Tuning mono-divalent cation water composition by the capacitive ion-exchange mechanism.

Soil salinization poses a significant challenge to agricultural activities. To address this, the agricultural industry seeks an irrigation water solution that reduces both ionic conductivity and sodium adsorption rate (SAR), thereby diminishing the risks of soil sodification and fostering sustainable crop production. Capacitive deionization (CDI) is an attractive electrochemical technology to advance this search. Recently, a one-dimensional transient CDI model unveiled a capacitive ion-exchange mechanism presenting the potential to adjust the treated water composition by modifying monovalent and divalent cation concentrations, thereby influencing the SAR index. This behavior would be achieved by using electrodes rich in surface functional groups able to efficiently capture divalent cations during conditioning and releasing them during charging while capturing monovalent ions. Beyond the theoretical modelling, the current experimental research demonstrates, for the first time, the effectiveness of the capacitive ion-exchange mechanism in a CDI pilot plant using real water samples spiked with solutions containing specific mono and divalent ions. Electrosorption experiments and computational modeling, specifically Density-Functional Theory (DFT), were used along with the analysis of the surface functional groups present in the electrodes to describe the capacitive ion-exchange phenomenon and validate the steps involved on it, highlighting the conditioning as a critical step. Various operational and flow modes confirm the versatility of CDI technology, achieving separation factors (RMg/Na) of 5-6 in batch, raising production from 0.5 to 0.8 L m-2 h-1 (batch) to 8.0-8.1 L m-2 h-1 when using single pass although reducing RMg/Na to 2. The reliability of the CDI technology in reducing SAR was also successfully tested with different influent compositions, including magnesium and calcium. Finally, the robustness of the capacitive ion-exchange mechanism was validated by a second CDI laboratory 9-cell stack cycled over 350 cycles. Our results confirm the reported theoretical model and expands the conclusions through the experiments in a pilot plant showing direct implications for employing CDI in agricultural applications.

Doxofylline as a steroid-sparing treatment in Mexican children with asthma.

OBJECTIVE: The aim of this pilot study was to assess the efficacy of doxofylline as an ICS-sparing agent in the treatment of Mexican children with asthma. METHODS: 10-week, open-label, crossover, pilot study, we examined the steroid-sparing effect of doxofylline in Mexican children with asthma. Patients aged 6-16 years treated with inhaled corticosteroids (ICS) for at least 8 wk before enrollment were divided randomly into two groups at the baseline visit. Group A (n = 31) received doxofylline (18 mg/kg/day) plus standard-dose budesonide (D + SDB) for the first 4-week period followed by doxofylline plus reduced-dose budesonide (D + RDB) for the second 4-week period. Group B (n = 30) received D + RDB followed by D + SDB. Clinical outcomes assessed included lung function (forced expiratory volume; in 1 s, FEV1), fractional exhaled nitric oxide (FeNO), asthma control, number of exacerbations and use of rescue medication (salbutamol). RESULTS: It was shown that combined use of doxofylline and ICS may allow children with asthma to reduce their daily dose of ICS while maintaining lung function and improving asthma control (p = 0.008). There were few asthma exacerbations and only one patient required treatment with systemic corticosteroids. Rescue medication use decreased significantly in patients receiving D + SDB during the first 4-week period. CONCLUSIONS: Our results suggest that doxofylline may be a steroid-sparing treatment in asthma, but longer-term, controlled studies are needed to confirm these observations.

Interleukin-6 as a biomarker of hypersensitivity reactions in chemotherapeutics and monoclonal antibodies.

BACKGROUND: In recent years, a new type of immediate hypersensitivity reaction known as cytokine release began to emerge, and within this phenotype of reactions, interleukin-6 is the most frequently associated with the presence during drug administration. Chemotherapeutic agents (QT) and monoclonal antibodies. OBJECTIVE: Determine interleukin-6 levels in hypersensitivity reactions to QT and monoclonal antibodies. METHODS: Observational and prospective study that was carried out from March 1, 2021 to March 1, 2022 in a university hospital in northeastern Mexico. Symptoms, severity, interleukin-6 levels, and skin tests of hypersensitivity reaction were evaluated at QT and monoclonal antibodies. RESULTS: A total of 41 patients with oncological disease were included, the most frequent being ovarian cancer. Symptoms as initial hypersensitivity reaction were neuromuscular in taxanes and cutaneous in Platinums.41.5% presented elevation of interleukin-6, and it was found more frequently in presence of metastases. Positive skin tests were found more frequently in the carboplatin and doxorubicin groups. The most frequently presented phenotype was type I in paclitaxel, carboplatin, and doxorubicin, and mixed-reaction (type I and cytokine release) in oxaliplatin. CONCLUSION: With the increasing prevalence of hypersensitivity reactions to biologic and antineoplastic therapies, interleukin-6 should be recognized as a biomarker in immediate hypersensitivity reactions to QT and monoclonal antibodies.

Hypersensitivity Reactions to Taxanes: A Comprehensive and Systematic Review of the Efficacy and Safety of Desensitization.

Taxanes in the treatment of cancer are associated with a significant incidence of hypersensitivity reactions, which may preclude their use in patients in need of first line therapy. Drug desensitization induces transient immunological tolerance and has allowed the reintroduction of taxanes in highly allergic patients. Increase the knowledge of hypersensitivity reactions (HSR) during the administration of taxanes. A systematic review regarding the safety and efficacy of rapid drug desensitization (RDD) for taxanes HSR. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was registered in PROSPERO(CRD42021242324) and a comprehensive search was conducted in Medline, Embase, Web of Science and Scopus databases. 25 studies encompassing 10 countries were identified and 976 patients with initial HSR to paclitaxel (n = 707) and docetaxel (n = 284), that underwent a total of 2,396 desensitizations. The most common symptoms were cutaneous (74.6%) with paclitaxel and respiratory (72.6%) with docetaxel. Severe initial hypersensitivity reactions including anaphylaxis occurred in 39.6% and 13% of paclitaxel and docetaxel cases respectively and during the first (87.4%) or second exposure (81.5%). Patients tolerated well RDD and breakthrough reactions (BTR) occurred in 32.2% of paclitaxel-treated patients and in 20.6% of docetaxel treated patients. Premedications included corticosteroids, antihistamines and leukotriene receptor antagonists. The most commonly used protocol was the BWH 3 bags 12 steps, all protocols showed a success rate between 95-100%, with no reported deaths. RDD is a safe and effective procedure in patients with HSR to taxanes and protocols should be standardized for wide range implementation.

Hypersensitivity reactions to anticancer chemotherapy and monoclonal antibodies: Safety and efficacy of desensitization.

BACKGROUND: Hypersensitivity reactions to anticancer chemotherapy and monoclonal antibodies may lead to discontinuation of first-line treatment options. Identification of these reactions can provide specific diagnosis and treatment by rapid drug desensitizations. OBJECTIVE: To determine the hypersensitivity reactions involved in anticancer chemotherapy and monoclonal antibodies, and the safety and efficacy of rapid drug desensitization. METHODS: We conducted an observational study of hypersensitivity reaction presented after the administration of anticancer chemotherapy and monoclonal antibodies in Mexico. We documented the symptoms of initial reaction and their severity, and the results of skin tests. We also report our experience of the administration of 12-step (mild-moderate reactions) and 16-step (severe reactions) desensitization protocols in these patients. RESULTS: Overall, 93 patients received 336 rapid drug desensitization; 105 to taxanes, 115 to platinum drugs, 101 to monoclonal antibodies, and 15 other anticancer chemotherapy. Hypersensitivity reaction to taxanes occurred in the first or second administration, platinum drugs after the sixth cycle, and rituximab in the first cycle. The most common symptom in carboplatin was urticaria, paclitaxel back pain, oxaliplatin and docetaxel dyspnea, and in the monoclonal antibodies cardiovascular symptoms. Skin tests were positive in 75% of the carboplatin group, and only 16.7% in docetaxel. There was a rapid drug desensitization success rate of 99.4% and 85.7% did not present any related hypersensitivity reaction. CONCLUSION: The diagnosis of hypersensitivity reaction to anticancer chemotherapy and monoclonal antibodies offers a panorama in the management of oncological diseases. Our standardized desensitization protocol is safe and effective and can be reproduced in other centers to treat patients who need to maintain first-line treatment.

A Systematic Study on the Redox Potentials of Phenazine-Derivatives in Aqueous Media: A Combined Computational and Experimental Work.

Phenazines are an emerging class of organic compounds that have been recently utilized in aqueous redox flow batteries, a promising technology for large-scale energy storage. A virtual screening based on density functional theory calculations is used to investigate the redox potentials of around 100 phenazine derivatives in aqueous media containing various electron-donating or electron-withdrawing groups at different positions. The calculations identify the crucial positions that should be functionalized with multiple hydroxy groups to design new anolytes. The combined experimental-computational methodology reported herein guides the development of a new molecule with a record low reversible redox potential as a potential anolyte for aqueous redox flow batteries.

Predictive factors for nephrectomy in renal trauma; assessment of a 6-point score.

PURPOSE: To evaluate predictive and associated risk factors for nephrectomy in renal trauma and assess a 6-point score for surgical decision-making. PATIENTS AND METHODS: This multicenter, retrospective, and observational study assessed 247 subjects with blunt or penetrating kidney trauma. Kidney injuries were classified according to the American Association for the Surgery of Trauma (AAST) Injury Scoring Scale. Renal trauma was classified as "low-grade" (Grades I-III), Grade IV, and Grade V. Subjects were compared according to conservative treatment (CTrt.) or nephrectomy. Predictive factors were evaluated with a multiple regression model. A 6-point score was evaluated with a ROC analysis. RESULTS: Patients requiring nephrectomy had a lower mean arterial pressure MAP compared to CTrt, 64.71 mmHg (SD ± 10.26) and 73.86 (SD ± 12.42), respectively (p = < 0.001). A response to IV solutions was observed in 90.2% of patients undergoing CTrt. (p = < 0.001, OR = 0.211, 95%CI = 0.101-0.442). Blood lactate ≥ 4 mmol/L was associated with nephrectomy (p = < 0.001). A hematoma ≥ 25 mm was observed in 41.5% of patients undergoing nephrectomy compared to 20.1% of CTrt. (p = 0.004, OR = 9.29, 95% CI = 1.37-5.58). A logistic regression analysis (p = < 0.001) showed that blood lactate ≥ 4 mmol/L (p = 0.043), an inadequate response to IV solutions (p = 0.041) and renal trauma grade IV-V (p = < 0.001), predicted nephrectomy. A 6-point score with a cut-off value ≥ 3 points showed 83% sensitivity and 87% specificity for nephrectomy with an AUC of 89.9% (p = < 0.001). CONCLUSIONS: An inadequate response to IV solutions, a lactate level ≥ 4 mmol/L, and grade IV-V renal trauma predict nephrectomy. A score ≥ 3 points showed a good performance in this population.

Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation.

INTRODUCTION: Pre-apheresis peripheral blood CD34+ cell count (PBCD34+) is the most important predictor of good cell mobilization before hematopoietic stem cell transplantation, albeit flow cytometry is not always immediately available. Identification of surrogate markers can be useful. The CD34+ cells proliferate after mobilization, resulting in elevated lactate dehydrogenase (LDH) activity and correlating with the PBCD34+ count. OBJECTIVE: To determine the LDH cut-off value at which adequate CD34+ cell mobilization is achieved and its diagnostic yield. MATERIALS AND METHODS: A total of 103 patients who received an autologous stem cell transplantation (ASCT) between January 2015 and January 2020 were included. Demographic and laboratory characteristics were obtained, including complete blood count, pre-apheresis PBCD34+ and LDH levels. Receiver operating characteristic (ROC) curves were performed to identify the optimal serum LDH activity cut-off points for ≥ 2 and ≥ 4 × 106 cells/kg post-mobilization CD34+ count and their diagnostic yield. RESULTS: A post-mobilization serum LDH cut-off value of 462 U/L yielded a sensitivity (Se) = 86.8% (positive predictive value [PPV] = 72.7%), a pre- and post-mobilization serum LDH difference cut-off value of 387 U/L, an Se = 45.7% (PPV = 97%) and an LDH ratio of 2.46, with an Se = 47.1% (PPV = 97%) for an optimal mobilization count (CD34+ ≥ 4 × 106). CONCLUSION: The LDH measurement represents a fast and affordable way to predict PBCD34+ mobilization in cases where flow cytometry is not immediately available. According to the LDH diagnostic yield, it could be used as a surrogate marker in transplant centers, supporting the CD34+ count, which remains the gold standard.

Anxiety in Mexican adults throughout the COVID-19 pandemic: A cross sectional study.

INTRODUCTION: Perceived fear during a pandemic along with measures used to contain it can develop or intensify anxiety symptoms. In Mexico, information on the psychological impact of the COVID-19 pandemic in the general population is scarce. OBJECTIVE: We examined the prevalence and factors associated with anxiety during the COVID-19 outbreak in a Mexican sample. METHOD: We conducted a cross sectional study from June 15, 2020, to January 31, 2021, in a state in north-eastern Mexico, using an online survey. Beck Anxiety Inventory was used to determine the prevalence and severity of anxiety. RESULTS: The overall prevalence of anxiety was 43.5 %. Categories with the highest anxiety prevalence within their groups were women (46.2 %), age group of 18-30 years (47.3 %), higher level of education (43 %), students (48.8 %) and people who weren't currently with a couple (47.3 %). Additionally, we found that people who reported clinically significant anxiety were more likely to be women, ages 18-30 years, not currently partnered and currently living with a psychiatric disorder. Moreover, patients with clinically significant anxiety were more likely to be diagnosed with a mood, anxiety, trauma and stress, or an eating disorder. We also observed that being a woman and having at least one psychiatric disorder were independent factors related to a positive anxiety screening. DISCUSSION AND CONCLUSION: COVID-19 outbreak results in considerable increase in anxiety symptoms among the Mexican population. It is important to acknowledge the psychological impact of contingency situations to provide information that can allow establishing preventive and therapeutic strategies.

Trauma cervical penetrante: experiencia de un hospital de enseñanza en México / Penetrating cervical trauma: experience of a teaching hospital in Mexico

Introducción. El trauma cervical penetrante es una entidad poco frecuente, con tendencia al alza, de considerable morbimortalidad. Es fundamental conocer su manejo por cirujanos en entrenamiento, quienes en su mayoría son comúnmente los proveedores del tratamiento en las áreas de urgencias. El objetivo de este estudio fue demostrar la experiencia de un centro de trauma en México en el tratamiento de trauma cervical penetrante administrado por cirujanos en entrenamiento. Métodos. Estudio retrospectivo de pacientes con diagnóstico de trauma cervical penetrante sometidos a exploración cervical entre los años 2014 y 2019. Se identificaron 110 expedientes, se excluyeron 26 por falta de datos indispensables para la investigación y se analizaron los datos de 84 pacientes. Resultados. El 96,4 % de los pacientes fueron hombres, la mayoría entre 16 y 50 años (83,3 %) y la zona anatómica II fue la más comúnmente lesionada (65,4 %). Las etiologías más frecuentes fueron heridas por arma cortopunzante (67,9 %) y heridas por proyectil de arma de fuego (25 %). El 95 % de los procedimientos fueron realizados por residentes de cuarto y quinto año. La mediana de días de estancia hospitalaria fue de 2 días. La incidencia de complicaciones fue de 9,5 % y la mortalidad de 1,2 %. Conclusiones. Los cirujanos generales en etapa de formación entrenados en centros de trauma tienen la capacidad de tratar de forma óptima el trauma cervical penetrante sin modificación de las tasas de morbimortalidad descritas en la literatura internacional.

Introduction. Penetrating cervical trauma is a rare entity, with an upward trend, of considerable morbidity and mortality. It is essential to acknowledge its management by surgeons in training, who are usually the providers in the emergency areas. The objective of this study was to demonstrate the experience of a trauma center in Mexico in the treatment of penetrating cervical trauma by surgeons in training. Methods. This was a retrospective study of patients diagnosed with penetrating cervical trauma who underwent cervical examination between 2014 and 2019; 110 records were identified, 26 were excluded due to lack of essential data for the analysis, and the data of 84 patients were included. Results. 96.4% of the patients were men, the majority between 16 and 50 years old (83.3%) and the anatomic zone II was the most frequently injured (65.4%). The most common etiologies were stab wounds (67.9%) and gunshot wounds (25%). Ninety five percent of the procedures were performed by fourth- and fifth-year residents. The median number of days of hospital stay was 2 (2-4) days. The incidence of complications was 9.5% and mortality in 1.2%. Conclusions. General surgeons in the trauma training stage can optimally treat penetrating cervical trauma with the same morbidity and mortality rates described in the international literature.

Staph's Toxins IgE Antibodies and Its Relation to the Severity of Allergic Rhinitis.

Background: Specific IgE against Staphylococcus can be found in approximately 40% of patients with allergies, also in patients without allergies because they may be sensitized. These antibodies are functional, and they can induce histamine release contributing to chronic pruritus which can worsen disease severity. The objective of this study was to compare levels of specific IgE against S. aureus toxins in those populations. Methods: A cross-sectional, comparative non-blinded survey was made at the Regional Center for Allergy and Clinical Immunology. Ninety-nine adults between 18 and 70 years of age with allergic rhinitis (AR) and without allergic rhinitis (wAR) were recruited. A clinical history and demographic data, and allergic sensitization patterns to 35 aeroallergens were obtained, and participants were classified according to their severity using the Allergic Rhinitis and Its Impact on Asthma (ARIA) classification. Specific IgE levels were determined using ImmunoCAP™ 100 platform. Results: The median age (IQR) of the participants was 23 (20-33.7); 56.2% were women. The most frequent comorbidities were asthma and obesity. Of the patients with AR, 46.7% were classified as mild intermittent and 25% as moderate persistent. IgE levels against staph toxins A, B, and TSST were significantly higher in the AR group vs the wAR group [median IQR 0.01 (0.01-0.03) vs. 0.01 (0-0.02), p = 0.01; 0.02 (0.01-0.03) vs. 0.01 (0-0.02), p= 0.02; 0.04 (0.02-0.09) vs. 0.01 (0-0.04), p=0.002, respectably]. A significant difference was found in serum IgE levels against Staph B toxin between severity subgroups. Conclusion: People with AR have higher IgE levels against staph toxins A, B and TSST than wAR subjects. However, it is not possible declare that the IgE titers were related to disease severity.

Factors associated with the desire to undergo post-mastectomy breast reconstruction in a Mexican breast cancer center.

PURPOSE: To assess the proportion of breast cancer patients treated with total mastectomy who are interested in undergoing breast reconstruction, the factors associated with their desire to undergo this procedure, and the motives stated for their decision. METHODS: Women with stage I-III breast cancer, public health insurance, and history of total mastectomy treated at a center in Monterrey, Mexico, were invited to answer a series of questionnaires regarding their clinical and demographic characteristics, information received about breast reconstruction, body image, and relationship satisfaction. RESULTS: A total of 100 patients were interviewed, of which 68% desired to undergo breast reconstruction. Only 35% recalled talking about this procedure with a physician and 85% claimed not to have enough information to make an informed decision. Those who desired breast reconstruction were younger (p < 0.001), more likely to be in a relationship (p = 0.025), and had a higher probability of having talked to a physician about the procedure (p = 0.019). Furthermore, they felt less sexually attractive (p < 0.001), more deformed (p = 0.006), and less feminine (p = 0.005) since the mastectomy. The main motives to undergo this procedure were to have breast symmetry and greater freedom on which clothes to wear, while the main deterrent was the high economical cost. CONCLUSIONS: Insufficient information about the procedure and high economical cost were identified as potential barriers to undergo breast reconstruction. The findings of this study emphasize the pressing need to optimize patient care by providing information in a standardized manner and improving access to breast reconstruction within the Mexican public healthcare system.

Estudios de laboratorio como herramienta en la identificación de apendicitis aguda y su diferenciación con hiperplasia linfoide / Laboratory studies as a tool for the differential diagnosis between acute appendicitis and lymphoid hyperplasia

RESUMEN Antecedentes: La apendicitis aguda (AA) es una de las principales patologías quirúrgicas en México y el mundo. A pesar de ser una patología frecuente, el manejo quirúrgico presenta una tasa del 10-20% de apendicitis blancas (AB) o hiperplasia folicular linfoide (HPL) por histopatología. Objetivo: Comparar los hallazgos clínicos, de laboratorio y radiológicos de pacientes con sospecha de AA con su diagnóstico por histopatología. Material y métodos: El estudio es retrospectivo, observacional y transversal. Se analizaron los datos de los pacientes con diagnóstico clínico de apendicitis aguda, desde febrero de 2013 hasta diciembre de 2017, atendidos en un hospital de tercer nivel en Monterrey, México. Se compararon los hallazgos de los pacientes con diagnóstico de AA vs. HPL, AA no complicadas vs. AA complicadas y pacientes pediátricos vs. adultos. Se realizó un análisis descriptivo por medio de frecuencias y porcentajes, y mediana y rango intercuartil (RIC), dada la distribución no paramétrica de estas variables. Se compararon los hallazgos por laboratorio mediante la prueba de Mann-Whitney. Se consideró una p< 0,05 como estadísticamente significativa. Resultados: En nuestro medio, ambos sexos tienen la misma frecuencia de presentación de AA. El tiempo de evolución es significativo en la presentación frecuente de AA complicada. Existe asociación entre leucocitosis, neutrofilia total y porcentual y recuento plaquetario mayor en presencia de AA vs. HPL. Conclusión: Los estudios de laboratorio no muestran cambios significativos en pacientes pediátricos con AA. En adultos con AA no complicada vs. apendicitis complicada, el aumento en WBC, NEU y NEU% son estadísticamente significativos.

ABSTRACT Background: Acute appendicitis (AA) is one of the main surgical pathologies in our country and worldwide. Despite being a surgery that is frequently done, it is still reported a 10-20% of negative appendectomies (NA). Objective: The objective of the study is to compare clinical, laboratory and radiology results with the histopathology diagnosis. Material and methods: A retrospective study was done analyzing the data of patients with clinical diagnosis of AA from February 2013 to December 2017, in a tertiary hospital in Monterrey, Mexico. They were classified by their histopathological results into different groups: AA or NA; and the AA was subdivided into complicated AA and uncomplicated AA. Finally, these groups were also subdivided by ages, into pediatric and adult groups of each category. A descriptive analysis was made using frequencies, percentages, median and the interquartile range. Laboratory results were compared with the Mann-Whitney test. Considering a p-value of p < 0.05 as statistically significant. Results: In our group of patients both genders had AA in a similar frequency, the time between the appearance of symptoms and reaching for medical advice was an important factor for having complicated AA. There is a correlation between leukocytosis, neutrophil count and platelet count elevated in presence of AA against NA. Conclusion: Laboratory studies did not report significant changes in pediatric patients with AA. In adults with uncomplicated AA vs. complicated AA, white blood cell count, and neutrophil count are statistically significant.

Asociación de tipología familiar y disfuncionalidad en familias con adolescentes de una población mexicana / Association of family typology and dysfunction in families with adolescents from a Mexican population

OBJETIVO: Determinar la asociación entre tipología y disfuncionalidad familiar en familias mexicanas con adolescentes. DISEÑO: Estudio observacional de tipo transversal. EMPLAZAMIENTO Y PARTICIPANTES: Cuatrocientas treinta y siete familias con adolescentes inscritos en una escuela secundaria pública de una población mexicana. Mediciones principales: Determinación de la tipología familiar (Consejo y Consenso Mexicano de Medicina Familiar) y la funcionalidad familiar (APGAR familiar) en adolescentes y sus padres/tutores. Identificación de las familias con percepciones concordantes entre miembros (kappa de Cohen), en las cuales se determinó la asociación entre tipología y percepción de disfuncionalidad familiar (odds ratio [OR]). RESULTADOS: Los tipos de familias están asociados con la funcionalidad familiar por parentesco, presencia física en el hogar y el nivel de pobreza familiar. Desde la percepción del adolescente, se asocian los tipos: nuclear simple (OR 0,5, IC 95% 0,3-0,8), monoparental extendida (OR 1,9, IC 95% 1,03-3,5), núcleo integrado (OR 0,6, IC 95% 0,4-0,9), pobreza familiar baja (OR 0,5, IC 95% 0,3-0,8) y pobreza familiar alta (OR 5,3, IC 95% 1,5-18,6). Desde la percepción del tutor: la monoparental (OR 1,9, IC 95% 1,09-3,4) y de pobreza familiar alta (OR 2 9, IC 95% 1,1-7,7). Hubo 259 familias con percepción concordante de funcionalidad/disfuncionalidad familiar con un kappa = 0,189, determinando que los tipos asociados son: la nuclear simple (OR 0,4, IC 95% 0,2-0,7), monoparental (OR 1,7, IC 95% 0,80-3,8), núcleo integrado (OR 0,5, IC 95% 0,3-0,8), núcleo no integrado (OR 1,9, IC 95% 1,09-3,5) y pobreza familiar alta (OR 13,8, IC 95% 1,7-108,5). CONCLUSIÓN: Los tipos de familia con adolescentes asociadas con disfuncionalidad familiar son las monoparentales, las de núcleo no integrado y aquellas con pobreza familiar alta, y como factores de protección, la nuclear simple y con núcleo integrado

OBJECTIVE: To determine the association between family typology and dysfunction in families with adolescents in a Mexican population. DESIGN: Cross-sectional observational study. Setting and population: A total of 437 families in a Mexican population with adolescents attending a public high school. MAIN MEASUREMENTS: Determination of family typology (Mexican Family Medicine Council and Consensus) and family function (family APGAR) in adolescents and their parents/guardians. Identification of families with concordant perceptions among members (Cohen kappa), in which the association between typology and perception of family dysfunction was determined (odds ratio [OR]). RESULTS: The types of families are associated with family function by kinship, physical presence in the home and the level of family poverty. From the perception of the adolescent, the types are associated with: simple nuclear (OR 0.5, 95% CI 0.3-0.8), extended single parent (OR 1.9, 95% CI 1.03-3.5), integrated nucleus (OR 0.6, 95% CI 0.4-0.9), low family poverty (OR 0.5, 95% CI 0.3-0.8), and high family poverty (OR 5.3, 95% CI 1.5-18.6). From the perception of the tutor: the single parent (OR 1.9, 95% CI 1.09-3.4), and high family poverty (OR 2.9, 95% CI 1.1-7.7). There were 259 families with concordant perception of family function/dysfunction with a Kappa = 0.189, determining that the types associated are: simple nuclear (OR 0.4, 95% CI 0.2-0.7), single-parent (OR 1.7, 95% CI 0.80-3.8), integrated nucleus (OR 0.5, 95% CI 0.3-0.8), non-integrated nucleus (OR 1.9, 95% CI 1.09-3.5), and high family poverty (OR 13.8, 95% CI 1.7-108.5). CONCLUSION: The family types with adolescents associated with family dysfunction are single-parent families with a non-integrated nucleus and high family poverty, and as protective factors, the simple nuclear and integrated nucleus

[Association of family typology and dysfunction in families with adolescents from a Mexican population]. / Asociación de tipología familiar y disfuncionalidad en familias con adolescentes de una población mexicana.

OBJECTIVE: To determine the association between family typology and dysfunction in families with adolescents in a Mexican population. DESIGN: Cross-sectional observational study. SETTING AND POPULATION: A total of 437 families in a Mexican population with adolescents attending a public high school. MAIN MEASUREMENTS: Determination of family typology (Mexican Family Medicine Council and Consensus) and family function (family APGAR) in adolescents and their parents/guardians. Identification of families with concordant perceptions among members (Cohen kappa), in which the association between typology and perception of family dysfunction was determined (odds ratio [OR]). RESULTS: The types of families are associated with family function by kinship, physical presence in the home and the level of family poverty. From the perception of the adolescent, the types are associated with: simple nuclear (OR 0.5, 95% CI 0.3-0.8), extended single parent (OR 1.9, 95% CI 1.03-3.5), integrated nucleus (OR 0.6, 95% CI 0.4-0.9), low family poverty (OR 0.5, 95% CI 0.3-0.8), and high family poverty (OR 5.3, 95% CI 1.5-18.6). From the perception of the tutor: the single parent (OR 1.9, 95% CI 1.09-3.4), and high family poverty (OR 2.9, 95% CI 1.1-7.7). There were 259 families with concordant perception of family function/dysfunction with a κ=0.189, determining that the types associated are: simple nuclear (OR 0.4, 95% CI 0.2-0.7), single-parent (OR 1.7, 95% CI 0.80-3.8), integrated nucleus (OR 0.5, 95% CI 0.3-0.8), non-integrated nucleus (OR 1.9, 95% CI 1.09-3.5), and high family poverty (OR 13.8, 95% CI 1.7-108.5). CONCLUSION: The family types with adolescents associated with family dysfunction are single-parent families with a non-integrated nucleus and high family poverty, and as protective factors, the simple nuclear and integrated nucleus.

External Validation of the ISAN, A2DS2, and AIS-APS Scores for Predicting Stroke-Associated Pneumonia.

BACKGROUND: The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN), Age, Atrial Fibrillation, Dysphagia, male sex, and National Institutes of Health Stroke Scale (A2DS2), and acute ischemic stroke-associated pneumonia score (AIS-APS) scores were created to predict stroke-associated pneumonia (SAP), one of the most important medical stroke complications. External validation of all such scores in an acute stroke population was the aim of our study. METHODS: Patients with ischemic or hemorrhagic stroke were prospectively enrolled in the multicenter Stroke-Induced Pneumonia in Andalucía project between October 2014 and May 2016. Receiver operating characteristic curves and linear regression analyses were used to determine discrimination ability of the scores. The Hosmer-Lemeshow goodness-of-fit test and the plot of observed versus predicted SAP risk were used to assess model calibration. RESULTS: Among 201 included patients, SAP rate was 15.5% (31). Higher ISAN, A2DS2, and AIS-APS scores were related to SAP (all P < .001). The C statistic was .83 (95% confidence interval [CI], .76-.91) for the ISAN score, .80 (95% CI, .70-.89) for the A2DS2 score, and .82 (95% CI, .74-.90) for the AIS-APS score, suggesting good discrimination. The ISAN and AIS-APS scores showed good calibration (Cox and Snell R2 = .206 and .174, respectively). The A2DS2 score showed the highest sensitivity (87%), and the AIS-APS score showed the highest specificity (92.8%). CONCLUSIONS: In our cohort, the external validation of ISAN, A2DS2, and AIS-APS scores have demonstrated their accurate prediction of SAP and the ability of these scores as screening tools to better manage SAP. The AIS-APS score would be recommendable for the development of future clinical trials.

Effects of twelve weeks of aerobic or strength training in addition to standard care in Parkinson's disease: a controlled study.

BACKGROUND: Physical exercise in addition to standard care (SC) in patients with Parkinson's disease (PD) is now a common practice in many care units. However, exercises can cover a wide range of interventions, and the specific effects of different interventions still deserve to be further investigated. AIM: The aim of this study was to compare the effects of 12 weeks of two different types of physical exercises with SC in patients suffering from PD. DESIGN: Pseudo-randomized controlled trial. SETTING: University laboratory for outcomes, University Hospital Centre for interventions. POPULATION: Fifty-two outpatients suffering from mild to moderate PD at baseline. METHODS: Participants were allocated to three groups: the strength training (ST) group performed individualized upper and lower limbs strength training, the aerobic training (AE) group performed tailored gradual aerobic cycling, and the third group received SC. The effects of the interventions on body function were assessed by measuring isokinetic concentric peak torque for knee extension and flexion, peak oxygen consumption (VO2peak) and peak work load (PWL) during an incremental maximal cycling test. Changes in mobility were evaluated from spatial-temporal gait features measured by mean of an accelerometer system and the Six-Minute Walk Distance (6MWD) Test. We used questionnaires to estimate health-related quality of life and habitual physical activity. RESULTS: No significant changes in any outcome measures occurred in the SC group. More than 80% of the participants adequately completed the AE and the ST interventions. The ST group significantly improved all peak torque measures (P≤0.01), except knee extension in the least affected side (P=0.13). This group also improved the PWL (P=0.009) and 6mwd (P=0.03). The AE group improved the VO2peak (P=0.02) and PWL (P<0.001). CONCLUSIONS: Physical fitness in patients with PD rapidly improved in compliance with training specificities, but better fitness hardly translated into better mobility and health-related quality of life. CLINICAL REHABILITATION IMPACT: Physiotherapists can efficiently propose physical conditioning to patients with mild to moderate PD, but these interventions are insufficient to improve gait and participation. Notwithstanding, ST is an efficient intervention for improving walking capacity.

Exploratory behaviour modulates the relationship between colony familiarity and helping in a cooperative bird.

Individuals within animal groups may differ in personality and degree of familiarity raising the question of how this influences their social interactions. In Iberian magpies Cyanopica cooki, a portion of first-year males engage in cooperative behaviours and dispersal, allowing addressing this question. In this study, we first investigate the relationship between colony familiarity (native versus foreign) and reproductive status (breeding versus helping) of males during 21 years. Secondly, we measure the exploratory behaviour and monitor reproductive status of a sample of individuals with different colony familiarity during 2 years. Long-term monitoring revealed that foreign individuals were more likely breeders. The analysis on the subset of individuals in which exploratory behaviour was measured revealed a mediatory effect of exploratory behaviour in the association between colony familiarity and helping behaviour. Specifically, among foreign individuals, higher explorative males were more frequently involved in helping behaviour than lower explorative ones. Conversely, among native males, breeders were more explorative than helpers. Our results suggest that aspects of personality may mediate the value of familiarity in reproductive tasks in social species.

MODE OF ATTACHMENT AND PATHOLOGY CAUSED BY PARORCHITES ZEDERI IN THREE SPECIES OF PENGUINS: PYGOSCELIS PAPUA, PYGOSCELIS ADELIAE, AND PYGOSCELIS ANTARCTICA IN ANTARCTICA.

We identified and compared gross and microscopic lesions associated with the cestode, Parorchites zederi, in the digestive tracts of three species of penguins (Spheniscidae): the Chinstrap ( Pygoscelis antarctica ), Gentoo ( Pygoscelis papua ), and Adélie penguins ( Pygoscelis adeliae ). The gastrointestinal tracts of 79 recently dead individuals (71 chicks and eight adults) were collected in locations throughout the Antarctic Peninsula during summer field trips in 2006-09. Parorchites zederi was found in the small intestine of 37 animals (47%), and 23 (62%) of these had parasite-associated lesions. The cestodes were either free in the intestinal lumen, clustered within mucosal ulcers, or deeply embedded in the intestinal wall. Histopathologic changes were most severe in adult Gentoo Penguins and included transmural fibrogranulomatous enteritis, hemorrhage, and edema. This report of pathology associated with P. zederi in the digestive tracts of penguins can serve as reference to monitor health in Antarctic birds associated with environmental changes.