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The presence of a horizontal aorta in patients treated with transcatheter aortic valve replacement increases the difficulty of the procedure. We present 5 cases with aortic stenosis with a horizontal aorta who underwent transcatheter aortic valve replacement using a self-expanding prostheses, with the objective of describing the techniques used and obtaining success with a snare catheter. ( Level of Difficulty: Intermediate. )., Competing Interests: The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2021 The Authors.)

Purpose: Structural differences have been described in the retina of prematurely born children, including increased macular thickness caused by failed migration of the inner retina during development and retinal nerve fiber layer (RNFL) thinning related to low birth weight. The present study aimed to evaluate the differences in macular and RNFL optical coherence tomography (OCT) findings between full-term and preterm children without retinopathy of prematurity (ROP)., Methods: Thirty-four premature (study group) and 43 full-term patients (control group)-aged 3 to 8 years-were studied. All children underwent a complete ophthalmological exam and OCT of the macula and optic nerve in both eyes to determine macular and RNFL thickness and morphology. Correlation analysis between central macular thickness, age, and visual acuity was also performed., Results: Central macular thickness was greater in the study group than in the control group; a difference of 14.2 μm was observed for the right eye (P = 0.002) and 12.16 μm for the left eye (P = 0.019). The thickness of the parafoveal and the perifoveal zones was consistently greater in the study group. 44.3% of eyes in the study group had mild forms of foveal hypoplasia (grades 1a and 1b) in qualitative description. No correlation between central macular thickness and visual acuity was found. There was no difference in RNFL thickness between both groups., Conclusion: Statistically significant structural differences were found in the macula of premature children, with a greater foveal thickness possibly reflecting retention of the inner retina during development, with no repercussion over visual acuity. RNFL thickness was similar in both groups., Competing Interests: None

Introduction: Alterations in the genes of lysine methylation as Lysine-specific demethylase 6B (KDM6B) have been associated with multiple neurodevelopmental disorders. Until now, there are few cases in the literature attributed to KDM6B mutations. This gap may be due to the fact that the exome sequencing technique is still being implemented in routine clinical practice., Material and Methods: A case is presented with its clinical and phenotypic characteristics. The sequence exome analysis was done with the Nimblegen SeqCap EZ MedExome capture kit+mtDNA 47Mb. The psychopathological approach from mental health was carried out through individual and family interviews, the Conner's questionnaires, ADHD rating scale, as well as the psychometry., Results: A frameshift variant in the KDM6B gene related to neurodevelopmental disorders with facial and body dysmorphia was obtained. The case was oriented as a neurodevelopmental disorder secondary to a genetic alteration and a comorbid Attention Deficit Hyperactivity Disorder (ADHD)., Conclusions: The clinical peculiarities shared by patients identified with the KDM6B mutation, raises the need to recognize it as a particular entity. The possibility of applying the exome sequencing technique to patients with syndromic phenotype and developmental impairment may clarify its etiopathogenesis. It is highly probable that the complexity of these cases requires an approach by a multidisciplinary team that includes genetics, neurology and psychiatry, among other specialties. The coordinated approach is essential to have a comprehensive vision of the case., (Copyright © 2021 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.)

One of the most common chronic diseases that causes missed school days and workdays is pediatric asthma, producing education, health and economic delays in low and middle-income countries. A patient-centered remarkable therapeutic strategy in the prevention and treatment of chronic diseases is the Therapeutic Patient Education (TPE) which denotes an outstanding difference in the outcomes, from the awareness, to the personal treatment adaption to prevent crises. In this paper, an intervention of TPE with learning objects (LOs) of a pediatric asthma course, designed to train the uncontrolled patient and the caregiver as a team on the specific knowledge to self-control the disease, was carried out at a health facility in Mexico. The Asthma Control Test (ACT) was used and the learning performance was evaluated with formative quizzes. A randomized controlled trial was designed, with pairs of children patients and caregivers during 60 days; the control group was trained with the usual approach, receiving general information about the disease. ACT measures showed statistical significance for the TPE group after the use of the LOs, achieving a controlled state, while the control group did not show difference. Also, the intervention group obtained a higher score in learning performance assessment. The users learned how to avoid risks, the personal triggers of the patient, how to correctly use the different treatments and accessories, consequently, they learned how to self-manage the disease. Our study also confirmed that control of asthma is not only a matter of knowledge, but financial issues to afford the treatment.

DNA nanotechnology creates precise shape-specific nanostructures through the self-assembly of short ssDNA oligonucleotides. One such shape, which has relevant biomedical applications due to its multivalency, is the star. However, building star-like nanostructures with a large size (>100 nm) using ssDNA is complex and challenging. This study presents a novel strategy to prepare stiff and large dsDNA nanostars by assembling duplex DNA fragments into star-shapes that are subsequently coated with a virus-inspired protein. The protein binds dsDNA and overcomes the high structural flexibility of naked dsDNA. The nanostar-like dsDNA templates with up to six arms were prepared by self-assembly of PCR-produced dsDNA fragments (211 to 722 bp) with a central DNA junction. Through gel electrophoresis and Atomic Force Microscopy it is demonstrated that single dsDNA nanostars are self-assembled and coated with the protein, and this has a large stiffening effect on the nanostar. Furthermore, the coating significantly enhances stability at high temperatures and protects nanostars against nuclease degradation for at least 10 hours. This study shows that DNA-binding proteins can be harnessed as structural "rigidifiers" of flexible branched dsDNA templates. This strategy opens a way to prepare structurally defined hybrid protein-dsDNA nanostructures that could be exploited as building blocks for novel DNA nanomaterials.

Searching for bacterial probiotics active upon Helicobacter pylori continue to be an important clinical challenge because of the increased prevalence of this highly priority pathogen in humans. In this work, we assess the in vivo anti-H. pylori SS1 (cagA+/vacAs2m2+) properties of a previously isolated human gastric probiotic strain Lactobacillus fermentum UCO-979C by using a Meriones unguiculatus (Mongolian gerbil) model. Animals were administered with a saline suspension of L. fermentum UCO-979C or H. pylori SS1 as negative and positive control for H. pylori colonisation controls, prior to assayed the challenge group that was administered with these two species per animal for detecting protective activity of the probiotic strain against colonisation. The results showed that L. fermentum UCO-979C strongly inhibited the colonisation of H. pylori decreasing up to 87% of the colonisation in the antrum by the pathogen, suggesting that this probiotic strain has a strong probiotic activity against H. pylori in the most valuable animal model for in vivo assays nowadays.

In Mexico more than 40% of reported snakebites are due to rattlesnake species. In general, the venoms of these snakes are characterized by the presence of highly enzymatic components that could provoke coagulopathies, local and systemic tissue damage and some cases neurotoxicity. In northwestern Mexico (Baja California Peninsula, Gulf of California and Pacific islands), 15 species of Crotalus are distributed. Such a biodiversity implies a high variability in venom compositions that in turns would results in high variability in clinical manifestations. In this work, venoms of Crotalus catalinensis, C. enyo enyo, C. mitchellii mitchellii and C. ruber lucasensis were studied. Lethal doses from 0.35 to 9.21 mg/kg were obtained being venom of C. m. mitchellii the most potent of all. Venoms of C. catalinensis, C. e. enyo and C. r. lucasensis show high hemorrhagic potency (1.34, 1.48 and 1.68 μg respectively). Coagulant activity was found in venoms of C. catalinensis (4.6 μg), C. e. enyo (101.9 μg) and C. m. mitchellii (13.6 μg). Our results point out hemorrhage as one of the most expected signs by three of the four most abundant species in the area. Also, neurotoxicity must be expected by C. m. mitchellii., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Backgorund: Moringa oleifera Lamarck is a species that has long been used in high demand in folk medicine, including for the treatment of epilepsy. Nevertheless, scientific studies demonstrating its anticonvulsant properties and the nature of the bioactive constituents are lacking., Hypothesis/aim: The aim of this study was to evaluate the anticonvulsant activities of the Moringa oleifera leaves in non-polar vs. polar extracts using behavioral and electroencephalographic (EEG) analyses in rodents., Methods: First, PTZ (80 mg/kg, i.p.)-induced tonic-clonic seizures were assayed via a dose-response (100, 200 and 300 mg/kg, i.p.) evaluation in mice. Then, a dosage of the extracts (100 or 300 mg/kg) and one metabolite (30 mg/kg, i.p.) was selected to evaluate its effect on PTZ (35 mg/kg, i.p.)-induced EEG paroxystic activities in rats compared to the effects of ethosuximide (reference anticonvulsant drug, 100 mg/kg, i.p.). Latent onset of the first paroxystic spike, first seizure and frequency as well as seizure severity, were determined using Racine's scale., Results: Moringa oleifera ethanol and hexane extracts produced a delay in the seizure latency in mice and rats; this effect was improved in the presence of the hexane extract containing the active metabolite hexadecanoic acid. The anticonvulsant effects were corroborated in the spectral analysis by the potency of the EEG due to a reduction in the spike frequency and amplitude, as well as in the duration and severity of the seizures. The effects of the hexane extract resembled those observed in the reference antiepileptic drug ethosuximide., Conclusion: Moringa oleifera leaves possess anticonvulsant activities due to the complementary of the non-polar and polar constituents. However, the non-polar constituents appear to exert an important influence via the partial participation of fatty acids, providing evidence of the effects of this plant in epilepsy therapy., (Copyright © 2017. Published by Elsevier GmbH.)

Epileptic seizures, as a dynamic phenomenon in brain behavior, obey a scale-free behavior, frequently analyzed by electrical activity recording. This recording can be seen as a surface that roughens with time. Dynamic scaling studies roughening processes or growing interfaces. In this theory, a set of exponents -obtained from scale invariance properties- characterize rough interfaces growth. The aim of the present study was to investigate scaling behavior in EEG time series fluctuations of a chemical animal model of temporal lobe epilepsy, with dynamic scaling to detect changes on seizure onset. We analyzed local variables in different sampling intervals and estimated rough, scaling and dynamic exponents. Results exhibited long-range correlations in interictal activity. Results of renormalization and data collapsing confirmed that each epoch of EEG fluctuations for interictal, preictal and postictal collapse in a curve in different scales, each segment independently; remarkably, we found non-scaling behavior in seizures epochs. Data for the different sampling intervals for ictal period do not collapse in one curve, which implies that ictal activity does not exhibit the same scaling behavior than the other epochs. Statistical significant differences of growth exponent were found between interictal and ictal segment, while for scaling exponent, significant differences were found between interictal and postictal segment. These results confirm the potential of scaling exponents as characteristic parameters to detect changes on seizure onset, which suggests their use as inputs for analysis methods for seizure detection in long-term recordings, while changes in growth exponent are potentially useful for prediction purposes., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Moringa oleifera has long been used in large demand in folk medicine to treat pain. The present study was undertaken to examine the antinociceptive and anti-inflammatory spectrum of M. oleifera leaf extracts discriminating the constituents' nature by using different kind of experimental models in rats. Pharmacological evaluation of a non-polar and/or polar extracts at several doses (30-300mg/kg, p.o.) was explored through experimental nociception using formalin test, carrageenan-induced paw edema and arthritis with subcutaneous injection of collagen in rats. Basic morphology characterization was done by scanning electronic microscopy and laser scanning confocal microscopy. Not only polar (from 30 or 100mg/kg, p.o.) but also non-polar extract produced significant inhibition of the nociceptive behavior with major efficacy in the inflammatory response in different assessed experimental models. This antinociceptive activity involved constituents of different nature and depended on the intensity of the induced painful stimulus. Phytochemical analysis showed the presence of kaempferol-3-glucoside in the polar extract and fatty acids like chlorogenic acid, among others, in the non-polar extract. Data obtained with M. oleifera leaf extracts give evidence of its potential for pain treatment., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

The impact of vectorial magnetic field effects on electrical conductivity and nonlinear optical transmittance exhibited by multi-wall carbon nanotubes was studied. The samples were synthetized by an aerosol pyrolysis processing route in a thin film form. Optical signals in a two-wave mixing configuration allowed us to identify two orthogonal directions of propagation for a magnetic field travelling through the nanomaterials studied. A selective modification in optical absorption was considered to be induced by magnetic perturbations in the sample. Standard optical Kerr gate measurements were carried out for exploring the third order nonlinear optical behavior of the film. A capacitive effect influenced by optical and magnetic excitations was distinguished to be characteristic of the sample. Magneto-quantum conductivity sensitive to the direction of an external magnetic field interacting with the tubes was analyzed. Magnetically-induced changes in electronic band parameters seem to be the main responsible for the optical and electrical modulation observed in the nanostructures. Immediate applications for developing magneto-optical and magneto-electrical functions can be contemplated.

Introduction: Oxygen saturation is considered as the 5(th) vital sign. Presently, there exist fixed and wireless pulse oximeters, being the latter most widely used in the last years. Some of them have no possibility of calibration. This situation leads the health staff to adopt therapeutic attitudes which can be wrong. Therefore, it is extremely important to know if these wireless oximeters show a right concordance as regards measurements, since it is of great interest in daily clinical practice., Objective: To evaluate concordance among measurements obtained by three different pulse oximeters currently used by health professionals., Materials and Methods: This is an observational, descriptive and cross-sectional study related to the concordance of the results obtained in measurements collected by three different pulse oximeters (one monitor and two wireless oximeters) which are available and in use in this hospital unit. The sample size calculation was performed for a concordance above 0.81 and an estimation error which did not exceed 0.20. The intraclass correlation index (ICI) was used to establish the concordance whereas the Landis-Koch criteria were used to interpret the results. Systematic errors were analyzed using the Bland-Altman plot., Results: The overall concordance among the three pulse oximeters analyzed resulted in 0.88, a value considered as "good" according to the Landis-Koch criteria., Conclusion: The results obtained show that in daily clinical practice both wireless pulse oximeters analyzed can be used with a certain reliability, taking into account the limitations of this research.

We study the static and dynamic properties of networks of crumpled creases formed in hand crushed sheets of paper. The fractal dimensionalities of crumpling networks in the unfolded (flat) and folded configurations are determined. Some other noteworthy features of crumpling networks are established. The physical implications of these findings are discussed. Specifically, we state that self-avoiding interactions introduce a characteristic length scale of sheet crumpling. A framework to model the crumpling phenomena is suggested. Mechanics of sheet crushing under external confinement is developed. The effect of compaction geometry on the crushing mechanics is revealed.

We point out that the chemical space of a totally disconnected Cantor dust K(n) [Symbol: see text E(n) is a compact metric space C(n) with the spectral dimension d(s) = d(ℓ) = n > D, where D and d(ℓ) = n are the fractal and chemical dimensions of K(n), respectively. Hence, we can define a random walk in the chemical space as a Markovian Gaussian process. The mapping of a random walk in C(n) into K(n) [Symbol: see text] E(n) defines the quenched Lévy flight on the Cantor dust with a single step duration independent of the step length. The equations, describing the superdiffusion and diffusion-reaction front propagation ruled by the local quenched Lévy flight on K(n) [Symbol: see text] E(n), are derived. The use of these equations to model superdiffusive phenomena, observed in some physical systems in which propagators decay faster than algebraically, is discussed.

Background: bacterial diversity of the stomach includes various species. Among them, Helicobacter pylori, a microorganism which has been associated to gastric diseases, is frequently isolated in this habitat. In addition, Lactobacillus spp., a genus including probiotic strains, has also been documented in this habitat. The co-existence of these two species in the stomach of symptomatic patient needs to be elucidated., Aims: our goal was to establish if Lactobacillus spp. and H. pylori co-exist in the stomach mucosa of symptomatic patients., Methods: gastric biopsies (antrum and/or the body) from 427 Chilean patients with gastrointestinal discomfort were analyzed. The H. pylori infection and/or Lactobacillus spp. colonization status was determined for each patient by standard culture techniques, and statistical correlations between the presence of those species and the age, gender, or the severity of the gastric disease were also established., Results: only 6.1% of the samples presented co-existence of Lactobacillus spp. and H. pylori. This former species was isolated in 42.6% of the patients as unique species, while Lactobacillus spp. was isolated as single species in 19.4% of the individuals. Chronic non-atrophic gastritis was prevalent in Lactobacillus spp. non colonized individuals, while chronic non-atrophic and chronic atrophic gastritis diagnosis was similar in Lactobacillus spp. harbouring individuals (p < 0.001). The presence of Lactobacillus spp. Significantly increased with age (p = 0.005), independently of gender., Conclusion: the negative Pearson correlation between Lactobacillus spp. and H. pylori (r = -0.112, p = 0.020) indicates that the co-existence of both species is low in human gastric mucosa of symptomatic patients.

We study the kinetics of water escape from balls folded from square aluminum foils of different thickness and edge size. We found that the water discharge rate obeys the scaling relation Q ∝ V{P}(M-M{r}){α} with the universal scaling exponents α=3 ± 0.1, where V{P} is the volume of pore space, M(t) is the actual mass of water in the ball, and M{r} is the mass of residual water. The last is found to be a power-law function of V{P}. The relation of these findings to the fractal geometry of randomly folded matter is discussed.

Background: Rabeprazole inhibits Helicobacter pylori in vitro. This property could influence the antibacterial activity of metronidazole or amoxicillin. Our goal was to evaluate in vitro the effect of rabeprazole upon the antibacterial activity of metronidazole and amoxicillin., Methods: The minimal inhibitory concentration (MIC) was determined by agar dilution upon 30 clinical isolates, and the antibacterial effect of the combined drugs was estimated by calculating the fractional inhibitory concentration index (FICI)., Results: Nine strains (30%) were resistant to metronidazole (MIC 8-256 mg/l) while only 1 strain was resistant to amoxicillin (MIC 1.0 mg/l). Rabeprazole also inhibited H. pylori (MIC 0.125-1.0 mg/l). The association of metronidazole and rabeprazole showed synergism in 30% of the strains (FICI < or =0.25), but also antagonism in 23.3% of the clinical isolates (FICI > or =4.0). Mostly, amoxicillin-rabeprazole showed an effect of synergism (53.3%)., Conclusion: The results presented suggest the need to keep in mind that failure in eradication therapies based on metronidazole and rabeprazole could be due to an antagonism of the drugs., (Copyright 2009 S. Karger AG, Basel.)

Cervical cancer (CC) is a major public health problem in developing countries and its most significant etiological risk factor is infection by the human papillomavirus (HPV). The main approach to date for the prevention of CC has been through screening programs, using the cervical smear (PAP test) to detect precursory lesions. The sensitivity and specificity of the PAP smear depend on the skills of the observer to recognize and classify a variety of cellular abnormalities. The development of early diagnoses to detect HPV infection has been a problem as cytology and colposcopy identify the lesion at an advanced stage. Therefore, molecular approaches have become more successful for early CC diagnosis. These molecular techniques recognize HPV DNA sequences by DNA hybridization, PCR-RFLP, hybrid capture and reverse line blot systems. Unfortunately, these systems cannot determine whether the HPV infection is active, latent or persistent. Thus, immunological techniques such as Western blot and ELISA have been designed to follow the immune response against the virus, and they can also be used to identify the stage of the infection. Several companies have developed, manufactured and merchandised gene-based testing systems for the screening, monitoring and diagnosis of HPV. Our review and comments focus on the critical analysis of existing products and their use in clinical practice as well as on immunological systems used mainly in research, but that may be applied in large population screening programs.

The present work describes the prevalence of cardiovascular risk factors in young mexican women. 96 women from 18 to 40 years of age were included. All of them were measured (height, waist and hip) and weighed, blood pressure was registered, laboratory exams were taken and a questionnaire was answered. Cardiovascular risk factors prevalence was estimated and the average concentrations of lipids and glucose and systolic and diastolic blood pressure were compared by age, BMI and WHI group. Of the studied women, 51% were overweight or obese and 51% had visceral obesity with a high prevalence of lipids abnormalities (hypoalpha-lipoproteinemia and hypertrigliceridemia), which increases progressively with age. Only 5% and 4% had normal to high systolic and dyastolic blood pressures and 7% had blood glucose > 110 mg/dL. In this sample of women with similar social, demographic, economic, and cultural characteristics, a high proportion was identified with body weight problems and lipids abnormalities, a frequent finding in Latin populations with multiple etiologies and associated with different cardiovascular risk factors.

Worldwide, the use of cocaine has an increased over the years, various secondary effects have been described. Here we present a 48 years old female with a 2-month evolution bucconasal ulcer in the hard palate induced by cocaine usage accompanied by swallow and phonation dysfunctions. Ethiopathogenesis, differential diagnoses and treatment are discussed.

We report a child with mental retardation, brain anomalies and congenital heart defect. His karyotype, after G-banding and FISH with a whole chromosome probe for chromosome 11 and a locus-specific probe for the MLL gene, was 46,XY,dup(11)(q23q23).ish dup(11)(q23q23)(wcp11+, MLL++) de novo; i.e., he had a pure partial 11q23 duplication. Clinical and cytogenetic findings of the present case were compared with the 7 previously reported cases with pure partial trisomy 11q; in 6/8 cases the region 11q23 was involved. We conclude that the scarce number of cases and their heterogeneity do not allow to establish a reliable genotype-phenotype correlation.

The antibacterial activity of sixteen Chilean red wines (Cabernet Sauvignon, Cabernet Merlot, Cabernet Organic and Pinot Noir), and the active extracts of two randomly selected wines were assayed for their antibacterial activity on six strains of Helicobacter pylori isolated from gastric biopsies. The active fraction of the wines was obtained by dichloromethane extraction, and the antibacterial activity of the wines and extracts was evaluated by an agar diffusion method. All the red wines studied showed some antibacterial activity on the six strains of H. pylori, although the strains were heterogeneous in their susceptibility to each particular wine. The active fraction of the two wines selected also showed good activity against the strains tested. The main active compound was identified as resveratrol. The results presented indicate that Chilean red wines have antibacterial activity against H. pylori, which depends mainly on the presence of resveratrol.

A 34-year-old man of Native American descent had flaccid paralysis of the extremities 2 days after a camping trip. He had no respiratory difficulty, sensory deficit, or abnormal reflexes. He was subsequently found to have a serum potassium level of 1.6 mEq/L, a thyrotropin level of <0.06 microIU/L, and a free thyroxin level of 5.30 ng/dL. Thyroid uptake and scan were consistent with those of Graves' disease. Symptoms rapidly resolved with potassium chloride, propranolol, prednisone, and antithyroid therapy. No further episodes occurred.

Deficits in both learning and memory after lesions of the cholinergic basal forebrain, in particular the nucleus basalis magnocellularis (NBM), have been widely reported. However, the participation of the cholinergic system in either acquisition or retrieval of memory process is still unclear. In this study, we tested the possibility that excitotoxic lesions of the NBM affect either acquisition or retrieval of two tasks. In the first experiment, animals were trained for two conditioned taste aversion tasks using different flavors, saccharine and saline. The acquisition of the first task was before NBM lesions (to test retrieval) and the acquisition of the second task was after the lesions (to test acquisition). Accordingly, in the first part of the second experiment, animals were trained in the Morris water maze (MWM), lesioned and finally tested. In the final part of this experiment, another set of animals was lesioned, then trained in the MWM and finally tested. All animals were able to retrieve conditioned taste aversion (CTA) and MWM when learned before NBM lesions; however, lesions disrupted the acquisition of CTA and MWM. The results suggest that the NBM and cholinergic system may play an important role in acquisition but not during retrieval of aversive memories.

Acinetobacter baumannii, mainly biotype 9, is an important nosocomial opportunist pathogen in Chile and other countries. The biological basis of its virulence and prevalence is still unknown. As lipopolysaccharide (LPS) is often associated with virulence, some biological properties of purified LPS from seven nosocomial isolates, comprising four isolates of A. baumannii biotype 9, two isolates of biotype 8 and one isolate of biotype 1, were investigated. LPS was extracted and purified from each isolate by the hot phenol-water method, and its ability to elicit a mitogenic response and to induce the synthesis of a tumour necrosis factor (TNF-alpha) in mouse spleen cells was determined. Activity was evaluated in vivo by determining the splenic index in comparison with LPS from Salmonella Typhimurium. All seven LPS samples were mitogenic on the basis of cellular proliferation experiments and six induced synthesis of TNF-alpha. Similar results were obtained in in-vivo experiments in which LPS induced spleen cell growth, as shown by determination of the splenic index. These results suggest that the LPS of A. baumannii might contribute to the pathogenic properties of this species.