Longitudinal clinical phenotyping of post COVID condition in Mexican adults recovering from severe COVID-19: a prospective cohort study.

Introduction: Few studies have evaluated the presence of Post COVID-19 conditions (PCC) in people from Latin America, a region that has been heavily afflicted by the COVID-19 pandemic. In this study, we describe the frequency, co-occurrence, predictors, and duration of 23 symptoms in a cohort of Mexican patients with PCC. Methods: We prospectively enrolled and followed adult patients hospitalized for severe COVID-19 at a tertiary care centre in Mexico City. The incidence of PCC symptoms was determined using questionnaires. Unsupervised clustering of PCC symptom co-occurrence and Kaplan-Meier analyses of symptom persistence were performed. The effect of baseline clinical characteristics was evaluated using Cox regression models and reported with hazard ratios (HR). Results: We found that amongst 192 patients with PCC, respiratory problems were the most prevalent and commonly co-occurred with functional activity impairment. 56% had ≥5 persistent symptoms. Symptom persistence probability at 360 days 0.78. Prior SARS-CoV-2 vaccination and infection during the Delta variant wave were associated with a shorter duration of PCC. Male sex was associated with a shorter duration of functional activity impairment and respiratory symptoms. Hypertension and diabetes were associated with a longer duration of functional impairment. Previous vaccination accelerated PCC recovery. Discussion: In our cohort, PCC symptoms were frequent (particularly respiratory and neurocognitive ones) and persistent. Importantly, prior SARS-CoV-2 vaccination resulted in a shorter duration of PCC.

Gastric variceal bleeding treated through endoscopic ultrasound-guided coiling and N-butyl-2-cyanoacrylate application.

OBJECTIVE: To evaluate efficacy and safety between dual angiotherapy (endocoil plus N-butyl-cyanoacrylate) guided by endoscopic ultrasound) versus N-butyl-cyanoacrylate in the secondary prophylaxis of gastroesophageal varices (GOV). METHOD: Prospective non-inferiority study comparing two gastric variceal eradication techniques. We evaluated technical and clinical success, GOV occlusion and eradication, rebleeding, reoperation, GOV-free period, complications, and mortality. Chi square for categorical variables and Student's t for numerical variables with a significance level of 0.05. RESULTS: There were 68 patients (average age 55.5 ± 10 years, women 44 (64.7%) and average body mass index 25.7 ± 3.5 kg/m2). The most frequent cause was alcoholic steatohepatitis (58%). Dual therapy had greater technical (100% vs. 94.3%) and clinical (100% vs. 85%) success. Obliteration was faster (100 vs. 79.2%). This group only required one session. The GOV size was 24 ± 14 mm and 1-2 endocoils were placed. The median follow-up was 221 days. The reoperation-free rate was high (100% vs. 94%; p = 0.9). CONCLUSIONS: Dual angiotherapy guided by endoscopic ultrasound and cyanoacrylate injection are effective for the eradication of GOV without differences in adverse event rates.

OBJETIVO: Evaluar la eficacia y la seguridad de la angioterapia dual (endo-coil más N-butil-cianoacrilato) guiada por ultrasonido endoscópico) frente a N-butil-cianoacrilato solo en la profilaxis secundaria de várices gásctricas. MÉTODO: Estudio prospectivo de no inferioridad comparando dos técnicas de erradicación de várices gástricas. Se evalúan el éxito técnico y clínico, la oclusión y la erradicación de GOV, el resangrado, la reintervención, el período libre de GOV, las complicaciones y la mortalidad. Análisis estadístico mediante prueba de χ2 para variables categóricas y t de Student para las numéricas, con nivel de significancia de 0.05. RESULTADOS: Fueron 68 pacientes (edad promedio 55.5 ± 10 años, mujeres 44 (64.7%) e índice de masa corporal promedio 25.7 ± 3.5 kg/m2). La causa más frecuente fue esteatohepatitis alcohólica (58%). La terapia dual tuvo mayor éxito técnico (100% vs. 94.3%) y clínico (100% vs. 85%), y la obliteración fue más rápida (100 vs. 79.2%); este grupo solo requirió una sesión. El tamaño de las GOV fue de 24 ± 14 mm y se colocaron uno o dos endo-coils. La mediana de seguimiento fue de 221 días. La tasa de libres de reintervención fue alta (100% vs. 94%; p = 0.9). CONCLUSIONES: La angioterapia dual guiada por ultrasonido y la inyección de cianoacrilato son efectivas para la erradicación de las GOV, sin diferencias en las tasas de eventos adversos.

Theoretical study of glycine amino acid adsorption on graphene oxide.

The non-dissociative and dissociative adsorptions of zwitterionic Gly on graphene oxide (GO) was studied in the framework of DFT using a cluster model approach. In this work, the interaction with an epoxy group of GO basal plane was mainly considered. As a comparison, the non-dissociative and dissociative adsorptions of neutral Gly were also taken into account. The non-dissociative adsorption modes for zwitterionic and neutral Gly conformers show binding energies of 12.2 and 14.4 kcal mol-1, respectively. These molecules are thought to remain over the GO surface due to attractive noncovalent interactions. Two dissociative adsorption modes, for Z-Gly and N-Gly, show smaller binding energies of 7.2 and 8.4 kcal mol-1, where the deprotonated species links strongly through a C-O or C-N covalent bond to the GO surface. The results obtained in the present theoretical approach to the glycine/graphene oxide system support the fact that glycine can be attached to epoxy groups of graphene oxide basal planes in addition to the anchoring on edge oxidation groups. In summary, we conclude that glycine can be used as a reducing agent as well as a functionalizer of GO sheets.

Hospital-Associated Multicenter Outbreak of Emerging Fungus Candida auris, Colombia, 2016.

Candida auris is an emerging multidrug-resistant fungus that causes hospital-associated outbreaks of invasive infections with high death rates. During 2015-2016, health authorities in Colombia detected an outbreak of C. auris. We conducted an investigation to characterize the epidemiology, transmission mechanisms, and reservoirs of this organism. We investigated 4 hospitals with confirmed cases of C. auris candidemia in 3 cities in Colombia. We abstracted medical records and collected swabs from contemporaneously hospitalized patients to assess for skin colonization. We identified 40 cases; median patient age was 23 years (IQR 4 months-56 years). Twelve (30%) patients were <1 year of age, and 24 (60%) were male. The 30-day mortality was 43%. Cases clustered in time and location; axilla and groin were the most commonly colonized sites. Temporal and spatial clustering of cases and skin colonization suggest person-to-person transmission of C. auris. These cases highlight the importance of adherence to infection control recommendations.

Cytosolic calcium localization and dynamics during early endosperm development in the genus Agave (Asparagales, Asparagaceae).

Calcium is a secondary messenger that regulates and coordinates the cellular responses to environmental cues. Despite calcium being a key player during fertilization in plants, little is known about its role during the development of the endosperm. For this reason, the distribution, abundance, and dynamics of cytosolic calcium during the first stages of endosperm development of Agave tequilana and Agave salmiana were analyzed. Cytosolic calcium and actin filaments detected in the embryo sacs of Agave tequilana and A. salmiana revealed that they play an important role during the division and nuclear migration of the endosperm. After fertilization, a relatively high concentration of cytosolic calcium was located in the primary nucleus of the endosperm, as well as around migrating nuclei during the development of the endosperm. Cytosolic calcium participates actively during the first mitosis of the endosperm mother cell and interacts with the actin filaments that generate the motor forces during the migration of the nuclei through the large cytoplasm of the central cell.

Hydrogenation and hydration of carbon dioxide: a detailed characterization of the reaction mechanisms based on the reaction force and reaction electronic flux analyses.

A computational DFT study of the reaction mechanism of hydrogenation and hydration of carbon dioxide is presented. It has been found that hydrogenation and hydration are endoenergetic reactions that are carried out in two steps, passing by a stable intermediate that is surrounded by energy barriers of 70 kcal/mol and 10 kcal/mol for hydrogenation and 50 kcal/mol and 10 kcal/mol for hydration. Using the reaction force analysis, we were able to characterize the physical nature of the activation barriers and found that activation energies are mostly due to structural rearrangements. An interesting difference in the reaction mechanisms disclosed by the reaction force and electronic flux analyses is that while in the hydrogenation reaction the mechanisms is conditioned by the H2 cleavage with a high energy barrier, in the hydration reaction the formation of a transient four member ring structure favoring an attractive local hydrogen bond interaction pushes the reaction toward the product with a considerably lower energy barrier.

The products of the reaction between 6-amine-1,3-dimethyl uracil and bis-chalcones induce cytotoxicity with massive vacuolation in HeLa cervical cancer cell line.

As a part of our research in the chemistry of chalcones we have prepared four pyrimidine monoadducts of bis-chalcones through the reaction with 6-amino-1,3-dimethyl uracil. These compounds displayed cytotoxicity with a massive vacuolation in different human cell lines in vitro. Compound 6 was the most cytotoxic inducer of vacuoles, this compound induced G1 phase cell cycle arrest, and their cytotoxicity went without morphological and biochemical evidence of apoptotic cell death in HeLa cells. In addition, our results showed that this vacuole formation does not require de novo protein synthesis and the content vacuolar is acidic. Compound 6 induce necrotic cell death with excessive vacuolation, similar to a process of autophagy. Spautin-1 an inhibitor of autophagy, decreased the transformation of microtubule-associated protein 1 light chain 3 (LC3B-I) to LC3B-II and the vacuolation induced by compound 6 in HeLa cells, both autophagy processes. These compounds could be of pivotal importance in the study of non-apoptotic cell death with vacuole formation and could be useful in research into new autophagy inhibitors agents.

[Early breastfeed weaning as a risk factor for acute appendicitis in children]. / El destete precoz como factor de riesgo de apendicitis aguda en niõs.

OBJECTIVE: To determine if short term exclusive (EBF), combined breastfeeding (CBF), or an early start of other kind of food constitute risk factors for appendicitis in children. MATERIALS AND METHODS: By means of a case-control study, the mothers of 200 children up to 16 years with a diagnosis of acute appendicitis and 200 matched controls were interviewed regarding the duration of breastfeeding and the start of other foods. Data were analyzed to calculate chi-square c2; odds ratio (OR) was used to calculate risk factors, confidence intervals (CI 95%) were also determined. RESULTS: There was no EBF in 52 cases (26%), or in 5 controls (2.5%) (p< 0.001). EBF lasted for 2.3 +/- 1.8 months in cases and 3 +/- 1.1 months in controls (p< 0.001). CBF lasted for 8.1 +/- 7.5 months in cases and 8.8 +/- 3.5 in controls (p< 0.001); ablactation was started at 4.4 +/- 1.3 months in cases and at 4.7+/-1.2 in controls (p< 0.05). The OR of developing appendicitis for non- EBF was 10.4 (CI 95% 4 - 26.5), for ablactation before 4 months 1.4, (CI 95% 0.9 - 2) and for CBF for less than 6 months 4.6, (CI 95% 2.3 - 8.3). CONCLUSIONS: The risk of developing appendicitis is higher among children who never received EBF and who were breastfed for less than 6 months.

El destete precoz como factor de riesgo de apendicitis aguda en niños / Early breastfeeding as a risk factor for acute appendicitis in children

Objetivo: Determinar si un régimen de alimentación al seno materno exclusiva (ASME) o combinada (ASMT) de corta duración, o una temprana ablactación constituyen factores de riesgo para desarrollar apendicitis aguda en la niñez. Material y métodos: Mediante un estudio de casos y controles se interrogó a las madres de 200 menores de edad preescolar, escolar y adolescente con diagnóstico de apendicitis aguda y de 200 controles pareados acerca de la duración de la alimentación al seno materno y la edad al inicio de fórmulas o papillas. Los datos fueron analizados mediante la prueba x², razón de momios (RM) e intervalos de confianza (IC 95%). Resultados: En 52 casos (26%), 5 controles no recibieron ASME (2.5%) (p< 0.001). La ASME se prolongó durante 2.3 ± 1.8 meses en los casos y 3 ± 1.1 meses en los controles (p< 0.001), y la ASMT durante 8.1 ± 7.5 meses en los casos y 8.8 ± 3.5 en los controles (p< 0.001); la ablactación ocurrió a los 4.4 ± 1.3 meses en los casos y 4.7 ± 1.2 en los controles (p< 0.05). El riesgo de padecer apendicitis para el que nunca recibió ASME fue de 10.4 (IC 95% 4 -26.5), para la ablactación antes de los 4 meses de 1.4, (IC 95% 0.9 - 2) y para la alimentación al seno materno menor a 6 meses de duración de 4.6, (IC 95% 2.3 8.3). Conclusiones: El riesgo de padecer apendicitis aumenta en los niños que no recibieron ASME y en los que recibieron ASMT por menos de seis meses.

Objective: To determine if short term exclusive (EBF), combined breastfeeding (CBF), or an early start of other kind of food constitute risk factors for appendicitis in children. Materials and methods: By means of a case control study, the mothers of 200 children up to 16 years with a diagnosis of acute appendicitis and 200 matched controls were interviewed regarding the duration of breastfeeding and the start of other foods. Data were analyzed to calculate chi square c²; odds ratio (OR) was used to calculate risk factors, confidence intervals (CI 95%) were also determined. Results: There was no EBF in 52 cases (26%), or in 5 controls (2.5%) (p< 0.001). EBF lasted for 2.3 ± 1.8 months in cases and 3 ± 1.1 months in controls (p< 0.001). CBF lasted for 8.1 ± 7.5 months in cases and 8.8 ± 3.5 in controls (p< 0.001); ablactation was started at 4.4 ± 1.3 months in cases and at 4.7 ± 1.2 in controls (p< 0.05). The OR of developing appendicitis for non- EBF was 10.4 (CI 95% 4 -26.5), for ablactation before 4 months 1.4, (CI 95% 0.9 - 2) and for CBF for less than 6 months 4.6, (CI 95% 2.3 8.3). Conclusions: The risk of developing appendicitis is higher among children who never received EBF and who were breastfed for less than 6 months.

Efceto Hipoglicemiante de Costus Speciosus (Zingiberaceae), en ratas / Hipoglycemic effect of Costus Specius (Zingiberaceae), on rats

Durante muchos siglos la gente ha usado plantas con propiedades medicinales para el tratamiento de diversas enfermedades. Una de estas enfermedades es diabetes mellitus. Una de las plantas usadas ampliamente por la población en Puerto Rico es Costus speciosus conocida vulgarmente como insulina. El objetivo principal de este estudio fue analizar las propiedades hipoglicemiantes que se le atribuyen al extracto de esta planta. Con estos fines se llevaron a cabo experimentos con ratas Sprague Dawley, a las cuales se les había inducido diabetes por medio de la inyección de estreptozotocina i.p. A un grupo de diez de estas ratas en ayunas (Grupo A) se le dio a tomar el extracto por 24 horas, mientras que a otro grupo testigo de diez ratas (grupo B) se le administró agua. El grupo A tuvo niveles de glucosa sanguínea significativamente inferiores a las ratas del grupo testigo. En otro experimento se incubaron células endoteliales con o sin el extracto de la planta en presencia de 2-desoxi-3H-glucosa (DG). Hubo una mayor captación de DG en las células que contenían el extracto de la planta. Esto indica que el extracto contiene algún o algunos compuestos que facilitan la entrada de glucosa a las células cuya acción es similar a la de insulina. En los ensayos de toxicidad general usando Artemia salina L., el valor CL50 18.45 :g/mL demuestra la presencia de uno o varios agentes farmacológicamente activos en el extracto. En conclusión, el extracto de Costus speciosus muestra un efecto hipoglicemiante en ratas diabéticas inducidas con estreptozotocina. Además, el extracto de esta planta estimula la captación de DG en las células endoteliales

Manejo actual de la coledocolitias / Present coledocholithiasis management

Se describe la frecuencia de la coledocolitiasis y se analizan las diferentes opciones terapéuticas disponibles. Desde el punto de vista no quirúrgico, son descritas en general las tecnicas, su frecuencia de éxito y complicaciones, así como las ventajas principales para la colangiopancreatografía retrograda endoscópica convencional, la litotripsia mecánica, electrohidráulica y con rayo láser se menciona la utilidad de la litotripsia extracospórea, la colocación de prótesis endobiliares y el manejo disolutivo con mono-octanoína. En el paciente posoperado y con presencia de sonda en T en el colédoco, resulta de gran utilidad el abordaje radiológico intervencionista. Por otro lado, las opciones quirúrgicas se han enriquecido con la cirugía laparoscópica o de invasión mínima, cuyo desarrollo ofrece una exploración transoperatoria tan eficaz como la de la cirugía abierta. Finalmente, se discute la elección de alguna opción dependiendo de factores como la edad, el sexo, etcétera

Inhibition of xanthine oxidase by Puerto Rican plant extracts

OBJECTIVES: This study was conducted to search for xanthine oxidase inhibitors in natural products obtained from plants collected in Puerto Rico and to assess the influence of these extracts in the prevention of cataractogenesis. BACKGROUND: Allopurinol is currently a xanthine oxidase inhibitor used in the treatment of gout. New alternatives with increased therapeutic activity and less side effects should be investigated. Preclusion of cataractogenesis in diabetic rats is also the focus of this investigation. Natural products in the form of plant extracts from Puerto Rico offer a rich and relatively untapped source for the discovery of new drugs that may address these kind of problems. METHODS: Nineteen collections of Myrtaceae plant extracts were screened for xanthine oxidase inhibition. A spectrophotometrical method was used employing allopurinol as positive control and a blank as negative control. A protocol of the assay with slight modifications was followed from the literature. Two extracts with the highest percentages of xanthine oxidase inhibition were evaluated for possible prevention of cataractogenesis in streptozotocin diabetic rats. The animals were given to drink these plant extracts ad libitum for three months while controls received water. The appearance of cataracts was assessed physically. RESULTS: Two of the nineteen plant extracts showed high inhibition percentages of xanthine oxidase. Eucalyptus deglupta and Syzygium malaccense displayed 51 per cent and 64 per cent inhibitions (IC50 44.5 micrograms/ml and IC50 51 micrograms/ml), respectively. As for the cataractogenesis inhibition, laboratory animals that drank E. deglupta for three months did not develop cataracts. CONCLUSIONS: Two plant extracts provided positive results with varying degrees of inhibition of xanthine oxidase. S. malaccense demonstrated the greatest xanthine oxidase inhibitory activity whereas E. deglupta presented the best finding for cataractogenesis prevention. The procedures used in this investigation are useful for the in vitro screening of xanthine oxidase inhibition and the in vivo evaluation of cataractogenesis prevention.

Ligadura de várices esofagogástricas con aplicador múltiple recargado. Unidad de Endoscopia del Servicio de Urgencias Hospital General de México O.D. (Reporte Preliminar) / Variceal esophageal band ligation with multi band ligator. Unit of Endoscopy of Service of Urgency Hospital General de Mexico

La hemorragia de tubo digestivo alto secundaria a várices esofágicas ocupa el primer lugar como causa en el servicio de urgencia en el Hospital General de México O.D. La escleroterapia ha demostrado ser un método de tratamiento seguro y eficaz, pero no libre de complicaciones. Ante la existencia de una nueva modalidad de tratamiento como es la ligadura con bandas de látex, informamos de nuestras primeras experiencias con este método, las expectativas del mismo, así como las modificaciones caseras en los aplicadores de ligas comerciales realizados en la Unidad de Endoscopia del Servicio de Urgencias, con el que se logró acceder a este método en nuestro medio

Evaluación del CA-125, ultrasonografía y estado menopausico como predictores de malignidad ovárica / Evaluation of the CA-125, ultrasonografia and state menopausico like predictores of ovarian malignancy

Objetivo: determinar el valor predictivo positivo del CA-125, ultrasonografía pélvica y estado menopáusico, y la asociación de éstos como predictores de malignidad ovárica. Material y Métodos: Estudio transversal, descriptivo y prospectivo efectuado en el Hospital Guillermo Almenara (julio-diciembre 1996). Se evalúan pacientes con diagnóstico preoperatorio de tumor ovárico y se determinan el indice morfológico (IM) de la Universidad de Kentucky (menor o mayor 5), el CA-125 sérico (menor 0 mayor 35 U/ml), la edad (menor 0 mayor 48a) y el diagnóstico histológico de los tumores pélvicos. Resultados: Se registraron 86 casos (63 benignos y 23 malignos) predominando los tumores serosos. El VPP fue 0.426 para el IM, 0.615 para el CA-125, 0889 para asociación IM mas CA-125, y cuando además se asoció el estado menopáusico, IM+CA-125+Em, el VPP fue 1.000. Discusión: Los tumores ováricos con IM menor 5 fueron y aquellos con IM mayor 5 sólo 42.6 por ciento fueron malignos (VPP:0.426). El VPP del CA-125 mejoró cuando éste se asoció al IM: 0.889. El estado menopáusico (edad) mejora aún más su valor predictivo. Conclusiones: 1. El IM tuvo un VPP menor que el del CA-125. 2. Con la asociación de éstos se mejora el VPP (se disminuye la tasa de falsos positivos). 3. La asociación IM+CA-125+EM optimiza el VPP alcanzando el 100 por ciento permitiendo diferenciar los tumores ováricos benignos. 4. Los predictores de malignidad ovárica son óptimos cuando éstos se asocian.

Hemorragia digestiva alta aguda uso de Ontomicina / Upper digestive acute hemorhage use of Ontomycin

Se presentan dos casos de HDAA, atendidos en urgencias del Hospital Obrero Nro. 1 de la ciudad de La Paz, durante mis estudios de residente en 1981, los cuales por la gravedad de la entidad nosologica presentada requirieron el uso de medidas heroicas para evitar su fallecimiento por sangrado activo a traves de disminuir la presion arterial esplacnica con la infusion de oxitocina Los resultados fueron satisfactorios.