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Abstract This study aimed to evaluate the pneumonia risk based on the patient’s sex during the COVID-19 pandemic and the early months of the endemic phase of the disease in Mexico. A retrospective cohort study was conducted using a dataset resulting from the epidemiological surveillance of COVID-19 (February 2020 to August 2023). Data from 1.6 million adults with laboratory-positive disease, were analyzed. Risk ratios (RR) and 95% confidence intervals (CI), computed through generalized linear regression models, were used. The overall risk of pneumonia was 9.3% (95% CI 9.2–9.4%), with sex-specific estimates of 7.0% (95% CI 6.9–7.1%) for women and 12.0% (95% CI 11.9–12.1%) for men. This disparity was consistently observed throughout all phases of the pandemic, including the endemic phase of the disease. After adjusting for age, predominant viral genotype at illness onset and preexisting medical conditions, men had a 3.3% higher risk of severe manifestations when compared to women (RR = 1.033, 95% CI 1.032–1.034). Our research highlights the potential role of patients’ sex as a factor influencing pneumonia risk during and after the COVID-19 pandemic in Mexico. These findings may provide useful considerations for healthcare planning and policy development focused on addressing the impact of the disease on vulnerable populations.

Background:. The International Society of Physical and Rehabilitation Medicine—ISPRM—is the pre-eminent scientific and educational society for medical specialists in rehabilitation. Its mission is to optimize functioning and health-related quality of life and minimize disability in persons with medical problems. The World Congress remains the society’s face-to-face meeting to update topics related to disability and rehabilitation. This manuscript describes the academic proposals and abstracts submitted and accepted after peer review, sorting them out according to the Standardized Abstract Topic List of the ISPRM World Congress bidding guidelines. It also aims to give recommendations for future congresses. Methods:. This study is a cross-sectional descriptive study of academic proposals and abstracts submitted to the ISPRM2023 Congress in Cartagena. To structure the academic program, the Congress Scientific Committee (CSC) opened 2 calls for wide-open international participation: one for academic proposals (Scientific sessions and workshops led by top experts) and another for abstract submissions inviting rehabilitation professionals in general, according to the ISPRM Congress classification of topics. Six members of the CSC assessed the academic proposals to ensure the representation of diverse topics and geographic areas. The abstracts were peer-reviewed following predefined quality criteria and assigned to 3 international juries according to their expertise. Results:. Participants submitted 142 proposals in English and 42 in Spanish from 6 continents: North and South America, Europe, Africa, Asia, and Oceania. The Clinical Sciences category (58.7%) out of 138 accepted proposals was the most common. Of 703 submitted abstracts, 692 got accepted to present their work, but only 418 were presented on-site: 127 (30.4%) oral and 291 poster presentations. The distribution of the submitted abstracts showed substantial interest in clinical science and therapeutics (73.9%), followed by engineering and technology (9.1%), biomedical sciences (4.5%), and health policy and systems (4.5%). Conclusions:. We made 8 recommendations for future congresses. It will be essential to review the topics involving emerging ones in physical and rehabilitation medicine that are gaining relevance, such as infectious diseases (COVID-19), cardiopulmonary disorders, metabolic diseases (obesity, osteoporosis), diagnostic and therapeutic ultrasound, and electrodiagnosis.

Abstract In high-altitude regions, such as the Peruvian Andes, understanding the transformation of precipitation types under climate change is critical to the sustainability of water resources and the survival of glaciers. In this study, we investigate the distribution and types of precipitation on a tropical glacier in the Peruvian Central Andes. We utilized data from an optical-laser disdrometer and compact weather station installed at 4709 m ASL, combined with future climate scenarios from the CMIP6 project, to model potential future changes in precipitation types. Our findings highlight that increasing temperatures could lead to significant reductions in solid-phase precipitation, including snow, graupel and hail, with implications for the mass balance of Andean glaciers. For instance, a 2 °C rise might result in less than 10% of precipitation as solid, in regard to the present day, transforming the hydrological processes of the region. The two future climate scenarios from the CMIP6 project, SSP2-4.5 and SSP5-8.5, offer a broad perspective on potential climate outcomes that could impact precipitation patterns in the Andes. Our study underscores the need to revisit and expand our understanding of high-altitude precipitation in the face of climate change, paving the way for improved water resource management strategies and sustainable glacier preservation efforts in these fragile ecosystems.

Abstract Systemic lupus erythematosus (SLE) is a multifactorial disease characterized by the convergence of genetic, immunological, and viral elements resulting in a complex interaction of both internal and external factors. The role of the Epstein-Barr virus (EBV) and human endogenous retroviruses (HERV-E) as triggers and maintenance elements in the pathogenesis of SLE has been widely recognized. Previous studies have independently evaluated the effects of EBV and HERV-E in this disease. In this work, for the first time, these viral factors are jointly investigated in SLE patients. This study aimed at assessing the differential expression of immune regulatory genes and the incidence of specific viral pathogens (EBV and HERV-E), alongside the detailed characterization of surface markers in T- and B-lymphocytes in patients with SLE and control participants. A comparative analysis between patients with SLE and control participants was performed, evaluating the expression of phenotypic markers and genes involved in the immune response (TNF-α, IL-2, IL-6, IL-10, IFNG, TLR3), as well as HERV-E gag and EBV viral genes (LMP1 and BZLF1).A significant association between SLE and EBV was found in this study. A notable increase in EBV LMP1 gene expression was observed in patients with SLE . Also, a significant overexpression of HERV-E was observed, in addition to a considerable increase in the distribution of the cell surface marker CD27 + on T- and B-lymphocytes, observed in individuals with SLE compared to the control group. This study provides evidence regarding the role that EBV virus plays in lymphocytes in the context of SLE, highlighting how both the virus and the host gene expression may influence disease pathogenesis by altering immune regulatory pathways mediated by TNF-α, IFN-γ, and IL-10, as well as parallel overexpression of HERV-E gag. The decrease in TLR3 could indicate a compromised antiviral response, which could facilitate viral reactivation and contribute to disease activity.

This study investigates the effectiveness of inclusion measures for women with disabilities at a public university in southern Spain, aiming to understand their needs and experiences. Utilizing a gender perspective, the research engaged 12 women from various university roles in semi-structured interviews, later analyzed using NVivo 20, and organized into categories assessing institutional resources, working/academic conditions, and the interplay of disability and gender. Findings indicate that, despite no direct discrimination based on sex, the patriarchal social framework still fosters gender and inclusion gaps. Peer support emerges as a protective factor, whereas obstacles such as resource scarcity, access challenges, and a lack of awareness about disability measures pose risks. The study highlights the need for enhanced visibility of inclusive measures and the development of agile, individualized policies. It underscores the importance of raising awareness, particularly about non-visible disabilities, through educational initiatives.

Introducción: El cáncer de laringe es la neoplasia maligna más común de las vías aerodigestivas, representa el 4,5% de los cánceres del organismo y el 30% del cáncer de cabeza y cuello. Las complicaciones postoperatorias de la laringectomía total son frecuentes y se conocen factores predisponentes para ello. Se estableció como objetivo conocer la prevalencia de las complicaciones de la laringectomía total, las medidas realizadas para su tratamiento, el sitio anatómico, la presencia o ausencia de tratamiento adyuvante previo. Materiales y métodos: Se realizó un estudio descriptivo y retrospectivo en el Hospital de Clínicas, Cátedra de Otorrinolaringología, del 2015 al 2022. El universo estuvo constituido por un total de 46 pacientes ingresados con el diagnóstico de cáncer de laringe, 21,7% (10) de los cuales se les realizó laringectomía total. Se excluyeron otras técnicas quirúrgicas. Resultados: 10pacientes sometidos a laringectomía total con un rango de edad de 31-70 años, todos de sexo masculino. El compromiso de la supraglotis fue del 30%. El 70% presentó complicaciones. La complicación más frecuente fue fistula faringocutánea, otras fueron sangrado en el postoperatorio inmediato e infección del sitio quirúrgico. El 71,4% de los pacientes con fistula se resolvieron únicamente con medidas conservadoras, 2 requirieron reintervención para el cierre del defecto. Conclusiones: Las complicaciones de la laringectomía total se presentan con mucha frecuencia, afectando a la calidad de vida, la evolución y recuperación post quirúrgica del paciente.

Objetivo. Analizar los elementos de un programa de navegación en Lima que facilitaron la vinculación de hombres que tienen sexo con hombres (HSH) y mujeres transgénero (MT) a la atención del VIH. Materiales y métodos. Realizamos entrevistas a 20 usuarios recibiendo servicios de navegación y a 4 navegadores pares viviendo con VIH. Resultados. El trabajo de los navegadores contribuyó a cubrir una brecha en los servicios para el VIH, brindando acompañamiento personalizado para navegar el sistema de salud y facilitando el proceso de vinculación a la atención médica. Conclusiones. La navegación de pacientes basada en el desarrollo de fortalezas de los usuarios puede ser una estrategia útil y factible para mejorar la vinculación al cuidado médico de HSH y MT en Perú, incorporando navegadores pares a los equipos de salud, horizontalidad en el trato y estrategias de salud pública con mayor participación comunitaria.

Abstract Exposure to high, marginally lethal doses or higher of ionizing radiation, either intentional or accidental, results in injury to various organs. Currently, there is only a limited number of safe and effective radiation countermeasures approved by US Food and Drug Administration for such injuries. These approved agents are effective for only the hematopoietic component of the acute radiation syndrome and must be administered only after the exposure event: currently, there is no FDA-approved agent that can be used prophylactically. The nutraceutical, gamma-tocotrienol (GT3) has been found to be a promising radioprotector of such exposure-related injuries, especially those of a hematopoietic nature, when tested in either rodents or nonhuman primates. We investigated the nature of injuries and the possible protective effects of GT3 within select organ systems/tissues caused by both non-lethal level (4.0 Gy), as well as potentially lethal level (5.8 Gy) of ionizing radiation, delivered as total-body or partial-body exposure. Results indicated that the most severe, dose-dependent injuries occurred within those organ systems with strong self-renewing capacities (e.g., the lymphohematopoietic and gastrointestinal systems), while in other tissues (e.g., liver, kidney, lung) endowed with less self-renewal, the pathologies noted tended to be less pronounced and less dependent on the level of exposure dose or on the applied exposure regimen. The prophylactic use of the test nutraceutical, GT3, appeared to limit the extent of irradiation-associated pathology within blood forming tissues and, to some extent, within the small intestine of the gastrointestinal tract. No distinct, global pattern of bodily protection was noted with the agent’s use, although a hint of a possible radioprotective benefit was suggested not only by a lessening of apparent injury within select organ systems, but also by way of noting the lack of early onset of moribundity within select GT3-treated animals.

Introducción y objetivo. A nivel mundial, solo el 5%-15% de quienes necesitan dispositivos de apoyo, pueden acceder a ellos. Se identifico las características sociodemográficas, clínicas y las barreras del Sistema de Salud de Colombia en pacientes con amputación de miembro inferior. Métodos. Se llevó a cabo un seguimiento longitudinal de 24 meses con 122 pacientes divididos en dos grupos: los que recibieron prótesis y los que no. De los 201 pacientes iniciales, 36 no se pudieron contactar y 43 fallecieron. Las evaluaciones se realizaron en tres intervalos: 3-6 meses, 6-12 meses y 12-24 meses. Resultados. El 61.4% recibió prótesis; los amputados por trauma, este porcentaje fue del 90.4%. La entrega de prótesis aumentó gradualmente después de los 12 meses. El tiempo medio desde la amputación hasta la recepción de la prótesis fue de 425 días (RIQ [297, 502]). La etiología médica representó el 82.8% en ambos grupos, predomino el nivel transfemoral (62.3%). Las principales barreras para la protetización fueron la disponibilidad de citas médicas, demoras en autorizaciones por parte de las EPS, falta de recursos económicos para transporte y la distancia a centros de rehabilitación. Conclusión. Se identificaron barreras que prolongan la entrega de prótesis o, en algunos casos, la impiden. Entre estas, destacan la escasez de citas médicas, demoras en autorizaciones y limitaciones económicas y geográficas.

Introduction Sleep deprivation has a great impact on the learning process in physicians in training. Therefore, inquiring on this phenomenon in the most recent investigations will facilitate the provision of evidence on the influence regarding the absence of sleep on the learning process in health personnel.

BackgroundStroke survivors who receive more rehabilitation therapy achieve better functional outcomes. The amount of rehabilitation that patients receive is, however, limited due to constraints of the healthcare system.ObjectiveTo assess whether EngageHealth, a mobile device application designed to deliver stroke rehabilitation exercises using asynchronous video recordings, increases the amount of outpatient rehabilitation in stroke patients and improves their upper extremity function and quality of life.DesignProspective single-arm study consisting of a 2-week pre-intervention phase without EngageHealth followed by a 4-week intervention period with EngageHealth.SettingAmbulatory care.ParticipantsTwenty-four stroke patients with upper extremity impairment were recruited at the Stanford Stroke Center outpatient clinic.InterventionsParticipants were instructed to use the EngageHealth application daily.Main outcome measuresAdherence, user experience, and change in the upper extremity Fugl-Meyer (UE-FM), Quality of Life in Neurological Disorders (Neuro-QoL), and Stroke Impact Scale (SIS).ResultsOf 23 participants, five (22%) used the application for 17 days, six (26%) used the application for 9–16 days, and 12 (52%) used it < 9 days. Sixty-three percent of participants would recommend the application to other stroke survivors, with fifty percent indicating they would continue using the application, if available. During the pre-intervention phase, there were no changes in hand function. During the intervention period, participants improved by 4 points on the UE-FM (P < 0.01), and 15 points in the hand-function domain of SIS (P = 0.03). Videos of participants' exercises were successfully recorded, allowing the clinician to review videos of the participants' completed tasks asynchronously. In-depth interviews revealed that participants viewed the EngageHealth application favorably, and that their perceived usefulness of the exercises affected their motivation.ConclusionsUse of the EngageHealth application in the home environment may improve upper extremity function in subacute/chronic stroke patients. Additional support strategies should be implemented in future studies to improve adherence. These findings from a prospective single-arm study, support the design of a randomized controlled trial to determine the efficacy of long-term use of the EngageHealth application.

Abstract Systemic lupus erythematosus (SLE) is an autoimmune and multisystem disease with a high public health impact. Lupus nephritis (LN), commonly known as renal involvement in SLE, is associated with a poorer prognosis and increased rates of morbidity and mortality in patients with SLE. Identifying new urinary biomarkers that can be used for LN prognosis or diagnosis is essential and is part of current active research. In this study, we applied an untargeted metabolomics approach involving liquid and gas chromatography coupled with mass spectrometry to urine samples collected from 17 individuals with SLE and no kidney damage, 23 individuals with LN, and 10 clinically healthy controls (HCs) to identify differential metabolic profiles for SLE and LN. The data analysis revealed a differentially abundant metabolite expression profile for each study group, and those metabolites may act as potential differential biomarkers of SLE and LN. The differential metabolic pathways found between the LN and SLE patients with no kidney involvement included primary bile acid biosynthesis, branched-chain amino acid synthesis and degradation, pantothenate and coenzyme A biosynthesis, lysine degradation, and tryptophan metabolism. Receiver operating characteristic curve analysis revealed that monopalmitin, glycolic acid, and glutamic acid allowed for the differentiation of individuals with SLE and no kidney involvement and individuals with LN considering high confidence levels. While the results offer promise, it is important to recognize the significant influence of medications and other external factors on metabolomics studies. This impact has the potential to obscure differences in metabolic profiles, presenting a considerable challenge in the identification of disease biomarkers. Therefore, experimental validation should be conducted with a larger sample size to explore the diagnostic potential of the metabolites found as well as to examine how treatment and disease activity influence the identified chemical compounds. This will be crucial for refining the accuracy and effectiveness of using urine metabolomics for diagnosing and monitoring lupus and lupus nephritis.

Introduction: academic stress is a common challenge among university students and can have negative effects on their performance and well-being, as well as hinder conscious learning regulation. This article presents a training program designed to address this problem from a neuropsychological approach and promote self-regulated learning. Objective: to evaluate the effectiveness of the self-regulated learning training strategy in reducing stress associated with the academic context. Method: a mixed research design was employed, involving eight second-year undergraduate students. The training program consisted of five sessions, each addressing specific aspects of self-regulated learning and academic stress management. Quantitative data were collected, and semi-structured interviews were conducted to gain a deeper understanding of the phenomenon. Results: the program had a positive impact on reducing stress associated with the academic context and improving performance in the sample. Participants reported increased awareness of their own learning strategies and improved ability to manage stress in the academic environment. Conclusions: this study demonstrates that a training program in self-regulated learning, based on a neuropsychological approach, can be effective in reducing stress associated with the academic context and increasing the performance of university students. These findings support the importance of providing students with strategies to manage stress and promote self-regulated learning.

Objective A grassroots environmental-justice organisation in Kansas City has been examining the disproportionate exposure to air pollution experienced by residents living fenceline to the largest classification railyard in the USA. Prior analyses showed limited increased risk for asthma exacerbation for patients with asthma living closer to toxic release inventory (TRI) facilities and railyards. In this study, we assessed geographical asthma and environmental disparities, to further explore community-level disparities.Design This is a cross-sectional study of population-level asthma rates, which included rates for all asthma encounters and acute asthma encounters (urgent care, emergency department, inpatient admission). Distances from census-tract centroids to nearest TRI facilities, railyards and highways were calculated. The association between asthma rates and distances was examined using Kendall’s τ correlation and multivariable Poisson regression models.Setting We used electronic medical record data from the regional paediatric hospital, census and Environmental Protection Agency (EPA) air monitoring data.Participants Patients with 2+ asthma encounters during the EPA study timeframe were identified.Results Residential distance from railyards exhibited a significant negative correlation with overall (−0.36 (CI −0.41 to –0.32)) and acute (−0.27 (CI −0.32 to –0.22)) asthma rates. Asthma rates were elevated among tracts north of the closest railyard (incident rate ratio: 1.38; CI 1.35 to 1.41) when compared with southern directionality. An increased distance from the nearest railyard of 3 km was associated with a decrease in overall asthma rates of 26%.Conclusion Significant negative associations between proximity to all pollution source types and asthma rates were observed. This community-level research has served as a tool for community engagement and will be used to support proposed local policy. Environmental justice work addresses local concerns involving small, limited datasets, if the data exist at all. The academic epidemiological platform may reconsider acceptable approaches to small population research in order to better serve communities with the most need.

Objectives Research trends concerning hearing loss within teen rural populations are limited and current evidence suggests that extended high-frequency audiometry can be a sensitive tool to detect subclinical hearing loss. Moreover, current research emphasises the importance of representing different ethnic populations in science. This study aimed to determine the prevalence of acquired hearing loss through conventional pure-tone (0.25–8 kHz) and extended high frequency (EHF) (9–20 kHz) audiometry in Afro-Colombian adolescents from a rural area in Colombia.Design Observational, cross-sectional study.Participants 230 Afro-Colombian adolescents aged 13–17 years who attended high school in a rural population from Cartagena, Colombia.Interventions Otoscopic examination, conventional (0.25–8 kHz) and EHF (9–20 kHz) audiometry tests were performed during February-March 2021. Sociodemographic and associated factor questionnaires were also applied to assess probable factors associated with EHF hearing loss.Main outcome measures Prevalence of acquired hearing loss using conventional and EHF audiometry, and factors associated with hearing loss.Results Of 230 adolescents who met the eligibility criteria, 133 (57.82%) were female. The mean age was 15.22 years (SD: 1.62). The prevalence of hearing loss in at least one ear assessed with conventional audiometry was 21.30% and with EHF audiometry 14.78%. The main abnormal otoscopic findings included: neotympanum (1.30%), myringosclerosis (0.87%) and monomeric scars (0.43%). Factors associated with a higher probability of EHF hearing loss found through logistic regression were older age (prevalence ratio (PR): 1.45; 95% CI 1.16 to 1.80), attending the ‘Picó’ four or more times a month (PR: 6.63; 95% CI 2.16 to 20.30), attending bars more than three times a month (PR: 1.14; 95% CI 1.03 to 1.59) and self-reported hearing difficulties (PR: 1.24; 95% CI 1.22 to 4.05).Conclusions Our results suggest that acquired hearing loss is already widespread among this young rural population.

During tuberculosis (TB), migration of dendritic cells (DCs) from the site of infection to the draining lymph nodes is known to be impaired, hindering the rapid development of protective T-cell-mediated immunity. However, the mechanisms involved in the delayed migration of DCs during TB are still poorly defined. Here, we found that infection of DCs with Mycobacterium tuberculosis (Mtb) triggers HIF1A-mediated aerobic glycolysis in a TLR2-dependent manner, and that this metabolic profile is essential for DC migration. In particular, the lactate dehydrogenase inhibitor oxamate and the HIF1A inhibitor PX-478 abrogated Mtb-induced DC migration in vitro to the lymphoid tissue-specific chemokine CCL21, and in vivo to lymph nodes in mice. Strikingly, we found that although monocytes from TB patients are inherently biased toward glycolysis metabolism, they differentiate into poorly glycolytic and poorly migratory DCs compared with healthy subjects. Taken together, these data suggest that because of their preexisting glycolytic state, circulating monocytes from TB patients are refractory to differentiation into migratory DCs, which may explain the delayed migration of these cells during the disease and opens avenues for host-directed therapies for TB.

Objectives To assess the association of socioeconomic demographics with recommendation for and uptake of risk-reducing bilateral salpingo-oophorectomy (rrBSO) in patients with BRCA1 and BRCA2 (BRCA1/2) mutations.Design Retrospective cohort, semistructured qualitative interviews.Setting and participants BRCA1/2 mutation carriers at an urban, public hospital with a racially and socioeconomically diverse population.Intervention None.Primary and secondary outcomes The primary outcomes were rate of rrBSO recommendation and completion. Secondary outcomes were sociodemographic variables associated with rrBSO completion.Results The cohort included 167 patients with BRCA1/2 mutations of whom 39% identified as black (n=65), 35% white (n=59) and 19% Hispanic (n=32). Over 95% (n=159) received the recommendation for age-appropriate rrBSO, and 52% (n=87) underwent rrBSO. Women who completed rrBSO were older in univariable analysis (p=0.05), but not in multivariable analysis. Completion of rrBSO was associated with residence in zip codes with lower unemployment and documented recommendation for rrBSO (p

Ehlers-Danlos syndrome comprises 13 hereditary connective tissue disorders associated with skin hyperelasticity, joint hypermobility, atrophic scarring, and blood vessel fragility. Hypermobile EDS, the most common subtype, has no clear genetic or molecular source. When presented with wide-ranging clinical symptoms, it requires effective clinical diagnosis. A 31-year-old female with hypermobile EDS underwent an abdominal Computed Tomography (CT) scan displaying a 2.9 cm soft-tissue mass possibly arising from the terminal ileum, which was revealed to be a desmoid fibromatosis. It is believed that Gastrointestinal (GI) manifestations may be associated with EDS, specifically the hypermobile subtype. The patient demonstrated manifestations commonly seen throughout the literature on hypermobile EDS, including abdominal pain, nausea, and diarrhoea. With symptoms worsening, a follow-up CT disclosed an enlargement of the ileocecal desmoid tumour, measuring 5.1 cm. Because all the subtypes of EDS share features such as tissue fragility, joint hypermobility, and skin hyperextensibility, and many of the manifestations are insufficient to establish a diagnosis, imaging modalities are essential for proper identification and patient management. Given the patient’s medical history and the involvement of EDS and desmoid tumours with connective tissue, there is a strong linkage between desmoid fibromatosis and the patient’s hypermobile Ehlers-Danlos diagnosis. The available literature does not clearly attribute such a tumour to the syndrome. This patient’s symptoms represent a possible association between hypermobile EDS and desmoid fibromatosis, warranting future research in this area. The patient is now stable and was recently discharged.

Abstract Arterial hypertension (AH) is a multifactorial and asymptomatic disease that affects vital organs such as the kidneys and heart. Considering its prevalence and the associated severe health repercussions, hypertension has become a disease of great relevance for public health across the globe. Conventionally, the classification of an individual as hypertensive or non-hypertensive is conducted through ambulatory blood pressure monitoring over a 24-h period. Although this method provides a reliable diagnosis, it has notable limitations, such as additional costs, intolerance experienced by some patients, and interferences derived from physical activities. Moreover, some patients with significant renal impairment may not present proteinuria. Accordingly, alternative methodologies are applied for the classification of individuals as hypertensive or non-hypertensive, such as the detection of metabolites in urine samples through liquid chromatography or mass spectrometry. However, the high cost of these techniques limits their applicability for clinical use. Consequently, an alternative methodology was developed for the detection of molecular patterns in urine collected from hypertension patients. This study generated a direct discrimination model for hypertensive and non-hypertensive individuals through the amplification of Raman signals in urine samples based on gold nanoparticles and supported by chemometric techniques such as partial least squares-discriminant analysis (PLS-DA). Specifically, 162 patient urine samples were used to create a PLS-DA model. These samples included 87 urine samples from patients diagnosed with hypertension and 75 samples from non-hypertensive volunteers. In the AH group, 35 patients were diagnosed with kidney damage and were further classified into a subgroup termed (RAH). The PLS-DA model with 4 latent variables (LV) was used to classify the hypertensive patients with external validation prediction (P) sensitivity of 86.4%, P specificity of 77.8%, and P accuracy of 82.5%. This study demonstrates the ability of surface-enhanced Raman spectroscopy to differentiate between hypertensive and non-hypertensive patients through urine samples, representing a significant advance in the detection and management of AH. Additionally, the same model was then used to discriminate only patients diagnosed with renal damage and controls with a P sensitivity of 100%, P specificity of 77.8%, and P accuracy of 82.5%.

En 2019, 2.410 millones de personas alrededor del mundo tenían condiciones que podrían beneficiarse de servicios de rehabilitación en algún momento durante el curso de su enfermedad, lo que contribuyó a 310 millones de años de vida vividos con discapacidad. Se estima que para finales del siglo XXI la rehabilitación será la estrategia sanitaria que optimice el funcionamiento de las personas con condiciones agudas, crónicas y causadas por el envejecimiento, por lo que el presente articulo aborda la situación actual de la especialidad en medicina física y rehabilitación en Colombia desde una visión del Grupo de Rehabilitación en Salud de la Universidad de Antioquia. De este modo, se hace una aproximación sobre la prestación de servicios en rehabilitación, los programas de formación en pregrado y postgrado, los recursos humanos disponibles en el área y la investigación en esta especialidad.

Mycoplasma spp. are wall-less bacteria able to infect mammals and are classified as hemotropic (hemoplasma) and nonhemotropic. In aquatic mammals, hemoplasma have been reported in California sea lions (Zalophus californianus) and river dolphins (Inia spp.). We investigated Mycoplasma spp. in blood samples of West Indian manatees (Trichechus manatus), pinnipeds (5 species), and marine cetaceans (18 species) that stranded or were undergoing rehabilitation in Brazil during 2002–2022. We detected Mycoplasma in blood of 18/130 (14.8%) cetaceans and 3/18 (16.6%) pinnipeds. All tested manatees were PCR-negative for Mycoplasma. Our findings indicate that >2 different hemoplasma species are circulating in cetaceans. The sequences from pinnipeds were similar to previously described sequences. We also detected a nonhemotropic Mycoplasma in 2 Franciscana dolphins (Pontoporia blainvillei) that might be associated with microscopic lesions. Because certain hemoplasmas can cause disease and death in immunosuppressed mammals, the bacteria could have conservation implications for already endangered aquatic mammals.

This study aimed to identify the factors associated with all-cause in-hospital mortality in laboratory-confirmed dengue cases from 2020 to mid-2024. A nationwide retrospective cohort study was conducted in Mexico and data from 18,436 participants were analyzed. Risk ratios (RRs) and 95% confidence intervals (CIs), estimated using generalized linear regression models, were used to evaluate the factors associated with all-cause in-hospital mortality risk. The overall case–fatality rate was 17.5 per 1000. In the multiple model, compared to dengue virus (DENV) 1 infections, DENV-2 (RR = 1.81, 95% CI 1.15–2.86) and DENV-3 (RR = 1.87, 95% CI 1.19–2.92) were associated with increased mortality risk. Patient characteristics, such as increasing age (RR = 1.02, 95% CI 1.01–1.03), type 2 diabetes mellitus (RR = 2.07, 95% CI 1.45–2.96), and chronic kidney disease (RR = 3.35, 95% CI 2.03–5.51), were also associated with an increased risk of a fatal outcome. We documented the influence of both the virus and individual susceptibility on mortality risk, underscoring the need for a comprehensive public health strategy for dengue.

Introducción. La hipertensión arterial sigue siendo un desafío para la salud pública del Paraguay, la falta de adherencia a los tratamientos es un problema desde el punto de vista médico, económico y psicosocial. El uso de la tecnología constituye una herramienta útil en el seguimiento de pacientes y mejoramiento de la adherencia al tratamiento farmacológico. Objetivo. Evaluar la adherencia al tratamiento farmacológico antihipertensivo en pacientes con hipertensión que asisten a servicio de salud público, mediante una herramienta digital telefónica. Materiales y métodos. Estudio cuasi-experimental realizado en pacientes mayores de 18 años de ambos sexos con hipertensión arterial; en los cuales se aplicaron intervenciones farmacéuticas mediante tecnología y se evaluó la adherencia al tratamiento mediante el cuestionario de Morisky-Green, junto con preguntas complementarias para conocer las causas. El protocolo de investigación fue aprobado por un Comité de Ética en Investigaciones de la FCQ-UNA (714/2021). Resultados. Participaron 60 pacientes. El 68,3% (n=41) al inicio mostró adherencia al tratamiento según el cuestionario de Morisky-Green, y el 31,7% (n=19) no cumplió con la indicación, después de las intervenciones se ha encontrado una mayor adherencia al tratamiento, llegando a 96,7% los cumplidores (p

Background Opioid overdoses in the USA have increased to unprecedented levels. Administration of the opioid antagonist naloxone can prevent overdoses.Objective This study was conducted to reveal the pharmacoepidemiologic patterns in naloxone prescribing to Medicaid patients from 2018 to 2021 as well as Medicare in 2019.Design Observational pharmacoepidemiologic studySetting US Medicare and Medicaid naloxone claimsIntervention The Medicaid State Drug Utilisation Data File was utilised to extract information on the number of prescriptions and the amount prescribed of naloxone at a national and state level. The Medicare Provider Utilisation and Payment was also utilised to analyse prescription data from 2019.Outcome measures States with naloxone prescription rates that were outliers of quartile analysis were noted.Results The number of generic naloxone prescriptions per 100 000 Medicaid enrollees decreased by 5.3%, whereas brand naloxone prescriptions increased by 245.1% from 2018 to 2021. There was a 33.1-fold difference in prescriptions between the highest (New Mexico=1809.5) and lowest (South Dakota=54.6) states in 2019. Medicare saw a 30.4-fold difference in prescriptions between the highest (New Mexico) and lowest states (also South Dakota) after correcting per 100 000 enrollees.Conclusions This pronounced increase in the number of naloxone prescriptions to Medicaid patients from 2018 to 2021 indicates a national response to this widespread public health emergency. Further research into the origins of the pronounced state-level disparities is warranted.

Abstract Trauma is the leading cause of death in the pediatric population. Although vascular trauma has an incidence of 6% in civilian population, iatrogenic injuries are the leading cause, and the most frequent injured vessel is the iliofemoral sector. However, little information is available and there are no guidelines about its treatment. Therefore, this review aimed to describe the information available concerning pediatric iatrogenic arterial trauma, focusing on the iliofemoral segment and present 3 cases. We described 11 articles with 171 patients, of whom 61% underwent surgery to treat iatrogenic trauma. Mean age was 3.28 years (standard deviation of 3.5 years), and 54% were female. Most iliofemoral injuries occurred after arterial catheterization for hemodynamic monitorization and therapeutic or diagnostic cardiac catheterization (due to congenital heart diseases, including septal defects, tetralogy of Fallot, aortic coarctation, and patent ductus arteriosus). For acute complications, arterial thrombosis was the leading injury, followed by pseudoaneurysm, hematoma, dissection, transection, avulsion, eversion, and combined lesions.

The increasing threat from antibiotic-resistant bacteria has necessitated the development of novel methods to counter bacterial infections. In this context, the application of metallic nanoparticles (NPs), especially gold (Au) and silver (Ag), has emerged as a promising strategy due to their remarkable antibacterial properties. This review examines research published between 2006 and 2023, focusing on leading journals in nanotechnology, materials science, and biomedical research. The primary applications explored are the efficacy of Ag and Au NPs as antibacterial agents, their synthesis methods, morphological properties, and mechanisms of action. An extensive review of the literature on NPs synthesis, morphology, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and effectiveness against various Gram(+/−) bacteria confirms the antibacterial efficacy of Au and Ag NPs. The synthesis methods and characteristics of NPs, such as size, shape, and surface charge, are crucial in determining their antibacterial activity, as these factors influence their interactions with bacterial cells. Furthermore, this review underscores the urgent necessity of standardizing synthesis techniques, MICs, and reporting protocols to enhance the comparability and reproducibility of future studies. Standardization is essential for ensuring the reliability of research findings and accelerating the clinical application of NP-based antimicrobial approaches. This review aims to propel NP-based antimicrobial strategies by elucidating the properties that enhance the antibacterial activity of Ag and Au NPs. By highlighting their inhibitory effects against various bacterial strains and relatively low cytotoxicity, this work positions Ag and Au NPs as promising materials for developing antibacterial agents, making a significant contribution to global efforts to combat antibiotic-resistant pathogens.

OBJECTIVES/GOALS: Policy makers are interested in understanding scientific collaborations that translate knowledge into population health. The objective of this study is to compare the translational research collaboration of the Hispanic Alliance of Clinical and Translational Research in 2020 and 2023 by using Social Network Analysis (SNA). METHODS/STUDY POPULATION: We conducted a systematic document review of all the Hispanic Alliance Calls for Pilot Projects from 2020 to 2023 including key attributes of the investigators and collaborators such as academic institution, highest degree, and collaborator type. Scientific collaboration was defined as two or more researchers working together in grant proposal for a pilot project application. Study data was recorded and tracked using an Excel spreadsheet. R Statistical software was used to analyze and map the networks resulting from collaboration interactions comparing the 2020 Call and 2023 Call. Network statistics were performed including nodes, isolates, edges, components, density, diameter, average degree, and the size of the main component. RESULTS/ANTICIPATED RESULTS: A total of 134 investigators comprised the overall network. The network are predominantly clinician (49.3%) and basic researchers (25.4%). Preliminary results shows that diversity of disciplines and affiliations in the collaborative relationships increased across time. Findings demonstrated that the number of nodes/actors increased from 16 to 65 comparing 2020 to 2023 and the edges/relationships from 12 to 53. The number of translational research cluster increased from 4 to 13 comparing 2020 to 2023. More extensive collaborative cluster occurred across time with over 15 researchers collaborating. A mentor was the key player connecting these research clusters. DISCUSSION/SIGNIFICANCE: This study provides critical data to mapping the IDeA CTR translational research collaboration patterns. Research collaboration increased across time. This innovative approach serves to foster data-driven decision-making to enhance collaboration, diversity, and program outcomes. It offers valuable insights for policy and practice.

Abstract The energy industry significantly contributes to anthropogenic methane emissions, which add to global warming and have been linked to an increased risk of cardiovascular diseases (CVD). This study aims to evaluate the relationship between energy-related methane emissions and the burden of CVD, measured in disability-adjusted life years (DALYs), in 2019. We conducted a cross-sectional analysis of datasets from 73 countries across all continents. The analyzed datasets included information from 2019 on environmental energy-related methane emissions, burden of DALYs due to CVD. The age-standardized prevalence of obesity in adults and life expectancy at birth were retrieved. The relationship between the variables of interest was evaluated using multiple linear regression models. In the multiple model, we observed a positive linear association between methane emissions and the log-transformed count of DALYs related to CVD. Specifically, for each unit increase in energy-related methane emissions, the burden of CVD increased by 0.06% (95% CI 0.03–0.09%, p

As we age, structural and functional changes in organs occur, a process associated with multiple comorbidities requiring continuous treatment and multiple medications. Inappropriate prescription in older adults is one of the leading causes of adverse drug reactions (ADRs), associated with increased morbidity and mortality and the use of health resources. The objective of this study was to establish the frequency of potentially inappropriate prescriptions (PPI) using the STOPP/START criteria in older adult patients from the outpatient service of a Social Security Hospital through an observational, descriptive, cross-sectional, and retrospective study during the first quarter of 2021. A total of 354 prescriptions from older adult outpatients (65 years and over), of both sexes, with data collection registered in the Integrated Hospital System (SIH), were analyzed. Demographic variables were considered, including frequency of PPI according to STOPP/START criteria, where the majority of the study population were women (61.6%) with a mean age of 74 years (SD= 7.06). Of the total number of patients whose prescriptions were part of the study, 57.06% (95% CI 57.14-56.97) presented at least 1 STOPP or START criterion. The criteria applied are a helpful tool in detecting possible problems related to prescription medications, which improve the safety of older adult patients in their pharmacological treatment when used in clinical practice.

Background: Introduction: depression and anxiety are common following traumatic brain injury (TBI). However, the relationship between these disorders and TBI severity remains contradictory. The objective of this study was to evaluate the association between the occurrence of anxious or depressive symptoms and TBI severity in adults with moderate or severe TBI in Medellín, Antioquia. Methods: Analytical study with a prospective cohort of patients aged 18 years and above with moderate or severe TBI. State and trait anxiety symp-toms (measured using the STAI-E and STAI-R, respectively) and depressive symptoms (measured using the PHQ-9) were assessed at baseline and at 6 months, and compared based on TBI severity measured using the Glasgow Coma Scale (GCS). Results: A total of 58 patients were included, with 35 having severe TBI and 23 having moderate TBI. 70.6% of the patients completed the follow-up. Traffic accidents and falls accounted for 86% of the TBI causes. Patients with severe TBI exhibited more intense depressive symptoms at baseline (p=0.027) and at six months (p=0.012). No significant differences were found in anxiety symptoms between groups, except for trait anxiety at six months in the severe TBI group (p=0.043). Conclusions: The intensity of depressive symptoms measured by the PHQ-9 is directly related to TBI severity assessed by the GCS, while the relationship between anxiety symptoms and TBI severity is less clear.

La soja es considerada uno de los cultivos más importantes del mundo, de igual manera los nematodos son de suma importancia a nivel mundial por su capacidad de causar enfermedades. Los nematodos fitoparásitos de los géneros Helicotylenchus, Scutellonema y Tylenchorhynchus han sido reportados en varias zonas de producción de soja. El presente estudio tuvo como objetivo, determinar el factor reproductivo de Helicotylenchus, Scutellonema y Tylenchorhynchus en cultivos de soja. Se seleccionaron cuatro campos comerciales de soja, en Itapúa y Canindeyú, los cuales fueron nombrados parcela comercial 1, 2, 3 y 4. Dentro de estos campos, se procedió a tomar 10 muestras compuestas al inicio de la siembra (población inicial) y al momento de la cosecha (población final). Se evaluó el factor reproductivo (FR) para cada nematodo fitoparásito usando la prueba de t de Student y se comparó si FR era igual o menor a uno (Ho) o mayor que uno (Ha). El nematodo Helicotylenchus fue detectado en las cuatro parcelas, pero solo en las parcelas comerciales 3 y 4 el FR fue significativamente mayor a 1 (P-valué). Se identificó la presencia de Scutellonema en las parcelas comerciales 1, 2 y 4 y el FR fue significativamente superior a 1 (P-valué). Tylenchorhynchus fue identificado en las parcelas comerciales 2 y 3 y en ambos casos, el FR fue significativamente superior a 1. Por lo tanto, se comprobó que los géneros Helicotylenchus, Scutellonema y Tylenchorhynchus se reproducen en campos asociados al cultivo de soja, por lo que pueden ser considerados posibles patógenos de este cultivo en Paraguay

Resistance to insecticides is one of the great challenges that vector control programs must face. The constant use of pyrethroid-type insecticides worldwide has caused selection pressure in populations of the Aedes aegypti vector, which has promoted the emergence of resistant populations. The resistance mechanism to pyrethroid insecticides most studied to date is target-site mutations that desensitize the voltage-gated sodium channel (VGSC) of the insect to the action of pyrethroids. In the present study, susceptibility to the pyrethroid insecticides permethrin, lambda-cyhalothrin, and deltamethrin was evaluated in fourteen populations from the department of Córdoba, Colombia. The CDC bottle bioassay and WHO tube methods were used. Additionally, the frequencies of the F1534C, V1016I, and V410L mutations were determined, and the association of resistance with the tri-locus haplotypes was examined. The results varied between the two techniques used, with resistance to permethrin observed in thirteen of the fourteen populations, resistance to lambda-cyhalothrin in two populations, and susceptibility to deltamethrin in all the populations under study with the CDC method. In contrast, the WHO method showed resistance to the three insecticides evaluated in all populations. The frequencies of the mutated alleles ranged from 0.05-0.43 for 1016I, 0.94-1.0 for 1534C, and 0.01-0.59 for 410L. The triple homozygous mutant CIL haplotype was associated with resistance to all three pyrethroids evaluated with the WHO bioassay, while with the CDC bioassay, it was only associated with resistance to permethrin. This study highlights the importance of implementing systematic monitoring of kdr mutations, allowing resistance management strategies to be dynamically adjusted to achieve effective control of Aedes aegypti.

Abstract Point of care rapid diagnostic tests (POC-RDT) for Hepatitis C virus (HCV), Human Immunodeficiency virus (HIV) and Hepatitis B virus (HBV), are ideal for screening in non-clinical outreach settings as they can provide immediate results and facilitate diagnosis, allowing high risk population screening. The aim of this study was to compare POC-RDT with laboratory conventional tests. A total of 301 vulnerable evaluable subjects (drug users, migrants and homeless population) were recruited at a mobile screening unit in outreach settings in Madrid. Fingerprick whole blood capillary samples were tested using the SD BIOLINE HCV POC-RDT, Determine HIV Early Detect and Determine HBsAg 2, and the results were assessed against the LIAISON XL HCV, HIV and Murex-HBsAg-Quant, reference assays, respectively. The feasibility and user satisfaction of the POC-RDT were evaluated through a questionnaire. The resolved sensitivity and resolved specificity and their 95% confidence intervals (95% CI) were as follows, respectively: SD-BIOLINE-HCV: 98.8% (95% CI 93.4, 100.0) and 100.0% (95% CI 98.3, 100.0); Determine HIV Early Detect: 100% (95% CI 85.2, 100.0) and 100% (95% CI 98.7, 100); and Determine HBsAg 2: 66.7% (95% CI 9.4, 99.2) and 100.0% (95% CI 98.7, 100.0). As expected, the number of subjects with a confirmed positive result for HBsAg was very low (n = 4). Therefore, the analytical sensitivity has been evaluated in addition: The Determine HBsAg 2 test demonstrated 100% sensitivity for standard concentrations ≥ 0.125 IU/mL. The subject questionnaire yielded positive feedback for most subjects. The POC-RDT fingerprick blood collection method was well received, and the tests demonstrated a comparable clinical performance with conventional tests in outreach settings and vulnerable high-risk populations.

Objetivos: La investigación se propuso tres objetivos: describir la representación social de salud y bienestar; caracterizar la labor de los profesionales de salud para promover el bienestar; establecer similitudes y diferencias entre lo que conocen y realizan, respecto del concepto de la Organización Mundial de la Salud. Materiales y métodos: Es un estudio descriptivo, transversal, multicéntrico (Cuba, México, Panamá y Perú); después de una revisión bibliográfica, se llevó cabo una encuesta y consulta a expertos. Se utilizó un muestreo no probabilístico y se realizaron análisis de estadística descriptiva. Resultados: Los profesionales de salud, perciben el bienestar muy agradable y cómodo, posible, dulce, bueno, responsable, flexible, seguro, blanco, algo ligero, pero un poco corto y difícil; a la salud la perciben muy agradable, posible, cómoda, flexible, dulce, responsable, segura, buena, blanca, ligera y larga pero difícil; la mayoría cree conocer los conceptos salud y bienestar de OMS/OPS, pero al compararlos con los establecidos por estos organismos, no son correctos, ni completos y su conocimiento resulta insuficiente. Conclusiones: Los profesionales de salud no tienen una comprensión total de la relación entre ambos conceptos; la mayoría realiza las acciones para promover el bienestar que le resultan fáciles; no se perciben como entes activos y transformadores en las actividades generadoras de una vida saludable y, por tanto, no se encuentran en consonancia con las transformaciones necesarias que privilegian salud y bienestar.

The prawn Macrobrachium tenellum shows aquaculture potential due to its well-defined reproductive cycle linked to female nutritional requirements. Significant changes occur in egg composition during the 16 to 17-day embryo development. Understanding the ontogenic proteins is crucial for developmental insights and controlled reproduction. We employed free-label quantitative proteomics to analyze egg peptides at the initial and final stages of wild females. Using the emPAI protocol and Proteome Discoverer 2.0, we identified 89 differentially expressed proteins in M. tenellum eggs. Of these, 27 were exclusive to early-stage development and three to late-stage. Abundant proteins included Vitellogenin, glyceraldehyde-3-phosphate dehydrogenase, histone 4, beta-actin, and hemocyanin. Gene Ontology analysis revealed 518 terms across molecular functions, biological processes, and cellular components using the GoRetriever tool of AgBase and the CateGOrizer tool of the Animal Genome Research Program. Carbohydrate metabolism was significant in early-stage development, with glyceraldehyde-3-phosphate dehydrogenase being the second most abundant protein. Proteins involved in ATP synthesis and cytoplasmic proteins associated with catalytic and binding activities related to primary metabolism were also detected. Our study elucidates the role of Vitellogenin in lipid transport activity and its potential involvement in the juvenile hormone feedback pathway. This pathway includes farnesoic acid O-methyltransferase and juvenile hormone epoxide oxidase, regulating protein biosynthesis, molt cycles (including chitinase activity), and potentially influencing controlled reproduction. Our proteomic analysis provides insights into the molecular mechanisms driving Ontogenic development in Macrobrachium tenellum, with implications for controlled reproduction strategies and advancements in aquaculture practices.

Objetivo: Evaluar la incidencia y factores asociados al pensamiento suicida en una muestra de médicos residentes de dos instituciones. Materiales y métodos: Se realizó un estudio de tipo descriptivo, observacional, prospectivo y transversal, entre los meses de septiembre a octubre del 2022, para estimar el pensamiento suicida en los médicos residentes de dos hospitales con la escala de Plutchik, además de buscar factores asociados. Se aplicó la estadística descriptiva con medidas de tendencia central y de dispersión, frecuencias relativas y absolutas; las pruebas ji al cuadrado de Pearson y de bondad de ajuste, así como la prueba de Kruskal-Wallis se emplearon para examinar las diferencias entre especialidades, y la prueba post-hoc de Tukey para evaluar la especialidad diferente. Resultados: Se respondió un total de 225 encuestas, de las cuales se eliminaron 20 por inadecuado diligenciamiento, y quedaron 205. El promedio de edad fue de 28,66 años (DS ± 2,360) y el 71,2 % correspondió al sexo femenino. En cuanto a las especialidades, se encontró a pediatría con el 28,8 % y a anestesiología con el 20,5 %. Se evidenció asociación significativa entre especialidades, con un valor de p = 0,0000, y grado académico de p = 0,003 (p ≤ 0,05). Según la especialidad, se encontraron diferencias en cuanto al pensamiento suicida; la prueba de Kruskal-Wallis mostró un valor de p = 0,000 y la prueba post-hoc de Tukey reveló que la especialidad de ginecología fue la diferente. Conclusiones: De acuerdo con los resultados de la muestra, alrededor de una cuarta parte de los médicos residentes manifiesta pensamiento suicida. La prevalencia en dicha muestra no presenta diferencia significativa con respecto a la incidencia a nivel latinoamericano. Se encontró una asociación entre ideas suicidas, especialidades médicas y grado académico. En cuanto a comparación entre las especialidades, ginecología fue la que mostró mayor ideación suicida. Este trabajo presenta algunas limitaciones, por ejemplo, existe una gran heterogeneidad de grupos, no se empleó una técnica de selección probabilística y las pruebas estadísticas empleadas fueron no paramétricas.

La fisioterapia en la unidad de cuidados intensivos se enfrenta a grandes desafíos debido a la complejidad fisiopatológica del paciente en estado crítico, la alta tecnificación de la atención y los constantes dilemas bioéticos durante la práctica clínica. El fisioterapeuta debe basar su actuar en principios bioéticos para garantizar el respeto a la autonomía del paciente, proporcionar intervenciones con el mayor nivel de evidencia, reduciendo los probables efectos adversos, y además distribuir de manera justa los recursos disponibles. El cuestionamiento de la práctica clínica desde la bioética permitirá tener una práctica clínica más humana, con toma de decisiones conjuntas y mayor nivel de satisfacción por parte del paciente o la familia. El objetivo del presente artículo es proporcionar una perspectiva general de la bioética en la práctica del fisioterapeuta que atiende a pacientes en la unidad de cuidados intensivos.

Objectives To evaluate the efficacy of antituberculosis therapy on pregnancy outcomes in infertile women with genital tuberculosis.Design Systematic review.Data sources We searched in PubMed/MEDLINE, CENTRAL and EMBASE up to 15 January 2023. Additionally, we manually search the reference lists of included studies.Eligibility criteria We included randomised controlled trials (RCT), non-RCTs (non-RCT) and cohort studies that evaluated the effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis compared with not receiving antituberculosis treatment or receiving the treatment for a shorter period.Data extraction and synthesis Two independent reviewers extracted data. We used Cochrane Risk of Bias 1.0 and Risk Of Bias In Non-randomised Studies tools for risk of bias assessment and meta-analysis was not performed. We used Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence.Results Two RCTs and one non-RCT were included. The antituberculosis regimens were based on isoniazid, rifampicin, pyrazinamide and ethambutol for 6–12 months. In women without structural damage, very low certainty of evidence from one RCT showed that the antituberculosis treatment may have little to no effect on pregnancy, full-term pregnancy, abortion or intrauterine death and ectopic pregnancy, but the evidence is very uncertain. In women with structural damage, very low certainty of evidence from one non-RCT showed that the antituberculosis treatment may reduce the pregnancy rate (297 fewer per 1000, 95% CI −416 to −101), but the evidence is very uncertain. In addition, very low certainty of evidence from one RCT compared a 9-month vs 6-month antituberculosis treatment regimen showed similar effects between the schemes, but the evidence is very uncertain. Two RCTs reported that no adverse events of antituberculosis treatment were noted or were similar in both groups.Conclusion The effect of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis is very uncertain.PROSPERO registration number CRD42022273145.

Cada vez se presentan más cambios ambientales en la Tierra relacionados a la presencia antrópica del ser humano. En la actualidad, existen múltiples problemas ambientales que se buscan solucionar debido a las consecuencias de los mismos, donde la tala de árboles es uno de ellos. La celulosa vegetal (obtenida principalmente de los árboles) es una materia prima de gran importancia en la fabricación de papel; por lo que el futuro de los bosques depende de la fabricación y el consumo de papel. La presente revisión analiza el uso de la celulosa bacteriana como materia prima para la sustitución de la celulosa vegetal en la industria papelera para una posible reducción de la tala de árboles.

Los Centros de Información de Medicamentos (CIM) son defi nidos como unidades operacionales que proporcionan información científi ca y técnica sobre medicamentos de forma objetiva y oportuna, constituyendo una óptima estrategia para atender necesidades particulares de información, con el fin de promover el uso correcto y seguro de los mismos. El propósito de este estudio es describir las consultas recibidas en el CIM de |UNA durante el periodo 2015 -2019 y su rol en la contribución al uso racional de medicamentos, para lo cual se llevó a cabo un estudio observacional descriptivo de corte transversal con recolección retrospectiva de la información. Se tomaron todas las fichas de consultas ingresadas a la base de datos del CIM durante el periodo en estudio. En el periodo de estudio se han realizado un total de 254 consultas, con un promedio de 51 consultas por año, en su mayoría se hicieron a nivel nacional y en un 13% de las mismas involucraban a pacientes. Los principales temas solicitados al CIM fueron aquellos relacionados a legislación farmacéutica (Registro y disponibilidad de medicamentos en el país), seguido de temas relacionados al uso racional, Farmacovigilancia entre otros. El análisis y caracterización permitió conocer las necesidades de información respecto a los medicamentos, brindar la información objetiva, dirigida y de calidad cumpliendo con el objetivo de promover el uso racional de medicamentos.

Objetivo: Identificar las causas de exclusión de los donantes renales vivos en un centro hospitalario de tercer nivel en el noroeste de México. Materiales y métodos: Estudio de tipo observacional, transversal, descriptivo, retrospectivo. Se realizó la evaluación de los expedientes clínicos de los candidatos vivos para donación renal, que abarcó el periodo comprendido entre el 1 de enero de 2019 y el 31 de diciembre de 2021. Resultados: De los 30 expedientes seleccionados, solo se eligieron 2 (6,6 %) donadores, es decir, existió un índice de rechazo de 28 (93,3 %) de los potenciales candidatos. La edad promedio fue de 40,7 años; al dividirlos en grupos de edad, se observó que el 7,44 % fueron ≤39 años; el 5,31 %, ≥50 años; y el 4,25 %, de 40 a 49 años. Dentro de las principales patologías que originaron el rechazo del donador vivo se encuentran las enfermedades crónicas, como afección renal desconocida, obesidad, diabetes mellitus, hipertensión arterial sistémica y cardiopatías, que representaron el 60,7 %. El deseo de donar es más frecuente entre consanguíneos que en no consanguíneos. En el caso de los consanguíneos, es decir, hermanos, padres, hijos, tíos, etc., el 64,2 % fue rechazado; en los no consanguíneos, el 34,7 %, que incluía a esposos y amigos. Conclusiones: Los resultados obtenidos sobre el índice de masa corporal (IMC) mostraron que el sobrepeso y la obesidad fueron las principales causas de exclusión, circunstancia que es particular en nuestro país respecto a su perfil epidemiológico. La cantidad de donantes vivos en nuestro centro se redujo porque la mayor parte de la población no es sana, padece obesidad y ello repercute al momento de presentarse como candidato a donante.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by a heterogeneous clinical picture that makes the diagnosis and follow-up of these patients difficult. This study aimed to identify correlations between clinical, immunological, and genetic biomarkers and clinical manifestations in SLE. A retrospective study of data from medical records and immunological and genetic studies of SLE patients in Paraguay was carried out. A descriptive analysis was performed based on the type of variable. Human leukocyte antigen (HLA) allele frequencies (DPA1, DPB1, DQA1, DQB1, and DRB1) were calculated, and univariate logistic regression analyses were performed between each of the explanatory variables and the presence or absence of each phenotype. Odds ratios, 95% confidence intervals, and p values were recorded. Associations with p

The emergence and global dissemination of bacterial strains from numerous species with resistance to multiple antibiotic classes has increased in recent years, both in the healthcare and the community setting [...]

Abstract Excessive adipose tissue can lead to metabolic abnormalities resulting in lipid alteration and oxidative stress (OS) status. The lipid accumulation product (LAP) index is a biomarker that indicates central lipid accumulation and has been proposed as an accurate and independent indicator of risk for several cardiometabolic related conditions. There is a lack of information about the possible association of LAP and OS biomarkers. Therefore, this work aimed to investigate the relationship between LAP and OS biomarkers in adults. A cross-sectional study was performed in 250 subjects attending the Hospital Regional de Alta Especialidad de la Península de Yucatán. Anthropometrical and clinical parameters were measured. The serum oxidative biomarkers such as malondialdehyde (MDA) and total antioxidant capacity (TAC) were evaluated by spectrophotometry and by the oxygen radical absorbance capacity (ORAC), respectively. A positive and significant correlation between serum levels of MDA and LAP (r = 0.162, p = 0.010) was observed. This relationship was stronger in women (r = 0.189, p = 0.013) than in men. The association between them remained significant after adjusting for confounders (r = 0.23, p

The global health emergency caused by COVID-19 concluded in May 2023, marking the beginning of an endemic phase. This study aimed to evaluate the association between vaccination status and other patient characteristics and the risk of severe disease during this new endemic period. A nationwide cohort study was conducted in Mexico, where we analyzed data from 646 adults who had received positive confirmation of COVID-19 through PCR testing from May to August 2023. The overall risk of severe symptoms in the study sample was 5.3%. The average time elapsed from the last vaccine shot to symptom onset was over six months in all the immunized groups (1, 2 or 3 vaccine doses). Compared to unvaccinated patients, those with three vaccine doses showed an elevated risk of severe symptoms. Advancing age and various chronic comorbidities (specifically cardiovascular, kidney, and obstructive pulmonary conditions) were associated with a heightened risk of severe COVID-19 manifestations. These findings underscore the ongoing seriousness of COVID-19, even in an endemic phase, underscoring the urgent need for tailored interventions aimed at high-risk patients.

In May 2023, the global health emergency status of COVID-19 concluded, marking the onset of an endemic era. This study assessed survival rates among PCR-confirmed adult inpatients during this phase and determined contributing factors. Employing a survival analysis approach, this investigation utilized a nationwide Mexican cohort encompassing 152 adult inpatients. Survival rates were computed using the Kaplan–Meier method, and a proportional Cox model identified mortality risk factors. Survival rates remained above 65% on day 14 after admission. Vaccination status, including the number of doses administered, was not significantly associated with fatal outcomes. Chronic kidney disease or a history of immunosuppression (due to any cause) increased mortality risk. Our findings underscore the persistent severity of COVID-19 beyond the global health emergency, emphasizing the necessity for tailored interventions for vulnerable patients.

Histologic and genetic mutation information from racially and ethnically diverse populations is warranted to better inform future cancer predisposition and promote health equity. A single institutional, retrospective capture of patients with gynecologic conditions and genetic susceptibilities to malignant neoplasms of the breast or ovaries was performed. This was achieved with manual curation of the electronic medical record (EMR) from 2010-2020 with the use of ICD-10 code searches. Among 8983 consecutive women identified with gynecologic conditions, 184 were diagnosed with pathogenic/likely pathogenic (P/LP) germline BRCA (gBRCA) mutations. Median age was 54 (22-90). Mutations included insertion/deletion (majority frameshift, 57.4%), substitution (32.4%), large structural rearrangement (5.4%), and alteration in splice site/intronic sequence (4.7%). A total of 48% were non-Hispanic White, 32% Hispanic or Latino, 13% Asian, 2% Black, and 5% Other. The most common pathology was high grade serous carcinoma (HGSC, 63%), followed by unclassified/high grade carcinoma (13%). Additional multigene panels led to the detection of 23 additional BRCA-positive patients with germline co-mutations and/or variants of uncertain significance in genes functionally involved in DNA repair mechanisms. Hispanic or Latino and Asian individuals comprised 45% of patients with concomitant gynecologic condition and gBRCA positivity in our cohort, confirming that germline mutations are represented across racial and ethnic groups. Insertion/deletion mutations, the majority of which led to a frameshift change, occurred in approximately half of our patient cohort, which may have prognostic implication for therapy resistance. Prospective studies are needed to unravel the significance of germline co-mutations in gynecologic patients.

The objective of this study was to assess COVID-19 classroom transmission in the university setting when physical distancing was eliminated. Data was collected in fall 2021 at a private university. Universal masking, robust contact tracing, vaccination requirement, and enforced testing were in place. Exposures were classified as classroom versus non-classroom. ANOVA and chi-squared tests were used to identify significant relationships between predictors and COVID-19 test result. Logistic regression was conducted to investigate the relationship between exposure type and test result. A total of 162 student cases were identified with 1,658 associated close contacts. One-third of contacts (31.1%, n = 516) only had a non-classroom exposure, 63.8% (n = 1,057) only had a classroom exposure, and 5.1% (n = 85) had both. Close contacts were significantly more likely to test positive if they had a non-classroom exposure (60 of 601; 10.0%) compared to a classroom exposure (1 of 1057; 0.1%) (OR 58.8, CI 18.5-333.3, p < 0.001). Removing physical distancing in classrooms that had universal masking did not result in high rates of COVID-19 transmission. This has policy implications because eliminating physical distancing does not greatly increase transmission risk when universal masking is in place.

Persistent human papillomavirus (HPV) infection is closely associated with cervical carcinoma. Co-infection in the endocervical environment with other microorganisms, such as Chlamydia trachomatis, may increase the risk of HPV infection and neoplastic progression. While in some individuals, Chlamydia trachomatis infection is resolved with the activation of Th1/IFN-γ-mediated immune response, others develop a chronic infection marked by Th2-mediated immune response, resulting in intracellular persistence of the bacterium and increasing the risk of HPV infection. This work aimed to quantify cytokines of the Th1/Th2/Th17 profile in exfoliated cervix cells (ECC) and peripheral blood (PB) of patients positive for Chlamydia trachomatis DNA, patients positive for Papillomavirus DNA, and healthy patients. Cytokine levels were quantified by flow cytometry in ECC and PB samples from patients positive for C. trachomatis DNA (n = 18), patients positive for HPV DNA (n = 30), and healthy patients (n = 17) treated at the Hospital de Amor, Campo Grande-MS. After analysis, a higher concentration of IL-17, IL-6, and IL-4 (p