The effect of a visuospatial interference intervention on posttraumatic intrusions: a cross-over randomized controlled trial.

Background: Intrusive memories form a core symptom of Posttraumatic Stress Disorder (PTSD). Based on concepts of visuospatial interference and memory-updating accounts, technological innovations aim to attenuate such intrusions using visuospatial interventions.Objective: This study aims to test the effect of a visuospatial Tetris-based intervention versus a verbal condition (Wiki) and a never-targeted control (no intervention) on intrusion frequency.Method: A randomized crossover trial was conducted including N = 38 PTSD patients who had at least 3 distinct intrusive memories of trauma. After both 2 weeks (intervention 1) and 4 weeks (intervention 2), one of the three memories was randomly selected and either the visuospatial intervention (memory reminder of a traumatic memory + Tetris) or verbal condition (reading a Wikipedia article + answering questions) was performed on their first memory in randomized order. In the week 4 session, the patient conducted the other intervention condition on their second memory (crossover). The third memory was never targeted (no intervention). Daily occurrence of intrusions over 8 weeks was collected using a diary and analysed using mixed Poisson regression models.Results: Overall, there was no significant reduction in intrusion frequency from either intervention compared to each other, and to no intervention control (relative risk Tetris/Wiki: 0.947; p = .31; relative risk no intervention/Tetris: 1.060; p = .15; relative risk no intervention/Wiki: 1.004; p = .92).Conclusions: There was no effect of either intervention on intrusions when administered in a crossover design where participants received both interventions. Design shortcomings and consequences for future studies are discussed.

Visuospatial interventions, including the computer game Tetris, have been studied as a potential means to decrease intrusive memories, a core feature of Posttraumatic Stress Disorder.In this study, two interventions are tested in a crossover design with patients with intrusive memories after traumatic experiences.There was no effect of either the visuospatial intervention or the verbal condition in this design.

Test UD Interferencia: Creación y validación de un nuevo instrumento de resistencia a la interferencia. Normalización y estandarización en población española / UD Interference Test: Creation and validation of a new instrument of resistance to interference. Normalization and standardization for Spanish population

Introducción: El test UD Interferencia evalúa la velocidad de procesamiento y la atención, y está basado en el concepto de interferencia del test de Stroop. El objetivo principal de este estudio es proporcionar una versión alternativa del test de Stroop que evite algunas de las limitaciones de versiones anteriores, relacionadas con el daltonismo y las dificultades de lectura en personas mayores, y obtener datos normativos y estandarizados para este test, adaptados a población española. Métodos: El estudio se enmarca dentro del proyecto Normacog, para el cual se evaluó a 905 participantes (18-93 años). Se analizó la fiabilidad y la validez concurrente y de constructo del test. Se analizaron el efecto de la edad, nivel educativo y sexo sobre el rendimiento en UD Interferencia y se crearon percentiles y puntuaciones escalares ajustadas por edad y nivel educativo. Resultados: El test muestra buena fiabilidad (α = 0,875) y validez concurrente (r de 0,443 a 0,725; p < 0,001) y de constructo (r de 0,472 a 0,737; p < 0,001). Se observó un efecto significativo de la edad y el nivel educativo sobre el rendimiento en UD Interferencia, explicando del 12 al 40% de la varianza. El sexo únicamente presentó un efecto significativo en la variable índice de resistencia a la interferencia. Conclusiones: Se presenta una versión alternativa del test de Stroop que presenta algunas ventajas sobre anteriores versiones. Se aportan baremos estandarizados y normalizados para población española que permiten corregir el test teniendo en cuenta la edad y educación de la persona evaluada.(AU)

Introduction: The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Test. The main purpose of the study is to provide an alternative version of the Stroop Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. Methods: This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. Results: The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; p < .001) and construct validity (r = 0.472-0.737; p < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12-40% of variance. Sex only had a significant effect on the resistance to interference index. Conclusions: We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.(AU)

UD Interference Test: creation and validation of a new instrument of resistance to interference. Normalisation and standardisation for Spanish population.

INTRODUCTION: The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Color and Word Test. The main purpose of the study is to provide an alternative version of the Stroop Color and Word Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. METHODS: This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. RESULTS: The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; P < .001) and construct validity (r = 0.472-0.737; P < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12% to 40% of variance. Sex only had a significant effect on the resistance to interference index. CONCLUSIONS: We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.

Current vision on diagnosis and comprehensive care in hepatic encephalopathy.

The first clinical guidelines on hepatic encephalopathy were published in 2009. Almost 14 years since that first publication, numerous advances in the field of diagnosis, treatment, and special condition care have been made. Therefore, as an initiative of the Asociación Mexicana de Gastroenterología A.C., we present a current view of those aspects. The manuscript described herein was formulated by 24 experts that participated in six working groups, analyzing, discussing, and summarizing the following topics: Definition of hepatic encephalopathy; recommended classifications; epidemiologic panorama, worldwide and in Mexico; diagnostic tools; conditions that merit a differential diagnosis; treatment; and primary and secondary prophylaxis. Likewise, these guidelines emphasize the management of certain special conditions, such as hepatic encephalopathy in acute liver failure and acute-on-chronic liver failure, as well as specific care in patients with hepatic encephalopathy, such as the use of medications and types of sedation, describing those that are permitted or recommended, and those that are not.

Biotin interference in several electrochemiluminescence immunoassays (eclia) / Interferencias por biotina en varios inmunoensayos de electroquimioluminiscencia

Background: The aim of this study is to define the interference of biotin in several endocrine, tumor marker, and vitamin assays performed by an electrochemiluminescence method, trying to determinate the critical level that causes biotin interference.– Material and methods: Working biotin solutions were prepared in phosphate-buffered saline (PBS) at different concentrations (10000, 7500, 5000, 2500, 1250, 625, and 312.5 ng/mL), which were spiked on the samples to obtain final concentrations ten-fold lower. Each serum biotin dilution was tested in triplicate, using at least two levels of analytes. Determinations of several endocrine, vitamins, tumor and bone markers were carried-out with eletrochemilumenescent immunoassays on the cobas e801 and cobas e411. Comparison between the results obtained by analyzing the biotin-spiked samples and the reference PBS-spiked samples was performed using Microsoft Excel. The relative bias with the interfering-free specimen was calculated for each biotin concentration. Interference was considered significant when the relative bias exceeded 10%. Glick´s interferographs were performed plotting the percentage of change vs. biotin concentration.– Results: Analyte concentrations were spuriously decreased in 12 sandwich immunoassays and falsely increased in 11 competitive immunoassays. However thyrotropin and CA 15.3 antigen were not significantly affected.– Conclusions: Except CA 15.3 and TSH, the methods tested were susceptible to biotin interference. Falsely low values occurred in sandwich assays and high bias in competitive assays. Clinicians and laboratorians should be aware of the medical importance of biotin interference as a cause of misdiagnosis and incorrect treatment. (AU)

Objetivos: El propósito de este estudio es evaluar la interferencia de la biotina en varios inmunoensayos de hormonas, marcadores tumorales y vitaminas que usan el método de electroquimioluminiscencia, tratando de determinar el nivel crítico de biotina que causa la interferencia.-Material and metodos: Las soluciones de trabajo de biotina se prepararon en solución de tampon fosfato (PBS) en diferentes concentraciones (10000, 7500, 5000, 2500, 1250, 625, and 312.5 ng/mL), y fueron añadidas a las muestras para obtener la concentración final 10 veces inferior. Cada dilución de biotina se ensayó por triplicado, usando al menos dos niveles de analito. Las determinaciones de magnitudes bioquímicas endocrinas, marcadores tumorales, vitaminas y marcadores óseos fueron realizadas mediante inmunoensayo electroquimioluminiscente en los analizadores Cobas e801 y cobas e411. Se compararaon los resultados obtenidos al analizar las muestras con biotina y las de referencia con el mismo volumen de PBS, usando el programa Microsoft Excel. El error relativo fue calculado respecto a las muestras libres de biotina para acda concentración. La interferencia fue considerada significativa cuando el error excede el 10% Se construyeron interferogramas de Glick representando el porcentaje de cambio respecto a la concentración de biotina.-Resultados: Las concentraciones de analito fueron disminuidas en 12 inmunoensayos sándwich y falsamente incrementadas en 11 inmunoensayos competitivos. Por el contrario la tirotropina y el CA 15.3 no fueron significativamente afectados.-Conclusiones: Excepto la tirotropina y el antígeno CA 15.3 el resto de métodos testados fueron susceptibles de interferencia por biotina. Se obtuvieron valores falsamente disminuidos en los ensayos tipo sándwich y elevados en los ensayos competitivos. Tanto clínicos como analistas deben ser conscientes de la importancia médica de la interferencia por biotina como causa de diagnóstico erróneo y tratamiento incorrecto. (AU)

Os LncRNAs Estão Envolvidos no Processo de Aterosclerose em Diversos Níveis / LncRNAs are Involved in the Process of Atherosclerosis at Diverse Levels

Resumo A aterosclerose é a causa mais comum de doença cardiovascular em todo o mundo, ela está associada a uma alta incidência de eventos clínicos. O acúmulo de evidências elucidou que os RNAs longos não codificantes (LncRNAs) são uma nova classe de transcritos com papéis críticos nos processos fisiopatológicos da aterosclerose. Nesta revisão, resumimos o progresso recente dos LncRNAs no desenvolvimento da aterosclerose. Descrevemos principalmente os diversos mecanismos regulatórios dos LncRNAs nos níveis transcricionais e pós-transcricionais. Este estudo pode fornecer informações úteis sobre os LncRNAs como alvos terapêuticos ou biomarcadores para o tratamento da aterosclerose.

Abstract Atherosclerosis is the most common cause of cardiovascular disease globally, associated with a high incidence of clinical events. Accumulating evidence has elucidated that long non-coding RNAs (lncRNAs) as a novel class of transcripts with critical roles in the pathophysiological processes of atherosclerosis. In this review, we summarize the recent progress of lncRNAs in the development of atherosclerosis. We mainly describe the diverse regulatory mechanisms of lncRNAs at the transcriptional and post-transcriptional levels. This study may provide helpful insights about lncRNAs as therapeutic targets or biomarkers for atherosclerosis treatment.

Structural hemoglobinopathies: Analysis of 128 cases and their relevance in the diabetic control.

BACKGROUND AND OBJECTIVES: Hemoglobinopathies are monogenic disorders with autosomal recessive inheritance. In Europe, with increased migration flows these conditions are appearing more frequently in non-endemic regions. HbA1c testing is useful for evaluating long-term glycaemic status in diabetes mellitus patients. During HbA1c evaluation, other hemoglobin fractions are detected, such as structural hemoglobinopathies. The principal objective of this work is to study the incidence of structural hemoglobinopathies in our area and their management. MATERIAL AND METHODS: Total population of 65,000 patients for glycaemic monitoring was evaluated with HPLC equipment (HPLC-ARKRAY® ADAMS, Menarini Diagnostics, Italy). This equipment quantifies different hemoglobin fractions. RESULTS: We identified a total of 128 variants, representing an incidence with respect to the study population of 0.19% (1.97‰). Most (69) were identified in the foreign population, and the most frequent variant identified was heterozygous S hemoglobinopathy. In six families, structural hemoglobinopathy was identified. Three patients with HbS/HbS were detected. Primary Health Centers were the origin of an important part of these variants (82). CONCLUSIONS: Our study describes a low incidence for structural variants compared with the estimated incidence in Spain. These variants can interfere with HbA1c testing. In these cases, glycated protein study is an appropriate alternative to monitor diabetic therapy.

Incerteza de medição associada à contagem microbiana de produtos farmacêuticos / Measurement uncertainty associated with microbial count of pharmaceutical products

A contaminação microbiana pode comprometer a eficácia e a segurança dos produtos farmacêuticos. Os testes de contagem microbiana são utilizados para avaliar a qualidade microbiológica de produtos farmacêuticos não estéreis, exigidos pela maioria dos compêndios farmacopeicos. Apesar disso, raramente é considerada a avaliação da incerteza de medição para testes de contagem microbiana, o que pode levar a falsas decisões quanto à conformidade/nãoconformidade. Neste trabalho avaliamos os efeitos de matriz nos testes de contagem microbiana e sua avaliação de incerteza top-down, e avaliamos a incerteza da medição utilizando a abordagem bottom-up, além de que estimamos os riscos do consumidor ou do produtor devido à incerteza da medição. As incertezas combinada e expandida são calculadas empregando-se a abordagem topdown consideraram a exatidão (recuperação) e a precisão como os principais componentes de incerteza. O componente de incerteza da exatidão foi o mais relevante em 59% das amostras estudadas, enquanto a precisão foi a principal fonte de incerteza em apenas 41% das amostras, sendo observado que quanto maior a interferência da matriz, maior o fator de incerteza e, consequentemente, maior a assimetria para o intervalo em torno da medida. A partir da abordagem bottom-up, foram identificadas e quantificadas três principais fontes de incerteza: fator de diluição, volume plaqueado e contagem das placas. A contribuição dessas fontes de incerteza depende do valor medido da carga microbiana em produtos farmacêuticos, a contribuição do fator de diluição e das incertezas do volume plaqueado aumentam com o aumento do valor medido, enquanto a contribuição da contagem das placas diminui com o aumento do valor medido. Foi possível avaliar o risco de decisões falsas devido à incerteza de medição, por meio das estimativas dos riscos do consumidor ou do produtor. Os riscos foram avaliados utilizando-se o método Monte Carlo. Portanto, foi demonstrado a relevância da avaliação da incerteza de medição para garantir a confiabilidade dos resultados dos testes de contagem microbiana e a apoiar a tomada de decisões quando a avaliação da conformidade/não-conformidade dos produtos farmacêuticos não estéreis

Microbial contamination can compromise the efficacy and safety of pharmaceutical products. Microbial counting tests are used to assess the microbiological quality of non-sterile pharmaceutical products required by most pharmacopoeia compendiums. Despite this, measurement uncertainty assessment for microbial count tests is rarely considered, which can lead to false compliance/non-compliance decisions. In this work we evaluated the matrix effects on microbial counting tests and their top-down uncertainty assessment, and evaluated measurement uncertainty using the bottom-up approach, inaddition to estimating the consumer's or producer's risks due to measurement uncertainty. The combined and expanded uncertainties calculated using the top-down approach considered accuracy (recovery) and accuracy as the main components of uncertainty. The uncertainty component of accuracy was the most relevant in 59% of the samples studied, while accuracy was the main source of uncertainty in only 41% of the samples, being observed that the greater the interference of the matrix, the greater the uncertainty factor and, consequently, the greater the asymmetry for the interval around the measurement. From the bottom-up approach, three main sources of uncertainty were identified and quantified: dilution factor, platelet volume and plaque count. The contribution of these sources of uncertainty depends on the measured value of microbial load in pharmaceutical products, the contribution of the dilution factor and uncertainties of the plated volume increase with the increase in the measured value, while the contribution of plate counting decreases with the increase of the measured value. It was possible to assess the risk of false decisions due to measurement uncertainty by estimating consumer or producer risks. The risks were evaluated using the Monte Carlo method. Therefore, the relevance of measuring uncertainty assessment has been demonstrated to ensure the reliability of microbial count test results and to support decision-making when assessing non-sterile pharmaceutical conformity/non-compliance

Biotin interference in several electrochemiluminescence immunoassays (eclia)

Background: The aim of this study is to define the interference of biotin in several endocrine, tumor marker, and vitamin assays performed by an electrochemiluminescence method, trying to determinate the critical level that causes biotin interference. Material and methods: Working biotin solutions were prepared in phosphate-buffered saline (PBS) at different concentrations (10000, 7500, 5000, 2500, 1250, 625, and 312.5 ng/mL), which were spiked on the samples to obtain final concentrations ten-fold lower. Each serum biotin dilution was tested in triplicate, using at least two levels of analytes. Determinations of several endocrine, vitamins, tumor and bone markers were carried-out with eletrochemilumenescent immunoassays on the cobas e801 and cobas e411. Comparison between the results obtained by analyzing the biotin-spiked samples and the reference PBS-spiked samples was performed using Microsoft Excel. The relative bias with the interfering-free specimen was calculated for each biotin concentration. Interference was considered significant when the relative bias exceeded 10%. Glick´s interferographs were performed plotting the percentage of change vs. biotin concentration. Results: Analyte concentrations were spuriously decreased in 12 sandwich immunoassays and falsely increased in 11 competitive immunoassays. However thyrotropin and CA 15.3 antigen were not significantly affected. Conclusions: Except CA 15.3 and TSH, the methods tested were susceptible to biotin interference. Falsely low values occurred in sandwich assays and high bias in competitive assays. Clinicians and laboratorians should be aware of the medical importance of biotin interference as a cause of misdiagnosis and incorrect treatment.(AU)

Objetivos: El propósito de este estudio es evaluar la interferencia de la biotina en varios inmunoensayos de hormonas, marcadores tumorales y vitaminas que usan el método de electroquimioluminiscencia, tratando de determinar el nivel crítico de biotina que causa la interferencia. Material and metodos: Las soluciones de trabajo de biotina se prepararon en solución de tampon fosfato (PBS) en diferentes concentraciones (10000, 7500, 5000, 2500, 1250, 625, and 312.5 ng/mL), y fueron añadidas a las muestras para obtener la concentración final 10 veces inferior. Cada dilución de biotina se ensayó por triplicado, usando al menos dos niveles de analito. Las determinaciones de magnitudes bioquímicas endocrinas, marcadores tumorales, vitaminas y marcadores óseos fueron realizadas mediante inmunoensayo electroquimioluminiscente en los analizadores Cobas e801 y cobas e411. Se compararaon los resultados obtenidos al analizar las muestras con biotina y las de referencia con el mismo volumen de PBS, usando el programa Microsoft Excel. El error relativo fue calculado respecto a las muestras libres de biotina para acda concentración. La interferencia fue considerada significativa cuando el error excede el 10% Se construyeron interferogramas de Glick representando el porcentaje de cambio respecto a la concentración de biotina. Resultados: Las concentraciones de analito fueron disminuidas en 12 inmunoensayos sándwich y falsamente incrementadas en 11 inmunoensayos competitivos. Por el contrario la tirotropina y el CA 15.3 no fueron significativamente afectados. Conclusiones: Excepto la tirotropina y el antígeno CA 15.3 el resto de métodos testados fueron susceptibles de interferencia por biotina. Se obtuvieron valores falsamente disminuidos en los ensayos tipo sándwich y elevados en los ensayos competitivos. Tanto clínicos como analistas deben ser conscientes de la importancia médica de la interferencia por biotina como causa de diagnóstico erróneo y tratamiento incorrecto.(AU)

Morpho-physiological performance of Mikania glomerata Spreng. and Mikania laevigata Sch. Bip ex Baker plants under different light conditions / Desempenho morfo-fisiológico de Mikania glomerata Spreng. e Mikania laevigata Sch. Bip ex Baker sob diferentes condições de luminosidade

In tropical and subtropical zones, lianas play important roles in the process of ecological succession. This study aims to evaluate the photosynthetic and morpho-physiological performance between two lianas species from Mikania genus in response to different levels of radiation: full sun (I0), 25% (I25), 50% (I50), and 75% (I75) retention of solar radiation flux. Plants grown under I75 showed a reduced net photosynthetic rate (A). We observed dynamic photoinhibition at I0 during hours of high irradiation and temperature. The highest and lowest leaf chlorophyll content occurred at I75 and I0, respectively, while carotenoids/total chlorophyll and leaf thickness increased under I0. Total dry mass was higher in plants grown at I0 and I25. However, A values and biomass production of Mikania laevigata were higher at I25, while for Mikania glomerata greater biomass accumulation was observed between I0-I50. Therefore, we concluded that M. laevigata and M. glomerata have different morpho-physiological performances under same the radiation conditions.

Em regiões tropical e subtropical, lianas desempenham um papel importante no processo de sucessão ecológica. O objetivo deste estudo foi avaliar as respostas fotossintéticas e morfo-fisiológicas entre duas espécies de Mikania em diferentes níveis de radiação: sol pleno (I0), 25% (I25), 50% (I50) e 75% (I75) de retenção do fluxo da radiação solar. Plantas crescidas sob I75 mostraram reduzida taxa fotossintética (A). Nós observamos fotoinibição dinâmica em plantas crescidas sob I0 durante as horas de alta irradiação e temperatura. O maior e menor conteúdo de clorofila ocorreu em plantas sob I75 e I0, respectivamente; enquanto carotenoides/clorofila total e espessuras da epiderme e mesofilo aumentaram sob I0. A massa seca total foi maior em plantas crescidas sob I0 e I25. No entanto, os valores de A e a produção de biomassa de M. laevigata foram maiores sob I25; enquanto para M. glomerata, maior acúmulo de biomassa foi observado entre I0-I50. Portanto, nós concluímos que M. laevigata e M. glomerata apresentaram diferentes respostas morfo-fisiológicas sob mesma condição de radiação.

UD Interference Test: Creation and validation of a new instrument of resistance to interference. Normalization and standardization for Spanish population. / Test UD Interferencia: Creación y validación de un nuevo instrumento de resistencia a la interferencia. Normalización y estandarización en población española.

INTRODUCTION: The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Test. The main purpose of the study is to provide an alternative version of the Stroop Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. METHODS: This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. RESULTS: The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; p < .001) and construct validity (r = 0.472-0.737; p < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12-40% of variance. Sex only had a significant effect on the resistance to interference index. CONCLUSIONS: We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.

Fundamentos moleculares de la exclusión competitiva durante la coinfección de virus respiratorios: a propósito del COVID-19 / Molecular foundations of competitive exclusion during coinfection of respiratory viruses: about COVID-19

Introducción: La idea de exclusión competitiva es indiscutible cuando se trata de animales y bacterias que intentan ocupar el mismo nicho ecológico, pero su aplicación a la coinfección viral no es tan sencilla de interpretar. La interferencia viral es un fenómeno en el que un virus suprime competitivamente la replicación de otros virus coinfectantes y es el resultado más común de las coinfecciones virales. Objetivo: Comprender mejor el comportamiento de las infecciones respiratorias concomitantes en escenarios de brotes comunitarios y de forma individual en entornos hospitalarios e individuos con comorbilidades. Métodos: Se realizó una búsqueda de información en las bases de datos MEDLINE / PubMed, SciELO y LILACS. También se consideraron artículos publicados en el repositorio de preimpresión medRxiv y los informes de los Centros para el Control y Prevención de enfermedades de los Estados Unidos de América. Mediante el gestor de referencias Mendeley, se eliminaron los duplicados y aquellos que no se ajustaban al objetivo del estudio, seleccionando 48 artículos para la revisión. Análisis y síntesis de la in formación: En la literatura científica se encontró evidencia que sustenta la exclusión competitiva viral entre virus relacionados que comparten células susceptibles y permisivas. Conclusión: La exclusión competitiva impide que dos virus que comparten rutas de transmisión similares y el mismo órgano diana, infecten no sólo al mismo tiempo, sino que también se propaguen con éxito. Por lo tanto, la sindemia producida por virus que comparten estas características podría ser un evento improbable(AU)

Introduction: The idea of competitive exclusion is undisputed when it comes to animals and bacteria trying to occupy the same ecological niche, but its application to viral coinfection is not so simple to interpret. Viral interference is a phenomenon in which one virus competitively suppresses the replication of other co-infecting viruses and is the most common outcome of viral co-infections. Objective: To better understand the behavior of concomitant respiratory infections in community outbreak settings and individually in hospital settings and individuals with comorbidities. Methods: A search for information was performed in the MEDLINE / PubMed, SciELO and LILACS databases. Articles published in the preprint repository medRxiv and reports from the US Centers for Disease Control and Prevention were also considered. Using the Mendeley reference manager, duplicates and those that did not fit the study objective were eliminated, selecting 48 articles for the review. Analysis and synthesis of information: Evidence supporting viral competitive exclusion between related viruses sharing susceptible and permissive cells was found in the scientific literature. Conclusion: Competitive exclusion prevents two viruses that share similar transmission routes and the same target organ from infecting not only at the same time, but also from spreading successfully. Therefore, syndemia produced by viruses sharing these characteristics could be an unlikely event(AU)

Potencial uso terapéutico del ARN de interferencia contra la COVID-19 / Potential therapeutic use of RNA interference against COVID-19

Introducción: El SARS-CoV-2 es el agente causal de la COVID-19, enfermedad respiratoria que ha causado miles de víctimas fatales a escala global, y para la cual no existe ninguna terapia curativa efectiva. Objetivo: Reflejar la relevancia potencial de la tecnología de ARN de interferencia (ARNi), como alternativa terapéutica contra la COVID-19. Material y métodos: Se consultaron las bases de datos especializadas en busca de artículos publicados hasta abril de 2020. Se emplearon descriptores específicos y operadores booleanos. Se empleó la estrategia de búsqueda avanzada para la selección de los artículos, teniendo en cuenta la calidad metodológica o validez de los estudios. Desarrollo: Fueron identificadas evidencias de aplicación a nivel experimental de la tecnología de ARNi contra el SARS-CoV. Se han diseñado y evaluado varios ARNs pequeños interferentes y ARNs pequeños con estructura en lazo, orientados al silenciamiento de genes esenciales del SARS-CoV, incluyendo aquellos que codifican las proteínas S, RdRp, M, E, N, 3a/3b y 7a/7b. Se comprobó la efectividad de los ARNi en el silenciamiento de sus genes diana. Aunque la mayoría de estas investigaciones se han realizado en sistemas in vitro, también se ha comprobado la utilidad terapéutica de la administración intranasal de ARNi en un modelo de SARS-CoV in vivo. Conclusiones: La tecnología de ARNi ha mostrado potencialidades como estrategia terapéutica contra el SARS-CoV en modelos celulares y animales. Dadas las similitudes a nivel genómico y en cuanto al proceso patogénico entre SARS-CoV y SARS-CoV-2, esta tecnología es potencialmente aplicable el tratamiento de la COVID-19(AU)

Introduction: SARS-CoV-2 is the causal agent of COVID-19, a respiratory disease that has caused thousands of deaths globally for which there is no effective curative therapy. Objective: To demonstrate the potential relevance of RNA interference (RNAi) technology as a therapeutic alternative in the treatment of COVID-19. Materials and methods: Specialized biomedical databases were searched looking for studies published until April 2020. The search was carried out using descriptors and Boolean operators. Advanced search strategy was used for the selection of articles, taking into account the methodological quality and validity of the studies. Results: Evidence of experimental application of RNAi technology against SARS-CoV was identified. Several small interfering RNAs and small loop-structured RNAs oriented to the silencing of essential SARS-CoV genes including those encoding the S, RdRp, M, E, N, 3a/3b and 7a/7b proteins have been designed and evaluated. The effectiveness of RNAi for silencing its target genes was proven. Although most of these research studies have been conducted in in vitro systems, the therapeutic effectiveness of the intranasal administration of small RNA interference has also been proven in an in vivo SARS-CoV model. Conclusions: RNAi technology has demonstrated to be a potential therapeutic strategy against SARS-CoV in cellular and animal models. Given the similarities at the genomic level and in terms of the pathogenic process between SARS-CoV and SARS-CoV-2, this technology has a potential applicability for the treatment of COVID-19(AU)

Elevación persistente de troponina I / Persistent elevation of troponin I

Resumen La troponina cardiaca es el marcador bioquímico más sensible y específico de daño/necrosis miocárdica, de ahí que desempeñe un papel crucial en el diagnóstico del síndrome coronario agudo. Sin embargo, en ocasiones, como en el caso clínico que se describirá, la elevación anormal de troponina no siempre obedece a un síndrome coronario agudo trombótico, sino a causa cardiaca sin enfermedad coronaria significativa, causa extracardiaca o alteración analítica (verdaderos falsos positivos). El interés de este caso radica en que siempre debería tenerse en mente la posibilidad de que se produzca un falso positivo de troponina por causa analítica, en especial en situaciones clínicas sin una razón obvia de daño miocárdico y cuando no sea evidente la confirmación de daño miocárdico mediante pruebas complementarias.

Abstract Cardiac troponin is the most sensitive and specific biochemical marker for myocardial damage / necrosis, and thus has a crucial role in the diagnosis of acute coronary syndrome. However, occasionally, as in the clinical case that will be described, the abnormal elevation of troponin does not always obey that of an acute coronary syndrome, but also to a cardiac cause with no significant coronary disease, extra-cardiac cause, or analytical change (true false positives). The interest in this case lies in that it should always be borne in mind that a false positive troponin can be produced due to an analytical cause. This can be the case in clinical situations with no obvious reason for myocardial damage and when the confirmation of myocardial damage may not be evident using complementary tests.

Efecto placebo y estimulación sonora binaural de ondas beta y theta en el rendimiento de una tarea de memoria de trabajo / Placebo Effect and Binaural Sound Stimulation of Beta Wave and Theta Wave in a Working Memory Task Performance

Resumen En el presente trabajo se realizó un estudio cuasi experimental de medidas repetidas con grupos caso y control, cuyo objetivo fue medir el efecto de los sonidos binaurales de onda beta y theta, y de la información placebo relacionada a ellos, sobre el rendimiento de una tarea de memoria de trabajo computarizada, versión libre del Automated Operation Span Task -AOSPAN-de Unsworth, Heitz, Schrock y Engle (2005). Dicha tarea se repitió en dos sesiones separadas por un lapso mínimo de dos semanas, una de las cuales se resolvía mientras se escuchaba una estimulación sonora binaural de onda beta o theta que, dependiendo del grupo, se acompañaba o no de información placebo. Se evaluaron 98 personas con distinto nivel de escolaridad divididas en seis grupos experimentales y uno de control. Se encontraron diferencias significativas en el tiempo de presentación de la tarea experimental asociada a información placebo, mostrando una mejoría en la segunda aplicación de la tarea. Debido a ambigüedades en los resultados, a pesar de encontrar diferencias significativas asociadas a la estimulación binaural de onda beta, no pudieron establecerse relaciones concretas entre la mejoría en el recuerdo de conjuntos de hasta cuatro elementos con la presencia de dicha variable. No se encontraron diferencias significativas en las variables de recuerdo global, lo cual puede explicarse por el tipo de tarea de memoria utilizado.

Abstract In this work, a quasi-experimental study of repeated measures with case and control groups was carried out, whose objective was to measure the effect of binaural sounds of beta and theta waves, and the placebo informa tion related to them, on the performance of a computerized working memory task, Automated Operation Span Task -AOSPAN- free version of Unsworth, Heitz, Schrock and Engle (2005). This task was repeated in two sessions separated by an interval of two weeks, one of which was resolved while listening to a binaural sound stimulation of beta wave or theta that, depending on the group, was supported or not by placebo information. 98 people with different levels of schooling were tested twice, divided into six experimental groups and one control group. Significant differences were found related to time duration in performing the experimental task associated with placebo information; it was showed an improvement the second time the task was administered. Due to ambiguities in the results, despite finding significant differences associated with binaural stimulation of beta wave, it was not possible to establish concrete relations between the improvement in the memory of sets up four elements with the presence of this variable. No significant differences were found in the global recall variables, which can be explained by the type of memory task performed.

Control de la interferencia en el trastorno por déficit de atención e hiperactividad (TDAH): revisión / Interference Control in Attention Deficit and Hyperactivity Disorder (ADHD): Review

Resumen Introducción: Investigaciones sobre el trastorno por déficit de atención e hiperactividad (TDAH) han evidenciado alteraciones en los procesos inhibitorios, en especial en el control de la interferencia, lo que explicaría las dificultades de los niños con TDAH para inhibir estímulos distractores y controlar su comportamiento. Objetivo: Identificar la literatura científica disponible sobre el desempeño en tareas que evalúan el control de la interferencia en niños con TDAH. Método: Se realizó una búsqueda de artículos científicos en las bases de datos de Pubmed, Scopus, Web of Sciencie con los términos ADHD (Attention Deficit Hyperactivity Disorder), Interference Control, Stroop y Flanker, publicados entre los años 2010 y 2017. Se identificaron 520 artículos, después de aplicar los criterios de inclusión y exclusión se seleccionaron 33 para hacer el análisis descriptivo. Resultados: El control de la interferencia se ve afectado en niños con TDAH, evidenciado en mayores tiempos de reacción, de ejecución, variabilidad de respuesta y porcentaje de errores, principalmente en los ensayos incongruentes. Igualmente, se mostraron patrones de activación cortical alterados y variaciones en potenciales evocados cognitivos. Conclusiones: El control de la interferencia se encuentra alterado en niños con TDAH, y el uso de más de un método de evaluación de los niños con este Trastorno puede ser útil para brindar más información del funcionamiento en el control de la interferencia en términos de tiempo y precisión en las tareas.

Abstract Introduction: Research on attention deficit hyperactivity disorder (ADHD) has shown alterations in interference control, which would explain the difficulties of children with ADHD to inhibit distracting stimuli and regulate their behavior. Objective: identifying available scientific literature about performance on task that evaluate the interference control in children with ADHD. Method: a search on Pubmed, Scopus and Web of Science databases with the terms ADHD, interference control, Stroop and Flanker, published between 2010 and 2017 was performed. 520 articles were identified, after applying the inclusion and exclusion criteria 33 articles were selected for descriptive analysis. Results: interference control is affected in children with ADHD, evidenced in greater reaction and execution times, variability of response and a high errors rate, primarily in incongruent trials. Altered cortical activation patterns and variations in cognitive evoked potentials were also shown. Conclusions: Interference control is altered in children with ADHD, the use of more than one evaluation method may be useful to provide more information on the functioning of interference control in terms of time and accuracy on tasks.

Pre-analytical variables evaluation in laboratory tests of patients attended at the Vitória da Conquista Central laboratory, Bahia, Brazil / Avaliação de variáveis pré-analíticas em exames laboratoriais de pacientes atendidos no Laboratório Central de Vitória da Conquista, Bahia, Brasil

ABSTRACT Introduction: Laboratory tests are intended to provide information necessary to clarify diagnoses or specific situations that cannot be elucidated by other means. Laboratory analyses are subject to several interferences. Even healthy individuals could suffer variations in laboratory tests due to biological factors, which may lead to misinterpretation of the results. Objective: Assess the pre-analytical variables in patients' laboratory tests at the Vitória da Conquista Central Laboratory, Bahia, Brazil. Material and method: This is a cross-sectional study with a descriptive approach and the use of a questionnaire as a research instrument. Data were collected through individual interviews, carried out at the laboratory. Results: The sample consisted of 425 patients, with female predominance (76.5%). Regarding patient instructions for laboratory tests, 94.6% had not been given any previous guidance, and 68.5% used some kind of medication, which could produce alterations in the exams. The use of the antihypertensive agents captopril, enalapril, hydrochlorothiazide or propranolol was associated with increased serum urea [odds ratio (OR) = 7.2, confidence interval (CI) = 95%, 1.87-27.58; p = 0.002], and smoking was associated with increased red blood cells count (OR = 3.7, CI = 95%, 0.86-15.75; p = 0.02). Conclusion: The findings indicate that pre-analytical variables remain an important focus for attention to the clinical laboratory. The correct data collection of patients' conditions is critical to support the post-analytical phase with useful information for the production of reliable exams and serve as a useful interpretation to diagnosis.

RESUMEN Introducción: Las pruebas de laboratorio tienen como objetivo proporcionar información necesaria a la aclaración de diagnósticos o situaciones específicas que no se pueden esclarecer por otros modos. Los análisis de laboratorio están sujetos a diversos interferentes. Incluso individuos sanos pueden presentar variaciones en las pruebas derivadas de factores que pueden crear equivocaciones en la interpretación de los resultados. Objetivo: Evaluar la influencia de variables preanalíticas en pruebas de laboratorio de pacientes atendidos en el Laboratório Central de Vitória da Conquista, Bahía, Brasil. Material y método: Estudio transversal con enfoque descriptivo y empleo de cuestionario como herramienta de investigación. Los datos fueron recogidos mediante entrevistas individuales, realizadas en el establecimiento investigado. Resultados: La muestra se compuso por 425 pacientes, con predominio de mujeres (76,5%). En cuanto a instrucciones para realización de las pruebas, el 94,6% de los pacientes no recibieron ningún tipo de orientación previa y el 68,5% utilizaban algún tipo de medicamento que puede producir alteraciones en pruebas. El uso de los antihipertensivos captopril, enalapril, hidroclorotiazida o propranolol estuvo asociado con el aumento de la urea sérica [oportunidad relativa (OR) = 7,2; intervalo de confianza (IC) = 95%, 1,87-27,58; p = 0,002]. El tabaquismo se ha asociado al aumento de eritrocitos (OR = 3,7; IC = 95%, 0,86-15,75; p = 0,02). Conclusión: Los hallazgos clínicos indican que variables preanalíticas son importante causa de atención para el laboratorio clínico. La correcta recogida de datos acerca de las condiciones de los pacientes es esencial para instrumentar la fase postanalítica con información relevante para la realización de pruebas fiables y que sean útiles para el proceso del diagnóstico.

RESUMO Introdução: Os exames laboratoriais têm como objetivo fornecer informações necessárias para o esclarecimento de diagnósticos ou situações específicas não passíveis de serem elucidadas por outros meios. As análises laboratoriais estão sujeitas a diversos interferentes. Mesmo indivíduos saudáveis podem apresentar variações nos exames decorrentes de fatores que podem gerar equívocos na interpretação dos resultados. Objetivos: Avaliar a influência de variáveis pré-analíticas em exames laboratoriais de pacientes atendidos no Laboratório Central do município de Vitória da Conquista, Bahia, Brasil. Material e método: Trata-se de um corte transversal com abordagem descritiva e utilização de questionário como instrumento de pesquisa. Os dados foram coletados por meio de entrevistas individuais, realizadas na instituição pesquisada. Resultados: A amostra foi composta por 425 pacientes, com predomínio de indivíduos do sexo feminino (76,5%). No que se refere a instruções para realização dos exames laboratoriais, 94,6% dos pacientes não receberam nenhum tipo de orientação prévia e 68,5% utilizavam algum tipo de medicamento que pode produzir alterações em exames. O uso dos anti-hipertensivos captopril, enalapril, hidroclorotiazida ou propranolol esteve associado ao aumento da ureia sérica [odds ratio (OR) = 7,2; intervalo de confiança (IC) = 95%, 1,87-27,58; p = 0,002]. O tabagismo associou-se ao aumento de eritrócitos (OR = 3,7; IC = 95%, 0,86-15,75; p = 0,02). Conclusão: Os achados indicam que variáveis pré-analíticas são importante fonte de atenção para o laboratório clínico. A correta coleta de dados acerca das condições dos pacientes é fundamental para instrumentar a fase pós-analítica com informações relevantes para a produção de exames fidedignos e que sejam úteis ao processo do diagnóstico.

Resistencia a la Interferencia de Distractores: Diseño y Aplicación de una Tarea de Entrenamiento para Niños / Resistance to Interference Distractor: Design and Application of a Training Task for Children

Resumen Desde la perspectiva no unitaria de la inhibición, la resistencia a la interferencia de los distractores refiere al proceso inhibitorio que participa en la atención selectiva; experimenta durante la infancia importantes cambios en su desarrollo y resulta fundamental para el desempeño de los niños en diversas actividades. Este trabajo se propuso diseñar una tarea de entrenamiento -informatizada, con un abordaje basado en procesos y a partir del paradigma de Flancos (Eriksen & Eriksen, 1974)- de este proceso inhibitorio, para niños con desarrollo típico de 6 a 8 años de edad; administrarla y analizar los efectos del entrenamiento sobre el proceso entrenado y otros no entrenados. Se trabajó con 54 niños, en 1º, 2º y 3º año de la escolaridad primaria. Se aplicó un diseño experimental con medidas pre y post-test (donde se administraron tareas de evaluación de resistencia a la interferencia de los distractores, inhibición de la respuesta y memoria de trabajo viso-espacial), un grupo experimental (que recibió el entrenamiento de la resistencia a la interferencia de distractores) y un grupo control activo. Luego de la intervención el grupo experimental presentó un mejor desempeño en una tarea que demanda el proceso entrenado. No se encontraron efectos sobre el rendimiento en otras tareas. Los efectos hallados son bajos, pudiendo deberse a la baja intensidad y duración de la intervención. Sin embargo, podrían constituir un aporte a la diferenciación de procesos inhibitorios, específicamente de la resistencia a la interferencia de distractores respecto y de la inhibición de la respuesta, en tanto el entrenamiento genera efectos en el proceso entrenado pero no el otro.

Abstract From the non-unitary perspective of inhibition, resistance to distractor interference is an inhibitory process related to selective attention, has developmental improvements throughout childhood and plays an important role in the children's performance in multiple activities. This work is aimed to design and administrate a resistance to interference distractor training task for children with typical development, between 6 and 8 years of age (a processes-based computerized flanker task). Also, this work is aimed to analyze the effects of the intervention on trained process and non-trained processes. We recruited children (n= 54) in the first three years of primary-school education. The study consisted of an experimental pre-test, post-test design (resistance to distractor interference, response inhibition and visuospatial working memory were administered), with experimental group (training resistance to distractor interference group) and active control group. After intervention, experimental group performed better in a resistance to distractor interference task. No effects on performance in other tasks were found. These small effects could be explained by the duration and the intensity of the intervention. However, these results contribute to non-unitary perspective about the differentiation of inhibitory processes, especially, to differentiation of resistance to distractor interference and response inhibition, because effects on trained process and absence of transfer to non-trained process were observed.

Accumulation of macronutrients in cowpea and weeds in competition and under soil water deficit / Acumulação de macronutrientes em feijão-caupi e plantas daninhas em competição e sob déficit hídrico no solo

The ability of a plant species to succeed in colonization of agroecosystem depends on its efficiency in the use of growth resources even in deficient conditions. The present study aimed to evaluate the effects of competition and water deficit in the soil on the accumulation of macronutrients of Vigna unguiculataL. Walp., Commelina benghalensis L. and Waltheria indica L. The study was conducted in a greenhouse, in randomized block design, with four replications. The treatments were arranged in a 5 × 2 factorial, with the first factor corresponding to types of interaction among species (V. unguiculata + C. benghalensis; V. unguiculata + W. indica; V. unguiculata in monoculture, C. benghalensis in monoculture and W. indica in monoculture), and the second of water regimes (irrigated and water deficit).The water deficit differently affects macronutrient content on the species, with decreased of K, Ca and Mg in cowpea, and N, P, K and Ca in W. indica. For C. benghalensis, the water deficit does not reduce the macronutrient contents on the plant. The competition between plants intensifies the effects of water deficit only on C. benghalensis, with a decreased on the content of all macronutrients studied. Under irrigated conditions, competition between plants was more damaging the weeds compared to cowpea. The C. benghalensis specie, free from interference, has a high potential for nutrient extraction under irrigated and water deficit regimes.

A capacidade de uma espécie vegetal para ter sucesso na colonização do agroecossistema depende da sua eficiência na utilização dos recursos de crescimento mesmo em condições deficientes. Objetivou-se avaliar os efeitos da competição e déficit hídrico no solo no conteúdo de macronutrientes de feijão-caupi (Vigna unguiculata L. Walp.), trapoeraba (Commelina benghalensis L.) e malva-branca (Waltheria indica L.). Foi conduzido estudo em casa de vegetação, em delineamento em blocos casualizado, com quatro repetições. Os tratamentos foram arranjados em fatorial 5 × 2, com o primeiro fator correspondente aos arranjos de competição entre as espécies (V. unguiculata + C. benghalensis; V. unguiculata + W. indica; V. unguiculataem monocultivo; C. benghalensis em monocultivo e W. indica em monocultivo), e o segundo dos regimes hídricos (irrigado e déficit hídrico). O déficit hídrico afeta de forma diferenciada o conteúdo de macronutrientes nas espécies, com redução de K, Ca e Mg no feijão-caupi, e N, P, K e Ca em W. indica. Para C. benghalensis, o déficit hídrico não reduz os conteúdos de macronutrientes na planta. A competição entre plantas intensifica os efeitos do déficit hídrico apenas em C. benghalensis, com redução do conteúdo de todos os macronutrientes estudados. Em condições irrigadas, a competição entre plantas foi mais prejudicial as plantas daninhas do que o feijão-caupi. Aespécie C. benghalensis, livre de interferência, apresenta elevado potencial de extração de nutrientes sob regimes irrigado e de déficit hídrico.

Anticuerpos anti-estreptavidina: Confusión diagnóstica por interferencia bioquímica / Anti-estreptavidin antibodies. Diagnostic confusion by biochemical interference

Se presenta el caso de una paciente que, durante los estudios por búsqueda de fertilidad y posterior embarazo, mostraba un perfil tiroideo alterado con niveles elevados de T4 libre y TSH normal. Luego de descartar un adenoma tirotropo y ante la ausencia de sintomatología clínica de hipertiroidismo, se investigó la posibilidad de interferencias analíticas en los inmunoensayos utilizados para la medición de las hormonas. Se han descrito interferencias causadas por anticuerpos heterófilos, macro TSH, anticuerpos anti-tiroideos, biotina, y en menor medida anticuerpos anti-estreptavidina y anti-rutenio. Los análisis de la paciente se realizaron en autoanalizador cuya plataforma emplea el sistema estreptavidina-biotina que es muy susceptible a varios interferentes. Un algoritmo propuesto incluye una serie de pruebas simples de realizar e interpretar que permiten detectar o descartar la presencia de interferentes. De acuerdo al mismo, se efectuó la comparación con una plataforma analítica diferente (que no utiliza el sistema estreptavidina-biotina), diluciones seriadas, precipitación con polietilenglicol 6000 y tratamiento con micropartículas recubiertas con estreptavidina. Los resultados obtenidos confirmaron la presencia de anticuerpos anti-estreptavidina en el suero de la paciente. Ante discordancias entre las manifestaciones clínicas y los resultados de laboratorio, se debe investigar la posibilidad de interferencias metodológicas para evitar el riesgo iatrogénico potencial que implica una interpretación bioquímica errónea.

We present the case of a patient who, during studies for fertility and subsequent pregnancy, showed an altered thyroid profile with elevated levels of free T4 and normal TSH. After ruling out a thyrotropic adenoma and in the absence of clinical symptoms of hyperthyroidism, the possibility of analytical interference in the immunoassays used to measure hormones was investigated. Interferences caused by heterophile antibodies, macro TSH, anti-thyroid antibodies, biotin, and to a lesser extent anti-streptavidin and anti-ruthenium antibodies have been described. The analysis of the patient was carried out in a self-analyzer whose platform uses the streptavidin-biotin system that is very susceptible to several interferents. A proposed algorithm includes a series of simple tests to perform and interpret that allow detecting or ruling out the presence of interferents. Accordingly, a comparison was made with a different analytical platform (which does not use the streptavidin-biotin system), serial dilutions, precipitation with polyethylene glycol 6000 and treatment with microparticles coated with streptavidin. Results obtained confirmed the presence of anti-streptavidin antibodies in the patient's serum. In the case of disagreements between clinical manifestations and laboratory results, the possibility of methodological interferences should be investigated in order to avoid the potential iatrogenic risk involved in an erroneous biochemical interpretation.