Guía para identificar características específicas en dispositivos de estimulación cardiaca mediante figura radiológica / Guide to identify specific characteristics in cardiac pacing devices by radiological figure

Resumen Esta guía propone brindar una ayuda a todos los médicos para la identificación metódica de cada marca comercial de marcapasos por radiografía simple de tórax, por medio de sus componentes electrónicos (conectores de electrodos, circuito lógico y batería), siendo necesario para la interrogación de dispositivos de marcapasos posterior a su implante. Se describirán los diferentes tipos de marcapasos, electrodos y modos de programación más frecuentemente utilizados.

Abstract This guide provides help for medical doctors systematically identifying each commercial brand of pacemakers by thoracic radiography through their electronic components (electrode connectors, logic circuit, and battery); this is crucial for watching the pacemaker after being implanted. We aimed to describe the different cardiac stimulation devices, electrodes, and programming modes more frequently used.

Guide to identify specific characteristics in cardiac pacing devices by radiological figure.

This guide provides help for medical doctors systematically identifying each commercial brand of pacemakers by thoracic radiography through their electronic components (electrode connectors, logic circuit, and battery); this is crucial for watching the pacemaker after being implanted. We aimed to describe the different cardiac stimulation devices, electrodes, and programming modes more frequently used.

Esta guía propone brindar una ayuda a todos los médicos para la identificación metódica de cada marca comercial de marcapasos por radiografía simple de tórax, por medio de sus componentes electrónicos (conectores de electrodos, circuito lógico y batería), siendo necesario para la interrogación de dispositivos de marcapasos posterior a su implante. Se describirán los diferentes tipos de marcapasos, electrodos y modos de programación más frecuentemente utilizados.

The enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis.

BACKGROUND: Educational attainment is associated with wellbeing and health, but patients with schizophrenia achieve lower levels of education than people without. Several effective interventions can ameliorate this situation. However, the magnitude of the education gap in schizophrenia and its change over time are unclear. We aimed to reconstruct the trajectories of educational attainment in patients with schizophrenia and, if reported, their healthy comparator controls. METHODS: We did a systematic review and meta-analysis including all studies reporting on patients with schizophrenia (of mean age ≥18 years) and describing the number of years of education of the participants, with or without healthy controls. There were no other design constraints on studies. We excluded studies that included only patients with other schizophrenia spectrum disorders and studies that did not specify the number of years of education of the participants. 22 reviewers participated in retrieving data from a search in PubMed and PsycINFO (Jan 1, 1970, to Nov 24, 2020). We estimated the birth date of participants from their mean age and publication date, and meta-analysed these data using random-effects models, focusing on educational attainment, the education gap, and changes over time. The primary outcome was years of education. The protocol was registered on PROSPERO (CRD42020220546). FINDINGS: From 32 593 initial references, we included 3321 studies reporting on 318 632 patients alongside 138 675 healthy controls (170 941 women and 275 821 men from studies describing sex or gender; data on ethnicity were not collected). Patients' educational attainment increased over time, mirroring that of controls. However, patients with schizophrenia in high-income countries had 19 months less education than controls (-1·59 years, 95% CI -1·66 to -1·53; p<0·0001), which is equivalent to a Cohen's d of -0·56 (95% CI -0·58 to -0·54) and implies an odds ratio of 2·58 for not completing 12 years of education (ie, not completing secondary education) for patients compared with controls. This gap remained stable throughout the decades; the rate of change in number of total years of education in time was not significant (annual change: 0·0047 years, 95% CI -0·0005 to 0·0099; p=0·078). For patients in low-income and middle-income countries, the education gap was significantly smaller than in high-income countries (smaller by 0·72 years, 0·85 to 0·59; p<0·0001), yet there was evidence that this gap was widening over the years, approaching that of high-income countries (annual change: -0·024 years, -0·037 to -0·011; p=0·0002). INTERPRETATION: Patients with schizophrenia have faced persistent inequality in educational attainment in the last century, despite advances in psychosocial and pharmacological treatment. Reducing this gap should become a priority to improve their functional outcomes. FUNDING: Ciencia y Tecnología para el Desarrollo (CYTED) to the Latin American Network for the Study of Early Psychosis (ANDES).

Influence of dietary vitamin E and selenium supplementation on broilers subjected to heat stress, Part II: oxidative stress, immune response, gut integrity, and intestinal microbiota.

This study evaluated the effects of vitamin E (Vit E) and selenium (Se) supplementation on mRNA abundance of antioxidant, immune response, and tight junction genes, as well as taxonomic and functional profiles of ileal microbiota of broilers exposed to daily 4-h elevated temperature during d 28 to 35. A total of 640-day-old Cobb male broiler chicks were randomly allocated to 32 floor pens in a 2 × 2 factorial arrangement that included ambient temperature (thermoneutral [TN] or heat stress [HS]) and dietary treatments (basal diet or Vit E + Se). Vit E and organic Se were added to the basal diet at the rate of 250 mg/kg and 1 mg/kg, respectively. Liver and jejunum tissue samples were taken on d 27 (1 bird/pen), d 28 and d 35 (2 birds/pen) from birds for qPCR analysis. Data were subjected to a 2-way ANOVA using the GLM procedure of JMP. Ileal contents were taken on d 27 and d 35 for microbial profiling. Microbiota data were analyzed in QIIME 2 and significance between treatments identified linear discriminant analysis effect size (LEfSe, P < 0.05). Dietary Vit E/Se significantly downregulated the mRNA levels of HSPs in liver and jejunal tissues of the HS-challenged birds both on d 28 and d 35. Moreover, mRNA abundance of TLR2, TNFα, IFNγ, IL-1ß, IL-10, and iNOS in the liver were significantly downregulated in birds fed the Vit E/Se diet on d 35. However, dietary treatment had no significant impact on oxidative stress, immunity, and gut integrity related genes analyzed in jejunal tissues on d 28 and d 35, except downregulation of IFNγ on d 35 (P = 0.052). LEfSe analysis revealed that Lachnospiraceae FE2018 and Ruminococcaceae NK4A214 groups was enriched in the Vit E/Se birds on d 35. Moreover, PICRUSt analysis predicted significant functional differences among the treatment groups. In conclusion, dietary supplementation of Vit E/Se mitigated the negative effects of HS potentially via improving antioxidant status, regulating cytokine responses and modifying ileal microbiota and its function.

Influence of dietary vitamin E and selenium supplementation on broilers subjected to heat stress, Part I: Growth performance, body composition and intestinal nutrient transporters.

High ambient temperature is one of the most common stressors in modern poultry production, resulting in reduced feed intake, weight gain, and increased mortality. This study evaluated the effects of vitamin E (Vit E) and organic selenium (Se) supplementation on performance, body composition, core body temperatures, and mRNA abundance of nutrient transporters in the jejunum of broilers exposed to daily 4-h elevated temperature during d 28 to 35. A total of 640 Cobb male birds were randomly allocated to 32 floor pens in a 2 × 2 factorial arrangement that included ambient temperature (thermoneutral, [TN]; or heat stress, [HS]) and dietary treatments (basal diet or Vit E + Se). Four rooms were used (2 TN and 2 HS) each housing half of the 8 replicate pens per group. Vit E and organic Se were added to the basal diet at the rate of 250 mg/kg and 1 mg/kg diet, respectively. Data were subjected to a 2-way ANOVA using the GLM procedure of JMP (SAS). During the HS period, birds fed the Vit E/Se diet had significantly lower mortality compared to nonsupplemented group (1.92% vs. 7.01%). Moreover, dietary Vit E/Se supplementation had a significant effect on performance by increasing BWG, FI, and European production efficiency factor (EPEF) during the entire experimental period (d 0-35). Dietary Vit E and Se supplementation significantly increased carcass, tissue, lean, and fat weights as well as bone mineral content (BMC) and bone mineral density (BMD) on d 35. Birds fed Vit E/Se supplemented diet had significantly lower (P = 0.010) core body temperature compared to birds fed the basal diet on d 30. Dietary treatment did not influence mRNA abundance of PepT1, SGLT1, or NaPi-IIb on d 28 or d 35. However, HS significantly upregulated levels of PepT1 and NaPi-IIb (P < 0.001) and downregulated that of SGLT1 (P = 0.017) on d 28. In conclusion, dietary Vit E and Se supplementation significantly improved broiler growth performance and carcass composition, and reduced heat-related mortality and core body temperature (on d 30) without influencing the mRNA abundance of intestinal nutrient transporters.

Gender, age and geographical representation over the past 50 years of schizophrenia research.

Previous studies have suggested that subjects participating in schizophrenia research are not representative of the demographics of the global population of people with schizophrenia, particularly in terms of gender and geographical location. We here explored if this has evolved throughout the decades, examining changes in geographical location, gender and age of participants in studies of schizophrenia published in the last 50 years. We examined this using a meta-analytical approach on an existing database including over 3,000 studies collated for another project. We found that the proportion of studies and participants from low-and-middle income countries has significantly increased over time, with considerable input from studies from China. However, it is still low when compared to the global population they represent. Women have been historically under-represented in studies, and still are in high-income countries. However, a significantly higher proportion of female participants have been included in studies over time. The age of participants included has not changed significantly over time. Overall, there have been improvements in the geographical and gender representation of people with schizophrenia. However, there is still a long way to go so research can be representative of the global population of people with schizophrenia, particularly in geographical terms.

Balanced nutrient density for broiler chickens using a range of digestible lysine-to-metabolizable energy ratios and nutrient density: Growth performance, nutrient utilisation and apparent metabolizable energy.

Currently, specific nutrient concentration, metabolizable energy (ME) and digestible amino acids are used as feed formulation criteria. A balanced nutrient density (BND) concept based on 2 criteria of nutrient density and balanced amino acids-to-ME ratio may offer more flexibility in optimisation of profit in formulation of diets compared with current formulation based on set values per unit of feed mass. A total of 672 one-d-old off-sex male Ross 308 broiler chickens were used across two 42-d performance trials in a 3 × 2 factorial arrangement of treatments with each diet replicated 8 times (14 birds per replicate). The experimental factors were 2 nutrient density levels (low [LD] and high [HD]) and 3 digestible lysine-to-ME ratios (DLYS:ME; low, medium, and high). Low density diets had ME of 2,876 and 3,023 kcal/kg for starter and finisher, respectively, while values for HD diets were 3,169 and 3,315 kcal/kg with proportionally higher non-nitrogenated nutrients. Separate digestibility and apparent metabolizable energy (AME) assays were conducted at d 21 and 42. Digestibility assays at d 7 were conducted on birds used for performance trials. Regardless of the diet density, birds fed low DLYS:ME had a lower (P < 0.01) feed intake (d 0 to 42) than medium and high DLYS:ME. Without interaction, birds fed low and medium DLYS:ME had a similar body weight gain being the heaviest while birds low DLYS:ME were the lightest. By an interaction (P < 0.05), the highest overall FCR value was observed for birds fed LD × low DLYS:ME and improved linearly when DLYS:ME increased to the highest level reaching a limit for birds fed HD × medium DLYS:ME. Calorie conversion linearly decreased (P < 0.001) with increments in DLYS:ME. Jejunal and ileal starch and protein digestibility were affected on d 21 and 42 but not on d 7 of age. Given the independence of response on BW and feed consumption, the use of BND as a flexible system in diet formulations has the potential to enable more accurate formulation for optimisation of growth performance of broiler chickens.

Effects of protease, phytase and a Bacillus sp. direct-fed microbial on nutrient and energy digestibility, ileal brush border digestive enzyme activity and cecal short-chain fatty acid concentration in broiler chickens.

Two experiments were conducted to determine the effects of protease and phytase (PP) and a Bacillus sp. direct-fed microbial (DFM) on dietary energy and nutrient utilization in broiler chickens. In the first experiment, Ross 308 broiler chicks were fed diets supplemented with PP and DFM in a 2×2 factorial arrangement. The 4 diets (control (CON), CON + PP, CON + DFM, and CON + PP + DFM) were fed from 15-21 days of age. In Experiment 1, significant interaction (P≤0.01) between PP and DFM on the apparent ileal digestibility coefficient for starch, crude protein, and amino acid indicated that both additives increased the digestibility. Both additives increased the nitrogen retention coefficient with a significant interaction (P≤0.01). Although no interaction was observed, significant main effects (P≤0.01) for nitrogen-corrected apparent ME (AMEn) for PP or DFM indicated an additive response. In a follow-up experiment, Ross 308 broiler chicks were fed the same experimental diets from 1-21 days of age. Activities of ileal brush border maltase, sucrase, and L-alanine aminopeptidase were increased (P≤0.01) by PP addition, while a trend (P = 0.07) for increased sucrase activity was observed in chickens fed DFM, in Experiment 2. The proportion of cecal butyrate was increased (P≤0.01) by DFM addition. Increased nutrient utilization and nitrogen retention appear to involve separate but complementary mechanisms for PP and DFM, however AMEn responses appear to have separate and additive mechanisms.

The role of added feed enzymes in promoting gut health in swine and poultry.

The value of added feed enzymes (FE) in promoting growth and efficiency of nutrient utilisation is well recognised in single-stomached animal production. However, the effects of FE on the microbiome of the gastrointestinal tract (GIT) are largely unrecognised. A critical role in host nutrition, health, performance and quality of the products produced is played by the intestinal microbiota. FE can make an impact on GIT microbial ecology by reducing undigested substrates and anti-nutritive factors and producing oligosaccharides in situ from dietary NSP with potential prebiotic effects. Investigations with molecular microbiology techniques have demonstrated FE-mediated responses on energy utilisation in broiler chickens that were associated with certain clusters of GIT bacteria. Furthermore, investigations using specific enteric pathogen challenge models have demonstrated the efficacy of FE in modulating gut health. Because FE probably change the substrate characteristics along the GIT, subsequent microbiota responses will vary according to the populations present at the time of administration and their reaction to such changes. Therefore, the microbiota responses to FE administration, rather than being absolute, are a continuum or a population of responses. However, recognition that FE can make an impact on the gut microbiota and thus gut health will probably stimulate development of FE capable of modulating gut microbiota to the benefit of host health under specific production conditions. The present review brings to light opportunities and challenges for the role of major FE (carbohydrases and phytase) on the gut health of poultry and swine species with a specific focus on the impact on GIT microbiota.

Efecto del sustttuyente sobre el anillo porfiríico y el agente oxidante en la funcionalización de compuestos alifáticos / Effect f porphyrrin substituents and oxdizing agent on the functionaliization of aliphatic compounds / Estdo de substittuintes sobre a porfirina e o agent oxidante na fuuncionalização de oligômeros alifáticos

En este trabajo se estudió la funcionalización de escualano y tetradecano al variar el efecto electrónico del sustituyente sobre los anillos aromáticos del núcleo porfirínico y el agente oxidante (KIO4,2KHSO5 ⋅KHSO4K2SO4,NaClO yH2O2). Se sintetizaron y caracterizaron tres metaloporfirinas: cloruro de meso-tetrakis-4-nitrofenil-porfirinato manganeso(III), cloruro de meso-tetrakis-2,4,6-trirnetoxifenirporfirinato manganeso(III) y cloruro de meso-tetrafenilporfirinato manganeso(III), con rendimientos del 40, 52 y 43%, respectivamente. Posteriormente se probaron 24 sistemas de funcionalización, que se cuantificaron empleando cromatografía de gases usando el método del patrón interno, y sus productos se identificaron por cromatografía de gases acoplada a espectrometría de masas e infrarrojo. Los resultados muestran que la adecuada selección del par porfirina-agente oxidante puede llevar a funcionalizaciones hasta del 42% para el tetradecano y del 80% para el escualano.

In this work was studied the functionalizations of squalane and tetradecane varying the electronic nature of the substituents over the porphyrinic ring and the oxidizing agent (KiO4,2KHSO5-KHS(VK2SO4, NaClO and H2O2). Three metallo-porphyrins (Mn(TTP)Cl, Mn ρ-NO2TPP) Cl and Mn(triMeOTPP)Cl) were synthesized and characterized with yields of 40, 52 and 43% respectively. Twenty four different functionalisation systems were carried out and quantified by gas chromatography using internal standard method and the products were identified by gas chromatography-mass spectroscopy. The functionalisations were quantified by CG and the products identified by GC-MS and FT-IR. The results showed that a good choice porphyirin-oxidizing agent pair can produce functionalization yields up to 42% for tetradecane and 80% for squalane.

O estudo da funcionalização de oligôme-ros orgânicos mediado por metalporfirinas como uma primeira aproximação em procura da post-funcionalização de polímeros como o polietileno e polipropileno tem despertado maior interesse nos últimos anos. Dentro deste contexto, no presente trabalho foi proposto o estudo da funcionalização de escualano e tetradecano para alterar a natureza química dos substituintes dos anéis aromáticos do núcleo porfirínico e do agente oxidante (KIO4, 2KHSO5KHSO4K2SO4, NaClO eH2O²). Foram sintetizados e purificados três diferentes metaloporfirinas, cloreto de meso-tetrakis-4-nitrofenirporfirinato manganês (III), cloreto de meso-tetrakis-2,4,6-trimetoxifenilporfirinato manganês (III) e cloreto de meso-tetrafenil-porfirinato manganês (III), com rendimentos do 40, 52 e 43%, respectivamente. Posteriormente, realizaram-se 24 funcionalizações, que foram quantificadas por cromatografia gasosa de alta resolução acoplada à espectrometria de massas (CGAR-EM), usando um oxidante, e levando em consideração as características químicas de cada composto, na qual obteve-se funcionalizações de até o 42% para o tetradecano e o 80% para o escualano.

Chlamidia trachomatis, Gardnerella vaginalis y otros microorganismos en gestantes del Hospital de Maternidad Rafael Calvo / Chlamydia trachomatis, Gardnerella vaginalis and others microorganisms in pregnancy at the hospital Rafael Calvo

Con el fin de conocer el índice de infección por Chlamydia trachomatis, Gardnerella vaginalis y otros gérmenes sexualmente transmisibles en un grupo de gestantes, se estudiaron 135 mujeres del primer, segundo y tercer trimestre de gestación atendidas en el Hospital de Maternidad Rafael Calvo. Mediante estudios combinados de laboratorio, que incluyeron exámenes directos, cultivos bacteriológicos y técnicas de inmunoensayo, se identificaron los microorganismos infectantes en el flujo vaginal, secreción endocervical y suero de 83 por ciento de los pacientes. Se encontró que el 15,5 por ciento, 9,6 por ciento, 8,5 por ciento, 40 por ciento, 8,8 por ciento y 0,7 por ciento de las gestantes tuvieron infección genital por C. trachomatis, G. vaginalis, T. Vaginalis, Candida sp., Streptococcus B y N. gonorrhoeae, respectivamente; ninguna paciente fue reactiva para marcador de infección activa por citomegalovirus. La cervicitis y el aborto, como antecedentes, fueron las patologías asociadas más frecuentemente halladas; la ruptura temprana de membranas, también se presentó en algunas de las pacientes. La significativa proporción de gestantes con infección por bacteias que causan complicaciones en el embarazo, amerita su estudio en el diagnóstico de rutina de la consulta prenatal del hospital de Maternidad Rafael Calvo