticamente significativo (p=0.88). No obstante, se contrastaron otras variables, como la necesidad de la Unidad de Cuidados Intensivos (UCI) para ambos grupos, 71 % en abordaje abierto y 20 % para el endoscópico, en lo cual si encontramos diferencia significativa (p=0.04). Conclusiones: El estudio no muestra una ventaja estadísticamente significativa del abordaje endoscópico frente al abordaje abierto, pero sí una menor necesidad de hospitalización en UCI, lo que reduciría los costos de atención.

Objective: To present our experience and assess the recurrence of juvenile nasopharyngeal angiofibroma after a surgical treatment (open versus endoscopic approach) in the country's northwestern Department of Otorhinolaryngology. Materials and methods: An observational, retrospective, analytical study. The medical records of patients diagnosed with juvenile nasopharyngeal angiofibroma, who were treated at the Department of Otorhinolaryngology - Head and Neck Surgery of this institution from 2014 to 2017, were reviewed. Results: A total of 19 patients diagnosed with juvenile nasopharyngeal angiofibroma underwent a surgical procedure, out of which 14 had an open surgery and 5 an endoscopic one. Recurrence accounted for 50 % and 40 %, respectively, which was not statistically significant (p = 0.88). However, other variables were compared, such as the need for admission to the Intensive Care Unit (ICU), which was represented by 71 % in the case of the open approach and 20 % for the endoscopic approach, where a significant difference was found (p = 0.04). Conclusions: The study shows no statistically significant advantage of the endoscopic approach versus the open approach, but demonstrates less need for ICU admissions, which would reduce healthcare costs.

Kinesiología respiratoria en pacientes asmáticos en edad escolar / Respiratory physiotherapy in asthmatic school-age patients

The role of respiratory physiotherapy in the asthmatic school-age patient is based on three pillars: evaluative, therapeutic and educational, which have gradually been incorporated and developed. Respiratory physiotherapy has advanced significantly, incorporating cardiorespiratory function tests into its diagnostic and follow-up services, allowing the execution of these tests at the primary level of healthcare. Manual and instrumental respiratory physiotherapy techniques increase the level of control of asthmatic patients. The evidence found in literature invites us to innovate the methodology we use at educational interventions in children and adolescents, with the inclusion of new technologies to motivate and generate meaningful learning in patients as well as in their parents/caregivers, thus improving adherence to treatment and achieving the desired control of the disease

El rol de la kinesiología respiratoria en el paciente asmático en etapa escolar, se basa en tres pilares: evaluativo, terapéutico y educativo, los cuales se han ido paulatinamente incorporando y desarrollando con el paso del tiempo. La kinesiología respiratoria ha avanzado significativamente, incorporando pruebas de función cardiorrespiratoria a su arsenal de prestaciones diagnósticas y de seguimiento, permitiendo la ejecución de éstas en el nivel primario de atención. Mediante la utilización de técnicas manuales e instrumentales, permite potenciar el nivel de control de los pacientes asmáticos. La literatura nos invita a innovar en la metodología a utilizar para realizar una intervención educativa efectiva en niños y adolescentes, incluyendo las nuevas tecnologías disponibles para motivar y generar un aprendizaje significativo en el paciente como en los padres/cuidadores, mejorando así la adherencia al tratamiento y por ende logrando el anhelado control de la enfermedad

Olcegepant blocks neurogenic and non-neurogenic CGRPergic vasodepressor responses and facilitates noradrenergic vasopressor responses in pithed rats.

BACKGROUND AND PURPOSE: Olcegepant (BIBN4096BS) is a selective non-peptide CGRP receptor antagonist with acute antimigraine properties. Since systemic vascular tone is modulated by perivascular (primary sensory CGRPergic and sympathetic) nerves, this randomized study investigated in pithed rats the effect of acute i.v. treatment with olcegepant on the neurogenic and non-neurogenic: (i) CGRPergic vasodepressor responses; and (ii) noradrenergic vasopressor responses. The pithed rat is an experimental model predictive of systemic (cardio) vascular side effects. EXPERIMENTAL APPROACH: Seventy-five male Wistar rats (divided into 15 groups, n = 5 each) were pithed, artificially ventilated and prepared for: (i) spinal stimulation (T9 -T12 ; 0.56-5.6 Hz) of the sensory CGRPergic vasodepressor outflow or i.v. bolus injections (0.1-1 µg·kg-1 ) of α-CGRP, substance P or acetylcholine, which induced frequency-dependent or dose-dependent vasodepressor responses; or (ii) spinal stimulation (T7 -T9 ; 0.03-3 Hz) of the sympathetic vasopressor outflow or i.v. bolus injections (0.03-3 µg·kg-1 ) of noradrenaline, which produced frequency-dependent or dose-dependent vasopressor responses. KEY RESULTS: Olcegepant (1000 and 3000 µg·kg-1 , i.v.) dose-dependently blocked the vasodepressor responses to sensory nerve stimulation or i.v. α-CGRP, without affecting those to substance P or acetylcholine. Whereas it potentiated the vasopressor responses to sympathetic nerve stimulation or i.v. noradrenaline. CONCLUSIONS AND IMPLICATIONS: Olcegepant (i.v.) selectively blocked the neurogenic and non-neurogenic CGRPergic vasodepressor responses. This blockade by olcegepant potentiated the neurogenic and non-neurogenic noradrenergic vasopressor responses in pithed rats, an effect that might result in an increased vascular resistance and, consequently, in a prohypertensive action.

Case Report of Sarcoidosis as a Great Mimicker in Various Populations.

INTRODUCTION: The prevalence of sarcoidosis varies as much as 1-40 cases per 100,000 depending on region and population. Sarcoid typically occurs in people younger than 50 years old, with a peak incidence with ages between 20 and 40 years old. African Americans are 3 times more likely to develop sarcoidosis than Caucasian Americans, and woman are more likely than men to develop sarcoidosis in any ethnic group; nonetheless, it remains a valid differential across any population. CASE: A 32 year old Hispanic man presented to the Emergency Department with night sweats, fatigue, and 35 pound unintentional weight loss over the last several weeks. He also reported a sore throat, occasional cough w/ yellowish sputum, and new onset dyspnea with exertion. He moved from Mexico to the U.S. 20 years prior and last visited the country 7 yrs ago. He never smoked and denied any TB exposure. His vitals at admit demonstrated tachycardia (pulse 108); and temperature of 99.4 á´¼F. He had coarse bilateral breath sounds on exam. Serum chemistries were unremarkable. Chest radiograph demonstrated perihilar fullness. Chest CT revealed enlarged mediastinal and perihilar LAD and airspace consolidation in right middle and lower lobes bilaterally. The patient was admitted to a negative pressure room w/ airborne precautions and RIPE therapy was initiated. PPD and AFB's were negative. He underwent bronchoscopy and was discharged on RIPE. Lung biopsy showed non-caseating granulomas. RIPE therapy was stopped, and he was referred to ophthalmology to rule out uveitis. Cultures from the procedure were negative for fungal growth, and he was started on prednisone 40 mg daily with taper 6 weeks later as his weight returned, night sweats subsided, and dyspnea on exertion improved. DISCUSSION: Sarcoidosis should be considered as a diagnosis in any gender of any racial or ethnic group. Sarcoid is a great mimicker of many serious illnesses including malignancies such as lymphomas, TB and atypical mycoplasma, fungal infections, and other granulomatous diseases, and other autoimmune disorders such a hypersensitivity pneumonitis. Diagnosis requires patient investigation and careful analysis of these differentials.

Antigenic and immunogenic spectrum of foot-and-mouth disease vaccine strain O1 Campos against representative viruses of topotypes that circulated in Asia over the past decade.

Identifying vaccine strains to control outbreaks of foot-and-mouth disease virus that could spread to new regions is essential for contingency plans. This is the first report on the antigenic/immunogenic relationships of the South American O1/Campos vaccine strain with representative isolates of the three currently active Asian type O topotypes. Virus neutralization tests using O1/Campos post-vaccination sera derived from cattle and pigs predicted for both species acceptable cross-protection, even after single vaccination, established by r1 values and by expectancy of protection using monovalent or polyvalent vaccines. The results indicate that effective oil vaccines containing the O1/Campos strain can be used against Asian isolates, expanding the scope of O1/Campos strain included in vaccine banks to control emergencies caused by Asian viruses, even on single-dose vaccination, and to cover the need of effective vaccines in Asia during systematic vaccination.

Fístula arteriovenosa uterina-pólipo placentario: tratamiento histeroscópico. Reporte de un caso / Uterine arteriovenous fistula - placental polyps: hysteroscopic treatment, case report

Resumen OBJETIVO: exponer el caso clínico de una paciente con fístula arteriovenosa uterina secundaria a legrado instrumentado, asociada con pólipos placentarios. CASO CLÍNICO: paciente de 29 años de edad, que acudió a consulta médica por deseo de embarazo, obtenido de manera espontánea, que finalizó en aborto por embarazo anembriónico de 8 semanas. El médico tratante efectuó legrado uterino instrumentado. Cinco meses después del evento, la paciente tuvo sangrado uterino anormal (abundante), que requirió hospitalización. El ultrasonido reportó útero con aumento de vascularización en la pared posterior, con sospecha de fístulas arteriovenosas, velocimetría Doppler normal y diástole alta de baja resistencia. El médico le sugirió embolización arterial selectiva. Una vez valorada por el equipo médico, se efectuó la evaluación integral de la patología uterina mediante ultrasonido, en el que se observó una masa intracavitaria con ecos mixtos, sugerentes de retención de restos ovuloplacentarios, comprobados posteriormente con histeroscopia. Durante el procedimiento histeroscópico (efectuado con histeroscopio Hopkins II Karl Storz de 2 mm y "camisa" diagnóstica de 2.8 mm de grosor) se detectó una masa compatible con restos ovuloplacentarios adheridos a la cara posterior del útero. Después de la valoración integral se decidió efectuar la evacuación uterina, por vía histeroscópica, con resectoscopio sin energía. El estudio histopatológico reportó restos ovuloplacentarios con marcados cambios por retención, decidua necrótica y hemorrágica, con inflamación subaguda severa. La paciente evolucionó satisfactoriamente durante el periodo posquirúrgico. La evaluación ultrasonográfica de control no mostró la fístula arteriovenosa uterina (desapareció la imagen en "ovillo").

Abstract OBJECTIVE: We report a case of a patient with arteriovenous fistula secondary to an instrumented uterine curettage, related to presence of placental polyps. CLINICAL CASE: A 29-year-old woman, who went to a doctor's office for a pregnancy protocol, reached spontaneously, but its finalized in abortion for an anembrionrary pregnancy of 8 weeks. The Doctor performed instrumented uterine curettage. Five months after the event, the patient had abnormal (abundant) uterine bleeding, which required hospitalization. Ultrasound with increased vascularization in the posterior wall, with suspected venereal arteries, normal Doppler velocimetry, and low diastole with low resistance. The physician suggested selective arterial embolization. A comprehensive evaluation of the pathology was performed by ultrasound, in which an intracavitary mass was observed with mixed echoes, suggestions of retention of ovuloplacental remains, later verified with hysteroscopy. During the hysteroscopic procedure (with Hopkins II, Karl Storz of 2 mm and a 2.8 mm "diagnostic" shirt), a mass compatible with the ovuloplacental remains attached to the posterior aspect of the uterus was detected. After the integral evaluation, it was decided to perform the uterine evacuation, using hysteroscopy, with a resectoscope without energy. The histopathological study reported ovuloplacental remains with marked changes by retention, necrotic and hemorrhagic decidua, with severe subacute inflammation. The patient progressed satisfactorily during the postoperative period. The ultrasonographic evaluation of control did not show the arteriovenous fistula.

Lose to win: marT pseudogenization in Salmonella enterica serovar Typhi contributed to the surV-dependent survival to H2O2, and inside human macrophage-like cells.

The difference in host range between Salmonella enterica serovar Typhimurium (S. Typhimurium) and Salmonella enterica serovar Typhi (S. Typhi) can be partially attributed to the gain of functions, to the loss of functions (i.e. pseudogenization), or to a combination of both processes. As previously reported, the loss of functions by pseudogenization may play a role in bacterial evolution, especially in host-restricted pathogens such as S. Typhi. The marT-fidL operon, located at the SPI-3, encodes the MarT transcriptional regulator and a hypothetical protein (i.e. FidL) with no significant similarities to known proteins, respectively. Even though predicted S. Typhimurium FidL exhibit 99.4% identity with S. Typhi FidL, marT has been annotated as a pseudogene in S. Typhi. In this work, we found that S. Typhi expressing S. Typhimurium marT-fidL exhibited an increased accumulation of reactive oxygen species (ROS), leading to a decreased survival in presence of H2O2. Moreover, we found that that the presence of a functional copy of S. Typhimurium marT-fidL in S. Typhi resulted in a repression of surV (STY4039), an ORF found in the S. Typhi SPI-3 but absent from S. Typhimurium SPI-3, that contribute to the resistance to H2O2 by decreasing the accumulation of ROS. Finally, we observed that the presence of S. Typhimurium marT-fidL in S. Typhi negatively affected the survival inside macrophage-like cells, but not in epithelial cells, after 24h post infection. Therefore, this work provides evidence arguing that marT pseudogenization in Salmonella Typhi contributed to the surV-dependent survival against H2O2, and inside human macrophage-like cells. This is a good example of how the loss of functions (marT pseudogenization) and the gain of functions (presence of surV) might contribute to phenotypic changes improving virulence.

The acute phase response induced by Escherichia coli lipopolysaccharide modifies the pharmacokinetics and metabolism of florfenicol in rabbits.

The aim of this study was to determine the effect of Escherichia coli lipopolysaccharide (LPS)-induced acute phase response (APR) on the pharmaco-kinetics and biotransformation of florfenicol (FFC) in rabbits. Six rabbits (3.0 ± 0.08 kg body weight (bw)) were distributed through a crossover design with 4 weeks of washout period. Pairs of rabbits similar in bw and sex were assigned to experimental groups: Group 1 (LPS) was treated with three intravenous doses of 1 µg/kg bw of E. coli LPS at intervals of 6 h, and Group 2 (control) was treated with an equivalent volume of saline solution (SS) at the same intervals and frequency of Group 1. At 24 h after the first injection of LPS or SS, an intravenous bolus of 20 mg/kg bw of FFC was administered. Blood samples were collected from the auricular vein before drug administration and at different times between 0.05 and 24.0 h after treatment. FFC and florfenicol-amine (FFC-a) were extracted from the plasma, and their concentrations were determined by high-performance liquid chromatography. A noncompartmental pharmacokinetic model was used for data analysis, and data were compared using the paired Student t-test. The mean values of AUC0-∞ in the endotoxaemic rabbits (26.3 ± 2.7 µg·h/mL) were significantly higher (P < 0.05) than values observed in healthy rabbits (17.2 ± 0.97 µg·h/mL). The total mean plasma clearance (CLT ) decreased from 1228 ± 107.5 mL·h/kg in the control group to 806.4 ± 91.4 mL·h/kg in the LPS-treated rabbits. A significant increase (P < 0.05) in the half-life of elimination was observed in the endotoxaemic rabbits (5.59 ± 1.14 h) compared to the values observed in healthy animals (3.44 ± 0.57 h). In conclusion, the administration of repeated doses of 1 µg/kg E. coli LPS induced an APR in rabbits, producing significant modifications in plasma concentrations of FFC leading to increases in the AUC, terminal half-life and mean residence time (MRT), but a significant decrease in CLT of the drug. As a consequence of the APR induced by LPS, there was a reduction in the metabolic conversion of FFC to their metabolite FFC-a in the liver, suggesting that the mediators released during the APR induced significant inhibitory effects on the hepatic drug-metabolizing enzymes.