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Pediatric patients and their caregivers often experience perioperative anxiety. Interventions reduce caregiver anxiety improve cooperation and contribute to an improved patient experience. This study seeks to evaluate the efficacy of virtual reality (VR)-assisted mindfulness on perioperative caregiver anxiety. Participants were randomized into a standard of care (SOC) group, which included snacks but no technology-based distractions, or a VR group, which included snacks and a VR-guided meditation. Caregiver anxiety was measured before and after the intervention using the Visual Analogue Scale for Anxiety (VAS-A). Secondary aims explored participants’ baseline anxiety with the State-Trait Anxiety Inventory (STAI). VR group participants completed a satisfaction survey. Linear regression models of VAS-A and STAI were used to compare group differences. Satisfaction survey results were reported with descriptive statistics. 26 participants were included, with 12 randomized to the SOC group and 14 to the VR group. VAS-A scores in the VR group were lower than those in the SOC group ( p = .002). The STAI found no change in participants’ state of anxiety in the SOC group ( p = .7108), compared to a significant reduction ( p = .014) in the VR group when controlling for anxiety traits. 12 of 14 caregivers in the VR group expressed satisfaction or strong satisfaction. This study supports the implementation of VR mindfulness as a method to reduce caregiver anxiety. VR use in the pediatric healthcare setting is safe and inexpensive, and the intervention had a high degree of participant satisfaction.

AimsThe volume of ambulatory total hip arthroplasty (THA) procedures is increasing due to the emphasis on value-based care. The purpose of the study is to identify the causes for failed same-day discharge (SDD) and perioperative factors leading to failed SDD.MethodsThis retrospective cohort study followed pre-selected patients for SDD THA from 1 August 2018 to 31 December 2020. Inclusion criteria were patients undergoing unilateral THA with appropriate social support, age 18 to 75 years, and BMI < 37 kg/m2. Patients with opioid dependence, coronary artery disease, and valvular heart disease were excluded. Demographics, comorbidities, and perioperative data were collected from the electronic medical records. Possible risk factors for failed SDD were identified using multivariate logistic regression.ResultsIn all, 278 patients were identified with a mean age of 57.1 years (SD 8.1) and a mean BMI of 27.3 kg/m2 (SD 4.5). A total of 96 patients failed SDD, with the most common reasons being failure to clear physical therapy (26%), dizziness (22%), and postoperative nausea and vomiting (11%). Risk factors associated with failed SDD included smokers (odds ratio (OR) 6.24; p = 0.009), a maximum postoperative pain score > 8 (OR 4.76; p = 0.004), and procedures starting after 11 am (OR 2.28; p = 0.015). A higher postoperative tolerable pain goal (numerical rating scale 4 to 10) was found to be associated with successful SDD (OR 2.7; p = 0.001). Age, BMI, surgical approach, American Society of Anesthesiologists grade, and anaesthesia type were not associated with failed SDD.ConclusionSDD is a safe and viable option for pre-selected patients interested in rapid recovery THA. The most common causes for failure to launch were failing to clear physical thereapy and patient symptomatology. Risk factors associated with failed SSD highlight the importance of preoperative counselling regarding smoking cessation and postoperative pain to set reasonable expectations. Future interventions should aim to improve patient postoperative mobilization, pain control, and decrease symptomatology.Cite this article: Bone Jt Open 2022;3(9):684–691.

OBJECTIVES: To assess the efficacy and safety of oral urea in patients with hyponatremia and heart failure (HF). METHODS AND RESULTS: This is a retrospective observational study of hospitalized and non-hospitalized patients with HF and hyponatremia (serum Na+ < 135 mEq/L) followed by the Heart Failure Unit between January 2013 and May 2018. The study evaluated sodium normalization levels (Na+ = 135 ± 3 mEq/L) after treatment with oral urea. Thirty-four patients were included in the study, and all were on standard treatment for HF. Natremia at the beginning of treatment with oral urea was 126.34 ± 5.41 mEq/L, and the mean on the day of normalization was 136.45 ± 3.22 mEq/L (p < 0.001). The mean time to achieve sodium normalization was 4.28 ± 2.37 days. Blood urea at the beginning of treatment with urea was 85.77 ± 50.51 mg/dl, and the mean on the day of Na+ normalization was 137.90 ± 56.66 mg/dl (p < 0.001). There was an increase in diuresis (p < 0.006) and plasma osmolarity (p < 0.001) as well as a slight decrease in serum potassium (p < 0.001). The mean dose of oral urea was 22.5 g/day. There were no important adverse effects, nor were there significant changes in creatinine levels or the estimated glomerular filtration rate by the MDRD formula. CONCLUSIONS: When added to the standard treatment for short periods of time, treatment with oral urea is safe and effective at correcting natremia and improving diuresis in patients with hypervolemic HF with hyponatremia.

Pulsed power generators create high-energy-density conditions by rapidly delivering an immense pulse of electrical current to a compact imploding load. Accurately measuring the shape and amplitude of this load current pulse is essential to understanding the behavior of all pulsed power experiments. At the Z Pulsed Power Facility, the closest-in load current measurements are provided by velocimetry techniques such as VISAR (velocity interferometer system for any reflector) and PDV (photonic Doppler velocimetry). Here, fiber-coupled interferometers measure the velocity history of an exploding metallic flyer plate that is embedded in the vertical walls of the current return can. The flyer plate is driven outward by the magnetic pressure from the load current such that magnetohydrodynamic modeling can be used to determine the load current waveform from the measured velocity history. In this paper, we present the first load current velocimetry measurements to be made from the horizontal top flyer plate that carries current radially inward from the return can to the load. These spatially resolved measurements, which span R=5–9 mm, are enabled by a transformative new velocimetry diagnostic—a line-imaging velocity interferometer called Z Line VISAR (ZLV)—whose optical performance overcomes the measurement challenges presented by the steep velocity gradients encountered on the top flyer plate. To validate ZLV’s capabilities, a 14-MA, 100-ns experiment was conducted to losslessly couple current up the return can and radially inward across the top flyer plate. Comparisons between the ZLV data obtained from this experiment and two-dimensional magnetohydrodynamic simulations driven with the current measured on the return can indicate that the current delivery across the top flyer plate is indeed lossless to within the few-percent uncertainty of the ZLV data. Given that the current coupling is lossless, the experimental results are used to demonstrate that one-dimensional current unfold techniques can be applied to generate a radially resolved load current map from the ZLV velocity data. This analysis provides a template for how to use the ZLV diagnostic to determine the efficacy of current delivery in future experiments where losses may occur in close proximity to the load.

La hipercolesterolemia familiar (HF) es el trastorno hereditario más frecuente. Se caracteriza por un aumento de los niveles de LDLc y un elevado riesgo enfermedad cardiovascular precoz. A pesar del elevado riesgo cardiovascular (RCV), la mayoría de los pacientes están sin diagnosticar ni tratar. Su diagnóstico precoz permite utilizar medidas preventivas, entre ellas, el tratamiento crónico con estatinas ha demostrado en los pacientes con HF sin enfermedad coronaria previa una marcada reducción del RCV, similar al de la población general. El objetivo del presente estudio es valorar la efectividad del diagnostico de HF mediante un cribado oportunista en nuestra área sanitaria.

Abstract Background In the setting of diabetes mellitus, mitochondrial dysfunction and oxidative stress are important pathogenic mechanisms causing end organ damage, including diabetic kidney disease (DKD), but mechanistic understanding at a cellular level remains obscure. In mouse models of DKD, glomerular endothelial cell (GEC) dysfunction precedes albuminuria and contributes to neighboring podocyte dysfunction, implicating GECs in breakdown of the glomerular filtration barrier. In the following studies we wished to explore the cellular mechanisms by which GECs become dysfunctional in the diabetic milieu, and the impact to neighboring podocytes. Methods Mouse GECs were exposed to high glucose media (HG) or 2.5% v/v serum from diabetic mice or serum from non-diabetic controls, and evaluated for mitochondrial function (oxygen consumption), structure (electron microscopy), morphology (mitotracker), mitochondrial superoxide (mitoSOX), as well as accumulation of oxidized products (DNA lesion frequency (8-oxoG, endo-G), double strand breaks (γ-H2AX), endothelial function (NOS activity), autophagy (LC3) and apoptotic cell death (Annexin/PI; caspase 3). Supernatant transfer experiments from GECs to podocytes were performed to establish the effects on podocyte survival and transwell experiments were performed to determine the effects in co-culture. Results Diabetic serum specifically causes mitochondrial dysfunction and mitochondrial superoxide release in GECs. There is a rapid oxidation of mitochondrial DNA and loss of mitochondrial biogenesis without cell death. Many of these effects are blocked by mitoTEMPO a selective mitochondrial anti-oxidant. Secreted factors from dysfunctional GECs were sufficient to cause podocyte apoptosis in supernatant transfer experiments, or in co-culture but this did not occur when GECs had been previously treated with mitoTEMPO. Conclusion Dissecting the impact of the diabetic environment on individual cell-types from the kidney glomerulus indicates that GECs become dysfunctional and pathological to neighboring podocytes by increased levels of mitochondrial superoxide in GEC. These studies indicate that GEC-signaling to podocytes contributes to the loss of the glomerular filtration barrier in DKD. Video abstract Graphical abstract

La anemia hemolítica autoinmune (AHAI) inducida por fármacos es un trastorno hematológico en cual se produce una destrucción inmnunitaria de los glóbulos rojos por anticuerpos. Los agentes mas asociados son antibióticos y algunos quimioterápicos, pero también se han comunicado casos asociados con diferentes vacunas, incluido tras las vacunas frente a la COVID 19. Presentamos un caso de AHAI cuyo probable desencadenante fue la vacuna COVID 19 Vaxzevria.

For the advancement of porcine xenotransplantation for clinical use in type 1 diabetes mellitus, the concerns of a sustainable and safe digestion enzyme blend must be overcome. Incorporating good manufacturing practices (GMP) can facilitate this through utilizing GMP-grade enzymes. In conjunction, still taking into account the cost-effectiveness, a wide concern. We evaluated how GMP-grade enzyme blends impact our piglet islets and their long-term effects. Preweaned porcine islets (PPIs) were isolated from 8- to 10-day-old pigs. Digestion enzyme blends, collagenase type V (Type V), collagenase AF-1 GMP-grade with collagenase NB 6 GMP-grade (AF-1 and NB 6), and collagenase AF-1 GMP-grade with collagenase neutral protease AF GMP-grade (AF-1 and NP AF) were compared. Islet quality control assessments, islet yield, viability, and function, were performed on days 3 and 7, and cell content was performed on day 7. GMP-grade AF-1 and NB 6 (17,209 ± 2,730 islet equivalent per gram of pancreatic tissue [IE/g] on day 3, 9,001 ± 1,034 IE/g on day 7) and AF-1 and NP AF (17,214 ± 3,901 IE/g on day 3, 8,833 ± 2,398 IE/g on day 7) showed a significant increase in islet yield compared to Type V (4,618 ± 1,240 IE/g on day 3, 1,923 ± 704 IE/g on day 7). Islet size, viability, and function showed comparable results in all enzyme blends. There was no significant difference in islet cellular content between enzyme blends. This study demonstrated a comparison of GMP-grade collagenase enzyme blends and a standard crude collagenase enzyme in preweaned-aged porcine, a novel topic in this age. GMP-grade enzyme blends of AF-1 and NB 6 and AF-1 and NP AF resulted in substantially higher yields and as effective PPIs compared to Type V. In the long run, considering costs, integrity, and sustainability, GMP-grade enzyme blends are more favorable for clinical application due to high reproducibility in comparison to undefined manufacturing processes of standard enzymes.

Previous studies have shown that necrostatin-1 (Nec-1) supplementation improved the viability of murine islets following exposure to nitric oxide, increased the survival of human islets during hypoxic culture, and augmented the maturation of pre-weaned porcine islets (PPIs) after 7 days of tissue culture. A limitation of these studies is that only one concentration of Nec-1 was used, and no studies have determined the optimal dose of Nec-1 for PPIs. Thus, the present study examined the effects of Nec-1 on PPIs at four different doses-0, 25, 50, 100, and 200 μM-after 7 days of tissue culture when supplemented on day 3. PPIs were isolated from pancreata of pre-weaned Yorkshire piglets (8-15 days old) and cultured in a specific islet maturation media added with Nec-1 on day 3 of tissue culture at 4 different doses-0, 25, 50, 100, and 200 μM (n = 6 for each dose). After 7 days of tissue culture, islets were assessed for recovery, viability, endocrine cellular content, GLUT2 expression in beta cells, and insulin secretion after glucose challenge. Nec-1 did not affect the viability of both intact islets and dissociated islets cells during tissue culture regardless of doses. Islets cultured in media supplemented with Nec-1 at 100 μM, but not 25, 50, or 200 μM, had a significantly higher recovery, composition of endocrine cells, GLUT2 expression in beta cells, and insulin secretion capacity than control islets cultured in media without Nec-1 supplementation. Moreover, culturing islets in 200 μM Nec-1 supplemented media not only failed to improve the insulin release but resulted in a lower glucose-induced insulin stimulation index compared to islets cultured in media added with 100 μM Nec-1. Xenotransplantation using porcine islets continues to demonstrate scientific advances to justify this area of research. Our findings indicate that Nec-1 supplementation at 100 μM was most effective to enhance the in vitro maturation of PPIs during tissue culture.

Pre-weaned porcine islets (PPIs) represent an unlimited source for islet transplantation but are functionally immature. We previously showed that necrostatin-1 (Nec-1) immediately after islet isolation enhanced the in vitro development of PPIs. Here, we examined the impact of Nec-1 on the in vivo function of PPIs after transplantation in diabetic mice. PPIs were isolated from pancreata of 8–15-day-old, pre-weaned pigs and cultured in media alone, or supplemented with Nec-1 (100 µM) on day 0 or on day 3 of culture (n = 5 for each group). On day 7, islet recovery, viability, oxygen consumption rate, insulin content, cellular composition, insulin secretion capacity, and transplant outcomes were evaluated. While islet viability and oxygen consumption rate remained high throughout 7-day tissue culture, Nec-1 supplementation on day 3 significantly improved islet recovery, insulin content, endocrine composition, GLUT2 expression, differentiation potential, proliferation capacity of endocrine cells, and insulin secretion. Adding Nec-1 on day 3 of tissue culture enhanced the islet recovery, proportion of delta cells, beta-cell differentiation and proliferation, and stimulation index. In vivo, this leads to shorter times to normoglycemia, better glycemic control, and higher circulating insulin. Our findings identify the novel time-dependent effects of Nec-1 supplementation on porcine islet quantity and quality prior to transplantation.

The aim of this pilot study was to assess: (1) the feasibility and acceptability of a Mindfulness-Based Virtual Reality (MBVR) intervention among children and young adults with Inflammatory Bowel Disease (IBD), and (2) the preliminary efficacy of MBVR on key psychological (anxiety) and physical (pain) outcomes. Participants were 62 children to young adults with IBD (M = 15.6 years; 69.4% Crohn’s disease; 58% male) recruited from an outpatient pediatric IBD clinic. Participants completed a baseline assessment, underwent the 6-min MBVR intervention, completed a post-intervention assessment and study satisfaction survey, and provided qualitative feedback. Results suggest strong feasibility and acceptability. Participants reported high levels of satisfaction with MBVR including high levels of enjoyment (M = 4.38; range 1–5) and relaxation (M = 4.35; range 1–5). Qualitative data revealed several key themes including participants interest in using MBVR in IBD medical settings (e.g., hospitalizations, IBD procedures, IBD treatments), as well as in their daily lives to support stress and symptom management. Preliminary analyses demonstrated improvements in anxiety (t = 4.79, p = 0.001) and pain (t = 3.72, p < 0.001) following MBVR. These findings provide initial support for the feasibility and acceptability of MBVR among children and young adults with IBD. Results also suggest MBVR may improve key IBD outcomes (e.g., anxiety, pain) and highlight the importance of conducting a randomized controlled trial and more rigorous research to determine intervention efficacy.

This content analysis of the literature explores issues associated with engaging in parent-school collaboration with Latino immigrant families. Sociocultural factors that contribute to the success of parent-school collaboration are identified, and elements that are necessary to include in parent-teacher collaboration such that they are culturally responsive to Latino immigrant families are suggested. Aspects such as the importance of parent connectedness, intercultural barriers to effective communication, and potentially necessary elements such as construct broadening and shared governance are explored. Limitations to the exploration and implications for future research are also presented.

Back pain is a major problem requiring pragmatic interventions, low in costs for health care providers and feasible for individuals to perform. Our objective was to test the effectiveness of a low-dose 5-month exercise intervention with small personnel investment on low back strength and self-perceived pain.Two hundred twenty-six employees (age: 42.7±10.2 years) from three mid-size companies were randomized to 5-month non-supervised training at home (3 times/week for 20 minutes) or wait-list-control. Health insurance professionals instructed the participants on trunk exercises at the start and then supervised participants once a month.Muscle strength for back extension increased after the 5-month intervention with a significant between-group difference (mean 27.4 Newton [95%CI 2.2; 60.3]) favoring the exercise group (p = 0.035). Low back pain was reduced more in subjects after exercise than control (mean difference -0.74 cm [95%CI -1.17; -0.27], p = 0.002). No between-group differences were observed for back pain related disability and work ability. After stratified analysis only subjects with preexisting chronic low back pain showed a between-group difference (exercise versus controls) after the intervention in their strength for back extension (mean 55.7 Newton [95%CI 2.8; 108.5], p = 0.039), self-perceived pain (mean -1.42 cm [95%CI -2.32; -0.51], p = 0.003) and work ability (mean 2.1 points [95%CI 0.2; 4.0], p = 0.032). Significant between-group differences were not observed in subjects without low back pain: strength for back extension (mean 23.4 Newton [95%CI -11.2; 58.1], p = 0.184), self-perceived pain (mean -0.48 cm [95%CI -0.99; 0.04], p = 0.067) and work ability (mean -0.1 points [95%CI -0.9; 0.9], p = 0.999). An interaction between low back pain subgroups and the study intervention (exercise versus control) was exclusively observed for the work ability index (p = 0.016).In middle-aged employees a low-dose, non-supervised exercise program implemented over 20 weeks improved trunk muscle strength and low back pain, and in those with preexisting chronic low back pain improved work ability.

Background: Atropine has been used as a successful primary medical treatment for hypertrophic pyloric stenosis. Several authors have reported a higher rate of incomplete pyloromyotomy with the laparoscopic approach compared to open. In this study, we evaluated the use of atropine as a medical treatment for infants with emesis persisting greater than 48 hours after a laparoscopic pyloromyotomy. Materials and Methods: We performed a retrospective chart review of infants receiving a laparoscopic pyloromyotomy between November 1998 and November 2012. Infants with emesis that persisted beyond 48 hours postoperatively were given 0.01mg/kg of oral atropine 10 minutes prior to feeding. Infants remained inpatient until they tolerated two consecutive feedings without emesis. Results: 965 patients underwent laparoscopic pyloromyotomy; 816 (84.6%) male and 149 (15.4%) female. Twenty-four (2.5%) received oral atropine. The mean length of stay for patients who received atropine was 5.6 ± 2.6 days, an average of 3 additional days. They were discharged home with a one-month supply of oral atropine. Follow up evaluation did not reveal any complications from receiving atropine. The median follow up was 21 days. None returned to the operating room for incomplete pyloromyotomy. There were 17 (1.8%) operative complications in our series; 9 mucosal perforations, 2 duodenal perforations, and 6 conversions to open for equipment failure or poor exposure. There were 4 (0.4%) post-operative complications: 2 episodes of apnea requiring reintubation and 2 incisional hernias that required a second operation. There were no deaths. Conclusion: Oral atropine is a viable treatment for persistent emesis after a pyloromyotomy and reduces the need for a second operation due to incomplete pyloromyotomy.

The projected global population is expected to reach around 9.7 billion by 2050, indicating a greater demand for proteins in the human diet. Cereal bran proteins (CBPs) have been identified as high-quality proteins, with potential applications in both the food and pharmaceutical industries. In 2020, global cereal grain production was 2.1 billion metric tonnes, including wheat, rice, corn, millet, barley, and oats. Cereal bran, obtained through milling, made up 10–20% of total cereal grain production, varying by grain type and milling degree. In this article, the molecular composition and nutritional value of CBPs are summarized, and recent advances in their extraction and purification are discussed. The functional properties of CBPs are then reviewed, including their solubility, binding, emulsifying, foaming, gelling, and thermal properties. Finally, current challenges to the application of CBPs in foods are highlighted, such as the presence of antinutritional factors, low digestibility, and allergenicity, as well as potential strategies to improve the nutritional and functional properties by overcoming these challenges. CBPs exhibit nutritional and functional attributes that are similar to those of other widely used plant-based protein sources. Thus, CBPs have considerable potential for use as ingredients in food, pharmaceutical, and other products. [ABSTRACT FROM AUTHOR]

Abstract Prognostic scales may help to optimize the use of hospital resources, which may be of prime interest in the context of a fast spreading pandemics. Nonetheless, such tools are underdeveloped in the context of COVID-19. In the present article we asked whether accurate prognostic scales could be developed to optimize the use of hospital resources. We retrospectively studied 467 files of hospitalized patients after COVID-19. The odds ratios for 16 different biomarkers were calculated, those that were significantly associated were screened by a Pearson’s correlation, and such index was used to establish the mathematical function for each marker. The scales to predict the need for hospitalization, intensive-care requirement and mortality had enhanced sensitivities (0.91 CI 0.87–0.94; 0.96 CI 0.94–0.98; 0.96 CI 0.94–0.98; all with p

Plants have proven to be important sources for discovering new compounds that are useful in the treatment of various diseases due to their phytoconstituents. Clove (Syzygium aromaticum L.), an aromatic plant widely cultivated around the world, has been traditionally used for food preservation and medicinal purposes. In particular, clove essential oil (CEO) has attracted attention for containing various bioactive compounds, such as phenolics (eugenol and eugenol acetate), terpenes (β-caryophyllene and α-humulene), and hydrocarbons. These constituents have found applications in cosmetics, food, and medicine industries due to their bioactivity. Pharmacologically, CEO has been tested against a variety of parasites and pathogenic microorganisms, demonstrating antibacterial and antifungal properties. Additionally, many studies have also demonstrated the analgesic, antioxidant, anticancer, antiseptic, and anti-inflammatory effects of this essential oil. However, CEO could degrade for different reasons, impacting its quality and bioactivity. To address this challenge, encapsulation is viewed as a promising strategy that could prolong the shelf life of CEO, improving its physicochemical stability and application in various areas. This review examines the phytochemical composition and biological activities of CEO and its constituents, as well as extraction methods to obtain it. Moreover, encapsulation strategies for CEO and numerous applications in different food fields are also highlighted.

Este trabajo es una revisión bibliográfica que compara la inmunidad anti-SARS-CoV-2 inducida por la infección natural y la inducida por vacunación, para entender las particularidades de la respuesta en cada caso, así como sus ventajas y desventajas. Se escogieron artículos que reportaran la medición de concentración de anticuerpos séricos, determinantes de inmunidad celular y/o evolución clínica de los pacientes. Se encontró que: A) Los pacientes recuperados de una infección por SARS-CoV-2 presentaron una respuesta mayor y más heterogénea de anticuerpos y células B de memoria que los pacientes vacunados, con un mayor número de linfocitos T CD4+, que cooperan con la diferenciación de linfocitos B y con la producción de anticuerpos neutralizantes. B) La vacunación previene la tormenta de citocinas asociada a la infección natural. C) Dos dosis de una vacuna basada en ARN mensajero logran una concentración de anticuerpos de clase IgG prácticamente igual a la de los pacientes severamente enfermos, pero sin el daño a los nódulos linfáticos asociado a la infección natural. D) Se puede aumentar el número de linfocitos B administrando dosis de refuerzo de la vacuna. Si bien, tanto la vacunación como la infección natural generan respuestas anti-SARS-CoV-2 significativas, la vacunación es el método más seguro para proteger a la población, pues evita el riesgo a la inmunopatología y a la mortalidad asociados con la infección natural. Más aún, la inmunidad híbrida (aquella que adquieren los pacientes que superaron la infección natural y fueron después vacunados) induce una producción de anticuerpos capaces de neutralizar por completo al SARS-CoV-2.

Objective: To assess the effectiveness of the diagnosis of Familial Hypercholesterolemia (FH) through opportunistic screening in the health area of Vigo. Material and Methods: An opportunistic screening was carried out retrospectively on all patients in the Vigo Health Area who had been requested to determine their LDLc during 2018. The inclusion criterion was LDL>250 mg/dL, and the exclusion criteria (TSH >4 mIU/L, A1C>6.5%, fasting glucose>126 mg/dL, Triglycerides>150 mg/dL, GGT>55 IU/L and/or alkaline phosphatase>135 IU/L, proteinuria>3g/L and serum albumin <30g/L). Opportunistic screening was performed using the Modulab Gold (IZASA) program. Results: The total number of LDL determinations was 236,528 out of 185,095 patients. 233 patients met the inclusion criteria. 162 were discarded due to the exclusion criteria. 71 patients with a possible diagnosis of HF were obtained. These patients underwent a clinical interview applying the criteria of the Dutch Lipid Clinics Network (DLCN). The results were: men (21.12%) and women (78.87%); the mean age was 58 years; had hypertension (22.53%), diabetes (1.4%), smoker (23.49%), received statins (63.38%). The results of applying the DLCN criteria were diagnosis possible (53.52%), probable (32.39%) and certain (14.08%). Conclusion: HF is an underdiagnosed and undertreated disease. The application of an opportunistic screening method with an alarm system for health professionals who request lipid profiles can make an early diagnosis of this disease with high cardiovascular risk. [ABSTRACT FROM AUTHOR]

Los noventa y nueve “ramalazos” que componen Cuentos malvados son “un esbozo abstracto en la nada” sobre monstruos invisibles, angustiosos, capaces de hacer tambalear e incluso desmoronar los cimientos de la razón. Esos monstruos representan fobias, pesadillas nocturnas y diurnas, que remiten a diferentes rostros del mal. Así, las siete secciones desarrollan un particular monstruo metafísico (“El agua”, “Ángeles”, “Las voces”, “Arañas y mariposas”, “El espejo”, “Los cuentos” y “Dentro del laberinto”) en el que cada microrrelato se ofrece como una urna claustrofófica del mal para el personaje y el lector, atrapados en un laberinto sin salida.

Phytopathogens are responsible for great losses in agriculture. In particular, Fusarium, Alternaria and Botrytis are fungal diseases that affect crops worldwide. In the search for eco-friendly solutions to pest control, plants and their chemo-biodiversity are promising sources of biopesticides for integrated pest management. The aim of the present study is to report the evaluation of sixteen plant species from the Canary Islands Archipelago against the phytopathogenic fungi Botrytis cinerea, Fusarium oxysporum, and Alternaria alternata. The plants were selected on the basis of their traditional uses in medicine and/or pest control, as well as on scientific studies reporting their uses in crop protection. Their growth inhibition (% I), in an in vitro test-assay on mycelium, was used to identify six ethanolic plant extracts displaying activity (% I > 30% at 1 mg/mL) against at least one of the assayed fungi. The most effective plant extracts were further fractionated by liquid–liquid partition, using solvents of increasing polarity. This procedure led to an improvement of the bioactivity against the phytopathogens, even affecting the hexane fraction from S. canariensis and achieving an 83.93% of growth inhibition at 0.5 mg/mL on B. cinerea. These findings identified five plant-derived extracts as potential candidates for the future development of new biofungicides, which could be applied in integrated pest management.

El virus de la inmunodeficiencia humana (VIH), al igual que los virus de las hepatitis B (VHB) y C (VHC), pertenecen a la familia de los retrovirus. Poseen un tamaño menor de 100 nm, información genética RNA y utilizan transcriptasa reversa como enzima para copiar el genoma dentro del DNA de las células huésped. Cada uno de aquellos exhibe afinidad por distintos tejidos, y un comportamiento diferente de las enfermedades que causan (1).

El trauma cardíaco ha ocurrido desde hace muchos siglos, siendo considerado inicialmente mortal en todos los casos. Desde la primera cardiorrajia exitosa realizada por Rehn, se han logrado considerables avances en el tratamiento de las heridas del corazón y, simultáneamente, se ha visto un marcado incremento de ellas debido a accidentes automovilísticos y al aumento de las acciones civiles violentas; la gran mayoría de las lesiones cardíacas son producidas por arma defuego o por arma blanca; sin embargo, ocasionalmente se han reportado casos en que tales lesiones son causadas por embolismo de cuerpos extraños, especialmente catéteres endovenosos y proyectiles, pero han sido muy pocos los casos en que la lesión cardíaca sea causada por la migración de un cuerpo extraño hasta el corazón, y sólo encontramos un caso reportado en que dicho cuerpo extraño produjo taponamiento cardíaco. Se presenta el caso de un paciente quien sufrió taponamiento ocasionado por lesión causada por una aguja de coser. Se hace una revisión de la literatura sobre el tema.

Endophytic fungi have been isolated from Artemisia austriaca (isolates HRO184, HRO183, HRO169 and HRO115), A. vulgaris (isolate HRO158) and A. thuscula (isolates HLP7, HLP26, HLP27, and HLP44) in Romania and La Palma, Canary Islands, Spain. The strains were studied for their bioactivity against phytopathgenic fungi (Alternaria alternata, Alternaria dauci, Alternaria brassicicola, Fusarium oxysporum, Fusarium solani, Fusarium moniliforme, Sclerotinia sclerotiorum, Botrytis cinerea, Phoma sp., Geotrichum sp. and Cladosporium sp.) using dual culture, agar dilution and volatile compounds (VOC) techniques. In dual culture assays, all Canarian isolates were strong antagonists of at least one pathogen and two Romanian isolates, HRO169 against S. sclerotiorum and HRO158 against A. brassicicola. In VOC assays, a difference was observed between slow growth isolates (1-2 cm/week) and normal growth (4-5 cm/week), therefore three moments of fungal pathogen inoculation were used: after three and five days from the endophyte inoculation. The highest inhibition gradually produced by the volatile compounds was observed with HLP44 isolate against Cladosporium sp. (%I = 31.5) at 7th day. Solvent extracts were obtained from HRO169, HRO158, HLP44, HLP27 and HLP7 isolates and further two of them (HRO158 and HLP44) were fractionated using vacuum-liquid chromatography eluted with n-hexane:EtAc:MeOH gradient to give seven fractions. Extract obtained from HLP44 isolate strongly inhibited A. brassicicola (%I = 44), F. moniliforme (%I =52.78) and S. sclerotiorum (%I = 50.4), at 0.1mg ml-1. Ethyl acetate fraction was the most active against A. brassicicola, F. solani and B. cinerea (%I = 42.68, 59.17 and 49.36, respectively, at 0.1mg ml-1) followed by the EtAc:MeOH (90:10) fraction which also inhibited A. brassicicola and F. solani (%I = 35.83 and 39.53, respectively). [ABSTRACT FROM AUTHOR]

Exosomes have gone from being considered simple containers of intracellular waste substances to be considered important carriers of cellular signals. Its broad capacity to promote tumour growth, both in situ and metastatic, has greatly intensified scientific research on them. In the same way and depending on its content, its tumour suppressive properties have opened a window of light and hope in the fight against cancer. In the present review we try to gather in a simple and understandable way the most relevant knowledge to date on the role of exosomes in oral squamous cell carcinoma, helping to understand their process of formation, release and activity on the tumour microenvironment.

Resultados de estudio que refiere a la aún vigente emergencia sanitaria por Covid-19 en Uruguay, país de América del Sur ubicado entre Argentina y Brasil. En territorio y en población es el país más chico de la región, que históricamente se ha acercado a estándares europeos, tendencia que se mantuvo de forma selectiva en el contexto de pandemia. Estrategia de investigación: estudio de tipo etnográfico se programó en tiempo acotado, entre abril y junio, apenas iniciada la crisis sanitaria. Se distribuyeron diez “antenas” de observación, en situaciones de vida cotidiana, en instituciones de salud y otros. Los recursos bibliográficos utilizados responden a una búsqueda de bases disciplinarias con reconocida solvencia, rescatando autores y marcos teóricos, integrando nuevas propuestas teórico-metodológicas y antecedentes afines a esta investigación. Motivación del peritaje antropológico: destacar diferencias (culturales) de comportamientos durante la crisis sanitaria, plantear el interés de conocer sobre objetivación de factores socio culturales que incidieron en la contención del avance epidemiológico y luego, en significativa presencia de contagios dentro del propio personal de salud. Resultados: encontramos modelos que ordenan la comprensión de hechos sociales, de datos reales. El abordaje realizado aporta conocimiento sobre representaciones, contenidos de imaginario social, que determinan actitudes y afectan condiciones objetivas en el ámbito social, institucional y personal.

La culpabilidad jurídico-penal tiene una doble vertiente como límite del Derecho Penal en un Estado social y democrático de Derecho y como categoría dogmática dentro de la teoría del delito. Sus contenidos han pretendido ser discutidos por algunos neurocientíficos a raíz de los avances alcanzados en la investigación del funcionamiento del cerebro, reeditando la tradicional discusión entre determinismo y libre albedrío. Aquí se adopta una posición compatibilista conforme a la cual se certifica la solidez de una concepción normativa de la culpabilidad y de la responsabilidad personal o subjetiva, pero se afirma la necesidad de permanecer atentos a los nuevos descubrimientos que las neurociencias puedan seguir aportándonos

Espido Freire (Bilbao, 1974) hatches in Soria Moria —for which she received the Ateneo de Sevilla Prize in 2007— a cyclic narrative frame where the characters are painted, placed in a real time and space —1914-1936, Canary Islands— but they could exist anytime and anywhere. Thus, —as in most of her literary work— the reference point is imaginary, Soria Moria. And the teenage protagonists —a polymorphous perverse’s embodiments— are exposed to a particular circular evil through childhood, friendship, marriage and family, which perpetuate oppressive models for women. Our purpose is to analyse these aspects through narratological, philosophical, sociological and psychoanalytical tools.

The use of fiberglass in dentistry has increased due to the improvements in the development of adhesive techniques reducing the cost of treatment and avoiding abutment tooth craving. The present study aims to evaluate the clinical usefulness of the new technique to fabricate a direct fiber-reinforced composite bridge (FRCB) over a long period of time. Twenty-one FRCB were performed with the new direct technique on 21 patients with a mean age of 58.85 years and female predominance in the Faculty of Dentistry of Oviedo (Spain). The framework design releases the embrasures allowing adequate interproximal brushing, avoidance of periodontal disease and interproximal caries. A baseline examination was performed and the patients were examined regularly at six-month intervals (nine years’ follow-up). The restorations were also evaluated by an examiner using parameters to check their stability, longevity and the lack of periodontal disease. The most frequent location was the maxillary premolar region and the purpose of the restorations was to give a definitive bridge in 100% of the patients. Only one total debonding of the prostheses was detected during the observation period at 24 months and three partial adhesive–cohesive veneering composite fractures at the pontic after 60, 72 and 84 months, respectively. Kaplan–Meier was performed to detect the overall survival rate of the restorations at the end of the follow-up. Nine-year survival rates for the FRCB was 95.2%. All the cases had a clinically acceptable periodontal condition and an interproximal absence of caries in the abutment teeth. Currently, this type of restoration allows a minimally invasive aesthetic and is an affordable procedure, being a good alternative to other types of treatments.

El objetivo de este estudio es evaluar la eficacia de un programa de prevención dirigido a reducir las tasas de cibervictimización en menores de la provincia de Alicante detectadas en 2014 en un proyecto previo llamado “CiberApp”. Para ello se intervino sobre una muestra de 1.575 menores de centros de ESO. La intervención consistió en la realización de 66 sesiones informativas de 50 minutos de duración (59 con los menores y 7 con sus progenitores y educadores). Se ha aplicado un cuestionario diseñado ad hoc para medir la frecuencia con la que los participantes llevaban a cabo comportamientos de riesgo en Internet (pretest), así como la frecuencia con la que tenían intención de hacerlo en el futuro (postest). La intervención ha sido eficaz para reducir en los menores la intención de hacer cada una de las conductas de riesgo evaluadas y para potenciar su autoprotección frente a ellas.

Cancer cells overexpress proton exchangers at the plasma membrane in order acidify the extracellular matrix and maintain the optimal pH for sustaining cancer growth. Among the families of proton exchangers implicated in carcinogenesis, carbonic anhydrases (CAs), monocarboxylate transporters (MCTs), Na+/H+ exchangers (NHEs), sodium bicarbonate cotransporters (NBCs), and vacuolar ATPases (V-ATPases) are highlighted. Considerable research has been carried out into the utility of the understanding of these machineries in the diagnosis and prognosis of several solid tumors. In addition, as therapeutic targets, the interference of their functions has contributed to the discovery or optimization of cancer therapies. According to recent reports, the study of these mechanisms seems promising in the particular case of oral squamous cell carcinoma (OSCC). In the present review, the latest advances in these fields are summarized, in particular, the usefulness of proton exchangers as potential prognostic biomarkers and therapeutic targets in OSCC.

En la Unidad de Cuidados Intensivos de la Clínica San Pedro Claver se adoptó como técnica de elección, la traqueostomía percutánea por dilatación en los pacientes críticamente enfermos, sometidos a ventilación mecánica prolongada, debido a que ha demostrado seguridad, bajo costo y menor tasa de complicaciones. Se presenta la experiencia en el transcurso de dos años con su aplicación.At the intensive care unit of San Pedro Claver Clinic in Bogotá, Colombia, we have adopted as the technique of choice the dilatation percutaneous tracheostomy in critically ill patients under prolonged mechanical ventilation. The technique has demonstrated to be secure, of low cost, and is associated with a minor rate of complications. We hereby report our experience over the past two years.