Relationship of Frailty, Nutritional Status and Oral Health-Related Quality of Life in Mexico City Nursing Home Residents.

BACKGROUND: We aimed to identify the association among nutritional status, Oral Health-Related Quality of Life (OHRQoL) and frailty, and to estimate the mediation effect of these conditions between age and frailty in a group of Mexico City nursing home residents. METHODS: We conducted a cross-sectional study. Fried's phenotype criteria, Full Mini Nutritional Assessment, and General Oral Health Assessment Index was applied. RESULTS: The participants (n = 286) mean age was 82.4 (± 9.2) years. The prevalence of frailty was 58%, and the prevalence of malnutrition and the risk of malnutrition were 22.7% and 59.5%, respectively. A higher risk of frailty was associated with older age (p = 0.015), sex (women) (p = 0.041), poor nutritional status (p <0.001) and compromised OHRQoL (p <0.001). Approximately 40% of the effect of age on frailty was mediated by nutritional status and OHRQoL (p <0.05). CONCLUSION: A strong association between nutritional status and frailty was observed. Additionally, OHRQoL was associated with frailty. The effect of age on frailty was mediated by OHRQoL and nutritional status. Interventions targeted to improve nutritional status and oral health may contribute to preventing or delaying the onset of frailty.

First detection of SARS-CoV-2 variant B.1.1.529 (Omicron) in Ecuador.

The National Institute of Research and Public Health reported the first local record of the Omicron variant detected in Ecuador. A fully vaccinated subject returned from South Africa with a negative RT-PCR. We present the cumulative frequency of the variants in Ecuador and a phylogenetic analysis of this new Omicron.

Application of the 2015 diagnostic criteria for neuromyelitis optica spectrum disorders in a cohort of Latin American patients.

BACKGROUND: The 2015 International Panel for neuromyelitis optica (NMO) spectrum disorders (NMOSD) diagnosis (IPND) criteria was recently proposed. However, because there are no studies evaluating application of the IPND criteria in Latin American populations, we aimed to assess whether these new criteria improve the diagnostic rate and reduce the time taken to make the diagnosis in a cohort of Latin American patients. METHODS: We reviewed medical records and applied both the 2006 and 2015 diagnostic criteria to all patients seen in four centers in Argentina, Brazil and Venezuela. Patients with multiple sclerosis (MS, n = 915) or other well-established central nervous system (CNS) inflammatory diseases were excluded. AQP4-ab status was measured using indirect immunofluorescence (23%) and cell-based assay (CBA, 77%). In addition, data on gender, ethnicity, age and symptoms at onset, relapses, neuroimaging and immunosuppressive therapy were collected. RESULTS: A total of 104 patients were classified as presenting NMOSD (2015 IPND). Of these, 64 patients (61.5%) fulfilled the 2006 NMO criteria (32 AQP4-ab positive, 17 AQP4-ab negative and 15 unknown). Thus, 40 new patients (38.5%) were classified as presenting NMOSD using the 2015 IPND criteria (33 AQP4-ab positive, 5 AQP4-ab negative and 2 unknown AQP4-ab status), with a median time taken to fulfill the 2015 NMOSD criteria (n = 104) of 1 month (95% CI: 0.6-1.3) and a median time taken to fulfill the 2006 NMO criteria (n = 64) of 18 months (95% CI: 9-26) (log-rank test: p < 0.0001). Females, with median age of 37 years, white ethnicity and recurrent course, predominated in all samples. Ninety-nine patients (95.1%) had at least 1 of the 3 major core clinical characteristics, of which optic neuritis (56.7%) was the most frequent symptom at disease onset. CONCLUSION: This study showed that there was a 62.5% increase in the rate of diagnosing NMOSD through the 2015 IPND criteria, in comparison with the 2006 NMO criteria, with a shorter median time to diagnosis.

Side-on cupric-superoxo triplet complexes as competent agents for H-abstraction relevant to the active site of PHM.

Copper complexes with N3S donors mimic the CuM site of copper monooxygenases and react with O2 affording side-on cupric-superoxo complexes capable of H-abstraction from dihydroanthracene and THF. Spectroscopic and DFT data of the Cu-superoxos support a spin triplet ground state for the side-on complexes, as well as a hemilabile thioether.

Semantic verbal fluency in elderly Mexican adults: Reference values.

INTRODUCTION: The semantic verbal fluency test (SVF) is sensitive to detecting cognitive decline. It is fast and easy to use in any cultural context; therefore, it is included in most of the neuropsychological assessment protocols. OBJECTIVE: To estimate normative values for the SVF test (animals), in an elderly population aged 65 years and over. MATERIAL AND METHOD: 1233 subjects who were healthy, cognitively preserved, residents of two areas (rural and urban) of Mexico were assessed. A neurological and neuropsychological exploration battery was applied, including SVF. RESULTS: The age average was 73+6 and schooling was 4.0+3.9 years, with 59% women. The average of the words generated in the SVF test was 14+5, and a correlation of 0.16 of these scores with age, education, and gender was found (p<.001), this allowed the estimation of the percentiles in accordance with these variables. CONCLUSIONS: The most important contribution provided by this study was that the data analysis enabled normative values to be obtained for an elderly Mexican population aged 65 years and over. It was also confirmed, as other neuropsychological assessment studies have done, that the SVF test is influenced by socio-demographic variables, such as age and education, aspects to be considered at the time of obtaining normative values. Finally, it was noted that the average scores obtained were lower than other published reference values, due to the low educational level of our sample.

Infrastructures, treatment modalities, and workload of radiation oncology departments in Spain with special attention to prostate cancer.

AIM: The purpose of the study was to describe infrastructures, treatment modalities, and workload in radiation oncology (RO) in Spain, referred particularly to prostate cancer (PC). METHODS: An epidemiologic, cross-sectional study was performed during 2008-2009. A study-specific questionnaire was sent to the 108 RO-registered departments. RESULTS: One hundred and two departments answered the survey, and six were contacted by telephone. Centers operated 236 treatment units: 23 (9.7 %) cobalt machines, 37 (15.7 %) mono-energetic linear accelerators, and 176 (74.6 %) multi-energy linear accelerators. Sixty-one (56.4 %) and 33 (30.5 %) departments, respectively, reported intensity-modulated radiation therapy (IMRT) and image-guided RT (IGRT) capabilities; three-dimensional-conformal RT was used in 75.8 % of patients. Virtual simulators were present in 95 departments (88.0 %), 35 use conventional simulators. Fifty-one departments (47.2 %) have brachytherapy units, 38 (35.2 %) perform prostatic implants. Departments saw a mean of 24.9 new patients/week; the number of patients treated annually was 102,054, corresponding to 88.4 % of patients with a RT indication. In 56.5 % of the hospitals, multidisciplinary teams were available to treat PC. CONCLUSIONS: Results provide an accurate picture of current situation of RO in Spain, showing a trend toward the progressive introduction of new technologies (IMRT, IGRT, brachytherapy).

[Neuropsychological evaluation, psychosocial factors, and psychiatric comorbidity of children with HIV infection]. / Evaluación neuropsicológica, factores psicosociales y co-morbilidad psiquiátrica en pacientes pediátricos infectados con el VIH.

UNLABELLED: Antiretroviral therapy has marked a change in the course of HIV infection, posing new challenges to improve quality of life in pediatric patients. OBJECTIVE: The goal of this paper was to identify psychosocial aspects of HIV-infected children and adolescents, and to evaluate their neuropsychological development and psychiatric co-morbidity. PATIENTS AND METHODS: A descriptive study was conducted, evaluating the neurocognitive performance of patients attending at the Pediatric Department of Instituto de Medicina Tropical Pedro Kourí of La Habana, Cuba, between February and July of 2008. For that purpose, interviews to the patients and their relatives were done with the application of appropriate tests for each age. RESULTS: Twenty-three patients ages 3-17 years (57% female) were studied. Sixteen (69.5%) were infected through vertical transmission, and 7 (30.5%) through other routes. School children infected through vertical transmission showed the most symptoms. Hyperactivity, anxiety, and learning disorders were the most frequently observed symptoms as well as hyperkinetic disorders, temporary tic disorders and mental retardation. CONCLUSION: This study shows the neuropsychological characterization of HIV-positive children and adolescents, considering the route of acquisition of the infection and the stage of the disease. It also describes psychiatric comorbidity of HIV-infected children.

Evaluación neuropsicológica, factores psicosociales y co-morbilidad psiquiátrica en pacientes pediátricos infectados con el VIH / Neuropsychological evaluation, psychosocial factors, and psychiatric comorbidity of children with HIV infection

Antiretroviral therapy has marked a change in the course of HIV infection, posing new challenges to improve quality of life in pediatric patients. Objective: The goal of this paper was to identify psychosocial aspects of HIV-infected children and adolescents, and to evaluate their neuropsychological development and psychiatric co-morbidity. Patients and Methods: A descriptive study was conducted, evaluating the neurocognitive performance of patients attending at the Pediatric Department of Instituto de Medicina Tropical Pedro Kourí of La Habana, Cuba, between February and July of 2008. For that purpose, interviews to the patients and their relatives were done with the application of appropriate tests for each age. Results: Twenty-three patients ages 3-17 years (57 percent female) were studied. Sixteen (69.5 percent) were infected through vertical transmission, and 7 (30.5 percent) through other routes. School children infected through vertical transmission showed the most symptoms. Hyperactivity, anxiety, and learning disorders were the most frequently observed symptoms as well as hyperkinetic disorders, temporary tic disorders and mental retardation. Conclusion: This study shows the neuropsychological characterization of HIV-positive children and adolescents, considering the route of acquisition of the infection and the stage of the disease. It also describes psychiatric comorbidity of HIV-infected children.

El tratamiento anti-retroviral marcó un cambio en la evolución de la infección por VIH, planteándose nuevos retos que mejoren la calidad de vida en las edades pediátricas. Objetivos: Identificar aspectos psicosociales en niño y adolescente que adquirieron la infección por VIH, evaluar el desarrollo neuropsicológico y describir la co-morbilidad psiquiátrica presente en el grupo estudiado. Pacientes y Métodos: Se realizó un estudio descriptivo, donde se evaluó el desempeño neurocognitivo de pacientes atendidos en la clínica pediátrica del Instituto de Medicina Tropical Pedro Kourí de La Habana, Cuba, entre los meses de febrero y julio de 2008, para lo cual se realizaron entrevistas a familiares, examen directo del participante y la aplicación de instrumentos específicos para cada edad. Resultados: Se evaluaron 23 niños y adolescentes entre los 3 y 17 años, predominó el sexo femenino con 13 (56,5 por ciento) y las edades entre los 6-11 años con 10 (43,5 por ciento) niños, más del 50 por ciento de los cuales se encontraban en los primeros años de escolarización, 16 (69,5 por ciento) infectados por trasmisión vertical y 7 (30,5 por ciento) por otras vías. Los escolares infectados por vía vertical fueron los que mayor sintomatología aportaron, la hiperactividad (57,1 por ciento), la ansiedad (42,8 por ciento) y las dificultades en el aprendizaje (14,2 por ciento), fueron los síntomas más frecuentes. El diagnóstico de trastorno hipercinético (13,0 por ciento) fue el más importante en la etapa escolar, mientras que el trastorno de adaptación depresivo lo fue en la adolescencia (8,6 por ciento). Conclusión: El estudio permitió la caracterización neuropsicológica de los niños y adolescentes estudiados, teniendo en cuenta las vías de adquisición de la infección, el momento evolutivo de la enfermedad y describir la co-morbilidad psiquiátrica asociada.

Artritis séptica en equinos: reporte de 11 casos (2000-2004) / Equine septicarthritis: 11 cases report (2000-2004)

Se presentan las principales características clínicas y paraclínicas de 11 casos de artritis séptica en equinos admitidos en la Clínica de Grandes Animales de la Universidad Nacional de Colombia entre 2000 y 2004. En general, los resultados son similares a los reportados por la literatura en estudios análogos, aunque se encontró una alta presencia de animales jóvenes en este estudio. Las herramientas paraclínicas más útiles para el diagnóstico fueron el recuento celular y el valor de proteína total en el líquido sinovial, en tanto que la ausencia de bacterias en los extendidos citológicos o los cultivos negativos no descartan la entidad. El uso de enrofloxacina sistémica en estos casos se ha mostrado de valor para la eliminación de la infección articular, a pesar de los riesgos teóricos de su uso en pacientes jóvenes. La artritis séptica debe ser considerada en todos los equinos que desarrollen inflamación y claudicación severas de manera súbita.

The main clinical and paraclinical characteristics of 11 cases of septic arthritis in equine patients admitted to the Large Animal Clinic at the Universidad Nacional de Colombia between 2000 and 2004 are presented. In general terms, the results are close to those reported in similar studies, although an elevated presence of young animals was found in this study. The most useful paraclinical tools for the diagnosis were the white blood cell count and the total protein value in the synovial fluid, whereas the absence of bacteria on direct smears or in culture does not rule out infection as a diagnosis. The use of systemic enrofloxacin in these cases was of value for the removal of the infection, although a theoretical concern exists about the effects of this antibiotic in young animals. Septic arthritis should be considered in every equine patient who develops a sudden swelling and lameness, with or without history of contamination.

Microcalcificaciones BIRADS 4: experiencia de 12 años / BIRADS 4 microcalcifications: 12 years of experience

Objetivo: Conocer el significado clínico y anátomopatológico de la presencia de microcalcificaciones BIRADS 4. Método: Análisis retrospectivo de 204 pacientes con microcalcificaciones BIRADS 4, sometidas a mastectomía parcial uni o bilateral en la Unidad de Patología Mamaria del Hospital Barros Luco-Trudeau, entre enero de 1993 y diciembre de 2004. Las pacientes ingresan a pabellón previa marcación con arpón metálico en zona de microcalcificaciones y control radiológico posterior de la pieza quirúrgica. Resultados: La localización de microcalcificaciones BIRADS 4 fue la mama izquierda en el 52 por ciento (106 casos), la mama derecha 42 por ciento (85 casos), y ambas 6 por ciento (13 casos). En la biopsia diferida destacan 17 casos con cáncer mamario (8,3 por ciento), condición fibroquística 197 casos (96,6 por ciento), hiperplasia sin atipía 49 casos (24 por ciento), hiperplasia con atipía 17 casos (8,3 por ciento), ectasia ductal 7 casos (3,4 por ciento), papilomatosis 6 casos (2,9 por ciento), mastitis crónica 4 casos (2 por ciento), fibroadenoma 4 casos (2 por ciento), galactoforitis 2 casos (1 por ciento) y necrosis grasa 2 casos (1 por ciento). Conclusión: Las microcalcificaciones BIRADS 4 constituyen un hallazgo mamográfico relevante por asociarse con cáncer de mama y lesiones de alto riesgo en un elevado porcentaje.

Association analysis of genotypic frequencies of matrilin-1 gene in patients with osteoarthritis.

OBJECTIVE: It has been suggested that genotypic variation in the gene which encodes the matrilin-1 (MATN-1) protein may be involved in the development of hip osteoarthritis (OA). We compared genotype frequencies of the MATN-1 gene (1p35) in patients with OA and controls to determine if there is any association between the MATN-1 genotype and OA. METHODS: 73 OA patients and 53 controls from a rheumatology ambulatory center and a university hospital were studied. They were unrelated subjects. Controls were free of clinical OA. OA was defined according to the American College of Rheumatology criteria. The MATN-1 microsatellite in the 3'untranslated region was amplified by PCR. The size of the amplification products was determined by capilar electrophoresis in a DNA Genetic Analizer Genotypic distribution was compared by the chi2 test. RESULTS: We identified 4 alleles according to their basepair (bp) length: A1 = 110 bp; A2 = 108 bp; A3 = 106 bp and A6 = 104 pb. Six genotypes were found, with an observed heterozygosity of 0.48. The most frequent genotype in OA and controls was A1/A1 (43.8% and 43.4%, respectively). No significant difference in genotype distribution was found between OA - even when discriminating by the affected joint - and controls. CONCLUSION: We did not find any difference in the MATN-1 genotype distribution in OA patients and controls. To our knowledge, this would be the first time a MATN-1 allele of 104 bp (A6) has been identified These results do not support a role of the MATN-1 genotypes in the occurrence of clinical OA.

Manejo de las fracturas de diáfisis femoral en niños / Management of the diaphiseal femoral fractures in children

Para determinar el manejo de las fracturas diafisiarias de fémur en niños, en el Hospital "Pérez de León" de Petare, se analizaron retrospectivamente 57 historias con este diagnóstico entre enero de 1995 y enero del 2000. Fueron evaluados 44 varones y 13 hembras entre 1-12 años con un promedio de edad de 5,8 años. 43 (75 por ciento) se trataron de forma ortopédica, de las cuales 28 (48 por ciento) con tracción cutánea seguida de espica con un promedio de hospitalización de 25,8 días; 10 (18 por ciento) con tracción esquelética seguida de espica con un promedio de hospitalización de 27,9 días; 5 (9 por ciento) con yeso de espica inmediato con promedio de hospitalización de 7,6 días y 14 (24 por ciento) quirúrgicamente con enclavado endomedular todos tipo kuntscher con promedio de hospitalización de 19,9 días. Como mecanismo de lesión se encuentran las caídas de altura 38 por ciento, arrollamiento 24 por ciento; caída de sus pies 18 por ciento; trauma directo 11 por ciento; accidentes de tránsito 7 por ciento y heridas por arma de fuego 2 por ciento 50 por ciento de los pacientes presentaron daños asociados tales como traumatismo craneoencefálicos, excoriaciones múltiples, trauma abdominal cerrado y fracturas adicionales. Con estos resultados podemos concluir que las fracturas de diáfisis de fémur en niños son cada vez más frecuentes en las salas de emergencias, que tanto las caídas de altura, arrollamiento y caída de sus pies revisten gran importancia como factor causal; y que el tratamiento ortopédico es el más utlizado hasta la edad preescolar y el quirúrgico en la edad escolar

[Cortico-subcortical electrophysiological study during the effects of benzodiazepines in patients with panic disorders]. / Estudio electrofisiológico córtico-subcortical durante los efectos de benzodiacepinas en pacientes con trastornos de pánico.

INTRODUCTION: Tribute to Robert Heath, M.D. a pioneer in human implanted corticosubcortical microelectrodes. OBJECTIVES: We evaluate retrospective electroencephalography (EEG), local evoked potentials (LEP) and extracellular unitary activity (EUA) of patients with diagnosis of panic disorder in association of simple partial seizures. These patients had presences or absence of agoraphobia. They received treatment with clonazepam or diazepam. PATIENTS AND METHODS: Ten patients with implanted corticosubcortical were divided in two groups. The five patients of group A were treated with clonazepam and the five patients of group B with diazepam. RESULTS: Panic attacks showed EEG thetha activity, increased amplitude of the negative phase of LEP, and an increase in the frequency of EUA in cortico-subcortical organizations. This changes occurred in all organizations with exception of the inhibitory reticular substance. Panic disorder produced abundance of repetitive epileptiform discharges that could precipitate convulsive crisis. Both benzodiazepines were efficacious although results with clonazepam were observed earlier: at 7 to 14 days. Benzodiazepines increased corticosubcortical EEG beta activity, decreased amplitude of negative phase of LEP, and diminution in the frequency of EUA. This changes occurred with exception on the inhibitory reticular system. We postulate: a) That panic disorder hyperexcitability at the cortico-subcortical neuronal level may be the result of gabergic dysfunction, or alteration in neuroinhibitory mechanism through GABAA receptors, and through GABAB neuromodulator receptors, and b) That there is a direct correlation between GABA inhibitory basic mechanism and electroencephalographic beta activity. CONCLUSIONS: Panic disorder produces neuronal hyperexcitability by gabergic dysfunction both benzodiazepines were efficacious in treatment.

[In vitro evaluation of antibacterial substances produced by bacteria isolated from different marine organisms]. / Evaluación in vitro de sustancias antibacterianas producidas por bacterias aisladas de diferentes organismos marinos.

Bacteria from several groups of marine organisms were isolated and, using direct antibiograms, identified those that produce antibacterial substances, using a human pathogenic strain of Staphylococcus aureus ATCC6538 as revealing microorganism. Bacteria which produce substances that inhibited S. aureus growth were identified through morphological, physiological and biochemical tests. Out of 290 bacteria, 54 (18.6%) inhibited the growth of S. aureus, but only 27 survived for identification. Bivalves, sponges and corals were the most represented from which 41.2, 33.3 and 29.7%, respectively, produced antibacterial substances of the isolated bacteria in each group. The marine species with highest proportions of these bacteria were the hard coral Madracis decactis (62.5%), the sponges Cliona sp. (57.1%) and the octocoral Plexaura flexuosa (50.0%). Out of the 27 strains that produced antibacterial substances, 51.8% were Aeromonas spp. and 14.8% Vibrio spp. Marine bacteria that produce antibacterial substances are abundant, most belong in the Vibrionacea group and were isolated mainly from corals and bivalve mollusks.

[Effect of intrafollicular interleukin-6 levels on the secretion of estradiol and progesterone in patients treated with in vitro fertilization and embryo transfer]. / Efecto de los niveles de interleucina-6 intrafolicular en la secreción de estradiol y progesterona de pacientes tratadas con fertilización in vitro y transferencia de embriones.

The objective was to evaluate the relationship between follicular fluid levels of Interleukin-6 (IL-6) and the seric concentrations of estradiol and progesterone during controlled ovarian hyper-stimulation. The levels of IL-6 were measured in follicular fluid of 15 patients undergone to in vitro fertilization and embryo transfer and correlated with the values of seric estradiol and progesterone. There were a negative correlation between follicular levels of IL-6 and either estradiol and progesterone. Four patients achieved pregnancy following embryo transfer (pregnancy rate 26.6%), one of them aborted. As conclusion, the increased levels of IL-6 may be a reaction to controlled ovarian hyper-stimulation and probably a protective response. According to the reduction of estradiol, there may be a subtle reduction in aromatase action by effect of IL-6 and other cytokines.