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Background: INSURE (Intubation, Surfactant administration, and Extubation) therapy is controversial in managing respiratory distress syndrome (RDS) in late preterm newborns. This study aims to determine whether the use of the INSURE in late preterm infants with RDS is associated with improved outcomes compared to similar infants managed with CPAP alone. Methods: A retrospective cohort study compared two different neonatal care units with two different treatments of RDS in late preterm infants in Bucaramanga, Colombia. One cohort used selective bubble CPAP and rescue surfactant, the second cohort used selective bubble CPAP and INSURE within the first hour of life. We included all the newborns with gestational age between 33 - 366/7 weeks, born between 2012 to 2017, that developed early RDS and were treated with CPAP. Results: We recruited 208 patients (57 CPAP and rescue surfactant and 151 CPAP + INSURE). Early INSURE was reported in 117 patients (56.3 %). INSURE therapy was associated with a reduced risk of CPAP failure (RR = 0.50; 95 % CI 0.26 - 0.98); this effect was evident only when surfactant was administered within the first two hours of life (RR = 0.29; 95 % CI 0.12 - 0.69). Early INSURE was associated with a decreased risk of pneumothorax (RR = 0.07; 95 % CI 0.01 - 0.77) and pulmonary hypertension (RR = 0.34; 95 % CI 0.14 - 0.78). Conclusions: Early INSURE therapy was associated with a reduced incidence of CPAP failure, pneumothorax, and pulmonary hypertension in late preterm infants with moderate to severe RDS. Large, well-powered randomized controlled trials are needed to confirm these observations, but its use is supported by studies with similar results in more premature infants.

Aims To map sensory and pelvic postganglionic neurons from three different regions of the female rat urethra. Methods The neuronal tracer True Blue (TB) was injected into the pre-pelvic, pelvic, and clitoral regions of the urethra from female Wistar rats. Seven days after TB injection, TB+ cells from the dorsal root ganglia (DRGs) and the major pelvic ganglion (MPG) were examined. The number and morphometry of TB+ cells were determined. Results TB+ cells were mainly distributed in lumbar 1 (L1), lumbar 2 (L2), lumbar 6 (L6), and sacral 1 (S1) DRGs, and in the MPG. The mean number of sensory neurons was 1200 ± 143. TB injection in pre-pelvic and pelvic urethra labeled neurons in L1, L2, L6, and S1 DRGs. TB injection in clitoral urethra labeled neurons in L6 and S1 DRGs. L6 DRG contained >50% of the total urethral TB+ neurons, and ~80% of the clitoral region. The mean value of the total number of MPG TB+ neurons was 1217 ± 72. DRG and MPG neurons projecting to the urethra presented a somatotopic distribution. Conclusions The results demonstrated that L6 DRG is the major supplier of afferent innervation to the urethra, and that the distal urethral region is exclusively innervated by lower lumbosacral DRGs. Considering that electrical stimulation of sensory pudendal nerve improves overactive bladder, and that most of the sensory neurons in the distal urethra are from L6 DRG, electrical stimulation of this ganglion may be an innovative and effective neuromodulation therapy for neurogenic urinary dysfunctions.

Introducción: la dieta cetogénica baja en calorías (DC) se conoce por su efecto para reducir el peso corporal. La pérdida de peso saludable debe reducir la grasa corporal y mantener la masa muscular, pero los metaanálisis previos no han evaluado estos cambios. El objetivo de este metaanálisis fue cuantificar el efecto de la dieta cetogénica comparada con una dieta hipocalórica (DH), sobre los cambios de composición corporal en adultos con exceso de peso. Métodos: se realizó una revisión sistemática y metaanálisis según la metodología Cochrane. Se consultaron 5 bases de datos usando los términos “Body Weight” OR “Body Composition” AND “Diet, Ketogenic”. Se incluyeron estudios experimentales controlados, seguimiento ≥4 semanas realizados en adultos con IMC ≥25 kg/m2 y desenlaces de peso y composición corporal. Resultados: la búsqueda arrojó 492 artículos, de los cuales se seleccionaron 10 para el metaanálisis y solo 3 presentaron bajo riesgo de sesgo. El metaanálisis indicó que la dieta cetogénica, respecto a la dieta hipocalórica, promueve mayor pérdida de peso (-6,9 kg, intervalo de confianza [IC] 95 %: -10,4; -3,3), de índice de masa corporal (IMC; -1,6 kg/m2; IC 95 %: -3,0; -0,2) y masa grasa (-0,8 kg; IC 95 %: -1,1; -0,5). No se encontró suficiente información para indagar sobre la masa muscular. Los riesgos de sesgo junto con el sesgo de publicación y de reporte podrían estar sobreestimando el efecto de la dieta cetogénica. Conclusiones: en adultos con exceso de peso y con seguimiento hasta de 12 meses, la dieta cetogénica, comparada con la dieta hipocalórica, presentó mayor pérdida de peso, disminución del IMC y reducción en la masa grasa, pero podría estar sobreestimado por sesgos de publicación o reporte. Por lo anterior, se considera innecesario emplear la dieta cetogénica para el control del peso corporal. Palabras clave: dieta cetogénica, sobrepeso, obesidad, metaanálisis.

espanolObjetivo: Estimar el impacto potencial de la disminucion teorica del indice de masa corporal, sobre la incidencia y la fraccion atribuible poblacional de canceres hepatico, colorrectal y de mama, en el contexto colombiano, 2016-2050. Metodologia: Se efectuo un estudio de macrosimulacion, bajo tres escenarios de distribuciones futuras del indice de masa corporal: el primero o de “Referencia” (sin intervenir el factor de riesgo), y dos de intervencion: el segundo, consistente en la reduccion gradual, acumulada en los primeros diez anos, del 10 % de la diferencia entre los valores medios esperados e ideales del indice de masa corporal, y sostenerla hasta el 2050; y el tercero, correspondiente a lograr “Toda la poblacion con indice de masa corporal ideal” a partir del 2017. Resultados: Se estimo, bajo el tercer escenario, que las proporciones de canceres que podrian evitarse oscilarian, en las mujeres, entre 8,0 % (cancer colorrectal) y 16,7 % (cancer hepatico), y en los hombres, entre 10,4 % (cancer colorrectal) y 12,2 % (cancer hepatico). Bajo el segundo escenario, los casos evitables proyectados corresponderian aproximadamente a 4009 canceres de mama (en mujeres), 2086 canceres colorrectales y 728 canceres hepaticos; y bajo el tercer escenario, a 48 410 canceres de mama, 25 089 canceres colorrectales y 8648 canceres hepaticos. Conclusion: Intervenir para disminuir el exceso de peso en la poblacion colombiana contribuiria especialmente a evitar, en ambos sexos, el cancer hepatico, y en las mujeres, los casos nuevos de cancer de mama portuguesObjetivo: Estimar o impacto da reducao teorica do indice de massa corporal, em incidencia e a fracao atribuivel da populacao de cânceres de figado, colorretal e de mama, no contexto colombiano, 2016-2050. Metodologia: Foi realizado um estudo de macro-simulacao, sob tres cenarios de distribuicoes futuras do indice de massa corporal: o primeiro ou de “Referencia” (sem intervir o fator de risco) e duas de intervencao: a segunda, consistindo na reducao gradual, acumulou nos primeiros dez anos, do 10 % da diferenca entre os valores medios esperados e ideais do indice de massa corporal e sustentando-o ate 2050; e a terceira, correspondendo ao alcancar “Toda a populacao com Indice de Massa Corporal ideal” a partir do 2017. Resultados: Estimou-se que as proporcoes de cânceres que poderiam ser evitadas no terceiro cenario variariam em mulheres entre 8,0 % (câncer colorretal) e 16,7 % (câncer de figado) e em homens entre 10,4 % (câncer colorretal) e 12,2 % (câncer de figado). Os casos evitaveis projetados sob a segundo cenario corresponderiam a aproximadamente 4009 cânceres de mama (em mulheres), 2086 cânceres colorretais e 728 cânceres de figado e, sob a terceiro cenario, a 48 410 cânceres de mama, 25 089 cânceres colorretais e 8648 cânceres de figado. Conclusao: Intervir para reduzir o excesso de peso na populacao colombiana, contribuiria especialmente para evitar o câncer de figado em ambos os sexos e novos casos de câncer de mama (em mulheres). EnglishObjective: To estimate the effect of a theoretical decrease impact of the body mass index on the incidence and the population attributable fraction of liver, colorectal and breast cancers in Colombian, 2016-2050.. Methodology: A macro-simulation study was performed under three scenarios of future distributions of the body mass index: the first or of “Reference” (without intervening on the risk factor) and two interventions scenarios: the second consisting of a gradual reduction, accumulated over the first ten years, of 10 % of the difference between the expected and ideal mean values of the body mass index and sustaining these until 2050; and the third corresponding to achieve “Complete population with ideal Body Mass Index” as of 2017. Results: It was estimated that the proportions of cancers that could be avoided under the third scenario, would range in women between 8,0 % (colorectal cancer) and 16,7 % (liver cancer) and in men between 10,4 % (colorectal cancer) and 12,2 % (liver cancer). The avoidable cases projected under the second scenario would correspond to approximately 4009 breast cancers (in women), 2086 colorectal cancers and 728 liver cancers, and under the third scenario to 48 410 breast cancers, 25 089 colorectal cancers and 8648 cancers liver. Conclusion: Intervening to reduce excess weight in the Colombian population, would especially contribute to avoid liver cancer in both sexes and the new cases of breast cancer (in women).

Cadmium, one of the more hazardous environmental contaminants, has been proposed as a metabolic disruptor. Vanadium has emerged as a possible treatment for metabolic diseases. Both metals are important in public health. We aimed to investigate whether vanadium treatment is effective against metabolic disturbances caused by chronic exposure to the lowest-observable adverse effect level of cadmium. Male Wistar rats were exposed to cadmium (32.5 ppm) in drinking water for 3 months. Metabolic complications such as overweight, visceral adipose gain, hyperglycemia, impaired glucose tolerance, and dyslipidemia were detected, and low glycogen levels and steatosis were observed in the tissues. Then, the control and treated animals were subdivided and treated with a solution of 5 μM NaVO3/kg/twice a week for 2 months. The control-NaVO3 group did not show zoometric or metabolic changes. A strong interaction of NaVO3 treatment over cadmium metabolic disruption was observed. The vanadium accumulation diminished cadmium concentration in tissues. Also, vanadium interaction improved glucose homeostasis. The major effect was observed on glycogen synthesis, which was fully recovered in all tissues analyzed. Additionally, vanadium treatment prevented overweight and visceral fat accumulation, improving BMI and the percentage of fat. However, NaVO3 treatment did not have an effect on dyslipidemia or steatosis. In conclusion, this work shows that vanadium administration has a strong effect against metabolic disturbances caused by chronic cadmium exposure, observing powerful interaction on glucose homeostasis.

Metabolic syndrome (MetS) represents a cluster of related metabolic abnormalities, including central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance. These metabolic derangements present significant risk factors for chronic kidney disease that carries to loss of essential micronutrients, which accelerates comorbidity apparition. The work aimed was to evaluate the trace element homeostasis regarding morphological adaptations and renal function in MetS early-onset. Fifty male Wistar rats were divided into two groups: (a) control group and (b) hypercaloric diet group that developed MetS early-onset after 3 months. Classical zoometric parameters do not show changes; however, biochemical modifications were observed such as hyperglycemia, protein glycation, insulin resistance, dyslipidemia, hyperinsulinemia, and hypoadiponectinemia. MetS early-onset group observed renal structural modifications, but no functional changes. The structural modifications observed were minimal glomerular injury, glomerular basement membrane thickening, as well as mesangial and tubular cells that showed growth and proliferation. In serum and kidney (cortex and medulla), the concentrations of Zn, Fe, Cr, Mg, Mn, Cu, Co, and Ni were no differences between the experimental groups, but excretory fractions of these were lower in the hypercaloric diet group. In conclusion, MetS early-onset coexist renal structural modification and a hyperreabsorptive activity of essential trace elements that avoid its loss; thus, the excretory fraction of oligo-elements could be used a biomarker of early renal injury caused by metabolic diseases in the clinical practice.

It is known that continuous abuse of amphetamine (AMPH) results in alterations in neuronal structure and cognitive behaviors related to the reward system. However, the impact of AMPH abuse on the hippocampus remains unknown. The aim of this study was to determine the damage caused by AMPH in the hippocampus in an addiction model. We reproduced the AMPH sensitization model proposed by Robinson et al. in 1997 and performed the novel object recognition test (NORt) to evaluate learning and memory behaviors. After the NORt, we performed Golgi-Cox staining, a stereological cell count, immunohistochemistry to determine the presence of GFAP, CASP3, and MT-III, and evaluated oxidative stress in the hippocampus. We found that AMPH treatment generates impairment in short- and long-term memories and a decrease in neuronal density in the CA1 region of the hippocampus. The morphological test showed an increase in the total dendritic length, but a decrease in the number of mature spines in the CA1 region. GFAP labeling increased in the CA1 region and MT-III increased in the CA1 and CA3 regions. Finally, we found a decrease in Zn concentration in the hippocampus after AMPH treatment. An increase in the dopaminergic tone caused by AMPH sensitization generates oxidative stress, neuronal death, and morphological changes in the hippocampus that affect cognitive behaviors like short- and long-term memories.

The perioperative nutritional intervention under the ERAS protocol has been positioned as a cost-effective strategy for the management of patients undergoing major surgery.

Pentraxin-3 has been reported as a promising biomarker of pre-eclampsia and its severity; however, available studies have small sample sizes, and analyses are not always adjusted for confounders. The aim of this study is to establish the strength of the association between maternal Pentraxin-3 level and pre-eclampsia or HELLP syndrome. It was a case-control study. Women with pre-eclampsia or HELLP syndrome were defined as cases, and women with healthy pregnancies at term (>37 weeks) were classified as controls. Plasma concentrations of Pentraxin-3 were determined at the time of delivery by quantitative enzyme immunoassay. Associations between Pentraxin-3 and pre-eclampsia and HELLP syndrome were assessed by multinomial logistic regression. Subsidiary analysis for the time of disease onset was also carried out. Odds ratios and 95% confidence intervals are reported. A total of 1024 pregnant women were included (461 controls, 368 pre-eclampsia, 195 HELLP). A positive log-linear relationship was found between the top pentraxin-3 quintile and HELLP syndrome. After adjustment for confounders (maternal age, ethnicity, socioeconomic position, date and place of recruitment, family history of pre-eclampsia, smoking, body mass index at beginning of pregnancy, gestational age and multiple pregnancy), the strength of the association was higher for HELLP syndrome [OR 1.13 (95% CI 1.08; 1.18)] than for pre-eclampsia [OR 1.03 (95% CI 1.03; 1.10)]. No difference according to time of onset or pentraxin-3 level was found. In summary, pentraxin-3 level was associated with pre-eclampsia, but it was more strongly associated with HELLP syndrome. Longitudinal studies with a lower probability of residual confounding are necessary to improve our knowledge about the role of pentraxin-3 in pre-eclampsia.

Genital hair is one of the secondary sexual traits that marks the beginning of puberty; its removal has been part of human culture since ancient times. This practice may lead to modifications in vaginal microbiome with potential repercussions on skin health and balance. We conducted a narrative review with the purpose of describing normal skin microbiota, its impact under microenvironment changes and genital hair removal. Menses, pathological conditions and pubic hair removal may alter vaginal microbiota, being the latter of special relevance giving the risk of hair microtrauma, irritations and potential spread of infectious agents. MÉD.UIS.2019;32(3):27-33 Resumo O cabelo genital é um dos traços sexuais secundários que marcam o início da puberdade; sua remoção faz parte da cultura humana desde os tempos antigos. Essa prática pode levar a modificações no microbioma vaginal com possíveis repercussões na saúde e equilíbrio da pele. Realizamos uma revisão narrativa com o objetivo de descrever a microbiota normal da pele, seu impacto nas alterações do microambiente e na remoção de pelos genitais. A menstruação, as condições patológicas e a remoção de pelos pubianos podem alterar a microbiota vaginal, sendo esta última de especial relevância dando o risco de microtraumatismo capilar, irritações e potencial disseminação de agentes infecciosos. MÉD.UIS.2019;32(3): 27-33 Resumen El vello genital es uno de los rasgos sexuales secundarios que marca el comienzo de la pubertad; su eliminación ha sido parte de la cultura humana desde la antigüedad. Esta práctica puede conducir a modificaciones en el microbioma vaginal con posibles repercusiones potenciales en la salud y el equilibrio de la piel. Realizamos una revisión narrativa con el propósito de describir la microbiota cutánea normal, su impacto bajo los cambios del microambiente y la depilación genital. La menstruación, las condiciones patológicas y la depilación púbica pueden alterar la microbiota vaginal, siendo esta última de especial relevancia dado el riesgo de microtraumatismos, irritaciones y posible propagación de agentes infecciosos. MÉD.UIS.2019;32(3): 27-33

The prevalence of malnutrition in homes for the elderly is well-known, yet research does not exist concerning differences among types of homes. In this study, the association of nutritional status (measured with MNA-FV and anthropometric measures) with the type of home for the elderly (charity, government, private) was evaluated. A cross-sectional study in adults > 60 years was carried out. Students t, U of Mann-Whitney, ANOVA, or Kruskal Wallis test with statistical significance p < 0.05 were used for statistical analysis. In the study, 152 elderly (95 female) persons with an average age of 81.4 years (SD 7.82) participated; 59.6% had a normal nutritional status and 45.3% had a normal BMI. Malnutrition, risk of malnutrition and low calf circumference were associated with private homes (p < 0.05). We concluded that nutritional status varies by type of home and this nutritional profile possibly depends on criteria used to admit persons into each type of facility.

This study presents a correlation between prenatal ultrasonographic images and neuropathologic findings of postmortem tissue samples from five confirmed cases of perinatal Zika virus (ZIKV) infection belonging to the cohort of the ZEN Initiative in Bucaramanga, Colombia. Deaths occurred between June 2016 and March 2017. Mothers consulted with ZIKV infection clinical manifestations or fetal central nervous system (CNS) abnormalities or both. A detailed ultrasound scan and neurosonographic protocol was performed by maternal fetal specialists. Perinatal autopsies were performed following the Colombian National Health Institute's ZIKV protocol. The autopsies were from two fetal deaths, and three early neonatal deaths. Gestational age was between 262/7 and 382/7 weeks. Two cases were classified as mild microcephaly. Few findings by ultrasound and pathology were found in case 1 because it was a late infection; the other cases presented findings corresponding to congenital Zika syndrome: craniofacial malformations, cerebellar hypoplasia, anomalies of the corpus callosum and ventriculomegaly, all confirmed in autopsy specimens. By ultrasonography, hyperechogenicities were seen in several brain structures, which correspond to cortical and periventricular calcifications, subependymal glial reactivity and perivascular rings. The ultrasound and pathological findings show a wide spectrum of CNS anomalies that confirm the neurotropic effect of the ZIKV, recognizing the neuroimaging findings of this disease (unilateral ventriculomegaly, alterations in the corpus callosum and cerebellum, and calcifications) are highly suggestive of ZIKV infection.

Cadmium is a nonessential transition metal considered one of the more hazardous environmental contaminants. The population is chronically exposed to this metal at low concentrations, designated as the LOAEL (lowest observable adverse effect level) dose. We aimed to investigate whether oral subacute exposure to cadmium LOAEL disrupts hormonal and metabolic effects of the liver-adipose axis in Wistar rats. Fifty male Wistar rats were separated into two groups: control (standard normocalorie diet + water free of cadmium) and cadmium (standard normocalorie diet + drinking water with 32.5 ppm CdCl2). After 1 month, zoometry, a serum lipid panel, adipokines, and proinflammatory cytokines were evaluated. Tests of glucose and insulin tolerance (ITT) and insulin resistance were performed. Histological studies on structure, triglyceride distribution, and protein expression of the insulin pathway were performed in the liver and retroperitoneal adipose tissue. In both tissues, the cadmium, triglyceride, glycogen, and proinflammatory cytokine contents were also quantified. The cadmium group developed dyslipidemia, glucose intolerance, hyperinsulinemia, hyperleptinemia, inflammation, and selective insulin resistance in the liver and adipose tissue. In the liver, glycogen synthesis was diminished, while de novo lipogenesis increased, which was associated with low GSK3β-pS9 and strong expression of SREBP-1c. Dysfunctional adipose tissue was observed with hypertrophy and lipolysis, without changes in SREBP-1c expression and low glycogen synthesis. Both tissues accumulated cadmium and developed inflammation. In conclusion, oral subacute cadmium LOAEL dose exposure induces inflammation, insulin signaling modifications, an early insulin resistance stage (insensibility), and impairment of the hormonal and metabolic liver-adipose axis in Wistar rats.

Cancer is one of the major causes of death in the world and its global burden is expected to continue increasing. In several types of cancers, reactive oxygen species (ROS) have been extensively linked to carcinogenesis and cancer progression. However, studies have reported conflicting evidence regarding the role of ROS in cancer, mostly dependent on the cancer type or the step of the tumorigenic process. We review recent studies describing diverse aspects of the interplay of ROS with cancer in the different stages of cancer progression, with a special focus on their role in carcinogenesis, their importance for cancer cell signaling and their relationship to the most prevalent cancer risk factors.

Autism spectrum disorder (ASD) is a range of neurodevelopmental disorders characterized by movement and social deficits with rapidly increasing incidence worldwide. Propionic acid (PPA) is a histone deacetylase inhibitor that regulates neuronal plasticity in the brain. Evaluation of the behavioral and cellular consequences of PPA exposure during a critical neurodevelopmental window is required. Therefore, in the present study we aimed to evaluate the effects of prenatal PPA exposure on locomotor behavior and astrocyte number, as well as on levels of nitric oxide (NO), synaptophysin (SYP; a marker of synaptic plasticity), and metallothionein 3 (MT-III; a marker of reactive oxygen species and zinc metabolism), in the prefrontal cortex (PFC) of male rats. All parameters were evaluated at three critical ages of development: postnatal days (PD) 21 (weaning age), PD35 (pre-pubertal age) and PD70 (post-pubertal age). Prenatal PPA exposure induced hypolocomotion and decreased rearing events at weaning age. Moreover, astrogliosis in the PFC was observed in PPA-treated rats at pre- and post-pubertal age. SYP levels were dramatically decreased in PPA-treated rats with simultaneous astrogliosis, suggesting reduced synaptic plasticity. MT-III expression was deregulated in PPA-treated rats. Finally, the expression of NO in the PFC remained unaltered in PPA-treated rats. These results mimic behavioral, neuronal and astrocytic characteristics observed in ASD patients.

Background. Acute Lymphoblastic Leukemia (ALL) is a hematolymphoid neoplasm with multiple complications and variable prognosis, which depends on several factors, one of them related to chemotherapeutic treatment. Objective. To describe the complications developed in patients diagnosed with ALL and who received chemotherapy treatment in Hospital San Rafael. Materials and methods. A retrospective analysis of clinical, paraclinical and demographic variables taken from clinical records of adult patients diagnosed with ALL admitted to hospital between 2016 and 2017. Results. A hundred and sixteen patients had hematological malignancies, 24 had ALL. Most of them had B-cell precursor ALL (79.2 %), 86.4 % were in the chemotherapy induction phase, 87.5 % developed febrile neutropenia, 37.5 % had tumor lysis syndrome, 58.3 % developed infectious complications, and 45.8 % died. Discussion. This is the first study known to date describing the complications in patients with ALL at Hospital San Rafael in Colombia. One of the major findings was the high frequency of febrile neutropenia episodes and infectious complications mainly associated with unfavorable outcomes, such as multiple organ failure and death. Therefore, clinicians should always have these complications in mind when a patient with hematological malignancies is receiving or is about to start a chemotherapeutic regimen. Conclusions. Bloodborne and respiratory tract infections were the most common sources of infection by Staphylococcus epidermidis and Klebsiella pneumoniae as causative agents. Likewise, the most frequent complication was febrile neutropenia. The first cause of death were infections complicated by sepsis; however, only one-third of the patients had a microbial isolation.

Cadmium (Cd) is a toxic metal and classified as a carcinogen whose exposure could affect the function of the central nervous system. There are studies that suggest that Cd promotes neurodegeneration in different regions of the brain, particularly in the hippocampus. It is proposed that its mechanism of toxicity maybe by an oxidative stress pathway, which modifies neuronal morphology and causes the death of neurons and consequently affecting cognitive tasks. However, this mechanism is not yet clear. The aim of the present work was to study the effect of Cd administration on recognition memory for 2, 3 and 4 months, neuronal morphology and immunoreactivity for caspase-3 and 9 in rat hippocampi. The results show that the administration of Cd decreased recognition memory. Likewise, it caused the dendritic morphology of the CA1, CA3 and dentate gyrus regions of the hippocampus to decrease with respect to the time of administration of this heavy metal. In addition, we observed a reduction in the density of dendritic spines as well as an increase in the immunoreactivity of caspase-3 and 9 in the same hippocampal regions of the animals treated with Cd. These results suggest that Cd affects the structure and function of the neurons of the hippocampus, which contribute to the deterioration of recognition memory. Our results suggest that the exposure to Cd represents a critical health problem, which if not addressed quickly, could cause much more serious problems in the quality of life of the human population, as well as in the environment in which they develop.

Background: Conventional serum tumor markers (CSTM) are widely used for monitoring patients with cancer. However, their usefulness as a diagnostic tool is controversial in primary or metastatic liver cancer (PMLC). Aim: To evaluate the diagnostic performance of the most commonly requested CSTM in the diagnostic approach of PMLC. Material and Methods: Review of medical records of patients aged over 18 years with a liver biopsy, attended from 2005 to 2017 in a tertiary hospital and a regional cancer center in Colombia. The results of liver biopsies were compared with tumor markers such as carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), CA 19-9, CA 125 and prostate specific antigen (PSA) using a receiver operating characteristic (ROC) curve analysis. Results: We reviewed 2063 medical records and retrieved 118 eligible patients (59 cases and 59 controls, 70% males). Thirty percent had obstructive jaundice. There was heterogeneity in the amount of tumor markers requested according to medical criteria. Only CA 19-9 showed discriminative capacity (> 17.6 U/m), with a cut-off point lower than that reported in the literature and a sensitivity of 69.5%, specificity of 91.6%, a positive likelihood ratio (LR) of 8.32, and a negative LR of 0.33. Conclusions: Except for CA 19-9, tumor markers were not useful for the initial diagnostic approach in patients with suspected primary or metastatic malignant liver tumors.

Objective To quantify the prevalence and related factors to the risk of anorexia and bulimia nervosa in undergraduate students at a private university in Bogotá, Colombia. Methods A cross-sectional study, which evaluated the frequency of food consumption, physical activity (International Physical Activity Questionnaire, short form), the risk of anorexia and bulimia nervosa (Sick, Control, One, Fat, and Food questionnaire) and demographic variables. The statistical analysis used a multivariate logistic regression model, where the outcome was the yes/no risk of anorexia or bulimia nervosa. Results A total of 1,545 university students participated. The average age was 19.2 years (+/-2.5), 65.7% were women, and 63.9% came from Bogotá. The risk of anorexia and bulimia nervosa was 27.6%. In the logistic regression, the risk was associated with female sex (OR 1.6 CI95% 1.2 to 2.1), daily consumption of cereals (OR 0.7 CI95% 0.6 to 0.9), daily fat consumption (OR 1.5 CI95% 1.1 to 2.1), eat light products (OR 1.8 CI95% 1.1 to 2.9), consume protein supplements (OR 0.4 CI95% 0.2 to 0.8), being in disagreement with physical activity for fun (OR 1.8 CI95% 1.1 to 3.1), and physical activity by appearance (OR 2.2 CI95% 1.6 to 2.9). Conclusions The prevalence of risk to anorexia and bulimia nervosa in the study sample is high. The associated factors were the consumption of cereals, fat, light products, and protein supplements. Physical activity by appearance and disagreement to do exercise by fun were associated with the risk of anorexia and bulimia nervosa. So it is recommended that universities implement awareness and education interventions to address this problem. RESUMO Objetivo Quantificar a prevalência e os fatores relacionados ao risco de anorexia e bulimia nervosa em estudantes de graduação de uma universidade particular de Bogotá, Colômbia. Métodos Estudo transversal, que avaliou a frequência de consumo alimentar, atividade física (ferramenta (Questionário Internacional de Atividade Física, versão curta), risco de anorexia e bulimia nervosa (Questionário de doença, controle, um, gordura e comida) e variáveis demográficas. A análise estatística utilizou um modelo de regressão logística multivariada, em que o resultado foi o risco sim / não de anorexia ou bulimia nervosa. Resultados Participaram 1.545 estudantes universitários. A idade média era de 19,2 anos (+/- 2,5), 65,7% eram mulheres e 63,9% eram de Bogotá. O risco de anorexia e bulimia nervosa foi de 27,6%. Na regressão logística, o risco foi associado ao sexo feminino (OR 1,6 IC95% 1,2 a 2,1), consumo diário de cereais (OR 0,7 IC95% 0,6 a 0,9), consumo diário de gordura (OR 1,5 IC95% 1,1 a 2,1), comer produtos leves (OR 1,8 IC95% 1,1 a 2,9), consomem suplementos proteicos (OR 0,4 IC95% 0,2 a 0,8), discordam de atividade física para se divertir (OR 1,8 IC95% 1,1 a 3,1) e atividade física pela aparência (OR 2,2 CI95% 1,6 a 2,9). Conclusão A prevalência de risco para anorexia e bulimia nervosa na amostra do estudo é alta. Os fatores associados foram o consumo de cereais, gorduras, produtos light e suplementos proteicos. A atividade física pela aparência e a discordância para fazer exercício pela diversão estiveram associadas ao risco de anorexia e bulimia nervosa. Portanto, é recomendado que as universidades implementem intervenções de conscientização e educação para resolver esse problema.

In the aging process, the brain presents biochemical and morphological alterations. The neurons of the limbic system show reduced size dendrites, in addition to the loss of dendritic spines. These disturbances trigger a decrease in motor and cognitive function. Likewise, it is reported that during aging, in the brain, there is a significant decrease in neurotrophic factors, which are essential in promoting the survival and plasticity of neurons. The carboxyl-terminal fragment of the heavy chain of the tetanus toxin (Hc-TeTx) acts similarly to neurotrophic factors, inducing neuroprotection in different models of neuronal damage. The aim here, was to evaluate the effect of Hc-TeTx on the motor processes of elderly mice (18 months old), and its impact on the dendritic morphology and density of dendritic spines of neurons in the limbic system. The morphological analysis in the dendrites was evaluated employing Golgi-Cox staining. Hc-TeTx was administered (0.5 mg/kg) intraperitoneally for three days in 18-month-old mice. Locomotor activity was evaluated in a novel environment 30 days after the last administration of Hc-TeTx. Mice treated with Hc-TeTx showed significant changes in their motor behavior, and an increased dendritic spine density of pyramidal neurons in layers 3 and 5 of the prefrontal cortex in the hippocampus, and medium spiny neurons of the nucleus accumbens (NAcc). In conclusion, the Hc-TeTx improves the plasticity of the brain regions of the limbic system of aged mice. Therefore, it is proposed as a pharmacological alternative to prevent or delay brain damage during aging.

The consumption of foods rich in carbohydrates, saturated fat, and sodium, accompanied by a sedentary routine, are factors that contribute to the progress of metabolic syndrome (MS). In this way, they cause the accumulation of body fat, hypertension, dyslipidemia, and hyperglycemia. Additionally, MS has been shown to cause oxidative stress, inflammation, and death of neurons in the hippocampus. Consequently, spatial and recognition memory is affected. It has recently been proposed that metformin decavanadate (MetfDeca) exerts insulin mimetic effects that enhance metabolism in MS animals; however, what effects it can cause on the hippocampal neurons of rats with MS are unknown. The objective of the work was to evaluate the effect of MetfDeca on hippocampal neurodegeneration and recognition memory in rats with MS. Administration of MetfDeca for 60 days in MS rats improved object recognition memory (NORt). In addition, MetfDeca reduced markers of oxidative stress and hippocampal neuroinflammation. Accompanied by an increase in the density and length of the dendritic spines of the hippocampus of rats with MS. We conclude that MetfDeca represents an important therapeutic agent to treat MS and induce neuronal and cognitive restoration mechanisms.

Metabolic syndrome (MS) results from excessive consumption of high-calorie foods and sedentary lifestyles. Clinically, insulin resistance, abdominal obesity, hyperglycemia, dyslipidemia, and hypertension are observed. MS has been considered a risk factor in the development of dementia. In the brain, a metabolically impaired environment generates oxidative stress and excessive production of pro-inflammatory cytokines that deteriorate the morphology and neuronal function in the hippocampus, leading to cognitive impairment. Therapeutic alternatives suggest that phenolic compounds can be part of the treatment for neuropathies and metabolic diseases. In recent years, the use of Gallic Acid (GA) has demonstrated antioxidant and anti-inflammatory effects that contribute to neuroprotection and memory improvement in animal models. However, the effect of GA on hippocampal neurodegeneration and memory impairment under MS conditions is still unclear. In this work, we administered GA (20 mg/kg) for 60 days to rats with MS. The results show that GA treatment improved zoometric and biochemical parameters, as well as the recognition memory, in animals with MS. Additionally, GA administration increased hippocampal dendritic spines and decreased oxidative stress and inflammation. Our results show that GA treatment improves metabolism: reducing the oxidative and inflammatory environment that facilitates the recovery of the neuronal morphology in the hippocampus of rats with MS. Consequently, the recognition of objects by these animals, suggesting that GA could be used therapeutically in metabolic disorders that cause dementia.

Recent reports on brain aging suggest that oxidative stress and inflammatory processes contribute to aging. Interestingly, sodium phenylbutyrate (PBA) is an inhibitor of histone deacetylase, which has anti-inflammatory properties. Several reports have suggested the effect of PBA on learning and memory processes, however there are no studies of the effect of this inhibitor of histone deacetylase on aging. Consequently, in the present study, the effect of PBA was studied in 18-month-old mice. The animals were administered PBA for 2 months after locomotor activity treatment and Morris water maze tests were performed. The Golgi-Cox staining technique and immunohistochemistry for glial fibrillary acidic protein (GFAP) and synaptophysin were performed for the morphological procedures. The administration of PBA improves learning and memory according to the Morris water maze test compared to vehicle-treated animals, which had unchanged locomotor activity. Using Golgi-Cox staining, dendritic length and the number of dendritic spines were measured in limbic regions, such as the nucleus accumbens (NAcc), prefrontal cortex (PFC) layer 3, and the CA1 of the dorsal hippocampus. In addition, PBA increased the number of dendritic spines in the PFC, NAcc, and CA1 subregions of the hippocampus with an increase in dendritic length only in the CA1 region. Moreover, PBA reduced the levels of the GFAP and increased the levels of synaptophysin in the studied regions. Thus, PBA can be a useful pharmacological tool to prevent or delay synaptic plasticity damage and cognitive impairment caused by age.

Multiple small studies have suggested that women with pre-eclampsia present elevated levels of C-reactive protein (CRP) and interleukin-6 (IL-6). However, little is known regarding the source of this CRP and IL-6 increase. Therefore, the aim of this study was to evaluate the relationship between CRP and IL-6 levels with pre-eclampsia considering different confounding factors. Using data from a large Colombian case-control study (3,590 cases of pre-eclampsia and 4,564 normotensive controls), CRP and IL-6 levels were measured in 914 cases and 1297 controls. The association between maternal serum levels of CRP and IL-6 with pre-eclampsia risk was evaluated using adjusted logistic regression models. Pre-eclampsia was defined as presence of blood pressure ≥140/90 mmHg and proteinuria ≥300mg/24 h (or ≥1 + dipstick). There was no evidence of association between high levels of CRP and IL-6 with pre-eclampsia after adjusting for the following factors: maternal and gestational age, ethnicity, place and year of recruitment, multiple-pregnancy, socio-economic position, smoking, and presence of infections during pregnancy. The adjusted OR for 1SD increase in log-CRP and log-IL-6 was 0.96 (95%CI 0.85, 1.08) and 1.09 (95%CI 0.97, 1.22), respectively. Although previous reports have suggested an association between high CRP and IL-6 levels with pre-eclampsia, sample size may lack the sufficient power to draw robust conclusions, and this association is likely to be explained by unaccounted biases. Our results, the largest case-control study reported up to date, demonstrate that there is not a causal association between elevated levels of CRP and IL-6 and the presence of pre-eclampsia.

Aging is a complex process that can lead to neurodegeneration and, consequently, several pathologies, including dementia. Physiological aging leads to changes in several body organs, including those of the central nervous system (CNS). Morphological changes in the CNS and particularly the brain result in motor and cognitive deficits affecting learning and memory and the circadian cycle. Characterizing neural modifications is critical to designing new therapies to target aging and associated pathologies. In this review, we compared aging to the changes occurring within the brain and particularly the limbic system. Then, we focused on key natural compounds, apamin, cerebrolysin, Curcuma longa, resveratrol, and N-PEP-12, which have shown neurotrophic effects particularly in the limbic system. Finally, we drew our conclusions delineating future perspectives for the development of novel natural therapeutics to ameliorate aging-related processes.

Context: The chronic exposure to Cadmium (Cd) constitute an risk to develop hypertension and cardiovascular diseases associated with the increase of oxidative stress.Objective: In this study, we investigate the role of metabolic changes produced by exposure to Cd on the endothelial dysfunction via oxidative stress.Methods: Male Wistar rats were exposed to Cd (32.5-ppm) for 2-months. The zoometry and blood pressure were evaluated, also glucose and lipids profiles in serum and vascular reactivity evaluated in isolated aorta rings.Results: Rats exposed to Cd showed an increase of blood pressure and biochemical parameters similar to metabolic syndrome. Additionally, rats exposed to Cd showed a reduced relaxation in aortic rings, which was reversed after the addition of SOD and apocynin an inhibitor of NADPH.Conclusion: The Cd-exposition induced hypertension and endothelial injury by that modifying the vascular relaxation and develop oxidative stress via NADPH oxidase, superoxide and loss nitric oxide bioavailability.

Metabolic syndrome (MS) is a health problem that is characterized by body fat accumulation, hypertension, dyslipidemia, and hyperglycemia; recently, it has been demonstrated that MS also damages memory processes. The first-line drug in the treatment of MS and type 2 diabetes mellitus is metformin, which is an antihyperglycemic agent. This drug has been shown to produce neuroprotection and to improve memory processes. However, the mechanism involved in this neuroprotection is unknown. A 90-day administration of metformin improved the cognitive processes of rats with MS as evaluated by the novel object recognition test, and this finding could be explained by an increase in the neuronal spine density and spine length. We also found that metformin increased the immunoreactivity of synaptophysin, sirtuin-1, AMP-activated protein kinase, and brain-derived neuronal factor, which are important plasticity markers. We conclude that metformin is an important therapeutic agent that increases neural plasticity and protects cognitive processes. The use of this drug is important in the minimization of the damage caused by MS.

Background: In October of 2015, an epidemic of Zika began in Colombia's geographic areas with a high population of mosquitoes of the genus Aedes. Our aim was to describe the outcome of fetuses of symptomatic pregnant women who were tested with RT-PCR for ZIKV according to trimester of infection. Methods: Symptomatic women were tested with RT-PCR for ZIKV and followed prospectively by obstetricians and high-risk maternal-fetal medicine specialists, using detailed anatomic ultrasound and neurosonography to detect fetal structural anomalies of the central nervous system (CNS) according to trimester of infection. Findings: 115 symptomatic women with a positive RT-PCR and 56 with a negative RT-PCR were enrolled in the study; CNS compromise of the fetus occurred in 24% and 20%, respectively (p=0.398). When symptomatic ZIKV positive women were categorized by trimester of infection, CNS anomalies were present in 38% of first-trimester infections, compared to 21% and 10% in second and third-trimester infections (p=0.012). Including all trimesters, neuronal migration disorders were the most frequent anomaly of the CNS (15%), followed by microcephaly (13%). Interpretation: Prevalence of CNS anomalies were similar between symptomatic RT-PCR ZIKV positive and negative pregnant women suggesting a high rate of false-negative results with RT-PCR. First-trimester infections were more frequent and severe compared to second and third-trimester infections in exposed fetuses. The prevalence of CNS anomalies was higher than previously reported in the literature, possibly due to fetal-ultrasound assessments' quality and expertise. Migrational disorders were the most frequently observed anomaly of the CNS, followed by microcephaly. Funding: Grants from the Universidad Industrial de Santander (UIS), and the Epidemiology Research Center at UIS, supported this study. Conflict of Interest: We declare no competing interests. Ethical Approval: The Committee on Ethics and Research from the Universidad Industrial de Santander and participating centers approved the study. All pregnant women signed informed consent for participation in this study.

Objective: Hand grip strength can provide an objective index of general upper strength, but hand dynamometer has not been validated for use in Colombia. The objective was to determine the interchangeability between Camry electronic and Jamar hydraulic hand grip dynamometers in a population found on the campus of the Universidad Nacional de Colombia and the elderly living in a community. Methods: This was a cross-sectional concordance study on 18-88-year-old males and females. Data regarding their demographics, health, and anthropometric variables were collected/measured and the Lin concordance correlation coefficient (CCC) along with Bland-Altman plots were used for evaluating concordance regarding both devices. Results: One hundred and thirty-three subjects participated in this study (average age 47±20.74 years-old). Right hand (RH) grip strength was 32.15 ± 9.96 kg with the Jamar dynamometer and 29.95 ± 9.18 kg with the Camry device. It is worth highlighting that the Jamar instrument presents higher values than the Camry instrument (p

An important worldwide health problem as the result of current lifestyle is metabolic syndrome (MS). It has been shown that MS induced by a high-calorie diet (HCD) in rats produces cognitive deterioration in the novel object recognition test (NORt) and decreases synaptic connections and dendritic order in the hippocampus and temporal cortex. However, it is unknown whether MS induced by an HCD participates in the cognitive process observed with the injection of Aβ1–42 into the hippocampus of rats as a model of Alzheimer disease (AD). The induction of MS in rats produces a deterioration in NORt; however, rats with MS injected with Aβ1–42 show a major deterioration in the cognitive process. This event could be explained by the increment in the oxidative stress in both cases studied (MS and Aβ1–42): together, the hippocampus and temporal cortex produce an enhancer effect. In the same way, we observed an increment in interleukin-1β, TNF-α, and GFAP, indicative of exacerbated inflammatory processes by the combination of MS and Aβ1–42. We can conclude that MS might play a key role in the apparition and development of cognitive disorders, including AD. We propose that metabolic theory is important to explain the apparition of cognitive diseases.

Introduction: Signet-ring cell carcinoma (SRCC) of the stomach is a histopathological type that has less response to chemotherapy and worse prognosis in patients with advanced gastric cancer, than other types of gastric carcinomas. Diagnostic value of the presence of signet-ring cells (SRC) in the endoscopic biopsy for the diagnosis of SRCC of the stomach, are unknown. Objectives: To calculate the diagnostic values of the presence of SRC in endoscopic biopsy for the diagnosis of SRCC of the stomach in a definitive surgical specimen biopsy. Materials and Methods: Retrospective diagnostic test study to determine the value of the presence of SRC in the endoscopic biopsy for the diagnosis of SRCC of the stomach in the surgical specimen biopsy. Inclusion criteria: Patients who underwent gastric surgery between 1996-2016. We calculated positive and negative predictive values (PPV and NPV), sensitivity, specificity, and positive and negative likelihood ratio (LR+ and LR-) of the presence of SRC in the endoscopic biopsy that predicts the diagnosis of SRCC of the stomach in the definitive biopsy. Confidence intervals (CI) of 95% were defined. Results: The diagnostic values of the presence of SRC in endoscopic biopsy to diagnose SRCC of the stomach in the surgical specimen biopsy were: PPV of 56.1% (95% CI, 47.8-64.1%), NPV of 91.3% (95% CI, 89-93.1%), sensitivity of 55.7% (95% CI, 47.4-63.7%), specificity of 91.4% (95% CI, 89.1-93.3%), LR+ of 6.5 (95% CI, 4.9-8.6) and LR- of 0.48 (95% CI, 0.4-0.6), a positive post-test probability of 56.1% (95% CI, 47.8-64.1%), and a negative post-test probability of 8.7% (95% CI, 6.9-11%). Conclusions: The presence of SRC in the endoscopic biopsy is not sufficient to diagnose SRCC of the stomach. The absence of SRC in the endoscopic biopsy has a high negative predictive value.

espanolEl acido clorhidrico cumple multiples funciones en el sistema gastrointestinal. El consumo de inhibidores de la bomba de protones (IBP) se ha incrementado de forma notoria en los ultimos anos influido por su consideracion como un simple “protector gastrico” sin practicamente efectos adversos. Las indicaciones de uso (profilaxis y tratamiento de las enfermedades acido-pepticas) no han variado sustancialmente en los ultimos anos; sin embargo, han proliferado los estudios sobre su seguridad (principalmente a largo plazo) sin que ninguno demuestre una certeza clara y creen incertidumbres entre los prescriptores. La retirada de prescripcion, cuando esta indicada, debe realizarse de manera escalonada. Los IBP son farmacos no exentos de riesgo y deben prescribirse cuando existe una indicacion adecuada, a la menor dosis eficaz, durante el menor tiempo posible y reevaluando periodicamente la necesidad de tratamiento. Es precisa una formacion continuada para garantizar la adecuacion de uso de los IBP. EnglishHydrochloric acid fulfills multiple functions in the gastrointestinal tract. Proton pump inhibitors (PPI) which suppress acid secretion, has been promoted as “gastric protectors” without major adverse effects. As a result, the number of prescriptions of PPIs is increasing significantly. Main indications (prophylaxis and treatment of acid-peptic diseases) have not changed substantially in the recent years; however, in numerous safety studies the long-term security of PPIs is questioned leading to uncertainty among prescribers. If the withdrawal of prescription was necessary it shall be reduced gradually before its final withdrawal. In fact, the use of PPI might be associated with important side effects. Therefore PPI shall be prescribed only in case of clear indication, at the lowest effective dose, for the shortest possible time and the need for treatment continuation shall be reviewed periodically. Continuous training for prescribers is required in order to guarantee the adequate use of PPI.

Introducción: Los paragangliomas son tumores benignos, altamente vascularizados; cuyas células se originan en la cresta neural embrionaria. El 90% de los paragangliomas se ubica en la glándula suprarrenal (feocromocitoma). Mientras que el 85% de los paragangliomas extra suprarrenales se localizan en el abdomen, 12% en el tórax y sólo un 3% en cabeza y cuello. El tumor del glomus carotídeo es un paraganglioma de crecimiento lento e infrecuente, representando 1 de cada 30.000 tumores de cabeza y cuello. Objetivo: Describir caso clínico de una paciente con glomus carotídeo, que se atendió en el Hospital Del Día Neuro-Salud IESS de la ciudad de Latacunga en marzo del 2021. Material y Métodos: Estudio descriptivo retrospectivo, presentación de caso. Se obtuvieron datos del paciente al momento del ingreso, seguimiento hospitalario y hasta el alta. Se actualizaron conocimientos sobre esta patología, con artículos de las bases de datos PUBMED, Scielo, Wiley y Elsevier. Resultados: Paciente femenina de 41 años de edad, acude por presentar masa en región cervical izquierda de crecimiento progresivo desde hace 2 años; indolora y acompañado por taquicardia. Al examen físico se encuentra tumoración en región cervical izquierda de aproximadamente 2 centímetros de diámetro, por lo que se realiza Angio-TAC de cuello; en donde se observa en la bifurcación de la carótida izquierda una lesión nodular de aproximadamente 16 x 14 x 12 milímetros. Conclusión: Los tumores del glomus carotídeo son generalmente benignos y de diagnóstico tardío. Los estudios de imágenes son fundamentales para su diagnóstico y estadificación.

In preterm newborn, problems with the interpretation of 17-OHP may occur.Evaluate 17-OHP values in healthy preterm newborns until they reach the corrected gestational age.Longitudinal study of 36 preterm infants with 17-OHP evaluation using ELISA from heel blood from 3 to 5 days and thereafter every 2 weeks until the corrected gestational age. Values adjusting multiple variables such as gestational age, birth weight and sex, among others were compared. The results were analyzed against 82 healthy full-term infants.In the first week of life, early term infants born within less than 34 months of gestational age show 17-OHP values that are much higher than the full term neonates. After a week, the values decrease and stabilize, but are still higher than those of full term neonates and remain so even at the corrected gestational age. (average difference of 63.0%, CI 95%: 11.8%-115.5%). 33.6% (41 samples) of a total of 122 samples taken from preterm infants were higher than 30 ng/mL.17-OHP values in early term infants are higher than those in full term neonates and can be related to postnatal adaptive processes. It is suggested that a second screening at the 37th week of corrected age be performed.En recién nacidos pretérmino se presentan problemas para interpretar la 17-OHP.Evaluar los valores de 17-OHP en recién nacidos sanos pretérmino hasta cuando alcanzan el término de edad gestacional corregida.Estudio longitudinal de 36 prematuros con evaluación de la 17-OHP por ELISA en sangre de talón desde los 3-5 días de vida y luego cada dos semanas hasta la edad gestacional de término corregida. Se comparó los valores ajustando múltiples variables como edad gestacional, peso al nacer y sexo, entre otras. Se analizaron los resultados frente a los de 82 recién nacidos a término sanos.En la primera semana de vida, los prematuros menores de 34 semanas de edad gestacional tienen valores de 17-OHP muy superiores a los neonatos de término. Al alcanzar la semana 34 de edad gestacional corregida, los valores descienden y se mantienen estables, siempre mayores a los de término, incluso al llegar a edad a término corregida (diferencia promedio de 63.0%, IC 95%: 11.8%-115.5%). El 33.6% (41 muestras) de un total de 122 muestras hechas en los prematuros eran mayores de 30 ng/mL.Los valores de 17-OHP en recién nacidos pretérmino son más altos que en neonatos a término, pudiendo ser relacionado con los procesos adaptativos postnatales. Se sugiere realizar un segundo tamizaje al llegar a la semana 37 de edad corregida.

Aggregation of the amyloid beta (Aβ) peptide and hyperphosphorylation of tau protein, which are markers of Alzheimer's disease (AD), have been reported also in diabetes mellitus (DM). One regulator of tau phosphorylation is O-GlcNAcylation, whereas for hyperphosphorylation it could be GSK3beta, which is activated in hyperglycemic conditions. With this in mind, both O-GlcNAcylation and phosphorylation of tau protein were evaluated in the brain of rats with streptozotocin (STZ)-induced hyperglycemia and hyperinsulinemia and treated with the As25-35 peptide in the hippocampal region CA1. Weight, glycated hemoglobin, glucose, and insulin were determined. Male Wistar rats were divided in groups (N=20): a) control, b) treated only with the Aβ25-35 peptide, c) treated with Aβ25-35 and STZ, and d) treated only with STZ. Results showed statistically significant differences in the mean weight, glucose levels, insulin concentration, and HbA1c percentage, between C- and D-treated groups and not STZ-treated A and B (P

Background: Avoiding primary C-section is the safest and most effective way of decreasing C-section rates. We analyzed circumstances and decisions made among pregnant women without history of C-section and cephalic single fetus (group B), who ended up having a Cesarean birth, to identify opportunities that may optimize the decisions about delivery. Methodology: We evaluated the clinical histories of pregnant women from group B who completed their pregnancies in the Hospital Universitario de Santander (Bucaramanga, Colombia) during 2013. We evaluated the decision moments from admission until birth, including the registry of the reasons for having a C-section, compliance of all the criteria to support the decision and its appropriateness, and how adequate were the procedures done during the induction or augmentation of labor. Results: We evaluated 1320 histories; 666 (55.7%) ended by C-Section. In 59.8% of the histories, we identified at least one decision that could have been addressed differently to optimize the delivery type and, potentially, avoid ending in a Cesarean birth. The most frequent opportunities arise due to a lack of clarity in the record of the reason for performing the C-section (70.1%), and inadequate use of labor induction in the patients that had to end their gestation (38.5%). Conclusion: In the Hospital Universitario de Santander during 2013, despite observing a meaningful subregistry of the indication to perform a C-section, we found that in one out of every two patients there are opportunities of improvement in the registry and attention to reduce the high incidence of C-sections in the institution. This analysis allowed us to create a checklist to fill out before making the final decision of performing a Cesarean birth.

Amphetamines (AMPH) are psychostimulants widely used for therapy as well as for recreational purposes. Previous results of our group showed that AMPH exposure in pregnant rats induces physiological and behavioral changes in the offspring at prepubertal and postpubertal ages. In addition, several reports have shown that AMPH are capable of modifying the morphology of neurons in some regions of the limbic system. These modifications can cause some psychiatric conditions. However, it is still unclear if there are changes to behavioral and morphological levels when low doses of AMPH are administered at a juvenile age. The aim of this study was to assess the effect of AMPH administration (1mg/kg) in Sprague-Dawley rats (postnatal day, PD21-PD35) on locomotor activity in a novel environment and compare the neuronal morphology of limbic system areas at three different ages: prepubertal (PD 36), pubertal (PD50) and postpubertal (PD 62). We found that AMPH altered locomotor activity in the prepubertal group, but did not have an effect on the other two age groups. The Golgi-Cox staining method was used to describe the neural morphology of five limbic regions: (Layers 3 and 5) the medial prefrontal cortex (mPFC), the dorsal and ventral hippocampus, the nucleus accumbens and the amygdala, showing that AMPH induced changes at pubertal ages in arborization and spine density of these neurons, but interestingly these changes did not persist at postpubertal ages. Our findings suggest that even early-life AMPH exposure does not induce long-term behavioral and morphological changes, however it causes alterations at pubertal ages in the limbic system networks, a stage of life strongly associated with the development of substance abuse behaviors.

BACKGROUND Over the years, many materials have been used in orbital reconstruction and cranioplasty. Among the materials in current use, polymethyl methacrylate (PMMA) offers a high degree of compatibility with human tissue. OBJECTIVE This work describes a new, custom-made, 3D printing-aided, prosthetic fabrication process for orbital and/or cranial reconstruction using PMMA. METHODS On the basis of information obtained from computerized tomography scanning processed in Digital Imaging and Communication in Medicine format and exported to treatment planning software, a 3D prosthesis master model was designed and digitally printed. This was then used to create an injection mold from which the prosthesis was cast in PMMA and implanted in the patient. Five patients with cranial and/or orbital defects of tumoral or traumatic etiology were treated by this method. After 5 to 7 years follow-up, no complications occurred to cause the removal of the prostheses. CONCLUSION This novel method makes it possible to produce customized PMMA prostheses to treat orbital and/or cranial defects that are cost-effective and individualized to each case.

Background: Gastrectomy is the main treatment for gastric and Siewert type II-III esophagogastric junction (EGJ) cancer. This surgery is associated with significant morbidity. Total morbidity rates vary across different studies and few have evaluated postoperative morbidity according to complication severity. Aim: To identify the predictors of severe postoperative morbidity. Methods: This was a retrospective cohort study from a prospective database. We included patients treated with gastrectomy for gastric or EGJ cancers between January 2012 and December 2016 at a single center. Severe morbidity was defined as Clavien-Dindo score ≥3. A multivariate analysis was performed to identify predictors of severe morbidity. Results: Two hundred and eighty-nine gastrectomies were performed (67% males, median age: 65 years). Tumor location was EGJ in 14%, upper third of the stomach in 30%, middle third in 26%, and lower third in 28%. In 196 (67%), a total gastrectomy was performed with a D2 lymph node dissection in 85%. Two hundred and eleven patients (79%) underwent an open gastrectomy. T status was T1 in 23% and T3/T4 in 68%. Postoperative mortality was 2.4% and morbidity rate was 41%. Severe morbidity was 11% and was mainly represented by esophagojejunostomy leak (2.4%), duodenal stump leak (2.1%), and respiratory complications (2%). On multivariate analysis, EGJ location and T3/T4 tumors were associated with a higher rate of severe postoperative morbidity. Conclusion: Severe postoperative morbidity after gastrectomy was 11%. Esophagogastric junction tumor location and T3/T4 status are risk factors for severe postoperative morbidity.

The main characteristic of brain aging is an exacerbated inflammatory and oxidative response that affects dendritic morphology and the function of the neurons of the prefrontal cortex (PFC) and the hippocampus. This consequently causes memory loss. Recently, the use of the Goji berry (Lycium barbarum) as an antioxidant extract has provided neuroprotection and neuroplasticity, however, its therapeutic potential has not been demonstrated in aging conditions. The objective of this study was to evaluate the effect of Goji administration on memory recognition, as well as the changes in the dendritic morphology of the PFC and Hippocampus pyramidal neurons in old rats. Goji (3 g/kg) was administrated for 60 days in 18-month-old rats. After the treatment, recognition memory was evaluated using the new object recognition task (NORt). The changes in the neuron morphology of the PFC and hippocampus pyramidal neurons in old rats were evaluated by Golgi-cox stain and immunoreactivity for synaptophysin, glial fibrillary acidic protein (GFAP), caspase-3, 3-nitrotyrosine (3-NT) and nuclear factor erythroid 2-related factor 2 (Nrf2). The rats treated with Goji showed a significant increase in dendritic morphology in the PFC and hippocampus neurons, a greater immunoreactivity to synaptophysin and a decrease in reactive astrogliosis and also in caspase-3, in 3-NT and in Nrf2 in these brain regions was also observed. Goji administration promotes the plasticity processes in the PFC and in the hippocampus of old rats, critical structures in the brain aging process.

Alzheimer’s disease (AD) is a complex neurodegenerative disorder associated with the aggregation of the amyloid-beta peptide (Aβ) into large oligomers and fibrils that damage healthy brain cells. The predominant peptide fragments in the plaques are mainly formed by the Aβ1–40 and Aβ1–42 peptides, albeit the eleven-residue Aβ25–35 segment is largely used in biological studies because it retains the neurotoxic properties of the longer Aβ peptides. Recent studies indicate that treatment with therapeutic steroid hormones reduces the progress of the disease in AD models. Particularly, treatment with 17β-aminoestrogens (AEs) has shown a significant alleviation of the AD development by inhibiting oxidative stress and neuronal death. Yet, the mechanism by which the AE molecules exhibit their beneficial effects remains speculative. To shed light into the molecular mechanism of inhibition of the AD development by AEs, we investigated the possibility of direct interaction with the Aβ25–35 peptide. First, we calculate various interacting electronic properties of three AE derivatives as follows: prolame, butolame, and pentolame by performing DFT calculations. To account for the polymorphic nature of the Aβ aggregates, we considered four different Aβ25–35 systems extracted from AD relevant fibril structures. From the calculation of different electron density properties, specific interacting loci were identified that guided the construction and optimization of various complexes. Interestingly, the results suggest a similar inhibitory mechanism based on the direct interaction between the AEs and the M35 residue that seems to be general and independent of the polymorphic properties of the Aβ aggregates. Our analysis of the complex formation provides a structural framework for understanding the AE therapeutic properties in the molecular inhibitory mechanism of Aβ aggregation.

Background: Laparoscopic gastrectomy has numerous perioperative advantages, but the long-term survival of patients after this procedure has been less studied. Aim: To compare survival, oncologic and perioperative outcomes between completely laparoscopic vs. open gastrectomy for early gastric cancer. Methods: This study was retrospective, and our main outcomes were the overall and disease-specific 5-year survival, lymph node count and R0 resection rate. Our secondary outcome was postoperative morbidity. Results: Were included 116 patients (59% men, age 68 years, comorbidities 73%, BMI 25) who underwent 50 laparoscopic gastrectomies and 66 open gastrectomies. The demographic characteristics, tumour location, type of surgery, extent of lymph node dissection and stage did not significantly differ between groups. The overall complication rate was similar in both groups (40% vs. 28%, p=ns), and complications graded at least Clavien 2 (36% vs. 18%, p=0.03), respiratory (9% vs. 0%, p=0.03) and wound-abdominal wall complications (12% vs. 0%, p=0.009) were significantly lower after laparoscopic gastrectomy. The lymph node count (21 vs. 23 nodes; p=ns) and R0 resection rate (100% vs. 96%; p=ns) did not significantly differ between groups. The 5-year overall survival (84% vs. 87%, p=0.31) and disease-specific survival (93% vs. 98%, p=0.20) did not significantly differ between the laparoscopic and open gastrectomy groups. Conclusion: The results of this study support similar oncologic outcome and long-term survival for patients with early gastric cancer after laparoscopic gastrectomy and open gastrectomy. In addition, the laparoscopic approach is associated with less severe morbidity and a lower occurrence of respiratory and wound-abdominal wall complications.

Alzheimer's disease (AD) is a neurodegenerative disorder caused by the aggregation of the amyloid-beta peptide (Aβ) in senile plaques and cerebral vasculature. The Aβ25-35 fraction has shown the most toxicity; its neurotoxic mechanisms are associated with the generation of oxidative stress and reactive astrogliosis that induce neuronal death and memory impairment. Studies indicate that pharmacological treatment with flavonoids reduces the rate of AD, in particular, it has been shown that antioxidants are compounds that could interact with this peptide due to their antioxidant proprieties. In this study, experimental and computational tools were used to calculate the molecular electrostatic potential and the Fukui function with the Gaussian 09 computational program, to predict the most reactive parts of these molecules and make the complex between Aβ25-35 and two flavonoids (catechin and epicatechin) in the absolute gas-phase, where a possible interaction between them was observed. This is important for understanding the Aβ25-35-Flavonoid (A-F) interaction as a therapeutic strategy to inhibit the neurotoxic effects that this peptide causes in AD, which currently is still considered an ambiguous process.