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Sexual arousal (SA) is a multidimensional experience that includes cognitive, emotional, motivational and physiological components. Texts with erotic content have been used to generate a state of SA. Erotic texts often include aggressive content that has not been evaluated in relation to SA. The aim of this work was to compare cortical functionality in women when reading a sexually explicit text (SET) and a sexually explicit text with aggression (SETA). Twenty-seven women participated. The EEG activity of the frontal, temporal and parietal locations was recorded during the reading of both texts. The participants found the SET to be more pleasant than the SETA. Both texts were identified as triggers of general and SA. While reading the SETA, there was an increase in absolute power in the frontal and parietal locations, a higher intrahemispheric correlation between the left frontal and temporal locations in fast frequency bands and a greater interhemispheric correlation between the frontal locations in the delta and alpha1 bands. These findings indicate that cortical functionality during SA in women differs based on the content and context of the erotic material being read, possibly associated with mechanisms that underlie the processing and incentive value assignment of stimuli with sexual and aggressive connotations.

ABSTRACT Acute pancreatitis (AP) is a rare but life‐threatening complication in patients with systemic lupus erythematosus (SLE). The case highlights the diagnostic challenges and treatment complexities in managing SLE‐associated pancreatitis. A 20‐year‐old female with a history of SLE presented with acute onset epigastric pain, vomiting, and signs of systemic inflammation. Laboratory findings revealed elevated amylase and lipase levels, confirming AP. Imaging studies showed interstitial edematous pancreatitis and bilateral pleural effusion. The patient was managed with aggressive fluid resuscitation, pain management, and supportive care. A systemic inflammatory response complicated her clinical course, and she required intensive care unit monitoring. This case underscores the importance of early recognition of AP in SLE patients and highlights the need for a multidisciplinary approach to manage this severe complication.

Introducción: la policitemia Vera es la neoplasia mieloproliferativa más común y entre sus complicaciones más frecuentes, destacan los eventos trombo-embólicos (predominantemente de componente arterial), relacionados con aumento de la morbimortalidad. A la fecha, además, se han presentado algunos reportes de casos de estenosis de las arterias renales en pacientes con policitemia Vera concomitante, que sugieren una relación fisiopatológica entre ambas entidades, pero la evidencia actual sigue siendo contradictoria. Caso clínico: a continuación, se expone el caso de una mujer de 73 años que se presentó con eritrocitosis y un cuadro concomitante de trombosis y estenosis de las arterias renales, en la que se descartó causas secundarias relacionadas y se llegó al diagnóstico de policitemia Vera luego de la confirmación de niveles bajos de eritropoyetina y detección de la mutación JAK-2 clásica. Con base en este caso clínico y la pertinente revisión de la literatura, se propone un algoritmo diagnóstico como parte del enfoque de la eritrocitosis. Conclusión: nuestro reporte de caso sugiere que además de los fenómenos trombóticos clásicos, existe una posible relación entre la policitemia Vera y la estenosis de las arterias renales, como previos trabajos habían observado.

Summary: Background: Yellow fever (YF), a mosquito-borne acute viral haemorrhagic illness, is endemic to many tropical and subtropical areas of Africa and Central and South America. Vaccination remains the most effective prevention strategy; however, as repeated outbreaks have exhausted vaccine stockpiles, there is a need for improved YF vaccines to meet global demand. A live-attenuated YF vaccine candidate (referred to as vYF) cloned from a YF-17D vaccine (YF-VAX®) sub-strain, adapted for growth in Vero cells cultured in serum-free media, is in clinical development. We report the innate and adaptive immune responses and the transcriptome profile of selected genes induced by vYF. Methods: Healthy adults aged 18–60 years were randomised at a 1:1:1:1 ratio to receive one dose of vYF at 4, 5 or 6 Log CCID50 or YF-VAX (reference vaccine), administered subcutaneously in the upper arm (ClinicalTrials.gov identifier: NCT04142086). Blood/serum samples were obtained at scheduled time points through 180 days (D180) post-vaccination. The surrogate endpoints assessed were: serum cytokine/chemokine concentrations, measured by bead-based Multiplex assay; peripheral blood vYF-specific IgG and IgM memory B cell frequencies, measured by FluoroSpot assay; and expression of genes involved in the immune response to YF-17D vaccination by RT-qPCR. Findings: There was no increase in any of the cytokine/chemokine concentrations assessed through D14 following vaccination with vYF or YF-VAX, except for a slight increase in IP-10 (CXCL10) levels. The gene expression profiles and kinetics following vaccination with vYF and YF-VAX were similar, inclusive of innate (antiviral responses [type-1 interferon, IFN signal transduction; interferon-stimulated genes], activated dendritic cells, viral sensing pattern recognition receptors) and adaptive (cell division in stimulated CD4+ T cells, B cell and antibody) immune signatures, which peaked at D7 and D14, respectively. Increases in vYF-specific IgG and IgM memory B cell frequencies at D28 and D180 were similar across the study groups. Interpretation: vYF-induced strong innate and adaptive immune responses comparable to those induced by YF-VAX, with similar transcriptomic and kinetic profiles observed. Funding: Sanofi.

Metastasizing cancer cells encounter a multitude of stresses throughout the metastatic cascade. Oxidative stress is known to be a major barrier for metastatic colonization, such that metastasizing cancer cells must rewire their metabolic pathways to increase their antioxidant capacity. NADPH is essential for regeneration of cellular antioxidants and several NADPH-regenerating pathways have been shown to play a role in metastasis. We have found that metastatic melanoma cells have increased levels of both NADPH and NADP+ suggesting increased de novo biosynthesis of NADP+. De novo biosynthesis of NADP+ occurs through a single enzymatic reaction catalyzed by NAD+ kinase (NADK). Here we show that different NADK isoforms are differentially expressed in metastatic melanoma cells, with Isoform 3 being specifically upregulated in metastasis. We find that Isoform 3 is more potent in expanding the NADP(H) pools, increasing oxidative stress resistance and promoting metastatic colonization compared to Isoform 1. We have found that Isoform 3 is transcriptionally upregulated by oxidative stress through the action of NRF2. Together, our work presents a previously uncharacterized role of NADK isoforms in oxidative stress resistance and metastasis and suggests that NADK Isoform 3 is a potential therapeutic target in metastatic disease.

INTRODUCCIÓN: La pandemia por COVID-19 condujo a la adopción de medidas de confinamiento con impacto en el control de la diabetes mellitus (DM). El objetivo fue evaluar el efecto de la pandemia en la atención de personas con DM del subsector público y privado de salud del Partido de General Pueyrredon (PGP). MÉTODOS: Se utilizó un diseño cuasiexperimental que comparó dos períodos: pandemia (3 de marzo de 2020 al 2 de marzo de 2021) y prepandemia (3 de marzo de 2019 al 2 de marzo de 2020). Se incluyó a personas de 18 años y más del PGP con diagnóstico de DM; se conformaron dos grupos según cobertura de salud. Los criterios de valoración principal fueron la hemoglobina glicosilada (HbA1c) y el control metabólico; los secundarios: glucemia basal, índice de masa corporal (IMC), triglicéridos, colesterol, consultas médicas, internación, fondo de ojo e índice albúmina/creatinina. Las diferencias con valor p

We present a case of obstruction in the third portion of the duodenum secondary to a phytobezoar in an adult patient with no surgical history and without a vegan diet. High intestinal obstruction due to a phytobezoar is rarely described in the literature, posing a diagnostic challenge when evaluating potential differentials in the emergency setting. Subsequently, we conduct a review focusing on tomographic findings and the surgical specimen, highlighting key points to consider when addressing such pathologies.

Resumen: Introducción: la vacunación antigripal es una medida efectiva pare reducir ingresos hospitalarios y mortalidad. El objetivo de este estudio es cuantificar la efectividad de la vacunación antigripal en pacientes hospitalizados por gripe para evitar su evolución a gravedad, considerando otros factores conocidos que influyen sobre esa gravedad. Métodos: estudio transversal de las temporadas epidemiológicas gripales 2016-2017 a 2019-2020 con pacientes hospitalizados en el Hospital Universitario Nuestra Señora de la Candelaria de Tenerife diagnosticados de gripe. Se estudiaron variables demográficas y de evolución básicas. El criterio de gravedad clínica empleado es el establecido por el Centro Nacional de Epidemiología de España. Mediante regresión logística binaria multivariable se estimó el riesgo de evolución a gravedad asociado al estado vacunal antigripal. Resultados: se recopilaron 1.416 pacientes, mujeres el 50%, mayores de 64 años el 56%, 17% con vacunación antigripal, 24% evolucionaron a gravedad, 3% fallecieron, 72% tratados con oseltamivir, 23% (IC95%: 19–27) no tratados con oseltamivir ingresaron en UCI, frente a 1,5% (IC95%: 1–2) sí tratados. Evolucionaron a gravedad el 25% (IC95%: 23–28) de no vacunados, frente al 18% (IC95%: 13–23) de vacunados. La odds ratio (OR) a evolución grave fue de 1,6 (IC95%: 1,1-2,2) para los no vacunados. Conclusiones: el paciente hospitalizado por gripe que no ha recibido vacunación antigripal presenta más del doble de riesgo a una evolución grave de la gripe frente al correctamente vacunado. La combinación de oseltamivir y vacunación reduce en casi un quinto su ingreso en la UCI. Abstract: Introduction: Influenza vaccination is an effective measure to reduce hospital admissions and mortality. The objective of this study is to quantify the effectiveness of influenza vaccination in patients hospitalized for influenza to prevent its evolution to severity, considering other known factors that influence such severity. Methods: Cross-sectional study of the 2016–2017 to 2019–2020 influenza epidemiological seasons with patients hospitalized at the Nuestra Señora de la Candelaria University Hospital in Tenerife diagnosed with influenza. Basic demographic and evolution variables were studied. The criteria for clinical severity used is that established by the Spanish National Epidemiology Center. Using multivariable binary logistic regression, the risk of progression to severity associated with influenza vaccination status was estimated. Results: A total of 1,416 patients were collected. Of whom 50% were women, 56% older than 64 years, 17% with flu vaccination, 24% evolved to severity, 3% died, 72% treated with oseltamivir, 23% (CI95%: 19–27) not treated with oseltamivir were admitted to the ICU, compared to 1.5% (CI95%: 1–2) treated, 25% (CI95%: 23–28) of the non-vaccinated patients developed severity, compared to 18% (CI95%: 13–23) of the vaccinated. The odds ratio (OR) to severe evolution was 1.6 (CI95%: 1.1–2.2) for those not vaccinated. Conclusions: Patients hospitalized for influenza who have not received influenza vaccination have a more than double the risk of a serious evolution of influenza compared to correctly vaccinated patients. The combination of oseltamivir and vaccination reduces their admission to the ICU by almost a fifth.

Introducción: Los conductores de taxi están propensos a una serie de factores de riesgo asociados a múltiples enfermedades, producto del sometimiento a estilos de vida no saludables. Objetivo: Estimar factores predictores del sobrepeso y obesidad en conductores de taxi, según variables socioeconómicas y dimensiones del estilo de vida. Metodología: Estudio cuantitativo, observacional, transversal, explicativo, llevado a cabo en un universo de 131 taxistas hombres, que trabajan en la ciudad de Azogues-Ecuador, aplicando la Escala del Estilo de Vida junto con la medición del peso y la talla de los participantes para obtener el índice de masa corporal. El análisis estadístico recurrió a métodos univariados (frecuencias, medidas de tendencia y dispersión) y multivariados (regresión logística binomial). Resultados: participantes de 35 a 42 años (45.8%), casados (90.84%), conducen más de 8 horas diarias (72.5%), con sobrepeso u obesidad (83.2%), llevan un estilo de vida no saludable global del 86.3%. La regresión logística mostró buen ajuste del modelo para las 3 variables incluidas: alimentación (OR = 1.53), apoyo interpersonal (OR = 0.454) y horas de conducción diarias (OR = 4.078). Discusión: Ser conductor de taxi es una actividad de riesgo para la salud que puede generar sobrepeso u obesidad, condiciones que pueden ser predichas por factores del estilo de vida y por condiciones laborales propias de esta actividad.

Introducción: La covid-19 alteró la situación laboral y el proceso docente educativo de las universidades médicas. Además, hubo un impacto muy negativo en todas las esferas económicas y sociales del país. En el sector de la salud se reorganizaron los servicios y recursos humanos, se afectó la producción del cuadro básico de medicamentos, aumentaron las presiones sobre el sistema de salud pública y asistencia social con el correspondiente incremento de los costos de salud pública y gastos públicos. Objetivo: Describir los efectos sociales, económicos y académicos de la covid-19 en la Facultad de Medicina No. 1 de la Universidad de Ciencias Médicas en Santiago de Cuba. Métodos: Se realizó un estudio observacional, descriptivo, retrospectivo, durante rebrotes de covid-19 en el periodo de enero a julio de 2021 en trabajadores disponibles y estudiantes de primero a quinto año de la facultad. Se evaluaron características generales y socioeconómicas para cada grupo, como certificados médicos y causas, días afectados, resultados de la pesquisa, y actividad formativa. Se utilizó la estadística descriptiva para el análisis y presentación de los resultados. Resultados: La incidencia de casos positivos fue baja, pero generó miles de días de incapacidad, por aislamientos e ingreso en el hogar. Se pesquisaron más de 5 000 personas sospechosas de la enfermedad, de ellos 19,9 % resultó positivo. La promoción superó 95 % en todos los años de la carrera y fue mayor al de etapa prepidémica, al igual que la eficiencia vertical. Conclusiones: Aunque hubo efectos sociales, económicos y académicos negativos, el trabajo comunitario integral contribuyó a la preservación de la salud de la población y se desarrolló el aprendizaje a distancia.

Methods Cross-sectional study with a thematic analytical approach, derived from the international initiative "The Health Care Workers Study" (HEROES), conducted among healthcare workers in Chile during the second semester of 2022 and the first of 2023 through semi-structured interviews and inductive coding. Results A narrative synthesis of 35 interviews in four themes: care at work: the presence of changes in work tasks, concern about becoming infected, collective "mystique", stigma due to being a healthcare worker, conflicts with patients; care at home: multiple ways of arranging household tasks, the relevance of living with others, interrelation with work dynamics, "double burden" among women; relationship with one's own mental health: recognition of mental health impact, the stress associated with change and uncertainty, perception of work overload, feelings of guilt or responsibility for infecting family members; and beliefs and values about the pandemic and its effects: acceptance of psychological impact on healthcare workers, organizational culture as a relevant element in postponing one's own mental health, initial disbelief in the effects of the pandemic, similarities with previous periods of social upheaval, and equality among people in terms of vulnerability to the disease. Conclusions Five elements emerge as potential areas for intervention: gender perspective, previous exposure to crisis experiences, self-care spaces, peer support, and institutional response. The care perspective helps study the relationship between some stressors and healthcare workers' mental health in the context of a pandemic.

Introducción: los tumores cerebrales constituyen la neoplasia maligna infantil más común, después de la leucemia y son la principal causa de muerte por cáncer infantil. Objetivo: caracterizar los pacientes pediátricos con tumores cerebrales. Métodos: se realizó un estudio observacional, descriptivo, de corte transversal en el Hospital Pediátrico Quirúrgico Docente Sur ``Dr. Antonio María Béguez, ´´ en Santiago de Cuba, se trabajó con 89 pacientes pediátricos, diagnosticados con tumores cerebrales. Se utilizó la estadística descriptiva para procesar la información con tablas y gráficos de frecuencia absoluta y porcentajes. Los datos fueron obtenidos de las entrevistas realizadas y de las historias clínicas, se analizaron variables como: la edad, el sexo, el color de piel, la procedencia, el estadio clínico, la localización y el tipo histológico, en el periodo 2020-2022. Resultados: predominó el rango de cero a cuatro años de edad y el sexo masculino con 32,58 % (n=29), el color de piel mestiza sobresalió con el 61,80 % (n=55). Según el estadio clínico de la enfermedad prevaleció el estadio III con 37,08 % (n=29). Según la localización, resaltaron los infratentoriales con 70,79 % (n=63) y el tipo histológico astrocitoma con 46,07 % (n=41). Conclusiones: predominan los tumores cerebrales en los primeros años de vida, en el sexo masculino. La mayoría de los pacientes diagnosticados con la enfermedad se encuentran en estadios clínicos avanzados, la localización más común es la infratentorial y el tipo histológico astrocitoma.

Abstract Background Initially discovered for its ability to regenerate ear holes, the Murphy Roth Large (MRL) mouse has been the subject of multiple research studies aimed at evaluating its ability to regenerate other body tissues and at deciphering the mechanisms underlying it. These enhanced abilities to regenerate, retained during adulthood, protect the MRL mouse from degenerative diseases such as osteoarthritis (OA). Here, we hypothesized that mesenchymal stromal/stem cells (MSC) derived from the regenerative MRL mouse could be involved in their regenerative potential through the release of pro-regenerative mediators. Method To address this hypothesis, we compared the secretome of MRL and BL6 MSC and identified several candidate molecules expressed at significantly higher levels by MRL MSC than by BL6 MSC. We selected one candidate, Plod2, and performed functional in vitro assays to evaluate its role on MRL MSC properties including metabolic profile, migration, and chondroprotective effects. To assess its contribution to MRL protection against OA, we used an experimental model for osteoarthritis induced by collagenase (CiOA). Results Among the candidate molecules highly expressed by MRL MSC, we focused our attention on procollagen-lysine,2-oxoglutarate 5-dioxygenase 2 (PLOD2). Plod2 silencing induced a decrease in the glycolytic function of MRL MSC, resulting in the alteration of their migratory and chondroprotective abilities in vitro. In vivo, we showed that Plod2 silencing in MRL MSC significantly impaired their capacity to protect mouse from developing OA. Conclusion Our results demonstrate that the chondroprotective and therapeutic properties of MRL MSC in the CiOA experimental model are in part mediated by PLOD2.

This study proposes a novel Hybrid Metaheuristic with explicit diversity control, aimed at finding an optimal feature subset by thoroughly exploring the search space to prevent premature convergence. Background/Objectives: Unlike traditional evolutionary computing techniques, which only consider the best individuals in a population, the proposed strategy also considers the worst individuals under certain conditions. In consequence, feature selection frequencies tend to be more uniform, decreasing the probability of premature convergent results and local-optima solutions. Methods: An image database containing 608 images, evenly balanced between positive and negative coronary stenosis cases, was used for experiments. A total of 473 features, including intensity, texture, and morphological types, were extracted from the image bank. A Support Vector Machine was employed to classify positive and negative stenosis cases, with Accuracy and the Jaccard Coefficient used as performance metrics. Results: The proposed strategy achieved a classification rate of 0.92 for Accuracy and 0.85 for the Jaccard Coefficient, obtaining a subset of 16 features, which represents a discrimination rate of 0.97 from the 473 initial features. Conclusions: The Hybrid Metaheuristic with explicit diversity control improved the classification performance of coronary stenosis cases compared to previous literature. Based on the achieved results, the identified feature subset demonstrates potential for use in clinical practice, particularly in decision-support information systems.

La amiloidosis por depósito de transtiretina es una enfermedad infrecuente y se debe al depósito de fibrillas de dicha proteína en diversos tejidos, aunque la afectación más frecuente es la cardíaca y la neurológica. Puede ser adquirida (antiguamente llamada “amiloidosis senil”) o, menos frecuentemente, hereditaria debido a mutaciones en el gen que codifica para la transtiretina (TTR). Una manifestación habitual de la TTR mutada (de ahora en adelante ATTRv) es la polineuropatía amiloidótica familiar. En el Hospital Italiano de Buenos Aires, desde el año 2010 existe un grupo transdisciplinario de profesionales nucleados por el interés en optimizar la atención de personas con amiloidosis, formado por profesionales de distintas especialidades y de referencia a nivel nacional, con foco en la asistencia, la docencia y la investigación. En el año 2020, este grupo, denominado Grupo de Estudio de Amiloidosis (GEA), confeccionó guías de práctica clínica para el tratamiento de la polineuuropatía amiloidótica familiar. Desde entonces se han publicado múltiples ensayos clínicos que aportan contundencia al conocimiento disponible hasta el momento, mientras están en desarrollo nuevas líneas de investigación que robustecen y estimulan el estudio en el área. En esta revisión se realiza una actualización de las guías existentes en lo que respecta al tratamiento de la polineuropatía amiloidótica familiar por transtiretina y se explora el estado del arte. En el tratamiento de la polineuropatía amiloidótica familiar es conocido el uso del patisirán (un siRNA o small interfering RNA dirigido a interferir con la síntesis hepatocitaria de transtiretina). Actualmente está aprobado también para pacientes con trasplante hepático previo y progresión sintomática. Además de este medicamento, hoy se recomienda el vutrisirán, de la misma familia farmacológica pero con una posología de más fácil manejo y un perfil aceptable de efectos adversos. La edición génica in vivo también está en boga como nueva línea de investigación, siendo parte de múltiples ensayos clínicos actuales en curso.

Introducción: el principal objetivo de la presente revisión es conocer la evidencia científica actual sobre el papel de los antioxidantes en relación con las amiloidosis. El estrés oxidativo ha sido estudiado en la amiloidosis y se realizó una revisión narrativa sobre artículos publicados en el uso de antioxidantes en el tratamiento de estas enfermedades. Estado del arte: se presentan artículos publicados desde el año 2010 hasta el año 2022, en relación con el empleo de carvedilol, epigalocatequina galato (EGCG), resveratrol y tetraciclinas en modelos y casos de amiloidosis. Discusión/Conclusión: la terapia antioxidante para la amiloidosis está en desarrollo temprano, por lo cual requiere más estudios clínicos para evaluar eficacia y seguridad a largo plazo. Los antioxidantes como el carvedilol y el EGCG muestran gran potencial en interferir con las fibrillas amiloides, pero se necesita más investigación para comprender su impacto completo y viabilidad como tratamiento a largo plazo.

Introduction: Maxillary torus are rare, asymptomatic and slowly progressive benign bony exostoses. Their exaggerated growth could affect swallowing, phonetics and the making of removable prostheses. Objective: To present the clinical case of the surgical approach of a wide palatal torus. Clinical Case: A 40-year-old female patient came to the dentistry service to consult about the presence of an elevated area in the midline of the hard palate, with a firm consistency. On clinical evaluation she was asymptomatic. A cone beam computed tomography was requested and a diagnosis of palatal torus was made. A double Y-shaped incision was made and the torus was sectioned in 6 parts to later remove the fragments with a percussive chisel. It was sutured and a containment splint was placed to keep the flap fixed. The evolution of the case was favorable. Conclusion: Palatal torus can disrupt some oral functions and their presence and size can be of concern to patients. A correct diagnosis and tomographic analysis can indicate to the clinician an adequate surgical approach when the case requires it.

Perú generó 8.215.355 t de residuos sólidos municipales en el 2021; de este, 57,64 % corresponde a residuos orgánicos (RO) y 61,28 % son dispuestos en rellenos sanitarios con múltiples deficiencias de gestión, lo que exige buscar alternativas para tratar de manera segura los RO. Frente a esta situación, el compostaje permite la biotransformación, la reducción y la obtención de biofertilizantes, que se pueden aplicar como sustrato o enmienda. El objetivo de la investigación fue evaluar indicadores de procesamiento y calidad de compost derivado de residuos sólidos orgánicos urbanos, en Leoncio Prado, región Huánuco, Perú. Se evaluaron los tipos de residuos, basados en la normativa peruana para caracterización de residuos, los indicadores del proceso (temperatura y pH), la caracterización fisicoquímica y calidad en base a las normas internacionales. Los resultados muestran diferencia significativa para pH, nitrógeno, calcio, potasio, cobre y zinc; contrariamente, la materia orgánica, el % de cenizas, la conductividad eléctrica, el sodio y el fósforo no mostraron diferencias, siendo lo más destacado los altos niveles de pH, además, la calidad del compost es de “Clase B”, según la norma chilena 2880. Los compost producidos son de calidad media y se recomienda su uso como sustrato o enmienda en la agricultura, previo tratamiento para corregir los altos niveles de pH.

Resumen: Objetivos: Determinar los cambios de frecuentación de consultas presenciales (CP) y telemáticas (CT) a su médico de familia en pacientes con diabetes tipo 2 (DM2) durante la pandemia de COVID-19 y su relación con el control de su enfermedad. Diseño: Estudio multicéntrico de seguimiento retrospectivo. Emplazamiento: Siete centros de salud en Tenerife, España. Participantes: Un total de 3.543 pacientes con DM2. Mediciones: Sexo, edad, CP, CT y control de DM2 mediante hemoglobina glicosilada (A1c) durante el periodo 2019-2021. Se ajustaron modelos de regresión logística con el control de DM2 como efecto, y con las demás mediciones como variables independientes. Resultados: El 50% eran mujeres. El 38% tenía 65 años o menos. Se midió la A1c al 84% de los pacientes en 2019, 68% en 2020, y 77% en 2021. Presentaron buen control el 58,4% en 2019, 46,1% en 2020 y 50,3% en 2021. Las CP fueron 7 en 2019, 4 en 2020 y 5 en 2021 (p

Background: Antithrombotic prophylaxis in hospitalized patients at risk of venous thromboembolic disease (VTE) is often overlooked. Objective: To evaluate the effectiveness of an educational program and an electronic alert on antithrombotic prophylaxis utilization in hospitalized patients at risk of VTE. Design: Quasi-experimental uncontrolled pre- and post-intervention study. Patients: ≥18 years, both genders with prophylaxis indication, and hos-pitalized ≥72 hours in 2009 (pre-intervention), 2016 (post-education), and 2017 (post-alert). Methods: We calculated crude and adjusted odds ratios (OR) for age, sex, patient type, and VTE risk factors for the association between antithrombotic prophylaxis use and interventions. Results: We included 239 patients (80 pre-intervention, 80 post-education, and 79 post-alert). Prophylaxis utilization increased from 66.2% pre-intervention to 90% post-alert. The post-alert group had 3.6 times higher odds of receiving prophylaxis in adjusted analysis (OR: 3.6, 95% CI: 1.4–9.1). Interventions did not significantly alter prophylaxis use in medical patients. Conclusions: An educational program and an electronic alert are effective in increasing antithrombotic prophylaxis utilization in hospitalized patients, with particular benefit in surgical patients.

Background/Objectives: Sterilization in dental practice is crucial for infection prevention. The aim of this study was to identify the presence and causes of bacterial growth using biological indicators in dental sterilization equipment in San Luis Potosí, S.L.P., Mexico, with different consecutive measurements over a year. Methods: This longitudinal cohort, conducted from January 2022 to January 2024 in San Luis Potosí, Mexico, aimed to identify the presence and causes of bacterial growth in dental sterilization equipment using biological indicators. A total of 207 dental offices were approached, and 175 participated, providing data through questionnaires and monitoring sterilization cycles with BIs. The checks were bimonthly for one year, with a total of six checks. Results: (a) An 11% (n = 1188) incidence of bacterial growth was observed, with a higher percentage in dry heat equipment (13%). (b) Upon analyzing the six consecutive verifications over a year, no statistically significant differences were observed in the failures of the sterilization cycles when comparing the two pieces of equipment. (c) Error in temperature and time of the equipment (OR = 4.0, 95% CI = 1.6–3.9, p = 0.0001) was significantly associated with the presence of bacterial growth during the one-year period. Conclusions: Monitoring sterilization cycles and identifying the causes of bacterial growth with different consecutive verifications decreased the presence of bacterial growth (failures) during the one-year period.

Background/Objectives: The aim of this study was to evaluate incidental findings in the mandible after the placement of dental implants using a new cone–beam computed tomography (CBCT) software. Methods: The initial sample consisted of 2872 CBCT scans of patients of both sexes. The parameters evaluated in this study were the location of the implants in the mandible, implant length, anatomical relationship of the implant with the mandibular canal, presence or absence of damage to the adjacent teeth, presence or absence of implant fractures, and presence or absence of bone support. Fisher’s exact test was performed to compare the variables. The significance level was set at p = 0.05. Results: Out of 2872 CBCT scans, 214 images of patients with an average age of 44.5 years were included. The most frequent location of the implants was the posterior region (93.5%), with 54% of the implants having a length between 9 and 14 mm. It was found that 92% of the implants were positioned above the mandibular canal. Damage to adjacent teeth was observed, with no correlation with the implant positioning (p = 1.000). In 100% of cases of implants in the anterior region, there was bone support. Fracture was observed in 1.7% of implants with a length between 9 and 14 mm. Conclusions: The installation of implants in the mandible occurs more frequently in the posterior region, with a high presence of bone support and a low incidence of damage to adjacent teeth, anatomical structures, and fractures.

En Colombia, para 2020, el cáncer de pulmón se reportó como la segunda neoplasia con mayor incidencia y la primera con mayor tasa de mortalidad según las cifras del ministerio de salud de Colombia. El compromiso peritoneal en el cáncer de pulmón es algo extremadamente raro, se considera

Jacinta, deaf from birth, chose to give birth to her own baby at home without her hearing aids. Fu-Yu assisted and took photos of the process. This is a Photo Essay about alternative possibilities to biomedical childbirth. We share our experience through this medium, as the ‘visual’ was our shared sensory perception at the time. Besides acknowledging the intersubjectivities that surfaced, we see the importance of recognising that ‘images are representations of the world filtered by the positionalities of the makers themselves, influenced by unique experiences that brought them to that point in time … Images become an extension of a way of thinking, visually connecting maker with participant along lines of thought’ (Cartwright and Crowder 2017, 515). Although Fu-Yu is the one operating the camera, Jacinta, her partner, her mother, her cat and her home ‘make the image’. Whilst Jacinta was in labour, Fu-Yu was assisting Carmen Susana (the midwife) and recording the event at the same time with a camera hanging around her neck. We want to offer the audience this shared ‘visual’ experience as an invitation to think and ‘visualise’ care and childbirth from a disability-studies perspective.

Transthyretin deposition amyloidosis is a rare disease caused by the deposition of fibrils of this protein in various tissues, although the most common manifestations are cardiac and neurological. It can be acquired (formerly known as “senile amyloidosis”) or hereditary due to mutations in the gene encoding for transthyretin (TTR).In 2020, the Amyloidosis Study Group created clinical practice guidelines for treating transthyretin amyloidotic cardiomyopathy. Since then, published clinical trials have strengthened the available knowledge, and new lines of research have emerged. This review updates the mentioned guidelines by exploring the state of the art. In the case of transthyretin (TTR) amyloidosis cardiomyopathy, therapeutic strategies are predominantly aimed at reducing the production and aggregation of TTR apart from providing supportive treatment for organ damage. Tafamidis, a TTR stabilizer that prevents its aggregation and deposition, is increasingly supported by evidence for its use in improving the survival of patients with this condition. Gene therapies such as messenger RNA silencers or in vivo gene editing to inhibit the expression of the gene encoding for TTR and generate long-term therapeutic effects are under investigation. Multiple monoclonal antibodies have been part of ongoing clinical trials since 2020.

El objetivo de este estudio fue estimar la prevalencia de diabetes mellitus (DM) y factores de riesgo cardiovascular en una población rural de la provincia de San Luis, Argentina. Estudio transversal desarrollado entre septiembre y noviembre de 2017 con habitantes de 18 años y más de cuatro localidades del departamento Juan Martín de Pueyrredón, San Luis. Los participantes respondieron preguntas por autorreporte sobre aspectos sociodemográficos, hábitos, factores psicosociales y de riesgo para enfermedades no transmisibles; se realizaron mediciones físicas, cuestionario FINDIRSC y extracción de muestras de sangre. Se obtuvieron estimaciones univariadas estratificadas por sexo con su intervalo de confianza del 95% (IC95%). Se trabajó con factores de expansión de la muestra; se calcularon prevalencias crudas y ajustadas. La población estuvo constituida por 424 varones (52,5%, IC95%: 46,0-58,9) y 384 mujeres (47,5%, IC95%: 41,1-54,0). Las prevalencias ajustadas para ambos sexos (por autorreporte) fueron: DM 11,8% (IC95%: 8,2-15,4); hipertensión arterial (HTA): 35,5% (IC95%: 31,0-40,1); colesterol elevado: 20,3% (IC 16,0-24,7). Los varones tuvieron colesterol HDL deseable y tensión arterial elevada en una proporción significativamente superior a las mujeres; las mujeres obesidad abdominal en mayor magnitud. El 16,4 % (IC95%: 11,0 - 23,6) ostentó riesgo alto-muy alto de desarrollar DM tipo 2 en los próximos 10 años. Las prevalencias ajustadas de DM, HTA y colesterol elevado fueron inferiores a la de la población urbana de la provincia de San Luis. Destacamos la contribución pionera de este trabajo al conocimiento del perfil de salud de las comunidades rurales de Argentina.

Abstract Introduction General practice data, particularly when combined with hospital and other health service data through data linkage, are increasingly being used for quality assurance, evaluation, health service planning and research. In this study, we explored community views on sharing general practice data for secondary purposes, including research, to establish what concerns and conditions need to be addressed in the process of developing a social licence to support such use. Methods We used a mixed‐methods approach with focus groups (November–December 2021), followed by a cross‐sectional survey (March–April 2022). Results The participants in this study strongly supported sharing general practice data with the clinicians responsible for their care, and where there were direct benefits for individual patients. Over 90% of survey participants (N = 2604) were willing to share their general practice information to directly support their health care, that is, for the primary purpose of collection. There was less support for sharing data for secondary purposes such as research and health service planning (36% and 45% respectively in broad agreement) or for linking general practice data to data in the education, social services and criminal justice systems (30%–36%). A substantial minority of participants were unsure or could not see how benefits would arise from sharing data for secondary purposes. Participants were concerned about the potential for privacy breaches, discrimination and data misuse and they wanted greater transparency and an opportunity to consent to data release. Conclusion The findings of this study suggest that the public may be more concerned about sharing general practice data for secondary purposes than they are about sharing data collected in other settings. Sharing general practice data more broadly will require careful attention to patient and public concerns, including focusing on the factors that will sustain trust and legitimacy in general practice and GPs. Patient and Public Contribution Members of the public were participants in the study. Data produced from their participation generated study findings. Clinical Trial Registration Not applicable.

La amiloidosis siempre ha representado un desafío diagnóstico. En el año 2020, el Grupo de Estudio de Amiloidosis (GEA), confeccionó la Guía de Práctica Clínica para el Diagnóstico de Amiloidosis1-3. Nuevas líneas de investigación se han desarrollado posteriormente. Esta revisión narrativa tiene como intención explorar el estado del arte en el diagnóstico de la amiloidosis. En pacientes con amiloidosis se recomienda la tipificación de la proteína mediante espectrometría de masa, técnica de difícil ejecución por requerir de microdisectores láser para la preparación de la muestra. Algunas publicaciones recientes proponen otros métodos para obtener la muestra de amiloide que se va a analizar, permitiendo prescindir de la microdisección. Por otra parte, en pacientes con amiloidosis TTR (aTTR) confirmada, la recomendación de secuenciar el gen amiloidogénico se encontraba destinada a los casos sospechosos de aTTR hereditaria, pero actualmente esta se ha extendido a todos los pacientes sin importar la edad. En lo que respecta a los estudios complementarios orientados al diagnóstico de compromiso cardíaco, se ha propuesto el uso de la inteligencia artificial para su interpretación, permitiendo la detección temprana de la enfermedad y el correcto diagnóstico diferencial. Para el diagnóstico de neuropatía, las últimas publicaciones proponen el uso de la cadena ligera de neurofilamento sérica, que también podría resultar un indicador útil para seguimiento. Finalmente, con referencia a la amiloidosis AL, la comunidad científica se encuentra interesada en definir qué características determinan el carácter amiloidogénico de las cadenas livianas. La N-glicosilación de dichas proteínas impresiona ser uno de los determinantes en cuestión.

Objective. To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design. Cross-sectional observational research with a quantitative approach. Methods. A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results. The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions. The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.

There are many diseases related to breast tissue that have specific radiological patterns and imaging findings. However, anaplastic large cell lymphoma associated with breast implants is a condition with nonspecific findings that has an increased incidence du to the exponential growth worldwide of augmentation mammoplasty over the years and the use of implants in aesthetic and reconstructive surgery. In this article, a review of the epidemiology, etiology, pathophysiology, and diagnosis of this disease is carried out, highlighting radiological findings suggestive of this disease, which allows the radiologist to provide information to the treating team for diagnosis and surgical planning if necessary.

The diagnosis of Myelodysplastic syndromes (MDS) is frequently challenging, especially in terms of the distinction from the other non-neoplastic causes of cytopenia. Currently, it is based on the presence of peripheral blood cytopenias, peripheral blood and bone marrow dysplasia/blasts, and clonal cytogenetic abnormalities, but MDS diagnostic features are polymorphic and non-specific. We investigated the utility of complete blood count (CBC) and research parameters (RUO) from the analyzer BC 6800 Plus (Mindray Diagnostics) to discriminate MDS-related cytopenia. Methods: 100 samples from healthy individuals were used to establish the values of research parameters in normal subjects. A retrospective study was conducted including 66 patients diagnosed with MDS, 90 cytopenic patients due to other diseases (cancer patients receiving therapy, aplastic anemia, other hematological malignancies) and 50 with macrocytic anemia. The Wilcoxon test was applied to detect statistical differences among the groups of patients, considering p < 0.05 significant. The diagnostic performance of the RUO parameters for discriminating MDS among cytopenias was evaluated using receiver operating characteristic (ROC) curve analysis. Amultivariable logistic regression model was performed to identify the potential predictors for having MDS. The area under curve (AUC) and the Hosmer–Lemeshow test of the model were assessed. The performance of the model was verified in a prospective study including 224 cytopenic patients (validation group). Results: In the MDS group, the mean cell volume (MCV), percentage of macrocytic red cells (MAC), red cell distribution width (RDW) and immature platelets fraction (IPF) had increased values compared to the cytopenic and normal patients, while platelets, red and white cell counts, Neu X (related to the cytoplasmic complexity of neutrophils), Neu Y (related to nucleic acid content) and Neu Z (related to cell size) were lower (p < 0.001). Neu X, Neu Y, and Neu Z showed higher AUC for detecting MDS > 0.80; MAC, RDW and IPF AUC > 0.76. The multivariable model demonstrated that Neu X and Neu Y could be used in the recognition of MDS, AUC 0.88. In the validation group, 89.0% of the MDS patients were well classified. Conclusion: MDS are common malignant disorders with a poor prognosis, and early diagnosis is warranted for optimal benefit from treatment. RUO gain insights to detect dysplasia of MDS and could be used in the differential diagnosis of MDS from cytopenias of other etiologies.

Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR–2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.

Objective: Determine the association between periodontal disease (PD) and obesity through an umbrella review. Materials and Methods: A search for information until March 2024 was carried out in the following electronic databases: PubMed, Cochrane library, Scopus, SciELO, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We included studies that were systematic reviews (SR) with or without meta-analysis, without time or language restrictions, that evaluated primary studies that associated PD with obesity. Literary or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the quality and overall confidence of the included studies. Results: The preliminary search yielded a total of 419 articles, discarding those that did not meet the selection criteria, leaving only 14 articles. All studies reported that PD was associated with obesity, with an OR and RR ranging from 1.1 to 1.46 and 1.64 to 2.21, respectively. Conclusions: Based on the results and conclusions of the SR with a high overall confidence level, PD is associated with obesity.

La amiloidosis AL es una enfermedad debida al depósito, en órganos y tejidos, de fibrillas formadas por cadenas livianas producidas de forma patológica por plasmocitos clonales. Su tratamiento actualmente está orientado a erradicar el clon de células plasmáticas; este históricamente se extrapoló de tratamientos disponibles y estudiados para otras discrasias sanguíneas. En el año 2020, el Grupo de Estudio de Amiloidosis (GEA) confeccionó distintas guías de práctica clínica para el tratamiento de la amiloidosis AL. Desde entonces se han publicado ensayos clínicos que arrojan contundencia al conocimiento disponible hasta el momento, y están en desarrollo nuevas líneas de investigación que robustecen y estimulan el estudio en el área. En esta revisión se realiza una actualización de las guías existentes en lo que respecta al tratamiento de la amiloidosis por cadenas livianas. Como evidencia de relevancia, en el último año estuvieron disponibles resultados de ensayos clínicos que respaldan el uso de esquemas basados en daratumumab (un anticuerpo monoclonal anti-CD38+) para pacientes con diagnóstico reciente de amiloidosis AL como primera línea. Además, para el tratamiento de la amiloidosis AL refractaria o recaída, la disponibilidad de bibliografía respaldatoria es escasa y extrapolada del tratamiento del mieloma múltiple; sin embargo, actualmente existe evidencia de calidad para recomendar el uso de ixazomib, un inhibidor de proteosoma reversible por vía oral disponible en la Argentina desde 2020. Por último, se mencionan algunas líneas de investigación con otros anticuerpos monoclonales y terapéuticas basadas en el uso de CAR-T cells.

ABSTRACTBackground There is a need for novel analgesics with favorable risk to benefit profiles. Oxytocin has recently gained attention for its potential analgesic properties.Aim The aim of this study was to perform an updated systematic review and meta-analysis evaluating the effect of oxytocin for pain management.Method Ovid MEDLINE, Embase, PsycINFO, CINAHL, and Clinicaltrials.gov were searched for articles reporting on associations between oxytocin and chronic pain management from January 2012 to February 2022. Studies published before 2012 that were identified in our previous systematic review were also eligible. Risk of bias of included studies was assessed. Synthesis of results was performed using meta-analysis and narrative synthesis.Results Searches returned 2087 unique citations. In total, 14 articles were included that reported on 1504 people living with pain. Results from meta-analysis and narrative review were mixed. Meta-analysis of three studies indicated that exogenous oxytocin administration did not result in a significant reduction in pain intensity relative to placebo (N = 3; n = 95; g = 0.31; 95% confidence interval [CI] −0.10, 0.73). Narrative review provided encouraging evidence that exogenous oxytocin administration reduced pain sensitivity among individuals with back pain, abdominal pain, and migraines. Results suggested that individual difference factors (e.g., sex and chronic pain condition) may influence oxytocin-induced nociception, but the heterogeneity and limited number of studies identified precluded further investigation.Discussion There is equipoise for the benefit of oxytocin for pain management. Future studies are imperative and should undertake more precise exploration of potential confounds and mechanisms of analgesic action to clarify inconsistency in the literature.

This study aims to report the epidemiological characterization, incidence, mortality and prognostic factors of tuberculosis in indigenous patients of Paraguay from 2018 to 2022. A retrospective cohort study was carried out with data extracted from the National Tuberculosis Program from January 2018 to June 2022. The clinical records of 1659 indigenous patients were included in the study. The indigenous population with tuberculosis in the period 2018-2022 was between 0 and 20 years old (25.4%), mostly female (54.6%), residing in Presidente Hayes (22.4%), and was from the rural area (74.3%), of the Mbya ethnic group (20.4%). The diagnosis was bacteriological in 69.2%, 96.1% had pulmonary location, 94.5% of the study population started treatment and 1.1% presented drug-resistance, while 88.3% corresponded to new cases. The highest number of new cases of tuberculosis in indigenous people was 336 in 2019. The incidence of tuberculosis was associated with age and area of residence, being more incident in the youngest and in the Presidente Hayes area. A total of 11.2% died, and the highest number of deaths occurred in 2019 with 47 cases (14%). We observed that the elderly, who did not start treatment, and who were coinfected with HIV were more likely to die from tuberculosis. The number of new cases and mortality from tuberculosis is high in the Paraguayan indigenous population. Age and coinfection with HIV continue to be risk factors for mortality.

Abstract Background The 2020 pandemic of SARS-CoV-2 causing COVID-19 disease is an unprecedented global emergency. COVID-19 appears to be a disease with an early phase where the virus replicates, coinciding with the first presentation of symptoms, followed by a later ‘inflammatory’ phase which results in severe disease in some individuals. It is known from other rapidly progressive infections such as sepsis and influenza that early treatment with antimicrobials is associated with a better outcome. The hypothesis is that this holds for COVID-19 and that early antiviral treatment may prevent progression to the later phase of the disease. Methods Trial design: Phase IIA randomised, double-blind, 2 × 2 design, placebo-controlled, interventional trial. Randomisation: Participants will be randomised 1:1 by stratification, with the following factors: gender, obesity, symptomatic or asymptomatic, current smoking status presence or absence of comorbidity, and if the participant has or has not been vaccinated. Blinding: Participants and investigators will both be blinded to treatment allocation (double-blind). Discussion We propose to conduct a proof-of-principle placebo-controlled clinical trial of favipiravir plus or minus nitazoxanide in health workers, their household members and patients treated at the Mexican Social Security Institute (IMSS) facilities. Participants with or without symptomatic COVID-19 or who tested positive will be assigned to receive favipiravir plus nitazoxanide or favipiravir plus nitazoxanide placebo. The primary outcome will be the difference in the amount of virus (‘viral load’) in the upper respiratory tract after 5 days of therapy. Secondary outcomes will include hospitalization, major morbidity and mortality, pharmacokinetics, and impact of antiviral therapy on viral genetic mutation rate. If favipiravir with nitazoxanide demonstrates important antiviral effects without significant toxicity, there will be a strong case for a larger trial in people at high risk of hospitalization or intensive care admission, for example older patients and/or those with comorbidities and with early disease. Trial registration ClinicalTrials.gov NCT04918927 . Registered on June 9, 2021.

Abstract Background The generation of induced pluripotent stem cells has opened the field of study for stem cell research, disease modeling and drug development. However, the epigenetic signatures present in somatic cells make cell reprogramming still an inefficient process. This epigenetic memory constitutes an obstacle in cellular reprogramming. Here, we report the effect of hydralazine (HYD) and valproic acid (VPA), two small molecules with proven epigenetic activity, on the expression of pluripotency genes in adult (aHF) and neonatal (nbHF) human fibroblasts. Methods aHF and nbHF were treated with HYD and/or VPA, and viability and gene expression assays for OCT4, NANOG, c-MYC, KLF4, DNMT1, TET3, ARID1A and ARID2 by quantitative PCR were performed. aHF and nbHF were transfected with episomal plasmid bearing Yamanaka factors (OCT4, SOX2, KLF4 and c-MYC) and exposed to HYD and VPA to determine the reprogramming efficiency. Methylation sensitive restriction enzyme (MSRE) qPCR assays were performed on OCT4 and NANOG promoter regions. Immunofluorescence assays were carried out for pluripotency genes on iPSC derived from aHF and nbHF. Results HYD upregulated the expression of OCT4 (2.5-fold) and NANOG (fourfold) genes but not c-Myc or KLF4 in aHF and had no significant effect on the expression of all these genes in nbHF. VPA upregulated the expression of NANOG (twofold) in aHF and c-MYC in nbHF, while it downregulated the expression of NANOG in nbHF. The combination of HYD and VPA canceled the OCT4 and NANOG overexpression induced by HYD in aHF, while it reinforced the effects of VPA on c-Myc expression in nbHF. The HYD-induced overexpression of OCT4 and NANOG in aHDF was not dependent on demethylation of gene promoters, and no changes in the reprogramming efficiency were observed in both cell populations despite the downregulation of epigenetic genes DNMT1, ARID1A, and ARID2 in nbHF. Conclusions Our data provide evidence that HYD regulates the expression of OCT4 and NANOG pluripotency genes as well as ARID1A and ARID2 genes, two members of the SWI/SNF chromatin remodeling complex family, in normal human dermal fibroblasts.

Summary: Background: The Omicron variant has challenged the control of the COVID-19 pandemic due to its immuno-evasive properties. The administration of a booster dose of a SARS-CoV-2 vaccine showed positive effects in the immunogenicity against SARS-CoV-2, effect that is even enhanced after the administration of a second booster. Methods: During a phase-3 clinical trial, we evaluated the effect of a second booster of CoronaVac®, an inactivated vaccine administered 6 months after the first booster, in the neutralization of SARS-CoV-2 (n = 87). In parallel, cellular immunity (n = 45) was analyzed in stimulated peripheral mononuclear cells by flow cytometry and ELISPOT. Findings: Although a 2.5-fold increase in neutralization of the ancestral SARS-CoV-2 was observed after the second booster when compared with prior its administration (Geometric mean units p

Thyroid dysfunction stands as the most prevalent endocrine disorder in individuals with Down syndrome, particularly showcasing both clinical and subclinical hypothyroidism. TSH and FT4 blood values serve as common diagnostic and treatment adjustment markers. In Down syndrome (DS), hormone values may deviate from those observed in the general population, which may lead to overdiagnosis and consequent iatrogenesis of subclinical hypothyroidism. The objective of this study was to analyze the appropriateness of the replacement therapeutic approach by identifying the TSH and FT4 values that can be considered normal in these patients. Methods: A cross-sectional study was conducted in 503 subjects with DS of both sexes and without age limit drawn from the Health Program for individuals with DS in Valencia (Spain) from February 1993 to November 2021. The exclusion criteria included hyperthyroidism, nodules, tumors, or individuals under treatment with drugs influencing iodine metabolism. The normality of data distribution was assessed using the Shapiro–Wilk test. Outliers were detected using the Reed’s criterion. Hormone values were estimated using quantile regression models for the 2.5th and 97.5th percentiles. Results: The normal values identified were 0.88–11.25 mIU/L for TSH and 0.71–1.63 ng/dL for FT4. The Wald test indicated no significant differences in the reference intervals based on age or sex. Conclusion: The establishment of these values, which, in people with DS, can be considered unique, is of great importance, allowing a watchful waiting attitude to be maintained before starting replacement therapy that is unnecessarily or adjusting medication in diagnosed cases.

Introducción: El estudio de las organizaciones, así como los estados psicológicos de sus trabajadores, que influyen en la calidad de los resultados, es un tema central en el orden social y académico. El estudio de la carga psíquica, definido como un estado no específico de deficiencia, que provoca el enfrentamiento del individuo con los síntomas de la disminución del rendimiento, reviste gran importancia en el contexto actual cubano, que rescata el análisis de los posibles riesgos psicosociales que afectan la salud del trabajador, refrendado en las normas 45001 y su relación, con la satisfacción laboral. Objetivos: Determinar la vivencia de carga psíquica y el grado de satisfacción laboral en el personal de la Oficina Central de una Empresa de Servicios. Métodos: El presente estudio se enmarca en el enfoque mixto de investigación y posee un diseño no experimental y transeccional. En cuanto a su alcance es descriptivo – exploratorio. Se aplicaron dos escalas valorativas “Mi trabajo exige de mi” y “Deseo en mi trabajo” y el cuestionario “Mi trabajo y yo”. (Martínez M, Vázquez M, 2004). El procesamiento de los datos fue a través del programa Microsoft Office Excel para Windows. Resultados: Los resultados demuestran que, aunque los sujetos perciben altas exigencias, estas no son generadoras de carga psíquica y la satisfacción laboral es positiva. Conclusiones: Se pudo cumplir con los objetivos, evidenciándose que, a pesar de las altas exigencias, no hay vivencia de carga psíquica y tampoco se afecta la satisfacción laboral Introduction: The study of organizations, as well as the psychological states of their workers, which influence the quality of the results, is a central issue in the social and academic order. The study of the psychic load, defined as a non-specific state of deficiency, which causes the individual to confront the symptoms of decreased performance, is of great importance in the current Cuban context, which rescues the analysis of the possible psychosocial risks that affect the worker's health, endorsed in the 45001 standards and its relationship with job satisfaction. Objectives: To determine the experience of mental burden and the degree of job satisfaction in the staff of the Central Office of a Service Company. Methods: This study is part of the mixed research approach and has a non-experimental and transectional design. As for its scope, it is exploratory descriptive. Two evaluative scales were applied My work demands of me and Desire in my work and the questionnaire My work and I. (Martínez M; Vázquez M, 2004) Data processing was done through the Microsoft Office Excel program for Windows. Results: The results show that, although the subjects perceive high demands, these do not generate psychological load and job satisfaction is positive. Conclusions: The objectives could be met, evidencing that, despite the high demands, there is no experience of psychological burden and job satisfaction is not affected either

Introducción: la simultaneidad de actividades entre las exigencias académicas y el adiestramiento médico durante las residencias provoca un elevado riesgo de desarrollar un desgaste profesional (o síndorme de burnout [sb]) en los médicos residentes. El objetivo fue identificar los factores psicosociales y sociodemográficos asociados al sb en médicos residentes. Materiales y métodos: estudio transversal y correlacional. Participaron 47 médicos residentes de un hospital público. Se aplicaron la Escala de Desgaste Ocupacional (edo), el Inventario Multifásico de la Personalidad Minnesota-2 Forma Reestructurada (mmpi2-rf) y un cuestionario sociodemográfico. Los datos se analizaron mediante la prueba de correlación no paramétrica de Spearman. Resultados: el 25.6 % de los participantes mostró burnout alto, y el 51 %, un agotamiento emocional alto. Respecto a los factores de personalidad y sociodemográficos asociados, solo mostraron relación significativa (p < 0.05) la escala de impulsividad (r = 0.341, p = 0.019) y las horas de ejercicio en la semana (r = −0.414, p = 0.004). Al segmentar por sexo, solo en los hombres del estudio existió una relación entre sb y psicoticismo (r = 0.468, p = 0.018), la disminución de la actividad física (r = −0.620, p = 0.001) y primeros años de residencia (r = −0.396, p = 0.050). Conclusiones: el alto agotamiento emocional de los residentes está asociado con problemas en el manejo de impulsos, distorsiones de la realidad (debido al psicoticismo), pertenecer a los primeros años de residencia y falta de ejercicio físico. Se requiere especial atención a la salud física y mental de[...]

Summary: Background: COVID-19 in paediatric ages could result in hospitalizations and death. In addition, excluding children from vaccination could turn them into reservoirs of the SARS-COV-2. Safe and effective COVID-19 vaccines are urgently needed for large-scale paediatric vaccination. ISMAELILLO study aimed to evaluate safety and immunogenicity of two strengths of a new recombinant receptor-binding domain (RBD) protein vaccine (Abdala) in paediatric population. Methods: A double-blinded, multicentre, randomised, phase 1/2 clinical trial was conducted in nine polyclinics in the province of Camagüey, Cuba. Healthy children and adolescents were stratified according to age (3–11 years old, or 12–18 years old) and they were randomly assigned (1:1; block size four) in two dosage level groups of vaccine to receive three intramuscular doses of 25 μg or 50 μg of RBD, 14 days apart. Main safety endpoint was analyzed as the percentage of serious adverse reactions during vaccination up to 28 days after the third dose (Day 56) in participants who received at least one dose vaccination. The primary immunogenicity endpoint assessed was seroconversion rate of anti-RBD IgG antibody at day 56. The immunogenicity outcomes were assessed in the per-protocol population. This trial is registered with Cuban Public Registry of Clinical Trials, RPCEC00000381. Findings: Between July 15, 2021, and August 16, 2021, 644 paediatric subjects were screened, of whom 592 were enrolled after verifying that they met the selection criteria: firstly 88 were included in Phase 1 of the study and 504 who completed Phase 2. The vaccine was well tolerated. Injection site pain was the most frequently reported local event (143 [8·4%] of 1707 total doses applied), taking place in 66/851 (7·8%) in the 25 μg group and in 77/856 (9·0%) in the 50 μg. The most common systemic adverse event (AE) was headache: 23/851 (2·7%) in the 25 μg group and 19/856 (2·2%) in the 50 μg. Reactogenicity was mild or moderate in severity, represented in 75% of cases by local symptoms, completely resolved in the first 24–48 h. Twenty-eight days after the third dose, seroconversion anti-RBD IgG were observed in 98·2% of the children and adolescents (231/234) for the 50 μg group and 98·7% (224/228) for the 25 μg group without differences between both strength. The specific IgG antibody geometric mean titres (GMT) showed higher titres between participants who received Abdala 50 μg (231·3; 95% CI 222·6–240·4) compared to those who received 25 μg (126·7; 95% CI 121·9–131·7). The mean ACE2 inhibition %, were 59·4% for 25 μg, and for 50 μg, 72·9% (p

Introduction: Aging is considered a physiological process in which a series of changes occur in the health of people over 60 years of age. It is necessary to implement actions aimed at preventing diseases and controlling existing ones. Objective: To evaluate the results of an intervention to improve the state of health in older adults. Methods: Applied research was carried out, descriptive and correlational design, which included a universe of 681 older adults residing in rural parishes of the Chimborazo province. The sample was made up of 243 elderly people. A health intervention was applied during a period of 6 months that included nutritional status, the practice of systematic physical activities and the level of knowledge about healthy habits and lifestyles as variables. The McNemar test was used to identify statistically significant changes in the practice of physical activities. Results: Average age of 65.77 years, predominance of the female sex (63.79%) and with associated comorbidities (81.25%). During the pretest, there was a predominance of older adults who did not perform physical activities (73.66%), with nutritional alterations (39.92% overweight and 19.75% obese) and with a low level of knowledge about health care in the elderly (63.37%). During the posttest all the indicators improved. Conclusions: Improvement of the nutritional status, the level of knowledge and the practice of physical exercises are achieved.

Primary hyperparathyroidism is a disease with multisystemic and heterogeneous manifestations, characterized by underlying high parathormone concentrations. Despite neuropsychiatric involvement being one of the manifestations, psychosis is rare. This is the case of a 68-year-old female with a 10-day clinical course of anorexia, mutism, dysphagia, constipation, and weight loss. The patient had disorganized speech associated with paranoid delusions. Prior to this visit, the patient was recently diagnosed with a mixed anxiety-depressive disorder. For this reason, treatment with antidepressants in combination with atypical antipsychotics was administered without a satisfactory response. Neuroimaging, infectious panel, and toxicology screening showed no abnormal findings. Hypercalcemia secondary to a retropharyngeal ectopic parathyroid adenoma was the causative etiology of her primary hyperparathyroidism, and hypercalcemia treatment resolved the psychotic episode. We highlight the importance of recognizing psychosis as a possible initial presentation of hyperparathyroidism and hypercalcemia. Ruling out organic etiologies prior to diagnosing a primary cause of psychosis is crucial, as their treatment can reverse the psychotic symptoms.

(1) Background/Objectives: Accurate determination of chronological age is crucial in legal dental identification. This study aimed to compare the effectiveness of different formulas in estimating the age of a Brazilian subpopulation by analyzing the pulp/tooth ratio of the maxillary canine and mandibular second premolar in panoramic and periapical radiographs. (2) Methods: The sample consisted of panoramic and periapical radiographs of 247 individuals. The file of each radiograph was opened in the Adobe Photoshop CS4® program to outline and obtain values in pixels for calculating the pulp/tooth ratio. Statistical analysis was conducted using the SPSS program, with a significance level set at 5%. (3) Results: The interclass correlation coefficient demonstrated excellent intra-observer agreement (0.990–0.999). The determination coefficients (R2) suggested that only 30–35% of the actual age results could be explained by the pulp/tooth ratio. The smallest differences were observed with Cameriere’s formula for the mandibular second premolar on panoramic radiographs (+4.1 years). The greatest differences were found with the formulas for the mandibular second premolar in panoramic radiographs of the Korean (+12.5 years) and Portuguese (−12.1 years) populations. (4) Conclusions: The equations employed showed little agreement between the actual age and the estimated age.

In this paper, a novel strategy to perform high-dimensional feature selection using an evolutionary algorithm for the automatic classification of coronary stenosis is introduced. The method involves a feature extraction stage to form a bank of 473 features considering different types such as intensity, texture and shape. The feature selection task is carried out on a high-dimensional feature bank, where the search space is denoted by O(2n) and n=473. The proposed evolutionary search strategy was compared in terms of the Jaccard coefficient and accuracy classification with different state-of-the-art methods. The highest feature selection rate, along with the best classification performance, was obtained with a subset of four features, representing a 99% discrimination rate. In the last stage, the feature subset was used as input to train a support vector machine using an independent testing set. The classification of coronary stenosis cases involves a binary classification type by considering positive and negative classes. The highest classification performance was obtained with the four-feature subset in terms of accuracy (0.86) and Jaccard coefficient (0.75) metrics. In addition, a second dataset containing 2788 instances was formed from a public image database, obtaining an accuracy of 0.89 and a Jaccard Coefficient of 0.80. Finally, based on the performance achieved with the four-feature subset, they can be suitable for use in a clinical decision support system.