Risk of adverse perinatal outcomes among women with clinical and subclinical histopathological chorioamnionitis.

Introduction: Histologic chorioamnionitis (HCA) is a placental inflammatory condition associated with adverse perinatal outcomes (APOs). This historical cohort study explores the risk of APOs in pregnant women with HCA and compares the impact of clinical chorioamnionitis (CCA) with subclinical chorioamnionitis (SCCA). Methodology: Placentas were evaluated by a perinatal pathologist tand all women with HCA were included. Two groups were integrated: (1) women with clinical chorioamnionitis (CCA) and (2) women with subclinical chorioamnionitis (SCCA). Additionally, we conducted a secondary analysis to compare the prevalence of APOs among stage 1, 2 and 3 of HCA and the risk of APOs between grades 1 and 2 of HCA. The APOs analyzed were preterm birth, stillbirth, neonatal weight < 1,500 g, neonatal sepsis. Relative risk with 95% confidence interval was calculated. Results: The study included 41 cases of CCA and 270 cases of SCCA. The mean gestational age at diagnosis and birth was 30.2 ± 5.4 weeks and 32.5 ± 5.1 weeks, for group 1 and 2, respectively. The study also found that women with HCA stage 3 and grade 2 had a higher prevalence and risk of adverse perinatal outcomes. Discussion: The findings of this study suggest the importance of placental histological study to excluded SCCA, which represents a significant risk to both maternal and neonatal health, contributing to high morbidity and mortality.

Effect of smoking on the redox status of knee osteoarthritis: A preliminary study.

Even though smoking has been scarcely studied in osteoarthritis (OA) etiology, it is considered a controversial risk factor for the disease. Exposure to tobacco smoke has been reported to promote oxidative stress (OS) as part of the damage mechanism. The aim of this study was to assess whether smoking increases cartilage damage through the generation of OS. Peripheral blood (PB) and synovial fluid (SF) samples from patients with OA were analyzed. The samples were stratified according to smoking habit, Kellgren-Lawrence score, pain, and cotinine concentrations in PB. Malondialdehyde (MDA), methylglyoxal (MGO), advanced protein oxidation products (APOPs), and myeloperoxidase (MPO) were assessed; the activity of antioxidant enzymes such as gamma-glutamyl transferase (GGT), glutathione S-transferase (GST) and catalase (CAT), as well as the activity of arginase, which favors the destruction of cartilage, was determined. When stratified by age, for individuals <60 years, the levels of MDA and APOPs and the activity of MPO and GST were higher, as well as antioxidant system activity in the smoking group (OA-S). A greater degree of pain in the OA-S group increased the concentrations of APOPs and arginase activity (P < 0.01 and P < 0.05, respectively). Arginase activity increased significantly with a higher degree of pain (P < 0.01). Active smoking can be an important risk factor for the development of OA by inducing systemic OS in young adults, in addition to reducing antioxidant enzymes in older adults and enhancing the degree of pain and loss of cartilage.

Progesterone modulates extracellular heat-shock proteins and interlukin-1ß in human choriodecidual after Escherichia coli infection.

INTRODUCTION: Chorioamnionitis is an adverse condition in human pregnancy caused by many bacterial pathogens including Escherichia coli (E. coli); which has been associated with higher risk of preterm birth. We recently reported that human maternal decidua (MDec) tissue responds to E. coli infection by secreting extracellular heat-shock proteins (eHsp)-60, -70 and interlukin-1ß (IL-1ß). Previous studies have shown that progesterone (P4) regulates the immune response, but it is unknown whether P4 inhibits the secretion of eHsp. The aim of this investigation was to determine the role of P4 on the secretion of eHsp-27, -60, -70 and IL-1ß in MDec after 3, 6, and 24 h of E. coli infection. METHODS: Nine human feto-maternal interface (HFMi) tissues were included and mounted in the Transwell culture system. Only the maternal decidua (MDec) was stimulated for 3, 6 and 24 h with E. coli alone or in combination with progesterone and RU486. After each treatment, the HFMi tissue was recovered to determine histological changes and the culture medium recovered to evaluate the levels of eHsp-27, -60, -70 and IL-1ß by ELISA and mRNA expression by RT-PCR. RESULTS: No structural changes were observed in the HFMi tissue treated with P4 and RU486. However, stimulation with E. coli produces diffuse inflammation and ischemic necrosis. E. coli induced infection decreases, in time- and dose-dependent manner, eHsp-27 and increases eHsp-60, eHsp-70 and IL-1ß levels. In contrast, incubation of HFMi tissue with E. coli + P4 reversed eHsp and IL-1ß secretion levels relative to E. coli stimulation group but not relative to the control group. The same profile was observed on the expression of eHsp-27 and eHsp-60. DISCUSSION: we found that progesterone modulates the anti-inflammatory (eHsp-27) and pro-inflammatory (eHsp-60 and eHsp-70) levels of eHsp induced by E. coli infection in human choriodecidual tissue. eHsp-60 and eHsp-70 levels were not completely reversed; maintaining the secretion of IL-1ß, which has been associated with adverse events during pregnancy.

Oxidative Stress and Air Pollution: Its Impact on Chronic Respiratory Diseases.

Redox regulation participates in the control of various aspects of metabolism. Reactive oxygen and nitrogen species participate in many reactions under physiological conditions. When these species overcome the antioxidant defense system, a distressed status emerges, increasing biomolecular damage and leading to functional alterations. Air pollution is one of the exogenous sources of reactive oxygen and nitrogen species. Ambient airborne particulate matter (PM) is important because of its complex composition, which includes transition metals and organic compounds. Once in contact with the lungs' epithelium, PM components initiate the synthesis of inflammatory mediators, macrophage activation, modulation of gene expression, and the activation of transcription factors, which are all related to the physiopathology of chronic respiratory diseases, including cancer. Even though the pathophysiological pathways that give rise to the development of distress and biological damage are not fully understood, scientific evidence indicates that redox-dependent signaling pathways are involved. This article presents an overview of the redox interaction of air pollution inside the human body and the courses related to chronic respiratory diseases.

Effect of Hypoxia in the Transcriptomic Profile of Lung Fibroblasts from Idiopathic Pulmonary Fibrosis.

Idiopathic pulmonary fibrosis (IPF) is an aging-associated disease characterized by exacerbated extracellular matrix deposition that disrupts oxygen exchange. Hypoxia and its transcription factors (HIF-1α and 2α) influence numerous circuits that could perpetuate fibrosis by increasing myofibroblasts differentiation and by promoting extracellular matrix accumulation. Therefore, this work aimed to elucidate the signature of hypoxia in the transcriptomic circuitry of IPF-derived fibroblasts. To determine this transcriptomic signature, a gene expression analysis with six lines of lung fibroblasts under normoxia or hypoxia was performed: three cell lines were derived from patients with IPF, and three were from healthy donors, a total of 36 replicates. We used the Clariom D platform, which allows us to evaluate a huge number of transcripts, to analyze the response to hypoxia in both controls and IPF. The control's response is greater by the number of genes and complexity. In the search for specific genes responsible for the IPF fibroblast phenotype, nineteen dysregulated genes were found in lung fibroblasts from IPF patients in hypoxia (nine upregulated and ten downregulated). In this sense, the signaling pathways revealed to be affected in the pulmonary fibroblasts of patients with IPF may represent an adaptation to chronic hypoxia.

Seasonal and Spatial Variability of PM2.5 Concentration, and Associated Metal(loid) Content in the Toluca Valley, Mexico.

This study provides evidence of the seasonal and spatial variation of metal(lloid)s in particulate matter minor to 2.5 microns (PM2.5) in the Toluca Valley Metropolitan Area (TVMA), the fifth largest urban center in Mexico. Four sites were sampled between 2013 and 2014, which included urban and industrial areas, in the dry-cold (November-February) and dry-hot (March-May) seasons; PM2.5 was collected using high- and medium-volume samplers. Metal(lloid) concentrations in PM2.5 were analyzed using inductively coupled plasma‒mass spectrometry (ICP‒MS). The highest 24-hour PM2.5 concentration in the northern area was observed, and the PM2.5 concentrations were independent of the season. Five metal(lloid)s with a recovery percentage above 80% were considered to be reported (Co, Cr, Cu, Mn, and Sb). The maximum concentrations of metal(lloid)s were observed during the dry-cold season, and concentrations were up to one hundred or thousand fold with respect to the dry-hot season. The 24-hour PM2.5 and metal(lloid) concentrations exceeded national and international guidelines to protect population health.

Plasma Endothelial and Oxidative Stress Biomarkers Associated with Late Mortality in Hospitalized COVID-19 Patients.

BACKGROUND: Coronavirus infectious disease 2019 (COVID-19) is a significant public health problem worldwide. COVID-19 increases the risk of non-pulmonary complications such as acute myocardial injury, renal failure, thromboembolic events, and multi-organic damage. Several studies have documented increased inflammation molecules, endothelial dysfunction biomarkers, and dysregulation of coagulation factors in COVID-19 patients. In addition, endothelium dysfunction is exacerbated by the oxidative stress (OxS) promoted by endocrine and cardiovascular molecules. Our objective was to evaluate whether endothelial and OxS biomarkers were associated with mortality in hospitalized COVID-19 patients. METHODS: A prospective cohort study was performed. Patients ≥18 years old with confirmed COVID-19 that required hospitalization were included in a prospective cohort study. Endothelium and oxidative stress biomarkers were collected between 3 and 5 days after admission. RESULTS: A total of 165 patients were evaluated; 56 patients succumbed. The median follow-up was 71 days [23-129]. Regarding endothelial dysfunction and OxS biomarkers, patients who did not survive had higher levels of nitrates (0.4564 [0.1817-0.6761] vs. 0.2817 [0.0517-0.5], p = 0.014), total nitrates (0.0507 [-0.0342-0.1809] vs. -0.0041 [-0.0887-0.0909], p = 0.016), sE-Selectin (1.095 [0.86-1.495] vs. 0.94 [0.71-1.19], p = 0.004), and malondialdehyde (MDA) (0.50 [0.26-0.72] vs. 0.36 [0.23-0.52], p = 0.010) compared to patients who survived. Endothelial and OxS biomarkers independently associated with mortality were sE-selectin (HR:2.54, CI95%; from 1.11 to 5.81, p = 0.027), nitrates (HR:4.92, CI95%; from 1.23 to 19.63, p = 0.024), and MDA (HR: 3.05, CI95%; from 1.14 to 8.15, p = 0.025). CONCLUSIONS: Endothelial dysfunction (sE-selectin and nitrates) and OxS (MDA) are independent indicators of a worse prognosis in COVID-19 patients requiring hospitalization.

[Progressive myositis ossificans: Case report]. / Miositis osificante progresiva: reporte de un caso.

Background: Myositis ossificans progressiva (MOP) is a low prevalence hereditary connective tissue disease (1:2,000,000 habitants). It is characterized by heterotopic ossification with an uncertain behavior that has been exceptionally related to neoplasms. The objective was to know the coexistence of MOP with neoplasms of mesodermal origin, so that they can be considered in the diagnosis of other patients, as well as formulate hypotheses to clarify their association. Clinical case: 27-year-old female with right gluteal and ischitiobial muscle pain that increased with exercise, without remission with analgesics until limiting the mobility of both extremities. A bone series was requested where areas of heterogeneous radiolucency were evidenced in the region of, both, thighs and pelvis in an irregular manner, similar to bone density, which was compatible with the ultrasound and tomographic findings; we concluded that they were images of myositis ossificans of the hip. The patient reported gastric symptoms and an endoscopy was requested, which histopathologically reported diffuse gastric carcinoma with signet ring cells; cabinet images showed an ovarian tumor. Conclusion: MOP is a low prevalence disease, which is why its knowledge and suspicion are essential for the diagnosis. We found little literature that involves the three entities; therefore, their pathophysiology and understanding is limited. Regarding MOP, at this moment there is no curative treatment; however, an accurate diagnosis allows to start rehabilitation in a timely manner with an improvement in the quality of life.

Introducción: la miositis osificante progresiva (MOP) es una enfermedad hereditaria del tejido conectivo de baja prevalencia (1:2,000,000 habitantes). Se caracteriza por osificación heterotópica con un comportamiento incierto que excepcionalmente se ha relacionado con neoplasias. Se buscó conocer la coexistencia de la MOP con neoplasias de origen mesodérmico, para que sean consideradas en el diagnóstico de otros pacientes, así como formular hipótesis para esclarecer su asociación. Caso clínico: mujer de 27 años con dolor de músculo isquitiobial y glúteo derecho que incrementaba con el ejercicio, sin remisión con analgésicos hasta limitar la movilidad de ambas extremidades. Se solicitó una serie ósea donde se evidenciaron zonas de radiolucidez heterogénea en la región de ambos muslos y pelvis de manera irregular, semejante a densidad ósea, que fue compatible con los hallazgos ecográficos y tomográficos; se concluyó que eran imágenes relacionadas con miositis osificante de cadera. La paciente refirió sintomatología gástrica y se solicitó una endoscopía que histopatológicamente reportó carcinoma gástrico difuso con células en anillo de sello; las imágenes de gabinete mostraron tumoración ovárica. Conclusión: la MOP es una patología de baja prevalencia, por lo que su conocimiento y sospecha son fundamentales para el diagnóstico. Hay poca literatura que involucre a las tres entidades; por ende, su fisiopatología y comprensión es limitada. En cuanto a la MOP, aún no hay un tratamiento curativo; sin embargo, el diagnóstico certero permite iniciar rehabilitación de manera oportuna con mejoría de la calidad de vida.

Education in environmental health: scientific contributions of the last 20 years / Educación en salud ambiental: aportes científicos de los últimos 20 años

Man's attitudes about the environment have generated irreversible damage to the planet, emerging as an alternative to this problem Environmental Education, which aims to reorient social awareness towards a friendly and thoughtful culture. Through environmental education, we seek to make people aware of the problems of the natural and social environment from their school education in childhood to generate values, new attitudes, behaviors, and beliefs aimed at caring for the environment and learning new relationships between people. Likewise, to carry out these environmental education strategies, it is important to know some specific parameters, such as biological diversity and conservation, in addition to the conservation policies carried out by each nation. In this sense, in this work a bibliometric study was carried out based on high-impact scientific production and stipulated by ScienceDirect related to Environmental Education during a period of the last 20 years. The results were grouped into five clusters: "Environmental Education" OR "Education for Sustainable Development" OR "Education for Sustainability" OR "Education for Climate Change" OR "Eco citizenship". The union of all these clusters are connected and intertwined with each other. Them in a dependent way, which is a consequence of the study carried out(AU)

Las actitudes del hombre sobre el medio ambiente han generado daños irreversibles al planeta, surgiendo como alternativa para esta problemática la Educación Ambiental, que tiene como finalidad reorientar la conciencia social hacia una cultura amigable y reflexiva. Mediante la educación ambiental se busca concientizar a las personas sobre los problemas del ambiente natural y social desde su formación escolar en la niñez para generar valores, nuevas actitudes, comportamientos y creencias orientadas al cuidado del medio ambiente y el aprendizaje de nuevas relaciones entre las personas. Asimismo, para lleva a cabo estas estrategias de educación ambiental, es importante conocer algunos parámetros específicos, como la diversidad biológica y conservación, además de las políticas propias de conservación llevada a cabo por cada nación. En ese sentido, en este este trabajo se realizó un estudio bibliométrico basado en la producción científica de alto impacto y estipuladas por ScienceDirect relacionados con la Educación Ambiental durante un periodo de los últimos 20 años. Los resultados fueron agrupados en cinco clustes: "Environmental Education" OR "Education for Sustainable Development" OR "Education for Sustainability" OR "Education for Climate Change" OR "Eco citizenship". La unión de todos estos clústers se encuentran conectados y entrelados entre ellos de manera dependiente, lo cual es consecuencia del estudio realiz(AU)

Miositis osificante progresiva: reporte de un caso / Progressive myositis ossificans: Case report

Introducción: la miositis osificante progresiva (MOP) es una enfermedad hereditaria del tejido conectivo de baja prevalencia (1:2,000,000 habitantes). Se caracteriza por osificación heterotópica con un comportamiento incierto que excepcionalmente se ha relacionado con neoplasias. Se buscó conocer la coexistencia de la MOP con neoplasias de origen mesodérmico, para que sean consideradas en el diagnóstico de otros pacientes, así como formular hipótesis para esclarecer su asociación. Caso clínico: mujer de 27 años con dolor de músculo isquitiobial y glúteo derecho que incrementaba con el ejercicio, sin remisión con analgésicos hasta limitar la movilidad de ambas extremidades. Se solicitó una serie ósea donde se evidenciaron zonas de radiolucidez heterogénea en la región de ambos muslos y pelvis de manera irregular, semejante a densidad ósea, que fue compatible con los hallazgos ecográficos y tomográficos; se concluyó que eran imágenes relacionadas con miositis osificante de cadera. La paciente refirió sintomatología gástrica y se solicitó una endoscopía que histopatológicamente reportó carcinoma gástrico difuso con células en anillo de sello; las imágenes de gabinete mostraron tumoración ovárica. Conclusión: la MOP es una patología de baja prevalencia, por lo que su conocimiento y sospecha son fundamentales para el diagnóstico. Hay poca literatura que involucre a las tres entidades; por ende, su fisiopatología y comprensión es limitada. En cuanto a la MOP, aún no hay un tratamiento curativo; sin embargo, el diagnóstico certero permite iniciar rehabilitación de manera oportuna con mejoría de la calidad de vida.

Background: Myositis ossificans progressiva (MOP) is a low prevalence hereditary connective tissue disease (1:2,000,000 habitants). It is characterized by heterotopic ossification with an uncertain behavior that has been exceptionally related to neoplasms. The objective was to know the coexistence of MOP with neoplasms of mesodermal origin, so that they can be considered in the diagnosis of other patients, as well as formulate hypotheses to clarify their association. Clinical case: 27-year-old female with right gluteal and ischitiobial muscle pain that increased with exercise, without remission with analgesics until limiting the mobility of both extremities. A bone series was requested where areas of heterogeneous radiolucency were evidenced in the region of, both, thighs and pelvis in an irregular manner, similar to bone density, which was compatible with the ultrasound and tomographic findings; we concluded that they were images of myositis ossificans of the hip. The patient reported gastric symptoms and an endoscopy was requested, which histopathologically reported diffuse gastric carcinoma with signet ring cells; cabinet images showed an ovarian tumor. Conclusion: MOP is a low prevalence disease, which is why its knowledge and suspicion are essential for the diagnosis. We found little literature that involves the three entities; therefore, their pathophysiology and understanding is limited. Regarding MOP, at this moment there is no curative treatment; however, an accurate diagnosis allows to start rehabilitation in a timely manner with an improvement in the quality of life.

Breaking infodemic: discovering SARS-CoV-2 / Rompiendo la infodemia: descubriendo el SARS-CoV-2

By December 2019, multiple cases of unexplained pneumonia were reported in some hospitals in the city of Wuhan, China. Since then, it had been confirmed that it corresponded to an acute respiratory infection caused by a new coronavirus that spread quickly, becoming pandemic in a very short time. On the other hand, this pandemic forced confinement for months, something unprecedented. In that time, millions of people went online for entertainment, education, etc. Consequently, the use of the Internet increased, bringing, on the one hand, online education, and entertainment on the Internet, ensuring social distancing; and on the other hand, it brought new new risks to human life, among them rumors. In this way and given the large number of publications that could denote the level of misinformation about COVID-19 and the impact it could have on global public health, various scientific publications were analyzed and identified from a bibliometric point of view. Potential relationships between the descriptors obtained from the bibliometric search were identified. The results were conglomerated into 5 clusters: Cluster 1, related to studies on access to information provided on COVID-19; cluster 2 shows the list of studies that have been carried out on the information on the COVID-19 vaccine, cluster 3 analyzes the different responses given by conspiracy theories, rumors and misinformation about COVID-19, the Group 4 shows cross-sectional and longitudinal research on COVID-19 and the information it provides to the health sector, and cluster 5 represents studies on scientific production and communication that have contributed to global health during the pandemic(AU)

Para diciembre de 2019, se registraron múltiples casos de una neumonía inexplicables en algunos hospitales de la ciudad de Wuhan, China. Desde ese momento se había confirmado correspondía a una infección respiratoria aguda causada por un nuevo coronavirus que se propagó rápidamente haciéndose pandémico en muy poco tiempo. Por otra parte, esta pademia obligó a un confinamiento por meses, algo sin precedente. En ese tiempo, millones de personas se conectaron en línea para entretenimiento, educación, etc. En consecuencia, el uso de Internet aumentó trayendo, por una parte, educación online y entretenimiento en Internet asegurando el distanciamiento social; y por otra parte, trajo nuevos nuevos riesgos a la vida humana, entre ellos los rumores. En ese sentido, y ante la gran cantidad de publicaciones que podrían denotar el nivel de desinformación sobre el COVID-19 y el impacto que podría tener en la salud pública mundial, se analizaron e identificaron diversas publicaciones científicas desde el punto de vista bibliométrico. Se identificaron las relaciones potenciales entre los descriptores arrojados de la búsqueda bibliométrica. Los resultados se conglomeraron en 5 clúster: El clúster 1, relacionado con los estudios sobre el acceso a la información proporcionada sobre COVID-19; el clúster 2, muestra la relación de los estudios que se han realizado sobre la información de la vacuna COVID-19, el clúster 3, analiza las distintas respuestas que dan las teorías conspirativas, los rumores y la desinformación sobre el COVID-19, el grupo 4 muestra investigaciones transversales y longitudinales sobre el COVID-19 y la información que brinda al sector salud, y el clúster 5 representa los estudios sobre producción y comunicación científicas que han contribuido a la salud mundial durante la pandemia(AU)

Osteopontin's relationship with malnutrition and oxidative stress in adolescents. A pilot study.

Osteopontin (OPN) is a protein involved in inflammatory illnesses such as fibrosis and cancer; its overexpression in cardiovascular diseases promotes the biomineralization of blood vessels and other soft tissues. Moreover, there is an active component of oxidative stress related with those diseases. The present study relates serum OPN levels with nutritional condition and oxidative stress in a group of adolescents. Anthropometric measurements were performed, and fasting blood samples were analyzed to determine OPN concentrations, blood chemistry parameters (glucose, triglycerides, total cholesterol, urea, uric acid, and creatinine) and oxidative stress biomarkers (Paraoxonase-1, Glutathione S-Transferase, Catalase, NAD(P)H Quinone Oxidoreductase, free carbonyl groups and malondialdehyde). Adolescents were categorized according to body mass index (BMI) and metabolic syndrome (MetS) criteria. We found increased OPN serum concentrations in overweight and obese adolescents, as well as in adolescents with MetS. Rises in OPN correlated with arm circumference and biomarkers of lipid peroxidation; with regard to serum glucose there was a trend to positive correlation. Our results suggest that serum OPN is associated to nutritional status and could be considered as an early biomarker of low-grade inflammation and probably the early biomineralization of soft tissues in adolescence.

Acute Stroke Care Is at Risk in the Era of COVID-19: Experience at a Comprehensive Stroke Center in Barcelona.

BACKGROUND AND PURPOSE: The purpose of the study is to analyze how the coronavirus disease 2019 (COVID-19) pandemic affected acute stroke care in a Comprehensive Stroke Center. METHODS: On February 28, 2020, contingency plans were implemented at Hospital Clinic of Barcelona to contain the COVID-19 pandemic. Among them, the decision to refrain from reallocating the Stroke Team and Stroke Unit to the care of patients with COVID-19. From March 1 to March 31, 2020, we measured the number of emergency calls to the Emergency Medical System in Catalonia (7.5 million inhabitants), and the Stroke Codes dispatched to Hospital Clinic of Barcelona. We recorded all stroke admissions, and the adequacy of acute care measures, including the number of thrombectomies, workflow metrics, angiographic results, and clinical outcomes. Data were compared with March 2019 using parametric or nonparametric methods as appropriate. RESULTS: At Hospital Clinic of Barcelona, 1232 patients with COVID-19 were admitted in March 2020, demanding 60% of the hospital bed capacity. Relative to March 2019, the Emergency Medical System had a 330% mean increment in the number of calls (158 005 versus 679 569), but fewer Stroke Code activations (517 versus 426). Stroke admissions (108 versus 83) and the number of thrombectomies (21 versus 16) declined at Hospital Clinic of Barcelona, particularly after lockdown of the population. Younger age was found in stroke admissions during the pandemic (median [interquartile range] 69 [64-73] versus 75 [73-80] years, P=0.009). In-hospital, there were no differences in workflow metrics, angiographic results, complications, or outcomes at discharge. CONCLUSIONS: The COVID-19 pandemic reduced by a quarter the stroke admissions and thrombectomies performed at a Comprehensive Stroke Center but did not affect the quality of care metrics. During the lockdown, there was an overload of emergency calls but fewer Stroke Code activations, particularly in elderly patients. Hospital contingency plans, patient transport systems, and population-targeted alerts must act concertedly to better protect the chain of stroke care in times of pandemic.

Physiological Network From Anthropometric and Blood Test Biomarkers.

Currently, research in physiology focuses on molecular mechanisms underlying the functioning of living organisms. Reductionist strategies are used to decompose systems into their components and to measure changes of physiological variables between experimental conditions. However, how these isolated physiological variables translate into the emergence -and collapse- of biological functions of the organism as a whole is often a less tractable question. To generate a useful representation of physiology as a system, known and unknown interactions between heterogeneous physiological components must be taken into account. In this work we use a Complex Inference Networks approach to build physiological networks from biomarkers. We employ two unrelated databases to generate Spearman correlation matrices of 81 and 54 physiological variables, respectively, including endocrine, mechanic, biochemical, anthropometric, physiological, and cellular variables. From these correlation matrices we generated physiological networks by selecting a p-value threshold indicating statistically significant links. We compared the networks from both samples to show which features are robust and representative for physiology in health. We found that although network topology is sensitive to the p-value threshold, an optimal value may be defined by combining criteria of stability of topological features and network connectedness. Unsupervised community detection algorithms allowed to obtain functional clusters that correlate well with current medical knowledge. Finally, we describe the topology of the physiological networks, which lie between random and ordered structural features, and may reflect system robustness and adaptability. Modularity of physiological networks allows to explore functional clusters that are consistent even when considering different physiological variables. Altogether Complex Inference Networks from biomarkers provide an efficient implementation of a systems biology approach that is visually understandable and robust. We hypothesize that physiological networks allow to translate concepts such as homeostasis into quantifiable properties of biological systems useful for determination and quantification of health and disease.

Relación entre las posturas de trabajo y síntomas musculoesqueléticos en estudiantes de odontología en Lima / Relationship between work postures and musculoskeletal symptoms in dental students in Lima

RESUMEN Introducción: La aparición temprana de síntomas musculoesqueléticos es un importante problema de salud ocupacional para los estudiantes de Odontología y que repercute en su calidad de vida. Objetivo: Determinar la relación entre las posturas de trabajo y la aparición temprana de síntomas musculoesqueléticos en los estudiantes de Odontología de la Universidad Nacional Mayor de San Marcos. Material y métodos: Estudio descriptivo, observacional y transversal. La muestra estuvo conformada por 70 estudiantes de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos. Para la determinación de la aparición temprana de síntomas musculoesqueléticos se empleó el Cuestionario Nórdico de Kuorinka y para el tipo de postura de trabajo clínico se empleó una lista de verificación postural. Resultados: Se encontró que 77,1 % (n=54) presentó algún tipo de postura incorrecta. El 67,7 % (n=46) indicó que la zona dorsal/lumbar fue la que presentó una mayor percepción de síntomas musculoesqueléticos, mientras el tipo de nivel de intensidad de dolor que más predominó fue el nivel moderado en la zona cervical (52,6 %), hombro (50 %) y muñeca/mano (40,9 %); en la zona lumbar (43,9 %) predominó un nivel fuerte. El tiempo de padecimiento de los síntomas musculoesqueléticos fue predominantemente entre 6 meses y 1 año. Conclusiones: En la población evaluada no existe una relación entre el tipo de postura y la aparición temprana de síntomas musculoesqueléticos. Asimismo, la zona dorsal/lumbar es la que frecuentemente es afectada durante el trabajo clínico odontológico.

ABSTRACT Introduction: The early appearance of musculoskeletal symptoms is an important occupational health problem for dental students that affects their quality of life. Objective: To determine the relationship between work postures and the early appearance of musculoskeletal symptoms in dental students of the National University of San Marcos. Material and methods: Descriptive, observational and cross-sectional study. The sample consisted of 70 students of the Faculty of Dentistry of the National University of San Marcos. The Kuorinka Nordic questionnaire was used for the determination of the early onset of musculoskeletal symptoms, and a postural checklist was used for the type of clinical work posture. Results: It was found that 77,1 % (n=54) presented some type of incorrect posture. Also, 67,7 % (n=46) indicated that the dorsal lumbar region presented the highest perception of musculoskeletal symptoms, while the level of intensity of pain that prevailed most was the moderate level in the cervical region (52,6 %), shoulder (50 %) and wrist/hand (40,9 %); in the lumbar area (43,9 %) a strong level prevailed. The time of suffering from musculoskeletal symptoms was predominantly between 6 months and 1 year. Conclusions: In the population evaluated, there is no relationship between the type of posture and the early onset of musculoskeletal symptoms. Likewise, the dorsal lumbar region is the one that is frequently affected during clinical dental work.

Neuron numbers increase in the human amygdala from birth to adulthood, but not in autism.

Remarkably little is known about the postnatal cellular development of the human amygdala. It plays a central role in mediating emotional behavior and has an unusually protracted development well into adulthood, increasing in size by 40% from youth to adulthood. Variation from this typical neurodevelopmental trajectory could have profound implications on normal emotional development. We report the results of a stereological analysis of the number of neurons in amygdala nuclei of 52 human brains ranging from 2 to 48 years of age [24 neurotypical and 28 autism spectrum disorder (ASD)]. In neurotypical development, the number of mature neurons in the basal and accessory basal nuclei increases from childhood to adulthood, coinciding with a decrease of immature neurons within the paralaminar nucleus. Individuals with ASD, in contrast, show an initial excess of amygdala neurons during childhood, followed by a reduction in adulthood across nuclei. We propose that there is a long-term contribution of mature neurons from the paralaminar nucleus to other nuclei of the neurotypical human amygdala and that this growth trajectory may be altered in ASD, potentially underlying the volumetric changes detected in ASD and other neurodevelopmental or neuropsychiatric disorders.

Tumor miofibroblástico: una entidad rara, a una edad de presentación neonatal aún más rara. Presentación de caso / Myofibroblastic tumor: a rare entity and even more rare age of presentation. A case report

Se expone el caso de un neonato, a quien durante el examen físico se le palpa una masa en el hipocondrio izquierdo. Le realizan ecografía abdominal con hallazgo de una masa de probable origen suprarrenal; la resonancia magnética (RM) muestra una masa dependiente del mesenterio. En cirugía se observa importante adhesión a los órganos vecinos, se le realiza biopsia con resultado de tumor miofibroblástico. Este tumor hace parte del grupo heterogéneo de lesiones formadoras de masa llamado pseudotumor inflamatorio, el cual se define como una neoplasia fibroblástica/ miofibroblástica, con potencial biológico intermedio, de mayor ocurrencia en niños. Dada la baja frecuencia de aparición en edad neonatal, se realiza una revisión de la literatura acerca de su etiología, diagnóstico y tratamiento.

We present the case of a neonate, who upon physical examination a mass is palpated in the left hypochondrium, Abdominal ultrasound is performed with finding of a mass of probable adrenal origin; magnetic resonance imaging (MRI) shows a mass dependent on the mesentery. In surgery, important adhesion to neighboring organs is observed; biopsy is performed with the result of myofibroblastic tumor. This tumor is part of the heterogeneous group of mass-forming lesions called inflammatory pseudotumor, which is defined as a fibroblastic/myofibroblastic neoplasm, with intermediate biological potential, of greater occurrence in children. Given the low frequency of appearance in neonatal age, a review of the literature about its aetiology, diagnosis and treatment is carried out.

Influence of Hospital Type on Outcomes of Individuals Aged 80 and Older with Stroke Treated Using Intravenous Thrombolysis.

OBJECTIVES: The aim of the study was to confirm the safety and effectiveness of using intravenous thrombolysis (IVT) with individuals aged 80 and older in routine practice in different hospital settings. DESIGN: Observasional registry. SETTING: Prospective multicenter population-based registry of acute stroke patients treated with reperfusion therapies in Catalonia, Spain (Sistema Online d'Informació de l'Ictus Agut). PARTICIPANTS: Individuals treated only with IVT (N = 3,231; 1,189 (36.8%) aged ≥80). MEASUREMENTS: Symptomatic intracranial hemorrhage, mortality, and favorable outcome (modified Rankin Scale (mRS) score = 0-2) at 3 months were evaluated according to hospital characteristics. Treating hospitals were classified in three categories: comprehensive stroke centers (CSCs), primary stroke centers (PSCs), and community hospitals operating a telestroke system (TS). First individuals aged 80 and older were compared with those younger than 80, and then participants aged 80 and older were focused on. RESULTS: Participants aged 80 and older had significantly higher baseline National Institute of Health Stroke Scale (NIHSS) scores, longer onset to treatment times, and worse outcomes than younger participants. For participants aged 80 and older, 90-day mortality was 23.2%, with 38.7% having favorable outcomes at 3 months. Symptomatic intracranial hemorrhage (SICH; Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy definition) was observed in 4.7% of subjects. None of the risk factors differed significantly between participants treated in different types of hospitals. Basal stroke severity measured according to NIHSS score was not significantly different either. The three different types of hospitals achieved similar outcomes, although the TS and PSC hospitals had significantly higher proportions of SICH (6.3% and 6.3%, respectively) than the CSC (3.2%). CONCLUSION: Older adults with acute stroke treated with IVT had similar outcomes regardless of hospital characteristics.

Acciones de cuidado y factores psicosociales en mujeres con diabetes mellitus tipo 2 / Caregiving and psychosocial factors in women with type 2 diabetes mellitus

PROPÓSITO. La diabetes es un problema de salud pública y se ha convertido en un desafío internacional, además de ocasionar daños físicos, puede provocar problemas psicosociales, depresión y estrés dificultando el autocuidado. El objetivo es determinar las acciones de cuidado en mujeres con DMT2 y su relación con síntomas depresivos y angustia. METODOLOGÍA. Estudio descriptivo correlacional. Datos obtenidos de 13 centros de salud. Población 215 mujeres entre 18 y 59 años con diagnóstico de diabetes mellitus tipo 2 (>1 año). Instrumentos utilizados: cuestionario de acciones de cuidado, escala de depresión, escala de distrés o angustia por la diabetes. RESULTADOS. Edad promedio de 45 años (DE=10.10). Las acciones de autocuidado se correlacionaron de forma negativa con depresión (r= -.301; p<.01), angustia (r= -.248; p<.01) y estrés emocional (r= -.203; p<.01), estrés relacionado al tratamiento (r= -.324; p<.01) y estrés interpersonal (r= -.193; p<.01). CONCLUSIÓN. La depresión y angustia juegan un papel importante en el cuidado de la diabetes, éstos se asocian con la falta de realización de actividades de autocuidado. Esto se corroboro evidenciando que las mujeres que realizan mayores acciones de autocuidado son las que tienen menos síntomas depresivos, angustia por diabetes, estrés emocional, estrés por el tratamiento y estrés interpersonal.

PURPOSE. Diabetes is a public health problem and has become an international challenge, as well as causing physical damage, can cause psychosocial problems, depression and stress, making self-care difficult. The objective is to determine the care actions in women with T2DM and their relationship with depressive symptoms and distress. METHODOLOGY. Descriptive correlational study. Data obtained from 13 health centers. Population 215 women between 18 and 59 years old with diagnosis of type 2 diabetes mellitus (> 1 year). Instruments used: self-care actions questionnaire, depression scale, distress scale or diabetes distress. RESULTS. Average age of 45 years (SD = 10.10). Self-care actions are (R = -.301, p <.01), distress (r = -.248; p <.01) and emotional stress (r = -.203; p <.01), related stress to treatment (r = -.324; p <.01) and interpersonal stress (r = -.193; p <.01). CONCLUSION. Depression and anxiety play an important role in caring for diabetes; these are associated with the lack of self-care activities. This corroborates evidence that women who perform greater self-care actions are those who have less depressive symptoms, anxiety, emotional stress, treatment stress and interpersonal stress.

[Prevalence of purchase of antibiotics without prescription and antibiotic recommendation practices for children under five years of age in private pharmacies in peri-urban areas of Lima, Peru]. / Prevalencia de compra sin receta y recomendación de antibióticos para niños menores de 5 años en farmacias privadas de zonas periurbanas en Lima, Perú.

OBJECTIVES: To determine the prevalence of purchase of antibiotics without prescription and antibiotic recommendation for its use in children <5 years of age in private pharmacies in peri-urban areas of Lima. MATERIALS AND METHODS: An anonymous population survey was conducted among adults who bought an antibiotic for a child <5 years of age from a private pharmacy. Fictitious cases were applied in a subgroup of pharmacies to evaluate antibiotic recommendation practices. RESULTS: The prevalence of purchase of antibiotics without a prescription was 13%, including 1.7% that were chosen by consumers and 11.3% that were recommended by pharmacists. A total of 66.7% of the medications purchased to treat colds were antibiotics, 56.9% of which were prescribed. 64.4% of medications purchased to treat bronchospasm, 96.4% of the medications to treat watery diarrhea and 90.9% of the medications to treat pharyngitis were antibiotics. Amoxicillin (51.5%) and trimethoprim-sulfamethoxazole (20.6%) were the most commonly purchased antibiotics. A pharmacist suggested an antibiotic in 60% of the fictitious common cold cases, 76% of the bronchospasm cases, 44% of the watery diarrhea cases, and 76% of the dysentery cases. CONCLUSIONS: The purchase of antibiotics for children <5 years of age in private pharmacies primarily occurs with a medical prescription. The pharmacist commonly recommended an antibiotic in cases lacking a prescription. Measures are needed to reduce the inappropriate use of antibiotics at medical facilities and in pharmacies.