Urbanization, migration, and indigenous health in Peru.

INTRODUCTION: We compare demographic, socioeconomic, and anthropometric characteristics and blood pressure (BP), between rural and urban Peruvian indigenous women. These are preliminary results from a project on urbanization, migration, and health. METHODS: Data were collected cross-sectionally (2019) and compared between a rural (n = 92) and an urban (n = 93) community. RESULTS: Height: µ = 148.3 ± 5.0 cm (range = 137-162), weight: µ = 62.0 ± 11.5 (range = 37.5-108.7), median waist circumference = 89.0 (IQR = 15.8, range = 64.0-126.0), BMI = 28.3 (IQR = 6.2, range = 16.7-40.0), with no significant rural-urban differences. Systolic but not diastolic BP was significantly higher in urban versus rural women (median = 110, IQR = 18, range = 80-170 vs. median = 120, IQR = 10, range = 90-170, p = .002 and median = 70, IQR = 17, range = 50-100 vs. median = 70, IQR = 10, range = 60-100, p = .354), respectively. CONCLUSIONS: Despite major lifestyle differences, there were no anthropometric differences between rural and urban women. Higher systolic BP in urban women may reflect social/economic stressors rather than dietary factors.

Urine Extracellular Vesicle GATA2 mRNA Discriminates Biopsy Result in Men with Suspicion of Prostate Cancer.

PURPOSE: Prostate specific antigen has limited performance in detecting prostate cancer. The transcription factor GATA2 is expressed in aggressive prostate cancer. We analyzed the predictive value of urine extracellular vesicle GATA2 mRNA alone and in combination with a multigene panel to improve detection of prostate cancer and high risk disease. MATERIALS AND METHODS: GATA2 mRNA was analyzed in matched extracellular vesicles isolated from urines before and after prostatectomy (16) and paired urine and tissue prostatectomy samples (19). Extracellular vesicle GATA2 mRNA performance to distinguish prostate cancer and high grade disease was tested in training (52) and validation (165) cohorts. The predictive value of a multigene score including GATA2, PCA3 and TMPRSS2-ERG (GAPT-E) was tested in both cohorts. RESULTS: Confirming its prostate origin, urine extracellular vesicle GATA2 mRNA levels decreased significantly after prostatectomy and correlated with prostate cancer tissue GATA2 mRNA levels. In the training and validation cohort GATA2 discriminated prostate cancer (AUC 0.74 and 0.66) and high grade disease (AUC 0.78 and 0.65), respectively. Notably, the GAPT-E score improved discrimination of prostate cancer (AUC 0.84 and 0.72) and high grade cancer (AUC 0.85 and 0.71) in both cohorts when compared with each biomarker alone and PT-E (PCA3 and TMPRSS2-ERG). A GAPT-E score for high grade prostate cancer would avoid 92.1% of unnecessary prostate biopsies, compared to 61.9% when a PT-E score is used. CONCLUSIONS: Urine extracellular vesicle GATA2 mRNA analysis improves the detection of high risk prostate cancer and may reduce the number of unnecessary biopsies.

[Ear, nose and throat disease profile in children with Down syndrome]. / Perfil de morbilidad otorrinolaringológica en niños con síndrome de Down.

INTRODUCTION: The children with Down syndrome (DS) are at increased risk of ear-nose-throat (ENT) disorders. International recommendations suggest early hearing screening and periodic specialist evaluation. Our goal was to characterize ENT disorders in children with DS, and propose recommendations for the Chilean population. PATIENTS AND METHOD: Cross-sectional, descriptive study, of children with DS, between 6 months and 15 years of age. The data was obtained by a health interview to the parents and review of medical records. RESULTS: We analyzed 134 patients with an average age of 44.5 months. The 78.8% had ENT disorders, the most frequent ENT disorders was allergic rhinitis and otitis media with effusion. Hearing screening was abnormal in a quarter of the patients, 50% of children over 3 years of age had obstructive sleep apnea diagnosed by polysomnogram. Older children had a statistically higher frequency of ENT disorders. CONCLUSIONS: This series shows a high rate of ENT disorders in children with DS, which supports recommendations for hearing screening, high suspicion of obstructive sleep apnea and routine referral to an ENT specialist for prevention and aggressive therapy in order to reduce hearing loss and improve development of the child with DS.

Histological and ultrastructural reaction to different materials for orthopaedic application.

Prosthetic joints loosening in absence of infection is the most common reason for revision surgery and is known as aseptic loosening. A significant role in the pathogenesis of implant failure undoubtedly played by the generation of wear debris, mainly from the load bearing joint surfaces, and the cellular reaction through the formation of tissue membrane around implants. This article analyzes histologic, immunohistochemical ad ultrastructural aspects of periprosthetic tissue membrane collected at time of surgical revision, paying attention on cell host response to different materials: metals, polyethylene and ceramics. Dimension of particles seems to be crucial in the activation of different cell population to wear debris.

Local adjuvants in surgical management of bone metastases.

Curettage is one of the most common method for surgical treatment of bone metastasis. Local adjuvant improve most commonly used for improving the effect of curettage in local cancer surgery may exerted their effects either chemically either physically; in Orthopedic Oncology the most common are phenol, liquid nitrogen, laser, and cement. This article reviewed the main characteristics of the most common chemical and physical agents used in bone oncology, emphasizing the toxic effects of some of them, especially phenol and liquid nitrogen.

An original method for the evaluation of in vivo controlled release of the ceramic materials.

In recent years, the use of ceramic materials in orthopaedics and dentistry is becoming increasingly popular. However, it is important to know their biological and mechanical properties to optimize their use. The aim of this study is to describe a specific method to assess in vivo the effects of chronic release of ceramic materials implanted, in relation also to the type of material, pellets or powders. This was achieved by implanting ceramic powders and pellets, formed by low cohesion grains, in the patellar tendon of 48 New Zealand adult rabbits (24 with powders and 24 with pellets). The motion of the joint allowed easily and progressively the release of grains, detached from surface of the pellets and released to the joint space. Animals were sacrificed at different intervals (1, 3, 6, 12 months). Retrieved knee joints underwent X-Ray, histological and ultrastructural analysis.

Zirconia toughened alumina (ZTA) powders: ultrastructural and histological analysis.

Ceramic materials, as Alumina and Zirconia, has made an improvement in the choice of new biomaterials for the load bearing application in dental and orthopaedic implants. These materials has shown mechanical resistance to high stress related to weight bearing and low debris in time. For this reason they are indicated on young patients implant, with high demanding activities and long life expectance. In literature however the risk of chronic inflammation due to chronic wear debris release and the possibility of carcinogenesis, is still to be definitively investigated. Another point to investigate is the acute reaction of the tissue in case of acute release of powders of these materials. The aim of this study was to investigate the possible local and systemic acute effects of ceramic precursors in form of powders of different size when released into articular joint. Powders of ZTA were implanted in the knee joint of twenty-four New Zealand white adult rabbits, that were sacrificed at 1,3,6, and 12 months. Radiographic, histological and immunoistochemestry analysis were conducted on periprosthetic tissue and peripheral organs, to verifying local host response and systemic toxic effects.

Complete Genome Sequences of 17 Clinical Campylobacter jejuni Strains from Chile.

Campylobacter jejuni is the leading cause of bacterial foodborne disease worldwide. Here, we report the complete annotated genomes and plasmid sequences of 17 Campylobacter jejuni strains isolated from patients with gastroenteritis in Santiago, Chile.

Improving the screening of tuberculosis in patient admitted in a secondary care hospital of La Habana.

INTRODUCTION: The reduction of tuberculosis reported in admitted patients in a community hospital in La Habana (Cuba) was identified as a quality gap and priority for action. The objective was to increase by 50% the number of bacilloscopies and smear-positive tuberculosis confirmed by December 2017. PATIENTS AND METHODS: A quality improvement initiative was conducted from January 2017 to December 2017 in a 300-bed secondary care teaching hospital. The improvement project was addressed to patients admitted with respiratory infections (upper or lower). The baseline was considered the period from January to December 2016. The intervention period was from January 2017 to June 2018. The intervention includes training activities for medical staff, monthly monitoring of bacilloscopies performed and feedback and analysis with leaders and departments. RESULTS: During the baseline period seven patients were confirmed with pulmonary tuberculosis and 160 bacilloscopies were performed (mean 40 bacilloscopies/quarter). During the intervention period were confirmed 22 cases of tuberculosis and 577 bacilloscopies were performed (mean 96 bacilloscopies/quarter). CONCLUSIONS: The number of bacilloscopies and sputum smear tuberculosis was successfully increased in admitted patients using the staff education, monitoring, and feedback as intervention measures. The next steps of the project will be focused in achieve the sustainability of the intervention, evaluation of educational needs of medical staff and design training activities accordingly and, screening of latent tuberculosis infections using of tuberculin skin test in selected high risk admitted patients.

Effect of 5% transdermal lidocaine patches on postoperative analgesia in dogs undergoing hemilaminectomy.

OBJECTIVES: To investigate the effect of 5% lidocaine patches on postoperative analgesia in dogs undergoing hemilaminectomy. MATERIALS AND METHODS: Client-owned dogs undergoing hemilaminectomy for a single acute intervertebral thoracolumbar disc extrusion were enrolled in this prospective, randomised, blinded clinical trial. Following methadone administration, anaesthesia was induced with propofol, and maintained with isoflurane in oxygen and fentanyl infusion, in both groups. After skin closure, two 1∙5 cm wide 5% lidocaine patch strips were attached along both sides of the wound in dogs allocated to Group L. In Group C, the two lidocaine patch strips were applied but the transparent isolating liner was not removed. Postoperatively, all dogs received a non-steroidal anti-inflammatory drug, gabapentin and diazepam. Methadone was administered according to the short form of Glasgow Composite Pain Scale with pain assessed every 2 hours for 48 hours by observers unaware of the treatment. RESULTS: Thirty-nine dogs completed the study. Demographic data, end-expiratory fraction of isoflurane, fentanyl consumption, anaesthesia and surgical times were similar between groups. The number of dogs requiring postoperative methadone and the number of doses of methadone administered were not different between groups. No macroscopic skin reaction was noticed once the patches were removed. CLINICAL SIGNIFICANCE: In this setting, 5% lidocaine patches did not provide additional postoperative analgesia in dogs undergoing hemilaminectomy.

Carbon burial and storage in tropical salt marshes under the influence of sea level rise.

Coastal vegetated habitats can be important sinks of organic carbon (Corg) and mitigate global warming by sequestering significant quantities of atmospheric CO2 and storing sedimentary Corg for long periods, although their Corg burial and storage capacity may be affected by on-going sea level rise and human intervention. Geochemical data from published 210Pb-dated sediment cores, collected from low-energy microtidal coastal wetlands in El Salvador (Jiquilisco Bay) and in Mexico (Salada Lagoon; Estero de Urias Lagoon; Sian Ka'an Biosphere Reserve) were revisited to assess temporal changes (within the last 100years) of Corg concentrations, storage and burial rates in tropical salt marshes under the influence of sea level rise and contrasting anthropization degree. Grain size distribution was used to identify hydrodynamic changes, and δ13C to distinguish terrigenous sediments from those accumulated under the influence of marine transgression. Although the accretion rate ranges in all sediment records were comparable, Corg concentrations (0.2-30%), stocks (30-465Mgha-1, by extrapolation to 1m depth), and burial rates (3-378gm-2year-1) varied widely within and among the study areas. However, in most sites sea level rise decreased Corg concentrations and stocks in sediments, but increased Corg burial rates. Lower Corg concentrations were attributed to the input of reworked marine particles, which contribute with a lower amount of Corg than terrigenous sediments; whereas higher Corg burial rates were driven by higher mass accumulation rates, influenced by increased flooding and human interventions in the surroundings. Corg accumulation and long-term preservation in tropical salt marshes can be as high as in mangrove or temperate salt marsh areas and, besides the reduction of Corg stocks by ongoing sea level rise, the disturbance of the long-term buried Corg inventories might cause high CO2 releases, for which they must be protected as a part of climate change mitigation efforts.

Retiro de elementos de osteosíntesis en trauma maxilofacial / Osteosynthesis elements removal in maxillofacial trauma

Resumen Objetivo: Analizar la prevalencia y los factores en la remoción de elementos de osteosíntesis (OTS) de pacientes tratados quirúrgicamente debido a fracturas maxilofaciales. Materiales y Método: Estudio retrospectivo descriptivo, donde fueron incluidos todos los pacientes con diagnóstico de fractura maxilofacial y tratados mediante reducción abierta y fijación interna rígida en un intervalo de 10 años, en el Servicio de Cirugía Oral y Maxilofacial en el Hospital Clínico Mutual de Seguridad (HCMS). Resultados: En un total de 807 pacientes intervenidos, con un rango etario entre 22-66 años, fueron utilizados 2.421 OTS. Entre ellos, 58 pacientes (7,2%) fueron sometidos a un segundo procedimiento quirúrgico, retirándose un total de 129 OTS (5,3%). La principal causa de retiro fue infección (41,1%), comúnmente de carácter tardío. El tercio inferior facial fue el más afectado, específicamente, la zona parasinfisiaria. El 39% fue retirado antes de los 12 meses de posicionados. Conclusiones: El retiro de OTS, posterior a trauma maxilofacial tiene una baja prevalencia. El sitio más afectado es el hueso mandibular y la mayoría se retira dentro de los primeros 12-24 meses. La etiología es variable, sin embargo, la infección se mantiene como una de las principales. Los hallazgos sugieren que no sería recomendable realizar este procedimiento de forma universal para todos los pacientes.

Aim: To analyse the prevalence and factors regarding to osteosynthesis elements (OTS) removal from patients surgically treated due to maxillofacial fractures. Materials and Method: Retrospective study in which all patients with diagnosis of maxillofacial fractures and treated with open reduction and internal rigid fixation were included, in an interval of 10 years, in the Maxillofacial Surgery Service of HCMS. Results: In 807 surgically treated patients, with an age between 22-66 years, 2.421 OTS were used. Among them, 58 patients (7.2%) underwent a second surgical procedure, with a total of 129 OTS removed (5.3%). The main cause of removal was infection (41.1%), commonly of a chronic nature. The lower third of the face was the most affected, specifically, the parasymphysis region. 39% of OTS were withdrawn before 12 months. Conclusions: OTS removal after maxillofacial trauma has a low prevalence, the most affected site is the mandibular bone, within the first 12-24 months. The aetiology is variable, however, infection remains one of the main. The findings suggest that it would not be advisable to perform this procedure universally for all patients.

Effect of Ag Addition on the Electrochemical Performance of Cu10Al in Artificial Saliva.

In this work we proposed to evaluate the corrosion resistance of four different alloys by electrochemical techniques, a binary alloy Cu10Al, and three ternary alloys Cu10Al-xAg (x = 5, 10, and 15 wt.%) to be used like biomaterials in dental application. Biomaterials proposed were tested in artificial saliva at 37°C for 48 h. In addition, pure metals Cu, Al, Ag, and Ti as reference materials were evaluated. In general the short time tests indicated that the Ag addition increases the corrosion resistance and reduces the extent of localized attack of the binary alloy. Moreover, tests for 48 hours showed that the Ag addition increases the stability of the passive layer, thereby reducing the corrosion rate of the binary alloy. SEM analysis showed that Cu10Al alloy was preferably corroded by grain boundaries, and the Ag addition modified the form of attack of the binary alloy. Cu-rich phases reacted with SCN(-) anions forming a film of CuSCN, and the Ag-rich phase is prone to react with SCN(-) anions forming AgSCN. Thus, binary and ternary alloys are susceptible to tarnish in the presence of thiocyanate ions.

Isolation and molecular characterization of quinolone resistant Salmonella spp. from poultry farms.

The antimicrobial susceptibility of 94 Salmonella strains isolated from different poultry farms in Chile (broiler and laggin hens) were analyzed by the dilution plates method. Thirty-nine of them were resistant to flumequine, nalidixic acid and oxolinic acid with MIC values higher than 64 microg/ml. These quinolone resistant strains were analyzed in order to determine the presence of mutations in the QRDR region of gyrA gene by AS-PCR-RFLP analysis. 51.3% of the strains showed mutations at codon Ser 83 and 41.0% showed mutations at codon Asp 87. No mutations were observed on codon Gly 81. These mutations were confirmed by sequenciation of one representative strain from different RFLP pattern. Likewise, no double mutations were observed. Over 90% of the quinolone resistant strains presented mutations at the QRDR region of the gyrA gene. Three phenotypically resistant strains did not show any mutations on the QRDR region of gyrA gene. However, other molecular resistant mechanism could be involve. This is the first study that demonstrate the emergency of quinolone and fluoroquinolone resistance in Chilean Salmonella strains isolated from poultry thus indicating the requirement of monitoring programmes in veterinary medicine.

Corrosion Performance of Fe-Cr-Ni Alloys in Artificial Saliva and Mouthwash Solution.

Several austenitic stainless steels suitable for high temperature applications because of their high corrosion resistance and excellent mechanical properties were investigated as biomaterials for dental use. The steels were evaluated by electrochemical techniques such as potentiodynamic polarization curves, cyclic polarization curves, measurements of open circuit potential, and linear polarization resistance. The performance of steels was evaluated in two types of environments: artificial saliva and mouthwash solution at 37°C for 48 hours. In order to compare the behavior of steels, titanium a material commonly used in dental applications was also tested in the same conditions. Results show that tested steels have characteristics that may make them attractive as biomaterials for dental applications. Contents of Cr, Ni, and other minor alloying elements (Mo, Ti, and Nb) determine the performance of stainless steels. In artificial saliva steels show a corrosion rate of the same order of magnitude as titanium and in mouthwash have greater corrosion resistance than titanium.

COVID-19: manejo de cuidados intensivos pediátrico / COVID-19: pediatric intensive care management

The appearance of a new nosological entity named by the World Health Organization (WHO) as CoVID-19, which is causing a global pandemic, has meant a major medical challenge. This article tries to concentrate the most important aspects in the management pediatric of the severe CoVID-19 patient, reviewing the existing literature with emphasis on ventilatory, hemodynamic and other affected systems management. It must be taken into account that due to the high possibility of contagion, it is necessary to review the protection measures for health personnel in the procedures that are routine in the seriously ill patient.

La aparición de una nueva entidad nosológica denominada por la Organización Mundial de la Salud (OMS) como CoVID-19, está causando una pandemia mundial que ha significado un desafío médico de gran envergadura Este artículo trata de concentrar los aspectos más importantes en el manejo pediátrico del paciente CoVID-19 grave, revisando la literatura existente poniendo énfasis en el manejo ventilatorio, hemodinámico y de otros sistemas afectados. Hay que tomar en cuenta que debido a la alta posibilidad de contagio se hace necesario revisar las medidas de protección para el personal de salud en los procedimientos que son de rutina en el paciente gravemente enfermo.

The influence of pH upon the kinetic parameters of the enzymatic hydrolysis of cellobiose with Novozym 188.

We have studied experimentally within the pH range of 3.65-5.5 at 50 degrees C the hydrolysis of cellobiose with Novozym 188, a commercial product with high beta-1,4-glucosidase activity derived from Aspergillus niger. We used wide variations in the conversion to be able to apply the integral method and thus determine that there is substrate and mixed product inhibition. Whether the SES triple compound contributes to the formation of glucose does not influence the fitting of the experimental results to the theoretical model to any significant extent. We have established how pH affects the kinetic parameters and ascertained that pH 4.3 is the optimum for the conversion of cellobiose into glucose.

The influence of pH and aeration rate on the fermentation of D-xylose by Candida shehatae.

The effects of the initial pH and air supply on the production of ethanol from D-xylose using the yeast Candida shehatae in a batch reactor were investigated. The initial pH was altered within the range of 2.5-6.5 and the specific aeration rate from 0.0-0.3 vv-1 min-1. The results showed that the most favorable initial pH for ethanol production was 4.5 and aeration via the stirring vortex of the bioreactor was sufficient. Under these conditions, the maximum specific growth rate (mu(m)) was 0.329 h-1; biomass production rate (b), 0.024 kg m-3 h-1; overall biomass yield (YGx/s), 0.036 kg kg-1; the specific uptake rate of D-xylose (qs), 2.0 kg kg-1 h-1; and the specific ethanol production rate (qE), 0.72 kg kg-1 h-1 (both at 20 h culture time). The average xylitol yield (Yxy/s) was 0.078 kg kg-1 and the overall ethanol yield (YGE/s), 0.41 kg kg-1. Both qs and qE diminished once the exponential growth phase was over.

Targeting cancer stem cells to suppress acquired chemotherapy resistance.

Acquired resistance has curtailed cancer survival since the dawn of the chemotherapy age more than half a century ago. Although the application of stem cell (SC) concepts to cancer captured the imagination of scientists for many years, only the last decade has yielded substantial evidence that cancer SCs (CSCs) contribute to chemotherapy resistance. Recent studies suggest that the functional and molecular properties of CSCs constitute therapeutic opportunities to improve the efficacy of chemotherapy. Here we review how these properties have stimulated combination strategies that suppress acquired resistance across a spectrum of malignancies. The clinical implementation of these strategies promises to rejuvenate the effort against an enduring challenge.

Electrochemical Study of Ni20Cr Coatings Applied by HVOF Process in ZnCl2-KCl at High Temperatures.

Corrosion behavior of Ni20Cr coatings deposited by HVOF (high velocity oxygen-fuel) process was evaluated in ZnCl2-KCl (1 : 1 mole ratio) molten salts. Electrochemical techniques employed were potentiodynamic polarization curves, open circuit potential, and linear polarization resistance (LPR) measurements. Experimental conditions included static air and temperatures of 350, 400, and 450°C. 304-type SS was evaluated in the same conditions as the Ni20Cr coatings and it was used as a reference material to assess the coatings corrosion resistance. Coatings were evaluated as-deposited and with a grinded surface finished condition. Results showed that Ni20Cr coatings have a better corrosion performance than 304-type SS. Analysis showed that Ni content of the coatings improved its corrosion resistance, and the low corrosion resistance of 304 stainless steel was attributed to the low stability of Fe and Cr and their oxides in the corrosive media used.