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Background:Computed Tomography chest scan can be a tool for classification of COVID 19 disease. We propose there is a relation between computed tomography severity index and inflammation biomarkers.Methods:Weperformed a retrospective analysis of hospitalized COVID 19 patients in Mexicali ́s General Hospital, during the period of March 2020 to December 2020. The inclusion criteria wasover 18 years old, confirmatory RT-PCR nasal swab and available CT chest scan. We extracteddata ofmedical records;variables studied were age, sex, date of symptom onset, date of admission, chest computed tomography score, RT-PCR result, laboratory values (D-dimer, fibrinogen, ferritin, procalcitonin, C-reactive protein, total leukocytes, lymphocytes), and outcome. Results:From March 2020 to December 2020, 397 patients were recruited that fulfilled the inclusion criteria from a 700 patient database. Statistically significant differences after ttests between survivors and non-survivors were found for C-reactive protein (means 47.1 ± 36 vs. 80.1 ± 54;p = 0.0009), procalcitonin (means 961 ± 279 vs. 1,032 ± 283; p = 0.023), white blood cells (means 10.57 ± 4.46 vs. 12.33 ± 6.22; p = 0.0026) and lymphocytes (means 0.79 ± 0.50 vs. 0.68 ± 0.40; p value= 0.026).Conclusions:Laboratory and imaging studies are fundamental for stratification and outcome prediction in COVID-19 patients. With these findings we can determine the prognosis of a patient, have a better approach, and search specifically for the relevant severity markers such as fibrinogen, white blood cells, lymphocytes, and C-reactive protein in hospitals with limited resources.

Aim: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2018 and 2019. Material and methods: from January 1, 2018 to December 31, 2019 the home enteral nutrition registry was recorded, and afterwards a further descriptive and analytical analysis was done. Results: in 2018, 4756 active patients were registered and the prevalence was 101.79 patients per one million inhabitants; in 2019 there were 4633 patients with a prevalence of 98.51 patients per one million inhabitants. They originated in 46 hospitals: 51.3 % were male, and median age was 71.0 years in both periods. The most frequent diagnosis was a neurological disorder that presents with aphagia or severe dysphagia - 58.7 % and 58.2 %, respectively. The main cause of episode termination was death. A total of 116 pediatric patients were registered in 2018 and 115 in 2019. Females represented 57.8 % and 59.1 %, respectively, in each of the periods. Median age at the beginning of HEN was 5 and 7 months. The most commonly recordered diagnostic group (42.2 % and 42.6 %) was included within the other pathologies group, followed by neurological disorders that present with aphagia or severe dysphagia in 41.4 % and 41.7 % of children. The route of administration was gastrostomy in 46.6 % and 46.1 %, respectively, in each of the periods. Conclusions: the NED registry of the NADYA-SENPE group continues to operate uninterruptedly since its inception. The number of registered patients and the number of participating hospitals remained stable in the last biennium analyzed.

Purpose: There is an unknown percentage of transgender and gender non-confirming individuals who undergo gender affirmation surgeries (GAS) that experiences regret. Regret could lead to physical and mental morbidity, also questioning the appropriateness of these procedures in selected patients. The aim of this study is to evaluate the prevalence of regret in transgender individuals who underwent GAS and evaluate associated factors. Methods: A systematic review was conducted following the PRISMA guidelines. A comprehensive research strategy was performed including the following databases: Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Random-effects meta-analysis of proportions, subgroup analysis, meta-regression, publication bias, and sensitivity analyses were performed. Results: A total of 27 studies, pooling 7,928 transgender patients that underwent any type of GAS were included in this review. The pooled prevalence of regret after GAS was 1% (95% Confidence interval [CI]

Aim: to communicate the home parenteral nutrition (HPN) data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe.com) for the year 2019. Material and methods: a descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1 to December 31, 2019. Results: a total of 283 patients (51.9 % women), 31 children, and 252 adults from 47 Spanish hospitals were registered, which represents a prevalence rate of 6.01 patients per million inhabitants for year 2019. The most frequent diagnosis in adults was "palliative oncological" and "others" (21.0 %). In children, it was Hirschsprung's disease together with necrotizing enterocolitis, alterations in intestinal motility, and chronic intestinal pseudo-obstruction, with 4 cases each (12.9 %). The first reason for the indication was short-bowel syndrome in both children (51.6 %) and adults (37.3 %). The most used type of catheter was tunnelled both in children (75.9 %) and in adults (40.8 %). Sixty-eight episodes ended, all in adults, and the most frequent cause was death (54.4 %); 38.2 % were switched to oral. Conclusions: the number of collaborating centers and professionals in the NADYA registry is increasing. The main indications and reasons for HPN termination remain stable.

Angiotensin converting enzyme 2 (ACE2) is the cellular receptor for SARS-CoV-2, so ACE2expressing cells can act as target cells and are susceptible to infection. ACE2 receptors are highly expressed in the oral cavity, so this may be a potential high-risk route for SARS-CoV2 infection. Furthermore, the virus can be detected in saliva, even before COVID-19 symptoms appear, with the consequent high risk of virus transmission in asymptomatic/ presymptomatic patients. Reducing oral viral load could lead to a lower risk of transmission via salivary droplets or aerosols and therefore contribute to the control of the pandemic. Our aim was to evaluate the available evidence testing the in-vitro and in-vivo effects of oral antiseptics to inactivate or eradicate coronaviruses. The criteria used were those described in the PRISMA declaration for performing systematic reviews. An electronic search was conducted in Medline (via PubMed) and in Web of Sciences, using the MeSH terms: 'mouthwash' OR 'oral rinse' OR 'mouth rinse' OR 'povidone iodine' OR 'hydrogen peroxide' OR 'cetylpyridinium chloride' AND 'COVID-19' OR 'SARS-CoV-2' OR 'coronavirus' OR 'SARS' OR 'MERS'. The initial search strategy identified 619 articles on two electronic databases. Seventeen articles were included assessing the virucidal efficacy of oral antiseptics against coronaviruses. In conclusion, there is sufficient in-vitro evidence to support the use of antiseptics to potentially reduce the viral load of SARSCoV-2 and other coronaviruses. However, in-vivo evidence for most oral antiseptics is limited. Randomized clinical trials with a control group are needed to demonstrate its clinical efficacy. (c) 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

We present a systematic search for optical counterparts to 13 gravitational wave (GW) triggers involving at least one neutron star during LIGO/Virgo's third observing run (O3). We searched binary neutron star (BNS) and neutron star black hole (NSBH) merger localizations with the Zwicky Transient Facility (ZTF) and undertook follow-up with the Global Relay of Observatories Watching Transients Happen (GROWTH) collaboration. The GW triggers had a median localization area of 4480 deg2, a median distance of 267 Mpc, and false-alarm rates ranging from 1.5 to 10-25 yr-1. The ZTF coverage in the g and r bands had a median enclosed probability of 39%, median depth of 20.8 mag, and median time lag between merger and the start of observations of 1.5 hr. The O3 follow-up by the GROWTH team comprised 340 UltraViolet/Optical/InfraRed (UVOIR) photometric points, 64 OIR spectra, and three radio images using 17 different telescopes. We find no promising kilonovae (radioactivity-powered counterparts), and we show how to convert the upper limits to constrain the underlying kilonova luminosity function. Initially, we assume that all GW triggers are bona fide astrophysical events regardless of false-alarm rate and that kilonovae accompanying BNS and NSBH mergers are drawn from a common population; later, we relax these assumptions. Assuming that all kilonovae are at least as luminous as the discovery magnitude of GW170817 (-16.1 mag), we calculate that our joint probability of detecting zero kilonovae is only 4.2%. If we assume that all kilonovae are brighter than-16.6 mag (the extrapolated peak magnitude of GW170817) and fade at a rate of 1 mag day-1 (similar to GW170817), the joint probability of zero detections is 7%. If we separate the NSBH and BNS populations based on the online classifications, the joint probability of zero detections, assuming all kilonovae are brighter than-16.6 mag, is 9.7% for NSBH and 7.9% for BNS mergers. Moreover, no more than 10-4, or φ > 30° to be consistent with our limits. We look forward to searches in the fourth GW observing run; even 17 neutron star mergers with only 50% coverage to a depth of-16 mag would constrain the maximum fraction of bright kilonovae to

Introducción: La gammagrafía de tiroides es un examen frecuentemente empleado en el estudio de la enfermedad tiroidea. Se recomienda su realización en el paciente con tirotoxicosis, nódulo tiroideo con citología indeterminada y en la búsqueda de tiroides ectópica. Objetivo: Determinar la pertinencia de la solicitud de la gammagrafía tiroidea en un servicio de medicina nuclear de referencia del oriente colombiano. Metodología: Estudio observacional, corte transversal retrospectivo tipo descriptivo. Se evaluaron las gammagrafías de tiroides realizadas en la unidad de medicina nuclear de la clínica Carlos Ardila Lulle durante 3 meses consecutivos que en la hoja de solicitud incluyeran todas las variables de interés. Se registró la indicación del estudio, formación académica del médico que solicitaba el examen, sexo del paciente, presencia concomitante de TSH con su valor respectivo y el consumo de levotiroxina previo al examen. Adicionalmente se registró el resultado gammagráfico. Resultados: 277 gammagrafías fueron analizadas, 244 (88%) eran mujeres. EL 67% no estaban correctamente indicadas y de estas el 32% de los pacientes estaban recibiendo suplencia hormonal, la cual fue suspendida 25 días antes de la realización del examen. Los médicos generales y médicos especialistas no endocrinólogos tienen la probabilidad de 9.08 veces y 9.37 veces respectivamente de no indicar adecuadamente la gammagrafía tiroidea respecto a los médicos endocrinólogos. Conclusiones: Dos de cada 3 gammagrafías tiroideas que se realizaron en un servicio de medicina nuclear de referencia del oriente colombiano no están adecuadamente indicadas, teniendo esto un impacto en la salud pública. [Sánchez-Orduz L, Wandurraga-Sánchez EA, García RE, Camacho PA. Pertinencia de la gammagrafía de tiroides en un servicio de medicina nuclear de referencia del oriente colombiano. MedUNAB 2015; 17(3): xx-xx]. Introduction: Thyroid scan is a test frequently used in the study of thyroid diseases. It is recommended to perform it in patients presenting thyrotoxicosis, thyroid nodules with indeterminate cytology and when diagnosing ectopic thyroid. Our objective was to determine the pertinence of ordering thyroid scan in a nuclear medicine department in eastern Colombia. Methodology: Observational, retrospective, and cross-sectional descriptive study. Thyroid scans including relevant variables performed in the nuclear medicine department at Carlos Ardila Lulle hospital were evaluated during 3 consecutive months. The indication of the study, academic background of physician requesting the test, patient’s gender, concomitant presence of TSH with its respective value, and intake of Levothyroxine before test. Test results were also taken into account. Results: Out of the 277 performed scans, 244 (88%) were women. 67% of them were not correctly indicated, and 32% of these patients were taking hormonal supplements, which was suspended 25 days before performing the test. General practitioners and consultants without specialization in endocrinology have a 9.08 and 9.37 probability respectively, of not indicating correctly the thyroid scan compared to endocrinologists. Conclusions: Two out of 3 thyroid scans performed in a nuclear medicine department in Eastern Colombia are not correctly indicated, producing a big impact in public health. [Sánchez-Orduz L, Wandurraga-Sánchez EA, García RE, Camacho PA. Pertinence of Thyroid Scan in a Nuclear Medicine Department in Eastern Colombia. MedUNAB 2015; 17(3): xx-xx]. Introdução: A cintilografia da tireóide é um teste muito usado no estudo de doenças da glândula tireóide. O monitoramento é recomendado em doentes com tireotoxicose, nódulos de tireóide com citologia indeterminada e suspeita de tireóide ectópica. Objetivo: Nosso objetivo foi determinar a pertinência do pedido de cintilografia da tireóide em um centro de referência de medicina nuclear no leste da Colômbia. Metodologia: Estudo de observação, com corte transversal retrospectivo e descritivo. As cintilografias realizadas na unidade de medicina nuclear da clínica Carlos Ardila Lulle foram avaliados por 3 meses consecutivos, incluindo no formulário todas as variáveis de interesse. Registrou-se a indicação do estudo, a formação acadêmica do médico que pediu o exame, o sexo do paciente, a presença concomitante de TSH com seu respectivo valor e o uso de levotiroxina antes de fazer o teste. Além disso foi registrado o resultado da cintilografia. Resultados: 277 cintilografias foram analisadas, 244 (88%) eram de mulheres. 67% não foram devidamente identificados e, destes, 32% dos pacientes estavam recebendo substituição hormonal, que foi suspensa 25 dias antes do exame. Os clínicos gerais e os especialistas não endocrinologistas têm a probabilidade de 9,08 vezes e 9,37 vezes, respectivamente, de não indicar corretamente o exame da tireóide, em relação aos médicos endocrinologistas. Conclusões: Dois de cada três exames de tireóide que são feitos num centro de referência de medicina nuclear no leste colombiano não estão corretamente solicitados, o que gera grande impacto na saúde pública. [Sánchez-Orduz L, Wandurraga-Sánchez EA, García RE, Camacho PA. Relevância da cintilografia da tireóide em um centro de referência de medicina nuclear no leste colombiano. MedUNAB 2015; 17(3): xx-xx].

To communicate the results of the Spanish Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE group for the year 2013.

In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima ( Cercado ) and in surrounding urban neighborhoods (non- Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non- Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being.

AIM: To communicate the results of the Spanish Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE group for the year 2013. MATERIAL AND METHODS: Data was recorded online by NADYA group collaborators that were responsible of the HPN follow-up from 1st January to 31st December 2013. RESULTS: A total of 197 patients and 202 episodes of HPN were registered from 35 hospitals that represents a rate of 4,22 patients/million habitants/year 2013. The median age was 53 years (IQR 40-64) for 189 adult patients and 7 months (IQR 6-35,5) for children. The most frequent disease in adults was neoplasm (30,7%) followed by other diseases (20,1%) and mesenteric ischemia (12,7%). Short bowel syndrome and intestinal obstruction (25,9%) were in 35.7% cases the indications for HPN. The most frequent diagnosis for children were the congenital intestinal disorders and other diagnosis, both with a (37,5%) and short bowel syndrome and intestinal obstruction were the indication for treatment, each was present in 50% of the sample. Tunneled catheters (50%) and subcutaneous reservoirs (27,7%) were frequently used. The septic complications related with catheter were commonly frequent with a rate of 0.74 infections/1000 HPN days. HPN duration presented a median of 1,69 days. A total of 86 episodes finalized during the year, death was the principal reason (45%), followed by "resumed oral via" (43,75%) while it happened inversely for children, 66,7% of them resumed oral via and 16,7% deceased. Fifteen per cent were considered for intestinal transplant, children were proportionally candidates, p-value 0.002. CONCLUSIONS: The number of participating centers and registered patients increased progressively respect to preceding years. Since 2003 Neoplasm is still being the principal pathological group. Death is adult's principal reason for finalizing HPN and "resuming oral via" for children. Despite that NADYA registry is consolidate as a essential source of relevant information about the advances in Home Artificial Nutrition in our country, currently is in an improvement process of the available information about patients characteristics with a special emphasis on children even though they still being a minority group. Yes Objetivo: comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE del años 2013. Material y métodos: recopilación de los datos del registro “on-line” introducidos por los colaboradores del grupo NADYA responsables del seguimiento de la NPD desde el 1 de enero de 2013 al 31 de diciembre de 2013. Resultados: se registraron 197 pacientes, procedentes de 35 hospitales, lo que representa una tasa de 4,22 pacientes/ millón habitantes/año 2013, con 202 episodios de NPD. La edad media de los 189 pacientes mayores de 14 años fue de 53 años (IIQ 40 – 64), y en los niños de 7 meses (IIQ 6 – 35,5). La patología más frecuente en los adultos fue la neoplasia (30,7%) seguida por otras patologías (20,1%) y la isquemia mesentérica (12,7%). En el 35,4% de los casos el motivo de indicación fue el síndrome de intestino corto, seguido de la obstrucción intestinal (25,9%). En los niños el diagnóstico más frecuente fueron las alteraciones congénitas intestinales y ‘otros diagnósticos’, ambas con un 37,5 %, y la causa de la indicación el síndrome de intestino corto y la obstrucción intestinal, que se repartieron el 50% de la muestra. Los catéteres más utilizados fueron los tunelizados (50%) y los reservorios subcutáneos (27,7%). Las complicaciones más frecuentes fueron las sépticas, relacionadas con el catéter, con una tasa de 0,74 infecciones/1.000 días de NPD. La duración de la NPD presentó una mediana de 1,69 años. Durante el año finalizaron 86 episodios, la principal causa de la finalización en adultos fue el fallecimiento (45%) seguido del ‘paso a la vía oral’ (43,75%) y en los niños a la inversa 66,7% pasan a vía oral y 16,7% fallecen. Se consideraron candidatos para trasplante intestinal el 15% de los pacientes, siendo proporcionalmente los candidatos niños, p-valor 0,002. Conclusiones: se observa un aumento progresivo de los centros participantes y de los pacientes registrados respecto a años anteriores. El principal grupo patológico sigue siendo oncológico, ocupando el primer lugar desde 2003. La principal causa de finalización de la NPD es en los adultos el fallecimiento y en los niños el ‘paso a vía oral’. Aunque el registro NADYA es un registro consolidado y ha sido y es fuente imprescindible de información relevante para el conocimiento de los avances de la Nutrición Artificial Domiciliaria en nuestro país, se encuentra en proceso de mejorar la información que ofrece sobre las características de los pacientes, con especial atención en el grupo de niños, aunque estos siguen siendo un número reducido.

Objective: To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2011 and 2012. Material and methods: We retrieved the data of the patients recorded from January 1st 2011 to December 31st 2012. Results: There were 3021 patients in the registry during the period from 29 hospitals, which gives 65.39 per million inhabitants. 97.95% were adults, 51.4% male. Mean age was 67.64 ± 19.1, median age was 72 years for adults and 7 months for children. Median duration with HEN was 351 days and for 97.5% was their first event with HEN. Most patients had HEN because of neurological disease (57.8%). Access route was nasogastric tube for 43.5% and gastrostomy for 33.5%. Most patients had limited activity level and, concerning autonomy, 54.8% needed total help. Nutritional formula was supplied from chemist’s office to 73.8% of patients and disposables, when necessary, was supplied from hospitals to 53.8% of patients. HEN was finished for 1,031 patients (34.1%) during the period of study, 56.6% due to decease and 22.2% due to recovery of oral intake. Conclusions: Data from NADYA-SENPE registry must be explained cautiously because it is a non-compulsory registry. In spite of the change in the methodology of the registry in 2010, tendencies regarding HEN have been maintained, other than oral route, Objetivos: Describir los resultados del registro de nutrición enteral domiciliaria (NED) del grupo NADYASENPE de los años 2011 y 12. Material y métodos: Se recopilaron los datos introducidos en el registro desde el 1 de enero de 2011 al 31 de diciembre de 2012. Resultados: Hubo 3021 pacientes en el registro durante el periodo, procedentes de 29 hospitales, lo que da una prevalencia de 65,39 casos por millón de habitantes. 97.95% fueron adultos, 51,4% varones. La edad media fue 67,64 ± 19,1 años y la mediana 72 años para los adultos y 7 meses para los niños. La duración media de la NED fue 351 días y para el 97,5% fue el primer episodio con NED. La mayoría de pacientes tenían NED por una enfermedad neurológica (57,8%). La vía de acceso fue sonda nasogástrica para el 43,5% y gastrostomía para el 33,5%. La mayoría de pacientes tuvieron un nivel de actividad física limitado y, respecto a la autonomía, 54,8% necesitaba ayuda total. La fórmula de nutrición se suministró desde las oficinas de farmacia para el 73,8% y los fungibles, cuando fueron necesarios, desde los hospitales para el 53,8%. La NED se suspendió en 1.031 pacientes (34,1%) durante el periodo de estudio, 56,6% debido a fallecimiento y 22,2% debido a recuperación de la vía oral. Conclusiones: Los datos del registro NADYA-SENPE deben ser interpretados con precaución ya que se trata de un registro voluntario. A pesar del cambio de metodología del registro en 2010, las tendencias en NED se han mantenido, salvo la importancia cuantitativa de la vía oral