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Este artículo plantea una distinción entre una teoría ideal y otra no ideal de la justicia en el contexto político denominado de transición. La distinción entre estas dos teorías se encuentra ligada a otros dos factores clave: una sociedad democrática y el tipo de liberalismo que sea implementado. La combinación de estos seis elementos puede generar distintas situaciones políticas para afrontar el pasado.

International audience; Background: Although >150,000 mitral TEER procedures have been performed worldwide, the impact of MR etiology on MV surgery after TEER remains unknown.Objectives: The authors sought to compare outcomes of mitral valve (MV) surgery after failed transcatheter edge-to-edge repair (TEER) stratified by mitral regurgitation (MR) etiology.Methods: Data from the CUTTING-EDGE registry were retrospectively analyzed. Surgeries were stratified by MR etiology: primary (PMR) and secondary (SMR). MVARC (Mitral Valve Academic Research Consortium) outcomes at 30 days and 1 year were evaluated. Median follow-up was 9.1 months (IQR: 1.1-25.8 months) after surgery.Results: From July 2009 to July 2020, 330 patients underwent MV surgery after TEER, of which 47% had PMR and 53.0% had SMR. Mean age was 73.8 ± 10.1 years, median STS risk at initial TEER was 4.0% (IQR: 2.2%-7.3%). Compared with PMR, SMR had a higher EuroSCORE, more comorbidities, lower LVEF pre-TEER and presurgery (all P < 0.05). SMR patients had more aborted TEER (25.7% vs 16.3%; P = 0.043), more surgery for mitral stenosis after TEER (19.4% vs 9.0%; P = 0.008), and fewer MV repairs (4.0% vs 11.0%; P = 0.019). Thirty-day mortality was numerically higher in SMR (20.4% vs 12.7%; P = 0.072), with an observed-to-expected ratio of 3.6 (95% CI: 1.9-5.3) overall, 2.6 (95% CI: 1.2-4.0) in PMR, and 4.6 (95% CI: 2.6-6.6) in SMR. SMR had significantly higher 1-year mortality (38.3% vs 23.2%; P = 0.019). On Kaplan-Meier analysis, the actuarial estimates of cumulative survival were significantly lower in SMR at 1 and 3 years.Conclusions: The risk of MV surgery after TEER is nontrivial, with higher mortality after surgery, especially in SMR patients. These findings provide valuable data for further research to improve these outcomes.

Introduction Venous leg ulcers (VLUs) are the final stage of chronic venous insufficiency. This study aims to characterize the association between cardiovascular diseases and VLU. Methods A multicentric case-control study analyzed 17,788 patients between 2015 and 2020. Cases were matched (1:2) by age and sex, and odds ratios (OR) were analyzed with conditional logistic regressions adjusted by risk factors. Results The prevalence of VLU was 15.2%. 2390 cases were analyzed. Diseases found to be associated with VLU were atrial fibrillation (OR, 1.21; 95% CI: 1.03–1.42), pulmonary hypertension (OR, 1.45; 95% CI: 1.06–2.00), right heart failure (OR, 1.27; 95% CI: 1.13–1.43), peripheral artery disease (OR, 2.21; 95% CI: 1.90–2.56), and history of pulmonary embolism (OR, 1.45; 95% CI: 1.06–2.00). Conclusions Certain cardiovascular conditions showed an association with VLU. Further studies are warranted to evaluate the effect that treating concomitant cardiovascular diseases might exert on the natural history of venous leg ulcers.

The intensity of radiation scatter that emanates from the X-ray beam during fluoroscopically guided interventions is greater below the fluoroscopy table than above. Yet interventionalists' lower legs are typically unshielded and table skirts are often positioned incorrectly. We sought to characterize the efficacy of the leg protector wraps (Leg Wraps, Burlington Medical Inc.) in reducing the radiation dose to the operator's lower leg during fenestrated and branched endovascular aneurysm repair (F-BEVAR).A prospective cohort study was performed evaluating the lower leg radiation dose reduction of one vascular surgeon during F/BEVAR using antimony/bismuth Enviro-Lite leg wraps (0.35 mm lead equivalency, 99.7% attenuation at 50 kVp; Burlington Medical, Hampton Roads, Virginia). Optically Stimulated Luminescence nanoDot detectors (microSTARii System, LANDAUER, Inc., Glenwood, Illinois) were placed over and under the left leg wrap at the anterior tibial tuberosity position to compare operator leg dose with and without this additional protection. The table-mounted lead skirt was used consistently in all cases. The nanoDot detectors were cross-calibrated with a survey meter (RaySafe X2 survey sensor, Fluke Biomedical, Cleveland, Ohio) by measuring scattered radiation at a position equivalent to an operator's mid-tibia while performing digital acquisitions of a 25-cm thick, 30 cm × 30 cm acrylic phantom with a Philips FD20 fluoroscope (Philips Healthcare, Best, The Netherlands) with the table skirt removed. The measured radiation doses were converted to a Hp (0.07) skin dose, assuming an RQR6 beam spectrum (IEC-61267). Paired Wilcoxon test was performed to identify significant attenuation of radiation exposure.Leg dose measurements from 40 F-BEVARs were analyzed. The patients had a median (interquartile range) body mass index of 27 (24-32) kg/mThe 0.35-mm lead-equivalent leg wraps significantly decreased scattered radiation to the lower leg during F-BEVAR. Protective leg wraps should be recommended to operators performing complex fluoroscopically guided procedures.

La teoría de la acción comunicativa de J. Habermas es una herramienta con un potencial explicativo que no ha sido atendido a cabalidad en el pensamiento político latinoamericano. La perspectiva asociativa de Habermas es una manera de comprender una teoría de la democracia robusta, la cual se encuentra con y contra el realismo político que caracteriza a la región. Así, el presente trabajo busca situar a la teoría de la acción comunicativa como una herramienta para pensar con y contra Habermas la democracia en América Latina.

El cáncer de próstata es un problema serio de salud a nivel mundial, es la neoplasia maligna más frecuente en hombres a nivel nacional e internacional, el 90% se diagnostica en mayores de 65 años y en México solo el 9.5% de los mayores de 60 años se han realizado alguna prueba de tamizaje. (CENETEC, 2018) En esta investigación se revisará de forma extensa el tema en busca de evidenciar la importancia del tamizaje para reducción de la morbimortalidad de esta patología. Se elaboró una revisión narrativa basada en literatura obtenida de diversas bases de datos, seleccionando la información recabada en base a la importancia, relevancia y grado de evidencia de su información. Tras entender la enfermedad en temas fisiopatológicos, así como su curso natural, en tema de prevención y salud pública es importante el diagnóstico en etapas temprana sobre todo en pacientes con factores de riesgo, utilizando métodos de tamizaje bien establecidos y estudiados como lo son el antígeno prostático específico y el tacto rectal, bajo estrategias de cribado bien desarrolladas, esto alrededor del mundo ha demostrado ser parte fundamental en la reducción de la morbimortalidad de forma significativa.

Introdução: A pandemia de Covid-19 trouxe desafios adicionais ao trabalho na saúde, impactando negativamente na saúde mental dos profissionais da saúde com destaque para a presença da síndrome de burnout (SB). Objetivo: Avaliar a prevalência da SB nos profissionais da saúde no período da pandemia de Covid-19. Metodologia: O estudo utilizou como metodologia uma revisão sistemática da literatura realizada na base de dados PubMed e na SciELO entre dezembro de 2021 e janeiro de 2022. Resultados e Discussão: Foram encontrados 89 artigos que abordavam SB e Covid-19, 87 desses com desenho transversal. As amostras variaram de 25 a 12.596 pessoas, em sua maioria era composta de equipe multiprofissional. Houve predominância de pesquisa naqueles países onde a pandemia adquiriu sua maior proporção, como na China, Itália, Espanha e Estados Unidos. A escala Maslach Burnout Inventory (MBI) foi aplicada em 54% das pesquisas. A prevalência de SB variou de 12% a 86,1% na maioria dos estudos, chegando ao extremo de 100% em um dos trabalhos. Dentre os fatores associados a SB, destacam-se ser mulher, jovem, com pouco tempo de experiência de trabalho, estar na linha de frente de combate a COVID-19, longas horas de trabalho, superlotação hospitalar, falta de equipamentos de proteção individual (EPI), postura hostil da chefia, dentre outros. Conclusão: A pandemia de COVID-19 favoreceu o aumento da prevalência de SB em profissionais de saúde e estratégias específicas de cuidados a saúde mental dessa população devem ser realizadas urgentemente.

BackgroundThe difficulty to predict fatal outcomes in COVID-19 patients, impacts in the general morbidity and mortality due to SARSCoV2 infection, as it wears out the hospital services that care for these patients. Unfortunately, in several of the candidates for prognostic biomarkers proposed, the predictive power is compromised when patients have pre-existing co-morbidities.MethodsA cohort of one hundred and forty-seven patients hospitalized for severe COVID19 was included in a descriptive, observational, single-center, and prospective study. Patients were recruited during the first COVID-19 pandemic wave (April-Nov, 2020). Data were collected from the clinical history while immunophenotyping by multiparameter flow cytometry analysis allowed us to assess the expression of surface markers on peripheral leukocytes. Patients were grouped according to the outcome in survivor or decease. The prognostic value of leukocytes, cytokines or HLA-DR, CD39, and CD73 was calculated.ResultsHypertension and chronic renal failure but not obesity and diabetes were conditions more frequent among the decease group. Mixed hypercitokinemia, including inflammatory (IL-6) and anti-inflammatory (IL-10) cytokines, was more evident in deceased patients. In the decease group, lymphopenia with a higher NLR value was present. HLA-DR expression and the percentage of CD39+ cells were higher than non COVID-19 patients, but remain similar despite outcome. ROC analysis and cut-off value of NLR (69.6%, 9.4), pNLR (71.1%, 13.6), IL-6 (79.7%, 135.2 pg/mL).ConclusionThe expression of HLA-DR, CD39, and CD73, as many serum cytokines (other than IL-6) and chemokines levels do not show prognostic potential compared to NLR and pNLR values.

The purpose of this systematic review and meta-analysis was to evaluate the ability of psychosocial interventions to reduce depression and anxiety, improve quality of life, and reduce hospitalization and mortality rates in patients with heart failure.Studies of psychosocial interventions published from 1970 to 2021 were identified through four databases (PubMed, Ovid MEDLINE, PsycINFO, Cochrane). Two authors independently conducted a focused analysis and reached a final consensus on the studies to include, followed by a quality check by a third author. A risk of bias assessment was conducted.Twenty-three studies were identified, but only 15 studies of mostly randomized controlled trials with a total of 1370 patients with heart failure were included in the meta-analysis. Interventions were either cognitive behavioral therapy (CBT) or stress management. The pooled intervention effect was in favor of the intervention for depression (combined difference in standardized mean change [DSMC]: -0.41; 95% confidence interval [CI] = -0.66 to -0.17; p = .001) and anxiety (combined DSMC: -0.33; 95% CI = -0.51 to -0.15; p.001) but was only a trend for quality of life (combined DSMC: 0.14; 95% CI = -0.00 to 0.29; p = .053). Evidence was limited that interventions produced lower rates of hospitalization (5 of 5 studies showing a beneficial effect) or death (1 of 5 with a beneficial effect).CBT and stress management interventions significantly reduced depression and anxiety compared with control conditions. CBT significantly improved quality of life compared with controls, but stress management did not. Longer treatment duration seemed to be an important factor related to treatment success.

Rheumatoid arthritis (RA) patients might experience anxiety and depressive symptoms. Deficient vitamin D levels may be a trigger for these conditions. The aim of this study was to determine the frequency of depression, anxiety symptoms, and suicidal risk or ideation in patients with RA associated with vitamin D serum levels.In this cross-sectional study, we recruited RA patients older than 18 years, classified into 3 groups according to serum vitamin D levels: sufficient, ≥30 ng/mL; insufficient, 20-29 ng/mL; and deficient,20 ng/mL. Based on the self-reported Plutchik and the Hospital Anxiety and Depression Scale, we evaluated the association of suicidal risk, depression, and anxiety with the vitamin D levels in RA and the Rheumatoid Arthritis Quality-of-Life Questionnaire.We studied 72 patients with RA between January and October 2019. We found an inverse correlation between Plutchik score and suicidal risk with inadequate vitamin D levels, but not with the Hospital Anxiety and Depression Scale. Suicidal ideation was associated with a higher score on the Rheumatoid Arthritis Quality-of-Life Questionnaire.Despite the high prevalence of depressive and anxiety symptoms in RA patients, a Plutchik low correlation coefficient with inadequate serum levels of vitamin D was found. However, in the analysis of covariance, we were able to find that vitamin D levels remain associated with a reduction of suicide ideation. Further studies are needed to identify a risk profile for early psychological interventions to improve the quality of life in RA patients.

Tropical dry forests (TDF) are one of the most threatened and poorly protected ecosystems in the Americas. Although there are international efforts for the restoration of TDF, how stress factors such as herbivory or water limitation due to changes in precipitation, impact the regeneration dynamics of these forests is poorly understood. Specifically, how seedlings of key tree species for TDF restoration cope with current abiotic pressures such as the intensification of climatic events, and biotic factors like herbivory, is not yet fully understood. Here, we compared seedling performance, and allocation of biomass, and water to roots vs. shoots for three legume, and one non-legume TDF tree species, as a response to water limitation and herbivory in an 8-month greenhouse experiment. Contrary to our expectations, we found that the non-legume species, G. ulmifolia, had the best performance compared to legumes, while N-fixing and non-fixing legumes showed similar performance. Based on our findings, we suggest the use of G. ulmifolia in TDF restoration projects due to its high performance despite abiotic and biotic stress factors, its allocation of biomass and water to belowground structures. We also recommend the use of N-fixing legume species owing to their ability to fix nitrogen, which guarantees an N input to the soil, important in the first stages of succession. However, the legume species used in this experiment do not appear to resist the abiotic and biotic stressors studied. Thus, more studies exploring the response of dry forest plant species to stress factors are key for informing and assuring more effective TDF restoration efforts.

Obesity is as an important risk factor and has been associated with a worse prognosis in at least 13 distinct tumor types. This is partially due to intercellular communication between tumor cells and adipose tissue-derived stem cells (ADSCs), which are increased in obese individuals. As yet, however, little is known about the molecular changes occurring in ADSCs in these conditions. Cervical cancer has a high incidence and mortality rate in women from developing countries, particularly in those with a high body mass index (BMI).We analyzed the expression profile of ADSCs co-cultured with cervical cancer cells through massive RNA sequencing followed by evaluation of various functional alterations resulting from the modified transcriptome.A total of 761 coding and non-coding dysregulated RNAs were identified in ADSCs after co-culture with HeLa cells (validation in CaSki and SiHA cells). Subsequent network analysis showed that these changes were correlated with migration, stemness, DNA repair and cytokine production. Functional experiments revealed a larger ALDHOur results suggest that intercellular communication between ADSCs and cervical cancer cells modifies the RNA expression profile in the former, including that of lncRNAs, which in turn can regulate the expression of diverse chemokines that favor malignancy-associated capacities such as migration.

Previous studies have shown that environmental conditions and plant attributes determine biomass stocks and productivity across multiple tropical forests. However, it is less clear how these factors act at local scales. We evaluated how the spatial variation of soil resource availability (soil nutrient and water content) and plant functional traits determine species biomass stocks and productivity in a Colombian tropical dry forest, based on spatially explicit soil sampling and an intensive plant trait characterization of 89 species in three 1-ha permanent plots with similar climate and floristic composition. Within each plot, we measured nine soil variables and ten functional traits and quantified forest biomass stocks and productivity for 10,161 individual trees in a period of 3 years. The soil resources where species were located and their functional traits had coordinated effects on the spatial distribution of forest biomass stocks across the plots. The highest biomass stocks were concentrated on nutrient-rich soils with low water availability and were dominated by conservative species with dense tissues and low hydraulic failure risk, probably because they are able to better cope with water limitation. Most of the remaining forest biomass stocks were found in nutrient-poor soils with high water availability and were dominated by acquisitive species. Sites with nutrient-rich soils and low water availability increased biomass survival but also mortality; however, the presence of conservative species in these sites also increased biomass survival, decreased mortality, and led to biomass accumulation, probably because their strong and hydraulically secure tissues are able to deal with water limitation for nutrient absorption during dry seasons. Interestingly, soil resources and functional traits had no effects on biomass recruitment. We conclude that strong coordinated effects of soil resources and functional traits determine local biomass processes of tropical dry forests with a central role of conservative trait species types, whereby these species promote community assembly and functioning but are also vulnerable to potential changes in water availability. Thus, conservation and restoration actions should pay special attention to soil and plant functional trait trade-offs to improve management practices in these threatened forests.

Fue en el campo político donde Valentín Paniagua desarrolló mejor su talento. Siendo aún muy joven, el presidente Belaunde lo nombró como ministro de Estado a cargo del sector Justicia en 1965, cuando todavía era miembro del Partido Demócrata Cristiano, fundado en 1956 al igual que Acción Popular. En 1974 renunció a dicho partido cuando su agrupación se acercó al régimen de la Fuerza Armada que encabezara el general Juan Velasco Alvarado, ingresando poco después a formar parte de Acción Popular, siendo elegido diputado en 1980 y presidente de dicha Cámara. Poco después, en 1984, fue nombrado ministro de Educación, dedicándose luego, desde 1985 hasta 1999, principalmente al ejercicio profesional, compartiendo dicha actividad con la docencia universitaria. Valentín fue un peruano que ocupó todos los cargos políticos de importancia. Congresista de la República (1963-1968, 1980-1985 y 2000), presidente de la Cámara de Diputados y presidente del Congreso, ministro de Estado en dos oportunidades, y Presidente de la República (2000-2001).

Sepsis is a pathological condition frequently caused by invasion of a pathogen and the subsequent unregulated response that threatens the patient's life through diverse organ failure. The incidence of sepsis is increasing, and there is no specific therapy. Despite technological contributions to treat sepsis or increased knowledge of its molecular pathophysiology, mortality remains high, and sepsis is a global health problem. Knowledge of the role of the cells involved in the host response through the synthesis of inflammatory mediators and their different effects on cells, tissues or systems is key to the development of medical treatments that regulate systems involved in such responses to pathogens. This review addresses new insights into the role of cells, their mediators, and the interaction between them that lead to the development of a state of immunosuppression.

Introduction Burn patients are discharged home with ongoing wound care needs. Many obtain assistance at home with home health services. There are few published studies that review factors associated with obtaining these services upon discharge. As such, this study aims to identify patient-specific and hospital-specific factors that may contribute to being discharged under the care of home health services. Methods The National Inpatient Sample was queried for all patients with age ≥ 18 years with ICD-9 codes for total body surface area (TBSA) burn ≥ 20% and non-elective admissions. Patients were further selected for those discharge home (routine) and those discharged under care of organized home health service organization. Years included were 2013- third quarter of 2015. Age, race, percent TBSA burn, demographic data, hospital factors and mortality were recorded. Statistical analysis was done with Chi-Square testing. Discharge was then used to perform a binary logistic regression using the significant variables. Results There were 3245 weighted cases. Females accounted for 21.3% of the population. Of these encounters, 22.8% were discharged home with home health services. The average age of those without home health was 39.61 ± 13.59 years, versus 44.75 ± 15.92 years for those with home health (p< 0.001). Gender, percent TBSA burn, quartile of median household income of residents in the patient's ZIP Code, patient insurance, use of alcohol or drugs (p< 0.001), hospital bed size, hospital region, and hospital control/ownership (p< 0.001) were found to be statistically significant on univariate analysis. Discharge with home health services was then used to perform a multivariate analysis with the statistically significant factors. This found age (p< 0.001), and alcohol or drug use (p< 0.001) to be significant factors. The additional statistically significant factors are listed in Table 1. Those with home health services were less likely to have history of drug or alcohol use (OR 0.550 [IQR 0.424-0.713]) but more likely to be older, and to have Government insurance (OR 2.899 [IQR 2.096-4.009]) or Private insurance (OR 2.398 [IQR 1.713-3.356]), compared to self pay. There is also significant variability based on hospital region. Conclusions Multiple patient-specific and hospital-specific factors may influence the possibility of burn patient being discharged home with home health services. It appears that patients who may benefit from these services were in fact captured as higher rates of home health services were noted among those with government insurance and within the lowest quartile of income based on patient zip codes. However, there seems to be room for improved services across the nation as there is great variability based on region. Applicability of Research to Practice Discuss factors associated with patients being discharged home with home health services. Identify areas of possible improvement to maximize access to these services for all burn patients.

Introduction Augmented renal clearance (ARC) has been reported to occur across many critical illnesses but has not been evaluated in critically ill burn patients. The impact of ARC on clinical outcomes within this population remains unknown. We hypothesize that ARC is prevalent in critically ill burn patients and is associated with improved survival. Methods We retrospectively reviewed a prospectively-maintained registry of Burn ICU patients from July 2021 – September 2022 at an academic burn center. We included patients in whom 24-hour urine creatinine collection was performed on admission and excluded patients in whom accurate collection was not performed within 48 hours of admission. Creatinine clearance was calculated for all patients who met inclusion criteria. ARC was determined to occur when creatine clearance exceeded 130 mL/min/1.73m2. Clinical outcomes were compared between patients with and without ARC. Results The analysis included 24 patients (67% male, median age 42 [31-55] years). The median percentage of total body surface area (TBSA) burned was 25 [10-38]. ARC was present in 17 patients (71%). Mean creatinine clearance was 162 ml/min/1.73m2 (range 37-313), and 7 patients (29%) had creatinine clearance greater than 200. Complication rates were low and were similar between patients with and without ARC (all p >0.05). Conclusions ARC appears to be a common phenomenon among critically injured burn patients. While the presence of ARC could be particularly meaningful in this population of patients that often receives massive volumes of resuscitative fluids, the sample size of our study did not permit the detection of statistically significant differences in outcomes between burn patients with and without ARC. Further work must be undertaken to assess the impact of ARC on fluid resuscitation strategies and medication dosing including that of antibiotics and thromboprophylaxis agents. Applicability of Research to Practice Augmented renal clearance (ARC) has never before been characterized in the population of critically injured burn patients. This topic merits further research, as it could have far-reaching clinical impact relating to fluid resuscitation practices and dosing of renally-cleared medications (antibiotics, thromboprophylaxis, etc.).

Introduction Given the resource-intense nature of treatment for burn injuries and the knowledge of at-risk populations, a public health approach to reducing individual and societal burden is indicated. To accomplish this, it is critical to understand the regional distribution of these injuries and the risk factors influencing one’s susceptibility to being burned. We hypothesize that there are common sociodemographic trends in burn injuries in a large southern geographic area. Methods Data was retrospectively reviewed for all burn patients admitted between 08/2013 and 12/2021 at a major burn center in a large southern geographic area. Sociodemographic data, burn characteristics and outcomes were analyzed. Patients with isolated inhalation injuries were excluded. One-way ANOVA was used for continuous variables with a P-value < 0.05. Binary logistic regression was used to evaluate independent risk factors for mortality. GIS software mapped injury locations alongside census data to augment statistics with visuospatial analysis. Results 1753 patients were included with an annual incidence rate of 36 per 100,000 person-years. Most were male (68%), Caucasian (60%) and non-Hispanic (67%). The most common etiology was cooking-related (14%), with scald and flame burns collectively making up 80%. Flame burns were significantly larger when compared to scald, electrical and chemical mechanisms (p< 0.05). Those between 19 and 45 years old were the largest age group (40%) with significantly larger burns compared to those 0-18 and 46-64 (p< 0.05), but not those > 65. Non-Hispanic patients had significantly larger burns than their Hispanic counterparts (p< 0.05) but no difference in mortality (p=.306). Patients utilizing Medicare/Medicaid were over three times more likely to die compared to those with commercial insurance. Conclusions In this cohort, male patients are injured at higher rates, however, they do not have more severe burns. The larger burns are distributed in a bimodal fashion between those 19-45 and those > 65, with hispanic ethnicity protective against larger burn injuries. This suggests separate mechanisms mediating larger burns in these two groups, and warrants further investigation. Insurance type, a surrogate for socioeconomic status (SES), is not associated with TBSA or LOS, however it does confer an increase in mortality in those with Medicare/Medicaid. GIS mapping verifies neighborhoods concentrated in more urban areas with lower median household incomes have higher injury rates. This highlights populations worth targeting for injury prevention, namely those between 19 and 45 of lower SES, particularly in the setting of cooking and food preparation. Applicability of Research to Practice Understanding regional trends in burn injury can target prevention efforts and identify at risk populations where further resources might be best allocated to ease the burden of burn injury.

Resumen La contaminación del suelo por hidrocarburos (HICOS) es uno de los graves problemas ambientales. Cuando los HICOS contaminan el suelo, afectan la relación carbono: nitrógeno, causan la inhibición de la vida microbiana y pérdida de fertilidad. Una alternativa es la biorremediación, pero la baja solubilidad y la absorción de los HICOS en el suelo dificulta la eliminación. Por ello, al inicio de la biorremediación es necesaria la bioestimulación con un detergente (DEGE) o biodetergente (BIODET) para solubilizar los HICOS. Sin embargo, algunas investigaciones señalan que estos detergentes actúan directamente en la eliminación de los HICOS, las evidencias señalan que el DEGE y BIODET solo permite la desorción de los HICOS para solubilizarlos, por la formación de micelas. Otros trabajos de biorremediación, aseguran que el tipo de DEGE y BIODET que utilizan solubiliza todos los HICOS de las mezclas contaminantes, pero de acuerdo a la composición del detergente, no pueden solubilizar toda la diversidad de HICOS. Otras investigaciones afirman la síntesis "in situ" de BIODET por microorganismos inoculados en la bioaumentación de suelo impactado por HICOS, sin demostrarlo experimentalmente. El objetivo de esta revisión es analizar en la biorremediación de suelo contaminado por HICOS, la importancia de DEGE, BIODET y las inconsistencias generadas por su aplicación. Abstract: Soil pollution by hydrocarbons (HYCOS) is one of the serious environmental problems. When HYCOS contaminate the soil, they affect the carbon: nitrogen ratio, causing inhibition of microbial life and loss of fertility. An alternative is bioremediation, but the low solubility and absorption of HYCOS in the soil makes it difficult to eliminate. Therefore, at the beginning of the bioremediation, biostimulation with a detergent (DEGE) or biodetergent (BIODET) is necessary to solubilize the HYCOS. However, some research indicates that the detergents acts directly in the extraction of the HYCOS, the evidence indicates that the DEGE and BIODET only allows the desorption of the HYCOS to solubilize them, by the formation of mice. Other bioremediation works assure that the type of DEG and BIODET that it uses solubilizes all the HYCOS of the contaminating mixtures, but according to the composition of the detergent, it cannot emussify the entire range of HYCOS. Other investigations affirm the synthesis "in situ" of BIODET by microorganisms inoculated in the bioaugmentation of soil impacted by HYCOS, without demonstrating it experimentally. The objective of this review is to analyze in the bioremediation of the soil contaminated by HYCOS, the importance of DEGE, BIODET and the inconsistencies generated by their application. Resumo: A poluição por Óleo por Hidrocarbonetos (HICOS) é um dos graves problemas ambientais. Quando os HICOS poluem a água, eles afetam a relação carbono- nitrogênio, causando a inibição da vida microbiana e perda de fertilidade. Uma alternativa é a biorremediação, mas a baixa solubilidade e absorção do HICOS em sua eliminação dificulta sua eliminação. Portanto, no início da biorremediação, a bioestimulação com detergente (DEGE) ou biodetergente (BIODET) é necessária para solubilizar o HICOS. Porém, algumas pesquisas indicam que esses detergentes atuam diretamente na eliminação dos HICOS, as evidências indicam que o DEGE e o BIODET só permitem a dessorção dos HICOS para solubilizá-los, pela formação de micelas. Outros trabalhos de biorremediação garantem que o tipo de DEGE e BIODET usado solubilize todos os HICOS das misturas contaminantes, mas dependendo da composição do detergente, eles não podem solubilizar toda a diversidade de HICOS. Outras investigações afirmam a síntese "in situ" de BIODET por microrganismos inoculados na bioaumentação de solos impactados por HICOS, sem demonstrá-la experimentalmente. O objetivo desta revisão é analisar na biorremediação de solos contaminados por HICOS, a importância do DEGE, do BIODET e as inconsistências geradas por sua aplicação.

Objectives The aim of this study was to evaluate clinical characteristics, mechanisms of failure, and outcomes of transcatheter aortic valve replacement (TAVR) explantation. Background Surgical explantation following TAVR may be required for structural valve degeneration, paravalvular leak, infection, or other reasons. However, in-depth data on indications and outcomes are lacking. Methods Data from a multicenter, international registry (EXPLANT-TAVR) of patients who underwent TAVR explantation were reviewed retrospectively. Explantations performed during the same admission as initial TAVR were excluded. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 6.7 months (interquartile range [IQR]: 1.0-18.8 months) after TAVR explantation and was 97.7% complete at 30 days and 86.1% complete at 1 year. Results From November 2009 to September 2020, 269 patients across 42 centers with a mean age of 72.7 ± 10.4 years underwent TAVR explantation. About one quarter (25.9%) were deemed low surgical risk at index TAVR, and median Society of Thoracic Surgeons risk at TAVR explantation was 5.6% (IQR: 3.2%-9.6%). The median time to explantation was 11.5 months (IQR: 4.0-32.4 months). Balloon-expandable and self-expanding or mechanically expandable valves accounted for 50.9% and 49.1%, respectively. Indications for explantation included endocarditis (43.1%), structural valve degeneration (20.1%), paravalvular leak (18.2%), and prosthesis-patient mismatch (10.8%). Redo TAVR was not feasible because of unfavorable anatomy in 26.8% of patients. Urgent or emergency cases were performed in 53.1% of patients, aortic root replacement in 13.4%, and 54.6% had concomitant cardiac procedures. Overall survival at last follow-up was 76.1%. In-hospital, 30-day, and 1-year mortality rates were 11.9%, 13.1%, and 28.5%, respectively, and stroke rates were 5.9%, 8.6%, and 18.7%, respectively. Conclusions The EXPLANT-TAVR registry reveals that surgical risks associated with TAVR explantation are not negligible and should be taken into consideration in the lifetime management of aortic stenosis.

Objectives The aim of this study was to determine clinical and echocardiographic characteristics, mechanisms of failure, and outcomes of mitral valve (MV) surgery after transcatheter edge-to-edge repair (TEER). Background Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking. Methods Data from the multicenter, international CUTTING-EDGE registry were retrospectively analyzed. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 9.0 months (interquartile range [IQR]: 1.2-25.7 months) after MV surgery, and follow-up was 96.1% complete at 30 days and 81.1% complete at 1 year. Results From July 2009 to July 2020, 332 patients across 34 centers underwent MV surgery after TEER. The mean age was 73.8 ± 10.1 years, median Society of Thoracic Surgeons risk for MV repair at initial TEER was 4.0 (IQR: 2.3-7.3), and primary/mixed and secondary mitral regurgitation were present in 59.0% and 38.5%, respectively. The median interval from TEER to surgery was 3.5 months (IQR: 0.5-11.9 months), with overall median Society of Thoracic Surgeons risk of 4.8% for MV replacement (IQR: 2.8%-8.4%). The primary indication for surgery was recurrent mitral regurgitation (33.5%), and MV replacement and concomitant tricuspid surgery were performed in 92.5% and 42.2% of patients, respectively. The 30-day and 1-year mortality rates were 16.6% and 31.3%, respectively. On Kaplan-Meier analysis, the actuarial estimates of mortality were 24.1% at 1 year and 31.7% at 3 years after MV surgery. Conclusions In this first report of the CUTTING-EDGE registry, the mortality and morbidity risks of MV surgery after TEER were not negligible, and only

Trichomonas vaginaliscauses trichomoniasis, an inflammatory process related to an increased rate of HIV transmission. In order to studyT. vaginalisinfection response in a microorganism-free environment, an infection model was established providing a host–parasite interaction system useful to study the interplay between immune cells and the parasite. Infected mice peritoneal cells were immunophenotyped at different times after infection using flow cytometry. Neutrophils and macrophages showed the most relevant increase from third to 12th day post-infection. A high number of B lymphocytes were present on 15th day post-infection, and an increase in memory T cells was observed on sixth day post-infection. The levels of NO increased at day 10 post-infection; no significant influence was observed onT. vaginalisclearance. Increased viability ofT. vaginaliswas observed when the NETs inhibitors, metformin and Cl−amidine, were administrated, highlighting the importance of this mechanism to control parasite infection (43 and 86%, respectively). This report presents a comprehensive cell count of the immune cells participating against trichomoniasis in anin vivointeraction system. These data highlight the relevance of innate mechanisms such as specific population changes of innate immune cells and their impact on theT. vaginalisviability.

La distinción entre el lenguaje del humanismo cívico y el republicanismo resulta una aclaración conceptual adecuada para comprender las acciones de Robespierre ante la apertura de una nueva concepción de la política. En el humanismo cívico es posible encontrar elementos que responden a los presupuestos del comunitarismo, en tanto problemas que se circunscriben a una región limitada, y el republicanismo responde a exigencias que son susceptibles de universalidad. Ahora bien, esta distinción no es clara, ya que, durante la Revolución francesa, en especial en el caso de Robespierre, encontramos una mezcla entre la exigencia de la virtud cívica clásica con la búsqueda de un fundamento de legitimidad política con un enfoque social. Así, la anomalía ideológica de Robespierre solo puede esclarecerse a través de la comprensión de las peculiaridades del lenguaje de la virtud y el universalismo moral Palabras clave Republicanismo, comunitarismo, lenguaje político, mentalidades. Referencias Baron, H. (1966). The crisis of the early Italian Renaissance. Civic humanism and republican liberty in an age of classicism and tyranny. Princeton, Estados Unidos: Princeton University Press.Benjamin, W. (2013). Über den Begriff der Geschichte. En R. Tiedemann (Ed.).Walter Benjamin. Sprache und Geschichte. Philosophische Essays (pp. 141-154). Stuttgart, Alemania: Reclam.Bergeron, L., Furet, F. y Koselleck, R. (2012). La época de las revoluciones europeas, 1780-1848. Ciudad de México, México: Siglo xxi.Bernal, R. (2016). Fraternidad y democracia en el origen de nuestra modernidad política. En G. Ambriz Arévalo y R. Bernal Lugo (Coords.). El derecho contra el capital. Reflexiones desde la izquierda contemporánea (pp. 36-71). Chilpancingo, México: Contraste.Castro Gómez, S. (2019). Republicanismo transmoderno. En El tonto y los canallas. Notas para un republicanismo transmoderno (pp. 161-220). Bogotá, Colombia: Editorial Pontificia Universidad Javeriana.Dubiel, H., Frankenberg, G. y Rödel, U. (1997). El dispositivo simbólico de la democracia. En La cuestión democrática (pp. 137-192). Madrid, España: Huerga y Fierro Editores.Gauthier, F. (2005, 23 de julio). Robespierre: por una república democrática social. Sin Permiso. Recuperado de http://www.sinpermiso.info/textos/robespierre- por-una-repblica-democrtica-y-social.Gaytán, F. (2016). Hacia los nuevos testamentos jacobinos: los decálogos normativos para la laicidad. En Manual de redentores: laicidad y derechos, entre populismo y neojacobinismo (pp. 57-101). Ciudad de México, México: Universidad Nacional Autónoma de México-Instituto de Investigaciones Jurídicas.Gilroy, P. (2014). El Atlántico negro. Modernidad y doble conciencia. Madrid, España: Akal.James, C. L. R. (2003). Los jacobinos negros. Toussaint L’Overture y la Revolución de Haití. Ciudad de México, México: Turner-Fondo de Cultura Económica.Kant, I. (1900 s.). Kant’s Gesammelte Schriften (Editado por la Real Academia Prusiana de las Ciencias). Berlín, Alemania: Reimer [hoy De Gruyter]. Koselleck, R. (2017). Erfahrungsraum und Erwartungshorizont zwei historischen Kategorien. En Vergangene Zukunft. Zur Semantik geschichtlicher Zeiten (pp. 349-375). Fráncfort, Alemania: Suhrkamp Verlag.Mandeville, B. (1983). La fábula de las abejas. Ciudad de México, México: Fondo de Cultura Económica.Maquiavelo, N. (2015). Discursos sobre la primera década de Tito Livio. Madrid, España: Alianza.McPherson, C.B. (1962). The political theory of possessive individualism: Hobbes to Locke. Nueva York, Estados Unidos: Oxford University Press.

Objective: This systematic review aims to examine the spectrum of research studies including cross-cultural and international studies that have focused on weight and health-related quality of life in children and adolescents. Methods: Following the PRISMA guidelines, studies published in the past 25 years from 1995 until 2020 that pertain to weight and health-related quality of life (HRQoL) in children and adolescents were identified through the use of Pubmed, ScienceDirect, Google Scholar, and PsycInfo databases. Two authors independently conducted a focused analysis and reached a final consensus on which studies to include using specific selection criteria followed by a quality check of the studies, resulting in the final selection of 25 studies. Results: The selected studies particularized the level of impaired quality of life among normal-weight, overweight and obese children and adolescents, and distinctly found that higher participant weight was correlated with a lower HRQoL score. Conclusion: Studies showed a significant negative correlation between weight and HRQoL. Multiple types of prevention and treatment programs are critically needed to provide resources to improve quality of life in overweight and obese children and adolescents.

Fibromuscular dysplasia (FMD) is a noninflammatory arterial disease that affects extracranial carotid arteries in young patients. The ideal treatment of FMD is still debatable and the role of carotid artery stenting (CAS) is controversial. The aim of this study was to assess the feasibility and outcomes of CAS in patients with FMD.Retrospective analysis of patients who underwent CAS was performed utilizing the Vascular Quality Initiative (VQI) database from December 2012 to May 2021. Patients who underwent CAS for atherosclerosis and FMD, were included and matched (1:1) by age, gender, and clinical presentation. Demographics, clinical parameters, and procedural data were analyzed. The endpoints included postoperative stroke and TIA and adverse events (perioperative and 1-year mortality, neurological change, access site complications, hematoma or bleeding, infection, congestive heart failure, arrhythmias, myocardial infarction, reperfusion symptoms, and hospital length of stay).After matching, fifty-five patients underwent CAS for FMD (mean age 58.7±14 years, 62% female, 69% white with mean body mass index of 28±6 kg/mCarotid artery stenting for fibromuscular dysplasia is a feasible and safe procedure with favorable technical success, low neurological complications, and good clinical outcomes at 1-year follow-up.

Pericardial effusions requiring pericardiocentesis have multiple causes that vary among geographical regions and health contexts. This procedure can be performed for diagnostic or therapeutic indications. The purpose of this study was to identify the principal causes of pericardial effusions and indications for pericardiocentesis, exploring differences among groups. This was a retrospective case series of patients who underwent pericardiocentesis for pericardial effusion in a single center in Latin America. Demographic, clinical, echocardiographic, and procedural variables were recorded and analyzed. The primary outcome was to determine the causes of pericardial effusions in these patients and the indication (diagnostic, therapeutic, or both). The results are presented in two groups (inflammatory and noninflammatory) according to the cause of the pericardial effusion. One hundred sixteen patients with pericardial effusion underwent pericardiocentesis. The median age was 58 years (IQR 46.2–70.7), and 50% were male. In the noninflammatory pericardial effusion group, there were 61 cases (53%), among which neoplastic pericardial effusion was the most frequent cause (n = 25, 40.9%). In the inflammatory group, there were 55 cases (47%), and the main cause was postpericardiectomy syndrome after cardiac surgery (n = 31, 56.4%). The principal indication for pericardiocentesis was therapeutic (n = 66, 56.8%). Large pericardial effusion without hemodynamic effect of cardiac tamponade was significantly more frequent in the inflammatory group (p = 0.03). In conclusion, the principal cause of pericardial effusion in patients who underwent pericardiocentesis was postpericardiectomy syndrome after cardiac surgery, followed by neoplastic pericardial effusion. Pericardiocentesis is mainly a therapeutic procedure.