Título del artículo:

Acute coronary syndromes following COVID-19 vaccine application: Kounis syndrome or chance?

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Annals of Medicine and Surgery

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Aminothiazole Ligand-Type Dioxo-Mo(VI) Complex Anchored on TiO2 Nanotubes for Selective Oxidation of Monoterpenes with Light and O2

Selective Oxygen Atom Transfer to α-pinene, β-pinene, (R)-limonene and camphene by dioxo-Mo(VI)Ln complex {Ln = 2-aminothiazole-4-carboxylic acid} anchored on TiO2 nanotubes (TiO2-NT) using O2 as oxidant and UV light was studied at ambient conditions. The Catalytic system was characterized by FTIR, 1H NMR and 13C, and elemental analysis. Molecular oxygen reoxidizes the (Mo(IV)=O) reduced unit in the darkness, forming an oxo-peroxo-Mo intermediate. The catalyst under UV radiation transfers two oxygen atoms to the olefin. The α-pinene is found to be the most reactive monoterpene. Graphical Abstract: [Figure not available: see fulltext.]

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Topics in Catalysis

Título del artículo:

Association of Sitting Time with Mortality and Cardiovascular Events in High-Income, Middle-Income, and Low-Income Countries

Importance: High amounts of sitting time are associated with increased risks of cardiovascular disease (CVD) and mortality in high-income countries, but it is unknown whether risks also increase in low- and middle-income countries. Objective: To investigate the association of sitting time with mortality and major CVD in countries at different economic levels using data from the Prospective Urban Rural Epidemiology study. Design, Setting, and Participants: This population-based cohort study included participants aged 35 to 70 years recruited from January 1, 2003, and followed up until August 31, 2021, in 21 high-income, middle-income, and low-income countries with a median follow-up of 11.1 years. Exposures: Daily sitting time measured using the International Physical Activity Questionnaire. Main Outcomes and Measures: The composite of all-cause mortality and major CVD (defined as cardiovascular death, myocardial infarction, stroke, or heart failure). Results: Of 105677 participants, 61925 (58.6%) were women, and the mean (SD) age was 50.4 (9.6) years. During a median follow-up of 11.1 (IQR, 8.6-12.2) years, 6233 deaths and 5696 major cardiovascular events (2349 myocardial infarctions, 2966 strokes, 671 heart failure, and 1792 cardiovascular deaths) were documented. Compared with the reference group (<4 hours per day of sitting), higher sitting time (≥8 hours per day) was associated with an increased risk of the composite outcome (hazard ratio [HR], 1.19; 95% CI, 1.11-1.28; Pfor trend <.001), all-cause mortality (HR, 1.20; 95% CI, 1.10-1.31; Pfor trend <.001), and major CVD (HR, 1.21; 95% CI, 1.10-1.34; Pfor trend <.001). When stratified by country income levels, the association of sitting time with the composite outcome was stronger in low-income and lower-middle-income countries (≥8 hours per day: HR, 1.29; 95% CI, 1.16-1.44) compared with high-income and upper-middle-income countries (HR, 1.08; 95% CI, 0.98-1.19; P for interaction =.02). Compared with those who reported sitting time less than 4 hours per day and high physical activity level, participants who sat for 8 or more hours per day experienced a 17% to 50% higher associated risk of the composite outcome across physical activity levels; and the risk was attenuated along with increased physical activity levels. Conclusions and Relevance: High amounts of sitting time were associated with increased risk of all-cause mortality and CVD in economically diverse settings, especially in low-income and lower-middle-income countries. Reducing sedentary time along with increasing physical activity might be an important strategy for easing the global burden of premature deaths and CVD.

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JAMA Cardiology

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Current and Future Frontiers of Molecularly Defined Oligodendrogliomas

Oligodendrogliomas are a subtype of adult diffuse glioma characterized by their better responsiveness to systemic chemotherapy than other high-grade glial tumors. The World Health Organization (WHO) 2021 brain tumor classification highlighted defining molecular markers, including 1p19q codeletion and IDH mutations which have become key in diagnosing and treating oligodendrogliomas. The management for patients with oligodendrogliomas includes observation or surgical resection potentially followed by radiation and chemotherapy with PCV (Procarbazine, Lomustine, and Vincristine) or Temozolomide. However, most of the available research about oligodendrogliomas includes a mix of histologically and molecularly diagnosed tumors. Even data driving our current management guidelines are based on post-hoc subgroup analyses of the 1p19q codeleted population in landmark prospective trials. Therefore, the optimal treatment paradigm for molecularly defined oligodendrogliomas is incompletely understood. Many questions remain open, such as the optimal timing of radiation and chemotherapy, the response to different chemotherapeutic agents, or what genetic factors influence responsiveness to these agents. Ultimately, oligodendrogliomas are still incurable and new therapies, such as targeting IDH mutations, are necessary. In this opinion piece, we present relevant literature in the field, discuss current challenges, and propose some studies that we think are necessary to answer these critical questions.

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Frontiers in Oncology

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A model of metformin mitochondrial metabolism in metachromatic leukodystrophy: first description of human Schwann cells transfected with CRISPR-Cas9

Metachromatic leukodystrophy is a neurological lysosomal deposit disease that affects public health despite its low incidence in the population. Currently, few reports are available on pathophysiological events related to enzyme deficiencies and subsequent sulfatide accumulation. This research aims to examine the use of metformin as an alternative treatment to counteract these effects. This was evaluated in human Schwann cells (HSCs) transfected or non-transfected with CRISPR-Cas9, and later treated with sulfatides and metformin. This resulted in transfected HSCs showing a significant increase in cell reactive oxygen species (ROS) production when exposed to 100 μM sulfatides (p = 0.0007), compared to non-transfected HSCs. Sulfatides at concentrations of 10 to 100 μM affected mitochondrial bioenergetics in transfected HSCs. Moreover, these analyses showed that transfected cells showed a decrease in basal and maximal respiration rates after exposure to 100 μM sulfatide. However, maximal and normal mitochondrial respiratory capacity decreased in cells treated with both sulfatide and metformin. This study has provided valuable insights into bioenergetic and mitochondrial effects of sulfatides in HSCs for the first time. Treatment with metformin (500 μM) restored the metabolic activity of these cells and decreased ROS production.

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Open Biology

Título del artículo:

Psychological effects associated with preventive isolation by COVID-19 in early childhood in Colombia

Background: There are enough documented records worldwide to date on the number ofinfections and deaths from the COVID-19 pandemic, and it is foreseeable that there will be a worsening of psychological health in the entire population, however, there are few studies that have addressed the emotional and psychological effects that preventive isolation has caused in Colombia in early childhood so the objective of this study was to know these effects through a survey carried out with caregivers of children in Colombia from different social strata. M ethod: Cross-sectional, descriptive, and quantitative study that included 1 006 surveys conducted in the last quarter of 2020. Results: The study mainly showed three psychological dimensions that impacted early childhood in Colombia during social isolation due to COVID-19: changes in an emotional state, behavior problems, and results of difficulties associated with sleep. Conclusions: Our results shed light on the specific groups with a higher risk of emotional and psychological difficulties due to a state of preventive confinement. These results suggest the strengthening of affective relationships at home and psychosocial support by qualified personnel for the good integral development of early childhood.

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Gaceta Medica de Caracas

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Ebstein\'s anomaly in newborn

Introduction: Ebstein\'s anomaly is a rare malformation with mild to severe respiratory symptomatic presentation due to congenital heart defects manifested during childhood. Objective: To present the case in which the timely diagnosis of this disease allowed the comprehensive treatment of the patient. Case presentation: Full-term newborn, who at seven hours of birth presented decreased oxygen saturation, physical examination without cyanosis, pansystolic murmur in auscultation and cardiomegaly detected by chest X-rays. An echocardiogram was performed to diagnose the baby as a carrier of Ebstein\'s disease with mild manifestations. Once he had clinical improvement, he was discharged with an indication for assessment by pediatric cardiology. Conclusions: Ebstein\'s anomaly may begin in the neonatal period with symptoms of variable severity. Clinical suspicion allows for diagnostic confirmation and close follow-up, especially in severe cases.

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Revista Cubana de Pediatria

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Isolated Escherichia coli resistance genes in broiler chicken

Poultry production due to consumer demand has increased annually, which leads to the use of additives such as antibiotics to favor rearing conditions, this increases the deficiency in the composition of production animals\' intestinal microbiota and can generate microbiological and genetic changes; this microbiota can reach humans through food chain, generating a possible horizontal transfer of genes that encode resistance to antibiotics. The objective was to identify resistance profiles and the genes that encode it. Materials and methods: From 200 chickens, 35 strains of Escherichia coli with extended spectrum beta-lactamase resistance phenotype were isolated from healthy broilers, from production farms in Santander (Colombia). 83 % of the AmpC gene, 86 % of the blaCTXM gene, 54 % of the blaSHV gene and 57 % of the blaTEM gene were identified. Regarding the genes that code for resistance to quinolones, 94 % of the qnrB gene, 9 % of the qnrC gene and 0 % of the qnrA gene were identified. The coexistence of the genes that encode for resistance to antibiotics is a serious problem that requires vigilance, in view of this; control strategies must be generated to avoid the spread through the food chain, as well as strategies for the control of the use of antibiotics in the production.

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Revista Mexicana De Ciencias Pecuarias

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Efficacy and Safety of Vagus Nerve Stimulation on Upper Limb Motor Recovery After Stroke. A Systematic Review and Meta-Analysis

Background: Upper limb motor impairment is one of the main complications of stroke, affecting quality of life both for the patient and their family. The aim of this systematic review was to summarize the scientific evidence on the safety and efficacy of Vagus Nerve Stimulation (VNS) on upper limb motor recovery after stroke. Methods: A systematic review and meta-analysis of studies that have evaluated the efficacy or safety of VNS in stroke patients was performed. The primary outcome was upper limb motor recovery. A search of articles published on MEDLINE, CENTRAL, EBSCO and LILACS up to December 2021 was performed, and a meta-analysis was developed to calculate the overall effects. Results: Eight studies evaluating VNS effects on motor function in stroke patients were included, of which 4 used implanted and 4 transcutaneous VNS. It was demonstrated that VNS, together with physical rehabilitation, increased upper limb motor function on average 7.06 points (95%CI 4.96; 9.16) as assessed by the Fugl-Meyer scale. Likewise, this improvement was significantly greater when compared to a control intervention (mean difference 2.48, 95%CI 0.98; 3.98). No deaths or serious adverse events related to the intervention were reported. The most frequent adverse events were dysphonia, dysphagia, nausea, skin redness, dysgeusia and pain related to device implantation. Conclusion: VNS, together with physical rehabilitation, improves upper limb motor function in stroke patients. Additionally, VNS is a safe intervention.

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Frontiers in Neurology

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Ethnic Differences in the Prevalence of Hypertension in Colombia: Association With Education Level

BACKGROUND: A higher prevalence of hypertension is reported among Afro-descendants compared with other ethnic groups in high-income countries; however, there is a paucity of information in low- and medium-income countries. METHODS: We evaluated 3,745 adults from 3 ethnic groups (552 White, 2,746 Mestizos, 447 Afro-descendants) enrolled in the prospective population-based cohort study (PURE) - Colombia. We assessed associations between anthropometric, socioeconomic, behavioral factors, and hypertension. RESULTS: The overall prevalence of hypertension was 39.2% and was higher in Afro-descendants (46.3%) than in Mestizos (37.6%) and Whites (41.5%), differences that were due to the higher prevalence in Afro-descendant women. Hypertension was associated with older age, increased body mass index, waist circumference and waist-to-hip ratio, independent of ethnicity. Low education was associated with hypertension in all ethnic groups, and particularly in Afro-descendants, for whom it was the factor with the strongest association with prevalence. Notably, 70% of Afro-descendants had a low level of education, compared with 52% of Whites - 26% of Whites were university graduates while only 7% of Afro-descendants were. We did not find that education level alone had a mediator effect, suggesting that it is not a causal risk factor for hypertension but is an indicator of socioeconomic status, itself an important determinant of hypertension prevalence. CONCLUSIONS: We found that a higher prevalence of hypertension in Colombian Afro-descendants than other ethnic groups. This was principally associated with their lower mean educational level, an indicator of lower socioeconomic status.

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American Journal of Hypertension

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Multilocus Sequence Typing helps understand the genetic diversity of Cryptosporidium hominis and Cryptosporidium parvum isolated from Colombian patients

Multilocus Sequence Typing has become a useful tool for the study of the genetic diversity and population structure of different organisms. In this study, a MLST approach with seven loci (CP47, MS5, MS9, MSC6-7, TP14, and gp60) was used to analyze the genetic diversity of Cryptosporidium hominis and Cryptosporidium parvum isolated from 28 Colombian patients. Five Cryptosporidium species were identified: C. hominis, C. parvum, Cryptosporidium felis, Cryptosporidium meleagridis, and Cryptosporidium suis. Unilocus gp60 analysis identified four allelic families for C. hominis (Ia, Ib, Id, and Ie) and two for C. parvum (IIa and IIc). There was polymorphic behavior of all markers evaluated for both C. hominis and C. parvum, particularly with the CP47, MS5, and gp60 markers. Phylogenetic analysis with consensus sequences (CS) of the markers showed a taxonomic agreement with the results obtained with the 18S rRNA and gp60 gene. Additionally, two monophyletic clades that clustered the species C. hominis and C. parvum were detected, with a higher number of subclades within the monophyletic groups compared to those with the gp60 gene. Thirteen MLG were identified for C. hominis and eight for C. parvum. Haplotypic and nucleotide diversity were detected, but only the latter was affected by the gp60 exclusion from the CS analysis. The gene fixation index showed an evolutionary closeness between the C. hominis samples and a less evolutionary closeness and greater sequence divergence in the C. parvum samples. Data obtained in this work support the implementation of MLST analysis in the study of the genetic diversity of Cryptosporidium, considering the more detailed information that it provides, which may explain some genetic events that with an unilocus approach could not be established. This is the first multilocus analysis of the intra-specific variability of Cryptosporidium from humans in South America.

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PLoS ONE

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Effects of Polybrominated Diphenyl Ethers on Hormonal and Reproductive Health in E-Waste-Exposed Population: A Systematic Review

Electronic waste management is a global rising concern that is primarily being handled by informal recycling practices. These release a mix of potentially hazardous chemicals, which is an important public health concern. These chemicals include polybrominated diphenyl ethers (PBDEs), used as flame retardants in electronic parts, which are persistent in nature and show bioaccumulative characteristics. Although PBDEs are suspected endocrine disruptors, particularly targeting thyroid and reproductive hormone functions, the relationship of PBDEs with these health effects are not well established. We used the Navigation Guide methodology to conduct a systematic review of studies in populations exposed to e-waste to better understand the relationships of these persistent flame retardants with hormonal and reproductive health. We assessed nineteen studies that fit our pre-determined inclusion criteria for risk of bias, indirectness, inconsistency, imprecision, and other criteria that helped rate the overall evidence for its quality and strength of evidence. The studies suggest PBDEs may have an adverse effect on thyroid hormones, reproductive hormones, semen quality, and neonatal health. However, more research is required to establish a relationship of these effects in the e-waste-exposed population. We identified the limitations of the data available and made recommendations for future scientific work.

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International Journal of Environmental Research and Public Health

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Return to sport and beyond following intramuscular tendon hamstring injury: A case report of an English Premier League football player

Background: Hamstring strain injuries are the most common type of injury in elite football and are associated with a high risk of reinjury, particularly those involving the intramuscular tendon (IMT). Limited information is available regarding the rehabilitation and return to sport (RTS) processes following such injuries. This case study describes the clinical presentation of an elite football player following IMT hamstring injury, their on- and off-pitch rehabilitation alongside performance monitoring throughout RTS and beyond. Case scenario: An elite football player suffered a grade 2c hamstring injury during an English Premier League (EPL) match. The player underwent early post-injury management, alongside progressive off-pitch physical preparation. The ‘control-chaos continuum’ was used as a framework for on-pitch rehabilitation to prepare the player for a return to full team training and competition. Objective and subjective markers of the player\'s response to progressive on- and off-pitch loading were monitored throughout RTS and beyond. Outcomes: The player returned to on-pitch rehabilitation after 11 days, to full team training having achieved weekly pre-injury chronic running load outputs after 35 days and played in the EPL 40 days post-injury. The player did not suffer reinjury for the rest of the EPL season. Conclusion: An understanding the unique structural and mechanical properties of the IMT, alongside expected RTS timeframes are important to inform rehabilitation and decision-making processes post-injury. Performance and frequent load-response monitoring throughout RTS and beyond, in conjunction with practitioner experience and effective communication are critical in facilitating effective RTS and reduce risk of reinjury following IMT injury.

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Physical Therapy in Sport

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Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine–Immune Therapeutic Mechanisms and Clinical Implications

Electroconvulsive therapy (ECT) is based on conducting an electrical current through the brain to stimulate it and trigger generalized convulsion activity with therapeutic ends. Due to the efficient use of ECT during the last years, interest in the molecular bases involved in its mechanism of action has increased. Therefore, different hypotheses have emerged. In this context, the goal of this review is to describe the neurobiological, endocrine, and immune mechanisms involved in ECT and to detail its clinical efficacy in different psychiatric pathologies. This is a narrative review in which an extensive literature search was performed on the Scopus, Embase, PubMed, ISI Web of Science, and Google Scholar databases from inception to February 2022. The terms “electroconvulsive therapy”, “neurobiological effects of electroconvulsive therapy”, “molecular mechanisms in electroconvulsive therapy”, and “psychiatric disorders” were among the keywords used in the search. The mechanisms of action of ECT include neurobiological function modifications and endocrine and immune changes that take place after ECT. Among these, the decrease in neural network hyperconnectivity, neuroinflammation reduction, neurogenesis promotion, modulation of different monoaminergic systems, and hypothalamus–hypophysis–adrenal and hypothalamus– hypophysis–thyroid axes normalization have been described. The majority of these elements are physiopathological components and therapeutic targets in different mental illnesses. Likewise, the use of ECT has recently expanded, with evidence of its use for other pathologies, such as Parkinson’s disease psychosis, malignant neuroleptic syndrome, post-traumatic stress disorder, and obsessive– compulsive disorder. In conclusion, there is sufficient evidence to support the efficacy of ECT in the treatment of different psychiatric disorders, potentially through immune, endocrine, and neurobiological systems.

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International Journal of Molecular Sciences

Título del artículo:

Immunomodulatory effect of a very-low-calorie ketogenic diet compared with bariatric surgery and a low-calorie diet in patients with excessive body weight

Background & aim: Inflammation and oxidative stress are the most probable mechanistic link between obesity and its co-diseases with cancer among them. The aim of this study was to evaluate whether the nutritional ketosis and weight loss induced by a very-low-calorie ketogenic diet (VLCKD) modulates the inflammatory and oxidative stress profile, compared with a standard, balanced hypocaloric diet (LCD) or bariatric surgery (BS) in patients with obesity. Methods: The study was performed in 79 patients with overweight or obesity and 32 normal-weight volunteers as the control group. Patients with obesity underwent a weight reduction therapy based on VLCKD, LCD or BS. The quantification of the circulating levels of a multiplexing test of cytokines and carcinogenesis/aging biomarkers, as well as of lipid peroxides and total antioxidant power, was carried out. Results: First, we observed that pro-inflammatory cytokines increase, while anti-inflammatory cytokines decrease under excessive body weight. Relevantly, when patients underwent weight loss strategies, it was shown that energy-restricted and surgical strategies of weight loss induced changes in circulating cytokine and lipid peroxides. This effect was more notable in patients following the VLCKD than the LCD or BS and it was observed mainly in the ketosis phase of the intervention. Particularly, IL-11, IL-12, IL-2, INF-γ, INF-β, Pentraxin-3 or MMP1 changed after VLCKD. Whereas, APRIL, TWEAK, osteocalcin and IL-28A increased after BS. Conclusion: As far as we know, this is the first study that evaluate the time-course of cytokines and oxidative stress markers after a VLCKD as compared with a standard LCD and BS. The observed results support the immunomodulatory effect of nutritional ketosis induced by a VLCKD synergistically with weight loss as a strategy to improve innate-immunity and to prevent infections and carcinogenesis in patients with obesity.

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Clinical Nutrition

Título del artículo:

Systematic review and meta-analysis of risk factors for Mesh infection following Abdominal Wall Hernia Repair Surgery

Background: Surgical Mesh Infection (SMI) after Abdominal Wall Hernia Repair (AWHR) represents a catastrophic complication. We performed a systematic review and meta-analysis to analyze the risk factors for SMI in the context of AWHR. Methods: PubMed, Embase, Scielo, and LILACS were searched without language or time restrictions from inception until June 2021. Articles evaluating the association between demographic, clinical, laboratory and surgical characteristics with SMI in AWHR were included. Results: 23 studies were evaluated, comprising a total of 118,790 patients (98% males; mean age 56.5 years) with a mesh infection pooled prevalence of 4%. Significant risk factors for SMI were type 2 diabetes mellitus, obesity, smoking history, steroids use, ASA III/IV, laparotomy vs laparoscopy, emergency surgery, duration of surgery and onlay mesh position vs sublay. The quality of evidence was regarded as very low–moderate. Conclusion: Several factors, highlighting sociodemographic characteristics, comorbidities, and the clinical scenario, may increase the risk of developing mesh infections in AWHR. The recognition and mitigation of these may significantly reduce mesh infection rates in this context.

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American Journal of Surgery

Título del artículo:

Nanosensors in clinical development of CAR-T cell immunotherapy

Immunotherapy using CAR-T cells is a new technological paradigm for cancer treatment. To avoid severe side effects and tumor escape variants observed for conventional CAR-T cells approach, adaptor CAR technologies are under development, where intermediate target modules redirect immune cells against cancer. In this work, silicon nanowire field-effect transistors are used to develop target modules for an optimized CAR-T cell operation. Focusing on a library of seven variants of E5B9 peptide that is used as CAR targeting epitope, we performed multiplexed binding tests using nanosensor chips. These peptides had been immobilized onto the sensor to compare the transistor signals upon titration with anti-La 5B9 antibodies. The correlation of binding affinities and sensor sensitivities enabled a selection of candidates for the interaction between CAR and target modules. An extremely low detection limit was observed for the sensor, down to femtomolar concentration, outperforming the current assay of the same purpose. Finally, the CAR T-cells redirection capability of selected peptides in target modules was proven successful in an in-vitro cytotoxicity assay. Our results open the perspective for the nanosensors to go beyond the early diagnostics in clinical cancer research towards developing and monitoring immunotherapeutic treatment, where the quantitative analysis with the standard techniques is limited.

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Biosensors and Bioelectronics

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WORK-BASED ISOMETRIC EXERCISES EFFECT ON BLOOD PRESSURE: THE EEFIT STUDY

OBJECTIVE: To evaluate the effect of two workplace isometric exercise interventions on blood pressure in hypertensive adults. DESIGN AND METHOD: A randomized controlled multicenter clinical trial conducted in hypertensive (>130 mmHg systolic blood pressure (SBP)) 35 to 65 years old in work places in Colombia. Participants were assigned to either of two interventions: isometric handgrip dynamometer training at 30% of maximum strength (HGD) or wall squat (WS), or to a control group following standard recommendations. The interventions were performed at the participant\'s workplace and consisted of 4 sets of 2 minutes of sustained isometric contraction with 2 minutes\' rest between sets, 3 times per week for 12 weeks. SBP and diastolic blood pressure (DBP) were measured using an automatic device (Omron) with a standardized protocol before and after the 12-week intervention. RESULTS: Pre and post measurements were completed by 105 hypertensive participants: mean age of 45 years (SD 9.5), 63.8% of which were men. In the HGD group (n = 38) there were significant decreases in SBP [Pre: 141 mmHg (SD 7.8), Post: 127 mmHg (SD 9.1) (p < 0.001)], and in DBP [Pre: 87 mmHg (SD 5.8), Post: 82 mmHg (SD 9.5) (p < 0.001)]. There were also significant decreases in the WS-group (n = 35) in SBP [Pre: 139 mmHg (SD 7.5), Post: 126 mmHg (SD 12.4) (p < 0.001)], and in DBP [Pre: 86 mmHg (SD 5.2), Post 82 mmHg (SD 8.1) (p < 0.001)]. In the control group (n = 32), there were no significant changes in either in SBP [Pre: 140 mmHg (SD 8.4), Post: 137 mmHg (SD 12.9)], or DBP [Pre: 86 mmHg (SD 5.0), Post: 85 mmHg (SD 8.0) (p = 0.71)]. CONCLUSIONS: Both workplace isometric training interventions resulted in significant and clinically relevant reductions in blood pressure in subjects with high blood pressure. The combination of effectiveness, modest time commitment (42 minutes per week) and ease with which the interventions can be implemented in the workplace setting makes them both attractive and practical options with minimal barriers for participation. Furthermore, WS can be performed without any equipment.

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Journal of hypertension

Título del artículo:

Impact of an educational intervention on the self-care agency among Nursing students

Objective: to determine the impact of an educational intervention through Problem-Based Learning (PBL) and based on Orem’s Self-Care Theory on the self-care agency in Nursing students from two Colombian universities. Method: a multicentre quasi-experimental before-and-after study conducted on 2019. The population included the 56 students of the first Nursing semester from two Colombian universities. The “Hacia el cuidado de la vida” (“Towards Life Care”) intervention was conducted, with 12 two-hour sessions during 13 weeks on mental and spiritual self-care, healthy lifestyles, body self-care and social self-care through PBL. Sociodemographic and academic variables were measured, as well as consumer habits. The Self-Care Agency was measured at baseline (B) and at the last session (P) through the ASA-B scale (very low: 1-24, low: 25-48, good: 49-72 or very good: 73-96scores). Descriptive andbivariate statistics were applied. Results: forty (40) persons completed the study; 82.1% were female, with 18 years as median age. The overall score in the ASA-B scale was increased overall in a statistically significant way [B: X= 71.1 (SD= 0.73)andP: X= 75.6 (SD= 1.07); p< 0.001] and in 18-to-20-year old single women, with a score of 11 in knowledge test in first or second quartile, past history of using alcohol or energy drinks (p< 0.05). There was no variation in score in terms of affiliation to sport teams, student federations or religious groups. Conclusion: the educational intervention based on the self-care theory and PBL applied to students in their first Nursing semester improved their self-care agency.

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Metas de Enfermeria

Título del artículo:

Effect­of­corpus­luteum­irrigation­assessed­by­Doppler­ultrasound­on­the­gestation­percentage­of­embryo recipient­Holstein­cows

The luteal vasculature plays a critical role in corpus luteum (CL) function and provides important information on the physiology and pathophysiology of this structure. To quantify the blood flow of the luteal tissue, Doppler ultrasound is used to detect the flow of red blood cells through the blood vessels. The objective of the present study was to determine the degree of irrigation of the CL evaluated by Doppler ultrasound on the day (D0) of embryo transfer (ET) and 25 days post-transfer and its relationship with the percentage of early gestation in Holstein recipient cows. Thirty multiparous, non-lactating Holstein cows were used as in vitro embryo recipients. The blood supply rate of the CL and the percentage of gestation were evaluated. The corpora lutea were categorized into 1 (high), 2 (medium) and 3 (low) according to the degree of blood supply. The percentage of cows with these degrees of CL irrigation on the day of transfer were 50% (15/30), 23.3% (7/30) and 27.7% (8/30). On day 25 post-transfer they were 33.3% (10/30), 43.3% (13/30) and 23.3% (7/30), respectively. Additionally, the percentage of early gestation (25 days post-transfer) was evaluated for grades 1, 2 and 3 of CL blood supply, whose results were: 20% (6/30), 6.6% (2/30) and 0%, respectively. It was possible to conclude that the Holstein breed recipients classified in high degree of CL blood irrigation, presented better (P < 0.05) percentage of gestation of embryos of in vitro origin.

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Taurus

Título del artículo:

Exploring the Evolution of the Topics and Research Fields of Territorial Development from a Comprehensive Bibliometric Analysis

Countries with great deficiencies in development, research, and innovation are investing resources to advance in this aspect; meanwhile, it is necessary to advance in initiatives that promote local development, through the correct use and management of endogenous territorial capacities to achieve economic, social, and environmental development, and this is where the territorial development approach has intervened during the last decades. To obtain an understanding of the evolution of the research field on territorial development, a study of research topics and groups of research topics is implemented from subscription-based data sources (Scopus, Science direct, Ebsco, and Web of Science) and open access (Lens and Dimension platforms). Keyword co-occurrence techniques were implemented, and indicators of link strength and density-centrality of clusters were used to abstract patterns of change within the field of study. The evolution of the area, trends, and issues related to territorial development are identified in the different databases, mapping a discipline that still lacks comparative publications between research results at different scales.

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Sustainability (Switzerland)

Título del artículo:

Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

Hernia repair is one of the most frequent interventions in surgery worldwide. The approach to abdominal wall and inguinal hernias remains a challenge due to emerging evidence on aspects such as timely diagnosis, use of innovative techniques or post-surgical care. However, pre-operative preparation is also a factor that substantially affects the absolute success rate of this type of condition. Time management between diagnosis and intervention, control of diseases that increase intra-abdominal pressure, weight and nutritional status, are some of the many elements to be considered in this type of patients before surgery. Considering that this condition carries high health care costs, especially in case of recurrence, has a risk of complications and affects the individual\'s functional capacity, the objective of this review is to synthesize evidence on the role of these factors on the short- and long-term outcome of inguinal hernia management, and to make suggestions on the general approach to this type of patients.

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Annals of Medicine and Surgery

Título del artículo:

Sensitivity and efficiency of RNA sample pooling for real-time quantitative polymerase chain reaction testing for SARS-CoV-2

Background: In spite of the worth of pool testing in public health, data on the sensitivity and efficiency of real-time quantitative polymerase chain reaction (RT-qPCR) pool testing for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in middle and low-income countries are limited. Methods: We mixed single specimens of extracted RNA positive for the SARS-CoV-2 envelope (E) gene by RT-qPCR with negative specimens, in pools of 4 (n=89), 8 (n=92), 16 (n=102), and 32 (n=105) specimens each. We estimated the average change in cycle threshold (Ct) for each pool size and added it to the Ct values of the first 1,350 tests in our lab, to obtain dilution-corrected Ct values. We estimated pool sensitivity as the proportion of samples with dilution-corrected Ct >40, and used it in simulations of the efficiency (tests used/true case detected) of binary split pool testing. Results: We tested 388 pools. Average Ct changes were 2.21, 2.51, 3.27, and 3.94 cycles, for pools of 4, 8, 16, and 32 specimens, respectively. Corresponding pool tests sensitivities were 91.1%, 89.6%, 85.8% and 82.5%. Pool testing was substantially more efficient than individual testing. For prevalence of 0.5% to 2.0%, the efficiency of pools of ≥8 specimens was 30% to 280% higher, and the number of people tested was 4.4 to 13.9 times higher than those of individual testing. Conclusions: Binary split pool testing substantially increases the number of people tested and the number of true cases detected per test used. This strategy is key to curtail the transmission of SARS-CoV-2, by increasing efficiency in the identification and isolation of symptomatic and asymptomatic infected individuals.

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Journal of Public Health and Emergency

Título del artículo:

The Anti-Coronavirus Therapies (ACT) Trials: Design, Baseline Characteristics, and Challenges

Background: Effective treatments for COVID-19 are urgently needed, but conducting randomized trials during the pandemic has been challenging. Methods: The Anti-Coronavirus Therapy (ACT) trials are parallel factorial international trials that aimed to enroll 3500 outpatients and 2500 inpatients with symptomatic COVID-19. The outpatient trial is evaluating colchicine vs usual care, and aspirin vs usual care. The primary outcome for the colchicine randomization is hospitalization or death, and for the aspirin randomization, it is major thrombosis, hospitalization, or death. The inpatient trial is evaluating colchicine vs usual care, and the combination of rivaroxaban 2.5 mg twice daily and aspirin 100 mg once daily vs usual care. The primary outcome for the colchicine randomization is need for high-flow oxygen, need for mechanical ventilation, or death, and for the rivaroxaban plus aspirin randomization, it is major thrombotic events, need for high-flow oxygen, need for mechanical ventilation, or death. Results: At the completion of enrollment on February 10, 2022, the outpatient trial had enrolled 3917 patients, and the inpatient trial had enrolled 2611 patients. Challenges encountered included lack of preliminary data about the interventions under evaluation, uncertainties related to the expected event rates, delays in regulatory and ethics approvals, and in obtaining study interventions, as well as the changing pattern of the COVID-19 pandemic. Conclusions: The ACT trials will determine the efficacy of anti-inflammatory therapy with colchicine, and antithrombotic therapy with aspirin given alone or in combination with rivaroxaban, across the spectrum of mild, moderate, and severe COVID-19. Lessons learned from the conduct of these trials will inform planning of future trials.

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CJC Open

Título del artículo:

IDH–wild-type glioblastoma cell density and infiltration distribution influence on supramarginal resection and its impact on overall survival: a mathematical model

OBJECTIVE Recent studies have proposed resection of the T2 FLAIR hyperintensity beyond the T1 contrast enhancement (supramarginal resection [SMR]) for IDH–wild-type glioblastoma (GBM) to further improve patients’ overall survival (OS). GBMs have significant variability in tumor cell density, distribution, and infiltration. Advanced mathematical models based on patient-specific radiographic features have provided new insights into GBM growth kinetics on two important parameters of tumor aggressiveness: proliferation rate (ρ) and diffusion rate (D). The aim of this study was to investigate OS of patients with IDH–wild-type GBM who underwent SMR based on a mathematical model of cell distribution and infiltration profile (tumor invasiveness profile). METHODS Volumetric measurements were obtained from the selected regions of interest from pre- and postoperative MRI studies of included patients. The tumor invasiveness profile (proliferation/diffusion [ρ/D] ratio) was calculated using the following formula: ρ/D ratio = (4π/3)2/3 × (6.106/[VT21/3 − VT11/3])2, where VT2 and VT1 are the preoperative FLAIR and contrast-enhancing volumes, respectively. Patients were split into subgroups based on their tumor invasiveness profiles. In this analysis, tumors were classified as nodular, moderately diffuse, or highly diffuse. RESULTS A total of 101 patients were included. Tumors were classified as nodular (n = 34), moderately diffuse (n = 34), and highly diffuse (n = 33). On multivariate analysis, increasing SMR had a significant positive correlation with OS for moderately and highly diffuse tumors (HR 0.99, 95% CI 0.98–0.99; p = 0.02; and HR 0.98, 95% CI 0.96–0.99; p = 0.04, respectively). On threshold analysis, OS benefit was seen with SMR from 10% to 29%, 10% to 59%, and 30% to 90%, for nodular, moderately diffuse, and highly diffuse, respectively. CONCLUSIONS The impact of SMR on OS for patients with IDH–wild-type GBM is influenced by the degree of tumor invasiveness. The authors’ results show that increasing SMR is associated with increased OS in patients with moderate and highly diffuse IDH–wild-type GBMs. When grouping SMR into 10% intervals, this benefit was seen for all tumor subgroups, although for nodular tumors, the maximum beneficial SMR percentage was considerably lower than in moderate and highly diffuse tumors.

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Journal of Neurosurgery