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This study aimed to calculate the healthcare resource utilization and direct medical costs in patients with 2 subtypes of axial spondyloarthritis (axSpA) in a rheumatic care center in Colombia.This is a retrospective cost-of-illness study. Patients with at least 1 medical consultation associated with an axSpA diagnosis between October 2018 and October 2019 were identified. Patients were classified as having radiographic (r-axSpA) or nonradiographic axSpA (nr-axSpA). Direct medical costs were calculated in Colombian pesos and expressed in American dollars using an exchange rate of 3263 Colombian pesos = 1 US dollar ($). Predictors of total direct costs were identified using a generalized linear model with gamma distribution and log-link.A total of 162 patients with a mean age of 49.6 years (± 13.7) were included in the study. Among these, 147 (90.7%) were considered as having r-axSpA and 15 (9.3%) nr-axSpA, with mean costs of $6600 (± 6203) and $843 (± 1135), respectively (P.001). The total direct mean cost was calculated at $6067 (± 6144) per patient. Medication costs were the main driver of total costs (97.6%, $5921), with biologic disease-modifying antirheumatic drugs accounting for nearly 92.0% ($5582) of these costs. Rheumatologist (100%) and physiatrist (64.2%) visits were the most frequently used medical service.The economic burden associated with axSpA in the Colombian setting is substantial. There is a significant difference in direct medical costs between the r-axSpA and the nr-axSpA. Health policies aimed at the comprehensive management of nr-axSpA would have an important role in the reduction of the associated direct medical costs.

To determine the sociodemographic and clinical profile of a representative sample of people with type 1 diabetes mellitus (DM1) in Spain and identify factors associated with glycemic control.A cross-sectional observational study was carried out in adults and children with DM1 treated in 75 Spanish public hospitals, geographically distributed in order to be representative of the Spanish population. Within each center, the patients were included on a consecutive basis as they visited the clinic. They were interviewed, and their clinical histories were reviewed. A descriptive statistical analysis was made, and factors associated with HbAA total of 647 patients were included: 55.3% females, aged 36.6 ± 14.4 years, 97.2% Caucasians, BMI 24.7 ± 4.4 kg/mThe management of patients with DM1 in Spain, as well as the treatment they receive, is similar to that seen in other Western countries. Blood glucose control is associated with educational level, disease duration, and the characteristics of treatment and self-care.

To describe the admissions of patients diagnosed with severe mental illness (SMI) and anxiety disorder in a regional hospital; to explore factors related to the patient’s referrer upon admission and prolonged stay.Cross-sectional study of episodes of admission to the regional Psychiatric Hospitalization Unit over a period of 11 years with ICD-10 diagnostic codesF20-29, F30-39, F60-69 and F40-48. The data was extracted through the Admissions Unit and the information from the electronic medical record. For the statistical treatment, descriptive or inferential tests were used with a confidence level of 95%.961 patients were included (2,324 total discharges), aged 40.8±14.0 years. The most frequent reasons for admission were: positive symptoms (agitation, delusions and hallucinations), followed by suicidal ideation and attempt. The main remitting agent of the patients was the family itself. Approximately 1/5 of the cases were referred by the health system itself, and ¼ of those admitted had self-excluded themselves from specialized supervision for more than a year.The problems that caused the admission and its origin, as well as its lack of follow-up, can be considered as a clear opportunity for improvement in the follow-up of patients with severe mental illness. An orientation towards proactivity, acting before the decompensation, would contribute to improving the care and quality of life of patients with severe mental illness and their environment.Describir los ingresos de pacientes diagnosticados de enfermedad mental grave y trastorno de ansiedad en un hospital comarcal; explorar los factores relacionados con la derivación del paciente al ingreso y con estancia prolongada.Estudio de corte transversal de los episodios de ingreso en la Unidad de Hospitalización Psiquiátrica comarcal en un periodo de 11 años con los códigos diagnósticos CIE-10 F20-29, F30-39, F60-69 y F40-48. Se extrajeron los datos a través de la Unidad de Admisión y la información de la historia clínica electrónica. Para el tratamiento estadístico se usaron pruebas descriptivas o inferenciales con nivel de confianza del 95%.Se incluyeron 961 pacientes (2.324 altas totales), con edad de 40,8±14,0 años. Los motivos más frecuentes de ingreso fueron: síntomas positivos (agitación, delirios y alucinaciones), seguidos de ideación e intento de suicidio. El principal agente remisor de los pacientes fue la propia familia. Aproximadamente 1/5 de casos fue derivado por el propio sistema sanitario, y ¼ de los ingresados se había autoexcluido de la supervisión especializada durante más de un año.Los problemas causantes del ingreso y su procedencia, así como su falta de seguimiento, pueden considerarse como una oportunidad clara de mejora en el seguimiento del paciente con enfermedad mental grave. Una orientación hacia la proactividad, actuando antes de la descompensación, contribuiría a mejorar la asistencia y calidad de vida de los pacientes con enfermedad mental grave y su entorno.

As a result of the SARS-CoV-2 pandemic, health systems globally have seen a dramatic increase in the occupancy of intensive care units, with mechanical ventilators being a resource in high demand in the care of these patients. This article proposes a protocol for testing low-cost mechanical ventilators in pig models, as part of the development of locally manufactured biomedical equipment that can support the health crisis caused by the pandemic. The protocol addresses aspects that include the pre-test phase, anesthetic and airway management, laboratory monitoring, recovery and monitoring of the animal. This document presents to the academic community a validation protocol of a mechanical ventilator prototype in a pig specimen that can be a reference for its application and revalidation by other groups interested in the development of local and low-cost technologies.A raíz de la pandemia generada por el SARS-CoV-2, los sistemas de salud de los distintos países han experimentado un dramático aumento en la ocupación de las unidades de cuidado intensivo y, por ende, una alta demanda de ventiladores mecánicos. En este artículo se propone un protocolo de pruebas de ventiladores mecánicos de bajo costo en modelos porcinos, como parte del desarrollo de equipos biomédicos que pueden apoyar la crisis sanitaria suscitada por la pandemia. El protocolo aborda aspectos que incluyen la fase previa a la prueba, el manejo anestésico, de vía aérea, seguimiento de laboratorio, recuperación y seguimiento del animal. Como resultado, se presenta a la comunidad académica un protocolo de validación de prototipo de ventilador mecánico en espécimen porcino como un referente para su aplicación y revalidación por parte de grupos interesados en el desarrollo de tecnologías locales de bajo costo.

The human colonic mucus is mainly composed of mucins, which are highly glycosylated proteins. The normal commensal colonic microbiota has mucolytic activity and is capable of releasing the monosaccharides contained in mucins, which can then be used as carbon sources by pathogens such as Enterohemorrhagic

Background Driver mutations are the genetic components responsible for tumor initiation and progression. These variants, which may be inherited, influence cancer risk and therefore underlie many familial cancers. The present study examines the potential association between SNPs in driver genes SF3B1 (rs4685), TBX3 (rs12366395, rs8853, and rs1061651) and MAP3K1 (rs72758040) and BC in BRCA1/2-negative Chilean families. Methods The SNPs were genotyped in 486 BC cases and 1258 controls by TaqMan Assay. Results Our data do not support an association between rs4685:C > T, rs8853:T > C, or rs1061651:T > C and BC risk. However, the rs12366395-G allele (A/G + G/G) was associated with risk in families with a strong history of BC (OR = 1.2 [95% CI 1.0–1.6] p = 0.02 and OR = 1.5 [95% CI 1.0–2.2] p = 0.02, respectively). Moreover, rs72758040-C was associated with increased risk in cases with a moderate-to-strong family history of BC (OR = 1.3 [95% CI 1.0–1.7] p = 0.02 and OR = 1.3 [95% CI 1.0–1.8] p = 0.03 respectively). Finally, risk was significantly higher in homozygous C/C cases from families with a moderate-to-strong BC history (OR = 1.8 [95% CI 1.0–3.1] p = 0.03 and OR = 1.9 [95% CI 1.1–3.4] p = 0.01, respectively). We also evaluated the combined impact of rs12366395-G and rs72758040-C. Familial BC risk increased in a dose-dependent manner with risk allele count, reflecting an additive effect (p-trend = 0.0002). Conclusions Our study suggests that germline variants in driver genes TBX3 (rs12366395) and MAP3K1 (rs72758040) may influence BC risk in BRCA1/2-negative Chilean families. Moreover, the presence of rs12366395-G and rs72758040-C could increase BC risk in a Chilean population.

The main purpose of this study was to assess the relation between cognitive behavioral therapy and possible changes in illness perceptions and anxiety in patients diagnosed with unruptured intracranial aneurysm. An observational study of an intervention with 67 patients with an unruptured intracranial aneurysm from two medical centers in a Colombian city (n = 35 on the intervention group) was carried out. To assess changes, measurements were taken at baseline and at one-year follow-up with the Beck Anxiety Inventory and the Illness Perception Questionnaire, brief version, taking into account the importance of perceptions in the process of adjusting to illness and acquiring healthy life habits. Hypotheses were tested by a structural model. The results obtained from this study showed that illness perceptions were related to anxiety levels at both time points; however, the relations were stronger before cognitive behavioral therapy (βt0 = 0.61, p 0.01; βt1 = 0.37, p 0.01). Cognitive behavioral therapy was found to be a moderator of changes in both illness perceptions and anxiety at the time of follow-up (β = -0.31, p 0.01; β = -0.26, p 0.01). The structural model suggests that cognitive behavioral therapy is associated with less anxiety (β = -0.17, p 0.05) and better illness perceptions (β = -0.35, p 0.01) in patients diagnosed with unruptured intracranial aneurysms.

Summary To determine urban–rural differences influencing mortality in patients with hip fracture in Colombian Andes Mountains over a 1-year period. Purpose To identify the urban–rural differences of sociodemographic variables, fracture-related characteristics, and preoperative and postoperative clinical factors associated with 1-year mortality in patients over 60 years old who underwent hip fracture surgery in the Andes Mountains. Methods A total of 126 patients with a fragility hip fracture during 2019–2020 were admitted to a tertiary care hospital. They were evaluated preoperatively and followed up until discharge. Those who survived were contacted by telephone at 1, 3, and 12 months. Univariate, bivariate, and Kaplan–Meier analyses with survival curves were performed. Relative risk was calculated with a 95% confidence interval. Results A total of 32.5% of the patients died within 1 year after surgery, with a significant difference between those who resided in rural areas (43.1%) and those who resided in urban areas (23.5%) (RR 1.70; 95% CI, 1.03 to 2.80, p = 0.036). In the multivariate analysis, anemia (hemoglobin level ≤ 9.0 g/dL during hospitalization) (RR 6.61; 95% CI, 1.49–29.37, p = 0.003), a blood transfusion requirement (RR 1.47; 95% CI, 1.07 to 2.01, p = 0.015), the type of fracture (subtrochanteric fracture (RR = 4.9, 95% CI = 1.418–16.943, p = 0.005)), and postoperative acute decompensation of chronic disease (RR 1.60; 95% CI, 1.01 to 2.53, p = 0.043) were found to be independent predictive factors of 1-year mortality after surgery. Conclusions There was a difference in 1-year mortality between patients from rural and urban areas. More studies must be conducted to determine whether rurality behaves as an independent risk factor or is related to other variables, such as the burden of comorbidities and in-hospital complications.

Taurine, a cysteine-derived zwitterionic sulfonic acid, is a common ingredient in energy drinks and is naturally found in fish and other seafood. In humans, taurine is produced mainly in the liver, and it can also be obtained from food. In target tissues, such as the retina, heart, and skeletal muscle, it functions as an essential antioxidant, osmolyte, and antiapoptotic agent. Taurine is also involved in energy metabolism and calcium homeostasis. Taurine plays a considerable role in bone growth and development, and high-profile reports have demonstrated the importance of its metabolism for bone health. However, these reports have not been collated for more than 10 years. Therefore, this review focuses on taurine–bone interactions and covers recently discovered aspects of taurine’s effects on osteoblastogenesis, osteoclastogenesis, bone structure, and bone pathologies (e.g., osteoporosis and fracture healing), with due attention to the taurine–cartilage relationship.

The response to Glucagon-like peptide-1 receptor agonists (GLP-1RAs) is highly varia-ble among patients. Thus, the identification of predictive biomarkers of therapeutic response to GLP-1 RA could help us to optimize the use of this class of drugs. GLP-1RAs increase exchange proteins directly activated by cAMP (EPAC). The aim of the present study was to assess whether the increase of EPAC1 after GLP-1RAs treatment could be a biomarker of clinical response.After showing that GLP-1 (10 ng/mL) significantly increased the expression of EPAC1 in human endo-thelial vascular cells (HUVEC), a pilot clinical study was planned. For this purpose 49 patients with type 2 diabetes who started treatment with liraglutide were included. EPAC1 concentration was determined by ELISA before and at one month of liraglutide treatment.We found that serum concentration of EPAC1 increased significantly after treatment with liraglutide. Only in those patients in whom EPAC1 increased (64%), a significant decrease in HbA1c, LDL-C, body mass index (BMI), and waist circumference was shown.This pilot study suggests that the increase of circulating EPAC1 after GLP-1RAs treatment could be a useful biomarker to predict clinical GLP1-RAs response.

IntroductionOne of the known risk factors for fall incidents is the use of specific medications, fall-risk-increasing drugs (FRIDs). However, to date, there is uncertainty related to the effectiveness of deprescribing as a single intervention in falls prevention. Thus, a comprehensive update of the literature focusing on all settings in which older people receive healthcare and all deprescribing interventions is warranted to enhance the current knowledge.Methods and analysisThis systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was performed in Cochrane Central Register of Controlled Trials, MEDLINE, Embase and PsycINFO (2 November 2020). We will also search in trial registers. We will include randomised controlled trials, in which any deprescribing intervention is compared with usual care and reports falls as an outcome. Both title and abstract screening and full-text screening will be done by two reviewers. The Cochrane Collaboration revised tool of Risk of Bias will be applied to perform risk of bias assessment. We will categorise the results separately for every setting. If a group of sufficiently comparable studies will be identified, we will perform a meta-analysis applying random effects model. We will investigate heterogeneity using a combination of visual inspection of the forest plot along with consideration of the χ2 test and the I2 statistic results. We have prespecified several subgroup and sensitivity analyses.Ethics and disseminationEthics approval is not applicable for this study since no original data will be collected. The results will be disseminated through peer-reviewed publication and conference presentations. Furthermore, this systematic review will inform the recommendations of working group of polypharmacy and FRIDs of the anticipated World’s Falls Guidelines.PROSPERO registration numberCRD42020218231.

Goals: The purpose of this study was to analyze the feasibility of using the information obtained from a one-channel electro-encephalography (EEG) signal to control a mouse pointer. We used a low-cost headset, with one dry sensor placed at the FP1 position, to steer a mouse pointer and make selections through a combination of the user’s attention level with the detection of voluntary blinks. There are two types of cursor movements: spinning and linear displacement. A sequence of blinks allows for switching between these movement types, while the attention level modulates the cursor’s speed. The influence of the attention level on performance was studied. Additionally, Fitts’ model and the evolution of the emotional states of participants, among other trajectory indicators, were analyzed. (2) Methods: Twenty participants distributed into two groups (Attention and No-Attention) performed three runs, on different days, in which 40 targets had to be reached and selected. Target positions and distances from the cursor’s initial position were chosen, providing eight different indices of difficulty (IDs). A self-assessment manikin (SAM) test and a final survey provided information about the system’s usability and the emotions of participants during the experiment. (3) Results: The performance was similar to some brain–computer interface (BCI) solutions found in the literature, with an averaged information transfer rate (ITR) of 7 bits/min. Concerning the cursor navigation, some trajectory indicators showed our proposed approach to be as good as common pointing devices, such as joysticks, trackballs, and so on. Only one of the 20 participants reported difficulty in managing the cursor and, according to the tests, most of them assessed the experience positively. Movement times and hit rates were significantly better for participants belonging to the attention group. (4) Conclusions: The proposed approach is a feasible low-cost solution to manage a mouse pointer

This study aimed to investigate the prognostic impact of the SYNTAX score II (SS-II) on ST-segment elevation myocardial infarction (STEMI) patients undergoing a primary percutaneous coronary intervention (pPCI).This retrospective cohort study included 1,689 patients with STEMI who underwent pPCI between January 2008 and December 2016. The patients were categorised into three groups based on SS-II tertiles (SS-II low tertile24 [n=585], SS-II intermediate tertile ≥24 and ≤34 [n=567], and SS-II high tertile34 [n=537]). In-hospital mortality was significantly lower in patients with low and mid SS-II when compared with high SS-II (0.7% vs 0.5% vs 16.4%, p=0.001). During follow-up (median 2.35 years), a high SS-II was positively correlated with MACE (12.3% for low SS-II vs 18.3% for mid SS-II vs 43.2% for high SS-II, p=0.001), all-cause mortality (1.5% vs 3.9% vs 14.2%, p=0.001) and heart failure (0.3% vs 2.7% vs 8.2%, p=0.001). The SS-II showed additive value on top of GRACE, anatomical SYNTAX score and residual SYNTAX score.The SS-II in patients with STEMI undergoing pPCI adds important prognostic information regarding midterm adverse outcomes, being an independent and powerful predictor of MACE, heart failure and all-cause mortality during follow-up.

Objective: The objective of this study was to examine the relationship between depressive symptoms and religiosity among older adults in Colombia.Methods: Data are drawn from the SABE (Salud, Biene...

Background: The basilic vein is a deep vein which usually requires superficialisation and surgical transposition. Material and methods: This is a retrospective study of 119 BBAVF-ST in patients with stage 5D chronic kidney disease who received an implant with a one-stage surgical technique (2011–2015). The percentage of primary (PP), assisted primary (APP) and secondary (SP) permeabilities were assessed, as well as the related complications. We analyzed the permeabilities using Kaplan–Meier survival curves and a univariate Log Rank analysis (Mantel–Cox). p values less than or equal to 0.05 were considered as significant. Results: The mean age of the study group was 67.9 years, with 63.8% of the subjects being male. A total of 57 complications were detected during the follow-up period: 24 stenosis (42.1%), 11 thrombosis (19.2%), 7 vascular access steal syndromes (12.2%), 7 upper limb oedemas (12.2%), 6 post-puncture haematomas (10.5%) and 2 infections (3.5%). The percentages of PP obtained at 1, 6, 12 and 24 months were 92.4%, 79.8%, 66.3% and 52%; APP: 94.1%, 87.3%, 80.4% and 65.6%, and SP: 95%, 89.1%, 84% and 67.5%, respectively. Diabetic patients presented with significantly worse permeabilities than vascular or idiopathic patients: (p = .037, .009 and .019, respectively). Conclusions: According to the results obtained in our study, the one-stage surgical implementation of BBAVF-ST presents high permeability rates and a small number of related complications. Diabetes mellitus is a factor related to a worse surgical prognosis. Some of the biggest advantages are the greater optimization of health resources and a shorter time in which the central venous catheter needs to remain in the body. Resumen: Introducción: La vena basílica se caracteriza por ser un vaso profundo que en la mayoría de los casos requiere superficialización y trasposición quirúrgica. Material y métodos: Estudio retrospectivo de 119 FAVn HB S-T en pacientes con insuficiencia renal crónica 5D implantadas en un solo acto quirúrgico (2011-2015). Se analiza el porcentaje de permeabilidades primaria (PP), primaria asistida (PPA) y secundaria (PS), así como las complicaciones asociadas. Análisis de permeabilidades mediante curvas de supervivencia Kaplan-Meier y análisis univariante mediante Log Rank (Mantel-Cox). Se considera significativa una p ≤ 0,05. Resultados: Edad media 67,9 años y 63,8% hombres. Durante el período de seguimiento se objetivaron un total de 57 complicaciones: 24 estenosis (42,1%), 11 trombosis (19,2%), 7 síndromes de robo vascular (12,2%), 7 edemas de extremidad superior (12,2%), 6 hematomas pospunción (10,5%) y 2 infecciones (3,5%). Los porcentajes de PP obtenidos a 1, 6, 12 y 24 meses: 92,4, 79,8, 66,3 y 52; PPA: 94,1, 87,3, 80,4 y 65,6%, y PS: 95, 89,1, 84 y 67,5%. Se constataron diferencias significativas en las curvas de PP, PPA y PS según la etiología, presentando peores permeabilidades los diabéticos respecto a la vascular e idiopática (p = 0,037, 0,009 y 0,019). Conclusiones: La implantación quirúrgica de FAVn HB S-T en un solo acto ofrece buenas tasas de permeabilidad y escaso número de complicaciones asociadas. La diabetes mellitus representa un factor de peor pronóstico quirúrgico. Entre las mayores ventajas destacan una mejor optimización de los recursos sanitarios y menor tiempo de permanencia del catéter venoso central. Keywords: Haemodialysis, Vascular access, Basilic-humeral arteriovenous fistula, Single-stage surgical technique, Palabras clave: Hemodiálisis, Acceso vascular, Fístula arteriovenosa nativa humerobasílica, Un solo acto quirúrgico

Coronary artery disease (CAD) is a common co-morbidity in transcatheter aortic valve implantation (TAVI) patients, but the prognostic value of coronary revascularization before TAVI is currently unknown. The aim of the present study was to assess the impact of coronary revascularization in patients who underwent TAVI. Patients underwent TAVI from 2008 to 2016 were included in the study. Baseline SYNTAX score and residual SYNTAX score (rSS) after percutaneous coronary intervention were calculated. Based on rSS, patients were classified as complete revascularization (rSS = 0), reasonably incomplete revascularization (rSS0 and8), and incomplete revascularization (rSS ≥8). The primary objective was to evaluate the impact of CAD and rSS on major cardiovascular adverse events (MACEs). The secondary objective was to assess the impact of rSS on hospitalization for heart failure. A total of 349 patients (mean age 82.4 ± 5.7 years, 53% women) were included in the study. A total of 187 patients (53.6%) had CAD (mean baseline SYNTAX score 9.2 ± 8.1). Percutaneous coronary intervention was performed in 29.9% of patients, achieving reasonably incomplete revascularization in 45.4%, and incomplete revascularization in 24.5%. The mean follow-up was 35.2 ± 25.3 months. No differences were observed in MACE rate between the CAD and non-CAD groups, or between the different degrees of revascularization. Differences were also not seen in the different levels of revascularization and hospitalization due to heart failure. In patients who underwent TAVI in this study, no association was found between the presence of CAD or the degree of revascularization in a long-term follow-up.

The microbiota regulates immunological development during early human life, with long-term effects on health and disease. Microbial products include short-chain fatty acids (SCFAs), formyl peptides (FPs), polysaccharide A (PSA), polyamines (PAs), sphingolipids (SLPs) and aryl hydrocarbon receptor (AhR) ligands. Anti-inflammatory SCFAs are produced by Actinobacteria, Bacteroidetes, Firmicutes, Spirochaetes and Verrucomicrobia by undigested-carbohydrate fermentation. Thus, fiber amount and type determine their occurrence. FPs bind receptors from the pattern recognition family, those from commensal bacteria induce a different response than those from pathogens. PSA is a capsular polysaccharide from B. fragilis stimulating immunoregulatory protein expression, promoting IL-2, STAT1 and STAT4 gene expression, affecting cytokine production and response modulation. PAs interact with neonatal immunity, contribute to gut maturation, modulate the gut–brain axis and regulate host immunity. SLPs are composed of a sphingoid attached to a fatty acid. Prokaryotic SLPs are mostly found in anaerobes. SLPs are involved in proliferation, apoptosis and immune regulation as signaling molecules. The AhR is a transcription factor regulating development, reproduction and metabolism. AhR binds many ligands due to its promiscuous binding site. It participates in immune tolerance, involving lymphocytes and antigen-presenting cells during early development in exposed humans.

Background When approaching a joint replacement procedure, pre-surgical planning is essential to predict an accurate estimation of implant size and position. There are currently two methods to achieve it, analog and digital. The present study aims to demonstrate how the hybrid technique is accurate and precise for pre-surgical planning in a non-cemented total hip replacement. Methods Concordance-type study is used against a gold standard, as well as inter- and intra-observer consistency evaluation of two orthopedic surgeons and two orthopedic surgery residents. Accuracy was calculated with the intra-class correlation coefficient (ICC). Afterwards, the same calculation was done considering a margin of error with one size more and one less. Results Thirty-eight patients were included in the study: 19 women and 19 men. Twenty-two prostheses (57.89%) were right-sided and 16 were left (42.11%). Twelve prostheses (31.57%) were Stryker and 26 Johnson & Johnson (68.43%). Acetabular cup correlation compared with the gold standard was moderate: ICC reported 0.45 (95% CI, 0.15–0.76). When adjusted by ± 1 size, ICC was 0.48 (95% CI, 0.18–0.79). On the other hand, results from the femoral stem reported ICC 0.85 (95% CI, 0.07–0.98). When adjusted by ± 1 size, ICC was 0.86 (95% CI, 0.06–0.99). Conclusions Hybrid templating is a reliable substitute for analog or digital planning. It is quick, inexpensive, accurate, and better results are observed in the femoral component regardless the level of expertise of the evaluator. Level of evidence Grade IV

IgM oligoclonal bands (OCMBs) against myelin-specific lipids have been identified as a marker for poor prognosis in multiple sclerosis (MS). The aim is to examine the relation between lipid-specific OCMBs (LS-OCMBs) and the evolution of MS. An analytical, ambispective and individual-based study was conducted. We selected 116 patients, out of whom 95 had LS-OCMBs. The predominant lipid recognized was phosphatidylcholine. The positive gangliosides OCMB group reached better scores in the 9HPT, and the phosphatidylcholine, sphingolipids and phosphatidylethanolamine OCMB groups showed statistical differences in the magnetic resonance parameters. In conclusion: some LS-OCMBs showed statistically significant differences with functional or imaging tests.

SummaryThe genetic diversity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential to impact the virus transmissibility and the escape from natural infection- or vaccine-elicited neutralizing antibodies. Here, representative samples from circulating SARS-CoV-2 in Colombia between January and April 2021, were processed for genome sequencing and lineage determination following the nanopore amplicon ARTIC network protocol and PANGOLIN pipeline. This strategy allowed us to identify the emergence of the B.1.621 lineage, considered a variant of interest (VOI) with the accumulation of several substitutions affecting the Spike protein, including the amino acid changes T95I, Y144T, Y145S and the insertion 146N in the N-terminal domain, R346K, E484K and N501Y in the Receptor-binding Domain (RBD) and P681H1 in the S1/S2 cleavage site of the Spike protein. The rapid increase in frequency and fixation in a relatively short time in Magdalena, Atlántico, Bolivar, Bogotá D.C, and Santander that were near the theoretical herd immunity suggests an epidemiologic impact. Further studies will be required to assess the biological and epidemiologic roles of the substitution pattern found in the B.1.621 lineage.HighlightsMonitoring the emergence of new variants of SARS-CoV-2 in real time is a worldwide priority.Emerging variants of SARS-CoV-2 may have high impact biological implications for public healthThe SARS-CoV-2 B.1.621 variant of interest was characterized by several substitutions: T95I, Y144T, Y145S, ins146N, R346K, E484K, N501Y and P681H in spike protein.

The transcriptional factor NF-κB is a nuclear factor involved in both physiological and pathological processes. This factor can control the transcription of more than 400 genes, including cytokines, chemokines, and their modulators, immune and non-immune receptors, proteins involved in antigen presentation and cell adhesion, acute phase and stress response proteins, regulators of apoptosis, growth factors, other transcription factors and their regulators, as well as different enzymes; all these molecules control several biological processes. NF-κB is a tightly regulated molecule that has also been related to apoptosis, cell proliferation, inflammation, and the control of innate and adaptive immune responses during onset of labor, in which it has a crucial role; thus, early activation of this factor may have an adverse effect, by inducing premature termination of pregnancy, with bad outcomes for the mother and the fetus, including product loss. Reviews compiling the different activities of NF-κB have been reported. However, an update regarding NF-κB regulation during pregnancy is lacking. In this work, we aimed to describe the state of the art around NF-κB activity, its regulatory role in pregnancy, and the effect of its dysregulation due to invasion by pathogens like Trichomonas vaginalis and Toxoplasma gondii as examples.

Toxoplasma gondii infection can trigger autoreactivity by different mechanisms. In the case of ocular toxoplasmosis, disruption of the blood-retinal barrier may cause exposure of confined retinal antigens such as recoverin. Besides, cross-reactivity can be induced by molecular mimicry of parasite antigens like HSP70, which shares 76% identity with the human ortholog. Autoreactivity can be a determining factor of clinical manifestations in the eye and in the central nervous system. We performed a prospective observational study to determine the presence of autoantibodies against recoverin and HSP70 by indirect ELISA in the serum of 65 patients with ocular, neuro-ophthalmic and congenital cerebral toxoplasmosis. We found systemic autoantibodies against recoverin and HSP70 in 33.8% and 15.6% of individuals, respectively. The presence of autoantibodies in cases of OT may be related to the severity of clinical manifestations, while in cases with CNS involvement they may have a protective role. Unexpectedly, anti-recoverin antibodies were found in patients with cerebral involvement, without ocular toxoplasmosis; therefore, we analyzed and proved cross-reactivity between recoverin and a brain antigen, hippocalcin, so the immunological phenomenon occurring in one immune-privileged organ (e.g. the central nervous system) could affect the environment of another (egg. the eye).

The purpose of this study was to examine differences in sports participation and the levels of physical activity (PA) and sedentary behaviour (SB) between schoolchildren with cystic fibrosis (CF) and a healthy control group (CG) taking into account the gender variable. PA and SB were measured with an accelerometer for 7 consecutive days in 44 children (24 girls, 11.0 (3.2) years) with CF and 45 age-, sex-, and socioeconomic status-matched controls (24 girls, 11.1 (3.0) years). CF patients and CG did not differ in moderate-to-vigorous PA (54 (31) vs. 59 (27) min/day respectively) or in SB (558 (106) vs. 553 (92) min/day respectively). There were no differences in meeting the PA guidelines between both groups (CF: 36.4% vs. CG: 42.4%). Gender analysis revealed that boys were more active and met more PA guidelines than girls regardless of the group (CF or CG), girls with CF being the least active group (only 16.7% met PA guidelines). A possible compensatory effect was found between SB and PA only in the CF sample, as for each minute/day spent in SB the odds of meeting PA guidelines decreased by 34%. These findings suggest that promoting a reduction in SB is as important as promoting PA in the CF population, especially in girls. Health caregivers, coaches, teachers, or parents could offer appealing supervised and unsupervised physical activities, foster the adoption of active lifestyles, or incorporate PA into daily routines to improve the health of CF schoolchildren.

The objective of this study is to study the influence of ocular variables in the perception of #thedress and to develop a logistic regression model that could help predict it. This is a cross-sectional study on 1,100 subjects. People who did not report one of the two main perceptions were excluded from the study. Dress perception was codified as 0 (white&gold) or 1 (black&blue). The association between dress perception and demographic and main ocular variables (age, gender, binocular visual acuity, grade of nuclear cataract, crystalline lens status [phakic/pseudophakic], spherical equivalent, and ocular health status) was tested using logistic regression. Receiver operation curves were used to test the predictive value of the model. Several variables were found to be related with dress perception. The best model included three variables—Age: adjusted odds ratio (OR) = 1.02 (1.01–1.03), p = 0.08; ocular refraction: adjusted OR = 1.07 (1.02–1.12), p = 0.009; and nuclear cataract grade: adjusted OR = 1.45 (1.05–1.99), p = 0.026. The predictive value of the model was low (area under the curve = 0.62). Older age, nuclear cataract grade, and hyperopia were associated with black&blue perception. The predictive capacity of the developed model was poor. Only a small proportion of the variability in the #thedress perception can be explained by ocular examination.

[Abstract] Background: Little is known about the impact of occupational seafaring on lower limb conditions. The aim of the study was to estimate the prevalence of dermatological diseases affecting the feet and lower extremities of seafarers, as well as the possible impact of working conditions on the development of the pathologies analysed. Materials and methods: A prevalence study was performed through self-completed questionnaires at the “Instituto Social de la Marina” (ISM) centres at A Coruña, Ribeira, Noya and Cádiz (Spain). Sociodemographic, anthropometric and podiatric variables, as well as the type of maritime sector, duty on board and, working footwear, were studied (n = 137). The study has been approved by the Ethics Committee of the University of A Coruña (CE 13/2016). Results: The average age of the study subjects was 45.71 ± 9.90 years and the number of years sailed was 20.31 ± 11.64 years. The most prevalent pathologies were mycosis (21.9%), helomas and tylomas (29.9%) and hyperhidrosis (17.5%). A statistically significant relationship was obtained between pruritus and scabies (p ≤ 0.000), xerosis (p ≤ 0.005), eczema (p ≤ 0.000), obesity (p ≤ 0.018) and psoriasis (p ≤ 0.005). A significant relationship was also found between onychocryptosis, and psoriasis (p ≤ 0.000). Frequency with which the study participants have visited the podiatrist was significantly related to the presence of helomas and tylomas (p ≤ 0.013) and hyperhidrosis (p ≤ 0.025). Conclusions: A high prevalence of diverse dermatological diseases has been found, revealing the importance of podiatric assessment in sea workers prior to boarding.

Ciclovia, also known as Open Streets initiatives in other countries, are city streets that are closed to motorized traffic and opened during certain times to residents for engaging in physical activity (PA). These initiatives are viewed by policy makers and health and community advocates as being beneficial to social, environmental, and community health. This study explores the geographic distribution of Ciclovia and Recreovia and the differences in geographic access assessed via distance-based measures, based on the socioeconomic status (SES) of the area. Results from this study show that the median distance to the Ciclovia according to SES ranges from 2930 m for SES 1 (most disadvantaged) to 482 m for SES 6 (wealthiest). The median distance to the Recreovia sites ranges from 5173 m for SES 1 to 3869 m for SES 6. This study found revealing urban inequities in the distribution of Ciclovia, whereas there was less inequalities within the Recreovia sites. This study shows that urban interventions are needed to promote recreational activity and reduce health disparities in under resourced, low SES areas.

Endoscopic enucleation of the prostate was first described by Hiraoka in 1986, using a monopolar resectoscope. His contribution was largely ignored until Gilling and Fraundorfer published their three-lobe enucleation technique with the Holmium laser in 1998 ,that ended establishing itself as a reliable option for the treatment of HBP, backed by ample scientific evidence. Later on, enucleation performed with other lasers, as well as bipolar energy, have shown concordance in their clinical results. As a result, the term AEEP (anatomic endoscopic enucleation of the prostate) emerged to encompass all these techniques. During the last few years there have been significant advances in two areas: first, technology, with the development of pulse modulation for Holmium generators (MOSES) as well as high-speed morcellators. Second, the development of new surgical techniques that recognize the importance of the early release of the sphincter from the apex of the adenoma during the operation as well as the careful preservation of the external sphincter's mucosa, to avoid early stress incontinence. In this paper,we review the recent evolution of both technology and surgical technique. AEEP has been risen to a new level, reducing operative time significantly, usually under one hour, and radically reducing the incidence of early temporary stress incontinence, and maybe also facilitating the learning curve of AEEP.La enucleación endoscópica de próstata fue descrita por primera vez por Hiraoka en 1986, usando un resector monopolar. Su aportación pasó desapercibida hasta que Gilling y Fraundorfer publicaron su técnica de enucleación en tres lóbulos con láser de Holmio en 1998, que se estableció como una opción de tratamiento de la obstrucción prostática benigna ampliamente respaldada por la evidencia científica. Posteriormentes e ha estudiado el uso de otros láseres así como de la energía bipolar para realizar enucleación endoscópica y se ha observado una concordancia en los resultados de estas técnicas, independientemente de la fuente de energía utilizada, que ha conducido a englobarlas bajo el acrónimo EEAP (enucleación endoscópica anatómica de próstata). En los últimos años se han producido avances muy relevantes en dos ámbitos: Uno, el ámbito tecnológico, con el desarrollo de la tecnología de modulación del pulso del láser de Holmio (MOSES) y de los morceladores de alto rendimiento. Otro, el desarrollo de nuevas técnicas quirúrgicas, que reconocen la importancia de liberar precozmente el esfínter del ápex del adenoma en la intervención y de preservar escrupulosamente la mucosa del esfínter externo, para evitar la incontinencia urinaria precoz postoperatoria. En este artículo se revisa la evolución reciente de la tecnología y de la técnica quirúrgica que han elevado a la enucleación endoscópica de próstata a otro nivel, reduciendo significativamente el tiempo operatorio, normalmente inferior a una hora, disminuyendo radicalmente la incontinencia precoz postoperatoria y probablemente, facilitando el aprendizaje de la técnica.

Public discussion, advocacy, and legislative consideration of policies aimed at reducing consumption of processed foods, such as sugar-sweetened beverage (SSB) taxes and mandatory front-of-package (FOP) warning labels, may stimulate product reformulation as a strategy to prevent regulation. In Colombia, there have been major legislative pushes for SSB taxes and FOP labels, although neither has passed to date. In light of the ongoing policy debate and successful implementation of similar policies in Peru and Chile, we explored manufacturer reformulation in the Colombian food supply. We compared the quantities of nutrients of concern (including sugar, sodium, and saturated fat) from the nutrition facts panels of the same 102 packaged foods and 36 beverages from the top-selling brands in Colombia between 2016 and 2018. Our analyses showed a substantial decrease in median sugar content of beverages, from 9.2 g per 100 mL to 5.2 g per 100 mL, and an increase in the percentage of beverages containing non-nutritive sweeteners (NNS), from 33% to 64% (p = 0.003). No meaningful changes in the quantities of nutrients of concern among foods were observed. Our findings suggest little reformulation has occurred in Colombia in the absence of mandatory policies, except for the substitution of sugar with NNS among beverages.

Rice (Oryza sativa L.) is a staple food for more than two billion people worldwide. Its cultivation demands large amounts of nutrients, particularly nitrogen and phosphorus (P). Consequently, low availability of these nutrients in the soil has led to the use of chemical fertilizers, generating increases in production costs and environmental damage. Soil host microorganisms known as plant growth-promoting rhizobacteria (PGPR) colonize the rhizosphere and facilitate the uptake of nutrients by the plants. In this study, rice seeds inoculated with PGPR were grown for 30 days in an inert substrate and fertilized with modified Hoagland nutrient solution with phosphate rock as a source of P. Treatments were repeated over time, obtaining five isolates which significantly increased plant length by up to 56% and dry weight of stems and roots up to 45% and 169% respectively relative to an uninoculated control. Selected strains showed in vitro tri-calcium phosphate solubilizing activity, mineralizing phytate activity, and phosphate release from rice straw (RS). Based on the above criteria, three isolates (IBUN-02755, -02,704 and -02,724) that contained β propeller phytase (BPP) genes, were selected to evaluate their effect as PGPR in rice seedlings. These were planted in a soil amended with RS under greenhouse conditions. The results showed that selected Bacillus spp. strains significantly increased plant length and dry weight or increased plant phosphate uptake up to two times compared to an un-inoculated control. This suggests that selected strains may have a capacity as PGPR using RS as carbon and a P amendment.

Toxoplasma gondii is the etiological agent of toxoplasmosis. Mother-to-child transmission of this parasite can occur during pregnancy. Newborns with congenital toxoplasmosis may develop central nervous system impairment, with severity ranging from subclinical manifestations to death. A proinflammatory/regulated specific immune profile is crucial in the defense against the parasite; nevertheless, its role in the infected pregnant women and the congenitally infected offspring has been poorly explored, and there is still no consensus about its relation to parasite vertical transmission or to severity and dissemination in the congenitally infected newborns. This work aimed to characterize these relations by means of principal component and principal factor analyses. For this purpose, we determined the specific production of the four immunoglobulin G antibody subclasses, cytokines, and lymphocyte proliferation in the T. gondii–infected pregnant women−10 who transmitted the infection to their offspring and seven who did not—as well as in 11 newborns congenitally infected and grouped according to disease severity (five mild and six moderate/severe) and dissemination (four local and seven disseminated). We found that the immune response of nontransmitter women differed from that of the transmitters, the latter having a stronger proinflammatory response, supporting a previous report. We also found that newborns who developed moderate/severe disease presented higher levels of lymphocyte proliferation, particularly of CD8+ and CD19+ cells, a high proportion of tumor necrosis factor α producers, and reduced expression of the immune modulator transforming growth factor β, as opposed to children who developed mild clinical complications. Our results suggest that a distinctive, not regulated, proinflammatory immune response might favor T. gondii vertical transmission and the development of severe clinical manifestations in congenitally infected newborns.

Aiming to increase the reproducibility of biomedical research results, biobanks obtain human tissues of the highest quality and carry out different storage methods adapted to the needs of analytical technique to be performed by the biomedical researchers. However, there is much controversy and little data concerning the real impact of different stabilization methods on tissue quality, integrity and functionality of derived biomolecules. The influence of four stabilization methods [RNAlater (RNL), snap freezing (SF), snap freezing using Optimal Cutting Tissue compound (SF-OCT) and formalin-fixed paraffin-embedded (FFPE)] on RNA quality and integrity was evaluated in paired samples of lung tissue. RNA integrity was evaluated through PCR-endpoint assays amplifying six fragments of different length of the HPRT1 gene and RNA Integrity Number (RIN). To evaluate the difference of tissue functionality among the stabilization methods tested, RT-qPCRs were performed focusing on the differential expression of the HPRT1, SNRPD3 and Jun genes. RNA from the samples preserved with the RNL or SF-OCT method showed better integrity compared to SF and FFPE, measured by PCR-endpoint and RTqPCR assays. However, only statistically significant differences were observed between the RNA from FFPE and other stabilization methods when gene expression of HPRT1, SNRPD3 and Jun housekeeping genes were determined by RT-qPCR. For the three mentioned genes, Cq and RIN values were highly correlated. The present work describes the fragility of SF samples, being critical the moment just before RNA extraction, although further experiments of tissue RNA are needed. Standardization pre-analytic workflow can lead to improved reproducibility between biomedical research studies. The present study demonstrated clear evidences about the impact of the stabilization method on RNA derived from lung human tissue samples., We thank all volunteers of Pulmonary Biobank Consortium for the participation and sample donation. We also thank Institut d'Investigacio Sanitaria de les Illes Balears (IdISBa) for publication funding (Liberi 2020 Program). This work was funded by the Ministerio de Ciencia, Innovacion y Universidades of Spain and Instituto de Salud Carlos III (PI16/00528) through the Spanish Biobank Network (PT17/0015/0001) and granted by Conselleria d'Innovacio, Recerca i Turisme del Govern de les Illes Balears (TEC/002/2017).

Anisakiasis is a global disease caused by consumption of raw or lightly cooked fish parasitised with Anisakis spp. third-stage larvae. Cases in the literature show colocalised anisakiasis and colorectal cancer, and the incidental finding of Anisakis larvae at the tumour site was reported. Data from our group suggested an epidemiological link between previous infection and gastrointestinal cancer. Furthermore, it has recently been reported that Anisakis products lead to inflammation and DNA damage. Based on these facts, the aim was to investigate whether Anisakis antigens are able to induce changes in the proliferation of epithelial cells in vitro or in the expression of serum microRNA (miRNA) in Sprague-Dawley rats. Anisakis complete extract (CE) induced increases in cell proliferation and decreases in apoptosis compared with nontreated cells, which resulted in a significant increase in the absolute number of viable cells at 48 h of exposure (P

ObjectiveWe aimed to assess the maternal and family determinants of four anthropometric typologies at the household level in Colombia for the years 2000, 2005 and 2010.DesignWe classified children Z-score (Z-score (>2) to assess stunting and overweight/obesity, respectively; mothers were categorized according to BMI to assess underweight (2) and overweight/obesity (≥25·0 kg/m2). At the household level, we established four final anthropometric typologies: normal, underweight, overweight and dual-burden households. Separate polytomous logistic regression models for each of the surveyed years were developed to examine several maternal and familial determinants of the different anthropometric typologies.SettingNational and sub-regional (urban and rural) representative samples from Colombia, South America.SubjectsDrawing on data from three waves of Colombia’s Demographic and Health Survey/Encuesta Nacional de Salud (DHS/ENDS), we examined individual and household information from mothers (18–49 years) and their children (birth–5 years).ResultsHigher parity was associated with an increased likelihood of overweight and dual burden. Higher levels of maternal education were correlated with lower prevalence of overweight, underweight and dual burden of malnutrition in all data collection waves. In 2010, participation in nutrition programmes for children ConclusionsResults suggest that maternal and family correlates of certain anthropometric typologies at the household level may be used to better frame policies aimed at improving social conditions and nutrition outcomes.

Introduction The aim of this study is to analyze the safety and efficacy of stent-graft endovascular treatment for visceral artery aneurysms and pseudoaneurysms. Methods Multicentric retrospective series of patients with visceral aneurysms and pseudoaneurysms treated by means of stent graft. The following variables were analyzed: Age, sex, type of lesion (aneurysms/pseudoaneurysms), localization, rate of success, intraprocedural and long term complication rate (SIR classification). Follow-up was performed under clinical and radiological assessment. Results Twenty-five patients (16 men), with a mean age of 59 (range 27–79), were treated. The indication was aneurysm in 19 patients and pseudoaneurysms in 6. The localizations were: splenic artery (12), hepatic artery (5), renal artery (4), celiac trunk (3) and gastroduodenal artery (1). Successful treatment rate was 96% (24/25 patients). Intraprocedural complication rate was 12% (4% major; 8% minor). Complete occlusion was demonstrated during follow up (mean 33 months, range 6–72) in the 24 patients with technical success. Two stent migrations (2/24; 8%) and 4 stent thrombosis (4/24; 16%) were detected. Mortality rate was 0%. Conclusion In our study, stent-graft endovascular treatment of visceral aneurysmns and pseudoaneurysms has demonstrated to be safe and is effective in the long-term in both elective and emergent cases, with a high rate of successful treatment and a low complication rate.

The first description of corneal dellen was made by E Fuchs in 1911.1968 Since then, the German term ‘dellen’ (denting) is used to refer to a focal thinning of the cornea secondary to an abnormal d...

During the progression of psoriatic lesions, abundant cellular infiltration of myeloid cells, such as macrophages and activated dendritic cells, occurs in the skin and the infiltrating cells interact with naive lymphoid cells to generate a T helper (Th)1 and Th17 environment. Therapies to treat psoriasis include phototherapy, non-steroidal and steroidal drugs, as well as antibodies to block tumor necrosis factor-alpha, interleukin (IL)-17-A and IL-12/IL-23, which all focus on decreasing the proinflammatory hallmark of psoriasis. The present study obtained the heptapeptide HP3 derived from phage display technology that blocks mononuclear cell adhesion to endothelial cells and inhibits trans-endothelial migrationin vitro. The activity of the heptapeptide in a murine model of psoriasis was also assessed, which indicated that early administration inhibited the development of psoriatic lesions. Therefore, the results suggested that HP3 may serve as a potential therapeutic target for psoriasis. Funding Agencies|IPN-Multidisciplinary Projects [SIP-1773, SIP-20149]; CONACyTConsejo Nacional de Ciencia y Tecnologia (CONACyT); BEIFI-IPN

DNA topoisomerase II (TOP2) is a major DNA metabolic enzyme, with important roles in replication, transcription, chromosome segregation and spatial organisation of the genome. TOP2 is the target of a class of anticancer drugs that poison the DNA-TOP2 transient complex to generate TOP2-linked DNA double-strand breaks (DSBs). The accumulation of DSBs kills tumour cells but can also result in genome instability. The way in which topoisomerase activity contributes to transcription remains unclear. In this work we have investigated how transcription contributes to TOP2-dependent DSB formation, genome instability and cell death. Our results demonstrate that gene transcription is an important source of abortive TOP2 activity. However, transcription does not contribute significantly to apoptosis or cell death promoted by TOP2-induced DSBs. On the contrary: transcription-dependent breaks greatly contribute to deleterious mutations and translocations, and can promote oncogenic rearrangements. Importantly, we show that TOP2-induced genome instability is mediated by mutagenic canonical non-homologous end joining whereas homologous recombination protects cells against these insults. Collectively, these results uncover mechanisms behind deleterious effects of TOP2 abortive activity during transcription, with relevant implications for chemotherapy., Spanish Ministry of Science and Innovation [BFU2016-76446-P, RYC-2014-16665]; youth employment plan of the Andalusian government and the University of Seville (to J.O.-P.); predoctoral fellowship from the University of Seville [VI PPIT-US to D.R.-C.]. Funding for open access charge: Spanish Ministry of Science and Innovation [BFU2016-76446-P].

We report the case of a 81–year-old woman who presented for a routine follow-up of her dry age related macular degeneration. Optical coherence tomography (OCT) using Triton OCT (Topcon, Tokyo) showed the presence of a round area behind the sclera , slightly inferior to the macula in her right eye. The morphology and position of this structure suggests this was a transversal cut of the inferior oblique muscle (IOM) close to its ocular insertion in her right eye. Several publications have reported the utility of OCT technology to visualize the anterior insertion of the rectus muscles. However, to the best of our knowledge this is the first publication to report the potential of posterior segment OCT to visualize the insertion oblique muscles in patients with severe chorioretinal atrophy. pre-print 291 KB

Background: Front-of-package warning labels are an increasingly common policy and have been implemented to inform consumers of the nutritional quality of ultra-processed foods. This study examined the proportion of Colombian products that could be subjected to such regulations. Methods: Two nutrition profile models were compared: the Pan American Health Organization (PAHO) model, and the nutrient profile established under the Chilean food labeling and advertising law (Chilean model). Products (n = 6708) exceeding nutrient criteria based on each model were identified as subject to regulation. Results: A total of 80.2% (PAHO model) to 66.4% (Chilean model) of foods met the criteria for regulation. The categories with the highest proportion of regulated products were meats (97.3% PAHO model, 87.5% Chilean model), sweets (95.6% PAHO) and snacks (Chilean model). The category with the lowest proportions of regulated products were cereals (47.3% PAHO model) and miscellaneous foods and fish/seafood (39.0% and 39.5%, respectively, Chilean model). Conclusions: Under both the PAHO and Chilean nutrient profile models, the majority of packaged foods available in Bogot&aacute, would be eligible to receive front-of-package warning labels. These results suggest a warning label law could have a major impact on the Colombian food supply, especially in the context of the growing prevalence of diet-related chronic diseases in Colombia.

Toxoplasmosis is a parasitic zoonosis distributed worldwide, caused by the ingestion of contaminated water/food with the parasite Toxoplasma gondii. If a pregnant woman is infected with this parasite, it may be transmitted to the fetus and produce ocular, neurological, or systemic damage with variable severity. The strength and profile of mother's immune response have been suggested as important factors involved in vertical transmission rate and severity of clinical outcome in the congenitally infected fetus. The aim of this work was to evaluate a possible relation between the mother's immune response during pregnancy and congenital transmission to the fetus. We obtained peripheral blood from T. gondii infected pregnant woman and tested it for anti T. gondii (IgG1, IgG2, IgG3, IgG4, and IgA) in serum. Peripheral blood mononuclear cells (PBMCs) were isolated to analyze the in vitro effect of soluble T. gondii antigens on proliferation and production of cytokines. We found that IgG2-4 and IgA antibodies and lymphocytes proliferation, especially CD4+, CD8+, and CD19+ were positive in a higher proportion of cases in transmitter than in non-transmitter women. Furthermore, IgG2-3 and IgA anti-Toxoplasma antibody levels were higher in those mothers who transmitted the infection than in those who did not. Interestingly, a higher proportion of positive cases to IFN-γ and negatives to the immunoregulatory cytokine TGF-β, were related to T. gondii vertical transmission. Our descriptive results are consistent with the paradoxical previous observations in murine models of congenital toxoplasmosis, which suggest that an increased immune response that protects the mothers from a disseminated or severe disease, and should protect the fetus from infection, is positively related to parasite transmission.

To conduct a systematic review examining the associations between neighborhood environments and self-rated health (SRH) and health-related quality of life (HR-QOL) in the urban context of Latin America. We conducted a structured search of quantitative studies in three bibliographic databases published in Spanish, English, Portuguese and French from January 1990 to December 2015. We restricted the search to studies conducted in Latin-American cities with one million and more inhabitants. Eleven studies were finally included in the analysis. Ten were cross-sectional studies and one was a cohort follow-up study. Two studies found positive associations between accessibility to parks and HR-QOL. One study found that high neighborhood social capital was positively associated with SRH. Neighborhood socioeconomic status was positively associated with both HR-QOL and SRH in two studies. A walkable neighborhood was positively associated with SRH in two studies. Three studies included attributes related with neighborhood security perception and road safety, with higher scores of HR-QOL, both in the physical and mental dimensions, while high levels of street noise were negatively associated. Narrowness and slope of streets were negatively associated with SRH. No association was found between the perception of neighborhood security and SRH. The results of this systematic review show that several studies conducted in Latin America have found significant associations between neighborhood environment and SRH and HRQOL. However, the relatively small number of studies and the heterogeneity among them require further studies to better understand this topic in the region.

FUS (fused in sarcoma) plays a key role in several steps of RNA metabolism, and dominant mutations in this protein are associated with neurodegenerative diseases. Here, we show that FUS is a component of the cellular response to topoisomerase I (TOP1)–induced DNA breakage; relocalising to the nucleolus in response to RNA polymerase II (Pol II) stalling at sites of TOP1-induced DNA breaks. This relocalisation is rapid and dynamic, reversing following the removal of TOP1-induced breaks and coinciding with the recovery of global transcription. Importantly, FUS relocalisation following TOP1-induced DNA breakage is associated with increased FUS binding at sites of RNA polymerase I transcription in ribosomal DNA and reduced FUS binding at sites of RNA Pol II transcription, suggesting that FUS relocates from sites of stalled RNA Pol II either to regulate pre-mRNA processing during transcriptional stress or to modulate ribosomal RNA biogenesis. Importantly, FUS-mutant patient fibroblasts are hypersensitive to TOP1-induced DNA breakage, highlighting the possible relevance of these findings to neurodegeneration., This work was funded by an MRC project grant to KW Caldecott and M Hafezparast (MR/K01854X/1), and MRC and ERC Programme grants to KW Caldecott (ERC SIDSCA 694996, MR/P010121/1). MI Martinez-Macias was also supported by an European Molecular Biology Organisation (EMBO) Long-Term Fellowship ALTF 751-2013.

Background The objective of this study was to analyze the original curvature of the aortic arch and thoracic aorta, and how it is modified after the placement of a thoracic endograft. Methods We retrospectively analyzed all patients primarily treated for thoracic aortic aneurysms and blunt traumatic aortic injuries by means of an endograft sealed into the aortic arch (zones, Z1–Z3) in 2 different centers (Vascular Surgery Division, Hospital Clinic, UB; and Vascular and Endovascular Surgery Department, Hospital Vall d’Hebron, UAB; Barcelona, Spain), between 2010 and 2015. The last preoperative and early (1-month) postoperative computed tomography angiography (CTA) was obtained for all cases, and an accurate 3-dimensional (3D) center lumen line was created, from the aortic valve to the renal arteries. Angles in 2-dimensional (2D; XY-plane) and 3D (referred to cranial-caudal Z-axis) were analyzed in: the distal ascending aorta, aortic arch, and thoracic aorta (at 5, 10, 15, and 20 cm from the brachiocephalic trunk [BCT]) and celiac trunk (CT). Changes in preoperative–postoperative CTA were compared independently for both diseases. Thirty-six cases were included (20 aneurysms, 16 blunt traumatic injuries; mean age, 69.5 and 42.5 years). Results After placement of an aortic endograft (sealed in Z1–Z2 in 30% of aneurysms and 75% of traumatic injuries; mean endograft length: 22.6 cm and 11.3 cm, respectively), a global left anterior displacement of the ascending aorta was observed (2D examination: −13.1° and −7.5°, P = 0.049 and 0.041, respectively). The 3D examination showed an average increase of the aortic angle at 5 and 10 cm from the BCT in the whole sample (+4.0°, +4.9° in reference to the vertical; P = 0.017, 0.001), softening the curvature of the proximal descending thoracic aorta. In addition, in traumatic injuries, a decrease in the aortic arch angle was observed (−3.5°, P = 0.030). Conclusions Placement of an endograft into the aortic arch and proximal thoracic aorta engenders a softening of the proximal descending thoracic aorta curvature, increasing its angle from the vertical. In blunt traumatic aortic injuries (with shorter and more proximally sealed endografts), an additional decrease of the aortic arch angle (3.5° more vertical), was observed.

To evaluate the efficacy and safety of the hydrodynamic thrombectomy catheter (AngioJet DVX) in the salvage of thrombosed hemodialysis vascular grafts. A retrospective study was designed, including all patients with occluded arteriovenous grafts treated with the AngioJet system between 2007 and 2014 in our institution. Outcomes included technical success, clinical success, complications, and primary and secondary patencies. Procedural success was defined as angiographic confirmation of flow restoration, the presence of a pulsatile thrill along the graft, and successful resumption of at least one hemodialysis session. Primary and secondary patencies after first AVG thrombectomy were calculated with Kaplan–Meier curves. Cox regression was used to determine prognostic factors of primary patency after every thrombectomy episode. A total of 149 thrombectomies were performed in 68 grafts. After thrombectomy, endovascular treatment of one or more stenosis was performed in all cases. Technical success was 93% and clinical success was 86%. Complications occurred in 7 thrombectomies, most of them were minor except for one anastomosis rupture requiring surgery. Primary and secondary patencies were 52, 41, and 23 and 76, 68, and 57% at 3, 6 and 12 months, respectively. Independent prognostic factors of poor patency after every thrombectomy episode were the presence of residual thrombus (OR 1.831, P = 0.008) and time from last thrombosis (less than 1 month; and OR 7.116, P

Febrile infection-related epilepsy syndrome (FIRES) is a rare condition which evolves into refractory status epilepticus (SE), with poor outcome in most cases. Conventional antiepileptic drugs fail to control SE in FIRES patients. We report the case of a previously healthy 4-year-old boy who was diagnosed with FIRES. One week after pharyngitis and high fever he started seizures, followed by refractory SE. Benzodiazepines, phenytoin, high-dose barbiturates that induce burst suppression, high doses of corticosteroids, plasmapheresis, immunoglobulins, propofol, lidocaine, ketamine, inhaled desflurane, ketogenic diet, lacosamide, and therapeutic hypothermia were tried at different times in a period of 8 weeks, but all of them were ineffective. Electroconvulsive therapy (ECT) has been used in refractory SE in children. We report a case in which ECT was successfully used for treatment of refractory SE in a pediatric patient with FIRES syndrome.

Policies to require warnings on the front of food and drinks high in nutrients of concern (e.g., added sugar, sodium, or saturated fat) are becoming increasingly common as an obesity prevention strategy. Colombia, a country with growing prevalence of obesity, is considering implementing a similar policy. The objective of this study was to assess perceptions and reactions to different warning designs. We conducted a randomized experiment in an online panel of adults age &gt, 18y (n = 1997). Participants were randomized to view one of four labels: a control label (barcode), an octagon warning, a circle warning, and a triangle warning. Participants viewed their randomly assigned label on a series of products and answered questions (continuous outcomes ranged from 1&ndash, 4). Compared to the control, all warnings led to higher perceived message effectiveness (increase in mean from 1.79 in the control to 2.59&ndash, 2.65 in the warning conditions, p &lt, 0.001), a higher percentage of participants who correctly identified products high in nutrients of concern (from 48% in the control condition to 84&ndash, 89% in the warning conditions, p &lt, 0.001), and reduced intentions to purchases these products (decrease in mean from 2.59 to 1.99&ndash, 2.01 in the warning conditions, p &lt, 0.001). Relative to the control, warnings performed similarly across education levels, suggesting this policy would be equitable in Colombia. Looking at differences by warning type, the pattern of results suggested that the octagon warnings performed best. After viewing all label types, 49% of participants selected the octagon warning as the one that most discouraged them from consuming products high in nutrients of concern, while 21% and 27% selected the circle and triangle warning. Colombian policymakers should consider the octagon warning as part of a front-of-package labeling policy to help consumers identify and reduce consumption of foods and drinks high in nutrients of concern.

Background The hypotheses of autoimmune, allergic or infectious etiology of severe mental illness have been reported in the scientific literature repeatedly. The main objective of this work is to study the relationship of inflammatory, autoimmunity or recent infection markers with the fact of suffering Severe Mental Disorders (SMD). Methods In the present case-control study, adult patients with a diagnosis of SMD were compared with controls who underwent routine health checks that included analytical control. Cases with psychosis substance-induced and controls with diagnosis of any psychiatric illness were excluded. In both groups, patients with chronic inflammatory diseases or intercurrent infectious disease were also excluded. A set of common analytical parameters, markers of infectious diseases and inflammatory markers were retrieved for both groups, as well as demographic and clinical data. Results A total of 212 subjects (81 cases and 131 controls) were recruited. From cases, 70 (86.4%) have a diagnosis of Schizophrenia Disease (SD) and 11 (13.6%) of Schizoaffective Disorder (SAD). In the multivariate model the female sex (OR 0.24, 95% CI 0.12–0.46) and the neutrophil-lymphocyte ratio (OR 3.00, 95% CI 1.91–4.70) were associated with the fact of being case. Conclusions Patients with SMD seem to have higher inflammatory markers compared to the general population, being the neutrophil-lymphocyte ratio, the marker associated with more strength. The role of inflammatory processes in the etiology of this type of disorders, if confirmed, opens interesting and innovative therapeutic possibilities.