Epoxide of diosgenin acetate synthesis: DoE for diastereoselective yield optimization, antimicroibial, antioxidant and antiproliferative effects.

Diosgenin and its derivatives have proved a huge importance in diverse biological activities. The optimized production of the diastereoisomers of the epoxide of diosgenin acetate by means of mCPBA is reported herein. This transformation had a previous design of experiments using the application of a statistical factorial DoE of 4 parameters (nk), where one variable is varied at a time, while others stay constant. The temperature showed the greatest effect on the reaction yield; so, at 298 K the diastereomeric ratio 3:1 of α and ß-epoxides, normally found, was raised to 1:1. Time was the second significant variable, but due to its high correlation with temperature, 30 min were required for a global 90% conversion at least. These diastereoisomers were characterized both isolated and in the mixtures obtained, to determine their antioxidant, antimicrobial and antiproliferative activity, finding a low antioxidant capacity by DPPH, but antimicrobial activity at the level of penicillin in gram negative bacteria by 1ß better to 1α. The antiproliferative capacity was higher for diastereoisomer ß, agreeing with the proportion of the mixture obtained by different conditions, increasing this in relation to the amount of this diastereoisomer present in hormone-dependent cancer cell lines such as Hela, PC-3 and MCF-7, with 10.0 µM obtained values of viability at 21.8 %, 35.8 % and 12.3 % respectively. DoE optimization allows to manipulate the ratio between diastereoisomers with the minimum number of experiments, extending the analysis of the effect of the ratio between diastereoisomers and the in silico potential as well as the biological activity.

Behavioural determinants of COVID-19 vaccination acceptance among healthcare workers: a rapid review.

OBJECTIVES: Vaccinating healthcare workers (HCWs) against COVID-19 has been a public health priority since rollout began in late 2020. Promoting COVID-19 vaccination among HCWs would benefit from identifying modifiable behavioural determinants. We sought to identify and categorize studies looking at COVID-19 vaccination acceptance to identify modifiable factors to increase uptake in HCWs. STUDY DESIGN: Rapid evidence review. METHODS: We searched MEDLINE and Cochrane databases until May 2021 and conducted a grey literature search to identify cross-sectional, cohort, and qualitative studies. Key barriers to, and enablers of, vaccine acceptance were categorized using the Theoretical Domains Framework (TDF), a comprehensive theoretical framework comprising 14 behavioural domains. RESULTS: From 19,591 records, 74 studies were included. Almost two-thirds of responding HCWs were willing to accept a COVID-19 vaccine (median = 64%, interquartile range = 50-78%). Twenty key barriers and enablers were identified and categorized into eight TDF domains. The most frequently identified barriers to COVID-19 vaccination were as follows: concerns about vaccine safety, efficacy, and speed of development (TDF domain: Beliefs about consequences); individuals in certain HCW roles (Social/professional role and identity); and mistrust in state/public health response to COVID-19 (Social influences). Routinely being vaccinated for seasonal influenza (Reinforcement), concerns about contracting COVID-19 (Beliefs about consequences) and working directly with COVID-19 patients (Social/professional role and identity) were key enablers of COVID-19 vaccination among HCWs. DISCUSSION: Our review identified eight (of a possible 14) behavioural determinants of COVID-19 vaccine acceptance among HCWs that, if targeted, could help design tailored vaccination messaging, policy, campaigns, and programs to support HCWs vaccination uptake.

Spanish-language cognitive screening tests: a critical review.

INTRODUCTION: Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini-Mental State Examination scales for cognitive impairment screening. DEVELOPMENT: We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. CONCLUSIONS: The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients.

Escalas de tamizaje cognitivo en habla hispana: una revisión crítica / Spanish-language screening scales: A critical review

Introducción: La demencia es una enfermedad crónica degenerativa de alto impacto para las familias y los sistemas de salud. Los instrumentos de medición del deterioro cognitivo que se utilizan actualmente tienen características psicométricas diferentes en cuanto a tiempo de aplicación, punto de corte, confiabilidad y validez. El objetivo de la presente revisión fue describir las características de las escalas Mini Cog, Prueba del reloj y Mini- Mental para tamizaje de deterioro cognitivo validadas al idioma español. Desarrollo: La búsqueda bibliográfica se realizó en 3 etapas mediante la base de datos Medline a partir del año 1953. Se realizó una selección de publicaciones validadas al español que incluyeran la confiabilidad, validez, sensibilidad y especificidad de las escalas. Conclusiones: Las 3 herramientas de tamizaje descritas en este artículo proporcionan un apoyo para el personal de salud. La detección oportuna es crucial para el pronóstico de las personas que viven con deterioro cognitivo leve o demencia. (AU)

Introduction: Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini–Mental State Examination scales for cognitive impairment screening. Development: We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. Conclusions: The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients. (AU)

Irradiation dose does not affect male reproductive organ size, sperm storage, and female remating propensity in Ceratitis capitata.

The Mediterranean fruit fly Ceratitis capitata is a globally invasive pest, often controlled with the sterile insect technique (SIT). For the SIT, mass-rearing of the target insect followed by irradiation are imperatives. Sterile males are often less able to inhibit female remating and transfer less number of sperm, and even irradiation could affect male reproductive organs, with consequences for their ability to inhibit female remating. On the other hand, male age could affect their ability to modulate female response after mating. Here, we evaluated the quality of the genetic sexing strain Vienna-8-tsl mass-reared in Bioplanta San Juan, Argentina, under laboratory conditions, with regard to: (i) the ability of sterile males irradiated at 100 or 140 Gy to inhibit female remating, in the same day and at 24 h of first copulation; (ii) the ability of 3, 4 or 5 day-old sterile males to inhibit female remating at 24 h of first copulation, and (iii) the effect of a reduction in irradiation doses on the number of sperm stored by females and reproductive organ size in virgin males. Sterile males were better able than wild males to inhibit female remating in the same day of first copulation and as able as wild males 1 day after first copulation. Male age did not affect their ability to inhibit female receptivity. Number of sperm stored by females, testes size and ectodermal accessory glands size were not affected by male identity, while sterile 100 Gy males had larger mesodermal accessory glands than control lab males. A reduction in irradiation dose does not impact any variable measured, except for percentage of sperm-depleted females: females mated with sterile 100 Gy males had lower probabilities to store sperm. The results showed here are very encouraging for tsl Vienna 8 strain reared in Argentina and are discussed in comparison with previous studies in C. capitata female remating with dissimilar results.

Generic high-capacity protein capture and release by pH control.

Techniques for immobilization and release of proteins are of general interest but challenging to develop. Here we show a new method for high-capacity (several µg cm-2) immobilization of proteins in polyelectrolyte brushes by multivalent hydrogen bonds. Upon increasing pH, the proteins are fully released with preserved structure and activity.

Little red riding hood in the social forest. Online grooming as a public health issue: a narrative review.

INTRODUCTION: Online grooming is a manipulative process through which an adult attempts to arrange a sexual interaction with a minor using internet. Children are constantly exposed to the online world, posing online grooming as a public health issue. OBJECTIVES: The aim of this narrative review is to describe the state of online grooming preventive strategies in recent literature through an overview of online grooming phenomenon. METHODS: Our literature review included research articles and reviews published between January 2014 and March 2019, as well as reference lists of included studies. RESULTS: The analysis provides a picture of online grooming phenomenon, identify recurrent features of perpetrators and victims. Several preventive strategies have been implemented, but they lack any kind of efficacy evaluation and miss a theory driven approach. Fragmentation of preventive initiatives is a critical issue, in contrast with the need of an institutional public health strategy. CONCLUSIONS: While the attention around online grooming is growing, there is still the need of further sensitizing the involved stakeholders and developing evidence based preventive strategies under an institutional guidance.

Paraxial optical fields whose intensity pattern skeletons are stable caustics.

We construct exact solutions to the paraxial wave equation in free space characterized by stable caustics. First, we show that any solution of the paraxial wave equation can be written as the superposition of plane waves determined by both the Hamilton-Jacobi and Laplace equations in free space. Then using the five elementary stable catastrophes, we construct solutions of the Hamilton-Jacobi and Laplace equations, and the corresponding exact solutions of the paraxial wave equation. Therefore, the evolution of the intensity patterns is governed by the paraxial wave equation and that of the corresponding caustic by the Hamilton-Jacobi equation.

Frequency, virulence factors and antifungal susceptibility of Candida parapsilosis species complex isolated from patients with candidemia in the central region of Argentina.

PURPOSE: Our objectives were to report species distribution and survival of patients with candidemia in Argentina's central region and to establish the prevalence of C.parapsilosis sensu lato species, their virulence factors and their antifungal susceptibility profiles. METHODS: Yeasts isolated from bloodstream infections in Córdoba (Argentina) (n=35) were molecularly identified. The production of lipase and acid aspartic protease (Sap), the adhesion capacity, and the isolates' ability to form biofilm were evaluated. The in vitro activity of 7 antifungal drugs was evaluated (CLSIdocument M27-4thed). RESULTS: C. albicans was the most prevalent species (48.57%) followed by C. parapsilosis sensu lato (28.57%). The 30-day survival rate for C. albicans candidemia was slightly lower than non-albicans blood infections (50.00% vs. 57.90%). C. parapsilosis sensu stricto and C. orthopsilosis account for 60% and 40% of the cryptic species. Sap production and biofilm formation capacity were higher in C. parapsilosis sensu strico than in C.orthopsilosis. All the strains were susceptible to caspofungin (CAS), anidulafungin (AFG), amphotericin B (AMB), posaconazole (POS) and voriconazole (VRC). Azoles were the most potent agent against C. parapsilosis sensu lato followed by echinocandins and AMB. There were no differences between MICs for fluconazole, VRC, POS and AMB. Contrarily, C. parapsilosis sensu stricto strains showed lower MIC than C. orthopsilopsis isolates for itraconazole and higher MIC values for echinocandins (P<0.01). CONCLUSIONS: We report a high frequency of isolation of C.orthopsilosis in candidemia patients of central region. Data on the prevalence, virulence capability and antifungal susceptibility of C. parapsilosis complex provide new epidemiological information about these cryptic species in Argentina.

LGBTIQ, pensar la diversidad / LGBTIQ, Thinking About Diversity

Con el objetivo de analizar la percepción acerca del colectivo LGBTIQ por parte del personal de salud, administrativos y usuarios del siste-ma de salud en CeMAP CABA (Ciudad Autónoma de Buenos Aires) OsPeCon, así como identificar la discriminación, sus causas y consecuencias, se realizó un estudio cualitativo, de caso, etnográfico.Se realizaron cinco grupos focales y se analizó la información siguiendo los pasos de la teoría fundamentada. En los grupos focales surgieron dudas acerca de la definición de orientación sexual y las siglas I-Q. Se reconocieron prejuicios relacionados al VIH/SIDA, ETS y adicciones como base de la discriminación y la estigmatización. Se evidenció la persistencia de creencias populares como origen de la orientación sexual. Se vio reflejada la heteronormatividad como característica social y la diferencia generacional como postura negativa. Se identificó como forma de discriminación a la violencia verbal y el rechazo al contacto, teniendo como consecuencia depresión, consumo de sustancias y suicidio. Las cuestiones de géneros son temas en continua evolución en la sociedad, por lo que creemos importante estar informados, con una visión empática y de respeto para brindar una atención adecuada a las personas LGBTIQ, teniendo un rol que nos permite deconstruir los estereotipos (AU)

This qualitative ethnographic case study analyzes perceptions of the LGBTIQ community held biomedical professionals, administrative staff and patients in the Health center of OSPeCon, CABA.The purpose of this analysis is to identify discrimination, its causes and consequencesFive focus groups were carried out and the information was analyzed according to the grounded theory.Major themes that emerged from focus groups included confusion regarding the definition of sexual orientation and the acronym I-Q Beliefs related to HIV/AIDS, STD and addiction were noted to be the foundation for discrimination and stigmatization. Other beliefs identified included heteronormativity, which was more prevalent in older generations. The use of popular beliefs to explain the origin of sexual orientation was often justification for discrimination Means of discrimination included verbal violence and rejecting personal contact. Consequences of discrimination identified included depression, substance abuse and suicide. Gender issues continue to evolve and we hope to analyze our own beliefs, deconstruct stereotypes, and educate ourselves in the development of an empathic and respectful attitude to this vulnerable population (AU)

Propuesta de protocolo diagnóstico, estadificador y quirúrgico para el cáncer de endometrio / Proposal for a diagnostic, staging and surgical protocol for endometrial carcinoma

El carcinoma de endometrio es la neoplasia más frecuente del tracto genital de la mujer en el mundo occidental es una patología que va en ascenso en los países en vías de desarrollo. En general, el pronóstico de carcinoma endometrial es bueno, con una supervivencia global de alrededor del 80 %. Se pueden definir tres grupos de acuerdo al riesgo de recurrencia, en alto, medio y bajo. Se realiza revisión bibliográfica y casuística para proponer protocolo de manejo quirúrgico en pacientes con cáncer de endometrio. Se definen tres etapas durante el protocolo: clínica, patológica y quirúrgica. Se realizan recomendaciones basados en la vía de abordaje, tipo de histerectomía, lavado peritoneal, linfadenectomía, omentectomía, y cito-reducción. Se plantean situaciones especiales y la importancia del ganglio centinela. La realización de protocolos quirúrgicos para el manejo de carcinoma endometrial permite la unificación de criterios, mejora la evaluación de respuesta rapéutica y facilita revisiones y mejoras a futuro.(AU)

The endometrial carcinoma is the most common neoplasia in the genital tract of women in the western world and is a condition that is increasing in the developing countries. In general, the rognosis of endometrial carcinoma is good, with an overall survival of about 80 %. It can define three groups according to the risk of the recurrence in high, medium and low. The literature review and case mix is performed to propose the surgical management protocol in patients with endometrial cancer. Three stage the clinical, the pathological and the surgical defined for the protocol. The recommendations based on the approach, type of the ysterectomy, te peritoneal washing, the lymphadenectomy, the omentectomy, and the debulking are made. The special situations and the importance of sentinel node arise. Performing the surgical protocol for the management of endometrial carcinoma allows the unification of criteria, the improved therapeutic response assessment and facilitates future revisions and improvements.(AU)

Correction to: Translation and cross-cultural adaptation of eight pediatric PROMIS® item banks into Spanish and German.

In the original publication of the article, two of the author names "L. A. Schröder, F. Metzner" and email address of the authors "J. Devine, J. Moon, A. C. Haller" were missed out. The correct author group with affiliations are provided in this correction.

Translation and cross-cultural adaptation of eight pediatric PROMIS® item banks into Spanish and German.

PURPOSE: The Patient-Reported Outcome Measurement Information System (PROMIS®) is a National Institutes of Health (NIH)-funded initiative to develop reliable, valid, and normed item banks to measure health. We describe the first large-scale translation and cross-cultural adaptation effort to German and Spanish of eight pediatric PROMIS item banks: Physical activity (PAC), subjective well-being (SWB), experiences of stress (EOS), and family relations (FAM). METHODS: We utilized methods outlined in the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force recommendations. Ten professional translators performed a translatability assessment and generated forward translations. Forward Translations were compared within a country and cross-culturally to identify problems and to produce a consensus-derived version, which was then back translated, evaluated, and revised where necessary. Reconciled versions were evaluated in cognitive interviews with 126 children before finalization. RESULTS: Eight resulting pediatric PROMIS® item banks were translated: Two PAC banks (22 total items), three SWB banks (125 total items), two EOS banks (45 total items), and one FAM bank (47 total items). Up to 92% of all items raised no or only minor translation difficulties, 0-5.6% were difficult to translate. Up to 20% item revisions were necessary to ensure conceptual equivalence and comprehensibility. Cognitive interviews indicated that 91-94% of the final items were appropriate for children (8-17 years). CONCLUSIONS: German and Spanish translations of eight PROMIS Pediatric item banks were created for clinical trials and routine pediatric health care. Initial translatability assessment and rigorous translation methodology helped to ensure conceptual equivalence and comprehensibility. Next steps include cross-cultural validation and adaptation studies.

Spanish-language screening scales: A critical review. / Escalas de tamizaje cognitivo en habla hispana: una revisión crítica.

INTRODUCTION: Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini-Mental State Examination scales for cognitive impairment screening. DEVELOPMENT: We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. CONCLUSIONS: The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients.

Mecanismos regulatorios del tono vascular pulmonar neonatal: una perspectiva molecular / Regulatory mechanisms of neonatal pulmonary vascular tone: a molecular perspective

La adaptación al medio extrauterino incluye un aumento considerable de la PaO2, que induce especialmente cambios estructurales y vasoactivos en la circulación pulmonar, que llevarán a una circulación previamente pobremente irrigada, a recibir ∼100% del gasto cardíaco del recién nacido, permitiendo el normal intercambio gaseoso. La regulación local de la circulación arterial pulmonar neonatal basal, es mantenida por un delicado equilibrio entre agentes vasoconstrictores y vasodilatadores. Este equilibrio, permite mantener la circulación pulmonar como un territorio de gran flujo sanguíneo y baja resistencia. La acción de los vasoconstrictores permite la formación de las interacciones entre actina y la cadena liviana de la miosina, esta es inducida en la célula muscular lisa principalmente por dos vías: a) dependiente de calcio, que consiste en aumentar el calcio intracelular, facilitando finalmente la unión de actina y miosina, y b) independiente de calcio, la cual a través de consecutivas fosforilaciones logra sensibilizar a las proteínas involucradas promoviendo la unión de actina y miosina. Estas acciones son mediadas por agonistas generados principalmente en el endotelio pulmonar, como endotelina-1 y tromboxano, o por agonistas provenientes de otros tipos celulares como la serotonina. Los agentes vasodilatadores regulan la respuesta vasoconstrictora, principalmente inhibiendo la señalización que induce la vasocontricción independiente de calcio, a través de la activación de proteínas quinasas que inhibirán la función de la ROCK quinasa, uno de los últimos efectores de la vasocontricción antes de la formación de la unión de actina y miosina. Esta revisión describe estos mecanismos de primordial importancia en las primeras horas de nuestra vida como individuos independientes.

The extrauterine-milieu adaptation includes a considerable increase in PaO2, that specifically induces structural and vasoactive changes at pulmonary circulation. Such changes transform a poor irrigated circulation into a circulation that receive ∼100% of neonatal cardiac output, supporting the normal alveolar-capillary gas exchange. Local regulation of basal neonatal pulmonary circulation is maintaining by a delicate equilibrium between vasoconstrictor and vasodilator agents. This equilibrium, allows to maintain the pulmonary circulation as an hemodynamic system with a high blood flow and a low vascular resistance. Vasocontrictors action allows actin and light-chain myosin interaction. Two main pathways induced this effect in smooth muscle cell: a) a calcium dependent pathway, that increases intracellular calcium, facilitating actin - myosin binding, and b) the independent calcium pathway, which achieves through consecutive phosphorylation reactions sensitize the proteins involved, promoting the binding of actin and light-chain myosin. These actions are mediated by agonists produced mainly in the pulmonary endothelium, such as endothelin-1 and thromboxane, or by agonists from other cell types such as serotonin. Vasodilator agents regulate the vasoconstrictor response, mainly by inhibiting signals that induce calcium-independent vasoconstriction, through activation of protein kinases, which in turn will inhibit the function of ROCK kinase, one of the last effectors of vasoconstriction before formation of the actin and light-chain myosin binding. This review will focus on describing these mechanisms of primal importance in the first hours of our lives as independent individuals.

Determinants associated with chronic and incident depression in Mexican older adults. / Determinantes asociados a depresión crónica e incidente en adultos mayores mexicanos.

Objective: To describe the association among socio-demographic, environmental, psychosocial and health determinants in Mexican elders with chronic and incident depression from a 3-year follow-up study. Methods: Data from a cohort study of 1512 Mexicans, 65 and more years old was analyzed. We used a multinomial regression model in order to analyze the associations between determinants of interest with chronic and incident depression conditions, taking as reference a group without depression. In addition, the risk profiles were identified and stratified by sex; and finally, the determinant´s were estimated individually and combined. Results: 43.1% of the whole sample did not present depression during the follow-up, 41.9% had chronic depression and 15% incident depression. Chronic depression had more associations with determinants, than incident depression; the latter was associated with poverty and loneliness. The risk profiles for the three depression´s conditions stratified by sex, showed notorious differences. Conclusion: Chronic and incident depressions in the elderly are distinct phenomena, the evaluation of the determinant´s contribution to these entities, will allow to identify associated conditions to chronic and incident depression, and the sex differential effect, which will contribute to identify populations and risk factors, to implement objective interventions.

[Comparison of neuromyelitis optica spectra according to AQP4 antibody serostatus in a Mexican referral centre]. / Comparacion de los espectros de neuromielitis optica segun el seroestado del anticuerpo AQP4 en un centro de referencia mexicano.

INTRODUCTION: Recent studies report that patients with neuromyelitis optica (NMO) or seropositive NMO spectra disorders display clinical characteristics that are different from those of patients who are seropositive for the aquaporin-4 (AQP4) antibody. AIM: To analyse the clinical and paraclinical characteristics of patients with NMO according to their serum AQP4 status. PATIENTS AND METHODS: We conducted a retrospective study of 100 patients with NMO who fulfilled the Wingerchuk criteria: 70 were positive for the AQP4 antibody and 30 were seronegative. RESULTS: 70% of the subjects met the criteria for NMO, and 30% met criteria for NMO spectra disorders. The seropositive patients presented greater disability in the scores on the American Spinal Injury Association scale (ASIA) and the Expanded Disability Status Scale (p = 0.034 and 0.004, respectively) compared to seronegatives during the follow-up; in this same group there was greater visual involvement (p = 0.02), a higher number of relapses (p = 0.008) and a greater number of spinal segments involved (p = 0.003). CONCLUSION: This study provides an overview of the clinical and paraclinical characteristics of patients with NMO according to the AQP4 antibody serostatus. Patients who are seropositive for the AQP4 antibody present greater clinical and imaging involvement.

TITLE: Comparacion de los espectros de neuromielitis optica segun el seroestado del anticuerpo AQP4 en un centro de referencia mexicano.Introduccion. Estudios recientes describen que los pacientes con neuromielitis optica (NMO) o trastornos del espectro de NMO seronegativos exhiben caracteristicas clinicas diferentes a los pacientes seropositivos al anticuerpo acuaporina-4 (AQP4). Objetivo. Analizar las caracteristicas clinicas y paraclinicas de pacientes con NMO segun el estado serico del anticuerpo AQP4. Pacientes y metodos. Estudio retrospectivo de 100 pacientes con NMO que cumplian los criterios de Wingerchuk: 70 presentaron positividad al anticuerpo AQP4 y 30 fueron seronegativos. Resultados. Un 70% de los sujetos cumplio los criterios para la NMO, y un 30%, para los trastornos del espectro de NMO. Los pacientes seropositivos presentaron mayor discapacidad en las puntuaciones de la escala de la Asociacion Americana de Lesion de la Medula Espinal (ASIA) y la escala ampliada del estado de discapacidad (p = 0,034 y 0,004, respectivamente) comparados con los seronegativos durante el seguimiento; en este mismo grupo hubo mayor afectacion visual (p = 0,02), mayor numero de recaidas (p = 0,008) y mayor numero de segmentos medulares afectados (p = 0,003). Conclusion. Este estudio proporciona una vision general de las caracteristicas clinicas y paraclinicas de los pacientes con NMO segun el seroestado del anticuerpo AQP4. Los pacientes seropositivos al anticuerpo AQP4 presentan mayor afectacion clinica e imaginologica.

Phototoxic reaction to a combined oral contraceptive (levonorgestrel/ethinylestradiol).

We present the case of a phototoxic skin reaction due to the regular intake of a combined oral contraceptive (levonorgestrel/ethinylestradiol). Upon spectrophotometer testing, we demonstrated high absorption in the UV-B region of the solar spectrum of the combined product (Ovoplex®), especially for the estrogen compound (ethinylestradiol).

Redes neuronales de la expresión facial / The neural networks of facial expression

Introducción. La percepción de caras involucra una amplia red de conexiones entre regiones corticales y subcorticales que intercambian y sincronizan información a través de haces de sustancia blanca. Este preciso sistema de comunicación puede verse afectado tanto a través de las propias estructuras como por las vías que las conectan. Objetivos. Delimitar el sustrato neuronal que subyace a la percepción de la expresión facial y analizar los diferentes factores que participan modulando la integridad de esta red neuronal, con el fin de proponer mejoras en los programas de rehabilitación. Desarrollo. Cuando la compleja red de conexiones que participa en la percepción de la expresión facial se altera por traumatismos, patologías neurodegenerativas, trastornos del desarrollo, incluso por aislamiento social o contextos negativos, se deteriora también la capacidad para interactuar de manera adaptativa con el entorno. Conclusiones. La posibilidad de restaurar la integridad de la red neuronal encargada del procesamiento de la expresión facial pasa por tener en cuenta diferentes variables que en mayor o menor grado se han mostrado capaces de modificar la estructura o funcionalidad de las redes neuronales, como el entrenamiento aeróbico, la estimulación magnética transcraneal, la estimulación eléctrica transcraneal y el aprendizaje, sin bien estas variables estarían condicionadas por la edad, el tipo y evolución del trastorno o el contexto generador, lo que plantearía la necesidad de protocolos de rehabilitación ajustados y orientados a delimitar el sustrato neuronal del déficit (AU)

INTRODUCTION. Face perception involves a broad network of connections between cortical and subcortical regions for the exchange and synchronization of information using white matter fibers. This precise communication system can be affected by the structures and the pathways that connect them. AIMS. To establish the neural substrate underlying the perception of facial expression and to analyze the different factors involved in modulating the integrity of this neural network, with the aim being to introduce improvements into rehabilitation programs. DEVELOPMENT. When the complex neural network involved in the perception of facial expression is altered by trauma, neurodegenerative disorders, developmental disorders, social isolation or negative contexts, the adaptive capacity to interact with the environment also deteriorates. CONCLUSIONS. Maintaining the neural network integrity responsible for processing facial expression requires considering different variables. To a greater or lesser extent, these variables modify the structure or function of neural networks, such as aerobic training, transcranial magnetic stimulation, transcranial electrical stimulation, and learning. These variables are affected by age, and the type and course of the condition or generator context, and raise the need for rehabilitation protocols that are adapted and designed to delimit the deficient neuronal substrate (AU)