Effect of receiving a customizable brochure on breast cancer patients' knowledge about their diagnosis and treatment: A randomized clinical trial.

BACKGROUND: Patients' lack of knowledge about their own disease may function as a barrier to shared decision-making and well-being. This study aimed to evaluate the impact of written educational materials on breast cancer patients. METHODS: This multicenter, parallel, unblinded, randomized trial included Latin American women aged ≥18 years with a recent breast cancer diagnosis yet to start systemic therapy. Participants underwent randomization in a 1:1 ratio to receive a customizable or standard educational brochure. The primary objective was accurate identification of molecular subtype. Secondary objectives included identification of clinical stage, treatment options, participation in decision-making, perceived quality of information received, and illness uncertainty. Follow-up occurred at 7-21 and 30-51 days post-randomization. CLINICALTRIALS: gov identifier: NCT05798312. RESULTS: One hundred sixty-five breast cancer patients with a median age of 53 years and 61 days from diagnosis were included (customizable: 82; standard: 83). At first available assessment, 52%, 48%, and 30% identified their molecular subtype, disease stage, and guideline-endorsed systemic treatment strategy, respectively. Accurate molecular subtype and stage identification were similar between groups. Per multivariate analysis, customizable brochure recipients were more likely to identify their guideline-recommended treatment modalities (OR: 4.20,p = 0.001). There were no differences between groups in the perceived quality of information received or illness uncertainty. Customizable brochure recipients reported increased participation in decision-making (p = 0.042). CONCLUSIONS: Over one third of recently diagnosed breast cancer patients are incognizant of their disease characteristics and treatment options. This study demonstrates a need to improve patient education and shows that customizable educational materials increase patients' understanding of recommended systemic therapies according to individual breast cancer characteristics.

Gochnatia glutinosa (D.Don) D.Don ex Hook. & Arn.: A plant with medicinal value against inflammatory disorders and infections.

Gochnatia glutinosa is a shrub that grown in the Argentinean semiarid region (Monte region) used in the ancestral medicine as an antiseptic and anti-inflammatory agent. This study was aimed to examine the morpho-anatomical characteristics of G. glutinosa aerial parts, identify the chemical composition of traditionally used preparations to assess its pharmacobotanical characterization and evaluate its activity as antiseptic and anti-inflammatory to give scientific support to its traditional uses. G. glutinosa morpho-anatomical description was performed following standard histological techniques. Tincture and infusion of its aerial parts were prepared and were subjected to phytochemical analysis. Xanthine oxidase (XOD) and lipoxygenase (LOX) inhibition experiments, as well as ABTS•+, superoxide radical, and hydrogen peroxide scavenging activity, were carried out. The growth inhibition of methicillin-resistant Staphylococcus aureus (MRSA) strains was also determined. The morpho-anatomical traits of G. glutinosa leaves and stems were reported for the first time. The medicinal preparations exhibited a large amount of phenolic chemicals mainly flavonoids such as rhamnetin, arcapillin, rhamnacin, hesperetin, isorhamnetin, centaureidin, europetin 7-O-mehylmyricetin, cirsiliol, sakuranetin, genkwanin and eupatorine and also phenolic acids and diterpenoid derivatives. Both preparations had free radical scavenging activity and were able to reduce both XOD and LOX activity, indicating their anti-inflammatory properties. Besides, tincture was effective against all MRSA strains (MIC values ranging from 60 to 240 g DW/mL). The results obtained in this work scientifically support the medicinal popular use of G. glutinosa as an antiseptic and anti-inflammatory. The identification of bioactive compounds and their morpho-anatomical description contribute to the quality control of this medicinal plant from Argentine Calchaquí Valley.

Comparative Analysis of Clinical Practice Guidelines for the Pharmacological Treatment of Type 2 Diabetes Mellitus in Latin America.

PURPOSE OF REVIEW: Type 2 diabetes mellitus (T2DM) is one of the leading causes of death and disability in the world. The majority of diabetes deaths (> 80%) occur in low- and middle-income countries, which are predominant in Latin America. Therefore, the purpose of this article is to compare the clinical practice guideline (CPG) for the pharmacological management of T2DM in Latin America (LA) with international reference guidelines. RECENT FINDINGS: Several LA countries have recently developed CPGs. However, the quality of these guidelines is unknown according to the AGREE II tool and taking as reference three CPGs of international impact: American Diabetes Association (ADA), European Diabetes Association (EASD), and Latin American Diabetes Association (ALAD). Ten CPGs were selected for analysis. The ADA scored > 80% on the AGREE II domains and was selected as the main comparator. Eighty percent of LA CPGs were developed before 2018. Only one was not recommended (all domains < 60%). The CPGs in LA have good quality but are outdated. They have significant gaps compared to the reference. There is a need for improvement, as proposing updates every three years to maintain the best available clinical evidence in all guidelines.

Morphological Characterization of Nicotiana tabacum Inflorescences and Chemical-Functional Analysis of Extracts Obtained from Its Powder by Using Green Solvents (NaDESs).

The production of smokeable tobacco for use in cigarettes is characterized by the production of pre-harvest and post-harvest waste, with ensuing undesirable effects on the environment. The inflorescences of tobacco after blunting, deflowering, or topping are considered pre-harvest waste and left in the field. Using green and ecofriendly solvents such as Natural deep eutectic solvents (NaDESs), these wastes could be used to obtain antioxidant molecules of interest in cosmetics. Taking into account its potential as plant matrix to obtain metabolites of commercial interest, tobacco inflorescences and inflorescence powders of different particle sizes were characterized by optic and electronic microscopy. Thus, the powdered inflorescences were extracted with four conventional solvents, i.e., distilled water (DW), acetone: distilled water (AW), ethanol 70° (EW), methanol (Me), and five NaDESs, i.e., lactic acid: sucrose (LAS), lactic acid: sucrose: distilled water (SALA), fructose: glucose: sucrose: distilled water (FGS), choline chloride: urea: distilled water (CU), and citric acid: propylene glycol (CAP). Among the tested NADESs, SALA was the most promising solvent; higher extraction yields of total phenolic compound (3420.0 ± 9.4 µg GAE/mL) than conventional solvents were attained and it was the only selective solvent to phenolics. CU was the best solvent for flavonoids and alkaloids extraction (215.3 ± 3.2 µg QE/mL and 392.3 ± 8.0 µg ACE/mL, respectively). All extracts showed antioxidant activity. A heatmap with dendrogram and main component analysis showed that acid-based NaDESs are grouped together, this group being the one with the best performance in H2O2 scavenging. The extracts obtained with green solvents could be used directly in cosmetic formulations as antioxidant ingredients because both tobacco flower oil and flower extracts are listed in the cosmetic ingredients database as non-toxic products. Additionally, the demand for sustainable ecological cosmetics is growing. In this sense, NaDESs represent an opportunity to develop innovative extracts with unique phytochemical fingerprints and biological activities.

Utility of laboratory and immune biomarkers in predicting disease progression and mortality among patients with moderate to severe COVID-19 disease at a Philippine tertiary hospital.

Purpose: This study was performed to determine the clinical biomarkers and cytokines that may be associated with disease progression and in-hospital mortality in a cohort of hospitalized patients with RT-PCR confirmed moderate to severe COVID-19 infection from October 2020 to September 2021, during the first wave of COVID-19 pandemic before the advent of vaccination. Patients and methods: Clinical profile was obtained from the medical records. Laboratory parameters (complete blood count [CBC], albumin, LDH, CRP, ferritin, D-dimer, and procalcitonin) and serum concentrations of cytokines (IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, IFN-γ, IP-10, TNF-α) were measured on Days 0-3, 4-10, 11-14 and beyond Day 14 from the onset of illness. Regression analysis was done to determine the association of the clinical laboratory biomarkers and cytokines with the primary outcomes of disease progression and mortality. ROC curves were generated to determine the predictive performance of the cytokines. Results: We included 400 hospitalized patients with COVID-19 infection, 69% had severe to critical COVID-19 on admission. Disease progression occurred in 139 (35%) patients, while 18% of the total cohort died (73 out of 400). High D-dimer >1 µg/mL (RR 3.5 95%CI 1.83-6.69), elevated LDH >359.5 U/L (RR 1.85 95%CI 1.05-3.25), lymphopenia (RR 1.91 95%CI 1.14-3.19), and hypoalbuminemia (RR 2.67, 95%CI 1.05-6.78) were significantly associated with disease progression. High D-dimer (RR 3.95, 95%CI 1.62-9.61) and high LDH (RR 5.43, 95%CI 2.39-12.37) were also significantly associated with increased risk of in-hospital mortality. Nonsurvivors had significantly higher IP-10 levels at 0 to 3, 4 to 10, and 11 to 14 days from illness onset (p<0.01), IL-6 levels at 0 to 3 days of illness (p=0.03) and IL-18 levels at days 11-14 of illness (p<0.001) compared to survivors. IP-10 had the best predictive performance for disease progression at days 0-3 (AUC 0.81, 95%CI: 0.68-0.95), followed by IL-6 at 11-14 days of illness (AUC 0.67, 95%CI: 0.61-0.73). IP-10 predicted mortality at 11-14 days of illness (AUC 0.77, 95%CI: 0.70-0.84), and IL-6 beyond 14 days of illness (AUC 0.75, 95%CI: 0.68-0.82). Conclusion: Elevated D-dimer, elevated LDH, lymphopenia and hypoalbuminemia are prognostic markers of disease progression. High IP-10 and IL-6 within the 14 days of illness herald disease progression. Additionally, elevated D-dimer and LDH, high IP-10, IL-6 and IL-18 were also associated with mortality. Timely utilization of these biomarkers can guide clinical monitoring and management decisions for COVID-19 patients in the Philippines.

Nicotiana tabacum Leaf Waste: Morphological Characterization and Chemical-Functional Analysis of Extracts Obtained from Powder Leaves by Using Green Solvents.

Tobacco cultivation and industrialization are characterized by the production of trillions of pre-harvest and post-harvest waste biomasses each year with the resulting negative effects on the environment. The leaves of blunt, pre-harvest waste, could be further used to obtain bioactive metabolites, i.e., polyphenols and alkaloids, for its potential cosmetic use. This study was conducted to obtain bio-compounds from pre-harvest tobacco leaf waste (var. Virginia) by applying conventional and green solvents (NaDES). Leaves and ground leaf waste were characterized based on their microscopic features. Conventional solvents, such as water, acetone, ethanol, and non-conventional solvents, such as Natural Deep Eutectic Solvents (NaDES), i.e., sucrose:lactic acid (LAS), frutose:glucose:sucrose (FGS), lactic acid:sucrose:water (SALA), choline chloride:urea (CU), and citric acid: propylene glycol (CAP) were used for bioactive extraction from tobacco waste powder. CU, FGS, and acetone/ethanol had similar behavior for the best extraction of alkaloids (6.37-11.23 mg ACE/g tobacco powder). LAS, FGS, SALA, and CU were more effective in phenolic compound extraction than conventional solvents (18.13-21.98 mg AGE/g tobacco powder). Because of this, LAS and SALA could be used to obtain phenolic-enriched extracts with lower alkaloid content rather than CU and FGS. Extracts of the powder obtained with conventional solvent or CU showed a high level of sugars (47 mg/g tobacco powder) The ABTS antioxidant capacity of tobacco leaf powder was higher in the extracts obtained with CU, FGS, and acetone (SC50 1.6-5 µg GAE/mL) while H2O2 scavenging activity was better in the extracts obtained with LAS, CAP and SALA (SC50 3.8-8.7 µg GAE/mL). Due to the biocompatibility of the NaDES with the components of tobacco leaf waste, the opportunity to apply these extracts directly in antioxidant formulations, such as cosmetics, phytotherapic, and other formulations of topic use seems promising. Furthermore, NaDES constituents, i.e., urea and organic acid can also have beneficial effects on the skin.

Predictors of mortality among inpatients with COVID-19 infection in a tertiary referral center in the Philippines.

Objectives: The aim of this study was to determine the predictors of mortality and describe laboratory trends among adults with confirmed COVID-19. Methods: The medical records of adult patients admitted to a referral hospital with COVID-19 were retrospectively reviewed. Demographic and clinical characteristics, and laboratory parameters, were compared between survivors and non-survivors. Predictors of mortality were determined by multivariate analysis. Mean laboratory values were plotted across illness duration. Results: Of 1215 patients, 203 (16.7%) had mild, 488 (40.2%) moderate, 183 (15.1%) severe, and 341 (28.1%) critical COVID-19 on admission. In-hospital mortality was 18.2% (0% mild, 6.1% moderate, 15.8% severe, 47.5% critical). Predictors of mortality were age ≥ 60 years, COPD, qSOFA score ≥ 2, WBC > 10 × 109/L, absolute lymphocyte count < 1000, neutrophil ≥ 70%, PaO2/FiO2 ratio ≤ 200, eGFR < 90 mL/min/1.73 m2, LDH > 600 U/L, and CRP > 12 mg/L. Non-survivors exhibited an increase in LDH and decreases in PaO2/FiO2 ratio and eGFR during the 2nd-3rd week of illness. Conclusion: The overall mortality rate was high. Predictors of mortality were similar to those of other reports globally. Marked inflammation and worsening pulmonary and renal function were evident among non-survivors by the 2nd-3rd week of illness.

Clinical characteristics of patients with asymptomatic and symptomatic COVID-19 admitted to a tertiary referral centre in the Philippines.

Objectives: To describe the clinical profile and outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) across the spectrum of disease severity. Methods: This retrospective study included adult patients with confirmed COVID-19 infection admitted to a referral hospital. Descriptive statistics, tests for trend, Kaplan-Meier curve and log-rank test were used to compare characteristics and outcomes across disease severity categories. Results: Of 1500 patients with COVID-19, 14.8% were asymptomatic, 13.5% had mild disease, 36.6% had moderate disease, 12.3% had severe disease and 22.7% had critical disease. Asymptomatic patients were admitted for a concurrent condition or for isolation. Patients aged >60 years, male gender and with co-morbidities had more severe disease. Fever, cough, shortness of breath, malaise, gastrointestinal symptoms and decreased sensorium were more common in patients with severe disease. Bilateral pulmonary infiltrates were common (51.1%), with sicker patients having more abnormal findings. The overall mortality rate was 15.1%. Adopting a symptom-based strategy reduced the length of hospitalization from a median of 13 [interquartile range (IQR) 7-21] days to 9 (IQR 5-14) days. Conclusion: The clinical profile and outcomes for this cohort of patients with COVID-19 was consistent with published reports. Asymptomatic infection was common, and universal testing may be a valuable strategy in the correct context, given the implications for infection control. A symptom-based strategy was found to reduce the length of hospitalization considerably.

Dual STAT­3 and IL­6R inhibition with stattic and tocilizumab decreases migration, invasion and proliferation of prostate cancer cells by targeting the IL­6/IL­6R/STAT­3 axis.

Prostate cancer (PCa) is a key public health problem worldwide; at diagnosis, a high percentage of patients exhibit tumor cell invasion of adjacent tissue. STAT­3, IL­6 receptor (R) and IL­6 serum levels are associated with enhanced PCa migratory, invasive, clonogenic and metastatic ability. Inhibiting the STAT­3 pathway at different levels (cytokines, receptors, and kinases) exhibits relative success in cancer. The present study investigated the effect of Stattic (Stt) + Tocilizumab (Tcz) on proliferative, clonogenic, migratory and invasive ability of human metastatic PCa (assessed by colony formation, wound healing and migration assay). RWPE­1 (epithelial prostate immortalized cells), 22Rv1 (Tumor cells), LNCaP (Metastatic cells) and DU­145 (metastatic, castration­resistant prostate cells) cells were used in vitro to evaluate levels of cytokines, chemokines, growth factors (Cytometric Bead Array), STAT­3, phosphorylated STAT­3 (In­Cell Western), IL­6R, vimentin and epithelial (E­) cadherin (Western Blot). The effect of inhibition of STAT­3 (expressed constitutively in DU­145 cells) with Stt and/or Tcz on expression levels of vimentin, VEGF, and E­cadherin, as well as proliferative, clonogenic, migratory and invasive capacity of metastatic PCa cells was assessed. The expression levels of IL­6, C­X­C chemokine ligand 8, VEGF and vimentin, as well as proliferation and migration, were increased in metastatic PCa cells. Treatment with Stt or Tcz decreased vimentin and VEGF and increased E­cadherin expression levels and inhibited proliferative, clonogenic, migratory and invasive capacity of DU­145 cells; addition of IL­6 decreased this inhibitory effect. However, Stt + Tcz maintained inhibition even in the present of high concentrations of IL­6. Stt + Tcz decreased expression of vimentin and VEGF and inhibited the proliferative, clonogenic, migratory and invasive capacity of metastatic PCa cells. To the best of our knowledge, the present study is the first to combine Stt, a STAT­3 inhibitor, with Tcz, an antibody against IL­6R, to target tumor cells.

Next-generation sequencing of bile cell-free DNA for the early detection of patients with malignant biliary strictures.

OBJECTIVE: Despite significant progresses in imaging and pathological evaluation, early differentiation between benign and malignant biliary strictures remains challenging. Endoscopic retrograde cholangiopancreatography (ERCP) is used to investigate biliary strictures, enabling the collection of bile. We tested the diagnostic potential of next-generation sequencing (NGS) mutational analysis of bile cell-free DNA (cfDNA). DESIGN: A prospective cohort of patients with suspicious biliary strictures (n=68) was studied. The performance of initial pathological diagnosis was compared with that of the mutational analysis of bile cfDNA collected at the time of first ERCP using an NGS panel open to clinical laboratory implementation, the Oncomine Pan-Cancer Cell-Free assay. RESULTS: An initial pathological diagnosis classified these strictures as of benign (n=26), indeterminate (n=9) or malignant (n=33) origin. Sensitivity and specificity of this diagnosis were 60% and 100%, respectively, as on follow-up 14 of the 26 and eight of the nine initially benign or indeterminate strictures resulted malignant. Sensitivity and specificity for malignancy of our NGS assay, herein named Bilemut, were 96.4% and 69.2%, respectively. Importantly, one of the four Bilemut false positives developed pancreatic cancer after extended follow-up. Remarkably, the sensitivity for malignancy of Bilemut was 100% in patients with an initial diagnosis of benign or indeterminate strictures. Analysis of 30 paired bile and tissue samples also demonstrated the superior performance of Bilemut. CONCLUSION: Implementation of Bilemut at the initial diagnostic stage for biliary strictures can significantly improve detection of malignancy, reduce delays in the clinical management of patients and assist in selecting patients for targeted therapies.

A Novel Prognostic Biomarker Panel for Early-Stage Colon Carcinoma.

Molecular characterization of colorectal cancer has helped us understand better the biology of the disease. However, previous efforts have yet to provide significant clinical value in order to be integrated into clinical practice for patients with early-stage colon cancer (CC). The purpose of this study was to assess PD-L1, GLUT-1, e-cadherin, MUC2, CDX2, and microsatellite instability (dMMR) and to propose a risk-panel with prognostic capabilities. Biomarkers were immunohistochemically assessed through tissue microarrays in a cohort of 144 patients with stage II/III colon cancer. A biomarker panel consisting of PD-L1, GLUT-1, dMMR, and potentially CDX2 was constructed that divided patients into low, medium, and high risk of overall survival or disease-free survival (DFS) in equally sized groups. Compared with low-risk patients, medium-risk patients have almost twice the risk of death (HR = 2.10 (0.99-4.46), p = 0.054), while high-risk patients have almost four times the risk (HR = 3.79 (1.77-8.11), p = 0.001). The multivariate goodness of fit was 0.756 and was correlated with Kaplan-Meier curves (p = 0.002). Consistent results were found for DFS. This study provides a critical basis for the future development of an immunohistochemical assessment capable of discerning early-stage CC patients as a function of their prognosis. This tool may aid with treatment personalization in daily clinical practice and improve survival outcomes.

Correlates between sexual desire and disposition to sexual fantasies with inhibitory control and cognitive planning in young Colombians / Correlación del deseo sexual y disposición a fantasías sexuales con control inhibitorio y planificación cognitiva en jóvenes colombianos

Abstract Objective: the research was oriented to investigate the correlation between some executive functions (inhibitory control, risk-benefit calculation, cognitive flexibility, the planning ability, and decision making) and the general, dyadic and solitary sexual desire, sexual desire inhibition and disposition to sexual fantasies in a 17-to-30-year-old people sample. Method: An observational cross-sectional study in a purposive sample of 64 young college students, aged between17 and -30, who were in a couple relationship at the time of the study and gave their consent for their participation in the research. The participants completed the Neuropsychological Battery of Executive Functions and Frontal Lobes tasks (BANFE for its abbreviation in Spanish): Stroop, card games, card classification and Hanoi Tower, and it was administered the Inhibited Sexual Desire Test, the Sexual Desire Inventory (SDI-2) and the Scale of Attitude Towards Sexual Fantasies. Results: The results indicate a correlation between the executive functions and sexual desire; it was found a correlation between total and dyadic sexual desire and disposition towards sexual fantasies with inhibitory control; and the inhibited sexual desire was correlated to planning ability and inhibitory control. Discussion: Although the study presents some methodological limitations (size of the sample and need of a more rigorous validation of instruments in the Colombian population), the results confirm previous research findings, allowing to formulate new hypotheses in the field of sexuality and neurosciences. The study findings draw attention to the educational implications aimed to develop the executive functions in adolescents and young people to prevent risky sexual behavior.

Resumen Objetivo: El estudio se orientó a indagar la relación entre algunas funciones ejecutivas (FE) (control inhibitorio, cálculo de riesgo-beneficio, flexibilidad cognitiva, habilidad de planeación y toma de decisiones) con el deseo sexual general, diádico y solitario, inhibición del deseo sexual y disposición hacia las fantasías sexuales en una muestra de jóvenes entre 17 y 30 años. Método: Estudio de enfoque cuantitativo de corte transversal. Mediante un muestreo intencional por conveniencia se seleccionaron 64 jóvenes entre 17 y 30 años, estudiantes universitarios que se encontraban en una relación de pareja. Para evaluar las variables de las FE se utilizaron tareas de la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales (BANFE): Stroop, juego de cartas, clasificación de cartas y Torre de Hanoi, y las variables relacionadas con el deseo sexual fueron valoradas mediante el Test del Deseo Sexual Inhibido, el Inventario del Deseo Sexual (SDI-2, sigla de Sexual Desire Inventory) y la Escala de la Actitud hacia las Fantasías Sexuales. Resultados: Se encontraron correlaciones entre las variables del deseo sexual, disposición hacia las fantasías sexuales y el deseo sexual inhibido; deseo sexual total y diádico y disposición hacia las fantasías sexuales correlacionó con el control inhibitorio; y el deseo sexual inhibido correlacionó con la planificación y el control de impulsos. Discusión: Los hallazgos del estudio llaman la atención sobre las implicaciones educativas encaminadas a desarrollar las funciones ejecutivas en adolescentes y jóvenes con el fin prevenir conductas sexuales de riesgo.

Morfo-anatomía foliar de Araujia odorata (Apocynaceae-Asclepiadoideae) en un gradiente altitudinal: histoquímica de laticíferos / Foliar morpho-anatomy of Araujia odorata (Apocynaceae-Asclepiadoideae) in an altitudinal gradient: histochemistry of laticifers

Araujia odorata is a sub-shrub native from Argentina, Brazil, Paraguay and Uruguay, whose latex, roots and leaves are used in traditional medicine. The objective of this work is to study the foliar morpho-anatomy of six populations in an altitudinal gradient (359-2155 m.a.s.l.) of Northwestern Argentine and to determine the nature of the compounds present in the laticiferous of the stems and fruits using conventional techniques for plant anatomy. The populations under study did not show significant morpho-anatomical differences. They presented simple leaves, pinnated brochydodromous venation, amphiestomatic isolateral lamina, brachy, anomo and amphicyclocytic stomata, eglandular trichomes, midvein with bicolateral vascular bundle and non-articulated laticifers continuous in the petiole, stem and fruits. Differences in the quantified foliar parameters are observed, however, only the density of trichomes, stomata and the thickness of the cuticle are positively correlated with the altitudinal gradient, indicating phenotypic plasticity. Histochemical analysis of laticifers and other stem idioblasts of A. odoratawas performed for the first time.

Araujia odorata, es un subarbusto nativo de Argentina, Brasil, Paraguay y Uruguay, cuyo látex, raíces y hojas son utilizados en medicina popular. Se plantea como objetivo realizar un estudio morfo-anatómico foliar de seis poblaciones del Noroeste Argentino en un gradiente altitudinal (359-2155 m.s.n.m) y determinar la naturaleza de los compuestos presentes en laticíferos de tallos y frutos mediante técnicas convencionales de anatomía vegetal. Las poblaciones estudiadas no evidenciaron diferencias morfo-anatómicas significativas. Presentan hojas simples, venación pinnada broquidódroma, lámina isolateral anfiestomática, estomas braqui, anomo y anficiclocíticos, tricomas eglandulares, nervio medio con haz bicolateral y laticíferos no-articulados continuos en pecíolo, tallo y frutos. Se observan diferencias en los parámetros foliares cuantificados, sin embargo, solo la de densidad de tricomas, estomas y el espesor de cutícula se correlacionan positivamente con el gradiente altitudinal indicando plasticidad fenotípica. Se realiza por primera vez un análisis histoquímico de los laticíferos y otros idioblastos del tallo A. odorata.

Effect of dietary stevia-based sweetener on body weight and humoral immune response of broiler chickens.

BACKGROUND AND AIM: Steviol glycosides extracted from the leaves of Stevia rebaudiana Bertoni have been of much consideration recently because of their beneficial effects on health, raising the possibilities for improving farm animals' health. Although some studies on stevia's dietary effect on body weight gain are available, few studies have been conducted to evaluate stevioside supplementation on immune response in broilers. This experiment aimed to analyze how a stevia-based sweetener can affect broiler chickens' growth performance and humoral response. MATERIALS AND METHODS: In this experiment, one hundred and twenty 1-day-old Cobb-line broiler chicks fed with commercial starter/grower diets were included in three groups and supplemented with stevia-based sweetener at levels 0, 80, and 160 ppm, respectively. Chickens were weighed on day 0 and every 7 days for the next 6 weeks. Chicks were then immunized on days 10 and 24 with a Newcastle and infectious bronchitis vaccine and blood sampled on days 7, 24, and 35. Serologic assays were performed to detect specific antibody levels. RESULTS: The body weight means and body weight gain on day 42 were found to be significantly higher in birds from the group fed with 80 ppm of stevia-based sweetener than those in the control group and slightly higher than those in the group supplemented with 160 ppm of stevia-based sweetener. Likewise, on day 35, antibodies against the Newcastle disease virus were higher in the treatment groups. Immune response to infectious bronchitis virus vaccination was not statistically different among the three groups through the experiment. CONCLUSION: Stevia-based sweetener at 80 ppm in commercial-based diets improved body weight gain and immune response in broiler chickens at the market age.

Prescripción y beneficios de la rehabilitación cardiovascular en pacientes con cardiopatías congénitas: Análisis de varios estudios

RESUMEN Introducción: Las cardiopatías congénitas son consideradas de gran importancia debido a que pertenecen a las enfermedades cardiovasculares con alto índice de mortalidad. Objetivo: Determinar los beneficios de la rehabilitación cardiovascular en las cardiopatías congénitas e identificar cuáles son los parámetros adecuados a la hora de prescribir estos programas en pacientes con este tipo de afecciones. Método: Revisión sistemática en combinación con un análisis descriptivo y cronología retrospectiva de artículos científicos publicados en bases de datos indexadas entre los años 2004 a 2019, con la finalidad de obtener un panorama más amplio de los programas de rehabilitación. Los datos extraídos fueron: tipo de población, grupos de intervención y control, tipos de cardiopatías congénitas, plazo del programa de rehabilitación cardíaca y frecuencia de la intervención. Resultados: De los 53528 documentos encontrados en las bases de datos mediante los descriptores médicos empleados, se seleccionaron 13, 5 de carácter experimental y 8 de revisión. En estos se encontraron aspectos relacionados con la mejoría de la calidad de vida y cuestiones psicológicas, entre otros efectos importantes a tener en cuenta en pacientes con cardiopatías congénitas que asisten a algún tipo de programa de rehabilitación cardíaca. Conclusiones: La promoción e implementación de programas seguros, consensos y guías de rehabilitación cardíaca, enfocados en pacientes que presenten alguna cardiopatía congénita, con una prescripción detallada de los ejercicios implementados, son necesarios en la actualidad, de manera tal que los pacientes perciban que no presentan complicaciones, si se llevan adecuadamente.

ABSTRACT Introduction: Congenital heart diseases are considered of great importance because they belong to the cardiovascular diseases leading to a high mortality rate. Objective: To determine the benefits of cardiovascular rehabilitation in congenital heart disease and to identify which parameters are appropriate when prescribing cardiovascular rehabilitation programs in patients with congenital heart disease. Method: Systematic review in combination with a descriptive analysis and retrospective chronology of scientific articles published in indexed databases from 2004 to 2019, aiming to obtain a broader picture of the rehabilitation programs. The data extracted included the type of population, intervention and control groups, types of congenital heart disease, time frame of the cardiac rehabilitation program, and frequency of intervention. Results: A total of 53,528 papers were found in databases after placing medical descriptors. At the end, 13 articles were selected, 5 experimental and 8 review articles. In these articles, improvements in quality of life, psychological aspects, among other effects were found, as well as data of importance to take into account in patients with congenital heart disease who are attending some type of cardiac rehabilitation program. Conclusions: There is a current need for the promotion and implementation of cardiac rehabilitation programs, consensuses and guidelines, focused on patients with congenital heart disease with a detailed prescription of the exercises implemented; as well as the patient being aware that the programs are safe and they do not present complications if properly developed.

PD-L1 as a Prognostic Factor in Early-Stage Colon Carcinoma within the Immunohistochemical Molecular Subtype Classification.

BACKGROUND: There is a patent need to better characterize early-stage colorectal cancer (CRC) patients. PD-1 ligand (PD-L1) expression has been proposed as a prognostic factor but yields mixed results in different settings. The Consensus Molecular Subtype (CMS) classification has yet to be integrated into clinical practice. We sought to evaluate the prognostic value of PD-L1 expression overall and within CMS in early-stage colon cancer patients, in the hope of assisting treatment choice in this setting. METHODS: Tissue-microarrays were constructed from tumor samples of 162 stage II/III CRC patients. They underwent automatic immunohistochemical staining for PD-L1 and the proposed CMS panel. Primary endpoints were overall survival (OS) and disease-free survival (DFS). RESULTS: PD-L1 expression was significantly and independently associated with better prognosis (HR = 0.46 (0.26-0.82), p = 0.009) and was mostly seen in immune cells of the tumor-related stroma. CMS4 five-folds the risk of mortalitycompared with CMS1 (HR = 5.58 (1.36, 22.0), p = 0.034). In the subgroup CMS2/CMS3 analysis, PD-L1 expression significantly differentiated individuals with better OS (p = 0.004) and DFS (p < 0.001). CONCLUSIONS: Our study suggests that PD-L1 expression is an independent prognostic factor in patients with stage II/III colon cancer. Additionally, it successfully differentiates patients with better prognosis in the CMS2/CMS3 group and may prove significant for the clinical relevance of the CMS classification.

A Long Journey of CICA-17 Quinoa Variety to Salinity Conditions in Egypt: Mineral Concentration in the Seeds.

Quinoa may be a promising alternative solution for arid regions, and it is necessary to test yield and mineral accumulation in grains under different soil types. Field experiments with Chenopodium quinoa (cv. CICA-17) were performed in Egypt in non-saline (electrical conductivity, 1.9 dS m-1) and saline (20 dS m-1) soils. Thirty-four chemical elements were studied in these crops. Results show different yields and mineral accumulations in the grains. Potassium (K), P, Mg, Ca, Na, Mn, and Fe are the main elements occurring in the quinoa grains, but their concentrations change between both soil types. Besides, soil salinity induced changes in the mineral pattern distribution among the different grain organs. Sodium was detected in the pericarp but not in other tissues. Pericarp structure may be a shield to prevent sodium entry to the underlying tissues but not for chloride, increasing its content in saline conditions. Under saline conditions, yield decreased to near 47%, and grain sizes greater than 1.68 mm were unfavored. Quinoa may serve as a complementary crop in the marginal lands of Egypt. It has an excellent nutrition perspective due to its mineral content and has a high potential to adapt to semi-arid and arid environments.